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HF 2234

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 03/09/2023 03:53pm

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

Bill Text Versions

Engrossments
Introduction Posted on 02/27/2023
1st Engrossment Posted on 03/06/2023

Current Version - 1st Engrossment

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A bill for an act
relating to human services; establishing a home and community-based services
systemic critical incident review team; clarifying adult foster care and community
residential setting licensing provisions; modifying substance use disorder treatment
requirements; extending certain councils and committees; clarifying
provider-controlled and own-home settings; making technical and conforming
changes; clarifying effective dates; repealing obsolete language related to chemical
health pilot program; amending Minnesota Statutes 2022, sections 245.462,
subdivisions 3, 12; 245.4711, subdivisions 3, 4; 245.477; 245.4835, subdivision
2; 245.4871, subdivisions 3, 19; 245.4873, subdivision 4; 245.4881, subdivisions
3, 4; 245.4885, subdivision 1; 245.4887; 245A.03, subdivision 7; 245A.11,
subdivision 7; 245A.16, subdivision 1; 245D.03, subdivision 1; 246.0135;
254A.035, subdivision 2; 254B.05, subdivisions 1a, 5; 256.01, by adding a
subdivision; 256B.0911, subdivision 23; 256B.092, subdivision 10; 256B.093,
subdivision 1; 256B.492; 256B.493, subdivisions 2a, 4; 256S.202, subdivision 1;
524.5-104; 524.5-313; Laws 2021, First Special Session chapter 7, article 2, section
17; article 6, section 12; article 11, section 18; article 13, section 43; Laws 2022,
chapter 98, article 4, section 37; repealing Minnesota Statutes 2022, sections
254B.13, subdivisions 1, 2, 2a, 4, 5, 6, 7, 8; 254B.16; 256.041, subdivision 10;
256B.49, subdivision 23; 260.835, subdivision 2.

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

Section 1.

Minnesota Statutes 2022, section 245.462, subdivision 3, is amended to read:


Subd. 3.

Case management services.

"Case management services" means activities
that are coordinated with the community support services program as defined in subdivision
6 and are designed to help adults with serious and persistent mental illness in gaining access
to needed medical, social, educational, vocational, and other necessary services as they
relate to the client's mental health needs. Case management services include developing a
functional assessment, an individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end, referring
and assisting the person to obtain needed mental health and other services, ensuring
coordination of services, and monitoring the delivery of services.

Sec. 2.

Minnesota Statutes 2022, section 245.462, subdivision 12, is amended to read:


Subd. 12.

Individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end.

"Individual
deleted text begin assessment summarydeleted text endnew text begin community support plannew text end" means a written plan developed by a case
manager on the basis of a diagnostic assessment and functional assessment. The plan
identifies specific services needed by an adult with serious and persistent mental illness to
develop independence or improved functioning in daily living, health and medication
management, social functioning, interpersonal relationships, financial management, housing,
transportation, and employment.

Sec. 3.

Minnesota Statutes 2022, section 245.4711, subdivision 3, is amended to read:


Subd. 3.

Duties of case manager.

Upon a determination of eligibility for case
management services, and if the adult consents to the services, the case manager shall
complete a written functional assessment according to section 245.462, subdivision 11a.
The case manager shall develop an individual deleted text beginassessment summarydeleted text endnew text begin community support
plan
new text end for the adult according to subdivision 4, paragraph (a), review the adult's progress, and
monitor the provision of services. If services are to be provided in a host county that is not
the county of financial responsibility, the case manager shall consult with the host county
and obtain a letter demonstrating the concurrence of the host county regarding the provision
of services.

Sec. 4.

Minnesota Statutes 2022, section 245.4711, subdivision 4, is amended to read:


Subd. 4.

Individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end.

(a) The case
manager must develop an individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end for each
adult that incorporates the client's individual treatment plan. The individual treatment plan
may not be a substitute for the development of an individual deleted text beginassessment summarydeleted text endnew text begin community
support plan
new text end. The individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end must be developed
within 30 days of client intake and reviewed at least every 180 days after it is developed,
unless the case manager receives a written request from the client or the client's family for
a review of the plan every 90 days after it is developed. The case manager is responsible
for developing the individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end based on a
diagnostic assessment and a functional assessment and for implementing and monitoring
the delivery of services according to the individual deleted text beginassessment summarydeleted text endnew text begin community support
plan
new text end. To the extent possible, the adult with serious and persistent mental illness, the person's
family, advocates, service providers, and significant others must be involved in all phases
of development and implementation of the individual deleted text beginor family assessment summarydeleted text endnew text begin
community support plan
new text end.

(b) The client's individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end must state:

(1) the goals of each service;

(2) the activities for accomplishing each goal;

(3) a schedule for each activity; and

(4) the frequency of face-to-face contacts by the case manager, as appropriate to client
need and the implementation of the individual deleted text beginassessment summarydeleted text endnew text begin community support
plan
new text end.

Sec. 5.

Minnesota Statutes 2022, section 245.477, is amended to read:


245.477 APPEALS.

Any adult who requests mental health services under sections 245.461 to 245.486 must
be advised of services available and the right to appeal at the time of the request and each
time the individual deleted text beginassessment summarydeleted text endnew text begin community support plannew text end or individual treatment
plan is reviewed. Any adult whose request for mental health services under sections 245.461
to 245.486 is denied, not acted upon with reasonable promptness, or whose services are
suspended, reduced, or terminated by action or inaction for which the county board is
responsible under sections 245.461 to 245.486 may contest that action or inaction before
the state agency as specified in section 256.045. The commissioner shall monitor the nature
and frequency of administrative appeals under this section.

Sec. 6.

Minnesota Statutes 2022, section 245.4835, subdivision 2, is amended to read:


Subd. 2.

Failure to maintain expenditures.

(a) If a county does not comply with
subdivision 1, the commissioner shall require the county to develop a corrective action plan
according to a format and timeline established by the commissioner. If the commissioner
determines that a county has not developed an acceptable corrective action plan within the
required timeline, or that the county is not in compliance with an approved corrective action
plan, the protections provided to that county under section 245.485 do not apply.

(b) The commissioner shall consider the following factors to determine whether to
approve a county's corrective action plan:

(1) the degree to which a county is maximizing revenues for mental health services from
noncounty sources;

(2) the degree to which a county is expanding use of alternative services that meet mental
health needs, but do not count as mental health services within existing reporting systems.
If approved by the commissioner, the alternative services must be included in the county's
base as well as subsequent years. The commissioner's approval for alternative services must
be based on the following criteria:

(i) the service must be provided to children with emotional disturbance or adults with
mental illness;

(ii) the services must be based on an individual treatment plan or individual deleted text beginassessment
summary
deleted text endnew text begin community support plannew text end as defined in the Comprehensive Mental Health Act;
and

(iii) the services must be supervised by a mental health professional and provided by
staff who meet the staff qualifications defined in sections 256B.0943, subdivision 7, and
256B.0623, subdivision 5.

(c) Additional county expenditures to make up for the prior year's underspending may
be spread out over a two-year period.

Sec. 7.

Minnesota Statutes 2022, section 245.4871, subdivision 3, is amended to read:


Subd. 3.

Case management services.

"Case management services" means activities
that are coordinated with the family community support services and are designed to help
the child with severe emotional disturbance and the child's family obtain needed mental
health services, social services, educational services, health services, vocational services,
recreational services, and related services in the areas of volunteer services, advocacy,
transportation, and legal services. Case management services include assisting in obtaining
a comprehensive diagnostic assessment, developing an individual family deleted text beginassessment summarydeleted text endnew text begin
community support plan
new text end, and assisting the child and the child's family in obtaining needed
services by coordination with other agencies and assuring continuity of care. Case managers
must assess and reassess the delivery, appropriateness, and effectiveness of services over
time.

Sec. 8.

Minnesota Statutes 2022, section 245.4871, subdivision 19, is amended to read:


Subd. 19.

Individual family deleted text beginassessment summarydeleted text endnew text begin community support
plan
new text end.

"Individual family deleted text beginassessment summarydeleted text endnew text begin community support plannew text end" means a written
plan developed by a case manager in conjunction with the family and the child with severe
emotional disturbance on the basis of a diagnostic assessment and a functional assessment.
The plan identifies specific services needed by a child and the child's family to:

(1) treat the symptoms and dysfunctions determined in the diagnostic assessment;

(2) relieve conditions leading to emotional disturbance and improve the personal
well-being of the child;

(3) improve family functioning;

(4) enhance daily living skills;

(5) improve functioning in education and recreation settings;

(6) improve interpersonal and family relationships;

(7) enhance vocational development; and

(8) assist in obtaining transportation, housing, health services, and employment.

Sec. 9.

Minnesota Statutes 2022, section 245.4873, subdivision 4, is amended to read:


Subd. 4.

Individual case coordination.

The case manager designated under section
245.4881 is responsible for ongoing coordination with any other person responsible for
planning, development, and delivery of social services, education, corrections, health, or
vocational services for the individual child. The new text beginindividual new text endfamily deleted text beginassessment summarydeleted text endnew text begin
community support plan
new text end developed by the case manager shall reflect the coordination among
the local service system providers.

Sec. 10.

Minnesota Statutes 2022, section 245.4881, subdivision 3, is amended to read:


Subd. 3.

Duties of case manager.

(a) Upon a determination of eligibility for case
management services, the case manager shall develop an individual family deleted text beginassessment
summary
deleted text endnew text begin community support plannew text end for a child as specified in subdivision 4, review the child's
progress, and monitor the provision of services. If services are to be provided in a host
county that is not the county of financial responsibility, the case manager shall consult with
the host county and obtain a letter demonstrating the concurrence of the host county regarding
the provision of services.

(b) The case manager shall note in the child's record the services needed by the child
and the child's family, the services requested by the family, services that are not available,
and the unmet needs of the child and child's family. The case manager shall note this
provision in the child's record.

Sec. 11.

Minnesota Statutes 2022, section 245.4881, subdivision 4, is amended to read:


Subd. 4.

Individual family deleted text beginassessment summarydeleted text endnew text begin community support plannew text end.

(a) For
each child, the case manager must develop an individual family deleted text beginassessment summarydeleted text endnew text begin
community support plan
new text end that incorporates the child's individual treatment plan. The individual
treatment plan may not be a substitute for the development of an individual family deleted text beginassessment
summary
deleted text endnew text begin community support plannew text end. The case manager is responsible for developing the
individual family deleted text beginassessment summarydeleted text endnew text begin community support plannew text end within 30 days of intake
based on a diagnostic assessment and for implementing and monitoring the delivery of
services according to the individual family deleted text beginassessment summarydeleted text endnew text begin community support plannew text end.
The case manager must review the plan at least every 180 calendar days after it is developed,
unless the case manager has received a written request from the child's family or an advocate
for the child for a review of the plan every 90 days after it is developed. To the extent
appropriate, the child with severe emotional disturbance, the child's family, advocates,
service providers, and significant others must be involved in all phases of development and
implementation of the individual family deleted text beginassessment summarydeleted text endnew text begin community support plannew text end.
Notwithstanding the lack of an individual family deleted text beginassessment summarydeleted text endnew text begin community support
plan
new text end, the case manager shall assist the child and child's family in accessing the needed
services listed in section 245.4884, subdivision 1.

(b) The child's individual family deleted text beginassessment summarydeleted text endnew text begin community support plannew text end must
state:

(1) the goals and expected outcomes of each service and criteria for evaluating the
effectiveness and appropriateness of the service;

(2) the activities for accomplishing each goal;

(3) a schedule for each activity; and

(4) the frequency of face-to-face contacts by the case manager, as appropriate to client
need and the implementation of the individual family deleted text beginassessment summarydeleted text endnew text begin community
support plan
new text end.

Sec. 12.

Minnesota Statutes 2022, section 245.4885, subdivision 1, is amended to read:


Subdivision 1.

Admission criteria.

(a) Prior to admission or placement, except in the
case of an emergency, all children referred for treatment of severe emotional disturbance
in a treatment foster care setting, residential treatment facility, or informally admitted to a
regional treatment center shall undergo an assessment to determine the appropriate level of
care if county funds are used to pay for the child's services. An emergency includes when
a child is in need of and has been referred for crisis stabilization services under section
245.4882, subdivision 6. A child who has been referred to residential treatment for crisis
stabilization services in a residential treatment center is not required to undergo an assessment
under this section.

(b) The county board shall determine the appropriate level of care for a child when
county-controlled funds are used to pay for the child's residential treatment under this
chapter, including residential treatment provided in a qualified residential treatment program
as defined in section 260C.007, subdivision 26d. When a county board does not have
responsibility for a child's placement and the child is enrolled in a prepaid health program
under section 256B.69, the enrolled child's contracted health plan must determine the
appropriate level of care for the child. When Indian Health Services funds or funds of a
tribally owned facility funded under the Indian Self-Determination and Education Assistance
Act, Public Law 93-638, are used for the child, the Indian Health Services or 638 tribal
health facility must determine the appropriate level of care for the child. When more than
one entity bears responsibility for a child's coverage, the entities shall coordinate level of
care determination activities for the child to the extent possible.

(c) The child's level of care determination shall determine whether the proposed treatment:

(1) is necessary;

(2) is appropriate to the child's individual treatment needs;

(3) cannot be effectively provided in the child's home; and

(4) provides a length of stay as short as possible consistent with the individual child's
needs.

(d) When a level of care determination is conducted, the county board or other entity
may not determine that a screening of a child, referral, or admission to a residential treatment
facility is not appropriate solely because services were not first provided to the child in a
less restrictive setting and the child failed to make progress toward or meet treatment goals
in the less restrictive setting. The level of care determination must be based on a diagnostic
assessment of a child that evaluates the child's family, school, and community living
situations; and an assessment of the child's need for care out of the home using a validated
tool which assesses a child's functional status and assigns an appropriate level of care to the
child. The validated tool must be approved by the commissioner of human services and
may be the validated tool approved for the child's assessment under section 260C.704 if the
juvenile treatment screening team recommended placement of the child in a qualified
residential treatment program. If a diagnostic assessment has been completed by a mental
health professional within the past 180 days, a new diagnostic assessment need not be
completed unless in the opinion of the current treating mental health professional the child's
mental health status has changed markedly since the assessment was completed. The child's
parent shall be notified if an assessment will not be completed and of the reasons. A copy
of the notice shall be placed in the child's file. Recommendations developed as part of the
level of care determination process shall include specific community services needed by
the child and, if appropriate, the child's family, and shall indicate whether these services
are available and accessible to the child and the child's family. The child and the child's
family must be invited to any meeting where the level of care determination is discussed
and decisions regarding residential treatment are made. The child and the child's family
may invite other relatives, friends, or advocates to attend these meetings.

(e) During the level of care determination process, the child, child's family, or child's
legal representative, as appropriate, must be informed of the child's eligibility for case
management services and family community support services and that an individual family
deleted text begin assessment summarydeleted text endnew text begin community support plannew text end is being developed by the case manager, if
assigned.

(f) The level of care determination, placement decision, and recommendations for mental
health services must be documented in the child's record and made available to the child's
family, as appropriate.

Sec. 13.

Minnesota Statutes 2022, section 245.4887, is amended to read:


245.4887 APPEALS.

A child or a child's family, as appropriate, who requests mental health services under
sections 245.487 to 245.4889 must be advised of services available and the right to appeal
as described in this section at the time of the request and each time the individual family
deleted text begin assessment summarydeleted text endnew text begin community support plannew text end or individual treatment plan is reviewed. A
child whose request for mental health services under sections 245.487 to 245.4889 is denied,
not acted upon with reasonable promptness, or whose services are suspended, reduced, or
terminated by action or inaction for which the county board is responsible under sections
245.487 to 245.4889 may contest that action or inaction before the state agency according
to section 256.045. The commissioner shall monitor the nature and frequency of
administrative appeals under this section.

Sec. 14.

Minnesota Statutes 2022, section 245A.03, subdivision 7, is amended to read:


Subd. 7.

Licensing moratorium.

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

(1) deleted text beginfoster care settingsdeleted text endnew text begin a license for a person in a foster care setting that is not the primary
residence of the license holder and
new text end where at least 80 percent of the residents are 55 years
of age or older;

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

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

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

(5) new foster care licenses or community residential setting licenses for people receiving
customized living or 24-hour customized living services under the brain injury or community
access for disability inclusion waiver plans under section 256B.49 and residing in the
customized living setting before July 1, 2022, for which a license is required. A customized
living service provider subject to this exception may rebut the presumption that a license
is required by seeking a reconsideration of the commissioner's determination. The
commissioner's disposition of a request for reconsideration is final and not subject to appeal
under chapter 14. The exception is available until June 30, 2023. This exception is available
when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people under the brain injury or community access for disability
inclusion waiver plans under section 256B.49 in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

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

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

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

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

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

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

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

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

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493.

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2022, section 245A.11, subdivision 7, is amended to read:


Subd. 7.

Adult foster carenew text begin and community residential settingsnew text end; variance for alternate
overnight supervision.

(a) The commissioner may grant a variance under section 245A.04,
subdivision 9
, tonew text begin statutes andnew text end rule parts requiring a caregiver to be present in an adult foster
care homenew text begin or a community residential settingnew text end during normal sleeping hours to allow for
alternative methods of overnight supervision. The commissioner may grant the variance if
the local county licensing agency recommends the variance and the county recommendation
includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of providing
overnight supervision and determined the plan protects the residents' health, safety, and
rights;

(2) the license holder has obtained written and signed informed consent from each
resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include the
use of technology, is specified for each resident in the resident's: (i) individualized plan of
care; (ii) deleted text beginindividual servicedeleted text endnew text begin supportnew text end plan under section 256B.092, subdivision 1b, if required;
or (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster carenew text begin or community
residential setting
new text end license holder must not have had a conditional license issued under section
245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24
months based on failure to provide adequate supervision, health care services, or resident
safety in the adult foster care homenew text begin or community residential settingnew text end.

(c) A license holder requesting a variance under this subdivision to utilize technology
as a component of a plan for alternative overnight supervision may request the commissioner's
review in the absence of a county recommendation. Upon receipt of such a request from a
license holder, the commissioner shall review the variance request with the county.

deleted text begin (d) A variance granted by the commissioner according to this subdivision before January
1, 2014, to a license holder for an adult foster care home must transfer with the license when
the license converts to a community residential setting license under chapter 245D. The
terms and conditions of the variance remain in effect as approved at the time the variance
was granted.
deleted text 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. 16.

Minnesota Statutes 2022, section 245A.16, subdivision 1, is amended to read:


Subdivision 1.

Delegation of authority to agencies.

(a) County agencies and private
agencies that have been designated or licensed by the commissioner to perform licensing
functions and activities under section 245A.04 and background studies for family child care
under chapter 245C; to recommend denial of applicants under section 245A.05; to issue
correction orders, to issue variances, and recommend a conditional license under section
245A.06; or to recommend suspending or revoking a license or issuing a fine under section
245A.07, shall comply with rules and directives of the commissioner governing those
functions and with this section. The following variances are excluded from the delegation
of variance authority and may be issued only by the commissioner:

(1) dual licensure of family child care and new text beginfamilynew text end child foster care, dual licensure of
new text begin familynew text end child new text beginfoster care new text endand new text beginfamilynew text end adult foster carenew text begin, dual licensure of child foster residence
setting and community residential setting
new text end, andnew text begin dual licensure of familynew text end adult foster care and
family child care;

(2) adult foster care maximum capacity;

(3) adult foster care minimum age requirement;

(4) child foster care maximum age requirement;

(5) variances regarding disqualified individuals except that, before the implementation
of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding
disqualified individuals when the county is responsible for conducting a consolidated
reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and
(b), of a county maltreatment determination and a disqualification based on serious or
recurring maltreatment;

(6) the required presence of a caregiver in the adult foster care residence during normal
sleeping hours;

(7) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder; and

(8) variances to section 245A.53 for a time-limited period. If the commissioner grants
a variance under this clause, the license holder must provide notice of the variance to all
parents and guardians of the children in care.

Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must
not grant a license holder a variance to exceed the maximum allowable family child care
license capacity of 14 children.

(b) A county agency that has been designated by the commissioner to issue family child
care variances must:

(1) publish the county agency's policies and criteria for issuing variances on the county's
public website and update the policies as necessary; and

(2) annually distribute the county agency's policies and criteria for issuing variances to
all family child care license holders in the county.

(c) Before the implementation of NETStudy 2.0, county agencies must report information
about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision
2
, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the
commissioner at least monthly in a format prescribed by the commissioner.

(d) For family child care programs, the commissioner shall require a county agency to
conduct one unannounced licensing review at least annually.

(e) For family adult day services programs, the commissioner may authorize licensing
reviews every two years after a licensee has had at least one annual review.

(f) A license issued under this section may be issued for up to two years.

(g) During implementation of chapter 245D, the commissioner shall consider:

(1) the role of counties in quality assurance;

(2) the duties of county licensing staff; and

(3) the possible use of joint powers agreements, according to section 471.59, with counties
through which some licensing duties under chapter 245D may be delegated by the
commissioner to the counties.

Any consideration related to this paragraph must meet all of the requirements of the corrective
action plan ordered by the federal Centers for Medicare and Medicaid Services.

(h) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or
successor provisions; and section 245D.061 or successor provisions, for family child foster
care programs providing out-of-home respite, as identified in section 245D.03, subdivision
1, paragraph (b), clause (1), is excluded from the delegation of authority to county and
private agencies.

(i) A county agency shall report to the commissioner, in a manner prescribed by the
commissioner, the following information for a licensed family child care program:

(1) the results of each licensing review completed, including the date of the review, and
any licensing correction order issued;

(2) any death, serious injury, or determination of substantiated maltreatment; and

(3) any fires that require the service of a fire department within 48 hours of the fire. The
information under this clause must also be reported to the state fire marshal within two
business days of receiving notice from a licensed family child care provider.

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2022, section 245D.03, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.

(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:

(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental disabilities, and elderly waiver plans, excluding
out-of-home respite care provided to children in a family child foster care home licensed
under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license
holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,
or successor provisions; and section 245D.061 or successor provisions, which must be
stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,
subpart 4;

(2) adult companion services as defined under the deleted text beginbrain injury, community access for
disability inclusion, community alternative care, and
deleted text end elderly waiver deleted text beginplansdeleted text endnew text begin plannew text end, excluding
adult companion services provided under the Corporation for National and Community
Services Senior Companion Program established under the Domestic Volunteer Service
Act of 1973, Public Law 98-288;

deleted text begin (3) personal support as defined under the developmental disabilities waiver plan;
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end 24-hour emergency assistance, personal emergency response as defined under
the community access for disability inclusion and developmental disabilities waiver plans;

deleted text begin (5)deleted text endnew text begin (4)new text end night supervision services as defined under the brain injury, community access
for disability inclusion, community alternative care, and developmental disabilities waiver
plans;

deleted text begin (6)deleted text endnew text begin (5)new text end homemaker services as defined under the community access for disability
inclusion, brain injury, community alternative care, developmental disabilities, and elderly
waiver plans, excluding providers licensed by the Department of Health under chapter 144A
and those providers providing cleaning services only;

deleted text begin (7)deleted text endnew text begin (6)new text end individual community living support under section 256S.13; and

deleted text begin (8)deleted text endnew text begin (7)new text end individualized home supportsnew text begin without trainingnew text end services as defined under the brain
injury, community alternative care, and community access for disability inclusion, and
developmental disabilities waiver plans.

(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:

(1) intervention services, including:

(i) positive support services as defined under the brain injury and community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(ii) in-home or out-of-home crisis respite services as defined under the brain injury,
community access for disability inclusion, community alternative care, and developmental
disabilities waiver plans; and

(iii) specialist services as defined under the current brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(2) in-home support services, including:

deleted text begin (i) in-home family support and supported living services as defined under the
developmental disabilities waiver plan;
deleted text end

deleted text begin (ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans;
deleted text end

deleted text begin (iii)deleted text endnew text begin (i)new text end semi-independent living services;

deleted text begin (iv)deleted text endnew text begin (ii)new text end individualized home support with training services as defined under the brain
injury, community alternative care, community access for disability inclusion, and
developmental disabilities waiver plans; and

deleted text begin (v)deleted text endnew text begin (iii)new text end individualized home support with family training services as defined under the
brain injury, community alternative care, community access for disability inclusion, and
developmental disabilities waiver plans;

(3) residential supports and services, including:

deleted text begin (i) supported living services as defined under the developmental disabilities waiver plan
provided in a family or corporate child foster care residence, a family adult foster care
residence, a community residential setting, or a supervised living facility;
deleted text end

deleted text begin (ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting;
deleted text end

deleted text begin (iii)deleted text endnew text begin (i)new text end community residential services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans provided in a corporate child foster care residence, a community residential
setting, or a supervised living facility;

deleted text begin (iv)deleted text endnew text begin (ii)new text end family residential services as defined in the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans
provided in a family child foster care residence or a family adult foster care residence; and

deleted text begin (v)deleted text endnew text begin (iii)new text end residential services provided to more than four persons with developmental
disabilities in a supervised living facility, including ICFs/DD;

(4) day services, including:

deleted text begin (i) structured day services as defined under the brain injury waiver plan;
deleted text end

deleted text begin (ii)deleted text endnew text begin (i)new text end day services under sections 252.41 to 252.46, and as defined under the brain
injury, community alternative care, community access for disability inclusion, and
developmental disabilities waiver plans;new text begin and
new text end

deleted text begin (iii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental disabilities waiver plan; and
deleted text end

deleted text begin (iv)deleted text endnew text begin (ii)new text end prevocational services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans;
and

(5) employment exploration services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(6) employment development services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(7) employment support services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans;
and

(8) integrated community support as defined under the brain injury and community
access for disability inclusion waiver plans beginning January 1, 2021, and community
alternative care and developmental disabilities waiver plans beginning January 1, 2023.

Sec. 18.

Minnesota Statutes 2022, section 246.0135, is amended to read:


246.0135 OPERATION OF REGIONAL TREATMENT CENTERS.

(a) The commissioner of human services is prohibited from closing any regional treatment
center or state-operated nursing home or any program at any of the regional treatment centers
or state-operated nursing homes, without specific legislative authorization. deleted text beginFor persons with
developmental disabilities who move from one regional treatment center to another regional
treatment center, the provisions of section 256B.092, subdivision 10, must be followed for
both the discharge from one regional treatment center and admission to another regional
treatment center, except that the move is not subject to the consensus requirement of section
256B.092, subdivision 10, paragraph (b).
deleted text end

(b) Prior to closing or downsizing a regional treatment center, the commissioner of
human services shall be responsible for assuring that community-based alternatives developed
in response are adequate to meet the program needs identified by each county within the
catchment area and do not require additional local county property tax expenditures.

(c) The nonfederal share of the cost of alternative treatment or care developed as the
result of the closure of a regional treatment center, including costs associated with fulfillment
of responsibilities under chapter 253B shall be paid from state funds appropriated for
purposes specified in section 246.013.

(d) The commissioner may not divert state funds used for providing for care or treatment
of persons residing in a regional treatment center for purposes unrelated to the care and
treatment of such persons.

Sec. 19.

Minnesota Statutes 2022, section 254A.035, subdivision 2, is amended to read:


Subd. 2.

Membership terms, compensation, removal and expiration.

The membership
of this council shall be composed of 17 persons who are American Indians and who are
appointed by the commissioner. The commissioner shall appoint one representative from
each of the following groups: Red Lake Band of Chippewa Indians; Fond du Lac Band,
Minnesota Chippewa Tribe; Grand Portage Band, Minnesota Chippewa Tribe; Leech Lake
Band, Minnesota Chippewa Tribe; Mille Lacs Band, Minnesota Chippewa Tribe; Bois Forte
Band, Minnesota Chippewa Tribe; White Earth Band, Minnesota Chippewa Tribe; Lower
Sioux Indian Reservation; Prairie Island Sioux Indian Reservation; Shakopee Mdewakanton
Sioux Indian Reservation; Upper Sioux Indian Reservation; International Falls Northern
Range; Duluth Urban Indian Community; and two representatives from the Minneapolis
Urban Indian Community and two from the St. Paul Urban Indian Community. The terms,
compensation, and removal of American Indian Advisory Council members shall be as
provided in section 15.059. deleted text beginThe council expires June 30, 2023.
deleted text end

Sec. 20.

Minnesota Statutes 2022, section 254B.05, subdivision 1a, is amended to read:


Subd. 1a.

Room and board provider requirements.

(a) Effective January 1, 2000,
vendors of room and board are eligible for behavioral health fund payment if the vendor:

(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;

(2) is determined to meet applicable health and safety requirements;

(3) is not a jail or prison;

(4) is not concurrently receiving funds under chapter 256I for the recipient;

(5) admits individuals who are 18 years of age or older;

(6) is registered as a board and lodging or lodging establishment according to section
157.17;

(7) has awake staff on site deleted text begin24 hours per daydeleted text endnew text begin whenever a client is presentnew text end;

(8) has staff who are at least 18 years of age and meet the requirements of section
245G.11, subdivision 1, paragraph (b);

(9) has emergency behavioral procedures that meet the requirements of section 245G.16;

(10) meets the requirements of section 245G.08, subdivision 5, if administering
medications to clients;

(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;

(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;

(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;

(14) has a grievance procedure that meets the requirements of section 245G.15,
subdivision 2
; and

(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.

(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).

(c) Programs providing children's mental health crisis admissions and stabilization under
section 245.4882, subdivision 6, are eligible vendors of room and board.

(d) Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
of room and board and are exempt from paragraph (a), clauses (6) to (15).

new text begin (e) A vendor that is not licensed as a residential treatment program must have a policy
to address staffing coverage when a client may unexpectedly need to be present at the room
and board site.
new text end

Sec. 21.

Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:


Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) care coordination services provided according to section 245G.07, subdivision 1,
paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;

(6) substance use disorder treatment services with medications for opioid use disorder
that are licensed according to sections 245G.01 to 245G.17 and 245G.22, or applicable
tribal license;

(7) substance use disorder treatment with medications for opioid use disorder plus
enhanced treatment services that meet the requirements of clause (6) and provide nine hours
of clinical services each week;

(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;

(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;

(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and

(12) room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) deleted text beginmeets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements
deleted text endnew text begin is licensednew text end under deleted text beginsectiondeleted text endnew text begin chapter 245A and
sections 245G.01 to
new text end 245G.19deleted text begin, subdivision 4deleted text end; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific or culturally responsive programs as defined in section 254B.01,
subdivision 4a
;

(3) disability responsive programs as defined in section 254B.01, subdivision 4b;

(4) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; or

(5) programs that offer services to individuals with co-occurring mental health and
substance use disorder problems if:

(i) the program meets the co-occurring requirements in section 245G.20;

(ii) 25 percent of the counseling staff are licensed mental health professionals under
section 245I.04, subdivision 2, or are students or licensing candidates under the supervision
of a licensed alcohol and drug counselor supervisor and mental health professional under
section 245I.04, subdivision 2, except that no more than 50 percent of the mental health
staff may be students or licensing candidates with time documented to be directly related
to provisions of co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance use disorder
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the substance use disorder facility of the child care provider's current licensure to provide
child care services. deleted text beginPrograms that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.
deleted text end

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, substance use disorder services that are otherwise covered
as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,
subdivision 3b. The use of telehealth to deliver services must be medically appropriate to
the condition and needs of the person being served. Reimbursement shall be at the same
rates and under the same conditions that would otherwise apply to direct face-to-face services.

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

(h) Payment for outpatient substance use disorder services that are licensed according
to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
prior authorization of a greater number of hours is obtained from the commissioner.

Sec. 22.

Minnesota Statutes 2022, section 256.01, is amended by adding a subdivision to
read:


new text begin Subd. 12b. new text end

new text begin Department of Human Services systemic critical incident review team. new text end

new text begin (a)
The commissioner may establish a Department of Human Services systemic critical incident
review team to review critical incidents reported as required under section 626.557 for
which the Department of Human Services is responsible under section 626.5572, subdivision
13; chapter 245D; or Minnesota Rules, chapter 9544. When reviewing a critical incident,
the systemic critical incident review team shall identify systemic influences to the incident
rather than determine the culpability of any actors involved in the incident. The systemic
critical incident review may assess the entire critical incident process from the point of an
entity reporting the critical incident through the ongoing case management process.
Department staff shall lead and conduct the reviews and may utilize county staff as reviewers.
The systemic critical incident review process may include but is not limited to:
new text end

new text begin (1) data collection about the incident and actors involved. Data may include the relevant
critical services; the service provider's policies and procedures applicable to the incident;
the coordinated service and support plan as defined in section 245D.02, subdivision 4b, for
the person receiving services; or an interview of an actor involved in the critical incident
or the review of the critical incident. Actors may include:
new text end

new text begin (i) staff of the provider agency;
new text end

new text begin (ii) lead agency staff administering home and community-based services delivered by
the provider;
new text end

new text begin (iii) Department of Human Services staff with oversight of home and community-based
services;
new text end

new text begin (iv) Department of Health staff with oversight of home and community-based services;
new text end

new text begin (v) members of the community including advocates, legal representatives, health care
providers, pharmacy staff, or others with knowledge of the incident or the actors in the
incident; and
new text end

new text begin (vi) staff from the Office of the Ombudsman for Mental Health and Developmental
Disabilities;
new text end

new text begin (2) systemic mapping of the critical incident. The team conducting the systemic mapping
of the incident may include any actors identified in clause (1), designated representatives
of other provider agencies, regional teams, and representatives of the local regional quality
council identified in section 256B.097; and
new text end

new text begin (3) analysis of the case for systemic influences.
new text end

new text begin Data collected by the critical incident review team shall be aggregated and provided to
regional teams, participating regional quality councils, and the commissioner. The regional
teams and quality councils shall analyze the data and make recommendations to the
commissioner regarding systemic changes that would decrease the number and severity of
critical incidents in the future or improve the quality of the home and community-based
service system.
new text end

new text begin (b) Cases selected for the systemic critical incident review process shall be selected by
a selection committee among the following critical incident categories:
new text end

new text begin (1) cases of caregiver neglect identified in section 626.5572, subdivision 17;
new text end

new text begin (2) cases involving financial exploitation identified in section 626.5572, subdivision 9;
new text end

new text begin (3) incidents identified in section 245D.02, subdivision 11;
new text end

new text begin (4) behavior interventions identified in Minnesota Rules, part 9544.0110; and
new text end

new text begin (5) service terminations reported to the department in accordance with section 245D.10,
subdivision 3a.
new text end

new text begin (c) The systemic critical incident review under this section shall not replace the process
for screening or investigating cases of alleged maltreatment of an adult under section 626.557.
The department may select cases for systemic critical incident review, under the jurisdiction
of the commissioner, reported for suspected maltreatment and closed following initial or
final disposition.
new text end

new text begin (d) The proceedings and records of the review team are confidential data on individuals
or protected nonpublic data as defined in section 13.02, subdivisions 3 and 13. Data that
document a person's opinions formed as a result of the review are not subject to discovery
or introduction into evidence in a civil or criminal action against a professional, the state,
or a county agency arising out of the matters that the team is reviewing. Information,
documents, and records otherwise available from other sources are not immune from
discovery or use in a civil or criminal action solely because the information, documents,
and records were assessed or presented during proceedings of the review team. A person
who presented information before the systemic critical incident review team or who is a
member of the team shall not be prevented from testifying about matters within the person's
knowledge. In a civil or criminal proceeding, a person shall not be questioned about opinions
formed by the person as a result of the review.
new text end

new text begin (e) By October 1 of each year, the commissioner shall prepare an annual public report
containing the following information:
new text end

new text begin (1) the number of cases reviewed under each critical incident category identified in
paragraph (b) and a geographical description of where cases under each category originated;
new text end

new text begin (2) an aggregate summary of the systemic themes from the critical incidents examined
by the critical incident review team during the previous year;
new text end

new text begin (3) a synopsis of the conclusions, incident analyses, or exploratory activities taken in
regard to the critical incidents examined by the critical incident review team; and
new text end

new text begin (4) recommendations made to the commissioner regarding systemic changes that could
decrease the number and severity of critical incidents in the future or improve the quality
of the home and community-based service system.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 23.

Minnesota Statutes 2022, section 256B.0911, subdivision 23, is amended to read:


Subd. 23.

MnCHOICES reassessments; option for alternative and self-directed
waiver services.

(a) At the time of reassessment, the certified assessor shall assess a person
receiving waiver residential supports and services and currently residing in a setting listed
in clauses (1) to (5) to determine if the person would prefer to be served in a
community-living setting as defined in section deleted text begin256B.49, subdivision 23deleted text endnew text begin 256B.492,
subdivision 1, paragraph (b)
new text end, or in a setting not controlled by a provider, or to receive
integrated community supports as described in section 245D.03, subdivision 1, paragraph
(c), clause (8). The certified assessor shall offer the person through a person-centered
planning process the option to receive alternative housing and service options. This paragraph
applies to those currently residing in a:

(1) community residential setting;

(2) licensed adult foster care home that is either not the primary residence of the license
holder or in which the license holder is not the primary caregiver;

(3) family adult foster care residence;

(4) customized living setting; or

(5) supervised living facility.

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

Minnesota Statutes 2022, section 256B.092, subdivision 10, is amended to read:


Subd. 10.

Admission of persons to and discharge of persons from regional treatment
centers.

(a) Prior to the admission of a person to a regional treatment center program for
persons with developmental disabilities, the case manager shall make efforts to secure
community-based alternatives. If these alternatives are rejected by the person, the person's
legal guardian or conservator, or the county agency in favor of a regional treatment center
placement, the case manager shall document the reasons why the alternatives were rejected.

deleted text begin (b) When discharge of a person from a regional treatment center to a community-based
service is proposed, the case manager shall convene the screening team and in addition to
members of the team identified in subdivision 7, the case manager shall invite to the meeting
the person's parents and near relatives, and the ombudsman established under section 245.92
if the person is under public guardianship. The meeting shall be convened at a time and
place that allows for participation of all team members and invited individuals who choose
to attend. The notice of the meeting shall inform the person's parents and near relatives
about the screening team process, and their right to request a review if they object to the
discharge, and shall provide the names and functions of advocacy organizations, and
information relating to assistance available to individuals interested in establishing private
guardianships under the provisions of section 252A.03. The screening team meeting shall
be conducted according to subdivisions 7 and 8. Discharge of the person shall not go forward
without consensus of the screening team.
deleted text end

deleted text begin (c) The results of the screening team meeting and individual service plan developed
according to subdivision 1b shall be used by the interdisciplinary team assembled in
accordance with Code of Federal Regulations, title 42, section 483.440, to evaluate and
make recommended modifications to the individual service plan as proposed. The individual
service plan shall specify postplacement monitoring to be done by the case manager according
to section 253B.15, subdivision 1a.
deleted text end

deleted text begin (d) Notice of the meeting of the interdisciplinary team assembled in accordance with
Code of Federal Regulations, title 42, section 483.440, shall be sent to all team members
15 days prior to the meeting, along with a copy of the proposed individual service plan. The
case manager shall request that proposed providers visit the person and observe the person's
program at the regional treatment center prior to the discharge. Whenever possible,
preplacement visits by the person to proposed service sites should also be scheduled in
advance of the meeting. Members of the interdisciplinary team assembled for the purpose
of discharge planning shall include but not be limited to the case manager, the person, the
person's legal guardian or conservator, parents and near relatives, the person's advocate,
representatives of proposed community service providers, representatives of the regional
treatment center residential and training and habilitation services, a registered nurse if the
person has overriding medical needs that impact the delivery of services, and a qualified
developmental disability professional specializing in behavior management if the person
to be discharged has behaviors that may result in injury to self or others. The case manager
may also invite other service providers who have expertise in an area related to specific
service needs of the person to be discharged.
deleted text end

deleted text begin (e) The interdisciplinary team shall review the proposed plan to assure that it identifies
service needs, availability of services, including support services, and the proposed providers'
abilities to meet the service needs identified in the person's individual service plan. The
interdisciplinary team shall review the most recent licensing reports of the proposed providers
and corrective action taken by the proposed provider, if required. The interdisciplinary team
shall review the current individual program plans for the person and agree to an interim
individual program plan to be followed for the first 30 days in the person's new living
arrangement. The interdisciplinary team may suggest revisions to the service plan, and all
team suggestions shall be documented. If the person is to be discharged to a community
intermediate care facility for persons with developmental disabilities, the team shall give
preference to facilities with a licensed capacity of 15 or fewer beds. Thirty days prior to the
date of discharge, the case manager shall send a final copy of the service plan to all invited
members of the team, the ombudsman, if the person is under public guardianship, and the
advocacy system established under United States Code, title 42, section 6042.
deleted text end

new text begin (b) Assessment and support planning must be completed in accordance with requirements
identified in section 256B.0911.
new text end

deleted text begin (f)deleted text endnew text begin (c)new text end No discharge shall take place until disputes are resolved under section 256.045,
subdivision 4a
, or until a review by the commissioner is completed upon request of the chief
executive officer or program director of the regional treatment center, or the county agency.
For persons under public guardianship, the ombudsman may request a review or hearing
under section 256.045. deleted text beginNotification schedules required under this subdivision may be waived
by members of the team when judged urgent and with agreement of the parents or near
relatives participating as members of the interdisciplinary team.
deleted text end

Sec. 25.

Minnesota Statutes 2022, section 256B.093, subdivision 1, is amended to read:


Subdivision 1.

State traumatic brain injury program.

(a) The commissioner of human
services shall:

(1) maintain a statewide traumatic brain injury program;

(2) supervise and coordinate services and policies for persons with traumatic brain
injuries;

(3) contract with qualified agencies or employ staff to provide statewide administrative
case management and consultation;

(4) maintain an advisory committee to provide recommendations in reports to the
commissioner regarding program and service needs of persons with brain injuries;

(5) investigate the need for the development of rules or statutes for the brain injury home
and community-based services waiver; and

(6) investigate present and potential models of service coordination which can be
delivered at the local level.

(b) The advisory committee required by paragraph (a), clause (4), must consist of no
fewer than ten members and no more than 30 members. The commissioner shall appoint
all advisory committee members to one- or two-year terms and appoint one member as
chair. deleted text beginThe advisory committee expires on June 30, 2023.
deleted text end

Sec. 26.

Minnesota Statutes 2022, section 256B.492, is amended to read:


256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH
DISABILITIES.

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section the following terms have
the meanings given.
new text end

new text begin (b) "Community-living setting" means a single-family home or multifamily dwelling
unit where a service recipient or a service recipient's family owns or rents and maintains
control over the individual unit as demonstrated by a lease agreement. Community-living
setting does not include a home or dwelling unit that the service provider owns, operates,
or leases or in which the service provider has a direct or indirect financial interest.
new text end

new text begin (c) "Controlling individual" has the meaning given in section 245A.02, subdivision 5a.
new text end

new text begin (d) "License holder" has the meaning given in section 245A.02, subdivision 9.
new text end

new text begin Subd. 2. new text end

new text begin Home and community-based waiver settings. new text end

(a) Individuals receiving services
under a home and community-based waiver under section 256B.092 or 256B.49 may receive
services in the following settings:

(1) home and community-based settings that comply with all requirements identified by
the federal Centers for Medicare and Medicaid Services in the Code of Federal Regulations,
title 42, section 441.301(c), and with the requirements of the federally approved transition
plan and waiver plans for each home and community-based services waiver; and

(2) settings required by the Housing Opportunities for Persons with AIDS Program.

(b) The settings in paragraph (a) must not have the qualities of an institution which
include, but are not limited to: regimented meal and sleep times, limitations on visitors, and
lack of privacy. Restrictions agreed to and documented in the person's individual service
plan shall not result in a residence having the qualities of an institution as long as the
restrictions for the person are not imposed upon others in the same residence and are the
least restrictive alternative, imposed for the shortest possible time to meet the person's needs.

new text begin Subd. 3. new text end

new text begin Community-living settings. new text end

new text begin (a) Individuals receiving services under a home
and community-based waiver under section 256B.092 or 256B.49 may receive services in
community-living settings. Community-living settings must meet the requirements of
subdivision 2, paragraph (a), clause (1).
new text end

new text begin (b) For the purposes of this section, direct financial interest exists if payment passes
between the license holder or any controlling individual of a licensed program and the
service recipient or an entity acting on the service recipient's behalf for the purpose of
obtaining or maintaining a dwelling. For the purposes of this section, indirect financial
interest exists if the license holder or any controlling individual of a licensed program has
an ownership or investment interest in the entity that owns, operates, leases, or otherwise
receives payment from the service recipient or an entity acting on the service recipient's
behalf for the purpose of obtaining or maintaining a dwelling.
new text end

new text begin (c) To ensure a service recipient or the service recipient's family maintains control over
the home or dwelling unit, community-living settings are subject to the following
requirements:
new text end

new text begin (1) service recipients must not be required to receive services or share services;
new text end

new text begin (2) service recipients must not be required to have a disability or specific diagnosis to
live in the community-living setting;
new text end

new text begin (3) service recipients may hire service providers of their choice;
new text end

new text begin (4) service recipients may choose whether to share their household and with whom;
new text end

new text begin (5) the home or multifamily dwelling unit must include living, sleeping, bathing, and
cooking areas;
new text end

new text begin (6) service recipients must have lockable access and egress;
new text end

new text begin (7) service recipients must be free to receive visitors and leave the settings at times and
for durations of their own choosing;
new text end

new text begin (8) leases must comply with chapter 504B;
new text end

new text begin (9) landlords must not charge different rents to tenants who are receiving home and
community-based services; and
new text end

new text begin (10) access to the greater community must be easily facilitated based on the service
recipient's needs and preferences.
new text end

new text begin (d) Nothing in this section prohibits a service recipient from having another person or
entity not affiliated with the service provider cosign a lease. Nothing in this section prohibits
a service recipient, during any period in which a service provider has cosigned the service
recipient's lease, from modifying services with an existing cosigning service provider and,
subject to the approval of the landlord, maintaining a lease cosigned by the service provider.
Nothing in this section prohibits a service recipient, during any period in which a service
provider has cosigned the service recipient's lease, from terminating services with the
cosigning service provider, receiving services from a new service provider, or, subject to
the approval of the landlord, maintaining a lease cosigned by the new service provider.
new text end

new text begin (e) A lease cosigned by a service provider meets the requirements of paragraph (b) if
the service recipient and service provider develop and implement a transition plan which
must provide that, within two years of cosigning the initial lease, the service provider shall
transfer the lease to the service recipient and other cosigners, if any.
new text end

new text begin (f) In the event the landlord has not approved the transfer of the lease within two years
of the service provider cosigning the initial lease, the service provider must submit a
time-limited extension request to the commissioner of human services to continue the
cosigned lease arrangement. The extension request must include:
new text end

new text begin (1) the reason the landlord denied the transfer;
new text end

new text begin (2) the plan to overcome the denial to transfer the lease;
new text end

new text begin (3) the length of time needed to successfully transfer the lease, not to exceed an additional
two years;
new text end

new text begin (4) a description of how the transition plan was followed, what occurred that led to the
landlord denying the transfer, and what changes in circumstances or condition, if any, the
service recipient experienced; and
new text end

new text begin (5) a revised transition plan to transfer the cosigned lease between the service provider
and the service recipient to the service recipient.
new text end

new text begin (g) The commissioner must approve an extension under paragraph (f) within sufficient
time to ensure the continued occupancy by the service recipient.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2022, section 256B.493, subdivision 2a, is amended to read:


Subd. 2a.

Closure process.

(a) The commissioner shall work with stakeholders to
establish a process for the application, review, approval, and implementation of setting
closures. Voluntary proposals from license holders for consolidation and closure of adult
foster care or community residential settings are encouraged. Whether voluntary or
involuntary, all closure plans must include:

(1) a description of the proposed closure plan, identifying the home or homes and
occupied beds;

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

(3) the proposed relocation plan jointly developed by the counties of financial
responsibility, the people living there and their legal representatives, if any, who wish to
continue to receive services from the provider, and the providers for current residents of
any adult foster care home designated for closure; and

(4) documentation from the provider in a format approved by the commissioner that all
the adult foster care homes or community residential settings receiving a planned closure
rate adjustment under the plan have accepted joint and severable for recovery of
overpayments under section 256B.0641, subdivision 2, for the facilities designated for
closure under this plan.

(b) The commissioner shall give first priority to closure plans which:

(1) target counties and geographic areas which have:

(i) need for other types of services;

(ii) need for specialized services;

(iii) higher than average per capita use of licensed corporate foster care or community
residential settings; or

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

(2) demonstrate savings of medical assistance expenditures; and

(3) demonstrate that alternative services are based on the recipient's choice of provider
and are consistent with federal law, state law, and federally approved waiver plans.

The commissioner shall also consider any information provided by people using services,
their legal representatives, family members, or the lead agency on the impact of the planned
closure on people and the services they need.

deleted text begin (c) For each closure plan approved by the commissioner, a contract must be established
between the commissioner, the counties of financial responsibility, and the participating
license holder.
deleted text end

Sec. 28.

Minnesota Statutes 2022, section 256B.493, subdivision 4, is amended to read:


Subd. 4.

Review and approval process.

(a) To be considered for approval, an application
must include:

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

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

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

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

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

(1) target counties and geographic areas which have:

(i) need for other types of services;

(ii) need for specialized services;

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

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

(2) demonstrate savings of medical assistance expenditures; and

(3) demonstrate that alternative services are based on the recipient's choice of provider
and are consistent with federal law, state law, and federally approved waiver plans.

The commissioner shall also consider any information provided by service recipients,
their legal representatives, family members, or the lead agency on the impact of the planned
closure on the recipients and the services they need.

(c) The commissioner shall select proposals that best meet the criteria established in this
subdivision for planned closure of adult foster care settings. The commissioner shall notify
license holders of the selections approved by the commissioner.

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 29.

Minnesota Statutes 2022, section 256S.202, subdivision 1, is amended to read:


Subdivision 1.

Customized living monthly service rate limits.

(a) Except for a
participant assigned to case mix classification L, as described in section 256S.18, subdivision
1, paragraph (b), the customized living monthly service rate limit shall not exceed 50 percent
of the monthly case mix budget cap, deleted text beginless the maintenance needs allowance,deleted text end adjusted at least
annually in the manner described under section 256S.18, subdivisions 5 and 6.

(b) The customized living monthly service rate limit for participants assigned to case
mix classification L must be the monthly service rate limit for participants assigned to case
mix classification A, reduced by 25 percent.

Sec. 30.

Minnesota Statutes 2022, section 524.5-104, is amended to read:


524.5-104 FACILITY OF TRANSFER.

(a) A person who may transfer money or personal property to a minor may do so, as to
an amount or value not exceeding the amount allowable as a tax exclusion gift under section
2503(b) of the Internal Revenue Code or a different amount that is approved by the court,
by transferring it to:

(1) a person who has the care and custody of the minor and with whom the minor resides;

(2) a guardian of the minor;

(3) a custodian under the Uniform Transfers To Minors Act or custodial trustee under
the Uniform Custodial Trust Act;

(4) a financial institution as a deposit in an interest-bearing account or certificate in the
sole name of the minor and giving notice of the deposit to the minor; or

(5) an ABLE account. A guardian only has the authority to establish an ABLE account.
The guardian may not administer the ABLE account in the guardian's capacity as guardian.new text begin
The guardian may appoint or name a person to exercise signature authority over an ABLE
account, including the individual selected by the eligible individual or the eligible individual's
agent under a power of attorney, conservator, spouse, parent, sibling, grandparent, or
representative payee, whether an individual or organization, appointed by the Social Security
Administration, in that order.
new text end

(b) This section does not apply if the person making payment or delivery knows that a
conservator has been appointed or that a proceeding for appointment of a conservator of
the minor is pending.

(c) A person who transfers money or property in compliance with this section is not
responsible for its proper application.

(d) A guardian or other person who receives money or property for a minor under
paragraph (a), clause (1) or (2), may only apply it to the support, care, education, health,
and welfare of the minor, and may not derive a personal financial benefit except for
reimbursement for necessary expenses. Any excess must be preserved for the future support,
care, education, health, and welfare of the minor and any balance must be transferred to the
minor upon emancipation or attaining majority.

new text begin EFFECTIVE DATE. new text end

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

Sec. 31.

Minnesota Statutes 2022, section 524.5-313, is amended to read:


524.5-313 POWERS AND DUTIES OF GUARDIAN.

(a) A guardian shall be subject to the control and direction of the court at all times and
in all things.

(b) The court shall grant to a guardian only those powers necessary to provide for the
demonstrated needs of the person subject to guardianship.

(c) The court may appoint a guardian if it determines that all the powers and duties listed
in this section are needed to provide for the needs of the incapacitated person. The court
may also appoint a guardian if it determines that a guardian is needed to provide for the
needs of the incapacitated person through the exercise of some, but not all, of the powers
and duties listed in this section. The duties and powers of a guardian or those which the
court may grant to a guardian include, but are not limited to:

(1) the power to have custody of the person subject to guardianship and the power to
establish a place of abode within or outside the state, except as otherwise provided in this
clause. The person subject to guardianship or any interested person may petition the court
to prevent or to initiate a change in abode. A person subject to guardianship may not be
admitted to a regional treatment center by the guardian except:

(i) after a hearing under chapter 253B;

(ii) for outpatient services; or

(iii) for the purpose of receiving temporary care for a specific period of time not to
exceed 90 days in any calendar year;

(2) the duty to provide for the care, comfort, and maintenance needs of the person subject
to guardianship, including food, clothing, shelter, health care, social and recreational
requirements, and, whenever appropriate, training, education, and habilitation or
rehabilitation. The guardian has no duty to pay for these requirements out of personal funds.
Whenever possible and appropriate, the guardian should meet these requirements through
governmental benefits or services to which the person subject to guardianship is entitled,
rather than from the estate of the person subject to guardianship. Failure to satisfy the needs
and requirements of this clause shall be grounds for removal of a private guardian, but the
guardian shall have no personal or monetary liability;

(3) the duty to take reasonable care of the clothing, furniture, vehicles, and other personal
effects of the person subject to guardianship, and, if other property requires protection, the
power to seek appointment of a conservator of the estate. The guardian must give notice by
mail to interested persons prior to the disposition of the clothing, furniture, vehicles, or
other personal effects of the person subject to guardianship. The notice must inform the
person of the right to object to the disposition of the property within ten days of the date of
mailing and to petition the court for a review of the guardian's proposed actions. Notice of
the objection must be served by mail or personal service on the guardian and the person
subject to guardianship unless the person subject to guardianship is the objector. The guardian
served with notice of an objection to the disposition of the property may not dispose of the
property unless the court approves the disposition after a hearing;

(4)(i) the power to give any necessary consent to enable the person subject to guardianship
to receive necessary medical or other professional care, counsel, treatment, or service, except
that no guardian may give consent for psychosurgery, electroshock, sterilization, or
experimental treatment of any kind unless the procedure is first approved by order of the
court as provided in this clause. The guardian shall not consent to any medical care for the
person subject to guardianship which violates the known conscientious, religious, or moral
belief of the person subject to guardianship;

(ii) a guardian who believes a procedure described in item (i) requiring prior court
approval to be necessary for the proper care of the person subject to guardianship, shall
petition the court for an order and, in the case of a public guardianship under chapter 252A,
obtain the written recommendation of the commissioner of human services. The court shall
fix the time and place for the hearing and shall give notice to the person subject to
guardianship in such manner as specified in section 524.5-308 and to interested persons.
The court shall appoint an attorney to represent the person subject to guardianship who is
not represented by counsel, provided that such appointment shall expire upon the expiration
of the appeal time for the order issued by the court under this section or the order dismissing
a petition, or upon such other time or event as the court may direct. In every case the court
shall determine if the procedure is in the best interest of the person subject to guardianship.
In making its determination, the court shall consider a written medical report which
specifically considers the medical risks of the procedure, whether alternative, less restrictive
methods of treatment could be used to protect the best interest of the person subject to
guardianship, and any recommendation of the commissioner of human services for a public
person subject to guardianship. The standard of proof is that of clear and convincing evidence;

(iii) in the case of a petition for sterilization of a person with developmental disabilities
subject to guardianship, the court shall appoint a licensed physician, a psychologist who is
qualified in the diagnosis and treatment of developmental disability, and a social worker
who is familiar with the social history and adjustment of the person subject to guardianship
or the case manager for the person subject to guardianship to examine or evaluate the person
subject to guardianship and to provide written reports to the court. The reports shall indicate
why sterilization is being proposed, whether sterilization is necessary and is the least intrusive
method for alleviating the problem presented, and whether it is in the best interest of the
person subject to guardianship. The medical report shall specifically consider the medical
risks of sterilization, the consequences of not performing the sterilization, and whether
alternative methods of contraception could be used to protect the best interest of the person
subject to guardianship;

(iv) any person subject to guardianship whose right to consent to a sterilization has not
been restricted under this section or section 252A.101 may be sterilized only if the person
subject to guardianship consents in writing or there is a sworn acknowledgment by an
interested person of a nonwritten consent by the person subject to guardianship. The consent
must certify that the person subject to guardianship has received a full explanation from a
physician or registered nurse of the nature and irreversible consequences of the sterilization;

(v) a guardian or the public guardian's designee who acts within the scope of authority
conferred by letters of guardianship under section 252A.101, subdivision 7, and according
to the standards established in this chapter or in chapter 252A shall not be civilly or criminally
liable for the provision of any necessary medical care, including, but not limited to, the
administration of psychotropic medication or the implementation of aversive and deprivation
procedures to which the guardian or the public guardian's designee has consented;

(5) in the event there is no duly appointed conservator of the estate of the person subject
to guardianship, the guardian shall have the power to approve or withhold approval of any
contract, except for necessities, which the person subject to guardianship may make or wish
to make;

(6) the duty and power to exercise supervisory authority over the person subject to
guardianship in a manner which limits civil rights and restricts personal freedom only to
the extent necessary to provide needed care and services. A guardian may not restrict the
ability of the person subject to guardianship to communicate, visit, or interact with others,
including receiving visitors or making or receiving telephone calls, personal mail, or
electronic communications including through social media, or participating in social activities,
unless the guardian has good cause to believe restriction is necessary because interaction
with the person poses a risk of significant physical, psychological, or financial harm to the
person subject to guardianship, and there is no other means to avoid such significant harm.
In all cases, the guardian shall provide written notice of the restrictions imposed to the court,
to the person subject to guardianship, and to the person subject to restrictions. The person
subject to guardianship or the person subject to restrictions may petition the court to remove
or modify the restrictions;

(7) if there is no acting conservator of the estate for the person subject to guardianship,
the guardian has the power to apply on behalf of the person subject to guardianship for any
assistance, services, or benefits available to the person subject to guardianship through any
unit of government;

(8) unless otherwise ordered by the court, the person subject to guardianship retains the
right to vote;

(9) the power to establish an ABLE account for a person subject to guardianship or
conservatorship. By this provision a guardian only has the authority to establish an ABLE
account, but may not administer the ABLE account in the guardian's capacity as guardiannew text begin.
The guardian may appoint or name a person to exercise signature authority over an ABLE
account, including the individual selected by the eligible individual or the eligible individual's
agent under a power of attorney; conservator; spouse; parent; sibling; grandparent; or
representative payee, whether an individual or organization, appointed by the SSA, in that
order
new text end; and

(10) if there is no conservator appointed for the person subject to guardianship, the
guardian has the duty and power to institute suit on behalf of the person subject to
guardianship and represent the person subject to guardianship in expungement proceedings,
harassment proceedings, and all civil court proceedings, including but not limited to
restraining orders, orders for protection, name changes, conciliation court, housing court,
family court, probate court, and juvenile court, provided that a guardian may not settle or
compromise any claim or debt owed to the estate without court approval.

new text begin EFFECTIVE DATE. new text end

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

Sec. 32.

Laws 2021, First Special Session chapter 7, article 2, section 17, the effective
date, is amended to read:


EFFECTIVE DATE.

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

Sec. 33.

Laws 2021, First Special Session chapter 7, article 6, section 12, the effective
date, is amended to read:


EFFECTIVE DATE.

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

Sec. 34.

Laws 2021, First Special Session chapter 7, article 11, section 18, the effective
date, is amended to read:


EFFECTIVE DATE.

This section is effective July 1, 2021, deleted text beginor upon federal approval,
whichever is later,
deleted text end except paragraph (f) is effective the day following final enactment. deleted text beginThe
commissioner shall notify the revisor of statutes when federal approval is obtained.
deleted text end

Sec. 35.

Laws 2021, First Special Session chapter 7, article 13, section 43, the effective
date, is amended to read:


EFFECTIVE DATE.

This section is effective January 1, 2022deleted text begin, or upon federal approval,
whichever is later, except the fifth sentence in paragraph (d) is effective January 1, 2022
deleted text end.
deleted text begin The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
deleted text end

Sec. 36.

Laws 2022, chapter 98, article 4, section 37, the effective date, is amended to
read:


EFFECTIVE DATE.

This section is effective July 1, 2022deleted text begin, or upon federal approval,
whichever is later
deleted text end. deleted text beginThe commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
deleted text end

Sec. 37. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2022, sections 254B.13, subdivisions 1, 2, 2a, 4, 5, 6, 7, and 8;
254B.16; 256.041, subdivision 10; 256B.49, subdivision 23; and 260.835, subdivision 2,
new text end new text begin
are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

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

APPENDIX

Repealed Minnesota Statutes: H2234-1

254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.

Subdivision 1.

Authorization for navigator pilot projects.

The commissioner may approve and implement navigator pilot projects developed under the planning process required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and enhance coordination of the delivery of chemical health services required under section 254B.03.

Subd. 2.

Program design and implementation.

(a) The commissioner and counties participating in the navigator pilot projects shall continue to work in partnership to refine and implement the navigator pilot projects initiated under Laws 2009, chapter 79, article 7, section 26.

(b) The commissioner and counties participating in the navigator pilot projects shall complete the planning phase and, if approved by the commissioner for implementation, enter into agreements governing the operation of the navigator pilot projects.

Subd. 2a.

Eligibility for navigator pilot program.

(a) To be considered for participation in a navigator pilot program, an individual must:

(1) be a resident of a county with an approved navigator program;

(2) be eligible for behavioral health fund services;

(3) be a voluntary participant in the navigator program;

(4) satisfy one of the following items:

(i) have at least one severity rating of three or above in dimension four, five, or six in a comprehensive assessment under section 245G.05, subdivision 2, paragraph (c), clauses (4) to (6); or

(ii) have at least one severity rating of two or above in dimension four, five, or six in a comprehensive assessment under section 245G.05, subdivision 2, paragraph (c), clauses (4) to (6), and be currently participating in a Rule 31 treatment program under chapter 245G or be within 60 days following discharge after participation in a Rule 31 treatment program; and

(5) have had at least two treatment episodes in the past two years, not limited to episodes reimbursed by the behavioral health fund. An admission to an emergency room, a detoxification program, or a hospital may be substituted for one treatment episode if it resulted from the individual's substance use disorder.

(b) New eligibility criteria may be added as mutually agreed upon by the commissioner and participating navigator programs.

Subd. 4.

Notice of navigator pilot project discontinuation.

Each county's participation in the navigator pilot project may be discontinued for any reason by the county or the commissioner of human services after 30 days' written notice to the other party.

Subd. 5.

Duties of commissioner.

(a) Notwithstanding any other provisions in this chapter, the commissioner may authorize navigator pilot projects to use the behavioral health fund to pay for nontreatment navigator pilot services:

(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph (a); and

(2) by vendors in addition to those authorized under section 254B.05 when not providing substance use disorder treatment services.

(b) For purposes of this section, "nontreatment navigator pilot services" include navigator services, peer support, family engagement and support, housing support, rent subsidies, supported employment, and independent living skills.

(c) State expenditures for substance use disorder services and nontreatment navigator pilot services provided by or through the navigator pilot projects must not be greater than the behavioral health fund expected share of forecasted expenditures in the absence of the navigator pilot projects. The commissioner may restructure the schedule of payments between the state and participating counties under the local agency share and division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to facilitate the operation of the navigator pilot projects.

(d) The commissioner may waive administrative rule requirements that are incompatible with the implementation of the navigator pilot project, except that any substance use disorder treatment funded under this section must continue to be provided by a licensed treatment provider.

(e) The commissioner shall not approve or enter into any agreement related to navigator pilot projects authorized under this section that puts current or future federal funding at risk.

(f) The commissioner shall provide participating navigator pilot projects with transactional data, reports, provider data, and other data generated by county activity to assess and measure outcomes. This information must be transmitted or made available in an acceptable form to participating navigator pilot projects at least once every six months or within a reasonable time following the commissioner's receipt of information from the counties needed to comply with this paragraph.

Subd. 6.

Duties of county board.

The county board, or other county entity that is approved to administer a navigator pilot project, shall:

(1) administer the navigator pilot project in a manner consistent with the objectives described in subdivision 2 and the planning process in subdivision 5;

(2) ensure that no one is denied substance use disorder treatment services for which they would otherwise be eligible under section 254A.03, subdivision 3; and

(3) provide the commissioner with timely and pertinent information as negotiated in agreements governing operation of the navigator pilot projects.

Subd. 7.

Managed care.

An individual who is eligible for the navigator pilot program under subdivision 2a is excluded from mandatory enrollment in managed care until these services are included in the health plan's benefit set.

Subd. 8.

Authorization for continuation of navigator pilots.

The navigator pilot projects implemented pursuant to subdivision 1 are authorized to continue operation after July 1, 2013, under existing agreements governing operation of the pilot projects.

254B.16 PILOT PROJECTS; TREATMENT FOR PREGNANT AND POSTPARTUM WOMEN WITH SUBSTANCE USE DISORDER.

Subdivision 1.

Pilot projects established.

(a) Within the limits of federal funds available specifically for this purpose, the commissioner of human services shall establish pilot projects to provide substance use disorder treatment and services to pregnant and postpartum women with a primary diagnosis of substance use disorder, including opioid use disorder. Pilot projects funded under this section must:

(1) promote flexible uses of funds to provide treatment and services to pregnant and postpartum women with substance use disorders;

(2) fund family-based treatment and services for pregnant and postpartum women with substance use disorders;

(3) identify gaps in services along the continuum of care that are provided to pregnant and postpartum women with substance use disorders; and

(4) encourage new approaches to service delivery and service delivery models.

(b) A pilot project funded under this section must provide at least a portion of its treatment and services to women who receive services on an outpatient basis.

Subd. 2.

Federal funds.

The commissioner shall apply for any available grant funds from the federal Center for Substance Abuse Treatment for these pilot projects.

256.041 CULTURAL AND ETHNIC COMMUNITIES LEADERSHIP COUNCIL.

Subd. 10.

Expiration.

The council expires on June 30, 2025.

256B.49 HOME AND COMMUNITY-BASED SERVICE WAIVERS FOR PERSONS WITH DISABILITIES.

Subd. 23.

Community-living settings.

(a) For the purposes of this chapter, "community-living settings" means a single-family home or multifamily dwelling unit where a service recipient or a service recipient's family owns or rents, and maintains control over the individual unit as demonstrated by a lease agreement. Community-living settings does not include a home or dwelling unit that the service provider owns, operates, or leases or in which the service provider has a direct or indirect financial interest.

(b) To ensure a service recipient or the service recipient's family maintains control over the home or dwelling unit, community-living settings are subject to the following requirements:

(1) service recipients must not be required to receive services or share services;

(2) service recipients must not be required to have a disability or specific diagnosis to live in the community-living setting;

(3) service recipients may hire service providers of their choice;

(4) service recipients may choose whether to share their household and with whom;

(5) the home or multifamily dwelling unit must include living, sleeping, bathing, and cooking areas;

(6) service recipients must have lockable access and egress;

(7) service recipients must be free to receive visitors and leave the settings at times and for durations of their own choosing;

(8) leases must comply with chapter 504B;

(9) landlords must not charge different rents to tenants who are receiving home and community-based services; and

(10) access to the greater community must be easily facilitated based on the service recipient's needs and preferences.

(c) Nothing in this section prohibits a service recipient from having another person or entity not affiliated with the service provider cosign a lease. Nothing in this section prohibits a service recipient, during any period in which a service provider has cosigned the service recipient's lease, from modifying services with an existing cosigning service provider and, subject to the approval of the landlord, maintaining a lease cosigned by the service provider. Nothing in this section prohibits a service recipient, during any period in which a service provider has cosigned the service recipient's lease, from terminating services with the cosigning service provider, receiving services from a new service provider, and, subject to the approval of the landlord, maintaining a lease cosigned by the new service provider.

(d) A lease cosigned by a service provider meets the requirements of paragraph (a) if the service recipient and service provider develop and implement a transition plan which must provide that, within two years of cosigning the initial lease, the service provider shall transfer the lease to the service recipient and other cosigners, if any.

(e) In the event the landlord has not approved the transfer of the lease within two years of the service provider cosigning the initial lease, the service provider must submit a time-limited extension request to the commissioner of human services to continue the cosigned lease arrangement. The extension request must include:

(1) the reason the landlord denied the transfer;

(2) the plan to overcome the denial to transfer the lease;

(3) the length of time needed to successfully transfer the lease, not to exceed an additional two years;

(4) a description of how the transition plan was followed, what occurred that led to the landlord denying the transfer, and what changes in circumstances or condition, if any, the service recipient experienced; and

(5) a revised transition plan to transfer the cosigned lease between the service provider and the service recipient to the service recipient.

The commissioner must approve an extension within sufficient time to ensure the continued occupancy by the service recipient.

260.835 AMERICAN INDIAN CHILD WELFARE ADVISORY COUNCIL.

Subd. 2.

Expiration.

The American Indian Child Welfare Advisory Council expires June 30, 2023.