Engrossments	Comparisons
Introduction		Posted on 02/17/2023
1st Engrossment		Posted on 03/16/2023	compared with SF2212 2nd Engrossment

ARTICLE 1

DEPARTMENT OF HEALTH POLICY

Section 1.

Minnesota Statutes 2022, section 62J.17, subdivision 5a, is amended to read:

Subd. 5a.

Retrospective review.

(a) The commissioner shall retrospectively review
each major spending commitment and deleted text begin notify the provider of the results of the review. The
commissioner shalldeleted text end determine whether the major spending commitment was appropriate.
In making the determination, the commissioner may consider the following criteria: the
major spending commitment's impact on the cost, access, and quality of health care; the
clinical effectiveness and cost-effectiveness of the major spending commitment; and the
alternatives available to the provider.new text begin If the major expenditure is determined not to be
appropriate, the commissioner shall notify the provider.
new text end

(b) The commissioner may not prevent or prohibit a major spending commitment subject
to retrospective review. However, if the provider fails the retrospective review, any major
spending commitments by that provider for the five-year period following the commissioner's
decision are subject to prospective review under subdivision 6a.

Sec. 2.

Minnesota Statutes 2022, section 144.1481, subdivision 1, is amended to read:

Subdivision 1.

Establishment; membership.

The commissioner of health shall establish
a deleted text begin 16-memberdeleted text end new text begin 21-membernew text end Rural Health Advisory Committee. The committee shall consist
of the following members, all of whom must reside outside the seven-county metropolitan
area, as defined in section 473.121, subdivision 2:

(1) two members from the house of representatives of the state of Minnesota, one from
the majority party and one from the minority party;

(2) two members from the senate of the state of Minnesota, one from the majority party
and one from the minority party;

(3) a volunteer member of an ambulance service based outside the seven-county
metropolitan area;

(4) a representative of a hospital located outside the seven-county metropolitan area;

(5) a representative of a nursing home located outside the seven-county metropolitan
area;

(6) a medical doctor or doctor of osteopathic medicine licensed under chapter 147;

(7) a dentist licensed under chapter 150Anew text begin or other oral health professional if a dentist is
not available to participatenew text end ;

(8) deleted text begin a midlevel practitionerdeleted text end new text begin an advanced practice professionalnew text end ;

(9) a registered nurse or licensed practical nurse;

(10) a licensed health care professional from an occupation not otherwise represented
on the committee;

(11) a representative of an institution of higher education located outside the seven-county
metropolitan area that provides training for rural health care providers; deleted text begin and
deleted text end

new text begin (12) a member of a Tribal nation;
new text end

new text begin (13) a representative of a local public health agency or community health board;
new text end

new text begin (14) a health professional or advocate with experience working with people with mental
illness;
new text end

new text begin (15) a representative of a community organization that works with individuals
experiencing health disparities;
new text end

new text begin (16) an individual with expertise in economic development, or an employer working
outside the seven-county metropolitan area; and
new text end

deleted text begin (12)deleted text end new text begin (17)new text end three consumers, at least one of whom must be deleted text begin an advocate for persons who
are mentally ill or developmentally disableddeleted text end new text begin from a community experiencing health
disparitiesnew text end .

The commissioner will make recommendations for committee membership. Committee
members will be appointed by the governor. In making appointments, the governor shall
ensure that appointments provide geographic balance among those areas of the state outside
the seven-county metropolitan area. The chair of the committee shall be elected by the
members. The advisory committee is governed by section 15.059, except that the members
do not receive per diem compensation.

Sec. 3.

Minnesota Statutes 2022, section 144.2151, is amended to read:

144.2151 new text begin FETAL DEATH new text end RECORDnew text begin AND CERTIFICATEnew text end OF BIRTH
RESULTING IN STILLBIRTH.

Subdivision 1.

deleted text begin Filingdeleted text end new text begin Registrationnew text end .

A new text begin fetal death new text end record deleted text begin of birth for each birth resulting
in a stillbirth in this state, on or after August 1, 2005,deleted text end new text begin must be establishednew text end for deleted text begin which adeleted text end new text begin eachnew text end
fetal death deleted text begin report is requireddeleted text end new text begin reported and registerednew text end under section 144.222, subdivision 1deleted text begin ,
shall be filed with the state registrar within five days after the birth if the parent or parents
of the stillbirth request to have a record of birth resulting in stillbirth prepareddeleted text end .

Subd. 2.

Information to parents.

The party responsible for filing a fetal death report
under section 144.222, subdivision 1, shall advise the parent or parents of a stillbirth:

deleted text begin (1) that they may request preparation of a record of birth resulting in stillbirth;
deleted text end

deleted text begin (2) that preparation of the record is optional; and
deleted text end

deleted text begin (3) how to obtain a certified copy of the record if one is requested and prepared.
deleted text end

new text begin (1) that the parent or parents may choose to provide a full name or provide only a last
name for the record;
new text end

new text begin (2) that the parent or parents may request a certificate of birth resulting in stillbirth after
the fetal death record is established;
new text end

new text begin (3) that the parent who gave birth may request an informational copy of the fetal death
record; and
new text end

new text begin (4) that the parent or parents named on the fetal death record and the party responsible
for reporting the fetal death may correct or amend the record to protect the integrity and
accuracy of vital records.
new text end

Subd. 3.

deleted text begin Preparationdeleted text end new text begin Responsibilities of the state registrarnew text end .

deleted text begin (a) Within five days after
delivery of a stillbirth, the parent or parents of the stillbirth may prepare and file the record
with the state registrar if the parent or parents of the stillbirth, after being advised as provided
in subdivision 2, request to have a record of birth resulting in stillbirth prepared.
deleted text end

deleted text begin (b) If the parent or parents of the stillbirth do not choose to provide a full name for the
stillbirth, the parent or parents may choose to file only a last name.
deleted text end

deleted text begin (c) Either parent of the stillbirth or, if neither parent is available, another person with
knowledge of the facts of the stillbirth shall attest to the accuracy of the personal data entered
on the record in time to permit the filing of the record within five days after delivery.
deleted text end

new text begin The state registrar shall:
new text end

new text begin (1) prescribe the process to:
new text end

new text begin (i) register a fetal death;
new text end

new text begin (ii) request the certificate of birth resulting in stillbirth; and
new text end

new text begin (iii) request the informational copy of a fetal death record;
new text end

new text begin (2) prescribe a standardized format for the certificate of birth resulting in stillbirth, which
shall integrate security features and be as similar as possible to a birth certificate;
new text end

new text begin (3) issue a certificate of birth resulting in stillbirth or a statement of no vital record found
to the parent or parents named on the fetal death record upon the parent's proper completion
of an attestation provided by the commissioner and payment of the required fee;
new text end

new text begin (4) correct or amend the fetal death record upon a request from the parent who gave
birth, parents, or the person who registered the fetal death or filed the report; and
new text end

new text begin (5) refuse to amend or correct the fetal death record when an applicant does not submit
the minimum documentation required to amend the record or when the state registrar has
cause to question the validity or completeness of the applicant's statements or any
documentary evidence and the deficiencies are not corrected. The state registrar shall advise
the applicant of the reason for this action and shall further advise the applicant of the right
of appeal to a court with competent jurisdiction over the Department of Health.
new text end

Subd. 4.

deleted text begin Retroactive applicationdeleted text end new text begin Delayed registrationnew text end .

deleted text begin Notwithstanding subdivisions
1 to 3,deleted text end If a deleted text begin birth thatdeleted text end new text begin fetal deathnew text end occurred in this state at any time deleted text begin resulted in a stillbirthdeleted text end for
which a fetal death report was required under section 144.222, subdivision 1, but a deleted text begin record
of birth resulting in stillbirth was not prepared under subdivision 3, a parent of the stillbirth
may submit to the state registrar, on or after August 1, 2005, a written request for preparation
of a record of birth resulting in stillbirth and evidence of the facts of the stillbirth in the
form and manner specified by the state registrar. The state registrar shall prepare and file
the record of birth resulting in stillbirth within 30 days after receiving satisfactory evidence
of the facts of the stillbirth.deleted text end new text begin fetal death was not registered and a record was not established,
a person responsible for registering the fetal death, the medical examiner or coroner with
jurisdiction, or a parent may submit to the state registrar a written request to register the
fetal death and submit the evidence to support the request.
new text end

deleted text begin Subd. 5. deleted text end

deleted text begin Responsibilities of state registrar. deleted text end

deleted text begin The state registrar shall:
deleted text end

deleted text begin (1) prescribe the form of and information to be included on a record of birth resulting
in stillbirth, which shall be as similar as possible to the form of and information included
on a record of birth;
deleted text end

deleted text begin (2) prescribe the form of and information to be provided by the parent of a stillbirth
requesting a record of birth resulting in stillbirth under subdivisions 3 and 4 and make this
form available on the Department of Health's website;
deleted text end

deleted text begin (3) issue a certified copy of a record of birth resulting in stillbirth to a parent of the
stillbirth that is the subject of the record if:
deleted text end

deleted text begin (i) a record of birth resulting in stillbirth has been prepared and filed under subdivision
3 or 4; and
deleted text end

deleted text begin (ii) the parent requesting a certified copy of the record submits the request in writing;
and
deleted text end

deleted text begin (4) create and implement a process for entering, preparing, and handling stillbirth records
identical or as close as possible to the processes for birth and fetal death records when
feasible, but no later than the date on which the next reprogramming of the Department of
Health's database for vital records is completed.
deleted text end

Sec. 4.

Minnesota Statutes 2022, section 144.222, is amended to read:

144.222 new text begin FETAL DEATH new text end REPORTS deleted text begin OF FETAL OR INFANT DEATHdeleted text end new text begin AND
REGISTRATIONnew text end .

Subdivision 1.

Fetal death report required.

A fetal death deleted text begin reportdeleted text end must be deleted text begin fileddeleted text end new text begin registered
or reportednew text end within five days of the death of a fetus for whom 20 or more weeks of gestation
have elapsed, except for abortions defined under section 145.4241. A fetal death deleted text begin report must
be prepareddeleted text end new text begin must be registered or reportednew text end in a format prescribed by the state registrar and
filed in accordance with Minnesota Rules, parts 4601.0100 to 4601.2600 by:

(1) a person in charge of an institution or that person's authorized designee if a fetus is
delivered in the institution or en route to the institution;

(2) a physician, certified nurse midwife, or other licensed medical personnel in attendance
at or immediately after the delivery if a fetus is delivered outside an institution; or

(3) a parent or other person in charge of the disposition of the remains if a fetal death
occurred without medical attendance at or immediately after the delivery.

deleted text begin Subd. 2. deleted text end

deleted text begin Sudden infant death. deleted text end

deleted text begin Each infant death which is diagnosed as sudden infant
death syndrome shall be reported within five days to the state registrar.
deleted text end

Sec. 5.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 2a. new text end

new text begin Connector. new text end

new text begin "Connector" means gooseneck, pigtail, and other service line
connectors. A connector is typically a short section of piping not exceeding two feet that
can be bent and used for connections between rigid service piping.
new text end

Sec. 6.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 3a. new text end

new text begin Galvanized requiring replacement. new text end

new text begin "Galvanized requiring replacement"
means a galvanized service line that is or was at any time connected to a lead service line
or lead status unknown service line, or is currently or was previously affixed to a lead
connector. The majority of galvanized service lines fall under this category.
new text end

Sec. 7.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 3b. new text end

new text begin Galvanized service line. new text end

new text begin "Galvanized service line" means a service line made
of iron or piping that has been dipped in zinc to prevent corrosion and rusting.
new text end

Sec. 8.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 3c. new text end

new text begin Lead connector. new text end

new text begin "Lead connector" means a connector made of lead.
new text end

Sec. 9.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 3d. new text end

new text begin Lead service line. new text end

new text begin "Lead service line" means a portion of pipe that is made
of lead, which connects the water main to the building inlet. A lead service line may be
owned by the water system, by the property owner, or both.
new text end

Sec. 10.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision
to read:

new text begin Subd. 3e. new text end

new text begin Lead status unknown service line or unknown service line. new text end

new text begin "Lead status
unknown service line" or "unknown service line" means a service line that has not been
demonstrated to meet or does not meet the definition of lead free in section 1417 of the Safe
Drinking Water Act.
new text end

Sec. 11.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision
to read:

new text begin Subd. 3f. new text end

new text begin Nonlead service line. new text end

new text begin "Nonlead service line" means a service line determined
through an evidence-based record, method, or technique not to be a lead service line or
galvanized service line requiring replacement. Most nonlead service lines are made of copper
or plastic.
new text end

Sec. 12.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Service line. new text end

new text begin "Service line" means a portion of pipe that connects the water
main to the building inlet. A service line may be owned by the water system, by the property
owner, or both. A service line may be made of many materials, such as lead, copper,
galvanized steel, or plastic.
new text end

Sec. 13.

new text begin [144.3853] CLASSIFICATION OF SERVICE LINES.
new text end

new text begin Subdivision 1. new text end

new text begin Classification of lead status of service line. new text end

new text begin (a) A water system may
classify the actual material of a service line, such as copper or plastic, as an alternative to
classifying the service line as a nonlead service line, for the purpose of the lead service line
inventory.
new text end

new text begin (b) It is not necessary to physically verify the material composition, such as copper or
plastic, of a service line for its lead status to be identified. For example, if records demonstrate
the service line was installed after a municipal, state, or federal ban on the installation of
lead service lines, the service line may be classified as a nonlead service line.
new text end

new text begin Subd. 2. new text end

new text begin Lead connector. new text end

new text begin For the purposes of the lead service line inventory and lead
service line replacement plan, if a service line has a lead connector, the service line shall
be classified as a lead service line or a galvanized service line requiring replacement.
new text end

new text begin Subd. 3. new text end

new text begin Galvanized service line. new text end

new text begin A galvanized service line may only be classified as
a nonlead service line if there is documentation verifying it was never connected to a lead
service line or lead connector. Rarely will a galvanized service line be considered a nonlead
service line.
new text end

Sec. 14.

Minnesota Statutes 2022, section 144.55, subdivision 3, is amended to read:

Subd. 3.

Standards for licensure.

(a) Notwithstanding the provisions of section 144.56,
for the purpose of hospital licensure, the commissioner of health shall use as minimum
standards the hospital certification regulations promulgated pursuant to title XVIII of the
Social Security Act, United States Code, title 42, section 1395, et seq. The commissioner
may use as minimum standards changes in the federal hospital certification regulations
promulgated after May 7, 1981, if the commissioner finds that such changes are reasonably
necessary to protect public health and safety. deleted text begin The commissioner shall also promulgate in
rules additional minimum standards for new construction.
deleted text end

new text begin (b) Hospitals must meet the applicable provisions of the 2022 edition of the Facility
Guidelines Institute Guidelines for Design and Construction of Hospitals. This minimum
design standard must be met for all new licenses, new construction, change of use, or change
of occupancy for which plan review packages are received on or after January 1, 2024.
new text end

new text begin (c) If the commissioner decides to update the edition of the guidelines specified in
paragraph (b) for purposes of this subdivision, the commissioner must notify the chairs and
ranking minority members of the legislative committees with jurisdiction over health care
and public safety of the planned update by January 15 of the year in which the new edition
will become effective. Following notice from the commissioner, the new edition shall
become effective for hospitals beginning August 1 of that year, unless otherwise provided
in law. The commissioner shall, by publication in the State Register, specify a date by which
hospitals must comply with the updated edition. The date by which hospitals must comply
shall not be sooner than 12 months after publication of the commissioner's notice in the
State Register and shall apply only to plan review packages received on or after that date.
new text end

new text begin (d) Hospitals shall be in compliance with all applicable state and local governing laws,
regulations, standards, ordinances, and codes for fire safety, building, and zoning
requirements.
new text end

deleted text begin (b)deleted text end new text begin (e)new text end Each hospital and outpatient surgical center shall establish policies and procedures
to prevent the transmission of human immunodeficiency virus and hepatitis B virus to
patients and within the health care setting. The policies and procedures shall be developed
in conformance with the most recent recommendations issued by the United States
Department of Health and Human Services, Public Health Service, Centers for Disease
Control. The commissioner of health shall evaluate a hospital's compliance with the policies
and procedures according to subdivision 4.

deleted text begin (c)deleted text end new text begin (f)new text end An outpatient surgical center must establish and maintain a comprehensive
tuberculosis infection control program according to the most current tuberculosis infection
control guidelines issued by the United States Centers for Disease Control and Prevention
(CDC), Division of Tuberculosis Elimination, as published in CDC's Morbidity and Mortality
Weekly Report (MMWR). This program must include a tuberculosis infection control plan
that covers all paid and unpaid employees, contractors, students, and volunteers. The
Department of Health shall provide technical assistance regarding implementation of the
guidelines.

deleted text begin (d)deleted text end new text begin (g)new text end Written compliance with this subdivision must be maintained by the outpatient
surgical center.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 15.

Minnesota Statutes 2022, section 144.6535, subdivision 1, is amended to read:

Subdivision 1.

Request for variance or waiver.

A hospital may request that the
commissioner grant a variance or waiver from the provisions of deleted text begin Minnesota Rules, chapter
4640 or 4645deleted text end new text begin section 144.55, subdivision 3, paragraph (b)new text end . A request for a variance or waiver
must be submitted to the commissioner in writing. Each request must contain:

(1) the specific deleted text begin rule or rulesdeleted text end new text begin requirementnew text end for which the variance or waiver is requested;

(2) the reasons for the request;

(3) the alternative measures that will be taken if a variance or waiver is granted;

(4) the length of time for which the variance or waiver is requested; and

(5) other relevant information deemed necessary by the commissioner to properly evaluate
the request for the variance or waiver.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 16.

Minnesota Statutes 2022, section 144.6535, subdivision 2, is amended to read:

Subd. 2.

Criteria for evaluation.

The decision to grant or deny a variance or waiver
must be based on the commissioner's evaluation of the following criteria:

(1) whether the variance or waiver will adversely affect the health, treatment, comfort,
safety, or well-being of a patient;

(2) whether the alternative measures to be taken, if any, are equivalent to or superior to
those prescribed in deleted text begin Minnesota Rules, chapter 4640 or 4645deleted text end new text begin section 144.55, subdivision 3,
paragraph (b)new text end ; and

(3) whether compliance with the deleted text begin rule or rulesdeleted text end new text begin requirementsnew text end would impose an undue
burden upon the applicant.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 17.

Minnesota Statutes 2022, section 144.6535, subdivision 4, is amended to read:

Subd. 4.

Effect of alternative measures or conditions.

(a) Alternative measures or
conditions attached to a variance or waiver have the same force and effect as the deleted text begin rulesdeleted text end new text begin
requirementnew text end under deleted text begin Minnesota Rules, chapter 4640 or 4645deleted text end new text begin section 144.55, subdivision 3,
paragraph (b)new text end , and are subject to the issuance of correction orders and penalty assessments
in accordance with section 144.55.

(b) Fines for a violation of this section shall be in the same amount as that specified for
the particular deleted text begin ruledeleted text end new text begin requirementnew text end for which the variance or waiver was requested.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 18.

Minnesota Statutes 2022, section 144.69, is amended to read:

144.69 CLASSIFICATION OF DATA ON INDIVIDUALS.

new text begin Subdivision 1. new text end

new text begin Data collected by the cancer reporting system. new text end

Notwithstanding any
law to the contrary, including section 13.05, subdivision 9, data collected on individuals by
the cancer deleted text begin surveillancedeleted text end new text begin reportingnew text end system, including the names and personal identifiers of
persons required in section 144.68 to report, shall be private and may only be used for the
purposes set forth in this section and sections 144.671, 144.672, and 144.68. Any disclosure
other than is provided for in this section and sections 144.671, 144.672, and 144.68, is
declared to be a misdemeanor and punishable as such. Except as provided by rule, and as
part of an epidemiologic investigation, an officer or employee of the commissioner of health
may interview patients named in any such report, or relatives of any such patient, only after
deleted text begin the consent ofdeleted text end new text begin notifyingnew text end the attending physician, advanced practice registered nurse, physician
assistant, or surgeon deleted text begin is obtaineddeleted text end .new text begin Research protections for patients must be consistent with
section 13.04, subdivision 2, and Code of Federal Regulations, title 45, part 46.
new text end

new text begin Subd. 2. new text end

new text begin Transfers of information to state cancer registries and federal government
agencies. new text end

new text begin (a) Information containing personal identifiers of a non-Minnesota resident
collected by the cancer reporting system may be provided to the statewide cancer registry
of the nonresident's home state solely for the purposes consistent with this section and
sections 144.671, 144.672, and 144.68, provided that the other state agrees to maintain the
classification of the information as provided under subdivision 1.
new text end

new text begin (b) Information, excluding direct identifiers such as name, Social Security number,
telephone number, and street address, collected by the cancer reporting system may be
provided to the Centers for Disease Control and Prevention's National Program of Cancer
Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results
Program registry.
new text end

Sec. 19.

Minnesota Statutes 2022, section 144.9501, subdivision 17, is amended to read:

Subd. 17.

Lead hazard reduction.

new text begin (a) new text end "Lead hazard reduction" means abatementnew text begin , swab
team services,new text end or interim controls undertaken to make a residence, child care facility, school,
playground, or other location where lead hazards are identified lead-safe by complying with
the lead standards and methods adopted under section 144.9508.

new text begin (b) Lead hazard reduction does not include renovation activity that is primarily intended
to remodel, repair, or restore a given structure or dwelling rather than abate or control
lead-based paint hazards.
new text end

new text begin (c) Lead hazard reduction does not include activities that disturb painted surfaces that
total:
new text end

new text begin (1) less than 20 square feet (two square meters) on exterior surfaces; or
new text end

new text begin (2) less than two square feet (0.2 square meters) in an interior room.
new text end

Sec. 20.

Minnesota Statutes 2022, section 144.9501, subdivision 26a, is amended to read:

Subd. 26a.

Regulated lead work.

deleted text begin (a)deleted text end "Regulated lead work" means:

(1) abatement;

(2) interim controls;

(3) a clearance inspection;

(4) a lead hazard screen;

(5) a lead inspection;

(6) a lead risk assessment;

(7) lead project designer services;

(8) lead sampling technician services;

(9) swab team services;

(10) renovation activities; deleted text begin or
deleted text end

new text begin (11) lead hazard reduction; or
new text end

deleted text begin (11)deleted text end new text begin (12)new text end activities performed to comply with lead orders issued by deleted text begin a community health
boarddeleted text end new text begin an assessing agencynew text end .

deleted text begin (b) Regulated lead work does not include abatement, interim controls, swab team services,
or renovation activities that disturb painted surfaces that total no more than:
deleted text end

deleted text begin (1) 20 square feet (two square meters) on exterior surfaces; or
deleted text end

deleted text begin (2) six square feet (0.6 square meters) in an interior room.
deleted text end

Sec. 21.

Minnesota Statutes 2022, section 144.9501, subdivision 26b, is amended to read:

Subd. 26b.

Renovation.

new text begin (a) new text end "Renovation" means the modification of any pre-1978
affected property new text begin for compensation new text end that results in the disturbance of known or presumed
lead-containing painted surfaces defined under section 144.9508, unless that activity is
performed as lead hazard reduction. A renovation performed for the purpose of converting
a building or part of a building into an affected property is a renovation under this
subdivision.

new text begin (b) Renovation does not include minor repair and maintenance activities described in
this paragraph. All activities that disturb painted surfaces and are performed within 30 days
of other activities that disturb painted surfaces in the same room must be considered a single
project when applying the criteria below. Unless the activity involves window replacement
or demolition of a painted surface, building component, or portion of a structure, for purposes
of this paragraph, "minor repair and maintenance" means activities that disturb painted
surfaces totaling:
new text end

new text begin (1) less than 20 square feet (two square meters) on exterior surfaces; or
new text end

new text begin (2) less than six square feet (0.6 square meters) in an interior room.
new text end

new text begin (c) Renovation does not include total demolition of a freestanding structure. For purposes
of this paragraph, "total demolition" means demolition and disposal of all interior and
exterior painted surfaces, including windows. Unpainted foundation building components
remaining after total demolition may be reused.
new text end

Sec. 22.

Minnesota Statutes 2022, section 144.9501, is amended by adding a subdivision
to read:

new text begin Subd. 33. new text end

new text begin Compensation. new text end

new text begin "Compensation" means money or other mutually agreed upon
form of payment given or received for regulated lead work, including rental payments,
rental income, or salaries derived from rental payments.
new text end

Sec. 23.

Minnesota Statutes 2022, section 144.9501, is amended by adding a subdivision
to read:

new text begin Subd. 34. new text end

new text begin Individual. new text end

new text begin "Individual" means a natural person.
new text end

Sec. 24.

Minnesota Statutes 2022, section 144.9505, subdivision 1, is amended to read:

Subdivision 1.

Licensing, certification, and permitting.

(a) Fees collected under this
section shall be deposited into the state treasury and credited to the state government special
revenue fund.

(b) Persons shall not advertise or otherwise present themselves as lead supervisors, lead
workers, lead inspectors, lead risk assessors, lead sampling technicians, lead project designers,
renovation firms, or lead firms unless they have licenses or certificates issued by the
commissioner under this section.

(c) The fees required in this section for inspectors, risk assessors, and certified lead firms
are waived for state or local government employees performing services for or as an assessing
agency.

(d) deleted text begin An individual who is the owner of property on which regulated lead work is to be
performed or an adult individual who is related to the property owner, as defined under
section 245A.02, subdivision 13, is exempt from the requirements to obtain a license and
pay a fee according to this section.deleted text end new text begin Individual residential property owners who perform
regulated lead work on their own residence are exempt from the licensure and firm
certification requirements of this section. Notwithstanding the provisions of paragraphs (a)
to (c), this exemption does not apply when the regulated lead work is a renovation performed
for compensation, when a child with an elevated blood level has been identified in the
residence or the building in which the residence is located, or when the residence is occupied
by one or more individuals who are not related to the property owner, as defined under
section 245A.02, subdivision 13.
new text end

deleted text begin (e) A person that employs individuals to perform regulated lead work outside of the
person's property must obtain certification as a certified lead firm. An individual who
performs lead hazard reduction, lead hazard screens, lead inspections, lead risk assessments,
clearance inspections, lead project designer services, lead sampling technician services,
swab team services, and activities performed to comply with lead orders must be employed
by a certified lead firm, unless the individual is a sole proprietor and does not employ any
other individuals, the individual is employed by a person that does not perform regulated
lead work outside of the person's property, or the individual is employed by an assessing
agency.
deleted text end

Sec. 25.

Minnesota Statutes 2022, section 144.9505, subdivision 1g, is amended to read:

Subd. 1g.

Certified lead firm.

A person whonew text begin performs ornew text end employs individuals to perform
regulated lead work, with the exception of renovation, deleted text begin outside of the person's propertydeleted text end must
obtain certification as a lead firm. The certificate must be in writing, contain an expiration
date, be signed by the commissioner, and give the name and address of the person to whom
it is issued. A lead firm certificate is valid for one year. The certification fee is $100, is
nonrefundable, and must be submitted with each application. The lead firm certificate or a
copy of the certificate must be readily available at the worksite for review by the contracting
entity, the commissioner, and other public health officials charged with the health, safety,
and welfare of the state's citizens.

Sec. 26.

Minnesota Statutes 2022, section 144.9505, subdivision 1h, is amended to read:

Subd. 1h.

Certified renovation firm.

A person who new text begin performs or new text end employs individuals
to perform renovation deleted text begin activities outside of the person's propertydeleted text end new text begin for compensationnew text end must
obtain certification as a renovation firm. The certificate must be in writing, contain an
expiration date, be signed by the commissioner, and give the name and address of the person
to whom it is issued. A renovation firm certificate is valid for two years. The certification
fee is $100, is nonrefundable, and must be submitted with each application. The renovation
firm certificate or a copy of the certificate must be readily available at the worksite for
review by the contracting entity, the commissioner, and other public health officials charged
with the health, safety, and welfare of the state's citizens.

Sec. 27.

Minnesota Statutes 2022, section 144.9508, subdivision 2, is amended to read:

Subd. 2.

Regulated lead work standards and methods.

(a) The commissioner shall
adopt rules establishing regulated lead work standards and methods in accordance with the
provisions of this section, for lead in paint, dust, drinking water, and soil in a manner that
protects public health and the environment for all residences, including residences also used
for a commercial purpose, child care facilities, playgrounds, and schools.

(b) In the rules required by this section, the commissioner shall require lead hazard
reduction of intact paint only if the commissioner finds that the intact paint is on a chewable
or lead-dust producing surface that is a known source of actual lead exposure to a specific
individual. The commissioner shall prohibit methods that disperse lead dust into the air that
could accumulate to a level that would exceed the lead dust standard specified under this
section. The commissioner shall work cooperatively with the commissioner of administration
to determine which lead hazard reduction methods adopted under this section may be used
for lead-safe practices including prohibited practices, preparation, disposal, and cleanup.
The commissioner shall work cooperatively with the commissioner of the Pollution Control
Agency to develop disposal procedures. In adopting rules under this section, the
commissioner shall require the best available technology for regulated lead work methods,
paint stabilization, and repainting.

(c) The commissioner of health shall adopt regulated lead work standards and methods
for lead in bare soil in a manner to protect public health and the environment. The
commissioner shall adopt a maximum standard of 100 parts of lead per million in bare soil.
The commissioner shall set a soil replacement standard not to exceed 25 parts of lead per
million. Soil lead hazard reduction methods shall focus on erosion control and covering of
bare soil.

(d) The commissioner shall adopt regulated lead work standards and methods for lead
in dust in a manner to protect the public health and environment. Dust standards shall use
a weight of lead per area measure and include dust on the floor, on the window sills, and
on window wells. Lead hazard reduction methods for dust shall focus on dust removal and
other practices which minimize the formation of lead dust from paint, soil, or other sources.

(e) The commissioner shall adopt lead hazard reduction standards and methods for lead
in drinking water both at the tap and public water supply system or private well in a manner
to protect the public health and the environment. The commissioner may adopt the rules
for controlling lead in drinking water as contained in Code of Federal Regulations, title 40,
part 141. Drinking water lead hazard reduction methods may include an educational approach
of minimizing lead exposure from lead in drinking water.

(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
removal of exterior lead-based coatings from residences and steel structures by abrasive
blasting methods is conducted in a manner that protects health and the environment.

(g) All regulated lead work standards shall provide reasonable margins of safety that
are consistent with more than a summary review of scientific evidence and an emphasis on
overprotection rather than underprotection when the scientific evidence is ambiguous.

(h) No unit of local government shall have an ordinance or regulation governing regulated
lead work standards or methods for lead in paint, dust, drinking water, or soil that require
a different regulated lead work standard or method than the standards or methods established
under this section.

(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit of
local government of an innovative lead hazard reduction method which is consistent in
approach with methods established under this section.

(j) The commissioner shall adopt rules for issuing lead orders required under section
144.9504, rules for notification of abatement or interim control activities requirements, and
other rules necessary to implement sections 144.9501 to 144.9512.

(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the Toxic
Substances Control Act new text begin and all regulations adopted thereunder new text end to ensure that renovation in
a pre-1978 affected property deleted text begin where a child or pregnant female residesdeleted text end is conducted in a
manner that protects health and the environment. Notwithstanding sections 14.125 and
14.128, the authority to adopt these rules does not expire.

(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of the
Toxic Substances Control Act. Notwithstanding sections 14.125 and 14.128, the authority
to adopt these rules does not expire.

Sec. 28.

Minnesota Statutes 2022, section 144A.06, subdivision 2, is amended to read:

Subd. 2.

New license required; change of ownership.

(a) The commissioner of health
by rule shall prescribe procedures for licensure under this section.

(b) A new license is required and the prospective licensee must apply for a license prior
to operating a currently licensed nursing home. The licensee must change whenever one of
the following events occur:

(1) the form of the licensee's legal entity structure is converted or changed to a different
type of legal entity structure;

(2) the licensee dissolves, consolidates, or merges with another legal organization and
the licensee's legal organization does not survive;

(3) within the previous 24 months, 50 percent or more of the licensee's ownership interest
is transferred, whether by a single transaction or multiple transactions to:

(i) a different personnew text begin or multiple different personsnew text end ; or

(ii) a person new text begin or multiple persons new text end who had less than a five percent ownership interest in
the facility at the time of the first transaction; or

(4) any other event or combination of events that results in a substitution, elimination,
or withdrawal of the licensee's responsibility for the facility.

Sec. 29.

Minnesota Statutes 2022, section 144A.071, subdivision 2, is amended to read:

Subd. 2.

Moratorium.

new text begin (a) new text end The commissioner of health, in coordination with the
commissioner of human services, shall deny each request for new licensed or certified
nursing home or certified boarding care beds except as provided in subdivision 3 or 4a, or
section 144A.073. "Certified bed" means a nursing home bed or a boarding care bed certified
by the commissioner of health for the purposes of the medical assistance program, under
United States Code, title 42, sections 1396 et seq. Certified beds in facilities which do not
allow medical assistance intake shall be deemed to be decertified for purposes of this section
only.

new text begin (b) new text end The commissioner of human services, in coordination with the commissioner of
health, shall deny any request to issue a license under section 252.28 and chapter 245A to
a nursing home or boarding care home, if that license would result in an increase in the
medical assistance reimbursement amount.

new text begin (c) new text end In addition, the commissioner of health must not approve any construction project
whose cost exceeds $1,000,000, unless:

deleted text begin (a)deleted text end new text begin (1)new text end any construction costs exceeding $1,000,000 are not added to the facility's
appraised value and are not included in the facility's payment rate for reimbursement under
the medical assistance program; or

deleted text begin (b)deleted text end new text begin (2)new text end the project:

deleted text begin (1)deleted text end new text begin (i)new text end has been approved through the process described in section 144A.073;

deleted text begin (2)deleted text end new text begin (ii)new text end meets an exception in subdivision 3 or 4a;

deleted text begin (3)deleted text end new text begin (iii)new text end is necessary to correct violations of state or federal law issued by the
commissioner of health;

deleted text begin (4)deleted text end new text begin (iv)new text end is necessary to repair or replace a portion of the facility that was damaged by
fire, lightning, ground shifts, or other such hazards, including environmental hazards,
provided that the provisions of subdivision 4a, clause (a), are met; or

deleted text begin (5)deleted text end new text begin (v)new text end is being proposed by a licensed nursing facility that is not certified to participate
in the medical assistance program and will not result in new licensed or certified beds.

new text begin (d) new text end Prior to the final plan approval of any construction project, the commissioners of
health and human services shall be provided with an itemized cost estimate for the project
construction costs. If a construction project is anticipated to be completed in phases, the
total estimated cost of all phases of the project shall be submitted to the commissioners and
shall be considered as one construction project. Once the construction project is completed
and prior to the final clearance by the commissioners, the total project construction costs
for the construction project shall be submitted to the commissioners. If the final project
construction cost exceeds the dollar threshold in this subdivision, the commissioner of
human services shall not recognize any of the project construction costs or the related
financing costs in excess of this threshold in establishing the facility's property-related
payment rate.

new text begin (e) new text end The dollar thresholds for construction projects are as follows: for construction projects
other than those authorized in deleted text begin clauses (1) to (6)deleted text end new text begin paragraph (c), clause (2), items (i) to (v)new text end ,
the dollar threshold is $1,000,000. For projects authorized after July 1, 1993, under deleted text begin clause
(1)deleted text end new text begin paragraph (c), clause (2), item (i)new text end , the dollar threshold is the cost estimate submitted
with a proposal for an exception under section 144A.073, plus inflation as calculated
according to section 256B.431, subdivision 3f, paragraph (a). For projects authorized under
deleted text begin clauses (2) to (4)deleted text end new text begin paragraph (c), clause (2), items (ii) to (iv)new text end , the dollar threshold is the
itemized estimate project construction costs submitted to the commissioner of health at the
time of final plan approval, plus inflation as calculated according to section 256B.431,
subdivision 3f, paragraph (a).

new text begin (f) new text end The commissioner of health shall adopt rules to implement this section or to amend
the emergency rules for granting exceptions to the moratorium on nursing homes under
section 144A.073.

new text begin (g) All construction projects approved through section 144A.073, subdivision 3, after
March 1, 2020, are subject to the fair rental value property rate as described in section
256R.26.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from March 1, 2020.
new text end

Sec. 30.

Minnesota Statutes 2022, section 144A.073, subdivision 3b, is amended to read:

Subd. 3b.

Amendments to approved projects.

(a) Nursing facilities that have received
approval deleted text begin on or after July 1, 1993,deleted text end for exceptions to the moratorium on nursing homes through
the process described in this section may request amendments to the designs of the projects
by writing the commissioner within 15 months of receiving approval. Applicants shall
submit supporting materials that demonstrate how the amended projects meet the criteria
described in paragraph (b).

(b) The commissioner shall approve requests for amendments for projects approved deleted text begin on
or after July 1, 1993,deleted text end according to the following criteria:

(1) the amended project designs must provide solutions to all of the problems addressed
by the original application that are at least as effective as the original solutions;

(2) the amended project designs may not reduce the space in each resident's living area
or in the total amount of common space devoted to resident and family uses by more than
five percent;

(3) the costs deleted text begin recognized for reimbursementdeleted text end of amended project designs shall be deleted text begin the
threshold amount of the original proposal as identified according to section 144A.071,
subdivision 2deleted text end new text begin the cost estimate associated with the project as originally approvednew text end , except
under conditions described in clause (4); and

(4) total costs deleted text begin up to ten percent greater than the cost identified in clause (3) may be
recognized for reimbursement ifdeleted text end new text begin of the amendment are no greater than ten percent of the
cost estimate associated with the project as initially approved ifnew text end the proposer can document
that one of the following circumstances is true:

(i) changes are needed due to a natural disaster;

(ii) conditions that affect the safety or durability of the project that could not have
reasonably been known prior to approval are discovered;

(iii) state or federal law require changes in project design; or

(iv) documentable circumstances occur that are beyond the control of the owner and
require changes in the design.

(c) Approval of a request for an amendment does not alter the expiration of approval of
the project according to subdivision 3.

new text begin (d) Reimbursement for amendments to approved projects is independent of the actual
construction costs and based on the allowable appraised value of the completed project. An
approved project may not be amended to reduce the scope of an approved project.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from March 1, 2020.
new text end

Sec. 31.

Minnesota Statutes 2022, section 144A.474, subdivision 3, is amended to read:

Subd. 3.

Survey process.

The survey process for core surveys shall include the following
as applicable to the particular licensee and setting surveyed:

(1) presurvey review of pertinent documents and notification to the ombudsman for
long-term care;

(2) an entrance conference with available staff;

(3) communication with managerial officials or the registered nurse in charge, if available,
and ongoing communication with key staff throughout the survey regarding information
needed by the surveyor, clarifications regarding home care requirements, and applicable
standards of practice;

(4) presentation of written contact information to the provider about the survey staff
conducting the survey, the supervisor, and the process for requesting a reconsideration of
the survey results;

(5) a brief tour of deleted text begin a sample ofdeleted text end the deleted text begin housing with services establishmentsdeleted text end new text begin establishmentnew text end
in which the provider is providing home care services;

(6) a sample selection of home care clients;

(7) information-gathering through client and staff observations, client and staff interviews,
and reviews of records, policies, procedures, practices, and other agency information;

(8) interviews of clients' family members, if available, with clients' consent when the
client can legally give consent;

(9) except for complaint surveys conducted by the Office of Health Facilities Complaints,
an deleted text begin on-sitedeleted text end exit conferencedeleted text begin ,deleted text end with preliminary findings deleted text begin shared anddeleted text end discussed with the providernew text begin
within one business day after completion of survey activitiesnew text end , deleted text begin documentation that an exit
conference occurred,deleted text end and new text begin with new text end written information provided on the process for requesting
a reconsideration of the survey results; and

(10) postsurvey analysis of findings and formulation of survey results, including
correction orders when applicable.

Sec. 32.

Minnesota Statutes 2022, section 144A.474, subdivision 9, is amended to read:

Subd. 9.

Follow-up surveys.

For providers that have Level 3 or Level 4 violations under
subdivision 11, deleted text begin or any violations determined to be widespread,deleted text end the department shall conduct
a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
survey, the surveyor will focus on whether the previous violations have been corrected and
may also address any new violations that are observed while evaluating the corrections that
have been made.

Sec. 33.

Minnesota Statutes 2022, section 144A.474, subdivision 12, is amended to read:

Subd. 12.

Reconsideration.

(a) The commissioner shall make available to home care
providers a correction order reconsideration process. This process may be used to challenge
the correction order issued, including the level and scope described in subdivision 11, and
any fine assessed. During the correction order reconsideration request, the issuance for the
correction orders under reconsideration are not stayed, but the department shall post
information on the website with the correction order that the licensee has requested a
reconsideration and that the review is pending.

(b) A licensed home care provider may request from the commissioner, in writing, a
correction order reconsideration regarding any correction order issued to the provider. The
written request for reconsideration must be received by the commissioner within 15 deleted text begin calendardeleted text end new text begin
businessnew text end days of the correction order receipt date. The correction order reconsideration shall
not be reviewed by any surveyor, investigator, or supervisor that participated in the writing
or reviewing of the correction order being disputed. The correction order reconsiderations
may be conducted in person, by telephone, by another electronic form, or in writing, as
determined by the commissioner. The commissioner shall respond in writing to the request
from a home care provider for a correction order reconsideration within 60 days of the date
the provider requests a reconsideration. The commissioner's response shall identify the
commissioner's decision regarding each citation challenged by the home care provider.

(1) supported in full, the correction order is supported in full, with no deletion of findings
to the citation;

(2) supported in substance, the correction order is supported, but one or more findings
are deleted or modified without any change in the citation;

(3) correction order cited an incorrect home care licensing requirement, the correction
order is amended by changing the correction order to the appropriate statutory reference;

(4) correction order was issued under an incorrect citation, the correction order is amended
to be issued under the more appropriate correction order citation;

(5) the correction order is rescinded;

(6) fine is amended, it is determined that the fine assigned to the correction order was
applied incorrectly; or

(7) the level or scope of the citation is modified based on the reconsideration.

(d) If the correction order findings are changed by the commissioner, the commissioner
shall update the correction order website.

(e) This subdivision does not apply to temporary licensees.

Sec. 34.

Minnesota Statutes 2022, section 144A.4791, subdivision 10, is amended to read:

Subd. 10.

Termination of service plan.

(a) If a home care provider terminates a service
plan with a client, and the client continues to need home care services, the home care provider
shall provide the client and the client's representative, if any, with a written notice of
termination which includes the following information:

(1) the effective date of termination;

(2) the reason for termination;

new text begin (3) a statement that the client may contact the Office of Ombudsman for Long-Term
Care to request an advocate to assist regarding the termination and contact information for
the office, including the office's central telephone number;
new text end

deleted text begin (3)deleted text end new text begin (4)new text end a list of known licensed home care providers in the client's immediate geographic
area;

deleted text begin (4)deleted text end new text begin (5)new text end a statement that the home care provider will participate in a coordinated transfer
of care of the client to another home care provider, health care provider, or caregiver, as
required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);

deleted text begin (5)deleted text end new text begin (6)new text end the name and contact information of a person employed by the home care provider
with whom the client may discuss the notice of termination; and

deleted text begin (6)deleted text end new text begin (7)new text end if applicable, a statement that the notice of termination of home care services
does not constitute notice of termination of deleted text begin the housing with services contract with a housing
with services establishmentdeleted text end new text begin any housing contractnew text end .

(b) When the home care provider voluntarily discontinues services to all clients, the
home care provider must notify the commissioner, lead agencies, and ombudsman for
long-term care about its clients and comply with the requirements in this subdivision.

Sec. 35.

Minnesota Statutes 2022, section 148.512, subdivision 10a, is amended to read:

Subd. 10a.

Hearing aid.

"Hearing aid" means deleted text begin an instrumentdeleted text end new text begin a prescribed aidnew text end , or any of
its parts, worn in the ear canal and designed to or represented as being able to aid deleted text begin or enhancedeleted text end
human hearing. "Hearing aid" includes the aid's parts, attachments, or accessories, including,
but not limited to, ear molds and behind the ear (BTE) devices with or without an ear mold.
Batteries and cords are not parts, attachments, or accessories of a hearing aid. Surgically
implanted hearing aids, and assistive listening devices not worn within the ear canal, are
not hearing aids.

Sec. 36.

Minnesota Statutes 2022, section 148.512, subdivision 10b, is amended to read:

Subd. 10b.

Hearing aid dispensing.

"Hearing aid dispensing" means making ear mold
impressions, prescribingdeleted text begin , or recommendingdeleted text end a hearing aid, assisting the consumer in
new text begin prescription new text end aid selectiondeleted text begin , selling hearing aids at retaildeleted text end , or testing human hearing in connection
with these activities regardless of whether the person conducting these activities has a
monetary interest in the dispensing of new text begin prescription new text end hearing aids to the consumer.new text begin Hearing
aid dispensing does not include selling over-the-counter hearing aids.
new text end

Sec. 37.

Minnesota Statutes 2022, section 148.512, is amended by adding a subdivision
to read:

new text begin Subd. 10c. new text end

new text begin Over-the-counter hearing aid or OTC hearing aid. new text end

new text begin "Over-the-counter
hearing aid" or "OTC hearing aid" has the meaning given to that term in Code of Federal
Regulations, title 21, section 800.30(b).
new text end

Sec. 38.

Minnesota Statutes 2022, section 148.512, is amended by adding a subdivision
to read:

new text begin Subd. 13a. new text end

new text begin Prescription hearing aid. new text end

new text begin "Prescription hearing aid" means a hearing aid
requiring a prescription from a certified hearing aid dispenser or licensed audiologist that
is not an OTC hearing aid.
new text end

Sec. 39.

Minnesota Statutes 2022, section 148.513, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Over-the-counter hearing aids. new text end

new text begin Nothing in sections 148.511 to 148.5198 shall
preclude licensed audiologists from dispensing or selling over-the-counter hearing aids.
new text end

Sec. 40.

Minnesota Statutes 2022, section 148.515, subdivision 6, is amended to read:

Subd. 6.

Dispensing audiologist examination requirements.

(a) Audiologists are
exempt from the written examination requirement in section 153A.14, subdivision 2h,
paragraph (a), clause (1).

(b) After July 31, 2005, all applicants for audiologist licensure under sections 148.512
to 148.5198 must achieve a passing score on the practical tests of proficiency described in
section 153A.14, subdivision 2h, paragraph (a), clause (2), within the time period described
in section 153A.14, subdivision 2h, paragraph (c).

(c) In order to dispense new text begin prescription new text end hearing aids as a sole proprietor, member of a
partnership, or for a limited liability company, corporation, or any other entity organized
for profit, a licensee who obtained audiologist licensure under sections 148.512 to 148.5198,
before August 1, 2005, and who is not certified to dispense new text begin prescription new text end hearing aids under
chapter 153A, must achieve a passing score on the practical tests of proficiency described
in section 153A.14, subdivision 2h, paragraph (a), clause (2), within the time period described
in section 153A.14, subdivision 2h, paragraph (c). All other audiologist licensees who
obtained licensure before August 1, 2005, are exempt from the practical tests.

(d) An applicant for an audiology license who obtains a temporary license under section
148.5175 may dispense new text begin prescription new text end hearing aids only under supervision of a licensed
audiologist who dispenses new text begin prescription new text end hearing aids.

Sec. 41.

Minnesota Statutes 2022, section 148.5175, is amended to read:

148.5175 TEMPORARY LICENSURE.

(a) The commissioner shall issue temporary licensure as a speech-language pathologist,
an audiologist, or both, to an applicant who:

(1) submits a signed and dated affidavit stating that the applicant is not the subject of a
disciplinary action or past disciplinary action in this or another jurisdiction and is not
disqualified on the basis of section 148.5195, subdivision 3; and

(2) either:

(i) provides a copy of a current credential as a speech-language pathologist, an audiologist,
or both, held in the District of Columbia or a state or territory of the United States; or

(ii) provides a copy of a current certificate of clinical competence issued by the American
Speech-Language-Hearing Association or board certification in audiology by the American
Board of Audiology.

(b) A temporary license issued to a person under this subdivision expires 90 days after
it is issued or on the date the commissioner grants or denies licensure, whichever occurs
first.

(c) Upon application, a temporary license shall be renewed twice to a person who is able
to demonstrate good cause for failure to meet the requirements for licensure within the
initial temporary licensure period and who is not the subject of a disciplinary action or
disqualified on the basis of section 148.5195, subdivision 3. Good cause includes but is not
limited to inability to take and complete the required practical exam for dispensing
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end .

(d) Upon application, a temporary license shall be issued to a person who meets the
requirements of section 148.515, subdivisions 2a and 4, but has not completed the
requirement in section 148.515, subdivision 6.

Sec. 42.

Minnesota Statutes 2022, section 148.5195, subdivision 3, is amended to read:

Subd. 3.

Grounds for disciplinary action by commissioner.

The commissioner may
take any of the disciplinary actions listed in subdivision 4 on proof that the individual has:

(1) intentionally submitted false or misleading information to the commissioner or the
advisory council;

(2) failed, within 30 days, to provide information in response to a written request by the
commissioner or advisory council;

(3) performed services of a speech-language pathologist or audiologist in an incompetent
or negligent manner;

(4) violated sections 148.511 to 148.5198;

(5) failed to perform services with reasonable judgment, skill, or safety due to the use
of alcohol or drugs, or other physical or mental impairment;

(6) violated any state or federal law, rule, or regulation, and the violation is a felony or
misdemeanor, an essential element of which is dishonesty, or which relates directly or
indirectly to the practice of speech-language pathology or audiology. Conviction for violating
any state or federal law which relates to speech-language pathology or audiology is
necessarily considered to constitute a violation, except as provided in chapter 364;

(7) aided or abetted another person in violating any provision of sections 148.511 to
148.5198;

(8) been or is being disciplined by another jurisdiction, if any of the grounds for the
discipline is the same or substantially equivalent to those under sections 148.511 to 148.5198;

(9) not cooperated with the commissioner or advisory council in an investigation
conducted according to subdivision 1;

(10) advertised in a manner that is false or misleading;

(11) engaged in conduct likely to deceive, defraud, or harm the public; or demonstrated
a willful or careless disregard for the health, welfare, or safety of a client;

(12) failed to disclose to the consumer any fee splitting or any promise to pay a portion
of a fee to any other professional other than a fee for services rendered by the other
professional to the client;

(13) engaged in abusive or fraudulent billing practices, including violations of federal
Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical
assistance laws;

(14) obtained money, property, or services from a consumer through the use of undue
influence, high pressure sales tactics, harassment, duress, deception, or fraud;

(15) performed services for a client who had no possibility of benefiting from the services;

(16) failed to refer a client for medical evaluation or to other health care professionals
when appropriate or when a client indicated symptoms associated with diseases that could
be medically or surgically treated;

(17) had the certification required by chapter 153A denied, suspended, or revoked
according to chapter 153A;

(18) used the term doctor of audiology, doctor of speech-language pathology, AuD, or
SLPD without having obtained the degree from an institution accredited by the North Central
Association of Colleges and Secondary Schools, the Council on Academic Accreditation
in Audiology and Speech-Language Pathology, the United States Department of Education,
or an equivalent;

(19) failed to comply with the requirements of section 148.5192 regarding supervision
of speech-language pathology assistants; or

(20) if the individual is an audiologist or certified hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser:

(i) prescribed deleted text begin or otherwise recommendeddeleted text end to a consumer or potential consumer the use
of a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end , unless the prescription from a physician deleted text begin or
recommendation fromdeleted text end new text begin ,new text end an audiologistnew text begin ,new text end or new text begin a new text end certified dispenser is in writing, is based on an
audiogram that is delivered to the consumer or potential consumer when the prescription
deleted text begin or recommendationdeleted text end is made, and bears the following information in all capital letters of
12-point or larger boldface type: "THIS PRESCRIPTION deleted text begin OR RECOMMENDATIONdeleted text end
MAY BE FILLED BY, AND new text begin PRESCRIPTION new text end HEARING deleted text begin INSTRUMENTSdeleted text end new text begin AIDSnew text end MAY
BE PURCHASED FROM, THE LICENSED AUDIOLOGIST OR CERTIFIED DISPENSER
OF YOUR CHOICE";

(ii) failed to give a copy of the audiogram, upon which the prescription deleted text begin or
recommendationdeleted text end is based, to the consumer when the consumer requests a copy;

(iii) failed to provide the consumer rights brochure required by section 148.5197,
subdivision 3;

(iv) failed to comply with restrictions on sales of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end
in sections 148.5197, subdivision 3, and 148.5198;

(v) failed to return a consumer's new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end used as a trade-in
or for a discount in the price of a newnew text begin prescriptionnew text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end when requested
by the consumer upon cancellation of the purchase agreement;

(vi) failed to follow Food and Drug Administration or Federal Trade Commission
regulations relating to dispensingnew text begin prescriptionnew text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ;

(vii) failed to dispense a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end in a competent manner or
without appropriate training;

(viii) delegated new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing authority to a person not
authorized to dispense a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end under this chapter or chapter
153A;

(ix) failed to comply with the requirements of an employer or supervisor of a hearing
deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser trainee;

(x) violated a state or federal court order or judgment, including a conciliation court
judgment, relating to the activities of the individual's new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensing; or

(xi) failed to include on the audiogram the practitioner's printed name, credential type,
credential number, signature, and date.

Sec. 43.

Minnesota Statutes 2022, section 148.5196, subdivision 1, is amended to read:

Subdivision 1.

Membership.

The commissioner shall appoint 12 persons to a
Speech-Language Pathologist and Audiologist Advisory Council. The 12 persons must
include:

(1) three public members, as defined in section 214.02. Two of the public members shall
be either persons receiving services of a speech-language pathologist or audiologist, or
family members of or caregivers to such persons, and at least one of the public members
shall be either a hearing deleted text begin instrumentdeleted text end new text begin aidnew text end user or an advocate of one;

(2) three speech-language pathologists licensed under sections 148.511 to 148.5198,
one of whom is currently and has been, for the five years immediately preceding the
appointment, engaged in the practice of speech-language pathology in Minnesota and each
of whom is employed in a different employment setting including, but not limited to, private
practice, hospitals, rehabilitation settings, educational settings, and government agencies;

(3) one speech-language pathologist licensed under sections 148.511 to 148.5198, who
is currently and has been, for the five years immediately preceding the appointment,
employed by a Minnesota public school district or a Minnesota public school district
consortium that is authorized by Minnesota Statutes and who is licensed in speech-language
pathology by the Professional Educator Licensing and Standards Board;

(4) three audiologists licensed under sections 148.511 to 148.5198, two of whom are
currently and have been, for the five years immediately preceding the appointment, engaged
in the practice of audiology and the dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end in
Minnesota and each of whom is employed in a different employment setting including, but
not limited to, private practice, hospitals, rehabilitation settings, educational settings, industry,
and government agencies;

(5) one nonaudiologist hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser recommended by a professional
association representing hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers; and

(6) one physician licensed under chapter 147 and certified by the American Board of
Otolaryngology, Head and Neck Surgery.

Sec. 44.

Minnesota Statutes 2022, section 148.5197, is amended to read:

148.5197 HEARING AID DISPENSING.

Subdivision 1.

Content of contracts.

Oral statements made by an audiologist or certified
dispenser regarding the provision of warranties, refunds, and service on the new text begin prescription
new text end hearing aid or aids dispensed must be written on, and become part of, the contract of sale,
specify the item or items covered, and indicate the person or business entity obligated to
provide the warranty, refund, or service.

Subd. 2.

Required use of license number.

The audiologist's license number or certified
dispenser's certificate number must appear on all contracts, bills of sale, and receipts used
in the sale of new text begin prescription new text end hearing aids.

Subd. 3.

Consumer rights information.

An audiologist or certified dispenser shall, at
the time of the deleted text begin recommendation ordeleted text end prescription, give a consumer rights brochure, prepared
by the commissioner and containing information about legal requirements pertaining to
dispensing of new text begin prescription new text end hearing aids, to each potential consumer of a new text begin prescription new text end hearing
aid. The brochure must contain information about the consumer information center described
in section 153A.18. A contract for a new text begin prescription new text end hearing aid must note the receipt of the
brochure by the consumer, along with the consumer's signature or initials.

Subd. 4.

Liability for contracts.

Owners of entities in the business of dispensing
new text begin prescription new text end hearing aids, employers of audiologists or persons who dispense new text begin prescription
new text end hearing aids, supervisors of trainees or audiology students, and hearing aid dispensers
conducting the transaction at issue are liable for satisfying all terms of contracts, written or
oral, made by their agents, employees, assignees, affiliates, or trainees, including terms
relating to products, repairs, warranties, service, and refunds. The commissioner may enforce
the terms of new text begin prescription new text end hearing aid contracts against the principal, employer, supervisor,
or dispenser who conducted the transaction and may impose any remedy provided for in
this chapter.

Sec. 45.

Minnesota Statutes 2022, section 148.5198, is amended to read:

148.5198 RESTRICTION ON SALE OF new text begin PRESCRIPTION new text end HEARING AIDS.

Subdivision 1.

45-calendar-day guarantee and buyer right to cancel.

(a) An audiologist
or certified dispenser dispensing a new text begin prescription new text end hearing aid in this state must comply with
paragraphs (b) and (c).

(b) The audiologist or certified dispenser must provide the buyer with a 45-calendar-day
written money-back guarantee. The guarantee must permit the buyer to cancel the purchase
for any reason within 45 calendar days after receiving the new text begin prescription new text end hearing aid by giving
or mailing written notice of cancellation to the audiologist or certified dispenser. If the buyer
mails the notice of cancellation, the 45-calendar-day period is counted using the postmark
date, to the date of receipt by the audiologist or certified dispenser. If the new text begin prescription new text end hearing
aid must be repaired, remade, or adjusted during the 45-calendar-day money-back guarantee
period, the running of the 45-calendar-day period is suspended one day for each 24-hour
period that the new text begin prescription new text end hearing aid is not in the buyer's possession. A repaired, remade,
or adjusted new text begin prescription new text end hearing aid must be claimed by the buyer within three business
days after notification of availability, after which time the running of the 45-calendar-day
period resumes. The guarantee must entitle the buyer, upon cancellation, to receive a refund
of payment within 30 days of return of the new text begin prescription new text end hearing aid to the audiologist or
certified dispenser. The audiologist or certified dispenser may retain as a cancellation fee
no more than $250 of the buyer's total purchase price of the new text begin prescription new text end hearing aid.

(c) The audiologist or certified dispenser shall provide the buyer with a contract written
in plain English, that contains uniform language and provisions that meet the requirements
under the Plain Language Contract Act, sections 325G.29 to 325G.36. The contract must
include, but is not limited to, the following: in immediate proximity to the space reserved
for the signature of the buyer, or on the first page if there is no space reserved for the
signature of the buyer, a clear and conspicuous disclosure of the following specific statement
in all capital letters of no less than 12-point boldface type: "MINNESOTA STATE LAW
GIVES THE BUYER THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON
AT ANY TIME PRIOR TO MIDNIGHT OF THE 45TH CALENDAR DAY AFTER
RECEIPT OF THE new text begin PRESCRIPTION new text end HEARING AID(S). THIS CANCELLATION MUST
BE IN WRITING AND MUST BE GIVEN OR MAILED TO THE AUDIOLOGIST OR
CERTIFIED DISPENSER. IF THE BUYER DECIDES TO RETURN THE new text begin PRESCRIPTION
new text end HEARING AID(S) WITHIN THIS 45-CALENDAR-DAY PERIOD, THE BUYER WILL
RECEIVE A REFUND OF THE TOTAL PURCHASE PRICE OF THE AID(S) FROM
WHICH THE AUDIOLOGIST OR CERTIFIED DISPENSER MAY RETAIN AS A
CANCELLATION FEE NO MORE THAN $250."

Subd. 2.

Itemized repair bill.

Any audiologist, certified dispenser, or company who
agrees to repair a new text begin prescription new text end hearing aid must provide the owner of the new text begin prescription new text end hearing
aid, or the owner's representative, with a bill that describes the repair and services rendered.
The bill must also include the repairing audiologist's, certified dispenser's, or company's
name, address, and telephone number.

This subdivision does not apply to an audiologist, certified dispenser, or company that
repairs a new text begin prescription new text end hearing aid pursuant to an express warranty covering the entire
new text begin prescription new text end hearing aid and the warranty covers the entire cost, both parts and labor, of the
repair.

Subd. 3.

Repair warranty.

Any guarantee of new text begin prescription new text end hearing aid repairs must be
in writing and delivered to the owner of the new text begin prescription new text end hearing aid, or the owner's
representative, stating the repairing audiologist's, certified dispenser's, or company's name,
address, telephone number, length of guarantee, model, and serial number of the new text begin prescription
new text end hearing aid and all other terms and conditions of the guarantee.

Subd. 4.

Misdemeanor.

A person found to have violated this section is guilty of a
misdemeanor.

Subd. 5.

Additional.

In addition to the penalty provided in subdivision 4, a person found
to have violated this section is subject to the penalties and remedies provided in section
325F.69, subdivision 1.

Subd. 6.

Estimates.

Upon the request of the owner of a new text begin prescription new text end hearing aid or the
owner's representative for a written estimate and prior to the commencement of repairs, a
repairing audiologist, certified dispenser, or company shall provide the customer with a
written estimate of the price of repairs. If a repairing audiologist, certified dispenser, or
company provides a written estimate of the price of repairs, it must not charge more than
the total price stated in the estimate for the repairs. If the repairing audiologist, certified
dispenser, or company after commencing repairs determines that additional work is necessary
to accomplish repairs that are the subject of a written estimate and if the repairing audiologist,
certified dispenser, or company did not unreasonably fail to disclose the possible need for
the additional work when the estimate was made, the repairing audiologist, certified
dispenser, or company may charge more than the estimate for the repairs if the repairing
audiologist, certified dispenser, or company immediately provides the owner or owner's
representative a revised written estimate pursuant to this section and receives authorization
to continue with the repairs. If continuation of the repairs is not authorized, the repairing
audiologist, certified dispenser, or company shall return the new text begin prescription new text end hearing aid as close
as possible to its former condition and shall release the new text begin prescription new text end hearing aid to the owner
or owner's representative upon payment of charges for repairs actually performed and not
in excess of the original estimate.

Sec. 46.

Minnesota Statutes 2022, section 151.37, subdivision 12, is amended to read:

Subd. 12.

Administration of opiate antagonists for drug overdose.

(a) A licensed
physician, a licensed advanced practice registered nurse authorized to prescribe drugs
pursuant to section 148.235, or a licensed physician assistant may authorize the following
individuals to administer opiate antagonists, as defined in section 604A.04, subdivision 1:

(1) an emergency medical responder registered pursuant to section 144E.27;

(2) a peace officer as defined in section 626.84, subdivision 1, paragraphs (c) and (d);

(3) correctional employees of a state or local political subdivision;

(4) staff of community-based health disease prevention or social service programs;

(5) a volunteer firefighter; and

(6) a deleted text begin licensed schooldeleted text end nurse or deleted text begin certified public health nursedeleted text end new text begin any other personnelnew text end employed
by, or under contract with, a deleted text begin school board under section 121A.21deleted text end new text begin charter, public, or private
schoolnew text end .

(b) For the purposes of this subdivision, opiate antagonists may be administered by one
of these individuals only if:

(1) the licensed physician, licensed physician assistant, or licensed advanced practice
registered nurse has issued a standing order to, or entered into a protocol with, the individual;
and

(2) the individual has training in the recognition of signs of opiate overdose and the use
of opiate antagonists as part of the emergency response to opiate overdose.

new text begin (d) Notwithstanding section 148.235, subdivisions 8 and 9, a licensed practical nurse is
authorized to possess and administer according to this subdivision an opiate antagonist in
a school setting.
new text end

Sec. 47.

Minnesota Statutes 2022, section 153A.13, subdivision 3, is amended to read:

Subd. 3.

Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end .

"Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end " means an instrumentdeleted text begin , or
any of its parts, worn in the ear canal and designed to or represented as being able to aid or
enhance human hearing. "Hearing instrument" includes the instrument's parts, attachments,
or accessories, including, but not limited to, ear molds and behind the ear (BTE) devices
with or without an ear mold. Batteries and cords are not parts, attachments, or accessories
of a hearing instrument. Surgically implanted hearing instruments, and assistive listening
devices not worn within the ear canal, are not hearing instruments.deleted text end new text begin as defined in section
148.512, subdivision 10a.
new text end

Sec. 48.

Minnesota Statutes 2022, section 153A.13, subdivision 4, is amended to read:

Subd. 4.

Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing.

"Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing"
deleted text begin means making ear mold impressions, prescribing, or recommending a hearing instrument,
assisting the consumer in instrument selection, selling hearing instruments at retail, or testing
human hearing in connection with these activities regardless of whether the person conducting
these activities has a monetary interest in the sale of hearing instruments to the consumer.deleted text end new text begin
has the meaning given in section 148.512, subdivision 10b.
new text end

Sec. 49.

Minnesota Statutes 2022, section 153A.13, subdivision 5, is amended to read:

Subd. 5.

Dispenser of hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end .

"Dispenser of hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end " means a natural person who engages in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensingnew text begin ,new text end
whether or not certified by the commissioner of health or licensed by an existing
health-related board, except that a person described as follows is not a dispenser of hearing
deleted text begin instrumentsdeleted text end new text begin aidsnew text end :

(1) a student participating in supervised field work that is necessary to meet requirements
of an accredited educational program if the student is designated by a title which clearly
indicates the student's status as a student trainee; or

(2) a person who helps a dispenser of hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end in an administrative or
clerical manner and does not engage in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing.

A person who offers to dispense a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end , or a person who
advertises, holds out to the public, or otherwise represents that the person is authorized to
dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aids,new text end must be certified by the commissioner except
when the person is an audiologist as defined in section 148.512.

Sec. 50.

Minnesota Statutes 2022, section 153A.13, subdivision 6, is amended to read:

Subd. 6.

Advisory council.

"Advisory council" means the Minnesota Hearing deleted text begin Instrumentdeleted text end new text begin
Aidnew text end Dispenser Advisory Council, or a committee of deleted text begin itdeleted text end new text begin the councilnew text end , established under section
153A.20.

Sec. 51.

Minnesota Statutes 2022, section 153A.13, subdivision 7, is amended to read:

Subd. 7.

ANSI.

"ANSI" means deleted text begin ANSI S3.6-1989,deleted text end American National Standard
Specification for Audiometers deleted text begin from the American National Standards Institute. This
document is available through the Minitex interlibrary loan systemdeleted text end new text begin as defined in the United
States Food and Drug Administration, Code of Federal Regulations, title 21, section
874.1050new text end .

Sec. 52.

Minnesota Statutes 2022, section 153A.13, subdivision 9, is amended to read:

Subd. 9.

Supervision.

"Supervision" means monitoring activities of, and accepting
responsibility for, the new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing activities of a trainee.

Sec. 53.

Minnesota Statutes 2022, section 153A.13, subdivision 10, is amended to read:

Subd. 10.

Direct supervision or directly supervised.

"Direct supervision" or "directly
supervised" means the on-site and contemporaneous location of a supervisor and trainee,
when the supervisor observes the trainee engaging in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensing with a consumer.

Sec. 54.

Minnesota Statutes 2022, section 153A.13, subdivision 11, is amended to read:

Subd. 11.

Indirect supervision or indirectly supervised.

"Indirect supervision" or
"indirectly supervised" means the remote and independent performance of new text begin prescription
new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing by a trainee when authorized under section 153A.14,
subdivision 4a, paragraph (b).

Sec. 55.

Minnesota Statutes 2022, section 153A.13, is amended by adding a subdivision
to read:

new text begin Subd. 12. new text end

new text begin Over-the-counter hearing aid or OTC hearing aid. new text end

new text begin "Over-the-counter
hearing aid" or "OTC hearing aid" has the meaning given in section 148.512, subdivision
10c.
new text end

Sec. 56.

Minnesota Statutes 2022, section 153A.13, is amended by adding a subdivision
to read:

new text begin Subd. 13. new text end

new text begin Prescription hearing aid. new text end

new text begin "Prescription hearing aid" has the meaning given
in section 148.512, subdivision 13a.
new text end

Sec. 57.

Minnesota Statutes 2022, section 153A.14, subdivision 1, is amended to read:

Subdivision 1.

Application for certificate.

An applicant must:

(1) be 21 years of age or older;

(2) apply to the commissioner for a certificate to dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end on application forms provided by the commissioner;

(3) at a minimum, provide the applicant's name, Social Security number, business address
and phone number, employer, and information about the applicant's education, training,
and experience in testing human hearing and fitting new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ;

(4) include with the application a statement that the statements in the application are
true and correct to the best of the applicant's knowledge and belief;

(5) include with the application a written and signed authorization that authorizes the
commissioner to make inquiries to appropriate regulatory agencies in this or any other state
where the applicant has sold new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ;

(6) submit certification to the commissioner that the applicant's audiometric equipment
has been calibrated to meet current ANSI standards within 12 months of the date of the
application;

(7) submit evidence of continuing education credits, if required;

(8) submit all fees as required under section 153A.17; and

(9) consent to a fingerprint-based criminal history records check required under section
144.0572, pay all required fees, and cooperate with all requests for information. An applicant
must complete a new criminal background check if more than one year has elapsed since
the applicant last applied for a license.

Sec. 58.

Minnesota Statutes 2022, section 153A.14, subdivision 2, is amended to read:

Subd. 2.

Issuance of certificate.

(a) The commissioner shall issue a certificate to each
dispenser of hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end who applies under subdivision 1 if the commissioner
determines that the applicant is in compliance with this chapter, has passed an examination
administered by the commissioner, has met the continuing education requirements, if
required, and has paid the fee set by the commissioner. The commissioner may reject or
deny an application for a certificate if there is evidence of a violation or failure to comply
with this chapter.

(b) The commissioner shall not issue a certificate to an applicant who refuses to consent
to a criminal history background check as required by section 144.0572 within 90 days after
submission of an application or fails to submit fingerprints to the Department of Human
Services. Any fees paid by the applicant to the Department of Health shall be forfeited if
the applicant refuses to consent to the background study.

Sec. 59.

Minnesota Statutes 2022, section 153A.14, subdivision 2h, is amended to read:

Subd. 2h.

Certification by examination.

An applicant must achieve a passing score,
as determined by the commissioner, on an examination according to paragraphs (a) to (c).

(a) The examination must include, but is not limited to:

(1) A written examination approved by the commissioner covering the following areas
as they pertain to new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end selling:

(i) basic physics of sound;

(ii) the anatomy and physiology of the ear;

(iii) the function of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ; and

(iv) the principles of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end selection.

(2) Practical tests of proficiency in the following techniques as they pertain to new text begin prescription
new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end selling:

(i) pure tone audiometry, including air conduction testing and bone conduction testing;

(ii) live voice or recorded voice speech audiometry including speech recognition
(discrimination) testing, most comfortable loudness level, and uncomfortable loudness
measurements of tolerance thresholds;

(iii) masking when indicated;

(iv) recording and evaluation of audiograms and speech audiometry to determine proper
selection and fitting of a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end ;

(v) taking ear mold impressions;

(vi) using an otoscope for the visual observation of the entire ear canal; and

(vii) state and federal laws, rules, and regulations.

(b) The practical examination shall be administered by the commissioner at least twice
a year.

(c) An applicant must achieve a passing score on all portions of the examination within
a two-year period. An applicant who does not achieve a passing score on all portions of the
examination within a two-year period must retake the entire examination and achieve a
passing score on each portion of the examination. An applicant who does not apply for
certification within one year of successful completion of the examination must retake the
examination and achieve a passing score on each portion of the examination. An applicant
may not take any part of the practical examination more than three times in a two-year
period.

Sec. 60.

Minnesota Statutes 2022, section 153A.14, subdivision 2i, is amended to read:

Subd. 2i.

Continuing education requirement.

On forms provided by the commissioner,
each certified dispenser must submit with the application for renewal of certification evidence
of completion of ten course hours of continuing education earned within the 12-month
period of November 1 to October 31, between the effective and expiration dates of
certification. Continuing education courses must be directly related tonew text begin prescriptionnew text end hearing
deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing and approved by the International Hearing Society, the American
Speech-Language-Hearing Association, or the American Academy of Audiology. Evidence
of completion of the ten course hours of continuing education must be submitted by
December 1 of each year. This requirement does not apply to dispensers certified for less
than one year.

Sec. 61.

Minnesota Statutes 2022, section 153A.14, subdivision 2j, is amended to read:

Subd. 2j.

Required use of certification number.

The certification holder must use the
certification number on all contracts, bills of sale, and receipts used in the sale of new text begin prescription
new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end .

Sec. 62.

Minnesota Statutes 2022, section 153A.14, subdivision 4, is amended to read:

Subd. 4.

Dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end without
certificate.

Except as provided in subdivisions 4a and 4c, and in sections 148.512 to
148.5198, it is unlawful for any person not holding a valid certificate to dispense a
new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end as defined in section 153A.13, subdivision 3. A person
who dispenses a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end without the certificate required by this
section is guilty of a gross misdemeanor.

Sec. 63.

Minnesota Statutes 2022, section 153A.14, subdivision 4a, is amended to read:

Subd. 4a.

Trainees.

(a) A person who is not certified under this section may dispense
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end as a trainee for a period not to exceed 12 months if
the person:

(1) submits an application on forms provided by the commissioner;

(2) is under the supervision of a certified dispenser meeting the requirements of this
subdivision;

(3) meets all requirements for certification except passage of the examination required
by this section; and

(4) uses the title "dispenser trainee" in contacts with the patients, clients, or consumers.

(b) A certified hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser may not supervise more than two trainees
at the same time and may not directly supervise more than one trainee at a time. The certified
dispenser is responsible for all actions or omissions of a trainee in connection with the
dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end . A certified dispenser may not supervise
a trainee if there are any commissioner, court, or other orders, currently in effect or issued
within the last five years, that were issued with respect to an action or omission of a certified
dispenser or a trainee under the certified dispenser's supervision.

Until taking and passing the practical examination testing the techniques described in
subdivision 2h, paragraph (a), clause (2), trainees must be directly supervised in all areas
described in subdivision 4b, and the activities tested by the practical examination. Thereafter,
trainees may dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end under indirect supervision until
expiration of the trainee period. Under indirect supervision, the trainee must complete two
monitored activities a week. Monitored activities may be executed by correspondence,
telephone, or other telephonic devices, and include, but are not limited to, evaluation of
audiograms, written reports, and contracts. The time spent in supervision must be recorded
and the record retained by the supervisor.

Sec. 64.

Minnesota Statutes 2022, section 153A.14, subdivision 4b, is amended to read:

Subd. 4b.

new text begin Prescription new text end hearing testing protocol.

A dispenser when conducting a hearing
test for the purpose of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing must:

(1) comply with the United States Food and Drug Administration warning regarding
potential medical conditions required by Code of Federal Regulations, title 21, section
deleted text begin 801.420deleted text end new text begin 801.422new text end ;

(2) complete a case history of the client's hearing;

(3) inspect the client's ears with an otoscope; and

(4) conduct the following tests on both ears of the client and document the results, and
if for any reason one of the following tests cannot be performed pursuant to the United
States Food and Drug Administration guidelines, an audiologist shall evaluate the hearing
and the need for a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end :

(i) air conduction at 250, 500, 1,000, 2,000, 4,000, and 8,000 Hertz. When a difference
of 20 dB or more occurs between adjacent octave frequencies the interoctave frequency
must be tested;

(ii) bone conduction at 500, 1,000, 2,000, and 4,000 Hertz for any frequency where the
air conduction threshold is greater than 15 dB HL;

(iii) monaural word recognition (discrimination), with a minimum of 25 words presented
for each ear; and

(iv) loudness discomfort level, monaural, for setting a new text begin prescription new text end hearing deleted text begin instrument'sdeleted text end new text begin
aid'snew text end maximum power output; and

(5) include masking in all tests whenever necessary to ensure accurate results.

Sec. 65.

Minnesota Statutes 2022, section 153A.14, subdivision 4c, is amended to read:

Subd. 4c.

Reciprocity.

(a) A person who has dispensed new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end in another jurisdiction may dispensenew text begin prescriptionnew text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end as a trainee
under indirect supervision if the person:

(1) satisfies the provisions of subdivision 4a, paragraph (a);

(2) submits a signed and dated affidavit stating that the applicant is not the subject of a
disciplinary action or past disciplinary action in this or another jurisdiction and is not
disqualified on the basis of section 153A.15, subdivision 1; and

(3) provides a copy of a current credential as a hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser held in
the District of Columbia or a state or territory of the United States.

(b) A person becoming a trainee under this subdivision who fails to take and pass the
practical examination described in subdivision 2h, paragraph (a), clause (2), when next
offered must cease dispensing new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end unless under direct
supervision.

Sec. 66.

Minnesota Statutes 2022, section 153A.14, subdivision 4e, is amended to read:

Subd. 4e.

new text begin Prescription new text end hearing aids; enforcement.

Costs incurred by the Minnesota
Department of Health for conducting investigations of unlicensed new text begin prescription new text end hearing aid
deleted text begin dispensersdeleted text end new text begin dispensingnew text end shall be apportioned between all licensed or credentialed professions
that dispense new text begin prescription new text end hearing aids.

Sec. 67.

Minnesota Statutes 2022, section 153A.14, subdivision 6, is amended to read:

Subd. 6.

new text begin Prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end to comply with federal and state
requirements.

The commissioner shall ensure that new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end
are dispensed in compliance with state requirements and the requirements of the United
States Food and Drug Administration. Failure to comply with state or federal regulations
may be grounds for enforcement actions under section 153A.15, subdivision 2.

Sec. 68.

Minnesota Statutes 2022, section 153A.14, subdivision 9, is amended to read:

Subd. 9.

Consumer rights.

A hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser shall comply with the
requirements of sections 148.5195, subdivision 3, clause (20); 148.5197; and 148.5198.

Sec. 69.

Minnesota Statutes 2022, section 153A.14, subdivision 11, is amended to read:

Subd. 11.

Requirement to maintain current information.

A dispenser must notify the
commissioner in writing within 30 days of the occurrence of any of the following:

(1) a change of name, address, home or business telephone number, or business name;

(2) the occurrence of conduct prohibited by section 153A.15;

(3) a settlement, conciliation court judgment, or award based on negligence, intentional
acts, or contractual violations committed in the dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end by the dispenser; and

(4) the cessation of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing activities as an
individual or a business.

Sec. 70.

Minnesota Statutes 2022, section 153A.14, is amended by adding a subdivision
to read:

new text begin Subd. 12. new text end

new text begin Over-the-counter hearing aids. new text end

new text begin Nothing in this chapter shall preclude certified
hearing aid dispensers from dispensing or selling over-the-counter hearing aids.
new text end

Sec. 71.

Minnesota Statutes 2022, section 153A.15, subdivision 1, is amended to read:

Subdivision 1.

Prohibited acts.

The commissioner may take enforcement action as
provided under subdivision 2 against a dispenser of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end
for the following acts and conduct:

(1) dispensing a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end to a minor person 18 years or younger
unless evaluated by an audiologist for hearing evaluation and new text begin prescription new text end hearing aid
evaluation;

(2) being disciplined through a revocation, suspension, restriction, or limitation by
another state for conduct subject to action under this chapter;

(3) presenting advertising that is false or misleading;

(4) providing the commissioner with false or misleading statements of credentials,
training, or experience;

(5) engaging in conduct likely to deceive, defraud, or harm the public; or demonstrating
a willful or careless disregard for the health, welfare, or safety of a consumer;

(6) splitting fees or promising to pay a portion of a fee to any other professional other
than a fee for services rendered by the other professional to the client;

(7) engaging in abusive or fraudulent billing practices, including violations of federal
Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical
assistance laws;

(8) obtaining money, property, or services from a consumer through the use of undue
influence, high pressure sales tactics, harassment, duress, deception, or fraud;

(9) performing the services of a certified hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser in an
incompetent or negligent manner;

(10) failing to comply with the requirements of this chapter as an employer, supervisor,
or trainee;

(11) failing to provide information in a timely manner in response to a request by the
commissioner, commissioner's designee, or the advisory council;

(12) being convicted within the past five years of violating any laws of the United States,
or any state or territory of the United States, and the violation is a felony, gross misdemeanor,
or misdemeanor, an essential element of which relates to new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin
aidnew text end dispensing, except as provided in chapter 364;

(13) failing to cooperate with the commissioner, the commissioner's designee, or the
advisory council in any investigation;

(14) failing to perform new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing with reasonable
judgment, skill, or safety due to the use of alcohol or drugs, or other physical or mental
impairment;

(15) failing to fully disclose actions taken against the applicant or the applicant's legal
authorization to dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end in this or another state;

(16) violating a state or federal court order or judgment, including a conciliation court
judgment, relating to the activities of the applicant in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensing;

(17) having been or being disciplined by the commissioner of the Department of Health,
or other authority, in this or another jurisdiction, if any of the grounds for the discipline are
the same or substantially equivalent to those in sections 153A.13 to 153A.18;

(18) misrepresenting the purpose of hearing tests, or in any way communicating that the
hearing test or hearing test protocol required by section 153A.14, subdivision 4b, is a medical
evaluation, a diagnostic hearing evaluation conducted by an audiologist, or is other than a
test to select a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end , except that the hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispenser can determine the need for or recommend the consumer obtain a medical evaluation
consistent with requirements of the United States Food and Drug Administration;

(19) violating any of the provisions of sections 148.5195, subdivision 3, clause (20);
148.5197; 148.5198; and 153A.13 to 153A.18; and

(20) aiding or abetting another person in violating any of the provisions of sections
148.5195, subdivision 3, clause (20); 148.5197; 148.5198; and 153A.13 to 153A.18.

Sec. 72.

Minnesota Statutes 2022, section 153A.15, subdivision 2, is amended to read:

Subd. 2.

Enforcement actions.

When the commissioner finds that a dispenser of
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end has violated one or more provisions of this chapter,
the commissioner may do one or more of the following:

(1) deny or reject the application for a certificate;

(2) revoke the certificate;

(3) suspend the certificate;

(4) impose, for each violation, a civil penalty that deprives the dispenser of any economic
advantage gained by the violation and that reimburses the Department of Health for costs
of the investigation and proceeding resulting in disciplinary action, including the amount
paid for services of the Office of Administrative Hearings, the amount paid for services of
the Office of the Attorney General, attorney fees, court reporters, witnesses, reproduction
of records, advisory council members' per diem compensation, department staff time, and
expenses incurred by advisory council members and department staff;

(5) censure or reprimand the dispenser;

(6) revoke or suspend the right to supervise trainees;

(7) revoke or suspend the right to be a trainee;

(8) impose a civil penalty not to exceed $10,000 for each separate violation; or

(9) any other action reasonably justified by the individual case.

Sec. 73.

Minnesota Statutes 2022, section 153A.15, subdivision 4, is amended to read:

Subd. 4.

Penalties.

Except as provided in section 153A.14, subdivision 4, a person
violating this chapter is guilty of a misdemeanor. The commissioner may impose an automatic
civil penalty equal to one-fourth the renewal fee on each hearing deleted text begin instrument sellerdeleted text end new text begin aid
dispensernew text end who fails to renew the certificate required in section 153A.14 by the renewal
deadline.

Sec. 74.

Minnesota Statutes 2022, section 153A.17, is amended to read:

153A.17 EXPENSES; FEES.

(a) The expenses for administering the certification requirements, including the complaint
handling system for hearing aid dispensers in sections 153A.14 and 153A.15, and the
Consumer Information Center under section 153A.18, must be paid from initial application
and examination fees, renewal fees, penalties, and fines. The commissioner shall only use
fees collected under this section for the purposes of administering this chapter. The legislature
must not transfer money generated by these fees from the state government special revenue
fund to the general fund. deleted text begin Surcharges collected by the commissioner of health under section
16E.22 are not subject to this paragraph.
deleted text end

(b) The fees are as follows:

(1) the initial certification application fee is $772.50;

(2) the annual renewal certification application fee is $750;

(3) the initial examination fee for the practical portion is $1,200, and $600 for each time
it is taken, thereafter; for individuals meeting the requirements of section 148.515, subdivision
2, the fee for the practical portion of the new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing
examination is $600 each time it is taken;

(4) the trainee application fee is $230;

(5) the penalty fee for late submission of a renewal application is $260; and

(6) the fee for verification of certification to other jurisdictions or entities is $25.

(c) The commissioner may prorate the certification fee for new applicants based on the
number of quarters remaining in the annual certification period.

(d) All fees are nonrefundable. All fees, penalties, and fines received must be deposited
in the state government special revenue fund.

(e) Hearing instrument dispensers who were certified before January 1, 2018, shall pay
a onetime surcharge of $22.50 to renew their certification when it expires after October 31,
2020. The surcharge shall cover the commissioner's costs associated with criminal
background checks.

Sec. 75.

Minnesota Statutes 2022, section 153A.175, is amended to read:

153A.175 PENALTY FEES.

(a) The penalty fee for holding oneself out as a hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser without
a current certificate after the credential has expired and before it is renewed is one-half the
amount of the certificate renewal fee for any part of the first day, plus one-half the certificate
renewal fee for any part of any subsequent days up to 30 days.

(b) The penalty fee for applicants who hold themselves out as hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensers after expiration of the trainee period and before being issued a certificate is
one-half the amount of the certificate application fee for any part of the first day, plus
one-half the certificate application fee for any part of any subsequent days up to 30 days.
This paragraph does not apply to applicants not qualifying for a certificate who hold
themselves out as hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers.

(c) The penalty fee for practicing new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing and
failing to submit a continuing education report by the due date with the correct number or
type of hours in the correct time period is $200 plus $200 for each missing clock hour.
"Missing" means not obtained between the effective and expiration dates of the certificate,
the one-month period following the certificate expiration date, or the 30 days following
notice of a penalty fee for failing to report all continuing education hours. The certificate
holder must obtain the missing number of continuing education hours by the next reporting
due date.

(d) Civil penalties and discipline incurred by certificate holders prior to August 1, 2005,
for conduct described in paragraph (a), (b), or (c) shall be recorded as nondisciplinary penalty
fees. Payment of a penalty fee does not preclude any disciplinary action reasonably justified
by the individual case.

Sec. 76.

Minnesota Statutes 2022, section 153A.18, is amended to read:

153A.18 CONSUMER INFORMATION CENTER.

The commissioner shall establish a Consumer Information Center to assist actual and
potential purchasers of new text begin prescription new text end hearing aids by providing them with information
regarding new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end sales. The Consumer Information Center shall
disseminate information about consumers' legal rights related to new text begin prescription new text end hearing
deleted text begin instrumentdeleted text end new text begin aidnew text end sales, provide information relating to complaints about dispensers of
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end , and provide information about outreach and advocacy
services for consumers of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end . In establishing the center
and developing the information, the commissioner shall consult with representatives of
hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers, audiologists, physicians, and consumers.

Sec. 77.

Minnesota Statutes 2022, section 153A.20, is amended to read:

153A.20 HEARING deleted text begin INSTRUMENTdeleted text end new text begin AIDnew text end DISPENSER ADVISORY COUNCIL.

Subdivision 1.

Membership.

(a) The commissioner shall appoint seven persons to a
Hearing deleted text begin Instrumentdeleted text end new text begin Aidnew text end Dispenser Advisory Council.

(b) The seven persons must include:

(1) three public members, as defined in section 214.02. At least one of the public members
shall be a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end user and one of the public members shall be
either a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end user or an advocate of one;

(2) three hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers certified under sections 153A.14 to 153A.20,
each of whom is currently, and has been for the five years immediately preceding their
appointment, engaged in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing in Minnesota and
who represent the occupation of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing and who
are not audiologists; and

(3) one audiologist licensed as an audiologist under chapter 148 who dispenses
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end , recommended by a professional association
representing audiologists and speech-language pathologists.

(c) The factors the commissioner may consider when appointing advisory council
members include, but are not limited to, professional affiliation, geographical location, and
type of practice.

(d) No two members of the advisory council shall be employees of, or have binding
contracts requiring sales exclusively for, the same new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
manufacturer or the same employer.

Subd. 2.

Organization.

The advisory council shall be organized and administered
according to section 15.059. The council may form committees to carry out its duties.

Subd. 3.

Duties.

At the commissioner's request, the advisory council shall:

(1) advise the commissioner regarding hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser certification
standards;

(2) provide for distribution of information regarding hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser
certification standards;

(3) review investigation summaries of competency violations and make recommendations
to the commissioner as to whether the allegations of incompetency are substantiated; and

(4) perform other duties as directed by the commissioner.

Sec. 78.

Minnesota Statutes 2022, section 256B.434, subdivision 4f, is amended to read:

Subd. 4f.

Construction project rate adjustments effective October 1, 2006.

(a)
Effective October 1, 2006, facilities reimbursed under this section may receive a property
rate adjustment for construction projects exceeding the threshold in section 256B.431,
subdivision 16, and below the threshold in section 144A.071, subdivision 2, deleted text begin clause (a)deleted text end new text begin
paragraph (c), clause (1)new text end . For these projects, capital assets purchased shall be counted as
construction project costs for a rate adjustment request made by a facility if they are: (1)
purchased within 24 months of the completion of the construction project; (2) purchased
after the completion date of any prior construction project; and (3) are not purchased prior
to July 14, 2005. Except as otherwise provided in this subdivision, the definitions, rate
calculation methods, and principles in sections 144A.071 and 256B.431 and Minnesota
Rules, parts 9549.0010 to 9549.0080, shall be used to calculate rate adjustments for allowable
construction projects under this subdivision and section 144A.073. Facilities completing
construction projects between October 1, 2005, and October 1, 2006, are eligible to have a
property rate adjustment effective October 1, 2006. Facilities completing projects after
October 1, 2006, are eligible for a property rate adjustment effective on the first day of the
month following the completion date. Facilities completing projects after January 1, 2018,
are eligible for a property rate adjustment effective on the first day of the month of January
or July, whichever occurs immediately following the completion date.

(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under
section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a
construction project on or after October 1, 2004, and do not have a contract under subdivision
3 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431,
subdivision 10, through September 30, 2006. If the request results in the commissioner
determining a rate adjustment is allowable, the rate adjustment is effective on the first of
the month following project completion. These facilities shall be allowed to accumulate
construction project costs for the period October 1, 2004, to September 30, 2006.

(c) Facilities shall be allowed construction project rate adjustments no sooner than 12
months after completing a previous construction project. Facilities must request the rate
adjustment according to section 256B.431, subdivision 10.

(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060,
subpart 11. For rate calculations under this section, the number of licensed beds in the
nursing facility shall be the number existing after the construction project is completed and
the number of days in the nursing facility's reporting period shall be 365.

(e) The value of assets to be recognized for a total replacement project as defined in
section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value
of assets to be recognized for all other projects shall be computed as described in clause
(2).

(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the
maximum amount of assets allowable in a facility's property rate calculation. If a facility's
current request for a rate adjustment results from the completion of a construction project
that was previously approved under section 144A.073, the assets to be used in the rate
calculation cannot exceed the lesser of the amount determined under sections 144A.071,
subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction
project. A current request that is not the result of a project under section 144A.073 cannot
exceed the limit under section 144A.071, subdivision 2, paragraph deleted text begin (a)deleted text end new text begin (c), clause (1)new text end .
Applicable credits must be deducted from the cost of the construction project.

(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be
used to compute the maximum amount of assets allowable in a facility's property rate
calculation.

(ii) The value of a facility's assets to be compared to the amount in item (i) begins with
the total appraised value from the last rate notice a facility received when its rates were set
under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value
shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each
rate year the facility received an inflation factor on its property-related rate when its rates
were set under this section. The value of assets listed as previous capital additions, capital
additions, and special projects on the facility's base year rate notice and the value of assets
related to a construction project for which the facility received a rate adjustment when its
rates were determined under this section shall be added to the indexed appraised value.

(iii) The maximum amount of assets to be recognized in computing a facility's rate
adjustment after a project is completed is the lesser of the aggregate replacement-cost-new
limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the
construction project.

(iv) If a facility's current request for a rate adjustment results from the completion of a
construction project that was previously approved under section 144A.073, the assets to be
added to the rate calculation cannot exceed the lesser of the amount determined under
sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable
costs of the construction project. A current request that is not the result of a project under
section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2,
paragraph deleted text begin (a)deleted text end new text begin (c), clause (1)new text end . Assets disposed of as a result of a construction project and
applicable credits must be deducted from the cost of the construction project.

(f) For construction projects approved under section 144A.073, allowable debt may
never exceed the lesser of the cost of the assets purchased, the threshold limit in section
144A.071, subdivision 2, or the replacement-cost-new limit less previously existing capital
debt.

(g) For construction projects that were not approved under section 144A.073, allowable
debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such
construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously
existing capital debt. Amounts of debt taken out that exceed the costs of a construction
project shall not be allowed regardless of the use of the funds.

For all construction projects being recognized, interest expense and average debt shall
be computed based on the first 12 months following project completion. "Previously existing
capital debt" means capital debt recognized on the last rate determined under section
256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt
recognized for a construction project for which the facility received a rate adjustment when
its rates were determined under this section.

For a total replacement project as defined in section 256B.431, subdivision 17d, the
value of previously existing capital debt shall be zero.

(h) In addition to the interest expense allowed from the application of paragraph (f), the
amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and
(3), will be added to interest expense.

(i) The equity portion of the construction project shall be computed as the allowable
assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be
multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added.
This sum must be divided by 95 percent of capacity days to compute the construction project
rate adjustment.

(j) For projects that are not a total replacement of a nursing facility, the amount in
paragraph (i) is adjusted for nonreimbursable areas and then added to the current property
payment rate of the facility.

(k) For projects that are a total replacement of a nursing facility, the amount in paragraph
(i) becomes the new property payment rate after being adjusted for nonreimbursable areas.
Any amounts existing in a facility's rate before the effective date of the construction project
for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements
under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431,
subdivision 19, shall be removed from the facility's rates.

(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060,
subpart 10, as the result of construction projects under this section. Allowable equipment
shall be included in the construction project costs.

(m) Capital assets purchased after the completion date of a construction project shall be
counted as construction project costs for any future rate adjustment request made by a facility
under section 144A.071, subdivision 2, deleted text begin clause (a)deleted text end new text begin paragraph (c), clause (1)new text end , if they are
purchased within 24 months of the completion of the future construction project.

(n) In subsequent rate years, the property payment rate for a facility that results from
the application of this subdivision shall be the amount inflated in subdivision 4.

(o) Construction projects are eligible for an equity incentive under section 256B.431,
subdivision 16. When computing the equity incentive for a construction project under this
subdivision, only the allowable costs and allowable debt related to the construction project
shall be used. The equity incentive shall not be a part of the property payment rate and not
inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing
facilities reimbursed under this section shall be allowed for a duration determined under
section 256B.431, subdivision 16, paragraph (c).

Sec. 79. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the term "cancer surveillance system" to "cancer
reporting system" wherever it appears in the next edition of Minnesota Statutes and Minnesota
Rules and in the online publication.
new text end

Sec. 80. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Rules, parts 4640.1500; 4640.1600; 4640.1700; 4640.1800; 4640.1900;
4640.2000; 4640.2100; 4640.2200; 4640.2300; 4640.2400; 4640.2500; 4640.2600;
4640.2700; 4640.2800; 4640.2900; 4640.3000; 4640.3100; 4640.3200; 4640.3300;
4640.3400; 4640.3500; 4640.3600; 4640.3700; 4640.3800; 4640.3900; 4640.4000;
4640.4100; 4640.4200; 4640.4300; 4640.6100; 4640.6200; 4640.6300; 4640.6400;
4645.0300; 4645.0400; 4645.0500; 4645.0600; 4645.0700; 4645.0800; 4645.0900;
4645.1000; 4645.1100; 4645.1200; 4645.1300; 4645.1400; 4645.1500; 4645.1600;
4645.1700; 4645.1800; 4645.1900; 4645.2000; 4645.2100; 4645.2200; 4645.2300;
4645.2400; 4645.2500; 4645.2600; 4645.2700; 4645.2800; 4645.2900; 4645.3000;
4645.3100; 4645.3200; 4645.3300; 4645.3400; 4645.3500; 4645.3600; 4645.3700;
4645.3800; 4645.3805; 4645.3900; 4645.4000; 4645.4100; 4645.4200; 4645.4300;
4645.4400; 4645.4500; 4645.4600; 4645.4700; 4645.4800; 4645.4900; 4645.5100; and
4645.5200, new text end new text begin are repealed effective January 1, 2024.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2022, sections 144.9505, subdivision 3; and 153A.14, subdivision
5, new text end new text begin are repealed.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES POLICY

Section 1.

Minnesota Statutes 2022, section 245.4661, subdivision 9, is amended to read:

Subd. 9.

Services and programs.

(a) The following three distinct grant programs are
funded under this section:

(1) mental health crisis services;

(2) housing with supports for adults with serious mental illness; and

(3) projects for assistance in transitioning from homelessness (PATH program).

(b) In addition, the following are eligible for grant funds:

(1) community education and prevention;

(2) client outreach;

(3) early identification and intervention;

(4) adult outpatient diagnostic assessment and psychological testing;

(5) peer support services;

(6) community support program services (CSP);

(7) adult residential crisis stabilization;

(8) supported employment;

(9) assertive community treatment (ACT);

(10) housing subsidies;

(11) basic living, social skills, and community intervention;

(12) emergency response services;

(13) adult outpatient psychotherapy;

(14) adult outpatient medication management;

(15) adult mobile crisis services;

(16) adult day treatment;

(17) partial hospitalization;

(18) adult residential treatment;

(19) adult mental health targeted case management;new text begin and
new text end

deleted text begin (20) intensive community rehabilitative services (ICRS); and
deleted text end

deleted text begin (21)deleted text end new text begin (20)new text end transportation.

Sec. 2.

Minnesota Statutes 2022, section 245.469, subdivision 3, is amended to read:

Subd. 3.

Mental health crisis services.

The commissioner of human services shall
increase access to mental health crisis services for children and adults. In order to increase
access, the commissioner must:

(1) develop a central phone number where calls can be routed to the appropriate crisis
services;

(2) provide telephone consultation 24 hours a day to mobile crisis teams who are serving
people with traumatic brain injury or intellectual disabilities who are experiencing a mental
health crisis;

(3) expand crisis services across the state, including rural areas of the state and examining
access per population;

(4) establish and implement state standardsnew text begin and requirementsnew text end for crisis servicesnew text begin as outlined
in section 256B.0624new text end ; and

(5) provide grants to adult mental health initiatives, counties, tribes, or community mental
health providers to establish new mental health crisis residential service capacity.

Priority will be given to regions that do not have a mental health crisis residential services
program, do not have an inpatient psychiatric unit within the region, do not have an inpatient
psychiatric unit within 90 miles, or have a demonstrated need based on the number of crisis
residential or intensive residential treatment beds available to meet the needs of the residents
in the region. At least 50 percent of the funds must be distributed to programs in rural
Minnesota. Grant funds may be used for start-up costs, including but not limited to
renovations, furnishings, and staff training. Grant applications shall provide details on how
the intended service will address identified needs and shall demonstrate collaboration with
crisis teams, other mental health providers, hospitals, and police.

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 [245.4903] CULTURAL AND ETHNIC MINORITY INFRASTRUCTURE
GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services shall establish a
cultural and ethnic minority infrastructure grant program to ensure that mental health and
substance use disorder treatment supports and services are culturally specific and culturally
responsive to meet the cultural needs of the communities served.
new text end

new text begin Subd. 2. new text end

new text begin Eligible applicants. new text end

new text begin An eligible applicant is a licensed entity or provider from
a cultural or ethnic minority population who:
new text end

new text begin (1) provides mental health or substance use disorder treatment services and supports to
individuals from cultural and ethnic minority populations, including individuals who are
lesbian, gay, bisexual, transgender, or queer and from cultural and ethnic minority
populations;
new text end

new text begin (2) provides or is qualified and has the capacity to provide clinical supervision and
support to members of culturally diverse and ethnic minority communities to qualify as
mental health and substance use disorder treatment providers; or
new text end

new text begin (3) has the capacity and experience to provide training for mental health and substance
use disorder treatment providers on cultural competency and cultural humility.
new text end

new text begin Subd. 2. new text end

new text begin Allowable grant activities. new text end

new text begin (a) The cultural and ethnic minority infrastructure
grant program grantees must engage in activities and provide supportive services to ensure
and increase equitable access to culturally specific and responsive care and to build
organizational and professional capacity for licensure and certification for the communities
served. Allowable grant activities include but are not limited to:
new text end

new text begin (1) workforce development activities focused on recruiting, supporting, training, and
supervision activities for mental health and substance use disorder practitioners and
professionals from diverse racial, cultural, and ethnic communities;
new text end

new text begin (2) supporting members of culturally diverse and ethnic minority communities to qualify
as mental health and substance use disorder professionals, practitioners, clinical supervisors,
recovery peer specialists, mental health certified peer specialists, and mental health certified
family peer specialists;
new text end

new text begin (3) culturally specific outreach, early intervention, trauma-informed services, and recovery
support in mental health and substance use disorder services;
new text end

new text begin (4) provision of trauma-informed, culturally responsive mental health and substance use
disorder supports and services for children and families, youth, or adults who are from
cultural and ethnic minority backgrounds and are uninsured or underinsured;
new text end

new text begin (5) mental health and substance use disorder service expansion and infrastructure
improvement activities, particularly in greater Minnesota;
new text end

new text begin (6) training for mental health and substance use disorder treatment providers on cultural
competency and cultural humility; and
new text end

new text begin (7) activities to increase the availability of culturally responsive mental health and
substance use disorder services for children and families, youth, or adults or to increase the
availability of substance use disorder services for individuals from cultural and ethnic
minorities in the state.
new text end

new text begin (b) The commissioner must assist grantees with meeting third-party credentialing
requirements, and grantees must obtain all available third-party reimbursement sources as
a condition of receiving grant funds. Grantees must serve individuals from cultural and
ethnic minority communities regardless of health coverage status or ability to pay.
new text end

new text begin Subd. 3. new text end

new text begin Data collection and outcomes. new text end

new text begin Grantees must provide regular data summaries
to the commissioner for purposes of evaluating the effectiveness of the cultural and ethnic
minority infrastructure grant program. The commissioner must use identified culturally
appropriate outcome measures instruments to evaluate outcomes and must evaluate program
activities by analyzing whether the program:
new text end

new text begin (1) increased access to culturally specific services for individuals from cultural and
ethnic minority communities across the state;
new text end

new text begin (2) increased the number of individuals from cultural and ethnic minority communities
served by grantees;
new text end

new text begin (3) increased cultural responsiveness and cultural competency of mental health and
substance use disorder treatment providers;
new text end

new text begin (4) increased the number of mental health and substance use disorder treatment providers
and clinical supervisors from cultural and ethnic minority communities;
new text end

new text begin (5) increased the number of mental health and substance use disorder treatment
organizations owned, managed, or led by individuals who are Black, Indigenous, or people
of color;
new text end

new text begin (6) reduced health disparities through improved clinical and functional outcomes for
those accessing services; and
new text end

new text begin (7) led to an overall increase in culturally specific mental health and substance use
disorder service availability.
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 [245.4906] MENTAL HEALTH CERTIFIED PEER SPECIALIST GRANT
PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The mental health certified peer specialist grant program
is established in the Department of Human Services to provide funding for training for
mental health certified peer specialists who provide services to support individuals with
lived experience of mental illness under section 256B.0615. Certified peer specialists provide
services to individuals who are receiving assertive community treatment or intensive
residential treatment services under section 256B.0622, adult rehabilitative mental health
services under section 256B.0623, or crisis response services under section 256B.0624.
Mental health certified peer specialist qualifications are defined in section 245I.04,
subdivision 10, and mental health certified peer specialists' scope of practice is defined in
section 245I.04, subdivision 11.
new text end

new text begin Subd. 2. new text end

new text begin Activities. new text end

new text begin Grant funding may be used to provide training for mental health
certified peer specialists as specified in section 256B.0615, subdivision 5.
new text end

new text begin Subd. 3. new text end

new text begin Outcomes. new text end

new text begin Evaluation includes the extent to which individuals receiving peer
services:
new text end

new text begin (1) experience progress on achieving treatment goals; and
new text end

new text begin (2) experience a reduction in hospital admissions.
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. 5.

new text begin [245.4907] MENTAL HEALTH CERTIFIED FAMILY PEER SPECIALIST
GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The mental health certified peer family specialist grant
program is established in the Department of Human Services to provide funding for training
for mental health certified peer family specialists who provide services to support individuals
with lived experience of mental illness under section 256B.0616. Certified family peer
specialists provide services to families who have a child with an emotional disturbance or
severe emotional disturbance under chapter 245. Certified family peer specialists provide
services to families whose children are receiving inpatient hospitalization under section
256B.0625, subdivision 1; partial hospitalization under Minnesota Rules, parts 9505.0370,
subpart 24, and 9505.0372, subpart 9; residential treatment under section 245.4882; children's
intensive behavioral health services under section 256B.0946; and day treatment, children's
therapeutic services and supports, or crisis response services under section 256B.0624.
Mental health certified family peer specialist qualifications are defined in section 245I.04,
subdivision 12, and mental health certified family peer specialists' scope of practice is
defined in section 245I.04, subdivision 13.
new text end

new text begin Subd. 2. new text end

new text begin Activities. new text end

new text begin Grant funding may be used to provide training for mental health
certified family peer specialists as specified in section 256B.0616, subdivision 5.
new text end

new text begin Subd. 3. new text end

new text begin Outcomes. new text end

new text begin Evaluation includes the extent to which individuals receiving family
peer services new text end new text begin :
new text end

new text begin (1) progress on achieving treatment goals; and
new text end

new text begin (2) experience a reduction in hospital admissions.
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 [245.991] PROJECTS FOR ASSISTANCE IN TRANSITION FROM
HOMELESSNESS PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The projects for assistance in transition from homelessness
program is established in the Department of Human Services to prevent or end homelessness
for people with serious mental illness or co-occurring substance use disorder and ensure
the commissioner may achieve the goals of the housing mission statement in section 245.461,
subdivision 4.
new text end

new text begin Subd. 2. new text end

new text begin Activities. new text end

new text begin All projects for assistance in transition from homelessness must
provide homeless outreach and case management services. Projects may provide clinical
assessment, habilitation and rehabilitation services, community mental health services,
substance use disorder treatment, housing transition and sustaining services, direct assistance
funding, and other activities as determined by the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin Program activities must be provided to people with serious mental
illness, or with co-occurring substance use disorder, who meet homeless criteria determined
by the commissioner. People receiving homeless outreach may be presumed eligible until
serious mental illness can be verified.
new text end

new text begin Subd. 4. new text end

new text begin Outcomes. new text end

new text begin Evaluation of each project includes the extent to which:
new text end

new text begin (1) grantees contact individuals through homeless outreach services;
new text end

new text begin (2) grantees enroll individuals in case management services;
new text end

new text begin (3) individuals access behavioral health services; and
new text end

new text begin (4) individuals transition from homelessness to housing.
new text end

new text begin Subd. 5. new text end

new text begin Federal aid or grants. new text end

new text begin The commissioner of human services must comply with
all conditions and requirements necessary to receive federal aid or grants with respect to
homeless services or programs as specified in section 245.70.
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. 7.

new text begin [245.992] HOUSING WITH SUPPORT FOR ADULTS WITH SERIOUS
MENTAL ILLNESS PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Creation. new text end

new text begin The housing with support for adults with serious mental illness
program is established in the Department of Human Services to prevent or end homelessness
for people with serious mental illness, increase the availability of housing with support, and
ensure the commissioner may achieve the goals of the housing mission statement in section
245.461, subdivision 4.
new text end

new text begin Subd. 2. new text end

new text begin Activities. new text end

new text begin The housing with support for adults with serious mental illness
program may provide a range of activities and supportive services to assure that people
obtain and retain permanent supportive housing. Program activities may include case
management, site-based housing services, housing transition and sustaining services, outreach
services, community support services, direct assistance funding, and other activities as
determined by the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin Subd. 4. new text end

new text begin Outcomes. new text end

new text begin Evaluation of program activities must utilize evidence-based
practices and must include the extent to which:
new text end

new text begin (1) grantees' housing and activities utilize evidence-based practices;
new text end

new text begin (2) individuals transition from homelessness to housing;
new text end

new text begin (3) individuals retain housing; and
new text end

new text begin (4) individuals are satisfied with their housing.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2022, section 256.478, is amended by adding a subdivision to
read:

new text begin Subd. 3. new text end

new text begin Authorized uses of grant funds. new text end

new text begin Grant funds may be used for but are not
limited to the following:
new text end

new text begin (1) increasing access to home and community-based services for an individual;
new text end

new text begin (2) improving caregiver-child relationships and aiding progress toward treatment goals;
and
new text end

new text begin (3) reducing emergency department visits.
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. 9.

Minnesota Statutes 2022, section 256.478, is amended by adding a subdivision to
read:

new text begin Subd. 4. new text end

new text begin Outcomes. new text end

new text begin Program evaluation is based on but not limited to the following
criteria:
new text end

new text begin (1) expediting discharges for individuals who no longer need hospital level of care;
new text end

new text begin (2) individuals obtaining and retaining housing;
new text end

new text begin (3) individuals maintaining community living by diverting admission to Anoka Metro
Regional Treatment Center and Forensic Mental Health Program;
new text end

new text begin (4) reducing recidivism rates of individuals returning to state institutions; and
new text end

new text begin (5) individuals' ability to live in the least restrictive community setting.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Minnesota Statutes 2022, section 256B.056, is amended by adding a subdivision
to read:

new text begin Subd. 5d. new text end

new text begin Medical assistance room and board rate. new text end

new text begin "Medical assistance room and
board rate" means an amount equal to 81 percent of the federal poverty guideline for a single
individual living alone in the community less the medical assistance personal needs allowance
under section 256B.35. The amount of the room and board rate, as defined in section 256I.03,
subdivision 2, that exceeds the medical assistance room and board rate is considered a
remedial care cost. A remedial care cost may be used to meet a spenddown obligation under
this section. The medical assistance room and board rate is to be adjusted on January 1 of
each year.
new text end

Sec. 11.

Minnesota Statutes 2022, section 256B.0622, subdivision 8, is amended to read:

Subd. 8.

Medical assistance payment for assertive community treatment and
intensive residential treatment services.

(a) Payment for intensive residential treatment
services and assertive community treatment in this section shall be based on one daily rate
per provider inclusive of the following services received by an eligible client in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.

(b) Except as indicated in paragraph (c), payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.

(c) The commissioner shall determine one rate for each provider that will bill medical
assistance for residential services under this section and one rate for each assertive community
treatment provider. If a single entity provides both services, one rate is established for the
entity's residential services and another rate for the entity's nonresidential services under
this section. A provider is not eligible for payment under this section without authorization
from the commissioner. The commissioner shall develop rates using the following criteria:

(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:

(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;

(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;

(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space;

(iv) assertive community treatment physical plant costs must be reimbursed as part of
the costs described in item (ii); and

(v) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;

(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and
consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;

(3) the number of service units;

(4) the degree to which clients will receive services other than services under this section;
and

(5) the costs of other services that will be separately reimbursed.

(d) The rate for intensive residential treatment services and assertive community treatment
must excludenew text begin the medical assistancenew text end room and boardnew text begin ratenew text end , as defined in section deleted text begin 256I.03,
subdivision 6deleted text end new text begin 256B.056, subdivision 5dnew text end , and services not covered under this section, such
as partial hospitalization, home care, and inpatient services.

(e) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.

(f) When services under this section are provided by an assertive community treatment
provider, case management functions must be an integral part of the team.

(g) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.

(h) The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph (c). The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (c).

(i) Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.

(j) A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.

Sec. 12.

Minnesota Statutes 2022, section 256B.0946, subdivision 6, is amended to read:

Subd. 6.

Excluded services.

(a) Services in clauses (1) to (7) are not covered under this
section and are not eligible for medical assistance payment as components of children's
intensive behavioral health services, but may be billed separately:

(1) inpatient psychiatric hospital treatment;

(2) mental health targeted case management;

(3) partial hospitalization;

(4) medication management;

(5) children's mental health day treatment services;

(6) crisis response services under section 256B.0624;

(7) transportation; and

(8) mental health certified family peer specialist services under section 256B.0616.

(b) Children receiving intensive behavioral health services are not eligible for medical
assistance reimbursement for the following services while receiving children's intensive
behavioral health services:

(1) psychotherapy and skills training components of children's therapeutic services and
supports under section 256B.0943;

(2) mental health behavioral aide services as defined in section 256B.0943, subdivision
1, paragraph (l);

(3) home and community-based waiver services;

(4) mental health residential treatment; and

(5)new text begin medical assistancenew text end room and board deleted text begin costsdeleted text end new text begin rate,new text end as defined in section deleted text begin 256I.03,
subdivision 6deleted text end new text begin 256B.056, subdivision 5dnew text end .

Sec. 13.

Minnesota Statutes 2022, section 256B.0947, subdivision 7a, is amended to read:

Subd. 7a.

Noncovered services.

(a) The rate for intensive rehabilitative mental health
services does not include medical assistance payment for services in clauses (1) to (7).
Services not covered under this paragraph may be billed separately:

(1) inpatient psychiatric hospital treatment;

(2) partial hospitalization;

(3) children's mental health day treatment services;

(4) physician services outside of care provided by a psychiatrist serving as a member of
the treatment team;

(5)new text begin medical assistancenew text end room and board deleted text begin costsdeleted text end new text begin ratenew text end , as defined in section deleted text begin 256I.03,
subdivision 6deleted text end new text begin 256B.056, subdivision 5dnew text end ;

(6) home and community-based waiver services; and

(7) other mental health services identified in the child's individualized education program.

(b) The following services are not covered under this section and are not eligible for
medical assistance payment while youth are receiving intensive rehabilitative mental health
services:

(1) mental health residential treatment; and

(2) mental health behavioral aide services, as defined in section 256B.0943, subdivision
1, paragraph (l).

Sec. 14.

Minnesota Statutes 2022, section 256D.02, is amended by adding a subdivision
to read:

new text begin Subd. 20. new text end

new text begin Date of application. new text end

new text begin "Date of application" has the meaning given in section
256P.01, subdivision 2b.
new text end

Sec. 15.

Minnesota Statutes 2022, section 256D.07, is amended to read:

256D.07 TIME OF PAYMENT OF ASSISTANCE.

An applicant for general assistance shall be deemed eligible if the application and the
verification of the statement on that application demonstrate that the applicant is within the
eligibility criteria established by sections 256D.01 to 256D.21 and any applicable rules of
the commissioner. Any person requesting general assistance shall be permitted by the county
agency to make an application for assistance as soon as administratively possible and in no
event later than the fourth day following the date on which assistance is first requested, and
no county agency shall require that a person requesting assistance appear at the offices of
the county agency more than once prior to the date on which the person is permitted to make
the application. deleted text begin The application shall be in writing in the manner and upon the form
prescribed by the commissioner and attested to by the oath of the applicant or in lieu thereof
shall contain the following declaration which shall be signed by the applicant: "I declare
that this application has been examined by me and to the best of my knowledge and belief
is a true and correct statement of every material point."deleted text end new text begin Applications must be submitted
according to section 256P.04, subdivision 1a.new text end On the date that general assistance is first
requested, the county agency shall inquire and determine whether the person requesting
assistance is in immediate need of food, shelter, clothing, assistance for necessary
transportation, or other emergency assistance pursuant to section 256D.06, subdivision 2.
A person in need of emergency assistance shall be granted emergency assistance immediately,
and necessary emergency assistance shall continue for up to 30 days following the date of
application. A determination of an applicant's eligibility for general assistance shall be made
by the county agency as soon as the required verifications are received by the county agency
and in no event later than 30 days following the date that the application is made. Any
verifications required of the applicant shall be reasonable, and the commissioner shall by
rule establish reasonable verifications. General assistance shall be granted to an eligible
applicant without the necessity of first securing action by the board of the county agency.
The first month's grant must be computed to cover the time period starting with the date deleted text begin a
signed application form is received by the county agencydeleted text end new text begin of application, as defined by
section 256P.01, subdivision 2b,new text end or from the date that the applicant meets all eligibility
factors, whichever occurs later.

If upon verification and due investigation it appears that the applicant provided false
information and the false information materially affected the applicant's eligibility for general
assistance or the amount of the applicant's general assistance grant, the county agency may
refer the matter to the county attorney. The county attorney may commence a criminal
prosecution or a civil action for the recovery of any general assistance wrongfully received,
or both.

Sec. 16.

Minnesota Statutes 2022, section 256I.03, subdivision 15, is amended to read:

Subd. 15.

Supportive housing.

"Supportive housing" means housing that is not
time-limited deleted text begin anddeleted text end new text begin ,new text end provides or coordinates services necessary for a resident to maintain
housing stabilitynew text begin , and is not licensed as an assisted living facility under chapter 144Gnew text end .

Sec. 17.

Minnesota Statutes 2022, section 256I.03, is amended by adding a subdivision
to read:

new text begin Subd. 16. new text end

new text begin Date of application. new text end

new text begin "Date of application" has the meaning given in section
256P.01, subdivision 2b.
new text end

Sec. 18.

Minnesota Statutes 2022, section 256I.04, subdivision 2, is amended to read:

Subd. 2.

Date of eligibility.

An individual who has met the eligibility requirements of
subdivision 1, shall have a housing support payment made on the individual's behalf from
the first day of the month deleted text begin in which a signeddeleted text end new text begin of the date ofnew text end application deleted text begin form is received by
a county agencydeleted text end ,new text begin as defined by section 256P.01, subdivision 2b,new text end or the first day of the month
in which all eligibility factors have been met, whichever is later.

Sec. 19.

Minnesota Statutes 2022, section 256I.06, subdivision 3, is amended to read:

Subd. 3.

Filing of application.

deleted text begin The county agency must immediately provide an
application form to any person requesting housing support. Application for housing support
must be in writing on a form prescribed by the commissioner.deleted text end new text begin Applications must be submitted
according to section 256P.04, subdivision 1a.new text end The county agency must determine an
applicant's eligibility for housing support as soon as the required verifications are received
by the county agency and within 30 days after a signed application is received by the county
agency for the aged or blind or within 60 days for people with a disability.

Sec. 20.

Minnesota Statutes 2022, section 256I.09, is amended to read:

256I.09 COMMUNITY LIVING INFRASTRUCTURE.

The commissioner shall award grants to agenciesnew text begin and multi-Tribal collaborativesnew text end through
an annual competitive process. Grants awarded under this section may be used for: (1)
outreach to locate and engage people who are homeless or residing in segregated settings
to screen for basic needs and assist with referral to community living resources; (2) building
capacity to provide technical assistance and consultation on housing and related support
service resources for persons with both disabilities and low income; or (3) streamlining the
administration and monitoring activities related to housing support funds. Agencies may
collaborate and submit a joint application for funding under this section.

Sec. 21.

Minnesota Statutes 2022, section 256J.08, subdivision 21, is amended to read:

Subd. 21.

Date of application.

"Date of application" deleted text begin means the date on which the county
agency receives an applicant's application as a signed written application, an application
submitted by telephone, or an application submitted through Internet telepresencedeleted text end new text begin has the
meaning given in section 256P.01, subdivision 2bnew text end .

Sec. 22.

Minnesota Statutes 2022, section 256J.09, subdivision 3, is amended to read:

Subd. 3.

Submitting application form.

(a) A county agency must offer, in person or
by mail, the application forms prescribed by the commissioner as soon as a person makes
a written or oral inquiry. At that time, the county agency must:

(1) inform the person that assistance begins on the date deleted text begin that thedeleted text end new text begin ofnew text end application deleted text begin is received
by the county agency either as a signed written application; an application submitted by
telephone; or an application submitted through Internet telepresence;deleted text end new text begin , as defined in section
256P.01, subdivision 2b,new text end or on the date that all eligibility criteria are met, whichever is later;

(2) inform a person that the person may submit the application by telephone or through
Internet telepresence;

(3) inform a person deleted text begin that when the person submits the application by telephone or through
Internet telepresence, the county agency must receive a signed written application within
30 days of the date that the person submitted the application by telephone or through Internet
telepresencedeleted text end new text begin of the application submission requirements in section 256P.04, subdivision
1anew text end ;

(4) inform the person that any delay in submitting the application will reduce the amount
of assistance paid for the month of application;

(5) inform a person that the person may submit the application before an interview;

(6) explain the information that will be verified during the application process by the
county agency as provided in section 256J.32;

(7) inform a person about the county agency's average application processing time and
explain how the application will be processed under subdivision 5;

(8) explain how to contact the county agency if a person's application information changes
and how to withdraw the application;

(9) inform a person that the next step in the application process is an interview and what
a person must do if the application is approved including, but not limited to, attending
orientation under section 256J.45 and complying with employment and training services
requirements in sections 256J.515 to 256J.57;

(10) inform the person that an interview must be conducted. The interview may be
conducted face-to-face in the county office or at a location mutually agreed upon, through
Internet telepresence, or by telephone;

(11) explain the child care and transportation services that are available under paragraph
(c) to enable caregivers to attend the interview, screening, and orientation; and

(12) identify any language barriers and arrange for translation assistance during
appointments, including, but not limited to, screening under subdivision 3a, orientation
under section 256J.45, and assessment under section 256J.521.

(b) Upon receipt of a signed application, the county agency must stamp the date of receipt
on the face of the application. The county agency must process the application within the
time period required under subdivision 5. An applicant may withdraw the application at
any time by giving written or oral notice to the county agency. The county agency must
issue a written notice confirming the withdrawal. The notice must inform the applicant of
the county agency's understanding that the applicant has withdrawn the application and no
longer wants to pursue it. When, within ten days of the date of the agency's notice, an
applicant informs a county agency, in writing, that the applicant does not wish to withdraw
the application, the county agency must reinstate the application and finish processing the
application.

(c) Upon a participant's request, the county agency must arrange for transportation and
child care or reimburse the participant for transportation and child care expenses necessary
to enable participants to attend the screening under subdivision 3a and orientation under
section 256J.45.

Sec. 23.

Minnesota Statutes 2022, section 256J.95, subdivision 5, is amended to read:

Subd. 5.

Submitting application form.

The eligibility date for the diversionary work
program begins on the date deleted text begin that the combineddeleted text end new text begin ofnew text end application deleted text begin form (CAF) is received by the
county agency either as a signed written application; an application submitted by telephone;
or an application submitted through Internet telepresence;deleted text end new text begin , as defined in section 256P.01,
subdivision 2b,new text end or on the date that diversionary work program eligibility criteria are met,
whichever is later. The county agency must inform an applicant deleted text begin that when the applicant
submits the application by telephone or through Internet telepresence, the county agency
must receive a signed written application within 30 days of the date that the applicant
submitted the application by telephone or through Internet telepresencedeleted text end new text begin of the application
submission requirements in section 256P.04, subdivision 1anew text end . The county agency must inform
the applicant that any delay in submitting the application will reduce the benefits paid for
the month of application. The county agency must inform a person that an application may
be submitted before the person has an interview appointment. Upon receipt of a signed
application, the county agency must stamp the date of receipt on the face of the application.
The applicant may withdraw the application at any time prior to approval by giving written
or oral notice to the county agency. The county agency must follow the notice requirements
in section 256J.09, subdivision 3, when issuing a notice confirming the withdrawal.

Sec. 24.

Minnesota Statutes 2022, section 256P.01, is amended by adding a subdivision
to read:

new text begin Subd. 2b. new text end

new text begin Date of application. new text end

new text begin "Date of application" means the date on which the agency
receives an applicant's application as a signed written application, an application submitted
by telephone, or an application submitted through Internet telepresence. The child care
assistance program under chapter 119B is exempt from this definition.
new text end

Sec. 25.

Minnesota Statutes 2022, section 256P.04, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Application submission. new text end

new text begin An agency must offer, in person or by mail, the
application forms prescribed by the commissioner as soon as a person makes a written or
oral inquiry about assistance. Applications must be received by the agency as a signed
written application, an application submitted by telephone, or an application submitted
through Internet telepresence. When a person submits an application by telephone or through
Internet telepresence, the agency must receive a signed written application within 30 days
of the date that the person submitted the application by telephone or through Internet
telepresence.
new text end

Sec. 26. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber the subdivisions in Minnesota Statutes, sections
256D.02 and 256I.03, in alphabetical order, excluding the first subdivision in each section,
and correct any cross-reference changes that result.
new text end

Sec. 27. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2022, section 256I.03, subdivision 6, new text end new text begin is repealed.
new text end

HF 2050

Bill Text Versions

Current Version - 1st Engrossment

ARTICLE 1

DEPARTMENT OF HEALTH POLICY

Section 1.

Subd. 5a.

Retrospective review.

Sec. 2.

Subdivision 1.

Establishment; membership.

Sec. 3.

144.2151 new text begin FETAL DEATH new text end RECORDnew text begin AND CERTIFICATEnew text end OF BIRTH RESULTING IN STILLBIRTH.

Subdivision 1.

deleted text begin Filingdeleted text end new text begin Registrationnew text end .

Subd. 2.

Information to parents.

Subd. 3.

deleted text begin Preparationdeleted text end new text begin Responsibilities of the state registrarnew text end .

Subd. 4.

deleted text begin Retroactive applicationdeleted text end new text begin Delayed registrationnew text end .

deleted text begin Subd. 5. deleted text end

deleted text begin Responsibilities of state registrar. deleted text end

Sec. 4.

144.222 new text begin FETAL DEATH new text end REPORTS deleted text begin OF FETAL OR INFANT DEATHdeleted text end new text begin AND REGISTRATIONnew text end .

Subdivision 1.

Fetal death report required.

deleted text begin Subd. 2. deleted text end

deleted text begin Sudden infant death. deleted text end

Sec. 5.

new text begin Subd. 2a. new text end

new text begin Connector. new text end

Sec. 6.

new text begin Subd. 3a. new text end

new text begin Galvanized requiring replacement. new text end

Sec. 7.

new text begin Subd. 3b. new text end

new text begin Galvanized service line. new text end

Sec. 8.

new text begin Subd. 3c. new text end

new text begin Lead connector. new text end

Sec. 9.

new text begin Subd. 3d. new text end

new text begin Lead service line. new text end

Sec. 10.

new text begin Subd. 3e. new text end

new text begin Lead status unknown service line or unknown service line. new text end

Sec. 11.

new text begin Subd. 3f. new text end

new text begin Nonlead service line. new text end

Sec. 12.

new text begin Subd. 4a. new text end

new text begin Service line. new text end

Sec. 13.

new text begin [144.3853] CLASSIFICATION OF SERVICE LINES. new text end

new text begin Subdivision 1. new text end

new text begin Classification of lead status of service line. new text end

new text begin Subd. 2. new text end

new text begin Lead connector. new text end

new text begin Subd. 3. new text end

new text begin Galvanized service line. new text end

Sec. 14.

Subd. 3.

Standards for licensure.

new text begin EFFECTIVE DATE. new text end

Sec. 15.

Subdivision 1.

Request for variance or waiver.

new text begin EFFECTIVE DATE. new text end

Sec. 16.

Subd. 2.

Criteria for evaluation.

new text begin EFFECTIVE DATE. new text end

Sec. 17.

Subd. 4.

Effect of alternative measures or conditions.

new text begin EFFECTIVE DATE. new text end

Sec. 18.

144.69 CLASSIFICATION OF DATA ON INDIVIDUALS.

new text begin Subdivision 1. new text end

144.2151 new text begin FETAL DEATH new text end RECORDnew text begin AND CERTIFICATEnew text end OF BIRTH
RESULTING IN STILLBIRTH.

144.222 new text begin FETAL DEATH new text end REPORTS deleted text begin OF FETAL OR INFANT DEATHdeleted text end new text begin AND
REGISTRATIONnew text end .

new text begin [144.3853] CLASSIFICATION OF SERVICE LINES.
new text end

new text begin Transfers of information to state cancer registries and federal government
agencies. new text end