1.1 	A bill for an act
1.2 	relating to human services; child care; foster care; disability services; civil 
1.3 	commitment; requiring students in foster care who change schools to be enrolled 
1.4 	within seven days; requiring responsible social services agencies to initiate and 
1.5 	facilitate phone calls between parents and foster care providers for children in 
1.6 	out-of-home placement; directing the commissioner of human services to modify 
1.7 	a report and develop training; prohibiting the commissioner of human services 
1.8 	from imposing new or additional reporting requirements on community-based 
1.9 	mental health service providers unless the commissioner first increases 
1.10 	reimbursement rates; extending the corporate adult foster care moratorium exception 
1.11 	for a fifth bed until 2024; modifying timelines for intensive support service 
1.12 	planning; permitting delegation of competency evaluations of direct support staff; 
1.13 	modifying the training requirements for direct support staff providing licensed 
1.14 	home and community-based services; codifying an existing grant program for fetal 
1.15 	alcohol disorder prevention activities; clarifying the excess income standard for 
1.16 	medical assistance; extending end date for first three years of life demonstration 
1.17 	project; permitting  advanced practice registered nurses and physician assistants 
1.18 	to order home health services under Medical Assistance; codifying existing session 
1.19 	law governing consumer-directed community supports; modifying provisions 
1.20 	regarding post-arrest community-based service coordination; Birth to Age Eight 
1.21 	pilot project participation requirements; eliminating requirement to involve state 
1.22 	medical review agent in determination and documentation of medically necessary 
1.23 	psychiatric residential treatment facility services; requiring establishment of per 
1.24 	diem rate per provider of youth psychiatric residential treatment services; permitting 
1.25 	facilities or licensed professionals to submit billing for arranged services; changing 
1.26 	definition relating to children's mental health crisis response services; modifying 
1.27 	intensive rehabilitative mental health services requirements and provider standards; 
1.28 	establishing a foster care moratorium exception for family to corporate foster care 
1.29 	conversions; establishing state policy regrading services offered to people with 
1.30 	disabilities; modifying existing direction to the commissioner of human services 
1.31 	regarding proposing changes to the home and community-based waivers; modifying 
1.32 	requirements for service planning for home and community-based services; 
1.33 	modifying definitions, requirements and eligibility for long-term care consultation 
1.34 	services; modifying case management requirements for individuals receiving 
1.35 	services through the home and community-based services waivers; transferring 
1.36 	authority to issue certain home and community-based services designations to 
1.37 	licensed home care providers from the commissioner of health to the commissioner 
1.38 	of human services; establishing a moratorium on initial home and community-based 
2.1 	services designations for providers providing certain customized living services 
2.2 	in unlicensed settings; modifying provisions relating to child care services grants; 
2.3 	clarifying commissioner authority to waive child care assistance program provider 
2.4 	requirements during declared disaster; modifying eligibility for children's mental 
2.5 	health respite grants; clarifying child care training requirements; removing certain 
2.6 	categories from being exempt from foster care initial license moratorium; modifying 
2.7 	provisions relating to home and community-based services; clarifying circumstances 
2.8 	for termination of state-operated services for individuals with complex behavioral 
2.9 	needs; removing provision limiting medical assistance coverage for intensive 
2.10 	mental health outpatient treatment to adults; modifying provisions relating to 
2.11 	withdrawal management, substance use disorder, housing support, and general 
2.12 	assistance programs; authorizing correction of housing support payments; permitting 
2.13 	child care assistance program providers to serve children over the age of 13 in 
2.14 	certain circumstances; modifying definition of "qualified professional" for purposes 
2.15 	of applying for housing support and general assistance; authorizing imposition of 
2.16 	fine for repeat violations of chemical dependency or substance abuse disorder 
2.17 	treatment program requirements; directing commissioner of human services to 
2.18 	consider continuous licenses for family day care providers; instructing the revisor 
2.19 	of statutes to modify references to the Disability Linkage Line; modifying 
2.20 	provisions governing civil commitment; authorizing engagement services pilot 
2.21 	project; requiring reports; amending Minnesota Statutes 2018, sections 119B.21; 
2.22 	119B.26; 144A.484, subdivisions 2, 4, 5, 6; 245.4682, subdivision 2; 245.4876, 
2.23 	by adding a subdivision; 245A.11, subdivision 2a; 245D.02, by adding a 
2.24 	subdivision; 245D.04, subdivision 3; 245D.071, subdivision 3; 245D.081, 
2.25 	subdivision 2; 245D.09, subdivisions 4, 4a; 245D.10, subdivision 3a; 245F.02, 
2.26 	subdivisions 7, 14; 245F.06, subdivision 2; 245F.12, subdivisions 2, 3; 245G.02, 
2.27 	subdivision 2; 245G.09, subdivision 1; 245H.08, subdivisions 4, 5; 253B.02, 
2.28 	subdivisions 4b, 7, 8, 9, 10, 13, 16, 17, 18, 19, 21, 22, 23, by adding a subdivision; 
2.29 	253B.03, subdivisions 1, 2, 3, 4a, 5, 6, 6b, 6d, 7, 10; 253B.04, subdivisions 1, 1a, 
2.30 	2; 253B.045, subdivisions 2, 3, 5, 6; 253B.06, subdivisions 1, 2, 3; 253B.07, 
2.31 	subdivisions 1, 2, 2a, 2b, 2d, 3, 5, 7; 253B.08, subdivisions 1, 2a, 5, 5a; 253B.09, 
2.32 	subdivisions 1, 2, 3a, 5; 253B.092; 253B.0921; 253B.095, subdivision 3; 253B.097, 
2.33 	subdivisions 1, 2, 3, 6; 253B.10; 253B.12, subdivisions 1, 3, 4, 7; 253B.13, 
2.34 	subdivision 1; 253B.14; 253B.141; 253B.15, subdivisions 1, 1a, 2, 3, 3a, 3b, 3c, 
2.35 	5, 7, 9, 10, by adding a subdivision; 253B.16; 253B.17; 253B.18, subdivisions 1, 
2.36 	2, 3, 4a, 4b, 4c, 5, 5a, 6, 7, 8, 10, 11, 12, 14, 15; 253B.19, subdivision 2; 253B.20, 
2.37 	subdivisions 1, 2, 3, 4, 6; 253B.21, subdivisions 1, 2, 3; 253B.212, subdivisions 
2.38 	1, 1a, 1b, 2; 253B.22, subdivisions 1, 2, 3, 4; 253B.23, subdivisions 1, 1b, 2; 
2.39 	253B.24; 253D.02, subdivision 6; 253D.07, subdivision 2; 253D.10, subdivision 
2.40 	2; 253D.28, subdivision 2; 256B.0625, subdivisions 5l, 56a; 256B.0652, subdivision 
2.41 	10; 256B.0653, subdivisions 5, 7; 256B.0654, subdivisions 1, 2a; 256B.0911, 
2.42 	subdivisions 1, 3, 3b, 4d, by adding subdivisions; 256B.092, subdivision 1a; 
2.43 	256B.0941, subdivisions 1, 3; 256B.0944, subdivision 1; 256B.0947, subdivisions 
2.44 	2, 4, 5, 6; 256B.0949, subdivisions 2, 5, 6, 9, 13, 14, 15, 16; 256B.49, subdivision 
2.45 	16; 256D.02, subdivision 17; 256I.03, subdivisions 3, 14; 256I.05, subdivisions 
2.46 	1c, 1n, 8; 256I.06, subdivision 2, by adding a subdivision; 256J.08, subdivision 
2.47 	73a; 256P.01, by adding a subdivision; 257.0725; 260C.219; Minnesota Statutes 
2.48 	2019 Supplement, sections 144A.484, subdivision 1; 245.4889, subdivision 1; 
2.49 	245A.03, subdivision 7; 245A.149; 245A.40, subdivision 7; 245D.071, subdivision 
2.50 	5; 245D.09, subdivision 5; 254A.03, subdivision 3, as amended; 254B.05, 
2.51 	subdivision 1; 256B.056, subdivision 5c; 256B.064, subdivision 2; 256B.0711, 
2.52 	subdivision 1; 256B.0911, subdivisions 1a, 3a, 3f; 256B.092, subdivision 1b; 
2.53 	256B.49, subdivisions 13, 14; 256B.4914, subdivision 10a; 256I.04, subdivision 
2.54 	2b; 256S.01, subdivision 6; 256S.19, subdivision 4; Laws 2016, chapter 189, article 
2.55 	15, section 29; Laws 2017, First Special Session chapter 6, article 7, section 33; 
2.56 	Laws 2019, First Special Session chapter 9, article 5, section 86; article 14, section 
2.57 	2, subdivision 33; proposing coding for new law in Minnesota Statutes, chapters 
2.58 	120A; 245D; 253B; 254A; 256B; repealing Minnesota Statutes 2018, sections 
3.1 	245F.02, subdivision 20; 253B.02, subdivisions 6, 12a; 253B.05, subdivisions 1, 
3.2 	2, 2b, 3, 4; 253B.064; 253B.065; 253B.066; 253B.09, subdivision 3; 253B.12, 
3.3 	subdivision 2; 253B.15, subdivision 11; 253B.20, subdivision 7; Laws 2005, First 
3.4 	Special Session chapter 4, article 7, sections 50; 51; Laws 2012, chapter 247, article 
3.5 	4, section 47, as amended; Laws 2015, chapter 71, article 7, section 54, as amended; 
3.6 	Laws 2017, First Special Session chapter 6, article 1, sections 44, as amended; 45, 
3.7 	as amended.
3.8 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.9 	ARTICLE 1
3.10 	CHILD PROTECTION AND OUT-OF-HOME PLACEMENT

3.11 	Section 1. [120A.21] ENROLLMENT OF A STUDENT IN FOSTER CARE.
3.12 	A student placed in foster care must remain enrolled in the student's prior school unless 
3.13 	it is determined that remaining enrolled in the prior school is not in the student's best interests. 
3.14 	If the student does not remain enrolled in the prior school, the student must be enrolled in 
3.15 	a new school within seven school days.

3.16 	Sec. 2. Minnesota Statutes 2018, section 257.0725, is amended to read:
3.17 	257.0725 ANNUAL REPORT.
3.18 	The commissioner of human services shall publish an annual report on child maltreatment 
3.19 	and on children in out-of-home placement. The commissioner shall confer with counties, 
3.20 	child welfare organizations, child advocacy organizations, the courts, and other groups on 
3.21 	how to improve the content and utility of the department's annual report. In regard to child 
3.22 	maltreatment, the report shall include the number and kinds of maltreatment reports received 
3.23 	and any other data that the commissioner determines is appropriate to include in a report 
3.24 	on child maltreatment. In regard to children in out-of-home placement, the report shall 
3.25 	include, by county and statewide, information on legal status, living arrangement, age, sex, 
3.26 	race, accumulated length of time in placement, reason for most recent placement, race of 
3.27 	family with whom placed, school enrollments within seven days of placement pursuant to 
3.28 	section 120A.21, and other information deemed appropriate on all children in out-of-home 
3.29 	placement. Out-of-home placement includes placement in any facility by an authorized 
3.30 	child-placing agency.

4.1 	Sec. 3. Minnesota Statutes 2018, section 260C.219, is amended to read:
4.2 	260C.219 AGENCY RESPONSIBILITIES FOR PARENTS AND CHILDREN IN 
4.3 	PLACEMENT.
4.4 		Subdivision 1.Responsibilities for parents; noncustodial parents. (a) When a child 
4.5 	is in foster care, the responsible social services agency shall make diligent efforts to identify, 
4.6 	locate, and, where appropriate, offer services to both parents of the child.
4.7 	(1) (b) The responsible social services agency shall assess whether a noncustodial or 
4.8 	nonadjudicated parent is willing and capable of providing for the day-to-day care of the 
4.9 	child temporarily or permanently. An assessment under this clause paragraph may include, 
4.10 	but is not limited to, obtaining information under section 260C.209. If after assessment, the 
4.11 	responsible social services agency determines that a noncustodial or nonadjudicated parent 
4.12 	is willing and capable of providing day-to-day care of the child, the responsible social 
4.13 	services agency may seek authority from the custodial parent or the court to have that parent 
4.14 	assume day-to-day care of the child. If a parent is not an adjudicated parent, the responsible 
4.15 	social services agency shall require the nonadjudicated parent to cooperate with paternity 
4.16 	establishment procedures as part of the case plan.
4.17 	(2) (c) If, after assessment, the responsible social services agency determines that the 
4.18 	child cannot be in the day-to-day care of either parent, the agency shall:
4.19 	(i) (1) prepare an out-of-home placement plan addressing the conditions that each parent 
4.20 	must meet before the child can be in that parent's day-to-day care; and
4.21 	(ii) (2) provide a parent who is the subject of a background study under section 260C.209
4.22 	15 days' notice that it intends to use the study to recommend against putting the child with 
4.23 	that parent, and the court shall afford the parent an opportunity to be heard concerning the 
4.24 	study.
4.25 	The results of a background study of a noncustodial parent shall not be used by the agency 
4.26 	to determine that the parent is incapable of providing day-to-day care of the child unless 
4.27 	the agency reasonably believes that placement of the child into the home of that parent 
4.28 	would endanger the child's health, safety, or welfare.
4.29 	(3) (d) If, after the provision of services following an out-of-home placement plan under 
4.30 	this section subdivision, the child cannot return to the care of the parent from whom the 
4.31 	child was removed or who had legal custody at the time the child was placed in foster care, 
4.32 	the agency may petition on behalf of a noncustodial parent to establish legal custody with 
4.33 	that parent under section 260C.515, subdivision 4. If paternity has not already been 
5.1 	established, it may be established in the same proceeding in the manner provided for under 
5.2 	chapter 257.
5.3 	(4) (e) The responsible social services agency may be relieved of the requirement to 
5.4 	locate and offer services to both parents by the juvenile court upon a finding of good cause 
5.5 	after the filing of a petition under section 260C.141.
5.6 		Subd. 2.Notice to parent or guardian. (b) The responsible social services agency shall 
5.7 	give notice to the parent or guardian of each child in foster care, other than a child in 
5.8 	voluntary foster care for treatment under chapter 260D, of the following information:
5.9 	(1) that the child's placement in foster care may result in termination of parental rights 
5.10 	or an order permanently placing the child out of the custody of the parent, but only after 
5.11 	notice and a hearing as required under this chapter and the juvenile court rules;
5.12 	(2) time limits on the length of placement and of reunification services, including the 
5.13 	date on which the child is expected to be returned to and safely maintained in the home of 
5.14 	the parent or parents or placed for adoption or otherwise permanently removed from the 
5.15 	care of the parent by court order;
5.16 	(3) the nature of the services available to the parent;
5.17 	(4) the consequences to the parent and the child if the parent fails or is unable to use 
5.18 	services to correct the circumstances that led to the child's placement;
5.19 	(5) the first consideration for placement with relatives;
5.20 	(6) the benefit to the child in getting the child out of foster care as soon as possible, 
5.21 	preferably by returning the child home, but if that is not possible, through a permanent legal 
5.22 	placement of the child away from the parent;
5.23 	(7) when safe for the child, the benefits to the child and the parent of maintaining 
5.24 	visitation with the child as soon as possible in the course of the case and, in any event, 
5.25 	according to the visitation plan under this section; and
5.26 	(8) the financial responsibilities and obligations, if any, of the parent or parents for the 
5.27 	support of the child during the period the child is in foster care.
5.28 		Subd. 3.Information for a parent considering voluntary placement. (c) The 
5.29 	responsible social services agency shall inform a parent considering voluntary placement 
5.30 	of a child under section 260C.227 of the following information:
5.31 	(1) the parent and the child each has a right to separate legal counsel before signing a 
5.32 	voluntary placement agreement, but not to counsel appointed at public expense;
6.1 	(2) the parent is not required to agree to the voluntary placement, and a parent who enters 
6.2 	a voluntary placement agreement may at any time request that the agency return the child. 
6.3 	If the parent so requests, the child must be returned within 24 hours of the receipt of the 
6.4 	request;
6.5 	(3) evidence gathered during the time the child is voluntarily placed may be used at a 
6.6 	later time as the basis for a petition alleging that the child is in need of protection or services 
6.7 	or as the basis for a petition seeking termination of parental rights or other permanent 
6.8 	placement of the child away from the parent;
6.9 	(4) if the responsible social services agency files a petition alleging that the child is in 
6.10 	need of protection or services or a petition seeking the termination of parental rights or other 
6.11 	permanent placement of the child away from the parent, the parent would have the right to 
6.12 	appointment of separate legal counsel and the child would have a right to the appointment 
6.13 	of counsel and a guardian ad litem as provided by law, and that counsel will be appointed 
6.14 	at public expense if they are unable to afford counsel; and
6.15 	(5) the timelines and procedures for review of voluntary placements under section 
6.16 	260C.212, subdivision 3, and the effect the time spent in voluntary placement on the 
6.17 	scheduling of a permanent placement determination hearing under sections 260C.503 to 
6.18 	260C.521.
6.19 		Subd. 4.Medical examinations. (d) When an agency accepts a child for placement, the 
6.20 	agency shall determine whether the child has had a physical examination by or under the 
6.21 	direction of a licensed physician within the 12 months immediately preceding the date when 
6.22 	the child came into the agency's care. If there is documentation that the child has had an 
6.23 	examination within the last 12 months, the agency is responsible for seeing that the child 
6.24 	has another physical examination within one year of the documented examination and 
6.25 	annually in subsequent years. If the agency determines that the child has not had a physical 
6.26 	examination within the 12 months immediately preceding placement, the agency shall ensure 
6.27 	that the child has an examination within 30 days of coming into the agency's care and once 
6.28 	a year in subsequent years.
6.29 		Subd. 5.Children reaching age of majority; copies of records. (e) Whether under 
6.30 	state guardianship or not, if a child leaves foster care by reason of having attained the age 
6.31 	of majority under state law, the child must be given at no cost a copy of the child's social 
6.32 	and medical history, as defined in section 259.43, and education report.
6.33 		Subd. 6.Prenatal alcohol exposure screening. The responsible social services agency 
6.34 	shall coordinate a prenatal alcohol exposure screening for any child who enters foster care 
7.1 	as soon as practicable but no later than 45 days after the removal of the child from the child's 
7.2 	home, if the agency has determined that the child has not previously been screened or 
7.3 	identified as being prenatally exposed to alcohol. The responsible social services agency 
7.4 	shall ensure that the screening is conducted in accordance with existing prenatal alcohol 
7.5 	exposure screening best practice guidelines and criteria developed and provided to the 
7.6 	responsible social services agencies by the statewide organization that focuses solely on 
7.7 	prevention of and intervention with fetal alcohol spectrum disorder and receives funding 
7.8 	under the appropriation for fetal alcohol spectrum disorder in Laws 2007, chapter 147, 
7.9 	article 19, section 4, subdivision 2.
7.10 		Subd. 7.Initial foster care phone call. (a) When a child enters foster care or moves to 
7.11 	a new foster care placement, the responsible social services agency shall coordinate a phone 
7.12 	call between the foster parent or facility and the child's parent or legal guardian to establish 
7.13 	a connection and encourage ongoing information sharing between the child's parent or legal 
7.14 	guardian and the foster parent or facility; and to provide an opportunity to share any 
7.15 	information regarding the child, the child's needs, or the child's care that would facilitate 
7.16 	the child's adjustment to the foster home, promote stability, reduce the risk of trauma, or 
7.17 	otherwise improve the quality of the child's care.
7.18 	(b) The responsible social services agency shall coordinate the phone call in paragraph 
7.19 	(a) as soon as practicable after the child arrives at the placement but no later than 48 hours 
7.20 	after the child's placement. If the responsible social services agency determines that the 
7.21 	phone call is not in the child's best interests, or if the agency is unable to identify, locate, 
7.22 	or contact the child's parent or legal guardian despite reasonable efforts, or despite active 
7.23 	efforts if the child is an American Indian child, the agency may delay the phone call until 
7.24 	up to 48 hours after the agency determines that the phone call is in the child's best interests, 
7.25 	or up to 48 hours after the child's parent or legal guardian is located or becomes available 
7.26 	for the phone call.
7.27 	(c) The responsible social services agency shall document the date and time of the phone 
7.28 	call in paragraph (a), its efforts to coordinate the phone call, its efforts to identify, locate, 
7.29 	or find availability for the child's parent or legal guardian, any determination of whether 
7.30 	the phone call is in the child's best interests, and any reasons that the phone call did not 
7.31 	occur.

7.32 	EFFECTIVE DATE. This section is effective for children who enter foster care on or 
7.33 	after August 1, 2020, except subdivision 7 is effective for children entering out-of-home 
7.34 	placement or moving between placements on or after November 1, 2020.

8.1 	Sec. 4. DIRECTION TO COMMISSIONER; INITIAL FOSTER CARE PHONE 
8.2 	CALL TRAINING.
 8.3 	By August 1, 2020, the commissioner of human services shall issue written guidance to 
8.4 	county social services agencies, foster parents, and facilities to fully implement the initial 
8.5 	foster care phone call procedures in Minnesota Statutes, section 260C.219, subdivision 6.

8.6 	EFFECTIVE DATE. This section is effective the day following final enactment.

8.7 	ARTICLE 2
8.8 	COMMUNITY SUPPORTS ADMINISTRATION

8.9 	Section 1. Minnesota Statutes 2018, section 245.4682, subdivision 2, is amended to read:
8.10 		Subd. 2.General provisions. (a) In the design and implementation of reforms to the 
8.11 	mental health system, the commissioner shall:
8.12 	(1) consult with consumers, families, counties, tribes, advocates, providers, and other 
8.13 	stakeholders;
8.14 	(2) bring to the legislature, and the State Advisory Council on Mental Health, by January 
8.15 	15, 2008, recommendations for legislation to update the role of counties and to clarify the 
8.16 	case management roles, functions, and decision-making authority of health plans and 
8.17 	counties, and to clarify county retention of the responsibility for the delivery of social 
8.18 	services as required under subdivision 3, paragraph (a);
8.19 	(3) withhold implementation of any recommended changes in case management roles, 
8.20 	functions, and decision-making authority until after the release of the report due January 
8.21 	15, 2008;
8.22 	(4) ensure continuity of care for persons affected by these reforms including ensuring 
8.23 	client choice of provider by requiring broad provider networks and developing mechanisms 
8.24 	to facilitate a smooth transition of service responsibilities;
8.25 	(5) provide accountability for the efficient and effective use of public and private 
8.26 	resources in achieving positive outcomes for consumers;
8.27 	(6) ensure client access to applicable protections and appeals; and
8.28 	(7) make budget transfers necessary to implement the reallocation of services and client 
8.29 	responsibilities between counties and health care programs that do not increase the state 
8.30 	and county costs and efficiently allocate state funds.
9.1 	(b) When making transfers under paragraph (a) necessary to implement movement of 
9.2 	responsibility for clients and services between counties and health care programs, the 
9.3 	commissioner, in consultation with counties, shall ensure that any transfer of state grants 
9.4 	to health care programs, including the value of case management transfer grants under 
9.5 	section 256B.0625, subdivision 20, does not exceed the value of the services being transferred 
9.6 	for the latest 12-month period for which data is available. The commissioner may make 
9.7 	quarterly adjustments based on the availability of additional data during the first four quarters 
9.8 	after the transfers first occur. If case management transfer grants under section 256B.0625, 
9.9 	subdivision 20, are repealed and the value, based on the last year prior to repeal, exceeds 
9.10 	the value of the services being transferred, the difference becomes an ongoing part of each 
9.11 	county's adult mental health grants under sections 245.4661 and 256E.12.
9.12 	(c) This appropriation is not authorized to be expended after December 31, 2010, unless 
9.13 	approved by the legislature.
9.14 	(d) Beginning July 1, 2020, the commissioner of human services shall not impose new 
9.15 	or additional state reporting requirements to those existing in law as of July 1, 2020, for 
9.16 	community-based mental health service providers as a condition for reimbursement for 
9.17 	mental health services provided through medical assistance or MinnesotaCare, unless the 
9.18 	corresponding service reimbursement rates are first increased. This provision does not apply 
9.19 	to any new services offered by community-based mental health service providers after July 
9.20 	1, 2020.

9.21 	Sec. 2. Minnesota Statutes 2018, section 245.4876, is amended by adding a subdivision 
9.22 	to read:
9.23 		Subd. 8.Prohibition against new or additional state reporting 
9.24 	requirements. Beginning July 1, 2020, the commissioner of human services shall not impose 
9.25 	new or additional state reporting requirements to those existing in law as of July 1, 2020, 
9.26 	for community-based mental health service providers as a condition for reimbursement for 
9.27 	children's mental health services provided through medical assistance or MinnesotaCare, 
9.28 	unless the corresponding service reimbursement rates are first increased. This provision 
9.29 	does not apply to any new children's mental health services offered by community-based 
9.30 	mental health service providers after July 1, 2020.

9.31 	Sec. 3. Minnesota Statutes 2018, section 245A.11, subdivision 2a, is amended to read:
9.32 		Subd. 2a.Adult foster care and community residential setting license capacity. (a) 
9.33 	The commissioner shall issue adult foster care and community residential setting licenses 
10.1 	with a maximum licensed capacity of four beds, including nonstaff roomers and boarders, 
10.2 	except that the commissioner may issue a license with a capacity of five beds, including 
10.3 	roomers and boarders, according to paragraphs (b) to (g).
10.4 	(b) The license holder may have a maximum license capacity of five if all persons in 
10.5 	care are age 55 or over and do not have a serious and persistent mental illness or a 
10.6 	developmental disability.
10.7 	(c) The commissioner may grant variances to paragraph (b) to allow a facility with a 
10.8 	licensed capacity of up to five persons to admit an individual under the age of 55 if the 
10.9 	variance complies with section 245A.04, subdivision 9, and approval of the variance is 
10.10 	recommended by the county in which the licensed facility is located.
10.11 	(d) The commissioner may grant variances to paragraph (a) to allow the use of an 
10.12 	additional bed, up to five, for emergency crisis services for a person with serious and 
10.13 	persistent mental illness or a developmental disability, regardless of age, if the variance 
10.14 	complies with section 245A.04, subdivision 9, and approval of the variance is recommended 
10.15 	by the county in which the licensed facility is located.
10.16 	(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an 
10.17 	additional bed, up to five, for respite services, as defined in section 245A.02, for persons 
10.18 	with disabilities, regardless of age, if the variance complies with sections 245A.03, 
10.19 	subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended 
10.20 	by the county in which the licensed facility is located. Respite care may be provided under 
10.21 	the following conditions:
10.22 	(1) staffing ratios cannot be reduced below the approved level for the individuals being 
10.23 	served in the home on a permanent basis;
10.24 	(2) no more than two different individuals can be accepted for respite services in any 
10.25 	calendar month and the total respite days may not exceed 120 days per program in any 
10.26 	calendar year;
10.27 	(3) the person receiving respite services must have his or her own bedroom, which could 
10.28 	be used for alternative purposes when not used as a respite bedroom, and cannot be the 
10.29 	room of another person who lives in the facility; and
10.30 	(4) individuals living in the facility must be notified when the variance is approved. The 
10.31 	provider must give 60 days' notice in writing to the residents and their legal representatives 
10.32 	prior to accepting the first respite placement. Notice must be given to residents at least two 
10.33 	days prior to service initiation, or as soon as the license holder is able if they receive notice 
11.1 	of the need for respite less than two days prior to initiation, each time a respite client will 
11.2 	be served, unless the requirement for this notice is waived by the resident or legal guardian.
11.3 	(f) The commissioner may issue an adult foster care or community residential setting 
11.4 	license with a capacity of five adults if the fifth bed does not increase the overall statewide 
11.5 	capacity of licensed adult foster care or community residential setting beds in homes that 
11.6 	are not the primary residence of the license holder, as identified in a plan submitted to the 
11.7 	commissioner by the county, when the capacity is recommended by the county licensing 
11.8 	agency of the county in which the facility is located and if the recommendation verifies 
11.9 	that:
11.10 	(1) the facility meets the physical environment requirements in the adult foster care 
11.11 	licensing rule;
11.12 	(2) the five-bed living arrangement is specified for each resident in the resident's:
11.13 	(i) individualized plan of care;
11.14 	(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
11.15 	(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, 
11.16 	subpart 19, if required;
11.17 	(3) the license holder obtains written and signed informed consent from each resident 
11.18 	or resident's legal representative documenting the resident's informed choice to remain 
11.19 	living in the home and that the resident's refusal to consent would not have resulted in 
11.20 	service termination; and
11.21 	(4) the facility was licensed for adult foster care before March 1, 2011 2016.
11.22 	(g) The commissioner shall not issue a new adult foster care license under paragraph (f) 
11.23 	after June 30, 2019 2024. The commissioner shall allow a facility with an adult foster care 
11.24 	license issued under paragraph (f) before June 30, 2019 2024, to continue with a capacity 
11.25 	of five adults if the license holder continues to comply with the requirements in paragraph 
11.26 	(f).

11.27 	Sec. 4. Minnesota Statutes 2018, section 245D.02, is amended by adding a subdivision to 
11.28 	read:
11.29 		Subd. 32a.Sexual violence. "Sexual violence" means the use of sexual actions or words 
11.30 	that are unwanted or harmful to another person.

12.1 	Sec. 5. Minnesota Statutes 2018, section 245D.071, subdivision 3, is amended to read:
12.2 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service initiation 
12.3 	the license holder must complete a preliminary coordinated service and support plan 
12.4 	addendum based on the coordinated service and support plan.
12.5 	(b) Within the scope of services, the license holder must, at a minimum, complete 
12.6 	assessments in the following areas before the 45-day planning meeting:
12.7 	(1) the person's ability to self-manage health and medical needs to maintain or improve 
12.8 	physical, mental, and emotional well-being, including, when applicable, allergies, seizures, 
12.9 	choking, special dietary needs, chronic medical conditions, self-administration of medication 
12.10 	or treatment orders, preventative screening, and medical and dental appointments;
12.11 	(2) the person's ability to self-manage personal safety to avoid injury or accident in the 
12.12 	service setting, including, when applicable, risk of falling, mobility, regulating water 
12.13 	temperature, community survival skills, water safety skills, and sensory disabilities; and
12.14 	(3) the person's ability to self-manage symptoms or behavior that may otherwise result 
12.15 	in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension 
12.16 	or termination of services by the license holder, or other symptoms or behaviors that may 
12.17 	jeopardize the health and welfare of the person or others.
12.18 	Assessments must produce information about the person that describes the person's overall 
12.19 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be 
12.20 	based on the person's status within the last 12 months at the time of service initiation. 
12.21 	Assessments based on older information must be documented and justified. Assessments 
12.22 	must be conducted annually at a minimum or within 30 days of a written request from the 
12.23 	person or the person's legal representative or case manager. The results must be reviewed 
12.24 	by the support team or expanded support team as part of a service plan review.
12.25 	(c) Within Before providing 45 days of service initiation or within 60 calendar days of  
12.26 	service initiation, whichever is shorter, the license holder must meet with the person, the 
12.27 	person's legal representative, the case manager, and other members of the support team or 
12.28 	expanded support team, and other people as identified by the person or the person's legal 
12.29 	representative to determine the following based on information obtained from the assessments 
12.30 	identified in paragraph (b), the person's identified needs in the coordinated service and 
12.31 	support plan, and the requirements in subdivision 4 and section 245D.07, subdivision 1a:
12.32 	(1) the scope of the services to be provided to support the person's daily needs and 
12.33 	activities;
13.1 	(2) the person's desired outcomes and the supports necessary to accomplish the person's 
13.2 	desired outcomes;
13.3 	(3) the person's preferences for how services and supports are provided, including how 
13.4 	the provider will support the person to have control of the person's schedule;
13.5 	(4) whether the current service setting is the most integrated setting available and 
13.6 	appropriate for the person; and
13.7 	(5) opportunities to develop and maintain essential and life-enriching skills, abilities, 
13.8 	strengths, interests, and preferences;
13.9 	(6) opportunities for community access, participation, and inclusion in preferred 
13.10 	community activities;
13.11 	(7) opportunities to develop and strengthen personal relationships with other persons of 
13.12 	the person's choice in the community;
13.13 	(8) opportunities to seek competitive employment and work at competitively paying 
13.14 	jobs in the community; and
13.15 	(5)(9) how services must be coordinated across other providers licensed under this 
13.16 	chapter serving the person and members of the support team or expanded support team to 
13.17 	ensure continuity of care and coordination of services for the person.
13.18 	(d) A discussion of how technology might be used to meet the person's desired outcomes 
13.19 	must be included in the 45-day planning meeting. The coordinated service and support plan 
13.20 	or support plan addendum must include a summary of this discussion. The summary must 
13.21 	include a statement regarding any decision that is made regarding the use of technology 
13.22 	and a description of any further research that needs to be completed before a decision 
13.23 	regarding the use of technology can be made. Nothing in this paragraph requires that the 
13.24 	coordinated service and support plan include the use of technology for the provision of 
13.25 	services.

13.26 	Sec. 6. Minnesota Statutes 2018, section 245D.081, subdivision 2, is amended to read:
13.27 		Subd. 2.Coordination and evaluation of individual service delivery. (a) Delivery 
13.28 	and evaluation of services provided by the license holder must be coordinated by a designated 
13.29 	staff person. Except as provided in clause (3), the designated coordinator must provide 
13.30 	supervision, support, and evaluation of activities that include:
13.31 	(1) oversight of the license holder's responsibilities assigned in the person's coordinated 
13.32 	service and support plan and the coordinated service and support plan addendum;
14.1 	(2) taking the action necessary to facilitate the accomplishment of the outcomes according 
14.2 	to the requirements in section 245D.07;
14.3 	(3) instruction and assistance to direct support staff implementing the coordinated service 
14.4 	and support plan and the service outcomes, including direct observation of service delivery 
14.5 	sufficient to assess staff competency. The designated coordinator may delegate the direct 
14.6 	observation and competency assessment of the service delivery activities of direct support 
14.7 	staff to an individual whom the designated coordinator has previously deemed competent 
14.8 	in those activities; and
14.9 	(4) evaluation of the effectiveness of service delivery, methodologies, and progress on 
14.10 	the person's outcomes based on the measurable and observable criteria for identifying when 
14.11 	the desired outcome has been achieved according to the requirements in section 245D.07.
14.12 	(b) The license holder must ensure that the designated coordinator is competent to 
14.13 	perform the required duties identified in paragraph (a) through education, training, and work 
14.14 	experience relevant to the primary disability of persons served by the license holder and 
14.15 	the individual persons for whom the designated coordinator is responsible. The designated 
14.16 	coordinator must have the skills and ability necessary to develop effective plans and to 
14.17 	design and use data systems to measure effectiveness of services and supports. The license 
14.18 	holder must verify and document competence according to the requirements in section 
14.19 	245D.09, subdivision 3. The designated coordinator must minimally have:
14.20 	(1) a baccalaureate degree in a field related to human services, and one year of full-time 
14.21 	work experience providing direct care services to persons with disabilities or persons age 
14.22 	65 and older;
14.23 	(2) an associate degree in a field related to human services, and two years of full-time 
14.24 	work experience providing direct care services to persons with disabilities or persons age 
14.25 	65 and older;
14.26 	(3) a diploma in a field related to human services from an accredited postsecondary 
14.27 	institution and three years of full-time work experience providing direct care services to 
14.28 	persons with disabilities or persons age 65 and older; or
14.29 	(4) a minimum of 50 hours of education and training related to human services and 
14.30 	disabilities; and
14.31 	(5) four years of full-time work experience providing direct care services to persons 
14.32 	with disabilities or persons age 65 and older under the supervision of a staff person who 
14.33 	meets the qualifications identified in clauses (1) to (3).

15.1 	Sec. 7. Minnesota Statutes 2018, section 245D.09, subdivision 4, is amended to read:
15.2 		Subd. 4.Orientation to program requirements.  Except for a license holder who does 
15.3 	not supervise any direct support staff, within 60 calendar days of hire, unless stated otherwise, 
15.4 	the license holder must provide and ensure completion of orientation sufficient to create 
15.5 	staff competency for direct support staff that combines supervised on-the-job training with 
15.6 	review of and instruction in the following areas:
15.7 	(1) the job description and how to complete specific job functions, including:
15.8 	(i) responding to and reporting incidents as required under section 245D.06, subdivision 
15.9 	1; and
15.10 	(ii) following safety practices established by the license holder and as required in section 
15.11 	245D.06, subdivision 2;
15.12 	(2) the license holder's current policies and procedures required under this chapter, 
15.13 	including their location and access, and staff responsibilities related to implementation of 
15.14 	those policies and procedures;
15.15 	(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal 
15.16 	Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff 
15.17 	responsibilities related to complying with data privacy practices;
15.18 	(4) the service recipient rights and staff responsibilities related to ensuring the exercise 
15.19 	and protection of those rights according to the requirements in section 245D.04;
15.20 	(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment reporting 
15.21 	and service planning for children and vulnerable adults, and staff responsibilities related to 
15.22 	protecting persons from maltreatment and reporting maltreatment. This orientation must be 
15.23 	provided within 72 hours of first providing direct contact services and annually thereafter 
15.24 	according to section 245A.65, subdivision 3;
15.25 	(6) the principles of person-centered service planning and delivery as identified in section 
15.26 	245D.07, subdivision 1a, and how they apply to direct support service provided by the staff 
15.27 	person;
15.28 	(7) the safe and correct use of manual restraint on an emergency basis according to the 
15.29 	requirements in section 245D.061 or successor provisions, and what constitutes the use of 
15.30 	restraints, time out, and seclusion, including chemical restraint;
16.1 	(8) staff responsibilities related to prohibited procedures under section 245D.06, 
16.2 	subdivision 5, or successor provisions, why such procedures are not effective for reducing 
16.3 	or eliminating symptoms or undesired behavior, and why such procedures are not safe;
16.4 	(9) basic first aid; and
16.5 	(10) strategies to minimize the risk of sexual violence, including concepts of healthy 
16.6 	relationships, consent, and bodily autonomy of people with disabilities; and
16.7 	(11) other topics as determined necessary in the person's coordinated service and support 
16.8 	plan by the case manager or other areas identified by the license holder.

16.9 	Sec. 8. Minnesota Statutes 2018, section 245D.09, subdivision 4a, is amended to read:
16.10 		Subd. 4a.Orientation to individual service recipient needs. (a) Before having 
16.11 	unsupervised direct contact with a person served by the program, or for whom the staff 
16.12 	person has not previously provided direct support, or any time the plans or procedures 
16.13 	identified in paragraphs (b) to (f) are revised, the staff person must review and receive 
16.14 	instruction on the requirements in paragraphs (b) to (f) as they relate to the staff person's 
16.15 	job functions for that person.
16.16 	(b) For community residential services, training and competency evaluations must include 
16.17 	the following, if identified in the coordinated service and support plan:
16.18 	(1) appropriate and safe techniques in personal hygiene and grooming, including hair 
16.19 	care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of daily 
16.20 	living (ADLs) as defined under section 256B.0659, subdivision 1;
16.21 	(2) an understanding of what constitutes a healthy diet according to data from the Centers 
16.22 	for Disease Control and Prevention and the skills necessary to prepare that diet; and
16.23 	(3) skills necessary to provide appropriate support in instrumental activities of daily 
16.24 	living (IADLs) as defined under section 256B.0659, subdivision 1.
16.25 	(c) The staff person must review and receive instruction on the person's coordinated 
16.26 	service and support plan or coordinated service and support plan addendum as it relates to 
16.27 	the responsibilities assigned to the license holder, and when applicable, the person's individual 
16.28 	abuse prevention plan, to achieve and demonstrate an understanding of the person as a 
16.29 	unique individual, and how to implement those plans.
16.30 	(d) The staff person must review and receive instruction on medication setup, assistance, 
16.31 	or administration procedures established for the person when assigned to the license holder 
16.32 	according to section 245D.05, subdivision 1, paragraph (b). Unlicensed staff may perform 
17.1 	medication setup or medication administration only after successful completion of a 
17.2 	medication setup or medication administration training, from a training curriculum developed 
17.3 	by a registered nurse or appropriate licensed health professional. The training curriculum 
17.4 	must incorporate an observed skill assessment conducted by the trainer to ensure unlicensed 
17.5 	staff demonstrate the ability to safely and correctly follow medication procedures.
17.6 	Medication administration must be taught by a registered nurse, clinical nurse specialist, 
17.7 	certified nurse practitioner, physician assistant, or physician if, at the time of service initiation 
17.8 	or any time thereafter, the person has or develops a health care condition that affects the 
17.9 	service options available to the person because the condition requires:
17.10 	(1) specialized or intensive medical or nursing supervision; and
17.11 	(2) nonmedical service providers to adapt their services to accommodate the health and 
17.12 	safety needs of the person.
17.13 	(e) The staff person must review and receive instruction on the safe and correct operation 
17.14 	of medical equipment used by the person to sustain life or to monitor a medical condition 
17.15 	that could become life-threatening without proper use of the medical equipment, including 
17.16 	but not limited to ventilators, feeding tubes, or endotracheal tubes. The training must be 
17.17 	provided by a licensed health care professional or a manufacturer's representative and 
17.18 	incorporate an observed skill assessment to ensure staff demonstrate the ability to safely 
17.19 	and correctly operate the equipment according to the treatment orders and the manufacturer's 
17.20 	instructions.
17.21 	(f) The staff person must review and receive instruction on mental health crisis response, 
17.22 	de-escalation techniques, and suicide intervention when providing direct support to a person 
17.23 	with a serious mental illness.
17.24 	(g) In the event of an emergency service initiation, the license holder must ensure the 
17.25 	training required in this subdivision occurs within 72 hours of the direct support staff person 
17.26 	first having unsupervised contact with the person receiving services. The license holder 
17.27 	must document the reason for the unplanned or emergency service initiation and maintain 
17.28 	the documentation in the person's service recipient record.
17.29 	(h) License holders who provide direct support services themselves must complete the 
17.30 	orientation required in subdivision 4, clauses (3) to (10) (11).

18.1 	Sec. 9. Minnesota Statutes 2019 Supplement, section 245D.09, subdivision 5, is amended 
18.2 	to read:
18.3 		Subd. 5.Annual training.  A license holder must provide annual training to direct support 
18.4 	staff on the topics identified in subdivision 4, clauses (3) to (10) (11). If the direct support 
18.5 	staff has a first aid certification, annual training under subdivision 4, clause (9), is not 
18.6 	required as long as the certification remains current.

18.7 	Sec. 10. [254A.21] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION 
18.8 	GRANTS.
18.9 	(a) The commissioner of human services shall award a grant to a statewide organization 
18.10 	that focuses solely on prevention of and intervention with fetal alcohol spectrum disorders. 
18.11 	The grant recipient must make subgrants to eligible regional collaboratives in rural and 
18.12 	urban areas of the state for the purposes specified in paragraph (c).
18.13 	(b) "Eligible regional collaboratives" means a partnership between at least one local 
18.14 	government or tribal government and at least one community-based organization and, where 
18.15 	available, a family home visiting program. For purposes of this paragraph, a local government 
18.16 	includes a county or a multicounty organization, a county-based purchasing entity, or a 
18.17 	community health board.
18.18 	(c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of 
18.19 	fetal alcohol spectrum disorders and other prenatal drug-related effects in children in 
18.20 	Minnesota by identifying and serving pregnant women suspected of or known to use or 
18.21 	abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services 
18.22 	to chemically dependent women to increase positive birth outcomes.
18.23 	(d) An eligible regional collaborative that receives a subgrant under this section must 
18.24 	report to the grant recipient by January 15 of each year on the services and programs funded 
18.25 	by the subgrant. The report must include measurable outcomes for the previous year, 
18.26 	including the number of pregnant women served and the number of toxic-free babies born. 
18.27 	The grant recipient must compile the information in the subgrant reports and submit a 
18.28 	summary report to the commissioner of human services by February 15 of each year.

19.1 	Sec. 11. Minnesota Statutes 2019 Supplement, section 256B.056, subdivision 5c, is 
19.2 	amended to read:
19.3 		Subd. 5c.Excess income standard. (a) The excess income standard for parents and 
19.4 	caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard 
19.5 	specified in subdivision 4, paragraph (b).
19.6 	(b) The excess income standard for a person whose eligibility is based on blindness, 
19.7 	disability, or age of 65 or more years shall equal:
19.8 	(1) 81 percent of the federal poverty guidelines; and
19.9 	(2) effective July 1, 2022, 100 percent of the federal poverty guidelines the standard 
19.10 	specified in subdivision 4, paragraph (a).

19.11 	Sec. 12. Minnesota Statutes 2018, section 256B.0625, subdivision 56a, is amended to 
19.12 	read:
19.13 		Subd. 56a.Post-arrestOfficer-involved community-based servicecare 
19.14 	coordination. (a) Medical assistance covers post-arrestofficer-involved community-based 
19.15 	servicecare coordination for an individual who:
19.16 	(1) has been identified as havingscreened positive for benefiting from treatment for a 
19.17 	mental illness or substance use disorder using a screening tool approved by the commissioner;
19.18 	(2) does not require the security of a public detention facility and is not considered an 
19.19 	inmate of a public institution as defined in Code of Federal Regulations, title 42, section 
19.20 	435.1010;
19.21 	(3) meets the eligibility requirements in section 256B.056; and
19.22 	(4) has agreed to participate in post-arrestofficer-involved community-based service
19.23 	care coordination through a diversion contract in lieu of incarceration.
19.24 	(b) Post-arrest Officer-involved community-based servicecare coordination means 
19.25 	navigating services to address a client's mental health, chemical health, social, economic, 
19.26 	and housing needs, or any other activity targeted at reducing the incidence of jail utilization 
19.27 	and connecting individuals with existing covered services available to them, including, but 
19.28 	not limited to, targeted case management, waiver case management, or care coordination.
19.29 	(c) Post-arrestOfficer-involved community-based servicecare coordination must be 
19.30 	provided by an individual who is an employee of a county or is under contract with a county, 
19.31 	or is an employee of or under contract with an Indian health service facility or facility owned 
19.32 	and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638 
20.1 	facility to provide post-arrestofficer-involved community-based care coordination and is 
20.2 	qualified under one of the following criteria:
20.3 	(1) a licensed mental health professional as defined in section 245.462, subdivision 18, 
20.4 	clauses (1) to (6);
20.5 	(2) a mental health practitioner as defined in section 245.462, subdivision 17, working 
20.6 	under the clinical supervision of a mental health professional; or
20.7 	(3) a certified peer specialist under section 256B.0615, working under the clinical 
20.8 	supervision of a mental health professional.;
20.9 	(4) an individual qualified as an alcohol and drug counselor under section 245G.11, 
20.10 	subdivision 5; or
20.11 	(5) a recovery peer qualified under section 245G.11, subdivision 8, working under the 
20.12 	supervision of an individual qualified as an alcohol and drug counselor under section 
20.13 	245G.11, subdivision 5.
20.14 	(d) Reimbursement is allowed for up to 60 days following the initial determination of 
20.15 	eligibility.
20.16 	(e) Providers of post-arrestofficer-involved community-based servicecare coordination 
20.17 	shall annually report to the commissioner on the number of individuals served, and number 
20.18 	of the community-based services that were accessed by recipients. The commissioner shall 
20.19 	ensure that services and payments provided under post-arrestofficer-involved 
20.20 	community-based servicecare coordination do not duplicate services or payments provided 
20.21 	under section 256B.0625, subdivision 20, 256B.0753, 256B.0755, or 256B.0757.
20.22 	(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for 
20.23 	post-arrest community-based service coordination services shall be provided by the county 
20.24 	providing the services, from sources other than federal funds or funds used to match other 
20.25 	federal funds.

20.26 	Sec. 13. Minnesota Statutes 2018, section 256B.0653, subdivision 5, is amended to read:
20.27 		Subd. 5.Home care therapies. (a) Home care therapies include the following: physical 
20.28 	therapy, occupational therapy, respiratory therapy, and speech and language pathology 
20.29 	therapy services.
20.30 	(b) Home care therapies must be:
21.1 	(1) provided in the recipient's residence or in the community where normal life activities 
21.2 	take the recipient after it has been determined the recipient is unable to access outpatient 
21.3 	therapy;
21.4 	(2) prescribed, ordered, or referred by a physician, advanced practice registered nurse, 
21.5 	or physician assistant, and documented in a plan of care and reviewed, according to 
21.6 	Minnesota Rules, part 9505.0390;
21.7 	(3) assessed by an appropriate therapist; and
21.8 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid provider 
21.9 	agency.
21.10 	(c) Restorative and specialized maintenance therapies must be provided according to 
21.11 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be used 
21.12 	as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
21.13 	(d) For both physical and occupational therapies, the therapist and the therapist's assistant 
21.14 	may not both bill for services provided to a recipient on the same day.

21.15 	Sec. 14. Minnesota Statutes 2018, section 256B.0653, subdivision 7, is amended to read:
21.16 		Subd. 7.Face-to-face encounter. (a) A face-to-face encounter by a qualifying provider 
21.17 	must be completed for all home health services regardless of the need for prior authorization, 
21.18 	except when providing a onetime perinatal visit by skilled nursing. The face-to-face encounter 
21.19 	may occur through telemedicine as defined in section 256B.0625, subdivision 3b. The 
21.20 	encounter must be related to the primary reason the recipient requires home health services 
21.21 	and must occur within the 90 days before or the 30 days after the start of services. The 
21.22 	face-to-face encounter may be conducted by one of the following practitioners, licensed in 
21.23 	Minnesota:
21.24 	(1) a physician;
21.25 	(2) a nurse practitioner or clinical nurse specialist;
21.26 	(3) a certified nurse midwife; or
21.27 	(4) a physician assistant.
21.28 	(b) The allowed nonphysician practitioner, as described in this subdivision, performing 
21.29 	the face-to-face encounter must communicate the clinical findings of that face-to-face 
21.30 	encounter to the ordering physician. ThoseThe clinical findings of that face-to-face encounter 
21.31 	must be incorporated into a written or electronic document included in the recipient's medical 
21.32 	record. To assure clinical correlation between the face-to-face encounter and the associated 
22.1 	home health services, the physician, advanced practice registered nurse, or physician assistant
22.2 	responsible for ordering the services must:
22.3 	(1) document that the face-to-face encounter, which is related to the primary reason the 
22.4 	recipient requires home health services, occurred within the required time period; and
22.5 	(2) indicate the practitioner who conducted the encounter and the date of the encounter.
22.6 	(c) For home health services requiring authorization, including prior authorization, home 
22.7 	health agencies must retain the qualifying documentation of a face-to-face encounter as part 
22.8 	of the recipient health service record, and submit the qualifying documentation to the 
22.9 	commissioner or the commissioner's designee upon request.

22.10 	Sec. 15. Minnesota Statutes 2018, section 256B.0654, subdivision 1, is amended to read:
22.11 		Subdivision 1.Definitions. (a) "Complex home care nursing" means home care nursing 
22.12 	services provided to recipients who meet the criteria for regular home care nursing and 
22.13 	require life-sustaining interventions to reduce the risk of long-term injury or death.
22.14 	(b) "Home care nursing" means ongoing physician-ordered hourly nursing services 
22.15 	ordered by a physician, advanced practice registered nurse, or physician assistant, performed 
22.16 	by a registered nurse or licensed practical nurse within the scope of practice as defined by 
22.17 	the Minnesota Nurse Practice Act under sections 148.171 to 148.285, in order to maintain 
22.18 	or restore a person's health.
22.19 	(c) "Home care nursing agency" means a medical assistance enrolled provider licensed 
22.20 	under chapter 144A to provide home care nursing services.
22.21 	(d) "Regular home care nursing" means home care nursing provided because:
22.22 	(1) the recipient requires more individual and continuous care than can be provided 
22.23 	during a skilled nurse visit; or
22.24 	(2) the cares are outside of the scope of services that can be provided by a home health 
22.25 	aide or personal care assistant.
22.26 	(e) "Shared home care nursing" means the provision of home care nursing services by 
22.27 	a home care nurse to two recipients at the same time and in the same setting.

22.28 	Sec. 16. Minnesota Statutes 2018, section 256B.0654, subdivision 2a, is amended to read:
22.29 		Subd. 2a.Home care nursing services. (a) Home care nursing services must be used:
22.30 	(1) in the recipient's home or outside the home when normal life activities require;
23.1 	(2) when the recipient requires more individual and continuous care than can be provided 
23.2 	during a skilled nurse visit; and
23.3 	(3) when the care required is outside of the scope of services that can be provided by a 
23.4 	home health aide or personal care assistant.
23.5 	(b) Home care nursing services must be:
23.6 	(1) assessed by a registered nurse on a form approved by the commissioner;
23.7 	(2) ordered by a physician, advanced practice registered nurse, or physician assistant,
23.8 	and documented in a plan of care that is reviewed by the ordering physician, advanced 
23.9 	practice registered nurse, or physician assistant at least once every 60 days; and
23.10 	(3) authorized by the commissioner under section 256B.0652.

23.11 	Sec. 17. Minnesota Statutes 2019 Supplement, section 256B.0711, subdivision 1, is 
23.12 	amended to read:
23.13 		Subdivision 1.Definitions. For purposes of this section:
23.14 	(a) "Commissioner" means the commissioner of human services unless otherwise 
23.15 	indicated.
23.16 	(b) "Covered program" means a program to provide direct support services funded in 
23.17 	whole or in part by the state of Minnesota, including the community first services and 
23.18 	supports program under section 256B.85, subdivision 2, paragraph (e); consumer directed
23.19 	consumer-directed community supports services and extended state plan personal care 
23.20 	assistance services available under programs established pursuant to home and 
23.21 	community-based service waivers authorized under section 1915(c) of the Social Security 
23.22 	Act, and Minnesota Statutes, including, but not limited to, chapter 256S and sections 
23.23 	256B.092 and 256B.49, and under the alternative care program, as offered pursuant to under
23.24 	section 256B.0913; the personal care assistance choice program, as established pursuant to
23.25 	under section 256B.0659, subdivisions 18 to 20; and any similar program that may provide 
23.26 	similar services in the future.
23.27 	(c) "Direct support services" means personal care assistance services covered by medical 
23.28 	assistance under section 256B.0625, subdivisions 19a and 19c; assistance with activities of 
23.29 	daily living as defined in section 256B.0659, subdivision 1, paragraph (b), and instrumental 
23.30 	activities of daily living as defined in section 256B.0659, subdivision 1, paragraph (i); and 
23.31 	other similar, in-home, nonprofessional long-term services and supports provided to an 
23.32 	elderly person or person with a disability by the person's employee or the employee of the 
24.1 	person's representative to meet such person's daily living needs and ensure that such person 
24.2 	may adequately function in the person's home and have safe access to the community.
24.3 	(d) "Individual provider" means an individual selected by and working under the direction 
24.4 	of a participant in a covered program, or a participant's representative, to provide direct 
24.5 	support services to the participant, but does not include an employee of a provider agency, 
24.6 	subject to the agency's direction and control commensurate with agency employee status.
24.7 	(e) "Participant" means a person who receives direct support services through a covered 
24.8 	program.
24.9 	(f) "Participant's representative" means a participant's legal guardian or an individual 
24.10 	having the authority and responsibility to act on behalf of a participant with respect to the 
24.11 	provision of direct support services through a covered program.

24.12 	Sec. 18. Minnesota Statutes 2018, section 256B.0941, subdivision 1, is amended to read:
24.13 		Subdivision 1.Eligibility. (a) An individual who is eligible for mental health treatment 
24.14 	services in a psychiatric residential treatment facility must meet all of the following criteria:
24.15 	(1) before admission, services are determined to be medically necessary by the state's 
24.16 	medical review agent according to Code of Federal Regulations, title 42, section 441.152;
24.17 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
24.18 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
24.19 	first;
24.20 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
24.21 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
24.22 	or a finding that the individual is a risk to self or others;
24.23 	(4) has functional impairment and a history of difficulty in functioning safely and 
24.24 	successfully in the community, school, home, or job; an inability to adequately care for 
24.25 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
24.26 	the individual's needs;
24.27 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
24.28 	the individual's condition or prevent further regression so that services will no longer be 
24.29 	needed;
24.30 	(6) utilized and exhausted other community-based mental health services, or clinical 
24.31 	evidence indicates that such services cannot provide the level of care needed; and
25.1 	(7) was referred for treatment in a psychiatric residential treatment facility by a qualified 
25.2 	mental health professional licensed as defined in section 245.4871, subdivision 27, clauses 
25.3 	(1) to (6).
25.4 	(b) A mental health professional making a referral shall submit documentation to the 
25.5 	state's medical review agent containing all information necessary to determine medical 
25.6 	necessity, including a standard diagnostic assessment completed within 180 days of the 
25.7 	individual's admission. Documentation shall include evidence of family participation in the 
25.8 	individual's treatment planning and signed consent for services The commissioner shall 
25.9 	provide oversight and review the use of referrals for clients admitted to psychiatric residential 
25.10 	treatment facilities to ensure that eligibility criteria, clinical services, and treatment planning 
25.11 	reflect clinical, state, and federal standards for psychiatric residential treatment facility level 
25.12 	of care. The commissioner shall coordinate the production of a statewide list of children 
25.13 	and youth who meet the medical necessity criteria for psychiatric residential treatment 
25.14 	facility level of care and who are awaiting admission. The commissioner and any recipient 
25.15 	of the list shall not use the statewide list to direct admission of children and youth to specific 
25.16 	facilities.

25.17 	EFFECTIVE DATE. This section is effective August 1, 2020, or upon federal approval, 
25.18 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
25.19 	when federal approval is obtained.

25.20 	Sec. 19. Minnesota Statutes 2018, section 256B.0941, subdivision 3, is amended to read:
25.21 		Subd. 3.Per diem rate. (a) The commissioner shall must establish a statewide one per 
25.22 	diem rate per provider for psychiatric residential treatment facility services for individuals 
25.23 	21 years of age or younger. The rate for a provider must not exceed the rate charged by that 
25.24 	provider for the same service to other payers. Payment must not be made to more than one 
25.25 	entity for each individual for services provided under this section on a given day. The 
25.26 	commissioner shall must set rates prospectively for the annual rate period. The commissioner 
25.27 	shall must require providers to submit annual cost reports on a uniform cost reporting form 
25.28 	and shall must use submitted cost reports to inform the rate-setting process. The cost reporting 
25.29 	shall must be done according to federal requirements for Medicare cost reports.
25.30 	(b) The following are included in the rate:
25.31 	(1) costs necessary for licensure and accreditation, meeting all staffing standards for 
25.32 	participation, meeting all service standards for participation, meeting all requirements for 
25.33 	active treatment, maintaining medical records, conducting utilization review, meeting 
25.34 	inspection of care, and discharge planning. The direct services costs must be determined 
26.1 	using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff 
26.2 	and service-related transportation; and
26.3 	(2) payment for room and board provided by facilities meeting all accreditation and 
26.4 	licensing requirements for participation.
26.5 	(c) A facility may submit a claim for payment outside of the per diem for professional 
26.6 	services arranged by and provided at the facility by an appropriately licensed professional 
26.7 	who is enrolled as a provider with Minnesota health care programs. Arranged services must 
26.8 	be billed by the facility on a separate claim, and the facility shall be responsible for payment 
26.9 	to the provider may be billed by either the facility or the licensed professional. These services 
26.10 	must be included in the individual plan of care and are subject to prior authorization by the 
26.11 	state's medical review agent.
26.12 	(d) Medicaid shall must reimburse for concurrent services as approved by the 
26.13 	commissioner to support continuity of care and successful discharge from the facility. 
26.14 	"Concurrent services" means services provided by another entity or provider while the 
26.15 	individual is admitted to a psychiatric residential treatment facility. Payment for concurrent 
26.16 	services may be limited and these services are subject to prior authorization by the state's 
26.17 	medical review agent. Concurrent services may include targeted case management, assertive 
26.18 	community treatment, clinical care consultation, team consultation, and treatment planning.
26.19 	(e) Payment rates under this subdivision shall must not include the costs of providing 
26.20 	the following services:
26.21 	(1) educational services;
26.22 	(2) acute medical care or specialty services for other medical conditions;
26.23 	(3) dental services; and
26.24 	(4) pharmacy drug costs.
26.25 	(f) For purposes of this section, "actual cost" means costs that are allowable, allocable, 
26.26 	reasonable, and consistent with federal reimbursement requirements in Code of Federal 
26.27 	Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of 
26.28 	Management and Budget Circular Number A-122, relating to nonprofit entities.

26.29 	Sec. 20. Minnesota Statutes 2018, section 256B.0944, subdivision 1, is amended to read:
26.30 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
26.31 	meanings given them.
27.1 	(a) "Mental health crisis" means a child's behavioral, emotional, or psychiatric situation 
27.2 	that, but for the provision of crisis response services to the child, would likely result in 
27.3 	significantly reduced levels of functioning in primary activities of daily living, an emergency 
27.4 	situation, or the child's placement in a more restrictive setting, including, but not limited 
27.5 	to, inpatient hospitalization.
27.6 	(b) "Mental health emergency" means a child's behavioral, emotional, or psychiatric 
27.7 	situation that causes an immediate need for mental health services and is consistent with 
27.8 	section 62Q.55. A physician, mental health professional, or crisis mental health practitioner 
27.9 	determines a mental health crisis or emergency for medical assistance reimbursement with 
27.10 	input from the client and the client's family, if possible.
27.11 	(c) "Mental health crisis assessment" means an immediate face-to-face assessment by 
27.12 	a physician, mental health professional, or mental health practitioner under the clinical 
27.13 	supervision of a mental health professional, following a screening that suggests the child 
27.14 	may be experiencing a mental health crisis or mental health emergency situation.
27.15 	(d) "Mental health mobile crisis intervention services" means face-to-face, short-term 
27.16 	intensive mental health services initiated during a mental health crisis or mental health 
27.17 	emergency. Mental health mobile crisis services must help the recipient cope with immediate 
27.18 	stressors, identify and utilize available resources and strengths, and begin to return to the 
27.19 	recipient's baseline level of functioning. Mental health mobile services must be provided 
27.20 	on site by a mobile crisis intervention team outside of an emergency room, urgent care, or
27.21 	an inpatient hospital setting.
27.22 	(e) "Mental health crisis stabilization services" means individualized mental health 
27.23 	services provided to a recipient following crisis intervention services that are designed to 
27.24 	restore the recipient to the recipient's prior functional level. The individual treatment plan 
27.25 	recommending mental health crisis stabilization must be completed by the intervention team 
27.26 	or by staff after an inpatient or urgent care visit. Mental health crisis stabilization services 
27.27 	may be provided in the recipient's home, the home of a family member or friend of the 
27.28 	recipient, schools, another community setting, or a short-term supervised, licensed residential 
27.29 	program if the service is not included in the facility's cost pool or per diem. Mental health 
27.30 	crisis stabilization is not reimbursable when provided as part of a partial hospitalization or 
27.31 	day treatment program.

27.32 	Sec. 21. Minnesota Statutes 2018, section 256B.0947, subdivision 2, is amended to read:
27.33 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
27.34 	given them.
28.1 	(a) "Intensive nonresidential rehabilitative mental health services" means child 
28.2 	rehabilitative mental health services as defined in section 256B.0943, except that these 
28.3 	services are provided by a multidisciplinary staff using a total team approach consistent 
28.4 	with assertive community treatment, as adapted for youth, and are directed to recipients 
28.5 	ages 16, 17, 18, 19, or 20 with a serious mental illness or co-occurring mental illness and 
28.6 	substance abuse addiction who require intensive services to prevent admission to an inpatient 
28.7 	psychiatric hospital or placement in a residential treatment facility or who require intensive 
28.8 	services to step down from inpatient or residential care to community-based care.
28.9 	(b) "Co-occurring mental illness and substance abuse addiction" means a dual diagnosis 
28.10 	of at least one form of mental illness and at least one substance use disorder. Substance use 
28.11 	disorders include alcohol or drug abuse or dependence, excluding nicotine use.
28.12 	(c) "Diagnostic assessment" has the meaning given to it in Minnesota Rules, part 
28.13 	9505.0370, subpart 11. A diagnostic assessment must be provided according to Minnesota 
28.14 	Rules, part 9505.0372, subpart 1, and for this section must incorporate a determination of 
28.15 	the youth's necessary level of care using a standardized functional assessment instrument 
28.16 	approved and periodically updated by the commissioner.
28.17 	(d) "Education specialist" means an individual with knowledge and experience working 
28.18 	with youth regarding special education requirements and goals, special education plans, 
28.19 	and coordination of educational activities with health care activities.
28.20 	(e) "Housing access support" means an ancillary activity to help an individual find, 
28.21 	obtain, retain, and move to safe and adequate housing. Housing access support does not 
28.22 	provide monetary assistance for rent, damage deposits, or application fees.
28.23 	(f) "Integrated dual disorders treatment" means the integrated treatment of co-occurring 
28.24 	mental illness and substance use disorders by a team of cross-trained clinicians within the 
28.25 	same program, and is characterized by assertive outreach, stage-wise comprehensive 
28.26 	treatment, treatment goal setting, and flexibility to work within each stage of treatment.
28.27 	(g) "Medication education services" means services provided individually or in groups, 
28.28 	which focus on:
28.29 	(1) educating the client and client's family or significant nonfamilial supporters about 
28.30 	mental illness and symptoms;
28.31 	(2) the role and effects of medications in treating symptoms of mental illness; and
28.32 	(3) the side effects of medications.
29.1 	Medication education is coordinated with medication management services and does not 
29.2 	duplicate it. Medication education services are provided by physicians, pharmacists, or 
29.3 	registered nurses with certification in psychiatric and mental health care.
29.4 	(h) "Peer specialist" means an employed team member who is a mental health certified 
29.5 	peer specialist according to section 256B.0615 and also a former children's mental health 
29.6 	consumer who:
29.7 	(1) provides direct services to clients including social, emotional, and instrumental 
29.8 	support and outreach;
29.9 	(2) assists younger peers to identify and achieve specific life goals;
29.10 	(3) works directly with clients to promote the client's self-determination, personal 
29.11 	responsibility, and empowerment;
29.12 	(4) assists youth with mental illness to regain control over their lives and their 
29.13 	developmental process in order to move effectively into adulthood;
29.14 	(5) provides training and education to other team members, consumer advocacy 
29.15 	organizations, and clients on resiliency and peer support; and
29.16 	(6) meets the following criteria:
29.17 	(i) is at least 22 years of age;
29.18 	(ii) has had a diagnosis of mental illness, as defined in Minnesota Rules, part 9505.0370, 
29.19 	subpart 20, or co-occurring mental illness and substance abuse addiction;
29.20 	(iii) is a former consumer of child and adolescent mental health services, or a former or 
29.21 	current consumer of adult mental health services for a period of at least two years;
29.22 	(iv) has at least a high school diploma or equivalent;
29.23 	(v) has successfully completed training requirements determined and periodically updated 
29.24 	by the commissioner;
29.25 	(vi) is willing to disclose the individual's own mental health history to team members 
29.26 	and clients; and
29.27 	(vii) must be free of substance use problems for at least one year.
29.28 	(i) "Provider agency" means a for-profit or nonprofit organization established to 
29.29 	administer an assertive community treatment for youth team.
29.30 	(j) "Substance use disorders" means one or more of the disorders defined in the diagnostic 
29.31 	and statistical manual of mental disorders, current edition.
30.1 	(k) "Transition services" means:
30.2 	(1) activities, materials, consultation, and coordination that ensures continuity of the 
30.3 	client's care in advance of and in preparation for the client's move from one stage of care 
30.4 	or life to another by maintaining contact with the client and assisting the client to establish 
30.5 	provider relationships;
30.6 	(2) providing the client with knowledge and skills needed posttransition;
30.7 	(3) establishing communication between sending and receiving entities;
30.8 	(4) supporting a client's request for service authorization and enrollment; and
30.9 	(5) establishing and enforcing procedures and schedules.
30.10 	A youth's transition from the children's mental health system and services to the adult 
30.11 	mental health system and services and return to the client's home and entry or re-entry into 
30.12 	community-based mental health services following discharge from an out-of-home placement 
30.13 	or inpatient hospital stay.
30.14 	(l) "Treatment team" means all staff who provide services to recipients under this section.
30.15 	(m) "Family peer specialist" means a staff person qualified under section 256B.0616.

30.16 	Sec. 22. Minnesota Statutes 2018, section 256B.0947, subdivision 4, is amended to read:
30.17 		Subd. 4.Provider contract requirements. (a) The intensive nonresidential rehabilitative 
30.18 	mental health services provider agency shall have a contract with the commissioner to 
30.19 	provide intensive transition youth rehabilitative mental health services.
30.20 	(b) The commissioner shall develop administrative and clinical contract standards and
30.21 	performance evaluation criteria for providers, including county providers, and may require 
30.22 	applicants and providers to submit documentation as needed to allow the commissioner to 
30.23 	determine whether the standards criteria are met.

30.24 	Sec. 23. Minnesota Statutes 2018, section 256B.0947, subdivision 5, is amended to read:
30.25 		Subd. 5.Standards for intensive nonresidential rehabilitative providers. (a) Services 
30.26 	must be provided by a provider entity as provided in subdivision 4.
30.27 	(b) The treatment team for intensive nonresidential rehabilitative mental health services 
30.28 	comprises both permanently employed core team members and client-specific team members 
30.29 	as follows:
31.1 	(1) The core treatment team is an entity that operates under the direction of an 
31.2 	independently licensed mental health professional, who is qualified under Minnesota Rules, 
31.3 	part 9505.0371, subpart 5, item A, and that assumes comprehensive clinical responsibility 
31.4 	for clients. Based on professional qualifications and client needs, clinically qualified core 
31.5 	team members are assigned on a rotating basis as the client's lead worker to coordinate a 
31.6 	client's care. The core team must comprise at least four full-time equivalent direct care staff 
31.7 	and must include, but is not limited to:
31.8 	(i) an independently licensed mental health professional, qualified under Minnesota 
31.9 	Rules, part 9505.0371, subpart 5, item A, who serves as team leader to provide administrative 
31.10 	direction and clinical supervision to the team;
31.11 	(ii) an advanced-practice registered nurse with certification in psychiatric or mental 
31.12 	health care or a board-certified child and adolescent psychiatrist, either of which must be 
31.13 	credentialed to prescribe medications;
31.14 	(iii) a licensed alcohol and drug counselor who is also trained in mental health 
31.15 	interventions; and
31.16 	(iv) a peer specialist as defined in subdivision 2, paragraph (h).
31.17 	(2) The core team may also include any of the following:
31.18 	(i) additional mental health professionals;
31.19 	(ii) a vocational specialist;
31.20 	(iii) an educational specialist;
31.21 	(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
31.22 	(v) a mental health practitioner, as defined in section 245.4871, subdivision 26;
31.23 	(vi) a mental health manager case management service provider, as defined in section 
31.24 	245.4871, subdivision 4; and
31.25 	(vii) a housing access specialist; and
31.26 	(viii) a family peer specialist as defined in subdivision 2, paragraph (m).
31.27 	(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc 
31.28 	members not employed by the team who consult on a specific client and who must accept 
31.29 	overall clinical direction from the treatment team for the duration of the client's placement 
31.30 	with the treatment team and must be paid by the provider agency at the rate for a typical 
32.1 	session by that provider with that client or at a rate negotiated with the client-specific 
32.2 	member. Client-specific treatment team members may include:
32.3 	(i) the mental health professional treating the client prior to placement with the treatment 
32.4 	team;
32.5 	(ii) the client's current substance abuse counselor, if applicable;
32.6 	(iii) a lead member of the client's individualized education program team or school-based 
32.7 	mental health provider, if applicable;
32.8 	(iv) a representative from the client's health care home or primary care clinic, as needed 
32.9 	to ensure integration of medical and behavioral health care;
32.10 	(v) the client's probation officer or other juvenile justice representative, if applicable; 
32.11 	and
32.12 	(vi) the client's current vocational or employment counselor, if applicable.
32.13 	(c) The clinical supervisor shall be an active member of the treatment team and shall 
32.14 	function as a practicing clinician at least on a part-time basis. The treatment team shall meet 
32.15 	with the clinical supervisor at least weekly to discuss recipients' progress and make rapid 
32.16 	adjustments to meet recipients' needs. The team meeting must include client-specific case 
32.17 	reviews and general treatment discussions among team members. Client-specific case 
32.18 	reviews and planning must be documented in the individual client's treatment record.
32.19 	(d) The staffing ratio must not exceed ten clients to one full-time equivalent treatment 
32.20 	team position.
32.21 	(e) The treatment team shall serve no more than 80 clients at any one time. Should local 
32.22 	demand exceed the team's capacity, an additional team must be established rather than 
32.23 	exceed this limit.
32.24 	(f) Nonclinical staff shall have prompt access in person or by telephone to a mental 
32.25 	health practitioner or mental health professional. The provider shall have the capacity to 
32.26 	promptly and appropriately respond to emergent needs and make any necessary staffing 
32.27 	adjustments to assure ensure the health and safety of clients.
32.28 	(g) The intensive nonresidential rehabilitative mental health services provider shall 
32.29 	participate in evaluation of the assertive community treatment for youth (Youth ACT) model 
32.30 	as conducted by the commissioner, including the collection and reporting of data and the 
32.31 	reporting of performance measures as specified by contract with the commissioner.
32.32 	(h) A regional treatment team may serve multiple counties.

33.1 	Sec. 24. Minnesota Statutes 2018, section 256B.0947, subdivision 6, is amended to read:
33.2 		Subd. 6.Service standards. The standards in this subdivision apply to intensive 
33.3 	nonresidential rehabilitative mental health services.
33.4 	(a) The treatment team shall must use team treatment, not an individual treatment model.
33.5 	(b) Services must be available at times that meet client needs.
33.6 	(c) Services must be age-appropriate and meet the specific needs of the client.
33.7 	(c) (d) The initial functional assessment must be completed within ten days of intake 
33.8 	and updated at least every three six months or prior to discharge from the service, whichever 
33.9 	comes first.
33.10 	(d) (e) An individual treatment plan must be completed for each client, according to 
33.11 	criteria specified in section 256B.0943, subdivision 6, paragraph (b), clause (2), and, 
33.12 	additionally, must:
33.13 	(1) be based on the information in the client's diagnostic assessment and baselines;
33.14 	(2) identify goals and objectives of treatment, a treatment strategy, a schedule for 
33.15 	accomplishing treatment goals and objectives, and the individuals responsible for providing 
33.16 	treatment services and supports;
33.17 	(3) be developed after completion of the client's diagnostic assessment by a mental health 
33.18 	professional or clinical trainee and before the provision of children's therapeutic services 
33.19 	and supports;
33.20 	(4) be developed through a child-centered, family-driven, culturally appropriate planning 
33.21 	process, including allowing parents and guardians to observe or participate in individual 
33.22 	and family treatment services, assessments, and treatment planning;
33.23 	(5) be reviewed at least once every six months and revised to document treatment progress 
33.24 	on each treatment objective and next goals or, if progress is not documented, to document 
33.25 	changes in treatment;
33.26 	(6) be signed by the clinical supervisor and by the client or by the client's parent or other 
33.27 	person authorized by statute to consent to mental health services for the client. A client's 
33.28 	parent may approve the client's individual treatment plan by secure electronic signature or 
33.29 	by documented oral approval that is later verified by written signature;
33.30 	(1) (7) be completed in consultation with the client's current therapist and key providers 
33.31 	and provide for ongoing consultation with the client's current therapist to ensure therapeutic 
33.32 	continuity and to facilitate the client's return to the community. For clients under the age of 
34.1 	18, the treatment team must consult with parents and guardians in developing the treatment 
34.2 	plan;
34.3 	(2) (8) if a need for substance use disorder treatment is indicated by validated assessment:
34.4 	(i) identify goals, objectives, and strategies of substance use disorder treatment; develop 
34.5 	a schedule for accomplishing treatment goals and objectives; and identify the individuals 
34.6 	responsible for providing treatment services and supports;
34.7 	(ii) be reviewed at least once every 90 days and revised, if necessary;
34.8 	(3) (9) be signed by the clinical supervisor and by the client and, if the client is a minor, 
34.9 	by the client's parent or other person authorized by statute to consent to mental health 
34.10 	treatment and substance use disorder treatment for the client; and
34.11 	(4) (10) provide for the client's transition out of intensive nonresidential rehabilitative 
34.12 	mental health services by defining the team's actions to assist the client and subsequent 
34.13 	providers in the transition to less intensive or "stepped down" services.
34.14 	(e) (f) The treatment team shall actively and assertively engage the client's family 
34.15 	members and significant others by establishing communication and collaboration with the 
34.16 	family and significant others and educating the family and significant others about the 
34.17 	client's mental illness, symptom management, and the family's role in treatment, unless the 
34.18 	team knows or has reason to suspect that the client has suffered or faces a threat of suffering 
34.19 	any physical or mental injury, abuse, or neglect from a family member or significant other.
34.20 	(f) (g) For a client age 18 or older, the treatment team may disclose to a family member, 
34.21 	other relative, or a close personal friend of the client, or other person identified by the client, 
34.22 	the protected health information directly relevant to such person's involvement with the 
34.23 	client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the 
34.24 	client is present, the treatment team shall obtain the client's agreement, provide the client 
34.25 	with an opportunity to object, or reasonably infer from the circumstances, based on the 
34.26 	exercise of professional judgment, that the client does not object. If the client is not present 
34.27 	or is unable, by incapacity or emergency circumstances, to agree or object, the treatment 
34.28 	team may, in the exercise of professional judgment, determine whether the disclosure is in 
34.29 	the best interests of the client and, if so, disclose only the protected health information that 
34.30 	is directly relevant to the family member's, relative's, friend's, or client-identified person's 
34.31 	involvement with the client's health care. The client may orally agree or object to the 
34.32 	disclosure and may prohibit or restrict disclosure to specific individuals.
35.1 	(g) (h) The treatment team shall provide interventions to promote positive interpersonal 
35.2 	relationships.

35.3 	Sec. 25. Minnesota Statutes 2018, section 256B.49, subdivision 16, is amended to read:
35.4 		Subd. 16.Services and supports. (a) Services and supports included in the home and 
35.5 	community-based waivers for persons with disabilities shall must meet the requirements 
35.6 	set out in United States Code, title 42, section 1396n. The services and supports, which are 
35.7 	offered as alternatives to institutional care, shall must promote consumer choice, community 
35.8 	inclusion, self-sufficiency, and self-determination.
35.9 	(b) Beginning January 1, 2003, The commissioner shall must simplify and improve 
35.10 	access to home and community-based waivered services, to the extent possible, through the 
35.11 	establishment of a common service menu that is available to eligible recipients regardless 
35.12 	of age, disability type, or waiver program.
35.13 	(c) Consumer directed community support services shall Consumer-directed community 
35.14 	supports must be offered as an option to all persons eligible for services under subdivision 
35.15 	11, by January 1, 2002.
35.16 	(d) Services and supports shall must be arranged and provided consistent with 
35.17 	individualized written plans of care for eligible waiver recipients.
35.18 	(e) A transitional supports allowance shall must be available to all persons under a home 
35.19 	and community-based waiver who are moving from a licensed setting to a community 
35.20 	setting. "Transitional supports allowance" means a onetime payment of up to $3,000, to 
35.21 	cover the costs, not covered by other sources, associated with moving from a licensed setting 
35.22 	to a community setting. Covered costs include:
35.23 	(1) lease or rent deposits;
35.24 	(2) security deposits;
35.25 	(3) utilities setup costs, including telephone;
35.26 	(4) essential furnishings and supplies; and
35.27 	(5) personal supports and transports needed to locate and transition to community settings.
35.28 	(f) The state of Minnesota and county agencies that administer home and 
35.29 	community-based waivered services for persons with disabilities, shall must not be liable 
35.30 	for damages, injuries, or liabilities sustained through the purchase of supports by the 
35.31 	individual, the individual's family, legal representative, or the authorized representative 
35.32 	with funds received through the consumer-directed community support service supports
36.1 	under this section. Liabilities include but are not limited to: workers' compensation liability, 
36.2 	the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act 
36.3 	(FUTA).

36.4 	Sec. 26. [256B.4911] CONSUMER-DIRECTED COMMUNITY SUPPORTS.
36.5 		Subdivision 1.Federal authority. Consumer-directed community supports, as referenced 
36.6 	in sections 256B.0913, subdivision 5, clause (17); 256B.092, subdivision 1b, clause (4); 
36.7 	256B.49, subdivision 16, paragraph (c); and chapter 256S are governed, in whole, by the 
36.8 	federally-approved waiver plans for home and community-based services.
36.9 		Subd. 2.Costs associated with physical activities. The expenses allowed for adults 
36.10 	under the consumer-directed community supports option must include the costs at the lowest 
36.11 	rate available considering daily, monthly, semiannual, annual, or membership rates, including 
36.12 	transportation, associated with physical exercise or other physical activities to maintain or 
36.13 	improve the person's health and functioning.
36.14 		Subd. 3.Expansion and increase of budget exceptions. (a) The commissioner of human 
36.15 	services must provide up to 30 percent more funds for either:
36.16 	(1) consumer-directed community supports participants under sections 256B.092 and 
36.17 	256B.49 who have a coordinated service and support plan which identifies the need for 
36.18 	more services or supports under consumer-directed community supports than the amount 
36.19 	the participants are currently receiving under the consumer-directed community supports 
36.20 	budget methodology to:
36.21 	(i) increase the amount of time a person works or otherwise improves employment 
36.22 	opportunities;
36.23 	(ii) plan a transition to, move to, or live in a setting described in section 256D.44, 
36.24 	subdivision 5, paragraph (g), clause (1), item (iii); or
36.25 	(iii) develop and implement a positive behavior support plan; or
36.26 	(2) home and community-based waiver participants under sections 256B.092 and 256B.49
36.27 	who are currently using licensed providers for: (i) employment supports or services during 
36.28 	the day; or (ii) residential services, either of which cost more annually than the person would 
36.29 	spend under a consumer-directed community supports plan for any or all of the supports 
36.30 	needed to meet a goal identified in clause (1), item (i), (ii), or (iii).
36.31 	(b) The exception under paragraph (a), clause (1), is limited to persons who can 
36.32 	demonstrate that they will have to discontinue using consumer-directed community supports 
37.1 	and accept other non-self-directed waiver services because their supports needed for a goal 
37.2 	described in paragraph (a), clause (1), item (i), (ii), or (iii), cannot be met within the 
37.3 	consumer-directed community supports budget limits.
37.4 	(c) The exception under paragraph (a), clause (2), is limited to persons who can 
37.5 	demonstrate that, upon choosing to become a consumer-directed community supports 
37.6 	participant, the total cost of services, including the exception, will be less than the cost of 
37.7 	current waiver services.
37.8 		Subd. 4.Budget exception for persons leaving institutions and crisis residential 
37.9 	settings. (a) The commissioner must establish an institutional and crisis bed 
37.10 	consumer-directed community supports budget exception process in the home and 
37.11 	community-based services waivers under sections 256B.092 and 256B.49. This budget 
37.12 	exception process must be available for any individual who:
37.13 	(1) is not offered available and appropriate services within 60 days since approval for 
37.14 	discharge from the individual's current institutional setting; and
37.15 	(2) requires services that are more expensive than appropriate services provided in a 
37.16 	noninstitutional setting using the consumer-directed community supports option.
37.17 	(b) Institutional settings for purposes of this exception include intermediate care facilities 
37.18 	for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka 
37.19 	Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds.
37.20 	(c) The budget exception must be limited to no more than the amount of appropriate 
37.21 	services provided in a noninstitutional setting as determined by the lead agency managing 
37.22 	the individual's home and community-based services waiver. The lead agency must notify 
37.23 	the Department of Human Services of the budget exception.
37.24 		Subd. 5.Shared services. (a) Medical assistance payments for shared services under 
37.25 	consumer-directed community supports are limited to this subdivision.
37.26 	(b) For purposes of this subdivision, "shared services" means services provided at the 
37.27 	same time by the same direct care worker for individuals who have entered into an agreement 
37.28 	to share consumer-directed community support services.
37.29 	(c) Shared services may include services in the personal assistance category as outlined 
37.30 	in the consumer-directed community supports community support plan and shared services 
37.31 	agreement, except:
37.32 	(1) services for more than three individuals provided by one worker at one time;
38.1 	(2) use of more than one worker for the shared services; and
38.2 	(3) a child care program licensed under chapter 245A or operated by a local school 
38.3 	district or private school.
38.4 	(d) The individuals, or as needed the individuals' representatives, must develop the plan 
38.5 	for shared services when developing or amending the consumer-directed community supports 
38.6 	plan, and must follow the consumer-directed community supports process for approval of 
38.7 	the plan by the lead agency. The plan for shared services in an individual's consumer-directed 
38.8 	community supports plan must include the intention to utilize shared services based on 
38.9 	individuals' needs and preferences.
38.10 	(e) Individuals sharing services must use the same financial management services 
38.11 	provider.
38.12 	(f) Individuals whose consumer-directed community supports community support plans 
38.13 	include an intent to utilize shared services must jointly develop, with the support of the 
38.14 	individuals' representatives as needed, a shared services agreement. This agreement must 
38.15 	include:
38.16 	(1) the names of the individuals receiving shared services;
38.17 	(2) the individuals' representative, if identified in their consumer-directed community 
38.18 	supports plans, and their duties;
38.19 	(3) the names of the case managers;
38.20 	(4) the financial management services provider;
38.21 	(5) the shared services that must be provided;
38.22 	(6) the schedule for shared services;
38.23 	(7) the location where shared services must be provided;
38.24 	(8) the training specific to each individual served;
38.25 	(9) the training specific to providing shared services to the individuals identified in the 
38.26 	agreement;
38.27 	(10) instructions to follow all required documentation for time and services provided;
38.28 	(11) a contingency plan for each individual that accounts for service provision and billing 
38.29 	in the absence of one of the individuals in a shared services setting due to illness or other 
38.30 	circumstances;
38.31 	(12) signatures of all parties involved in the shared services; and
39.1 	(13) agreement by each individual who is sharing services on the number of shared hours 
39.2 	for services provided.
39.3 	(g) Any individual or any individual's representative may withdraw from participating 
39.4 	in a shared services agreement at any time.
39.5 	(h) The lead agency for each individual must authorize the use of the shared services 
39.6 	option based on the criteria that the shared service is appropriate to meet the needs, health, 
39.7 	and safety of each individual for whom they provide case management or care coordination.
39.8 	(i) This subdivision must not be construed to reduce the total authorized 
39.9 	consumer-directed community supports budget for an individual.
39.10 	(j) No later than September 30, 2019, the commissioner of human services must:
39.11 	(1) submit an amendment to the Centers for Medicare and Medicaid Services for the 
39.12 	home and community-based services waivers authorized under sections 256B.0913, 
39.13 	256B.092, and 256B.49, and chapter 256S, to allow for a shared services option under 
39.14 	consumer-directed community supports; and
39.15 	(2) with stakeholder input, develop guidance for shared services in consumer-directed 
39.16 	community supports within the community-based services manual. Guidance must include:
39.17 	(i) recommendations for negotiating payment for one-to-two and one-to-three services; 
39.18 	and
39.19 	(ii) a template of the shared services agreement.

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

39.24 	Sec. 27. Minnesota Statutes 2019 Supplement, section 256B.4914, subdivision 10a, is 
39.25 	amended to read:
39.26 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
39.27 	that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the 
39.28 	service. As determined by the commissioner, in consultation with stakeholders identified 
39.29 	in subdivision 17, a provider enrolled to provide services with rates determined under this 
39.30 	section must submit requested cost data to the commissioner to support research on the cost 
39.31 	of providing services that have rates determined by the disability waiver rates system. 
39.32 	Requested cost data may include, but is not limited to:
40.1 	(1) worker wage costs;
40.2 	(2) benefits paid;
40.3 	(3) supervisor wage costs;
40.4 	(4) executive wage costs;
40.5 	(5) vacation, sick, and training time paid;
40.6 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
40.7 	(7) administrative costs paid;
40.8 	(8) program costs paid;
40.9 	(9) transportation costs paid;
40.10 	(10) staff vacancy rates; and
40.11 	(11) recipient absence rates; and
40.12 	(12) other data relating to costs required to provide services requested by the 
40.13 	commissioner.
40.14 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
40.15 	year that ended not more than 18 months prior to the submission date. The commissioner 
40.16 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
40.17 	fails to submit required reporting data, the commissioner shall provide notice to providers 
40.18 	that have not provided required data 30 days after the required submission date, and a second 
40.19 	notice for providers who have not provided required data 60 days after the required 
40.20 	submission date. The commissioner shall temporarily suspend payments to the provider if 
40.21 	cost data is not received 90 days after the required submission date. Withheld payments 
40.22 	shall be made once data is received by the commissioner.
40.23 	(c) The commissioner shall conduct a random validation of data submitted under 
40.24 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
40.25 	in paragraph (a) and provide recommendations for adjustments to cost components.
40.26 	(d) The commissioner shall analyze cost documentation in paragraph (a) and, in 
40.27 	consultation with stakeholders identified in subdivision 17, may submit recommendations 
40.28 	on component values and inflationary factor adjustments to the chairs and ranking minority 
40.29 	members of the legislative committees with jurisdiction over human services every four 
40.30 	years beginning January 1, 2021. When analyzing the costs associated with absences from 
40.31 	day programs, unit-based services with programming, and unit-based services without 
41.1 	programming except respite, and when recommending adjustments to the absence and 
41.2 	utilization ratios for these services, the commissioner must use at least 24 consecutive 
41.3 	months of cost reporting data, claims data, or other available data. The commissioner must 
41.4 	not include in the commissioner's analysis or recommendations factors unsupported by the 
41.5 	cost or claims data, including but not limited to assumptions regarding variable expenses. 
41.6 	The commissioner shall make recommendations in conjunction with reports submitted to 
41.7 	the legislature according to subdivision 10, paragraph (c). The commissioner shall release 
41.8 	cost data in an aggregate form, and cost data from individual providers shall not be released 
41.9 	except as provided for in current law.
41.10 	(e) The commissioner, in consultation with stakeholders identified in subdivision 17, 
41.11 	shall develop and implement a process for providing training and technical assistance 
41.12 	necessary to support provider submission of cost documentation required under paragraph 
41.13 	(a).
41.14 	(f) By December 31, 2020, providers paid with rates calculated under subdivision 5, 
41.15 	paragraph (b), shall identify additional revenues from the competitive workforce factor and 
41.16 	prepare a written distribution plan for the revenues. A provider shall make the provider's 
41.17 	distribution plan available and accessible to all direct care staff for a minimum of one 
41.18 	calendar year. Upon request, a provider shall submit the written distribution plan to the 
41.19 	commissioner.
41.20 	(g) Providers enrolled to provide services with rates determined under section 256B.4914, 
41.21 	subdivision 3, shall submit labor market data to the commissioner annually on or before 
41.22 	November 1, including but not limited to:
41.23 	(1) number of direct care staff;
41.24 	(2) wages of direct care staff;
41.25 	(3) overtime wages of direct care staff;
41.26 	(4) hours worked by direct care staff;
41.27 	(5) overtime hours worked by direct care staff;
41.28 	(6) benefits provided to direct care staff;
41.29 	(7) direct care staff job vacancies; and
41.30 	(8) direct care staff retention rates.
41.31 	(h) The commissioner shall publish annual reports on provider and state-level labor 
41.32 	market data, including but not limited to the data obtained under paragraph (g).
42.1 	(i) The commissioner may temporarily suspend payments to the provider if data requested 
42.2 	under paragraph (g) is not received 90 days after the required submission date. Withheld 
42.3 	payments shall be made once data is received by the commissioner.
42.4 	(j) Providers who receive payment under this section for less than 25 percent of their 
42.5 	clients in the year prior to the report may attest to the commissioner in a manner determined 
42.6 	by the commissioner that they are declining to provide the data required under paragraph 
42.7 	(g) and will not be subject to the payment suspension in paragraph (i).

42.8 	Sec. 28. Minnesota Statutes 2019 Supplement, section 256S.01, subdivision 6, is amended 
42.9 	to read:
42.10 		Subd. 6.Immunity; consumer-directed community supports. The state of Minnesota, 
42.11 	or a county, managed care plan, county-based purchasing plan, or tribal government under 
42.12 	contract to administer the elderly waiver, is not liable for damages, injuries, or liabilities 
42.13 	sustained as a result of the participant, the participant's family, or the participant's authorized 
42.14 	representatives purchasing direct supports or goods with funds received through 
42.15 	consumer-directed community support services supports under the elderly waiver. Liabilities 
42.16 	include, but are not limited to, workers' compensation liability, Federal Insurance 
42.17 	Contributions Act under United States Code, title 26, subtitle c, chapter 21, or Federal 
42.18 	Unemployment Tax Act under Internal Revenue Code, chapter 23.

42.19 	Sec. 29. Minnesota Statutes 2019 Supplement, section 256S.19, subdivision 4, is amended 
42.20 	to read:
42.21 		Subd. 4.Calculation of monthly conversion budget cap with consumer-directed 
42.22 	community supports. For the elderly waiver monthly conversion budget cap for the cost 
42.23 	of elderly waiver services with consumer-directed community support services supports, 
42.24 	the nursing facility case mix adjusted total payment rate used under subdivision 3 to calculate 
42.25 	the monthly conversion budget cap for elderly waiver services without consumer-directed 
42.26 	community supports must be reduced by a percentage equal to the percentage difference 
42.27 	between the consumer-directed services community supports budget limit that would be 
42.28 	assigned according to the elderly waiver plan and the corresponding monthly case mix 
42.29 	budget cap under this chapter, but not to exceed 50 percent.

43.1 	Sec. 30. Laws 2016, chapter 189, article 15, section 29, is amended to read:
43.2 	Sec. 29. DIRECTION TO COMMISSIONERS; INCOME AND ASSET EXCLUSION.
 43.3 	(a) The commissioner of human services shall not count payments made to families by 
43.4 	the income and child development in the first three years of life demonstration project as 
43.5 	income or assets for purposes of determining or redetermining eligibility for child care 
43.6 	assistance programs under Minnesota Statutes, chapter 119B; the Minnesota family 
43.7 	investment program, work benefit program, or diversionary work program under Minnesota 
43.8 	Statutes, chapter 256J, during the duration of the demonstration.
43.9 	(b) The commissioner of human services shall not count payments made to families by 
43.10 	the income and child development in the first three years of life demonstration project as 
43.11 	income for purposes of determining or redetermining eligibility for medical assistance under 
43.12 	Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter 
43.13 	256L.
43.14 	(c) For the purposes of this section, "income and child development in the first three 
43.15 	years of life demonstration project" means a demonstration project funded by the United 
43.16 	States Department of Health and Human Services National Institutes of Health to evaluate 
43.17 	whether the unconditional cash payments have a causal effect on the cognitive, 
43.18 	socioemotional, and brain development of infants and toddlers.
43.19 	(d) This section shall only be implemented if Minnesota is chosen as a site for the child 
43.20 	development in the first three years of life demonstration project, and expires January 1, 
43.21 	2022 2026.
43.22 	(e) The commissioner of human services shall provide a report to the chairs and ranking 
43.23 	minority members of the legislative committees having jurisdiction over human services 
43.24 	issues by January 1, 2023 2027, informing the legislature on the progress and outcomes of 
43.25 	the demonstration under this section.

43.26 	Sec. 31. Laws 2017, First Special Session chapter 6, article 7, section 33, subdivision 2, 
43.27 	is amended to read:
43.28 		Subd. 2.Pilot design and goals. The pilot will establish five key developmental milestone 
43.29 	markers from birth to age eight. Enrollees in the Pilot program participants will be 
43.30 	developmentally assessed and tracked by a technology solution that tracks developmental 
43.31 	milestones along the established developmental continuum. If a child's pilot program 
43.32 	participant's progress falls below established milestones and the weighted scoring, the 
44.1 	coordinated service system will focus on identified areas of concern, mobilize appropriate 
44.2 	supportive services, and offer referrals or services to identified children and their families
44.3 	pilot program participants.

44.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

44.5 	Sec. 32. Laws 2017, First Special Session chapter 6, article 7, section 33, subdivision 3, 
44.6 	is amended to read:
44.7 		Subd. 3.Program participants in phase 1 target population. Pilot program participants 
44.8 	must opt in and provide parental or guardian consent to participate and be enrolled or engaged 
44.9 	in one or more of the following:
44.10 	(1) be enrolled in a Women's Infant & Children (WIC) program;
44.11 	(2) be participating in a family home visiting program, or nurse family practice, or 
44.12 	Healthy Families America (HFA) Follow Along Program;
44.13 	(3) be children and families qualifying for and participating in early language learners 
44.14 	(ELL) in the school district in which they reside; and
44.15 	(4) opt in and provide parental consent to participate in the pilot project.
44.16 	(3) school's early childhood screening; or
44.17 	(4) any other Dakota County or school program that is determined as useful for identifying 
44.18 	children at risk of falling below established guidelines.

44.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

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

44.22
44.23	Subd. 33.Grant Programs; Chemical 
Dependency Treatment Support Grants

44.24	Appropriations by Fund
	
44.25	General
	2,636,000
	2,636,000
	
44.26	Lottery Prize
	1,733,000
	1,733,000
	
44.27 	(a) Problem Gambling. $225,000 in fiscal 
44.28 	year 2020 and $225,000 in fiscal year 2021 
44.29 	are from the lottery prize fund for a grant to 
44.30 	the state affiliate recognized by the National 
44.31 	Council on Problem Gambling. The affiliate 
45.1 	must provide services to increase public 
45.2 	awareness of problem gambling, education, 
45.3 	and training for individuals and organizations 
45.4 	providing effective treatment services to 
45.5 	problem gamblers and their families, and 
45.6 	research related to problem gambling.
45.7 	(b) Fetal Alcohol Spectrum Disorders 
45.8 	Grants for Fiscal Year 2020. (1) $500,000 
45.9 	in fiscal year 2020 and $500,000 in fiscal year 
45.10 	2021 are fromis from the general fund for a 
45.11 	grant to Proof Alliance. Of this appropriation, 
45.12 	Proof Alliance shall make grants to eligible 
45.13 	regional collaboratives for the purposes 
45.14 	specified in clause (3).
45.15 	(2) "Eligible regional collaboratives" means 
45.16 	a partnership between at least one local 
45.17 	government or tribal government and at least 
45.18 	one community-based organization and, where 
45.19 	available, a family home visiting program. For 
45.20 	purposes of this clause, a local government 
45.21 	includes a county or multicounty organization, 
45.22 	a tribal government, a county-based 
45.23 	purchasing entity, or a community health 
45.24 	board.
45.25 	(3) Eligible regional collaboratives must use 
45.26 	grant funds to reduce the incidence of fetal 
45.27 	alcohol spectrum disorders and other prenatal 
45.28 	drug-related effects in children in Minnesota 
45.29 	by identifying and serving pregnant women 
45.30 	suspected of or known to use or abuse alcohol 
45.31 	or other drugs. Eligible regional collaboratives 
45.32 	must provide intensive services to chemically 
45.33 	dependent women to increase positive birth 
45.34 	outcomes.
46.1 	(4) Proof Alliance must make grants to eligible 
46.2 	regional collaboratives from both rural and 
46.3 	urban areas of the state.
46.4 	(5) An eligible regional collaborative that 
46.5 	receives a grant under this paragraph must 
46.6 	report to Proof Alliance by January 15 of each 
46.7 	year on the services and programs funded by 
46.8 	the grant. The report must include measurable 
46.9 	outcomes for the previous year, including the 
46.10 	number of pregnant women served and the 
46.11 	number of toxic-free babies born. Proof 
46.12 	Alliance must compile the information in these 
46.13 	reports and report that information to the 
46.14 	commissioner of human services by February 
46.15 	15 of each year.
46.16 	(c) Fetal Alcohol Spectrum Disorders 
46.17 	Grants for Fiscal Year 2021. $500,000 in 
46.18 	fiscal year 2021 is from the general fund for 
46.19 	a grant under Minnesota Statutes, section 
46.20 	254A.21, to a statewide organization that 
46.21 	focuses solely on prevention of and 
46.22 	intervention with fetal alcohol spectrum 
46.23 	disorders.

46.24 	Sec. 34. ADULT FOSTER CARE MORATORIUM EXEMPTION.
 46.25 	A family foster care home located in Elk River, Sherburne County, and initially licensed 
46.26 	in 2003 to serve four people that seeks to transition to a corporate foster care home or 
46.27 	community residential setting is exempt from the moratorium under Minnesota Statutes, 
46.28 	section 245A.03, subdivision 7, and has until July 1, 2021, to transition to a corporate foster 
46.29 	care or community residential setting.

46.30 	EFFECTIVE DATE. This section is effective July 1, 2020.

46.31 	Sec. 35. TREATMENT OF PREVIOUSLY OBTAINED FEDERAL APPROVALS.
 46.32 	This act must not be construed to require the commissioner to seek federal approval for 
46.33 	provisions in Minnesota Statutes, section 256B.4911, for which the commissioner has 
47.1 	already received federal approval. Federal approvals the commissioner previously obtained 
47.2 	for provisions repealed in section 30 survive and apply to the corresponding subdivisions 
47.3 	in Minnesota Statutes, section 256B.4911.

47.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

47.5 	Sec. 36. REPEALER.
 47.6 	(a) Laws 2005, First Special Session chapter 4, article 7, section 50, is repealed.
47.7 	(b) Laws 2005, First Special Session chapter 4, article 7, section 51, is repealed.
47.8 	(c) Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter 
47.9 	312, article 27, section 72, Laws 2015, chapter 71, article 7, section 58, Laws 2016, chapter 
47.10 	144, section 1, Laws 2017, First Special Session chapter 6, article 1, section 43, Laws 2017, 
47.11 	First Special Session chapter 6, article 1, section 54, is repealed.
47.12 	(d) Laws 2015, chapter 71, article 7, section 54, as amended by Laws 2017, First Special 
47.13 	Session chapter 6, article 1, section 54, is repealed.
47.14 	(e) Laws 2017, First Special Session chapter 6, article 1, section 44, as amended by 
47.15 	Laws 2019, First Special Session chapter 9, article 5, section 80, is repealed.
47.16 	(f) Laws 2017, First Special Session chapter 6, article 1, section 45, as amended by Laws 
47.17 	2019, First Special Session chapter 9, article 5, section 81, is repealed.

47.18 	EFFECTIVE DATE. This section is effective the day following final enactment.

47.19 	ARTICLE 3
47.20 	EMPLOYMENT FIRST, INDEPENDENT LIVING FIRST, AND SELF-DIRECTION 
47.21 	FIRST

47.22 	Section 1. [256B.4905] HOME AND COMMUNITY-BASED SERVICES POLICY 
47.23 	STATEMENT.
47.24 		Subdivision 1.Employment first policy. It is the policy of this state that all working-age 
47.25 	Minnesotans with disabilities can work, want to work, and can achieve competitive integrated 
47.26 	employment, and that each working-age Minnesotan with a disability be offered the 
47.27 	opportunity to work and earn a competitive wage before being offered other supports and 
47.28 	services.
47.29 		Subd. 2.Employment first implementation for disability waiver services. The 
47.30 	commissioner of human services shall ensure that:
48.1 	(1) the disability waivers under sections 256B.092 and 256B.49 support the presumption 
48.2 	that all working-age Minnesotans with disabilities can work, want to work, and can achieve 
48.3 	competitive integrated employment; and
48.4 	(2) each waiver recipient of working age be offered, after an informed decision-making 
48.5 	process and during a person-centered planning process, the opportunity to work and earn a 
48.6 	competitive wage before being offered exclusively day services as defined in section 
48.7 	245D.03, subdivision 1, paragraph (c), clause (4), or successor provisions.
48.8 		Subd. 3.Independent living first policy. It is the policy of this state that all adult 
48.9 	Minnesotans with disabilities can and want to live independently with proper supports and 
48.10 	services; and that each adult Minnesotan with a disability be offered the opportunity to live 
48.11 	as independently as possible before being offered supports and services in provider-controlled 
48.12 	settings.
48.13 		Subd. 4.Independent living first implementation for disability waiver services. The 
48.14 	commissioner of human services shall ensure that:
48.15 	(1) the disability waivers under sections 256B.092 and 256B.49 support the presumption 
48.16 	that all adult Minnesotans with disabilities can and want to live independently with proper 
48.17 	services and supports as needed; and
48.18 	(2) each adult waiver recipient be offered, after an informed decision-making process 
48.19 	and during a person-centered planning process, the opportunity to live as independently as 
48.20 	possible before being offered customized living services provided in a single family home 
48.21 	or residential supports and services as defined in section 245D.03, subdivision 1, paragraph 
48.22 	(c), clause (3), or successor provisions, unless the residential supports and services are 
48.23 	provided in a family adult foster care residence under a shared living option as described 
48.24 	in Laws 2013, chapter 108, article 7, section 62.
48.25 		Subd. 5.Self-direction first policy. It is the policy of this state that adult Minnesotans 
48.26 	with disabilities and families of children with disabilities can and want to use self-directed 
48.27 	services and supports; and that each adult Minnesotan with a disability and each family of 
48.28 	the child with a disability be offered the opportunity to choose self-directed services and 
48.29 	supports before being offered services and supports that are not self-directed.
48.30 		Subd. 6.Self-directed first implementation for disability waiver services. The 
48.31 	commissioner of human services shall ensure that:
49.1 	(1) the disability waivers under sections 256B.092 and 256B.49 support the presumption 
49.2 	that adult Minnesotans with disabilities and families of children with disabilities can and 
49.3 	want to use self-directed services and supports, including self-directed funding options; and
49.4 	(2) each waiver recipient be offered, after an informed decision-making process and 
49.5 	during a person-centered planning process, the opportunity to choose self-directed services 
49.6 	and supports, including self-directed funding options, before being offered  services and 
49.7 	supports that are not self-directed.

49.8 	EFFECTIVE DATE. This section is effective the day following final enactment.

49.9 	Sec. 2. Laws 2019, First Special Session chapter 9, article 5, section 86, is amended to 
49.10 	read:
49.11 	Sec. 86. DISABILITY WAIVER RECONFIGURATION.
 49.12 		Subdivision 1.Intent. It is the intent of the legislature to reform the medical assistance 
49.13 	waiver programs for people with disabilities to simplify administration of the programs,. 
49.14 	Disability waiver reconfiguration must incentivize inclusive, person-centered, individualized
49.15 	supports,and services; enhance each person's self-determination and personal authority 
49.16 	over the person's service choice,; align benefits across waivers, encourage; ensure equity 
49.17 	across programs and populations, and; promote long-term sustainability of needed waiver
49.18 	services. To the maximum extent possible, the Disability waiver reconfiguration must; and
49.19 	maintain service stability and continuity of care, while prioritizing, promoting the most, 
49.20 	and creating incentives for independent and, integrated, and individualized supports of each 
49.21 	person's choosing in both short- and long-termand services chosen by each person through 
49.22 	an informed decision-making process and person-centered planning.
49.23 		Subd. 2.Report. By January 15, 2021, the commissioner of human services shall submit 
49.24 	a report to the members of the legislative committees with jurisdiction over human services 
49.25 	on any necessary waivers, state plan amendments, requests for new funding or realignment 
49.26 	of existing funds, any changes to state statute or rule, and any other federal authority 
49.27 	necessary to implement this section. The report must include information about the 
49.28 	commissioner's work to collect feedback and input from providers, persons accessing home 
49.29 	and community-based services waivers and their families, and client advocacy organizations.
49.30 		Subd. 3.Proposal. By January 15, 2021, the commissioner shall develop a proposal to 
49.31 	reconfigure the medical assistance waivers provided in sections 256B.092 and 256B.49. 
49.32 	The proposal shall include all necessary plans for implementing two home and 
49.33 	community-based services waiver programs, as authorized under section 1915(c) of the 
50.1 	Social Security Act that serve persons who are determined to require the levels of care 
50.2 	provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care 
50.3 	facility for persons with developmental disabilities. The proposal must include in each home 
50.4 	and community-based waiver program options to self-direct services. Before submitting 
50.5 	the final report to the legislature, the commissioner shall publish a draft report with sufficient 
50.6 	time for interested persons to offer additional feedback.

50.7 	EFFECTIVE DATE. This section is effective the day following final enactment.

50.8 	ARTICLE 4
50.9 	ASSESSMENT, CASE MANAGEMENT, AND SERVICE PLANNING 
50.10 	MODIFICATIONS

50.11 	Section 1. Minnesota Statutes 2019 Supplement, section 245D.071, subdivision 5, is 
50.12 	amended to read:
50.13 		Subd. 5.Service plan review and evaluation. (a) The license holder must give the 
50.14 	person or the person's legal representative and case manager an opportunity to participate 
50.15 	in the ongoing review and development of the service plan and the methods used to support 
50.16 	the person and accomplish outcomes identified in subdivisions 3 and 4. At least once per 
50.17 	year, or within 30 days of a written request by the person, the person's legal representative, 
50.18 	or the case manager, the license holder, in coordination with the person's support team or 
50.19 	expanded support team, must meet with the person, the person's legal representative, and 
50.20 	the case manager, and participate in service plan review meetings following stated timelines 
50.21 	established in the person's coordinated service and support plan or coordinated service and 
50.22 	support plan addendum. The purpose of the service plan review is to determine whether 
50.23 	changes are needed to the service plan based on the assessment information, the license 
50.24 	holder's evaluation of progress towards toward accomplishing outcomes, or other information 
50.25 	provided by the support team or expanded support team.
50.26 	(b) At least once per year, the license holder, in coordination with the person's support 
50.27 	team or expanded support team, must meet with the person, the person's legal representative, 
50.28 	and the case manager to discuss how technology might be used to meet the person's desired 
50.29 	outcomes. The coordinated service and support plan addendum must include a summary of 
50.30 	this discussion. The summary must include a statement regarding any decision made related 
50.31 	to the use of technology and a description of any further research that must be completed 
50.32 	before a decision regarding the use of technology can be made. Nothing in this paragraph 
50.33 	requires the coordinated service and support plan addendum to include the use of technology 
50.34 	for the provision of services.
51.1 	(c) At least once per year, the license holder, in coordination with the person's support 
51.2 	team or expanded support team, must meet with a person receiving residential supports and 
51.3 	services, the person's legal representative, and the case manager to discuss options for 
51.4 	transitioning out of a community setting controlled by a provider and into a setting not 
51.5 	controlled by a provider.
51.6 	(d) The coordinated service and support plan addendum must include a summary of the 
51.7 	discussion required in paragraph (c). The summary must include a statement about any 
51.8 	decision made regarding transitioning out of a provider-controlled setting and a description 
51.9 	of any further research or education that must be completed before a decision regarding 
51.10 	transitioning out of a provider-controlled setting can be made.
51.11 	(e) At least once per year, the license holder, in coordination with the person's support 
51.12 	team or expanded support team, must meet with a person receiving day services, the person's 
51.13 	legal representative, and the case manager to discuss options for transitioning to an 
51.14 	employment service described in section 245D.03, subdivision 1, paragraph (c), clauses (5) 
51.15 	to (7).
51.16 	(f) The coordinated service and support plan addendum must include a summary of the 
51.17 	discussion required in paragraph (e). The summary must include a statement about any 
51.18 	decision made concerning transition to an employment service and a description of any 
51.19 	further research or education that must be completed before a decision regarding transitioning 
51.20 	to an employment service can be made.
51.21 	(g) The license holder must summarize the person's status and progress toward achieving 
51.22 	the identified outcomes and make recommendations and identify the rationale for changing, 
51.23 	continuing, or discontinuing implementation of supports and methods identified in 
51.24 	subdivision 4 in a report available at the time of the progress review meeting. The report 
51.25 	must be sent at least five working days prior to the progress review meeting if requested by 
51.26 	the team in the coordinated service and support plan or coordinated service and support 
51.27 	plan addendum.
51.28 	(d) (h) The license holder must send the coordinated service and support plan addendum 
51.29 	to the person, the person's legal representative, and the case manager by mail within ten 
51.30 	working days of the progress review meeting. Within ten working days of the mailing of 
51.31 	the coordinated service and support plan addendum, the license holder must obtain dated 
51.32 	signatures from the person or the person's legal representative and the case manager to 
51.33 	document approval of any changes to the coordinated service and support plan addendum.
52.1 	(e) (i) If, within ten working days of submitting changes to the coordinated service and 
52.2 	support plan and coordinated service and support plan addendum, the person or the person's 
52.3 	legal representative or case manager has not signed and returned to the license holder the 
52.4 	coordinated service and support plan or coordinated service and support plan addendum or 
52.5 	has not proposed written modifications to the license holder's submission, the submission 
52.6 	is deemed approved and the coordinated service and support plan addendum becomes 
52.7 	effective and remains in effect until the legal representative or case manager submits a 
52.8 	written request to revise the coordinated service and support plan addendum.

52.9 	Sec. 2. Minnesota Statutes 2018, section 256B.0911, subdivision 1, is amended to read:
52.10 		Subdivision 1.Purpose and goal. (a) The purpose of long-term care consultation services 
52.11 	is to assist persons with long-term or chronic care needs in making care decisions and 
52.12 	selecting support and service options that meet their needs and reflect their preferences. 
52.13 	The availability of, and access to, information and other types of assistance, including 
52.14 	long-term care consultation assessment and community support planning, is also intended 
52.15 	to prevent or delay institutional placements and to provide access to transition assistance 
52.16 	after admission placement. Further, the goal of these long-term care consultation services 
52.17 	is to contain costs associated with unnecessary institutional admissions. Long-term 
52.18 	consultation services must be available to any person regardless of public program eligibility.
52.19 	(b) The commissioner of human services shall seek to maximize use of available federal 
52.20 	and state funds and establish the broadest program possible within the funding available.
52.21 	(b) These (c) Long-term care consultation services must be coordinated with long-term 
52.22 	care options counseling provided under subdivision 4d, section 256.975, subdivisions 7 to 
52.23 	7c, and section 256.01, subdivision 24.
52.24 	(d) The lead agency providing long-term care consultation services shall encourage the 
52.25 	use of volunteers from families, religious organizations, social clubs, and similar civic and 
52.26 	service organizations to provide community-based services.

52.27 	Sec. 3. Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision 1a, is 
52.28 	amended to read:
52.29 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
52.30 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
52.31 	services" means:
53.1 	(1) intake for and access to assistance in identifying services needed to maintain an 
53.2 	individual in the most inclusive environment;
53.3 	(2) providing recommendations for and referrals to cost-effective community services 
53.4 	that are available to the individual;
53.5 	(3) development of an individual's person-centered community support plan;
53.6 	(4) providing information regarding eligibility for Minnesota health care programs;
53.7 	(5) face-to-face long-term care consultation assessments, which may be completed in a 
53.8 	hospital, nursing facility, intermediate care facility for persons with developmental disabilities 
53.9 	(ICF/DDs), regional treatment centers, or the person's current or planned residence;
53.10 	(6) determination of home and community-based waiver and other service eligibility as 
53.11 	required under chapter 256S and sections 256B.0913, 256B.092, and 256B.49, including 
53.12 	level of care determination for individuals who need an institutional level of care as 
53.13 	determined under subdivision 4e, based on a long-term care consultation assessment and 
53.14 	community support plan development, appropriate referrals to obtain necessary diagnostic 
53.15 	information, and including an eligibility determination for consumer-directed community 
53.16 	supports;
53.17 	(7) providing recommendations for institutional placement when there are no 
53.18 	cost-effective community services available;
53.19 	(8) providing access to assistance to transition people back to community settings after 
53.20 	institutional admission; and
53.21 	(9) providing information about competitive employment, with or without supports, for 
53.22 	school-age youth and working-age adults and referrals to the Disability Linkage Line and 
53.23 	Disability Benefits 101 to ensure that an informed choice about competitive employment 
53.24 	can be made. For the purposes of this subdivision, "competitive employment" means work 
53.25 	in the competitive labor market that is performed on a full-time or part-time basis in an 
53.26 	integrated setting, and for which an individual is compensated at or above the minimum 
53.27 	wage, but not less than the customary wage and level of benefits paid by the employer for 
53.28 	the same or similar work performed by individuals without disabilities;
53.29 	(10) providing information about independent living to ensure that a fully informed 
53.30 	choice about independent living can be made; and
53.31 	(11) providing information about self-directed services and supports, including 
53.32 	self-directed funding options, to ensure that a fully informed choice about self-directed 
53.33 	options can be made.
54.1 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
54.2 	and 3a, "long-term care consultation services" also means:
54.3 	(1) service eligibility determination for the following state plan services identified in:
54.4 	(i) personal care assistance services under section 256B.0625, subdivisions 19a and 19c;
54.5 	(ii) consumer support grants under section 256.476; or
54.6 	(iii) community first services and supports under section 256B.85;
54.7 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
54.8 	gaining access to:
54.9 	(i) relocation-targeted  case management services available under sections section
54.10 	256B.0621, subdivision 2, clause (4),;
54.11 	(ii) case management services targeted to vulnerable adults or developmental disabilities 
54.12 	under section256B.0924,; and
54.13 	(iii) case management services targeted to people with developmental disabilities under 
54.14 	Minnesota Rules, part 9525.0016;
54.15 	(3) determination of eligibility for semi-independent living services under section 
54.16 	252.275; and
54.17 	(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) 
54.18 	and (3).
54.19 	(c) "Long-term care options counseling" means the services provided by the linkage 
54.20 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also 
54.21 	includes telephone assistance and follow up once a long-term care consultation assessment 
54.22 	has been completed.
54.23 	(d) "Minnesota health care programs" means the medical assistance program under this 
54.24 	chapter and the alternative care program under section 256B.0913.
54.25 	(e) "Lead agencies" means counties administering or tribes and health plans under 
54.26 	contract with the commissioner to administer long-term care consultation assessment and 
54.27 	support planning services.
54.28 	(f) "Person-centered planning" is a process that includes the active participation of a 
54.29 	person in the planning of the person's services, including in making meaningful and informed 
54.30 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
55.1 	and informed choices about the services the person receives. For the purposes of this section,
55.2 	the settings in which the person receives them, and the setting in which the person lives.
55.3 	(g) "Informed choice" means a voluntary choice of services, settings, and living 
55.4 	arrangement by a person from all available service and setting options based on accurate 
55.5 	and complete information concerning all available service and setting options and concerning 
55.6 	the person's own preferences, abilities, goals, and objectives. In order for a person to make 
55.7 	an informed choice, all available options must be developed and presented to the person in 
55.8 	a way the person can understand to empower the person to make decisions fully informed 
55.9 	choices.
55.10 	(h) "Available service and setting options" or "available options," with respect to the 
55.11 	home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49, 
55.12 	means all services and settings defined under the relevant waiver plan.
55.13 	(i) "Independent living" means living in a setting that is not controlled by a provider.

55.14 	Sec. 4. Minnesota Statutes 2018, section 256B.0911, is amended by adding a subdivision 
55.15 	to read:
55.16 		Subd. 1b.Eligibility. (a) To be eligible for long-term care consultation services, a person 
55.17 	must be:
55.18 	(1) enrolled in medical assistance;
55.19 	(2) determined financially eligible for the alternative care program;
55.20 	(3) determined to have a developmental disability or related condition as defined in 
55.21 	Minnesota Rules, part 9525.0016, subpart 2, items A to E; or
55.22 	(4) referred to a lead agency under section 256.975, subdivision 7c, paragraph (a), clause 
55.23 	(2), following a nursing facility preadmission screening.
55.24 	(b) To be eligible for long-term care consultation services, a person enrolled in medical 
55.25 	assistance must also have utilized state plan services for at least six months and be either:
55.26 	(1) age 65 or older;
55.27 	(2) blind; or
55.28 	(3) determined to have a disability by the commissioner's state medical review team as 
55.29 	identified in section 256B.055, subdivision 7, or by the Social Security Administration.

56.1 	Sec. 5. Minnesota Statutes 2018, section 256B.0911, is amended by adding a subdivision 
56.2 	to read:
56.3 		Subd. 1c.Assessments for personal care assistance services. Notwithstanding 
56.4 	subdivision 1b, paragraph (b), a lead agency may assess a recipient's need for personal care 
56.5 	assistance services under this section.

56.6 	Sec. 6. Minnesota Statutes 2018, section 256B.0911, subdivision 3, is amended to read:
56.7 		Subd. 3.Long-term care consultation team. (a) A long-term care consultation team 
56.8 	shall be established by the county board of commissioners. Two or more counties may 
56.9 	collaborate to establish a joint local consultation team or teams.
56.10 	(b) Each lead agency shall establish and maintain a team of certified assessors qualified 
56.11 	under subdivision 2b, paragraph (b). Each team member is responsible for providing 
56.12 	consultation with other team members upon request. The team is responsible for providing 
56.13 	long-term care consultation services to all eligible persons located in the county who request 
56.14 	the services, regardless of eligibility for Minnesota health care programs. The team of 
56.15 	certified assessors must include, at a minimum:
56.16 	(1) a social worker; and
56.17 	(2) a public health nurse or registered nurse.
56.18 	(c) The commissioner shall allow arrangements and make recommendations that 
56.19 	encourage counties and tribes to collaborate to establish joint local long-term care 
56.20 	consultation teams to ensure that long-term care consultations are done within the timelines 
56.21 	and parameters of the service. This includes integrated service models as required in 
56.22 	subdivision 1, paragraph (b).
56.23 	(d) Tribes and health plans under contract with the commissioner must provide long-term 
56.24 	care consultation services as specified in the contract.
56.25 	(e) The lead agency must provide the commissioner with an administrative contact for 
56.26 	communication purposes.

56.27 	Sec. 7. Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision 3a, is 
56.28 	amended to read:
56.29 		Subd. 3a.Assessment and support planning. (a) Eligible persons requesting assessment, 
56.30 	services planning, or other assistance intended to support community-based living, including 
56.31 	persons who need assessment in order to determine waiver or alternative care program 
57.1 	eligibility, must be visited by a long-term care consultation team within 20 calendar days 
57.2 	after the date on which an assessment was requested or recommended. Upon statewide 
57.3 	implementation of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment 
57.4 	of a person requesting personal care assistance services. The commissioner shall provide 
57.5 	at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
57.6 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
57.7 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
57.8 	assessors to conduct the assessment. For a person with complex health care needs, a public 
57.9 	health or registered nurse from the team must be consulted.
57.10 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
57.11 	be used to complete a comprehensive, conversation-based, person-centered assessment. 
57.12 	The assessment must include the health, psychological, functional, environmental, and 
57.13 	social needs of the individual necessary to develop a person-centered community support 
57.14 	plan that meets the individual's needs and preferences.
57.15 	(d) The assessment must be conducted by a certified assessor in a face-to-face 
57.16 	conversational interview with the person being assessed. The person's legal representative 
57.17 	must provide input during the assessment process and may do so remotely if requested. At 
57.18 	the request of the person, other individuals may participate in the assessment to provide 
57.19 	information on the needs, strengths, and preferences of the person necessary to develop a 
57.20 	community support plan that ensures the person's health and safety. Except for legal 
57.21 	representatives or family members invited by the person, persons participating in the 
57.22 	assessment may not be a provider of service or have any financial interest in the provision 
57.23 	of services. For persons who are to be assessed for elderly waiver customized living or adult 
57.24 	day services under chapter 256S, with the permission of the person being assessed or the 
57.25 	person's designated or legal representative, the client's current or proposed provider of 
57.26 	services may submit a copy of the provider's nursing assessment or written report outlining 
57.27 	its recommendations regarding the client's care needs. The person conducting the assessment 
57.28 	must notify the provider of the date by which this information is to be submitted. This 
57.29 	information shall be provided to the person conducting the assessment prior to the assessment. 
57.30 	For a person who is to be assessed for waiver services under section 256B.092 or 256B.49, 
57.31 	with the permission of the person being assessed or the person's designated legal 
57.32 	representative, the person's current provider of services may submit a written report outlining 
57.33 	recommendations regarding the person's care needs the person completed in consultation 
57.34 	with someone who is known to the person and has interaction with the person on a regular 
57.35 	basis. The provider must submit the report at least 60 days before the end of the person's 
58.1 	current service agreement. The certified assessor must consider the content of the submitted 
58.2 	report prior to finalizing the person's assessment or reassessment.
58.3 	(e) The certified assessor and the individual responsible for developing the coordinated 
58.4 	service and support plan must complete the community support plan and the coordinated 
58.5 	service and support plan no more than 60 calendar days from the assessment visit. The 
58.6 	person or the person's legal representative must be provided with a written community 
58.7 	support plan within the timelines established by the commissioner, regardless of whether 
58.8 	the person is eligible for Minnesota health care programs.
58.9 	(f) For a person being assessed for elderly waiver services under chapter 256S, a provider 
58.10 	who submitted information under paragraph (d) shall receive the final written community 
58.11 	support plan when available and the Residential Services Workbook.
58.12 	(g) The written community support plan must include:
58.13 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
58.14 	(2) the individual's options and choices to meet identified needs, including:
58.15 	(i) all available options for case management services and providers, including;
58.16 	(ii) all available options for employment services, settings, and providers;
58.17 	(iii) all available options for living arrangements;
58.18 	(iv) all available options for self-directed services and supports, including self-directed 
58.19 	budget options; and
58.20 	(v) service provided in a non-disability-specific setting;
58.21 	(3) identification of health and safety risks and how those risks will be addressed, 
58.22 	including personal risk management strategies;
58.23 	(4) referral information; and
58.24 	(5) informal caregiver supports, if applicable.
58.25 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
58.26 	(b), clause (1), the person or person's representative must also receive a copy of the home 
58.27 	care service plan developed by the certified assessor.
58.28 	(h) A person may request assistance in identifying community supports without 
58.29 	participating in a complete assessment. Upon a request for assistance identifying community 
58.30 	support, the a person who is not eligible for long-term care consultations services must be 
59.1 	transferred or referred to long-term care options counseling services available under sections 
59.2 	256.975, subdivision 7, and 256.01, subdivision 24, for telephone assistance and follow up.
59.3 	(i) The person has the right to make the final decision:
59.4 	(1) between institutional placement and community placement after the recommendations 
59.5 	have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);
59.6 	(2) between community placement in a setting controlled by a provider and living 
59.7 	independently in a setting not controlled by a provider;
59.8 	(3) between day services and employment services; and
59.9 	(4) regarding available options for self-directed services and supports, including 
59.10 	self-directed funding options.
59.11 	(j) The lead agency must give the person receiving assessment or support planning, or 
59.12 	the person's legal representative, materials, and forms supplied by the commissioner 
59.13 	containing the following information:
59.14 	(1) written recommendations for community-based services and consumer-directed 
59.15 	options;
59.16 	(2) documentation that the most cost-effective alternatives available were offered to the 
59.17 	individual. For purposes of this clause, "cost-effective" means community services and 
59.18 	living arrangements that cost the same as or less than institutional care. For an individual 
59.19 	found to meet eligibility criteria for home and community-based service programs under 
59.20 	chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally 
59.21 	approved waiver plan for each program;
59.22 	(3) the need for and purpose of preadmission screening conducted by long-term care 
59.23 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
59.24 	nursing facility placement. If the individual selects nursing facility placement, the lead 
59.25 	agency shall forward information needed to complete the level of care determinations and 
59.26 	screening for developmental disability and mental illness collected during the assessment 
59.27 	to the long-term care options counselor using forms provided by the commissioner;
59.28 	(4) the role of long-term care consultation assessment and support planning in eligibility 
59.29 	determination for waiver and alternative care programs, and state plan home care, case 
59.30 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
59.31 	and (b);
59.32 	(5) information about Minnesota health care programs;
60.1 	(6) the person's freedom to accept or reject the recommendations of the team;
60.2 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
60.3 	Act, chapter 13;
60.4 	(8) the certified assessor's decision regarding the person's need for institutional level of 
60.5 	care as determined under criteria established in subdivision 4e and the certified assessor's 
60.6 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
60.7 	paragraphs (a), clause (6), and (b); and
60.8 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
60.9 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
60.10 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
60.11 	or the lead agency's final decisions regarding public programs eligibility according to section 
60.12 	256.045, subdivision 3. The certified assessor must verbally communicate this appeal right 
60.13 	to the person and must visually point out where in the document the right to appeal is stated; 
60.14 	and
60.15 	(10) documentation that available options for employment services, independent living, 
60.16 	and self-directed services and supports were offered to the individual.
60.17 	(k) Face-to-face assessment completed as part of service eligibility determination for 
60.18 	the alternative care, elderly waiver, developmental disabilities, community access for 
60.19 	disability inclusion, community alternative care, and brain injury waiver programs under 
60.20 	chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish service 
60.21 	eligibility for no more than 60 calendar days after the date of assessment.
60.22 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
60.23 	to the date of assessment. If an assessment was completed more than 60 days before the 
60.24 	effective waiver or alternative care program eligibility start date, assessment and support 
60.25 	plan information must be updated and documented in the department's Medicaid Management 
60.26 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
60.27 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
60.28 	cannot be prior to the date the most recent updated assessment is completed.
60.29 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
60.30 	assessment and documented in the department's Medicaid Management Information System 
60.31 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
60.32 	of the previous face-to-face assessment when all other eligibility requirements are met.
61.1 	(n) At the time of reassessment, the certified assessor shall assess each person receiving 
61.2 	waiver residential supports and services currently residing in a community residential setting, 
61.3 	or licensed adult foster care home that is either not the primary residence of the license 
61.4 	holder, or in which the license holder is not the primary caregiver, family adult foster care 
61.5 	residence, or supervised living facility to determine if that person would prefer to be served 
61.6 	in a community-living setting as defined in section 256B.49, subdivision 23, in a setting 
61.7 	not controlled by a provider, or to receive integrated community supports as described in 
61.8 	section 245D.03, subdivision 1, paragraph (c), clause (8). The certified assessor shall offer 
61.9 	the person, through a person-centered planning process, the option to receive alternative 
61.10 	housing and service options.
61.11 	(o) At the time of reassessment, the certified assessor shall assess each person receiving 
61.12 	waiver day services to determine if that person would prefer to receive employment services 
61.13 	as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified 
61.14 	assessor shall offer the person through a person-centered planning process the option to 
61.15 	receive employment services.
61.16 	(p) At the time of reassessment, the certified assessor shall assess each person receiving 
61.17 	non-self-directed waiver services to determine if that person would prefer an available 
61.18 	service and setting option that would permit self-directed services and supports. The certified 
61.19 	assessor shall offer the person through a person-centered planning process the option to 
61.20 	receive self-directed services and supports.

61.21 	Sec. 8. Minnesota Statutes 2018, section 256B.0911, subdivision 3b, is amended to read:
61.22 		Subd. 3b.Transition assistance. (a) Notwithstanding subdivision 1b, lead agency 
61.23 	certified assessors shall provide assistance to all persons residing in a nursing facility, 
61.24 	hospital, regional treatment center, or intermediate care facility for persons with 
61.25 	developmental disabilities who request or are referred for assistance. Transition assistance 
61.26 	must include assessment, community support plan development, referrals to long-term care 
61.27 	options counseling under section 256.975, subdivision 7, for community support plan 
61.28 	implementation and to Minnesota health care programs, including home and 
61.29 	community-based waiver services and consumer-directed options through the waivers, and 
61.30 	referrals to programs that provide assistance with housing. Transition assistance must also 
61.31 	include information about the Centers for Independent Living, Disability Linkage Line, and 
61.32 	about other organizations that can provide assistance with relocation efforts, and information 
61.33 	about contacting these organizations to obtain their assistance and support.
61.34 	(b) The lead agency shall ensure that:
62.1 	(1) referrals for in-person assessments are taken from long-term care options counselors 
62.2 	as provided for in section 256.975, subdivision 7, paragraph (b), clause (11);
62.3 	(2) persons assessed in institutions receive information about transition assistance that 
62.4 	is available;
62.5 	(3) the assessment is completed for persons within 20 calendar days of the date of request 
62.6 	or recommendation for assessment;
62.7 	(4) there is a plan for transition and follow-up for the individual's return to the community, 
62.8 	including notification of other local agencies when a person may require assistance from 
62.9 	agencies located in another county; and
62.10 	(5) relocation targeted relocation-targeted case management as defined in section 
62.11 	256B.0621, subdivision 2, clause (4), is authorized for an eligible medical assistance 
62.12 	recipient.

62.13 	Sec. 9. Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision 3f, is amended 
62.14 	to read:
62.15 		Subd. 3f.Long-term care reassessments and community support plan updates. (a) 
62.16 	Prior to a face-to-face reassessment, the certified assessor must review the person's most 
62.17 	recent assessment. Reassessments must be tailored using the professional judgment of the 
62.18 	assessor to the person's known needs, strengths, preferences, and circumstances. 
62.19 	Reassessments provide information to support the person's informed choice and opportunities 
62.20 	to express choice regarding activities that contribute to quality of life, as well as information 
62.21 	and opportunity to identify goals related to desired employment, community activities, and 
62.22 	preferred living environment. Reassessments require a review of the most recent assessment, 
62.23 	review of the current coordinated service and support plan's effectiveness, monitoring of 
62.24 	services, and the development of an updated person-centered community support plan. 
62.25 	Reassessments must verify continued service eligibility or, offer alternatives as warranted,
62.26 	and provide an opportunity for quality assurance of service delivery. Face-to-face 
62.27 	reassessments must be conducted annually or as required by federal and state laws and rules. 
62.28 	For reassessments, the certified assessor and the individual responsible for developing the 
62.29 	coordinated service and support plan must ensure the continuity of care for the person 
62.30 	receiving services and complete the updated community support plan and the updated 
62.31 	coordinated service and support plan no more than 60 days from the reassessment visit.
63.1 	(b) The commissioner shall develop mechanisms for providers and case managers to 
63.2 	share information with the assessor to facilitate a reassessment and support planning process 
63.3 	tailored to the person's current needs and preferences.
63.4 	(c) An individual or an individual's legal representative may indicate, in writing, at the 
63.5 	conclusion of an annual reassessment that a complete annual long-term care consultation 
63.6 	reassessment is not desired for up to two years. Before granting an individual's request to 
63.7 	decline one or two complete annual reassessments, the certified assessor must provide the 
63.8 	individual sufficient information to make a fully informed choice to decline complete annual 
63.9 	reassessments. An eligible individual may request a reassessment at any time. In lieu of an 
63.10 	annual complete long-term care consultation assessment for individuals who decline the 
63.11 	assessment, certified assessors shall annually perform only those activities required by 
63.12 	federal law to maintain the individual's service eligibility.

63.13 	Sec. 10. Minnesota Statutes 2018, section 256B.0911, subdivision 4d, is amended to read:
63.14 		Subd. 4d.Preadmission screening of individuals under 65 years of age. (a) It is the 
63.15 	policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness 
63.16 	are served in the most integrated setting appropriate to their needs and have the necessary 
63.17 	information to make informed choices about home and community-based service options.
63.18 	(b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing 
63.19 	facility must be screened prior to admission according to the requirements outlined in section 
63.20 	256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as 
63.21 	required under section 256.975, subdivision 7.
63.22 	(c) Notwithstanding subdivision 1b, individuals under 65 years of age who are admitted 
63.23 	to nursing facilities with only a telephone screening must receive a face-to-face assessment 
63.24 	from the long-term care consultation team member of the county in which the facility is 
63.25 	located or from the recipient's county case manager within the timeline established by the 
63.26 	commissioner, based on review of data.
63.27 	(d) At the face-to-face assessment, the long-term care consultation team member or 
63.28 	county case manager must perform the activities required under subdivision 3b.
63.29 	(e) For individuals under 21 years of age, a screening interview which recommends 
63.30 	nursing facility admission must be face-to-face and approved by the commissioner before 
63.31 	the individual is admitted to the nursing facility.
63.32 	(f) In the event that an individual under 65 years of age is admitted to a nursing facility 
63.33 	on an emergency basis, the Senior LinkAge Line must be notified of the admission on the 
64.1 	next working day, and a face-to-face assessment as described in paragraph (c) must be 
64.2 	conducted within the timeline established by the commissioner, based on review of data.
64.3 	(g) At the face-to-face assessment, the long-term care consultation team member or the 
64.4 	case manager must present information about home and community-based options, including 
64.5 	consumer-directed options, so the individual can make informed choices. If the individual 
64.6 	chooses home and community-based services, the long-term care consultation team member 
64.7 	or case manager must complete a written relocation plan within 20 working days of the 
64.8 	visit. The plan shall describe the services needed to move out of the facility and a time line 
64.9 	for the move which is designed to ensure a smooth transition to the individual's home and 
64.10 	community.
64.11 	(h) Notwithstanding subdivision 1b, an individual under 65 years of age residing in a 
64.12 	nursing facility shall receive a face-to-face assessment at least every 12 months to review 
64.13 	the person's service choices and available alternatives unless the individual indicates, in 
64.14 	writing, that annual visits are not desired. In this case, the individual must receive a 
64.15 	face-to-face assessment at least once every 36 months for the same purposes.
64.16 	(i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county 
64.17 	agencies directly for face-to-face assessments for individuals under 65 years of age who 
64.18 	are being considered for placement or residing in a nursing facility.
64.19 	(j) Funding for preadmission screening follow-up shall be provided to the Disability 
64.20 	Linkage Line for the under-60 population by the Department of Human Services to cover 
64.21 	options counseling salaries and expenses to provide the services described in subdivisions 
64.22 	7a to 7c. The Disability Linkage Line shall employ, or contract with other agencies to 
64.23 	employ, within the limits of available funding, sufficient personnel to provide preadmission 
64.24 	screening follow-up services and shall seek to maximize federal funding for the service as 
64.25 	provided under section 256.01, subdivision 2, paragraph (aa).

64.26 	Sec. 11. Minnesota Statutes 2018, section 256B.092, subdivision 1a, is amended to read:
64.27 		Subd. 1a.Case management services. (a) Each recipient of a home and community-based 
64.28 	waiver shall be provided case management services by qualified vendors as described in 
64.29 	the federally approved waiver application.
64.30 	(b) Case management service activities provided to or arranged for a person include:
64.31 	(1) development of the person-centered coordinated service and support plan under 
64.32 	subdivision 1b;
65.1 	(2) informing the individual or the individual's legal guardian or conservator, or parent 
65.2 	if the person is a minor, of service options, including all service options available under the 
65.3 	waiver plan;
65.4 	(3) consulting with relevant medical experts or service providers;
65.5 	(4) assisting the person in the identification of potential providers, including:
65.6 	(i) providers of services provided in a non-disability-specific setting;
65.7 	(ii) employment service providers;
65.8 	(iii) providers of services provided in settings that are not controlled by a provider; and
65.9 	(iv) providers of financial management services;
65.10 	(5) assisting the person to access services and assisting in appeals under section 256.045;
65.11 	(6) coordination of services, if coordination is not provided by another service provider;
65.12 	(7) evaluation and monitoring of the services identified in the coordinated service and 
65.13 	support plan, which must incorporate at least one annual face-to-face visit by the case 
65.14 	manager with each person; and
65.15 	(8) reviewing coordinated service and support plans and providing the lead agency with 
65.16 	recommendations for service authorization based upon the individual's needs identified in 
65.17 	the coordinated service and support plan.
65.18 	(c) Case management service activities that are provided to the person with a 
65.19 	developmental disability shall be provided directly by county agencies or under contract. 
65.20 	Case management services must be provided by a public or private agency that is enrolled 
65.21 	as a medical assistance provider determined by the commissioner to meet all of the 
65.22 	requirements in the approved federal waiver plans. Case management services must not be 
65.23 	provided to a recipient by a private agency that has a financial interest in the provision of 
65.24 	any other services included in the recipient's coordinated service and support plan. For 
65.25 	purposes of this section, "private agency" means any agency that is not identified as a lead 
65.26 	agency under section 256B.0911, subdivision 1a, paragraph (e).
65.27 	(d) Case managers are responsible for service provisions listed in paragraphs (a) and 
65.28 	(b). Case managers shall collaborate with consumers, families, legal representatives, and 
65.29 	relevant medical experts and service providers in the development and annual review of the 
65.30 	person-centered coordinated service and support plan and habilitation plan.
65.31 	(e) For persons who need a positive support transition plan as required in chapter 245D, 
65.32 	the case manager shall participate in the development and ongoing evaluation of the plan 
66.1 	with the expanded support team. At least quarterly, the case manager, in consultation with 
66.2 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
66.3 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
66.4 	identify whether the plan has been developed and implemented in a manner to achieve the 
66.5 	following within the required timelines:
66.6 	(1) phasing out the use of prohibited procedures;
66.7 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
66.8 	timeline; and
66.9 	(3) accomplishment of identified outcomes.
66.10 	If adequate progress is not being made, the case manager shall consult with the person's 
66.11 	expanded support team to identify needed modifications and whether additional professional 
66.12 	support is required to provide consultation.
66.13 	(f) The Department of Human Services shall offer ongoing education in case management 
66.14 	to case managers. Case managers shall receive no less than ten hours of case management 
66.15 	education and disability-related training each year. The education and training must include 
66.16 	person-centered planning. For the purposes of this section, "person-centered planning" or 
66.17 	"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph 
66.18 	(f).

66.19 	Sec. 12. Minnesota Statutes 2019 Supplement, section 256B.092, subdivision 1b, is 
66.20 	amended to read:
66.21 		Subd. 1b.Coordinated service and support plan. (a) Each recipient of home and 
66.22 	community-based waivered services shall be provided a copy of the written person-centered 
66.23 	coordinated service and support plan that:
66.24 	(1) is developed with and signed by the recipient within the timelines established by the 
66.25 	commissioner and section 256B.0911, subdivision 3a, paragraph (e);
66.26 	(2) includes the person's need for service, including identification of service needs that 
66.27 	will be or that are met by the person's relatives, friends, and others, as well as community 
66.28 	services used by the general public;
66.29 	(3) reasonably ensures the health and welfare of the recipient;
66.30 	(4) identifies the person's preferences for services as stated by the person, the person's 
66.31 	legal guardian or conservator, or the parent if the person is a minor, including the person's 
67.1 	choices made on self-directed options and on, services and supports to achieve employment 
67.2 	goals, and living arrangements;
67.3 	(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
67.4 	paragraph (o), of service and support providers, and identifies all available options for case 
67.5 	management services and providers;
67.6 	(6) identifies long-range and short-range goals for the person;
67.7 	(7) identifies specific services and the amount and frequency of the services to be provided 
67.8 	to the person based on assessed needs, preferences, and available resources. The 
67.9 	person-centered coordinated service and support plan shall also specify other services the 
67.10 	person needs that are not available;
67.11 	(8) identifies the need for an individual program plan to be developed by the provider 
67.12 	according to the respective state and federal licensing and certification standards, and 
67.13 	additional assessments to be completed or arranged by the provider after service initiation;
67.14 	(9) identifies provider responsibilities to implement and make recommendations for 
67.15 	modification to the coordinated service and support plan;
67.16 	(10) includes notice of the right to request a conciliation conference or a hearing under 
67.17 	section 256.045;
67.18 	(11) is agreed upon and signed by the person, the person's legal guardian or conservator, 
67.19 	or the parent if the person is a minor, and the authorized county representative;
67.20 	(12) is reviewed by a health professional if the person has overriding medical needs that 
67.21 	impact the delivery of services; and
67.22 	(13) includes the authorized annual and monthly amounts for the services.
67.23 	(b) In developing the person-centered coordinated service and support plan, the case 
67.24 	manager is encouraged to include the use of volunteers, religious organizations, social clubs, 
67.25 	and civic and service organizations to support the individual in the community. The lead 
67.26 	agency must be held harmless for damages or injuries sustained through the use of volunteers 
67.27 	and agencies under this paragraph, including workers' compensation liability.
67.28 	(c) Approved, written, and signed changes to a consumer's services that meet the criteria 
67.29 	in this subdivision shall be an addendum to that consumer's individual service plan.

68.1 	Sec. 13. Minnesota Statutes 2019 Supplement, section 256B.49, subdivision 13, is amended 
68.2 	to read:
68.3 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
68.4 	shall be provided case management services by qualified vendors as described in the federally 
68.5 	approved waiver application. The case management service activities provided must include:
68.6 	(1) finalizing the person-centered written coordinated service and support plan within 
68.7 	the timelines established by the commissioner and section 256B.0911, subdivision 3a, 
68.8 	paragraph (e);
68.9 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
68.10 	options, including all service options available under the waiver plans;
68.11 	(3) assisting the recipient in the identification of potential service providers and, including:
68.12 	(i) available options for case management service and providers, including;
68.13 	(ii) providers of services provided in a non-disability-specific setting;
68.14 	(iii) employment service providers;
68.15 	(iv) providers of services provided in settings that are not community residential settings; 
68.16 	and
68.17 	(v) providers of financial management services;
68.18 	(4) assisting the recipient to access services and assisting with appeals under section 
68.19 	256.045; and
68.20 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
68.21 	plan.
68.22 	(b) The case manager may delegate certain aspects of the case management service 
68.23 	activities to another individual provided there is oversight by the case manager. The case 
68.24 	manager may not delegate those aspects which require professional judgment including:
68.25 	(1) finalizing the person-centered coordinated service and support plan;
68.26 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
68.27 	approved person-centered coordinated service and support plan; and
68.28 	(3) adjustments to the person-centered coordinated service and support plan.
68.29 	(c) Case management services must be provided by a public or private agency that is 
68.30 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
68.31 	the requirements in the approved federal waiver plans. Case management services must not 
69.1 	be provided to a recipient by a private agency that has any financial interest in the provision 
69.2 	of any other services included in the recipient's coordinated service and support plan. For 
69.3 	purposes of this section, "private agency" means any agency that is not identified as a lead 
69.4 	agency under section 256B.0911, subdivision 1a, paragraph (e).
69.5 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
69.6 	the case manager shall participate in the development and ongoing evaluation of the plan 
69.7 	with the expanded support team. At least quarterly, the case manager, in consultation with 
69.8 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
69.9 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
69.10 	identify whether the plan has been developed and implemented in a manner to achieve the 
69.11 	following within the required timelines:
69.12 	(1) phasing out the use of prohibited procedures;
69.13 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
69.14 	timeline; and
69.15 	(3) accomplishment of identified outcomes.
69.16 	If adequate progress is not being made, the case manager shall consult with the person's 
69.17 	expanded support team to identify needed modifications and whether additional professional 
69.18 	support is required to provide consultation.
69.19 	(e) The Department of Human Services shall offer ongoing education in case management 
69.20 	to case managers. Case managers shall receive no less than ten hours of case management 
69.21 	education and disability-related training each year. The education and training must include 
69.22 	person-centered planning. For the purposes of this section, "person-centered planning" or 
69.23 	"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph 
69.24 	(f).

69.25 	Sec. 14. Minnesota Statutes 2019 Supplement, section 256B.49, subdivision 14, is amended 
69.26 	to read:
69.27 		Subd. 14.Assessment and reassessment. (a) Assessments and reassessments shall be 
69.28 	conducted by certified assessors according to section 256B.0911, subdivision 2b. The 
69.29 	certified assessor, with the permission of the recipient or the recipient's designated legal 
69.30 	representative, may invite other individuals to attend the assessment. With the permission 
69.31 	of the recipient or the recipient's designated legal representative, the recipient's current 
69.32 	provider of services may submit a written report outlining their recommendations regarding 
69.33 	the recipient's care needs prepared by a direct service employee who is familiar with the 
70.1 	person. The provider must submit the report at least 60 days before the end of the person's 
70.2 	current service agreement. The certified assessor must consider the content of the submitted 
70.3 	report prior to finalizing the person's assessment or reassessment.
70.4 	(b) There must be a determination that the client requires a hospital level of care or a 
70.5 	nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and 
70.6 	subsequent assessments to initiate and maintain participation in the waiver program.
70.7 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
70.8 	appropriate to determine nursing facility level of care for purposes of medical assistance 
70.9 	payment for nursing facility services, only face-to-face assessments conducted according 
70.10 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
70.11 	determination or a nursing facility level of care determination must be accepted for purposes 
70.12 	of initial and ongoing access to waiver services payment.
70.13 	(d) Recipients who are found eligible for home and community-based services under 
70.14 	this section before their 65th birthday may remain eligible for these services after their 65th 
70.15 	birthday if they continue to meet all other eligibility factors.
70.16 	(e) At the time of reassessment, the certified assessor shall assess each person receiving 
70.17 	waiver residential supports and services currently residing in a community residential setting, 
70.18 	family adult foster care residence, or supervised living facility to determine if that person 
70.19 	would prefer to be served in a community-living setting as defined in subdivision 23 or to 
70.20 	receive integrated community supports as described in section 245D.03, subdivision 1, 
70.21 	paragraph (c), clause (8). The certified assessor shall offer the person through a 
70.22 	person-centered planning process the option to receive alternative housing and service 
70.23 	options.
70.24 	(f) At the time of reassessment, the certified assessor shall assess each person receiving 
70.25 	waiver day services to determine if that person would prefer to receive employment services 
70.26 	as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified 
70.27 	assessor shall offer the person through a person-centered planning process the option to 
70.28 	receive employment services.
70.29 	(g) At the time of reassessment, the certified assessor shall assess each person receiving 
70.30 	nonself-directed waiver services to determine if that person would prefer an available service 
70.31 	and setting option that would permit self-directed services and supports. The certified 
70.32 	assessor shall offer the person through a person-centered planning process the option to 
70.33 	receive self-directed services and supports.

71.1 	ARTICLE 5
71.2 	CUSTOMIZED LIVING MODIFICATIONS

71.3 	Section 1. Minnesota Statutes 2019 Supplement, section 144A.484, subdivision 1, is 
71.4 	amended to read:
71.5 		Subdivision 1.Integrated licensing established. (a) A home care provider applicant 
71.6 	or license holder may apply annually to the commissioner of health for a home and 
71.7 	community-based services designation for the provision of basic support services identified 
71.8 	under section 245D.03, subdivision 1, paragraph (b). The designation allows the license 
71.9 	holder to provide basic support services, except for the provision under section 256B.49 of 
71.10 	customized living services as defined in the brain injury or the community access for 
71.11 	disability inclusion waivers that would otherwise require licensure under chapter 245D, 
71.12 	under the license holder's home care license governed by sections 144A.43 to 144A.4799.
71.13 	(b) A home care provider applicant or license holder may apply annually to the 
71.14 	commissioner of human services under section 245D.35 for a home and community-based 
71.15 	services designation for each location in which the applicant or license holder provides 
71.16 	under section 256B.49 customized living services as defined in the brain injury or the 
71.17 	community access for disability inclusion waivers. The designation allows the license holder 
71.18 	to provide customized living services that would otherwise require licensure under chapter 
71.19 	245D, under the license holder's home care license governed by sections 144A.43 to 
71.20 	144A.4799.

71.21 	EFFECTIVE DATE. This section is effective June 1, 2020, and applies to home care 
71.22 	license applications; home care license renewals; home and community-based services 
71.23 	designation applications; and home and community-based services designation applications 
71.24 	occurring on or after that date.

71.25 	Sec. 2. Minnesota Statutes 2018, section 144A.484, subdivision 2, is amended to read:
71.26 		Subd. 2.Application for home and community-based services designation. An 
71.27 	application for a home and community-based services designation under subdivision 1, 
71.28 	paragraph (a), must be made on the forms and in the manner prescribed by the commissioner. 
71.29 	The commissioner shall provide the applicant with instruction for completing the application 
71.30 	and provide information about the requirements of other state agencies that affect the 
71.31 	applicant. Application for the home and community-based services designation under 
71.32 	subdivision 1, paragraph (a), is subject to the requirements under section 144A.473.

72.1 	EFFECTIVE DATE. This section is effective June 1, 2020, and applies to home care 
72.2 	license applications; home care license renewals; home and community-based services 
72.3 	designation applications; and home and community-based services designation applications 
72.4 	occurring on or after that date.

72.5 	Sec. 3. Minnesota Statutes 2018, section 144A.484, subdivision 4, is amended to read:
72.6 		Subd. 4.Applicability of home and community-based services requirements. A 
72.7 	home care provider with a home and community-based services designation under subdivision 
72.8 	1 must comply with the requirements for home care services governed by this chapter. For 
72.9 	the provision of basic support services, including customized living services, the home care 
72.10 	provider must also comply with the following home and community-based services licensing 
72.11 	requirements:
72.12 	(1) service planning and delivery requirements in section 245D.07;
72.13 	(2) protection standards in section 245D.06;
72.14 	(3) emergency use of manual restraints in section 245D.061; and
72.15 	(4) protection-related rights in section 245D.04, subdivision 3, paragraph (a), clauses 
72.16 	(5), (7), (8), (12), and (13), and paragraph (b).
72.17 	A home care provider with the integrated license-home and community-based services 
72.18 	designation under subdivision 1 may utilize a bill of rights which incorporates the service 
72.19 	recipient rights in section 245D.04, subdivision 3, paragraph (a), clauses (5), (7), (8), (12), 
72.20 	and (13), and paragraph (b) with the home care bill of rights in section 144A.44.

72.21 	EFFECTIVE DATE. This section is effective June 1, 2020, and applies to home care 
72.22 	license applications; home care license renewals; home and community-based services 
72.23 	designation applications; and home and community-based services designation applications 
72.24 	occurring on or after that date.

72.25 	Sec. 4. Minnesota Statutes 2018, section 144A.484, subdivision 5, is amended to read:
72.26 		Subd. 5.Monitoring and enforcement. (a) The commissioner shall monitor for 
72.27 	compliance with the home and community-based services requirements identified in 
72.28 	subdivision 4, in accordance with this section and any agreements by the commissioners of 
72.29 	health and human services.
72.30 	(b) The commissioner shall enforce compliance with applicable home and 
72.31 	community-based services licensing requirements as follows:
73.1 	(1) the commissioner may deny a home and community-based services designation 
73.2 	under subdivision 1, paragraph (a), in accordance with section 144A.473 or 144A.475; and
73.3 	(2) if the commissioner finds that the applicant or license holder has failed to comply 
73.4 	with the applicable home and community-based services designation requirements, the 
73.5 	commissioner may issue:
73.6 	(i) a correction order in accordance with section 144A.474;
73.7 	(ii) an order of conditional license in accordance with section 144A.475;
73.8 	(iii) a sanction in accordance with section 144A.475; or
73.9 	(iv) any combination of clauses (i) to (iii).

73.10 	EFFECTIVE DATE. This section is effective June 1, 2020, and applies to home care 
73.11 	license applications; home care license renewals; home and community-based services 
73.12 	designation applications; and home and community-based services designation applications 
73.13 	occurring on or after that date.

73.14 	Sec. 5. Minnesota Statutes 2018, section 144A.484, subdivision 6, is amended to read:
73.15 		Subd. 6.Appeals. A home care provider applicant that has been denied a temporary 
73.16 	license will also be denied their application for the home and community-based services 
73.17 	designation. The applicant may request reconsideration in accordance with section 144A.473, 
73.18 	subdivision 3. A licensed home care provider whose application for a home and 
73.19 	community-based services designation under subdivision 1, paragraph (a), has been denied 
73.20 	or whose designation has been suspended or revoked may appeal the denial, suspension, 
73.21 	revocation, or refusal to renew a home and community-based services designation in 
73.22 	accordance with section 144A.475. A license holder may request reconsideration of a 
73.23 	correction order in accordance with section 144A.474, subdivision 12.

73.24 	EFFECTIVE DATE. This section is effective June 1, 2020, and applies to home care 
73.25 	license applications; home care license renewals; home and community-based services 
73.26 	designation applications; and home and community-based services designation applications 
73.27 	occurring on or after that date.

73.28 	Sec. 6. [245D.35] HOME AND COMMUNITY-BASED SERVICES DESIGNATION.
73.29 		Subdivision 1.Designation for customized living services. (a) Notwithstanding section 
73.30 	245A.03, subdivision 2, paragraph (a), clause (23), a home care provider applying for 
73.31 	licensure under chapter 144A or a home care provider licensed under chapter 144A may 
74.1 	apply annually to the commissioner for a home and community-based services designation 
74.2 	for each location in which the applicant or license holder provides under section 256B.49 
74.3 	customized living services  as defined in the brain injury or the community access for 
74.4 	disability inclusion waivers. The designation allows the license holder to provide customized 
74.5 	living services that would otherwise require licensure under this chapter, under the license 
74.6 	holder's home care license governed by chapter 144A.
74.7 	(b) Unless designated by the commissioner under this section, an individual, organization, 
74.8 	or government entity must not provide customized living services under section 256B.49 
74.9 	in a setting that is not otherwise licensed by the commissioner.
74.10 	(c) Licensed home care providers and home care license applicants seeking designation 
74.11 	under this section must request this designation for each location in which the provider 
74.12 	intends to provide customized living services under section 256B.49. The provider or 
74.13 	applicant must request the designation on forms and in the manner prescribed by the 
74.14 	commissioner.
74.15 		Subd. 2.Designation for customized living services moratorium. (a) The commissioner 
74.16 	shall not issue an initial home and community-based services designation for a location in 
74.17 	which customized living services as defined under the brain injury or community access 
74.18 	for disability inclusion waiver plans are provided under section 256B.49. The commissioner 
74.19 	may renew designations previously issued by the commissioner or the commissioner of 
74.20 	health under section 144A.484.
74.21 	(b) Exceptions to the moratorium include new locations for the provision of customized 
74.22 	living services under section 256B.49 the commissioner determines are needed.
74.23 	(c) When approving an exception under paragraph (b), the commissioner shall consider 
74.24 	the availability of beds in registered housing with services establishments, licensed assisted 
74.25 	living facilities, and licensed foster care homes in the geographic area in which the home 
74.26 	care provider seeks to operate, the results of a person's choices during their annual assessment 
74.27 	and service plan review, and the recommendation of the local county board. The 
74.28 	determination by the commissioner regarding an exception is final and not subject to appeal.

74.29 	EFFECTIVE DATE. This section is effective June 1, 2020, and applies to home care 
74.30 	license applications; home care license renewals; home and community-based services 
74.31 	designation applications; and home and community-based services designation applications 
74.32 	occurring on or after that date.

75.1 	Sec. 7. DIRECTION TO THE COMMISSIONER; CUSTOMIZED LIVING 
75.2 	REPORT.
 75.3 	By December 1, 2020, the commissioner of human services shall submit a report to the 
75.4 	chairs and ranking minority members of the legislative committees with jurisdiction over 
75.5 	human services policy and finance. The report must include the commissioner's assessment 
75.6 	of the prevalence of customized living services provided under Minnesota Statutes, section 
75.7 	256B.49, supplanting the provision of residential services and supports licensed under 
75.8 	Minnesota Statutes, chapter 245D, and provided in settings licensed under Minnesota 
75.9 	Statutes, chapter 245A. The commissioner shall include recommendations regarding the 
75.10 	continuation of the moratorium on home and community-based services designations under 
75.11 	Minnesota Statutes, section 245D.35, and other policy recommendations to ensure that 
75.12 	customized living services are being provided in a manner consistent with the policy 
75.13 	objectives of the foster care licensing moratorium under Minnesota Statutes, section 245A.03, 
75.14 	subdivision 3.

75.15 	ARTICLE 6
75.16 	DEPARTMENT OF HUMAN SERVICES POLICY PROPOSALS

75.17 	Section 1. Minnesota Statutes 2018, section 119B.21, is amended to read:
75.18 	119B.21 CHILD CARE SERVICES GRANTS.
75.19 		Subdivision 1.Distribution of grant funds. (a) The commissioner shall distribute funds 
75.20 	to the child care resource and referral programs designated under section sections 119B.189 
75.21 	and119B.19, subdivision 1a, for child care services grants to centers under subdivision 5 
75.22 	and family child care programs based upon the following factors improve child care quality, 
75.23 	support start-up of new programs, and expand existing programs.
75.24 	(b) Up to ten percent of funds appropriated for grants under this section may be used by 
75.25 	the commissioner for statewide child care development initiatives, training initiatives, 
75.26 	collaboration programs, and research and data collection. The commissioner shall develop 
75.27 	eligibility guidelines and a process to distribute funds under this paragraph.
75.28 	(c) At least 90 percent of funds appropriated for grants under this section may be 
75.29 	distributed by the commissioner to child care resource and referral programs under section
75.30 	sections 119B.189 and119B.19, subdivision 1a, for child care center grants and family 
75.31 	child care grants based on the following factors:
75.32 	(1) the number of children under 13 years of age needing child care in the region;
75.33 	(2) the region served by the program;
76.1 	(3) the ratio of children under 13 years of age needing child care to the number of licensed 
76.2 	spaces in the region;
76.3 	(4) the number of licensed child care providers and school-age care programs in the 
76.4 	region; and
76.5 	(5) other related factors determined by the commissioner.
76.6 	(d) Child care resource and referral programs must award child care center grants and 
76.7 	family child care services grants based on the recommendation of the child care district 
76.8 	proposal review committees under subdivision 3.
76.9 	(e) The commissioner may distribute funds under this section for a two-year period.
76.10 		Subd. 1a.Eligible programs. A child care resource and referral program designated 
76.11 	under section 119B.19, subdivision 1a, may award child care services grants to:
76.12 	(1) a child care center licensed under Minnesota Rules, chapter 9503, or in the process 
76.13 	of becoming licensed;
76.14 	(2) a family or group family child care home licensed under Minnesota Rules, chapter 
76.15 	9502, or in the process of becoming licensed;
76.16 	(3) corporations or public agencies that develop or provide child care services;
76.17 	(4) a school-age care program;
76.18 	(5) a tribally licensed child care program;
76.19 	(6) legal nonlicensed or family, friend, and neighbor child care providers; or
76.20 	(7) other programs as determined by the commissioner.
76.21 		Subd. 3.Child care district proposal review committees. (a) Child care district proposal 
76.22 	review committees review applications for family child care grants and child care center
76.23 	services grants under this section and make funding recommendations to the child care 
76.24 	resource and referral program designated under section sections 119B.189 and119B.19, 
76.25 	subdivision 1a. Each region within a district must be represented on the review committee. 
76.26 	The child care district proposal review committees must complete their reviews and forward 
76.27 	their recommendations to the child care resource and referral district programs by the date 
76.28 	specified by the commissioner.
76.29 	(b) A child care resource and referral district program shall establish a process to select 
76.30 	members of the child care district proposal review committee. Members must reflect a broad 
76.31 	cross-section of the community, and may include the following constituent groups: family 
77.1 	child care providers, child care center providers, school-age care providers, parents who 
77.2 	use child care services, health services, social services, public schools, Head Start, employers, 
77.3 	representatives of cultural and ethnic communities, and other citizens with demonstrated 
77.4 	interest in child care issues. Members of the proposal review committee with a direct financial 
77.5 	interest in a pending grant proposal may not provide a recommendation or participate in 
77.6 	the ranking of that grant proposal.
77.7 	(c) The child care resource and referral district program may reimburse committee 
77.8 	members for their actual travel, child care, and child care provider substitute expenses for 
77.9 	up to two committee meetings per year. The program may also pay offer a stipend to parent 
77.10 	representatives proposal review committee members for participating in two meetings per 
77.11 	year the grant review process.
77.12 		Subd. 5.Child care services grants. (a) A child care resource and referral program 
77.13 	designated under section sections 119B.189 and119B.19, subdivision 1a, may award child 
77.14 	care services grants for:
77.15 	(1) creating new licensed child care facilities and expanding existing facilities, including, 
77.16 	but not limited to, supplies, equipment, facility renovation, and remodeling;
77.17 	(2) improving licensed child care facility programs facility improvements, including but 
77.18 	not limited to improvements to meet licensing requirements;
77.19 	(3) staff training and development services including, but not limited to, in-service 
77.20 	training, curriculum development, accreditation, certification, consulting, resource centers, 
77.21 	program and resource materials, supporting effective teacher-child interactions, child-focused 
77.22 	teaching, and content-driven classroom instruction;
77.23 	(4) capacity building through the purchase of appropriate technology to create, enhance, 
77.24 	and maintain business management systems;
77.25 	(5) emergency assistance for child care programs;
77.26 	(6) new programs or projects for the creation, expansion, or improvement of programs 
77.27 	that serve ethnic immigrant and refugee communities; and
77.28 	(7) targeted recruitment initiatives to expand and build the capacity of the child care 
77.29 	system and to improve the quality of care provided by legal nonlicensed child care providers.; 
77.30 	and
77.31 	(8) other uses as approved by the commissioner.
78.1 	(b) A child care resource and referral organization designated under section sections 
78.2 	119B.189 and119B.19, subdivision 1a, may award child care services grants of up to $1,000 
78.3 	to family child care providers. These grants may be used for: eligible programs in amounts 
78.4 	up to a maximum determined by the commissioner for each type of eligible program.
78.5 	(1) facility improvements, including, but not limited to, improvements to meet licensing 
78.6 	requirements;
78.7 	(2) improvements to expand a child care facility or program;
78.8 	(3) toys and equipment;
78.9 	(4) technology and software to create, enhance, and maintain business management 
78.10 	systems;
78.11 	(5) start-up costs;
78.12 	(6) staff training and development; and
78.13 	(7) other uses approved by the commissioner.
78.14 	(c) A child care resource and referral program designated under section 119B.19, 
78.15 	subdivision 1a, may award child care services grants to:
78.16 	(1) licensed providers;
78.17 	(2) providers in the process of being licensed;
78.18 	(3) corporations or public agencies that develop or provide child care services;
78.19 	(4) school-age care programs;
78.20 	(5) legal nonlicensed or family, friend, and neighbor care providers; or
78.21 	(6) any combination of clauses (1) to (5).
78.22 	(d) A child care center that is a recipient of a child care services grant for facility 
78.23 	improvements or staff training and development must provide a 25 percent local match. A 
78.24 	local match is not required for grants to family child care providers.
78.25 	(e) Beginning July 1, 2009, grants to child care centers under this subdivision shall be 
78.26 	increasingly awarded for activities that improve provider quality, including activities under 
78.27 	paragraph (a), clauses (1) to (3) and (6). Grants to family child care providers shall be 
78.28 	increasingly awarded for activities that improve provider quality, including activities under 
78.29 	paragraph (b), clauses (1), (3), and (6).

79.1 	Sec. 2. Minnesota Statutes 2018, section 119B.26, is amended to read:
79.2 	119B.26 AUTHORITY TO WAIVE REQUIREMENTS DURING DISASTER 
79.3 	PERIODS.
79.4 	The commissioner may waive requirements under this chapter for up to nine months 
79.5 	after the disaster in areas where a federal disaster has been declared under United States 
79.6 	Code, title 42, section 5121, et seq., or the governor has exercised authority under chapter 
79.7 	12. The commissioner may waive requirements retroactively from the date of the disaster.
79.8 	The commissioner shall notify the chairs of the house of representatives and senate 
79.9 	committees with jurisdiction over this chapter and the house of representatives Ways and 
79.10 	Means Committee ten days before the effective date of any waiver granted within five 
79.11 	business days after the commissioner grants a waiver under this section.

79.12 	EFFECTIVE DATE. This section is effective July 1, 2020.

79.13 	Sec. 3. Minnesota Statutes 2019 Supplement, section 245.4889, subdivision 1, is amended 
79.14 	to read:
79.15 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
79.16 	make grants from available appropriations to assist:
79.17 	(1) counties;
79.18 	(2) Indian tribes;
79.19 	(3) children's collaboratives under section 124D.23 or 245.493; or
79.20 	(4) mental health service providers.
79.21 	(b) The following services are eligible for grants under this section:
79.22 	(1) services to children with emotional disturbances as defined in section 245.4871, 
79.23 	subdivision 15, and their families;
79.24 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
79.25 	age 21 and their families;
79.26 	(3) respite care services for children with emotional disturbances or severe emotional 
79.27 	disturbances who are at risk of out-of-home placement. A child is not required to have case 
79.28 	management services to receive respite care services;
79.29 	(4) children's mental health crisis services;
79.30 	(5) mental health services for people from cultural and ethnic minorities;
80.1 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
80.2 	(7) services to promote and develop the capacity of providers to use evidence-based 
80.3 	practices in providing children's mental health services;
80.4 	(8) school-linked mental health services under section 245.4901;
80.5 	(9) building evidence-based mental health intervention capacity for children birth to age 
80.6 	five;
80.7 	(10) suicide prevention and counseling services that use text messaging statewide;
80.8 	(11) mental health first aid training;
80.9 	(12) training for parents, collaborative partners, and mental health providers on the 
80.10 	impact of adverse childhood experiences and trauma and development of an interactive 
80.11 	website to share information and strategies to promote resilience and prevent trauma;
80.12 	(13) transition age services to develop or expand mental health treatment and supports 
80.13 	for adolescents and young adults 26 years of age or younger;
80.14 	(14) early childhood mental health consultation;
80.15 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
80.16 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
80.17 	psychosis;
80.18 	(16) psychiatric consultation for primary care practitioners; and
80.19 	(17) providers to begin operations and meet program requirements when establishing a 
80.20 	new children's mental health program. These may be start-up grants.
80.21 	(c) Services under paragraph (b) must be designed to help each child to function and 
80.22 	remain with the child's family in the community and delivered consistent with the child's 
80.23 	treatment plan. Transition services to eligible young adults under this paragraph must be 
80.24 	designed to foster independent living in the community.
80.25 	(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party 
80.26 	reimbursement sources, if applicable.

80.27 	EFFECTIVE DATE. This section is effective the day following final enactment.

81.1 	Sec. 4. Minnesota Statutes 2019 Supplement, section 245A.03, subdivision 7, is amended 
81.2 	to read:
81.3 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
81.4 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
81.5 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
81.6 	for a physical location that will not be the primary residence of the license holder for the 
81.7 	entire period of licensure. If a license is issued during this moratorium, and the license 
81.8 	holder changes the license holder's primary residence away from the physical location of 
81.9 	the foster care license, the commissioner shall revoke the license according to section 
81.10 	245A.07. The commissioner shall not issue an initial license for a community residential 
81.11 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
81.12 	the commissioner shall consider the resource need determination process in paragraph (h), 
81.13 	the availability of foster care licensed beds in the geographic area in which the licensee 
81.14 	seeks to operate, the results of a person's choices during their annual assessment and service 
81.15 	plan review, and the recommendation of the local county board. The determination by the 
81.16 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
81.17 	(1) foster care settings that are required to be registered under chapter 144D;
81.18 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
81.19 	community residential setting licenses replacing adult foster care licenses in existence on 
81.20 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
81.21 	(b);
81.22 	(3) new foster care licenses or community residential setting licenses determined to be 
81.23 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
81.24 	or regional treatment center; restructuring of state-operated services that limits the capacity 
81.25 	of state-operated facilities; or allowing movement to the community for people who no 
81.26 	longer require the level of care provided in state-operated facilities as provided under section 
81.27 	256B.092, subdivision 13, or 256B.49, subdivision 24;
81.28 	(4) new foster care licenses or community residential setting licenses determined to be 
81.29 	needed by the commissioner under paragraph (b) for persons requiring hospital level care;
81.30 	or
81.31 	(5) new foster care licenses or community residential setting licenses determined to be 
81.32 	needed by the commissioner for the transition of people from personal care assistance to 
81.33 	the home and community-based services;
82.1 	(6) new foster care licenses or community residential setting licenses determined to be 
82.2 	needed by the commissioner for the transition of people from the residential care waiver 
82.3 	services to foster care services. This exception applies only when:
82.4 	(i) the person's case manager provided the person with information about the choice of 
82.5 	service, service provider, and location of service to help the person make an informed choice; 
82.6 	and
82.7 	(ii) the person's foster care services are less than or equal to the cost of the person's 
82.8 	services delivered in the residential care waiver service setting as determined by the lead 
82.9 	agency; or
82.10 	(7) new foster care licenses or community residential setting licenses for people receiving 
82.11 	services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and 
82.12 	for which a license is required. This exception does not apply to people living in their own 
82.13 	home. For purposes of this clause, there is a presumption that a foster care or community 
82.14 	residential setting license is required for services provided to three or more people in a 
82.15 	dwelling unit when the setting is controlled by the provider. A license holder subject to this 
82.16 	exception may rebut the presumption that a license is required by seeking a reconsideration 
82.17 	of the commissioner's determination. The commissioner's disposition of a request for 
82.18 	reconsideration is final and not subject to appeal under chapter 14. The exception is available 
82.19 	until June 30, 2018. This exception is available when:
82.20 	(i) the person's case manager provided the person with information about the choice of 
82.21 	service, service provider, and location of service, including in the person's home, to help 
82.22 	the person make an informed choice; and
82.23 	(ii) the person's services provided in the licensed foster care or community residential 
82.24 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
82.25 	setting as determined by the lead agency.
82.26 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
82.27 	community residential settings as defined under this subdivision. As part of the determination, 
82.28 	the commissioner shall consider the availability of foster care capacity in the area in which 
82.29 	the licensee seeks to operate, and the recommendation of the local county board. The 
82.30 	determination by the commissioner must be final. A determination of need is not required 
82.31 	for a change in ownership at the same address.
82.32 	(c) When an adult resident served by the program moves out of a foster home that is not 
82.33 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
82.34 	paragraph (f), or the adult community residential setting, the county shall immediately 
83.1 	inform the Department of Human Services Licensing Division. The department may decrease 
83.2 	the statewide licensed capacity for adult foster care settings.
83.3 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
83.4 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
83.5 	residents whose primary diagnosis is mental illness and the license holder is certified under 
83.6 	the requirements in subdivision 6a or section 245D.33.
83.7 	(e) A resource need determination process, managed at the state level, using the available 
83.8 	reports required by section 144A.351, and other data and information shall be used to 
83.9 	determine where the reduced capacity determined under section 256B.493 will be 
83.10 	implemented. The commissioner shall consult with the stakeholders described in section 
83.11 	144A.351, and employ a variety of methods to improve the state's capacity to meet the 
83.12 	informed decisions of those people who want to move out of corporate foster care or 
83.13 	community residential settings, long-term service needs within budgetary limits, including 
83.14 	seeking proposals from service providers or lead agencies to change service type, capacity, 
83.15 	or location to improve services, increase the independence of residents, and better meet 
83.16 	needs identified by the long-term services and supports reports and statewide data and 
83.17 	information.
83.18 	(f) At the time of application and reapplication for licensure, the applicant and the license 
83.19 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
83.20 	required to inform the commissioner whether the physical location where the foster care 
83.21 	will be provided is or will be the primary residence of the license holder for the entire period 
83.22 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
83.23 	or license holder must notify the commissioner immediately. The commissioner shall print 
83.24 	on the foster care license certificate whether or not the physical location is the primary 
83.25 	residence of the license holder.
83.26 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
83.27 	primary residence of the license holder and that also provide services in the foster care home 
83.28 	that are covered by a federally approved home and community-based services waiver, as 
83.29 	authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human 
83.30 	services licensing division that the license holder provides or intends to provide these 
83.31 	waiver-funded services.
83.32 	(h) The commissioner may adjust capacity to address needs identified in section 
83.33 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
83.34 	delicense existing settings. Delicensing of settings will be accomplished through a process 
84.1 	identified in section 256B.493. Annually, by August 1, the commissioner shall provide 
84.2 	information and data on capacity of licensed long-term services and supports, actions taken 
84.3 	under the subdivision to manage statewide long-term services and supports resources, and 
84.4 	any recommendations for change to the legislative committees with jurisdiction over the 
84.5 	health and human services budget.
84.6 	(i) The commissioner must notify a license holder when its corporate foster care or 
84.7 	community residential setting licensed beds are reduced under this section. The notice of 
84.8 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
84.9 	mail or personal service. The notice must state why the licensed beds are reduced and must 
84.10 	inform the license holder of its right to request reconsideration by the commissioner. The 
84.11 	license holder's request for reconsideration must be in writing. If mailed, the request for 
84.12 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
84.13 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
84.14 	reconsideration is made by personal service, it must be received by the commissioner within 
84.15 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
84.16 	(j) The commissioner shall not issue an initial license for children's residential treatment 
84.17 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
84.18 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
84.19 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
84.20 	moratorium described in this paragraph. The commissioner has the authority to manage 
84.21 	existing statewide capacity for children's residential treatment services subject to the 
84.22 	moratorium under this paragraph and may issue an initial license for such facilities if the 
84.23 	initial license would not increase the statewide capacity for children's residential treatment 
84.24 	services subject to the moratorium under this paragraph.

84.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

84.26 	Sec. 5. Minnesota Statutes 2019 Supplement, section 245A.149, is amended to read:
84.27 	245A.149 SUPERVISION OF FAMILY CHILD CARE LICENSE HOLDER'S 
84.28 	OWN CHILD.
84.29 	(a) Notwithstanding Minnesota Rules, part 9502.0365, subpart 5, and with the license 
84.30 	holder's consent, an individual may be present in the licensed space, may supervise the 
84.31 	family child care license holder's own child both inside and outside of the licensed space, 
84.32 	and is exempt from the training and supervision requirements of this chapter and Minnesota 
84.33 	Rules, chapter 9502, if the individual:
85.1 	(1) is related to the license holder or to the license holder's child, as defined in section 
85.2 	245A.02, subdivision 13, or is a household member who the license holder has reported to 
85.3 	the county agency;
85.4 	(2) is not a designated caregiver, helper, or substitute for the licensed program;
85.5 	(3) is involved only in the care of the license holder's own child; and
85.6 	(4) (3) does not have direct, unsupervised contact with any nonrelative children receiving 
85.7 	services.
85.8 	(b) If the individual in paragraph (a) is not a household member, the individual is also 
85.9 	exempt from background study requirements under chapter 245C.

85.10 	EFFECTIVE DATE. This section is effective the day following final enactment.

85.11 	Sec. 6. Minnesota Statutes 2019 Supplement, section 245A.40, subdivision 7, is amended 
85.12 	to read:
85.13 		Subd. 7.In-service. (a) A license holder must ensure that the center director, staff 
85.14 	persons, substitutes, and unsupervised volunteers complete in-service training each calendar 
85.15 	year.
85.16 	(b) The center director and staff persons who work more than 20 hours per week must 
85.17 	complete 24 hours of in-service training each calendar year. Staff persons who work 20 
85.18 	hours or less per week must complete 12 hours of in-service training each calendar year. 
85.19 	Substitutes and unsupervised volunteers must complete the requirements of paragraphs (e) 
85.20 	to (h) (d) to (g) and do not otherwise have a minimum number of hours of training to 
85.21 	complete.
85.22 	(c) The number of in-service training hours may be prorated for individuals not employed 
85.23 	for an entire year.
85.24 	(d) Each year, in-service training must include:
85.25 	(1) the center's procedures for maintaining health and safety according to section 245A.41 
85.26 	and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according 
85.27 	to Minnesota Rules, part 9503.0110;
85.28 	(2) the reporting responsibilities under section 626.556 and Minnesota Rules, part 
85.29 	9503.0130;
86.1 	(3) at least one-half hour of training on the standards under section 245A.1435 and on 
86.2 	reducing the risk of sudden unexpected infant death as required under subdivision 5, if 
86.3 	applicable; and
86.4 	(4) at least one-half hour of training on the risk of abusive head trauma from shaking 
86.5 	infants and young children as required under subdivision 5a, if applicable.
86.6 	(e) Each year, or when a change is made, whichever is more frequent, in-service training 
86.7 	must be provided on: (1) the center's risk reduction plan under section 245A.66, subdivision 
86.8 	2; and (2) a child's individual child care program plan as required under Minnesota Rules, 
86.9 	part 9503.0065, subpart 3.
86.10 	(f) At least once every two calendar years, the in-service training must include:
86.11 	(1) child development and learning training under subdivision 2;
86.12 	(2) pediatric first aid that meets the requirements of subdivision 3;
86.13 	(3) pediatric cardiopulmonary resuscitation training that meets the requirements of 
86.14 	subdivision 4;
86.15 	(4) cultural dynamics training to increase awareness of cultural differences; and
86.16 	(5) disabilities training to increase awareness of differing abilities of children.
86.17 	(g) At least once every five years, in-service training must include child passenger 
86.18 	restraint training that meets the requirements of subdivision 6, if applicable.
86.19 	(h) The remaining hours of the in-service training requirement must be met by completing 
86.20 	training in the following content areas of the Minnesota Knowledge and Competency 
86.21 	Framework:
86.22 	(1) Content area I: child development and learning;
86.23 	(2) Content area II: developmentally appropriate learning experiences;
86.24 	(3) Content area III: relationships with families;
86.25 	(4) Content area IV: assessment, evaluation, and individualization;
86.26 	(5) Content area V: historical and contemporary development of early childhood 
86.27 	education;
86.28 	(6) Content area VI: professionalism;
86.29 	(7) Content area VII: health, safety, and nutrition; and
86.30 	(8) Content area VIII: application through clinical experiences.
87.1 	(i) For purposes of this subdivision, the following terms have the meanings given them.
87.2 	(1) "Child development and learning training" means training in understanding how 
87.3 	children develop physically, cognitively, emotionally, and socially and learn as part of the 
87.4 	children's family, culture, and community.
87.5 	(2) "Developmentally appropriate learning experiences" means creating positive learning 
87.6 	experiences, promoting cognitive development, promoting social and emotional development, 
87.7 	promoting physical development, and promoting creative development.
87.8 	(3) "Relationships with families" means training on building a positive, respectful 
87.9 	relationship with the child's family.
87.10 	(4) "Assessment, evaluation, and individualization" means training in observing, 
87.11 	recording, and assessing development; assessing and using information to plan; and assessing 
87.12 	and using information to enhance and maintain program quality.
87.13 	(5) "Historical and contemporary development of early childhood education" means 
87.14 	training in past and current practices in early childhood education and how current events 
87.15 	and issues affect children, families, and programs.
87.16 	(6) "Professionalism" means training in knowledge, skills, and abilities that promote 
87.17 	ongoing professional development.
87.18 	(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring 
87.19 	safety, and providing healthy nutrition.
87.20 	(8) "Application through clinical experiences" means clinical experiences in which a 
87.21 	person applies effective teaching practices using a range of educational programming models.
87.22 	(j) The license holder must ensure that documentation, as required in subdivision 10, 
87.23 	includes the number of total training hours required to be completed, name of the training, 
87.24 	the Minnesota Knowledge and Competency Framework content area, number of hours 
87.25 	completed, and the director's approval of the training.
87.26 	(k) In-service training completed by a staff person that is not specific to that child care 
87.27 	center is transferable upon a staff person's change in employment to another child care 
87.28 	program.

87.29 	EFFECTIVE DATE. This section is effective the day following final enactment.

88.1 	Sec. 7. Minnesota Statutes 2018, section 245D.04, subdivision 3, is amended to read:
88.2 		Subd. 3.Protection-related rights. (a) A person's protection-related rights include the 
88.3 	right to:
88.4 	(1) have personal, financial, service, health, and medical information kept private, and 
88.5 	be advised of disclosure of this information by the license holder;
88.6 	(2) access records and recorded information about the person in accordance with 
88.7 	applicable state and federal law, regulation, or rule;
88.8 	(3) be free from maltreatment;
88.9 	(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited 
88.10 	procedure identified in section 245D.06, subdivision 5, or successor provisions, except for: 
88.11 	(i) emergency use of manual restraint to protect the person from imminent danger to self 
88.12 	or others according to the requirements in section 245D.061 or successor provisions; or (ii) 
88.13 	the use of safety interventions as part of a positive support transition plan under section 
88.14 	245D.06, subdivision 8, or successor provisions;
88.15 	(5) receive services in a clean and safe environment when the license holder is the owner, 
88.16 	lessor, or tenant of the service site;
88.17 	(6) be treated with courtesy and respect and receive respectful treatment of the person's 
88.18 	property;
88.19 	(7) reasonable observance of cultural and ethnic practice and religion;
88.20 	(8) be free from bias and harassment regarding race, gender, age, disability, spirituality, 
88.21 	and sexual orientation;
88.22 	(9) be informed of and use the license holder's grievance policy and procedures, including 
88.23 	knowing how to contact persons responsible for addressing problems and to appeal under 
88.24 	section 256.045;
88.25 	(10) know the name, telephone number, and the website, e-mail, and street addresses of 
88.26 	protection and advocacy services, including the appropriate state-appointed ombudsman, 
88.27 	and a brief description of how to file a complaint with these offices;
88.28 	(11) assert these rights personally, or have them asserted by the person's family, 
88.29 	authorized representative, or legal representative, without retaliation;
88.30 	(12) give or withhold written informed consent to participate in any research or 
88.31 	experimental treatment;
89.1 	(13) associate with other persons of the person's choice, in the community;
89.2 	(14) personal privacy, including the right to use the lock on the person's bedroom or unit 
89.3 	door;
89.4 	(15) engage in chosen activities; and
89.5 	(16) access to the person's personal possessions at any time, including financial resources.
89.6 	(b) For a person residing in a residential site licensed according to chapter 245A, or 
89.7 	where the license holder is the owner, lessor, or tenant of the residential service site, 
89.8 	protection-related rights also include the right to:
89.9 	(1) have daily, private access to and use of a non-coin-operated telephone for local calls 
89.10 	and long-distance calls made collect or paid for by the person;
89.11 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
89.12 	correspondence or communication;
89.13 	(3) have use of and free access to common areas in the residence and the freedom to 
89.14 	come and go from the residence at will;
89.15 	(4) choose the person's visitors and time of visits and have privacy for visits with the 
89.16 	person's spouse, next of kin, legal counsel, religious adviser, or others, in accordance with 
89.17 	section 363A.09 of the Human Rights Act, including privacy in the person's bedroom;
89.18 	(5) have access to three nutritionally balanced meals and nutritious snacks between 
89.19 	meals each day;
89.20 	(6) have freedom and support to access food and potable water at any time;
89.21 	(7) have the freedom to furnish and decorate the person's bedroom or living unit;
89.22 	(8) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling 
89.23 	paint, mold, vermin, and insects;
89.24 	(9) a setting that is free from hazards that threaten the person's health or safety; and
89.25 	(10) a setting that meets the definition of a dwelling unit within a residential occupancy 
89.26 	as defined in the State Fire Code.
89.27 	(c) Restriction of a person's rights under paragraph (a), clauses (13) to (16), or paragraph 
89.28 	(b) is allowed only if determined necessary to ensure the health, safety, and well-being of 
89.29 	the person. Any restriction of those rights must be documented in the person's coordinated 
89.30 	service and support plan or coordinated service and support plan addendum. The restriction 
89.31 	must be implemented in the least restrictive alternative manner necessary to protect the 
90.1 	person and provide support to reduce or eliminate the need for the restriction in the most 
90.2 	integrated setting and inclusive manner. The documentation must include the following 
90.3 	information:
90.4 	(1) the justification for the restriction based on an assessment of the person's vulnerability 
90.5 	related to exercising the right without restriction;
90.6 	(2) the objective measures set as conditions for ending the restriction;
90.7 	(3) a schedule for reviewing the need for the restriction based on the conditions for 
90.8 	ending the restriction to occur semiannually from the date of initial approval, at a minimum, 
90.9 	or more frequently if requested by the person, the person's legal representative, if any, and 
90.10 	case manager; and
90.11 	(4) signed and dated approval for the restriction from the person, or the person's legal 
90.12 	representative, if any. A restriction may be implemented only when the required approval 
90.13 	has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the 
90.14 	right must be immediately and fully restored.

90.15 	Sec. 8. Minnesota Statutes 2018, section 245D.10, subdivision 3a, is amended to read:
90.16 		Subd. 3a.Service termination. (a) The license holder must establish policies and 
90.17 	procedures for service termination that promote continuity of care and service coordination 
90.18 	with the person and the case manager and with other licensed caregivers, if any, who also 
90.19 	provide support to the person. The policy must include the requirements specified in 
90.20 	paragraphs (b) to (f).
90.21 	(b) The license holder must permit each person to remain in the program and must not 
90.22 	terminate services unless:
90.23 	(1) the termination is necessary for the person's welfare and the facility cannot meet the
90.24 	person's needs cannot be met in the facility;
90.25 	(2) the safety of the person or others in the program is endangered and positive support 
90.26 	strategies were attempted and have not achieved and effectively maintained safety for the 
90.27 	person or others;
90.28 	(3) the health of the person or others in the program would otherwise be endangered;
90.29 	(4) the program has not been paid for services;
90.30 	(5) the program ceases to operate; or
90.31 	(6) the person has been terminated by the lead agency from waiver eligibility.; or
91.1 	(7) for state-operated community-based services, the person no longer demonstrates 
91.2 	complex behavioral needs that cannot be met by private community-based providers 
91.3 	identified in section 252.50, subdivision 5, paragraph (a), clause (1).
91.4 	(c) Prior to giving notice of service termination, the license holder must document actions 
91.5 	taken to minimize or eliminate the need for termination. Action taken by the license holder 
91.6 	must include, at a minimum:
91.7 	(1) consultation with the person's support team or expanded support team to identify 
91.8 	and resolve issues leading to issuance of the termination notice; and
91.9 	(2) a request to the case manager for intervention services identified in section 245D.03, 
91.10 	subdivision 1, paragraph (c), clause (1), or other professional consultation or intervention 
91.11 	services to support the person in the program. This requirement does not apply to notices 
91.12 	of service termination issued under paragraph (b), clause (4). clauses (4) and (7); and
91.13 	(3) consultation with the person's support team or expanded support team to identify 
91.14 	that the person no longer demonstrates complex behavioral needs that cannot be met by 
91.15 	private community-based providers identified in section 252.50, subdivision 5, paragraph 
91.16 	(a), clause (1).
91.17 	If, based on the best interests of the person, the circumstances at the time of the notice were 
91.18 	such that the license holder was unable to take the action specified in clauses (1) and (2), 
91.19 	the license holder must document the specific circumstances and the reason for being unable 
91.20 	to do so.
91.21 	(d) The notice of service termination must meet the following requirements:
91.22 	(1) the license holder must notify the person or the person's legal representative and the 
91.23 	case manager in writing of the intended service termination. If the service termination is 
91.24 	from residential supports and services as defined in section 245D.03, subdivision 1, paragraph 
91.25 	(c), clause (3), the license holder must also notify the commissioner in writing; and
91.26 	(2) the notice must include:
91.27 	(i) the reason for the action;
91.28 	(ii) except for a service termination under paragraph (b), clause (5), a summary of actions 
91.29 	taken to minimize or eliminate the need for service termination or temporary service 
91.30 	suspension as required under paragraph (c), and why these measures failed to prevent the 
91.31 	termination or suspension;
92.1 	(iii) the person's right to appeal the termination of services under section 256.045, 
92.2 	subdivision 3, paragraph (a); and
92.3 	(iv) the person's right to seek a temporary order staying the termination of services 
92.4 	according to the procedures in section 256.045, subdivision 4a or 6, paragraph (c).
92.5 	(e) Notice of the proposed termination of service, including those situations that began 
92.6 	with a temporary service suspension, must be given at least 60 days prior to termination 
92.7 	when a license holder is providing intensive supports and services identified in section 
92.8 	245D.03, subdivision 1, paragraph (c), 90 days prior to termination of services under section 
92.9 	245D.10, subdivision 3a, paragraph (b), clause (7), and 30 days prior to termination for all 
92.10 	other services licensed under this chapter. This notice may be given in conjunction with a 
92.11 	notice of temporary service suspension under subdivision 3.
92.12 	(f) During the service termination notice period, the license holder must:
92.13 	(1) work with the support team or expanded support team to develop reasonable 
92.14 	alternatives to protect the person and others and to support continuity of care;
92.15 	(2) provide information requested by the person or case manager; and
92.16 	(3) maintain information about the service termination, including the written notice of 
92.17 	intended service termination, in the service recipient record.

92.18 	Sec. 9. Minnesota Statutes 2018, section 245F.02, subdivision 7, is amended to read:
92.19 		Subd. 7.Clinically managed program. "Clinically managed program" means a 
92.20 	residential setting with staff comprised of a medical director and a licensed practical nurse. 
92.21 	A licensed practical nurse must be on site 24 hours a day, seven days a week. A qualified 
92.22 	medical professional licensed practitioner must be available by telephone or in person for 
92.23 	consultation 24 hours a day. Patients admitted to this level of service receive medical 
92.24 	observation, evaluation, and stabilization services during the detoxification process; access 
92.25 	to medications administered by trained, licensed staff to manage withdrawal; and a 
92.26 	comprehensive assessment pursuant to section 245G.05 245F.06.

92.27 	Sec. 10. Minnesota Statutes 2018, section 245F.02, subdivision 14, is amended to read:
92.28 		Subd. 14.Medically monitored program. "Medically monitored program" means a 
92.29 	residential setting with staff that includes a registered nurse and a medical director. A 
92.30 	registered nurse must be on site 24 hours a day. A medical director licensed practitioner
92.31 	must be on site available seven days a week, and patients must have the ability to be seen 
92.32 	by a medical director licensed practitioner within 24 hours. Patients admitted to this level 
93.1 	of service receive medical observation, evaluation, and stabilization services during the 
93.2 	detoxification process; medications administered by trained, licensed staff to manage 
93.3 	withdrawal; and a comprehensive assessment pursuant to Minnesota Rules, part 9530.6422
93.4 	section 245F.06.

93.5 	Sec. 11. Minnesota Statutes 2018, section 245F.06, subdivision 2, is amended to read:
93.6 		Subd. 2.Comprehensive assessment and assessment summary. (a) Prior to a medically 
93.7 	stable discharge, but not later than 72 hours following admission, a license holder must 
93.8 	provide a comprehensive assessment and assessment summary according to sections 
93.9 	245.4863, paragraph (a), and 245G.05, for each patient who has a positive screening for a 
93.10 	substance use disorder. If a patient's medical condition prevents a comprehensive assessment 
93.11 	from being completed within 72 hours, the license holder must document why the assessment 
93.12 	was not completed. The comprehensive assessment must include documentation of the 
93.13 	appropriateness of an involuntary referral through the civil commitment process.
93.14 	(b) If available to the program, a patient's previous comprehensive assessment may be 
93.15 	used in the patient record. If a previously completed comprehensive assessment is used, its 
93.16 	contents must be reviewed to ensure the assessment is accurate and current and complies 
93.17 	with the requirements of this chapter. The review must be completed by a staff person 
93.18 	qualified according to section 245G.11, subdivision 5. The license holder must document 
93.19 	that the review was completed and that the previously completed assessment is accurate 
93.20 	and current, or the license holder must complete an updated or new assessment.

93.21 	Sec. 12. Minnesota Statutes 2018, section 245F.12, subdivision 2, is amended to read:
93.22 		Subd. 2.Services provided at clinically managed programs. In addition to the services 
93.23 	listed in subdivision 1, clinically managed programs must:
93.24 	(1) have a licensed practical nurse on site 24 hours a day and a medical director;
93.25 	(2) provide an initial health assessment conducted by a nurse upon admission;
93.26 	(3) provide daily on-site medical evaluation by a nurse;
93.27 	(4) have a registered nurse available by telephone or in person for consultation 24 hours 
93.28 	a day;
93.29 	(5) have a qualified medical professional licensed practitioner available by telephone 
93.30 	or in person for consultation 24 hours a day; and
94.1 	(6) have appropriately licensed staff available to administer medications according to 
94.2 	prescriber-approved orders.

94.3 	Sec. 13. Minnesota Statutes 2018, section 245F.12, subdivision 3, is amended to read:
94.4 		Subd. 3.Services provided at medically monitored programs. In addition to the 
94.5 	services listed in subdivision 1, medically monitored programs must have a registered nurse 
94.6 	on site 24 hours a day and a medical director. Medically monitored programs must provide 
94.7 	intensive inpatient withdrawal management services which must include:
94.8 	(1) an initial health assessment conducted by a registered nurse upon admission;
94.9 	(2) the availability of a medical evaluation and consultation with a registered nurse 24 
94.10 	hours a day;
94.11 	(3) the availability of a qualified medical professional licensed practitioner by telephone 
94.12 	or in person for consultation 24 hours a day;
94.13 	(4) the ability to be seen within 24 hours or sooner by a qualified medical professional
94.14 	licensed practitioner if the initial health assessment indicates the need to be seen;
94.15 	(5) the availability of on-site monitoring of patient care seven days a week by a qualified 
94.16 	medical professional licensed practitioner; and
94.17 	(6) appropriately licensed staff available to administer medications according to 
94.18 	prescriber-approved orders.

94.19 	Sec. 14. Minnesota Statutes 2018, section 245G.02, subdivision 2, is amended to read:
94.20 		Subd. 2.Exemption from license requirement. This chapter does not apply to a county 
94.21 	or recovery community organization that is providing a service for which the county or 
94.22 	recovery community organization is an eligible vendor under section 254B.05. This chapter 
94.23 	does not apply to an organization whose primary functions are information, referral, 
94.24 	diagnosis, case management, and assessment for the purposes of client placement, education, 
94.25 	support group services, or self-help programs. This chapter does not apply to the activities 
94.26 	of a licensed professional in private practice. A license holder providing the initial set of 
94.27 	substance use disorder services allowable under section 254A.03, subdivision 3, paragraph 
94.28 	(c), to an individual referred to a licensed nonresidential substance use disorder treatment 
94.29 	program after a positive screen for alcohol or substance misuse is exempt from sections 
94.30 	245G.05; 245G.06, subdivisions 1, 2, and 4; 245G.07, subdivisions 1, paragraph (a), clauses 
94.31 	(2) to (4), and 2, clauses (1) to (7); and 245G.17.

95.1 	Sec. 15. Minnesota Statutes 2018, section 245G.09, subdivision 1, is amended to read:
95.2 		Subdivision 1.Client records required. (a) A license holder must maintain a file of 
95.3 	current and accurate client records on the premises where the treatment service is provided 
95.4 	or coordinated. For services provided off site, client records must be available at the program 
95.5 	and adhere to the same clinical and administrative policies and procedures as services 
95.6 	provided on site. The content and format of client records must be uniform and entries in 
95.7 	each record must be signed and dated by the staff member making the entry. Client records 
95.8 	must be protected against loss, tampering, or unauthorized disclosure according to section 
95.9 	254A.09, chapter 13, and Code of Federal Regulations, title 42, chapter 1, part 2, subpart 
95.10 	B, sections 2.1 to 2.67, and title 45, parts 160 to 164.
95.11 	(b) The program must have a policy and procedure that identifies how the program will 
95.12 	track and record client attendance at treatment activities, including the date, duration, and 
95.13 	nature of each treatment service provided to the client.
95.14 	(c) The program must identify in the client record designation of an individual who is 
95.15 	receiving services under section 254A.03, subdivision 3, including the start date and end 
95.16 	date of services eligible under section 254A.03, subdivision 3.

95.17 	Sec. 16. Minnesota Statutes 2018, section 245H.08, subdivision 4, is amended to read:
95.18 		Subd. 4.Maximum group size. (a) For a child six weeks old through 16 months old, 
95.19 	the maximum group size shall be no more than eight children.
95.20 	(b) For a child 16 months old through 33 months old, the maximum group size shall be 
95.21 	no more than 14 children.
95.22 	(c) For a child 33 months old through prekindergarten, a maximum group size shall be 
95.23 	no more than 20 children.
95.24 	(d) For a child in kindergarten through 13 years old, a maximum group size shall be no 
95.25 	more than 30 children.
95.26 	(e) The maximum group size applies at all times except during group activity coordination 
95.27 	time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and 
95.28 	special activity including a film, guest speaker, indoor large muscle activity, or holiday 
95.29 	program.
95.30 	(f) Notwithstanding paragraph (d), a certified center may continue to serve a child older 
95.31 	than 13 years if one of the following conditions is true:
96.1 	(1) the child remains eligible for child care assistance under section 119B.09, subdivision 
96.2 	1, paragraph (e); or
96.3 	(2) the certified center serves children in a middle-school-only program, defined as 
96.4 	grades 6 through 8.

96.5 	EFFECTIVE DATE. This section is effective the day following final enactment.

96.6 	Sec. 17. Minnesota Statutes 2018, section 245H.08, subdivision 5, is amended to read:
96.7 		Subd. 5.Ratios. (a) The minimally acceptable staff-to-child ratios are:

96.8	six weeks old through 16 months old
	1:4
	
96.9	16 months old through 33 months old
	1:7
	
96.10	33 months old through prekindergarten
	1:10
	
96.11	kindergarten through 13 years old
	1:15
	
96.12 	(b) Kindergarten includes a child of sufficient age to have attended the first day of 
96.13 	kindergarten or who is eligible to enter kindergarten within the next four months.
96.14 	(c) For mixed groups, the ratio for the age group of the youngest child applies.
96.15 	(d) Notwithstanding paragraph (a), a certified center may continue to serve a child older 
96.16 	than 13 years if one of the following conditions is true:
96.17 	(1) the child remains eligible for child care assistance under section 119B.09, subdivision 
96.18 	1, paragraph (e); or
96.19 	(2) the certified center serves children in a middle-school-only program, defined as 
96.20 	grades 6 through 8.

96.21 	EFFECTIVE DATE. This section is effective the day following final enactment.

96.22 	Sec. 18. Minnesota Statutes 2019 Supplement, section 254A.03, subdivision 3, as amended 
96.23 	by Laws 2020, chapter 74, article 3, section 3, is amended to read:
96.24 		Subd. 3.Rules for substance use disorder care. (a) The commissioner of human 
96.25 	services shall establish by rule criteria to be used in determining the appropriate level of 
96.26 	chemical dependency care for each recipient of public assistance seeking treatment for 
96.27 	substance misuse or substance use disorder. Upon federal approval of a comprehensive 
96.28 	assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding 
96.29 	the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of 
96.30 	comprehensive assessments under section 254B.05 may determine and approve the 
96.31 	appropriate level of substance use disorder treatment for a recipient of public assistance. 
97.1 	The process for determining an individual's financial eligibility for the consolidated chemical 
97.2 	dependency treatment fund or determining an individual's enrollment in or eligibility for a 
97.3 	publicly subsidized health plan is not affected by the individual's choice to access a 
97.4 	comprehensive assessment for placement.
97.5 	(b) The commissioner shall develop and implement a utilization review process for 
97.6 	publicly funded treatment placements to monitor and review the clinical appropriateness 
97.7 	and timeliness of all publicly funded placements in treatment.
97.8 	(c) If a screen result is positive for alcohol or substance misuse, a brief screening for 
97.9 	alcohol or substance use disorder that is provided to a recipient of public assistance within 
97.10 	a primary care clinic, hospital, or other medical setting or school setting establishes medical 
97.11 	necessity and approval for an initial set of substance use disorder services identified in 
97.12 	section 254B.05, subdivision 5. The initial set of services approved for a recipient whose 
97.13 	screen result is positive may include any combination of up to four hours of individual or 
97.14 	group substance use disorder treatment, two hours of substance use disorder treatment 
97.15 	coordination, or two hours of substance use disorder peer support services provided by a 
97.16 	qualified individual according to chapter 245G. A recipient must obtain an assessment 
97.17 	pursuant to paragraph (a) to be approved for additional treatment services. Minnesota Rules, 
97.18 	parts 9530.6600 to 9530.6655, and a comprehensive assessment pursuant to section 245G.05 
97.19 	are not applicable to the initial set of services allowed under this subdivision. A positive 
97.20 	screen result establishes eligibility for the initial set of services allowed under this 
97.21 	subdivision.
97.22 	(d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, an individual may 
97.23 	choose to obtain a comprehensive assessment as provided in section 245G.05. Individuals 
97.24 	obtaining a comprehensive assessment may access any enrolled provider that is licensed to 
97.25 	provide the level of service authorized pursuant to section 254A.19, subdivision 3, paragraph 
97.26 	(d). If the individual is enrolled in a prepaid health plan, the individual must comply with 
97.27 	any provider network requirements or limitations. This paragraph expires July 1, 2022.

97.28 	Sec. 19. Minnesota Statutes 2019 Supplement, section 254B.05, subdivision 1, is amended 
97.29 	to read:
97.30 		Subdivision 1.Licensure required. (a) Programs licensed by the commissioner are 
97.31 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
97.32 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
97.33 	substance use disorder treatment, extended care, transitional residence, or outpatient treatment 
97.34 	services, and are licensed by tribal government are eligible vendors.
98.1 	(b) A licensed professional in private practice as defined in section 245G.01, subdivision 
98.2 	17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible 
98.3 	vendor of a comprehensive assessment and assessment summary provided according to 
98.4 	section 245G.05, and treatment services provided according to sections 245G.06 and 
98.5 	245G.07, subdivision 1, paragraphs (a), clauses (1) to (4), and (b); and subdivision 2.
98.6 	(c) A county is an eligible vendor for a comprehensive assessment and assessment 
98.7 	summary when provided by an individual who meets the staffing credentials of section 
98.8 	245G.11, subdivisions 1 and 5, and completed according to the requirements of section 
98.9 	245G.05. A county is an eligible vendor of care coordination services when provided by an 
98.10 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and 
98.11 	provided according to the requirements of section 245G.07, subdivision 1, paragraph (a), 
98.12 	clause (5).
98.13 	(d) A recovery community organization that meets certification requirements identified 
98.14 	by the commissioner is an eligible vendor of peer support services.
98.15 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
98.16 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
98.17 	nonresidential substance use disorder treatment or withdrawal management program by the 
98.18 	commissioner or by tribal government or do not meet the requirements of subdivisions 1a 
98.19 	and 1b are not eligible vendors.

98.20 	Sec. 20. Minnesota Statutes 2018, section 256B.0625, subdivision 5l, is amended to read:
98.21 		Subd. 5l.Intensive mental health outpatient treatment. Medical assistance covers 
98.22 	intensive mental health outpatient treatment for dialectical behavioral therapy for adults. 
98.23 	The commissioner shall establish:
98.24 	(1) certification procedures to ensure that providers of these services are qualified; and
98.25 	(2) treatment protocols including required service components and criteria for admission, 
98.26 	continued treatment, and discharge.

98.27 	Sec. 21. Minnesota Statutes 2019 Supplement, section 256B.064, subdivision 2, is amended 
98.28 	to read:
98.29 		Subd. 2.Imposition of monetary recovery and sanctions. (a) The commissioner shall 
98.30 	determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor 
98.31 	of medical care under this section. Except as provided in paragraphs (b) and (d), neither a 
98.32 	monetary recovery nor a sanction will be imposed by the commissioner without prior notice 
99.1 	and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed 
99.2 	action, provided that the commissioner may suspend or reduce payment to a vendor of 
99.3 	medical care, except a nursing home or convalescent care facility, after notice and prior to 
99.4 	the hearing if in the commissioner's opinion that action is necessary to protect the public 
99.5 	welfare and the interests of the program.
99.6 	(b) Except when the commissioner finds good cause not to suspend payments under 
99.7 	Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall 
99.8 	withhold or reduce payments to a vendor of medical care without providing advance notice 
99.9 	of such withholding or reduction if either of the following occurs:
99.10 	(1) the vendor is convicted of a crime involving the conduct described in subdivision 
99.11 	1a; or
99.12 	(2) the commissioner determines there is a credible allegation of fraud for which an 
99.13 	investigation is pending under the program. A credible allegation of fraud is an allegation 
99.14 	which has been verified by the state, from any source, including but not limited to:
99.15 	(i) fraud hotline complaints;
99.16 	(ii) claims data mining; and
99.17 	(iii) patterns identified through provider audits, civil false claims cases, and law 
99.18 	enforcement investigations.
99.19 	Allegations are considered to be credible when they have an indicia of reliability and 
99.20 	the state agency has reviewed all allegations, facts, and evidence carefully and acts 
99.21 	judiciously on a case-by-case basis.
99.22 	(c) The commissioner must send notice of the withholding or reduction of payments 
99.23 	under paragraph (b) within five days of taking such action unless requested in writing by a 
99.24 	law enforcement agency to temporarily withhold the notice. The notice must:
99.25 	(1) state that payments are being withheld according to paragraph (b);
99.26 	(2) set forth the general allegations as to the nature of the withholding action, but need 
99.27 	not disclose any specific information concerning an ongoing investigation;
99.28 	(3) except in the case of a conviction for conduct described in subdivision 1a, state that 
99.29 	the withholding is for a temporary period and cite the circumstances under which withholding 
99.30 	will be terminated;
99.31 	(4) identify the types of claims to which the withholding applies; and
100.1 	(5) inform the vendor of the right to submit written evidence for consideration by the 
100.2 	commissioner.
100.3 	The withholding or reduction of payments will not continue after the commissioner 
100.4 	determines there is insufficient evidence of fraud by the vendor, or after legal proceedings 
100.5 	relating to the alleged fraud are completed, unless the commissioner has sent notice of 
100.6 	intention to impose monetary recovery or sanctions under paragraph (a). Upon conviction 
100.7 	for a crime related to the provision, management, or administration of a health service under 
100.8 	medical assistance, a payment held pursuant to this section by the commissioner or a managed 
100.9 	care organization that contracts with the commissioner under section 256B.035 is forfeited 
100.10 	to the commissioner or managed care organization, regardless of the amount charged in the 
100.11 	criminal complaint or the amount of criminal restitution ordered.
100.12 	(d) The commissioner shall suspend or terminate a vendor's participation in the program 
100.13 	without providing advance notice and an opportunity for a hearing when the suspension or 
100.14 	termination is required because of the vendor's exclusion from participation in Medicare. 
100.15 	Within five days of taking such action, the commissioner must send notice of the suspension 
100.16 	or termination. The notice must:
100.17 	(1) state that suspension or termination is the result of the vendor's exclusion from 
100.18 	Medicare;
100.19 	(2) identify the effective date of the suspension or termination; and
100.20 	(3) inform the vendor of the need to be reinstated to Medicare before reapplying for 
100.21 	participation in the program.
100.22 	(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is 
100.23 	to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision 
100.24 	3, by filing with the commissioner a written request of appeal. The appeal request must be 
100.25 	received by the commissioner no later than 30 days after the date the notification of monetary 
100.26 	recovery or sanction was mailed to the vendor. The appeal request must specify:
100.27 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
100.28 	involved for each disputed item;
100.29 	(2) the computation that the vendor believes is correct;
100.30 	(3) the authority in statute or rule upon which the vendor relies for each disputed item;
100.31 	(4) the name and address of the person or entity with whom contacts may be made 
100.32 	regarding the appeal; and
101.1 	(5) other information required by the commissioner.
101.2 	(f) The commissioner may order a vendor to forfeit a fine for failure to fully document 
101.3 	services according to standards in this chapter and Minnesota Rules, chapter 9505. The 
101.4 	commissioner may assess fines if specific required components of documentation are 
101.5 	missing. The fine for incomplete documentation shall equal 20 percent of the amount paid 
101.6 	on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is 
101.7 	less. If the commissioner determines that a vendor repeatedly violated this chapter, chapter 
101.8 	254B or 245G, or Minnesota Rules, chapter 9505, related to the provision of services to 
101.9 	program recipients and the submission of claims for payment, the commissioner may order 
101.10 	a vendor to forfeit a fine based on the nature, severity, and chronicity of the violations, in 
101.11 	an amount of up to $5,000 or 20 percent of the value of the claims, whichever is greater.
101.12 	(g) The vendor shall pay the fine assessed on or before the payment date specified. If 
101.13 	the vendor fails to pay the fine, the commissioner may withhold or reduce payments and 
101.14 	recover the amount of the fine. A timely appeal shall stay payment of the fine until the 
101.15 	commissioner issues a final order.

101.16 	Sec. 22. Minnesota Statutes 2018, section 256B.0652, subdivision 10, is amended to read:
101.17 		Subd. 10. Authorization for foster care setting. (a) Home care services provided in 
101.18 	an adult or child foster care setting must receive authorization by the commissioner according 
101.19 	to the limits established in subdivision 11.
101.20 	(b) The commissioner may not authorize:
101.21 	(1) home care services that are the responsibility of the foster care provider under the 
101.22 	terms of the foster care placement agreement, difficulty of care rate as of January 1, 2010
101.23 	assessment under sections 256N.24 and 260C.4411, and administrative rules;
101.24 	(2) personal care assistance services when the foster care license holder is also the 
101.25 	personal care provider or personal care assistant, unless the foster home is the licensed 
101.26 	provider's primary residence as defined in section 256B.0625, subdivision 19a; or
101.27 	(3) personal care assistant and home care nursing services when the licensed capacity 
101.28 	is greater than four six, unless all conditions for a variance under section 245A.04, 
101.29 	subdivision 9a, are satisfied for a sibling, as defined in section 260C.007, subdivision 32.

101.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

102.1 	Sec. 23. Minnesota Statutes 2018, section 256B.0949, subdivision 2, is amended to read:
102.2 		Subd. 2.Definitions. (a) The terms used in this section have the meanings given in this 
102.3 	subdivision.
102.4 	(b) "Agency" means the legal entity that is enrolled with Minnesota health care programs 
102.5 	as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide 
102.6 	EIDBI services and that has the legal responsibility to ensure that its employees or contractors 
102.7 	carry out the responsibilities defined in this section. Agency includes a licensed individual 
102.8 	professional who practices independently and acts as an agency.
102.9 	(c) "Autism spectrum disorder or a related condition" or "ASD or a related condition" 
102.10 	means either autism spectrum disorder (ASD) as defined in the current version of the 
102.11 	Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found 
102.12 	to be closely related to ASD, as identified under the current version of the DSM, and meets 
102.13 	all of the following criteria:
102.14 	(1) is severe and chronic;
102.15 	(2) results in impairment of adaptive behavior and function similar to that of a person 
102.16 	with ASD;
102.17 	(3) requires treatment or services similar to those required for a person with ASD; and
102.18 	(4) results in substantial functional limitations in three core developmental deficits of 
102.19 	ASD: social or interpersonal interaction; functional communication, including nonverbal 
102.20 	or social communication; and restrictive, or repetitive behaviors or hyperreactivity or 
102.21 	hyporeactivity to sensory input; and may include deficits or a high level of support in one 
102.22 	or more of the following domains:
102.23 	(i) behavioral challenges and self-regulation;
102.24 	(ii) cognition;
102.25 	(iii) learning and play;
102.26 	(ii) (iv) self-care; or
102.27 	(iii) behavioral challenges;
102.28 	(iv) expressive communication;
102.29 	(v) receptive communication;
102.30 	(vi) cognitive functioning; or
102.31 	(vii) (v) safety.
103.1 	(d) "Person" means a person under 21 years of age.
103.2 	(e) "Clinical supervision" means the overall responsibility for the control and direction 
103.3 	of EIDBI service delivery, including individual treatment planning, staff supervision, 
103.4 	individual treatment plan progress monitoring, and treatment review for each person. Clinical 
103.5 	supervision is provided by a qualified supervising professional (QSP) who takes full 
103.6 	professional responsibility for the service provided by each supervisee.
103.7 	(f) "Commissioner" means the commissioner of human services, unless otherwise 
103.8 	specified.
103.9 	(g) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive 
103.10 	evaluation of a person to determine medical necessity for EIDBI services based on the 
103.11 	requirements in subdivision 5.
103.12 	(h) "Department" means the Department of Human Services, unless otherwise specified.
103.13 	(i) "Early intensive developmental and behavioral intervention benefit" or "EIDBI 
103.14 	benefit" means a variety of individualized, intensive treatment modalities approved and 
103.15 	published by the commissioner that are based in behavioral and developmental science 
103.16 	consistent with best practices on effectiveness.
103.17 	(j) "Generalizable goals" means results or gains that are observed during a variety of 
103.18 	activities over time with different people, such as providers, family members, other adults, 
103.19 	and people, and in different environments including, but not limited to, clinics, homes, 
103.20 	schools, and the community.
103.21 	(k) "Incident" means when any of the following occur:
103.22 	(1) an illness, accident, or injury that requires first aid treatment;
103.23 	(2) a bump or blow to the head; or
103.24 	(3) an unusual or unexpected event that jeopardizes the safety of a person or staff, 
103.25 	including a person leaving the agency unattended.
103.26 	(l) "Individual treatment plan" or "ITP" means the person-centered, individualized written 
103.27 	plan of care that integrates and coordinates person and family information from the CMDE 
103.28 	for a person who meets medical necessity for the EIDBI benefit. An individual treatment 
103.29 	plan must meet the standards in subdivision 6.
103.30 	(m) "Legal representative" means the parent of a child who is under 18 years of age, a 
103.31 	court-appointed guardian, or other representative with legal authority to make decisions 
103.32 	about service for a person. For the purpose of this subdivision, "other representative with 
104.1 	legal authority to make decisions" includes a health care agent or an attorney-in-fact 
104.2 	authorized through a health care directive or power of attorney.
104.3 	(n) "Mental health professional" has the meaning given in section 245.4871, subdivision 
104.4 	27, clauses (1) to (6).
104.5 	(o) "Person-centered" means a service that both responds to the identified needs, interests, 
104.6 	values, preferences, and desired outcomes of the person or the person's legal representative 
104.7 	and respects the person's history, dignity, and cultural background and allows inclusion and 
104.8 	participation in the person's community.
104.9 	(p) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II, or 
104.10 	level III treatment provider.

104.11 	Sec. 24. Minnesota Statutes 2018, section 256B.0949, subdivision 5, is amended to read:
104.12 		Subd. 5.Comprehensive multidisciplinary evaluation. (a) A CMDE must be completed 
104.13 	to determine medical necessity of EIDBI services. For the commissioner to authorize EIDBI 
104.14 	services, the CMDE provider must submit the CMDE to the commissioner and the person 
104.15 	or the person's legal representative as determined by the commissioner. Information and 
104.16 	assessments must be performed, reviewed, and relied upon for the eligibility determination, 
104.17 	treatment and services recommendations, and treatment plan development for the person.
104.18 	(b) The CMDE provider must review the diagnostic assessment to confirm the person 
104.19 	has an eligible diagnosis and the diagnostic assessment meets standards required under 
104.20 	subdivision 4. If the CMDE provider elects to complete the diagnostic assessment at the 
104.21 	same time as the CMDE, the CMDE provider must certify that the CMDE meets all standards 
104.22 	as required under subdivision 4.
104.23 	(b) (c) The CMDE must:
104.24 	(1) include an assessment of the person's developmental skills, functional behavior, 
104.25 	needs, and capacities based on direct observation of the person which must be administered 
104.26 	by a CMDE provider, include medical or assessment information from the person's physician 
104.27 	or advanced practice registered nurse, and may also include input from family members, 
104.28 	school personnel, child care providers, or other caregivers, as well as any medical or 
104.29 	assessment information from other licensed professionals such as rehabilitation or habilitation 
104.30 	therapists, licensed school personnel, or mental health professionals;
104.31 	(2) include and document the person's legal representative's or primary caregiver's 
104.32 	preferences for involvement in the person's treatment; and
105.1 	(3) provide information about the range of current EIDBI treatment modalities recognized 
105.2 	by the commissioner.

105.3 	Sec. 25. Minnesota Statutes 2018, section 256B.0949, subdivision 6, is amended to read:
105.4 		Subd. 6.Individual treatment plan. (a) The QSP, level I treatment provider, or level 
105.5 	II treatment provider who integrates and coordinates person and family information from 
105.6 	the CMDE and ITP progress monitoring process to develop the ITP must develop and 
105.7 	monitor the ITP.
105.8 	(b) Each person's ITP must be:
105.9 	(1) culturally and linguistically appropriate, as required under subdivision 3a, 
105.10 	individualized, and person-centered; and
105.11 	(2) based on the diagnosis and CMDE information specified in subdivisions 4 and 5.
105.12 	(c) The ITP must specify:
105.13 	(1) the medically necessary treatment and service;
105.14 	(2) the treatment modality that shall be used to meet the goals and objectives, including:
105.15 	(i) baseline measures and projected dates of accomplishment;
105.16 	(ii) the frequency, intensity, location, and duration of each service provided;
105.17 	(iii) the level of legal representative or primary caregiver training and counseling;
105.18 	(iv) any change or modification to the physical and social environments necessary to 
105.19 	provide a service;
105.20 	(v) significant changes in the person's condition or family circumstance;
105.21 	(vi) any specialized equipment or material required;
105.22 	(vii) (vi) techniques that support and are consistent with the person's communication 
105.23 	mode and learning style;
105.24 	(viii) (vii) the name of the QSP; and
105.25 	(ix) (viii) progress monitoring results and goal mastery data; and
105.26 	(3) the discharge criteria that shall must be used and a defined transition plan that meets 
105.27 	the requirement of paragraph (g).
105.28 	(d) Implementation of the ITP must be supervised by a QSP.
106.1 	(e) The ITP must be submitted to the commissioner and the person or the person's legal 
106.2 	representative for approval in a manner determined by the commissioner for this purpose.
106.3 	(f) A service included in the ITP must meet all applicable requirements for medical 
106.4 	necessity and coverage.
106.5 	(g) To terminate service, the provider must send notice of termination to the person or 
106.6 	the person's legal representative. The transition period begins when the person or the person's 
106.7 	legal representative receives notice of termination from the EIDBI service and ends when 
106.8 	the EIDBI service is terminated. Up to 30 days of continued service is allowed during the 
106.9 	transition period. Services during the transition period shall be consistent with the ITP. The 
106.10 	transition plan shall must include:
106.11 	(1) protocols for changing service when medically necessary;
106.12 	(2) how the transition will occur;
106.13 	(3) the time allowed to make the transition; and
106.14 	(4) a description of how the person or the person's legal representative will be informed 
106.15 	of and involved in the transition.

106.16 	Sec. 26. Minnesota Statutes 2018, section 256B.0949, subdivision 9, is amended to read:
106.17 		Subd. 9.Revision of treatment options. (a) The commissioner may revise covered 
106.18 	treatment options modalities as needed based on outcome data and other evidence. EIDBI 
106.19 	treatment modalities approved by the department must:
106.20 	(1) cause no harm to the person or the person's family;
106.21 	(2) be individualized and person-centered;
106.22 	(3) be developmentally appropriate and highly structured, with well-defined goals and 
106.23 	objectives that provide a strategic direction for treatment;
106.24 	(4) be based in recognized principles of developmental and behavioral science;
106.25 	(5) utilize sound practices that are replicable across providers and maintain the fidelity 
106.26 	of the specific modality;
106.27 	(6) demonstrate an evidentiary basis;
106.28 	(7) have goals and objectives that are measurable, achievable, and regularly evaluated 
106.29 	and adjusted to ensure that adequate progress is being made;
106.30 	(8) be provided intensively with a high staff-to-person ratio; and
107.1 	(9) include participation by the person and the person's legal representative in decision 
107.2 	making, knowledge building and capacity building, and developing and implementing the 
107.3 	person's ITP.
107.4 	(b) Before revisions in department recognized treatment modalities become effective, 
107.5 	the commissioner must provide public notice of the changes, the reasons for the change, 
107.6 	and a 30-day public comment period to those who request notice through an electronic list 
107.7 	accessible to the public on the department's website.

107.8 	Sec. 27. Minnesota Statutes 2018, section 256B.0949, subdivision 13, is amended to read:
107.9 		Subd. 13.Covered services. (a) The services described in paragraphs (b) to (i) are 
107.10 	eligible for reimbursement by medical assistance under this section. Services must be 
107.11 	provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must 
107.12 	address the person's medically necessary treatment goals and must be targeted to develop, 
107.13 	enhance, or maintain the individual developmental skills of a person with ASD or a related 
107.14 	condition to improve functional communication, including nonverbal or social 
107.15 	communication, social or interpersonal interaction, restrictive or repetitive behaviors, 
107.16 	hyperreactivity or hyporeactivity to sensory input, behavioral challenges and self-regulation, 
107.17 	cognition, learning and play, self-care, and safety.
107.18 	(b) EIDBI modalities include, but are not limited to: treatment must be delivered 
107.19 	consistent with the standards of an approved modality, as published by the commissioner. 
107.20 	EIDBI modalities include:
107.21 	(1) applied behavior analysis (ABA);
107.22 	(2) developmental individual-difference relationship-based model (DIR/Floortime);
107.23 	(3) early start Denver model (ESDM);
107.24 	(4) PLAY project; or
107.25 	(5) relationship development intervention (RDI).; or
107.26 	(6) additional modalities not listed in clauses (1) to (5) upon approval by the 
107.27 	commissioner.
107.28 	(c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b), 
107.29 	clauses (1) to (5), as the primary modality for treatment as a covered service, or several 
107.30 	EIDBI modalities in combination as the primary modality of treatment, as approved by the 
107.31 	commissioner. An EIDBI provider that identifies and provides assurance of qualifications 
107.32 	for a single specific treatment modality must document the required qualifications to meet 
108.1 	fidelity to the specific model. Additional EIDBI modalities not listed in paragraph (b) may 
108.2 	be covered upon approval by the commissioner.
108.3 	(d) Each qualified EIDBI provider must identify and provide assurance of qualifications 
108.4 	for professional licensure certification, or training in evidence-based treatment methods, 
108.5 	and must document the required qualifications outlined in subdivision 15 in a manner 
108.6 	determined by the commissioner.
108.7 	(d) (e) CMDE is a comprehensive evaluation of the person's developmental status to 
108.8 	determine medical necessity for EIDBI services and meets the requirements of subdivision 
108.9 	5. The services must be provided by a qualified CMDE provider.
108.10 	(e) (f) EIDBI intervention observation and direction is the clinical direction and oversight 
108.11 	of EIDBI services by the QSP, level I treatment provider, or level II treatment provider, 
108.12 	including developmental and behavioral techniques, progress measurement, data collection, 
108.13 	function of behaviors, and generalization of acquired skills for the direct benefit of a person. 
108.14 	EIDBI intervention observation and direction informs any modification of the methods
108.15 	current treatment protocol to support the outcomes outlined in the ITP. EIDBI intervention 
108.16 	observation and direction provides a real-time response to EIDBI interventions to maximize 
108.17 	the benefit to the person.
108.18 	(g) Intervention is medically necessary direct treatment provided to a person with ASD 
108.19 	or a related condition as outlined in their ITP. All intervention services must be provided 
108.20 	under the direction of a QSP. Intervention may take place across multiple settings. The 
108.21 	frequency and intensity of intervention services are provided based on the number of 
108.22 	treatment goals, person and family or caregiver preferences, and other factors. Intervention 
108.23 	services may be provided individually or in a group. Intervention with a higher provider 
108.24 	ratio may occur when deemed medically necessary through the person's ITP.
108.25 	(1) Individual intervention is treatment by protocol administered by a single qualified 
108.26 	EIDBI provider delivered face-to-face to one person.
108.27 	(2) Group intervention is treatment by protocol provided by one or more qualified EIDBI 
108.28 	providers, delivered to at least two people who receive EIDBI services.
108.29 	(f) (h) ITP development and ITP progress monitoring is development of the initial, 
108.30 	annual, and progress monitoring of an ITP. ITP development and ITP progress monitoring 
108.31 	documents, provides provide oversight and ongoing evaluation of a person's treatment and 
108.32 	progress on targeted goals and objectives, and integrates integrate and coordinates coordinate
108.33 	the person's and the person's legal representative's information from the CMDE and ITP 
109.1 	progress monitoring. This service must be reviewed and completed by the QSP, and may 
109.2 	include input from a level I treatment provider or a level II treatment provider.
109.3 	(g) (i) Family caregiver training and counseling is specialized training and education 
109.4 	for a family or primary caregiver to understand the person's developmental status and help 
109.5 	with the person's needs and development. This service must be provided by the QSP, level 
109.6 	I treatment provider, or level II treatment provider.
109.7 	(h) (j) A coordinated care conference is a voluntary face-to-face meeting with the person 
109.8 	and the person's family to review the CMDE or ITP progress monitoring and to integrate 
109.9 	and coordinate services across providers and service-delivery systems to develop the ITP. 
109.10 	This service must be provided by the QSP and may include the CMDE provider or a level 
109.11 	I treatment provider or a level II treatment provider.
109.12 	(i) (k) Travel time is allowable billing for traveling to and from the person's home, 
109.13 	school, a community setting, or place of service outside of an EIDBI center, clinic, or office 
109.14 	from a specified location to provide face-to-face EIDBI intervention, observation and 
109.15 	direction, or family caregiver training and counseling. The person's ITP must specify the 
109.16 	reasons the provider must travel to the person.
109.17 	(j) (l) Medical assistance covers medically necessary EIDBI services and consultations 
109.18 	delivered by a licensed health care provider via telemedicine, as defined under section 
109.19 	256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered 
109.20 	in person. Medical assistance coverage is limited to three telemedicine services per person 
109.21 	per calendar week.

109.22 	Sec. 28. Minnesota Statutes 2018, section 256B.0949, subdivision 14, is amended to read:
109.23 		Subd. 14.Person's rights. A person or the person's legal representative has the right to:
109.24 	(1) protection as defined under the health care bill of rights under section 144.651;
109.25 	(2) designate an advocate to be present in all aspects of the person's and person's family's 
109.26 	services at the request of the person or the person's legal representative;
109.27 	(3) be informed of the agency policy on assigning staff to a person;
109.28 	(4) be informed of the opportunity to observe the person while receiving services;
109.29 	(5) be informed of services in a manner that respects and takes into consideration the 
109.30 	person's and the person's legal representative's culture, values, and preferences in accordance 
109.31 	with subdivision 3a;
110.1 	(6) be free from seclusion and restraint, except for emergency use of manual restraint 
110.2 	in emergencies as defined in section 245D.02, subdivision 8a;
110.3 	(7) be under the supervision of a responsible adult at all times;
110.4 	(8) be notified by the agency within 24 hours if an incident occurs or the person is injured 
110.5 	while receiving services, including what occurred and how agency staff responded to the 
110.6 	incident;
110.7 	(9) request a voluntary coordinated care conference; and
110.8 	(10) request a CMDE provider of the person's or the person's legal representative's 
110.9 	choice.; and
110.10 	(11) be free of all prohibitions as defined in Minnesota Rules, part 9544.0060.

110.11 	Sec. 29. Minnesota Statutes 2018, section 256B.0949, subdivision 15, is amended to read:
110.12 		Subd. 15.EIDBI provider qualifications. (a) A QSP must be employed by an agency 
110.13 	and be:
110.14 	(1) a licensed mental health professional who has at least 2,000 hours of supervised 
110.15 	clinical experience or training in examining or treating people with ASD or a related condition 
110.16 	or equivalent documented coursework at the graduate level by an accredited university in 
110.17 	ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child 
110.18 	development; or
110.19 	(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised 
110.20 	clinical experience or training in examining or treating people with ASD or a related condition 
110.21 	or equivalent documented coursework at the graduate level by an accredited university in 
110.22 	the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and 
110.23 	typical child development.
110.24 	(b) A level I treatment provider must be employed by an agency and:
110.25 	(1) have at least 2,000 hours of supervised clinical experience or training in examining 
110.26 	or treating people with ASD or a related condition or equivalent documented coursework 
110.27 	at the graduate level by an accredited university in ASD diagnostics, ASD developmental 
110.28 	and behavioral treatment strategies, and typical child development or an equivalent 
110.29 	combination of documented coursework or hours of experience; and
110.30 	(2) have or be at least one of the following:
111.1 	(i) a master's degree in behavioral health or child development or related fields including, 
111.2 	but not limited to, mental health, special education, social work, psychology, speech 
111.3 	pathology, or occupational therapy from an accredited college or university;
111.4 	(ii) a bachelor's degree in a behavioral health, child development, or related field 
111.5 	including, but not limited to, mental health, special education, social work, psychology, 
111.6 	speech pathology, or occupational therapy, from an accredited college or university, and 
111.7 	advanced certification in a treatment modality recognized by the department;
111.8 	(iii) a board-certified behavior analyst; or
111.9 	(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical 
111.10 	experience that meets all registration, supervision, and continuing education requirements 
111.11 	of the certification.
111.12 	(c) A level II treatment provider must be employed by an agency and must be:
111.13 	(1) a person who has a bachelor's degree from an accredited college or university in a 
111.14 	behavioral or child development science or related field including, but not limited to, mental 
111.15 	health, special education, social work, psychology, speech pathology, or occupational 
111.16 	therapy; and meet meets at least one of the following:
111.17 	(i) has at least 1,000 hours of supervised clinical experience or training in examining or 
111.18 	treating people with ASD or a related condition or equivalent documented coursework at 
111.19 	the graduate level by an accredited university in ASD diagnostics, ASD developmental and 
111.20 	behavioral treatment strategies, and typical child development or a combination of 
111.21 	coursework or hours of experience;
111.22 	(ii) has certification as a board-certified assistant behavior analyst from the Behavior 
111.23 	Analyst Certification Board;
111.24 	(iii) is a registered behavior technician as defined by the Behavior Analyst Certification 
111.25 	Board; or
111.26 	(iv) is certified in one of the other treatment modalities recognized by the department; 
111.27 	or
111.28 	(2) a person who has:
111.29 	(i) an associate's degree in a behavioral or child development science or related field 
111.30 	including, but not limited to, mental health, special education, social work, psychology, 
111.31 	speech pathology, or occupational therapy from an accredited college or university; and
112.1 	(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people 
112.2 	with ASD or a related condition. Hours worked as a mental health behavioral aide or level 
112.3 	III treatment provider may be included in the required hours of experience; or
112.4 	(3) a person who has at least 4,000 hours of supervised clinical experience in delivering 
112.5 	treatment to people with ASD or a related condition. Hours worked as a mental health 
112.6 	behavioral aide or level III treatment provider may be included in the required hours of 
112.7 	experience; or
112.8 	(4) a person who is a graduate student in a behavioral science, child development science, 
112.9 	or related field and is receiving clinical supervision by a QSP affiliated with an agency to 
112.10 	meet the clinical training requirements for experience and training with people with ASD 
112.11 	or a related condition; or
112.12 	(5) a person who is at least 18 years of age and who:
112.13 	(i) is fluent in a non-English language;
112.14 	(ii) completed the level III EIDBI training requirements; and
112.15 	(iii) receives observation and direction from a QSP or level I treatment provider at least 
112.16 	once a week until the person meets 1,000 hours of supervised clinical experience.
112.17 	(d) A level III treatment provider must be employed by an agency, have completed the 
112.18 	level III training requirement, be at least 18 years of age, and have at least one of the 
112.19 	following:
112.20 	(1) a high school diploma or commissioner of education-selected high school equivalency 
112.21 	certification;
112.22 	(2) fluency in a non-English language; or
112.23 	(3) one year of experience as a primary personal care assistant, community health worker, 
112.24 	waiver service provider, or special education assistant to a person with ASD or a related 
112.25 	condition within the previous five years.; or
112.26 	(4) completion of all required EIDBI training within six months of employment.

112.27 	Sec. 30. Minnesota Statutes 2018, section 256B.0949, subdivision 16, is amended to read:
112.28 		Subd. 16.Agency duties. (a) An agency delivering an EIDBI service under this section 
112.29 	must:
113.1 	(1) enroll as a medical assistance Minnesota health care program provider according to 
113.2 	Minnesota Rules, part 9505.0195, and section 256B.04, subdivision 21, and meet all 
113.3 	applicable provider standards and requirements;
113.4 	(2) demonstrate compliance with federal and state laws for EIDBI service;
113.5 	(3) verify and maintain records of a service provided to the person or the person's legal 
113.6 	representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;
113.7 	(4) demonstrate that while enrolled or seeking enrollment as a Minnesota health care 
113.8 	program provider the agency did not have a lead agency contract or provider agreement 
113.9 	discontinued because of a conviction of fraud; or did not have an owner, board member, or 
113.10 	manager fail a state or federal criminal background check or appear on the list of excluded 
113.11 	individuals or entities maintained by the federal Department of Human Services Office of 
113.12 	Inspector General;
113.13 	(5) have established business practices including written policies and procedures, internal 
113.14 	controls, and a system that demonstrates the organization's ability to deliver quality EIDBI 
113.15 	services;
113.16 	(6) have an office located in Minnesota or a border state;
113.17 	(7) conduct a criminal background check on an individual who has direct contact with 
113.18 	the person or the person's legal representative;
113.19 	(8) report maltreatment according to sections 626.556 and 626.557;
113.20 	(9) comply with any data requests consistent with the Minnesota Government Data 
113.21 	Practices Act, sections 256B.064 and 256B.27;
113.22 	(10) provide training for all agency staff on the requirements and responsibilities listed 
113.23 	in the Maltreatment of Minors Act, section 626.556, and the Vulnerable Adult Protection 
113.24 	Act, section 626.557, including mandated and voluntary reporting, nonretaliation, and the 
113.25 	agency's policy for all staff on how to report suspected abuse and neglect;
113.26 	(11) have a written policy to resolve issues collaboratively with the person and the 
113.27 	person's legal representative when possible. The policy must include a timeline for when 
113.28 	the person and the person's legal representative will be notified about issues that arise in 
113.29 	the provision of services;
113.30 	(12) provide the person's legal representative with prompt notification if the person is 
113.31 	injured while being served by the agency. An incident report must be completed by the 
114.1 	agency staff member in charge of the person. A copy of all incident and injury reports must 
114.2 	remain on file at the agency for at least five years from the report of the incident; and
114.3 	(13) before starting a service, provide the person or the person's legal representative a 
114.4 	description of the treatment modality that the person shall receive, including the staffing 
114.5 	certification levels and training of the staff who shall provide a treatment.
114.6 	(b) When delivering the ITP, and annually thereafter, an agency must provide the person 
114.7 	or the person's legal representative with:
114.8 	(1) a written copy and a verbal explanation of the person's or person's legal 
114.9 	representative's rights and the agency's responsibilities;
114.10 	(2) documentation in the person's file the date that the person or the person's legal 
114.11 	representative received a copy and explanation of the person's or person's legal 
114.12 	representative's rights and the agency's responsibilities; and
114.13 	(3) reasonable accommodations to provide the information in another format or language 
114.14 	as needed to facilitate understanding of the person's or person's legal representative's rights 
114.15 	and the agency's responsibilities.

114.16 	Sec. 31. Minnesota Statutes 2018, section 256D.02, subdivision 17, is amended to read:
114.17 		Subd. 17.Professional certification. "Professional certification" means a statement 
114.18 	about a person's illness, injury, or incapacity that is signed by a "qualified professional" as 
114.19 	defined in section 256J.08, subdivision 73a 256P.01, subdivision 6a.

114.20 	Sec. 32. Minnesota Statutes 2018, section 256I.03, subdivision 3, is amended to read:
114.21 		Subd. 3.Housing support. "Housing support" means a group living situation assistance
114.22 	that provides at a minimum room and board to unrelated persons who meet the eligibility 
114.23 	requirements of section 256I.04. To receive payment for a group residence rate housing 
114.24 	support, the residence must meet the requirements under section 256I.04, subdivisions 2a 
114.25 	to 2f.

114.26 	Sec. 33. Minnesota Statutes 2018, section 256I.03, subdivision 14, is amended to read:
114.27 		Subd. 14.Qualified professional. "Qualified professional" means an individual as 
114.28 	defined in section 256J.08, subdivision 73a, or245G.11, subdivision 3, 4, or 5, or 256P.01, 
114.29 	subdivision 6a; or an individual approved by the director of human services or a designee 
114.30 	of the director.

115.1 	Sec. 34. Minnesota Statutes 2019 Supplement, section 256I.04, subdivision 2b, is amended 
115.2 	to read:
115.3 		Subd. 2b.Housing support agreements. (a) Agreements between agencies and providers 
115.4 	of housing support must be in writing on a form developed and approved by the commissioner 
115.5 	and must specify the name and address under which the establishment subject to the 
115.6 	agreement does business and under which the establishment, or service provider, if different 
115.7 	from the group residential housing establishment, is licensed by the Department of Health 
115.8 	or the Department of Human Services; the specific license or registration from the 
115.9 	Department of Health or the Department of Human Services held by the provider and the 
115.10 	number of beds subject to that license; the address of the location or locations at which 
115.11 	group residential housing support is provided under this agreement; the per diem and monthly 
115.12 	rates that are to be paid from housing support funds for each eligible resident at each location; 
115.13 	the number of beds at each location which are subject to the agreement; whether the license 
115.14 	holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; 
115.15 	and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06 
115.16 	and subject to any changes to those sections.
115.17 	(b) Providers are required to verify the following minimum requirements in the 
115.18 	agreement:
115.19 	(1) current license or registration, including authorization if managing or monitoring 
115.20 	medications;
115.21 	(2) all staff who have direct contact with recipients meet the staff qualifications;
115.22 	(3) the provision of housing support;
115.23 	(4) the provision of supplementary services, if applicable;
115.24 	(5) reports of adverse events, including recipient death or serious injury;
115.25 	(6) submission of residency requirements that could result in recipient eviction; and
115.26 	(7) confirmation that the provider will not limit or restrict the number of hours an 
115.27 	applicant or recipient chooses to be employed, as specified in subdivision 5.
115.28 	(c) Agreements may be terminated with or without cause by the commissioner, the 
115.29 	agency, or the provider with two calendar months prior notice. The commissioner may 
115.30 	immediately terminate an agreement under subdivision 2d.

116.1 	Sec. 35. Minnesota Statutes 2018, section 256I.05, subdivision 1c, is amended to read:
116.2 		Subd. 1c.Rate increases. An agency may not increase the rates negotiated for housing 
116.3 	support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).
116.4 	(a) An agency may increase the rates for room and board to the MSA equivalent rate 
116.5 	for those settings whose current rate is below the MSA equivalent rate.
116.6 	(b) An agency may increase the rates for residents in adult foster care whose difficulty 
116.7 	of care has increased. The total housing support rate for these residents must not exceed the 
116.8 	maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase 
116.9 	difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding 
116.10 	by home and community-based waiver programs under title XIX of the Social Security Act.
116.11 	(c) The room and board rates will be increased each year when the MSA equivalent rate 
116.12 	is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less 
116.13 	the amount of the increase in the medical assistance personal needs allowance under section 
116.14 	256B.35.
116.15 	(d) When housing support pays for an individual's room and board, or other costs 
116.16 	necessary to provide room and board, the rate payable to the residence must continue for 
116.17 	up to 18 calendar days per incident that the person is temporarily absent from the residence, 
116.18 	not to exceed 60 days in a calendar year, if the absence or absences have received the prior 
116.19 	approval of are reported in advance to the county agency's social service staff. Prior approval
116.20 	Advance reporting is not required for emergency absences due to crisis, illness, or injury.
116.21 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
116.22 	change criteria exists if the establishment experiences a 25 percent increase or decrease in 
116.23 	the total number of its beds, if the net cost of capital additions or improvements is in excess 
116.24 	of 15 percent of the current market value of the residence, or if the residence physically 
116.25 	moves, or changes its licensure, and incurs a resulting increase in operation and property 
116.26 	costs.
116.27 	(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid 
116.28 	for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who 
116.29 	reside in residences that are licensed by the commissioner of health as a boarding care home, 
116.30 	but are not certified for the purposes of the medical assistance program. However, an increase 
116.31 	under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical 
116.32 	assistance reimbursement rate for nursing home resident class A, in the geographic grouping 
116.33 	in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to 
116.34 	9549.0058.

117.1 	Sec. 36. Minnesota Statutes 2018, section 256I.05, subdivision 1n, is amended to read:
117.2 		Subd. 1n.Supplemental rate; Mahnomen County. Notwithstanding the provisions of 
117.3 	this section, for the rate period July 1, 2010, to June 30, 2011, a county agency shall negotiate 
117.4 	a supplemental service rate in addition to the rate specified in subdivision 1, not to exceed 
117.5 	$753 per month or the existing rate, including any legislative authorized inflationary 
117.6 	adjustments, for a group residential housing support provider located in Mahnomen County 
117.7 	that operates a 28-bed facility providing 24-hour care to individuals who are homeless, 
117.8 	disabled, chemically dependent, mentally ill, or chronically homeless.

117.9 	Sec. 37. Minnesota Statutes 2018, section 256I.05, subdivision 8, is amended to read:
117.10 		Subd. 8.State participation. For a resident of a group residence person who is eligible 
117.11 	under section 256I.04, subdivision 1, paragraph (b), state participation in the group residential
117.12 	housing support payment is determined according to section 256D.03, subdivision 2. For 
117.13 	a resident of a group residence person who is eligible under section 256I.04, subdivision 1, 
117.14 	paragraph (a), state participation in the group residential housing support rate is determined 
117.15 	according to section 256D.36.

117.16 	Sec. 38. Minnesota Statutes 2018, section 256I.06, subdivision 2, is amended to read:
117.17 		Subd. 2.Time of payment. A county agency may make payments in advance for an 
117.18 	individual whose stay is expected to last beyond the calendar month for which the payment 
117.19 	is made. Housing support payments made by a county agency on behalf of an individual 
117.20 	who is not expected to remain in the group residence establishment beyond the month for 
117.21 	which payment is made must be made subsequent to the individual's departure from the 
117.22 	residence.

117.23 	Sec. 39. Minnesota Statutes 2018, section 256I.06, is amended by adding a subdivision 
117.24 	to read:
117.25 		Subd. 10. Correction of overpayments and underpayments. The agency shall make 
117.26 	an adjustment to housing support payments issued to individuals consistent with requirements 
117.27 	of federal law and regulation and state law and rule and shall issue or recover benefits as 
117.28 	appropriate. A recipient or former recipient is not responsible for overpayments due to 
117.29 	agency error, unless the amount of the overpayment is large enough that a reasonable person 
117.30 	would know it is an error.

118.1 	Sec. 40. Minnesota Statutes 2018, section 256J.08, subdivision 73a, is amended to read:
118.2 		Subd. 73a.Qualified professional. "Qualified professional" means an individual as 
118.3 	defined in section 256P.01, subdivision 6a. (a) For physical illness, injury, or incapacity, a 
118.4 	"qualified professional" means a licensed physician, a physician assistant, a nurse practitioner, 
118.5 	or a licensed chiropractor.
118.6 	(b) For developmental disability and intelligence testing, a "qualified professional" 
118.7 	means an individual qualified by training and experience to administer the tests necessary 
118.8 	to make determinations, such as tests of intellectual functioning, assessments of adaptive 
118.9 	behavior, adaptive skills, and developmental functioning. These professionals include 
118.10 	licensed psychologists, certified school psychologists, or certified psychometrists working 
118.11 	under the supervision of a licensed psychologist.
118.12 	(c) For learning disabilities, a "qualified professional" means a licensed psychologist or 
118.13 	school psychologist with experience determining learning disabilities.
118.14 	(d) For mental health, a "qualified professional" means a licensed physician or a qualified 
118.15 	mental health professional. A "qualified mental health professional" means:
118.16 	(1) for children, in psychiatric nursing, a registered nurse who is licensed under sections 
118.17 	148.171 to 148.285, and who is certified as a clinical specialist in child and adolescent 
118.18 	psychiatric or mental health nursing by a national nurse certification organization or who 
118.19 	has a master's degree in nursing or one of the behavioral sciences or related fields from an 
118.20 	accredited college or university or its equivalent, with at least 4,000 hours of post-master's 
118.21 	supervised experience in the delivery of clinical services in the treatment of mental illness;
118.22 	(2) for adults, in psychiatric nursing, a registered nurse who is licensed under sections 
118.23 	148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric and 
118.24 	mental health nursing by a national nurse certification organization or who has a master's 
118.25 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
118.26 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
118.27 	experience in the delivery of clinical services in the treatment of mental illness;
118.28 	(3) in clinical social work, a person licensed as an independent clinical social worker 
118.29 	under chapter 148D, or a person with a master's degree in social work from an accredited 
118.30 	college or university, with at least 4,000 hours of post-master's supervised experience in 
118.31 	the delivery of clinical services in the treatment of mental illness;
119.1 	(4) in psychology, an individual licensed by the Board of Psychology under sections 
119.2 	148.88 to 148.98, who has stated to the Board of Psychology competencies in the diagnosis 
119.3 	and treatment of mental illness;
119.4 	(5) in psychiatry, a physician licensed under chapter 147 and certified by the American 
119.5 	Board of Psychiatry and Neurology or eligible for board certification in psychiatry;
119.6 	(6) in marriage and family therapy, the mental health professional must be a marriage 
119.7 	and family therapist licensed under sections 148B.29 to 148B.39, with at least two years of 
119.8 	post-master's supervised experience in the delivery of clinical services in the treatment of 
119.9 	mental illness; and
119.10 	(7) in licensed professional clinical counseling, the mental health professional shall be 
119.11 	a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours 
119.12 	of post-master's supervised experience in the delivery of clinical services in the treatment 
119.13 	of mental illness.

119.14 	Sec. 41. Minnesota Statutes 2018, section 256P.01, is amended by adding a subdivision 
119.15 	to read:
119.16 		Subd. 6a.Qualified professional. (a) For illness, injury, or incapacity, a "qualified 
119.17 	professional" means a licensed physician, physician assistant, nurse practitioner, physical 
119.18 	therapist, occupational therapist, or licensed chiropractor, according to their scope of practice.
119.19 	(b) For developmental disability, learning disability, and intelligence testing, a "qualified 
119.20 	professional" means a licensed physician, physician assistant, nurse practitioner, licensed 
119.21 	independent clinical social worker, licensed psychologist, certified school psychologist, or 
119.22 	certified psychometrist working under the supervision of a licensed psychologist.
119.23 	(c) For mental health, a "qualified professional" means a licensed physician,  nurse 
119.24 	practitioner, or qualified mental health professional under section 245.462, subdivision 18, 
119.25 	clauses (1) to (6).
119.26 	(d) For substance use disorder, a "qualified professional" means an individual as defined 
119.27 	in section 245G.11, subdivision 3, 4, or 5.

119.28 	Sec. 42. DIRECTION TO THE COMMISSIONER; EVALUATION OF 
119.29 	CONTINUOUS LICENSES.
 119.30 	By January 1, 2021, the commissioner of human services shall consult with family child 
119.31 	care license holders and county agencies to determine whether family child care licenses 
119.32 	should automatically renew instead of requiring license holders to reapply for licensure. If 
120.1 	the commissioner determines that family child care licenses should automatically renew, 
120.2 	the commissioner must propose legislation for the 2021 legislative session to make the 
120.3 	required amendments to statutes and administrative rules, as necessary.

120.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

120.5 	Sec. 43. REVISOR INSTRUCTION; CORRECTING TERMINOLOGY.
 120.6 	In Minnesota Statutes, sections 256.01, subdivisions 2 and 24; 256.975, subdivision 7; 
120.7 	256B.0911, subdivisions 1a, 3b, and 4d; and 256B.439, subdivision 4, the revisor of statutes 
120.8 	must substitute the term "Disability Linkage Line" or similar terms for "Disability Hub" or 
120.9 	similar terms. The revisor must also make grammatical changes related to the changes in 
120.10 	terms.

120.11 	Sec. 44. REPEALER.
 120.12 	Minnesota Statutes 2018, section 245F.02, subdivision 20, is repealed.

120.13 	EFFECTIVE DATE. This section is effective the day following final enactment.

120.14 	ARTICLE 7
120.15 	CIVIL COMMITMENT

120.16 	Section 1. Minnesota Statutes 2018, section 253B.02, subdivision 4b, is amended to read:
120.17 		Subd. 4b.Community-based treatment program. "Community-based treatment
120.18 	program" means treatment and services provided at the community level, including but not 
120.19 	limited to community support services programs defined in section 245.462, subdivision 6; 
120.20 	day treatment services defined in section 245.462, subdivision 8; outpatient services defined 
120.21 	in section 245.462, subdivision 21; mental health crisis services under section 245.462, 
120.22 	subdivision 14c; outpatient services defined in section 245.462, subdivision 21; assertive 
120.23 	community treatment services under section 256B.0622; adult rehabilitation mental health 
120.24 	services under section 256B.0623; home and community-based waivers; supportive housing; 
120.25 	and residential treatment services as defined in section 245.462, subdivision 23.
120.26 	Community-based treatment program excludes services provided by a state-operated 
120.27 	treatment program.

120.28 	Sec. 2. Minnesota Statutes 2018, section 253B.02, subdivision 7, is amended to read:
120.29 		Subd. 7.Examiner. "Examiner" means a person who is knowledgeable, trained, and 
120.30 	practicing in the diagnosis and assessment or in the treatment of the alleged impairment, 
121.1 	and who is: a licensed physician, a mental health professional as defined in section 245.462, 
121.2 	subdivision 18, clauses (1) to (6), a licensed physician assistant, or an advanced practice 
121.3 	registered nurse (APRN) as defined in section 148.171, subdivision 3, who is practicing in 
121.4 	the emergency room of a hospital, so long as the hospital has a process for credentialing 
121.5 	and recredentialing any APRN acting as an examiner in an emergency room.
121.6 	(1) a licensed physician;
121.7 	(2) a licensed psychologist who has a doctoral degree in psychology or who became a 
121.8 	licensed consulting psychologist before July 2, 1975; or
121.9 	(3) an advanced practice registered nurse certified in mental health or a licensed physician 
121.10 	assistant, except that only a physician or psychologist meeting these requirements may be 
121.11 	appointed by the court as described by sections 253B.07, subdivision 3; 253B.092, 
121.12 	subdivision 8, paragraph (b); 253B.17, subdivision 3; 253B.18, subdivision 2; and 253B.19, 
121.13 	subdivisions 1 and 2, and only a physician or psychologist may conduct an assessment as 
121.14 	described by Minnesota Rules of Criminal Procedure, rule 20.

121.15 	Sec. 3. Minnesota Statutes 2018, section 253B.02, is amended by adding a subdivision to 
121.16 	read:
121.17 		Subd. 7a.Court examiner. "Court examiner" means a person appointed to serve the 
121.18 	court, and who is a physician or licensed psychologist who has a doctoral degree in 
121.19 	psychology.

121.20 	Sec. 4. Minnesota Statutes 2018, section 253B.02, subdivision 8, is amended to read:
121.21 		Subd. 8.Head of the treatment facility or program. "Head of the treatment facility
121.22 	or program" means the person who is charged with overall responsibility for the professional 
121.23 	program of care and treatment of the facility or the person's designee treatment facility, 
121.24 	state-operated treatment program, or community-based treatment program.

121.25 	Sec. 5. Minnesota Statutes 2018, section 253B.02, subdivision 9, is amended to read:
121.26 		Subd. 9.Health officer. "Health officer" means:
121.27 	(1) a licensed physician;
121.28 	(2) a licensed psychologist a mental health professional as defined in section 245.462, 
121.29 	subdivision 18, clauses (1) to (6);
121.30 	(3) a licensed social worker;
122.1 	(4) a registered nurse working in an emergency room of a hospital;
122.2 	(5) a psychiatric or public health nurse as defined in section 145A.02, subdivision 18;
122.3 	(6) (5) an advanced practice registered nurse (APRN) as defined in section 148.171, 
122.4 	subdivision 3;
122.5 	(7) (6) a mental health professional practitioner as defined in section 245.462, subdivision 
122.6 	17, providing mental health mobile crisis intervention services as described under section 
122.7 	256B.0624 with the consultation and approval by a mental health professional; or
122.8 	(8) (7) a formally designated member of a prepetition screening unit established by 
122.9 	section 253B.07.

122.10 	Sec. 6. Minnesota Statutes 2018, section 253B.02, subdivision 10, is amended to read:
122.11 		Subd. 10.Interested person. "Interested person" means:
122.12 	(1) an adult who has a specific interest in the patient or proposed patient, including but 
122.13 	not limited to, a public official, including a local welfare agency acting under section 
122.14 	626.5561, and; a health care or mental health provider or the provider's employee or agent;
122.15 	the legal guardian, spouse, parent, legal counsel, adult child, or next of kin,; or other person 
122.16 	designated by a patient or proposed patient; or
122.17 	(2) a health plan company that is providing coverage for a proposed patient.

122.18 	Sec. 7. Minnesota Statutes 2018, section 253B.02, subdivision 13, is amended to read:
122.19 		Subd. 13.Person who is mentally ill poses a risk of harm due to a mental illness. (a) 
122.20 	A "person who is mentally ill poses a risk of harm due to a mental illness" means any person 
122.21 	who has an organic disorder of the brain or a substantial psychiatric disorder of thought, 
122.22 	mood, perception, orientation, or memory which that grossly impairs judgment, behavior, 
122.23 	capacity to recognize reality, or to reason or understand, which that is manifested by instances 
122.24 	of grossly disturbed behavior or faulty perceptions and who, due to this impairment, poses 
122.25 	a substantial likelihood of physical harm to self or others as demonstrated by:
122.26 	(1) a failure to obtain necessary food, clothing, shelter, or medical care as a result of the 
122.27 	impairment;
122.28 	(2) an inability for reasons other than indigence to obtain necessary food, clothing, 
122.29 	shelter, or medical care as a result of the impairment and it is more probable than not that 
122.30 	the person will suffer substantial harm, significant psychiatric deterioration or debilitation, 
122.31 	or serious illness, unless appropriate treatment and services are provided;
123.1 	(3) a recent attempt or threat to physically harm self or others; or
123.2 	(4) recent and volitional conduct involving significant damage to substantial property.
123.3 	(b) A person is not mentally ill does not pose a risk of harm due to mental illness under 
123.4 	this section if the person's impairment is solely due to:
123.5 	(1) epilepsy;
123.6 	(2) developmental disability;
123.7 	(3) brief periods of intoxication caused by alcohol, drugs, or other mind-altering 
123.8 	substances; or
123.9 	(4) dependence upon or addiction to any alcohol, drugs, or other mind-altering substances.

123.10 	Sec. 8. Minnesota Statutes 2018, section 253B.02, subdivision 16, is amended to read:
123.11 		Subd. 16.Peace officer. "Peace officer" means a sheriff or deputy sheriff, or municipal 
123.12 	or other local police officer, or a State Patrol officer when engaged in the authorized duties 
123.13 	of office.

123.14 	Sec. 9. Minnesota Statutes 2018, section 253B.02, subdivision 17, is amended to read:
123.15 		Subd. 17.Person who is mentally ill has a mental illness and is dangerous to the 
123.16 	public. (a) A "person who is mentally illhas a mental illness and is dangerous to the public" 
123.17 	is a person:
123.18 	(1) who is mentally ill has an organic disorder of the brain or a substantial psychiatric 
123.19 	disorder of thought, mood, perception, orientation, or memory that grossly impairs judgment, 
123.20 	behavior, capacity to recognize reality, or to reason or understand, and is manifested by 
123.21 	instances of grossly disturbed behavior or faulty perceptions; and
123.22 	(2) who as a result of that mental illness impairment presents a clear danger to the safety 
123.23 	of others as demonstrated by the facts that (i) the person has engaged in an overt act causing 
123.24 	or attempting to cause serious physical harm to another and (ii) there is a substantial 
123.25 	likelihood that the person will engage in acts capable of inflicting serious physical harm on 
123.26 	another.
123.27 	(b) A person committed as a sexual psychopathic personality or sexually dangerous 
123.28 	person as defined in subdivisions 18a and 18b is subject to the provisions of this chapter 
123.29 	that apply to persons who are mentally ill and dangerous to the public.

124.1 	Sec. 10. Minnesota Statutes 2018, section 253B.02, subdivision 18, is amended to read:
124.2 		Subd. 18.Regional State-operated treatment center program. "Regional State-operated
124.3 	treatment center program" means any state-operated facility for persons who are mentally 
124.4 	ill, developmentally disabled, or chemically dependent under the direct administrative 
124.5 	authority of the commissioner means any state-operated program including community 
124.6 	behavioral health hospitals, crisis centers, residential facilities, outpatient services, and other 
124.7 	community-based services developed and operated by the state and under the commissioner's 
124.8 	control for a person who has a mental illness, developmental disability, or chemical 
124.9 	dependency.

124.10 	Sec. 11. Minnesota Statutes 2018, section 253B.02, subdivision 19, is amended to read:
124.11 		Subd. 19.Treatment facility. "Treatment facility" means a non-state-operated hospital, 
124.12 	community mental health center, or other treatment providerresidential treatment provider, 
124.13 	crisis residential withdrawal management center, or corporate foster care home qualified 
124.14 	to provide care and treatment for persons who are mentally ill, developmentally disabled, 
124.15 	or chemically dependent who have a mental illness, developmental disability, or chemical 
124.16 	dependency.

124.17 	Sec. 12. Minnesota Statutes 2018, section 253B.02, subdivision 21, is amended to read:
124.18 		Subd. 21.Pass. "Pass" means any authorized temporary, unsupervised absence from a 
124.19 	state-operated treatment facility program.

124.20 	Sec. 13. Minnesota Statutes 2018, section 253B.02, subdivision 22, is amended to read:
124.21 		Subd. 22.Pass plan. "Pass plan" means the part of a treatment plan for a person patient
124.22 	who has been committed as mentally ill and a person who has a mental illness and is
124.23 	dangerous to the public that specifies the terms and conditions under which the patient may 
124.24 	be released on a pass.

124.25 	Sec. 14. Minnesota Statutes 2018, section 253B.02, subdivision 23, is amended to read:
124.26 		Subd. 23.Pass-eligible status. "Pass-eligible status" means the status under which a 
124.27 	person patient committed as mentally ill and a person who has a mental illness and is
124.28 	dangerous to the public may be released on passes after approval of a pass plan by the head 
124.29 	of a state-operated treatment facility program.

125.1 	Sec. 15. Minnesota Statutes 2018, section 253B.03, subdivision 1, is amended to read:
125.2 		Subdivision 1.Restraints. (a) A patient has the right to be free from restraints. Restraints 
125.3 	shall not be applied to a patient in a treatment facility or state-operated treatment program 
125.4 	unless the head of the treatment facility, head of the state-operated treatment program, a 
125.5 	member of the medical staff, or a licensed peace officer who has custody of the patient 
125.6 	determines that they restraints are necessary for the safety of the patient or others.
125.7 	(b) Restraints shall not be applied to patients with developmental disabilities except as 
125.8 	permitted under section 245.825 and rules of the commissioner of human services. Consent 
125.9 	must be obtained from the person patient or person's patient's guardian except for emergency 
125.10 	procedures as permitted under rules of the commissioner adopted under section 245.825.
125.11 	(c) Each use of a restraint and reason for it shall be made part of the clinical record of 
125.12 	the patient under the signature of the head of the treatment facility.

125.13 	Sec. 16. Minnesota Statutes 2018, section 253B.03, subdivision 2, is amended to read:
125.14 		Subd. 2.Correspondence. A patient has the right to correspond freely without censorship. 
125.15 	The head of the treatment facility or head of the state-operated treatment program may 
125.16 	restrict correspondence if the patient's medical welfare requires this restriction. For patients
125.17 	a patient in regional a state-operated treatment centers program, that determination may be 
125.18 	reviewed by the commissioner. Any limitation imposed on the exercise of a patient's 
125.19 	correspondence rights and the reason for it shall be made a part of the clinical record of the 
125.20 	patient. Any communication which is not delivered to a patient shall be immediately returned 
125.21 	to the sender.

125.22 	Sec. 17. Minnesota Statutes 2018, section 253B.03, subdivision 3, is amended to read:
125.23 		Subd. 3.Visitors and phone calls. Subject to the general rules of the treatment facility
125.24 	or state-operated treatment program, a patient has the right to receive visitors and make 
125.25 	phone calls. The head of the treatment facility or head of the state-operated treatment program 
125.26 	may restrict visits and phone calls on determining that the medical welfare of the patient 
125.27 	requires it. Any limitation imposed on the exercise of the patient's visitation and phone call 
125.28 	rights and the reason for it shall be made a part of the clinical record of the patient.

125.29 	Sec. 18. Minnesota Statutes 2018, section 253B.03, subdivision 4a, is amended to read:
125.30 		Subd. 4a.Disclosure of patient's admission. Upon admission to a treatment facility or 
125.31 	state-operated treatment program where federal law prohibits unauthorized disclosure of 
125.32 	patient or resident identifying information to callers and visitors, the patient or resident, or 
126.1 	the legal guardian of the patient or resident, shall be given the opportunity to authorize 
126.2 	disclosure of the patient's or resident's presence in the facility to callers and visitors who 
126.3 	may seek to communicate with the patient or resident. To the extent possible, the legal 
126.4 	guardian of a patient or resident shall consider the opinions of the patient or resident regarding 
126.5 	the disclosure of the patient's or resident's presence in the facility.

126.6 	Sec. 19. Minnesota Statutes 2018, section 253B.03, subdivision 5, is amended to read:
126.7 		Subd. 5.Periodic assessment. A patient has the right to periodic medical assessment, 
126.8 	including assessment of the medical necessity of continuing care and, if the treatment facility, 
126.9 	state-operated treatment program, or community-based treatment program declines to provide 
126.10 	continuing care, the right to receive specific written reasons why continuing care is declined 
126.11 	at the time of the assessment. The treatment facility, state-operated treatment program, or 
126.12 	community-based treatment program shall assess the physical and mental condition of every 
126.13 	patient as frequently as necessary, but not less often than annually. If the patient refuses to 
126.14 	be examined, the treatment facility, state-operated treatment program, or community-based 
126.15 	treatment program shall document in the patient's chart its attempts to examine the patient. 
126.16 	If a person patient is committed as developmentally disabled for an indeterminate period 
126.17 	of time, the three-year judicial review must include the annual reviews for each year as 
126.18 	outlined in Minnesota Rules, part 9525.0075, subpart 6 regarding the patient's need for 
126.19 	continued commitment.

126.20 	Sec. 20. Minnesota Statutes 2018, section 253B.03, subdivision 6, is amended to read:
126.21 		Subd. 6.Consent for medical procedure. (a) A patient has the right to give prior consent 
126.22 	to any medical or surgical treatment, other than treatment for chemical dependency or 
126.23 	nonintrusive treatment for mental illness.
126.24 	(b) The following procedures shall be used to obtain consent for any treatment necessary 
126.25 	to preserve the life or health of any committed patient:
126.26 	(a) (1) the written, informed consent of a competent adult patient for the treatment is 
126.27 	sufficient.;
126.28 	(b) (2) if the patient is subject to guardianship which includes the provision of medical 
126.29 	care, the written, informed consent of the guardian for the treatment is sufficient.;
126.30 	(c) (3) if the head of the treatment facility or state-operated treatment program determines 
126.31 	that the patient is not competent to consent to the treatment and the patient has not been 
126.32 	adjudicated incompetent, written, informed consent for the surgery or medical treatment 
127.1 	shall be obtained from the person appointed the health care power of attorney, the patient's 
127.2 	agent under the health care directive, or the nearest proper relative. For this purpose, the 
127.3 	following persons are proper relatives, in the order listed: the patient's spouse, parent, adult 
127.4 	child, or adult sibling. If the nearest proper relatives cannot be located, refuse to consent to 
127.5 	the procedure, or are unable to consent, the head of the treatment facility or state-operated 
127.6 	treatment program or an interested person may petition the committing court for approval 
127.7 	for the treatment or may petition a court of competent jurisdiction for the appointment of a 
127.8 	guardian. The determination that the patient is not competent, and the reasons for the 
127.9 	determination, shall be documented in the patient's clinical record.;
127.10 	(d) (4) consent to treatment of any minor patient shall be secured in accordance with 
127.11 	sections 144.341 to 144.346. A minor 16 years of age or older may consent to hospitalization, 
127.12 	routine diagnostic evaluation, and emergency or short-term acute care.; and
127.13 	(e) (5) in the case of an emergency when the persons ordinarily qualified to give consent 
127.14 	cannot be located in sufficient time to address the emergency need, the head of the treatment 
127.15 	facility or state-operated treatment program may give consent.
127.16 	(c) No person who consents to treatment pursuant to the provisions of this subdivision 
127.17 	shall be civilly or criminally liable for the performance or the manner of performing the 
127.18 	treatment. No person shall be liable for performing treatment without consent if written, 
127.19 	informed consent was given pursuant to this subdivision. This provision shall not affect any 
127.20 	other liability which may result from the manner in which the treatment is performed.

127.21 	Sec. 21. Minnesota Statutes 2018, section 253B.03, subdivision 6b, is amended to read:
127.22 		Subd. 6b.Consent for mental health treatment. A competent person patient admitted 
127.23 	voluntarily to a treatment facility or state-operated treatment program may be subjected to 
127.24 	intrusive mental health treatment only with the person's patient's written informed consent. 
127.25 	For purposes of this section, "intrusive mental health treatment" means electroshock
127.26 	electroconvulsive therapy and neuroleptic medication and does not include treatment for a 
127.27 	developmental disability. An incompetent person patient who has prepared a directive under 
127.28 	subdivision 6d regarding intrusive mental health treatment with intrusive therapies must be 
127.29 	treated in accordance with this section, except in cases of emergencies.

127.30 	Sec. 22. Minnesota Statutes 2018, section 253B.03, subdivision 6d, is amended to read:
127.31 		Subd. 6d.Adult mental health treatment. (a) A competent adult patient may make a 
127.32 	declaration of preferences or instructions regarding intrusive mental health treatment. These 
127.33 	preferences or instructions may include, but are not limited to, consent to or refusal of these 
128.1 	treatments. A declaration of preferences or instructions may include a health care directive 
128.2 	under chapter 145C or a psychiatric directive.
128.3 	(b) A declaration may designate a proxy to make decisions about intrusive mental health 
128.4 	treatment. A proxy designated to make decisions about intrusive mental health treatments 
128.5 	and who agrees to serve as proxy may make decisions on behalf of a declarant consistent 
128.6 	with any desires the declarant expresses in the declaration.
128.7 	(c) A declaration is effective only if it is signed by the declarant and two witnesses. The 
128.8 	witnesses must include a statement that they believe the declarant understands the nature 
128.9 	and significance of the declaration. A declaration becomes operative when it is delivered 
128.10 	to the declarant's physician or other mental health treatment provider. The physician or 
128.11 	provider must comply with it the declaration to the fullest extent possible, consistent with 
128.12 	reasonable medical practice, the availability of treatments requested, and applicable law. 
128.13 	The physician or provider shall continue to obtain the declarant's informed consent to all 
128.14 	intrusive mental health treatment decisions if the declarant is capable of informed consent. 
128.15 	A treatment provider may must not require a person patient to make a declaration under 
128.16 	this subdivision as a condition of receiving services.
128.17 	(d) The physician or other provider shall make the declaration a part of the declarant's 
128.18 	medical record. If the physician or other provider is unwilling at any time to comply with 
128.19 	the declaration, the physician or provider must promptly notify the declarant and document 
128.20 	the notification in the declarant's medical record. If the declarant has been committed as a 
128.21 	patient under this chapter, the physician or provider may subject a declarant to intrusive 
128.22 	treatment in a manner contrary to the declarant's expressed wishes, only upon order of the 
128.23 	committing court. If the declarant is not a committed patient under this chapter, The physician 
128.24 	or provider may subject the declarant to intrusive treatment in a manner contrary to the 
128.25 	declarant's expressed wishes, only if the declarant is committed as mentally ill a person who 
128.26 	poses a risk of harm due to mental illness or mentally ill as a person who has a mental illness
128.27 	and is dangerous to the public and a court order authorizing the treatment has been issued
128.28 	or an emergency has been declared under section 253B.092, subdivision 3.
128.29 	(e) A declaration under this subdivision may be revoked in whole or in part at any time 
128.30 	and in any manner by the declarant if the declarant is competent at the time of revocation. 
128.31 	A revocation is effective when a competent declarant communicates the revocation to the 
128.32 	attending physician or other provider. The attending physician or other provider shall note 
128.33 	the revocation as part of the declarant's medical record.
129.1 	(f) A provider who administers intrusive mental health treatment according to and in 
129.2 	good faith reliance upon the validity of a declaration under this subdivision is held harmless 
129.3 	from any liability resulting from a subsequent finding of invalidity.
129.4 	(g) In addition to making a declaration under this subdivision, a competent adult may 
129.5 	delegate parental powers under section 524.5-211 or may nominate a guardian under sections 
129.6 	524.5-101 to 524.5-502.

129.7 	Sec. 23. Minnesota Statutes 2018, section 253B.03, subdivision 7, is amended to read:
129.8 		Subd. 7.Program Treatment plan. A person patient receiving services under this 
129.9 	chapter has the right to receive proper care and treatment, best adapted, according to 
129.10 	contemporary professional standards, to rendering further supervision unnecessary. The 
129.11 	treatment facility, state-operated treatment program, or community-based treatment program
129.12 	shall devise a written program treatment plan for each person patient which describes in 
129.13 	behavioral terms the case problems, the precise goals, including the expected period of time 
129.14 	for treatment, and the specific measures to be employed. Each plan shall be reviewed at 
129.15 	least quarterly to determine progress toward the goals, and to modify the program plan as 
129.16 	necessary.The development and review of treatment plans must be conducted as required 
129.17 	under the license or certification of the treatment facility, state-operated treatment program, 
129.18 	or community-based treatment program. If there are no review requirements under the 
129.19 	license or certification, the treatment plan must be reviewed quarterly. The program treatment
129.20 	plan shall be devised and reviewed with the designated agency and with the patient. The 
129.21 	clinical record shall reflect the program treatment plan review. If the designated agency or 
129.22 	the patient does not participate in the planning and review, the clinical record shall include 
129.23 	reasons for nonparticipation and the plans for future involvement. The commissioner shall 
129.24 	monitor the programtreatment plan and review process for regional centers state-operated 
129.25 	treatment programs to insureensure compliance with the provisions of this subdivision.

129.26 	Sec. 24. Minnesota Statutes 2018, section 253B.03, subdivision 10, is amended to read:
129.27 		Subd. 10.Notification. (a) All persons patients admitted or committed to a treatment 
129.28 	facility or state-operated treatment program, or temporarily confined under section 253B.045, 
129.29 	shall be notified in writing of their rights regarding hospitalization and other treatment at 
129.30 	the time of admission.
129.31 	(b) This notification must include:
129.32 	(1) patient rights specified in this section and section 144.651, including nursing home 
129.33 	discharge rights;
130.1 	(2) the right to obtain treatment and services voluntarily under this chapter;
130.2 	(3) the right to voluntary admission and release under section 253B.04;
130.3 	(4) rights in case of an emergency admission under section 253B.05 253B.051, including 
130.4 	the right to documentation in support of an emergency hold and the right to a summary 
130.5 	hearing before a judge if the patient believes an emergency hold is improper;
130.6 	(5) the right to request expedited review under section 62M.05 if additional days of 
130.7 	inpatient stay are denied;
130.8 	(6) the right to continuing benefits pending appeal and to an expedited administrative 
130.9 	hearing under section 256.045 if the patient is a recipient of medical assistance or 
130.10 	MinnesotaCare; and
130.11 	(7) the right to an external appeal process under section 62Q.73, including the right to 
130.12 	a second opinion.

130.13 	Sec. 25. Minnesota Statutes 2018, section 253B.04, subdivision 1, is amended to read:
130.14 		Subdivision 1.Voluntary admission and treatment. (a) Voluntary admission is preferred 
130.15 	over involuntary commitment and treatment. Any person 16 years of age or older may 
130.16 	request to be admitted to a treatment facility or state-operated treatment program as a 
130.17 	voluntary patient for observation, evaluation, diagnosis, care and treatment without making 
130.18 	formal written application. Any person under the age of 16 years may be admitted as a 
130.19 	patient with the consent of a parent or legal guardian if it is determined by independent 
130.20 	examination that there is reasonable evidence that (1) the proposed patient has a mental 
130.21 	illness, or is developmentally disabled developmental disability, or chemically dependent
130.22 	chemical dependency; and (2) the proposed patient is suitable for treatment. The head of 
130.23 	the treatment facility or head of the state-operated treatment program shall not arbitrarily 
130.24 	refuse any person seeking admission as a voluntary patient. In making decisions regarding 
130.25 	admissions, the treatment facility or state-operated treatment program shall use clinical 
130.26 	admission criteria consistent with the current applicable inpatient admission standards 
130.27 	established by professional organizations including the American Psychiatric Association 
130.28 	or, the American Academy of Child and Adolescent Psychiatry, the Joint Commission, and 
130.29 	the American Society of Addiction Medicine. These criteria must be no more restrictive 
130.30 	than, and must be consistent with, the requirements of section 62Q.53. The treatment facility 
130.31 	or head of the state-operated treatment program may not refuse to admit a person voluntarily 
130.32 	solely because the person does not meet the criteria for involuntary holds under section 
131.1 	253B.05 253B.051 or the definition of a person who poses a risk of harm due to mental 
131.2 	illness under section 253B.02, subdivision 13.
131.3 	(b) In addition to the consent provisions of paragraph (a), a person who is 16 or 17 years 
131.4 	of age who refuses to consent personally to admission may be admitted as a patient for 
131.5 	mental illness or chemical dependency treatment with the consent of a parent or legal 
131.6 	guardian if it is determined by an independent examination that there is reasonable evidence 
131.7 	that the proposed patient is chemically dependent or has a mental illness and is suitable for 
131.8 	treatment. The person conducting the examination shall notify the proposed patient and the 
131.9 	parent or legal guardian of this determination.
131.10 	(c) A person who is voluntarily participating in treatment for a mental illness is not 
131.11 	subject to civil commitment under this chapter if the person:
131.12 	(1) has given informed consent or, if lacking capacity, is a person for whom legally valid 
131.13 	substitute consent has been given; and
131.14 	(2) is participating in a medically appropriate course of treatment, including clinically 
131.15 	appropriate and lawful use of neuroleptic medication and electroconvulsive therapy. The 
131.16 	limitation on commitment in this paragraph does not apply if, based on clinical assessment, 
131.17 	the court finds that it is unlikely that the person patient will remain in and cooperate with 
131.18 	a medically appropriate course of treatment absent commitment and the standards for 
131.19 	commitment are otherwise met. This paragraph does not apply to a person for whom 
131.20 	commitment proceedings are initiated pursuant to rule 20.01 or 20.02 of the Rules of Criminal 
131.21 	Procedure, or a person found by the court to meet the requirements under section 253B.02, 
131.22 	subdivision 17.
131.23 	(d) Legally valid substitute consent may be provided by a proxy under a health care 
131.24 	directive, a guardian or conservator with authority to consent to mental health treatment, 
131.25 	or consent to admission under subdivision 1a or 1b.

131.26 	Sec. 26. Minnesota Statutes 2018, section 253B.04, subdivision 1a, is amended to read:
131.27 		Subd. 1a.Voluntary treatment or admission for persons with a mental illness. (a) 
131.28 	A person with a mental illness may seek or voluntarily agree to accept treatment or admission 
131.29 	to a state-operated treatment program or treatment facility. If the mental health provider 
131.30 	determines that the person lacks the capacity to give informed consent for the treatment or 
131.31 	admission, and in the absence of a health care power of attorney directive or health care 
131.32 	power of attorney that authorizes consent, the designated agency or its designee may give 
132.1 	informed consent for mental health treatment or admission to a treatment facility or 
132.2 	state-operated treatment program on behalf of the person.
132.3 	(b) The designated agency shall apply the following criteria in determining the person's 
132.4 	ability to give informed consent:
132.5 	(1) whether the person demonstrates an awareness of the person's illness, and the reasons 
132.6 	for treatment, its risks, benefits and alternatives, and the possible consequences of refusing 
132.7 	treatment; and
132.8 	(2) whether the person communicates verbally or nonverbally a clear choice concerning 
132.9 	treatment that is a reasoned one, not based on delusion, even though it may not be in the 
132.10 	person's best interests.
132.11 	(c) The basis for the designated agency's decision that the person lacks the capacity to 
132.12 	give informed consent for treatment or admission, and that the patient has voluntarily 
132.13 	accepted treatment or admission, must be documented in writing.
132.14 	(d) A mental health provider treatment facility or state-operated treatment program that 
132.15 	provides treatment in reliance on the written consent given by the designated agency under 
132.16 	this subdivision or by a substitute decision maker appointed by the court is not civilly or 
132.17 	criminally liable for performing treatment without consent. This paragraph does not affect 
132.18 	any other liability that may result from the manner in which the treatment is performed.
132.19 	(e) A person patient who receives treatment or is admitted to a treatment facility or 
132.20 	state-operated treatment program under this subdivision or subdivision 1b has the right to 
132.21 	refuse treatment at any time or to be released from a treatment facility or state-operated 
132.22 	treatment program as provided under subdivision 2. The person patient or any interested 
132.23 	person acting on the person's patient's behalf may seek court review within five days for a 
132.24 	determination of whether the person's patient's agreement to accept treatment or admission 
132.25 	is voluntary. At the time a person patient agrees to treatment or admission to a treatment 
132.26 	facility or state-operated treatment program under this subdivision, the designated agency 
132.27 	or its designee shall inform the person patient in writing of the person's patient's rights under 
132.28 	this paragraph.
132.29 	(f) This subdivision does not authorize the administration of neuroleptic medications. 
132.30 	Neuroleptic medications may be administered only as provided in section 253B.092.

132.31 	Sec. 27. Minnesota Statutes 2018, section 253B.04, subdivision 2, is amended to read:
132.32 		Subd. 2.Release. Every patient admitted for mental illness or developmental disability 
132.33 	under this section shall be informed in writing at the time of admission that the patient has 
133.1 	a right to leave the treatment facility or state-operated treatment program within 12 hours 
133.2 	of making a request, unless held under another provision of this chapter. Every patient 
133.3 	admitted for chemical dependency under this section shall be informed in writing at the 
133.4 	time of admission that the patient has a right to leave the treatment facility or state-operated 
133.5 	treatment program within 72 hours, exclusive of Saturdays, Sundays, and legal holidays, 
133.6 	of making a request, unless held under another provision of this chapter. The request shall 
133.7 	be submitted in writing to the head of the treatment facility or state-operated treatment 
133.8 	program or the person's designee.

133.9 	Sec. 28. [253B.041] SERVICES FOR ENGAGEMENT IN TREATMENT.
133.10 		Subdivision 1.Eligibility. (a) The purpose of engagement services is to avoid the need 
133.11 	for commitment and to enable the proposed patient to voluntarily engage in needed treatment. 
133.12 	An interested person may apply to the county where a proposed patient resides to request 
133.13 	engagement services.
133.14 	(b) To be eligible for engagement services, the proposed patient must be at least 18 years 
133.15 	of age, have a mental illness, and either:
133.16 	(1) be exhibiting symptoms of serious mental illness including hallucinations, mania, 
133.17 	delusional thoughts, or be unable to obtain necessary food, clothing, shelter, medical care, 
133.18 	or provide necessary hygiene due to the patient's mental illness; or
133.19 	(2) have a history of failing to adhere to treatment for mental illness, in that:
133.20 	(i) the proposed patient's mental illness has been a substantial factor in necessitating 
133.21 	hospitalization, or incarceration in a state or local correctional facility, not including any 
133.22 	period during which the person was hospitalized or incarcerated immediately preceding 
133.23 	filing the application for engagement; or
133.24 	(ii) the proposed patient is exhibiting symptoms or behavior that may lead to 
133.25 	hospitalization, incarceration, or court-ordered treatment.
133.26 		Subd. 2.Administration. (a) Upon receipt of a request for engagement services, the 
133.27 	county's prepetition screening team shall conduct an investigation to determine whether the 
133.28 	proposed patient is eligible. In making this determination, the screening team shall seek any 
133.29 	relevant information from an interested person.
133.30 	(b) If the screening team determines that the proposed patient is eligible, engagement 
133.31 	services must begin and include, but are not limited to:
134.1 	(1) assertive attempts to engage the patient in voluntary treatment for mental illness for 
134.2 	at least 90 days. Engagement services must be person-centered and continue even if the 
134.3 	patient is an inmate in a non-state-operated correctional facility;
134.4 	(2) efforts to engage the patient's existing systems of support, including interested persons, 
134.5 	unless the engagement provider determines that involvement is not helpful to the patient. 
134.6 	This includes education on restricting means of harm, suicide prevention, and engagement; 
134.7 	and
134.8 	(3) collaboration with the patient to meet immediate needs including access to housing, 
134.9 	food, income, disability verification, medications, and treatment for medical conditions.
134.10 	(c) Engagement services regarding potential treatment options must take into account 
134.11 	the patient's preferences for services and supports. The county may offer engagement services 
134.12 	through the designated agency or another agency under contract. Engagement services staff 
134.13 	must have training in person-centered care. Engagement services staff may include but are 
134.14 	not limited to mobile crisis teams under section 245.462, certified peer specialists under 
134.15 	section 256B.0615, community-based treatment programs, and homeless outreach workers.
134.16 	(d) If the patient voluntarily consents to receive mental health treatment, the engagement 
134.17 	services staff must facilitate the referral to an appropriate mental health treatment provider 
134.18 	including support obtaining health insurance if the proposed patient is currently or may 
134.19 	become uninsured. If the proposed patient initially consents to treatment, but fails to initiate 
134.20 	or continue treatment, the engagement services team must continue outreach efforts to the 
134.21 	patient.
134.22 		Subd. 3.Commitment. Engagement services for a patient to seek treatment may be 
134.23 	stopped if the proposed patient is in need of commitment and satisfies the commitment 
134.24 	criteria under section 253B.09, subdivision 1. In such a case, the engagement services team 
134.25 	must immediately notify the designated agency, initiate the prepetition screening process 
134.26 	under section 253B.07, or seek an emergency hold if necessary to ensure the safety of the 
134.27 	patient or others.
134.28 		Subd. 4.Evaluation. Counties may, but are not required to, provide engagement services. 
134.29 	The commissioner may conduct a pilot project evaluating the impact of engagement services 
134.30 	in decreasing commitments, increasing engagement in treatment, and other measures.

134.31 	Sec. 29. Minnesota Statutes 2018, section 253B.045, subdivision 2, is amended to read:
134.32 		Subd. 2.Facilities. (a) Each county or a group of counties shall maintain or provide by 
134.33 	contract a facility for confinement of persons held temporarily for observation, evaluation, 
135.1 	diagnosis, treatment, and care. When the temporary confinement is provided at a regional
135.2 	state-operated treatment center program, the commissioner shall charge the county of 
135.3 	financial responsibility for the costs of confinement of persons patients hospitalized under 
135.4 	section 253B.05, subdivisions 1 and 2, sections 253B.051 and section253B.07, subdivision 
135.5 	2b, except that the commissioner shall bill the responsible health plan first. Any charges 
135.6 	not covered, including co-pays and deductibles shall be the responsibility of the county. If 
135.7 	the person patient has health plan coverage, but the hospitalization does not meet the criteria 
135.8 	in subdivision 6 or section 62M.07, 62Q.53, or 62Q.535, the county is responsible. When 
135.9 	a person is temporarily confined in a Department of Corrections facility solely under 
135.10 	subdivision 1a, and not based on any separate correctional authority:
135.11 	(1) the commissioner of corrections may charge the county of financial responsibility 
135.12 	for the costs of confinement; and
135.13 	(2) the Department of Human Services shall use existing appropriations to fund all 
135.14 	remaining nonconfinement costs. The funds received by the commissioner for the 
135.15 	confinement and nonconfinement costs are appropriated to the department for these purposes.
135.16 	(b) For the purposes of this subdivision, "county of financial responsibility" has the 
135.17 	meaning specified in section 253B.02, subdivision 4c, or, if the person patient has no 
135.18 	residence in this state, the county which initiated the confinement. The charge for 
135.19 	confinement in a facility operated by the commissioner of human services shall be based 
135.20 	on the commissioner's determination of the cost of care pursuant to section 246.50, 
135.21 	subdivision 5. When there is a dispute as to which county is the county of financial 
135.22 	responsibility, the county charged for the costs of confinement shall pay for them pending 
135.23 	final determination of the dispute over financial responsibility.

135.24 	Sec. 30. Minnesota Statutes 2018, section 253B.045, subdivision 3, is amended to read:
135.25 		Subd. 3.Cost of care. Notwithstanding subdivision 2, a county shall be responsible for 
135.26 	the cost of care as specified under section 246.54 for persons a patient hospitalized at a 
135.27 	regionalstate-operated treatment center program in accordance with section 253B.09 and 
135.28 	the person's patient's legal status has been changed to a court hold under section 253B.07, 
135.29 	subdivision 2b, pending a judicial determination regarding continued commitment pursuant 
135.30 	to sections 253B.12 and 253B.13.

135.31 	Sec. 31. Minnesota Statutes 2018, section 253B.045, subdivision 5, is amended to read:
135.32 		Subd. 5.Health plan company; definition. For purposes of this section, "health plan 
135.33 	company" has the meaning given it in section 62Q.01, subdivision 4, and also includes a 
136.1 	demonstration provider as defined in section 256B.69, subdivision 2, paragraph (b),; and a 
136.2 	county or group of counties participating in county-based purchasing according to section 
136.3 	256B.692, and a children's mental health collaborative under contract to provide medical 
136.4 	assistance for individuals enrolled in the prepaid medical assistance and MinnesotaCare 
136.5 	programs according to sections 245.493 to 245.495.

136.6 	Sec. 32. Minnesota Statutes 2018, section 253B.045, subdivision 6, is amended to read:
136.7 		Subd. 6.Coverage. (a) For purposes of this section, "mental health services" means all 
136.8 	covered services that are intended to treat or ameliorate an emotional, behavioral, or 
136.9 	psychiatric condition and that are covered by the policy, contract, or certificate of coverage 
136.10 	of the enrollee's health plan company or by law.
136.11 	(b) All health plan companies that provide coverage for mental health services must 
136.12 	cover or provide mental health services ordered by a court of competent jurisdiction under 
136.13 	a court order that is issued on the basis of a behavioral care evaluation performed by a 
136.14 	licensed psychiatrist or a doctoral level licensed psychologist, which includes a diagnosis 
136.15 	and an individual treatment plan for care in the most appropriate, least restrictive 
136.16 	environment. The health plan company must be given a copy of the court order and the 
136.17 	behavioral care evaluation. The health plan company shall be financially liable for the 
136.18 	evaluation if performed by a participating provider of the health plan company and shall be 
136.19 	financially liable for the care included in the court-ordered individual treatment plan if the 
136.20 	care is covered by the health plan company and ordered to be provided by a participating 
136.21 	provider or another provider as required by rule or law. This court-ordered coverage must 
136.22 	not be subject to a separate medical necessity determination by a health plan company under 
136.23 	its utilization procedures.

136.24 	Sec. 33. [253B.051] EMERGENCY ADMISSION.
136.25 		Subdivision 1.Peace officer or health officer authority. (a) If a peace officer or health 
136.26 	officer has reason to believe, either through direct observation of the person's behavior or 
136.27 	upon reliable information of the person's recent behavior and, if available, knowledge or 
136.28 	reliable information concerning the person's past behavior or treatment that the person:
136.29 	(1) has a mental illness or developmental disability and is in danger of harming self or 
136.30 	others if the officer does not immediately detain the patient, the peace officer or health 
136.31 	officer may take the person into custody and transport the person to an examiner or a 
136.32 	treatment facility, state-operated treatment program, or community-based treatment program;
137.1 	(2) is chemically dependent or intoxicated in public and in danger of harming self or 
137.2 	others if the officer does not immediately detain the patient, the peace officer or health 
137.3 	officer may take the person into custody and transport the person to a treatment facility, 
137.4 	state-operated treatment program, or community-based treatment program; or
137.5 	(3) is chemically dependent or intoxicated in public and not in danger of harming self, 
137.6 	others, or property, the peace officer or health officer may take the person into custody and 
137.7 	transport the person to the person's home.
137.8 	(b) An examiner's written statement or a health officer's written statement in compliance 
137.9 	with the requirements of subdivision 2 is sufficient authority for a peace officer or health 
137.10 	officer to take the person into custody and transport the person to a treatment facility, 
137.11 	state-operated treatment program, or community-based treatment program.
137.12 	(c) A peace officer or health officer who takes a person into custody and transports the 
137.13 	person to a treatment facility, state-operated treatment program, or community-based 
137.14 	treatment program under this subdivision shall make written application for admission of 
137.15 	the person containing:
137.16 	(1) the officer's statement specifying the reasons and circumstances under which the 
137.17 	person was taken into custody;
137.18 	(2) identifying information on specific individuals to the extent practicable, if danger to 
137.19 	those individuals is a basis for the emergency hold; and
137.20 	(3) the officer's name, the agency that employs the officer, and the telephone number or 
137.21 	other contact information for purposes of receiving notice under subdivision 3.
137.22 	(d) A copy of the examiner's written statement and officer's application shall be made 
137.23 	available to the person taken into custody.
137.24 	(e) The officer may provide the transportation personally or may arrange to have the 
137.25 	person transported by a suitable medical or mental health transportation provider. As far as 
137.26 	practicable, a peace officer who provides transportation for a person placed in a treatment 
137.27 	facility, state-operated treatment program, or community-based treatment program under 
137.28 	this subdivision must not be in uniform and must not use a vehicle visibly marked as a law 
137.29 	enforcement vehicle.
137.30 		Subd. 2.Emergency hold. (a) A treatment facility, state-operated treatment program, 
137.31 	or community-based treatment program, other than a facility operated by the Minnesota sex 
137.32 	offender program, may admit or hold a patient, including a patient transported under 
137.33 	subdivision 1, for emergency care and treatment if the head of the facility or program 
138.1 	consents to holding the patient and an examiner provides a written statement in support of 
138.2 	holding the patient.
138.3 	(b) The written statement must indicate that:
138.4 	(1) the examiner examined the patient not more than 15 days prior to admission;
138.5 	(2) the examiner interviewed the patient, or if not, the specific reasons why the examiner 
138.6 	did not interview the patient;
138.7 	(3) the examiner has the opinion that the patient has a mental illness or developmental 
138.8 	disability, or is chemically dependent and is in danger of causing harm to self or others if 
138.9 	a facility or program does not immediately detain the patient. The statement must include 
138.10 	observations of the patient's behavior and avoid conclusory language. The statement must 
138.11 	be specific enough to provide an adequate record for review. If danger to specific individuals 
138.12 	is a basis for the emergency hold, the statement must identify those individuals to the extent 
138.13 	practicable; and
138.14 	(4) the facility or program cannot obtain a court order in time to prevent the anticipated 
138.15 	injury.
138.16 	(c) Prior to an examiner writing a statement, if another person brought the patient to the 
138.17 	treatment facility, state-operated treatment program, or community-based treatment program, 
138.18 	the examiner shall make a good-faith effort to obtain information from that person, which 
138.19 	the examiner must consider in deciding whether to place the patient on an emergency hold. 
138.20 	To the extent available, the statement must include direct observations of the patient's 
138.21 	behaviors, reliable knowledge of the patient's recent and past behavior, and information 
138.22 	regarding the patient's psychiatric history, past treatment, and current mental health providers. 
138.23 	The examiner shall also inquire about health care directives under chapter 145C and advance 
138.24 	psychiatric directives under section 253B.03, subdivision 6d.
138.25 	(d) The facility or program must give a copy of the examiner's written statement to the 
138.26 	patient immediately upon initiating the emergency hold. The treatment facility, state-operated 
138.27 	treatment program, or community-based treatment program shall maintain a copy of the 
138.28 	examiner's written statement. The program or facility must inform the patient in writing of 
138.29 	the right to (1) leave after 72 hours, (2) have a medical examination within 48 hours, and 
138.30 	(3) request a change to voluntary status. The facility or program shall assist the patient in 
138.31 	exercising the rights granted in this subdivision.
138.32 	(e) The facility or program must not allow the patient nor require the patient's consent 
138.33 	to participate in a clinical drug trial during an emergency admission or hold under this 
139.1 	subdivision. If a patient gives consent to participate in a drug trial during a period of an 
139.2 	emergency admission or hold, it is void and unenforceable. This paragraph does not prohibit 
139.3 	a patient from continuing participation in a clinical drug trial if the patient was participating 
139.4 	in the clinical drug trial at the time of the emergency admission or hold.
139.5 		Subd. 3.Duration of hold, release procedures, and change of status. (a) If a peace 
139.6 	officer or health officer transports a person to a treatment facility, state-operated treatment 
139.7 	program, or community-based treatment program under subdivision 1, an examiner at the 
139.8 	facility or program must examine the patient and make a determination about the need for 
139.9 	an emergency hold as soon as possible and within 12 hours of the person's arrival. The peace 
139.10 	officer or health officer hold ends upon whichever occurs first: (1) initiation of an emergency 
139.11 	hold on the person under subdivision 2; (2) the person's voluntary admission; (3) the 
139.12 	examiner's decision not to admit the person; or (4) 12 hours after the person's arrival.
139.13 	(b) Under this section, the facility or program may hold a patient up to 72 hours, exclusive 
139.14 	of Saturdays, Sundays, and legal holidays, after the examiner signs the written statement 
139.15 	for an emergency hold of the patient. The facility or program must release a patient when 
139.16 	the emergency hold expires unless the facility or program obtains a court order to hold the 
139.17 	patient. The facility or program may not place the patient on a consecutive emergency hold 
139.18 	under this section.
139.19 	(c) If the interested person files a petition to civilly commit the patient, the court may 
139.20 	issue a judicial hold order pursuant to section 253B.07, subdivision 2b.
139.21 	(d) During the 72-hour hold, a court must not release a patient under this section unless 
139.22 	the court received a written petition for the patient's release and the court has held a summary 
139.23 	hearing regarding the patient's release.
139.24 	(e) The written petition for the patient's release must include the patient's name, the basis 
139.25 	for the hold, the location of the hold, and a statement explaining why the hold is improper. 
139.26 	The petition must also include copies of any written documentation under subdivision 1 or 
139.27 	2 that support the hold, unless the facility or program holding the patient refuses to supply 
139.28 	the documentation. Upon receipt of a petition, the court must comply with the following:
139.29 	(1) the court must hold the hearing as soon as practicable and the court may conduct the 
139.30 	hearing by telephone conference call, interactive video conference, or similar method by 
139.31 	which the participants are able to simultaneously hear each other;
139.32 	(2) before deciding to release the patient, the court shall make every reasonable effort 
139.33 	to provide notice of the proposed release and reasonable opportunity to be heard to:
140.1 	(i) any specific individuals identified in a statement under subdivision 1 or 2 or individuals 
140.2 	identified in the record who might be endangered if the person is not held;
140.3 	(ii) the examiner whose written statement was the basis for the hold under subdivision 
140.4 	2; and
140.5 	(iii) the peace officer or health officer who applied for a hold under subdivision 1; and
140.6 	(3) if the court decides to release the patient, the court shall direct the patient's release 
140.7 	and shall issue written findings supporting the decision. The facility or program must not 
140.8 	delay the patient's release pending the written order.
140.9 	(f) Notwithstanding section 144.293, subdivisions 2 and 4, if a treatment facility, 
140.10 	state-operated treatment program, or community-based treatment program releases or 
140.11 	discharges a patient during the 72-hour hold; the examiner refuses to admit the patient; or 
140.12 	the patient leaves without the consent of the treating health care provider, the head of the 
140.13 	treatment facility, state-operated treatment program, or community-based treatment program 
140.14 	shall immediately notify the agency that employs the peace officer or health officer who 
140.15 	initiated the transport hold. This paragraph does not apply to the extent that the notice would 
140.16 	violate federal law governing the confidentiality of alcohol and drug abuse patient records 
140.17 	under Code of Federal Regulations, title 42, part 2.
140.18 	(g) If a patient is intoxicated in public and a facility or program holds the patient under 
140.19 	this section for detoxification, a treatment facility, state-operated treatment program, or 
140.20 	community-based treatment program may release the patient without providing notice under 
140.21 	paragraph (f) as soon as the treatment facility, state-operated treatment program, or 
140.22 	community-based treatment program determines that the person is no longer in danger of 
140.23 	causing harm to self or others. The facility or program must provide notice to the peace 
140.24 	officer or health officer who transported the person, or to the appropriate law enforcement 
140.25 	agency, if the officer or agency requests notification.
140.26 	(h) A treatment facility or state-operated treatment program must change a patient's 
140.27 	status to voluntary status as provided in section 253B.04 upon the patient's request in writing 
140.28 	if the head of the facility or program consents to the change.

140.29 	Sec. 34. Minnesota Statutes 2018, section 253B.06, subdivision 1, is amended to read:
140.30 		Subdivision 1.Persons who are mentally ill or developmentally disabled with mental 
140.31 	illness or developmental disability. A physician must examine every patient hospitalized 
140.32 	as mentally ill or developmentally disabled due to mental illness or developmental disability
140.33 	pursuant to section 253B.04 or 253B.05 must be examined by a physician 253B.051 as soon 
141.1 	as possible but no more than 48 hours following the patient's admission. The physician shall
141.2 	must be knowledgeable and trained in the diagnosis of diagnosing the alleged disability 
141.3 	related to the need for patient's mental illness or developmental disability, forming the basis 
141.4 	of the patient's admission as a person who is mentally ill or developmentally disabled.

141.5 	Sec. 35. Minnesota Statutes 2018, section 253B.06, subdivision 2, is amended to read:
141.6 		Subd. 2.Chemically dependent persons. Patients hospitalized A treatment facility, 
141.7 	state-operated treatment program, or community-based treatment program must examine a 
141.8 	patient hospitalized as chemically dependent pursuant to section 253B.04 or 253B.05 shall 
141.9 	also be examined253B.051 within 48 hours of admission. At a minimum, the examination 
141.10 	shall consist of a physical evaluation by facility staffthe facility or program must physically 
141.11 	examine the patient according to procedures established by a physician, and an evaluation 
141.12 	by staff examining the patient must be knowledgeable and trained in the diagnosis of the 
141.13 	alleged disability related to the need for forming the basis of the patient's admission as a 
141.14 	chemically dependent person.

141.15 	Sec. 36. Minnesota Statutes 2018, section 253B.06, subdivision 3, is amended to read:
141.16 		Subd. 3.Discharge. At the end of a 48-hour period, any the facility or program shall 
141.17 	discharge a patient admitted pursuant to section 253B.05 shall be discharged253B.051 if 
141.18 	an examination has not been held or if the examiner or evaluation staff person fails to notify 
141.19 	the head of the treatment facility or program in writing that in the examiner's or staff person's 
141.20 	opinion the patient is apparently in need of care, treatment, and evaluation as a mentally ill, 
141.21 	developmentally disabled, or chemically dependent person who has a mental illness, 
141.22 	developmental disability, or chemical dependency.

141.23 	Sec. 37. Minnesota Statutes 2018, section 253B.07, subdivision 1, is amended to read:
141.24 		Subdivision 1.Prepetition screening. (a) Prior to filing a petition for commitment of 
141.25 	or early intervention for a proposed patient, an interested person shall apply to the designated 
141.26 	agency in the county of financial responsibility or the county where the proposed patient is 
141.27 	present for conduct of a preliminary investigation as provided in section 253B.23, subdivision 
141.28 	1b, except when the proposed patient has been acquitted of a crime under section 611.026
141.29 	and the county attorney is required to file a petition for commitment. The designated agency 
141.30 	shall appoint a screening team to conduct an investigation. The petitioner may not be a 
141.31 	member of the screening team. The investigation must include:
142.1 	(1) a personal an interview with the proposed patient and other individuals who appear 
142.2 	to have knowledge of the condition of the proposed patient, if practicable. In-person 
142.3 	interviews with the proposed patient are preferred. If the proposed patient is not interviewed, 
142.4 	specific reasons must be documented;
142.5 	(2) identification and investigation of specific alleged conduct which is the basis for 
142.6 	application;
142.7 	(3) identification, exploration, and listing of the specific reasons for rejecting or 
142.8 	recommending alternatives to involuntary placement;
142.9 	(4) in the case of a commitment based on mental illness, the following information, if 
142.10 	it is known or available, that may be relevant to the administration of neuroleptic medications, 
142.11 	including the existence of a declaration under section 253B.03, subdivision 6d, or a health 
142.12 	care directive under chapter 145C or a guardian, conservator, proxy, or agent with authority 
142.13 	to make health care decisions for the proposed patient; information regarding the capacity 
142.14 	of the proposed patient to make decisions regarding administration of neuroleptic medication; 
142.15 	and whether the proposed patient is likely to consent or refuse consent to administration of 
142.16 	the medication;
142.17 	(5) seeking input from the proposed patient's health plan company to provide the court 
142.18 	with information about services the enrollee needs and the least restrictive alternatives the 
142.19 	patient's relevant treatment history and current treatment providers; and
142.20 	(6) in the case of a commitment based on mental illness, information listed in clause (4) 
142.21 	for other purposes relevant to treatment.
142.22 	(b) In conducting the investigation required by this subdivision, the screening team shall 
142.23 	have access to all relevant medical records of proposed patients currently in treatment 
142.24 	facilities, state-operated treatment programs, or community-based treatment programs. The 
142.25 	interviewer shall inform the proposed patient that any information provided by the proposed 
142.26 	patient may be included in the prepetition screening report and may be considered in the 
142.27 	commitment proceedings. Data collected pursuant to this clause shall be considered private 
142.28 	data on individuals. The prepetition screening report is not admissible as evidence except 
142.29 	by agreement of counsel or as permitted by this chapter or the rules of court and is not 
142.30 	admissible in any court proceedings unrelated to the commitment proceedings.
142.31 	(c) The prepetition screening team shall provide a notice, written in easily understood 
142.32 	language, to the proposed patient, the petitioner, persons named in a declaration under 
142.33 	chapter 145C or section 253B.03, subdivision 6d, and, with the proposed patient's consent, 
142.34 	other interested parties. The team shall ask the patient if the patient wants the notice read 
143.1 	and shall read the notice to the patient upon request. The notice must contain information 
143.2 	regarding the process, purpose, and legal effects of civil commitment and early intervention. 
143.3 	The notice must inform the proposed patient that:
143.4 	(1) if a petition is filed, the patient has certain rights, including the right to a 
143.5 	court-appointed attorney, the right to request a second court examiner, the right to attend 
143.6 	hearings, and the right to oppose the proceeding and to present and contest evidence; and
143.7 	(2) if the proposed patient is committed to a state regional treatment center or group 
143.8 	home state-operated treatment program, the patient may be billed for the cost of care and 
143.9 	the state has the right to make a claim against the patient's estate for this cost.
143.10 	The ombudsman for mental health and developmental disabilities shall develop a form 
143.11 	for the notice which includes the requirements of this paragraph.
143.12 	(d) When the prepetition screening team recommends commitment, a written report 
143.13 	shall be sent to the county attorney for the county in which the petition is to be filed. The 
143.14 	statement of facts contained in the written report must meet the requirements of subdivision 
143.15 	2, paragraph (b).
143.16 	(e) The prepetition screening team shall refuse to support a petition if the investigation 
143.17 	does not disclose evidence sufficient to support commitment. Notice of the prepetition 
143.18 	screening team's decision shall be provided to the prospective petitioner, any specific 
143.19 	individuals identified in the examiner's statement, and to the proposed patient.
143.20 	(f) If the interested person wishes to proceed with a petition contrary to the 
143.21 	recommendation of the prepetition screening team, application may be made directly to the 
143.22 	county attorney, who shall determine whether or not to proceed with the petition. Notice of 
143.23 	the county attorney's determination shall be provided to the interested party.
143.24 	(g) If the proposed patient has been acquitted of a crime under section 611.026, the 
143.25 	county attorney shall apply to the designated county agency in the county in which the 
143.26 	acquittal took place for a preliminary investigation unless substantially the same information 
143.27 	relevant to the proposed patient's current mental condition, as could be obtained by a 
143.28 	preliminary investigation, is part of the court record in the criminal proceeding or is contained 
143.29 	in the report of a mental examination conducted in connection with the criminal proceeding. 
143.30 	If a court petitions for commitment pursuant to the Rules of Criminal or Juvenile Procedure 
143.31 	or a county attorney petitions pursuant to acquittal of a criminal charge under section 611.026, 
143.32 	the prepetition investigation, if required by this section, shall be completed within seven 
143.33 	days after the filing of the petition.

144.1 	Sec. 38. Minnesota Statutes 2018, section 253B.07, subdivision 2, is amended to read:
144.2 		Subd. 2.The petition. (a) Any interested person, except a member of the prepetition 
144.3 	screening team, may file a petition for commitment in the district court of the county of 
144.4 	financial responsibility or the county where the proposed patient is present. If the head of 
144.5 	the treatment facility, state-operated treatment program, or community-based treatment 
144.6 	program believes that commitment is required and no petition has been filed, the head of 
144.7 	the treatment facility that person shall petition for the commitment of the person proposed 
144.8 	patient.
144.9 	(b) The petition shall set forth the name and address of the proposed patient, the name 
144.10 	and address of the patient's nearest relatives, and the reasons for the petition. The petition 
144.11 	must contain factual descriptions of the proposed patient's recent behavior, including a 
144.12 	description of the behavior, where it occurred, and the time period over which it occurred. 
144.13 	Each factual allegation must be supported by observations of witnesses named in the petition. 
144.14 	Petitions shall be stated in behavioral terms and shall not contain judgmental or conclusory 
144.15 	statements.
144.16 	(c) The petition shall be accompanied by a written statement by an examiner stating that 
144.17 	the examiner has examined the proposed patient within the 15 days preceding the filing of 
144.18 	the petition and is of the opinion that the proposed patient is suffering has a designated 
144.19 	disability and should be committed to a treatment facility, state-operated treatment program, 
144.20 	or community-based treatment program. The statement shall include the reasons for the 
144.21 	opinion. In the case of a commitment based on mental illness, the petition and the examiner's 
144.22 	statement shall include, to the extent this information is available, a statement and opinion 
144.23 	regarding the proposed patient's need for treatment with neuroleptic medication and the 
144.24 	patient's capacity to make decisions regarding the administration of neuroleptic medications, 
144.25 	and the reasons for the opinion. If use of neuroleptic medications is recommended by the 
144.26 	treating physician medical practitioner or other qualified medical provider, the petition for 
144.27 	commitment must, if applicable, include or be accompanied by a request for proceedings 
144.28 	under section 253B.092. Failure to include the required information regarding neuroleptic 
144.29 	medications in the examiner's statement, or to include a request for an order regarding 
144.30 	neuroleptic medications with the commitment petition, is not a basis for dismissing the 
144.31 	commitment petition. If a petitioner has been unable to secure a statement from an examiner, 
144.32 	the petition shall include documentation that a reasonable effort has been made to secure 
144.33 	the supporting statement.

145.1 	Sec. 39. Minnesota Statutes 2018, section 253B.07, subdivision 2a, is amended to read:
145.2 		Subd. 2a.Petition originating from criminal proceedings. (a) If criminal charges are 
145.3 	pending against a defendant, the court shall order simultaneous competency and civil 
145.4 	commitment examinations in accordance with Minnesota Rules of Criminal Procedure, rule 
145.5 	20.04, when the following conditions are met:
145.6 	(1) the prosecutor or defense counsel doubts the defendant's competency and a motion 
145.7 	is made challenging competency, or the court on its initiative raises the issue under rule 
145.8 	20.01; and
145.9 	(2) the prosecutor and defense counsel agree simultaneous examinations are appropriate.
145.10 	No additional examination under subdivision 3 is required in a subsequent civil commitment 
145.11 	proceeding unless a second examination is requested by defense counsel appointed following 
145.12 	the filing of any petition for commitment.
145.13 	(b) Only a court examiner may conduct an assessment as described in Minnesota Rules 
145.14 	of Criminal Procedure, rules 20.01, subdivision 4, and 20.02, subdivision 2.
145.15 	(c) Where a county is ordered to consider civil commitment following a determination 
145.16 	of incompetency under Minnesota Rules of Criminal Procedure, rule 20.01, the county in 
145.17 	which the criminal matter is pending is responsible to conduct prepetition screening and, if 
145.18 	statutory conditions for commitment are satisfied, to file the commitment petition in that 
145.19 	county. By agreement between county attorneys, prepetition screening and filing the petition 
145.20 	may be handled in the county of financial responsibility or the county where the proposed 
145.21 	patient is present.
145.22 	(b) (d) Following an acquittal of a person of a criminal charge under section 611.026, 
145.23 	the petition shall be filed by the county attorney of the county in which the acquittal took 
145.24 	place and the petition shall be filed with the court in which the acquittal took place, and that 
145.25 	court shall be the committing court for purposes of this chapter. When a petition is filed 
145.26 	pursuant to subdivision 2 with the court in which acquittal of a criminal charge took place, 
145.27 	the court shall assign the judge before whom the acquittal took place to hear the commitment 
145.28 	proceedings unless that judge is unavailable.

145.29 	Sec. 40. Minnesota Statutes 2018, section 253B.07, subdivision 2b, is amended to read:
145.30 		Subd. 2b.Apprehend and hold orders. (a) The court may order the treatment facility 
145.31 	or state-operated treatment program to hold the person in a treatment facility proposed 
145.32 	patient or direct a health officer, peace officer, or other person to take the proposed patient 
145.33 	into custody and transport the proposed patient to a treatment facility or state-operated 
146.1 	treatment program for observation, evaluation, diagnosis, care, treatment, and, if necessary, 
146.2 	confinement, when:
146.3 	(1) there has been a particularized showing by the petitioner that serious physical harm 
146.4 	to the proposed patient or others is likely unless the proposed patient is immediately 
146.5 	apprehended;
146.6 	(2) the proposed patient has not voluntarily appeared for the examination or the 
146.7 	commitment hearing pursuant to the summons; or
146.8 	(3) a person is held pursuant to section 253B.05 253B.051 and a request for a petition 
146.9 	for commitment has been filed.
146.10 	(b) The order of the court may be executed on any day and at any time by the use of all 
146.11 	necessary means including the imposition of necessary restraint upon the proposed patient. 
146.12 	Where possible, a peace officer taking the proposed patient into custody pursuant to this 
146.13 	subdivision shall not be in uniform and shall not use a motor vehicle visibly marked as a 
146.14 	police law enforcement vehicle. Except as provided in section 253D.10, subdivision 2, in 
146.15 	the case of an individual on a judicial hold due to a petition for civil commitment under 
146.16 	chapter 253D, assignment of custody during the hold is to the commissioner of human 
146.17 	services. The commissioner is responsible for determining the appropriate placement within 
146.18 	a secure treatment facility under the authority of the commissioner.
146.19 	(c) A proposed patient must not be allowed or required to consent to nor participate in 
146.20 	a clinical drug trial while an order is in effect under this subdivision. A consent given while 
146.21 	an order is in effect is void and unenforceable. This paragraph does not prohibit a patient 
146.22 	from continuing participation in a clinical drug trial if the patient was participating in the 
146.23 	clinical drug trial at the time the order was issued under this subdivision.

146.24 	Sec. 41. Minnesota Statutes 2018, section 253B.07, subdivision 2d, is amended to read:
146.25 		Subd. 2d.Change of venue. Either party may move to have the venue of the petition 
146.26 	changed to the district court of the Minnesota county where the person currently lives, 
146.27 	whether independently or pursuant to a placement. The county attorney of the proposed 
146.28 	county of venue must be notified of the motion and provided the opportunity to respond 
146.29 	before the court rules on the motion. The court shall grant the motion if it determines that 
146.30 	the transfer is appropriate and is in the interests of justice. If the petition has been filed 
146.31 	pursuant to the Rules of Criminal or Juvenile Procedure, venue may not be changed without 
146.32 	the agreement of the county attorney of the proposed county of venue and the approval of 
146.33 	the court in which the juvenile or criminal proceedings are pending.

147.1 	Sec. 42. Minnesota Statutes 2018, section 253B.07, subdivision 3, is amended to read:
147.2 		Subd. 3.Court-appointed examiners. After a petition has been filed, the court shall 
147.3 	appoint an a court examiner. Prior to the hearing, the court shall inform the proposed patient 
147.4 	of the right to an independent second examination. At the proposed patient's request, the 
147.5 	court shall appoint a second court examiner of the patient's choosing to be paid for by the 
147.6 	county at a rate of compensation fixed by the court.

147.7 	Sec. 43. Minnesota Statutes 2018, section 253B.07, subdivision 5, is amended to read:
147.8 		Subd. 5.Prehearing examination; report. The examination shall be held at a treatment 
147.9 	facility or other suitable place the court determines is not likely to harm the health of the 
147.10 	proposed patient. The county attorney and the patient's attorney may be present during the 
147.11 	examination. Either party may waive this right. Unless otherwise agreed by the parties, a 
147.12 	court-appointed court examiner shall file the report with the court not less than 48 hours 
147.13 	prior to the commitment hearing. The court shall ensure that copies of the court examiner's 
147.14 	report are provided to the county attorney, the proposed patient, and the patient's counsel.

147.15 	Sec. 44. Minnesota Statutes 2018, section 253B.07, subdivision 7, is amended to read:
147.16 		Subd. 7.Preliminary hearing. (a) No proposed patient may be held in a treatment 
147.17 	facility or state-operated treatment program under a judicial hold pursuant to subdivision 
147.18 	2b longer than 72 hours, exclusive of Saturdays, Sundays, and legal holidays, unless the 
147.19 	court holds a preliminary hearing and determines that the standard is met to hold the person
147.20 	proposed patient.
147.21 	(b) The proposed patient, patient's counsel, the petitioner, the county attorney, and any 
147.22 	other persons as the court directs shall be given at least 24 hours written notice of the 
147.23 	preliminary hearing. The notice shall include the alleged grounds for confinement. The 
147.24 	proposed patient shall be represented at the preliminary hearing by counsel. The court may 
147.25 	admit reliable hearsay evidence, including written reports, for the purpose of the preliminary 
147.26 	hearing.
147.27 	(c) The court, on its motion or on the motion of any party, may exclude or excuse a 
147.28 	proposed patient who is seriously disruptive or who is incapable of comprehending and 
147.29 	participating in the proceedings. In such instances, the court shall, with specificity on the 
147.30 	record, state the behavior of the proposed patient or other circumstances which justify 
147.31 	proceeding in the absence of the proposed patient.
148.1 	(d) The court may continue the judicial hold of the proposed patient if it finds, by a 
148.2 	preponderance of the evidence, that serious physical harm to the proposed patient or others 
148.3 	is likely if the proposed patient is not immediately confined. If a proposed patient was 
148.4 	acquitted of a crime against the person under section 611.026 immediately preceding the 
148.5 	filing of the petition, the court may presume that serious physical harm to the patient or 
148.6 	others is likely if the proposed patient is not immediately confined.
148.7 	(e) Upon a showing that a person proposed patient subject to a petition for commitment 
148.8 	may need treatment with neuroleptic medications and that the person proposed patient may 
148.9 	lack capacity to make decisions regarding that treatment, the court may appoint a substitute 
148.10 	decision-maker as provided in section 253B.092, subdivision 6. The substitute decision-maker 
148.11 	shall meet with the proposed patient and provider and make a report to the court at the 
148.12 	hearing under section 253B.08 regarding whether the administration of neuroleptic 
148.13 	medications is appropriate under the criteria of section 253B.092, subdivision 7. If the 
148.14 	substitute decision-maker consents to treatment with neuroleptic medications and the 
148.15 	proposed patient does not refuse the medication, neuroleptic medication may be administered 
148.16 	to the proposed patient. If the substitute decision-maker does not consent or the proposed 
148.17 	patient refuses, neuroleptic medication may not be administered without a court order, or 
148.18 	in an emergency as set forth in section 253B.092, subdivision 3.

148.19 	Sec. 45. Minnesota Statutes 2018, section 253B.08, subdivision 1, is amended to read:
148.20 		Subdivision 1.Time for commitment hearing. (a) The hearing on the commitment 
148.21 	petition shall be held within 14 days from the date of the filing of the petition, except that 
148.22 	the hearing on a commitment petition pursuant to section 253D.07 shall be held within 90 
148.23 	days from the date of the filing of the petition. For good cause shown, the court may extend 
148.24 	the time of hearing up to an additional 30 days. The proceeding shall be dismissed if the 
148.25 	proposed patient has not had a hearing on a commitment petition within the allowed time.
148.26 	(b) The proposed patient, or the head of the treatment facility or state-operated treatment 
148.27 	program in which the person patient is held, may demand in writing at any time that the 
148.28 	hearing be held immediately. Unless the hearing is held within five days of the date of the 
148.29 	demand, exclusive of Saturdays, Sundays, and legal holidays, the petition shall be 
148.30 	automatically dismissed if the patient is being held in a treatment facility or state-operated 
148.31 	treatment program pursuant to court order. For good cause shown, the court may extend 
148.32 	the time of hearing on the demand for an additional ten days. This paragraph does not apply 
148.33 	to a commitment petition brought under section 253B.18 or chapter 253D.

149.1 	Sec. 46. Minnesota Statutes 2018, section 253B.08, subdivision 2a, is amended to read:
149.2 		Subd. 2a.Place of hearing. The hearing shall be conducted in a manner consistent with 
149.3 	orderly procedure. The hearing shall be held at a courtroom meeting standards prescribed 
149.4 	by local court rule which may be at a treatment facility or state-operated treatment program. 
149.5 	The hearing may be conducted by interactive video conference under General Rules of 
149.6 	Practice, rule 131, and Minnesota Rules of Civil Commitment, rule 14.

149.7 	Sec. 47. Minnesota Statutes 2018, section 253B.08, subdivision 5, is amended to read:
149.8 		Subd. 5.Absence permitted. (a) The court may permit the proposed patient to waive 
149.9 	the right to attend the hearing if it determines that the waiver is freely given. At the time of 
149.10 	the hearing, the proposed patient shall not be so under the influence of drugs, medication, 
149.11 	or other treatment so as to be hampered in participating in the proceedings. When the licensed 
149.12 	physician or licensed psychologist attending the patient professional responsible for the 
149.13 	proposed patient's treatment is of the opinion that the discontinuance of drugs, medication,
149.14 	or other treatment is not in the best interest of the proposed patient, the court, at the time of 
149.15 	the hearing, shall be presented a record of all drugs, medication or other treatment which 
149.16 	the proposed patient has received during the 48 hours immediately prior to the hearing.
149.17 	(b) The court, on its own motion or on the motion of any party, may exclude or excuse 
149.18 	a proposed patient who is seriously disruptive or who is incapable of comprehending and 
149.19 	participating in the proceedings. In such instances, the court shall, with specificity on the 
149.20 	record, state the behavior of the proposed patient or other circumstances justifying proceeding 
149.21 	in the absence of the proposed patient.

149.22 	Sec. 48. Minnesota Statutes 2018, section 253B.08, subdivision 5a, is amended to read:
149.23 		Subd. 5a.Witnesses. The proposed patient or the patient's counsel and the county attorney 
149.24 	may present and cross-examine witnesses, including court examiners, at the hearing. The 
149.25 	court may in its discretion receive the testimony of any other person. Opinions of 
149.26 	court-appointed court examiners may not be admitted into evidence unless the court examiner 
149.27 	is present to testify, except by agreement of the parties.

149.28 	Sec. 49. Minnesota Statutes 2018, section 253B.09, subdivision 1, is amended to read:
149.29 		Subdivision 1.Standard of proof. (a) If the court finds by clear and convincing evidence 
149.30 	that the proposed patient is a person who is mentally ill, developmentally disabled, or 
149.31 	chemically dependent who poses a risk of harm due to mental illness, or is a person who 
149.32 	has a developmental disability or chemical dependency, and after careful consideration of 
150.1 	reasonable alternative dispositions, including but not limited to, dismissal of petition,;
150.2 	voluntary outpatient care,; voluntary admission to a treatment facility, state-operated 
150.3 	treatment program, or community-based treatment program; appointment of a guardian or 
150.4 	conservator,; or release before commitment as provided for in subdivision 4, it finds that 
150.5 	there is no suitable alternative to judicial commitment, the court shall commit the patient 
150.6 	to the least restrictive treatment program or alternative programs which can meet the patient's 
150.7 	treatment needs consistent with section 253B.03, subdivision 7.
150.8 	(b) In deciding on the least restrictive program, the court shall consider a range of 
150.9 	treatment alternatives including, but not limited to, community-based nonresidential 
150.10 	treatment, community residential treatment, partial hospitalization, acute care hospital, 
150.11 	assertive community treatment teams, and regional state-operated  treatment center services
150.12 	programs. The court shall also consider the proposed patient's treatment preferences and 
150.13 	willingness to participate voluntarily in the treatment ordered. The court may not commit 
150.14 	a patient to a facility or program that is not capable of meeting the patient's needs.
150.15 	(c) If, after careful consideration of reasonable alternative dispositions, the court finds 
150.16 	no suitable alternative to judicial commitment and the court finds that the least restrictive 
150.17 	alternative as determined in paragraph (a) is a treatment facility or community-based 
150.18 	treatment program that is less restrictive or more community based than a state-operated 
150.19 	treatment program, and there is a treatment facility or a community-based treatment program 
150.20 	willing to accept the civilly committed patient, the court may commit the patient to both 
150.21 	the treatment facility or community-based treatment program and to the commissioner, in 
150.22 	the event that treatment in a state-operated treatment program becomes the least restrictive 
150.23 	alternative. If there is a change in the patient's level of care, then:
150.24 	(1) if the patient needs a higher level of care requiring admission to a state-operated 
150.25 	treatment program, custody of the patient and authority and responsibility for the commitment 
150.26 	may be transferred to the commissioner for as long as the patient needs a higher level of 
150.27 	care; and
150.28 	(2) when the patient no longer needs treatment in a state-operated treatment program, 
150.29 	the program may provisionally discharge the patient to an appropriate placement or release 
150.30 	the patient to the treatment facility or community-based treatment program if the program 
150.31 	continues to be willing and able to readmit the patient, in which case the commitment, its 
150.32 	authority, and responsibilities revert to the non-state-operated treatment program. Both 
150.33 	agencies accepting commitment shall coordinate admission and discharge planning to 
150.34 	facilitate timely access to the other's services to meet the patient's needs and shall coordinate 
150.35 	treatment planning consistent with section 253B.03, subdivision 7.
151.1 	(c) (d) If the commitment as mentally ill, chemically dependent, or developmentally 
151.2 	disabled is to a service facility provided by the commissioner of human services a person 
151.3 	is committed to a state-operated treatment program as a person who poses a risk of harm 
151.4 	due to mental illness or as a person who has a developmental disability or chemical 
151.5 	dependency, the court shall order the commitment to the commissioner. The commissioner 
151.6 	shall designate the placement of the person to the court.
151.7 	(d) (e) If the court finds a proposed patient to be a person who is mentally ill poses a 
151.8 	risk of harm due to mental illness under section 253B.02, subdivision 13, paragraph (a),
151.9 	clause (2) or (4), the court shall commit the patient to a treatment facility or community-based 
151.10 	treatment program that meets the proposed patient's needs. For purposes of this paragraph, 
151.11 	a community-based program may include inpatient mental health services at a community 
151.12 	hospital.

151.13 	Sec. 50. Minnesota Statutes 2018, section 253B.09, subdivision 2, is amended to read:
151.14 		Subd. 2.Findings. (a) The court shall find the facts specifically, and separately state its 
151.15 	conclusions of law. Where commitment is ordered, the findings of fact and conclusions of 
151.16 	law shall specifically state the proposed patient's conduct which is a basis for determining 
151.17 	that each of the requisites for commitment is met.
151.18 	(b) If commitment is ordered, the findings shall also identify less restrictive alternatives 
151.19 	considered and rejected by the court and the reasons for rejecting each alternative.
151.20 	(c) If the proceedings are dismissed, the court may direct that the person be transported 
151.21 	back to a suitable location including to the person's home.

151.22 	Sec. 51. Minnesota Statutes 2018, section 253B.09, subdivision 3a, is amended to read:
151.23 		Subd. 3a.Reporting judicial commitments; private treatment program or 
151.24 	facility. Notwithstanding section 253B.23, subdivision 9, when a court commits a patient 
151.25 	to a non-state-operated treatment facility or program or facility other than a state-operated 
151.26 	program or facility, the court shall report the commitment to the commissioner through the 
151.27 	supreme court information system for purposes of providing commitment information for 
151.28 	firearm background checks under section 245.041. If the patient is committed to a 
151.29 	state-operated treatment program, the court shall send a copy of the commitment order to 
151.30 	the commissioner.

152.1 	Sec. 52. Minnesota Statutes 2018, section 253B.09, subdivision 5, is amended to read:
152.2 		Subd. 5.Initial commitment period. The initial commitment begins on the date that 
152.3 	the court issues its order or warrant under section 253B.10, subdivision 1. For persons a 
152.4 	person committed as mentally ill, developmentally disabled, a person who poses a risk of 
152.5 	harm due to mental illness, a developmental disability, or chemically dependentchemical 
152.6 	dependency, the initial commitment shall not exceed six months.

152.7 	Sec. 53. Minnesota Statutes 2018, section 253B.092, is amended to read:
152.8 	253B.092 ADMINISTRATION OF NEUROLEPTIC MEDICATION.
152.9 		Subdivision 1.General. Neuroleptic medications may be administered, only as provided 
152.10 	in this section, to patients subject to early intervention or civil commitment as mentally ill, 
152.11 	mentally ill and dangerous, a sexually dangerous person, or a person with a sexual 
152.12 	psychopathic personality under this chapter or chapter 253D. For purposes of this section, 
152.13 	"patient" includes a proposed patient who is the subject of a petition for early intervention 
152.14 	or commitment and a committed person as defined in section 253D.02, subdivision 4.
152.15 		Subd. 2.Administration without judicial review. (a) Neuroleptic medications may be 
152.16 	administered without judicial review in the following circumstances:
152.17 	(1) the patient has the capacity to make an informed decision under subdivision 4;
152.18 	(2) the patient does not have the present capacity to consent to the administration of 
152.19 	neuroleptic medication, but prepared a health care power of attorney, a health care directive 
152.20 	under chapter 145C, or a declaration under section 253B.03, subdivision 6d, requesting 
152.21 	treatment or authorizing an agent or proxy to request treatment, and the agent or proxy has 
152.22 	requested the treatment;
152.23 	(3) the patient has been prescribed neuroleptic medication prior to admission to a 
152.24 	treatment facility, but lacks the present capacity to consent to the administration of that 
152.25 	neuroleptic medication; continued administration of the medication is in the patient's best 
152.26 	interest; and the patient does not refuse administration of the medication. In this situation, 
152.27 	the previously prescribed neuroleptic medication may be continued for up to 14 days while 
152.28 	the treating physician medical practitioner:
152.29 	(i) is obtaining a substitute decision-maker appointed by the court under subdivision 6; 
152.30 	or
152.31 	(ii) is requesting a court order authorizing administering neuroleptic medication or an 
152.32 	amendment to a current court order authorizing administration of neuroleptic medication;
153.1 	(4) a substitute decision-maker appointed by the court consents to the administration of 
153.2 	the neuroleptic medication and the patient does not refuse administration of the medication; 
153.3 	or
153.4 	(5) the substitute decision-maker does not consent or the patient is refusing medication, 
153.5 	and the patient is in an emergency situation.
153.6 	(b) For the purposes of paragraph (a), clause (3), if a person requests a substitute 
153.7 	decision-maker or requests a court order administering neuroleptic medication within 14 
153.8 	days, the treating medical practitioner may continue administering the medication to the 
153.9 	patient through the hearing date or until the court otherwise issues an order.
153.10 		Subd. 3.Emergency administration. A treating physician medical practitioner may 
153.11 	administer neuroleptic medication to a patient who does not have capacity to make a decision 
153.12 	regarding administration of the medication if the patient is in an emergency situation. 
153.13 	Medication may be administered for so long as the emergency continues to exist, up to 14 
153.14 	days, if the treating physician medical practitioner determines that the medication is necessary 
153.15 	to prevent serious, immediate physical harm to the patient or to others. If a request for 
153.16 	authorization to administer medication is made to the court within the 14 days, the treating 
153.17 	physician medical practitioner may continue the medication through the date of the first 
153.18 	court hearing, if the emergency continues to exist. If the request for authorization to 
153.19 	administer medication is made to the court in conjunction with a petition for commitment 
153.20 	or early intervention and the court makes a determination at the preliminary hearing under 
153.21 	section 253B.07, subdivision 7, that there is sufficient cause to continue the physician's
153.22 	medical practitioner's order until the hearing under section 253B.08, the treating physician
153.23 	medical practitioner may continue the medication until that hearing, if the emergency 
153.24 	continues to exist. The treatment facility, state-operated treatment program, or 
153.25 	community-based treatment program shall document the emergency in the patient's medical 
153.26 	record in specific behavioral terms.
153.27 		Subd. 4.Patients with capacity to make informed decision. A patient who has the 
153.28 	capacity to make an informed decision regarding the administration of neuroleptic medication 
153.29 	may consent or refuse consent to administration of the medication. The informed consent 
153.30 	of a patient must be in writing.
153.31 		Subd. 5.Determination of capacity. (a) There is a rebuttable presumption that a patient 
153.32 	is presumed to have has the capacity to make decisions regarding administration of 
153.33 	neuroleptic medication.
154.1 	(b) In determining A person's patient has the capacity to make decisions regarding the 
154.2 	administration of neuroleptic medication, the court shall consider if the patient:
154.3 	(1) whether the person demonstrates has an awareness of the nature of the person's 
154.4 	patient's situation, including the reasons for hospitalization, and the possible consequences 
154.5 	of refusing treatment with neuroleptic medications;
154.6 	(2) whether the person demonstrateshas an understanding of treatment with neuroleptic 
154.7 	medications and the risks, benefits, and alternatives; and
154.8 	(3) whether the person communicates verbally or nonverbally a clear choice regarding 
154.9 	treatment with neuroleptic medications that is a reasoned one not based on delusion a 
154.10 	symptom of the patient's mental illness, even though it may not be in the person'spatient's 
154.11 	best interests.
154.12 	(c) Disagreement with the physician's medical practitioner's recommendation alone is 
154.13 	not evidence of an unreasonable decision.
154.14 		Subd. 6.Patients without capacity to make informed decision; substitute 
154.15 	decision-maker. (a) Upon request of any person, and upon a showing that administration 
154.16 	of neuroleptic medications may be recommended and that the person patient may lack 
154.17 	capacity to make decisions regarding the administration of neuroleptic medication, the court 
154.18 	shall appoint a substitute decision-maker with authority to consent to the administration of 
154.19 	neuroleptic medication as provided in this section. A hearing is not required for an 
154.20 	appointment under this paragraph. The substitute decision-maker must be an individual or 
154.21 	a community or institutional multidisciplinary panel designated by the local mental health 
154.22 	authority. In appointing a substitute decision-maker, the court shall give preference to a 
154.23 	guardian or conservator, proxy, or health care agent with authority to make health care 
154.24 	decisions for the patient. The court may provide for the payment of a reasonable fee to the 
154.25 	substitute decision-maker for services under this section or may appoint a volunteer.
154.26 	(b) If the person's treating physician patient's treating medical practitioner recommends 
154.27 	treatment with neuroleptic medication, the substitute decision-maker may give or withhold 
154.28 	consent to the administration of the medication, based on the standards under subdivision 
154.29 	7. If the substitute decision-maker gives informed consent to the treatment and the person
154.30 	patient does not refuse, the substitute decision-maker shall provide written consent to the 
154.31 	treating physician medical practitioner and the medication may be administered. The 
154.32 	substitute decision-maker shall also notify the court that consent has been given. If the 
154.33 	substitute decision-maker refuses or withdraws consent or the person patient refuses the 
155.1 	medication, neuroleptic medication may must not be administered to the person without
155.2 	patient except with a court order or in an emergency.
155.3 	(c) A substitute decision-maker appointed under this section has access to the relevant 
155.4 	sections of the patient's health records on the past or present administration of medication. 
155.5 	The designated agency or a person involved in the patient's physical or mental health care 
155.6 	may disclose information to the substitute decision-maker for the sole purpose of performing 
155.7 	the responsibilities under this section. The substitute decision-maker may not disclose health 
155.8 	records obtained under this paragraph except to the extent necessary to carry out the duties 
155.9 	under this section.
155.10 	(d) At a hearing under section 253B.08, the petitioner has the burden of proving incapacity 
155.11 	by a preponderance of the evidence. If a substitute decision-maker has been appointed by 
155.12 	the court, the court shall make findings regarding the patient's capacity to make decisions 
155.13 	regarding the administration of neuroleptic medications and affirm or reverse its appointment 
155.14 	of a substitute decision-maker. If the court affirms the appointment of the substitute 
155.15 	decision-maker, and if the substitute decision-maker has consented to the administration of 
155.16 	the medication and the patient has not refused, the court shall make findings that the substitute 
155.17 	decision-maker has consented and the treatment is authorized. If a substitute decision-maker 
155.18 	has not yet been appointed, upon request the court shall make findings regarding the patient's 
155.19 	capacity and appoint a substitute decision-maker if appropriate.
155.20 	(e) If an order for civil commitment or early intervention did not provide for the 
155.21 	appointment of a substitute decision-maker or for the administration of neuroleptic 
155.22 	medication, the a treatment facility, state-operated treatment program, or community-based 
155.23 	treatment program may later request the appointment of a substitute decision-maker upon 
155.24 	a showing that administration of neuroleptic medications is recommended and that the 
155.25 	person patient lacks capacity to make decisions regarding the administration of neuroleptic 
155.26 	medications. A hearing is not required in order to administer the neuroleptic medication 
155.27 	unless requested under subdivision 10 or if the substitute decision-maker withholds or 
155.28 	refuses consent or the person patient refuses the medication.
155.29 	(f) The substitute decision-maker's authority to consent to treatment lasts for the duration 
155.30 	of the court's order of appointment or until modified by the court.
155.31 	If the substitute decision-maker withdraws consent or the patient refuses consent, 
155.32 	neuroleptic medication may not be administered without a court order.
155.33 	(g) If there is no hearing after the preliminary hearing, then the court shall, upon the 
155.34 	request of any interested party, review the reasonableness of the substitute decision-maker's 
156.1 	decision based on the standards under subdivision 7. The court shall enter an order upholding 
156.2 	or reversing the decision within seven days.
156.3 		Subd. 7.When person patient lacks capacity to make decisions about medication. (a) 
156.4 	When a person patient lacks capacity to make decisions regarding the administration of 
156.5 	neuroleptic medication, the substitute decision-maker or the court shall use the standards 
156.6 	in this subdivision in making a decision regarding administration of the medication.
156.7 	(b) If the person patient clearly stated what the person patient would choose to do in this 
156.8 	situation when the person patient had the capacity to make a reasoned decision, the person's
156.9 	patient's wishes must be followed. Evidence of the person's patient's wishes may include 
156.10 	written instruments, including a durable power of attorney for health care under chapter 
156.11 	145C or a declaration under section 253B.03, subdivision 6d.
156.12 	(c) If evidence of the person's patient's wishes regarding the administration of neuroleptic 
156.13 	medications is conflicting or lacking, the decision must be based on what a reasonable 
156.14 	person would do, taking into consideration:
156.15 	(1) the person's patient's family, community, moral, religious, and social values;
156.16 	(2) the medical risks, benefits, and alternatives to the proposed treatment;
156.17 	(3) past efficacy and any extenuating circumstances of past use of neuroleptic 
156.18 	medications; and
156.19 	(4) any other relevant factors.
156.20 		Subd. 8.Procedure when patient refuses neuroleptic medication. (a) If the substitute 
156.21 	decision-maker or the patient refuses to consent to treatment with neuroleptic medications, 
156.22 	and absent an emergency as set forth in subdivision 3, neuroleptic medications may not be 
156.23 	administered without a court order. Upon receiving a written request for a hearing, the court 
156.24 	shall schedule the hearing within 14 days of the request. The matter may be heard as part 
156.25 	of any other district court proceeding under this chapter. By agreement of the parties or for 
156.26 	good cause shown, the court may extend the time of hearing an additional 30 days.
156.27 	(b) The patient must be examined by a court examiner prior to the hearing. If the patient 
156.28 	refuses to participate in an examination, the court examiner may rely on the patient's medical 
156.29 	records to reach an opinion as to the appropriateness of neuroleptic medication. The patient 
156.30 	is entitled to counsel and a second court examiner, if requested by the patient or patient's 
156.31 	counsel.
156.32 	(c) The court may base its decision on relevant and admissible evidence, including the 
156.33 	testimony of a treating physician medical practitioner or other qualified physician, a member 
157.1 	of the patient's treatment team, a court-appointed court examiner, witness testimony, or the 
157.2 	patient's medical records.
157.3 	(d) If the court finds that the patient has the capacity to decide whether to take neuroleptic 
157.4 	medication or that the patient lacks capacity to decide and the standards for making a decision 
157.5 	to administer the medications under subdivision 7 are not met, the treating treatment facility, 
157.6 	state-operated treatment program, or community-based treatment program may not administer 
157.7 	medication without the patient's informed written consent or without the declaration of an 
157.8 	emergency, or until further review by the court.
157.9 	(e) If the court finds that the patient lacks capacity to decide whether to take neuroleptic 
157.10 	medication and has applied the standards set forth in subdivision 7, the court may authorize 
157.11 	the treating treatment facility, state-operated treatment program, or community-based 
157.12 	treatment program and any other community or treatment facility or program to which the 
157.13 	patient may be transferred or provisionally discharged, to involuntarily administer the 
157.14 	medication to the patient. A copy of the order must be given to the patient, the patient's 
157.15 	attorney, the county attorney, and the treatment facility, state-operated treatment program, 
157.16 	or community-based treatment program. The treatment facility, state-operated treatment 
157.17 	program, or community-based treatment program may not begin administration of the 
157.18 	neuroleptic medication until it notifies the patient of the court's order authorizing the 
157.19 	treatment.
157.20 	(f) A finding of lack of capacity under this section must not be construed to determine 
157.21 	the patient's competence for any other purpose.
157.22 	(g) The court may authorize the administration of neuroleptic medication until the 
157.23 	termination of a determinate commitment. If the patient is committed for an indeterminate 
157.24 	period, the court may authorize treatment of neuroleptic medication for not more than two 
157.25 	years, subject to the patient's right to petition the court for review of the order. The treatment 
157.26 	facility, state-operated treatment program, or community-based treatment program must 
157.27 	submit annual reports to the court, which shall provide copies to the patient and the respective 
157.28 	attorneys.
157.29 	(h) The court may limit the maximum dosage of neuroleptic medication that may be 
157.30 	administered.
157.31 	(i) If physical force is required to administer the neuroleptic medication, the facility or 
157.32 	program may only use injectable medications. If physical force is needed to administer the 
157.33 	medication, medication may only take place be administered in a treatment facility or 
157.34 	therapeutic setting where the person's condition can be reassessed and appropriate medical 
158.1 	staff personnel qualified to administer medication are available, including in the community, 
158.2 	a county jail, or a correctional facility. The facility or program may not use a nasogastric 
158.3 	tube to administer neuroleptic medication involuntarily.
158.4 		Subd. 9.Immunity. A substitute decision-maker who consents to treatment is not civilly 
158.5 	or criminally liable for the performance of or the manner of performing the treatment. A 
158.6 	person is not liable for performing treatment without consent if the substitute decision-maker 
158.7 	has given written consent. This provision does not affect any other liability that may result 
158.8 	from the manner in which the treatment is performed.
158.9 		Subd. 10.Review. A patient or other person may petition the court under section 253B.17
158.10 	for review of any determination under this section or for a decision regarding the 
158.11 	administration of neuroleptic medications, appointment of a substitute decision-maker, or 
158.12 	the patient's capacity to make decisions regarding administration of neuroleptic medications.

158.13 	Sec. 54. Minnesota Statutes 2018, section 253B.0921, is amended to read:
158.14 	253B.0921 ACCESS TO MEDICAL RECORDS.
158.15 	A treating physician medical practitioner who makes medical decisions regarding the 
158.16 	prescription and administration of medication for treatment of a mental illness has access 
158.17 	to the relevant sections of a patient's health records on past administration of medication at 
158.18 	any treatment facility, program, or treatment provider, if the patient lacks the capacity to 
158.19 	authorize the release of records. Upon request of a treating physician medical practitioner
158.20 	under this section, a treatment facility, program, or treatment provider shall supply complete 
158.21 	information relating to the past records on administration of medication of a patient subject 
158.22 	to this chapter. A patient who has the capacity to authorize the release of data retains the 
158.23 	right to make decisions regarding access to medical records as provided by sections 144.291
158.24 	to 144.298.

158.25 	Sec. 55. Minnesota Statutes 2018, section 253B.095, subdivision 3, is amended to read:
158.26 		Subd. 3.Duration. The maximum duration of a stayed order under this section is six 
158.27 	months. The court may continue the order for a maximum of an additional 12 months if, 
158.28 	after notice and hearing, under sections 253B.08 and 253B.09 the court finds that (1) the 
158.29 	person continues to be mentally ill, chemically dependent, or developmentally disabled,
158.30 	have a mental illness, developmental disability, or chemical dependency, and (2) an order 
158.31 	is needed to protect the patient or others because the person is likely to attempt to physically 
158.32 	harm self or others or fail to obtain necessary food, clothing, shelter, or medical care unless 
158.33 	the person is under the supervision of a stayed commitment.

159.1 	Sec. 56. Minnesota Statutes 2018, section 253B.097, subdivision 1, is amended to read:
159.2 		Subdivision 1.Findings. In addition to the findings required under section 253B.09, 
159.3 	subdivision 2, an order committing a person to a community-based treatment program must 
159.4 	include:
159.5 	(1) a written plan for services to the patient;
159.6 	(2) a finding that the proposed treatment is available and accessible to the patient and 
159.7 	that public or private financial resources are available to pay for the proposed treatment;
159.8 	(3) conditions the patient must meet in order to obtain an early release from commitment 
159.9 	or to avoid a hearing for further commitment; and
159.10 	(4) consequences of the patient's failure to follow the commitment order. Consequences 
159.11 	may include commitment to another setting for treatment.

159.12 	Sec. 57. Minnesota Statutes 2018, section 253B.097, subdivision 2, is amended to read:
159.13 		Subd. 2.Case manager. When a court commits a patient with mental illness to a 
159.14 	community-based treatment program, the court shall appoint a case manager from the county 
159.15 	agency or other entity under contract with the county agency to provide case management 
159.16 	services.

159.17 	Sec. 58. Minnesota Statutes 2018, section 253B.097, subdivision 3, is amended to read:
159.18 		Subd. 3.Reports. The case manager shall report to the court at least once every 90 days. 
159.19 	The case manager shall immediately report to the court a substantial failure of the patient 
159.20 	or provider to comply with the conditions of the commitment.

159.21 	Sec. 59. Minnesota Statutes 2018, section 253B.097, subdivision 6, is amended to read:
159.22 		Subd. 6.Immunity from liability. No treatment facility, community-based treatment 
159.23 	program, or person is financially liable, personally or otherwise, for the patient's actions of 
159.24 	the patient if the facility or person follows accepted community standards of professional 
159.25 	practice in the management, supervision, and treatment of the patient. For purposes of this 
159.26 	subdivision, "person" means official, staff, employee of the treatment facility, 
159.27 	community-based treatment program, physician, or other individual who is responsible for 
159.28 	the a patient's management, supervision, or treatment of a patient's community-based 
159.29 	treatment under this section.

160.1 	Sec. 60. Minnesota Statutes 2018, section 253B.10, is amended to read:
160.2 	253B.10 PROCEDURES UPON COMMITMENT.
160.3 		Subdivision 1.Administrative requirements. (a) When a person is committed, the 
160.4 	court shall issue a warrant or an order committing the patient to the custody of the head of 
160.5 	the treatment facility, state-operated treatment program, or community-based treatment 
160.6 	program. The warrant or order shall state that the patient meets the statutory criteria for 
160.7 	civil commitment.
160.8 	(b) The commissioner shall prioritize patients being admitted from jail or a correctional 
160.9 	institution who are:
160.10 	(1) ordered confined in a state hospital state-operated treatment program for an 
160.11 	examination under Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4, 
160.12 	paragraph (a), and 20.02, subdivision 2;
160.13 	(2) under civil commitment for competency treatment and continuing supervision under 
160.14 	Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
160.15 	(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal 
160.16 	Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be 
160.17 	detained in a state hospital or other facility state-operated treatment program pending 
160.18 	completion of the civil commitment proceedings; or
160.19 	(4) committed under this chapter to the commissioner after dismissal of the patient's 
160.20 	criminal charges.
160.21 	Patients described in this paragraph must be admitted to a service operated by the 
160.22 	commissioner state-operated treatment program within 48 hours. The commitment must be 
160.23 	ordered by the court as provided in section 253B.09, subdivision 1, paragraph (c) (d).
160.24 	(c) Upon the arrival of a patient at the designated treatment facility, state-operated 
160.25 	treatment program, or community-based treatment program, the head of the facility or 
160.26 	program shall retain the duplicate of the warrant and endorse receipt upon the original 
160.27 	warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must 
160.28 	be filed in the court of commitment. After arrival, the patient shall be under the control and 
160.29 	custody of the head of the treatment facility or program.
160.30 	(d) Copies of the petition for commitment, the court's findings of fact and conclusions 
160.31 	of law, the court order committing the patient, the report of the court examiners, and the 
160.32 	prepetition report, and any medical and behavioral information available shall be provided 
160.33 	at the time of admission of a patient to the designated treatment facility or program to which 
161.1 	the patient is committed. Upon a patient's referral to the commissioner of human services 
161.2 	for admission pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment 
161.3 	facility, jail, or correctional facility that has provided care or supervision to the patient in 
161.4 	the previous two years shall, when requested by the treatment facility or commissioner, 
161.5 	provide copies of the patient's medical and behavioral records to the Department of Human 
161.6 	Services for purposes of preadmission planning. This information shall be provided by the 
161.7 	head of the treatment facility to treatment facility staff in a consistent and timely manner 
161.8 	and pursuant to all applicable laws. This information shall also be provided by the head of 
161.9 	the treatment facility to treatment facility staff in a consistent and timely manner and pursuant 
161.10 	to all applicable laws.
161.11 		Subd. 2.Transportation. (a) When a patient is about to be placed in a treatment facility, 
161.12 	state-operated treatment program, or community-based treatment program, the court may 
161.13 	order the designated agency, the treatment facility, state-operated treatment program, or 
161.14 	community-based treatment program, or any responsible adult to transport the patient to 
161.15 	the treatment facility. A protected transport provider may transport the patient according to 
161.16 	section 256B.0625, subdivision 17. Whenever possible, a peace officer who provides the 
161.17 	transportation shall not be in uniform and shall not use a vehicle visibly marked as a police
161.18 	law enforcement vehicle. The proposed patient may be accompanied by one or more 
161.19 	interested persons.
161.20 	(b) When a patient who is at a regional state-operated treatment center program requests 
161.21 	a hearing for adjudication of a patient's status pursuant to section 253B.17, the commissioner 
161.22 	shall provide transportation.
161.23 		Subd. 3.Notice of admission. Whenever a committed person has been admitted to a 
161.24 	treatment facility, state-operated treatment program, or community-based treatment program
161.25 	under the provisions of section 253B.09 or 253B.18, the head of the treatment facility or 
161.26 	program shall immediately notify the patient's spouse, health care agent, or parent and the 
161.27 	county of financial responsibility if the county may be liable for a portion of the cost of 
161.28 	treatment. If the committed person was admitted upon the petition of a spouse, health care 
161.29 	agent, or parent, the head of the treatment facility, state-operated treatment program, or 
161.30 	community-based treatment program shall notify an interested person other than the 
161.31 	petitioner.
161.32 		Subd. 3a.Interim custody and treatment of committed person. When the patient is 
161.33 	present in a treatment facility or state-operated treatment program at the time of the court's 
161.34 	commitment order, unless the court orders otherwise, the commitment order constitutes 
162.1 	authority for that facility or program to confine and provide treatment to the patient until 
162.2 	the patient is transferred to the facility or program to which the patient has been committed.
162.3 		Subd. 4.Private treatment. Patients or other responsible persons are required to pay 
162.4 	the necessary charges for patients committed or transferred to private treatment facilities
162.5 	or community-based treatment programs. Private Treatment facilities or community-based 
162.6 	treatment programs may not refuse to accept a committed person solely based on the person's 
162.7 	court-ordered status. Insurers must provide treatment and services as ordered by the court 
162.8 	under section 253B.045, subdivision 6, or as required under chapter 62M.
162.9 		Subd. 5.Transfer to voluntary status. At any time prior to the expiration of the initial 
162.10 	commitment period, a patient who has not been committed as mentally ill a person who has 
162.11 	a mental illness and is dangerous to the public or as a sexually dangerous person or as a 
162.12 	sexual psychopathic personality may be transferred to voluntary status upon the patient's 
162.13 	application in writing with the consent of the head of the facility or program to which the 
162.14 	person is committed. Upon transfer, the head of the treatment facility, state-operated treatment 
162.15 	program, or community-based treatment program shall immediately notify the court in 
162.16 	writing and the court shall terminate the proceedings.

162.17 	Sec. 61. Minnesota Statutes 2018, section 253B.12, subdivision 1, is amended to read:
162.18 		Subdivision 1.Reports. (a) If a patient who was committed as a person who is mentally 
162.19 	ill, developmentally disabled, or chemically dependentwho poses a risk of harm due to a 
162.20 	mental illness, or as a person who has a developmental disability or chemical dependency, 
162.21 	is discharged from commitment within the first 60 days after the date of the initial 
162.22 	commitment order, the head of the treatment facility, state-operated treatment program, or 
162.23 	community-based treatment program shall file a written report with the committing court 
162.24 	describing the patient's need for further treatment. A copy of the report must be provided 
162.25 	to the county attorney, the patient, and the patient's counsel.
162.26 	(b) If a patient who was committed as a person who is mentally ill, developmentally 
162.27 	disabled, or chemically dependentwho poses a risk of harm due to a mental illness, or as a 
162.28 	person who has a developmental disability or chemical dependency, remains in treatment 
162.29 	more than 60 days after the date of the commitment, then at least 60 days, but not more than 
162.30 	90 days, after the date of the order, the head of the facility or program that has custody of 
162.31 	the patient shall file a written report with the committing court and provide a copy to the 
162.32 	county attorney, the patient, and the patient's counsel. The report must set forth in detailed 
162.33 	narrative form at least the following:
162.34 	(1) the diagnosis of the patient with the supporting data;
163.1 	(2) the anticipated discharge date;
163.2 	(3) an individualized treatment plan;
163.3 	(4) a detailed description of the discharge planning process with suggested after care 
163.4 	plan;
163.5 	(5) whether the patient is in need of further care and treatment, the treatment facility 
163.6 	which, state-operated treatment program, or community-based treatment program that is 
163.7 	needed, and evidence to support the response;
163.8 	(6) whether the patient satisfies the statutory requirement for continued commitment to 
163.9 	a treatment facility, with documentation to support the opinion; and
163.10 	(7) a statement from the patient related to accepting treatment, if possible; and
163.11 	(7) (8) whether the administration of neuroleptic medication is clinically indicated, 
163.12 	whether the patient is able to give informed consent to that medication, and the basis for 
163.13 	these opinions.
163.14 	(c) Prior to the termination of the initial commitment order or final discharge of the 
163.15 	patient, the head of the treatment facility or program that has custody or care of the patient 
163.16 	shall file a written report with the committing court with a copy to the county attorney, the 
163.17 	patient, and the patient's counsel that sets forth the information required in paragraph (b).
163.18 	(d) If the patient has been provisionally discharged from a treatment facility or program, 
163.19 	the report shall be filed by the designated agency, which may submit the discharge report 
163.20 	as part of its report.
163.21 	(e) If no written report is filed within the required time, or If a report describes the patient 
163.22 	as not in need of further institutional care and court-ordered treatment, the proceedings must 
163.23 	be terminated by the committing court and the patient discharged from the treatment facility, 
163.24 	state-operated treatment program, or community-based treatment program, unless the patient 
163.25 	chooses to voluntarily receive services.
163.26 	(f) If no written report is filed within the required time, the court must notify the county, 
163.27 	facility or program to which the person is committed, and designated agency and require a 
163.28 	report be filed within five business days. If a report is not filed within five business days a 
163.29 	hearing must be held within three business days.

163.30 	Sec. 62. Minnesota Statutes 2018, section 253B.12, subdivision 3, is amended to read:
163.31 		Subd. 3.Examination. Prior to the review hearing, the court shall inform the patient of 
163.32 	the right to an independent examination by an a court examiner chosen by the patient and 
164.1 	appointed in accordance with provisions of section 253B.07, subdivision 3. The report of 
164.2 	the court examiner may be submitted at the hearing.

164.3 	Sec. 63. Minnesota Statutes 2018, section 253B.12, subdivision 4, is amended to read:
164.4 		Subd. 4.Hearing; standard of proof. (a) The committing court shall not make a final 
164.5 	determination of the need to continue commitment unless the court finds by clear and 
164.6 	convincing evidence that (1) the person patient continues to be mentally ill, developmentally 
164.7 	disabled, or chemically dependent have a mental illness, developmental disability, or chemical 
164.8 	dependency; (2) involuntary commitment is necessary for the protection of the patient or 
164.9 	others; and (3) there is no alternative to involuntary commitment.
164.10 	(b) In determining whether a person patient continues to be mentally ill, chemically 
164.11 	dependent, or developmentally disabled, require commitment due to mental illness, 
164.12 	developmental disability, or chemical dependency, the court need not find that there has 
164.13 	been a recent attempt or threat to physically harm self or others, or a recent failure to provide 
164.14 	necessary personal food, clothing, shelter, or medical care. Instead, the court must find that 
164.15 	the patient is likely to attempt to physically harm self or others, or to fail to provide obtain
164.16 	necessary personal food, clothing, shelter, or medical care unless involuntary commitment 
164.17 	is continued.

164.18 	Sec. 64. Minnesota Statutes 2018, section 253B.12, subdivision 7, is amended to read:
164.19 		Subd. 7.Record required. Where continued commitment is ordered, the findings of 
164.20 	fact and conclusions of law shall specifically state the conduct of the proposed patient which 
164.21 	is the basis for the final determination, that the statutory criteria of commitment continue 
164.22 	to be met, and that less restrictive alternatives have been considered and rejected by the 
164.23 	court. Reasons for rejecting each alternative shall be stated. A copy of the final order for 
164.24 	continued commitment shall be forwarded to the head of the treatment facility or program 
164.25 	to which the person is committed and, if the patient has been provisionally discharged, to 
164.26 	the designated agency responsible for monitoring the provisional discharge.

164.27 	Sec. 65. Minnesota Statutes 2018, section 253B.13, subdivision 1, is amended to read:
164.28 		Subdivision 1.Mentally ill or chemically dependent Persons with mental illness or 
164.29 	chemical dependency. (a) If at the conclusion of a review hearing the court finds that the 
164.30 	person continues to be mentally ill or chemically dependent have mental illness or chemical 
164.31 	dependency and in need of treatment or supervision, the court shall determine the length of 
165.1 	continued commitment. No period of commitment shall exceed this length of time or 12 
165.2 	months, whichever is less.
165.3 	(b) At the conclusion of the prescribed period under paragraph (a), commitment may 
165.4 	not be continued unless a new petition is filed pursuant to section 253B.07 and hearing and 
165.5 	determination made on it. If the petition was filed before the end of the previous commitment 
165.6 	and, for good cause shown, the court has not completed the hearing and the determination 
165.7 	by the end of the commitment period, the court may for good cause extend the previous 
165.8 	commitment for up to 14 days to allow the completion of the hearing and the issuance of 
165.9 	the determination. The standard of proof for the new petition is the standard specified in 
165.10 	section 253B.12, subdivision 4. Notwithstanding the provisions of section 253B.09, 
165.11 	subdivision 5, the initial commitment period under the new petition shall be the probable 
165.12 	length of commitment necessary or 12 months, whichever is less. The standard of proof at 
165.13 	the hearing on the new petition shall be the standard specified in section 253B.12, subdivision 
165.14 	4.

165.15 	Sec. 66. Minnesota Statutes 2018, section 253B.14, is amended to read:
165.16 	253B.14 TRANSFER OF COMMITTED PERSONS.
165.17 	The commissioner may transfer any committed person, other than a person committed 
165.18 	as mentally ill and a person who has a mental illness and is dangerous to the public, or as
165.19 	a sexually dangerous person or as a sexual psychopathic personality, from one regional
165.20 	state-operated treatment center program to any other state-operated treatment facility under 
165.21 	the commissioner's jurisdiction which is program capable of providing proper care and 
165.22 	treatment. When a committed person is transferred from one state-operated treatment facility
165.23 	program to another, written notice shall be given to the committing court, the county attorney, 
165.24 	the patient's counsel, and to the person's parent, health care agent, or spouse or, if none is 
165.25 	known, to an interested person, and the designated agency.

165.26 	Sec. 67. Minnesota Statutes 2018, section 253B.141, is amended to read:
165.27 	253B.141 AUTHORITY TO DETAIN AND TRANSPORT A MISSING PATIENT.
165.28 		Subdivision 1.Report of absence. (a) If a patient committed under this chapter or 
165.29 	detained in a treatment facility or state-operated treatment program under a judicial hold is 
165.30 	absent without authorization, and either: (1) does not return voluntarily within 72 hours of 
165.31 	the time the unauthorized absence began; or (2) is considered by the head of the treatment
165.32 	facility or program to be a danger to self or others, then the head of the treatment facility
165.33 	or program shall report the absence to the local law enforcement agency. The head of the 
166.1 	treatment facility or program shall also notify the committing court that the patient is absent 
166.2 	and that the absence has been reported to the local law enforcement agency. The committing 
166.3 	court may issue an order directing the law enforcement agency to transport the patient to 
166.4 	an appropriate treatment facility, state-operated treatment program, or community-based 
166.5 	treatment program.
166.6 	(b) Upon receiving a report that a patient subject to this section is absent without 
166.7 	authorization, the local law enforcement agency shall enter information on the patient into 
166.8 	the missing persons file of the National Crime Information Center computer according to 
166.9 	the missing persons practices.
166.10 		Subd. 2.Apprehension; return to facility or program. (a) Upon receiving the report 
166.11 	of absence from the head of the treatment facility, state-operated treatment program, or 
166.12 	community-based treatment program or the committing court, a patient may be apprehended 
166.13 	and held by a peace officer in any jurisdiction pending return to the facility or program from 
166.14 	which the patient is absent without authorization. A patient may also be returned to any 
166.15 	facility operated by the commissioner state-operated treatment program or any other treatment 
166.16 	facility or community-based treatment program willing to accept the person. A person who 
166.17 	is mentally ill has a mental illness and is dangerous to the public and detained under this 
166.18 	subdivision may be held in a jail or lockup only if:
166.19 	(1) there is no other feasible place of detention for the patient;
166.20 	(2) the detention is for less than 24 hours; and
166.21 	(3) there are protections in place, including segregation of the patient, to ensure the 
166.22 	safety of the patient.
166.23 	(b) If a patient is detained under this subdivision, the head of the treatment facility or 
166.24 	program from which the patient is absent shall arrange to pick up the patient within 24 hours 
166.25 	of the time detention was begun and shall be responsible for securing transportation for the 
166.26 	patient to the facility or program. The expense of detaining and transporting a patient shall 
166.27 	be the responsibility of the treatment facility or program from which the patient is absent. 
166.28 	The expense of detaining and transporting a patient to a state-operated treatment facility 
166.29 	operated by the Department of Human Servicesprogram shall be paid by the commissioner 
166.30 	unless paid by the patient or persons on behalf of the patient.
166.31 		Subd. 3.Notice of apprehension. Immediately after an absent patient is located, the 
166.32 	head of the treatment facility or program from which the patient is absent, or the law 
166.33 	enforcement agency that located or returned the absent patient, shall notify the law 
166.34 	enforcement agency that first received the absent patient report under this section and that 
167.1 	agency shall cancel the missing persons entry from the National Crime Information Center 
167.2 	computer.

167.3 	Sec. 68. Minnesota Statutes 2018, section 253B.15, subdivision 1, is amended to read:
167.4 		Subdivision 1.Provisional discharge. (a) The head of the treatment facility, 
167.5 	state-operated treatment program, or community-based treatment program may provisionally 
167.6 	discharge any patient without discharging the commitment, unless the patient was found 
167.7 	by the committing court to be a person who is mentally ill and has a mental illness and is
167.8 	dangerous to the public, or a sexually dangerous person, or a sexual psychopathic personality.
167.9 	(b) When a patient committed to the commissioner becomes ready for provisional 
167.10 	discharge before being placed in a state-operated treatment program, the head of the treatment 
167.11 	facility or community-based treatment program where the patient is placed pending transfer 
167.12 	to the commissioner may provisionally discharge the patient pursuant to this subdivision.
167.13 	(c) Each patient released on provisional discharge shall have a written aftercare
167.14 	provisional discharge plan developed with input from the patient and the designated agency 
167.15 	which specifies the services and treatment to be provided as part of the aftercare provisional 
167.16 	discharge plan, the financial resources available to pay for the services specified, the expected 
167.17 	period of provisional discharge, the precise goals for the granting of a final discharge, and 
167.18 	conditions or restrictions on the patient during the period of the provisional discharge. The 
167.19 	aftercare provisional discharge plan shall be provided to the patient, the patient's attorney, 
167.20 	and the designated agency.
167.21 	(d) The aftercareprovisional discharge plan shall be reviewed on a quarterly basis by 
167.22 	the patient, designated agency and other appropriate persons. The aftercare provisional 
167.23 	discharge plan shall contain the grounds upon which a provisional discharge may be revoked. 
167.24 	The provisional discharge shall terminate on the date specified in the plan unless specific 
167.25 	action is taken to revoke or extend it.

167.26 	Sec. 69. Minnesota Statutes 2018, section 253B.15, subdivision 1a, is amended to read:
167.27 		Subd. 1a.Representative of designated agency. Before a provisional discharge is 
167.28 	granted, a representative of the designated agency must be identified to ensure continuity 
167.29 	of care by being involved with the treatment facility, state-operated treatment program, or 
167.30 	community-based treatment program and the patient prior to the provisional discharge. The 
167.31 	representative of the designated agency shall coordinate plans for and monitor the patient's 
167.32 	aftercare program. When the patient is on a provisional discharge, the representative of the 
168.1 	designated agency shall provide the treatment report to the court required under section 
168.2 	253B.12, subdivision 1.

168.3 	Sec. 70. Minnesota Statutes 2018, section 253B.15, subdivision 2, is amended to read:
168.4 		Subd. 2.Revocation of provisional discharge. (a) The designated agency may revoke
168.5 	initiate with the court a revocation of a provisional discharge if revocation is the least 
168.6 	restrictive alternative and either:
168.7 	(1) the patient has violated material conditions of the provisional discharge, and the 
168.8 	violation creates the need to return the patient to a more restrictive setting or more intensive 
168.9 	community services; or
168.10 	(2) there exists a serious likelihood that the safety of the patient or others will be 
168.11 	jeopardized, in that either the patient's need for food, clothing, shelter, or medical care are 
168.12 	not being met, or will not be met in the near future, or the patient has attempted or threatened 
168.13 	to seriously physically harm self or others; and.
168.14 	(3) revocation is the least restrictive alternative available.
168.15 	(b) Any interested person may request that the designated agency revoke the patient's 
168.16 	provisional discharge. Any person making a request shall provide the designated agency 
168.17 	with a written report setting forth the specific facts, including witnesses, dates and locations, 
168.18 	supporting a revocation, demonstrating that every effort has been made to avoid revocation 
168.19 	and that revocation is the least restrictive alternative available.

168.20 	Sec. 71. Minnesota Statutes 2018, section 253B.15, subdivision 3, is amended to read:
168.21 		Subd. 3.Procedure; notice. Revocation shall be commenced by the designated agency's 
168.22 	written notice of intent to revoke provisional discharge given or sent to the patient, the 
168.23 	patient's attorney, and the treatment facility or program from which the patient was 
168.24 	provisionally discharged, and the current community services provider. The notice shall set 
168.25 	forth the grounds upon which the intention to revoke is based, and shall inform the patient 
168.26 	of the rights of a patient under this chapter.

168.27 	Sec. 72. Minnesota Statutes 2018, section 253B.15, subdivision 3a, is amended to read:
168.28 		Subd. 3a.Report to the court. Within 48 hours, excluding weekends and legal holidays, 
168.29 	of giving notice to the patient, the designated agency shall file with the court a copy of the 
168.30 	notice and a report setting forth the specific facts, including witnesses, dates and locations, 
168.31 	which (1) support revocation, (2) demonstrate that revocation is the least restrictive alternative 
169.1 	available, and (3) show that specific efforts were made to avoid revocation. The designated 
169.2 	agency shall provide copies of the report to the patient, the patient's attorney, the county 
169.3 	attorney, and the treatment facility or program from which the patient was provisionally 
169.4 	discharged within 48 hours of giving notice to the patient under subdivision 3.

169.5 	Sec. 73. Minnesota Statutes 2018, section 253B.15, subdivision 3b, is amended to read:
169.6 		Subd. 3b.Review. The patient or patient's attorney may request judicial review of the 
169.7 	intended revocation by filing a petition for review and an affidavit with the committing 
169.8 	court. The affidavit shall state specific grounds for opposing the revocation. If the patient 
169.9 	does not file a petition for review within five days of receiving the notice under subdivision 
169.10 	3, revocation of the provisional discharge is final and the court, without hearing, may order 
169.11 	the patient into a treatment facility or program from which the patient was provisionally 
169.12 	discharged, another treatment facility, state-operated treatment program, or community-based 
169.13 	treatment program that consents to receive the patient, or more intensive community 
169.14 	treatment. If the patient files a petition for review, the court shall review the petition and 
169.15 	determine whether a genuine issue exists as to the propriety of the revocation. The burden 
169.16 	of proof is on the designated agency to show that no genuine issue exists as to the propriety 
169.17 	of the revocation. If the court finds that no genuine issue exists as to the propriety of the 
169.18 	revocation, the revocation of the provisional discharge is final.

169.19 	Sec. 74. Minnesota Statutes 2018, section 253B.15, subdivision 3c, is amended to read:
169.20 		Subd. 3c.Hearing. (a) If the court finds under subdivision 3b that a genuine issue exists 
169.21 	as to the propriety of the revocation, the court shall hold a hearing on the petition within 
169.22 	three days after the patient files the petition. The court may continue the review hearing for 
169.23 	an additional five days upon any party's showing of good cause. At the hearing, the burden 
169.24 	of proof is on the designated agency to show a factual basis for the revocation. At the 
169.25 	conclusion of the hearing, the court shall make specific findings of fact. The court shall 
169.26 	affirm the revocation if it finds:
169.27 	(1) a factual basis for revocation due to:
169.28 	(i) a violation of the material conditions of the provisional discharge that creates a need 
169.29 	for the patient to return to a more restrictive setting or more intensive community services; 
169.30 	or
169.31 	(ii) a probable danger of harm to the patient or others if the provisional discharge is not 
169.32 	revoked; and
170.1 	(2) that revocation is the least restrictive alternative available.
170.2 	(b) If the court does not affirm the revocation, the court shall order the patient returned 
170.3 	to provisional discharge status.

170.4 	Sec. 75. Minnesota Statutes 2018, section 253B.15, subdivision 5, is amended to read:
170.5 		Subd. 5.Return to facility. When the designated agency gives or sends notice of the 
170.6 	intent to revoke a patient's provisional discharge, it may also apply to the committing court 
170.7 	for an order directing that the patient be returned to a the facility or program from which 
170.8 	the patient was provisionally discharged or another treatment facility, state-operated treatment 
170.9 	program, or community-based treatment program that consents to receive the patient. The 
170.10 	court may order the patient returned to a facility or program prior to a review hearing only 
170.11 	upon finding that immediate return to a facility is necessary because there is a serious 
170.12 	likelihood that the safety of the patient or others will be jeopardized, in that (1) the patient's 
170.13 	need for food, clothing, shelter, or medical care is not being met, or will not be met in the 
170.14 	near future, or (2) the patient has attempted or threatened to seriously harm self or others. 
170.15 	If a voluntary return is not arranged, the head of the treatment facility, state-operated 
170.16 	treatment program, or community-based treatment program may request a health officer or 
170.17 	a peace officer to return the patient to the treatment facility or program from which the 
170.18 	patient was released or to any other treatment facility which, state-operated treatment 
170.19 	program, or community-based treatment program that consents to receive the patient. If 
170.20 	necessary, the head of the treatment facility, state-operated treatment program, or 
170.21 	community-based treatment program may request the committing court to direct a health 
170.22 	officer or peace officer in the county where the patient is located to return the patient to the 
170.23 	treatment facility or program or to another treatment facility which, state-operated treatment 
170.24 	program, or community-based treatment program that consents to receive the patient. The 
170.25 	expense of returning the patient to a regional state-operated treatment center program shall 
170.26 	be paid by the commissioner unless paid by the patient or the patient's relatives. If the court 
170.27 	orders the patient to return to the treatment facility or program, or if a health officer or peace 
170.28 	officer returns the patient to the treatment facility or program, and the patient wants judicial 
170.29 	review of the revocation, the patient or the patient's attorney must file the petition for review 
170.30 	and affidavit required under subdivision 3b within 14 days of receipt of the notice of the 
170.31 	intent to revoke.

171.1 	Sec. 76. Minnesota Statutes 2018, section 253B.15, subdivision 7, is amended to read:
171.2 		Subd. 7.Modification and extension of provisional discharge. (a) A provisional 
171.3 	discharge may be modified upon agreement of the parties.
171.4 	(b) A provisional discharge may be extended only in those circumstances where the 
171.5 	patient has not achieved the goals set forth in the provisional discharge plan or continues 
171.6 	to need the supervision or assistance provided by an extension of the provisional discharge. 
171.7 	In determining whether the provisional discharge is to be extended, the head of the facility
171.8 	designated agency shall consider the willingness and ability of the patient to voluntarily 
171.9 	obtain needed care and treatment.
171.10 	(c) The designated agency shall recommend extension of a provisional discharge only 
171.11 	after a preliminary conference with the patient and other appropriate persons. The patient 
171.12 	shall be given the opportunity to object or make suggestions for alternatives to extension.
171.13 	(d)(c) The designated agency must provide any recommendation for proposed extension 
171.14 	shall be made in writing to the head of the facility and to the patient and the patient's attorney 
171.15 	at least 30 days prior to the expiration of the provisional discharge unless the patient cannot 
171.16 	be located or is unavailable to receive the notice. The written recommendation submitted
171.17 	proposal for extension shall include: the specific grounds for recommending proposing the 
171.18 	extension, the date of the preliminary conference and results, the anniversary date of the 
171.19 	provisional discharge, the termination date of the provisional discharge, and the proposed 
171.20 	length of extension. If the grounds for recommending proposing the extension occur less 
171.21 	than 30 days before its expiration, the designated agency must submit the written 
171.22 	recommendation shall occurproposal for extension as soon as practicable.
171.23 	(e) The head of the facility (d) The designated agency shall extend a provisional discharge 
171.24 	only after providing the patient an opportunity for a meeting to object or make suggestions 
171.25 	for alternatives to an extension. The designated agency shall issue provide a written decision 
171.26 	to the patient and the patient's attorney regarding extension within five days after receiving 
171.27 	the recommendation from the designated agency the patient's input or after holding a meeting 
171.28 	with the patient or after the patient has declined to provide input or participate in the meeting. 
171.29 	The designated agency may seek input from the community-based treatment team or other 
171.30 	persons the patient chooses.

172.1 	Sec. 77. Minnesota Statutes 2018, section 253B.15, is amended by adding a subdivision 
172.2 	to read:
172.3 		Subd. 8a.Provisional discharge extension. If the provisional discharge extends until 
172.4 	the end of the period of commitment and, before the commitment expires, the court extends 
172.5 	the commitment under section 253B.12 or issues a new commitment order under section 
172.6 	253B.13, the provisional discharge shall continue for the duration of the new or extended 
172.7 	period of commitment ordered unless the commitment order provides otherwise or the 
172.8 	designated agency revokes the patient's provisional discharge pursuant to this section. To 
172.9 	continue the patient's provisional discharge under this subdivision, the designated agency 
172.10 	is not required to comply with the procedures in subdivision 7.

172.11 	Sec. 78. Minnesota Statutes 2018, section 253B.15, subdivision 9, is amended to read:
172.12 		Subd. 9.Expiration of provisional discharge. (a) Except as otherwise provided, a 
172.13 	provisional discharge is absolute when it expires. If, while on provisional discharge or 
172.14 	extended provisional discharge, a patient is discharged as provided in section 253B.16, the 
172.15 	discharge shall be absolute.
172.16 	(b) The designated agency shall give notice of the expiration of the provisional discharge 
172.17 	shall be given by the head of the treatment facility to the committing court; the petitioner, 
172.18 	if known; the patient's attorney; the county attorney in the county of commitment; the 
172.19 	commissioner; and the designated agency facility or program that provisionally discharged 
172.20 	the patient.

172.21 	Sec. 79. Minnesota Statutes 2018, section 253B.15, subdivision 10, is amended to read:
172.22 		Subd. 10.Voluntary return. (a) With the consent of the head of the treatment facility
172.23 	or state-operated treatment program, a patient may voluntarily return to inpatient status at 
172.24 	the treatment facility as follows:
172.25 	(1) as a voluntary patient, in which case the patient's commitment is discharged;
172.26 	(2) as a committed patient, in which case the patient's provisional discharge is voluntarily 
172.27 	revoked; or
172.28 	(3) on temporary return from provisional discharge, in which case both the commitment 
172.29 	and the provisional discharge remain in effect.
172.30 	(b) Prior to readmission, the patient shall be informed of status upon readmission.

173.1 	Sec. 80. Minnesota Statutes 2018, section 253B.16, is amended to read:
173.2 	253B.16 DISCHARGE OF COMMITTED PERSONS.
173.3 		Subdivision 1.Date. The head of a treatment facility, state-operated treatment program, 
173.4 	or community-based treatment program shall discharge any patient admitted as a person 
173.5 	who is mentally ill or chemically dependent, or a person with awho poses a risk of harm 
173.6 	due to mental illness, or a person who has a chemical dependency or a developmental 
173.7 	disability admitted under Minnesota Rules of Criminal Procedure, rules 20.01 and 20.02, 
173.8 	to the secure bed component of the Minnesota extended treatment options when the head 
173.9 	of the facility or program certifies that the person is no longer in need of care and treatment 
173.10 	under commitment or at the conclusion of any period of time specified in the commitment 
173.11 	order, whichever occurs first. The head of a treatment facility or program shall discharge 
173.12 	any person admitted as developmentally disabled, except those admitted under Minnesota 
173.13 	Rules of Criminal Procedure, rules 20.01 and 20.02, to the secure bed component of the 
173.14 	Minnesota extended treatment options, a person with a developmental disability when that 
173.15 	person's screening team has determined, under section 256B.092, subdivision 8, that the 
173.16 	person's needs can be met by services provided in the community and a plan has been 
173.17 	developed in consultation with the interdisciplinary team to place the person in the available 
173.18 	community services.
173.19 		Subd. 2.Notification of discharge. Prior to the discharge or provisional discharge of 
173.20 	any committed person patient, the head of the treatment facility, state-operated treatment 
173.21 	program, or community-based treatment program shall notify the designated agency and 
173.22 	the patient's spouse or health care agent, or if there is no spouse or health care agent, then 
173.23 	an adult child, or if there is none, the next of kin of the patient, of the proposed discharge. 
173.24 	The facility or program shall send the notice shall be sent to the last known address of the 
173.25 	person to be notified by certified mail with return receipt. The notice in writing and shall 
173.26 	include the following: (1) the proposed date of discharge or provisional discharge; (2) the 
173.27 	date, time and place of the meeting of the staff who have been treating the patient to discuss 
173.28 	discharge and discharge planning; (3) the fact that the patient will be present at the meeting; 
173.29 	and (4) the fact that the next of kin or health care agent may attend that staff meeting and 
173.30 	present any information relevant to the discharge of the patient. The notice shall be sent at 
173.31 	least one week prior to the date set for the meeting.

174.1 	Sec. 81. Minnesota Statutes 2018, section 253B.17, is amended to read:
174.2 	253B.17 RELEASE; JUDICIAL DETERMINATION.
174.3 		Subdivision 1.Petition. Any patient, except one committed as a sexually dangerous 
174.4 	person or a person with a sexual psychopathic personality or as a person who is mentally 
174.5 	ill andhas a mental illness and is dangerous to the public as provided in section 253B.18, 
174.6 	subdivision 3, or any interested person may petition the committing court or the court to 
174.7 	which venue has been transferred for an order that the patient is not in need of continued 
174.8 	care and treatment under commitment or for an order that an individual is no longer a person 
174.9 	who is mentally ill, developmentally disabled, or chemically dependent who poses a risk 
174.10 	of harm due to mental illness, or a person who has a developmental disability or chemical 
174.11 	dependency, or for any other relief. A patient committed as a person who is mentally ill or 
174.12 	mentally ill and who poses a risk of harm due to mental illness, a person who has a mental 
174.13 	illness and is dangerous or to the public, a sexually dangerous person, or a person with a 
174.14 	sexual psychopathic personality may petition the committing court or the court to which 
174.15 	venue has been transferred for a hearing concerning the administration of neuroleptic 
174.16 	medication.
174.17 		Subd. 2.Notice of hearing. Upon the filing of the petition, the court shall fix the time 
174.18 	and place for the hearing on it. Ten days' notice of the hearing shall be given to the county 
174.19 	attorney, the patient, patient's counsel, the person who filed the initial commitment petition, 
174.20 	the head of the treatment facility or program to which the person is committed, and other 
174.21 	persons as the court directs. Any person may oppose the petition.
174.22 		Subd. 3.Court examiners. The court shall appoint an a court examiner and, at the 
174.23 	patient's request, shall appoint a second court examiner of the patient's choosing to be paid 
174.24 	for by the county at a rate of compensation to be fixed by the court. Unless otherwise agreed 
174.25 	by the parties, the examinersa court examiner shall file a report with the court not less than 
174.26 	48 hours prior to the hearing under this section.
174.27 		Subd. 4.Evidence. The patient, patient's counsel, the petitioner, and the county attorney 
174.28 	shall be entitled to be present at the hearing and to present and cross-examine witnesses, 
174.29 	including court examiners. The court may hear any relevant testimony and evidence which 
174.30 	is offered at the hearing.
174.31 		Subd. 5.Order. Upon completion of the hearing, the court shall enter an order stating 
174.32 	its findings and decision and mail it the order to the head of the treatment facility, 
174.33 	state-operated treatment program, or community-based treatment program.

175.1 	Sec. 82. Minnesota Statutes 2018, section 253B.18, subdivision 1, is amended to read:
175.2 		Subdivision 1.Procedure. (a) Upon the filing of a petition alleging that a proposed 
175.3 	patient is a person who is mentally ill and has a mental illness and is dangerous to the public, 
175.4 	the court shall hear the petition as provided in sections 253B.07 and 253B.08. If the court 
175.5 	finds by clear and convincing evidence that the proposed patient is a person who is mentally 
175.6 	ill and has a mental illness and is dangerous to the public, it shall commit the person to a 
175.7 	secure treatment facility or to a treatment facility or state-operated treatment program willing 
175.8 	to accept the patient under commitment. The court shall commit the patient to a secure 
175.9 	treatment facility unless the patient establishes or others establish by clear and convincing 
175.10 	evidence that a less restrictive state-operated treatment program or treatment program facility
175.11 	is available that is consistent with the patient's treatment needs and the requirements of 
175.12 	public safety. In any case where the petition was filed immediately following the acquittal 
175.13 	of the proposed patient for a crime against the person pursuant to a verdict of not guilty by 
175.14 	reason of mental illness, the verdict constitutes evidence that the proposed patient is a person 
175.15 	who is mentally ill and has a mental illness and is dangerous to the public within the meaning 
175.16 	of this section. The proposed patient has the burden of going forward in the presentation of 
175.17 	evidence. The standard of proof remains as required by this chapter. Upon commitment, 
175.18 	admission procedures shall be carried out pursuant to section 253B.10.
175.19 	(b) Once a patient is admitted to a treatment facility or state-operated treatment program
175.20 	pursuant to a commitment under this subdivision, treatment must begin regardless of whether 
175.21 	a review hearing will be held under subdivision 2.

175.22 	Sec. 83. Minnesota Statutes 2018, section 253B.18, subdivision 2, is amended to read:
175.23 		Subd. 2.Review; hearing. (a) A written treatment report shall be filed by the treatment 
175.24 	facility or state-operated treatment program with the committing court within 60 days after 
175.25 	commitment. If the person is in the custody of the commissioner of corrections when the 
175.26 	initial commitment is ordered under subdivision 1, the written treatment report must be filed 
175.27 	within 60 days after the person is admitted to a secure the state-operated treatment program 
175.28 	or treatment facility. The court shall hold a hearing to make a final determination as to 
175.29 	whether the person patient should remain committed as a person who is mentally ill and
175.30 	has a mental illness and is dangerous to the public. The hearing shall be held within the 
175.31 	earlier of 14 days of the court's receipt of the written treatment report, or within 90 days of 
175.32 	the date of initial commitment or admission, unless otherwise agreed by the parties.
175.33 	(b) The court may, with agreement of the county attorney and the patient's attorney for 
175.34 	the patient:
176.1 	(1) waive the review hearing under this subdivision and immediately order an 
176.2 	indeterminate commitment under subdivision 3; or
176.3 	(2) continue the review hearing for up to one year.
176.4 	(c) If the court finds that the patient should be committed as a person who is mentally 
176.5 	ill who poses a risk of harm due to mental illness, but not as a person who is mentally ill 
176.6 	andhas a mental illness and is dangerous to the public, the court may commit the person
176.7 	patient as a person who is mentally ill who poses a risk of harm due to mental illness and 
176.8 	the person shall be deemed court shall deem the patient not to have been found to be 
176.9 	dangerous to the public for the purposes of subdivisions 4a to 15. Failure of the treatment 
176.10 	facility or state-operated treatment program to provide the required treatment report at the 
176.11 	end of the 60-day period shall not result in automatic discharge of the patient.

176.12 	Sec. 84. Minnesota Statutes 2018, section 253B.18, subdivision 3, is amended to read:
176.13 		Subd. 3.Indeterminate commitment. If the court finds at the final determination hearing 
176.14 	held pursuant to subdivision 2 that the patient continues to be a person who is mentally ill 
176.15 	andhas a mental illness and is dangerous to the public, then the court shall order commitment 
176.16 	of the proposed patient for an indeterminate period of time. After a final determination that 
176.17 	a patient is a person who is mentally ill and has a mental illness and is dangerous to the 
176.18 	public, the patient shall be transferred, provisionally discharged or discharged, only as 
176.19 	provided in this section.

176.20 	Sec. 85. Minnesota Statutes 2018, section 253B.18, subdivision 4a, is amended to read:
176.21 		Subd. 4a.Release on pass; notification. A patient who has been committed as a person 
176.22 	who is mentally ill and has a mental illness and is dangerous to the public and who is confined 
176.23 	at a secure treatment facility or has been transferred out of a state-operated services secure 
176.24 	treatment facility according to section 253B.18, subdivision 6, shall not be released on a 
176.25 	pass unless the pass is part of a pass plan that has been approved by the medical director of 
176.26 	the secure treatment facility. The pass plan must have a specific therapeutic purpose 
176.27 	consistent with the treatment plan, must be established for a specific period of time, and 
176.28 	must have specific levels of liberty delineated. The county case manager must be invited 
176.29 	to participate in the development of the pass plan. At least ten days prior to a determination 
176.30 	on the plan, the medical director shall notify the designated agency, the committing court, 
176.31 	the county attorney of the county of commitment, an interested person, the local law 
176.32 	enforcement agency where the facility is located, the county attorney and the local law 
176.33 	enforcement agency in the location where the pass is to occur, the petitioner, and the 
177.1 	petitioner's counsel of the plan, the nature of the passes proposed, and their right to object 
177.2 	to the plan. If any notified person objects prior to the proposed date of implementation, the 
177.3 	person shall have an opportunity to appear, personally or in writing, before the medical 
177.4 	director, within ten days of the objection, to present grounds for opposing the plan. The 
177.5 	pass plan shall not be implemented until the objecting person has been furnished that 
177.6 	opportunity. Nothing in this subdivision shall be construed to give a patient an affirmative 
177.7 	right to a pass plan.

177.8 	Sec. 86. Minnesota Statutes 2018, section 253B.18, subdivision 4b, is amended to read:
177.9 		Subd. 4b.Pass-eligible status; notification. (a) The following patients committed to a 
177.10 	secure treatment facility shall not be placed on pass-eligible status unless that status has 
177.11 	been approved by the medical director of the secure treatment facility:
177.12 	(a) (1) a patient who has been committed as a person who is mentally ill and has a mental 
177.13 	illness and is dangerous to the public and who:
177.14 	(1) (i) was found incompetent to proceed to trial for a felony or was found not guilty by 
177.15 	reason of mental illness of a felony immediately prior to the filing of the commitment 
177.16 	petition;
177.17 	(2) (ii) was convicted of a felony immediately prior to or during commitment as a person 
177.18 	who is mentally ill and has a mental illness and is dangerous to the public; or
177.19 	(3) (iii) is subject to a commitment to the commissioner of corrections; and
177.20 	(b) (2) a patient who has been committed as a psychopathic personality, a sexually 
177.21 	psychopathic personality, or a sexually dangerous person.
177.22 	(b) At least ten days prior to a determination on the status, the medical director shall 
177.23 	notify the committing court, the county attorney of the county of commitment, the designated 
177.24 	agency, an interested person, the petitioner, and the petitioner's counsel of the proposed 
177.25 	status, and their right to request review by the special review board. If within ten days of 
177.26 	receiving notice any notified person requests review by filing a notice of objection with the 
177.27 	commissioner and the head of the secure treatment facility, a hearing shall be held before 
177.28 	the special review board. The proposed status shall not be implemented unless it receives 
177.29 	a favorable recommendation by a majority of the board and approval by the commissioner. 
177.30 	The order of the commissioner is appealable as provided in section 253B.19.
177.31 	(c) Nothing in this subdivision shall be construed to give a patient an affirmative right 
177.32 	to seek pass-eligible status from the special review board.

178.1 	Sec. 87. Minnesota Statutes 2018, section 253B.18, subdivision 4c, is amended to read:
178.2 		Subd. 4c.Special review board. (a) The commissioner shall establish one or more 
178.3 	panels of a special review board. The board shall consist of three members experienced in 
178.4 	the field of mental illness. One member of each special review board panel shall be a 
178.5 	psychiatrist or a doctoral level psychologist with forensic experience and one member shall 
178.6 	be an attorney. No member shall be affiliated with the Department of Human Services. The 
178.7 	special review board shall meet at least every six months and at the call of the commissioner. 
178.8 	It shall hear and consider all petitions for a reduction in custody or to appeal a revocation 
178.9 	of provisional discharge. A "reduction in custody" means transfer from a secure treatment 
178.10 	facility, discharge, and provisional discharge. Patients may be transferred by the 
178.11 	commissioner between secure treatment facilities without a special review board hearing.
178.12 	Members of the special review board shall receive compensation and reimbursement 
178.13 	for expenses as established by the commissioner.
178.14 	(b) The special review board must review each denied petition under subdivision 5 for 
178.15 	barriers and obstacles preventing the patient from progressing in treatment. Based on the 
178.16 	cases before the board in the previous year, the special review board shall provide to the 
178.17 	commissioner an annual summation of the barriers to treatment progress, and 
178.18 	recommendations to achieve the common goal of making progress in treatment.
178.19 	(c) A petition filed by a person committed as mentally ill anda person who has a mental 
178.20 	illness and is dangerous to the public under this section must be heard as provided in 
178.21 	subdivision 5 and, as applicable, subdivision 13. A petition filed by a person committed as 
178.22 	a sexual psychopathic personality or as a sexually dangerous person under chapter 253D, 
178.23 	or committed as both mentally ill and a person who has a mental illness and is dangerous 
178.24 	to the public under this section and as a sexual psychopathic personality or as a sexually 
178.25 	dangerous person must be heard as provided in section 253D.27.

178.26 	Sec. 88. Minnesota Statutes 2018, section 253B.18, subdivision 5, is amended to read:
178.27 		Subd. 5.Petition; notice of hearing; attendance; order. (a) A petition for a reduction 
178.28 	in custody or revocation of provisional discharge shall be filed with the commissioner and 
178.29 	may be filed by the patient or by the head of the treatment facility or state-operated treatment 
178.30 	program to which the person was committed or has been transferred. A patient may not 
178.31 	petition the special review board for six months following commitment under subdivision 
178.32 	3 or following the final disposition of any previous petition and subsequent appeal by the 
178.33 	patient. The head of the state-operated treatment program or head of the treatment facility 
178.34 	must schedule a hearing before the special review board for any patient who has not appeared 
179.1 	before the special review board in the previous three years, and schedule a hearing at least 
179.2 	every three years thereafter. The medical director may petition at any time.
179.3 	(b) Fourteen days prior to the hearing, the committing court, the county attorney of the 
179.4 	county of commitment, the designated agency, interested person, the petitioner, and the 
179.5 	petitioner's counsel shall be given written notice by the commissioner of the time and place 
179.6 	of the hearing before the special review board. Only those entitled to statutory notice of the 
179.7 	hearing or those administratively required to attend may be present at the hearing. The 
179.8 	patient may designate interested persons to receive notice by providing the names and 
179.9 	addresses to the commissioner at least 21 days before the hearing. The board shall provide 
179.10 	the commissioner with written findings of fact and recommendations within 21 days of the 
179.11 	hearing. The commissioner shall issue an order no later than 14 days after receiving the 
179.12 	recommendation of the special review board. A copy of the order shall be mailed to every 
179.13 	person entitled to statutory notice of the hearing within five days after it the order is signed. 
179.14 	No order by the commissioner shall be effective sooner than 30 days after the order is signed, 
179.15 	unless the county attorney, the patient, and the commissioner agree that it may become 
179.16 	effective sooner.
179.17 	(c) The special review board shall hold a hearing on each petition prior to making its 
179.18 	recommendation to the commissioner. The special review board proceedings are not contested 
179.19 	cases as defined in chapter 14. Any person or agency receiving notice that submits 
179.20 	documentary evidence to the special review board prior to the hearing shall also provide 
179.21 	copies to the patient, the patient's counsel, the county attorney of the county of commitment, 
179.22 	the case manager, and the commissioner.
179.23 	(d) Prior to the final decision by the commissioner, the special review board may be 
179.24 	reconvened to consider events or circumstances that occurred subsequent to the hearing.
179.25 	(e) In making their recommendations and order, the special review board and 
179.26 	commissioner must consider any statements received from victims under subdivision 5a.

179.27 	Sec. 89. Minnesota Statutes 2018, section 253B.18, subdivision 5a, is amended to read:
179.28 		Subd. 5a.Victim notification of petition and release; right to submit statement. (a) 
179.29 	As used in this subdivision:
179.30 	(1) "crime" has the meaning given to "violent crime" in section 609.1095, and includes 
179.31 	criminal sexual conduct in the fifth degree and offenses within the definition of "crime 
179.32 	against the person" in section 253B.02, subdivision 4a, and also includes offenses listed in 
180.1 	section 253D.02, subdivision 8, paragraph (b), regardless of whether they are sexually 
180.2 	motivated;
180.3 	(2) "victim" means a person who has incurred loss or harm as a result of a crime the 
180.4 	behavior for which forms the basis for a commitment under this section or chapter 253D; 
180.5 	and
180.6 	(3) "convicted" and "conviction" have the meanings given in section 609.02, subdivision 
180.7 	5, and also include juvenile court adjudications, findings under Minnesota Rules of Criminal 
180.8 	Procedure, rule 20.02, that the elements of a crime have been proved, and findings in 
180.9 	commitment cases under this section or chapter 253D that an act or acts constituting a crime 
180.10 	occurred.
180.11 	(b) A county attorney who files a petition to commit a person under this section or chapter 
180.12 	253D shall make a reasonable effort to provide prompt notice of filing the petition to any 
180.13 	victim of a crime for which the person was convicted. In addition, the county attorney shall 
180.14 	make a reasonable effort to promptly notify the victim of the resolution of the petition.
180.15 	(c) Before provisionally discharging, discharging, granting pass-eligible status, approving 
180.16 	a pass plan, or otherwise permanently or temporarily releasing a person committed under 
180.17 	this section from a state-operated treatment program or treatment facility, the head of the 
180.18 	state-operated treatment program or head of the treatment facility shall make a reasonable 
180.19 	effort to notify any victim of a crime for which the person was convicted that the person 
180.20 	may be discharged or released and that the victim has a right to submit a written statement 
180.21 	regarding decisions of the medical director, special review board, or commissioner with 
180.22 	respect to the person. To the extent possible, the notice must be provided at least 14 days 
180.23 	before any special review board hearing or before a determination on a pass plan. 
180.24 	Notwithstanding section 611A.06, subdivision 4, the commissioner shall provide the judicial 
180.25 	appeal panel with victim information in order to comply with the provisions of this section. 
180.26 	The judicial appeal panel shall ensure that the data on victims remains private as provided 
180.27 	for in section 611A.06, subdivision 4.
180.28 	(d) This subdivision applies only to victims who have requested notification through 
180.29 	the Department of Corrections electronic victim notification system, or by contacting, in 
180.30 	writing, the county attorney in the county where the conviction for the crime occurred. A 
180.31 	request for notice under this subdivision received by the commissioner of corrections through 
180.32 	the Department of Corrections electronic victim notification system shall be promptly 
180.33 	forwarded to the prosecutorial authority with jurisdiction over the offense to which the 
180.34 	notice relates or, following commitment, the head of the state-operated treatment program 
181.1 	or head of the treatment facility. A county attorney who receives a request for notification 
181.2 	under this paragraph following commitment shall promptly forward the request to the 
181.3 	commissioner of human services.
181.4 	(e) The rights under this subdivision are in addition to rights available to a victim under 
181.5 	chapter 611A. This provision does not give a victim all the rights of a "notified person" or 
181.6 	a person "entitled to statutory notice" under subdivision 4a, 4b, or 5 or section 253D.14.

181.7 	Sec. 90. Minnesota Statutes 2018, section 253B.18, subdivision 6, is amended to read:
181.8 		Subd. 6.Transfer. (a) A patient who is mentally ill and a person who has a mental 
181.9 	illness and is dangerous to the public shall not be transferred out of a secure treatment facility 
181.10 	unless it appears to the satisfaction of the commissioner, after a hearing and favorable 
181.11 	recommendation by a majority of the special review board, that the transfer is appropriate. 
181.12 	Transfer may be to other regional centers under the commissioner's control another 
181.13 	state-operated treatment program. In those instances where a commitment also exists to the 
181.14 	Department of Corrections, transfer may be to a facility designated by the commissioner of 
181.15 	corrections.
181.16 	(b) The following factors must be considered in determining whether a transfer is 
181.17 	appropriate:
181.18 	(1) the person's clinical progress and present treatment needs;
181.19 	(2) the need for security to accomplish continuing treatment;
181.20 	(3) the need for continued institutionalization;
181.21 	(4) which facility can best meet the person's needs; and
181.22 	(5) whether transfer can be accomplished with a reasonable degree of safety for the 
181.23 	public.

181.24 	Sec. 91. Minnesota Statutes 2018, section 253B.18, subdivision 7, is amended to read:
181.25 		Subd. 7.Provisional discharge. (a) A patient who is mentally ill and a person who has 
181.26 	a mental illness and is dangerous to the public shall not be provisionally discharged unless 
181.27 	it appears to the satisfaction of the commissioner, after a hearing and a favorable 
181.28 	recommendation by a majority of the special review board, that the patient is capable of 
181.29 	making an acceptable adjustment to open society.
181.30 	(b) The following factors are to be considered in determining whether a provisional 
181.31 	discharge shall be recommended: (1) whether the patient's course of hospitalization and 
182.1 	present mental status indicate there is no longer a need for treatment and supervision in the 
182.2 	patient's current treatment setting; and (2) whether the conditions of the provisional discharge 
182.3 	plan will provide a reasonable degree of protection to the public and will enable the patient 
182.4 	to adjust successfully to the community.

182.5 	Sec. 92. Minnesota Statutes 2018, section 253B.18, subdivision 8, is amended to read:
182.6 		Subd. 8.Provisional discharge plan. A provisional discharge plan shall be developed, 
182.7 	implemented, and monitored by the designated agency in conjunction with the patient, the 
182.8 	treatment facility or state-operated treatment program to which the person is committed,
182.9 	and other appropriate persons. The designated agency shall, at least quarterly, review the 
182.10 	provisional discharge plan with the patient and submit a written report to the commissioner 
182.11 	and the treatment facility or program concerning the patient's status and compliance with 
182.12 	each term of the provisional discharge plan.

182.13 	Sec. 93. Minnesota Statutes 2018, section 253B.18, subdivision 10, is amended to read:
182.14 		Subd. 10.Provisional discharge; revocation. (a) The head of the treatment facility or 
182.15 	state-operated treatment program from which the person was provisionally discharged may 
182.16 	revoke a provisional discharge if any of the following grounds exist:
182.17 	(i) the patient has departed from the conditions of the provisional discharge plan;
182.18 	(ii) the patient is exhibiting signs of a mental illness which may require in-hospital 
182.19 	evaluation or treatment; or
182.20 	(iii) the patient is exhibiting behavior which may be dangerous to self or others.
182.21 	(b) Revocation shall be commenced by a notice of intent to revoke provisional discharge, 
182.22 	which shall be served upon the patient, patient's counsel, and the designated agency. The 
182.23 	notice shall set forth the grounds upon which the intention to revoke is based, and shall 
182.24 	inform the patient of the rights of a patient under this chapter.
182.25 	(c) In all nonemergency situations, prior to revoking a provisional discharge, the head 
182.26 	of the treatment facility or program shall obtain a revocation report from the designated 
182.27 	agency outlining the specific reasons for recommending the revocation, including but not 
182.28 	limited to the specific facts upon which the revocation recommendation is based.
182.29 	(d) The patient must be provided a copy of the revocation report and informed orally 
182.30 	and in writing of the rights of a patient under this section.

183.1 	Sec. 94. Minnesota Statutes 2018, section 253B.18, subdivision 11, is amended to read:
183.2 		Subd. 11.Exceptions. If an emergency exists, the head of the treatment facility or 
183.3 	state-operated treatment program may revoke the provisional discharge and, either orally 
183.4 	or in writing, order that the patient be immediately returned to the treatment facility or 
183.5 	program. In emergency cases, a revocation report documenting reasons for revocation shall 
183.6 	be submitted by the designated agency within seven days after the patient is returned to the 
183.7 	treatment facility or program.

183.8 	Sec. 95. Minnesota Statutes 2018, section 253B.18, subdivision 12, is amended to read:
183.9 		Subd. 12.Return of patient. After revocation of a provisional discharge or if the patient 
183.10 	is absent without authorization, the head of the treatment facility or state-operated treatment 
183.11 	program may request the patient to return to the treatment facility or program voluntarily. 
183.12 	The head of the treatment facility or state-operated treatment program may request a health 
183.13 	officer, a welfare officer, or a peace officer to return the patient to the treatment facility or 
183.14 	program. If a voluntary return is not arranged, the head of the treatment facility or 
183.15 	state-operated treatment program shall inform the committing court of the revocation or 
183.16 	absence and the court shall direct a health or peace officer in the county where the patient 
183.17 	is located to return the patient to the treatment facility or program or to another state-operated 
183.18 	treatment program or to another treatment facility willing to accept the patient. The expense 
183.19 	of returning the patient to a regional state-operated treatment center program shall be paid 
183.20 	by the commissioner unless paid by the patient or other persons on the patient's behalf.

183.21 	Sec. 96. Minnesota Statutes 2018, section 253B.18, subdivision 14, is amended to read:
183.22 		Subd. 14.Voluntary readmission. (a) With the consent of the head of the treatment 
183.23 	facility or state-operated treatment program, a patient may voluntarily return from provisional 
183.24 	discharge for a period of up to 30 days, or up to 60 days with the consent of the designated 
183.25 	agency. If the patient is not returned to provisional discharge status within 60 days, the 
183.26 	provisional discharge is revoked. Within 15 days of receiving notice of the change in status, 
183.27 	the patient may request a review of the matter before the special review board. The board 
183.28 	may recommend a return to a provisional discharge status.
183.29 	(b) The treatment facility or state-operated treatment program is not required to petition 
183.30 	for a further review by the special review board unless the patient's return to the community 
183.31 	results in substantive change to the existing provisional discharge plan. All the terms and 
183.32 	conditions of the provisional discharge order shall remain unchanged if the patient is released 
183.33 	again.

184.1 	Sec. 97. Minnesota Statutes 2018, section 253B.18, subdivision 15, is amended to read:
184.2 		Subd. 15.Discharge. (a) A patient who is mentally ill and a person who has a mental 
184.3 	illness and is dangerous to the public shall not be discharged unless it appears to the 
184.4 	satisfaction of the commissioner, after a hearing and a favorable recommendation by a 
184.5 	majority of the special review board, that the patient is capable of making an acceptable 
184.6 	adjustment to open society, is no longer dangerous to the public, and is no longer in need 
184.7 	of treatment and supervision.
184.8 	(b) In determining whether a discharge shall be recommended, the special review board 
184.9 	and commissioner shall consider whether specific conditions exist to provide a reasonable 
184.10 	degree of protection to the public and to assist the patient in adjusting to the community. If 
184.11 	the desired conditions do not exist, the discharge shall not be granted.

184.12 	Sec. 98. Minnesota Statutes 2018, section 253B.19, subdivision 2, is amended to read:
184.13 		Subd. 2.Petition; hearing. (a) A person patient committed as mentally ill anda person 
184.14 	who has a mental illness and is dangerous to the public under section 253B.18, or the county 
184.15 	attorney of the county from which the person patient was committed or the county of financial 
184.16 	responsibility, may petition the judicial appeal panel for a rehearing and reconsideration of 
184.17 	a decision by the commissioner under section 253B.18, subdivision 5. The judicial appeal 
184.18 	panel must not consider petitions for relief other than those considered by the commissioner 
184.19 	from which the appeal is taken. The petition must be filed with the supreme court within 
184.20 	30 days after the decision of the commissioner is signed. The hearing must be held within 
184.21 	45 days of the filing of the petition unless an extension is granted for good cause.
184.22 	(b) For an appeal under paragraph (a), the supreme court shall refer the petition to the 
184.23 	chief judge of the judicial appeal panel. The chief judge shall notify the patient, the county 
184.24 	attorney of the county of commitment, the designated agency, the commissioner, the head 
184.25 	of the treatment facility or program to which the patient was committed, any interested 
184.26 	person, and other persons the chief judge designates, of the time and place of the hearing 
184.27 	on the petition. The notice shall be given at least 14 days prior to the date of the hearing.
184.28 	(c) Any person may oppose the petition. The patient, the patient's counsel, the county 
184.29 	attorney of the committing county or the county of financial responsibility, and the 
184.30 	commissioner shall participate as parties to the proceeding pending before the judicial appeal 
184.31 	panel and shall, except when the patient is committed solely as mentally ill and a person 
184.32 	who has a mental illness and is dangerous to the public, no later than 20 days before the 
184.33 	hearing on the petition, inform the judicial appeal panel and the opposing party in writing 
184.34 	whether they support or oppose the petition and provide a summary of facts in support of 
185.1 	their position. The judicial appeal panel may appoint court examiners and may adjourn the 
185.2 	hearing from time to time. It shall hear and receive all relevant testimony and evidence and 
185.3 	make a record of all proceedings. The patient, the patient's counsel, and the county attorney 
185.4 	of the committing county or the county of financial responsibility have the right to be present 
185.5 	and may present and cross-examine all witnesses and offer a factual and legal basis in 
185.6 	support of their positions. The petitioning party seeking discharge or provisional discharge 
185.7 	bears the burden of going forward with the evidence, which means presenting a prima facie 
185.8 	case with competent evidence to show that the person is entitled to the requested relief. If 
185.9 	the petitioning party has met this burden, the party opposing discharge or provisional 
185.10 	discharge bears the burden of proof by clear and convincing evidence that the discharge or 
185.11 	provisional discharge should be denied. A party seeking transfer under section 253B.18, 
185.12 	subdivision 6, must establish by a preponderance of the evidence that the transfer is 
185.13 	appropriate.

185.14 	Sec. 99. Minnesota Statutes 2018, section 253B.20, subdivision 1, is amended to read:
185.15 		Subdivision 1.Notice to court. When a committed person is discharged, provisionally 
185.16 	discharged, or transferred to another treatment facility, or partially hospitalized state-operated 
185.17 	treatment program, or community-based treatment program, or when the person patient
185.18 	dies, is absent without authorization, or is returned, the treatment facility, state-operated 
185.19 	treatment program, or community-based treatment program having custody of the patient 
185.20 	shall notify the committing court, the county attorney, and the patient's attorney.

185.21 	Sec. 100. Minnesota Statutes 2018, section 253B.20, subdivision 2, is amended to read:
185.22 		Subd. 2.Necessities. The head of thestate-operated treatment facility program shall 
185.23 	make necessary arrangements at the expense of the state to insure that no patient is discharged 
185.24 	or provisionally discharged without suitable clothing. The head of the state-operated treatment 
185.25 	facility program shall, if necessary, provide the patient with a sufficient sum of money to 
185.26 	secure transportation home, or to another destination of the patient's choice, if the destination 
185.27 	is located within a reasonable distance of the state-operated treatment facility program. The 
185.28 	commissioner shall establish procedures by rule to help the patient receive all public 
185.29 	assistance benefits provided by state or federal law to which the patient is entitled by 
185.30 	residence and circumstances. The rule shall be uniformly applied in all counties. All counties 
185.31 	shall provide temporary relief whenever necessary to meet the intent of this subdivision.

186.1 	Sec. 101. Minnesota Statutes 2018, section 253B.20, subdivision 3, is amended to read:
186.2 		Subd. 3.Notice to designated agency. The head of the treatment facility, state-operated 
186.3 	treatment program, or community-based treatment program, upon the provisional discharge 
186.4 	of any committed person, shall notify the designated agency before the patient leaves the 
186.5 	treatment facility or program. Whenever possible the notice shall be given at least one week 
186.6 	before the patient is to leave the facility or program.

186.7 	Sec. 102. Minnesota Statutes 2018, section 253B.20, subdivision 4, is amended to read:
186.8 		Subd. 4.Aftercare services. Prior to the date of discharge or provisional discharge of 
186.9 	any committed person, the designated agency of the county of financial responsibility, in 
186.10 	cooperation with the head of the treatment facility, state-operated treatment program, or 
186.11 	community-based treatment program, and the patient's physician mental health professional, 
186.12 	if notified pursuant to subdivision 6, shall establish a continuing plan of aftercare services 
186.13 	for the patient including a plan for medical and psychiatric treatment, nursing care, vocational 
186.14 	assistance, and other assistance the patient needs. The designated agency shall provide case 
186.15 	management services, supervise and assist the patient in finding employment, suitable 
186.16 	shelter, and adequate medical and psychiatric treatment, and aid in the patient's readjustment 
186.17 	to the community.

186.18 	Sec. 103. Minnesota Statutes 2018, section 253B.20, subdivision 6, is amended to read:
186.19 		Subd. 6.Notice to physicianmental health professional. The head of the treatment 
186.20 	facility, state-operated treatment program, or community-based treatment program shall 
186.21 	notify the physician mental health professional of any committed person at the time of the 
186.22 	patient's discharge or provisional discharge, unless the patient objects to the notice.

186.23 	Sec. 104. Minnesota Statutes 2018, section 253B.21, subdivision 1, is amended to read:
186.24 		Subdivision 1.Administrative procedures. If the patient is entitled to care by any 
186.25 	agency of the United States in this state, the commitment warrant shall be in triplicate, 
186.26 	committing the patient to the joint custody of the head of the treatment facility, state-operated 
186.27 	treatment program, or community-based treatment program and the federal agency. If the 
186.28 	federal agency is unable or unwilling to receive the patient at the time of commitment, the 
186.29 	patient may subsequently be transferred to it upon its request.

187.1 	Sec. 105. Minnesota Statutes 2018, section 253B.21, subdivision 2, is amended to read:
187.2 		Subd. 2.Applicable regulations. Any person, when admitted to an institution of a 
187.3 	federal agency within or without this state, shall be subject to the rules and regulations of 
187.4 	the federal agency, except that nothing in this section shall deprive any person of rights 
187.5 	secured to patients of state state-operated treatment programs, treatment facilities, and 
187.6 	community-based treatment programs by this chapter.

187.7 	Sec. 106. Minnesota Statutes 2018, section 253B.21, subdivision 3, is amended to read:
187.8 		Subd. 3.Powers. The chief officer of any treatment facility operated by a federal agency 
187.9 	to which any person is admitted shall have the same powers as the heads of treatment 
187.10 	facilities state-operated treatment programs within this state with respect to admission, 
187.11 	retention of custody, transfer, parole, or discharge of the committed person.

187.12 	Sec. 107. Minnesota Statutes 2018, section 253B.212, subdivision 1, is amended to read:
187.13 		Subdivision 1.Cost of care; commitment by tribal court order; Red Lake Band of 
187.14 	Chippewa Indians. The commissioner of human services may contract with and receive 
187.15 	payment from the Indian Health Service of the United States Department of Health and 
187.16 	Human Services for the care and treatment of those members of the Red Lake Band of 
187.17 	Chippewa Indians who have been committed by tribal court order to the Indian Health 
187.18 	Service for care and treatment of mental illness, developmental disability, or chemical 
187.19 	dependency. The contract shall provide that the Indian Health Service may not transfer any 
187.20 	person for admission to a regional center state-operated treatment program unless the 
187.21 	commitment procedure utilized by the tribal court provided due process protections similar 
187.22 	to those afforded by sections 253B.05 253B.051 to 253B.10.

187.23 	Sec. 108. Minnesota Statutes 2018, section 253B.212, subdivision 1a, is amended to read:
187.24 		Subd. 1a.Cost of care; commitment by tribal court order; White Earth Band of 
187.25 	Ojibwe Indians. The commissioner of human services may contract with and receive 
187.26 	payment from the Indian Health Service of the United States Department of Health and 
187.27 	Human Services for the care and treatment of those members of the White Earth Band of 
187.28 	Ojibwe Indians who have been committed by tribal court order to the Indian Health Service 
187.29 	for care and treatment of mental illness, developmental disability, or chemical dependency. 
187.30 	The tribe may also contract directly with the commissioner for treatment of those members 
187.31 	of the White Earth Band who have been committed by tribal court order to the White Earth 
187.32 	Department of Health for care and treatment of mental illness, developmental disability, or 
188.1 	chemical dependency. The contract shall provide that the Indian Health Service and the 
188.2 	White Earth Band shall not transfer any person for admission to a regional center
188.3 	state-operated treatment program unless the commitment procedure utilized by the tribal 
188.4 	court provided due process protections similar to those afforded by sections 253B.05
188.5 	253B.051 to 253B.10.

188.6 	Sec. 109. Minnesota Statutes 2018, section 253B.212, subdivision 1b, is amended to read:
188.7 		Subd. 1b.Cost of care; commitment by tribal court order; any federally recognized 
188.8 	Indian tribe within the state of Minnesota. The commissioner of human services may 
188.9 	contract with and receive payment from the Indian Health Service of the United States 
188.10 	Department of Health and Human Services for the care and treatment of those members of 
188.11 	any federally recognized Indian tribe within the state, who have been committed by tribal 
188.12 	court order to the Indian Health Service for care and treatment of mental illness, 
188.13 	developmental disability, or chemical dependency. The tribe may also contract directly with 
188.14 	the commissioner for treatment of those members of any federally recognized Indian tribe 
188.15 	within the state who have been committed by tribal court order to the respective tribal 
188.16 	Department of Health for care and treatment of mental illness, developmental disability, or 
188.17 	chemical dependency. The contract shall provide that the Indian Health Service and any 
188.18 	federally recognized Indian tribe within the state shall not transfer any person for admission 
188.19 	to a regional center state-operated treatment program unless the commitment procedure 
188.20 	utilized by the tribal court provided due process protections similar to those afforded by 
188.21 	sections 253B.05 253B.051 to 253B.10.

188.22 	Sec. 110. Minnesota Statutes 2018, section 253B.212, subdivision 2, is amended to read:
188.23 		Subd. 2.Effect given to tribal commitment order. (a) When, under an agreement 
188.24 	entered into pursuant to subdivision 1, 1a, or 1b, the Indian Health Service or the placing 
188.25 	tribe applies to a regional center state-operated treatment program for admission of a person 
188.26 	committed to the jurisdiction of the health service by the tribal court as a person who is 
188.27 	mentally ill, developmentally disabled, or chemically dependent due to mental illness, 
188.28 	developmental disability, or chemical dependency, the commissioner may treat the patient 
188.29 	with the consent of the Indian Health Service or the placing tribe.
188.30 	(b) A person admitted to a regional center state-operated treatment program pursuant to 
188.31 	this section has all the rights accorded by section 253B.03. In addition, treatment reports, 
188.32 	prepared in accordance with the requirements of section 253B.12, subdivision 1, shall be 
188.33 	filed with the Indian Health Service or the placing tribe within 60 days of commencement 
189.1 	of the patient's stay at the facility program. A subsequent treatment report shall be filed with 
189.2 	the Indian Health Service or the placing tribe within six months of the patient's admission 
189.3 	to the facility program or prior to discharge, whichever comes first. Provisional discharge 
189.4 	or transfer of the patient may be authorized by the head of the treatment facility program
189.5 	only with the consent of the Indian Health Service or the placing tribe. Discharge from the 
189.6 	facility program to the Indian Health Service or the placing tribe may be authorized by the 
189.7 	head of the treatment facility program after notice to and consultation with the Indian Health 
189.8 	Service or the placing tribe.

189.9 	Sec. 111. Minnesota Statutes 2018, section 253B.22, subdivision 1, is amended to read:
189.10 		Subdivision 1.Establishment. The commissioner shall establish a review board of three 
189.11 	or more persons for each regional center the Anoka-Metro Regional Treatment Center, 
189.12 	Minnesota Security Hospital, and Minnesota sex offender program to review the admission 
189.13 	and retention of its patients of that program receiving services under this chapter. One 
189.14 	member shall be qualified in the diagnosis of mental illness, developmental disability, or 
189.15 	chemical dependency, and one member shall be an attorney. The commissioner may, upon 
189.16 	written request from the appropriate federal authority, establish a review panel for any 
189.17 	federal treatment facility within the state to review the admission and retention of patients 
189.18 	hospitalized under this chapter. For any review board established for a federal treatment 
189.19 	facility, one of the persons appointed by the commissioner shall be the commissioner of 
189.20 	veterans affairs or the commissioner's designee.

189.21 	Sec. 112. Minnesota Statutes 2018, section 253B.22, subdivision 2, is amended to read:
189.22 		Subd. 2.Right to appear. Each treatment facility program specified in subdivision 1
189.23 	shall be visited by the review board at least once every six months. Upon request each 
189.24 	patient in the treatment facility program shall have the right to appear before the review 
189.25 	board during the visit.

189.26 	Sec. 113. Minnesota Statutes 2018, section 253B.22, subdivision 3, is amended to read:
189.27 		Subd. 3.Notice. The head of the treatment facility each program specified in subdivision 
189.28 	1 shall notify each patient at the time of admission by a simple written statement of the 
189.29 	patient's right to appear before the review board and the next date when the board will visit 
189.30 	the treatment facility that program. A request to appear before the board need not be in 
189.31 	writing. Any employee of the treatment facility program receiving a patient's request to 
189.32 	appear before the board shall notify the head of the treatment facility program of the request.

190.1 	Sec. 114. Minnesota Statutes 2018, section 253B.22, subdivision 4, is amended to read:
190.2 		Subd. 4.Review. The board shall review the admission and retention of patients at its 
190.3 	respective treatment facility the program. The board may examine the records of all patients 
190.4 	admitted and may examine personally at its own instigation all patients who from the records 
190.5 	or otherwise appear to justify reasonable doubt as to continued need of confinement in a 
190.6 	treatment facility the program. The review board shall report its findings to the commissioner 
190.7 	and to the head of the treatment facility program. The board may also receive reports from 
190.8 	patients, interested persons, and treatment facility employees of the program, and investigate 
190.9 	conditions affecting the care of patients.

190.10 	Sec. 115. Minnesota Statutes 2018, section 253B.23, subdivision 1, is amended to read:
190.11 		Subdivision 1.Costs of hearings. (a) In each proceeding under this chapter the court 
190.12 	shall allow and order paid to each witness subpoenaed the fees and mileage prescribed by 
190.13 	law; to each examiner a reasonable sum for services and for travel; to persons conveying 
190.14 	the patient to the place of detention, disbursements for the travel, board, and lodging of the 
190.15 	patient and of themselves and their authorized assistants; and to the patient's counsel, when 
190.16 	appointed by the court, a reasonable sum for travel and for the time spent in court or in 
190.17 	preparing for the hearing. Upon the court's order, the county auditor shall issue a warrant 
190.18 	on the county treasurer for payment of the amounts allowed, excluding the costs of the court 
190.19 	examiner, which must be paid by the state courts.
190.20 	(b) Whenever venue of a proceeding has been transferred under this chapter, the costs 
190.21 	of the proceedings shall be reimbursed to the county where the proceedings were conducted 
190.22 	by the county of financial responsibility.

190.23 	Sec. 116. Minnesota Statutes 2018, section 253B.23, subdivision 1b, is amended to read:
190.24 		Subd. 1b.Responsibility for conducting prepetition screening and filing commitment 
190.25 	and early intervention petitions. (a) The county of financial responsibility is responsible 
190.26 	to conduct prepetition screening pursuant to section 253B.07, subdivision 1, and, if statutory 
190.27 	conditions for early intervention or commitment are satisfied, to file a petition pursuant to 
190.28 	section 253B.064, subdivision 1, paragraph (a);253B.07, subdivision 1subdivision 2, 
190.29 	paragraph (a);, or 253D.07.
190.30 	(b) Except in cases under chapter 253D, if the county of financial responsibility refuses 
190.31 	or fails to conduct prepetition screening or file a petition, or if it is unclear which county is 
190.32 	the county of financial responsibility, the county where the proposed patient is present is 
191.1 	responsible to conduct the prepetition screening and, if statutory conditions for early 
191.2 	intervention or commitment are satisfied, file the petition.
191.3 	(c) In cases under chapter 253D, if the county of financial responsibility refuses or fails 
191.4 	to file a petition, or if it is unclear which county is the county of financial responsibility, 
191.5 	then (1) the county where the conviction for which the person is incarcerated was entered, 
191.6 	or (2) the county where the proposed patient is present, if the person is not currently 
191.7 	incarcerated based on conviction, is responsible to file the petition if statutory conditions 
191.8 	for commitment are satisfied.
191.9 	(d) When a proposed patient is an inmate confined to an adult correctional facility under 
191.10 	the control of the commissioner of corrections and commitment proceedings are initiated 
191.11 	or proposed to be initiated pursuant to section 241.69, the county where the correctional 
191.12 	facility is located may agree to perform the responsibilities specified in paragraph (a).
191.13 	(e) Any dispute concerning financial responsibility for the costs of the proceedings and 
191.14 	treatment will be resolved pursuant to chapter 256G.
191.15 	(f) This subdivision and the sections of law cited in this subdivision address venue only. 
191.16 	Nothing in this chapter is intended to limit the statewide jurisdiction of district courts over 
191.17 	civil commitment matters.

191.18 	Sec. 117. Minnesota Statutes 2018, section 253B.23, subdivision 2, is amended to read:
191.19 		Subd. 2.Legal results of commitment status. (a) Except as otherwise provided in this 
191.20 	chapter and in sections 246.15 and 246.16, no person by reason of commitment or treatment 
191.21 	pursuant to this chapter shall be deprived of any legal right, including but not limited to the 
191.22 	right to dispose of property, sue and be sued, execute instruments, make purchases, enter 
191.23 	into contractual relationships, vote, and hold a driver's license. Commitment or treatment 
191.24 	of any patient pursuant to this chapter is not a judicial determination of legal incompetency 
191.25 	except to the extent provided in section 253B.03, subdivision 6.
191.26 	(b) Proceedings for determination of legal incompetency and the appointment of a 
191.27 	guardian for a person subject to commitment under this chapter may be commenced before, 
191.28 	during, or after commitment proceedings have been instituted and may be conducted jointly 
191.29 	with the commitment proceedings. The court shall notify the head of the treatment facility
191.30 	or program to which the patient is committed of a finding that the patient is incompetent.
191.31 	(c) Where the person to be committed is a minor or owns property of value and it appears 
191.32 	to the court that the person is not competent to manage a personal estate, the court shall 
191.33 	appoint a general conservator of the person's estate as provided by law.

192.1 	Sec. 118. Minnesota Statutes 2018, section 253B.24, is amended to read:
192.2 	253B.24 TRANSMITTAL OF DATA TO NATIONAL INSTANT CRIMINAL 
192.3 	BACKGROUND CHECK SYSTEM.
192.4 	When a court:
192.5 	(1) commits a person under this chapter as being mentally ill, developmentally disabled, 
192.6 	mentally ill and dangerous, or chemically dependent due to mental illness, developmental 
192.7 	disability, or chemical dependency, or as a person who has a mental illness and is dangerous 
192.8 	to the public;
192.9 	(2) determines in a criminal case that a person is incompetent to stand trial or not guilty 
192.10 	by reason of mental illness; or
192.11 	(3) restores a person's ability to possess a firearm under section 609.165, subdivision 
192.12 	1d, or 624.713, subdivision 4,
192.13 	the court shall ensure that this information is electronically transmitted within three business 
192.14 	days to the National Instant Criminal Background Check System.

192.15 	Sec. 119. Minnesota Statutes 2018, section 253D.02, subdivision 6, is amended to read:
192.16 		Subd. 6.Court examiner. "Court examiner" has the meaning given in section 253B.02, 
192.17 	subdivision 7 7a.

192.18 	Sec. 120. Minnesota Statutes 2018, section 253D.07, subdivision 2, is amended to read:
192.19 		Subd. 2.Petition. Upon the filing of a petition alleging that a proposed respondent is a 
192.20 	sexually dangerous person or a person with a sexual psychopathic personality, the court 
192.21 	shall hear the petition as provided all of the applicable procedures contained in sections 
192.22 	253B.07 and 253B.08 apply to the commitment proceeding.

192.23 	Sec. 121. Minnesota Statutes 2018, section 253D.10, subdivision 2, is amended to read:
192.24 		Subd. 2.Correctional facilities. (a) A person who is being petitioned for commitment 
192.25 	under this chapter and who is placed under a judicial hold order under section 253B.07, 
192.26 	subdivision 2b or 7, may be confined at a Department of Corrections or a county correctional 
192.27 	or detention facility, rather than a secure treatment facility, until a determination of the 
192.28 	commitment petition as specified in this subdivision.
193.1 	(b) A court may order that a person who is being petitioned for commitment under this 
193.2 	chapter be confined in a Department of Corrections facility pursuant to the judicial hold 
193.3 	order under the following circumstances and conditions:
193.4 	(1) The person is currently serving a sentence in a Department of Corrections facility 
193.5 	and the court determines that the person has made a knowing and voluntary (i) waiver of 
193.6 	the right to be held in a secure treatment facility and (ii) election to be held in a Department 
193.7 	of Corrections facility. The order confining the person in the Department of Corrections 
193.8 	facility shall remain in effect until the court vacates the order or the person's criminal sentence 
193.9 	and conditional release term expire.
193.10 	In no case may the person be held in a Department of Corrections facility pursuant only 
193.11 	to this subdivision, and not pursuant to any separate correctional authority, for more than 
193.12 	210 days.
193.13 	(2) A person who has elected to be confined in a Department of Corrections facility 
193.14 	under this subdivision may revoke the election by filing a written notice of intent to revoke 
193.15 	the election with the court and serving the notice upon the Department of Corrections and 
193.16 	the county attorney. The court shall order the person transferred to a secure treatment facility 
193.17 	within 15 days of the date that the notice of revocation was filed with the court, except that, 
193.18 	if the person has additional time to serve in prison at the end of the 15-day period, the person 
193.19 	shall not be transferred to a secure treatment facility until the person's prison term expires. 
193.20 	After a person has revoked an election to remain in a Department of Corrections facility 
193.21 	under this subdivision, the court may not adopt another election to remain in a Department 
193.22 	of Corrections facility without the agreement of both parties and the Department of 
193.23 	Corrections.
193.24 	(3) Upon petition by the commissioner of corrections, after notice to the parties and 
193.25 	opportunity for hearing and for good cause shown, the court may order that the person's 
193.26 	place of confinement be changed from the Department of Corrections to a secure treatment 
193.27 	facility.
193.28 	(4) While at a Department of Corrections facility pursuant to this subdivision, the person 
193.29 	shall remain subject to all rules and practices applicable to correctional inmates in the facility 
193.30 	in which the person is placed including, but not limited to, the powers and duties of the 
193.31 	commissioner of corrections under section 241.01, powers relating to use of force under 
193.32 	section 243.52, and the right of the commissioner of corrections to determine the place of 
193.33 	confinement in a prison, reformatory, or other facility.
194.1 	(5) A person may not be confined in a Department of Corrections facility under this 
194.2 	provision beyond the end of the person's executed sentence or the end of any applicable 
194.3 	conditional release period, whichever is later. If a person confined in a Department of 
194.4 	Corrections facility pursuant to this provision reaches the person's supervised release date 
194.5 	and is subject to a period of conditional release, the period of conditional release shall 
194.6 	commence on the supervised release date even though the person remains in the Department 
194.7 	of Corrections facility pursuant to this provision. At the end of the later of the executed 
194.8 	sentence or any applicable conditional release period, the person shall be transferred to a 
194.9 	secure treatment facility.
194.10 	(6) Nothing in this section may be construed to establish a right of an inmate in a state 
194.11 	correctional facility to participate in sex offender treatment. This section must be construed 
194.12 	in a manner consistent with the provisions of section 244.03.
194.13 	(c) When a person is temporarily confined in a Department of Corrections facility solely 
194.14 	under this subdivision and not based on any separate correctional authority, the commissioner 
194.15 	of corrections may charge the county of financial responsibility for the costs of confinement, 
194.16 	and the Department of Human Services shall use existing appropriations to fund all remaining 
194.17 	nonconfinement costs. The funds received by the commissioner for the confinement and 
194.18 	nonconfinement costs are appropriated to the department for these purposes.
194.19 	(c) (d) The committing county may offer a person who is being petitioned for commitment 
194.20 	under this chapter and who is placed under a judicial hold order under section 253B.07, 
194.21 	subdivision 2b or 7, the option to be held in a county correctional or detention facility rather 
194.22 	than a secure treatment facility, under such terms as may be agreed to by the county, the 
194.23 	commitment petitioner, and the commitment respondent. If a person makes such an election 
194.24 	under this paragraph, the court hold order shall specify the terms of the agreement, including 
194.25 	the conditions for revoking the election.

194.26 	Sec. 122. Minnesota Statutes 2018, section 253D.28, subdivision 2, is amended to read:
194.27 		Subd. 2.Procedure. (a) The supreme court shall refer a petition for rehearing and 
194.28 	reconsideration to the chief judge of the judicial appeal panel. The chief judge shall notify 
194.29 	the committed person, the county attorneys of the county of commitment and county of 
194.30 	financial responsibility, the commissioner, the executive director, any interested person, 
194.31 	and other persons the chief judge designates, of the time and place of the hearing on the 
194.32 	petition. The notice shall be given at least 14 days prior to the date of the hearing. The 
194.33 	hearing may be conducted by interactive video conference under General Rules of Practice, 
194.34 	rule 131, and Minnesota Rules of Civil Commitment, rule 14.
195.1 	(b) Any person may oppose the petition. The committed person, the committed person's 
195.2 	counsel, the county attorneys of the committing county and county of financial responsibility, 
195.3 	and the commissioner shall participate as parties to the proceeding pending before the 
195.4 	judicial appeal panel and shall, no later than 20 days before the hearing on the petition, 
195.5 	inform the judicial appeal panel and the opposing party in writing whether they support or 
195.6 	oppose the petition and provide a summary of facts in support of their position.
195.7 	(c) The judicial appeal panel may appoint court examiners and may adjourn the hearing 
195.8 	from time to time. It shall hear and receive all relevant testimony and evidence and make 
195.9 	a record of all proceedings. The committed person, the committed person's counsel, and the 
195.10 	county attorney of the committing county or the county of financial responsibility have the 
195.11 	right to be present and may present and cross-examine all witnesses and offer a factual and 
195.12 	legal basis in support of their positions.
195.13 	(d) The petitioning party seeking discharge or provisional discharge bears the burden 
195.14 	of going forward with the evidence, which means presenting a prima facie case with 
195.15 	competent evidence to show that the person is entitled to the requested relief. If the petitioning 
195.16 	party has met this burden, the party opposing discharge or provisional discharge bears the 
195.17 	burden of proof by clear and convincing evidence that the discharge or provisional discharge 
195.18 	should be denied.
195.19 	(e) A party seeking transfer under section 253D.29 must establish by a preponderance 
195.20 	of the evidence that the transfer is appropriate.

195.21 	Sec. 123. REVISOR INSTRUCTION.
 195.22 	The revisor of statutes shall renumber Minnesota Statutes, section 253B.02, so that the 
195.23 	subdivisions are alphabetical. The revisor shall correct any cross-references that arise as a 
195.24 	result of the renumbering.

195.25 	Sec. 124. REPEALER.
 195.26 	Minnesota Statutes 2018, sections 253B.02, subdivisions 6 and 12a; 253B.05, subdivisions 
195.27 	1, 2, 2b, 3, and 4; 253B.064; 253B.065; 253B.066; 253B.09, subdivision 3; 253B.12, 
195.28 	subdivision 2; 253B.15, subdivision 11; and 253B.20, subdivision 7, are repealed.

APPENDIX 

Repealed Minnesota Statutes: S3322-1 

245F.02 DEFINITIONS.Subd. 20.Qualified medical professional. 
"Qualified medical professional" means an individual licensed in Minnesota as a doctor of osteopathic medicine or physician, or an individual licensed in Minnesota as an advanced practice registered nurse by the Board of Nursing and certified to practice as a clinical nurse specialist or nurse practitioner by a national nurse organization acceptable to the board. 

253B.02 DEFINITIONS.Subd. 6.Emergency treatment. 
"Emergency treatment" means the treatment of a patient pursuant to section 253B.05 which is necessary to protect the patient or others from immediate harm. 

Subd. 12a.Mental illness. 
"Mental illness" has the meaning given in section 245.462, subdivision 20. 

253B.05 EMERGENCY ADMISSION.Subdivision 1.Emergency hold. 
(a) Any person may be admitted or held for emergency care and treatment in a treatment facility, except to a facility operated by the Minnesota sex offender program, with the consent of the head of the treatment facility upon a written statement by an examiner that: 

(1) the examiner has examined the person not more than 15 days prior to admission; 

(2) the examiner is of the opinion, for stated reasons, that the person is mentally ill, developmentally disabled, or chemically dependent, and is in danger of causing injury to self or others if not immediately detained; and 

(3) an order of the court cannot be obtained in time to prevent the anticipated injury. 

(b) If the proposed patient has been brought to the treatment facility by another person, the examiner shall make a good faith effort to obtain a statement of information that is available from that person, which must be taken into consideration in deciding whether to place the proposed patient on an emergency hold. The statement of information must include, to the extent available, direct observations of the proposed patient's behaviors, reliable knowledge of recent and past behavior, and information regarding psychiatric history, past treatment, and current mental health providers. The examiner shall also inquire into the existence of health care directives under chapter 145, and advance psychiatric directives under section 253B.03, subdivision 6d. 

(c) The examiner's statement shall be: (1) sufficient authority for a peace or health officer to transport a patient to a treatment facility, (2) stated in behavioral terms and not in conclusory language, and (3) of sufficient specificity to provide an adequate record for review. If danger to specific individuals is a basis for the emergency hold, the statement must identify those individuals, to the extent practicable. A copy of the examiner's statement shall be personally served on the person immediately upon admission and a copy shall be maintained by the treatment facility. 

(d) A patient must not be allowed or required to consent to nor participate in a clinical drug trial during an emergency admission or hold under this subdivision or subdivision 2. A consent given during a period of an emergency admission or hold is void and unenforceable. This paragraph does not prohibit a patient from continuing participation in a clinical drug trial if the patient was participating in the drug trial at the time of the emergency admission or hold. 

Subd. 2.Peace or health officer authority. 
(a) A peace or health officer may take a person into custody and transport the person to a licensed physician or treatment facility if the officer has reason to believe, either through direct observation of the person's behavior, or upon reliable information of the person's recent behavior and knowledge of the person's past behavior or psychiatric treatment, that the person is mentally ill or developmentally disabled and in danger of injuring self or others if not immediately detained. A peace or health officer or a person working under such officer's supervision, may take a person who is believed to be chemically dependent or is intoxicated in public into custody and transport the person to a treatment facility. If the person is intoxicated in public or is believed to be chemically dependent and is not in danger of causing self-harm or harm to any person or property, the peace or health officer may transport the person home. The peace or health officer shall make written application for admission of the person to the treatment facility. The application shall contain the peace or health officer's statement specifying the reasons for and circumstances under which the person was taken into custody. If danger to specific individuals is a basis for the emergency hold, the statement must include identifying information on those individuals, to the extent practicable. A copy of the statement shall be made available to the person taken into custody. The peace or health officer who makes the application shall provide the officer's name, the agency that employs the officer, and the telephone number or other contact information for purposes of receiving notice under subdivision 3, paragraph (d). 

(b) As far as is practicable, a peace officer who provides transportation for a person placed in a facility under this subdivision may not be in uniform and may not use a vehicle visibly marked as a law enforcement vehicle. 

(c) A person may be admitted to a treatment facility for emergency care and treatment under this subdivision with the consent of the head of the facility under the following circumstances: (1) a written statement shall only be made by the following individuals who are knowledgeable, trained, and practicing in the diagnosis and treatment of mental illness or developmental disability; the medical officer, or the officer's designee on duty at the facility, including a licensed physician, a licensed physician assistant, or an advanced practice registered nurse who after preliminary examination has determined that the person has symptoms of mental illness or developmental disability and appears to be in danger of harming self or others if not immediately detained; or (2) a written statement is made by the institution program director or the director's designee on duty at the facility after preliminary examination that the person has symptoms of chemical dependency and appears to be in danger of harming self or others if not immediately detained or is intoxicated in public. 

Subd. 2b.Notice. 
Every person held pursuant to this section must be informed in writing at the time of admission of the right to leave after 72 hours, to a medical examination within 48 hours, and to request a change to voluntary status. The treatment facility shall, upon request, assist the person in exercising the rights granted in this subdivision. 

Subd. 3.Duration of hold. 
(a) Any person held pursuant to this section may be held up to 72 hours, exclusive of Saturdays, Sundays, and legal holidays after admission. If a petition for the commitment of the person is filed in the district court in the county of financial responsibility or of the county in which the treatment facility is located, the court may issue a judicial hold order pursuant to section 253B.07, subdivision 2b. 

(b) During the 72-hour hold period, a court may not release a person held under this section unless the court has received a written petition for release and held a summary hearing regarding the release. The petition must include the name of the person being held, the basis for and location of the hold, and a statement as to why the hold is improper. The petition also must include copies of any written documentation under subdivision 1 or 2 in support of the hold, unless the person holding the petitioner refuses to supply the documentation. The hearing must be held as soon as practicable and may be conducted by means of a telephone conference call or similar method by which the participants are able to simultaneously hear each other. If the court decides to release the person, the court shall direct the release and shall issue written findings supporting the decision. The release may not be delayed pending the written order. Before deciding to release the person, the court shall make every reasonable effort to provide notice of the proposed release to: 

(1) any specific individuals identified in a statement under subdivision 1 or 2 or individuals identified in the record who might be endangered if the person was not held; 

(2) the examiner whose written statement was a basis for a hold under subdivision 1; and 

(3) the peace or health officer who applied for a hold under subdivision 2. 

(c) If a person is intoxicated in public and held under this section for detoxification, a treatment facility may release the person without providing notice under paragraph (d) as soon as the treatment facility determines the person is no longer a danger to themselves or others. Notice must be provided to the peace officer or health officer who transported the person, or the appropriate law enforcement agency, if the officer or agency requests notification. 

(d) Notwithstanding section 144.293, subdivisions 2 and 4, if a treatment facility releases or discharges a person during the 72-hour hold period or if the person leaves the facility without the consent of the treating health care provider, the head of the treatment facility shall immediately notify the agency which employs the peace or health officer who transported the person to the treatment facility under this section. This paragraph does not apply to the extent that the notice would violate federal law governing the confidentiality of alcohol and drug abuse patient records under Code of Federal Regulations, title 42, part 2. 

(e) A person held under a 72-hour emergency hold must be released by the facility within 72 hours unless a court order to hold the person is obtained. A consecutive emergency hold order under this section may not be issued. 

Subd. 4.Change of status. 
Any person admitted pursuant to this section shall be changed to voluntary status provided by section 253B.04 upon the person's request in writing and with the consent of the head of the treatment facility. 

253B.064 COURT-ORDERED EARLY INTERVENTION; PRELIMINARY PROCEDURES.Subdivision 1.General. 
(a) An interested person may apply to the designated agency for early intervention of a proposed patient in the county of financial responsibility or the county where the patient is present. If the designated agency determines that early intervention may be appropriate, a prepetition screening report must be prepared pursuant to section 253B.07, subdivision 1. The county attorney may file a petition for early intervention following the procedures of section 253B.07, subdivision 2. 

(b) The proposed patient is entitled to representation by counsel, pursuant to section 253B.07, subdivision 2c. The proposed patient shall be examined by an examiner, and has the right to a second independent examiner, pursuant to section 253B.07, subdivisions 3 and 5. 

Subd. 2.Prehearing examination; failure to appear. 
If a proposed patient fails to appear for the examination, the court may: 

(1) reschedule the examination; or 

(2) deem the failure to appear as a waiver of the proposed patient's right to an examination and consider the failure to appear when deciding the merits of the petition for early intervention. 

Subd. 3.County option. 
Nothing in sections 253B.064 to 253B.066 requires a county to use early intervention procedures. 

253B.065 COURT-ORDERED EARLY INTERVENTION; HEARING PROCEDURES.Subdivision 1.Time for early intervention hearing. 
The hearing on the petition for early intervention shall be held within 14 days from the date of the filing of the petition. For good cause shown, the court may extend the time of hearing up to an additional 30 days. When any proposed patient has not had a hearing on a petition filed for early intervention within the allowed time, the proceedings shall be dismissed. 

Subd. 2.Notice of hearing. 
The proposed patient, the patient's counsel, the petitioner, the county attorney, and any other persons as the court directs shall be given at least five days' notice that a hearing will be held and at least two days' notice of the time and date of the hearing, except that any person may waive notice. Notice to the proposed patient may be waived by patient's counsel. 

Subd. 3.Failure to appear. 
If a proposed patient fails to appear at the hearing, the court may reschedule the hearing within five days and direct a health officer, peace officer, or other person to take the proposed patient to an appropriate treatment facility designated by the court and transport the person to the hearing. 

Subd. 4.Procedures. 
The hearing must be conducted pursuant to section 253B.08, subdivisions 3 to 8. 

Subd. 5.Early intervention criteria. 
(a) A court shall order early intervention treatment of a proposed patient who meets the criteria under paragraph (b) or (c). The early intervention treatment must be less intrusive than long-term inpatient commitment and must be the least restrictive treatment program available that can meet the patient's treatment needs. 

(b) The court shall order early intervention treatment if the court finds all of the elements of the following factors by clear and convincing evidence: 

(1) the proposed patient is mentally ill; 

(2) the proposed patient refuses to accept appropriate mental health treatment; and 

(3) the proposed patient's mental illness is manifested by instances of grossly disturbed behavior or faulty perceptions and either: 

(i) the grossly disturbed behavior or faulty perceptions significantly interfere with the proposed patient's ability to care for self and the proposed patient, when competent, would have chosen substantially similar treatment under the same circumstances; or 

(ii) due to the mental illness, the proposed patient received court-ordered inpatient treatment under section 253B.09 at least two times in the previous three years; the patient is exhibiting symptoms or behavior substantially similar to those that precipitated one or more of the court-ordered treatments; and the patient is reasonably expected to physically or mentally deteriorate to the point of meeting the criteria for commitment under section 253B.09 unless treated. 

For purposes of this paragraph, a proposed patient who was released under section 253B.095 and whose release was not revoked is not considered to have received court-ordered inpatient treatment under section 253B.09. 

(c) The court may order early intervention treatment if the court finds by clear and convincing evidence that a pregnant woman is a chemically dependent person. A chemically dependent person for purposes of this section is a woman who has during pregnancy engaged in excessive use, for a nonmedical purpose, of controlled substances or their derivatives, alcohol, or inhalants that will pose a substantial risk of damage to the brain or physical development of the fetus. 

(d) For purposes of paragraphs (b) and (c), none of the following constitute a refusal to accept appropriate mental health treatment: 

(1) a willingness to take medication but a reasonable disagreement about type or dosage; 

(2) a good faith effort to follow a reasonable alternative treatment plan, including treatment as specified in a valid advance directive under chapter 145C or section 253B.03, subdivision 6d; 

(3) an inability to obtain access to appropriate treatment because of inadequate health care coverage or an insurer's refusal or delay in providing coverage for the treatment; or 

(4) an inability to obtain access to needed mental health services because the provider will only accept patients who are under a court order or because the provider gives persons under a court order a priority over voluntary patients in obtaining treatment and services. 

253B.066 COURT-ORDERED EARLY INTERVENTION; DECISION; TREATMENT ALTERNATIVES; DURATION.Subdivision 1.Treatment alternatives. 
If the court orders early intervention under section 253B.065, subdivision 5, the court may include in its order a variety of treatment alternatives including, but not limited to, day treatment, medication compliance monitoring, assertive community treatment, crisis assessment and stabilization, partial hospitalization, and short-term hospitalization not to exceed 21 days. 

If the court orders short-term hospitalization and the proposed patient will not go voluntarily, the court may direct a health officer, peace officer, or other person to take the person into custody and transport the person to the hospital. 

Subd. 2.Findings. 
The court shall find the facts specifically and separately state its conclusions of law in its order. Where early intervention is ordered, the findings of fact and conclusions of law shall specifically state the proposed patient's conduct which is a basis for determining that each of the requisites for early intervention is met. 

The court shall also determine the nature and extent of the property of the patient and of the persons who are liable for the patient's care. 

Subd. 3.Duration. 
The order for early intervention shall not exceed 90 days. 

253B.09 DECISION; STANDARD OF PROOF; DURATION.Subd. 3.Financial determination. 
The court shall determine the nature and extent of the property of the patient and of the persons who are liable for the patient's care. If the patient is committed to a regional treatment center, the court shall send a copy of the commitment order to the commissioner. 

253B.12 TREATMENT REPORT; REVIEW; HEARING.Subd. 2.Basis for discharge. 
If no written report is filed within the required time or if the written statement describes the patient as not in need of further institutional care and treatment, the proceedings shall be terminated by the committing court, and the patient shall be discharged from the treatment facility. 

253B.15 PROVISIONAL DISCHARGE; PARTIAL INSTITUTIONALIZATION.Subd. 11.Partial institutionalization. 
The head of a treatment facility may place any committed person on a status of partial institutionalization. The status shall allow the patient to be absent from the facility for certain fixed periods of time. The head of the facility may terminate the status at any time. 

253B.20 DISCHARGE; ADMINISTRATIVE PROCEDURE.Subd. 7.Services. 
A committed person may at any time after discharge, provisional discharge or partial treatment, apply to the head of the treatment facility within whose district the committed person resides for treatment. The head of the treatment facility, on determining that the applicant requires service, may provide needed services related to mental illness, developmental disability, or chemical dependency to the applicant. The services shall be provided in regional centers under terms and conditions established by the commissioner. 

Repealed Minnesota Session Laws: S3322-1 

Laws 2005, First Special Session chapter 4, article 7, section 50
Sec. 50. CONSUMER-DIRECTED COMMUNITY SUPPORTS METHODOLOGY. 
(a) Effective upon federal approval, for persons using the home and community-based waiver for persons with developmental disabilities whose consumer-directed community supports budgets were reduced by the October 2004, state-set budget methodology, the commissioner of human services must allow exceptions to exceed the state-set budget formula up to the daily average cost during calendar year 2004 or for persons who graduated from school during 2004, the average daily cost during July through December 2004, less one-half of case management and home modifications over $5,000 when the individual's county of financial responsibility determines that: 

(1) necessary alternative services will cost the same or more than the person's current budget; and  

(2) administrative expenses or provider rates will result in fewer hours of needed staffing for the person than under the consumer-directed community supports option. Any exceptions the county grants must be within the county's allowable aggregate amount for the home and community-based waiver for persons with developmental disabilities. 

(b) This section expires on the date the commissioner of human services implements a new consumer-directed community supports budget methodology that is based on information about the services and supports intensity needs of persons using the option and that adequately accounts for the increased costs of adults who graduate from school and need services funded by the waiver during the day. 

Laws 2005, First Special Session chapter 4, article 7, section 51
Sec. 51. COSTS ASSOCIATED WITH PHYSICAL ACTIVITIES. 
Effective upon federal approval, the expenses allowed for adults under the consumer-directed community supports option shall include the costs at the lowest rate available considering daily, monthly, semi-annual, annual, or membership rates, including transportation, associated with physical exercise or other physical activities to maintain or improve the person's health and functioning. 

Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter 312, article 27, section 72; as amended by Laws 2015, chapter 71, article 7, section 58; as amended by Laws 2016, chapter 144, section 1; as amended by Laws 2017, First Special Session chapter 6, article 1, section 54
Sec. 72. Laws 2012, chapter 247, article 4, section 47, is amended to read:Sec. 47. COMMISSIONER TO SEEK AMENDMENT FOR EXCEPTION TO CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY. 
By July 1, 2014, if necessary, the commissioner shall request an amendment to the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.092 and 256B.49, to establish an exception to the consumer-directed community supports budget methodology to provide up to 20 percent more funds for those participants who have their 21st birthday and graduate from high school between 2013 to 2015 and are authorized for more services under consumer-directed community supports prior to graduation than the amount they are eligible to receive under the current consumer-directed community supports budget methodology. The exception is limited to those who can demonstrate that they will have to leave consumer-directed community supports and use other waiver services because their need for day or employment supports cannot be met within the consumer-directed community supports budget limits. The commissioner shall consult with the stakeholder group authorized under Minnesota Statutes, section 256B.0657, subdivision 11, to implement this provision. The exception process shall be effective upon federal approval for persons eligible through June 30, 2017. 

Laws 2015, chapter 71, article 7, section 54, as amended by Laws 2017, First Special Session chapter 6, article 1, section 54
Sec. 54. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY EXCEPTION. 
(a) No later than September 30, 2015, if necessary, the commissioner of human services shall submit an amendment to the Centers for Medicare and Medicaid Services for the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.092 and 256B.49, to establish an exception to the consumer-directed community supports budget methodology to provide up to 20 percent more funds for: 

(1) consumer-directed community supports participants who have graduated from high school and have a coordinated service and support plan which identifies the need for more services under consumer-directed community supports, either prior to graduation or in order to increase the amount of time a person works or to improve their employment opportunities, than the amount they are eligible to receive under the current consumer-directed community supports budget methodology; and 

(2) home and community-based waiver participants who are currently using licensed services for employment supports or services during the day which cost more annually than the person would spend under a consumer-directed community supports plan for individualized employment supports or services during the day. 

(b) The exception under paragraph (a) is limited to those persons who can demonstrate either that they will have to leave consumer-directed community supports and use other waiver services because their need for day or employment supports cannot be met within the consumer-directed community supports budget limits or they will move to consumer-directed community supports and their services will cost less than services currently being used. 

EFFECTIVE DATE. 
The exception under this section is effective October 1, 2015, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when this occurs. 

Laws 2017, First Special Session chapter 6, article 1, section 44, as amended by Laws 2019, First Special Session chapter 9, article 5, section 80
Sec. 80. Laws 2017, First Special Session chapter 6, article 1, section 44, is amended to read:Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY EXCEPTION. 
(a) No later than September 30, 2017, if necessary, the commissioner of human services shall submit an amendment to the Centers for Medicare and Medicaid Services for the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.092 and 256B.49, to expand the exception to the consumer-directed community supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide up to 30 percent more funds for either: 

(1) consumer-directed community supports participants who have a coordinated service and support plan which identifies the need for an increased amount of services or supports under consumer-directed community supports than the amount they are currently receiving under the consumer-directed community supports budget methodology: 

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

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

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

(2) home and community-based waiver participants who are currently using licensed providers for (i) employment supports or services during the day; or (ii) residential services, either of which cost more annually than the person would spend under a consumer-directed community supports plan for any or all of the supports needed to meet the goals identified in paragraph (a), clause (1), items (i), (ii), and (iii). 

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

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

Laws 2017, First Special Session chapter 6, article 1, section 45, as amended by Laws 2019, First Special Session chapter 9, article 5, section 81
Sec. 81. Laws 2017, First Special Session chapter 6, article 1, section 45, is amended to read:Sec. 45. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY.Subdivision 1.Exception for persons leaving institutions and crisis residential settings. 
(a) By September 30, 2017, the commissioner shall establish an institutional and crisis bed consumer-directed community supports budget exception process in the home and community-based services waivers under Minnesota Statutes, sections 256B.092 and 256B.49. This budget exception process shall be available for any individual who: 

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

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

(b) Institutional settings for purposes of this exception include intermediate care facilities for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget exception shall be limited to no more than the amount of appropriate services provided in a noninstitutional setting as determined by the lead agency managing the individual's home and community-based services waiver. The lead agency shall notify the Department of Human Services of the budget exception. 

Subd. 2.Shared services. 
(a) Medical assistance payments for shared services under consumer-directed community supports are limited to this subdivision. 

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

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

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

(2) use of more than one worker for the shared services; and 

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

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

(e) Individuals sharing services must use the same financial management services provider. 

(f) Individuals whose consumer-directed community supports community support plans include the intention to utilize shared services must also jointly develop, with the support of their representatives as needed, a shared services agreement. This agreement must include: 

(1) the names of the individuals receiving shared services; 

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

(3) the names of the case managers; 

(4) the financial management services provider; 

(5) the shared services that must be provided; 

(6) the schedule for shared services; 

(7) the location where shared services must be provided; 

(8) the training specific to each individual served; 

(9) the training specific to providing shared services to the individuals identified in the agreement; 

(10) instructions to follow all required documentation for time and services provided; 

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

(12) signatures of all parties involved in the shared services; and 

(13) agreement by each of the individuals who are sharing services on the number of shared hours for services provided. 

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

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

(i) Nothing in this subdivision must be construed to reduce the total authorized consumer-directed community supports budget for an individual. 

(j) No later than September 30, 2019, the commissioner of human services shall: 

(1) submit an amendment to the Centers for Medicare and Medicaid Services for the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.0913, 256B.0915, 256B.092, and 256B.49, to allow for a shared services option under consumer-directed community supports; and 

(2) with stakeholder input, develop guidance for shared services in consumer-directed community-supports within the Community Based Services Manual. Guidance must include: 

(i) recommendations for negotiating payment for one-to-two and one-to-three services; and 

(ii) a template of the shared services agreement. 

EFFECTIVE DATE. 
This section is effective October 1, 2019, or upon federal approval, whichever is later, except for subdivision 2, paragraph (j), which is effective the day following final enactment. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.