1.1 	A bill for an act
1.2 	relating to state government; modifying provisions governing health, health care, 
1.3 	human services, human services licensing and background studies, health-related 
1.4 	licensing boards, prescription drugs, health insurance, telehealth, children and 
1.5 	family services, behavioral health, direct care and treatment, disability services 
1.6 	and continuing care for older adults, community supports, and chemical and mental 
1.7 	health services; establishing a budget for health and human services; making 
1.8 	forecast adjustments; making technical and conforming changes; requiring reports; 
1.9 	transferring money; appropriating money;amending Minnesota Statutes 2020, 
1.10 	sections 62A.04, subdivision 2; 62A.10, by adding a subdivision; 62A.15, 
1.11 	subdivision 4, by adding a subdivision; 62A.152, subdivision 3; 62A.3094, 
1.12 	subdivision 1; 62A.65, subdivision 1, by adding a subdivision; 62C.01, by adding 
1.13 	a subdivision; 62D.01, by adding a subdivision; 62D.095, subdivisions 2, 3, 4, 5; 
1.14 	62J.495, subdivisions 1, 2, 3, 4; 62J.497, subdivisions 1, 3; 62J.498; 62J.4981; 
1.15 	62J.4982; 62J.63, subdivisions 1, 2; 62Q.01, subdivision 2a; 62Q.02; 62Q.096; 
1.16 	62Q.46; 62Q.677, by adding a subdivision; 62Q.81; 62U.04, subdivisions 4, 5, 
1.17 	11; 62V.05, by adding a subdivision; 62W.11; 103H.201, subdivision 1; 119B.011, 
1.18 	subdivision 15; 119B.025, subdivision 4; 119B.03, subdivisions 4, 6; 119B.09, 
1.19 	subdivision 4; 119B.11, subdivision 2a; 119B.125, subdivision 1; 119B.13, 
1.20 	subdivisions 1, 1a, 6, 7; 119B.25, subdivision 3; 122A.18, subdivision 8; 136A.128, 
1.21 	subdivisions 2, 4; 144.0724, subdivisions 1, 2, 3a, 4, 5, 7, 8, 9, 12; 144.1205, 
1.22 	subdivisions 2, 4, 8, 9, by adding a subdivision; 144.125, subdivision 1; 144.1481, 
1.23 	subdivision 1; 144.1501, subdivisions 1, 2, 3; 144.1911, subdivision 6; 144.212, 
1.24 	by adding a subdivision; 144.225, subdivisions 2, 7; 144.226, by adding 
1.25 	subdivisions; 144.55, subdivisions 4, 6; 144.551, subdivision 1, by adding a 
1.26 	subdivision; 144.555; 144.651, subdivision 2; 144.9501, subdivision 17; 144.9502, 
1.27 	subdivision 3; 144.9504, subdivisions 2, 5; 144D.01, subdivision 4; 144G.08, 
1.28 	subdivision 7, as amended; 144G.84; 145.893, subdivision 1; 145.894; 145.897; 
1.29 	145.899; 145.901, subdivisions 2, 4; 147.033; 148.90, subdivision 2; 148.911; 
1.30 	148B.30, subdivision 1; 148B.31; 148B.51; 148B.5301, subdivision 2; 148B.54, 
1.31 	subdivision 2; 148E.010, by adding a subdivision; 148E.120, subdivision 2; 
1.32 	148E.130, subdivision 1, by adding a subdivision; 148F.11, subdivision 1; 151.01, 
1.33 	by adding subdivisions; 151.071, subdivisions 1, 2; 151.37, subdivision 2; 151.555, 
1.34 	subdivisions 1, 7, 11, by adding a subdivision; 152.01, subdivision 23; 152.02, 
1.35 	subdivisions 2, 3; 152.11, subdivision 1a, by adding a subdivision; 152.12, by 
1.36 	adding a subdivision; 152.125, subdivision 3; 152.22, subdivisions 6, 11, by adding 
1.37 	subdivisions; 152.23; 152.25, by adding a subdivision; 152.26; 152.27, subdivisions 
1.38 	3, 4, 6; 152.28, subdivision 1; 152.29, subdivisions 1, 3, by adding subdivisions; 
2.1 	152.31; 152.32, subdivision 3; 156.12, subdivision 2; 171.07, by adding a 
2.2 	subdivision; 174.30, subdivision 3; 245.462, subdivisions 1, 6, 8, 9, 14, 16, 17, 
2.3 	18, 21, 23, by adding a subdivision; 245.4661, subdivision 5; 245.4662, subdivision 
2.4 	1; 245.467, subdivisions 2, 3; 245.469, subdivisions 1, 2; 245.470, subdivision 1; 
2.5 	245.4712, subdivision 2; 245.472, subdivision 2; 245.4863; 245.4871, subdivisions 
2.6 	9a, 10, 11a, 17, 21, 26, 27, 29, 31, 32, 34, by adding a subdivision; 245.4876, 
2.7 	subdivisions 2, 3; 245.4879, subdivision 1; 245.488, subdivision 1; 245.4882, 
2.8 	subdivisions 1, 3; 245.4885, subdivision 1; 245.4889, subdivision 1; 245.4901, 
2.9 	subdivision 2; 245.62, subdivision 2; 245.735, subdivisions 3, 5, by adding a 
2.10 	subdivision; 245A.02, by adding subdivisions; 245A.03, subdivision 7; 245A.04, 
2.11 	subdivision 5; 245A.041, by adding a subdivision; 245A.043, subdivision 3; 
2.12 	245A.05; 245A.07, subdivision 1; 245A.10, subdivision 4; 245A.14, subdivision 
2.13 	4; 245A.16, by adding a subdivision; 245A.50, subdivisions 7, 9; 245A.65, 
2.14 	subdivision 2; 245C.02, subdivisions 4a, 5, by adding subdivisions; 245C.03; 
2.15 	245C.05, subdivisions 1, 2, 2a, 2b, 2c, 2d, 4; 245C.08, subdivision 3, by adding a 
2.16 	subdivision; 245C.10, subdivision 15, by adding subdivisions; 245C.13, subdivision 
2.17 	2; 245C.14, subdivision 1, by adding a subdivision; 245C.15, by adding a 
2.18 	subdivision; 245C.16, subdivisions 1, 2; 245C.17, subdivision 1, by adding a 
2.19 	subdivision; 245C.18; 245C.24, subdivisions 2, 3, 4, by adding a subdivision; 
2.20 	245C.32, subdivision 1a; 245D.02, subdivision 20; 245F.04, subdivision 2; 
2.21 	245G.01, subdivisions 13, 26; 245G.03, subdivision 2; 245G.06, subdivision 1; 
2.22 	246.54, subdivision 1b; 254A.19, subdivision 5; 254B.01, subdivision 4a, by 
2.23 	adding a subdivision; 254B.05, subdivision 5; 254B.12, by adding a subdivision; 
2.24 	256.01, subdivisions 14b, 28; 256.0112, subdivision 6; 256.041; 256.042, 
2.25 	subdivisions 2, 4; 256.043, subdivision 3; 256.969, subdivisions 2b, 9, by adding 
2.26 	a subdivision; 256.9695, subdivision 1; 256.9741, subdivision 1; 256.98, 
2.27 	subdivision 1; 256.983; 256B.04, subdivisions 12, 14; 256B.055, subdivision 6; 
2.28 	256B.056, subdivision 10; 256B.057, subdivision 3; 256B.06, subdivision 4; 
2.29 	256B.0615, subdivisions 1, 5; 256B.0616, subdivisions 1, 3, 5; 256B.0621, 
2.30 	subdivision 10; 256B.0622, subdivisions 1, 2, 3a, 4, 7, 7a, 7b, 7d; 256B.0623, 
2.31 	subdivisions 1, 2, 3, 4, 5, 6, 9, 12; 256B.0624; 256B.0625, subdivisions 3b, 3c, 
2.32 	3d, 3e, 5, 5m, 9, 10, 13, 13c, 13d, 13e, 13h, 17, 17b, 18, 18b, 19c, 20, 20b, 28a, 
2.33 	30, 31, 42, 46, 48, 49, 52, 56a, 58, by adding subdivisions; 256B.0631, subdivision 
2.34 	1; 256B.0638, subdivisions 3, 5, 6; 256B.0659, subdivision 13; 256B.0757, 
2.35 	subdivision 4c; 256B.0759, subdivisions 2, 4, by adding subdivisions; 256B.0911, 
2.36 	subdivisions 1a, 3a, 3f, 4d; 256B.092, subdivisions 4, 5, 12; 256B.0924, subdivision 
2.37 	6; 256B.094, subdivision 6; 256B.0941, subdivision 1; 256B.0943, subdivisions 
2.38 	1, 2, 3, 4, 5, 5a, 6, 7, 9, 11; 256B.0946, subdivisions 1, 1a, 2, 3, 4, 6; 256B.0947, 
2.39 	subdivisions 1, 2, 3, 3a, 5, 6, 7; 256B.0949, subdivisions 2, 4, 5a, by adding a 
2.40 	subdivision; 256B.097, by adding subdivisions; 256B.196, subdivision 2; 256B.25, 
2.41 	subdivision 3; 256B.439, by adding subdivisions; 256B.49, subdivisions 11, 11a, 
2.42 	14, 17, by adding a subdivision; 256B.4914, subdivisions 5, 6, 7, 8, 9, by adding 
2.43 	a subdivision; 256B.69, subdivisions 5a, 6, 6d, by adding subdivisions; 256B.6928, 
2.44 	subdivision 5; 256B.75; 256B.76, subdivisions 2, 4; 256B.761; 256B.763; 256B.79, 
2.45 	subdivisions 1, 3; 256B.85, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12, 
2.46 	12b, 13, 13a, 15, 17a, 18a, 20b, 23, 23a, by adding subdivisions; 256D.03, by 
2.47 	adding a subdivision; 256D.051, by adding subdivisions; 256D.0515; 256D.0516, 
2.48 	subdivision 2; 256E.34, subdivision 1; 256I.03, subdivision 13; 256I.04, subdivision 
2.49 	3; 256I.05, subdivisions 1a, 1c, 11; 256I.06, subdivisions 6, 8; 256J.08, subdivisions 
2.50 	15, 71, 79; 256J.09, subdivision 3; 256J.10; 256J.21, subdivisions 3, 4, 5; 256J.24, 
2.51 	subdivision 5; 256J.30, subdivision 8; 256J.33, subdivisions 1, 2, 4; 256J.37, 
2.52 	subdivisions 1, 1b, 3, 3a; 256J.45, subdivision 1; 256J.626, subdivision 1; 256J.95, 
2.53 	subdivision 9; 256L.01, subdivision 5; 256L.03, subdivision 5; 256L.04, subdivision 
2.54 	7b; 256L.05, subdivision 3a; 256L.11, subdivisions 6a, 7; 256N.25, subdivisions 
2.55 	2, 3; 256N.26, subdivisions 11, 13; 256P.01, subdivisions 3, 6a, by adding a 
2.56 	subdivision; 256P.04, subdivisions 4, 8; 256P.06, subdivisions 2, 3; 256P.07; 
2.57 	256S.05, subdivision 2; 256S.18, subdivision 7; 256S.20, subdivision 1; 260.761, 
2.58 	subdivision 2; 260C.007, subdivisions 6, 14, 26c, 31; 260C.157, subdivision 3; 
3.1 	260C.212, subdivisions 1a, 13; 260C.215, subdivision 4; 260C.4412; 260C.452; 
3.2 	260C.704; 260C.706; 260C.708; 260C.71; 260C.712; 260C.714; 260D.01; 260D.05; 
3.3 	260D.06, subdivision 2; 260D.07; 260D.08; 260D.14; 260E.01; 260E.02, 
3.4 	subdivision 1; 260E.03, subdivision 22, by adding subdivisions; 260E.06, 
3.5 	subdivision 1; 260E.14, subdivisions 2, 5; 260E.17, subdivision 1; 260E.18; 
3.6 	260E.20, subdivision 2; 260E.24, subdivisions 2, 7; 260E.31, subdivision 1; 
3.7 	260E.33, subdivision 1, by adding a subdivision; 260E.35, subdivision 6; 260E.36, 
3.8 	by adding a subdivision; 295.50, subdivision 9b; 295.53, subdivision 1; 325F.721, 
3.9 	subdivision 1; 326.71, subdivision 4; 326.75, subdivisions 1, 2, 3; Laws 2019, 
3.10 	First Special Session chapter 9, article 14, section 3, as amended; Laws 2020, First 
3.11 	Special Session chapter 7, section 1, subdivision 2, as amended; Laws 2020, Fifth 
3.12 	Special Session chapter 3, article 10, section 3; Laws 2020, Seventh Special Session 
3.13 	chapter 1, article 6, section 12, subdivision 4; proposing coding for new law in 
3.14 	Minnesota Statutes, chapters 62A; 62J; 62Q; 62W; 119B; 144; 145; 151; 245; 
3.15 	245A; 245C; 254B; 256B; 256P; 256S; proposing coding for new law as Minnesota 
3.16 	Statutes, chapter 245I; repealing Minnesota Statutes 2020, sections 16A.724, 
3.17 	subdivision 2; 62A.67; 62A.671; 62A.672; 62J.63, subdivision 3; 119B.04; 
3.18 	119B.125, subdivision 5; 144.0721, subdivision 1; 144.0722; 144.0724, subdivision 
3.19 	10; 144.693; 245.462, subdivision 4a; 245.4871, subdivision 32a; 245.4879, 
3.20 	subdivision 2; 245.62, subdivisions 3, 4; 245.69, subdivision 2; 245.735, 
3.21 	subdivisions 1, 2, 4; 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10, 11, 12, 
3.22 	13, 14, 16; 256B.0596; 256B.0615, subdivision 2; 256B.0616, subdivision 2; 
3.23 	256B.0622, subdivisions 3, 5a; 256B.0623, subdivisions 7, 8, 10, 11; 256B.0625, 
3.24 	subdivisions 5l, 18c, 18d, 18e, 18h, 35a, 35b, 61, 62, 65; 256B.0916, subdivisions 
3.25 	2, 3, 4, 5, 8, 11, 12; 256B.0924, subdivision 4a; 256B.0943, subdivisions 8, 10; 
3.26 	256B.0944; 256B.0946, subdivision 5; 256B.097, subdivisions 1, 2, 3, 4, 5, 6; 
3.27 	256B.49, subdivisions 26, 27; 256D.051, subdivisions 1, 1a, 2, 2a, 3, 3a, 3b, 6b, 
3.28 	6c, 7, 8, 9, 18; 256D.052, subdivision 3; 256J.08, subdivisions 10, 53, 61, 62, 81, 
3.29 	83; 256J.21, subdivisions 1, 2; 256J.30, subdivisions 5, 7, 8; 256J.33, subdivisions 
3.30 	3, 4, 5; 256J.34, subdivisions 1, 2, 3, 4; 256J.37, subdivision 10; 256S.20, 
3.31 	subdivision 2; Minnesota Rules, parts 9505.0275; 9505.0370; 9505.0371; 
3.32 	9505.0372; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 
3.33 	15, 16, 17, 18, 19, 20, 21, 22; 9505.1699; 9505.1701; 9505.1703; 9505.1706; 
3.34 	9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730; 9505.1733; 
3.35 	9505.1736; 9505.1739; 9505.1742; 9505.1745; 9505.1748; 9520.0010; 9520.0020; 
3.36 	9520.0030; 9520.0040; 9520.0050; 9520.0060; 9520.0070; 9520.0080; 9520.0090; 
3.37 	9520.0100; 9520.0110; 9520.0120; 9520.0130; 9520.0140; 9520.0150; 9520.0160; 
3.38 	9520.0170; 9520.0180; 9520.0190; 9520.0200; 9520.0210; 9520.0230; 9520.0750; 
3.39 	9520.0760; 9520.0770; 9520.0780; 9520.0790; 9520.0800; 9520.0810; 9520.0820; 
3.40 	9520.0830; 9520.0840; 9520.0850; 9520.0860; 9520.0870; 9530.6800; 9530.6810.
3.41 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.42 	ARTICLE 1
3.43 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE PROGRAMS

3.44 	Section 1. [62A.002] APPLICABILITY OF CHAPTER.
3.45 	Any benefit or coverage mandate included in this chapter does not apply to managed 
3.46 	care plans or county-based purchasing plans when the plan is providing coverage to state 
3.47 	public health care program enrollees under chapter 256B or 256L.

4.1 	Sec. 2. Minnesota Statutes 2020, section 62C.01, is amended by adding a subdivision to 
4.2 	read:
4.3 		Subd. 4.Applicability. Any benefit or coverage mandate included in this chapter does 
4.4 	not apply to managed care plans or county-based purchasing plans when the plan is providing 
4.5 	coverage to state public health care program enrollees under chapter 256B or 256L.

4.6 	Sec. 3. Minnesota Statutes 2020, section 62D.01, is amended by adding a subdivision to 
4.7 	read:
4.8 		Subd. 3.Applicability. Any benefit or coverage mandate included in this chapter does 
4.9 	not apply to managed care plans or county-based purchasing plans when the plan is providing 
4.10 	coverage to state public health care program enrollees under chapter 256B or 256L.

4.11 	Sec. 4. [62J.011] APPLICABILITY OF CHAPTER.
4.12 	Any benefit or coverage mandate included in this chapter does not apply to managed 
4.13 	care plans or county-based purchasing plans when the plan is providing coverage to state 
4.14 	public health care program enrollees under chapter 256B or 256L.

4.15 	Sec. 5. Minnesota Statutes 2020, section 62Q.02, is amended to read:
4.16 	62Q.02 APPLICABILITY OF CHAPTER.
4.17 	(a) This chapter applies only to health plans, as defined in section 62Q.01, and not to 
4.18 	other types of insurance issued or renewed by health plan companies, unless otherwise 
4.19 	specified.
4.20 	(b) This chapter applies to a health plan company only with respect to health plans, as 
4.21 	defined in section 62Q.01, issued or renewed by the health plan company, unless otherwise 
4.22 	specified.
4.23 	(c) If a health plan company issues or renews health plans in other states, this chapter 
4.24 	applies only to health plans issued or renewed in this state for Minnesota residents, or to 
4.25 	cover a resident of the state, unless otherwise specified.
4.26 	(d) Any benefit or coverage mandate included in this chapter does not apply to managed 
4.27 	care plans or county-based purchasing plans when the plan is providing coverage to state 
4.28 	public health care program enrollees under chapter 256B or 256L.

5.1 	Sec. 6. Minnesota Statutes 2020, section 174.30, subdivision 3, is amended to read:
5.2 		Subd. 3.Other standards; wheelchair securement; protected transport. (a) A special 
5.3 	transportation service that transports individuals occupying wheelchairs is subject to the 
5.4 	provisions of sections 299A.11 to 299A.17 concerning wheelchair securement devices. The 
5.5 	commissioners of transportation and public safety shall cooperate in the enforcement of 
5.6 	this section and sections 299A.11 to 299A.17 so that a single inspection is sufficient to 
5.7 	ascertain compliance with sections 299A.11 to 299A.17 and with the standards adopted 
5.8 	under this section. Representatives of the Department of Transportation may inspect 
5.9 	wheelchair securement devices in vehicles operated by special transportation service 
5.10 	providers to determine compliance with sections 299A.11 to 299A.17 and to issue certificates 
5.11 	under section 299A.14, subdivision 4.
5.12 	(b) In place of a certificate issued under section 299A.14, the commissioner may issue 
5.13 	a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if 
5.14 	the device complies with sections 299A.11 to 299A.17 and the decal displays the information 
5.15 	in section 299A.14, subdivision 4.
5.16 	(c) For vehicles designated as protected transport under section 256B.0625, subdivision 
5.17 	17, paragraph (h) (g), the commissioner of transportation, during the commissioner's 
5.18 	inspection, shall check to ensure the safety provisions contained in that paragraph are in 
5.19 	working order.

5.20 	Sec. 7. Minnesota Statutes 2020, section 256.01, subdivision 28, is amended to read:
5.21 		Subd. 28.Statewide health information exchange. (a) The commissioner has the 
5.22 	authority to join and participate as a member in a legal entity developing and operating a 
5.23 	statewide health information exchange or to develop and operate an encounter alerting 
5.24 	service that shall meet the following criteria:
5.25 	(1) the legal entity must meet all constitutional and statutory requirements to allow the 
5.26 	commissioner to participate; and
5.27 	(2) the commissioner or the commissioner's designated representative must have the 
5.28 	right to participate in the governance of the legal entity under the same terms and conditions 
5.29 	and subject to the same requirements as any other member in the legal entity and in that 
5.30 	role shall act to advance state interests and lessen the burdens of government.
5.31 	(b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated share 
5.32 	of development-related expenses of the legal entity retroactively from October 29, 2007, 
5.33 	regardless of the date the commissioner joins the legal entity as a member.

6.1 	Sec. 8. Minnesota Statutes 2020, section 256.969, subdivision 2b, is amended to read:
6.2 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
6.3 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
6.4 	to the following:
6.5 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
6.6 	methodology;
6.7 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
6.8 	under subdivision 25;
6.9 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
6.10 	distinct parts as defined by Medicare shall be paid according to the methodology under 
6.11 	subdivision 12; and
6.12 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
6.13 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
6.14 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
6.15 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
6.16 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
6.17 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
6.18 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
6.19 	period as other hospitals.
6.20 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
6.21 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
6.22 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
6.23 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
6.24 	manner similar to Medicare. The base year or years for the rates effective November 1, 
6.25 	2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, 
6.26 	ensuring that the total aggregate payments under the rebased system are equal to the total 
6.27 	aggregate payments that were made for the same number and types of services in the base 
6.28 	year. Separate budget neutrality calculations shall be determined for payments made to 
6.29 	critical access hospitals and payments made to hospitals paid under the DRG system. Only 
6.30 	the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being 
6.31 	rebased during the entire base period shall be incorporated into the budget neutrality 
6.32 	calculation.
7.1 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
7.2 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
7.3 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
7.4 	a five percent increase or decrease from the base year payments for any hospital. Any 
7.5 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
7.6 	shall maintain budget neutrality as described in paragraph (c).
7.7 	(e) For discharges occurring on or after November 1, 2014, the commissioner may make 
7.8 	additional adjustments to the rebased rates, and when evaluating whether additional 
7.9 	adjustments should be made, the commissioner shall consider the impact of the rates on the 
7.10 	following:
7.11 	(1) pediatric services;
7.12 	(2) behavioral health services;
7.13 	(3) trauma services as defined by the National Uniform Billing Committee;
7.14 	(4) transplant services;
7.15 	(5) obstetric services, newborn services, and behavioral health services provided by 
7.16 	hospitals outside the seven-county metropolitan area;
7.17 	(6) outlier admissions;
7.18 	(7) low-volume providers; and
7.19 	(8) services provided by small rural hospitals that are not critical access hospitals.
7.20 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
7.21 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
7.22 	admission is standardized by the applicable Medicare wage index and adjusted by the 
7.23 	hospital's disproportionate population adjustment;
7.24 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
7.25 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
7.26 	October 31, 2014;
7.27 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
7.28 	inpatient services covered by medical assistance; and
7.29 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
7.30 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
7.31 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
8.1 	program in effect during the base year or years. In determining hospital payment rates for 
8.2 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
8.3 	methods and allowable costs of the Medicare program in effect during the base year or 
8.4 	years.
8.5 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
8.6 	the rates established under paragraph (c), and any adjustments made to the rates under 
8.7 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
8.8 	total aggregate payments for the same number and types of services under the rebased rates 
8.9 	are equal to the total aggregate payments made during calendar year 2013.
8.10 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
8.11 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
8.12 	in hospital costs between the existing base year or years and the next base year or years. In 
8.13 	any year that inpatient claims volume falls below the threshold required to ensure a statically 
8.14 	valid sample of claims, the commissioner may combine claims data from two consecutive 
8.15 	years to serve as the base year. Years in which inpatient claims volume is reduced or altered 
8.16 	due to a pandemic or other public health emergency shall not be used as a base year or part 
8.17 	of a base year if the base year includes more than one year. Changes in costs between base 
8.18 	years shall be measured using the lower of the hospital cost index defined in subdivision 1, 
8.19 	paragraph (a), or the percentage change in the case mix adjusted cost per claim. The 
8.20 	commissioner shall establish the base year for each rebasing period considering the most 
8.21 	recent year or years for which filed Medicare cost reports are available. The estimated 
8.22 	change in the average payment per hospital discharge resulting from a scheduled rebasing 
8.23 	must be calculated and made available to the legislature by January 15 of each year in which 
8.24 	rebasing is scheduled to occur, and must include by hospital the differential in payment 
8.25 	rates compared to the individual hospital's costs.
8.26 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
8.27 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
8.28 	using a new cost-based methodology. The commissioner shall establish within the 
8.29 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
8.30 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
8.31 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
8.32 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
8.33 	decrease from the base year payments for any hospital, except a hospital that had payments 
8.34 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
8.35 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
9.1 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
9.2 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
9.3 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
9.4 	following criteria:
9.5 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
9.6 	shall have a rate set that equals 85 percent of their base year costs;
9.7 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
9.8 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
9.9 	base year costs; and
9.10 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
9.11 	shall have a rate set that equals 100 percent of their base year costs.
9.12 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
9.13 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
9.14 	methodology may include, but are not limited to:
9.15 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
9.16 	hospital's charges to the medical assistance program;
9.17 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
9.18 	hospital's payments received from the medical assistance program for the care of medical 
9.19 	assistance patients;
9.20 	(3) the ratio between the hospital's charges to the medical assistance program and the 
9.21 	hospital's payments received from the medical assistance program for the care of medical 
9.22 	assistance patients;
9.23 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
9.24 	(5) the proportion of that hospital's costs that are administrative and trends in 
9.25 	administrative costs; and
9.26 	(6) geographic location.

9.27 	Sec. 9. Minnesota Statutes 2020, section 256.969, is amended by adding a subdivision to 
9.28 	read:
9.29 		Subd. 2f.Alternate inpatient payment rate. Effective January 1, 2022, for a hospital 
9.30 	eligible to receive disproportionate share hospital payments under subdivision 9, paragraph 
9.31 	(d), clause (6), the commissioner shall reduce the amount calculated under subdivision 9, 
9.32 	paragraph (d), clause (6), by 99 percent and compute an alternate inpatient payment rate. 
10.1 	The alternate payment rate shall be structured to target a total aggregate reimbursement 
10.2 	amount equal to what the hospital would have received for providing fee-for-service inpatient 
10.3 	services under this section to patients enrolled in medical assistance had the hospital received 
10.4 	the entire amount calculated under subdivision 9, paragraph (d), clause (6).

10.5 	EFFECTIVE DATE. This section is effective January 1, 2022.

10.6 	Sec. 10. Minnesota Statutes 2020, section 256.969, subdivision 9, is amended to read:
10.7 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For admissions 
10.8 	occurring on or after July 1, 1993, the medical assistance disproportionate population 
10.9 	adjustment shall comply with federal law and shall be paid to a hospital, excluding regional 
10.10 	treatment centers and facilities of the federal Indian Health Service, with a medical assistance 
10.11 	inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined 
10.12 	as follows:
10.13 	(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic 
10.14 	mean for all hospitals excluding regional treatment centers and facilities of the federal Indian 
10.15 	Health Service but less than or equal to one standard deviation above the mean, the 
10.16 	adjustment must be determined by multiplying the total of the operating and property 
10.17 	payment rates by the difference between the hospital's actual medical assistance inpatient 
10.18 	utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers 
10.19 	and facilities of the federal Indian Health Service; and
10.20 	(2) for a hospital with a medical assistance inpatient utilization rate above one standard 
10.21 	deviation above the mean, the adjustment must be determined by multiplying the adjustment 
10.22 	that would be determined under clause (1) for that hospital by 1.1. The commissioner shall 
10.23 	report annually on the number of hospitals likely to receive the adjustment authorized by 
10.24 	this paragraph. The commissioner shall specifically report on the adjustments received by 
10.25 	public hospitals and public hospital corporations located in cities of the first class.
10.26 	(b) Certified public expenditures made by Hennepin County Medical Center shall be 
10.27 	considered Medicaid disproportionate share hospital payments. Hennepin County and 
10.28 	Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning 
10.29 	July 1, 2005, or another date specified by the commissioner, that may qualify for 
10.30 	reimbursement under federal law. Based on these reports, the commissioner shall apply for 
10.31 	federal matching funds.
11.1 	(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective 
11.2 	retroactively from July 1, 2005, or the earliest effective date approved by the Centers for 
11.3 	Medicare and Medicaid Services.
11.4 	(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid 
11.5 	in accordance with a new methodology using 2012 as the base year. Annual payments made 
11.6 	under this paragraph shall equal the total amount of payments made for 2012. A licensed 
11.7 	children's hospital shall receive only a single DSH factor for children's hospitals. Other 
11.8 	DSH factors may be combined to arrive at a single factor for each hospital that is eligible 
11.9 	for DSH payments. The new methodology shall make payments only to hospitals located 
11.10 	in Minnesota and include the following factors:
11.11 	(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the 
11.12 	base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000 
11.13 	fee-for-service discharges in the base year shall receive a factor of 0.7880;
11.14 	(2) a hospital that has in effect for the initial rate year a contract with the commissioner 
11.15 	to provide extended psychiatric inpatient services under section 256.9693 shall receive a 
11.16 	factor of 0.0160;
11.17 	(3) a hospital that has received medical assistance payment from the fee-for-service 
11.18 	program for at least 20 transplant services in the base year shall receive a factor of 0.0435;
11.19 	(4) a hospital that has a medical assistance utilization rate in the base year between 20 
11.20 	percent up to one standard deviation above the statewide mean utilization rate shall receive 
11.21 	a factor of 0.0468;
11.22 	(5) a hospital that has a medical assistance utilization rate in the base year that is at least 
11.23 	one standard deviation above the statewide mean utilization rate but is less than two and 
11.24 	one-half standard deviations above the mean shall receive a factor of 0.2300; and
11.25 	(6) a hospital that is a level one trauma center and that has a medical assistance utilization 
11.26 	rate in the base year that is at least two and one-half standard deviations above the statewide 
11.27 	mean utilization rate shall receive a factor of 0.3711.
11.28 	(e) For the purposes of determining eligibility for the disproportionate share hospital 
11.29 	factors in paragraph (d), clauses (1) to (6), the medical assistance utilization rate and 
11.30 	discharge thresholds shall be measured using only one year when a two-year base period 
11.31 	is used.
11.32 	(e) (f) Any payments or portion of payments made to a hospital under this subdivision 
11.33 	that are subsequently returned to the commissioner because the payments are found to 
12.1 	exceed the hospital-specific DSH limit for that hospital shall be redistributed, proportionate 
12.2 	to the number of fee-for-service discharges, to other DSH-eligible non-children's hospitals 
12.3 	that have a medical assistance utilization rate that is at least one standard deviation above 
12.4 	the mean.
12.5 	(f) (g) An additional payment adjustment shall be established by the commissioner under 
12.6 	this subdivision for a hospital that provides high levels of administering high-cost drugs to 
12.7 	enrollees in fee-for-service medical assistance. The commissioner shall consider factors 
12.8 	including fee-for-service medical assistance utilization rates and payments made for drugs 
12.9 	purchased through the 340B drug purchasing program and administered to fee-for-service 
12.10 	enrollees. If any part of this adjustment exceeds a hospital's hospital-specific disproportionate 
12.11 	share hospital limit, or if the hospital qualifies for the alternative payment rate described in 
12.12 	subdivision 2e, the commissioner shall make a payment to the hospital that equals the 
12.13 	nonfederal share of the amount that exceeds the limit. The total nonfederal share of the 
12.14 	amount of the payment adjustment under this paragraph shall not exceed $1,500,000
12.15 	$9,000,000.

12.16 	EFFECTIVE DATE. This section is effective July 1, 2021, except that the amendment 
12.17 	to paragraph (g) is effective January 1, 2023.

12.18 	Sec. 11. Minnesota Statutes 2020, section 256.9695, subdivision 1, is amended to read:
12.19 		Subdivision 1.Appeals. A hospital may appeal a decision arising from the application 
12.20 	of standards or methods under section 256.9685, 256.9686, or 256.969, if an appeal would 
12.21 	result in a change to the hospital's payment rate or payments. Both overpayments and 
12.22 	underpayments that result from the submission of appeals shall be implemented. Regardless 
12.23 	of any appeal outcome, relative values, Medicare wage indexes, Medicare cost-to-charge 
12.24 	ratios, and policy adjusters shall not be changed. The appeal shall be heard by an 
12.25 	administrative law judge according to sections 14.57 to 14.62, or upon agreement by both 
12.26 	parties, according to a modified appeals procedure established by the commissioner and the 
12.27 	Office of Administrative Hearings. In any proceeding under this section, the appealing party 
12.28 	must demonstrate by a preponderance of the evidence that the commissioner's determination 
12.29 	is incorrect or not according to law.
12.30 	To appeal a payment rate or payment determination or a determination made from base 
12.31 	year information, the hospital shall file a written appeal request to the commissioner within 
12.32 	60 days of the date the preliminary payment rate determination was mailed. The appeal 
12.33 	request shall specify: (i) the disputed items; (ii) the authority in federal or state statute or 
12.34 	rule upon which the hospital relies for each disputed item; and (iii) the name and address 
13.1 	of the person to contact regarding the appeal. Facts to be considered in any appeal of base 
13.2 	year information are limited to those in existence 12 18 months after the last day of the 
13.3 	calendar year that is the base year for the payment rates in dispute.

13.4 	Sec. 12. Minnesota Statutes 2020, section 256.983, is amended to read:
13.5 	256.983 FRAUD PREVENTION INVESTIGATIONS.
13.6 		Subdivision 1.Programs established. Within the limits of available appropriations, the 
13.7 	commissioner of human services shall require the maintenance of budget neutral fraud 
13.8 	prevention investigation programs in the counties or tribal agencies participating in the 
13.9 	fraud prevention investigation project established under this section. If funds are sufficient, 
13.10 	the commissioner may also extend fraud prevention investigation programs to other counties 
13.11 	or tribal agencies provided the expansion is budget neutral to the state. Under any expansion, 
13.12 	the commissioner has the final authority in decisions regarding the creation and realignment 
13.13 	of individual county, tribal agency, or regional operations.
13.14 		Subd. 2.County and tribal agency proposals. Each participating county and tribal 
13.15 	agency shall develop and submit an annual staffing and funding proposal to the commissioner 
13.16 	no later than April 30 of each year. Each proposal shall include, but not be limited to, the 
13.17 	staffing and funding of the fraud prevention investigation program, a job description for 
13.18 	investigators involved in the fraud prevention investigation program, and the organizational 
13.19 	structure of the county or tribal agency unit, training programs for case workers, and the 
13.20 	operational requirements which may be directed by the commissioner. The proposal shall 
13.21 	be approved, to include any changes directed or negotiated by the commissioner, no later 
13.22 	than June 30 of each year.
13.23 		Subd. 3.Department responsibilities. The commissioner shall establish training 
13.24 	programs which shall be attended by all investigative and supervisory staff of the involved 
13.25 	county and tribal agencies. The commissioner shall also develop the necessary operational 
13.26 	guidelines, forms, and reporting mechanisms, which shall be used by the involved county
13.27 	or tribal agencies. An individual's application or redetermination form for public assistance 
13.28 	benefits, including child care assistance programs and medical care programs, must include 
13.29 	an authorization for release by the individual to obtain documentation for any information 
13.30 	on that form which is involved in a fraud prevention investigation. The authorization for 
13.31 	release is effective for six months after public assistance benefits have ceased.
13.32 		Subd. 4.Funding. (a) County and tribal agency reimbursement shall be made through 
13.33 	the settlement provisions applicable to the Supplemental Nutrition Assistance Program 
14.1 	(SNAP), MFIP, child care assistance programs, the medical assistance program, and other 
14.2 	federal and state-funded programs.
14.3 	(b) The commissioner will maintain program compliance if for any three consecutive 
14.4 	month period, a county or tribal agency fails to comply with fraud prevention investigation 
14.5 	program guidelines, or fails to meet the cost-effectiveness standards developed by the 
14.6 	commissioner. This result is contingent on the commissioner providing written notice, 
14.7 	including an offer of technical assistance, within 30 days of the end of the third or subsequent 
14.8 	month of noncompliance. The county or tribal agency shall be required to submit a corrective 
14.9 	action plan to the commissioner within 30 days of receipt of a notice of noncompliance. 
14.10 	Failure to submit a corrective action plan or, continued deviation from standards of more 
14.11 	than ten percent after submission of a corrective action plan, will result in denial of funding 
14.12 	for each subsequent month, or billing the county or tribal agency for fraud prevention 
14.13 	investigation (FPI) service provided by the commissioner, or reallocation of program grant 
14.14 	funds, or investigative resources, or both, to other counties or tribal agencies. The denial of 
14.15 	funding shall apply to the general settlement received by the county or tribal agency on a 
14.16 	quarterly basis and shall not reduce the grant amount applicable to the FPI project.
14.17 		Subd. 5.Child care providers; financial misconduct. (a) A county or tribal agency 
14.18 	may conduct investigations of financial misconduct by child care providers as described in 
14.19 	chapter 245E. Prior to opening an investigation, a county or tribal agency must contact the 
14.20 	commissioner to determine whether an investigation under this chapter may compromise 
14.21 	an ongoing investigation.
14.22 	(b) If, upon investigation, a preponderance of evidence shows a provider committed an 
14.23 	intentional program violation, intentionally gave the county or tribe materially false 
14.24 	information on the provider's billing forms, provided false attendance records to a county, 
14.25 	tribe, or the commissioner, or committed financial misconduct as described in section 
14.26 	245E.01, subdivision 8, the county or tribal agency may suspend a provider's payment 
14.27 	pursuant to chapter 245E, or deny or revoke a provider's authorization pursuant to section 
14.28 	119B.13, subdivision 6, paragraph (d), clause (2), prior to pursuing other available remedies. 
14.29 	The county or tribe must send notice in accordance with the requirements of section 
14.30 	119B.161, subdivision 2. If a provider's payment is suspended under this section, the payment 
14.31 	suspension shall remain in effect until: (1) the commissioner, county, tribe, or a law 
14.32 	enforcement authority determines that there is insufficient evidence warranting the action 
14.33 	and a county, tribe, or the commissioner does not pursue an additional administrative remedy 
14.34 	under chapter 119B or 245E, or section 256.046 or 256.98; or (2) all criminal, civil, and 
15.1 	administrative proceedings related to the provider's alleged misconduct conclude and any 
15.2 	appeal rights are exhausted.
15.3 	(c) For the purposes of this section, an intentional program violation includes intentionally 
15.4 	making false or misleading statements; intentionally misrepresenting, concealing, or 
15.5 	withholding facts; and repeatedly and intentionally violating program regulations under 
15.6 	chapters 119B and 245E.
15.7 	(d) A provider has the right to administrative review under section 119B.161 if: (1) 
15.8 	payment is suspended under chapter 245E; or (2) the provider's authorization was denied 
15.9 	or revoked under section 119B.13, subdivision 6, paragraph (d), clause (2).

15.10 	Sec. 13. [256B.0371] ADMINISTRATION OF DENTAL SERVICES.
15.11 	(a) Effective January 1, 2023, the commissioner shall contract with a dental administrator 
15.12 	to administer dental services for all recipients of medical assistance and MinnesotaCare, 
15.13 	including persons enrolled in managed care as described in section 256B.69.
15.14 	(b) The dental administrator must provide administrative services, including but not 
15.15 	limited to:
15.16 	(1) provider recruitment, contracting, and assistance;
15.17 	(2) recipient outreach and assistance;
15.18 	(3) utilization management and reviews of medical necessity for dental services;
15.19 	(4) dental claims processing;
15.20 	(5) coordination of dental care with other services;
15.21 	(6) management of fraud and abuse;
15.22 	(7) monitoring access to dental services;
15.23 	(8) performance measurement;
15.24 	(9) quality improvement and evaluation; and
15.25 	(10) management of third-party liability requirements.
15.26 	(c) Payments to contracted dental providers must be at the rates established under section 
15.27 	256B.76.

15.28 	EFFECTIVE DATE. This section is effective January 1, 2023.

16.1 	Sec. 14. Minnesota Statutes 2020, section 256B.04, subdivision 12, is amended to read:
16.2 		Subd. 12.Limitation on services. (a) Place limits on the types of services covered by 
16.3 	medical assistance, the frequency with which the same or similar services may be covered 
16.4 	by medical assistance for an individual recipient, and the amount paid for each covered 
16.5 	service. The state agency shall promulgate rules establishing maximum reimbursement rates 
16.6 	for emergency and nonemergency transportation.
16.7 	The rules shall provide:
16.8 	(1) an opportunity for all recognized transportation providers to be reimbursed for 
16.9 	nonemergency transportation consistent with the maximum rates established by the agency; 
16.10 	and
16.11 	(2) reimbursement of public and private nonprofit providers serving the population with 
16.12 	a disability generally at reasonable maximum rates that reflect the cost of providing the 
16.13 	service regardless of the fare that might be charged by the provider for similar services to 
16.14 	individuals other than those receiving medical assistance or medical care under this chapter.
16.15 	(b) The commissioner shall encourage providers reimbursed under this chapter to 
16.16 	coordinate their operation with similar services that are operating in the same community. 
16.17 	To the extent practicable, the commissioner shall encourage eligible individuals to utilize 
16.18 	less expensive providers capable of serving their needs.
16.19 	(c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective 
16.20 	on January 1, 1981, "recognized provider of transportation services" means an operator of 
16.21 	special transportation service as defined in section 174.29 that has been issued a current 
16.22 	certificate of compliance with operating standards of the commissioner of transportation 
16.23 	or, if those standards do not apply to the operator, that the agency finds is able to provide 
16.24 	the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized 
16.25 	transportation provider" includes an operator of special transportation service that the agency 
16.26 	finds is able to provide the required transportation in a safe and reliable manner.

16.27 	Sec. 15. Minnesota Statutes 2020, section 256B.04, subdivision 14, is amended to read:
16.28 		Subd. 14.Competitive bidding. (a) When determined to be effective, economical, and 
16.29 	feasible, the commissioner may utilize volume purchase through competitive bidding and 
16.30 	negotiation under the provisions of chapter 16C, to provide items under the medical assistance 
16.31 	program including but not limited to the following:
16.32 	(1) eyeglasses;
17.1 	(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation 
17.2 	on a short-term basis, until the vendor can obtain the necessary supply from the contract 
17.3 	dealer;
17.4 	(3) hearing aids and supplies; and
17.5 	(4) durable medical equipment, including but not limited to:
17.6 	(i) hospital beds;
17.7 	(ii) commodes;
17.8 	(iii) glide-about chairs;
17.9 	(iv) patient lift apparatus;
17.10 	(v) wheelchairs and accessories;
17.11 	(vi) oxygen administration equipment;
17.12 	(vii) respiratory therapy equipment;
17.13 	(viii) electronic diagnostic, therapeutic and life-support systems; and
17.14 	(ix) allergen-reducing products as described in section 256B.0625, subdivision 67, 
17.15 	paragraph (c) or (d);
17.16 	(5) nonemergency medical transportation level of need determinations, disbursement of 
17.17 	public transportation passes and tokens, and volunteer and recipient mileage and parking 
17.18 	reimbursements; and
17.19 	(6) drugs.
17.20 	(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not 
17.21 	affect contract payments under this subdivision unless specifically identified.
17.22 	(c) The commissioner may not utilize volume purchase through competitive bidding 
17.23 	and negotiation under the provisions of chapter 16C for special transportation services or
17.24 	incontinence products and related supplies.

17.25 	Sec. 16. Minnesota Statutes 2020, section 256B.055, subdivision 6, is amended to read:
17.26 		Subd. 6.Pregnant women; needy unborn child. Medical assistance may be paid for 
17.27 	a pregnant woman who meets the other eligibility criteria of this section and whose unborn 
17.28 	child would be eligible as a needy child under subdivision 10 if born and living with the 
17.29 	woman. In accordance with Code of Federal Regulations, title 42, section 435.956, the 
17.30 	commissioner must accept self-attestation of pregnancy unless the agency has information 
18.1 	that is not reasonably compatible with such attestation. For purposes of this subdivision, a 
18.2 	woman is considered pregnant for 60 dayssix months postpartum.

18.3 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
18.4 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
18.5 	approval has been obtained.

18.6 	Sec. 17. Minnesota Statutes 2020, section 256B.056, subdivision 10, is amended to read:
18.7 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who are 
18.8 	applying for the continuation of medical assistance coverage following the end of the 60-day
18.9 	six-month postpartum period to update their income and asset information and to submit 
18.10 	any required income or asset verification.
18.11 	(b) The commissioner shall determine the eligibility of private-sector health care coverage 
18.12 	for infants less than one year of age eligible under section 256B.055, subdivision 10, or 
18.13 	256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is 
18.14 	determined to be cost-effective.
18.15 	(c) The commissioner shall verify assets and income for all applicants, and for all 
18.16 	recipients upon renewal.
18.17 	(d) The commissioner shall utilize information obtained through the electronic service 
18.18 	established by the secretary of the United States Department of Health and Human Services 
18.19 	and other available electronic data sources in Code of Federal Regulations, title 42, sections 
18.20 	435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish 
18.21 	standards to define when information obtained electronically is reasonably compatible with 
18.22 	information provided by applicants and enrollees, including use of self-attestation, to 
18.23 	accomplish real-time eligibility determinations and maintain program integrity.
18.24 	(e) Each person applying for or receiving medical assistance under section 256B.055, 
18.25 	subdivision 7, and any other person whose resources are required by law to be disclosed to 
18.26 	determine the applicant's or recipient's eligibility must authorize the commissioner to obtain 
18.27 	information from financial institutions to identify unreported accounts as required in section 
18.28 	256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner 
18.29 	may determine that the applicant or recipient is ineligible for medical assistance. For purposes 
18.30 	of this paragraph, an authorization to identify unreported accounts meets the requirements 
18.31 	of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not 
18.32 	be furnished to the financial institution.
19.1 	(f) County and tribal agencies shall comply with the standards established by the 
19.2 	commissioner for appropriate use of the asset verification system specified in section 256.01, 
19.3 	subdivision 18f.

19.4 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
19.5 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
19.6 	approval has been obtained.

19.7 	Sec. 18. Minnesota Statutes 2020, section 256B.057, subdivision 3, is amended to read:
19.8 		Subd. 3.Qualified Medicare beneficiaries. (a) A person who is entitled to Part A 
19.9 	Medicare benefits, whose income is equal to or less than 100 percent of the federal poverty 
19.10 	guidelines, and whose assets are no more than $10,000 for a single individual and $18,000 
19.11 	for a married couple or family of two or more, is eligible for medical assistance 
19.12 	reimbursement of Medicare Part A and Part B premiums, Part A and Part B coinsurance 
19.13 	and deductibles, and cost-effective premiums for enrollment with a health maintenance 
19.14 	organization or a competitive medical plan under section 1876 of the Social Security Act.
19.15 	if:
19.16 	(1) the person is entitled to Medicare Part A benefits;
19.17 	(2) the person's income is equal to or less than 100 percent of the federal poverty 
19.18 	guidelines; and
19.19 	(3) the person's assets are no more than (i) $10,000 for a single individual, or (ii) $18,000 
19.20 	for a married couple or family of two or more; or, when the resource limits for eligibility 
19.21 	for the Medicare Part D extra help low income subsidy (LIS) exceed either amount in item 
19.22 	(i) or (ii), the person's assets are no more than the LIS resource limit in United States Code, 
19.23 	title 42, section 1396d, subsection (p).
19.24 	(b) Reimbursement of the Medicare coinsurance and deductibles, when added to the 
19.25 	amount paid by Medicare, must not exceed the total rate the provider would have received 
19.26 	for the same service or services if the person were a medical assistance recipient with 
19.27 	Medicare coverage. Increases in benefits under Title II of the Social Security Act shall not 
19.28 	be counted as income for purposes of this subdivision until July 1 of each year.

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

19.30 	Sec. 19. Minnesota Statutes 2020, section 256B.06, subdivision 4, is amended to read:
19.31 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited to 
19.32 	citizens of the United States, qualified noncitizens as defined in this subdivision, and other 
20.1 	persons residing lawfully in the United States. Citizens or nationals of the United States 
20.2 	must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality 
20.3 	according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 
20.4 	109-171.
20.5 	(b) "Qualified noncitizen" means a person who meets one of the following immigration 
20.6 	criteria:
20.7 	(1) admitted for lawful permanent residence according to United States Code, title 8;
20.8 	(2) admitted to the United States as a refugee according to United States Code, title 8, 
20.9 	section 1157;
20.10 	(3) granted asylum according to United States Code, title 8, section 1158;
20.11 	(4) granted withholding of deportation according to United States Code, title 8, section 
20.12 	1253(h);
20.13 	(5) paroled for a period of at least one year according to United States Code, title 8, 
20.14 	section 1182(d)(5);
20.15 	(6) granted conditional entrant status according to United States Code, title 8, section 
20.16 	1153(a)(7);
20.17 	(7) determined to be a battered noncitizen by the United States Attorney General 
20.18 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
20.19 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
20.20 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United States 
20.21 	Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility 
20.22 	Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 
20.23 	or
20.24 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
20.25 	Law 96-422, the Refugee Education Assistance Act of 1980.
20.26 	(c) All qualified noncitizens who were residing in the United States before August 22, 
20.27 	1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical 
20.28 	assistance with federal financial participation.
20.29 	(d) Beginning December 1, 1996, qualified noncitizens who entered the United States 
20.30 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
20.31 	chapter are eligible for medical assistance with federal participation for five years if they 
20.32 	meet one of the following criteria:
21.1 	(1) refugees admitted to the United States according to United States Code, title 8, section 
21.2 	1157;
21.3 	(2) persons granted asylum according to United States Code, title 8, section 1158;
21.4 	(3) persons granted withholding of deportation according to United States Code, title 8, 
21.5 	section 1253(h);
21.6 	(4) veterans of the United States armed forces with an honorable discharge for a reason 
21.7 	other than noncitizen status, their spouses and unmarried minor dependent children; or
21.8 	(5) persons on active duty in the United States armed forces, other than for training, 
21.9 	their spouses and unmarried minor dependent children.
21.10 	Beginning July 1, 2010, children and pregnant women who are noncitizens described 
21.11 	in paragraph (b) or who are lawfully present in the United States as defined in Code of 
21.12 	Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements 
21.13 	of this chapter, are eligible for medical assistance with federal financial participation as 
21.14 	provided by the federal Children's Health Insurance Program Reauthorization Act of 2009, 
21.15 	Public Law 111-3.
21.16 	(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are 
21.17 	eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision, 
21.18 	a "nonimmigrant" is a person in one of the classes listed in United States Code, title 8, 
21.19 	section 1101(a)(15).
21.20 	(f) Payment shall also be made for care and services that are furnished to noncitizens, 
21.21 	regardless of immigration status, who otherwise meet the eligibility requirements of this 
21.22 	chapter, if such care and services are necessary for the treatment of an emergency medical 
21.23 	condition.
21.24 	(g) For purposes of this subdivision, the term "emergency medical condition" means a 
21.25 	medical condition that meets the requirements of United States Code, title 42, section 
21.26 	1396b(v).
21.27 	(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of 
21.28 	an emergency medical condition are limited to the following:
21.29 	(i) services delivered in an emergency room or by an ambulance service licensed under 
21.30 	chapter 144E that are directly related to the treatment of an emergency medical condition;
21.31 	(ii) services delivered in an inpatient hospital setting following admission from an 
21.32 	emergency room or clinic for an acute emergency condition; and
22.1 	(iii) follow-up services that are directly related to the original service provided to treat 
22.2 	the emergency medical condition and are covered by the global payment made to the 
22.3 	provider.
22.4 	(2) Services for the treatment of emergency medical conditions do not include:
22.5 	(i) services delivered in an emergency room or inpatient setting to treat a nonemergency 
22.6 	condition;
22.7 	(ii) organ transplants, stem cell transplants, and related care;
22.8 	(iii) services for routine prenatal care;
22.9 	(iv) continuing care, including long-term care, nursing facility services, home health 
22.10 	care, adult day care, day training, or supportive living services;
22.11 	(v) elective surgery;
22.12 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part 
22.13 	of an emergency room visit;
22.14 	(vii) preventative health care and family planning services;
22.15 	(viii) rehabilitation services;
22.16 	(ix) physical, occupational, or speech therapy;
22.17 	(x) transportation services;
22.18 	(xi) case management;
22.19 	(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
22.20 	(xiii) dental services;
22.21 	(xiv) hospice care;
22.22 	(xv) audiology services and hearing aids;
22.23 	(xvi) podiatry services;
22.24 	(xvii) chiropractic services;
22.25 	(xviii) immunizations;
22.26 	(xix) vision services and eyeglasses;
22.27 	(xx) waiver services;
22.28 	(xxi) individualized education programs; or
23.1 	(xxii) chemical dependency treatment.
23.2 	(i) Pregnant noncitizens who are ineligible for federally funded medical assistance 
23.3 	because of immigration status, are not covered by a group health plan or health insurance 
23.4 	coverage according to Code of Federal Regulations, title 42, section 457.310, and who 
23.5 	otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance 
23.6 	through the period of pregnancy, including labor and delivery, and 60 dayssix months
23.7 	postpartum, to the extent federal funds are available under title XXI of the Social Security 
23.8 	Act, and the state children's health insurance program.
23.9 	(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services 
23.10 	from a nonprofit center established to serve victims of torture and are otherwise ineligible 
23.11 	for medical assistance under this chapter are eligible for medical assistance without federal 
23.12 	financial participation. These individuals are eligible only for the period during which they 
23.13 	are receiving services from the center. Individuals eligible under this paragraph shall not 
23.14 	be required to participate in prepaid medical assistance. The nonprofit center referenced 
23.15 	under this paragraph may establish itself as a provider of mental health targeted case 
23.16 	management services through a county contract under section 256.0112, subdivision 6. If 
23.17 	the nonprofit center is unable to secure a contract with a lead county in its service area, then, 
23.18 	notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner 
23.19 	may negotiate a contract with the nonprofit center for provision of mental health targeted 
23.20 	case management services. When serving clients who are not the financial responsibility 
23.21 	of their contracted lead county, the nonprofit center must gain the concurrence of the county 
23.22 	of financial responsibility prior to providing mental health targeted case management services 
23.23 	for those clients.
23.24 	(k) Notwithstanding paragraph (h), clause (2), the following services are covered as 
23.25 	emergency medical conditions under paragraph (f) except where coverage is prohibited 
23.26 	under federal law for services under clauses (1) and (2):
23.27 	(1) dialysis services provided in a hospital or freestanding dialysis facility;
23.28 	(2) surgery and the administration of chemotherapy, radiation, and related services 
23.29 	necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and 
23.30 	requires surgery, chemotherapy, or radiation treatment; and
23.31 	(3) kidney transplant if the person has been diagnosed with end stage renal disease, is 
23.32 	currently receiving dialysis services, and is a potential candidate for a kidney transplant.
23.33 	(l) Effective July 1, 2013, recipients of emergency medical assistance under this 
23.34 	subdivision are eligible for coverage of the elderly waiver services provided under chapter 
24.1 	256S, and coverage of rehabilitative services provided in a nursing facility. The age limit 
24.2 	for elderly waiver services does not apply. In order to qualify for coverage, a recipient of 
24.3 	emergency medical assistance is subject to the assessment and reassessment requirements 
24.4 	of section 256B.0911. Initial and continued enrollment under this paragraph is subject to 
24.5 	the limits of available funding.

24.6 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
24.7 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
24.8 	approval has been obtained.

24.9 	Sec. 20. Minnesota Statutes 2020, section 256B.0625, subdivision 3c, is amended to read:
24.10 		Subd. 3c.Health Services Policy Committee Advisory Council. (a) The commissioner, 
24.11 	after receiving recommendations from professional physician associations, professional 
24.12 	associations representing licensed nonphysician health care professionals, and consumer 
24.13 	groups, shall establish a 13-member 14-member Health Services Policy Committee Advisory 
24.14 	Council, which consists of 12 13 voting members and one nonvoting member. The Health 
24.15 	Services Policy Committee Advisory Council shall advise the commissioner regarding (1)
24.16 	health services pertaining to the administration of health care benefits covered under the 
24.17 	medical assistance and MinnesotaCare programs Minnesota health care programs (MHCP); 
24.18 	and (2) evidence-based decision-making and health care benefit and coverage policies for 
24.19 	MHCP. The Health Services Advisory Council shall consider available evidence regarding 
24.20 	quality, safety, and cost-effectiveness when advising the commissioner. The Health Services 
24.21 	Policy Committee Advisory Council shall meet at least quarterly. The Health Services Policy 
24.22 	Committee Advisory Council shall annually elect select a physician chair from among its 
24.23 	members, who shall work directly with the commissioner's medical director, to establish 
24.24 	the agenda for each meeting. The Health Services Policy Committee shall also Advisory 
24.25 	Council may recommend criteria for verifying centers of excellence for specific aspects of 
24.26 	medical care where a specific set of combined services, a volume of patients necessary to 
24.27 	maintain a high level of competency, or a specific level of technical capacity is associated 
24.28 	with improved health outcomes.
24.29 	(b) The commissioner shall establish a dental subcommittee subcouncil to operate under 
24.30 	the Health Services Policy Committee Advisory Council. The dental subcommittee
24.31 	subcouncil consists of general dentists, dental specialists, safety net providers, dental 
24.32 	hygienists, health plan company and county and public health representatives, health 
24.33 	researchers, consumers, and a designee of the commissioner of health. The dental 
24.34 	subcommittee subcouncil shall advise the commissioner regarding:
25.1 	(1) the critical access dental program under section 256B.76, subdivision 4, including 
25.2 	but not limited to criteria for designating and terminating critical access dental providers;
25.3 	(2) any changes to the critical access dental provider program necessary to comply with 
25.4 	program expenditure limits;
25.5 	(3) dental coverage policy based on evidence, quality, continuity of care, and best 
25.6 	practices;
25.7 	(4) the development of dental delivery models; and
25.8 	(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
25.9 	(c) The Health Services Policy Committee shall study approaches to making provider 
25.10 	reimbursement under the medical assistance and MinnesotaCare programs contingent on 
25.11 	patient participation in a patient-centered decision-making process, and shall evaluate the 
25.12 	impact of these approaches on health care quality, patient satisfaction, and health care costs. 
25.13 	The committee shall present findings and recommendations to the commissioner and the 
25.14 	legislative committees with jurisdiction over health care by January 15, 2010.
25.15 	(d) (c) The Health Services Policy Committee shall Advisory Council may monitor and 
25.16 	track the practice patterns of physicians providing services to medical assistance and 
25.17 	MinnesotaCare enrollees health care providers who serve MHCP recipients under 
25.18 	fee-for-service, managed care, and county-based purchasing. The committee monitoring 
25.19 	and tracking shall focus on services or specialties for which there is a high variation in 
25.20 	utilization or quality across physicians providers, or which are associated with high medical 
25.21 	costs. The commissioner, based upon the findings of the committee Health Services Advisory 
25.22 	Council, shall regularly may notify physicians providers whose practice patterns indicate 
25.23 	below average quality or higher than average utilization or costs. Managed care and 
25.24 	county-based purchasing plans shall provide the commissioner with utilization and cost 
25.25 	data necessary to implement this paragraph, and the commissioner shall make this these
25.26 	data available to the committee Health Services Advisory Council.
25.27 	(e) The Health Services Policy Committee shall review caesarean section rates for the 
25.28 	fee-for-service medical assistance population. The committee may develop best practices 
25.29 	policies related to the minimization of caesarean sections, including but not limited to 
25.30 	standards and guidelines for health care providers and health care facilities.

25.31 	Sec. 21. Minnesota Statutes 2020, section 256B.0625, subdivision 3d, is amended to read:
25.32 		Subd. 3d.Health Services Policy Committee Advisory Council members. (a) The 
25.33 	Health Services Policy Committee Advisory Council consists of:
26.1 	(1) seven six voting members who are licensed physicians actively engaged in the practice 
26.2 	of medicine in Minnesota, one of whom must be actively engaged in the treatment of persons 
26.3 	with mental illness, and three of whom must represent health plans currently under contract 
26.4 	to serve medical assistance MHCP recipients;
26.5 	(2) two voting members who are licensed physician specialists actively practicing their 
26.6 	specialty in Minnesota;
26.7 	(3) two voting members who are nonphysician health care professionals licensed or 
26.8 	registered in their profession and actively engaged in their practice of their profession in 
26.9 	Minnesota;
26.10 	(4) one voting member who is a health care or mental health professional licensed or 
26.11 	registered in the member's profession, actively engaged in the practice of the member's 
26.12 	profession in Minnesota, and actively engaged in the treatment of persons with mental 
26.13 	illness;
26.14 	(4) one consumer (5) two consumers who shall serve as a voting member members; and
26.15 	(5) (6) the commissioner's medical director who shall serve as a nonvoting member.
26.16 	(b) Members of the Health Services Policy Committee Advisory Council shall not be 
26.17 	employed by the Department of Human Services state of Minnesota, except for the medical 
26.18 	director. A quorum shall comprise a simple majority of the voting members. Vacant seats 
26.19 	shall not count toward a quorum.

26.20 	Sec. 22. Minnesota Statutes 2020, section 256B.0625, subdivision 3e, is amended to read:
26.21 		Subd. 3e.Health Services Policy Committee Advisory Council terms and 
26.22 	compensation. Committee Members shall serve staggered three-year terms, with one-third 
26.23 	of the voting members' terms expiring annually. Members may be reappointed by the 
26.24 	commissioner. The commissioner may require more frequent Health Services Policy 
26.25 	Committee Advisory Council meetings as needed. An honorarium of $200 per meeting and 
26.26 	reimbursement for mileage and parking shall be paid to each committee council member 
26.27 	in attendance except the medical director. The Health Services Policy Committee Advisory 
26.28 	Council does not expire as provided in section 15.059, subdivision 6.

26.29 	Sec. 23. Minnesota Statutes 2020, section 256B.0625, subdivision 9, is amended to read:
26.30 		Subd. 9.Dental services. (a) Medical assistance covers dental services. The commissioner 
26.31 	shall contract with a dental administrator for the administration of dental services. The 
27.1 	contract shall include the administration of dental services for persons enrolled in managed 
27.2 	care as described in section 256B.69.
27.3 	(b) Medical assistance dental coverage for nonpregnant adults is limited to the following 
27.4 	services:
27.5 	(1) comprehensive exams, limited to once every five years;
27.6 	(2) periodic exams, limited to one per year;
27.7 	(3) limited exams;
27.8 	(4) bitewing x-rays, limited to one per year;
27.9 	(5) periapical x-rays;
27.10 	(6) panoramic x-rays, limited to one every five years except (1) when medically necessary 
27.11 	for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once 
27.12 	every two years for patients who cannot cooperate for intraoral film due to a developmental 
27.13 	disability or medical condition that does not allow for intraoral film placement;
27.14 	(7) prophylaxis, limited to one per year;
27.15 	(8) application of fluoride varnish, limited to one per year;
27.16 	(9) posterior fillings, all at the amalgam rate;
27.17 	(10) anterior fillings;
27.18 	(11) endodontics, limited to root canals on the anterior and premolars only;
27.19 	(12) removable prostheses, each dental arch limited to one every six years;
27.20 	(13) oral surgery, limited to extractions, biopsies, and incision and drainage of abscesses;
27.21 	(14) palliative treatment and sedative fillings for relief of pain; and
27.22 	(15) full-mouth debridement, limited to one every five years.; and
27.23 	(16) nonsurgical treatment for periodontal disease, including scaling and root planing 
27.24 	once every two years for each quadrant, and routine periodontal maintenance procedures.
27.25 	(c) In addition to the services specified in paragraph (b), medical assistance covers the 
27.26 	following services for adults, if provided in an outpatient hospital setting or freestanding 
27.27 	ambulatory surgical center as part of outpatient dental surgery:
27.28 	(1) periodontics, limited to periodontal scaling and root planing once every two years;
27.29 	(2) general anesthesia; and
28.1 	(3) full-mouth survey once every five years.
28.2 	(d) Medical assistance covers medically necessary dental services for children and 
28.3 	pregnant women. The following guidelines apply:
28.4 	(1) posterior fillings are paid at the amalgam rate;
28.5 	(2) application of sealants are covered once every five years per permanent molar for 
28.6 	children only;
28.7 	(3) application of fluoride varnish is covered once every six months; and
28.8 	(4) orthodontia is eligible for coverage for children only.
28.9 	(e) In addition to the services specified in paragraphs (b) and (c), medical assistance 
28.10 	covers the following services for adults:
28.11 	(1) house calls or extended care facility calls for on-site delivery of covered services;
28.12 	(2) behavioral management when additional staff time is required to accommodate 
28.13 	behavioral challenges and sedation is not used;
28.14 	(3) oral or IV sedation, if the covered dental service cannot be performed safely without 
28.15 	it or would otherwise require the service to be performed under general anesthesia in a 
28.16 	hospital or surgical center; and
28.17 	(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but 
28.18 	no more than four times per year.
28.19 	(f) The commissioner shall not require prior authorization for the services included in 
28.20 	paragraph (e), clauses (1) to (3), and shall prohibit managed care and county-based purchasing 
28.21 	plans from requiring prior authorization for the services included in paragraph (e), clauses 
28.22 	(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.

28.23 	EFFECTIVE DATE. This section is effective July 1, 2021, except that the amendments 
28.24 	to paragraphs (a) and (f) are effective January 1, 2023.

28.25 	Sec. 24. Minnesota Statutes 2020, section 256B.0625, subdivision 13, is amended to read:
28.26 		Subd. 13.Drugs. (a) Medical assistance covers drugs, except for fertility drugs when 
28.27 	specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed 
28.28 	by a licensed pharmacist, by a physician enrolled in the medical assistance program as a 
28.29 	dispensing physician, or by a physician, a physician assistant, or an advanced practice 
28.30 	registered nurse employed by or under contract with a community health board as defined 
28.31 	in section 145A.02, subdivision 5, for the purposes of communicable disease control.
29.1 	(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 
29.2 	unless authorized by the commissioner. or the drug appears on the 90-day supply list 
29.3 	published by the commissioner. The 90-day supply list shall be published by the 
29.4 	commissioner on the department's website. The commissioner may add to, delete from, and 
29.5 	otherwise modify the 90-day supply list after providing public notice and the opportunity 
29.6 	for a 15-day public comment period. The 90-day supply list may include cost-effective 
29.7 	generic drugs and shall not include controlled substances.
29.8 	(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical 
29.9 	ingredient" is defined as a substance that is represented for use in a drug and when used in 
29.10 	the manufacturing, processing, or packaging of a drug becomes an active ingredient of the 
29.11 	drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle 
29.12 	for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and 
29.13 	excipients which are included in the medical assistance formulary. Medical assistance covers 
29.14 	selected active pharmaceutical ingredients and excipients used in compounded prescriptions 
29.15 	when the compounded combination is specifically approved by the commissioner or when 
29.16 	a commercially available product:
29.17 	(1) is not a therapeutic option for the patient;
29.18 	(2) does not exist in the same combination of active ingredients in the same strengths 
29.19 	as the compounded prescription; and
29.20 	(3) cannot be used in place of the active pharmaceutical ingredient in the compounded 
29.21 	prescription.
29.22 	(d) Medical assistance covers the following over-the-counter drugs when prescribed by 
29.23 	a licensed practitioner or by a licensed pharmacist who meets standards established by the 
29.24 	commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family 
29.25 	planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults 
29.26 	with documented vitamin deficiencies, vitamins for children under the age of seven and 
29.27 	pregnant or nursing women, and any other over-the-counter drug identified by the 
29.28 	commissioner, in consultation with the Formulary Committee, as necessary, appropriate, 
29.29 	and cost-effective for the treatment of certain specified chronic diseases, conditions, or 
29.30 	disorders, and this determination shall not be subject to the requirements of chapter 14. A 
29.31 	pharmacist may prescribe over-the-counter medications as provided under this paragraph 
29.32 	for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter 
29.33 	drugs under this paragraph, licensed pharmacists must consult with the recipient to determine 
30.1 	necessity, provide drug counseling, review drug therapy for potential adverse interactions, 
30.2 	and make referrals as needed to other health care professionals.
30.3 	(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable 
30.4 	under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and 
30.5 	Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible 
30.6 	for drug coverage as defined in the Medicare Prescription Drug, Improvement, and 
30.7 	Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these 
30.8 	individuals, medical assistance may cover drugs from the drug classes listed in United States 
30.9 	Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 
30.10 	13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall 
30.11 	not be covered.
30.12 	(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing 
30.13 	Program and dispensed by 340B covered entities and ambulatory pharmacies under common 
30.14 	ownership of the 340B covered entity. Medical assistance does not cover drugs acquired 
30.15 	through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.
30.16 	By March 1 of each year, each 340B covered entity and ambulatory pharmacy under common 
30.17 	ownership of the 340B covered entity must report to the commissioner its reimbursements 
30.18 	for the previous calendar year from each managed care and county-based purchasing plan, 
30.19 	or the pharmacy benefit manager contracted with the managed care or county-based 
30.20 	purchasing plan. The report must include:
30.21 	(1) the National Provider Identification (NPI) number for each 340B covered entity or 
30.22 	ambulatory pharmacy under common ownership of the 340B covered entity;
30.23 	(2) the name of each 340B covered entity;
30.24 	(3) the servicing address of each 340B covered entity;
30.25 	(4) the aggregate cost of drugs purchased during the prior calendar year through the 
30.26 	340B program;
30.27 	(5) the aggregate cost of drugs purchased during the prior calendar year outside of the 
30.28 	340B program;
30.29 	(6) the total reimbursement received by the 340B covered entity from all payers, including 
30.30 	uninsured patients, for all drugs during the prior calendar year; and
30.31 	(7) either: (i) the number of outpatient 340B pharmacy claims and reimbursement amounts 
30.32 	from each managed care and county-based purchasing plan, or pharmacy benefit manager 
30.33 	contracted with the managed care or county-based purchasing plan; or (ii) the number of 
31.1 	professional or facility 340B claim lines and reimbursement amounts during the prior 
31.2 	calendar year from each managed care and county-based purchasing plan.
31.3 	The commissioner shall submit a copy of the reports to the chairs and ranking minority 
31.4 	members of the legislative committees with jurisdiction over health care policy and finance 
31.5 	by April 1 of each year. Drugs acquired through the federal 340B Drug Pricing Program 
31.6 	and dispensed by a 340B covered entity or ambulatory pharmacy under common ownership 
31.7 	of the 340B covered entity are not eligible for coverage if the 340B covered entity or 
31.8 	ambulatory pharmacy under common ownership of the 340B covered entity fails to submit 
31.9 	a report to the commissioner containing the information required under clauses (1) to (7).
31.10 	(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal 
31.11 	contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section 
31.12 	151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a 
31.13 	licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists 
31.14 	used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed 
31.15 	pharmacist in accordance with section 151.37, subdivision 16.

31.16 	Sec. 25. Minnesota Statutes 2020, section 256B.0625, subdivision 13c, is amended to 
31.17 	read:
31.18 		Subd. 13c.Formulary Committee. The commissioner, after receiving recommendations 
31.19 	from professional medical associations and professional pharmacy associations, and consumer 
31.20 	groups shall designate a Formulary Committee to carry out duties as described in subdivisions 
31.21 	13 to 13g. The Formulary Committee shall be comprised of four licensed physicians actively 
31.22 	engaged in the practice of medicine in Minnesota, one of whom must be actively engaged 
31.23 	in the treatment of persons with mental illness; at least three licensed pharmacists actively 
31.24 	engaged in the practice of pharmacy in Minnesota; and one consumer representative; the 
31.25 	remainder to be made up of health care professionals who are licensed in their field and 
31.26 	have recognized knowledge in the clinically appropriate prescribing, dispensing, and 
31.27 	monitoring of covered outpatient drugs. Members of the Formulary Committee shall not 
31.28 	be employed by the Department of Human Services, but the committee shall be staffed by 
31.29 	an employee of the department who shall serve as an ex officio, nonvoting member of the 
31.30 	committee. The department's medical director shall also serve as an ex officio, nonvoting 
31.31 	member for the committee. Committee members shall serve three-year terms and may be 
31.32 	reappointed by the commissioner. The Formulary Committee shall meet at least twice per 
31.33 	year. The commissioner may require more frequent Formulary Committee meetings as 
31.34 	needed. An honorarium of $100 per meeting and reimbursement for mileage shall be paid 
32.1 	to each committee member in attendance. The Formulary Committee expires June 30, 2022.
32.2 	Notwithstanding section 15.059, subdivision 6, the Formulary Committee does not expire.

32.3 	Sec. 26. Minnesota Statutes 2020, section 256B.0625, subdivision 13d, is amended to 
32.4 	read:
32.5 		Subd. 13d.Drug formulary. (a) The commissioner shall establish a drug formulary. Its 
32.6 	establishment and publication shall not be subject to the requirements of the Administrative 
32.7 	Procedure Act, but the Formulary Committee shall review and comment on the formulary 
32.8 	contents.
32.9 	(b) The formulary shall not include:
32.10 	(1) drugs, active pharmaceutical ingredients, or products for which there is no federal 
32.11 	funding;
32.12 	(2) over-the-counter drugs, except as provided in subdivision 13;
32.13 	(3) drugs or active pharmaceutical ingredients used for weight loss, except that medically 
32.14 	necessary lipase inhibitors may be covered for a recipient with type II diabetes;
32.15 	(4) (3) drugs or active pharmaceutical ingredients when used for the treatment of 
32.16 	impotence or erectile dysfunction;
32.17 	(5) (4) drugs or active pharmaceutical ingredients for which medical value has not been 
32.18 	established;
32.19 	(6) (5) drugs from manufacturers who have not signed a rebate agreement with the 
32.20 	Department of Health and Human Services pursuant to section 1927 of title XIX of the 
32.21 	Social Security Act; and
32.22 	(7) (6) medical cannabis as defined in section 152.22, subdivision 6.
32.23 	(c) If a single-source drug used by at least two percent of the fee-for-service medical 
32.24 	assistance recipients is removed from the formulary due to the failure of the manufacturer 
32.25 	to sign a rebate agreement with the Department of Health and Human Services, the 
32.26 	commissioner shall notify prescribing practitioners within 30 days of receiving notification 
32.27 	from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was 
32.28 	not signed.

33.1 	Sec. 27. Minnesota Statutes 2020, section 256B.0625, subdivision 13e, is amended to 
33.2 	read:
33.3 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
33.4 	be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the 
33.5 	usual and customary price charged to the public. The usual and customary price means the 
33.6 	lowest price charged by the provider to a patient who pays for the prescription by cash, 
33.7 	check, or charge account and includes prices the pharmacy charges to a patient enrolled in 
33.8 	a prescription savings club or prescription discount club administered by the pharmacy or 
33.9 	pharmacy chain. The amount of payment basis must be reduced to reflect all discount 
33.10 	amounts applied to the charge by any third-party provider/insurer agreement or contract for 
33.11 	submitted charges to medical assistance programs. The net submitted charge may not be 
33.12 	greater than the patient liability for the service. The professional dispensing fee shall be 
33.13 	$10.48 $10.77 for prescriptions filled with legend drugs meeting the definition of "covered 
33.14 	outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The 
33.15 	dispensing fee for intravenous solutions that must be compounded by the pharmacist shall 
33.16 	be $10.48 $10.77 per bag claim. The professional dispensing fee for prescriptions filled 
33.17 	with over-the-counter drugs meeting the definition of covered outpatient drugs shall be 
33.18 	$10.48 $10.77 for dispensed quantities equal to or greater than the number of units contained 
33.19 	in the manufacturer's original package. The professional dispensing fee shall be prorated 
33.20 	based on the percentage of the package dispensed when the pharmacy dispenses a quantity 
33.21 	less than the number of units contained in the manufacturer's original package. The pharmacy 
33.22 	dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered 
33.23 	outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units 
33.24 	contained in the manufacturer's original package and shall be prorated based on the 
33.25 	percentage of the package dispensed when the pharmacy dispenses a quantity less than the 
33.26 	number of units contained in the manufacturer's original package. The National Average 
33.27 	Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug. 
33.28 	For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient 
33.29 	cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for 
33.30 	a provider participating in the federal 340B Drug Pricing Program shall be either the 340B 
33.31 	Drug Pricing Program ceiling price established by the Health Resources and Services 
33.32 	Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as 
33.33 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in 
33.34 	the United States, not including prompt pay or other discounts, rebates, or reductions in 
33.35 	price, for the most recent month for which information is available, as reported in wholesale 
33.36 	price guides or other publications of drug or biological pricing data. The maximum allowable 
34.1 	cost of a multisource drug may be set by the commissioner and it shall be comparable to 
34.2 	the actual acquisition cost of the drug product and no higher than the NADAC of the generic 
34.3 	product. Establishment of the amount of payment for drugs shall not be subject to the 
34.4 	requirements of the Administrative Procedure Act.
34.5 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
34.6 	an automated drug distribution system meeting the requirements of section 151.58, or a 
34.7 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
34.8 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
34.9 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
34.10 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
34.11 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
34.12 	pharmacy must use a billing period not less than one calendar month or 30 days.
34.13 	(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota 
34.14 	Rules, part 6800.2700, is required to credit the department for the actual acquisition cost 
34.15 	of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective 
34.16 	billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that 
34.17 	is less than a 30-day supply.
34.18 	(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC 
34.19 	of the generic product or the maximum allowable cost established by the commissioner 
34.20 	unless prior authorization for the brand name product has been granted according to the 
34.21 	criteria established by the Drug Formulary Committee as required by subdivision 13f, 
34.22 	paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in 
34.23 	a manner consistent with section 151.21, subdivision 2.
34.24 	(e) The basis for determining the amount of payment for drugs administered in an 
34.25 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
34.26 	provider, 106 percent of the average sales price as determined by the United States 
34.27 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
34.28 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
34.29 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
34.30 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
34.31 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
34.32 	The commissioner shall discount the payment rate for drugs obtained through the federal 
34.33 	340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an 
34.34 	outpatient setting shall be made to the administering facility or practitioner. A retail or 
35.1 	specialty pharmacy dispensing a drug for administration in an outpatient setting is not 
35.2 	eligible for direct reimbursement.
35.3 	(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy 
35.4 	products that are lower than the ingredient cost formulas specified in paragraph (a). The 
35.5 	commissioner may require individuals enrolled in the health care programs administered 
35.6 	by the department to obtain specialty pharmacy products from providers with whom the 
35.7 	commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are 
35.8 	defined as those used by a small number of recipients or recipients with complex and chronic 
35.9 	diseases that require expensive and challenging drug regimens. Examples of these conditions 
35.10 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, 
35.11 	growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of 
35.12 	cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
35.13 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that 
35.14 	require complex care. The commissioner shall consult with the Formulary Committee to 
35.15 	develop a list of specialty pharmacy products subject to maximum allowable cost 
35.16 	reimbursement. In consulting with the Formulary Committee in developing this list, the 
35.17 	commissioner shall take into consideration the population served by specialty pharmacy 
35.18 	products, the current delivery system and standard of care in the state, and access to care 
35.19 	issues. The commissioner shall have the discretion to adjust the maximum allowable cost 
35.20 	to prevent access to care issues.
35.21 	(g) Home infusion therapy services provided by home infusion therapy pharmacies must 
35.22 	be paid at rates according to subdivision 8d.
35.23 	(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey 
35.24 	for all pharmacies that are physically located in the state of Minnesota that dispense outpatient 
35.25 	drugs under medical assistance. The commissioner shall ensure that the vendor has prior 
35.26 	experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the 
35.27 	department to dispense outpatient prescription drugs to fee-for-service members must 
35.28 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
35.29 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
35.30 	measure a single statewide cost of dispensing for specialty prescription drugs and a single 
35.31 	statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies 
35.32 	to measure the mean, mean weighted by total prescription volume, mean weighted by 
35.33 	medical assistance prescription volume, median, median weighted by total prescription 
35.34 	volume, and median weighted by total medical assistance prescription volume. The 
35.35 	commissioner shall post a copy of the final cost of dispensing survey report on the 
36.1 	department's website. The initial survey must be completed no later than January 1, 2021, 
36.2 	and repeated every three years. The commissioner shall provide a summary of the results 
36.3 	of each cost of dispensing survey and provide recommendations for any changes to the 
36.4 	dispensing fee to the chairs and ranking members of the legislative committees with 
36.5 	jurisdiction over medical assistance pharmacy reimbursement.
36.6 	(i) The commissioner shall increase the ingredient cost reimbursement calculated in 
36.7 	paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to 
36.8 	the wholesale drug distributor tax under section 295.52.

36.9 	Sec. 28. Minnesota Statutes 2020, section 256B.0625, subdivision 17, is amended to read:
36.10 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
36.11 	means motor vehicle transportation provided by a public or private person that serves 
36.12 	Minnesota health care program beneficiaries who do not require emergency ambulance 
36.13 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
36.14 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
36.15 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
36.16 	emergency or nonemergency medical care when paid directly to an ambulance company, 
36.17 	nonemergency medical transportation company, or other recognized providers of 
36.18 	transportation services. Medical transportation must be provided by:
36.19 	(1) nonemergency medical transportation providers who meet the requirements of this 
36.20 	subdivision;
36.21 	(2) ambulances, as defined in section 144E.001, subdivision 2;
36.22 	(3) taxicabs that meet the requirements of this subdivision;
36.23 	(4) public transit, as defined in section 174.22, subdivision 7; or
36.24 	(5) not-for-hire vehicles, including volunteer drivers.
36.25 	(c) Medical assistance covers nonemergency medical transportation provided by 
36.26 	nonemergency medical transportation providers enrolled in the Minnesota health care 
36.27 	programs. All nonemergency medical transportation providers must comply with the 
36.28 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
36.29 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
36.30 	commissioner and reported on the claim as the individual who provided the service. All 
36.31 	nonemergency medical transportation providers shall bill for nonemergency medical 
36.32 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
37.1 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
37.2 	requirements outlined in this paragraph.
37.3 	(d) An organization may be terminated, denied, or suspended from enrollment if:
37.4 	(1) the provider has not initiated background studies on the individuals specified in 
37.5 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
37.6 	(2) the provider has initiated background studies on the individuals specified in section 
37.7 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
37.8 	(i) the commissioner has sent the provider a notice that the individual has been 
37.9 	disqualified under section 245C.14; and
37.10 	(ii) the individual has not received a disqualification set-aside specific to the special 
37.11 	transportation services provider under sections 245C.22 and 245C.23.
37.12 	(e) The administrative agency of nonemergency medical transportation must:
37.13 	(1) adhere to the policies defined by the commissioner in consultation with the 
37.14 	Nonemergency Medical Transportation Advisory Committee;
37.15 	(2) pay nonemergency medical transportation providers for services provided to 
37.16 	Minnesota health care programs beneficiaries to obtain covered medical services; and
37.17 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
37.18 	trips, and number of trips by mode; and.
37.19 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
37.20 	administrative structure assessment tool that meets the technical requirements established 
37.21 	by the commissioner, reconciles trip information with claims being submitted by providers, 
37.22 	and ensures prompt payment for nonemergency medical transportation services.
37.23 	(f) Until the commissioner implements the single administrative structure and delivery 
37.24 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
37.25 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
37.26 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
37.27 	(g) (f) The commissioner may use an order by the recipient's attending physician, 
37.28 	advanced practice registered nurse, or a medical or mental health professional to certify that 
37.29 	the recipient requires nonemergency medical transportation services. Nonemergency medical 
37.30 	transportation providers shall perform driver-assisted services for eligible individuals, when 
37.31 	appropriate. Driver-assisted service includes passenger pickup at and return to the individual's 
37.32 	residence or place of business, assistance with admittance of the individual to the medical 
38.1 	facility, and assistance in passenger securement or in securing of wheelchairs, child seats, 
38.2 	or stretchers in the vehicle.
38.3 	Nonemergency medical transportation providers must take clients to the health care 
38.4 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
38.5 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
38.6 	authorization from the local agency administrator.
38.7 	Nonemergency medical transportation providers may not bill for separate base rates for 
38.8 	the continuation of a trip beyond the original destination. Nonemergency medical 
38.9 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
38.10 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
38.11 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
38.12 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
38.13 	services.
38.14 	(h)(g) The administrative agency shall use the level of service process established by 
38.15 	the commissioner in consultation with the Nonemergency Medical Transportation Advisory 
38.16 	Committee to determine the client's most appropriate mode of transportation. If public transit 
38.17 	or a certified transportation provider is not available to provide the appropriate service mode 
38.18 	for the client, the client may receive a onetime service upgrade.
38.19 	(i) (h) The covered modes of transportation are:
38.20 	(1) client reimbursement, which includes client mileage reimbursement provided to 
38.21 	clients who have their own transportation, or to family or an acquaintance who provides 
38.22 	transportation to the client;
38.23 	(2) volunteer transport, which includes transportation by volunteers using their own 
38.24 	vehicle;
38.25 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
38.26 	or public transit. If a taxicab or public transit is not available, the client can receive 
38.27 	transportation from another nonemergency medical transportation provider;
38.28 	(4) assisted transport, which includes transport provided to clients who require assistance 
38.29 	by a nonemergency medical transportation provider;
38.30 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
38.31 	dependent on a device and requires a nonemergency medical transportation provider with 
38.32 	a vehicle containing a lift or ramp;
39.1 	(6) protected transport, which includes transport provided to a client who has received 
39.2 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
39.3 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
39.4 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
39.5 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
39.6 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
39.7 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
39.8 	a client in a prone or supine position.
39.9 	(j) The local agency shall be the single administrative agency and shall administer and 
39.10 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
39.11 	commissioner has developed, made available, and funded the web-based single administrative 
39.12 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
39.13 	agency's financial obligation is limited to funds provided by the state or federal government.
39.14 	(k) (i) The commissioner shall:
39.15 	(1) in consultation with the Nonemergency Medical Transportation Advisory Committee,
39.16 	verify that the mode and use of nonemergency medical transportation is appropriate;
39.17 	(2) verify that the client is going to an approved medical appointment; and
39.18 	(3) investigate all complaints and appeals.
39.19 	(l) The administrative agency shall pay for the services provided in this subdivision and 
39.20 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
39.21 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
39.22 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
39.23 	(m)(j) Payments for nonemergency medical transportation must be paid based on the 
39.24 	client's assessed mode under paragraph (h) (g), not the type of vehicle used to provide the 
39.25 	service. The medical assistance reimbursement rates for nonemergency medical transportation 
39.26 	services that are payable by or on behalf of the commissioner for nonemergency medical 
39.27 	transportation services are:
39.28 	(1) $0.22 per mile for client reimbursement;
39.29 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
39.30 	transport;
40.1 	(3) equivalent to the standard fare for unassisted transport when provided by public 
40.2 	transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency 
40.3 	medical transportation provider;
40.4 	(4) $13 for the base rate and $1.30 per mile for assisted transport;
40.5 	(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
40.6 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
40.7 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
40.8 	an additional attendant if deemed medically necessary.
40.9 	(n) The base rate for nonemergency medical transportation services in areas defined 
40.10 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
40.11 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
40.12 	services in areas defined under RUCA to be rural or super rural areas is:
40.13 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
40.14 	rate in paragraph (m), clauses (1) to (7); and
40.15 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
40.16 	rate in paragraph (m), clauses (1) to (7).
40.17 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
40.18 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
40.19 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
40.20 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
40.21 	a census-tract based classification system under which a geographical area is determined 
40.22 	to be urban, rural, or super rural.
40.23 	(q) (k) The commissioner, when determining reimbursement rates for nonemergency 
40.24 	medical transportation under paragraphs (m) and (n), shall exempt all modes of transportation 
40.25 	listed under paragraph (i) (h) from Minnesota Rules, part 9505.0445, item R, subitem (2).

40.26 	EFFECTIVE DATE. This section is effective January 1, 2023.

40.27 	Sec. 29. Minnesota Statutes 2020, section 256B.0625, subdivision 17b, is amended to 
40.28 	read:
40.29 		Subd. 17b.Documentation required. (a) As a condition for payment, nonemergency 
40.30 	medical transportation providers must document each occurrence of a service provided to 
40.31 	a recipient according to this subdivision. Providers must maintain odometer and other records 
41.1 	sufficient to distinguish individual trips with specific vehicles and drivers. The documentation 
41.2 	may be collected and maintained using electronic systems or software or in paper form but 
41.3 	must be made available and produced upon request. Program funds paid for transportation 
41.4 	that is not documented according to this subdivision shall be recovered by the nonemergency 
41.5 	medical transportation vendor or department.
41.6 	(b) A nonemergency medical transportation provider must compile transportation records 
41.7 	that meet the following requirements:
41.8 	(1) the record must be in English and must be legible according to the standard of a 
41.9 	reasonable person;
41.10 	(2) the recipient's name must be on each page of the record; and
41.11 	(3) each entry in the record must document:
41.12 	(i) the date on which the entry is made;
41.13 	(ii) the date or dates the service is provided;
41.14 	(iii) the printed last name, first name, and middle initial of the driver;
41.15 	(iv) the signature of the driver attesting to the following: "I certify that I have accurately 
41.16 	reported in this record the trip miles I actually drove and the dates and times I actually drove 
41.17 	them. I understand that misreporting the miles driven and hours worked is fraud for which 
41.18 	I could face criminal prosecution or civil proceedings.";
41.19 	(v) the signature of the recipient or authorized party attesting to the following: "I certify 
41.20 	that I received the reported transportation service.", or the signature of the provider of 
41.21 	medical services certifying that the recipient was delivered to the provider;
41.22 	(vi) the address, or the description if the address is not available, of both the origin and 
41.23 	destination, and the mileage for the most direct route from the origin to the destination;
41.24 	(vii) the mode of transportation in which the service is provided;
41.25 	(viii) the license plate number of the vehicle used to transport the recipient;
41.26 	(ix) whether the service was ambulatory or nonambulatory;
41.27 	(x) the time of the pickup and the time of the drop-off with "a.m." and "p.m." 
41.28 	designations;
41.29 	(xi) the name of the extra attendant when an extra attendant is used to provide special 
41.30 	transportation service; and
41.31 	(xii) the electronic source documentation used to calculate driving directions and mileage.

42.1 	EFFECTIVE DATE. This section is effective January 1, 2023.

42.2 	Sec. 30. Minnesota Statutes 2020, section 256B.0625, subdivision 18, is amended to read:
42.3 		Subd. 18.Bus Public transit or taxicab transportation. (a) To the extent authorized 
42.4 	by rule of the state agency, medical assistance covers the most appropriate and cost-effective 
42.5 	form of transportation incurred by any ambulatory eligible person for obtaining 
42.6 	nonemergency medical care.
42.7 	(b) The commissioner may provide a monthly public transit pass to recipients who are 
42.8 	well-served by public transit for the recipient's nonemergency medical transportation needs. 
42.9 	Any recipient who is eligible for one public transit trip for a medically necessary covered 
42.10 	service may select to receive a transit pass for that month. Recipients who do not have any 
42.11 	transportation needs for a medically necessary service in any given month or who have 
42.12 	received a transit pass for that month through another program administered by a county or 
42.13 	Tribe are not eligible for a transit pass that month. The commissioner shall not require 
42.14 	recipients to select a monthly transit pass if the recipient's transportation needs cannot be 
42.15 	served by public transit systems. Recipients who receive a monthly transit pass are not 
42.16 	eligible for other modes of transportation, unless an unexpected need arises that cannot be 
42.17 	accessed through public transit.

42.18 	EFFECTIVE DATE. This section is effective January 1, 2022.

42.19 	Sec. 31. Minnesota Statutes 2020, section 256B.0625, subdivision 18b, is amended to 
42.20 	read:
42.21 		Subd. 18b.Broker dispatching prohibition Administration of nonemergency medical 
42.22 	transportation. Except for establishing level of service process, the commissioner shall 
42.23 	not use a broker or coordinator for any purpose related to nonemergency medical 
42.24 	transportation services under subdivision 18. The commissioner shall contract either statewide 
42.25 	or regionally for the administration of the nonemergency medical transportation program 
42.26 	in compliance with the provisions of this chapter. The contract shall include the 
42.27 	administration of all covered modes under the nonemergency medical transportation benefit 
42.28 	for those enrolled in managed care as described in section 256B.69.

42.29 	EFFECTIVE DATE. This section is effective January 1, 2023.

42.30 	Sec. 32. Minnesota Statutes 2020, section 256B.0625, subdivision 30, is amended to read:
42.31 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic services, 
42.32 	federally qualified health center services, nonprofit community health clinic services, and 
43.1 	public health clinic services. Rural health clinic services and federally qualified health center 
43.2 	services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and 
43.3 	(C). Payment for rural health clinic and federally qualified health center services shall be 
43.4 	made according to applicable federal law and regulation.
43.5 	(b) A federally qualified health center (FQHC) that is beginning initial operation shall 
43.6 	submit an estimate of budgeted costs and visits for the initial reporting period in the form 
43.7 	and detail required by the commissioner. An FQHC that is already in operation shall submit 
43.8 	an initial report using actual costs and visits for the initial reporting period. Within 90 days 
43.9 	of the end of its reporting period, an FQHC shall submit, in the form and detail required by 
43.10 	the commissioner, a report of its operations, including allowable costs actually incurred for 
43.11 	the period and the actual number of visits for services furnished during the period, and other 
43.12 	information required by the commissioner. FQHCs that file Medicare cost reports shall 
43.13 	provide the commissioner with a copy of the most recent Medicare cost report filed with 
43.14 	the Medicare program intermediary for the reporting year which support the costs claimed 
43.15 	on their cost report to the state.
43.16 	(c) In order to continue cost-based payment under the medical assistance program 
43.17 	according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation 
43.18 	as an essential community provider within six months of final adoption of rules by the 
43.19 	Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and 
43.20 	rural health clinics that have applied for essential community provider status within the 
43.21 	six-month time prescribed, medical assistance payments will continue to be made according 
43.22 	to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural 
43.23 	health clinics that either do not apply within the time specified above or who have had 
43.24 	essential community provider status for three years, medical assistance payments for health 
43.25 	services provided by these entities shall be according to the same rates and conditions 
43.26 	applicable to the same service provided by health care providers that are not FQHCs or rural 
43.27 	health clinics.
43.28 	(d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural 
43.29 	health clinic to make application for an essential community provider designation in order 
43.30 	to have cost-based payments made according to paragraphs (a) and (b) no longer apply.
43.31 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall 
43.32 	be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
43.33 	(f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health 
43.34 	clinic may elect to be paid either under the prospective payment system established in United 
44.1 	States Code, title 42, section 1396a(aa), or under an alternative payment methodology 
44.2 	consistent with the requirements of United States Code, title 42, section 1396a(aa), and 
44.3 	approved by the Centers for Medicare and Medicaid Services. The alternative payment 
44.4 	methodology shall be 100 percent of cost as determined according to Medicare cost 
44.5 	principles.
44.6 	(g) Effective for services provided on or after January 1, 2021, all claims for payment 
44.7 	of clinic services provided by FQHCs and rural health clinics shall be paid by the 
44.8 	commissioner, according to an annual election by the FQHC or rural health clinic, under 
44.9 	the current prospective payment system described in paragraph (f) or the alternative payment 
44.10 	methodology described in paragraph (l).
44.11 	(h) For purposes of this section, "nonprofit community clinic" is a clinic that:
44.12 	(1) has nonprofit status as specified in chapter 317A;
44.13 	(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
44.14 	(3) is established to provide health services to low-income population groups, uninsured, 
44.15 	high-risk and special needs populations, underserved and other special needs populations;
44.16 	(4) employs professional staff at least one-half of which are familiar with the cultural 
44.17 	background of their clients;
44.18 	(5) charges for services on a sliding fee scale designed to provide assistance to 
44.19 	low-income clients based on current poverty income guidelines and family size; and
44.20 	(6) does not restrict access or services because of a client's financial limitations or public 
44.21 	assistance status and provides no-cost care as needed.
44.22 	(i) Effective for services provided on or after January 1, 2015, all claims for payment 
44.23 	of clinic services provided by FQHCs and rural health clinics shall be paid by the 
44.24 	commissioner. the commissioner shall determine the most feasible method for paying claims 
44.25 	from the following options:
44.26 	(1) FQHCs and rural health clinics submit claims directly to the commissioner for 
44.27 	payment, and the commissioner provides claims information for recipients enrolled in a 
44.28 	managed care or county-based purchasing plan to the plan, on a regular basis; or
44.29 	(2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed 
44.30 	care or county-based purchasing plan to the plan, and those claims are submitted by the 
44.31 	plan to the commissioner for payment to the clinic.
45.1 	(j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate 
45.2 	and pay monthly the proposed managed care supplemental payments to clinics, and clinics 
45.3 	shall conduct a timely review of the payment calculation data in order to finalize all 
45.4 	supplemental payments in accordance with federal law. Any issues arising from a clinic's 
45.5 	review must be reported to the commissioner by January 1, 2017. Upon final agreement 
45.6 	between the commissioner and a clinic on issues identified under this subdivision, and in 
45.7 	accordance with United States Code, title 42, section 1396a(bb), no supplemental payments 
45.8 	for managed care plan or county-based purchasing plan claims for services provided prior 
45.9 	to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are 
45.10 	unable to resolve issues under this subdivision, the parties shall submit the dispute to the 
45.11 	arbitration process under section 14.57.
45.12 	(k) The commissioner shall seek a federal waiver, authorized under section 1115 of the 
45.13 	Social Security Act, to obtain federal financial participation at the 100 percent federal 
45.14 	matching percentage available to facilities of the Indian Health Service or tribal organization 
45.15 	in accordance with section 1905(b) of the Social Security Act for expenditures made to 
45.16 	organizations dually certified under Title V of the Indian Health Care Improvement Act, 
45.17 	Public Law 94-437, and as a federally qualified health center under paragraph (a) that 
45.18 	provides services to American Indian and Alaskan Native individuals eligible for services 
45.19 	under this subdivision.
45.20 	(l) All claims for payment of clinic services provided by FQHCs and rural health clinics, 
45.21 	that have elected to be paid under this paragraph, shall be paid by the commissioner according 
45.22 	to the following requirements:
45.23 	(1) the commissioner shall establish a single medical and single dental organization 
45.24 	encounter rate for each FQHC and rural health clinic when applicable;
45.25 	(2) each FQHC and rural health clinic is eligible for same day reimbursement of one 
45.26 	medical and one dental organization encounter rate if eligible medical and dental visits are 
45.27 	provided on the same day;
45.28 	(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance 
45.29 	with current applicable Medicare cost principles, their allowable costs, including direct 
45.30 	patient care costs and patient-related support services. Nonallowable costs include, but are 
45.31 	not limited to:
45.32 	(i) general social services and administrative costs;
45.33 	(ii) retail pharmacy;
46.1 	(iii) patient incentives, food, housing assistance, and utility assistance;
46.2 	(iv) external lab and x-ray;
46.3 	(v) navigation services;
46.4 	(vi) health care taxes;
46.5 	(vii) advertising, public relations, and marketing;
46.6 	(viii) office entertainment costs, food, alcohol, and gifts;
46.7 	(ix) contributions and donations;
46.8 	(x) bad debts or losses on awards or contracts;
46.9 	(xi) fines, penalties, damages, or other settlements;
46.10 	(xii) fund-raising, investment management, and associated administrative costs;
46.11 	(xiii) research and associated administrative costs;
46.12 	(xiv) nonpaid workers;
46.13 	(xv) lobbying;
46.14 	(xvi) scholarships and student aid; and
46.15 	(xvii) nonmedical assistance covered services;
46.16 	(4) the commissioner shall review the list of nonallowable costs in the years between 
46.17 	the rebasing process established in clause (5), in consultation with the Minnesota Association 
46.18 	of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall 
46.19 	publish the list and any updates in the Minnesota health care programs provider manual;
46.20 	(5) the initial applicable base year organization encounter rates for FQHCs and rural 
46.21 	health clinics shall be computed for services delivered on or after January 1, 2021, and:
46.22 	(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports 
46.23 	from 2017 and 2018;
46.24 	(ii) must be according to current applicable Medicare cost principles as applicable to 
46.25 	FQHCs and rural health clinics without the application of productivity screens and upper 
46.26 	payment limits or the Medicare prospective payment system FQHC aggregate mean upper 
46.27 	payment limit;
46.28 	(iii) must be subsequently rebased every two years thereafter using the Medicare cost 
46.29 	reports that are three and four years prior to the rebasing year. Years in which organizational 
46.30 	cost or claims volume is reduced or altered due to a pandemic, disease, or other public health 
47.1 	emergency shall not be used as part of a base year when the base year includes more than 
47.2 	one year. The commissioner may use the Medicare cost reports of a year unaffected by a 
47.3 	pandemic, disease, or other public health emergency, or previous two consecutive years, 
47.4 	inflated to the base year as established under item (iv);
47.5 	(iv) must be inflated to the base year using the inflation factor described in clause (6); 
47.6 	and
47.7 	(v) the commissioner must provide for a 60-day appeals process under section 14.57;
47.8 	(6) the commissioner shall annually inflate the applicable organization encounter rates 
47.9 	for FQHCs and rural health clinics from the base year payment rate to the effective date by 
47.10 	using the CMS FQHC Market Basket inflator established under United States Code, title 
47.11 	42, section 1395m(o), less productivity;
47.12 	(7) FQHCs and rural health clinics that have elected the alternative payment methodology 
47.13 	under this paragraph shall submit all necessary documentation required by the commissioner 
47.14 	to compute the rebased organization encounter rates no later than six months following the 
47.15 	date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid 
47.16 	Services;
47.17 	(8) the commissioner shall reimburse FQHCs and rural health clinics an additional 
47.18 	amount relative to their medical and dental organization encounter rates that is attributable 
47.19 	to the tax required to be paid according to section 295.52, if applicable;
47.20 	(9) FQHCs and rural health clinics may submit change of scope requests to the 
47.21 	commissioner if the change of scope would result in an increase or decrease of 2.5 percent 
47.22 	or higher in the medical or dental organization encounter rate currently received by the 
47.23 	FQHC or rural health clinic;
47.24 	(10) for FQHCs and rural health clinics seeking a change in scope with the commissioner 
47.25 	under clause (9) that requires the approval of the scope change by the federal Health 
47.26 	Resources Services Administration:
47.27 	(i) FQHCs and rural health clinics shall submit the change of scope request, including 
47.28 	the start date of services, to the commissioner within seven business days of submission of 
47.29 	the scope change to the federal Health Resources Services Administration;
47.30 	(ii) the commissioner shall establish the effective date of the payment change as the 
47.31 	federal Health Resources Services Administration date of approval of the FQHC's or rural 
47.32 	health clinic's scope change request, or the effective start date of services, whichever is 
47.33 	later; and
48.1 	(iii) within 45 days of one year after the effective date established in item (ii), the 
48.2 	commissioner shall conduct a retroactive review to determine if the actual costs established 
48.3 	under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in 
48.4 	the medical or dental organization encounter rate, and if this is the case, the commissioner 
48.5 	shall revise the rate accordingly and shall adjust payments retrospectively to the effective 
48.6 	date established in item (ii);
48.7 	(11) for change of scope requests that do not require federal Health Resources Services 
48.8 	Administration approval, the FQHC and rural health clinic shall submit the request to the 
48.9 	commissioner before implementing the change, and the effective date of the change is the 
48.10 	date the commissioner received the FQHC's or rural health clinic's request, or the effective 
48.11 	start date of the service, whichever is later. The commissioner shall provide a response to 
48.12 	the FQHC's or rural health clinic's request within 45 days of submission and provide a final 
48.13 	approval within 120 days of submission. This timeline may be waived at the mutual 
48.14 	agreement of the commissioner and the FQHC or rural health clinic if more information is 
48.15 	needed to evaluate the request;
48.16 	(12) the commissioner, when establishing organization encounter rates for new FQHCs 
48.17 	and rural health clinics, shall consider the patient caseload of existing FQHCs and rural 
48.18 	health clinics in a 60-mile radius for organizations established outside of the seven-county 
48.19 	metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan 
48.20 	area. If this information is not available, the commissioner may use Medicare cost reports 
48.21 	or audited financial statements to establish base rate;
48.22 	(13) the commissioner shall establish a quality measures workgroup that includes 
48.23 	representatives from the Minnesota Association of Community Health Centers, FQHCs, 
48.24 	and rural health clinics, to evaluate clinical and nonclinical measures; and
48.25 	(14) the commissioner shall not disallow or reduce costs that are related to an FQHC's 
48.26 	or rural health clinic's participation in health care educational programs to the extent that 
48.27 	the costs are not accounted for in the alternative payment methodology encounter rate 
48.28 	established in this paragraph.

48.29 	Sec. 33. Minnesota Statutes 2020, section 256B.0625, subdivision 31, is amended to read:
48.30 		Subd. 31.Medical supplies and equipment. (a) Medical assistance covers medical 
48.31 	supplies and equipment. Separate payment outside of the facility's payment rate shall be 
48.32 	made for wheelchairs and wheelchair accessories for recipients who are residents of 
48.33 	intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs 
48.34 	and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions 
49.1 	and limitations as coverage for recipients who do not reside in institutions. A wheelchair 
49.2 	purchased outside of the facility's payment rate is the property of the recipient.
49.3 	(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies 
49.4 	must enroll as a Medicare provider.
49.5 	(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics, 
49.6 	or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment 
49.7 	requirement if:
49.8 	(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic, 
49.9 	or medical supply;
49.10 	(2) the vendor serves ten or fewer medical assistance recipients per year;
49.11 	(3) the commissioner finds that other vendors are not available to provide same or similar 
49.12 	durable medical equipment, prosthetics, orthotics, or medical supplies; and
49.13 	(4) the vendor complies with all screening requirements in this chapter and Code of 
49.14 	Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from 
49.15 	the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare 
49.16 	and Medicaid Services approved national accreditation organization as complying with the 
49.17 	Medicare program's supplier and quality standards and the vendor serves primarily pediatric 
49.18 	patients.
49.19 	(d) Durable medical equipment means a device or equipment that:
49.20 	(1) can withstand repeated use;
49.21 	(2) is generally not useful in the absence of an illness, injury, or disability; and
49.22 	(3) is provided to correct or accommodate a physiological disorder or physical condition 
49.23 	or is generally used primarily for a medical purpose.
49.24 	(e) Electronic tablets may be considered durable medical equipment if the electronic 
49.25 	tablet will be used as an augmentative and alternative communication system as defined 
49.26 	under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must 
49.27 	be locked in order to prevent use not related to communication.
49.28 	(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be 
49.29 	locked to prevent use not as an augmentative communication device, a recipient of waiver 
49.30 	services may use an electronic tablet for a use not related to communication when the 
49.31 	recipient has been authorized under the waiver to receive one or more additional applications 
50.1 	that can be loaded onto the electronic tablet, such that allowing the additional use prevents 
50.2 	the purchase of a separate electronic tablet with waiver funds.
50.3 	(g) An order or prescription for medical supplies, equipment, or appliances must meet 
50.4 	the requirements in Code of Federal Regulations, title 42, part 440.70.
50.5 	(h) Allergen-reducing products provided according to subdivision 67, paragraph (c) or 
50.6 	(d), shall be considered durable medical equipment.

50.7 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
50.8 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
50.9 	when federal approval is obtained.

50.10 	Sec. 34. Minnesota Statutes 2020, section 256B.0625, subdivision 58, is amended to read:
50.11 		Subd. 58.Early and periodic screening, diagnosis, and treatment services. (a) Medical 
50.12 	assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT). 
50.13 	In administering the EPSDT program, the commissioner shall, at a minimum:
50.14 	(1) provide information to children and families, using the most effective mode identified, 
50.15 	regarding:
50.16 	(i) the benefits of preventative health care visits;
50.17 	(ii) the services available as part of the EPSDT program; and
50.18 	(iii) assistance finding a provider, transportation, or interpreter services;
50.19 	(2) maintain an up-to-date periodicity schedule published in the department policy 
50.20 	manual, taking into consideration the most up-to-date community standard of care; and
50.21 	(3) maintain up-to-date policies for providers on the delivery of EPSDT services that 
50.22 	are in the provider manual on the department website.
50.23 	(b) The commissioner may contract for the administration of the outreach services as 
50.24 	required within the EPSDT program.
50.25 	(c) The commissioner may contract for the required EPSDT outreach services, including 
50.26 	but not limited to children enrolled or attributed to an integrated health partnership 
50.27 	demonstration project described in section 256B.0755. Integrated health partnerships that 
50.28 	choose to include the EPSDT outreach services within the integrated health partnership's 
50.29 	contracted responsibilities must receive compensation from the commissioner on a 
50.30 	per-member per-month basis for each included child. Integrated health partnerships must 
50.31 	accept responsibility for the effectiveness of outreach services it delivers. For children who 
51.1 	are not a part of the demonstration project, the commissioner may contract for the 
51.2 	administration of the outreach services.
51.3 	(d) The payment amount for a complete EPSDT screening shall not include charges for 
51.4 	health care services and products that are available at no cost to the provider and shall not 
51.5 	exceed the rate established per Minnesota Rules, part 9505.0445, item M, effective October 
51.6 	1, 2010.

51.7 	EFFECTIVE DATE. This section is effective July 1, 2021, except that paragraph (c) 
51.8 	is effective January 1, 2022.

51.9 	Sec. 35. Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision 
51.10 	to read:
51.11 		Subd. 67.Enhanced asthma care services. (a) Medical assistance covers enhanced 
51.12 	asthma care services and related products to be provided in the children's homes for children 
51.13 	with poorly controlled asthma. To be eligible for services and products under this subdivision, 
51.14 	a child must:
51.15 	(1) have poorly controlled asthma defined by having received health care for the child's 
51.16 	asthma from a hospital emergency department at least one time in the past year or have 
51.17 	been hospitalized for the treatment of asthma at least one time in the past year; and
51.18 	(2) receive a referral for services and products under this subdivision from a treating 
51.19 	health care provider.
51.20 	(b) Covered services include home visits provided by a registered environmental health 
51.21 	specialist or lead risk assessor currently credentialed by the Department of Health or a 
51.22 	healthy homes specialist credentialed by the Building Performance Institute.
51.23 	(c) Covered products include the following allergen-reducing products that are identified 
51.24 	as needed and recommended for the child by a registered environmental health specialist, 
51.25 	healthy homes specialist, lead risk assessor, certified asthma educator, public health nurse, 
51.26 	or other health care professional providing asthma care for the child, and proven to reduce 
51.27 	asthma triggers:
51.28 	(1) allergen encasements for mattresses, box springs, and pillows;
51.29 	(2) an allergen-rated vacuum cleaner, filters, and bags;
51.30 	(3) a dehumidifier and filters;
51.31 	(4) HEPA single-room air cleaners and filters;
52.1 	(5) integrated pest management, including traps and starter packages of food storage 
52.2 	containers;
52.3 	(6) a damp mopping system;
52.4 	(7) if the child does not have access to a bed, a waterproof hospital-grade mattress; and
52.5 	(8) for homeowners only, furnace filters.
52.6 	(d) The commissioner shall determine additional products that may be covered as new 
52.7 	best practices for asthma care are identified.
52.8 	(e) A home assessment is a home visit to identify asthma triggers in the home and to 
52.9 	provide education on trigger-reducing products. A child is limited to two home assessments 
52.10 	except that a child may receive an additional home assessment if the child moves to a new 
52.11 	home; if a new asthma trigger, including tobacco smoke, enters the home; or if the child's 
52.12 	health care provider identifies a new allergy for the child, including an allergy to mold, 
52.13 	pests, pets, or dust mites. The commissioner shall determine the frequency with which a 
52.14 	child may receive a product under paragraph (c) or (d) based on the reasonable expected 
52.15 	lifetime of the product.

52.16 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
52.17 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
52.18 	when federal approval is obtained.

52.19 	Sec. 36. Minnesota Statutes 2020, section 256B.0631, subdivision 1, is amended to read:
52.20 		Subdivision 1.Cost-sharing. (a) Except as provided in subdivision 2, the medical 
52.21 	assistance benefit plan shall include the following cost-sharing for all recipients, effective 
52.22 	for services provided on or after September 1, 2011:
52.23 	(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes of this 
52.24 	subdivision, a visit means an episode of service which is required because of a recipient's 
52.25 	symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting 
52.26 	by a physician or physician assistant, chiropractor, podiatrist, nurse midwife, advanced 
52.27 	practice nurse, audiologist, optician, or optometrist;
52.28 	(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that this 
52.29 	co-payment shall be increased to $20 upon federal approval;
52.30 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, subject 
52.31 	to a $12 per month maximum for prescription drug co-payments. No co-payments shall 
52.32 	apply to antipsychotic drugs when used for the treatment of mental illness. No co-payments 
53.1 	shall apply to medications when used for the prevention or treatment of the human 
53.2 	immunodeficiency virus (HIV);
53.3 	(4) a family deductible equal to $2.75 per month per family and adjusted annually by 
53.4 	the percentage increase in the medical care component of the CPI-U for the period of 
53.5 	September to September of the preceding calendar year, rounded to the next higher five-cent 
53.6 	increment; and
53.7 	(5) total monthly cost-sharing must not exceed five percent of family income. For 
53.8 	purposes of this paragraph, family income is the total earned and unearned income of the 
53.9 	individual and the individual's spouse, if the spouse is enrolled in medical assistance and 
53.10 	also subject to the five percent limit on cost-sharing. This paragraph does not apply to 
53.11 	premiums charged to individuals described under section 256B.057, subdivision 9.
53.12 	(b) Recipients of medical assistance are responsible for all co-payments and deductibles 
53.13 	in this subdivision.
53.14 	(c) Notwithstanding paragraph (b), the commissioner, through the contracting process 
53.15 	under sections 256B.69 and 256B.692, may allow managed care plans and county-based 
53.16 	purchasing plans to waive the family deductible under paragraph (a), clause (4). The value 
53.17 	of the family deductible shall not be included in the capitation payment to managed care 
53.18 	plans and county-based purchasing plans. Managed care plans and county-based purchasing 
53.19 	plans shall certify annually to the commissioner the dollar value of the family deductible.
53.20 	(d) Notwithstanding paragraph (b), the commissioner may waive the collection of the 
53.21 	family deductible described under paragraph (a), clause (4), from individuals and allow 
53.22 	long-term care and waivered service providers to assume responsibility for payment.
53.23 	(e) Notwithstanding paragraph (b), the commissioner, through the contracting process 
53.24 	under section 256B.0756 shall allow the pilot program in Hennepin County to waive 
53.25 	co-payments. The value of the co-payments shall not be included in the capitation payment 
53.26 	amount to the integrated health care delivery networks under the pilot program.

53.27 	EFFECTIVE DATE. This section is effective January 1, 2022, subject to federal 
53.28 	approval. The commissioner of human services shall notify the revisor of statutes when 
53.29 	federal approval is obtained.

53.30 	Sec. 37. Minnesota Statutes 2020, section 256B.0638, subdivision 3, is amended to read:
53.31 		Subd. 3.Opioid prescribing work group. (a) The commissioner of human services, in 
53.32 	consultation with the commissioner of health, shall appoint the following voting members 
53.33 	to an opioid prescribing work group:
54.1 	(1) two consumer members who have been impacted by an opioid abuse disorder or 
54.2 	opioid dependence disorder, either personally or with family members;
54.3 	(2) one member who is a licensed physician actively practicing in Minnesota and 
54.4 	registered as a practitioner with the DEA;
54.5 	(3) one member who is a licensed pharmacist actively practicing in Minnesota and 
54.6 	registered as a practitioner with the DEA;
54.7 	(4) one member who is a licensed nurse practitioner actively practicing in Minnesota 
54.8 	and registered as a practitioner with the DEA;
54.9 	(5) one member who is a licensed dentist actively practicing in Minnesota and registered 
54.10 	as a practitioner with the DEA;
54.11 	(6) two members who are nonphysician licensed health care professionals actively 
54.12 	engaged in the practice of their profession in Minnesota, and their practice includes treating 
54.13 	pain;
54.14 	(7) one member who is a mental health professional who is licensed or registered in a 
54.15 	mental health profession, who is actively engaged in the practice of that profession in 
54.16 	Minnesota, and whose practice includes treating patients with chemical dependency or 
54.17 	substance abuse;
54.18 	(8) one member who is a medical examiner for a Minnesota county;
54.19 	(9) one member of the Health Services Policy Committee established under section 
54.20 	256B.0625, subdivisions 3c to 3e;
54.21 	(10) one member who is a medical director of a health plan company doing business in 
54.22 	Minnesota;
54.23 	(11) one member who is a pharmacy director of a health plan company doing business 
54.24 	in Minnesota; and
54.25 	(12) one member representing Minnesota law enforcement.; and
54.26 	(13) two consumer members who are Minnesota residents and who have used or are 
54.27 	using opioids to manage chronic pain.
54.28 	(b) In addition, the work group shall include the following nonvoting members:
54.29 	(1) the medical director for the medical assistance program;
54.30 	(2) a member representing the Department of Human Services pharmacy unit; and
54.31 	(3) the medical director for the Department of Labor and Industry.; and
55.1 	(4) a member representing the Minnesota Department of Health.
55.2 	(c) An honorarium of $200 per meeting and reimbursement for mileage and parking 
55.3 	shall be paid to each voting member in attendance.

55.4 	Sec. 38. Minnesota Statutes 2020, section 256B.0638, subdivision 5, is amended to read:
55.5 		Subd. 5.Program implementation. (a) The commissioner shall implement the programs 
55.6 	within the Minnesota health care program to improve the health of and quality of care 
55.7 	provided to Minnesota health care program enrollees. The commissioner shall annually 
55.8 	collect and report to provider groups the sentinel measures of data showing individual opioid 
55.9 	prescribers data showing the sentinel measures of their prescribers' opioid prescribing 
55.10 	patterns compared to their anonymized peers. Provider groups shall distribute data to their 
55.11 	affiliated, contracted, or employed opioid prescribers.
55.12 	(b) The commissioner shall notify an opioid prescriber and all provider groups with 
55.13 	which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing 
55.14 	pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber 
55.15 	and any provider group that receives a notice under this paragraph shall submit to the 
55.16 	commissioner a quality improvement plan for review and approval by the commissioner 
55.17 	with the goal of bringing the opioid prescriber's prescribing practices into alignment with 
55.18 	community standards. A quality improvement plan must include:
55.19 	(1) components of the program described in subdivision 4, paragraph (a);
55.20 	(2) internal practice-based measures to review the prescribing practice of the opioid 
55.21 	prescriber and, where appropriate, any other opioid prescribers employed by or affiliated 
55.22 	with any of the provider groups with which the opioid prescriber is employed or affiliated; 
55.23 	and
55.24 	(3) appropriate use of the prescription monitoring program under section 152.126.
55.25 	(c) If, after a year from the commissioner's notice under paragraph (b), the opioid 
55.26 	prescriber's prescribing practices do not improve so that they are consistent with community 
55.27 	standards, the commissioner shall take one or more of the following steps:
55.28 	(1) monitor prescribing practices more frequently than annually;
55.29 	(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel 
55.30 	measures; or
56.1 	(3) require the opioid prescriber to participate in additional quality improvement efforts, 
56.2 	including but not limited to mandatory use of the prescription monitoring program established 
56.3 	under section 152.126.
56.4 	(d) The commissioner shall terminate from Minnesota health care programs all opioid 
56.5 	prescribers and provider groups whose prescribing practices fall within the applicable opioid 
56.6 	disenrollment standards.

56.7 	Sec. 39. Minnesota Statutes 2020, section 256B.0638, subdivision 6, is amended to read:
56.8 		Subd. 6.Data practices. (a) Reports and data identifying an opioid prescriber are private 
56.9 	data on individuals as defined under section 13.02, subdivision 12, until an opioid prescriber 
56.10 	is subject to termination as a medical assistance provider under this section. Notwithstanding 
56.11 	this data classification, the commissioner shall share with all of the provider groups with 
56.12 	which an opioid prescriber is employed, contracted, or affiliated, a report identifying an 
56.13 	opioid prescriber who is subject to quality improvement activities the data under subdivision 
56.14 	5, paragraph (a), (b), or (c).
56.15 	(b) Reports and data identifying a provider group are nonpublic data as defined under 
56.16 	section 13.02, subdivision 9, until the provider group is subject to termination as a medical 
56.17 	assistance provider under this section.
56.18 	(c) Upon termination under this section, reports and data identifying an opioid prescriber 
56.19 	or provider group are public, except that any identifying information of Minnesota health 
56.20 	care program enrollees must be redacted by the commissioner.

56.21 	Sec. 40. Minnesota Statutes 2020, section 256B.0659, subdivision 13, is amended to read:
56.22 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional must 
56.23 	work for a personal care assistance provider agency, meet the definition of qualified 
56.24 	professional under section 256B.0625, subdivision 19c, and enroll with the department as 
56.25 	a qualified professional after clearing clear a background study, and meet provider training 
56.26 	requirements. Before a qualified professional provides services, the personal care assistance 
56.27 	provider agency must initiate a background study on the qualified professional under chapter 
56.28 	245C, and the personal care assistance provider agency must have received a notice from 
56.29 	the commissioner that the qualified professional:
56.30 	(1) is not disqualified under section 245C.14; or
56.31 	(2) is disqualified, but the qualified professional has received a set aside of the 
56.32 	disqualification under section 245C.22.
57.1 	(b) The qualified professional shall perform the duties of training, supervision, and 
57.2 	evaluation of the personal care assistance staff and evaluation of the effectiveness of personal 
57.3 	care assistance services. The qualified professional shall:
57.4 	(1) develop and monitor with the recipient a personal care assistance care plan based on 
57.5 	the service plan and individualized needs of the recipient;
57.6 	(2) develop and monitor with the recipient a monthly plan for the use of personal care 
57.7 	assistance services;
57.8 	(3) review documentation of personal care assistance services provided;
57.9 	(4) provide training and ensure competency for the personal care assistant in the individual 
57.10 	needs of the recipient; and
57.11 	(5) document all training, communication, evaluations, and needed actions to improve 
57.12 	performance of the personal care assistants.
57.13 	(c) Effective July 1, 2011, The qualified professional shall complete the provider training 
57.14 	with basic information about the personal care assistance program approved by the 
57.15 	commissioner. Newly hired qualified professionals must complete the training within six 
57.16 	months of the date hired by a personal care assistance provider agency. Qualified 
57.17 	professionals who have completed the required training as a worker from a personal care 
57.18 	assistance provider agency do not need to repeat the required training if they are hired by 
57.19 	another agency, if they have completed the training within the last three years. The required 
57.20 	training must be available with meaningful access according to title VI of the Civil Rights 
57.21 	Act and federal regulations adopted under that law or any guidance from the United States 
57.22 	Health and Human Services Department. The required training must be available online or 
57.23 	by electronic remote connection. The required training must provide for competency testing 
57.24 	to demonstrate an understanding of the content without attending in-person training. A 
57.25 	qualified professional is allowed to be employed and is not subject to the training requirement 
57.26 	until the training is offered online or through remote electronic connection. A qualified 
57.27 	professional employed by a personal care assistance provider agency certified for 
57.28 	participation in Medicare as a home health agency is exempt from the training required in 
57.29 	this subdivision. When available, the qualified professional working for a Medicare-certified 
57.30 	home health agency must successfully complete the competency test. The commissioner 
57.31 	shall ensure there is a mechanism in place to verify the identity of persons completing the 
57.32 	competency testing electronically.

58.1 	Sec. 41. Minnesota Statutes 2020, section 256B.196, subdivision 2, is amended to read:
58.2 		Subd. 2.Commissioner's duties. (a) For the purposes of this subdivision and subdivision 
58.3 	3, the commissioner shall determine the fee-for-service outpatient hospital services upper 
58.4 	payment limit for nonstate government hospitals. The commissioner shall then determine 
58.5 	the amount of a supplemental payment to Hennepin County Medical Center and Regions 
58.6 	Hospital for these services that would increase medical assistance spending in this category 
58.7 	to the aggregate upper payment limit for all nonstate government hospitals in Minnesota. 
58.8 	In making this determination, the commissioner shall allot the available increases between 
58.9 	Hennepin County Medical Center and Regions Hospital based on the ratio of medical 
58.10 	assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner 
58.11 	shall adjust this allotment as necessary based on federal approvals, the amount of 
58.12 	intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors, 
58.13 	in order to maximize the additional total payments. The commissioner shall inform Hennepin 
58.14 	County and Ramsey County of the periodic intergovernmental transfers necessary to match 
58.15 	federal Medicaid payments available under this subdivision in order to make supplementary 
58.16 	medical assistance payments to Hennepin County Medical Center and Regions Hospital 
58.17 	equal to an amount that when combined with existing medical assistance payments to 
58.18 	nonstate governmental hospitals would increase total payments to hospitals in this category 
58.19 	for outpatient services to the aggregate upper payment limit for all hospitals in this category 
58.20 	in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make 
58.21 	supplementary payments to Hennepin County Medical Center and Regions Hospital.
58.22 	(b) For the purposes of this subdivision and subdivision 3, the commissioner shall 
58.23 	determine an upper payment limit for physicians and other billing professionals affiliated 
58.24 	with Hennepin County Medical Center and with Regions Hospital. The upper payment limit 
58.25 	shall be based on the average commercial rate or be determined using another method 
58.26 	acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall 
58.27 	inform Hennepin County and Ramsey County of the periodic intergovernmental transfers 
58.28 	necessary to match the federal Medicaid payments available under this subdivision in order 
58.29 	to make supplementary payments to physicians and other billing professionals affiliated 
58.30 	with Hennepin County Medical Center and to make supplementary payments to physicians 
58.31 	and other billing professionals affiliated with Regions Hospital through HealthPartners 
58.32 	Medical Group equal to the difference between the established medical assistance payment 
58.33 	for physician and other billing professional services and the upper payment limit. Upon 
58.34 	receipt of these periodic transfers, the commissioner shall make supplementary payments 
58.35 	to physicians and other billing professionals affiliated with Hennepin County Medical Center 
59.1 	and shall make supplementary payments to physicians and other billing professionals 
59.2 	affiliated with Regions Hospital through HealthPartners Medical Group.
59.3 	(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make monthly 
59.4 	voluntary intergovernmental transfers to the commissioner in amounts not to exceed 
59.5 	$12,000,000 per year from Hennepin County and $6,000,000 per year from Ramsey County. 
59.6 	The commissioner shall increase the medical assistance capitation payments to any licensed 
59.7 	health plan under contract with the medical assistance program that agrees to make enhanced 
59.8 	payments to Hennepin County Medical Center or Regions Hospital. The increase shall be 
59.9 	in an amount equal to the annual value of the monthly transfers plus federal financial 
59.10 	participation, with each health plan receiving its pro rata share of the increase based on the 
59.11 	pro rata share of medical assistance admissions to Hennepin County Medical Center and
59.12 	Regions Hospital by those plans. For the purposes of this paragraph, "the base amount" 
59.13 	means the total annual value of increased medical assistance capitation payments, including 
59.14 	the voluntary intergovernmental transfers, under this paragraph in calendar year 2017. For 
59.15 	managed care contracts beginning on or after January 1, 2018, the commissioner shall reduce 
59.16 	the total annual value of increased medical assistance capitation payments under this 
59.17 	paragraph by an amount equal to ten percent of the base amount, and by an additional ten 
59.18 	percent of the base amount for each subsequent contract year until December 31, 2025. 
59.19 	Upon the request of the commissioner, health plans shall submit individual-level cost data 
59.20 	for verification purposes. The commissioner may ratably reduce these payments on a pro 
59.21 	rata basis in order to satisfy federal requirements for actuarial soundness. If payments are 
59.22 	reduced, transfers shall be reduced accordingly. Any licensed health plan that receives 
59.23 	increased medical assistance capitation payments under the intergovernmental transfer 
59.24 	described in this paragraph shall increase its medical assistance payments to Hennepin 
59.25 	County Medical Center and Regions Hospital by the same amount as the increased payments 
59.26 	received in the capitation payment described in this paragraph. This paragraph expires 
59.27 	January 1, 2026.
59.28 	(d) For the purposes of this subdivision and subdivision 3, the commissioner shall 
59.29 	determine an upper payment limit for ambulance services affiliated with Hennepin County 
59.30 	Medical Center and the city of St. Paul, and ambulance services owned and operated by 
59.31 	another governmental entity that chooses to participate by requesting the commissioner to 
59.32 	determine an upper payment limit. The upper payment limit shall be based on the average 
59.33 	commercial rate or be determined using another method acceptable to the Centers for 
59.34 	Medicare and Medicaid Services. The commissioner shall inform Hennepin County, the 
59.35 	city of St. Paul, and other participating governmental entities of the periodic 
60.1 	intergovernmental transfers necessary to match the federal Medicaid payments available 
60.2 	under this subdivision in order to make supplementary payments to Hennepin County 
60.3 	Medical Center, the city of St. Paul, and other participating governmental entities equal to 
60.4 	the difference between the established medical assistance payment for ambulance services 
60.5 	and the upper payment limit. Upon receipt of these periodic transfers, the commissioner 
60.6 	shall make supplementary payments to Hennepin County Medical Center, the city of St. 
60.7 	Paul, and other participating governmental entities. A tribal government that owns and 
60.8 	operates an ambulance service is not eligible to participate under this subdivision.
60.9 	(e) For the purposes of this subdivision and subdivision 3, the commissioner shall 
60.10 	determine an upper payment limit for physicians, dentists, and other billing professionals 
60.11 	affiliated with the University of Minnesota and University of Minnesota Physicians. The 
60.12 	upper payment limit shall be based on the average commercial rate or be determined using 
60.13 	another method acceptable to the Centers for Medicare and Medicaid Services. The 
60.14 	commissioner shall inform the University of Minnesota Medical School and University of 
60.15 	Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to 
60.16 	match the federal Medicaid payments available under this subdivision in order to make 
60.17 	supplementary payments to physicians, dentists, and other billing professionals affiliated 
60.18 	with the University of Minnesota and the University of Minnesota Physicians equal to the 
60.19 	difference between the established medical assistance payment for physician, dentist, and 
60.20 	other billing professional services and the upper payment limit. Upon receipt of these periodic 
60.21 	transfers, the commissioner shall make supplementary payments to physicians, dentists, 
60.22 	and other billing professionals affiliated with the University of Minnesota and the University 
60.23 	of Minnesota Physicians.
60.24 	(f) The commissioner shall inform the transferring governmental entities on an ongoing 
60.25 	basis of the need for any changes needed in the intergovernmental transfers in order to 
60.26 	continue the payments under paragraphs (a) to (e), at their maximum level, including 
60.27 	increases in upper payment limits, changes in the federal Medicaid match, and other factors.
60.28 	(g) The payments in paragraphs (a) to (e) shall be implemented independently of each 
60.29 	other, subject to federal approval and to the receipt of transfers under subdivision 3.
60.30 	(h) All of the data and funding transactions related to the payments in paragraphs (a) to 
60.31 	(e) shall be between the commissioner and the governmental entities.
60.32 	(i) For purposes of this subdivision, billing professionals are limited to physicians, nurse 
60.33 	practitioners, nurse midwives, clinical nurse specialists, physician assistants, 
61.1 	anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and 
61.2 	dental therapists.

61.3 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval 
61.4 	of both this section and Minnesota Statutes, section 256B.1973, whichever is later. The 
61.5 	commissioner of human services shall notify the revisor of statutes when federal approval 
61.6 	is obtained.

61.7 	Sec. 42. [256B.1973] DIRECTED PAYMENT ARRANGEMENTS.
61.8 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
61.9 	the meanings given them.
61.10 	(b) "Billing professionals" means physicians, nurse practitioners, nurse midwives, clinical 
61.11 	nurse specialists, physician assistants, anesthesiologists, and certified registered anesthetists, 
61.12 	and may include dentists, individually enrolled dental hygienists, and dental therapists.
61.13 	(c) "Health plan" means a managed care or county-based purchasing plan that is under 
61.14 	contract with the commissioner to deliver services to medical assistance enrollees under 
61.15 	section 256B.69.
61.16 	(d) "High medical assistance utilization" means a medical assistance utilization rate 
61.17 	equal to the standard established in section 256.969, subdivision 9, paragraph (d), clause 
61.18 	(6).
61.19 		Subd. 2.Federal approval required. Each directed payment arrangement under this 
61.20 	section is contingent on federal approval and must conform with the requirements for 
61.21 	permissible directed managed care organization expenditures under section 256B.6928, 
61.22 	subdivision 5.
61.23 		Subd. 3.Eligible providers. Eligible providers under this section are nonstate government 
61.24 	teaching hospitals with high medical assistance utilization and a level 1 trauma center and 
61.25 	the hospital's affiliated billing professionals, ambulance services, and clinics.
61.26 		Subd. 4.Voluntary intergovernmental transfers. A nonstate governmental entity that 
61.27 	is eligible to perform intergovernmental transfers may make voluntary intergovernmental 
61.28 	transfers to the commissioner. The commissioner shall inform the nonstate governmental 
61.29 	entity of the intergovernmental transfers necessary to maximize the allowable directed 
61.30 	payments.
61.31 		Subd. 5.Commissioner's duties; state-directed fee schedule requirement. (a) For 
61.32 	each federally approved directed payment arrangement that is a state-directed fee schedule 
62.1 	requirement, the commissioner shall determine a uniform adjustment factor to be applied 
62.2 	to each claim submitted by an eligible provider to a health plan. The uniform adjustment 
62.3 	factor shall be determined using the average commercial payer rate or using another method 
62.4 	acceptable to the Centers for Medicare and Medicaid Services if the average commercial 
62.5 	payer rate is not approved, minus the amount necessary for the plan to satisfy tax liabilities 
62.6 	under sections 256.9657 and 297I.05 attributable to the directed payment arrangement. The 
62.7 	commissioner shall ensure that the application of the uniform adjustment factor maximizes 
62.8 	the allowable directed payments and does not result in payments exceeding federal limits, 
62.9 	and may use an annual settle-up process. The directed payment shall be specific to each 
62.10 	health plan and prospectively incorporated into capitation payments for that plan.
62.11 	(b) For each federally approved directed payment arrangement that is a state-directed 
62.12 	fee schedule requirement, the commissioner shall develop a plan for the initial 
62.13 	implementation of the state-directed fee schedule requirement to ensure that the eligible 
62.14 	provider receives the entire permissible value of the federally approved directed payment 
62.15 	arrangement. If federal approval of a directed payment arrangement under this subdivision 
62.16 	is retroactive, the commissioner shall make a onetime pro rata increase to the uniform 
62.17 	adjustment factor and the initial payments in order to include claims submitted between the 
62.18 	retroactive federal approval date and the period captured by the initial payments.
62.19 		Subd. 6.Health plan duties; submission of claims. In accordance with its contract, 
62.20 	each health plan shall submit to the commissioner payment information for each claim paid 
62.21 	to an eligible provider for services provided to a medical assistance enrollee.
62.22 		Subd. 7.Health plan duties; directed payments. In accordance with its contract, each 
62.23 	health plan shall make directed payments to the eligible provider in an amount equal to the 
62.24 	payment amounts the plan received from the commissioner.
62.25 		Subd. 8.State quality goals. The directed payment arrangement and state-directed fee 
62.26 	schedule requirement must align the state quality goals to Hennepin Healthcare medical 
62.27 	assistance patients, including unstably housed individuals, those with higher levels of social 
62.28 	and clinical risk, limited English proficiency (LEP) patients, adults with serious chronic 
62.29 	conditions, and individuals of color. The directed payment arrangement must maintain 
62.30 	quality and access to a full range of health care delivery mechanisms for these patients that 
62.31 	may include behavioral health, emergent care, preventive care, hospitalization, transportation, 
62.32 	interpreter services, and pharmaceutical services. The commissioner, in consultation with 
62.33 	Hennepin Healthcare, shall submit to the Centers for Medicare and Medicaid Services a 
62.34 	methodology to measure access to care and the achievement of state quality goals.

63.1 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
63.2 	whichever is later, unless the federal approval provides for an effective date that is before 
63.3 	the date the federal approval was issued, including a retroactive effective date, in which 
63.4 	case this section is effective retroactively from the federally approved effective date. The 
63.5 	commissioner of human services shall notify the revisor of statutes when federal approval 
63.6 	is obtained.

63.7 	Sec. 43. Minnesota Statutes 2020, section 256B.69, subdivision 6d, is amended to read:
63.8 		Subd. 6d.Prescription drugs.  The commissioner may shall exclude or modify coverage 
63.9 	for outpatient prescription drugs dispensed by a pharmacy to a member eligible for medical 
63.10 	assistance under this chapter from the prepaid managed care contracts entered into under 
63.11 	this section in order to increase savings to the state by collecting additional prescription 
63.12 	drug rebates. The contracts must maintain incentives for the managed care plan to manage 
63.13 	drug costs and utilization and may require that the managed care plans maintain an open 
63.14 	drug formulary. In order to manage drug costs and utilization, the contracts may authorize 
63.15 	the managed care plans to use preferred drug lists and prior authorization. This subdivision 
63.16 	is contingent on federal approval of the managed care contract changes and the collection 
63.17 	of additional prescription drug rebates.

63.18 	EFFECTIVE DATE. This section is effective January 1, 2023, or upon completion of 
63.19 	the Medicaid Management Information System pharmacy module modernization project, 
63.20 	whichever is later. The commissioner shall notify the revisor of statutes when the project 
63.21 	is completed.

63.22 	Sec. 44. Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision 
63.23 	to read:
63.24 		Subd. 9f.Annual report on provider reimbursement rates. (a) The commissioner, 
63.25 	by December 15 of each year, shall submit to the chairs and ranking minority members of 
63.26 	the legislative committees with jurisdiction over health care policy and finance a report on 
63.27 	managed care and county-based purchasing plan provider reimbursement rates. The report 
63.28 	must comply with sections 3.195 and 3.197.
63.29 	(b) The report must include, for each managed care and county-based purchasing plan, 
63.30 	the mean and median provider reimbursement rates by county for the calendar year preceding 
63.31 	the reporting year, for the five most common billing codes statewide across all plans, in 
63.32 	each of the following provider service categories:
63.33 	(1) physician services - prenatal and preventive;
64.1 	(2) physician services - nonprenatal and nonpreventive;
64.2 	(3) dental services;
64.3 	(4) inpatient hospital services;
64.4 	(5) outpatient hospital services; and
64.5 	(6) mental health services.
64.6 	(c) The commissioner shall also include in the report:
64.7 	(1) the mean and median reimbursement rates across all plans by county for the calendar 
64.8 	year preceding the reporting year for the billing codes and provider service categories 
64.9 	described in paragraph (b); and
64.10 	(2) the mean and median fee-for-service reimbursement rates by county for the calendar 
64.11 	year preceding the reporting year for the billing codes and provider service categories 
64.12 	described in paragraph (b).

64.13 	Sec. 45. Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision 
64.14 	to read:
64.15 		Subd. 9g.Annual report on prepaid health plan reimbursement to 340B covered 
64.16 	entities. (a) By March 1 of each year, each managed care and county-based purchasing plan 
64.17 	shall report to the commissioner its reimbursement to 340B covered entities for the previous 
64.18 	calendar year. The report must include:
64.19 	(1) the National Provider Identification (NPI) number for each 340B covered entity;
64.20 	(2) the name of each 340B covered entity;
64.21 	(3) the servicing address of each 340B covered entity; and
64.22 	(4) either: (i) the number of outpatient 340B pharmacy claims and reimbursement 
64.23 	amounts; or (ii) the number of professional or facility 340B claim lines and reimbursement 
64.24 	amounts.
64.25 	(b) The commissioner shall submit a copy of the reports to the chairs and ranking minority 
64.26 	members of the legislative committees with jurisdiction over health care policy and finance 
64.27 	by April 1 of each year.

64.28 	Sec. 46. Minnesota Statutes 2020, section 256B.6928, subdivision 5, is amended to read:
64.29 		Subd. 5.Direction of managed care organization expenditures. (a) The commissioner 
64.30 	shall not direct managed care organizations expenditures under the managed care contract, 
65.1 	except in as permitted under Code of Federal Regulations, part 42, section 438.6(c). The 
65.2 	exception under this paragraph includes the following situations:
65.3 	(1) implementation of a value-based purchasing model for provider reimbursement, 
65.4 	including pay-for-performance arrangements, bundled payments, or other service payments 
65.5 	intended to recognize value or outcomes over volume of services;
65.6 	(2) participation in a multipayer or medical assistance-specific delivery system reform 
65.7 	or performance improvement initiative; or
65.8 	(3) implementation of a minimum or maximum fee schedule, or a uniform dollar or 
65.9 	percentage increase for network providers that provide a particular service. The maximum 
65.10 	fee schedule must allow the managed care organization the ability to reasonably manage 
65.11 	risk and provide discretion in accomplishing the goals of the contract.
65.12 	(b) Any managed care contract that directs managed care organization expenditures as 
65.13 	permitted under paragraph (a), clauses (1) to (3), must be developed in accordance with 
65.14 	Code of Federal Regulations, part 42, sections 438.4 and 438.5; comply with actuarial 
65.15 	soundness and generally accepted actuarial principles and practices; and have written 
65.16 	approval from the Centers for Medicare and Medicaid Services before implementation. To 
65.17 	obtain approval, the commissioner shall demonstrate in writing that the contract arrangement:
65.18 	(1) is based on the utilization and delivery of services;
65.19 	(2) directs expenditures equally, using the same terms of performance for a class of 
65.20 	providers providing service under the contract;
65.21 	(3) is intended to advance at least one of the goals and objectives in the commissioner's 
65.22 	quality strategy;
65.23 	(4) has an evaluation plan that measures the degree to which the arrangement advances 
65.24 	at least one of the goals in the commissioner's quality strategy;
65.25 	(5) does not condition network provider participation on the network provider entering 
65.26 	into or adhering to an intergovernmental transfer agreement; and
65.27 	(6) is not renewed automatically.
65.28 	(c) For contract arrangements identified in paragraph (a), clauses (1) and (2), the 
65.29 	commissioner shall:
65.30 	(1) make participation in the value-based purchasing model, special delivery system 
65.31 	reform, or performance improvement initiative available, using the same terms of 
66.1 	performance, to a class of providers providing services under the contract related to the 
66.2 	model, reform, or initiative; and
66.3 	(2) use a common set of performance measures across all payers and providers.
66.4 	(d) The commissioner shall not set the amount or frequency of the expenditures or recoup 
66.5 	from the managed care organization any unspent funds allocated for these arrangements.

66.6 	Sec. 47. Minnesota Statutes 2020, section 256B.75, is amended to read:
66.7 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
66.8 	(a) For outpatient hospital facility fee payments for services rendered on or after October 
66.9 	1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, 
66.10 	or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for 
66.11 	which there is a federal maximum allowable payment. Effective for services rendered on 
66.12 	or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and 
66.13 	emergency room facility fees shall be increased by eight percent over the rates in effect on 
66.14 	December 31, 1999, except for those services for which there is a federal maximum allowable 
66.15 	payment. Services for which there is a federal maximum allowable payment shall be paid 
66.16 	at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total 
66.17 	aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare 
66.18 	upper limit. If it is determined that a provision of this section conflicts with existing or 
66.19 	future requirements of the United States government with respect to federal financial 
66.20 	participation in medical assistance, the federal requirements prevail. The commissioner 
66.21 	may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial 
66.22 	participation resulting from rates that are in excess of the Medicare upper limitations.
66.23 	(b) (1) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory 
66.24 	surgery hospital facility fee services for critical access hospitals designated under section 
66.25 	144.1483, clause (9), shall be paid on a cost-based payment system that is based on the 
66.26 	cost-finding methods and allowable costs of the Medicare program. Effective for services 
66.27 	provided on or after July 1, 2015, rates established for critical access hospitals under this 
66.28 	paragraph for the applicable payment year shall be the final payment and shall not be settled 
66.29 	to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal 
66.30 	year ending in 2017, the rate for outpatient hospital services shall be computed using 
66.31 	information from each hospital's Medicare cost report as filed with Medicare for the year 
66.32 	that is two years before the year that the rate is being computed. Rates shall be computed 
66.33 	using information from Worksheet C series until the department finalizes the medical 
66.34 	assistance cost reporting process for critical access hospitals. After the cost reporting process 
67.1 	is finalized, rates shall be computed using information from Title XIX Worksheet D series. 
67.2 	The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs 
67.3 	related to rural health clinics and federally qualified health clinics, divided by ancillary 
67.4 	charges plus outpatient charges, excluding charges related to rural health clinics and federally 
67.5 	qualified health clinics.
67.6 	(2) Effective for services provided on or after January 1, 2023, the rate described in 
67.7 	clause (1) shall be increased for hospitals providing high levels of high-cost drugs or 340B 
67.8 	drugs. The rate adjustment shall be based on each hospital's share of the total reimbursement 
67.9 	for 340B drugs to all critical access hospitals, but shall not exceed three percentage points.
67.10 	(c) Effective for services provided on or after July 1, 2003, rates that are based on the 
67.11 	Medicare outpatient prospective payment system shall be replaced by a budget neutral 
67.12 	prospective payment system that is derived using medical assistance data. The commissioner 
67.13 	shall provide a proposal to the 2003 legislature to define and implement this provision.
67.14 	When implementing prospective payment methodologies, the commissioner shall use general 
67.15 	methods and rate calculation parameters similar to the applicable Medicare prospective 
67.16 	payment systems for services delivered in outpatient hospital and ambulatory surgical center 
67.17 	settings unless other payment methodologies for these services are specified in this chapter.
67.18 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
67.19 	before third-party liability and spenddown, made to hospitals for outpatient hospital facility 
67.20 	services is reduced by .5 percent from the current statutory rate.
67.21 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
67.22 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility 
67.23 	services before third-party liability and spenddown, is reduced five percent from the current 
67.24 	statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from 
67.25 	this paragraph.
67.26 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
67.27 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
67.28 	hospital facility services before third-party liability and spenddown, is reduced three percent 
67.29 	from the current statutory rates. Mental health services and facilities defined under section 
67.30 	256.969, subdivision 16, are excluded from this paragraph.

68.1 	Sec. 48. Minnesota Statutes 2020, section 256B.76, subdivision 2, is amended to read:
68.2 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after October 
68.3 	1, 1992, through December 31, 2022, the commissioner shall make payments for dental 
68.4 	services as follows:
68.5 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent 
68.6 	above the rate in effect on June 30, 1992; and
68.7 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile 
68.8 	of 1989, less the percent in aggregate necessary to equal the above increases.
68.9 	(b) Beginning October 1, 1999, through December 31, 2022, the payment for tooth 
68.10 	sealants and fluoride treatments shall be the lower of (1) submitted charge, or (2) 80 percent 
68.11 	of median 1997 charges.
68.12 	(c) Effective for services rendered on or after January 1, 2000, through December 31, 
68.13 	2022, payment rates for dental services shall be increased by three percent over the rates in 
68.14 	effect on December 31, 1999.
68.15 	(d) Effective for services provided on or after January 1, 2002, through December 31, 
68.16 	2022, payment for diagnostic examinations and dental x-rays provided to children under 
68.17 	age 21 shall be the lower of (1) the submitted charge, or (2) 85 percent of median 1999 
68.18 	charges.
68.19 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000, 
68.20 	for managed care.
68.21 	(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated 
68.22 	dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare 
68.23 	principles of reimbursement. This payment shall be effective for services rendered on or 
68.24 	after January 1, 2011, to recipients enrolled in managed care plans or county-based 
68.25 	purchasing plans.
68.26 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in 
68.27 	paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a 
68.28 	supplemental state payment equal to the difference between the total payments in paragraph 
68.29 	(f) and $1,850,000 shall be paid from the general fund to state-operated services for the 
68.30 	operation of the dental clinics.
68.31 	(h) If the cost-based payment system for state-operated dental clinics described in 
68.32 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
68.33 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
69.1 	receive the critical access dental reimbursement rate as described under subdivision 4, 
69.2 	paragraph (a).
69.3 	(i) Effective for services rendered on or after September 1, 2011, through June 30, 2013, 
69.4 	payment rates for dental services shall be reduced by three percent. This reduction does not 
69.5 	apply to state-operated dental clinics in paragraph (f).
69.6 	(j) (i) Effective for services rendered on or after January 1, 2014, through December 31, 
69.7 	2022, payment rates for dental services shall be increased by five percent from the rates in 
69.8 	effect on December 31, 2013. This increase does not apply to state-operated dental clinics 
69.9 	in paragraph (f), federally qualified health centers, rural health centers, and Indian health 
69.10 	services. Effective January 1, 2014, payments made to managed care plans and county-based 
69.11 	purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment 
69.12 	increase described in this paragraph.
69.13 	(k) Effective for services rendered on or after July 1, 2015, through December 31, 2016, 
69.14 	the commissioner shall increase payment rates for services furnished by dental providers 
69.15 	located outside of the seven-county metropolitan area by the maximum percentage possible 
69.16 	above the rates in effect on June 30, 2015, while remaining within the limits of funding 
69.17 	appropriated for this purpose. This increase does not apply to state-operated dental clinics 
69.18 	in paragraph (f), federally qualified health centers, rural health centers, and Indian health 
69.19 	services. Effective January 1, 2016, through December 31, 2016, payments to managed care 
69.20 	plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect 
69.21 	the payment increase described in this paragraph. The commissioner shall require managed 
69.22 	care and county-based purchasing plans to pass on the full amount of the increase, in the 
69.23 	form of higher payment rates to dental providers located outside of the seven-county 
69.24 	metropolitan area.
69.25 	(l) (j) Effective for services provided on or after January 1, 2017, through December 31, 
69.26 	2022, the commissioner shall increase payment rates by 9.65 percent for dental services 
69.27 	provided outside of the seven-county metropolitan area. This increase does not apply to 
69.28 	state-operated dental clinics in paragraph (f), federally qualified health centers, rural health 
69.29 	centers, or Indian health services. Effective January 1, 2017, payments to managed care 
69.30 	plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect 
69.31 	the payment increase described in this paragraph.
69.32 	(m) (k) Effective for services provided on or after July 1, 2017, through December 31, 
69.33 	2022, the commissioner shall increase payment rates by 23.8 percent for dental services 
69.34 	provided to enrollees under the age of 21. This rate increase does not apply to state-operated 
70.1 	dental clinics in paragraph (f), federally qualified health centers, rural health centers, or 
70.2 	Indian health centers. This rate increase does not apply to managed care plans and 
70.3 	county-based purchasing plans.
70.4 	(l) Effective for services provided on or after January 1, 2023, payment for dental services 
70.5 	shall be the lower of the submitted charge or the ....... percentile of 2018 submitted charges 
70.6 	from claims paid by the commissioner. The commissioner shall increase this payment 
70.7 	amount by 20 percent for providers designated as critical access dental providers under 
70.8 	medical assistance and MinnesotaCare. The critical access dental provider payment add-on 
70.9 	shall be calculated to be specific to each individual clinic location within a larger system. 
70.10 	This paragraph does not apply to federally qualified health centers, rural health centers, 
70.11 	state-operated dental clinics, or Indian health centers.
70.12 	(m) Beginning January 1, 2026, and every four years thereafter, the commissioner shall 
70.13 	rebase payment rates for dental services to the first percentile of submitted charges for the 
70.14 	applicable base year using charge data from paid claims submitted by providers. The base 
70.15 	year used for each rebasing shall be the calendar year that is two years prior to the effective 
70.16 	date of the rebasing.

70.17 	Sec. 49. Minnesota Statutes 2020, section 256B.76, subdivision 4, is amended to read:
70.18 		Subd. 4.Critical access dental providers.  (a) The commissioner shall increase 
70.19 	reimbursements to dentists and dental clinics deemed by the commissioner to be critical 
70.20 	access dental providers. For dental services rendered on or after July 1, 2016, through 
70.21 	December 31, 2022, the commissioner shall increase reimbursement by 37.5 percent above 
70.22 	the reimbursement rate that would otherwise be paid to the critical access dental provider, 
70.23 	except as specified under paragraph (b). The commissioner shall pay the managed care 
70.24 	plans and county-based purchasing plans in amounts sufficient to reflect increased 
70.25 	reimbursements to critical access dental providers as approved by the commissioner.
70.26 	(b) For dental services rendered on or after July 1, 2016, through December 31, 2022, 
70.27 	by a dental clinic or dental group that meets the critical access dental provider designation 
70.28 	under paragraph (d), clause (4), and is owned and operated by a health maintenance 
70.29 	organization licensed under chapter 62D, the commissioner shall increase reimbursement 
70.30 	by 35 percent above the reimbursement rate that would otherwise be paid to the critical 
70.31 	access provider.
70.32 	(c) Critical access dental payments made under paragraph (a) or (b) for dental services 
70.33 	provided by a critical access dental provider to an enrollee of a managed care plan or 
70.34 	county-based purchasing plan must not reflect any capitated payments or cost-based payments 
71.1 	from the managed care plan or county-based purchasing plan. The managed care plan or 
71.2 	county-based purchasing plan must base the additional critical access dental payment on 
71.3 	the amount that would have been paid for that service had the dental provider been paid 
71.4 	according to the managed care plan or county-based purchasing plan's fee schedule that 
71.5 	applies to dental providers that are not paid under a capitated payment or cost-based payment.
71.6 	(d) The commissioner shall designate the following dentists and dental clinics as critical 
71.7 	access dental providers:
71.8 	(1) nonprofit community clinics that:
71.9 	(i) have nonprofit status in accordance with chapter 317A;
71.10 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
71.11 	501(c)(3);
71.12 	(iii) are established to provide oral health services to patients who are low income, 
71.13 	uninsured, have special needs, and are underserved;
71.14 	(iv) have professional staff familiar with the cultural background of the clinic's patients;
71.15 	(v) charge for services on a sliding fee scale designed to provide assistance to low-income 
71.16 	patients based on current poverty income guidelines and family size;
71.17 	(vi) do not restrict access or services because of a patient's financial limitations or public 
71.18 	assistance status; and
71.19 	(vii) have free care available as needed;
71.20 	(2) federally qualified health centers, rural health clinics, and public health clinics;
71.21 	(3) hospital-based dental clinics owned and operated by a city, county, or former state 
71.22 	hospital as defined in section 62Q.19, subdivision 1, paragraph (a), clause (4);
71.23 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
71.24 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
71.25 	patients who are uninsured or covered by medical assistance or MinnesotaCare;
71.26 	(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota 
71.27 	State Colleges and Universities system; and
71.28 	(6) private practicing dentists if:
71.29 	(i) the dentist's office is located within the seven-county metropolitan area and more 
71.30 	than 50 percent of the dentist's patient encounters per year are with patients who are uninsured 
71.31 	or covered by medical assistance or MinnesotaCare; or
72.1 	(ii) the dentist's office is located outside the seven-county metropolitan area and more 
72.2 	than 25 percent of the dentist's patient encounters per year are with patients who are uninsured 
72.3 	or covered by medical assistance or MinnesotaCare.

72.4 	Sec. 50. Minnesota Statutes 2020, section 256B.79, subdivision 1, is amended to read:
72.5 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
72.6 	the meanings given them.
72.7 	(b) "Adverse outcomes" means maternal opiate addiction, other reportable prenatal 
72.8 	substance abuse, low birth weight, or preterm birth.
72.9 	(c) "Qualified integrated perinatal care collaborative" or "collaborative" means a 
72.10 	combination of (1) members of community-based organizations that represent communities 
72.11 	within the identified targeted populations, and (2) local or tribally based service entities, 
72.12 	including health care, public health, social services, mental health, chemical dependency 
72.13 	treatment, and community-based providers, determined by the commissioner to meet the 
72.14 	criteria for the provision of integrated care and enhanced services for enrollees within 
72.15 	targeted populations.
72.16 	(d) "Targeted populations" means pregnant medical assistance enrollees residing in 
72.17 	geographic areas communities identified by the commissioner as being at above-average 
72.18 	risk for adverse outcomes.

72.19 	Sec. 51. Minnesota Statutes 2020, section 256B.79, subdivision 3, is amended to read:
72.20 		Subd. 3.Grant awards. The commissioner shall award grants to qualifying applicants 
72.21 	to support interdisciplinary, integrated perinatal care. Grant funds must be distributed through 
72.22 	a request for proposals process to a designated lead agency within an entity that has been 
72.23 	determined to be a qualified integrated perinatal care collaborative or within an entity in 
72.24 	the process of meeting the qualifications to become a qualified integrated perinatal care 
72.25 	collaborative, and priority shall be given to qualified integrated perinatal care collaboratives 
72.26 	that received grants under this section prior to January 1, 2019. Grant awards must be used 
72.27 	to support interdisciplinary, team-based needs assessments, planning, and implementation 
72.28 	of integrated care and enhanced services for targeted populations. In determining grant 
72.29 	award amounts, the commissioner shall consider the identified health and social risks linked 
72.30 	to adverse outcomes and attributed to enrollees within the identified targeted population.

73.1 	Sec. 52. Minnesota Statutes 2020, section 256L.01, subdivision 5, is amended to read:
73.2 		Subd. 5.Income.  "Income" has the meaning given for modified adjusted gross income, 
73.3 	as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's 
73.4 	current income, or if income fluctuates month to month, the income for the 12-month 
73.5 	eligibility period projected annual income for the applicable tax year.

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

73.7 	Sec. 53. Minnesota Statutes 2020, section 256L.03, subdivision 5, is amended to read:
73.8 		Subd. 5.Cost-sharing. (a) Co-payments, coinsurance, and deductibles do not apply to 
73.9 	children under the age of 21 and, to American Indians as defined in Code of Federal 
73.10 	Regulations, title 42, section 600.5, or to pre-exposure prophylaxis (PrEP) and postexposure 
73.11 	prophylaxis (PEP) medications when used for the prevention or treatment of the human 
73.12 	immunodeficiency virus (HIV).
73.13 	(b) The commissioner shall adjust co-payments, coinsurance, and deductibles for covered 
73.14 	services in a manner sufficient to maintain the actuarial value of the benefit to 94 percent. 
73.15 	The cost-sharing changes described in this paragraph do not apply to eligible recipients or 
73.16 	services exempt from cost-sharing under state law. The cost-sharing changes described in 
73.17 	this paragraph shall not be implemented prior to January 1, 2016.
73.18 	(c) The cost-sharing changes authorized under paragraph (b) must satisfy the requirements 
73.19 	for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations, 
73.20 	title 42, sections 600.510 and 600.520.

73.21 	EFFECTIVE DATE. This section is effective January 1, 2022, subject to federal 
73.22 	approval. The commissioner of human services shall notify the revisor of statutes when 
73.23 	federal approval is obtained.

73.24 	Sec. 54. Minnesota Statutes 2020, section 256L.04, subdivision 7b, is amended to read:
73.25 		Subd. 7b.Annual income limits adjustment. The commissioner shall adjust the income 
73.26 	limits under this section annually each July 1 on January 1 as described in section 256B.056, 
73.27 	subdivision 1c provided in Code of Federal Regulations, title 26, section 1.36B-1(h).

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

73.29 	Sec. 55. Minnesota Statutes 2020, section 256L.05, subdivision 3a, is amended to read:
73.30 		Subd. 3a.Redetermination of eligibility. (a) An enrollee's eligibility must be 
73.31 	redetermined on an annual basis, in accordance with Code of Federal Regulations, title 42, 
74.1 	section 435.916 (a). The 12-month eligibility period begins the month of application. 
74.2 	Beginning July 1, 2017, the commissioner shall adjust the eligibility period for enrollees to 
74.3 	implement renewals throughout the year according to guidance from the Centers for Medicare 
74.4 	and Medicaid Services. The period of eligibility is the entire calendar year following the 
74.5 	year in which eligibility is redetermined. Eligibility redeterminations shall occur during the 
74.6 	open enrollment period for qualified health plans as specified in Code of Federal Regulations, 
74.7 	title 45, section 155.410(e)(3).
74.8 	(b) Each new period of eligibility must take into account any changes in circumstances 
74.9 	that impact eligibility and premium amount. Coverage begins as provided in section 256L.06.

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

74.11 	Sec. 56. Minnesota Statutes 2020, section 256L.11, subdivision 6a, is amended to read:
74.12 		Subd. 6a.Dental providers. Effective for dental services provided to MinnesotaCare 
74.13 	enrollees on or after January 1, 2018, through December 31, 2022, the commissioner shall 
74.14 	increase payment rates to dental providers by 54 percent. Payments made to prepaid health 
74.15 	plans under section 256L.12 shall reflect the payment increase described in this subdivision. 
74.16 	The prepaid health plans under contract with the commissioner shall provide payments to 
74.17 	dental providers that are at least equal to a rate that includes the payment rate specified in 
74.18 	this subdivision, and if applicable to the provider, the rates described under subdivision 7.

74.19 	Sec. 57. Minnesota Statutes 2020, section 256L.11, subdivision 7, is amended to read:
74.20 		Subd. 7.Critical access dental providers. Effective for dental services provided to 
74.21 	MinnesotaCare enrollees on or after July 1, 2017, through December 31, 2022, the 
74.22 	commissioner shall increase payment rates to dentists and dental clinics deemed by the 
74.23 	commissioner to be critical access providers under section 256B.76, subdivision 4, by 20 
74.24 	percent above the payment rate that would otherwise be paid to the provider. The 
74.25 	commissioner shall pay the prepaid health plans under contract with the commissioner 
74.26 	amounts sufficient to reflect this rate increase. The prepaid health plan must pass this rate 
74.27 	increase to providers who have been identified by the commissioner as critical access dental 
74.28 	providers under section 256B.76, subdivision 4.

74.29 	Sec. 58. Minnesota Statutes 2020, section 295.53, subdivision 1, is amended to read:
74.30 		Subdivision 1.Exclusions and exemptions. (a) The following payments are excluded 
74.31 	from the gross revenues subject to the hospital, surgical center, or health care provider taxes 
74.32 	under sections 295.50 to 295.59:
75.1 	(1) payments received by a health care provider or the wholly owned subsidiary of a 
75.2 	health care provider for care provided outside Minnesota;
75.3 	(2) government payments received by the commissioner of human services for 
75.4 	state-operated services;
75.5 	(3) payments received by a health care provider for hearing aids and related equipment 
75.6 	or prescription eyewear delivered outside of Minnesota; and
75.7 	(4) payments received by an educational institution from student tuition, student activity 
75.8 	fees, health care service fees, government appropriations, donations, or grants, and for 
75.9 	services identified in and provided under an individualized education program as defined 
75.10 	in section 256B.0625 or Code of Federal Regulations, chapter 34, section 300.340(a). Fee 
75.11 	for service payments and payments for extended coverage are taxable.
75.12 	(b) The following payments are exempted from the gross revenues subject to hospital, 
75.13 	surgical center, or health care provider taxes under sections 295.50 to 295.59:
75.14 	(1) payments received for services provided under the Medicare program, including 
75.15 	payments received from the government and organizations governed by sections 1833, 
75.16 	1853, and 1876 of title XVIII of the federal Social Security Act, United States Code, title 
75.17 	42, section 1395; and enrollee deductibles, co-insurance, and co-payments, whether paid 
75.18 	by the Medicare enrollee, by Medicare supplemental coverage as described in section 
75.19 	62A.011, subdivision 3, clause (10), or by Medicaid payments under title XIX of the federal 
75.20 	Social Security Act. Payments for services not covered by Medicare are taxable;
75.21 	(2) payments received for home health care services;
75.22 	(3) payments received from hospitals or surgical centers for goods and services on which 
75.23 	liability for tax is imposed under section 295.52 or the source of funds for the payment is 
75.24 	exempt under clause (1), (6), (9), (10), or (11);
75.25 	(4) payments received from the health care providers for goods and services on which 
75.26 	liability for tax is imposed under this chapter or the source of funds for the payment is 
75.27 	exempt under clause (1), (6), (9), (10), or (11);
75.28 	(5) amounts paid for legend drugs to a wholesale drug distributor who is subject to tax 
75.29 	under section 295.52, subdivision 3, reduced by reimbursement received for legend drugs 
75.30 	otherwise exempt under this chapter;
75.31 	(6) payments received from the chemical dependency fund under chapter 254B;
76.1 	(7) payments received in the nature of charitable donations that are not designated for 
76.2 	providing patient services to a specific individual or group;
76.3 	(8) payments received for providing patient services incurred through a formal program 
76.4 	of health care research conducted in conformity with federal regulations governing research 
76.5 	on human subjects. Payments received from patients or from other persons paying on behalf 
76.6 	of the patients are subject to tax;
76.7 	(9) payments received from any governmental agency for services benefiting the public, 
76.8 	not including payments made by the government in its capacity as an employer or insurer 
76.9 	or payments made by the government for services provided under the MinnesotaCare 
76.10 	program or the medical assistance program governed by title XIX of the federal Social 
76.11 	Security Act, United States Code, title 42, sections 1396 to 1396v;
76.12 	(10) payments received under the federal Employees Health Benefits Act, United States 
76.13 	Code, title 5, section 8909(f), as amended by the Omnibus Reconciliation Act of 1990. 
76.14 	Enrollee deductibles, co-insurance, and co-payments are subject to tax;
76.15 	(11) payments received under the federal Tricare program, Code of Federal Regulations, 
76.16 	title 32, section 199.17(a)(7). Enrollee deductibles, co-insurance, and co-payments are 
76.17 	subject to tax; and
76.18 	(12) supplemental or, enhanced, or uniform adjustment factor payments authorized under 
76.19 	section 256B.196or,256B.197, or 256B.1973.
76.20 	(c) Payments received by wholesale drug distributors for legend drugs sold directly to 
76.21 	veterinarians or veterinary bulk purchasing organizations are excluded from the gross 
76.22 	revenues subject to the wholesale drug distributor tax under sections 295.50 to 295.59.

76.23 	EFFECTIVE DATE. This section is effective for taxable years beginning after December 
76.24 	31, 2021.

76.25 	Sec. 59. COURT RULING ON AFFORDABLE CARE ACT.
 76.26 	In the event the United States Supreme Court reverses, in whole or in part, Public Law 
76.27 	111-148, as amended by Public Law 111-152, the commissioner of human services shall 
76.28 	take all actions necessary to maintain the current policies of the medical assistance and 
76.29 	MinnesotaCare programs, including but not limited to pursuing federal funds, or if federal 
76.30 	funding is not available, operating programs with state funding for at least one year following 
76.31 	the date of the Supreme Court decision or until the conclusion of the next regular legislative 
76.32 	session, whichever is later. Nothing in this section prohibits the commissioner from making 
77.1 	changes necessary to comply with federal or state requirements for the medical assistance 
77.2 	or MinnesotaCare programs that were not affected by the Supreme Court decision.

77.3 	Sec. 60. DELIVERY REFORM ANALYSIS REPORT.
 77.4 	(a) The commissioner of human services shall present to the chairs and ranking minority 
77.5 	members of the legislative committees with jurisdiction over health care policy and finance, 
77.6 	by January 15, 2023, a report comparing service delivery and payment system models for 
77.7 	delivering services to Medical Assistance enrollees for whom income eligibility is determined 
77.8 	using the modified adjusted gross income methodology under Minnesota Statutes, section 
77.9 	256B.056, subdivision 1a, paragraph (b), clause (1), and MinnesotaCare enrollees eligible 
77.10 	under Minnesota Statutes, chapter 256L. The report must compare the current delivery 
77.11 	model with at least two alternative models. The alternative models must include a state-based 
77.12 	model in which the state holds the plan risk as the insurer and may contract with a third-party 
77.13 	administrator for claims processing and plan administration. The alternative models may 
77.14 	include but are not limited to:
77.15 	(1) expanding the use of integrated health partnerships under Minnesota Statutes, section 
77.16 	256B.0755;
77.17 	(2) delivering care under fee-for-service through a primary care case management system; 
77.18 	and
77.19 	(3) continuing to contract with managed care and county-based purchasing plans for 
77.20 	some or all enrollees under modified contracts.
77.21 	(b) The report must include:
77.22 	(1) a description of how each model would address:
77.23 	(i) racial and other inequities in the delivery of health care and health care outcomes;
77.24 	(ii) geographic inequities in the delivery of health care;
77.25 	(iii) the provision of incentives for preventive care and other best practices;
77.26 	(iv) reimbursing providers for high-quality, value-based care at levels sufficient to sustain 
77.27 	or increase enrollee access to care; and
77.28 	(v) transparency and simplicity for enrollees, health care providers, and policymakers;
77.29 	(2) a comparison of the projected cost of each model; and
78.1 	(3) an implementation timeline for each model, that includes the earliest date by which 
78.2 	each model could be implemented if authorized during the 2023 legislative session, and a 
78.3 	discussion of barriers to implementation.

78.4 	Sec. 61. DENTAL HOME DEMONSTRATION PROJECT.
 78.5 	(a) The Dental Services Advisory Committee, in collaboration with stakeholders, shall 
78.6 	design a dental home demonstration project and present recommendations by February 1, 
78.7 	2022, to the commissioner and the chairs and ranking minority members of the legislative 
78.8 	committees with jurisdiction over health finance and policy.
78.9 	(b) The Dental Services Advisory Committee, at a minimum, shall engage with the 
78.10 	following stakeholders: the Minnesota Department of Health, the Minnesota Dental 
78.11 	Association, the Minnesota Dental Hygienists' Association, the University of Minnesota 
78.12 	School of Dentistry, dental programs operated by the Minnesota State Colleges and 
78.13 	Universities system, and representatives of each of the following dental provider types 
78.14 	serving medical assistance and MinnesotaCare enrollees:
78.15 	(1) private practice dental clinics for which medical assistance and MinnesotaCare 
78.16 	enrollees comprise more than 25 percent of the clinic's patient load;
78.17 	(2) private practice dental clinics for which medical assistance and MinnesotaCare 
78.18 	enrollees comprise 25 percent or less of the clinic's patient load;
78.19 	(3) nonprofit dental clinics with a primary focus on serving Indigenous communities 
78.20 	and other communities of color;
78.21 	(4) nonprofit dental clinics with a primary focus on providing eldercare;
78.22 	(5) nonprofit dental clinics with a primary focus on serving children;
78.23 	(6) nonprofit dental clinics providing services within the seven-county metropolitan 
78.24 	area;
78.25 	(7) nonprofit dental clinics providing services outside of the seven-county metropolitan 
78.26 	area; and
78.27 	(8) multispecialty hospital-based dental clinics.
78.28 	(c) The dental home demonstration project shall give incentives for qualified providers 
78.29 	that provide high-quality, patient-centered, comprehensive, and coordinated oral health 
78.30 	services. The demonstration project shall seek to increase the number of new dental providers 
78.31 	serving medical assistance and MinnesotaCare enrollees and increase the capacity of existing 
79.1 	providers. The demonstration project must test payment methods that establish value-based 
79.2 	incentives to:
79.3 	(1) increase the extent to which current dental providers serve medical assistance and 
79.4 	MinnesotaCare enrollees across their lifespan;
79.5 	(2) develop service models that create equity and reduce disparities in access to dental 
79.6 	services for high-risk and medically and socially complex enrollees;
79.7 	(3) advance alternative delivery models of care within community settings using 
79.8 	evidence-based approaches and innovative workforce teams; and
79.9 	(4) improve the quality of dental care by meeting dental home goals.

79.10 	Sec. 62. DIRECTION TO COMMISSIONER; INCOME AND ASSET EXCLUSION 
79.11 	FOR ST. PAUL GUARANTEED INCOME DEMONSTRATION PROJECT.
 79.12 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in this 
79.13 	subdivision have the meanings given.
79.14 	(b) "Commissioner" means the commissioner of human services unless specified 
79.15 	otherwise.
79.16 	(c) "Guaranteed income demonstration project" means a demonstration project in St. 
79.17 	Paul to evaluate how unconditional cash payments have a causal effect on income volatility, 
79.18 	financial well-being, and early childhood development in infants and toddlers.
79.19 		Subd. 2.Commissioner; income and asset exclusion. (a) During the duration of the 
79.20 	guaranteed income demonstration project, the commissioner shall not count payments made 
79.21 	to families by the guaranteed income demonstration project as income or assets for purposes 
79.22 	of determining or redetermining eligibility for the following programs:
79.23 	(1) child care assistance programs under Minnesota Statutes, chapter 119B; and
79.24 	(2) the Minnesota family investment program, work benefit program, or diversionary 
79.25 	work program under Minnesota Statutes, chapter 256J.
79.26 	(b) During the duration of the guaranteed income demonstration project, the commissioner 
79.27 	shall not count payments made to families by the guaranteed income demonstration project 
79.28 	as income or assets for purposes of determining or redetermining eligibility for the following 
79.29 	programs:
79.30 	(1) medical assistance under Minnesota Statutes, chapter 256B; and
79.31 	(2) MinnesotaCare under Minnesota Statutes, chapter 256L.
80.1 		Subd. 3.Report. The city of St. Paul shall provide a report to the chairs and ranking 
80.2 	minority members of the legislative committees with jurisdiction over human services policy 
80.3 	and finance by February 15, 2023, with information on the progress and outcomes of the 
80.4 	guaranteed income demonstration project under this section.
80.5 		Subd. 4.Expiration. This section expires June 30, 2023.

80.6 	EFFECTIVE DATE. This section is effective July 1, 2021, except for subdivision 2, 
80.7 	paragraph (b), which is effective July 1, 2021, or upon federal approval, whichever is later.

80.8 	Sec. 63. EXPANSION OF OUTPATIENT DRUG CARVE OUT; PRESCRIPTION 
80.9 	DRUG PURCHASING PROGRAM.
 80.10 	The commissioner of human services, in consultation with the commissioners of 
80.11 	commerce and health, shall assess the feasibility of, and develop recommendations for: (1) 
80.12 	expanding the outpatient prescription drug carve out under Minnesota Statutes, section 
80.13 	256B.69, subdivision 6d, to include MinnesotaCare enrollees; and (2) establishing a 
80.14 	prescription drug purchasing program to serve nonpublic program enrollees of health plan 
80.15 	companies. The recommendations must address the process and terms by which the 
80.16 	commissioner would contract with health plan companies to administer prescription drug 
80.17 	benefits for the companies' enrollees and develop and manage a formulary. The commissioner 
80.18 	shall present recommendations to the chairs and ranking minority members of the legislative 
80.19 	committees with jurisdiction over commerce and health and human services policy and 
80.20 	finance by December 15, 2023.

80.21 	Sec. 64. FEDERAL APPROVAL; EXTENSION OF POSTPARTUM COVERAGE.
 80.22 	The commissioner of human services shall seek all federal waivers and approvals 
80.23 	necessary to extend medical assistance postpartum coverage, as provided in Minnesota 
80.24 	Statutes, section 256B.055, subdivision 6.

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

80.26 	Sec. 65. PROPOSAL FOR A PUBLIC OPTION.
 80.27 	(a) The commissioner of human services shall consult with the Centers for Medicare 
80.28 	and Medicaid Services, the Internal Revenue Service, and other relevant federal agencies 
80.29 	to develop a proposal for a public option program. The proposal may consider multiple 
80.30 	public option structures, at least one of which must be through expanded enrollment into 
80.31 	MinnesotaCare. Each option must:
81.1 	(1) allow individuals with incomes above the maximum income eligibility limit under 
81.2 	Minnesota Statutes, section 256L.04, subdivision 1 or 7, the option of purchasing coverage 
81.3 	through the public option;
81.4 	(2) allow undocumented noncitizens, and individuals with access to subsidized employer 
81.5 	health coverage who are subject to the family glitch, the option of purchasing through the 
81.6 	public option;
81.7 	(3) establish a small employer public option that allows employers with 50 or fewer 
81.8 	employees to offer the public option to the employer's employees and contribute to the 
81.9 	employees' premiums;
81.10 	(4) allow the state to:
81.11 	(i) receive the maximum pass through of federal dollars that would otherwise be used 
81.12 	to provide coverage for eligible public option enrollees if the enrollees were instead covered 
81.13 	through qualified health plans with premium tax credits, emergency medical assistance, or 
81.14 	other relevant programs; and
81.15 	(ii) continue to receive basic health program payments for eligible MinnesotaCare 
81.16 	enrollees; and
81.17 	(5) be administered in coordination with the existing MinnesotaCare program to maximize 
81.18 	efficiency and improve continuity of care, consistent with the requirements of Minnesota 
81.19 	Statutes, sections 256L.06, 256L.10, and 256L.11.
81.20 	(b) Each public option proposal must include:
81.21 	(1) a premium scale for public option enrollees that at least meets the Affordable Care 
81.22 	Act affordability standard for each income level;
81.23 	(2) an analysis of the impact of the public option on MNsure enrollment and the consumer 
81.24 	assistance program and, if necessary, a proposal to ensure that the public option has an 
81.25 	adequate enrollment infrastructure and consumer assistance capacity;
81.26 	(3) actuarial and financial analyses necessary to project program enrollment and costs; 
81.27 	and
81.28 	(4) an analysis of the cost of implementing the public option using current eligibility 
81.29 	and enrollment technology systems, and at the option of the commissioner, an analysis of 
81.30 	alternative eligibility and enrollment systems that may reduce initial and ongoing costs and 
81.31 	improve functionality and accessibility.
82.1 	(c) The commissioner shall incorporate into the design of the public option mechanisms 
82.2 	to ensure the long-term financial sustainability of MinnesotaCare and mitigate any adverse 
82.3 	financial impacts to MNsure. These mechanisms must minimize: (i) adverse selection; (ii) 
82.4 	state financial risk and expenditures; and (iii) potential impacts on premiums in the individual 
82.5 	and group insurance markets.
82.6 	(d) The commissioner shall present the proposal to the chairs and ranking minority 
82.7 	members of the legislative committees with jurisdiction over health care policy and finance 
82.8 	by December 15, 2021. The proposal must include recommendations on any legislative 
82.9 	changes necessary to implement the public option. Any implementation of the proposal that 
82.10 	requires a state financial contribution must be contingent on legislative approval.

82.11 	Sec. 66. RESPONSE TO COVID-19 PUBLIC HEALTH EMERGENCY.
 82.12 	(a) Notwithstanding Minnesota Statutes, section 256B.057, subdivision 9, 256L.06, 
82.13 	subdivision 3, or any other provision to the contrary, the commissioner shall not collect any 
82.14 	unpaid premium for a coverage month that occurred during the COVID-19 public health 
82.15 	emergency declared by the United States Secretary of Health and Human Services.
82.16 	(b) Notwithstanding any provision to the contrary, periodic data matching under 
82.17 	Minnesota Statutes, section 256B.0561, subdivision 2, may be suspended for up to six 
82.18 	months following the last day of the COVID-19 public health emergency declared by the 
82.19 	United States Secretary of Health and Human Services.
82.20 	(c) Notwithstanding any provision to the contrary, the requirement for the commissioner 
82.21 	of human services to issue an annual report on periodic data matching under Minnesota 
82.22 	Statutes, section 256B.0561, is suspended for one year following the last day of the 
82.23 	COVID-19 public health emergency declared by the United States Secretary of Health and 
82.24 	Human Services.

82.25 	EFFECTIVE DATE. This section is effective the day following final enactment, except 
82.26 	paragraph (a) related to MinnesotaCare premiums is effective upon federal approval. The 
82.27 	commissioner shall notify the revisor of statutes when federal approval is received.

82.28 	Sec. 67. REVISOR INSTRUCTION.
 82.29 	The revisor of statutes must change the term "Health Services Policy Committee" to 
82.30 	"Health Services Advisory Council" wherever the term appears in Minnesota Statutes and 
82.31 	may make any necessary changes to grammar or sentence structure to preserve the meaning 
82.32 	of the text.

83.1 	Sec. 68. REPEALER.
 83.2 	(a) Minnesota Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 
83.3 	7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and 22; 9505.1699; 9505.1701; 9505.1703; 
83.4 	9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730; 
83.5 	9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; and 9505.1748, are repealed.
83.6 	(b) Minnesota Statutes 2020, section 256B.0625, subdivisions 18c, 18d, 18e, and 18h,
83.7 	are repealed.

83.8 	EFFECTIVE DATE. Paragraph (a) is effective July 1, 2021, and paragraph (b) is 
83.9 	effective January 1, 2023.

83.10 	ARTICLE 2
83.11 	DEPARTMENT OF HUMAN SERVICES LICENSING AND BACKGROUND 
83.12 	STUDIES

83.13 	Section 1. Minnesota Statutes 2020, section 62V.05, is amended by adding a subdivision 
83.14 	to read:
83.15 		Subd. 4a.Background study required. (a) The board must initiate background studies 
83.16 	under section 245C.031 of:
83.17 	(1) each navigator;
83.18 	(2) each in-person assister; and
83.19 	(3) each certified application counselor.
83.20 	(b) The board may initiate the background studies required by paragraph (a) using the 
83.21 	online NETStudy 2.0 system operated by the commissioner of human services.
83.22 	(c) The board shall not permit any individual to provide any service or function listed 
83.23 	in paragraph (a) until the board has received notification from the commissioner of human 
83.24 	services indicating that the individual:
83.25 	(1) is not disqualified under chapter 245C; or
83.26 	(2) is disqualified, but has received a set aside from the board of that disqualification 
83.27 	according to sections 245C.22 and 245C.23.
83.28 	(d) The board or its delegate shall review a reconsideration request of an individual in 
83.29 	paragraph (a), including granting a set aside, according to the procedures and criteria in 
83.30 	chapter 245C. The board shall notify the individual and the Department of Human Services 
83.31 	of the board's decision.

84.1 	Sec. 2. Minnesota Statutes 2020, section 122A.18, subdivision 8, is amended to read:
84.2 		Subd. 8.Background checks studies. (a) The Professional Educator Licensing and 
84.3 	Standards Board and the Board of School Administrators must obtain a initiate criminal 
84.4 	history background check on studies of all first-time teaching applicants for educator licenses 
84.5 	under their jurisdiction. Applicants must include with their licensure applications:
84.6 	(1) an executed criminal history consent form, including fingerprints; and
84.7 	(2) payment to conduct the background checkstudy. The Professional Educator Licensing 
84.8 	and Standards Board must deposit payments received under this subdivision in an account 
84.9 	in the special revenue fund. Amounts in the account are annually appropriated to the 
84.10 	Professional Educator Licensing and Standards Board to pay for the costs of background 
84.11 	checksstudies on applicants for licensure.
84.12 	(b) The background checkstudy for all first-time teaching applicants for licenses must 
84.13 	include a review of information from the Bureau of Criminal Apprehension, including 
84.14 	criminal history data as defined in section 13.87, and must also include a review of the 
84.15 	national criminal records repository. The superintendent of the Bureau of Criminal 
84.16 	Apprehension is authorized to exchange fingerprints with the Federal Bureau of Investigation 
84.17 	for purposes of the criminal history check. The superintendent shall recover the cost to the 
84.18 	bureau of a background check through the fee charged to the applicant under paragraph (a).
84.19 	(c) The Professional Educator Licensing and Standards Board must contract with may 
84.20 	initiate criminal history background studies through the commissioner of human services 
84.21 	according to section 245C.031 to conduct background checks and obtain background check
84.22 	study data required under this chapter.

84.23 	Sec. 3. [245.975] OMBUDSPERSON FOR FAMILY CHILD CARE PROVIDERS.
84.24 		Subdivision 1.Appointment. The governor shall appoint an ombudsperson in the 
84.25 	classified service to assist family child care providers with licensing, compliance, and other 
84.26 	issues facing family child care providers. The ombudsperson must be selected without regard 
84.27 	to the person's political affiliation.
84.28 		Subd. 2.Duties. (a) The ombudsperson's duties shall include:
84.29 	(1) advocating on behalf of a family child care provider to address all areas of concern 
84.30 	related to the provision of child care services, including licensing monitoring activities, 
84.31 	licensing actions, and other interactions with state and county licensing staff;
85.1 	(2) providing recommendations for family child care improvement or family child care 
85.2 	provider education;
85.3 	(3) operating a telephone line to answer questions, receive complaints, and discuss 
85.4 	agency actions when a family child care provider believes their rights or program may have 
85.5 	been adversely affected; and
85.6 	(4) assisting family child care license applicants with navigating the application process.
85.7 	(b) The ombudsperson must report annually by December 31 to the commissioner and 
85.8 	the chairs and ranking minority members of the legislative committees with jurisdiction 
85.9 	over child care on the services provided by the ombudsperson to child care providers, 
85.10 	including the number and locations of child care providers served, and the activities of the 
85.11 	ombudsperson in carrying out the duties under this section. The commissioner shall determine 
85.12 	the form of the report and may specify additional reporting requirements.
85.13 		Subd. 3.Staff. The ombudsperson may appoint and compensate out of available funds 
85.14 	a deputy, confidential secretary, and other employees in the unclassified service as authorized 
85.15 	by law. The ombudsperson and the full-time staff are members of the Minnesota State 
85.16 	Retirement Association. The ombudsperson may delegate to members of the staff any 
85.17 	authority or duties of the office except the duty to provide reports to the governor, 
85.18 	commissioner, or the legislature.
85.19 		Subd. 4.Access to records. (a) The ombudsperson or designee, excluding volunteers, 
85.20 	has access to data of a state agency necessary for the discharge of the ombudsperson's duties, 
85.21 	including records classified as confidential data on individuals or private data on individuals 
85.22 	under chapter 13 or any other law. The ombudsperson's data request must relate to a specific 
85.23 	case and is subject to section 13.03, subdivision 4. If the data concerns an individual, the 
85.24 	ombudsperson or designee shall first obtain the individual's consent. If the individual cannot 
85.25 	consent and has no parent or legal guardian, then access to the data is authorized by this 
85.26 	section.
85.27 	(b) The ombudsperson and designees must adhere to the Minnesota Government Data 
85.28 	Practices Act and must not disseminate any private or confidential data on individuals unless 
85.29 	specifically authorized by state, local, or federal law or pursuant to a court order.
85.30 	(c) The commissioner and county agency must provide the ombudsperson copies of all 
85.31 	fix-it tickets, correction orders, and licensing actions issued to family child care providers.
85.32 		Subd. 5.Independence of action. In carrying out the duties under this section, the 
85.33 	ombudsperson may act independently of the department to provide testimony to the 
86.1 	legislature, make periodic reports to the legislature, and address areas of concern to child 
86.2 	care providers.
86.3 		Subd. 6.Civil actions. The ombudsperson or designee is not civilly liable for any action 
86.4 	taken under this section if the action was taken in good faith, was within the scope of the 
86.5 	ombudsperson's authority, and did not constitute willful or reckless misconduct.
86.6 		Subd. 7.Qualifications. The ombudsperson must be a person who has knowledge and 
86.7 	experience concerning the provision of family child care. The ombudsperson must be 
86.8 	experienced in dealing with governmental entities, interpretation of laws and regulations, 
86.9 	investigations, record keeping, report writing, public speaking, and management. A person 
86.10 	is not eligible to serve as the ombudsperson while holding public office or while holding a 
86.11 	family child care license.
86.12 		Subd. 8.Office support. The commissioner shall provide the ombudsperson with the 
86.13 	necessary office space, supplies, equipment, and clerical support to effectively perform the 
86.14 	duties under this section.
86.15 		Subd. 9.Posting. (a) The commissioner shall post on the department's website the 
86.16 	mailing address, e-mail address, and telephone number for the office of the ombudsperson. 
86.17 	The commissioner shall provide family child care providers with the mailing address, e-mail 
86.18 	address, and telephone number of the office on the family child care licensing website and 
86.19 	upon request from a family child care applicant or provider. Counties must provide family 
86.20 	child care applicants and providers with the name, mailing address, e-mail address, and 
86.21 	telephone number of the office upon request.
86.22 	(b) The ombudsperson must approve all postings and notices required by the department 
86.23 	and counties under this subdivision.

86.24 	Sec. 4. Minnesota Statutes 2020, section 245A.043, subdivision 3, is amended to read:
86.25 		Subd. 3.Change of ownership process. (a) When a change in ownership is proposed 
86.26 	and the party intends to assume operation without an interruption in service longer than 60 
86.27 	days after acquiring the program or service, the license holder must provide the commissioner 
86.28 	with written notice of the proposed change on a form provided by the commissioner at least 
86.29 	60 days before the anticipated date of the change in ownership. For purposes of this 
86.30 	subdivision and subdivision 4, "party" means the party that intends to operate the service 
86.31 	or program.
86.32 	(b) The party must submit a license application under this chapter on the form and in 
86.33 	the manner prescribed by the commissioner at least 30 days before the change in ownership 
87.1 	is complete, and must include documentation to support the upcoming change. The party 
87.2 	must comply with background study requirements under chapter 245C and shall pay the 
87.3 	application fee required under section 245A.10. A party that intends to assume operation 
87.4 	without an interruption in service longer than 60 days after acquiring the program or service 
87.5 	is exempt from the requirements of Minnesota Rules, part 9530.6800.
87.6 	(c) The commissioner may streamline application procedures when the party is an existing 
87.7 	license holder under this chapter and is acquiring a program licensed under this chapter or 
87.8 	service in the same service class as one or more licensed programs or services the party 
87.9 	operates and those licenses are in substantial compliance. For purposes of this subdivision, 
87.10 	"substantial compliance" means within the previous 12 months the commissioner did not 
87.11 	(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make 
87.12 	a license held by the party conditional according to section 245A.06.
87.13 	(d) Except when a temporary change in ownership license is issued pursuant to 
87.14 	subdivision 4, the existing license holder is solely responsible for operating the program 
87.15 	according to applicable laws and rules until a license under this chapter is issued to the 
87.16 	party.
87.17 	(e) If a licensing inspection of the program or service was conducted within the previous 
87.18 	12 months and the existing license holder's license record demonstrates substantial 
87.19 	compliance with the applicable licensing requirements, the commissioner may waive the 
87.20 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
87.21 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
87.22 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
87.23 	inspected for compliance with the building code or that no inspection was deemed warranted.
87.24 	(f) If the party is seeking a license for a program or service that has an outstanding action 
87.25 	under section 245A.06 or 245A.07, the party must submit a letter as part of the application 
87.26 	process identifying how the party has or will come into full compliance with the licensing 
87.27 	requirements.
87.28 	(g) The commissioner shall evaluate the party's application according to section 245A.04, 
87.29 	subdivision 6. If the commissioner determines that the party has remedied or demonstrates 
87.30 	the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has 
87.31 	determined that the program otherwise complies with all applicable laws and rules, the 
87.32 	commissioner shall issue a license or conditional license under this chapter. The conditional 
87.33 	license remains in effect until the commissioner determines that the grounds for the action 
87.34 	are corrected or no longer exist.
88.1 	(h) The commissioner may deny an application as provided in section 245A.05. An 
88.2 	applicant whose application was denied by the commissioner may appeal the denial according 
88.3 	to section 245A.05.
88.4 	(i) This subdivision does not apply to a licensed program or service located in a home 
88.5 	where the license holder resides.

88.6 	Sec. 5. Minnesota Statutes 2020, section 245A.05, is amended to read:
88.7 	245A.05 DENIAL OF APPLICATION.
88.8 	(a) The commissioner may deny a license if an applicant or controlling individual:
88.9 	(1) fails to submit a substantially complete application after receiving notice from the 
88.10 	commissioner under section 245A.04, subdivision 1;
88.11 	(2) fails to comply with applicable laws or rules;
88.12 	(3) knowingly withholds relevant information from or gives false or misleading 
88.13 	information to the commissioner in connection with an application for a license or during 
88.14 	an investigation;
88.15 	(4) has a disqualification that has not been set aside under section 245C.22 and no 
88.16 	variance has been granted;
88.17 	(5) has an individual living in the household who received a background study under 
88.18 	section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that 
88.19 	has not been set aside under section 245C.22, and no variance has been granted;
88.20 	(6) is associated with an individual who received a background study under section 
88.21 	245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to 
88.22 	children or vulnerable adults, and who has a disqualification that has not been set aside 
88.23 	under section 245C.22, and no variance has been granted;
88.24 	(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);
88.25 	(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision 
88.26 	6;
88.27 	(9) has a history of noncompliance as a license holder or controlling individual with 
88.28 	applicable laws or rules, including but not limited to this chapter and chapters 119B and 
88.29 	245C; or
88.30 	(10) is prohibited from holding a license according to section 245.095.; or
89.1 	(11) for a family foster setting, has nondisqualifying background study information, as 
89.2 	described in section 245C.05, subdivision 4, that reflects on the individual's ability to safely 
89.3 	provide care to foster children.
89.4 	(b) An applicant whose application has been denied by the commissioner must be given 
89.5 	notice of the denial, which must state the reasons for the denial in plain language. Notice 
89.6 	must be given by certified mail or personal service. The notice must state the reasons the 
89.7 	application was denied and must inform the applicant of the right to a contested case hearing 
89.8 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may 
89.9 	appeal the denial by notifying the commissioner in writing by certified mail or personal 
89.10 	service. If mailed, the appeal must be postmarked and sent to the commissioner within 20 
89.11 	calendar days after the applicant received the notice of denial. If an appeal request is made 
89.12 	by personal service, it must be received by the commissioner within 20 calendar days after 
89.13 	the applicant received the notice of denial. Section 245A.08 applies to hearings held to 
89.14 	appeal the commissioner's denial of an application.

89.15 	EFFECTIVE DATE. This section is effective July 1, 2022.

89.16 	Sec. 6. Minnesota Statutes 2020, section 245A.07, subdivision 1, is amended to read:
89.17 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
89.18 	under section 245A.06, the commissioner may suspend or revoke the license, impose a fine, 
89.19 	or secure an injunction against the continuing operation of the program of a license holder 
89.20 	who does not comply with applicable law or rule, or who has nondisqualifying background 
89.21 	study information, as described in section 245C.05, subdivision 4, that reflects on the license 
89.22 	holder's ability to safely provide care to foster children. When applying sanctions authorized 
89.23 	under this section, the commissioner shall consider the nature, chronicity, or severity of the 
89.24 	violation of law or rule and the effect of the violation on the health, safety, or rights of 
89.25 	persons served by the program.
89.26 	(b) If a license holder appeals the suspension or revocation of a license and the license 
89.27 	holder continues to operate the program pending a final order on the appeal, the commissioner 
89.28 	shall issue the license holder a temporary provisional license. Unless otherwise specified 
89.29 	by the commissioner, variances in effect on the date of the license sanction under appeal 
89.30 	continue under the temporary provisional license. If a license holder fails to comply with 
89.31 	applicable law or rule while operating under a temporary provisional license, the 
89.32 	commissioner may impose additional sanctions under this section and section 245A.06, and 
89.33 	may terminate any prior variance. If a temporary provisional license is set to expire, a new 
89.34 	temporary provisional license shall be issued to the license holder upon payment of any fee 
90.1 	required under section 245A.10. The temporary provisional license shall expire on the date 
90.2 	the final order is issued. If the license holder prevails on the appeal, a new nonprovisional 
90.3 	license shall be issued for the remainder of the current license period.
90.4 	(c) If a license holder is under investigation and the license issued under this chapter is 
90.5 	due to expire before completion of the investigation, the program shall be issued a new 
90.6 	license upon completion of the reapplication requirements and payment of any applicable 
90.7 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
90.8 	against the new license under this section, section 245A.06, or 245A.08.
90.9 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
90.10 	holder prior to the completion of any investigation shall not preclude the commissioner 
90.11 	from issuing a licensing sanction under this section or section 245A.06 at the conclusion 
90.12 	of the investigation.

90.13 	EFFECTIVE DATE. This section is effective July 1, 2022.

90.14 	Sec. 7. Minnesota Statutes 2020, section 245A.10, subdivision 4, is amended to read:
90.15 		Subd. 4.License or certification fee for certain programs. (a) Child care centers shall 
90.16 	pay an annual nonrefundable license fee based on the following schedule:

90.1890.17
		Licensed Capacity
	Child Care Center
License Fee
	
90.19		1 to 24 persons
	$200
	
90.20		25 to 49 persons
	$300
	
90.21		50 to 74 persons
	$400
	
90.22		75 to 99 persons
	$500
	
90.23		100 to 124 persons
	$600
	
90.24		125 to 149 persons
	$700
	
90.25		150 to 174 persons
	$800
	
90.26		175 to 199 persons
	$900
	
90.27		200 to 224 persons
	$1,000
	
90.28		225 or more persons
	$1,100
	
90.29 	(b)(1) A program licensed to provide one or more of the home and community-based 
90.30 	services and supports identified under chapter 245D to persons with disabilities or age 65 
90.31 	and older, shall pay an annual nonrefundable license fee based on revenues derived from 
90.32 	the provision of services that would require licensure under chapter 245D during the calendar 
90.33 	year immediately preceding the year in which the license fee is paid, according to the 
90.34 	following schedule:

91.1	License Holder Annual Revenue
		License Fee
	
91.2	less than or equal to $10,000
		$200
	
91.3
91.4	greater than $10,000 but less than or 
equal to $25,000
		$300
	
91.5
91.6	greater than $25,000 but less than or 
equal to $50,000
		$400
	
91.7
91.8	greater than $50,000 but less than or 
equal to $100,000
		$500
	
91.991.10
	greater than $100,000 but less than or 
equal to $150,000
		$600
	
91.11
91.12	greater than $150,000 but less than or 
equal to $200,000
		$800
	
91.13
91.14	greater than $200,000 but less than or 
equal to $250,000
		$1,000
	
91.15
91.16	greater than $250,000 but less than or 
equal to $300,000
		$1,200
	
91.17
91.18	greater than $300,000 but less than or 
equal to $350,000
		$1,400
	
91.19
91.20	greater than $350,000 but less than or 
equal to $400,000
		$1,600
	
91.21
91.22	greater than $400,000 but less than or 
equal to $450,000
		$1,800
	
91.23
91.24	greater than $450,000 but less than or 
equal to $500,000
		$2,000
	
91.25
91.26	greater than $500,000 but less than or 
equal to $600,000
		$2,250
	
91.27
91.28	greater than $600,000 but less than or 
equal to $700,000
		$2,500
	
91.29
91.30	greater than $700,000 but less than or 
equal to $800,000
		$2,750
	
91.31
91.32	greater than $800,000 but less than or 
equal to $900,000
		$3,000
	
91.33
91.34	greater than $900,000 but less than or 
equal to $1,000,000
		$3,250
	
91.35
91.36	greater than $1,000,000 but less than or 
equal to $1,250,000
		$3,500
	
91.37
91.38	greater than $1,250,000 but less than or 
equal to $1,500,000
		$3,750
	
91.39
91.40	greater than $1,500,000 but less than or 
equal to $1,750,000
		$4,000
	
91.41
91.42	greater than $1,750,000 but less than or 
equal to $2,000,000
		$4,250
	
91.43
91.44	greater than $2,000,000 but less than or 
equal to $2,500,000
		$4,500
	
92.1
92.2	greater than $2,500,000 but less than or 
equal to $3,000,000
		$4,750
	
92.3
92.4	greater than $3,000,000 but less than or 
equal to $3,500,000
		$5,000
	
92.5
92.6	greater than $3,500,000 but less than or 
equal to $4,000,000
		$5,500
	
92.7
92.8	greater than $4,000,000 but less than or 
equal to $4,500,000
		$6,000
	
92.992.10
	greater than $4,500,000 but less than or 
equal to $5,000,000
		$6,500
	
92.11
92.12	greater than $5,000,000 but less than or 
equal to $7,500,000
		$7,000
	
92.13
92.14	greater than $7,500,000 but less than or 
equal to $10,000,000
		$8,500
	
92.15
92.16	greater than $10,000,000 but less than or 
equal to $12,500,000
		$10,000
	
92.17
92.18	greater than $12,500,000 but less than or 
equal to $15,000,000
		$14,000
	
92.19	greater than $15,000,000
		$18,000
	
92.20 	(2) If requested, the license holder shall provide the commissioner information to verify 
92.21 	the license holder's annual revenues or other information as needed, including copies of 
92.22 	documents submitted to the Department of Revenue.
92.23 	(3) At each annual renewal, a license holder may elect to pay the highest renewal fee, 
92.24 	and not provide annual revenue information to the commissioner.
92.25 	(4) A license holder that knowingly provides the commissioner incorrect revenue amounts 
92.26 	for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount 
92.27 	of double the fee the provider should have paid.
92.28 	(5) Notwithstanding clause (1), a license holder providing services under one or more 
92.29 	licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license 
92.30 	fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license 
92.31 	holder for all licenses held under chapter 245B for calendar year 2013. For calendar year 
92.32 	2017 and thereafter, the license holder shall pay an annual license fee according to clause 
92.33 	(1).
92.34 	(c) A chemical dependency treatment program licensed under chapter 245G, to provide 
92.35 	chemical dependency treatment shall pay an annual nonrefundable license fee based on the 
92.36 	following schedule:

92.37		Licensed Capacity
	License Fee
	
92.38		1 to 24 persons
	$600
	
93.1		25 to 49 persons
	$800
	
93.2		50 to 74 persons
	$1,000
	
93.3		75 to 99 persons
	$1,200
	
93.4		100 or more persons
	$1,400
	
93.5 	(d) A chemical dependency detoxification program licensed under Minnesota Rules, 
93.6 	parts 9530.6510 to 9530.6590, to provide detoxification services or a withdrawal management 
93.7 	program licensed under chapter 245F shall pay an annual nonrefundable license fee based 
93.8 	on the following schedule:

93.9		Licensed Capacity
	License Fee
	
93.10		1 to 24 persons
	$760
	
93.11		25 to 49 persons
	$960
	
93.12		50 or more persons
	$1,160
	
93.13 	A detoxification program that also operates a withdrawal management program at the same 
93.14 	location shall only pay one fee based upon the licensed capacity of the program with the 
93.15 	higher overall capacity.
93.16 	(e) Except for child foster care, a residential facility licensed under Minnesota Rules, 
93.17 	chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the 
93.18 	following schedule:

93.19		Licensed Capacity
	License Fee
	
93.20		1 to 24 persons
	$1,000
	
93.21		25 to 49 persons
	$1,100
	
93.22		50 to 74 persons
	$1,200
	
93.23		75 to 99 persons
	$1,300
	
93.24		100 or more persons
	$1,400
	
93.25 	(f) A residential facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670, 
93.26 	to serve persons with mental illness shall pay an annual nonrefundable license fee based on 
93.27 	the following schedule:

93.28		Licensed Capacity
	License Fee
	
93.29		1 to 24 persons
	$2,525
	
93.30		25 or more persons
	$2,725
	
93.31 	(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400, 
93.32 	to serve persons with physical disabilities shall pay an annual nonrefundable license fee 
93.33 	based on the following schedule:

94.1		Licensed Capacity
	License Fee
	
94.2		1 to 24 persons
	$450
	
94.3		25 to 49 persons
	$650
	
94.4		50 to 74 persons
	$850
	
94.5		75 to 99 persons
	$1,050
	
94.6		100 or more persons
	$1,250
	
94.7 	(h) A program licensed to provide independent living assistance for youth under section 
94.8 	245A.22 shall pay an annual nonrefundable license fee of $1,500.
94.9 	(i) A private agency licensed to provide foster care and adoption services under Minnesota 
94.10 	Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.
94.11 	(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts 
94.12 	9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the 
94.13 	following schedule:

94.14		Licensed Capacity
	License Fee
	
94.15		1 to 24 persons
	$500
	
94.16		25 to 49 persons
	$700
	
94.17		50 to 74 persons
	$900
	
94.18		75 to 99 persons
	$1,100
	
94.19		100 or more persons
	$1,300
	
94.20 	(k) A program licensed to provide treatment services to persons with sexual psychopathic 
94.21 	personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to 
94.22 	9515.3110, shall pay an annual nonrefundable license fee of $20,000.
94.23 	(l) A mental health center or mental health clinic requesting certification for purposes 
94.24 	of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750 
94.25 	to 9520.0870, shall pay a certification fee of $1,550 per year. If the mental health center or 
94.26 	mental health clinic provides services at a primary location with satellite facilities, the 
94.27 	satellite facilities shall be certified with the primary location without an additional charge.

94.28 	Sec. 8. Minnesota Statutes 2020, section 245A.14, subdivision 4, is amended to read:
94.29 		Subd. 4.Special family daychild care homes. Nonresidential child care programs 
94.30 	serving 14 or fewer children that are conducted at a location other than the license holder's 
94.31 	own residence shall be licensed under this section and the rules governing family daychild
94.32 	care or group family daychild care if:
95.1 	(a) the license holder is the primary provider of care and the nonresidential child care 
95.2 	program is conducted in a dwelling that is located on a residential lot;
95.3 	(b) the license holder is an employer who may or may not be the primary provider of 
95.4 	care, and the purpose for the child care program is to provide child care services to children 
95.5 	of the license holder's employees;
95.6 	(c) the license holder is a church or religious organization;
95.7 	(d) the license holder is a community collaborative child care provider. For purposes of 
95.8 	this subdivision, a community collaborative child care provider is a provider participating 
95.9 	in a cooperative agreement with a community action agency as defined in section 256E.31;
95.10 	(e) the license holder is a not-for-profit agency that provides child care in a dwelling 
95.11 	located on a residential lot and the license holder maintains two or more contracts with 
95.12 	community employers or other community organizations to provide child care services. 
95.13 	The county licensing agency may grant a capacity variance to a license holder licensed 
95.14 	under this paragraph to exceed the licensed capacity of 14 children by no more than five 
95.15 	children during transition periods related to the work schedules of parents, if the license 
95.16 	holder meets the following requirements:
95.17 	(1) the program does not exceed a capacity of 14 children more than a cumulative total 
95.18 	of four hours per day;
95.19 	(2) the program meets a one to seven staff-to-child ratio during the variance period;
95.20 	(3) all employees receive at least an extra four hours of training per year than required 
95.21 	in the rules governing family child care each year;
95.22 	(4) the facility has square footage required per child under Minnesota Rules, part 
95.23 	9502.0425;
95.24 	(5) the program is in compliance with local zoning regulations;
95.25 	(6) the program is in compliance with the applicable fire code as follows:
95.26 	(i) if the program serves more than five children older than 2-1/2 years of age, but no 
95.27 	more than five children 2-1/2 years of age or less, the applicable fire code is educational 
95.28 	occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015, 
95.29 	Section 202; or
95.30 	(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable 
95.31 	fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2015, 
95.32 	Section 202, unless the rooms in which the children are cared for are located on a level of 
96.1 	exit discharge and each of these child care rooms has an exit door directly to the exterior, 
96.2 	then the applicable fire code is Group E occupancies, as provided in the Minnesota State 
96.3 	Fire Code 2015, Section 202; and
96.4 	(7) any age and capacity limitations required by the fire code inspection and square 
96.5 	footage determinations shall be printed on the license; or
96.6 	(f) the license holder is the primary provider of care and has located the licensed child 
96.7 	care program in a commercial space, if the license holder meets the following requirements:
96.8 	(1) the program is in compliance with local zoning regulations;
96.9 	(2) the program is in compliance with the applicable fire code as follows:
96.10 	(i) if the program serves more than five children older than 2-1/2 years of age, but no 
96.11 	more than five children 2-1/2 years of age or less, the applicable fire code is educational 
96.12 	occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015, 
96.13 	Section 202; or
96.14 	(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable 
96.15 	fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire Code 2015, 
96.16 	Section 202;
96.17 	(3) any age and capacity limitations required by the fire code inspection and square 
96.18 	footage determinations are printed on the license; and
96.19 	(4) the license holder prominently displays the license issued by the commissioner which 
96.20 	contains the statement "This special family child care provider is not licensed as a child 
96.21 	care center."
96.22 	(g) The commissioner may approve two or more licenses under paragraphs (a) to (f) to 
96.23 	be issued at the same location or under one contiguous roof, if each license holder is able 
96.24 	to demonstrate compliance with all applicable rules and laws. Each license holder must 
96.25 	operate the license holder's respective licensed program as a distinct program and within 
96.26 	the capacity, age, and ratio distributions of each license. Notwithstanding Minnesota Rules, 
96.27 	part 9502.0335, subpart 12, the commissioner may issue up to four licenses to an organization 
96.28 	licensed under paragraphs (b), (c), or (e). Each license must have its own primary provider 
96.29 	of care as required under paragraph (i). Each license must operate as a distinct and separate 
96.30 	program in compliance with all applicable laws and regulations.
96.31 	(h) The commissioner may grant variances to this section to allow a primary provider 
96.32 	of care, a not-for-profit organization, a church or religious organization, an employer, or a 
96.33 	community collaborative to be licensed to provide child care under paragraphs (e) and (f) 
97.1 	if the license holder meets the other requirements of the statute. For licenses issued under 
97.2 	paragraphs (b), (c), (d), (e), or (f), the commissioner may approve up to four licenses at the 
97.3 	same location or under one contiguous roof if each license holder is able to demonstrate 
97.4 	compliance with all applicable rules and laws. Each licensed program must operate as a 
97.5 	distinct program and within the capacity, age, and ratio distributions of each license.
97.6 	(i) For a license issued under paragraphs (b), (c), or (e), the license holder must designate 
97.7 	a person to be the primary provider of care at the licensed location on a form and in a manner 
97.8 	prescribed by the commissioner. The license holder shall notify the commissioner in writing 
97.9 	before there is a change of the person designated to be the primary provider of care. The 
97.10 	primary provider of care:
97.11 	(1) must be the person who will be the provider of care at the program and present during 
97.12 	the hours of operation;
97.13 	(2) must operate the program in compliance with applicable laws and regulations under 
97.14 	chapter 245A and Minnesota Rules, chapter 9502;
97.15 	(3) is considered a child care background study subject as defined in section 245C.02, 
97.16 	subdivision 6a, and must comply with background study requirements in chapter 245C; and
97.17 	(4) must complete the training that is required of license holders in section 245A.50.
97.18 	(j) For any license issued under this subdivision, the license holder must ensure that any 
97.19 	other caregiver, substitute, or helper who assists in the care of children meets the training 
97.20 	requirements in section 245A.50 and background study requirements under chapter 245C.

97.21 	Sec. 9. Minnesota Statutes 2020, section 245A.16, is amended by adding a subdivision to 
97.22 	read:
97.23 		Subd. 9.Licensed family foster settings. (a) Before recommending to grant a license, 
97.24 	deny a license under section 245A.05, or revoke a license under section 245A.07 for 
97.25 	nondisqualifying background study information received under section 245C.05, subdivision 
97.26 	4, paragraph (a), clause (3), for a licensed family foster setting, a county agency or private 
97.27 	agency that has been designated or licensed by the commissioner must review the following:
97.28 	(1) the type of offenses;
97.29 	(2) the number of offenses;
97.30 	(3) the nature of the offenses;
97.31 	(4) the age of the individual at the time of the offenses;
98.1 	(5) the length of time that has elapsed since the last offense;
98.2 	(6) the relationship of the offenses and the capacity to care for a child;
98.3 	(7) evidence of rehabilitation;
98.4 	(8) information or knowledge from community members regarding the individual's 
98.5 	capacity to provide foster care;
98.6 	(9) any available information regarding child maltreatment reports or child in need of 
98.7 	protection or services petitions, or related cases, in which the individual has been involved 
98.8 	or implicated, and documentation that the individual has remedied issues or conditions 
98.9 	identified in child protection or court records that are relevant to safely caring for a child;
98.10 	(10) a statement from the study subject;
98.11 	(11) a statement from the license holder; and
98.12 	(12) other aggravating and mitigating factors.
98.13 	(b) For purposes of this section, "evidence of rehabilitation" includes but is not limited 
98.14 	to the following:
98.15 	(1) maintaining a safe and stable residence;
98.16 	(2) continuous, regular, or stable employment;
98.17 	(3) successful participation in an education or job training program;
98.18 	(4) positive involvement with the community or extended family;
98.19 	(5) compliance with the terms and conditions of probation or parole following the 
98.20 	individual's most recent conviction;
98.21 	(6) if the individual has had a substance use disorder, successful completion of a substance 
98.22 	use disorder assessment, substance use disorder treatment, and recommended continuing 
98.23 	care, if applicable, demonstrated abstinence from controlled substances, as defined in section 
98.24 	152.01, subdivision 4, or the establishment of a sober network;
98.25 	(7) if the individual has had a mental illness or documented mental health issues, 
98.26 	demonstrated completion of a mental health evaluation, participation in therapy or other 
98.27 	recommended mental health treatment, or appropriate medication management, if applicable;
98.28 	(8) if the individual's offense or conduct involved domestic violence, demonstrated 
98.29 	completion of a domestic violence or anger management program, and the absence of any 
98.30 	orders for protection or harassment restraining orders against the individual since the previous 
98.31 	offense or conduct;
99.1 	(9) written letters of support from individuals of good repute, including but not limited 
99.2 	to employers, members of the clergy, probation or parole officers, volunteer supervisors, 
99.3 	or social services workers;
99.4 	(10) demonstrated remorse for convictions or conduct, or demonstrated positive behavior 
99.5 	changes; and
99.6 	(11) absence of convictions or arrests since the previous offense or conduct, including 
99.7 	any convictions that were expunged or pardoned.
99.8 	(c) An applicant for a family foster setting license must sign all releases of information 
99.9 	requested by the county or private licensing agency.
99.10 	(d) When licensing a relative for a family foster setting, the commissioner shall also 
99.11 	consider the importance of maintaining the child's relationship with relatives as an additional 
99.12 	significant factor in determining whether an application will be denied.
99.13 	(e) When recommending that the commissioner deny or revoke a license, the county or 
99.14 	private licensing agency must send a summary of the review completed according to 
99.15 	paragraph (a), on a form developed by the commissioner, to the commissioner and include 
99.16 	any recommendation for licensing action.

99.17 	EFFECTIVE DATE. This section is effective July 1, 2022.

99.18 	Sec. 10. Minnesota Statutes 2020, section 245A.50, subdivision 7, is amended to read:
99.19 		Subd. 7.Training requirements for family and group family child care. (a) For 
99.20 	purposes of family and group family child care, the license holder and each second adult 
99.21 	caregiver must complete 16 hours of ongoing training each year. Repeat of topical training 
99.22 	requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training 
99.23 	requirement. Additional ongoing training subjects to meet the annual 16-hour training 
99.24 	requirement must be selected from the following areas:
99.25 	(1) child development and learning training in understanding how a child develops 
99.26 	physically, cognitively, emotionally, and socially, and how a child learns as part of the 
99.27 	child's family, culture, and community;
99.28 	(2) developmentally appropriate learning experiences, including training in creating 
99.29 	positive learning experiences, promoting cognitive development, promoting social and 
99.30 	emotional development, promoting physical development, promoting creative development; 
99.31 	and behavior guidance;
100.1 	(3) relationships with families, including training in building a positive, respectful 
100.2 	relationship with the child's family;
100.3 	(4) assessment, evaluation, and individualization, including training in observing, 
100.4 	recording, and assessing development; assessing and using information to plan; and assessing 
100.5 	and using information to enhance and maintain program quality;
100.6 	(5) historical and contemporary development of early childhood education, including 
100.7 	training in past and current practices in early childhood education and how current events 
100.8 	and issues affect children, families, and programs;
100.9 	(6) professionalism, including training in knowledge, skills, and abilities that promote 
100.10 	ongoing professional development; and
100.11 	(7) health, safety, and nutrition, including training in establishing healthy practices; 
100.12 	ensuring safety; and providing healthy nutrition.
100.13 	(b) A provider who is approved as a trainer through the Develop data system may count 
100.14 	up to two hours of training instruction toward the annual 16-hour training requirement in 
100.15 	paragraph (a). The provider may only count training instruction hours for the first instance 
100.16 	in which they deliver a particular content-specific training during each licensing year. Hours 
100.17 	counted as training instruction must be approved through the Develop data system with 
100.18 	attendance verified on the trainer's individual learning record and must be in Knowledge 
100.19 	and Competency Framework content area VII A (Establishing Healthy Practices) or B 
100.20 	(Ensuring Safety).

100.21 	Sec. 11. Minnesota Statutes 2020, section 245A.50, subdivision 9, is amended to read:
100.22 		Subd. 9.Supervising for safety; training requirement. (a) Courses required by this 
100.23 	subdivision must include the following health and safety topics:
100.24 	(1) preventing and controlling infectious diseases;
100.25 	(2) administering medication;
100.26 	(3) preventing and responding to allergies;
100.27 	(4) ensuring building and physical premises safety;
100.28 	(5) handling and storing biological contaminants;
100.29 	(6) preventing and reporting child abuse and maltreatment; and
100.30 	(7) emergency preparedness.
101.1 	(b) Before initial licensure and before caring for a child, all family child care license 
101.2 	holders and each second adult caregiver shall complete and document the completion of 
101.3 	the six-hour Supervising for Safety for Family Child Care course developed by the 
101.4 	commissioner.
101.5 	(c) The license holder must ensure and document that, before caring for a child, all 
101.6 	substitutes have completed the four-hour Basics of Licensed Family Child Care for 
101.7 	Substitutes course developed by the commissioner, which must include health and safety 
101.8 	topics as well as child development and learning.
101.9 	(d) The family child care license holder and each second adult caregiver shall complete 
101.10 	and document:
101.11 	(1) the annual completion of either:
101.12 	(i) a two-hour active supervision course developed by the commissioner; or
101.13 	(ii) any courses in the ensuring safety competency area under the health, safety, and 
101.14 	nutrition standard of the Knowledge and Competency Framework that the commissioner 
101.15 	has identified as an active supervision training course; and
101.16 	(2) the completion at least once every five years of the two-hour courses Health and 
101.17 	Safety I and Health and Safety II. When the training is due for the first time or expires, it 
101.18 	must be taken no later than the day before the anniversary of the license holder's license 
101.19 	effective date. A license holder's or second adult caregiver's completion of either training 
101.20 	in a given year meets the annual active supervision training requirement in clause (1).
101.21 	(e) At least once every three years, license holders must ensure and document that 
101.22 	substitutes have completed the four-hour Basics of Licensed Family Child Care for 
101.23 	Substitutes course. When the training expires, it must be retaken no later than the day before 
101.24 	the anniversary of the license holder's license effective date.

101.25 	Sec. 12. Minnesota Statutes 2020, section 245C.02, subdivision 4a, is amended to read:
101.26 		Subd. 4a.Authorized fingerprint collection vendor. "Authorized fingerprint collection 
101.27 	vendor" means a qualified organization under a written contract with the commissioner to 
101.28 	provide services in accordance with section 245C.05, subdivision 5, paragraph (b). The 
101.29 	commissioner may retain the services of more than one authorized fingerprint collection 
101.30 	vendor.

102.1 	Sec. 13. Minnesota Statutes 2020, section 245C.02, subdivision 5, is amended to read:
102.2 		Subd. 5.Background study. "Background study" means:
102.3 	(1) the collection and processing of a background study subject's fingerprints, including 
102.4 	the process of obtaining a background study subject's classifiable fingerprints and photograph 
102.5 	as required by section 245C.05, subdivision 5, paragraph (b); and
102.6 	(2) the review of records conducted by the commissioner to determine whether a subject 
102.7 	is disqualified from direct contact with persons served by a program and, where specifically 
102.8 	provided in statutes, whether a subject is disqualified from having access to persons served 
102.9 	by a program and from working in a children's residential facility or foster residence setting.

102.10 	Sec. 14. Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision 
102.11 	to read:
102.12 		Subd. 5b.Alternative background study. "Alternative background study" means:
102.13 	(1) the collection and processing of a background study subject's fingerprints, including 
102.14 	the process of obtaining a background study subject's classifiable fingerprints and photograph 
102.15 	as required by section 245C.05, subdivision 5, paragraph (b); and
102.16 	(2) a review of records conducted by the commissioner pursuant to section 245C.08 in 
102.17 	order to forward the background study investigating information to the entity that submitted 
102.18 	the alternative background study request under section 245C.031, subdivision 2. The 
102.19 	commissioner shall not make any eligibility determinations on background studies conducted 
102.20 	under section 245C.031.

102.21 	Sec. 15. Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision 
102.22 	to read:
102.23 		Subd. 11c.Entity. "Entity" means any program, organization, or agency initiating a 
102.24 	background study.

102.25 	Sec. 16. Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision 
102.26 	to read:
102.27 		Subd. 16a.Results. "Results" means a determination that a study subject is eligible, 
102.28 	disqualified, set aside, granted a variance, or that more time is needed to complete the 
102.29 	background study.

103.1 	Sec. 17. Minnesota Statutes 2020, section 245C.03, is amended to read:
103.2 	245C.03 BACKGROUND STUDY; INDIVIDUALS TO BE STUDIED.
103.3 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a background 
103.4 	study on:
103.5 	(1) the person or persons applying for a license;
103.6 	(2) an individual age 13 and over living in the household where the licensed program 
103.7 	will be provided who is not receiving licensed services from the program;
103.8 	(3) current or prospective employees or contractors of the applicant who will have direct 
103.9 	contact with persons served by the facility, agency, or program;
103.10 	(4) volunteers or student volunteers who will have direct contact with persons served 
103.11 	by the program to provide program services if the contact is not under the continuous, direct 
103.12 	supervision by an individual listed in clause (1) or (3);
103.13 	(5) an individual age ten to 12 living in the household where the licensed services will 
103.14 	be provided when the commissioner has reasonable cause as defined in section 245C.02, 
103.15 	subdivision 15;
103.16 	(6) an individual who, without providing direct contact services at a licensed program, 
103.17 	may have unsupervised access to children or vulnerable adults receiving services from a 
103.18 	program, when the commissioner has reasonable cause as defined in section 245C.02, 
103.19 	subdivision 15;
103.20 	(7) all controlling individuals as defined in section 245A.02, subdivision 5a;
103.21 	(8) notwithstanding the other requirements in this subdivision, child care background 
103.22 	study subjects as defined in section 245C.02, subdivision 6a; and
103.23 	(9) notwithstanding clause (3), for children's residential facilities and foster residence 
103.24 	settings, any adult working in the facility, whether or not the individual will have direct 
103.25 	contact with persons served by the facility.
103.26 	(b) For child foster care when the license holder resides in the home where foster care 
103.27 	services are provided, a short-term substitute caregiver providing direct contact services for 
103.28 	a child for less than 72 hours of continuous care is not required to receive a background 
103.29 	study under this chapter.
103.30 	(c) This subdivision applies to the following programs that must be licensed under 
103.31 	chapter 245A:
104.1 	(1) adult foster care;
104.2 	(2) child foster care;
104.3 	(3) children's residential facilities;
104.4 	(4) family child care;
104.5 	(5) licensed child care centers;
104.6 	(6) licensed home and community-based services under chapter 245D;
104.7 	(7) residential mental health programs for adults;
104.8 	(8) substance use disorder treatment programs under chapter 245G;
104.9 	(9) withdrawal management programs under chapter 245F;
104.10 	(10) programs that provide treatment services to persons with sexual psychopathic 
104.11 	personalities or sexually dangerous persons;
104.12 	(11) adult day care centers;
104.13 	(12) family adult day services;
104.14 	(13) independent living assistance for youth;
104.15 	(14) detoxification programs;
104.16 	(15) community residential settings; and
104.17 	(16) intensive residential treatment services and residential crisis stabilization under 
104.18 	chapter 245I.
104.19 		Subd. 1a.Procedure. (a) Individuals and organizations that are required under this 
104.20 	section to have or initiate background studies shall comply with the requirements of this 
104.21 	chapter.
104.22 	(b) All studies conducted under this section shall be conducted according to sections 
104.23 	299C.60 to 299C.64. This requirement does not apply to subdivisions 1, paragraph (c), 
104.24 	clauses (2) to (5), and 6a.
104.25 		Subd. 2.Personal care provider organizations. The commissioner shall conduct 
104.26 	background studies on any individual required under sections 256B.0651 to 256B.0654 and 
104.27 	256B.0659 to have a background study completed under this chapter.
104.28 		Subd. 3.Supplemental nursing services agencies. The commissioner shall conduct all 
104.29 	background studies required under this chapter and initiated by supplemental nursing services 
104.30 	agencies registered under section 144A.71, subdivision 1.
105.1 		Subd. 3a.Personal care assistance provider agency; background studies. Personal 
105.2 	care assistance provider agencies enrolled to provide personal care assistance services under 
105.3 	the medical assistance program must meet the following requirements:
105.4 	(1) owners who have a five percent interest or more and all managing employees are 
105.5 	subject to a background study as provided in this chapter. This requirement applies to 
105.6 	currently enrolled personal care assistance provider agencies and agencies seeking enrollment 
105.7 	as a personal care assistance provider agency. "Managing employee" has the same meaning 
105.8 	as Code of Federal Regulations, title 42, section 455.101. An organization is barred from 
105.9 	enrollment if:
105.10 	(i) the organization has not initiated background studies of owners and managing 
105.11 	employees; or
105.12 	(ii) the organization has initiated background studies of owners and managing employees 
105.13 	and the commissioner has sent the organization a notice that an owner or managing employee 
105.14 	of the organization has been disqualified under section 245C.14, and the owner or managing 
105.15 	employee has not received a set aside of the disqualification under section 245C.22; and
105.16 	(2) a background study must be initiated and completed for all qualified professionals.
105.17 		Subd. 3b.Exception to personal care assistant; requirements. The personal care 
105.18 	assistant for a recipient may be allowed to enroll with a different personal care assistance 
105.19 	provider agency upon initiation of a new background study according to this chapter if:
105.20 	(1) the commissioner determines that a change in enrollment or affiliation of the personal 
105.21 	care assistant is needed in order to ensure continuity of services and protect the health and 
105.22 	safety of the recipient;
105.23 	(2) the chosen agency has been continuously enrolled as a personal care assistance 
105.24 	provider agency for at least two years;
105.25 	(3) the recipient chooses to transfer to the personal care assistance provider agency;
105.26 	(4) the personal care assistant has been continuously enrolled with the former personal 
105.27 	care assistance provider agency since the last background study was completed; and
105.28 	(5) the personal care assistant continues to meet requirements of section 256B.0659, 
105.29 	subdivision 11, notwithstanding paragraph (a), clause (3).
105.30 		Subd. 4.Personnel agencies; educational programs; professional services 
105.31 	agencies. The commissioner also may conduct studies on individuals specified in subdivision 
105.32 	1, paragraph (a), clauses (3) and (4), when the studies are initiated by:
106.1 	(1) personnel pool agencies;
106.2 	(2) temporary personnel agencies;
106.3 	(3) educational programs that train individuals by providing direct contact services in 
106.4 	licensed programs; and
106.5 	(4) professional services agencies that are not licensed and which contract with licensed 
106.6 	programs to provide direct contact services or individuals who provide direct contact services.
106.7 		Subd. 5.Other state agencies. The commissioner shall conduct background studies on 
106.8 	applicants and license holders under the jurisdiction of other state agencies who are required 
106.9 	in other statutory sections to initiate background studies under this chapter, including the 
106.10 	applicant's or license holder's employees, contractors, and volunteers when required under 
106.11 	other statutory sections.
106.12 		Subd. 5a.Facilities serving children or adults licensed or regulated by the 
106.13 	Department of Health. (a) The commissioner shall conduct background studies of:
106.14 	(1) individuals providing services who have direct contact, as defined under section 
106.15 	245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes, 
106.16 	outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and 
106.17 	home care agencies licensed under chapter 144A; assisted living facilities and assisted living 
106.18 	facilities with dementia care licensed under chapter 144G; and board and lodging 
106.19 	establishments that are registered to provide supportive or health supervision services under 
106.20 	section 157.17;
106.21 	(2) individuals specified in subdivision 2 who provide direct contact services in a nursing 
106.22 	home or a home care agency licensed under chapter 144A; an assisted living facility or 
106.23 	assisted living facility with dementia care licensed under chapter 144G; or a boarding care 
106.24 	home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides 
106.25 	outside of Minnesota, the study must include a check for substantiated findings of 
106.26 	maltreatment of adults and children in the individual's state of residence when the state 
106.27 	makes the information available;
106.28 	(3) all other employees in assisted living facilities or assisted living facilities with 
106.29 	dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A, 
106.30 	and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of 
106.31 	an individual in this section shall disqualify the individual from positions allowing direct 
106.32 	contact with or access to patients or residents receiving services. "Access" means physical 
106.33 	access to a client or the client's personal property without continuous, direct supervision as 
107.1 	defined in section 245C.02, subdivision 8, when the employee's employment responsibilities 
107.2 	do not include providing direct contact services;
107.3 	(4) individuals employed by a supplemental nursing services agency, as defined under 
107.4 	section 144A.70, who are providing services in health care facilities; and
107.5 	(5) controlling persons of a supplemental nursing services agency, as defined by section 
107.6 	144A.70.
107.7 	(b) If a facility or program is licensed by the Department of Human Services and the 
107.8 	Department of Health and is subject to the background study provisions of this chapter, the 
107.9 	Department of Human Services is solely responsible for the background studies of individuals 
107.10 	in the jointly licensed program.
107.11 	(c) The commissioner of health shall review and make decisions regarding reconsideration 
107.12 	requests, including whether to grant variances, according to the procedures and criteria in 
107.13 	this chapter. The commissioner of health shall inform the requesting individual and the 
107.14 	Department of Human Services of the commissioner of health's decision regarding the 
107.15 	reconsideration. The commissioner of health's decision to grant or deny a reconsideration 
107.16 	of a disqualification is a final administrative agency action.
107.17 		Subd. 5b.Facilities serving children or youth licensed by the Department of 
107.18 	Corrections. (a) The commissioner shall conduct background studies of individuals working 
107.19 	in secure and nonsecure children's residential facilities, juvenile detention facilities, and 
107.20 	foster residence settings, whether or not the individual will have direct contact, as defined 
107.21 	under section 245C.02, subdivision 11, with persons served in the facilities or settings.
107.22 	(b) A clerk or administrator of any court, the Bureau of Criminal Apprehension, a 
107.23 	prosecuting attorney, a county sheriff, or a chief of a local police department shall assist in 
107.24 	conducting background studies by providing the commissioner of human services or the 
107.25 	commissioner's representative all criminal conviction data available from local and state 
107.26 	criminal history record repositories related to applicants, operators, all persons living in a 
107.27 	household, and all staff of any facility subject to background studies under this subdivision.
107.28 	(c) For the purpose of this subdivision, the term "secure and nonsecure residential facility 
107.29 	and detention facility" includes programs licensed or certified under section 241.021, 
107.30 	subdivision 2.
107.31 	(d) If an individual is disqualified, the Department of Human Services shall notify the 
107.32 	disqualified individual and the facility in which the disqualified individual provides services 
107.33 	of the disqualification and shall inform the disqualified individual of the right to request a 
108.1 	reconsideration of the disqualification by submitting the request to the Department of 
108.2 	Corrections.
108.3 	(e) The commissioner of corrections shall review and make decisions regarding 
108.4 	reconsideration requests, including whether to grant variances, according to the procedures 
108.5 	and criteria in this chapter. The commissioner of corrections shall inform the requesting 
108.6 	individual and the Department of Human Services of the commissioner of corrections' 
108.7 	decision regarding the reconsideration. The commissioner of corrections' decision to grant 
108.8 	or deny a reconsideration of a disqualification is the final administrative agency action.
108.9 		Subd. 6.Unlicensed home and community-based waiver providers of service to 
108.10 	seniors and individuals with disabilities. (a) The commissioner shall conduct background 
108.11 	studies on of any individual required under section 256B.4912 to have a background study 
108.12 	completed under this chapter who provides direct contact, as defined in section 245C.02, 
108.13 	subdivision 11, for services specified in the federally approved home and community-based 
108.14 	waiver plans under section 256B.4912. The individual studied must meet the requirements 
108.15 	of this chapter prior to providing waiver services and as part of ongoing enrollment.
108.16 	(b) The requirements in paragraph (a) apply to consumer-directed community supports 
108.17 	under section 256B.4911.
108.18 		Subd. 6a.Legal nonlicensed and certified child care programs. The commissioner 
108.19 	shall conduct background studies on an individual of the following individuals as required 
108.20 	under by sections 119B.125 and 245H.10to complete a background study under this chapter.:
108.21 	(1) every individual who applies for certification;
108.22 	(2) every member of a provider's household who is age 13 and older and lives in the 
108.23 	household where nonlicensed child care is provided; and
108.24 	(3) an individual who is at least ten years of age and under 13 years of age and lives in 
108.25 	the household where the nonlicensed child care will be provided when the county has 
108.26 	reasonable cause as defined under section 245C.02, subdivision 15.
108.27 		Subd. 7.Children's therapeutic services and supports providers. The commissioner 
108.28 	shall conduct background studies according to this chapter when initiated by a children's 
108.29 	therapeutic services and supports provider of all direct service providers and volunteers for 
108.30 	children's therapeutic services and supports providers under section 256B.0943.
108.31 		Subd. 8.Self-initiated background studies. Upon implementation of NETStudy 2.0, 
108.32 	the commissioner shall conduct background studies according to this chapter when initiated 
109.1 	by an individual who is not on the master roster. A subject under this subdivision who is 
109.2 	not disqualified must be placed on the inactive roster.
109.3 		Subd. 9.Community first services and supports and financial management services 
109.4 	organizations. The commissioner shall conduct background studies on any individual 
109.5 	required under section 256B.85 to have a background study completed under this chapter.
109.6 	Individuals affiliated with Community First Services and Supports (CFSS) agency-providers 
109.7 	and Financial Management Services (FMS) providers enrolled to provide CFSS services 
109.8 	under the medical assistance program must meet the following requirements:
109.9 	(1) owners who have a five percent interest or more and all managing employees are 
109.10 	subject to a background study under this chapter. This requirement applies to currently 
109.11 	enrolled providers and agencies seeking enrollment. "Managing employee" has the meaning 
109.12 	given in Code of Federal Regulations, title 42, section 455.101. An organization is barred 
109.13 	from enrollment if:
109.14 	(i) the organization has not initiated background studies of owners and managing 
109.15 	employees; or
109.16 	(ii) the organization has initiated background studies of owners and managing employees 
109.17 	and the commissioner has sent the organization a notice that an owner or managing employee 
109.18 	of the organization has been disqualified under section 245C.14 and the owner or managing 
109.19 	employee has not received a set aside of the disqualification under section 245C.22;
109.20 	(2) a background study must be initiated and completed for all staff who will have direct 
109.21 	contact with the participant to provide worker training and development; and
109.22 	(3) a background study must be initiated and completed for all support workers.
109.23 		Subd. 9a.Exception to support worker requirements for continuity of services. The 
109.24 	support worker for a participant may enroll with a different Community First Services and 
109.25 	Supports (CFSS) agency-provider or Financial Management Services (FMS) provider upon 
109.26 	initiation, rather than completion, of a new background study according to this chapter if:
109.27 	(1) the commissioner determines that the support worker's change in enrollment or 
109.28 	affiliation is necessary to ensure continuity of services and to protect the health and safety 
109.29 	of the participant;
109.30 	(2) the chosen agency-provider or FMS provider has been continuously enrolled as a 
109.31 	CFSS agency-provider or FMS provider for at least two years or since the inception of the 
109.32 	CFSS program, whichever is shorter;
110.1 	(3) the participant served by the support worker chooses to transfer to the CFSS 
110.2 	agency-provider or the FMS provider to which the support worker is transferring;
110.3 	(4) the support worker has been continuously enrolled with the former CFSS 
110.4 	agency-provider or FMS provider since the support worker's last background study was 
110.5 	completed; and
110.6 	(5) the support worker continues to meet the requirements of section 256B.85, subdivision 
110.7 	16, notwithstanding paragraph (a), clause (1).
110.8 		Subd. 10.Providers of group residential housing or supplementary services. (a) The 
110.9 	commissioner shall conduct background studies on any individual required under section 
110.10 	256I.04 to have a background study completed under this chapter. of the following individuals 
110.11 	who provide services under section 256I.04:
110.12 	(1) controlling individuals as defined in section 245A.02;
110.13 	(2) managerial officials as defined in section 245A.02; and
110.14 	(3) all employees and volunteers of the establishment who have direct contact with 
110.15 	recipients or who have unsupervised access to recipients, recipients' personal property, or 
110.16 	recipients' private data.
110.17 	(b) The provider of housing support must comply with all requirements for entities 
110.18 	initiating background studies under this chapter.
110.19 	(c) A provider of housing support must demonstrate that all individuals who are required 
110.20 	to have a background study according to paragraph (a) have a notice stating that:
110.21 	(1) the individual is not disqualified under section 245C.14; or
110.22 	(2) the individual is disqualified and the individual has been issued a set aside of the 
110.23 	disqualification for the setting under section 245C.22.
110.24 		Subd. 11.Child protection workers or social services staff having responsibility for 
110.25 	child protective duties. (a) The commissioner must complete background studies, according 
110.26 	to paragraph (b) and section 245C.04, subdivision 10, when initiated by a county social 
110.27 	services agency or by a local welfare agency according to section 626.559, subdivision 1b.
110.28 	(b) For background studies completed by the commissioner under this subdivision, the 
110.29 	commissioner shall not make a disqualification decision, but shall provide the background 
110.30 	study information received to the county that initiated the study.
110.31 		Subd. 12.Providers of special transportation service. (a) The commissioner shall 
110.32 	conduct background studies on any individual required under section 174.30 to have a 
111.1 	background study completed under this chapter. of the following individuals who provide 
111.2 	special transportation services under section 174.30:
111.3 	(1) each person with a direct or indirect ownership interest of five percent or higher in 
111.4 	a transportation service provider;
111.5 	(2) each controlling individual as defined under section 245A.02;
111.6 	(3) a managerial official as defined in section 245A.02;
111.7 	(4) each driver employed by the transportation service provider;
111.8 	(5) each individual employed by the transportation service provider to assist a passenger 
111.9 	during transport; and
111.10 	(6) each employee of the transportation service agency who provides administrative 
111.11 	support, including an employee who:
111.12 	(i) may have face-to-face contact with or access to passengers, passengers' personal 
111.13 	property, or passengers' private data;
111.14 	(ii) performs any scheduling or dispatching tasks; or
111.15 	(iii) performs any billing activities.
111.16 	(b) When a local or contracted agency is authorizing a ride under section 256B.0625, 
111.17 	subdivision 17, by a volunteer driver, and the agency authorizing the ride has a reason to 
111.18 	believe that the volunteer driver has a history that would disqualify the volunteer driver or 
111.19 	that may pose a risk to the health or safety of passengers, the agency may initiate a 
111.20 	background study that shall be completed according to this chapter using the commissioner 
111.21 	of human services' online NETStudy system, or by contacting the Department of Human 
111.22 	Services background study division for assistance. The agency that initiates the background 
111.23 	study under this paragraph shall be responsible for providing the volunteer driver with the 
111.24 	privacy notice required by section 245C.05, subdivision 2c, and with the payment for the 
111.25 	background study required by section 245C.10 before the background study is completed.
111.26 		Subd. 13.Providers of housing support services. The commissioner shall conduct 
111.27 	background studies on of any individual provider of housing support services required under
111.28 	by section 256B.051 to have a background study completed under this chapter.
111.29 		Subd. 14.Tribal nursing facilities. For completed background studies to comply with 
111.30 	a Tribal organization's licensing requirements for individuals affiliated with a tribally licensed 
111.31 	nursing facility, the commissioner shall obtain state and national criminal history data.
112.1 		Subd. 15.Early intensive developmental and behavioral intervention providers. The 
112.2 	commissioner shall conduct background studies according to this chapter when initiated by 
112.3 	an early intensive developmental and behavioral intervention provider under section 
112.4 	256B.0949.

112.5 	EFFECTIVE DATE. This section is effective July 1, 2021, except subdivision 6, 
112.6 	paragraph (b), is effective upon federal approval and subdivision 15 is effective the day 
112.7 	following final enactment. The commissioner of human services shall notify the revisor of 
112.8 	statutes when federal approval is obtained.

112.9 	Sec. 18. [245C.031] BACKGROUND STUDY; ALTERNATIVE BACKGROUND 
112.10 	STUDIES.
112.11 		Subdivision 1.Alternative background studies. (a) The commissioner shall conduct 
112.12 	an alternative background study of individuals listed in this section.
112.13 	(b) Notwithstanding other sections of this chapter, all alternative background studies 
112.14 	except subdivision 12 shall be conducted according to this section and with section 299C.60 
112.15 	to 299C.64.
112.16 	(c) All terms in this section shall have the definitions provided in section 245C.02.
112.17 	(d) The entity that submits an alternative background study request under this section 
112.18 	shall submit the request to the commissioner according to section 245C.05.
112.19 	(e) The commissioner shall comply with the destruction requirements in section 245C.051.
112.20 	(f) Background studies conducted under this section are subject to the provisions of 
112.21 	section 245C.32.
112.22 	(g) The commissioner shall forward all information that the commissioner receives under 
112.23 	section 245C.08 to the entity that submitted the alternative background study request under 
112.24 	subdivision 2. The commissioner shall not make any eligibility determinations regarding 
112.25 	background studies conducted under this section.
112.26 		Subd. 2.Access to information. Each entity that submits an alternative background 
112.27 	study request shall enter into an agreement with the commissioner before submitting requests 
112.28 	for alternative background studies under this section. As a part of the agreement, the entity 
112.29 	must agree to comply with state and federal law.
112.30 		Subd. 3.Child protection workers or social services staff having responsibility for 
112.31 	child protective duties. The commissioner shall conduct an alternative background study 
112.32 	of any person who has responsibility for child protection duties when the background study 
113.1 	is initiated by a county social services agency or by a local welfare agency according to 
113.2 	section 260E.36, subdivision 3.
113.3 		Subd. 4.Applicants, licensees, and other occupations regulated by the commissioner 
113.4 	of health. The commissioner shall conduct an alternative background study, including a 
113.5 	check of state data, and a national criminal history records check of the following individuals. 
113.6 	For studies under this section, the following persons shall complete a consent form:
113.7 	(1) an applicant for initial licensure, temporary licensure, or relicensure after a lapse in 
113.8 	licensure as an audiologist or speech-language pathologist or an applicant for initial 
113.9 	certification as a hearing instrument dispenser who must submit to a background study 
113.10 	under section 144.0572.
113.11 	(2) an applicant for a renewal license or certificate as an audiologist, speech-language 
113.12 	pathologist, or hearing instrument dispenser who was licensed or obtained a certificate 
113.13 	before January 1, 2018.
113.14 		Subd. 5.Guardians and conservators. (a) The commissioner shall conduct an alternative 
113.15 	background study of:
113.16 	(1) every court-appointed guardian and conservator, unless a background study has been 
113.17 	completed of the person under this section within the previous five years. The alternative 
113.18 	background study shall be completed prior to the appointment of the guardian or conservator, 
113.19 	unless a court determines that it would be in the best interests of the ward or protected person 
113.20 	to appoint a guardian or conservator before the alternative background study can be 
113.21 	completed. If the court appoints the guardian or conservator while the alternative background 
113.22 	study is pending, the alternative background study must be completed as soon as reasonably 
113.23 	possible after the guardian or conservator's appointment and no later than 30 days after the 
113.24 	guardian or conservator's appointment; and
113.25 	(2) a guardian and a conservator once every five years after the guardian or conservator's 
113.26 	appointment if the person continues to serve as a guardian or conservator.
113.27 	(b) An alternative background study is not required if the guardian or conservator is:
113.28 	(1) a state agency or county;
113.29 	(2) a parent or guardian of a proposed ward or protected person who has a developmental 
113.30 	disability if the parent or guardian has raised the proposed ward or protected person in the 
113.31 	family home until the time that the petition is filed, unless counsel appointed for the proposed 
113.32 	ward or protected person under section 524.5-205, paragraph (d); 524.5-304, paragraph (b); 
114.1 	524.5-405, paragraph (a); or 524.5-406, paragraph (b), recommends a background study; 
114.2 	or
114.3 	(3) a bank with trust powers, a bank and trust company, or a trust company, organized 
114.4 	under the laws of any state or of the United States and regulated by the commissioner of 
114.5 	commerce or a federal regulator.
114.6 		Subd. 6.Guardians and conservators; required checks. (a) An alternative background 
114.7 	study for a guardian or conservator pursuant to subdivision 5 shall include:
114.8 	(1) criminal history data from the Bureau of Criminal Apprehension and other criminal 
114.9 	history data obtained by the commissioner of human services;
114.10 	(2) data regarding whether the person has been a perpetrator of substantiated maltreatment 
114.11 	of a vulnerable adult under section 626.557 or a minor under chapter 260E. If the subject 
114.12 	of the study has been the perpetrator of substantiated maltreatment of a vulnerable adult or 
114.13 	a minor, the commissioner must include a copy of the public portion of the investigation 
114.14 	memorandum under section 626.557, subdivision 12b, or the public portion of the 
114.15 	investigation memorandum under section 260E.30. The commissioner shall provide the 
114.16 	court with information from a review of information according to subdivision 7 if the study 
114.17 	subject provided information that the study subject has a current or prior affiliation with a 
114.18 	state licensing agency;
114.19 	(3) criminal history data from a national criminal history record check as defined in 
114.20 	section 245C.02, subdivision 13c; and
114.21 	(4) state licensing agency data if a search of the database or databases of the agencies 
114.22 	listed in subdivision 7 shows that the proposed guardian or conservator has held a 
114.23 	professional license directly related to the responsibilities of a professional fiduciary from 
114.24 	an agency listed in subdivision 7 that was conditioned, suspended, revoked, or canceled.
114.25 	(b) If the guardian or conservator is not an individual, the background study must be 
114.26 	completed of all individuals who are currently employed by the proposed guardian or 
114.27 	conservator who are responsible for exercising powers and duties under the guardianship 
114.28 	or conservatorship.
114.29 		Subd. 7.Guardians and conservators; state licensing data. (a) Within 25 working 
114.30 	days of receiving the request for an alternative background study of a guardian or conservator, 
114.31 	the commissioner shall provide the court with licensing agency data for licenses directly 
114.32 	related to the responsibilities of a guardian or conservator if the study subject has a current 
114.33 	or prior affiliation with the:
115.1 	(1) Lawyers Responsibility Board;
115.2 	(2) State Board of Accountancy;
115.3 	(3) Board of Social Work;
115.4 	(4) Board of Psychology;
115.5 	(5) Board or Nursing;
115.6 	(6) Board of Medical Practice;
115.7 	(7) Department of Education;
115.8 	(8) Department of Commerce;
115.9 	(9) Board of Chiropractic Examiners;
115.10 	(10) Board of Dentistry;
115.11 	(11) Board of Marriage and Family Therapy;
115.12 	(12) Department of Human Services;
115.13 	(13) Peace Officer Standards and Training (POST) Board; and
115.14 	(14) Professional Educator Licensing and Standards Board.
115.15 	(b) The commissioner and each of the agencies listed above, except for the Department 
115.16 	of Human Services, shall enter into a written agreement to provide the commissioner with 
115.17 	electronic access to the relevant licensing data and to provide the commissioner with a 
115.18 	quarterly list of new sanctions issued by the agency.
115.19 	(c) The commissioner shall provide to the court the electronically available data 
115.20 	maintained in the agency's database, including whether the proposed guardian or conservator 
115.21 	is or has been licensed by the agency and whether a disciplinary action or a sanction against 
115.22 	the individual's license, including a condition, suspension, revocation, or cancellation, is in 
115.23 	the licensing agency's database.
115.24 	(d) If the proposed guardian or conservator has resided in a state other than Minnesota 
115.25 	during the previous ten years, licensing agency data under this section shall also include 
115.26 	licensing agency data from any other state where the proposed guardian or conservator 
115.27 	reported to have resided during the previous ten years if the study subject has a current or 
115.28 	prior affiliation to the licensing agency. If the proposed guardian or conservator has or has 
115.29 	had a professional license in another state that is directly related to the responsibilities of a 
115.30 	guardian or conservator from one of the agencies listed under paragraph (a), state licensing 
115.31 	agency data shall also include data from the relevant licensing agency of the other state.
116.1 	(e) The commissioner is not required to repeat a search for Minnesota or out-of-state 
116.2 	licensing data on an individual if the commissioner has provided this information to the 
116.3 	court within the prior five years.
116.4 	(f) The commissioner shall review the information in paragraph (c) at least once every 
116.5 	four months to determine whether an individual who has been studied within the previous 
116.6 	five years:
116.7 	(1) has any new disciplinary action or sanction against the individual's license; or
116.8 	(2) did not disclose a prior or current affiliation with a Minnesota licensing agency.
116.9 	(g) If the commissioner's review in paragraph (f) identifies new information, the 
116.10 	commissioner shall provide any new information to the court.
116.11 		Subd. 8.Guardians ad litem. The commissioner shall conduct an alternative background 
116.12 	study of:
116.13 	(1) a guardian ad litem appointed under section 518.165 if a background study of the 
116.14 	guardian ad litem has not been completed within the past three years. The background study 
116.15 	of the guardian ad litem must be completed before the court appoints the guardian ad litem, 
116.16 	unless the court determines that it is in the best interests of the child to appoint the guardian 
116.17 	ad litem before a background study is completed by the commissioner.
116.18 	(2) a guardian ad litem once every three years after the guardian has been appointed, as 
116.19 	long as the individual continues to serve as a guardian ad litem.
116.20 		Subd. 9.Guardians ad litem; required checks. (a) An alternative background study 
116.21 	for a guardian ad litem under subdivision 8 must include:
116.22 	(1) criminal history data from the Bureau of Criminal Apprehension and other criminal 
116.23 	history data obtained by the commissioner of human services; and
116.24 	(2) data regarding whether the person has been a perpetrator of substantiated maltreatment 
116.25 	of a minor or a vulnerable adult. If the study subject has been determined by the Department 
116.26 	of Human Services or the Department of Health to be the perpetrator of substantiated 
116.27 	maltreatment of a minor or a vulnerable adult in a licensed facility, the response must include 
116.28 	a copy of the public portion of the investigation memorandum under section 260E.30 or the 
116.29 	public portion of the investigation memorandum under section 626.557, subdivision 12b. 
116.30 	When the background study shows that the subject has been determined by a county adult 
116.31 	protection or child protection agency to have been responsible for maltreatment, the court 
116.32 	shall be informed of the county, the date of the finding, and the nature of the maltreatment 
116.33 	that was substantiated.
117.1 	(b) For checks of records under paragraph (a), clauses (1) and (2), the commissioner 
117.2 	shall provide the records within 15 working days of receiving the request. The information 
117.3 	obtained under sections 245C.05 and 245C.08 from a national criminal history records 
117.4 	check shall be provided within three working days of the commissioner's receipt of the data.
117.5 	(c) Notwithstanding section 260E.30 or 626.557, subdivision 12b, if the commissioner 
117.6 	or county lead agency or lead investigative agency has information that a person of whom 
117.7 	a background study was previously completed under this section has been determined to 
117.8 	be a perpetrator of maltreatment of a minor or vulnerable adult, the commissioner or the 
117.9 	county may provide this information to the court that requested the background study.
117.10 		Subd. 10.First-time applicants for educator licenses with the Professional Educator 
117.11 	Licensing and Standards Board. The Professional Educator Licensing and Standards 
117.12 	Board shall make all eligibility determinations for alternative background studies conducted 
117.13 	under this section for the Professional Educator Licensing and Standards Board. The 
117.14 	commissioner may conduct an alternative background study of all first-time applicants for 
117.15 	educator licenses pursuant to section 122A.18, subdivision 8. The alternative background 
117.16 	study for all first-time applicants for educator licenses must include a review of information 
117.17 	from the Bureau of Criminal Apprehension, including criminal history data as defined in 
117.18 	section 13.87, and must also include a review of the national criminal records repository.
117.19 		Subd. 11.First-time applicants for administrator licenses with the Board of School 
117.20 	Administrators. The Board of School Administrators shall make all eligibility determinations 
117.21 	for alternative background studies conducted under this section for the Board of School 
117.22 	Administrators. The commissioner may conduct an alternative background study of all 
117.23 	first-time applicants for administrator licenses pursuant to section 122A.18, subdivision 8. 
117.24 	The alternative background study for all first-time applicants for administrator licenses must 
117.25 	include a review of information from the Bureau of Criminal Apprehension, including 
117.26 	criminal history data as defined in section 13.87, and must also include a review of the 
117.27 	national criminal records repository.
117.28 		Subd. 12.Occupations regulated by MNsure. (a) The commissioner shall conduct a 
117.29 	background study of any individual required under section 62V.05 to have a background 
117.30 	study completed under this chapter. Notwithstanding subdivision 1, paragraph (g), the 
117.31 	commissioner shall conduct a background study only based on Minnesota criminal records 
117.32 	of:
117.33 	(1) each navigator;
117.34 	(2) each in-person assister; and
118.1 	(3) each certified application counselor.
118.2 	(b) The MNsure board of directors may initiate background studies required by paragraph 
118.3 	(a) using the online NETStudy 2.0 system operated by the commissioner.
118.4 	(c) The commissioner shall review information that the commissioner receives to 
118.5 	determine if the study subject has potentially disqualifying offenses. The commissioner 
118.6 	shall send a letter to the subject indicating any of the subject's potential disqualifications as 
118.7 	well as any relevant records. The commissioner shall send a copy of the letter indicating 
118.8 	any of the subject's potential disqualifications to the MNsure board.
118.9 	(d) The MNsure board or its delegate shall review a reconsideration request of an 
118.10 	individual in paragraph (a), including granting a set aside, according to the procedures and 
118.11 	criteria in chapter 245C. The board shall notify the individual and the Department of Human 
118.12 	Services of the board's decision.

118.13 	Sec. 19. Minnesota Statutes 2020, section 245C.05, subdivision 1, is amended to read:
118.14 		Subdivision 1.Individual studied. (a) The individual who is the subject of the 
118.15 	background study must provide the applicant, license holder, or other entity under section 
118.16 	245C.04 with sufficient information to ensure an accurate study, including:
118.17 	(1) the individual's first, middle, and last name and all other names by which the 
118.18 	individual has been known;
118.19 	(2) current home address, city, and state of residence;
118.20 	(3) current zip code;
118.21 	(4) sex;
118.22 	(5) date of birth;
118.23 	(6) driver's license number or state identification number; and
118.24 	(7) upon implementation of NETStudy 2.0, the home address, city, county, and state of 
118.25 	residence for the past five years.
118.26 	(b) Every subject of a background study conducted or initiated by counties or private 
118.27 	agencies under this chapter must also provide the home address, city, county, and state of 
118.28 	residence for the past five years.
118.29 	(c) Every subject of a background study related to private agency adoptions or related 
118.30 	to child foster care licensed through a private agency, who is 18 years of age or older, shall 
118.31 	also provide the commissioner a signed consent for the release of any information received 
119.1 	from national crime information databases to the private agency that initiated the background 
119.2 	study.
119.3 	(d) The subject of a background study shall provide fingerprints and a photograph as 
119.4 	required in subdivision 5.
119.5 	(e) The subject of a background study shall submit a completed criminal and maltreatment 
119.6 	history records check consent form for applicable national and state level record checks.

119.7 	Sec. 20. Minnesota Statutes 2020, section 245C.05, subdivision 2, is amended to read:
119.8 		Subd. 2.Applicant, license holder, or other entity. (a) The applicant, license holder, 
119.9 	or other entities entity initiating the background study as provided in this chapter shall verify 
119.10 	that the information collected under subdivision 1 about an individual who is the subject of 
119.11 	the background study is correct and must provide the information on forms or in a format 
119.12 	prescribed by the commissioner.
119.13 	(b) The information collected under subdivision 1 about an individual who is the subject 
119.14 	of a completed background study may only be viewable by an entity that initiates a 
119.15 	subsequent background study on that individual under NETStudy 2.0 after the entity has 
119.16 	paid the applicable fee for the study and has provided the individual with the privacy notice 
119.17 	in subdivision 2c.

119.18 	Sec. 21. Minnesota Statutes 2020, section 245C.05, subdivision 2a, is amended to read:
119.19 		Subd. 2a.County or private agency. For background studies related to child foster care 
119.20 	when the applicant or license holder resides in the home where child foster care services 
119.21 	are provided, county and private agencies initiating the background study must collect the 
119.22 	information under subdivision 1 and forward it to the commissioner.

119.23 	Sec. 22. Minnesota Statutes 2020, section 245C.05, subdivision 2b, is amended to read:
119.24 		Subd. 2b.County agency to collect and forward information to commissioner. (a) 
119.25 	For background studies related to all family adult day services and to adult foster care when 
119.26 	the adult foster care license holder resides in the adult foster care residence, the county 
119.27 	agency or private agency initiating the background study must collect the information 
119.28 	required under subdivision 1 and forward it to the commissioner.
119.29 	(b) Upon implementation of NETStudy 2.0, for background studies related to family 
119.30 	child care and legal nonlicensed child care authorized under chapter 119B, the county agency 
120.1 	initiating the background study must collect the information required under subdivision 1 
120.2 	and provide the information to the commissioner.

120.3 	Sec. 23. Minnesota Statutes 2020, section 245C.05, subdivision 2c, is amended to read:
120.4 		Subd. 2c.Privacy notice to background study subject. (a) Prior to initiating each 
120.5 	background study, the entity initiating the study must provide the commissioner's privacy 
120.6 	notice to the background study subject required under section 13.04, subdivision 2. The 
120.7 	notice must be available through the commissioner's electronic NETStudy and NETStudy 
120.8 	2.0 systems and shall include the information in paragraphs (b) and (c).
120.9 	(b) The background study subject shall be informed that any previous background studies 
120.10 	that received a set-aside will be reviewed, and without further contact with the background 
120.11 	study subject, the commissioner may notify the agency that initiated the subsequent 
120.12 	background study:
120.13 	(1) that the individual has a disqualification that has been set aside for the program or 
120.14 	agency that initiated the study;
120.15 	(2) the reason for the disqualification; and
120.16 	(3) that information about the decision to set aside the disqualification will be available 
120.17 	to the license holder upon request without the consent of the background study subject.
120.18 	(c) The background study subject must also be informed that:
120.19 	(1) the subject's fingerprints collected for purposes of completing the background study 
120.20 	under this chapter must not be retained by the Department of Public Safety, Bureau of 
120.21 	Criminal Apprehension, or by the commissioner. The Federal Bureau of Investigation will 
120.22 	only retain fingerprints of subjects with a criminal history not retain background study 
120.23 	subjects' fingerprints;
120.24 	(2) effective upon implementation of NETStudy 2.0, the subject's photographic image 
120.25 	will be retained by the commissioner, and if the subject has provided the subject's Social 
120.26 	Security number for purposes of the background study, the photographic image will be 
120.27 	available to prospective employers and agencies initiating background studies under this 
120.28 	chapter to verify the identity of the subject of the background study;
120.29 	(3) the commissioner's authorized fingerprint collection vendor or vendors shall, for 
120.30 	purposes of verifying the identity of the background study subject, be able to view the 
120.31 	identifying information entered into NETStudy 2.0 by the entity that initiated the background 
120.32 	study, but shall not retain the subject's fingerprints, photograph, or information from 
121.1 	NETStudy 2.0. The authorized fingerprint collection vendor or vendors shall retain no more 
121.2 	than the subject's name and the date and time the subject's fingerprints were recorded and 
121.3 	sent, only as necessary for auditing and billing activities;
121.4 	(4) the commissioner shall provide the subject notice, as required in section 245C.17, 
121.5 	subdivision 1, paragraph (a), when an entity initiates a background study on the individual;
121.6 	(5) the subject may request in writing a report listing the entities that initiated a 
121.7 	background study on the individual as provided in section 245C.17, subdivision 1, paragraph 
121.8 	(b);
121.9 	(6) the subject may request in writing that information used to complete the individual's 
121.10 	background study in NETStudy 2.0 be destroyed if the requirements of section 245C.051, 
121.11 	paragraph (a), are met; and
121.12 	(7) notwithstanding clause (6), the commissioner shall destroy:
121.13 	(i) the subject's photograph after a period of two years when the requirements of section 
121.14 	245C.051, paragraph (c), are met; and
121.15 	(ii) any data collected on a subject under this chapter after a period of two years following 
121.16 	the individual's death as provided in section 245C.051, paragraph (d).

121.17 	Sec. 24. Minnesota Statutes 2020, section 245C.05, subdivision 2d, is amended to read:
121.18 		Subd. 2d.Fingerprint data notification. The commissioner of human services shall 
121.19 	notify all background study subjects under this chapter that the Department of Human 
121.20 	Services, Department of Public Safety, and the Bureau of Criminal Apprehension do not 
121.21 	retain fingerprint data after a background study is completed, and that the Federal Bureau 
121.22 	of Investigation only retains the fingerprints of subjects who have a criminal history does 
121.23 	not retain background study subjects' fingerprints.

121.24 	Sec. 25. Minnesota Statutes 2020, section 245C.05, subdivision 4, is amended to read:
121.25 		Subd. 4.Electronic transmission. (a) For background studies conducted by the 
121.26 	Department of Human Services, the commissioner shall implement a secure system for the 
121.27 	electronic transmission of:
121.28 	(1) background study information to the commissioner;
121.29 	(2) background study results to the license holder;
121.30 	(3) background study results information obtained under this section and section 245C.08
121.31 	to counties and private agencies for background studies conducted by the commissioner for 
122.1 	child foster care, including a summary of nondisqualifying results, except as prohibited by 
122.2 	law; and
122.3 	(4) background study results to county agencies for background studies conducted by 
122.4 	the commissioner for adult foster care and family adult day services and, upon 
122.5 	implementation of NETStudy 2.0, family child care and legal nonlicensed child care 
122.6 	authorized under chapter 119B.
122.7 	(b) Unless the commissioner has granted a hardship variance under paragraph (c), a 
122.8 	license holder or an applicant must use the electronic transmission system known as 
122.9 	NETStudy or NETStudy 2.0 to submit all requests for background studies to the 
122.10 	commissioner as required by this chapter.
122.11 	(c) A license holder or applicant whose program is located in an area in which high-speed 
122.12 	Internet is inaccessible may request the commissioner to grant a variance to the electronic 
122.13 	transmission requirement.
122.14 	(d) Section 245C.08, subdivision 3, paragraph (c), applies to results transmitted under 
122.15 	this subdivision.

122.16 	EFFECTIVE DATE. This section is effective July 1, 2022.

122.17 	Sec. 26. Minnesota Statutes 2020, section 245C.08, subdivision 3, is amended to read:
122.18 		Subd. 3.Arrest and investigative information. (a) For any background study completed 
122.19 	under this section, if the commissioner has reasonable cause to believe the information is 
122.20 	pertinent to the disqualification of an individual, the commissioner also may review arrest 
122.21 	and investigative information from:
122.22 	(1) the Bureau of Criminal Apprehension;
122.23 	(2) the commissioners of health and human services;
122.24 	(3) a county attorney;
122.25 	(4) a county sheriff;
122.26 	(5) a county agency;
122.27 	(6) a local chief of police;
122.28 	(7) other states;
122.29 	(8) the courts;
122.30 	(9) the Federal Bureau of Investigation;
123.1 	(10) the National Criminal Records Repository; and
123.2 	(11) criminal records from other states.
123.3 	(b) Except when specifically required by law, the commissioner is not required to conduct 
123.4 	more than one review of a subject's records from the Federal Bureau of Investigation if a 
123.5 	review of the subject's criminal history with the Federal Bureau of Investigation has already 
123.6 	been completed by the commissioner and there has been no break in the subject's affiliation 
123.7 	with the entity that initiated the background study.
123.8 	(c) If the commissioner conducts a national criminal history record check when required 
123.9 	by law and uses the information from the national criminal history record check to make a 
123.10 	disqualification determination, the data obtained is private data and cannot be shared with 
123.11 	county agencies, private agencies, or prospective employers of the background study subject.
123.12 	(d) If the commissioner conducts a national criminal history record check when required 
123.13 	by law and uses the information from the national criminal history record check to make a 
123.14 	disqualification determination, the license holder or entity that submitted the study is not 
123.15 	required to obtain a copy of the background study subject's disqualification letter under 
123.16 	section 245C.17, subdivision 3.

123.17 	Sec. 27. Minnesota Statutes 2020, section 245C.08, is amended by adding a subdivision 
123.18 	to read:
123.19 		Subd. 5.Authorization. The commissioner of human services shall be authorized to 
123.20 	receive information under this chapter.

123.21 	Sec. 28. Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision 
123.22 	to read:
123.23 		Subd. 1b.Background study fees. (a) The commissioner shall recover the cost of 
123.24 	background studies. Except as otherwise provided in subdivisions 1c and 1d, the fees 
123.25 	collected under this section shall be appropriated to the commissioner for the purpose of 
123.26 	conducting background studies under this chapter. Fees under this section are charges under 
123.27 	section 16A.1283, paragraph (b), clause (3).
123.28 	(b) Background study fees may include:
123.29 	(1) a fee to compensate the commissioner's authorized fingerprint collection vendor or 
123.30 	vendors for obtaining and processing a background study subject's classifiable fingerprints 
123.31 	and photograph pursuant to subdivision 1c; and
124.1 	(2) a separate fee under subdivision 1c to complete a review of background-study-related 
124.2 	records as authorized under this chapter.
124.3 	(c) Fees charged under paragraph (b) may be paid in whole or part when authorized by 
124.4 	law by a state agency or board; by state court administration; by a service provider, employer, 
124.5 	license holder, or other organization that initiates the background study; by the commissioner 
124.6 	or other organization with duly appropriated funds; by a background study subject; or by 
124.7 	some combination of these sources.

124.8 	Sec. 29. Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision 
124.9 	to read:
124.10 		Subd. 1c.Fingerprint and photograph processing fees. The commissioner shall enter 
124.11 	into a contract with a qualified vendor or vendors to obtain and process a background study 
124.12 	subject's classifiable fingerprints and photograph as required by section 245C.05. The 
124.13 	commissioner may, at their discretion, directly collect fees and reimburse the commissioner's 
124.14 	authorized fingerprint collection vendor for the vendor's services or require the vendor to 
124.15 	collect the fees. The authorized vendor is responsible for reimbursing the vendor's 
124.16 	subcontractors at a rate specified in the contract with the commissioner.

124.17 	Sec. 30. Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision 
124.18 	to read:
124.19 		Subd. 1d.Background studies fee schedule. (a) By March 1 each year, the commissioner 
124.20 	shall publish a schedule of fees sufficient to administer and conduct background studies 
124.21 	under this chapter. The published schedule of fees shall be effective on July 1 each year.
124.22 	(b) Fees shall be based on the actual costs of administering and conducting background 
124.23 	studies, including payments to external agencies, department indirect cost payments under 
124.24 	section 16A.127, processing fees, and costs related to due process.
124.25 	(c) The commissioner shall publish a notice of fees by posting fee amounts on the 
124.26 	department website. The notice shall specify the actual costs that comprise the fees including 
124.27 	the categories described in paragraph (b).
124.28 	(d) The published schedule of fees shall remain in effect from July 1 to June 30 each 
124.29 	year.
124.30 	(e) The fees collected under this subdivision are appropriated to the commissioner for 
124.31 	the purpose of conducting background studies, alternative background studies, and criminal 
124.32 	background checks.

125.1 	EFFECTIVE DATE. This section is effective July 1, 2021. The commissioner of human 
125.2 	services shall publish the initial fee schedule on the Department of Human Services website 
125.3 	on July 1, 2021, and the initial fee schedule is effective September 1, 2021.

125.4 	Sec. 31. Minnesota Statutes 2020, section 245C.10, subdivision 15, is amended to read:
125.5 		Subd. 15.Guardians and conservators. The commissioner shall recover the cost of 
125.6 	conducting background studies for guardians and conservators under section 524.5-118 
125.7 	through a fee of no more than $110 per study. The fees collected under this subdivision are 
125.8 	appropriated to the commissioner for the purpose of conducting background studies. fee 
125.9 	for conducting an alternative background study for appointment of a professional guardian 
125.10 	or conservator must be paid by the guardian or conservator. In other cases, the fee must be 
125.11 	paid as follows:
125.12 	(1) if the matter is proceeding in forma pauperis, the fee must be paid as an expense for 
125.13 	purposes of section 524.5-502, paragraph (a);
125.14 	(2) if there is an estate of the ward or protected person, the fee must be paid from the 
125.15 	estate; or
125.16 	(3) in the case of a guardianship or conservatorship of a person that is not proceeding 
125.17 	in forma pauperis, the fee must be paid by the guardian, conservator, or the court.

125.18 	Sec. 32. Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision 
125.19 	to read:
125.20 		Subd. 17.Early intensive developmental and behavioral intervention providers. The 
125.21 	commissioner shall recover the cost of background studies required under section 245C.03, 
125.22 	subdivision 15, for the purposes of early intensive developmental and behavioral intervention 
125.23 	under section 256B.0949, through a fee of no more than $20 per study charged to the enrolled 
125.24 	agency. The fees collected under this subdivision are appropriated to the commissioner for 
125.25 	the purpose of conducting background studies.

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

125.27 	Sec. 33. Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision 
125.28 	to read:
125.29 		Subd. 18.Applicants, licensees, and other occupations regulated by commissioner 
125.30 	of health. The applicant or license holder is responsible for paying to the Department of 
126.1 	Human Services all fees associated with the preparation of the fingerprints, the criminal 
126.2 	records check consent form, and the criminal background check.

126.3 	Sec. 34. Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision 
126.4 	to read:
126.5 		Subd. 19.Occupations regulated by MNsure. The commissioner shall set fees to 
126.6 	recover the cost of background studies and criminal background checks initiated by MNsure 
126.7 	under sections 62V.05 and 245C.031. The fee amount shall be established through 
126.8 	interagency agreement between the commissioner and the board of MNsure or its designee. 
126.9 	The fees collected under this subdivision shall be deposited in the special revenue fund and 
126.10 	are appropriated to the commissioner for the purpose of conducting background studies and 
126.11 	criminal background checks.

126.12 	Sec. 35. Minnesota Statutes 2020, section 245C.13, subdivision 2, is amended to read:
126.13 		Subd. 2.Activities pending completion of background study. The subject of a 
126.14 	background study may not perform any activity requiring a background study under 
126.15 	paragraph (c) until the commissioner has issued one of the notices under paragraph (a).
126.16 	(a) Notices from the commissioner required prior to activity under paragraph (c) include:
126.17 	(1) a notice of the study results under section 245C.17 stating that:
126.18 	(i) the individual is not disqualified; or
126.19 	(ii) more time is needed to complete the study but the individual is not required to be 
126.20 	removed from direct contact or access to people receiving services prior to completion of 
126.21 	the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice 
126.22 	that more time is needed to complete the study must also indicate whether the individual is 
126.23 	required to be under continuous direct supervision prior to completion of the background 
126.24 	study. When more time is necessary to complete a background study of an individual 
126.25 	affiliated with a Title IV-E eligible children's residential facility or foster residence setting, 
126.26 	the individual may not work in the facility or setting regardless of whether or not the 
126.27 	individual is supervised;
126.28 	(2) a notice that a disqualification has been set aside under section 245C.23; or
126.29 	(3) a notice that a variance has been granted related to the individual under section 
126.30 	245C.30.
127.1 	(b) For a background study affiliated with a licensed child care center or certified 
127.2 	license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii), 
127.3 	must require the individual to be under continuous direct supervision prior to completion 
127.4 	of the background study except as permitted in subdivision 3.
127.5 	(c) Activities prohibited prior to receipt of notice under paragraph (a) include:
127.6 	(1) being issued a license;
127.7 	(2) living in the household where the licensed program will be provided;
127.8 	(3) providing direct contact services to persons served by a program unless the subject 
127.9 	is under continuous direct supervision;
127.10 	(4) having access to persons receiving services if the background study was completed 
127.11 	under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2), 
127.12 	(5), or (6), unless the subject is under continuous direct supervision;
127.13 	(5) for licensed child care centers and certified license-exempt child care centers, 
127.14 	providing direct contact services to persons served by the program; or
127.15 	(6) for children's residential facilities or foster residence settings, working in the facility 
127.16 	or setting.; or
127.17 	(7) for background studies affiliated with a personal care provider organization, except 
127.18 	as provided in section 245C.03, subdivision 3b, before a personal care assistant provides 
127.19 	services, the personal care assistance provider agency must initiate a background study of 
127.20 	the personal care assistant under this chapter and the personal care assistance provider 
127.21 	agency must have received a notice from the commissioner that the personal care assistant 
127.22 	is:
127.23 	(i) not disqualified under section 245C.14; or
127.24 	(ii) disqualified, but the personal care assistant has received a set aside of the 
127.25 	disqualification under section 245C.22.

127.26 	Sec. 36. Minnesota Statutes 2020, section 245C.14, subdivision 1, is amended to read:
127.27 		Subdivision 1.Disqualification from direct contact. (a) The commissioner shall 
127.28 	disqualify an individual who is the subject of a background study from any position allowing 
127.29 	direct contact with persons receiving services from the license holder or entity identified in 
127.30 	section 245C.03, upon receipt of information showing, or when a background study 
127.31 	completed under this chapter shows any of the following:
128.1 	(1) a conviction of, admission to, or Alford plea to one or more crimes listed in section 
128.2 	245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor, 
128.3 	or misdemeanor level crime;
128.4 	(2) a preponderance of the evidence indicates the individual has committed an act or 
128.5 	acts that meet the definition of any of the crimes listed in section 245C.15, regardless of 
128.6 	whether the preponderance of the evidence is for a felony, gross misdemeanor, or 
128.7 	misdemeanor level crime; or
128.8 	(3) an investigation results in an administrative determination listed under section 
128.9 	245C.15, subdivision 4, paragraph (b).
128.10 	(b) No individual who is disqualified following a background study under section 
128.11 	245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with 
128.12 	persons served by a program or entity identified in section 245C.03, unless the commissioner 
128.13 	has provided written notice under section 245C.17 stating that:
128.14 	(1) the individual may remain in direct contact during the period in which the individual 
128.15 	may request reconsideration as provided in section 245C.21, subdivision 2;
128.16 	(2) the commissioner has set aside the individual's disqualification for that program or 
128.17 	entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or
128.18 	(3) the license holder has been granted a variance for the disqualified individual under 
128.19 	section 245C.30.
128.20 	(c) Notwithstanding paragraph (a), for the purposes of a background study affiliated 
128.21 	with a licensed family foster setting, the commissioner shall disqualify an individual who 
128.22 	is the subject of a background study from any position allowing direct contact with persons 
128.23 	receiving services from the license holder or entity identified in section 245C.03, upon 
128.24 	receipt of information showing or when a background study completed under this chapter 
128.25 	shows reason for disqualification under section 245C.15, subdivision 4a.

128.26 	EFFECTIVE DATE. This section is effective July 1, 2022.

128.27 	Sec. 37. Minnesota Statutes 2020, section 245C.14, is amended by adding a subdivision 
128.28 	to read:
128.29 		Subd. 4.Disqualification from working in licensed child care centers or certified 
128.30 	license-exempt child care centers. (a) For a background study affiliated with a licensed 
128.31 	child care center or certified license-exempt child care center, if an individual is disqualified 
128.32 	from direct contact under subdivision 1, the commissioner must also disqualify the individual 
129.1 	from working in any position regardless of whether the individual would have direct contact 
129.2 	with or access to children served in the licensed child care center or certified license-exempt 
129.3 	child care center and from having access to a person receiving services from the center.
129.4 	(b) Notwithstanding any other requirement of this chapter, for a background study 
129.5 	affiliated with a licensed child care center or a certified license-exempt child care center, if 
129.6 	an individual is disqualified, the individual may not work in the child care center until the 
129.7 	commissioner has issued a notice stating that:
129.8 	(1) the individual is not disqualified;
129.9 	(2) a disqualification has been set aside under section 245C.23; or
129.10 	(3) a variance has been granted related to the individual under section 245C.30.

129.11 	Sec. 38. Minnesota Statutes 2020, section 245C.15, is amended by adding a subdivision 
129.12 	to read:
129.13 		Subd. 4a.Licensed family foster setting disqualifications. (a) Notwithstanding 
129.14 	subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting, 
129.15 	regardless of how much time has passed, an individual is disqualified under section 245C.14 
129.16 	if the individual committed an act that resulted in a felony-level conviction for sections: 
129.17 	609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder 
129.18 	in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in 
129.19 	the second degree); 609.2112 (criminal vehicular homicide); 609.221 (assault in the first 
129.20 	degree); 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse); 
129.21 	609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense 
129.22 	under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or 
129.23 	neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325 
129.24 	(criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245 
129.25 	(aggravated robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder 
129.26 	of an unborn child in the first degree); 609.2662 (murder of an unborn child in the second 
129.27 	degree); 609.2663 (murder of an unborn child in the third degree); 609.2664 (manslaughter 
129.28 	of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the 
129.29 	second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault 
129.30 	of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the 
129.31 	commission of a crime); 609.322, subdivision 1 (solicitation, inducement, and promotion 
129.32 	of prostitution; sex trafficking in the first degree); 609.324, subdivision 1 (other prohibited 
129.33 	acts; engaging in, hiring, or agreeing to hire minor to engage in prostitution); 609.342 
129.34 	(criminal sexual conduct in the first degree); 609.343 (criminal sexual conduct in the second 
130.1 	degree); 609.344 (criminal sexual conduct in the third degree); 609.345 (criminal sexual 
130.2 	conduct in the fourth degree); 609.3451 (criminal sexual conduct in the fifth degree); 
130.3 	609.3453 (criminal sexual predatory conduct); 609.352 (solicitation of children to engage 
130.4 	in sexual conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or 
130.5 	endangerment of a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary 
130.6 	in the first degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246 
130.7 	(use of minors in sexual performance prohibited); or 617.247 (possession of pictorial 
130.8 	representations of minors).
130.9 	(b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated 
130.10 	with a licensed family foster setting, an individual is disqualified under section 245C.14, 
130.11 	regardless of how much time has passed, if the individual:
130.12 	(1) committed an action under paragraph (d) that resulted in death or involved sexual 
130.13 	abuse, as defined in section 260E.03, subdivision 20;
130.14 	(2) committed an act that resulted in a gross misdemeanor-level conviction for section 
130.15 	609.3451 (criminal sexual conduct in the fifth degree);
130.16 	(3) committed an act against or involving a minor that resulted in a felony-level conviction 
130.17 	for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the 
130.18 	third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree); 
130.19 	or
130.20 	(4) committed an act that resulted in a misdemeanor or gross misdemeanor-level 
130.21 	conviction for section 617.293 (dissemination and display of harmful materials to minors).
130.22 	(c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed 
130.23 	family foster setting, an individual is disqualified under section 245C.14 if less than 20 
130.24 	years have passed since the termination of the individual's parental rights under section 
130.25 	260C.301, subdivision 1, paragraph (b), or if the individual consented to a termination of 
130.26 	parental rights under section 260C.301, subdivision 1, paragraph (a), to settle a petition to 
130.27 	involuntarily terminate parental rights. An individual is disqualified under section 245C.14 
130.28 	if less than 20 years have passed since the termination of the individual's parental rights in 
130.29 	any other state or country, where the conditions for the individual's termination of parental 
130.30 	rights are substantially similar to the conditions in section 260C.301, subdivision 1, paragraph 
130.31 	(b).
130.32 	(d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed 
130.33 	family foster setting, an individual is disqualified under section 245C.14 if less than five 
130.34 	years have passed since a felony-level violation for sections: 152.021 (controlled substance 
131.1 	crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023 
131.2 	(controlled substance crime in the third degree); 152.024 (controlled substance crime in the 
131.3 	fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing 
131.4 	controlled substances across state borders); 152.0262, subdivision 1, paragraph (b) 
131.5 	(possession of substance with intent to manufacture methamphetamine); 152.027, subdivision 
131.6 	6, paragraph (c) (sale or possession of synthetic cannabinoids); 152.096 (conspiracies 
131.7 	prohibited); 152.097 (simulated controlled substances); 152.136 (anhydrous ammonia; 
131.8 	prohibited conduct; criminal penalties; civil liabilities); 152.137 (methamphetamine-related 
131.9 	crimes involving children or vulnerable adults); 169A.24 (felony first-degree driving while 
131.10 	impaired); 243.166 (violation of predatory offender registration requirements); 609.2113 
131.11 	(criminal vehicular operation; bodily harm); 609.2114 (criminal vehicular operation; unborn 
131.12 	child); 609.228 (great bodily harm caused by distribution of drugs); 609.2325 (criminal 
131.13 	abuse of a vulnerable adult not resulting in the death of a vulnerable adult); 609.233 (criminal 
131.14 	neglect); 609.235 (use of drugs to injure or facilitate a crime); 609.24 (simple robbery); 
131.15 	609.322, subdivision 1a (solicitation, inducement, and promotion of prostitution; sex 
131.16 	trafficking in the second degree); 609.498, subdivision 1 (tampering with a witness in the 
131.17 	first degree); 609.498, subdivision 1b (aggravated first-degree witness tampering); 609.562 
131.18 	(arson in the second degree); 609.563 (arson in the third degree); 609.582, subdivision 2 
131.19 	(burglary in the second degree); 609.66 (felony dangerous weapons); 609.687 (adulteration); 
131.20 	609.713 (terroristic threats); 609.749, subdivision 3, 4, or 5 (felony-level harassment or 
131.21 	stalking); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); or 
131.22 	624.713 (certain people not to possess firearms).
131.23 	(e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a 
131.24 	background study affiliated with a licensed family child foster care license, an individual 
131.25 	is disqualified under section 245C.14 if less than five years have passed since:
131.26 	(1) a felony-level violation for an act not against or involving a minor that constitutes: 
131.27 	section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third 
131.28 	degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the 
131.29 	fifth degree);
131.30 	(2) a violation of an order for protection under section 518B.01, subdivision 14;
131.31 	(3) a determination or disposition of the individual's failure to make required reports 
131.32 	under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition 
131.33 	under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment 
131.34 	was recurring or serious;
132.1 	(4) a determination or disposition of the individual's substantiated serious or recurring 
132.2 	maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or 
132.3 	serious or recurring maltreatment in any other state, the elements of which are substantially 
132.4 	similar to the elements of maltreatment under chapter 260E or section 626.557 and meet 
132.5 	the definition of serious maltreatment or recurring maltreatment;
132.6 	(5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in 
132.7 	the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect); 
132.8 	609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child); 
132.9 	609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or
132.10 	(6) committing an act against or involving a minor that resulted in a misdemeanor-level 
132.11 	violation of section 609.224, subdivision 1 (assault in the fifth degree).
132.12 	(f) For purposes of this subdivision, the disqualification begins from:
132.13 	(1) the date of the alleged violation, if the individual was not convicted;
132.14 	(2) the date of conviction, if the individual was convicted of the violation but not 
132.15 	committed to the custody of the commissioner of corrections; or
132.16 	(3) the date of release from prison, if the individual was convicted of the violation and 
132.17 	committed to the custody of the commissioner of corrections.
132.18 	Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation 
132.19 	of the individual's supervised release, the disqualification begins from the date of release 
132.20 	from the subsequent incarceration.
132.21 	(g) An individual's aiding and abetting, attempt, or conspiracy to commit any of the 
132.22 	offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota 
132.23 	Statutes, permanently disqualifies the individual under section 245C.14. An individual is 
132.24 	disqualified under section 245C.14 if less than five years have passed since the individual's 
132.25 	aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs 
132.26 	(d) and (e).
132.27 	(h) An individual's offense in any other state or country, where the elements of the 
132.28 	offense are substantially similar to any of the offenses listed in paragraphs (a) and (b), 
132.29 	permanently disqualifies the individual under section 245C.14. An individual is disqualified 
132.30 	under section 245C.14 if less than five years has passed since an offense in any other state 
132.31 	or country, the elements of which are substantially similar to the elements of any offense 
132.32 	listed in paragraphs (d) and (e).

132.33 	EFFECTIVE DATE. This section is effective July 1, 2022.

133.1 	Sec. 39. Minnesota Statutes 2020, section 245C.16, subdivision 1, is amended to read:
133.2 		Subdivision 1.Determining immediate risk of harm. (a) If the commissioner determines 
133.3 	that the individual studied has a disqualifying characteristic, the commissioner shall review 
133.4 	the information immediately available and make a determination as to the subject's immediate 
133.5 	risk of harm to persons served by the program where the individual studied will have direct 
133.6 	contact with, or access to, people receiving services.
133.7 	(b) The commissioner shall consider all relevant information available, including the 
133.8 	following factors in determining the immediate risk of harm:
133.9 	(1) the recency of the disqualifying characteristic;
133.10 	(2) the recency of discharge from probation for the crimes;
133.11 	(3) the number of disqualifying characteristics;
133.12 	(4) the intrusiveness or violence of the disqualifying characteristic;
133.13 	(5) the vulnerability of the victim involved in the disqualifying characteristic;
133.14 	(6) the similarity of the victim to the persons served by the program where the individual 
133.15 	studied will have direct contact;
133.16 	(7) whether the individual has a disqualification from a previous background study that 
133.17 	has not been set aside; and
133.18 	(8) if the individual has a disqualification which may not be set aside because it is a 
133.19 	permanent bar under section 245C.24, subdivision 1, or the individual is a child care 
133.20 	background study subject who has a felony-level conviction for a drug-related offense in 
133.21 	the last five years, the commissioner may order the immediate removal of the individual 
133.22 	from any position allowing direct contact with, or access to, persons receiving services from 
133.23 	the program and from working in a children's residential facility or foster residence setting.; 
133.24 	and
133.25 	(9) if the individual has a disqualification which may not be set aside because it is a 
133.26 	permanent bar under section 245C.24, subdivision 2, or the individual is a child care 
133.27 	background study subject who has a felony-level conviction for a drug-related offense during 
133.28 	the last five years, the commissioner may order the immediate removal of the individual 
133.29 	from any position allowing direct contact with or access to persons receiving services from 
133.30 	the center and from working in a licensed child care center or certified license-exempt child 
133.31 	care center.
134.1 	(c) This section does not apply when the subject of a background study is regulated by 
134.2 	a health-related licensing board as defined in chapter 214, and the subject is determined to 
134.3 	be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
134.4 	(d) This section does not apply to a background study related to an initial application 
134.5 	for a child foster family setting license.
134.6 	(e) Except for paragraph (f), this section does not apply to a background study that is 
134.7 	also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a 
134.8 	personal care assistant or a qualified professional as defined in section 256B.0659, 
134.9 	subdivision 1.
134.10 	(f) If the commissioner has reason to believe, based on arrest information or an active 
134.11 	maltreatment investigation, that an individual poses an imminent risk of harm to persons 
134.12 	receiving services, the commissioner may order that the person be continuously supervised 
134.13 	or immediately removed pending the conclusion of the maltreatment investigation or criminal 
134.14 	proceedings.

134.15 	Sec. 40. Minnesota Statutes 2020, section 245C.16, subdivision 2, is amended to read:
134.16 		Subd. 2.Findings. (a) After evaluating the information immediately available under 
134.17 	subdivision 1, the commissioner may have reason to believe one of the following:
134.18 	(1) the individual poses an imminent risk of harm to persons served by the program 
134.19 	where the individual studied will have direct contact or access to persons served by the 
134.20 	program or where the individual studied will work;
134.21 	(2) the individual poses a risk of harm requiring continuous, direct supervision while 
134.22 	providing direct contact services during the period in which the subject may request a 
134.23 	reconsideration; or
134.24 	(3) the individual does not pose an imminent risk of harm or a risk of harm requiring 
134.25 	continuous, direct supervision while providing direct contact services during the period in 
134.26 	which the subject may request a reconsideration.
134.27 	(b) After determining an individual's risk of harm under this section, the commissioner 
134.28 	must notify the subject of the background study and the applicant or license holder as 
134.29 	required under section 245C.17.
134.30 	(c) For Title IV-E eligible children's residential facilities and foster residence settings, 
134.31 	the commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).
135.1 	(d) For licensed child care centers or certified license-exempt child care centers, the 
135.2 	commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).

135.3 	Sec. 41. Minnesota Statutes 2020, section 245C.17, subdivision 1, is amended to read:
135.4 		Subdivision 1.Time frame for notice of study results and auditing system access. (a) 
135.5 	Within three working days after the commissioner's receipt of a request for a background 
135.6 	study submitted through the commissioner's NETStudy or NETStudy 2.0 system, the 
135.7 	commissioner shall notify the background study subject and the license holder or other 
135.8 	entity as provided in this chapter in writing or by electronic transmission of the results of 
135.9 	the study or that more time is needed to complete the study. The notice to the individual 
135.10 	shall include the identity of the entity that initiated the background study.
135.11 	(b) Before being provided access to NETStudy 2.0, the license holder or other entity 
135.12 	under section 245C.04 shall sign an acknowledgment of responsibilities form developed 
135.13 	by the commissioner that includes identifying the sensitive background study information 
135.14 	person, who must be an employee of the license holder or entity. All queries to NETStudy 
135.15 	2.0 are electronically recorded and subject to audit by the commissioner. The electronic 
135.16 	record shall identify the specific user. A background study subject may request in writing 
135.17 	to the commissioner a report listing the entities that initiated a background study on the 
135.18 	individual.
135.19 	(c) When the commissioner has completed a prior background study on an individual 
135.20 	that resulted in an order for immediate removal and more time is necessary to complete a 
135.21 	subsequent study, the notice that more time is needed that is issued under paragraph (a) 
135.22 	shall include an order for immediate removal of the individual from any position allowing 
135.23 	direct contact with or access to people receiving services and from working in a children's 
135.24 	residential facility or, foster residence setting, child care center, or certified license-exempt 
135.25 	child care center pending completion of the background study.

135.26 	Sec. 42. Minnesota Statutes 2020, section 245C.17, is amended by adding a subdivision 
135.27 	to read:
135.28 		Subd. 8.Disqualification notice to child care centers and certified license-exempt 
135.29 	child care centers. (a) For child care centers and certified license-exempt child care centers, 
135.30 	all notices under this section that order the license holder to immediately remove the 
135.31 	individual studied from any position allowing direct contact with, or access to a person 
135.32 	served by the center, must also order the license holder to immediately remove the individual 
136.1 	studied from working in any position regardless of whether the individual would have direct 
136.2 	contact with or access to children served in the center.
136.3 	(b) For child care centers and certified license-exempt child care centers, notices under 
136.4 	this section must not allow an individual to work in the center.

136.5 	Sec. 43. Minnesota Statutes 2020, section 245C.18, is amended to read:
136.6 	245C.18 OBLIGATION TO REMOVE DISQUALIFIED INDIVIDUAL FROM 
136.7 	DIRECT CONTACT AND FROM WORKING IN A PROGRAM, FACILITY, OR
136.8 	SETTING, OR CENTER.
136.9 	(a) Upon receipt of notice from the commissioner, the license holder must remove a 
136.10 	disqualified individual from direct contact with persons served by the licensed program if:
136.11 	(1) the individual does not request reconsideration under section 245C.21 within the 
136.12 	prescribed time;
136.13 	(2) the individual submits a timely request for reconsideration, the commissioner does 
136.14 	not set aside the disqualification under section 245C.22, subdivision 4, and the individual 
136.15 	does not submit a timely request for a hearing under sections 245C.27 and 256.045, or 
136.16 	245C.28 and chapter 14; or
136.17 	(3) the individual submits a timely request for a hearing under sections 245C.27 and 
136.18 	256.045, or 245C.28 and chapter 14, and the commissioner does not set aside or rescind the 
136.19 	disqualification under section 245A.08, subdivision 5, or 256.045.
136.20 	(b) For children's residential facility and foster residence setting license holders, upon 
136.21 	receipt of notice from the commissioner under paragraph (a), the license holder must also 
136.22 	remove the disqualified individual from working in the program, facility, or setting and 
136.23 	from access to persons served by the licensed program.
136.24 	(c) For Title IV-E eligible children's residential facility and foster residence setting 
136.25 	license holders, upon receipt of notice from the commissioner under paragraph (a), the 
136.26 	license holder must also remove the disqualified individual from working in the program 
136.27 	and from access to persons served by the program and must not allow the individual to work 
136.28 	in the facility or setting until the commissioner has issued a notice stating that:
136.29 	(1) the individual is not disqualified;
136.30 	(2) a disqualification has been set aside under section 245C.23; or
136.31 	(3) a variance has been granted related to the individual under section 245C.30.
137.1 	(d) For licensed child care center and certified license-exempt child care center license 
137.2 	holders, upon receipt of notice from the commissioner under paragraph (a), the license 
137.3 	holder must remove the disqualified individual from working in any position regardless of 
137.4 	whether the individual would have direct contact with or access to children served in the 
137.5 	center and from having access to persons served by the center and must not allow the 
137.6 	individual to work in the center until the commissioner has issued a notice stating that:
137.7 	(1) the individual is not disqualified;
137.8 	(2) a disqualification has been set aside under section 245C.23; or
137.9 	(3) a variance has been granted related to the individual under section 245C.30.

137.10 	Sec. 44. Minnesota Statutes 2020, section 245C.24, subdivision 2, is amended to read:
137.11 		Subd. 2.Permanent bar to set aside a disqualification. (a) Except as provided in 
137.12 	paragraphs (b) to (e) (f), the commissioner may not set aside the disqualification of any 
137.13 	individual disqualified pursuant to this chapter, regardless of how much time has passed, 
137.14 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
137.15 	1.
137.16 	(b) For an individual in the chemical dependency or corrections field who was disqualified 
137.17 	for a crime or conduct listed under section 245C.15, subdivision 1, and whose disqualification 
137.18 	was set aside prior to July 1, 2005, the commissioner must consider granting a variance 
137.19 	pursuant to section 245C.30 for the license holder for a program dealing primarily with 
137.20 	adults. A request for reconsideration evaluated under this paragraph must include a letter 
137.21 	of recommendation from the license holder that was subject to the prior set-aside decision 
137.22 	addressing the individual's quality of care to children or vulnerable adults and the 
137.23 	circumstances of the individual's departure from that service.
137.24 	(c) If an individual who requires a background study for nonemergency medical 
137.25 	transportation services under section 245C.03, subdivision 12, was disqualified for a crime 
137.26 	or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have 
137.27 	passed since the discharge of the sentence imposed, the commissioner may consider granting 
137.28 	a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this 
137.29 	paragraph must include a letter of recommendation from the employer. This paragraph does 
137.30 	not apply to a person disqualified based on a violation of sections 243.166; 609.185 to 
137.31 	609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3, 
137.32 	clause (1); 617.246; or 617.247.
138.1 	(d) When a licensed foster care provider adopts an individual who had received foster 
138.2 	care services from the provider for over six months, and the adopted individual is required 
138.3 	to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause 
138.4 	(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30 
138.5 	to permit the adopted individual with a permanent disqualification to remain affiliated with 
138.6 	the license holder under the conditions of the variance when the variance is recommended 
138.7 	by the county of responsibility for each of the remaining individuals in placement in the 
138.8 	home and the licensing agency for the home.
138.9 	(e) For an individual 18 years of age or older affiliated with a licensed family foster 
138.10 	setting, the commissioner must not set aside or grant a variance for the disqualification of 
138.11 	any individual disqualified pursuant to this chapter, regardless of how much time has passed, 
138.12 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
138.13 	4a, paragraphs (a) and (b).
138.14 	(f) In connection with a family foster setting license, the commissioner may grant a 
138.15 	variance to the disqualification for an individual who is under 18 years of age at the time 
138.16 	the background study is submitted.

138.17 	EFFECTIVE DATE. This section is effective July 1, 2022.

138.18 	Sec. 45. Minnesota Statutes 2020, section 245C.24, subdivision 3, is amended to read:
138.19 		Subd. 3.Ten-year bar to set aside disqualification. (a) The commissioner may not set 
138.20 	aside the disqualification of an individual in connection with a license to provide family 
138.21 	child care for children, foster care for children in the provider's home, or foster care or day 
138.22 	care services for adults in the provider's home if: (1) less than ten years has passed since 
138.23 	the discharge of the sentence imposed, if any, for the offense; or (2) when disqualified based 
138.24 	on a preponderance of evidence determination under section 245C.14, subdivision 1, 
138.25 	paragraph (a), clause (2), or an admission under section 245C.14, subdivision 1, paragraph 
138.26 	(a), clause (1), and less than ten years has passed since the individual committed the act or 
138.27 	admitted to committing the act, whichever is later; and (3) the individual has committed a 
138.28 	violation of any of the following offenses: sections 609.165 (felon ineligible to possess 
138.29 	firearm); criminal vehicular homicide or criminal vehicular operation causing death under 
138.30 	609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.215 (aiding 
138.31 	suicide or aiding attempted suicide); felony violations under 609.223 or 609.2231 (assault 
138.32 	in the third or fourth degree); 609.229 (crimes committed for benefit of a gang); 609.713
138.33 	(terroristic threats); 609.235 (use of drugs to injure or to facilitate crime); 609.24 (simple 
138.34 	robbery); 609.255 (false imprisonment); 609.562 (arson in the second degree); 609.71 (riot); 
139.1 	609.498, subdivision 1 or 1b (aggravated first-degree or first-degree tampering with a 
139.2 	witness); burglary in the first or second degree under 609.582 (burglary); 609.66 (dangerous 
139.3 	weapon); 609.665 (spring guns); 609.67 (machine guns and short-barreled shotguns); 
139.4 	609.749, subdivision 2 (gross misdemeanor harassment); 152.021 or 152.022 (controlled 
139.5 	substance crime in the first or second degree); 152.023, subdivision 1, clause (3) or (4) or 
139.6 	subdivision 2, clause (4) (controlled substance crime in the third degree); 152.024, 
139.7 	subdivision 1, clause (2), (3), or (4) (controlled substance crime in the fourth degree); 
139.8 	609.224, subdivision 2, paragraph (c) (fifth-degree assault by a caregiver against a vulnerable 
139.9 	adult); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of residents or 
139.10 	patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal neglect of a 
139.11 	vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure 
139.12 	to report); 609.265 (abduction); 609.2664 to 609.2665 (manslaughter of an unborn child in 
139.13 	the first or second degree); 609.267 to 609.2672 (assault of an unborn child in the first, 
139.14 	second, or third degree); 609.268 (injury or death of an unborn child in the commission of 
139.15 	a crime); repeat offenses under 617.23 (indecent exposure); 617.293 (disseminating or 
139.16 	displaying harmful material to minors); a felony-level conviction involving alcohol or drug 
139.17 	use, a gross misdemeanor offense under 609.324, subdivision 1 (other prohibited acts); a 
139.18 	gross misdemeanor offense under 609.378 (neglect or endangerment of a child); a gross 
139.19 	misdemeanor offense under 609.377 (malicious punishment of a child); 609.72, subdivision 
139.20 	3 (disorderly conduct against a vulnerable adult); or 624.713 (certain persons not to possess 
139.21 	firearms); or Minnesota Statutes 2012, section 609.21.
139.22 	(b) The commissioner may not set aside the disqualification of an individual if less than 
139.23 	ten years have passed since the individual's aiding and abetting, attempt, or conspiracy to 
139.24 	commit any of the offenses listed in paragraph (a) as each of these offenses is defined in 
139.25 	Minnesota Statutes.
139.26 	(c) The commissioner may not set aside the disqualification of an individual if less than 
139.27 	ten years have passed since the discharge of the sentence imposed for an offense in any 
139.28 	other state or country, the elements of which are substantially similar to the elements of any 
139.29 	of the offenses listed in paragraph (a).

139.30 	EFFECTIVE DATE. This section is effective July 1, 2022.

139.31 	Sec. 46. Minnesota Statutes 2020, section 245C.24, subdivision 4, is amended to read:
139.32 		Subd. 4.Seven-year bar to set aside disqualification. The commissioner may not set 
139.33 	aside the disqualification of an individual in connection with a license to provide family 
140.1 	child care for children, foster care for children in the provider's home, or foster care or day 
140.2 	care services for adults in the provider's home if within seven years preceding the study:
140.3 	(1) the individual committed an act that constitutes maltreatment of a child under sections 
140.4 	260E.24, subdivisions 1, 2, and 3, and 260E.30, subdivisions 1, 2, and 4, and the maltreatment 
140.5 	resulted in substantial bodily harm as defined in section 609.02, subdivision 7a, or substantial 
140.6 	mental or emotional harm as supported by competent psychological or psychiatric evidence; 
140.7 	or
140.8 	(2) the individual was determined under section 626.557 to be the perpetrator of a 
140.9 	substantiated incident of maltreatment of a vulnerable adult that resulted in substantial 
140.10 	bodily harm as defined in section 609.02, subdivision 7a, or substantial mental or emotional 
140.11 	harm as supported by competent psychological or psychiatric evidence.

140.12 	EFFECTIVE DATE. This section is effective July 1, 2022.

140.13 	Sec. 47. Minnesota Statutes 2020, section 245C.24, is amended by adding a subdivision 
140.14 	to read:
140.15 		Subd. 6.Five-year bar to set aside disqualification; family foster setting. (a) The 
140.16 	commissioner shall not set aside or grant a variance for the disqualification of an individual 
140.17 	18 years of age or older in connection with a foster family setting license if within five years 
140.18 	preceding the study the individual is convicted of a felony in section 245C.15, subdivision 
140.19 	4a, paragraph (d).
140.20 	(b) In connection with a foster family setting license, the commissioner may set aside 
140.21 	or grant a variance to the disqualification for an individual who is under 18 years of age at 
140.22 	the time the background study is submitted.

140.23 	EFFECTIVE DATE. This section is effective July 1, 2022.

140.24 	Sec. 48. Minnesota Statutes 2020, section 245C.32, subdivision 1a, is amended to read:
140.25 		Subd. 1a.NETStudy 2.0 system. (a) The commissioner shall design, develop, and test 
140.26 	the NETStudy 2.0 system and implement it no later than September 1, 2015.
140.27 	(b) The NETStudy 2.0 system developed and implemented by the commissioner shall 
140.28 	incorporate and meet all applicable data security standards and policies required by the 
140.29 	Federal Bureau of Investigation (FBI), Department of Public Safety, Bureau of Criminal 
140.30 	Apprehension, and the Office of MN.IT Services. The system shall meet all required 
140.31 	standards for encryption of data at the database level as well as encryption of data that 
140.32 	travels electronically among agencies initiating background studies, the commissioner's 
141.1 	authorized fingerprint collection vendor or vendors, the commissioner, the Bureau of Criminal 
141.2 	Apprehension, and in cases involving national criminal record checks, the FBI.
141.3 	(c) The data system developed and implemented by the commissioner shall incorporate 
141.4 	a system of data security that allows the commissioner to control access to the data field 
141.5 	level by the commissioner's employees. The commissioner shall establish that employees 
141.6 	have access to the minimum amount of private data on any individual as is necessary to 
141.7 	perform their duties under this chapter.
141.8 	(d) The commissioner shall oversee regular quality and compliance audits of the 
141.9 	authorized fingerprint collection vendor or vendors.

141.10 	Sec. 49. Minnesota Statutes 2020, section 245F.04, subdivision 2, is amended to read:
141.11 		Subd. 2.Contents of application. Prior to the issuance of a license, an applicant must 
141.12 	submit, on forms provided by the commissioner, documentation demonstrating the following:
141.13 	(1) compliance with this section;
141.14 	(2) compliance with applicable building, fire, and safety codes; health rules; zoning 
141.15 	ordinances; and other applicable rules and regulations or documentation that a waiver has 
141.16 	been granted. The granting of a waiver does not constitute modification of any requirement 
141.17 	of this section; and
141.18 	(3) completion of an assessment of need for a new or expanded program as required by 
141.19 	Minnesota Rules, part 9530.6800; and
141.20 	(4) (3) insurance coverage, including bonding, sufficient to cover all patient funds, 
141.21 	property, and interests.

141.22 	Sec. 50. Minnesota Statutes 2020, section 245G.03, subdivision 2, is amended to read:
141.23 		Subd. 2.Application. (a) Before the commissioner issues a license, an applicant must 
141.24 	submit, on forms provided by the commissioner, any documents the commissioner requires.
141.25 	(b) At least 60 days prior to submitting an application for licensure under this chapter, 
141.26 	the applicant must notify the county human services director in writing of the applicant's 
141.27 	intent to open a new treatment program. The written notification must include, at a minimum:
141.28 	(1) a description of the proposed treatment program;
141.29 	(2) a description of the target population to be served by the treatment program; and
142.1 	(3) a copy of the program's abuse prevention plan, as required under section 245A.65, 
142.2 	subdivision 2.
142.3 	(c) The county human services director may submit a written statement to the 
142.4 	commissioner regarding the county's support of or opposition to the opening of the new 
142.5 	treatment program. The written statement must include documentation of the rationale for 
142.6 	the county's determination. The commissioner shall consider the county's written statement 
142.7 	when determining whether to issue a license for the treatment program. If the county does 
142.8 	not submit a written statement, the commissioner shall confirm with the county that the 
142.9 	county received the notification required by paragraph (b).

142.10 	Sec. 51. Minnesota Statutes 2020, section 256B.0949, is amended by adding a subdivision 
142.11 	to read:
142.12 		Subd. 16a.Background studies. The requirements for background studies under this 
142.13 	section shall be met by an early intensive developmental and behavioral intervention services 
142.14 	agency through the commissioner's NETStudy system as provided under sections 245C.03, 
142.15 	subdivision 15, and 245C.10, subdivision 17.

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

142.17 	Sec. 52. Minnesota Statutes 2020, section 260C.215, subdivision 4, is amended to read:
142.18 		Subd. 4.Duties of commissioner. The commissioner of human services shall:
142.19 	(1) provide practice guidance to responsible social services agencies and licensed 
142.20 	child-placing agencies that reflect federal and state laws and policy direction on placement 
142.21 	of children;
142.22 	(2) develop criteria for determining whether a prospective adoptive or foster family has 
142.23 	the ability to understand and validate the child's cultural background;
142.24 	(3) provide a standardized training curriculum for adoption and foster care workers and 
142.25 	administrators who work with children. Training must address the following objectives:
142.26 	(i) developing and maintaining sensitivity to all cultures;
142.27 	(ii) assessing values and their cultural implications;
142.28 	(iii) making individualized placement decisions that advance the best interests of a 
142.29 	particular child under section 260C.212, subdivision 2; and
142.30 	(iv) issues related to cross-cultural placement;
143.1 	(4) provide a training curriculum for all prospective adoptive and foster families that 
143.2 	prepares them to care for the needs of adoptive and foster children taking into consideration 
143.3 	the needs of children outlined in section 260C.212, subdivision 2, paragraph (b), and, as 
143.4 	necessary, preparation is continued after placement of the child and includes the knowledge 
143.5 	and skills related to reasonable and prudent parenting standards for the participation of the 
143.6 	child in age or developmentally appropriate activities, according to section 260C.212, 
143.7 	subdivision 14;
143.8 	(5) develop and provide to responsible social services agencies and licensed child-placing 
143.9 	agencies a home study format to assess the capacities and needs of prospective adoptive 
143.10 	and foster families. The format must address problem-solving skills; parenting skills; evaluate 
143.11 	the degree to which the prospective family has the ability to understand and validate the 
143.12 	child's cultural background, and other issues needed to provide sufficient information for 
143.13 	agencies to make an individualized placement decision consistent with section 260C.212, 
143.14 	subdivision 2. For a study of a prospective foster parent, the format must also address the 
143.15 	capacity of the prospective foster parent to provide a safe, healthy, smoke-free home 
143.16 	environment. If a prospective adoptive parent has also been a foster parent, any update 
143.17 	necessary to a home study for the purpose of adoption may be completed by the licensing 
143.18 	authority responsible for the foster parent's license. If a prospective adoptive parent with 
143.19 	an approved adoptive home study also applies for a foster care license, the license application 
143.20 	may be made with the same agency which provided the adoptive home study; and
143.21 	(6) consult with representatives reflecting diverse populations from the councils 
143.22 	established under sections 3.922 and 15.0145, and other state, local, and community 
143.23 	organizations.; and
143.24 	(7) establish family foster setting licensing guidelines for county agencies and private 
143.25 	agencies designated or licensed by the commissioner to perform licensing functions and 
143.26 	activities under section 245A.04. Guidelines that the commissioner establishes under this 
143.27 	clause shall be considered directives of the commissioner under section 245A.16.

143.28 	EFFECTIVE DATE. This section is effective July 1, 2023.

143.29 	Sec. 53. Laws 2020, First Special Session chapter 7, section 1, as amended by Laws 2020, 
143.30 	Third Special Session chapter 1, section 3, is amended by adding a subdivision to read:
143.31 		Subd. 5.Waivers and modifications; extension for 180 days. When the peacetime 
143.32 	emergency declared by the governor in response to the COVID-19 outbreak expires, is 
143.33 	terminated, or is rescinded by the proper authority, waiver CV23: modifying background 
143.34 	study requirements, issued by the commissioner of human services pursuant to Executive 
144.1 	Orders 20-11 and 20-12, including any amendments to the modification issued before the 
144.2 	peacetime emergency expires, shall remain in effect for 180 days after the peacetime 
144.3 	emergency ends.

144.4 	EFFECTIVE DATE. This section is effective the day following final enactment or 
144.5 	retroactively from the date the peacetime emergency declared by the governor in response 
144.6 	to the COVID-19 outbreak ends, whichever is earlier.

144.7 	Sec. 54. CHILD CARE CENTER REGULATION MODERNIZATION.
 144.8 	(a) The commissioner of human services shall contract with an experienced and 
144.9 	independent organization or individual consultant to conduct the work outlined in this 
144.10 	section. If practicable, the commissioner must contract with the National Association for 
144.11 	Regulatory Administration.
144.12 	(b) The consultant must develop a proposal for revised licensing standards that includes 
144.13 	a risk-based model for monitoring compliance with child care center licensing standards, 
144.14 	grounded in national regulatory best practices. Violations in the new model must be weighted 
144.15 	to reflect the potential risk that the violations pose to children's health and safety, and 
144.16 	licensing sanctions must be tied to the potential risk. The proposed new model must protect 
144.17 	the health and safety of children in child care centers and be child-centered, family-friendly, 
144.18 	and fair to providers.
144.19 	(c) The consultant shall develop and implement a stakeholder engagement process that 
144.20 	solicits input from parents, licensed child care centers, staff of the Department of Human 
144.21 	Services, and experts in child development about appropriate licensing standards, appropriate 
144.22 	tiers for violations of the standards based on the potential risk of harm that each violation 
144.23 	poses, and appropriate licensing sanctions for each tier.
144.24 	(d) The consultant shall solicit input from parents, licensed child care centers, and staff 
144.25 	of the Department of Human Services about which child care centers should be eligible for 
144.26 	abbreviated inspections that predict compliance with other licensing standards for licensed 
144.27 	child care centers using key indicators previously identified by an empirically based statistical 
144.28 	methodology developed by the National Association for Regulatory Administration and the 
144.29 	Research Institute for Key Indicators.
144.30 	(e) No later than February 1, 2024, the commissioner shall submit a report and proposed 
144.31 	legislation required to implement the new licensing model to the chairs and ranking minority 
144.32 	members of the legislative committees with jurisdiction over child care regulation.

145.1 	Sec. 55. CHILD FOSTER CARE LICENSING GUIDELINES.
 145.2 	By July 1, 2023, the commissioner of human services shall, in consultation with 
145.3 	stakeholders with expertise in child protection and children's behavioral health, develop 
145.4 	family foster setting licensing guidelines for county agencies and private agencies that 
145.5 	perform licensing functions. Stakeholders include but are not limited to child advocates, 
145.6 	representatives from community organizations, representatives of the state ethnic councils, 
145.7 	the ombudsperson for families, family foster setting providers, youth who have experienced 
145.8 	family foster setting placements, county child protection staff, and representatives of county 
145.9 	and private licensing agencies.

145.10 	Sec. 56. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FAMILY 
145.11 	CHILD CARE ONE-STOP ASSISTANCE NETWORK.
 145.12 	By January 1, 2022, the commissioner of human services shall, in consultation with 
145.13 	county agencies, providers, and other relevant stakeholders, develop a proposal to create, 
145.14 	advertise, and implement a one-stop regional assistance network comprised of individuals 
145.15 	who have experience starting a licensed family or group family child care program or 
145.16 	technical expertise regarding the applicable licensing statutes and procedures, in order to 
145.17 	assist individuals with matters relating to starting or sustaining a licensed family or group 
145.18 	family child care program. The proposal shall include an estimated timeline for 
145.19 	implementation of the assistance network, an estimated budget of the cost of the assistance 
145.20 	network, and any necessary legislative proposals to implement the assistance network. The 
145.21 	proposal shall also include a plan to raise awareness and distribute contact information for 
145.22 	the assistance network to all licensed family or group family child care providers.

145.23 	Sec. 57. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
145.24 	RECOMMENDED FAMILY CHILD CARE ORIENTATION TRAINING.
 145.25 	(a) By July 1, 2022, the commissioner of human services shall develop, in consultation 
145.26 	with licensed family child care providers and representatives from counties, recommended 
145.27 	orientation training for family child care license applicants to ensure that all family child 
145.28 	care license applicants have access to information about Minnesota Statutes, chapters 245A 
145.29 	and 245C, and Minnesota Rules, chapter 9502.
145.30 	(b) The orientation training is voluntary and completion of the orientation is not required 
145.31 	to receive or maintain a family child care license.

146.1 	Sec. 58. FAMILY CHILD CARE REGULATION MODERNIZATION.
 146.2 	(a) The commissioner of human services shall contract with an experienced and 
146.3 	independent organization or individual consultant to conduct the work outlined in this 
146.4 	section. If practicable, the commissioner must contract with the National Association for 
146.5 	Regulatory Administration.
146.6 	(b) The consultant must develop a proposal for updated family child care licensing 
146.7 	standards and solicit input from stakeholders as described in paragraph (d).
146.8 	(c) The consultant must develop a proposal for a risk-based model for monitoring 
146.9 	compliance with family child care licensing standards, grounded in national regulatory best 
146.10 	practices. Violations in the new model must be weighted to reflect the potential risk they 
146.11 	pose to children's health and safety, and licensing sanctions must be tied to the potential 
146.12 	risk. The proposed new model must protect the health and safety of children in family child 
146.13 	care programs and be child-centered, family-friendly, and fair to providers.
146.14 	(d) The consultant shall develop and implement a stakeholder engagement process that 
146.15 	solicits input from parents, licensed family child care providers, county licensors, staff of 
146.16 	the Department of Human Services, and experts in child development about licensing 
146.17 	standards, tiers for violations of the standards based on the potential risk of harm that each 
146.18 	violation poses, and licensing sanctions for each tier.
146.19 	(e) The consultant shall solicit input from parents, licensed family child care providers, 
146.20 	county licensors, and staff of the Department of Human Services about which family child 
146.21 	care providers should be eligible for abbreviated inspections that predict compliance with 
146.22 	other licensing standards for licensed family child care providers using key indicators 
146.23 	previously identified by an empirically based statistical methodology developed by the 
146.24 	National Association for Regulatory Administration and the Research Institute for Key 
146.25 	Indicators.
146.26 	(f) No later than February 1, 2024, the commissioner shall submit a report and proposed 
146.27 	legislation required to implement the new licensing model and the new licensing standards 
146.28 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
146.29 	over child care regulation.

146.30 	Sec. 59. FAMILY CHILD CARE TRAINING ADVISORY COMMITTEE.
 146.31 		Subdivision 1.Formation; duties. (a) The Family Child Care Training Advisory 
146.32 	Committee shall advise the commissioner of human services on the training requirements 
146.33 	for licensed family and group family child care providers. Beginning January 1, 2022, the 
147.1 	advisory committee shall meet at least twice per year. The advisory committee shall annually 
147.2 	elect a chair from among its members who shall establish the agenda for each meeting. The 
147.3 	commissioner or commissioner's designee shall attend all advisory committee meetings.
147.4 	(b) The Family Child Care Training Advisory Committee shall advise and make 
147.5 	recommendations to the commissioner of human services and the contractors working on 
147.6 	the family child care licensing modernization project on:
147.7 	(1) updates to the rules and statutes governing family child care training, including 
147.8 	technical updates to facilitate providers' understanding of training requirements;
147.9 	(2) difficulties facing family child care providers in completing training requirements, 
147.10 	including proposed solutions to provider difficulties; and
147.11 	(3) other ideas for improving access to and quality of training for family child care 
147.12 	providers.
147.13 	(c) The Family Child Care Training Advisory Committee shall expire December 1, 2025.
147.14 		Subd. 2.Advisory committee members. (a) The Family Child Care Training Advisory 
147.15 	Committee consists of:
147.16 	(1) four members representing family child care providers from greater Minnesota, 
147.17 	including two appointed by the speaker of the house and two appointed by the senate majority 
147.18 	leader;
147.19 	(2) two members representing family child care providers from the seven-county 
147.20 	metropolitan area as defined in Minnesota Statutes, section 473.121, subdivision 2, including 
147.21 	one appointed by the speaker of the house and one appointed by the senate majority leader;
147.22 	(3) one member appointed by the Minnesota Association of Child Care Professionals;
147.23 	(4) one member appointed by the Minnesota Child Care Provider Information Network;
147.24 	(5) two members appointed by the Association of Minnesota Child Care Licensors, 
147.25 	including one from greater Minnesota and one from the seven-county metropolitan area, as 
147.26 	defined in Minnesota Statutes, section 473.121, subdivision 2; and
147.27 	(6) five members with experience in child development, instructional design, and training 
147.28 	delivery, with:
147.29 	(i) one member appointed by Child Care Aware of Minnesota;
147.30 	(ii) one member appointed by the Minnesota Initiative Foundations;
147.31 	(iii) one member appointed by the Center for Inclusive Child Care;
148.1 	(iv) one member appointed by the Greater Minnesota Partnership; and
148.2 	(v) one member appointed by Achieve, the Minnesota Center for Professional 
148.3 	Development.
148.4 	(b) Advisory committee members shall not be employed by the Department of Human 
148.5 	Services. Advisory committee members shall receive no compensation for their participation 
148.6 	in the advisory committee.
148.7 	(c) Advisory committee members must include representatives of diverse cultural 
148.8 	communities.
148.9 	(d) Advisory committee members shall serve two-year terms. Initial appointments to 
148.10 	the advisory committee must be made by December 1, 2021. Subsequent appointments to 
148.11 	the advisory committee must be made by December 1 of the year in which the member's 
148.12 	term expires.
148.13 		Subd. 3.Commissioner report. The commissioner of human services shall report 
148.14 	annually by November 1 to the chairs and ranking minority members of the legislative 
148.15 	committees with jurisdiction over early care and education programs on any recommendations 
148.16 	from the Family Child Care Training Advisory Committee.

148.17 	Sec. 60. REVISOR INSTRUCTION.
 148.18 	The revisor of statutes shall renumber Minnesota Statutes, section 245C.02, so that the 
148.19 	subdivisions are alphabetical. The revisor shall correct any cross-references that arise as a 
148.20 	result of the renumbering.

148.21 	Sec. 61. REPEALER.
 148.22 	(a) Minnesota Statutes 2020, section 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 
148.23 	10, 11, 12, 13, 14, and 16, are repealed.
148.24 	(b) Minnesota Rules, parts 9530.6800; and 9530.6810, are repealed.

148.25 	EFFECTIVE DATE. Paragraph (b) is effective the day following final enactment.

148.26 	ARTICLE 3
148.27 	HEALTH DEPARTMENT

148.28 	Section 1. Minnesota Statutes 2020, section 62J.495, subdivision 1, is amended to read:
148.29 		Subdivision 1.Implementation. The commissioner of health, in consultation with the 
148.30 	e-Health Advisory Committee, shall develop uniform standards to be used for the 
149.1 	interoperable electronic health records system for sharing and synchronizing patient data 
149.2 	across systems. The standards must be compatible with federal efforts. The uniform standards 
149.3 	must be developed by January 1, 2009, and updated on an ongoing basis. The commissioner 
149.4 	shall include an update on standards development as part of an annual report to the legislature.
149.5 	Individual health care providers in private practice with no other providers and health care 
149.6 	providers that do not accept reimbursement from a group purchaser, as defined in section 
149.7 	62J.03, subdivision 6, are excluded from the requirements of this section.

149.8 	Sec. 2. Minnesota Statutes 2020, section 62J.495, subdivision 2, is amended to read:
149.9 		Subd. 2.E-Health Advisory Committee. (a) The commissioner shall establish an 
149.10 	e-Health Advisory Committee governed by section 15.059 to advise the commissioner on 
149.11 	the following matters:
149.12 	(1) assessment of the adoption and effective use of health information technology by 
149.13 	the state, licensed health care providers and facilities, and local public health agencies;
149.14 	(2) recommendations for implementing a statewide interoperable health information 
149.15 	infrastructure, to include estimates of necessary resources, and for determining standards 
149.16 	for clinical data exchange, clinical support programs, patient privacy requirements, and 
149.17 	maintenance of the security and confidentiality of individual patient data;
149.18 	(3) recommendations for encouraging use of innovative health care applications using 
149.19 	information technology and systems to improve patient care and reduce the cost of care, 
149.20 	including applications relating to disease management and personal health management 
149.21 	that enable remote monitoring of patients' conditions, especially those with chronic 
149.22 	conditions; and
149.23 	(4) other related issues as requested by the commissioner.
149.24 	(b) The members of the e-Health Advisory Committee shall include the commissioners, 
149.25 	or commissioners' designees, of health, human services, administration, and commerce and 
149.26 	additional members to be appointed by the commissioner to include persons representing 
149.27 	Minnesota's local public health agencies, licensed hospitals and other licensed facilities and 
149.28 	providers, private purchasers, the medical and nursing professions, health insurers and health 
149.29 	plans, the state quality improvement organization, academic and research institutions, 
149.30 	consumer advisory organizations with an interest and expertise in health information 
149.31 	technology, and other stakeholders as identified by the commissioner to fulfill the 
149.32 	requirements of section 3013, paragraph (g), of the HITECH Act.
150.1 	(c) The commissioner shall prepare and issue an annual report not later than January 30 
150.2 	of each year outlining progress to date in implementing a statewide health information 
150.3 	infrastructure and recommending action on policy and necessary resources to continue the 
150.4 	promotion of adoption and effective use of health information technology.
150.5 	(d) This subdivision expires June 30, 2021 2031.

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

150.7 	Sec. 3. Minnesota Statutes 2020, section 62J.495, subdivision 3, is amended to read:
150.8 		Subd. 3.Interoperable electronic health record requirements.  (a) Hospitals and health 
150.9 	care providers must meet the following criteria when implementing an interoperable 
150.10 	electronic health records system within their hospital system or clinical practice setting.
150.11 	(b) The electronic health record must be a qualified electronic health record.
150.12 	(c) The electronic health record must be certified by the Office of the National 
150.13 	Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health 
150.14 	care providers if a certified electronic health record product for the provider's particular 
150.15 	practice setting is available. This criterion shall be considered met if a hospital or health 
150.16 	care provider is using an electronic health records system that has been certified within the 
150.17 	last three years, even if a more current version of the system has been certified within the 
150.18 	three-year period.
150.19 	(d) The electronic health record must meet the standards established according to section 
150.20 	3004 of the HITECH Act as applicable.
150.21 	(e) The electronic health record must have the ability to generate information on clinical 
150.22 	quality measures and other measures reported under sections 4101, 4102, and 4201 of the 
150.23 	HITECH Act.
150.24 	(f) The electronic health record system must be connected to a state-certified health 
150.25 	information organization either directly or through a connection facilitated by a state-certified
150.26 	health data intermediary as defined in section 62J.498.
150.27 	(g) A health care provider who is a prescriber or dispenser of legend drugs must have 
150.28 	an electronic health record system that meets the requirements of section 62J.497.

150.29 	Sec. 4. Minnesota Statutes 2020, section 62J.495, subdivision 4, is amended to read:
150.30 		Subd. 4.Coordination with national HIT activities. (a) The commissioner, in 
150.31 	consultation with the e-Health Advisory Committee, shall update the statewide 
151.1 	implementation plan required under subdivision 2 and released June 2008, to be consistent 
151.2 	with the updated federal HIT Strategic Plan released by the Office of the National Coordinator 
151.3 	in accordance with section 3001 of the HITECH Act. The statewide plan shall meet the 
151.4 	requirements for a plan required under section 3013 of the HITECH Act plans.
151.5 	(b) The commissioner, in consultation with the e-Health Advisory Committee, shall 
151.6 	work to ensure coordination between state, regional, and national efforts to support and 
151.7 	accelerate efforts to effectively use health information technology to improve the quality 
151.8 	and coordination of health care and the continuity of patient care among health care providers, 
151.9 	to reduce medical errors, to improve population health, to reduce health disparities, and to 
151.10 	reduce chronic disease. The commissioner's coordination efforts shall include but not be 
151.11 	limited to:
151.12 	(1) assisting in the development and support of health information technology regional 
151.13 	extension centers established under section 3012(c) of the HITECH Act to provide technical 
151.14 	assistance and disseminate best practices;
151.15 	(2) providing supplemental information to the best practices gathered by regional centers 
151.16 	to ensure that the information is relayed in a meaningful way to the Minnesota health care 
151.17 	community;
151.18 	(3) (1) providing financial and technical support to Minnesota health care providers to 
151.19 	encourage implementation of admission, discharge and transfer alerts, and care summary 
151.20 	document exchange transactions and to evaluate the impact of health information technology 
151.21 	on cost and quality of care. Communications about available financial and technical support 
151.22 	shall include clear information about the interoperable health record requirements in 
151.23 	subdivision 1, including a separate statement in bold-face type clarifying the exceptions to 
151.24 	those requirements;
151.25 	(4) (2) providing educational resources and technical assistance to health care providers 
151.26 	and patients related to state and national privacy, security, and consent laws governing 
151.27 	clinical health information, including the requirements in sections 144.291 to 144.298. In 
151.28 	carrying out these activities, the commissioner's technical assistance does not constitute 
151.29 	legal advice;
151.30 	(5) (3) assessing Minnesota's legal, financial, and regulatory framework for health 
151.31 	information exchange, including the requirements in sections 144.291 to 144.298, and 
151.32 	making recommendations for modifications that would strengthen the ability of Minnesota 
151.33 	health care providers to securely exchange data in compliance with patient preferences and 
151.34 	in a way that is efficient and financially sustainable; and
152.1 	(6) (4) seeking public input on both patient impact and costs associated with requirements 
152.2 	related to patient consent for release of health records for the purposes of treatment, payment, 
152.3 	and health care operations, as required in section 144.293, subdivision 2. The commissioner 
152.4 	shall provide a report to the legislature on the findings of this public input process no later 
152.5 	than February 1, 2017.
152.6 	(c) The commissioner, in consultation with the e-Health Advisory Committee, shall 
152.7 	monitor national activity related to health information technology and shall coordinate 
152.8 	statewide input on policy development. The commissioner shall coordinate statewide 
152.9 	responses to proposed federal health information technology regulations in order to ensure 
152.10 	that the needs of the Minnesota health care community are adequately and efficiently 
152.11 	addressed in the proposed regulations. The commissioner's responses may include, but are 
152.12 	not limited to:
152.13 	(1) reviewing and evaluating any standard, implementation specification, or certification 
152.14 	criteria proposed by the national HIT standards committee committees;
152.15 	(2) reviewing and evaluating policy proposed by the national HIT policy committee
152.16 	committees relating to the implementation of a nationwide health information technology 
152.17 	infrastructure; and
152.18 	(3) monitoring and responding to activity related to the development of quality measures 
152.19 	and other measures as required by section 4101 of the HITECH Act. Any response related 
152.20 	to quality measures shall consider and address the quality efforts required under chapter 
152.21 	62U; and
152.22 	(4) monitoring and responding to national activity related to privacy, security, and data 
152.23 	stewardship of electronic health information and individually identifiable health information.
152.24 	(d) To the extent that the state is either required or allowed to apply, or designate an 
152.25 	entity to apply for or carry out activities and programs under section 3013 of the HITECH 
152.26 	Act, the commissioner of health, in consultation with the e-Health Advisory Committee 
152.27 	and the commissioner of human services, shall be the lead applicant or sole designating 
152.28 	authority. The commissioner shall make such designations consistent with the goals and 
152.29 	objectives of sections 62J.495 to 62J.497 and 62J.50 to 62J.61.
152.30 	(e) The commissioner of human services shall apply for funding necessary to administer 
152.31 	the incentive payments to providers authorized under title IV of the American Recovery 
152.32 	and Reinvestment Act.
153.1 	(f) The commissioner shall include in the report to the legislature information on the 
153.2 	activities of this subdivision and provide recommendations on any relevant policy changes 
153.3 	that should be considered in Minnesota.

153.4 	Sec. 5. Minnesota Statutes 2020, section 62J.497, subdivision 1, is amended to read:
153.5 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
153.6 	the meanings given.
153.7 	(b) "Backward compatible" means that the newer version of a data transmission standard 
153.8 	would retain, at a minimum, the full functionality of the versions previously adopted, and 
153.9 	would permit the successful completion of the applicable transactions with entities that 
153.10 	continue to use the older versions.
153.11 	(c) (b) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 
153.12 	30. Dispensing does not include the direct administering of a controlled substance to a 
153.13 	patient by a licensed health care professional.
153.14 	(d) (c) "Dispenser" means a person authorized by law to dispense a controlled substance, 
153.15 	pursuant to a valid prescription.
153.16 	(e) (d) "Electronic media" has the meaning given under Code of Federal Regulations, 
153.17 	title 45, part 160.103.
153.18 	(f) (e) "E-prescribing" means the transmission using electronic media of prescription or 
153.19 	prescription-related information between a prescriber, dispenser, pharmacy benefit manager, 
153.20 	or group purchaser, either directly or through an intermediary, including an e-prescribing 
153.21 	network. E-prescribing includes, but is not limited to, two-way transmissions between the 
153.22 	point of care and the dispenser and two-way transmissions related to eligibility, formulary, 
153.23 	and medication history information.
153.24 	(g) (f) "Electronic prescription drug program" means a program that provides for 
153.25 	e-prescribing.
153.26 	(h) (g) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
153.27 	(i) (h) "HL7 messages" means a standard approved by the standards development 
153.28 	organization known as Health Level Seven.
153.29 	(j) (i) "National Provider Identifier" or "NPI" means the identifier described under Code 
153.30 	of Federal Regulations, title 45, part 162.406.
153.31 	(k) (j) "NCPDP" means the National Council for Prescription Drug Programs, Inc.
154.1 	(l) (k) "NCPDP Formulary and Benefits Standard" means the most recent version of the
154.2 	National Council for Prescription Drug Programs Formulary and Benefits Standard, 
154.3 	Implementation Guide, Version 1, Release 0, October 2005 or the most recent standard 
154.4 	adopted by the Centers for Medicare and Medicaid Services for e-prescribing under Medicare 
154.5 	Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act and regulations 
154.6 	adopted under it. The standards shall be implemented according to the Centers for Medicare 
154.7 	and Medicaid Services schedule for compliance.
154.8 	(m) (l) "NCPDP SCRIPT Standard" means the most recent version of the National 
154.9 	Council for Prescription Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, 
154.10 	Implementation Guide Version 8, Release 1 (Version 8.1), October 2005, or the most recent 
154.11 	standard adopted by the Centers for Medicare and Medicaid Services for e-prescribing under 
154.12 	Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and 
154.13 	regulations adopted under it. The standards shall be implemented according to the Centers 
154.14 	for Medicare and Medicaid Services schedule for compliance. Subsequently released versions 
154.15 	of the NCPDP SCRIPT Standard may be used, provided that the new version of the standard 
154.16 	is backward compatible to the current version adopted by the Centers for Medicare and 
154.17 	Medicaid Services.
154.18 	(n) (m) "Pharmacy" has the meaning given in section 151.01, subdivision 2.
154.19 	(o) (n) "Prescriber" means a licensed health care practitioner, other than a veterinarian, 
154.20 	as defined in section 151.01, subdivision 23.
154.21 	(p) (o) "Prescription-related information" means information regarding eligibility for 
154.22 	drug benefits, medication history, or related health or drug information.
154.23 	(q) (p) "Provider" or "health care provider" has the meaning given in section 62J.03, 
154.24 	subdivision 8.

154.25 	Sec. 6. Minnesota Statutes 2020, section 62J.497, subdivision 3, is amended to read:
154.26 		Subd. 3.Standards for electronic prescribing. (a) Prescribers and dispensers must use 
154.27 	the NCPDP SCRIPT Standard for the communication of a prescription or prescription-related 
154.28 	information. The NCPDP SCRIPT Standard shall be used to conduct the following 
154.29 	transactions:
154.30 	(1) get message transaction;
154.31 	(2) status response transaction;
154.32 	(3) error response transaction;
155.1 	(4) new prescription transaction;
155.2 	(5) prescription change request transaction;
155.3 	(6) prescription change response transaction;
155.4 	(7) refill prescription request transaction;
155.5 	(8) refill prescription response transaction;
155.6 	(9) verification transaction;
155.7 	(10) password change transaction;
155.8 	(11) cancel prescription request transaction; and
155.9 	(12) cancel prescription response transaction.
155.10 	(b) Providers, group purchasers, prescribers, and dispensers must use the NCPDP SCRIPT 
155.11 	Standard for communicating and transmitting medication history information.
155.12 	(c) Providers, group purchasers, prescribers, and dispensers must use the NCPDP 
155.13 	Formulary and Benefits Standard for communicating and transmitting formulary and benefit 
155.14 	information.
155.15 	(d) Providers, group purchasers, prescribers, and dispensers must use the national provider 
155.16 	identifier to identify a health care provider in e-prescribing or prescription-related transactions 
155.17 	when a health care provider's identifier is required.
155.18 	(e) Providers, group purchasers, prescribers, and dispensers must communicate eligibility 
155.19 	information and conduct health care eligibility benefit inquiry and response transactions 
155.20 	according to the requirements of section 62J.536.

155.21 	Sec. 7. Minnesota Statutes 2020, section 62J.498, is amended to read:
155.22 	62J.498 HEALTH INFORMATION EXCHANGE.
155.23 		Subdivision 1.Definitions. (a) The following definitions apply to sections 62J.498 to 
155.24 	62J.4982:
155.25 	(b) "Clinical data repository" means a real time database that consolidates data from a 
155.26 	variety of clinical sources to present a unified view of a single patient and is used by a 
155.27 	state-certified health information exchange service provider to enable health information 
155.28 	exchange among health care providers that are not related health care entities as defined in 
155.29 	section 144.291, subdivision 2, paragraph (k). This does not include clinical data that are 
156.1 	submitted to the commissioner for public health purposes required or permitted by law, 
156.2 	including any rules adopted by the commissioner.
156.3 	(c) "Clinical transaction" means any meaningful use transaction or other health 
156.4 	information exchange transaction that is not covered by section 62J.536.
156.5 	(d) "Commissioner" means the commissioner of health.
156.6 	(e) "Health care provider" or "provider" means a health care provider or provider as 
156.7 	defined in section 62J.03, subdivision 8.
156.8 	(f) "Health data intermediary" means an entity that provides the technical capabilities 
156.9 	or related products and services to enable health information exchange among health care 
156.10 	providers that are not related health care entities as defined in section 144.291, subdivision 
156.11 	2, paragraph (k). This includes but is not limited to health information service providers 
156.12 	(HISP), electronic health record vendors, and pharmaceutical electronic data intermediaries 
156.13 	as defined in section 62J.495.
156.14 	(g) "Health information exchange" means the electronic transmission of health-related 
156.15 	information between organizations according to nationally recognized standards.
156.16 	(h) "Health information exchange service provider" means a health data intermediary 
156.17 	or health information organization.
156.18 	(i) "Health information organization" means an organization that oversees, governs, and 
156.19 	facilitates health information exchange among health care providers that are not related 
156.20 	health care entities as defined in section 144.291, subdivision 2, paragraph (k), to improve 
156.21 	coordination of patient care and the efficiency of health care delivery.
156.22 	(j) "HITECH Act" means the Health Information Technology for Economic and Clinical 
156.23 	Health Act as defined in section 62J.495.
156.24 	(k) (j) "Major participating entity" means:
156.25 	(1) a participating entity that receives compensation for services that is greater than 30 
156.26 	percent of the health information organization's gross annual revenues from the health 
156.27 	information exchange service provider;
156.28 	(2) a participating entity providing administrative, financial, or management services to 
156.29 	the health information organization, if the total payment for all services provided by the 
156.30 	participating entity exceeds three percent of the gross revenue of the health information 
156.31 	organization; and
157.1 	(3) a participating entity that nominates or appoints 30 percent or more of the board of 
157.2 	directors or equivalent governing body of the health information organization.
157.3 	(l) (k) "Master patient index" means an electronic database that holds unique identifiers 
157.4 	of patients registered at a care facility and is used by a state-certified health information 
157.5 	exchange service provider to enable health information exchange among health care providers 
157.6 	that are not related health care entities as defined in section 144.291, subdivision 2, paragraph 
157.7 	(k). This does not include data that are submitted to the commissioner for public health 
157.8 	purposes required or permitted by law, including any rules adopted by the commissioner.
157.9 	(m) "Meaningful use" means use of certified electronic health record technology to 
157.10 	improve quality, safety, and efficiency and reduce health disparities; engage patients and 
157.11 	families; improve care coordination and population and public health; and maintain privacy 
157.12 	and security of patient health information as established by the Centers for Medicare and 
157.13 	Medicaid Services and the Minnesota Department of Human Services pursuant to sections 
157.14 	4101, 4102, and 4201 of the HITECH Act.
157.15 	(n) "Meaningful use transaction" means an electronic transaction that a health care 
157.16 	provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare 
157.17 	penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
157.18 	(o) (l) "Participating entity" means any of the following persons, health care providers, 
157.19 	companies, or other organizations with which a health information organization or health 
157.20 	data intermediary has contracts or other agreements for the provision of health information 
157.21 	exchange services:
157.22 	(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home 
157.23 	licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise 
157.24 	licensed under the laws of this state or registered with the commissioner;
157.25 	(2) a health care provider, and any other health care professional otherwise licensed 
157.26 	under the laws of this state or registered with the commissioner;
157.27 	(3) a group, professional corporation, or other organization that provides the services of 
157.28 	individuals or entities identified in clause (2), including but not limited to a medical clinic, 
157.29 	a medical group, a home health care agency, an urgent care center, and an emergent care 
157.30 	center;
157.31 	(4) a health plan as defined in section 62A.011, subdivision 3; and
157.32 	(5) a state agency as defined in section 13.02, subdivision 17.
158.1 	(p) (m) "Reciprocal agreement" means an arrangement in which two or more health 
158.2 	information exchange service providers agree to share in-kind services and resources to 
158.3 	allow for the pass-through of clinical transactions.
158.4 	(q) "State-certified health data intermediary" means a health data intermediary that has 
158.5 	been issued a certificate of authority to operate in Minnesota.
158.6 	(r) (n) "State-certified health information organization" means a health information 
158.7 	organization that has been issued a certificate of authority to operate in Minnesota.
158.8 		Subd. 2.Health information exchange oversight. (a) The commissioner shall protect 
158.9 	the public interest on matters pertaining to health information exchange. The commissioner 
158.10 	shall:
158.11 	(1) review and act on applications from health data intermediaries and health information 
158.12 	organizations for certificates of authority to operate in Minnesota;
158.13 	(2) require information to be provided as needed from health information exchange 
158.14 	service providers in order to meet requirements established under sections 62J.498 to 
158.15 	62J.4982;
158.16 	(2) (3) provide ongoing monitoring to ensure compliance with criteria established under 
158.17 	sections 62J.498 to 62J.4982;
158.18 	(3) (4) respond to public complaints related to health information exchange services;
158.19 	(4) (5) take enforcement actions as necessary, including the imposition of fines, 
158.20 	suspension, or revocation of certificates of authority as outlined in section 62J.4982;
158.21 	(5) (6) provide a biennial report on the status of health information exchange services 
158.22 	that includes but is not limited to:
158.23 	(i) recommendations on actions necessary to ensure that health information exchange 
158.24 	services are adequate to meet the needs of Minnesota citizens and providers statewide;
158.25 	(ii) recommendations on enforcement actions to ensure that health information exchange 
158.26 	service providers act in the public interest without causing disruption in health information 
158.27 	exchange services;
158.28 	(iii) recommendations on updates to criteria for obtaining certificates of authority under 
158.29 	this section; and
158.30 	(iv) recommendations on standard operating procedures for health information exchange, 
158.31 	including but not limited to the management of consumer preferences; and
159.1 	(6) (7) other duties necessary to protect the public interest.
159.2 	(b) As part of the application review process for certification under paragraph (a), prior 
159.3 	to issuing a certificate of authority, the commissioner shall:
159.4 	(1) make all portions of the application classified as public data available to the public 
159.5 	for at least ten days while an application is under consideration. At the request of the 
159.6 	commissioner, the applicant shall participate in a public hearing by presenting an overview 
159.7 	of their application and responding to questions from interested parties; and
159.8 	(2) consult with hospitals, physicians, and other providers prior to issuing a certificate 
159.9 	of authority.
159.10 	(c) When the commissioner is actively considering a suspension or revocation of a 
159.11 	certificate of authority as described in section 62J.4982, subdivision 3, all investigatory data 
159.12 	that are collected, created, or maintained related to the suspension or revocation are classified 
159.13 	as confidential data on individuals and as protected nonpublic data in the case of data not 
159.14 	on individuals.
159.15 	(d) The commissioner may disclose data classified as protected nonpublic or confidential 
159.16 	under paragraph (c) if disclosing the data will protect the health or safety of patients.
159.17 	(e) After the commissioner makes a final determination regarding a suspension or 
159.18 	revocation of a certificate of authority, all minutes, orders for hearing, findings of fact, 
159.19 	conclusions of law, and the specification of the final disciplinary action, are classified as 
159.20 	public data.

159.21 	Sec. 8. Minnesota Statutes 2020, section 62J.4981, is amended to read:
159.22 	62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH 
159.23 	INFORMATION EXCHANGE SERVICES.
159.24 		Subdivision 1.Authority to require organizations to apply. The commissioner shall 
159.25 	require a health data intermediary or a health information organization to apply for a 
159.26 	certificate of authority under this section. An applicant may continue to operate until the 
159.27 	commissioner acts on the application. If the application is denied, the applicant is considered 
159.28 	a health information exchange service provider whose certificate of authority has been 
159.29 	revoked under section 62J.4982, subdivision 2, paragraph (d).
159.30 		Subd. 2.Certificate of authority for health data intermediaries. (a) A health data 
159.31 	intermediary must be certified by the state and comply with requirements established in this 
159.32 	section.
160.1 	(b) Notwithstanding any law to the contrary, any corporation organized to do so may 
160.2 	apply to the commissioner for a certificate of authority to establish and operate as a health 
160.3 	data intermediary in compliance with this section. No person shall establish or operate a 
160.4 	health data intermediary in this state, nor sell or offer to sell, or solicit offers to purchase 
160.5 	or receive advance or periodic consideration in conjunction with a health data intermediary 
160.6 	contract unless the organization has a certificate of authority or has an application under 
160.7 	active consideration under this section.
160.8 	(c) In issuing the certificate of authority, the commissioner shall determine whether the 
160.9 	applicant for the certificate of authority has demonstrated that the applicant meets the 
160.10 	following minimum criteria:
160.11 	(1) hold reciprocal agreements with at least one state-certified health information 
160.12 	organization to access patient data, and for the transmission and receipt of clinical 
160.13 	transactions. Reciprocal agreements must meet the requirements established in subdivision 
160.14 	5; and
160.15 	(2) participate in statewide shared health information exchange services as defined by 
160.16 	the commissioner to support interoperability between state-certified health information 
160.17 	organizations and state-certified health data intermediaries.
160.18 		Subd. 3.Certificate of authority for health information organizations. (a) A health 
160.19 	information organization must obtain a certificate of authority from the commissioner and 
160.20 	demonstrate compliance with the criteria in paragraph (c).
160.21 	(b) Notwithstanding any law to the contrary, an organization may apply for a certificate 
160.22 	of authority to establish and operate a health information organization under this section. 
160.23 	No person shall establish or operate a health information organization in this state, nor sell 
160.24 	or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in 
160.25 	conjunction with a health information organization or health information contract unless 
160.26 	the organization has a certificate of authority under this section.
160.27 	(c) In issuing the certificate of authority, the commissioner shall determine whether the 
160.28 	applicant for the certificate of authority has demonstrated that the applicant meets the 
160.29 	following minimum criteria:
160.30 	(1) the entity is a legally established organization;
160.31 	(2) appropriate insurance, including liability insurance, for the operation of the health 
160.32 	information organization is in place and sufficient to protect the interest of the public and 
160.33 	participating entities;
161.1 	(3) strategic and operational plans address governance, technical infrastructure, legal 
161.2 	and policy issues, finance, and business operations in regard to how the organization will 
161.3 	expand to support providers in achieving health information exchange goals over time;
161.4 	(4) the entity addresses the parameters to be used with participating entities and other 
161.5 	health information exchange service providers for clinical transactions, compliance with 
161.6 	Minnesota law, and interstate health information exchange trust agreements;
161.7 	(5) the entity's board of directors or equivalent governing body is composed of members 
161.8 	that broadly represent the health information organization's participating entities and 
161.9 	consumers;
161.10 	(6) the entity maintains a professional staff responsible to the board of directors or 
161.11 	equivalent governing body with the capacity to ensure accountability to the organization's 
161.12 	mission;
161.13 	(7) the organization is compliant with national certification and accreditation programs 
161.14 	designated by the commissioner;
161.15 	(8) the entity maintains the capability to query for patient information based on national 
161.16 	standards. The query capability may utilize a master patient index, clinical data repository, 
161.17 	or record locator service as defined in section 144.291, subdivision 2, paragraph (j). The 
161.18 	entity must be compliant with the requirements of section 144.293, subdivision 8, when 
161.19 	conducting clinical transactions;
161.20 	(9) the organization demonstrates interoperability with all other state-certified health 
161.21 	information organizations using nationally recognized standards;
161.22 	(10) the organization demonstrates compliance with all privacy and security requirements 
161.23 	required by state and federal law; and
161.24 	(11) the organization uses financial policies and procedures consistent with generally 
161.25 	accepted accounting principles and has an independent audit of the organization's financials 
161.26 	on an annual basis.
161.27 	(d) Health information organizations that have obtained a certificate of authority must:
161.28 	(1) meet the requirements established for connecting to the National eHealth Exchange;
161.29 	(2) annually submit strategic and operational plans for review by the commissioner that 
161.30 	address:
162.1 	(i) progress in achieving objectives included in previously submitted strategic and 
162.2 	operational plans across the following domains: business and technical operations, technical 
162.3 	infrastructure, legal and policy issues, finance, and organizational governance;
162.4 	(ii) plans for ensuring the necessary capacity to support clinical transactions;
162.5 	(iii) approach for attaining financial sustainability, including public and private financing 
162.6 	strategies, and rate structures;
162.7 	(iv) rates of adoption, utilization, and transaction volume, and mechanisms to support 
162.8 	health information exchange; and
162.9 	(v) an explanation of methods employed to address the needs of community clinics, 
162.10 	critical access hospitals, and free clinics in accessing health information exchange services;
162.11 	(3) enter into reciprocal agreements with all other state-certified health information 
162.12 	organizations and state-certified health data intermediaries to enable access to patient data, 
162.13 	and for the transmission and receipt of clinical transactions. Reciprocal agreements must 
162.14 	meet the requirements in subdivision 5;
162.15 	(4) participate in statewide shared health information exchange services as defined by 
162.16 	the commissioner to support interoperability between state-certified health information 
162.17 	organizations and state-certified health data intermediaries; and
162.18 	(5) comply with additional requirements for the certification or recertification of health 
162.19 	information organizations that may be established by the commissioner.
162.20 		Subd. 4.Application for certificate of authority for health information exchange 
162.21 	service providers organizations. (a) Each application for a certificate of authority shall 
162.22 	be in a form prescribed by the commissioner and verified by an officer or authorized 
162.23 	representative of the applicant. Each application shall include the following in addition to 
162.24 	information described in the criteria in subdivisions 2 and subdivision 3:
162.25 	(1) for health information organizations only, a copy of the basic organizational document, 
162.26 	if any, of the applicant and of each major participating entity, such as the articles of 
162.27 	incorporation, or other applicable documents, and all amendments to it;
162.28 	(2) for health information organizations only, a list of the names, addresses, and official 
162.29 	positions of the following:
162.30 	(i) all members of the board of directors or equivalent governing body, and the principal 
162.31 	officers and, if applicable, shareholders of the applicant organization; and
163.1 	(ii) all members of the board of directors or equivalent governing body, and the principal 
163.2 	officers of each major participating entity and, if applicable, each shareholder beneficially 
163.3 	owning more than ten percent of any voting stock of the major participating entity;
163.4 	(3) for health information organizations only, the name and address of each participating 
163.5 	entity and the agreed-upon duration of each contract or agreement if applicable;
163.6 	(4) a copy of each standard agreement or contract intended to bind the participating 
163.7 	entities and the health information exchange service provider organization. Contractual 
163.8 	provisions shall be consistent with the purposes of this section, in regard to the services to 
163.9 	be performed under the standard agreement or contract, the manner in which payment for 
163.10 	services is determined, the nature and extent of responsibilities to be retained by the health 
163.11 	information organization, and contractual termination provisions;
163.12 	(5) a statement generally describing the health information exchange service provider
163.13 	organization, its health information exchange contracts, facilities, and personnel, including 
163.14 	a statement describing the manner in which the applicant proposes to provide participants 
163.15 	with comprehensive health information exchange services;
163.16 	(6) a statement reasonably describing the geographic area or areas to be served and the 
163.17 	type or types of participants to be served;
163.18 	(7) a description of the complaint procedures to be used as required under this section;
163.19 	(8) a description of the mechanism by which participating entities will have an opportunity 
163.20 	to participate in matters of policy and operation;
163.21 	(9) a copy of any pertinent agreements between the health information organization and 
163.22 	insurers, including liability insurers, demonstrating coverage is in place;
163.23 	(10) a copy of the conflict of interest policy that applies to all members of the board of 
163.24 	directors or equivalent governing body and the principal officers of the health information 
163.25 	organization; and
163.26 	(11) other information as the commissioner may reasonably require to be provided.
163.27 	(b) Within 45 days after the receipt of the application for a certificate of authority, the 
163.28 	commissioner shall determine whether or not the application submitted meets the 
163.29 	requirements for completion in paragraph (a), and notify the applicant of any further 
163.30 	information required for the application to be processed.
163.31 	(c) Within 90 days after the receipt of a complete application for a certificate of authority, 
163.32 	the commissioner shall issue a certificate of authority to the applicant if the commissioner 
164.1 	determines that the applicant meets the minimum criteria requirements of subdivision 2 for 
164.2 	health data intermediaries or subdivision 3 for health information organizations. If the 
164.3 	commissioner determines that the applicant is not qualified, the commissioner shall notify 
164.4 	the applicant and specify the reasons for disqualification.
164.5 	(d) Upon being granted a certificate of authority to operate as a state-certified health 
164.6 	information organization or state-certified health data intermediary, the organization must 
164.7 	operate in compliance with the provisions of this section. Noncompliance may result in the 
164.8 	imposition of a fine or the suspension or revocation of the certificate of authority according 
164.9 	to section 62J.4982.
164.10 		Subd. 5.Reciprocal agreements between health information exchange entities
164.11 	organizations. (a) Reciprocal agreements between two health information organizations 
164.12 	or between a health information organization and a health data intermediary must include 
164.13 	a fair and equitable model for charges between the entities that:
164.14 	(1) does not impede the secure transmission of clinical transactions;
164.15 	(2) does not charge a fee for the exchange of meaningful use transactions transmitted 
164.16 	according to nationally recognized standards where no additional value-added service is 
164.17 	rendered to the sending or receiving health information organization or health data 
164.18 	intermediary either directly or on behalf of the client;
164.19 	(3) is consistent with fair market value and proportionately reflects the value-added 
164.20 	services accessed as a result of the agreement; and
164.21 	(4) prevents health care stakeholders from being charged multiple times for the same 
164.22 	service.
164.23 	(b) Reciprocal agreements must include comparable quality of service standards that 
164.24 	ensure equitable levels of services.
164.25 	(c) Reciprocal agreements are subject to review and approval by the commissioner.
164.26 	(d) Nothing in this section precludes a state-certified health information organization or 
164.27 	state-certified health data intermediary from entering into contractual agreements for the 
164.28 	provision of value-added services beyond meaningful use transactions.

164.29 	Sec. 9. Minnesota Statutes 2020, section 62J.4982, is amended to read:
164.30 	62J.4982 ENFORCEMENT AUTHORITY; COMPLIANCE.
164.31 		Subdivision 1.Penalties and enforcement. (a) The commissioner may, for any violation 
164.32 	of statute or rule applicable to a health information exchange service provider organization, 
165.1 	levy an administrative penalty in an amount up to $25,000 for each violation. In determining 
165.2 	the level of an administrative penalty, the commissioner shall consider the following factors:
165.3 	(1) the number of participating entities affected by the violation;
165.4 	(2) the effect of the violation on participating entities' access to health information 
165.5 	exchange services;
165.6 	(3) if only one participating entity is affected, the effect of the violation on the patients 
165.7 	of that entity;
165.8 	(4) whether the violation is an isolated incident or part of a pattern of violations;
165.9 	(5) the economic benefits derived by the health information organization or a health data 
165.10 	intermediary by virtue of the violation;
165.11 	(6) whether the violation hindered or facilitated an individual's ability to obtain health 
165.12 	care;
165.13 	(7) whether the violation was intentional;
165.14 	(8) whether the violation was beyond the direct control of the health information exchange 
165.15 	service provider organization;
165.16 	(9) any history of prior compliance with the provisions of this section, including 
165.17 	violations;
165.18 	(10) whether and to what extent the health information exchange service provider
165.19 	organization attempted to correct previous violations;
165.20 	(11) how the health information exchange service provider organization responded to 
165.21 	technical assistance from the commissioner provided in the context of a compliance effort; 
165.22 	and
165.23 	(12) the financial condition of the health information exchange service provider
165.24 	organization including, but not limited to, whether the health information exchange service 
165.25 	provider organization had financial difficulties that affected its ability to comply or whether 
165.26 	the imposition of an administrative monetary penalty would jeopardize the ability of the 
165.27 	health information exchange service provider organization to continue to deliver health 
165.28 	information exchange services.
165.29 	The commissioner shall give reasonable notice in writing to the health information 
165.30 	exchange service provider organization of the intent to levy the penalty and the reasons for 
165.31 	it. A health information exchange service provider organization may have 15 days within 
165.32 	which to contest whether the facts found constitute a violation of sections 62J.4981 and 
166.1 	62J.4982, according to the contested case and judicial review provisions of sections 14.57
166.2 	to 14.69.
166.3 	(b) If the commissioner has reason to believe that a violation of section 62J.4981 or 
166.4 	62J.4982 has occurred or is likely, the commissioner may confer with the persons involved 
166.5 	before commencing action under subdivision 2. The commissioner may notify the health 
166.6 	information exchange service provider organization and the representatives, or other persons 
166.7 	who appear to be involved in the suspected violation, to arrange a voluntary conference 
166.8 	with the alleged violators or their authorized representatives. The purpose of the conference 
166.9 	is to attempt to learn the facts about the suspected violation and, if it appears that a violation 
166.10 	has occurred or is threatened, to find a way to correct or prevent it. The conference is not 
166.11 	governed by any formal procedural requirements, and may be conducted as the commissioner 
166.12 	considers appropriate.
166.13 	(c) The commissioner may issue an order directing a health information exchange service 
166.14 	provider organization or a representative of a health information exchange service provider
166.15 	organization to cease and desist from engaging in any act or practice in violation of sections 
166.16 	62J.4981 and 62J.4982.
166.17 	(d) Within 20 days after service of the order to cease and desist, a health information 
166.18 	exchange service provider organization may contest whether the facts found constitute a 
166.19 	violation of sections 62J.4981 and 62J.4982 according to the contested case and judicial 
166.20 	review provisions of sections 14.57 to 14.69.
166.21 	(e) In the event of noncompliance with a cease and desist order issued under this 
166.22 	subdivision, the commissioner may institute a proceeding to obtain injunctive relief or other 
166.23 	appropriate relief in Ramsey County District Court.
166.24 		Subd. 2.Suspension or revocation of certificates of authority. (a) The commissioner 
166.25 	may suspend or revoke a certificate of authority issued to a health data intermediary or
166.26 	health information organization under section 62J.4981 if the commissioner finds that:
166.27 	(1) the health information exchange service provider organization is operating 
166.28 	significantly in contravention of its basic organizational document, or in a manner contrary 
166.29 	to that described in and reasonably inferred from any other information submitted under 
166.30 	section 62J.4981, unless amendments to the submissions have been filed with and approved 
166.31 	by the commissioner;
166.32 	(2) the health information exchange service provider organization is unable to fulfill its 
166.33 	obligations to furnish comprehensive health information exchange services as required 
166.34 	under its health information exchange contract;
167.1 	(3) the health information exchange service provider organization is no longer financially 
167.2 	solvent or may not reasonably be expected to meet its obligations to participating entities;
167.3 	(4) the health information exchange service provider organization has failed to implement 
167.4 	the complaint system in a manner designed to reasonably resolve valid complaints;
167.5 	(5) the health information exchange service provider organization, or any person acting 
167.6 	with its sanction, has advertised or merchandised its services in an untrue, misleading, 
167.7 	deceptive, or unfair manner;
167.8 	(6) the continued operation of the health information exchange service provider
167.9 	organization would be hazardous to its participating entities or the patients served by the 
167.10 	participating entities; or
167.11 	(7) the health information exchange service provider organization has otherwise failed 
167.12 	to substantially comply with section 62J.4981 or with any other statute or administrative 
167.13 	rule applicable to health information exchange service providers, or has submitted false 
167.14 	information in any report required under sections 62J.498 to 62J.4982.
167.15 	(b) A certificate of authority shall be suspended or revoked only after meeting the 
167.16 	requirements of subdivision 3.
167.17 	(c) If the certificate of authority of a health information exchange service provider
167.18 	organization is suspended, the health information exchange service provider organization
167.19 	shall not, during the period of suspension, enroll any additional participating entities, and 
167.20 	shall not engage in any advertising or solicitation.
167.21 	(d) If the certificate of authority of a health information exchange service provider
167.22 	organization is revoked, the organization shall proceed, immediately following the effective 
167.23 	date of the order of revocation, to wind up its affairs, and shall conduct no further business 
167.24 	except as necessary to the orderly conclusion of the affairs of the organization. The 
167.25 	organization shall engage in no further advertising or solicitation. The commissioner may, 
167.26 	by written order, permit further operation of the organization as the commissioner finds to 
167.27 	be in the best interest of participating entities, to the end that participating entities will be 
167.28 	given the greatest practical opportunity to access continuing health information exchange 
167.29 	services.
167.30 		Subd. 3.Denial, suspension, and revocation; administrative procedures. (a) When 
167.31 	the commissioner has cause to believe that grounds for the denial, suspension, or revocation 
167.32 	of a certificate of authority exist, the commissioner shall notify the health information 
168.1 	exchange service provider organization in writing stating the grounds for denial, suspension, 
168.2 	or revocation and setting a time within 20 days for a hearing on the matter.
168.3 	(b) After a hearing before the commissioner at which the health information exchange 
168.4 	service provider organization may respond to the grounds for denial, suspension, or 
168.5 	revocation, or upon the failure of the health information exchange service provider
168.6 	organization to appear at the hearing, the commissioner shall take action as deemed necessary 
168.7 	and shall issue written findings and mail them to the health information exchange service 
168.8 	provider organization.
168.9 	(c) If suspension, revocation, or administrative penalty is proposed according to this 
168.10 	section, the commissioner must deliver, or send by certified mail with return receipt 
168.11 	requested, to the health information exchange service provider organization written notice 
168.12 	of the commissioner's intent to impose a penalty. This notice of proposed determination 
168.13 	must include:
168.14 	(1) a reference to the statutory basis for the penalty;
168.15 	(2) a description of the findings of fact regarding the violations with respect to which 
168.16 	the penalty is proposed;
168.17 	(3) the nature and amount of the proposed penalty;
168.18 	(4) any circumstances described in subdivision 1, paragraph (a), that were considered 
168.19 	in determining the amount of the proposed penalty;
168.20 	(5) instructions for responding to the notice, including a statement of the health 
168.21 	information exchange service provider's organization's right to a contested case proceeding 
168.22 	and a statement that failure to request a contested case proceeding within 30 calendar days 
168.23 	permits the imposition of the proposed penalty; and
168.24 	(6) the address to which the contested case proceeding request must be sent.
168.25 		Subd. 4.Coordination.  The commissioner shall, to the extent possible, seek the advice 
168.26 	of the Minnesota e-Health Advisory Committee, in the review and update of criteria for the 
168.27 	certification and recertification of health information exchange service providers
168.28 	organizations when implementing sections 62J.498 to 62J.4982.
168.29 		Subd. 5.Fees and monetary penalties. (a) The commissioner shall assess fees on every 
168.30 	health information exchange service provider organization subject to sections 62J.4981 and 
168.31 	62J.4982 as follows:
169.1 	(1) filing an application for certificate of authority to operate as a health information 
169.2 	organization, $7,000; and
169.3 	(2) filing an application for certificate of authority to operate as a health data intermediary, 
169.4 	$7,000;
169.5 	(3) annual health information organization certificate fee, $7,000; and.
169.6 	(4) annual health data intermediary certificate fee, $7,000.
169.7 	(b) Fees collected under this section shall be deposited in the state treasury and credited 
169.8 	to the state government special revenue fund.
169.9 	(c) Administrative monetary penalties imposed under this subdivision shall be credited 
169.10 	to an account in the special revenue fund and are appropriated to the commissioner for the 
169.11 	purposes of sections 62J.498 to 62J.4982.

169.12 	Sec. 10. Minnesota Statutes 2020, section 62J.63, subdivision 1, is amended to read:
169.13 		Subdivision 1.Establishment; administrationSupport for state health care 
169.14 	purchasing and performance measurement. The commissioner of health shall establish 
169.15 	and administer the Center for Health Care Purchasing Improvement as an administrative 
169.16 	unit within the Department of Health. The Center for Health Care Purchasing Improvement 
169.17 	shall support the state in its efforts to be a more prudent and efficient purchaser of quality 
169.18 	health care services. The center shall, aid the state in developing and using more common 
169.19 	strategies and approaches for health care performance measurement and health care 
169.20 	purchasing. The common strategies and approaches shall, promote greater transparency of 
169.21 	health care costs and quality, and greater accountability for health care results and 
169.22 	improvement. The center shall also, and identify barriers to more efficient, effective, quality 
169.23 	health care and options for overcoming the barriers.

169.24 	Sec. 11. Minnesota Statutes 2020, section 62J.63, subdivision 2, is amended to read:
169.25 		Subd. 2.Staffing; Duties; scope. (a) The commissioner of health may appoint a director, 
169.26 	and up to three additional senior-level staff or codirectors, and other staff as needed who 
169.27 	are under the direction of the commissioner. The staff of the center are in the unclassified 
169.28 	service.:
169.29 	(b) With the authorization of the commissioner of health, and in consultation or 
169.30 	interagency agreement with the appropriate commissioners of state agencies, the director, 
169.31 	or codirectors, may:
170.1 	(1) initiate projects to develop plan designs for state health care purchasing;
170.2 	(2) (1) require reports or surveys to evaluate the performance of current health care 
170.3 	purchasing or administrative simplification strategies;
170.4 	(3) (2) calculate fiscal impacts, including net savings and return on investment, of health 
170.5 	care purchasing strategies and initiatives;
170.6 	(4) conduct policy audits of state programs to measure conformity to state statute or 
170.7 	other purchasing initiatives or objectives;
170.8 	(5) (3) support the Administrative Uniformity Committee under section sections62J.50
170.9 	and 62J.536 and other relevant groups or activities to advance agreement on health care 
170.10 	administrative process streamlining;
170.11 	(6) consult with the Health Economics Unit of the Department of Health regarding 
170.12 	reports and assessments of the health care marketplace;
170.13 	(7) consult with the Department of Commerce regarding health care regulatory issues 
170.14 	and legislative initiatives;
170.15 	(8) work with appropriate Department of Human Services staff and the Centers for 
170.16 	Medicare and Medicaid Services to address federal requirements and conformity issues for 
170.17 	health care purchasing;
170.18 	(9) assist the Minnesota Comprehensive Health Association in health care purchasing 
170.19 	strategies;
170.20 	(10) convene medical directors of agencies engaged in health care purchasing for advice, 
170.21 	collaboration, and exploring possible synergies;
170.22 	(11) (4) contact and participate with other relevant health care task forces, study activities, 
170.23 	and similar efforts with regard to health care performance measurement and 
170.24 	performance-based purchasing; and
170.25 	(12) (5) assist in seeking external funding through appropriate grants or other funding 
170.26 	opportunities and may administer grants and externally funded projects.

170.27 	Sec. 12. [62J.826] MEDICAL PRACTICES; CURRENT STANDARD CHARGES; 
170.28 	COMPARISON TOOL.
170.29 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
170.30 	(b) "Chargemaster" means the list of all individual items and services maintained by a 
170.31 	medical practice for which the medical practice has established a charge.
171.1 	(c) "Diagnostic laboratory testing" means a service charged using a CPT code within 
171.2 	the CPT code range of 80047 to 89398.
171.3 	(d) "Diagnostic radiology service" means a service charged using a CPT code within 
171.4 	the CPT code range of 70010 to 7999 and includes the provision of x-rays, computed 
171.5 	tomography scans, positron emission tomography scans, magnetic resonance imaging scans, 
171.6 	and mammographies.
171.7 	(e) "Hospital" means an acute care institution licensed under sections 144.50 to 144.58, 
171.8 	but does not include a health care institution conducted for those who rely primarily upon 
171.9 	treatment by prayer or spiritual means in accordance with the creed or tenets of any church 
171.10 	or denomination.
171.11 	(f) "Medical practice" means a business that:
171.12 	(1) earns revenue by providing medical care to the public;
171.13 	(2) issues payment claims to health plan companies and other payers; and
171.14 	(3) may be identified by its federal tax identification number.
171.15 	(g) "Outpatient surgical center" means a health care facility other than a hospital offering 
171.16 	elective outpatient surgery under a license issued under sections 144.50 to 144.58.
171.17 		Subd. 2.Requirement; current standard charges. The following medical practices 
171.18 	must make available to the public a list of the medical practice's current standard charges, 
171.19 	as reflected in the medical practice's chargemaster, for all items and services provided by 
171.20 	the medical practice:
171.21 	(1) hospitals;
171.22 	(2) outpatient surgical centers; and
171.23 	(3) any other medical practice that has revenue of greater than $50,000,000 per year and 
171.24 	that derives the majority of the medical practice's revenue by providing one or more of the 
171.25 	following services:
171.26 	(i) diagnostic radiology services;
171.27 	(ii) diagnostic laboratory testing;
171.28 	(iii) orthopedic surgical procedures, including joint arthroplasty procedures within the 
171.29 	CPT code range of 26990 to 27899;
171.30 	(iv) ophthalmologic surgical procedures, including cataract surgery coded using CPT 
171.31 	code 66982 or 66984, or refractive correction surgery to improve visual acuity;
172.1 	(v) anesthesia services commonly provided as an ancillary to services provided at a 
172.2 	hospital, outpatient surgical center, or medical practice that provides orthopedic surgical 
172.3 	procedures or ophthalmologic surgical procedures; or
172.4 	(vi) oncology services, including radiation oncology treatments within the CPT code 
172.5 	range of 77261 to 77799 and drug infusions.
172.6 		Subd. 3.Required file format and data attributes. (a) A medical practice required to 
172.7 	post the medical practice's current standard charges must post the following data attributes 
172.8 	in the listed order:
172.9 	(1) federal tax identification number for the medical practice;
172.10 	(2) name of the medical practice, defined as the provider name that the medical practice 
172.11 	enters on the CMS claim form 1500 or a successor form when the medical practice submits 
172.12 	health care claims to a payer organization;
172.13 	(3) internal chargemaster record identification, defined as the internal record identifier 
172.14 	for this chargemaster line item in the medical practice's billing system;
172.15 	(4) service billing code system, defined as a code signifying the HIPAA-compliant 
172.16 	billing code system from which the service billing code was drawn;
172.17 	(5) service billing code, defined as a specific billing code drawn from the service billing 
172.18 	code system denoted by the value in the service billing code type field;
172.19 	(6) service description, defined as the shortest, nonabbreviated official description 
172.20 	associated with the service billing code in the applicable service billing code system;
172.21 	(7) revenue code, defined as the National Uniform Billing Committee revenue code 
172.22 	denoting the patient's location within the medical practice where the patient will receive the 
172.23 	item or service subject to this charge. This value is required only if the charge amount is 
172.24 	dependent on the location within the medical practice where the item or service is provided;
172.25 	(8) revenue code description, defined as the description provided by the National Uniform 
172.26 	Billing Committee for the revenue code. This value is required only if the charge amount 
172.27 	is dependent on the location within the medical practice where the item or service is provided;
172.28 	(9) national drug code, defined as the national drug code for a drug that is administered 
172.29 	as part of the service subject to this charge. This field is required only when the charge 
172.30 	amount is dependent on which, if any, drug is being administered as part of this service;
172.31 	(10) national drug code description, defined as the official description associated with 
172.32 	the national drug code for a drug that is administered as part of the service subject to this 
173.1 	charge. This field is required only when the charge amount is dependent on which, if any, 
173.2 	drug is being administered as part of this service;
173.3 	(11) inpatient gross charge, defined as the charge for an individual item or service that 
173.4 	is reflected on a hospital's chargemaster, absent any discounts as defined in Code of Federal 
173.5 	Regulations, title 45, section 180.20, for an item or service provided on an inpatient basis;
173.6 	(12) outpatient gross charge, defined as the charge for an individual item or service that 
173.7 	is reflected on a chargemaster, absent any discounts as defined in Code of Federal 
173.8 	Regulations, title 45, section 180.20, for an item or service provided on an outpatient basis;
173.9 	(13) inpatient discounted cash price, defined as the charge that applies to an individual 
173.10 	who pays cash or a cash equivalent for an item or service being reported under this section 
173.11 	and provided on an inpatient basis;
173.12 	(14) outpatient discounted cash price, defined as the charge that applies to an individual 
173.13 	who pays cash or a cash equivalent for an item or service being reported under this section 
173.14 	and provided on an outpatient basis;
173.15 	(15) charge unit, defined as the unit cost basis for the charge;
173.16 	(16) effective date of the charge; and
173.17 	(17) payer-specific negotiated charges, as defined in Code of Federal Regulations, title 
173.18 	45, section 180.20. There must be a separate field for each payer's rate and the payers must 
173.19 	be listed in alphabetical order.
173.20 	(b) The data attributes specified in paragraph (a) must be posted in the form of a 
173.21 	comma-separated values file, with all text values quoted and all leading and trailing white 
173.22 	spaces trimmed before and after data attribute values.
173.23 	(c) The data attributes specified in paragraph (a) must be posted on a web page labeled 
173.24 	"Cost of Care at [Name of Medical Practice]" which members of the public can access via 
173.25 	a direct, clearly labeled link on the medical practice's main billing web page, and which is 
173.26 	searchable by entering the words "cost of care at [name of medical practice]" into an Internet 
173.27 	search engine. The consumer-friendly list of standard charges for a limited set of shoppable 
173.28 	services required under Code of Federal Regulations, title 45, section 180.60, must be 
173.29 	presented on the same web page.
173.30 	(d) The file must be named according to the following convention: 
173.31 	<ein>_<hospital-name>_standardcharges.csv as required by Code of Federal Regulations, 
173.32 	title 45, section 180.50.

174.1 	EFFECTIVE DATE. This section is effective January 1, 2022.

174.2 	Sec. 13. Minnesota Statutes 2020, section 62U.04, subdivision 4, is amended to read:
174.3 		Subd. 4.Encounter data. (a) Beginning July 1, 2009, and every six months thereafter,
174.4 	All health plan companies and third-party administrators shall submit encounter data on a 
174.5 	monthly basis to a private entity designated by the commissioner of health. The data shall 
174.6 	be submitted in a form and manner specified by the commissioner subject to the following 
174.7 	requirements:
174.8 	(1) the data must be de-identified data as described under the Code of Federal Regulations, 
174.9 	title 45, section 164.514;
174.10 	(2) the data for each encounter must include an identifier for the patient's health care 
174.11 	home if the patient has selected a health care home and, for claims incurred on or after 
174.12 	January 1, 2019, data deemed necessary by the commissioner to uniquely identify claims 
174.13 	in the individual health insurance market; and
174.14 	(3) except for the identifier described in clause (2), the data must not include information 
174.15 	that is not included in a health care claim or equivalent encounter information transaction 
174.16 	that is required under section 62J.536.
174.17 	(b) The commissioner or the commissioner's designee shall only use the data submitted 
174.18 	under paragraph (a) to carry out the commissioner's responsibilities in this section, including 
174.19 	supplying the data to providers so they can verify their results of the peer grouping process 
174.20 	consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d), 
174.21 	and adopted by the commissioner and, if necessary, submit comments to the commissioner 
174.22 	or initiate an appeal.
174.23 	(c) Data on providers collected under this subdivision are private data on individuals or 
174.24 	nonpublic data, as defined in section 13.02. Notwithstanding the data classifications in this 
174.25 	paragraph, data on providers collected under this subdivision may be released or published 
174.26 	as authorized in subdivision 11. Notwithstanding the definition of summary data in section 
174.27 	13.02, subdivision 19, summary data prepared under this subdivision may be derived from 
174.28 	nonpublic data. The commissioner or the commissioner's designee shall establish procedures 
174.29 	and safeguards to protect the integrity and confidentiality of any data that it maintains.
174.30 	(d) The commissioner or the commissioner's designee shall not publish analyses or 
174.31 	reports that identify, or could potentially identify, individual patients.
174.32 	(e) The commissioner shall compile summary information on the data submitted under 
174.33 	this subdivision. The commissioner shall work with its vendors to assess the data submitted 
175.1 	in terms of compliance with the data submission requirements and the completeness of the 
175.2 	data submitted by comparing the data with summary information compiled by the 
175.3 	commissioner and with established and emerging data quality standards to ensure data 
175.4 	quality.

175.5 	Sec. 14. Minnesota Statutes 2020, section 62U.04, subdivision 5, is amended to read:
175.6 		Subd. 5.Pricing data. (a) Beginning July 1, 2009, and annually on January 1 thereafter, 
175.7 	all health plan companies and third-party administrators shall submit data on their contracted 
175.8 	prices with health care providers to a private entity designated by the commissioner of health 
175.9 	for the purposes of performing the analyses required under this subdivision. The data shall 
175.10 	be submitted in the form and manner specified by the commissioner of health.
175.11 	(b) The commissioner or the commissioner's designee shall only use the data submitted 
175.12 	under this subdivision to carry out the commissioner's responsibilities under this section, 
175.13 	including supplying the data to providers so they can verify their results of the peer grouping 
175.14 	process consistent with the recommendations developed pursuant to subdivision 3c, paragraph 
175.15 	(d), and adopted by the commissioner and, if necessary, submit comments to the 
175.16 	commissioner or initiate an appeal.
175.17 	(c) Data collected under this subdivision are nonpublic data as defined in section 13.02. 
175.18 	Notwithstanding the data classification in this paragraph, data collected under this subdivision 
175.19 	may be released or published as authorized in subdivision 11. Notwithstanding the definition 
175.20 	of summary data in section 13.02, subdivision 19, summary data prepared under this section 
175.21 	may be derived from nonpublic data. The commissioner shall establish procedures and 
175.22 	safeguards to protect the integrity and confidentiality of any data that it maintains.

175.23 	Sec. 15. Minnesota Statutes 2020, section 62U.04, subdivision 11, is amended to read:
175.24 		Subd. 11.Restricted uses of the all-payer claims data. (a) Notwithstanding subdivision 
175.25 	4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's 
175.26 	designee shall only use the data submitted under subdivisions 4 and 5 for the following 
175.27 	purposes:
175.28 	(1) to evaluate the performance of the health care home program as authorized under 
175.29 	section 62U.03, subdivision 7;
175.30 	(2) to study, in collaboration with the reducing avoidable readmissions effectively 
175.31 	(RARE) campaign, hospital readmission trends and rates;
176.1 	(3) to analyze variations in health care costs, quality, utilization, and illness burden based 
176.2 	on geographical areas or populations;
176.3 	(4) to evaluate the state innovation model (SIM) testing grant received by the Departments 
176.4 	of Health and Human Services, including the analysis of health care cost, quality, and 
176.5 	utilization baseline and trend information for targeted populations and communities; and
176.6 	(5) to compile one or more public use files of summary data or tables that must:
176.7 	(i) be available to the public for no or minimal cost by March 1, 2016, and available by 
176.8 	web-based electronic data download by June 30, 2019;
176.9 	(ii) not identify individual patients, or payers, or providersbut that may identify the 
176.10 	rendering or billing hospital, clinic, or medical practice;
176.11 	(iii) be updated by the commissioner, at least annually, with the most current data 
176.12 	available;
176.13 	(iv) contain clear and conspicuous explanations of the characteristics of the data, such 
176.14 	as the dates of the data contained in the files, the absence of costs of care for uninsured 
176.15 	patients or nonresidents, and other disclaimers that provide appropriate context; and
176.16 	(v) not lead to the collection of additional data elements beyond what is authorized under 
176.17 	this section as of June 30, 2015.
176.18 	(b) The commissioner may publish the results of the authorized uses identified in 
176.19 	paragraph (a) so long as the data released publicly do not contain information or descriptions 
176.20 	in which the identity of individual hospitals, clinics, or other providers may be discerned.
176.21 	The data published under this paragraph may identify hospitals, clinics, and medical practices 
176.22 	so long as no individual health professionals are identified and the commissioner finds the 
176.23 	data to be accurate, valid, and suitable for publication for such use.
176.24 	(c) Nothing in this subdivision shall be construed to prohibit the commissioner from 
176.25 	using the data collected under subdivision 4 to complete the state-based risk adjustment 
176.26 	system assessment due to the legislature on October 1, 2015.
176.27 	(d) The commissioner or the commissioner's designee may use the data submitted under 
176.28 	subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1, 
176.29 	2023.
176.30 	(e) The commissioner shall consult with the all-payer claims database work group 
176.31 	established under subdivision 12 regarding the technical considerations necessary to create 
176.32 	the public use files of summary data described in paragraph (a), clause (5).

177.1 	Sec. 16. Minnesota Statutes 2020, section 103H.201, subdivision 1, is amended to read:
177.2 		Subdivision 1.Procedure. (a) If groundwater quality monitoring results show that there 
177.3 	is a degradation of groundwater, the commissioner of health may promulgate health risk 
177.4 	limits under subdivision 2 for substances degrading the groundwater.
177.5 	(b) Health risk limits shall be determined by two methods depending on their toxicological 
177.6 	end point.
177.7 	(c) For systemic toxicants that are not carcinogens, the adopted health risk limits shall 
177.8 	be derived using United States Environmental Protection Agency risk assessment methods 
177.9 	using a reference dose, a drinking water equivalent, and a relative source contribution factor.
177.10 	(d) For toxicants that are known or probable carcinogens, the adopted health risk limits 
177.11 	shall be derived from a quantitative estimate of the chemical's carcinogenic potency published 
177.12 	by the United States Environmental Protection Agency and or determined by the 
177.13 	commissioner to have undergone thorough scientific review.

177.14 	Sec. 17. [144.066] DISTRIBUTION OF COVID-19 VACCINES.
177.15 		Subdivision 1.Definitions. (a) The terms defined in this subdivision apply to this section 
177.16 	and sections 144.0661 to 144.0663.
177.17 	(b) "Commissioner" means the commissioner of health.
177.18 	(c) "COVID-19 vaccine" means a vaccine against severe acute respiratory syndrome 
177.19 	coronavirus 2 (SARS-CoV-2).
177.20 	(d) "Department" means the Department of Health.
177.21 	(e) "Disproportionately impacted community" means a community or population that 
177.22 	has been disproportionately and negatively impacted by the COVID-19 pandemic.
177.23 	(f) "Local health department" has the meaning given in section 145A.02, subdivision 
177.24 	8b.
177.25 	(g) "Mobile vaccination vehicle" means a vehicle-mounted unit that is either motorized 
177.26 	or trailered, that is readily movable without disassembling, and at which vaccines are 
177.27 	provided in more than one geographic location.
177.28 		Subd. 2.Distribution. The commissioner shall establish and maintain partnerships or 
177.29 	agreements with local health departments; local health care providers, including community 
177.30 	health centers and primary care providers; and local pharmacies to administer COVID-19 
178.1 	vaccines throughout the state. COVID-19 vaccines may also be administered via mobile 
178.2 	vaccination vehicles authorized under section 144.0662.
178.3 		Subd. 3.Second dose or booster. For all COVID-19 vaccines for which a second dose 
178.4 	or booster is required, during the first vaccine appointment the registered vaccine provider 
178.5 	should be directed by the department during the vaccine provider registration process to 
178.6 	assist vaccine recipients with scheduling an appointment for the second dose or booster. 
178.7 	This assistance may be provided during the observation period following vaccine 
178.8 	administration.
178.9 		Subd. 4.Nondiscrimination. Nothing in sections 144.066 to 144.0663 shall be construed 
178.10 	to allow or require the denial of any benefit or opportunity on the basis of race, color, creed, 
178.11 	marital status, status with regard to public assistance, disability, genetic information, sexual 
178.12 	orientation, age, religion, national origin, sex, or membership in a local human rights 
178.13 	commission.

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

178.15 	Sec. 18. [144.0661] EQUITABLE COVID-19 VACCINE DISTRIBUTION.
178.16 		Subdivision 1. COVID-19 vaccination equity and outreach. The commissioner shall 
178.17 	establish positions to continue the department's COVID-19 vaccination equity and outreach 
178.18 	activities and to plan and implement actions and programs to overcome disparities in 
178.19 	COVID-19 vaccination rates that are rooted in historic and current racism; biases based on 
178.20 	ethnicity, income, primary language, immigration status, or disability; geography; or 
178.21 	transportation access, language access, or Internet access. This work shall be managed by 
178.22 	a director who shall serve in a leadership role in the department's COVID-19 response.
178.23 		Subd. 2.Vaccine education and outreach campaign; direct delivery of 
178.24 	information. (a) The commissioner shall administer a COVID-19 vaccine education and 
178.25 	outreach campaign that engages in direct delivery of information to members of 
178.26 	disproportionately impacted communities. In this campaign, the commissioner shall contract 
178.27 	with community-based organizations including community faith-based organizations, tribal 
178.28 	governments, local health departments, and local health care providers, including community 
178.29 	health centers and primary care providers, to deliver the following information in a culturally 
178.30 	relevant and linguistically appropriate manner:
178.31 	(1) medically and scientifically accurate information on the safety, efficacy, science, 
178.32 	and benefits of vaccines generally and COVID-19 vaccines in particular;
179.1 	(2) information on how members of disproportionately impacted communities may 
179.2 	obtain a COVID-19 vaccine including, if applicable, obtaining a vaccine from a mobile 
179.3 	vaccination vehicle; and
179.4 	(3) measures to prevent transmission of COVID-19, including adequate indoor ventilation, 
179.5 	wearing face coverings, and physical distancing from individuals outside the household.
179.6 	(b) This information must be delivered directly by methods that include phone calls, 
179.7 	text messages, physically distanced door-to-door and street canvassing, and digital 
179.8 	event-based communication involving live and interactive messengers. For purposes of this 
179.9 	subdivision, direct delivery shall not include delivery by television, radio, newspaper, or 
179.10 	other forms of mass media.
179.11 		Subd. 3.Vaccine education and outreach campaign; mass media. The commissioner 
179.12 	shall administer a mass media campaign to provide COVID-19 vaccine education and 
179.13 	outreach to members of disproportionately impacted communities. In this campaign, the 
179.14 	commissioner shall contract with media vendors to provide the following information to 
179.15 	members of disproportionately impacted communities in a manner that is culturally relevant 
179.16 	and linguistically appropriate:
179.17 	(1) medically and scientifically accurate information on the safety, efficacy, science, 
179.18 	and benefits of COVID-19 vaccines; and
179.19 	(2) information on how members of disproportionately impacted communities may 
179.20 	obtain a COVID-19 vaccine.
179.21 		Subd. 4.Community assistance. The commissioner shall administer a program to help 
179.22 	members of disproportionately impacted communities arrange for and prepare to obtain a 
179.23 	COVID-19 vaccine and to support transportation-limited members of these communities 
179.24 	with transportation to vaccination appointments or otherwise arrange for vaccine providers 
179.25 	to reach members of these communities.
179.26 		Subd. 5.Equitable distribution of COVID-19 vaccines. The commissioner shall 
179.27 	establish a set of metrics to measure the equitable distribution of COVID-19 vaccines in 
179.28 	the state, and shall set and periodically update goals for COVID-19 vaccine distribution in 
179.29 	the state that are focused on equity.
179.30 		Subd. 6.Expiration of programs. The vaccine education and outreach programs in 
179.31 	subdivisions 2 and 3 and the community assistance program in subdivision 4 shall operate 
179.32 	until a sufficient percentage of individuals in each county or census tract have received the 
180.1 	full series of COVID-19 vaccines to protect individuals in each county or census tract from 
180.2 	COVID-19.

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

180.4 	Sec. 19. [144.0662] MOBILE VACCINATION PROGRAM.
180.5 		Subdivision 1.Administration. The commissioner, in partnership with local health 
180.6 	departments and the regional health care coalitions, shall administer a mobile vaccination 
180.7 	program in which mobile vaccination vehicles are deployed to communities around the state 
180.8 	to provide COVID-19 vaccines to individuals. The commissioner shall deploy mobile 
180.9 	vaccination vehicles to communities to improve access to vaccines based on factors that 
180.10 	include but are not limited to vulnerability, likelihood of exposure, limits to transportation 
180.11 	access, rate of vaccine uptake, and limited access to vaccines or barriers to obtaining vaccines.
180.12 		Subd. 2.Eligibility. Notwithstanding the phases and priorities of the state's COVID-19 
180.13 	allocation and prioritization plan or guidance, all individuals in a community to which a 
180.14 	mobile vaccination vehicle is deployed shall be eligible to receive COVID-19 vaccines from 
180.15 	the vehicle.
180.16 		Subd. 3.Staffing. Each mobile vaccination vehicle must be staffed in accordance with 
180.17 	Centers for Disease Control and Prevention guidelines and may be staffed with additional 
180.18 	support staff based on needs determined by local request. Additional support staff may 
180.19 	include but are not limited to community partners and translators.
180.20 		Subd. 4.Second doses. For vaccine recipients who receive a first dose of a COVID-19 
180.21 	vaccine from a mobile vaccination vehicle, vehicle staff shall provide assistance in scheduling 
180.22 	an appointment with a mobile vaccination vehicle or with another vaccine provider for any 
180.23 	needed second dose or booster. The commissioner shall, to the extent possible, deploy 
180.24 	mobile vaccination vehicles in a manner that allows vaccine recipients to receive second 
180.25 	doses or boosters from a mobile vaccination vehicle.
180.26 		Subd. 5.Expiration. The commissioner shall administer the mobile vaccination vehicle 
180.27 	program until a sufficient percentage of individuals in each county or census tract have 
180.28 	received the full series of COVID-19 vaccines to protect individuals in each county or 
180.29 	census tract from the spread of COVID-19.

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

181.1 	Sec. 20. [144.0663] COVID-19 VACCINATION PLAN AND DATA; REPORTS.
181.2 		Subdivision 1.COVID-19 vaccination plan; implementation protocols. The 
181.3 	commissioner shall:
181.4 	(1) publish the set of metrics and goals for equitable COVID-19 vaccine distribution 
181.5 	established by the commissioner under section 144.0661, subdivision 5; and
181.6 	(2) publish implementation protocols to address the disparities in COVID-19 vaccination 
181.7 	rates in certain communities and ensure that members of disproportionately impacted 
181.8 	communities are given adequate access to COVID-19 vaccines.
181.9 		Subd. 2.Data on COVID-19 vaccines. On at least a weekly basis, the commissioner 
181.10 	shall publish on the department website:
181.11 	(1) data measuring compliance with the set of metrics and goals for equitable COVID-19 
181.12 	vaccine distribution established by the commissioner under section 144.0661, subdivision 
181.13 	5; and
181.14 	(2) summary data on individuals who have received one or two doses of a COVID-19 
181.15 	vaccine, broken out by race, gender, ethnicity, age within an age range, and zip code.
181.16 		Subd. 3.Quarterly reports. On a quarterly basis while funds are available, the 
181.17 	commissioner shall report to the chairs and ranking minority members of the legislative 
181.18 	committees with jurisdiction over finance, ways and means, and health care:
181.19 	(1) funds distributed to local health departments for COVID-19 activities and the sources 
181.20 	of the funds; and
181.21 	(2) funds expended to implement sections 144.066 to 144.0663.

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

181.23 	Sec. 21. Minnesota Statutes 2020, section 144.0724, subdivision 1, is amended to read:
181.24 		Subdivision 1.Resident reimbursement case mix classifications. The commissioner 
181.25 	of health shall establish resident reimbursement case mix classifications based upon the 
181.26 	assessments of residents of nursing homes and boarding care homes conducted under this 
181.27 	section and according to section 256R.17.

181.28 	Sec. 22. Minnesota Statutes 2020, section 144.0724, subdivision 2, is amended to read:
181.29 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
181.30 	given.
182.1 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
182.2 	periods in the MDS assessment process. This look-back period is also called the observation 
182.3 	or assessment period.
182.4 	(b) "Case mix index" means the weighting factors assigned to the RUG-IV classifications.
182.5 	(c) "Index maximization" means classifying a resident who could be assigned to more 
182.6 	than one category, to the category with the highest case mix index.
182.7 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
182.8 	and functional status elements, that include common definitions and coding categories 
182.9 	specified by the Centers for Medicare and Medicaid Services and designated by the 
182.10 	Minnesota Department of Health.
182.11 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
182.12 	person authorized to pay the nursing home expenses of the resident, a representative of the 
182.13 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
182.14 	other individual designated by the resident.
182.15 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
182.16 	facility's residents according to their clinical and functional status identified in data supplied 
182.17 	by the facility's Minimum Data Set.
182.18 	(g) "Activities of daily living" means grooming, includes personal hygiene, dressing, 
182.19 	bathing, transferring, bed mobility, positioning, locomotion, eating, and toileting.
182.20 	(h) "Nursing facility level of care determination" means the assessment process that 
182.21 	results in a determination of a resident's or prospective resident's need for nursing facility 
182.22 	level of care as established in subdivision 11 for purposes of medical assistance payment 
182.23 	of long-term care services for:
182.24 	(1) nursing facility services under section 256B.434 or chapter 256R;
182.25 	(2) elderly waiver services under chapter 256S;
182.26 	(3) CADI and BI waiver services under section 256B.49; and
182.27 	(4) state payment of alternative care services under section 256B.0913.

182.28 	Sec. 23. Minnesota Statutes 2020, section 144.0724, subdivision 3a, is amended to read:
182.29 		Subd. 3a.Resident reimbursement case mix classifications beginning January 1, 
182.30 	2012. (a) Beginning January 1, 2012, resident reimbursement case mix classifications shall 
182.31 	be based on the Minimum Data Set, version 3.0 assessment instrument, or its successor 
183.1 	version mandated by the Centers for Medicare and Medicaid Services that nursing facilities 
183.2 	are required to complete for all residents. The commissioner of health shall establish resident 
183.3 	classifications according to the RUG-IV, 48 group, resource utilization groups. Resident 
183.4 	classification must be established based on the individual items on the Minimum Data Set, 
183.5 	which must be completed according to the Long Term Care Facility Resident Assessment 
183.6 	Instrument User's Manual Version 3.0 or its successor issued by the Centers for Medicare 
183.7 	and Medicaid Services.
183.8 	(b) Each resident must be classified based on the information from the Minimum Data 
183.9 	Set according to general categories as defined in the Case Mix Classification Manual for 
183.10 	Nursing Facilities issued by the Minnesota Department of Health.

183.11 	Sec. 24. Minnesota Statutes 2020, section 144.0724, subdivision 5, is amended to read:
183.12 		Subd. 5.Short stays. (a) A facility must submit to the commissioner of health an 
183.13 	admission assessment for all residents who stay in the facility 14 days or less., unless the 
183.14 	resident is admitted and discharged from the facility on the same day, in which case the 
183.15 	admission assessment is not required. When an admission assessment is not submitted, the 
183.16 	case mix classification shall be the rate with a case mix index of 1.0.
183.17 	(b) Notwithstanding the admission assessment requirements of paragraph (a), a facility 
183.18 	may elect to accept a short stay rate with a case mix index of 1.0 for all facility residents 
183.19 	who stay 14 days or less in lieu of submitting an admission assessment. Facilities shall make 
183.20 	this election annually.
183.21 	(c) Nursing facilities must elect one of the options described in paragraphs (a) and (b) 
183.22 	by reporting to the commissioner of health, as prescribed by the commissioner. The election 
183.23 	is effective on July 1 each year.

183.24 	Sec. 25. Minnesota Statutes 2020, section 144.0724, subdivision 7, is amended to read:
183.25 		Subd. 7.Notice of resident reimbursement case mix classification. (a) The 
183.26 	commissioner of health shall provide to a nursing facility a notice for each resident of the 
183.27 	reimbursement classification established under subdivision 1. The notice must inform the 
183.28 	resident of the case mix classification that was assigned, the opportunity to review the 
183.29 	documentation supporting the classification, the opportunity to obtain clarification from the 
183.30 	commissioner, and the opportunity to request a reconsideration of the classification and the 
183.31 	address and telephone number of the Office of Ombudsman for Long-Term Care. The 
183.32 	commissioner must transmit the notice of resident classification by electronic means to the 
183.33 	nursing facility. A The nursing facility is responsible for the distribution of the notice to 
184.1 	each resident, to the person responsible for the payment of the resident's nursing home 
184.2 	expenses, or to another person designated by the resident or the resident's representative. 
184.3 	This notice must be distributed within three working business days after the facility's receipt 
184.4 	of the electronic file of notice of case mix classifications from the commissioner of health.
184.5 	(b) If a facility submits a modification to the most recent assessment used to establish 
184.6 	a case mix classification conducted under subdivision 3 that results modifying assessment 
184.7 	resulting in a change in the case mix classification, the facility shall give must provide a
184.8 	written notice to the resident or the resident's representative about regarding the item or 
184.9 	items that was were modified and the reason for the modification modifications. The notice 
184.10 	of modified assessment may must be provided at the same time that the resident or resident's 
184.11 	representative is provided the resident's modified notice of classification within three business 
184.12 	days after distribution of the resident case mix classification notice.

184.13 	Sec. 26. Minnesota Statutes 2020, section 144.0724, subdivision 8, is amended to read:
184.14 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, or 
184.15 	resident's representative, or the nursing facility or boarding care home may request that the 
184.16 	commissioner of health reconsider the assigned reimbursement case mix classification and 
184.17 	any item or items changed during the audit process. The request for reconsideration must 
184.18 	be submitted in writing to the commissioner within 30 days of the day the resident or the 
184.19 	resident's representative receives the resident classification notice of health.
184.20 	(b) For reconsideration requests initiated by the resident or the resident's representative:
184.21 	(1) The resident or the resident's representative must submit in writing a reconsideration 
184.22 	request to the facility administrator within 30 days of receipt of the resident classification 
184.23 	notice. The written request for reconsideration must include the name of the resident, the 
184.24 	name and address of the facility in which the resident resides, the reasons for the 
184.25 	reconsideration, and documentation supporting the request. The documentation accompanying 
184.26 	the reconsideration request is limited to a copy of the MDS that determined the classification 
184.27 	and other documents that would support or change the MDS findings.
184.28 	(2) Within three business days of receiving the reconsideration request, the nursing 
184.29 	facility must submit to the commissioner of health a completed reconsideration request 
184.30 	form, a copy of the resident's or resident's representative's written request, and all supporting 
184.31 	documentation used to complete the assessment being considered. If the facility fails to 
184.32 	provide the required information, the reconsideration will be completed with the information 
184.33 	submitted and the facility cannot make further reconsideration requests on this classification.
185.1 	(b) (3) Upon written request and within three business days, the nursing facility must 
185.2 	give the resident or the resident's representative a copy of the assessment form being 
185.3 	reconsidered and the other all supporting documentation that was given to the commissioner 
185.4 	of health used to support complete the assessment findings. The nursing facility shall also 
185.5 	provide access to and a copy of other information from the resident's record that has been 
185.6 	requested by or on behalf of the resident to support a resident's reconsideration request. A 
185.7 	copy of any requested material must be provided within three working days of receipt of a 
185.8 	written request for the information. Notwithstanding any law to the contrary, the facility 
185.9 	may not charge a fee for providing copies of the requested documentation. If a facility fails 
185.10 	to provide the material required documents within this time, it is subject to the issuance of 
185.11 	a correction order and penalty assessment under sections 144.653 and 144A.10. 
185.12 	Notwithstanding those sections, any correction order issued under this subdivision must 
185.13 	require that the nursing facility immediately comply with the request for information, and 
185.14 	that as of the date of the issuance of the correction order, the facility shall forfeit to the state 
185.15 	a $100 fine for the first day of noncompliance, and an increase in the $100 fine by $50 
185.16 	increments for each day the noncompliance continues.
185.17 	(c) in addition to the information required under paragraphs (a) and (b), a reconsideration 
185.18 	request from a nursing facility must contain the following information: (i) the date the 
185.19 	reimbursement classification notices were received by the facility; (ii) the date the 
185.20 	classification notices were distributed to the resident or the resident's representative; and 
185.21 	(iii) For reconsideration requests initiated by the facility:
185.22 	(1) The facility is required to inform the resident or the resident's representative in writing 
185.23 	that a reconsideration of the resident's case mix classification is being requested. The notice 
185.24 	must inform the resident or the resident's representative:
185.25 	(i) of the date and reason for the reconsideration request;
185.26 	(ii) of the potential for a classification and subsequent rate change;
185.27 	(iii) of the extent of the potential rate change;
185.28 	(iv) that copies of the request and supporting documentation are available for review; 
185.29 	and
185.30 	(v) that the resident or the resident's representative has the right to request a 
185.31 	reconsideration.
185.32 	(2) Within 30 days of receipt of the audit exit report or resident classification notice, the 
185.33 	facility must submit to the commissioner of health a completed reconsideration request 
186.1 	form, all supporting documentation used to complete the assessment being reconsidered, 
186.2 	and a copy of a the notice sent to informing the resident or to the resident's representative. 
186.3 	This notice must inform the resident or the resident's representative that a reconsideration 
186.4 	of the resident's classification is being requested, the reason for the request, that the resident's 
186.5 	rate will change if the request is approved by the commissioner, the extent of the change, 
186.6 	that copies of the facility's request and supporting documentation are available for review, 
186.7 	and that the resident also has the right to request a reconsideration.
186.8 	(3) If the facility fails to provide the required information listed in item (iii) with the 
186.9 	reconsideration request, the commissioner may request that the facility provide the 
186.10 	information within 14 calendar days., the reconsideration request must may be denied if the 
186.11 	information is then not provided, and the facility may not make further reconsideration 
186.12 	requests on that specific reimbursement this classification.
186.13 	(d) Reconsideration by the commissioner must be made by individuals not involved in 
186.14 	reviewing the assessment, audit, or reconsideration that established the disputed classification. 
186.15 	The reconsideration must be based upon the assessment that determined the classification 
186.16 	and upon the information provided to the commissioner of health under paragraphs (a) and 
186.17 	(b) to (c). If necessary for evaluating the reconsideration request, the commissioner may 
186.18 	conduct on-site reviews. Within 15 working business days of receiving the request for 
186.19 	reconsideration, the commissioner shall affirm or modify the original resident classification. 
186.20 	The original classification must be modified if the commissioner determines that the 
186.21 	assessment resulting in the classification did not accurately reflect characteristics of the 
186.22 	resident at the time of the assessment. The resident and the nursing facility or boarding care 
186.23 	home shall be notified within five working days after the decision is made. The commissioner 
186.24 	must transmit the reconsideration classification notice by electronic means to the nursing 
186.25 	facility. The nursing facility is responsible for the distribution of the notice to the resident 
186.26 	or the resident's representative. The notice must be distributed by the nursing facility within 
186.27 	three business days after receipt. A decision by the commissioner under this subdivision is 
186.28 	the final administrative decision of the agency for the party requesting reconsideration.
186.29 	(e) The resident case mix classification established by the commissioner shall be the 
186.30 	classification that which applies to the resident while the request for reconsideration is 
186.31 	pending. If a request for reconsideration applies to an assessment used to determine nursing 
186.32 	facility level of care under subdivision 4, paragraph (c), the resident shall continue to be 
186.33 	eligible for nursing facility level of care while the request for reconsideration is pending.
186.34 	(f) The commissioner may request additional documentation regarding a reconsideration 
186.35 	necessary to make an accurate reconsideration determination.

187.1 	Sec. 27. Minnesota Statutes 2020, section 144.0724, subdivision 9, is amended to read:
187.2 		Subd. 9.Audit authority. (a) The commissioner shall audit the accuracy of resident 
187.3 	assessments performed under section 256R.17 through any of the following: desk audits; 
187.4 	on-site review of residents and their records; and interviews with staff, residents, or residents' 
187.5 	families. The commissioner shall reclassify a resident if the commissioner determines that 
187.6 	the resident was incorrectly classified.
187.7 	(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
187.8 	(c) A facility must grant the commissioner access to examine the medical records relating 
187.9 	to the resident assessments selected for audit under this subdivision. The commissioner may 
187.10 	also observe and speak to facility staff and residents.
187.11 	(d) The commissioner shall consider documentation under the time frames for coding 
187.12 	items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment 
187.13 	Instrument User's Manual published by the Centers for Medicare and Medicaid Services.
187.14 	(e) The commissioner shall develop an audit selection procedure that includes the 
187.15 	following factors:
187.16 	(1) Each facility shall be audited annually. If a facility has two successive audits in which 
187.17 	the percentage of change is five percent or less and the facility has not been the subject of 
187.18 	a special audit in the past 36 months, the facility may be audited biannually. A stratified 
187.19 	sample of 15 percent, with a minimum of ten assessments, of the most current assessments 
187.20 	shall be selected for audit. If more than 20 percent of the RUG-IV classifications are changed 
187.21 	as a result of the audit, the audit shall be expanded to a second 15 percent sample, with a 
187.22 	minimum of ten assessments. If the total change between the first and second samples is 
187.23 	35 percent or greater, the commissioner may expand the audit to all of the remaining 
187.24 	assessments.
187.25 	(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility 
187.26 	again within six months. If a facility has two expanded audits within a 24-month period, 
187.27 	that facility will be audited at least every six months for the next 18 months.
187.28 	(3) The commissioner may conduct special audits if the commissioner determines that 
187.29 	circumstances exist that could alter or affect the validity of case mix classifications of 
187.30 	residents. These circumstances include, but are not limited to, the following:
187.31 	(i) frequent changes in the administration or management of the facility;
187.32 	(ii) an unusually high percentage of residents in a specific case mix classification;
188.1 	(iii) a high frequency in the number of reconsideration requests received from a facility;
188.2 	(iv) frequent adjustments of case mix classifications as the result of reconsiderations or 
188.3 	audits;
188.4 	(v) a criminal indictment alleging provider fraud;
188.5 	(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;
188.6 	(vii) an atypical pattern of scoring minimum data set items;
188.7 	(viii) nonsubmission of assessments;
188.8 	(ix) late submission of assessments; or
188.9 	(x) a previous history of audit changes of 35 percent or greater.
188.10 	(f) Within 15 working days of completing the audit process, the commissioner shall 
188.11 	make available electronically the results of the audit to the facility. If the results of the audit 
188.12 	reflect a change in the resident's case mix classification, a case mix classification notice 
188.13 	will be made available electronically to the facility, using the procedure in subdivision 7, 
188.14 	paragraph (a). The notice must contain the resident's classification and a statement informing 
188.15 	the resident, the resident's authorized representative, and the facility of their right to review 
188.16 	the commissioner's documents supporting the classification and to request a reconsideration 
188.17 	of the classification. This notice must also include the address and telephone number of the 
188.18 	Office of Ombudsman for Long-Term Care. If the audit results in a case mix classification 
188.19 	change, the commissioner must transmit the audit classification notice by electronic means 
188.20 	to the nursing facility within 15 business days of completing an audit. The nursing facility 
188.21 	is responsible for distribution of the notice to each resident or the resident's representative. 
188.22 	This notice must be distributed by the nursing facility within three business days after 
188.23 	receipt. The notice must inform the resident of the case mix classification assigned, the 
188.24 	opportunity to review the documentation supporting the classification, the opportunity to 
188.25 	obtain clarification from the commissioner, the opportunity to request a reconsideration of 
188.26 	the classification, and the address and telephone number of the Office of Ombudsman for 
188.27 	Long-Term Care.

188.28 	Sec. 28. Minnesota Statutes 2020, section 144.0724, subdivision 12, is amended to read:
188.29 		Subd. 12.Appeal of nursing facility level of care determination. (a) A resident or 
188.30 	prospective resident whose level of care determination results in a denial of long-term care 
188.31 	services can appeal the determination as outlined in section 256B.0911, subdivision 3a, 
188.32 	paragraph (h), clause (9).
189.1 	(b) The commissioner of human services shall ensure that notice of changes in eligibility 
189.2 	due to a nursing facility level of care determination is provided to each affected recipient 
189.3 	or the recipient's guardian at least 30 days before the effective date of the change. The notice 
189.4 	shall include the following information:
189.5 	(1) how to obtain further information on the changes;
189.6 	(2) how to receive assistance in obtaining other services;
189.7 	(3) a list of community resources; and
189.8 	(4) appeal rights.
189.9 	A recipient who meets the criteria in section 256B.0922, subdivision 2, paragraph (a), clauses 
189.10 	(1) and (2), may request continued services pending appeal within the time period allowed 
189.11 	to request an appeal under section 256.045, subdivision 3, paragraph (i). This paragraph is 
189.12 	in effect for appeals filed between January 1, 2015, and December 31, 2016.

189.13 	Sec. 29. Minnesota Statutes 2020, section 144.1205, subdivision 2, is amended to read:
189.14 		Subd. 2.Initial and annual fee. (a) A licensee must pay an initial fee that is equivalent 
189.15 	to the annual fee upon issuance of the initial license.
189.16 	(b) A licensee must pay an annual fee at least 60 days before the anniversary date of the 
189.17 	issuance of the license. The annual fee is as follows:

189.19189.18
	TYPE
		ANNUAL
LICENSE FEE
	
189.21189.20
	Academic broad scope - type A, B, or C
		$19,920
$25,896
		
189.22	Academic broad scope - type B
		19,920
		
189.23	Academic broad scope - type C
		19,920
		
189.24	Academic broad scope - type A, B, or C (4-8 locations)
		$31,075
		
189.25	Academic broad scope - type A, B, or C (9 or more locations)
		$36,254
		
189.27189.26
	Medical broad scope - type A
		19,920
$25,896
		
189.28	Medical broad scope- type A (4-8 locations)
		$31,075
		
189.29	Medical broad scope- type A (9 or more locations)
		$36,254
		
189.30	Medical institution - diagnostic and therapeutic
		3,680
		
189.31
189.32
189.33	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies
		$4,784
		
189.34
189.35
189.36	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies (4-8 locations)
		$5,740
		
190.1
190.2
190.3	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies (9 or more locations)
		$6,697
		
190.4	Medical institution - diagnostic (no written directives)
		3,680
		
190.5	Medical private practice - diagnostic and therapeutic
		3,680
		
190.6	Medical private practice - diagnostic (no written directives)
		3,680
		
190.7	Eye applicators
		3,680
		
190.8	Nuclear medical vans
		3,680
		
190.9	High dose rate afterloader
		3,680
		
190.10	Mobile high dose rate afterloader
		3,680
		
190.11	Medical therapy - other emerging technology
		3,680
		
190.13190.12
	Teletherapy
		8,960
$11,648
		
190.15190.14
	Gamma knife
		8,960
$11,648
		
190.16	Veterinary medicine
		2,000 $2,600
		
190.17	In vitro testing lab
		2,000 $2,600
		
190.19190.18
	Nuclear pharmacy
		8,800
$11,440
		
190.20	Nuclear pharmacy (5 or more locations)
		$13,728
		
190.21	Radiopharmaceutical distribution (10 CFR 32.72)
		3,840 $4,992
		
190.22
190.23	Radiopharmaceutical processing and distribution (10 CFR 
32.72)
		8,800
$11,440
		
190.24
190.25	Radiopharmaceutical processing and distribution (10 CFR 
32.72) (5 or more locations)
		$13,728
		
190.26	Medical sealed sources - distribution (10 CFR 32.74)
		3,840 $4,992
		
190.27
190.28	Medical sealed sources - processing and distribution (10 CFR 
32.74)
		8,800
$11,440
		
190.29
190.30	Medical sealed sources - processing and distribution (10 CFR 
32.74) (5 or more locations)
		$13,728
		
190.31	Well logging - sealed sources
		3,760 $4,888
		
190.32
190.33	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other)
		2,000 $2,600
		
190.34	Measuring systems - portable gauge
		2,000
		
190.35
190.36	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other) (4-8 locations)
		$3,120
		
190.37
190.38	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other) (9 or more locations)
		$3,640
		
190.39	X-ray fluorescent analyzer
		1,520 $1,976
		
190.40	Measuring systems - gas chromatograph
		2,000
		
190.41	Measuring systems - other
		2,000
		
191.1
191.2	Broad scope Manufacturing and distribution - type A broad 
scope
		19,920
$25,896
		
191.3
191.4	Manufacturing and distribution - type A broad scope (4-8 
locations)
		$31,075
		
191.5
191.6	Manufacturing and distribution - type A broad scope (9 or more 
locations)
		$36,254
		
191.7
191.8	Broad scope Manufacturing and distribution - type B or C broad 
scope
		17,600
$22,880
		
191.9	Broad scope Manufacturing and distribution - type C
		17,600
		
191.10
191.11	Manufacturing and distribution - type B or C broad scope (4-8 
locations)
		$27,456
		
191.12
191.13	Manufacturing and distribution - type B or C broad scope (9 
or more locations)
		$32,032
		
191.14	Manufacturing and distribution - other
		5,280 $6,864
		
191.15	Manufacturing and distribution - other (4-8 locations)
		$8,236
		
191.16	Manufacturing and distribution - other (9 or more locations)
		$9,609
		
191.18191.17
	Nuclear laundry
		18,640
$24,232
		
191.19	Decontamination services
		4,960 $6,448
		
191.20	Leak test services only
		2,000 $2,600
		
191.21	Instrument calibration service only, less than 100 curies
		2,000 $2,600
		
191.22	Instrument calibration service only, 100 curies or more
		2,000
		
191.23	Service, maintenance, installation, source changes, etc.
		4,960 $6,448
		
191.24	Waste disposal service, prepackaged only
		6,000 $7,800
		
191.26191.25
	Waste disposal
		8,320
$10,816
		
191.27	Distribution - general licensed devices (sealed sources)
		1,760 $2,288
		
191.28	Distribution - general licensed material (unsealed sources)
		1,120 $1,456
		
191.30191.29
	Industrial radiography - fixed or temporary location
		9,840
$12,792
		
191.31	Industrial radiography - temporary job sites
		9,840
		
191.32
191.33	Industrial radiography - fixed or temporary location (5 or more 
locations)
		$16,629
		
191.34	Irradiators, self-shielding, less than 10,000 curies
		2,880 $3,744
		
191.35	Irradiators, other, less than 10,000 curies
		5,360 $6,968
		
191.36	Irradiators, self-shielding, 10,000 curies or more
		2,880
		
191.38191.37
	Research and development - type A, B, or C broad scope
		9,520
$12,376
		
191.39	Research and development - type B broad scope
		9,520
		
191.40	Research and development - type C broad scope
		9,520
		
191.41
191.42	Research and development - type A, B, or C broad scope (4-8 
locations)
		$14,851
		
192.1
192.2	Research and development - type A, B, or C broad scope (9 or 
more locations)
		$17,326
		
192.3	Research and development - other
		4,480 $5,824
		
192.4	Storage - no operations
		2,000 $2,600
		
192.5	Source material - shielding
		584 $759
		
192.6	Special nuclear material plutonium - neutron source in device
		3,680 $4,784
		
192.7
192.8	Pacemaker by-product and/or special nuclear material - medical 
(institution)
		3,680 $4,784
		
192.9192.10
	Pacemaker by-product and/or special nuclear material - 
manufacturing and distribution
		5,280 $6,864
		
192.11	Accelerator-produced radioactive material
		3,840 $4,992
		
192.12	Nonprofit educational institutions
		300 $500
		
192.13	General license registration
		150

192.14 	Sec. 30. Minnesota Statutes 2020, section 144.1205, subdivision 4, is amended to read:
192.15 		Subd. 4.Initial and renewal application fee. A licensee must pay an initial and a 
192.16 	renewal application fee as follows: according to this subdivision.

192.17	TYPE
	APPLICATION FEE
	
192.19192.18
	Academic broad scope - type A, B, or C
		$ 5,920
$6,808
		
192.20	Academic broad scope - type B
		5,920
		
192.21	Academic broad scope - type C
		5,920
		
192.22	Medical broad scope - type A
		3,920 $4,508
		
192.23
192.24
192.25	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies
		$1,748
		
192.26	Medical institution - diagnostic and therapeutic
		1,520
		
192.27	Medical institution - diagnostic (no written directives)
		1,520
		
192.28	Medical private practice - diagnostic and therapeutic
		1,520
		
192.29	Medical private practice - diagnostic (no written directives)
		1,520
		
192.30	Eye applicators
		1,520
		
192.31	Nuclear medical vans
		1,520
		
192.32	High dose rate afterloader
		1,520
		
192.33	Mobile high dose rate afterloader
		1,520
		
192.34	Medical therapy - other emerging technology
		1,520
		
192.35	Teletherapy
		5,520 $6,348
		
192.36	Gamma knife
		5,520 $6,348
		
192.37	Veterinary medicine
		960 $1,104
		
192.38	In vitro testing lab
		960 $1,104
		
193.1	Nuclear pharmacy
		4,880 $5,612
		
193.2	Radiopharmaceutical distribution (10 CFR 32.72)
		2,160 $2,484
		
193.3
193.4	Radiopharmaceutical processing and distribution (10 CFR 
32.72)
		4,880 $5,612
		
193.5	Medical sealed sources - distribution (10 CFR 32.74)
		2,160 $2,484
		
193.6
193.7	Medical sealed sources - processing and distribution (10 CFR 
32.74)
		4,880 $5,612
		
193.8	Well logging - sealed sources
		1,600 $1,840
		
193.9193.10
	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other)
		960 $1,104
		
193.11	Measuring systems - portable gauge
		960
		
193.12	X-ray fluorescent analyzer
		584 $671
		
193.13	Measuring systems - gas chromatograph
		960
		
193.14	Measuring systems - other
		960
		
193.15
193.16	Broad scope Manufacturing and distribution - type A, B, and 
C broad scope
		5,920 $6,854
		
193.17	Broad scope manufacturing and distribution - type B
		5,920
		
193.18	Broad scope manufacturing and distribution - type C
		5,920
		
193.19	Manufacturing and distribution - other
		2,320 $2,668
		
193.21193.20
	Nuclear laundry
		10,080
$11,592
		
193.22	Decontamination services
		2,640 $3,036
		
193.23	Leak test services only
		960 $1,104
		
193.24	Instrument calibration service only, less than 100 curies
		960 $1,104
		
193.25	Instrument calibration service only, 100 curies or more
		960
		
193.26	Service, maintenance, installation, source changes, etc.
		2,640 $3,036
		
193.27	Waste disposal service, prepackaged only
		2,240 $2,576
		
193.28	Waste disposal
		1,520 $1,748
		
193.29	Distribution - general licensed devices (sealed sources)
		880 $1,012
		
193.30	Distribution - general licensed material (unsealed sources)
		520 $598
		
193.31	Industrial radiography - fixed or temporary location
		2,640 $3,036
		
193.32	Industrial radiography - temporary job sites
		2,640
		
193.33	Irradiators, self-shielding, less than 10,000 curies
		1,440 $1,656
		
193.34	Irradiators, other, less than 10,000 curies
		2,960 $3,404
		
193.35	Irradiators, self-shielding, 10,000 curies or more
		1,440
		
193.36	Research and development - type A, B, or C broad scope
		4,960 $5,704
		
193.37	Research and development - type B broad scope
		4,960
		
193.38	Research and development - type C broad scope
		4,960
		
193.39	Research and development - other
		2,400 $2,760
		
193.40	Storage - no operations
		960 $1,104
		
194.1	Source material - shielding
		136 $156
		
194.2	Special nuclear material plutonium - neutron source in device
		1,200 $1,380
		
194.3
194.4	Pacemaker by-product and/or special nuclear material - medical 
(institution)
		1,200 $1,380
		
194.5
194.6	Pacemaker by-product and/or special nuclear material - 
manufacturing and distribution
		2,320 $2,668
		
194.7	Accelerator-produced radioactive material
		4,100 $4,715
		
194.8	Nonprofit educational institutions
		300 $345
		
194.9	General license registration
		0
		
194.10	Industrial radiographer certification
		150

194.11 	Sec. 31. Minnesota Statutes 2020, section 144.1205, subdivision 8, is amended to read:
194.12 		Subd. 8.Reciprocity fee. A licensee submitting an application for reciprocal recognition 
194.13 	of a materials license issued by another agreement state or the United States Nuclear 
194.14 	Regulatory Commission for a period of 180 days or less during a calendar year must pay 
194.15 	$1,200 $2,400. For a period of 181 days or more, the licensee must obtain a license under 
194.16 	subdivision 4.

194.17 	Sec. 32. Minnesota Statutes 2020, section 144.1205, subdivision 9, is amended to read:
194.18 		Subd. 9.Fees for license amendments. A licensee must pay a fee of $300 $600 to 
194.19 	amend a license as follows:
194.20 	(1) to amend a license requiring review including, but not limited to, addition of isotopes, 
194.21 	procedure changes, new authorized users, or a new radiation safety officer; andor
194.22 	(2) to amend a license requiring review and a site visit including, but not limited to, 
194.23 	facility move or addition of processes.

194.24 	Sec. 33. Minnesota Statutes 2020, section 144.1205, is amended by adding a subdivision 
194.25 	to read:
194.26 		Subd. 10.Fees for general license registrations. A person required to register generally 
194.27 	licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual 
194.28 	registration fee of $450.

194.29 	Sec. 34. Minnesota Statutes 2020, section 144.125, subdivision 1, is amended to read:
194.30 		Subdivision 1.Duty to perform testing. (a) It is the duty of (1) the administrative officer 
194.31 	or other person in charge of each institution caring for infants 28 days or less of age, (2) the 
194.32 	person required in pursuance of the provisions of section 144.215, to register the birth of a 
195.1 	child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have 
195.2 	administered to every infant or child in its care tests for heritable and congenital disorders 
195.3 	according to subdivision 2 and rules prescribed by the state commissioner of health.
195.4 	(b) Testing, recording of test results, reporting of test results, and follow-up of infants 
195.5 	with heritable congenital disorders, including hearing loss detected through the early hearing 
195.6 	detection and intervention program in section 144.966, shall be performed at the times and 
195.7 	in the manner prescribed by the commissioner of health.
195.8 	(c) The fee to support the newborn screening program, including tests administered 
195.9 	under this section and section 144.966, shall be $135 $177 per specimen. This fee amount 
195.10 	shall be deposited in the state treasury and credited to the state government special revenue 
195.11 	fund.
195.12 	(d) The fee to offset the cost of the support services provided under section 144.966, 
195.13 	subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury 
195.14 	and credited to the general fund.

195.15 	Sec. 35. [144.1461] DIGNITY IN PREGNANCY AND CHILDBIRTH.
195.16 		Subdivision 1.Citation. This section may be cited as the "Dignity in Pregnancy and 
195.17 	Childbirth Act."
195.18 		Subd. 2.Continuing education requirement. (a) Hospitals with obstetric care and birth 
195.19 	centers must provide continuing education on anti-racism training and implicit bias. The 
195.20 	continuing education must be evidence-based and must include at a minimum the following 
195.21 	criteria:
195.22 	(1) education aimed at identifying personal, interpersonal, institutional, structural, and 
195.23 	cultural barriers to inclusion;
195.24 	(2) identifying and implementing corrective measures to promote anti-racism practices 
195.25 	and decrease implicit bias at the interpersonal and institutional levels, including the 
195.26 	institution's ongoing policies and practices;
195.27 	(3) providing information on the ongoing effects of historical and contemporary exclusion 
195.28 	and oppression of Black and Indigenous communities with the greatest health disparities 
195.29 	related to maternal and infant mortality and morbidity;
195.30 	(4) providing information and discussion of health disparities in the perinatal health care 
195.31 	field including how systemic racism and implicit bias have different impacts on health 
195.32 	outcomes for different racial and ethnic communities; and
196.1 	(5) soliciting perspectives of diverse, local constituency groups and experts on racial, 
196.2 	identity, cultural, and provider-community relationship issues.
196.3 	(b) In addition to the initial continuing educational requirement in paragraph (a), hospitals 
196.4 	with obstetric care and birth centers must provide an annual refresher course that reflects 
196.5 	current trends on race, culture, identity, and anti-racism principles and institutional implicit 
196.6 	bias.
196.7 	(c) Hospitals with obstetric care and birth centers must develop continuing education 
196.8 	materials on anti-racism and implicit bias that must be provided and updated annually for 
196.9 	direct care employees and contractors who routinely care for patients who are pregnant or 
196.10 	postpartum.
196.11 	(d) Hospitals with obstetric care and birth centers shall coordinate with health-related 
196.12 	licensing boards to obtain continuing education credits for the trainings and materials 
196.13 	required in this section. The commissioner of health shall monitor compliance with this 
196.14 	section. Initial training for the continuing education requirements in this subdivision must 
196.15 	be completed by December 31, 2022. The commissioner may inspect the training records 
196.16 	or require reports on the continuing education materials in this section from hospitals with 
196.17 	obstetric care and birth centers.
196.18 	(e) A facility described in paragraph (d) must provide a certificate of training completion 
196.19 	to another facility or a training attendee upon request. A facility may accept the training 
196.20 	certificate from another facility for a health care provider that works in more than one 
196.21 	facility.

196.22 	Sec. 36. Minnesota Statutes 2020, section 144.1481, subdivision 1, is amended to read:
196.23 		Subdivision 1.Establishment; membership. The commissioner of health shall establish 
196.24 	a 15-member 16-member Rural Health Advisory Committee. The committee shall consist 
196.25 	of the following members, all of whom must reside outside the seven-county metropolitan 
196.26 	area, as defined in section 473.121, subdivision 2:
196.27 	(1) two members from the house of representatives of the state of Minnesota, one from 
196.28 	the majority party and one from the minority party;
196.29 	(2) two members from the senate of the state of Minnesota, one from the majority party 
196.30 	and one from the minority party;
196.31 	(3) a volunteer member of an ambulance service based outside the seven-county 
196.32 	metropolitan area;
197.1 	(4) a representative of a hospital located outside the seven-county metropolitan area;
197.2 	(5) a representative of a nursing home located outside the seven-county metropolitan 
197.3 	area;
197.4 	(6) a medical doctor or doctor of osteopathic medicine licensed under chapter 147;
197.5 	(7) a dentist licensed under chapter 150A;
197.6 	(8) a midlevel practitioner;
197.7 	(8) (9) a registered nurse or licensed practical nurse;
197.8 	(9) (10) a licensed health care professional from an occupation not otherwise represented 
197.9 	on the committee;
197.10 	(10) (11) a representative of an institution of higher education located outside the 
197.11 	seven-county metropolitan area that provides training for rural health care providers; and
197.12 	(11) (12) three consumers, at least one of whom must be an advocate for persons who 
197.13 	are mentally ill or developmentally disabled.
197.14 	The commissioner will make recommendations for committee membership. Committee 
197.15 	members will be appointed by the governor. In making appointments, the governor shall 
197.16 	ensure that appointments provide geographic balance among those areas of the state outside 
197.17 	the seven-county metropolitan area. The chair of the committee shall be elected by the 
197.18 	members. The advisory committee is governed by section 15.059, except that the members 
197.19 	do not receive per diem compensation.

197.20 	Sec. 37. Minnesota Statutes 2020, section 144.1501, subdivision 1, is amended to read:
197.21 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
197.22 	apply.
197.23 	(b) "Advanced dental therapist" means an individual who is licensed as a dental therapist 
197.24 	under section 150A.06, and who is certified as an advanced dental therapist under section 
197.25 	150A.106.
197.26 	(c) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and 
197.27 	drug counselor under chapter 148F.
197.28 	(c) (d) "Dental therapist" means an individual who is licensed as a dental therapist under 
197.29 	section 150A.06.
197.30 	(d) (e) "Dentist" means an individual who is licensed to practice dentistry.
198.1 	(e) (f) "Designated rural area" means a statutory and home rule charter city or township 
198.2 	that is outside the seven-county metropolitan area as defined in section 473.121, subdivision 
198.3 	2, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
198.4 	(f) (g) "Emergency circumstances" means those conditions that make it impossible for 
198.5 	the participant to fulfill the service commitment, including death, total and permanent 
198.6 	disability, or temporary disability lasting more than two years.
198.7 	(g) (h) "Mental health professional" means an individual providing clinical services in 
198.8 	the treatment of mental illness who is qualified in at least one of the ways specified in section 
198.9 	245.462, subdivision 18.
198.10 	(h) (i) "Medical resident" means an individual participating in a medical residency in 
198.11 	family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
198.12 	(i) (j) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse anesthetist, 
198.13 	advanced clinical nurse specialist, or physician assistant.
198.14 	(j) (k) "Nurse" means an individual who has completed training and received all licensing 
198.15 	or certification necessary to perform duties as a licensed practical nurse or registered nurse.
198.16 	(k) (l) "Nurse-midwife" means a registered nurse who has graduated from a program of 
198.17 	study designed to prepare registered nurses for advanced practice as nurse-midwives.
198.18 	(l) (m) "Nurse practitioner" means a registered nurse who has graduated from a program 
198.19 	of study designed to prepare registered nurses for advanced practice as nurse practitioners.
198.20 	(m) (n) "Pharmacist" means an individual with a valid license issued under chapter 151.
198.21 	(n) (o) "Physician" means an individual who is licensed to practice medicine in the areas 
198.22 	of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
198.23 	(o) (p) "Physician assistant" means a person licensed under chapter 147A.
198.24 	(p) (q) "Public health nurse" means a registered nurse licensed in Minnesota who has 
198.25 	obtained a registration certificate as a public health nurse from the Board of Nursing in 
198.26 	accordance with Minnesota Rules, chapter 6316.
198.27 	(q) (r) "Qualified educational loan" means a government, commercial, or foundation 
198.28 	loan for actual costs paid for tuition, reasonable education expenses, and reasonable living 
198.29 	expenses related to the graduate or undergraduate education of a health care professional.
198.30 	(r) (s) "Underserved urban community" means a Minnesota urban area or population 
198.31 	included in the list of designated primary medical care health professional shortage areas 
198.32 	(HPSAs), medically underserved areas (MUAs), or medically underserved populations 
199.1 	(MUPs) maintained and updated by the United States Department of Health and Human 
199.2 	Services.

199.3 	Sec. 38. Minnesota Statutes 2020, section 144.1501, subdivision 2, is amended to read:
199.4 		Subd. 2.Creation of account. (a) A health professional education loan forgiveness 
199.5 	program account is established. The commissioner of health shall use money from the 
199.6 	account to establish a loan forgiveness program:
199.7 	(1) for medical residents and, mental health professionals, and alcohol and drug 
199.8 	counselors agreeing to practice in designated rural areas or underserved urban communities 
199.9 	or specializing in the area of pediatric psychiatry;
199.10 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
199.11 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
199.12 	at the undergraduate level or the equivalent at the graduate level;
199.13 	(3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care 
199.14 	facility for persons with developmental disability; a hospital if the hospital owns and operates 
199.15 	a Minnesota nursing home and a minimum of 50 percent of the hours worked by the nurse 
199.16 	is in the nursing home; a housing with services establishment as defined in section 144D.01, 
199.17 	subdivision 4; or for a home care provider as defined in section 144A.43, subdivision 4; or 
199.18 	agree to teach at least 12 credit hours, or 720 hours per year in the nursing field in a 
199.19 	postsecondary program at the undergraduate level or the equivalent at the graduate level;
199.20 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
199.21 	hours per year in their designated field in a postsecondary program at the undergraduate 
199.22 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
199.23 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
199.24 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
199.25 	technology, radiologic technology, and surgical technology;
199.26 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
199.27 	who agree to practice in designated rural areas; and
199.28 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
199.29 	encounters to state public program enrollees or patients receiving sliding fee schedule 
199.30 	discounts through a formal sliding fee schedule meeting the standards established by the 
199.31 	United States Department of Health and Human Services under Code of Federal Regulations, 
199.32 	title 42, section 51, chapter 303.
200.1 	(b) Appropriations made to the account do not cancel and are available until expended, 
200.2 	except that at the end of each biennium, any remaining balance in the account that is not 
200.3 	committed by contract and not needed to fulfill existing commitments shall cancel to the 
200.4 	fund.

200.5 	Sec. 39. Minnesota Statutes 2020, section 144.1501, subdivision 3, is amended to read:
200.6 		Subd. 3.Eligibility. (a) To be eligible to participate in the loan forgiveness program, an 
200.7 	individual must:
200.8 	(1) be a medical or dental resident; a licensed pharmacist; or be enrolled in a training or 
200.9 	education program to become a dentist, dental therapist, advanced dental therapist, mental 
200.10 	health professional, alcohol and drug counselor, pharmacist, public health nurse, midlevel 
200.11 	practitioner, registered nurse, or a licensed practical nurse. The commissioner may also 
200.12 	consider applications submitted by graduates in eligible professions who are licensed and 
200.13 	in practice; and
200.14 	(2) submit an application to the commissioner of health.
200.15 	(b) An applicant selected to participate must sign a contract to agree to serve a minimum 
200.16 	three-year full-time service obligation according to subdivision 2, which shall begin no later 
200.17 	than March 31 following completion of required training, with the exception of a nurse, 
200.18 	who must agree to serve a minimum two-year full-time service obligation according to 
200.19 	subdivision 2, which shall begin no later than March 31 following completion of required 
200.20 	training.

200.21 	Sec. 40. Minnesota Statutes 2020, section 144.1911, subdivision 6, is amended to read:
200.22 		Subd. 6.International medical graduate primary care residency grant program 
200.23 	and revolving account. (a) The commissioner shall award grants to support primary care 
200.24 	residency positions designated for Minnesota immigrant physicians who are willing to serve 
200.25 	in rural or underserved areas of the state. No grant shall exceed $150,000 per residency 
200.26 	position per year. Eligible primary care residency grant recipients include accredited family 
200.27 	medicine, general surgery, internal medicine, obstetrics and gynecology, psychiatry, and 
200.28 	pediatric residency programs. Eligible primary care residency programs shall apply to the 
200.29 	commissioner. Applications must include the number of anticipated residents to be funded 
200.30 	using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded to 
200.31 	grantees in a grant agreement do not lapse until the grant agreement expires. Before any 
200.32 	funds are distributed, a grant recipient shall provide the commissioner with the following:
201.1 	(1) a copy of the signed contract between the primary care residency program and the 
201.2 	participating international medical graduate;
201.3 	(2) certification that the participating international medical graduate has lived in 
201.4 	Minnesota for at least two years and is certified by the Educational Commission on Foreign 
201.5 	Medical Graduates. Residency programs may also require that participating international 
201.6 	medical graduates hold a Minnesota certificate of clinical readiness for residency, once the 
201.7 	certificates become available; and
201.8 	(3) verification that the participating international medical graduate has executed a 
201.9 	participant agreement pursuant to paragraph (b).
201.10 	(b) Upon acceptance by a participating residency program, international medical graduates 
201.11 	shall enter into an agreement with the commissioner to provide primary care for at least 
201.12 	five years in a rural or underserved area of Minnesota after graduating from the residency 
201.13 	program and make payments to the revolving international medical graduate residency 
201.14 	account for five years beginning in their second year of postresidency employment. 
201.15 	Participants shall pay $15,000 or ten percent of their annual compensation each year, 
201.16 	whichever is less.
201.17 	(c) A revolving international medical graduate residency account is established as an 
201.18 	account in the special revenue fund in the state treasury. The commissioner of management 
201.19 	and budget shall credit to the account appropriations, payments, and transfers to the account. 
201.20 	Earnings, such as interest, dividends, and any other earnings arising from fund assets, must 
201.21 	be credited to the account. Funds in the account are appropriated annually to the 
201.22 	commissioner to award grants and administer the grant program established in paragraph 
201.23 	(a). Notwithstanding any law to the contrary, any funds deposited in the account do not 
201.24 	expire. The commissioner may accept contributions to the account from private sector 
201.25 	entities subject to the following provisions:
201.26 	(1) the contributing entity may not specify the recipient or recipients of any grant issued 
201.27 	under this subdivision;
201.28 	(2) the commissioner shall make public the identity of any private contributor to the 
201.29 	account, as well as the amount of the contribution provided; and
201.30 	(3) a contributing entity may not specify that the recipient or recipients of any funds use 
201.31 	specific products or services, nor may the contributing entity imply that a contribution is 
201.32 	an endorsement of any specific product or service.

202.1 	Sec. 41. Minnesota Statutes 2020, section 144.212, is amended by adding a subdivision 
202.2 	to read:
202.3 		Subd. 12.Homeless youth. "Homeless youth" has the meaning given in section 256K.45, 
202.4 	subdivision 1a.

202.5 	Sec. 42. Minnesota Statutes 2020, section 144.225, subdivision 2, is amended to read:
202.6 		Subd. 2.Data about births. (a) Except as otherwise provided in this subdivision, data 
202.7 	pertaining to the birth of a child to a woman who was not married to the child's father when 
202.8 	the child was conceived nor when the child was born, including the original record of birth 
202.9 	and the certified vital record, are confidential data. At the time of the birth of a child to a 
202.10 	woman who was not married to the child's father when the child was conceived nor when 
202.11 	the child was born, the mother may designate demographic data pertaining to the birth as 
202.12 	public. Notwithstanding the designation of the data as confidential, it may be disclosed:
202.13 	(1) to a parent or guardian of the child;
202.14 	(2) to the child when the child is 16 years of age or older, except as provided in clause 
202.15 	(3);
202.16 	(3) to the child if the child is a homeless youth;
202.17 	(3) (4) under paragraph (b), (e), or (f), or (g); or
202.18 	(4) (5) pursuant to a court order. For purposes of this section, a subpoena does not 
202.19 	constitute a court order.
202.20 	(b) Unless the child is adopted, data pertaining to the birth of a child that are not accessible 
202.21 	to the public become public data if 100 years have elapsed since the birth of the child who 
202.22 	is the subject of the data, or as provided under section 13.10, whichever occurs first.
202.23 	(c) If a child is adopted, data pertaining to the child's birth are governed by the provisions 
202.24 	relating to adoption records, including sections 13.10, subdivision 5; 144.218, subdivision 
202.25 	1; 144.2252; and 259.89.
202.26 	(d) The name and address of a mother under paragraph (a) and the child's date of birth 
202.27 	may be disclosed to the county social services, tribal health department, or public health 
202.28 	member of a family services collaborative for purposes of providing services under section 
202.29 	124D.23.
202.30 	(e) The commissioner of human services shall have access to birth records for:
202.31 	(1) the purposes of administering medical assistance and the MinnesotaCare program;
203.1 	(2) child support enforcement purposes; and
203.2 	(3) other public health purposes as determined by the commissioner of health.
203.3 	(f) Tribal child support programs shall have access to birth records for child support 
203.4 	enforcement purposes.
203.5 	(g) An entity administering a children's savings program that starts at birth shall have 
203.6 	access to birth records for the purpose of opening an account in the program for the child 
203.7 	as a beneficiary. For purposes of this paragraph, "children's savings program" means a 
203.8 	long-term savings or investment program that helps children and their families build savings 
203.9 	for the future.

203.10 	Sec. 43. Minnesota Statutes 2020, section 144.225, subdivision 7, is amended to read:
203.11 		Subd. 7.Certified birth or death record. (a) The state registrar or local issuance office 
203.12 	shall issue a certified birth or death record or a statement of no vital record found to an 
203.13 	individual upon the individual's proper completion of an attestation provided by the 
203.14 	commissioner and, except as provided in section 144.2255, payment of the required fee:
203.15 	(1) to a person who has a tangible interest in the requested vital record. A person who 
203.16 	has a tangible interest is:
203.17 	(i) the subject of the vital record;
203.18 	(ii) a child of the subject;
203.19 	(iii) the spouse of the subject;
203.20 	(iv) a parent of the subject;
203.21 	(v) the grandparent or grandchild of the subject;
203.22 	(vi) if the requested record is a death record, a sibling of the subject;
203.23 	(vii) the party responsible for filing the vital record;
203.24 	(viii) (vii) the legal custodian, guardian or conservator, or health care agent of the subject;
203.25 	(ix) (viii) a personal representative, by sworn affidavit of the fact that the certified copy 
203.26 	is required for administration of the estate;
203.27 	(x) (ix) a successor of the subject, as defined in section 524.1-201, if the subject is 
203.28 	deceased, by sworn affidavit of the fact that the certified copy is required for administration 
203.29 	of the estate;
204.1 	(xi) (x) if the requested record is a death record, a trustee of a trust by sworn affidavit 
204.2 	of the fact that the certified copy is needed for the proper administration of the trust;
204.3 	(xii) (xi) a person or entity who demonstrates that a certified vital record is necessary 
204.4 	for the determination or protection of a personal or property right, pursuant to rules adopted 
204.5 	by the commissioner; or
204.6 	(xiii) (xii) an adoption agency in order to complete confidential postadoption searches 
204.7 	as required by section 259.83;
204.8 	(2) to any local, state, tribal, or federal governmental agency upon request if the certified 
204.9 	vital record is necessary for the governmental agency to perform its authorized duties;
204.10 	(3) to an attorney representing the subject of the vital record or another person listed in 
204.11 	clause (1), upon evidence of the attorney's license;
204.12 	(4) pursuant to a court order issued by a court of competent jurisdiction. For purposes 
204.13 	of this section, a subpoena does not constitute a court order; or
204.14 	(5) to a representative authorized by a person under clauses (1) to (4).
204.15 	(b) The state registrar or local issuance office shall also issue a certified death record to 
204.16 	an individual described in paragraph (a), clause (1), items (ii) to (viii) (xi), if, on behalf of 
204.17 	the individual, a licensed mortician furnishes the registrar with a properly completed 
204.18 	attestation in the form provided by the commissioner within 180 days of the time of death 
204.19 	of the subject of the death record. This paragraph is not subject to the requirements specified 
204.20 	in Minnesota Rules, part 4601.2600, subpart 5, item B.

204.21 	Sec. 44. [144.2255] CERTIFIED BIRTH RECORD FOR HOMELESS YOUTH.
204.22 		Subdivision 1.Application; certified birth record. A subject of a birth record who is 
204.23 	a homeless youth in Minnesota or another state may apply to the state registrar or a local 
204.24 	issuance office for a certified birth record according to this section. The state registrar or 
204.25 	local issuance office shall issue a certified birth record or statement of no vital record found 
204.26 	to a subject of a birth record who submits:
204.27 	(1) a completed application signed by the subject of the birth record;
204.28 	(2) a statement that the subject of the birth record is a homeless youth, signed by the 
204.29 	subject of the birth record; and
204.30 	(3) one of the following:
205.1 	(i) a document of identity listed in Minnesota Rules, part 4601.2600, subpart 8, or, at 
205.2 	the discretion of the state registrar or local issuance office, Minnesota Rules, part 4601.2600, 
205.3 	subpart 9;
205.4 	(ii) a statement that complies with Minnesota Rules, part 4601.2600, subparts 6 and 7; 
205.5 	or
205.6 	(iii) a statement verifying that the subject of the birth record is a homeless youth that 
205.7 	complies with the requirements in subdivision 2 and is from an employee of a human services 
205.8 	agency that receives public funding to provide services to homeless youth, runaway youth, 
205.9 	youth with mental illness, or youth with substance use disorders; a school staff person who 
205.10 	provides services to homeless youth; or a school social worker.
205.11 		Subd. 2.Statement verifying subject is a homeless youth. A statement verifying that 
205.12 	a subject of a birth record is a homeless youth must include:
205.13 	(1) the following information regarding the individual providing the statement: first 
205.14 	name, middle name, if any, and last name; home or business address; telephone number, if 
205.15 	any; and e-mail address, if any;
205.16 	(2) the first name, middle name, if any, and last name of the subject of the birth record; 
205.17 	and
205.18 	(3) a statement specifying the relationship of the individual providing the statement to 
205.19 	the subject of the birth record and verifying that the subject of the birth record is a homeless 
205.20 	youth.
205.21 	The individual providing the statement must also provide a copy of the individual's 
205.22 	employment identification.
205.23 		Subd. 3.Expiration; reissuance. If a subject of a birth record obtains a certified birth 
205.24 	record under this section using the statement specified in subdivision 1, clause (3), item 
205.25 	(iii), the certified birth record issued shall expire six months after the date of issuance. Upon 
205.26 	expiration of the certified birth record, the subject of the birth record may surrender the 
205.27 	expired birth record to the state registrar or a local issuance office and obtain another birth 
205.28 	record. Each certified birth record obtained under this subdivision shall expire six months 
205.29 	after the date of issuance. If the subject of the birth record does not surrender the expired 
205.30 	birth record, the subject may apply for a certified birth record using the process in subdivision 
205.31 	1.
206.1 		Subd. 4.Fees waived. The state registrar or local issuance office shall not charge any 
206.2 	fee for issuance of a certified birth record or statement of no vital record found under this 
206.3 	section.
206.4 		Subd. 5.Data practices. Data listed under subdivision 1, clauses (2) and (3), item (iii), 
206.5 	are private data on individuals.

206.6 	EFFECTIVE DATE. This section is effective the day following final enactment for 
206.7 	applications for and the issuance of certified birth records on or after January 1, 2022.

206.8 	Sec. 45. Minnesota Statutes 2020, section 144.226, is amended by adding a subdivision 
206.9 	to read:
206.10 		Subd. 7.Transaction fees. The state registrar may charge and permit agents to charge 
206.11 	a convenience fee and a transaction fee for electronic transactions and transactions by 
206.12 	telephone or Internet, as well as the fees established under subdivisions 1 to 4. The 
206.13 	convenience fee may not exceed three percent of the cost of the charges for payment. The 
206.14 	state registrar may permit agents to charge and retain a transaction fee as payment agreed 
206.15 	upon under contract. When an electronic convenience fee or transaction fee is charged, the 
206.16 	agent charging the fee is required to post information on their web page informing individuals 
206.17 	of the fee. The information must be near the point of payment, clearly visible, include the 
206.18 	amount of the fee, and state: "This contracted agent is allowed by state law to charge a 
206.19 	convenience fee and transaction fee for this electronic transaction."

206.20 	Sec. 46. Minnesota Statutes 2020, section 144.226, is amended by adding a subdivision 
206.21 	to read:
206.22 		Subd. 8.Birth record fees waived for homeless youth. A subject of a birth record who 
206.23 	is a homeless youth shall not be charged any of the fees specified in this section for a certified 
206.24 	birth record or statement of no vital record found under section 144.2255.

206.25 	EFFECTIVE DATE. This section is effective the day following final enactment for 
206.26 	applications for and the issuance of certified birth records on or after January 1, 2022.

206.27 	Sec. 47. Minnesota Statutes 2020, section 144.55, subdivision 4, is amended to read:
206.28 		Subd. 4.Routine inspections; presumption. Any hospital surveyed and accredited 
206.29 	under the standards of the hospital accreditation program of an approved accrediting 
206.30 	organization that submits to the commissioner within a reasonable time copies of (a) its 
206.31 	currently valid accreditation certificate and accreditation letter, together with accompanying 
206.32 	recommendations and comments and (b) any further recommendations, progress reports 
207.1 	and correspondence directly related to the accreditation is presumed to comply with 
207.2 	application requirements of subdivision 1 and the standards requirements of subdivision 3 
207.3 	and no further routine inspections or accreditation information shall be required by the 
207.4 	commissioner to determine compliance. Notwithstanding the provisions of sections 144.54
207.5 	and 144.653, subdivisions 2 and 4, hospitals shall be inspected only as provided in this 
207.6 	section. The provisions of section 144.653 relating to the assessment and collection of fines 
207.7 	shall not apply to any hospital. The commissioner of health shall annually conduct, with 
207.8 	notice, validation inspections of a selected sample of the number of hospitals accredited by 
207.9 	an approved accrediting organization, not to exceed ten percent of accredited hospitals, for 
207.10 	the purpose of determining compliance with the provisions of subdivision 3. If a validation 
207.11 	survey discloses a failure to comply with subdivision 3, the provisions of section 144.653
207.12 	relating to correction orders, reinspections, and notices of noncompliance shall apply. The 
207.13 	commissioner shall also conduct any inspection necessary to determine whether hospital 
207.14 	construction, addition, or remodeling projects comply with standards for construction 
207.15 	promulgated in rules pursuant to subdivision 3. The commissioner shall also conduct any 
207.16 	inspections necessary to determine whether a hospital or hospital corporate system continues 
207.17 	to satisfy the conditions on which a hospital construction moratorium exception was granted 
207.18 	under section 144.551. Pursuant to section 144.653, the commissioner shall inspect any 
207.19 	hospital that does not have a currently valid hospital accreditation certificate from an 
207.20 	approved accrediting organization. Nothing in this subdivision shall be construed to limit 
207.21 	the investigative powers of the Office of Health Facility Complaints as established in sections 
207.22 	144A.51 to 144A.54.

207.23 	Sec. 48. Minnesota Statutes 2020, section 144.55, subdivision 6, is amended to read:
207.24 		Subd. 6.Suspension, revocation, and refusal to renew. (a) The commissioner may 
207.25 	refuse to grant or renew, or may suspend or revoke, a license on any of the following grounds:
207.26 	(1) violation of any of the provisions of sections 144.50 to 144.56 or the rules or standards 
207.27 	issued pursuant thereto, or Minnesota Rules, chapters 4650 and 4675;
207.28 	(2) permitting, aiding, or abetting the commission of any illegal act in the institution;
207.29 	(3) conduct or practices detrimental to the welfare of the patient; or
207.30 	(4) obtaining or attempting to obtain a license by fraud or misrepresentation; or
207.31 	(5) with respect to hospitals and outpatient surgical centers, if the commissioner 
207.32 	determines that there is a pattern of conduct that one or more physicians or advanced practice 
207.33 	registered nurses who have a "financial or economic interest," as defined in section 144.6521, 
208.1 	subdivision 3, in the hospital or outpatient surgical center, have not provided the notice and 
208.2 	disclosure of the financial or economic interest required by section 144.6521.
208.3 	(b) The commissioner shall not renew a license for a boarding care bed in a resident 
208.4 	room with more than four beds.
208.5 	(c) The commissioner shall not renew licenses for hospital beds issued to a hospital or 
208.6 	hospital corporate system pursuant to a hospital construction moratorium exception under 
208.7 	section 144.551 if the commissioner determines the hospital or hospital corporate system 
208.8 	is not satisfying the conditions on which the exception was granted.

208.9 	EFFECTIVE DATE. This section is effective for license renewals occurring on or after 
208.10 	July 1, 2021.

208.11 	Sec. 49. Minnesota Statutes 2020, section 144.551, subdivision 1, is amended to read:
208.12 		Subdivision 1.Restricted construction or modification. (a) The following construction 
208.13 	or modification may not be commenced:
208.14 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
208.15 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
208.16 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
208.17 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
208.18 	state; and
208.19 	(2) the establishment of a new hospital.
208.20 	(b) This section does not apply to:
208.21 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
208.22 	facility that is a national referral center engaged in substantial programs of patient care, 
208.23 	medical research, and medical education meeting state and national needs that receives more 
208.24 	than 40 percent of its patients from outside the state of Minnesota;
208.25 	(2) a project for construction or modification for which a health care facility held an 
208.26 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
208.27 	certificate;
208.28 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
208.29 	appeal results in an order reversing the denial;
208.30 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
208.31 	section 2;
209.1 	(5) a project involving consolidation of pediatric specialty hospital services within the 
209.2 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
209.3 	of pediatric specialty hospital beds among the hospitals being consolidated;
209.4 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
209.5 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
209.6 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
209.7 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
209.8 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
209.9 	(7) the relocation or redistribution of hospital beds within a hospital building or 
209.10 	identifiable complex of buildings provided the relocation or redistribution does not result 
209.11 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
209.12 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
209.13 	state or a region of the state;
209.14 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
209.15 	involves the transfer of beds from a closed facility site or complex to an existing site or 
209.16 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
209.17 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
209.18 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
209.19 	health systems agency boundary in place on July 1, 1983; and (iv) the relocation or 
209.20 	redistribution does not involve the construction of a new hospital building; and (v) the 
209.21 	transferred beds are used first to replace within the hospital corporate system the total number 
209.22 	of beds previously used in the closed facility site or complex for mental health services and 
209.23 	substance use disorder services. Only after the hospital corporate system has fulfilled the 
209.24 	requirements of this item may the remainder of the available capacity of the closed facility 
209.25 	site or complex be transferred for any other purpose;
209.26 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
209.27 	County that primarily serves adolescents and that receives more than 70 percent of its 
209.28 	patients from outside the state of Minnesota;
209.29 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
209.30 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
209.31 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
209.32 	construction of the initial building or as the result of future expansion, will not exceed 70 
209.33 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
210.1 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
210.2 	the commissioner of human services to a new or existing facility, building, or complex 
210.3 	operated by the commissioner of human services; from one regional treatment center site 
210.4 	to another; or from one building or site to a new or existing building or site on the same 
210.5 	campus;
210.6 	(12) the construction or relocation of hospital beds operated by a hospital having a 
210.7 	statutory obligation to provide hospital and medical services for the indigent that does not 
210.8 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
210.9 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
210.10 	Medical Center to Regions Hospital under this clause;
210.11 	(13) a construction project involving the addition of up to 31 new beds in an existing 
210.12 	nonfederal hospital in Beltrami County;
210.13 	(14) a construction project involving the addition of up to eight new beds in an existing 
210.14 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
210.15 	(15) a construction project involving the addition of 20 new hospital beds in an existing 
210.16 	hospital in Carver County serving the southwest suburban metropolitan area;
210.17 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
210.18 	of up to two psychiatric facilities or units for children provided that the operation of the 
210.19 	facilities or units have received the approval of the commissioner of human services;
210.20 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
210.21 	services in an existing hospital in Itasca County;
210.22 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
210.23 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
210.24 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
210.25 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
210.26 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
210.27 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
210.28 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
210.29 	to the extent that the critical access hospital does not seek to exceed the maximum number 
210.30 	of beds permitted such hospital under federal law;
210.31 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
210.32 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
211.1 	(i) the project, including each hospital or health system that will own or control the entity 
211.2 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
211.3 	Council as of March 1, 2006;
211.4 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
211.5 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
211.6 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
211.7 	have been found to be in the public interest by the commissioner of health as of April 1, 
211.8 	2005;
211.9 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
211.10 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
211.11 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
211.12 	services, and emergency room services;
211.13 	(iv) the new hospital:
211.14 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
211.15 	needs of the Maple Grove service area and the surrounding communities currently being 
211.16 	served by the hospital or health system that will own or control the entity that will hold the 
211.17 	new hospital license;
211.18 	(B) will provide uncompensated care;
211.19 	(C) will provide mental health services, including inpatient beds;
211.20 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
211.21 	occupations and have a commitment to providing clinical training programs for physicians 
211.22 	and other health care providers;
211.23 	(E) will demonstrate a commitment to quality care and patient safety;
211.24 	(F) will have an electronic medical records system, including physician order entry;
211.25 	(G) will provide a broad range of senior services;
211.26 	(H) will provide emergency medical services that will coordinate care with regional 
211.27 	providers of trauma services and licensed emergency ambulance services in order to enhance 
211.28 	the continuity of care for emergency medical patients; and
211.29 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
211.30 	the control of the entity holding the new hospital license; and
212.1 	(v) as of 30 days following submission of a written plan, the commissioner of health 
212.2 	has not determined that the hospitals or health systems that will own or control the entity 
212.3 	that will hold the new hospital license are unable to meet the criteria of this clause;
212.4 	(21) a project approved under section 144.553;
212.5 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
212.6 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
212.7 	is approved by the Cass County Board;
212.8 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
212.9 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
212.10 	a separately licensed 13-bed skilled nursing facility;
212.11 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
212.12 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
212.13 	who are under 21 years of age on the date of admission. The commissioner conducted a 
212.14 	public interest review of the mental health needs of Minnesota and the Twin Cities 
212.15 	metropolitan area in 2008. No further public interest review shall be conducted for the 
212.16 	construction or expansion project under this clause;
212.17 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
212.18 	commissioner finds the project is in the public interest after the public interest review 
212.19 	conducted under section 144.552 is complete;
212.20 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
212.21 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
212.22 	admission, if the commissioner finds the project is in the public interest after the public 
212.23 	interest review conducted under section 144.552 is complete;
212.24 	(ii) this project shall serve patients in the continuing care benefit program under section 
212.25 	256.9693. The project may also serve patients not in the continuing care benefit program; 
212.26 	and
212.27 	(iii) if the project ceases to participate in the continuing care benefit program, the 
212.28 	commissioner must complete a subsequent public interest review under section 144.552. If 
212.29 	the project is found not to be in the public interest, the license must be terminated six months 
212.30 	from the date of that finding. If the commissioner of human services terminates the contract 
212.31 	without cause or reduces per diem payment rates for patients under the continuing care 
212.32 	benefit program below the rates in effect for services provided on December 31, 2015, the 
213.1 	project may cease to participate in the continuing care benefit program and continue to 
213.2 	operate without a subsequent public interest review;
213.3 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
213.4 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
213.5 	date of admission; or
213.6 	(28) a project to add 55 licensed beds in an existing safety net, level I trauma center 
213.7 	hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which 
213.8 	15 beds are to be used for inpatient mental health and 40 are to be used for other services. 
213.9 	In addition, five unlicensed observation mental health beds shall be added.;
213.10 	(29) notwithstanding section 144.552, a project to add 45 licensed beds in an existing 
213.11 	safety net, level I trauma center hospital in Ramsey County as designated under section 
213.12 	383A.91, subdivision 5. The commissioner conducted a public interest review of the 
213.13 	construction and expansion of this hospital in 2018. No further public interest review shall 
213.14 	be conducted for the project under this clause; or
213.15 	(30) the addition of licensed beds in a hospital or hospital corporate system to primarily 
213.16 	provide mental health services or substance use disorder services. In order to add beds under 
213.17 	this clause, a hospital must have an emergency department and must not be a hospital that 
213.18 	solely provides treatment to adults for mental illnesses or substance use disorders. Beds 
213.19 	added under this clause must be available to serve medical assistance and MinnesotaCare 
213.20 	enrollees. Notwithstanding section 144.552, public interest review shall not be required for 
213.21 	an addition of beds under this clause.

213.22 	EFFECTIVE DATE. (a) Paragraph (b), clause (29), is effective the day following final 
213.23 	enactment, contingent upon:
213.24 	(1) the addition of the 15 inpatient mental health beds specified in paragraph (b), clause 
213.25 	(28), to the Ramsey County level I trauma center's bed capacity;
213.26 	(2) five of the 45 additional beds authorized in paragraph (b), clause (29), being 
213.27 	designated for use for inpatient mental health and added to the hospital's bed capacity before 
213.28 	the remaining 40 beds authorized under that clause are added; and
213.29 	(3) the Ramsey County level I trauma center's agreement to not participate in the Revenue 
213.30 	Recapture Act under Minnesota Statutes, chapter 270, and Minnesota Statutes, section 
213.31 	270C.41.
213.32 	(b) The amendment to paragraph (b), clause (8), and paragraph (b), clause (30), are 
213.33 	effective the day following final enactment.

214.1 	Sec. 50. Minnesota Statutes 2020, section 144.551, is amended by adding a subdivision 
214.2 	to read:
214.3 		Subd. 5.Monitoring. The commissioner shall monitor the implementation of exceptions 
214.4 	under this section. Each hospital or hospital corporate system granted an exception under 
214.5 	this section shall submit to the commissioner each year a report on how the hospital or 
214.6 	hospital corporate system continues to satisfy the conditions on which the exception was 
214.7 	granted.

214.8 	Sec. 51. Minnesota Statutes 2020, section 144.555, is amended to read:
214.9 	144.555 HOSPITAL FACILITY OR CAMPUS CLOSINGS, RELOCATING 
214.10 	SERVICES, OR CEASING TO OFFER CERTAIN SERVICES; PATIENT 
214.11 	RELOCATIONS.
214.12 		Subdivision 1.Notice of closing or curtailing service operations; facilities other than 
214.13 	hospitals. If a facility licensed under sections 144.50 to 144.56, other than a hospital,
214.14 	voluntarily plans to cease operations or to curtail operations to the extent that patients or 
214.15 	residents must be relocated, the controlling persons of the facility must notify the 
214.16 	commissioner of health at least 90 days before the scheduled cessation or curtailment. The 
214.17 	commissioner shall cooperate with the controlling persons and advise them about relocating 
214.18 	the patients or residents.
214.19 		Subd. 1a.Notice of closing, curtailing operations, relocating services, or ceasing to 
214.20 	offer certain services; hospitals. (a) The controlling persons of a hospital licensed under 
214.21 	sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health at 
214.22 	least nine months before a scheduled action if the hospital or hospital campus voluntarily 
214.23 	plans to:
214.24 	(1) cease operations;
214.25 	(2) curtail operations to the extent that patients must be relocated;
214.26 	(3) relocate the provision of health services to another hospital or another hospital 
214.27 	campus; or
214.28 	(4) cease offering maternity care and newborn care services, intensive care unit services, 
214.29 	inpatient mental health services, or inpatient substance use disorder treatment services.
214.30 	(b) The commissioner shall cooperate with the controlling persons and advise them 
214.31 	about relocating the patients. The controlling persons of the hospital or hospital campus 
214.32 	must comply with section 144.556.
215.1 		Subd. 1b.Public hearing. Upon receiving notice under subdivision 1a, the commissioner 
215.2 	shall conduct a public hearing on the scheduled cessation of operations, curtailment of 
215.3 	operations, relocation of health services, or cessation in offering health services. The 
215.4 	commissioner must provide adequate public notice of the hearing in a time and manner 
215.5 	determined by the commissioner. The public hearing must be held in the community where 
215.6 	the hospital or hospital campus is located at least six months before the scheduled cessation 
215.7 	or curtailment of operations, relocation of health services, or cessation in offering health 
215.8 	services. The controlling persons of the hospital or hospital campus must participate in the 
215.9 	public hearing. The public hearing must include:
215.10 	(1) an explanation by the controlling persons of the reasons for ceasing or curtailing 
215.11 	operations, relocating health services, or ceasing to offer any of the listed health services;
215.12 	(2) a description of the actions that controlling persons will take to ensure that residents 
215.13 	in the hospital's or campus's service area have continued access to the health services being 
215.14 	eliminated, curtailed, or relocated;
215.15 	(3) an opportunity for public testimony on the scheduled cessation or curtailment of 
215.16 	operations, relocation of health services, or cessation in offering any of the listed health 
215.17 	services, and on the hospital's or campus's plan to ensure continued access to those health 
215.18 	services being eliminated, curtailed, or relocated; and
215.19 	(4) an opportunity for the controlling persons to respond to questions from interested 
215.20 	persons.
215.21 		Subd. 2.Penalty. Failure to notify the commissioner under subdivision 1 or 1a or failure 
215.22 	to participate in a public hearing under subdivision 1b may result in issuance of a correction 
215.23 	order under section 144.653, subdivision 5.

215.24 	Sec. 52. [144.556] RIGHT OF FIRST REFUSAL FOR HOSPITAL OR HOSPITAL 
215.25 	CAMPUS.
215.26 		Subdivision 1.Prerequisite before sale, conveyance, or ceasing operations of hospital 
215.27 	or hospital campus. The controlling persons of a hospital licensed under sections 144.50 
215.28 	to 144.56 shall not sell or convey the hospital or a campus of the hospital, offer to sell or 
215.29 	convey the hospital or hospital campus, or voluntarily cease operations of the hospital or 
215.30 	hospital campus unless the controlling persons have first made a good faith offer to sell or 
215.31 	convey the hospital or hospital campus to the home rule charter or statutory city, county, 
215.32 	town, or hospital district in which the hospital or hospital campus is located.
216.1 		Subd. 2.Offer. The offer to sell or convey the hospital or hospital campus must be at a 
216.2 	price that does not exceed the current fair market value of the hospital or hospital campus. 
216.3 	A party to whom an offer is made under subdivision 1 must accept or decline the offer 
216.4 	within 60 days after receipt. If the party fails to respond within 60 days after receipt, the 
216.5 	offer is deemed declined.

216.6 	Sec. 53. Minnesota Statutes 2020, section 144.9501, subdivision 17, is amended to read:
216.7 		Subd. 17.Lead hazard reduction. "Lead hazard reduction" means abatement or interim 
216.8 	controls undertaken to make a residence, child care facility, school, or playground, or other 
216.9 	location where lead hazards are identified lead-safe by complying with the lead standards 
216.10 	and methods adopted under section 144.9508.

216.11 	Sec. 54. Minnesota Statutes 2020, section 144.9502, subdivision 3, is amended to read:
216.12 		Subd. 3.Reports of blood lead analysis required. (a) Every hospital, medical clinic, 
216.13 	medical laboratory, other facility, or individual performing blood lead analysis shall report 
216.14 	the results after the analysis of each specimen analyzed, for both capillary and venous 
216.15 	specimens, and epidemiologic information required in this section to the commissioner of 
216.16 	health, within the time frames set forth in clauses (1) and (2):
216.17 	(1) within two working days by telephone, fax, or electronic transmission as prescribed 
216.18 	by the commissioner, with written or electronic confirmation within one month as prescribed 
216.19 	by the commissioner, for a venous blood lead level equal to or greater than 15 micrograms 
216.20 	of lead per deciliter of whole blood; or
216.21 	(2) within one month in writing or by electronic transmission as prescribed by the 
216.22 	commissioner, for any capillary result or for a venous blood lead level less than 15 
216.23 	micrograms of lead per deciliter of whole blood.
216.24 	(b) If a blood lead analysis is performed outside of Minnesota and the facility performing 
216.25 	the analysis does not report the blood lead analysis results and epidemiological information 
216.26 	required in this section to the commissioner, the provider who collected the blood specimen 
216.27 	must satisfy the reporting requirements of this section. For purposes of this section, "provider" 
216.28 	has the meaning given in section 62D.02, subdivision 9.
216.29 	(c) The commissioner shall coordinate with hospitals, medical clinics, medical 
216.30 	laboratories, and other facilities performing blood lead analysis to develop a universal 
216.31 	reporting form and mechanism.

217.1 	Sec. 55. Minnesota Statutes 2020, section 144.9504, subdivision 2, is amended to read:
217.2 		Subd. 2.Lead risk assessment. (a) Notwithstanding section 144.9501, subdivision 6a, 
217.3 	for purposes of this subdivision, "child" means an individual under 18 years of age.
217.4 	(b) An assessing agency shall conduct a lead risk assessment of a residence, residential 
217.5 	or commercial child care facility, playground, school, or other location where lead hazards 
217.6 	are suspected according to the venous blood lead level and time frame set forth in clauses 
217.7 	(1) to (4) for purposes of secondary prevention:
217.8 	(1) within 48 hours of a child or pregnant female in the residence, residential or 
217.9 	commercial child care facility, playground, school, or other location where lead hazards are 
217.10 	suspected being identified to the agency as having a venous blood lead level equal to or 
217.11 	greater than 60 micrograms of lead per deciliter of whole blood;
217.12 	(2) within five working days of a child or pregnant female in the residence, residential 
217.13 	or commercial child care facility, playground, school, or other location where lead hazards 
217.14 	are suspected being identified to the agency as having a venous blood lead level equal to 
217.15 	or greater than 45 micrograms of lead per deciliter of whole blood;
217.16 	(3) within ten working days of a child in the residence being identified to the agency as 
217.17 	having a venous blood lead level equal to or greater than 15 micrograms of lead per deciliter 
217.18 	of whole blood; or
217.19 	(4) (3) within ten working days of a child or pregnant female in the residence, residential 
217.20 	or commercial child care facility, playground, school, or other location where lead hazards 
217.21 	are suspected being identified to the agency as having a venous blood lead level equal to 
217.22 	or greater than ten micrograms of lead per deciliter of whole blood.; or
217.23 	(4) within 20 working days of a child or pregnant female in the residence, residential or 
217.24 	commercial child care facility, playground, school, or other location where lead hazards are 
217.25 	suspected being identified to the agency as having a venous blood lead level equal to or 
217.26 	greater than five micrograms per deciliter of whole blood.
217.27 	An assessing agency may refer investigations at sites other than the child's or pregnant 
217.28 	female's residence to the commissioner.
217.29 	(b) (c) Within the limits of available local, state, and federal appropriations, an assessing 
217.30 	agency may also conduct a lead risk assessment for children with any elevated blood lead 
217.31 	level.
217.32 	(c) (d) In a building with two or more dwelling units, an assessing agency shall assess 
217.33 	the individual unit in which the conditions of this section are met and shall inspect all 
218.1 	common areas accessible to a child. If a child visits one or more other sites such as another 
218.2 	residence, or a residential or commercial child care facility, playground, or school, the 
218.3 	assessing agency shall also inspect the other sites. The assessing agency shall have one 
218.4 	additional day added to the time frame set forth in this subdivision to complete the lead risk 
218.5 	assessment for each additional site.
218.6 	(d) (e) Within the limits of appropriations, the assessing agency shall identify the known 
218.7 	addresses for the previous 12 months of the child or pregnant female with venous blood 
218.8 	lead levels of at least 15 micrograms per deciliter for the child or at least ten micrograms 
218.9 	per deciliter for the pregnant female; notify the property owners, landlords, and tenants at 
218.10 	those addresses that an elevated blood lead level was found in a person who resided at the 
218.11 	property; and give them primary prevention information. Within the limits of appropriations, 
218.12 	the assessing agency may perform a risk assessment and issue corrective orders in the 
218.13 	properties, if it is likely that the previous address contributed to the child's or pregnant 
218.14 	female's blood lead level. The assessing agency shall provide the notice required by this 
218.15 	subdivision without identifying the child or pregnant female with the elevated blood lead 
218.16 	level. The assessing agency is not required to obtain the consent of the child's parent or 
218.17 	guardian or the consent of the pregnant female for purposes of this subdivision. This 
218.18 	information shall be classified as private data on individuals as defined under section 13.02, 
218.19 	subdivision 12.
218.20 	(e) (f) The assessing agency shall conduct the lead risk assessment according to rules 
218.21 	adopted by the commissioner under section 144.9508. An assessing agency shall have lead 
218.22 	risk assessments performed by lead risk assessors licensed by the commissioner according 
218.23 	to rules adopted under section 144.9508. If a property owner refuses to allow a lead risk 
218.24 	assessment, the assessing agency shall begin legal proceedings to gain entry to the property 
218.25 	and the time frame for conducting a lead risk assessment set forth in this subdivision no 
218.26 	longer applies. A lead risk assessor or assessing agency may observe the performance of 
218.27 	lead hazard reduction in progress and shall enforce the provisions of this section under 
218.28 	section 144.9509. Deteriorated painted surfaces, bare soil, and dust must be tested with 
218.29 	appropriate analytical equipment to determine the lead content, except that deteriorated 
218.30 	painted surfaces or bare soil need not be tested if the property owner agrees to engage in 
218.31 	lead hazard reduction on those surfaces. The lead content of drinking water must be measured 
218.32 	if another probable source of lead exposure is not identified. Within a standard metropolitan 
218.33 	statistical area, an assessing agency may order lead hazard reduction of bare soil without 
218.34 	measuring the lead content of the bare soil if the property is in a census tract in which soil 
218.35 	sampling has been performed according to rules established by the commissioner and at 
219.1 	least 25 percent of the soil samples contain lead concentrations above the standard in section 
219.2 	144.9508.
219.3 	(f) (g) Each assessing agency shall establish an administrative appeal procedure which 
219.4 	allows a property owner to contest the nature and conditions of any lead order issued by 
219.5 	the assessing agency. Assessing agencies must consider appeals that propose lower cost 
219.6 	methods that make the residence lead safe. The commissioner shall use the authority and 
219.7 	appeal procedure granted under sections 144.989 to 144.993.
219.8 	(g) (h) Sections 144.9501 to 144.9512 neither authorize nor prohibit an assessing agency 
219.9 	from charging a property owner for the cost of a lead risk assessment.

219.10 	Sec. 56. Minnesota Statutes 2020, section 144.9504, subdivision 5, is amended to read:
219.11 		Subd. 5.Lead orders. (a) An assessing agency, after conducting a lead risk assessment, 
219.12 	shall order a property owner to perform lead hazard reduction on all lead sources that exceed 
219.13 	a standard adopted according to section 144.9508. If lead risk assessments and lead orders 
219.14 	are conducted at times when weather or soil conditions do not permit the lead risk assessment 
219.15 	or lead hazard reduction, external surfaces and soil lead shall be assessed, and lead orders 
219.16 	complied with, if necessary, at the first opportunity that weather and soil conditions allow.
219.17 	(b) If, after conducting a lead risk assessment, an assessing agency determines that the 
219.18 	property owner's lead hazard originated from another source location, the assessing agency 
219.19 	may order the responsible person of the source location to:
219.20 	(1) perform lead hazard reduction at the site where the assessing agency conducted the 
219.21 	lead risk assessment; and
219.22 	(2) remediate the conditions at the source location that allowed the lead hazard, pollutant, 
219.23 	or contaminant to migrate from the source location.
219.24 	(c) For purposes of this subdivision, "pollutant or contaminant" has the meaning given 
219.25 	in section 115B.02, subdivision 13, and "responsible person" has the meaning given in 
219.26 	section 115B.03.
219.27 	(b) (d) If the paint standard under section 144.9508 is violated, but the paint is intact, 
219.28 	the assessing agency shall not order the paint to be removed unless the intact paint is a 
219.29 	known source of actual lead exposure to a specific person. Before the assessing agency may 
219.30 	order the intact paint to be removed, a reasonable effort must be made to protect the child 
219.31 	and preserve the intact paint by the use of guards or other protective devices and methods.
220.1 	(c) (e) Whenever windows and doors or other components covered with deteriorated 
220.2 	lead-based paint have sound substrate or are not rotting, those components should be repaired, 
220.3 	sent out for stripping or planed down to remove deteriorated lead-based paint, or covered 
220.4 	with protective guards instead of being replaced, provided that such an activity is the least 
220.5 	cost method. However, a property owner who has been ordered to perform lead hazard 
220.6 	reduction may choose any method to address deteriorated lead-based paint on windows, 
220.7 	doors, or other components, provided that the method is approved in rules adopted under 
220.8 	section 144.9508 and that it is appropriate to the specific property.
220.9 	(d) (f) Lead orders must require that any source of damage, such as leaking roofs, 
220.10 	plumbing, and windows, be repaired or replaced, as needed, to prevent damage to 
220.11 	lead-containing interior surfaces.
220.12 	(e) (g) The assessing agency is not required to pay for lead hazard reduction. The 
220.13 	assessing agency shall enforce the lead orders issued to a property owner under this section.

220.14 	Sec. 57. Minnesota Statutes 2020, section 144G.08, subdivision 7, as amended by Laws 
220.15 	2020, Seventh Special Session chapter 1, article 6, section 5, is amended to read:
220.16 		Subd. 7.Assisted living facility. "Assisted living facility" means a facility that an 
220.17 	establishment where an operating person or legal entity, either directly or through contract, 
220.18 	business relationship, or common ownership with another person or entity, provides sleeping 
220.19 	accommodations and assisted living services to one or more adults in the facility. Assisted 
220.20 	living facility includes assisted living facility with dementia care, and does not include:
220.21 	(1) emergency shelter, transitional housing, or any other residential units serving 
220.22 	exclusively or primarily homeless individuals, as defined under section 116L.361;
220.23 	(2) a nursing home licensed under chapter 144A;
220.24 	(3) a hospital, certified boarding care, or supervised living facility licensed under sections 
220.25 	144.50 to 144.56;
220.26 	(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 
220.27 	9520.0500 to 9520.0670, or under chapter 245D or 245G;
220.28 	(5) services and residential settings licensed under chapter 245A, including adult foster 
220.29 	care and services and settings governed under the standards in chapter 245D;
220.30 	(6) a private home in which the residents are related by kinship, law, or affinity with the 
220.31 	provider of services;
221.1 	(7) a duly organized condominium, cooperative, and common interest community, or 
221.2 	owners' association of the condominium, cooperative, and common interest community 
221.3 	where at least 80 percent of the units that comprise the condominium, cooperative, or 
221.4 	common interest community are occupied by individuals who are the owners, members, or 
221.5 	shareholders of the units;
221.6 	(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;
221.7 	(9) a setting offering services conducted by and for the adherents of any recognized 
221.8 	church or religious denomination for its members exclusively through spiritual means or 
221.9 	by prayer for healing;
221.10 	(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with 
221.11 	low-income housing tax credits pursuant to United States Code, title 26, section 42, and 
221.12 	units financed by the Minnesota Housing Finance Agency that are intended to serve 
221.13 	individuals with disabilities or individuals who are homeless, except for those developments 
221.14 	that market or hold themselves out as assisted living facilities and provide assisted living 
221.15 	services;
221.16 	(11) rental housing developed under United States Code, title 42, section 1437, or United 
221.17 	States Code, title 12, section 1701q;
221.18 	(12) rental housing designated for occupancy by only elderly or elderly and disabled 
221.19 	residents under United States Code, title 42, section 1437e, or rental housing for qualifying 
221.20 	families under Code of Federal Regulations, title 24, section 983.56;
221.21 	(13) rental housing funded under United States Code, title 42, chapter 89, or United 
221.22 	States Code, title 42, section 8011;
221.23 	(14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b); or
221.24 	(15) (14) any establishment that exclusively or primarily serves as a shelter or temporary 
221.25 	shelter for victims of domestic or any other form of violence.

221.26 	EFFECTIVE DATE. This section is effective August 1, 2021.

221.27 	Sec. 58. Minnesota Statutes 2020, section 144G.84, is amended to read:
221.28 	144G.84 SERVICES FOR RESIDENTS WITH DEMENTIA.
221.29 	(a) In addition to the minimum services required in section 144G.41, an assisted living 
221.30 	facility with dementia care must also provide the following services:
222.1 	(1) assistance with activities of daily living that address the needs of each resident with 
222.2 	dementia due to cognitive or physical limitations. These services must meet or be in addition 
222.3 	to the requirements in the licensing rules for the facility. Services must be provided in a 
222.4 	person-centered manner that promotes resident choice, dignity, and sustains the resident's 
222.5 	abilities;
222.6 	(2) nonpharmacological practices that are person-centered and evidence-informed;
222.7 	(3) services to prepare and educate persons living with dementia and their legal and 
222.8 	designated representatives about transitions in care and ensuring complete, timely 
222.9 	communication between, across, and within settings; and
222.10 	(4) services that provide residents with choices for meaningful engagement with other 
222.11 	facility residents and the broader community.
222.12 	(b) Each resident must be evaluated for activities according to the licensing rules of the 
222.13 	facility. In addition, the evaluation must address the following:
222.14 	(1) past and current interests;
222.15 	(2) current abilities and skills;
222.16 	(3) emotional and social needs and patterns;
222.17 	(4) physical abilities and limitations;
222.18 	(5) adaptations necessary for the resident to participate; and
222.19 	(6) identification of activities for behavioral interventions.
222.20 	(c) An individualized activity plan must be developed for each resident based on their 
222.21 	activity evaluation. The plan must reflect the resident's activity preferences and needs.
222.22 	(d) A selection of daily structured and non-structured activities must be provided and 
222.23 	included on the resident's activity service or care plan as appropriate. Daily activity options 
222.24 	based on resident evaluation may include but are not limited to:
222.25 	(1) occupation or chore related tasks;
222.26 	(2) scheduled and planned events such as entertainment or outings;
222.27 	(3) spontaneous activities for enjoyment or those that may help defuse a behavior;
222.28 	(4) one-to-one activities that encourage positive relationships between residents and 
222.29 	staff such as telling a life story, reminiscing, or playing music;
222.30 	(5) spiritual, creative, and intellectual activities;
223.1 	(6) sensory stimulation activities;
223.2 	(7) physical activities that enhance or maintain a resident's ability to ambulate or move; 
223.3 	and
223.4 	(8) a resident's individualized activity plan for regular outdoor activities activity.
223.5 	(e) Behavioral symptoms that negatively impact the resident and others in the assisted 
223.6 	living facility with dementia care must be evaluated and included on the service or care 
223.7 	plan. The staff must initiate and coordinate outside consultation or acute care when indicated.
223.8 	(f) Support must be offered to family and other significant relationships on a regularly 
223.9 	scheduled basis but not less than quarterly.
223.10 	(g) Access to secured outdoor space and walkways that allow residents to enter and 
223.11 	return without staff assistance must be provided. Existing housing with services 
223.12 	establishments registered under chapter 144D prior to August 1, 2021, that obtain an assisted 
223.13 	living facility license must provide residents with regular access to outdoor space. A licensee 
223.14 	with new construction on or after August 1, 2021, or a new licensee that was not previously 
223.15 	registered under chapter 144D prior to August 1, 2021, must provide regular access to 
223.16 	secured outdoor space on the premises of the facility. A resident's access to outdoor space 
223.17 	must be in accordance with the resident's documented care plan.

223.18 	EFFECTIVE DATE. This section is effective August 1, 2021.

223.19 	Sec. 59. [145.87] HOME VISITING FOR PREGNANT WOMEN AND FAMILIES 
223.20 	WITH YOUNG CHILDREN.
223.21 		Subdivision 1.Definitions. (a) The terms defined in this subdivision apply to this section 
223.22 	and have the meanings given them.
223.23 	(b) "Evidence-based home visiting program" means a program that:
223.24 	(1) is based on a clear, consistent program or model that is research-based and grounded 
223.25 	in relevant, empirically based knowledge;
223.26 	(2) is linked to program-determined outcomes and is associated with a national 
223.27 	organization, institution of higher education, or national or state public health institute;
223.28 	(3) has comprehensive home visitation standards that ensure high-quality service delivery 
223.29 	and continuous quality improvement;
223.30 	(4) has demonstrated significant, sustained positive outcomes; and
223.31 	(5) either:
224.1 	(i) has been evaluated using rigorous randomized controlled research designs and the 
224.2 	evaluation results have been published in a peer-reviewed journal; or
224.3 	(ii) is based on quasi-experimental research using two or more separate, comparable 
224.4 	client samples.
224.5 	(c) "Evidence-informed home visiting program" means a program that:
224.6 	(1) has data or evidence demonstrating effectiveness at achieving positive outcomes for 
224.7 	pregnant women and young children; and
224.8 	(2) either:
224.9 	(i) has an active evaluation of the program; or
224.10 	(ii) has a plan and timeline for an active evaluation of the program to be conducted.
224.11 	(d) "Health equity" means every individual has a fair opportunity to attain the individual's 
224.12 	full health potential and no individual is disadvantaged from achieving this potential.
224.13 	(e) "Promising practice home visiting program" means a program that has shown 
224.14 	improvement toward achieving positive outcomes for pregnant women or young children.
224.15 		Subd. 2.Grants for home visiting programs. (a) The commissioner of health shall 
224.16 	award grants to community health boards, nonprofit organizations, and tribal nations to start 
224.17 	up or expand voluntary home visiting programs serving pregnant women and families with 
224.18 	young children. Home visiting programs supported under this section shall provide voluntary 
224.19 	home visits by early childhood professionals or health professionals, including but not 
224.20 	limited to nurses, social workers, early childhood educators, and trained paraprofessionals. 
224.21 	Grant money shall be used to:
224.22 	(1) establish or expand evidence-based, evidence-informed, or promising practice home 
224.23 	visiting programs that address health equity and utilize community-driven health strategies;
224.24 	(2) serve families with young children or pregnant women who have high needs or are 
224.25 	high-risk, including but not limited to a family with low income, a parent or pregnant woman 
224.26 	with a mental illness or a substance use disorder, or a parent or pregnant woman experiencing 
224.27 	housing instability or domestic abuse; and
224.28 	(3) improve program outcomes in two or more of the following areas:
224.29 	(i) maternal and newborn health;
224.30 	(ii) school readiness and achievement;
224.31 	(iii) family economic self-sufficiency;
225.1 	(iv) coordination and referral for other community resources and supports;
225.2 	(v) reduction in child injuries, abuse, or neglect; or
225.3 	(vi) reduction in crime or domestic violence.
225.4 	(b) Grants awarded to evidence-informed and promising practice home visiting programs 
225.5 	must include money to evaluate program outcomes for up to four of the areas listed in 
225.6 	paragraph (a), clause (3).
225.7 		Subd. 3.Grant prioritization. (a) In awarding grants, the commissioner shall give 
225.8 	priority to community health boards, nonprofit organizations, and tribal nations seeking to 
225.9 	expand home visiting services with community or regional partnerships.
225.10 	(b) The commissioner shall allocate at least 75 percent of the grant money awarded each 
225.11 	grant cycle to evidence-based home visiting programs that address health equity and up to 
225.12 	25 percent of the grant money awarded each grant cycle to evidence-informed or promising 
225.13 	practice home visiting programs that address health equity and utilize community-driven 
225.14 	health strategies.
225.15 		Subd. 4.Administrative costs. The commissioner may use up to seven percent of the 
225.16 	annual appropriation under this section to provide training and technical assistance and to 
225.17 	administer and evaluate the program. The commissioner may contract for training, 
225.18 	capacity-building support for grantees or potential grantees, technical assistance, and 
225.19 	evaluation support.
225.20 		Subd. 5.Use of state general fund appropriations. Appropriations dedicated to 
225.21 	establishing or expanding evidence-based home visiting programs shall, for grants awarded 
225.22 	on or after July 1, 2021, be awarded according to this section. This section shall not govern 
225.23 	grant awards of federal funds for home visiting programs and shall not govern grant awards 
225.24 	using state general fund appropriations dedicated to establishing or expanding nurse-family 
225.25 	partnership home visiting programs.

225.26 	Sec. 60. Minnesota Statutes 2020, section 145.893, subdivision 1, is amended to read:
225.27 		Subdivision 1.Vouchers Food benefits. An eligible individual shall receive vouchers
225.28 	food benefits for the purchase of specified nutritional supplements in type and quantity 
225.29 	approved by the commissioner. Alternate forms of delivery may be developed by the 
225.30 	commissioner in appropriate cases.

226.1 	Sec. 61. Minnesota Statutes 2020, section 145.894, is amended to read:
226.2 	145.894 STATE COMMISSIONER OF HEALTH; DUTIES, RESPONSIBILITIES.
226.3 	The commissioner of health shall:
226.4 	(1) develop a comprehensive state plan for the delivery of nutritional supplements to 
226.5 	pregnant and lactating women, infants, and children;
226.6 	(2) contract with existing local public or private nonprofit organizations for the 
226.7 	administration of the nutritional supplement program;
226.8 	(3) develop and implement a public education program promoting the provisions of 
226.9 	sections 145.891 to 145.897, and provide for the delivery of individual and family nutrition 
226.10 	education and counseling at project sites. The education programs must include a campaign 
226.11 	to promote breast feeding;
226.12 	(4) develop in cooperation with other agencies and vendors a uniform state voucherfood 
226.13 	benefit system for the delivery of nutritional supplements;
226.14 	(5) authorize local health agencies to issue vouchers bimonthly food benefits trimonthly
226.15 	to some or all eligible individuals served by the agency, provided the agency demonstrates 
226.16 	that the federal minimum requirements for providing nutrition education will continue to 
226.17 	be met and that the quality of nutrition education and health services provided by the agency 
226.18 	will not be adversely impacted;
226.19 	(6) investigate and implement a system to reduce the cost of nutritional supplements 
226.20 	and maintain ongoing negotiations with nonparticipating manufacturers and suppliers to 
226.21 	maximize cost savings;
226.22 	(7) develop, analyze, and evaluate the health aspects of the nutritional supplement 
226.23 	program and establish nutritional guidelines for the program;
226.24 	(8) apply for, administer, and annually expend at least 99 percent of available federal 
226.25 	or private funds;
226.26 	(9) aggressively market services to eligible individuals by conducting ongoing outreach 
226.27 	activities and by coordinating with and providing marketing materials and technical assistance 
226.28 	to local human services and community service agencies and nonprofit service providers;
226.29 	(10) determine, on July 1 of each year, the number of pregnant women participating in 
226.30 	each special supplemental food program for women, infants, and children (WIC) and, in 
226.31 	1986, 1987, and 1988, at the commissioner's discretion, designate a different food program 
227.1 	deliverer if the current deliverer fails to increase the participation of pregnant women in the 
227.2 	program by at least ten percent over the previous year's participation rate;
227.3 	(11) promulgate all rules necessary to carry out the provisions of sections 145.891 to 
227.4 	145.897; and
227.5 	(12) ensure that any state appropriation to supplement the federal program is spent 
227.6 	consistent with federal requirements.

227.7 	Sec. 62. Minnesota Statutes 2020, section 145.897, is amended to read:
227.8 	145.897 VOUCHERS FOOD BENEFITS.
227.9 	Vouchers Food benefits issued pursuant to sections 145.891 to 145.897 shall be only 
227.10 	for the purchase of those foods determined by the commissioner United States Department 
227.11 	of Agriculture to be desirable nutritional supplements for pregnant and lactating women, 
227.12 	infants and children. These foods shall include, but not be limited to, iron fortified infant 
227.13 	formula, vegetable or fruit juices, cereal, milk, cheese, and eggs.

227.14 	Sec. 63. Minnesota Statutes 2020, section 145.899, is amended to read:
227.15 	145.899 WIC VOUCHERS FOOD BENEFITS FOR ORGANICS.
227.16 	Vouchers Food benefits for the special supplemental nutrition program for women, 
227.17 	infants, and children (WIC) may be used to purchase cost-neutral organic WIC allowable 
227.18 	food. The commissioner of health shall regularly evaluate the list of WIC allowable food 
227.19 	in accordance with federal requirements and shall add to the list any organic WIC allowable 
227.20 	foods determined to be cost-neutral.

227.21 	Sec. 64. Minnesota Statutes 2020, section 145.901, subdivision 2, is amended to read:
227.22 		Subd. 2.Access to data. (a) The commissioner of health has access to medical data as 
227.23 	defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined 
227.24 	in section 13.83, subdivision 1, and health records created, maintained, or stored by providers 
227.25 	as defined in section 144.291, subdivision 2, paragraph (i), without the consent of the subject 
227.26 	of the data, and without the consent of the parent, spouse, other guardian, or legal 
227.27 	representative of the subject of the data, when the subject of the data is a woman who died 
227.28 	during a pregnancy or within 12 months of a fetal death, a live birth, or other termination 
227.29 	of a pregnancy.
227.30 	The commissioner has access only to medical data and health records related to deaths 
227.31 	that occur on or after July 1, 2000, including the names of the providers, clinics, or other 
228.1 	health services such as family home visiting programs; the women, infants, and children 
228.2 	(WIC) program; prescription monitoring programs; and behavioral health services, where 
228.3 	care was received before, during, or related to the pregnancy or death. The commissioner 
228.4 	has access to records maintained by a medical examiner, a coroner, or hospitals or to hospital 
228.5 	discharge data, for the purpose of providing the name and location of any pre-pregnancy, 
228.6 	prenatal, or other care received by the subject of the data up to one year after the end of the 
228.7 	pregnancy.
228.8 	(b) The provider or responsible authority that creates, maintains, or stores the data shall 
228.9 	furnish the data upon the request of the commissioner. The provider or responsible authority 
228.10 	may charge a fee for providing the data, not to exceed the actual cost of retrieving and 
228.11 	duplicating the data.
228.12 	(c) The commissioner shall make a good faith reasonable effort to notify the parent, 
228.13 	spouse, other guardian, or legal representative of the subject of the data before collecting 
228.14 	data on the subject. For purposes of this paragraph, "reasonable effort" means one notice 
228.15 	is sent by certified mail to the last known address of the parent, spouse, guardian, or legal 
228.16 	representative informing the recipient of the data collection and offering a public health 
228.17 	nurse support visit if desired.
228.18 	(d) The commissioner does not have access to coroner or medical examiner data that 
228.19 	are part of an active investigation as described in section 13.83.
228.20 	(e) The commissioner may request and receive from a coroner or medical examiner the 
228.21 	name of the health care provider that provided prenatal, postpartum, or other health services 
228.22 	to the subject of the data.
228.23 	(f) The commissioner may access Department of Human Services data to identify sources 
228.24 	of care and services to assist with the evaluation of welfare systems, including housing, to 
228.25 	reduce preventable maternal deaths.
228.26 	(g) The commissioner may request and receive law enforcement reports or incident 
228.27 	reports related to the subject of the data.

228.28 	Sec. 65. Minnesota Statutes 2020, section 145.901, subdivision 4, is amended to read:
228.29 		Subd. 4.Classification of data. (a) Data provided to the commissioner from source 
228.30 	records under subdivision 2, including identifying information on individual providers, data 
228.31 	subjects, or their children, and data derived by the commissioner under subdivision 3 for 
228.32 	the purpose of carrying out maternal death studies, are classified as confidential data on 
229.1 	individuals or confidential data on decedents, as defined in sections 13.02, subdivision 3, 
229.2 	and 13.10, subdivision 1, paragraph (a).
229.3 	(b) Information classified under paragraph (a) shall not be subject to discovery or 
229.4 	introduction into evidence in any administrative, civil, or criminal proceeding. Such 
229.5 	information otherwise available from an original source shall not be immune from discovery 
229.6 	or barred from introduction into evidence merely because it was utilized by the commissioner 
229.7 	in carrying out maternal death studies.
229.8 	(c) Summary data on maternal death studies created by the commissioner, which does 
229.9 	not identify individual data subjects or individual providers, shall be public in accordance 
229.10 	with section 13.05, subdivision 7.
229.11 	(d) Data provided by the commissioner of human services to the commissioner of health 
229.12 	under this section retain the same classification the data held when retained by the 
229.13 	commissioner of human services, as required under section 13.03, subdivision 4, paragraph 
229.14 	(c).

229.15 	Sec. 66. [145.9013] SEVERE MATERNAL MORBIDITY STUDIES.
229.16 		Subdivision 1.Purpose. (a) The commissioner of health may conduct maternal morbidity 
229.17 	studies to assist the planning, implementation, and evaluation of medical, health, and welfare 
229.18 	service systems and to reduce the numbers of preventable adverse maternal outcomes in 
229.19 	Minnesota.
229.20 	(b) For purposes of this section, "maternal morbidity" has the meaning given to severe 
229.21 	maternal morbidity by the Centers for Disease Control and Prevention and includes an 
229.22 	unexpected outcome of labor or delivery that results in significant short- or long-term 
229.23 	consequences to a woman's health.
229.24 		Subd. 2.Access to data. (a) The commissioner has access to medical data as defined in 
229.25 	section 13.384, subdivision 1, paragraph (b), and health records created, maintained, or 
229.26 	stored by providers when the subject of the data experienced one or more maternal 
229.27 	morbidities during a pregnancy or within 12 months of the end of a pregnancy. The 
229.28 	commissioner has access only to medical data and health records related to maternal 
229.29 	morbidities that occur on or after January 1, 2015, including the names of providers and 
229.30 	clinics where care was received before, during, or related to the pregnancy. The commissioner 
229.31 	has access to records maintained by family home visiting programs; the women, infants, 
229.32 	and children (WIC) program; prescription monitoring programs; behavioral health services 
229.33 	programs; substance use disorder treatment facilities; and hospitals for the purpose of 
230.1 	providing the name and location of any pre-pregnancy, prenatal, or other care received by 
230.2 	the subject of the data up to one year following the end of the pregnancy.
230.3 	(b) The provider or responsible authority that creates, maintains, or stores the data under 
230.4 	paragraph (a) shall provide the commissioner with access to information on each maternal 
230.5 	morbidity case in the manner and at times that the commissioner designates. The provider 
230.6 	or responsible authority may charge a fee for providing the data, not to exceed the actual 
230.7 	cost of retrieving and duplicating the data.
230.8 	(c) Once the commissioner has determined that the subject of the data meets the criteria 
230.9 	in paragraph (a) for a maternal morbidity review, the commissioner must inform the subject 
230.10 	of the data about the collection of the subject's data under this section. At any time during 
230.11 	the maternal morbidity review process, the subject of the data may request in writing, using 
230.12 	a form prescribed by the commissioner, that the commissioner remove the subject of the 
230.13 	data's personal identifying information from data obtained by the commissioner under this 
230.14 	section. The commissioner must comply with such requests. For purposes of this paragraph, 
230.15 	"inform the subject of the data about the collection of the subject's data" means one notice 
230.16 	sent by certified mail to the last known address of the subject of the data.
230.17 	(d) The subject of the data may voluntarily participate in an informant interview with 
230.18 	staff on behalf of the commissioner related to the maternal experience. If the subject of the 
230.19 	data agrees to the interview, the commissioner may compensate the subject of the data for 
230.20 	time and other expenses related to the interview.
230.21 	(e) The commissioner may access Department of Human Services data to identify sources 
230.22 	of care and services to assist with the evaluation of welfare systems to reduce preventable 
230.23 	maternal morbidities.
230.24 		Subd. 3.Management of records. After the commissioner has collected all data about 
230.25 	a subject of a maternal morbidity study needed to perform the study, the data from source 
230.26 	records obtained under subdivision 2, other than data identifying the subject, must be 
230.27 	transferred to separate records to be maintained by the commissioner. Notwithstanding 
230.28 	section 138.17, after the data has been transferred, all source records obtained under 
230.29 	subdivision 2 possessed by the commissioner must be destroyed.
230.30 		Subd. 4.Classification of data. (a) Data provided to the commissioner from source 
230.31 	records under subdivision 2, including identifying information on individual providers, data 
230.32 	subjects, or their children, and data derived by the commissioner under subdivision 3 for 
230.33 	the purpose of carrying out maternal morbidity studies, are classified as confidential data 
231.1 	on individuals or confidential data on decedents, as defined in sections 13.02, subdivision 
231.2 	3, and 13.10, subdivision 1, paragraph (a).
231.3 	(b) Information classified under paragraph (a) shall not be subject to discovery or 
231.4 	introduction into evidence in any administrative, civil, or criminal proceeding. Such 
231.5 	information otherwise available from an original source shall not be immune from discovery 
231.6 	or barred from introduction into evidence merely because the information was utilized by 
231.7 	the commissioner in carrying out maternal morbidity studies.
231.8 	(c) Summary data on maternal morbidity studies created by the commissioner, which 
231.9 	does not identify individual data subjects or individual providers, shall be public in 
231.10 	accordance with section 13.05, subdivision 7.
231.11 	(d) Data provided by the commissioner of human services to the commissioner of health 
231.12 	under this section retains the same classification the data held when retained by the 
231.13 	commissioner of human services, as required under section 13.03, subdivision 4, paragraph 
231.14 	(c).

231.15 	Sec. 67. Minnesota Statutes 2020, section 152.01, subdivision 23, is amended to read:
231.16 		Subd. 23.Analog. (a) Except as provided in paragraph (b), "analog" means a substance, 
231.17 	the chemical structure of which is substantially similar to the chemical structure of a 
231.18 	controlled substance in Schedule I or II:
231.19 	(1) that has a stimulant, depressant, or hallucinogenic effect on the central nervous system 
231.20 	that is substantially similar to or greater than the stimulant, depressant, or hallucinogenic 
231.21 	effect on the central nervous system of a controlled substance in Schedule I or II; or
231.22 	(2) with respect to a particular person, if the person represents or intends that the substance 
231.23 	have a stimulant, depressant, or hallucinogenic effect on the central nervous system that is 
231.24 	substantially similar to or greater than the stimulant, depressant, or hallucinogenic effect 
231.25 	on the central nervous system of a controlled substance in Schedule I or II.
231.26 	(b) "Analog" does not include:
231.27 	(1) a controlled substance;
231.28 	(2) any substance for which there is an approved new drug application under the Federal 
231.29 	Food, Drug, and Cosmetic Act; or
231.30 	(3) with respect to a particular person, any substance, if an exemption is in effect for 
231.31 	investigational use, for that person, as provided by United States Code, title 21, section 355, 
231.32 	and the person is registered as a controlled substance researcher as required under section 
232.1 	152.12, subdivision 3, to the extent conduct with respect to the substance is pursuant to the 
232.2 	exemption and registration; or
232.3 	(4) marijuana or tetrahydrocannabinols naturally contained in a plant of the genus 
232.4 	cannabis or in the resinous extractives of the plant.

232.5 	EFFECTIVE DATE. This section is effective August 1, 2021, and applies to crimes 
232.6 	committed on or after that date.

232.7 	Sec. 68. Minnesota Statutes 2020, section 152.02, subdivision 2, is amended to read:
232.8 		Subd. 2.Schedule I. (a) Schedule I consists of the substances listed in this subdivision.
232.9 	(b) Opiates. Unless specifically excepted or unless listed in another schedule, any of the 
232.10 	following substances, including their analogs, isomers, esters, ethers, salts, and salts of 
232.11 	isomers, esters, and ethers, whenever the existence of the analogs, isomers, esters, ethers, 
232.12 	and salts is possible:
232.13 	(1) acetylmethadol;
232.14 	(2) allylprodine;
232.15 	(3) alphacetylmethadol (except levo-alphacetylmethadol, also known as levomethadyl 
232.16 	acetate);
232.17 	(4) alphameprodine;
232.18 	(5) alphamethadol;
232.19 	(6) alpha-methylfentanyl benzethidine;
232.20 	(7) betacetylmethadol;
232.21 	(8) betameprodine;
232.22 	(9) betamethadol;
232.23 	(10) betaprodine;
232.24 	(11) clonitazene;
232.25 	(12) dextromoramide;
232.26 	(13) diampromide;
232.27 	(14) diethyliambutene;
232.28 	(15) difenoxin;
232.29 	(16) dimenoxadol;
233.1 	(17) dimepheptanol;
233.2 	(18) dimethyliambutene;
233.3 	(19) dioxaphetyl butyrate;
233.4 	(20) dipipanone;
233.5 	(21) ethylmethylthiambutene;
233.6 	(22) etonitazene;
233.7 	(23) etoxeridine;
233.8 	(24) furethidine;
233.9 	(25) hydroxypethidine;
233.10 	(26) ketobemidone;
233.11 	(27) levomoramide;
233.12 	(28) levophenacylmorphan;
233.13 	(29) 3-methylfentanyl;
233.14 	(30) acetyl-alpha-methylfentanyl;
233.15 	(31) alpha-methylthiofentanyl;
233.16 	(32) benzylfentanyl beta-hydroxyfentanyl;
233.17 	(33) beta-hydroxy-3-methylfentanyl;
233.18 	(34) 3-methylthiofentanyl;
233.19 	(35) thenylfentanyl;
233.20 	(36) thiofentanyl;
233.21 	(37) para-fluorofentanyl;
233.22 	(38) morpheridine;
233.23 	(39) 1-methyl-4-phenyl-4-propionoxypiperidine;
233.24 	(40) noracymethadol;
233.25 	(41) norlevorphanol;
233.26 	(42) normethadone;
233.27 	(43) norpipanone;
234.1 	(44) 1-(2-phenylethyl)-4-phenyl-4-acetoxypiperidine (PEPAP);
234.2 	(45) phenadoxone;
234.3 	(46) phenampromide;
234.4 	(47) phenomorphan;
234.5 	(48) phenoperidine;
234.6 	(49) piritramide;
234.7 	(50) proheptazine;
234.8 	(51) properidine;
234.9 	(52) propiram;
234.10 	(53) racemoramide;
234.11 	(54) tilidine;
234.12 	(55) trimeperidine;
234.13 	(56) N-(1-Phenethylpiperidin-4-yl)-N-phenylacetamide (acetyl fentanyl);
234.14 	(57) 3,4-dichloro-N-[(1R,2R)-2-(dimethylamino)cyclohexyl]-N-
234.15 	methylbenzamide(U47700);
234.16 	(58) N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide(furanylfentanyl);
234.17 	(59) 4-(4-bromophenyl)-4-dimethylamino-1-phenethylcyclohexanol (bromadol);
234.18 	(60) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopropanecarboxamide (Cyclopropryl 
234.19 	fentanyl);
234.20 	(61) N-(1-phenethylpiperidin-4-yl)-N-phenylbutanamide) (butyryl fentanyl);
234.21 	(62) 1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) (MT-45);
234.22 	(63) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopentanecarboxamide (cyclopentyl 
234.23 	fentanyl);
234.24 	(64) N-(1-phenethylpiperidin-4-yl)-N-phenylisobutyramide (isobutyryl fentanyl);
234.25 	(65) N-(1-phenethylpiperidin-4-yl)-N-phenylpentanamide (valeryl fentanyl);
234.26 	(66) N-(4-chlorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide 
234.27 	(para-chloroisobutyryl fentanyl);
235.1 	(67) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)butyramide (para-fluorobutyryl 
235.2 	fentanyl);
235.3 	(68) N-(4-methoxyphenyl)-N-(1-phenethylpiperidin-4-yl)butyramide 
235.4 	(para-methoxybutyryl fentanyl);
235.5 	(69) N-(2-fluorophenyl)-2-methoxy-N-(1-phenethylpiperidin-4-yl)acetamide (ocfentanil);
235.6 	(70) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl 
235.7 	fentanyl or para-fluoroisobutyryl fentanyl);
235.8 	(71) N-(1-phenethylpiperidin-4-yl)-N-phenylacrylamide (acryl fentanyl or 
235.9 	acryloylfentanyl);
235.10 	(72) 2-methoxy-N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide (methoxyacetyl 
235.11 	fentanyl);
235.12 	(73) N-(2-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)propionamide (ortho-fluorofentanyl 
235.13 	or 2-fluorofentanyl);
235.14 	(74) N-(1-phenethylpiperidin-4-yl)-N-phenyltetrahydrofuran-2-carboxamide 
235.15 	(tetrahydrofuranyl fentanyl); and
235.16 	(75) Fentanyl-related substances, their isomers, esters, ethers, salts and salts of isomers, 
235.17 	esters and ethers, meaning any substance not otherwise listed under another federal 
235.18 	Administration Controlled Substance Code Number or not otherwise listed in this section, 
235.19 	and for which no exemption or approval is in effect under section 505 of the Federal Food, 
235.20 	Drug, and Cosmetic Act, United States Code , title 21, section 355, that is structurally related 
235.21 	to fentanyl by one or more of the following modifications:
235.22 	(i) replacement of the phenyl portion of the phenethyl group by any monocycle, whether 
235.23 	or not further substituted in or on the monocycle;
235.24 	(ii) substitution in or on the phenethyl group with alkyl, alkenyl, alkoxyl, hydroxyl, halo, 
235.25 	haloalkyl, amino, or nitro groups;
235.26 	(iii) substitution in or on the piperidine ring with alkyl, alkenyl, alkoxyl, ester, ether, 
235.27 	hydroxyl, halo, haloalkyl, amino, or nitro groups;
235.28 	(iv) replacement of the aniline ring with any aromatic monocycle whether or not further 
235.29 	substituted in or on the aromatic monocycle; or
235.30 	(v) replacement of the N-propionyl group by another acyl group.
236.1 	(c) Opium derivatives. Any of the following substances, their analogs, salts, isomers, 
236.2 	and salts of isomers, unless specifically excepted or unless listed in another schedule, 
236.3 	whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
236.4 	(1) acetorphine;
236.5 	(2) acetyldihydrocodeine;
236.6 	(3) benzylmorphine;
236.7 	(4) codeine methylbromide;
236.8 	(5) codeine-n-oxide;
236.9 	(6) cyprenorphine;
236.10 	(7) desomorphine;
236.11 	(8) dihydromorphine;
236.12 	(9) drotebanol;
236.13 	(10) etorphine;
236.14 	(11) heroin;
236.15 	(12) hydromorphinol;
236.16 	(13) methyldesorphine;
236.17 	(14) methyldihydromorphine;
236.18 	(15) morphine methylbromide;
236.19 	(16) morphine methylsulfonate;
236.20 	(17) morphine-n-oxide;
236.21 	(18) myrophine;
236.22 	(19) nicocodeine;
236.23 	(20) nicomorphine;
236.24 	(21) normorphine;
236.25 	(22) pholcodine; and
236.26 	(23) thebacon.
236.27 	(d) Hallucinogens. Any material, compound, mixture or preparation which contains any 
236.28 	quantity of the following substances, their analogs, salts, isomers (whether optical, positional, 
237.1 	or geometric), and salts of isomers, unless specifically excepted or unless listed in another 
237.2 	schedule, whenever the existence of the analogs, salts, isomers, and salts of isomers is 
237.3 	possible:
237.4 	(1) methylenedioxy amphetamine;
237.5 	(2) methylenedioxymethamphetamine;
237.6 	(3) methylenedioxy-N-ethylamphetamine (MDEA);
237.7 	(4) n-hydroxy-methylenedioxyamphetamine;
237.8 	(5) 4-bromo-2,5-dimethoxyamphetamine (DOB);
237.9 	(6) 2,5-dimethoxyamphetamine (2,5-DMA);
237.10 	(7) 4-methoxyamphetamine;
237.11 	(8) 5-methoxy-3, 4-methylenedioxyamphetamine;
237.12 	(9) alpha-ethyltryptamine;
237.13 	(10) bufotenine;
237.14 	(11) diethyltryptamine;
237.15 	(12) dimethyltryptamine;
237.16 	(13) 3,4,5-trimethoxyamphetamine;
237.17 	(14) 4-methyl-2, 5-dimethoxyamphetamine (DOM);
237.18 	(15) ibogaine;
237.19 	(16) lysergic acid diethylamide (LSD);
237.20 	(17) mescaline;
237.21 	(18) parahexyl;
237.22 	(19) N-ethyl-3-piperidyl benzilate;
237.23 	(20) N-methyl-3-piperidyl benzilate;
237.24 	(21) psilocybin;
237.25 	(22) psilocyn;
237.26 	(23) tenocyclidine (TPCP or TCP);
237.27 	(24) N-ethyl-1-phenyl-cyclohexylamine (PCE);
237.28 	(25) 1-(1-phenylcyclohexyl) pyrrolidine (PCPy);
238.1 	(26) 1-[1-(2-thienyl)cyclohexyl]-pyrrolidine (TCPy);
238.2 	(27) 4-chloro-2,5-dimethoxyamphetamine (DOC);
238.3 	(28) 4-ethyl-2,5-dimethoxyamphetamine (DOET);
238.4 	(29) 4-iodo-2,5-dimethoxyamphetamine (DOI);
238.5 	(30) 4-bromo-2,5-dimethoxyphenethylamine (2C-B);
238.6 	(31) 4-chloro-2,5-dimethoxyphenethylamine (2C-C);
238.7 	(32) 4-methyl-2,5-dimethoxyphenethylamine (2C-D);
238.8 	(33) 4-ethyl-2,5-dimethoxyphenethylamine (2C-E);
238.9 	(34) 4-iodo-2,5-dimethoxyphenethylamine (2C-I);
238.10 	(35) 4-propyl-2,5-dimethoxyphenethylamine (2C-P);
238.11 	(36) 4-isopropylthio-2,5-dimethoxyphenethylamine (2C-T-4);
238.12 	(37) 4-propylthio-2,5-dimethoxyphenethylamine (2C-T-7);
238.13 	(38) 2-(8-bromo-2,3,6,7-tetrahydrofuro [2,3-f][1]benzofuran-4-yl)ethanamine 
238.14 	(2-CB-FLY);
238.15 	(39) bromo-benzodifuranyl-isopropylamine (Bromo-DragonFLY);
238.16 	(40) alpha-methyltryptamine (AMT);
238.17 	(41) N,N-diisopropyltryptamine (DiPT);
238.18 	(42) 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT);
238.19 	(43) 4-acetoxy-N,N-diethyltryptamine (4-AcO-DET);
238.20 	(44) 4-hydroxy-N-methyl-N-propyltryptamine (4-HO-MPT);
238.21 	(45) 4-hydroxy-N,N-dipropyltryptamine (4-HO-DPT);
238.22 	(46) 4-hydroxy-N,N-diallyltryptamine (4-HO-DALT);
238.23 	(47) 4-hydroxy-N,N-diisopropyltryptamine (4-HO-DiPT);
238.24 	(48) 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT);
238.25 	(49) 5-methoxy-α-methyltryptamine (5-MeO-AMT);
238.26 	(50) 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT);
238.27 	(51) 5-methylthio-N,N-dimethyltryptamine (5-MeS-DMT);
239.1 	(52) 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT);
239.2 	(53) 5-methoxy-α-ethyltryptamine (5-MeO-AET);
239.3 	(54) 5-methoxy-N,N-dipropyltryptamine (5-MeO-DPT);
239.4 	(55) 5-methoxy-N,N-diethyltryptamine (5-MeO-DET);
239.5 	(56) 5-methoxy-N,N-diallyltryptamine (5-MeO-DALT);
239.6 	(57) methoxetamine (MXE);
239.7 	(58) 5-iodo-2-aminoindane (5-IAI);
239.8 	(59) 5,6-methylenedioxy-2-aminoindane (MDAI);
239.9 	(60) 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B-NBOMe);
239.10 	(61) 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25C-NBOMe);
239.11 	(62) 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe);
239.12 	(63) 2-(2,5-Dimethoxyphenyl)ethanamine (2C-H);
239.13 	(64) 2-(4-Ethylthio-2,5-dimethoxyphenyl)ethanamine (2C-T-2);
239.14 	(65) N,N-Dipropyltryptamine (DPT);
239.15 	(66) 3-[1-(Piperidin-1-yl)cyclohexyl]phenol (3-HO-PCP);
239.16 	(67) N-ethyl-1-(3-methoxyphenyl)cyclohexanamine (3-MeO-PCE);
239.17 	(68) 4-[1-(3-methoxyphenyl)cyclohexyl]morpholine (3-MeO-PCMo);
239.18 	(69) 1-[1-(4-methoxyphenyl)cyclohexyl]-piperidine (methoxydine, 4-MeO-PCP);
239.19 	(70) 2-(2-Chlorophenyl)-2-(ethylamino)cyclohexan-1-one (N-Ethylnorketamine, 
239.20 	ethketamine, NENK);
239.21 	(71) methylenedioxy-N,N-dimethylamphetamine (MDDMA);
239.22 	(72) 3-(2-Ethyl(methyl)aminoethyl)-1H-indol-4-yl (4-AcO-MET); and
239.23 	(73) 2-Phenyl-2-(methylamino)cyclohexanone (deschloroketamine).
239.24 	(e) Peyote. All parts of the plant presently classified botanically as Lophophora williamsii 
239.25 	Lemaire, whether growing or not, the seeds thereof, any extract from any part of the plant, 
239.26 	and every compound, manufacture, salts, derivative, mixture, or preparation of the plant, 
239.27 	its seeds or extracts. The listing of peyote as a controlled substance in Schedule I does not 
239.28 	apply to the nondrug use of peyote in bona fide religious ceremonies of the American Indian 
239.29 	Church, and members of the American Indian Church are exempt from registration. Any 
240.1 	person who manufactures peyote for or distributes peyote to the American Indian Church, 
240.2 	however, is required to obtain federal registration annually and to comply with all other 
240.3 	requirements of law.
240.4 	(f) Central nervous system depressants. Unless specifically excepted or unless listed in 
240.5 	another schedule, any material compound, mixture, or preparation which contains any 
240.6 	quantity of the following substances, their analogs, salts, isomers, and salts of isomers 
240.7 	whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
240.8 	(1) mecloqualone;
240.9 	(2) methaqualone;
240.10 	(3) gamma-hydroxybutyric acid (GHB), including its esters and ethers;
240.11 	(4) flunitrazepam;
240.12 	(5) 2-(2-Methoxyphenyl)-2-(methylamino)cyclohexanone (2-MeO-2-deschloroketamine, 
240.13 	methoxyketamine);
240.14 	(6) tianeptine;
240.15 	(7) clonazolam;
240.16 	(8) etizolam;
240.17 	(9) flubromazolam; and
240.18 	(10) flubromazepam.
240.19 	(g) Stimulants. Unless specifically excepted or unless listed in another schedule, any 
240.20 	material compound, mixture, or preparation which contains any quantity of the following 
240.21 	substances, their analogs, salts, isomers, and salts of isomers whenever the existence of the 
240.22 	analogs, salts, isomers, and salts of isomers is possible:
240.23 	(1) aminorex;
240.24 	(2) cathinone;
240.25 	(3) fenethylline;
240.26 	(4) methcathinone;
240.27 	(5) methylaminorex;
240.28 	(6) N,N-dimethylamphetamine;
240.29 	(7) N-benzylpiperazine (BZP);
241.1 	(8) methylmethcathinone (mephedrone);
241.2 	(9) 3,4-methylenedioxy-N-methylcathinone (methylone);
241.3 	(10) methoxymethcathinone (methedrone);
241.4 	(11) methylenedioxypyrovalerone (MDPV);
241.5 	(12) 3-fluoro-N-methylcathinone (3-FMC);
241.6 	(13) methylethcathinone (MEC);
241.7 	(14) 1-benzofuran-6-ylpropan-2-amine (6-APB);
241.8 	(15) dimethylmethcathinone (DMMC);
241.9 	(16) fluoroamphetamine;
241.10 	(17) fluoromethamphetamine;
241.11 	(18) α-methylaminobutyrophenone (MABP or buphedrone);
241.12 	(19) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one (butylone);
241.13 	(20) 2-(methylamino)-1-(4-methylphenyl)butan-1-one (4-MEMABP or BZ-6378);
241.14 	(21) 1-(naphthalen-2-yl)-2-(pyrrolidin-1-yl) pentan-1-one (naphthylpyrovalerone or 
241.15 	naphyrone);
241.16 	(22) (alpha-pyrrolidinopentiophenone (alpha-PVP);
241.17 	(23) (RS)-1-(4-methylphenyl)-2-(1-pyrrolidinyl)-1-hexanone (4-Me-PHP or MPHP);
241.18 	(24) 2-(1-pyrrolidinyl)-hexanophenone (Alpha-PHP);
241.19 	(25) 4-methyl-N-ethylcathinone (4-MEC);
241.20 	(26) 4-methyl-alpha-pyrrolidinopropiophenone (4-MePPP);
241.21 	(27) 2-(methylamino)-1-phenylpentan-1-one (pentedrone);
241.22 	(28) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)pentan-1-one (pentylone);
241.23 	(29) 4-fluoro-N-methylcathinone (4-FMC);
241.24 	(30) 3,4-methylenedioxy-N-ethylcathinone (ethylone);
241.25 	(31) alpha-pyrrolidinobutiophenone (α-PBP);
241.26 	(32) 5-(2-Aminopropyl)-2,3-dihydrobenzofuran (5-APDB);
241.27 	(33) 1-phenyl-2-(1-pyrrolidinyl)-1-heptanone (PV8);
242.1 	(34) 6-(2-Aminopropyl)-2,3-dihydrobenzofuran (6-APDB);
242.2 	(35) 4-methyl-alpha-ethylaminopentiophenone (4-MEAPP);
242.3 	(36) 4'-chloro-alpha-pyrrolidinopropiophenone (4'-chloro-PPP);
242.4 	(37) 1-(1,3-Benzodioxol-5-yl)-2-(dimethylamino)butan-1-one (dibutylone, bk-DMBDB);
242.5 	(38) 1-(3-chlorophenyl) piperazine (meta-chlorophenylpiperazine or mCPP);
242.6 	(39) 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)-pentan-1-one (N-ethylpentylone, ephylone); 
242.7 	and
242.8 	(40) any other substance, except bupropion or compounds listed under a different 
242.9 	schedule, that is structurally derived from 2-aminopropan-1-one by substitution at the 
242.10 	1-position with either phenyl, naphthyl, or thiophene ring systems, whether or not the 
242.11 	compound is further modified in any of the following ways:
242.12 	(i) by substitution in the ring system to any extent with alkyl, alkylenedioxy, alkoxy, 
242.13 	haloalkyl, hydroxyl, or halide substituents, whether or not further substituted in the ring 
242.14 	system by one or more other univalent substituents;
242.15 	(ii) by substitution at the 3-position with an acyclic alkyl substituent;
242.16 	(iii) by substitution at the 2-amino nitrogen atom with alkyl, dialkyl, benzyl, or 
242.17 	methoxybenzyl groups; or
242.18 	(iv) by inclusion of the 2-amino nitrogen atom in a cyclic structure.
242.19 	(h) Marijuana, Synthetic tetrahydrocannabinols, and synthetic cannabinoids. Unless 
242.20 	specifically excepted or unless listed in another schedule, any natural or synthetic material, 
242.21 	compound, mixture, or preparation that contains any quantity of the following substances, 
242.22 	their analogs, isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever 
242.23 	the existence of the isomers, esters, ethers, or salts is possible:
242.24 	(1) marijuana;
242.25 	(2) (1) synthetic tetrahydrocannabinols naturally contained in a plant of the genus 
242.26 	Cannabis, that are the synthetic equivalents of the substances contained in the cannabis 
242.27 	plant or in the resinous extractives of the plant, or synthetic substances with similar chemical 
242.28 	structure and pharmacological activity to those substances contained in the plant or resinous 
242.29 	extract, including, but not limited to, 1 cis or trans tetrahydrocannabinol, 6 cis or trans 
242.30 	tetrahydrocannabinol, and 3,4 cis or trans tetrahydrocannabinol;
242.31 	(3) (2) synthetic cannabinoids, including the following substances:
243.1 	(i) Naphthoylindoles, which are any compounds containing a 3-(1-napthoyl)indole 
243.2 	structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, 
243.3 	alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
243.4 	2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any 
243.5 	extent and whether or not substituted in the naphthyl ring to any extent. Examples of 
243.6 	naphthoylindoles include, but are not limited to:
243.7 	(A) 1-Pentyl-3-(1-naphthoyl)indole (JWH-018 and AM-678);
243.8 	(B) 1-Butyl-3-(1-naphthoyl)indole (JWH-073);
243.9 	(C) 1-Pentyl-3-(4-methoxy-1-naphthoyl)indole (JWH-081);
243.10 	(D) 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200);
243.11 	(E) 1-Propyl-2-methyl-3-(1-naphthoyl)indole (JWH-015);
243.12 	(F) 1-Hexyl-3-(1-naphthoyl)indole (JWH-019);
243.13 	(G) 1-Pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122);
243.14 	(H) 1-Pentyl-3-(4-ethyl-1-naphthoyl)indole (JWH-210);
243.15 	(I) 1-Pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398);
243.16 	(J) 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM-2201).
243.17 	(ii) Napthylmethylindoles, which are any compounds containing a 
243.18 	1H-indol-3-yl-(1-naphthyl)methane structure with substitution at the nitrogen atom of the 
243.19 	indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 
243.20 	1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group, whether or not further 
243.21 	substituted in the indole ring to any extent and whether or not substituted in the naphthyl 
243.22 	ring to any extent. Examples of naphthylmethylindoles include, but are not limited to:
243.23 	(A) 1-Pentyl-1H-indol-3-yl-(1-naphthyl)methane (JWH-175);
243.24 	(B) 1-Pentyl-1H-indol-3-yl-(4-methyl-1-naphthyl)methane (JWH-184).
243.25 	(iii) Naphthoylpyrroles, which are any compounds containing a 3-(1-naphthoyl)pyrrole 
243.26 	structure with substitution at the nitrogen atom of the pyrrole ring by an alkyl, haloalkyl, 
243.27 	alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
243.28 	2-(4-morpholinyl)ethyl group whether or not further substituted in the pyrrole ring to any 
243.29 	extent, whether or not substituted in the naphthyl ring to any extent. Examples of 
243.30 	naphthoylpyrroles include, but are not limited to, 
243.31 	(5-(2-fluorophenyl)-1-pentylpyrrol-3-yl)-naphthalen-1-ylmethanone (JWH-307).
244.1 	(iv) Naphthylmethylindenes, which are any compounds containing a naphthylideneindene 
244.2 	structure with substitution at the 3-position of the indene ring by an alkyl, haloalkyl, alkenyl, 
244.3 	cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
244.4 	2-(4-morpholinyl)ethyl group whether or not further substituted in the indene ring to any 
244.5 	extent, whether or not substituted in the naphthyl ring to any extent. Examples of 
244.6 	naphthylemethylindenes include, but are not limited to, 
244.7 	E-1-[1-(1-naphthalenylmethylene)-1H-inden-3-yl]pentane (JWH-176).
244.8 	(v) Phenylacetylindoles, which are any compounds containing a 3-phenylacetylindole 
244.9 	structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, 
244.10 	alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
244.11 	2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any 
244.12 	extent, whether or not substituted in the phenyl ring to any extent. Examples of 
244.13 	phenylacetylindoles include, but are not limited to:
244.14 	(A) 1-(2-cyclohexylethyl)-3-(2-methoxyphenylacetyl)indole (RCS-8);
244.15 	(B) 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250);
244.16 	(C) 1-pentyl-3-(2-methylphenylacetyl)indole (JWH-251);
244.17 	(D) 1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203).
244.18 	(vi) Cyclohexylphenols, which are compounds containing a 
244.19 	2-(3-hydroxycyclohexyl)phenol structure with substitution at the 5-position of the phenolic 
244.20 	ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 
244.21 	1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group whether or not substituted 
244.22 	in the cyclohexyl ring to any extent. Examples of cyclohexylphenols include, but are not 
244.23 	limited to:
244.24 	(A) 5-(1,1-dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol (CP 47,497);
244.25 	(B) 5-(1,1-dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol 
244.26 	(Cannabicyclohexanol or CP 47,497 C8 homologue);
244.27 	(C) 5-(1,1-dimethylheptyl)-2-[(1R,2R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl] 
244.28 	-phenol (CP 55,940).
244.29 	(vii) Benzoylindoles, which are any compounds containing a 3-(benzoyl)indole structure 
244.30 	with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl, 
244.31 	cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or 
244.32 	2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any 
245.1 	extent and whether or not substituted in the phenyl ring to any extent. Examples of 
245.2 	benzoylindoles include, but are not limited to:
245.3 	(A) 1-Pentyl-3-(4-methoxybenzoyl)indole (RCS-4);
245.4 	(B) 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM-694);
245.5 	(C) (4-methoxyphenyl-[2-methyl-1-(2-(4-morpholinyl)ethyl)indol-3-yl]methanone (WIN 
245.6 	48,098 or Pravadoline).
245.7 	(viii) Others specifically named:
245.8 	(A) (6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl) 
245.9 	-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (HU-210);
245.10 	(B) (6aS,10aS)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl) 
245.11 	-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (Dexanabinol or HU-211);
245.12 	(C) 2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de] 
245.13 	-1,4-benzoxazin-6-yl-1-naphthalenylmethanone (WIN 55,212-2);
245.14 	(D) (1-pentylindol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone (UR-144);
245.15 	(E) (1-(5-fluoropentyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)methanone 
245.16 	(XLR-11);
245.17 	(F) 1-pentyl-N-tricyclo[3.3.1.13,7]dec-1-yl-1H-indazole-3-carboxamide 
245.18 	(AKB-48(APINACA));
245.19 	(G) N-((3s,5s,7s)-adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide 
245.20 	(5-Fluoro-AKB-48);
245.21 	(H) 1-pentyl-8-quinolinyl ester-1H-indole-3-carboxylic acid (PB-22);
245.22 	(I) 8-quinolinyl ester-1-(5-fluoropentyl)-1H-indole-3-carboxylic acid (5-Fluoro PB-22);
245.23 	(J) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-pentyl-1H-indazole- 3-carboxamide 
245.24 	(AB-PINACA);
245.25 	(K) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-[(4-fluorophenyl)methyl]- 
245.26 	1H-indazole-3-carboxamide (AB-FUBINACA);
245.27 	(L) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H- 
245.28 	indazole-3-carboxamide(AB-CHMINACA);
245.29 	(M) (S)-methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3- methylbutanoate 
245.30 	(5-fluoro-AMB);
246.1 	(N) [1-(5-fluoropentyl)-1H-indazol-3-yl](naphthalen-1-yl) methanone (THJ-2201);
246.2 	(O) (1-(5-fluoropentyl)-1H-benzo[d]imidazol-2-yl)(naphthalen-1-yl)methanone) 
246.3 	(FUBIMINA);
246.4 	(P) (7-methoxy-1-(2-morpholinoethyl)-N-((1S,2S,4R)-1,3,3-trimethylbicyclo 
246.5 	[2.2.1]heptan-2-yl)-1H-indole-3-carboxamide (MN-25 or UR-12);
246.6 	(Q) (S)-N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl) 
246.7 	-1H-indole-3-carboxamide (5-fluoro-ABICA);
246.8 	(R) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl) 
246.9 	-1H-indole-3-carboxamide;
246.10 	(S) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl) 
246.11 	-1H-indazole-3-carboxamide;
246.12 	(T) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido) -3,3-dimethylbutanoate;
246.13 	(U) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1(cyclohexylmethyl)-1 
246.14 	H-indazole-3-carboxamide (MAB-CHMINACA);
246.15 	(V) N-(1-Amino-3,3-dimethyl-1-oxo-2-butanyl)-1-pentyl-1H-indazole-3-carboxamide 
246.16 	(ADB-PINACA);
246.17 	(W) methyl (1-(4-fluorobenzyl)-1H-indazole-3-carbonyl)-L-valinate (FUB-AMB);
246.18 	(X) N-[(1S)-2-amino-2-oxo-1-(phenylmethyl)ethyl]-1-(cyclohexylmethyl)-1H-Indazole-
246.19 	3-carboxamide. (APP-CHMINACA);
246.20 	(Y) quinolin-8-yl 1-(4-fluorobenzyl)-1H-indole-3-carboxylate (FUB-PB-22); and
246.21 	(Z) methyl N-[1-(cyclohexylmethyl)-1H-indole-3-carbonyl]valinate (MMB-CHMICA).
246.22 	(ix) Additional substances specifically named:
246.23 	(A) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1 
246.24 	H-pyrrolo[2,3-B]pyridine-3-carboxamide (5F-CUMYL-P7AICA);
246.25 	(B) 1-(4-cyanobutyl)-N-(2- phenylpropan-2-yl)-1 H-indazole-3-carboxamide 
246.26 	(4-CN-Cumyl-Butinaca);
246.27 	(C) naphthalen-1-yl-1-(5-fluoropentyl)-1-H-indole-3-carboxylate (NM2201; CBL2201);
246.28 	(D) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1 
246.29 	H-indazole-3-carboxamide (5F-ABPINACA);
247.1 	(E) methyl-2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate 
247.2 	(MDMB CHMICA);
247.3 	(F) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate 
247.4 	(5F-ADB; 5F-MDMB-PINACA); and
247.5 	(G) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl) 
247.6 	1H-indazole-3-carboxamide (ADB-FUBINACA).
247.7 	(i) A controlled substance analog, to the extent that it is implicitly or explicitly intended 
247.8 	for human consumption.

247.9 	EFFECTIVE DATE. This section is effective August 1, 2021, and applies to crimes 
247.10 	committed on or after that date.

247.11 	Sec. 69. Minnesota Statutes 2020, section 152.02, subdivision 3, is amended to read:
247.12 		Subd. 3.Schedule II. (a) Schedule II consists of the substances listed in this subdivision.
247.13 	(b) Unless specifically excepted or unless listed in another schedule, any of the following 
247.14 	substances whether produced directly or indirectly by extraction from substances of vegetable 
247.15 	origin or independently by means of chemical synthesis, or by a combination of extraction 
247.16 	and chemical synthesis:
247.17 	(1) Opium and opiate, and any salt, compound, derivative, or preparation of opium or 
247.18 	opiate.
247.19 	(i) Excluding:
247.20 	(A) apomorphine;
247.21 	(B) thebaine-derived butorphanol;
247.22 	(C) dextrophan;
247.23 	(D) nalbuphine;
247.24 	(E) nalmefene;
247.25 	(F) naloxegol;
247.26 	(G) naloxone;
247.27 	(H) naltrexone; and
247.28 	(I) their respective salts;
247.29 	(ii) but including the following:
248.1 	(A) opium, in all forms and extracts;
248.2 	(B) codeine;
248.3 	(C) dihydroetorphine;
248.4 	(D) ethylmorphine;
248.5 	(E) etorphine hydrochloride;
248.6 	(F) hydrocodone;
248.7 	(G) hydromorphone;
248.8 	(H) metopon;
248.9 	(I) morphine;
248.10 	(J) oxycodone;
248.11 	(K) oxymorphone;
248.12 	(L) thebaine;
248.13 	(M) oripavine;
248.14 	(2) any salt, compound, derivative, or preparation thereof which is chemically equivalent 
248.15 	or identical with any of the substances referred to in clause (1), except that these substances 
248.16 	shall not include the isoquinoline alkaloids of opium;
248.17 	(3) opium poppy and poppy straw;
248.18 	(4) coca leaves and any salt, cocaine compound, derivative, or preparation of coca leaves 
248.19 	(including cocaine and ecgonine and their salts, isomers, derivatives, and salts of isomers 
248.20 	and derivatives), and any salt, compound, derivative, or preparation thereof which is 
248.21 	chemically equivalent or identical with any of these substances, except that the substances 
248.22 	shall not include decocainized coca leaves or extraction of coca leaves, which extractions 
248.23 	do not contain cocaine or ecgonine;
248.24 	(5) concentrate of poppy straw (the crude extract of poppy straw in either liquid, solid, 
248.25 	or powder form which contains the phenanthrene alkaloids of the opium poppy).
248.26 	(c) Any of the following opiates, including their isomers, esters, ethers, salts, and salts 
248.27 	of isomers, esters and ethers, unless specifically excepted, or unless listed in another schedule, 
248.28 	whenever the existence of such isomers, esters, ethers and salts is possible within the specific 
248.29 	chemical designation:
248.30 	(1) alfentanil;
249.1 	(2) alphaprodine;
249.2 	(3) anileridine;
249.3 	(4) bezitramide;
249.4 	(5) bulk dextropropoxyphene (nondosage forms);
249.5 	(6) carfentanil;
249.6 	(7) dihydrocodeine;
249.7 	(8) dihydromorphinone;
249.8 	(9) diphenoxylate;
249.9 	(10) fentanyl;
249.10 	(11) isomethadone;
249.11 	(12) levo-alpha-acetylmethadol (LAAM);
249.12 	(13) levomethorphan;
249.13 	(14) levorphanol;
249.14 	(15) metazocine;
249.15 	(16) methadone;
249.16 	(17) methadone - intermediate, 4-cyano-2-dimethylamino-4, 4-diphenylbutane;
249.17 	(18) moramide - intermediate, 2-methyl-3-morpholino-1, 1-diphenyl-propane-carboxylic 
249.18 	acid;
249.19 	(19) pethidine;
249.20 	(20) pethidine - intermediate - a, 4-cyano-1-methyl-4-phenylpiperidine;
249.21 	(21) pethidine - intermediate - b, ethyl-4-phenylpiperidine-4-carboxylate;
249.22 	(22) pethidine - intermediate - c, 1-methyl-4-phenylpiperidine-4-carboxylic acid;
249.23 	(23) phenazocine;
249.24 	(24) piminodine;
249.25 	(25) racemethorphan;
249.26 	(26) racemorphan;
249.27 	(27) remifentanil;
250.1 	(28) sufentanil;
250.2 	(29) tapentadol;
250.3 	(30) 4-Anilino-N-phenethylpiperidine.
250.4 	(d) Unless specifically excepted or unless listed in another schedule, any material, 
250.5 	compound, mixture, or preparation which contains any quantity of the following substances 
250.6 	having a stimulant effect on the central nervous system:
250.7 	(1) amphetamine, its salts, optical isomers, and salts of its optical isomers;
250.8 	(2) methamphetamine, its salts, isomers, and salts of its isomers;
250.9 	(3) phenmetrazine and its salts;
250.10 	(4) methylphenidate;
250.11 	(5) lisdexamfetamine.
250.12 	(e) Unless specifically excepted or unless listed in another schedule, any material, 
250.13 	compound, mixture, or preparation which contains any quantity of the following substances 
250.14 	having a depressant effect on the central nervous system, including its salts, isomers, and 
250.15 	salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible 
250.16 	within the specific chemical designation:
250.17 	(1) amobarbital;
250.18 	(2) glutethimide;
250.19 	(3) secobarbital;
250.20 	(4) pentobarbital;
250.21 	(5) phencyclidine;
250.22 	(6) phencyclidine immediate precursors:
250.23 	(i) 1-phenylcyclohexylamine;
250.24 	(ii) 1-piperidinocyclohexanecarbonitrile;
250.25 	(7) phenylacetone.
250.26 	(f) Cannabis and cannabinoids:
250.27 	(1) nabilone;
250.28 	(2) unless specifically excepted or unless listed in another schedule, any natural material, 
250.29 	compound, mixture, or preparation that contains any quantity of the following substances, 
251.1 	their analogs, isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever 
251.2 	the existence of the isomers, esters, ethers, or salts is possible:
251.3 	(i) marijuana; and
251.4 	(ii) tetrahydrocannabinols naturally contained in a plant of the genus cannabis or in the 
251.5 	resinous extractives of the plant; and
251.6 	(2) (3) dronabinol [(-)-delta-9-trans-tetrahydrocannabinol (delta-9-THC)] in an oral 
251.7 	solution in a drug product approved for marketing by the United States Food and Drug 
251.8 	Administration.

251.9 	EFFECTIVE DATE. This section is effective August 1, 2021, and applies to crimes 
251.10 	committed on or after that date.

251.11 	Sec. 70. Minnesota Statutes 2020, section 152.11, subdivision 1a, is amended to read:
251.12 		Subd. 1a.Prescription requirements for Schedule II controlled substances. Except 
251.13 	as allowed under section 152.29, no person may dispense a controlled substance included 
251.14 	in Schedule II of section 152.02 without a prescription issued by a doctor of medicine, a 
251.15 	doctor of osteopathic medicine licensed to practice medicine, a doctor of dental surgery, a 
251.16 	doctor of dental medicine, a doctor of podiatry, or a doctor of veterinary medicine, lawfully 
251.17 	licensed to prescribe in this state or by a practitioner licensed to prescribe controlled 
251.18 	substances by the state in which the prescription is issued, and having a current federal Drug 
251.19 	Enforcement Administration registration number. The prescription must either be printed 
251.20 	or written in ink and contain the handwritten signature of the prescriber or be transmitted 
251.21 	electronically or by facsimile as permitted under subdivision 1. Provided that in emergency 
251.22 	situations, as authorized by federal law, such drug may be dispensed upon oral prescription 
251.23 	reduced promptly to writing and filed by the pharmacist. Such prescriptions shall be retained 
251.24 	in conformity with section 152.101. No prescription for a Schedule II substance may be 
251.25 	refilled.

251.26 	Sec. 71. Minnesota Statutes 2020, section 152.11, is amended by adding a subdivision to 
251.27 	read:
251.28 		Subd. 5.Exception. References in this section to Schedule II controlled substances do 
251.29 	not extend to marijuana or tetrahydrocannabinols.

252.1 	Sec. 72. Minnesota Statutes 2020, section 152.12, is amended by adding a subdivision to 
252.2 	read:
252.3 		Subd. 6.Exception. References in this section to Schedule II controlled substances do 
252.4 	not extend to marijuana or tetrahydrocannabinols.

252.5 	Sec. 73. Minnesota Statutes 2020, section 152.125, subdivision 3, is amended to read:
252.6 		Subd. 3.Limits on applicability. This section does not apply to:
252.7 	(1) a physician's treatment of an individual for chemical dependency resulting from the 
252.8 	use of controlled substances in Schedules II to V of section 152.02;
252.9 	(2) the prescription or administration of controlled substances in Schedules II to V of 
252.10 	section 152.02 to an individual whom the physician knows to be using the controlled 
252.11 	substances for nontherapeutic purposes;
252.12 	(3) the prescription or administration of controlled substances in Schedules II to V of 
252.13 	section 152.02 for the purpose of terminating the life of an individual having intractable 
252.14 	pain; or
252.15 	(4) the prescription or administration of a controlled substance in Schedules II to V of 
252.16 	section 152.02 that is not a controlled substance approved by the United States Food and 
252.17 	Drug Administration for pain relief; or
252.18 	(5) the administration of medical cannabis under sections 152.22 to 152.37.

252.19 	Sec. 74. Minnesota Statutes 2020, section 152.22, is amended by adding a subdivision to 
252.20 	read:
252.21 		Subd. 5c.Hemp processor. "Hemp processor" means a person or business licensed by 
252.22 	the commissioner of agriculture under chapter 18K to convert raw hemp into a product.

252.23 	Sec. 75. Minnesota Statutes 2020, section 152.22, subdivision 6, is amended to read:
252.24 		Subd. 6.Medical cannabis. (a) "Medical cannabis" means any species of the genus 
252.25 	cannabis plant, or any mixture or preparation of them, including whole plant extracts and 
252.26 	resins, and is delivered in the form of:
252.27 	(1) liquid, including, but not limited to, oil;
252.28 	(2) pill;
252.29 	(3) vaporized delivery method with use of liquid or oil but which does not require the 
252.30 	use of dried leaves or plant form; or;
253.1 	(4) combustion with use of dried raw cannabis; or
253.2 	(4) (5) any other method, excluding smoking, approved by the commissioner.
253.3 	(b) This definition includes any part of the genus cannabis plant prior to being processed 
253.4 	into a form allowed under paragraph (a), that is possessed by a person while that person is 
253.5 	engaged in employment duties necessary to carry out a requirement under sections 152.22 
253.6 	to 152.37 for a registered manufacturer or a laboratory under contract with a registered 
253.7 	manufacturer. This definition also includes any hemp acquired by a manufacturer by a hemp 
253.8 	grower as permitted under section 152.29, subdivision 1, paragraph (b).

253.9 	EFFECTIVE DATE. This section is effective the earlier of (1) March 1, 2022, or (2) 
253.10 	a date, as determined by the commissioner of health, by which (i) the rules adopted or 
253.11 	amended under Minnesota Statutes, section 152.26, paragraph (b), are in effect and (ii) the 
253.12 	independent laboratories under contract with the manufacturers have the necessary procedures 
253.13 	and equipment in place to perform the required testing of dried raw cannabis. If this section 
253.14 	is effective before March 1, 2022, the commissioner shall provide notice of that effective 
253.15 	date to the public.

253.16 	Sec. 76. Minnesota Statutes 2020, section 152.22, subdivision 11, is amended to read:
253.17 		Subd. 11.Registered designated caregiver. "Registered designated caregiver" means 
253.18 	a person who:
253.19 	(1) is at least 18 years old;
253.20 	(2) does not have a conviction for a disqualifying felony offense;
253.21 	(3) has been approved by the commissioner to assist a patient who has been identified 
253.22 	by a health care practitioner as developmentally or physically disabled and therefore requires 
253.23 	assistance in administering medical cannabis or obtaining medical cannabis from a 
253.24 	distribution facility due to the disability; and
253.25 	(4) is authorized by the commissioner to assist the patient with the use of medical 
253.26 	cannabis.

253.27 	Sec. 77. Minnesota Statutes 2020, section 152.22, is amended by adding a subdivision to 
253.28 	read:
253.29 		Subd. 13a.Tribal medical cannabis program. "Tribal medical cannabis program" 
253.30 	means a medical cannabis program operated by a federally recognized Indian Tribe located 
254.1 	within the state that has been recognized by the commissioner of health in accordance with 
254.2 	section 152.25, subdivision 5.

254.3 	Sec. 78. Minnesota Statutes 2020, section 152.23, is amended to read:
254.4 	152.23 LIMITATIONS.
254.5 	(a) Nothing in sections 152.22 to 152.37 permits any person to engage in and does not 
254.6 	prevent the imposition of any civil, criminal, or other penalties for:
254.7 	(1) undertaking any task under the influence of medical cannabis that would constitute 
254.8 	negligence or professional malpractice;
254.9 	(2) possessing or engaging in the use of medical cannabis:
254.10 	(i) on a school bus or van;
254.11 	(ii) on the grounds of any preschool or primary or secondary school;
254.12 	(iii) in any correctional facility; or
254.13 	(iv) on the grounds of any child care facility or home day care;
254.14 	(3) vaporizing or combusting medical cannabis pursuant to section 152.22, subdivision 
254.15 	6:
254.16 	(i) on any form of public transportation;
254.17 	(ii) where the vapor would be inhaled by a nonpatient minor child or where the smoke 
254.18 	would be inhaled by a minor child; or
254.19 	(iii) in any public place, including any indoor or outdoor area used by or open to the 
254.20 	general public or a place of employment as defined under section 144.413, subdivision 1b; 
254.21 	and
254.22 	(4) operating, navigating, or being in actual physical control of any motor vehicle, 
254.23 	aircraft, train, or motorboat, or working on transportation property, equipment, or facilities 
254.24 	while under the influence of medical cannabis.
254.25 	(b) Nothing in sections 152.22 to 152.37 require the medical assistance and 
254.26 	MinnesotaCare programs to reimburse an enrollee or a provider for costs associated with 
254.27 	the medical use of cannabis. Medical assistance and MinnesotaCare shall continue to provide 
254.28 	coverage for all services related to treatment of an enrollee's qualifying medical condition 
254.29 	if the service is covered under chapter 256B or 256L.

255.1 	Sec. 79. Minnesota Statutes 2020, section 152.25, is amended by adding a subdivision to 
255.2 	read:
255.3 		Subd. 5.Tribal medical cannabis programs. Upon the request of an Indian Tribe 
255.4 	operating a Tribal medical cannabis program, the commissioner shall determine if the 
255.5 	standards for the Tribal medical cannabis program meet or exceed the standards required 
255.6 	under sections 152.22 to 152.37 in terms of qualifying for the medical cannabis program, 
255.7 	allowable forms of medical cannabis, production and distribution requirements, product 
255.8 	safety and testing, and security measures. If the commissioner determines that the Tribal 
255.9 	medical cannabis program meets or exceeds the standards in sections 152.22 to 152.37, the 
255.10 	commissioner shall recognize the Tribal medical cannabis program and shall post the Tribal 
255.11 	medical cannabis programs that have been recognized by the commissioner on the 
255.12 	Department of Health's website.

255.13 	Sec. 80. Minnesota Statutes 2020, section 152.26, is amended to read:
255.14 	152.26 RULEMAKING.
255.15 	(a) The commissioner may adopt rules to implement sections 152.22 to 152.37. Rules 
255.16 	for which notice is published in the State Register before January 1, 2015, may be adopted 
255.17 	using the process in section 14.389.
255.18 	(b) The commissioner may adopt or amend rules, using the procedure in section 14.386, 
255.19 	paragraph (a), to implement the addition of dried raw cannabis as an allowable form of 
255.20 	medical cannabis under section 152.22, subdivision 6, paragraph (a), clause (4). Section 
255.21 	14.386, paragraph (b), does not apply to these rules.

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

255.23 	Sec. 81. Minnesota Statutes 2020, section 152.27, subdivision 3, is amended to read:
255.24 		Subd. 3.Patient application. (a) The commissioner shall develop a patient application 
255.25 	for enrollment into the registry program. The application shall be available to the patient 
255.26 	and given to health care practitioners in the state who are eligible to serve as health care 
255.27 	practitioners. The application must include:
255.28 	(1) the name, mailing address, and date of birth of the patient;
255.29 	(2) the name, mailing address, and telephone number of the patient's health care 
255.30 	practitioner;
256.1 	(3) the name, mailing address, and date of birth of the patient's designated caregiver, if 
256.2 	any, or the patient's parent, legal guardian, or spouse if the parent, legal guardian, or spouse 
256.3 	will be acting as a caregiver;
256.4 	(4) a copy of the certification from the patient's health care practitioner that is dated 
256.5 	within 90 days prior to submitting the application which that certifies that the patient has 
256.6 	been diagnosed with a qualifying medical condition and, if applicable, that, in the health 
256.7 	care practitioner's medical opinion, the patient is developmentally or physically disabled 
256.8 	and, as a result of that disability, the patient requires assistance in administering medical 
256.9 	cannabis or obtaining medical cannabis from a distribution facility; and
256.10 	(5) all other signed affidavits and enrollment forms required by the commissioner under 
256.11 	sections 152.22 to 152.37, including, but not limited to, the disclosure form required under 
256.12 	paragraph (c).
256.13 	(b) The commissioner shall require a patient to resubmit a copy of the certification from 
256.14 	the patient's health care practitioner on a yearly basis and shall require that the recertification 
256.15 	be dated within 90 days of submission.
256.16 	(c) The commissioner shall develop a disclosure form and require, as a condition of 
256.17 	enrollment, all patients to sign a copy of the disclosure. The disclosure must include:
256.18 	(1) a statement that, notwithstanding any law to the contrary, the commissioner, or an 
256.19 	employee of any state agency, may not be held civilly or criminally liable for any injury, 
256.20 	loss of property, personal injury, or death caused by any act or omission while acting within 
256.21 	the scope of office or employment under sections 152.22 to 152.37; and
256.22 	(2) the patient's acknowledgment that enrollment in the patient registry program is 
256.23 	conditional on the patient's agreement to meet all of the requirements of sections 152.22 to 
256.24 	152.37.

256.25 	Sec. 82. Minnesota Statutes 2020, section 152.27, subdivision 4, is amended to read:
256.26 		Subd. 4.Registered designated caregiver. (a) The commissioner shall register a 
256.27 	designated caregiver for a patient if the patient's health care practitioner has certified that 
256.28 	the patient, in the health care practitioner's medical opinion, is developmentally or physically 
256.29 	disabled and, as a result of that disability, the patient requires assistance in administering 
256.30 	medical cannabis or obtaining medical cannabis from a distribution facility and the caregiver 
256.31 	has agreed, in writing, to be the patient's designated caregiver. As a condition of registration 
256.32 	as a designated caregiver, the commissioner shall require the person to:
256.33 	(1) be at least 18 years of age;
257.1 	(2) agree to only possess the patient's medical cannabis for purposes of assisting the 
257.2 	patient; and
257.3 	(3) agree that if the application is approved, the person will not be a registered designated 
257.4 	caregiver for more than one patient, unless the six registered patients at one time. Patients 
257.5 	who reside in the same residence shall count as one patient.
257.6 	(b) The commissioner shall conduct a criminal background check on the designated 
257.7 	caregiver prior to registration to ensure that the person does not have a conviction for a 
257.8 	disqualifying felony offense. Any cost of the background check shall be paid by the person 
257.9 	seeking registration as a designated caregiver. A designated caregiver must have the criminal 
257.10 	background check renewed every two years.
257.11 	(c) Nothing in sections 152.22 to 152.37 shall be construed to prevent a person registered 
257.12 	as a designated caregiver from also being enrolled in the registry program as a patient and 
257.13 	possessing and using medical cannabis as a patient.

257.14 	Sec. 83. Minnesota Statutes 2020, section 152.27, subdivision 6, is amended to read:
257.15 		Subd. 6.Patient enrollment. (a) After receipt of a patient's application, application fees, 
257.16 	and signed disclosure, the commissioner shall enroll the patient in the registry program and 
257.17 	issue the patient and patient's registered designated caregiver or parent, legal guardian, or 
257.18 	spouse, if applicable, a registry verification. The commissioner shall approve or deny a 
257.19 	patient's application for participation in the registry program within 30 days after the 
257.20 	commissioner receives the patient's application and application fee. The commissioner may 
257.21 	approve applications up to 60 days after the receipt of a patient's application and application 
257.22 	fees until January 1, 2016. A patient's enrollment in the registry program shall only be 
257.23 	denied if the patient:
257.24 	(1) does not have certification from a health care practitioner that the patient has been 
257.25 	diagnosed with a qualifying medical condition;
257.26 	(2) has not signed and returned the disclosure form required under subdivision 3, 
257.27 	paragraph (c), to the commissioner;
257.28 	(3) does not provide the information required; or
257.29 	(4) has previously been removed from the registry program for violations of section 
257.30 	152.30 or 152.33; or
257.31 	(5) (4) provides false information.
258.1 	(b) The commissioner shall give written notice to a patient of the reason for denying 
258.2 	enrollment in the registry program.
258.3 	(c) Denial of enrollment into the registry program is considered a final decision of the 
258.4 	commissioner and is subject to judicial review under the Administrative Procedure Act 
258.5 	pursuant to chapter 14.
258.6 	(d) A patient's enrollment in the registry program may only be revoked upon the death 
258.7 	of the patient or if a patient violates a requirement under section 152.30 or 152.33. If a 
258.8 	patient's enrollment in the registry program has been revoked due to a violation of section 
258.9 	152.30 or 152.33, the patient may reapply for enrollment 12 months from the date the 
258.10 	patient's enrollment was revoked. The commissioner shall process the application in 
258.11 	accordance with this section.
258.12 	(e) The commissioner shall develop a registry verification to provide to the patient, the 
258.13 	health care practitioner identified in the patient's application, and to the manufacturer. The 
258.14 	registry verification shall include:
258.15 	(1) the patient's name and date of birth;
258.16 	(2) the patient registry number assigned to the patient; and
258.17 	(3) the name and date of birth of the patient's registered designated caregiver, if any, or 
258.18 	the name of the patient's parent, legal guardian, or spouse if the parent, legal guardian, or 
258.19 	spouse will be acting as a caregiver.
258.20 	(f) The commissioner shall not deny a patient's application for participation in the registry 
258.21 	program or revoke a patient's enrollment in the registry program solely because the patient 
258.22 	is also enrolled in a Tribal medical cannabis program.

258.23 	Sec. 84. Minnesota Statutes 2020, section 152.28, subdivision 1, is amended to read:
258.24 		Subdivision 1.Health care practitioner duties. (a) Prior to a patient's enrollment in 
258.25 	the registry program, a health care practitioner shall:
258.26 	(1) determine, in the health care practitioner's medical judgment, whether a patient suffers 
258.27 	from a qualifying medical condition, and, if so determined, provide the patient with a 
258.28 	certification of that diagnosis;
258.29 	(2) determine whether a patient is developmentally or physically disabled and, as a result 
258.30 	of that disability, the patient requires assistance in administering medical cannabis or 
258.31 	obtaining medical cannabis from a distribution facility, and, if so determined, include that 
258.32 	determination on the patient's certification of diagnosis;
259.1 	(3) advise patients, registered designated caregivers, and parents, legal guardians, or 
259.2 	spouses who are acting as caregivers of the existence of any nonprofit patient support groups 
259.3 	or organizations;
259.4 	(4) (3) provide explanatory information from the commissioner to patients with qualifying 
259.5 	medical conditions, including disclosure to all patients about the experimental nature of 
259.6 	therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the 
259.7 	proposed treatment; the application and other materials from the commissioner; and provide 
259.8 	patients with the Tennessen warning as required by section 13.04, subdivision 2; and
259.9 	(5) (4) agree to continue treatment of the patient's qualifying medical condition and 
259.10 	report medical findings to the commissioner.
259.11 	(b) Upon notification from the commissioner of the patient's enrollment in the registry 
259.12 	program, the health care practitioner shall:
259.13 	(1) participate in the patient registry reporting system under the guidance and supervision 
259.14 	of the commissioner;
259.15 	(2) report health records of the patient throughout the ongoing treatment of the patient 
259.16 	to the commissioner in a manner determined by the commissioner and in accordance with 
259.17 	subdivision 2;
259.18 	(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying 
259.19 	medical condition and, if so, issue the patient a new certification of that diagnosis; and
259.20 	(4) otherwise comply with all requirements developed by the commissioner.
259.21 	(c) A health care practitioner may conduct a patient assessment to issue a recertification 
259.22 	as required under paragraph (b), clause (3), via telemedicine as defined under section 
259.23 	62A.671, subdivision 9.
259.24 	(d) Nothing in this section requires a health care practitioner to participate in the registry 
259.25 	program.

259.26 	Sec. 85. Minnesota Statutes 2020, section 152.29, subdivision 1, is amended to read:
259.27 		Subdivision 1.Manufacturer; requirements. (a) A manufacturer may operate eight 
259.28 	distribution facilities, which may include the manufacturer's single location for cultivation, 
259.29 	harvesting, manufacturing, packaging, and processing but is not required to include that 
259.30 	location. The commissioner shall designate the geographical service areas to be served by 
259.31 	each manufacturer based on geographical need throughout the state to improve patient 
259.32 	access. A manufacturer shall not have more than two distribution facilities in each 
260.1 	geographical service area assigned to the manufacturer by the commissioner. A manufacturer 
260.2 	shall operate only one location where all cultivation, harvesting, manufacturing, packaging, 
260.3 	and processing of medical cannabis shall be conducted. This location may be one of the 
260.4 	manufacturer's distribution facility sites. The additional distribution facilities may dispense 
260.5 	medical cannabis and medical cannabis products but may not contain any medical cannabis 
260.6 	in a form other than those forms allowed under section 152.22, subdivision 6, and the 
260.7 	manufacturer shall not conduct any cultivation, harvesting, manufacturing, packaging, or 
260.8 	processing at the other distribution facility sites. Any distribution facility operated by the 
260.9 	manufacturer is subject to all of the requirements applying to the manufacturer under sections 
260.10 	152.22 to 152.37, including, but not limited to, security and distribution requirements.
260.11 	(b) A manufacturer may acquire hemp grown in this state from a hemp grower, and may 
260.12 	acquire hemp products produced by a hemp processor. A manufacturer may manufacture 
260.13 	or process hemp and hemp products into an allowable form of medical cannabis under 
260.14 	section 152.22, subdivision 6. Hemp and hemp products acquired by a manufacturer under 
260.15 	this paragraph is are subject to the same quality control program, security and testing 
260.16 	requirements, and other requirements that apply to medical cannabis under sections 152.22
260.17 	to 152.37 and Minnesota Rules, chapter 4770.
260.18 	(c) A medical cannabis manufacturer shall contract with a laboratory approved by the 
260.19 	commissioner, subject to any additional requirements set by the commissioner, for purposes 
260.20 	of testing medical cannabis manufactured or hemp or hemp products acquired by the medical 
260.21 	cannabis manufacturer as to content, contamination, and consistency to verify the medical 
260.22 	cannabis meets the requirements of section 152.22, subdivision 6. The cost of laboratory 
260.23 	testing shall be paid by the manufacturer.
260.24 	(d) The operating documents of a manufacturer must include:
260.25 	(1) procedures for the oversight of the manufacturer and procedures to ensure accurate 
260.26 	record keeping;
260.27 	(2) procedures for the implementation of appropriate security measures to deter and 
260.28 	prevent the theft of medical cannabis and unauthorized entrance into areas containing medical 
260.29 	cannabis; and
260.30 	(3) procedures for the delivery and transportation of hemp between hemp growers and 
260.31 	manufacturers and for the delivery and transportation of hemp products between hemp 
260.32 	processors and manufacturers.
260.33 	(e) A manufacturer shall implement security requirements, including requirements for 
260.34 	the delivery and transportation of hemp and hemp products, protection of each location by 
261.1 	a fully operational security alarm system, facility access controls, perimeter intrusion 
261.2 	detection systems, and a personnel identification system.
261.3 	(f) A manufacturer shall not share office space with, refer patients to a health care 
261.4 	practitioner, or have any financial relationship with a health care practitioner.
261.5 	(g) A manufacturer shall not permit any person to consume medical cannabis on the 
261.6 	property of the manufacturer.
261.7 	(h) A manufacturer is subject to reasonable inspection by the commissioner.
261.8 	(i) For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is not 
261.9 	subject to the Board of Pharmacy licensure or regulatory requirements under chapter 151.
261.10 	(j) A medical cannabis manufacturer may not employ any person who is under 21 years 
261.11 	of age or who has been convicted of a disqualifying felony offense. An employee of a 
261.12 	medical cannabis manufacturer must submit a completed criminal history records check 
261.13 	consent form, a full set of classifiable fingerprints, and the required fees for submission to 
261.14 	the Bureau of Criminal Apprehension before an employee may begin working with the 
261.15 	manufacturer. The bureau must conduct a Minnesota criminal history records check and 
261.16 	the superintendent is authorized to exchange the fingerprints with the Federal Bureau of 
261.17 	Investigation to obtain the applicant's national criminal history record information. The 
261.18 	bureau shall return the results of the Minnesota and federal criminal history records checks 
261.19 	to the commissioner.
261.20 	(k) A manufacturer may not operate in any location, whether for distribution or 
261.21 	cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a 
261.22 	public or private school existing before the date of the manufacturer's registration with the 
261.23 	commissioner.
261.24 	(l) A manufacturer shall comply with reasonable restrictions set by the commissioner 
261.25 	relating to signage, marketing, display, and advertising of medical cannabis.
261.26 	(m) Before a manufacturer acquires hemp from a hemp grower or hemp products from 
261.27 	a hemp processor, the manufacturer must verify that the hemp grower or hemp processor 
261.28 	has a valid license issued by the commissioner of agriculture under chapter 18K.
261.29 	(n) Until a state-centralized, seed-to-sale system is implemented that can track a specific 
261.30 	medical cannabis plant from cultivation through testing and point of sale, the commissioner 
261.31 	shall conduct at least one unannounced inspection per year of each manufacturer that includes 
261.32 	inspection of:
261.33 	(1) business operations;
262.1 	(2) physical locations of the manufacturer's manufacturing facility and distribution 
262.2 	facilities;
262.3 	(3) financial information and inventory documentation, including laboratory testing 
262.4 	results; and
262.5 	(4) physical and electronic security alarm systems.

262.6 	Sec. 86. Minnesota Statutes 2020, section 152.29, subdivision 3, is amended to read:
262.7 		Subd. 3.Manufacturer; distribution. (a) A manufacturer shall require that employees 
262.8 	licensed as pharmacists pursuant to chapter 151 be the only employees to give final approval 
262.9 	for the distribution of medical cannabis to a patient. A manufacturer may transport medical 
262.10 	cannabis or medical cannabis products that have been cultivated, harvested, manufactured, 
262.11 	packaged, and processed by that manufacturer to another registered manufacturer for the 
262.12 	other manufacturer to distribute.
262.13 	(b) A manufacturer may distribute medical cannabis products, whether or not the products 
262.14 	have been manufactured by that manufacturer.
262.15 	(c) Prior to distribution of any medical cannabis, the manufacturer shall:
262.16 	(1) verify that the manufacturer has received the registry verification from the 
262.17 	commissioner for that individual patient;
262.18 	(2) verify that the person requesting the distribution of medical cannabis is the patient, 
262.19 	the patient's registered designated caregiver, or the patient's parent, legal guardian, or spouse 
262.20 	listed in the registry verification using the procedures described in section 152.11, subdivision 
262.21 	2d;
262.22 	(3) assign a tracking number to any medical cannabis distributed from the manufacturer;
262.23 	(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to 
262.24 	chapter 151 has consulted with the patient to determine the proper dosage for the individual 
262.25 	patient after reviewing the ranges of chemical compositions of the medical cannabis and 
262.26 	the ranges of proper dosages reported by the commissioner. For purposes of this clause, a 
262.27 	consultation may be conducted remotely using a by secure videoconference, telephone, or 
262.28 	other remote means, so long as the employee providing the consultation is able to confirm 
262.29 	the identity of the patient, the consultation occurs while the patient is at a distribution facility,
262.30 	and the consultation adheres to patient privacy requirements that apply to health care services 
262.31 	delivered through telemedicine. A pharmacist consultation under this clause is not required 
262.32 	when a manufacturer is distributing medical cannabis to a patient according to a 
263.1 	patient-specific dosage plan established with that manufacturer and is not modifying the 
263.2 	dosage or product being distributed under that plan and the medical cannabis is distributed 
263.3 	by a pharmacy technician;
263.4 	(5) properly package medical cannabis in compliance with the United States Poison 
263.5 	Prevention Packing Act regarding child-resistant packaging and exemptions for packaging 
263.6 	for elderly patients, and label distributed medical cannabis with a list of all active ingredients 
263.7 	and individually identifying information, including:
263.8 	(i) the patient's name and date of birth;
263.9 	(ii) the name and date of birth of the patient's registered designated caregiver or, if listed 
263.10 	on the registry verification, the name of the patient's parent or legal guardian, if applicable;
263.11 	(iii) the patient's registry identification number;
263.12 	(iv) the chemical composition of the medical cannabis; and
263.13 	(v) the dosage; and
263.14 	(6) ensure that the medical cannabis distributed contains a maximum of a 90-day supply 
263.15 	of the dosage determined for that patient.
263.16 	(d) A manufacturer shall require any employee of the manufacturer who is transporting 
263.17 	medical cannabis or medical cannabis products to a distribution facility or to another 
263.18 	registered manufacturer to carry identification showing that the person is an employee of 
263.19 	the manufacturer.
263.20 	(e) A manufacturer shall distribute medical cannabis in dried raw cannabis form only 
263.21 	to a patient age 21 or older, or to the registered designated caregiver, parent, legal guardian, 
263.22 	or spouse of a patient age 21 or older.

263.23 	EFFECTIVE DATE. Paragraph (e) is effective the earlier of (1) March 1, 2022, or (2) 
263.24 	a date, as determined by the commissioner of health, by which (i) the rules adopted or 
263.25 	amended under Minnesota Statutes, section 152.26, paragraph (b), are in effect and (ii) the 
263.26 	independent laboratories under contract with the manufacturers have the necessary procedures 
263.27 	and equipment in place to perform the required testing of dried raw cannabis. If this section 
263.28 	is effective before March 1, 2022, the commissioner shall provide notice of that effective 
263.29 	date to the public.

264.1 	Sec. 87. Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to 
264.2 	read:
264.3 		Subd. 3b.Distribution to recipient in a motor vehicle. A manufacturer may distribute 
264.4 	medical cannabis to a patient, registered designated caregiver, or parent, legal guardian, or 
264.5 	spouse of a patient who is at the distribution facility but remains in a motor vehicle, provided:
264.6 	(1) distribution facility staff receive payment and distribute medical cannabis in a 
264.7 	designated zone that is as close as feasible to the front door of the distribution facility;
264.8 	(2) the manufacturer ensures that the receipt of payment and distribution of medical 
264.9 	cannabis are visually recorded by a closed-circuit television surveillance camera at the 
264.10 	distribution facility and provides any other necessary security safeguards;
264.11 	(3) the manufacturer does not store medical cannabis outside a restricted access area at 
264.12 	the distribution facility, and distribution facility staff transport medical cannabis from a 
264.13 	restricted access area at the distribution facility to the designated zone for distribution only 
264.14 	after confirming that the patient, designated caregiver, or parent, guardian, or spouse has 
264.15 	arrived in the designated zone;
264.16 	(4) the payment and distribution of medical cannabis take place only after a pharmacist 
264.17 	consultation takes place, if required under subdivision 3, paragraph (c), clause (4);
264.18 	(5) immediately following distribution of medical cannabis, distribution facility staff 
264.19 	enter the transaction in the state medical cannabis registry information technology database; 
264.20 	and
264.21 	(6) immediately following distribution of medical cannabis, distribution facility staff 
264.22 	take the payment received into the distribution facility.

264.23 	Sec. 88. Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to 
264.24 	read:
264.25 		Subd. 3c.Disposal of medical cannabis plant root balls. Notwithstanding Minnesota 
264.26 	Rules, part 4770.1200, subpart 2, item C, a manufacturer is not required to grind root balls 
264.27 	of medical cannabis plants or incorporate them with a greater quantity of nonconsumable 
264.28 	solid waste before transporting root balls to another location for disposal. For purposes of 
264.29 	this subdivision, "root ball" means a compact mass of roots formed by a plant and any 
264.30 	attached growing medium.

265.1 	Sec. 89. Minnesota Statutes 2020, section 152.31, is amended to read:
265.2 	152.31 DATA PRACTICES.
265.3 	(a) Government data in patient files maintained by the commissioner and the health care 
265.4 	practitioner, and data submitted to or by a medical cannabis manufacturer, are private data 
265.5 	on individuals, as defined in section 13.02, subdivision 12, or nonpublic data, as defined in 
265.6 	section 13.02, subdivision 9, but may be used for purposes of complying with chapter 13 
265.7 	and complying with a request from the legislative auditor or the state auditor in the 
265.8 	performance of official duties. The provisions of section 13.05, subdivision 11, apply to a 
265.9 	registration agreement entered between the commissioner and a medical cannabis 
265.10 	manufacturer under section 152.25.
265.11 	(b) Not public data maintained by the commissioner may not be used for any purpose 
265.12 	not provided for in sections 152.22 to 152.37, and may not be combined or linked in any 
265.13 	manner with any other list, dataset, or database.
265.14 	(c) The commissioner may execute data sharing arrangements with the commissioner 
265.15 	of agriculture to verify licensing, inspection, and compliance information related to hemp 
265.16 	growers and hemp processors under chapter 18K.

265.17 	Sec. 90. Minnesota Statutes 2020, section 152.32, subdivision 3, is amended to read:
265.18 		Subd. 3.Discrimination prohibited. (a) No school or landlord may refuse to enroll or 
265.19 	lease to and may not otherwise penalize a person solely for the person's status as a patient 
265.20 	enrolled in the registry program under sections 152.22 to 152.37, unless failing to do so 
265.21 	would violate federal law or regulations or cause the school or landlord to lose a monetary 
265.22 	or licensing-related benefit under federal law or regulations.
265.23 	(b) For the purposes of medical care, including organ transplants, a registry program 
265.24 	enrollee's use of medical cannabis under sections 152.22 to 152.37 is considered the 
265.25 	equivalent of the authorized use of any other medication used at the discretion of a physician 
265.26 	or advanced practice registered nurse and does not constitute the use of an illicit substance 
265.27 	or otherwise disqualify a patient from needed medical care.
265.28 	(c) Unless a failure to do so would violate federal law or regulations or cause an employer 
265.29 	to lose a monetary or licensing-related benefit under federal law or regulations, an employer 
265.30 	may not discriminate against a person in hiring, termination, or any term or condition of 
265.31 	employment, or otherwise penalize a person, if the discrimination is based upon either of 
265.32 	the following:
266.1 	(1) the person's status as a patient enrolled in the registry program under sections 152.22 
266.2 	to 152.37; or
266.3 	(2) a patient's positive drug test for cannabis components or metabolites, unless the 
266.4 	patient used, possessed, or was impaired by medical cannabis on the premises of the place 
266.5 	of employment or during the hours of employment.
266.6 	(d) An employee who is required to undergo employer drug testing pursuant to section 
266.7 	181.953 may present verification of enrollment in the patient registry as part of the employee's 
266.8 	explanation under section 181.953, subdivision 6.
266.9 	(e) A person shall not be denied custody of a minor child or visitation rights or parenting 
266.10 	time with a minor child solely based on the person's status as a patient enrolled in the registry 
266.11 	program under sections 152.22 to 152.37. There shall be no presumption of neglect or child 
266.12 	endangerment for conduct allowed under sections 152.22 to 152.37, unless the person's 
266.13 	behavior is such that it creates an unreasonable danger to the safety of the minor as 
266.14 	established by clear and convincing evidence.
266.15 	(f) This subdivision applies to any person enrolled in a Tribal medical cannabis program 
266.16 	to the same extent as if the person was enrolled in the registry program under sections 152.22 
266.17 	to 152.37.

266.18 	Sec. 91. Minnesota Statutes 2020, section 171.07, is amended by adding a subdivision to 
266.19 	read:
266.20 		Subd. 3b.Identification card for homeless youth. (a) A homeless youth, as defined in 
266.21 	section 256K.45, subdivision 1a, who meets the requirements of this subdivision may obtain 
266.22 	a noncompliant identification card, notwithstanding section 171.06, subdivision 3.
266.23 	(b) An applicant under this subdivision must:
266.24 	(1) provide the applicant's full name, date of birth, and sex;
266.25 	(2) provide the applicant's height in feet and inches, weight in pounds, and eye color;
266.26 	(3) submit a certified copy of a birth certificate issued by a government bureau of vital 
266.27 	statistics or equivalent agency in the applicant's state of birth, which must bear the raised 
266.28 	or authorized seal of the issuing government entity; and
266.29 	(4) submit a statement verifying that the applicant is a homeless youth who resides in 
266.30 	Minnesota that is signed by:
267.1 	(i) an employee of a human services agency receiving public funding to provide services 
267.2 	to homeless youth, runaway youth, youth with mental illness, or youth with substance use 
267.3 	disorders; or
267.4 	(ii) staff at a school who provide services to homeless youth or a school social worker.
267.5 	(c) For a noncompliant identification card under this subdivision:
267.6 	(1) the commissioner must not impose a fee, surcharge, or filing fee under section 171.06, 
267.7 	subdivision 2; and
267.8 	(2) a driver's license agent must not impose a filing fee under section 171.061, subdivision 
267.9 	4.
267.10 	(d) Minnesota Rules, parts 7410.0400 and 7410.0410, or successor rules, do not apply 
267.11 	for an identification card under this subdivision.

267.12 	EFFECTIVE DATE. This section is effective the day following final enactment for 
267.13 	application and issuance of Minnesota identification cards on and after January 1, 2022.

267.14 	Sec. 92. Minnesota Statutes 2020, section 256.98, subdivision 1, is amended to read:
267.15 		Subdivision 1.Wrongfully obtaining assistance. (a) A person who commits any of the 
267.16 	following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897, 
267.17 	the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program 
267.18 	formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, 256I, 256J, 256K, or 
267.19 	256L, child care assistance programs, and emergency assistance programs under section 
267.20 	256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses 
267.21 	(1) to (5):
267.22 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
267.23 	willfully false statement or representation, by intentional concealment of any material fact, 
267.24 	or by impersonation or other fraudulent device, assistance or the continued receipt of 
267.25 	assistance, to include child care assistance or vouchers food benefits produced according 
267.26 	to sections 145.891 to 145.897 and MinnesotaCare services according to sections 256.9365, 
267.27 	256.94, and 256L.01 to 256L.15, to which the person is not entitled or assistance greater 
267.28 	than that to which the person is entitled;
267.29 	(2) knowingly aids or abets in buying or in any way disposing of the property of a 
267.30 	recipient or applicant of assistance without the consent of the county agency; or
268.1 	(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments 
268.2 	to which the individual is not entitled as a provider of subsidized child care, or by furnishing 
268.3 	or concurring in a willfully false claim for child care assistance.
268.4 	(b) The continued receipt of assistance to which the person is not entitled or greater than 
268.5 	that to which the person is entitled as a result of any of the acts, failure to act, or concealment 
268.6 	described in this subdivision shall be deemed to be continuing offenses from the date that 
268.7 	the first act or failure to act occurred.

268.8 	Sec. 93. Minnesota Statutes 2020, section 256B.0625, subdivision 52, is amended to read:
268.9 		Subd. 52.Lead risk assessments. (a) Effective October 1, 2007, or six months after 
268.10 	federal approval, whichever is later, medical assistance covers lead risk assessments provided 
268.11 	by a lead risk assessor who is licensed by the commissioner of health under section 144.9505
268.12 	and employed by an assessing agency as defined in section 144.9501. Medical assistance 
268.13 	covers a onetime on-site investigation of a recipient's home or primary residence to determine 
268.14 	the existence of lead so long as the recipient is under the age of 21 and has a venous blood 
268.15 	lead level specified in section 144.9504, subdivision 2, paragraph (a) (b).
268.16 	(b) Medical assistance reimbursement covers the lead risk assessor's time to complete 
268.17 	the following activities:
268.18 	(1) gathering samples;
268.19 	(2) interviewing family members;
268.20 	(3) gathering data, including meter readings; and
268.21 	(4) providing a report with the results of the investigation and options for reducing 
268.22 	lead-based paint hazards.
268.23 	Medical assistance coverage of lead risk assessment does not include testing of 
268.24 	environmental substances such as water, paint, or soil or any other laboratory services. 
268.25 	Medical assistance coverage of lead risk assessments is not included in the capitated services 
268.26 	for children enrolled in health plans through the prepaid medical assistance program and 
268.27 	the MinnesotaCare program.
268.28 	(c) Payment for lead risk assessment must be cost-based and must meet the criteria for 
268.29 	federal financial participation under the Medicaid program. The rate must be based on 
268.30 	allowable expenditures from cost information gathered. Under section 144.9507, subdivision 
268.31 	5, federal medical assistance funds may not replace existing funding for lead-related activities. 
268.32 	The nonfederal share of costs for services provided under this subdivision must be from 
269.1 	state or local funds and is the responsibility of the agency providing the risk assessment. 
269.2 	When the risk assessment is conducted by the commissioner of health, the state share must 
269.3 	be from appropriations to the commissioner of health for this purpose. Eligible expenditures 
269.4 	for the nonfederal share of costs may not be made from federal funds or funds used to match 
269.5 	other federal funds. Any federal disallowances are the responsibility of the agency providing 
269.6 	risk assessment services.

269.7 	Sec. 94. Minnesota Statutes 2020, section 326.71, subdivision 4, is amended to read:
269.8 		Subd. 4.Asbestos-related work. "Asbestos-related work" means the enclosure, removal, 
269.9 	or encapsulation of asbestos-containing material in a quantity that meets or exceeds 260 
269.10 	linear feet of friable asbestos-containing material on pipes, 160 square feet of friable 
269.11 	asbestos-containing material on other facility components, or, if linear feet or square feet 
269.12 	cannot be measured, a total of 35 cubic feet of friable asbestos-containing material on or 
269.13 	off all facility components in one facility. In the case of single or multifamily residences, 
269.14 	"asbestos-related work" also means the enclosure, removal, or encapsulation of greater than 
269.15 	ten but less than 260 linear feet of friable asbestos-containing material on pipes, greater 
269.16 	than six but less than 160 square feet of friable asbestos-containing material on other facility 
269.17 	components, or, if linear feet or square feet cannot be measured, greater than one cubic foot 
269.18 	but less than 35 cubic feet of friable asbestos-containing material on or off all facility 
269.19 	components in one facility. This provision excludes asbestos-containing floor tiles and 
269.20 	sheeting, roofing materials, siding, and all ceilings with asbestos-containing material in 
269.21 	single family residences and buildings with no more than four dwelling units.
269.22 	Asbestos-related work includes asbestos abatement area preparation; enclosure, removal, 
269.23 	or encapsulation operations; and an air quality monitoring specified in rule to assure that 
269.24 	the abatement and adjacent areas are not contaminated with asbestos fibers during the project 
269.25 	and after completion.
269.26 	For purposes of this subdivision, the quantity of asbestos containingasbestos-containing
269.27 	material applies separately for every project.

269.28 	Sec. 95. Minnesota Statutes 2020, section 326.75, subdivision 1, is amended to read:
269.29 		Subdivision 1.Licensing fee. A person required to be licensed under section 326.72
269.30 	shall, before receipt of the license and before causing asbestos-related work to be performed, 
269.31 	pay the commissioner an annual license fee of $100 $105.

270.1 	Sec. 96. Minnesota Statutes 2020, section 326.75, subdivision 2, is amended to read:
270.2 		Subd. 2.Certification fee. An individual required to be certified as an asbestos worker 
270.3 	or asbestos site supervisor under section 326.73, subdivision 1, shall pay the commissioner 
270.4 	a certification fee of $50 $52.50 before the issuance of the certificate. The commissioner 
270.5 	may establish by rule fees required before the issuance of An individual required to be 
270.6 	certified as an asbestos inspector, asbestos management planner, and asbestos project 
270.7 	designer certificates required under section 326.73, subdivisions 2, 3, and 4, shall pay the 
270.8 	commissioner a certification fee of $105 before the issuance of the certificate.

270.9 	Sec. 97. Minnesota Statutes 2020, section 326.75, subdivision 3, is amended to read:
270.10 		Subd. 3.Permit fee. Five calendar days before beginning asbestos-related work, a person 
270.11 	shall pay a project permit fee to the commissioner equal to one two percent of the total costs 
270.12 	of the asbestos-related work. For asbestos-related work performed in single or multifamily 
270.13 	residences, of greater than ten but less than 260 linear feet of asbestos-containing material 
270.14 	on pipes, or greater than six but less than 160 square feet of asbestos-containing material 
270.15 	on other facility components, a person shall pay a project permit fee of $35 to the 
270.16 	commissioner.

270.17 	Sec. 98. Laws 2020, Seventh Special Session chapter 1, article 6, section 12, subdivision 
270.18 	4, is amended to read:
270.19 		Subd. 4.Housing with services establishment registration; conversion to an assisted 
270.20 	living facility license.  (a) Housing with services establishments registered under chapter 
270.21 	144D, providing home care services according to chapter 144A to at least one resident, and 
270.22 	intending to provide assisted living services on or after August 1, 2021, must submit an 
270.23 	application for an assisted living facility license in accordance with section 144G.12 no 
270.24 	later than June 1, 2021. The commissioner shall consider the application in accordance with 
270.25 	section 144G.16 144G.15.
270.26 	(b) Notwithstanding the housing with services contract requirements identified in section 
270.27 	144D.04, any existing housing with services establishment registered under chapter 144D 
270.28 	that does not intend to convert its registration to an assisted living facility license under this 
270.29 	chapter must provide written notice to its residents at least 60 days before the expiration of 
270.30 	its registration, or no later than May 31, 2021, whichever is earlier. The notice must:
270.31 	(1) state that the housing with services establishment does not intend to convert to an 
270.32 	assisted living facility;
271.1 	(2) include the date when the housing with services establishment will no longer provide 
271.2 	housing with services;
271.3 	(3) include the name, e-mail address, and phone number of the individual associated 
271.4 	with the housing with services establishment that the recipient of home care services may 
271.5 	contact to discuss the notice;
271.6 	(4) include the contact information consisting of the phone number, e-mail address, 
271.7 	mailing address, and website for the Office of Ombudsman for Long-Term Care and the 
271.8 	Office of Ombudsman for Mental Health and Developmental Disabilities; and
271.9 	(5) for residents who receive home and community-based waiver services under section 
271.10 	256B.49 and chapter 256S, also be provided to the resident's case manager at the same time 
271.11 	that it is provided to the resident.
271.12 	(c) A housing with services registrant that obtains an assisted living facility license, but 
271.13 	does so under a different business name as a result of reincorporation, and continues to 
271.14 	provide services to the recipient, is not subject to the 60-day notice required under paragraph 
271.15 	(b). However, the provider must otherwise provide notice to the recipient as required under 
271.16 	sections 144D.04 and 144D.045, as applicable, and section 144D.09.
271.17 	(d) All registered housing with services establishments providing assisted living under 
271.18 	sections 144G.01 to 144G.07 prior to August 1, 2021, must have an assisted living facility 
271.19 	license under this chapter.
271.20 	(e) Effective August 1, 2021, any housing with services establishment registered under 
271.21 	chapter 144D that has not converted its registration to an assisted living facility license 
271.22 	under this chapter is prohibited from providing assisted living services.

271.23 	EFFECTIVE DATE. This section is effective retroactively from December 17, 2020.

271.24 	Sec. 99. ADDITIONAL MEMBER TO COVID-19 VACCINE ALLOCATION 
271.25 	ADVISORY GROUP.
 271.26 	The commissioner of health shall appoint an individual who is an expert on vaccine 
271.27 	disinformation to the state COVID-19 Vaccine Allocation Advisory Group no later than 
271.28 	.......

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

272.1 	Sec. 100. FEDERAL SCHEDULE I EXEMPTION APPLICATION FOR MEDICAL 
272.2 	USE OF CANNABIS.
 272.3 	By September 1, 2021, the commissioner of health shall apply to the Drug Enforcement 
272.4 	Administration's Office of Diversion Control for an exception under Code of Federal 
272.5 	Regulations, title 21, section 1307.03, and request formal written acknowledgment that the 
272.6 	listing of marijuana, marijuana extract, and tetrahydrocannabinols as controlled substances 
272.7 	in federal Schedule I does not apply to the protected activities in Minnesota Statutes, section 
272.8 	152.32, subdivision 2, pursuant to the medical cannabis program established under Minnesota 
272.9 	Statutes, sections 152.22 to 152.37. The application shall include the presumption in 
272.10 	Minnesota Statutes, section 152.32, subdivision 1.

272.11 	Sec. 101. MENTAL HEALTH CULTURAL COMMUNITY CONTINUING 
272.12 	EDUCATION GRANT PROGRAM.
 272.13 	The commissioner of health shall develop a grant program, in consultation with the 
272.14 	relevant mental health licensing boards, to provide for the continuing education necessary 
272.15 	for social workers, marriage and family therapists, psychologists, and professional clinical 
272.16 	counselors who are members of communities of color or underrepresented communities, 
272.17 	as defined in Minnesota Statutes, section 148E.010, subdivision 20, and who work for 
272.18 	community mental health providers, to become supervisors for individuals pursuing licensure 
272.19 	in mental health professions.

272.20 	Sec. 102. RECOMMENDATIONS; EXPANDED ACCESS TO DATA FROM 
272.21 	ALL-PAYER CLAIMS DATABASE.
 272.22 	The commissioner of health shall develop recommendations to expand access to data 
272.23 	in the all-payer claims database under Minnesota Statutes, section 62U.04, to additional 
272.24 	outside entities for public health or research purposes. In the recommendations, the 
272.25 	commissioner must address an application process for outside entities to access the data, 
272.26 	how the department will exercise ongoing oversight over data use by outside entities, 
272.27 	purposes for which the data may be used by outside entities, establishment of a data access 
272.28 	committee to advise the department on selecting outside entities that may access the data, 
272.29 	and steps outside entities must take to protect data held by those entities from unauthorized 
272.30 	use. Following development of these recommendations, an outside entity that accesses data 
272.31 	in compliance with these recommendations may publish results that identify hospitals, 
272.32 	clinics, and medical practices so long as no individual health professionals are identified 
272.33 	and the commissioner finds the data to be accurate, valid, and suitable for publication for 
273.1 	such use. The commissioner shall submit these recommendations by December 15, 2021, 
273.2 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
273.3 	over health policy and civil law.

273.4 	Sec. 103. SKIN LIGHTENING PRODUCTS PUBLIC AWARENESS AND 
273.5 	EDUCATION GRANT PROGRAM.
 273.6 		Subdivision 1.Establishment; purpose. The commissioner of health shall develop a 
273.7 	grant program for the purpose of increasing public awareness and education on the health 
273.8 	dangers associated with using skin lightening creams and products that contain mercury 
273.9 	that are manufactured in other countries and brought into this country and sold illegally 
273.10 	online or in stores.
273.11 		Subd. 2.Grants authorized. The commissioner shall award grants through a request 
273.12 	for proposal process to community-based, nonprofit organizations that serve ethnic 
273.13 	communities and that focus on public health outreach to Black, Indigenous, and people of 
273.14 	color communities on the issue of skin lightening products and chemical exposure from 
273.15 	these products. Priority in awarding grants shall be given to organizations that have 
273.16 	historically provided services to ethnic communities on the skin lightening and chemical 
273.17 	exposure issue for the past three years.
273.18 		Subd. 3.Grant allocation. (a) Grantees must use the funds to conduct public awareness 
273.19 	and education activities that are culturally specific and community-based and focus on:
273.20 	(1) the dangers of exposure to mercury through dermal absorption, inhalation, 
273.21 	hand-to-mouth contact, and through contact with individuals who have used these skin 
273.22 	lightening products;
273.23 	(2) the signs and symptoms of mercury poisoning;
273.24 	(3) the health effects of mercury poisoning, including the permanent effects on the central 
273.25 	nervous system and kidneys;
273.26 	(4) the dangers of using these products or being exposed to these products during 
273.27 	pregnancy and breastfeeding to the mother and to the infant;
273.28 	(5) knowing how to identify products that contain mercury; and
273.29 	(6) proper disposal of the product if the product contains mercury.
273.30 	(b) The grant application must include:
273.31 	(1) a description of the purpose or project for which the grant funds will be used;
274.1 	(2) a description of the objectives, a work plan, and a timeline for implementation; and
274.2 	(3) the community or group the grant proposes to focus on.

274.3 	Sec. 104. TRAUMA-INFORMED GUN VIOLENCE REDUCTION; PILOT 
274.4 	PROGRAM.
 274.5 		Subdivision 1.Pilot program. (a) The commissioner of health shall establish a pilot 
274.6 	program to aid in the reduction of trauma resulting from gun violence and address the root 
274.7 	causes of gun violence by making the following resources available to professionals and 
274.8 	organizations in health care, public health, mental health, social service, law enforcement, 
274.9 	and victim advocacy and other professionals who are most likely to encounter individuals 
274.10 	who have been victims, witnesses, or perpetrators of gun violence occurring in a community, 
274.11 	or in a domestic or other setting:
274.12 	(1) training on recognizing trauma as both a result and a cause of gun violence;
274.13 	(2) developing skills to address the effects of trauma on individuals and family members;
274.14 	(3) investments in community-based organizations to enable high-quality, targeted 
274.15 	services to individuals in need. This may include resources for additional training, hiring 
274.16 	of specialized staff needed to address trauma-related issues, management information 
274.17 	systems to facilitate data collection, and expansion of existing programming;
274.18 	(4) replication and expansion of effective community-based gun violence prevention 
274.19 	initiatives, such as Project Life, the Minneapolis Group Violence Intervention initiative, to 
274.20 	connect at-risk individuals to mental health services, job readiness programs, and employment 
274.21 	opportunities; and
274.22 	(5) education campaigns and outreach materials to educate communities, organizations, 
274.23 	and the public about the relationship between trauma and gun violence.
274.24 	(b) The pilot program shall address the traumatic effects of gun violence exposure using 
274.25 	a holistic treatment modality.
274.26 		Subd. 2.Program guidelines and protocols. (a) The commissioner, with advice from 
274.27 	an advisory panel knowledgeable about gun violence and its traumatic impact, shall develop 
274.28 	protocols and program guidelines that address resources and training to be used by 
274.29 	professionals who encounter individuals who have perpetrated or been impacted by gun 
274.30 	violence. Educational, training, and outreach material must be culturally appropriate for the 
274.31 	community and provided in multiple languages for those with limited English language 
274.32 	proficiency. The materials developed must address necessary responses by local, state, and 
275.1 	other governmental entities tasked with addressing gun violence. The protocols must include 
275.2 	a method of informing affected communities and local governments representing those 
275.3 	communities on effective strategies to target community, domestic, and other forms of gun 
275.4 	violence.
275.5 	(b) The commissioner may enter into contractual agreements with community-based 
275.6 	organizations or experts in the field to perform any of the activities under this section.
275.7 		Subd. 3.Report. By November 15, 2021, the commissioner shall submit a report on the 
275.8 	progress of the pilot program to the chairs and ranking minority members of the committees 
275.9 	with jurisdiction over health and public safety.

275.10 	Sec. 105. REVISOR INSTRUCTION.
 275.11 	The revisor of statutes shall amend the section headnote for Minnesota Statutes, section 
275.12 	62J.63, to read "HEALTH CARE PURCHASING AND PERFORMANCE 
275.13 	MEASUREMENT."

275.14 	Sec. 106. REPEALER.
 275.15 	Minnesota Statutes 2020, sections 62J.63, subdivision 3; 144.0721, subdivision 1; 
275.16 	144.0722; 144.0724, subdivision 10; and 144.693, are repealed.

275.17 	ARTICLE 4
275.18 	HEALTH-RELATED LICENSING BOARDS

275.19 	Section 1. Minnesota Statutes 2020, section 148.90, subdivision 2, is amended to read:
275.20 		Subd. 2.Members. (a) The members of the board shall:
275.21 	(1) be appointed by the governor;
275.22 	(2) be residents of the state;
275.23 	(3) serve for not more than two consecutive terms;
275.24 	(4) designate the officers of the board; and
275.25 	(5) administer oaths pertaining to the business of the board.
275.26 	(b) A public member of the board shall represent the public interest and shall not:
275.27 	(1) be a psychologist or have engaged in the practice of psychology;
275.28 	(2) be an applicant or former applicant for licensure;
276.1 	(3) be a member of another health profession and be licensed by a health-related licensing 
276.2 	board as defined under section 214.01, subdivision 2; the commissioner of health; or licensed, 
276.3 	certified, or registered by another jurisdiction;
276.4 	(4) be a member of a household that includes a psychologist; or
276.5 	(5) have conflicts of interest or the appearance of conflicts with duties as a board member.
276.6 	(c) At the time of their appointments, at least two members of the board must reside 
276.7 	outside of the seven-county metropolitan area.
276.8 	(d) At the time of their appointments, at least two members of the board must be members 
276.9 	of:
276.10 	(1) a community of color; or
276.11 	(2) an underrepresented community, defined as a group that is not represented in the 
276.12 	majority with respect to race, ethnicity, national origin, sexual orientation, gender identity, 
276.13 	or physical ability.

276.14 	Sec. 2. Minnesota Statutes 2020, section 148.911, is amended to read:
276.15 	148.911 CONTINUING EDUCATION.
276.16 	(a) Upon application for license renewal, a licensee shall provide the board with 
276.17 	satisfactory evidence that the licensee has completed continuing education requirements 
276.18 	established by the board. Continuing education programs shall be approved under section 
276.19 	148.905, subdivision 1, clause (10). The board shall establish by rule the number of 
276.20 	continuing education training hours required each year and may specify subject or skills 
276.21 	areas that the licensee shall address.
276.22 	(b) At least four of the required continuing education hours must be on increasing the 
276.23 	knowledge, understanding, self-awareness, and practice skills to competently address the 
276.24 	psychological needs of individuals from diverse socioeconomic and cultural backgrounds. 
276.25 	Topics include but are not limited to:
276.26 	(1) understanding culture, its functions, and strengths that exist in varied cultures;
276.27 	(2) understanding clients' cultures and differences among and between cultural groups;
276.28 	(3) understanding the nature of social diversity and oppression;
276.29 	(4) understanding cultural humility; and
276.30 	(5) understanding human diversity, meaning individual client differences that are 
276.31 	associated with the client's cultural group, including race, ethnicity, national origin, religious 
277.1 	affiliation, language, age, gender, gender identity, physical and mental capabilities, sexual 
277.2 	orientation, and socioeconomic status.

277.3 	EFFECTIVE DATE. This section is effective July 1, 2023.

277.4 	Sec. 3. Minnesota Statutes 2020, section 148B.30, subdivision 1, is amended to read:
277.5 		Subdivision 1.Creation. (a) There is created a Board of Marriage and Family Therapy 
277.6 	that consists of seven members appointed by the governor. Four members shall be licensed, 
277.7 	practicing marriage and family therapists, each of whom shall for at least five years 
277.8 	immediately preceding appointment, have been actively engaged as a marriage and family 
277.9 	therapist, rendering professional services in marriage and family therapy. One member shall 
277.10 	be engaged in the professional teaching and research of marriage and family therapy. Two 
277.11 	members shall be representatives of the general public who have no direct affiliation with 
277.12 	the practice of marriage and family therapy. All members shall have been a resident of the 
277.13 	state two years preceding their appointment. Of the first board members appointed, three 
277.14 	shall continue in office for two years, two members for three years, and two members, 
277.15 	including the chair, for terms of four years respectively. Their successors shall be appointed 
277.16 	for terms of four years each, except that a person chosen to fill a vacancy shall be appointed 
277.17 	only for the unexpired term of the board member whom the newly appointed member 
277.18 	succeeds. Upon the expiration of a board member's term of office, the board member shall 
277.19 	continue to serve until a successor is appointed and qualified.
277.20 	(b) At the time of their appointments, at least two members must reside outside of the 
277.21 	seven-county metropolitan area.
277.22 	(c) At the time of their appointments, at least two members must be members of:
277.23 	(1) a community of color; or
277.24 	(2) an underrepresented community, defined as a group that is not represented in the 
277.25 	majority with respect to race, ethnicity, national origin, sexual orientation, gender identity, 
277.26 	or physical ability.

277.27 	Sec. 4. Minnesota Statutes 2020, section 148B.31, is amended to read:
277.28 	148B.31 DUTIES OF THE BOARD.
277.29 	(a) The board shall:
277.30 	(1) adopt and enforce rules for marriage and family therapy licensing, which shall be 
277.31 	designed to protect the public;
278.1 	(2) develop by rule appropriate techniques, including examinations and other methods, 
278.2 	for determining whether applicants and licensees are qualified under sections 148B.29 to 
278.3 	148B.392;
278.4 	(3) issue licenses to individuals who are qualified under sections 148B.29 to 148B.392;
278.5 	(4) establish and implement procedures designed to assure that licensed marriage and 
278.6 	family therapists will comply with the board's rules;
278.7 	(5) study and investigate the practice of marriage and family therapy within the state in 
278.8 	order to improve the standards imposed for the licensing of marriage and family therapists 
278.9 	and to improve the procedures and methods used for enforcement of the board's standards;
278.10 	(6) formulate and implement a code of ethics for all licensed marriage and family 
278.11 	therapists; and
278.12 	(7) establish continuing education requirements for marriage and family therapists.
278.13 	(b) At least four of the 40 continuing education training hours required under Minnesota 
278.14 	Rules, part 5300.0320, subpart 2, must be on increasing the knowledge, understanding, 
278.15 	self-awareness, and practice skills that enable a marriage and family therapist to serve clients 
278.16 	from diverse socioeconomic and cultural backgrounds. Topics include but are not limited 
278.17 	to:
278.18 	(1) understanding culture, its functions, and strengths that exist in varied cultures;
278.19 	(2) understanding clients' cultures and differences among and between cultural groups;
278.20 	(3) understanding the nature of social diversity and oppression; and
278.21 	(4) understanding cultural humility.

278.22 	EFFECTIVE DATE. This section is effective July 1, 2023.

278.23 	Sec. 5. Minnesota Statutes 2020, section 148B.51, is amended to read:
278.24 	148B.51 BOARD OF BEHAVIORAL HEALTH AND THERAPY.
278.25 	(a) The Board of Behavioral Health and Therapy consists of 13 members appointed by 
278.26 	the governor. Five of the members shall be professional counselors licensed or eligible for 
278.27 	licensure under sections 148B.50 to 148B.593. Five of the members shall be alcohol and 
278.28 	drug counselors licensed under chapter 148F. Three of the members shall be public members 
278.29 	as defined in section 214.02. The board shall annually elect from its membership a chair 
278.30 	and vice-chair. The board shall appoint and employ an executive director who is not a 
278.31 	member of the board. The employment of the executive director shall be subject to the terms 
279.1 	described in section 214.04, subdivision 2a. Chapter 214 applies to the Board of Behavioral 
279.2 	Health and Therapy unless superseded by sections 148B.50 to 148B.593.
279.3 	(b) At the time of their appointments, at least three members must reside outside of the 
279.4 	seven-county metropolitan area.
279.5 	(c) At the time of their appointments, at least three members must be members of:
279.6 	(1) a community of color; or
279.7 	(2) an underrepresented community, defined as a group that is not represented in the 
279.8 	majority with respect to race, ethnicity, national origin, sexual orientation, gender identity, 
279.9 	or physical ability.

279.10 	Sec. 6. Minnesota Statutes 2020, section 148B.54, subdivision 2, is amended to read:
279.11 		Subd. 2.Continuing education. (a) At the completion of the first four years of licensure, 
279.12 	a licensee must provide evidence satisfactory to the board of completion of 12 additional 
279.13 	postgraduate semester credit hours or its equivalent in counseling as determined by the 
279.14 	board, except that no licensee shall be required to show evidence of greater than 60 semester 
279.15 	hours or its equivalent. In addition to completing the requisite graduate coursework, each 
279.16 	licensee shall also complete in the first four years of licensure a minimum of 40 hours of 
279.17 	continuing education activities approved by the board under Minnesota Rules, part 2150.2540. 
279.18 	Graduate credit hours successfully completed in the first four years of licensure may be 
279.19 	applied to both the graduate credit requirement and to the requirement for 40 hours of 
279.20 	continuing education activities. A licensee may receive 15 continuing education hours per 
279.21 	semester credit hour or ten continuing education hours per quarter credit hour. Thereafter, 
279.22 	at the time of renewal, each licensee shall provide evidence satisfactory to the board that 
279.23 	the licensee has completed during each two-year period at least the equivalent of 40 clock 
279.24 	hours of professional postdegree continuing education in programs approved by the board 
279.25 	and continues to be qualified to practice under sections 148B.50 to 148B.593.
279.26 	(b) At least four of the required 40 continuing education clock hours must be on increasing 
279.27 	the knowledge, understanding, self-awareness, and practice skills that enable a licensed 
279.28 	professional counselor and licensed professional clinical counselor to serve clients from 
279.29 	diverse socioeconomic and cultural backgrounds. Topics include but are not limited to:
279.30 	(1) understanding culture, culture's functions, and strengths that exist in varied cultures;
279.31 	(2) understanding clients' cultures and differences among and between cultural groups;
279.32 	(3) understanding the nature of social diversity and oppression; and
280.1 	(4) understanding cultural humility.

280.2 	EFFECTIVE DATE. This section is effective July 1, 2023.

280.3 	Sec. 7. Minnesota Statutes 2020, section 148E.010, is amended by adding a subdivision 
280.4 	to read:
280.5 		Subd. 7f.Cultural responsiveness. "Cultural responsiveness" means increasing the 
280.6 	knowledge, understanding, self-awareness, and practice skills that enable a social worker 
280.7 	to serve clients from diverse socioeconomic and cultural backgrounds including:
280.8 	(1) understanding culture, its functions, and strengths that exist in varied cultures;
280.9 	(2) understanding clients' cultures and differences among and between cultural groups;
280.10 	(3) understanding the nature of social diversity and oppression; and
280.11 	(4) understanding cultural humility.

280.12 	Sec. 8. Minnesota Statutes 2020, section 148E.130, subdivision 1, is amended to read:
280.13 		Subdivision 1.Total clock hours required. (a) A licensee must complete 40 hours of 
280.14 	continuing education for each two-year renewal term. At the time of license renewal, a 
280.15 	licensee must provide evidence satisfactory to the board that the licensee has completed the 
280.16 	required continuing education hours during the previous renewal term. Of the total clock 
280.17 	hours required:
280.18 	(1) all licensees must complete:
280.19 	(i) two hours in social work ethics as defined in section 148E.010; and
280.20 	(ii) four hours in cultural responsiveness;
280.21 	(2) licensed independent clinical social workers must complete 12 clock hours in one 
280.22 	or more of the clinical content areas specified in section 148E.055, subdivision 5, paragraph 
280.23 	(a), clause (2);
280.24 	(3) licensees providing licensing supervision according to sections 148E.100 to 148E.125, 
280.25 	must complete six clock hours in supervision as defined in section 148E.010; and
280.26 	(4) no more than half of the required clock hours may be completed via continuing 
280.27 	education independent learning as defined in section 148E.010.
280.28 	(b) If the licensee's renewal term is prorated to be less or more than 24 months, the total 
280.29 	number of required clock hours is prorated proportionately.

281.1 	Sec. 9. Minnesota Statutes 2020, section 148E.130, is amended by adding a subdivision 
281.2 	to read:
281.3 		Subd. 1b.New content clock hours required effective July 1, 2021. (a) The content 
281.4 	clock hours in subdivision 1, paragraph (a), clause (1), item (ii), apply to all new licenses 
281.5 	issued effective July 1, 2021, under section 148E.055.
281.6 	(b) Any licensee issued a license prior to July 1, 2021, under section 148E.055 must 
281.7 	comply with the clock hours in subdivision 1, including the content clock hours in subdivision 
281.8 	1, paragraph (a), clause (1), item (ii), at the first two-year renewal term after July 1, 2021.

281.9 	Sec. 10. Minnesota Statutes 2020, section 156.12, subdivision 2, is amended to read:
281.10 		Subd. 2.Authorized activities. No provision of this chapter shall be construed to prohibit:
281.11 	(a) a person from rendering necessary gratuitous assistance in the treatment of any animal 
281.12 	when the assistance does not amount to prescribing, testing for, or diagnosing, operating, 
281.13 	or vaccinating and when the attendance of a licensed veterinarian cannot be procured;
281.14 	(b) a person who is a regular student in an accredited or approved college of veterinary 
281.15 	medicine from performing duties or actions assigned by instructors or preceptors or working 
281.16 	under the direct supervision of a licensed veterinarian;
281.17 	(c) a veterinarian regularly licensed in another jurisdiction from consulting with a licensed 
281.18 	veterinarian in this state;
281.19 	(d) the owner of an animal and the owner's regular employee from caring for and 
281.20 	administering to the animal belonging to the owner, except where the ownership of the 
281.21 	animal was transferred for purposes of circumventing this chapter;
281.22 	(e) veterinarians who are in compliance with subdivision 6 and who are employed by 
281.23 	the University of Minnesota from performing their duties with the College of Veterinary 
281.24 	Medicine, College of Agriculture, Agricultural Experiment Station, Agricultural Extension 
281.25 	Service, Medical School, School of Public Health, or other unit within the university; or a 
281.26 	person from lecturing or giving instructions or demonstrations at the university or in 
281.27 	connection with a continuing education course or seminar to veterinarians or pathologists 
281.28 	at the University of Minnesota Veterinary Diagnostic Laboratory;
281.29 	(f) any person from selling or applying any pesticide, insecticide or herbicide;
281.30 	(g) any person from engaging in bona fide scientific research or investigations which 
281.31 	reasonably requires experimentation involving animals;
282.1 	(h) any employee of a licensed veterinarian from performing duties other than diagnosis, 
282.2 	prescription or surgical correction under the direction and supervision of the veterinarian, 
282.3 	who shall be responsible for the performance of the employee;
282.4 	(i) a graduate of a foreign college of veterinary medicine from working under the direct 
282.5 	personal instruction, control, or supervision of a veterinarian faculty member of the College 
282.6 	of Veterinary Medicine, University of Minnesota in order to complete the requirements 
282.7 	necessary to obtain an ECFVG or PAVE certificate;
282.8 	(j) a licensed chiropractor registered under section 148.01, subdivision 1a, from practicing 
282.9 	animal chiropractic.; or
282.10 	(k) a person certified by the Emergency Medical Services Regulatory Board under 
282.11 	chapter 144E from providing emergency medical care to a police dog wounded in the line 
282.12 	of duty.

282.13 	Sec. 11. MENTAL HEALTH PROFESSIONAL LICENSING SUPERVISION.
 282.14 	(a) The Board of Psychology, the Board of Marriage and Family Therapy, the Board of 
282.15 	Social Work, and the Board of Behavioral Health and Therapy must convene to develop 
282.16 	recommendations for:
282.17 	(1) providing certification of individuals across multiple mental health professions who 
282.18 	may serve as supervisors;
282.19 	(2) adopting a single, common supervision certificate for all mental health professional 
282.20 	education programs;
282.21 	(3) determining ways for internship hours to be counted toward licensure in mental 
282.22 	health professions; and
282.23 	(4) determining ways for practicum hours to count toward supervisory experience.
282.24 	(b) No later than February 1, 2023, the commissioners must submit a written report to 
282.25 	the members of the legislative committees with jurisdiction over health and human services 
282.26 	on the recommendations developed under paragraph (a).

282.27 	ARTICLE 5
282.28 	PRESCRIPTION DRUGS

282.29 	Section 1. [62J.841] DEFINITIONS.
282.30 		Subdivision 1.Scope. For purposes of sections 62J.841 to 62J.845, the following 
282.31 	definitions apply.
283.1 		Subd. 2.Consumer Price Index. "Consumer Price Index" means the Consumer Price 
283.2 	Index, Annual Average, for All Urban Consumers, CPI-U: U.S. City Average, All Items, 
283.3 	reported by the United States Department of Labor, Bureau of Labor Statistics, or its 
283.4 	successor or, if the index is discontinued, an equivalent index reported by a federal authority 
283.5 	or, if no such index is reported, "Consumer Price Index" means a comparable index chosen 
283.6 	by the Bureau of Labor Statistics.
283.7 		Subd. 3.Generic or off-patent drug. "Generic or off-patent drug" means any prescription 
283.8 	drug for which any exclusive marketing rights granted under the Federal Food, Drug, and 
283.9 	Cosmetic Act, section 351 of the federal Public Health Service Act, and federal patent law 
283.10 	have expired, including any drug-device combination product for the delivery of a generic 
283.11 	drug.
283.12 		Subd. 4.Manufacturer. "Manufacturer" has the meaning provided in section 151.01, 
283.13 	subdivision 14a.
283.14 		Subd. 5.Prescription drug. "Prescription drug" means a drug for human use subject 
283.15 	to United States Code, title 21, section 353(b)(1).
283.16 		Subd. 6.Wholesale acquisition cost. "Wholesale acquisition cost" has the meaning 
283.17 	provided in United States Code, title 42, section 1395w-3a.
283.18 		Subd. 7.Wholesale distributor. "Wholesale distributor" has the meaning provided in 
283.19 	section 151.441, subdivision 14.

283.20 	Sec. 2. [62J.842] EXCESSIVE PRICE INCREASES PROHIBITED.
283.21 		Subdivision 1.Prohibition. No manufacturer shall impose, or cause to be imposed, an 
283.22 	excessive price increase, whether directly or through a wholesale distributor, pharmacy, or 
283.23 	similar intermediary, on the sale of any generic or off-patent drug sold, dispensed, or 
283.24 	delivered to any consumer in the state.
283.25 		Subd. 2.Excessive price increase. A price increase is excessive for purposes of this 
283.26 	section when:
283.27 	(1) the price increase, adjusted for inflation utilizing the Consumer Price Index, exceeds:
283.28 	(i) 15 percent of the wholesale acquisition cost over the immediately preceding calendar 
283.29 	year; or
283.30 	(ii) 40 percent of the wholesale acquisition cost over the immediately preceding three 
283.31 	calendar years; and
284.1 	(2) the price increase, adjusted for inflation utilizing the Consumer Price Index, exceeds 
284.2 	$30 for:
284.3 	(i) a 30-day supply of the drug; or
284.4 	(ii) a course of treatment lasting less than 30 days.
284.5 		Subd. 3.Exemption. It is not a violation of this section for a wholesale distributor or 
284.6 	pharmacy to increase the price of a generic or off-patent drug if the price increase is directly 
284.7 	attributable to additional costs for the drug imposed on the wholesale distributor or pharmacy 
284.8 	by the manufacturer of the drug.

284.9 	Sec. 3. [62J.843] REGISTERED AGENT AND OFFICE WITHIN THE STATE.
284.10 	Any manufacturer that sells, distributes, delivers, or offers for sale any generic or 
284.11 	off-patent drug in the state is required to maintain a registered agent and office within the 
284.12 	state.

284.13 	Sec. 4. [62J.844] ENFORCEMENT.
284.14 		Subdivision 1.Notification. The commissioner of management and budget and any 
284.15 	other state agency that provides or purchases a pharmacy benefit except the Department of 
284.16 	Human Services, and any entity under contract with a state agency to provide a pharmacy 
284.17 	benefit other than an entity under contract with the Department of Human Services, shall 
284.18 	notify the manufacturer of a generic or off-patent drug, the attorney general, and the Board 
284.19 	of Pharmacy of any price increase that is in violation of section 62J.842.
284.20 		Subd. 2.Submission of drug cost statement and other information by manufacturer; 
284.21 	investigation by attorney general. (a) Within 45 days of receiving a notice under subdivision 
284.22 	1, the manufacturer of the generic or off-patent drug shall submit a drug cost statement to 
284.23 	the attorney general. The statement must:
284.24 	(1) itemize the cost components related to production of the drug;
284.25 	(2) identify the circumstances and timing of any increase in materials or manufacturing 
284.26 	costs that caused any increase during the preceding calendar year, or preceding three calendar 
284.27 	years as applicable, in the price of the drug; and
284.28 	(3) provide any other information that the manufacturer believes to be relevant to a 
284.29 	determination of whether a violation of section 62J.842 has occurred.
284.30 	(b) The attorney general may investigate whether a violation of section 62J.842 has 
284.31 	occurred, is occurring, or is about to occur, in accordance with section 8.31, subdivision 2.
285.1 		Subd. 3.Petition to court. (a) On petition of the attorney general, a court may issue an 
285.2 	order:
285.3 	(1) compelling the manufacturer of a generic or off-patent drug to:
285.4 	(i) provide the drug cost statement required under subdivision 2, paragraph (a); and
285.5 	(ii) answer interrogatories, produce records or documents, or be examined under oath, 
285.6 	as required by the attorney general under subdivision 2, paragraph (b);
285.7 	(2) restraining or enjoining a violation of sections 62J.841 to 62J.845, including issuing 
285.8 	an order requiring that drug prices be restored to levels that comply with section 62J.842;
285.9 	(3) requiring the manufacturer to provide an accounting to the attorney general of all 
285.10 	revenues resulting from a violation of section 62J.842;
285.11 	(4) requiring the manufacturer to repay to all consumers, including any third-party payers, 
285.12 	any money acquired as a result of a price increase that violates section 62J.842;
285.13 	(5) notwithstanding section 16A.151, requiring that all revenues generated from a 
285.14 	violation of section 62J.842 be remitted to the state and deposited into a special fund, to be 
285.15 	used for initiatives to reduce the cost to consumers of acquiring prescription drugs, if a 
285.16 	manufacturer is unable to determine the individual transactions necessary to provide the 
285.17 	repayments described in clause (4);
285.18 	(6) imposing a civil penalty of up to $10,000 per day for each violation of section 62J.842;
285.19 	(7) providing for the attorney general's recovery of its costs and disbursements incurred 
285.20 	in bringing an action against a manufacturer found in violation of section 62J.842, including 
285.21 	the costs of investigation and reasonable attorney's fees; and
285.22 	(8) providing any other appropriate relief, including any other equitable relief as 
285.23 	determined by the court.
285.24 	(b) For purposes of paragraph (a), clause (6), every individual transaction in violation 
285.25 	of section 62J.842 shall be considered a separate violation.
285.26 		Subd. 4.Private right of action. Any action brought pursuant to section 8.31, subdivision 
285.27 	3a, by a person injured by a violation of this section is for the benefit of the public.

286.1 	Sec. 5. [62J.845] PROHIBITION ON WITHDRAWAL OF GENERIC OR 
286.2 	OFF-PATENT DRUGS FOR SALE.
286.3 		Subdivision 1.Prohibition. A manufacturer of a generic or off-patent drug is prohibited 
286.4 	from withdrawing that drug from sale or distribution within this state for the purpose of 
286.5 	avoiding the prohibition on excessive price increases under section 62J.842.
286.6 		Subd. 2.Notice to board and attorney general. Any manufacturer that intends to 
286.7 	withdraw a generic or off-patent drug from sale or distribution within the state shall provide 
286.8 	a written notice of withdrawal to the Board of Pharmacy and the attorney general, at least 
286.9 	180 days prior to the withdrawal.
286.10 		Subd. 3.Financial penalty. The attorney general shall assess a penalty of $500,000 on 
286.11 	any manufacturer of a generic or off-patent drug that it determines has failed to comply 
286.12 	with the requirements of this section.

286.13 	Sec. 6. [62J.846] SEVERABILITY.
286.14 	If any provision of sections 62J.841 to 62J.845 or the application thereof to any person 
286.15 	or circumstance is held invalid for any reason in a court of competent jurisdiction, the 
286.16 	invalidity does not affect other provisions or any other application of sections 62J.841 to 
286.17 	62J.845 that can be given effect without the invalid provision or application.

286.18 	Sec. 7. Minnesota Statutes 2020, section 62Q.81, is amended by adding a subdivision to 
286.19 	read:
286.20 		Subd. 6.Prescription drug benefits. (a) A health plan company that offers individual 
286.21 	health plans must ensure that no fewer than 25 percent of the individual health plans the 
286.22 	company offers in each geographic area that the health plan company services at each level 
286.23 	of coverage described in subdivision 1, paragraph (b), clause (3), applies a predeductible, 
286.24 	flat-dollar amount co-payment structure to the entire drug benefit, including all tiers.
286.25 	(b) A health plan company that offers small group health plans must ensure that no fewer 
286.26 	than 25 percent of small group health plans the company offers in each geographic area that 
286.27 	the health plan company services at each level of coverage described in subdivision 1, 
286.28 	paragraph (b), clause (3), applies a predeductible, flat-dollar amount co-payment structure 
286.29 	to the entire drug benefit, including all tiers.
286.30 	(c) The highest allowable co-payment for the highest cost drug tier for health plans 
286.31 	offered pursuant to this subdivision must be no greater than 1/12 of the plan's out-of-pocket 
286.32 	maximum for an individual.
287.1 	(d) The flat-dollar amount co-payment tier structure for prescription drugs under this 
287.2 	subdivision must be graduated and proportionate.
287.3 	(e) All individual and small group health plans offered pursuant to this subdivision must 
287.4 	be:
287.5 	(1) clearly and appropriately named to aid the purchaser in the selection process;
287.6 	(2) marketed in the same manner as other health plans offered by the health plan company; 
287.7 	and
287.8 	(3) offered for purchase to any individual or small group.
287.9 	(f) This subdivision does not apply to catastrophic plans, grandfathered plans, large 
287.10 	group health plans, health savings accounts (HSAs), qualified high deductible health benefit 
287.11 	plans, limited health benefit plans, or short-term limited-duration health insurance policies.
287.12 	(g) Health plan companies must meet the requirements in this subdivision separately for 
287.13 	plans offered through MNsure under chapter 62V and plans offered outside of MNsure.

287.14 	EFFECTIVE DATE. This section is effective January 1, 2022, and applies to individual 
287.15 	and small group health plans offered, issued, or renewed on or after that date.

287.16 	Sec. 8. [62Q.83] PRESCRIPTION DRUG BENEFIT TRANSPARENCY AND 
287.17 	MANAGEMENT.
287.18 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
287.19 	the meanings given.
287.20 	(b) "Drug" has the meaning given in section 151.01, subdivision 5.
287.21 	(c) "Enrollee contract term" means the 12-month term during which benefits associated 
287.22 	with health plan company products are in effect. For managed care plans and county-based 
287.23 	purchasing plans under section 256B.69 and chapter 256L, enrollee contract term means a 
287.24 	single calendar quarter.
287.25 	(d) "Formulary" means a list of prescription drugs that have been developed by clinical 
287.26 	and pharmacy experts and represents the health plan company's medically appropriate and 
287.27 	cost-effective prescription drugs approved for use.
287.28 	(e) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, and 
287.29 	includes an entity that performs pharmacy benefits management for the health plan company.
287.30 	(f) "Pharmacy benefits management" means the administration or management of 
287.31 	prescription drug benefits provided by the health plan company for the benefit of its enrollees 
288.1 	and may include but is not limited to procurement of prescription drugs, clinical formulary 
288.2 	development and management services, claims processing, and rebate contracting and 
288.3 	administration.
288.4 	(g) "Prescription" has the meaning given in section 151.01, subdivision 16a.
288.5 		Subd. 2.Prescription drug benefit disclosure. (a) A health plan company that provides 
288.6 	prescription drug benefit coverage and uses a formulary must make its formulary and related 
288.7 	benefit information available by electronic means and, upon request, in writing at least 30 
288.8 	days prior to annual renewal dates.
288.9 	(b) Formularies must be organized and disclosed consistent with the most recent version 
288.10 	of the United States Pharmacopeia's Model Guidelines.
288.11 	(c) For each item or category of items on the formulary, the specific enrollee benefit 
288.12 	terms must be identified, including enrollee cost-sharing and expected out-of-pocket costs.
288.13 		Subd. 3.Formulary changes. (a) Once a formulary has been established, a health plan 
288.14 	company may, at any time during the enrollee's contract term:
288.15 	(1) expand its formulary by adding drugs to the formulary;
288.16 	(2) reduce co-payments or coinsurance; or
288.17 	(3) move a drug to a benefit category that reduces an enrollee's cost.
288.18 	(b) A health plan company may remove a brand name drug from its formulary or place 
288.19 	a brand name drug in a benefit category that increases an enrollee's cost only upon the 
288.20 	addition to the formulary of a generic or multisource brand name drug rated as therapeutically 
288.21 	equivalent according to the Food and Drug Administration (FDA) Orange Book or a biologic 
288.22 	drug rated as interchangeable according to the FDA Purple Book at a lower cost to the 
288.23 	enrollee and upon at least a 60-day notice to prescribers, pharmacists, and affected enrollees.
288.24 	(c) A health plan company may change utilization review requirements or move drugs 
288.25 	to a benefit category that increases an enrollee's cost during the enrollee's contract term 
288.26 	upon at least a 60-day notice to prescribers, pharmacists, and affected enrollees, provided 
288.27 	that these changes do not apply to enrollees who are currently taking the drugs affected by 
288.28 	these changes for the duration of the enrollee's contract term.
288.29 	(d) A health plan company may remove any drugs from its formulary that have been 
288.30 	deemed unsafe by the FDA; that have been withdrawn by either the FDA or the product 
288.31 	manufacturer; or when an independent source of research, clinical guidelines, or 
289.1 	evidence-based standards has issued drug-specific warnings or recommended changes in 
289.2 	drug usage.
289.3 		Subd. 4.Exclusion. This section does not apply to health coverage provided through 
289.4 	the State Employee Group Insurance Plan (SEGIP) under chapter 43A.

289.5 	Sec. 9. [62W.0751] ALTERNATIVE BIOLOGICAL PRODUCTS.
289.6 		Subdivision 1.Definitions. (a) For the purposes of this section, the following definitions 
289.7 	have the meanings given.
289.8 	(b) "Biological product" has the meaning given in section 151.01, subdivision 40.
289.9 	(c) "Biosimilar" or "biosimilar product" has the meaning given in section 151.01, 
289.10 	subdivision 43.
289.11 	(d) "Interchangeable biological product" has the meaning given in section 151.01, 
289.12 	subdivision 41.
289.13 	(e) "Reference biological product" has the meaning given in section 151.01, subdivision 
289.14 	44.
289.15 		Subd. 2.Pharmacy and provider choice related to dispensing reference biological 
289.16 	products, interchangeable biological products, or biosimilar products. (a) A pharmacy 
289.17 	benefit manager or health carrier must not require or demonstrate a preference for a pharmacy 
289.18 	or health care provider to prescribe or dispense a single biological product for which there 
289.19 	is a United States Food and Drug Administration-approved biosimilar or interchangeable 
289.20 	biological product relative to a reference biological product, except as provided in paragraph 
289.21 	(b).
289.22 	(b) If a pharmacy benefit manager or health carrier elects coverage of a product listed 
289.23 	in paragraph (a), it must also elect equivalent coverage for at least three reference, biosimilar, 
289.24 	or interchangeable biological products, or the total number of products that have been 
289.25 	approved by the United States Food and Drug Administration relative to the reference 
289.26 	product if less than three, for which the wholesale acquisition cost is less than the wholesale 
289.27 	acquisition cost of the product listed in paragraph (a).
289.28 	(c) A pharmacy benefit manager or health carrier must not impose limits on access to a 
289.29 	product required to be covered under paragraph (b) that are more restrictive than limits 
289.30 	imposed on access to a product listed in paragraph (a), or that otherwise have the same 
289.31 	effect as giving preferred status to a product listed in paragraph (a) over the product required 
289.32 	to be covered under paragraph (b).
290.1 	(d) This section does not apply to coverage provided through a public health care program 
290.2 	under chapter 256B or 256L, or health plan coverage through the State Employee Group 
290.3 	Insurance Plan (SEGIP) under chapter 43A.

290.4 	EFFECTIVE DATE. This section is effective January 1, 2022.

290.5 	Sec. 10. Minnesota Statutes 2020, section 62W.11, is amended to read:
290.6 	62W.11 GAG CLAUSE PROHIBITION.
290.7 	(a) No contract between a pharmacy benefit manager or health carrier and a pharmacy 
290.8 	or pharmacist shall prohibit, restrict, or penalize a pharmacy or pharmacist from disclosing 
290.9 	to an enrollee any health care information that the pharmacy or pharmacist deems appropriate 
290.10 	regarding the nature of treatment; the risks or alternatives; the availability of alternative 
290.11 	therapies, consultations, or tests; the decision of utilization reviewers or similar persons to 
290.12 	authorize or deny services; the process that is used to authorize or deny health care services 
290.13 	or benefits; or information on financial incentives and structures used by the health carrier 
290.14 	or pharmacy benefit manager.
290.15 	(b) A pharmacy or pharmacist must provide to an enrollee information regarding the 
290.16 	enrollee's total cost for each prescription drug dispensed where part or all of the cost of the 
290.17 	prescription is being paid or reimbursed by the employer-sponsored plan or by a health 
290.18 	carrier or pharmacy benefit manager, in accordance with section 151.214, subdivision 1.
290.19 	(c) A pharmacy benefit manager or health carrier must not prohibit a pharmacist or 
290.20 	pharmacy from discussing information regarding the total cost for pharmacy services for a 
290.21 	prescription drug, including the patient's co-payment amount and, the pharmacy's own usual 
290.22 	and customary price of for the prescription drug, the pharmacy's acquisition cost for the 
290.23 	prescription drug, and the amount the pharmacy is being reimbursed by the pharmacy benefit 
290.24 	manager or health carrier for the prescription drug.
290.25 	(d) A pharmacy benefit manager must not prohibit a pharmacist or pharmacy from 
290.26 	discussing with a health carrier the amount the pharmacy is being paid or reimbursed for a 
290.27 	prescription drug by the pharmacy benefit manager or the pharmacy's acquisition cost for 
290.28 	a prescription drug.
290.29 	(d) (e) A pharmacy benefit manager or health carrier must not prohibit a pharmacist or 
290.30 	pharmacy from discussing the availability of any therapeutically equivalent alternative 
290.31 	prescription drugs or alternative methods for purchasing the prescription drug, including 
290.32 	but not limited to paying out-of-pocket the pharmacy's usual and customary price when that 
291.1 	amount is less expensive to the enrollee than the amount the enrollee is required to pay for 
291.2 	the prescription drug under the enrollee's health plan.

291.3 	Sec. 11. Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to 
291.4 	read:
291.5 		Subd. 43.Biosimilar product. "Biosimilar" or "interchangeable biological product" 
291.6 	means a biological product that the United States Food and Drug Administration has licensed, 
291.7 	and determined to be "biosimilar" under United States Code, title 42, section 262(i)(2).

291.8 	EFFECTIVE DATE. This section is effective January 1, 2022.

291.9 	Sec. 12. Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to 
291.10 	read:
291.11 		Subd. 44.Reference biological product. "Reference biological product" means the 
291.12 	single biological product for which the United States Food and Drug Administration has 
291.13 	approved an initial biological product license application, against which other biological 
291.14 	products are evaluated for licensure as biosimilar products or interchangeable biological 
291.15 	products.

291.16 	EFFECTIVE DATE. This section is effective January 1, 2022.

291.17 	Sec. 13. Minnesota Statutes 2020, section 151.071, subdivision 1, is amended to read:
291.18 		Subdivision 1.Forms of disciplinary action. When the board finds that a licensee, 
291.19 	registrant, or applicant has engaged in conduct prohibited under subdivision 2, it may do 
291.20 	one or more of the following:
291.21 	(1) deny the issuance of a license or registration;
291.22 	(2) refuse to renew a license or registration;
291.23 	(3) revoke the license or registration;
291.24 	(4) suspend the license or registration;
291.25 	(5) impose limitations, conditions, or both on the license or registration, including but 
291.26 	not limited to: the limitation of practice to designated settings; the limitation of the scope 
291.27 	of practice within designated settings; the imposition of retraining or rehabilitation 
291.28 	requirements; the requirement of practice under supervision; the requirement of participation 
291.29 	in a diversion program such as that established pursuant to section 214.31 or the conditioning 
292.1 	of continued practice on demonstration of knowledge or skills by appropriate examination 
292.2 	or other review of skill and competence;
292.3 	(6) impose a civil penalty not exceeding $10,000 for each separate violation, except that 
292.4 	a civil penalty not exceeding $25,000 may be imposed for each separate violation of section 
292.5 	62J.842, the amount of the civil penalty to be fixed so as to deprive a licensee or registrant 
292.6 	of any economic advantage gained by reason of the violation, to discourage similar violations 
292.7 	by the licensee or registrant or any other licensee or registrant, or to reimburse the board 
292.8 	for the cost of the investigation and proceeding, including but not limited to, fees paid for 
292.9 	services provided by the Office of Administrative Hearings, legal and investigative services 
292.10 	provided by the Office of the Attorney General, court reporters, witnesses, reproduction of 
292.11 	records, board members' per diem compensation, board staff time, and travel costs and 
292.12 	expenses incurred by board staff and board members; and
292.13 	(7) reprimand the licensee or registrant.

292.14 	Sec. 14. Minnesota Statutes 2020, section 151.071, subdivision 2, is amended to read:
292.15 		Subd. 2.Grounds for disciplinary action. The following conduct is prohibited and is 
292.16 	grounds for disciplinary action:
292.17 	(1) failure to demonstrate the qualifications or satisfy the requirements for a license or 
292.18 	registration contained in this chapter or the rules of the board. The burden of proof is on 
292.19 	the applicant to demonstrate such qualifications or satisfaction of such requirements;
292.20 	(2) obtaining a license by fraud or by misleading the board in any way during the 
292.21 	application process or obtaining a license by cheating, or attempting to subvert the licensing 
292.22 	examination process. Conduct that subverts or attempts to subvert the licensing examination 
292.23 	process includes, but is not limited to: (i) conduct that violates the security of the examination 
292.24 	materials, such as removing examination materials from the examination room or having 
292.25 	unauthorized possession of any portion of a future, current, or previously administered 
292.26 	licensing examination; (ii) conduct that violates the standard of test administration, such as 
292.27 	communicating with another examinee during administration of the examination, copying 
292.28 	another examinee's answers, permitting another examinee to copy one's answers, or 
292.29 	possessing unauthorized materials; or (iii) impersonating an examinee or permitting an 
292.30 	impersonator to take the examination on one's own behalf;
292.31 	(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist 
292.32 	or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration, 
292.33 	conviction of a felony reasonably related to the practice of pharmacy. Conviction as used 
293.1 	in this subdivision includes a conviction of an offense that if committed in this state would 
293.2 	be deemed a felony without regard to its designation elsewhere, or a criminal proceeding 
293.3 	where a finding or verdict of guilt is made or returned but the adjudication of guilt is either 
293.4 	withheld or not entered thereon. The board may delay the issuance of a new license or 
293.5 	registration if the applicant has been charged with a felony until the matter has been 
293.6 	adjudicated;
293.7 	(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner 
293.8 	or applicant is convicted of a felony reasonably related to the operation of the facility. The 
293.9 	board may delay the issuance of a new license or registration if the owner or applicant has 
293.10 	been charged with a felony until the matter has been adjudicated;
293.11 	(5) for a controlled substance researcher, conviction of a felony reasonably related to 
293.12 	controlled substances or to the practice of the researcher's profession. The board may delay 
293.13 	the issuance of a registration if the applicant has been charged with a felony until the matter 
293.14 	has been adjudicated;
293.15 	(6) disciplinary action taken by another state or by one of this state's health licensing 
293.16 	agencies:
293.17 	(i) revocation, suspension, restriction, limitation, or other disciplinary action against a 
293.18 	license or registration in another state or jurisdiction, failure to report to the board that 
293.19 	charges or allegations regarding the person's license or registration have been brought in 
293.20 	another state or jurisdiction, or having been refused a license or registration by any other 
293.21 	state or jurisdiction. The board may delay the issuance of a new license or registration if an 
293.22 	investigation or disciplinary action is pending in another state or jurisdiction until the 
293.23 	investigation or action has been dismissed or otherwise resolved; and
293.24 	(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a 
293.25 	license or registration issued by another of this state's health licensing agencies, failure to 
293.26 	report to the board that charges regarding the person's license or registration have been 
293.27 	brought by another of this state's health licensing agencies, or having been refused a license 
293.28 	or registration by another of this state's health licensing agencies. The board may delay the 
293.29 	issuance of a new license or registration if a disciplinary action is pending before another 
293.30 	of this state's health licensing agencies until the action has been dismissed or otherwise 
293.31 	resolved;
293.32 	(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of 
293.33 	any order of the board, of any of the provisions of this chapter or any rules of the board or 
294.1 	violation of any federal, state, or local law or rule reasonably pertaining to the practice of 
294.2 	pharmacy;
294.3 	(8) for a facility, other than a pharmacy, licensed by the board, violations of any order 
294.4 	of the board, of any of the provisions of this chapter or the rules of the board or violation 
294.5 	of any federal, state, or local law relating to the operation of the facility;
294.6 	(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the 
294.7 	public, or demonstrating a willful or careless disregard for the health, welfare, or safety of 
294.8 	a patient; or pharmacy practice that is professionally incompetent, in that it may create 
294.9 	unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of 
294.10 	actual injury need not be established;
294.11 	(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it 
294.12 	is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy 
294.13 	technician or pharmacist intern if that person is performing duties allowed by this chapter 
294.14 	or the rules of the board;
294.15 	(11) for an individual licensed or registered by the board, adjudication as mentally ill 
294.16 	or developmentally disabled, or as a chemically dependent person, a person dangerous to 
294.17 	the public, a sexually dangerous person, or a person who has a sexual psychopathic 
294.18 	personality, by a court of competent jurisdiction, within or without this state. Such 
294.19 	adjudication shall automatically suspend a license for the duration thereof unless the board 
294.20 	orders otherwise;
294.21 	(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified 
294.22 	in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in 
294.23 	board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist 
294.24 	intern or performing duties specifically reserved for pharmacists under this chapter or the 
294.25 	rules of the board;
294.26 	(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on 
294.27 	duty except as allowed by a variance approved by the board;
294.28 	(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety 
294.29 	to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type 
294.30 	of material or as a result of any mental or physical condition, including deterioration through 
294.31 	the aging process or loss of motor skills. In the case of registered pharmacy technicians, 
294.32 	pharmacist interns, or controlled substance researchers, the inability to carry out duties 
294.33 	allowed under this chapter or the rules of the board with reasonable skill and safety to 
294.34 	patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type 
295.1 	of material or as a result of any mental or physical condition, including deterioration through 
295.2 	the aging process or loss of motor skills;
295.3 	(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas 
295.4 	dispenser, or controlled substance researcher, revealing a privileged communication from 
295.5 	or relating to a patient except when otherwise required or permitted by law;
295.6 	(16) for a pharmacist or pharmacy, improper management of patient records, including 
295.7 	failure to maintain adequate patient records, to comply with a patient's request made pursuant 
295.8 	to sections 144.291 to 144.298, or to furnish a patient record or report required by law;
295.9 	(17) fee splitting, including without limitation:
295.10 	(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate, 
295.11 	kickback, or other form of remuneration, directly or indirectly, for the referral of patients;
295.12 	(ii) referring a patient to any health care provider as defined in sections 144.291 to 
295.13 	144.298 in which the licensee or registrant has a financial or economic interest as defined 
295.14 	in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the 
295.15 	licensee's or registrant's financial or economic interest in accordance with section 144.6521; 
295.16 	and
295.17 	(iii) any arrangement through which a pharmacy, in which the prescribing practitioner 
295.18 	does not have a significant ownership interest, fills a prescription drug order and the 
295.19 	prescribing practitioner is involved in any manner, directly or indirectly, in setting the price 
295.20 	for the filled prescription that is charged to the patient, the patient's insurer or pharmacy 
295.21 	benefit manager, or other person paying for the prescription or, in the case of veterinary 
295.22 	patients, the price for the filled prescription that is charged to the client or other person 
295.23 	paying for the prescription, except that a veterinarian and a pharmacy may enter into such 
295.24 	an arrangement provided that the client or other person paying for the prescription is notified, 
295.25 	in writing and with each prescription dispensed, about the arrangement, unless such 
295.26 	arrangement involves pharmacy services provided for livestock, poultry, and agricultural 
295.27 	production systems, in which case client notification would not be required;
295.28 	(18) engaging in abusive or fraudulent billing practices, including violations of the 
295.29 	federal Medicare and Medicaid laws or state medical assistance laws or rules;
295.30 	(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted 
295.31 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
295.32 	to a patient;
296.1 	(20) failure to make reports as required by section 151.072 or to cooperate with an 
296.2 	investigation of the board as required by section 151.074;
296.3 	(21) knowingly providing false or misleading information that is directly related to the 
296.4 	care of a patient unless done for an accepted therapeutic purpose such as the dispensing and 
296.5 	administration of a placebo;
296.6 	(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as 
296.7 	established by any of the following:
296.8 	(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation 
296.9 	of section 609.215, subdivision 1 or 2;
296.10 	(ii) a copy of the record of a judgment of contempt of court for violating an injunction 
296.11 	issued under section 609.215, subdivision 4;
296.12 	(iii) a copy of the record of a judgment assessing damages under section 609.215, 
296.13 	subdivision 5; or
296.14 	(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2. 
296.15 	The board must investigate any complaint of a violation of section 609.215, subdivision 1 
296.16 	or 2;
296.17 	(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For 
296.18 	a pharmacist intern, pharmacy technician, or controlled substance researcher, performing 
296.19 	duties permitted to such individuals by this chapter or the rules of the board under a lapsed 
296.20 	or nonrenewed registration. For a facility required to be licensed under this chapter, operation 
296.21 	of the facility under a lapsed or nonrenewed license or registration; and
296.22 	(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge 
296.23 	from the health professionals services program for reasons other than the satisfactory 
296.24 	completion of the program.; and
296.25 	(25) for a manufacturer, a violation of section 62J.842 or section 62J.845.

296.26 	Sec. 15. [151.335] DELIVERY THROUGH COMMON CARRIER; COMPLIANCE 
296.27 	WITH TEMPERATURE REQUIREMENTS.
296.28 	In addition to complying with the requirements of Minnesota Rules, part 6800.3000, a 
296.29 	mail order or specialty pharmacy that employs the United States Postal Service or other 
296.30 	common carrier to deliver a filled prescription directly to a patient must ensure that the drug 
296.31 	is delivered in compliance with temperature requirements established by the manufacturer 
296.32 	of the drug. The pharmacy must develop written policies and procedures that are consistent 
297.1 	with United States Pharmacopeia, chapters 1079 and 1118, and with nationally recognized 
297.2 	standards issued by standard-setting or accreditation organizations recognized by the board 
297.3 	through guidance. The policies and procedures must be provided to the board upon request.

297.4 	Sec. 16. Minnesota Statutes 2020, section 151.555, subdivision 1, is amended to read:
297.5 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
297.6 	subdivision have the meanings given.
297.7 	(b) "Central repository" means a wholesale distributor that meets the requirements under 
297.8 	subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this 
297.9 	section.
297.10 	(c) "Distribute" means to deliver, other than by administering or dispensing.
297.11 	(d) "Donor" means:
297.12 	(1) a health care facility as defined in this subdivision;
297.13 	(2) a skilled nursing facility licensed under chapter 144A;
297.14 	(3) an assisted living facility registered under chapter 144D where there is centralized 
297.15 	storage of drugs and 24-hour on-site licensed nursing coverage provided seven days a week;
297.16 	(4) a pharmacy licensed under section 151.19, and located either in the state or outside 
297.17 	the state;
297.18 	(5) a drug wholesaler licensed under section 151.47;
297.19 	(6) a drug manufacturer licensed under section 151.252; or
297.20 	(7) an individual at least 18 years of age, provided that the drug or medical supply that 
297.21 	is donated was obtained legally and meets the requirements of this section for donation.
297.22 	(e) "Drug" means any prescription drug that has been approved for medical use in the 
297.23 	United States, is listed in the United States Pharmacopoeia or National Formulary, and 
297.24 	meets the criteria established under this section for donation; or any over-the-counter 
297.25 	medication that meets the criteria established under this section for donation. This definition 
297.26 	includes cancer drugs and antirejection drugs, but does not include controlled substances, 
297.27 	as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed 
297.28 	to a patient registered with the drug's manufacturer in accordance with federal Food and 
297.29 	Drug Administration requirements.
297.30 	(f) "Health care facility" means:
298.1 	(1) a physician's office or health care clinic where licensed practitioners provide health 
298.2 	care to patients;
298.3 	(2) a hospital licensed under section 144.50;
298.4 	(3) a pharmacy licensed under section 151.19 and located in Minnesota; or
298.5 	(4) a nonprofit community clinic, including a federally qualified health center; a rural 
298.6 	health clinic; public health clinic; or other community clinic that provides health care utilizing 
298.7 	a sliding fee scale to patients who are low-income, uninsured, or underinsured.
298.8 	(g) "Local repository" means a health care facility that elects to accept donated drugs 
298.9 	and medical supplies and meets the requirements of subdivision 4.
298.10 	(h) "Medical supplies" or "supplies" means any prescription and nonprescription medical 
298.11 	supplies needed to administer a prescription drug.
298.12 	(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is 
298.13 	sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or 
298.14 	unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose 
298.15 	packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules, 
298.16 	part 6800.3750.
298.17 	(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that 
298.18 	it does not include a veterinarian.

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

298.20 	Sec. 17. Minnesota Statutes 2020, section 151.555, subdivision 7, is amended to read:
298.21 		Subd. 7.Standards and procedures for inspecting and storing donated prescription 
298.22 	drugs and supplies. (a) A pharmacist or authorized practitioner who is employed by or 
298.23 	under contract with the central repository or a local repository shall inspect all donated 
298.24 	prescription drugs and supplies before the drug or supply is dispensed to determine, to the 
298.25 	extent reasonably possible in the professional judgment of the pharmacist or practitioner, 
298.26 	that the drug or supply is not adulterated or misbranded, has not been tampered with, is safe 
298.27 	and suitable for dispensing, has not been subject to a recall, and meets the requirements for 
298.28 	donation. The pharmacist or practitioner who inspects the drugs or supplies shall sign an 
298.29 	inspection record stating that the requirements for donation have been met. If a local 
298.30 	repository receives drugs and supplies from the central repository, the local repository does 
298.31 	not need to reinspect the drugs and supplies.
299.1 	(b) The central repository and local repositories shall store donated drugs and supplies 
299.2 	in a secure storage area under environmental conditions appropriate for the drug or supply 
299.3 	being stored. Donated drugs and supplies may not be stored with nondonated inventory. If 
299.4 	donated drugs or supplies are not inspected immediately upon receipt, a repository must 
299.5 	quarantine the donated drugs or supplies separately from all dispensing stock until the 
299.6 	donated drugs or supplies have been inspected and (1) approved for dispensing under the 
299.7 	program; (2) disposed of pursuant to paragraph (c); or (3) returned to the donor pursuant to 
299.8 	paragraph (d).
299.9 	(c) The central repository and local repositories shall dispose of all prescription drugs 
299.10 	and medical supplies that are not suitable for donation in compliance with applicable federal 
299.11 	and state statutes, regulations, and rules concerning hazardous waste.
299.12 	(d) In the event that controlled substances or prescription drugs that can only be dispensed 
299.13 	to a patient registered with the drug's manufacturer are shipped or delivered to a central or 
299.14 	local repository for donation, the shipment delivery must be documented by the repository 
299.15 	and returned immediately to the donor or the donor's representative that provided the drugs.
299.16 	(e) Each repository must develop drug and medical supply recall policies and procedures. 
299.17 	If a repository receives a recall notification, the repository shall destroy all of the drug or 
299.18 	medical supply in its inventory that is the subject of the recall and complete a record of 
299.19 	destruction form in accordance with paragraph (f). If a drug or medical supply that is the 
299.20 	subject of a Class I or Class II recall has been dispensed, the repository shall immediately 
299.21 	notify the recipient of the recalled drug or medical supply. A drug that potentially is subject 
299.22 	to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug 
299.23 	is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
299.24 	(f) A record of destruction of donated drugs and supplies that are not dispensed under 
299.25 	subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation 
299.26 	shall be maintained by the repository for at least five two years. For each drug or supply 
299.27 	destroyed, the record shall include the following information:
299.28 	(1) the date of destruction;
299.29 	(2) the name, strength, and quantity of the drug destroyed; and
299.30 	(3) the name of the person or firm that destroyed the drug.

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

300.1 	Sec. 18. Minnesota Statutes 2020, section 151.555, subdivision 11, is amended to read:
300.2 		Subd. 11.Forms and record-keeping requirements. (a) The following forms developed 
300.3 	for the administration of this program shall be utilized by the participants of the program 
300.4 	and shall be available on the board's website:
300.5 	(1) intake application form described under subdivision 5;
300.6 	(2) local repository participation form described under subdivision 4;
300.7 	(3) local repository withdrawal form described under subdivision 4;
300.8 	(4) drug repository donor form described under subdivision 6;
300.9 	(5) record of destruction form described under subdivision 7; and
300.10 	(6) drug repository recipient form described under subdivision 8.
300.11 	(b) All records, including drug inventory, inspection, and disposal of donated prescription 
300.12 	drugs and medical supplies, must be maintained by a repository for a minimum of five two
300.13 	years. Records required as part of this program must be maintained pursuant to all applicable 
300.14 	practice acts.
300.15 	(c) Data collected by the drug repository program from all local repositories shall be 
300.16 	submitted quarterly or upon request to the central repository. Data collected may consist of 
300.17 	the information, records, and forms required to be collected under this section.
300.18 	(d) The central repository shall submit reports to the board as required by the contract 
300.19 	or upon request of the board.

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

300.21 	Sec. 19. Minnesota Statutes 2020, section 151.555, is amended by adding a subdivision 
300.22 	to read:
300.23 		Subd. 14.Cooperation. The central repository, as approved by the Board of Pharmacy, 
300.24 	may enter into an agreement with another state that has an established drug repository or 
300.25 	drug donation program if the other state's program includes regulations to ensure the purity, 
300.26 	integrity, and safety of the drugs and supplies donated, to permit the central repository to 
300.27 	offer to another state program inventory that is not needed by a Minnesota resident and to 
300.28 	accept inventory from another state program to be distributed to local repositories and 
300.29 	dispensed to Minnesota residents in accordance with this program.

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

301.1 	Sec. 20. Minnesota Statutes 2020, section 256B.69, subdivision 6, is amended to read:
301.2 		Subd. 6.Service delivery. (a) Each demonstration provider shall be responsible for the 
301.3 	health care coordination for eligible individuals. Demonstration providers:
301.4 	(1) shall authorize and arrange for the provision of all needed health services including 
301.5 	but not limited to the full range of services listed in sections 256B.02, subdivision 8, and 
301.6 	256B.0625 in order to ensure appropriate health care is delivered to enrollees. 
301.7 	Notwithstanding section 256B.0621, demonstration providers that provide nursing home 
301.8 	and community-based services under this section shall provide relocation service coordination 
301.9 	to enrolled persons age 65 and over;
301.10 	(2) shall accept the prospective, per capita payment from the commissioner in return for 
301.11 	the provision of comprehensive and coordinated health care services for eligible individuals 
301.12 	enrolled in the program;
301.13 	(3) may contract with other health care and social service practitioners to provide services 
301.14 	to enrollees; and
301.15 	(4) shall institute recipient grievance procedures according to the method established 
301.16 	by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved 
301.17 	through this process shall be appealable to the commissioner as provided in subdivision 11.
301.18 	(b) Demonstration providers must comply with the standards for claims settlement under 
301.19 	section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health care and 
301.20 	social service practitioners to provide services to enrollees. A demonstration provider must 
301.21 	pay a clean claim, as defined in Code of Federal Regulations, title 42, section 447.45(b), 
301.22 	within 30 business days of the date of acceptance of the claim.
301.23 	(c) Managed care plans and county-based purchasing plans must comply with section 
301.24 	62Q.83.

301.25 	Sec. 21. STUDY OF PHARMACY AND PROVIDER CHOICE OF BIOLOGICAL 
301.26 	PRODUCTS.
 301.27 	The commissioner of health, within the limits of existing resources, shall analyze the 
301.28 	effect of Minnesota Statutes, section 62W.0751, on the net price for different payors of 
301.29 	biological products, interchangeable biological products, and biosimilar products. The 
301.30 	commissioner of health shall report findings to the chairs and ranking minority members 
301.31 	of the legislative committees with jurisdiction over health and human services policy and 
301.32 	finance, and insurance, by December 15, 2023.

302.1 	Sec. 22. STUDY OF TEMPERATURE MONITORING.
 302.2 	The Board of Pharmacy shall conduct a study to determine the appropriateness and 
302.3 	feasibility of requiring mail order and specialty pharmacies to enclose in each medication's 
302.4 	packaging a method by which the patient can easily detect improper storage or temperature 
302.5 	variations that may have occurred during the delivery of a medication. The board shall 
302.6 	report the results of the study by January 15, 2022, to the chairs and ranking minority 
302.7 	members of the legislative committees with jurisdiction over health finance and policy.

302.8 	ARTICLE 6
302.9 	HEALTH INSURANCE

302.10 	Section 1. Minnesota Statutes 2020, section 62A.04, subdivision 2, is amended to read:
302.11 		Subd. 2.Required provisions. Except as provided in subdivision 4 each such policy 
302.12 	delivered or issued for delivery to any person in this state shall contain the provisions 
302.13 	specified in this subdivision in the words in which the same appear in this section. The 
302.14 	insurer may, at its option, substitute for one or more of such provisions corresponding 
302.15 	provisions of different wording approved by the commissioner which are in each instance 
302.16 	not less favorable in any respect to the insured or the beneficiary. Such provisions shall be 
302.17 	preceded individually by the caption appearing in this subdivision or, at the option of the 
302.18 	insurer, by such appropriate individual or group captions or subcaptions as the commissioner 
302.19 	may approve.
302.20 	(1) A provision as follows:
302.21 	ENTIRE CONTRACT; CHANGES: This policy, including the endorsements and the 
302.22 	attached papers, if any, constitutes the entire contract of insurance. No change in this policy 
302.23 	shall be valid until approved by an executive officer of the insurer and unless such approval 
302.24 	be endorsed hereon or attached hereto. No agent has authority to change this policy or to 
302.25 	waive any of its provisions.
302.26 	(2) A provision as follows:
302.27 	TIME LIMIT ON CERTAIN DEFENSES: (a) After two years from the date of issue of 
302.28 	this policy no misstatements, except fraudulent misstatements, made by the applicant in the 
302.29 	application for such policy shall be used to void the policy or to deny a claim for loss incurred 
302.30 	or disability (as defined in the policy) commencing after the expiration of such two year 
302.31 	period.
303.1 	The foregoing policy provision shall not be so construed as to affect any legal requirement 
303.2 	for avoidance of a policy or denial of a claim during such initial two year period, nor to 
303.3 	limit the application of clauses (1), (2), (3), (4) and (5), in the event of misstatement with 
303.4 	respect to age or occupation or other insurance. A policy which the insured has the right to 
303.5 	continue in force subject to its terms by the timely payment of premium (1) until at least 
303.6 	age 50 or, (2) in the case of a policy issued after age 44, for at least five years from its date 
303.7 	of issue, may contain in lieu of the foregoing the following provisions (from which the 
303.8 	clause in parentheses may be omitted at the insurer's option) under the caption 
303.9 	"INCONTESTABLE":
303.10 	After this policy has been in force for a period of two years during the lifetime of the 
303.11 	insured (excluding any period during which the insured is disabled), it shall become 
303.12 	incontestable as to the statements contained in the application.
303.13 	(b) No claim for loss incurred or disability (as defined in the policy) commencing after 
303.14 	two years from the date of issue of this policy shall be reduced or denied on the ground that 
303.15 	a disease or physical condition not excluded from coverage by name or specific description 
303.16 	effective on the date of loss had existed prior to the effective date of coverage of this policy.
303.17 	(3)(a) Except as required for qualified health plans sold through MNsure to individuals 
303.18 	receiving advance payments of the premium tax credit, a provision as follows:
303.19 	GRACE PERIOD: A grace period of ..... (insert a number not less than "7" for weekly 
303.20 	premium policies, "10" for monthly premium policies and "31" for all other policies) days 
303.21 	will be granted for the payment of each premium falling due after the first premium, during 
303.22 	which grace period the policy shall continue in force.
303.23 	A policy which contains a cancellation provision may add, at the end of the above 
303.24 	provision,
303.25 	subject to the right of the insurer to cancel in accordance with the cancellation provision 
303.26 	hereof.
303.27 	A policy in which the insurer reserves the right to refuse any renewal shall have, at the 
303.28 	beginning of the above provision,
303.29 	Unless not less than five days prior to the premium due date the insurer has delivered 
303.30 	to the insured or has mailed to the insured's last address as shown by the records of the 
303.31 	insurer written notice of its intention not to renew this policy beyond the period for which 
303.32 	the premium has been accepted.
304.1 	(b) For qualified individual and small group health plans sold through MNsure to 
304.2 	individuals receiving advance payments of the premium tax credit, a grace period provision 
304.3 	must be included that complies with the Affordable Care Act and is no less restrictive than 
304.4 	the grace period required by the Affordable Care Act section 62A.65, subdivision 2a.
304.5 	(4) A provision as follows:
304.6 	REINSTATEMENT: If any renewal premium be not paid within the time granted the 
304.7 	insured for payment, a subsequent acceptance of premium by the insurer or by any agent 
304.8 	duly authorized by the insurer to accept such premium, without requiring in connection 
304.9 	therewith an application for reinstatement, shall reinstate the policy. If the insurer or such 
304.10 	agent requires an application for reinstatement and issues a conditional receipt for the 
304.11 	premium tendered, the policy will be reinstated upon approval of such application by the 
304.12 	insurer or, lacking such approval, upon the forty-fifth day following the date of such 
304.13 	conditional receipt unless the insurer has previously notified the insured in writing of its 
304.14 	disapproval of such application. For health plans described in section 62A.011, subdivision 
304.15 	3, clause (10), an insurer must accept payment of a renewal premium and reinstate the 
304.16 	policy, if the insured applies for reinstatement no later than 60 days after the due date for 
304.17 	the premium payment, unless:
304.18 	(1) the insured has in the interim left the state or the insurer's service area; or
304.19 	(2) the insured has applied for reinstatement on two or more prior occasions.
304.20 	The reinstated policy shall cover only loss resulting from such accidental injury as may 
304.21 	be sustained after the date of reinstatement and loss due to such sickness as may begin more 
304.22 	than ten days after such date. In all other respects the insured and insurer shall have the 
304.23 	same rights thereunder as they had under the policy immediately before the due date of the 
304.24 	defaulted premium, subject to any provisions endorsed hereon or attached hereto in 
304.25 	connection with the reinstatement. Any premium accepted in connection with a reinstatement 
304.26 	shall be applied to a period for which premium has not been previously paid, but not to any 
304.27 	period more than 60 days prior to the date of reinstatement. The last sentence of the above 
304.28 	provision may be omitted from any policy which the insured has the right to continue in 
304.29 	force subject to its terms by the timely payment of premiums (1) until at least age 50, or, 
304.30 	(2) in the case of a policy issued after age 44, for at least five years from its date of issue.
304.31 	(5) A provision as follows:
304.32 	NOTICE OF CLAIM: Written notice of claim must be given to the insurer within 20 
304.33 	days after the occurrence or commencement of any loss covered by the policy, or as soon 
304.34 	thereafter as is reasonably possible. Notice given by or on behalf of the insured or the 
305.1 	beneficiary to the insurer at ..... (insert the location of such office as the insurer may designate 
305.2 	for the purpose), or to any authorized agent of the insurer, with information sufficient to 
305.3 	identify the insured, shall be deemed notice to the insurer.
305.4 	In a policy providing a loss-of-time benefit which may be payable for at least two years, 
305.5 	an insurer may at its option insert the following between the first and second sentences of 
305.6 	the above provision:
305.7 	Subject to the qualifications set forth below, if the insured suffers loss of time on account 
305.8 	of disability for which indemnity may be payable for at least two years, the insured shall, 
305.9 	at least once in every six months after having given notice of claim, give to the insurer 
305.10 	notice of continuance of said disability, except in the event of legal incapacity. The period 
305.11 	of six months following any filing of proof by the insured or any payment by the insurer 
305.12 	on account of such claim or any denial of liability in whole or in part by the insurer shall 
305.13 	be excluded in applying this provision. Delay in the giving of such notice shall not impair 
305.14 	the insured's right to any indemnity which would otherwise have accrued during the period 
305.15 	of six months preceding the date on which such notice is actually given.
305.16 	(6) A provision as follows:
305.17 	CLAIM FORMS: The insurer, upon receipt of a notice of claim, will furnish to the 
305.18 	claimant such forms as are usually furnished by it for filing proofs of loss. If such forms 
305.19 	are not furnished within 15 days after the giving of such notice the claimant shall be deemed 
305.20 	to have complied with the requirements of this policy as to proof of loss upon submitting, 
305.21 	within the time fixed in the policy for filing proofs of loss, written proof covering the 
305.22 	occurrence, the character and the extent of the loss for which claim is made.
305.23 	(7) A provision as follows:
305.24 	PROOFS OF LOSS: Written proof of loss must be furnished to the insurer at its said 
305.25 	office in case of claim for loss for which this policy provides any periodic payment contingent 
305.26 	upon continuing loss within 90 days after the termination of the period for which the insurer 
305.27 	is liable and in case of claim for any other loss within 90 days after the date of such loss. 
305.28 	Failure to furnish such proof within the time required shall not invalidate nor reduce any 
305.29 	claim if it was not reasonably possible to give proof within such time, provided such proof 
305.30 	is furnished as soon as reasonably possible and in no event, except in the absence of legal 
305.31 	capacity, later than one year from the time proof is otherwise required.
305.32 	(8) A provision as follows:
306.1 	TIME OF PAYMENT OF CLAIMS: Indemnities payable under this policy for any loss 
306.2 	other than loss for which this policy provides periodic payment will be paid immediately 
306.3 	upon receipt of due written proof of such loss. Subject to due written proof of loss, all 
306.4 	accrued indemnities for loss for which this policy provides periodic payment will be paid 
306.5 	..... (insert period for payment which must not be less frequently than monthly) and any 
306.6 	balance remaining unpaid upon the termination of liability will be paid immediately upon 
306.7 	receipt of due written proof.
306.8 	(9) A provision as follows:
306.9 	PAYMENT OF CLAIMS: Indemnity for loss of life will be payable in accordance with 
306.10 	the beneficiary designation and the provisions respecting such payment which may be 
306.11 	prescribed herein and effective at the time of payment. If no such designation or provision 
306.12 	is then effective, such indemnity shall be payable to the estate of the insured. Any other 
306.13 	accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid 
306.14 	either to such beneficiary or to such estate. All other indemnities will be payable to the 
306.15 	insured.
306.16 	The following provisions, or either of them, may be included with the foregoing provision 
306.17 	at the option of the insurer:
306.18 	If any indemnity of this policy shall be payable to the estate of the insured, or to an 
306.19 	insured or beneficiary who is a minor or otherwise not competent to give a valid release, 
306.20 	the insurer may pay such indemnity, up to an amount not exceeding $..... (insert an amount 
306.21 	which shall not exceed $1,000), to any relative by blood or connection by marriage of the 
306.22 	insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any 
306.23 	payment made by the insurer in good faith pursuant to this provision shall fully discharge 
306.24 	the insurer to the extent of such payment.
306.25 	Subject to any written direction of the insured in the application or otherwise all or a 
306.26 	portion of any indemnities provided by this policy on account of hospital, nursing, medical, 
306.27 	or surgical services may, at the insurer's option and unless the insured requests otherwise 
306.28 	in writing not later than the time of filing proofs of such loss, be paid directly to the hospital 
306.29 	or person rendering such services; but it is not required that the service be rendered by a 
306.30 	particular hospital or person.
306.31 	(10) A provision as follows:
306.32 	PHYSICAL EXAMINATIONS AND AUTOPSY: The insurer at its own expense shall 
306.33 	have the right and opportunity to examine the person of the insured when and as often as it 
307.1 	may reasonably require during the pendency of a claim hereunder and to make an autopsy 
307.2 	in case of death where it is not forbidden by law.
307.3 	(11) A provision as follows:
307.4 	LEGAL ACTIONS: No action at law or in equity shall be brought to recover on this 
307.5 	policy prior to the expiration of 60 days after written proof of loss has been furnished in 
307.6 	accordance with the requirements of this policy. No such action shall be brought after the 
307.7 	expiration of three years after the time written proof of loss is required to be furnished.
307.8 	(12) A provision as follows:
307.9 	CHANGE OF BENEFICIARY: Unless the insured makes an irrevocable designation 
307.10 	of beneficiary, the right to change of beneficiary is reserved to the insured and the consent 
307.11 	of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this 
307.12 	policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy. 
307.13 	The first clause of this provision, relating to the irrevocable designation of beneficiary, may 
307.14 	be omitted at the insurer's option.

307.15 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
307.16 	sold, issued, or renewed on or after that date.

307.17 	Sec. 2. Minnesota Statutes 2020, section 62A.10, is amended by adding a subdivision to 
307.18 	read:
307.19 		Subd. 5.Prohibition on waiting periods that exceed 90 days. (a) For purposes of this 
307.20 	subdivision, "waiting period" means the period that must pass before coverage becomes 
307.21 	effective for an individual who is otherwise eligible to enroll under the terms of a group 
307.22 	health plan.
307.23 	(b) A health carrier offering a group health plan must not apply a waiting period that 
307.24 	exceeds 90 days, with exceptions for the circumstances described in paragraphs (c) to (e). 
307.25 	A health carrier does not violate this subdivision solely because an individual is permitted 
307.26 	to take additional time to elect coverage beyond the end of the 90-day waiting period.
307.27 	(c) If a group health plan conditions eligibility on an employee working full time or 
307.28 	regularly having a specified number of service hours per period, and the plan is unable to 
307.29 	determine whether a newly hired employee is full time or reasonably expected to regularly 
307.30 	work the specific number of hours per period, the plan may take a reasonable period of 
307.31 	time, not to exceed 12 months beginning on any date between the employee's start date and 
307.32 	the first day of the first calendar month after the employee's start date, to determine whether 
307.33 	the employee meets the plan's eligibility condition.
308.1 	(d) If a group health plan conditions eligibility on an employee having completed a 
308.2 	cumulative number of service hours, the cumulative hours-of-service requirement must not 
308.3 	exceed 1,200 hours.
308.4 	(e) An orientation period may be added to the 90-day waiting period if the orientation 
308.5 	period is one month or less. The one-month period is determined by adding one calendar 
308.6 	month and subtracting one calendar day, measured from an employee's start date in a position 
308.7 	that is otherwise eligible for coverage.
308.8 	(f) A group health plan may treat an employee whose employment has terminated and 
308.9 	is later rehired as newly eligible upon rehire and require the rehired employee to meet the 
308.10 	plan's eligibility criteria and waiting period again, if doing so is reasonable under the 
308.11 	circumstances. Treating an employee as rehired is reasonable if the employee has a break 
308.12 	in service of at least 13 weeks, or at least 26 weeks if the employer is an educational 
308.13 	institution.

308.14 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
308.15 	sold, issued, or renewed on or after that date.

308.16 	Sec. 3. Minnesota Statutes 2020, section 62A.15, is amended by adding a subdivision to 
308.17 	read:
308.18 		Subd. 3c.Mental health services. All benefits provided by a policy or contract referred 
308.19 	to in subdivision 1 relating to expenses incurred for mental health treatment or services 
308.20 	provided by a mental health professional must also include treatment and services provided 
308.21 	by a clinical trainee to the extent that the services and treatment are within the scope of 
308.22 	practice of the clinical trainee according to Minnesota Rules, part 9505.0371, subpart 5, 
308.23 	item C. This subdivision is intended to provide equal payment of benefits for mental health 
308.24 	treatment and services provided by a mental health professional, as defined in Minnesota 
308.25 	Rules, part 9505.0371, subpart 5, item A, or a clinical trainee and is not intended to change 
308.26 	or add to the benefits provided for in those policies or contracts.

308.27 	EFFECTIVE DATE. This section is effective January 1, 2022, and applies to policies 
308.28 	and contracts offered, issued, or renewed on or after that date.

308.29 	Sec. 4. Minnesota Statutes 2020, section 62A.15, subdivision 4, is amended to read:
308.30 		Subd. 4.Denial of benefits. (a) No carrier referred to in subdivision 1 may, in the 
308.31 	payment of claims to employees in this state, deny benefits payable for services covered by 
308.32 	the policy or contract if the services are lawfully performed by a licensed chiropractor, 
309.1 	licensed optometrist, a registered nurse meeting the requirements of subdivision 3a, or a 
309.2 	licensed acupuncture practitioner, or a mental health clinical trainee.
309.3 	(b) When carriers referred to in subdivision 1 make claim determinations concerning 
309.4 	the appropriateness, quality, or utilization of chiropractic health care for Minnesotans, any 
309.5 	of these determinations that are made by health care professionals must be made by, or 
309.6 	under the direction of, or subject to the review of licensed doctors of chiropractic.
309.7 	(c) When a carrier referred to in subdivision 1 makes a denial of payment claim 
309.8 	determination concerning the appropriateness, quality, or utilization of acupuncture services 
309.9 	for individuals in this state performed by a licensed acupuncture practitioner, a denial of 
309.10 	payment claim determination that is made by a health professional must be made by, under 
309.11 	the direction of, or subject to the review of a licensed acupuncture practitioner.

309.12 	EFFECTIVE DATE. This section is effective January 1, 2022.

309.13 	Sec. 5. Minnesota Statutes 2020, section 62A.65, subdivision 1, is amended to read:
309.14 		Subdivision 1.Applicability. No health carrier, as defined in section 62A.011, shall 
309.15 	offer, sell, issue, or renew any individual health plan, as defined in section 62A.011, to a 
309.16 	Minnesota resident except in compliance with this section. This section does not apply to 
309.17 	the Comprehensive Health Association established in section 62E.10. A health carrier must 
309.18 	only offer, sell, issue, or renew individual health plans on a guaranteed issue basis and at a 
309.19 	premium rate that does not vary based on the health status of the individual.

309.20 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
309.21 	sold, issued, or renewed on or after that date.

309.22 	Sec. 6. Minnesota Statutes 2020, section 62A.65, is amended by adding a subdivision to 
309.23 	read:
309.24 		Subd. 2a.Grace period for nonpayment of premium. (a) Notwithstanding any other 
309.25 	law to the contrary, an individual health plan may be canceled for nonpayment of premiums, 
309.26 	but must include a grace period as described in this subdivision.
309.27 	(b) The grace period must be three consecutive months. During the grace period, the 
309.28 	health carrier must:
309.29 	(1) pay all claims for services that would have been covered if the premium had been 
309.30 	paid, which are provided to the enrollee during the first month of the grace period, and may 
309.31 	pend claims for services provided to an enrollee in the second and third months of the grace 
309.32 	period; and
310.1 	(2) notify health care providers of the possibility of denied claims when an enrollee is 
310.2 	in the second and third month of the grace period.
310.3 	(c) In order to stop a cancellation, an enrollee must pay all outstanding premiums before 
310.4 	the end of the grace period.
310.5 	(d) If a health plan is canceled under this subdivision, the final day of the enrollment is 
310.6 	the last day of the first month of the three-month grace period.

310.7 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
310.8 	sold, issued, or renewed on or after that date.

310.9 	Sec. 7. Minnesota Statutes 2020, section 62D.095, subdivision 2, is amended to read:
310.10 		Subd. 2.Co-payments.  A health maintenance contract may impose a co-payment and 
310.11 	coinsurance consistent with the provisions of the Affordable Care Act as defined under 
310.12 	section 62A.011, subdivision 1a state and federal law.

310.13 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
310.14 	sold, issued, or renewed on or after that date.

310.15 	Sec. 8. Minnesota Statutes 2020, section 62D.095, subdivision 3, is amended to read:
310.16 		Subd. 3.Deductibles.  A health maintenance contract may impose a deductible consistent 
310.17 	with the provisions of the Affordable Care Act as defined under section 62A.011, subdivision 
310.18 	1a state and federal law.

310.19 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
310.20 	sold, issued, or renewed on or after that date.

310.21 	Sec. 9. Minnesota Statutes 2020, section 62D.095, subdivision 4, is amended to read:
310.22 		Subd. 4.Annual out-of-pocket maximums.  A health maintenance contract may impose 
310.23 	an annual out-of-pocket maximum consistent with the provisions of the Affordable Care 
310.24 	Act as defined under section 62A.011, subdivision 1a section 62Q.677, subdivision 6a.

310.25 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
310.26 	sold, issued, or renewed on or after that date.

310.27 	Sec. 10. Minnesota Statutes 2020, section 62D.095, subdivision 5, is amended to read:
310.28 		Subd. 5.Exceptions. No co-payments or deductibles may be imposed on preventive 
310.29 	health care items and services consistent with the provisions of the Affordable Care Act as 
311.1 	defined under section 62A.011, subdivision 1a, as defined in section 62Q.46, subdivision 
311.2 	1.

311.3 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
311.4 	sold, issued, or renewed on or after that date.

311.5 	Sec. 11. Minnesota Statutes 2020, section 62Q.01, subdivision 2a, is amended to read:
311.6 		Subd. 2a.Dependent child to the limiting age. "Dependent child to the limiting age" 
311.7 	or "dependent children to the limiting age" means those individuals who are eligible and 
311.8 	covered as a dependent child under the terms of a health plan who have not yet attained 26 
311.9 	years of age. A health plan company must not deny or restrict eligibility for a dependent 
311.10 	child to the limiting age based on financial dependency, residency, marital status, or student 
311.11 	status. For coverage under plans offered by the Minnesota Comprehensive Health 
311.12 	Association, dependent to the limiting age means dependent as defined in section 62A.302, 
311.13 	subdivision 3. Notwithstanding the provisions in this subdivision, a health plan may include:
311.14 	(1) eligibility requirements regarding the absence of other health plan coverage as 
311.15 	permitted by the Affordable Care Act for grandfathered plan coverage; or
311.16 	(2) an age greater than 26 in its policy, contract, or certificate of coverage.

311.17 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
311.18 	sold, issued, or renewed on or after that date.

311.19 	Sec. 12. [62Q.097] REQUIREMENTS FOR TIMELY PROVIDER 
311.20 	CREDENTIALING.
311.21 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
311.22 	(b) "Clean application for provider credentialing" or "clean application" means an 
311.23 	application for provider credentialing submitted by a health care provider to a health plan 
311.24 	company that is complete, is in the format required by the health plan company, and includes 
311.25 	all information and substantiation required by the health plan company and does not require 
311.26 	evaluation of any identified potential quality or safety concern.
311.27 	(c) "Provider credentialing" means the process undertaken by a health plan company to 
311.28 	evaluate and approve a health care provider's education, training, residency, licenses, 
311.29 	certifications, and history of significant quality or safety concerns in order to approve the 
311.30 	health care provider to provide health care services to patients at a clinic or facility.
312.1 		Subd. 2.Time limit for credentialing determination. A health plan company that 
312.2 	receives an application for provider credentialing must:
312.3 	(1) if the application is determined to be a clean application for provider credentialing 
312.4 	and if the health care provider submitting the application or the clinic or facility at which 
312.5 	the health care provider provides services requests the information, affirm that the health 
312.6 	care provider's application is a clean application and notify the health care provider or clinic 
312.7 	or facility of the date by which the health plan company will make a determination on the 
312.8 	health care provider's application;
312.9 	(2) if the application is determined not to be a clean application, inform the health care 
312.10 	provider of the application's deficiencies or missing information or substantiation within 
312.11 	three business days after the health plan company determines the application is not a clean 
312.12 	application; and
312.13 	(3) make a determination on the health care provider's clean application within 45 days 
312.14 	after receiving the clean application unless the health plan company identifies a substantive 
312.15 	quality or safety concern in the course of provider credentialing that requires further 
312.16 	investigation. Upon notice to the health care provider, clinic, or facility, the health plan 
312.17 	company is allowed 30 additional days to investigate any quality or safety concerns.

312.18 	EFFECTIVE DATE; APPLICATION. This section applies to applications for provider 
312.19 	credentialing submitted to a health plan company on or after January 1, 2022.

312.20 	Sec. 13. Minnesota Statutes 2020, section 62Q.46, is amended to read:
312.21 	62Q.46 PREVENTIVE ITEMS AND SERVICES.
312.22 		Subdivision 1.Coverage for preventive items and services. (a) "Preventive items and 
312.23 	services" has the meaning specified in the Affordable Care Act means the items and services 
312.24 	categorized as preventive under subdivision 1a.
312.25 	(b) A health plan company must provide coverage for preventive items and services at 
312.26 	a participating provider without imposing cost-sharing requirements, including a deductible, 
312.27 	coinsurance, or co-payment. Nothing in this section prohibits a health plan company that 
312.28 	has a network of providers from excluding coverage or imposing cost-sharing requirements 
312.29 	for preventive items or services that are delivered by an out-of-network provider.
312.30 	(c) A health plan company is not required to provide coverage for any items or services 
312.31 	specified in any recommendation or guideline described in paragraph (a) if the 
312.32 	recommendation or guideline is no longer included as a preventive item or service as defined 
312.33 	in paragraph (a). Annually, a health plan company must determine whether any additional 
313.1 	items or services must be covered without cost-sharing requirements or whether any items 
313.2 	or services are no longer required to be covered.
313.3 	(d) Nothing in this section prevents a health plan company from using reasonable medical 
313.4 	management techniques to determine the frequency, method, treatment, or setting for a 
313.5 	preventive item or service to the extent not specified in the recommendation or guideline.
313.6 	(e) This section does not apply to grandfathered plans.
313.7 	(f) This section does not apply to plans offered by the Minnesota Comprehensive Health 
313.8 	Association.
313.9 		Subd. 1a.Preventive items and services. The commissioner of commerce must provide 
313.10 	health plan companies with information regarding which items and services must be 
313.11 	categorized as preventive.
313.12 		Subd. 2.Coverage for office visits in conjunction with preventive items and 
313.13 	services. (a) A health plan company may impose cost-sharing requirements with respect to 
313.14 	an office visit if a preventive item or service is billed separately or is tracked separately as 
313.15 	individual encounter data from the office visit.
313.16 	(b) A health plan company must not impose cost-sharing requirements with respect to 
313.17 	an office visit if a preventive item or service is not billed separately or is not tracked 
313.18 	separately as individual encounter data from the office visit and the primary purpose of the 
313.19 	office visit is the delivery of the preventive item or service.
313.20 	(c) A health plan company may impose cost-sharing requirements with respect to an 
313.21 	office visit if a preventive item or service is not billed separately or is not tracked separately 
313.22 	as individual encounter data from the office visit and the primary purpose of the office visit 
313.23 	is not the delivery of the preventive item or service.
313.24 		Subd. 3.Additional services not prohibited. Nothing in this section prohibits a health 
313.25 	plan company from providing coverage for preventive items and services in addition to 
313.26 	those specified in the Affordable Care Act subdivision 1a, or from denying coverage for 
313.27 	preventive items and services that are not recommended as preventive items and services 
313.28 	under the Affordable Care Act subdivision 1a. A health plan company may impose 
313.29 	cost-sharing requirements for a treatment not described in the Affordable Care Act
313.30 	subdivision 1a even if the treatment results from a preventive item or service described in 
313.31 	the Affordable Care Act subdivision 1a.

313.32 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
313.33 	sold, issued, or renewed on or after that date.

314.1 	Sec. 14. [62Q.472] SCREENING AND TESTING FOR OPIOIDS.
314.2 	(a) A health plan company shall not place a lifetime or annual limit on screenings and 
314.3 	urinalysis testing for opioids for an enrollee in an inpatient or outpatient substance use 
314.4 	disorder treatment program when ordered by a health care provider and performed by an 
314.5 	accredited clinical laboratory. A health plan company is not prohibited from conducting a 
314.6 	medical necessity review when screenings or urinalysis testing for an enrollee exceeds 24 
314.7 	tests in any 12-month period.
314.8 	(b) This section does not apply to managed care plans or county-based purchasing plans 
314.9 	when the plan is providing coverage to public health care program enrollees under chapter 
314.10 	256B or 256L.

314.11 	EFFECTIVE DATE. This section is effective January 1, 2022, and applies to health 
314.12 	plans offered, issued, or renewed on or after that date.

314.13 	Sec. 15. [62Q.521] COVERAGE OF CONTRACEPTIVES AND CONTRACEPTIVE 
314.14 	SERVICES.
314.15 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
314.16 	(b) "Closely held for-profit entity" means an entity that:
314.17 	(1) is not a nonprofit entity;
314.18 	(2) has more than 50 percent of the value of its ownership interest owned directly or 
314.19 	indirectly by five or fewer individuals, or has an ownership structure that is substantially 
314.20 	similar; and
314.21 	(3) has no publicly traded ownership interest, having any class of common equity 
314.22 	securities required to be registered under United States Code, title 15, section 781.
314.23 	For purposes of this paragraph:
314.24 	(i) ownership interests owned by a corporation, partnership, estate, or trust are considered 
314.25 	owned proportionately by that entity's shareholders, partners, or beneficiaries;
314.26 	(ii) ownership interests owned by a nonprofit entity are considered owned by a single 
314.27 	owner;
314.28 	(iii) ownership interests owned by an individual are considered owned, directly or 
314.29 	indirectly, by or for the individual's family. For purposes of this item, "family" means 
314.30 	brothers and sisters, including half-brothers and half-sisters, a spouse, ancestors, and lineal 
314.31 	descendants; and
315.1 	(iv) if an individual or entity holds an option to purchase an ownership interest, the 
315.2 	individual or entity is considered to be the owner of those ownership interests.
315.3 	(c) "Contraceptive" means a drug, device, or other product approved by the Food and 
315.4 	Drug Administration to prevent unintended pregnancy.
315.5 	(d) "Contraceptive service" means consultation, examination, procedure, and medical 
315.6 	service related to the prevention of unintended pregnancy. This includes but is not limited 
315.7 	to voluntary sterilization procedures, patient education, counseling on contraceptives, and 
315.8 	follow-up services related to contraceptives or contraceptive services, management of side 
315.9 	effects, counseling for continued adherence, and device insertion or removal.
315.10 	(e) "Eligible organization" means an organization that opposes providing coverage for 
315.11 	some or all contraceptives or contraceptive services on account of religious objections and 
315.12 	that is:
315.13 	(1) organized as a nonprofit entity and holds itself as a religious employer; or
315.14 	(2) organized and operates as a closely held for-profit entity, and the organization's 
315.15 	highest governing body has adopted, under the organization's applicable rules of governance 
315.16 	and consistent with state law, a resolution or similar action establishing that it objects to 
315.17 	covering some or all contraceptives or contraceptive services on account of the owners' 
315.18 	sincerely held religious beliefs.
315.19 	(f) "Medical necessity" includes but is not limited to considerations such as severity of 
315.20 	side effects, difference in permanence and reversibility of a contraceptive or contraceptive 
315.21 	service, and ability to adhere to the appropriate use of the contraceptive method or service, 
315.22 	as determined by the attending provider.
315.23 	(g) "Religious employer" means an organization that is organized and operates as a 
315.24 	nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal 
315.25 	Revenue Code of 1986, as amended.
315.26 	(h) "Therapeutic equivalent version" means a drug, device, or product that can be expected 
315.27 	to have the same clinical effect and safety profile when administered to a patient under the 
315.28 	conditions specified in the labeling, and that:
315.29 	(1) is approved as safe and effective;
315.30 	(2) is a pharmaceutical equivalent, (i) containing identical amounts of the same active 
315.31 	drug ingredient in the same dosage form and route of administration, and (ii) meeting 
315.32 	compendial or other applicable standards of strength, quality, purity, and identity;
316.1 	(3) is bioequivalent in that:
316.2 	(i) the drug, device, or product does not present a known or potential bioequivalence 
316.3 	problem and meets an acceptable in vitro standard; or
316.4 	(ii) if the drug, device, or product does present a known or potential bioequivalence 
316.5 	problem, it is shown to meet an appropriate bioequivalence standard;
316.6 	(4) is adequately labeled; and
316.7 	(5) is manufactured in compliance with current manufacturing practice regulations.
316.8 		Subd. 2.Required coverage; cost-sharing prohibited. (a) A health plan must provide 
316.9 	coverage for all prescription contraceptives and contraceptive services.
316.10 	(b) A health plan company must not impose cost-sharing requirements, including co-pays, 
316.11 	deductibles, or co-insurance, for contraceptives or contraceptive services.
316.12 	(c) Notwithstanding paragraph (b), a health plan that is a high-deductible health plan in 
316.13 	conjunction with a health savings account must include cost-sharing for contraceptives and 
316.14 	contraceptive services at the minimum level necessary to preserve the enrollee's ability to 
316.15 	make tax exempt contributions and withdrawals from the health savings account, as provided 
316.16 	by section 223 of the Internal Revenue Code of 1986, as amended.
316.17 	(d) A health plan company must not impose any referral requirements, restrictions, or 
316.18 	delays for contraceptives or contraceptive services.
316.19 	(e) If more than one therapeutic equivalent version of a contraceptive is approved by 
316.20 	the FDA, a health plan must cover at least one therapeutic equivalent version, but is not 
316.21 	required to cover all therapeutic equivalent versions.
316.22 	(f) For each health plan, a health plan company must list the contraceptives and 
316.23 	contraceptive services that are covered without cost-sharing in a manner that is easily 
316.24 	accessible to enrollees, health care providers, and representatives of health care providers. 
316.25 	The list for each health plan must be promptly updated to reflect changes to the coverage.
316.26 	(g) If an enrollee's attending provider recommends a particular contraceptive or 
316.27 	contraceptive service based on a determination of medical necessity for that enrollee, the 
316.28 	health plan must cover that contraceptive or contraceptive service without cost-sharing. The 
316.29 	health plan company issuing the health plan must defer to the attending provider's 
316.30 	determination that the particular contraceptive or contraceptive service is medically necessary 
316.31 	for the enrollee.
317.1 		Subd. 3.Religious employers; exempt. (a) A religious employer is not required to cover 
317.2 	contraceptives or contraceptive services if the employer has religious objections to the 
317.3 	coverage. A religious employer that chooses not to provide coverage for some or all 
317.4 	contraceptives and contraceptive services must notify employees as part of the hiring process 
317.5 	and all employees at least 30 days before:
317.6 	(1) an employee enrolls in the health plan; or
317.7 	(2) the effective date of the health plan, whichever occurs first.
317.8 	(b) If the religious employer provides coverage for some contraceptives or contraceptive 
317.9 	services, the notice must provide a list of the contraceptives or contraceptive services the 
317.10 	employer refuses to cover.
317.11 		Subd. 4.Accommodation for eligible organizations. (a) A health plan established or 
317.12 	maintained by an eligible organization complies with the requirements of subdivision 2 to 
317.13 	provide coverage of contraceptives and contraceptive services if the eligible organization 
317.14 	provides notice to any health plan company the eligible organization contracts with that it 
317.15 	is an eligible organization and that the eligible organization has a religious objection to 
317.16 	coverage for all or a subset of contraceptives or contraceptive services.
317.17 	(b) The notice from an eligible organization to a health plan company under paragraph 
317.18 	(a) must include the name of the eligible organization, a statement that it objects to coverage 
317.19 	for some or all of contraceptives or contraceptive services, including a list of the contraceptive 
317.20 	services the eligible organization objects to, if applicable, and the health plan name. The 
317.21 	notice must be executed by a person authorized to provide notice on behalf of the eligible 
317.22 	organization.
317.23 	(c) An eligible organization must provide a copy of the notice under paragraph (b) to 
317.24 	prospective employees as part of the hiring process and to all employees at least 30 days 
317.25 	before:
317.26 	(1) an employee enrolls in the health plan; or
317.27 	(2) the effective date of the health plan, whichever occurs first.
317.28 	(d) A health plan company that receives a copy of the notice under paragraph (a) with 
317.29 	respect to a health plan established or maintained by an eligible organization must:
317.30 	(1) expressly exclude coverage for some or all contraceptives or contraceptive services 
317.31 	from the health plan and provide separate payments for any contraceptive or contraceptive 
317.32 	service required to be covered under subdivision 2 for enrollees as long as the enrollee 
317.33 	remains enrolled in the health plan; or
318.1 	(2) arrange for an issuer or other entity to provide payments for contraceptive services 
318.2 	for plan participants and beneficiaries without imposing any cost-sharing requirements, or 
318.3 	imposing a premium fee or other charge, or any portion thereof directly or indirectly, on 
318.4 	the eligible organization, the group health plan, or plan participants or beneficiaries.
318.5 	(e) The health plan company must not impose any cost-sharing requirements, including 
318.6 	co-pays, deductibles, or co-insurance, or directly or indirectly impose any premium, fee, or 
318.7 	other charge for contraceptive services or contraceptives on the eligible organization, health 
318.8 	plan, or enrollee.
318.9 	(f) On January 1, 2022, and every year thereafter a health plan company must notify the 
318.10 	commissioner, in a manner to be determined by the commissioner, regarding the number 
318.11 	of eligible organizations granted an accommodation under this subdivision.

318.12 	EFFECTIVE DATE. This section is effective January 1, 2022, and applies to coverage 
318.13 	offered, sold, issued, or renewed on or after that date.

318.14 	Sec. 16. [62Q.522] COVERAGE FOR PRESCRIPTION CONTRACEPTIVES; 
318.15 	SUPPLY REQUIREMENTS.
318.16 		Subdivision 1.Scope of coverage. Except as otherwise provided in section 62Q.521, 
318.17 	subdivision 3, all health plans that provide prescription coverage must comply with the 
318.18 	requirements of this section.
318.19 		Subd. 2.Definition. For purposes of this section, "prescription contraceptive" means 
318.20 	any drug or device that requires a prescription and is approved by the Food and Drug 
318.21 	Administration to prevent pregnancy. Prescription contraceptive does not include an 
318.22 	emergency contraceptive drug that prevents pregnancy when administered after sexual 
318.23 	contact.
318.24 		Subd. 3.Required coverage. (a) Health plan coverage for a prescription contraceptive 
318.25 	must provide a 12-month supply for any prescription contraceptive, regardless of whether 
318.26 	the enrollee was covered by the health plan at the time of the first dispensing.
318.27 	(b) The prescribing health care provider must determine the appropriate number of 
318.28 	months to prescribe the prescription contraceptives for, up to 12 months.

318.29 	EFFECTIVE DATE. This section is effective January 1, 2022, and applies to coverage 
318.30 	offered, sold, issued, or renewed on or after that date.

319.1 	Sec. 17. Minnesota Statutes 2020, section 62Q.677, is amended by adding a subdivision 
319.2 	to read:
319.3 		Subd. 6a.Out-of-pocket annual maximum. By October of each year, the commissioner 
319.4 	of commerce must determine the maximum annual out-of-pocket limits applicable to 
319.5 	individual health plans and small group health plans.

319.6 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
319.7 	sold, issued, or renewed on or after that date.

319.8 	Sec. 18. Minnesota Statutes 2020, section 62Q.81, is amended to read:
319.9 	62Q.81 ESSENTIAL HEALTH BENEFIT PACKAGE REQUIREMENTS.
319.10 		Subdivision 1.Essential health benefits package. (a) Health plan companies offering 
319.11 	individual and small group health plans must include the essential health benefits package 
319.12 	required under section 1302(a) of the Affordable Care Act and as described in this 
319.13 	subdivision.
319.14 	(b) The essential health benefits package means insurance coverage that:
319.15 	(1) provides the essential health benefits as outlined in the Affordable Care Act described 
319.16 	in subdivision 4;
319.17 	(2) limits cost-sharing for such the coverage in accordance with the Affordable Care 
319.18 	Act, as described in subdivision 2; and
319.19 	(3) subject to subdivision 3, provides bronze, silver, gold, or platinum level of coverage 
319.20 	in accordance with the Affordable Care Act, as described in subdivision 3.
319.21 		Subd. 2.Cost-sharing; coverage for enrollees under the age of 21. (a) Cost-sharing 
319.22 	includes (1) deductibles, coinsurance, co-payments, or similar charges, and (2) qualified 
319.23 	medical expenses, as defined in section 223(d)(2) of the Internal Revenue Code of 1986, 
319.24 	as amended. Cost-sharing does not include premiums, balance billing from non-network 
319.25 	providers, or spending for noncovered services.
319.26 	(b) Cost-sharing per year for individual health plans is limited to the amount allowed 
319.27 	under section 223(c)(2)(A)(ii) of the Internal Revenue Code of 1986, as amended, increased 
319.28 	by an amount equal to the product of that amount and the premium adjustment percentage. 
319.29 	The premium adjustment percentage is the percentage that the average per capita premium 
319.30 	for health insurance coverage in the United States for the preceding calendar year exceeds 
319.31 	the average per capita premium for 2017. If the amount of the increase is not a multiple of 
319.32 	$50, the increases must be rounded to the next lowest multiple of $50.
320.1 	(c) Cost-sharing per year for small group health plans is limited to twice the amount 
320.2 	allowed under paragraph (b).
320.3 	(d) If a health plan company offers health plans in any level of coverage specified under 
320.4 	section 1302(d) of the Affordable Care Act, as described in subdivision 1, paragraph (b), 
320.5 	clause (3) 3, the health plan company shall also offer coverage in that level to individuals 
320.6 	who have not attained 21 years of age as of the beginning of a policy year.
320.7 		Subd. 3.Levels of coverage; alternative compliance for catastrophic plans. (a) A 
320.8 	health plan in the bronze level must provide a level of coverage designed to provide benefits 
320.9 	that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided 
320.10 	under the plan.
320.11 	(b) A health plan in the silver level must provide a level of coverage designed to provide 
320.12 	benefits that are actuarially equivalent to 70 percent of the full actuarial value of the benefits 
320.13 	provided under the plan.
320.14 	(c) A health plan in the gold level must provide a level of coverage designed to provide 
320.15 	benefits that are actuarially equivalent to 80 percent of the full actuarial value of the benefits 
320.16 	provided under the plan.
320.17 	(d) A health plan in the platinum level must provide a level of coverage designed to 
320.18 	provide benefits that are actuarially equivalent to 90 percent of the full actuarial value of 
320.19 	the benefits provided under the plan.
320.20 	(e) A health plan company that does not provide an individual or small group health 
320.21 	plan in the bronze, silver, gold, or platinum level of coverage, as described in subdivision 
320.22 	1, paragraph (b), clause (3), shall be treated as meeting meets the requirements of this section 
320.23 	1302(d) of the Affordable Care Act with respect to any policy plan year if the health plan 
320.24 	company provides a catastrophic plan that meets the following requirements of section 
320.25 	1302(e) of the Affordable Care Act.:
320.26 	(1) enrollment in the health plan is limited only to individuals that:
320.27 	(i) have not attained age 30 before the beginning of the plan year;
320.28 	(ii) are unable to access affordable coverage; or
320.29 	(iii) are experiencing a hardship in reference to the individual's capability to access 
320.30 	coverage; and
320.31 	(2) the health plan provides:
321.1 	(i) essential health benefits, except that the plan does not provide benefits for any plan 
321.2 	year until the individual has incurred cost-sharing expenses in an amount equal to the 
321.3 	limitation in effect under subdivision 2; and
321.4 	(ii) coverage for at least three primary care visits.
321.5 		Subd. 4.Essential health benefits; definition. (a) For purposes of this section, "essential 
321.6 	health benefits" has the meaning given under section 1302(b) of the Affordable Care Act 
321.7 	and includes means:
321.8 	(1) ambulatory patient services;
321.9 	(2) emergency services;
321.10 	(3) hospitalization;
321.11 	(4) laboratory services;
321.12 	(5) maternity and newborn care;
321.13 	(6) mental health and substance use disorder services, including behavioral health 
321.14 	treatment;
321.15 	(7) pediatric services, including oral and vision care;
321.16 	(8) prescription drugs;
321.17 	(9) preventive and wellness services and chronic disease management;
321.18 	(10) rehabilitative and habilitative services and devices; and
321.19 	(11) additional essential health benefits included in the EHB-benchmark plan, as defined 
321.20 	under the Affordable Care Act health plan described in paragraph (c).
321.21 	(b) If a service provider does not have a contractual relationship with the health plan to 
321.22 	provide services, emergency services must be provided without imposing any prior 
321.23 	authorization requirement or limitation on coverage that is more restrictive than the 
321.24 	requirements or limitations that apply to emergency services received from providers who 
321.25 	have a contractual relationship with the health plan. If services are provided out-of-network, 
321.26 	the cost-sharing must be equivalent to services provided in-network.
321.27 	(c) The scope of essential health benefits under paragraph (a) must be equal to the scope 
321.28 	of benefits provided under a typical employer plan.
321.29 	(d) Essential health benefits must:
322.1 	(1) reflect an appropriate balance among the categories to ensure benefits are not unduly 
322.2 	weighted toward any category;
322.3 	(2) not make coverage decisions, determine reimbursement rates, establish incentive 
322.4 	programs, or design benefits in a manner that discriminates against individuals on the basis 
322.5 	of age, disability, or expected length of life;
322.6 	(3) account for the health care needs of diverse segments of the population, including 
322.7 	women, children, persons with disabilities, and other groups; and
322.8 	(4) ensure that health benefits established as essential are not subject to denial against 
322.9 	the individual's wishes on the basis of the individual's age or expected length of life or of 
322.10 	the individual's present or predicted disability, degree of medical dependency, or quality of 
322.11 	life.
322.12 		Subd. 5.Exception. This section does not apply to a dental plan described in section 
322.13 	1311(d)(2)(B)(ii) of the Affordable Care Act that is limited in scope and provides pediatric 
322.14 	dental benefits.

322.15 	EFFECTIVE DATE. This section is effective January 1, 2022, for health plans offered, 
322.16 	sold, issued, or renewed on or after that date.

322.17 	Sec. 19. Minnesota Statutes 2020, section 256B.0625, subdivision 10, is amended to read:
322.18 		Subd. 10.Laboratory and, x-ray, and opioid screening services. (a) Medical assistance 
322.19 	covers laboratory and x-ray services.
322.20 	(b) Medical assistance covers screening and urinalysis tests for opioids without lifetime 
322.21 	or annual limits.

322.22 	EFFECTIVE DATE. This section is effective January 1, 2022.

322.23 	Sec. 20. Minnesota Statutes 2020, section 256B.0625, subdivision 13, is amended to read:
322.24 		Subd. 13.Drugs. (a) Medical assistance covers drugs, except for fertility drugs when 
322.25 	specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed 
322.26 	by a licensed pharmacist, by a physician enrolled in the medical assistance program as a 
322.27 	dispensing physician, or by a physician, a physician assistant, or an advanced practice 
322.28 	registered nurse employed by or under contract with a community health board as defined 
322.29 	in section 145A.02, subdivision 5, for the purposes of communicable disease control.
322.30 	(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 
322.31 	unless authorized by the commissioner or as provided in paragraph (h).
323.1 	(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical 
323.2 	ingredient" is defined as a substance that is represented for use in a drug and when used in 
323.3 	the manufacturing, processing, or packaging of a drug becomes an active ingredient of the 
323.4 	drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle 
323.5 	for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and 
323.6 	excipients which are included in the medical assistance formulary. Medical assistance covers 
323.7 	selected active pharmaceutical ingredients and excipients used in compounded prescriptions 
323.8 	when the compounded combination is specifically approved by the commissioner or when 
323.9 	a commercially available product:
323.10 	(1) is not a therapeutic option for the patient;
323.11 	(2) does not exist in the same combination of active ingredients in the same strengths 
323.12 	as the compounded prescription; and
323.13 	(3) cannot be used in place of the active pharmaceutical ingredient in the compounded 
323.14 	prescription.
323.15 	(d) Medical assistance covers the following over-the-counter drugs when prescribed by 
323.16 	a licensed practitioner or by a licensed pharmacist who meets standards established by the 
323.17 	commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family 
323.18 	planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults 
323.19 	with documented vitamin deficiencies, vitamins for children under the age of seven and 
323.20 	pregnant or nursing women, and any other over-the-counter drug identified by the 
323.21 	commissioner, in consultation with the Formulary Committee, as necessary, appropriate, 
323.22 	and cost-effective for the treatment of certain specified chronic diseases, conditions, or 
323.23 	disorders, and this determination shall not be subject to the requirements of chapter 14. A 
323.24 	pharmacist may prescribe over-the-counter medications as provided under this paragraph 
323.25 	for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter 
323.26 	drugs under this paragraph, licensed pharmacists must consult with the recipient to determine 
323.27 	necessity, provide drug counseling, review drug therapy for potential adverse interactions, 
323.28 	and make referrals as needed to other health care professionals.
323.29 	(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable 
323.30 	under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and 
323.31 	Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible 
323.32 	for drug coverage as defined in the Medicare Prescription Drug, Improvement, and 
323.33 	Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these 
323.34 	individuals, medical assistance may cover drugs from the drug classes listed in United States 
324.1 	Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 
324.2 	13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall 
324.3 	not be covered.
324.4 	(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing 
324.5 	Program and dispensed by 340B covered entities and ambulatory pharmacies under common 
324.6 	ownership of the 340B covered entity. Medical assistance does not cover drugs acquired 
324.7 	through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.
324.8 	(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal 
324.9 	contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section 
324.10 	151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a 
324.11 	licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists 
324.12 	used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed 
324.13 	pharmacist in accordance with section 151.37, subdivision 16.
324.14 	(h) Medical assistance coverage for a prescription contraceptive must provide a 12-month 
324.15 	supply for any prescription contraceptive. The prescribing health care provider must 
324.16 	determine the appropriate number of months to prescribe the prescription contraceptives, 
324.17 	up to 12 months. For the purposes of this paragraph, "prescription contraceptive" means 
324.18 	any drug or device that requires a prescription and is approved by the Food and Drug 
324.19 	Administration to prevent pregnancy. Prescription contraceptive does not include an 
324.20 	emergency contraceptive drug approved to prevent pregnancy when administered after 
324.21 	sexual contact.

324.22 	EFFECTIVE DATE. This section applies to medical assistance and MinnesotaCare 
324.23 	coverage effective January 1, 2022.

324.24 	Sec. 21. COMMISSIONER OF COMMERCE; DETERMINATION OF 
324.25 	PREVENTIVE ITEMS AND SERVICES.
 324.26 	The commissioner of commerce must determine the items and services that are preventive 
324.27 	under Minnesota Statutes, section 62Q.46, subdivision 1a. Items and services that are 
324.28 	preventive must include:
324.29 	(1) evidence-based items or services that have in effect a rating of A or B pursuant to 
324.30 	the recommendations of the United States Preventive Services Task Force in effect January 
324.31 	1, 2021, and with respect to the individual involved;
324.32 	(2) immunizations for routine use in children, adolescents, and adults that have in effect 
324.33 	a recommendation from the Advisory Committee on Immunization Practices of the Centers 
325.1 	for Disease Control and Prevention with respect to the individual involved. For the purposes 
325.2 	of this clause, a recommendation from the Advisory Committee on Immunization Practices 
325.3 	of the Centers for Disease Control and Prevention is considered in effect after it has been 
325.4 	adopted by the Director of the Centers for Disease Control and Prevention and a 
325.5 	recommendation is considered to be for routine use if it is listed on the Immunization 
325.6 	Schedules of the Centers for Disease Control and Prevention;
325.7 	(3) with respect to infants, children, and adolescents, evidence-informed preventive care 
325.8 	and screenings provided for in comprehensive guidelines supported by the Health Resources 
325.9 	and Services Administration; and
325.10 	(4) with respect to women, additional preventive care and screenings not described in 
325.11 	clause (1), as provided for in comprehensive guidelines supported by the Health Resources 
325.12 	and Services Administration.

325.13 	ARTICLE 7
325.14 	TELEHEALTH

325.15 	Section 1. [62A.673] COVERAGE OF SERVICES PROVIDED THROUGH 
325.16 	TELEHEALTH.
325.17 		Subdivision 1.Citation. This section may be cited as the "Minnesota Telehealth Act."
325.18 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
325.19 	subdivision have the meanings given.
325.20 	(b) "Distant site" means a site at which a health care provider is located while providing 
325.21 	health care services or consultations by means of telehealth.
325.22 	(c) "Health care provider" means a health care professional who is licensed or registered 
325.23 	by the state to perform health care services within the provider's scope of practice and in 
325.24 	accordance with state law. A health care provider includes a mental health professional as 
325.25 	defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; a mental health 
325.26 	practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision 26; 
325.27 	a treatment coordinator under section 245G.11, subdivision 7; an alcohol and drug counselor 
325.28 	under section 245G.11, subdivision 5; and a recovery peer under section 245G.11, subdivision 
325.29 	8.
325.30 	(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
325.31 	(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan 
325.32 	includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental 
326.1 	plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed 
326.2 	to pay benefits directly to the policy holder.
326.3 	(f) "Originating site" means a site at which a patient is located at the time health care 
326.4 	services are provided to the patient by means of telehealth. For purposes of store-and-forward 
326.5 	transfer, the originating site also means the location at which a health care provider transfers 
326.6 	or transmits information to the distant site.
326.7 	(g) "Store-and-forward transfer" means the asynchronous electronic transfer of a patient's 
326.8 	medical information or data from an originating site to a distant site for the purposes of 
326.9 	diagnostic and therapeutic assistance in the care of a patient.
326.10 	(h) "Telehealth" means the delivery of health care services or consultations through the 
326.11 	use of real-time, two-way interactive audio and visual or audio-only communications to 
326.12 	provide or support health care delivery and facilitate the assessment, diagnosis, consultation, 
326.13 	treatment, education, and care management of a patient's health care. Telehealth includes 
326.14 	the application of secure video conferencing, store-and-forward transfers, and synchronous 
326.15 	interactions between a patient located at an originating site and a health care provider located 
326.16 	at a distant site. Telehealth includes audio-only communication between a health care 
326.17 	provider and a patient if the communication is a scheduled appointment and the standard 
326.18 	of care for the service can be met through the use of audio-only communication. Telehealth 
326.19 	does not include communication between health care providers or between a health care 
326.20 	provider and a patient that consists solely of an e-mail or facsimile transmission. Telehealth 
326.21 	does not include communication between health care providers that consists solely of a 
326.22 	telephone conversation.
326.23 	(i) "Telemonitoring services" means the remote monitoring of clinical data related to 
326.24 	the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits 
326.25 	the data electronically to a health care provider for analysis. Telemonitoring is intended to 
326.26 	collect an enrollee's health-related data for the purpose of assisting a health care provider 
326.27 	in assessing and monitoring the enrollee's medical condition or status.
326.28 		Subd. 3.Coverage of telehealth. (a) A health plan sold, issued, or renewed by a health 
326.29 	carrier in Minnesota must (1) cover benefits delivered through telehealth in the same manner 
326.30 	as any other benefits covered under the health plan, and (2) comply with this section.
326.31 	(b) Coverage for services delivered through telehealth must not be limited on the basis 
326.32 	of geography, location, or distance for travel.
326.33 	(c) A health carrier must not create a separate provider network or provide incentives 
326.34 	to enrollees to use a separate provider network to deliver services through telehealth that 
327.1 	does not include network providers who provide in-person care to patients for the same 
327.2 	service.
327.3 	(d) A health carrier may require a deductible, co-payment, or coinsurance payment for 
327.4 	a health care service provided through telehealth, provided that the deductible, co-payment, 
327.5 	or coinsurance payment is not in addition to, and does not exceed, the deductible, co-payment, 
327.6 	or coinsurance applicable for the same service provided through in-person contact.
327.7 	(e) Nothing in this section:
327.8 	(1) requires a health carrier to provide coverage for services that are not medically 
327.9 	necessary or are not covered under the enrollee's health plan; or
327.10 	(2) prohibits a health carrier from:
327.11 	(i) establishing criteria that a health care provider must meet to demonstrate the safety 
327.12 	or efficacy of delivering a particular service through telehealth for which the health carrier 
327.13 	does not already reimburse other health care providers for delivering the service through 
327.14 	telehealth;
327.15 	(ii) establishing reasonable medical management techniques, provided the criteria or 
327.16 	techniques are not unduly burdensome or unreasonable for the particular service; or
327.17 	(iii) requiring documentation or billing practices designed to protect the health carrier 
327.18 	or patient from fraudulent claims, provided the practices are not unduly burdensome or 
327.19 	unreasonable for the particular service.
327.20 	(f) Nothing in this section requires the use of telehealth when a health care provider 
327.21 	determines that the delivery of a health care service through telehealth is not appropriate or 
327.22 	when an enrollee chooses not to receive a health care service through telehealth.
327.23 		Subd. 4.Parity between telehealth and in-person services. (a) A health carrier must 
327.24 	not restrict or deny coverage of a health care service that is covered under a health plan 
327.25 	solely:
327.26 	(1) because the health care service provided by the health care provider through telehealth 
327.27 	is not provided through in-person contact; or
327.28 	(2) based on the communication technology or application used to deliver the health 
327.29 	care service through telehealth, provided the technology or application complies with this 
327.30 	section and is appropriate for the particular service.
328.1 	(b) Prior authorization may be required for health care services delivered through 
328.2 	telehealth only if prior authorization is required before the delivery of the same service 
328.3 	through in-person contact.
328.4 	(c) A health carrier may require a utilization review for services delivered through 
328.5 	telehealth, provided the utilization review is conducted in the same manner and uses the 
328.6 	same clinical review criteria as a utilization review for the same services delivered through 
328.7 	in-person contact.
328.8 		Subd. 5.Reimbursement for services delivered through telehealth. (a) A health carrier 
328.9 	must reimburse the health care provider for services delivered through telehealth on the 
328.10 	same basis and at the same rate as the health carrier would apply to those services if the 
328.11 	services had been delivered by the health care provider through in-person contact.
328.12 	(b) A health carrier must not deny or limit reimbursement based solely on a health care 
328.13 	provider delivering the service or consultation through telehealth instead of through in-person 
328.14 	contact.
328.15 	(c) A health carrier must not deny or limit reimbursement based solely on the technology 
328.16 	and equipment used by the health care provider to deliver the health care service or 
328.17 	consultation through telehealth, provided the technology and equipment used by the provider 
328.18 	meets the requirements of this section and is appropriate for the particular service.
328.19 		Subd. 6.Telehealth equipment. (a) A health carrier must not require a health care 
328.20 	provider to use specific telecommunications technology and equipment as a condition of 
328.21 	coverage under this section, provided the health care provider uses telecommunications 
328.22 	technology and equipment that complies with current industry interoperable standards and 
328.23 	complies with standards required under the federal Health Insurance Portability and 
328.24 	Accountability Act of 1996, Public Law 104-191, and regulations promulgated under that 
328.25 	Act, unless authorized under this section.
328.26 	(b) A health carrier must provide coverage for health care services delivered through 
328.27 	telehealth by means of the use of audio-only telephone communication if the communication 
328.28 	is a scheduled appointment and the standard of care for that particular service can be met 
328.29 	through the use of audio-only communication.
328.30 		Subd. 7.Telemonitoring services. A health carrier must provide coverage for 
328.31 	telemonitoring services if:
328.32 	(1) the telemonitoring service is medically appropriate based on the enrollee's medical 
328.33 	condition or status;
329.1 	(2) the enrollee is cognitively and physically capable of operating the monitoring device 
329.2 	or equipment, or the enrollee has a caregiver who is willing and able to assist with the 
329.3 	monitoring device or equipment; and
329.4 	(3) the enrollee resides in a setting that is suitable for telemonitoring and not in a setting 
329.5 	that has health care staff on site.

329.6 	EFFECTIVE DATE. This section is effective January 1, 2022.

329.7 	Sec. 2. Minnesota Statutes 2020, section 147.033, is amended to read:
329.8 	147.033 PRACTICE OF TELEMEDICINE TELEHEALTH.
329.9 		Subdivision 1.Definition. For the purposes of this section, "telemedicine" means the 
329.10 	delivery of health care services or consultations while the patient is at an originating site 
329.11 	and the licensed health care provider is at a distant site. A communication between licensed 
329.12 	health care providers that consists solely of a telephone conversation, e-mail, or facsimile 
329.13 	transmission does not constitute telemedicine consultations or services. A communication 
329.14 	between a licensed health care provider and a patient that consists solely of an e-mail or 
329.15 	facsimile transmission does not constitute telemedicine consultations or services. 
329.16 	Telemedicine may be provided by means of real-time two-way interactive audio, and visual 
329.17 	communications, including the application of secure video conferencing or store-and-forward 
329.18 	technology to provide or support health care delivery, that facilitate the assessment, diagnosis, 
329.19 	consultation, treatment, education, and care management of a patient's health care.
329.20 	"telehealth" has the meaning given in section 62A.673, subdivision 2, paragraph (h).
329.21 		Subd. 2.Physician-patient relationship. A physician-patient relationship may be 
329.22 	established through telemedicine telehealth.
329.23 		Subd. 3.Standards of practice and conduct. A physician providing health care services 
329.24 	by telemedicine telehealth in this state shall be held to the same standards of practice and 
329.25 	conduct as provided in this chapter for in-person health care services.

329.26 	EFFECTIVE DATE. This section is effective January 1, 2022.

329.27 	Sec. 3. Minnesota Statutes 2020, section 151.37, subdivision 2, is amended to read:
329.28 		Subd. 2.Prescribing and filing. (a) A licensed practitioner in the course of professional 
329.29 	practice only, may prescribe, administer, and dispense a legend drug, and may cause the 
329.30 	same to be administered by a nurse, a physician assistant, or medical student or resident 
329.31 	under the practitioner's direction and supervision, and may cause a person who is an 
329.32 	appropriately certified, registered, or licensed health care professional to prescribe, dispense, 
330.1 	and administer the same within the expressed legal scope of the person's practice as defined 
330.2 	in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference 
330.3 	to a specific patient, by directing a licensed dietitian or licensed nutritionist, pursuant to 
330.4 	section 148.634; a nurse, pursuant to section 148.235, subdivisions 8 and 9; physician 
330.5 	assistant; medical student or resident; or pharmacist according to section 151.01, subdivision 
330.6 	27, to adhere to a particular practice guideline or protocol when treating patients whose 
330.7 	condition falls within such guideline or protocol, and when such guideline or protocol 
330.8 	specifies the circumstances under which the legend drug is to be prescribed and administered. 
330.9 	An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic 
330.10 	order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. 
330.11 	This paragraph applies to a physician assistant only if the physician assistant meets the 
330.12 	requirements of section 147A.18 sections 147A.02 and 147A.09.
330.13 	(b) The commissioner of health, if a licensed practitioner, or a person designated by the 
330.14 	commissioner who is a licensed practitioner, may prescribe a legend drug to an individual 
330.15 	or by protocol for mass dispensing purposes where the commissioner finds that the conditions 
330.16 	triggering section 144.4197 or 144.4198, subdivision 2, paragraph (b), exist. The 
330.17 	commissioner, if a licensed practitioner, or a designated licensed practitioner, may prescribe, 
330.18 	dispense, or administer a legend drug or other substance listed in subdivision 10 to control 
330.19 	tuberculosis and other communicable diseases. The commissioner may modify state drug 
330.20 	labeling requirements, and medical screening criteria and documentation, where time is 
330.21 	critical and limited labeling and screening are most likely to ensure legend drugs reach the 
330.22 	maximum number of persons in a timely fashion so as to reduce morbidity and mortality.
330.23 	(c) A licensed practitioner that dispenses for profit a legend drug that is to be administered 
330.24 	orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the 
330.25 	practitioner's licensing board a statement indicating that the practitioner dispenses legend 
330.26 	drugs for profit, the general circumstances under which the practitioner dispenses for profit, 
330.27 	and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs 
330.28 	for profit after July 31, 1990, unless the statement has been filed with the appropriate 
330.29 	licensing board. For purposes of this paragraph, "profit" means (1) any amount received by 
330.30 	the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are 
330.31 	purchased in prepackaged form, or (2) any amount received by the practitioner in excess 
330.32 	of the acquisition cost of a legend drug plus the cost of making the drug available if the 
330.33 	legend drug requires compounding, packaging, or other treatment. The statement filed under 
330.34 	this paragraph is public data under section 13.03. This paragraph does not apply to a licensed 
330.35 	doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed 
331.1 	practitioner with the authority to prescribe, dispense, and administer a legend drug under 
331.2 	paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing 
331.3 	by a community health clinic when the profit from dispensing is used to meet operating 
331.4 	expenses.
331.5 	(d) A prescription drug order for the following drugs is not valid, unless it can be 
331.6 	established that the prescription drug order was based on a documented patient evaluation, 
331.7 	including an examination, adequate to establish a diagnosis and identify underlying conditions 
331.8 	and contraindications to treatment:
331.9 	(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;
331.10 	(2) drugs defined by the Board of Pharmacy as controlled substances under section 
331.11 	152.02, subdivisions 7, 8, and 12;
331.12 	(3) muscle relaxants;
331.13 	(4) centrally acting analgesics with opioid activity;
331.14 	(5) drugs containing butalbital; or
331.15 	(6) phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.
331.16 	For purposes of prescribing drugs listed in clause (6), the requirement for a documented 
331.17 	patient evaluation, including an examination, may be met through the use of telemedicine, 
331.18 	as defined in section 147.033, subdivision 1.
331.19 	(e) For the purposes of paragraph (d), the requirement for an examination shall be met 
331.20 	if:
331.21 	(1) an in-person examination has been completed in any of the following circumstances:
331.22 	(1) (i) the prescribing practitioner examines the patient at the time the prescription or 
331.23 	drug order is issued;
331.24 	(2) (ii) the prescribing practitioner has performed a prior examination of the patient;
331.25 	(3) (iii) another prescribing practitioner practicing within the same group or clinic as 
331.26 	the prescribing practitioner has examined the patient;
331.27 	(4) (iv) a consulting practitioner to whom the prescribing practitioner has referred the 
331.28 	patient has examined the patient; or
331.29 	(5) (v) the referring practitioner has performed an examination in the case of a consultant 
331.30 	practitioner issuing a prescription or drug order when providing services by means of 
331.31 	telemedicine.; or
332.1 	(2) the prescription order is for a drug listed in paragraph (d), clause (6), or for medication 
332.2 	assisted therapy for a substance use disorder, and the prescribing practitioner has completed 
332.3 	an examination of the patient via telehealth as defined in section 62A.673, subdivision 2, 
332.4 	paragraph (h).
332.5 	(f) Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a 
332.6 	drug through the use of a guideline or protocol pursuant to paragraph (a).
332.7 	(g) Nothing in this chapter prohibits a licensed practitioner from issuing a prescription 
332.8 	or dispensing a legend drug in accordance with the Expedited Partner Therapy in the 
332.9 	Management of Sexually Transmitted Diseases guidance document issued by the United 
332.10 	States Centers for Disease Control.
332.11 	(h) Nothing in paragraph (d) or (e) limits prescription, administration, or dispensing of 
332.12 	legend drugs through a public health clinic or other distribution mechanism approved by 
332.13 	the commissioner of health or a community health board in order to prevent, mitigate, or 
332.14 	treat a pandemic illness, infectious disease outbreak, or intentional or accidental release of 
332.15 	a biological, chemical, or radiological agent.
332.16 	(i) No pharmacist employed by, under contract to, or working for a pharmacy located 
332.17 	within the state and licensed under section 151.19, subdivision 1, may dispense a legend 
332.18 	drug based on a prescription that the pharmacist knows, or would reasonably be expected 
332.19 	to know, is not valid under paragraph (d).
332.20 	(j) No pharmacist employed by, under contract to, or working for a pharmacy located 
332.21 	outside the state and licensed under section 151.19, subdivision 1, may dispense a legend 
332.22 	drug to a resident of this state based on a prescription that the pharmacist knows, or would 
332.23 	reasonably be expected to know, is not valid under paragraph (d).
332.24 	(k) Nothing in this chapter prohibits the commissioner of health, if a licensed practitioner, 
332.25 	or, if not a licensed practitioner, a designee of the commissioner who is a licensed 
332.26 	practitioner, from prescribing legend drugs for field-delivered therapy in the treatment of 
332.27 	a communicable disease according to the Centers For Disease Control and Prevention Partner 
332.28 	Services Guidelines.

332.29 	EFFECTIVE DATE. This section is effective January 1, 2022.

332.30 	Sec. 4. Minnesota Statutes 2020, section 245G.01, subdivision 13, is amended to read:
332.31 		Subd. 13.Face-to-face. "Face-to-face" means two-way, real-time, interactive and visual
332.32 	communication between a client and a treatment service provider and includes services 
332.33 	delivered in person or via telemedicine telehealth with priority being given to interactive 
333.1 	audio and visual communication, if available. Meetings required by section 245G.22, 
333.2 	subdivision 4, must be conducted by interactive video and visual communication.

333.3 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
333.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
333.5 	when federal approval is obtained.

333.6 	Sec. 5. Minnesota Statutes 2020, section 245G.01, subdivision 26, is amended to read:
333.7 		Subd. 26.Telemedicine Telehealth. "Telemedicine" "Telehealth" means the delivery 
333.8 	of a substance use disorder treatment service while the client is at an originating site and 
333.9 	the licensed health care provider is at a distant site via telehealth as defined in section 
333.10 	256B.0625, subdivision 3b, and as specified in section 254B.05, subdivision 5, paragraph 
333.11 	(f).

333.12 	EFFECTIVE DATE. This section is effective January 1, 2022.

333.13 	Sec. 6. Minnesota Statutes 2020, section 245G.06, subdivision 1, is amended to read:
333.14 		Subdivision 1.General. Each client must have a person-centered individual treatment 
333.15 	plan developed by an alcohol and drug counselor within ten days from the day of service 
333.16 	initiation for a residential program and within five calendar days on which a treatment 
333.17 	session has been provided from the day of service initiation for a client in a nonresidential 
333.18 	program. Opioid treatment programs must complete the individual treatment plan within 
333.19 	21 days from the day of service initiation. The individual treatment plan must be signed by 
333.20 	the client and the alcohol and drug counselor and document the client's involvement in the 
333.21 	development of the plan. The individual treatment plan is developed upon the qualified staff 
333.22 	member's dated signature. Treatment planning must include ongoing assessment of client 
333.23 	needs. An individual treatment plan must be updated based on new information gathered 
333.24 	about the client's condition, the client's level of participation, and on whether methods 
333.25 	identified have the intended effect. A change to the plan must be signed by the client and 
333.26 	the alcohol and drug counselor. If the client chooses to have family or others involved in 
333.27 	treatment services, the client's individual treatment plan must include how the family or 
333.28 	others will be involved in the client's treatment. If a client is receiving treatment services 
333.29 	or an assessment via telehealth and the license holder documents the reason the client's 
333.30 	signature cannot be obtained, the alcohol and drug counselor may document the client's 
333.31 	verbal approval or electronic written approval of the treatment plan or change to the treatment 
333.32 	plan in lieu of the client's signature.

333.33 	EFFECTIVE DATE. This section is effective January 1, 2022.

334.1 	Sec. 7. Minnesota Statutes 2020, section 254A.19, subdivision 5, is amended to read:
334.2 		Subd. 5.Assessment via telemedicine telehealth. Notwithstanding Minnesota Rules, 
334.3 	part 9530.6615, subpart 3, item A, a chemical use assessment may be conducted via 
334.4 	telemedicine telehealth as defined in section 256B.0625, subdivision 3b.

334.5 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
334.6 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
334.7 	when federal approval is obtained.

334.8 	Sec. 8. Minnesota Statutes 2020, section 254B.05, subdivision 5, is amended to read:
334.9 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
334.10 	use disorder services and service enhancements funded under this chapter.
334.11 	(b) Eligible substance use disorder treatment services include:
334.12 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
334.13 	245G.17, or applicable tribal license;
334.14 	(2) comprehensive assessments provided according to sections 245.4863, paragraph (a), 
334.15 	and 245G.05;
334.16 	(3) care coordination services provided according to section 245G.07, subdivision 1, 
334.17 	paragraph (a), clause (5);
334.18 	(4) peer recovery support services provided according to section 245G.07, subdivision 
334.19 	2, clause (8);
334.20 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
334.21 	services provided according to chapter 245F;
334.22 	(6) medication-assisted therapy services that are licensed according to sections 245G.01 
334.23 	to 245G.17 and 245G.22, or applicable tribal license;
334.24 	(7) medication-assisted therapy plus enhanced treatment services that meet the 
334.25 	requirements of clause (6) and provide nine hours of clinical services each week;
334.26 	(8) high, medium, and low intensity residential treatment services that are licensed 
334.27 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
334.28 	provide, respectively, 30, 15, and five hours of clinical services each week;
334.29 	(9) hospital-based treatment services that are licensed according to sections 245G.01 to 
334.30 	245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
334.31 	144.56;
335.1 	(10) adolescent treatment programs that are licensed as outpatient treatment programs 
335.2 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
335.3 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
335.4 	applicable tribal license;
335.5 	(11) high-intensity residential treatment services that are licensed according to sections 
335.6 	245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of 
335.7 	clinical services each week provided by a state-operated vendor or to clients who have been 
335.8 	civilly committed to the commissioner, present the most complex and difficult care needs, 
335.9 	and are a potential threat to the community; and
335.10 	(12) room and board facilities that meet the requirements of subdivision 1a.
335.11 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
335.12 	of paragraph (b) and one of the following additional requirements:
335.13 	(1) programs that serve parents with their children if the program:
335.14 	(i) provides on-site child care during the hours of treatment activity that:
335.15 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
335.16 	9503; or
335.17 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
335.18 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
335.19 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
335.20 	licensed under chapter 245A as:
335.21 	(A) a child care center under Minnesota Rules, chapter 9503; or
335.22 	(B) a family child care home under Minnesota Rules, chapter 9502;
335.23 	(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or 
335.24 	programs or subprograms serving special populations, if the program or subprogram meets 
335.25 	the following requirements:
335.26 	(i) is designed to address the unique needs of individuals who share a common language, 
335.27 	racial, ethnic, or social background;
335.28 	(ii) is governed with significant input from individuals of that specific background; and
335.29 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
335.30 	whom are of that specific background, except when the common social background of the 
335.31 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
336.1 	treatment staff who have the necessary professional training, as approved by the 
336.2 	commissioner, to serve clients with the specific disabilities that the program is designed to 
336.3 	serve;
336.4 	(3) programs that offer medical services delivered by appropriately credentialed health 
336.5 	care staff in an amount equal to two hours per client per week if the medical needs of the 
336.6 	client and the nature and provision of any medical services provided are documented in the 
336.7 	client file; and
336.8 	(4) programs that offer services to individuals with co-occurring mental health and 
336.9 	chemical dependency problems if:
336.10 	(i) the program meets the co-occurring requirements in section 245G.20;
336.11 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
336.12 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
336.13 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
336.14 	mental health professional, except that no more than 50 percent of the mental health staff 
336.15 	may be students or licensing candidates with time documented to be directly related to 
336.16 	provisions of co-occurring services;
336.17 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
336.18 	health diagnostic assessment within ten days of admission;
336.19 	(iv) the program has standards for multidisciplinary case review that include a monthly 
336.20 	review for each client that, at a minimum, includes a licensed mental health professional 
336.21 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
336.22 	(v) family education is offered that addresses mental health and substance abuse disorders 
336.23 	and the interaction between the two; and
336.24 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
336.25 	training annually.
336.26 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
336.27 	that provides arrangements for off-site child care must maintain current documentation at 
336.28 	the chemical dependency facility of the child care provider's current licensure to provide 
336.29 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
336.30 	must be deemed in compliance with the licensing requirements in section 245G.19.
336.31 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
336.32 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
336.33 	in paragraph (c), clause (4), items (i) to (iv).
337.1 	(f) Subject to federal approval, chemical dependency services that are otherwise covered 
337.2 	as direct face-to-face services may be provided via two-way interactive video telehealth as 
337.3 	defined in section 256B.0625, subdivision 3b. The use of two-way interactive video telehealth 
337.4 	to deliver services must be medically appropriate to the condition and needs of the person 
337.5 	being served. Reimbursement shall be at the same rates and under the same conditions that 
337.6 	would otherwise apply to direct face-to-face services. The interactive video equipment and 
337.7 	connection must comply with Medicare standards in effect at the time the service is provided.
337.8 	(g) For the purpose of reimbursement under this section, substance use disorder treatment 
337.9 	services provided in a group setting without a group participant maximum or maximum 
337.10 	client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one. 
337.11 	At least one of the attending staff must meet the qualifications as established under this 
337.12 	chapter for the type of treatment service provided. A recovery peer may not be included as 
337.13 	part of the staff ratio.

337.14 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
337.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
337.16 	when federal approval is obtained.

337.17 	Sec. 9. Minnesota Statutes 2020, section 256B.0621, subdivision 10, is amended to read:
337.18 		Subd. 10.Payment rates. The commissioner shall set payment rates for targeted case 
337.19 	management under this subdivision. Case managers may bill according to the following 
337.20 	criteria:
337.21 	(1) for relocation targeted case management, case managers may bill for direct case 
337.22 	management activities, including face-to-face contact, telephone contact, and interactive 
337.23 	video contact according to section 256B.0924, subdivision 4a, in the lesser of:
337.24 	(i) 180 days preceding an eligible recipient's discharge from an institution; or
337.25 	(ii) the limits and conditions which apply to federal Medicaid funding for this service;
337.26 	(2) for home care targeted case management, case managers may bill for direct case 
337.27 	management activities, including face-to-face and telephone contacts; and
337.28 	(3) billings for targeted case management services under this subdivision shall not 
337.29 	duplicate payments made under other program authorities for the same purpose.

337.30 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
337.31 	of human services shall notify the revisor of statutes when federal approval is obtained.

338.1 	Sec. 10. Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:
338.2 		Subd. 3b.Telemedicine Telehealth services. (a) Medical assistance covers medically 
338.3 	necessary services and consultations delivered by a licensed health care provider via 
338.4 	telemedicine through telehealth in the same manner as if the service or consultation was 
338.5 	delivered in person through in-person contact. Coverage is limited to three telemedicine 
338.6 	services per enrollee per calendar week, except as provided in paragraph (f). Telemedicine
338.7 	Services or consultations delivered through telehealth shall be paid at the full allowable 
338.8 	rate.
338.9 	(b) The commissioner shall may establish criteria that a health care provider must attest 
338.10 	to in order to demonstrate the safety or efficacy of delivering a particular service via 
338.11 	telemedicine through telehealth. The attestation may include that the health care provider:
338.12 	(1) has identified the categories or types of services the health care provider will provide 
338.13 	via telemedicine through telehealth;
338.14 	(2) has written policies and procedures specific to telemedicine services delivered through 
338.15 	telehealth that are regularly reviewed and updated;
338.16 	(3) has policies and procedures that adequately address patient safety before, during, 
338.17 	and after the telemedicine service is rendered delivered through telehealth;
338.18 	(4) has established protocols addressing how and when to discontinue telemedicine 
338.19 	services; and
338.20 	(5) has an established quality assurance process related to telemedicine delivering services
338.21 	through telehealth.
338.22 	(c) As a condition of payment, a licensed health care provider must document each 
338.23 	occurrence of a health service provided by telemedicine delivered through telehealth to a 
338.24 	medical assistance enrollee. Health care service records for services provided by telemedicine
338.25 	delivered through telehealth must meet the requirements set forth in Minnesota Rules, part 
338.26 	9505.2175, subparts 1 and 2, and must document:
338.27 	(1) the type of service provided by telemedicine delivered through telehealth;
338.28 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
338.29 	designation;
338.30 	(3) the licensed health care provider's basis for determining that telemedicine telehealth
338.31 	is an appropriate and effective means for delivering the service to the enrollee;
339.1 	(4) the mode of transmission of used to deliver the telemedicine service through telehealth 
339.2 	and records evidencing that a particular mode of transmission was utilized;
339.3 	(5) the location of the originating site and the distant site;
339.4 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
339.5 	another physician through telehealth, the written opinion from the consulting physician 
339.6 	providing the telemedicine telehealth consultation; and
339.7 	(7) compliance with the criteria attested to by the health care provider in accordance 
339.8 	with paragraph (b).
339.9 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
339.10 	"telemedicine" is defined as the delivery of health care services or consultations while the 
339.11 	patient is at an originating site and the licensed health care provider is at a distant site. A 
339.12 	communication between licensed health care providers, or a licensed health care provider 
339.13 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
339.14 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
339.15 	by means of real-time two-way, interactive audio and visual communications, including the 
339.16 	application of secure video conferencing or store-and-forward technology to provide or 
339.17 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
339.18 	treatment, education, and care management of a patient's health care.:
339.19 	(1) "telehealth" means the delivery of health care services or consultations through the 
339.20 	use of real-time, two-way interactive audio and visual or audio-only communications to 
339.21 	provide or support health care delivery and facilitate the assessment, diagnosis, consultation, 
339.22 	treatment, education, and care management of a patient's health care. Telehealth includes 
339.23 	the application of secure video conferencing, store-and-forward transfers, and synchronous 
339.24 	interactions between a patient located at an originating site and a health care provider located 
339.25 	at a distant site. Unless interactive visual and audio communication is specifically required, 
339.26 	telehealth includes audio-only communication between a health care provider and a patient, 
339.27 	if the communication is a scheduled appointment with the health care provider and the 
339.28 	standard of care for the service can be met through the use of audio-only communication. 
339.29 	Telehealth does not include communication between health care providers, or communication 
339.30 	between a health care provider and a patient that consists solely of an e-mail or facsimile 
339.31 	transmission;
339.32 	(e) For purposes of this section, "licensed(2) "health care provider" means a licensed
339.33 	health care provider under section 62A.671, subdivision 6 as defined under section 62A.673, 
339.34 	a community paramedic as defined under section 144E.001, subdivision 5f, or a mental 
340.1 	health practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision 
340.2 	26, working under the general supervision of a mental health professional, and a community 
340.3 	health worker who meets the criteria under subdivision 49, paragraph (a); "health care 
340.4 	provider" is defined under section 62A.671, subdivision 3;, a mental health certified peer 
340.5 	specialist under section 256B.0615, subdivision 5, a mental health certified family peer 
340.6 	specialist under section 256B.0616, subdivision 5, a mental health rehabilitation worker 
340.7 	under section 256B.0623, subdivision 5, paragraph (a), clause (4), and paragraph (b), a 
340.8 	mental health behavioral aide under section 256B.0943, subdivision 7, paragraph (b), clause 
340.9 	(3), a treatment coordinator under section 245G.11, subdivision 7, an alcohol and drug 
340.10 	counselor under section 245G.11, subdivision 5, a recovery peer under section 245G.11, 
340.11 	subdivision 8, and a mental health case manager under section 245.462, subdivision 4; and
340.12 	(3) "originating site" is defined under section 62A.671, subdivision 7, "distant site," and 
340.13 	"store-and-forward transfer" have the meanings given in section 62A.673, subdivision 2.
340.14 	(f) The limit on coverage of three telemedicine services per enrollee per calendar week 
340.15 	does not apply if:
340.16 	(1) the telemedicine services provided by the licensed health care provider are for the 
340.17 	treatment and control of tuberculosis; and
340.18 	(2) the services are provided in a manner consistent with the recommendations and best 
340.19 	practices specified by the Centers for Disease Control and Prevention and the commissioner 
340.20 	of health.

340.21 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
340.22 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
340.23 	when federal approval is obtained.

340.24 	Sec. 11. Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision 
340.25 	to read:
340.26 		Subd. 3h.Telemonitoring services. (a) Medical assistance covers telemonitoring services 
340.27 	if a recipient:
340.28 	(1) has been diagnosed and is receiving services for at least one of the following chronic 
340.29 	conditions: hypertension, cancer, congestive heart failure, chronic obstructive pulmonary 
340.30 	disease, asthma, or diabetes;
340.31 	(2) requires at least five times per week monitoring to manage the chronic condition, as 
340.32 	ordered by the recipient's health care provider;
341.1 	(3) has had two or more emergency room or inpatient hospitalization stays within the 
341.2 	last 12 months due to the chronic condition or the recipient's health care provider has 
341.3 	identified that telemonitoring services would likely prevent the recipient's admission or 
341.4 	readmission to a hospital, emergency room, or nursing facility;
341.5 	(4) is cognitively and physically capable of operating the monitoring device or equipment, 
341.6 	or the recipient has a caregiver who is willing and able to assist with the monitoring device 
341.7 	or equipment; and
341.8 	(5) resides in a setting that is suitable for telemonitoring and not in a setting that has 
341.9 	health care staff on site.
341.10 	(b) For purposes of this subdivision, "telemonitoring services" means the remote 
341.11 	monitoring of data related to a recipient's vital signs or biometric data by a monitoring 
341.12 	device or equipment that transmits the data electronically to a provider for analysis. The 
341.13 	assessment and monitoring of the health data transmitted by telemonitoring must be 
341.14 	performed by one of the following licensed health care professionals: physician, podiatrist, 
341.15 	registered nurse, advanced practice registered nurse, physician assistant, respiratory therapist, 
341.16 	or licensed professional working under the supervision of a medical director.

341.17 	EFFECTIVE DATE. This section is effective January 1, 2022.

341.18 	Sec. 12. Minnesota Statutes 2020, section 256B.0625, subdivision 13h, is amended to 
341.19 	read:
341.20 		Subd. 13h.Medication therapy management services. (a) Medical assistance covers 
341.21 	medication therapy management services for a recipient taking prescriptions to treat or 
341.22 	prevent one or more chronic medical conditions. For purposes of this subdivision, 
341.23 	"medication therapy management" means the provision of the following pharmaceutical 
341.24 	care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's 
341.25 	medications:
341.26 	(1) performing or obtaining necessary assessments of the patient's health status;
341.27 	(2) formulating a medication treatment plan, which may include prescribing medications 
341.28 	or products in accordance with section 151.37, subdivision 14, 15, or 16;
341.29 	(3) monitoring and evaluating the patient's response to therapy, including safety and 
341.30 	effectiveness;
341.31 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
341.32 	medication-related problems, including adverse drug events;
342.1 	(5) documenting the care delivered and communicating essential information to the 
342.2 	patient's other primary care providers;
342.3 	(6) providing verbal education and training designed to enhance patient understanding 
342.4 	and appropriate use of the patient's medications;
342.5 	(7) providing information, support services, and resources designed to enhance patient 
342.6 	adherence with the patient's therapeutic regimens; and
342.7 	(8) coordinating and integrating medication therapy management services within the 
342.8 	broader health care management services being provided to the patient.
342.9 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
342.10 	the pharmacist as defined in section 151.01, subdivision 27.
342.11 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
342.12 	must meet the following requirements:
342.13 	(1) have a valid license issued by the Board of Pharmacy of the state in which the 
342.14 	medication therapy management service is being performed;
342.15 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
342.16 	completed a structured and comprehensive education program approved by the Board of 
342.17 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
342.18 	documentation of pharmaceutical care management services that has both clinical and 
342.19 	didactic elements; and
342.20 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
342.21 	have developed a structured patient care process that is offered in a private or semiprivate 
342.22 	patient care area that is separate from the commercial business that also occurs in the setting, 
342.23 	or in home settings, including long-term care settings, group homes, and facilities providing 
342.24 	assisted living services, but excluding skilled nursing facilities; and
342.25 	(4) (3) make use of an electronic patient record system that meets state standards.
342.26 	(c) For purposes of reimbursement for medication therapy management services, the 
342.27 	commissioner may enroll individual pharmacists as medical assistance providers. The 
342.28 	commissioner may also establish contact requirements between the pharmacist and recipient, 
342.29 	including limitinglimits on the number of reimbursable consultations per recipient.
342.30 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
342.31 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
342.32 	requirements may provide The Medication therapy management services may be provided 
343.1 	via two-way interactive video telehealth as defined in subdivision 3b and may be delivered 
343.2 	into a patient's residence. Reimbursement shall be at the same rates and under the same 
343.3 	conditions that would otherwise apply to the services provided. To qualify for reimbursement 
343.4 	under this paragraph, the pharmacist providing the services must meet the requirements of 
343.5 	paragraph (b), and must be located within an ambulatory care setting that meets the 
343.6 	requirements of paragraph (b), clause (3). The patient must also be located within an 
343.7 	ambulatory care setting that meets the requirements of paragraph (b), clause (3). Services 
343.8 	provided under this paragraph may not be transmitted into the patient's residence.
343.9 	(e) Medication therapy management services may be delivered into a patient's residence 
343.10 	via secure interactive video if the medication therapy management services are performed 
343.11 	electronically during a covered home care visit by an enrolled provider. Reimbursement 
343.12 	shall be at the same rates and under the same conditions that would otherwise apply to the 
343.13 	services provided. To qualify for reimbursement under this paragraph, the pharmacist 
343.14 	providing the services must meet the requirements of paragraph (b) and must be located 
343.15 	within an ambulatory care setting that meets the requirements of paragraph (b), clause (3).

343.16 	EFFECTIVE DATE. This section is effective January 1, 2022.

343.17 	Sec. 13. Minnesota Statutes 2020, section 256B.0625, subdivision 20, is amended to read:
343.18 		Subd. 20.Mental health case management. (a) To the extent authorized by rule of the 
343.19 	state agency, medical assistance covers case management services to persons with serious 
343.20 	and persistent mental illness and children with severe emotional disturbance. Services 
343.21 	provided under this section must meet the relevant standards in sections 245.461 to 245.4887, 
343.22 	the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 
343.23 	9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
343.24 	(b) Entities meeting program standards set out in rules governing family community 
343.25 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
343.26 	assistance reimbursement for case management services for children with severe emotional 
343.27 	disturbance when these services meet the program standards in Minnesota Rules, parts 
343.28 	9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
343.29 	(c) Medical assistance and MinnesotaCare payment for mental health case management 
343.30 	shall be made on a monthly basis. In order to receive payment for an eligible child, the 
343.31 	provider must document at least a face-to-face contact or a contact by interactive video that 
343.32 	meets the requirements of subdivision 20b with the child, the child's parents, or the child's 
343.33 	legal representative. To receive payment for an eligible adult, the provider must document:
344.1 	(1) at least a face-to-face contact, or a contact by interactive video that meets the 
344.2 	requirements of subdivision 20b, with the adult or the adult's legal representative or a contact 
344.3 	by interactive video that meets the requirements of subdivision 20b; or
344.4 	(2) at least a telephone contact with the adult or the adult's legal representative and 
344.5 	document a face-to-face contact or a contact by interactive video that meets the requirements 
344.6 	of subdivision 20b with the adult or the adult's legal representative within the preceding 
344.7 	two months.
344.8 	(d) Payment for mental health case management provided by county or state staff shall 
344.9 	be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph 
344.10 	(b), with separate rates calculated for child welfare and mental health, and within mental 
344.11 	health, separate rates for children and adults.
344.12 	(e) Payment for mental health case management provided by Indian health services or 
344.13 	by agencies operated by Indian tribes may be made according to this section or other relevant 
344.14 	federally approved rate setting methodology.
344.15 	(f) Payment for mental health case management provided by vendors who contract with 
344.16 	a county or Indian tribe shall be based on a monthly rate negotiated by the host county or 
344.17 	tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 
344.18 	service to other payers. If the service is provided by a team of contracted vendors, the county 
344.19 	or tribe may negotiate a team rate with a vendor who is a member of the team. The team 
344.20 	shall determine how to distribute the rate among its members. No reimbursement received 
344.21 	by contracted vendors shall be returned to the county or tribe, except to reimburse the county 
344.22 	or tribe for advance funding provided by the county or tribe to the vendor.
344.23 	(g) If the service is provided by a team which includes contracted vendors, tribal staff, 
344.24 	and county or state staff, the costs for county or state staff participation in the team shall be 
344.25 	included in the rate for county-provided services. In this case, the contracted vendor, the 
344.26 	tribal agency, and the county may each receive separate payment for services provided by 
344.27 	each entity in the same month. In order to prevent duplication of services, each entity must 
344.28 	document, in the recipient's file, the need for team case management and a description of 
344.29 	the roles of the team members.
344.30 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
344.31 	mental health case management shall be provided by the recipient's county of responsibility, 
344.32 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
344.33 	used to match other federal funds. If the service is provided by a tribal agency, the nonfederal 
344.34 	share, if any, shall be provided by the recipient's tribe. When this service is paid by the state 
345.1 	without a federal share through fee-for-service, 50 percent of the cost shall be provided by 
345.2 	the recipient's county of responsibility.
345.3 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance 
345.4 	and MinnesotaCare include mental health case management. When the service is provided 
345.5 	through prepaid capitation, the nonfederal share is paid by the state and the county pays no 
345.6 	share.
345.7 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider 
345.8 	that does not meet the reporting or other requirements of this section. The county of 
345.9 	responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, 
345.10 	is responsible for any federal disallowances. The county or tribe may share this responsibility 
345.11 	with its contracted vendors.
345.12 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
345.13 	expenditures under this section to repay the special revenue maximization account under 
345.14 	section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
345.15 	(1) the costs of developing and implementing this section; and
345.16 	(2) programming the information systems.
345.17 	(l) Payments to counties and tribal agencies for case management expenditures under 
345.18 	this section shall only be made from federal earnings from services provided under this 
345.19 	section. When this service is paid by the state without a federal share through fee-for-service, 
345.20 	50 percent of the cost shall be provided by the state. Payments to county-contracted vendors 
345.21 	shall include the federal earnings, the state share, and the county share.
345.22 	(m) Case management services under this subdivision do not include therapy, treatment, 
345.23 	legal, or outreach services.
345.24 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
345.25 	and the recipient's institutional care is paid by medical assistance, payment for case 
345.26 	management services under this subdivision is limited to the lesser of:
345.27 	(1) the last 180 days of the recipient's residency in that facility and may not exceed more 
345.28 	than six months in a calendar year; or
345.29 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
345.30 	(o) Payment for case management services under this subdivision shall not duplicate 
345.31 	payments made under other program authorities for the same purpose.
346.1 	(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting 
346.2 	licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week, 
346.3 	mental health targeted case management services must actively support identification of 
346.4 	community alternatives for the recipient and discharge planning.

346.5 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
346.6 	of human services shall notify the revisor of statutes when federal approval is obtained.

346.7 	Sec. 14. Minnesota Statutes 2020, section 256B.0625, subdivision 20b, is amended to 
346.8 	read:
346.9 		Subd. 20b.Mental health Targeted case management face-to-face contact through 
346.10 	interactive video. (a) Subject to federal approval, contact made for targeted case management 
346.11 	by interactive video shall be eligible for payment if:
346.12 	(1) the person receiving targeted case management services is residing in:
346.13 	(i) a hospital;
346.14 	(ii) a nursing facility; or
346.15 	(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging 
346.16 	establishment or lodging establishment that provides supportive services or health supervision 
346.17 	services according to section 157.17 that is staffed 24 hours a day, seven days a week;
346.18 	(2) interactive video is in the best interests of the person and is deemed appropriate by 
346.19 	the person receiving targeted case management or the person's legal guardian, the case 
346.20 	management provider, and the provider operating the setting where the person is residing;
346.21 	(3) the use of interactive video is approved as part of the person's written personal service 
346.22 	or case plan, taking into consideration the person's vulnerability and active personal 
346.23 	relationships; and
346.24 	(4) interactive video is used for up to, but not more than, 50 percent of the minimum 
346.25 	required face-to-facecontact.(a) Minimum required face-to-face contacts for targeted case 
346.26 	management may be provided through interactive video if interactive video is in the best 
346.27 	interests of the person and is deemed appropriate by the person receiving targeted case 
346.28 	management or the person's legal guardian and the case management provider.
346.29 	(b) The person receiving targeted case management or the person's legal guardian has 
346.30 	the right to choose and consent to the use of interactive video under this subdivision and 
346.31 	has the right to refuse the use of interactive video at any time.
347.1 	(c) The commissioner shallmay establish criteria that a targeted case management 
347.2 	provider must attest to in order to demonstrate the safety or efficacy of delivering the service
347.3 	meeting the minimum face-to-face contact requirements for targeted case management via 
347.4 	interactive video. The attestation may include that the case management provider has:
347.5 	(1) written policies and procedures specific to interactive video services that are regularly 
347.6 	reviewed and updated;
347.7 	(2) policies and procedures that adequately address client safety before, during, and after 
347.8 	the interactive video services are rendered;
347.9 	(3) established protocols addressing how and when to discontinue interactive video 
347.10 	services; and
347.11 	(4) established a quality assurance process related to interactive video services.
347.12 	(d) As a condition of payment, the targeted case management provider must document 
347.13 	the following for each occurrence of targeted case management provided by interactive 
347.14 	video for the purpose of face-to-face contact:
347.15 	(1) the time the servicecontact began and the time the servicecontact ended, including 
347.16 	an a.m. and p.m. designation;
347.17 	(2) the basis for determining that interactive video is an appropriate and effective means 
347.18 	for delivering the service tocontacting the person receiving targeted case management 
347.19 	services;
347.20 	(3) the mode of transmission of the interactive video services and records evidencing 
347.21 	that a particular mode of transmission was utilized; and
347.22 	(4) the location of the originating site and the distant site; and.
347.23 	(5) compliance with the criteria attested to by the targeted case management provider 
347.24 	as provided in paragraph (c).
347.25 	(e) Interactive video must not be used to meet minimum face-to-face contact requirements 
347.26 	for children who are in out-of-home placement or receiving case management services for 
347.27 	child protection reasons.
347.28 	(f) For the purposes of this section, "interactive video" means real-time, two-way 
347.29 	interactive audio and visual communications.

347.30 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
347.31 	of human services shall notify the revisor of statutes when federal approval is obtained.

348.1 	Sec. 15. Minnesota Statutes 2020, section 256B.0625, subdivision 46, is amended to read:
348.2 		Subd. 46.Mental health telemedicine telehealth. Effective January 1, 2006, and Subject 
348.3 	to federal approval, mental health services that are otherwise covered by medical assistance 
348.4 	as direct face-to-face services may be provided via two-way interactive video telehealth as 
348.5 	defined in subdivision 3b. Use of two-way interactive video telehealth to deliver services
348.6 	must be medically appropriate to the condition and needs of the person being served. 
348.7 	Reimbursement is at the same rates and under the same conditions that would otherwise 
348.8 	apply to the service. The interactive video equipment and connection must comply with 
348.9 	Medicare standards in effect at the time the service is provided.

348.10 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
348.11 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
348.12 	when federal approval is obtained.

348.13 	Sec. 16. Minnesota Statutes 2020, section 256B.0911, subdivision 1a, is amended to read:
348.14 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
348.15 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
348.16 	services" means:
348.17 	(1) intake for and access to assistance in identifying services needed to maintain an 
348.18 	individual in the most inclusive environment;
348.19 	(2) providing recommendations for and referrals to cost-effective community services 
348.20 	that are available to the individual;
348.21 	(3) development of an individual's person-centered community support plan;
348.22 	(4) providing information regarding eligibility for Minnesota health care programs;
348.23 	(5) face-to-face long-term care consultation assessments conducted according to 
348.24 	subdivision 3a, which may be completed in a hospital, nursing facility, intermediate care 
348.25 	facility for persons with developmental disabilities (ICF/DDs), regional treatment centers, 
348.26 	or the person's current or planned residence;
348.27 	(6) determination of home and community-based waiver and other service eligibility as 
348.28 	required under chapter 256S and sections 256B.0913, 256B.092, and 256B.49, including 
348.29 	level of care determination for individuals who need an institutional level of care as 
348.30 	determined under subdivision 4e, based on a long-term care consultation assessment and 
348.31 	community support plan development, appropriate referrals to obtain necessary diagnostic 
349.1 	information, and including an eligibility determination for consumer-directed community 
349.2 	supports;
349.3 	(7) providing recommendations for institutional placement when there are no 
349.4 	cost-effective community services available;
349.5 	(8) providing access to assistance to transition people back to community settings after 
349.6 	institutional admission;
349.7 	(9) providing information about competitive employment, with or without supports, for 
349.8 	school-age youth and working-age adults and referrals to the Disability Hub and Disability 
349.9 	Benefits 101 to ensure that an informed choice about competitive employment can be made. 
349.10 	For the purposes of this subdivision, "competitive employment" means work in the 
349.11 	competitive labor market that is performed on a full-time or part-time basis in an integrated 
349.12 	setting, and for which an individual is compensated at or above the minimum wage, but not 
349.13 	less than the customary wage and level of benefits paid by the employer for the same or 
349.14 	similar work performed by individuals without disabilities;
349.15 	(10) providing information about independent living to ensure that an informed choice 
349.16 	about independent living can be made; and
349.17 	(11) providing information about self-directed services and supports, including 
349.18 	self-directed funding options, to ensure that an informed choice about self-directed options 
349.19 	can be made.
349.20 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
349.21 	and 3a, "long-term care consultation services" also means:
349.22 	(1) service eligibility determination for the following state plan services:
349.23 	(i) personal care assistance services under section 256B.0625, subdivisions 19a and 19c;
349.24 	(ii) consumer support grants under section 256.476; or
349.25 	(iii) community first services and supports under section 256B.85;
349.26 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
349.27 	gaining access to:
349.28 	(i) relocation targeted case management services available under section 256B.0621, 
349.29 	subdivision 2, clause (4);
349.30 	(ii) case management services targeted to vulnerable adults or developmental disabilities 
349.31 	under section 256B.0924; and
350.1 	(iii) case management services targeted to people with developmental disabilities under 
350.2 	Minnesota Rules, part 9525.0016;
350.3 	(3) determination of eligibility for semi-independent living services under section 
350.4 	252.275; and
350.5 	(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) 
350.6 	and (3).
350.7 	(c) "Long-term care options counseling" means the services provided by sections 256.01, 
350.8 	subdivision 24, and 256.975, subdivision 7, and also includes telephone assistance and 
350.9 	follow up once a long-term care consultation assessment has been completed.
350.10 	(d) "Minnesota health care programs" means the medical assistance program under this 
350.11 	chapter and the alternative care program under section 256B.0913.
350.12 	(e) "Lead agencies" means counties administering or tribes and health plans under 
350.13 	contract with the commissioner to administer long-term care consultation services.
350.14 	(f) "Person-centered planning" is a process that includes the active participation of a 
350.15 	person in the planning of the person's services, including in making meaningful and informed 
350.16 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
350.17 	and informed choices about the services the person receives, the settings in which the person 
350.18 	receives the services, and the setting in which the person lives.
350.19 	(g) "Informed choice" means a voluntary choice of services, settings, living arrangement, 
350.20 	and work by a person from all available service and setting options based on accurate and 
350.21 	complete information concerning all available service and setting options and concerning 
350.22 	the person's own preferences, abilities, goals, and objectives. In order for a person to make 
350.23 	an informed choice, all available options must be developed and presented to the person in 
350.24 	a way the person can understand to empower the person to make fully informed choices.
350.25 	(h) "Available service and setting options" or "available options," with respect to the 
350.26 	home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49, 
350.27 	means all services and settings defined under the waiver plan for which a waiver applicant 
350.28 	or waiver participant is eligible.
350.29 	(i) "Independent living" means living in a setting that is not controlled by a provider.

350.30 	Sec. 17. Minnesota Statutes 2020, section 256B.0911, subdivision 3a, is amended to read:
350.31 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
350.32 	planning, or other assistance intended to support community-based living, including persons 
351.1 	who need assessment in order to determine waiver or alternative care program eligibility, 
351.2 	must be visited by a long-term care consultation team within 20 calendar days after the date 
351.3 	on which an assessment was requested or recommended. Upon statewide implementation 
351.4 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
351.5 	requesting personal care assistance services. The commissioner shall provide at least a 
351.6 	90-day notice to lead agencies prior to the effective date of this requirement. Face-to-face
351.7 	Assessments must be conducted according to paragraphs (b) to (i) (q).
351.8 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
351.9 	assessors to conduct the assessment. For a person with complex health care needs, a public 
351.10 	health or registered nurse from the team must be consulted.
351.11 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
351.12 	be used to complete a comprehensive, conversation-based, person-centered assessment. 
351.13 	The assessment must include the health, psychological, functional, environmental, and 
351.14 	social needs of the individual necessary to develop a person-centered community support 
351.15 	plan that meets the individual's needs and preferences.
351.16 	(d) Except as provided in paragraph (q), the assessment must be conducted by a certified 
351.17 	assessor in a face-to-face conversational interview with the person being assessed. The 
351.18 	person's legal representative must provide input during the assessment process and may do 
351.19 	so remotely if requested. At the request of the person, other individuals may participate in 
351.20 	the assessment to provide information on the needs, strengths, and preferences of the person 
351.21 	necessary to develop a community support plan that ensures the person's health and safety. 
351.22 	Except for legal representatives or family members invited by the person, persons 
351.23 	participating in the assessment may not be a provider of service or have any financial interest 
351.24 	in the provision of services. For persons who are to be assessed for elderly waiver customized 
351.25 	living or adult day services under chapter 256S, with the permission of the person being 
351.26 	assessed or the person's designated or legal representative, the client's current or proposed 
351.27 	provider of services may submit a copy of the provider's nursing assessment or written 
351.28 	report outlining its recommendations regarding the client's care needs. The person conducting 
351.29 	the assessment must notify the provider of the date by which this information is to be 
351.30 	submitted. This information shall be provided to the person conducting the assessment prior 
351.31 	to the assessment. For a person who is to be assessed for waiver services under section 
351.32 	256B.092 or 256B.49, with the permission of the person being assessed or the person's 
351.33 	designated legal representative, the person's current provider of services may submit a 
351.34 	written report outlining recommendations regarding the person's care needs the person 
351.35 	completed in consultation with someone who is known to the person and has interaction 
352.1 	with the person on a regular basis. The provider must submit the report at least 60 days 
352.2 	before the end of the person's current service agreement. The certified assessor must consider 
352.3 	the content of the submitted report prior to finalizing the person's assessment or reassessment.
352.4 	(e) The certified assessor and the individual responsible for developing the coordinated 
352.5 	service and support plan must complete the community support plan and the coordinated 
352.6 	service and support plan no more than 60 calendar days from the assessment visit. The 
352.7 	person or the person's legal representative must be provided with a written community 
352.8 	support plan within the timelines established by the commissioner, regardless of whether 
352.9 	the person is eligible for Minnesota health care programs.
352.10 	(f) For a person being assessed for elderly waiver services under chapter 256S, a provider 
352.11 	who submitted information under paragraph (d) shall receive the final written community 
352.12 	support plan when available and the Residential Services Workbook.
352.13 	(g) The written community support plan must include:
352.14 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
352.15 	(2) the individual's options and choices to meet identified needs, including:
352.16 	(i) all available options for case management services and providers;
352.17 	(ii) all available options for employment services, settings, and providers;
352.18 	(iii) all available options for living arrangements;
352.19 	(iv) all available options for self-directed services and supports, including self-directed 
352.20 	budget options; and
352.21 	(v) service provided in a non-disability-specific setting;
352.22 	(3) identification of health and safety risks and how those risks will be addressed, 
352.23 	including personal risk management strategies;
352.24 	(4) referral information; and
352.25 	(5) informal caregiver supports, if applicable.
352.26 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
352.27 	(b), clause (1), the person or person's representative must also receive a copy of the home 
352.28 	care service plan developed by the certified assessor.
352.29 	(h) A person may request assistance in identifying community supports without 
352.30 	participating in a complete assessment. Upon a request for assistance identifying community 
352.31 	support, the person must be transferred or referred to long-term care options counseling 
353.1 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
353.2 	telephone assistance and follow up.
353.3 	(i) The person has the right to make the final decision:
353.4 	(1) between institutional placement and community placement after the recommendations 
353.5 	have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);
353.6 	(2) between community placement in a setting controlled by a provider and living 
353.7 	independently in a setting not controlled by a provider;
353.8 	(3) between day services and employment services; and
353.9 	(4) regarding available options for self-directed services and supports, including 
353.10 	self-directed funding options.
353.11 	(j) The lead agency must give the person receiving long-term care consultation services 
353.12 	or the person's legal representative, materials, and forms supplied by the commissioner 
353.13 	containing the following information:
353.14 	(1) written recommendations for community-based services and consumer-directed 
353.15 	options;
353.16 	(2) documentation that the most cost-effective alternatives available were offered to the 
353.17 	individual. For purposes of this clause, "cost-effective" means community services and 
353.18 	living arrangements that cost the same as or less than institutional care. For an individual 
353.19 	found to meet eligibility criteria for home and community-based service programs under 
353.20 	chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally 
353.21 	approved waiver plan for each program;
353.22 	(3) the need for and purpose of preadmission screening conducted by long-term care 
353.23 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
353.24 	nursing facility placement. If the individual selects nursing facility placement, the lead 
353.25 	agency shall forward information needed to complete the level of care determinations and 
353.26 	screening for developmental disability and mental illness collected during the assessment 
353.27 	to the long-term care options counselor using forms provided by the commissioner;
353.28 	(4) the role of long-term care consultation assessment and support planning in eligibility 
353.29 	determination for waiver and alternative care programs, and state plan home care, case 
353.30 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
353.31 	and (b);
353.32 	(5) information about Minnesota health care programs;
354.1 	(6) the person's freedom to accept or reject the recommendations of the team;
354.2 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
354.3 	Act, chapter 13;
354.4 	(8) the certified assessor's decision regarding the person's need for institutional level of 
354.5 	care as determined under criteria established in subdivision 4e and the certified assessor's 
354.6 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
354.7 	paragraphs (a), clause (6), and (b);
354.8 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
354.9 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
354.10 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
354.11 	or the lead agency's final decisions regarding public programs eligibility according to section 
354.12 	256.045, subdivision 3. The certified assessor must verbally communicate this appeal right 
354.13 	to the person and must visually point out where in the document the right to appeal is stated; 
354.14 	and
354.15 	(10) documentation that available options for employment services, independent living, 
354.16 	and self-directed services and supports were described to the individual.
354.17 	(k) Face-to-face Assessment completed as part of an eligibility determination for multiple 
354.18 	programs for the alternative care, elderly waiver, developmental disabilities, community 
354.19 	access for disability inclusion, community alternative care, and brain injury waiver programs 
354.20 	under chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish 
354.21 	service eligibility for no more than 60 calendar days after the date of assessment.
354.22 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
354.23 	to the date of assessment. If an assessment was completed more than 60 days before the 
354.24 	effective waiver or alternative care program eligibility start date, assessment and support 
354.25 	plan information must be updated and documented in the department's Medicaid Management 
354.26 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
354.27 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
354.28 	cannot be prior to the date the most recent updated assessment is completed.
354.29 	(m) If an eligibility update is completed within 90 days of the previous face-to-face
354.30 	assessment and documented in the department's Medicaid Management Information System 
354.31 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
354.32 	of the previous face-to-face assessment when all other eligibility requirements are met.
355.1 	(n) At the time of reassessment, the certified assessor shall assess each person receiving 
355.2 	waiver residential supports and services currently residing in a community residential setting, 
355.3 	licensed adult foster care home that is either not the primary residence of the license holder 
355.4 	or in which the license holder is not the primary caregiver, family adult foster care residence, 
355.5 	customized living setting, or supervised living facility to determine if that person would 
355.6 	prefer to be served in a community-living setting as defined in section 256B.49, subdivision 
355.7 	23, in a setting not controlled by a provider, or to receive integrated community supports 
355.8 	as described in section 245D.03, subdivision 1, paragraph (c), clause (8). The certified 
355.9 	assessor shall offer the person, through a person-centered planning process, the option to 
355.10 	receive alternative housing and service options.
355.11 	(o) At the time of reassessment, the certified assessor shall assess each person receiving 
355.12 	waiver day services to determine if that person would prefer to receive employment services 
355.13 	as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified 
355.14 	assessor shall describe to the person through a person-centered planning process the option 
355.15 	to receive employment services.
355.16 	(p) At the time of reassessment, the certified assessor shall assess each person receiving 
355.17 	non-self-directed waiver services to determine if that person would prefer an available 
355.18 	service and setting option that would permit self-directed services and supports. The certified 
355.19 	assessor shall describe to the person through a person-centered planning process the option 
355.20 	to receive self-directed services and supports.
355.21 	(q) All assessments performed according to this subdivision must be face-to-face unless 
355.22 	the assessment is a reassessment meeting the requirements of this paragraph. Subject to 
355.23 	federal approval, remote reassessments conducted by interactive video or telephone may 
355.24 	substitute for face-to-face reassessments for services provided by alternative care under 
355.25 	section 256B.0913, the elderly waiver under chapter 256S, the developmental disabilities 
355.26 	waiver under section 256B.092, and the community access for disability inclusion, 
355.27 	community alternative care, and brain injury waiver programs under section 256B.49. 
355.28 	Remote reassessments may be substituted for two consecutive reassessments if followed 
355.29 	by a face-to-face reassessment. A remote reassessment is permitted only if the person being 
355.30 	reassessed, the person's legal representative, and the lead agency case manager all agree 
355.31 	that there is no change in the person's condition, there is no need for a change in service, 
355.32 	and that a remote reassessment is appropriate. The person being reassessed, or the person's 
355.33 	legal representative, has the right to refuse a remote reassessment at any time. During a 
355.34 	remote reassessment, if the certified assessor determines in the assessor's sole judgment 
355.35 	that a remote reassessment is inappropriate, the certified assessor shall suspend the remote 
356.1 	reassessment and schedule a face-to-face reassessment to complete the reassessment. All 
356.2 	other requirements of a face-to-face reassessment apply to a remote reassessment.

356.3 	Sec. 18. Minnesota Statutes 2020, section 256B.0911, subdivision 3f, is amended to read:
356.4 		Subd. 3f.Long-term care reassessments and community support plan updates. (a) 
356.5 	Prior to a face-to-face reassessment, the certified assessor must review the person's most 
356.6 	recent assessment. Reassessments must be tailored using the professional judgment of the 
356.7 	assessor to the person's known needs, strengths, preferences, and circumstances. 
356.8 	Reassessments provide information to support the person's informed choice and opportunities 
356.9 	to express choice regarding activities that contribute to quality of life, as well as information 
356.10 	and opportunity to identify goals related to desired employment, community activities, and 
356.11 	preferred living environment. Reassessments require a review of the most recent assessment, 
356.12 	review of the current coordinated service and support plan's effectiveness, monitoring of 
356.13 	services, and the development of an updated person-centered community support plan. 
356.14 	Reassessments must verify continued eligibility, offer alternatives as warranted, and provide 
356.15 	an opportunity for quality assurance of service delivery. Face-to-face Reassessments must 
356.16 	be conducted annually or as required by federal and state laws and rules. For reassessments, 
356.17 	the certified assessor and the individual responsible for developing the coordinated service 
356.18 	and support plan must ensure the continuity of care for the person receiving services and 
356.19 	complete the updated community support plan and the updated coordinated service and 
356.20 	support plan no more than 60 days from the reassessment visit.
356.21 	(b) The commissioner shall develop mechanisms for providers and case managers to 
356.22 	share information with the assessor to facilitate a reassessment and support planning process 
356.23 	tailored to the person's current needs and preferences.

356.24 	Sec. 19. Minnesota Statutes 2020, section 256B.0911, subdivision 4d, is amended to read:
356.25 		Subd. 4d.Preadmission screening of individuals under 65 years of age. (a) It is the 
356.26 	policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness 
356.27 	are served in the most integrated setting appropriate to their needs and have the necessary 
356.28 	information to make informed choices about home and community-based service options.
356.29 	(b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing 
356.30 	facility must be screened prior to admission according to the requirements outlined in section 
356.31 	256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as 
356.32 	required under section 256.975, subdivision 7.
357.1 	(c) Individuals under 65 years of age who are admitted to nursing facilities with only a 
357.2 	telephone screening must receive a face-to-face assessment from the long-term care 
357.3 	consultation team member of the county in which the facility is located or from the recipient's 
357.4 	county case manager within the timeline established by the commissioner, based on review 
357.5 	of data.
357.6 	(d) At the face-to-face assessment, the long-term care consultation team member or 
357.7 	county case manager must perform the activities required under subdivision 3b.
357.8 	(e) For individuals under 21 years of age, a screening interview which recommends 
357.9 	nursing facility admission must be face-to-face and approved by the commissioner before 
357.10 	the individual is admitted to the nursing facility.
357.11 	(f) In the event that an individual under 65 years of age is admitted to a nursing facility 
357.12 	on an emergency basis, the Senior LinkAge Line must be notified of the admission on the 
357.13 	next working day, and a face-to-face assessment as described in paragraph (c) must be 
357.14 	conducted within the timeline established by the commissioner, based on review of data.
357.15 	(g) At the face-to-face assessment, the long-term care consultation team member or the 
357.16 	case manager must present information about home and community-based options, including 
357.17 	consumer-directed options, so the individual can make informed choices. If the individual 
357.18 	chooses home and community-based services, the long-term care consultation team member 
357.19 	or case manager must complete a written relocation plan within 20 working days of the 
357.20 	visit. The plan shall describe the services needed to move out of the facility and a time line 
357.21 	for the move which is designed to ensure a smooth transition to the individual's home and 
357.22 	community.
357.23 	(h) An individual under 65 years of age residing in a nursing facility shall receive a 
357.24 	face-to-face assessment reassessment at least every 12 months to review the person's service 
357.25 	choices and available alternatives unless the individual indicates, in writing, that annual 
357.26 	visits are not desired. In this case, the individual must receive a face-to-face assessment
357.27 	reassessment at least once every 36 months for the same purposes. A remote reassessment 
357.28 	is permitted only if the person being reassessed, the person's legal representative, and the 
357.29 	lead agency case manager all agree that there is no change in the person's condition, there 
357.30 	is no need for a change in service, and that a remote reassessment is appropriate. The person 
357.31 	being reassessed, or the person's legal representative, has the right to refuse a remote 
357.32 	reassessment at any time. During a remote reassessment, if the certified assessor determines 
357.33 	in the assessor's sole judgment that a remote reassessment is inappropriate, the certified 
357.34 	assessor shall suspend the remote reassessment and schedule a face-to-face reassessment 
358.1 	to complete the reassessment. All other requirements of a face-to-face reassessment apply 
358.2 	to a remote reassessment.
358.3 	(i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county 
358.4 	agencies directly for face-to-face assessments for individuals under 65 years of age who 
358.5 	are being considered for placement or residing in a nursing facility.
358.6 	(j) Funding for preadmission screening follow-up shall be provided to the Disability 
358.7 	Hub for the under-60 population by the Department of Human Services to cover options 
358.8 	counseling salaries and expenses to provide the services described in subdivisions 7a to 7c. 
358.9 	The Disability Hub shall employ, or contract with other agencies to employ, within the 
358.10 	limits of available funding, sufficient personnel to provide preadmission screening follow-up 
358.11 	services and shall seek to maximize federal funding for the service as provided under section 
358.12 	256.01, subdivision 2, paragraph (aa).

358.13 	Sec. 20. Minnesota Statutes 2020, section 256B.0924, subdivision 6, is amended to read:
358.14 		Subd. 6.Payment for targeted case management. (a) Medical assistance and 
358.15 	MinnesotaCare payment for targeted case management shall be made on a monthly basis. 
358.16 	In order to receive payment for an eligible adult, the provider must document at least one 
358.17 	contact per month and not more than two consecutive months without a face-to-face contact 
358.18 	or a contact by interactive video that meets the requirements of section 256B.0625, 
358.19 	subdivision 20b, with the adult or the adult's legal representative, family, primary caregiver, 
358.20 	or other relevant persons identified as necessary to the development or implementation of 
358.21 	the goals of the personal service plan.
358.22 	(b) Payment for targeted case management provided by county staff under this subdivision 
358.23 	shall be based on the monthly rate methodology under section 256B.094, subdivision 6, 
358.24 	paragraph (b), calculated as one combined average rate together with adult mental health 
358.25 	case management under section 256B.0625, subdivision 20, except for calendar year 2002. 
358.26 	In calendar year 2002, the rate for case management under this section shall be the same as 
358.27 	the rate for adult mental health case management in effect as of December 31, 2001. Billing 
358.28 	and payment must identify the recipient's primary population group to allow tracking of 
358.29 	revenues.
358.30 	(c) Payment for targeted case management provided by county-contracted vendors shall 
358.31 	be based on a monthly rate negotiated by the host county. The negotiated rate must not 
358.32 	exceed the rate charged by the vendor for the same service to other payers. If the service is 
358.33 	provided by a team of contracted vendors, the county may negotiate a team rate with a 
358.34 	vendor who is a member of the team. The team shall determine how to distribute the rate 
359.1 	among its members. No reimbursement received by contracted vendors shall be returned 
359.2 	to the county, except to reimburse the county for advance funding provided by the county 
359.3 	to the vendor.
359.4 	(d) If the service is provided by a team that includes contracted vendors and county staff, 
359.5 	the costs for county staff participation on the team shall be included in the rate for 
359.6 	county-provided services. In this case, the contracted vendor and the county may each 
359.7 	receive separate payment for services provided by each entity in the same month. In order 
359.8 	to prevent duplication of services, the county must document, in the recipient's file, the need 
359.9 	for team targeted case management and a description of the different roles of the team 
359.10 	members.
359.11 	(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
359.12 	targeted case management shall be provided by the recipient's county of responsibility, as 
359.13 	defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
359.14 	used to match other federal funds.
359.15 	(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider 
359.16 	that does not meet the reporting or other requirements of this section. The county of 
359.17 	responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal 
359.18 	disallowances. The county may share this responsibility with its contracted vendors.
359.19 	(g) The commissioner shall set aside five percent of the federal funds received under 
359.20 	this section for use in reimbursing the state for costs of developing and implementing this 
359.21 	section.
359.22 	(h) Payments to counties for targeted case management expenditures under this section 
359.23 	shall only be made from federal earnings from services provided under this section. Payments 
359.24 	to contracted vendors shall include both the federal earnings and the county share.
359.25 	(i) Notwithstanding section 256B.041, county payments for the cost of case management 
359.26 	services provided by county staff shall not be made to the commissioner of management 
359.27 	and budget. For the purposes of targeted case management services provided by county 
359.28 	staff under this section, the centralized disbursement of payments to counties under section 
359.29 	256B.041 consists only of federal earnings from services provided under this section.
359.30 	(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
359.31 	and the recipient's institutional care is paid by medical assistance, payment for targeted case 
359.32 	management services under this subdivision is limited to the lesser of:
359.33 	(1) the last 180 days of the recipient's residency in that facility; or
360.1 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
360.2 	(k) Payment for targeted case management services under this subdivision shall not 
360.3 	duplicate payments made under other program authorities for the same purpose.
360.4 	(l) Any growth in targeted case management services and cost increases under this 
360.5 	section shall be the responsibility of the counties.

360.6 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
360.7 	of human services shall notify the revisor of statutes when federal approval is obtained.

360.8 	Sec. 21. Minnesota Statutes 2020, section 256B.094, subdivision 6, is amended to read:
360.9 		Subd. 6.Medical assistance reimbursement of case management services. (a) Medical 
360.10 	assistance reimbursement for services under this section shall be made on a monthly basis. 
360.11 	Payment is based on face-to-face, interactive video, or telephone contacts between the case 
360.12 	manager and the client, client's family, primary caregiver, legal representative, or other 
360.13 	relevant person identified as necessary to the development or implementation of the goals 
360.14 	of the individual service plan regarding the status of the client, the individual service plan, 
360.15 	or the goals for the client. These contacts must meet the minimum standards in clauses (1) 
360.16 	and (2):
360.17 	(1) there must be a face-to-face contact, or a contact by interactive video that meets the 
360.18 	requirements of section 256B.0625, subdivision 20b, at least once a month except as provided 
360.19 	in clause (2); and
360.20 	(2) for a client placed outside of the county of financial responsibility, or a client served 
360.21 	by tribal social services placed outside the reservation, in an excluded time facility under 
360.22 	section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of 
360.23 	Children, section 260.93, and the placement in either case is more than 60 miles beyond 
360.24 	the county or reservation boundaries, there must be at least one contact per month and not 
360.25 	more than two consecutive months without a face-to-face contact.
360.26 	Face-to-face contacts under this paragraph may be conducted using interactive video for 
360.27 	up to two consecutive contacts following each in-person contact.
360.28 	(b) Except as provided under paragraph (c), the payment rate is established using time 
360.29 	study data on activities of provider service staff and reports required under sections 245.482
360.30 	and 256.01, subdivision 2, paragraph (p).
361.1 	(c) Payments for tribes may be made according to section 256B.0625 or other relevant 
361.2 	federally approved rate setting methodology for child welfare targeted case management 
361.3 	provided by Indian health services and facilities operated by a tribe or tribal organization.
361.4 	(d) Payment for case management provided by county or tribal social services contracted 
361.5 	vendors shall be based on a monthly rate negotiated by the host county or tribal social 
361.6 	services. The negotiated rate must not exceed the rate charged by the vendor for the same 
361.7 	service to other payers. If the service is provided by a team of contracted vendors, the county 
361.8 	or tribal social services may negotiate a team rate with a vendor who is a member of the 
361.9 	team. The team shall determine how to distribute the rate among its members. No 
361.10 	reimbursement received by contracted vendors shall be returned to the county or tribal social 
361.11 	services, except to reimburse the county or tribal social services for advance funding provided 
361.12 	by the county or tribal social services to the vendor.
361.13 	(e) If the service is provided by a team that includes contracted vendors and county or 
361.14 	tribal social services staff, the costs for county or tribal social services staff participation in 
361.15 	the team shall be included in the rate for county or tribal social services provided services. 
361.16 	In this case, the contracted vendor and the county or tribal social services may each receive 
361.17 	separate payment for services provided by each entity in the same month. To prevent 
361.18 	duplication of services, each entity must document, in the recipient's file, the need for team 
361.19 	case management and a description of the roles and services of the team members.
361.20 	(f) Separate payment rates may be established for different groups of providers to 
361.21 	maximize reimbursement as determined by the commissioner. The payment rate will be 
361.22 	reviewed annually and revised periodically to be consistent with the most recent time study 
361.23 	and other data. Payment for services will be made upon submission of a valid claim and 
361.24 	verification of proper documentation described in subdivision 7. Federal administrative 
361.25 	revenue earned through the time study, or under paragraph (c), shall be distributed according 
361.26 	to earnings, to counties, reservations, or groups of counties or reservations which have the 
361.27 	same payment rate under this subdivision, and to the group of counties or reservations which 
361.28 	are not certified providers under section 256F.10. The commissioner shall modify the 
361.29 	requirements set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to 
361.30 	accomplish this.

361.31 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
361.32 	of human services shall notify the revisor of statutes when federal approval is obtained.

362.1 	Sec. 22. Minnesota Statutes 2020, section 256B.49, subdivision 14, is amended to read:
362.2 		Subd. 14.Assessment and reassessment. (a) Assessments and reassessments shall be 
362.3 	conducted by certified assessors according to section 256B.0911, subdivision 2b.
362.4 	(b) There must be a determination that the client requires a hospital level of care or a 
362.5 	nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and 
362.6 	subsequent assessments to initiate and maintain participation in the waiver program.
362.7 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
362.8 	appropriate to determine nursing facility level of care for purposes of medical assistance 
362.9 	payment for nursing facility services, only face-to-face assessments conducted according 
362.10 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
362.11 	determination or a nursing facility level of care determination must be accepted for purposes 
362.12 	of initial and ongoing access to waiver services payment.
362.13 	(d) Recipients who are found eligible for home and community-based services under 
362.14 	this section before their 65th birthday may remain eligible for these services after their 65th 
362.15 	birthday if they continue to meet all other eligibility factors.

362.16 	Sec. 23. Minnesota Statutes 2020, section 256J.09, subdivision 3, is amended to read:
362.17 		Subd. 3.Submitting application form. (a) A county agency must offer, in person or 
362.18 	by mail, the application forms prescribed by the commissioner as soon as a person makes 
362.19 	a written or oral inquiry. At that time, the county agency must:
362.20 	(1) inform the person that assistance begins with on the date that the signed application 
362.21 	is received by the county agency either as a written application; an application submitted 
362.22 	by telephone; or an application submitted through Internet telepresence; or on the date that 
362.23 	all eligibility criteria are met, whichever is later;
362.24 	(2) inform a person that the person may submit the application by telephone or through 
362.25 	Internet telepresence;
362.26 	(3) inform a person that when the person submits the application by telephone or through 
362.27 	Internet telepresence, the county agency must receive a signed written application within 
362.28 	30 days of the date that the person submitted the application by telephone or through Internet 
362.29 	telepresence;
362.30 	(4) inform the person that any delay in submitting the application will reduce the amount 
362.31 	of assistance paid for the month of application;
362.32 	(3) (5) inform a person that the person may submit the application before an interview;
363.1 	(4) (6) explain the information that will be verified during the application process by 
363.2 	the county agency as provided in section 256J.32;
363.3 	(5) (7) inform a person about the county agency's average application processing time 
363.4 	and explain how the application will be processed under subdivision 5;
363.5 	(6) (8) explain how to contact the county agency if a person's application information 
363.6 	changes and how to withdraw the application;
363.7 	(7) (9) inform a person that the next step in the application process is an interview and 
363.8 	what a person must do if the application is approved including, but not limited to, attending 
363.9 	orientation under section 256J.45 and complying with employment and training services 
363.10 	requirements in sections 256J.515 to 256J.57;
363.11 	(8) (10) inform the person that the an interview must be conducted. The interview may 
363.12 	be conducted face-to-face in the county office or at a location mutually agreed upon, through 
363.13 	Internet telepresence, or at a location mutually agreed upon by telephone;
363.14 	(9) inform a person who has received MFIP or DWP in the past 12 months of the option 
363.15 	to have a face-to-face, Internet telepresence, or telephone interview;
363.16 	(10) (11) explain the child care and transportation services that are available under 
363.17 	paragraph (c) to enable caregivers to attend the interview, screening, and orientation; and
363.18 	(11) (12) identify any language barriers and arrange for translation assistance during 
363.19 	appointments, including, but not limited to, screening under subdivision 3a, orientation 
363.20 	under section 256J.45, and assessment under section 256J.521.
363.21 	(b) Upon receipt of a signed application, the county agency must stamp the date of receipt 
363.22 	on the face of the application. The county agency must process the application within the 
363.23 	time period required under subdivision 5. An applicant may withdraw the application at 
363.24 	any time by giving written or oral notice to the county agency. The county agency must 
363.25 	issue a written notice confirming the withdrawal. The notice must inform the applicant of 
363.26 	the county agency's understanding that the applicant has withdrawn the application and no 
363.27 	longer wants to pursue it. When, within ten days of the date of the agency's notice, an 
363.28 	applicant informs a county agency, in writing, that the applicant does not wish to withdraw 
363.29 	the application, the county agency must reinstate the application and finish processing the 
363.30 	application.
363.31 	(c) Upon a participant's request, the county agency must arrange for transportation and 
363.32 	child care or reimburse the participant for transportation and child care expenses necessary 
364.1 	to enable participants to attend the screening under subdivision 3a and orientation under 
364.2 	section 256J.45.

364.3 	Sec. 24. Minnesota Statutes 2020, section 256J.45, subdivision 1, is amended to read:
364.4 		Subdivision 1.County agency to provide orientation. A county agency must provide 
364.5 	a face-to-face an orientation to each MFIP caregiver unless the caregiver is:
364.6 	(1) a single parent, or one parent in a two-parent family, employed at least 35 hours per 
364.7 	week; or
364.8 	(2) a second parent in a two-parent family who is employed for 20 or more hours per 
364.9 	week provided the first parent is employed at least 35 hours per week.
364.10 	The county agency must inform caregivers who are not exempt under clause (1) or (2) that 
364.11 	failure to attend the orientation is considered an occurrence of noncompliance with program 
364.12 	requirements, and will result in the imposition of a sanction under section 256J.46. If the 
364.13 	client complies with the orientation requirement prior to the first day of the month in which 
364.14 	the grant reduction is proposed to occur, the orientation sanction shall be lifted.

364.15 	Sec. 25. Minnesota Statutes 2020, section 256S.05, subdivision 2, is amended to read:
364.16 		Subd. 2.Nursing facility level of care determination required. Notwithstanding other 
364.17 	assessments identified in section 144.0724, subdivision 4, only face-to-face assessments 
364.18 	conducted according to section 256B.0911, subdivisions 3, 3a, and 3b, that result in a nursing 
364.19 	facility level of care determination at initial and subsequent assessments shall be accepted 
364.20 	for purposes of a participant's initial and ongoing participation in the elderly waiver and a 
364.21 	service provider's access to service payments under this chapter.

364.22 	Sec. 26. STUDY OF TELEHEALTH.
 364.23 	(a) The commissioner of health, in consultation with the commissioners of human services 
364.24 	and commerce, shall study the impact of telehealth payment methodologies and expansion 
364.25 	under the Minnesota Telehealth Act on the coverage and provision of health care services 
364.26 	under public health care programs and private health insurance. The study shall review and 
364.27 	make recommendations related to:
364.28 	(1) the impact of telehealth payment methodologies and expansion on access to health 
364.29 	care services, quality of care, and value-based payments and innovation in care delivery;
365.1 	(2) the short-term and long-term impacts of telehealth payment methodologies and 
365.2 	expansion in reducing health care disparities and providing equitable access for underserved 
365.3 	communities;
365.4 	(3) the use of audio-only communication in supporting equitable access to health care 
365.5 	services, including behavioral health services for the elderly, rural communities, and 
365.6 	communities of color, and eliminating barriers for vulnerable and underserved populations;
365.7 	(4) whether there is evidence to suggest that increased access to telehealth improves 
365.8 	health outcomes and, if so, for which services and populations; and
365.9 	(5) the effect of payment parity on public and private health care costs, health care 
365.10 	premiums, and health outcomes.
365.11 	(b) When conducting the study, the commissioner shall consult with stakeholders and 
365.12 	communities impacted by telehealth payment and expansion. The commissioner, 
365.13 	notwithstanding Minnesota Statutes, section 62U.04, subdivision 11, may use data available 
365.14 	under that section to conduct the study. The commissioner shall report findings to the chairs 
365.15 	and ranking minority members of the legislative committees with jurisdiction over health 
365.16 	care policy and finance and commerce, by February 15, 2023.

365.17 	Sec. 27. EXPIRATION DATE.
 365.18 	(a) Sections 1 to 15, 20, and 21 expire July 1, 2023.
365.19 	(b) Notwithstanding paragraph (a), the definition of "originating site" in Minnesota 
365.20 	Statutes, section 256B.0625, subdivision 3b, paragraph (d), clause (3), shall not expire.

365.21 	Sec. 28. REVISOR INSTRUCTION.
 365.22 	The revisor of statutes shall substitute the term "telemedicine" with "telehealth" whenever 
365.23 	the term appears in Minnesota Statutes and substitute Minnesota Statutes, section 62A.673, 
365.24 	whenever references to Minnesota Statutes, sections 62A.67, 62A.671, and 62A.672, appear 
365.25 	in Minnesota Statutes.

365.26 	Sec. 29. REPEALER.
 365.27 	(a) Minnesota Statutes 2020, sections 62A.67; 62A.671; and 62A.672, are repealed 
365.28 	January 1, 2022, and are revived and reenacted July 1, 2023.
365.29 	(b) Minnesota Statutes 2020, sections 256B.0596; and 256B.0924, subdivision 4a, are 
365.30 	repealed upon federal approval and are revived and reenacted July 1, 2023. The commissioner 
365.31 	of human services shall notify the revisor of statutes when federal approval is obtained.

366.1 	ARTICLE 8
366.2 	ECONOMIC SUPPORTS

366.3 	Section 1. Minnesota Statutes 2020, section 119B.011, subdivision 15, is amended to read:
366.4 		Subd. 15.Income. "Income" means earned income as defined under section 256P.01, 
366.5 	subdivision 3, unearned income as defined under section 256P.01, subdivision 8, and public 
366.6 	assistance cash benefits, including the Minnesota family investment program, diversionary 
366.7 	work program, work benefit, Minnesota supplemental aid, general assistance, refugee cash 
366.8 	assistance, at-home infant child care subsidy payments, and child support and maintenance 
366.9 	distributed to the a family under section 256.741, subdivision 2a, and nonrecurring income 
366.10 	over $60 per quarter unless earmarked and used for the purpose for which it was intended. 
366.11 	The following are deducted from income: funds used to pay for health insurance premiums 
366.12 	for family members, and child or spousal support paid to or on behalf of a person or persons 
366.13 	who live outside of the household. Income sources that are not included in this subdivision 
366.14 	and section 256P.06, subdivision 3, are not counted as income.

366.15 	EFFECTIVE DATE. This section is effective March 1, 2023.

366.16 	Sec. 2. Minnesota Statutes 2020, section 119B.025, subdivision 4, is amended to read:
366.17 		Subd. 4.Changes in eligibility. (a) The county shall process a change in eligibility 
366.18 	factors according to paragraphs (b) to (g).
366.19 	(b) A family is subject to the reporting requirements in section 256P.07, subdivision 6.
366.20 	(c) If a family reports a change or a change is known to the agency before the family's 
366.21 	regularly scheduled redetermination, the county must act on the change. The commissioner 
366.22 	shall establish standards for verifying a change.
366.23 	(d) A change in income occurs on the day the participant received the first payment 
366.24 	reflecting the change in income.
366.25 	(e) During a family's 12-month eligibility period, if the family's income increases and 
366.26 	remains at or below 85 percent of the state median income, adjusted for family size, there 
366.27 	is no change to the family's eligibility. The county shall not request verification of the 
366.28 	change. The co-payment fee shall not increase during the remaining portion of the family's 
366.29 	12-month eligibility period.
366.30 	(f) During a family's 12-month eligibility period, if the family's income increases and 
366.31 	exceeds 85 percent of the state median income, adjusted for family size, the family is not 
366.32 	eligible for child care assistance. The family must be given 15 calendar days to provide 
367.1 	verification of the change. If the required verification is not returned or confirms ineligibility, 
367.2 	the family's eligibility ends following a subsequent 15-day adverse action notice.
367.3 	(g) Notwithstanding Minnesota Rules, parts 3400.0040, subpart 3, and 3400.0170, 
367.4 	subpart 1, if an applicant or participant reports that employment ended, the agency may 
367.5 	accept a signed statement from the applicant or participant as verification that employment 
367.6 	ended.

367.7 	EFFECTIVE DATE. This section is effective March 1, 2023.

367.8 	Sec. 3. Minnesota Statutes 2020, section 256D.03, is amended by adding a subdivision to 
367.9 	read:
367.10 		Subd. 2b.Budgeting and reporting. County agencies shall determine eligibility and 
367.11 	calculate benefit amounts for general assistance according to the provisions in sections 
367.12 	256P.06, 256P.07, 256P.09, and 256P.10.

367.13 	EFFECTIVE DATE. This section is effective March 1, 2023.

367.14 	Sec. 4. Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision 
367.15 	to read:
367.16 		Subd. 20.SNAP employment and training. The commissioner shall implement a 
367.17 	Supplemental Nutrition Assistance Program (SNAP) employment and training program 
367.18 	that meets the SNAP employment and training participation requirements of the United 
367.19 	States Department of Agriculture governed by Code of Federal Regulations, title 7, section 
367.20 	273.7. The commissioner shall operate a SNAP employment and training program in which 
367.21 	SNAP recipients elect to participate. In order to receive SNAP assistance beyond the time 
367.22 	limit, unless residing in an area covered by a time-limit waiver governed by Code of Federal 
367.23 	Regulations, title 7, section 273.24, nonexempt SNAP recipients who do not meet federal 
367.24 	SNAP work requirements must participate in an employment and training program. In 
367.25 	addition to county and tribal agencies that administer SNAP, the commissioner may contract 
367.26 	with third-party providers for SNAP employment and training services.

367.27 	EFFECTIVE DATE. This section is effective August 1, 2021.

367.28 	Sec. 5. Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision 
367.29 	to read:
367.30 		Subd. 21.County and tribal agency duties. County or tribal agencies that administer 
367.31 	SNAP shall inform adult SNAP recipients about employment and training services and 
368.1 	providers in the recipient's area. County or tribal agencies that administer SNAP may elect 
368.2 	to subcontract with a public or private entity approved by the commissioner to provide 
368.3 	SNAP employment and training services.

368.4 	EFFECTIVE DATE. This section is effective August 1, 2021.

368.5 	Sec. 6. Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision 
368.6 	to read:
368.7 		Subd. 22.Duties of commissioner. In addition to any other duties imposed by law, the 
368.8 	commissioner shall:
368.9 	(1) supervise the administration of SNAP employment and training services to county, 
368.10 	tribal, and contracted agencies under this section and Code of Federal Regulations, title 7, 
368.11 	section 273.7;
368.12 	(2) disburse money allocated and reimbursed for SNAP employment and training services 
368.13 	to county, tribal, and contracted agencies;
368.14 	(3) accept and supervise the disbursement of any funds that may be provided by the 
368.15 	federal government or other sources for SNAP employment and training services;
368.16 	(4) cooperate with other agencies, including any federal agency or agency of another 
368.17 	state, in all matters concerning the powers and duties of the commissioner under this section;
368.18 	(5) coordinate with the commissioner of employment and economic development to 
368.19 	deliver employment and training services statewide;
368.20 	(6) work in partnership with counties, tribes, and other agencies to enhance the reach 
368.21 	and services of a statewide SNAP employment and training program; and
368.22 	(7) identify eligible nonfederal funds to earn federal reimbursement for SNAP 
368.23 	employment and training services.

368.24 	EFFECTIVE DATE. This section is effective August 1, 2021.

368.25 	Sec. 7. Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision 
368.26 	to read:
368.27 		Subd. 23.Recipient duties. Unless residing in an area covered by a time-limit waiver, 
368.28 	nonexempt SNAP recipients must meet federal SNAP work requirements to receive SNAP 
368.29 	assistance beyond the time limit.

368.30 	EFFECTIVE DATE. This section is effective August 1, 2021.

369.1 	Sec. 8. Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision 
369.2 	to read:
369.3 		Subd. 24.Program funding. (a) The United States Department of Agriculture annually 
369.4 	allocates SNAP employment and training funds to the commissioner of human services for 
369.5 	the operation of the SNAP employment and training program.
369.6 	(b) The United States Department of Agriculture authorizes the disbursement of SNAP 
369.7 	employment and training reimbursement funds to the commissioner of human services for 
369.8 	the operation of the SNAP employment and training program.
369.9 	(c) Except for funds allocated for state program development and administrative purposes 
369.10 	or designated by the United States Department of Agriculture for a specific project, the 
369.11 	commissioner of human services shall disburse money allocated for federal SNAP 
369.12 	employment and training to counties and tribes that administer SNAP based on a formula 
369.13 	determined by the commissioner that includes but is not limited to the county's or tribe's 
369.14 	proportion of adult SNAP recipients as compared to the statewide total.
369.15 	(d) The commissioner of human services shall disburse federal funds that the 
369.16 	commissioner receives as reimbursement for SNAP employment and training costs to the 
369.17 	state agency, county, tribe, or contracted agency that incurred the costs being reimbursed.
369.18 	(e) The commissioner of human services may reallocate unexpended money disbursed 
369.19 	under this section to county, tribal, or contracted agencies that demonstrate a need for 
369.20 	additional funds.

369.21 	EFFECTIVE DATE. This section is effective August 1, 2021.

369.22 	Sec. 9. Minnesota Statutes 2020, section 256D.0515, is amended to read:
369.23 	256D.0515 ASSET LIMITATIONS FOR SUPPLEMENTAL NUTRITION 
369.24 	ASSISTANCE PROGRAM HOUSEHOLDS.
369.25 	All Supplemental Nutrition Assistance Program (SNAP) households must be determined 
369.26 	eligible for the benefit discussed under section 256.029. SNAP households must demonstrate 
369.27 	that their gross income is equal to or less than 165 200 percent of the federal poverty 
369.28 	guidelines for the same family size.

369.29 	Sec. 10. Minnesota Statutes 2020, section 256D.0516, subdivision 2, is amended to read:
369.30 		Subd. 2.SNAP reporting requirements. The commissioner of human services shall 
369.31 	implement simplified reporting as permitted under the Food and Nutrition Act of 2008, as 
370.1 	amended, and the SNAP regulations in Code of Federal Regulations, title 7, part 273. SNAP 
370.2 	benefit recipient households required to report periodically shall not be required to report 
370.3 	more often than one time every six months. This provision shall not apply to households 
370.4 	receiving food benefits under the Minnesota family investment program waiver.

370.5 	EFFECTIVE DATE. This section is effective March 1, 2023.

370.6 	Sec. 11. Minnesota Statutes 2020, section 256E.34, subdivision 1, is amended to read:
370.7 		Subdivision 1.Distribution of appropriation. The commissioner must distribute funds 
370.8 	appropriated to the commissioner by law for that purpose to Hunger Solutions, a statewide 
370.9 	association of food shelves organized as a nonprofit corporation as defined under section 
370.10 	501(c)(3) of the Internal Revenue Code of 1986, to distribute to qualifying food shelves. A 
370.11 	food shelf qualifies under this section if:
370.12 	(1) it is a nonprofit corporation, or is affiliated with a nonprofit corporation, as defined 
370.13 	in section 501(c)(3) of the Internal Revenue Code of 1986 or a federally recognized tribal 
370.14 	nation;
370.15 	(2) it distributes standard food orders without charge to needy individuals. The standard 
370.16 	food order must consist of at least a two-day supply or six pounds per person of nutritionally 
370.17 	balanced food items;
370.18 	(3) it does not limit food distributions to individuals of a particular religious affiliation, 
370.19 	race, or other criteria unrelated to need or to requirements necessary to administration of a 
370.20 	fair and orderly distribution system;
370.21 	(4) it does not use the money received or the food distribution program to foster or 
370.22 	advance religious or political views; and
370.23 	(5) it has a stable address and directly serves individuals.

370.24 	Sec. 12. Minnesota Statutes 2020, section 256I.03, subdivision 13, is amended to read:
370.25 		Subd. 13.Prospective budgeting. "Prospective budgeting" means estimating the amount 
370.26 	of monthly income a person will have in the payment month has the meaning given in 
370.27 	section 256P.01, subdivision 9.

370.28 	EFFECTIVE DATE. This section is effective March 1, 2023.

371.1 	Sec. 13. Minnesota Statutes 2020, section 256I.06, subdivision 6, is amended to read:
371.2 		Subd. 6.Reports. Recipients must report changes in circumstances according to section 
371.3 	256P.07that affect eligibility or housing support payment amounts, other than changes in 
371.4 	earned income, within ten days of the change. Recipients with countable earned income 
371.5 	must complete a household report form at least once every six months according to section 
371.6 	256P.10. If the report form is not received before the end of the month in which it is due, 
371.7 	the county agency must terminate eligibility for housing support payments. The termination 
371.8 	shall be effective on the first day of the month following the month in which the report was 
371.9 	due. If a complete report is received within the month eligibility was terminated, the 
371.10 	individual is considered to have continued an application for housing support payment 
371.11 	effective the first day of the month the eligibility was terminated.

371.12 	EFFECTIVE DATE. This section is effective March 1, 2023.

371.13 	Sec. 14. Minnesota Statutes 2020, section 256I.06, subdivision 8, is amended to read:
371.14 		Subd. 8.Amount of housing support payment. (a) The amount of a room and board 
371.15 	payment to be made on behalf of an eligible individual is determined by subtracting the 
371.16 	individual's countable income under section 256I.04, subdivision 1, for a whole calendar 
371.17 	month from the room and board rate for that same month. The housing support payment is 
371.18 	determined by multiplying the housing support rate times the period of time the individual 
371.19 	was a resident or temporarily absent under section 256I.05, subdivision 1c, paragraph (d).
371.20 	(b) For an individual with earned income under paragraph (a), prospective budgeting 
371.21 	must be used to determine the amount of the individual's payment for the following six-month 
371.22 	period. An increase in income shall not affect an individual's eligibility or payment amount 
371.23 	until the month following the reporting month. A decrease in income shall be effective the 
371.24 	first day of the month after the month in which the decrease is reported.
371.25 	(c) (b) For an individual who receives housing support payments under section 256I.04, 
371.26 	subdivision 1, paragraph (c), the amount of the housing support payment is determined by 
371.27 	multiplying the housing support rate times the period of time the individual was a resident.

371.28 	EFFECTIVE DATE. This section is effective March 1, 2023.

371.29 	Sec. 15. Minnesota Statutes 2020, section 256J.08, subdivision 15, is amended to read:
371.30 		Subd. 15.Countable income. "Countable income" means earned and unearned income 
371.31 	that is not excluded under section 256J.21, subdivision 2 described in section 256P.06, 
371.32 	subdivision 3, or disregarded under section 256J.21, subdivision 3, or section 256P.03.

372.1 	EFFECTIVE DATE. This section is effective August 1, 2021.

372.2 	Sec. 16. Minnesota Statutes 2020, section 256J.08, subdivision 71, is amended to read:
372.3 		Subd. 71.Prospective budgeting. "Prospective budgeting" means a method of 
372.4 	determining the amount of the assistance payment in which the budget month and payment 
372.5 	month are the same has the meaning given in section 256P.01, subdivision 9.

372.6 	EFFECTIVE DATE. This section is effective March 1, 2023.

372.7 	Sec. 17. Minnesota Statutes 2020, section 256J.08, subdivision 79, is amended to read:
372.8 		Subd. 79.Recurring income. "Recurring income" means a form of income which is:
372.9 	(1) received periodically, and may be received irregularly when receipt can be anticipated 
372.10 	even though the date of receipt cannot be predicted; and
372.11 	(2) from the same source or of the same type that is received and budgeted in a 
372.12 	prospective month and is received in one or both of the first two retrospective months.

372.13 	EFFECTIVE DATE. This section is effective March 1, 2023.

372.14 	Sec. 18. Minnesota Statutes 2020, section 256J.10, is amended to read:
372.15 	256J.10 MFIP ELIGIBILITY REQUIREMENTS.
372.16 	To be eligible for MFIP, applicants must meet the general eligibility requirements in 
372.17 	sections 256J.11 to 256J.15, the property limitations in section 256P.02, and the income 
372.18 	limitations in section sections256J.21 and 256P.06.

372.19 	EFFECTIVE DATE. This section is effective August 1, 2021.

372.20 	Sec. 19. Minnesota Statutes 2020, section 256J.21, subdivision 3, is amended to read:
372.21 		Subd. 3.Initial income test. The agency shall determine initial eligibility by considering 
372.22 	all earned and unearned income that is not excluded under subdivision 2as defined in section 
372.23 	256P.06. To be eligible for MFIP, the assistance unit's countable income minus the earned 
372.24 	income disregards in paragraph (a) and section 256P.03 must be below the family wage 
372.25 	level according to section 256J.24, subdivision 7, for that size assistance unit.
372.26 	(a) The initial eligibility determination must disregard the following items:
372.27 	(1) the earned income disregard as determined in section 256P.03;
373.1 	(2) dependent care costs must be deducted from gross earned income for the actual 
373.2 	amount paid for dependent care up to a maximum of $200 per month for each child less 
373.3 	than two years of age, and $175 per month for each child two years of age and older;
373.4 	(3) all payments made according to a court order for spousal support or the support of 
373.5 	children not living in the assistance unit's household shall be disregarded from the income 
373.6 	of the person with the legal obligation to pay support; and
373.7 	(4) an allocation for the unmet need of an ineligible spouse or an ineligible child under 
373.8 	the age of 21 for whom the caregiver is financially responsible and who lives with the 
373.9 	caregiver according to section 256J.36.
373.10 	(b) After initial eligibility is established, The income test is for a six-month period. The 
373.11 	assistance payment calculation is based on the monthly income test prospective budgeting 
373.12 	according to section 256P.09.

373.13 	EFFECTIVE DATE. This section is effective August 1, 2021, except for the 
373.14 	amendments in subdivision 3, paragraph (b), which are effective March 1, 2023.

373.15 	Sec. 20. Minnesota Statutes 2020, section 256J.21, subdivision 4, is amended to read:
373.16 		Subd. 4.Monthly Income test and determination of assistance payment. The county 
373.17 	agency shall determine ongoing eligibility and the assistance payment amount according 
373.18 	to the monthly income test. To be eligible for MFIP, the result of the computations in 
373.19 	paragraphs (a) to (e) applied to prospective budgeting must be at least $1.
373.20 	(a) Apply an income disregard as defined in section 256P.03, to gross earnings and 
373.21 	subtract this amount from the family wage level. If the difference is equal to or greater than 
373.22 	the MFIP transitional standard, the assistance payment is equal to the MFIP transitional 
373.23 	standard. If the difference is less than the MFIP transitional standard, the assistance payment 
373.24 	is equal to the difference. The earned income disregard in this paragraph must be deducted 
373.25 	every month there is earned income.
373.26 	(b) All payments made according to a court order for spousal support or the support of 
373.27 	children not living in the assistance unit's household must be disregarded from the income 
373.28 	of the person with the legal obligation to pay support.
373.29 	(c) An allocation for the unmet need of an ineligible spouse or an ineligible child under 
373.30 	the age of 21 for whom the caregiver is financially responsible and who lives with the 
373.31 	caregiver must be made according to section 256J.36.
374.1 	(d) Subtract unearned income dollar for dollar from the MFIP transitional standard to 
374.2 	determine the assistance payment amount.
374.3 	(e) When income is both earned and unearned, the amount of the assistance payment 
374.4 	must be determined by first treating gross earned income as specified in paragraph (a). After 
374.5 	determining the amount of the assistance payment under paragraph (a), unearned income 
374.6 	must be subtracted from that amount dollar for dollar to determine the assistance payment 
374.7 	amount.
374.8 	(f) When the monthly income is greater than the MFIP transitional standard after 
374.9 	deductions and the income will only exceed the standard for one month, the county agency 
374.10 	must suspend the assistance payment for the payment month.

374.11 	EFFECTIVE DATE. This section is effective March 1, 2023.

374.12 	Sec. 21. Minnesota Statutes 2020, section 256J.21, subdivision 5, is amended to read:
374.13 		Subd. 5.Distribution of income. (a) The income of all members of the assistance unit 
374.14 	must be counted. Income may also be deemed from ineligible persons to the assistance unit. 
374.15 	Income must be attributed to the person who earns it or to the assistance unit according to 
374.16 	paragraphs (a) to (b) and (c).
374.17 	(a) Funds distributed from a trust, whether from the principal holdings or sale of trust 
374.18 	property or from the interest and other earnings of the trust holdings, must be considered 
374.19 	income when the income is legally available to an applicant or participant. Trusts are 
374.20 	presumed legally available unless an applicant or participant can document that the trust is 
374.21 	not legally available.
374.22 	(b) Income from jointly owned property must be divided equally among property owners 
374.23 	unless the terms of ownership provide for a different distribution.
374.24 	(c) Deductions are not allowed from the gross income of a financially responsible 
374.25 	household member or by the members of an assistance unit to meet a current or prior debt.

374.26 	EFFECTIVE DATE. This section is effective August 1, 2021.

374.27 	Sec. 22. Minnesota Statutes 2020, section 256J.24, subdivision 5, is amended to read:
374.28 		Subd. 5.MFIP transitional standard. (a) The MFIP transitional standard is based on 
374.29 	the number of persons in the assistance unit eligible for both food and cash assistance. The 
374.30 	amount of the transitional standard is published annually by the Department of Human 
374.31 	Services.
375.1 	(b) The amount of the MFIP cash assistance portion of the transitional standard is 
375.2 	increased $100 per month per household. This increase shall be reflected in the MFIP cash 
375.3 	assistance portion of the transitional standard published annually by the commissioner.
375.4 	(c) On October 1 of each year, the commissioner of human services shall adjust the cash 
375.5 	assistance portion under paragraph (a) for inflation based on the CPI-U for the prior calendar 
375.6 	year.

375.7 	EFFECTIVE DATE. This section is effective for the fiscal year beginning on July 1, 
375.8 	2021.

375.9 	Sec. 23. Minnesota Statutes 2020, section 256J.30, subdivision 8, is amended to read:
375.10 		Subd. 8.Late MFIP household report forms. (a) Paragraphs (b) to (e) apply to the 
375.11 	reporting requirements in subdivision 7.
375.12 	(b) When the county agency receives an incomplete MFIP household report form, the 
375.13 	county agency must immediately return the incomplete form and clearly state what the 
375.14 	caregiver must do for the form to be complete contact the caregiver by phone or in writing 
375.15 	to acquire the necessary information to complete the form.
375.16 	(c) The automated eligibility system must send a notice of proposed termination of 
375.17 	assistance to the assistance unit if a complete MFIP household report form is not received 
375.18 	by a county agency. The automated notice must be mailed to the caregiver by approximately 
375.19 	the 16th of the month. When a caregiver submits an incomplete form on or after the date a 
375.20 	notice of proposed termination has been sent, the termination is valid unless the caregiver 
375.21 	submits a complete form before the end of the month.
375.22 	(d) An assistance unit required to submit an MFIP household report form is considered 
375.23 	to have continued its application for assistance if a complete MFIP household report form 
375.24 	is received within a calendar month after the month in which the form was due and assistance 
375.25 	shall be paid for the period beginning with the first day of that calendar month.
375.26 	(e) A county agency must allow good cause exemptions from the reporting requirements 
375.27 	under subdivision 5 when any of the following factors cause a caregiver to fail to provide 
375.28 	the county agency with a completed MFIP household report form before the end of the 
375.29 	month in which the form is due:
375.30 	(1) an employer delays completion of employment verification;
375.31 	(2) a county agency does not help a caregiver complete the MFIP household report form 
375.32 	when the caregiver asks for help;
376.1 	(3) a caregiver does not receive an MFIP household report form due to mistake on the 
376.2 	part of the department or the county agency or due to a reported change in address;
376.3 	(4) a caregiver is ill, or physically or mentally incapacitated; or
376.4 	(5) some other circumstance occurs that a caregiver could not avoid with reasonable 
376.5 	care which prevents the caregiver from providing a completed MFIP household report form 
376.6 	before the end of the month in which the form is due.

376.7 	Sec. 24. Minnesota Statutes 2020, section 256J.33, subdivision 1, is amended to read:
376.8 		Subdivision 1.Determination of eligibility. (a) A county agency must determine MFIP 
376.9 	eligibility prospectively for a payment month based on retrospectively assessing income 
376.10 	and the county agency's best estimate of the circumstances that will exist in the payment 
376.11 	month.
376.12 	Except as described in section 256J.34, subdivision 1, when prospective eligibility exists,
376.13 	(b) A county agency must calculate the amount of the assistance payment using retrospective
376.14 	prospective budgeting. To determine MFIP eligibility and the assistance payment amount, 
376.15 	a county agency must apply countable income, described in section sections 256P.06 and
376.16 	256J.37, subdivisions 3 to 10 9, received by members of an assistance unit or by other 
376.17 	persons whose income is counted for the assistance unit, described under sections 256J.21
376.18 	and256J.37, subdivisions 1 to 2, and 256P.06, subdivision 1.
376.19 	(c) This income must be applied to the MFIP standard of need or family wage level 
376.20 	subject to this section and sections 256J.34 to 256J.36. Countable income received in a 
376.21 	calendar month and not otherwise excluded under section 256J.21, subdivision 2, must be 
376.22 	applied to the needs of an assistance unit.
376.23 	(d) An assistance unit is not eligible when the countable income equals or exceeds the 
376.24 	MFIP standard of need or the family wage level for the assistance unit.

376.25 	EFFECTIVE DATE. Paragraph (a) is effective March 1, 2023. Paragraph (b) is effective 
376.26 	March 1, 2023, except the amendment striking section 256J.21 and inserting section 256P.06 
376.27 	is effective August 1, 2021. Paragraph (c) is effective August 1, 2021, except the amendment 
376.28 	striking "in a calendar month" is effective March 1, 2023. Paragraph (d) is effective March 
376.29 	1, 2023.

376.30 	Sec. 25. Minnesota Statutes 2020, section 256J.33, subdivision 2, is amended to read:
376.31 		Subd. 2.Prospective eligibility. An agency must determine whether the eligibility 
376.32 	requirements that pertain to an assistance unit, including those in sections 256J.11 to 256J.15
377.1 	and 256P.02, will be met prospectively for the payment month period. Except for the 
377.2 	provisions in section 256J.34, subdivision 1, The income test will be applied retrospectively
377.3 	prospectively.

377.4 	EFFECTIVE DATE. This section is effective March 1, 2023.

377.5 	Sec. 26. Minnesota Statutes 2020, section 256J.33, subdivision 4, is amended to read:
377.6 		Subd. 4.Monthly income test. A county agency must apply the monthly income test 
377.7 	retrospectively for each month of MFIP eligibility. An assistance unit is not eligible when 
377.8 	the countable income equals or exceeds the MFIP standard of need or the family wage level 
377.9 	for the assistance unit. The income applied against the monthly income test must include:
377.10 	(1) gross earned income from employment as described in chapter 256P, prior to 
377.11 	mandatory payroll deductions, voluntary payroll deductions, wage authorizations, and after 
377.12 	the disregards in section 256J.21, subdivision 4, and the allocations in section 256J.36, 
377.13 	unless the employment income is specifically excluded under section 256J.21, subdivision 
377.14 	2;
377.15 	(2) gross earned income from self-employment less deductions for self-employment 
377.16 	expenses in section 256J.37, subdivision 5, but prior to any reductions for personal or 
377.17 	business state and federal income taxes, personal FICA, personal health and life insurance, 
377.18 	and after the disregards in section 256J.21, subdivision 4, and the allocations in section 
377.19 	256J.36;
377.20 	(3) unearned income as described in section 256P.06, subdivision 3, after deductions 
377.21 	for allowable expenses in section 256J.37, subdivision 9, and allocations in section 256J.36, 
377.22 	unless the income has been specifically excluded in section 256J.21, subdivision 2;
377.23 	(4) gross earned income from employment as determined under clause (1) which is 
377.24 	received by a member of an assistance unit who is a minor child or minor caregiver and 
377.25 	less than a half-time student;
377.26 	(5) child support received by an assistance unit, excluded under section 256J.21, 
377.27 	subdivision 2, clause (49), or section 256P.06, subdivision 3, clause (2), item (xvi);
377.28 	(6) spousal support received by an assistance unit;
377.29 	(7) the income of a parent when that parent is not included in the assistance unit;
377.30 	(8) the income of an eligible relative and spouse who seek to be included in the assistance 
377.31 	unit; and
377.32 	(9) the unearned income of a minor child included in the assistance unit.

378.1 	EFFECTIVE DATE. This section is effective August 1, 2021.

378.2 	Sec. 27. Minnesota Statutes 2020, section 256J.37, subdivision 1, is amended to read:
378.3 		Subdivision 1.Deemed income from ineligible assistance unit members.  The income 
378.4 	of ineligible assistance unit members, except individuals identified in section 256J.24, 
378.5 	subdivision 3, paragraph (a), clause (1), must be deemed after allowing the following 
378.6 	disregards:
378.7 	(1) an earned income disregard as determined under section 256P.03;
378.8 	(2) all payments made by the ineligible person according to a court order for spousal 
378.9 	support or the support of children not living in the assistance unit's household; and
378.10 	(3) an amount for the unmet needs of the ineligible persons who live in the household 
378.11 	who, if eligible, would be assistance unit members under section 256J.24, subdivision 2 or 
378.12 	4, paragraph (b). This amount is equal to the difference between the MFIP transitional 
378.13 	standard when the ineligible persons are included in the assistance unit and the MFIP 
378.14 	transitional standard when the ineligible persons are not included in the assistance unit.

378.15 	EFFECTIVE DATE. This section is effective August 1, 2021.

378.16 	Sec. 28. Minnesota Statutes 2020, section 256J.37, subdivision 1b, is amended to read:
378.17 		Subd. 1b.Deemed income from parents of minor caregivers. In households where 
378.18 	minor caregivers live with a parent or parents or a stepparent who do not receive MFIP for 
378.19 	themselves or their minor children, the income of the parents or a stepparent must be deemed 
378.20 	after allowing the following disregards:
378.21 	(1) income of the parents equal to 200 percent of the federal poverty guideline for a 
378.22 	family size not including the minor parent and the minor parent's child in the household 
378.23 	according to section 256J.21, subdivision 2, clause (43); and
378.24 	(2) all payments made by parents according to a court order for spousal support or the 
378.25 	support of children not living in the parent's household.

378.26 	EFFECTIVE DATE. This section is effective August 1, 2021.

378.27 	Sec. 29. Minnesota Statutes 2020, section 256J.37, subdivision 3, is amended to read:
378.28 		Subd. 3.Earned income of wage, salary, and contractual employees. The agency 
378.29 	must include gross earned income less any disregards in the initial and monthly income 
378.30 	test. Gross earned income received by persons employed on a contractual basis must be 
379.1 	prorated over the period covered by the contract even when payments are received over a 
379.2 	lesser period of time.

379.3 	EFFECTIVE DATE. This section is effective March 1, 2023.

379.4 	Sec. 30. Minnesota Statutes 2020, section 256J.37, subdivision 3a, is amended to read:
379.5 		Subd. 3a.Rental subsidies; unearned income. (a) Effective July 1, 2003, the agency 
379.6 	shall count $50 of the value of public and assisted rental subsidies provided through the 
379.7 	Department of Housing and Urban Development (HUD) as unearned income to the cash 
379.8 	portion of the MFIP grant. The full amount of the subsidy must be counted as unearned 
379.9 	income when the subsidy is less than $50. The income from this subsidy shall be budgeted 
379.10 	according to section 256J.34 256P.09.
379.11 	(b) The provisions of this subdivision shall not apply to an MFIP assistance unit which 
379.12 	includes a participant who is:
379.13 	(1) age 60 or older;
379.14 	(2) a caregiver who is suffering from an illness, injury, or incapacity that has been 
379.15 	certified by a qualified professional when the illness, injury, or incapacity is expected to 
379.16 	continue for more than 30 days and severely limits the person's ability to obtain or maintain 
379.17 	suitable employment; or
379.18 	(3) a caregiver whose presence in the home is required due to the illness or incapacity 
379.19 	of another member in the assistance unit, a relative in the household, or a foster child in the 
379.20 	household when the illness or incapacity and the need for the participant's presence in the 
379.21 	home has been certified by a qualified professional and is expected to continue for more 
379.22 	than 30 days.
379.23 	(c) The provisions of this subdivision shall not apply to an MFIP assistance unit where 
379.24 	the parental caregiver is an SSI participant.

379.25 	EFFECTIVE DATE. This section is effective March 1, 2023.

379.26 	Sec. 31. Minnesota Statutes 2020, section 256J.626, subdivision 1, is amended to read:
379.27 		Subdivision 1.Consolidated fund. The consolidated fund is established to support 
379.28 	counties and tribes in meeting their duties under this chapter. Counties and tribes must use 
379.29 	funds from the consolidated fund to develop programs and services that are designed to 
379.30 	improve participant outcomes as measured in section 256J.751, subdivision 2. Counties and 
379.31 	tribes that administer MFIP eligibility may use the funds for any allowable expenditures 
380.1 	under subdivision 2, including case management. Tribes that do not administer MFIP 
380.2 	eligibility may use the funds for any allowable expenditures under subdivision 2, including 
380.3 	case management, except those in subdivision 2, paragraph (a), clauses (1) and (6). All 
380.4 	payments made through the MFIP consolidated fund to support a caregiver's pursuit of 
380.5 	greater economic stability does not count when determining a family's available income.

380.6 	Sec. 32. Minnesota Statutes 2020, section 256J.95, subdivision 9, is amended to read:
380.7 		Subd. 9.Property and income limitations. The asset limits and exclusions in section 
380.8 	256P.02 apply to applicants and participants of DWP. All payments, unless excluded in 
380.9 	section 256J.21 as described in section 256P.06, subdivision 3, must be counted as income 
380.10 	to determine eligibility for the diversionary work program. The agency shall treat income 
380.11 	as outlined in section 256J.37, except for subdivision 3a. The initial income test and the 
380.12 	disregards in section 256J.21, subdivision 3, shall be followed for determining eligibility 
380.13 	for the diversionary work program.

380.14 	EFFECTIVE DATE. This section is effective August 1, 2021.

380.15 	Sec. 33. Minnesota Statutes 2020, section 256P.01, subdivision 3, is amended to read:
380.16 		Subd. 3.Earned income. "Earned income" means cash or in-kind income earned through 
380.17 	the receipt of wages, salary, commissions, bonuses, tips, gratuities, profit from employment 
380.18 	activities, net profit from self-employment activities, payments made by an employer for 
380.19 	regularly accrued vacation or sick leave, severance pay based on accrued leave time, 
380.20 	payments from training programs at a rate at or greater than the state's minimum wage,
380.21 	royalties, honoraria, or other profit from activity that results from the client's work, service,
380.22 	effort, or labor for purposes other than student financial assistance, rehabilitation programs, 
380.23 	student training programs, or service programs such as AmeriCorps. The income must be 
380.24 	in return for, or as a result of, legal activity.

380.25 	EFFECTIVE DATE. This section is effective August 1, 2021.

380.26 	Sec. 34. Minnesota Statutes 2020, section 256P.01, is amended by adding a subdivision 
380.27 	to read:
380.28 		Subd. 9.Prospective budgeting. "Prospective budgeting" means estimating the amount 
380.29 	of monthly income that an assistance unit will have in the payment month.

380.30 	EFFECTIVE DATE. This section is effective March 1, 2023.

381.1 	Sec. 35. Minnesota Statutes 2020, section 256P.04, subdivision 4, is amended to read:
381.2 		Subd. 4.Factors to be verified. (a) The agency shall verify the following at application:
381.3 	(1) identity of adults;
381.4 	(2) age, if necessary to determine eligibility;
381.5 	(3) immigration status;
381.6 	(4) income;
381.7 	(5) spousal support and child support payments made to persons outside the household;
381.8 	(6) vehicles;
381.9 	(7) checking and savings accounts;
381.10 	(8) inconsistent information, if related to eligibility;
381.11 	(9) residence; and
381.12 	(10) Social Security number; and.
381.13 	(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), item 
381.14 	(ix), for the intended purpose for which it was given and received.
381.15 	(b) Applicants who are qualified noncitizens and victims of domestic violence as defined 
381.16 	under section 256J.08, subdivision 73, clause (7)clauses (8) and (9), are not required to 
381.17 	verify the information in paragraph (a), clause (10). When a Social Security number is not 
381.18 	provided to the agency for verification, this requirement is satisfied when each member of 
381.19 	the assistance unit cooperates with the procedures for verification of Social Security numbers, 
381.20 	issuance of duplicate cards, and issuance of new numbers which have been established 
381.21 	jointly between the Social Security Administration and the commissioner.

381.22 	EFFECTIVE DATE. This section is effective March 1, 2023, except for paragraph (b), 
381.23 	which is effective July 1, 2021.

381.24 	Sec. 36. Minnesota Statutes 2020, section 256P.04, subdivision 8, is amended to read:
381.25 		Subd. 8.Recertification. The agency shall recertify eligibility in an annual interview 
381.26 	with the participant. The interview may be conducted by telephone, by Internet telepresence, 
381.27 	or face-to-face in the county office or in another location mutually agreed upon. A participant 
381.28 	must be given the option of a telephone interview or Internet telepresence to recertify 
381.29 	eligibility annually. During the interview recertification and reporting under section 256P.10, 
381.30 	the agency shall verify the following:
382.1 	(1) income, unless excluded, including self-employment earnings;
382.2 	(2) assets when the value is within $200 of the asset limit; and
382.3 	(3) inconsistent information, if related to eligibility.

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

382.5 	Sec. 37. Minnesota Statutes 2020, section 256P.06, subdivision 2, is amended to read:
382.6 		Subd. 2.Exempted individuals Exemptions. (a) The following members of an assistance 
382.7 	unit under chapters 119B and 256J are exempt from having their earned income count 
382.8 	towards toward the income of an assistance unit:
382.9 	(1) children under six years old;
382.10 	(2) caregivers under 20 years of age enrolled at least half-time in school; and
382.11 	(3) minors enrolled in school full time.
382.12 	(b) The following members of an assistance unit are exempt from having their earned 
382.13 	and unearned income count towards toward the income of an assistance unit for 12 
382.14 	consecutive calendar months, beginning the month following the marriage date, for benefits 
382.15 	under chapter 256J if the household income does not exceed 275 percent of the federal 
382.16 	poverty guideline:
382.17 	(1) a new spouse to a caretaker in an existing assistance unit; and
382.18 	(2) the spouse designated by a newly married couple, both of whom were already 
382.19 	members of an assistance unit under chapter 256J.
382.20 	(c) If members identified in paragraph (b) also receive assistance under section 119B.05, 
382.21 	they are exempt from having their earned and unearned income count towards toward the 
382.22 	income of the assistance unit if the household income prior to the exemption does not exceed 
382.23 	67 percent of the state median income for recipients for 26 consecutive biweekly periods 
382.24 	beginning the second biweekly period after the marriage date.
382.25 	(d) For individuals who are members of an assistance unit under chapters 256I and 256J, 
382.26 	the assistance standard effective in January 2020 for a household of one under chapter 256J 
382.27 	shall be counted as income under chapter 256I, and any subsequent increases to unearned 
382.28 	income under chapter 256J shall be exempt.

383.1 	Sec. 38. Minnesota Statutes 2020, section 256P.06, subdivision 3, is amended to read:
383.2 		Subd. 3.Income inclusions. The following must be included in determining the income 
383.3 	of an assistance unit:
383.4 	(1) earned income; and
383.5 	(2) unearned income, which includes:
383.6 	(i) interest and dividends from investments and savings;
383.7 	(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;
383.8 	(iii) proceeds from rent and contract for deed payments in excess of the principal and 
383.9 	interest portion owed on property;
383.10 	(iv) income from trusts, excluding special needs and supplemental needs trusts;
383.11 	(v) interest income from loans made by the participant or household;
383.12 	(vi) cash prizes and winnings according to guidance provided for the Supplemental 
383.13 	Nutrition Assistance Program;
383.14 	(vii) unemployment insurance income that is received by an adult member of the 
383.15 	assistance unit unless the individual receiving unemployment insurance income is:
383.16 	(A) 18 years of age and enrolled in a secondary school; or
383.17 	(B) 18 or 19 years of age, a caregiver, and is enrolled in school at least half-time;
383.18 	(viii) retirement, survivors, and disability insurance payments;
383.19 	(ix) nonrecurring income over $60 per quarter unless earmarked and used for the purpose 
383.20 	for which it is intended. Income and use of this income is subject to verification requirements 
383.21 	under section 256P.04;
383.22 	(x) (ix) retirement benefits;
383.23 	(xi) (x) cash assistance benefits, as defined by each program in chapters 119B, 256D, 
383.24 	256I, and 256J;
383.25 	(xii) (xi) tribal per capita payments unless excluded by federal and state law;
383.26 	(xiii) (xii) income and payments from service and rehabilitation programs that meet or 
383.27 	exceed the state's minimum wage rate;
383.28 	(xiv) (xiii) income from members of the United States armed forces unless excluded 
383.29 	from income taxes according to federal or state law;
384.1 	(xv) (xiv) all child support payments for programs under chapters 119B, 256D, and 256I;
384.2 	(xvi) (xv) the amount of child support received that exceeds $100 for assistance units 
384.3 	with one child and $200 for assistance units with two or more children for programs under 
384.4 	chapter 256J; and
384.5 	(xvii) (xvi) spousal support.; and
384.6 	(xvii) workers' compensation.

384.7 	EFFECTIVE DATE. This section is effective March 1, 2023, except subdivision 3, 
384.8 	clause (2), item (vii), which is effective the day following final enactment and subdivision 
384.9 	3, clause (2), item (xvii), which is effective August 1, 2021.

384.10 	Sec. 39. Minnesota Statutes 2020, section 256P.07, is amended to read:
384.11 	256P.07 REPORTING OF INCOME AND CHANGES.
384.12 		Subdivision 1.Exempted programs. Participants who receive Supplemental Security 
384.13 	Income and qualify for Minnesota supplemental aid under chapter 256D and or for housing 
384.14 	support under chapter 256I on the basis of eligibility for Supplemental Security Income are 
384.15 	exempt from this section reporting income.
384.16 		Subd. 1a.Child care assistance programs. Participants who qualify for child care 
384.17 	assistance programs under chapter 119B are exempt from this section except for the reporting 
384.18 	requirements in subdivision 6.
384.19 		Subd. 2.Reporting requirements. An applicant or participant must provide information 
384.20 	on an application and any subsequent reporting forms about the assistance unit's 
384.21 	circumstances that affect eligibility or benefits. An applicant or assistance unit must report 
384.22 	changes identified in subdivision subdivisions 3, 4, 5, 7, 8, and 9 during the application 
384.23 	period or by the tenth of the month following the month that the change occurred. When 
384.24 	information is not accurately reported, both an overpayment and a referral for a fraud 
384.25 	investigation may result. When information or documentation is not provided, the receipt 
384.26 	of any benefit may be delayed or denied, depending on the type of information required 
384.27 	and its effect on eligibility.
384.28 		Subd. 3.Changes that must be reported. An assistance unit must report the changes 
384.29 	or anticipated changes specified in clauses (1) to (12) within ten days of the date they occur, 
384.30 	at the time of recertification of eligibility under section 256P.04, subdivisions 8 and 9, or 
384.31 	within eight calendar days of a reporting period, whichever occurs first. An assistance unit 
384.32 	must report other changes at the time of recertification of eligibility under section 256P.04, 
385.1 	subdivisions 8 and 9, or at the end of a reporting period, as applicable. When an agency 
385.2 	could have reduced or terminated assistance for one or more payment months if a delay in 
385.3 	reporting a change specified under clauses (1) to (12) had not occurred, the agency must 
385.4 	determine whether a timely notice could have been issued on the day that the change 
385.5 	occurred. When a timely notice could have been issued, each month's overpayment 
385.6 	subsequent to that notice must be considered a client error overpayment under section 
385.7 	119B.11, subdivision 2a, or 256P.08. Changes in circumstances that must be reported within 
385.8 	ten days must also be reported for the reporting period in which those changes occurred. 
385.9 	Within ten days, an assistance unit must report:
385.10 	(1) a change in earned income of $100 per month or greater with the exception of a 
385.11 	program under chapter 119B;
385.12 	(2) a change in unearned income of $50 per month or greater with the exception of a 
385.13 	program under chapter 119B;
385.14 	(3) a change in employment status and hours with the exception of a program under 
385.15 	chapter 119B;
385.16 	(4) a change in address or residence;
385.17 	(5) a change in household composition with the exception of programs under chapter 
385.18 	256I;
385.19 	(6) a receipt of a lump-sum payment with the exception of a program under chapter 
385.20 	119B;
385.21 	(7) an increase in assets if over $9,000 with the exception of programs under chapter 
385.22 	119B;
385.23 	(8) a change in citizenship or immigration status;
385.24 	(9) a change in family status with the exception of programs under chapter 256I;
385.25 	(10) a change in disability status of a unit member, with the exception of programs under 
385.26 	chapter 119B;
385.27 	(11) a new rent subsidy or a change in rent subsidy with the exception of a program 
385.28 	under chapter 119B; and
385.29 	(12) a sale, purchase, or transfer of real property with the exception of a program under 
385.30 	chapter 119B. An assistance unit must report changes or anticipated changes as described 
385.31 	in this section.
385.32 	(a) An assistance unit must report:
386.1 	(1) a change in eligibility for Supplemental Security Income, Retirement Survivors 
386.2 	Disability Insurance, or another federal income support;
386.3 	(2) a change in address or residence;
386.4 	(3) a change in household composition with the exception of programs under chapter 
386.5 	256I;
386.6 	(4) cash prizes and winnings according to guidance provided for the Supplemental 
386.7 	Nutrition Assistance Program;
386.8 	(5) a change in citizenship or immigration status;
386.9 	(6) a change in family status with the exception of programs under chapter 256I; and
386.10 	(7) assets when the value is at or above the asset limit.
386.11 	(b) When an agency could have reduced or terminated assistance for one or more payment 
386.12 	months if a delay in reporting a change specified in clauses (1) to (7) had not occurred, the 
386.13 	agency must determine whether a timely notice could have been issued on the day that the 
386.14 	change occurred. When a timely notice could have been issued, each month's overpayment 
386.15 	subsequent to the notice must be considered a client error overpayment under section 
386.16 	256P.08.
386.17 		Subd. 4.MFIP-specific reporting. In addition to subdivision 3, an assistance unit under 
386.18 	chapter 256J, within ten days of the change, must report:
386.19 	(1) a pregnancy not resulting in birth when there are no other minor children; and
386.20 	(2) a change in school attendance of a parent under 20 years of age or of an employed 
386.21 	child.; and
386.22 	(3) an individual who is 18 or 19 years of age attending high school who graduates or 
386.23 	drops out of school.
386.24 		Subd. 5.DWP-specific reporting. In addition to subdivisions 3 and 4, an assistance 
386.25 	unit participating in the diversionary work program under section 256J.95 must report on 
386.26 	an application:
386.27 	(1) shelter expenses; and
386.28 	(2) utility expenses.
386.29 		Subd. 6.Child care assistance programs-specific reporting. (a) In addition to 
386.30 	subdivision 3, An assistance unit under chapter 119B, within ten days of the change, must 
386.31 	report:
387.1 	(1) a change in a parentally responsible individual's custody schedule for any child 
387.2 	receiving child care assistance program benefits;
387.3 	(2) a permanent end in a parentally responsible individual's authorized activity; and
387.4 	(3) if the unit's family's annual included income exceeds 85 percent of the state median 
387.5 	income, adjusted for family size.;
387.6 	(4) a change in address or residence;
387.7 	(5) a change in household composition;
387.8 	(6) a change in citizenship or immigration status; and
387.9 	(7) a change in family status.
387.10 	(b) An assistance unit subject to section 119B.095, subdivision 1, paragraph (b), must 
387.11 	report a change in the unit's authorized activity status.
387.12 	(c) An assistance unit must notify the county when the unit wants to reduce the number 
387.13 	of authorized hours for children in the unit.
387.14 		Subd. 7.Minnesota supplemental aid-specific reporting.  (a) In addition to subdivision 
387.15 	3 and notwithstanding the exemption in subdivision 1, an assistance unit participating in 
387.16 	the Minnesota supplemental aid program under section 256D.44, subdivision 5, paragraph 
387.17 	(g), within ten days of the change, chapter 256D must report shelter expenses.:
387.18 	(1) a change in unearned income of $50 per month or greater; and
387.19 	(2) a change in earned income of $100 per month or greater.
387.20 	(b) An assistance unit receiving housing assistance under section 256D.44, subdivision 
387.21 	5, paragraph (g), including assistance units who also receive Supplemental Security Income, 
387.22 	must report:
387.23 	(1) a change in shelter expenses; and
387.24 	(2) a new rent subsidy or a change in a rent subsidy.
387.25 		Subd. 8.Housing support-specific reporting. (a) In addition to subdivision 3, an 
387.26 	assistance unit participating in the housing support program under chapter 256I must report:
387.27 	(1) a change in unearned income of $50 per month or greater; and
387.28 	(2) a change in earned income of $100 per month or greater, with the exception of 
387.29 	participants already subject to six-month reporting requirements in section 256P.10.
388.1 	(b) Notwithstanding the exemptions in subdivisions 1 and 3, an assistance unit receiving 
388.2 	housing support under chapter 256I, including an assistance unit that receives Supplemental 
388.3 	Security Income, must report:
388.4 	(1) a new rent subsidy or a change in a rent subsidy;
388.5 	(2) a change in the disability status of a unit member; and
388.6 	(3) a change in household composition if the assistance unit is a participant in housing 
388.7 	support under section 256I.04, subdivision 3, paragraph (a), clause (3).
388.8 		Subd. 9.General assistance-specific reporting. In addition to subdivision 3, an 
388.9 	assistance unit participating in the general assistance program under chapter 256D must 
388.10 	report:
388.11 	(1) a change in unearned income of $50 per month or greater;
388.12 	(2) a change in earned income of $100 per month or greater, with the exception of 
388.13 	participants who are already subject to six-month reporting requirements in section 256P.10; 
388.14 	and
388.15 	(3) changes in any condition that would result in the loss of a basis for eligibility in 
388.16 	section 256D.05, subdivision 1, paragraph (a).

388.17 	EFFECTIVE DATE. This section is effective March 1, 2023.

388.18 	Sec. 40. [256P.09] PROSPECTIVE BUDGETING OF BENEFITS.
388.19 		Subdivision 1.Exempted programs. Assistance units who qualify for child care 
388.20 	assistance programs under chapter 119B; housing support assistance units under chapter 
388.21 	256I who are not subject to reporting under section 256P.10; and assistance units who 
388.22 	qualify for Minnesota Supplemental Aid under chapter 256D are exempt from this section.
388.23 		Subd. 2.Prospective budgeting of benefits. An agency must use prospective budgeting 
388.24 	to calculate an assistance payment amount.
388.25 		Subd. 3.Income changes. Prospective budgeting must be used to determine the amount 
388.26 	of the assistance unit's benefit for the following six-month period. An increase in income 
388.27 	shall not affect an assistance unit's eligibility or benefit amount until the next case review 
388.28 	unless otherwise required by section 256P.07. A decrease in income shall be effective on 
388.29 	the date that the change occurs if the change is reported by the tenth of the month following 
388.30 	the month when the change occurred. If the decrease in income is not reported by the tenth 
388.31 	of the month following the month when the change occurred, the change in income shall 
388.32 	be effective the month following the month when the change is reported.

389.1 	EFFECTIVE DATE. This section is effective March 1, 2023.

389.2 	Sec. 41. [256P.10] SIX-MONTH REPORTING.
389.3 		Subdivision 1.Exempted programs. Assistance units who qualify for child care 
389.4 	assistance programs under chapter 119B; assistance units who qualify for Minnesota 
389.5 	Supplemental Aid under chapter 256D; and assistance units who qualify for housing support 
389.6 	under chapter 256I and also receive Supplemental Security Income are exempt from this 
389.7 	section.
389.8 		Subd. 2.Reporting. (a) Every six months, an assistance unit that qualifies for the 
389.9 	Minnesota family investment program under chapter 256J; an assistance unit that qualifies 
389.10 	for general assistance under chapter 256D with earned income of $100 per month or greater; 
389.11 	or an assistance unit that qualifies for housing support under chapter 256I with earned 
389.12 	income of $100 per month or greater is subject to six month case reviews. The initial 
389.13 	reporting period may be shorter than six months in order to align with other program reporting 
389.14 	periods.
389.15 	(b) An assistance unit that qualifies for the Minnesota family investment program and 
389.16 	an assistance unit that qualifies for general assistance as described in paragraph (a) must 
389.17 	complete household report forms as prescribed by the commissioner for redetermination of 
389.18 	benefits.
389.19 	(c) An assistance unit that qualifies for housing support as described in paragraph (a) 
389.20 	must complete household report forms as prescribed by the commissioner to provide 
389.21 	information about earned income.
389.22 	(d) An assistance unit that qualifies for housing support and also receives assistance 
389.23 	through the Minnesota family investment program shall be subject to the requirements of 
389.24 	this section for purposes of the Minnesota family investment program but not for housing 
389.25 	support.
389.26 	(e) An assistance unit must submit a household report form in compliance with the 
389.27 	provisions in section 256P.04, subdivision 11.
389.28 	(f) An assistance unit may choose to report changes under this section at any time.
389.29 		Subd. 3.When to terminate assistance. (a) An agency must terminate benefits when 
389.30 	the participant fails to submit the household report form before the end of the six month 
389.31 	review period. If the participant submits the household report form within 30 days of the 
389.32 	termination of benefits, benefits must be reinstated and made available retroactively for the 
389.33 	full benefit month.
390.1 	(b) When an assistance unit is determined to be ineligible for assistance according to 
390.2 	this section and chapter 256D, 256I, or 256J, the agency must terminate assistance.

390.3 	EFFECTIVE DATE. This section is effective March 1, 2023.

390.4 	Sec. 42. Laws 2020, First Special Session chapter 7, section 1, as amended by Laws 2020, 
390.5 	Third Special Session chapter 1, section 3, is amended by adding a subdivision to read:
390.6 		Subd. 5.Waivers and modifications. When the peacetime emergency declared by the 
390.7 	governor in response to the COVID-19 outbreak expires, is terminated, or is rescinded by 
390.8 	the proper authority, the following waivers and modifications to human services programs 
390.9 	issued by the commissioner of human services pursuant to Executive Orders 20-12 and 
390.10 	20-42, including any amendments to the waivers or modifications issued before the peacetime 
390.11 	emergency expires, shall remain in effect until December 31, 2021, unless necessary federal 
390.12 	approval is not received at any time for a waiver or modification:
390.13 	(1) Executive Order 21-15: when determining eligibility for cash assistance programs, 
390.14 	not counting as income any emergency economic relief provided through the American 
390.15 	Rescue Plan Act of 2021; and
390.16 	(2) CV.04.A4: waiving interviews for annual eligibility recertifications of households 
390.17 	receiving cash assistance in which all necessary information has been submitted and verified.

390.18 	Sec. 43. DIRECTION TO COMMISSIONER; LONG-TERM HOMELESS 
390.19 	SUPPORTIVE SERVICES REPORT.
 390.20 	(a) No later than January 15, 2023, the commissioner of human services shall produce 
390.21 	a report which shows the projects funded under Minnesota Statutes, section 256K.26, and 
390.22 	provide a copy of the report to the chairs and ranking minority members of the legislative 
390.23 	committees with jurisdiction over services for persons experiencing homelessness.
390.24 	(b) This report must be updated annually for two additional years and the commissioner 
390.25 	must provide copies of the updated reports to the chairs and ranking minority members of 
390.26 	the legislative committees with jurisdiction over services for persons experiencing 
390.27 	homelessness by January 15, 2024, and January 15, 2025.

390.28 	Sec. 44. 2022 REPORT TO LEGISLATURE ON RUNAWAY AND HOMELESS 
390.29 	YOUTH.
 390.30 		Subdivision 1.Report development. The commissioner of human services is exempt 
390.31 	from preparing the report required under Minnesota Statutes, section 256K.45, subdivision 
391.1 	2, in 2023 and shall instead update the information in the 2007 legislative report on runaway 
391.2 	and homeless youth. In developing the updated report, the commissioner must use existing 
391.3 	data, studies, and analysis provided by state, county, and other entities including:
391.4 	(1) Minnesota Housing Finance Agency analysis on housing availability;
391.5 	(2) the Minnesota state plan to end homelessness;
391.6 	(3) the continuum of care counts of youth experiencing homelessness and assessments 
391.7 	as provided by Department of Housing and Urban Development (HUD) required coordinated 
391.8 	entry systems;
391.9 	(4) the biannual Department of Human Services report on the Homeless Youth Act;
391.10 	(5) the Wilder Research homeless study;
391.11 	(6) the Voices of Youth Count sponsored by Hennepin County; and
391.12 	(7) privately funded analysis, including:
391.13 	(i) nine evidence-based principles to support youth in overcoming homelessness;
391.14 	(ii) the return on investment analysis conducted for YouthLink by Foldes Consulting; 
391.15 	and
391.16 	(iii) the evaluation of Homeless Youth Act resources conducted by Rainbow Research.
391.17 		Subd. 2.Key elements; due date. (a) The report must include three key elements where 
391.18 	significant learning has occurred in the state since the 2007 report, including:
391.19 	(1) the unique causes of youth homelessness;
391.20 	(2) targeted responses to youth homelessness, including the significance of positive 
391.21 	youth development as fundamental to each targeted response; and
391.22 	(3) recommendations based on existing reports and analysis on how to end youth 
391.23 	homelessness.
391.24 	(b) To the extent that data is available, the report must include:
391.25 	(1) a general accounting of the federal and philanthropic funds leveraged to support 
391.26 	homeless youth activities;
391.27 	(2) a general accounting of the increase in volunteer responses to support youth 
391.28 	experiencing homelessness; and
391.29 	(3) a data-driven accounting of geographic areas or distinct populations that have gaps 
391.30 	in service or are not yet served by homeless youth responses.
392.1 	(c) The commissioner of human services shall consult with and incorporate the expertise 
392.2 	of community-based providers of homeless youth services and other expert stakeholders to 
392.3 	complete the report. The commissioner shall submit the report to the chairs and ranking 
392.4 	minority members of the legislative committees with jurisdiction over youth homelessness 
392.5 	by December 15, 2022.

392.6 	Sec. 45. REPEALER.
 392.7 	(a) Minnesota Statutes 2020, sections 256D.051, subdivisions 1, 1a, 2, 2a, 3, 3a, 3b, 6b, 
392.8 	6c, 7, 8, 9, and 18; 256D.052, subdivision 3; and 256J.21, subdivisions 1 and 2, are repealed.
392.9 	(b) Minnesota Statutes 2020, sections 256J.08, subdivisions 10, 53, 61, 62, 81, and 83; 
392.10 	256J.30, subdivisions 5, 7, and 8; 256J.33, subdivisions 3, 4, and 5; 256J.34, subdivisions 
392.11 	1, 2, 3, and 4; and 256J.37, subdivision 10, are repealed.

392.12 	EFFECTIVE DATE. Paragraph (a) is effective August 1, 2021. Paragraph (b) is effective 
392.13 	March 1, 2023.

392.14 	ARTICLE 9
392.15 	CHILD CARE ASSISTANCE

392.16 	Section 1. Minnesota Statutes 2020, section 119B.03, subdivision 4, is amended to read:
392.17 		Subd. 4.Funding priority. (a) First priority for child care assistance under the basic 
392.18 	sliding fee program must be given to eligible non-MFIP families who do not have a high 
392.19 	school diploma or commissioner of education-selected high school equivalency certification 
392.20 	or who need remedial and basic skill courses in order to pursue employment or to pursue 
392.21 	education leading to employment and who need child care assistance to participate in the 
392.22 	education program. This includes student parents as defined under section 119B.011, 
392.23 	subdivision 19b. Within this priority, the following subpriorities must be used:
392.24 	(1) child care needs of minor parents;
392.25 	(2) child care needs of parents under 21 years of age; and
392.26 	(3) child care needs of other parents within the priority group described in this paragraph.
392.27 	(b) Second priority must be given to parents who have completed their MFIP or DWP 
392.28 	transition year, or parents who are no longer receiving or eligible for diversionary work 
392.29 	program supports families in which at least one parent is a veteran, as defined under section 
392.30 	197.447.
393.1 	(c) Third priority must be given to eligible families who are eligible for portable basic 
393.2 	sliding fee assistance through the portability pool under subdivision 9 do not meet the 
393.3 	specifications of paragraph (a), (b), (d), or (e).
393.4 	(d) Fourth priority must be given to families in which at least one parent is a veteran as 
393.5 	defined under section 197.447 who are eligible for portable basic sliding fee assistance 
393.6 	through the portability pool under subdivision 9.
393.7 	(e) Fifth priority must be given to eligible families receiving services under section 
393.8 	119B.011, subdivision 20a, if the parents have completed their MFIP or DWP transition 
393.9 	year, or if the parents are no longer receiving or eligible for DWP supports.
393.10 	(e) (f) Families under paragraph (b) (e) must be added to the basic sliding fee waiting 
393.11 	list on the date they begin the complete their transition year under section 119B.011, 
393.12 	subdivision 20, and must be moved into the basic sliding fee program as soon as possible 
393.13 	after they complete their transition year.

393.14 	EFFECTIVE DATE. This section is effective July 1, 2021.

393.15 	Sec. 2. Minnesota Statutes 2020, section 119B.03, subdivision 6, is amended to read:
393.16 		Subd. 6.Allocation formula. The allocation component of basic sliding fee state and 
393.17 	federal funds shall be allocated on a calendar year basis. Funds shall be allocated first in 
393.18 	amounts equal to each county's guaranteed floor according to subdivision 8, with any 
393.19 	remaining available funds allocated according to the following formula:
393.20 	(a) One-fourth of the funds shall be allocated in proportion to each county's total 
393.21 	expenditures for the basic sliding fee child care program reported during the most recent 
393.22 	fiscal year completed at the time of the notice of allocation.
393.23 	(b) Up to one-fourth of the funds shall be allocated in proportion to the number of families 
393.24 	participating in the transition year child care program as reported during and averaged over 
393.25 	the most recent six months completed at the time of the notice of allocation. Funds in excess 
393.26 	of the amount necessary to serve all families in this category shall be allocated according 
393.27 	to paragraph (f) (e).
393.28 	(c) Up to one-fourth of the funds shall be allocated in proportion to the average of each 
393.29 	county's most recent six months of reported first, second, and third priority waiting list as 
393.30 	defined in subdivision 2 and the reinstatement list of those families whose assistance was 
393.31 	terminated with the approval of the commissioner under Minnesota Rules, part 3400.0183, 
393.32 	subpart 1. Funds in excess of the amount necessary to serve all families in this category 
393.33 	shall be allocated according to paragraph (f).
394.1 	(d) (c) Up to one-fourth one-half of the funds shall be allocated in proportion to the 
394.2 	average of each county's most recent six 12 months of reported waiting list as defined in 
394.3 	subdivision 2 and the reinstatement list of those families whose assistance was terminated 
394.4 	with the approval of the commissioner under Minnesota Rules, part 3400.0183, subpart 1. 
394.5 	Funds in excess of the amount necessary to serve all families in this category shall be 
394.6 	allocated according to paragraph (f) (e).
394.7 	(e) (d) The amount necessary to serve all families in paragraphs (b), (c), and (d) (c) shall 
394.8 	be calculated based on the basic sliding fee average cost of care per family in the county 
394.9 	with the highest cost in the most recently completed calendar year.
394.10 	(f) (e) Funds in excess of the amount necessary to serve all families in paragraphs (b), 
394.11 	(c), and (d) (c) shall be allocated in proportion to each county's total expenditures for the 
394.12 	basic sliding fee child care program reported during the most recent fiscal year completed 
394.13 	at the time of the notice of allocation.

394.14 	EFFECTIVE DATE. This section is effective January 1, 2022. The 2022 calendar year 
394.15 	shall be a phase-in year for the allocation formula in this section using phase-in provisions 
394.16 	determined by the commissioner of human services.

394.17 	Sec. 3. Minnesota Statutes 2020, section 119B.09, subdivision 4, is amended to read:
394.18 		Subd. 4.Eligibility; annual income; calculation. (a) Annual income of the applicant 
394.19 	family is the current monthly income of the family multiplied by 12 or the income for the 
394.20 	12-month period immediately preceding the date of application, or income calculated by 
394.21 	the method which provides the most accurate assessment of income available to the family.
394.22 	(b) Self-employment income must be calculated based on gross receipts less operating 
394.23 	expenses.
394.24 	(c) Income changes are processed under section 119B.025, subdivision 4. Included lump 
394.25 	sums counted as income under section 256P.06, subdivision 3 119B.011, subdivision 15, 
394.26 	must be annualized over 12 months. Income must be verified with documentary evidence. 
394.27 	If the applicant does not have sufficient evidence of income, verification must be obtained 
394.28 	from the source of the income.

394.29 	EFFECTIVE DATE. This section is effective March 1, 2023.

394.30 	Sec. 4. Minnesota Statutes 2020, section 119B.11, subdivision 2a, is amended to read:
394.31 		Subd. 2a.Recovery of overpayments. (a) An amount of child care assistance paid to a 
394.32 	recipient or provider in excess of the payment due is recoverable by the county agency or 
395.1 	commissioner under paragraphs (b) and (c), even when the overpayment was caused by 
395.2 	agency error or circumstances outside the responsibility and control of the family or provider.
395.3 	(b) An overpayment must be recouped or recovered from the family if the overpayment 
395.4 	benefited the family by causing the family to pay less for child care expenses than the family 
395.5 	otherwise would have been required to pay under child care assistance program requirements. 
395.6 	If the family remains eligible for child care assistance, the overpayment must be recovered 
395.7 	through recoupment as identified in Minnesota Rules, part 3400.0187, except that the 
395.8 	overpayments must be calculated and collected on a service period basis. If the family no 
395.9 	longer remains eligible for child care assistance, the county or commissioner may choose 
395.10 	to initiate efforts to recover overpayments from the family for overpayment less than $50. 
395.11 	If the overpayment is greater than or equal to $50, the county or commissioner shall seek 
395.12 	voluntary repayment of the overpayment from the family. If the county or commissioner is 
395.13 	unable to recoup the overpayment through voluntary repayment, the county or commissioner 
395.14 	shall initiate civil court proceedings to recover the overpayment unless the county's or 
395.15 	commissioner's costs to recover the overpayment will exceed the amount of the overpayment. 
395.16 	A family with an outstanding debt under this subdivision is not eligible for child care 
395.17 	assistance until: (1) the debt is paid in full; or (2) satisfactory arrangements are made with 
395.18 	the county or commissioner to retire the debt consistent with the requirements of this chapter 
395.19 	and Minnesota Rules, chapter 3400, and the family is in compliance with the arrangements; 
395.20 	or (3) the commissioner determines that it is in the best interests of the state to compromise 
395.21 	debts owed to the state pursuant to section 16D.15. The commissioner's authority to recoup 
395.22 	and recover overpayments from families in this paragraph is limited to investigations 
395.23 	conducted under chapter 245E.
395.24 	(c) The county or commissioner must recover an overpayment from a provider if the 
395.25 	overpayment did not benefit the family by causing it to receive more child care assistance 
395.26 	or to pay less for child care expenses than the family otherwise would have been eligible 
395.27 	to receive or required to pay under child care assistance program requirements, and benefited 
395.28 	the provider by causing the provider to receive more child care assistance than otherwise 
395.29 	would have been paid on the family's behalf under child care assistance program 
395.30 	requirements. If the provider continues to care for children receiving child care assistance, 
395.31 	the overpayment must be recovered through reductions in child care assistance payments 
395.32 	for services as described in an agreement with the county recoupment as identified in 
395.33 	Minnesota Rules, part 3400.0187. The provider may not charge families using that provider 
395.34 	more to cover the cost of recouping the overpayment. If the provider no longer cares for 
395.35 	children receiving child care assistance, the county or commissioner may choose to initiate 
396.1 	efforts to recover overpayments of less than $50 from the provider. If the overpayment is 
396.2 	greater than or equal to $50, the county or commissioner shall seek voluntary repayment 
396.3 	of the overpayment from the provider. If the county or commissioner is unable to recoup 
396.4 	the overpayment through voluntary repayment, the county or commissioner shall initiate 
396.5 	civil court proceedings to recover the overpayment unless the county's or commissioner's
396.6 	costs to recover the overpayment will exceed the amount of the overpayment. A provider 
396.7 	with an outstanding debt under this subdivision is not eligible to care for children receiving 
396.8 	child care assistance until:
396.9 	(1) the debt is paid in full; or
396.10 	(2) satisfactory arrangements are made with the county or commissioner to retire the 
396.11 	debt consistent with the requirements of this chapter and Minnesota Rules, chapter 3400, 
396.12 	and the provider is in compliance with the arrangements.; or
396.13 	(3) the commissioner determines that it is in the best interests of the state to compromise 
396.14 	debts owed to the state pursuant to section 16D.15.
396.15 	(d) When both the family and the provider acted together to intentionally cause the 
396.16 	overpayment, both the family and the provider are jointly liable for the overpayment 
396.17 	regardless of who benefited from the overpayment. The county or commissioner must 
396.18 	recover the overpayment as provided in paragraphs (b) and (c). When the family or the 
396.19 	provider is in compliance with a repayment agreement, the party in compliance is eligible 
396.20 	to receive child care assistance or to care for children receiving child care assistance despite 
396.21 	the other party's noncompliance with repayment arrangements.

396.22 	EFFECTIVE DATE. This section is effective August 1, 2021.

396.23 	Sec. 5. Minnesota Statutes 2020, section 119B.125, subdivision 1, is amended to read:
396.24 		Subdivision 1.Authorization. Except as provided in subdivision 5, A county or the 
396.25 	commissioner must authorize the provider chosen by an applicant or a participant before 
396.26 	the county can authorize payment for care provided by that provider. The commissioner 
396.27 	must establish the requirements necessary for authorization of providers. A provider must 
396.28 	be reauthorized every two years. A legal, nonlicensed family child care provider also must 
396.29 	be reauthorized when another person over the age of 13 joins the household, a current 
396.30 	household member turns 13, or there is reason to believe that a household member has a 
396.31 	factor that prevents authorization. The provider is required to report all family changes that 
396.32 	would require reauthorization. When a provider has been authorized for payment for 
396.33 	providing care for families in more than one county, the county responsible for 
397.1 	reauthorization of that provider is the county of the family with a current authorization for 
397.2 	that provider and who has used the provider for the longest length of time.

397.3 	EFFECTIVE DATE. This section is effective August 1, 2021.

397.4 	Sec. 6. Minnesota Statutes 2020, section 119B.13, subdivision 1, is amended to read:
397.5 		Subdivision 1.Subsidy restrictions. (a) The maximum rate paid for child care assistance 
397.6 	in any county or county price cluster under the child care fund shall be the greater of the 
397.7 	25th percentile of the 2018 child care provider rate survey or the rates in effect at the time 
397.8 	of the update. set in accordance with rates and policies established by the commissioner, 
397.9 	dependent on federal funds, and consistent with federal law, up to a maximum of the 75th 
397.10 	percentile of the most recent child care provider rate survey, but in no event shall the 
397.11 	maximum rate be less than the greater of the 50th percentile of the most recent child care 
397.12 	provider rate survey or the rates in effect at the time of the update. The rate increase is 
397.13 	effective no later than the first full service period on or after January 1 of the year following 
397.14 	the provider rate survey. For a child care provider located within the boundaries of a city 
397.15 	located in two or more of the counties of Benton, Sherburne, and Stearns, the maximum 
397.16 	rate paid for child care assistance shall be equal to the maximum rate paid in the county 
397.17 	with the highest maximum reimbursement rates or the provider's charge, whichever is less. 
397.18 	The commissioner may: (1) assign a county with no reported provider prices to a similar 
397.19 	price cluster; and (2) consider county level access when determining final price clusters.
397.20 	(b) A rate which includes a special needs rate paid under subdivision 3 may be in excess 
397.21 	of the maximum rate allowed under this subdivision.
397.22 	(c) The department shall monitor the effect of this paragraph on provider rates. The 
397.23 	county shall pay the provider's full charges for every child in care up to the maximum 
397.24 	established. The commissioner shall determine the maximum rate for each type of care on 
397.25 	an hourly, full-day, and weekly basis, including special needs and disability care.
397.26 	(d) If a child uses one provider, the maximum payment for one day of care must not 
397.27 	exceed the daily rate. The maximum payment for one week of care must not exceed the 
397.28 	weekly rate.
397.29 	(e) If a child uses two providers under section 119B.097, the maximum payment must 
397.30 	not exceed:
397.31 	(1) the daily rate for one day of care;
397.32 	(2) the weekly rate for one week of care by the child's primary provider; and
398.1 	(3) two daily rates during two weeks of care by a child's secondary provider.
398.2 	(f) Child care providers receiving reimbursement under this chapter must not be paid 
398.3 	activity fees or an additional amount above the maximum rates for care provided during 
398.4 	nonstandard hours for families receiving assistance.
398.5 	(g) If the provider charge is greater than the maximum provider rate allowed, the parent 
398.6 	is responsible for payment of the difference in the rates in addition to any family co-payment 
398.7 	fee.
398.8 	(h) All maximum provider rates changes shall be implemented on the Monday following 
398.9 	the effective date of the maximum provider rate.
398.10 	(i) Beginning September 21, 2020, (h) The maximum registration fee paid for child care 
398.11 	assistance in any county or county price cluster under the child care fund shall be the greater 
398.12 	of the 25th percentile of the 2018 child care provider rate survey or the registration fee in 
398.13 	effect at the time of the update.set in accordance with rates and policies established by the 
398.14 	commissioner, dependent on federal funds, and consistent with federal law, up to a maximum 
398.15 	of the 75th percentile of the most recent child care provider rate survey, but in no event 
398.16 	shall the maximum registration fee be less than the greater of the 50th percentile of the most 
398.17 	recent child care provider rate survey or the registration fee in effect at the time of the update. 
398.18 	Each maximum registration fee update must be implemented on the same schedule as 
398.19 	maximum child care assistance rate increases under paragraph (a). Maximum registration 
398.20 	fees must be set for licensed family child care and for child care centers. For a child care 
398.21 	provider located in the boundaries of a city located in two or more of the counties of Benton, 
398.22 	Sherburne, and Stearns, the maximum registration fee paid for child care assistance shall 
398.23 	be equal to the maximum registration fee paid in the county with the highest maximum 
398.24 	registration fee or the provider's charge, whichever is less.

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

398.26 	Sec. 7. Minnesota Statutes 2020, section 119B.13, subdivision 1a, is amended to read:
398.27 		Subd. 1a.Legal nonlicensed family child care provider rates. (a) Legal nonlicensed 
398.28 	family child care providers receiving reimbursement under this chapter must be paid on an 
398.29 	hourly basis for care provided to families receiving assistance.
398.30 	(b) The maximum rate paid to legal nonlicensed family child care providers must be 68
398.31 	90 percent of the county maximum hourly rate for licensed family child care providers. The 
398.32 	rate increase is effective the first full service period on or after January 1 of the year following 
398.33 	the provider rate survey. In counties or county price clusters where the maximum hourly 
399.1 	rate for licensed family child care providers is higher than the maximum weekly rate for 
399.2 	those providers divided by 50, the maximum hourly rate that may be paid to legal nonlicensed 
399.3 	family child care providers is the rate equal to the maximum weekly rate for licensed family 
399.4 	child care providers divided by 50 and then multiplied by 0.68 0.90. The maximum payment 
399.5 	to a provider for one day of care must not exceed the maximum hourly rate times ten. The 
399.6 	maximum payment to a provider for one week of care must not exceed the maximum hourly 
399.7 	rate times 50.
399.8 	(c) A rate which includes a special needs rate paid under subdivision 3 may be in excess 
399.9 	of the maximum rate allowed under this subdivision.
399.10 	(d) Legal nonlicensed family child care providers receiving reimbursement under this 
399.11 	chapter may not be paid registration fees for families receiving assistance.

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

399.13 	Sec. 8. Minnesota Statutes 2020, section 119B.13, subdivision 6, is amended to read:
399.14 		Subd. 6.Provider payments. (a) A provider shall bill only for services documented 
399.15 	according to section 119B.125, subdivision 6. The provider shall bill for services provided 
399.16 	within ten days of the end of the service period. Payments under the child care fund shall 
399.17 	be made within 21 days of receiving a complete bill from the provider. Counties or the state 
399.18 	may establish policies that make payments on a more frequent basis.
399.19 	(b) If a provider has received an authorization of care and been issued a billing form for 
399.20 	an eligible family, the bill must be submitted within 60 days of the last date of service on 
399.21 	the bill. A bill submitted more than 60 days after the last date of service must be paid if the 
399.22 	county determines that the provider has shown good cause why the bill was not submitted 
399.23 	within 60 days. Good cause must be defined in the county's child care fund plan under 
399.24 	section 119B.08, subdivision 3, and the definition of good cause must include county error. 
399.25 	Any bill submitted more than a year after the last date of service on the bill must not be 
399.26 	paid.
399.27 	(c) If a provider provided care for a time period without receiving an authorization of 
399.28 	care and a billing form for an eligible family, payment of child care assistance may only be 
399.29 	made retroactively for a maximum of six three months from the date the provider is issued 
399.30 	an authorization of care and billing form. For a family at application, if a provider provided 
399.31 	child care during a time period without receiving an authorization of care and a billing form, 
399.32 	a county may only make child care assistance payments to the provider retroactively from 
399.33 	the date that child care began, or from the date that the family's eligibility began under 
400.1 	section 119B.09, subdivision 7, or from the date that the family meets authorization 
400.2 	requirements, not to exceed six months from the date the provider is issued an authorization 
400.3 	of care and billing form, whichever is later.
400.4 	(d) A county or the commissioner may refuse to issue a child care authorization to a 
400.5 	certified, licensed, or legal nonlicensed provider, revoke an existing child care authorization 
400.6 	to a certified, licensed, or legal nonlicensed provider, stop payment issued to a certified, 
400.7 	licensed, or legal nonlicensed provider, or refuse to pay a bill submitted by a certified, 
400.8 	licensed, or legal nonlicensed provider if:
400.9 	(1) the provider admits to intentionally giving the county materially false information 
400.10 	on the provider's billing forms;
400.11 	(2) a county or the commissioner finds by a preponderance of the evidence that the 
400.12 	provider intentionally gave the county materially false information on the provider's billing 
400.13 	forms, or provided false attendance records to a county or the commissioner;
400.14 	(3) the provider is in violation of child care assistance program rules, until the agency 
400.15 	determines those violations have been corrected;
400.16 	(4) the provider is operating after:
400.17 	(i) an order of suspension of the provider's license issued by the commissioner;
400.18 	(ii) an order of revocation of the provider's license issued by the commissioner; or
400.19 	(iii) a final order of conditional license issued by the commissioner for as long as the 
400.20 	conditional license is in effect an order of decertification issued to the provider;
400.21 	(5) the provider submits false attendance reports or refuses to provide documentation 
400.22 	of the child's attendance upon request;
400.23 	(6) the provider gives false child care price information; or
400.24 	(7) the provider fails to report decreases in a child's attendance as required under section 
400.25 	119B.125, subdivision 9.
400.26 	(e) For purposes of paragraph (d), clauses (3), (5), (6), and (7), the county or the 
400.27 	commissioner may withhold the provider's authorization or payment for a period of time 
400.28 	not to exceed three months beyond the time the condition has been corrected.
400.29 	(f) A county's payment policies must be included in the county's child care plan under 
400.30 	section 119B.08, subdivision 3. If payments are made by the state, in addition to being in 
400.31 	compliance with this subdivision, the payments must be made in compliance with section 
400.32 	16A.124.
401.1 	(g) If the commissioner or responsible county agency suspends or refuses payment to a 
401.2 	provider under paragraph (d), clause (1) or (2), or chapter 245E and the provider has:
401.3 	(1) a disqualification for wrongfully obtaining assistance under section 256.98, 
401.4 	subdivision 8, paragraph (c);
401.5 	(2) an administrative disqualification under section 256.046, subdivision 3; or
401.6 	(3) a termination under section 245E.02, subdivision 4, paragraph (c), clause (4), or 
401.7 	245E.06;
401.8 	then the provider forfeits the payment to the commissioner or the responsible county agency, 
401.9 	regardless of the amount assessed in an overpayment, charged in a criminal complaint, or 
401.10 	ordered as criminal restitution.

401.11 	EFFECTIVE DATE. This section is effective August 1, 2021.

401.12 	Sec. 9. Minnesota Statutes 2020, section 119B.13, subdivision 7, is amended to read:
401.13 		Subd. 7.Absent days. (a) Licensed child care providers and license-exempt centers 
401.14 	must not be reimbursed for more than 25 full-day absent days per child, excluding holidays, 
401.15 	in a calendar year, or for more than ten consecutive full-day absent days. "Absent day" 
401.16 	means any day that the child is authorized and scheduled to be in care with a licensed 
401.17 	provider or license-exempt center, and the child is absent from the care for the entire day. 
401.18 	Legal nonlicensed family child care providers must not be reimbursed for absent days. If a 
401.19 	child attends for part of the time authorized to be in care in a day, but is absent for part of 
401.20 	the time authorized to be in care in that same day, the absent time must be reimbursed but 
401.21 	the time must not count toward the absent days limit. Child care providers must only be 
401.22 	reimbursed for absent days if the provider has a written policy for child absences and charges 
401.23 	all other families in care for similar absences.
401.24 	(b) Notwithstanding paragraph (a), children with documented medical conditions that 
401.25 	cause more frequent absences may exceed the 25 absent days limit, or ten consecutive 
401.26 	full-day absent days limit. Absences due to a documented medical condition of a parent or 
401.27 	sibling who lives in the same residence as the child receiving child care assistance do not 
401.28 	count against the absent days limit in a calendar year. Documentation of medical conditions 
401.29 	must be on the forms and submitted according to the timelines established by the 
401.30 	commissioner. A public health nurse or school nurse may verify the illness in lieu of a 
401.31 	medical practitioner. If a provider sends a child home early due to a medical reason, 
401.32 	including, but not limited to, fever or contagious illness, the child care center director or 
401.33 	lead teacher may verify the illness in lieu of a medical practitioner.
402.1 	(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit 
402.2 	if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or 
402.3 	commissioner of education-selected high school equivalency certification; and (3) is a 
402.4 	student in a school district or another similar program that provides or arranges for child 
402.5 	care, parenting support, social services, career and employment supports, and academic 
402.6 	support to achieve high school graduation, upon request of the program and approval of the 
402.7 	county. If a child attends part of an authorized day, payment to the provider must be for the 
402.8 	full amount of care authorized for that day.
402.9 	(d) Child care providers must be reimbursed for up to ten federal or state holidays or 
402.10 	designated holidays per year when the provider charges all families for these days and the 
402.11 	holiday or designated holiday falls on a day when the child is authorized to be in attendance. 
402.12 	Parents may substitute other cultural or religious holidays for the ten recognized state and 
402.13 	federal holidays. Holidays do not count toward the absent days limit.
402.14 	(e) A family or child care provider must not be assessed an overpayment for an absent 
402.15 	day payment unless (1) there was an error in the amount of care authorized for the family, 
402.16 	or (2) all of the allowed full-day absent payments for the child have been paid, or (3) the 
402.17 	family or provider did not timely report a change as required under law.
402.18 	(f) The provider and family shall receive notification of the number of absent days used 
402.19 	upon initial provider authorization for a family and ongoing notification of the number of 
402.20 	absent days used as of the date of the notification.
402.21 	(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days 
402.22 	per child, excluding holidays, in a calendar year; and ten consecutive full-day absent days.
402.23 	(h) For purposes of this subdivision, "holidays limit" means ten full-day holidays per 
402.24 	child, excluding absent days, in a calendar year.
402.25 	(i) If a day meets the criteria of an absent day or a holiday under this subdivision, the 
402.26 	provider must bill that day as an absent day or holiday. A provider's failure to properly bill 
402.27 	an absent day or a holiday results in an overpayment, regardless of whether the child reached, 
402.28 	or is exempt from, the absent days limit or holidays limit for the calendar year.

402.29 	EFFECTIVE DATE. This section is effective August 1, 2021.

402.30 	Sec. 10. Minnesota Statutes 2020, section 119B.25, subdivision 3, is amended to read:
402.31 		Subd. 3.Financing program. A nonprofit corporation that receives a grant under this 
402.32 	section shall use the money to:
403.1 	(1) establish a revolving loan fund to make loans to existing, expanding, and new licensed 
403.2 	and legal unlicensed child care and early childhood education sites;
403.3 	(2) establish a fund to guarantee private loans to improve or construct a child care or 
403.4 	early childhood education site;
403.5 	(3) establish a fund to provide forgivable loans or grants to match all or part of a loan 
403.6 	made under this section;
403.7 	(4) establish a fund as a reserve against bad debt; and
403.8 	(5) establish a fund to provide business planning assistance for child care providers.; 
403.9 	and
403.10 	(6) provide training and consultation for child care providers to build and strengthen 
403.11 	their businesses and acquire key business skills.
403.12 	The nonprofit corporation shall establish the terms and conditions for loans and loan 
403.13 	guarantees including, but not limited to, interest rates, repayment agreements, private match 
403.14 	requirements, and conditions for loan forgiveness. The nonprofit corporation shall establish 
403.15 	a minimum interest rate for loans to ensure that necessary loan administration costs are 
403.16 	covered. The nonprofit corporation may use interest earnings for administrative expenses.

403.17 	Sec. 11. REPEALER.
 403.18 	Minnesota Statutes 2020, sections 119B.04; and 119B.125, subdivision 5, are repealed.

403.19 	EFFECTIVE DATE. This section is effective August 1, 2021.

403.20 	ARTICLE 10
403.21 	CHILD PROTECTION

403.22 	Section 1. Minnesota Statutes 2020, section 256N.25, subdivision 2, is amended to read:
403.23 		Subd. 2.Negotiation of agreement. (a) When a child is determined to be eligible for 
403.24 	Northstar kinship assistance or adoption assistance, the financially responsible agency, or, 
403.25 	if there is no financially responsible agency, the agency designated by the commissioner, 
403.26 	must negotiate with the caregiver to develop an agreement under subdivision 1. If and when 
403.27 	the caregiver and agency reach concurrence as to the terms of the agreement, both parties 
403.28 	shall sign the agreement. The agency must submit the agreement, along with the eligibility 
403.29 	determination outlined in sections 256N.22, subdivision 7, and 256N.23, subdivision 7, to 
403.30 	the commissioner for final review, approval, and signature according to subdivision 1.
404.1 	(b) A monthly payment is provided as part of the adoption assistance or Northstar kinship 
404.2 	assistance agreement to support the care of children unless the child is eligible for adoption 
404.3 	assistance and determined to be an at-risk child, in which case no payment will be made 
404.4 	unless and until the caregiver obtains written documentation from a qualified expert that 
404.5 	the potential disability upon which eligibility for the agreement was based has manifested 
404.6 	itself.
404.7 	(1) The amount of the payment made on behalf of a child eligible for Northstar kinship 
404.8 	assistance or adoption assistance is determined through agreement between the prospective 
404.9 	relative custodian or the adoptive parent and the financially responsible agency, or, if there 
404.10 	is no financially responsible agency, the agency designated by the commissioner, using the 
404.11 	assessment tool established by the commissioner in section 256N.24, subdivision 2, and the 
404.12 	associated benefit and payments outlined in section 256N.26. Except as provided under 
404.13 	section 256N.24, subdivision 1, paragraph (c), the assessment tool establishes the monthly 
404.14 	benefit level for a child under foster care. The monthly payment under a Northstar kinship 
404.15 	assistance agreement or adoption assistance agreement may be negotiated up to the monthly 
404.16 	benefit level under foster care. In no case may the amount of the payment under a Northstar 
404.17 	kinship assistance agreement or adoption assistance agreement exceed the foster care 
404.18 	maintenance payment which would have been paid during the month if the child with respect 
404.19 	to whom the Northstar kinship assistance or adoption assistance payment is made had been 
404.20 	in a foster family home in the state.
404.21 	(2) The rate schedule for the agreement is determined based on the age of the child on 
404.22 	the date that the prospective adoptive parent or parents or relative custodian or custodians 
404.23 	sign the agreement.
404.24 	(3) The income of the relative custodian or custodians or adoptive parent or parents must 
404.25 	not be taken into consideration when determining eligibility for Northstar kinship assistance 
404.26 	or adoption assistance or the amount of the payments under section 256N.26.
404.27 	(4) With the concurrence of the relative custodian or adoptive parent, the amount of the 
404.28 	payment may be adjusted periodically using the assessment tool established by the 
404.29 	commissioner in section 256N.24, subdivision 2, and the agreement renegotiated under 
404.30 	subdivision 3 when there is a change in the child's needs or the family's circumstances.
404.31 	(5) An adoptive parent of an at-risk child with an adoption assistance agreement may 
404.32 	request a reassessment of the child under section 256N.24, subdivision 10, and renegotiation 
404.33 	of the adoption assistance agreement under subdivision 3 to include a monthly payment, if 
404.34 	the caregiver has written documentation from a qualified expert that the potential disability 
405.1 	upon which eligibility for the agreement was based has manifested itself. Documentation 
405.2 	of the disability must be limited to evidence deemed appropriate by the commissioner.
405.3 	(c) For Northstar kinship assistance agreements:
405.4 	(1) the initial amount of the monthly Northstar kinship assistance payment must be 
405.5 	equivalent to the foster care rate in effect at the time that the agreement is signed less any 
405.6 	offsets under section 256N.26, subdivision 11, or a lesser negotiated amount if agreed to 
405.7 	by the prospective relative custodian and specified in that agreement, unless the Northstar 
405.8 	kinship assistance agreement is entered into when a child is under the age of six; and
405.9 	(2) the amount of the monthly payment for a Northstar kinship assistance agreement for 
405.10 	a child who is under the age of six must be as specified in section 256N.26, subdivision 5.
405.11 	(d) For adoption assistance agreements:
405.12 	(1) for a child in foster care with the prospective adoptive parent immediately prior to 
405.13 	adoptive placement, the initial amount of the monthly adoption assistance payment must 
405.14 	be equivalent to the foster care rate in effect at the time that the agreement is signed less 
405.15 	any offsets in section 256N.26, subdivision 11, or a lesser negotiated amount if agreed to 
405.16 	by the prospective adoptive parents and specified in that agreement, unless the child is 
405.17 	identified as at-risk or the adoption assistance agreement is entered into when a child is 
405.18 	under the age of six;
405.19 	(2) for an at-risk child who must be assigned level A as outlined in section 256N.26, no 
405.20 	payment will be made unless and until the potential disability manifests itself, as documented 
405.21 	by an appropriate professional, and the commissioner authorizes commencement of payment 
405.22 	by modifying the agreement accordingly;
405.23 	(3) the amount of the monthly payment for an adoption assistance agreement for a child 
405.24 	under the age of six, other than an at-risk child, must be as specified in section 256N.26, 
405.25 	subdivision 5;
405.26 	(4) for a child who is in the Northstar kinship assistance program immediately prior to 
405.27 	adoptive placement, the initial amount of the adoption assistance payment must be equivalent 
405.28 	to the Northstar kinship assistance payment in effect at the time that the adoption assistance 
405.29 	agreement is signed or a lesser amount if agreed to by the prospective adoptive parent and 
405.30 	specified in that agreement, unless the child is identified as an at-risk child; and
405.31 	(5) for a child who is not in foster care placement or the Northstar kinship assistance 
405.32 	program immediately prior to adoptive placement or negotiation of the adoption assistance 
405.33 	agreement, the initial amount of the adoption assistance agreement must be determined 
406.1 	using the assessment tool and process in this section and the corresponding payment amount 
406.2 	outlined in section 256N.26.

406.3 	Sec. 2. Minnesota Statutes 2020, section 256N.25, subdivision 3, is amended to read:
406.4 		Subd. 3.Renegotiation of agreement. (a) A relative custodian or adoptive parent of a 
406.5 	child with a Northstar kinship assistance or adoption assistance agreement may request 
406.6 	renegotiation of the agreement when there is a change in the needs of the child or in the 
406.7 	family's circumstances. When a relative custodian or adoptive parent requests renegotiation 
406.8 	of the agreement, a reassessment of the child must be completed consistent with section 
406.9 	256N.24, subdivisions 10 and 11. If the reassessment indicates that the child's level has 
406.10 	changed, the financially responsible agency or, if there is no financially responsible agency, 
406.11 	the agency designated by the commissioner or the commissioner's designee, and the caregiver 
406.12 	must renegotiate the agreement to include a payment with the level determined through the 
406.13 	reassessment process. The agreement must not be renegotiated unless the commissioner, 
406.14 	the financially responsible agency, and the caregiver mutually agree to the changes. The 
406.15 	effective date of any renegotiated agreement must be determined by the commissioner.
406.16 	(b) An adoptive parent of an at-risk child with an adoption assistance agreement may 
406.17 	request renegotiation of the agreement to include a monthly payment under section 256N.26
406.18 	if the caregiver has written documentation from a qualified expert that the potential disability 
406.19 	upon which eligibility for the agreement was based has manifested itself. Documentation 
406.20 	of the disability must be limited to evidence deemed appropriate by the commissioner. Prior 
406.21 	to renegotiating the agreement, a reassessment of the child must be conducted as outlined 
406.22 	in section 256N.24, subdivision 10. The reassessment must be used to renegotiate the 
406.23 	agreement to include an appropriate monthly payment. The agreement must not be 
406.24 	renegotiated unless the commissioner, the financially responsible agency, and the caregiver 
406.25 	mutually agree to the changes. The effective date of any renegotiated agreement must be 
406.26 	determined by the commissioner.
406.27 	(c) Renegotiation of a Northstar kinship assistance or adoption assistance agreement is 
406.28 	required when one of the circumstances outlined in section 256N.26, subdivision 13, occurs.

406.29 	Sec. 3. Minnesota Statutes 2020, section 256N.26, subdivision 11, is amended to read:
406.30 		Subd. 11.Child income or income attributable to the child. (a) A monthly Northstar 
406.31 	kinship assistance or adoption assistance payment must be considered as income and 
406.32 	resources attributable to the child. Northstar kinship assistance and adoption assistance are 
407.1 	exempt from garnishment, except as permissible under the laws of the state where the child 
407.2 	resides.
407.3 	(b) When a child is placed into foster care, any income and resources attributable to the 
407.4 	child are treated as provided in sections 252.27 and 260C.331, or 260B.331, as applicable 
407.5 	to the child being placed.
407.6 	(c) Consideration of income and resources attributable to the child must be part of the 
407.7 	negotiation process outlined in section 256N.25, subdivision 2. In some circumstances, the 
407.8 	receipt of other income on behalf of the child may impact the amount of the monthly payment 
407.9 	received by the relative custodian or adoptive parent on behalf of the child through Northstar 
407.10 	Care for Children. Supplemental Security Income (SSI), retirement survivor's disability 
407.11 	insurance (RSDI), veteran's benefits, railroad retirement benefits, and black lung benefits 
407.12 	are considered income and resources attributable to the child.

407.13 	Sec. 4. Minnesota Statutes 2020, section 256N.26, subdivision 13, is amended to read:
407.14 		Subd. 13.Treatment of retirement survivor's disability insurance, veteran's benefits, 
407.15 	railroad retirement benefits, and black lung benefits. (a) If a child placed in foster care 
407.16 	receives retirement survivor's disability insurance, veteran's benefits, railroad retirement 
407.17 	benefits, or black lung benefits at the time of foster care placement or subsequent to 
407.18 	placement in foster care, the financially responsible agency may apply to be the payee for 
407.19 	the child for the duration of the child's placement in foster care. If it is anticipated that a 
407.20 	child will be eligible to receive retirement survivor's disability insurance, veteran's benefits, 
407.21 	railroad retirement benefits, or black lung benefits after finalization of the adoption or 
407.22 	assignment of permanent legal and physical custody, the permanent caregiver shall apply 
407.23 	to be the payee of those benefits on the child's behalf. The monthly amount of the other 
407.24 	benefits must be considered an offset to the amount of the payment the child is determined 
407.25 	eligible for under Northstar Care for Children.
407.26 	(b) If a child becomes eligible for retirement survivor's disability insurance, veteran's 
407.27 	benefits, railroad retirement benefits, or black lung benefits, after the initial amount of the 
407.28 	payment under Northstar Care for Children is finalized, the permanent caregiver shall contact 
407.29 	the commissioner to redetermine the payment under Northstar Care for Children. The 
407.30 	monthly amount of the other benefits must be considered an offset to the amount of the 
407.31 	payment the child is determined eligible for under Northstar Care for Children.
407.32 	(c) If a child ceases to be eligible for retirement survivor's disability insurance, veteran's 
407.33 	benefits, railroad retirement benefits, or black lung benefits after the initial amount of the 
407.34 	payment under Northstar Care for Children is finalized, the permanent caregiver shall contact 
408.1 	the commissioner to redetermine the payment under Northstar Care for Children. The 
408.2 	monthly amount of the payment under Northstar Care for Children must be the amount the 
408.3 	child was determined to be eligible for prior to consideration of any offset.
408.4 	(d) If the monthly payment received on behalf of the child under retirement survivor's 
408.5 	disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits 
408.6 	changes after the adoption assistance or Northstar kinship assistance agreement is finalized, 
408.7 	the permanent caregiver shall notify the commissioner as to the new monthly payment 
408.8 	amount, regardless of the amount of the change in payment. If the monthly payment changes 
408.9 	by $75 or more, even if the change occurs incrementally over the duration of the term of 
408.10 	the adoption assistance or Northstar kinship assistance agreement, the monthly payment 
408.11 	under Northstar Care for Children must be adjusted without further consent to reflect the 
408.12 	amount of the increase or decrease in the offset amount. Any subsequent change to the 
408.13 	payment must be reported and handled in the same manner. A change of monthly payments 
408.14 	of less than $75 is not a permissible reason to renegotiate the adoption assistance or Northstar 
408.15 	kinship assistance agreement under section 256N.25, subdivision 3. The commissioner shall 
408.16 	review and revise the limit at which the adoption assistance or Northstar kinship assistance 
408.17 	agreement must be renegotiated in accordance with subdivision 9.

408.18 	Sec. 5. Minnesota Statutes 2020, section 260.761, subdivision 2, is amended to read:
408.19 		Subd. 2.Agency and court notice to tribes. (a) When a local social services agency 
408.20 	has information that a family assessment or, investigation, or noncaregiver sex trafficking 
408.21 	assessment being conducted may involve an Indian child, the local social services agency 
408.22 	shall notify the Indian child's tribe of the family assessment or, investigation, or noncaregiver 
408.23 	sex trafficking assessment according to section 260E.18. The local social services agency 
408.24 	shall provide initial notice shall be provided by telephone and by e-mail or facsimile. The 
408.25 	local social services agency shall request that the tribe or a designated tribal representative 
408.26 	participate in evaluating the family circumstances, identifying family and tribal community 
408.27 	resources, and developing case plans.
408.28 	(b) When a local social services agency has information that a child receiving services 
408.29 	may be an Indian child, the local social services agency shall notify the tribe by telephone 
408.30 	and by e-mail or facsimile of the child's full name and date of birth, the full names and dates 
408.31 	of birth of the child's biological parents, and, if known, the full names and dates of birth of 
408.32 	the child's grandparents and of the child's Indian custodian. This notification must be provided 
408.33 	so for the tribe can to determine if the child is enrolled in the tribe or eligible for tribal 
408.34 	membership, and must be provided the agency must provide this notification to the tribe
409.1 	within seven days of receiving information that the child may be an Indian child. If 
409.2 	information regarding the child's grandparents or Indian custodian is not available within 
409.3 	the seven-day period, the local social services agency shall continue to request this 
409.4 	information and shall notify the tribe when it is received. Notice shall be provided to all 
409.5 	tribes to which the child may have any tribal lineage. If the identity or location of the child's 
409.6 	parent or Indian custodian and tribe cannot be determined, the local social services agency 
409.7 	shall provide the notice required in this paragraph to the United States secretary of the 
409.8 	interior.
409.9 	(c) In accordance with sections 260C.151 and 260C.152, when a court has reason to 
409.10 	believe that a child placed in emergency protective care is an Indian child, the court 
409.11 	administrator or a designee shall, as soon as possible and before a hearing takes place, notify 
409.12 	the tribal social services agency by telephone and by e-mail or facsimile of the date, time, 
409.13 	and location of the emergency protective case hearing. The court shall make efforts to allow 
409.14 	appearances by telephone for tribal representatives, parents, and Indian custodians.
409.15 	(d) A local social services agency must provide the notices required under this subdivision 
409.16 	at the earliest possible time to facilitate involvement of the Indian child's tribe. Nothing in 
409.17 	this subdivision is intended to hinder the ability of the local social services agency and the 
409.18 	court to respond to an emergency situation. Lack of participation by a tribe shall not prevent 
409.19 	the tribe from intervening in services and proceedings at a later date. A tribe may participate 
409.20 	in a case at any time. At any stage of the local social services agency's involvement with 
409.21 	an Indian child, the agency shall provide full cooperation to the tribal social services agency, 
409.22 	including disclosure of all data concerning the Indian child. Nothing in this subdivision 
409.23 	relieves the local social services agency of satisfying the notice requirements in the Indian 
409.24 	Child Welfare Act.

409.25 	Sec. 6. Minnesota Statutes 2020, section 260C.007, subdivision 14, is amended to read:
409.26 		Subd. 14.Egregious harm. "Egregious harm" means the infliction of bodily harm to a 
409.27 	child or neglect of a child which demonstrates a grossly inadequate ability to provide 
409.28 	minimally adequate parental care. The Egregious harm need not have occurred in the state 
409.29 	or in the county where a termination of parental rights action is otherwise properly venued. 
409.30 	Egregious harm includes, but is not limited to:
409.31 	(1) conduct towards toward a child that constitutes a violation of sections 609.185 to 
409.32 	609.2114, 609.222, subdivision 2, 609.223, or any other similar law of any other state;
409.33 	(2) the infliction of "substantial bodily harm" to a child, as defined in section 609.02, 
409.34 	subdivision 7a;
410.1 	(3) conduct towards toward a child that constitutes felony malicious punishment of a 
410.2 	child under section 609.377;
410.3 	(4) conduct towards toward a child that constitutes felony unreasonable restraint of a 
410.4 	child under section 609.255, subdivision 3;
410.5 	(5) conduct towards toward a child that constitutes felony neglect or endangerment of 
410.6 	a child under section 609.378;
410.7 	(6) conduct towards toward a child that constitutes assault under section 609.221, 609.222, 
410.8 	or 609.223;
410.9 	(7) conduct towards toward a child that constitutes sex trafficking, solicitation, 
410.10 	inducement, or promotion of, or receiving profit derived from prostitution under section 
410.11 	609.322;
410.12 	(8) conduct towards toward a child that constitutes murder or voluntary manslaughter 
410.13 	as defined by United States Code, title 18, section 1111(a) or 1112(a);
410.14 	(9) conduct towards toward a child that constitutes aiding or abetting, attempting, 
410.15 	conspiring, or soliciting to commit a murder or voluntary manslaughter that constitutes a 
410.16 	violation of United States Code, title 18, section 1111(a) or 1112(a); or
410.17 	(10) conduct toward a child that constitutes criminal sexual conduct under sections 
410.18 	609.342 to 609.345.

410.19 	Sec. 7. Minnesota Statutes 2020, section 260E.01, is amended to read:
410.20 	260E.01 POLICY.
410.21 	(a) The legislature hereby declares that the public policy of this state is to protect children 
410.22 	whose health or welfare may be jeopardized through maltreatment. While it is recognized 
410.23 	that most parents want to keep their children safe, sometimes circumstances or conditions 
410.24 	interfere with their ability to do so. When this occurs, the health and safety of the children 
410.25 	must be of paramount concern. Intervention and prevention efforts must address immediate 
410.26 	concerns for child safety and the ongoing risk of maltreatment and should engage the 
410.27 	protective capacities of families. In furtherance of this public policy, it is the intent of the 
410.28 	legislature under this chapter to:
410.29 	(1) protect children and promote child safety;
410.30 	(2) strengthen the family;
411.1 	(3) make the home, school, and community safe for children by promoting responsible 
411.2 	child care in all settings; and
411.3 	(4) provide, when necessary, a safe temporary or permanent home environment for 
411.4 	maltreated children.
411.5 	(b) In addition, it is the policy of this state to:
411.6 	(1) require the reporting of maltreatment of children in the home, school, and community 
411.7 	settings;
411.8 	(2) provide for the voluntary reporting of maltreatment of children;
411.9 	(3) require an investigation when the report alleges sexual abuse or substantial child 
411.10 	endangerment, except when the report alleges sex trafficking by a noncaregiver sex trafficker;
411.11 	(4) provide a family assessment, if appropriate, when the report does not allege sexual 
411.12 	abuse or substantial child endangerment; and
411.13 	(5) provide a noncaregiver sex trafficking assessment when the report alleges sex 
411.14 	trafficking by a noncaregiver sex trafficker; and
411.15 	(6) provide protective, family support, and family preservation services when needed 
411.16 	in appropriate cases.

411.17 	Sec. 8. Minnesota Statutes 2020, section 260E.02, subdivision 1, is amended to read:
411.18 		Subdivision 1.Establishment of team. A county shall establish a multidisciplinary 
411.19 	child protection team that may include, but is not be limited to, the director of the local 
411.20 	welfare agency or designees, the county attorney or designees, the county sheriff or designees, 
411.21 	representatives of health and education, representatives of mental health, representatives of 
411.22 	agencies providing specialized services or responding to youth who experience or are at 
411.23 	risk of experiencing sex trafficking or sexual exploitation, or other appropriate human 
411.24 	services or community-based agencies, and parent groups. As used in this section, a 
411.25 	"community-based agency" may include, but is not limited to, schools, social services 
411.26 	agencies, family service and mental health collaboratives, children's advocacy centers, early 
411.27 	childhood and family education programs, Head Start, or other agencies serving children 
411.28 	and families. A member of the team must be designated as the lead person of the team 
411.29 	responsible for the planning process to develop standards for the team's activities with 
411.30 	battered women's and domestic abuse programs and services.

412.1 	Sec. 9. Minnesota Statutes 2020, section 260E.03, is amended by adding a subdivision to 
412.2 	read:
412.3 		Subd. 15a.Noncaregiver sex trafficker. "Noncaregiver sex trafficker" means an 
412.4 	individual who is alleged to have engaged in the act of sex trafficking a child, who is not a 
412.5 	person responsible for the child's care, who does not have a significant relationship with 
412.6 	the child as defined in section 609.341, and who is not a person in a current or recent position 
412.7 	of authority as defined in section 609.341, subdivision 10.

412.8 	Sec. 10. Minnesota Statutes 2020, section 260E.03, is amended by adding a subdivision 
412.9 	to read:
412.10 		Subd. 15b.Noncaregiver sex trafficking assessment. "Noncaregiver sex trafficking 
412.11 	assessment" is a comprehensive assessment of child safety, the risk of subsequent child 
412.12 	maltreatment, and strengths and needs of the child and family. The local welfare agency 
412.13 	shall only perform a noncaregiver sex trafficking assessment when a maltreatment report 
412.14 	alleges sex trafficking of a child by someone other than the child's caregiver. A noncaregiver 
412.15 	sex trafficking assessment does not include a determination of whether child maltreatment 
412.16 	occurred. A noncaregiver sex trafficking assessment includes a determination of a family's 
412.17 	need for services to address the safety of the child or children, the safety of family members, 
412.18 	and the risk of subsequent child maltreatment.

412.19 	Sec. 11. Minnesota Statutes 2020, section 260E.03, subdivision 22, is amended to read:
412.20 		Subd. 22.Substantial child endangerment. "Substantial child endangerment" means 
412.21 	that a person responsible for a child's care, by act or omission, commits or attempts to 
412.22 	commit an act against a child under their in the person's care that constitutes any of the 
412.23 	following:
412.24 	(1) egregious harm under subdivision 5;
412.25 	(2) abandonment under section 260C.301, subdivision 2;
412.26 	(3) neglect under subdivision 15, paragraph (a), clause (2), that substantially endangers 
412.27 	the child's physical or mental health, including a growth delay, which may be referred to 
412.28 	as failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
412.29 	(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
412.30 	(5) manslaughter in the first or second degree under section 609.20 or 609.205;
412.31 	(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
413.1 	(7) sex trafficking, solicitation, inducement, and or promotion of prostitution under 
413.2 	section 609.322;
413.3 	(8) criminal sexual conduct under sections 609.342 to 609.3451;
413.4 	(9) solicitation of children to engage in sexual conduct under section 609.352;
413.5 	(10) malicious punishment or neglect or endangerment of a child under section 609.377 
413.6 	or 609.378;
413.7 	(11) use of a minor in sexual performance under section 617.246; or
413.8 	(12) parental behavior, status, or condition that mandates that requiring the county 
413.9 	attorney to file a termination of parental rights petition under section 260C.503, subdivision 
413.10 	2.

413.11 	Sec. 12. Minnesota Statutes 2020, section 260E.14, subdivision 2, is amended to read:
413.12 		Subd. 2.Sexual abuse. (a) The local welfare agency is the agency responsible for 
413.13 	investigating an allegation of sexual abuse if the alleged offender is the parent, guardian, 
413.14 	sibling, or an individual functioning within the family unit as a person responsible for the 
413.15 	child's care, or a person with a significant relationship to the child if that person resides in 
413.16 	the child's household.
413.17 	(b) The local welfare agency is also responsible for assessing or investigating when a 
413.18 	child is identified as a victim of sex trafficking.

413.19 	Sec. 13. Minnesota Statutes 2020, section 260E.14, subdivision 5, is amended to read:
413.20 		Subd. 5.Law enforcement. (a) The local law enforcement agency is the agency 
413.21 	responsible for investigating a report of maltreatment if a violation of a criminal statute is 
413.22 	alleged.
413.23 	(b) Law enforcement and the responsible agency must coordinate their investigations 
413.24 	or assessments as required under this chapter when the: (1) a report alleges maltreatment 
413.25 	that is a violation of a criminal statute by a person who is a parent, guardian, sibling, person 
413.26 	responsible for the child's care functioning within the family unit, or by a person who lives 
413.27 	in the child's household and who has a significant relationship to the child, in a setting other 
413.28 	than a facility as defined in section 260E.03; or (2) a report alleges sex trafficking of a child.

414.1 	Sec. 14. Minnesota Statutes 2020, section 260E.17, subdivision 1, is amended to read:
414.2 		Subdivision 1.Local welfare agency. (a) Upon receipt of a report, the local welfare 
414.3 	agency shall determine whether to conduct a family assessment or, an investigation, or a 
414.4 	noncaregiver sex trafficking assessment as appropriate to prevent or provide a remedy for 
414.5 	maltreatment.
414.6 	(b) The local welfare agency shall conduct an investigation when the report involves 
414.7 	sexual abuse, except as indicated in paragraph (f), or substantial child endangerment.
414.8 	(c) The local welfare agency shall begin an immediate investigation if, at any time when 
414.9 	the local welfare agency is using responding with a family assessment response, and the 
414.10 	local welfare agency determines that there is reason to believe that sexual abuse or, substantial 
414.11 	child endangerment, or a serious threat to the child's safety exists.
414.12 	(d) The local welfare agency may conduct a family assessment for reports that do not 
414.13 	allege sexual abuse, except as indicated in paragraph (f), or substantial child endangerment. 
414.14 	In determining that a family assessment is appropriate, the local welfare agency may consider 
414.15 	issues of child safety, parental cooperation, and the need for an immediate response.
414.16 	(e) The local welfare agency may conduct a family assessment on for a report that was 
414.17 	initially screened and assigned for an investigation. In determining that a complete 
414.18 	investigation is not required, the local welfare agency must document the reason for 
414.19 	terminating the investigation and notify the local law enforcement agency if the local law 
414.20 	enforcement agency is conducting a joint investigation.
414.21 	(f) The local welfare agency shall conduct a noncaregiver sex trafficking assessment 
414.22 	when a maltreatment report alleges sex trafficking of a child and the alleged offender is a 
414.23 	noncaregiver sex trafficker as defined by section 260E.03, subdivision 15a.
414.24 	(g) During a noncaregiver sex trafficking assessment, the local welfare agency shall 
414.25 	initiate an immediate investigation if there is reason to believe that a child's parent, caregiver, 
414.26 	or household member allegedly engaged in the act of sex trafficking a child or was alleged 
414.27 	to have engaged in any conduct requiring the agency to conduct an investigation.

414.28 	Sec. 15. Minnesota Statutes 2020, section 260E.18, is amended to read:
414.29 	260E.18 NOTICE TO CHILD'S TRIBE.
414.30 	The local welfare agency shall provide immediate notice, according to section 260.761, 
414.31 	subdivision 2, to an Indian child's tribe when the agency has reason to believe that the family 
414.32 	assessment or, investigation, or noncaregiver sex trafficking assessment may involve an 
415.1 	Indian child. For purposes of this section, "immediate notice" means notice provided within 
415.2 	24 hours.

415.3 	Sec. 16. Minnesota Statutes 2020, section 260E.20, subdivision 2, is amended to read:
415.4 		Subd. 2.Face-to-face contact. (a) Upon receipt of a screened in report, the local welfare 
415.5 	agency shall conduct a have face-to-face contact with the child reported to be maltreated 
415.6 	and with the child's primary caregiver sufficient to complete a safety assessment and ensure 
415.7 	the immediate safety of the child.
415.8 	(b) Except in a noncaregiver sex trafficking assessment, the local welfare agency shall 
415.9 	have face-to-face contact with the child and primary caregiver shall occur immediately if 
415.10 	sexual abuse or substantial child endangerment is alleged and within five calendar days for 
415.11 	all other reports. If the alleged offender was not already interviewed as the primary caregiver, 
415.12 	the local welfare agency shall also conduct a face-to-face interview with the alleged offender 
415.13 	in the early stages of the assessment or investigation, except in a noncaregiver sex trafficking 
415.14 	assessment.
415.15 	(c) At the initial contact with the alleged offender, the local welfare agency or the agency 
415.16 	responsible for assessing or investigating the report must inform the alleged offender of the 
415.17 	complaints or allegations made against the individual in a manner consistent with laws 
415.18 	protecting the rights of the person who made the report. The interview with the alleged 
415.19 	offender may be postponed if it would jeopardize an active law enforcement investigation.
415.20 	In a noncaregiver sex trafficking assessment, the local child welfare agency is not required 
415.21 	to interview the alleged offender.
415.22 	(d) The local welfare agency or the agency responsible for assessing or investigating 
415.23 	the report must provide the alleged offender with an opportunity to make a statement, except 
415.24 	in a noncaregiver sex trafficking assessment where the local welfare agency may rely on 
415.25 	law enforcement data. The alleged offender may submit supporting documentation relevant 
415.26 	to the assessment or investigation.

415.27 	Sec. 17. Minnesota Statutes 2020, section 260E.24, subdivision 2, is amended to read:
415.28 		Subd. 2.Determination after family assessment or a noncaregiver sex trafficking 
415.29 	assessment. After conducting a family assessment or a noncaregiver sex trafficking 
415.30 	assessment, the local welfare agency shall determine whether child protective services are 
415.31 	needed to address the safety of the child and other family members and the risk of subsequent 
415.32 	maltreatment.

416.1 	Sec. 18. Minnesota Statutes 2020, section 260E.24, subdivision 7, is amended to read:
416.2 		Subd. 7.Notification at conclusion of family assessment or a noncaregiver sex 
416.3 	trafficking assessment. Within ten working days of the conclusion of a family assessment
416.4 	or a noncaregiver sex trafficking assessment, the local welfare agency shall notify the parent 
416.5 	or guardian of the child of the need for services to address child safety concerns or significant 
416.6 	risk of subsequent maltreatment. The local welfare agency and the family may also jointly 
416.7 	agree that family support and family preservation services are needed.

416.8 	Sec. 19. Minnesota Statutes 2020, section 260E.33, subdivision 1, is amended to read:
416.9 		Subdivision 1.Following a family assessment or a noncaregiver sex trafficking 
416.10 	assessment. Administrative reconsideration is not applicable to a family assessment or 
416.11 	noncaregiver sex trafficking assessment since no determination concerning maltreatment 
416.12 	is made.

416.13 	Sec. 20. Minnesota Statutes 2020, section 260E.35, subdivision 6, is amended to read:
416.14 		Subd. 6.Data retention. (a) Notwithstanding sections 138.163 and 138.17, a record 
416.15 	maintained or a record derived from a report of maltreatment by a local welfare agency, 
416.16 	agency responsible for assessing or investigating the report, court services agency, or school 
416.17 	under this chapter shall be destroyed as provided in paragraphs (b) to (e) by the responsible 
416.18 	authority.
416.19 	(b) For a report alleging maltreatment that was not accepted for an assessment or an 
416.20 	investigation, a family assessment case, a noncaregiver sex trafficking assessment case, and 
416.21 	a case where an investigation results in no determination of maltreatment or the need for 
416.22 	child protective services, the record must be maintained for a period of five years after the 
416.23 	date that the report was not accepted for assessment or investigation or the date of the final 
416.24 	entry in the case record. A record of a report that was not accepted must contain sufficient 
416.25 	information to identify the subjects of the report, the nature of the alleged maltreatment, 
416.26 	and the reasons as to why the report was not accepted. Records under this paragraph may 
416.27 	not be used for employment, background checks, or purposes other than to assist in future 
416.28 	screening decisions and risk and safety assessments.
416.29 	(c) All records relating to reports that, upon investigation, indicate either maltreatment 
416.30 	or a need for child protective services shall be maintained for ten years after the date of the 
416.31 	final entry in the case record.
417.1 	(d) All records regarding a report of maltreatment, including a notification of intent to 
417.2 	interview that was received by a school under section 260E.22, subdivision 7, shall be 
417.3 	destroyed by the school when ordered to do so by the agency conducting the assessment or 
417.4 	investigation. The agency shall order the destruction of the notification when other records 
417.5 	relating to the report under investigation or assessment are destroyed under this subdivision.
417.6 	(e) Private or confidential data released to a court services agency under subdivision 3, 
417.7 	paragraph (d), must be destroyed by the court services agency when ordered to do so by the 
417.8 	local welfare agency that released the data. The local welfare agency or agency responsible 
417.9 	for assessing or investigating the report shall order destruction of the data when other records 
417.10 	relating to the assessment or investigation are destroyed under this subdivision.

417.11 	ARTICLE 11
417.12 	CHILD PROTECTION POLICY

417.13 	Section 1. Minnesota Statutes 2020, section 245.4885, subdivision 1, is amended to read:
417.14 		Subdivision 1.Admission criteria. (a) Prior to admission or placement, except in the 
417.15 	case of an emergency, all children referred for treatment of severe emotional disturbance 
417.16 	in a treatment foster care setting, residential treatment facility, or informally admitted to a 
417.17 	regional treatment center shall undergo an assessment to determine the appropriate level of 
417.18 	care if public funds are used to pay for the child's services.
417.19 	(b) The responsible social services agency shall determine the appropriate level of care 
417.20 	for a child when county-controlled funds are used to pay for the child's services or placement 
417.21 	in a qualified residential treatment facility under chapter 260C and licensed by the 
417.22 	commissioner under chapter 245A. In accordance with section 260C.157, a juvenile treatment 
417.23 	screening team shall conduct a screening of a child before the team may recommend whether 
417.24 	to place a child in a qualified residential treatment program as defined in section 260C.007, 
417.25 	subdivision 26d. When a social services agency does not have responsibility for a child's 
417.26 	placement and the child is enrolled in a prepaid health program under section 256B.69, the 
417.27 	enrolled child's contracted health plan must determine the appropriate level of care for the 
417.28 	child. When Indian Health Services funds or funds of a tribally owned facility funded under 
417.29 	the Indian Self-Determination and Education Assistance Act, Public Law 93-638, are to be 
417.30 	used for a child, the Indian Health Services or 638 tribal health facility must determine the 
417.31 	appropriate level of care for the child. When more than one entity bears responsibility for
417.32 	a child's coverage, the entities shall coordinate level of care determination activities for the 
417.33 	child to the extent possible.
418.1 	(c) The responsible social services agency must make the child's level of care 
418.2 	determination available to the child's juvenile treatment screening team, as permitted under 
418.3 	chapter 13. The level of care determination shall inform the juvenile treatment screening 
418.4 	team process and the assessment in section 260C.704 when considering whether to place 
418.5 	the child in a qualified residential treatment program. When the responsible social services 
418.6 	agency is not involved in determining a child's placement, the child's level of care 
418.7 	determination shall determine whether the proposed treatment:
418.8 	(1) is necessary;
418.9 	(2) is appropriate to the child's individual treatment needs;
418.10 	(3) cannot be effectively provided in the child's home; and
418.11 	(4) provides a length of stay as short as possible consistent with the individual child's 
418.12 	need needs.
418.13 	(d) When a level of care determination is conducted, the responsible social services 
418.14 	agency or other entity may not determine that a screening of a child under section 260C.157
418.15 	or referral or admission to a treatment foster care setting or residential treatment facility is 
418.16 	not appropriate solely because services were not first provided to the child in a less restrictive 
418.17 	setting and the child failed to make progress toward or meet treatment goals in the less 
418.18 	restrictive setting. The level of care determination must be based on a diagnostic assessment
418.19 	of a child that includes a functional assessment which evaluates the child's family, school, 
418.20 	and community living situations; and an assessment of the child's need for care out of the 
418.21 	home using a validated tool which assesses a child's functional status and assigns an 
418.22 	appropriate level of care to the child. The validated tool must be approved by the 
418.23 	commissioner of human services and may be the validated tool approved for the child's 
418.24 	assessment under section 260C.704 if the juvenile treatment screening team recommended 
418.25 	placement of the child in a qualified residential treatment program. If a diagnostic assessment 
418.26 	including a functional assessment has been completed by a mental health professional within 
418.27 	the past 180 days, a new diagnostic assessment need not be completed unless in the opinion 
418.28 	of the current treating mental health professional the child's mental health status has changed 
418.29 	markedly since the assessment was completed. The child's parent shall be notified if an 
418.30 	assessment will not be completed and of the reasons. A copy of the notice shall be placed 
418.31 	in the child's file. Recommendations developed as part of the level of care determination 
418.32 	process shall include specific community services needed by the child and, if appropriate, 
418.33 	the child's family, and shall indicate whether or not these services are available and accessible 
418.34 	to the child and the child's family.
419.1 	(e) During the level of care determination process, the child, child's family, or child's 
419.2 	legal representative, as appropriate, must be informed of the child's eligibility for case 
419.3 	management services and family community support services and that an individual family 
419.4 	community support plan is being developed by the case manager, if assigned.
419.5 	(f) When the responsible social services agency has authority, the agency must engage 
419.6 	the child's parents in case planning under sections 260C.212 and 260C.708 and chapter 
419.7 	260D unless a court terminates the parent's rights or court orders restrict the parent from 
419.8 	participating in case planning, visitation, or parental responsibilities.
419.9 	(g) The level of care determination, and placement decision, and recommendations for 
419.10 	mental health services must be documented in the child's record, as required in chapter
419.11 	chapters260C and 260D.

419.12 	EFFECTIVE DATE. This section is effective September 30, 2021.

419.13 	Sec. 2. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
419.14 	read:
419.15 		Subd. 3c.At risk of becoming a victim of sex trafficking or commercial sexual 
419.16 	exploitation. For the purposes of section 245A.25, a youth who is "at risk of becoming a 
419.17 	victim of sex trafficking or commercial sexual exploitation" means a youth who meets the 
419.18 	criteria established by the commissioner of human services for this purpose.

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

419.20 	Sec. 3. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
419.21 	read:
419.22 		Subd. 4a.Children's residential facility. "Children's residential facility" is defined as 
419.23 	a residential program licensed under this chapter or chapter 241 according to the applicable 
419.24 	standards in Minnesota Rules, parts 2960.0010 to 2960.0710.

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

419.26 	Sec. 4. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
419.27 	read:
419.28 		Subd. 6d.Foster family setting. "Foster family setting" has the meaning given in 
419.29 	Minnesota Rules, chapter 2960.3010, subpart 23, and includes settings licensed by the 
419.30 	commissioner of human services or the commissioner of corrections.

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

420.1 	Sec. 5. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
420.2 	read:
420.3 		Subd. 6e.Foster residence setting. "Foster residence setting" has the meaning given 
420.4 	in Minnesota Rules, chapter 2960.3010, subpart 26, and includes settings licensed by the 
420.5 	commissioner of human services or the commissioner of corrections.

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

420.7 	Sec. 6. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
420.8 	read:
420.9 		Subd. 18a.Trauma. For the purposes of section 245A.25, "trauma" means an event, 
420.10 	series of events, or set of circumstances experienced by an individual as physically or 
420.11 	emotionally harmful or life-threatening and has lasting adverse effects on the individual's 
420.12 	functioning and mental, physical, social, emotional, or spiritual well-being. Trauma includes 
420.13 	the cumulative emotional or psychological harm of group traumatic experiences transmitted 
420.14 	across generations within a community that are often associated with racial and ethnic 
420.15 	population groups that have suffered major intergenerational losses.

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

420.17 	Sec. 7. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
420.18 	read:
420.19 		Subd. 23.Victim of sex trafficking or commercial sexual exploitation. For the purposes 
420.20 	of section 245A.25, "victim of sex trafficking or commercial sexual exploitation" means a 
420.21 	person who meets the definitions in section 260C.007, subdivision 31, clauses (4) and (5).

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

420.23 	Sec. 8. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
420.24 	read:
420.25 		Subd. 24.Youth. For the purposes of section 245A.25, "youth" means a "child" as 
420.26 	defined in section 260C.007, subdivision 4, and includes individuals under 21 years of age 
420.27 	who are in foster care pursuant to section 260C.451.

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

421.1 	Sec. 9. Minnesota Statutes 2020, section 245A.041, is amended by adding a subdivision 
421.2 	to read:
421.3 		Subd. 6.First date of working in a facility or setting; documentation 
421.4 	requirements. Children's residential facility and foster residence setting license holders 
421.5 	must document the first date that a person who is a background study subject begins working 
421.6 	in the license holder's facility or setting. If the license holder does not maintain documentation 
421.7 	of each background study subject's first date of working in the facility or setting in the 
421.8 	license holder's personnel files, the license holder must provide documentation to the 
421.9 	commissioner that contains the first date that each background study subject began working 
421.10 	in the license holder's program upon the commissioner's request.

421.11 	EFFECTIVE DATE. This section is effective August 1, 2021.

421.12 	Sec. 10. [245A.25] RESIDENTIAL PROGRAM CERTIFICATIONS FOR 
421.13 	COMPLIANCE WITH THE FAMILY FIRST PREVENTION SERVICES ACT.
421.14 		Subdivision 1.Certification scope and applicability. (a) This section establishes the 
421.15 	requirements that a children's residential facility or child foster residence setting must meet 
421.16 	to be certified for the purposes of Title IV-E funding requirements as:
421.17 	(1) a qualified residential treatment program;
421.18 	(2) a residential setting specializing in providing care and supportive services for youth 
421.19 	who have been or are at risk of becoming victims of sex trafficking or commercial sexual 
421.20 	exploitation;
421.21 	(3) a residential setting specializing in providing prenatal, postpartum, or parenting 
421.22 	support for youth; or
421.23 	(4) a supervised independent living setting for youth who are 18 years of age or older.
421.24 	(b) This section does not apply to a foster family setting in which the license holder 
421.25 	resides in the foster home.
421.26 	(c) Children's residential facilities licensed as detention settings according to Minnesota 
421.27 	Rules, parts 2960.0230 to 2960.0290, or secure programs according to Minnesota Rules, 
421.28 	parts 2960.0300 to 2960.0420, may not be certified under this section.
421.29 	(d) For purposes of this section, "license holder" means an individual, organization, or 
421.30 	government entity that was issued a children's residential facility or foster residence setting 
421.31 	license by the commissioner of human services under this chapter or by the commissioner 
421.32 	of corrections under chapter 241.
422.1 	(e) Certifications issued under this section for foster residence settings may only be 
422.2 	issued by the commissioner of human services and are not delegated to county or private 
422.3 	licensing agencies under section 245A.16.
422.4 		Subd. 2.Program certification types and requests for certification. (a) By July 1, 
422.5 	2021, the commissioner of human services must offer certifications to license holders for 
422.6 	the following types of programs:
422.7 	(1) qualified residential treatment programs;
422.8 	(2) residential settings specializing in providing care and supportive services for youth 
422.9 	who have been or are at risk of becoming victims of sex trafficking or commercial sexual 
422.10 	exploitation;
422.11 	(3) residential settings specializing in providing prenatal, postpartum, or parenting 
422.12 	support for youth; and
422.13 	(4) supervised independent living settings for youth who are 18 years of age or older.
422.14 	(b) An applicant or license holder must submit a request for certification under this 
422.15 	section on a form and in a manner prescribed by the commissioner of human services. The 
422.16 	decision of the commissioner of human services to grant or deny a certification request is 
422.17 	final and not subject to appeal under chapter 14.
422.18 		Subd. 3.Trauma-informed care. (a) Programs certified under subdivisions 4 or 5 must 
422.19 	provide services to a person according to a trauma-informed model of care that meets the 
422.20 	requirements of this subdivision, except that programs certified under subdivision 5 are not 
422.21 	required to meet the requirements of paragraph (e).
422.22 	(b) For the purposes of this section, "trauma-informed care" is defined as care that:
422.23 	(1) acknowledges the effects of trauma on a person receiving services and on the person's 
422.24 	family;
422.25 	(2) modifies services to respond to the effects of trauma on the person receiving services;
422.26 	(3) emphasizes skill and strength-building rather than symptom management; and
422.27 	(4) focuses on the physical and psychological safety of the person receiving services 
422.28 	and the person's family.
422.29 	(c) The license holder must have a process for identifying the signs and symptoms of 
422.30 	trauma in a youth and must address the youth's needs related to trauma. This process must 
422.31 	include:
423.1 	(1) screening for trauma by completing a trauma-specific screening tool with each youth 
423.2 	upon the youth's admission or obtaining the results of a trauma-specific screening tool that 
423.3 	was completed with the youth within 30 days prior to the youth's admission to the program; 
423.4 	and
423.5 	(2) ensuring that trauma-based interventions targeting specific trauma-related symptoms 
423.6 	are available to each youth when needed to assist the youth in obtaining services. For 
423.7 	qualified residential treatment programs, this must include the provision of services in 
423.8 	paragraph (e).
423.9 	(d) The license holder must develop and provide services to each youth according to the 
423.10 	principles of trauma-informed care including:
423.11 	(1) recognizing the impact of trauma on a youth when determining the youth's service 
423.12 	needs and providing services to the youth;
423.13 	(2) allowing each youth to participate in reviewing and developing the youth's 
423.14 	individualized treatment or service plan;
423.15 	(3) providing services to each youth that are person-centered and culturally responsive; 
423.16 	and
423.17 	(4) adjusting services for each youth to address additional needs of the youth.
423.18 	(e) In addition to the other requirements of this subdivision, qualified residential treatment 
423.19 	programs must use a trauma-based treatment model that includes:
423.20 	(1) assessing each youth to determine if the youth needs trauma-specific treatment 
423.21 	interventions;
423.22 	(2) identifying in each youth's treatment plan how the program will provide 
423.23 	trauma-specific treatment interventions to the youth;
423.24 	(3) providing trauma-specific treatment interventions to a youth that target the youth's 
423.25 	specific trauma-related symptoms; and
423.26 	(4) training all clinical staff of the program on trauma-specific treatment interventions.
423.27 	(f) At the license holder's program, the license holder must provide a physical, social, 
423.28 	and emotional environment that:
423.29 	(1) promotes the physical and psychological safety of each youth;
423.30 	(2) avoids aspects that may be retraumatizing;
423.31 	(3) responds to trauma experienced by each youth and the youth's other needs; and
424.1 	(4) includes designated spaces that are available to each youth for engaging in sensory 
424.2 	and self-soothing activities.
424.3 	(g) The license holder must base the program's policies and procedures on 
424.4 	trauma-informed principles. In the program's policies and procedures, the license holder 
424.5 	must:
424.6 	(1) describe how the program provides services according to a trauma-informed model 
424.7 	of care;
424.8 	(2) describe how the program's environment fulfills the requirements of paragraph (f);
424.9 	(3) prohibit the use of aversive consequences for a youth's violation of program rules 
424.10 	or any other reason;
424.11 	(4) describe the process for how the license holder incorporates trauma-informed 
424.12 	principles and practices into the organizational culture of the license holder's program; and
424.13 	(5) if the program is certified to use restrictive procedures under Minnesota Rules, part 
424.14 	2960.0710, describe how the program uses restrictive procedures only when necessary for 
424.15 	a youth in a manner that addresses the youth's history of trauma and avoids causing the 
424.16 	youth additional trauma.
424.17 	(h) Prior to allowing a staff person to have direct contact, as defined in section 245C.02, 
424.18 	subdivision 11, with a youth and annually thereafter, the license holder must train each staff 
424.19 	person about:
424.20 	(1) concepts of trauma-informed care and how to provide services to each youth according 
424.21 	to these concepts; and
424.22 	(2) impacts of each youth's culture, race, gender, and sexual orientation on the youth's 
424.23 	behavioral health and traumatic experiences.
424.24 		Subd. 4.Qualified residential treatment programs; certification requirements. (a) 
424.25 	To be certified as a qualified residential treatment program, a license holder must meet:
424.26 	(1) the definition of a qualified residential treatment program in section 260C.007, 
424.27 	subdivision 26d;
424.28 	(2) the requirements for providing trauma-informed care and using a trauma-based 
424.29 	treatment model in subdivision 3; and
424.30 	(3) the requirements of this subdivision.
425.1 	(b) For each youth placed at the license holder's program, the license holder must 
425.2 	collaborate with the responsible social services agency and other appropriate parties to 
425.3 	implement the youth's out-of-home placement plan and the youth's short-term and long-term 
425.4 	mental health and behavioral health goals in the assessment required by sections 260C.212, 
425.5 	subdivision 1; 260C.704; and 260C.708.
425.6 	(c) A qualified residential treatment program must use a trauma-based treatment model 
425.7 	that meets all of the requirements of subdivision 3 that is designed to address the needs, 
425.8 	including clinical needs, of youth with serious emotional or behavioral disorders or 
425.9 	disturbances. The license holder must develop, document, and review a treatment plan for 
425.10 	each youth according to the requirements of Minnesota Rules, parts 2960.0180, subpart 2, 
425.11 	item B; and 2960.0190, subpart 2.
425.12 	(d) The following types of staff must be on-site according to the program's treatment 
425.13 	model and must be available 24 hours a day and seven days a week to provide care within 
425.14 	the scope of their practice:
425.15 	(1) a registered nurse or licensed practical nurse licensed by the Minnesota Board of 
425.16 	Nursing to practice professional nursing or practical nursing as defined in section 148.171, 
425.17 	subdivisions 14 and 15; and
425.18 	(2) other licensed clinical staff to meet each youth's clinical needs.
425.19 	(e) A qualified residential treatment program must be accredited by one of the following 
425.20 	independent, not-for-profit organizations:
425.21 	(1) the Commission on Accreditation of Rehabilitation Facilities (CARF);
425.22 	(2) the Joint Commission;
425.23 	(3) the Council on Accreditation (COA); or
425.24 	(4) another independent, not-for-profit accrediting organization approved by the Secretary 
425.25 	of the United States Department of Health and Human Services.
425.26 	(f) The license holder must facilitate participation of a youth's family members in the 
425.27 	youth's treatment program, consistent with the youth's best interests and according to the 
425.28 	youth's out-of-home placement plan required by sections 260C.212, subdivision 1; and 
425.29 	260C.708.
425.30 	(g) The license holder must contact and facilitate outreach to each youth's family 
425.31 	members, including the youth's siblings, and must document outreach to the youth's family 
425.32 	members in the youth's file, including the contact method and each family member's contact 
426.1 	information. In the youth's file, the license holder must record and maintain the contact 
426.2 	information for all known biological family members and fictive kin of the youth.
426.3 	(h) The license holder must document in the youth's file how the program integrates 
426.4 	family members into the treatment process for the youth, including after the youth's discharge 
426.5 	from the program, and how the program maintains the youth's connections to the youth's 
426.6 	siblings.
426.7 	(i) The program must provide discharge planning and family-based aftercare support to 
426.8 	each youth for at least six months after the youth's discharge from the program. When 
426.9 	providing aftercare to a youth, the program must have monthly contact with the youth and 
426.10 	the youth's caregivers to promote the youth's engagement in aftercare services and to regularly 
426.11 	evaluate the family's needs. The program's monthly contact with the youth may be 
426.12 	face-to-face, by telephone, or virtual.
426.13 	(j) The license holder must maintain a service delivery plan that describes how the 
426.14 	program provides services according to the requirements in paragraphs (b) to (i).
426.15 		Subd. 5.Residential settings specializing in providing care and supportive services 
426.16 	for youth who have been or are at risk of becoming victims of sex trafficking or 
426.17 	commercial sexual exploitation; certification requirements. (a) To be certified as a 
426.18 	residential setting specializing in providing care and supportive services for youth who have 
426.19 	been or are at risk of becoming victims of sex trafficking or commercial sexual exploitation, 
426.20 	a license holder must meet the requirements of this subdivision.
426.21 	(b) Settings certified according to this subdivision are exempt from the requirements of 
426.22 	section 245A.04, subdivision 11, paragraph (b).
426.23 	(c) The program must use a trauma-informed model of care that meets all of the applicable 
426.24 	requirements of subdivision 3, and that is designed to address the needs, including emotional 
426.25 	and mental health needs, of youth who have been or are at risk of becoming victims of sex 
426.26 	trafficking or commercial sexual exploitation.
426.27 	(d) The program must provide high quality care and supportive services for youth who 
426.28 	have been or are at risk of becoming victims of sex trafficking or commercial sexual 
426.29 	exploitation and must:
426.30 	(1) offer a safe setting to each youth designed to prevent ongoing and future trafficking 
426.31 	of the youth;
426.32 	(2) provide equitable, culturally responsive, and individualized services to each youth;
427.1 	(3) assist each youth with accessing medical, mental health, legal, advocacy, and family 
427.2 	services based on the youth's individual needs;
427.3 	(4) provide each youth with relevant educational, life skills, and employment supports 
427.4 	based on the youth's individual needs;
427.5 	(5) offer a trafficking prevention education curriculum and provide support for each 
427.6 	youth at risk of future sex trafficking or commercial sexual exploitation; and
427.7 	(6) engage with the discharge planning process for each youth and the youth's family.
427.8 	(e) The license holder must maintain a service delivery plan that describes how the 
427.9 	program provides services according to the requirements in paragraphs (c) and (d).
427.10 	(f) The license holder must ensure that each staff person who has direct contact, as 
427.11 	defined in section 245C.02, subdivision 11, with a youth served by the license holder's 
427.12 	program completes a human trafficking training approved by the Department of Human 
427.13 	Services' Children and Family Services Administration before the staff person has direct 
427.14 	contact with a youth served by the program and annually thereafter. For programs certified 
427.15 	prior to January 1, 2022, the license holder must ensure that each staff person at the license 
427.16 	holder's program completes the initial training by January 1, 2022.
427.17 		Subd. 6.Residential settings specializing in providing prenatal, postpartum, or 
427.18 	parenting supports for youth; certification requirements. (a) To be certified as a 
427.19 	residential setting specializing in providing prenatal, postpartum, or parenting supports for 
427.20 	youth, a license holder must meet the requirements of this subdivision.
427.21 	(b) The license holder must collaborate with the responsible social services agency and 
427.22 	other appropriate parties to implement each youth's out-of-home placement plan required 
427.23 	by section 260C.212, subdivision 1.
427.24 	(c) The license holder must specialize in providing prenatal, postpartum, or parenting 
427.25 	supports for youth and must:
427.26 	(1) provide equitable, culturally responsive, and individualized services to each youth;
427.27 	(2) assist each youth with accessing postpartum services during the same period of time 
427.28 	that a woman is considered pregnant for the purposes of medical assistance eligibility under 
427.29 	section 256B.055, subdivision 6, including providing each youth with:
427.30 	(i) sexual and reproductive health services and education; and
427.31 	(ii) a postpartum mental health assessment and follow-up services; and
427.32 	(3) discharge planning that includes the youth and the youth's family.
428.1 	(d) On or before the date of a child's initial physical presence at the facility, the license 
428.2 	holder must provide education to the child's parent related to safe bathing and reducing the 
428.3 	risk of sudden unexpected infant death and abusive head trauma from shaking infants and 
428.4 	young children. The license holder must use the educational material developed by the 
428.5 	commissioner of human services to comply with this requirement. At a minimum, the 
428.6 	education must address:
428.7 	(1) instruction that: (i) a child or infant should never be left unattended around water; 
428.8 	(ii) a tub should be filled with only two to four inches of water for infants; and (iii) an infant 
428.9 	should never be put into a tub when the water is running; and
428.10 	(2) the risk factors related to sudden unexpected infant death and abusive head trauma 
428.11 	from shaking infants and young children and means of reducing the risks, including the 
428.12 	safety precautions identified in section 245A.1435 and the risks of co-sleeping.
428.13 	The license holder must document the parent's receipt of the education and keep the 
428.14 	documentation in the parent's file. The documentation must indicate whether the parent 
428.15 	agrees to comply with the safeguards described in this paragraph. If the parent refuses to 
428.16 	comply, program staff must provide additional education to the parent as described in the 
428.17 	parental supervision plan. The parental supervision plan must include the intervention, 
428.18 	frequency, and staff responsible for the duration of the parent's participation in the program 
428.19 	or until the parent agrees to comply with the safeguards described in this paragraph.
428.20 	(e) On or before the date of a child's initial physical presence at the facility, the license 
428.21 	holder must document the parent's capacity to meet the health and safety needs of the child 
428.22 	while on the facility premises considering the following factors:
428.23 	(1) the parent's physical and mental health;
428.24 	(2) the parent being under the influence of drugs, alcohol, medications, or other chemicals;
428.25 	(3) the child's physical and mental health; and
428.26 	(4) any other information available to the license holder indicating that the parent may 
428.27 	not be able to adequately care for the child.
428.28 	(f) The license holder must have written procedures specifying the actions that staff shall 
428.29 	take if a parent is or becomes unable to adequately care for the parent's child.
428.30 	(g) If the parent refuses to comply with the safeguards described in paragraph (d) or is 
428.31 	unable to adequately care for the child, the license holder must develop a parental supervision 
428.32 	plan in conjunction with the parent. The plan must account for any factors in paragraph (e) 
429.1 	that contribute to the parent's inability to adequately care for the child. The plan must be 
429.2 	dated and signed by the staff person who completed the plan.
429.3 	(h) The license holder must have written procedures addressing whether the program 
429.4 	permits a parent to arrange for supervision of the parent's child by another youth in the 
429.5 	program. If permitted, the facility must have a procedure that requires staff approval of the 
429.6 	supervision arrangement before the supervision by the nonparental youth occurs. The 
429.7 	procedure for approval must include an assessment of the nonparental youth's capacity to 
429.8 	assume the supervisory responsibilities using the criteria in paragraph (e). The license holder 
429.9 	must document the license holder's approval of the supervisory arrangement and the 
429.10 	assessment of the nonparental youth's capacity to supervise the child and must keep this 
429.11 	documentation in the file of the parent whose child is being supervised by the nonparental 
429.12 	youth.
429.13 	(i) The license holder must maintain a service delivery plan that describes how the 
429.14 	program provides services according to paragraphs (b) to (h).
429.15 		Subd. 7.Supervised independent living settings for youth 18 years of age or older; 
429.16 	certification requirements. (a) To be certified as a supervised independent living setting 
429.17 	for youth who are 18 years of age or older, a license holder must meet the requirements of 
429.18 	this subdivision.
429.19 	(b) A license holder must provide training, counseling, instruction, supervision, and 
429.20 	assistance for independent living, to meet the needs of the youth being served.
429.21 	(c) A license holder may provide services to assist the youth with locating housing, 
429.22 	money management, meal preparation, shopping, health care, transportation, and any other 
429.23 	support services necessary to meet the youth's needs and improve the youth's ability to 
429.24 	conduct such tasks independently.
429.25 	(d) The service plan for the youth must contain an objective of independent living skills.
429.26 	(e) The license holder must maintain a service delivery plan that describes how the 
429.27 	program provides services according to paragraphs (b) to (d).
429.28 		Subd. 8.Monitoring and inspections. (a) For a program licensed by the commissioner 
429.29 	of human services, the commissioner of human services may review a program's compliance 
429.30 	with certification requirements by conducting an inspection, a licensing review, or an 
429.31 	investigation of the program. The commissioner may issue a correction order to the license 
429.32 	holder for a program's noncompliance with the certification requirements of this section. 
429.33 	For a program licensed by the commissioner of human services, a license holder must make 
430.1 	a request for reconsideration of a correction order according to section 245A.06, subdivision 
430.2 	2.
430.3 	(b) For a program licensed by the commissioner of corrections, the commissioner of 
430.4 	human services may review the program's compliance with the requirements for a certification 
430.5 	issued under this section biennially and may issue a correction order identifying the program's 
430.6 	noncompliance with the requirements of this section. The correction order must state the 
430.7 	following:
430.8 	(1) the conditions that constitute a violation of a law or rule;
430.9 	(2) the specific law or rule violated; and
430.10 	(3) the time allowed for the program to correct each violation.
430.11 	(c) For a program licensed by the commissioner of corrections, if a license holder believes 
430.12 	that there are errors in the correction order of the commissioner of human services, the 
430.13 	license holder may ask the Department of Human Services to reconsider the parts of the 
430.14 	correction order that the license holder alleges are in error. To submit a request for 
430.15 	reconsideration, the license holder must send a written request for reconsideration by United 
430.16 	States mail to the commissioner of human services. The request for reconsideration must 
430.17 	be postmarked within 20 calendar days of the date that the correction order was received 
430.18 	by the license holder and must:
430.19 	(1) specify the parts of the correction order that are alleged to be in error;
430.20 	(2) explain why the parts of the correction order are in error; and
430.21 	(3) include documentation to support the allegation of error.
430.22 	A request for reconsideration does not stay any provisions or requirements of the correction 
430.23 	order. The commissioner of human services' disposition of a request for reconsideration is 
430.24 	final and not subject to appeal under chapter 14.
430.25 	(d) Nothing in this subdivision prohibits the commissioner of human services from 
430.26 	decertifying a license holder according to subdivision 9 prior to issuing a correction order.
430.27 		Subd. 9.Decertification. (a) The commissioner of human services may rescind a 
430.28 	certification issued under this section if a license holder fails to comply with the certification 
430.29 	requirements in this section.
430.30 	(b) The license holder may request reconsideration of a decertification by notifying the 
430.31 	commissioner of human services by certified mail or personal service. The license holder 
430.32 	must request reconsideration of a decertification in writing. If the license holder sends the 
431.1 	request for reconsideration of a decertification by certified mail, the license holder must 
431.2 	send the request by United States mail to the commissioner of human services and the 
431.3 	request must be postmarked within 20 calendar days after the license holder received the 
431.4 	notice of decertification. If the license holder requests reconsideration of a decertification 
431.5 	by personal service, the request for reconsideration must be received by the commissioner 
431.6 	of human services within 20 calendar days after the license holder received the notice of 
431.7 	decertification. When submitting a request for reconsideration of a decertification, the license 
431.8 	holder must submit a written argument or evidence in support of the request for 
431.9 	reconsideration.
431.10 	(c) The commissioner of human services' disposition of a request for reconsideration is 
431.11 	final and not subject to appeal under chapter 14.
431.12 		Subd. 10.Variances. The commissioner of human services may grant variances to the 
431.13 	requirements in this section that do not affect a youth's health or safety or compliance with 
431.14 	federal requirements for Title IV-E funding if the conditions in section 245A.04, subdivision 
431.15 	9, are met.

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

431.17 	Sec. 11. Minnesota Statutes 2020, section 256.01, subdivision 14b, is amended to read:
431.18 		Subd. 14b.American Indian child welfare projects. (a) The commissioner of human 
431.19 	services may authorize projects to initiate tribal delivery of child welfare services to American 
431.20 	Indian children and their parents and custodians living on the reservation. The commissioner 
431.21 	has authority to solicit and determine which tribes may participate in a project. Grants may 
431.22 	be issued to Minnesota Indian tribes to support the projects. The commissioner may waive 
431.23 	existing state rules as needed to accomplish the projects. The commissioner may authorize 
431.24 	projects to use alternative methods of (1) screening, investigating, and assessing reports of 
431.25 	child maltreatment, and (2) administrative reconsideration, administrative appeal, and 
431.26 	judicial appeal of maltreatment determinations, provided the alternative methods used by 
431.27 	the projects comply with the provisions of section 256.045 and chapter 260E that deal with 
431.28 	the rights of individuals who are the subjects of reports or investigations, including notice 
431.29 	and appeal rights and data practices requirements. The commissioner shall only authorize 
431.30 	alternative methods that comply with the public policy under section 260E.01. The 
431.31 	commissioner may seek any federal approval necessary to carry out the projects as well as 
431.32 	seek and use any funds available to the commissioner, including use of federal funds, 
431.33 	foundation funds, existing grant funds, and other funds. The commissioner is authorized to 
431.34 	advance state funds as necessary to operate the projects. Federal reimbursement applicable 
432.1 	to the projects is appropriated to the commissioner for the purposes of the projects. The 
432.2 	projects must be required to address responsibility for safety, permanency, and well-being 
432.3 	of children.
432.4 	(b) For the purposes of this section, "American Indian child" means a person under 21 
432.5 	years old and who is a tribal member or eligible for membership in one of the tribes chosen 
432.6 	for a project under this subdivision and who is residing on the reservation of that tribe.
432.7 	(c) In order to qualify for an American Indian child welfare project, a tribe must:
432.8 	(1) be one of the existing tribes with reservation land in Minnesota;
432.9 	(2) have a tribal court with jurisdiction over child custody proceedings;
432.10 	(3) have a substantial number of children for whom determinations of maltreatment have 
432.11 	occurred;
432.12 	(4)(i) have capacity to respond to reports of abuse and neglect under chapter 260E; or 
432.13 	(ii) have codified the tribe's screening, investigation, and assessment of reports of child 
432.14 	maltreatment procedures, if authorized to use an alternative method by the commissioner 
432.15 	under paragraph (a);
432.16 	(5) provide a wide range of services to families in need of child welfare services; and
432.17 	(6) have a tribal-state title IV-E agreement in effect.; and
432.18 	(7) enter into host Tribal contracts pursuant to section 256.0112, subdivision 6.
432.19 	(d) Grants awarded under this section may be used for the nonfederal costs of providing 
432.20 	child welfare services to American Indian children on the tribe's reservation, including costs 
432.21 	associated with:
432.22 	(1) assessment and prevention of child abuse and neglect;
432.23 	(2) family preservation;
432.24 	(3) facilitative, supportive, and reunification services;
432.25 	(4) out-of-home placement for children removed from the home for child protective 
432.26 	purposes; and
432.27 	(5) other activities and services approved by the commissioner that further the goals of 
432.28 	providing safety, permanency, and well-being of American Indian children.
432.29 	(e) When a tribe has initiated a project and has been approved by the commissioner to 
432.30 	assume child welfare responsibilities for American Indian children of that tribe under this 
432.31 	section, the affected county social service agency is relieved of responsibility for responding 
433.1 	to reports of abuse and neglect under chapter 260E for those children during the time within 
433.2 	which the tribal project is in effect and funded. The commissioner shall work with tribes 
433.3 	and affected counties to develop procedures for data collection, evaluation, and clarification 
433.4 	of ongoing role and financial responsibilities of the county and tribe for child welfare services 
433.5 	prior to initiation of the project. Children who have not been identified by the tribe as 
433.6 	participating in the project shall remain the responsibility of the county. Nothing in this 
433.7 	section shall alter responsibilities of the county for law enforcement or court services.
433.8 	(f) Participating tribes may conduct children's mental health screenings under section 
433.9 	245.4874, subdivision 1, paragraph (a), clause (12), for children who are eligible for the 
433.10 	initiative and living on the reservation and who meet one of the following criteria:
433.11 	(1) the child must be receiving child protective services;
433.12 	(2) the child must be in foster care; or
433.13 	(3) the child's parents must have had parental rights suspended or terminated.
433.14 	Tribes may access reimbursement from available state funds for conducting the screenings. 
433.15 	Nothing in this section shall alter responsibilities of the county for providing services under 
433.16 	section 245.487.
433.17 	(g) Participating tribes may establish a local child mortality review panel. In establishing 
433.18 	a local child mortality review panel, the tribe agrees to conduct local child mortality reviews 
433.19 	for child deaths or near-fatalities occurring on the reservation under subdivision 12. Tribes 
433.20 	with established child mortality review panels shall have access to nonpublic data and shall 
433.21 	protect nonpublic data under subdivision 12, paragraphs (c) to (e). The tribe shall provide 
433.22 	written notice to the commissioner and affected counties when a local child mortality review 
433.23 	panel has been established and shall provide data upon request of the commissioner for 
433.24 	purposes of sharing nonpublic data with members of the state child mortality review panel 
433.25 	in connection to an individual case.
433.26 	(h) The commissioner shall collect information on outcomes relating to child safety, 
433.27 	permanency, and well-being of American Indian children who are served in the projects. 
433.28 	Participating tribes must provide information to the state in a format and completeness 
433.29 	deemed acceptable by the state to meet state and federal reporting requirements.
433.30 	(i) In consultation with the White Earth Band, the commissioner shall develop and submit 
433.31 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
433.32 	over health and human services a plan to transfer legal responsibility for providing child 
433.33 	protective services to White Earth Band member children residing in Hennepin County to 
434.1 	the White Earth Band. The plan shall include a financing proposal, definitions of key terms, 
434.2 	statutory amendments required, and other provisions required to implement the plan. The 
434.3 	commissioner shall submit the plan by January 15, 2012.

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

434.5 	Sec. 12. Minnesota Statutes 2020, section 256.0112, subdivision 6, is amended to read:
434.6 		Subd. 6.Contracting within and across county lines; lead county contracts; lead 
434.7 	tribal contracts. Paragraphs (a) to (e) govern contracting within and across county lines 
434.8 	and lead county contracts. Paragraphs (a) to (e) govern contracting within and across 
434.9 	reservation boundaries and lead tribal contracts for initiative tribes under section 256.01, 
434.10 	subdivision 14b. For purposes of this subdivision, "local agency" includes a tribe or a county 
434.11 	agency.
434.12 	(a) Once a local agency and an approved vendor execute a contract that meets the 
434.13 	requirements of this subdivision, the contract governs all other purchases of service from 
434.14 	the vendor by all other local agencies for the term of the contract. The local agency that 
434.15 	negotiated and entered into the contract becomes the lead tribe or county for the contract.
434.16 	(b) When the local agency in the county or reservation where a vendor is located wants 
434.17 	to purchase services from that vendor and the vendor has no contract with the local agency 
434.18 	or any other tribe or county, the local agency must negotiate and execute a contract with 
434.19 	the vendor.
434.20 	(c) When a local agency in one county wants to purchase services from a vendor located 
434.21 	in another county or reservation, it must notify the local agency in the county or reservation
434.22 	where the vendor is located. Within 30 days of being notified, the local agency in the vendor's 
434.23 	county or reservation must:
434.24 	(1) if it has a contract with the vendor, send a copy to the inquiring local agency;
434.25 	(2) if there is a contract with the vendor for which another local agency is the lead tribe 
434.26 	or county, identify the lead tribe or county to the inquiring agency; or
434.27 	(3) if no local agency has a contract with the vendor, inform the inquiring agency whether 
434.28 	it will negotiate a contract and become the lead tribe or county. If the agency where the 
434.29 	vendor is located will not negotiate a contract with the vendor because of concerns related 
434.30 	to clients' health and safety, the agency must share those concerns with the inquiring local 
434.31 	agency.
435.1 	(d) If the local agency in the county where the vendor is located declines to negotiate a 
435.2 	contract with the vendor or fails to respond within 30 days of receiving the notification 
435.3 	under paragraph (c), the inquiring agency is authorized to negotiate a contract and must 
435.4 	notify the local agency that declined or failed to respond.
435.5 	(e) When the inquiring county local agency under paragraph (d) becomes the lead tribe 
435.6 	or county for a contract and the contract expires and needs to be renegotiated, that tribe or 
435.7 	county must again follow the requirements under paragraph (c) and notify the local agency 
435.8 	where the vendor is located. The local agency where the vendor is located has the option 
435.9 	of becoming the lead tribe or county for the new contract. If the local agency does not 
435.10 	exercise the option, paragraph (d) applies.
435.11 	(f) This subdivision does not affect the requirement to seek county concurrence under 
435.12 	section 256B.092, subdivision 8a, when the services are to be purchased for a person with 
435.13 	a developmental disability or under section 245.4711, subdivision 3, when the services to 
435.14 	be purchased are for an adult with serious and persistent mental illness.

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

435.16 	Sec. 13. Minnesota Statutes 2020, section 260C.007, subdivision 6, is amended to read:
435.17 		Subd. 6.Child in need of protection or services. "Child in need of protection or 
435.18 	services" means a child who is in need of protection or services because the child:
435.19 	(1) is abandoned or without parent, guardian, or custodian;
435.20 	(2)(i) has been a victim of physical or sexual abuse as defined in section 260E.03, 
435.21 	subdivision 18 or 20, (ii) resides with or has resided with a victim of child abuse as defined 
435.22 	in subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or 
435.23 	would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or child 
435.24 	abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment as 
435.25 	defined in subdivision 15;
435.26 	(3) is without necessary food, clothing, shelter, education, or other required care for the 
435.27 	child's physical or mental health or morals because the child's parent, guardian, or custodian 
435.28 	is unable or unwilling to provide that care;
435.29 	(4) is without the special care made necessary by a physical, mental, or emotional 
435.30 	condition because the child's parent, guardian, or custodian is unable or unwilling to provide 
435.31 	that care;
436.1 	(5) is medically neglected, which includes, but is not limited to, the withholding of 
436.2 	medically indicated treatment from an infant with a disability with a life-threatening 
436.3 	condition. The term "withholding of medically indicated treatment" means the failure to 
436.4 	respond to the infant's life-threatening conditions by providing treatment, including 
436.5 	appropriate nutrition, hydration, and medication which, in the treating physician's or advanced 
436.6 	practice registered nurse's reasonable medical judgment, will be most likely to be effective 
436.7 	in ameliorating or correcting all conditions, except that the term does not include the failure 
436.8 	to provide treatment other than appropriate nutrition, hydration, or medication to an infant 
436.9 	when, in the treating physician's or advanced practice registered nurse's reasonable medical 
436.10 	judgment:
436.11 	(i) the infant is chronically and irreversibly comatose;
436.12 	(ii) the provision of the treatment would merely prolong dying, not be effective in 
436.13 	ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be 
436.14 	futile in terms of the survival of the infant; or
436.15 	(iii) the provision of the treatment would be virtually futile in terms of the survival of 
436.16 	the infant and the treatment itself under the circumstances would be inhumane;
436.17 	(6) is one whose parent, guardian, or other custodian for good cause desires to be relieved 
436.18 	of the child's care and custody, including a child who entered foster care under a voluntary 
436.19 	placement agreement between the parent and the responsible social services agency under 
436.20 	section 260C.227;
436.21 	(7) has been placed for adoption or care in violation of law;
436.22 	(8) is without proper parental care because of the emotional, mental, or physical disability, 
436.23 	or state of immaturity of the child's parent, guardian, or other custodian;
436.24 	(9) is one whose behavior, condition, or environment is such as to be injurious or 
436.25 	dangerous to the child or others. An injurious or dangerous environment may include, but 
436.26 	is not limited to, the exposure of a child to criminal activity in the child's home;
436.27 	(10) is experiencing growth delays, which may be referred to as failure to thrive, that 
436.28 	have been diagnosed by a physician and are due to parental neglect;
436.29 	(11) is a sexually exploited youth;
436.30 	(12) has committed a delinquent act or a juvenile petty offense before becoming ten 13
436.31 	years old;
436.32 	(13) is a runaway;
437.1 	(14) is a habitual truant;
437.2 	(15) has been found incompetent to proceed or has been found not guilty by reason of 
437.3 	mental illness or mental deficiency in connection with a delinquency proceeding, a 
437.4 	certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a 
437.5 	proceeding involving a juvenile petty offense; or
437.6 	(16) has a parent whose parental rights to one or more other children were involuntarily 
437.7 	terminated or whose custodial rights to another child have been involuntarily transferred to 
437.8 	a relative and there is a case plan prepared by the responsible social services agency 
437.9 	documenting a compelling reason why filing the termination of parental rights petition under 
437.10 	section 260C.503, subdivision 2, is not in the best interests of the child.

437.11 	Sec. 14. Minnesota Statutes 2020, section 260C.007, subdivision 26c, is amended to read:
437.12 		Subd. 26c.Qualified individual. (a) "Qualified individual" means a trained culturally 
437.13 	competent professional or licensed clinician, including a mental health professional under 
437.14 	section 245.4871, subdivision 27, who is notqualified to conduct the assessment approved 
437.15 	by the commissioner. The qualified individual must not be an employee of the responsible 
437.16 	social services agency and who is not connected to or affiliated with any placement setting 
437.17 	in which a responsible social services agency has placed children.
437.18 	(b) When the Indian Child Welfare Act of 1978, United States Code, title 25, sections 
437.19 	1901 to 1963, applies to a child, the county must contact the child's tribe without delay to 
437.20 	give the tribe the option to designate a qualified individual who is a trained culturally 
437.21 	competent professional or licensed clinician, including a mental health professional under 
437.22 	section 245.4871, subdivision 27, who is not employed by the responsible social services 
437.23 	agency and who is not connected to or affiliated with any placement setting in which a 
437.24 	responsible social services agency has placed children. Only a federal waiver that 
437.25 	demonstrates maintained objectivity may allow a responsible social services agency employee 
437.26 	or tribal employee affiliated with any placement setting in which the responsible social 
437.27 	services agency has placed children to be designated the qualified individual.

437.28 	Sec. 15. Minnesota Statutes 2020, section 260C.007, subdivision 31, is amended to read:
437.29 		Subd. 31.Sexually exploited youth. "Sexually exploited youth" means an individual 
437.30 	who:
438.1 	(1) is alleged to have engaged in conduct which would, if committed by an adult, violate 
438.2 	any federal, state, or local law relating to being hired, offering to be hired, or agreeing to 
438.3 	be hired by another individual to engage in sexual penetration or sexual conduct;
438.4 	(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345, 
438.5 	609.3451, 609.3453, 609.352, 617.246, or 617.247;
438.6 	(3) is a victim of a crime described in United States Code, title 18, section 2260; 2421; 
438.7 	2422; 2423; 2425; 2425A; or 2256; or
438.8 	(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.; or
438.9 	(5) is a victim of commercial sexual exploitation as defined in United States Code, title 
438.10 	22, section 7102(11)(A) and (12).

438.11 	EFFECTIVE DATE. This section is effective September 30, 2021.

438.12 	Sec. 16. Minnesota Statutes 2020, section 260C.157, subdivision 3, is amended to read:
438.13 		Subd. 3.Juvenile treatment screening team. (a) The responsible social services agency 
438.14 	shall establish a juvenile treatment screening team to conduct screenings under this chapter 
438.15 	and section 245.487, subdivision 3, and chapter 260D for a child to receive treatment for 
438.16 	an emotional disturbance, a developmental disability, or related condition in a residential 
438.17 	treatment facility licensed by the commissioner of human services under chapter 245A, or 
438.18 	licensed or approved by a tribe. A screening team is not required for a child to be in: (1) a 
438.19 	residential facility specializing in prenatal, postpartum, or parenting support; (2) a facility 
438.20 	specializing in high-quality residential care and supportive services to children and youth 
438.21 	who are have been or are at risk of becoming victims of sex-trafficking victims or are at 
438.22 	risk of becoming sex-trafficking victims or commercial sexual exploitation; (3) supervised 
438.23 	settings for youth who are 18 years old of age or older and living independently; or (4) a 
438.24 	licensed residential family-based treatment facility for substance abuse consistent with 
438.25 	section 260C.190. Screenings are also not required when a child must be placed in a facility 
438.26 	due to an emotional crisis or other mental health emergency.
438.27 	(b) The responsible social services agency shall conduct screenings within 15 days of a 
438.28 	request for a screening, unless the screening is for the purpose of residential treatment and 
438.29 	the child is enrolled in a prepaid health program under section 256B.69, in which case the 
438.30 	agency shall conduct the screening within ten working days of a request. The responsible 
438.31 	social services agency shall convene the juvenile treatment screening team, which may be 
438.32 	constituted under section 245.4885 or 256B.092 or Minnesota Rules, parts 9530.6600 to 
438.33 	9530.6655. The team shall consist of social workers; persons with expertise in the treatment 
439.1 	of juveniles who are emotionally disableddisturbed, chemically dependent, or have a 
439.2 	developmental disability; and the child's parent, guardian, or permanent legal custodian. 
439.3 	The team may include the child's relatives as defined in section 260C.007, subdivisions 26b
439.4 	and 27, the child's foster care provider, and professionals who are a resource to the child's 
439.5 	family such as teachers, medical or mental health providers, and clergy, as appropriate, 
439.6 	consistent with the family and permanency team as defined in section 260C.007, subdivision 
439.7 	16a. Prior to forming the team, the responsible social services agency must consult with the 
439.8 	child's parents, the child if the child is age 14 or older, the child's parents, and, if applicable, 
439.9 	the child's tribe to obtain recommendations regarding which individuals to include on the 
439.10 	team and to ensure that the team is family-centered and will act in the child's best interest
439.11 	interests. If the child, child's parents, or legal guardians raise concerns about specific relatives 
439.12 	or professionals, the team should not include those individuals. This provision does not 
439.13 	apply to paragraph (c).
439.14 	(c) If the agency provides notice to tribes under section 260.761, and the child screened 
439.15 	is an Indian child, the responsible social services agency must make a rigorous and concerted 
439.16 	effort to include a designated representative of the Indian child's tribe on the juvenile 
439.17 	treatment screening team, unless the child's tribal authority declines to appoint a 
439.18 	representative. The Indian child's tribe may delegate its authority to represent the child to 
439.19 	any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12. 
439.20 	The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections 
439.21 	1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to 
439.22 	260.835, apply to this section.
439.23 	(d) If the court, prior to, or as part of, a final disposition or other court order, proposes 
439.24 	to place a child with an emotional disturbance or developmental disability or related condition 
439.25 	in residential treatment, the responsible social services agency must conduct a screening. 
439.26 	If the team recommends treating the child in a qualified residential treatment program, the 
439.27 	agency must follow the requirements of sections 260C.70 to 260C.714.
439.28 	The court shall ascertain whether the child is an Indian child and shall notify the 
439.29 	responsible social services agency and, if the child is an Indian child, shall notify the Indian 
439.30 	child's tribe as paragraph (c) requires.
439.31 	(e) When the responsible social services agency is responsible for placing and caring 
439.32 	for the child and the screening team recommends placing a child in a qualified residential 
439.33 	treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1) 
439.34 	begin the assessment and processes required in section 260C.704 without delay; and (2) 
439.35 	conduct a relative search according to section 260C.221 to assemble the child's family and 
440.1 	permanency team under section 260C.706. Prior to notifying relatives regarding the family 
440.2 	and permanency team, the responsible social services agency must consult with the child's 
440.3 	parent or legal guardian, the child if the child is age 14 or older, the child's parents and, if 
440.4 	applicable, the child's tribe to ensure that the agency is providing notice to individuals who 
440.5 	will act in the child's best interestinterests. The child and the child's parents may identify 
440.6 	a culturally competent qualified individual to complete the child's assessment. The agency 
440.7 	shall make efforts to refer the assessment to the identified qualified individual. The 
440.8 	assessment may not be delayed for the purpose of having the assessment completed by a 
440.9 	specific qualified individual.
440.10 	(f) When a screening team determines that a child does not need treatment in a qualified 
440.11 	residential treatment program, the screening team must:
440.12 	(1) document the services and supports that will prevent the child's foster care placement 
440.13 	and will support the child remaining at home;
440.14 	(2) document the services and supports that the agency will arrange to place the child 
440.15 	in a family foster home; or
440.16 	(3) document the services and supports that the agency has provided in any other setting.
440.17 	(g) When the Indian child's tribe or tribal health care services provider or Indian Health 
440.18 	Services provider proposes to place a child for the primary purpose of treatment for an 
440.19 	emotional disturbance, a developmental disability, or co-occurring emotional disturbance 
440.20 	and chemical dependency, the Indian child's tribe or the tribe delegated by the child's tribe 
440.21 	shall submit necessary documentation to the county juvenile treatment screening team, 
440.22 	which must invite the Indian child's tribe to designate a representative to the screening team.
440.23 	(h) The responsible social services agency must conduct and document the screening in 
440.24 	a format approved by the commissioner of human services.

440.25 	EFFECTIVE DATE. This section is effective September 30, 2021.

440.26 	Sec. 17. Minnesota Statutes 2020, section 260C.212, subdivision 1a, is amended to read:
440.27 		Subd. 1a.Out-of-home placement plan update. (a) Within 30 days of placing the child 
440.28 	in foster care, the agency must file the child's initial out-of-home placement plan with the 
440.29 	court. After filing the child's initial out-of-home placement plan, the agency shall update 
440.30 	and file the child's out-of-home placement plan with the court as follows:
440.31 	(1) when the agency moves a child to a different foster care setting, the agency shall 
440.32 	inform the court within 30 days of the child's placement change or court-ordered trial home 
441.1 	visit. The agency must file the child's updated out-of-home placement plan with the court 
441.2 	at the next required review hearing;
441.3 	(2) when the agency places a child in a qualified residential treatment program as defined 
441.4 	in section 260C.007, subdivision 26d, or moves a child from one qualified residential 
441.5 	treatment program to a different qualified residential treatment program, the agency must 
441.6 	update the child's out-of-home placement plan within 60 days. To meet the requirements 
441.7 	of section 260C.708, the agency must file the child's out-of-home placement plan with the 
441.8 	court as part of the 60-day hearing and along with the agency's report seeking the court's 
441.9 	approval of the child's placement at a qualified residential treatment program under section 
441.10 	260C.71. After the court issues an order, the agency must update the child's out-of-home 
441.11 	placement plan after the court hearing to document the court's approval or disapproval of 
441.12 	the child's placement in a qualified residential treatment program;
441.13 	(3) when the agency places a child with the child's parent in a licensed residential 
441.14 	family-based substance use disorder treatment program under section 260C.190, the agency 
441.15 	must identify the treatment program where the child will be placed in the child's out-of-home 
441.16 	placement plan prior to the child's placement. The agency must file the child's out-of-home 
441.17 	placement plan with the court at the next required review hearing; and
441.18 	(4) under sections 260C.227 and 260C.521, the agency must update the child's
441.19 	out-of-home placement plan and file the child's out-of-home placement plan with the court.
441.20 	(b) When none of the items in paragraph (a) apply, the agency must update the child's
441.21 	out-of-home placement plan no later than 180 days after the child's initial placement and 
441.22 	every six months thereafter, consistent with section 260C.203, paragraph (a).

441.23 	EFFECTIVE DATE. This section is effective September 30, 2021.

441.24 	Sec. 18. Minnesota Statutes 2020, section 260C.212, subdivision 13, is amended to read:
441.25 		Subd. 13.Protecting missing and runaway children and youth at risk of sex 
441.26 	trafficking or commercial sexual exploitation. (a) The local social services agency shall 
441.27 	expeditiously locate any child missing from foster care.
441.28 	(b) The local social services agency shall report immediately, but no later than 24 hours, 
441.29 	after receiving information on a missing or abducted child to the local law enforcement 
441.30 	agency for entry into the National Crime Information Center (NCIC) database of the Federal 
441.31 	Bureau of Investigation, and to the National Center for Missing and Exploited Children.
442.1 	(c) The local social services agency shall not discharge a child from foster care or close 
442.2 	the social services case until diligent efforts have been exhausted to locate the child and the 
442.3 	court terminates the agency's jurisdiction.
442.4 	(d) The local social services agency shall determine the primary factors that contributed 
442.5 	to the child's running away or otherwise being absent from care and, to the extent possible 
442.6 	and appropriate, respond to those factors in current and subsequent placements.
442.7 	(e) The local social services agency shall determine what the child experienced while 
442.8 	absent from care, including screening the child to determine if the child is a possible sex 
442.9 	trafficking or commercial sexual exploitation victim as defined in section 609.321, 
442.10 	subdivision 7b 260C.007, subdivision 31.
442.11 	(f) The local social services agency shall report immediately, but no later than 24 hours, 
442.12 	to the local law enforcement agency any reasonable cause to believe a child is, or is at risk 
442.13 	of being, a sex trafficking or commercial sexual exploitation victim.
442.14 	(g) The local social services agency shall determine appropriate services as described 
442.15 	in section 145.4717 with respect to any child for whom the local social services agency has 
442.16 	responsibility for placement, care, or supervision when the local social services agency has 
442.17 	reasonable cause to believe that the child is, or is at risk of being, a sex trafficking or 
442.18 	commercial sexual exploitation victim.

442.19 	EFFECTIVE DATE. This section is effective September 30, 2021.

442.20 	Sec. 19. Minnesota Statutes 2020, section 260C.4412, is amended to read:
442.21 	260C.4412 PAYMENT FOR RESIDENTIAL PLACEMENTS.
442.22 	(a) When a child is placed in a foster care group residential setting under Minnesota 
442.23 	Rules, parts 2960.0020 to 2960.0710, a foster residence licensed under chapter 245A that 
442.24 	meets the standards of Minnesota Rules, parts 2960.3200 to 2960.3230, or a children's 
442.25 	residential facility licensed or approved by a tribe, foster care maintenance payments must 
442.26 	be made on behalf of the child to cover the cost of providing food, clothing, shelter, daily 
442.27 	supervision, school supplies, child's personal incidentals and supports, reasonable travel for 
442.28 	visitation, or other transportation needs associated with the items listed. Daily supervision 
442.29 	in the group residential setting includes routine day-to-day direction and arrangements to 
442.30 	ensure the well-being and safety of the child. It may also include reasonable costs of 
442.31 	administration and operation of the facility.
442.32 	(b) The commissioner of human services shall specify the title IV-E administrative 
442.33 	procedures under section 256.82 for each of the following residential program settings:
443.1 	(1) residential programs licensed under chapter 245A or licensed by a tribe, including:
443.2 	(i) qualified residential treatment programs as defined in section 260C.007, subdivision 
443.3 	26d;
443.4 	(ii) program settings specializing in providing prenatal, postpartum, or parenting supports 
443.5 	for youth; and
443.6 	(iii) program settings providing high-quality residential care and supportive services to 
443.7 	children and youth who are, or are at risk of becoming, sex trafficking victims;
443.8 	(2) licensed residential family-based substance use disorder treatment programs as 
443.9 	defined in section 260C.007, subdivision 22a; and
443.10 	(3) supervised settings in which a foster child age 18 or older may live independently, 
443.11 	consistent with section 260C.451.
443.12 	(c) A lead county contract under section 256.0112, subdivision 6, is not required to 
443.13 	establish the foster care maintenance payment in paragraph (a) for foster residence settings 
443.14 	licensed under chapter 245A that meet the standards of Minnesota Rules, parts 2960.3200 
443.15 	to 2960.3230. The foster care maintenance payment for these settings must be consistent 
443.16 	with section 256N.26, subdivision 3, and subject to the annual revision as specified in section 
443.17 	256N.26, subdivision 9.

443.18 	Sec. 20. Minnesota Statutes 2020, section 260C.452, is amended to read:
443.19 	260C.452 SUCCESSFUL TRANSITION TO ADULTHOOD.
443.20 		Subdivision 1.Scope and purpose. (a) For purposes of this section, "youth" means a 
443.21 	person who is at least 14 years of age and under 23 years of age.
443.22 	(b) This section pertains to a child youth who:
443.23 	(1) is in foster care and is 14 years of age or older, including a youth who is under the 
443.24 	guardianship of the commissioner of human services, or who;
443.25 	(2) has a permanency disposition of permanent custody to the agency, or who;
443.26 	(3) will leave foster care at 18 to 21 years of age. when the youth is 18 years of age or 
443.27 	older and under 21 years of age;
443.28 	(4) has left foster care due to adoption when the youth was 16 years of age or older;
443.29 	(5) has left foster care due to a transfer of permanent legal and physical custody to a 
443.30 	relative, or Tribal equivalent, when the youth was 16 years of age or older; or
444.1 	(6) was reunified with the youth's primary caretaker when the youth was 14 years of age 
444.2 	or older and under 18 years of age.
444.3 	(c) The purpose of this section is to provide support to each youth who is transitioning 
444.4 	to adulthood by providing services to the youth in the areas of:
444.5 	(1) education;
444.6 	(2) employment;
444.7 	(3) daily living skills such as financial literacy training and driving instruction; preventive 
444.8 	health activities including promoting abstinence from substance use and smoking; and 
444.9 	nutrition education and pregnancy prevention;
444.10 	(4) forming meaningful, permanent connections with caring adults;
444.11 	(5) engaging in age and developmentally appropriate activities under section 260C.212, 
444.12 	subdivision 14, and positive youth development;
444.13 	(6) financial, housing, counseling, and other services to assist a youth over 18 years of 
444.14 	age in achieving self-sufficiency and accepting personal responsibility for the transition 
444.15 	from adolescence to adulthood; and
444.16 	(7) making vouchers available for education and training.
444.17 	(d) The responsible social services agency may provide support and case management 
444.18 	services to a youth as defined in paragraph (a) until the youth reaches the age of 23 years. 
444.19 	According to section 260C.451, a youth's placement in a foster care setting will end when 
444.20 	the youth reaches the age of 21 years.
444.21 		Subd. 1a.Case management services. Case management services include the 
444.22 	responsibility for planning, coordinating, authorizing, monitoring, and evaluating services 
444.23 	for a youth and shall be provided to a youth by the responsible social services agency or 
444.24 	the contracted agency. Case management services include the out-of-home placement plan 
444.25 	under section 260C.212, subdivision 1, when the youth is in out-of-home placement.
444.26 		Subd. 2.Independent living plan. When the child youth is 14 years of age or older and 
444.27 	is receiving support from the responsible social services agency under this section, the 
444.28 	responsible social services agency, in consultation with the child youth, shall complete the
444.29 	youth's independent living plan according to section 260C.212, subdivision 1, paragraph 
444.30 	(c), clause (12), regardless of the youth's current placement status.
444.31 		Subd. 3.Notification. Six months before the child is expected to be discharged from 
444.32 	foster care, the responsible social services agency shall provide written notice to the child 
445.1 	regarding the right to continued access to services for certain children in foster care past 18 
445.2 	years of age and of the right to appeal a denial of social services under section 256.045.
445.3 		Subd. 4.Administrative or court review of placements. (a) When the child youth is 
445.4 	14 years of age or older, the court, in consultation with the child youth, shall review the
445.5 	youth's independent living plan according to section 260C.203, paragraph (d).
445.6 	(b) The responsible social services agency shall file a copy of the notification required 
445.7 	in subdivision 3 of foster care benefits for a youth who is 18 years of age or older according 
445.8 	to section 260C.451, subdivision 1, with the court. If the responsible social services agency 
445.9 	does not file the notice by the time the child youth is 17-1/2 years of age, the court shall 
445.10 	require the responsible social services agency to file the notice.
445.11 	(c) When a youth is 18 years of age or older, the court shall ensure that the responsible 
445.12 	social services agency assists the child youth in obtaining the following documents before 
445.13 	the child youth leaves foster care: a Social Security card; an official or certified copy of the 
445.14 	child's youth's birth certificate; a state identification card or driver's license, tribal enrollment 
445.15 	identification card, green card, or school visa; health insurance information; the child's
445.16 	youth's school, medical, and dental records; a contact list of the child's youth's medical, 
445.17 	dental, and mental health providers; and contact information for the child's youth's siblings, 
445.18 	if the siblings are in foster care.
445.19 	(d) For a child youth who will be discharged from foster care at 18 years of age or older 
445.20 	because the youth is not eligible for extended foster care benefits or chooses to leave foster 
445.21 	care, the responsible social services agency must develop a personalized transition plan as 
445.22 	directed by the child youth during the 90-day period immediately prior to the expected date 
445.23 	of discharge. The transition plan must be as detailed as the child youth elects and include 
445.24 	specific options, including but not limited to:
445.25 	(1) affordable housing with necessary supports that does not include a homeless shelter;
445.26 	(2) health insurance, including eligibility for medical assistance as defined in section 
445.27 	256B.055, subdivision 17;
445.28 	(3) education, including application to the Education and Training Voucher Program;
445.29 	(4) local opportunities for mentors and continuing support services, including the Healthy 
445.30 	Transitions and Homeless Prevention program, if available;
445.31 	(5) workforce supports and employment services;
446.1 	(6) a copy of the child's youth's consumer credit report as defined in section 13C.001
446.2 	and assistance in interpreting and resolving any inaccuracies in the report, at no cost to the 
446.3 	child youth;
446.4 	(7) information on executing a health care directive under chapter 145C and on the 
446.5 	importance of designating another individual to make health care decisions on behalf of the 
446.6 	child youth if the child youth becomes unable to participate in decisions;
446.7 	(8) appropriate contact information through 21 years of age if the child youth needs 
446.8 	information or help dealing with a crisis situation; and
446.9 	(9) official documentation that the youth was previously in foster care.
446.10 		Subd. 5.Notice of termination of foster care social services. (a) When Before a child
446.11 	youth who is 18 years of age or older leaves foster care at 18 years of age or older, the 
446.12 	responsible social services agency shall give the child youth written notice that foster care 
446.13 	shall terminate 30 days from the date that the notice is sent by the agency according to 
446.14 	section 260C.451, subdivision 8.
446.15 	(b) The child or the child's guardian ad litem may file a motion asking the court to review 
446.16 	the responsible social services agency's determination within 15 days of receiving the notice. 
446.17 	The child shall not be discharged from foster care until the motion is heard. The responsible 
446.18 	social services agency shall work with the child to transition out of foster care.
446.19 	(c) The written notice of termination of benefits shall be on a form prescribed by the 
446.20 	commissioner and shall give notice of the right to have the responsible social services 
446.21 	agency's determination reviewed by the court under this section or sections 260C.203, 
446.22 	260C.317, and 260C.515, subdivision 5 or 6. A copy of the termination notice shall be sent 
446.23 	to the child and the child's attorney, if any, the foster care provider, the child's guardian ad 
446.24 	litem, and the court. The responsible social services agency is not responsible for paying 
446.25 	foster care benefits for any period of time after the child leaves foster care.
446.26 	(b) Before case management services will end for a youth who is at least 18 years of 
446.27 	age and under 23 years of age, the responsible social services agency shall give the youth: 
446.28 	(1) written notice that case management services for the youth shall terminate; and (2) 
446.29 	written notice that the youth has the right to appeal the termination of case management 
446.30 	services under section 256.045, subdivision 3, by responding in writing within ten days of 
446.31 	the date that the agency mailed the notice. The termination notice must include information 
446.32 	about services for which the youth is eligible and how to access the services.

446.33 	EFFECTIVE DATE. This section is effective July 1, 2021.

447.1 	Sec. 21. Minnesota Statutes 2020, section 260C.704, is amended to read:
447.2 	260C.704 REQUIREMENTS FOR THE QUALIFIED INDIVIDUAL'S 
447.3 	ASSESSMENT OF THE CHILD FOR PLACEMENT IN A QUALIFIED 
447.4 	RESIDENTIAL TREATMENT PROGRAM.
447.5 	(a) A qualified individual must complete an assessment of the child prior to or within
447.6 	30 days of the child's placement in a qualified residential treatment program in a format 
447.7 	approved by the commissioner of human services, andunless, due to a crisis, the child must 
447.8 	immediately be placed in a qualified residential treatment program. When a child must 
447.9 	immediately be placed in a qualified residential treatment program without an assessment, 
447.10 	the qualified individual must complete the child's assessment within 30 days of the child's 
447.11 	placement. The qualified individual must:
447.12 	(1) assess the child's needs and strengths, using an age-appropriate, evidence-based, 
447.13 	validated, functional assessment approved by the commissioner of human services;
447.14 	(2) determine whether the child's needs can be met by the child's family members or 
447.15 	through placement in a family foster home; or, if not, determine which residential setting 
447.16 	would provide the child with the most effective and appropriate level of care to the child 
447.17 	in the least restrictive environment;
447.18 	(3) develop a list of short- and long-term mental and behavioral health goals for the 
447.19 	child; and
447.20 	(4) work with the child's family and permanency team using culturally competent 
447.21 	practices.
447.22 	If a level of care determination was conducted under section 245.4885, that information 
447.23 	must be shared with the qualified individual and the juvenile treatment screening team.
447.24 	(b) The child and the child's parents, when appropriate, may request that a specific 
447.25 	culturally competent qualified individual complete the child's assessment. The agency shall 
447.26 	make efforts to refer the child to the identified qualified individual to complete the 
447.27 	assessment. The assessment must not be delayed for a specific qualified individual to 
447.28 	complete the assessment.
447.29 	(c) The qualified individual must provide the assessment, when complete, to the 
447.30 	responsible social services agency, the child's parents or legal guardians, the guardian ad 
447.31 	litem, and the court. If the assessment recommends placement of the child in a qualified 
447.32 	residential treatment facility, the agency must distribute the assessment to the child's parent 
447.33 	or legal guardian and file the assessment with the court report as required in section 260C.71, 
448.1 	subdivision 2. If the assessment does not recommend placement in a qualified residential 
448.2 	treatment facility, the agency must provide a copy of the assessment to the parents or legal 
448.3 	guardians and the guardian ad litem and file the assessment determination with the court at 
448.4 	the next required hearing as required in section 260C.71, subdivision 5. If court rules and 
448.5 	chapter 13 permit disclosure of the results of the child's assessment, the agency may share 
448.6 	the results of the child's assessment with the child's foster care provider, other members of 
448.7 	the child's family, and the family and permanency team. The agency must not share the 
448.8 	child's private medical data with the family and permanency team unless: (1) chapter 13
448.9 	permits the agency to disclose the child's private medical data to the family and permanency 
448.10 	team; or (2) the child's parent has authorized the agency to disclose the child's private medical 
448.11 	data to the family and permanency team.
448.12 	(d) For an Indian child, the assessment of the child must follow the order of placement 
448.13 	preferences in the Indian Child Welfare Act of 1978, United States Code, title 25, section 
448.14 	1915.
448.15 	(e) In the assessment determination, the qualified individual must specify in writing:
448.16 	(1) the reasons why the child's needs cannot be met by the child's family or in a family 
448.17 	foster home. A shortage of family foster homes is not an acceptable reason for determining 
448.18 	that a family foster home cannot meet a child's needs;
448.19 	(2) why the recommended placement in a qualified residential treatment program will 
448.20 	provide the child with the most effective and appropriate level of care to meet the child's 
448.21 	needs in the least restrictive environment possible and how placing the child at the treatment 
448.22 	program is consistent with the short-term and long-term goals of the child's permanency 
448.23 	plan; and
448.24 	(3) if the qualified individual's placement recommendation is not the placement setting 
448.25 	that the parent, family and permanency team, child, or tribe prefer, the qualified individual 
448.26 	must identify the reasons why the qualified individual does not recommend the parent's, 
448.27 	family and permanency team's, child's, or tribe's placement preferences. The out-of-home 
448.28 	placement plan under section 260C.708 must also include reasons why the qualified 
448.29 	individual did not recommend the preferences of the parents, family and permanency team, 
448.30 	child, or tribe.
448.31 	(f) If the qualified individual determines that the child's family or a family foster home 
448.32 	or other less restrictive placement may meet the child's needs, the agency must move the 
448.33 	child out of the qualified residential treatment program and transition the child to a less 
448.34 	restrictive setting within 30 days of the determination. If the responsible social services 
449.1 	agency has placement authority of the child, the agency must make a plan for the child's 
449.2 	placement according to section 260C.212, subdivision 2. The agency must file the child's 
449.3 	assessment determination with the court at the next required hearing.
449.4 	(g) If the qualified individual recommends placing the child in a qualified residential 
449.5 	treatment program and if the responsible social services agency has placement authority of 
449.6 	the child, the agency shall make referrals to appropriate qualified residential treatment 
449.7 	programs and upon acceptance by an appropriate program, place the child in an approved 
449.8 	or certified qualified residential treatment program.

449.9 	EFFECTIVE DATE. This section is effective September 30, 2021.

449.10 	Sec. 22. Minnesota Statutes 2020, section 260C.706, is amended to read:
449.11 	260C.706 FAMILY AND PERMANENCY TEAM REQUIREMENTS.
449.12 	(a) When the responsible social services agency's juvenile treatment screening team, as 
449.13 	defined in section 260C.157, recommends placing the child in a qualified residential treatment 
449.14 	program, the agency must assemble a family and permanency team within ten days.
449.15 	(1) The team must include all appropriate biological family members, the child's parents, 
449.16 	legal guardians or custodians, foster care providers, and relatives as defined in section 
449.17 	260C.007, subdivisions 26c 26b and 27, and professionals, as appropriate, who are a resource 
449.18 	to the child's family, such as teachers, medical or mental health providers, or clergy.
449.19 	(2) When a child is placed in foster care prior to the qualified residential treatment 
449.20 	program, the agency shall include relatives responding to the relative search notice as 
449.21 	required under section 260C.221 on this team, unless the juvenile court finds that contacting 
449.22 	a specific relative would endangerpresent a safety or health risk to the parent, guardian, 
449.23 	child, sibling, or any other family member.
449.24 	(3) When a qualified residential treatment program is the child's initial placement setting, 
449.25 	the responsible social services agency must engage with the child and the child's parents to 
449.26 	determine the appropriate family and permanency team members.
449.27 	(4) When the permanency goal is to reunify the child with the child's parent or legal 
449.28 	guardian, the purpose of the relative search and focus of the family and permanency team 
449.29 	is to preserve family relationships and identify and develop supports for the child and parents.
449.30 	(5) The responsible agency must make a good faith effort to identify and assemble all 
449.31 	appropriate individuals to be part of the child's family and permanency team and request 
449.32 	input from the parents regarding relative search efforts consistent with section 260C.221.  
450.1 	The out-of-home placement plan in section 260C.708 must include all contact information 
450.2 	for the team members, as well as contact information for family members or relatives who 
450.3 	are not a part of the family and permanency team.
450.4 	(6) If the child is age 14 or older, the team must include members of the family and 
450.5 	permanency team that the child selects in accordance with section 260C.212, subdivision 
450.6 	1, paragraph (b).
450.7 	(7) Consistent with section 260C.221, a responsible social services agency may disclose 
450.8 	relevant and appropriate private data about the child to relatives in order for the relatives 
450.9 	to participate in caring and planning for the child's placement.
450.10 	(8) If the child is an Indian child under section 260.751, the responsible social services 
450.11 	agency must make active efforts to include the child's tribal representative on the family 
450.12 	and permanency team.
450.13 	(b) The family and permanency team shall meet regarding the assessment required under 
450.14 	section 260C.704 to determine whether it is necessary and appropriate to place the child in 
450.15 	a qualified residential treatment program and to participate in case planning under section 
450.16 	260C.708.
450.17 	(c) When reunification of the child with the child's parent or legal guardian is the 
450.18 	permanency plan, the family and permanency team shall support the parent-child relationship 
450.19 	by recognizing the parent's legal authority, consulting with the parent regarding ongoing 
450.20 	planning for the child, and assisting the parent with visiting and contacting the child.
450.21 	(d) When the agency's permanency plan is to transfer the child's permanent legal and 
450.22 	physical custody to a relative or for the child's adoption, the team shall:
450.23 	(1) coordinate with the proposed guardian to provide the child with educational services, 
450.24 	medical care, and dental care;
450.25 	(2) coordinate with the proposed guardian, the agency, and the foster care facility to 
450.26 	meet the child's treatment needs after the child is placed in a permanent placement with the 
450.27 	proposed guardian;
450.28 	(3) plan to meet the child's need for safety, stability, and connection with the child's 
450.29 	family and community after the child is placed in a permanent placement with the proposed 
450.30 	guardian; and
450.31 	(4) in the case of an Indian child, communicate with the child's tribe to identify necessary 
450.32 	and appropriate services for the child, transition planning for the child, the child's treatment 
451.1 	needs, and how to maintain the child's connections to the child's community, family, and 
451.2 	tribe.
451.3 	(e) The agency shall invite the family and permanency team to participate in case planning 
451.4 	and the agency shall give the team notice of court reviews under sections 260C.152 and 
451.5 	260C.221 until: (1) the child is reunited with the child's parents; or (2) the child's foster care 
451.6 	placement ends and the child is in a permanent placement.

451.7 	EFFECTIVE DATE. This section is effective September 30, 2021.

451.8 	Sec. 23. Minnesota Statutes 2020, section 260C.708, is amended to read:
451.9 	260C.708 OUT-OF-HOME PLACEMENT PLAN FOR QUALIFIED 
451.10 	RESIDENTIAL TREATMENT PROGRAM PLACEMENTS.
451.11 	(a) When the responsible social services agency places a child in a qualified residential 
451.12 	treatment program as defined in section 260C.007, subdivision 26d, the out-of-home 
451.13 	placement plan must include:
451.14 	(1) the case plan requirements in section 260.212, subdivision 1 260C.212;
451.15 	(2) the reasonable and good faith efforts of the responsible social services agency to 
451.16 	identify and include all of the individuals required to be on the child's family and permanency 
451.17 	team under section 260C.007;
451.18 	(3) all contact information for members of the child's family and permanency team and 
451.19 	for other relatives who are not part of the family and permanency team;
451.20 	(4) evidence that the agency scheduled meetings of the family and permanency team, 
451.21 	including meetings relating to the assessment required under section 260C.704, at a time 
451.22 	and place convenient for the family;
451.23 	(5) evidence that the family and permanency team is involved in the assessment required 
451.24 	under section 260C.704 to determine the appropriateness of the child's placement in a 
451.25 	qualified residential treatment program;
451.26 	(6) the family and permanency team's placement preferences for the child in the 
451.27 	assessment required under section 260C.704. When making a decision about the child's 
451.28 	placement preferences, the family and permanency team must recognize:
451.29 	(i) that the agency should place a child with the child's siblings unless a court finds that 
451.30 	placing a child with the child's siblings is not possible due to a child's specialized placement 
451.31 	needs or is otherwise contrary to the child's best interests; and
452.1 	(ii) that the agency should place an Indian child according to the requirements of the 
452.2 	Indian Child Welfare Act, the Minnesota Family Preservation Act under sections 260.751 
452.3 	to 260.835, and section 260C.193, subdivision 3, paragraph (g);
452.4 	(5) (7) when reunification of the child with the child's parent or legal guardian is the 
452.5 	agency's goal, evidence demonstrating that the parent or legal guardian provided input about 
452.6 	the members of the family and permanency team under section 260C.706;
452.7 	(6) (8) when the agency's permanency goal is to reunify the child with the child's parent 
452.8 	or legal guardian, the out-of-home placement plan must identify services and supports that 
452.9 	maintain the parent-child relationship and the parent's legal authority, decision-making, and 
452.10 	responsibility for ongoing planning for the child. In addition, the agency must assist the 
452.11 	parent with visiting and contacting the child;
452.12 	(7) (9) when the agency's permanency goal is to transfer permanent legal and physical 
452.13 	custody of the child to a proposed guardian or to finalize the child's adoption, the case plan 
452.14 	must document the agency's steps to transfer permanent legal and physical custody of the 
452.15 	child or finalize adoption, as required in section 260C.212, subdivision 1, paragraph (c), 
452.16 	clauses (6) and (7); and
452.17 	(8) (10) the qualified individual's recommendation regarding the child's placement in a 
452.18 	qualified residential treatment program and the court approval or disapproval of the placement 
452.19 	as required in section 260C.71.
452.20 	(b) If the placement preferences of the family and permanency team, child, and tribe, if 
452.21 	applicable, are not consistent with the placement setting that the qualified individual 
452.22 	recommends, the case plan must include the reasons why the qualified individual did not 
452.23 	recommend following the preferences of the family and permanency team, child, and the 
452.24 	tribe.
452.25 	(c) The agency must file the out-of-home placement plan with the court as part of the 
452.26 	60-day hearing court order under section 260C.71.

452.27 	EFFECTIVE DATE. This section is effective September 30, 2021.

452.28 	Sec. 24. Minnesota Statutes 2020, section 260C.71, is amended to read:
452.29 	260C.71 COURT APPROVAL REQUIREMENTS.
452.30 		Subdivision 1.Judicial review. When the responsible social services agency has legal 
452.31 	authority to place a child at a qualified residential treatment facility under section 260C.007, 
452.32 	subdivision 21a, and the child's assessment under section 260C.704 recommends placing 
453.1 	the child in a qualified residential treatment facility, the agency shall place the child at a 
453.2 	qualified residential facility. Within 60 days of placing the child at a qualified residential 
453.3 	treatment facility, the agency must obtain a court order finding that the child's placement 
453.4 	is appropriate and meets the child's individualized needs.
453.5 		Subd. 2.Qualified residential treatment program; agency report to court. (a) The 
453.6 	responsible social services agency shall file a written report with the court after receiving 
453.7 	the qualified individual's assessment as specified in section 260C.704 prior to the child's 
453.8 	placement or within 35 days of the date of the child's placement in a qualified residential 
453.9 	treatment facility. The written report shall contain or have attached:
453.10 	(1) the child's name, date of birth, race, gender, and current address;
453.11 	(2) the names, races, dates of birth, residence, and post office address of the child's 
453.12 	parents or legal custodian, or guardian;
453.13 	(3) the name and address of the qualified residential treatment program, including a 
453.14 	chief administrator of the facility;
453.15 	(4) a statement of the facts that necessitated the child's foster care placement;
453.16 	(5) the child's out-of-home placement plan under section 260C.212, subdivision 1, 
453.17 	including the requirements in section 260C.708;
453.18 	(6) if the child is placed in an out-of-state qualified residential treatment program, the 
453.19 	compelling reasons why the child's needs cannot be met by an in-state placement;
453.20 	(7) the qualified individual's assessment of the child under section 260C.704, paragraph 
453.21 	(c), in a format approved by the commissioner;
453.22 	(8) if, at the time required for the report under this subdivision, the child's parent or legal 
453.23 	guardian, a child who is ten years of age or older, the family and permanency team, or a 
453.24 	tribe disagrees with the recommended qualified residential treatment program placement, 
453.25 	the agency shall include information regarding the disagreement, and to the extent possible, 
453.26 	the basis for the disagreement in the report;
453.27 	(9) any other information that the responsible social services agency, child's parent, legal 
453.28 	custodian or guardian, child, or in the case of an Indian child, tribe would like the court to 
453.29 	consider; and
453.30 	(10) the agency shall file the written report with the court and serve on the parties a 
453.31 	request for a hearing or a court order without a hearing.
454.1 	(b) The agency must inform the child's parent or legal guardian and a child who is ten 
454.2 	years of age or older of the court review requirements of this section and the child's and 
454.3 	child's parent's or legal guardian's right to submit information to the court:
454.4 	(1) the agency must inform the child's parent or legal guardian and a child who is ten 
454.5 	years of age or older of the reporting date and the date by which the agency must receive 
454.6 	information from the child and child's parent so that the agency is able to submit the report 
454.7 	required by this subdivision to the court;
454.8 	(2) the agency must inform the child's parent or legal guardian and a child who is ten 
454.9 	years of age or older that the court will hold a hearing upon the request of the child or the 
454.10 	child's parent; and
454.11 	(3) the agency must inform the child's parent or legal guardian and a child who is ten 
454.12 	years of age or older that they have the right to request a hearing and the right to present 
454.13 	information to the court for the court's review under this subdivision.
454.14 		Subd. 3.Court hearing. (a) The court shall hold a hearing when a party or a child who 
454.15 	is ten years of age or older requests a hearing.
454.16 	(b) In all other circumstances, the court has the discretion to hold a hearing or issue an 
454.17 	order without a hearing.
454.18 		Subd. 4.Court findings and order. (a) Within 60 days from the beginning of each 
454.19 	placement in a qualified residential treatment program when the qualified individual's 
454.20 	assessment of the child recommends placing the child in a qualified residential treatment 
454.21 	program, the court must consider the qualified individual's assessment of the child under 
454.22 	section 260C.704 and issue an order to:
454.23 	(1) consider the qualified individual's assessment of whether it is necessary and 
454.24 	appropriate to place the child in a qualified residential treatment program under section 
454.25 	260C.704;
454.26 	(2) (1) determine whether a family foster home can meet the child's needs, whether it is 
454.27 	necessary and appropriate to place a child in a qualified residential treatment program that 
454.28 	is the least restrictive environment possible, and whether the child's placement is consistent 
454.29 	with the child's short and long term goals as specified in the permanency plan; and
454.30 	(3) (2) approve or disapprove of the child's placement.
454.31 	(b) In the out-of-home placement plan, the agency must document the court's approval 
454.32 	or disapproval of the placement, as specified in section 260C.708. If the court disapproves 
454.33 	of the child's placement in a qualified residential treatment program, the responsible social 
455.1 	services agency shall: (1) remove the child from the qualified residential treatment program 
455.2 	within 30 days of the court's order; and (2) make a plan for the child's placement that is 
455.3 	consistent with the child's best interests under section 260C.212, subdivision 2.
455.4 		Subd. 5.Court review and approval not required. When the responsible social services 
455.5 	agency has legal authority to place a child under section 260C.007, subdivision 21a, and 
455.6 	the qualified individual's assessment of the child does not recommend placing the child in 
455.7 	a qualified residential treatment program, the court is not required to hold a hearing and the 
455.8 	court is not required to issue an order. Pursuant to section 260C.704, paragraph (f), the 
455.9 	responsible social services agency shall make a plan for the child's placement consistent 
455.10 	with the child's best interests under section 260C.212, subdivision 2. The agency must file 
455.11 	the agency's assessment determination for the child with the court at the next required 
455.12 	hearing.

455.13 	EFFECTIVE DATE. This section is effective September 30, 2021.

455.14 	Sec. 25. Minnesota Statutes 2020, section 260C.712, is amended to read:
455.15 	260C.712 ONGOING REVIEWS AND PERMANENCY HEARING 
455.16 	REQUIREMENTS.
455.17 	As long as a child remains placed in a qualified residential treatment program, the 
455.18 	responsible social services agency shall submit evidence at each administrative review under 
455.19 	section 260C.203; each court review under sections 260C.202, 260C.203, and260C.204, 
455.20 	260D.06, 260D.07, and 260D.08; and each permanency hearing under section 260C.515, 
455.21 	260C.519, or260C.521, or 260D.07 that:
455.22 	(1) demonstrates that an ongoing assessment of the strengths and needs of the child 
455.23 	continues to support the determination that the child's needs cannot be met through placement 
455.24 	in a family foster home;
455.25 	(2) demonstrates that the placement of the child in a qualified residential treatment 
455.26 	program provides the most effective and appropriate level of care for the child in the least 
455.27 	restrictive environment;
455.28 	(3) demonstrates how the placement is consistent with the short-term and long-term 
455.29 	goals for the child, as specified in the child's permanency plan;
455.30 	(4) documents how the child's specific treatment or service needs will be met in the 
455.31 	placement;
456.1 	(5) documents the length of time that the agency expects the child to need treatment or 
456.2 	services; and
456.3 	(6) documents the responsible social services agency's efforts to prepare the child to 
456.4 	return home or to be placed with a fit and willing relative, legal guardian, adoptive parent, 
456.5 	or foster family.; and
456.6 	(7) if the child is placed in a qualified residential treatment program out-of-state, the 
456.7 	compelling reasons for placing the child out-of-state and the reasons that the child's needs 
456.8 	cannot be met by an in-state placement.

456.9 	EFFECTIVE DATE. This section is effective September 30, 2021.

456.10 	Sec. 26. Minnesota Statutes 2020, section 260C.714, is amended to read:
456.11 	260C.714 REVIEW OF EXTENDED QUALIFIED RESIDENTIAL TREATMENT 
456.12 	PROGRAM PLACEMENTS.
456.13 	(a) When a responsible social services agency places a child in a qualified residential 
456.14 	treatment program for more than 12 consecutive months or 18 nonconsecutive months or, 
456.15 	in the case of a child who is under 13 years of age, for more than six consecutive or 
456.16 	nonconsecutive months, the agency must submit: (1) the signed approval by the county 
456.17 	social services director of the responsible social services agency; and (2) the evidence 
456.18 	supporting the child's placement at the most recent court review or permanency hearing 
456.19 	under section 260C.712, paragraph (b).
456.20 	(b) The commissioner shall specify the procedures and requirements for the agency's 
456.21 	review and approval of a child's extended qualified residential treatment program placement. 
456.22 	The commissioner may consult with counties, tribes, child-placing agencies, mental health 
456.23 	providers, licensed facilities, the child, the child's parents, and the family and permanency 
456.24 	team members to develop case plan requirements and engage in periodic reviews of the 
456.25 	case plan.

456.26 	EFFECTIVE DATE. This section is effective September 30, 2021.

456.27 	Sec. 27. Minnesota Statutes 2020, section 260D.01, is amended to read:
456.28 	260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
456.29 	(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for 
456.30 	treatment" provisions of the Juvenile Court Act.
457.1 	(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary 
457.2 	foster care for treatment upon the filing of a report or petition required under this chapter. 
457.3 	All obligations of the responsible social services agency to a child and family in foster care 
457.4 	contained in chapter 260C not inconsistent with this chapter are also obligations of the 
457.5 	agency with regard to a child in foster care for treatment under this chapter.
457.6 	(c) This chapter shall be construed consistently with the mission of the children's mental 
457.7 	health service system as set out in section 245.487, subdivision 3, and the duties of an agency 
457.8 	under sections 256B.092 and 260C.157 and Minnesota Rules, parts 9525.0004 to 9525.0016, 
457.9 	to meet the needs of a child with a developmental disability or related condition. This 
457.10 	chapter:
457.11 	(1) establishes voluntary foster care through a voluntary foster care agreement as the 
457.12 	means for an agency and a parent to provide needed treatment when the child must be in 
457.13 	foster care to receive necessary treatment for an emotional disturbance or developmental 
457.14 	disability or related condition;
457.15 	(2) establishes court review requirements for a child in voluntary foster care for treatment 
457.16 	due to emotional disturbance or developmental disability or a related condition;
457.17 	(3) establishes the ongoing responsibility of the parent as legal custodian to visit the 
457.18 	child, to plan together with the agency for the child's treatment needs, to be available and 
457.19 	accessible to the agency to make treatment decisions, and to obtain necessary medical, 
457.20 	dental, and other care for the child; and
457.21 	(4) applies to voluntary foster care when the child's parent and the agency agree that the 
457.22 	child's treatment needs require foster care either:
457.23 	(i) due to a level of care determination by the agency's screening team informed by the
457.24 	child's diagnostic and functional assessment under section 245.4885; or
457.25 	(ii) due to a determination regarding the level of services needed by the child by the 
457.26 	responsible social services' services agency's screening team under section 256B.092, and 
457.27 	Minnesota Rules, parts 9525.0004 to 9525.0016.; and
457.28 	(5) includes the requirements for a child's placement in sections 260C.70 to 260C.714, 
457.29 	when the juvenile treatment screening team recommends placing a child in a qualified 
457.30 	residential treatment program, except as modified by this chapter.
457.31 	(d) This chapter does not apply when there is a current determination under chapter 
457.32 	260E that the child requires child protective services or when the child is in foster care for 
457.33 	any reason other than treatment for the child's emotional disturbance or developmental 
458.1 	disability or related condition. When there is a determination under chapter 260E that the 
458.2 	child requires child protective services based on an assessment that there are safety and risk 
458.3 	issues for the child that have not been mitigated through the parent's engagement in services 
458.4 	or otherwise, or when the child is in foster care for any reason other than the child's emotional 
458.5 	disturbance or developmental disability or related condition, the provisions of chapter 260C
458.6 	apply.
458.7 	(e) The paramount consideration in all proceedings concerning a child in voluntary foster 
458.8 	care for treatment is the safety, health, and the best interests of the child. The purpose of 
458.9 	this chapter is:
458.10 	(1) to ensure that a child with a disability is provided the services necessary to treat or 
458.11 	ameliorate the symptoms of the child's disability;
458.12 	(2) to preserve and strengthen the child's family ties whenever possible and in the child's 
458.13 	best interests, approving the child's placement away from the child's parents only when the 
458.14 	child's need for care or treatment requires it out-of-home placement and the child cannot 
458.15 	be maintained in the home of the parent; and
458.16 	(3) to ensure that the child's parent retains legal custody of the child and associated 
458.17 	decision-making authority unless the child's parent willfully fails or is unable to make 
458.18 	decisions that meet the child's safety, health, and best interests. The court may not find that 
458.19 	the parent willfully fails or is unable to make decisions that meet the child's needs solely 
458.20 	because the parent disagrees with the agency's choice of foster care facility, unless the 
458.21 	agency files a petition under chapter 260C, and establishes by clear and convincing evidence 
458.22 	that the child is in need of protection or services.
458.23 	(f) The legal parent-child relationship shall be supported under this chapter by maintaining 
458.24 	the parent's legal authority and responsibility for ongoing planning for the child and by the 
458.25 	agency's assisting the parent, where when necessary, to exercise the parent's ongoing right 
458.26 	and obligation to visit or to have reasonable contact with the child. Ongoing planning means:
458.27 	(1) actively participating in the planning and provision of educational services, medical, 
458.28 	and dental care for the child;
458.29 	(2) actively planning and participating with the agency and the foster care facility for 
458.30 	the child's treatment needs; and
458.31 	(3) planning to meet the child's need for safety, stability, and permanency, and the child's 
458.32 	need to stay connected to the child's family and community.;
459.1 	(4) engaging with the responsible social services agency to ensure that the family and 
459.2 	permanency team under section 260C.706 consists of appropriate family members. For 
459.3 	purposes of voluntary placement of a child in foster care for treatment under chapter 260D, 
459.4 	prior to forming the child's family and permanency team, the responsible social services 
459.5 	agency must consult with the child's parent or legal guardian, the child if the child is 14 
459.6 	years of age or older, and, if applicable, the child's tribe to obtain recommendations regarding 
459.7 	which individuals to include on the team and to ensure that the team is family-centered and 
459.8 	will act in the child's best interests. If the child, child's parents, or legal guardians raise 
459.9 	concerns about specific relatives or professionals, the team should not include those 
459.10 	individuals unless the individual is a treating professional or an important connection to the 
459.11 	youth as outlined in the case or crisis plan; and
459.12 	(5) For a voluntary placement under this chapter in a qualified residential treatment 
459.13 	program, as defined in section 260C.007, subdivision 26d, for purposes of engaging in a 
459.14 	relative search as provided in section 260C.221, the county agency must consult with the 
459.15 	child's parent or legal guardian, the child if the child is 14 years of age or older, and, if 
459.16 	applicable, the child's tribe to obtain recommendations regarding which adult relatives the 
459.17 	county agency should notify. If the child, child's parents, or legal guardians raise concerns 
459.18 	about specific relatives, the county agency should not notify those relatives.
459.19 	(g) The provisions of section 260.012 to ensure placement prevention, family 
459.20 	reunification, and all active and reasonable effort requirements of that section apply. This 
459.21 	chapter shall be construed consistently with the requirements of the Indian Child Welfare 
459.22 	Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the 
459.23 	Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

459.24 	EFFECTIVE DATE. This section is effective September 30, 2021.

459.25 	Sec. 28. Minnesota Statutes 2020, section 260D.05, is amended to read:
459.26 	260D.05 ADMINISTRATIVE REVIEW OF CHILD IN VOLUNTARY FOSTER 
459.27 	CARE FOR TREATMENT.
459.28 	The administrative reviews required under section 260C.203 must be conducted for a 
459.29 	child in voluntary foster care for treatment, except that the initial administrative review 
459.30 	must take place prior to the submission of the report to the court required under section 
459.31 	260D.06, subdivision 2. When a child is placed in a qualified residential treatment program 
459.32 	as defined in section 260C.007, subdivision 26d, the responsible social services agency 
459.33 	must submit evidence to the court as specified in section 260C.712.

460.1 	EFFECTIVE DATE. This section is effective September 30, 2021.

460.2 	Sec. 29. Minnesota Statutes 2020, section 260D.06, subdivision 2, is amended to read:
460.3 		Subd. 2.Agency report to court; court review. The agency shall obtain judicial review 
460.4 	by reporting to the court according to the following procedures:
460.5 	(a) A written report shall be forwarded to the court within 165 days of the date of the 
460.6 	voluntary placement agreement. The written report shall contain or have attached:
460.7 	(1) a statement of facts that necessitate the child's foster care placement;
460.8 	(2) the child's name, date of birth, race, gender, and current address;
460.9 	(3) the names, race, date of birth, residence, and post office addresses of the child's 
460.10 	parents or legal custodian;
460.11 	(4) a statement regarding the child's eligibility for membership or enrollment in an Indian 
460.12 	tribe and the agency's compliance with applicable provisions of sections 260.751 to 260.835;
460.13 	(5) the names and addresses of the foster parents or chief administrator of the facility in 
460.14 	which the child is placed, if the child is not in a family foster home or group home;
460.15 	(6) a copy of the out-of-home placement plan required under section 260C.212, 
460.16 	subdivision 1;
460.17 	(7) a written summary of the proceedings of any administrative review required under 
460.18 	section 260C.203; and
460.19 	(8) evidence as specified in section 260C.712 when a child is placed in a qualified 
460.20 	residential treatment program as defined in section 260C.007, subdivision 26d; and
460.21 	(9) any other information the agency, parent or legal custodian, the child or the foster 
460.22 	parent, or other residential facility wants the court to consider.
460.23 	(b) In the case of a child in placement due to emotional disturbance, the written report 
460.24 	shall include as an attachment, the child's individual treatment plan developed by the child's 
460.25 	treatment professional, as provided in section 245.4871, subdivision 21, or the child's 
460.26 	standard written plan, as provided in section 125A.023, subdivision 3, paragraph (e).
460.27 	(c) In the case of a child in placement due to developmental disability or a related 
460.28 	condition, the written report shall include as an attachment, the child's individual service 
460.29 	plan, as provided in section 256B.092, subdivision 1b; the child's individual program plan, 
460.30 	as provided in Minnesota Rules, part 9525.0004, subpart 11; the child's waiver care plan; 
461.1 	or the child's standard written plan, as provided in section 125A.023, subdivision 3, paragraph 
461.2 	(e).
461.3 	(d) The agency must inform the child, age 12 or older, the child's parent, and the foster 
461.4 	parent or foster care facility of the reporting and court review requirements of this section 
461.5 	and of their right to submit information to the court:
461.6 	(1) if the child or the child's parent or the foster care provider wants to send information 
461.7 	to the court, the agency shall advise those persons of the reporting date and the date by 
461.8 	which the agency must receive the information they want forwarded to the court so the 
461.9 	agency is timely able submit it with the agency's report required under this subdivision;
461.10 	(2) the agency must also inform the child, age 12 or older, the child's parent, and the 
461.11 	foster care facility that they have the right to be heard in person by the court and how to 
461.12 	exercise that right;
461.13 	(3) the agency must also inform the child, age 12 or older, the child's parent, and the 
461.14 	foster care provider that an in-court hearing will be held if requested by the child, the parent, 
461.15 	or the foster care provider; and
461.16 	(4) if, at the time required for the report under this section, a child, age 12 or older, 
461.17 	disagrees about the foster care facility or services provided under the out-of-home placement 
461.18 	plan required under section 260C.212, subdivision 1, the agency shall include information 
461.19 	regarding the child's disagreement, and to the extent possible, the basis for the child's 
461.20 	disagreement in the report required under this section.
461.21 	(e) After receiving the required report, the court has jurisdiction to make the following 
461.22 	determinations and must do so within ten days of receiving the forwarded report, whether 
461.23 	a hearing is requested:
461.24 	(1) whether the voluntary foster care arrangement is in the child's best interests;
461.25 	(2) whether the parent and agency are appropriately planning for the child; and
461.26 	(3) in the case of a child age 12 or older, who disagrees with the foster care facility or 
461.27 	services provided under the out-of-home placement plan, whether it is appropriate to appoint 
461.28 	counsel and a guardian ad litem for the child using standards and procedures under section 
461.29 	260C.163.
461.30 	(f) Unless requested by a parent, representative of the foster care facility, or the child, 
461.31 	no in-court hearing is required in order for the court to make findings and issue an order as 
461.32 	required in paragraph (e).
462.1 	(g) If the court finds the voluntary foster care arrangement is in the child's best interests 
462.2 	and that the agency and parent are appropriately planning for the child, the court shall issue 
462.3 	an order containing explicit, individualized findings to support its determination. The 
462.4 	individualized findings shall be based on the agency's written report and other materials 
462.5 	submitted to the court. The court may make this determination notwithstanding the child's 
462.6 	disagreement, if any, reported under paragraph (d).
462.7 	(h) The court shall send a copy of the order to the county attorney, the agency, parent, 
462.8 	child, age 12 or older, and the foster parent or foster care facility.
462.9 	(i) The court shall also send the parent, the child, age 12 or older, the foster parent, or 
462.10 	representative of the foster care facility notice of the permanency review hearing required 
462.11 	under section 260D.07, paragraph (e).
462.12 	(j) If the court finds continuing the voluntary foster care arrangement is not in the child's 
462.13 	best interests or that the agency or the parent are not appropriately planning for the child, 
462.14 	the court shall notify the agency, the parent, the foster parent or foster care facility, the child, 
462.15 	age 12 or older, and the county attorney of the court's determinations and the basis for the 
462.16 	court's determinations. In this case, the court shall set the matter for hearing and appoint a 
462.17 	guardian ad litem for the child under section 260C.163, subdivision 5.

462.18 	EFFECTIVE DATE. This section is effective September 30, 2021.

462.19 	Sec. 30. Minnesota Statutes 2020, section 260D.07, is amended to read:
462.20 	260D.07 REQUIRED PERMANENCY REVIEW HEARING.
462.21 	(a) When the court has found that the voluntary arrangement is in the child's best interests 
462.22 	and that the agency and parent are appropriately planning for the child pursuant to the report 
462.23 	submitted under section 260D.06, and the child continues in voluntary foster care as defined 
462.24 	in section 260D.02, subdivision 10, for 13 months from the date of the voluntary foster care 
462.25 	agreement, or has been in placement for 15 of the last 22 months, the agency must:
462.26 	(1) terminate the voluntary foster care agreement and return the child home; or
462.27 	(2) determine whether there are compelling reasons to continue the voluntary foster care 
462.28 	arrangement and, if the agency determines there are compelling reasons, seek judicial 
462.29 	approval of its determination; or
462.30 	(3) file a petition for the termination of parental rights.
462.31 	(b) When the agency is asking for the court's approval of its determination that there are 
462.32 	compelling reasons to continue the child in the voluntary foster care arrangement, the agency 
463.1 	shall file a "Petition for Permanency Review Regarding a Child in Voluntary Foster Care 
463.2 	for Treatment" and ask the court to proceed under this section.
463.3 	(c) The "Petition for Permanency Review Regarding a Child in Voluntary Foster Care 
463.4 	for Treatment" shall be drafted or approved by the county attorney and be under oath. The 
463.5 	petition shall include:
463.6 	(1) the date of the voluntary placement agreement;
463.7 	(2) whether the petition is due to the child's developmental disability or emotional 
463.8 	disturbance;
463.9 	(3) the plan for the ongoing care of the child and the parent's participation in the plan;
463.10 	(4) a description of the parent's visitation and contact with the child;
463.11 	(5) the date of the court finding that the foster care placement was in the best interests 
463.12 	of the child, if required under section 260D.06, or the date the agency filed the motion under 
463.13 	section 260D.09, paragraph (b);
463.14 	(6) the agency's reasonable efforts to finalize the permanent plan for the child, including 
463.15 	returning the child to the care of the child's family; and
463.16 	(7) a citation to this chapter as the basis for the petition.; and
463.17 	(8) evidence as specified in section 260C.712 when a child is placed in a qualified 
463.18 	residential treatment program as defined in section 260C.007, subdivision 26d.
463.19 	(d) An updated copy of the out-of-home placement plan required under section 260C.212, 
463.20 	subdivision 1, shall be filed with the petition.
463.21 	(e) The court shall set the date for the permanency review hearing no later than 14 months 
463.22 	after the child has been in placement or within 30 days of the petition filing date when the 
463.23 	child has been in placement 15 of the last 22 months. The court shall serve the petition 
463.24 	together with a notice of hearing by United States mail on the parent, the child age 12 or 
463.25 	older, the child's guardian ad litem, if one has been appointed, the agency, the county 
463.26 	attorney, and counsel for any party.
463.27 	(f) The court shall conduct the permanency review hearing on the petition no later than 
463.28 	14 months after the date of the voluntary placement agreement, within 30 days of the filing 
463.29 	of the petition when the child has been in placement 15 of the last 22 months, or within 15 
463.30 	days of a motion to terminate jurisdiction and to dismiss an order for foster care under 
463.31 	chapter 260C, as provided in section 260D.09, paragraph (b).
463.32 	(g) At the permanency review hearing, the court shall:
464.1 	(1) inquire of the parent if the parent has reviewed the "Petition for Permanency Review 
464.2 	Regarding a Child in Voluntary Foster Care for Treatment," whether the petition is accurate, 
464.3 	and whether the parent agrees to the continued voluntary foster care arrangement as being 
464.4 	in the child's best interests;
464.5 	(2) inquire of the parent if the parent is satisfied with the agency's reasonable efforts to 
464.6 	finalize the permanent plan for the child, including whether there are services available and 
464.7 	accessible to the parent that might allow the child to safely be with the child's family;
464.8 	(3) inquire of the parent if the parent consents to the court entering an order that:
464.9 	(i) approves the responsible agency's reasonable efforts to finalize the permanent plan 
464.10 	for the child, which includes ongoing future planning for the safety, health, and best interests 
464.11 	of the child; and
464.12 	(ii) approves the responsible agency's determination that there are compelling reasons 
464.13 	why the continued voluntary foster care arrangement is in the child's best interests; and
464.14 	(4) inquire of the child's guardian ad litem and any other party whether the guardian or 
464.15 	the party agrees that:
464.16 	(i) the court should approve the responsible agency's reasonable efforts to finalize the 
464.17 	permanent plan for the child, which includes ongoing and future planning for the safety, 
464.18 	health, and best interests of the child; and
464.19 	(ii) the court should approve of the responsible agency's determination that there are 
464.20 	compelling reasons why the continued voluntary foster care arrangement is in the child's 
464.21 	best interests.
464.22 	(h) At a permanency review hearing under this section, the court may take the following 
464.23 	actions based on the contents of the sworn petition and the consent of the parent:
464.24 	(1) approve the agency's compelling reasons that the voluntary foster care arrangement 
464.25 	is in the best interests of the child; and
464.26 	(2) find that the agency has made reasonable efforts to finalize the permanent plan for 
464.27 	the child.
464.28 	(i) A child, age 12 or older, may object to the agency's request that the court approve its 
464.29 	compelling reasons for the continued voluntary arrangement and may be heard on the reasons 
464.30 	for the objection. Notwithstanding the child's objection, the court may approve the agency's 
464.31 	compelling reasons and the voluntary arrangement.
465.1 	(j) If the court does not approve the voluntary arrangement after hearing from the child 
465.2 	or the child's guardian ad litem, the court shall dismiss the petition. In this case, either:
465.3 	(1) the child must be returned to the care of the parent; or
465.4 	(2) the agency must file a petition under section 260C.141, asking for appropriate relief 
465.5 	under sections 260C.301 or 260C.503 to 260C.521.
465.6 	(k) When the court approves the agency's compelling reasons for the child to continue 
465.7 	in voluntary foster care for treatment, and finds that the agency has made reasonable efforts 
465.8 	to finalize a permanent plan for the child, the court shall approve the continued voluntary 
465.9 	foster care arrangement, and continue the matter under the court's jurisdiction for the purposes 
465.10 	of reviewing the child's placement every 12 months while the child is in foster care.
465.11 	(l) A finding that the court approves the continued voluntary placement means the agency 
465.12 	has continued legal authority to place the child while a voluntary placement agreement 
465.13 	remains in effect. The parent or the agency may terminate a voluntary agreement as provided 
465.14 	in section 260D.10. Termination of a voluntary foster care placement of an Indian child is 
465.15 	governed by section 260.765, subdivision 4.

465.16 	EFFECTIVE DATE. This section is effective September 30, 2021.

465.17 	Sec. 31. Minnesota Statutes 2020, section 260D.08, is amended to read:
465.18 	260D.08 ANNUAL REVIEW.
465.19 	(a) After the court conducts a permanency review hearing under section 260D.07, the 
465.20 	matter must be returned to the court for further review of the responsible social services 
465.21 	reasonable efforts to finalize the permanent plan for the child and the child's foster care 
465.22 	placement at least every 12 months while the child is in foster care. The court shall give 
465.23 	notice to the parent and child, age 12 or older, and the foster parents of the continued review 
465.24 	requirements under this section at the permanency review hearing.
465.25 	(b) Every 12 months, the court shall determine whether the agency made reasonable 
465.26 	efforts to finalize the permanency plan for the child, which means the exercise of due 
465.27 	diligence by the agency to:
465.28 	(1) ensure that the agreement for voluntary foster care is the most appropriate legal 
465.29 	arrangement to meet the child's safety, health, and best interests and to conduct a genuine 
465.30 	examination of whether there is another permanency disposition order under chapter 260C, 
465.31 	including returning the child home, that would better serve the child's need for a stable and 
465.32 	permanent home;
466.1 	(2) engage and support the parent in continued involvement in planning and decision 
466.2 	making for the needs of the child;
466.3 	(3) strengthen the child's ties to the parent, relatives, and community;
466.4 	(4) implement the out-of-home placement plan required under section 260C.212, 
466.5 	subdivision 1, and ensure that the plan requires the provision of appropriate services to 
466.6 	address the physical health, mental health, and educational needs of the child; and
466.7 	(5) submit evidence to the court as specified in section 260C.712 when a child is placed 
466.8 	in a qualified residential treatment program setting as defined in section 260C.007, 
466.9 	subdivision 26d; and
466.10 	(5) (6) ensure appropriate planning for the child's safe, permanent, and independent 
466.11 	living arrangement after the child's 18th birthday.

466.12 	EFFECTIVE DATE. This section is effective September 30, 2021.

466.13 	Sec. 32. Minnesota Statutes 2020, section 260D.14, is amended to read:
466.14 	260D.14 SUCCESSFUL TRANSITION TO ADULTHOOD FOR CHILDREN
466.15 	YOUTH IN VOLUNTARY PLACEMENT.
466.16 		Subdivision 1.Case planning. When the child a youth is 14 years of age or older, the 
466.17 	responsible social services agency shall ensure that a child youth in foster care under this 
466.18 	chapter is provided with the case plan requirements in section 260C.212, subdivisions 1
466.19 	and 14.
466.20 		Subd. 2.Notification. The responsible social services agency shall provide a youth with
466.21 	written notice of the right to continued access to services for certain children in foster care 
466.22 	past 18 years of age under section 260C.452, subdivision 3 foster care benefits that a youth 
466.23 	who is 18 years of age or older may continue to receive according to section 260C.451, 
466.24 	subdivision 1, and of the right to appeal a denial of social services under section 256.045. 
466.25 	The notice must be provided to the child youth six months before the child's youth's 18th 
466.26 	birthday.
466.27 		Subd. 3.Administrative or court reviews. When the child a youth is 17 14 years of 
466.28 	age or older, the administrative review or court hearing must include a review of the 
466.29 	responsible social services agency's support for the child's youth's successful transition to 
466.30 	adulthood as required in section 260C.452, subdivision 4.

466.31 	EFFECTIVE DATE. This section is effective July 1, 2021.

467.1 	Sec. 33. Minnesota Statutes 2020, section 260E.06, subdivision 1, is amended to read:
467.2 		Subdivision 1.Mandatory reporters. (a) A person who knows or has reason to believe 
467.3 	a child is being maltreated, as defined in section 260E.03, or has been maltreated within 
467.4 	the preceding three years shall immediately report the information to the local welfare 
467.5 	agency, agency responsible for assessing or investigating the report, police department, 
467.6 	county sheriff, tribal social services agency, or tribal police department if the person is:
467.7 	(1) a professional or professional's delegate who is engaged in the practice of the healing 
467.8 	arts, social services, hospital administration, psychological or psychiatric treatment, child 
467.9 	care, education, correctional supervision, probation and correctional services, or law 
467.10 	enforcement; or
467.11 	(2) employed as a member of the clergy and received the information while engaged in 
467.12 	ministerial duties, provided that a member of the clergy is not required by this subdivision 
467.13 	to report information that is otherwise privileged under section 595.02, subdivision 1, 
467.14 	paragraph (c).; or
467.15 	(3) an owner, administrator, or employee who is 18 years of age or older of a public or 
467.16 	private youth recreation program or other organization that provides services or activities 
467.17 	requiring face-to-face contact with and supervision of children.
467.18 	(b) "Practice of social services" for the purposes of this subdivision includes but is not 
467.19 	limited to employee assistance counseling and the provision of guardian ad litem and 
467.20 	parenting time expeditor services.

467.21 	Sec. 34. Minnesota Statutes 2020, section 260E.20, subdivision 2, is amended to read:
467.22 		Subd. 2.Face-to-face contact. (a) Upon receipt of a screened in report, the local welfare 
467.23 	agency shall conduct a face-to-face contact with the child reported to be maltreated and 
467.24 	with the child's primary caregiver sufficient to complete a safety assessment and ensure the 
467.25 	immediate safety of the child.
467.26 	(b) The Face-to-face contact with the child and primary caregiver shall occur immediately 
467.27 	if sexual abuse or substantial child endangerment is alleged and within five calendar days 
467.28 	for all other reports. If the alleged offender was not already interviewed as the primary 
467.29 	caregiver, the local welfare agency shall also conduct a face-to-face interview with the 
467.30 	alleged offender in the early stages of the assessment or investigation. Face-to-face contact 
467.31 	with the child and primary caregiver in response to a report alleging sexual abuse or 
467.32 	substantial child endangerment may be postponed for no more than five calendar days if 
467.33 	the child is residing in a location that is confirmed to restrict contact with the alleged offender 
468.1 	as established in guidelines issued by the commissioner, or if the local welfare agency is 
468.2 	pursuing a court order for the child's caregiver to produce the child for questioning under 
468.3 	section 260E.22, subdivision 5.
468.4 	(c) At the initial contact with the alleged offender, the local welfare agency or the agency 
468.5 	responsible for assessing or investigating the report must inform the alleged offender of the 
468.6 	complaints or allegations made against the individual in a manner consistent with laws 
468.7 	protecting the rights of the person who made the report. The interview with the alleged 
468.8 	offender may be postponed if it would jeopardize an active law enforcement investigation.
468.9 	(d) The local welfare agency or the agency responsible for assessing or investigating 
468.10 	the report must provide the alleged offender with an opportunity to make a statement. The 
468.11 	alleged offender may submit supporting documentation relevant to the assessment or 
468.12 	investigation.

468.13 	Sec. 35. Minnesota Statutes 2020, section 260E.31, subdivision 1, is amended to read:
468.14 		Subdivision 1.Reports required. (a) Except as provided in paragraph (b), a person 
468.15 	mandated to report under this chapter shall immediately report to the local welfare agency 
468.16 	if the person knows or has reason to believe that a woman is pregnant and has used a 
468.17 	controlled substance for a nonmedical purpose during the pregnancy, including but not 
468.18 	limited to tetrahydrocannabinol, or has consumed alcoholic beverages during the pregnancy 
468.19 	in any way that is habitual or excessive.
468.20 	(b) A health care professional or a social service professional who is mandated to report 
468.21 	under this chapter is exempt from reporting under paragraph (a) a woman's use or 
468.22 	consumption of tetrahydrocannabinol or alcoholic beverages during pregnancy if the 
468.23 	professional is providing or collaborating with other professionals to provide the woman 
468.24 	with prenatal care, postpartum care, or other health care services, including care of the 
468.25 	woman's infant. If the woman does not continue to receive regular prenatal or postpartum 
468.26 	care, after the woman's health care professional has made attempts to contact the woman, 
468.27 	then the professional is required to report under paragraph (a).
468.28 	(c) Any person may make a voluntary report if the person knows or has reason to believe 
468.29 	that a woman is pregnant and has used a controlled substance for a nonmedical purpose 
468.30 	during the pregnancy, including but not limited to tetrahydrocannabinol, or has consumed 
468.31 	alcoholic beverages during the pregnancy in any way that is habitual or excessive.
468.32 	(d) An oral report shall be made immediately by telephone or otherwise. An oral report 
468.33 	made by a person required to report shall be followed within 72 hours, exclusive of weekends 
469.1 	and holidays, by a report in writing to the local welfare agency. Any report shall be of 
469.2 	sufficient content to identify the pregnant woman, the nature and extent of the use, if known, 
469.3 	and the name and address of the reporter. The local welfare agency shall accept a report 
469.4 	made under paragraph (c) notwithstanding refusal by a voluntary reporter to provide the 
469.5 	reporter's name or address as long as the report is otherwise sufficient.
469.6 	(e) For purposes of this section, "prenatal care" means the comprehensive package of 
469.7 	medical and psychological support provided throughout the pregnancy.

469.8 	Sec. 36. Minnesota Statutes 2020, section 260E.33, is amended by adding a subdivision 
469.9 	to read:
469.10 		Subd. 6a.Notification of contested case hearing. When an appeal of a lead investigative 
469.11 	agency determination results in a contested case hearing under chapter 245A or 245C, the 
469.12 	administrative law judge shall notify the parent, legal custodian, or guardian of the child 
469.13 	who is the subject of the maltreatment determination. The notice must be sent by certified 
469.14 	mail and inform the parent, legal custodian, or guardian of the child of the right to file a 
469.15 	signed written statement in the proceedings and the right to attend and participate in the 
469.16 	hearing. The parent, legal custodian, or guardian of the child may file a written statement 
469.17 	with the administrative law judge hearing the case no later than five business days before 
469.18 	commencement of the hearing. The administrative law judge shall include the written 
469.19 	statement in the hearing record and consider the statement in deciding the appeal. The lead 
469.20 	investigative agency shall provide to the administrative law judge the address of the parent, 
469.21 	legal custodian, or guardian of the child. If the lead investigative agency is not reasonably 
469.22 	able to determine the address of the parent, legal custodian, or guardian of the child, the 
469.23 	administrative law judge is not required to send a hearing notice under this subdivision.

469.24 	Sec. 37. Minnesota Statutes 2020, section 260E.36, is amended by adding a subdivision 
469.25 	to read:
469.26 		Subd. 1b.Sex trafficking and sexual exploitation training requirement. As required 
469.27 	by the Child Abuse Prevention and Treatment Act amendments through Public Law 114-22 
469.28 	and to implement Public Law 115-123, all child protection social workers and social services 
469.29 	staff who have responsibility for child protective duties under this chapter or chapter 260C 
469.30 	shall complete training implemented by the commissioner of human services regarding sex 
469.31 	trafficking and sexual exploitation of children and youth.

469.32 	EFFECTIVE DATE. This section is effective July 1, 2021.

470.1 	Sec. 38. DIRECTION TO THE COMMISSIONER; QUALIFIED RESIDENTIAL 
470.2 	TREATMENT TRANSITION SUPPORTS.
 470.3 	The commissioner of human services shall consult with stakeholders to develop policies 
470.4 	regarding aftercare supports for the transition of a child from a qualified residential treatment 
470.5 	program, as defined in Minnesota Statutes, section 260C.007, subdivision 26d, to 
470.6 	reunification with the child's parent or legal guardian, including potential placement in a 
470.7 	less restrictive setting prior to reunification that aligns with the child's permanency plan and 
470.8 	person-centered support plan, when applicable. The policies must be consistent with 
470.9 	Minnesota Rules, part 2960.0190, and Minnesota Statutes, section 245A.25, subdivision 4, 
470.10 	paragraph (i), and address the coordination of the qualified residential treatment program 
470.11 	discharge planning and aftercare supports where needed, the county social services case 
470.12 	plan, and services from community-based providers, to maintain the child's progress with 
470.13 	behavioral health goals in the child's treatment plan. The commissioner must complete 
470.14 	development of the policy guidance by December 31, 2022.

470.15 	Sec. 39. REVISOR INSTRUCTION.
 470.16 	The revisor of statutes shall place the following first grade headnote in Minnesota 
470.17 	Statutes, chapter 260C, preceding Minnesota Statutes, sections 260C.70 to 260C.714: 
470.18 	PLACEMENT OF CHILDREN IN QUALIFIED RESIDENTIAL TREATMENT.

470.19 	ARTICLE 12
470.20 	BEHAVIORAL HEALTH

470.21 	Section 1. Minnesota Statutes 2020, section 245.462, subdivision 17, is amended to read:
470.22 		Subd. 17.Mental health practitioner. (a) "Mental health practitioner" means a person 
470.23 	providing services to adults with mental illness or children with emotional disturbance who 
470.24 	is qualified in at least one of the ways described in paragraphs (b) to (g). A mental health 
470.25 	practitioner for a child client must have training working with children. A mental health 
470.26 	practitioner for an adult client must have training working with adults.
470.27 	(b) For purposes of this subdivision, a practitioner is qualified through relevant 
470.28 	coursework if the practitioner completes at least 30 semester hours or 45 quarter hours in 
470.29 	behavioral sciences or related fields and:
470.30 	(1) has at least 2,000 hours of supervised experience in the delivery of services to adults 
470.31 	or children with:
470.32 	(i) mental illness, substance use disorder, or emotional disturbance; or
471.1 	(ii) traumatic brain injury or developmental disabilities and completes training on mental 
471.2 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
471.3 	mental illness and substance abuse, and psychotropic medications and side effects;
471.4 	(2) is fluent in the non-English language of the ethnic group to which at least 50 percent 
471.5 	of the practitioner's clients belong, completes 40 hours of training in the delivery of services 
471.6 	to adults with mental illness or children with emotional disturbance, and receives clinical 
471.7 	supervision from a mental health professional at least once a week until the requirement of 
471.8 	2,000 hours of supervised experience is met;
471.9 	(3) is working in a day treatment program under section 245.4712, subdivision 2; or
471.10 	(4) has completed a practicum or internship that (i) requires direct interaction with adults 
471.11 	or children served, and (ii) is focused on behavioral sciences or related fields.; or
471.12 	(5) is in the process of completing a practicum or internship as part of a formal 
471.13 	undergraduate or graduate training program in social work, psychology, or counseling.
471.14 	(c) For purposes of this subdivision, a practitioner is qualified through work experience 
471.15 	if the person:
471.16 	(1) has at least 4,000 hours of supervised experience in the delivery of services to adults 
471.17 	or children with:
471.18 	(i) mental illness, substance use disorder, or emotional disturbance; or
471.19 	(ii) traumatic brain injury or developmental disabilities and completes training on mental 
471.20 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
471.21 	mental illness and substance abuse, and psychotropic medications and side effects; or
471.22 	(2) has at least 2,000 hours of supervised experience in the delivery of services to adults 
471.23 	or children with:
471.24 	(i) mental illness, emotional disturbance, or substance use disorder, and receives clinical 
471.25 	supervision as required by applicable statutes and rules from a mental health professional 
471.26 	at least once a week until the requirement of 4,000 hours of supervised experience is met; 
471.27 	or
471.28 	(ii) traumatic brain injury or developmental disabilities; completes training on mental 
471.29 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
471.30 	mental illness and substance abuse, and psychotropic medications and side effects; and 
471.31 	receives clinical supervision as required by applicable statutes and rules at least once a week 
472.1 	from a mental health professional until the requirement of 4,000 hours of supervised 
472.2 	experience is met.
472.3 	(d) For purposes of this subdivision, a practitioner is qualified through a graduate student 
472.4 	internship if the practitioner is a graduate student in behavioral sciences or related fields 
472.5 	and is formally assigned by an accredited college or university to an agency or facility for 
472.6 	clinical training.
472.7 	(e) For purposes of this subdivision, a practitioner is qualified by a bachelor's or master's 
472.8 	degree if the practitioner:
472.9 	(1) holds a master's or other graduate degree in behavioral sciences or related fields; or
472.10 	(2) holds a bachelor's degree in behavioral sciences or related fields and completes a 
472.11 	practicum or internship that (i) requires direct interaction with adults or children served, 
472.12 	and (ii) is focused on behavioral sciences or related fields.
472.13 	(f) For purposes of this subdivision, a practitioner is qualified as a vendor of medical 
472.14 	care if the practitioner meets the definition of vendor of medical care in section 256B.02, 
472.15 	subdivision 7, paragraphs (b) and (c), and is serving a federally recognized tribe.
472.16 	(g) For purposes of medical assistance coverage of diagnostic assessments, explanations 
472.17 	of findings, and psychotherapy under section 256B.0625, subdivision 65, a mental health 
472.18 	practitioner working as a clinical trainee means that the practitioner's clinical supervision 
472.19 	experience is helping the practitioner gain knowledge and skills necessary to practice 
472.20 	effectively and independently. This may include supervision of direct practice, treatment 
472.21 	team collaboration, continued professional learning, and job management. The practitioner 
472.22 	must also:
472.23 	(1) comply with requirements for licensure or board certification as a mental health 
472.24 	professional, according to the qualifications under Minnesota Rules, part 9505.0371, subpart 
472.25 	5, item A, including supervised practice in the delivery of mental health services for the 
472.26 	treatment of mental illness; or
472.27 	(2) be a student in a bona fide field placement or internship under a program leading to 
472.28 	completion of the requirements for licensure as a mental health professional according to 
472.29 	the qualifications under Minnesota Rules, part 9505.0371, subpart 5, item A.
472.30 	(h) For purposes of this subdivision, "behavioral sciences or related fields" has the 
472.31 	meaning given in section 256B.0623, subdivision 5, paragraph (d).
473.1 	(i) Notwithstanding the licensing requirements established by a health-related licensing 
473.2 	board, as defined in section 214.01, subdivision 2, this subdivision supersedes any other 
473.3 	statute or rule.

473.4 	Sec. 2. Minnesota Statutes 2020, section 245.4876, subdivision 3, is amended to read:
473.5 		Subd. 3.Individual treatment plans. All providers of outpatient services, day treatment 
473.6 	services, professional home-based family treatment, residential treatment, and acute care 
473.7 	hospital inpatient treatment, and all regional treatment centers that provide mental health 
473.8 	services for children must develop an individual treatment plan for each child client. The 
473.9 	individual treatment plan must be based on a diagnostic assessment. To the extent appropriate, 
473.10 	the child and the child's family shall be involved in all phases of developing and 
473.11 	implementing the individual treatment plan. Providers of residential treatment, professional 
473.12 	home-based family treatment, and acute care hospital inpatient treatment, and regional 
473.13 	treatment centers must develop the individual treatment plan within ten working days of 
473.14 	client intake or admission and must review the individual treatment plan every 90 days after 
473.15 	intake, except that the administrative review of the treatment plan of a child placed in a 
473.16 	residential facility shall be as specified in sections 260C.203 and 260C.212, subdivision 9. 
473.17 	Providers of day treatment services must develop the individual treatment plan before the 
473.18 	completion of five working days in which service is provided or within 30 days after the 
473.19 	diagnostic assessment is completed or obtained, whichever occurs first. Providers of 
473.20 	outpatient services must develop the individual treatment plan within 30 days after the 
473.21 	diagnostic assessment is completed or obtained or by the end of the second session of an 
473.22 	outpatient service, not including the session in which the diagnostic assessment was provided, 
473.23 	whichever occurs first. Providers of outpatient and day treatment services must review the 
473.24 	individual treatment plan every 90 days after intake.

473.25 	Sec. 3. Minnesota Statutes 2020, section 245.4882, subdivision 1, is amended to read:
473.26 		Subdivision 1.Availability of residential treatment services. County boards must 
473.27 	provide or contract for enough residential treatment services to meet the needs of each child 
473.28 	with severe emotional disturbance residing in the county and needing this level of care. 
473.29 	Length of stay is based on the child's residential treatment need and shall be subject to the 
473.30 	six-month review process established in section 260C.203, and for children in voluntary 
473.31 	placement for treatment, the court review process in section 260D.06 reviewed every 90 
473.32 	days. Services must be appropriate to the child's age and treatment needs and must be made 
473.33 	available as close to the county as possible. Residential treatment must be designed to:
474.1 	(1) help the child improve family living and social interaction skills;
474.2 	(2) help the child gain the necessary skills to return to the community;
474.3 	(3) stabilize crisis admissions; and
474.4 	(4) work with families throughout the placement to improve the ability of the families 
474.5 	to care for children with severe emotional disturbance in the home.

474.6 	Sec. 4. Minnesota Statutes 2020, section 245.4882, subdivision 3, is amended to read:
474.7 		Subd. 3.Transition to community. Residential treatment facilities and regional treatment 
474.8 	centers serving children must plan for and assist those children and their families in making 
474.9 	a transition to less restrictive community-based services. Discharge planning for the child 
474.10 	to return to the community must include identification of and referrals to appropriate home 
474.11 	and community supports that meet the needs of the child and family. Discharge planning 
474.12 	must begin within 30 days after the child enters residential treatment and be updated every 
474.13 	60 days. Residential treatment facilities must also arrange for appropriate follow-up care 
474.14 	in the community. Before a child is discharged, the residential treatment facility or regional 
474.15 	treatment center shall provide notification to the child's case manager, if any, so that the 
474.16 	case manager can monitor and coordinate the transition and make timely arrangements for 
474.17 	the child's appropriate follow-up care in the community.

474.18 	Sec. 5. Minnesota Statutes 2020, section 245.4885, subdivision 1, is amended to read:
474.19 		Subdivision 1.Admission criteria. (a) Prior to admission or placement, except in the 
474.20 	case of an emergency, all children referred for treatment of severe emotional disturbance 
474.21 	in a treatment foster care setting, residential treatment facility, or informally admitted to a 
474.22 	regional treatment center shall undergo an assessment to determine the appropriate level of 
474.23 	care if public county funds are used to pay for the child's services.
474.24 	(b) The responsible social services agency county board shall determine the appropriate 
474.25 	level of care for a child when county-controlled funds are used to pay for the child's services 
474.26 	or placement in a qualified residential treatment facility under chapter 260C and licensed 
474.27 	by the commissioner under chapter 245A. In accordance with section 260C.157, a juvenile 
474.28 	treatment screening team shall conduct a screening before the team may recommend whether 
474.29 	to place a child residential treatment under this chapter, including residential treatment 
474.30 	provided in a qualified residential treatment program as defined in section 260C.007, 
474.31 	subdivision 26d. When a social services agency county board does not have responsibility 
474.32 	for a child's placement and the child is enrolled in a prepaid health program under section 
475.1 	256B.69, the enrolled child's contracted health plan must determine the appropriate level 
475.2 	of care for the child. When Indian Health Services funds or funds of a tribally owned facility 
475.3 	funded under the Indian Self-Determination and Education Assistance Act, Public Law 
475.4 	93-638, are to be used for the child, the Indian Health Services or 638 tribal health facility 
475.5 	must determine the appropriate level of care for the child. When more than one entity bears 
475.6 	responsibility for a child's coverage, the entities shall coordinate level of care determination 
475.7 	activities for the child to the extent possible.
475.8 	(c) The responsible social services agency must make the level of care determination 
475.9 	available to the juvenile treatment screening team, as permitted under chapter 13. The level 
475.10 	of care determination shall inform the juvenile treatment screening team process and the 
475.11 	assessment in section 260C.704 when considering whether to place the child in a qualified 
475.12 	residential treatment program. When the responsible social services agency is not involved 
475.13 	in determining a child's placement, the child's level of care determination shall determine 
475.14 	whether the proposed treatment:
475.15 	(1) is necessary;
475.16 	(2) is appropriate to the child's individual treatment needs;
475.17 	(3) cannot be effectively provided in the child's home; and
475.18 	(4) provides a length of stay as short as possible consistent with the individual child's 
475.19 	need needs.
475.20 	(d) When a level of care determination is conducted, the responsible social services 
475.21 	agency county board or other entity may not determine that a screening under section 
475.22 	260C.157 or, referral, or admission to a treatment foster care setting or residential treatment 
475.23 	facility is not appropriate solely because services were not first provided to the child in a 
475.24 	less restrictive setting and the child failed to make progress toward or meet treatment goals 
475.25 	in the less restrictive setting. The level of care determination must be based on a diagnostic 
475.26 	assessment of a child that includes a functional assessment which evaluates family, school, 
475.27 	and community living situations; and an assessment of the child's need for care out of the 
475.28 	home using a validated tool which assesses a child's functional status and assigns an 
475.29 	appropriate level of care to the child. The validated tool must be approved by the 
475.30 	commissioner of human services. If a diagnostic assessment including a functional assessment
475.31 	has been completed by a mental health professional within the past 180 days, a new diagnostic 
475.32 	assessment need not be completed unless in the opinion of the current treating mental health 
475.33 	professional the child's mental health status has changed markedly since the assessment 
475.34 	was completed. The child's parent shall be notified if an assessment will not be completed 
476.1 	and of the reasons. A copy of the notice shall be placed in the child's file. Recommendations 
476.2 	developed as part of the level of care determination process shall include specific community 
476.3 	services needed by the child and, if appropriate, the child's family, and shall indicate whether 
476.4 	or not these services are available and accessible to the child and the child's family. The 
476.5 	child and the child's family must be invited to any meeting where the level of care 
476.6 	determination is discussed and decisions regarding residential treatment are made. The child 
476.7 	and the child's family may invite other relatives, friends, or advocates to attend these 
476.8 	meetings.
476.9 	(e) During the level of care determination process, the child, child's family, or child's 
476.10 	legal representative, as appropriate, must be informed of the child's eligibility for case 
476.11 	management services and family community support services and that an individual family 
476.12 	community support plan is being developed by the case manager, if assigned.
476.13 	(f) When the responsible social services agency has authority, the agency must engage 
476.14 	the child's parents in case planning under sections 260C.212 and 260C.708 unless a court 
476.15 	terminates the parent's rights or court orders restrict the parent from participating in case 
476.16 	planning, visitation, or parental responsibilities.
476.17 	(g) (f) The level of care determination, and placement decision, and recommendations 
476.18 	for mental health services must be documented in the child's record, as required in chapter 
476.19 	260C and made available to the child's family, as appropriate.

476.20 	EFFECTIVE DATE. This section is effective September 30, 2021.

476.21 	Sec. 6. Minnesota Statutes 2020, section 245.4889, subdivision 1, is amended to read:
476.22 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
476.23 	make grants from available appropriations to assist:
476.24 	(1) counties;
476.25 	(2) Indian tribes;
476.26 	(3) children's collaboratives under section 124D.23 or 245.493; or
476.27 	(4) mental health service providers.
476.28 	(b) The following services are eligible for grants under this section:
476.29 	(1) services to children with emotional disturbances as defined in section 245.4871, 
476.30 	subdivision 15, and their families;
477.1 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
477.2 	age 21 and their families;
477.3 	(3) respite care services for children with emotional disturbances or severe emotional 
477.4 	disturbances who are at risk of out-of-home placement. A child is not required to have case 
477.5 	management services to receive respite care services;
477.6 	(4) children's mental health crisis services;
477.7 	(5) mental health services for people from cultural and ethnic minorities, including 
477.8 	supervision of clinical trainees who are Black, indigenous, or people of color, providing 
477.9 	services in clinics that serve clients enrolled in medical assistance;
477.10 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
477.11 	(7) services to promote and develop the capacity of providers to use evidence-based 
477.12 	practices in providing children's mental health services;
477.13 	(8) school-linked mental health services under section 245.4901;
477.14 	(9) building evidence-based mental health intervention capacity for children birth to age 
477.15 	five;
477.16 	(10) suicide prevention and counseling services that use text messaging statewide;
477.17 	(11) mental health first aid training;
477.18 	(12) training for parents, collaborative partners, and mental health providers on the 
477.19 	impact of adverse childhood experiences and trauma and development of an interactive 
477.20 	website to share information and strategies to promote resilience and prevent trauma;
477.21 	(13) transition age services to develop or expand mental health treatment and supports 
477.22 	for adolescents and young adults 26 years of age or younger;
477.23 	(14) early childhood mental health consultation;
477.24 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
477.25 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
477.26 	psychosis;
477.27 	(16) psychiatric consultation for primary care practitioners; and
477.28 	(17) providers to begin operations and meet program requirements when establishing a 
477.29 	new children's mental health program. These may be start-up grants.; and
478.1 	(18) mental health services based on traditional, spiritual, and holistic healing practices, 
478.2 	provided by cultural healers from African American, American Indian, Asian American, 
478.3 	Latinx, Pacific Islander, and Pan-African communities.
478.4 	(c) Services under paragraph (b) must be designed to help each child to function and 
478.5 	remain with the child's family in the community and delivered consistent with the child's 
478.6 	treatment plan. Transition services to eligible young adults under this paragraph must be 
478.7 	designed to foster independent living in the community.
478.8 	(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party 
478.9 	reimbursement sources, if applicable.

478.10 	Sec. 7. [245.4902] CULTURALLY INFORMED AND CULTURALLY RESPONSIVE 
478.11 	MENTAL HEALTH TASK FORCE.
478.12 		Subdivision 1.Establishment; duties. The Culturally Informed and Culturally 
478.13 	Responsive Mental Health Task Force is established to evaluate and make recommendations 
478.14 	on improving the provision of culturally informed and culturally responsive mental health 
478.15 	services throughout Minnesota. The task force must make recommendations on:
478.16 	(1) recruiting mental health providers from diverse racial and ethnic communities;
478.17 	(2) training all mental health providers on cultural competency and cultural humility;
478.18 	(3) assessing the extent to which mental health provider organizations embrace diversity 
478.19 	and demonstrate proficiency in culturally competent mental health treatment and services; 
478.20 	and
478.21 	(4) increasing the number of mental health organizations owned, managed, or led by 
478.22 	individuals who are Black, indigenous, or people of color.
478.23 		Subd. 2.Membership. (a) The task force must consist of the following 16 members:
478.24 	(1) the commissioner of human services or the commissioner's designee;
478.25 	(2) one representative from the Board of Psychology;
478.26 	(3) one representative from the Board of Marriage and Family Therapy;
478.27 	(4) one representative from the Board of Behavioral Health and Therapy;
478.28 	(5) one representative from the Board of Social Work;
478.29 	(6) three members representing undergraduate and graduate-level mental health 
478.30 	professional education programs, appointed by the governor;
479.1 	(7) three mental health providers who are members of communities of color or 
479.2 	underrepresented communities, as defined in section 148E.010, subdivision 20, appointed 
479.3 	by the governor;
479.4 	(8) two members representing mental health advocacy organizations, appointed by the 
479.5 	governor;
479.6 	(9) two mental health providers, appointed by the governor; and
479.7 	(10) one expert in providing training and education in cultural competency and cultural 
479.8 	responsiveness, appointed by the governor.
479.9 	(b) Appointments to the task force must be made no later than June 1, 2022.
479.10 	(c) Member compensation and reimbursement for expenses are governed by section 
479.11 	15.059, subdivision 3.
479.12 		Subd. 3.Chairs; meetings. The members of the task force must elect two cochairs of 
479.13 	the task force no earlier than July 1, 2022, and the cochairs must convene the first meeting 
479.14 	of the task force no later than August 15, 2022. The task force must meet upon the call of 
479.15 	the cochairs, sufficiently often to accomplish the duties identified in this section. The task 
479.16 	force is subject to the open meeting law under chapter 13D.
479.17 		Subd. 4.Administrative support. The Department of Human Services must provide 
479.18 	administrative support and meeting space for the task force.
479.19 		Subd. 5.Reports. No later than January 1, 2023, and by January 1 of each year thereafter, 
479.20 	the task force must submit a written report to the members of the legislative committees 
479.21 	with jurisdiction over health and human services on the recommendations developed under 
479.22 	subdivision 1.
479.23 		Subd. 6.Expiration. The task force expires on January 1, 2025.

479.24 	Sec. 8. Minnesota Statutes 2020, section 245.735, subdivision 3, is amended to read:
479.25 		Subd. 3.Certified community behavioral health clinics. (a) The commissioner shall 
479.26 	establish a state certification process for certified community behavioral health clinics 
479.27 	(CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified under this 
479.28 	section to be eligible for reimbursement under medical assistance, without service area 
479.29 	limits based on geographic area or region. The commissioner shall consult with CCBHC 
479.30 	stakeholders before establishing and implementing changes in the certification process and 
479.31 	requirements. Entities that choose to be CCBHCs must:
480.1 	(1) comply with the CCBHC criteria published by the United States Department of 
480.2 	Health and Human Services;
480.3 	(1) comply with state licensing requirements and other requirements issued by the 
480.4 	commissioner;
480.5 	(2) employ or contract for clinic staff who have backgrounds in diverse disciplines, 
480.6 	including licensed mental health professionals and licensed alcohol and drug counselors, 
480.7 	and staff who are culturally and linguistically trained to meet the needs of the population 
480.8 	the clinic serves;
480.9 	(3) ensure that clinic services are available and accessible to individuals and families of 
480.10 	all ages and genders and that crisis management services are available 24 hours per day;
480.11 	(4) establish fees for clinic services for individuals who are not enrolled in medical 
480.12 	assistance using a sliding fee scale that ensures that services to patients are not denied or 
480.13 	limited due to an individual's inability to pay for services;
480.14 	(5) comply with quality assurance reporting requirements and other reporting 
480.15 	requirements, including any required reporting of encounter data, clinical outcomes data, 
480.16 	and quality data;
480.17 	(6) provide crisis mental health and substance use services, withdrawal management 
480.18 	services, emergency crisis intervention services, and stabilization services through existing 
480.19 	mobile crisis services; screening, assessment, and diagnosis services, including risk 
480.20 	assessments and level of care determinations; person- and family-centered treatment planning; 
480.21 	outpatient mental health and substance use services; targeted case management; psychiatric 
480.22 	rehabilitation services; peer support and counselor services and family support services; 
480.23 	and intensive community-based mental health services, including mental health services 
480.24 	for members of the armed forces and veterans;. CCBHCs must directly provide the majority 
480.25 	of these services to enrollees, but may coordinate some services with another entity through 
480.26 	a collaboration or agreement, pursuant to paragraph (b);
480.27 	(7) provide coordination of care across settings and providers to ensure seamless 
480.28 	transitions for individuals being served across the full spectrum of health services, including 
480.29 	acute, chronic, and behavioral needs. Care coordination may be accomplished through 
480.30 	partnerships or formal contracts with:
480.31 	(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified 
480.32 	health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or 
480.33 	community-based mental health providers; and
481.1 	(ii) other community services, supports, and providers, including schools, child welfare 
481.2 	agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally 
481.3 	licensed health care and mental health facilities, urban Indian health clinics, Department of 
481.4 	Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals, 
481.5 	and hospital outpatient clinics;
481.6 	(8) be certified as mental health clinics under section 245.69, subdivision 2;
481.7 	(9) comply with standards established by the commissioner relating to mental health 
481.8 	services in Minnesota Rules, parts 9505.0370 to 9505.0372 CCBHC screenings, assessments, 
481.9 	and evaluations;
481.10 	(10) be licensed to provide substance use disorder treatment under chapter 245G;
481.11 	(11) be certified to provide children's therapeutic services and supports under section 
481.12 	256B.0943;
481.13 	(12) be certified to provide adult rehabilitative mental health services under section 
481.14 	256B.0623;
481.15 	(13) be enrolled to provide mental health crisis response services under sections 
481.16 	256B.0624 and 256B.0944;
481.17 	(14) be enrolled to provide mental health targeted case management under section 
481.18 	256B.0625, subdivision 20;
481.19 	(15) comply with standards relating to mental health case management in Minnesota 
481.20 	Rules, parts 9520.0900 to 9520.0926;
481.21 	(16) provide services that comply with the evidence-based practices described in 
481.22 	paragraph (e); and
481.23 	(17) comply with standards relating to peer services under sections 256B.0615, 
481.24 	256B.0616, and 245G.07, subdivision 1, paragraph (a), clause (5), as applicable when peer 
481.25 	services are provided.
481.26 	(b) If an entity a certified CCBHC is unable to provide one or more of the services listed 
481.27 	in paragraph (a), clauses (6) to (17), the commissioner may certify the entity as a CCBHC, 
481.28 	if the entity has a current may contract with another entity that has the required authority 
481.29 	to provide that service and that meets federal CCBHC the following criteria as a designated 
481.30 	collaborating organization, or, to the extent allowed by the federal CCBHC criteria, the 
481.31 	commissioner may approve a referral arrangement. The CCBHC must meet federal 
481.32 	requirements regarding the type and scope of services to be provided directly by the CCBHC.:
482.1 	(1) the entity has a formal agreement with the CCBHC to furnish one or more of the 
482.2 	services under paragraph (a), clause (6);
482.3 	(2) the entity provides assurances that it will provide services according to CCBHC 
482.4 	service standards and provider requirements;
482.5 	(3) the entity agrees that the CCBHC is responsible for coordinating care and has clinical 
482.6 	and financial responsibility for the services that the entity provides under the agreement; 
482.7 	and
482.8 	(4) the entity meets any additional requirements issued by the commissioner.
482.9 	(c) Notwithstanding any other law that requires a county contract or other form of county 
482.10 	approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets 
482.11 	CCBHC requirements may receive the prospective payment under section 256B.0625, 
482.12 	subdivision 5m, for those services without a county contract or county approval. As part of 
482.13 	the certification process in paragraph (a), the commissioner shall require a letter of support 
482.14 	from the CCBHC's host county confirming that the CCBHC and the county or counties it 
482.15 	serves have an ongoing relationship to facilitate access and continuity of care, especially 
482.16 	for individuals who are uninsured or who may go on and off medical assistance.
482.17 	(d) When the standards listed in paragraph (a) or other applicable standards conflict or 
482.18 	address similar issues in duplicative or incompatible ways, the commissioner may grant 
482.19 	variances to state requirements if the variances do not conflict with federal requirements
482.20 	for services reimbursed under medical assistance. If standards overlap, the commissioner 
482.21 	may substitute all or a part of a licensure or certification that is substantially the same as 
482.22 	another licensure or certification. The commissioner shall consult with stakeholders, as 
482.23 	described in subdivision 4, before granting variances under this provision. For the CCBHC 
482.24 	that is certified but not approved for prospective payment under section 256B.0625, 
482.25 	subdivision 5m, the commissioner may grant a variance under this paragraph if the variance 
482.26 	does not increase the state share of costs.
482.27 	(e) The commissioner shall issue a list of required evidence-based practices to be 
482.28 	delivered by CCBHCs, and may also provide a list of recommended evidence-based practices. 
482.29 	The commissioner may update the list to reflect advances in outcomes research and medical 
482.30 	services for persons living with mental illnesses or substance use disorders. The commissioner 
482.31 	shall take into consideration the adequacy of evidence to support the efficacy of the practice, 
482.32 	the quality of workforce available, and the current availability of the practice in the state. 
482.33 	At least 30 days before issuing the initial list and any revisions, the commissioner shall 
482.34 	provide stakeholders with an opportunity to comment.
483.1 	(f) The commissioner shall recertify CCBHCs at least every three years. The 
483.2 	commissioner shall establish a process for decertification and shall require corrective action, 
483.3 	medical assistance repayment, or decertification of a CCBHC that no longer meets the 
483.4 	requirements in this section or that fails to meet the standards provided by the commissioner 
483.5 	in the application and certification process.

483.6 	Sec. 9. Minnesota Statutes 2020, section 245.735, subdivision 5, is amended to read:
483.7 		Subd. 5.Information systems support. The commissioner and the state chief information 
483.8 	officer shall provide information systems support to the projects as necessary to comply 
483.9 	with state and federal requirements.

483.10 	Sec. 10. Minnesota Statutes 2020, section 245.735, is amended by adding a subdivision 
483.11 	to read:
483.12 		Subd. 6.Demonstration entities. The commissioner may operate the demonstration 
483.13 	program established by section 223 of the Protecting Access to Medicare Act if federal 
483.14 	funding for the demonstration program remains available from the United States Department 
483.15 	of Health and Human Services. To the extent practicable, the commissioner shall align the 
483.16 	requirements of the demonstration program with the requirements under this section for 
483.17 	CCBHCs receiving medical assistance reimbursement. A CCBHC may not apply to 
483.18 	participate as a billing provider in both the CCBHC federal demonstration and the benefit 
483.19 	for CCBHCs under the medical assistance program.

483.20 	Sec. 11. Minnesota Statutes 2020, section 254B.01, subdivision 4a, is amended to read:
483.21 		Subd. 4a.Culturally specific or culturally responsive program. (a) "Culturally specific 
483.22 	or culturally responsive program" means a substance use disorder treatment service program 
483.23 	or subprogram that is recovery-focused andculturally responsive or culturally specific when 
483.24 	the program attests that it:
483.25 	(1) improves service quality to and outcomes of a specific population community that 
483.26 	shares a common language, racial, ethnic, or social background by advancing health equity 
483.27 	to help eliminate health disparities; and
483.28 	(2) ensures effective, equitable, comprehensive, and respectful quality care services that 
483.29 	are responsive to an individual within a specific population's community's values, beliefs 
483.30 	and practices, health literacy, preferred language, and other communication needs.; and
483.31 	(3) is compliant with the national standards for culturally and linguistically appropriate 
483.32 	services or other equivalent standards, as determined by the commissioner.
484.1 	(b) A tribally licensed substance use disorder program that is designated as serving a 
484.2 	culturally specific population by the applicable tribal government is deemed to satisfy this 
484.3 	subdivision.
484.4 	(c) A program satisfies the requirements of this subdivision if it attests that the program:
484.5 	(1) is designed to address the unique needs of individuals who share a common language, 
484.6 	racial, ethnic, or social background;
484.7 	(2) is governed with significant input from individuals of that specific background; and
484.8 	(3) employs individuals to provide treatment services, at least 50 percent of whom are 
484.9 	members of the specific community being served.

484.10 	EFFECTIVE DATE. This section is effective January 1, 2022.

484.11 	Sec. 12. Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision 
484.12 	to read:
484.13 		Subd. 4b.Disability responsive program. "Disability responsive program" means a 
484.14 	program that:
484.15 	(1) is designed to serve individuals with disabilities, including individuals with traumatic 
484.16 	brain injuries, developmental disabilities, cognitive disabilities, and physical disabilities; 
484.17 	and
484.18 	(2) employs individuals to provide treatment services who have the necessary professional 
484.19 	training, as approved by the commissioner, to serve individuals with the specific disabilities 
484.20 	that the program is designed to serve.

484.21 	EFFECTIVE DATE. This section is effective January 1, 2022.

484.22 	Sec. 13. Minnesota Statutes 2020, section 254B.05, subdivision 5, is amended to read:
484.23 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
484.24 	use disorder services and service enhancements funded under this chapter.
484.25 	(b) Eligible substance use disorder treatment services include:
484.26 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
484.27 	245G.17, or applicable tribal license;
484.28 	(2) comprehensive assessments provided according to sections 245.4863, paragraph (a), 
484.29 	and 245G.05;
485.1 	(3) care coordination services provided according to section 245G.07, subdivision 1, 
485.2 	paragraph (a), clause (5);
485.3 	(4) peer recovery support services provided according to section 245G.07, subdivision 
485.4 	2, clause (8);
485.5 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
485.6 	services provided according to chapter 245F;
485.7 	(6) medication-assisted therapy services that are licensed according to sections 245G.01 
485.8 	to 245G.17 and 245G.22, or applicable tribal license;
485.9 	(7) medication-assisted therapy plus enhanced treatment services that meet the 
485.10 	requirements of clause (6) and provide nine hours of clinical services each week;
485.11 	(8) high, medium, and low intensity residential treatment services that are licensed 
485.12 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
485.13 	provide, respectively, 30, 15, and five hours of clinical services each week;
485.14 	(9) hospital-based treatment services that are licensed according to sections 245G.01 to 
485.15 	245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
485.16 	144.56;
485.17 	(10) adolescent treatment programs that are licensed as outpatient treatment programs 
485.18 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
485.19 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
485.20 	applicable tribal license;
485.21 	(11) high-intensity residential treatment services that are licensed according to sections 
485.22 	245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of 
485.23 	clinical services each week provided by a state-operated vendor or to clients who have been 
485.24 	civilly committed to the commissioner, present the most complex and difficult care needs, 
485.25 	and are a potential threat to the community; and
485.26 	(12) room and board facilities that meet the requirements of subdivision 1a.
485.27 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
485.28 	of paragraph (b) and one of the following additional requirements:
485.29 	(1) programs that serve parents with their children if the program:
485.30 	(i) provides on-site child care during the hours of treatment activity that:
485.31 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
485.32 	9503; or
486.1 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
486.2 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
486.3 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
486.4 	licensed under chapter 245A as:
486.5 	(A) a child care center under Minnesota Rules, chapter 9503; or
486.6 	(B) a family child care home under Minnesota Rules, chapter 9502;
486.7 	(2) culturally specific or culturally responsive programs as defined in section 254B.01, 
486.8 	subdivision 4a,; or
486.9 	(3) disability responsive programs as defined in section 254B.01, subdivision 4b.
486.10 	programs or subprograms serving special populations, if the program or subprogram 
486.11 	meets the following requirements:
486.12 	(i) is designed to address the unique needs of individuals who share a common language, 
486.13 	racial, ethnic, or social background;
486.14 	(ii) is governed with significant input from individuals of that specific background; and
486.15 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
486.16 	whom are of that specific background, except when the common social background of the 
486.17 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
486.18 	treatment staff who have the necessary professional training, as approved by the 
486.19 	commissioner, to serve clients with the specific disabilities that the program is designed to 
486.20 	serve;
486.21 	(3) programs that offer medical services delivered by appropriately credentialed health 
486.22 	care staff in an amount equal to two hours per client per week if the medical needs of the 
486.23 	client and the nature and provision of any medical services provided are documented in the 
486.24 	client file; and
486.25 	(4) programs that offer services to individuals with co-occurring mental health and 
486.26 	chemical dependency problems if:
486.27 	(i) the program meets the co-occurring requirements in section 245G.20;
486.28 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
486.29 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
486.30 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
486.31 	mental health professional, except that no more than 50 percent of the mental health staff 
487.1 	may be students or licensing candidates with time documented to be directly related to 
487.2 	provisions of co-occurring services;
487.3 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
487.4 	health diagnostic assessment within ten days of admission;
487.5 	(iv) the program has standards for multidisciplinary case review that include a monthly 
487.6 	review for each client that, at a minimum, includes a licensed mental health professional 
487.7 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
487.8 	(v) family education is offered that addresses mental health and substance abuse disorders 
487.9 	and the interaction between the two; and
487.10 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
487.11 	training annually.
487.12 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
487.13 	that provides arrangements for off-site child care must maintain current documentation at 
487.14 	the chemical dependency facility of the child care provider's current licensure to provide 
487.15 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
487.16 	must be deemed in compliance with the licensing requirements in section 245G.19.
487.17 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
487.18 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
487.19 	in paragraph (c), clause (4), items (i) to (iv).
487.20 	(f)(e) Subject to federal approval, chemical dependencysubstance use disorder services 
487.21 	that are otherwise covered as direct face-to-face services may be provided via two-way 
487.22 	interactive video according to section 256B.0625, subdivision 3b. The use of two-way 
487.23 	interactive video must be medically appropriate to the condition and needs of the person 
487.24 	being served. Reimbursement shall be at the same rates and under the same conditions that 
487.25 	would otherwise apply to direct face-to-face services. The interactive video equipment and 
487.26 	connection must comply with Medicare standards in effect at the time the service is provided.
487.27 	(g) (f) For the purpose of reimbursement under this section, substance use disorder 
487.28 	treatment services provided in a group setting without a group participant maximum or 
487.29 	maximum client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 
487.30 	48 to one. At least one of the attending staff must meet the qualifications as established 
487.31 	under this chapter for the type of treatment service provided. A recovery peer may not be 
487.32 	included as part of the staff ratio.
488.1 	(g) Payment for outpatient substance use disorder services that are licensed according 
488.2 	to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless 
488.3 	prior authorization of a greater number of hours is obtained from the commissioner.

488.4 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
488.5 	whichever is later, except paragraph (e) is effective July 1, 2021.

488.6 	Sec. 14. Minnesota Statutes 2020, section 254B.12, is amended by adding a subdivision 
488.7 	to read:
488.8 		Subd. 4.Culturally specific or culturally responsive program and disability 
488.9 	responsive program provider rate increase. For the chemical dependency services listed 
488.10 	in section 254B.05, subdivision 5, provided by programs that meet the requirements of 
488.11 	section 254B.05, subdivision 5, paragraph (c), clauses (1), (2), and (3), on or after January 
488.12 	1, 2022, payment rates shall increase by five percent over the rates in effect on January 1, 
488.13 	2021. The commissioner shall increase prepaid medical assistance capitation rates as 
488.14 	appropriate to reflect this increase.

488.15 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
488.16 	whichever is later.

488.17 	Sec. 15. [254B.151] SUBSTANCE USE DISORDER COMMUNITY OF PRACTICE.
488.18 		Subdivision 1.Establishment; purpose. The commissioner of human services, in 
488.19 	consultation with substance use disorder subject matter experts, shall establish a substance 
488.20 	use disorder community of practice. The purposes of the community of practice are to 
488.21 	improve treatment outcomes for individuals with substance use disorders and reduce 
488.22 	disparities by using evidence-based and best practices through peer-to-peer and 
488.23 	person-to-provider sharing.
488.24 		Subd. 2.Participants; meetings. (a) The community of practice must include the 
488.25 	following participants:
488.26 	(1) researchers or members of the academic community who are substance use disorder 
488.27 	subject matter experts, who do not have financial relationships with treatment providers;
488.28 	(2) substance use disorder treatment providers;
488.29 	(3) representatives from recovery community organizations;
488.30 	(4) a representative from the Department of Human Services;
488.31 	(5) a representative from the Department of Health;
489.1 	(6) a representative from the Department of Corrections;
489.2 	(7) representatives from county social services agencies;
489.3 	(8) representatives from tribal nations or tribal social services providers; and
489.4 	(9) representatives from managed care organizations.
489.5 	(b) The community of practice must include individuals who have used substance use 
489.6 	disorder treatment services and must highlight the voices and experiences of individuals 
489.7 	who are Black, indigenous, people of color, and people from other communities that are 
489.8 	disproportionately impacted by substance use disorders.
489.9 	(c) The community of practice must meet regularly and must hold its first meeting before 
489.10 	January 1, 2022.
489.11 	(d) Compensation and reimbursement for expenses for participants in paragraph (b) are 
489.12 	governed by section 15.059, subdivision 3.
489.13 		Subd. 3.Duties. (a) The community of practice must:
489.14 	(1) identify gaps in substance use disorder treatment services;
489.15 	(2) enhance collective knowledge of issues related to substance use disorder;
489.16 	(3) understand evidence-based practices, best practices, and promising approaches to 
489.17 	address substance use disorder;
489.18 	(4) use knowledge gathered through the community of practice to develop strategic plans 
489.19 	to improve outcomes for individuals who participate in substance use disorder treatment 
489.20 	and related services in Minnesota;
489.21 	(5) increase knowledge about the challenges and opportunities learned by implementing 
489.22 	strategies; and
489.23 	(6) develop capacity for community advocacy.
489.24 	(b) The commissioner, in collaboration with subject matter experts and other participants, 
489.25 	may issue reports and recommendations to the legislative chairs and ranking minority 
489.26 	members of committees with jurisdiction over health and human services policy and finance 
489.27 	and local and regional governments.

490.1 	Sec. 16. Minnesota Statutes 2020, section 256.042, subdivision 2, is amended to read:
490.2 		Subd. 2.Membership. (a) The council shall consist of the following 19 28 voting 
490.3 	members, appointed by the commissioner of human services except as otherwise specified, 
490.4 	and three nonvoting members:
490.5 	(1) two members of the house of representatives, appointed in the following sequence: 
490.6 	the first from the majority party appointed by the speaker of the house and the second from 
490.7 	the minority party appointed by the minority leader. Of these two members, one member 
490.8 	must represent a district outside of the seven-county metropolitan area, and one member 
490.9 	must represent a district that includes the seven-county metropolitan area. The appointment 
490.10 	by the minority leader must ensure that this requirement for geographic diversity in 
490.11 	appointments is met;
490.12 	(2) two members of the senate, appointed in the following sequence: the first from the 
490.13 	majority party appointed by the senate majority leader and the second from the minority 
490.14 	party appointed by the senate minority leader. Of these two members, one member must 
490.15 	represent a district outside of the seven-county metropolitan area and one member must 
490.16 	represent a district that includes the seven-county metropolitan area. The appointment by 
490.17 	the minority leader must ensure that this requirement for geographic diversity in appointments 
490.18 	is met;
490.19 	(3) one member appointed by the Board of Pharmacy;
490.20 	(4) one member who is a physician appointed by the Minnesota Medical Association;
490.21 	(5) one member representing opioid treatment programs, sober living programs, or 
490.22 	substance use disorder programs licensed under chapter 245G;
490.23 	(6) one member appointed by the Minnesota Society of Addiction Medicine who is an 
490.24 	addiction psychiatrist;
490.25 	(7) one member representing professionals providing alternative pain management 
490.26 	therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;
490.27 	(8) one member representing nonprofit organizations conducting initiatives to address 
490.28 	the opioid epidemic, with the commissioner's initial appointment being a member 
490.29 	representing the Steve Rummler Hope Network, and subsequent appointments representing 
490.30 	this or other organizations;
490.31 	(9) one member appointed by the Minnesota Ambulance Association who is serving 
490.32 	with an ambulance service as an emergency medical technician, advanced emergency 
490.33 	medical technician, or paramedic;
491.1 	(10) one member representing the Minnesota courts who is a judge or law enforcement 
491.2 	officer;
491.3 	(11) one public member who is a Minnesota resident and who is in opioid addiction 
491.4 	recovery;
491.5 	(12) two 11 members representing Indian tribes, one representing the Ojibwe tribes and 
491.6 	one representing the Dakota tribes each of Minnesota's tribal nations;
491.7 	(13) one public member who is a Minnesota resident and who is suffering from chronic 
491.8 	pain, intractable pain, or a rare disease or condition;
491.9 	(14) one mental health advocate representing persons with mental illness;
491.10 	(15) one member appointed by the Minnesota Hospital Association;
491.11 	(16) one member representing a local health department; and
491.12 	(17) the commissioners of human services, health, and corrections, or their designees, 
491.13 	who shall be ex officio nonvoting members of the council.
491.14 	(b) The commissioner of human services shall coordinate the commissioner's 
491.15 	appointments to provide geographic, racial, and gender diversity, and shall ensure that at 
491.16 	least one-half of council members appointed by the commissioner reside outside of the 
491.17 	seven-county metropolitan area. Of the members appointed by the commissioner, to the 
491.18 	extent practicable, at least one member must represent a community of color 
491.19 	disproportionately affected by the opioid epidemic.
491.20 	(c) The council is governed by section 15.059, except that members of the council shall 
491.21 	serve three-year terms and shall receive no compensation other than reimbursement for 
491.22 	expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.
491.23 	(d) The chair shall convene the council at least quarterly, and may convene other meetings 
491.24 	as necessary. The chair shall convene meetings at different locations in the state to provide 
491.25 	geographic access, and shall ensure that at least one-half of the meetings are held at locations 
491.26 	outside of the seven-county metropolitan area.
491.27 	(e) The commissioner of human services shall provide staff and administrative services 
491.28 	for the advisory council.
491.29 	(f) The council is subject to chapter 13D.

492.1 	Sec. 17. Minnesota Statutes 2020, section 256.042, subdivision 4, is amended to read:
492.2 		Subd. 4.Grants. (a) The commissioner of human services shall submit a report of the 
492.3 	grants proposed by the advisory council to be awarded for the upcoming fiscal calendar
492.4 	year to the chairs and ranking minority members of the legislative committees with 
492.5 	jurisdiction over health and human services policy and finance, by MarchDecember 1 of 
492.6 	each year, beginning March 1, 2020.
492.7 	(b) The commissioner of human services shall award grants from the opiate epidemic 
492.8 	response fund under section 256.043. The grants shall be awarded to proposals selected by 
492.9 	the advisory council that address the priorities in subdivision 1, paragraph (a), clauses (1) 
492.10 	to (4), unless otherwise appropriated by the legislature. No more than threeten percent of 
492.11 	the grant amount may be used by a grantee for administration.

492.12 	Sec. 18. Minnesota Statutes 2020, section 256.043, subdivision 3, is amended to read:
492.13 		Subd. 3.Appropriations from fund. (a) After the appropriations in Laws 2019, chapter 
492.14 	63, article 3, section 1, paragraphs (e), (f), (g), and (h) are made, $249,000 is appropriated 
492.15 	to the commissioner of human services for the provision of administrative services to the 
492.16 	Opiate Epidemic Response Advisory Council and for the administration of the grants awarded 
492.17 	under paragraph (e).
492.18 	(b) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration 
492.19 	fees under section 151.066.
492.20 	(c) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
492.21 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
492.22 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
492.23 	(d) After the appropriations in paragraphs (a) to (c) are made, 50 percent of the remaining 
492.24 	amount is appropriated to the commissioner of human services for distribution to county 
492.25 	social service and tribal social service agencies to provide child protection services to 
492.26 	children and families who are affected by addiction. The commissioner shall distribute this 
492.27 	money proportionally to counties and tribal social service agencies based on out-of-home 
492.28 	placement episodes where parental drug abuse is the primary reason for the out-of-home 
492.29 	placement using data from the previous calendar year. County and tribal social service 
492.30 	agencies receiving funds from the opiate epidemic response fund must annually report to 
492.31 	the commissioner on how the funds were used to provide child protection services, including 
492.32 	measurable outcomes, as determined by the commissioner. County social service agencies 
492.33 	and tribal social service agencies must not use funds received under this paragraph to supplant 
493.1 	current state or local funding received for child protection services for children and families 
493.2 	who are affected by addiction.
493.3 	(e) After making the appropriations in paragraphs (a) to (d), the remaining amount in 
493.4 	the fund is appropriated to the commissioner to award grants as specified by the Opiate 
493.5 	Epidemic Response Advisory Council in accordance with section 256.042, unless otherwise 
493.6 	appropriated by the legislature.
493.7 	(f) Beginning in fiscal year 2022 and each year thereafter, funds for county social service 
493.8 	and tribal social service agencies under paragraph (d) and grant funds specified by the Opiate 
493.9 	Epidemic Response Advisory Council under paragraph (e) shall be distributed on a calendar 
493.10 	year basis.

493.11 	Sec. 19. Minnesota Statutes 2020, section 256B.0625, subdivision 5m, is amended to read:
493.12 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
493.13 	assistance covers certified community behavioral health clinic (CCBHC) services that meet 
493.14 	the requirements of section 245.735, subdivision 3.
493.15 	(b) The commissioner shall establish standards and methodologies for areimburse 
493.16 	CCBHCs on a per-visit basis under the prospective payment system for medical assistance 
493.17 	payments for services delivered by a CCBHC, in accordance with guidance issued by the 
493.18 	Centers for Medicare and Medicaid Services as described in paragraph (c). The commissioner 
493.19 	shall include a quality bonus incentive payment in the prospective payment system based 
493.20 	on federal criteria, as described in paragraph (e). There is no county share for medical 
493.21 	assistance services when reimbursed through the CCBHC prospective payment system.
493.22 	(c) Unless otherwise indicated in applicable federal requirements, the prospective payment 
493.23 	system must continue to be based on the federal instructions issued for the federal section 
493.24 	223 CCBHC demonstration, except: The commissioner shall ensure that the prospective 
493.25 	payment system for CCBHC payments under medical assistance meets the following 
493.26 	requirements:
493.27 	(1) the prospective payment rate shall be a provider-specific rate calculated for each 
493.28 	CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable 
493.29 	costs for CCBHCs divided by the total annual number of CCBHC visits. For calculating 
493.30 	the payment rate, total annual visits include visits covered by medical assistance and visits 
493.31 	not covered by medical assistance. Allowable costs include but are not limited to the salaries 
493.32 	and benefits of medical assistance providers; the cost of CCBHC services provided under 
494.1 	section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as 
494.2 	insurance or supplies needed to provide CCBHC services;
494.3 	(2) payment shall be limited to one payment per day per medical assistance enrollee for 
494.4 	each CCBHC visit eligible for reimbursement. A CCBHC visit is eligible for reimbursement 
494.5 	if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph 
494.6 	(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or 
494.7 	licensed agency employed by or under contract with a CCBHC;
494.8 	(3) new payment rates set by the commissioner for newly certified CCBHCs under 
494.9 	section 245.735, subdivision 3, shall be based on rates for established CCBHCs with a 
494.10 	similar scope of services. If no comparable CCBHC exists, the commissioner shall establish 
494.11 	a clinic-specific rate using audited historical cost report data adjusted for the estimated cost 
494.12 	of delivering CCBHC services, including the estimated cost of providing the full scope of 
494.13 	services and the projected change in visits resulting from the change in scope;
494.14 	(1) (4) the commissioner shall rebase CCBHC rates at least once every three years and 
494.15 	12 months following an initial rate or a rate change due to a change in the scope of services, 
494.16 	whichever is earlier;
494.17 	(2) (5) the commissioner shall provide for a 60-day appeals process after notice of the 
494.18 	results of the rebasing;
494.19 	(3) the prohibition against inclusion of new facilities in the demonstration does not apply 
494.20 	after the demonstration ends;
494.21 	(4) (6) the prospective payment rate under this section does not apply to services rendered 
494.22 	by CCBHCs to individuals who are dually eligible for Medicare and medical assistance 
494.23 	when Medicare is the primary payer for the service. An entity that receives a prospective 
494.24 	payment system rate that overlaps with the CCBHC rate is not eligible for the CCBHC rate;
494.25 	(5) (7) payments for CCBHC services to individuals enrolled in managed care shall be 
494.26 	coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall 
494.27 	complete the phase-out of CCBHC wrap payments within 60 days of the implementation 
494.28 	of the prospective payment system in the Medicaid Management Information System 
494.29 	(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments 
494.30 	due made payable to CCBHCs no later than 18 months thereafter;
494.31 	(6) initial prospective payment rates for CCBHCs certified after July 1, 2019, shall be 
494.32 	based on rates for comparable CCBHCs. If no comparable provider exists, the commissioner 
495.1 	shall compute a CCBHC-specific rate based upon the CCBHC's audited costs adjusted for 
495.2 	changes in the scope of services;
495.3 	(7) (8) the prospective payment rate for each CCBHC shall be adjusted annually updated
495.4 	by trending each provider-specific rate by the Medicare Economic Index as defined for the 
495.5 	federal section 223 CCBHC demonstration for primary care services. This update shall 
495.6 	occur each year in between rebasing periods determined by the commissioner in accordance 
495.7 	with clause (4). CCBHCs must provide data on costs and visits to the state annually using 
495.8 	the CCBHC cost report established by the commissioner; and
495.9 	(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of 
495.10 	services when such changes are expected to result in an adjustment to the CCBHC payment 
495.11 	rate by 2.5 percent or more. The CCBHC must provide the commissioner with information 
495.12 	regarding the changes in the scope of services, including the estimated cost of providing 
495.13 	the new or modified services and any projected increase or decrease in the number of visits 
495.14 	resulting from the change. Rate adjustments for changes in scope shall occur no more than 
495.15 	once per year in between rebasing periods per CCBHC and are effective on the date of the 
495.16 	annual CCBHC rate update.
495.17 	(8) the commissioner shall seek federal approval for a CCBHC rate methodology that 
495.18 	allows for rate modifications based on changes in scope for an individual CCBHC, including 
495.19 	for changes to the type, intensity, or duration of services. Upon federal approval, a CCBHC 
495.20 	may submit a change of scope request to the commissioner if the change in scope would 
495.21 	result in a change of 2.5 percent or more in the prospective payment system rate currently 
495.22 	received by the CCBHC. CCBHC change of scope requests must be according to a format 
495.23 	and timeline to be determined by the commissioner in consultation with CCBHCs.
495.24 	(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC 
495.25 	providers at the prospective payment rate. The commissioner shall monitor the effect of 
495.26 	this requirement on the rate of access to the services delivered by CCBHC providers. If, for 
495.27 	any contract year, federal approval is not received for this paragraph, the commissioner 
495.28 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
495.29 	plans for that contract year to reflect the removal of this provision. Contracts between 
495.30 	managed care plans and county-based purchasing plans and providers to whom this paragraph 
495.31 	applies must allow recovery of payments from those providers if capitation rates are adjusted 
495.32 	in accordance with this paragraph. Payment recoveries must not exceed the amount equal 
495.33 	to any increase in rates that results from this provision. This paragraph expires if federal 
495.34 	approval is not received for this paragraph at any time.
496.1 	(e) The commissioner shall implement a quality incentive payment program for CCBHCs 
496.2 	that meets the following requirements:
496.3 	(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric 
496.4 	thresholds for performance metrics established by the commissioner, in addition to payments 
496.5 	for which the CCBHC is eligible under the prospective payment system described in 
496.6 	paragraph (c);
496.7 	(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement 
496.8 	year to be eligible for incentive payments;
496.9 	(3) each CCBHC shall receive written notice of the criteria that must be met in order to 
496.10 	receive quality incentive payments at least 90 days prior to the measurement year; and
496.11 	(4) a CCBHC must provide the commissioner with data needed to determine incentive 
496.12 	payment eligibility within six months following the measurement year. The commissioner 
496.13 	shall notify CCBHC providers of their performance on the required measures and the 
496.14 	incentive payment amount within 12 months following the measurement year.
496.15 	(f) All claims to managed care plans for CCBHC services as provided under this section 
496.16 	shall be submitted directly to, and paid by, the commissioner on the dates specified no later 
496.17 	than January 1 of the following calendar year, if:
496.18 	(1) one or more managed care plans does not comply with the federal requirement for 
496.19 	payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42, 
496.20 	section 447.45(b), and the managed care plan does not resolve the payment issue within 30 
496.21 	days of noncompliance; and
496.22 	(2) the total amount of clean claims not paid in accordance with federal requirements 
496.23 	by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims 
496.24 	eligible for payment by managed care plans.
496.25 	If the conditions in this paragraph are met between January 1 and June 30 of a calendar 
496.26 	year, claims shall be submitted to and paid by the commissioner beginning on January 1 of 
496.27 	the following year. If the conditions in this paragraph are met between July 1 and December 
496.28 	31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning 
496.29 	on July 1 of the following year.

496.30 	Sec. 20. Minnesota Statutes 2020, section 256B.0625, subdivision 20, is amended to read:
496.31 		Subd. 20.Mental health case management. (a) To the extent authorized by rule of the 
496.32 	state agency, medical assistance covers case management services to persons with serious 
497.1 	and persistent mental illness and children with severe emotional disturbance. Services 
497.2 	provided under this section must meet the relevant standards in sections 245.461 to 245.4887, 
497.3 	the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 
497.4 	9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
497.5 	(b) Entities meeting program standards set out in rules governing family community 
497.6 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
497.7 	assistance reimbursement for case management services for children with severe emotional 
497.8 	disturbance when these services meet the program standards in Minnesota Rules, parts 
497.9 	9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
497.10 	(c) Medical assistance and MinnesotaCare payment for mental health case management 
497.11 	shall be made on a monthly basis. In order to receive payment for an eligible child, the 
497.12 	provider must document at least a face-to-face contact with the child, the child's parents, or 
497.13 	the child's legal representative. To receive payment for an eligible adult, the provider must 
497.14 	document:
497.15 	(1) at least a face-to-face contact with the adult or the adult's legal representative or a 
497.16 	contact by interactive video that meets the requirements of subdivision 20b; or
497.17 	(2) at least a telephone contact with the adult or the adult's legal representative and 
497.18 	document a face-to-face contact or a contact by interactive video that meets the requirements 
497.19 	of subdivision 20b with the adult or the adult's legal representative within the preceding 
497.20 	two months.
497.21 	(d) Payment for mental health case management provided by county or state staff shall 
497.22 	be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph 
497.23 	(b), with separate rates calculated for child welfare and mental health, and within mental 
497.24 	health, separate rates for children and adults.
497.25 	(e) Payment for mental health case management provided by Indian health services or 
497.26 	by agencies operated by Indian tribes may be made according to this section or other relevant 
497.27 	federally approved rate setting methodology.
497.28 	(f) Payment for mental health case management provided by vendors who contract with 
497.29 	a county or Indian tribe shall be based on a monthly rate negotiated by the host county or 
497.30 	tribe must be calculated in accordance with section 256B.076, subdivision 2. Payment for 
497.31 	mental health case management provided by vendors who contract with a Tribe must be 
497.32 	based on a monthly rate negotiated by the Tribe. The negotiated rate must not exceed the 
497.33 	rate charged by the vendor for the same service to other payers. If the service is provided 
497.34 	by a team of contracted vendors, the county or tribe may negotiate a team rate with a vendor 
498.1 	who is a member of the team. The team shall determine how to distribute the rate among 
498.2 	its members. No reimbursement received by contracted vendors shall be returned to the 
498.3 	county or tribe, except to reimburse the county or tribe for advance funding provided by 
498.4 	the county or tribe to the vendor.
498.5 	(g) If the service is provided by a team which includes contracted vendors, tribal staff, 
498.6 	and county or state staff, the costs for county or state staff participation in the team shall be 
498.7 	included in the rate for county-provided services. In this case, the contracted vendor, the 
498.8 	tribal agency, and the county may each receive separate payment for services provided by 
498.9 	each entity in the same month. In order to prevent duplication of services, each entity must 
498.10 	document, in the recipient's file, the need for team case management and a description of 
498.11 	the roles of the team members.
498.12 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
498.13 	mental health case management shall be provided by the recipient's county of responsibility, 
498.14 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
498.15 	used to match other federal funds. If the service is provided by a tribal agency, the nonfederal 
498.16 	share, if any, shall be provided by the recipient's tribe. When this service is paid by the state 
498.17 	without a federal share through fee-for-service, 50 percent of the cost shall be provided by 
498.18 	the recipient's county of responsibility.
498.19 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance 
498.20 	and MinnesotaCare include mental health case management. When the service is provided 
498.21 	through prepaid capitation, the nonfederal share is paid by the state and the county pays no 
498.22 	share.
498.23 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider 
498.24 	that does not meet the reporting or other requirements of this section. The county of 
498.25 	responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, 
498.26 	is responsible for any federal disallowances. The county or tribe may share this responsibility 
498.27 	with its contracted vendors.
498.28 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
498.29 	expenditures under this section to repay the special revenue maximization account under 
498.30 	section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
498.31 	(1) the costs of developing and implementing this section; and
498.32 	(2) programming the information systems.
499.1 	(l) Payments to counties and tribal agencies for case management expenditures under 
499.2 	this section shall only be made from federal earnings from services provided under this 
499.3 	section. When this service is paid by the state without a federal share through fee-for-service, 
499.4 	50 percent of the cost shall be provided by the state. Payments to county-contracted vendors 
499.5 	shall include the federal earnings, the state share, and the county share.
499.6 	(m) Case management services under this subdivision do not include therapy, treatment, 
499.7 	legal, or outreach services.
499.8 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
499.9 	and the recipient's institutional care is paid by medical assistance, payment for case 
499.10 	management services under this subdivision is limited to the lesser of:
499.11 	(1) the last 180 days of the recipient's residency in that facility and may not exceed more 
499.12 	than six months in a calendar year; or
499.13 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
499.14 	(o) Payment for case management services under this subdivision shall not duplicate 
499.15 	payments made under other program authorities for the same purpose.
499.16 	(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting 
499.17 	licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week, 
499.18 	mental health targeted case management services must actively support identification of 
499.19 	community alternatives for the recipient and discharge planning.

499.20 	Sec. 21. Minnesota Statutes 2020, section 256B.0759, subdivision 2, is amended to read:
499.21 		Subd. 2.Provider participation. (a) Outpatient substance use disorder treatment 
499.22 	providers may elect to participate in the demonstration project and meet the requirements 
499.23 	of subdivision 3. To participate, a provider must notify the commissioner of the provider's 
499.24 	intent to participate in a format required by the commissioner and enroll as a demonstration 
499.25 	project provider.
499.26 	(b) A program licensed by the Department of Human Services as a residential treatment 
499.27 	program according to section 245G.21 and that receives payment under this chapter must 
499.28 	enroll as a demonstration project provider and meet the requirements of subdivision 3 by 
499.29 	January 1, 2022. The commissioner may grant an extension, for a period not to exceed six 
499.30 	months, to a program that is unable to meet the requirements of subdivision 3 due to 
499.31 	demonstrated extraordinary circumstances. A program seeking an extension must apply in 
499.32 	a format approved by the commissioner by November 1, 2021. A program that does not 
500.1 	meet the requirements under this paragraph by July 1, 2023, is ineligible for payment for 
500.2 	services provided under sections 254B.05 and 256B.0625.
500.3 	(c) A program licensed by the Department of Human Services as a withdrawal 
500.4 	management program according to chapter 245F and that receives payment under this 
500.5 	chapter must enroll as a demonstration project provider and meet the requirements of 
500.6 	subdivision 3 by January 1, 2022. The commissioner may grant an extension, for a period 
500.7 	not to exceed six months, to a program that is unable to meet the requirements of subdivision 
500.8 	3 due to demonstrated extraordinary circumstances. A program seeking an extension must 
500.9 	apply in a format approved by the commissioner by November 1, 2021. A program that 
500.10 	does not meet the requirements under this paragraph by July 1, 2023, is ineligible for payment 
500.11 	for services provided under sections 254B.05 and 256B.0625.
500.12 	(d) An out-of-state residential substance use disorder treatment program that receives 
500.13 	payment under this chapter must enroll as a demonstration project provider and meet the 
500.14 	requirements of subdivision 3 by January 1, 2022. The commissioner may grant an extension, 
500.15 	for a period not to exceed six months, to a program that is unable to meet the requirements 
500.16 	of subdivision 3 due to demonstrated extraordinary circumstances. A program seeking an 
500.17 	extension must apply in a format approved by the commissioner by November 1, 2021. 
500.18 	Programs that do not meet the requirements under this paragraph by July 1, 2023, are 
500.19 	ineligible for payment for services provided under sections 254B.05 and 256B.0625.
500.20 	(e) Tribally licensed programs may elect to participate in the demonstration project and 
500.21 	meet the requirements of subdivision 3. The Department of Human Services must consult 
500.22 	with tribal nations to discuss participation in the substance use disorder demonstration 
500.23 	project.
500.24 	(f) All rate enhancements for services rendered by demonstration project providers that 
500.25 	voluntarily enrolled before July 1, 2021, are applicable only to dates of service on or after 
500.26 	the effective date of the provider's enrollment in the demonstration project, except as 
500.27 	authorized under paragraph (g). The commissioner shall recoup any rate enhancements paid 
500.28 	under paragraph (g) to a provider that does not meet the requirements of subdivision 3 by 
500.29 	July 1, 2021.
500.30 	(g) The commissioner may allow providers enrolled in the demonstration project before 
500.31 	July 1, 2021, to receive applicable rate enhancements authorized under subdivision 4 for 
500.32 	services provided to fee-for-service enrollees on dates of service no earlier than July 22, 
500.33 	2020, and to managed care enrollees on dates of service no earlier than January 1, 2021, if:
501.1 	(1) the provider attests that during the time period for which it is seeking the rate 
501.2 	enhancement, it was taking meaningful steps and had a reasonable plan approved by the 
501.3 	commissioner to meet the demonstration project requirements in subdivision 3;
501.4 	(2) the provider submits the attestation and evidence of meeting the requirements of 
501.5 	subdivision 3, including all information requested by the commissioner, in a format specified 
501.6 	by the commissioner; and
501.7 	(3) the commissioner received the provider's application for enrollment on or before 
501.8 	June 1, 2021.

501.9 	EFFECTIVE DATE. This section is effective July 1, 2021, or upon federal approval, 
501.10 	whichever is later, except paragraphs (f) and (g) are effective the day following final 
501.11 	enactment.

501.12 	Sec. 22. Minnesota Statutes 2020, section 256B.0759, subdivision 4, is amended to read:
501.13 		Subd. 4.Provider payment rates. (a) Payment rates for participating providers must 
501.14 	be increased for services provided to medical assistance enrollees. To receive a rate increase, 
501.15 	participating providers must meet demonstration project requirements, provider standards 
501.16 	under subdivision 3, and provide evidence of formal referral arrangements with providers 
501.17 	delivering step-up or step-down levels of care.
501.18 	(b) The commissioner may temporarily suspend payments to the provider according to 
501.19 	section 256B.04, subdivision 21, paragraph (d), if the requirements in paragraph (a) are not 
501.20 	met. Payments withheld from the provider must be made once the commissioner determines 
501.21 	that the requirements in paragraph (a) are met.
501.22 	(b) (c) For substance use disorder services under section 254B.05, subdivision 5, 
501.23 	paragraph (b), clause (8), provided on or after July 1, 2020, payment rates must be increased 
501.24 	by 15 30 percent over the rates in effect on December 31, 2019.
501.25 	(c) (d) For substance use disorder services under section 254B.05, subdivision 5, 
501.26 	paragraph (b), clauses (1), (6), and (7), and adolescent treatment programs that are licensed 
501.27 	as outpatient treatment programs according to sections 245G.01 to 245G.18, provided on 
501.28 	or after January 1, 2021, payment rates must be increased by ten 25 percent over the rates 
501.29 	in effect on December 31, 2020.
501.30 	(d) (e) Effective January 1, 2021, and contingent on annual federal approval, managed 
501.31 	care plans and county-based purchasing plans must reimburse providers of the substance 
501.32 	use disorder services meeting the criteria described in paragraph (a) who are employed by 
501.33 	or under contract with the plan an amount that is at least equal to the fee-for-service base 
502.1 	rate payment for the substance use disorder services described in paragraphs (b) (c) and (c)
502.2 	(d). The commissioner must monitor the effect of this requirement on the rate of access to 
502.3 	substance use disorder services and residential substance use disorder rates. Capitation rates 
502.4 	paid to managed care organizations and county-based purchasing plans must reflect the 
502.5 	impact of this requirement. This paragraph expires if federal approval is not received at any 
502.6 	time as required under this paragraph.
502.7 	(e) (f) Effective July 1, 2021, contracts between managed care plans and county-based 
502.8 	purchasing plans and providers to whom paragraph (d) (e) applies must allow recovery of 
502.9 	payments from those providers if, for any contract year, federal approval for the provisions 
502.10 	of paragraph (d) (e) is not received, and capitation rates are adjusted as a result. Payment 
502.11 	recoveries must not exceed the amount equal to any decrease in rates that results from this 
502.12 	provision.

502.13 	EFFECTIVE DATE. This section is effective July 1, 2021, except the amendments to 
502.14 	the payment rate percentage increases in paragraphs (c) and (d) are effective January 1, 
502.15 	2022.

502.16 	Sec. 23. Minnesota Statutes 2020, section 256B.0759, is amended by adding a subdivision 
502.17 	to read:
502.18 		Subd. 6.Data and outcome measures; public posting. Beginning July 1, 2021, and at 
502.19 	least annually thereafter, all data and outcome measures from the previous year of the 
502.20 	demonstration project shall be posted publicly on the Department of Human Services website 
502.21 	in an accessible and user-friendly format.

502.22 	EFFECTIVE DATE. This section is effective July 1, 2021.

502.23 	Sec. 24. Minnesota Statutes 2020, section 256B.0759, is amended by adding a subdivision 
502.24 	to read:
502.25 		Subd. 7.Federal approval; demonstration project extension. The commissioner shall 
502.26 	seek a five-year extension of the demonstration project under this section and to receive 
502.27 	enhanced federal financial participation.

502.28 	EFFECTIVE DATE. This section is effective July 1, 2021.

503.1 	Sec. 25. Minnesota Statutes 2020, section 256B.0759, is amended by adding a subdivision 
503.2 	to read:
503.3 		Subd. 8.Demonstration project evaluation work group. Beginning October 1, 2021, 
503.4 	the commissioner shall assemble a work group of relevant stakeholders, including but not 
503.5 	limited to demonstration project participants and the Minnesota Association of Resources 
503.6 	for Recovery and Chemical Health, that shall meet quarterly for the duration of the 
503.7 	demonstration to evaluate the long-term sustainability of any improvements to quality or 
503.8 	access to substance use disorder treatment services caused by participation in the 
503.9 	demonstration project. The work group shall also determine how to implement successful 
503.10 	outcomes of the demonstration project once the project expires.

503.11 	EFFECTIVE DATE. This section is effective July 1, 2021.

503.12 	Sec. 26. [256B.076] CASE MANAGEMENT SERVICES.
503.13 		Subdivision 1.Generally. (a) It is the policy of this state to ensure that individuals on 
503.14 	medical assistance receive cost-effective and coordinated care, including efforts to address 
503.15 	the profound effects of housing instability, food insecurity, and other social determinants 
503.16 	of health. Therefore, subject to federal approval, medical assistance covers targeted case 
503.17 	management services as described in this section.
503.18 	(b) The commissioner, in collaboration with tribes, counties, providers, and individuals 
503.19 	served, must propose further modifications to targeted case management services to ensure 
503.20 	a program that complies with all federal requirements, delivers services in a cost-effective 
503.21 	and efficient manner, creates uniform expectations for targeted case management services, 
503.22 	addresses health disparities, and promotes person- and family-centered services.
503.23 		Subd. 2.Rate setting. (a) The commissioner must develop and implement a statewide 
503.24 	rate methodology for any county that subcontracts targeted case management services to a 
503.25 	vendor. On January 1, 2022, or upon federal approval, whichever is later, a county must 
503.26 	use this methodology for any targeted case management services paid by medical assistance 
503.27 	and delivered through a subcontractor.
503.28 	(b) In setting this rate, the commissioner must include the following:
503.29 	(1) prevailing wages;
503.30 	(2) employee-related expense factor;
503.31 	(3) paid time off and training factors;
503.32 	(4) supervision and span of control;
504.1 	(5) distribution of time factor;
504.2 	(6) administrative factor;
504.3 	(7) absence factor;
504.4 	(8) program support factor; and
504.5 	(9) caseload sizes as described in subdivision 3.
504.6 	(c) A county may request that the commissioner authorize a rate based on a lower caseload 
504.7 	size when a subcontractor is assigned to serve individuals with needs, such as homelessness 
504.8 	or specific linguistic or cultural needs, that significantly exceed other eligible populations. 
504.9 	A county must include the following in the request:
504.10 	(1) the number of clients to be served by a full-time equivalent staffer;
504.11 	(2) the specific factors that require a case manager to provide significantly more hours 
504.12 	of reimbursable services to a client; and
504.13 	(3) how the county intends to monitor case size and outcomes.
504.14 	(d) The commissioner must adjust only the factor for caseload in paragraph (b), clause 
504.15 	(9), in response to a request under paragraph (c).
504.16 		Subd. 3.Caseload sizes. A county-subcontracted provider of targeted case management 
504.17 	services to the following populations must not exceed the following limits:
504.18 	(1) for children with severe emotional disturbance, 15 clients to one full-time equivalent 
504.19 	case manager;
504.20 	(2) for adults with severe and persistent mental illness, 30 clients to one full-time 
504.21 	equivalent case manager;
504.22 	(3) for child welfare targeted case management, 25 clients to one full-time equivalent 
504.23 	case manager; and
504.24 	(4) for vulnerable adults and adults who have developmental disabilities, 45 clients to 
504.25 	one full-time equivalent case manager.

504.26 	Sec. 27. Minnesota Statutes 2020, section 256B.0924, subdivision 6, is amended to read:
504.27 		Subd. 6.Payment for targeted case management. (a) Medical assistance and 
504.28 	MinnesotaCare payment for targeted case management shall be made on a monthly basis. 
504.29 	In order to receive payment for an eligible adult, the provider must document at least one 
504.30 	contact per month and not more than two consecutive months without a face-to-face contact 
505.1 	with the adult or the adult's legal representative, family, primary caregiver, or other relevant 
505.2 	persons identified as necessary to the development or implementation of the goals of the 
505.3 	personal service plan.
505.4 	(b) Payment for targeted case management provided by county staff under this subdivision 
505.5 	shall be based on the monthly rate methodology under section 256B.094, subdivision 6, 
505.6 	paragraph (b), calculated as one combined average rate together with adult mental health 
505.7 	case management under section 256B.0625, subdivision 20, except for calendar year 2002. 
505.8 	In calendar year 2002, the rate for case management under this section shall be the same as 
505.9 	the rate for adult mental health case management in effect as of December 31, 2001. Billing 
505.10 	and payment must identify the recipient's primary population group to allow tracking of 
505.11 	revenues.
505.12 	(c) Payment for targeted case management provided by county-contracted vendors shall 
505.13 	be based on a monthly rate negotiated by the host county calculated in accordance with 
505.14 	section 256B.076, subdivision 2. The negotiated rate must not exceed the rate charged by 
505.15 	the vendor for the same service to other payers. If the service is provided by a team of 
505.16 	contracted vendors, the county may negotiate a team rate with a vendor who is a member 
505.17 	of the team. The team shall determine how to distribute the rate among its members. No 
505.18 	reimbursement received by contracted vendors shall be returned to the county, except to 
505.19 	reimburse the county for advance funding provided by the county to the vendor.
505.20 	(d) If the service is provided by a team that includes contracted vendors and county staff, 
505.21 	the costs for county staff participation on the team shall be included in the rate for 
505.22 	county-provided services. In this case, the contracted vendor and the county may each 
505.23 	receive separate payment for services provided by each entity in the same month. In order 
505.24 	to prevent duplication of services, the county must document, in the recipient's file, the need 
505.25 	for team targeted case management and a description of the different roles of the team 
505.26 	members.
505.27 	(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
505.28 	targeted case management shall be provided by the recipient's county of responsibility, as 
505.29 	defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
505.30 	used to match other federal funds.
505.31 	(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider 
505.32 	that does not meet the reporting or other requirements of this section. The county of 
505.33 	responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal 
505.34 	disallowances. The county may share this responsibility with its contracted vendors.
506.1 	(g) The commissioner shall set aside five percent of the federal funds received under 
506.2 	this section for use in reimbursing the state for costs of developing and implementing this 
506.3 	section.
506.4 	(h) Payments to counties for targeted case management expenditures under this section 
506.5 	shall only be made from federal earnings from services provided under this section. Payments 
506.6 	to contracted vendors shall include both the federal earnings and the county share.
506.7 	(i) Notwithstanding section 256B.041, county payments for the cost of case management 
506.8 	services provided by county staff shall not be made to the commissioner of management 
506.9 	and budget. For the purposes of targeted case management services provided by county 
506.10 	staff under this section, the centralized disbursement of payments to counties under section 
506.11 	256B.041 consists only of federal earnings from services provided under this section.
506.12 	(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
506.13 	and the recipient's institutional care is paid by medical assistance, payment for targeted case 
506.14 	management services under this subdivision is limited to the lesser of:
506.15 	(1) the last 180 days of the recipient's residency in that facility; or
506.16 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
506.17 	(k) Payment for targeted case management services under this subdivision shall not 
506.18 	duplicate payments made under other program authorities for the same purpose.
506.19 	(l) Any growth in targeted case management services and cost increases under this 
506.20 	section shall be the responsibility of the counties.

506.21 	Sec. 28. Minnesota Statutes 2020, section 256B.094, subdivision 6, is amended to read:
506.22 		Subd. 6.Medical assistance reimbursement of case management services. (a) Medical 
506.23 	assistance reimbursement for services under this section shall be made on a monthly basis. 
506.24 	Payment is based on face-to-face or telephone contacts between the case manager and the 
506.25 	client, client's family, primary caregiver, legal representative, or other relevant person 
506.26 	identified as necessary to the development or implementation of the goals of the individual 
506.27 	service plan regarding the status of the client, the individual service plan, or the goals for 
506.28 	the client. These contacts must meet the minimum standards in clauses (1) and (2):
506.29 	(1) there must be a face-to-face contact at least once a month except as provided in clause 
506.30 	(2); and
506.31 	(2) for a client placed outside of the county of financial responsibility, or a client served 
506.32 	by tribal social services placed outside the reservation, in an excluded time facility under 
507.1 	section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of 
507.2 	Children, section 260.93, and the placement in either case is more than 60 miles beyond 
507.3 	the county or reservation boundaries, there must be at least one contact per month and not 
507.4 	more than two consecutive months without a face-to-face contact.
507.5 	(b) Except as provided under paragraph (c), the payment rate is established using time 
507.6 	study data on activities of provider service staff and reports required under sections 245.482
507.7 	and 256.01, subdivision 2, paragraph (p).
507.8 	(c) Payments for tribes may be made according to section 256B.0625 or other relevant 
507.9 	federally approved rate setting methodology for child welfare targeted case management 
507.10 	provided by Indian health services and facilities operated by a tribe or tribal organization.
507.11 	(d) Payment for case management provided by county or tribal social services contracted 
507.12 	vendors shall be based on a monthly rate negotiated by the host county or tribal social 
507.13 	services must be calculated in accordance with section 256B.076, subdivision 2. Payment 
507.14 	for case management provided by vendors who contract with a Tribe must be based on a 
507.15 	monthly rate negotiated by the Tribe. The negotiated rate must not exceed the rate charged 
507.16 	by the vendor for the same service to other payers. If the service is provided by a team of 
507.17 	contracted vendors, the county or tribal social services may negotiate a team rate with a 
507.18 	vendor who is a member of the team. The team shall determine how to distribute the rate 
507.19 	among its members. No reimbursement received by contracted vendors shall be returned 
507.20 	to the county or tribal social services, except to reimburse the county or tribal social services 
507.21 	for advance funding provided by the county or tribal social services to the vendor.
507.22 	(e) If the service is provided by a team that includes contracted vendors and county or 
507.23 	tribal social services staff, the costs for county or tribal social services staff participation in 
507.24 	the team shall be included in the rate for county or tribal social services provided services. 
507.25 	In this case, the contracted vendor and the county or tribal social services may each receive 
507.26 	separate payment for services provided by each entity in the same month. To prevent 
507.27 	duplication of services, each entity must document, in the recipient's file, the need for team 
507.28 	case management and a description of the roles and services of the team members.
507.29 	Separate payment rates may be established for different groups of providers to maximize 
507.30 	reimbursement as determined by the commissioner. The payment rate will be reviewed 
507.31 	annually and revised periodically to be consistent with the most recent time study and other 
507.32 	data. Payment for services will be made upon submission of a valid claim and verification 
507.33 	of proper documentation described in subdivision 7. Federal administrative revenue earned 
507.34 	through the time study, or under paragraph (c), shall be distributed according to earnings, 
508.1 	to counties, reservations, or groups of counties or reservations which have the same payment 
508.2 	rate under this subdivision, and to the group of counties or reservations which are not 
508.3 	certified providers under section 256F.10. The commissioner shall modify the requirements 
508.4 	set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish this.

508.5 	Sec. 29. DIRECTION TO THE COMMISSIONER; ADULT MENTAL HEALTH 
508.6 	INITIATIVES REFORM.
 508.7 	In establishing a legislative proposal for reforming the funding formula to distribute 
508.8 	adult mental health initiative funds, the commissioner of human services shall ensure that 
508.9 	funding currently received as a result of the closure of the Moose Lake Regional Treatment 
508.10 	Center is not reallocated from any region that does not have a community behavioral health 
508.11 	hospital. Upon finalization of the adult mental health initiatives reform, the commissioner 
508.12 	shall notify the chairs and ranking minority members of the legislative committees with 
508.13 	jurisdiction over health and human services finance and policy.

508.14 	Sec. 30. DIRECTION TO THE COMMISSIONER; ALTERNATIVE MENTAL 
508.15 	HEALTH PROFESSIONAL LICENSING PATHWAYS WORK GROUP.
 508.16 	(a) The commissioners of human services and health must convene a work group 
508.17 	consisting of representatives from the Board of Psychology; the Board of Marriage and 
508.18 	Family Therapy; the Board of Social Work; the Board of Behavioral Health and Therapy; 
508.19 	five mental health providers from diverse cultural communities; a representative from the 
508.20 	Minnesota Council of Health Plans; a representative from a state health care program; two 
508.21 	representatives from mental health associations or community mental health clinics led by 
508.22 	individuals who are Black, indigenous, or people of color; and representatives from mental 
508.23 	health professional graduate programs to evaluate and make recommendations on possible 
508.24 	alternative pathways to mental health professional licensure in Minnesota. The work group 
508.25 	must:
508.26 	(1) identify barriers to licensure in mental health professions;
508.27 	(2) collect data on the number of individuals graduating from educational programs but 
508.28 	not passing licensing exams;
508.29 	(3) evaluate the feasibility of alternative pathways for licensure in mental health 
508.30 	professions, ensuring provider competency and professionalism; and
508.31 	(4) consult with national behavioral health testing entities.
509.1 	(b) Mental health providers participating in the work group may be reimbursed for 
509.2 	expenses in the same manner as authorized by the commissioner's plan adopted under 
509.3 	Minnesota Statutes, section 43A.18, subdivision 2, upon approval by the commissioner. 
509.4 	Members who, as a result of time spent attending work group meetings, incur child care 
509.5 	expenses that would not otherwise have been incurred, may be reimbursed for those expenses 
509.6 	upon approval by the commissioner. Reimbursements may be approved for no more than 
509.7 	five individual providers.
509.8 	(c) No later than February 1, 2023, the commissioners must submit a written report to 
509.9 	the members of the legislative committees with jurisdiction over health and human services 
509.10 	on the work group's findings and recommendations developed on alternative licensing 
509.11 	pathways.

509.12 	Sec. 31. DIRECTION TO THE COMMISSIONER; CHILDREN'S MENTAL 
509.13 	HEALTH RESIDENTIAL TREATMENT WORK GROUP.
 509.14 	The commissioner of human services, in consultation with counties, children's mental 
509.15 	health residential providers, and children's mental health advocates, must organize a work 
509.16 	group and develop recommendations on how to efficiently and effectively fund room and 
509.17 	board costs for children's mental health residential treatment under the children's mental 
509.18 	health act. The work group may also provide recommendations on how to address systemic 
509.19 	barriers in transitioning children into the community and community-based treatment options. 
509.20 	The commissioner shall submit the recommendations to the chairs and ranking minority 
509.21 	members of the legislative committees with jurisdiction over health and human services 
509.22 	policy and finance by February 15, 2022.

509.23 	Sec. 32. DIRECTION TO THE COMMISSIONER; CULTURALLY AND 
509.24 	LINGUISTICALLY APPROPRIATE SERVICES.
 509.25 	The commissioner of human services, in consultation with substance use disorder 
509.26 	treatment providers, lead agencies, and individuals who receive substance use disorder 
509.27 	treatment services, shall develop a statewide implementation and transition plan for culturally 
509.28 	and linguistically appropriate services (CLAS) national standards, including technical 
509.29 	assistance for providers to transition to the CLAS standards and to improve disparate 
509.30 	treatment outcomes. The commissioner must consult with individuals who are Black, 
509.31 	indigenous, people of color, and linguistically diverse in the development of the 
509.32 	implementation and transition plans under this section.

510.1 	Sec. 33. DIRECTION TO THE COMMISSIONER; RATE RECOMMENDATIONS 
510.2 	FOR OPIOID TREATMENT PROGRAMS.
 510.3 	The commissioner of human services shall evaluate the rate structure for opioid treatment 
510.4 	programs licensed under Minnesota Statutes, section 245G.22, and report recommendations, 
510.5 	including a revised rate structure and proposed draft legislation, to the chairs and ranking 
510.6 	minority members of the legislative committees with jurisdiction over human services policy 
510.7 	and finance by October 1, 2021.

510.8 	Sec. 34. DIRECTION TO THE COMMISSIONER; SOBER HOUSING PROGRAM 
510.9 	RECOMMENDATIONS.
 510.10 	(a) The commissioner of human services, in consultation with stakeholders, must develop 
510.11 	recommendations on:
510.12 	(1) increasing access to sober housing programs;
510.13 	(2) promoting person-centered practices and cultural responsiveness in sober housing 
510.14 	programs;
510.15 	(3) potential oversight of sober housing programs; and
510.16 	(4) providing consumer protections for individuals in sober housing programs with 
510.17 	substance use disorders and individuals with co-occurring mental illnesses.
510.18 	(b) Stakeholders include but are not limited to the Minnesota Association of Sober 
510.19 	Homes, the Minnesota Association of Resources for Recovery and Chemical Health, 
510.20 	Minnesota Recovery Connection, NAMI Minnesota, the National Alliance of Recovery 
510.21 	Residencies (NARR), Oxford Houses, Inc., sober housing programs based in Minnesota 
510.22 	that are not members of the Minnesota Association of Sober Homes, a member of Alcoholics 
510.23 	Anonymous, and residents and former residents of sober housing programs based in 
510.24 	Minnesota. Stakeholders must equitably represent various geographic areas of the state and 
510.25 	must include individuals in recovery and providers representing Black, indigenous, people 
510.26 	of color, or immigrant communities.
510.27 	(c) The commissioner must complete and submit a report on these recommendations to 
510.28 	the chairs and ranking minority members of the legislative committees with jurisdiction 
510.29 	over health and human services policy and finance on or before March 1, 2022.

511.1 	Sec. 35. DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER 
511.2 	TREATMENT PAPERWORK REDUCTION.
 511.3 	(a) The commissioner of human services, in consultation with counties, tribes, managed 
511.4 	care organizations, substance use disorder treatment professional associations, and other 
511.5 	relevant stakeholders, shall develop, assess, and recommend systems improvements to 
511.6 	minimize regulatory paperwork and improve systems for substance use disorder programs 
511.7 	licensed under Minnesota Statutes, chapter 245A, and regulated under Minnesota Statutes, 
511.8 	chapters 245F and 245G, and Minnesota Rules, chapters 2960 and 9530. The commissioner 
511.9 	of human services shall make available any resources needed from other divisions within 
511.10 	the department to implement systems improvements.
511.11 	(b) The commissioner of health shall make available needed information and resources 
511.12 	from the Division of Health Policy.
511.13 	(c) The Office of MN.IT Services shall provide advance consultation and implementation 
511.14 	of the changes needed in data systems.
511.15 	(d) The commissioner of human services shall contract with a vendor that has experience 
511.16 	with developing statewide system changes for multiple states at the payer and provider 
511.17 	levels. If the commissioner, after exercising reasonable diligence, is unable to secure a 
511.18 	vendor with the requisite qualifications, then the commissioner may select the best qualified 
511.19 	vendor available. When developing recommendations, the commissioner shall consider 
511.20 	input from all stakeholders. The commissioner's recommendations shall maximize benefits 
511.21 	for clients and utility for providers, regulatory agencies, and payers.
511.22 	(e) The commissioner of human services and contracted vendor shall follow the 
511.23 	recommendations from the report issued in response to Laws 2019, First Special Session 
511.24 	chapter 9, article 6, section 76.
511.25 	(f) By December 15, 2022, the commissioner of human services shall take steps to 
511.26 	implement paperwork reductions and systems improvements within the commissioner's 
511.27 	authority and submit to the chairs and ranking minority members of the legislative committees 
511.28 	with jurisdiction over health and human services a report that includes recommendations 
511.29 	for changes in statutes that would further enhance systems improvements to reduce 
511.30 	paperwork. The report shall include a summary of the approaches developed and assessed 
511.31 	by the commissioner of human services and stakeholders and the results of any assessments 
511.32 	conducted.

512.1 	Sec. 36. DIRECTION TO THE COMMISSIONER; TRIBAL OVERPAYMENT 
512.2 	PROTOCOLS.
 512.3 	The commissioner of human services, in consultation with the Tribal nations, shall 
512.4 	develop protocols that must be used to address and attempt to resolve any future overpayment 
512.5 	involving any Tribal nation in Minnesota.

512.6 	Sec. 37. SUBSTANCE USE DISORDER TREATMENT RATE RESTRUCTURE 
512.7 	ANALYSIS.
 512.8 	(a) By January 1, 2022, the commissioner shall issue a request for proposals for 
512.9 	frameworks and modeling of substance use disorder rates. Rates must be predicated on a 
512.10 	uniform methodology that is transparent, culturally responsive, supports staffing needed to 
512.11 	treat a patient's assessed need, and promotes quality service delivery and patient choice. 
512.12 	The commissioner must consult with substance use disorder treatment programs across the 
512.13 	spectrum of services, substance use disorder treatment programs from across each region 
512.14 	of the state, and culturally responsive providers in the development of the request for proposal 
512.15 	process and for the duration of the contract.
512.16 	(b) By January 15, 2023, the commissioner of human services shall submit a report to 
512.17 	the chairs and ranking minority members of the legislative committees with jurisdiction 
512.18 	over human services policy and finance on the results of the vendor's work. The report must 
512.19 	include legislative language necessary to implement a new substance use disorder treatment 
512.20 	rate methodology and a detailed fiscal analysis.

512.21 	Sec. 38. REVISOR INSTRUCTION.
 512.22 	The revisor of statutes shall replace "EXCELLENCE IN MENTAL HEALTH 
512.23 	DEMONSTRATION PROJECT" with "CERTIFIED COMMUNITY BEHAVIORAL 
512.24 	HEALTH CLINIC SERVICES" in the section headnote for Minnesota Statutes, section 
512.25 	245.735.

512.26 	Sec. 39. REPEALER.
 512.27 	(a) Minnesota Statutes 2020, section 256B.0596, is repealed.
512.28 	(b) Minnesota Statutes 2020, section 245.735, subdivisions 1, 2, and 4, are repealed.
512.29 	(c) Minnesota Statutes 2020, section 245.4871, subdivision 32a, is repealed.

512.30 	EFFECTIVE DATE. Paragraph (c) is effective September 30, 2021.

513.1 	ARTICLE 13
513.2 	DIRECT CARE AND TREATMENT

513.3 	Section 1. Minnesota Statutes 2020, section 246.54, subdivision 1b, is amended to read:
513.4 		Subd. 1b.Community behavioral health hospitals. A county's payment of the cost of 
513.5 	care provided at state-operated community-based behavioral health hospitals for adults and 
513.6 	children shall be according to the following schedule:
513.7 	(1) 100 percent for each day during the stay, including the day of admission, when the 
513.8 	facility determines that it is clinically appropriate for the client to be discharged; and
513.9 	(2) the county shall not be entitled to reimbursement from the client, the client's estate, 
513.10 	or from the client's relatives, except as provided in section 246.53.

513.11 	ARTICLE 14
513.12 	DISABILITY SERVICES AND CONTINUING CARE FOR OLDER ADULTS

513.13 	Section 1. Minnesota Statutes 2020, section 144.0724, subdivision 4, is amended to read:
513.14 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and electronically 
513.15 	submit to the commissioner of health federal database MDS assessments that conform with 
513.16 	the assessment schedule defined by Code of Federal Regulations, title 42, section 483.20, 
513.17 	and published by the United States Department of Health and Human Services, Centers for 
513.18 	Medicare and Medicaid Services, in the Long Term Care Facility Resident Assessment 
513.19 	Instrument User's Manual, version 3.0, and subsequent updates when or its successor issued 
513.20 	by the Centers for Medicare and Medicaid Services. The commissioner of health may 
513.21 	substitute successor manuals or question and answer documents published by the United 
513.22 	States Department of Health and Human Services, Centers for Medicare and Medicaid 
513.23 	Services, to replace or supplement the current version of the manual or document.
513.24 	(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987 
513.25 	(OBRA) used to determine a case mix classification for reimbursement include the following:
513.26 	(1) a new admission comprehensive assessment, which must have an assessment reference 
513.27 	date (ARD) within 14 calendar days after admission, excluding readmissions;
513.28 	(2) an annual comprehensive assessment, which must have an assessment reference date 
513.29 	(ARD) ARD within 92 days of the a previous quarterly review assessment and the or a
513.30 	previous comprehensive assessment, which must occur at least once every 366 days;
513.31 	(3) a significant change in status comprehensive assessment, which must be completed
513.32 	have an ARD within 14 days of the identification of after the facility determines, or should 
514.1 	have determined, that there has been a significant change in the resident's physical or mental 
514.2 	condition, whether an improvement or a decline, and regardless of the amount of time since 
514.3 	the last significant change in status comprehensive assessment or quarterly review 
514.4 	assessment;
514.5 	(4) all a quarterly assessments review assessment must have an assessment reference 
514.6 	date (ARD) ARD within 92 days of the ARD of the previous quarterly review assessment 
514.7 	or a previous comprehensive assessment;
514.8 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
514.9 	being corrected is the current one being used for RUG classification; and
514.10 	(6) any significant correction to a prior quarterly review assessment, if the assessment 
514.11 	being corrected is the current one being used for RUG classification.;
514.12 	(7) a required significant change in status assessment when:
514.13 	(i) all speech, occupational, and physical therapies have ended. The ARD of this 
514.14 	assessment must be set on day eight after all therapy services have ended; and
514.15 	(ii) isolation for an infectious disease has ended. The ARD of this assessment must be 
514.16 	set on day 15 after isolation has ended; and
514.17 	(8) any modifications to the most recent assessments under clauses (1) to (7).
514.18 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
514.19 	determine nursing facility level of care include the following:
514.20 	(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by 
514.21 	the Senior LinkAge Line or other organization under contract with the Minnesota Board on 
514.22 	Aging; and
514.23 	(2) a nursing facility level of care determination as provided for under section 256B.0911, 
514.24 	subdivision 4e, as part of a face-to-face long-term care consultation assessment completed 
514.25 	under section 256B.0911, by a county, tribe, or managed care organization under contract 
514.26 	with the Department of Human Services.

514.27 	Sec. 2. Minnesota Statutes 2020, section 245A.03, subdivision 7, is amended to read:
514.28 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
514.29 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
514.30 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
514.31 	for a physical location that will not be the primary residence of the license holder for the 
514.32 	entire period of licensure. If a license is issued during this moratorium, and the license 
515.1 	holder changes the license holder's primary residence away from the physical location of 
515.2 	the foster care license, the commissioner shall revoke the license according to section 
515.3 	245A.07. The commissioner shall not issue an initial license for a community residential 
515.4 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
515.5 	the commissioner shall consider the resource need determination process in paragraph (h), 
515.6 	the availability of foster care licensed beds in the geographic area in which the licensee 
515.7 	seeks to operate, the results of a person's choices during their annual assessment and service 
515.8 	plan review, and the recommendation of the local county board. The determination by the 
515.9 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
515.10 	(1) foster care settings that are required to be registered under chapter 144D;
515.11 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
515.12 	community residential setting licenses replacing adult foster care licenses in existence on 
515.13 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
515.14 	(b);
515.15 	(3) new foster care licenses or community residential setting licenses determined to be 
515.16 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
515.17 	or regional treatment center; restructuring of state-operated services that limits the capacity 
515.18 	of state-operated facilities; or allowing movement to the community for people who no 
515.19 	longer require the level of care provided in state-operated facilities as provided under section 
515.20 	256B.092, subdivision 13, or 256B.49, subdivision 24;
515.21 	(4) new foster care licenses or community residential setting licenses determined to be 
515.22 	needed by the commissioner under paragraph (b) for persons requiring hospital level care; 
515.23 	or
515.24 	(5) new foster care licenses or community residential setting licenses for people receiving 
515.25 	services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and 
515.26 	for which a license is required. This exception does not apply to people living in their own 
515.27 	home. For purposes of this clause, there is a presumption that a foster care or community 
515.28 	residential setting license is required for services provided to three or more people in a 
515.29 	dwelling unit when the setting is controlled by the provider. A license holder subject to this 
515.30 	exception may rebut the presumption that a license is required by seeking a reconsideration 
515.31 	of the commissioner's determination. The commissioner's disposition of a request for 
515.32 	reconsideration is final and not subject to appeal under chapter 14. The exception is available 
515.33 	until June 30, 2018. This exception is available when:
516.1 	(i) the person's case manager provided the person with information about the choice of 
516.2 	service, service provider, and location of service, including in the person's home, to help 
516.3 	the person make an informed choice; and
516.4 	(ii) the person's services provided in the licensed foster care or community residential 
516.5 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
516.6 	setting as determined by the lead agency.; or
516.7 	(6) new foster care licenses or community residential setting licenses for people receiving 
516.8 	customized living or 24-hour customized living services under the brain injury or community 
516.9 	access for disability inclusion waiver plans under section 256B.49 and residing in the 
516.10 	customized living setting before July 1, 2022, for which a license is required. A customized 
516.11 	living service provider subject to this exception may rebut the presumption that a license 
516.12 	is required by seeking a reconsideration of the commissioner's determination. The 
516.13 	commissioner's disposition of a request for reconsideration is final and not subject to appeal 
516.14 	under chapter 14. The exception is available until June 30, 2023. This exception is available 
516.15 	when:
516.16 	(i) the person's customized living services are provided in a customized living service 
516.17 	setting serving four or fewer people under the brain injury or community access for disability 
516.18 	inclusion waiver plans under section 256B.49 in a single-family home operational on or 
516.19 	before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;
516.20 	(ii) the person's case manager provided the person with information about the choice of 
516.21 	service, service provider, and location of service, including in the person's home, to help 
516.22 	the person make an informed choice; and
516.23 	(iii) the person's services provided in the licensed foster care or community residential 
516.24 	setting are less than or equal to the cost of the person's services delivered in the customized 
516.25 	living setting as determined by the lead agency.
516.26 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
516.27 	community residential settings as defined under this subdivision. As part of the determination, 
516.28 	the commissioner shall consider the availability of foster care capacity in the area in which 
516.29 	the licensee seeks to operate, and the recommendation of the local county board. The 
516.30 	determination by the commissioner must be final. A determination of need is not required 
516.31 	for a change in ownership at the same address.
516.32 	(c) When an adult resident served by the program moves out of a foster home that is not 
516.33 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
516.34 	paragraph (f), or the adult community residential setting, the county shall immediately 
517.1 	inform the Department of Human Services Licensing Division. The department may decrease 
517.2 	the statewide licensed capacity for adult foster care settings.
517.3 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
517.4 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
517.5 	residents whose primary diagnosis is mental illness and the license holder is certified under 
517.6 	the requirements in subdivision 6a or section 245D.33.
517.7 	(e) A resource need determination process, managed at the state level, using the available 
517.8 	reports required by section 144A.351, and other data and information shall be used to 
517.9 	determine where the reduced capacity determined under section 256B.493 will be 
517.10 	implemented. The commissioner shall consult with the stakeholders described in section 
517.11 	144A.351, and employ a variety of methods to improve the state's capacity to meet the 
517.12 	informed decisions of those people who want to move out of corporate foster care or 
517.13 	community residential settings, long-term service needs within budgetary limits, including 
517.14 	seeking proposals from service providers or lead agencies to change service type, capacity, 
517.15 	or location to improve services, increase the independence of residents, and better meet 
517.16 	needs identified by the long-term services and supports reports and statewide data and 
517.17 	information.
517.18 	(f) At the time of application and reapplication for licensure, the applicant and the license 
517.19 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
517.20 	required to inform the commissioner whether the physical location where the foster care 
517.21 	will be provided is or will be the primary residence of the license holder for the entire period 
517.22 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
517.23 	or license holder must notify the commissioner immediately. The commissioner shall print 
517.24 	on the foster care license certificate whether or not the physical location is the primary 
517.25 	residence of the license holder.
517.26 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
517.27 	primary residence of the license holder and that also provide services in the foster care home 
517.28 	that are covered by a federally approved home and community-based services waiver, as 
517.29 	authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human 
517.30 	services licensing division that the license holder provides or intends to provide these 
517.31 	waiver-funded services.
517.32 	(h) The commissioner may adjust capacity to address needs identified in section 
517.33 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
517.34 	delicense existing settings. Delicensing of settings will be accomplished through a process 
518.1 	identified in section 256B.493. Annually, by August 1, the commissioner shall provide 
518.2 	information and data on capacity of licensed long-term services and supports, actions taken 
518.3 	under the subdivision to manage statewide long-term services and supports resources, and 
518.4 	any recommendations for change to the legislative committees with jurisdiction over the 
518.5 	health and human services budget.
518.6 	(i) The commissioner must notify a license holder when its corporate foster care or 
518.7 	community residential setting licensed beds are reduced under this section. The notice of 
518.8 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
518.9 	mail or personal service. The notice must state why the licensed beds are reduced and must 
518.10 	inform the license holder of its right to request reconsideration by the commissioner. The 
518.11 	license holder's request for reconsideration must be in writing. If mailed, the request for 
518.12 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
518.13 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
518.14 	reconsideration is made by personal service, it must be received by the commissioner within 
518.15 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
518.16 	(j) The commissioner shall not issue an initial license for children's residential treatment 
518.17 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
518.18 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
518.19 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
518.20 	moratorium described in this paragraph. The commissioner has the authority to manage 
518.21 	existing statewide capacity for children's residential treatment services subject to the 
518.22 	moratorium under this paragraph and may issue an initial license for such facilities if the 
518.23 	initial license would not increase the statewide capacity for children's residential treatment 
518.24 	services subject to the moratorium under this paragraph.

518.25 	EFFECTIVE DATE. This section is effective July 1, 2022.

518.26 	Sec. 3. Minnesota Statutes 2020, section 256.9741, subdivision 1, is amended to read:
518.27 		Subdivision 1.Long-term care facility. "Long-term care facility" means a nursing home 
518.28 	licensed under sections 144A.02 to 144A.10; a boarding care home licensed under sections 
518.29 	144.50 to 144.56; an assisted living facility or an assisted living facility with dementia care 
518.30 	licensed under chapter 144G; or a licensed or registered residential setting that provides or 
518.31 	arranges for the provision of home care services; or a setting defined under section 144G.08, 
518.32 	subdivision 7, clauses (10) to (13), that provides or arranges for the provision of home care 
518.33 	services.

518.34 	EFFECTIVE DATE. This section is effective August 1, 2021.

519.1 	Sec. 4. Minnesota Statutes 2020, section 256B.0911, subdivision 3a, is amended to read:
519.2 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
519.3 	planning, or other assistance intended to support community-based living, including persons 
519.4 	who need assessment in order to determine waiver or alternative care program eligibility, 
519.5 	must be visited by a long-term care consultation team within 20 calendar days after the date 
519.6 	on which an assessment was requested or recommended. Upon statewide implementation 
519.7 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
519.8 	requesting personal care assistance services. The commissioner shall provide at least a 
519.9 	90-day notice to lead agencies prior to the effective date of this requirement. Face-to-face 
519.10 	assessments must be conducted according to paragraphs (b) to (i).
519.11 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
519.12 	assessors to conduct the assessment. For a person with complex health care needs, a public 
519.13 	health or registered nurse from the team must be consulted.
519.14 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
519.15 	be used to complete a comprehensive, conversation-based, person-centered assessment. 
519.16 	The assessment must include the health, psychological, functional, environmental, and 
519.17 	social needs of the individual necessary to develop a person-centered community support 
519.18 	plan that meets the individual's needs and preferences.
519.19 	(d) The assessment must be conducted by a certified assessor in a face-to-face 
519.20 	conversational interview with the person being assessed. The person's legal representative 
519.21 	must provide input during the assessment process and may do so remotely if requested. At 
519.22 	the request of the person, other individuals may participate in the assessment to provide 
519.23 	information on the needs, strengths, and preferences of the person necessary to develop a 
519.24 	community support plan that ensures the person's health and safety. Except for legal 
519.25 	representatives or family members invited by the person, persons participating in the 
519.26 	assessment may not be a provider of service or have any financial interest in the provision 
519.27 	of services. For persons who are to be assessed for elderly waiver customized living or adult 
519.28 	day services under chapter 256S, with the permission of the person being assessed or the 
519.29 	person's designated or legal representative, the client's current or proposed provider of 
519.30 	services may submit a copy of the provider's nursing assessment or written report outlining 
519.31 	its recommendations regarding the client's care needs. The person conducting the assessment 
519.32 	must notify the provider of the date by which this information is to be submitted. This 
519.33 	information shall be provided to the person conducting the assessment prior to the assessment. 
519.34 	For a person who is to be assessed for waiver services under section 256B.092 or 256B.49, 
519.35 	with the permission of the person being assessed or the person's designated legal 
520.1 	representative, the person's current provider of services may submit a written report outlining 
520.2 	recommendations regarding the person's care needs the person completed in consultation 
520.3 	with someone who is known to the person and has interaction with the person on a regular 
520.4 	basis. The provider must submit the report at least 60 days before the end of the person's 
520.5 	current service agreement. The certified assessor must consider the content of the submitted 
520.6 	report prior to finalizing the person's assessment or reassessment.
520.7 	(e) The certified assessor and the individual responsible for developing the coordinated 
520.8 	service and support plan must complete the community support plan and the coordinated 
520.9 	service and support plan no more than 60 calendar days from the assessment visit. The 
520.10 	person or the person's legal representative must be provided with a written community 
520.11 	support plan within the timelines established by the commissioner, regardless of whether 
520.12 	the person is eligible for Minnesota health care programs.
520.13 	(f) For a person being assessed for elderly waiver services under chapter 256S, a provider 
520.14 	who submitted information under paragraph (d) shall receive the final written community 
520.15 	support plan when available and the Residential Services Workbook.
520.16 	(g) The written community support plan must include:
520.17 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
520.18 	(2) the individual's options and choices to meet identified needs, including:
520.19 	(i) all available options for case management services and providers;
520.20 	(ii) all available options for employment services, settings, and providers;
520.21 	(iii) all available options for living arrangements;
520.22 	(iv) all available options for self-directed services and supports, including self-directed 
520.23 	budget options; and
520.24 	(v) service provided in a non-disability-specific setting;
520.25 	(3) identification of health and safety risks and how those risks will be addressed, 
520.26 	including personal risk management strategies;
520.27 	(4) referral information; and
520.28 	(5) informal caregiver supports, if applicable.
520.29 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
520.30 	(b), clause (1), the person or person's representative must also receive a copy of the home 
520.31 	care service plan developed by the certified assessor.
521.1 	(h) A person may request assistance in identifying community supports without 
521.2 	participating in a complete assessment. Upon a request for assistance identifying community 
521.3 	support, the person must be transferred or referred to long-term care options counseling 
521.4 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
521.5 	telephone assistance and follow up.
521.6 	(i) The person has the right to make the final decision:
521.7 	(1) between institutional placement and community placement after the recommendations 
521.8 	have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);
521.9 	(2) between community placement in a setting controlled by a provider and living 
521.10 	independently in a setting not controlled by a provider;
521.11 	(3) between day services and employment services; and
521.12 	(4) regarding available options for self-directed services and supports, including 
521.13 	self-directed funding options.
521.14 	(j) The lead agency must give the person receiving long-term care consultation services 
521.15 	or the person's legal representative, materials, and forms supplied by the commissioner 
521.16 	containing the following information:
521.17 	(1) written recommendations for community-based services and consumer-directed 
521.18 	options;
521.19 	(2) documentation that the most cost-effective alternatives available were offered to the 
521.20 	individual. For purposes of this clause, "cost-effective" means community services and 
521.21 	living arrangements that cost the same as or less than institutional care. For an individual 
521.22 	found to meet eligibility criteria for home and community-based service programs under 
521.23 	chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally 
521.24 	approved waiver plan for each program;
521.25 	(3) the need for and purpose of preadmission screening conducted by long-term care 
521.26 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
521.27 	nursing facility placement. If the individual selects nursing facility placement, the lead 
521.28 	agency shall forward information needed to complete the level of care determinations and 
521.29 	screening for developmental disability and mental illness collected during the assessment 
521.30 	to the long-term care options counselor using forms provided by the commissioner;
521.31 	(4) the role of long-term care consultation assessment and support planning in eligibility 
521.32 	determination for waiver and alternative care programs, and state plan home care, case 
522.1 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
522.2 	and (b);
522.3 	(5) information about Minnesota health care programs;
522.4 	(6) the person's freedom to accept or reject the recommendations of the team;
522.5 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
522.6 	Act, chapter 13;
522.7 	(8) the certified assessor's decision regarding the person's need for institutional level of 
522.8 	care as determined under criteria established in subdivision 4e and the certified assessor's 
522.9 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
522.10 	paragraphs (a), clause (6), and (b);
522.11 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
522.12 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
522.13 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
522.14 	or the lead agency's final decisions regarding public programs eligibility according to section 
522.15 	256.045, subdivision 3. The certified assessor must verbally communicate this appeal right 
522.16 	to the person and must visually point out where in the document the right to appeal is stated; 
522.17 	and
522.18 	(10) documentation that available options for employment services, independent living, 
522.19 	and self-directed services and supports were described to the individual.
522.20 	(k) Face-to-face assessment completed as part of an eligibility determination for multiple 
522.21 	programs for the alternative care, elderly waiver, developmental disabilities, community 
522.22 	access for disability inclusion, community alternative care, and brain injury waiver programs 
522.23 	under chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish 
522.24 	service eligibility for no more than 60 calendar days after the date of assessment.
522.25 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
522.26 	to the date of assessment. If an assessment was completed more than 60 days before the 
522.27 	effective waiver or alternative care program eligibility start date, assessment and support 
522.28 	plan information must be updated and documented in the department's Medicaid Management 
522.29 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
522.30 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
522.31 	cannot be prior to the date the most recent updated assessment is completed.
522.32 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
522.33 	assessment and documented in the department's Medicaid Management Information System 
523.1 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
523.2 	of the previous face-to-face assessment when all other eligibility requirements are met.
523.3 	(n) If a person who receives home- and community-based waiver services under section 
523.4 	256B.0913, 256B.092, or 256B.49, or chapter 256S, temporarily enters for 121 days or less 
523.5 	a hospital, institution of mental disease, nursing facility, intensive residential treatment 
523.6 	services program, transitional care unit, or inpatient substance use disorder treatment setting, 
523.7 	the person may return to the community with home- and community-based waiver services 
523.8 	under the same waiver, without requiring an assessment or reassessment under this section, 
523.9 	unless the person's annual reassessment is otherwise due. Nothing in this section shall change 
523.10 	annual long-term care consultation reassessment requirements, payment for institutional or 
523.11 	treatment services, medical assistance financial eligibility, or any other law.
523.12 	(n) (o) At the time of reassessment, the certified assessor shall assess each person 
523.13 	receiving waiver residential supports and services currently residing in a community 
523.14 	residential setting, licensed adult foster care home that is either not the primary residence 
523.15 	of the license holder or in which the license holder is not the primary caregiver, family adult 
523.16 	foster care residence, customized living setting, or supervised living facility to determine 
523.17 	if that person would prefer to be served in a community-living setting as defined in section 
523.18 	256B.49, subdivision 23, in a setting not controlled by a provider, or to receive integrated 
523.19 	community supports as described in section 245D.03, subdivision 1, paragraph (c), clause 
523.20 	(8). The certified assessor shall offer the person, through a person-centered planning process, 
523.21 	the option to receive alternative housing and service options.
523.22 	(o) (p) At the time of reassessment, the certified assessor shall assess each person 
523.23 	receiving waiver day services to determine if that person would prefer to receive employment 
523.24 	services as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). 
523.25 	The certified assessor shall describe to the person through a person-centered planning process 
523.26 	the option to receive employment services.
523.27 	(p) (q) At the time of reassessment, the certified assessor shall assess each person 
523.28 	receiving non-self-directed waiver services to determine if that person would prefer an 
523.29 	available service and setting option that would permit self-directed services and supports. 
523.30 	The certified assessor shall describe to the person through a person-centered planning process 
523.31 	the option to receive self-directed services and supports.

523.32 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
523.33 	shall notify the revisor of statutes when federal approval is obtained.

524.1 	Sec. 5. Minnesota Statutes 2020, section 256B.092, subdivision 4, is amended to read:
524.2 		Subd. 4.Home and community-based services for developmental disabilities. (a) 
524.3 	The commissioner shall make payments to approved vendors participating in the medical 
524.4 	assistance program to pay costs of providing home and community-based services, including 
524.5 	case management service activities provided as an approved home and community-based 
524.6 	service, to medical assistance eligible persons with developmental disabilities who have 
524.7 	been screened under subdivision 7 and according to federal requirements. Federal 
524.8 	requirements include those services and limitations included in the federally approved 
524.9 	application for home and community-based services for persons with developmental 
524.10 	disabilities and subsequent amendments.
524.11 	(b) Effective July 1, 1995, contingent upon federal approval and state appropriations 
524.12 	made available for this purpose, and in conjunction with Laws 1995, chapter 207, article 8, 
524.13 	section 40, the commissioner of human services shall allocate resources to county agencies 
524.14 	for home and community-based waivered services for persons with developmental disabilities 
524.15 	authorized but not receiving those services as of June 30, 1995, based upon the average 
524.16 	resource need of persons with similar functional characteristics. To ensure service continuity 
524.17 	for service recipients receiving home and community-based waivered services for persons 
524.18 	with developmental disabilities prior to July 1, 1995, the commissioner shall make available 
524.19 	to the county of financial responsibility home and community-based waivered services 
524.20 	resources based upon fiscal year 1995 authorized levels.
524.21 	(c) Home and community-based resources for all recipients shall be managed by the 
524.22 	county of financial responsibility within an allowable reimbursement average established 
524.23 	for each county. Payments for home and community-based services provided to individual 
524.24 	recipients shall not exceed amounts authorized by the county of financial responsibility. 
524.25 	For specifically identified former residents of nursing facilities, the commissioner shall be 
524.26 	responsible for authorizing payments and payment limits under the appropriate home and 
524.27 	community-based service program. Payment is available under this subdivision only for 
524.28 	persons who, if not provided these services, would require the level of care provided in an 
524.29 	intermediate care facility for persons with developmental disabilities.
524.30 	(d) (b) The commissioner shall comply with the requirements in the federally approved 
524.31 	transition plan for the home and community-based services waivers for the elderly authorized 
524.32 	under this section.

525.1 	EFFECTIVE DATE. This section is effective January 1, 2023, or upon federal approval, 
525.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
525.3 	when federal approval is obtained.

525.4 	Sec. 6. Minnesota Statutes 2020, section 256B.092, subdivision 5, is amended to read:
525.5 		Subd. 5.Federal waivers. (a) The commissioner shall apply for any federal waivers 
525.6 	necessary to secure, to the extent allowed by law, federal financial participation under United 
525.7 	States Code, title 42, sections 1396 et seq., as amended, for the provision of services to 
525.8 	persons who, in the absence of the services, would need the level of care provided in a 
525.9 	regional treatment center or a community intermediate care facility for persons with 
525.10 	developmental disabilities. The commissioner may seek amendments to the waivers or apply 
525.11 	for additional waivers under United States Code, title 42, sections 1396 et seq., as amended, 
525.12 	to contain costs. The commissioner shall ensure that payment for the cost of providing home 
525.13 	and community-based alternative services under the federal waiver plan shall not exceed 
525.14 	the cost of intermediate care services including day training and habilitation services that 
525.15 	would have been provided without the waivered services.
525.16 	The commissioner shall seek an amendment to the 1915c home and community-based 
525.17 	waiver to allow properly licensed adult foster care homes to provide residential services to 
525.18 	up to five individuals with developmental disabilities. If the amendment to the waiver is 
525.19 	approved, adult foster care providers that can accommodate five individuals shall increase 
525.20 	their capacity to five beds, provided the providers continue to meet all applicable licensing 
525.21 	requirements.
525.22 	(b) The commissioner, in administering home and community-based waivers for persons 
525.23 	with developmental disabilities, shall ensure that day services for eligible persons are not 
525.24 	provided by the person's residential service provider, unless the person or the person's legal 
525.25 	representative is offered a choice of providers and agrees in writing to provision of day 
525.26 	services by the residential service provider. The coordinated service and support plan for 
525.27 	individuals who choose to have their residential service provider provide their day services 
525.28 	must describe how health, safety, protection, and habilitation needs will be met, including 
525.29 	how frequent and regular contact with persons other than the residential service provider 
525.30 	will occur. The coordinated service and support plan must address the provision of services 
525.31 	during the day outside the residence on weekdays.
525.32 	(c) When a lead agency is evaluating denials, reductions, or terminations of home and 
525.33 	community-based services under section 256B.0916 for an individual, the lead agency shall 
525.34 	offer to meet with the individual or the individual's guardian in order to discuss the 
526.1 	prioritization of service needs within the coordinated service and support plan. The reduction 
526.2 	in the authorized services for an individual due to changes in funding for waivered services 
526.3 	may not exceed the amount needed to ensure medically necessary services to meet the 
526.4 	individual's health, safety, and welfare.
526.5 	(d) The commissioner shall seek federal approval to allow for the reconfiguration of the 
526.6 	1915(c) home and community-based waivers in this section, as authorized under section 
526.7 	1915(c) of the federal Social Security Act, to implement a two-waiver program structure.
526.8 	(e) The transition to two disability home and community-based services waiver programs 
526.9 	must align with the independent living first policy under section 256B.4905. Unless 
526.10 	superseded by any other state or federal law, waiver eligibility criteria shall be the same for 
526.11 	each waiver. The waiver program that a person uses shall be determined by the support 
526.12 	planning process and whether the person chooses to live in a provider-controlled setting or 
526.13 	in the person's own home.
526.14 	(f) The commissioner shall seek federal approval for the 1915(c) home and 
526.15 	community-based waivers in this section, as authorized under section 1915(c) of the federal 
526.16 	Social Security Act, to implement an individual resource allocation methodology.

526.17 	EFFECTIVE DATE. This section is effective January 1, 2023, or 90 days after federal 
526.18 	approval, whichever is later. The commissioner of human services shall notify the revisor 
526.19 	of statutes when federal approval is obtained.

526.20 	Sec. 7. Minnesota Statutes 2020, section 256B.092, subdivision 12, is amended to read:
526.21 		Subd. 12.Waivered Waiver services statewide priorities. (a) The commissioner shall 
526.22 	establish statewide priorities for individuals on the waiting list for developmental disabilities 
526.23 	(DD) waiver services, as of January 1, 2010. The statewide priorities must include, but are 
526.24 	not limited to, individuals who continue to have a need for waiver services after they have 
526.25 	maximized the use of state plan services and other funding resources, including natural 
526.26 	supports, prior to accessing waiver services, and who meet at least one of the following 
526.27 	criteria:
526.28 	(1) no longer require the intensity of services provided where they are currently living; 
526.29 	or
526.30 	(2) make a request to move from an institutional setting.
526.31 	(b) After the priorities in paragraph (a) are met, priority must also be given to individuals 
526.32 	who meet at least one of the following criteria:
527.1 	(1) have unstable living situations due to the age, incapacity, or sudden loss of the primary 
527.2 	caregivers;
527.3 	(2) are moving from an institution due to bed closures;
527.4 	(3) experience a sudden closure of their current living arrangement;
527.5 	(4) require protection from confirmed abuse, neglect, or exploitation;
527.6 	(5) experience a sudden change in need that can no longer be met through state plan 
527.7 	services or other funding resources alone; or
527.8 	(6) meet other priorities established by the department.
527.9 	(c) When allocating new enrollment resources to lead agencies, the commissioner must 
527.10 	take into consideration the number of individuals waiting who meet statewide priorities and 
527.11 	the lead agencies' current use of waiver funds and existing service options. The commissioner 
527.12 	has the authority to transfer funds between counties, groups of counties, and tribes to 
527.13 	accommodate statewide priorities and resource needs while accounting for a necessary base 
527.14 	level reserve amount for each county, group of counties, and tribe.

527.15 	Sec. 8. Minnesota Statutes 2020, section 256B.097, is amended by adding a subdivision 
527.16 	to read:
527.17 		Subd. 7.Regional quality councils and systems improvement. The commissioner of 
527.18 	human services shall maintain the regional quality councils initially established under 
527.19 	Minnesota Statutes 2020, section 256B.097, subdivision 4. The regional quality councils 
527.20 	shall:
527.21 	(1) support efforts and initiatives that drive overall systems and social change to promote 
527.22 	inclusion of people who have disabilities in the state of Minnesota;
527.23 	(2) improve person-centered outcomes in disability services; and
527.24 	(3) identify or enhance quality of life indicators for people who have disabilities.

527.25 	Sec. 9. Minnesota Statutes 2020, section 256B.097, is amended by adding a subdivision 
527.26 	to read:
527.27 		Subd. 8.Membership and staff. (a) Regional quality councils shall be comprised of 
527.28 	key stakeholders including, but not limited to:
527.29 	(1) individuals who have disabilities;
527.30 	(2) family members of people who have disabilities;
528.1 	(3) disability service providers;
528.2 	(4) disability advocacy groups;
528.3 	(5) lead agency staff; and
528.4 	(6) staff of state agencies with jurisdiction over special education and disability services.
528.5 	(b) Membership in a regional quality council must be representative of the communities 
528.6 	in which the council operates, with an emphasis on individuals with lived experience from 
528.7 	diverse racial and cultural backgrounds.
528.8 	(c) Each regional quality council may hire staff to perform the duties assigned in 
528.9 	subdivision 9.

528.10 	Sec. 10. Minnesota Statutes 2020, section 256B.097, is amended by adding a subdivision 
528.11 	to read:
528.12 		Subd. 9.Duties. (a) Each regional quality council shall:
528.13 	(1) identify issues and barriers that impede Minnesotans who have disabilities from 
528.14 	optimizing choice of home and community-based services;
528.15 	(2) promote informed decision making, autonomy, and self-direction;
528.16 	(3) analyze and review quality outcomes and critical incident data, and immediately 
528.17 	report incidents of life safety concerns to the Department of Human Services Licensing 
528.18 	Division;
528.19 	(4) inform a comprehensive system for effective incident reporting, investigation, analysis, 
528.20 	and follow-up;
528.21 	(5) collaborate on projects and initiatives to advance priorities shared with state agencies, 
528.22 	lead agencies, educational institutions, advocacy organizations, community partners, and 
528.23 	other entities engaged in disability service improvements;
528.24 	(6) establish partnerships and working relationships with individuals and groups in the 
528.25 	regions;
528.26 	(7) identify and implement regional and statewide quality improvement projects;
528.27 	(8) transform systems and drive social change in alignment with the disability rights and 
528.28 	disability justice movements identified by leaders who have disabilities;
529.1 	(9) provide information and training programs for persons who have disabilities and 
529.2 	their families and legal representatives on formal and informal support options and quality 
529.3 	expectations;
529.4 	(10) make recommendations to state agencies and other key decision-makers regarding 
529.5 	disability services and supports;
529.6 	(11) submit every two years a report to committees with jurisdiction over disability 
529.7 	services on the status, outcomes, improvement priorities, and activities in the region;
529.8 	(12) support people by advocating to resolve complaints between the counties, providers, 
529.9 	persons receiving services, and their families and legal representatives; and
529.10 	(13) recruit, train, and assign duties to regional quality council teams, including council 
529.11 	members, interns, and volunteers, taking into account the skills necessary for the team 
529.12 	members to be successful in this work.
529.13 	(b) Each regional quality council may engage in quality improvement initiatives related 
529.14 	to but not limited to:
529.15 	(1) the home and community-based services waiver programs for persons with 
529.16 	developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, 
529.17 	including brain injuries and services for those persons who qualify for nursing facility level 
529.18 	of care or hospital facility level of care and any other services licensed under chapter 245D;
529.19 	(2) home care services under section 256B.0651;
529.20 	(3) family support grants under section 252.32;
529.21 	(4) consumer support grants under section 256.476;
529.22 	(5) semi-independent living services under section 252.275; and
529.23 	(6) services provided through an intermediate care facility for persons with developmental 
529.24 	disabilities.
529.25 	(c) Each regional quality council's work must be informed and directed by the needs 
529.26 	and desires of persons who have disabilities in the region in which the council operates.

529.27 	Sec. 11. Minnesota Statutes 2020, section 256B.097, is amended by adding a subdivision 
529.28 	to read:
529.29 		Subd. 10.Compensation. (a) A member of a regional quality council who does not 
529.30 	receive a salary or wages from an employer may be paid a per diem and reimbursed for 
529.31 	expenses related to the member's participation in efforts and initiatives described in 
530.1 	subdivision 9 in the same manner and in an amount not to exceed the amount authorized 
530.2 	by the commissioner's plan adopted under section 43A.18, subdivision 2.
530.3 	(b) Regional quality councils may charge fees for their services.

530.4 	Sec. 12. Minnesota Statutes 2020, section 256B.439, is amended by adding a subdivision 
530.5 	to read:
530.6 		Subd. 3c.Contact information for consumer surveys for nursing facilities and home 
530.7 	and community-based services. For purposes of conducting the consumer surveys under 
530.8 	subdivisions 3 and 3a, the commissioner may request contact information of clients and 
530.9 	associated key representatives. Providers must furnish the contact information available to 
530.10 	the provider.

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

530.12 	Sec. 13. Minnesota Statutes 2020, section 256B.439, is amended by adding a subdivision 
530.13 	to read:
530.14 		Subd. 3d.Resident experience survey and family survey for assisted living 
530.15 	facilities. The commissioner shall develop and administer a resident experience survey for 
530.16 	assisted living facility residents and a family survey for families of assisted living facility 
530.17 	residents. Money appropriated to the commissioner to administer the resident experience 
530.18 	survey and family survey is available in either fiscal year of the biennium in which it is 
530.19 	appropriated.

530.20 	Sec. 14. Minnesota Statutes 2020, section 256B.49, subdivision 11, is amended to read:
530.21 		Subd. 11.Authority. (a) The commissioner is authorized to apply for home and 
530.22 	community-based service waivers, as authorized under section 1915(c) of the federal Social 
530.23 	Security Act to serve persons under the age of 65 who are determined to require the level 
530.24 	of care provided in a nursing home and persons who require the level of care provided in a 
530.25 	hospital. The commissioner shall apply for the home and community-based waivers in order 
530.26 	to:
530.27 	(1) promote the support of persons with disabilities in the most integrated settings;
530.28 	(2) expand the availability of services for persons who are eligible for medical assistance;
530.29 	(3) promote cost-effective options to institutional care; and
530.30 	(4) obtain federal financial participation.
531.1 	(b) The provision of waivered waiver services to medical assistance recipients with 
531.2 	disabilities shall comply with the requirements outlined in the federally approved applications 
531.3 	for home and community-based services and subsequent amendments, including provision 
531.4 	of services according to a service plan designed to meet the needs of the individual. For 
531.5 	purposes of this section, the approved home and community-based application is considered 
531.6 	the necessary federal requirement.
531.7 	(c) The commissioner shall provide interested persons serving on agency advisory 
531.8 	committees, task forces, the Centers for Independent Living, and others who request to be 
531.9 	on a list to receive, notice of, and an opportunity to comment on, at least 30 days before 
531.10 	any effective dates, (1) any substantive changes to the state's disability services program 
531.11 	manual, or (2) changes or amendments to the federally approved applications for home and 
531.12 	community-based waivers, prior to their submission to the federal Centers for Medicare 
531.13 	and Medicaid Services.
531.14 	(d) The commissioner shall seek approval, as authorized under section 1915(c) of the 
531.15 	federal Social Security Act, to allow medical assistance eligibility under this section for 
531.16 	children under age 21 without deeming of parental income or assets.
531.17 	(e) The commissioner shall seek approval, as authorized under section 1915(c) of the 
531.18 	Social Act, to allow medical assistance eligibility under this section for individuals under 
531.19 	age 65 without deeming the spouse's income or assets.
531.20 	(f) The commissioner shall comply with the requirements in the federally approved 
531.21 	transition plan for the home and community-based services waivers authorized under this 
531.22 	section.
531.23 	(g) The commissioner shall seek federal approval to allow for the reconfiguration of the 
531.24 	1915(c) home and community-based waivers in this section, as authorized under section 
531.25 	1915(c) of the federal Social Security Act, to implement a two-waiver program structure.
531.26 	(h) The commissioner shall seek federal approval for the 1915(c) home and 
531.27 	community-based waivers in this section, as authorized under section 1915(c) of the federal 
531.28 	Social Security Act, to implement an individual resource allocation methodology.

531.29 	EFFECTIVE DATE. This section is effective January 1, 2023, or 90 days after federal 
531.30 	approval, whichever is later. The commissioner of human services shall notify the revisor 
531.31 	of statutes when federal approval is obtained.

532.1 	Sec. 15. Minnesota Statutes 2020, section 256B.49, subdivision 11a, is amended to read:
532.2 		Subd. 11a.Waivered Waiver services statewide priorities. (a) The commissioner shall 
532.3 	establish statewide priorities for individuals on the waiting list for community alternative 
532.4 	care, community access for disability inclusion, and brain injury waiver services, as of 
532.5 	January 1, 2010. The statewide priorities must include, but are not limited to, individuals 
532.6 	who continue to have a need for waiver services after they have maximized the use of state 
532.7 	plan services and other funding resources, including natural supports, prior to accessing 
532.8 	waiver services, and who meet at least one of the following criteria:
532.9 	(1) no longer require the intensity of services provided where they are currently living; 
532.10 	or
532.11 	(2) make a request to move from an institutional setting.
532.12 	(b) After the priorities in paragraph (a) are met, priority must also be given to individuals 
532.13 	who meet at least one of the following criteria:
532.14 	(1) have unstable living situations due to the age, incapacity, or sudden loss of the primary 
532.15 	caregivers;
532.16 	(2) are moving from an institution due to bed closures;
532.17 	(3) experience a sudden closure of their current living arrangement;
532.18 	(4) require protection from confirmed abuse, neglect, or exploitation;
532.19 	(5) experience a sudden change in need that can no longer be met through state plan 
532.20 	services or other funding resources alone; or
532.21 	(6) meet other priorities established by the department.
532.22 	(c) When allocating new enrollment resources to lead agencies, the commissioner must 
532.23 	take into consideration the number of individuals waiting who meet statewide priorities and 
532.24 	the lead agencies' current use of waiver funds and existing service options. The commissioner 
532.25 	has the authority to transfer funds between counties, groups of counties, and tribes to 
532.26 	accommodate statewide priorities and resource needs while accounting for a necessary base 
532.27 	level reserve amount for each county, group of counties, and tribe.

532.28 	EFFECTIVE DATE. This section is effective January 1, 2023, or upon federal approval, 
532.29 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
532.30 	when federal approval is obtained.

533.1 	Sec. 16. Minnesota Statutes 2020, section 256B.49, subdivision 17, is amended to read:
533.2 		Subd. 17.Cost of services and supports. (a) The commissioner shall ensure that the 
533.3 	average per capita expenditures estimated in any fiscal year for home and community-based 
533.4 	waiver recipients does not exceed the average per capita expenditures that would have been 
533.5 	made to provide institutional services for recipients in the absence of the waiver.
533.6 	(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 
533.7 	need-based methods for allocating to local agencies the home and community-based waivered 
533.8 	service resources available to support recipients with disabilities in need of the level of care 
533.9 	provided in a nursing facility or a hospital. The commissioner shall allocate resources to 
533.10 	single counties and county partnerships in a manner that reflects consideration of:
533.11 	(1) an incentive-based payment process for achieving outcomes;
533.12 	(2) the need for a state-level risk pool;
533.13 	(3) the need for retention of management responsibility at the state agency level; and
533.14 	(4) a phase-in strategy as appropriate.
533.15 	(c) Until the allocation methods described in paragraph (b) are implemented, the annual 
533.16 	allowable reimbursement level of home and community-based waiver services shall be the 
533.17 	greater of:
533.18 	(1) the statewide average payment amount which the recipient is assigned under the 
533.19 	waiver reimbursement system in place on June 30, 2001, modified by the percentage of any 
533.20 	provider rate increase appropriated for home and community-based services; or
533.21 	(2) an amount approved by the commissioner based on the recipient's extraordinary 
533.22 	needs that cannot be met within the current allowable reimbursement level. The increased 
533.23 	reimbursement level must be necessary to allow the recipient to be discharged from an 
533.24 	institution or to prevent imminent placement in an institution. The additional reimbursement 
533.25 	may be used to secure environmental modifications; assistive technology and equipment; 
533.26 	and increased costs for supervision, training, and support services necessary to address the 
533.27 	recipient's extraordinary needs. The commissioner may approve an increased reimbursement 
533.28 	level for up to one year of the recipient's relocation from an institution or up to six months 
533.29 	of a determination that a current waiver recipient is at imminent risk of being placed in an 
533.30 	institution.
533.31 	(d) (b) Beginning July 1, 2001, medically necessary home care nursing services will be 
533.32 	authorized under this section as complex and regular care according to sections 256B.0651
533.33 	to 256B.0654 and 256B.0659. The rate established by the commissioner for registered nurse 
534.1 	or licensed practical nurse services under any home and community-based waiver as of 
534.2 	January 1, 2001, shall not be reduced.
534.3 	(e) (c) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009 
534.4 	legislature adopts a rate reduction that impacts payment to providers of adult foster care 
534.5 	services, the commissioner may issue adult foster care licenses that permit a capacity of 
534.6 	five adults. The application for a five-bed license must meet the requirements of section 
534.7 	245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care services, 
534.8 	the county must negotiate a revised per diem rate for room and board and waiver services 
534.9 	that reflects the legislated rate reduction and results in an overall average per diem reduction 
534.10 	for all foster care recipients in that home. The revised per diem must allow the provider to 
534.11 	maintain, as much as possible, the level of services or enhanced services provided in the 
534.12 	residence, while mitigating the losses of the legislated rate reduction.

534.13 	EFFECTIVE DATE. This section is effective January 1, 2023, or upon federal approval, 
534.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
534.15 	when federal approval is obtained.

534.16 	Sec. 17. Minnesota Statutes 2020, section 256B.49, is amended by adding a subdivision 
534.17 	to read:
534.18 		Subd. 28.Customized living moratorium for brain injury and community access 
534.19 	for disability inclusion waivers. (a) Notwithstanding section 245A.03, subdivision 2, 
534.20 	paragraph (a), clause (23), the commissioner shall not enroll new customized living settings 
534.21 	serving four or fewer people in a single-family home to deliver customized living services 
534.22 	as defined under the brain injury or community access for disability inclusion waiver plans 
534.23 	under section 256B.49 to prevent new developments of customized living settings that 
534.24 	otherwise meet the residential program definition under section 245A.02, subdivision 14.
534.25 	(b) The commissioner may approve an exception to paragraph (a) when:
534.26 	(1) a customized living setting with a change in ownership at the same address is in 
534.27 	existence and operational on or before June 30, 2021; and
534.28 	(2) a customized living setting is serving four or fewer people in a multiple-family 
534.29 	dwelling if each person has a personal self-contained living unit that contains living, sleeping, 
534.30 	eating, cooking, and bathroom areas.
534.31 	(c) Customized living settings operational on or before June 30, 2021, are considered 
534.32 	existing customized living settings.
535.1 	(d) For any new customized living settings operational on or after July 1, 2021, serving 
535.2 	four or fewer people in a single-family home to deliver customized living services as defined 
535.3 	in paragraph (a), the authorizing lead agency is financially responsible for all home and 
535.4 	community-based service payments in the setting.
535.5 	(e) For purposes of this subdivision, "operational" means customized living services are 
535.6 	authorized and delivered to a person on or before June 30, 2021, in the customized living 
535.7 	setting.

535.8 	EFFECTIVE DATE. This section is effective July 1, 2021. This section applies only 
535.9 	to customized living services as defined under the brain injury or community access for 
535.10 	disability inclusion waiver plans under Minnesota Statutes, section 256B.49.

535.11 	Sec. 18. Minnesota Statutes 2020, section 256B.4914, subdivision 5, is amended to read:
535.12 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
535.13 	is established to determine staffing costs associated with providing services to individuals 
535.14 	receiving home and community-based services. For purposes of developing and calculating 
535.15 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
535.16 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
535.17 	the most recent edition of the Occupational Handbook must be used. The base wage index 
535.18 	must be calculated as follows:
535.19 	(1) for residential direct care staff, the sum of:
535.20 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
535.21 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing assistant (SOC 
535.22 	code 31-1014); and 20 percent of the median wage for social and human services aide (SOC 
535.23 	code 21-1093); and
535.24 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
535.25 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
535.26 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
535.27 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
535.28 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
535.29 	(2) for adult day services, 70 percent of the median wage for nursing assistant (SOC 
535.30 	code 31-1014); and 30 percent of the median wage for personal care aide (SOC code 
535.31 	39-9021);
535.32 	(3) for day services, day support services, and prevocational services, 20 percent of the 
535.33 	median wage for nursing assistant (SOC code 31-1014); 20 percent of the median wage for 
536.1 	psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social 
536.2 	and human services aide (SOC code 21-1093);
536.3 	(4) for residential asleep-overnight staff, the wage is the minimum wage in Minnesota 
536.4 	for large employers, except in a family foster care setting, the wage is 36 percent of the 
536.5 	minimum wage in Minnesota for large employers;
536.6 	(5) for positive supports analyst staff, 100 percent of the median wage for mental health 
536.7 	counselors (SOC code 21-1014);
536.8 	(6) for positive supports professional staff, 100 percent of the median wage for clinical 
536.9 	counseling and school psychologist (SOC code 19-3031);
536.10 	(7) for positive supports specialist staff, 100 percent of the median wage for psychiatric 
536.11 	technicians (SOC code 29-2053);
536.12 	(8) for supportive living services staff, 20 percent of the median wage for nursing assistant 
536.13 	(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
536.14 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
536.15 	21-1093);
536.16 	(9) for housing access coordination staff, 100 percent of the median wage for community 
536.17 	and social services specialist (SOC code 21-1099);
536.18 	(10) for in-home family support and individualized home supports with family training 
536.19 	staff, 20 percent of the median wage for nursing aide (SOC code 31-1012); 30 percent of 
536.20 	the median wage for community social service specialist (SOC code 21-1099); 40 percent 
536.21 	of the median wage for social and human services aide (SOC code 21-1093); and ten percent 
536.22 	of the median wage for psychiatric technician (SOC code 29-2053);
536.23 	(11) for individualized home supports with training services staff, 40 percent of the 
536.24 	median wage for community social service specialist (SOC code 21-1099); 50 percent of 
536.25 	the median wage for social and human services aide (SOC code 21-1093); and ten percent 
536.26 	of the median wage for psychiatric technician (SOC code 29-2053);
536.27 	(12) for independent living skills staff, 40 percent of the median wage for community 
536.28 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
536.29 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
536.30 	technician (SOC code 29-2053);
536.31 	(13) for employment support services staff, 50 percent of the median wage for 
536.32 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
536.33 	community and social services specialist (SOC code 21-1099);
537.1 	(14) for employment exploration services staff, 50 percent of the median wage for 
537.2 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
537.3 	community and social services specialist (SOC code 21-1099);
537.4 	(15) for employment development services staff, 50 percent of the median wage for 
537.5 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
537.6 	of the median wage for community and social services specialist (SOC code 21-1099);
537.7 	(16) for individualized home support staff, 50 percent of the median wage for personal 
537.8 	and home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing 
537.9 	assistant (SOC code 31-1014);
537.10 	(17) for adult companion staff, 50 percent of the median wage for personal and home 
537.11 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
537.12 	(SOC code 31-1014);
537.13 	(18) for night supervision staff, 20 percent of the median wage for home health aide 
537.14 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
537.15 	(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code 
537.16 	31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053); 
537.17 	and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
537.18 	(19) for respite staff, 50 percent of the median wage for personal and home care aide 
537.19 	(SOC code 39-9021); and 50 percent of the median wage for nursing assistant (SOC code 
537.20 	31-1014);
537.21 	(20) for personal support staff, 50 percent of the median wage for personal and home 
537.22 	care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant 
537.23 	(SOC code 31-1014);
537.24 	(21) for supervisory staff, 100 percent of the median wage for community and social 
537.25 	services specialist (SOC code 21-1099), with the exception of the supervisor of positive 
537.26 	supports professional, positive supports analyst, and positive supports specialists, which is 
537.27 	100 percent of the median wage for clinical counseling and school psychologist (SOC code 
537.28 	19-3031);
537.29 	(22) for registered nurse staff, 100 percent of the median wage for registered nurses 
537.30 	(SOC code 29-1141); and
537.31 	(23) for licensed practical nurse staff, 100 percent of the median wage for licensed 
537.32 	practical nurses (SOC code 29-2061).
538.1 	(b) Component values for corporate foster care services, corporate supportive living 
538.2 	services daily, community residential services, and integrated community support services 
538.3 	are:
538.4 	(1) competitive workforce factor: 4.7 percent;
538.5 	(2) supervisory span of control ratio: 11 percent;
538.6 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
538.7 	(4) employee-related cost ratio: 23.6 percent;
538.8 	(5) general administrative support ratio: 13.25 percent;
538.9 	(6) program-related expense ratio: 1.3 percent; and
538.10 	(7) absence and utilization factor ratio: 3.9 percent.
538.11 	(c) Component values for family foster care are:
538.12 	(1) competitive workforce factor: 4.7 percent;
538.13 	(2) supervisory span of control ratio: 11 percent;
538.14 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
538.15 	(4) employee-related cost ratio: 23.6 percent;
538.16 	(5) general administrative support ratio: 3.3 percent;
538.17 	(6) program-related expense ratio: 1.3 percent; and
538.18 	(7) absence factor: 1.7 percent.
538.19 	(d) (c) Component values for day training and habilitation, day support services, and 
538.20 	prevocational services are:
538.21 	(1) competitive workforce factor: 4.7 percent;
538.22 	(2) supervisory span of control ratio: 11 percent;
538.23 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
538.24 	(4) employee-related cost ratio: 23.6 percent;
538.25 	(5) program plan support ratio: 5.6 percent;
538.26 	(6) client programming and support ratio: ten percent;
538.27 	(7) general administrative support ratio: 13.25 percent;
538.28 	(8) program-related expense ratio: 1.8 percent; and
539.1 	(9) absence and utilization factor ratio: 9.4 percent.
539.2 	(d) Component values for day support services and prevocational services delivered 
539.3 	remotely are:
539.4 	(1) competitive workforce factor: 4.7 percent;
539.5 	(2) supervisory span of control ratio: 11 percent;
539.6 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
539.7 	(4) employee-related cost ratio: 23.6 percent;
539.8 	(5) program plan support ratio: 5.6 percent;
539.9 	(6) client programming and support ratio: 7.67 percent;
539.10 	(7) general administrative support ratio: 13.25 percent;
539.11 	(8) program-related expense ratio: 1.8 percent; and
539.12 	(9) absence and utilization factor ratio: 9.4 percent.
539.13 	(e) Component values for adult day services are:
539.14 	(1) competitive workforce factor: 4.7 percent;
539.15 	(2) supervisory span of control ratio: 11 percent;
539.16 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
539.17 	(4) employee-related cost ratio: 23.6 percent;
539.18 	(5) program plan support ratio: 5.6 percent;
539.19 	(6) client programming and support ratio: 7.4 percent;
539.20 	(7) general administrative support ratio: 13.25 percent;
539.21 	(8) program-related expense ratio: 1.8 percent; and
539.22 	(9) absence and utilization factor ratio: 9.4 percent.
539.23 	(f) Component values for unit-based services with programming are:
539.24 	(1) competitive workforce factor: 4.7 percent;
539.25 	(2) supervisory span of control ratio: 11 percent;
539.26 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
539.27 	(4) employee-related cost ratio: 23.6 percent;
540.1 	(5) program plan supports ratio: 15.5 percent;
540.2 	(6) client programming and supports ratio: 4.7 percent;
540.3 	(7) general administrative support ratio: 13.25 percent;
540.4 	(8) program-related expense ratio: 6.1 percent; and
540.5 	(9) absence and utilization factor ratio: 3.9 percent.
540.6 	(g) Component values for unit-based services with programming delivered remotely 
540.7 	are:
540.8 	(1) competitive workforce factor: 4.7 percent;
540.9 	(2) supervisory span of control ratio: 11 percent;
540.10 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
540.11 	(4) employee-related cost ratio: 23.6 percent;
540.12 	(5) program plan supports ratio: 5.6 percent;
540.13 	(6) client programming and supports ratio: 1.53 percent;
540.14 	(7) general administrative support ratio: 13.25 percent;
540.15 	(8) program-related expense ratio: 6.1 percent; and
540.16 	(9) absence and utilization factor ratio: 3.9 percent.
540.17 	(g) (h) Component values for unit-based services without programming except respite 
540.18 	are:
540.19 	(1) competitive workforce factor: 4.7 percent;
540.20 	(2) supervisory span of control ratio: 11 percent;
540.21 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
540.22 	(4) employee-related cost ratio: 23.6 percent;
540.23 	(5) program plan support ratio: 7.0 percent;
540.24 	(6) client programming and support ratio: 2.3 percent;
540.25 	(7) general administrative support ratio: 13.25 percent;
540.26 	(8) program-related expense ratio: 2.9 percent; and
540.27 	(9) absence and utilization factor ratio: 3.9 percent.
541.1 	(i) Component values for unit-based services without programming delivered remotely, 
541.2 	except respite, are:
541.3 	(1) competitive workforce factor: 4.7 percent;
541.4 	(2) supervisory span of control ratio: 11 percent;
541.5 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
541.6 	(4) employee-related cost ratio: 23.6 percent;
541.7 	(5) program plan support ratio: 1.3 percent;
541.8 	(6) client programming and support ratio: 1.14 percent;
541.9 	(7) general administrative support ratio: 13.25 percent;
541.10 	(8) program-related expense ratio: 2.9 percent; and
541.11 	(9) absence and utilization factor ratio: 3.9 percent.
541.12 	(h) (j) Component values for unit-based services without programming for respite are:
541.13 	(1) competitive workforce factor: 4.7 percent;
541.14 	(2) supervisory span of control ratio: 11 percent;
541.15 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
541.16 	(4) employee-related cost ratio: 23.6 percent;
541.17 	(5) general administrative support ratio: 13.25 percent;
541.18 	(6) program-related expense ratio: 2.9 percent; and
541.19 	(7) absence and utilization factor ratio: 3.9 percent.
541.20 	(i) (k) On July 1, 2022, and every two years thereafter, the commissioner shall update 
541.21 	the base wage index in paragraph (a) based on wage data by SOC from the Bureau of Labor 
541.22 	Statistics available 30 months and one day prior to the scheduled update. The commissioner 
541.23 	shall publish these updated values and load them into the rate management system.
541.24 	(j) (l) Beginning February 1, 2021, and every two years thereafter, the commissioner 
541.25 	shall report to the chairs and ranking minority members of the legislative committees and 
541.26 	divisions with jurisdiction over health and human services policy and finance an analysis 
541.27 	of the competitive workforce factor. The report must include recommendations to update 
541.28 	the competitive workforce factor using:
542.1 	(1) the most recently available wage data by SOC code for the weighted average wage 
542.2 	for direct care staff for residential services and direct care staff for day services;
542.3 	(2) the most recently available wage data by SOC code of the weighted average wage 
542.4 	of comparable occupations; and
542.5 	(3) workforce data as required under subdivision 10a, paragraph (g).
542.6 	The commissioner shall not recommend an increase or decrease of the competitive workforce 
542.7 	factor from the current value by more than two percentage points. If, after a biennial analysis 
542.8 	for the next report, the competitive workforce factor is less than or equal to zero, the 
542.9 	commissioner shall recommend a competitive workforce factor of zero.
542.10 	(k) (m) On July 1, 2022, and every two years thereafter, the commissioner shall update 
542.11 	the framework components in paragraph (d) (c), clause (6); paragraph (e) (d), clause (6); 
542.12 	paragraph (f) (e), clause (6); and paragraph (g) (f), clause (6); paragraph (g), clause (6); 
542.13 	paragraph (h), clause 6; and paragraph (i), clause (6); subdivision 6, paragraphs (b), clauses 
542.14 	(9) and (10), and (e), clause (10); and subdivision 7, clauses (11), (17), and (18); and 
542.15 	subdivision 18, for changes in the Consumer Price Index. The commissioner shall adjust 
542.16 	these values higher or lower by the percentage change in the CPI-U from the date of the 
542.17 	previous update to the data available 30 months and one day prior to the scheduled update. 
542.18 	The commissioner shall publish these updated values and load them into the rate management 
542.19 	system.
542.20 	(l) (n) Upon the implementation of the updates under paragraphs (i) (k) and (k) (m), rate 
542.21 	adjustments authorized under section 256B.439, subdivision 7; Laws 2013, chapter 108, 
542.22 	article 7, section 60; and Laws 2014, chapter 312, article 27, section 75, shall be removed 
542.23 	from service rates calculated under this section.
542.24 	(m) (o) Any rate adjustments applied to the service rates calculated under this section 
542.25 	outside of the cost components and rate methodology specified in this section shall be 
542.26 	removed from rate calculations upon implementation of the updates under paragraphs (i)
542.27 	(k) and (k) (m).
542.28 	(n) (p) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer 
542.29 	Price Index items are unavailable in the future, the commissioner shall recommend to the 
542.30 	legislature codes or items to update and replace missing component values.

542.31 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
542.32 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
542.33 	when federal approval is obtained.

543.1 	Sec. 19. Minnesota Statutes 2020, section 256B.4914, subdivision 6, is amended to read:
543.2 		Subd. 6.Payments for residential support services. (a) For purposes of this subdivision, 
543.3 	residential support services includes 24-hour customized living services, community 
543.4 	residential services, customized living services, family residential services, foster care 
543.5 	services,and integrated community supports, and supportive living services daily.
543.6 	(b) Payments for community residential services, corporate foster care services, corporate 
543.7 	supportive living services daily, family residential services, and family foster care services
543.8 	must be calculated as follows:
543.9 	(1) determine the number of shared staffing and individual direct staff hours to meet a 
543.10 	recipient's needs provided on site or through monitoring technology;
543.11 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
543.12 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
543.13 	5;
543.14 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
543.15 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
543.16 	5, paragraph (b), clause (1);
543.17 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
543.18 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
543.19 	to the result of clause (3);
543.20 	(5) multiply the number of shared and individual direct staff hours provided on site or 
543.21 	through monitoring technology and nursing hours by the appropriate staff wages;
543.22 	(6) multiply the number of shared and individual direct staff hours provided on site or 
543.23 	through monitoring technology and nursing hours by the product of the supervision span 
543.24 	of control ratio in subdivision 5, paragraph (b), clause (2), and the appropriate supervision 
543.25 	wage in subdivision 5, paragraph (a), clause (21);
543.26 	(7) combine the results of clauses (5) and (6), excluding any shared and individual direct 
543.27 	staff hours provided through monitoring technology, and multiply the result by one plus 
543.28 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), 
543.29 	clause (3). This is defined as the direct staffing cost;
543.30 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
543.31 	and individual direct staff hours provided through monitoring technology, by one plus the 
543.32 	employee-related cost ratio in subdivision 5, paragraph (b), clause (4);
544.1 	(9) for client programming and supports, the commissioner shall add $2,179; and
544.2 	(10) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if 
544.3 	customized for adapted transport, based on the resident with the highest assessed need.
544.4 	(c) The total rate must be calculated using the following steps:
544.5 	(1) subtotal paragraph (b), clauses (8) to (10), and the direct staffing cost of any shared 
544.6 	and individual direct staff hours provided through monitoring technology that was excluded 
544.7 	in clause (8);
544.8 	(2) sum the standard general and administrative rate, the program-related expense ratio, 
544.9 	and the absence and utilization ratio;
544.10 	(3) divide the result of clause (1) by one minus the result of clause (2). This is the total 
544.11 	payment amount; and
544.12 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner to 
544.13 	adjust for regional differences in the cost of providing services.
544.14 	(d) The payment methodology for customized living, 24-hour customized living, and 
544.15 	residential care services must be the customized living tool. Revisions to the customized 
544.16 	living tool must be made to reflect the services and activities unique to disability-related 
544.17 	recipient needs. Customized living and 24-hour customized living rates determined under 
544.18 	this section shall not include more than 24 hours of support in a daily unit. The commissioner 
544.19 	shall establish acuity-based input limits, based on case mix, for customized living and 
544.20 	24-hour customized living rates determined under this section.
544.21 	(e) Payments for integrated community support services must be calculated as follows:
544.22 	(1) the base shared staffing shall be eight hours divided by the number of people receiving 
544.23 	support in the integrated community support setting;
544.24 	(2) the individual staffing hours shall be the average number of direct support hours 
544.25 	provided directly to the service recipient;
544.26 	(3) the personnel hourly wage rate must be based on the most recent Bureau of Labor 
544.27 	Statistics Minnesota-specific rates or rates derived by the commissioner as provided in 
544.28 	subdivision 5;
544.29 	(4) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
544.30 	result of clause (3) by the product of one plus the competitive workforce factor in subdivision 
544.31 	5, paragraph (b), clause (1);
545.1 	(5) for a recipient requiring customization for deaf and hard-of-hearing language 
545.2 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
545.3 	to the result of clause (4);
545.4 	(6) multiply the number of shared and individual direct staff hours in clauses (1) and 
545.5 	(2) by the appropriate staff wages;
545.6 	(7) multiply the number of shared and individual direct staff hours in clauses (1) and 
545.7 	(2) by the product of the supervisory span of control ratio in subdivision 5, paragraph (b), 
545.8 	clause (2), and the appropriate supervisory wage in subdivision 5, paragraph (a), clause 
545.9 	(21);
545.10 	(8) combine the results of clauses (6) and (7) and multiply the result by one plus the 
545.11 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause 
545.12 	(3). This is defined as the direct staffing cost;
545.13 	(9) for employee-related expenses, multiply the direct staffing cost by one plus the 
545.14 	employee-related cost ratio in subdivision 5, paragraph (b), clause (4); and
545.15 	(10) for client programming and supports, the commissioner shall add $2,260.21 divided 
545.16 	by 365.
545.17 	(f) The total rate must be calculated as follows:
545.18 	(1) add the results of paragraph (e), clauses (9) and (10);
545.19 	(2) add the standard general and administrative rate, the program-related expense ratio, 
545.20 	and the absence and utilization factor ratio;
545.21 	(3) divide the result of clause (1) by one minus the result of clause (2). This is the total 
545.22 	payment amount; and
545.23 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner to 
545.24 	adjust for regional differences in the cost of providing services.
545.25 	(g) The payment methodology for customized living and 24-hour customized living 
545.26 	services must be the customized living tool. The commissioner shall revise the customized 
545.27 	living tool to reflect the services and activities unique to disability-related recipient needs 
545.28 	and adjust for regional differences in the cost of providing services.
545.29 	(h) The number of days authorized for all individuals enrolling in residential services 
545.30 	must include every day that services start and end.

546.1 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
546.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
546.3 	when federal approval is obtained.

546.4 	Sec. 20. Minnesota Statutes 2020, section 256B.4914, subdivision 7, is amended to read:
546.5 		Subd. 7.Payments for day programs. Payments for services with day programs 
546.6 	including adult day services, day treatment and habilitation, day support services, 
546.7 	prevocational services, and structured day services, provided in person or remotely, must 
546.8 	be calculated as follows:
546.9 	(1) determine the number of units of service and staffing ratio to meet a recipient's needs:
546.10 	(i) the staffing ratios for the units of service provided to a recipient in a typical week 
546.11 	must be averaged to determine an individual's staffing ratio; and
546.12 	(ii) the commissioner, in consultation with service providers, shall develop a uniform 
546.13 	staffing ratio worksheet to be used to determine staffing ratios under this subdivision;
546.14 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
546.15 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
546.16 	5;
546.17 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
546.18 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
546.19 	5, paragraph (d) (c), clause (1);
546.20 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
546.21 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
546.22 	to the result of clause (3);
546.23 	(5) multiply the number of day program direct staff hours and nursing hours by the 
546.24 	appropriate staff wage;
546.25 	(6) multiply the number of day direct staff hours by the product of the supervision span 
546.26 	of control ratio in subdivision 5, paragraph (d) (c), clause (2), for in-person services or 
546.27 	subdivision 5, paragraph (d), clause (2), for remote services, and the appropriate supervision 
546.28 	wage in subdivision 5, paragraph (a), clause (21);
546.29 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
546.30 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d) (c), 
546.31 	clause (3), for in-person services or subdivision 5, paragraph (d), clause (3), for remote 
546.32 	services. This is defined as the direct staffing rate;
547.1 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
547.2 	plan support ratio in subdivision 5, paragraph (d) (c), clause (5), for in-person services or 
547.3 	subdivision 5, paragraph (d), clause (5), for remote services;
547.4 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
547.5 	employee-related cost ratio in subdivision 5, paragraph (d) (c), clause (4), for in-person 
547.6 	services or subdivision 5, paragraph (d), clause (4), for remote services;
547.7 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
547.8 	the client programming and support ratio in subdivision 5, paragraph (d) (c), clause (6), for 
547.9 	in-person services or subdivision 5, paragraph (d), clause (6), for remote services;
547.10 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
547.11 	to meet individual needs for in-person service only;
547.12 	(12) for adult day bath services, add $7.01 per 15 minute unit;
547.13 	(13) this is the subtotal rate;
547.14 	(14) sum the standard general and administrative rate, the program-related expense ratio, 
547.15 	and the absence and utilization factor ratio;
547.16 	(15) divide the result of clause (13) by one minus the result of clause (14). This is the 
547.17 	total payment amount;
547.18 	(16) adjust the result of clause (15) by a factor to be determined by the commissioner 
547.19 	to adjust for regional differences in the cost of providing services;
547.20 	(17) for transportation provided as part of day training and habilitation for an individual 
547.21 	who does not require a lift, add:
547.22 	(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without 
547.23 	a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a 
547.24 	vehicle with a lift;
547.25 	(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without 
547.26 	a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a 
547.27 	vehicle with a lift;
547.28 	(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without 
547.29 	a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a 
547.30 	vehicle with a lift; or
548.1 	(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift, 
548.2 	$16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle 
548.3 	with a lift;
548.4 	(18) for transportation provided as part of day training and habilitation for an individual 
548.5 	who does require a lift, add:
548.6 	(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a 
548.7 	lift, and $15.05 for a shared ride in a vehicle with a lift;
548.8 	(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a 
548.9 	lift, and $28.16 for a shared ride in a vehicle with a lift;
548.10 	(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a 
548.11 	lift, and $58.76 for a shared ride in a vehicle with a lift; or
548.12 	(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift, 
548.13 	and $80.93 for a shared ride in a vehicle with a lift.

548.14 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
548.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
548.16 	when federal approval is obtained.

548.17 	Sec. 21. Minnesota Statutes 2020, section 256B.4914, subdivision 8, is amended to read:
548.18 		Subd. 8.Payments for unit-based services with programming. Payments for unit-based 
548.19 	services with programming, including employment exploration services, employment 
548.20 	development services, housing access coordination, individualized home supports with 
548.21 	family training, individualized home supports with training, in-home family support, 
548.22 	independent living skills training, and hourly supported living services provided to an 
548.23 	individual outside of any day or residential service plan, provided in person or remotely,
548.24 	must be calculated as follows, unless the services are authorized separately under subdivision 
548.25 	6 or 7:
548.26 	(1) determine the number of units of service to meet a recipient's needs;
548.27 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
548.28 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
548.29 	5;
548.30 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
548.31 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
548.32 	5, paragraph (f), clause (1);
549.1 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
549.2 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
549.3 	to the result of clause (3);
549.4 	(5) multiply the number of direct staff hours by the appropriate staff wage;
549.5 	(6) multiply the number of direct staff hours by the product of the supervision span of 
549.6 	control ratio in subdivision 5, paragraph (f), clause (2), for in-person services or subdivision 
549.7 	5, paragraph (g), clause (2), for remote services, and the appropriate supervision wage in 
549.8 	subdivision 5, paragraph (a), clause (21);
549.9 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
549.10 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (f), clause 
549.11 	(3), for in-person services or subdivision 5, paragraph (g), clause (3), for remote services. 
549.12 	This is defined as the direct staffing rate;
549.13 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
549.14 	plan supports ratio in subdivision 5, paragraph (f), clause (5), for in-person services or 
549.15 	subdivision 5, paragraph (g), clause (5), for remote services;
549.16 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
549.17 	employee-related cost ratio in subdivision 5, paragraph (f), clause (4), for in-person services 
549.18 	or subdivision 5, paragraph (g), clause (4), for remote services;
549.19 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
549.20 	the client programming and supports ratio in subdivision 5, paragraph (f), clause (6), for 
549.21 	in-person services or subdivision 5, paragraph (g), clause (6), for remote services;
549.22 	(11) this is the subtotal rate;
549.23 	(12) sum the standard general and administrative rate, the program-related expense ratio, 
549.24 	and the absence and utilization factor ratio;
549.25 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
549.26 	total payment amount;
549.27 	(14) for employment exploration services provided in a shared manner, divide the total 
549.28 	payment amount in clause (13) by the number of service recipients, not to exceed five. For 
549.29 	employment support services provided in a shared manner, divide the total payment amount 
549.30 	in clause (13) by the number of service recipients, not to exceed six. For independent living 
549.31 	skills training, individualized home supports with training, and individualized home supports 
549.32 	with family training provided in a shared manner, divide the total payment amount in clause 
549.33 	(13) by the number of service recipients, not to exceed two; and
550.1 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
550.2 	to adjust for regional differences in the cost of providing services.

550.3 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
550.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
550.5 	when federal approval is obtained.

550.6 	Sec. 22. Minnesota Statutes 2020, section 256B.4914, subdivision 9, is amended to read:
550.7 		Subd. 9.Payments for unit-based services without programming. Payments for 
550.8 	unit-based services without programming, including individualized home supports, night 
550.9 	supervision, personal support, respite, and companion care provided to an individual outside 
550.10 	of any day or residential service plan, provided in person or remotely, must be calculated 
550.11 	as follows unless the services are authorized separately under subdivision 6 or 7:
550.12 	(1) for all services except respite, determine the number of units of service to meet a 
550.13 	recipient's needs;
550.14 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
550.15 	Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
550.16 	(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
550.17 	result of clause (2) by the product of one plus the competitive workforce factor in subdivision 
550.18 	5, paragraph (g) (h), clause (1);
550.19 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
550.20 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
550.21 	to the result of clause (3);
550.22 	(5) multiply the number of direct staff hours by the appropriate staff wage;
550.23 	(6) multiply the number of direct staff hours by the product of the supervision span of 
550.24 	control ratio in subdivision 5, paragraph (g) (h), clause (2), for in-person services or 
550.25 	subdivision 5, paragraph (i), clause (2), for remote services, and the appropriate supervision 
550.26 	wage in subdivision 5, paragraph (a), clause (21);
550.27 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
550.28 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g) (h), 
550.29 	clause (3), for in-person services or subdivision 5, paragraph (i), clause (3), for remote 
550.30 	services. This is defined as the direct staffing rate;
551.1 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
551.2 	plan support ratio in subdivision 5, paragraph (g) (h), clause (5), for in-person services or 
551.3 	subdivision 5, paragraph (i), clause (5), for remote services;
551.4 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
551.5 	employee-related cost ratio in subdivision 5, paragraph (g) (h), clause (4), for in-person 
551.6 	services or subdivision 5, paragraph (i), clause (4), for remote services;
551.7 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
551.8 	the client programming and support ratio in subdivision 5, paragraph (g) (h), clause (6), for 
551.9 	in-person services or subdivision 5, paragraph (i), clause (6), for remote services;
551.10 	(11) this is the subtotal rate;
551.11 	(12) sum the standard general and administrative rate, the program-related expense ratio, 
551.12 	and the absence and utilization factor ratio;
551.13 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
551.14 	total payment amount;
551.15 	(14) for respite services, determine the number of day units of service to meet an 
551.16 	individual's needs;
551.17 	(15) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
551.18 	Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
551.19 	(16) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the 
551.20 	result of clause (15) by the product of one plus the competitive workforce factor in 
551.21 	subdivision 5, paragraph (h) (j), clause (1);
551.22 	(17) for a recipient requiring deaf and hard-of-hearing customization under subdivision 
551.23 	12, add the customization rate provided in subdivision 12 to the result of clause (16);
551.24 	(18) multiply the number of direct staff hours by the appropriate staff wage;
551.25 	(19) multiply the number of direct staff hours by the product of the supervisory span of 
551.26 	control ratio in subdivision 5, paragraph (h) (j), clause (2), and the appropriate supervision 
551.27 	wage in subdivision 5, paragraph (a), clause (21);
551.28 	(20) combine the results of clauses (18) and (19), and multiply the result by one plus 
551.29 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (h)
551.30 	(j), clause (3). This is defined as the direct staffing rate;
551.31 	(21) for employee-related expenses, multiply the result of clause (20) by one plus the 
551.32 	employee-related cost ratio in subdivision 5, paragraph (h) (j), clause (4);
552.1 	(22) this is the subtotal rate;
552.2 	(23) sum the standard general and administrative rate, the program-related expense ratio, 
552.3 	and the absence and utilization factor ratio;
552.4 	(24) divide the result of clause (22) by one minus the result of clause (23). This is the 
552.5 	total payment amount;
552.6 	(25) for individualized home supports provided in a shared manner, divide the total 
552.7 	payment amount in clause (13) by the number of service recipients, not to exceed two;
552.8 	(26) for respite care services provided in a shared manner, divide the total payment 
552.9 	amount in clause (24) by the number of service recipients, not to exceed three; and
552.10 	(27) adjust the result of clauses (13), (25), and (26) by a factor to be determined by the 
552.11 	commissioner to adjust for regional differences in the cost of providing services.

552.12 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
552.13 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
552.14 	when federal approval is obtained.

552.15 	Sec. 23. Minnesota Statutes 2020, section 256B.4914, is amended by adding a subdivision 
552.16 	to read:
552.17 		Subd. 18.Payments for family residential services. The commissioner shall establish 
552.18 	rates for family residential services based on a person's assessed needs as described in the 
552.19 	federally approved waiver plans.

552.20 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
552.21 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
552.22 	when federal approval is obtained.

552.23 	Sec. 24. Minnesota Statutes 2020, section 256B.69, subdivision 5a, is amended to read:
552.24 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section and 
552.25 	section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner 
552.26 	may issue separate contracts with requirements specific to services to medical assistance 
552.27 	recipients age 65 and older.
552.28 	(b) A prepaid health plan providing covered health services for eligible persons pursuant 
552.29 	to chapters 256B and 256L is responsible for complying with the terms of its contract with 
552.30 	the commissioner. Requirements applicable to managed care programs under chapters 256B
553.1 	and 256L established after the effective date of a contract with the commissioner take effect 
553.2 	when the contract is next issued or renewed.
553.3 	(c) The commissioner shall withhold five percent of managed care plan payments under 
553.4 	this section and county-based purchasing plan payments under section 256B.692 for the 
553.5 	prepaid medical assistance program pending completion of performance targets. Each 
553.6 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
553.7 	except in the case of a performance target based on a federal or state law or rule. Criteria 
553.8 	for assessment of each performance target must be outlined in writing prior to the contract 
553.9 	effective date. Clinical or utilization performance targets and their related criteria must 
553.10 	consider evidence-based research and reasonable interventions when available or applicable 
553.11 	to the populations served, and must be developed with input from external clinical experts 
553.12 	and stakeholders, including managed care plans, county-based purchasing plans, and 
553.13 	providers. The managed care or county-based purchasing plan must demonstrate, to the 
553.14 	commissioner's satisfaction, that the data submitted regarding attainment of the performance 
553.15 	target is accurate. The commissioner shall periodically change the administrative measures 
553.16 	used as performance targets in order to improve plan performance across a broader range 
553.17 	of administrative services. The performance targets must include measurement of plan 
553.18 	efforts to contain spending on health care services and administrative activities. The 
553.19 	commissioner may adopt plan-specific performance targets that take into account factors 
553.20 	affecting only one plan, including characteristics of the plan's enrollee population. The 
553.21 	withheld funds must be returned no sooner than July of the following year if performance 
553.22 	targets in the contract are achieved. The commissioner may exclude special demonstration 
553.23 	projects under subdivision 23.
553.24 	(d) The commissioner shall require that managed care plans:
553.25 	(1) use the assessment and authorization processes, forms, timelines, standards, 
553.26 	documentation, and data reporting requirements, protocols, billing processes, and policies 
553.27 	consistent with medical assistance fee-for-service or the Department of Human Services 
553.28 	contract requirements for all personal care assistance services under section 256B.0659.; 
553.29 	and
553.30 	(2) by January 30 of each year that follows a rate increase for any aspect of services 
553.31 	under section 256B.0659 or 256B.85, inform the commissioner and the chairs and ranking 
553.32 	minority members of the legislative committees with jurisdiction over rates determined 
553.33 	under section 256B.851 of the amount of the rate increase that is paid to each personal care 
553.34 	assistance provider agency with which the plan has a contract.
554.1 	(e) Effective for services rendered on or after January 1, 2012, the commissioner shall 
554.2 	include as part of the performance targets described in paragraph (c) a reduction in the health 
554.3 	plan's emergency department utilization rate for medical assistance and MinnesotaCare 
554.4 	enrollees, as determined by the commissioner. For 2012, the reduction shall be based on 
554.5 	the health plan's utilization in 2009. To earn the return of the withhold each subsequent 
554.6 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
554.7 	reduction of no less than ten percent of the plan's emergency department utilization rate for 
554.8 	medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described 
554.9 	in subdivisions 23 and 28, compared to the previous measurement year until the final 
554.10 	performance target is reached. When measuring performance, the commissioner must 
554.11 	consider the difference in health risk in a managed care or county-based purchasing plan's 
554.12 	membership in the baseline year compared to the measurement year, and work with the 
554.13 	managed care or county-based purchasing plan to account for differences that they agree 
554.14 	are significant.
554.15 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
554.16 	the following calendar year if the managed care plan or county-based purchasing plan 
554.17 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
554.18 	was achieved. The commissioner shall structure the withhold so that the commissioner 
554.19 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
554.20 	in utilization less than the targeted amount.
554.21 	The withhold described in this paragraph shall continue for each consecutive contract 
554.22 	period until the plan's emergency room utilization rate for state health care program enrollees 
554.23 	is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance 
554.24 	and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the 
554.25 	health plans in meeting this performance target and shall accept payment withholds that 
554.26 	may be returned to the hospitals if the performance target is achieved.
554.27 	(f) Effective for services rendered on or after January 1, 2012, the commissioner shall 
554.28 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
554.29 	hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as 
554.30 	determined by the commissioner. To earn the return of the withhold each year, the managed 
554.31 	care plan or county-based purchasing plan must achieve a qualifying reduction of no less 
554.32 	than five percent of the plan's hospital admission rate for medical assistance and 
554.33 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
554.34 	28, compared to the previous calendar year until the final performance target is reached. 
554.35 	When measuring performance, the commissioner must consider the difference in health risk 
555.1 	in a managed care or county-based purchasing plan's membership in the baseline year 
555.2 	compared to the measurement year, and work with the managed care or county-based 
555.3 	purchasing plan to account for differences that they agree are significant.
555.4 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
555.5 	the following calendar year if the managed care plan or county-based purchasing plan 
555.6 	demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization 
555.7 	rate was achieved. The commissioner shall structure the withhold so that the commissioner 
555.8 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
555.9 	in utilization less than the targeted amount.
555.10 	The withhold described in this paragraph shall continue until there is a 25 percent 
555.11 	reduction in the hospital admission rate compared to the hospital admission rates in calendar 
555.12 	year 2011, as determined by the commissioner. The hospital admissions in this performance 
555.13 	target do not include the admissions applicable to the subsequent hospital admission 
555.14 	performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting 
555.15 	this performance target and shall accept payment withholds that may be returned to the 
555.16 	hospitals if the performance target is achieved.
555.17 	(g) Effective for services rendered on or after January 1, 2012, the commissioner shall 
555.18 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
555.19 	hospitalization admission rates for subsequent hospitalizations within 30 days of a previous 
555.20 	hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare 
555.21 	enrollees, as determined by the commissioner. To earn the return of the withhold each year, 
555.22 	the managed care plan or county-based purchasing plan must achieve a qualifying reduction 
555.23 	of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees, 
555.24 	excluding enrollees in programs described in subdivisions 23 and 28, of no less than five 
555.25 	percent compared to the previous calendar year until the final performance target is reached.
555.26 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
555.27 	the following calendar year if the managed care plan or county-based purchasing plan 
555.28 	demonstrates to the satisfaction of the commissioner that a qualifying reduction in the 
555.29 	subsequent hospitalization rate was achieved. The commissioner shall structure the withhold 
555.30 	so that the commissioner returns a portion of the withheld funds in amounts commensurate 
555.31 	with achieved reductions in utilization less than the targeted amount.
555.32 	The withhold described in this paragraph must continue for each consecutive contract 
555.33 	period until the plan's subsequent hospitalization rate for medical assistance and 
555.34 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
556.1 	28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year 
556.2 	2011. Hospitals shall cooperate with the plans in meeting this performance target and shall 
556.3 	accept payment withholds that must be returned to the hospitals if the performance target 
556.4 	is achieved.
556.5 	(h) Effective for services rendered on or after January 1, 2013, through December 31, 
556.6 	2013, the commissioner shall withhold 4.5 percent of managed care plan payments under 
556.7 	this section and county-based purchasing plan payments under section 256B.692 for the 
556.8 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
556.9 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
556.10 	special demonstration projects under subdivision 23.
556.11 	(i) Effective for services rendered on or after January 1, 2014, the commissioner shall 
556.12 	withhold three percent of managed care plan payments under this section and county-based 
556.13 	purchasing plan payments under section 256B.692 for the prepaid medical assistance 
556.14 	program. The withheld funds must be returned no sooner than July 1 and no later than July 
556.15 	31 of the following year. The commissioner may exclude special demonstration projects 
556.16 	under subdivision 23.
556.17 	(j) A managed care plan or a county-based purchasing plan under section 256B.692 may 
556.18 	include as admitted assets under section 62D.044 any amount withheld under this section 
556.19 	that is reasonably expected to be returned.
556.20 	(k) Contracts between the commissioner and a prepaid health plan are exempt from the 
556.21 	set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and 
556.22 	7.
556.23 	(l) The return of the withhold under paragraphs (h) and (i) is not subject to the 
556.24 	requirements of paragraph (c).
556.25 	(m) Managed care plans and county-based purchasing plans shall maintain current and 
556.26 	fully executed agreements for all subcontractors, including bargaining groups, for 
556.27 	administrative services that are expensed to the state's public health care programs. 
556.28 	Subcontractor agreements determined to be material, as defined by the commissioner after 
556.29 	taking into account state contracting and relevant statutory requirements, must be in the 
556.30 	form of a written instrument or electronic document containing the elements of offer, 
556.31 	acceptance, consideration, payment terms, scope, duration of the contract, and how the 
556.32 	subcontractor services relate to state public health care programs. Upon request, the 
556.33 	commissioner shall have access to all subcontractor documentation under this paragraph. 
557.1 	Nothing in this paragraph shall allow release of information that is nonpublic data pursuant 
557.2 	to section 13.02.

557.3 	EFFECTIVE DATE. This section is effective January 1, 2023.

557.4 	Sec. 25. Minnesota Statutes 2020, section 256B.85, subdivision 2, is amended to read:
557.5 		Subd. 2.Definitions. (a) For the purposes of this section and section 256B.851, the terms 
557.6 	defined in this subdivision have the meanings given.
557.7 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, dressing, 
557.8 	bathing, mobility, positioning, and transferring.
557.9 	(c) "Agency-provider model" means a method of CFSS under which a qualified agency 
557.10 	provides services and supports through the agency's own employees and policies. The agency 
557.11 	must allow the participant to have a significant role in the selection and dismissal of support 
557.12 	workers of their choice for the delivery of their specific services and supports.
557.13 	(d) "Behavior" means a description of a need for services and supports used to determine 
557.14 	the home care rating and additional service units. The presence of Level I behavior is used 
557.15 	to determine the home care rating.
557.16 	(e) "Budget model" means a service delivery method of CFSS that allows the use of a 
557.17 	service budget and assistance from a financial management services (FMS) provider for a 
557.18 	participant to directly employ support workers and purchase supports and goods.
557.19 	(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that 
557.20 	has been ordered by a physician, and is specified in a community support plan, including:
557.21 	(1) tube feedings requiring:
557.22 	(i) a gastrojejunostomy tube; or
557.23 	(ii) continuous tube feeding lasting longer than 12 hours per day;
557.24 	(2) wounds described as:
557.25 	(i) stage III or stage IV;
557.26 	(ii) multiple wounds;
557.27 	(iii) requiring sterile or clean dressing changes or a wound vac; or
557.28 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
557.29 	care;
557.30 	(3) parenteral therapy described as:
558.1 	(i) IV therapy more than two times per week lasting longer than four hours for each 
558.2 	treatment; or
558.3 	(ii) total parenteral nutrition (TPN) daily;
558.4 	(4) respiratory interventions, including:
558.5 	(i) oxygen required more than eight hours per day;
558.6 	(ii) respiratory vest more than one time per day;
558.7 	(iii) bronchial drainage treatments more than two times per day;
558.8 	(iv) sterile or clean suctioning more than six times per day;
558.9 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
558.10 	as BiPAP and CPAP; and
558.11 	(vi) ventilator dependence under section 256B.0651;
558.12 	(5) insertion and maintenance of catheter, including:
558.13 	(i) sterile catheter changes more than one time per month;
558.14 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
558.15 	times per day; or
558.16 	(iii) bladder irrigations;
558.17 	(6) bowel program more than two times per week requiring more than 30 minutes to 
558.18 	perform each time;
558.19 	(7) neurological intervention, including:
558.20 	(i) seizures more than two times per week and requiring significant physical assistance 
558.21 	to maintain safety; or
558.22 	(ii) swallowing disorders diagnosed by a physician and requiring specialized assistance 
558.23 	from another on a daily basis; and
558.24 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
558.25 	hands-on assistance and interventions in six to eight activities of daily living.
558.26 	(g) "Community first services and supports" or "CFSS" means the assistance and supports 
558.27 	program under this section needed for accomplishing activities of daily living, instrumental 
558.28 	activities of daily living, and health-related tasks through hands-on assistance to accomplish 
558.29 	the task or constant supervision and cueing to accomplish the task, or the purchase of goods 
558.30 	as defined in subdivision 7, clause (3), that replace the need for human assistance.
559.1 	(h) "Community first services and supports service delivery plan" or "CFSS service 
559.2 	delivery plan" means a written document detailing the services and supports chosen by the 
559.3 	participant to meet assessed needs that are within the approved CFSS service authorization, 
559.4 	as determined in subdivision 8. Services and supports are based on the coordinated service 
559.5 	and support plan identified in section 256S.10.
559.6 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
559.7 	organization that provides assistance to the participant in making informed choices about 
559.8 	CFSS services in general and self-directed tasks in particular, and in developing a 
559.9 	person-centered CFSS service delivery plan to achieve quality service outcomes.
559.10 	(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
559.11 	(k) "Dependency" in activities of daily living means a person requires hands-on assistance 
559.12 	or constant supervision and cueing to accomplish one or more of the activities of daily living 
559.13 	every day or on the days during the week that the activity is performed; however, a child 
559.14 	may not be found to be dependent in an activity of daily living if, because of the child's age, 
559.15 	an adult would either perform the activity for the child or assist the child with the activity 
559.16 	and the assistance needed is the assistance appropriate for a typical child of the same age.
559.17 	(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are 
559.18 	included in the CFSS service delivery plan through one of the home and community-based 
559.19 	services waivers and as approved and authorized under chapter 256S and sections 256B.092, 
559.20 	subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state 
559.21 	plan CFSS services for participants.
559.22 	(m) "Financial management services provider" or "FMS provider" means a qualified 
559.23 	organization required for participants using the budget model under subdivision 13 that is 
559.24 	an enrolled provider with the department to provide vendor fiscal/employer agent financial 
559.25 	management services (FMS).
559.26 	(n) "Health-related procedures and tasks" means procedures and tasks related to the 
559.27 	specific assessed health needs of a participant that can be taught or assigned by a 
559.28 	state-licensed health care or mental health professional and performed by a support worker.
559.29 	(o) "Instrumental activities of daily living" means activities related to living independently 
559.30 	in the community, including but not limited to: meal planning, preparation, and cooking; 
559.31 	shopping for food, clothing, or other essential items; laundry; housecleaning; assistance 
559.32 	with medications; managing finances; communicating needs and preferences during activities; 
559.33 	arranging supports; and assistance with traveling around and participating in the community.
560.1 	(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph 
560.2 	(e).
560.3 	(q) "Legal representative" means parent of a minor, a court-appointed guardian, or 
560.4 	another representative with legal authority to make decisions about services and supports 
560.5 	for the participant. Other representatives with legal authority to make decisions include but 
560.6 	are not limited to a health care agent or an attorney-in-fact authorized through a health care 
560.7 	directive or power of attorney.
560.8 	(r) "Level I behavior" means physical aggression towards toward self or others or 
560.9 	destruction of property that requires the immediate response of another person.
560.10 	(s) "Medication assistance" means providing verbal or visual reminders to take regularly 
560.11 	scheduled medication, and includes any of the following supports listed in clauses (1) to 
560.12 	(3) and other types of assistance, except that a support worker may not determine medication 
560.13 	dose or time for medication or inject medications into veins, muscles, or skin:
560.14 	(1) under the direction of the participant or the participant's representative, bringing 
560.15 	medications to the participant including medications given through a nebulizer, opening a 
560.16 	container of previously set-up medications, emptying the container into the participant's 
560.17 	hand, opening and giving the medication in the original container to the participant, or 
560.18 	bringing to the participant liquids or food to accompany the medication;
560.19 	(2) organizing medications as directed by the participant or the participant's representative; 
560.20 	and
560.21 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
560.22 	(t) "Participant" means a person who is eligible for CFSS.
560.23 	(u) "Participant's representative" means a parent, family member, advocate, or other 
560.24 	adult authorized by the participant or participant's legal representative, if any, to serve as a 
560.25 	representative in connection with the provision of CFSS. This authorization must be in 
560.26 	writing or by another method that clearly indicates the participant's free choice and may be 
560.27 	withdrawn at any time. The participant's representative must have no financial interest in 
560.28 	the provision of any services included in the participant's CFSS service delivery plan and 
560.29 	must be capable of providing the support necessary to assist the participant in the use of 
560.30 	CFSS. If through the assessment process described in subdivision 5 a participant is 
560.31 	determined to be in need of a participant's representative, one must be selected. If the 
560.32 	participant is unable to assist in the selection of a participant's representative, the legal 
560.33 	representative shall appoint one. Two persons may be designated as a participant's 
561.1 	representative for reasons such as divided households and court-ordered custodies. Duties 
561.2 	of a participant's representatives may include:
561.3 	(1) being available while services are provided in a method agreed upon by the participant 
561.4 	or the participant's legal representative and documented in the participant's CFSS service 
561.5 	delivery plan;
561.6 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is 
561.7 	being followed; and
561.8 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
561.9 	verification of the CFSS services.
561.10 	(v) "Person-centered planning process" means a process that is directed by the participant 
561.11 	to plan for CFSS services and supports.
561.12 	(w) "Service budget" means the authorized dollar amount used for the budget model or 
561.13 	for the purchase of goods.
561.14 	(x) "Shared services" means the provision of CFSS services by the same CFSS support 
561.15 	worker to two or three participants who voluntarily enter into an agreement to receive 
561.16 	services at the same time and in the same setting by the same employer.
561.17 	(y) "Support worker" means a qualified and trained employee of the agency-provider 
561.18 	as required by subdivision 11b or of the participant employer under the budget model as 
561.19 	required by subdivision 14 who has direct contact with the participant and provides services 
561.20 	as specified within the participant's CFSS service delivery plan.
561.21 	(z) "Unit" means the increment of service based on hours or minutes identified in the 
561.22 	service agreement.
561.23 	(aa) "Vendor fiscal employer agent" means an agency that provides financial management 
561.24 	services.
561.25 	(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share 
561.26 	of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
561.27 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
561.28 	long-term care insurance, uniform allowance, contributions to employee retirement accounts, 
561.29 	or other forms of employee compensation and benefits.
561.30 	(cc) "Worker training and development" means services provided according to subdivision 
561.31 	18a for developing workers' skills as required by the participant's individual CFSS service 
561.32 	delivery plan that are arranged for or provided by the agency-provider or purchased by the 
562.1 	participant employer. These services include training, education, direct observation and 
562.2 	supervision, and evaluation and coaching of job skills and tasks, including supervision of 
562.3 	health-related tasks or behavioral supports.

562.4 	EFFECTIVE DATE. This section is effective January 1, 2023, or upon federal approval, 
562.5 	whichever is later. The commissioner of human services must notify the revisor of statutes 
562.6 	when federal approval is obtained.

562.7 	Sec. 26. [256B.851] COMMUNITY FIRST SERVICES AND SUPPORTS; PAYMENT 
562.8 	RATES.
562.9 		Subdivision 1.Application. (a) The payment methodologies in this section apply to:
562.10 	(1) community first services and supports (CFSS), extended CFSS, and enhanced rate 
562.11 	CFSS under section 256B.85; and
562.12 	(2) personal care assistance services under section 256B.0625, subdivisions 19a and 
562.13 	19c; extended personal care assistance service as defined in section 256B.0659, subdivision 
562.14 	1; and enhanced rate personal care assistance services under section 256B.0659, subdivision 
562.15 	17a.
562.16 	(b) This section does not change existing personal care assistance program or community 
562.17 	first services and supports policies and procedures.
562.18 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
562.19 	meanings given in section 256B.85, subdivision 2, and as follows.
562.20 	(b) "Commissioner" means the commissioner of human services.
562.21 	(c) "Component value" means an underlying factor that is built into the rate methodology 
562.22 	to calculate service rates and is part of the cost of providing services.
562.23 	(d) "Payment rate" or "rate" means reimbursement to an eligible provider for services 
562.24 	provided to a qualified individual based on an approved service authorization.
562.25 		Subd. 3.Payment rates; base wage index.  When initially establishing the base wage 
562.26 	component values, the commissioner must use the Minnesota-specific median wage for the 
562.27 	standard occupational classification (SOC) codes published by the Bureau of Labor Statistics 
562.28 	in the edition of the Occupational Handbook available January 1, 2021. The commissioner 
562.29 	must calculate the base wage component values as follows for:
562.30 	(1) personal care assistance services, CFSS, extended personal care assistance services, 
562.31 	and extended CFSS. The base wage component value equals the median wage for personal 
562.32 	care aide (SOC code 31-1120);
563.1 	(2) enhanced rate personal care assistance services and enhanced rate CFSS. The base 
563.2 	wage component value equals the product of median wage for personal care aide (SOC 
563.3 	code 31-1120) and the value of the enhanced rate under section 256B.0659, subdivision 
563.4 	17a; and
563.5 	(3) qualified professional services and CFSS worker training and development. The base 
563.6 	wage component value equals the sum of 70 percent of the median wage for registered nurse 
563.7 	(SOC code 29-1141), 15 percent of the median wage for health care social worker (SOC 
563.8 	code 21-1099), and 15 percent of the median wage for social and human service assistant 
563.9 	(SOC code 21-1093).
563.10 		Subd. 4.Payment rates; total wage index. (a) The commissioner must multiply the 
563.11 	base wage component values in subdivision 3 by one plus the appropriate competitive 
563.12 	workforce factor. The product is the total wage component value.
563.13 	(b) For personal care assistance services, CFSS, extended personal care assistance 
563.14 	services, extended CFSS, enhanced rate personal care assistance services, and enhanced 
563.15 	rate CFSS, the initial competitive workforce factor is 4.7 percent.
563.16 	(c) For qualified professional services and CFSS worker training and development, the 
563.17 	competitive workforce factor is zero percent.
563.18 	(d) On August 1, 2024, and every two years thereafter, the commissioner shall report 
563.19 	recommendations to the chairs and ranking minority members of the legislative committees 
563.20 	and divisions with jurisdiction over health and human services policy and finance an update 
563.21 	of the competitive workforce factors in this subdivision using the most recently available 
563.22 	data. The commissioner shall make adjustments to the competitive workforce factor toward 
563.23 	the percent difference between: (1) the median wage for personal care aide (SOC code 
563.24 	31-1120); and (2) the weighted average wage for all other SOC codes with the same Bureau 
563.25 	of Labor Statistics classifications for education, experience, and training required for job 
563.26 	competency.
563.27 	(e) The commissioner shall recommend an increase or decrease of the competitive 
563.28 	workforce factor from its previous value by no more than three percentage points. If, after 
563.29 	a biennial adjustment, the competitive workforce factor is less than or equal to zero, the 
563.30 	competitive workforce factor shall be zero.
563.31 		Subd. 5.Payment rates; component values. (a) The commissioner must use the 
563.32 	following component values:
563.33 	(1) employee vacation, sick, and training factor, 8.71 percent;
564.1 	(2) employer taxes and workers' compensation factor, 11.56 percent;
564.2 	(3) employee benefits factor, 12.04 percent;
564.3 	(4) client programming and supports factor, 2.30 percent;
564.4 	(5) program plan support factor, 7.00 percent;
564.5 	(6) general business and administrative expenses factor, 13.25 percent;
564.6 	(7) program administration expenses factor, 2.90 percent; and
564.7 	(8) absence and utilization factor, 3.90 percent.
564.8 	(b) For purposes of implementation, the commissioner shall use the following 
564.9 	implementation components:
564.10 	(1) personal care assistance services and CFSS: 75.45 percent;
564.11 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 75.45 
564.12 	percent; and
564.13 	(3) qualified professional services and CFSS worker training and development: 75.45 
564.14 	percent.
564.15 		Subd. 6.Payment rates; rate determination. (a) The commissioner must determine 
564.16 	the rate for personal care assistance services, CFSS, extended personal care assistance 
564.17 	services, extended CFSS, enhanced rate personal care assistance services, enhanced rate 
564.18 	CFSS, qualified professional services, and CFSS worker training and development as 
564.19 	follows:
564.20 	(1) multiply the appropriate total wage component value calculated in subdivision 4 by 
564.21 	one plus the employee vacation, sick, and training factor in subdivision 5;
564.22 	(2) for program plan support, multiply the result of clause (1) by one plus the program 
564.23 	plan support factor in subdivision 5;
564.24 	(3) for employee-related expenses, add the employer taxes and workers' compensation 
564.25 	factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is 
564.26 	employee-related expenses. Multiply the product of clause (2) by one plus the value for 
564.27 	employee-related expenses;
564.28 	(4) for client programming and supports, multiply the product of clause (3) by one plus 
564.29 	the client programming and supports factor in subdivision 5;
565.1 	(5) for administrative expenses, add the general business and administrative expenses 
565.2 	factor in subdivision 5, the program administration expenses factor in subdivision 5, and 
565.3 	the absence and utilization factor in subdivision 5;
565.4 	(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is 
565.5 	the hourly rate;
565.6 	(7) multiply the hourly rate by the appropriate implementation component under 
565.7 	subdivision 5. This is the adjusted hourly rate; and
565.8 	(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment 
565.9 	rate.
565.10 	(b) The commissioner must publish the total adjusted payment rates.
565.11 		Subd. 7.Personal care provider agency; required reporting and analysis of cost 
565.12 	data. (a) The commissioner shall evaluate on an ongoing basis whether the base wage 
565.13 	component values and component values in this section appropriately address the cost to 
565.14 	provide the service. The commissioner shall make recommendations to adjust the rate 
565.15 	methodology as indicated by the evaluation. As determined by the commissioner and in 
565.16 	consultation with stakeholders, agencies enrolled to provide services with rates determined 
565.17 	under this section must submit requested cost data to the commissioner. The commissioner 
565.18 	may request cost data, including but not limited to:
565.19 	(1) worker wage costs;
565.20 	(2) benefits paid;
565.21 	(3) supervisor wage costs;
565.22 	(4) executive wage costs;
565.23 	(5) vacation, sick, and training time paid;
565.24 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
565.25 	(7) administrative costs paid;
565.26 	(8) program costs paid;
565.27 	(9) transportation costs paid;
565.28 	(10) staff vacancy rates; and
565.29 	(11) other data relating to costs required to provide services requested by the 
565.30 	commissioner.
566.1 	(b) At least once in any three-year period, a provider must submit the required cost data 
566.2 	for a fiscal year that ended not more than 18 months prior to the submission date. The 
566.3 	commissioner must provide each provider a 90-day notice prior to its submission due date. 
566.4 	If a provider fails to submit required cost data, the commissioner must provide notice to a 
566.5 	provider that has not provided required cost data 30 days after the required submission date 
566.6 	and a second notice to a provider that has not provided required cost data 60 days after the 
566.7 	required submission date. The commissioner must temporarily suspend payments to a 
566.8 	provider if the commissioner has not received required cost data 90 days after the required 
566.9 	submission date. The commissioner must make withheld payments when the required cost 
566.10 	data is received by the commissioner.
566.11 	(c) The commissioner must conduct a random validation of data submitted under this 
566.12 	subdivision to ensure data accuracy. The commissioner shall analyze cost documentation 
566.13 	in paragraph (a) and provide recommendations for adjustments to cost components.
566.14 	(d) The commissioner shall analyze cost documentation in paragraph (a) and may submit 
566.15 	recommendations on component values, updated base wage component values, and 
566.16 	competitive workforce factors to the chair and ranking minority members of the legislative 
566.17 	committees and divisions with jurisdiction over human services policy and finance every 
566.18 	two years beginning August 1, 2026. The commissioner shall release cost data in an aggregate 
566.19 	form, and cost data from individual providers shall not be released except as provided for 
566.20 	in current law.
566.21 	(e) The commissioner, in consultation with stakeholders, must develop and implement 
566.22 	a process for providing training and technical assistance necessary to support provider 
566.23 	submission of cost data required under this subdivision.
566.24 		Subd. 8.Payment rates; reports required. (a) The commissioner must assess the 
566.25 	standard component values and publish evaluation findings and recommended changes to 
566.26 	the rate methodology in a report to the legislature by August 1, 2026.
566.27 	(b) The commissioner must assess the long-term impacts of the rate methodology 
566.28 	implementation on staff providing services with rates determined under this section, including 
566.29 	but not limited to measuring changes in wages, benefits provided, hours worked, and 
566.30 	retention. The commissioner must publish evaluation findings in a report to the legislature 
566.31 	by August 1, 2028, and once every two years thereafter.
566.32 		Subd. 9.Self-directed services workforce. Nothing in this section limits the 
566.33 	commissioner's authority over terms and conditions for individual providers in covered 
566.34 	programs as defined in section 256B.0711. The commissioner's authority over terms and 
567.1 	conditions for individual providers in covered programs remains subject to the state's 
567.2 	obligations to meet and negotiate under chapter 179A, as modified and made applicable to 
567.3 	individual providers under section 179A.54, and to agreements with any exclusive 
567.4 	representative of individual providers, as authorized by chapter 179A, as modified and made 
567.5 	applicable to individual providers under section 179A.54. A change in the rate for services 
567.6 	within the covered programs defined in section 256B.0711 does not constitute a change in 
567.7 	a term or condition for individual providers in covered programs and is not subject to the 
567.8 	state's obligation to meet and negotiate under chapter 179A, except that, notwithstanding 
567.9 	any other law to the contrary, the state shall meet and negotiate with the exclusive 
567.10 	representative of individual providers over wage and benefit increases made possible by 
567.11 	rate increases provided between January 1, 2023 and June 30, 2023. Any resulting tentative 
567.12 	agreement shall be submitted to the legislature to be accepted or rejected in accordance with 
567.13 	sections 3.855 and 179A.22.

567.14 	EFFECTIVE DATE. This section is effective January 1, 2023, or upon federal approval, 
567.15 	whichever is later. The commissioner of human services must notify the revisor of statutes 
567.16 	when federal approval is obtained.

567.17 	Sec. 27. Minnesota Statutes 2020, section 256I.04, subdivision 3, is amended to read:
567.18 		Subd. 3.Moratorium on development of housing support beds. (a) Agencies shall 
567.19 	not enter into agreements for new housing support beds with total rates in excess of the 
567.20 	MSA equivalent rate except:
567.21 	(1) for establishments licensed under chapter 245D provided the facility is needed to 
567.22 	meet the census reduction targets for persons with developmental disabilities at regional 
567.23 	treatment centers;
567.24 	(2) up to 80 beds in a single, specialized facility located in Hennepin County that will 
567.25 	provide housing for chronic inebriates who are repetitive users of detoxification centers and 
567.26 	are refused placement in emergency shelters because of their state of intoxication, and 
567.27 	planning for the specialized facility must have been initiated before July 1, 1991, in 
567.28 	anticipation of receiving a grant from the Housing Finance Agency under section 462A.05, 
567.29 	subdivision 20a, paragraph (b);
567.30 	(3) notwithstanding the provisions of subdivision 2a, for up to 226 500 supportive 
567.31 	housing units in Anoka, Carver, Dakota, Hennepin, or Ramsey, Scott, or Washington County 
567.32 	for homeless adults with a mental illness, a history of substance abuse, or human 
567.33 	immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this 
567.34 	section, "homeless adult" means a person who is living on the street or in a shelter or 
568.1 	discharged from a regional treatment center, community hospital, or residential treatment 
568.2 	program and, has no appropriate housing available, and lacks the resources and support 
568.3 	necessary to access appropriate housing. At least 70 percent of the supportive housing units 
568.4 	must serve homeless adults with mental illness, substance abuse problems, or human 
568.5 	immunodeficiency virus or acquired immunodeficiency syndrome who are about to be or, 
568.6 	within the previous six months, have been discharged from a regional treatment center, or 
568.7 	a state-contracted psychiatric bed in a community hospital, or a residential mental health 
568.8 	or chemical dependency treatment program. If a person meets the requirements of subdivision 
568.9 	1, paragraph (a) or (b), and receives a federal or state housing subsidy, the housing support 
568.10 	rate for that person is limited to the supplementary rate under section 256I.05, subdivision 
568.11 	1a, and is determined by subtracting the amount of the person's countable income that 
568.12 	exceeds the MSA equivalent rate from the housing support supplementary service rate. A 
568.13 	resident in a demonstration project site who no longer participates in the demonstration 
568.14 	program shall retain eligibility for a housing support payment in an amount determined 
568.15 	under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under 
568.16 	section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are 
568.17 	available and the services can be provided through a managed care entity. If federal matching 
568.18 	funds are not available, then service funding will continue under section 256I.05, subdivision 
568.19 	1a;
568.20 	(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in 
568.21 	Hennepin County providing services for recovering and chemically dependent men that has 
568.22 	had a housing support contract with the county and has been licensed as a board and lodge 
568.23 	facility with special services since 1980;
568.24 	(5) for a housing support provider located in the city of St. Cloud, or a county contiguous 
568.25 	to the city of St. Cloud, that operates a 40-bed facility, that received financing through the 
568.26 	Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves 
568.27 	chemically dependent clientele, providing 24-hour-a-day supervision;
568.28 	(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent 
568.29 	persons, operated by a housing support provider that currently operates a 304-bed facility 
568.30 	in Minneapolis, and a 44-bed facility in Duluth;
568.31 	(7) for a housing support provider that operates two ten-bed facilities, one located in 
568.32 	Hennepin County and one located in Ramsey County, that provide community support and 
568.33 	24-hour-a-day supervision to serve the mental health needs of individuals who have 
568.34 	chronically lived unsheltered; and
569.1 	(8) for a facility authorized for recipients of housing support in Hennepin County with 
569.2 	a capacity of up to 48 beds that has been licensed since 1978 as a board and lodging facility 
569.3 	and that until August 1, 2007, operated as a licensed chemical dependency treatment program.
569.4 	(b) An agency may enter into a housing support agreement for beds with rates in excess 
569.5 	of the MSA equivalent rate in addition to those currently covered under a housing support 
569.6 	agreement if the additional beds are only a replacement of beds with rates in excess of the 
569.7 	MSA equivalent rate which have been made available due to closure of a setting, a change 
569.8 	of licensure or certification which removes the beds from housing support payment, or as 
569.9 	a result of the downsizing of a setting authorized for recipients of housing support. The 
569.10 	transfer of available beds from one agency to another can only occur by the agreement of 
569.11 	both agencies.
569.12 	(c) The appropriation for this subdivision must include administrative funding equal to 
569.13 	the cost of two full-time equivalent employees to process eligibility. The commissioner 
569.14 	must disburse administrative funding to the fiscal agent for the counties under this 
569.15 	subdivision.

569.16 	Sec. 28. Minnesota Statutes 2020, section 256I.05, subdivision 1a, is amended to read:
569.17 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
569.18 	subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other 
569.19 	services necessary to provide room and board if the residence is licensed by or registered 
569.20 	by the Department of Health, or licensed by the Department of Human Services to provide 
569.21 	services in addition to room and board, and if the provider of services is not also concurrently 
569.22 	receiving funding for services for a recipient under a home and community-based waiver 
569.23 	under title XIX of the federal Social Security Act; or funding from the medical assistance 
569.24 	program under section 256B.0659, for personal care services for residents in the setting; or 
569.25 	residing in a setting which receives funding under section 245.73. If funding is available 
569.26 	for other necessary services through a home and community-based waiver, or personal care 
569.27 	services under section 256B.0659, then the housing support rate is limited to the rate set in 
569.28 	subdivision 1. Unless otherwise provided in law, in no case may the supplementary service 
569.29 	rate exceed $426.37. The registration and licensure requirement does not apply to 
569.30 	establishments which are exempt from state licensure because they are located on Indian 
569.31 	reservations and for which the tribe has prescribed health and safety requirements. Service 
569.32 	payments under this section may be prohibited under rules to prevent the supplanting of 
569.33 	federal funds with state funds. The commissioner shall pursue the feasibility of obtaining 
569.34 	the approval of the Secretary of Health and Human Services to provide home and 
570.1 	community-based waiver services under title XIX of the federal Social Security Act for 
570.2 	residents who are not eligible for an existing home and community-based waiver due to a 
570.3 	primary diagnosis of mental illness or chemical dependency and shall apply for a waiver if 
570.4 	it is determined to be cost-effective.
570.5 	(b) The commissioner is authorized to make cost-neutral transfers from the housing 
570.6 	support fund for beds under this section to other funding programs administered by the 
570.7 	department after consultation with the county or counties agency in which the affected beds 
570.8 	are located. The commissioner may also make cost-neutral transfers from the housing support 
570.9 	fund to county human service agencies for beds permanently removed from the housing 
570.10 	support census under a plan submitted by the county agency and approved by the 
570.11 	commissioner. The commissioner shall report the amount of any transfers under this provision 
570.12 	annually to the legislature.
570.13 	(c) Counties Agencies must not negotiate supplementary service rates with providers of 
570.14 	housing support that are licensed as board and lodging with special services and that do not 
570.15 	encourage a policy of sobriety on their premises and make referrals to available community 
570.16 	services for volunteer and employment opportunities for residents.

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

570.18 	Sec. 29. Minnesota Statutes 2020, section 256I.05, subdivision 1c, is amended to read:
570.19 		Subd. 1c.Rate increases. An agency may not increase the rates negotiated for housing 
570.20 	support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).
570.21 	(a) An agency may increase the rates for room and board to the MSA equivalent rate 
570.22 	for those settings whose current rate is below the MSA equivalent rate.
570.23 	(b) An agency may increase the rates for residents in adult foster care whose difficulty 
570.24 	of care has increased. The total housing support rate for these residents must not exceed the 
570.25 	maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase 
570.26 	difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding 
570.27 	by home and community-based waiver programs under title XIX of the Social Security Act.
570.28 	(c) The room and board rates will be increased each year when the MSA equivalent rate 
570.29 	is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less 
570.30 	the amount of the increase in the medical assistance personal needs allowance under section 
570.31 	256B.35.
570.32 	(d) When housing support pays for an individual's room and board, or other costs 
570.33 	necessary to provide room and board, the rate payable to the residence must continue for 
571.1 	up to 18 calendar days per incident that the person is temporarily absent from the residence, 
571.2 	not to exceed 60 days in a calendar year, if the absence or absences are reported in advance 
571.3 	to the county agency's social service staff. Advance reporting is not required for emergency 
571.4 	absences due to crisis, illness, or injury. For purposes of maintaining housing while 
571.5 	temporarily absent due to residential behavioral health treatment or health care treatment 
571.6 	that requires admission to an inpatient hospital, nursing facility, or other health care facility, 
571.7 	the room and board rate for an individual is payable beyond an 18-calendar-day absence 
571.8 	period, not to exceed 150 days in a calendar year.
571.9 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
571.10 	change criteria exists if the establishment experiences a 25 percent increase or decrease in 
571.11 	the total number of its beds, if the net cost of capital additions or improvements is in excess 
571.12 	of 15 percent of the current market value of the residence, or if the residence physically 
571.13 	moves, or changes its licensure, and incurs a resulting increase in operation and property 
571.14 	costs.
571.15 	(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid 
571.16 	for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who 
571.17 	reside in residences that are licensed by the commissioner of health as a boarding care home, 
571.18 	but are not certified for the purposes of the medical assistance program. However, an increase 
571.19 	under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical 
571.20 	assistance reimbursement rate for nursing home resident class A, in the geographic grouping 
571.21 	in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to 
571.22 	9549.0058.

571.23 	Sec. 30. Minnesota Statutes 2020, section 256I.05, subdivision 11, is amended to read:
571.24 		Subd. 11.Transfer of emergency shelter funds. (a) The commissioner shall make a 
571.25 	cost-neutral transfer of funding from the housing support fund to county human service 
571.26 	agencies the agency for emergency shelter beds removed from the housing support census 
571.27 	under a biennial plan submitted by the county agency and approved by the commissioner. 
571.28 	The plan must describe: (1) anticipated and actual outcomes for persons experiencing 
571.29 	homelessness in emergency shelters; (2) improved efficiencies in administration; (3) 
571.30 	requirements for individual eligibility; and (4) plans for quality assurance monitoring and 
571.31 	quality assurance outcomes. The commissioner shall review the county agency plan to 
571.32 	monitor implementation and outcomes at least biennially, and more frequently if the 
571.33 	commissioner deems necessary.
572.1 	(b) The funding under paragraph (a) may be used for the provision of room and board 
572.2 	or supplemental services according to section 256I.03, subdivisions 2 and 8. Providers must 
572.3 	meet the requirements of section 256I.04, subdivisions 2a to 2f. Funding must be allocated 
572.4 	annually, and the room and board portion of the allocation shall be adjusted according to 
572.5 	the percentage change in the housing support room and board rate. The room and board 
572.6 	portion of the allocation shall be determined at the time of transfer. The commissioner or 
572.7 	county agency may return beds to the housing support fund with 180 days' notice, including 
572.8 	financial reconciliation.

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

572.10 	Sec. 31. Minnesota Statutes 2020, section 256S.18, subdivision 7, is amended to read:
572.11 		Subd. 7.Monthly case mix budget cap exception. The commissioner shall approve an 
572.12 	exception to the monthly case mix budget cap in paragraph (a) subdivision 3 to account for 
572.13 	the additional cost of providing enhanced rate personal care assistance services under section 
572.14 	256B.0659 or enhanced rate community first services and supports under section 256B.85. 
572.15 	The exception shall not exceed 107.5 percent of the budget otherwise available to the 
572.16 	individual.The commissioner must calculate the difference between the rate for personal 
572.17 	care assistance services and enhanced rate personal care assistance services. The additional 
572.18 	budget amount approved under an exception must not exceed this difference. The exception 
572.19 	must be reapproved on an annual basis at the time of a participant's annual reassessment.

572.20 	EFFECTIVE DATE. This section is effective July 1, 2021, or upon federal approval, 
572.21 	whichever is later. The commissioner of human services must notify the revisor of statutes 
572.22 	when federal approval is obtained.

572.23 	Sec. 32. Minnesota Statutes 2020, section 256S.20, subdivision 1, is amended to read:
572.24 		Subdivision 1.Customized living services provider requirements. Only a provider 
572.25 	licensed by the Department of Health as a comprehensive home care provider may provide
572.26 	(a) To deliver customized living services or 24-hour customized living services., a provider 
572.27 	must:
572.28 	(1) be licensed as an assisted living facility under chapter 144G; or
572.29 	(2) be licensed as a comprehensive home care provider under chapter 144A and be 
572.30 	delivering services: (i) in a setting defined under section 144G.08, subdivision 7, clauses 
572.31 	(11) to (13); or (ii) in an affordable housing setting under section 144G.08, subdivision 7, 
572.32 	clause (10), that is delivering authorized customized living services to a person in the setting 
573.1 	on or before April 1, 2021. A licensed home care provider is subject to section 256B.0651, 
573.2 	subdivision 14.
573.3 	(b) Settings under paragraph (a), clause (2), must comply with section 256S.2003.

573.4 	EFFECTIVE DATE. This section is effective August 1, 2021.

573.5 	Sec. 33. [256S.2003] CUSTOMIZED LIVING SERVICES; REQUIREMENTS OF 
573.6 	PROVIDERS IN DESIGNATED SETTINGS.
573.7 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
573.8 	the meanings given.
573.9 	(b) "Designated provider" means a home care provider licensed under chapter 144A that 
573.10 	provides customized living services to some or all of the residents of a designated setting 
573.11 	and that is either the setting itself or another entity with which the setting has a contract or 
573.12 	business relationship.
573.13 	(c) "Designated setting" means a setting defined under section 256S.20, subdivision 1, 
573.14 	paragraph (a), clause (2).
573.15 	(d) "Resident" means a person receiving customized living services in a designated 
573.16 	setting.
573.17 		Subd. 2.Attestation of compliance with requirements. Upon enrollment with the 
573.18 	department to provide customized living services, a designated provider of customized 
573.19 	living services must submit an attestation that the provider is in compliance with subdivisions 
573.20 	3 to 8.
573.21 		Subd. 3.Contracts. (a) Every designated provider must execute a written contract with 
573.22 	a resident or the resident's representative and must operate in accordance with the terms of 
573.23 	the contract. The resident or the resident's representative must be given a complete copy of 
573.24 	the contract and all supporting documents and attachments and any changes whenever 
573.25 	changes are made.
573.26 	(b) The contract must include at least the following elements in itself or through 
573.27 	supporting documents or attachments:
573.28 	(1) the name, street address, and mailing address of the designated provider;
573.29 	(2) the name and mailing address of the owner or owners of the designated provider 
573.30 	and, if the owner or owners are not natural persons, identification of the type of business 
573.31 	entity of the owner or owners;
574.1 	(3) the name and mailing address of the managing agent, through management agreement 
574.2 	or lease agreement, of the designated provider, if different from the owner or owners;
574.3 	(4) the name and address of at least one natural person who is authorized to accept service 
574.4 	of process on behalf of the owner or owners and managing agent;
574.5 	(5) a statement identifying the designated provider's home care license number;
574.6 	(6) the term of the contract;
574.7 	(7) an itemization and description of the services to be provided to the resident;
574.8 	(8) a conspicuous notice informing the resident of the policy concerning the conditions 
574.9 	under which and the process through which the contract may be modified, amended, or 
574.10 	terminated;
574.11 	(9) a description of the designated provider's complaint resolution process available to 
574.12 	residents including the toll-free complaint line for the Office of Ombudsman for Long-Term 
574.13 	Care;
574.14 	(10) the resident's designated representative, if any;
574.15 	(11) the designated provider's referral procedures if the contract is terminated;
574.16 	(12) a statement regarding the ability of a resident to receive services from service 
574.17 	providers with whom the designated provider does not have an arrangement;
574.18 	(13) a statement regarding the availability of public funds for payment for residence or 
574.19 	services; and
574.20 	(14) a statement regarding the availability of and contact information for long-term care 
574.21 	consultation services under section 256B.0911 in the county in which the establishment is 
574.22 	located.
574.23 	(c) The contract must include a statement regarding:
574.24 	(1) the ability of a resident to furnish and decorate the resident's unit within the terms 
574.25 	of the lease;
574.26 	(2) a resident's right to access food at any time;
574.27 	(3) a resident's right to choose the resident's visitors and times of visits;
574.28 	(4) a resident's right to choose a roommate if sharing a unit; and
574.29 	(5) a resident's right to have and use a lockable door to the resident's unit. The designated 
574.30 	setting must provide the locks on the unit. Only a staff member with a specific need to enter 
575.1 	the unit shall have keys, and advance notice must be given to the resident before entrance, 
575.2 	when possible.
575.3 	(d) A restriction of a resident's rights under this subdivision is allowed only if determined 
575.4 	necessary for health and safety reasons identified by the home care provider's registered 
575.5 	nurse in an initial assessment or reassessment, as defined under section 144A.4791, 
575.6 	subdivision 8, and documented in the written service plan under section 144A.4791, 
575.7 	subdivision 9. Any restrictions of those rights for people served under this chapter and 
575.8 	section 256B.49 must be documented in the resident's coordinated service and support plan, 
575.9 	as defined under sections 256B.49, subdivision 15, and 256S.10.
575.10 	(e) The contract and related documents executed by each resident or resident's 
575.11 	representative must be maintained by the designated provider in files from the date of 
575.12 	execution until three years after the contract is terminated.
575.13 		Subd. 4.Training in dementia. (a) If a designated provider has a special program or 
575.14 	special care unit for residents with Alzheimer's disease or other dementias or advertises, 
575.15 	markets, or otherwise promotes the provision of services for persons with Alzheimer's 
575.16 	disease or other dementias, whether in a segregated or general unit, employees of the provider 
575.17 	must meet the following training requirements:
575.18 	(1) supervisors of direct-care staff must have at least eight hours of initial training on 
575.19 	topics specified under paragraph (b) within 120 working hours of the employment start 
575.20 	date, and must have at least two hours of training on topics related to dementia care for each 
575.21 	12 months of employment thereafter;
575.22 	(2) direct-care employees must have completed at least eight hours of initial training on 
575.23 	topics specified under paragraph (b) within 160 working hours of the employment start 
575.24 	date. Until this initial training is complete, an employee must not provide direct care unless 
575.25 	there is another employee on site who has completed the initial eight hours of training on 
575.26 	topics related to dementia care and who can act as a resource and assist if issues arise. A 
575.27 	trainer of the requirements under paragraph (b), or a supervisor meeting the requirements 
575.28 	in clause (1), must be available for consultation with the new employee until the training 
575.29 	requirement is complete. Direct-care employees must have at least two hours of training on 
575.30 	topics related to dementia care for each 12 months of employment thereafter;
575.31 	(3) staff who do not provide direct care, including maintenance, housekeeping, and food 
575.32 	service staff, must have at least four hours of initial training on topics specified under 
575.33 	paragraph (b) within 160 working hours of the employment start date, and must have at 
576.1 	least two hours of training on topics related to dementia care for each 12 months of 
576.2 	employment thereafter; and
576.3 	(4) new employees may satisfy the initial training requirements under clauses (1) to (3) 
576.4 	by producing written proof of previously completed required training within the past 18 
576.5 	months.
576.6 	(b) Areas of required training include:
576.7 	(1) an explanation of Alzheimer's disease and related disorders;
576.8 	(2) assistance with activities of daily living;
576.9 	(3) problem solving with challenging behaviors; and
576.10 	(4) communication skills.
576.11 	(c) The provider must provide to residents and prospective residents in written or 
576.12 	electronic form a description of the training program, the categories of employees trained, 
576.13 	the frequency of training, and the basic topics covered.
576.14 		Subd. 5.Restraints. Residents must be free from any physical or chemical restraints 
576.15 	imposed for purposes of discipline or convenience.
576.16 		Subd. 6.Termination of contract. A designated provider must include with notice of 
576.17 	termination of contract information about how to contact the ombudsman for long-term 
576.18 	care, including the address and telephone number, along with a statement of how to request 
576.19 	problem-solving assistance.
576.20 		Subd. 7.Manager requirements. (a) The person primarily responsible for oversight 
576.21 	and management of the designated provider, as designated by the owner, must obtain at 
576.22 	least 30 hours of continuing education every two years of employment as the manager in 
576.23 	topics relevant to the operations of the facility and the needs of its tenants. Continuing 
576.24 	education earned to maintain a professional license, such as a nursing home administrator 
576.25 	license, nursing license, social worker license, or real estate license, can be used to complete 
576.26 	this requirement.
576.27 	(b) New managers may satisfy the initial dementia training requirements by producing 
576.28 	written proof of previously completed required training within the past 18 months.
576.29 		Subd. 8.Emergency planning. (a) Each designated provider must meet the following 
576.30 	requirements:
577.1 	(1) have a written emergency disaster plan that contains a plan for evacuation, addresses 
577.2 	elements of sheltering in-place, identifies temporary relocation sites, and details staff 
577.3 	assignments in the event of a disaster or an emergency;
577.4 	(2) prominently post an emergency disaster plan;
577.5 	(3) provide building emergency exit diagrams to all residents upon signing a contract;
577.6 	(4) post emergency exit diagrams on each floor; and
577.7 	(5) have a written policy and procedure regarding missing residents.
577.8 	(b) Each designated provider must provide emergency and disaster training to all staff 
577.9 	during the initial staff orientation and annually thereafter and must make emergency and 
577.10 	disaster training available to all residents annually. Staff who have not received emergency 
577.11 	and disaster training are allowed to work only when trained staff are also working on site.
577.12 	(c) Each designated provider location must conduct and document a fire drill or other 
577.13 	emergency drill at least once every six months. To the extent possible, drills must be 
577.14 	coordinated with local fire departments or other community emergency resources.
577.15 		Subd. 9.Other laws. Each designated provider must comply with chapter 504B, and 
577.16 	must obtain and maintain all other licenses, permits, registrations, or other required 
577.17 	governmental approvals. A designated provider is not required to obtain a lodging license 
577.18 	under chapter 157 and related rules.

577.19 	EFFECTIVE DATE. This section is effective August 1, 2021.

577.20 	Sec. 34. Laws 2020, Fifth Special Session chapter 3, article 10, section 3, is amended to 
577.21 	read:
577.22 	Sec. 3. TEMPORARY PERSONAL CARE ASSISTANCE COMPENSATION FOR 
577.23 	SERVICES PROVIDED BY A PARENT OR SPOUSE.
 577.24 	(a) Notwithstanding Minnesota Statutes, section 256B.0659, subdivisions 3, paragraph 
577.25 	(a), clause (1); 11, paragraph (c); and 19, paragraph (b), clause (3), during a peacetime 
577.26 	emergency declared by the governor under Minnesota Statutes, section 12.31, subdivision 
577.27 	2, for an outbreak of COVID-19, a parent, stepparent, or legal guardian of a minor who is 
577.28 	a personal care assistance recipient or a spouse of a personal care assistance recipient may 
577.29 	provide and be paid for providing personal care assistance services.
577.30 	(b) This section expires February 7, 2021 upon the expiration of the COVID-19 public 
577.31 	health emergency declared by the United States Secretary of Health and Human Services.

578.1 	EFFECTIVE DATE; REVIVAL AND REENACTMENT. This section is effective 
578.2 	the day following final enactment, or upon federal approval, whichever is later, and Laws 
578.3 	2020, Fifth Special Session chapter 3, article 10, section 3, is revived and reenacted as of 
578.4 	that date.

578.5 	Sec. 35. SELF-DIRECTED WORKER CONTRACT RATIFICATION.
 578.6 	The labor agreement between the state of Minnesota and the Service Employees 
578.7 	International Union Healthcare Minnesota, submitted to the Legislative Coordinating 
578.8 	Commission on March 1, 2021, is ratified.

578.9 	Sec. 36. DIRECTION TO THE COMMISSIONER; CUSTOMIZED LIVING 
578.10 	REPORT.
 578.11 	(a) By January 15, 2022, the commissioner of human services shall submit a report to 
578.12 	the chairs and ranking minority members of the legislative committees with jurisdiction 
578.13 	over human services policy and finance. The report must include the commissioner's:
578.14 	(1) assessment of the prevalence of customized living services provided under Minnesota 
578.15 	Statutes, section 256B.49, supplanting the provision of residential services and supports 
578.16 	licensed under Minnesota Statutes, chapter 245D, and provided in settings licensed under 
578.17 	Minnesota Statutes, chapter 245A;
578.18 	(2) recommendations regarding the continuation of the moratorium on home and 
578.19 	community-based services customized living settings under Minnesota Statutes, section 
578.20 	256B.49, subdivision 28;
578.21 	(3) other policy recommendations to ensure that customized living services are being 
578.22 	provided in a manner consistent with the policy objectives of the foster care licensing 
578.23 	moratorium under Minnesota Statutes, section 245A.03, subdivision 7; and
578.24 	(4) recommendations for needed statutory changes to implement the transition from 
578.25 	existing four-person or fewer customized living settings to corporate adult foster care or 
578.26 	community residential settings.
578.27 	(b) The commissioner of health shall provide the commissioner of human services with 
578.28 	the required data to complete the report in paragraph (a) and implement the moratorium on 
578.29 	home and community-based services customized living settings under Minnesota Statutes, 
578.30 	section 256B.49, subdivision 28. The data must include, at a minimum, each registered 
578.31 	housing with services establishment under Minnesota Statutes, chapter 144D, enrolled as 
578.32 	a customized living setting to deliver customized living services as defined under the brain 
579.1 	injury or community access for disability inclusion waiver plans under Minnesota Statutes, 
579.2 	section 256B.49.

579.3 	Sec. 37. DIRECTION TO COMMISSIONER; PROVIDER STANDARDS FOR 
579.4 	CUSTOMIZED LIVING SERVICES IN DESIGNATED SETTINGS.
 579.5 	The commissioner of human services shall review policies and provider standards for 
579.6 	customized living services provided in settings identified in Minnesota Statutes, section 
579.7 	256S.20, subdivision 1, paragraph (a), clause (2), in consultation with stakeholders. The 
579.8 	commissioner may provide recommendations to the chairs and ranking minority members 
579.9 	of the legislative committees and divisions with jurisdiction over customized living services 
579.10 	by February 15, 2022, regarding appropriate regulatory oversight and payment policies for 
579.11 	customized living services delivered in these settings.

579.12 	Sec. 38. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.
 579.13 	The Governor's Council on an Age-Friendly Minnesota, established in Executive Order 
579.14 	19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and 
579.15 	private partners' collaborative work on emergency preparedness, with a focus on older 
579.16 	adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic. 
579.17 	The Governor's Council on an Age-Friendly Minnesota is extended and expires October 1, 
579.18 	2022.

579.19 	Sec. 39. RATE INCREASE FOR DIRECT SUPPORT SERVICES WORKFORCE.
 579.20 	(a) Effective October 1, 2021, or upon federal approval, whichever is later, if the labor 
579.21 	agreement between the state of Minnesota and the Service Employees International Union 
579.22 	Healthcare Minnesota under Minnesota Statutes, section 179A.54, is approved pursuant to 
579.23 	Minnesota Statutes, section 3.855, the commissioner of human services shall increase:
579.24 	(1) reimbursement rates, individual budgets, grants, or allocations by 4.14 percent for 
579.25 	services under paragraph (b) provided on or after October 1, 2021, or upon federal approval, 
579.26 	whichever is later, to implement the minimum hourly wage, holiday, and paid time off 
579.27 	provisions of that agreement;
579.28 	(2) reimbursement rates, individual budgets, grants, or allocations by 2.95 percent for 
579.29 	services under paragraph (b) provided on or after July 1, 2022, or upon federal approval, 
579.30 	whichever is later, to implement the minimum hourly wage, holiday, and paid time off 
579.31 	provisions of that agreement;
580.1 	(3) individual budgets, grants, or allocations by 1.58 percent for services under paragraph 
580.2 	(c) provided on or after October 1, 2021, or upon federal approval, whichever is later, to 
580.3 	implement the minimum hourly wage, holiday, and paid time off provisions of that 
580.4 	agreement; and
580.5 	(4) individual budgets, grants, or allocations by .81 percent for services under paragraph 
580.6 	(c) provided on or after July 1, 2022, or upon federal approval, whichever is later, to 
580.7 	implement the minimum hourly wage, holiday, and paid time off provisions of that 
580.8 	agreement.
580.9 	(b) The rate changes described in paragraph (a), clauses (1) and (2), apply to direct 
580.10 	support services provided through a covered program, as defined in Minnesota Statutes, 
580.11 	section 256B.0711, subdivision 1, with the exception of consumer-directed community 
580.12 	supports available under programs established pursuant to home and community-based 
580.13 	service waivers authorized under section 1915(c) of the federal Social Security Act and 
580.14 	Minnesota Statutes, including but not limited to chapter 256S and sections 256B.092 and 
580.15 	256B.49, and under the alternative care program under Minnesota Statutes, section 
580.16 	256B.0913.
580.17 	(c) The funding changes described in paragraph (a), clauses (3) and (4), apply to 
580.18 	consumer-directed community supports available under programs established pursuant to 
580.19 	home and community-based service waivers authorized under section 1915(c) of the federal 
580.20 	Social Security Act, and Minnesota Statutes, including but not limited to chapter 256S and 
580.21 	sections 256B.092 and 256B.49, and under the alternative care program under Minnesota 
580.22 	Statutes, section 256B.0913.

580.23 	Sec. 40. WAIVER REIMAGINE PHASE II.
 580.24 	(a) The commissioner of human services must implement a two-home and 
580.25 	community-based services waiver program structure, as authorized under section 1915(c) 
580.26 	of the federal Social Security Act, that serves persons who are determined by a certified 
580.27 	assessor to require the levels of care provided in a nursing home, a hospital, a neurobehavioral 
580.28 	hospital, or an intermediate care facility for persons with developmental disabilities.
580.29 	(b) The commissioner of human services must implement an individualized budget 
580.30 	methodology, as authorized under section 1915(c) of the federal Social Security Act, that 
580.31 	serves persons who are determined by a certified assessor to require the levels of care 
580.32 	provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care 
580.33 	facility for persons with developmental disabilities.
581.1 	(c) The commissioner of human services may seek all federal authority necessary to 
581.2 	implement this section.

581.3 	EFFECTIVE DATE. This section is effective September 1, 2024, or 90 days after 
581.4 	federal approval, whichever is later. The commissioner of human services shall notify the 
581.5 	revisor of statutes when federal approval is obtained.

581.6 	Sec. 41. REPEALER.
 581.7 	(a) Minnesota Statutes 2020, section 256B.097, subdivisions 1, 2, 3, 4, 5, and 6, are 
581.8 	repealed effective July 1, 2021.
581.9 	(b) Minnesota Statutes 2020, sections 256B.0916, subdivisions 2, 3, 4, 5, 8, 11, and 12; 
581.10 	and 256B.49, subdivisions 26 and 27, are repealed effective January 1, 2023, or upon federal 
581.11 	approval, whichever is later. The commissioner of human services shall notify the revisor 
581.12 	of statutes when federal approval is obtained.
581.13 	(c) Minnesota Statutes 2020, section 256S.20, subdivision 2, is repealed effective August 
581.14 	1, 2021.

581.15 	ARTICLE 15
581.16 	COMMUNITY SUPPORTS POLICY

581.17 	Section 1. Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:
581.18 		Subd. 6.Service standards. The standards in this subdivision apply to intensive 
581.19 	nonresidential rehabilitative mental health services.
581.20 	(a) The treatment team must use team treatment, not an individual treatment model.
581.21 	(b) Services must be available at times that meet client needs.
581.22 	(c) Services must be age-appropriate and meet the specific needs of the client.
581.23 	(d) The initial functional assessment must be completed within ten days of intake and 
581.24 	updated at least every six months or prior to discharge from the service, whichever comes 
581.25 	first.
581.26 	(e) The treatment team must complete an individual treatment plan for each client and 
581.27 	the individual treatment plan must:
581.28 	(1) be based on the information in the client's diagnostic assessment and baselines;
582.1 	(2) identify goals and objectives of treatment, a treatment strategy, a schedule for 
582.2 	accomplishing treatment goals and objectives, and the individuals responsible for providing 
582.3 	treatment services and supports;
582.4 	(3) be developed after completion of the client's diagnostic assessment by a mental health 
582.5 	professional or clinical trainee and before the provision of children's therapeutic services 
582.6 	and supports;
582.7 	(4) be developed through a child-centered, family-driven, culturally appropriate planning 
582.8 	process, including allowing parents and guardians to observe or participate in individual 
582.9 	and family treatment services, assessments, and treatment planning;
582.10 	(5) be reviewed at least once every six months and revised to document treatment progress 
582.11 	on each treatment objective and next goals or, if progress is not documented, to document 
582.12 	changes in treatment;
582.13 	(6) be signed by the clinical supervisor and by the client or by the client's parent or other 
582.14 	person authorized by statute to consent to mental health services for the client. A client's 
582.15 	parent may approve the client's individual treatment plan by secure electronic signature or 
582.16 	by documented oral approval that is later verified by written signature;
582.17 	(7) be completed in consultation with the client's current therapist and key providers and 
582.18 	provide for ongoing consultation with the client's current therapist to ensure therapeutic 
582.19 	continuity and to facilitate the client's return to the community. For clients under the age of 
582.20 	18, the treatment team must consult with parents and guardians in developing the treatment 
582.21 	plan;
582.22 	(8) if a need for substance use disorder treatment is indicated by validated assessment:
582.23 	(i) identify goals, objectives, and strategies of substance use disorder treatment; develop 
582.24 	a schedule for accomplishing treatment goals and objectives; and identify the individuals 
582.25 	responsible for providing treatment services and supports;
582.26 	(ii) be reviewed at least once every 90 days and revised, if necessary;
582.27 	(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by 
582.28 	the client's parent or other person authorized by statute to consent to mental health treatment 
582.29 	and substance use disorder treatment for the client; and
582.30 	(10) provide for the client's transition out of intensive nonresidential rehabilitative mental 
582.31 	health services by defining the team's actions to assist the client and subsequent providers 
582.32 	in the transition to less intensive or "stepped down" services.
583.1 	(f) The treatment team shall actively and assertively engage the client's family members 
583.2 	and significant others by establishing communication and collaboration with the family and 
583.3 	significant others and educating the family and significant others about the client's mental 
583.4 	illness, symptom management, and the family's role in treatment, unless the team knows or 
583.5 	has reason to suspect that the client has suffered or faces a threat of suffering any physical 
583.6 	or mental injury, abuse, or neglect from a family member or significant other.
583.7 	(g) For a client age 18 or older, the treatment team may disclose to a family member, 
583.8 	other relative, or a close personal friend of the client, or other person identified by the client, 
583.9 	the protected health information directly relevant to such person's involvement with the 
583.10 	client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the 
583.11 	client is present, the treatment team shall obtain the client's agreement, provide the client 
583.12 	with an opportunity to object, or reasonably infer from the circumstances, based on the 
583.13 	exercise of professional judgment, that the client does not object. If the client is not present 
583.14 	or is unable, by incapacity or emergency circumstances, to agree or object, the treatment 
583.15 	team may, in the exercise of professional judgment, determine whether the disclosure is in 
583.16 	the best interests of the client and, if so, disclose only the protected health information that 
583.17 	is directly relevant to the family member's, relative's, friend's, or client-identified person's 
583.18 	involvement with the client's health care. The client may orally agree or object to the 
583.19 	disclosure and may prohibit or restrict disclosure to specific individuals.
583.20 	(h) The treatment team shall provide interventions to promote positive interpersonal 
583.21 	relationships.

583.22 	Sec. 2. Minnesota Statutes 2020, section 256B.69, subdivision 5a, is amended to read:
583.23 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section and 
583.24 	section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner 
583.25 	may issue separate contracts with requirements specific to services to medical assistance 
583.26 	recipients age 65 and older.
583.27 	(b) A prepaid health plan providing covered health services for eligible persons pursuant 
583.28 	to chapters 256B and 256L is responsible for complying with the terms of its contract with 
583.29 	the commissioner. Requirements applicable to managed care programs under chapters 256B
583.30 	and 256L established after the effective date of a contract with the commissioner take effect 
583.31 	when the contract is next issued or renewed.
583.32 	(c) The commissioner shall withhold five percent of managed care plan payments under 
583.33 	this section and county-based purchasing plan payments under section 256B.692 for the 
583.34 	prepaid medical assistance program pending completion of performance targets. Each 
584.1 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
584.2 	except in the case of a performance target based on a federal or state law or rule. Criteria 
584.3 	for assessment of each performance target must be outlined in writing prior to the contract 
584.4 	effective date. Clinical or utilization performance targets and their related criteria must 
584.5 	consider evidence-based research and reasonable interventions when available or applicable 
584.6 	to the populations served, and must be developed with input from external clinical experts 
584.7 	and stakeholders, including managed care plans, county-based purchasing plans, and 
584.8 	providers. The managed care or county-based purchasing plan must demonstrate, to the 
584.9 	commissioner's satisfaction, that the data submitted regarding attainment of the performance 
584.10 	target is accurate. The commissioner shall periodically change the administrative measures 
584.11 	used as performance targets in order to improve plan performance across a broader range 
584.12 	of administrative services. The performance targets must include measurement of plan 
584.13 	efforts to contain spending on health care services and administrative activities. The 
584.14 	commissioner may adopt plan-specific performance targets that take into account factors 
584.15 	affecting only one plan, including characteristics of the plan's enrollee population. The 
584.16 	withheld funds must be returned no sooner than July of the following year if performance 
584.17 	targets in the contract are achieved. The commissioner may exclude special demonstration 
584.18 	projects under subdivision 23.
584.19 	(d) The commissioner shall require that managed care plans use the assessment and 
584.20 	authorization processes, forms, timelines, standards, documentation, and data reporting 
584.21 	requirements, protocols, billing processes, and policies consistent with medical assistance 
584.22 	fee-for-service or the Department of Human Services contract requirements for all personal 
584.23 	care assistance services under section 256B.0659 and community first services and supports 
584.24 	under section 256B.85.
584.25 	(e) Effective for services rendered on or after January 1, 2012, the commissioner shall 
584.26 	include as part of the performance targets described in paragraph (c) a reduction in the health 
584.27 	plan's emergency department utilization rate for medical assistance and MinnesotaCare 
584.28 	enrollees, as determined by the commissioner. For 2012, the reduction shall be based on 
584.29 	the health plan's utilization in 2009. To earn the return of the withhold each subsequent 
584.30 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
584.31 	reduction of no less than ten percent of the plan's emergency department utilization rate for 
584.32 	medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described 
584.33 	in subdivisions 23 and 28, compared to the previous measurement year until the final 
584.34 	performance target is reached. When measuring performance, the commissioner must 
584.35 	consider the difference in health risk in a managed care or county-based purchasing plan's 
585.1 	membership in the baseline year compared to the measurement year, and work with the 
585.2 	managed care or county-based purchasing plan to account for differences that they agree 
585.3 	are significant.
585.4 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
585.5 	the following calendar year if the managed care plan or county-based purchasing plan 
585.6 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
585.7 	was achieved. The commissioner shall structure the withhold so that the commissioner 
585.8 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
585.9 	in utilization less than the targeted amount.
585.10 	The withhold described in this paragraph shall continue for each consecutive contract 
585.11 	period until the plan's emergency room utilization rate for state health care program enrollees 
585.12 	is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance 
585.13 	and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the 
585.14 	health plans in meeting this performance target and shall accept payment withholds that 
585.15 	may be returned to the hospitals if the performance target is achieved.
585.16 	(f) Effective for services rendered on or after January 1, 2012, the commissioner shall 
585.17 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
585.18 	hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as 
585.19 	determined by the commissioner. To earn the return of the withhold each year, the managed 
585.20 	care plan or county-based purchasing plan must achieve a qualifying reduction of no less 
585.21 	than five percent of the plan's hospital admission rate for medical assistance and 
585.22 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
585.23 	28, compared to the previous calendar year until the final performance target is reached. 
585.24 	When measuring performance, the commissioner must consider the difference in health risk 
585.25 	in a managed care or county-based purchasing plan's membership in the baseline year 
585.26 	compared to the measurement year, and work with the managed care or county-based 
585.27 	purchasing plan to account for differences that they agree are significant.
585.28 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
585.29 	the following calendar year if the managed care plan or county-based purchasing plan 
585.30 	demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization 
585.31 	rate was achieved. The commissioner shall structure the withhold so that the commissioner 
585.32 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
585.33 	in utilization less than the targeted amount.
586.1 	The withhold described in this paragraph shall continue until there is a 25 percent 
586.2 	reduction in the hospital admission rate compared to the hospital admission rates in calendar 
586.3 	year 2011, as determined by the commissioner. The hospital admissions in this performance 
586.4 	target do not include the admissions applicable to the subsequent hospital admission 
586.5 	performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting 
586.6 	this performance target and shall accept payment withholds that may be returned to the 
586.7 	hospitals if the performance target is achieved.
586.8 	(g) Effective for services rendered on or after January 1, 2012, the commissioner shall 
586.9 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
586.10 	hospitalization admission rates for subsequent hospitalizations within 30 days of a previous 
586.11 	hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare 
586.12 	enrollees, as determined by the commissioner. To earn the return of the withhold each year, 
586.13 	the managed care plan or county-based purchasing plan must achieve a qualifying reduction 
586.14 	of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees, 
586.15 	excluding enrollees in programs described in subdivisions 23 and 28, of no less than five 
586.16 	percent compared to the previous calendar year until the final performance target is reached.
586.17 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
586.18 	the following calendar year if the managed care plan or county-based purchasing plan 
586.19 	demonstrates to the satisfaction of the commissioner that a qualifying reduction in the 
586.20 	subsequent hospitalization rate was achieved. The commissioner shall structure the withhold 
586.21 	so that the commissioner returns a portion of the withheld funds in amounts commensurate 
586.22 	with achieved reductions in utilization less than the targeted amount.
586.23 	The withhold described in this paragraph must continue for each consecutive contract 
586.24 	period until the plan's subsequent hospitalization rate for medical assistance and 
586.25 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
586.26 	28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year 
586.27 	2011. Hospitals shall cooperate with the plans in meeting this performance target and shall 
586.28 	accept payment withholds that must be returned to the hospitals if the performance target 
586.29 	is achieved.
586.30 	(h) Effective for services rendered on or after January 1, 2013, through December 31, 
586.31 	2013, the commissioner shall withhold 4.5 percent of managed care plan payments under 
586.32 	this section and county-based purchasing plan payments under section 256B.692 for the 
586.33 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
586.34 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
586.35 	special demonstration projects under subdivision 23.
587.1 	(i) Effective for services rendered on or after January 1, 2014, the commissioner shall 
587.2 	withhold three percent of managed care plan payments under this section and county-based 
587.3 	purchasing plan payments under section 256B.692 for the prepaid medical assistance 
587.4 	program. The withheld funds must be returned no sooner than July 1 and no later than July 
587.5 	31 of the following year. The commissioner may exclude special demonstration projects 
587.6 	under subdivision 23.
587.7 	(j) A managed care plan or a county-based purchasing plan under section 256B.692 may 
587.8 	include as admitted assets under section 62D.044 any amount withheld under this section 
587.9 	that is reasonably expected to be returned.
587.10 	(k) Contracts between the commissioner and a prepaid health plan are exempt from the 
587.11 	set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and 
587.12 	7.
587.13 	(l) The return of the withhold under paragraphs (h) and (i) is not subject to the 
587.14 	requirements of paragraph (c).
587.15 	(m) Managed care plans and county-based purchasing plans shall maintain current and 
587.16 	fully executed agreements for all subcontractors, including bargaining groups, for 
587.17 	administrative services that are expensed to the state's public health care programs. 
587.18 	Subcontractor agreements determined to be material, as defined by the commissioner after 
587.19 	taking into account state contracting and relevant statutory requirements, must be in the 
587.20 	form of a written instrument or electronic document containing the elements of offer, 
587.21 	acceptance, consideration, payment terms, scope, duration of the contract, and how the 
587.22 	subcontractor services relate to state public health care programs. Upon request, the 
587.23 	commissioner shall have access to all subcontractor documentation under this paragraph. 
587.24 	Nothing in this paragraph shall allow release of information that is nonpublic data pursuant 
587.25 	to section 13.02.

587.26 	Sec. 3. Minnesota Statutes 2020, section 256B.85, subdivision 1, is amended to read:
587.27 		Subdivision 1.Basis and scope. (a) Upon federal approval, the commissioner shall 
587.28 	establish a state plan option for the provision of home and community-based personal 
587.29 	assistance service and supports called "community first services and supports (CFSS)."
587.30 	(b) CFSS is a participant-controlled method of selecting and providing services and 
587.31 	supports that allows the participant maximum control of the services and supports. 
587.32 	Participants may choose the degree to which they direct and manage their supports by 
587.33 	choosing to have a significant and meaningful role in the management of services and 
588.1 	supports including by directly employing support workers with the necessary supports to 
588.2 	perform that function.
588.3 	(c) CFSS is available statewide to eligible people to assist with accomplishing activities 
588.4 	of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related 
588.5 	procedures and tasks through hands-on assistance to accomplish the task or constant 
588.6 	supervision and cueing to accomplish the task; and to assist with acquiring, maintaining, 
588.7 	and enhancing the skills necessary to accomplish ADLs, IADLs, and health-related 
588.8 	procedures and tasks. CFSS allows payment for the participant for certain supports and 
588.9 	goods such as environmental modifications and technology that are intended to replace or 
588.10 	decrease the need for human assistance.
588.11 	(d) Upon federal approval, CFSS will replace the personal care assistance program under 
588.12 	sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
588.13 	(e) For the purposes of this section, notwithstanding the provisions of section 144A.43, 
588.14 	subdivision 3, supports purchased under CFSS are not considered home care services.

588.15 	Sec. 4. Minnesota Statutes 2020, section 256B.85, subdivision 2, is amended to read:
588.16 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
588.17 	subdivision have the meanings given.
588.18 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, dressing, 
588.19 	bathing, mobility, positioning, and transferring.:
588.20 	(1) dressing, including assistance with choosing, applying, and changing clothing and 
588.21 	applying special appliances, wraps, or clothing;
588.22 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
588.23 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail 
588.24 	care, except for recipients who are diabetic or have poor circulation;
588.25 	(3) bathing, including assistance with basic personal hygiene and skin care;
588.26 	(4) eating, including assistance with hand washing and applying orthotics required for 
588.27 	eating, transfers, or feeding;
588.28 	(5) transfers, including assistance with transferring the participant from one seating or 
588.29 	reclining area to another;
588.30 	(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility 
588.31 	does not include providing transportation for a participant;
589.1 	(7) positioning, including assistance with positioning or turning a participant for necessary 
589.2 	care and comfort; and
589.3 	(8) toileting, including assistance with bowel or bladder elimination and care, transfers, 
589.4 	mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing 
589.5 	the perineal area, inspection of the skin, and adjusting clothing.
589.6 	(c) "Agency-provider model" means a method of CFSS under which a qualified agency 
589.7 	provides services and supports through the agency's own employees and policies. The agency 
589.8 	must allow the participant to have a significant role in the selection and dismissal of support 
589.9 	workers of their choice for the delivery of their specific services and supports.
589.10 	(d) "Behavior" means a description of a need for services and supports used to determine 
589.11 	the home care rating and additional service units. The presence of Level I behavior is used 
589.12 	to determine the home care rating.
589.13 	(e) "Budget model" means a service delivery method of CFSS that allows the use of a 
589.14 	service budget and assistance from a financial management services (FMS) provider for a 
589.15 	participant to directly employ support workers and purchase supports and goods.
589.16 	(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that 
589.17 	has been ordered by a physician, advanced practice registered nurse, or physician's assistant 
589.18 	and is specified in a community support plan, including:
589.19 	(1) tube feedings requiring:
589.20 	(i) a gastrojejunostomy tube; or
589.21 	(ii) continuous tube feeding lasting longer than 12 hours per day;
589.22 	(2) wounds described as:
589.23 	(i) stage III or stage IV;
589.24 	(ii) multiple wounds;
589.25 	(iii) requiring sterile or clean dressing changes or a wound vac; or
589.26 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
589.27 	care;
589.28 	(3) parenteral therapy described as:
589.29 	(i) IV therapy more than two times per week lasting longer than four hours for each 
589.30 	treatment; or
589.31 	(ii) total parenteral nutrition (TPN) daily;
590.1 	(4) respiratory interventions, including:
590.2 	(i) oxygen required more than eight hours per day;
590.3 	(ii) respiratory vest more than one time per day;
590.4 	(iii) bronchial drainage treatments more than two times per day;
590.5 	(iv) sterile or clean suctioning more than six times per day;
590.6 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
590.7 	as BiPAP and CPAP; and
590.8 	(vi) ventilator dependence under section 256B.0651;
590.9 	(5) insertion and maintenance of catheter, including:
590.10 	(i) sterile catheter changes more than one time per month;
590.11 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
590.12 	times per day; or
590.13 	(iii) bladder irrigations;
590.14 	(6) bowel program more than two times per week requiring more than 30 minutes to 
590.15 	perform each time;
590.16 	(7) neurological intervention, including:
590.17 	(i) seizures more than two times per week and requiring significant physical assistance 
590.18 	to maintain safety; or
590.19 	(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse, 
590.20 	or physician's assistant and requiring specialized assistance from another on a daily basis; 
590.21 	and
590.22 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
590.23 	hands-on assistance and interventions in six to eight activities of daily living.
590.24 	(g) "Community first services and supports" or "CFSS" means the assistance and supports 
590.25 	program under this section needed for accomplishing activities of daily living, instrumental 
590.26 	activities of daily living, and health-related tasks through hands-on assistance to accomplish 
590.27 	the task or constant supervision and cueing to accomplish the task, or the purchase of goods 
590.28 	as defined in subdivision 7, clause (3), that replace the need for human assistance.
590.29 	(h) "Community first services and supports service delivery plan" or "CFSS service 
590.30 	delivery plan" means a written document detailing the services and supports chosen by the 
591.1 	participant to meet assessed needs that are within the approved CFSS service authorization, 
591.2 	as determined in subdivision 8. Services and supports are based on the coordinated service 
591.3 	and support plan identified in section sections 256B.092, subdivision 1b, and256S.10.
591.4 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
591.5 	organization that provides assistance to the participant in making informed choices about 
591.6 	CFSS services in general and self-directed tasks in particular, and in developing a 
591.7 	person-centered CFSS service delivery plan to achieve quality service outcomes.
591.8 	(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
591.9 	(k) "Dependency" in activities of daily living means a person requires hands-on assistance 
591.10 	or constant supervision and cueing to accomplish one or more of the activities of daily living 
591.11 	every day or on the days during the week that the activity is performed; however, a child 
591.12 	may must not be found to be dependent in an activity of daily living if, because of the child's 
591.13 	age, an adult would either perform the activity for the child or assist the child with the 
591.14 	activity and the assistance needed is the assistance appropriate for a typical child of the 
591.15 	same age.
591.16 	(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are 
591.17 	included in the CFSS service delivery plan through one of the home and community-based 
591.18 	services waivers and as approved and authorized under chapter 256S and sections 256B.092, 
591.19 	subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state 
591.20 	plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
591.21 	(m) "Financial management services provider" or "FMS provider" means a qualified 
591.22 	organization required for participants using the budget model under subdivision 13 that is 
591.23 	an enrolled provider with the department to provide vendor fiscal/employer agent financial 
591.24 	management services (FMS).
591.25 	(n) "Health-related procedures and tasks" means procedures and tasks related to the 
591.26 	specific assessed health needs of a participant that can be taught or assigned by a 
591.27 	state-licensed health care or mental health professional and performed by a support worker.
591.28 	(o) "Instrumental activities of daily living" means activities related to living independently 
591.29 	in the community, including but not limited to: meal planning, preparation, and cooking; 
591.30 	shopping for food, clothing, or other essential items; laundry; housecleaning; assistance 
591.31 	with medications; managing finances; communicating needs and preferences during activities; 
591.32 	arranging supports; and assistance with traveling around and participating in the community.
592.1 	(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph 
592.2 	(e).
592.3 	(q) "Legal representative" means parent of a minor, a court-appointed guardian, or 
592.4 	another representative with legal authority to make decisions about services and supports 
592.5 	for the participant. Other representatives with legal authority to make decisions include but 
592.6 	are not limited to a health care agent or an attorney-in-fact authorized through a health care 
592.7 	directive or power of attorney.
592.8 	(r) "Level I behavior" means physical aggression towards self or others or destruction 
592.9 	of property that requires the immediate response of another person.
592.10 	(s) "Medication assistance" means providing verbal or visual reminders to take regularly 
592.11 	scheduled medication, and includes any of the following supports listed in clauses (1) to 
592.12 	(3) and other types of assistance, except that a support worker may must not determine 
592.13 	medication dose or time for medication or inject medications into veins, muscles, or skin:
592.14 	(1) under the direction of the participant or the participant's representative, bringing 
592.15 	medications to the participant including medications given through a nebulizer, opening a 
592.16 	container of previously set-up medications, emptying the container into the participant's 
592.17 	hand, opening and giving the medication in the original container to the participant, or 
592.18 	bringing to the participant liquids or food to accompany the medication;
592.19 	(2) organizing medications as directed by the participant or the participant's representative; 
592.20 	and
592.21 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
592.22 	(t) "Participant" means a person who is eligible for CFSS.
592.23 	(u) "Participant's representative" means a parent, family member, advocate, or other 
592.24 	adult authorized by the participant or participant's legal representative, if any, to serve as a 
592.25 	representative in connection with the provision of CFSS. This authorization must be in 
592.26 	writing or by another method that clearly indicates the participant's free choice and may be 
592.27 	withdrawn at any time. The participant's representative must have no financial interest in 
592.28 	the provision of any services included in the participant's CFSS service delivery plan and 
592.29 	must be capable of providing the support necessary to assist the participant in the use of 
592.30 	CFSS. If through the assessment process described in subdivision 5 a participant is 
592.31 	determined to be in need of a participant's representative, one must be selected. If the 
592.32 	participant is unable to assist in the selection of a participant's representative, the legal 
592.33 	representative shall appoint one. Two persons may be designated as a participant's 
593.1 	representative for reasons such as divided households and court-ordered custodies. Duties 
593.2 	of a participant's representatives may include:
593.3 	(1) being available while services are provided in a method agreed upon by the participant 
593.4 	or the participant's legal representative and documented in the participant's CFSS service 
593.5 	delivery plan;
593.6 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is 
593.7 	being followed; and
593.8 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
593.9 	verification of the CFSS services.
593.10 	(v) "Person-centered planning process" means a process that is directed by the participant 
593.11 	to plan for CFSS services and supports.
593.12 	(w) "Service budget" means the authorized dollar amount used for the budget model or 
593.13 	for the purchase of goods.
593.14 	(x) "Shared services" means the provision of CFSS services by the same CFSS support 
593.15 	worker to two or three participants who voluntarily enter into an a written agreement to 
593.16 	receive services at the same time and, in the same setting by, and through the same employer
593.17 	agency-provider or FMS provider.
593.18 	(y) "Support worker" means a qualified and trained employee of the agency-provider 
593.19 	as required by subdivision 11b or of the participant employer under the budget model as 
593.20 	required by subdivision 14 who has direct contact with the participant and provides services 
593.21 	as specified within the participant's CFSS service delivery plan.
593.22 	(z) "Unit" means the increment of service based on hours or minutes identified in the 
593.23 	service agreement.
593.24 	(aa) "Vendor fiscal employer agent" means an agency that provides financial management 
593.25 	services.
593.26 	(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share 
593.27 	of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
593.28 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
593.29 	long-term care insurance, uniform allowance, contributions to employee retirement accounts, 
593.30 	or other forms of employee compensation and benefits.
593.31 	(cc) "Worker training and development" means services provided according to subdivision 
593.32 	18a for developing workers' skills as required by the participant's individual CFSS service 
594.1 	delivery plan that are arranged for or provided by the agency-provider or purchased by the 
594.2 	participant employer. These services include training, education, direct observation and 
594.3 	supervision, and evaluation and coaching of job skills and tasks, including supervision of 
594.4 	health-related tasks or behavioral supports.

594.5 	Sec. 5. Minnesota Statutes 2020, section 256B.85, subdivision 3, is amended to read:
594.6 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the following:
594.7 	(1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056, 
594.8 	or 256B.057, subdivisions 5 and 9;
594.9 	(1) is determined eligible for medical assistance under this chapter, excluding those 
594.10 	under section 256B.057, subdivisions 3, 3a, 3b, and 4;
594.11 	(2) is a participant in the alternative care program under section 256B.0913;
594.12 	(3) is a waiver participant as defined under chapter 256S or section 256B.092, 256B.093, 
594.13 	or 256B.49; or
594.14 	(4) has medical services identified in a person's individualized education program and 
594.15 	is eligible for services as determined in section 256B.0625, subdivision 26.
594.16 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
594.17 	meet all of the following:
594.18 	(1) require assistance and be determined dependent in one activity of daily living or 
594.19 	Level I behavior based on assessment under section 256B.0911; and
594.20 	(2) is not a participant under a family support grant under section 252.32.
594.21 	(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision 
594.22 	6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible 
594.23 	for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as 
594.24 	determined under section 256B.0911.

594.25 	Sec. 6. Minnesota Statutes 2020, section 256B.85, subdivision 4, is amended to read:
594.26 		Subd. 4.Eligibility for other services. Selection of CFSS by a participant must not 
594.27 	restrict access to other medically necessary care and services furnished under the state plan 
594.28 	benefit or other services available through the alternative care program.

594.29 	Sec. 7. Minnesota Statutes 2020, section 256B.85, subdivision 5, is amended to read:
594.30 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
595.1 	(1) be conducted by a certified assessor according to the criteria established in section 
595.2 	256B.0911, subdivision 3a;
595.3 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there is 
595.4 	a significant change in the participant's condition or a change in the need for services and 
595.5 	supports, or at the request of the participant when the participant experiences a change in 
595.6 	condition or needs a change in the services or supports; and
595.7 	(3) be completed using the format established by the commissioner.
595.8 	(b) The results of the assessment and any recommendations and authorizations for CFSS 
595.9 	must be determined and communicated in writing by the lead agency's certified assessor as 
595.10 	defined in section 256B.0911 to the participant and the agency-provider or FMS provider 
595.11 	chosen by the participant or the participant's representative and chosen CFSS providers
595.12 	within 40 calendarten business days and must include the participant's right to appeal the 
595.13 	assessment under section 256.045, subdivision 3.
595.14 	(c) The lead agency assessor may authorize a temporary authorization for CFSS services 
595.15 	to be provided under the agency-provider model. The lead agency assessor may authorize 
595.16 	a temporary authorization for CFSS services to be provided under the agency-provider 
595.17 	model without using the assessment process described in this subdivision. Authorization 
595.18 	for a temporary level of CFSS services under the agency-provider model is limited to the 
595.19 	time specified by the commissioner, but shall not exceed 45 days. The level of services 
595.20 	authorized under this paragraph shall have no bearing on a future authorization. Participants 
595.21 	approved for a temporary authorization shall access the consultation service For CFSS 
595.22 	services needed beyond the 45-day temporary authorization, the lead agency must conduct 
595.23 	an assessment as described in this subdivision and participants must use consultation services
595.24 	to complete their orientation and selection of a service model.

595.25 	Sec. 8. Minnesota Statutes 2020, section 256B.85, subdivision 6, is amended to read:
595.26 		Subd. 6.Community first services and supports service delivery plan. (a) The CFSS 
595.27 	service delivery plan must be developed and evaluated through a person-centered planning 
595.28 	process by the participant, or the participant's representative or legal representative who 
595.29 	may be assisted by a consultation services provider. The CFSS service delivery plan must 
595.30 	reflect the services and supports that are important to the participant and for the participant 
595.31 	to meet the needs assessed by the certified assessor and identified in the coordinated service 
595.32 	and support plan identified in section sections 256B.092, subdivision 1b, and256S.10. The 
595.33 	CFSS service delivery plan must be reviewed by the participant, the consultation services 
595.34 	provider, and the agency-provider or FMS provider prior to starting services and at least 
596.1 	annually upon reassessment, or when there is a significant change in the participant's 
596.2 	condition, or a change in the need for services and supports.
596.3 	(b) The commissioner shall establish the format and criteria for the CFSS service delivery 
596.4 	plan.
596.5 	(c) The CFSS service delivery plan must be person-centered and:
596.6 	(1) specify the consultation services provider, agency-provider, or FMS provider selected 
596.7 	by the participant;
596.8 	(2) reflect the setting in which the participant resides that is chosen by the participant;
596.9 	(3) reflect the participant's strengths and preferences;
596.10 	(4) include the methods and supports used to address the needs as identified through an 
596.11 	assessment of functional needs;
596.12 	(5) include the participant's identified goals and desired outcomes;
596.13 	(6) reflect the services and supports, paid and unpaid, that will assist the participant to 
596.14 	achieve identified goals, including the costs of the services and supports, and the providers 
596.15 	of those services and supports, including natural supports;
596.16 	(7) identify the amount and frequency of face-to-face supports and amount and frequency 
596.17 	of remote supports and technology that will be used;
596.18 	(8) identify risk factors and measures in place to minimize them, including individualized 
596.19 	backup plans;
596.20 	(9) be understandable to the participant and the individuals providing support;
596.21 	(10) identify the individual or entity responsible for monitoring the plan;
596.22 	(11) be finalized and agreed to in writing by the participant and signed by all individuals 
596.23 	and providers responsible for its implementation;
596.24 	(12) be distributed to the participant and other people involved in the plan;
596.25 	(13) prevent the provision of unnecessary or inappropriate care;
596.26 	(14) include a detailed budget for expenditures for budget model participants or 
596.27 	participants under the agency-provider model if purchasing goods; and
596.28 	(15) include a plan for worker training and development provided according to 
596.29 	subdivision 18a detailing what service components will be used, when the service components 
597.1 	will be used, how they will be provided, and how these service components relate to the 
597.2 	participant's individual needs and CFSS support worker services.
597.3 	(d) The CFSS service delivery plan must describe the units or dollar amount available 
597.4 	to the participant. The total units of agency-provider services or the service budget amount 
597.5 	for the budget model include both annual totals and a monthly average amount that cover 
597.6 	the number of months of the service agreement. The amount used each month may vary, 
597.7 	but additional funds must not be provided above the annual service authorization amount, 
597.8 	determined according to subdivision 8, unless a change in condition is assessed and 
597.9 	authorized by the certified assessor and documented in the coordinated service and support 
597.10 	plan and CFSS service delivery plan.
597.11 	(e) In assisting with the development or modification of the CFSS service delivery plan 
597.12 	during the authorization time period, the consultation services provider shall:
597.13 	(1) consult with the FMS provider on the spending budget when applicable; and
597.14 	(2) consult with the participant or participant's representative, agency-provider, and case 
597.15 	manager/ or care coordinator.
597.16 	(f) The CFSS service delivery plan must be approved by the consultation services provider 
597.17 	for participants without a case manager or care coordinator who is responsible for authorizing 
597.18 	services. A case manager or care coordinator must approve the plan for a waiver or alternative 
597.19 	care program participant.

597.20 	Sec. 9. Minnesota Statutes 2020, section 256B.85, subdivision 7, is amended to read:
597.21 		Subd. 7.Community first services and supports; covered services.  Services and 
597.22 	supports covered under CFSS include:
597.23 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of 
597.24 	daily living (IADLs), and health-related procedures and tasks through hands-on assistance 
597.25 	to accomplish the task or constant supervision and cueing to accomplish the task;
597.26 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to 
597.27 	accomplish activities of daily living, instrumental activities of daily living, or health-related 
597.28 	tasks;
597.29 	(3) expenditures for items, services, supports, environmental modifications, or goods, 
597.30 	including assistive technology. These expenditures must:
597.31 	(i) relate to a need identified in a participant's CFSS service delivery plan; and
598.1 	(ii) increase independence or substitute for human assistance, to the extent that 
598.2 	expenditures would otherwise be made for human assistance for the participant's assessed 
598.3 	needs;
598.4 	(4) observation and redirection for behavior or symptoms where there is a need for 
598.5 	assistance;
598.6 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices, 
598.7 	to ensure continuity of the participant's services and supports;
598.8 	(6) services provided by a consultation services provider as defined under subdivision 
598.9 	17, that is under contract with the department and enrolled as a Minnesota health care 
598.10 	program provider;
598.11 	(7) services provided by an FMS provider as defined under subdivision 13a, that is an 
598.12 	enrolled provider with the department;
598.13 	(8) CFSS services provided by a support worker who is a parent, stepparent, or legal 
598.14 	guardian of a participant under age 18, or who is the participant's spouse. These support 
598.15 	workers shall not:
598.16 	(i) provide any medical assistance home and community-based services in excess of 40 
598.17 	hours per seven-day period regardless of the number of parents providing services, 
598.18 	combination of parents and spouses providing services, or number of children who receive 
598.19 	medical assistance services; and
598.20 	(ii) have a wage that exceeds the current rate for a CFSS support worker including the 
598.21 	wage, benefits, and payroll taxes; and
598.22 	(9) worker training and development services as described in subdivision 18a.

598.23 	Sec. 10. Minnesota Statutes 2020, section 256B.85, subdivision 8, is amended to read:
598.24 		Subd. 8.Determination of CFSS service authorization amount. (a) All community 
598.25 	first services and supports must be authorized by the commissioner or the commissioner's 
598.26 	designee before services begin. The authorization for CFSS must be completed as soon as 
598.27 	possible following an assessment but no later than 40 calendar days from the date of the 
598.28 	assessment.
598.29 	(b) The amount of CFSS authorized must be based on the participant's home care rating 
598.30 	described in paragraphs (d) and (e) and any additional service units for which the participant 
598.31 	qualifies as described in paragraph (f).
599.1 	(c) The home care rating shall be determined by the commissioner or the commissioner's 
599.2 	designee based on information submitted to the commissioner identifying the following for 
599.3 	a participant:
599.4 	(1) the total number of dependencies of activities of daily living;
599.5 	(2) the presence of complex health-related needs; and
599.6 	(3) the presence of Level I behavior.
599.7 	(d) The methodology to determine the total service units for CFSS for each home care 
599.8 	rating is based on the median paid units per day for each home care rating from fiscal year 
599.9 	2007 data for the PCA program.
599.10 	(e) Each home care rating is designated by the letters P through Z and EN and has the 
599.11 	following base number of service units assigned:
599.12 	(1) P home care rating requires Level I behavior or one to three dependencies in ADLs 
599.13 	and qualifies the person for five service units;
599.14 	(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs 
599.15 	and qualifies the person for six service units;
599.16 	(3) R home care rating requires a complex health-related need and one to three 
599.17 	dependencies in ADLs and qualifies the person for seven service units;
599.18 	(4) S home care rating requires four to six dependencies in ADLs and qualifies the person 
599.19 	for ten service units;
599.20 	(5) T home care rating requires four to six dependencies in ADLs and Level I behavior 
599.21 	and qualifies the person for 11 service units;
599.22 	(6) U home care rating requires four to six dependencies in ADLs and a complex 
599.23 	health-related need and qualifies the person for 14 service units;
599.24 	(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the 
599.25 	person for 17 service units;
599.26 	(8) W home care rating requires seven to eight dependencies in ADLs and Level I 
599.27 	behavior and qualifies the person for 20 service units;
599.28 	(9) Z home care rating requires seven to eight dependencies in ADLs and a complex 
599.29 	health-related need and qualifies the person for 30 service units; and
599.30 	(10) EN home care rating includes ventilator dependency as defined in section 256B.0651, 
599.31 	subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent 
600.1 	and the EN home care rating and utilize a combination of CFSS and home care nursing 
600.2 	services is limited to a total of 96 service units per day for those services in combination. 
600.3 	Additional units may be authorized when a person's assessment indicates a need for two 
600.4 	staff to perform activities. Additional time is limited to 16 service units per day.
600.5 	(f) Additional service units are provided through the assessment and identification of 
600.6 	the following:
600.7 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
600.8 	living;
600.9 	(2) 30 additional minutes per day for each complex health-related need; and
600.10 	(3) 30 additional minutes per day when the for each behavior under this clause that 
600.11 	requires assistance at least four times per week for one or more of the following behaviors:
600.12 	(i) level I behavior that requires the immediate response of another person;
600.13 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior; 
600.14 	or
600.15 	(iii) increased need for assistance for participants who are verbally aggressive or resistive 
600.16 	to care so that the time needed to perform activities of daily living is increased.
600.17 	(g) The service budget for budget model participants shall be based on:
600.18 	(1) assessed units as determined by the home care rating; and
600.19 	(2) an adjustment needed for administrative expenses.

600.20 	Sec. 11. Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision 
600.21 	to read:
600.22 		Subd. 8a.Authorization; exceptions. All CFSS services must be authorized by the 
600.23 	commissioner or the commissioner's designee as described in subdivision 8 except when:
600.24 	(1) the lead agency temporarily authorizes services in the agency-provider model as 
600.25 	described in subdivision 5, paragraph (c);
600.26 	(2) CFSS services in the agency-provider model were required to treat an emergency 
600.27 	medical condition that if not immediately treated could cause a participant serious physical 
600.28 	or mental disability, continuation of severe pain, or death. The CFSS agency provider must 
600.29 	request retroactive authorization from the lead agency no later than five working days after 
600.30 	providing the initial emergency service. The CFSS agency provider must be able to 
600.31 	substantiate the emergency through documentation such as reports, notes, and admission 
601.1 	or discharge histories. A lead agency must follow the authorization process in subdivision 
601.2 	5 after the lead agency receives the request for authorization from the agency provider;
601.3 	(3) the lead agency authorizes a temporary increase to the amount of services authorized 
601.4 	in the agency or budget model to accommodate the participant's temporary higher need for 
601.5 	services. Authorization for a temporary level of CFSS services is limited to the time specified 
601.6 	by the commissioner, but shall not exceed 45 days. The level of services authorized under 
601.7 	this clause shall have no bearing on a future authorization;
601.8 	(4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated, 
601.9 	and an authorization for CFSS services is completed based on the date of a current 
601.10 	assessment, eligibility, and request for authorization;
601.11 	(5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization 
601.12 	requests must be submitted by the provider within 20 working days of the notice of denial 
601.13 	or adjustment. A copy of the notice must be included with the request;
601.14 	(6) the commissioner has determined that a lead agency or state human services agency 
601.15 	has made an error; or
601.16 	(7) a participant enrolled in managed care experiences a temporary disenrollment from 
601.17 	a health plan, in which case the commissioner shall accept the current health plan 
601.18 	authorization for CFSS services for up to 60 days. The request must be received within the 
601.19 	first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after 
601.20 	the 60 days and before 90 days, the provider shall request an additional 30-day extension 
601.21 	of the current health plan authorization, for a total limit of 90 days from the time of 
601.22 	disenrollment.

601.23 	Sec. 12. Minnesota Statutes 2020, section 256B.85, subdivision 9, is amended to read:
601.24 		Subd. 9.Noncovered services. (a) Services or supports that are not eligible for payment 
601.25 	under this section include those that:
601.26 	(1) are not authorized by the certified assessor or included in the CFSS service delivery 
601.27 	plan;
601.28 	(2) are provided prior to the authorization of services and the approval of the CFSS 
601.29 	service delivery plan;
601.30 	(3) are duplicative of other paid services in the CFSS service delivery plan;
602.1 	(4) supplant natural unpaid supports that appropriately meet a need in the CFSS service 
602.2 	delivery plan, are provided voluntarily to the participant, and are selected by the participant 
602.3 	in lieu of other services and supports;
602.4 	(5) are not effective means to meet the participant's needs; and
602.5 	(6) are available through other funding sources, including, but not limited to, funding 
602.6 	through title IV-E of the Social Security Act.
602.7 	(b) Additional services, goods, or supports that are not covered include:
602.8 	(1) those that are not for the direct benefit of the participant, except that services for 
602.9 	caregivers such as training to improve the ability to provide CFSS are considered to directly 
602.10 	benefit the participant if chosen by the participant and approved in the support plan;
602.11 	(2) any fees incurred by the participant, such as Minnesota health care programs fees 
602.12 	and co-pays, legal fees, or costs related to advocate agencies;
602.13 	(3) insurance, except for insurance costs related to employee coverage;
602.14 	(4) room and board costs for the participant;
602.15 	(5) services, supports, or goods that are not related to the assessed needs;
602.16 	(6) special education and related services provided under the Individuals with Disabilities 
602.17 	Education Act and vocational rehabilitation services provided under the Rehabilitation Act 
602.18 	of 1973;
602.19 	(7) assistive technology devices and assistive technology services other than those for 
602.20 	back-up systems or mechanisms to ensure continuity of service and supports listed in 
602.21 	subdivision 7;
602.22 	(8) medical supplies and equipment covered under medical assistance;
602.23 	(9) environmental modifications, except as specified in subdivision 7;
602.24 	(10) expenses for travel, lodging, or meals related to training the participant or the 
602.25 	participant's representative or legal representative;
602.26 	(11) experimental treatments;
602.27 	(12) any service or good covered by other state plan services, including prescription and 
602.28 	over-the-counter medications, compounds, and solutions and related fees, including premiums 
602.29 	and co-payments;
602.30 	(13) membership dues or costs, except when the service is necessary and appropriate to 
602.31 	treat a health condition or to improve or maintain the adult participant's health condition. 
603.1 	The condition must be identified in the participant's CFSS service delivery plan and 
603.2 	monitored by a Minnesota health care program enrolled physician, advanced practice 
603.3 	registered nurse, or physician's assistant;
603.4 	(14) vacation expenses other than the cost of direct services;
603.5 	(15) vehicle maintenance or modifications not related to the disability, health condition, 
603.6 	or physical need;
603.7 	(16) tickets and related costs to attend sporting or other recreational or entertainment 
603.8 	events;
603.9 	(17) services provided and billed by a provider who is not an enrolled CFSS provider;
603.10 	(18) CFSS provided by a participant's representative or paid legal guardian;
603.11 	(19) services that are used solely as a child care or babysitting service;
603.12 	(20) services that are the responsibility or in the daily rate of a residential or program 
603.13 	license holder under the terms of a service agreement and administrative rules;
603.14 	(21) sterile procedures;
603.15 	(22) giving of injections into veins, muscles, or skin;
603.16 	(23) homemaker services that are not an integral part of the assessed CFSS service;
603.17 	(24) home maintenance or chore services;
603.18 	(25) home care services, including hospice services if elected by the participant, covered 
603.19 	by Medicare or any other insurance held by the participant;
603.20 	(26) services to other members of the participant's household;
603.21 	(27) services not specified as covered under medical assistance as CFSS;
603.22 	(28) application of restraints or implementation of deprivation procedures;
603.23 	(29) assessments by CFSS provider organizations or by independently enrolled registered 
603.24 	nurses;
603.25 	(30) services provided in lieu of legally required staffing in a residential or child care 
603.26 	setting; and
603.27 	(31) services provided by the residential or program a foster care license holder in a 
603.28 	residence for more than four participants. except when the home of the person receiving 
603.29 	services is the licensed foster care provider's primary residence;
604.1 	(32) services that are the responsibility of the foster care provider under the terms of the 
604.2 	foster care placement agreement, assessment under sections 256N.24 and 260C.4411, and 
604.3 	administrative rules under sections 256N.24 and 260C.4411;
604.4 	(33) services in a setting that has a licensed capacity greater than six, unless all conditions 
604.5 	for a variance under section 245A.04, subdivision 9a, are satisfied for a sibling, as defined 
604.6 	in section 260C.007, subdivision 32;
604.7 	(34) services from a provider who owns or otherwise controls the living arrangement, 
604.8 	except when the provider of services is related by blood, marriage, or adoption or when the 
604.9 	provider is a licensed foster care provider who is not prohibited from providing services 
604.10 	under clauses (31) to (33);
604.11 	(35) instrumental activities of daily living for children younger than 18 years of age, 
604.12 	except when immediate attention is needed for health or hygiene reasons integral to an 
604.13 	assessed need for assistance with activities of daily living, health-related procedures, and 
604.14 	tasks or behaviors; or
604.15 	(36) services provided to a resident of a nursing facility, hospital, intermediate care 
604.16 	facility, or health care facility licensed by the commissioner of health.

604.17 	Sec. 13. Minnesota Statutes 2020, section 256B.85, subdivision 10, is amended to read:
604.18 		Subd. 10.Agency-provider and FMS provider qualifications and duties. (a) 
604.19 	Agency-providers identified in subdivision 11 and FMS providers identified in subdivision 
604.20 	13a shall:
604.21 	(1) enroll as a medical assistance Minnesota health care programs provider and meet all 
604.22 	applicable provider standards and requirements including completion of required provider 
604.23 	training as determined by the commissioner;
604.24 	(2) demonstrate compliance with federal and state laws and policies for CFSS as 
604.25 	determined by the commissioner;
604.26 	(3) comply with background study requirements under chapter 245C and maintain 
604.27 	documentation of background study requests and results;
604.28 	(4) verify and maintain records of all services and expenditures by the participant, 
604.29 	including hours worked by support workers;
604.30 	(5) not engage in any agency-initiated direct contact or marketing in person, by telephone, 
604.31 	or other electronic means to potential participants, guardians, family members, or participants' 
604.32 	representatives;
605.1 	(6) directly provide services and not use a subcontractor or reporting agent;
605.2 	(7) meet the financial requirements established by the commissioner for financial 
605.3 	solvency;
605.4 	(8) have never had a lead agency contract or provider agreement discontinued due to 
605.5 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
605.6 	criminal background check while enrolled or seeking enrollment as a Minnesota health care 
605.7 	programs provider; and
605.8 	(9) have an office located in Minnesota.
605.9 	(b) In conducting general duties, agency-providers and FMS providers shall:
605.10 	(1) pay support workers based upon actual hours of services provided;
605.11 	(2) pay for worker training and development services based upon actual hours of services 
605.12 	provided or the unit cost of the training session purchased;
605.13 	(3) withhold and pay all applicable federal and state payroll taxes;
605.14 	(4) make arrangements and pay unemployment insurance, taxes, workers' compensation, 
605.15 	liability insurance, and other benefits, if any;
605.16 	(5) enter into a written agreement with the participant, participant's representative, or 
605.17 	legal representative that assigns roles and responsibilities to be performed before services, 
605.18 	supports, or goods are provided and that meets the requirements of subdivisions 20a, 20b, 
605.19 	and 20c for agency-providers;
605.20 	(6) report maltreatment as required under section 626.557 and chapter 260E;
605.21 	(7) comply with the labor market reporting requirements described in section 256B.4912, 
605.22 	subdivision 1a;
605.23 	(8) comply with any data requests from the department consistent with the Minnesota 
605.24 	Government Data Practices Act under chapter 13; and
605.25 	(9) maintain documentation for the requirements under subdivision 16, paragraph (e), 
605.26 	clause (2), to qualify for an enhanced rate under this section.; and
605.27 	(10) request reassessments 60 days before the end of the current authorization for CFSS 
605.28 	on forms provided by the commissioner.

606.1 	Sec. 14. Minnesota Statutes 2020, section 256B.85, subdivision 11, is amended to read:
606.2 		Subd. 11.Agency-provider model. (a) The agency-provider model includes services 
606.3 	provided by support workers and staff providing worker training and development services 
606.4 	who are employed by an agency-provider that meets the criteria established by the 
606.5 	commissioner, including required training.
606.6 	(b) The agency-provider shall allow the participant to have a significant role in the 
606.7 	selection and dismissal of the support workers for the delivery of the services and supports 
606.8 	specified in the participant's CFSS service delivery plan. The agency must make a reasonable 
606.9 	effort to fulfill the participant's request for the participant's preferred worker.
606.10 	(c) A participant may use authorized units of CFSS services as needed within a service 
606.11 	agreement that is not greater than 12 months. Using authorized units in a flexible manner 
606.12 	in either the agency-provider model or the budget model does not increase the total amount 
606.13 	of services and supports authorized for a participant or included in the participant's CFSS 
606.14 	service delivery plan.
606.15 	(d) A participant may share CFSS services. Two or three CFSS participants may share 
606.16 	services at the same time provided by the same support worker.
606.17 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated 
606.18 	by the medical assistance payment for CFSS for support worker wages and benefits, except 
606.19 	all of the revenue generated by a medical assistance rate increase due to a collective 
606.20 	bargaining agreement under section 179A.54 must be used for support worker wages and 
606.21 	benefits. The agency-provider must document how this requirement is being met. The 
606.22 	revenue generated by the worker training and development services and the reasonable costs 
606.23 	associated with the worker training and development services must not be used in making 
606.24 	this calculation.
606.25 	(f) The agency-provider model must be used by individuals participants who are restricted 
606.26 	by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 
606.27 	9505.2245.
606.28 	(g) Participants purchasing goods under this model, along with support worker services, 
606.29 	must:
606.30 	(1) specify the goods in the CFSS service delivery plan and detailed budget for 
606.31 	expenditures that must be approved by the consultation services provider, case manager, or 
606.32 	care coordinator; and
606.33 	(2) use the FMS provider for the billing and payment of such goods.

607.1 	Sec. 15. Minnesota Statutes 2020, section 256B.85, subdivision 11b, is amended to read:
607.2 		Subd. 11b.Agency-provider model; support worker competency. (a) The 
607.3 	agency-provider must ensure that support workers are competent to meet the participant's 
607.4 	assessed needs, goals, and additional requirements as written in the CFSS service delivery 
607.5 	plan. Within 30 days of any support worker beginning to provide services for a participant,
607.6 	The agency-provider must evaluate the competency of the worker through direct observation 
607.7 	of the support worker's performance of the job functions in a setting where the participant 
607.8 	is using CFSS. within 30 days of:
607.9 	(1) any support worker beginning to provide services for a participant; or
607.10 	(2) any support worker beginning to provide shared services.
607.11 	(b) The agency-provider must verify and maintain evidence of support worker 
607.12 	competency, including documentation of the support worker's:
607.13 	(1) education and experience relevant to the job responsibilities assigned to the support 
607.14 	worker and the needs of the participant;
607.15 	(2) relevant training received from sources other than the agency-provider;
607.16 	(3) orientation and instruction to implement services and supports to participant needs 
607.17 	and preferences as identified in the CFSS service delivery plan; and
607.18 	(4) orientation and instruction delivered by an individual competent to perform, teach, 
607.19 	or assign the health-related tasks for tracheostomy suctioning and services to participants 
607.20 	on ventilator support, including equipment operation and maintenance; and
607.21 	(4) (5) periodic performance reviews completed by the agency-provider at least annually, 
607.22 	including any evaluations required under subdivision 11a, paragraph (a). If a support worker 
607.23 	is a minor, all evaluations of worker competency must be completed in person and in a 
607.24 	setting where the participant is using CFSS.
607.25 	(c) The agency-provider must develop a worker training and development plan with the 
607.26 	participant to ensure support worker competency. The worker training and development 
607.27 	plan must be updated when:
607.28 	(1) the support worker begins providing services;
607.29 	(2) the support worker begins providing shared services;
607.30 	(2) (3) there is any change in condition or a modification to the CFSS service delivery 
607.31 	plan; or
608.1 	(3) (4) a performance review indicates that additional training is needed.

608.2 	Sec. 16. Minnesota Statutes 2020, section 256B.85, subdivision 12, is amended to read:
608.3 		Subd. 12.Requirements for enrollment of CFSS agency-providers. (a) All CFSS 
608.4 	agency-providers must provide, at the time of enrollment, reenrollment, and revalidation 
608.5 	as a CFSS agency-provider in a format determined by the commissioner, information and 
608.6 	documentation that includes, but is not limited to, the following:
608.7 	(1) the CFSS agency-provider's current contact information including address, telephone 
608.8 	number, and e-mail address;
608.9 	(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's 
608.10 	Medicaid revenue in the previous calendar year is less than or equal to $300,000, the 
608.11 	agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid 
608.12 	revenue in the previous calendar year is greater than $300,000, the agency-provider must 
608.13 	purchase a surety bond of $100,000. The surety bond must be in a form approved by the 
608.14 	commissioner, must be renewed annually, and must allow for recovery of costs and fees in 
608.15 	pursuing a claim on the bond;
608.16 	(3) proof of fidelity bond coverage in the amount of $20,000 per provider location;
608.17 	(4) proof of workers' compensation insurance coverage;
608.18 	(5) proof of liability insurance;
608.19 	(6) a description copy of the CFSS agency-provider's organization organizational chart
608.20 	identifying the names and roles of all owners, managing employees, staff, board of directors, 
608.21 	and the additional documentation reporting any affiliations of the directors and owners to 
608.22 	other service providers;
608.23 	(7) a copy of proof that the CFSS agency-provider's agency-provider has written policies 
608.24 	and procedures including: hiring of employees; training requirements; service delivery; and 
608.25 	employee and consumer safety, including the process for notification and resolution of 
608.26 	participant grievances, incident response, identification and prevention of communicable 
608.27 	diseases, and employee misconduct;
608.28 	(8) copies of all other forms proof that the CFSS agency-provider uses in the course of 
608.29 	daily business including, but not limited to has all of the following forms and documents:
608.30 	(i) a copy of the CFSS agency-provider's time sheet; and
608.31 	(ii) a copy of the participant's individual CFSS service delivery plan;
609.1 	(9) a list of all training and classes that the CFSS agency-provider requires of its staff 
609.2 	providing CFSS services;
609.3 	(10) documentation that the CFSS agency-provider and staff have successfully completed 
609.4 	all the training required by this section;
609.5 	(11) documentation of the agency-provider's marketing practices;
609.6 	(12) disclosure of ownership, leasing, or management of all residential properties that 
609.7 	are used or could be used for providing home care services;
609.8 	(13) documentation that the agency-provider will use at least the following percentages 
609.9 	of revenue generated from the medical assistance rate paid for CFSS services for CFSS 
609.10 	support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except 
609.11 	100 percent of the revenue generated by a medical assistance rate increase due to a collective 
609.12 	bargaining agreement under section 179A.54 must be used for support worker wages and 
609.13 	benefits. The revenue generated by the worker training and development services and the 
609.14 	reasonable costs associated with the worker training and development services shall not be 
609.15 	used in making this calculation; and
609.16 	(14) documentation that the agency-provider does not burden participants' free exercise 
609.17 	of their right to choose service providers by requiring CFSS support workers to sign an 
609.18 	agreement not to work with any particular CFSS participant or for another CFSS 
609.19 	agency-provider after leaving the agency and that the agency is not taking action on any 
609.20 	such agreements or requirements regardless of the date signed.
609.21 	(b) CFSS agency-providers shall provide to the commissioner the information specified 
609.22 	in paragraph (a).
609.23 	(c) All CFSS agency-providers shall require all employees in management and 
609.24 	supervisory positions and owners of the agency who are active in the day-to-day management 
609.25 	and operations of the agency to complete mandatory training as determined by the 
609.26 	commissioner. Employees in management and supervisory positions and owners who are 
609.27 	active in the day-to-day operations of an agency who have completed the required training 
609.28 	as an employee with a CFSS agency-provider do not need to repeat the required training if 
609.29 	they are hired by another agency, if and they have completed the training within the past 
609.30 	three years. CFSS agency-provider billing staff shall complete training about CFSS program 
609.31 	financial management. Any new owners or employees in management and supervisory 
609.32 	positions involved in the day-to-day operations are required to complete mandatory training 
609.33 	as a requisite of working for the agency.
610.1 	(d) The commissioner shall send annual review notifications to agency-providers 30 
610.2 	days prior to renewal. The notification must:
610.3 	(1) list the materials and information the agency-provider is required to submit;
610.4 	(2) provide instructions on submitting information to the commissioner; and
610.5 	(3) provide a due date by which the commissioner must receive the requested information.
610.6 	Agency-providers shall submit all required documentation for annual review within 30 days 
610.7 	of notification from the commissioner. If an agency-provider fails to submit all the required 
610.8 	documentation, the commissioner may take action under subdivision 23a.
610.9 	(d) Agency-providers shall submit all required documentation in this section within 30 
610.10 	days of notification from the commissioner. If an agency-provider fails to submit all the 
610.11 	required documentation, the commissioner may take action under subdivision 23a.

610.12 	Sec. 17. Minnesota Statutes 2020, section 256B.85, subdivision 12b, is amended to read:
610.13 		Subd. 12b.CFSS agency-provider requirements; notice regarding termination of 
610.14 	services. (a) An agency-provider must provide written notice when it intends to terminate 
610.15 	services with a participant at least ten 30 calendar days before the proposed service 
610.16 	termination is to become effective, except in cases where:
610.17 	(1) the participant engages in conduct that significantly alters the terms of the CFSS 
610.18 	service delivery plan with the agency-provider;
610.19 	(2) the participant or other persons at the setting where services are being provided 
610.20 	engage in conduct that creates an imminent risk of harm to the support worker or other 
610.21 	agency-provider staff; or
610.22 	(3) an emergency or a significant change in the participant's condition occurs within a 
610.23 	24-hour period that results in the participant's service needs exceeding the participant's 
610.24 	identified needs in the current CFSS service delivery plan so that the agency-provider cannot 
610.25 	safely meet the participant's needs.
610.26 	(b) When a participant initiates a request to terminate CFSS services with the 
610.27 	agency-provider, the agency-provider must give the participant a written acknowledgement
610.28 	acknowledgment of the participant's service termination request that includes the date the 
610.29 	request was received by the agency-provider and the requested date of termination.
610.30 	(c) The agency-provider must participate in a coordinated transfer of the participant to 
610.31 	a new agency-provider to ensure continuity of care.

611.1 	Sec. 18. Minnesota Statutes 2020, section 256B.85, subdivision 13, is amended to read:
611.2 		Subd. 13.Budget model. (a) Under the budget model participants exercise responsibility 
611.3 	and control over the services and supports described and budgeted within the CFSS service 
611.4 	delivery plan. Participants must use services specified in subdivision 13a provided by an 
611.5 	FMS provider. Under this model, participants may use their approved service budget 
611.6 	allocation to:
611.7 	(1) directly employ support workers, and pay wages, federal and state payroll taxes, and 
611.8 	premiums for workers' compensation, liability, and health insurance coverage; and
611.9 	(2) obtain supports and goods as defined in subdivision 7.
611.10 	(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may 
611.11 	authorize a legal representative or participant's representative to do so on their behalf.
611.12 	(c) If two or more participants using the budget model live in the same household and 
611.13 	have the same worker, the participants must use the same FMS provider.
611.14 	(d) If the FMS provider advises that there is a joint employer in the budget model, all 
611.15 	participants associated with that joint employer must use the same FMS provider.
611.16 	(c) (e) The commissioner shall disenroll or exclude participants from the budget model 
611.17 	and transfer them to the agency-provider model under, but not limited to, the following 
611.18 	circumstances:
611.19 	(1) when a participant has been restricted by the Minnesota restricted recipient program, 
611.20 	in which case the participant may be excluded for a specified time period under Minnesota 
611.21 	Rules, parts 9505.2160 to 9505.2245;
611.22 	(2) when a participant exits the budget model during the participant's service plan year. 
611.23 	Upon transfer, the participant shall not access the budget model for the remainder of that 
611.24 	service plan year; or
611.25 	(3) when the department determines that the participant or participant's representative 
611.26 	or legal representative is unable to fulfill the responsibilities under the budget model, as 
611.27 	specified in subdivision 14.
611.28 	(d) (f) A participant may appeal in writing to the department under section 256.045, 
611.29 	subdivision 3, to contest the department's decision under paragraph (c) (e), clause (3), to 
611.30 	disenroll or exclude the participant from the budget model.

612.1 	Sec. 19. Minnesota Statutes 2020, section 256B.85, subdivision 13a, is amended to read:
612.2 		Subd. 13a.Financial management services. (a) Services provided by an FMS provider 
612.3 	include but are not limited to: filing and payment of federal and state payroll taxes on behalf 
612.4 	of the participant; initiating and complying with background study requirements under 
612.5 	chapter 245C and maintaining documentation of background study requests and results; 
612.6 	billing for approved CFSS services with authorized funds; monitoring expenditures; 
612.7 	accounting for and disbursing CFSS funds; providing assistance in obtaining and filing for 
612.8 	liability, workers' compensation, and unemployment coverage; and providing participant 
612.9 	instruction and technical assistance to the participant in fulfilling employer-related 
612.10 	requirements in accordance with section 3504 of the Internal Revenue Code and related 
612.11 	regulations and interpretations, including Code of Federal Regulations, title 26, section 
612.12 	31.3504-1.
612.13 	(b) Agency-provider services shall not be provided by the FMS provider.
612.14 	(c) The FMS provider shall provide service functions as determined by the commissioner 
612.15 	for budget model participants that include but are not limited to:
612.16 	(1) assistance with the development of the detailed budget for expenditures portion of 
612.17 	the CFSS service delivery plan as requested by the consultation services provider or 
612.18 	participant;
612.19 	(2) data recording and reporting of participant spending;
612.20 	(3) other duties established by the department, including with respect to providing 
612.21 	assistance to the participant, participant's representative, or legal representative in performing 
612.22 	employer responsibilities regarding support workers. The support worker shall not be 
612.23 	considered the employee of the FMS provider; and
612.24 	(4) billing, payment, and accounting of approved expenditures for goods.
612.25 	(d) The FMS provider shall obtain an assurance statement from the participant employer 
612.26 	agreeing to follow state and federal regulations and CFSS policies regarding employment 
612.27 	of support workers.
612.28 	(e) The FMS provider shall:
612.29 	(1) not limit or restrict the participant's choice of service or support providers or service 
612.30 	delivery models consistent with any applicable state and federal requirements;
613.1 	(2) provide the participant, consultation services provider, and case manager or care 
613.2 	coordinator, if applicable, with a monthly written summary of the spending for services and 
613.3 	supports that were billed against the spending budget;
613.4 	(3) be knowledgeable of state and federal employment regulations, including those under 
613.5 	the Fair Labor Standards Act of 1938, and comply with the requirements under section 3504 
613.6 	of the Internal Revenue Code and related regulations and interpretations, including Code 
613.7 	of Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability 
613.8 	for vendor fiscal/employer agent, and any requirements necessary to process employer and 
613.9 	employee deductions, provide appropriate and timely submission of employer tax liabilities, 
613.10 	and maintain documentation to support medical assistance claims;
613.11 	(4) have current and adequate liability insurance and bonding and sufficient cash flow 
613.12 	as determined by the commissioner and have on staff or under contract a certified public 
613.13 	accountant or an individual with a baccalaureate degree in accounting;
613.14 	(5) assume fiscal accountability for state funds designated for the program and be held 
613.15 	liable for any overpayments or violations of applicable statutes or rules, including but not 
613.16 	limited to the Minnesota False Claims Act, chapter 15C; and
613.17 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
613.18 	supports expenditures for any goods purchased and maintain time records of support workers. 
613.19 	The documentation and time records must be maintained for a minimum of five years from 
613.20 	the claim date and be available for audit or review upon request by the commissioner. Claims 
613.21 	submitted by the FMS provider to the commissioner for payment must correspond with 
613.22 	services, amounts, and time periods as authorized in the participant's service budget and 
613.23 	service plan and must contain specific identifying information as determined by the 
613.24 	commissioner.; and
613.25 	(7) provide written notice to the participant or the participant's representative at least 30 
613.26 	calendar days before a proposed service termination becomes effective.
613.27 	(f) The commissioner of human services shall:
613.28 	(1) establish rates and payment methodology for the FMS provider;
613.29 	(2) identify a process to ensure quality and performance standards for the FMS provider 
613.30 	and ensure statewide access to FMS providers; and
613.31 	(3) establish a uniform protocol for delivering and administering CFSS services to be 
613.32 	used by eligible FMS providers.

614.1 	Sec. 20. Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision 
614.2 	to read:
614.3 		Subd. 14a.Participant's representative responsibilities. (a) If a participant is unable 
614.4 	to direct the participant's own care, the participant must use a participant's representative 
614.5 	to receive CFSS services. A participant's representative is required if:
614.6 	(1) the person is under 18 years of age;
614.7 	(2) the person has a court-appointed guardian; or
614.8 	(3) an assessment according to section 256B.0659, subdivision 3a, determines that the 
614.9 	participant is in need of a participant's representative.
614.10 	(b) A participant's representative must:
614.11 	(1) be at least 18 years of age;
614.12 	(2) actively participate in planning and directing CFSS services;
614.13 	(3) have sufficient knowledge of the participant's circumstances to use CFSS services 
614.14 	consistent with the participant's health and safety needs identified in the participant's service 
614.15 	delivery plan;
614.16 	(4) not have a financial interest in the provision of any services included in the 
614.17 	participant's CFSS service delivery plan; and
614.18 	(5) be capable of providing the support necessary to assist the participant in the use of 
614.19 	CFSS services.
614.20 	(c) A participant's representative must not be the:
614.21 	(1) support worker;
614.22 	(2) worker training and development service provider;
614.23 	(3) agency-provider staff, unless related to the participant by blood, marriage, or adoption;
614.24 	(4) consultation service provider, unless related to the participant by blood, marriage, 
614.25 	or adoption;
614.26 	(5) FMS staff, unless related to the participant by blood, marriage, or adoption;
614.27 	(6) FMS owner or manager; or
614.28 	(7) lead agency staff acting as part of employment.
615.1 	(d) A licensed family foster parent who lives with the participant may be the participant's 
615.2 	representative if the family foster parent meets the other participant's representative 
615.3 	requirements.
615.4 	(e) There may be two persons designated as the participant's representative, including 
615.5 	instances of divided households and court-ordered custodies. Each person named as the 
615.6 	participant's representative must meet the program criteria and responsibilities.
615.7 	(f) The participant or the participant's legal representative shall appoint a participant's 
615.8 	representative. The participant's representative must be identified at the time of assessment 
615.9 	and listed on the participant's service agreement and CFSS service delivery plan.
615.10 	(g) A participant's representative must enter into a written agreement with an 
615.11 	agency-provider or FMS on a form determined by the commissioner and maintained in the 
615.12 	participant's file, to:
615.13 	(1) be available while care is provided using a method agreed upon by the participant 
615.14 	or the participant's legal representative and documented in the participant's service delivery 
615.15 	plan;
615.16 	(2) monitor CFSS services to ensure the participant's service delivery plan is followed;
615.17 	(3) review and sign support worker time sheets after services are provided to verify the 
615.18 	provision of services;
615.19 	(4) review and sign vendor paperwork to verify receipt of goods; and
615.20 	(5) in the budget model, review and sign documentation to verify worker training and 
615.21 	development expenditures.
615.22 	(h) A participant's representative may delegate responsibility to another adult who is not 
615.23 	the support worker during a temporary absence of at least 24 hours but not more than six 
615.24 	months. To delegate responsibility, the participant's representative must:
615.25 	(1) ensure that the delegate serving as the participant's representative satisfies the 
615.26 	requirements of the participant's representative;
615.27 	(2) ensure that the delegate performs the functions of the participant's representative;
615.28 	(3) communicate to the CFSS agency-provider or FMS provider about the need for a 
615.29 	delegate by updating the written agreement to include the name of the delegate and the 
615.30 	delegate's contact information; and
615.31 	(4) ensure that the delegate protects the participant's privacy according to federal and 
615.32 	state data privacy laws.
616.1 	(i) The designation of a participant's representative remains in place until:
616.2 	(1) the participant revokes the designation;
616.3 	(2) the participant's representative withdraws the designation or becomes unable to fulfill 
616.4 	the duties;
616.5 	(3) the legal authority to act as a participant's representative changes; or
616.6 	(4) the participant's representative is disqualified.
616.7 	(j) A lead agency may disqualify a participant's representative who engages in conduct 
616.8 	that creates an imminent risk of harm to the participant, the support workers, or other staff. 
616.9 	A participant's representative who fails to provide support required by the participant must 
616.10 	be referred to the common entry point.

616.11 	Sec. 21. Minnesota Statutes 2020, section 256B.85, subdivision 15, is amended to read:
616.12 		Subd. 15.Documentation of support services provided; time sheets. (a) CFSS services 
616.13 	provided to a participant by a support worker employed by either an agency-provider or the 
616.14 	participant employer must be documented daily by each support worker, on a time sheet. 
616.15 	Time sheets may be created, submitted, and maintained electronically. Time sheets must 
616.16 	be submitted by the support worker at least once per month to the:
616.17 	(1) agency-provider when the participant is using the agency-provider model. The 
616.18 	agency-provider must maintain a record of the time sheet and provide a copy of the time 
616.19 	sheet to the participant; or
616.20 	(2) participant and the participant's FMS provider when the participant is using the 
616.21 	budget model. The participant and the FMS provider must maintain a record of the time 
616.22 	sheet.
616.23 	(b) The documentation on the time sheet must correspond to the participant's assessed 
616.24 	needs within the scope of CFSS covered services. The accuracy of the time sheets must be 
616.25 	verified by the:
616.26 	(1) agency-provider when the participant is using the agency-provider model; or
616.27 	(2) participant employer and the participant's FMS provider when the participant is using 
616.28 	the budget model.
616.29 	(c) The time sheet must document the time the support worker provides services to the 
616.30 	participant. The following elements must be included in the time sheet:
616.31 	(1) the support worker's full name and individual provider number;
617.1 	(2) the agency-provider's name and telephone numbers, when responsible for the CFSS 
617.2 	service delivery plan;
617.3 	(3) the participant's full name;
617.4 	(4) the dates within the pay period established by the agency-provider or FMS provider, 
617.5 	including month, day, and year, and arrival and departure times with a.m. or p.m. notations 
617.6 	for days worked within the established pay period;
617.7 	(5) the covered services provided to the participant on each date of service;
617.8 	(6) a the signature line for of the participant or the participant's representative and a 
617.9 	statement that the participant's or participant's representative's signature is verification of 
617.10 	the time sheet's accuracy;
617.11 	(7) the personal signature of the support worker;
617.12 	(8) any shared care provided, if applicable;
617.13 	(9) a statement that it is a federal crime to provide false information on CFSS billings 
617.14 	for medical assistance payments; and
617.15 	(10) dates and location of participant stays in a hospital, care facility, or incarceration 
617.16 	occurring within the established pay period.

617.17 	Sec. 22. Minnesota Statutes 2020, section 256B.85, subdivision 17a, is amended to read:
617.18 		Subd. 17a.Consultation services provider qualifications and 
617.19 	requirements. Consultation services providers must meet the following qualifications and 
617.20 	requirements:
617.21 	(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4) 
617.22 	and (5);
617.23 	(2) are under contract with the department;
617.24 	(3) are not the FMS provider, the lead agency, or the CFSS or home and community-based 
617.25 	services waiver vendor or agency-provider to the participant;
617.26 	(4) meet the service standards as established by the commissioner;
617.27 	(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation 
617.28 	service provider's Medicaid revenue in the previous calendar year is less than or equal to 
617.29 	$300,000, the consultation service provider must purchase a surety bond of $50,000. If the 
617.30 	agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000, 
617.31 	the consultation service provider must purchase a surety bond of $100,000. The surety bond 
618.1 	must be in a form approved by the commissioner, must be renewed annually, and must 
618.2 	allow for recovery of costs and fees in pursuing a claim on the bond;
618.3 	(5) (6) employ lead professional staff with a minimum of threetwo years of experience 
618.4 	in providing services such as support planning, support broker, case management or care 
618.5 	coordination, or consultation services and consumer education to participants using a 
618.6 	self-directed program using FMS under medical assistance;
618.7 	(7) report maltreatment as required under chapter 260E and section 626.557;
618.8 	(6) (8) comply with medical assistance provider requirements;
618.9 	(7) (9) understand the CFSS program and its policies;
618.10 	(8) (10) are knowledgeable about self-directed principles and the application of the 
618.11 	person-centered planning process;
618.12 	(9) (11) have general knowledge of the FMS provider duties and the vendor 
618.13 	fiscal/employer agent model, including all applicable federal, state, and local laws and 
618.14 	regulations regarding tax, labor, employment, and liability and workers' compensation 
618.15 	coverage for household workers; and
618.16 	(10) (12) have all employees, including lead professional staff, staff in management and 
618.17 	supervisory positions, and owners of the agency who are active in the day-to-day management 
618.18 	and operations of the agency, complete training as specified in the contract with the 
618.19 	department.

618.20 	Sec. 23. Minnesota Statutes 2020, section 256B.85, subdivision 18a, is amended to read:
618.21 		Subd. 18a.Worker training and development services. (a) The commissioner shall 
618.22 	develop the scope of tasks and functions, service standards, and service limits for worker 
618.23 	training and development services.
618.24 	(b) Worker training and development costs are in addition to the participant's assessed 
618.25 	service units or service budget. Services provided according to this subdivision must:
618.26 	(1) help support workers obtain and expand the skills and knowledge necessary to ensure 
618.27 	competency in providing quality services as needed and defined in the participant's CFSS 
618.28 	service delivery plan and as required under subdivisions 11b and 14;
618.29 	(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased 
618.30 	by the participant employer under the budget model as identified in subdivision 13; and
619.1 	(3) be delivered by an individual competent to perform, teach, or assign the tasks, 
619.2 	including health-related tasks, identified in the plan through education, training, and work 
619.3 	experience relevant to the person's assessed needs; and
619.4 	(3) (4) be described in the participant's CFSS service delivery plan and documented in 
619.5 	the participant's file.
619.6 	(c) Services covered under worker training and development shall include:
619.7 	(1) support worker training on the participant's individual assessed needs and condition, 
619.8 	provided individually or in a group setting by a skilled and knowledgeable trainer beyond 
619.9 	any training the participant or participant's representative provides;
619.10 	(2) tuition for professional classes and workshops for the participant's support workers 
619.11 	that relate to the participant's assessed needs and condition;
619.12 	(3) direct observation, monitoring, coaching, and documentation of support worker job 
619.13 	skills and tasks, beyond any training the participant or participant's representative provides, 
619.14 	including supervision of health-related tasks or behavioral supports that is conducted by an 
619.15 	appropriate professional based on the participant's assessed needs. These services must be 
619.16 	provided at the start of services or the start of a new support worker except as provided in 
619.17 	paragraph (d) and must be specified in the participant's CFSS service delivery plan; and
619.18 	(4) the activities to evaluate CFSS services and ensure support worker competency 
619.19 	described in subdivisions 11a and 11b.
619.20 	(d) The services in paragraph (c), clause (3), are not required to be provided for a new 
619.21 	support worker providing services for a participant due to staffing failures, unless the support 
619.22 	worker is expected to provide ongoing backup staffing coverage.
619.23 	(e) Worker training and development services shall not include:
619.24 	(1) general agency training, worker orientation, or training on CFSS self-directed models;
619.25 	(2) payment for preparation or development time for the trainer or presenter;
619.26 	(3) payment of the support worker's salary or compensation during the training;
619.27 	(4) training or supervision provided by the participant, the participant's support worker, 
619.28 	or the participant's informal supports, including the participant's representative; or
619.29 	(5) services in excess of 96 units the rate set by the commissioner per annual service 
619.30 	agreement, unless approved by the department.

620.1 	Sec. 24. Minnesota Statutes 2020, section 256B.85, subdivision 20b, is amended to read:
620.2 		Subd. 20b.Service-related rights under an agency-provider. A participant receiving 
620.3 	CFSS from an agency-provider has service-related rights to:
620.4 	(1) participate in and approve the initial development and ongoing modification and 
620.5 	evaluation of CFSS services provided to the participant;
620.6 	(2) refuse or terminate services and be informed of the consequences of refusing or 
620.7 	terminating services;
620.8 	(3) before services are initiated, be told the limits to the services available from the 
620.9 	agency-provider, including the agency-provider's knowledge, skill, and ability to meet the 
620.10 	participant's needs identified in the CFSS service delivery plan;
620.11 	(4) a coordinated transfer of services when there will be a change in the agency-provider;
620.12 	(5) before services are initiated, be told what the agency-provider charges for the services;
620.13 	(6) before services are initiated, be told to what extent payment may be expected from 
620.14 	health insurance, public programs, or other sources, if known; and what charges the 
620.15 	participant may be responsible for paying;
620.16 	(7) receive services from an individual who is competent and trained, who has 
620.17 	professional certification or licensure, as required, and who meets additional qualifications 
620.18 	identified in the participant's CFSS service delivery plan;
620.19 	(8) have the participant's preferences for support workers identified and documented, 
620.20 	and have those preferences met when possible; and
620.21 	(9) before services are initiated, be told the choices that are available from the 
620.22 	agency-provider for meeting the participant's assessed needs identified in the CFSS service 
620.23 	delivery plan, including but not limited to which support worker staff will be providing 
620.24 	services and, the proposed frequency and schedule of visits, and any agreements for shared 
620.25 	services.

620.26 	Sec. 25. Minnesota Statutes 2020, section 256B.85, subdivision 23, is amended to read:
620.27 		Subd. 23.Commissioner's access. (a) When the commissioner is investigating a possible 
620.28 	overpayment of Medicaid funds, the commissioner must be given immediate access without 
620.29 	prior notice to the agency-provider, consultation services provider, or FMS provider's office 
620.30 	during regular business hours and to documentation and records related to services provided 
620.31 	and submission of claims for services provided. Denying the commissioner access to records 
620.32 	is cause for immediate suspension of payment and terminating If the agency-provider's 
621.1 	enrollment or agency-provider, FMS provider's enrollment provider, or consultation services 
621.2 	provider denies the commissioner access to records, the provider's payment may be 
621.3 	immediately suspended or the provider's enrollment may be terminated according to section 
621.4 	256B.064or terminating the consultation services provider contract.
621.5 	(b) The commissioner has the authority to request proof of compliance with laws, rules, 
621.6 	and policies from agency-providers, consultation services providers, FMS providers, and 
621.7 	participants.
621.8 	(c) When relevant to an investigation conducted by the commissioner, the commissioner 
621.9 	must be given access to the business office, documents, and records of the agency-provider, 
621.10 	consultation services provider, or FMS provider, including records maintained in electronic 
621.11 	format; participants served by the program; and staff during regular business hours. The 
621.12 	commissioner must be given access without prior notice and as often as the commissioner 
621.13 	considers necessary if the commissioner is investigating an alleged violation of applicable 
621.14 	laws or rules. The commissioner may request and shall receive assistance from lead agencies 
621.15 	and other state, county, and municipal agencies and departments. The commissioner's access 
621.16 	includes being allowed to photocopy, photograph, and make audio and video recordings at 
621.17 	the commissioner's expense.

621.18 	Sec. 26. Minnesota Statutes 2020, section 256B.85, subdivision 23a, is amended to read:
621.19 		Subd. 23a.Sanctions; information for participants upon termination of services. (a) 
621.20 	The commissioner may withhold payment from the provider or suspend or terminate the 
621.21 	provider enrollment number if the provider fails to comply fully with applicable laws or 
621.22 	rules. The provider has the right to appeal the decision of the commissioner under section 
621.23 	256B.064.
621.24 	(b) Notwithstanding subdivision 13, paragraph (c), if a participant employer fails to 
621.25 	comply fully with applicable laws or rules, the commissioner may disenroll the participant 
621.26 	from the budget model. A participant may appeal in writing to the department under section 
621.27 	256.045, subdivision 3, to contest the department's decision to disenroll the participant from 
621.28 	the budget model.
621.29 	(c) Agency-providers of CFSS services or FMS providers must provide each participant 
621.30 	with a copy of participant protections in subdivision 20c at least 30 days prior to terminating 
621.31 	services to a participant, if the termination results from sanctions under this subdivision or 
621.32 	section 256B.064, such as a payment withhold or a suspension or termination of the provider 
621.33 	enrollment number. If a CFSS agency-provider or, FMS provider, or consultation services 
621.34 	provider determines it is unable to continue providing services to a participant because of 
622.1 	an action under this subdivision or section 256B.064, the agency-provider or, FMS provider, 
622.2 	or consultation services provider must notify the participant, the participant's representative, 
622.3 	and the commissioner 30 days prior to terminating services to the participant, and must 
622.4 	assist the commissioner and lead agency in supporting the participant in transitioning to 
622.5 	another CFSS agency-provider or, FMS provider, or consultation services provider of the 
622.6 	participant's choice.
622.7 	(d) In the event the commissioner withholds payment from a CFSS agency-provider or,
622.8 	FMS provider, or consultation services provider, or suspends or terminates a provider 
622.9 	enrollment number of a CFSS agency-provider or, FMS provider, or consultation services 
622.10 	provider under this subdivision or section 256B.064, the commissioner may inform the 
622.11 	Office of Ombudsman for Long-Term Care and the lead agencies for all participants with 
622.12 	active service agreements with the agency-provider or, FMS provider, or consultation 
622.13 	services provider. At the commissioner's request, the lead agencies must contact participants 
622.14 	to ensure that the participants are continuing to receive needed care, and that the participants 
622.15 	have been given free choice of agency-provider or, FMS provider, or consultation services 
622.16 	provider if they transfer to another CFSS agency-provider or, FMS provider, or consultation 
622.17 	services provider. In addition, the commissioner or the commissioner's delegate may directly 
622.18 	notify participants who receive care from the agency-provider or, FMS provider, or 
622.19 	consultation services provider that payments have been or will be withheld or that the 
622.20 	provider's participation in medical assistance has been or will be suspended or terminated, 
622.21 	if the commissioner determines that the notification is necessary to protect the welfare of 
622.22 	the participants.

622.23 	ARTICLE 16
622.24 	MISCELLANEOUS

622.25 	Section 1. [119B.195] RETAINING EARLY EDUCATORS THROUGH ATTAINING 
622.26 	INCENTIVES NOW (REETAIN) GRANT PROGRAM.
622.27 		Subdivision 1.Establishment; purpose. The retaining early educators through attaining 
622.28 	incentives now (REETAIN) grant program is established to provide competitive grants to 
622.29 	incentivize well-trained child care professionals to remain in the workforce. The overall 
622.30 	goal of the REETAIN grant program is to create more consistent care for children over time.
622.31 		Subd. 2.Administration. The commissioner shall administer the REETAIN grant 
622.32 	program through a grant to a nonprofit with the demonstrated ability to manage benefit 
622.33 	programs for child care professionals. Up to ten percent of grant money may be used for 
622.34 	administration of the grant program.
623.1 		Subd. 3.Application. Applicants must apply for the REETAIN grant program using 
623.2 	the forms and according to timelines established by the commissioner.
623.3 		Subd. 4.Eligibility. (a) To be eligible for a grant, an applicant must:
623.4 	(1) be licensed to provide child care or work for a licensed child care program;
623.5 	(2) work directly with children at least 30 hours per week;
623.6 	(3) have worked in the applicant's current position for at least 12 months;
623.7 	(4) agree to work in the early childhood care and education field for at least 12 months 
623.8 	upon receiving a grant under this section;
623.9 	(5) have a career lattice step of five or higher;
623.10 	(6) have a current membership with the Minnesota quality improvement and registry 
623.11 	tool;
623.12 	(7) not be a current teacher education and compensation helps scholarship recipient; and
623.13 	(8) meet any other requirements determined by the commissioner.
623.14 	(b) Grant recipients must sign a contract agreeing to remain in the early childhood care 
623.15 	and education field for 12 months.
623.16 		Subd. 5.Grant awards. Grant awards must be made annually and may be made up to 
623.17 	an amount per recipient determined by the commissioner. Grant recipients may use grant 
623.18 	money for program supplies, training, or personal expenses.
623.19 		Subd. 6.Report. By January 1 each year, the commissioner must report to the legislative 
623.20 	committees with jurisdiction over child care about the number of grants awarded to recipients 
623.21 	and outcomes of the grant program since the last report.

623.22 	Sec. 2. Minnesota Statutes 2020, section 136A.128, subdivision 2, is amended to read:
623.23 		Subd. 2.Program components. (a) The nonprofit organization must use the grant for:
623.24 	(1) tuition scholarships up to $5,000 $10,000 per year for courses leading to the nationally 
623.25 	recognized child development associate credential or college-level courses leading to an 
623.26 	associate's degree or bachelor's degree in early childhood development and school-age care; 
623.27 	and
623.28 	(2) education incentives of a minimum of $100 $250 to participants in the tuition 
623.29 	scholarship program if they complete a year of working in the early care and education 
623.30 	field.
624.1 	(b) Applicants for the scholarship must be employed by a licensed early childhood or 
624.2 	child care program and working directly with children, a licensed family child care provider,
624.3 	employed by a public prekindergarten program, or an employee in a school-age program 
624.4 	exempt from licensing under section 245A.03, subdivision 2, paragraph (a), clause (12). 
624.5 	Lower wage earners must be given priority in awarding the tuition scholarships. Scholarship 
624.6 	recipients must contribute at least ten percent of the total scholarship and must be sponsored 
624.7 	by their employers, who must also contribute ten at least five percent of the total scholarship. 
624.8 	Scholarship recipients who are self-employed must contribute 20 percent of the total 
624.9 	scholarship.

624.10 	Sec. 3. Minnesota Statutes 2020, section 136A.128, subdivision 4, is amended to read:
624.11 		Subd. 4.Administration. A nonprofit organization that receives a grant under this 
624.12 	section may use five ten percent of the grant amount to administer the program.

624.13 	Sec. 4. Minnesota Statutes 2020, section 256.041, is amended to read:
624.14 	256.041 CULTURAL AND ETHNIC COMMUNITIES LEADERSHIP COUNCIL.
624.15 		Subdivision 1.Establishment; purpose. (a) There is hereby established the Cultural 
624.16 	and Ethnic Communities Leadership Council for the Department of Human Services. The 
624.17 	purpose of the council is to advise the commissioner of human services on reducing
624.18 	implementing strategies to reduce inequities and disparities that particularly affect racial 
624.19 	and ethnic groups in Minnesota.
624.20 	(b) This council is comprised of racially and ethnically diverse community leaders 
624.21 	including American Indians who are residents of Minnesota facing the compounded 
624.22 	challenges of systemic inequities. Members include people who are refugees, immigrants, 
624.23 	and LGBTQ+; people who have disabilities; and people who live in rural Minnesota.
624.24 		Subd. 2.Members. (a) The council must consist of:
624.25 	(1) the chairs and ranking minority members of the committees in the house of 
624.26 	representatives and the senate with jurisdiction over human services; and
624.27 	(2) no fewer than 15 and no more than 25 members appointed by and serving at the 
624.28 	pleasure of the commissioner of human services, in consultation with county, tribal, cultural, 
624.29 	and ethnic communities; diverse program participants; and parent representatives from these 
624.30 	communities; and cultural and ethnic communities leadership council members.
625.1 	(b) In making appointments under this section, the commissioner shall give priority 
625.2 	consideration to public members of the legislative councils of color established under chapter 
625.3 	3 section 15.0145.
625.4 	(c) Members must be appointed to allow for representation of the following groups:
625.5 	(1) racial and ethnic minority groups;
625.6 	(2) the American Indian community, which must be represented by two members;
625.7 	(3) culturally and linguistically specific advocacy groups and service providers;
625.8 	(4) human services program participants;
625.9 	(5) public and private institutions;
625.10 	(6) parents of human services program participants;
625.11 	(7) members of the faith community;
625.12 	(8) Department of Human Services employees; and
625.13 	(9) any other group the commissioner deems appropriate to facilitate the goals and duties 
625.14 	of the council.
625.15 		Subd. 3.Guidelines. The commissioner shall direct the development of guidelines 
625.16 	defining the membership of the council; setting out definitions; and developing duties of 
625.17 	the commissioner, the council, and council members regarding racial and ethnic disparities 
625.18 	reduction. The guidelines must be developed in consultation with:
625.19 	(1) the chairs of relevant committees; and
625.20 	(2) county, tribal, and cultural communities and program participants from these 
625.21 	communities.
625.22 		Subd. 4.Chair. The commissioner shall accept recommendations from the council to 
625.23 	appoint a chair or chairs.
625.24 		Subd. 5.Terms for first appointees. The initial members appointed shall serve until 
625.25 	January 15, 2016.
625.26 		Subd. 6.Terms. A term shall be for two years and appointees may be reappointed to 
625.27 	serve two additional terms. The commissioner shall make appointments to replace members 
625.28 	vacating their positions by January 15 of each year in a timely manner, no more than three 
625.29 	months after the council reviews panel recommendations.
626.1 		Subd. 7.Duties of commissioner. (a) The commissioner of human services or the 
626.2 	commissioner's designee shall:
626.3 	(1) maintain and actively engage with the council established in this section;
626.4 	(2) supervise and coordinate policies for persons from racial, ethnic, cultural, linguistic, 
626.5 	and tribal communities who experience disparities in access and outcomes;
626.6 	(3) identify human services rules or statutes affecting persons from racial, ethnic, cultural, 
626.7 	linguistic, and tribal communities that may need to be revised;
626.8 	(4) investigate and implement cost-effective equitable and culturally responsive models 
626.9 	of service delivery such as including careful adaptation adoption of clinically proven services 
626.10 	that constitute one strategy for increasing to increase the number of culturally relevant 
626.11 	services available to currently underserved populations; and
626.12 	(5) based on recommendations of the council, review identified department policies that 
626.13 	maintain racial, ethnic, cultural, linguistic, and tribal disparities, and; make adjustments to 
626.14 	ensure those disparities are not perpetuated.; and advise the department on progress and 
626.15 	accountability measures for addressing inequities;
626.16 	(6) in partnership with the council, renew and implement equity policy with action plans 
626.17 	and resources necessary to implement the action plans;
626.18 	(7) support interagency collaboration to advance equity;
626.19 	(8) address the council at least twice annually on the state of equity within the department; 
626.20 	and
626.21 	(9) support member participation in the council, including participation in educational 
626.22 	and community engagement events across Minnesota that address equity in human services.
626.23 	(b) The commissioner of human services or the commissioner's designee shall consult 
626.24 	with the council and receive recommendations from the council when meeting the 
626.25 	requirements in this subdivision.
626.26 		Subd. 8.Duties of council. The council shall:
626.27 	(1) recommend to the commissioner for review identified policies in the Department of 
626.28 	Human Services policy, budgetary, and operational decisions and practices that maintain
626.29 	impact racial, ethnic, cultural, linguistic, and tribal disparities;
626.30 	(2) with community input, advance legislative proposals to improve racial and health 
626.31 	equity outcomes;
627.1 	(3) identify issues regarding inequities and disparities by engaging diverse populations 
627.2 	in human services programs;
627.3 	(3) (4) engage in mutual learning essential for achieving human services parity and 
627.4 	optimal wellness for service recipients;
627.5 	(4) (5) raise awareness about human services disparities to the legislature and media;
627.6 	(5) (6) provide technical assistance and consultation support to counties, private nonprofit 
627.7 	agencies, and other service providers to build their capacity to provide equitable human 
627.8 	services for persons from racial, ethnic, cultural, linguistic, and tribal communities who 
627.9 	experience disparities in access and outcomes;
627.10 	(6) (7) provide technical assistance to promote statewide development of culturally and 
627.11 	linguistically appropriate, accessible, and cost-effective human services and related policies;
627.12 	(7) provide (8) recommend and monitor training and outreach to facilitate access to 
627.13 	culturally and linguistically appropriate, accessible, and cost-effective human services to 
627.14 	prevent disparities;
627.15 	(8) facilitate culturally appropriate and culturally sensitive admissions, continued services, 
627.16 	discharges, and utilization review for human services agencies and institutions;
627.17 	(9) form work groups to help carry out the duties of the council that include, but are not 
627.18 	limited to, persons who provide and receive services and representatives of advocacy groups, 
627.19 	and provide the work groups with clear guidelines, standardized parameters, and tasks for 
627.20 	the work groups to accomplish;
627.21 	(10) promote information sharing in the human services community and statewide; and
627.22 	(11) by February 15 each year in the second year of the biennium, prepare and submit 
627.23 	to the chairs and ranking minority members of the committees in the house of representatives 
627.24 	and the senate with jurisdiction over human services a report that summarizes the activities 
627.25 	of the council, identifies the major problems and issues confronting racial and ethnic groups 
627.26 	in accessing human services, makes recommendations to address issues, and lists the specific 
627.27 	objectives that the council seeks to attain during the next biennium, and recommendations 
627.28 	to strengthen equity, diversity, and inclusion within the department. The report must also 
627.29 	include a list of programs, groups, and grants used to reduce disparities, and statistically 
627.30 	valid reports of outcomes on the reduction of the disparities. identify racial and ethnic groups' 
627.31 	difficulty in accessing human services and make recommendations to address the issues. 
627.32 	The report must include any updated Department of Human Services equity policy, 
627.33 	implementation plans, equity initiatives, and the council's progress.
628.1 		Subd. 9.Duties of council members. The members of the council shall:
628.2 	(1) with no more than three absences per year, attend and participate in scheduled 
628.3 	meetings and be prepared by reviewing meeting notes;
628.4 	(2) maintain open communication channels with respective constituencies;
628.5 	(3) identify and communicate issues and risks that could impact the timely completion 
628.6 	of tasks;
628.7 	(4) collaborate on inequity and disparity reduction efforts;
628.8 	(5) communicate updates of the council's work progress and status on the Department 
628.9 	of Human Services website; and
628.10 	(6) participate in any activities the council or chair deems appropriate and necessary to 
628.11 	facilitate the goals and duties of the council.; and
628.12 	(7) participate in work groups to carry out council duties.
628.13 		Subd. 10.Expiration. The council expires on June 30, 2022 shall expire when racial 
628.14 	and ethnic-based disparities no longer exist in the state of Minnesota.
628.15 		Subd. 11.Compensation. Compensation for members of the council is governed by 
628.16 	section 15.059, subdivision 3.

628.17 	Sec. 5. CHILDREN WITH DISABILITIES INCLUSIVE CHILD CARE ACCESS 
628.18 	EXPANSION GRANT PROGRAM.
 628.19 		Subdivision 1.Establishment. (a) The commissioner of human services shall establish 
628.20 	a competitive grant program to expand access to licensed family child care providers or 
628.21 	licensed child care centers for children with disabilities including medical complexities. 
628.22 	The commissioner shall award grants to counties or Tribes, including at least one county 
628.23 	from the seven-county metropolitan area and at least one county or Tribe outside the 
628.24 	seven-county metropolitan area, and grant funds shall be used to enable child care providers 
628.25 	to develop an inclusive child care setting and offer care to children with disabilities and 
628.26 	children without disabilities. Grants shall be awarded to at least two applicants beginning 
628.27 	no later than December 1, 2021.
628.28 	(b) For purposes of this section, "child with a disability" means a child who has a 
628.29 	substantial delay or has an identifiable physical, medical, emotional, or mental condition 
628.30 	that hinders development.
629.1 	(c) For purposes of this section, "inclusive child care setting" means child care provided 
629.2 	in a manner that serves children with disabilities in the same setting as children without 
629.3 	disabilities.
629.4 		Subd. 2.Commissioner's duties. To administer the grant program, the commissioner 
629.5 	shall:
629.6 	(1) consult with relevant stakeholders to develop a request for proposals that at least 
629.7 	requires grant applicants to identify the items or services and estimated accompanying costs, 
629.8 	where possible, needed to expand access to inclusive child care settings for children with 
629.9 	disabilities;
629.10 	(2) develop procedures for data collection, qualitative and quantitative measurement of 
629.11 	grant program outcomes, and reporting requirements for grant recipients;
629.12 	(3) convene a working group of grant recipients, partner child care providers, and 
629.13 	participating families to assess progress on grant activities, share best practices, and collect 
629.14 	and review data on grant activities; and
629.15 	(4) by February 1, 2023, provide a report to the chairs and ranking minority members 
629.16 	of the legislative committees with jurisdiction over early childhood programs on the activities 
629.17 	and outcomes of the grant program with legislative recommendations for implementing 
629.18 	inclusive child care settings statewide. The report shall be made available to the public.
629.19 		Subd. 3.Grant activities. Grant recipients shall use grant funds for the cost of facility 
629.20 	modifications, resources, or services necessary to expand access to inclusive child care 
629.21 	settings for children with disabilities, including:
629.22 	(1) onetime needs to equip a child care setting to serve children with disabilities, including 
629.23 	but not limited to environmental modifications; accessibility modifications; sensory 
629.24 	adaptation; training materials and staff time for training, including for substitutes; or 
629.25 	equipment purchases, including durable medical equipment;
629.26 	(2) ongoing medical- or disability-related services for children with disabilities in 
629.27 	inclusive child care settings, including but not limited to mental health supports; inclusion 
629.28 	specialist services; home care nursing; behavioral supports; coaching or training for staff 
629.29 	and substitutes; substitute teaching time; or additional child care staff, an enhanced rate, or 
629.30 	another mechanism to increase staff-to-child ratio; and
629.31 	(3) other expenses determined by the grant recipient and each partner child care provider 
629.32 	to be necessary to establish an inclusive child care setting and serve children with disabilities 
629.33 	at the provider's location.
630.1 		Subd. 4.Requirements for grant recipients. Upon receipt of grant funds and throughout 
630.2 	the grant period, grant recipients shall:
630.3 	(1) partner with at least two but no more than five child care providers, each of which 
630.4 	must meet one of the following criteria:
630.5 	(i) serve 29 or fewer children, including at least two children with a disability who are 
630.6 	not a family member of the child care provider if the participating child care provider is a 
630.7 	family child care provider; or
630.8 	(ii) serve more than 30 children, including at least three children with a disability;
630.9 	(2) develop and follow a process to ensure that grant funding is used to support children 
630.10 	with disabilities who, without the additional supports made available through the grant, 
630.11 	would have difficulty accessing an inclusive child care setting;
630.12 	(3) pursue funding for ongoing services needed for children with disabilities in inclusive 
630.13 	child care settings, such as Medicaid or private health insurance coverage; additional grant 
630.14 	funding; or other funding sources;
630.15 	(4) explore and seek opportunities to use existing federal funds to provide ongoing 
630.16 	support to family child care providers or child care centers serving children with disabilities. 
630.17 	Grant recipients shall seek to minimize family financial obligations for child care for a child 
630.18 	with disabilities beyond what child care would cost for a child without disabilities; and
630.19 	(5) identify and utilize training resources for child care providers, where available and 
630.20 	applicable, for at least one of the grant recipient's partner child care providers.
630.21 		Subd. 5.Reporting. Grant recipients shall report to the commissioner every six months, 
630.22 	in a manner specified by the commissioner, on the following:
630.23 	(1) the number, type, and cost of additional supports needed to serve children with 
630.24 	disabilities in inclusive child care settings;
630.25 	(2) best practices for billing;
630.26 	(3) availability and use of funding sources other than through the grant program;
630.27 	(4) processes for identifying families of children with disabilities who could benefit 
630.28 	from grant activities and connecting them with a child care provider interested in serving 
630.29 	them;
630.30 	(5) processes and eligibility criteria used to determine whether a child is a child with a 
630.31 	disability and means of prioritizing grant funding to serve children with significant support 
630.32 	needs associated with their disability; and
631.1 	(6) any other information deemed relevant by the commissioner.

631.2 	Sec. 6. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FAMILY 
631.3 	CHILD CARE SHARED SERVICES INNOVATION GRANTS.
 631.4 	The commissioner of human services shall establish a grant program to test strategies 
631.5 	by which family child care providers may share services and thereby achieve economies of 
631.6 	scale. The commissioner shall report the results of the grant program to the legislative 
631.7 	committees with jurisdiction over early care and education programs.

631.8 	Sec. 7. REPORT ON PARTICIPATION IN EARLY CHILDHOOD PROGRAMS 
631.9 	BY CHILDREN IN FOSTER CARE.
 631.10 		Subdivision 1.Reporting requirement. (a) The commissioner of human services shall 
631.11 	report on the participation in early care and education programs by children under age six 
631.12 	who have experienced foster care, as defined in Minnesota Statutes, section 260C.007, 
631.13 	subdivision 18, at any time during the reporting period.
631.14 	(b) For purposes of this section, "early care and education program" means Early Head 
631.15 	Start and Head Start under the federal Improving Head Start for School Readiness Act of 
631.16 	2007; special education programs under Minnesota Statutes, chapter 125A; early learning 
631.17 	scholarships under Minnesota Statutes, section 124D.165; school readiness under Minnesota 
631.18 	Statutes, sections 124D.15 and 124D.16; school readiness plus under Laws 2017, First 
631.19 	Special Session chapter 5, article 8, section 9; voluntary prekindergarten under Minnesota 
631.20 	Statutes, section 124D.151; child care assistance under Minnesota Statutes, chapter 119B; 
631.21 	and other programs as determined by the commissioner.
631.22 		Subd. 2.Report content. (a) The report shall provide counts and rates of participation 
631.23 	in the early care and education program by each child's race, ethnicity, age, and county of 
631.24 	residence. The report shall use the most current administrative data and systems, including 
631.25 	the Early Childhood Longitudinal Data System, and include recommendations for collecting 
631.26 	any other administrative data listed in this paragraph that is not currently available.
631.27 	(b) The report shall include recommendations to:
631.28 	(1) provide the data described in paragraph (a) on an annual basis as part of the report 
631.29 	required under Minnesota Statutes, section 257.0725;
631.30 	(2) facilitate children's continued participation in early care and education programs 
631.31 	after reunification, adoption, or transfer of permanent legal and physical custody; and
632.1 	(3) regularly report measures of early childhood well-being for children who have 
632.2 	experienced foster care. "Measures of early childhood well-being" include administrative 
632.3 	data from developmental screenings, school readiness assessments, well-child medical visits, 
632.4 	and other sources as determined by the commissioner, in consultation with the commissioners 
632.5 	of health, education, and management and budget, county social service and public health 
632.6 	agencies, and school districts.
632.7 	(c) The report shall include an implementation plan to increase the rates of participation 
632.8 	among children and their foster families in early care and education programs, including 
632.9 	processes for referrals and follow-up. The plan shall be developed in collaboration with 
632.10 	affected communities and families, incorporating their experiences and feedback. 
632.11 	Representatives from county public health agencies; county social service agencies, including 
632.12 	child protection services; early childhood care and education providers; the judiciary; and 
632.13 	school districts must collaborate on the plan's development and implementation strategy.
632.14 	(d) The report shall identify barriers to be addressed to ensure that early care and 
632.15 	education programs are responsive to the cultural, logistical, and racial equity concerns and 
632.16 	needs of children's foster families and families of origin and the report shall identify methods 
632.17 	to ensure that the experiences and feedback from children's foster families and families of 
632.18 	origin are included in the ongoing implementation of early care and education programs.
632.19 		Subd. 3.Submission to legislature. By June 30, 2022, the commissioner shall submit 
632.20 	an interim progress report, including identification of potential administrative data sources 
632.21 	and barriers and a listing of plan development participants, and by December 1, 2022, the 
632.22 	commissioner shall submit the final report required under this section to the legislative 
632.23 	committees with jurisdiction over early care and education programs.

632.24 	Sec. 8. REVISOR INSTRUCTION.
 632.25 	The revisor of statutes shall renumber Minnesota Statutes, section 136A.128, in Minnesota 
632.26 	Statutes, chapter 119B. The revisor shall also make necessary cross-reference changes 
632.27 	consistent with the renumbering.

632.28 	ARTICLE 17
632.29 	MENTAL HEALTH UNIFORM SERVICE STANDARDS

632.30 	Section 1. [245I.01] PURPOSE AND CITATION.
632.31 		Subdivision 1.Citation. This chapter may be cited as the "Mental Health Uniform 
632.32 	Service Standards Act."
633.1 		Subd. 2.Purpose. In accordance with sections 245.461 and 245.487, the purpose of this 
633.2 	chapter is to create a system of mental health care that is unified, accountable, and 
633.3 	comprehensive, and to promote the recovery and resiliency of Minnesotans who have mental 
633.4 	illnesses. The state's public policy is to support Minnesotans' access to quality outpatient 
633.5 	and residential mental health services. Further, the state's public policy is to protect the 
633.6 	health and safety, rights, and well-being of Minnesotans receiving mental health services.

633.7 	Sec. 2. [245I.011] APPLICABILITY.
633.8 		Subdivision 1.License requirements. A license holder under this chapter must comply 
633.9 	with the requirements in chapters 245A, 245C, and 260E; section 626.557; and Minnesota 
633.10 	Rules, chapter 9544.
633.11 		Subd. 2.Variances. (a) The commissioner may grant a variance to an applicant, license 
633.12 	holder, or certification holder as long as the variance does not affect the staff qualifications 
633.13 	or the health or safety of any person in a licensed or certified program and the applicant, 
633.14 	license holder, or certification holder meets the following conditions:
633.15 	(1) an applicant, license holder, or certification holder must request the variance on a 
633.16 	form approved by the commissioner and in a manner prescribed by the commissioner;
633.17 	(2) the request for a variance must include the:
633.18 	(i) reasons that the applicant, license holder, or certification holder cannot comply with 
633.19 	a requirement as stated in the law; and
633.20 	(ii) alternative equivalent measures that the applicant, license holder, or certification 
633.21 	holder will follow to comply with the intent of the law; and
633.22 	(3) the request for a variance must state the period of time when the variance is requested.
633.23 	(b) The commissioner may grant a permanent variance when the conditions under which 
633.24 	the applicant, license holder, or certification holder requested the variance do not affect the 
633.25 	health or safety of any person whom the licensed or certified program serves, and when the 
633.26 	conditions of the variance do not compromise the qualifications of staff who provide services 
633.27 	to clients. A permanent variance expires when the conditions that warranted the variance 
633.28 	change in any way. Any applicant, license holder, or certification holder must inform the 
633.29 	commissioner of any changes to the conditions that warranted the permanent variance. If 
633.30 	an applicant, license holder, or certification holder fails to advise the commissioner of 
633.31 	changes to the conditions that warranted the variance, the commissioner must revoke the 
633.32 	permanent variance and may impose other sanctions under sections 245A.06 and 245A.07.
634.1 	(c) The commissioner's decision to grant or deny a variance request is final and not 
634.2 	subject to appeal under the provisions of chapter 14.
634.3 		Subd. 3.Certification required. (a) An individual, organization, or government entity 
634.4 	that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause 
634.5 	(19), and chooses to be identified as a certified mental health clinic must:
634.6 	(1) be a mental health clinic that is certified under section 245I.20;
634.7 	(2) comply with all of the responsibilities assigned to a license holder by this chapter 
634.8 	except subdivision 1; and
634.9 	(3) comply with all of the responsibilities assigned to a certification holder by chapter 
634.10 	245A.
634.11 	(b) An individual, organization, or government entity described by this subdivision must 
634.12 	obtain a criminal background study for each staff person or volunteer who provides direct 
634.13 	contact services to clients.
634.14 		Subd. 4.License required. An individual, organization, or government entity providing 
634.15 	intensive residential treatment services or residential crisis stabilization to adults must be 
634.16 	licensed under section 245I.23. An entity with an adult foster care license providing 
634.17 	residential crisis stabilization is exempt from licensure under section 245I.23.
634.18 		Subd. 5.Programs certified under chapter 256B. (a) An individual, organization, or 
634.19 	government entity certified under the following sections must comply with all of the 
634.20 	responsibilities assigned to a license holder under this chapter except subdivision 1:
634.21 	(1) an assertive community treatment provider under section 256B.0622, subdivision 
634.22 	3a;
634.23 	(2) an adult rehabilitative mental health services provider under section 256B.0623;
634.24 	(3) a mobile crisis team under section 256B.0624;
634.25 	(4) a children's therapeutic services and supports provider under section 256B.0943;
634.26 	(5) an intensive treatment in foster care provider under section 256B.0946; and
634.27 	(6) an intensive nonresidential rehabilitative mental health services provider under section 
634.28 	256B.0947.
634.29 	(b) An individual, organization, or government entity certified under the sections listed 
634.30 	in paragraph (a), clauses (1) to (6), must obtain a criminal background study for each staff 
634.31 	person and volunteer providing direct contact services to a client.

635.1 	Sec. 3. [245I.02] DEFINITIONS.
635.2 		Subdivision 1.Scope. For purposes of this chapter, the terms in this section have the 
635.3 	meanings given.
635.4 		Subd. 2.Approval. "Approval" means the documented review of, opportunity to request 
635.5 	changes to, and agreement with a treatment document. An individual may demonstrate 
635.6 	approval with a written signature, secure electronic signature, or documented oral approval.
635.7 		Subd. 3.Behavioral sciences or related fields. "Behavioral sciences or related fields" 
635.8 	means an education from an accredited college or university in social work, psychology, 
635.9 	sociology, community counseling, family social science, child development, child 
635.10 	psychology, community mental health, addiction counseling, counseling and guidance, 
635.11 	special education, nursing, and other similar fields approved by the commissioner.
635.12 		Subd. 4.Business day. "Business day" means a weekday on which government offices 
635.13 	are open for business. Business day does not include state or federal holidays, Saturdays, 
635.14 	or Sundays.
635.15 		Subd. 5.Case manager. "Case manager" means a client's case manager according to 
635.16 	section 256B.0596; 256B.0621; 256B.0625, subdivision 20; 256B.092, subdivision 1a; 
635.17 	256B.0924; 256B.093, subdivision 3a; 256B.094; or 256B.49.
635.18 		Subd. 6.Certified rehabilitation specialist. "Certified rehabilitation specialist" means 
635.19 	a staff person who meets the qualifications of section 245I.04, subdivision 8.
635.20 		Subd. 7.Child. "Child" means a client under the age of 18.
635.21 		Subd. 8.Client. "Client" means a person who is seeking or receiving services regulated 
635.22 	by this chapter. For the purpose of a client's consent to services, client includes a parent, 
635.23 	guardian, or other individual legally authorized to consent on behalf of a client to services.
635.24 		Subd. 9.Clinical trainee. "Clinical trainee" means a staff person who is qualified 
635.25 	according to section 245I.04, subdivision 6.
635.26 		Subd. 10.Commissioner. "Commissioner" means the commissioner of human services 
635.27 	or the commissioner's designee.
635.28 		Subd. 11.Co-occurring substance use disorder treatment. "Co-occurring substance 
635.29 	use disorder treatment" means the treatment of a person who has a co-occurring mental 
635.30 	illness and substance use disorder. Co-occurring substance use disorder treatment is 
635.31 	characterized by stage-wise comprehensive treatment, treatment goal setting, and flexibility 
635.32 	for clients at each stage of treatment. Co-occurring substance use disorder treatment includes 
636.1 	assessing and tracking each client's stage of change readiness and treatment using a treatment 
636.2 	approach based on a client's stage of change, such as motivational interviewing when working 
636.3 	with a client at an earlier stage of change readiness and a cognitive behavioral approach 
636.4 	and relapse prevention to work with a client at a later stage of change; and facilitating a 
636.5 	client's access to community supports.
636.6 		Subd. 12.Crisis plan. "Crisis plan" means a plan to prevent and de-escalate a client's 
636.7 	future crisis situation, with the goal of preventing future crises for the client and the client's 
636.8 	family and other natural supports. Crisis plan includes a crisis plan developed according to 
636.9 	section 245.4871, subdivision 9a.
636.10 		Subd. 13.Critical incident. "Critical incident" means an occurrence involving a client 
636.11 	that requires a license holder to respond in a manner that is not part of the license holder's 
636.12 	ordinary daily routine. Critical incident includes a client's suicide, attempted suicide, or 
636.13 	homicide; a client's death; an injury to a client or other person that is life-threatening or 
636.14 	requires medical treatment; a fire that requires a fire department's response; alleged 
636.15 	maltreatment of a client; an assault of a client; an assault by a client; or other situation that 
636.16 	requires a response by law enforcement, the fire department, an ambulance, or another 
636.17 	emergency response provider.
636.18 		Subd. 14.Diagnostic assessment. "Diagnostic assessment" means the evaluation and 
636.19 	report of a client's potential diagnoses that a mental health professional or clinical trainee 
636.20 	completes under section 245I.10, subdivisions 4 to 6.
636.21 		Subd. 15.Direct contact. "Direct contact" has the meaning given in section 245C.02, 
636.22 	subdivision 11.
636.23 		Subd. 16.Family and other natural supports. "Family and other natural supports" 
636.24 	means the people whom a client identifies as having a high degree of importance to the 
636.25 	client. Family and other natural supports also means people that the client identifies as being 
636.26 	important to the client's mental health treatment, regardless of whether the person is related 
636.27 	to the client or lives in the same household as the client.
636.28 		Subd. 17.Functional assessment. "Functional assessment" means the assessment of a 
636.29 	client's current level of functioning relative to functioning that is appropriate for someone 
636.30 	the client's age. For a client five years of age or younger, a functional assessment is the 
636.31 	Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age, 
636.32 	a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII). 
636.33 	For a client 18 years of age or older, a functional assessment is the functional assessment 
636.34 	described in section 245I.10, subdivision 9.
637.1 		Subd. 18.Individual abuse prevention plan. "Individual abuse prevention plan" means 
637.2 	a plan according to section 245A.65, subdivision 2, paragraph (b), and section 626.557, 
637.3 	subdivision 14.
637.4 		Subd. 19.Level of care assessment. "Level of care assessment" means the level of care 
637.5 	decision support tool appropriate to the client's age. For a client five years of age or younger, 
637.6 	a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For 
637.7 	a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service 
637.8 	Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment 
637.9 	is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS).
637.10 		Subd. 20.License. "License" has the meaning given in section 245A.02, subdivision 8.
637.11 		Subd. 21.License holder. "License holder" has the meaning given in section 245A.02, 
637.12 	subdivision 9.
637.13 		Subd. 22.Licensed prescriber. "Licensed prescriber" means an individual who is 
637.14 	authorized to prescribe legend drugs under section 151.37.
637.15 		Subd. 23.Mental health behavioral aide. "Mental health behavioral aide" means a 
637.16 	staff person who is qualified under section 245I.04, subdivision 16.
637.17 		Subd. 24.Mental health certified family peer specialist. "Mental health certified 
637.18 	family peer specialist" means a staff person who is qualified under section 245I.04, 
637.19 	subdivision 12.
637.20 		Subd. 25.Mental health certified peer specialist. "Mental health certified peer 
637.21 	specialist" means a staff person who is qualified under section 245I.04, subdivision 10.
637.22 		Subd. 26.Mental health practitioner. "Mental health practitioner" means a staff person 
637.23 	who is qualified under section 245I.04, subdivision 4.
637.24 		Subd. 27.Mental health professional. "Mental health professional" means a staff person 
637.25 	who is qualified under section 245I.04, subdivision 2.
637.26 		Subd. 28.Mental health rehabilitation worker. "Mental health rehabilitation worker" 
637.27 	means a staff person who is qualified under section 245I.04, subdivision 14.
637.28 		Subd. 29.Mental illness. "Mental illness" means any of the conditions included in the 
637.29 	most recent editions of the DC: 0-5 Diagnostic Classification of Mental Health and 
637.30 	Development Disorders of Infancy and Early Childhood published by Zero to Three or the 
637.31 	Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric 
637.32 	Association.
638.1 		Subd. 30.Organization. "Organization" has the meaning given in section 245A.02, 
638.2 	subdivision 10c.
638.3 		Subd. 31.Personnel file. "Personnel file" means a set of records under section 245I.07, 
638.4 	paragraph (a). Personnel files excludes information related to a person's employment that 
638.5 	is not included in section 245I.07.
638.6 		Subd. 32.Registered nurse. "Registered nurse" means a staff person who is qualified 
638.7 	under section 148.171, subdivision 20.
638.8 		Subd. 33.Rehabilitative mental health services. "Rehabilitative mental health services" 
638.9 	means mental health services provided to an adult client that enable the client to develop 
638.10 	and achieve psychiatric stability, social competencies, personal and emotional adjustment, 
638.11 	independent living skills, family roles, and community skills when symptoms of mental 
638.12 	illness has impaired any of the client's abilities in these areas.
638.13 		Subd. 34.Residential program. "Residential program" has the meaning given in section 
638.14 	245A.02, subdivision 14.
638.15 		Subd. 35.Signature. "Signature" means a written signature or an electronic signature 
638.16 	defined in section 325L.02, paragraph (h).
638.17 		Subd. 36.Staff person. "Staff person" means an individual who works under a license 
638.18 	holder's direction or under a contract with a license holder. Staff person includes an intern, 
638.19 	consultant, contractor, individual who works part-time, and an individual who does not 
638.20 	provide direct contact services to clients. Staff person includes a volunteer who provides 
638.21 	treatment services to a client or a volunteer whom the license holder regards as a staff person 
638.22 	for the purpose of meeting staffing or service delivery requirements. A staff person must 
638.23 	be 18 years of age or older.
638.24 		Subd. 37.Strengths. "Strengths" means a person's inner characteristics, virtues, external 
638.25 	relationships, activities, and connections to resources that contribute to a client's resilience 
638.26 	and core competencies. A person can build on strengths to support recovery.
638.27 		Subd. 38.Trauma. "Trauma" means an event, series of events, or set of circumstances 
638.28 	that is experienced by an individual as physically or emotionally harmful or life-threatening 
638.29 	that has lasting adverse effects on the individual's functioning and mental, physical, social, 
638.30 	emotional, or spiritual well-being. Trauma includes group traumatic experiences. Group 
638.31 	traumatic experiences are emotional or psychological harm that a group experiences. Group 
638.32 	traumatic experiences can be transmitted across generations within a community and are 
639.1 	often associated with racial and ethnic population groups who suffer major intergenerational 
639.2 	losses.
639.3 		Subd. 39.Treatment plan. "Treatment plan" means services that a license holder 
639.4 	formulates to respond to a client's needs and goals. A treatment plan includes individual 
639.5 	treatment plans under section 245I.10, subdivisions 7 and 8; initial treatment plans under 
639.6 	section 245I.23, subdivision 7; and crisis treatment plans under sections 245I.23, subdivision 
639.7 	8, and 256B.0624, subdivision 11.
639.8 		Subd. 40.Treatment supervision. "Treatment supervision" means a mental health 
639.9 	professional's or certified rehabilitation specialist's oversight, direction, and evaluation of 
639.10 	a staff person providing services to a client according to section 245I.06.
639.11 		Subd. 41.Volunteer. "Volunteer" means an individual who, under the direction of the 
639.12 	license holder, provides services to or facilitates an activity for a client without compensation.

639.13 	Sec. 4. [245I.03] REQUIRED POLICIES AND PROCEDURES.
639.14 		Subdivision 1.Generally. A license holder must establish, enforce, and maintain policies 
639.15 	and procedures to comply with the requirements of this chapter and chapters 245A, 245C, 
639.16 	and 260E; sections 626.557 and 626.5572; and Minnesota Rules, chapter 9544. The license 
639.17 	holder must make all policies and procedures available in writing to each staff person. The 
639.18 	license holder must complete and document a review of policies and procedures every two 
639.19 	years and update policies and procedures as necessary. Each policy and procedure must 
639.20 	identify the date that it was initiated and the dates of all revisions. The license holder must 
639.21 	clearly communicate any policy and procedural change to each staff person and provide 
639.22 	necessary training to each staff person to implement any policy and procedural change.
639.23 		Subd. 2.Health and safety. A license holder must have policies and procedures to 
639.24 	ensure the health and safety of each staff person and client during the provision of services, 
639.25 	including policies and procedures for services based in community settings.
639.26 		Subd. 3.Client rights. A license holder must have policies and procedures to ensure 
639.27 	that each staff person complies with the client rights and protections requirements in section 
639.28 	245I.12.
639.29 		Subd. 4.Behavioral emergencies. (a) A license holder must have procedures that each 
639.30 	staff person follows when responding to a client who exhibits behavior that threatens the 
639.31 	immediate safety of the client or others. A license holder's behavioral emergency procedures 
639.32 	must incorporate person-centered planning and trauma-informed care.
639.33 	(b) A license holder's behavioral emergency procedures must include:
640.1 	(1) a plan designed to prevent the client from inflicting self-harm and harming others;
640.2 	(2) contact information for emergency resources that a staff person must use when the 
640.3 	license holder's behavioral emergency procedures are unsuccessful in controlling a client's 
640.4 	behavior;
640.5 	(3) the types of behavioral emergency procedures that a staff person may use;
640.6 	(4) the specific circumstances under which the program may use behavioral emergency 
640.7 	procedures; and
640.8 	(5) the staff persons whom the license holder authorizes to implement behavioral 
640.9 	emergency procedures.
640.10 	(c) The license holder's behavioral emergency procedures must not include secluding 
640.11 	or restraining a client except as allowed under section 245.8261.
640.12 	(d) Staff persons must not use behavioral emergency procedures to enforce program 
640.13 	rules or for the convenience of staff persons. Behavioral emergency procedures must not 
640.14 	be part of any client's treatment plan. A staff person may not use behavioral emergency 
640.15 	procedures except in response to a client's current behavior that threatens the immediate 
640.16 	safety of the client or others.
640.17 		Subd. 5.Health services and medications. If a license holder is licensed as a residential 
640.18 	program, stores or administers client medications, or observes clients self-administer 
640.19 	medications, the license holder must ensure that a staff person who is a registered nurse or 
640.20 	licensed prescriber reviews and approves of the license holder's policies and procedures to 
640.21 	comply with the health services and medications requirements in section 245I.11, the training 
640.22 	requirements in section 245I.05, subdivision 6, and the documentation requirements in 
640.23 	section 245I.08, subdivision 5.
640.24 		Subd. 6.Reporting maltreatment. A license holder must have policies and procedures 
640.25 	for reporting a staff person's suspected maltreatment, abuse, or neglect of a client according 
640.26 	to chapter 260E and section 626.557.
640.27 		Subd. 7.Critical incidents. If a license holder is licensed as a residential program, the 
640.28 	license holder must have policies and procedures for reporting and maintaining records of 
640.29 	critical incidents according to section 245I.13.
640.30 		Subd. 8.Personnel. A license holder must have personnel policies and procedures that:
640.31 	(1) include a chart or description of the organizational structure of the program that 
640.32 	indicates positions and lines of authority;
641.1 	(2) ensure that it will not adversely affect a staff person's retention, promotion, job 
641.2 	assignment, or pay when a staff person communicates in good faith with the Department 
641.3 	of Human Services, the Office of Ombudsman for Mental Health and Developmental 
641.4 	Disabilities, the Department of Health, a health-related licensing board, a law enforcement 
641.5 	agency, or a local agency investigating a complaint regarding a client's rights, health, or 
641.6 	safety;
641.7 	(3) prohibit a staff person from having sexual contact with a client in violation of chapter 
641.8 	604, sections 609.344 or 609.345;
641.9 	(4) prohibit a staff person from neglecting, abusing, or maltreating a client as described 
641.10 	in chapter 260E and sections 626.557 and 626.5572;
641.11 	(5) include the drug and alcohol policy described in section 245A.04, subdivision 1, 
641.12 	paragraph (c);
641.13 	(6) describe the process for disciplinary action, suspension, or dismissal of a staff person 
641.14 	for violating a policy provision described in clauses (3) to (5);
641.15 	(7) describe the license holder's response to a staff person who violates other program 
641.16 	policies or who has a behavioral problem that interferes with providing treatment services 
641.17 	to clients; and
641.18 	(8) describe each staff person's position that includes the staff person's responsibilities, 
641.19 	authority to execute the responsibilities, and qualifications for the position.
641.20 		Subd. 9.Volunteers. A license holder must have policies and procedures for using 
641.21 	volunteers, including when a license holder must submit a background study for a volunteer, 
641.22 	and the specific tasks that a volunteer may perform.
641.23 		Subd. 10.Data privacy. (a) A license holder must have policies and procedures that 
641.24 	comply with all applicable state and federal law. A license holder's use of electronic record 
641.25 	keeping or electronic signatures does not alter a license holder's obligations to comply with 
641.26 	applicable state and federal law.
641.27 	(b) A license holder must have policies and procedures for a staff person to promptly 
641.28 	document a client's revocation of consent to disclose the client's health record. The license 
641.29 	holder must verify that the license holder has permission to disclose a client's health record 
641.30 	before releasing any client data.

642.1 	Sec. 5. [245I.04] PROVIDER QUALIFICATIONS AND SCOPE OF PRACTICE.
642.2 		Subdivision 1.Tribal providers. For purposes of this section, a tribal entity may 
642.3 	credential an individual according to section 256B.02, subdivision 7, paragraphs (b) and 
642.4 	(c).
642.5 		Subd. 2.Mental health professional qualifications. The following individuals may 
642.6 	provide services to a client as a mental health professional:
642.7 	(1) a registered nurse who is licensed under sections 148.171 to 148.285 and is certified 
642.8 	as a: (i) clinical nurse specialist in child or adolescent, family, or adult psychiatric and 
642.9 	mental health nursing by a national certification organization; or (ii) nurse practitioner in 
642.10 	adult or family psychiatric and mental health nursing by a national nurse certification 
642.11 	organization;
642.12 	(2) a licensed independent clinical social worker as defined in section 148E.050, 
642.13 	subdivision 5;
642.14 	(3) a psychologist licensed by the Board of Psychology under sections 148.88 to 148.98;
642.15 	(4) a physician licensed under chapter 147 if the physician is: (i) certified by the American 
642.16 	Board of Psychiatry and Neurology; (ii) certified by the American Osteopathic Board of 
642.17 	Neurology and Psychiatry; or (iii) eligible for board certification in psychiatry;
642.18 	(5) a marriage and family therapist licensed under sections 148B.29 to 148B.392; or
642.19 	(6) a licensed professional clinical counselor licensed under section 148B.5301.
642.20 		Subd. 3.Mental health professional scope of practice. A mental health professional 
642.21 	must maintain a valid license with the mental health professional's governing health-related 
642.22 	licensing board and must only provide services to a client within the scope of practice 
642.23 	determined by the applicable health-related licensing board.
642.24 		Subd. 4.Mental health practitioner qualifications. (a) An individual who is qualified 
642.25 	in at least one of the ways described in paragraph (b) to (d) may serve as a mental health 
642.26 	practitioner.
642.27 	(b) An individual is qualified as a mental health practitioner through relevant coursework 
642.28 	if the individual completes at least 30 semester hours or 45 quarter hours in behavioral 
642.29 	sciences or related fields and:
642.30 	(1) has at least 2,000 hours of experience providing services to individuals with:
642.31 	(i) a mental illness or a substance use disorder; or
643.1 	(ii) a traumatic brain injury or a developmental disability, and completes the additional 
643.2 	training described in section 245I.05, subdivision 3, paragraph (c), before providing direct 
643.3 	contact services to a client;
643.4 	(2) is fluent in the non-English language of the ethnic group to which at least 50 percent 
643.5 	of the individual's clients belong, and completes the additional training described in section 
643.6 	245I.05, subdivision 3, paragraph (c), before providing direct contact services to a client;
643.7 	(3) is working in a day treatment program under section 256B.0671, subdivision 3, or 
643.8 	256B.0943; or
643.9 	(4) has completed a practicum or internship that (i) required direct interaction with adult 
643.10 	clients or child clients, and (ii) was focused on behavioral sciences or related fields.
643.11 	(c) An individual is qualified as a mental health practitioner through work experience 
643.12 	if the individual:
643.13 	(1) has at least 4,000 hours of experience in the delivery of services to individuals with:
643.14 	(i) a mental illness or a substance use disorder; or
643.15 	(ii) a traumatic brain injury or a developmental disability, and completes the additional 
643.16 	training described in section 245I.05, subdivision 3, paragraph (c), before providing direct 
643.17 	contact services to clients; or
643.18 	(2) receives treatment supervision at least once per week until meeting the requirement 
643.19 	in clause (1) of 4,000 hours of experience and has at least 2,000 hours of experience providing 
643.20 	services to individuals with:
643.21 	(i) a mental illness or a substance use disorder; or
643.22 	(ii) a traumatic brain injury or a developmental disability, and completes the additional 
643.23 	training described in section 245I.05, subdivision 3, paragraph (c), before providing direct 
643.24 	contact services to clients.
643.25 	(d) An individual is qualified as a mental health practitioner if the individual has a 
643.26 	master's or other graduate degree in behavioral sciences or related fields.
643.27 		Subd. 5.Mental health practitioner scope of practice. (a) A mental health practitioner 
643.28 	under the treatment supervision of a mental health professional or certified rehabilitation 
643.29 	specialist may provide an adult client with client education, rehabilitative mental health 
643.30 	services, functional assessments, level of care assessments, and treatment plans. A mental 
643.31 	health practitioner under the treatment supervision of a mental health professional may 
644.1 	provide skill-building services to a child client and complete treatment plans for a child 
644.2 	client.
644.3 	(b) A mental health practitioner must not provide treatment supervision to other staff 
644.4 	persons. A mental health practitioner may provide direction to mental health rehabilitation 
644.5 	workers and mental health behavioral aides.
644.6 	(c) A mental health practitioner who provides services to clients according to section 
644.7 	256B.0624 or 256B.0944 may perform crisis assessments and interventions for a client.
644.8 		Subd. 6.Clinical trainee qualifications. (a) A clinical trainee is a staff person who: (1) 
644.9 	is enrolled in an accredited graduate program of study to prepare the staff person for 
644.10 	independent licensure as a mental health professional and who is participating in a practicum 
644.11 	or internship with the license holder through the individual's graduate program; or (2) has 
644.12 	completed an accredited graduate program of study to prepare the staff person for independent 
644.13 	licensure as a mental health professional and who is in compliance with the requirements 
644.14 	of the applicable health-related licensing board, including requirements for supervised 
644.15 	practice.
644.16 	(b) A clinical trainee is responsible for notifying and applying to a health-related licensing 
644.17 	board to ensure that the trainee meets the requirements of the health-related licensing board. 
644.18 	As permitted by a health-related licensing board, treatment supervision under this chapter 
644.19 	may be integrated into a plan to meet the supervisory requirements of the health-related 
644.20 	licensing board but does not supersede those requirements.
644.21 		Subd. 7.Clinical trainee scope of practice. (a) A clinical trainee under the treatment 
644.22 	supervision of a mental health professional may provide a client with psychotherapy, client 
644.23 	education, rehabilitative mental health services, diagnostic assessments, functional 
644.24 	assessments, level of care assessments, and treatment plans.
644.25 	(b) A clinical trainee must not provide treatment supervision to other staff persons. A 
644.26 	clinical trainee may provide direction to mental health behavioral aides and mental health 
644.27 	rehabilitation workers.
644.28 	(c) A psychological clinical trainee under the treatment supervision of a psychologist 
644.29 	may perform psychological testing of clients.
644.30 	(d) A clinical trainee must not provide services to clients that violate any practice act of 
644.31 	a health-related licensing board, including failure to obtain licensure if licensure is required.
644.32 		Subd. 8.Certified rehabilitation specialist qualifications. A certified rehabilitation 
644.33 	specialist must have:
645.1 	(1) a master's degree from an accredited college or university in behavioral sciences or 
645.2 	related fields;
645.3 	(2) at least 4,000 hours of post-master's supervised experience providing mental health 
645.4 	services to clients; and
645.5 	(3) a valid national certification as a certified rehabilitation counselor or certified 
645.6 	psychosocial rehabilitation practitioner.
645.7 		Subd. 9.Certified rehabilitation specialist scope of practice. (a) A certified 
645.8 	rehabilitation specialist may provide an adult client with client education, rehabilitative 
645.9 	mental health services, functional assessments, level of care assessments, and treatment 
645.10 	plans.
645.11 	(b) A certified rehabilitation specialist may provide treatment supervision to a mental 
645.12 	health certified peer specialist, mental health practitioner, and mental health rehabilitation 
645.13 	worker.
645.14 		Subd. 10.Mental health certified peer specialist qualifications. A mental health 
645.15 	certified peer specialist must:
645.16 	(1) have been diagnosed with a mental illness;
645.17 	(2) be a current or former mental health services client; and
645.18 	(3) have a valid certification as a mental health certified peer specialist under section 
645.19 	256B.0615.
645.20 		Subd. 11.Mental health certified peer specialist scope of practice. A mental health 
645.21 	certified peer specialist under the treatment supervision of a mental health professional or 
645.22 	certified rehabilitation specialist must:
645.23 	(1) provide individualized peer support to each client;
645.24 	(2) promote a client's recovery goals, self-sufficiency, self-advocacy, and development 
645.25 	of natural supports; and
645.26 	(3) support a client's maintenance of skills that the client has learned from other services.
645.27 		Subd. 12.Mental health certified family peer specialist qualifications. A mental 
645.28 	health certified family peer specialist must:
645.29 	(1) have raised or be currently raising a child with a mental illness;
645.30 	(2) have experience navigating the children's mental health system; and
646.1 	(3) have a valid certification as a mental health certified family peer specialist under 
646.2 	section 256B.0616.
646.3 		Subd. 13.Mental health certified family peer specialist scope of practice. A mental 
646.4 	health certified family peer specialist under the treatment supervision of a mental health 
646.5 	professional must provide services to increase the child's ability to function in the child's 
646.6 	home, school, and community. The mental health certified family peer specialist must:
646.7 	(1) provide family peer support to build on a client's family's strengths and help the 
646.8 	family achieve desired outcomes;
646.9 	(2) provide nonadversarial advocacy to a child client and the child's family that 
646.10 	encourages partnership and promotes the child's positive change and growth;
646.11 	(3) support families in advocating for culturally appropriate services for a child in each 
646.12 	treatment setting;
646.13 	(4) promote resiliency, self-advocacy, and development of natural supports;
646.14 	(5) support maintenance of skills learned from other services;
646.15 	(6) establish and lead parent support groups;
646.16 	(7) assist parents in developing coping and problem-solving skills; and
646.17 	(8) educate parents about mental illnesses and community resources, including resources 
646.18 	that connect parents with similar experiences to one another.
646.19 		Subd. 14.Mental health rehabilitation worker qualifications. (a) A mental health 
646.20 	rehabilitation worker must:
646.21 	(1) have a high school diploma or equivalent; and
646.22 	(2) meet one of the following qualification requirements:
646.23 	(i) be fluent in the non-English language or competent in the culture of the ethnic group 
646.24 	to which at least 20 percent of the mental health rehabilitation worker's clients belong;
646.25 	(ii) have an associate of arts degree;
646.26 	(iii) have two years of full-time postsecondary education or a total of 15 semester hours 
646.27 	or 23 quarter hours in behavioral sciences or related fields;
646.28 	(iv) be a registered nurse;
646.29 	(v) have, within the previous ten years, three years of personal life experience with 
646.30 	mental illness;
647.1 	(vi) have, within the previous ten years, three years of life experience as a primary 
647.2 	caregiver to an adult with a mental illness, traumatic brain injury, substance use disorder, 
647.3 	or developmental disability; or
647.4 	(vii) have, within the previous ten years, 2,000 hours of work experience providing 
647.5 	health and human services to individuals.
647.6 	(b) A mental health rehabilitation worker who is scheduled as an overnight staff person 
647.7 	and works alone is exempt from the additional qualification requirements in paragraph (a), 
647.8 	clause (2).
647.9 		Subd. 15.Mental health rehabilitation worker scope of practice. A mental health 
647.10 	rehabilitation worker under the treatment supervision of a mental health professional or 
647.11 	certified rehabilitation specialist may provide rehabilitative mental health services to an 
647.12 	adult client according to the client's treatment plan.
647.13 		Subd. 16.Mental health behavioral aide qualifications. (a) A level 1 mental health 
647.14 	behavioral aide must have: (1) a high school diploma or equivalent; or (2) two years of 
647.15 	experience as a primary caregiver to a child with mental illness within the previous ten 
647.16 	years.
647.17 	(b) A level 2 mental health behavioral aide must: (1) have an associate or bachelor's 
647.18 	degree; or (2) be certified by a program under section 256B.0943, subdivision 8a.
647.19 		Subd. 17.Mental health behavioral aide scope of practice. While under the treatment 
647.20 	supervision of a mental health professional, a mental health behavioral aide may practice 
647.21 	psychosocial skills with a child client according to the child's treatment plan and individual 
647.22 	behavior plan that a mental health professional, clinical trainee, or mental health practitioner 
647.23 	has previously taught to the child.

647.24 	Sec. 6. [245I.05] TRAINING REQUIRED.
647.25 		Subdivision 1.Training plan. A license holder must develop a training plan to ensure 
647.26 	that staff persons receive ongoing training according to this section. The training plan must 
647.27 	include:
647.28 	(1) a formal process to evaluate the training needs of each staff person. An annual 
647.29 	performance evaluation of a staff person satisfies this requirement;
647.30 	(2) a description of how the license holder conducts ongoing training of each staff person, 
647.31 	including whether ongoing training is based on a staff person's hire date or a specified annual 
647.32 	cycle determined by the program;
648.1 	(3) a description of how the license holder verifies and documents each staff person's 
648.2 	previous training experience. A license holder may consider a staff person to have met a 
648.3 	training requirement in subdivision 3, paragraph (d) or (e), if the staff person has received 
648.4 	equivalent postsecondary education in the previous four years or training experience in the 
648.5 	previous two years; and
648.6 	(4) a description of how the license holder determines when a staff person needs 
648.7 	additional training, including when the license holder will provide additional training.
648.8 		Subd. 2.Documentation of training. (a) The license holder must provide training to 
648.9 	each staff person according to the training plan and must document that the license holder 
648.10 	provided the training to each staff person. The license holder must document the following 
648.11 	information for each staff person's training:
648.12 	(1) the topics of the training;
648.13 	(2) the name of the trainee;
648.14 	(3) the name and credentials of the trainer;
648.15 	(4) the license holder's method of evaluating the trainee's competency upon completion 
648.16 	of training;
648.17 	(5) the date of the training; and
648.18 	(6) the length of training in hours and minutes.
648.19 	(b) Documentation of a staff person's continuing education credit accepted by the 
648.20 	governing health-related licensing board is sufficient to document training for purposes of 
648.21 	this subdivision.
648.22 		Subd. 3.Initial training. (a) A staff person must receive training about:
648.23 	(1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and
648.24 	(2) the maltreatment of minor reporting requirements and definitions in chapter 260E 
648.25 	within 72 hours of first providing direct contact services to a client.
648.26 	(b) Before providing direct contact services to a client, a staff person must receive training 
648.27 	about:
648.28 	(1) client rights and protections under section 245I.12;
648.29 	(2) the Minnesota Health Records Act, including client confidentiality, family engagement 
648.30 	under section 144.294, and client privacy;
649.1 	(3) emergency procedures that the staff person must follow when responding to a fire, 
649.2 	inclement weather, a report of a missing person, and a behavioral or medical emergency;
649.3 	(4) specific activities and job functions for which the staff person is responsible, including 
649.4 	the license holder's program policies and procedures applicable to the staff person's position;
649.5 	(5) professional boundaries that the staff person must maintain; and
649.6 	(6) specific needs of each client to whom the staff person will be providing direct contact 
649.7 	services, including each client's developmental status, cognitive functioning, physical and 
649.8 	mental abilities.
649.9 	(c) Before providing direct contact services to a client, a mental health rehabilitation 
649.10 	worker, mental health behavioral aide, or mental health practitioner qualified under section 
649.11 	245I.04, subdivision 4, must receive 30 hours of training about:
649.12 	(1) mental illnesses;
649.13 	(2) client recovery and resiliency;
649.14 	(3) mental health de-escalation techniques;
649.15 	(4) co-occurring mental illness and substance use disorders; and
649.16 	(5) psychotropic medications and medication side effects.
649.17 	(d) Within 90 days of first providing direct contact services to an adult client, a clinical 
649.18 	trainee, mental health practitioner, mental health certified peer specialist, or mental health 
649.19 	rehabilitation worker must receive training about:
649.20 	(1) trauma-informed care and secondary trauma;
649.21 	(2) person-centered individual treatment plans, including seeking partnerships with 
649.22 	family and other natural supports;
649.23 	(3) co-occurring substance use disorders; and
649.24 	(4) culturally responsive treatment practices.
649.25 	(e) Within 90 days of first providing direct contact services to a child client, a clinical 
649.26 	trainee, mental health practitioner, mental health certified family peer specialist, mental 
649.27 	health certified peer specialist, or mental health behavioral aide must receive training about 
649.28 	the topics in clauses (1) to (5). This training must address the developmental characteristics 
649.29 	of each child served by the license holder and address the needs of each child in the context 
649.30 	of the child's family, support system, and culture. Training topics must include:
650.1 	(1) trauma-informed care and secondary trauma, including adverse childhood experiences 
650.2 	(ACEs);
650.3 	(2) family-centered treatment plan development, including seeking partnership with a 
650.4 	child client's family and other natural supports;
650.5 	(3) mental illness and co-occurring substance use disorders in family systems;
650.6 	(4) culturally responsive treatment practices; and
650.7 	(5) child development, including cognitive functioning, and physical and mental abilities.
650.8 	(f) For a mental health behavioral aide, the training under paragraph (e) must include 
650.9 	parent team training using a curriculum approved by the commissioner.
650.10 		Subd. 4.Ongoing training. (a) A license holder must ensure that staff persons who 
650.11 	provide direct contact services to clients receive annual training about the topics in 
650.12 	subdivision 3, paragraphs (a) and (b), clauses (1) to (3).
650.13 	(b) A license holder must ensure that each staff person who is qualified under section 
650.14 	245I.04 who is not a mental health professional receives 30 hours of training every two 
650.15 	years. The training topics must be based on the program's needs and the staff person's areas 
650.16 	of competency.
650.17 		Subd. 5.Additional training for medication administration. (a) Prior to administering 
650.18 	medications to a client under delegated authority or observing a client self-administer 
650.19 	medications, a staff person who is not a licensed prescriber, registered nurse, or licensed 
650.20 	practical nurse qualified under section 148.171, subdivision 8, must receive training about 
650.21 	psychotropic medications, side effects, and medication management.
650.22 	(b) Prior to administering medications to a client under delegated authority, a staff person 
650.23 	must successfully complete a:
650.24 	(1) medication administration training program for unlicensed personnel through an 
650.25 	accredited Minnesota postsecondary educational institution with completion of the course 
650.26 	documented in writing and placed in the staff person's personnel file; or
650.27 	(2) formalized training program taught by a registered nurse or licensed prescriber that 
650.28 	is offered by the license holder. A staff person's successful completion of the formalized 
650.29 	training program must include direct observation of the staff person to determine the staff 
650.30 	person's areas of competency.

651.1 	Sec. 7. [245I.06] TREATMENT SUPERVISION.
651.2 		Subdivision 1.Generally. (a) A license holder must ensure that a mental health 
651.3 	professional or certified rehabilitation specialist provides treatment supervision to each staff 
651.4 	person who provides services to a client and who is not a mental health professional or 
651.5 	certified rehabilitation specialist. When providing treatment supervision, a treatment 
651.6 	supervisor must follow a staff person's written treatment supervision plan.
651.7 	(b) Treatment supervision must focus on each client's treatment needs and the ability of 
651.8 	the staff person under treatment supervision to provide services to each client, including 
651.9 	the following topics related to the staff person's current caseload:
651.10 	(1) a review and evaluation of the interventions that the staff person delivers to each 
651.11 	client;
651.12 	(2) instruction on alternative strategies if a client is not achieving treatment goals;
651.13 	(3) a review and evaluation of each client's assessments, treatment plans, and progress 
651.14 	notes for accuracy and appropriateness;
651.15 	(4) instruction on the cultural norms or values of the clients and communities that the 
651.16 	license holder serves and the impact that a client's culture has on providing treatment;
651.17 	(5) evaluation of and feedback regarding a direct service staff person's areas of 
651.18 	competency; and
651.19 	(6) coaching, teaching, and practicing skills with a staff person.
651.20 	(c) A treatment supervisor must provide treatment supervision to a staff person using 
651.21 	methods that allow for immediate feedback, including in-person, telephone, and interactive 
651.22 	video supervision.
651.23 	(d) A treatment supervisor's responsibility for a staff person receiving treatment 
651.24 	supervision is limited to the services provided by the associated license holder. If a staff 
651.25 	person receiving treatment supervision is employed by multiple license holders, each license 
651.26 	holder is responsible for providing treatment supervision related to the treatment of the 
651.27 	license holder's clients.
651.28 		Subd. 2.Treatment supervision planning. (a) A treatment supervisor and the staff 
651.29 	person supervised by the treatment supervisor must develop a written treatment supervision 
651.30 	plan. The license holder must ensure that a new staff person's treatment supervision plan is 
651.31 	completed and implemented by a treatment supervisor and the new staff person within 30 
652.1 	days of the new staff person's first day of employment. The license holder must review and 
652.2 	update each staff person's treatment supervision plan annually.
652.3 	(b) Each staff person's treatment supervision plan must include:
652.4 	(1) the name and qualifications of the staff person receiving treatment supervision;
652.5 	(2) the names and licensures of the treatment supervisors who are supervising the staff 
652.6 	person;
652.7 	(3) how frequently the treatment supervisors must provide treatment supervision to the 
652.8 	staff person; and
652.9 	(4) the staff person's authorized scope of practice, including a description of the client 
652.10 	population that the staff person serves, and a description of the treatment methods and 
652.11 	modalities that the staff person may use to provide services to clients.
652.12 		Subd. 3.Treatment supervision and direct observation of mental health 
652.13 	rehabilitation workers and mental health behavioral aides. (a) A mental health behavioral 
652.14 	aide or a mental health rehabilitation worker must receive direct observation from a mental 
652.15 	health professional, clinical trainee, certified rehabilitation specialist, or mental health 
652.16 	practitioner while the mental health behavioral aide or mental health rehabilitation worker 
652.17 	provides treatment services to clients, no less than twice per month for the first six months 
652.18 	of employment and once per month thereafter. The staff person performing the direct 
652.19 	observation must approve of the progress note for the observed treatment service.
652.20 	(b) For a mental health rehabilitation worker qualified under section 245I.04, subdivision 
652.21 	14, paragraph (a), clause (2), item (i), treatment supervision in the first 2,000 hours of work 
652.22 	must at a minimum consist of:
652.23 	(1) monthly individual supervision; and
652.24 	(2) direct observation twice per month.

652.25 	Sec. 8. [245I.07] PERSONNEL FILES.
652.26 	(a) For each staff person, a license holder must maintain a personnel file that includes:
652.27 	(1) verification of the staff person's qualifications required for the position including 
652.28 	training, education, practicum or internship agreement, licensure, and any other required 
652.29 	qualifications;
652.30 	(2) documentation related to the staff person's background study;
652.31 	(3) the hiring date of the staff person;
653.1 	(4) a description of the staff person's job responsibilities with the license holder;
653.2 	(5) the date that the staff person's specific duties and responsibilities became effective, 
653.3 	including the date that the staff person began having direct contact with clients;
653.4 	(6) documentation of the staff person's training as required by section 245I.05, subdivision 
653.5 	2;
653.6 	(7) a verification copy of license renewals that the staff person completed during the 
653.7 	staff person's employment;
653.8 	(8) annual job performance evaluations; and
653.9 	(9) if applicable, the staff person's alleged and substantiated violations of the license 
653.10 	holder's policies under section 245I.03, subdivision 8, clauses (3) to (7), and the license 
653.11 	holder's response.
653.12 	(b) The license holder must ensure that all personnel files are readily accessible for the 
653.13 	commissioner's review. The license holder is not required to keep personnel files in a single 
653.14 	location.

653.15 	Sec. 9. [245I.08] DOCUMENTATION STANDARDS.
653.16 		Subdivision 1.Generally. A license holder must ensure that all documentation required 
653.17 	by this chapter complies with this section.
653.18 		Subd. 2.Documentation standards. A license holder must ensure that all documentation 
653.19 	required by this chapter:
653.20 	(1) is legible;
653.21 	(2) identifies the applicable client and staff person on each page; and
653.22 	(3) is signed and dated by the staff persons who provided services to the client or 
653.23 	completed the documentation, including the staff persons' credentials.
653.24 		Subd. 3.Documenting approval. A license holder must ensure that all diagnostic 
653.25 	assessments, functional assessments, level of care assessments, and treatment plans completed 
653.26 	by a clinical trainee or mental health practitioner contain documentation of approval by a 
653.27 	treatment supervisor within five business days of initial completion by the staff person under 
653.28 	treatment supervision.
653.29 		Subd. 4.Progress notes. A license holder must use a progress note to document each 
653.30 	occurrence of a mental health service that a staff person provides to a client. A progress 
653.31 	note must include the following:
654.1 	(1) the type of service;
654.2 	(2) the date of service;
654.3 	(3) the start and stop time of the service unless the license holder is licensed as a 
654.4 	residential program;
654.5 	(4) the location of the service;
654.6 	(5) the scope of the service, including: (i) the targeted goal and objective; (ii) the 
654.7 	intervention that the staff person provided to the client and the methods that the staff person 
654.8 	used; (iii) the client's response to the intervention; (iv) the staff person's plan to take future 
654.9 	actions, including changes in treatment that the staff person will implement if the intervention 
654.10 	was ineffective; and (v) the service modality;
654.11 	(6) the signature, printed name, and credentials of the staff person who provided the 
654.12 	service to the client;
654.13 	(7) the mental health provider travel documentation required by section 256B.0625, if 
654.14 	applicable; and
654.15 	(8) significant observations by the staff person, if applicable, including: (i) the client's 
654.16 	current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with 
654.17 	or referrals to other professionals, family, or significant others; and (iv) changes in the 
654.18 	client's mental or physical symptoms.
654.19 		Subd. 5.Medication administration record. If a license holder administers or observes 
654.20 	a client self-administer medications, the license holder must maintain a medication 
654.21 	administration record for each client that contains the following, as applicable:
654.22 	(1) the client's date of birth;
654.23 	(2) the client's allergies;
654.24 	(3) all medication orders for the client, including client-specific orders for 
654.25 	over-the-counter medications and approved condition-specific protocols;
654.26 	(4) the name of each ordered medication, date of each medication's expiration, each 
654.27 	medication's dosage frequency, method of administration, and time;
654.28 	(5) the licensed prescriber's name and telephone number;
654.29 	(6) the date of initiation;
654.30 	(7) the signature, printed name, and credentials of the staff person who administered the 
654.31 	medication or observed the client self-administer the medication; and
655.1 	(8) the reason that the license holder did not administer the client's prescribed medication 
655.2 	or observe the client self-administer the client's prescribed medication.

655.3 	Sec. 10. [245I.09] CLIENT FILES.
655.4 		Subdivision 1.Generally. (a) A license holder must maintain a file for each client that 
655.5 	contains the client's current and accurate records. The license holder must store each client 
655.6 	file on the premises where the license holder provides or coordinates services for the client. 
655.7 	The license holder must ensure that all client files are readily accessible for the 
655.8 	commissioner's review. The license holder is not required to keep client files in a single 
655.9 	location.
655.10 	(b) The license holder must protect client records against loss, tampering, or unauthorized 
655.11 	disclosure of confidential client data according to the Minnesota Government Data Practices 
655.12 	Act, chapter 13; the privacy provisions of the Minnesota health care programs provider 
655.13 	agreement; the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 
655.14 	Public Law 104-191; and the Minnesota Health Records Act, sections 144.291 to 144.298.
655.15 		Subd. 2.Record retention. A license holder must retain client records of a discharged 
655.16 	client for a minimum of five years from the date of the client's discharge. A license holder 
655.17 	who ceases to provide treatment services to a client must retain the client's records for a 
655.18 	minimum of five years from the date that the license holder stopped providing services to 
655.19 	the client and must notify the commissioner of the location of the client records and the 
655.20 	name of the individual responsible for storing and maintaining the client records.
655.21 		Subd. 3.Contents. A license holder must retain a clear and complete record of the 
655.22 	information that the license holder receives regarding a client, and of the services that the 
655.23 	license holder provides to the client. If applicable, each client's file must include the following 
655.24 	information:
655.25 	(1) the client's screenings, assessments, and testing;
655.26 	(2) the client's treatment plans and reviews of the client's treatment plan;
655.27 	(3) the client's individual abuse prevention plans;
655.28 	(4) the client's health care directive under section 145C.01, subdivision 5a, and the 
655.29 	client's emergency contacts;
655.30 	(5) the client's crisis plans;
655.31 	(6) the client's consents for releases of information and documentation of the client's 
655.32 	releases of information;
656.1 	(7) the client's significant medical and health-related information;
656.2 	(8) a record of each communication that a staff person has with the client's other mental 
656.3 	health providers and persons interested in the client, including the client's case manager, 
656.4 	family members, primary caregiver, legal representatives, court representatives, 
656.5 	representatives from the correctional system, or school administration;
656.6 	(9) written information by the client that the client requests to include in the client's file; 
656.7 	and
656.8 	(10) the date of the client's discharge from the license holder's program, the reason that 
656.9 	the license holder discontinued services for the client, and the client's discharge summaries.

656.10 	Sec. 11. [245I.10] ASSESSMENT AND TREATMENT PLANNING.
656.11 		Subdivision 1.Definitions. (a) "Diagnostic formulation" means a written analysis and 
656.12 	explanation of a client's clinical assessment to develop a hypothesis about the cause and 
656.13 	nature of a client's presenting problems and to identify the most suitable approach for treating 
656.14 	the client.
656.15 	(b) "Responsivity factors" means the factors other than the diagnostic formulation that 
656.16 	may modify a client's treatment needs. This includes a client's learning style, abilities, 
656.17 	cognitive functioning, cultural background, and personal circumstances. When documenting 
656.18 	a client's responsivity factors a mental health professional or clinical trainee must include 
656.19 	an analysis of how a client's strengths are reflected in the license holder's plan to deliver 
656.20 	services to the client.
656.21 		Subd. 2.Generally. (a) A license holder must use a client's diagnostic assessment or 
656.22 	crisis assessment to determine a client's eligibility for mental health services, except as 
656.23 	provided in this section.
656.24 	(b) Prior to completing a client's initial diagnostic assessment, a license holder may 
656.25 	provide a client with the following services:
656.26 	(1) an explanation of findings;
656.27 	(2) neuropsychological testing, neuropsychological assessment, and psychological 
656.28 	testing;
656.29 	(3) any combination of psychotherapy sessions, family psychotherapy sessions, and 
656.30 	family psychoeducation sessions not to exceed three sessions;
656.31 	(4) crisis assessment services according to section 256B.0624; and
657.1 	(5) ten days of intensive residential treatment services according to the assessment and 
657.2 	treatment planning standards in section 245.23, subdivision 7.
657.3 	(c) Based on the client's needs that a crisis assessment identifies under section 256B.0624, 
657.4 	a license holder may provide a client with the following services:
657.5 	(1) crisis intervention and stabilization services under section 245I.23 or 256B.0624; 
657.6 	and
657.7 	(2) any combination of psychotherapy sessions, group psychotherapy sessions, family 
657.8 	psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions 
657.9 	within a 12-month period without prior authorization.
657.10 	(d) Based on the client's needs in the client's brief diagnostic assessment, a license holder 
657.11 	may provide a client with any combination of psychotherapy sessions, group psychotherapy 
657.12 	sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed 
657.13 	ten sessions within a 12-month period without prior authorization for any new client or for 
657.14 	an existing client who the license holder projects will need fewer than ten sessions during 
657.15 	the next 12 months.
657.16 	(e) Based on the client's needs that a hospital's medical history and presentation 
657.17 	examination identifies, a license holder may provide a client with:
657.18 	(1) any combination of psychotherapy sessions, group psychotherapy sessions, family 
657.19 	psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions 
657.20 	within a 12-month period without prior authorization for any new client or for an existing 
657.21 	client who the license holder projects will need fewer than ten sessions during the next 12 
657.22 	months; and
657.23 	(2) up to five days of day treatment services or partial hospitalization.
657.24 	(f) A license holder must complete a new standard diagnostic assessment of a client:
657.25 	(1) when the client requires services of a greater number or intensity than the services 
657.26 	that paragraphs (b) to (e) describe;
657.27 	(2) at least annually following the client's initial diagnostic assessment if the client needs 
657.28 	additional mental health services and the client does not meet the criteria for a brief 
657.29 	assessment;
657.30 	(3) when the client's mental health condition has changed markedly since the client's 
657.31 	most recent diagnostic assessment; or
658.1 	(4) when the client's current mental health condition does not meet the criteria of the 
658.2 	client's current diagnosis.
658.3 	(g) For an existing client, the license holder must ensure that a new standard diagnostic 
658.4 	assessment includes a written update containing all significant new or changed information 
658.5 	about the client, and an update regarding what information has not significantly changed, 
658.6 	including a discussion with the client about changes in the client's life situation, functioning, 
658.7 	presenting problems, and progress with achieving treatment goals since the client's last 
658.8 	diagnostic assessment was completed.
658.9 		Subd. 3.Continuity of services. (a) For any client with a diagnostic assessment 
658.10 	completed under Minnesota Rules, parts 9505.0370 to 9505.0372, before the effective date 
658.11 	of this section, the diagnostic assessment is valid for authorizing the client's treatment and 
658.12 	billing for one calendar year after the date that the assessment was completed.
658.13 	(b) For any client with an individual treatment plan completed under section 256B.0622, 
658.14 	256B.0623, 256B.0943, 256B.0946, or 256B.0947 or Minnesota Rules, parts 9505.0370 to 
658.15 	9505.0372, the client's treatment plan is valid for authorizing treatment and billing until the 
658.16 	treatment plan's expiration date.
658.17 	(c) This subdivision expires July 1, 2023.
658.18 		Subd. 4.Diagnostic assessment. A client's diagnostic assessment must: (1) identify at 
658.19 	least one mental health diagnosis for which the client meets the diagnostic criteria and 
658.20 	recommend mental health services to develop the client's mental health services and treatment 
658.21 	plan; or (2) include a finding that the client does not meet the criteria for a mental health 
658.22 	disorder.
658.23 		Subd. 5.Brief diagnostic assessment; required elements. (a) Only a mental health 
658.24 	professional or clinical trainee may complete a brief diagnostic assessment of a client. A 
658.25 	license holder may only use a brief diagnostic assessment for a client who is six years of 
658.26 	age or older.
658.27 	(b) When conducting a brief diagnostic assessment of a client, the assessor must complete 
658.28 	a face-to-face interview with the client and a written evaluation of the client. The assessor 
658.29 	must gather and document initial components of the client's standard diagnostic assessment, 
658.30 	including the client's:
658.31 	(1) age;
658.32 	(2) description of symptoms, including the reason for the client's referral;
658.33 	(3) history of mental health treatment;
659.1 	(4) cultural influences on the client; and
659.2 	(5) mental status examination.
659.3 	(c) Based on the initial components of the assessment, the assessor must develop a 
659.4 	provisional diagnostic formulation about the client. The assessor may use the client's 
659.5 	provisional diagnostic formulation to address the client's immediate needs and presenting 
659.6 	problems.
659.7 	(d) A mental health professional or clinical trainee may use treatment sessions with the 
659.8 	client authorized by a brief diagnostic assessment to gather additional information about 
659.9 	the client to complete the client's standard diagnostic assessment if the number of sessions 
659.10 	will exceed the coverage limits in subdivision 2.
659.11 		Subd. 6.Standard diagnostic assessment; required elements. (a) Only a mental health 
659.12 	professional or a clinical trainee may complete a standard diagnostic assessment of a client. 
659.13 	A standard diagnostic assessment of a client must include a face-to-face interview with a 
659.14 	client and a written evaluation of the client. The assessor must complete a client's standard 
659.15 	diagnostic assessment within the client's cultural context.
659.16 	(b) When completing a standard diagnostic assessment of a client, the assessor must 
659.17 	gather and document information about the client's current life situation, including the 
659.18 	following information:
659.19 	(1) the client's age;
659.20 	(2) the client's current living situation, including the client's housing status and household 
659.21 	members;
659.22 	(3) the status of the client's basic needs;
659.23 	(4) the client's education level and employment status;
659.24 	(5) the client's current medications;
659.25 	(6) any immediate risks to the client's health and safety;
659.26 	(7) the client's perceptions of the client's condition;
659.27 	(8) the client's description of the client's symptoms, including the reason for the client's 
659.28 	referral;
659.29 	(9) the client's history of mental health treatment; and
659.30 	(10) cultural influences on the client.
660.1 	(c) If the assessor cannot obtain the information that this subdivision requires without 
660.2 	retraumatizing the client or harming the client's willingness to engage in treatment, the 
660.3 	assessor must identify which topics will require further assessment during the course of the 
660.4 	client's treatment. The assessor must gather and document information related to the following 
660.5 	topics:
660.6 	(1) the client's relationship with the client's family and other significant personal 
660.7 	relationships, including the client's evaluation of the quality of each relationship;
660.8 	(2) the client's strengths and resources, including the extent and quality of the client's 
660.9 	social networks;
660.10 	(3) important developmental incidents in the client's life;
660.11 	(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
660.12 	(5) the client's history of or exposure to alcohol and drug usage and treatment; and
660.13 	(6) the client's health history and the client's family health history, including the client's 
660.14 	physical, chemical, and mental health history.
660.15 	(d) When completing a standard diagnostic assessment of a client, an assessor must use 
660.16 	a recognized diagnostic framework.
660.17 	(1) When completing a standard diagnostic assessment of a client who is five years of 
660.18 	age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic 
660.19 	Classification of Mental Health and Development Disorders of Infancy and Early Childhood 
660.20 	published by Zero to Three.
660.21 	(2) When completing a standard diagnostic assessment of a client who is six years of 
660.22 	age or older, the assessor must use the current edition of the Diagnostic and Statistical 
660.23 	Manual of Mental Disorders published by the American Psychiatric Association.
660.24 	(3) When completing a standard diagnostic assessment of a client who is five years of 
660.25 	age or younger, an assessor must administer the Early Childhood Service Intensity Instrument 
660.26 	(ECSII) to the client and include the results in the client's assessment.
660.27 	(4) When completing a standard diagnostic assessment of a client who is six to 17 years 
660.28 	of age, an assessor must administer the Child and Adolescent Service Intensity Instrument 
660.29 	(CASII) to the client and include the results in the client's assessment.
660.30 	(5) When completing a standard diagnostic assessment of a client who is 18 years of 
660.31 	age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria 
660.32 	in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders 
661.1 	published by the American Psychiatric Association to screen and assess the client for a 
661.2 	substance use disorder.
661.3 	(e) When completing a standard diagnostic assessment of a client, the assessor must 
661.4 	include and document the following components of the assessment:
661.5 	(1) the client's mental status examination;
661.6 	(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources; 
661.7 	vulnerabilities; safety needs, including client information that supports the assessor's findings 
661.8 	after applying a recognized diagnostic framework from paragraph (d); and any differential 
661.9 	diagnosis of the client;
661.10 	(3) an explanation of: (i) how the assessor diagnosed the client using the information 
661.11 	from the client's interview, assessment, psychological testing, and collateral information 
661.12 	about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths; 
661.13 	and (v) the client's responsivity factors.
661.14 	(f) When completing a standard diagnostic assessment of a client, the assessor must 
661.15 	consult the client and the client's family about which services that the client and the family 
661.16 	prefer to treat the client. The assessor must make referrals for the client as to services required 
661.17 	by law.
661.18 		Subd. 7.Individual treatment plan. A license holder must follow each client's written 
661.19 	individual treatment plan when providing services to the client with the following exceptions:
661.20 	(1) services that do not require that a license holder completes a standard diagnostic 
661.21 	assessment of a client before providing services to the client;
661.22 	(2) when developing a service plan; and
661.23 	(3) when a client re-engages in services under subdivision 8, paragraph (b).
661.24 		Subd. 8.Individual treatment plan; required elements. (a) After completing a client's 
661.25 	diagnostic assessment and before providing services to the client, the license holder must 
661.26 	complete the client's individual treatment plan. The license holder must:
661.27 	(1) base the client's individual treatment plan on the client's diagnostic assessment and 
661.28 	baseline measurements;
661.29 	(2) for a child client, use a child-centered, family-driven, and culturally appropriate 
661.30 	planning process that allows the child's parents and guardians to observe and participate in 
661.31 	the child's individual and family treatment services, assessments, and treatment planning;
662.1 	(3) for an adult client, use a person-centered, culturally appropriate planning process 
662.2 	that allows the client's family and other natural supports to observe and participate in the 
662.3 	client's treatment services, assessments, and treatment planning;
662.4 	(4) identify the client's treatment goals, measureable treatment objectives, a schedule 
662.5 	for accomplishing the client's treatment goals and objectives, a treatment strategy, and the 
662.6 	individuals responsible for providing treatment services and supports to the client. The 
662.7 	license holder must have a treatment strategy to engage the client in treatment if the client:
662.8 	(i) has a history of not engaging in treatment; and
662.9 	(ii) is ordered by a court to participate in treatment services or to take neuroleptic 
662.10 	medications;
662.11 	(5) identify the participants involved in the client's treatment planning. The client must 
662.12 	be a participant in the client's treatment planning. If applicable, the license holder must 
662.13 	document the reasons that the license holder did not involve the client's family or other 
662.14 	natural supports in the client's treatment planning;
662.15 	(6) review the client's individual treatment plan every 180 days and update the client's 
662.16 	individual treatment plan with the client's treatment progress, new treatment objectives and 
662.17 	goals or, if the client has not made treatment progress, changes in the license holder's 
662.18 	approach to treatment; and
662.19 	(7) ensure that the client approves of the client's individual treatment plan unless a court 
662.20 	orders the client's treatment plan under chapter 253B.
662.21 	(b) If the client disagrees with the client's treatment plan, the license holder must 
662.22 	document in the client file the reasons why the client does not agree with the treatment plan. 
662.23 	If the license holder cannot obtain the client's approval of the treatment plan, a mental health 
662.24 	professional must make efforts to obtain approval from a person who is authorized to consent 
662.25 	on the client's behalf within 30 days after the client's previous individual treatment plan 
662.26 	expired. A license holder may not deny a client service during this time period solely because 
662.27 	the license holder could not obtain the client's approval of the client's individual treatment 
662.28 	plan. A license holder may continue to bill for the client's otherwise eligible services when 
662.29 	the client re-engages in services.
662.30 		Subd. 9.Functional assessment; required elements. When a license holder is 
662.31 	completing a functional assessment for an adult client, the license holder must:
662.32 	(1) complete a functional assessment of the client after completing the client's diagnostic 
662.33 	assessment;
663.1 	(2) use a collaborative process that allows the client and the client's family and other 
663.2 	natural supports, the client's referral sources, and the client's providers to provide information 
663.3 	about how the client's symptoms of mental illness impact the client's functioning;
663.4 	(3) if applicable, document the reasons that the license holder did not contact the client's 
663.5 	family and other natural supports;
663.6 	(4) assess and document how the client's symptoms of mental illness impact the client's 
663.7 	functioning in the following areas:
663.8 	(i) the client's mental health symptoms;
663.9 	(ii) the client's mental health service needs;
663.10 	(iii) the client's substance use;
663.11 	(iv) the client's vocational and educational functioning;
663.12 	(v) the client's social functioning, including the use of leisure time;
663.13 	(vi) the client's interpersonal functioning, including relationships with the client's family 
663.14 	and other natural supports;
663.15 	(vii) the client's ability to provide self-care and live independently;
663.16 	(viii) the client's medical and dental health;
663.17 	(ix) the client's financial assistance needs; and
663.18 	(x) the client's housing and transportation needs;
663.19 	(5) include a narrative summarizing the client's strengths, resources, and all areas of 
663.20 	functional impairment;
663.21 	(6) complete the client's functional assessment before the client's initial individual 
663.22 	treatment plan unless a service specifies otherwise; and
663.23 	(7) update the client's functional assessment with the client's current functioning whenever 
663.24 	there is a significant change in the client's functioning or at least every 180 days, unless a 
663.25 	service specifies otherwise.

663.26 	Sec. 12. [245I.11] HEALTH SERVICES AND MEDICATIONS.
663.27 		Subdivision 1.Generally. If a license holder is licensed as a residential program, stores 
663.28 	or administers client medications, or observes clients self-administer medications, the license 
663.29 	holder must ensure that a staff person who is a registered nurse or licensed prescriber is 
663.30 	responsible for overseeing storage and administration of client medications and observing 
664.1 	as a client self-administers medications, including training according to section 245I.05, 
664.2 	subdivision 6, and documenting the occurrence according to section 245I.08, subdivision 
664.3 	5.
664.4 		Subd. 2.Health services. If a license holder is licensed as a residential program, the 
664.5 	license holder must:
664.6 	(1) ensure that a client is screened for health issues within 72 hours of the client's 
664.7 	admission;
664.8 	(2) monitor the physical health needs of each client on an ongoing basis;
664.9 	(3) offer referrals to clients and coordinate each client's care with psychiatric and medical 
664.10 	services;
664.11 	(4) identify circumstances in which a staff person must notify a registered nurse or 
664.12 	licensed prescriber of any of a client's health concerns and the process for providing 
664.13 	notification of client health concerns; and
664.14 	(5) identify the circumstances in which the license holder must obtain medical care for 
664.15 	a client and the process for obtaining medical care for a client.
664.16 		Subd. 3.Storing and accounting for medications. (a) If a license holder stores client 
664.17 	medications, the license holder must:
664.18 	(1) store client medications in original containers in a locked location;
664.19 	(2) store refrigerated client medications in special trays or containers that are separate 
664.20 	from food;
664.21 	(3) store client medications marked "for external use only" in a compartment that is 
664.22 	separate from other client medications;
664.23 	(4) store Schedule II to IV drugs listed in section 152.02, subdivisions 3 to 5, in a 
664.24 	compartment that is locked separately from other medications;
664.25 	(5) ensure that only authorized staff persons have access to stored client medications;
664.26 	(6) follow a documentation procedure on each shift to account for all scheduled drugs; 
664.27 	and
664.28 	(7) record each incident when a staff person accepts a supply of client medications and 
664.29 	destroy discontinued, outdated, or deteriorated client medications.
664.30 	(b) If a license holder is licensed as a residential program, the license holder must allow 
664.31 	clients who self-administer medications to keep a private medication supply. The license 
665.1 	holder must ensure that the client stores all private medication in a locked container in the 
665.2 	client's private living area, unless the private medication supply poses a health and safety 
665.3 	risk to any clients. A client must not maintain a private medication supply of a prescription 
665.4 	medication without a written medication order from a licensed prescriber and a prescription 
665.5 	label that includes the client's name.
665.6 		Subd. 4.Medication orders. (a) If a license holder stores, prescribes, or administers 
665.7 	medications or observes a client self-administer medications, the license holder must:
665.8 	(1) ensure that a licensed prescriber writes all orders to accept, administer, or discontinue 
665.9 	client medications;
665.10 	(2) accept nonwritten orders to administer client medications in emergency circumstances 
665.11 	only;
665.12 	(3) establish a timeline and process for obtaining a written order with the licensed 
665.13 	prescriber's signature when the license holder accepts a nonwritten order to administer client 
665.14 	medications;
665.15 	(4) obtain prescription medication renewals from a licensed prescriber for each client 
665.16 	every 90 days for psychotropic medications and annually for all other medications; and
665.17 	(5) maintain the client's right to privacy and dignity.
665.18 	(b) If a license holder employs a licensed prescriber, the license holder must inform the 
665.19 	client about potential medication effects and side effects and obtain and document the client's 
665.20 	informed consent before the licensed prescriber prescribes a medication.
665.21 		Subd. 5.Medication administration. If a license holder is licensed as a residential 
665.22 	program, the license holder must:
665.23 	(1) assess and document each client's ability to self-administer medication. In the 
665.24 	assessment, the license holder must evaluate the client's ability to: (i) comply with prescribed 
665.25 	medication regimens; and (ii) store the client's medications safely and in a manner that 
665.26 	protects other individuals in the facility. Through the assessment process, the license holder 
665.27 	must assist the client in developing the skills necessary to safely self-administer medication;
665.28 	(2) monitor the effectiveness of medications, side effects of medications, and adverse 
665.29 	reactions to medications for each client. The license holder must address and document any 
665.30 	concerns about a client's medications;
665.31 	(3) ensure that no staff person or client gives a legend drug supply for one client to 
665.32 	another client;
666.1 	(4) have policies and procedures for: (i) keeping a record of each client's medication 
666.2 	orders; (ii) keeping a record of any incident of deferring a client's medications; (iii) 
666.3 	documenting any incident when a client's medication is omitted; and (iv) documenting when 
666.4 	a client refuses to take medications as prescribed; and
666.5 	(5) document and track medication errors, document whether the license holder notified 
666.6 	anyone about the medication error, determine if the license holder must take any follow-up 
666.7 	actions, and identify the staff persons who are responsible for taking follow-up actions.

666.8 	Sec. 13. [245I.12] CLIENT RIGHTS AND PROTECTIONS.
666.9 		Subdivision 1.Client rights. A license holder must ensure that all clients have the 
666.10 	following rights:
666.11 	(1) the rights listed in the health care bill of rights in section 144.651;
666.12 	(2) the right to be free from discrimination based on age, race, color, creed, religion, 
666.13 	national origin, gender, marital status, disability, sexual orientation, and status with regard 
666.14 	to public assistance. The license holder must follow all applicable state and federal laws 
666.15 	including the Minnesota Human Rights Act, chapter 363A; and
666.16 	(3) the right to be informed prior to a photograph or audio or video recording being made 
666.17 	of the client. The client has the right to refuse to allow any recording or photograph of the 
666.18 	client that is not for the purposes of identification or supervision by the license holder.
666.19 		Subd. 2.Restrictions to client rights. If the license holder restricts a client's right, the 
666.20 	license holder must document in the client file a mental health professional's approval of 
666.21 	the restriction and the reasons for the restriction.
666.22 		Subd. 3.Notice of rights. The license holder must give a copy of the client's rights 
666.23 	according to this section to each client on the day of the client's admission. The license 
666.24 	holder must document that the license holder gave a copy of the client's rights to each client 
666.25 	on the day of the client's admission according to this section. The license holder must post 
666.26 	a copy of the client rights in an area visible or accessible to all clients. The license holder 
666.27 	must include the client rights in Minnesota Rules, chapter 9544, for applicable clients.
666.28 		Subd. 4.Client property. (a) The license holder must meet the requirements of section 
666.29 	245A.04, subdivision 13.
666.30 	(b) If the license holder is unable to obtain a client's signature acknowledging the receipt 
666.31 	or disbursement of the client's funds or property required by section 245A.04, subdivision 
666.32 	13, paragraph (c), clause (1), two staff persons must sign documentation acknowledging 
667.1 	that the staff persons witnessed the client's receipt or disbursement of the client's funds or 
667.2 	property.
667.3 	(c) The license holder must return all of the client's funds and other property to the client 
667.4 	except for the following items:
667.5 	(1) illicit drugs, drug paraphernalia, and drug containers that are subject to forfeiture 
667.6 	under section 609.5316. The license holder must give illicit drugs, drug paraphernalia, and 
667.7 	drug containers to a local law enforcement agency or destroy the items; and
667.8 	(2) weapons, explosives, and other property that may cause serious harm to the client 
667.9 	or others. The license holder may give a client's weapons and explosives to a local law 
667.10 	enforcement agency. The license holder must notify the client that a local law enforcement 
667.11 	agency has the client's property and that the client has the right to reclaim the property if 
667.12 	the client has a legal right to possess the item.
667.13 	(d) If a client leaves the license holder's program but abandons the client's funds or 
667.14 	property, the license holder must retain and store the client's funds or property, including 
667.15 	medications, for a minimum of 30 days after the client's discharge from the program.
667.16 		Subd. 5.Client grievances. (a) The license holder must have a grievance procedure 
667.17 	that:
667.18 	(1) describes to clients how the license holder will meet the requirements in this 
667.19 	subdivision; and
667.20 	(2) contains the current public contact information of the Department of Human Services, 
667.21 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
667.22 	Disabilities; the Department of Health, Office of Health Facilities Complaints; and all 
667.23 	applicable health-related licensing boards.
667.24 	(b) On the day of each client's admission, the license holder must explain the grievance 
667.25 	procedure to the client.
667.26 	(c) The license holder must:
667.27 	(1) post the grievance procedure in a place visible to clients and provide a copy of the 
667.28 	grievance procedure upon request;
667.29 	(2) allow clients, former clients, and their authorized representatives to submit a grievance 
667.30 	to the license holder;
667.31 	(3) within three business days of receiving a client's grievance, acknowledge in writing 
667.32 	that the license holder received the client's grievance. If applicable, the license holder must 
668.1 	include a notice of the client's separate appeal rights for a managed care organization's 
668.2 	reduction, termination, or denial of a covered service;
668.3 	(4) within 15 business days of receiving a client's grievance, provide a written final 
668.4 	response to the client's grievance containing the license holder's official response to the 
668.5 	grievance; and
668.6 	(5) allow the client to bring a grievance to the person with the highest level of authority 
668.7 	in the program.

668.8 	Sec. 14. [245I.13] CRITICAL INCIDENTS.
668.9 	If a license holder is licensed as a residential program, the license holder must report all 
668.10 	critical incidents to the commissioner within ten days of learning of the incident on a form 
668.11 	approved by the commissioner. The license holder must keep a record of critical incidents 
668.12 	in a central location that is readily accessible to the commissioner for review upon the 
668.13 	commissioner's request for a minimum of two licensing periods.

668.14 	Sec. 15. [245I.20] MENTAL HEALTH CLINIC.
668.15 		Subdivision 1.Purpose. Certified mental health clinics provide clinical services for the 
668.16 	treatment of mental illnesses with a treatment team that reflects multiple disciplines and 
668.17 	areas of expertise.
668.18 		Subd. 2.Definitions. (a) "Clinical services" means services provided to a client to 
668.19 	diagnose, describe, predict, and explain the client's status relative to a condition or problem 
668.20 	as described in the: (1) current edition of the Diagnostic and Statistical Manual of Mental 
668.21 	Disorders published by the American Psychiatric Association; or (2) current edition of the 
668.22 	DC: 0-5 Diagnostic Classification of Mental Health and Development Disorders of Infancy 
668.23 	and Early Childhood published by Zero to Three. Where necessary, clinical services includes 
668.24 	services to treat a client to reduce the client's impairment due to the client's condition. 
668.25 	Clinical services also includes individual treatment planning, case review, record-keeping 
668.26 	required for a client's treatment, and treatment supervision. For the purposes of this section, 
668.27 	clinical services excludes services delivered to a client under a separate license and services 
668.28 	listed under section 245I.011, subdivision 5.
668.29 	(b) "Competent" means having professional education, training, continuing education, 
668.30 	consultation, supervision, experience, or a combination thereof necessary to demonstrate 
668.31 	sufficient knowledge of and proficiency in a specific clinical service.
669.1 	(c) "Discipline" means a branch of professional knowledge or skill acquired through a 
669.2 	specific course of study, training, and supervised practice. Discipline is usually documented 
669.3 	by a specific educational degree, licensure, or certification of proficiency. Examples of the 
669.4 	mental health disciplines include but are not limited to psychiatry, psychology, clinical 
669.5 	social work, marriage and family therapy, clinical counseling, and psychiatric nursing.
669.6 	(d) "Treatment team" means the mental health professionals, mental health practitioners, 
669.7 	and clinical trainees who provide clinical services to clients.
669.8 		Subd. 3.Organizational structure. (a) A mental health clinic location must be an entire 
669.9 	facility or a clearly identified unit within a facility that is administratively and clinically 
669.10 	separate from the rest of the facility. The mental health clinic location may provide services 
669.11 	other than clinical services to clients, including medical services, substance use disorder 
669.12 	services, social services, training, and education.
669.13 	(b) The certification holder must notify the commissioner of all mental health clinic 
669.14 	locations. If there is more than one mental health clinic location, the certification holder 
669.15 	must designate one location as the main location and all of the other locations as satellite 
669.16 	locations. The main location as a unit and the clinic as a whole must comply with the 
669.17 	minimum staffing standards in subdivision 4.
669.18 	(c) The certification holder must ensure that each satellite location:
669.19 	(1) adheres to the same policies and procedures as the main location;
669.20 	(2) provides treatment team members with face-to-face or telephone access to a mental 
669.21 	health professional for the purposes of supervision whenever the satellite location is open. 
669.22 	The certification holder must maintain a schedule of the mental health professionals who 
669.23 	will be available and the contact information for each available mental health professional. 
669.24 	The schedule must be current and readily available to treatment team members; and
669.25 	(3) enables clients to access all of the mental health clinic's clinical services and treatment 
669.26 	team members, as needed.
669.27 		Subd. 4.Minimum staffing standards. (a) A certification holder's treatment team must 
669.28 	consist of at least four mental health professionals. At least two of the mental health 
669.29 	professionals must be employed by or under contract with the mental health clinic for a 
669.30 	minimum of 35 hours per week each. Each of the two mental health professionals must 
669.31 	specialize in a different mental health discipline.
669.32 	(b) The treatment team must include:
670.1 	(1) a physician qualified as a mental health professional according to section 245I.04, 
670.2 	subdivision 2, clause (4), or a nurse qualified as a mental health professional according to 
670.3 	section 245I.04, subdivision 2, clause (1); and
670.4 	(2) a psychologist qualified as a mental health professional according to section 245I.04, 
670.5 	subdivision 2, clause (3).
670.6 	(c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical 
670.7 	services at least:
670.8 	(1) eight hours every two weeks if the mental health clinic has over 25.0 full-time 
670.9 	equivalent treatment team members;
670.10 	(2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent 
670.11 	treatment team members;
670.12 	(3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent 
670.13 	treatment team members; or
670.14 	(4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent 
670.15 	treatment team members or only provides in-home services to clients.
670.16 	(d) The certification holder must maintain a record that demonstrates compliance with 
670.17 	this subdivision.
670.18 		Subd. 5.Treatment supervision specified. (a) A mental health professional must remain 
670.19 	responsible for each client's case. The certification holder must document the name of the 
670.20 	mental health professional responsible for each case and the dates that the mental health 
670.21 	professional is responsible for the client's case from beginning date to end date. The 
670.22 	certification holder must assign each client's case for assessment, diagnosis, and treatment 
670.23 	services to a treatment team member who is competent in the assigned clinical service, the 
670.24 	recommended treatment strategy, and in treating the client's characteristics.
670.25 	(b) Treatment supervision of mental health practitioners and clinical trainees required 
670.26 	by section 245I.06 must include case reviews as described in this paragraph. Every two 
670.27 	months, a mental health professional must complete a case review of each client assigned 
670.28 	to the mental health professional when the client is receiving clinical services from a mental 
670.29 	health practitioner or clinical trainee. The case review must include a consultation process 
670.30 	that thoroughly examines the client's condition and treatment, including: (1) a review of the 
670.31 	client's reason for seeking treatment, diagnoses and assessments, and the individual treatment 
670.32 	plan; (2) a review of the appropriateness, duration, and outcome of treatment provided to 
670.33 	the client; and (3) treatment recommendations.
671.1 		Subd. 6.Additional policy and procedure requirements. (a) In addition to the policies 
671.2 	and procedures required by section 245I.03, the certification holder must establish, enforce, 
671.3 	and maintain the policies and procedures required by this subdivision.
671.4 	(b) The certification holder must have a clinical evaluation procedure to identify and 
671.5 	document each treatment team member's areas of competence.
671.6 	(c) The certification holder must have policies and procedures for client intake and case 
671.7 	assignment that:
671.8 	(1) outline the client intake process;
671.9 	(2) describe how the mental health clinic determines the appropriateness of accepting a 
671.10 	client into treatment by reviewing the client's condition and need for treatment, the clinical 
671.11 	services that the mental health clinic offers to clients, and other available resources; and
671.12 	(3) contain a process for assigning a client's case to a mental health professional who is 
671.13 	responsible for the client's case and other treatment team members.
671.14 		Subd. 7.Referrals. If necessary treatment for a client or treatment desired by a client 
671.15 	is not available at the mental health clinic, the certification holder must facilitate appropriate 
671.16 	referrals for the client. When making a referral for a client, the treatment team member must 
671.17 	document a discussion with the client that includes: (1) the reason for the client's referral; 
671.18 	(2) potential treatment resources for the client; and (3) the client's response to receiving a 
671.19 	referral.
671.20 		Subd. 8.Emergency service. For the certification holder's telephone numbers that clients 
671.21 	regularly access, the certification holder must include the contact information for the area's 
671.22 	mental health crisis services as part of the certification holder's message when a live operator 
671.23 	is not available to answer clients' calls.
671.24 		Subd. 9.Quality assurance and improvement plan. (a) At a minimum, a certification 
671.25 	holder must develop a written quality assurance and improvement plan that includes a plan 
671.26 	for:
671.27 	(1) encouraging ongoing consultation among members of the treatment team;
671.28 	(2) obtaining and evaluating feedback about services from clients, family and other 
671.29 	natural supports, referral sources, and staff persons;
671.30 	(3) measuring and evaluating client outcomes;
671.31 	(4) reviewing client suicide deaths and suicide attempts;
671.32 	(5) examining the quality of clinical service delivery to clients; and
672.1 	(6) self-monitoring of compliance with this chapter.
672.2 	(b) At least annually, the certification holder must review, evaluate, and update the 
672.3 	quality assurance and improvement plan. The review must: (1) include documentation of 
672.4 	the actions that the certification holder will take as a result of information obtained from 
672.5 	monitoring activities in the plan; and (2) establish goals for improved service delivery to 
672.6 	clients for the next year.
672.7 		Subd. 10.Application procedures. (a) The applicant for certification must submit any 
672.8 	documents that the commissioner requires on forms approved by the commissioner.
672.9 	(b) Upon submitting an application for certification, an applicant must pay the application 
672.10 	fee required by section 245A.10, subdivision 3.
672.11 	(c) The commissioner must act on an application within 90 working days of receiving 
672.12 	a completed application.
672.13 	(d) When the commissioner receives an application for initial certification that is 
672.14 	incomplete because the applicant failed to submit required documents or is deficient because 
672.15 	the submitted documents do not meet certification requirements, the commissioner must 
672.16 	provide the applicant with written notice that the application is incomplete or deficient. In 
672.17 	the notice, the commissioner must identify the particular documents that are missing or 
672.18 	deficient and give the applicant 45 days to submit a second application that is complete. An 
672.19 	applicant's failure to submit a complete application within 45 days after receiving notice 
672.20 	from the commissioner is a basis for certification denial.
672.21 	(e) The commissioner must give notice of a denial to an applicant when the commissioner 
672.22 	has made the decision to deny the certification application. In the notice of denial, the 
672.23 	commissioner must state the reasons for the denial in plain language. The commissioner 
672.24 	must send or deliver the notice of denial to an applicant by certified mail or personal service. 
672.25 	In the notice of denial, the commissioner must state the reasons that the commissioner denied 
672.26 	the application and must inform the applicant of the applicant's right to request a contested 
672.27 	case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The 
672.28 	applicant may appeal the denial by notifying the commissioner in writing by certified mail 
672.29 	or personal service. If mailed, the appeal must be postmarked and sent to the commissioner 
672.30 	within 20 calendar days after the applicant received the notice of denial. If an applicant 
672.31 	delivers an appeal by personal service, the commissioner must receive the appeal within 20 
672.32 	calendar days after the applicant received the notice of denial.
672.33 		Subd. 11.Commissioner's right of access. (a) When the commissioner is exercising 
672.34 	the powers conferred to the commissioner by this chapter, if the mental health clinic is in 
673.1 	operation and the information is relevant to the commissioner's inspection or investigation, 
673.2 	the certification holder must provide the commissioner access to:
673.3 	(1) the physical facility and grounds where the program is located;
673.4 	(2) documentation and records, including electronically maintained records;
673.5 	(3) clients served by the mental health clinic;
673.6 	(4) staff persons of the mental health clinic; and
673.7 	(5) personnel records of current and former staff of the mental health clinic.
673.8 	(b) The certification holder must provide the commissioner with access to the facility 
673.9 	and grounds, documentation and records, clients, and staff without prior notice and as often 
673.10 	as the commissioner considers necessary if the commissioner is investigating alleged 
673.11 	maltreatment or a violation of a law or rule, or conducting an inspection. When conducting 
673.12 	an inspection, the commissioner may request and must receive assistance from other state, 
673.13 	county, and municipal governmental agencies and departments. The applicant or certification 
673.14 	holder must allow the commissioner, at the commissioner's expense, to photocopy, 
673.15 	photograph, and make audio and video recordings during an inspection.
673.16 		Subd. 12.Monitoring and inspections. (a) The commissioner may conduct a certification 
673.17 	review of the certified mental health clinic every two years to determine the certification 
673.18 	holder's compliance with applicable rules and statutes.
673.19 	(b) The commissioner must offer the certification holder a choice of dates for an 
673.20 	announced certification review. A certification review must occur during the clinic's normal 
673.21 	working hours.
673.22 	(c) The commissioner must make the results of certification reviews and investigations 
673.23 	publicly available on the department's website.
673.24 		Subd. 13.Correction orders. (a) If the applicant or certification holder fails to comply 
673.25 	with a law or rule, the commissioner may issue a correction order. The correction order 
673.26 	must state:
673.27 	(1) the condition that constitutes a violation of the law or rule;
673.28 	(2) the specific law or rule that the applicant or certification holder has violated; and
673.29 	(3) the time that the applicant or certification holder is allowed to correct each violation.
673.30 	(b) If the applicant or certification holder believes that the commissioner's correction 
673.31 	order is erroneous, the applicant or certification holder may ask the commissioner to 
674.1 	reconsider the part of the correction order that is allegedly erroneous. An applicant or 
674.2 	certification holder must make a request for reconsideration in writing. The request must 
674.3 	be postmarked and sent to the commissioner within 20 calendar days after the applicant or 
674.4 	certification holder received the correction order; and the request must:
674.5 	(1) specify the part of the correction order that is allegedly erroneous;
674.6 	(2) explain why the specified part is erroneous; and
674.7 	(3) include documentation to support the allegation of error.
674.8 	(c) A request for reconsideration does not stay any provision or requirement of the 
674.9 	correction order. The commissioner's disposition of a request for reconsideration is final 
674.10 	and not subject to appeal.
674.11 	(d) If the commissioner finds that the applicant or certification holder failed to correct 
674.12 	the violation specified in the correction order, the commissioner may decertify the certified 
674.13 	mental health clinic according to subdivision 14.
674.14 	(e) Nothing in this subdivision prohibits the commissioner from decertifying a mental 
674.15 	health clinic according to subdivision 14.
674.16 		Subd. 14.Decertification. (a) The commissioner may decertify a mental health clinic 
674.17 	if a certification holder:
674.18 	(1) failed to comply with an applicable law or rule; or
674.19 	(2) knowingly withheld relevant information from or gave false or misleading information 
674.20 	to the commissioner in connection with an application for certification, during an 
674.21 	investigation, or regarding compliance with applicable laws or rules.
674.22 	(b) When considering decertification of a mental health clinic, the commissioner must 
674.23 	consider the nature, chronicity, or severity of the violation of law or rule and the effect of 
674.24 	the violation on the health, safety, or rights of clients.
674.25 	(c) If the commissioner decertifies a mental health clinic, the order of decertification 
674.26 	must inform the certification holder of the right to have a contested case hearing under 
674.27 	chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The certification holder 
674.28 	may appeal the decertification. The certification holder must appeal a decertification in 
674.29 	writing and send or deliver the appeal to the commissioner by certified mail or personal 
674.30 	service. If the certification holder mails the appeal, the appeal must be postmarked and sent 
674.31 	to the commissioner within ten calendar days after the certification holder receives the order 
674.32 	of decertification. If the certification holder delivers an appeal by personal service, the 
675.1 	commissioner must receive the appeal within ten calendar days after the certification holder 
675.2 	received the order. If a certification holder submits a timely appeal of an order of 
675.3 	decertification, the certification holder may continue to operate the program until the 
675.4 	commissioner issues a final order on the decertification.
675.5 	(d) If the commissioner decertifies a mental health clinic pursuant to paragraph (a), 
675.6 	clause (1), based on a determination that the mental health clinic was responsible for 
675.7 	maltreatment, and if the certification holder appeals the decertification according to paragraph 
675.8 	(c), and appeals the maltreatment determination under section 260E.33, the final 
675.9 	decertification determination is stayed until the commissioner issues a final decision regarding 
675.10 	the maltreatment appeal.
675.11 		Subd. 15.Transfer prohibited. A certification issued under this section is only valid 
675.12 	for the premises and the individual, organization, or government entity identified by the 
675.13 	commissioner on the certification. A certification is not transferable or assignable.
675.14 		Subd. 16.Notifications required and noncompliance. (a) A certification holder must 
675.15 	notify the commissioner, in a manner prescribed by the commissioner, and obtain the 
675.16 	commissioner's approval before making any change to the name of the certification holder 
675.17 	or the location of the mental health clinic.
675.18 	(b) Changes in mental health clinic organization, staffing, treatment, or quality assurance 
675.19 	procedures that affect the ability of the certification holder to comply with the minimum 
675.20 	standards of this section must be reported in writing by the certification holder to the 
675.21 	commissioner within 15 days of the occurrence. Review of the change must be conducted 
675.22 	by the commissioner. A certification holder with changes resulting in noncompliance in 
675.23 	minimum standards must receive written notice and may have up to 180 days to correct the 
675.24 	areas of noncompliance before being decertified. Interim procedures to resolve the 
675.25 	noncompliance on a temporary basis must be developed and submitted in writing to the 
675.26 	commissioner for approval within 30 days of the commissioner's determination of the 
675.27 	noncompliance. Not reporting an occurrence of a change that results in noncompliance 
675.28 	within 15 days, failure to develop an approved interim procedure within 30 days of the 
675.29 	determination of the noncompliance, or nonresolution of the noncompliance within 180 
675.30 	days will result in immediate decertification.
675.31 	(c) The mental health clinic may be required to submit written information to the 
675.32 	department to document that the mental health clinic has maintained compliance with this 
675.33 	section and mental health clinic procedures.

676.1 	Sec. 16. [245I.23] INTENSIVE RESIDENTIAL TREATMENT SERVICES AND 
676.2 	RESIDENTIAL CRISIS STABILIZATION.
676.3 		Subdivision 1.Purpose. (a) Intensive residential treatment services is a community-based 
676.4 	medically monitored level of care for an adult client that uses established rehabilitative 
676.5 	principles to promote a client's recovery and to develop and achieve psychiatric stability, 
676.6 	personal and emotional adjustment, self-sufficiency, and other skills that help a client 
676.7 	transition to a more independent setting.
676.8 	(b) Residential crisis stabilization provides structure and support to an adult client in a 
676.9 	community living environment when a client has experienced a mental health crisis and 
676.10 	needs short-term services to ensure that the client can safely return to the client's home or 
676.11 	precrisis living environment with additional services and supports identified in the client's 
676.12 	crisis assessment.
676.13 		Subd. 2.Definitions. (a) "Program location" means a set of rooms that are each physically 
676.14 	self-contained and have defining walls extending from floor to ceiling. Program location 
676.15 	includes bedrooms, living rooms or lounge areas, bathrooms, and connecting areas.
676.16 	(b) "Treatment team" means a group of staff persons who provide intensive residential 
676.17 	treatment services or residential crisis stabilization to clients. The treatment team includes 
676.18 	mental health professionals, mental health practitioners, clinical trainees, certified 
676.19 	rehabilitation specialists, mental health rehabilitation workers, and mental health certified 
676.20 	peer specialists.
676.21 		Subd. 3.Treatment services description. The license holder must describe in writing 
676.22 	all treatment services that the license holder provides. The license holder must have the 
676.23 	description readily available for the commissioner upon the commissioner's request.
676.24 		Subd. 4.Required intensive residential treatment services. (a) On a daily basis, the 
676.25 	license holder must follow a client's treatment plan to provide intensive residential treatment 
676.26 	services to the client to improve the client's functioning.
676.27 	(b) The license holder must offer and have the capacity to directly provide the following 
676.28 	treatment services to each client:
676.29 	(1) rehabilitative mental health services;
676.30 	(2) crisis prevention planning to assist a client with:
676.31 	(i) identifying and addressing patterns in the client's history and experience of the client's 
676.32 	mental illness; and
677.1 	(ii) developing crisis prevention strategies that include de-escalation strategies that have 
677.2 	been effective for the client in the past;
677.3 	(3) health services and administering medication;
677.4 	(4) co-occurring substance use disorder treatment;
677.5 	(5) engaging the client's family and other natural supports in the client's treatment and 
677.6 	educating the client's family and other natural supports to strengthen the client's social and 
677.7 	family relationships; and
677.8 	(6) making referrals for the client to other service providers in the community and 
677.9 	supporting the client's transition from intensive residential treatment services to another 
677.10 	setting.
677.11 	(c) The license holder must include Illness Management and Recovery (IMR), Enhanced 
677.12 	Illness Management and Recovery (E-IMR), or other similar interventions in the license 
677.13 	holder's programming as approved by the commissioner.
677.14 		Subd. 5.Required residential crisis stabilization services. (a) On a daily basis, the 
677.15 	license holder must follow a client's individual crisis treatment plan to provide services to 
677.16 	the client in residential crisis stabilization to improve the client's functioning.
677.17 	(b) The license holder must offer and have the capacity to directly provide the following 
677.18 	treatment services to the client:
677.19 	(1) crisis stabilization services as described in section 256B.0624, subdivision 7;
677.20 	(2) rehabilitative mental health services;
677.21 	(3) health services and administering the client's medications; and
677.22 	(4) making referrals for the client to other service providers in the community and 
677.23 	supporting the client's transition from residential crisis stabilization to another setting.
677.24 		Subd. 6.Optional treatment services. (a) If the license holder offers additional treatment 
677.25 	services to a client, the treatment service must be:
677.26 	(1) approved by the commissioner; and
677.27 	(2)(i) a mental health evidence-based practice that the federal Department of Health and 
677.28 	Human Services Substance Abuse and Mental Health Service Administration has adopted;
677.29 	(ii) a nationally recognized mental health service that substantial research has validated 
677.30 	as effective in helping individuals with serious mental illness achieve treatment goals; or
678.1 	(iii) developed under state-sponsored research of publicly funded mental health programs 
678.2 	and validated to be effective for individuals, families, and communities.
678.3 	(b) Before providing an optional treatment service to a client, the license holder must 
678.4 	provide adequate training to a staff person about providing the optional treatment service 
678.5 	to a client.
678.6 		Subd. 7.Intensive residential treatment services assessment and treatment 
678.7 	planning. (a) Within 12 hours of a client's admission, the license holder must evaluate and 
678.8 	document the client's immediate needs, including the client's:
678.9 	(1) health and safety, including the client's need for crisis assistance;
678.10 	(2) responsibilities for children, family and other natural supports, and employers; and
678.11 	(3) housing and legal issues.
678.12 	(b) Within 24 hours of the client's admission, the license holder must complete an initial 
678.13 	treatment plan for the client. The license holder must:
678.14 	(1) base the client's initial treatment plan on the client's referral information and an 
678.15 	assessment of the client's immediate needs;
678.16 	(2) consider crisis assistance strategies that have been effective for the client in the past;
678.17 	(3) identify the client's initial treatment goals, measurable treatment objectives, and 
678.18 	specific interventions that the license holder will use to help the client engage in treatment;
678.19 	(4) identify the participants involved in the client's treatment planning. The client must 
678.20 	be a participant; and
678.21 	(5) ensure that a treatment supervisor approves of the client's initial treatment plan if a 
678.22 	mental health practitioner or clinical trainee completes the client's treatment plan, 
678.23 	notwithstanding section 245I.08, subdivision 3.
678.24 	(c) According to section 245A.65, subdivision 2, paragraph (b), the license holder must 
678.25 	complete an individual abuse prevention plan as part of a client's initial treatment plan.
678.26 	(d) Within five days of the client's admission and again within 60 days after the client's 
678.27 	admission, the license holder must complete a level of care assessment of the client. If the 
678.28 	license holder determines that a client does not need a medically monitored level of service, 
678.29 	a treatment supervisor must document how the client's admission to and continued services 
678.30 	in intensive residential treatment services are medically necessary for the client.
679.1 	(e) Within ten days of a client's admission, the license holder must complete or review 
679.2 	and update the client's standard diagnostic assessment.
679.3 	(f) Within ten days of a client's admission, the license holder must complete the client's 
679.4 	individual treatment plan, notwithstanding section 245I.10, subdivision 8. Within 40 days 
679.5 	after the client's admission and again within 70 days after the client's admission, the license 
679.6 	holder must update the client's individual treatment plan. The license holder must focus the 
679.7 	client's treatment planning on preparing the client for a successful transition from intensive 
679.8 	residential treatment services to another setting. In addition to the required elements of an 
679.9 	individual treatment plan under section 245I.10, subdivision 8, the license holder must 
679.10 	identify the following information in the client's individual treatment plan: (1) the client's 
679.11 	referrals and resources for the client's health and safety; and (2) the staff persons who are 
679.12 	responsible for following up with the client's referrals and resources. If the client does not 
679.13 	receive a referral or resource that the client needs, the license holder must document the 
679.14 	reason that the license holder did not make the referral or did not connect the client to a 
679.15 	particular resource. The license holder is responsible for determining whether additional 
679.16 	follow-up is required on behalf of the client.
679.17 	(g) Within 30 days of the client's admission, the license holder must complete a functional 
679.18 	assessment of the client. Within 60 days after the client's admission, the license holder must 
679.19 	update the client's functional assessment to include any changes in the client's functioning 
679.20 	and symptoms.
679.21 	(h) For a client with a current substance use disorder diagnosis and for a client whose 
679.22 	substance use disorder screening in the client's standard diagnostic assessment indicates the 
679.23 	possibility that the client has a substance use disorder, the license holder must complete a 
679.24 	written assessment of the client's substance use within 30 days of the client's admission. In 
679.25 	the substance use assessment, the license holder must: (1) evaluate the client's history of 
679.26 	substance use, relapses, and hospitalizations related to substance use; (2) assess the effects 
679.27 	of the client's substance use on the client's relationships including with family member and 
679.28 	others; (3) identify financial problems, health issues, housing instability, and unemployment; 
679.29 	(4) assess the client's legal problems, past and pending incarceration, violence, and 
679.30 	victimization; and (5) evaluate the client's suicide attempts, noncompliance with taking 
679.31 	prescribed medications, and noncompliance with psychosocial treatment.
679.32 	(i) On a weekly basis, a mental health professional or certified rehabilitation specialist 
679.33 	must review each client's treatment plan and individual abuse prevention plan. The license 
679.34 	holder must document in the client's file each weekly review of the client's treatment plan 
679.35 	and individual abuse prevention plan.
680.1 		Subd. 8.Residential crisis stabilization assessment and treatment planning. (a) 
680.2 	Within 12 hours of a client's admission, the license holder must evaluate the client and 
680.3 	document the client's immediate needs, including the client's:
680.4 	(1) health and safety, including the client's need for crisis assistance;
680.5 	(2) responsibilities for children, family and other natural supports, and employers; and
680.6 	(3) housing and legal issues.
680.7 	(b) Within 24 hours of a client's admission, the license holder must complete a crisis 
680.8 	treatment plan for the client under section 256B.0624, subdivision 11. The license holder 
680.9 	must base the client's crisis treatment plan on the client's referral information and an 
680.10 	assessment of the client's immediate needs.
680.11 	(c) Section 245A.65, subdivision 2, paragraph (b), requires the license holder to complete 
680.12 	an individual abuse prevention plan for a client as part of the client's crisis treatment plan.
680.13 		Subd. 9.Key staff positions. (a) The license holder must have a staff person assigned 
680.14 	to each of the following key staff positions at all times:
680.15 	(1) a program director who qualifies as a mental health practitioner. The license holder 
680.16 	must designate the program director as responsible for all aspects of the operation of the 
680.17 	program and the program's compliance with all applicable requirements. The program 
680.18 	director must know and understand the implications of this chapter; chapters 245A, 245C, 
680.19 	and 260E; sections 626.557 and 626.5572; Minnesota Rules, chapter 9544; and all other 
680.20 	applicable requirements. The license holder must document in the program director's 
680.21 	personnel file how the program director demonstrates knowledge of these requirements. 
680.22 	The program director may also serve as the treatment director of the program, if qualified;
680.23 	(2) a treatment director who qualifies as a mental health professional. The treatment 
680.24 	director must be responsible for overseeing treatment services for clients and the treatment 
680.25 	supervision of all staff persons; and
680.26 	(3) a registered nurse who qualifies as a mental health practitioner. The registered nurse 
680.27 	must:
680.28 	(i) work at the program location a minimum of eight hours per week;
680.29 	(ii) provide monitoring and supervision of staff persons as defined in section 148.171, 
680.30 	subdivisions 8a and 23;
680.31 	(iii) be responsible for the review and approval of health service and medication policies 
680.32 	and procedures under section 245I.03, subdivision 5; and
681.1 	(iv) oversee the license holder's provision of health services to clients, medication storage, 
681.2 	and medication administration to clients.
681.3 	(b) Within five business days of a change in a key staff position, the license holder must 
681.4 	notify the commissioner of the staffing change. The license holder must notify the 
681.5 	commissioner of the staffing change on a form approved by the commissioner and include 
681.6 	the name of the staff person now assigned to the key staff position and the staff person's 
681.7 	qualifications.
681.8 		Subd. 10.Minimum treatment team staffing levels and ratios. (a) The license holder 
681.9 	must maintain a treatment team staffing level sufficient to:
681.10 	(1) provide continuous daily coverage of all shifts;
681.11 	(2) follow each client's treatment plan and meet each client's needs as identified in the 
681.12 	client's treatment plan;
681.13 	(3) implement program requirements; and
681.14 	(4) safely monitor and guide the activities of each client, taking into account the client's 
681.15 	level of behavioral and psychiatric stability, cultural needs, and vulnerabilities.
681.16 	(b) The license holder must ensure that treatment team members:
681.17 	(1) remain awake during all work hours; and
681.18 	(2) are available to monitor and guide the activities of each client whenever clients are 
681.19 	present in the program.
681.20 	(c) On each shift, the license holder must maintain a treatment team staffing ratio of at 
681.21 	least one treatment team member to nine clients. If the license holder is serving nine or 
681.22 	fewer clients, at least one treatment team member on the day shift must be a mental health 
681.23 	professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner. 
681.24 	If the license holder is serving more than nine clients, at least one of the treatment team 
681.25 	members working during both the day and evening shifts must be a mental health 
681.26 	professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner.
681.27 	(d) If the license holder provides residential crisis stabilization to clients and is serving 
681.28 	at least one client in residential crisis stabilization and more than four clients in residential 
681.29 	crisis stabilization and intensive residential treatment services, the license holder must 
681.30 	maintain a treatment team staffing ratio on each shift of at least two treatment team members 
681.31 	during the client's first 48 hours in residential crisis stabilization.
682.1 		Subd. 11.Shift exchange. A license holder must ensure that treatment team members 
682.2 	working on different shifts exchange information about a client as necessary to effectively 
682.3 	care for the client and to follow and update a client's treatment plan and individual abuse 
682.4 	prevention plan.
682.5 		Subd. 12.Daily documentation. (a) For each day that a client is present in the program, 
682.6 	the license holder must provide a daily summary in the client's file that includes observations 
682.7 	about the client's behavior and symptoms, including any critical incidents in which the client 
682.8 	was involved.
682.9 	(b) For each day that a client is not present in the program, the license holder must 
682.10 	document the reason for a client's absence in the client's file.
682.11 		Subd. 13.Access to a mental health professional, clinical trainee, certified 
682.12 	rehabilitation specialist, or mental health practitioner. Treatment team members must 
682.13 	have access in person or by telephone to a mental health professional, clinical trainee, 
682.14 	certified rehabilitation specialist, or mental health practitioner within 30 minutes. The license 
682.15 	holder must maintain a schedule of mental health professionals, clinical trainees, certified 
682.16 	rehabilitation specialists, or mental health practitioners who will be available and contact 
682.17 	information to reach them. The license holder must keep the schedule current and make the 
682.18 	schedule readily available to treatment team members.
682.19 		Subd. 14.Weekly team meetings. (a) The license holder must hold weekly team meetings 
682.20 	and ancillary meetings according to this subdivision.
682.21 	(b) A mental health professional or certified rehabilitation specialist must hold at least 
682.22 	one team meeting each calendar week and be physically present at the team meeting. All 
682.23 	treatment team members, including treatment team members who work on a part-time or 
682.24 	intermittent basis, must participate in a minimum of one team meeting during each calendar 
682.25 	week when the treatment team member is working for the license holder. The license holder 
682.26 	must document all weekly team meetings, including the names of meeting attendees.
682.27 	(c) If a treatment team member cannot participate in a weekly team meeting, the treatment 
682.28 	team member must participate in an ancillary meeting. A mental health professional, certified 
682.29 	rehabilitation specialist, clinical trainee, or mental health practitioner who participated in 
682.30 	the most recent weekly team meeting may lead the ancillary meeting. During the ancillary 
682.31 	meeting, the treatment team member leading the ancillary meeting must review the 
682.32 	information that was shared at the most recent weekly team meeting, including revisions 
682.33 	to client treatment plans and other information that the treatment supervisors exchanged 
683.1 	with treatment team members. The license holder must document all ancillary meetings, 
683.2 	including the names of meeting attendees.
683.3 		Subd. 15.Intensive residential treatment services admission criteria. (a) An eligible 
683.4 	client for intensive residential treatment services is an individual who:
683.5 	(1) is age 18 or older;
683.6 	(2) is diagnosed with a mental illness;
683.7 	(3) because of a mental illness, has a substantial disability and functional impairment 
683.8 	in three or more areas listed in section 245I.10, subdivision 9, clause (4), that markedly 
683.9 	reduce the individual's self-sufficiency;
683.10 	(4) has one or more of the following: a history of recurring or prolonged inpatient 
683.11 	hospitalizations during the past year, significant independent living instability, homelessness, 
683.12 	or very frequent use of mental health and related services with poor outcomes for the 
683.13 	individual; and
683.14 	(5) in the written opinion of a mental health professional, needs mental health services 
683.15 	that available community-based services cannot provide, or is likely to experience a mental 
683.16 	health crisis or require a more restrictive setting if the individual does not receive intensive 
683.17 	rehabilitative mental health services.
683.18 	(b) The license holder must not limit or restrict intensive residential treatment services 
683.19 	to a client based solely on:
683.20 	(1) the client's substance use;
683.21 	(2) the county in which the client resides; or
683.22 	(3) whether the client elects to receive other services for which the client may be eligible, 
683.23 	including case management services.
683.24 	(c) This subdivision does not prohibit the license holder from restricting admissions of 
683.25 	individuals who present an imminent risk of harm or danger to themselves or others.
683.26 		Subd. 16.Residential crisis stabilization services admission criteria. An eligible client 
683.27 	for residential crisis stabilization is an individual who is age 18 or older and meets the 
683.28 	eligibility criteria in section 256B.0624, subdivision 3.
683.29 		Subd. 17.Admissions referrals and determinations. (a) The license holder must 
683.30 	identify the information that the license holder needs to make a determination about a 
683.31 	person's admission referral.
684.1 	(b) The license holder must:
684.2 	(1) always be available to receive referral information about a person seeking admission 
684.3 	to the license holder's program;
684.4 	(2) respond to the referral source within eight hours of receiving a referral and, within 
684.5 	eight hours, communicate with the referral source about what information the license holder 
684.6 	needs to make a determination concerning the person's admission;
684.7 	(3) consider the license holder's staffing ratio and the areas of treatment team members' 
684.8 	competency when determining whether the license holder is able to meet the needs of a 
684.9 	person seeking admission; and
684.10 	(4) determine whether to admit a person within 72 hours of receiving all necessary 
684.11 	information from the referral source.
684.12 		Subd. 18.Discharge standards. (a) When a license holder discharges a client from a 
684.13 	program, the license holder must categorize the discharge as a successful discharge, 
684.14 	program-initiated discharge, or non-program-initiated discharge according to the criteria in 
684.15 	this subdivision. The license holder must meet the standards associated with the type of 
684.16 	discharge according to this subdivision.
684.17 	(b) To successfully discharge a client from a program, the license holder must ensure 
684.18 	that the following criteria are met:
684.19 	(1) the client must substantially meet the client's documented treatment plan goals and 
684.20 	objectives;
684.21 	(2) the client must complete discharge planning with the treatment team; and
684.22 	(3) the client and treatment team must arrange for the client to receive continuing care 
684.23 	at a less intensive level of care after discharge.
684.24 	(c) Prior to successfully discharging a client from a program, the license holder must 
684.25 	complete the client's discharge summary and provide the client with a copy of the client's 
684.26 	discharge summary in plain language that includes:
684.27 	(1) a brief review of the client's problems and strengths during the period that the license 
684.28 	holder provided services to the client;
684.29 	(2) the client's response to the client's treatment plan;
684.30 	(3) the goals and objectives that the license holder recommends that the client addresses 
684.31 	during the first three months following the client's discharge from the program;
685.1 	(4) the recommended actions, supports, and services that will assist the client with a 
685.2 	successful transition from the program to another setting;
685.3 	(5) the client's crisis plan; and
685.4 	(6) the client's forwarding address and telephone number.
685.5 	(d) For a non-program-initiated discharge of a client from a program, the following 
685.6 	criteria must be met:
685.7 	(1)(i) the client has withdrawn the client's consent for treatment; (ii) the license holder 
685.8 	has determined that the client has the capacity to make an informed decision; and (iii) the 
685.9 	client does not meet the criteria for an emergency hold under section 253B.051, subdivision 
685.10 	2;
685.11 	(2) the client has left the program against staff person advice;
685.12 	(3) an entity with legal authority to remove the client has decided to remove the client 
685.13 	from the program; or
685.14 	(4) a source of payment for the services is no longer available.
685.15 	(e) Within ten days of a non-program-initiated discharge of a client from a program, the 
685.16 	license holder must complete the client's discharge summary in plain language that includes:
685.17 	(1) the reasons for the client's discharge;
685.18 	(2) a description of attempts by staff persons to enable the client to continue treatment 
685.19 	or to consent to treatment; and
685.20 	(3) recommended actions, supports, and services that will assist the client with a 
685.21 	successful transition from the program to another setting.
685.22 	(f) For a program-initiated discharge of a client from a program, the following criteria 
685.23 	must be met:
685.24 	(1) the client is competent but has not participated in treatment or has not followed the 
685.25 	program rules and regulations and the client has not participated to such a degree that the 
685.26 	program's level of care is ineffective or unsafe for the client, despite multiple, documented 
685.27 	attempts that the license holder has made to address the client's lack of participation in 
685.28 	treatment;
685.29 	(2) the client has not made progress toward the client's treatment goals and objectives 
685.30 	despite the license holder's persistent efforts to engage the client in treatment, and the license 
685.31 	holder has no reasonable expectation that the client will make progress at the program's 
686.1 	level of care nor does the client require the program's level of care to maintain the current 
686.2 	level of functioning;
686.3 	(3) a court order or the client's legal status requires the client to participate in the program 
686.4 	but the client has left the program against staff person advice; or
686.5 	(4) the client meets criteria for a more intensive level of care and a more intensive level 
686.6 	of care is available to the client.
686.7 	(g) Prior to a program-initiated discharge of a client from a program, the license holder 
686.8 	must consult the client, the client's family and other natural supports, and the client's case 
686.9 	manager, if applicable, to review the issues involved in the program's decision to discharge 
686.10 	the client from the program. During the discharge review process, which must not exceed 
686.11 	five working days, the license holder must determine whether the license holder, treatment 
686.12 	team, and any interested persons can develop additional strategies to resolve the issues 
686.13 	leading to the client's discharge and to permit the client to have an opportunity to continue 
686.14 	receiving services from the license holder. The license holder may temporarily remove a 
686.15 	client from the program facility during the five-day discharge review period. The license 
686.16 	holder must document the client's discharge review in the client's file.
686.17 	(h) Prior to a program-initiated discharge of a client from the program, the license holder 
686.18 	must complete the client's discharge summary and provide the client with a copy of the 
686.19 	discharge summary in plain language that includes:
686.20 	(1) the reasons for the client's discharge;
686.21 	(2) the alternatives to discharge that the license holder considered or attempted to 
686.22 	implement;
686.23 	(3) the names of each individual who is involved in the decision to discharge the client 
686.24 	and a description of each individual's involvement; and
686.25 	(4) recommended actions, supports, and services that will assist the client with a 
686.26 	successful transition from the program to another setting.
686.27 		Subd. 19.Program facility. (a) The license holder must be licensed or certified as a 
686.28 	board and lodging facility, supervised living facility, or a boarding care home by the 
686.29 	Department of Health.
686.30 	(b) The license holder must have a capacity of five to 16 beds and the program must not 
686.31 	be declared as an institution for mental disease.
687.1 	(c) The license holder must furnish each program location to meet the psychological, 
687.2 	emotional, and developmental needs of clients.
687.3 	(d) The license holder must provide one living room or lounge area per program location. 
687.4 	There must be space available to provide services according to each client's treatment plan, 
687.5 	such as an area for learning recreation time skills and areas for learning independent living 
687.6 	skills, such as laundering clothes and preparing meals.
687.7 	(e) The license holder must ensure that each program location allows each client to have 
687.8 	privacy. Each client must have privacy during assessment interviews and counseling sessions. 
687.9 	Each client must have a space designated for the client to see outside visitors at the program 
687.10 	facility.
687.11 		Subd. 20.Physical separation of services. If the license holder offers services to 
687.12 	individuals who are not receiving intensive residential treatment services or residential 
687.13 	stabilization at the program location, the license holder must inform the commissioner and 
687.14 	submit a plan for approval to the commissioner about how and when the license holder will 
687.15 	provide services. The license holder must only provide services to clients who are not 
687.16 	receiving intensive residential treatment services or residential crisis stabilization in an area 
687.17 	that is physically separated from the area in which the license holder provides clients with 
687.18 	intensive residential treatment services or residential crisis stabilization.
687.19 		Subd. 21.Dividing staff time between locations. A license holder must obtain approval 
687.20 	from the commissioner prior to providing intensive residential treatment services or 
687.21 	residential crisis stabilization to clients in more than one program location under one license 
687.22 	and dividing one staff person's time between program locations during the same work period.
687.23 		Subd. 22.Additional policy and procedure requirements. (a) In addition to the policies 
687.24 	and procedures in section 245I.03, the license holder must establish, enforce, and maintain 
687.25 	the policies and procedures in this subdivision.
687.26 	(b) The license holder must have policies and procedures for receiving referrals and 
687.27 	making admissions determinations about referred persons under subdivisions 14 to 16.
687.28 	(c) The license holder must have policies and procedures for discharging clients under 
687.29 	subdivision 17. In the policies and procedures, the license holder must identify the staff 
687.30 	persons who are authorized to discharge clients from the program.
687.31 		Subd. 23.Quality assurance and improvement plan. (a) A license holder must develop 
687.32 	a written quality assurance and improvement plan that includes a plan to:
687.33 	(1) encourage ongoing consultation between members of the treatment team;
688.1 	(2) obtain and evaluate feedback about services from clients, family and other natural 
688.2 	supports, referral sources, and staff persons;
688.3 	(3) measure and evaluate client outcomes in the program;
688.4 	(4) review critical incidents in the program;
688.5 	(5) examine the quality of clinical services in the program; and
688.6 	(6) self-monitor the license holder's compliance with this chapter.
688.7 	(b) At least annually, the license holder must review, evaluate, and update the license 
688.8 	holder's quality assurance and improvement plan. The license holder's review must:
688.9 	(1) document the actions that the license holder will take in response to the information 
688.10 	that the license holder obtains from the monitoring activities in the plan; and
688.11 	(2) establish goals for improving the license holder's services to clients during the next 
688.12 	year.
688.13 		Subd. 24.Application. When an applicant requests licensure to provide intensive 
688.14 	residential treatment services, residential crisis stabilization, or both to clients, the applicant 
688.15 	must submit, on forms that the commissioner provides, any documents that the commissioner 
688.16 	requires.

688.17 	Sec. 17. [256B.0671] COVERED MENTAL HEALTH SERVICES.
688.18 		Subdivision 1.Definitions. (a) "Clinical trainee" means a staff person who is qualified 
688.19 	under section 245I.04, subdivision 6.
688.20 	(b) "Mental health practitioner" means a staff person who is qualified under section 
688.21 	245I.04, subdivision 4.
688.22 	(c) "Mental health professional" means a staff person who is qualified under section 
688.23 	245I.04, subdivision 2.
688.24 		Subd. 2.Generally. (a) An individual, organization, or government entity providing 
688.25 	mental health services to a client under this section must obtain a criminal background study 
688.26 	of each staff person or volunteer who is providing direct contact services to a client.
688.27 	(b) An individual, organization, or government entity providing mental health services 
688.28 	to a client under this section must comply with all responsibilities that chapter 245I assigns 
688.29 	to a license holder, except section 245I.011, subdivision 1, unless all of the individual's, 
688.30 	organization's, or government entity's treatment staff are qualified as mental health 
688.31 	professionals.
689.1 	(c) An individual, organization, or government entity providing mental health services 
689.2 	to a client under this section must comply with the following requirements if all of the 
689.3 	license holder's treatment staff are qualified as mental health professionals:
689.4 	(1) provider qualifications and scopes of practice under section 245I.04;
689.5 	(2) maintaining and updating personnel files under section 245I.07;
689.6 	(3) documenting under section 245I.08;
689.7 	(4) maintaining and updating client files under section 245I.09;
689.8 	(5) completing client assessments and treatment planning under section 245I.10;
689.9 	(6) providing clients with health services and medications under section 245I.11; and
689.10 	(7) respecting and enforcing client rights under section 245I.12.
689.11 		Subd. 3.Adult day treatment services. (a) Subject to federal approval, medical 
689.12 	assistance covers adult day treatment (ADT) services that are provided under contract with 
689.13 	the county board. Adult day treatment payment is subject to the conditions in paragraphs 
689.14 	(b) to (e). The provider must make reasonable and good faith efforts to report individual 
689.15 	client outcomes to the commissioner using instruments, protocols, and forms approved by 
689.16 	the commissioner.
689.17 	(b) Adult day treatment is an intensive psychotherapeutic treatment to reduce or relieve 
689.18 	the effects of mental illness on a client to enable the client to benefit from a lower level of 
689.19 	care and to live and function more independently in the community. Adult day treatment 
689.20 	services must be provided to a client to stabilize the client's mental health and to improve 
689.21 	the client's independent living and socialization skills. Adult day treatment must consist of 
689.22 	at least one hour of group psychotherapy and must include group time focused on 
689.23 	rehabilitative interventions or other therapeutic services that a multidisciplinary team provides 
689.24 	to each client. Adult day treatment services are not a part of inpatient or residential treatment 
689.25 	services. The following providers may apply to become adult day treatment providers:
689.26 	(1) a hospital accredited by the Joint Commission on Accreditation of Health 
689.27 	Organizations and licensed under sections 144.50 to 144.55;
689.28 	(2) a community mental health center under section 256B.0625, subdivision 5; or
689.29 	(3) an entity that is under contract with the county board to operate a program that meets 
689.30 	the requirements of section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170 
689.31 	to 9505.0475.
689.32 	(c) An adult day treatment (ADT) services provider must:
690.1 	(1) ensure that the commissioner has approved of the organization as an adult day 
690.2 	treatment provider organization;
690.3 	(2) ensure that a multidisciplinary team provides ADT services to a group of clients. A 
690.4 	mental health professional must supervise each multidisciplinary staff person who provides 
690.5 	ADT services;
690.6 	(3) make ADT services available to the client at least two days a week for at least three 
690.7 	consecutive hours per day. ADT services may be longer than three hours per day, but medical 
690.8 	assistance may not reimburse a provider for more than 15 hours per week;
690.9 	(4) provide ADT services to each client that includes group psychotherapy by a mental 
690.10 	health professional or clinical trainee and daily rehabilitative interventions by a mental 
690.11 	health professional, clinical trainee, or mental health practitioner; and
690.12 	(5) include ADT services in the client's individual treatment plan, when appropriate. 
690.13 	The adult day treatment provider must:
690.14 	(i) complete a functional assessment of each client under section 245I.10, subdivision 
690.15 	9;
690.16 	(ii) notwithstanding section 245I.10, subdivision 8, review the client's progress and 
690.17 	update the individual treatment plan at least every 90 days until the client is discharged 
690.18 	from the program; and
690.19 	(iii) include a discharge plan for the client in the client's individual treatment plan.
690.20 	(d) To be eligible for adult day treatment, a client must:
690.21 	(1) be 18 years of age or older;
690.22 	(2) not reside in a nursing facility, hospital, institute of mental disease, or state-operated 
690.23 	treatment center unless the client has an active discharge plan that indicates a move to an 
690.24 	independent living setting within 180 days;
690.25 	(3) have the capacity to engage in rehabilitative programming, skills activities, and 
690.26 	psychotherapy in the structured, therapeutic setting of an adult day treatment program and 
690.27 	demonstrate measurable improvements in functioning resulting from participation in the 
690.28 	adult day treatment program;
690.29 	(4) have a level of care assessment under section 245I.02, subdivision 19, recommending 
690.30 	that the client participate in services with the level of intensity and duration of an adult day 
690.31 	treatment program; and
691.1 	(5) have the recommendation of a mental health professional for adult day treatment 
691.2 	services. The mental health professional must find that adult day treatment services are 
691.3 	medically necessary for the client.
691.4 	(e) Medical assistance does not cover the following services as adult day treatment 
691.5 	services:
691.6 	(1) services that are primarily recreational or that are provided in a setting that is not 
691.7 	under medical supervision, including sports activities, exercise groups, craft hours, leisure 
691.8 	time, social hours, meal or snack time, trips to community activities, and tours;
691.9 	(2) social or educational services that do not have or cannot reasonably be expected to 
691.10 	have a therapeutic outcome related to the client's mental illness;
691.11 	(3) consultations with other providers or service agency staff persons about the care or 
691.12 	progress of a client;
691.13 	(4) prevention or education programs that are provided to the community;
691.14 	(5) day treatment for clients with a primary diagnosis of a substance use disorder;
691.15 	(6) day treatment provided in the client's home;
691.16 	(7) psychotherapy for more than two hours per day; and
691.17 	(8) participation in meal preparation and eating that is not part of a clinical treatment 
691.18 	plan to address the client's eating disorder.
691.19 		Subd. 4.Explanation of findings. (a) Subject to federal approval, medical assistance 
691.20 	covers an explanation of findings that a mental health professional or clinical trainee provides 
691.21 	when the provider has obtained the authorization from the client or the client's representative 
691.22 	to release the information.
691.23 	(b) A mental health professional or clinical trainee provides an explanation of findings 
691.24 	to assist the client or related parties in understanding the results of the client's testing or 
691.25 	diagnostic assessment and the client's mental illness, and provides professional insight that 
691.26 	the client or related parties need to carry out a client's treatment plan. Related parties may 
691.27 	include the client's family and other natural supports and other service providers working 
691.28 	with the client.
691.29 	(c) An explanation of findings is not paid for separately when a mental health professional 
691.30 	or clinical trainee explains the results of psychological testing or a diagnostic assessment 
691.31 	to the client or the client's representative as part of the client's psychological testing or a 
691.32 	diagnostic assessment.
692.1 		Subd. 5.Family psychoeducation services. (a) Subject to federal approval, medical 
692.2 	assistance covers family psychoeducation services provided to a child up to age 21 with a 
692.3 	diagnosed mental health condition when identified in the child's individual treatment plan 
692.4 	and provided by a mental health professional or a clinical trainee who has determined it 
692.5 	medically necessary to involve family members in the child's care.
692.6 	(b) "Family psychoeducation services" means information or demonstration provided 
692.7 	to an individual or family as part of an individual, family, multifamily group, or peer group 
692.8 	session to explain, educate, and support the child and family in understanding a child's 
692.9 	symptoms of mental illness, the impact on the child's development, and needed components 
692.10 	of treatment and skill development so that the individual, family, or group can help the child 
692.11 	to prevent relapse, prevent the acquisition of comorbid disorders, and achieve optimal mental 
692.12 	health and long-term resilience.
692.13 		Subd. 6.Dialectical behavior therapy. (a) Subject to federal approval, medical assistance 
692.14 	covers intensive mental health outpatient treatment for dialectical behavior therapy for 
692.15 	adults. A dialectical behavior therapy provider must make reasonable and good faith efforts 
692.16 	to report individual client outcomes to the commissioner using instruments and protocols 
692.17 	that are approved by the commissioner.
692.18 	(b) "Dialectical behavior therapy" means an evidence-based treatment approach that a 
692.19 	mental health professional or clinical trainee provides to a client or a group of clients in an 
692.20 	intensive outpatient treatment program using a combination of individualized rehabilitative 
692.21 	and psychotherapeutic interventions. A dialectical behavior therapy program involves: 
692.22 	individual dialectical behavior therapy, group skills training, telephone coaching, and team 
692.23 	consultation meetings.
692.24 	(c) To be eligible for dialectical behavior therapy, a client must:
692.25 	(1) be 18 years of age or older;
692.26 	(2) have mental health needs that available community-based services cannot meet or 
692.27 	that the client must receive concurrently with other community-based services;
692.28 	(3) have either:
692.29 	(i) a diagnosis of borderline personality disorder; or
692.30 	(ii) multiple mental health diagnoses, exhibit behaviors characterized by impulsivity or 
692.31 	intentional self-harm, and be at significant risk of death, morbidity, disability, or severe 
692.32 	dysfunction in multiple areas of the client's life;
693.1 	(4) be cognitively capable of participating in dialectical behavior therapy as an intensive 
693.2 	therapy program and be able and willing to follow program policies and rules to ensure the 
693.3 	safety of the client and others; and
693.4 	(5) be at significant risk of one or more of the following if the client does not receive 
693.5 	dialectical behavior therapy:
693.6 	(i) having a mental health crisis;
693.7 	(ii) requiring a more restrictive setting such as hospitalization;
693.8 	(iii) decompensating; or
693.9 	(iv) engaging in intentional self-harm behavior.
693.10 	(d) Individual dialectical behavior therapy combines individualized rehabilitative and 
693.11 	psychotherapeutic interventions to treat a client's suicidal and other dysfunctional behaviors 
693.12 	and to reinforce a client's use of adaptive skillful behaviors. A mental health professional 
693.13 	or clinical trainee must provide individual dialectical behavior therapy to a client. A mental 
693.14 	health professional or clinical trainee providing dialectical behavior therapy to a client must:
693.15 	(1) identify, prioritize, and sequence the client's behavioral targets;
693.16 	(2) treat the client's behavioral targets;
693.17 	(3) assist the client in applying dialectical behavior therapy skills to the client's natural 
693.18 	environment through telephone coaching outside of treatment sessions;
693.19 	(4) measure the client's progress toward dialectical behavior therapy targets;
693.20 	(5) help the client manage mental health crises and life-threatening behaviors; and
693.21 	(6) help the client learn and apply effective behaviors when working with other treatment 
693.22 	providers.
693.23 	(e) Group skills training combines individualized psychotherapeutic and psychiatric 
693.24 	rehabilitative interventions conducted in a group setting to reduce the client's suicidal and 
693.25 	other dysfunctional coping behaviors and restore function. Group skills training must teach 
693.26 	the client adaptive skills in the following areas: (1) mindfulness; (2) interpersonal 
693.27 	effectiveness; (3) emotional regulation; and (4) distress tolerance.
693.28 	(f) Group skills training must be provided by two mental health professionals or by a 
693.29 	mental health professional co-facilitating with a clinical trainee or a mental health practitioner. 
693.30 	Individual skills training must be provided by a mental health professional, a clinical trainee, 
693.31 	or a mental health practitioner.
694.1 	(g) Before a program provides dialectical behavior therapy to a client, the commissioner 
694.2 	must certify the program as a dialectical behavior therapy provider. To qualify for 
694.3 	certification as a dialectical behavior therapy provider, a provider must:
694.4 	(1) allow the commissioner to inspect the provider's program;
694.5 	(2) provide evidence to the commissioner that the program's policies, procedures, and 
694.6 	practices meet the requirements of this subdivision and chapter 245I;
694.7 	(3) be enrolled as a MHCP provider; and
694.8 	(4) have a manual that outlines the program's policies, procedures, and practices that 
694.9 	meet the requirements of this subdivision.
694.10 		Subd. 7.Mental health clinical care consultation. (a) Subject to federal approval, 
694.11 	medical assistance covers clinical care consultation for a person up to age 21 who is 
694.12 	diagnosed with a complex mental health condition or a mental health condition that co-occurs 
694.13 	with other complex and chronic conditions, when described in the person's individual 
694.14 	treatment plan and provided by a mental health professional or a clinical trainee.
694.15 	(b) "Clinical care consultation" means communication from a treating mental health 
694.16 	professional to other providers or educators not under the treatment supervision of the 
694.17 	treating mental health professional who are working with the same client to inform, inquire, 
694.18 	and instruct regarding the client's symptoms; strategies for effective engagement, care, and 
694.19 	intervention needs; and treatment expectations across service settings and to direct and 
694.20 	coordinate clinical service components provided to the client and family.
694.21 		Subd. 8.Neuropsychological assessment. (a) Subject to federal approval, medical 
694.22 	assistance covers a client's neuropsychological assessment.
694.23 	(b) Neuropsychological assessment" means a specialized clinical assessment of the 
694.24 	client's underlying cognitive abilities related to thinking, reasoning, and judgment that is 
694.25 	conducted by a qualified neuropsychologist. A neuropsychological assessment must include 
694.26 	a face-to-face interview with the client, interpretation of the test results, and preparation 
694.27 	and completion of a report.
694.28 	(c) A client is eligible for a neuropsychological assessment if the client meets at least 
694.29 	one of the following criteria:
694.30 	(1) the client has a known or strongly suspected brain disorder based on the client's 
694.31 	medical history or the client's prior neurological evaluation, including a history of significant 
694.32 	head trauma, brain tumor, stroke, seizure disorder, multiple sclerosis, neurodegenerative 
694.33 	disorder, significant exposure to neurotoxins, central nervous system infection, metabolic 
695.1 	or toxic encephalopathy, fetal alcohol syndrome, or congenital malformation of the brain; 
695.2 	or
695.3 	(2) the client has cognitive or behavioral symptoms that suggest that the client has an 
695.4 	organic condition that cannot be readily attributed to functional psychopathology or suspected 
695.5 	neuropsychological impairment in addition to functional psychopathology. The client's 
695.6 	symptoms may include:
695.7 	(i) having a poor memory or impaired problem solving;
695.8 	(ii) experiencing change in mental status evidenced by lethargy, confusion, or 
695.9 	disorientation;
695.10 	(iii) experiencing a deteriorating level of functioning;
695.11 	(iv) displaying a marked change in behavior or personality;
695.12 	(v) in a child or an adolescent, having significant delays in acquiring academic skill or 
695.13 	poor attention relative to peers;
695.14 	(vi) in a child or an adolescent, having reached a significant plateau in expected 
695.15 	development of cognitive, social, emotional, or physical functioning relative to peers; and
695.16 	(vii) in a child or an adolescent, significant inability to develop expected knowledge, 
695.17 	skills, or abilities to adapt to new or changing cognitive, social, emotional, or physical 
695.18 	demands.
695.19 	(d) The neuropsychological assessment must be completed by a neuropsychologist who:
695.20 	(1) was awarded a diploma by the American Board of Clinical Neuropsychology, the 
695.21 	American Board of Professional Neuropsychology, or the American Board of Pediatric 
695.22 	Neuropsychology;
695.23 	(2) earned a doctoral degree in psychology from an accredited university training program 
695.24 	and:
695.25 	(i) completed an internship or its equivalent in a clinically relevant area of professional 
695.26 	psychology;
695.27 	(ii) completed the equivalent of two full-time years of experience and specialized training, 
695.28 	at least one of which is at the postdoctoral level, supervised by a clinical neuropsychologist 
695.29 	in the study and practice of clinical neuropsychology and related neurosciences; and
695.30 	(iii) holds a current license to practice psychology independently according to sections 
695.31 	144.88 to 144.98;
696.1 	(3) is licensed or credentialed by another state's board of psychology examiners in the 
696.2 	specialty of neuropsychology using requirements equivalent to requirements specified by 
696.3 	one of the boards named in clause (1); or
696.4 	(4) was approved by the commissioner as an eligible provider of neuropsychological 
696.5 	assessments prior to December 31, 2010.
696.6 		Subd. 9.Neuropsychological testing. (a) Subject to federal approval, medical assistance 
696.7 	covers neuropsychological testing for clients.
696.8 	(b) "Neuropsychological testing" means administering standardized tests and measures 
696.9 	designed to evaluate the client's ability to attend to, process, interpret, comprehend, 
696.10 	communicate, learn, and recall information and use problem solving and judgment.
696.11 	(c) Medical assistance covers neuropsychological testing of a client when the client:
696.12 	(1) has a significant mental status change that is not a result of a metabolic disorder and 
696.13 	that has failed to respond to treatment;
696.14 	(2) is a child or adolescent with a significant plateau in expected development of 
696.15 	cognitive, social, emotional, or physical function relative to peers;
696.16 	(3) is a child or adolescent with a significant inability to develop expected knowledge, 
696.17 	skills, or abilities to adapt to new or changing cognitive, social, physical, or emotional 
696.18 	demands; or
696.19 	(4) has a significant behavioral change, memory loss, or suspected neuropsychological 
696.20 	impairment in addition to functional psychopathology, or other organic brain injury or one 
696.21 	of the following:
696.22 	(i) traumatic brain injury;
696.23 	(ii) stroke;
696.24 	(iii) brain tumor;
696.25 	(iv) substance use disorder;
696.26 	(v) cerebral anoxic or hypoxic episode;
696.27 	(vi) central nervous system infection or other infectious disease;
696.28 	(vii) neoplasms or vascular injury of the central nervous system;
696.29 	(viii) neurodegenerative disorders;
696.30 	(ix) demyelinating disease;
697.1 	(x) extrapyramidal disease;
697.2 	(xi) exposure to systemic or intrathecal agents or cranial radiation known to be associated 
697.3 	with cerebral dysfunction;
697.4 	(xii) systemic medical conditions known to be associated with cerebral dysfunction, 
697.5 	including renal disease, hepatic encephalopathy, cardiac anomaly, sickle cell disease, and 
697.6 	related hematologic anomalies, and autoimmune disorders, including lupus, erythematosus, 
697.7 	or celiac disease;
697.8 	(xiii) congenital genetic or metabolic disorders known to be associated with cerebral 
697.9 	dysfunction, including phenylketonuria, craniofacial syndromes, or congenital hydrocephalus;
697.10 	(xiv) severe or prolonged nutrition or malabsorption syndromes; or
697.11 	(xv) a condition presenting in a manner difficult for a clinician to distinguish between 
697.12 	the neurocognitive effects of a neurogenic syndrome, including dementia or encephalopathy; 
697.13 	and a major depressive disorder when adequate treatment for major depressive disorder has 
697.14 	not improved the client's neurocognitive functioning; or another disorder, including autism, 
697.15 	selective mutism, anxiety disorder, or reactive attachment disorder.
697.16 	(d) Neuropsychological testing must be administered or clinically supervised by a 
697.17 	qualified neuropsychologist under subdivision 8, paragraph (c).
697.18 	(e) Medical assistance does not cover neuropsychological testing of a client when the 
697.19 	testing is:
697.20 	(1) primarily for educational purposes;
697.21 	(2) primarily for vocational counseling or training;
697.22 	(3) for personnel or employment testing;
697.23 	(4) a routine battery of psychological tests given to the client at the client's inpatient 
697.24 	admission or during a client's continued inpatient stay; or
697.25 	(5) for legal or forensic purposes.
697.26 		Subd. 10.Psychological testing. (a) Subject to federal approval, medical assistance 
697.27 	covers psychological testing of a client.
697.28 	(b) "Psychological testing" means the use of tests or other psychometric instruments to 
697.29 	determine the status of a client's mental, intellectual, and emotional functioning.
697.30 	(c) The psychological testing must:
698.1 	(1) be administered or supervised by a licensed psychologist qualified under section 
698.2 	245I.04, subdivision 2, clause (3), who is competent in the area of psychological testing; 
698.3 	and
698.4 	(2) be validated in a face-to-face interview between the client and a licensed psychologist 
698.5 	or a clinical trainee in psychology under the treatment supervision of a licensed psychologist 
698.6 	under section 245I.06.
698.7 	(d) A licensed psychologist must supervise the administration, scoring, and interpretation 
698.8 	of a client's psychological tests when a clinical psychology trainee, technician, psychometrist, 
698.9 	or psychological assistant or a computer-assisted psychological testing program completes 
698.10 	the psychological testing of the client. The report resulting from the psychological testing 
698.11 	must be signed by the licensed psychologist who conducts the face-to-face interview with 
698.12 	the client. The licensed psychologist or a staff person who is under treatment supervision 
698.13 	must place the client's psychological testing report in the client's record and release one 
698.14 	copy of the report to the client and additional copies to individuals authorized by the client 
698.15 	to receive the report.
698.16 		Subd. 11.Psychotherapy. (a) Subject to federal approval, medical assistance covers 
698.17 	psychotherapy for a client.
698.18 	(b) "Psychotherapy" means treatment of a client with mental illness that applies to the 
698.19 	most appropriate psychological, psychiatric, psychosocial, or interpersonal method that 
698.20 	conforms to prevailing community standards of professional practice to meet the mental 
698.21 	health needs of the client. Medical assistance covers psychotherapy if a mental health 
698.22 	professional or a clinical trainee provides psychotherapy to a client.
698.23 	(c) "Individual psychotherapy" means psychotherapy that a mental health professional 
698.24 	or clinical trainee designs for a client.
698.25 	(d) "Family psychotherapy" means psychotherapy that a mental health professional or 
698.26 	clinical trainee designs for a client and one or more of the client's family members or primary 
698.27 	caregiver whose participation is necessary to accomplish the client's treatment goals. Family 
698.28 	members or primary caregivers participating in a therapy session do not need to be eligible 
698.29 	for medical assistance for medical assistance to cover family psychotherapy. For purposes 
698.30 	of this paragraph, "primary caregiver whose participation is necessary to accomplish the 
698.31 	client's treatment goals" excludes shift or facility staff persons who work at the client's 
698.32 	residence. Medical assistance payments for family psychotherapy are limited to face-to-face 
698.33 	sessions during which the client is present throughout the session, unless the mental health 
698.34 	professional or clinical trainee believes that the client's exclusion from the family 
699.1 	psychotherapy session is necessary to meet the goals of the client's individual treatment 
699.2 	plan. If the client is excluded from a family psychotherapy session, a mental health 
699.3 	professional or clinical trainee must document the reason for the client's exclusion and the 
699.4 	length of time that the client is excluded. The mental health professional must also document 
699.5 	any reason that a member of the client's family is excluded from a psychotherapy session.
699.6 	(e) Group psychotherapy is appropriate for a client who, because of the nature of the 
699.7 	client's emotional, behavioral, or social dysfunctions, can benefit from treatment in a group 
699.8 	setting. For a group of three to eight clients, at least one mental health professional or clinical 
699.9 	trainee must provide psychotherapy to the group. For a group of nine to 12 clients, a team 
699.10 	of at least two mental health professionals or two clinical trainees or one mental health 
699.11 	professional and one clinical trainee must provide psychotherapy to the group. Medical 
699.12 	assistance will cover group psychotherapy for a group of no more than 12 persons.
699.13 	(f) A multiple-family group psychotherapy session is eligible for medical assistance if 
699.14 	a mental health professional or clinical trainee designs the psychotherapy session for at least 
699.15 	two but not more than five families. A mental health professional or clinical trainee must 
699.16 	design multiple-family group psychotherapy sessions to meet the treatment needs of each 
699.17 	client. If the client is excluded from a psychotherapy session, the mental health professional 
699.18 	or clinical trainee must document the reason for the client's exclusion and the length of time 
699.19 	that the client was excluded. The mental health professional or clinical trainee must document 
699.20 	any reason that a member of the client's family was excluded from a psychotherapy session.
699.21 		Subd. 12.Partial hospitalization. (a) Subject to federal approval, medical assistance 
699.22 	covers a client's partial hospitalization.
699.23 	(b) "Partial hospitalization" means a provider's time-limited, structured program of 
699.24 	psychotherapy and other therapeutic services, as defined in United States Code, title 42, 
699.25 	chapter 7, subchapter XVIII, part E, section 1395x(ff), that a multidisciplinary staff person 
699.26 	provides in an outpatient hospital facility or community mental health center that meets 
699.27 	Medicare requirements to provide partial hospitalization services to a client.
699.28 	(c) Partial hospitalization is an appropriate alternative to inpatient hospitalization for a 
699.29 	client who is experiencing an acute episode of mental illness who meets the criteria for an 
699.30 	inpatient hospital admission under Minnesota Rules, part 9505.0520, subpart 1, and who 
699.31 	has family and community resources that support the client's residence in the community. 
699.32 	Partial hospitalization consists of multiple intensive short-term therapeutic services for a 
699.33 	client that a multidisciplinary staff person provides to a client to treat the client's mental 
699.34 	illness.
700.1 		Subd. 13.Diagnostic assessments. Subject to federal approval, medical assistance covers 
700.2 	a client's diagnostic assessments that a mental health professional or clinical trainee completes 
700.3 	under section 245I.10.

700.4 	Sec. 18. DIRECTION TO COMMISSIONER; SINGLE COMPREHENSIVE 
700.5 	LICENSE STRUCTURE.
 700.6 	The commissioner of human services, in consultation with stakeholders including 
700.7 	counties, tribes, managed care organizations, provider organizations, advocacy groups, and 
700.8 	clients and clients' families, shall develop recommendations to develop a single 
700.9 	comprehensive licensing structure for mental health service programs, including outpatient 
700.10 	and residential services for adults and children. The recommendations must prioritize 
700.11 	program integrity, the welfare of clients and clients' families, improved integration of mental 
700.12 	health and substance use disorder services, and the reduction of administrative burden on 
700.13 	providers.

700.14 	Sec. 19. EFFECTIVE DATE.
 700.15 	This article is effective July 1, 2022, or upon federal approval, whichever is later. The 
700.16 	commissioner of human services shall notify the revisor of statutes when federal approval 
700.17 	is obtained.

700.18 	ARTICLE 18
700.19 	CRISIS RESPONSE SERVICES

700.20 	Section 1. Minnesota Statutes 2020, section 245.469, subdivision 1, is amended to read:
700.21 		Subdivision 1.Availability of emergency services. By July 1, 1988,(a) County boards 
700.22 	must provide or contract for enough emergency services within the county to meet the needs 
700.23 	of adults, children, and families in the county who are experiencing an emotional crisis or 
700.24 	mental illness. Clients may be required to pay a fee according to section 245.481.Emergency 
700.25 	service providers must not delay the timely provision of emergency services to a client 
700.26 	because of the unwillingness or inability of the client to pay for services. Emergency services 
700.27 	must include assessment, crisis intervention, and appropriate case disposition. Emergency 
700.28 	services must:
700.29 	(1) promote the safety and emotional stability of adults with mental illness or emotional 
700.30 	crises each client;
701.1 	(2) minimize further deterioration of adults with mental illness or emotional crises each 
701.2 	client;
701.3 	(3) help adults with mental illness or emotional crises each client to obtain ongoing care 
701.4 	and treatment; and
701.5 	(4) prevent placement in settings that are more intensive, costly, or restrictive than 
701.6 	necessary and appropriate to meet client needs.; and
701.7 	(5) provide support, psychoeducation, and referrals to each client's family members, 
701.8 	service providers, and other third parties on behalf of the client in need of emergency 
701.9 	services.
701.10 	(b) If a county provides engagement services under section 253B.041, the county's 
701.11 	emergency service providers must refer clients to engagement services when the client 
701.12 	meets the criteria for engagement services.

701.13 	Sec. 2. Minnesota Statutes 2020, section 245.469, subdivision 2, is amended to read:
701.14 		Subd. 2.Specific requirements. (a) The county board shall require that all service 
701.15 	providers of emergency services to adults with mental illness provide immediate direct 
701.16 	access to a mental health professional during regular business hours. For evenings, weekends, 
701.17 	and holidays, the service may be by direct toll-free telephone access to a mental health 
701.18 	professional, a clinical trainee, or mental health practitioner, or until January 1, 1991, a 
701.19 	designated person with training in human services who receives clinical supervision from 
701.20 	a mental health professional.
701.21 	(b) The commissioner may waive the requirement in paragraph (a) that the evening, 
701.22 	weekend, and holiday service be provided by a mental health professional, clinical trainee,
701.23 	or mental health practitioner after January 1, 1991, if the county documents that:
701.24 	(1) mental health professionals, clinical trainees, or mental health practitioners are 
701.25 	unavailable to provide this service;
701.26 	(2) services are provided by a designated person with training in human services who 
701.27 	receives clinical treatment supervision from a mental health professional; and
701.28 	(3) the service provider is not also the provider of fire and public safety emergency 
701.29 	services.
701.30 	(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the 
701.31 	evening, weekend, and holiday service not be provided by the provider of fire and public 
701.32 	safety emergency services if:
702.1 	(1) every person who will be providing the first telephone contact has received at least 
702.2 	eight hours of training on emergency mental health services reviewed by the state advisory 
702.3 	council on mental health and then approved by the commissioner;
702.4 	(2) every person who will be providing the first telephone contact will annually receive 
702.5 	at least four hours of continued training on emergency mental health services reviewed by 
702.6 	the state advisory council on mental health and then approved by the commissioner;
702.7 	(3) the local social service agency has provided public education about available 
702.8 	emergency mental health services and can assure potential users of emergency services that 
702.9 	their calls will be handled appropriately;
702.10 	(4) the local social service agency agrees to provide the commissioner with accurate 
702.11 	data on the number of emergency mental health service calls received;
702.12 	(5) the local social service agency agrees to monitor the frequency and quality of 
702.13 	emergency services; and
702.14 	(6) the local social service agency describes how it will comply with paragraph (d).
702.15 	(d) Whenever emergency service during nonbusiness hours is provided by anyone other 
702.16 	than a mental health professional, a mental health professional must be available on call for 
702.17 	an emergency assessment and crisis intervention services, and must be available for at least 
702.18 	telephone consultation within 30 minutes.

702.19 	Sec. 3. Minnesota Statutes 2020, section 245.4879, subdivision 1, is amended to read:
702.20 		Subdivision 1.Availability of emergency services. County boards must provide or 
702.21 	contract for enough mental health emergency services within the county to meet the needs 
702.22 	of children, and children's families when clinically appropriate, in the county who are 
702.23 	experiencing an emotional crisis or emotional disturbance. The county board shall ensure 
702.24 	that parents, providers, and county residents are informed about when and how to access 
702.25 	emergency mental health services for children. A child or the child's parent may be required 
702.26 	to pay a fee according to section 245.481. Emergency service providers shall not delay the 
702.27 	timely provision of emergency service because of delays in determining this fee or because 
702.28 	of the unwillingness or inability of the parent to pay the fee. Emergency services must 
702.29 	include assessment, crisis intervention, and appropriate case disposition. Emergency services 
702.30 	must: according to section 245.469.
702.31 	(1) promote the safety and emotional stability of children with emotional disturbances 
702.32 	or emotional crises;
703.1 	(2) minimize further deterioration of the child with emotional disturbance or emotional 
703.2 	crisis;
703.3 	(3) help each child with an emotional disturbance or emotional crisis to obtain ongoing 
703.4 	care and treatment; and
703.5 	(4) prevent placement in settings that are more intensive, costly, or restrictive than 
703.6 	necessary and appropriate to meet the child's needs.

703.7 	Sec. 4. Minnesota Statutes 2020, section 256B.0624, is amended to read:
703.8 	256B.0624 ADULT CRISIS RESPONSE SERVICES COVERED.
703.9 		Subdivision 1.Scope. Medical assistance covers adult mental health crisis response 
703.10 	services as defined in subdivision 2, paragraphs (c) to (e),(a) Subject to federal approval, 
703.11 	if provided to a recipient as defined in subdivision 3 and provided by a qualified provider 
703.12 	entity as defined in this section and by a qualified individual provider working within the 
703.13 	provider's scope of practice and as defined in this subdivision and identified in the recipient's 
703.14 	individual crisis treatment plan as defined in subdivision 11 and if determined to be medically 
703.15 	necessary medical assistance covers medically necessary crisis response services when the 
703.16 	services are provided according to the standards in this section.
703.17 	(b) Subject to federal approval, medical assistance covers medically necessary residential 
703.18 	crisis stabilization for adults when the services are provided by an entity licensed under and 
703.19 	meeting the standards in section 245I.23 or an entity with an adult foster care license meeting 
703.20 	the standards in this section.
703.21 	(c) The provider entity must make reasonable and good faith efforts to report individual 
703.22 	client outcomes to the commissioner using instruments and protocols approved by the 
703.23 	commissioner.
703.24 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
703.25 	given them.
703.26 	(a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation 
703.27 	which, but for the provision of crisis response services, would likely result in significantly 
703.28 	reduced levels of functioning in primary activities of daily living, or in an emergency 
703.29 	situation, or in the placement of the recipient in a more restrictive setting, including, but 
703.30 	not limited to, inpatient hospitalization.
704.1 	(b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric situation 
704.2 	which causes an immediate need for mental health services and is consistent with section 
704.3 	62Q.55.
704.4 	A mental health crisis or emergency is determined for medical assistance service 
704.5 	reimbursement by a physician, a mental health professional, or crisis mental health 
704.6 	practitioner with input from the recipient whenever possible.
704.7 	(a) "Certified rehabilitation specialist" means a staff person who is qualified under section 
704.8 	245I.04, subdivision 8.
704.9 	(b) "Clinical trainee" means a staff person who is qualified under section 245I.04, 
704.10 	subdivision 6.
704.11 	(c) "Mental health Crisis assessment" means an immediate face-to-face assessment by 
704.12 	a physician, a mental health professional, or mental health practitioner under the clinical 
704.13 	supervision of a mental health professional, following a screening that suggests that the 
704.14 	adult may be experiencing a mental health crisis or mental health emergency situation. It 
704.15 	includes, when feasible, assessing whether the person might be willing to voluntarily accept 
704.16 	treatment, determining whether the person has an advance directive, and obtaining 
704.17 	information and history from involved family members or caretakers a qualified member 
704.18 	of a crisis team, as described in subdivision 6a.
704.19 	(d) "Mental health mobile Crisis intervention services" means face-to-face, short-term 
704.20 	intensive mental health services initiated during a mental health crisis or mental health 
704.21 	emergency to help the recipient cope with immediate stressors, identify and utilize available 
704.22 	resources and strengths, engage in voluntary treatment, and begin to return to the recipient's 
704.23 	baseline level of functioning. The services, including screening and treatment plan 
704.24 	recommendations, must be culturally and linguistically appropriate.
704.25 	(1) This service is provided on site by a mobile crisis intervention team outside of an 
704.26 	inpatient hospital setting. Mental health mobile crisis intervention services must be available 
704.27 	24 hours a day, seven days a week.
704.28 	(2) The initial screening must consider other available services to determine which 
704.29 	service intervention would best address the recipient's needs and circumstances.
704.30 	(3) The mobile crisis intervention team must be available to meet promptly face-to-face 
704.31 	with a person in mental health crisis or emergency in a community setting or hospital 
704.32 	emergency room.
705.1 	(4) The intervention must consist of a mental health crisis assessment and a crisis 
705.2 	treatment plan.
705.3 	(5) The team must be available to individuals who are experiencing a co-occurring 
705.4 	substance use disorder, who do not need the level of care provided in a detoxification facility.
705.5 	(6) The treatment plan must include recommendations for any needed crisis stabilization 
705.6 	services for the recipient, including engagement in treatment planning and family 
705.7 	psychoeducation.
705.8 	(e) "Crisis screening" means a screening of a client's potential mental health crisis 
705.9 	situation under subdivision 6.
705.10 	(e) (f) "Mental health Crisis stabilization services" means individualized mental health 
705.11 	services provided to a recipient following crisis intervention services which are designed 
705.12 	to restore the recipient to the recipient's prior functional level. Mental health Crisis 
705.13 	stabilization services may be provided in the recipient's home, the home of a family member 
705.14 	or friend of the recipient, another community setting, or a short-term supervised, licensed 
705.15 	residential program, or an emergency department. Mental health crisis stabilization does 
705.16 	not include partial hospitalization or day treatment. Mental health Crisis stabilization services 
705.17 	includes family psychoeducation.
705.18 	(g) "Crisis team" means the staff of a provider entity who are supervised and prepared 
705.19 	to provide mobile crisis services to a client in a potential mental health crisis situation.
705.20 	(h) "Mental health certified family peer specialist" means a staff person who is qualified 
705.21 	under section 245I.04, subdivision 12.
705.22 	(i) "Mental health certified peer specialist" means a staff person who is qualified under 
705.23 	section 245I.04, subdivision 10.
705.24 	(j) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without 
705.25 	the provision of crisis response services, would likely result in significantly reducing the 
705.26 	recipient's levels of functioning in primary activities of daily living, in an emergency situation 
705.27 	under section 62Q.55, or in the placement of the recipient in a more restrictive setting, 
705.28 	including but not limited to inpatient hospitalization.
705.29 	(k) "Mental health practitioner" means a staff person who is qualified under section 
705.30 	245I.04, subdivision 4.
705.31 	(l) "Mental health professional" means a staff person who is qualified under section 
705.32 	245I.04, subdivision 2.
706.1 	(m) "Mental health rehabilitation worker" means a staff person who is qualified under 
706.2 	section 245I.04, subdivision 14.
706.3 	(n) "Mobile crisis services" means screening, assessment, intervention, and community 
706.4 	based stabilization, excluding residential crisis stabilization, that is provided to a recipient.
706.5 		Subd. 3.Eligibility. An eligible recipient is an individual who:
706.6 	(1) is age 18 or older;
706.7 	(2) is screened as possibly experiencing a mental health crisis or emergency where a 
706.8 	mental health crisis assessment is needed; and
706.9 	(3) is assessed as experiencing a mental health crisis or emergency, and mental health 
706.10 	crisis intervention or crisis intervention and stabilization services are determined to be 
706.11 	medically necessary.
706.12 	(a) A recipient is eligible for crisis assessment services when the recipient has screened 
706.13 	positive for a potential mental health crisis during a crisis screening.
706.14 	(b) A recipient is eligible for crisis intervention services and crisis stabilization services 
706.15 	when the recipient has been assessed during a crisis assessment to be experiencing a mental 
706.16 	health crisis.
706.17 		Subd. 4.Provider entity standards. (a) A provider entity is an entity that meets the 
706.18 	standards listed in paragraph (c) and mobile crisis provider must be:
706.19 	(1) is a county board operated entity; or
706.20 	(2) an Indian health services facility or facility owned and operated by a tribe or tribal 
706.21 	organization operating under United States Code, title 325, section 450f; or
706.22 	(2) is (3) a provider entity that is under contract with the county board in the county 
706.23 	where the potential crisis or emergency is occurring. To provide services under this section, 
706.24 	the provider entity must directly provide the services; or if services are subcontracted, the 
706.25 	provider entity must maintain responsibility for services and billing.
706.26 	(b) A mobile crisis provider must meet the following standards:
706.27 	(1) must ensure that crisis screenings, crisis assessments, and crisis intervention services 
706.28 	are available to a recipient 24 hours a day, seven days a week;
706.29 	(2) must be able to respond to a call for services in a designated service area or according 
706.30 	to a written agreement with the local mental health authority for an adjacent area;
707.1 	(3) must have at least one mental health professional on staff at all times and at least 
707.2 	one additional staff member capable of leading a crisis response in the community; and
707.3 	(4) must provide the commissioner with information about the number of requests for 
707.4 	service, the number of people that the provider serves face-to-face, outcomes, and the 
707.5 	protocols that the provider uses when deciding when to respond in the community.
707.6 	(b) (c) A provider entity that provides crisis stabilization services in a residential setting 
707.7 	under subdivision 7 is not required to meet the requirements of paragraph paragraphs (a), 
707.8 	clauses (1) and (2) to (b), but must meet all other requirements of this subdivision.
707.9 	(c) The adult mental health (d) A crisis response services provider entity must have the 
707.10 	capacity to meet and carry out the standards in section 245I.011, subdivision 5, and the 
707.11 	following standards:
707.12 	(1) has the capacity to recruit, hire, and manage and train mental health professionals, 
707.13 	practitioners, and rehabilitation workers ensures that staff persons provide support for a 
707.14 	recipient's family and natural supports, by enabling the recipient's family and natural supports 
707.15 	to observe and participate in the recipient's treatment, assessments, and planning services;
707.16 	(2) has adequate administrative ability to ensure availability of services;
707.17 	(3) is able to ensure adequate preservice and in-service training;
707.18 	(4) (3) is able to ensure that staff providing these services are skilled in the delivery of 
707.19 	mental health crisis response services to recipients;
707.20 	(5) (4) is able to ensure that staff are capable of implementing culturally specific treatment 
707.21 	identified in the individual crisis treatment plan that is meaningful and appropriate as 
707.22 	determined by the recipient's culture, beliefs, values, and language;
707.23 	(6) (5) is able to ensure enough flexibility to respond to the changing intervention and 
707.24 	care needs of a recipient as identified by the recipient or family member during the service 
707.25 	partnership between the recipient and providers;
707.26 	(7) (6) is able to ensure that mental health professionals and mental health practitioners
707.27 	staff have the communication tools and procedures to communicate and consult promptly 
707.28 	about crisis assessment and interventions as services occur;
707.29 	(8) (7) is able to coordinate these services with county emergency services, community 
707.30 	hospitals, ambulance, transportation services, social services, law enforcement, engagement 
707.31 	services, and mental health crisis services through regularly scheduled interagency meetings;
708.1 	(9) is able to ensure that mental health crisis assessment and mobile crisis intervention 
708.2 	services are available 24 hours a day, seven days a week;
708.3 	(10) (8) is able to ensure that services are coordinated with other mental behavioral
708.4 	health service providers, county mental health authorities, or federally recognized American 
708.5 	Indian authorities and others as necessary, with the consent of the adult recipient or parent 
708.6 	or guardian. Services must also be coordinated with the recipient's case manager if the adult
708.7 	recipient is receiving case management services;
708.8 	(11) (9) is able to ensure that crisis intervention services are provided in a manner 
708.9 	consistent with sections 245.461 to 245.486 and 245.487 to 245.4879;
708.10 	(12) is able to submit information as required by the state;
708.11 	(13) maintains staff training and personnel files;
708.12 	(10) is able to coordinate detoxification services for the recipient according to Minnesota 
708.13 	Rules, parts 9530.6605 to 9530.6655, or withdrawal management according to chapter 245F;
708.14 	(14) (11) is able to establish and maintain a quality assurance and evaluation plan to 
708.15 	evaluate the outcomes of services and recipient satisfaction; and
708.16 	(15) is able to keep records as required by applicable laws;
708.17 	(16) is able to comply with all applicable laws and statutes;
708.18 	(17) (12) is an enrolled medical assistance provider; and.
708.19 	(18) develops and maintains written policies and procedures regarding service provision 
708.20 	and administration of the provider entity, including safety of staff and recipients in high-risk 
708.21 	situations.
708.22 		Subd. 4a.Alternative provider standards. If a county or tribe demonstrates that, due 
708.23 	to geographic or other barriers, it is not feasible to provide mobile crisis intervention services 
708.24 	according to the standards in subdivision 4, paragraph (c), clause (9) (b), the commissioner 
708.25 	may approve a crisis response provider based on an alternative plan proposed by a county 
708.26 	or group of counties tribe. The alternative plan must:
708.27 	(1) result in increased access and a reduction in disparities in the availability of mobile 
708.28 	crisis services;
708.29 	(2) provide mobile crisis services outside of the usual nine-to-five office hours and on 
708.30 	weekends and holidays; and
708.31 	(3) comply with standards for emergency mental health services in section 245.469.
709.1 		Subd. 5.Mobile Crisis assessment and intervention staff qualifications. For provision 
709.2 	of adult mental health mobile crisis intervention services, a mobile crisis intervention team 
709.3 	is comprised of at least two mental health professionals as defined in section 245.462, 
709.4 	subdivision 18, clauses (1) to (6), or a combination of at least one mental health professional 
709.5 	and one mental health practitioner as defined in section 245.462, subdivision 17, with the 
709.6 	required mental health crisis training and under the clinical supervision of a mental health 
709.7 	professional on the team. The team must have at least two people with at least one member 
709.8 	providing on-site crisis intervention services when needed.(a) Qualified individual staff of 
709.9 	a qualified provider entity must provide crisis assessment and intervention services to a 
709.10 	recipient. A staff member providing crisis assessment and intervention services to a recipient 
709.11 	must be qualified as a:
709.12 	(1) mental health professional;
709.13 	(2) clinical trainee;
709.14 	(3) mental health practitioner;
709.15 	(4) mental health certified family peer specialist; or
709.16 	(5) mental health certified peer specialist.
709.17 	(b) When crisis assessment and intervention services are provided to a recipient in the 
709.18 	community, a mental health professional, clinical trainee, or mental health practitioner must 
709.19 	lead the response.
709.20 	(c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph 
709.21 	(b), must be specific to providing crisis services to children and adults and include training 
709.22 	about evidence-based practices identified by the commissioner of health to reduce the 
709.23 	recipient's risk of suicide and self-injurious behavior.
709.24 	(d) Team members must be experienced in mental health crisis assessment, crisis 
709.25 	intervention techniques, treatment engagement strategies, working with families, and clinical 
709.26 	decision-making under emergency conditions and have knowledge of local services and 
709.27 	resources. The team must recommend and coordinate the team's services with appropriate 
709.28 	local resources such as the county social services agency, mental health services, and local 
709.29 	law enforcement when necessary.
709.30 		Subd. 6.Crisis assessment and mobile intervention treatment planning screening. (a) 
709.31 	Prior to initiating mobile crisis intervention services, a screening of the potential crisis 
709.32 	situation must be conducted. The crisis screening may use the resources of crisis assistance 
709.33 	and emergency services as defined in sections 245.462, subdivision 6, and section245.469, 
710.1 	subdivisions 1 and 2. The crisis screening must gather information, determine whether a 
710.2 	mental health crisis situation exists, identify parties involved, and determine an appropriate 
710.3 	response.
710.4 	(b) When conducting the crisis screening of a recipient, a provider must:
710.5 	(1) employ evidence-based practices to reduce the recipient's risk of suicide and 
710.6 	self-injurious behavior;
710.7 	(2) work with the recipient to establish a plan and time frame for responding to the 
710.8 	recipient's mental health crisis, including responding to the recipient's immediate need for 
710.9 	support by telephone or text message until the provider can respond to the recipient 
710.10 	face-to-face;
710.11 	(3) document significant factors in determining whether the recipient is experiencing a 
710.12 	mental health crisis, including prior requests for crisis services, a recipient's recent 
710.13 	presentation at an emergency department, known calls to 911 or law enforcement, or 
710.14 	information from third parties with knowledge of a recipient's history or current needs;
710.15 	(4) accept calls from interested third parties and consider the additional needs or potential 
710.16 	mental health crises that the third parties may be experiencing;
710.17 	(5) provide psychoeducation, including means reduction, to relevant third parties 
710.18 	including family members or other persons living with the recipient; and
710.19 	(6) consider other available services to determine which service intervention would best 
710.20 	address the recipient's needs and circumstances.
710.21 	(c) For the purposes of this section, the following situations indicate a positive screen 
710.22 	for a potential mental health crisis and the provider must prioritize providing a face-to-face 
710.23 	crisis assessment of the recipient, unless a provider documents specific evidence to show 
710.24 	why this was not possible, including insufficient staffing resources, concerns for staff or 
710.25 	recipient safety, or other clinical factors:
710.26 	(1) the recipient presents at an emergency department or urgent care setting and the 
710.27 	health care team at that location requested crisis services; or
710.28 	(2) a peace officer requested crisis services for a recipient who is potentially subject to 
710.29 	transportation under section 253B.051.
710.30 	(d) A provider is not required to have direct contact with the recipient to determine that 
710.31 	the recipient is experiencing a potential mental health crisis. A mobile crisis provider may 
711.1 	gather relevant information about the recipient from a third party to establish the recipient's 
711.2 	need for services and potential safety factors.
711.3 		Subd. 6a.Crisis assessment. (b) (a) If a crisis exists recipient screens positive for 
711.4 	potential mental health crisis, a crisis assessment must be completed. A crisis assessment 
711.5 	evaluates any immediate needs for which emergency services are needed and, as time 
711.6 	permits, the recipient's current life situation, health information, including current 
711.7 	medications, sources of stress, mental health problems and symptoms, strengths, cultural 
711.8 	considerations, support network, vulnerabilities, current functioning, and the recipient's 
711.9 	preferences as communicated directly by the recipient, or as communicated in a health care 
711.10 	directive as described in chapters 145C and 253B, the crisis treatment plan described under 
711.11 	paragraph (d) subdivision 11, a crisis prevention plan, or a wellness recovery action plan.
711.12 	(b) A provider must conduct a crisis assessment at the recipient's location whenever 
711.13 	possible.
711.14 	(c) Whenever possible, the assessor must attempt to include input from the recipient and 
711.15 	the recipient's family and other natural supports to assess whether a crisis exists.
711.16 	(d) A crisis assessment includes determining: (1) whether the recipient is willing to 
711.17 	voluntarily engage in treatment or (2) has an advance directive and (3) gathering the 
711.18 	recipient's information and history from involved family or other natural supports.
711.19 	(e) A crisis assessment must include coordinated response with other health care providers 
711.20 	if the assessment indicates that a recipient needs detoxification, withdrawal management, 
711.21 	or medical stabilization in addition to crisis response services. If the recipient does not need 
711.22 	an acute level of care, a team must serve an otherwise eligible recipient who has a 
711.23 	co-occurring substance use disorder.
711.24 	(f) If, after completing a crisis assessment of a recipient, a provider refers a recipient to 
711.25 	an intensive setting, including an emergency department, inpatient hospitalization, or 
711.26 	residential crisis stabilization, one of the crisis team members who completed or conferred 
711.27 	about the recipient's crisis assessment must immediately contact the referral entity and 
711.28 	consult with the triage nurse or other staff responsible for intake at the referral entity. During 
711.29 	the consultation, the crisis team member must convey key findings or concerns that led to 
711.30 	the recipient's referral. Following the immediate consultation, the provider must also send 
711.31 	written documentation upon completion. The provider must document if these releases 
711.32 	occurred with authorization by the recipient, the recipient's legal guardian, or as allowed 
711.33 	by section 144.293, subdivision 5.
712.1 		Subd. 6b.Crisis intervention services. (c) (a) If the crisis assessment determines mobile 
712.2 	crisis intervention services are needed, the crisis intervention services must be provided 
712.3 	promptly. As opportunity presents during the intervention, at least two members of the 
712.4 	mobile crisis intervention team must confer directly or by telephone about the crisis 
712.5 	assessment, crisis treatment plan, and actions taken and needed. At least one of the team 
712.6 	members must be on site providing face-to-face crisis intervention services. If providing 
712.7 	on-site crisis intervention services, a clinical trainee or mental health practitioner must seek 
712.8 	clinical treatment supervision as required in subdivision 9.
712.9 	(b) If a provider delivers crisis intervention services while the recipient is absent, the 
712.10 	provider must document the reason for delivering services while the recipient is absent.
712.11 	(d) (c) The mobile crisis intervention team must develop an initial, brief a crisis treatment 
712.12 	plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention
712.13 	according to subdivision 11. The plan must address the needs and problems noted in the 
712.14 	crisis assessment and include measurable short-term goals, cultural considerations, and 
712.15 	frequency and type of services to be provided to achieve the goals and reduce or eliminate 
712.16 	the crisis. The treatment plan must be updated as needed to reflect current goals and services.
712.17 	(e) (d) The mobile crisis intervention team must document which short-term goals crisis 
712.18 	treatment plan goals and objectives have been met and when no further crisis intervention 
712.19 	services are required.
712.20 	(f) (e) If the recipient's mental health crisis is stabilized, but the recipient needs a referral 
712.21 	to other services, the team must provide referrals to these services. If the recipient has a 
712.22 	case manager, planning for other services must be coordinated with the case manager. If 
712.23 	the recipient is unable to follow up on the referral, the team must link the recipient to the 
712.24 	service and follow up to ensure the recipient is receiving the service.
712.25 	(g) (f) If the recipient's mental health crisis is stabilized and the recipient does not have 
712.26 	an advance directive, the case manager or crisis team shall offer to work with the recipient 
712.27 	to develop one.
712.28 		Subd. 7.Crisis stabilization services. (a) Crisis stabilization services must be provided 
712.29 	by qualified staff of a crisis stabilization services provider entity and must meet the following 
712.30 	standards:
712.31 	(1) a crisis stabilization treatment plan must be developed which that meets the criteria 
712.32 	in subdivision 11;
712.33 	(2) staff must be qualified as defined in subdivision 8; and
713.1 	(3) crisis stabilization services must be delivered according to the crisis treatment plan 
713.2 	and include face-to-face contact with the recipient by qualified staff for further assessment, 
713.3 	help with referrals, updating of the crisis stabilization treatment plan, supportive counseling,
713.4 	skills training, and collaboration with other service providers in the community.; and
713.5 	(4) if a provider delivers crisis stabilization services while the recipient is absent, the 
713.6 	provider must document the reason for delivering services while the recipient is absent.
713.7 	(b) If crisis stabilization services are provided in a supervised, licensed residential setting, 
713.8 	the recipient must be contacted face-to-face daily by a qualified mental health practitioner 
713.9 	or mental health professional. The program must have 24-hour-a-day residential staffing 
713.10 	which may include staff who do not meet the qualifications in subdivision 8. The residential 
713.11 	staff must have 24-hour-a-day immediate direct or telephone access to a qualified mental 
713.12 	health professional or practitioner.
713.13 	(c) (b) If crisis stabilization services are provided in a supervised, licensed residential 
713.14 	setting that serves no more than four adult residents, and one or more individuals are present 
713.15 	at the setting to receive residential crisis stabilization services, the residential staff must 
713.16 	include, for at least eight hours per day, at least one individual who meets the qualifications 
713.17 	in subdivision 8, paragraph (a), clause (1) or (2) mental health professional, clinical trainee, 
713.18 	certified rehabilitation specialist, or mental health practitioner.
713.19 	(d) If crisis stabilization services are provided in a supervised, licensed residential setting 
713.20 	that serves more than four adult residents, and one or more are recipients of crisis stabilization 
713.21 	services, the residential staff must include, for 24 hours a day, at least one individual who 
713.22 	meets the qualifications in subdivision 8. During the first 48 hours that a recipient is in the 
713.23 	residential program, the residential program must have at least two staff working 24 hours 
713.24 	a day. Staffing levels may be adjusted thereafter according to the needs of the recipient as 
713.25 	specified in the crisis stabilization treatment plan.
713.26 		Subd. 8.Adult Crisis stabilization staff qualifications. (a) Adult Mental health crisis 
713.27 	stabilization services must be provided by qualified individual staff of a qualified provider 
713.28 	entity. Individual provider staff must have the following qualifications A staff member 
713.29 	providing crisis stabilization services to a recipient must be qualified as a:
713.30 	(1) be a mental health professional as defined in section 245.462, subdivision 18, clauses 
713.31 	(1) to (6);
713.32 	(2) be a certified rehabilitation specialist;
713.33 	(3) clinical trainee;
714.1 	(4) mental health practitioner as defined in section 245.462, subdivision 17. The mental 
714.2 	health practitioner must work under the clinical supervision of a mental health professional;
714.3 	(5) mental health certified family peer specialist;
714.4 	(3) be a (6) mental health certified peer specialist under section 256B.0615. The certified 
714.5 	peer specialist must work under the clinical supervision of a mental health professional; or
714.6 	(4) be a (7) mental health rehabilitation worker who meets the criteria in section 
714.7 	256B.0623, subdivision 5, paragraph (a), clause (4); works under the direction of a mental 
714.8 	health practitioner as defined in section 245.462, subdivision 17, or under direction of a 
714.9 	mental health professional; and works under the clinical supervision of a mental health 
714.10 	professional.
714.11 	(b) Mental health practitioners and mental health rehabilitation workers must have 
714.12 	completed at least 30 hours of training in crisis intervention and stabilization during the 
714.13 	past two years. The 30 hours of ongoing training required in section 245I.05, subdivision 
714.14 	4, paragraph (b), must be specific to providing crisis services to children and adults and 
714.15 	include training about evidence-based practices identified by the commissioner of health 
714.16 	to reduce a recipient's risk of suicide and self-injurious behavior.
714.17 		Subd. 9.Supervision. Clinical trainees and mental health practitioners may provide 
714.18 	crisis assessment and mobile crisis intervention services if the following clinical treatment
714.19 	supervision requirements are met:
714.20 	(1) the mental health provider entity must accept full responsibility for the services 
714.21 	provided;
714.22 	(2) the mental health professional of the provider entity, who is an employee or under 
714.23 	contract with the provider entity, must be immediately available by phone or in person for 
714.24 	clinical treatment supervision;
714.25 	(3) the mental health professional is consulted, in person or by phone, during the first 
714.26 	three hours when a clinical trainee or mental health practitioner provides on-site service
714.27 	crisis assessment or crisis intervention services; and
714.28 	(4) the mental health professional must:
714.29 	(i) review and approve, as defined in section 245I.02, subdivision 2, of the tentative 
714.30 	crisis assessment and crisis treatment plan within 24 hours of first providing services to the 
714.31 	recipient, notwithstanding section 245I.08, subdivision 3; and
714.32 	(ii) document the consultation required in clause (3).; and
715.1 	(iii) sign the crisis assessment and treatment plan within the next business day;
715.2 	(5) if the mobile crisis intervention services continue into a second calendar day, a mental 
715.3 	health professional must contact the recipient face-to-face on the second day to provide 
715.4 	services and update the crisis treatment plan; and
715.5 	(6) the on-site observation must be documented in the recipient's record and signed by 
715.6 	the mental health professional.
715.7 		Subd. 10.Recipient file. Providers of mobile crisis intervention or crisis stabilization 
715.8 	services must maintain a file for each recipient containing the following information:
715.9 	(1) individual crisis treatment plans signed by the recipient, mental health professional, 
715.10 	and mental health practitioner who developed the crisis treatment plan, or if the recipient 
715.11 	refused to sign the plan, the date and reason stated by the recipient as to why the recipient 
715.12 	would not sign the plan;
715.13 	(2) signed release forms;
715.14 	(3) recipient health information and current medications;
715.15 	(4) emergency contacts for the recipient;
715.16 	(5) case records which document the date of service, place of service delivery, signature 
715.17 	of the person providing the service, and the nature, extent, and units of service. Direct or 
715.18 	telephone contact with the recipient's family or others should be documented;
715.19 	(6) required clinical supervision by mental health professionals;
715.20 	(7) summary of the recipient's case reviews by staff;
715.21 	(8) any written information by the recipient that the recipient wants in the file; and
715.22 	(9) an advance directive, if there is one available.
715.23 	Documentation in the file must comply with all requirements of the commissioner.
715.24 		Subd. 11.Crisis treatment plan. The individual crisis stabilization treatment plan must 
715.25 	include, at a minimum:
715.26 	(1) a list of problems identified in the assessment;
715.27 	(2) a list of the recipient's strengths and resources;
715.28 	(3) concrete, measurable short-term goals and tasks to be achieved, including time frames 
715.29 	for achievement;
715.30 	(4) specific objectives directed toward the achievement of each one of the goals;
716.1 	(5) documentation of the participants involved in the service planning. The recipient, if 
716.2 	possible, must be a participant. The recipient or the recipient's legal guardian must sign the 
716.3 	service plan or documentation must be provided why this was not possible. A copy of the 
716.4 	plan must be given to the recipient and the recipient's legal guardian. The plan should include 
716.5 	services arranged, including specific providers where applicable;
716.6 	(6) planned frequency and type of services initiated;
716.7 	(7) a crisis response action plan if a crisis should occur;
716.8 	(8) clear progress notes on outcome of goals;
716.9 	(9) a written plan must be completed within 24 hours of beginning services with the 
716.10 	recipient; and
716.11 	(10) a treatment plan must be developed by a mental health professional or mental health 
716.12 	practitioner under the clinical supervision of a mental health professional. The mental health 
716.13 	professional must approve and sign all treatment plans.
716.14 	(a) Within 24 hours of the recipient's admission, the provider entity must complete the 
716.15 	recipient's crisis treatment plan. The provider entity must:
716.16 	(1) base the recipient's crisis treatment plan on the recipient's crisis assessment;
716.17 	(2) consider crisis assistance strategies that have been effective for the recipient in the 
716.18 	past;
716.19 	(3) for a child recipient, use a child-centered, family-driven, and culturally appropriate 
716.20 	planning process that allows the recipient's parents and guardians to observe or participate 
716.21 	in the recipient's individual and family treatment services, assessment, and treatment 
716.22 	planning;
716.23 	(4) for an adult recipient, use a person-centered, culturally appropriate planning process 
716.24 	that allows the recipient's family and other natural supports to observe or participate in 
716.25 	treatment services, assessment, and treatment planning;
716.26 	(5) identify the participants involved in the recipient's treatment planning. The recipient, 
716.27 	if possible, must be a participant;
716.28 	(6) identify the recipient's initial treatment goals, measurable treatment objectives, and 
716.29 	specific interventions that the license holder will use to help the recipient engage in treatment;
716.30 	(7) include documentation of referral to and scheduling of services, including specific 
716.31 	providers where applicable;
717.1 	(8) ensure that the recipient or the recipient's legal guardian approves under section 
717.2 	245I.02, subdivision 2, of the recipient's crisis treatment plan unless a court orders the 
717.3 	recipient's treatment plan under chapter 253B. If the recipient or the recipient's legal guardian 
717.4 	disagrees with the crisis treatment plan, the license holder must document in the client file 
717.5 	the reasons why the recipient disagrees with the crisis treatment plan; and
717.6 	(9) ensure that a treatment supervisor approves under section 245I.02, subdivision 2, of 
717.7 	the recipient's treatment plan within 24 hours of the recipient's admission if a mental health 
717.8 	practitioner or clinical trainee completes the crisis treatment plan, notwithstanding section 
717.9 	245I.08, subdivision 3.
717.10 	(b) The provider entity must provide the recipient and the recipient's legal guardian with 
717.11 	a copy of the recipient's crisis treatment plan.
717.12 		Subd. 12.Excluded services. The following services are excluded from reimbursement 
717.13 	under this section:
717.14 	(1) room and board services;
717.15 	(2) services delivered to a recipient while admitted to an inpatient hospital;
717.16 	(3) recipient transportation costs may be covered under other medical assistance 
717.17 	provisions, but transportation services are not an adult mental health crisis response service;
717.18 	(4) services provided and billed by a provider who is not enrolled under medical 
717.19 	assistance to provide adult mental health crisis response services;
717.20 	(5) services performed by volunteers;
717.21 	(6) direct billing of time spent "on call" when not delivering services to a recipient;
717.22 	(7) provider service time included in case management reimbursement. When a provider 
717.23 	is eligible to provide more than one type of medical assistance service, the recipient must 
717.24 	have a choice of provider for each service, unless otherwise provided for by law;
717.25 	(8) outreach services to potential recipients; and
717.26 	(9) a mental health service that is not medically necessary.;
717.27 	(10) services that a residential treatment center licensed under Minnesota Rules, chapter 
717.28 	2960, provides to a client;
717.29 	(11) partial hospitalization or day treatment; and
717.30 	(12) a crisis assessment that a residential provider completes when a daily rate is paid 
717.31 	for the recipient's crisis stabilization.

718.1 	Sec. 5. EFFECTIVE DATE.
 718.2 	This article is effective July 1, 2022, or upon federal approval, whichever is later. The 
718.3 	commissioner of human services shall notify the revisor of statutes when federal approval 
718.4 	is obtained.

718.5 	ARTICLE 19
718.6 	MENTAL HEALTH UNIFORM SERVICE STANDARDS; CONFORMING 
718.7 	CHANGES

718.8 	Section 1. Minnesota Statutes 2020, section 62A.152, subdivision 3, is amended to read:
718.9 		Subd. 3.Provider discrimination prohibited. All group policies and group subscriber 
718.10 	contracts that provide benefits for mental or nervous disorder treatments in a hospital must 
718.11 	provide direct reimbursement for those services if performed by a mental health professional, 
718.12 	as defined in sections 245.462, subdivision 18, clauses (1) to (5); and 245.4871, subdivision 
718.13 	27, clauses (1) to (5) qualified according to section 245I.04, subdivision 2, to the extent that 
718.14 	the services and treatment are within the scope of mental health professional licensure.
718.15 	This subdivision is intended to provide payment of benefits for mental or nervous disorder 
718.16 	treatments performed by a licensed mental health professional in a hospital and is not 
718.17 	intended to change or add benefits for those services provided in policies or contracts to 
718.18 	which this subdivision applies.

718.19 	Sec. 2. Minnesota Statutes 2020, section 62A.3094, subdivision 1, is amended to read:
718.20 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in 
718.21 	paragraphs (b) to (d) have the meanings given.
718.22 	(b) "Autism spectrum disorders" means the conditions as determined by criteria set forth 
718.23 	in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of 
718.24 	the American Psychiatric Association.
718.25 	(c) "Medically necessary care" means health care services appropriate, in terms of type, 
718.26 	frequency, level, setting, and duration, to the enrollee's condition, and diagnostic testing 
718.27 	and preventative services. Medically necessary care must be consistent with generally 
718.28 	accepted practice parameters as determined by physicians and licensed psychologists who 
718.29 	typically manage patients who have autism spectrum disorders.
718.30 	(d) "Mental health professional" means a mental health professional as defined in section 
718.31 	245.4871, subdivision 27 who is qualified according to section 245I.04, subdivision 2, 
719.1 	clause (1), (2), (3), (4), or (6), who has training and expertise in autism spectrum disorder 
719.2 	and child development.

719.3 	Sec. 3. Minnesota Statutes 2020, section 62Q.096, is amended to read:
719.4 	62Q.096 CREDENTIALING OF PROVIDERS.
719.5 	If a health plan company has initially credentialed, as providers in its provider network, 
719.6 	individual providers employed by or under contract with an entity that:
719.7 	(1) is authorized to bill under section 256B.0625, subdivision 5;
719.8 	(2) meets the requirements of Minnesota Rules, parts 9520.0750 to 9520.0870 is a mental 
719.9 	health clinic certified under section 245I.20;
719.10 	(3) is designated an essential community provider under section 62Q.19; and
719.11 	(4) is under contract with the health plan company to provide mental health services, 
719.12 	the health plan company must continue to credential at least the same number of providers 
719.13 	from that entity, as long as those providers meet the health plan company's credentialing 
719.14 	standards.
719.15 	A health plan company shall not refuse to credential these providers on the grounds that 
719.16 	their provider network has a sufficient number of providers of that type.

719.17 	Sec. 4. Minnesota Statutes 2020, section 144.651, subdivision 2, is amended to read:
719.18 		Subd. 2.Definitions. For the purposes of this section, "patient" means a person who is 
719.19 	admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for 
719.20 	the purpose of diagnosis or treatment bearing on the physical or mental health of that person. 
719.21 	For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means a 
719.22 	person who receives health care services at an outpatient surgical center or at a birth center 
719.23 	licensed under section 144.615. "Patient" also means a minor who is admitted to a residential 
719.24 	program as defined in section 253C.01. For purposes of subdivisions 1, 3 to 16, 18, 20 and 
719.25 	30, "patient" also means any person who is receiving mental health treatment on an outpatient 
719.26 	basis or in a community support program or other community-based program. "Resident" 
719.27 	means a person who is admitted to a nonacute care facility including extended care facilities, 
719.28 	nursing homes, and boarding care homes for care required because of prolonged mental or 
719.29 	physical illness or disability, recovery from injury or disease, or advancing age. For purposes 
719.30 	of all subdivisions except subdivisions 28 and 29, "resident" also means a person who is 
719.31 	admitted to a facility licensed as a board and lodging facility under Minnesota Rules, parts 
719.32 	4625.0100 to 4625.2355, a boarding care home under sections 144.50 to 144.56, or a 
720.1 	supervised living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which 
720.2 	operates a rehabilitation program licensed under chapter 245Gor 245I, or Minnesota Rules, 
720.3 	parts 9530.6510 to 9530.6590.

720.4 	Sec. 5. Minnesota Statutes 2020, section 144D.01, subdivision 4, is amended to read:
720.5 		Subd. 4.Housing with services establishment or establishment. (a) "Housing with 
720.6 	services establishment" or "establishment" means:
720.7 	(1) an establishment providing sleeping accommodations to one or more adult residents, 
720.8 	at least 80 percent of which are 55 years of age or older, and offering or providing, for a 
720.9 	fee, one or more regularly scheduled health-related services or two or more regularly 
720.10 	scheduled supportive services, whether offered or provided directly by the establishment 
720.11 	or by another entity arranged for by the establishment; or
720.12 	(2) an establishment that registers under section 144D.025.
720.13 	(b) Housing with services establishment does not include:
720.14 	(1) a nursing home licensed under chapter 144A;
720.15 	(2) a hospital, certified boarding care home, or supervised living facility licensed under 
720.16 	sections 144.50 to 144.56;
720.17 	(3) a board and lodging establishment licensed under chapter 157 and Minnesota Rules, 
720.18 	parts 9520.0500 to 9520.0670, or under chapter 245Dor,245G, or 245I;
720.19 	(4) a board and lodging establishment which serves as a shelter for battered women or 
720.20 	other similar purpose;
720.21 	(5) a family adult foster care home licensed by the Department of Human Services;
720.22 	(6) private homes in which the residents are related by kinship, law, or affinity with the 
720.23 	providers of services;
720.24 	(7) residential settings for persons with developmental disabilities in which the services 
720.25 	are licensed under chapter 245D;
720.26 	(8) a home-sharing arrangement such as when an elderly or disabled person or 
720.27 	single-parent family makes lodging in a private residence available to another person in 
720.28 	exchange for services or rent, or both;
720.29 	(9) a duly organized condominium, cooperative, common interest community, or owners' 
720.30 	association of the foregoing where at least 80 percent of the units that comprise the 
721.1 	condominium, cooperative, or common interest community are occupied by individuals 
721.2 	who are the owners, members, or shareholders of the units;
721.3 	(10) services for persons with developmental disabilities that are provided under a license 
721.4 	under chapter 245D; or
721.5 	(11) a temporary family health care dwelling as defined in sections 394.307 and 462.3593.

721.6 	Sec. 6. Minnesota Statutes 2020, section 144G.08, subdivision 7, as amended by Laws 
721.7 	2020, Seventh Special Session chapter 1, article 6, section 5, is amended to read:
721.8 		Subd. 7.Assisted living facility. "Assisted living facility" means a facility that provides 
721.9 	sleeping accommodations and assisted living services to one or more adults. Assisted living 
721.10 	facility includes assisted living facility with dementia care, and does not include:
721.11 	(1) emergency shelter, transitional housing, or any other residential units serving 
721.12 	exclusively or primarily homeless individuals, as defined under section 116L.361;
721.13 	(2) a nursing home licensed under chapter 144A;
721.14 	(3) a hospital, certified boarding care, or supervised living facility licensed under sections 
721.15 	144.50 to 144.56;
721.16 	(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 
721.17 	9520.0500 to 9520.0670, or under chapter 245Dor,245G, or 245I;
721.18 	(5) services and residential settings licensed under chapter 245A, including adult foster 
721.19 	care and services and settings governed under the standards in chapter 245D;
721.20 	(6) a private home in which the residents are related by kinship, law, or affinity with the 
721.21 	provider of services;
721.22 	(7) a duly organized condominium, cooperative, and common interest community, or 
721.23 	owners' association of the condominium, cooperative, and common interest community 
721.24 	where at least 80 percent of the units that comprise the condominium, cooperative, or 
721.25 	common interest community are occupied by individuals who are the owners, members, or 
721.26 	shareholders of the units;
721.27 	(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;
721.28 	(9) a setting offering services conducted by and for the adherents of any recognized 
721.29 	church or religious denomination for its members exclusively through spiritual means or 
721.30 	by prayer for healing;
722.1 	(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with 
722.2 	low-income housing tax credits pursuant to United States Code, title 26, section 42, and 
722.3 	units financed by the Minnesota Housing Finance Agency that are intended to serve 
722.4 	individuals with disabilities or individuals who are homeless, except for those developments 
722.5 	that market or hold themselves out as assisted living facilities and provide assisted living 
722.6 	services;
722.7 	(11) rental housing developed under United States Code, title 42, section 1437, or United 
722.8 	States Code, title 12, section 1701q;
722.9 	(12) rental housing designated for occupancy by only elderly or elderly and disabled 
722.10 	residents under United States Code, title 42, section 1437e, or rental housing for qualifying 
722.11 	families under Code of Federal Regulations, title 24, section 983.56;
722.12 	(13) rental housing funded under United States Code, title 42, chapter 89, or United 
722.13 	States Code, title 42, section 8011;
722.14 	(14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b); or
722.15 	(15) any establishment that exclusively or primarily serves as a shelter or temporary 
722.16 	shelter for victims of domestic or any other form of violence.

722.17 	Sec. 7. Minnesota Statutes 2020, section 148B.5301, subdivision 2, is amended to read:
722.18 		Subd. 2.Supervision. (a) To qualify as a LPCC, an applicant must have completed 
722.19 	4,000 hours of post-master's degree supervised professional practice in the delivery of 
722.20 	clinical services in the diagnosis and treatment of mental illnesses and disorders in both 
722.21 	children and adults. The supervised practice shall be conducted according to the requirements 
722.22 	in paragraphs (b) to (e).
722.23 	(b) The supervision must have been received under a contract that defines clinical practice 
722.24 	and supervision from a mental health professional as defined in section 245.462, subdivision 
722.25 	18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6) who is qualified 
722.26 	according to section 245I.04, subdivision 2, or by a board-approved supervisor, who has at 
722.27 	least two years of postlicensure experience in the delivery of clinical services in the diagnosis 
722.28 	and treatment of mental illnesses and disorders. All supervisors must meet the supervisor 
722.29 	requirements in Minnesota Rules, part 2150.5010.
722.30 	(c) The supervision must be obtained at the rate of two hours of supervision per 40 hours 
722.31 	of professional practice. The supervision must be evenly distributed over the course of the 
722.32 	supervised professional practice. At least 75 percent of the required supervision hours must 
722.33 	be received in person. The remaining 25 percent of the required hours may be received by 
723.1 	telephone or by audio or audiovisual electronic device. At least 50 percent of the required 
723.2 	hours of supervision must be received on an individual basis. The remaining 50 percent 
723.3 	may be received in a group setting.
723.4 	(d) The supervised practice must include at least 1,800 hours of clinical client contact.
723.5 	(e) The supervised practice must be clinical practice. Supervision includes the observation 
723.6 	by the supervisor of the successful application of professional counseling knowledge, skills, 
723.7 	and values in the differential diagnosis and treatment of psychosocial function, disability, 
723.8 	or impairment, including addictions and emotional, mental, and behavioral disorders.

723.9 	Sec. 8. Minnesota Statutes 2020, section 148E.120, subdivision 2, is amended to read:
723.10 		Subd. 2.Alternate supervisors. (a) The board may approve an alternate supervisor as 
723.11 	determined in this subdivision. The board shall approve up to 25 percent of the required 
723.12 	supervision hours by a licensed mental health professional who is competent and qualified 
723.13 	to provide supervision according to the mental health professional's respective licensing 
723.14 	board, as established by section 245.462, subdivision 18, clauses (1) to (6), or 245.4871, 
723.15 	subdivision 27, clauses (1) to (6) 245I.04, subdivision 2.
723.16 	(b) The board shall approve up to 100 percent of the required supervision hours by an 
723.17 	alternate supervisor if the board determines that:
723.18 	(1) there are five or fewer supervisors in the county where the licensee practices social 
723.19 	work who meet the applicable licensure requirements in subdivision 1;
723.20 	(2) the supervisor is an unlicensed social worker who is employed in, and provides the 
723.21 	supervision in, a setting exempt from licensure by section 148E.065, and who has 
723.22 	qualifications equivalent to the applicable requirements specified in sections 148E.100 to 
723.23 	148E.115;
723.24 	(3) the supervisor is a social worker engaged in authorized social work practice in Iowa, 
723.25 	Manitoba, North Dakota, Ontario, South Dakota, or Wisconsin, and has the qualifications 
723.26 	equivalent to the applicable requirements in sections 148E.100 to 148E.115; or
723.27 	(4) the applicant or licensee is engaged in nonclinical authorized social work practice 
723.28 	outside of Minnesota and the supervisor meets the qualifications equivalent to the applicable 
723.29 	requirements in sections 148E.100 to 148E.115, or the supervisor is an equivalent mental 
723.30 	health professional, as determined by the board, who is credentialed by a state, territorial, 
723.31 	provincial, or foreign licensing agency; or
724.1 	(5) the applicant or licensee is engaged in clinical authorized social work practice outside 
724.2 	of Minnesota and the supervisor meets qualifications equivalent to the applicable 
724.3 	requirements in section 148E.115, or the supervisor is an equivalent mental health 
724.4 	professional as determined by the board, who is credentialed by a state, territorial, provincial, 
724.5 	or foreign licensing agency.
724.6 	(c) In order for the board to consider an alternate supervisor under this section, the 
724.7 	licensee must:
724.8 	(1) request in the supervision plan and verification submitted according to section 
724.9 	148E.125 that an alternate supervisor conduct the supervision; and
724.10 	(2) describe the proposed supervision and the name and qualifications of the proposed 
724.11 	alternate supervisor. The board may audit the information provided to determine compliance 
724.12 	with the requirements of this section.

724.13 	Sec. 9. Minnesota Statutes 2020, section 148F.11, subdivision 1, is amended to read:
724.14 		Subdivision 1.Other professionals. (a) Nothing in this chapter prevents members of 
724.15 	other professions or occupations from performing functions for which they are qualified or 
724.16 	licensed. This exception includes, but is not limited to: licensed physicians; registered nurses; 
724.17 	licensed practical nurses; licensed psychologists and licensed psychological practitioners; 
724.18 	members of the clergy provided such services are provided within the scope of regular 
724.19 	ministries; American Indian medicine men and women; licensed attorneys; probation officers; 
724.20 	licensed marriage and family therapists; licensed social workers; social workers employed 
724.21 	by city, county, or state agencies; licensed professional counselors; licensed professional 
724.22 	clinical counselors; licensed school counselors; registered occupational therapists or 
724.23 	occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders 
724.24 	(UMICAD) certified counselors when providing services to Native American people; city, 
724.25 	county, or state employees when providing assessments or case management under Minnesota 
724.26 	Rules, chapter 9530; and individuals defined in section 256B.0623, subdivision 5, paragraph 
724.27 	(a), clauses (1) and (2) to (6), providing integrated dual diagnosis co-occurring substance 
724.28 	use disorder treatment in adult mental health rehabilitative programs certified or licensed 
724.29 	by the Department of Human Services under section 245I.23, 256B.0622, or 256B.0623.
724.30 	(b) Nothing in this chapter prohibits technicians and resident managers in programs 
724.31 	licensed by the Department of Human Services from discharging their duties as provided 
724.32 	in Minnesota Rules, chapter 9530.
725.1 	(c) Any person who is exempt from licensure under this section must not use a title 
725.2 	incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug 
725.3 	counselor" or otherwise hold himself or herself out to the public by any title or description 
725.4 	stating or implying that he or she is engaged in the practice of alcohol and drug counseling, 
725.5 	or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless 
725.6 	that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice 
725.7 	of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the 
725.8 	use of one of the titles in paragraph (a).

725.9 	Sec. 10. Minnesota Statutes 2020, section 245.462, subdivision 1, is amended to read:
725.10 		Subdivision 1.Definitions. The definitions in this section apply to sections 245.461 to 
725.11 	245.486 245.4863.

725.12 	Sec. 11. Minnesota Statutes 2020, section 245.462, subdivision 6, is amended to read:
725.13 		Subd. 6.Community support services program. "Community support services program" 
725.14 	means services, other than inpatient or residential treatment services, provided or coordinated 
725.15 	by an identified program and staff under the clinical treatment supervision of a mental health 
725.16 	professional designed to help adults with serious and persistent mental illness to function 
725.17 	and remain in the community. A community support services program includes:
725.18 	(1) client outreach,
725.19 	(2) medication monitoring,
725.20 	(3) assistance in independent living skills,
725.21 	(4) development of employability and work-related opportunities,
725.22 	(5) crisis assistance,
725.23 	(6) psychosocial rehabilitation,
725.24 	(7) help in applying for government benefits, and
725.25 	(8) housing support services.
725.26 	The community support services program must be coordinated with the case management 
725.27 	services specified in section 245.4711.

725.28 	Sec. 12. Minnesota Statutes 2020, section 245.462, subdivision 8, is amended to read:
725.29 		Subd. 8.Day treatment services. "Day treatment," "day treatment services," or "day 
725.30 	treatment program" means a structured program of treatment and care provided to an adult 
726.1 	in or by: (1) a hospital accredited by the joint commission on accreditation of health 
726.2 	organizations and licensed under sections 144.50 to 144.55; (2) a community mental health 
726.3 	center under section 245.62; or (3) an entity that is under contract with the county board to 
726.4 	operate a program that meets the requirements of section 245.4712, subdivision 2, and 
726.5 	Minnesota Rules, parts 9505.0170 to 9505.0475. Day treatment consists of group 
726.6 	psychotherapy and other intensive therapeutic services that are provided at least two days 
726.7 	a week by a multidisciplinary staff under the clinical supervision of a mental health 
726.8 	professional. Day treatment may include education and consultation provided to families 
726.9 	and other individuals as part of the treatment process. The services are aimed at stabilizing 
726.10 	the adult's mental health status, providing mental health services, and developing and 
726.11 	improving the adult's independent living and socialization skills. The goal of day treatment 
726.12 	is to reduce or relieve mental illness and to enable the adult to live in the community. Day 
726.13 	treatment services are not a part of inpatient or residential treatment services. Day treatment 
726.14 	services are distinguished from day care by their structured therapeutic program of 
726.15 	psychotherapy services. The commissioner may limit medical assistance reimbursement 
726.16 	for day treatment to 15 hours per week per person the treatment services described by section 
726.17 	256B.0671, subdivision 3.

726.18 	Sec. 13. Minnesota Statutes 2020, section 245.462, subdivision 9, is amended to read:
726.19 		Subd. 9.Diagnostic assessment. (a) "Diagnostic assessment" has the meaning given in 
726.20 	Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota 
726.21 	Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a 
726.22 	standard, extended, or brief diagnostic assessment, or an adult update section 245I.10, 
726.23 	subdivisions 4 to 6.
726.24 	(b) A brief diagnostic assessment must include a face-to-face interview with the client 
726.25 	and a written evaluation of the client by a mental health professional or a clinical trainee, 
726.26 	as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or 
726.27 	clinical trainee must gather initial components of a standard diagnostic assessment, including 
726.28 	the client's:
726.29 	(1) age;
726.30 	(2) description of symptoms, including reason for referral;
726.31 	(3) history of mental health treatment;
726.32 	(4) cultural influences and their impact on the client; and
726.33 	(5) mental status examination.
727.1 	(c) On the basis of the initial components, the professional or clinical trainee must draw 
727.2 	a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's 
727.3 	immediate needs or presenting problem.
727.4 	(d) Treatment sessions conducted under authorization of a brief assessment may be used 
727.5 	to gather additional information necessary to complete a standard diagnostic assessment or 
727.6 	an extended diagnostic assessment.
727.7 	(e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
727.8 	unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible 
727.9 	for psychological testing as part of the diagnostic process.
727.10 	(f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
727.11 	unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction 
727.12 	with the diagnostic assessment process, a client is eligible for up to three individual or family 
727.13 	psychotherapy sessions or family psychoeducation sessions or a combination of the above 
727.14 	sessions not to exceed three sessions.
727.15 	(g) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item B, subitem (3), 
727.16 	unit (a), a brief diagnostic assessment may be used for a client's family who requires a 
727.17 	language interpreter to participate in the assessment.

727.18 	Sec. 14. Minnesota Statutes 2020, section 245.462, subdivision 14, is amended to read:
727.19 		Subd. 14.Individual treatment plan. "Individual treatment plan" means a written plan 
727.20 	of intervention, treatment, and services for an adult with mental illness that is developed 
727.21 	by a service provider under the clinical supervision of a mental health professional on the 
727.22 	basis of a diagnostic assessment. The plan identifies goals and objectives of treatment, 
727.23 	treatment strategy, a schedule for accomplishing treatment goals and objectives, and the 
727.24 	individual responsible for providing treatment to the adult with mental illness the formulation 
727.25 	of planned services that are responsive to the needs and goals of a client. An individual 
727.26 	treatment plan must be completed according to section 245I.10, subdivisions 7 and 8.

727.27 	Sec. 15. Minnesota Statutes 2020, section 245.462, subdivision 16, is amended to read:
727.28 		Subd. 16.Mental health funds. "Mental health funds" are funds expended under sections 
727.29 	245.73 and 256E.12, federal mental health block grant funds, and funds expended under 
727.30 	section 256D.06 to facilities licensed under section 245I.23 or Minnesota Rules, parts 
727.31 	9520.0500 to 9520.0670.

728.1 	Sec. 16. Minnesota Statutes 2020, section 245.462, subdivision 17, is amended to read:
728.2 		Subd. 17.Mental health practitioner. (a) "Mental health practitioner" means a staff 
728.3 	person providing services to adults with mental illness or children with emotional disturbance 
728.4 	who is qualified in at least one of the ways described in paragraphs (b) to (g). A mental 
728.5 	health practitioner for a child client must have training working with children. A mental 
728.6 	health practitioner for an adult client must have training working with adults qualified 
728.7 	according to section 245I.04, subdivision 4.
728.8 	(b) For purposes of this subdivision, a practitioner is qualified through relevant 
728.9 	coursework if the practitioner completes at least 30 semester hours or 45 quarter hours in 
728.10 	behavioral sciences or related fields and:
728.11 	(1) has at least 2,000 hours of supervised experience in the delivery of services to adults 
728.12 	or children with:
728.13 	(i) mental illness, substance use disorder, or emotional disturbance; or
728.14 	(ii) traumatic brain injury or developmental disabilities and completes training on mental 
728.15 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
728.16 	mental illness and substance abuse, and psychotropic medications and side effects;
728.17 	(2) is fluent in the non-English language of the ethnic group to which at least 50 percent 
728.18 	of the practitioner's clients belong, completes 40 hours of training in the delivery of services 
728.19 	to adults with mental illness or children with emotional disturbance, and receives clinical 
728.20 	supervision from a mental health professional at least once a week until the requirement of 
728.21 	2,000 hours of supervised experience is met;
728.22 	(3) is working in a day treatment program under section 245.4712, subdivision 2; or
728.23 	(4) has completed a practicum or internship that (i) requires direct interaction with adults 
728.24 	or children served, and (ii) is focused on behavioral sciences or related fields.
728.25 	(c) For purposes of this subdivision, a practitioner is qualified through work experience 
728.26 	if the person:
728.27 	(1) has at least 4,000 hours of supervised experience in the delivery of services to adults 
728.28 	or children with:
728.29 	(i) mental illness, substance use disorder, or emotional disturbance; or
728.30 	(ii) traumatic brain injury or developmental disabilities and completes training on mental 
728.31 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
728.32 	mental illness and substance abuse, and psychotropic medications and side effects; or
729.1 	(2) has at least 2,000 hours of supervised experience in the delivery of services to adults 
729.2 	or children with:
729.3 	(i) mental illness, emotional disturbance, or substance use disorder, and receives clinical 
729.4 	supervision as required by applicable statutes and rules from a mental health professional 
729.5 	at least once a week until the requirement of 4,000 hours of supervised experience is met; 
729.6 	or
729.7 	(ii) traumatic brain injury or developmental disabilities; completes training on mental 
729.8 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
729.9 	mental illness and substance abuse, and psychotropic medications and side effects; and 
729.10 	receives clinical supervision as required by applicable statutes and rules at least once a week 
729.11 	from a mental health professional until the requirement of 4,000 hours of supervised 
729.12 	experience is met.
729.13 	(d) For purposes of this subdivision, a practitioner is qualified through a graduate student 
729.14 	internship if the practitioner is a graduate student in behavioral sciences or related fields 
729.15 	and is formally assigned by an accredited college or university to an agency or facility for 
729.16 	clinical training.
729.17 	(e) For purposes of this subdivision, a practitioner is qualified by a bachelor's or master's 
729.18 	degree if the practitioner:
729.19 	(1) holds a master's or other graduate degree in behavioral sciences or related fields; or
729.20 	(2) holds a bachelor's degree in behavioral sciences or related fields and completes a 
729.21 	practicum or internship that (i) requires direct interaction with adults or children served, 
729.22 	and (ii) is focused on behavioral sciences or related fields.
729.23 	(f) For purposes of this subdivision, a practitioner is qualified as a vendor of medical 
729.24 	care if the practitioner meets the definition of vendor of medical care in section 256B.02, 
729.25 	subdivision 7, paragraphs (b) and (c), and is serving a federally recognized tribe.
729.26 	(g) For purposes of medical assistance coverage of diagnostic assessments, explanations 
729.27 	of findings, and psychotherapy under section 256B.0625, subdivision 65, a mental health 
729.28 	practitioner working as a clinical trainee means that the practitioner's clinical supervision 
729.29 	experience is helping the practitioner gain knowledge and skills necessary to practice 
729.30 	effectively and independently. This may include supervision of direct practice, treatment 
729.31 	team collaboration, continued professional learning, and job management. The practitioner 
729.32 	must also:
730.1 	(1) comply with requirements for licensure or board certification as a mental health 
730.2 	professional, according to the qualifications under Minnesota Rules, part 9505.0371, subpart 
730.3 	5, item A, including supervised practice in the delivery of mental health services for the 
730.4 	treatment of mental illness; or
730.5 	(2) be a student in a bona fide field placement or internship under a program leading to 
730.6 	completion of the requirements for licensure as a mental health professional according to 
730.7 	the qualifications under Minnesota Rules, part 9505.0371, subpart 5, item A.
730.8 	(h) For purposes of this subdivision, "behavioral sciences or related fields" has the 
730.9 	meaning given in section 256B.0623, subdivision 5, paragraph (d).
730.10 	(i) Notwithstanding the licensing requirements established by a health-related licensing 
730.11 	board, as defined in section 214.01, subdivision 2, this subdivision supersedes any other 
730.12 	statute or rule.

730.13 	Sec. 17. Minnesota Statutes 2020, section 245.462, subdivision 18, is amended to read:
730.14 		Subd. 18.Mental health professional. "Mental health professional" means a staff person 
730.15 	providing clinical services in the treatment of mental illness who is qualified in at least one 
730.16 	of the following ways: who is qualified according to section 245I.04, subdivision 2.
730.17 	(1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171 to 
730.18 	148.285; and:
730.19 	(i) who is certified as a clinical specialist or as a nurse practitioner in adult or family 
730.20 	psychiatric and mental health nursing by a national nurse certification organization; or
730.21 	(ii) who has a master's degree in nursing or one of the behavioral sciences or related 
730.22 	fields from an accredited college or university or its equivalent, with at least 4,000 hours 
730.23 	of post-master's supervised experience in the delivery of clinical services in the treatment 
730.24 	of mental illness;
730.25 	(2) in clinical social work: a person licensed as an independent clinical social worker 
730.26 	under chapter 148D, or a person with a master's degree in social work from an accredited 
730.27 	college or university, with at least 4,000 hours of post-master's supervised experience in 
730.28 	the delivery of clinical services in the treatment of mental illness;
730.29 	(3) in psychology: an individual licensed by the Board of Psychology under sections 
730.30 	148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis 
730.31 	and treatment of mental illness;
731.1 	(4) in psychiatry: a physician licensed under chapter 147 and certified by the American 
731.2 	Board of Psychiatry and Neurology or eligible for board certification in psychiatry, or an 
731.3 	osteopathic physician licensed under chapter 147 and certified by the American Osteopathic 
731.4 	Board of Neurology and Psychiatry or eligible for board certification in psychiatry;
731.5 	(5) in marriage and family therapy: the mental health professional must be a marriage 
731.6 	and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of 
731.7 	post-master's supervised experience in the delivery of clinical services in the treatment of 
731.8 	mental illness;
731.9 	(6) in licensed professional clinical counseling, the mental health professional shall be 
731.10 	a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours 
731.11 	of post-master's supervised experience in the delivery of clinical services in the treatment 
731.12 	of mental illness; or
731.13 	(7) in allied fields: a person with a master's degree from an accredited college or university 
731.14 	in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's 
731.15 	supervised experience in the delivery of clinical services in the treatment of mental illness.

731.16 	Sec. 18. Minnesota Statutes 2020, section 245.462, subdivision 21, is amended to read:
731.17 		Subd. 21.Outpatient services. "Outpatient services" means mental health services, 
731.18 	excluding day treatment and community support services programs, provided by or under 
731.19 	the clinical treatment supervision of a mental health professional to adults with mental 
731.20 	illness who live outside a hospital. Outpatient services include clinical activities such as 
731.21 	individual, group, and family therapy; individual treatment planning; diagnostic assessments; 
731.22 	medication management; and psychological testing.

731.23 	Sec. 19. Minnesota Statutes 2020, section 245.462, subdivision 23, is amended to read:
731.24 		Subd. 23.Residential treatment. "Residential treatment" means a 24-hour-a-day program 
731.25 	under the clinical treatment supervision of a mental health professional, in a community 
731.26 	residential setting other than an acute care hospital or regional treatment center inpatient 
731.27 	unit, that must be licensed as a residential treatment program for adults with mental illness 
731.28 	under chapter 245I, Minnesota Rules, parts 9520.0500 to 9520.0670, or other rules adopted 
731.29 	by the commissioner.

732.1 	Sec. 20. Minnesota Statutes 2020, section 245.462, is amended by adding a subdivision 
732.2 	to read:
732.3 		Subd. 27.Treatment supervision. "Treatment supervision" means the treatment 
732.4 	supervision described by section 245I.06.

732.5 	Sec. 21. Minnesota Statutes 2020, section 245.4661, subdivision 5, is amended to read:
732.6 		Subd. 5.Planning for pilot projects. (a) Each local plan for a pilot project, with the 
732.7 	exception of the placement of a Minnesota specialty treatment facility as defined in paragraph 
732.8 	(c), must be developed under the direction of the county board, or multiple county boards 
732.9 	acting jointly, as the local mental health authority. The planning process for each pilot shall 
732.10 	include, but not be limited to, mental health consumers, families, advocates, local mental 
732.11 	health advisory councils, local and state providers, representatives of state and local public 
732.12 	employee bargaining units, and the department of human services. As part of the planning 
732.13 	process, the county board or boards shall designate a managing entity responsible for receipt 
732.14 	of funds and management of the pilot project.
732.15 	(b) For Minnesota specialty treatment facilities, the commissioner shall issue a request 
732.16 	for proposal for regions in which a need has been identified for services.
732.17 	(c) For purposes of this section, "Minnesota specialty treatment facility" is defined as 
732.18 	an intensive residential treatment service licensed under section 256B.0622, subdivision 2, 
732.19 	paragraph (b) chapter 245I.

732.20 	Sec. 22. Minnesota Statutes 2020, section 245.4662, subdivision 1, is amended to read:
732.21 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
732.22 	the meanings given them.
732.23 	(b) "Community partnership" means a project involving the collaboration of two or more 
732.24 	eligible applicants.
732.25 	(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service 
732.26 	provider, hospital, or community partnership. Eligible applicant does not include a 
732.27 	state-operated direct care and treatment facility or program under chapter 246.
732.28 	(d) "Intensive residential treatment services" has the meaning given in section 256B.0622, 
732.29 	subdivision 2.
732.30 	(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section 
732.31 	473.121, subdivision 2.

733.1 	Sec. 23. Minnesota Statutes 2020, section 245.467, subdivision 2, is amended to read:
733.2 		Subd. 2.Diagnostic assessment. All providers of residential, acute care hospital inpatient, 
733.3 	and regional treatment centers must complete a diagnostic assessment for each of their 
733.4 	clients within five days of admission. Providers of day treatment services must complete a 
733.5 	diagnostic assessment within five days after the adult's second visit or within 30 days after 
733.6 	intake, whichever occurs first. In cases where a diagnostic assessment is available and has 
733.7 	been completed within three years preceding admission, only an adult diagnostic assessment 
733.8 	update is necessary. An "adult diagnostic assessment update" means a written summary by 
733.9 	a mental health professional of the adult's current mental health status and service needs 
733.10 	and includes a face-to-face interview with the adult. If the adult's mental health status has 
733.11 	changed markedly since the adult's most recent diagnostic assessment, a new diagnostic 
733.12 	assessment is required. Compliance with the provisions of this subdivision does not ensure 
733.13 	eligibility for medical assistance reimbursement under chapter 256B. Providers of services 
733.14 	governed by this section must complete a diagnostic assessment according to the standards 
733.15 	of section 245I.10, subdivisions 4 to 6.

733.16 	Sec. 24. Minnesota Statutes 2020, section 245.467, subdivision 3, is amended to read:
733.17 		Subd. 3.Individual treatment plans. All providers of outpatient services, day treatment 
733.18 	services, residential treatment, acute care hospital inpatient treatment, and all regional 
733.19 	treatment centers must develop an individual treatment plan for each of their adult clients. 
733.20 	The individual treatment plan must be based on a diagnostic assessment. To the extent 
733.21 	possible, the adult client shall be involved in all phases of developing and implementing 
733.22 	the individual treatment plan. Providers of residential treatment and acute care hospital 
733.23 	inpatient treatment, and all regional treatment centers must develop the individual treatment 
733.24 	plan within ten days of client intake and must review the individual treatment plan every 
733.25 	90 days after intake. Providers of day treatment services must develop the individual 
733.26 	treatment plan before the completion of five working days in which service is provided or 
733.27 	within 30 days after the diagnostic assessment is completed or obtained, whichever occurs 
733.28 	first. Providers of outpatient services must develop the individual treatment plan within 30 
733.29 	days after the diagnostic assessment is completed or obtained or by the end of the second 
733.30 	session of an outpatient service, not including the session in which the diagnostic assessment 
733.31 	was provided, whichever occurs first. Outpatient and day treatment services providers must 
733.32 	review the individual treatment plan every 90 days after intake. Providers of services 
733.33 	governed by this section must complete an individual treatment plan according to the 
733.34 	standards of section 245I.10, subdivisions 7 and 8.

734.1 	Sec. 25. Minnesota Statutes 2020, section 245.470, subdivision 1, is amended to read:
734.2 		Subdivision 1.Availability of outpatient services. (a) County boards must provide or 
734.3 	contract for enough outpatient services within the county to meet the needs of adults with 
734.4 	mental illness residing in the county. Services may be provided directly by the county 
734.5 	through county-operated mental health centers or mental health clinics approved by the 
734.6 	commissioner under section 245.69, subdivision 2 meeting the standards of chapter 245I; 
734.7 	by contract with privately operated mental health centers or mental health clinics approved 
734.8 	by the commissioner under section 245.69, subdivision 2 meeting the standards of chapter 
734.9 	245I; by contract with hospital mental health outpatient programs certified by the Joint 
734.10 	Commission on Accreditation of Hospital Organizations; or by contract with a licensed
734.11 	mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (6). 
734.12 	Clients may be required to pay a fee according to section 245.481. Outpatient services 
734.13 	include:
734.14 	(1) conducting diagnostic assessments;
734.15 	(2) conducting psychological testing;
734.16 	(3) developing or modifying individual treatment plans;
734.17 	(4) making referrals and recommending placements as appropriate;
734.18 	(5) treating an adult's mental health needs through therapy;
734.19 	(6) prescribing and managing medication and evaluating the effectiveness of prescribed 
734.20 	medication; and
734.21 	(7) preventing placement in settings that are more intensive, costly, or restrictive than 
734.22 	necessary and appropriate to meet client needs.
734.23 	(b) County boards may request a waiver allowing outpatient services to be provided in 
734.24 	a nearby trade area if it is determined that the client can best be served outside the county.

734.25 	Sec. 26. Minnesota Statutes 2020, section 245.4712, subdivision 2, is amended to read:
734.26 		Subd. 2.Day treatment services provided. (a) Day treatment services must be developed 
734.27 	as a part of the community support services available to adults with serious and persistent 
734.28 	mental illness residing in the county. Adults may be required to pay a fee according to 
734.29 	section 245.481. Day treatment services must be designed to:
734.30 	(1) provide a structured environment for treatment;
734.31 	(2) provide support for residing in the community;
735.1 	(3) prevent placement in settings that are more intensive, costly, or restrictive than 
735.2 	necessary and appropriate to meet client need;
735.3 	(4) coordinate with or be offered in conjunction with a local education agency's special 
735.4 	education program; and
735.5 	(5) operate on a continuous basis throughout the year.
735.6 	(b) For purposes of complying with medical assistance requirements, an adult day 
735.7 	treatment program must comply with the method of clinical supervision specified in 
735.8 	Minnesota Rules, part 9505.0371, subpart 4. The clinical supervision must be performed 
735.9 	by a qualified supervisor who satisfies the requirements of Minnesota Rules, part 9505.0371, 
735.10 	subpart 5. An adult day treatment program must comply with medical assistance requirements 
735.11 	in section 256B.0671, subdivision 3.
735.12 	A day treatment program must demonstrate compliance with this clinical supervision 
735.13 	requirement by the commissioner's review and approval of the program according to 
735.14 	Minnesota Rules, part 9505.0372, subpart 8.
735.15 	(c) County boards may request a waiver from including day treatment services if they 
735.16 	can document that:
735.17 	(1) an alternative plan of care exists through the county's community support services 
735.18 	for clients who would otherwise need day treatment services;
735.19 	(2) day treatment, if included, would be duplicative of other components of the 
735.20 	community support services; and
735.21 	(3) county demographics and geography make the provision of day treatment services 
735.22 	cost ineffective and infeasible.

735.23 	Sec. 27. Minnesota Statutes 2020, section 245.472, subdivision 2, is amended to read:
735.24 		Subd. 2.Specific requirements. Providers of residential services must be licensed under 
735.25 	chapter 245I or applicable rules adopted by the commissioner and must be clinically 
735.26 	supervised by a mental health professional. Persons employed in facilities licensed under 
735.27 	Minnesota Rules, parts 9520.0500 to 9520.0670, in the capacity of program director as of 
735.28 	July 1, 1987, in accordance with Minnesota Rules, parts 9520.0500 to 9520.0670, may be 
735.29 	allowed to continue providing clinical supervision within a facility, provided they continue 
735.30 	to be employed as a program director in a facility licensed under Minnesota Rules, parts 
735.31 	9520.0500 to 9520.0670. Residential services must be provided under treatment supervision.

736.1 	Sec. 28. Minnesota Statutes 2020, section 245.4863, is amended to read:
736.2 	245.4863 INTEGRATED CO-OCCURRING DISORDER TREATMENT.
736.3 	(a) The commissioner shall require individuals who perform chemical dependency 
736.4 	assessments to screen clients for co-occurring mental health disorders, and staff who perform 
736.5 	mental health diagnostic assessments to screen for co-occurring substance use disorders. 
736.6 	Screening tools must be approved by the commissioner. If a client screens positive for a 
736.7 	co-occurring mental health or substance use disorder, the individual performing the screening 
736.8 	must document what actions will be taken in response to the results and whether further 
736.9 	assessments must be performed.
736.10 	(b) Notwithstanding paragraph (a), screening is not required when:
736.11 	(1) the presence of co-occurring disorders was documented for the client in the past 12 
736.12 	months;
736.13 	(2) the client is currently receiving co-occurring disorders treatment;
736.14 	(3) the client is being referred for co-occurring disorders treatment; or
736.15 	(4) a mental health professional, as defined in Minnesota Rules, part 9505.0370, subpart 
736.16 	18, who is competent to perform diagnostic assessments of co-occurring disorders is 
736.17 	performing a diagnostic assessment that meets the requirements in Minnesota Rules, part 
736.18 	9533.0090, subpart 5, to identify whether the client may have co-occurring mental health 
736.19 	and chemical dependency disorders. If an individual is identified to have co-occurring 
736.20 	mental health and substance use disorders, the assessing mental health professional must 
736.21 	document what actions will be taken to address the client's co-occurring disorders.
736.22 	(c) The commissioner shall adopt rules as necessary to implement this section. The 
736.23 	commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing 
736.24 	a certification process for integrated dual disorder treatment providers and a system through 
736.25 	which individuals receive integrated dual diagnosis treatment if assessed as having both a 
736.26 	substance use disorder and either a serious mental illness or emotional disturbance.
736.27 	(d) The commissioner shall apply for any federal waivers necessary to secure, to the 
736.28 	extent allowed by law, federal financial participation for the provision of integrated dual 
736.29 	diagnosis treatment to persons with co-occurring disorders.

736.30 	Sec. 29. Minnesota Statutes 2020, section 245.4871, subdivision 9a, is amended to read:
736.31 		Subd. 9a.Crisis assistance planning. "Crisis assistance planning" means assistance to 
736.32 	the child, the child's family, and all providers of services to the child to: recognize factors 
737.1 	precipitating a mental health crisis, identify behaviors related to the crisis, and be informed 
737.2 	of available resources to resolve the crisis. Crisis assistance requires the development of a 
737.3 	plan which addresses prevention and intervention strategies to be used in a potential crisis. 
737.4 	Other interventions include: (1) arranging for admission to acute care hospital inpatient 
737.5 	treatment the development of a written plan to assist a child and the child's family in 
737.6 	preventing and addressing a potential crisis and is distinct from mobile crisis services defined 
737.7 	in section 256B.0624. The plan must address prevention, deescalation, and intervention 
737.8 	strategies to be used in a crisis. The plan identifies factors that might precipitate a crisis, 
737.9 	behaviors or symptoms related to the emergence of a crisis, and the resources available to 
737.10 	resolve a crisis. The plan must address the following potential needs: (1) acute care; (2) 
737.11 	crisis placement; (3) community resources for follow-up; and (4) emotional support to the 
737.12 	family during crisis. When appropriate for the child's needs, the plan must include strategies 
737.13 	to reduce the child's risk of suicide and self-injurious behavior. Crisis assistance planning
737.14 	does not include services designed to secure the safety of a child who is at risk of abuse or 
737.15 	neglect or necessary emergency services.

737.16 	Sec. 30. Minnesota Statutes 2020, section 245.4871, subdivision 10, is amended to read:
737.17 		Subd. 10.Day treatment services. "Day treatment," "day treatment services," or "day 
737.18 	treatment program" means a structured program of treatment and care provided to a child 
737.19 	in:
737.20 	(1) an outpatient hospital accredited by the Joint Commission on Accreditation of Health 
737.21 	Organizations and licensed under sections 144.50 to 144.55;
737.22 	(2) a community mental health center under section 245.62;
737.23 	(3) an entity that is under contract with the county board to operate a program that meets 
737.24 	the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170
737.25 	to 9505.0475; or
737.26 	(4) an entity that operates a program that meets the requirements of section 245.4884, 
737.27 	subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475, that is under contract 
737.28 	with an entity that is under contract with a county board.; or
737.29 	(5) a program certified under section 256B.0943.
737.30 	Day treatment consists of group psychotherapy and other intensive therapeutic services 
737.31 	that are provided for a minimum two-hour time block by a multidisciplinary staff under the 
737.32 	clinical treatment supervision of a mental health professional. Day treatment may include 
737.33 	education and consultation provided to families and other individuals as an extension of the 
738.1 	treatment process. The services are aimed at stabilizing the child's mental health status, and 
738.2 	developing and improving the child's daily independent living and socialization skills. Day 
738.3 	treatment services are distinguished from day care by their structured therapeutic program 
738.4 	of psychotherapy services. Day treatment services are not a part of inpatient hospital or 
738.5 	residential treatment services.
738.6 	A day treatment service must be available to a child up to 15 hours a week throughout 
738.7 	the year and must be coordinated with, integrated with, or part of an education program 
738.8 	offered by the child's school.

738.9 	Sec. 31. Minnesota Statutes 2020, section 245.4871, subdivision 11a, is amended to read:
738.10 		Subd. 11a.Diagnostic assessment. (a) "Diagnostic assessment" has the meaning given 
738.11 	in Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota 
738.12 	Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a 
738.13 	standard, extended, or brief diagnostic assessment, or an adult update section 245I.10, 
738.14 	subdivisions 4 to 6.
738.15 	(b) A brief diagnostic assessment must include a face-to-face interview with the client 
738.16 	and a written evaluation of the client by a mental health professional or a clinical trainee, 
738.17 	as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or 
738.18 	clinical trainee must gather initial components of a standard diagnostic assessment, including 
738.19 	the client's:
738.20 	(1) age;
738.21 	(2) description of symptoms, including reason for referral;
738.22 	(3) history of mental health treatment;
738.23 	(4) cultural influences and their impact on the client; and
738.24 	(5) mental status examination.
738.25 	(c) On the basis of the brief components, the professional or clinical trainee must draw 
738.26 	a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's 
738.27 	immediate needs or presenting problem.
738.28 	(d) Treatment sessions conducted under authorization of a brief assessment may be used 
738.29 	to gather additional information necessary to complete a standard diagnostic assessment or 
738.30 	an extended diagnostic assessment.
739.1 	(e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
739.2 	unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible 
739.3 	for psychological testing as part of the diagnostic process.
739.4 	(f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
739.5 	unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction 
739.6 	with the diagnostic assessment process, a client is eligible for up to three individual or family 
739.7 	psychotherapy sessions or family psychoeducation sessions or a combination of the above 
739.8 	sessions not to exceed three sessions.

739.9 	Sec. 32. Minnesota Statutes 2020, section 245.4871, subdivision 17, is amended to read:
739.10 		Subd. 17.Family community support services. "Family community support services" 
739.11 	means services provided under the clinical treatment supervision of a mental health 
739.12 	professional and designed to help each child with severe emotional disturbance to function 
739.13 	and remain with the child's family in the community. Family community support services 
739.14 	do not include acute care hospital inpatient treatment, residential treatment services, or 
739.15 	regional treatment center services. Family community support services include:
739.16 	(1) client outreach to each child with severe emotional disturbance and the child's family;
739.17 	(2) medication monitoring where necessary;
739.18 	(3) assistance in developing independent living skills;
739.19 	(4) assistance in developing parenting skills necessary to address the needs of the child 
739.20 	with severe emotional disturbance;
739.21 	(5) assistance with leisure and recreational activities;
739.22 	(6) crisis assistance planning, including crisis placement and respite care;
739.23 	(7) professional home-based family treatment;
739.24 	(8) foster care with therapeutic supports;
739.25 	(9) day treatment;
739.26 	(10) assistance in locating respite care and special needs day care; and
739.27 	(11) assistance in obtaining potential financial resources, including those benefits listed 
739.28 	in section 245.4884, subdivision 5.

740.1 	Sec. 33. Minnesota Statutes 2020, section 245.4871, subdivision 21, is amended to read:
740.2 		Subd. 21.Individual treatment plan. "Individual treatment plan" means a written plan 
740.3 	of intervention, treatment, and services for a child with an emotional disturbance that is 
740.4 	developed by a service provider under the clinical supervision of a mental health professional 
740.5 	on the basis of a diagnostic assessment. An individual treatment plan for a child must be 
740.6 	developed in conjunction with the family unless clinically inappropriate. The plan identifies 
740.7 	goals and objectives of treatment, treatment strategy, a schedule for accomplishing treatment 
740.8 	goals and objectives, and the individuals responsible for providing treatment to the child 
740.9 	with an emotional disturbance the formulation of planned services that are responsive to 
740.10 	the needs and goals of a client. An individual treatment plan must be completed according 
740.11 	to section 245I.10, subdivisions 7 and 8.

740.12 	Sec. 34. Minnesota Statutes 2020, section 245.4871, subdivision 26, is amended to read:
740.13 		Subd. 26.Mental health practitioner. "Mental health practitioner" has the meaning 
740.14 	given in section 245.462, subdivision 17 means a staff person who is qualified according 
740.15 	to section 245I.04, subdivision 4.

740.16 	Sec. 35. Minnesota Statutes 2020, section 245.4871, subdivision 27, is amended to read:
740.17 		Subd. 27.Mental health professional. "Mental health professional" means a staff person 
740.18 	providing clinical services in the diagnosis and treatment of children's emotional disorders. 
740.19 	A mental health professional must have training and experience in working with children 
740.20 	consistent with the age group to which the mental health professional is assigned. A mental 
740.21 	health professional must be qualified in at least one of the following ways: who is qualified 
740.22 	according to section 245I.04, subdivision 2.
740.23 	(1) in psychiatric nursing, the mental health professional must be a registered nurse who 
740.24 	is licensed under sections 148.171 to 148.285 and who is certified as a clinical specialist in 
740.25 	child and adolescent psychiatric or mental health nursing by a national nurse certification 
740.26 	organization or who has a master's degree in nursing or one of the behavioral sciences or 
740.27 	related fields from an accredited college or university or its equivalent, with at least 4,000 
740.28 	hours of post-master's supervised experience in the delivery of clinical services in the 
740.29 	treatment of mental illness;
740.30 	(2) in clinical social work, the mental health professional must be a person licensed as 
740.31 	an independent clinical social worker under chapter 148D, or a person with a master's degree 
740.32 	in social work from an accredited college or university, with at least 4,000 hours of 
741.1 	post-master's supervised experience in the delivery of clinical services in the treatment of 
741.2 	mental disorders;
741.3 	(3) in psychology, the mental health professional must be an individual licensed by the 
741.4 	board of psychology under sections 148.88 to 148.98 who has stated to the board of 
741.5 	psychology competencies in the diagnosis and treatment of mental disorders;
741.6 	(4) in psychiatry, the mental health professional must be a physician licensed under 
741.7 	chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible 
741.8 	for board certification in psychiatry or an osteopathic physician licensed under chapter 147 
741.9 	and certified by the American Osteopathic Board of Neurology and Psychiatry or eligible 
741.10 	for board certification in psychiatry;
741.11 	(5) in marriage and family therapy, the mental health professional must be a marriage 
741.12 	and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of 
741.13 	post-master's supervised experience in the delivery of clinical services in the treatment of 
741.14 	mental disorders or emotional disturbances;
741.15 	(6) in licensed professional clinical counseling, the mental health professional shall be 
741.16 	a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours 
741.17 	of post-master's supervised experience in the delivery of clinical services in the treatment 
741.18 	of mental disorders or emotional disturbances; or
741.19 	(7) in allied fields, the mental health professional must be a person with a master's degree 
741.20 	from an accredited college or university in one of the behavioral sciences or related fields, 
741.21 	with at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
741.22 	services in the treatment of emotional disturbances.

741.23 	Sec. 36. Minnesota Statutes 2020, section 245.4871, subdivision 29, is amended to read:
741.24 		Subd. 29.Outpatient services. "Outpatient services" means mental health services, 
741.25 	excluding day treatment and community support services programs, provided by or under 
741.26 	the clinical treatment supervision of a mental health professional to children with emotional 
741.27 	disturbances who live outside a hospital. Outpatient services include clinical activities such 
741.28 	as individual, group, and family therapy; individual treatment planning; diagnostic 
741.29 	assessments; medication management; and psychological testing.

741.30 	Sec. 37. Minnesota Statutes 2020, section 245.4871, subdivision 31, is amended to read:
741.31 		Subd. 31.Professional home-based family treatment. "Professional home-based family 
741.32 	treatment" means intensive mental health services provided to children because of an 
742.1 	emotional disturbance (1) who are at risk of out-of-home placement; (2) who are in 
742.2 	out-of-home placement; or (3) who are returning from out-of-home placement. Services 
742.3 	are provided to the child and the child's family primarily in the child's home environment. 
742.4 	Services may also be provided in the child's school, child care setting, or other community 
742.5 	setting appropriate to the child. Services must be provided on an individual family basis, 
742.6 	must be child-oriented and family-oriented, and must be designed using information from 
742.7 	diagnostic and functional assessments to meet the specific mental health needs of the child 
742.8 	and the child's family. Examples of services are: (1) individual therapy; (2) family therapy; 
742.9 	(3) client outreach; (4) assistance in developing individual living skills; (5) assistance in 
742.10 	developing parenting skills necessary to address the needs of the child; (6) assistance with 
742.11 	leisure and recreational services; (7) crisis assistance planning, including crisis respite care 
742.12 	and arranging for crisis placement; and (8) assistance in locating respite and child care. 
742.13 	Services must be coordinated with other services provided to the child and family.

742.14 	Sec. 38. Minnesota Statutes 2020, section 245.4871, subdivision 32, is amended to read:
742.15 		Subd. 32.Residential treatment. "Residential treatment" means a 24-hour-a-day program 
742.16 	under the clinical treatment supervision of a mental health professional, in a community 
742.17 	residential setting other than an acute care hospital or regional treatment center inpatient 
742.18 	unit, that must be licensed as a residential treatment program for children with emotional 
742.19 	disturbances under Minnesota Rules, parts 2960.0580 to 2960.0700, or other rules adopted 
742.20 	by the commissioner.

742.21 	Sec. 39. Minnesota Statutes 2020, section 245.4871, subdivision 34, is amended to read:
742.22 		Subd. 34.Therapeutic support of foster care. "Therapeutic support of foster care" 
742.23 	means the mental health training and mental health support services and clinical treatment
742.24 	supervision provided by a mental health professional to foster families caring for children 
742.25 	with severe emotional disturbance to provide a therapeutic family environment and support 
742.26 	for the child's improved functioning. Therapeutic support of foster care includes services 
742.27 	provided under section 256B.0946.

742.28 	Sec. 40. Minnesota Statutes 2020, section 245.4871, is amended by adding a subdivision 
742.29 	to read:
742.30 		Subd. 36.Treatment supervision. "Treatment supervision" means the treatment 
742.31 	supervision described by section 245I.06.

743.1 	Sec. 41. Minnesota Statutes 2020, section 245.4876, subdivision 2, is amended to read:
743.2 		Subd. 2.Diagnostic assessment. All residential treatment facilities and acute care 
743.3 	hospital inpatient treatment facilities that provide mental health services for children must 
743.4 	complete a diagnostic assessment for each of their child clients within five working days 
743.5 	of admission. Providers of day treatment services for children must complete a diagnostic 
743.6 	assessment within five days after the child's second visit or 30 days after intake, whichever 
743.7 	occurs first. In cases where a diagnostic assessment is available and has been completed 
743.8 	within 180 days preceding admission, only updating is necessary. "Updating" means a 
743.9 	written summary by a mental health professional of the child's current mental health status 
743.10 	and service needs. If the child's mental health status has changed markedly since the child's 
743.11 	most recent diagnostic assessment, a new diagnostic assessment is required. Compliance 
743.12 	with the provisions of this subdivision does not ensure eligibility for medical assistance 
743.13 	reimbursement under chapter 256B. Providers of services governed by this section shall 
743.14 	complete a diagnostic assessment according to the standards of section 245I.10, subdivisions 
743.15 	4 to 6.

743.16 	Sec. 42. Minnesota Statutes 2020, section 245.4876, subdivision 3, is amended to read:
743.17 		Subd. 3.Individual treatment plans. All providers of outpatient services, day treatment 
743.18 	services, professional home-based family treatment, residential treatment, and acute care 
743.19 	hospital inpatient treatment, and all regional treatment centers that provide mental health 
743.20 	services for children must develop an individual treatment plan for each child client. The 
743.21 	individual treatment plan must be based on a diagnostic assessment. To the extent appropriate, 
743.22 	the child and the child's family shall be involved in all phases of developing and 
743.23 	implementing the individual treatment plan. Providers of residential treatment, professional 
743.24 	home-based family treatment, and acute care hospital inpatient treatment, and regional 
743.25 	treatment centers must develop the individual treatment plan within ten working days of 
743.26 	client intake or admission and must review the individual treatment plan every 90 days after 
743.27 	intake, except that the administrative review of the treatment plan of a child placed in a 
743.28 	residential facility shall be as specified in sections 260C.203 and 260C.212, subdivision 9. 
743.29 	Providers of day treatment services must develop the individual treatment plan before the 
743.30 	completion of five working days in which service is provided or within 30 days after the 
743.31 	diagnostic assessment is completed or obtained, whichever occurs first. Providers of 
743.32 	outpatient services must develop the individual treatment plan within 30 days after the 
743.33 	diagnostic assessment is completed or obtained or by the end of the second session of an 
743.34 	outpatient service, not including the session in which the diagnostic assessment was provided, 
743.35 	whichever occurs first. Providers of outpatient and day treatment services must review the 
744.1 	individual treatment plan every 90 days after intake. Providers of services governed by this 
744.2 	section shall complete an individual treatment plan according to the standards of section 
744.3 	245I.10, subdivisions 7 and 8.

744.4 	Sec. 43. Minnesota Statutes 2020, section 245.488, subdivision 1, is amended to read:
744.5 		Subdivision 1.Availability of outpatient services. (a) County boards must provide or 
744.6 	contract for enough outpatient services within the county to meet the needs of each child 
744.7 	with emotional disturbance residing in the county and the child's family. Services may be 
744.8 	provided directly by the county through county-operated mental health centers or mental 
744.9 	health clinics approved by the commissioner under section 245.69, subdivision 2 meeting 
744.10 	the standards of chapter 245I; by contract with privately operated mental health centers or
744.11 	mental health clinics approved by the commissioner under section 245.69, subdivision 2
744.12 	meeting the standards of chapter 245I; by contract with hospital mental health outpatient 
744.13 	programs certified by the Joint Commission on Accreditation of Hospital Organizations; 
744.14 	or by contract with a licensed mental health professional as defined in section 245.4871, 
744.15 	subdivision 27, clauses (1) to (6). A child or a child's parent may be required to pay a fee 
744.16 	based in accordance with section 245.481. Outpatient services include:
744.17 	(1) conducting diagnostic assessments;
744.18 	(2) conducting psychological testing;
744.19 	(3) developing or modifying individual treatment plans;
744.20 	(4) making referrals and recommending placements as appropriate;
744.21 	(5) treating the child's mental health needs through therapy; and
744.22 	(6) prescribing and managing medication and evaluating the effectiveness of prescribed 
744.23 	medication.
744.24 	(b) County boards may request a waiver allowing outpatient services to be provided in 
744.25 	a nearby trade area if it is determined that the child requires necessary and appropriate 
744.26 	services that are only available outside the county.
744.27 	(c) Outpatient services offered by the county board to prevent placement must be at the 
744.28 	level of treatment appropriate to the child's diagnostic assessment.

744.29 	Sec. 44. Minnesota Statutes 2020, section 245.4901, subdivision 2, is amended to read:
744.30 		Subd. 2.Eligible applicants. An eligible applicant for school-linked mental health grants 
744.31 	is an entity that is:
745.1 	(1) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 9520.0870
745.2 	section 245I.20;
745.3 	(2) a community mental health center under section 256B.0625, subdivision 5;
745.4 	(3) an Indian health service facility or a facility owned and operated by a tribe or tribal 
745.5 	organization operating under United States Code, title 25, section 5321;
745.6 	(4) a provider of children's therapeutic services and supports as defined in section 
745.7 	256B.0943; or
745.8 	(5) enrolled in medical assistance as a mental health or substance use disorder provider 
745.9 	agency and employs at least two full-time equivalent mental health professionals qualified 
745.10 	according to section 245I.16 245I.04, subdivision 2, or two alcohol and drug counselors 
745.11 	licensed or exempt from licensure under chapter 148F who are qualified to provide clinical 
745.12 	services to children and families.

745.13 	Sec. 45. Minnesota Statutes 2020, section 245.62, subdivision 2, is amended to read:
745.14 		Subd. 2.Definition. A community mental health center is a private nonprofit corporation 
745.15 	or public agency approved under the rules promulgated by the commissioner pursuant to 
745.16 	subdivision 4 standards of section 256B.0625, subdivision 5.

745.17 	Sec. 46. Minnesota Statutes 2020, section 245A.04, subdivision 5, is amended to read:
745.18 		Subd. 5.Commissioner's right of access. (a) When the commissioner is exercising the 
745.19 	powers conferred by this chapter, sections 245.69 and section626.557, and chapter 260E, 
745.20 	the commissioner must be given access to:
745.21 	(1) the physical plant and grounds where the program is provided;
745.22 	(2) documents and records, including records maintained in electronic format;
745.23 	(3) persons served by the program; and
745.24 	(4) staff and personnel records of current and former staff whenever the program is in 
745.25 	operation and the information is relevant to inspections or investigations conducted by the 
745.26 	commissioner. Upon request, the license holder must provide the commissioner verification 
745.27 	of documentation of staff work experience, training, or educational requirements.
745.28 	The commissioner must be given access without prior notice and as often as the 
745.29 	commissioner considers necessary if the commissioner is investigating alleged maltreatment, 
745.30 	conducting a licensing inspection, or investigating an alleged violation of applicable laws 
745.31 	or rules. In conducting inspections, the commissioner may request and shall receive assistance 
746.1 	from other state, county, and municipal governmental agencies and departments. The 
746.2 	applicant or license holder shall allow the commissioner to photocopy, photograph, and 
746.3 	make audio and video tape recordings during the inspection of the program at the 
746.4 	commissioner's expense. The commissioner shall obtain a court order or the consent of the 
746.5 	subject of the records or the parents or legal guardian of the subject before photocopying 
746.6 	hospital medical records.
746.7 	(b) Persons served by the program have the right to refuse to consent to be interviewed, 
746.8 	photographed, or audio or videotaped. Failure or refusal of an applicant or license holder 
746.9 	to fully comply with this subdivision is reasonable cause for the commissioner to deny the 
746.10 	application or immediately suspend or revoke the license.

746.11 	Sec. 47. Minnesota Statutes 2020, section 245A.10, subdivision 4, is amended to read:
746.12 		Subd. 4.License or certification fee for certain programs. (a) Child care centers shall 
746.13 	pay an annual nonrefundable license fee based on the following schedule:

746.15746.14
		Licensed Capacity
	Child Care Center
License Fee
	
746.16		1 to 24 persons
	$200
	
746.17		25 to 49 persons
	$300
	
746.18		50 to 74 persons
	$400
	
746.19		75 to 99 persons
	$500
	
746.20		100 to 124 persons
	$600
	
746.21		125 to 149 persons
	$700
	
746.22		150 to 174 persons
	$800
	
746.23		175 to 199 persons
	$900
	
746.24		200 to 224 persons
	$1,000
	
746.25		225 or more persons
	$1,100
	
746.26 	(b)(1) A program licensed to provide one or more of the home and community-based 
746.27 	services and supports identified under chapter 245D to persons with disabilities or age 65 
746.28 	and older, shall pay an annual nonrefundable license fee based on revenues derived from 
746.29 	the provision of services that would require licensure under chapter 245D during the calendar 
746.30 	year immediately preceding the year in which the license fee is paid, according to the 
746.31 	following schedule:

746.32	License Holder Annual Revenue
		License Fee
	
746.33	less than or equal to $10,000
		$200
	
746.34
746.35	greater than $10,000 but less than or 
equal to $25,000
		$300
	
747.1
747.2	greater than $25,000 but less than or 
equal to $50,000
		$400
	
747.3
747.4	greater than $50,000 but less than or 
equal to $100,000
		$500
	
747.5
747.6	greater than $100,000 but less than or 
equal to $150,000
		$600
	
747.7
747.8	greater than $150,000 but less than or 
equal to $200,000
		$800
	
747.9747.10
	greater than $200,000 but less than or 
equal to $250,000
		$1,000
	
747.11
747.12	greater than $250,000 but less than or 
equal to $300,000
		$1,200
	
747.13
747.14	greater than $300,000 but less than or 
equal to $350,000
		$1,400
	
747.15
747.16	greater than $350,000 but less than or 
equal to $400,000
		$1,600
	
747.17
747.18	greater than $400,000 but less than or 
equal to $450,000
		$1,800
	
747.19
747.20	greater than $450,000 but less than or 
equal to $500,000
		$2,000
	
747.21
747.22	greater than $500,000 but less than or 
equal to $600,000
		$2,250
	
747.23
747.24	greater than $600,000 but less than or 
equal to $700,000
		$2,500
	
747.25
747.26	greater than $700,000 but less than or 
equal to $800,000
		$2,750
	
747.27
747.28	greater than $800,000 but less than or 
equal to $900,000
		$3,000
	
747.29
747.30	greater than $900,000 but less than or 
equal to $1,000,000
		$3,250
	
747.31
747.32	greater than $1,000,000 but less than or 
equal to $1,250,000
		$3,500
	
747.33
747.34	greater than $1,250,000 but less than or 
equal to $1,500,000
		$3,750
	
747.35
747.36	greater than $1,500,000 but less than or 
equal to $1,750,000
		$4,000
	
747.37
747.38	greater than $1,750,000 but less than or 
equal to $2,000,000
		$4,250
	
747.39
747.40	greater than $2,000,000 but less than or 
equal to $2,500,000
		$4,500
	
747.41
747.42	greater than $2,500,000 but less than or 
equal to $3,000,000
		$4,750
	
747.43
747.44	greater than $3,000,000 but less than or 
equal to $3,500,000
		$5,000
	
747.45
747.46	greater than $3,500,000 but less than or 
equal to $4,000,000
		$5,500
	
748.1
748.2	greater than $4,000,000 but less than or 
equal to $4,500,000
		$6,000
	
748.3
748.4	greater than $4,500,000 but less than or 
equal to $5,000,000
		$6,500
	
748.5
748.6	greater than $5,000,000 but less than or 
equal to $7,500,000
		$7,000
	
748.7
748.8	greater than $7,500,000 but less than or 
equal to $10,000,000
		$8,500
	
748.9748.10
	greater than $10,000,000 but less than or 
equal to $12,500,000
		$10,000
	
748.11
748.12	greater than $12,500,000 but less than or 
equal to $15,000,000
		$14,000
	
748.13	greater than $15,000,000
		$18,000
	
748.14 	(2) If requested, the license holder shall provide the commissioner information to verify 
748.15 	the license holder's annual revenues or other information as needed, including copies of 
748.16 	documents submitted to the Department of Revenue.
748.17 	(3) At each annual renewal, a license holder may elect to pay the highest renewal fee, 
748.18 	and not provide annual revenue information to the commissioner.
748.19 	(4) A license holder that knowingly provides the commissioner incorrect revenue amounts 
748.20 	for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount 
748.21 	of double the fee the provider should have paid.
748.22 	(5) Notwithstanding clause (1), a license holder providing services under one or more 
748.23 	licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license 
748.24 	fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license 
748.25 	holder for all licenses held under chapter 245B for calendar year 2013. For calendar year 
748.26 	2017 and thereafter, the license holder shall pay an annual license fee according to clause 
748.27 	(1).
748.28 	(c) A chemical dependency treatment program licensed under chapter 245G, to provide 
748.29 	chemical dependency treatment shall pay an annual nonrefundable license fee based on the 
748.30 	following schedule:

748.31		Licensed Capacity
	License Fee
	
748.32		1 to 24 persons
	$600
	
748.33		25 to 49 persons
	$800
	
748.34		50 to 74 persons
	$1,000
	
748.35		75 to 99 persons
	$1,200
	
748.36		100 or more persons
	$1,400
	
749.1 	(d) A chemical dependency program licensed under Minnesota Rules, parts 9530.6510 
749.2 	to 9530.6590, to provide detoxification services shall pay an annual nonrefundable license 
749.3 	fee based on the following schedule:

749.4		Licensed Capacity
	License Fee
	
749.5		1 to 24 persons
	$760
	
749.6		25 to 49 persons
	$960
	
749.7		50 or more persons
	$1,160
	
749.8 	(e) Except for child foster care, a residential facility licensed under Minnesota Rules, 
749.9 	chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the 
749.10 	following schedule:

749.11		Licensed Capacity
	License Fee
	
749.12		1 to 24 persons
	$1,000
	
749.13		25 to 49 persons
	$1,100
	
749.14		50 to 74 persons
	$1,200
	
749.15		75 to 99 persons
	$1,300
	
749.16		100 or more persons
	$1,400
	
749.17 	(f) A residential facility licensed under section 245I.23 or Minnesota Rules, parts 
749.18 	9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual 
749.19 	nonrefundable license fee based on the following schedule:

749.20		Licensed Capacity
	License Fee
	
749.21		1 to 24 persons
	$2,525
	
749.22		25 or more persons
	$2,725
	
749.23 	(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400, 
749.24 	to serve persons with physical disabilities shall pay an annual nonrefundable license fee 
749.25 	based on the following schedule:

749.26		Licensed Capacity
	License Fee
	
749.27		1 to 24 persons
	$450
	
749.28		25 to 49 persons
	$650
	
749.29		50 to 74 persons
	$850
	
749.30		75 to 99 persons
	$1,050
	
749.31		100 or more persons
	$1,250
	
749.32 	(h) A program licensed to provide independent living assistance for youth under section 
749.33 	245A.22 shall pay an annual nonrefundable license fee of $1,500.
750.1 	(i) A private agency licensed to provide foster care and adoption services under Minnesota 
750.2 	Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.
750.3 	(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts 
750.4 	9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the 
750.5 	following schedule:

750.6		Licensed Capacity
	License Fee
	
750.7		1 to 24 persons
	$500
	
750.8		25 to 49 persons
	$700
	
750.9		50 to 74 persons
	$900
	
750.10		75 to 99 persons
	$1,100
	
750.11		100 or more persons
	$1,300
	
750.12 	(k) A program licensed to provide treatment services to persons with sexual psychopathic 
750.13 	personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to 
750.14 	9515.3110, shall pay an annual nonrefundable license fee of $20,000.
750.15 	(l) A mental health center or mental health clinic requesting certification for purposes 
750.16 	of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750 
750.17 	to 9520.0870 certified under section 245I.20, shall pay aan annual nonrefundable certification 
750.18 	fee of $1,550 per year. If the mental health center or mental health clinic provides services 
750.19 	at a primary location with satellite facilities, the satellite facilities shall be certified with the 
750.20 	primary location without an additional charge.

750.21 	Sec. 48. Minnesota Statutes 2020, section 245A.65, subdivision 2, is amended to read:
750.22 		Subd. 2.Abuse prevention plans. All license holders shall establish and enforce ongoing 
750.23 	written program abuse prevention plans and individual abuse prevention plans as required 
750.24 	under section 626.557, subdivision 14.
750.25 	(a) The scope of the program abuse prevention plan is limited to the population, physical 
750.26 	plant, and environment within the control of the license holder and the location where 
750.27 	licensed services are provided. In addition to the requirements in section 626.557, subdivision 
750.28 	14, the program abuse prevention plan shall meet the requirements in clauses (1) to (5).
750.29 	(1) The assessment of the population shall include an evaluation of the following factors: 
750.30 	age, gender, mental functioning, physical and emotional health or behavior of the client; 
750.31 	the need for specialized programs of care for clients; the need for training of staff to meet 
750.32 	identified individual needs; and the knowledge a license holder may have regarding previous 
750.33 	abuse that is relevant to minimizing risk of abuse for clients.
751.1 	(2) The assessment of the physical plant where the licensed services are provided shall 
751.2 	include an evaluation of the following factors: the condition and design of the building as 
751.3 	it relates to the safety of the clients; and the existence of areas in the building which are 
751.4 	difficult to supervise.
751.5 	(3) The assessment of the environment for each facility and for each site when living 
751.6 	arrangements are provided by the agency shall include an evaluation of the following factors: 
751.7 	the location of the program in a particular neighborhood or community; the type of grounds 
751.8 	and terrain surrounding the building; the type of internal programming; and the program's 
751.9 	staffing patterns.
751.10 	(4) The license holder shall provide an orientation to the program abuse prevention plan 
751.11 	for clients receiving services. If applicable, the client's legal representative must be notified 
751.12 	of the orientation. The license holder shall provide this orientation for each new person 
751.13 	within 24 hours of admission, or for persons who would benefit more from a later orientation, 
751.14 	the orientation may take place within 72 hours.
751.15 	(5) The license holder's governing body or the governing body's delegated representative 
751.16 	shall review the plan at least annually using the assessment factors in the plan and any 
751.17 	substantiated maltreatment findings that occurred since the last review. The governing body 
751.18 	or the governing body's delegated representative shall revise the plan, if necessary, to reflect 
751.19 	the review results.
751.20 	(6) A copy of the program abuse prevention plan shall be posted in a prominent location 
751.21 	in the program and be available upon request to mandated reporters, persons receiving 
751.22 	services, and legal representatives.
751.23 	(b) In addition to the requirements in section 626.557, subdivision 14, the individual 
751.24 	abuse prevention plan shall meet the requirements in clauses (1) and (2).
751.25 	(1) The plan shall include a statement of measures that will be taken to minimize the 
751.26 	risk of abuse to the vulnerable adult when the individual assessment required in section 
751.27 	626.557, subdivision 14, paragraph (b), indicates the need for measures in addition to the 
751.28 	specific measures identified in the program abuse prevention plan. The measures shall 
751.29 	include the specific actions the program will take to minimize the risk of abuse within the 
751.30 	scope of the licensed services, and will identify referrals made when the vulnerable adult 
751.31 	is susceptible to abuse outside the scope or control of the licensed services. When the 
751.32 	assessment indicates that the vulnerable adult does not need specific risk reduction measures 
751.33 	in addition to those identified in the program abuse prevention plan, the individual abuse 
751.34 	prevention plan shall document this determination.
752.1 	(2) An individual abuse prevention plan shall be developed for each new person as part 
752.2 	of the initial individual program plan or service plan required under the applicable licensing 
752.3 	rule or statute. The review and evaluation of the individual abuse prevention plan shall be 
752.4 	done as part of the review of the program plan or, service plan, or treatment plan. The person 
752.5 	receiving services shall participate in the development of the individual abuse prevention 
752.6 	plan to the full extent of the person's abilities. If applicable, the person's legal representative 
752.7 	shall be given the opportunity to participate with or for the person in the development of 
752.8 	the plan. The interdisciplinary team shall document the review of all abuse prevention plans 
752.9 	at least annually, using the individual assessment and any reports of abuse relating to the 
752.10 	person. The plan shall be revised to reflect the results of this review.

752.11 	Sec. 49. Minnesota Statutes 2020, section 245D.02, subdivision 20, is amended to read:
752.12 		Subd. 20.Mental health crisis intervention team. "Mental health crisis intervention 
752.13 	team" means a mental health crisis response provider as identified in section 256B.0624, 
752.14 	subdivision 2, paragraph (d), for adults, and in section 256B.0944, subdivision 1, paragraph 
752.15 	(d), for children.

752.16 	Sec. 50. Minnesota Statutes 2020, section 256B.0615, subdivision 1, is amended to read:
752.17 		Subdivision 1.Scope. Medical assistance covers mental health certified peer specialist 
752.18 	services, as established in subdivision 2, subject to federal approval, if provided to recipients 
752.19 	who are eligible for services under sections 256B.0622, 256B.0623, and 256B.0624 and 
752.20 	are provided by a mental health certified peer specialist who has completed the training 
752.21 	under subdivision 5 and is qualified according to section 245I.04, subdivision 10.

752.22 	Sec. 51. Minnesota Statutes 2020, section 256B.0615, subdivision 5, is amended to read:
752.23 		Subd. 5.Certified peer specialist training and certification. The commissioner of 
752.24 	human services shall develop a training and certification process for certified peer specialists, 
752.25 	who must be at least 21 years of age. The candidates must have had a primary diagnosis of 
752.26 	mental illness, be a current or former consumer of mental health services, and must 
752.27 	demonstrate leadership and advocacy skills and a strong dedication to recovery. The training 
752.28 	curriculum must teach participating consumers specific skills relevant to providing peer 
752.29 	support to other consumers. In addition to initial training and certification, the commissioner 
752.30 	shall develop ongoing continuing educational workshops on pertinent issues related to peer 
752.31 	support counseling.

753.1 	Sec. 52. Minnesota Statutes 2020, section 256B.0616, subdivision 1, is amended to read:
753.2 		Subdivision 1.Scope. Medical assistance covers mental health certified family peer 
753.3 	specialists services, as established in subdivision 2, subject to federal approval, if provided 
753.4 	to recipients who have an emotional disturbance or severe emotional disturbance under 
753.5 	chapter 245, and are provided by a mental health certified family peer specialist who has 
753.6 	completed the training under subdivision 5 and is qualified according to section 245I.04, 
753.7 	subdivision 12. A family peer specialist cannot provide services to the peer specialist's 
753.8 	family.

753.9 	Sec. 53. Minnesota Statutes 2020, section 256B.0616, subdivision 3, is amended to read:
753.10 		Subd. 3.Eligibility. Family peer support services may be located in provided to recipients 
753.11 	of inpatient hospitalization, partial hospitalization, residential treatment, intensive treatment 
753.12 	in foster care, day treatment, children's therapeutic services and supports, or crisis services.

753.13 	Sec. 54. Minnesota Statutes 2020, section 256B.0616, subdivision 5, is amended to read:
753.14 		Subd. 5.Certified family peer specialist training and certification. The commissioner 
753.15 	shall develop a training and certification process for certified family peer specialists who 
753.16 	must be at least 21 years of age. The candidates must have raised or be currently raising a 
753.17 	child with a mental illness, have had experience navigating the children's mental health 
753.18 	system, and must demonstrate leadership and advocacy skills and a strong dedication to 
753.19 	family-driven and family-focused services. The training curriculum must teach participating 
753.20 	family peer specialists specific skills relevant to providing peer support to other parents. In 
753.21 	addition to initial training and certification, the commissioner shall develop ongoing 
753.22 	continuing educational workshops on pertinent issues related to family peer support 
753.23 	counseling.

753.24 	Sec. 55. Minnesota Statutes 2020, section 256B.0622, subdivision 1, is amended to read:
753.25 		Subdivision 1.Scope. (a) Subject to federal approval, medical assistance covers medically 
753.26 	necessary, assertive community treatment for clients as defined in subdivision 2a and 
753.27 	intensive residential treatment services for clients as defined in subdivision 3, when the 
753.28 	services are provided by an entity certified under and meeting the standards in this section.
753.29 	(b) Subject to federal approval, medical assistance covers medically necessary, intensive 
753.30 	residential treatment services when the services are provided by an entity licensed under 
753.31 	and meeting the standards in section 245I.23.
754.1 	(c) The provider entity must make reasonable and good faith efforts to report individual 
754.2 	client outcomes to the commissioner, using instruments and protocols approved by the 
754.3 	commissioner.

754.4 	Sec. 56. Minnesota Statutes 2020, section 256B.0622, subdivision 2, is amended to read:
754.5 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
754.6 	meanings given them.
754.7 	(b) "ACT team" means the group of interdisciplinary mental health staff who work as 
754.8 	a team to provide assertive community treatment.
754.9 	(c) "Assertive community treatment" means intensive nonresidential treatment and 
754.10 	rehabilitative mental health services provided according to the assertive community treatment 
754.11 	model. Assertive community treatment provides a single, fixed point of responsibility for 
754.12 	treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per 
754.13 	day, seven days per week, in a community-based setting.
754.14 	(d) "Individual treatment plan" means the document that results from a person-centered 
754.15 	planning process of determining real-life outcomes with clients and developing strategies 
754.16 	to achieve those outcomes a plan described by section 245I.10, subdivisions 7 and 8.
754.17 	(e) "Assertive engagement" means the use of collaborative strategies to engage clients 
754.18 	to receive services.
754.19 	(f) "Benefits and finance support" means assisting clients in capably managing financial 
754.20 	affairs. Services include, but are not limited to, assisting clients in applying for benefits; 
754.21 	assisting with redetermination of benefits; providing financial crisis management; teaching 
754.22 	and supporting budgeting skills and asset development; and coordinating with a client's 
754.23 	representative payee, if applicable.
754.24 	(g) "Co-occurring disorder treatment" means the treatment of co-occurring mental illness 
754.25 	and substance use disorders and is characterized by assertive outreach, stage-wise 
754.26 	comprehensive treatment, treatment goal setting, and flexibility to work within each stage 
754.27 	of treatment. Services include, but are not limited to, assessing and tracking clients' stages 
754.28 	of change readiness and treatment; applying the appropriate treatment based on stages of 
754.29 	change, such as outreach and motivational interviewing techniques to work with clients in 
754.30 	earlier stages of change readiness and cognitive behavioral approaches and relapse prevention 
754.31 	to work with clients in later stages of change; and facilitating access to community supports.
754.32 	(h) (e) "Crisis assessment and intervention" means mental health crisis response services 
754.33 	as defined in section 256B.0624, subdivision 2, paragraphs (c) to (e).
755.1 	(i) "Employment services" means assisting clients to work at jobs of their choosing. 
755.2 	Services must follow the principles of the individual placement and support (IPS) 
755.3 	employment model, including focusing on competitive employment; emphasizing individual 
755.4 	client preferences and strengths; ensuring employment services are integrated with mental 
755.5 	health services; conducting rapid job searches and systematic job development according 
755.6 	to client preferences and choices; providing benefits counseling; and offering all services 
755.7 	in an individualized and time-unlimited manner. Services shall also include educating clients 
755.8 	about opportunities and benefits of work and school and assisting the client in learning job 
755.9 	skills, navigating the work place, and managing work relationships.
755.10 	(j) "Family psychoeducation and support" means services provided to the client's family 
755.11 	and other natural supports to restore and strengthen the client's unique social and family 
755.12 	relationships. Services include, but are not limited to, individualized psychoeducation about 
755.13 	the client's illness and the role of the family and other significant people in the therapeutic 
755.14 	process; family intervention to restore contact, resolve conflict, and maintain relationships 
755.15 	with family and other significant people in the client's life; ongoing communication and 
755.16 	collaboration between the ACT team and the family; introduction and referral to family 
755.17 	self-help programs and advocacy organizations that promote recovery and family 
755.18 	engagement, individual supportive counseling, parenting training, and service coordination 
755.19 	to help clients fulfill parenting responsibilities; coordinating services for the child and 
755.20 	restoring relationships with children who are not in the client's custody; and coordinating 
755.21 	with child welfare and family agencies, if applicable. These services must be provided with 
755.22 	the client's agreement and consent.
755.23 	(k) "Housing access support" means assisting clients to find, obtain, retain, and move 
755.24 	to safe and adequate housing of their choice. Housing access support includes, but is not 
755.25 	limited to, locating housing options with a focus on integrated independent settings; applying 
755.26 	for housing subsidies, programs, or resources; assisting the client in developing relationships 
755.27 	with local landlords; providing tenancy support and advocacy for the individual's tenancy 
755.28 	rights at the client's home; and assisting with relocation.
755.29 	(l) (f) "Individual treatment team" means a minimum of three members of the ACT team 
755.30 	who are responsible for consistently carrying out most of a client's assertive community 
755.31 	treatment services.
755.32 	(m) "Intensive residential treatment services treatment team" means all staff who provide 
755.33 	intensive residential treatment services under this section to clients. At a minimum, this 
755.34 	includes the clinical supervisor; mental health professionals as defined in section 245.462, 
755.35 	subdivision 18, clauses (1) to (6); mental health practitioners as defined in section 245.462, 
756.1 	subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision 
756.2 	5, paragraph (a), clause (4); and mental health certified peer specialists under section 
756.3 	256B.0615.
756.4 	(n) "Intensive residential treatment services" means short-term, time-limited services 
756.5 	provided in a residential setting to clients who are in need of more restrictive settings and 
756.6 	are at risk of significant functional deterioration if they do not receive these services. Services 
756.7 	are designed to develop and enhance psychiatric stability, personal and emotional adjustment, 
756.8 	self-sufficiency, and skills to live in a more independent setting. Services must be directed 
756.9 	toward a targeted discharge date with specified client outcomes.
756.10 	(o) "Medication assistance and support" means assisting clients in accessing medication, 
756.11 	developing the ability to take medications with greater independence, and providing 
756.12 	medication setup. This includes the prescription, administration, and order of medication 
756.13 	by appropriate medical staff.
756.14 	(p) "Medication education" means educating clients on the role and effects of medications 
756.15 	in treating symptoms of mental illness and the side effects of medications.
756.16 	(q) "Overnight staff" means a member of the intensive residential treatment services 
756.17 	team who is responsible during hours when clients are typically asleep.
756.18 	(r) "Mental health certified peer specialist services" has the meaning given in section 
756.19 	256B.0615.
756.20 	(s) "Physical health services" means any service or treatment to meet the physical health 
756.21 	needs of the client to support the client's mental health recovery. Services include, but are 
756.22 	not limited to, education on primary health issues, including wellness education; medication 
756.23 	administration and monitoring; providing and coordinating medical screening and follow-up; 
756.24 	scheduling routine and acute medical and dental care visits; tobacco cessation strategies; 
756.25 	assisting clients in attending appointments; communicating with other providers; and 
756.26 	integrating all physical and mental health treatment.
756.27 	(t) (g) "Primary team member" means the person who leads and coordinates the activities 
756.28 	of the individual treatment team and is the individual treatment team member who has 
756.29 	primary responsibility for establishing and maintaining a therapeutic relationship with the 
756.30 	client on a continuing basis.
756.31 	(u) "Rehabilitative mental health services" means mental health services that are 
756.32 	rehabilitative and enable the client to develop and enhance psychiatric stability, social 
757.1 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
757.2 	community skills, when these abilities are impaired by the symptoms of mental illness.
757.3 	(v) "Symptom management" means supporting clients in identifying and targeting the 
757.4 	symptoms and occurrence patterns of their mental illness and developing strategies to reduce 
757.5 	the impact of those symptoms.
757.6 	(w) "Therapeutic interventions" means empirically supported techniques to address 
757.7 	specific symptoms and behaviors such as anxiety, psychotic symptoms, emotional 
757.8 	dysregulation, and trauma symptoms. Interventions include empirically supported 
757.9 	psychotherapies including, but not limited to, cognitive behavioral therapy, exposure therapy, 
757.10 	acceptance and commitment therapy, interpersonal therapy, and motivational interviewing.
757.11 	(x) "Wellness self-management and prevention" means a combination of approaches to 
757.12 	working with the client to build and apply skills related to recovery, and to support the client 
757.13 	in participating in leisure and recreational activities, civic participation, and meaningful 
757.14 	structure.
757.15 	(h) "Certified rehabilitation specialist" means a staff person who is qualified according 
757.16 	to section 245I.04, subdivision 8.
757.17 	(i) "Clinical trainee" means a staff person who is qualified according to section 245I.04, 
757.18 	subdivision 6.
757.19 	(j) "Mental health certified peer specialist" means a staff person who is qualified 
757.20 	according to section 245I.04, subdivision 10.
757.21 	(k) "Mental health practitioner" means a staff person who is qualified according to section 
757.22 	245I.04, subdivision 4.
757.23 	(l) "Mental health professional" means a staff person who is qualified according to 
757.24 	section 245I.04, subdivision 2.
757.25 	(m) "Mental health rehabilitation worker" means a staff person who is qualified according 
757.26 	to section 245I.04, subdivision 14.

757.27 	Sec. 57. Minnesota Statutes 2020, section 256B.0622, subdivision 3a, is amended to read:
757.28 		Subd. 3a.Provider certification and contract requirements for assertive community 
757.29 	treatment. (a) The assertive community treatment provider must:
757.30 	(1) have a contract with the host county to provide assertive community treatment 
757.31 	services; and
758.1 	(2) have each ACT team be certified by the state following the certification process and 
758.2 	procedures developed by the commissioner. The certification process determines whether 
758.3 	the ACT team meets the standards for assertive community treatment under this section as 
758.4 	well as, the standards in chapter 245I as required in section 245I.011, subdivision 5, and
758.5 	minimum program fidelity standards as measured by a nationally recognized fidelity tool 
758.6 	approved by the commissioner. Recertification must occur at least every three years.
758.7 	(b) An ACT team certified under this subdivision must meet the following standards:
758.8 	(1) have capacity to recruit, hire, manage, and train required ACT team members;
758.9 	(2) have adequate administrative ability to ensure availability of services;
758.10 	(3) ensure adequate preservice and ongoing training for staff;
758.11 	(4) ensure that staff is capable of implementing culturally specific services that are 
758.12 	culturally responsive and appropriate as determined by the client's culture, beliefs, values, 
758.13 	and language as identified in the individual treatment plan;
758.14 	(5) (3) ensure flexibility in service delivery to respond to the changing and intermittent 
758.15 	care needs of a client as identified by the client and the individual treatment plan;
758.16 	(6) develop and maintain client files, individual treatment plans, and contact charting;
758.17 	(7) develop and maintain staff training and personnel files;
758.18 	(8) submit information as required by the state;
758.19 	(9) (4) keep all necessary records required by law;
758.20 	(10) comply with all applicable laws;
758.21 	(11) (5) be an enrolled Medicaid provider; and
758.22 	(12) (6) establish and maintain a quality assurance plan to determine specific service 
758.23 	outcomes and the client's satisfaction with services; and.
758.24 	(13) develop and maintain written policies and procedures regarding service provision 
758.25 	and administration of the provider entity.
758.26 	(c) The commissioner may intervene at any time and decertify an ACT team with cause. 
758.27 	The commissioner shall establish a process for decertification of an ACT team and shall 
758.28 	require corrective action, medical assistance repayment, or decertification of an ACT team 
758.29 	that no longer meets the requirements in this section or that fails to meet the clinical quality 
758.30 	standards or administrative standards provided by the commissioner in the application and 
758.31 	certification process. The decertification is subject to appeal to the state.

759.1 	Sec. 58. Minnesota Statutes 2020, section 256B.0622, subdivision 4, is amended to read:
759.2 		Subd. 4.Provider entity licensure and contract requirements for intensive residential 
759.3 	treatment services. (a) The intensive residential treatment services provider entity must:
759.4 	(1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;
759.5 	(2) not exceed 16 beds per site; and
759.6 	(3) comply with the additional standards in this section.
759.7 	(b) (a) The commissioner shall develop procedures for counties and providers to submit 
759.8 	other documentation as needed to allow the commissioner to determine whether the standards 
759.9 	in this section are met.
759.10 	(c) (b) A provider entity must specify in the provider entity's application what geographic 
759.11 	area and populations will be served by the proposed program. A provider entity must 
759.12 	document that the capacity or program specialties of existing programs are not sufficient 
759.13 	to meet the service needs of the target population. A provider entity must submit evidence 
759.14 	of ongoing relationships with other providers and levels of care to facilitate referrals to and 
759.15 	from the proposed program.
759.16 	(d) (c) A provider entity must submit documentation that the provider entity requested 
759.17 	a statement of need from each county board and tribal authority that serves as a local mental 
759.18 	health authority in the proposed service area. The statement of need must specify if the local 
759.19 	mental health authority supports or does not support the need for the proposed program and 
759.20 	the basis for this determination. If a local mental health authority does not respond within 
759.21 	60 days of the receipt of the request, the commissioner shall determine the need for the 
759.22 	program based on the documentation submitted by the provider entity.

759.23 	Sec. 59. Minnesota Statutes 2020, section 256B.0622, subdivision 7, is amended to read:
759.24 		Subd. 7.Assertive community treatment service standards. (a) ACT teams must offer 
759.25 	and have the capacity to directly provide the following services:
759.26 	(1) assertive engagement using collaborative strategies to encourage clients to receive 
759.27 	services;
759.28 	(2) benefits and finance support that assists clients to capably manage financial affairs. 
759.29 	Services include but are not limited to assisting clients in applying for benefits, assisting 
759.30 	with redetermination of benefits, providing financial crisis management, teaching and 
759.31 	supporting budgeting skills and asset development, and coordinating with a client's 
759.32 	representative payee, if applicable;
760.1 	(3) co-occurring substance use disorder treatment as defined in section 245I.02, 
760.2 	subdivision 11;
760.3 	(4) crisis assessment and intervention;
760.4 	(5) employment services that assist clients to work at jobs of the clients' choosing. 
760.5 	Services must follow the principles of the individual placement and support employment 
760.6 	model, including focusing on competitive employment, emphasizing individual client 
760.7 	preferences and strengths, ensuring employment services are integrated with mental health 
760.8 	services, conducting rapid job searches and systematic job development according to client 
760.9 	preferences and choices, providing benefits counseling, and offering all services in an 
760.10 	individualized and time-unlimited manner. Services must also include educating clients 
760.11 	about opportunities and benefits of work and school and assisting the client in learning job 
760.12 	skills, navigating the workplace, workplace accommodations, and managing work 
760.13 	relationships;
760.14 	(6) family psychoeducation and support provided to the client's family and other natural 
760.15 	supports to restore and strengthen the client's unique social and family relationships. Services 
760.16 	include but are not limited to individualized psychoeducation about the client's illness and 
760.17 	the role of the family and other significant people in the therapeutic process; family 
760.18 	intervention to restore contact, resolve conflict, and maintain relationships with family and 
760.19 	other significant people in the client's life; ongoing communication and collaboration between 
760.20 	the ACT team and the family; introduction and referral to family self-help programs and 
760.21 	advocacy organizations that promote recovery and family engagement, individual supportive 
760.22 	counseling, parenting training, and service coordination to help clients fulfill parenting 
760.23 	responsibilities; coordinating services for the child and restoring relationships with children 
760.24 	who are not in the client's custody; and coordinating with child welfare and family agencies, 
760.25 	if applicable. These services must be provided with the client's agreement and consent;
760.26 	(7) housing access support that assists clients to find, obtain, retain, and move to safe 
760.27 	and adequate housing of their choice. Housing access support includes but is not limited to 
760.28 	locating housing options with a focus on integrated independent settings; applying for 
760.29 	housing subsidies, programs, or resources; assisting the client in developing relationships 
760.30 	with local landlords; providing tenancy support and advocacy for the individual's tenancy 
760.31 	rights at the client's home; and assisting with relocation;
760.32 	(8) medication assistance and support that assists clients in accessing medication, 
760.33 	developing the ability to take medications with greater independence, and providing 
761.1 	medication setup. Medication assistance and support includes assisting the client with the 
761.2 	prescription, administration, and ordering of medication by appropriate medical staff;
761.3 	(9) medication education that educates clients on the role and effects of medications in 
761.4 	treating symptoms of mental illness and the side effects of medications;
761.5 	(10) mental health certified peer specialists services according to section 256B.0615;
761.6 	(11) physical health services to meet the physical health needs of the client to support 
761.7 	the client's mental health recovery. Services include but are not limited to education on 
761.8 	primary health and wellness issues, medication administration and monitoring, providing 
761.9 	and coordinating medical screening and follow-up, scheduling routine and acute medical 
761.10 	and dental care visits, tobacco cessation strategies, assisting clients in attending appointments, 
761.11 	communicating with other providers, and integrating all physical and mental health treatment;
761.12 	(12) rehabilitative mental health services as defined in section 245I.02, subdivision 33;
761.13 	(13) symptom management that supports clients in identifying and targeting the symptoms 
761.14 	and occurrence patterns of their mental illness and developing strategies to reduce the impact 
761.15 	of those symptoms;
761.16 	(14) therapeutic interventions to address specific symptoms and behaviors such as 
761.17 	anxiety, psychotic symptoms, emotional dysregulation, and trauma symptoms. Interventions 
761.18 	include empirically supported psychotherapies including but not limited to cognitive 
761.19 	behavioral therapy, exposure therapy, acceptance and commitment therapy, interpersonal 
761.20 	therapy, and motivational interviewing;
761.21 	(15) wellness self-management and prevention that includes a combination of approaches 
761.22 	to working with the client to build and apply skills related to recovery, and to support the 
761.23 	client in participating in leisure and recreational activities, civic participation, and meaningful 
761.24 	structure; and
761.25 	(16) other services based on client needs as identified in a client's assertive community 
761.26 	treatment individual treatment plan.
761.27 	(b) ACT teams must ensure the provision of all services necessary to meet a client's 
761.28 	needs as identified in the client's individual treatment plan.

761.29 	Sec. 60. Minnesota Statutes 2020, section 256B.0622, subdivision 7a, is amended to read:
761.30 		Subd. 7a.Assertive community treatment team staff requirements and roles. (a) 
761.31 	The required treatment staff qualifications and roles for an ACT team are:
761.32 	(1) the team leader:
762.1 	(i) shall be a licensed mental health professional who is qualified under Minnesota Rules, 
762.2 	part 9505.0371, subpart 5, item A. Individuals who are not licensed but who are eligible 
762.3 	for licensure and are otherwise qualified may also fulfill this role but must obtain full 
762.4 	licensure within 24 months of assuming the role of team leader;
762.5 	(ii) must be an active member of the ACT team and provide some direct services to 
762.6 	clients;
762.7 	(iii) must be a single full-time staff member, dedicated to the ACT team, who is 
762.8 	responsible for overseeing the administrative operations of the team, providing clinical 
762.9 	oversight treatment supervision of services in conjunction with the psychiatrist or psychiatric 
762.10 	care provider, and supervising team members to ensure delivery of best and ethical practices; 
762.11 	and
762.12 	(iv) must be available to provide overall clinical oversight treatment supervision to the 
762.13 	ACT team after regular business hours and on weekends and holidays. The team leader may 
762.14 	delegate this duty to another qualified member of the ACT team;
762.15 	(2) the psychiatric care provider:
762.16 	(i) must be a licensed psychiatrist certified by the American Board of Psychiatry and 
762.17 	Neurology or eligible for board certification or certified by the American Osteopathic Board 
762.18 	of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who 
762.19 	is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A mental health 
762.20 	professional permitted to prescribe psychiatric medications as part of the mental health 
762.21 	professional's scope of practice. The psychiatric care provider must have demonstrated 
762.22 	clinical experience working with individuals with serious and persistent mental illness;
762.23 	(ii) shall collaborate with the team leader in sharing overall clinical responsibility for 
762.24 	screening and admitting clients; monitoring clients' treatment and team member service 
762.25 	delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects, 
762.26 	and health-related conditions; actively collaborating with nurses; and helping provide clinical
762.27 	treatment supervision to the team;
762.28 	(iii) shall fulfill the following functions for assertive community treatment clients: 
762.29 	provide assessment and treatment of clients' symptoms and response to medications, including 
762.30 	side effects; provide brief therapy to clients; provide diagnostic and medication education 
762.31 	to clients, with medication decisions based on shared decision making; monitor clients' 
762.32 	nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and 
762.33 	community visits;
763.1 	(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized 
763.2 	for mental health treatment and shall communicate directly with the client's inpatient 
763.3 	psychiatric care providers to ensure continuity of care;
763.4 	(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per 
763.5 	50 clients. Part-time psychiatric care providers shall have designated hours to work on the 
763.6 	team, with sufficient blocks of time on consistent days to carry out the provider's clinical, 
763.7 	supervisory, and administrative responsibilities. No more than two psychiatric care providers 
763.8 	may share this role;
763.9 	(vi) may not provide specific roles and responsibilities by telemedicine unless approved 
763.10 	by the commissioner; and
763.11 	(vii) shall provide psychiatric backup to the program after regular business hours and 
763.12 	on weekends and holidays. The psychiatric care provider may delegate this duty to another 
763.13 	qualified psychiatric provider;
763.14 	(3) the nursing staff:
763.15 	(i) shall consist of one to three registered nurses or advanced practice registered nurses, 
763.16 	of whom at least one has a minimum of one-year experience working with adults with 
763.17 	serious mental illness and a working knowledge of psychiatric medications. No more than 
763.18 	two individuals can share a full-time equivalent position;
763.19 	(ii) are responsible for managing medication, administering and documenting medication 
763.20 	treatment, and managing a secure medication room; and
763.21 	(iii) shall develop strategies, in collaboration with clients, to maximize taking medications 
763.22 	as prescribed; screen and monitor clients' mental and physical health conditions and 
763.23 	medication side effects; engage in health promotion, prevention, and education activities; 
763.24 	communicate and coordinate services with other medical providers; facilitate the development 
763.25 	of the individual treatment plan for clients assigned; and educate the ACT team in monitoring 
763.26 	psychiatric and physical health symptoms and medication side effects;
763.27 	(4) the co-occurring disorder specialist:
763.28 	(i) shall be a full-time equivalent co-occurring disorder specialist who has received 
763.29 	specific training on co-occurring disorders that is consistent with national evidence-based 
763.30 	practices. The training must include practical knowledge of common substances and how 
763.31 	they affect mental illnesses, the ability to assess substance use disorders and the client's 
763.32 	stage of treatment, motivational interviewing, and skills necessary to provide counseling to 
763.33 	clients at all different stages of change and treatment. The co-occurring disorder specialist 
764.1 	may also be an individual who is a licensed alcohol and drug counselor as described in 
764.2 	section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience, 
764.3 	and other requirements in section 245G.11, subdivision 5. No more than two co-occurring 
764.4 	disorder specialists may occupy this role; and
764.5 	(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients. 
764.6 	The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT 
764.7 	team members on co-occurring disorders;
764.8 	(5) the vocational specialist:
764.9 	(i) shall be a full-time vocational specialist who has at least one-year experience providing 
764.10 	employment services or advanced education that involved field training in vocational services 
764.11 	to individuals with mental illness. An individual who does not meet these qualifications 
764.12 	may also serve as the vocational specialist upon completing a training plan approved by the 
764.13 	commissioner;
764.14 	(ii) shall provide or facilitate the provision of vocational services to clients. The vocational 
764.15 	specialist serves as a consultant and educator to fellow ACT team members on these services; 
764.16 	and
764.17 	(iii) should must not refer individuals to receive any type of vocational services or linkage 
764.18 	by providers outside of the ACT team;
764.19 	(6) the mental health certified peer specialist:
764.20 	(i) shall be a full-time equivalent mental health certified peer specialist as defined in 
764.21 	section 256B.0615. No more than two individuals can share this position. The mental health 
764.22 	certified peer specialist is a fully integrated team member who provides highly individualized 
764.23 	services in the community and promotes the self-determination and shared decision-making 
764.24 	abilities of clients. This requirement may be waived due to workforce shortages upon 
764.25 	approval of the commissioner;
764.26 	(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery, 
764.27 	self-advocacy, and self-direction, promote wellness management strategies, and assist clients 
764.28 	in developing advance directives; and
764.29 	(iii) must model recovery values, attitudes, beliefs, and personal action to encourage 
764.30 	wellness and resilience, provide consultation to team members, promote a culture where 
764.31 	the clients' points of view and preferences are recognized, understood, respected, and 
764.32 	integrated into treatment, and serve in a manner equivalent to other team members;
765.1 	(7) the program administrative assistant shall be a full-time office-based program 
765.2 	administrative assistant position assigned to solely work with the ACT team, providing a 
765.3 	range of supports to the team, clients, and families; and
765.4 	(8) additional staff:
765.5 	(i) shall be based on team size. Additional treatment team staff may include licensed
765.6 	mental health professionals as defined in Minnesota Rules, part 9505.0371, subpart 5, item 
765.7 	A; clinical trainees; certified rehabilitation specialists; mental health practitioners as defined 
765.8 	in section 245.462, subdivision 17; a mental health practitioner working as a clinical trainee 
765.9 	according to Minnesota Rules, part 9505.0371, subpart 5, item C; or mental health 
765.10 	rehabilitation workers as defined in section 256B.0623, subdivision 5, paragraph (a), clause 
765.11 	(4). These individuals shall have the knowledge, skills, and abilities required by the 
765.12 	population served to carry out rehabilitation and support functions; and
765.13 	(ii) shall be selected based on specific program needs or the population served.
765.14 	(b) Each ACT team must clearly document schedules for all ACT team members.
765.15 	(c) Each ACT team member must serve as a primary team member for clients assigned 
765.16 	by the team leader and are responsible for facilitating the individual treatment plan process 
765.17 	for those clients. The primary team member for a client is the responsible team member 
765.18 	knowledgeable about the client's life and circumstances and writes the individual treatment 
765.19 	plan. The primary team member provides individual supportive therapy or counseling, and 
765.20 	provides primary support and education to the client's family and support system.
765.21 	(d) Members of the ACT team must have strong clinical skills, professional qualifications, 
765.22 	experience, and competency to provide a full breadth of rehabilitation services. Each staff 
765.23 	member shall be proficient in their respective discipline and be able to work collaboratively 
765.24 	as a member of a multidisciplinary team to deliver the majority of the treatment, 
765.25 	rehabilitation, and support services clients require to fully benefit from receiving assertive 
765.26 	community treatment.
765.27 	(e) Each ACT team member must fulfill training requirements established by the 
765.28 	commissioner.

765.29 	Sec. 61. Minnesota Statutes 2020, section 256B.0622, subdivision 7b, is amended to read:
765.30 		Subd. 7b.Assertive community treatment program size and opportunities. (a) Each 
765.31 	ACT team shall maintain an annual average caseload that does not exceed 100 clients. 
765.32 	Staff-to-client ratios shall be based on team size as follows:
766.1 	(1) a small ACT team must:
766.2 	(i) employ at least six but no more than seven full-time treatment team staff, excluding 
766.3 	the program assistant and the psychiatric care provider;
766.4 	(ii) serve an annual average maximum of no more than 50 clients;
766.5 	(iii) ensure at least one full-time equivalent position for every eight clients served;
766.6 	(iv) schedule ACT team staff for at least eight-hour shift coverage on weekdays and 
766.7 	on-call duty to provide crisis services and deliver services after hours when staff are not 
766.8 	working;
766.9 	(v) provide crisis services during business hours if the small ACT team does not have 
766.10 	sufficient staff numbers to operate an after-hours on-call system. During all other hours, 
766.11 	the ACT team may arrange for coverage for crisis assessment and intervention services 
766.12 	through a reliable crisis-intervention provider as long as there is a mechanism by which the 
766.13 	ACT team communicates routinely with the crisis-intervention provider and the on-call 
766.14 	ACT team staff are available to see clients face-to-face when necessary or if requested by 
766.15 	the crisis-intervention services provider;
766.16 	(vi) adjust schedules and provide staff to carry out the needed service activities in the 
766.17 	evenings or on weekend days or holidays, when necessary;
766.18 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
766.19 	provider is not regularly scheduled to work. If availability of the ACT team's psychiatric 
766.20 	care provider during all hours is not feasible, alternative psychiatric prescriber backup must 
766.21 	be arranged and a mechanism of timely communication and coordination established in 
766.22 	writing; and
766.23 	(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each 
766.24 	week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time 
766.25 	equivalent nursing, one full-time substance abuse co-occurring disorder specialist, one 
766.26 	full-time equivalent mental health certified peer specialist, one full-time vocational specialist, 
766.27 	one full-time program assistant, and at least one additional full-time ACT team member 
766.28 	who has mental health professional, certified rehabilitation specialist, clinical trainee, or 
766.29 	mental health practitioner status; and
766.30 	(2) a midsize ACT team shall:
766.31 	(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry 
766.32 	time for 51 clients, with an additional two hours for every six clients added to the team, 1.5 
766.33 	to two full-time equivalent nursing staff, one full-time substance abuse co-occurring disorder
767.1 	specialist, one full-time equivalent mental health certified peer specialist, one full-time 
767.2 	vocational specialist, one full-time program assistant, and at least 1.5 to two additional 
767.3 	full-time equivalent ACT members, with at least one dedicated full-time staff member with 
767.4 	mental health professional status. Remaining team members may have mental health 
767.5 	professional, certified rehabilitation specialist, clinical trainee, or mental health practitioner 
767.6 	status;
767.7 	(ii) employ seven or more treatment team full-time equivalents, excluding the program 
767.8 	assistant and the psychiatric care provider;
767.9 	(iii) serve an annual average maximum caseload of 51 to 74 clients;
767.10 	(iv) ensure at least one full-time equivalent position for every nine clients served;
767.11 	(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays 
767.12 	and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum 
767.13 	specifications, staff are regularly scheduled to provide the necessary services on a 
767.14 	client-by-client basis in the evenings and on weekends and holidays;
767.15 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
767.16 	when staff are not working;
767.17 	(vii) have the authority to arrange for coverage for crisis assessment and intervention 
767.18 	services through a reliable crisis-intervention provider as long as there is a mechanism by 
767.19 	which the ACT team communicates routinely with the crisis-intervention provider and the 
767.20 	on-call ACT team staff are available to see clients face-to-face when necessary or if requested 
767.21 	by the crisis-intervention services provider; and
767.22 	(viii) arrange for and provide psychiatric backup during all hours the psychiatric care 
767.23 	provider is not regularly scheduled to work. If availability of the psychiatric care provider 
767.24 	during all hours is not feasible, alternative psychiatric prescriber backup must be arranged 
767.25 	and a mechanism of timely communication and coordination established in writing;
767.26 	(3) a large ACT team must:
767.27 	(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week 
767.28 	per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff, 
767.29 	one full-time substance abuse co-occurring disorder specialist, one full-time equivalent 
767.30 	mental health certified peer specialist, one full-time vocational specialist, one full-time 
767.31 	program assistant, and at least two additional full-time equivalent ACT team members, with 
767.32 	at least one dedicated full-time staff member with mental health professional status. 
768.1 	Remaining team members may have mental health professional or mental health practitioner 
768.2 	status;
768.3 	(ii) employ nine or more treatment team full-time equivalents, excluding the program 
768.4 	assistant and psychiatric care provider;
768.5 	(iii) serve an annual average maximum caseload of 75 to 100 clients;
768.6 	(iv) ensure at least one full-time equivalent position for every nine individuals served;
768.7 	(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the 
768.8 	second shift providing services at least 12 hours per day weekdays. For weekends and 
768.9 	holidays, the team must operate and schedule ACT team staff to work one eight-hour shift, 
768.10 	with a minimum of two staff each weekend day and every holiday;
768.11 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
768.12 	when staff are not working; and
768.13 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
768.14 	provider is not regularly scheduled to work. If availability of the ACT team psychiatric care 
768.15 	provider during all hours is not feasible, alternative psychiatric backup must be arranged 
768.16 	and a mechanism of timely communication and coordination established in writing.
768.17 	(b) An ACT team of any size may have a staff-to-client ratio that is lower than the 
768.18 	requirements described in paragraph (a) upon approval by the commissioner, but may not 
768.19 	exceed a one-to-ten staff-to-client ratio.

768.20 	Sec. 62. Minnesota Statutes 2020, section 256B.0622, subdivision 7d, is amended to read:
768.21 		Subd. 7d.Assertive community treatment assessment and individual treatment 
768.22 	plan. (a) An initial assessment, including a diagnostic assessment that meets the requirements 
768.23 	of Minnesota Rules, part 9505.0372, subpart 1, and a 30-day treatment plan shall be 
768.24 	completed the day of the client's admission to assertive community treatment by the ACT 
768.25 	team leader or the psychiatric care provider, with participation by designated ACT team 
768.26 	members and the client. The initial assessment must include obtaining or completing a 
768.27 	standard diagnostic assessment according to section 245I.10, subdivision 6, and completing 
768.28 	a 30-day individual treatment plan. The team leader, psychiatric care provider, or other 
768.29 	mental health professional designated by the team leader or psychiatric care provider, must 
768.30 	update the client's diagnostic assessment at least annually.
769.1 	(b) An initial A functional assessment must be completed within ten days of intake and 
769.2 	updated every six months for assertive community treatment, or prior to discharge from the 
769.3 	service, whichever comes first according to section 245I.10, subdivision 9.
769.4 	(c) Within 30 days of the client's assertive community treatment admission, the ACT 
769.5 	team shall complete an in-depth assessment of the domains listed under section 245.462, 
769.6 	subdivision 11a.
769.7 	(d) Each part of the in-depth functional assessment areas shall be completed by each 
769.8 	respective team specialist or an ACT team member with skill and knowledge in the area 
769.9 	being assessed. The assessments are based upon all available information, including that 
769.10 	from client interview family and identified natural supports, and written summaries from 
769.11 	other agencies, including police, courts, county social service agencies, outpatient facilities, 
769.12 	and inpatient facilities, where applicable.
769.13 	(e) (c) Between 30 and 45 days after the client's admission to assertive community 
769.14 	treatment, the entire ACT team must hold a comprehensive case conference, where all team 
769.15 	members, including the psychiatric provider, present information discovered from the 
769.16 	completed in-depth assessments and provide treatment recommendations. The conference 
769.17 	must serve as the basis for the first six-month individual treatment plan, which must be 
769.18 	written by the primary team member.
769.19 	(f) (d) The client's psychiatric care provider, primary team member, and individual 
769.20 	treatment team members shall assume responsibility for preparing the written narrative of 
769.21 	the results from the psychiatric and social functioning history timeline and the comprehensive 
769.22 	assessment.
769.23 	(g) (e) The primary team member and individual treatment team members shall be 
769.24 	assigned by the team leader in collaboration with the psychiatric care provider by the time 
769.25 	of the first treatment planning meeting or 30 days after admission, whichever occurs first.
769.26 	(h) (f) Individual treatment plans must be developed through the following treatment 
769.27 	planning process:
769.28 	(1) The individual treatment plan shall be developed in collaboration with the client and 
769.29 	the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT 
769.30 	team shall evaluate, together with each client, the client's needs, strengths, and preferences 
769.31 	and develop the individual treatment plan collaboratively. The ACT team shall make every 
769.32 	effort to ensure that the client and the client's family and natural supports, with the client's 
769.33 	consent, are in attendance at the treatment planning meeting, are involved in ongoing 
770.1 	meetings related to treatment, and have the necessary supports to fully participate. The 
770.2 	client's participation in the development of the individual treatment plan shall be documented.
770.3 	(2) The client and the ACT team shall work together to formulate and prioritize the 
770.4 	issues, set goals, research approaches and interventions, and establish the plan. The plan is 
770.5 	individually tailored so that the treatment, rehabilitation, and support approaches and 
770.6 	interventions achieve optimum symptom reduction, help fulfill the personal needs and 
770.7 	aspirations of the client, take into account the cultural beliefs and realities of the individual, 
770.8 	and improve all the aspects of psychosocial functioning that are important to the client. The 
770.9 	process supports strengths, rehabilitation, and recovery.
770.10 	(3) Each client's individual treatment plan shall identify service needs, strengths and 
770.11 	capacities, and barriers, and set specific and measurable short- and long-term goals for each 
770.12 	service need. The individual treatment plan must clearly specify the approaches and 
770.13 	interventions necessary for the client to achieve the individual goals, when the interventions 
770.14 	shall happen, and identify which ACT team member shall carry out the approaches and 
770.15 	interventions.
770.16 	(4) The primary team member and the individual treatment team, together with the client 
770.17 	and the client's family and natural supports with the client's consent, are responsible for 
770.18 	reviewing and rewriting the treatment goals and individual treatment plan whenever there 
770.19 	is a major decision point in the client's course of treatment or at least every six months.
770.20 	(5) The primary team member shall prepare a summary that thoroughly describes in 
770.21 	writing the client's and the individual treatment team's evaluation of the client's progress 
770.22 	and goal attainment, the effectiveness of the interventions, and the satisfaction with services 
770.23 	since the last individual treatment plan. The client's most recent diagnostic assessment must 
770.24 	be included with the treatment plan summary.
770.25 	(6) The individual treatment plan and review must be signed approved or acknowledged 
770.26 	by the client, the primary team member, the team leader, the psychiatric care provider, and 
770.27 	all individual treatment team members. A copy of the signed approved individual treatment 
770.28 	plan is must be made available to the client.

770.29 	Sec. 63. Minnesota Statutes 2020, section 256B.0623, subdivision 1, is amended to read:
770.30 		Subdivision 1.Scope. Subject to federal approval, medical assistance covers medically 
770.31 	necessary adult rehabilitative mental health services as defined in subdivision 2, subject to 
770.32 	federal approval, if provided to recipients as defined in subdivision 3 and provided by a 
770.33 	qualified provider entity meeting the standards in this section and by a qualified individual 
771.1 	provider working within the provider's scope of practice and identified in the recipient's 
771.2 	individual treatment plan as defined in section 245.462, subdivision 14, and if determined 
771.3 	to be medically necessary according to section 62Q.53 when the services are provided by 
771.4 	an entity meeting the standards in this section. The provider entity must make reasonable 
771.5 	and good faith efforts to report individual client outcomes to the commissioner, using 
771.6 	instruments and protocols approved by the commissioner.

771.7 	Sec. 64. Minnesota Statutes 2020, section 256B.0623, subdivision 2, is amended to read:
771.8 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
771.9 	given them.
771.10 	(a) "Adult rehabilitative mental health services" means mental health services which are 
771.11 	rehabilitative and enable the recipient to develop and enhance psychiatric stability, social 
771.12 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
771.13 	community skills, when these abilities are impaired by the symptoms of mental illness. 
771.14 	Adult rehabilitative mental health services are also appropriate when provided to enable a 
771.15 	recipient to retain stability and functioning, if the recipient would be at risk of significant 
771.16 	functional decompensation or more restrictive service settings without these services the 
771.17 	services described in section 245I.02, subdivision 33.
771.18 	(1) Adult rehabilitative mental health services instruct, assist, and support the recipient 
771.19 	in areas such as: interpersonal communication skills, community resource utilization and 
771.20 	integration skills, crisis assistance, relapse prevention skills, health care directives, budgeting 
771.21 	and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills, 
771.22 	transportation skills, medication education and monitoring, mental illness symptom 
771.23 	management skills, household management skills, employment-related skills, parenting 
771.24 	skills, and transition to community living services.
771.25 	(2) These services shall be provided to the recipient on a one-to-one basis in the recipient's 
771.26 	home or another community setting or in groups.
771.27 	(b) "Medication education services" means services provided individually or in groups 
771.28 	which focus on educating the recipient about mental illness and symptoms; the role and 
771.29 	effects of medications in treating symptoms of mental illness; and the side effects of 
771.30 	medications. Medication education is coordinated with medication management services 
771.31 	and does not duplicate it. Medication education services are provided by physicians, advanced 
771.32 	practice registered nurses, pharmacists, physician assistants, or registered nurses.
772.1 	(c) "Transition to community living services" means services which maintain continuity 
772.2 	of contact between the rehabilitation services provider and the recipient and which facilitate 
772.3 	discharge from a hospital, residential treatment program under Minnesota Rules, chapter 
772.4 	9505, board and lodging facility, or nursing home. Transition to community living services 
772.5 	are not intended to provide other areas of adult rehabilitative mental health services.

772.6 	Sec. 65. Minnesota Statutes 2020, section 256B.0623, subdivision 3, is amended to read:
772.7 		Subd. 3.Eligibility. An eligible recipient is an individual who:
772.8 	(1) is age 18 or older;
772.9 	(2) is diagnosed with a medical condition, such as mental illness or traumatic brain 
772.10 	injury, for which adult rehabilitative mental health services are needed;
772.11 	(3) has substantial disability and functional impairment in three or more of the areas 
772.12 	listed in section 245.462, subdivision 11a 245I.10, subdivision 9, clause (4), so that 
772.13 	self-sufficiency is markedly reduced; and
772.14 	(4) has had a recent standard diagnostic assessment or an adult diagnostic assessment 
772.15 	update by a qualified professional that documents adult rehabilitative mental health services 
772.16 	are medically necessary to address identified disability and functional impairments and 
772.17 	individual recipient goals.

772.18 	Sec. 66. Minnesota Statutes 2020, section 256B.0623, subdivision 4, is amended to read:
772.19 		Subd. 4.Provider entity standards. (a) The provider entity must be certified by the 
772.20 	state following the certification process and procedures developed by the commissioner.
772.21 	(b) The certification process is a determination as to whether the entity meets the standards 
772.22 	in this subdivision section and chapter 245I, as required in section 245I.011, subdivision 5. 
772.23 	The certification must specify which adult rehabilitative mental health services the entity 
772.24 	is qualified to provide.
772.25 	(c) A noncounty provider entity must obtain additional certification from each county 
772.26 	in which it will provide services. The additional certification must be based on the adequacy 
772.27 	of the entity's knowledge of that county's local health and human service system, and the 
772.28 	ability of the entity to coordinate its services with the other services available in that county. 
772.29 	A county-operated entity must obtain this additional certification from any other county in 
772.30 	which it will provide services.
772.31 	(d) State-level recertification must occur at least every three years.
773.1 	(e) The commissioner may intervene at any time and decertify providers with cause. 
773.2 	The decertification is subject to appeal to the state. A county board may recommend that 
773.3 	the state decertify a provider for cause.
773.4 	(f) The adult rehabilitative mental health services provider entity must meet the following 
773.5 	standards:
773.6 	(1) have capacity to recruit, hire, manage, and train mental health professionals, mental 
773.7 	health practitioners, and mental health rehabilitation workers qualified staff;
773.8 	(2) have adequate administrative ability to ensure availability of services;
773.9 	(3) ensure adequate preservice and inservice and ongoing training for staff;
773.10 	(4) (3) ensure that mental health professionals, mental health practitioners, and mental 
773.11 	health rehabilitation workers staff are skilled in the delivery of the specific adult rehabilitative 
773.12 	mental health services provided to the individual eligible recipient;
773.13 	(5) ensure that staff is capable of implementing culturally specific services that are 
773.14 	culturally competent and appropriate as determined by the recipient's culture, beliefs, values, 
773.15 	and language as identified in the individual treatment plan;
773.16 	(6) (4) ensure enough flexibility in service delivery to respond to the changing and 
773.17 	intermittent care needs of a recipient as identified by the recipient and the individual treatment 
773.18 	plan;
773.19 	(7) ensure that the mental health professional or mental health practitioner, who is under 
773.20 	the clinical supervision of a mental health professional, involved in a recipient's services 
773.21 	participates in the development of the individual treatment plan;
773.22 	(8) (5) assist the recipient in arranging needed crisis assessment, intervention, and 
773.23 	stabilization services;
773.24 	(9) (6) ensure that services are coordinated with other recipient mental health services 
773.25 	providers and the county mental health authority and the federally recognized American 
773.26 	Indian authority and necessary others after obtaining the consent of the recipient. Services 
773.27 	must also be coordinated with the recipient's case manager or care coordinator if the recipient 
773.28 	is receiving case management or care coordination services;
773.29 	(10) develop and maintain recipient files, individual treatment plans, and contact charting;
773.30 	(11) develop and maintain staff training and personnel files;
773.31 	(12) submit information as required by the state;
774.1 	(13) establish and maintain a quality assurance plan to evaluate the outcome of services 
774.2 	provided;
774.3 	(14) (7) keep all necessary records required by law;
774.4 	(15) (8) deliver services as required by section 245.461;
774.5 	(16) comply with all applicable laws;
774.6 	(17) (9) be an enrolled Medicaid provider; and
774.7 	(18) (10) maintain a quality assurance plan to determine specific service outcomes and 
774.8 	the recipient's satisfaction with services; and.
774.9 	(19) develop and maintain written policies and procedures regarding service provision 
774.10 	and administration of the provider entity.

774.11 	Sec. 67. Minnesota Statutes 2020, section 256B.0623, subdivision 5, is amended to read:
774.12 		Subd. 5.Qualifications of provider staff. (a) Adult rehabilitative mental health services 
774.13 	must be provided by qualified individual provider staff of a certified provider entity. 
774.14 	Individual provider staff must be qualified under one of the following criteria as:
774.15 	(1) a mental health professional as defined in section 245.462, subdivision 18, clauses 
774.16 	(1) to (6). If the recipient has a current diagnostic assessment by a licensed mental health 
774.17 	professional as defined in section 245.462, subdivision 18, clauses (1) to (6), recommending 
774.18 	receipt of adult mental health rehabilitative services, the definition of mental health 
774.19 	professional for purposes of this section includes a person who is qualified under section 
774.20 	245.462, subdivision 18, clause (7), and who holds a current and valid national certification 
774.21 	as a certified rehabilitation counselor or certified psychosocial rehabilitation practitioner
774.22 	who is qualified according to section 245I.04, subdivision 2;
774.23 	(2) a certified rehabilitation specialist who is qualified according to section 245I.04, 
774.24 	subdivision 8;
774.25 	(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
774.26 	(4) a mental health practitioner as defined in section 245.462, subdivision 17. The mental 
774.27 	health practitioner must work under the clinical supervision of a mental health professional
774.28 	qualified according to section 245I.04, subdivision 4;
774.29 	(3) (5) a mental health certified peer specialist under section 256B.0615. The certified 
774.30 	peer specialist must work under the clinical supervision of a mental health professional who 
774.31 	is qualified according to section 245I.04, subdivision 10; or
775.1 	(4) (6) a mental health rehabilitation worker who is qualified according to section 245I.04, 
775.2 	subdivision 14. A mental health rehabilitation worker means a staff person working under 
775.3 	the direction of a mental health practitioner or mental health professional and under the 
775.4 	clinical supervision of a mental health professional in the implementation of rehabilitative 
775.5 	mental health services as identified in the recipient's individual treatment plan who:
775.6 	(i) is at least 21 years of age;
775.7 	(ii) has a high school diploma or equivalent;
775.8 	(iii) has successfully completed 30 hours of training during the two years immediately 
775.9 	prior to the date of hire, or before provision of direct services, in all of the following areas: 
775.10 	recovery from mental illness, mental health de-escalation techniques, recipient rights, 
775.11 	recipient-centered individual treatment planning, behavioral terminology, mental illness, 
775.12 	co-occurring mental illness and substance abuse, psychotropic medications and side effects, 
775.13 	functional assessment, local community resources, adult vulnerability, recipient 
775.14 	confidentiality; and
775.15 	(iv) meets the qualifications in paragraph (b).
775.16 	(b) In addition to the requirements in paragraph (a), a mental health rehabilitation worker 
775.17 	must also meet the qualifications in clause (1), (2), or (3):
775.18 	(1) has an associates of arts degree, two years of full-time postsecondary education, or 
775.19 	a total of 15 semester hours or 23 quarter hours in behavioral sciences or related fields; is 
775.20 	a registered nurse; or within the previous ten years has:
775.21 	(i) three years of personal life experience with serious mental illness;
775.22 	(ii) three years of life experience as a primary caregiver to an adult with a serious mental 
775.23 	illness, traumatic brain injury, substance use disorder, or developmental disability; or
775.24 	(iii) 2,000 hours of supervised work experience in the delivery of mental health services 
775.25 	to adults with a serious mental illness, traumatic brain injury, substance use disorder, or 
775.26 	developmental disability;
775.27 	(2)(i) is fluent in the non-English language or competent in the culture of the ethnic 
775.28 	group to which at least 20 percent of the mental health rehabilitation worker's clients belong;
775.29 	(ii) receives during the first 2,000 hours of work, monthly documented individual clinical 
775.30 	supervision by a mental health professional;
776.1 	(iii) has 18 hours of documented field supervision by a mental health professional or 
776.2 	mental health practitioner during the first 160 hours of contact work with recipients, and at 
776.3 	least six hours of field supervision quarterly during the following year;
776.4 	(iv) has review and cosignature of charting of recipient contacts during field supervision 
776.5 	by a mental health professional or mental health practitioner; and
776.6 	(v) has 15 hours of additional continuing education on mental health topics during the 
776.7 	first year of employment and 15 hours during every additional year of employment; or
776.8 	(3) for providers of crisis residential services, intensive residential treatment services, 
776.9 	partial hospitalization, and day treatment services:
776.10 	(i) satisfies clause (2), items (ii) to (iv); and
776.11 	(ii) has 40 hours of additional continuing education on mental health topics during the 
776.12 	first year of employment.
776.13 	(c) A mental health rehabilitation worker who solely acts and is scheduled as overnight 
776.14 	staff is not required to comply with paragraph (a), clause (4), item (iv).
776.15 	(d) For purposes of this subdivision, "behavioral sciences or related fields" means an 
776.16 	education from an accredited college or university and includes but is not limited to social 
776.17 	work, psychology, sociology, community counseling, family social science, child 
776.18 	development, child psychology, community mental health, addiction counseling, counseling 
776.19 	and guidance, special education, and other fields as approved by the commissioner.

776.20 	Sec. 68. Minnesota Statutes 2020, section 256B.0623, subdivision 6, is amended to read:
776.21 		Subd. 6.Required training and supervision. (a) Mental health rehabilitation workers 
776.22 	must receive ongoing continuing education training of at least 30 hours every two years in 
776.23 	areas of mental illness and mental health services and other areas specific to the population 
776.24 	being served. Mental health rehabilitation workers must also be subject to the ongoing 
776.25 	direction and clinical supervision standards in paragraphs (c) and (d).
776.26 	(b) Mental health practitioners must receive ongoing continuing education training as 
776.27 	required by their professional license; or if the practitioner is not licensed, the practitioner 
776.28 	must receive ongoing continuing education training of at least 30 hours every two years in 
776.29 	areas of mental illness and mental health services. Mental health practitioners must meet 
776.30 	the ongoing clinical supervision standards in paragraph (c).
776.31 	(c) Clinical supervision may be provided by a full- or part-time qualified professional 
776.32 	employed by or under contract with the provider entity. Clinical supervision may be provided 
777.1 	by interactive videoconferencing according to procedures developed by the commissioner. 
777.2 	A mental health professional providing clinical supervision of staff delivering adult 
777.3 	rehabilitative mental health services must provide the following guidance:
777.4 	(1) review the information in the recipient's file;
777.5 	(2) review and approve initial and updates of individual treatment plans;
777.6 	(a) A treatment supervisor providing treatment supervision required by section 245I.06 
777.7 	must:
777.8 	(3) (1) meet with mental health rehabilitation workers and practitioners, individually or 
777.9 	in small groups, staff receiving treatment supervision at least monthly to discuss treatment 
777.10 	topics of interest to the workers and practitioners;
777.11 	(4) meet with mental health rehabilitation workers and practitioners, individually or in 
777.12 	small groups, at least monthly to discuss and treatment plans of recipients, and approve by 
777.13 	signature and document in the recipient's file any resulting plan updates; and
777.14 	(5) (2) meet at least monthly with the directing clinical trainee or mental health 
777.15 	practitioner, if there is one, to review needs of the adult rehabilitative mental health services 
777.16 	program, review staff on-site observations and evaluate mental health rehabilitation workers, 
777.17 	plan staff training, review program evaluation and development, and consult with the 
777.18 	directing clinical trainee or mental health practitioner; and.
777.19 	(6) be available for urgent consultation as the individual recipient needs or the situation 
777.20 	necessitates.
777.21 	(d) (b) An adult rehabilitative mental health services provider entity must have a treatment 
777.22 	director who is a mental health practitioner or mental health professional clinical trainee, 
777.23 	certified rehabilitation specialist, or mental health practitioner. The treatment director must 
777.24 	ensure the following:
777.25 	(1) while delivering direct services to recipients, a newly hired mental health rehabilitation 
777.26 	worker must be directly observed delivering services to recipients by a mental health 
777.27 	practitioner or mental health professional for at least six hours per 40 hours worked during 
777.28 	the first 160 hours that the mental health rehabilitation worker works ensure the direct 
777.29 	observation of mental health rehabilitation workers required by section 245I.06, subdivision 
777.30 	3, is provided;
777.31 	(2) the mental health rehabilitation worker must receive ongoing on-site direct service 
777.32 	observation by a mental health professional or mental health practitioner for at least six 
777.33 	hours for every six months of employment;
778.1 	(3) progress notes are reviewed from on-site service observation prepared by the mental 
778.2 	health rehabilitation worker and mental health practitioner for accuracy and consistency 
778.3 	with actual recipient contact and the individual treatment plan and goals;
778.4 	(4) (2) ensure immediate availability by phone or in person for consultation by a mental 
778.5 	health professional, certified rehabilitation specialist, clinical trainee, or a mental health 
778.6 	practitioner to the mental health rehabilitation services worker during service provision;
778.7 	(5) oversee the identification of changes in individual recipient treatment strategies, 
778.8 	revise the plan, and communicate treatment instructions and methodologies as appropriate 
778.9 	to ensure that treatment is implemented correctly;
778.10 	(6) (3) model service practices which: respect the recipient, include the recipient in 
778.11 	planning and implementation of the individual treatment plan, recognize the recipient's 
778.12 	strengths, collaborate and coordinate with other involved parties and providers;
778.13 	(7) (4) ensure that clinical trainees, mental health practitioners, and mental health 
778.14 	rehabilitation workers are able to effectively communicate with the recipients, significant 
778.15 	others, and providers; and
778.16 	(8) (5) oversee the record of the results of on-site direct observation and charting, progress 
778.17 	note evaluation, and corrective actions taken to modify the work of the clinical trainees, 
778.18 	mental health practitioners, and mental health rehabilitation workers.
778.19 	(e) (c) A clinical trainee or mental health practitioner who is providing treatment direction 
778.20 	for a provider entity must receive treatment supervision at least monthly from a mental 
778.21 	health professional to:
778.22 	(1) identify and plan for general needs of the recipient population served;
778.23 	(2) identify and plan to address provider entity program needs and effectiveness;
778.24 	(3) identify and plan provider entity staff training and personnel needs and issues; and
778.25 	(4) plan, implement, and evaluate provider entity quality improvement programs.

778.26 	Sec. 69. Minnesota Statutes 2020, section 256B.0623, subdivision 9, is amended to read:
778.27 		Subd. 9.Functional assessment. (a) Providers of adult rehabilitative mental health 
778.28 	services must complete a written functional assessment as defined in section 245.462, 
778.29 	subdivision 11a according to section 245I.10, subdivision 9, for each recipient. The functional 
778.30 	assessment must be completed within 30 days of intake, and reviewed and updated at least 
778.31 	every six months after it is developed, unless there is a significant change in the functioning 
778.32 	of the recipient. If there is a significant change in functioning, the assessment must be 
779.1 	updated. A single functional assessment can meet case management and adult rehabilitative 
779.2 	mental health services requirements if agreed to by the recipient. Unless the recipient refuses, 
779.3 	the recipient must have significant participation in the development of the functional 
779.4 	assessment.
779.5 	(b) When a provider of adult rehabilitative mental health services completes a written 
779.6 	functional assessment, the provider must also complete a level of care assessment as defined 
779.7 	in section 245I.02, subdivision 19, for the recipient.

779.8 	Sec. 70. Minnesota Statutes 2020, section 256B.0623, subdivision 12, is amended to read:
779.9 		Subd. 12.Additional requirements. (a) Providers of adult rehabilitative mental health 
779.10 	services must comply with the requirements relating to referrals for case management in 
779.11 	section 245.467, subdivision 4.
779.12 	(b) Adult rehabilitative mental health services are provided for most recipients in the 
779.13 	recipient's home and community. Services may also be provided at the home of a relative 
779.14 	or significant other, job site, psychosocial clubhouse, drop-in center, social setting, classroom, 
779.15 	or other places in the community. Except for "transition to community services," the place 
779.16 	of service does not include a regional treatment center, nursing home, residential treatment 
779.17 	facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), or section 
779.18 	245I.23, or an acute care hospital.
779.19 	(c) Adult rehabilitative mental health services may be provided in group settings if 
779.20 	appropriate to each participating recipient's needs and individual treatment plan. A group 
779.21 	is defined as two to ten clients, at least one of whom is a recipient, who is concurrently 
779.22 	receiving a service which is identified in this section. The service and group must be specified 
779.23 	in the recipient's individual treatment plan. No more than two qualified staff may bill 
779.24 	Medicaid for services provided to the same group of recipients. If two adult rehabilitative 
779.25 	mental health workers bill for recipients in the same group session, they must each bill for 
779.26 	different recipients.
779.27 	(d) Adult rehabilitative mental health services are appropriate if provided to enable a 
779.28 	recipient to retain stability and functioning, when the recipient is at risk of significant 
779.29 	functional decompensation or requiring more restrictive service settings without these 
779.30 	services.
779.31 	(e) Adult rehabilitative mental health services instruct, assist, and support the recipient 
779.32 	in areas including: interpersonal communication skills, community resource utilization and 
779.33 	integration skills, crisis planning, relapse prevention skills, health care directives, budgeting 
780.1 	and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills, 
780.2 	transportation skills, medication education and monitoring, mental illness symptom 
780.3 	management skills, household management skills, employment-related skills, parenting 
780.4 	skills, and transition to community living services.
780.5 	(f) Community intervention, including consultation with relatives, guardians, friends, 
780.6 	employers, treatment providers, and other significant individuals, is appropriate when 
780.7 	directed exclusively to the treatment of the client.

780.8 	Sec. 71. Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:
780.9 		Subd. 3b.Telemedicine services. (a) Medical assistance covers medically necessary 
780.10 	services and consultations delivered by a licensed health care provider via telemedicine in 
780.11 	the same manner as if the service or consultation was delivered in person. Coverage is 
780.12 	limited to three telemedicine services per enrollee per calendar week, except as provided 
780.13 	in paragraph (f). Telemedicine services shall be paid at the full allowable rate.
780.14 	(b) The commissioner shall establish criteria that a health care provider must attest to 
780.15 	in order to demonstrate the safety or efficacy of delivering a particular service via 
780.16 	telemedicine. The attestation may include that the health care provider:
780.17 	(1) has identified the categories or types of services the health care provider will provide 
780.18 	via telemedicine;
780.19 	(2) has written policies and procedures specific to telemedicine services that are regularly 
780.20 	reviewed and updated;
780.21 	(3) has policies and procedures that adequately address patient safety before, during, 
780.22 	and after the telemedicine service is rendered;
780.23 	(4) has established protocols addressing how and when to discontinue telemedicine 
780.24 	services; and
780.25 	(5) has an established quality assurance process related to telemedicine services.
780.26 	(c) As a condition of payment, a licensed health care provider must document each 
780.27 	occurrence of a health service provided by telemedicine to a medical assistance enrollee. 
780.28 	Health care service records for services provided by telemedicine must meet the requirements 
780.29 	set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:
780.30 	(1) the type of service provided by telemedicine;
780.31 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
780.32 	designation;
781.1 	(3) the licensed health care provider's basis for determining that telemedicine is an 
781.2 	appropriate and effective means for delivering the service to the enrollee;
781.3 	(4) the mode of transmission of the telemedicine service and records evidencing that a 
781.4 	particular mode of transmission was utilized;
781.5 	(5) the location of the originating site and the distant site;
781.6 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
781.7 	another physician, the written opinion from the consulting physician providing the 
781.8 	telemedicine consultation; and
781.9 	(7) compliance with the criteria attested to by the health care provider in accordance 
781.10 	with paragraph (b).
781.11 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
781.12 	"telemedicine" is defined as the delivery of health care services or consultations while the 
781.13 	patient is at an originating site and the licensed health care provider is at a distant site. A 
781.14 	communication between licensed health care providers, or a licensed health care provider 
781.15 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
781.16 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
781.17 	by means of real-time two-way, interactive audio and visual communications, including the 
781.18 	application of secure video conferencing or store-and-forward technology to provide or 
781.19 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
781.20 	treatment, education, and care management of a patient's health care.
781.21 	(e) For purposes of this section, "licensed health care provider" means a licensed health 
781.22 	care provider under section 62A.671, subdivision 6, a community paramedic as defined 
781.23 	under section 144E.001, subdivision 5f, or a clinical trainee who is qualified according to 
781.24 	section 245I.04, subdivision 6, a mental health practitioner defined under section 245.462, 
781.25 	subdivision 17, or 245.4871, subdivision 26, working under the general supervision of a 
781.26 	mental health professional qualified according to section 245I.04, subdivision 4, and a 
781.27 	community health worker who meets the criteria under subdivision 49, paragraph (a); "health 
781.28 	care provider" is defined under section 62A.671, subdivision 3; and "originating site" is 
781.29 	defined under section 62A.671, subdivision 7.
781.30 	(f) The limit on coverage of three telemedicine services per enrollee per calendar week 
781.31 	does not apply if:
781.32 	(1) the telemedicine services provided by the licensed health care provider are for the 
781.33 	treatment and control of tuberculosis; and
782.1 	(2) the services are provided in a manner consistent with the recommendations and best 
782.2 	practices specified by the Centers for Disease Control and Prevention and the commissioner 
782.3 	of health.

782.4 	Sec. 72. Minnesota Statutes 2020, section 256B.0625, subdivision 5, is amended to read:
782.5 		Subd. 5.Community mental health center services. Medical assistance covers 
782.6 	community mental health center services provided by a community mental health center 
782.7 	that meets the requirements in paragraphs (a) to (j).
782.8 	(a) The provider is licensed under Minnesota Rules, parts 9520.0750 to 9520.0870 must 
782.9 	be certified as a mental health clinic under section 245I.20.
782.10 	(b) The provider provides mental health services under the clinical supervision of a 
782.11 	mental health professional who is licensed for independent practice at the doctoral level or 
782.12 	by a board-certified psychiatrist In addition to the policies and procedures required by 
782.13 	section 245I.03, the provider must establish, enforce, and maintain the policies and procedures 
782.14 	for oversight of clinical services by a doctoral level psychologist or a board certified or 
782.15 	board eligible psychiatrist who is eligible for board certification. Clinical supervision has 
782.16 	the meaning given in Minnesota Rules, part 9505.0370, subpart 6. These policies and 
782.17 	procedures must be developed with the involvement of a doctoral level psychologist and a 
782.18 	board certified or board eligible psychiatrist, and must include:
782.19 	(1) requirements for when to seek clinical consultation by doctoral level psychologist 
782.20 	or a board certified or board eligible psychiatrist;
782.21 	(2) requirements for the involvement of a doctoral level psychologist or a board certified 
782.22 	or board eligible psychiatrist in the direction of clinical services; and
782.23 	(3) involvement of a doctoral level psychologist or a board certified or board eligible 
782.24 	psychiatrist in quality improvement initiatives and review as part of a multidisciplinary care 
782.25 	team.
782.26 	(c) The provider must be a private nonprofit corporation or a governmental agency and 
782.27 	have a community board of directors as specified by section 245.66.
782.28 	(d) The provider must have a sliding fee scale that meets the requirements in section 
782.29 	245.481, and agree to serve within the limits of its capacity all individuals residing in its 
782.30 	service delivery area.
782.31 	(e) At a minimum, the provider must provide the following outpatient mental health 
782.32 	services: diagnostic assessment; explanation of findings; family, group, and individual 
783.1 	psychotherapy, including crisis intervention psychotherapy services, multiple family group 
783.2 	psychotherapy, psychological testing, and medication management. In addition, the provider 
783.3 	must provide or be capable of providing upon request of the local mental health authority 
783.4 	day treatment services, multiple family group psychotherapy, and professional home-based 
783.5 	mental health services. The provider must have the capacity to provide such services to 
783.6 	specialized populations such as the elderly, families with children, persons who are seriously 
783.7 	and persistently mentally ill, and children who are seriously emotionally disturbed.
783.8 	(f) The provider must be capable of providing the services specified in paragraph (e) to 
783.9 	individuals who are diagnosed with both dually diagnosed with mental illness or emotional 
783.10 	disturbance, and chemical dependency substance use disorder, and to individuals who are
783.11 	dually diagnosed with a mental illness or emotional disturbance and developmental disability.
783.12 	(g) The provider must provide 24-hour emergency care services or demonstrate the 
783.13 	capacity to assist recipients in need of such services to access such services on a 24-hour 
783.14 	basis.
783.15 	(h) The provider must have a contract with the local mental health authority to provide 
783.16 	one or more of the services specified in paragraph (e).
783.17 	(i) The provider must agree, upon request of the local mental health authority, to enter 
783.18 	into a contract with the county to provide mental health services not reimbursable under 
783.19 	the medical assistance program.
783.20 	(j) The provider may not be enrolled with the medical assistance program as both a 
783.21 	hospital and a community mental health center. The community mental health center's 
783.22 	administrative, organizational, and financial structure must be separate and distinct from 
783.23 	that of the hospital.
783.24 	(k) The commissioner may require the provider to annually attest that the provider meets 
783.25 	the requirements in this subdivision using a form that the commissioner provides.

783.26 	EFFECTIVE DATE. Paragraphs (e), (f), and (k) are effective the day following final 
783.27 	enactment.

783.28 	Sec. 73. Minnesota Statutes 2020, section 256B.0625, subdivision 19c, is amended to 
783.29 	read:
783.30 		Subd. 19c.Personal care. Medical assistance covers personal care assistance services 
783.31 	provided by an individual who is qualified to provide the services according to subdivision 
783.32 	19a and sections 256B.0651 to 256B.0654, provided in accordance with a plan, and 
783.33 	supervised by a qualified professional.
784.1 	"Qualified professional" means a mental health professional as defined in section 245.462, 
784.2 	subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6); a registered 
784.3 	nurse as defined in sections 148.171 to 148.285, a licensed social worker as defined in 
784.4 	sections 148E.010 and 148E.055, or a qualified designated coordinator under section 
784.5 	245D.081, subdivision 2. The qualified professional shall perform the duties required in 
784.6 	section 256B.0659.

784.7 	Sec. 74. Minnesota Statutes 2020, section 256B.0625, subdivision 28a, is amended to 
784.8 	read:
784.9 		Subd. 28a.Licensed physician assistant services. (a) Medical assistance covers services 
784.10 	performed by a licensed physician assistant if the service is otherwise covered under this 
784.11 	chapter as a physician service and if the service is within the scope of practice of a licensed 
784.12 	physician assistant as defined in section 147A.09.
784.13 	(b) Licensed physician assistants, who are supervised by a physician certified by the 
784.14 	American Board of Psychiatry and Neurology or eligible for board certification in psychiatry, 
784.15 	may bill for medication management and evaluation and management services provided to 
784.16 	medical assistance enrollees in inpatient hospital settings, and in outpatient settings after 
784.17 	the licensed physician assistant completes 2,000 hours of clinical experience in the evaluation 
784.18 	and treatment of mental health, consistent with their authorized scope of practice, as defined 
784.19 	in section 147A.09, with the exception of performing psychotherapy or diagnostic 
784.20 	assessments or providing clinical treatment supervision.

784.21 	Sec. 75. Minnesota Statutes 2020, section 256B.0625, subdivision 42, is amended to read:
784.22 		Subd. 42.Mental health professional. Notwithstanding Minnesota Rules, part 
784.23 	9505.0175, subpart 28, the definition of a mental health professional shall include a person 
784.24 	who is qualified as specified in according to section 245.462, subdivision 18, clauses (1) to 
784.25 	(6); or 245.4871, subdivision 27, clauses (1) to (6) 245I.04, subdivision 2, for the purpose 
784.26 	of this section and Minnesota Rules, parts 9505.0170 to 9505.0475.

784.27 	Sec. 76. Minnesota Statutes 2020, section 256B.0625, subdivision 48, is amended to read:
784.28 		Subd. 48.Psychiatric consultation to primary care practitioners.  Medical assistance 
784.29 	covers consultation provided by a psychiatrist, a psychologist, an advanced practice registered 
784.30 	nurse certified in psychiatric mental health, a licensed independent clinical social worker, 
784.31 	as defined in section 245.462, subdivision 18, clause (2), or a licensed marriage and family 
784.32 	therapist, as defined in section 245.462, subdivision 18, clause (5) mental health professional 
785.1 	who is qualified according to section 245I.04, subdivision 2, except a licensed professional 
785.2 	clinical counselor licensed under section 148B.5301, via telephone, e-mail, facsimile, or 
785.3 	other means of communication to primary care practitioners, including pediatricians. The 
785.4 	need for consultation and the receipt of the consultation must be documented in the patient 
785.5 	record maintained by the primary care practitioner. If the patient consents, and subject to 
785.6 	federal limitations and data privacy provisions, the consultation may be provided without 
785.7 	the patient present.

785.8 	Sec. 77. Minnesota Statutes 2020, section 256B.0625, subdivision 49, is amended to read:
785.9 		Subd. 49.Community health worker. (a) Medical assistance covers the care 
785.10 	coordination and patient education services provided by a community health worker if the 
785.11 	community health worker has:
785.12 	(1) received a certificate from the Minnesota State Colleges and Universities System 
785.13 	approved community health worker curriculum; or.
785.14 	(2) at least five years of supervised experience with an enrolled physician, registered 
785.15 	nurse, advanced practice registered nurse, mental health professional as defined in section 
785.16 	245.462, subdivision 18, clauses (1) to (6), and section 245.4871, subdivision 27, clauses 
785.17 	(1) to (5), or dentist, or at least five years of supervised experience by a certified public 
785.18 	health nurse operating under the direct authority of an enrolled unit of government.
785.19 	Community health workers eligible for payment under clause (2) must complete the 
785.20 	certification program by January 1, 2010, to continue to be eligible for payment.
785.21 	(b) Community health workers must work under the supervision of a medical assistance 
785.22 	enrolled physician, registered nurse, advanced practice registered nurse, mental health 
785.23 	professional as defined in section 245.462, subdivision 18, clauses (1) to (6), and section 
785.24 	245.4871, subdivision 27, clauses (1) to (5), or dentist, or work under the supervision of a 
785.25 	certified public health nurse operating under the direct authority of an enrolled unit of 
785.26 	government.
785.27 	(c) Care coordination and patient education services covered under this subdivision 
785.28 	include, but are not limited to, services relating to oral health and dental care.

786.1 	Sec. 78. Minnesota Statutes 2020, section 256B.0625, subdivision 56a, is amended to 
786.2 	read:
786.3 		Subd. 56a.Officer-involved community-based care coordination. (a) Medical 
786.4 	assistance covers officer-involved community-based care coordination for an individual 
786.5 	who:
786.6 	(1) has screened positive for benefiting from treatment for a mental illness or substance 
786.7 	use disorder using a tool approved by the commissioner;
786.8 	(2) does not require the security of a public detention facility and is not considered an 
786.9 	inmate of a public institution as defined in Code of Federal Regulations, title 42, section 
786.10 	435.1010;
786.11 	(3) meets the eligibility requirements in section 256B.056; and
786.12 	(4) has agreed to participate in officer-involved community-based care coordination.
786.13 	(b) Officer-involved community-based care coordination means navigating services to 
786.14 	address a client's mental health, chemical health, social, economic, and housing needs, or 
786.15 	any other activity targeted at reducing the incidence of jail utilization and connecting 
786.16 	individuals with existing covered services available to them, including, but not limited to, 
786.17 	targeted case management, waiver case management, or care coordination.
786.18 	(c) Officer-involved community-based care coordination must be provided by an 
786.19 	individual who is an employee of or is under contract with a county, or is an employee of 
786.20 	or under contract with an Indian health service facility or facility owned and operated by a 
786.21 	tribe or a tribal organization operating under Public Law 93-638 as a 638 facility to provide 
786.22 	officer-involved community-based care coordination and is qualified under one of the 
786.23 	following criteria:
786.24 	(1) a licensed mental health professional as defined in section 245.462, subdivision 18, 
786.25 	clauses (1) to (6);
786.26 	(2) a clinical trainee who is qualified according to section 245I.04, subdivision 6, working 
786.27 	under the treatment supervision of a mental health professional according to section 245I.06;
786.28 	(3) a mental health practitioner as defined in section 245.462, subdivision 17 who is 
786.29 	qualified according to section 245I.04, subdivision 4, working under the clinical treatment
786.30 	supervision of a mental health professional according to section 245I.06;
787.1 	(3) (4) a mental health certified peer specialist under section 256B.0615 who is qualified 
787.2 	according to section 245I.04, subdivision 10, working under the clinical treatment supervision 
787.3 	of a mental health professional according to section 245I.06;
787.4 	(4) an individual qualified as an alcohol and drug counselor under section 245G.11, 
787.5 	subdivision 5; or
787.6 	(5) a recovery peer qualified under section 245G.11, subdivision 8, working under the 
787.7 	supervision of an individual qualified as an alcohol and drug counselor under section 
787.8 	245G.11, subdivision 5.
787.9 	(d) Reimbursement is allowed for up to 60 days following the initial determination of 
787.10 	eligibility.
787.11 	(e) Providers of officer-involved community-based care coordination shall annually 
787.12 	report to the commissioner on the number of individuals served, and number of the 
787.13 	community-based services that were accessed by recipients. The commissioner shall ensure 
787.14 	that services and payments provided under officer-involved community-based care 
787.15 	coordination do not duplicate services or payments provided under section 256B.0625, 
787.16 	subdivision 20, 256B.0753, 256B.0755, or 256B.0757.
787.17 	(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for 
787.18 	officer-involved community-based care coordination services shall be provided by the 
787.19 	county providing the services, from sources other than federal funds or funds used to match 
787.20 	other federal funds.

787.21 	Sec. 79. Minnesota Statutes 2020, section 256B.0757, subdivision 4c, is amended to read:
787.22 		Subd. 4c.Behavioral health home services staff qualifications. (a) A behavioral health 
787.23 	home services provider must maintain staff with required professional qualifications 
787.24 	appropriate to the setting.
787.25 	(b) If behavioral health home services are offered in a mental health setting, the 
787.26 	integration specialist must be a registered nurse licensed under the Minnesota Nurse Practice 
787.27 	Act, sections 148.171 to 148.285.
787.28 	(c) If behavioral health home services are offered in a primary care setting, the integration 
787.29 	specialist must be a mental health professional as defined in who is qualified according to
787.30 	section 245.462, subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) 
787.31 	to (6) 245I.04, subdivision 2.
788.1 	(d) If behavioral health home services are offered in either a primary care setting or 
788.2 	mental health setting, the systems navigator must be a mental health practitioner as defined 
788.3 	in who is qualified according to section 245.462, subdivision 17 245I.04, subdivision 4, or 
788.4 	a community health worker as defined in section 256B.0625, subdivision 49.
788.5 	(e) If behavioral health home services are offered in either a primary care setting or 
788.6 	mental health setting, the qualified health home specialist must be one of the following:
788.7 	(1) a mental health certified peer support specialist as defined in who is qualified 
788.8 	according to section 256B.0615 245I.04, subdivision 10;
788.9 	(2) a mental health certified family peer support specialist as defined in who is qualified 
788.10 	according to section 256B.0616 245I.04, subdivision 12;
788.11 	(3) a case management associate as defined in section 245.462, subdivision 4, paragraph 
788.12 	(g), or 245.4871, subdivision 4, paragraph (j);
788.13 	(4) a mental health rehabilitation worker as defined in who is qualified according to
788.14 	section 256B.0623, subdivision 5, clause (4) 245I.04, subdivision 14;
788.15 	(5) a community paramedic as defined in section 144E.28, subdivision 9;
788.16 	(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5); 
788.17 	or
788.18 	(7) a community health worker as defined in section 256B.0625, subdivision 49.

788.19 	Sec. 80. Minnesota Statutes 2020, section 256B.0941, subdivision 1, is amended to read:
788.20 		Subdivision 1.Eligibility. (a) An individual who is eligible for mental health treatment 
788.21 	services in a psychiatric residential treatment facility must meet all of the following criteria:
788.22 	(1) before admission, services are determined to be medically necessary according to 
788.23 	Code of Federal Regulations, title 42, section 441.152;
788.24 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
788.25 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
788.26 	first;
788.27 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
788.28 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
788.29 	or a finding that the individual is a risk to self or others;
788.30 	(4) has functional impairment and a history of difficulty in functioning safely and 
788.31 	successfully in the community, school, home, or job; an inability to adequately care for 
789.1 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
789.2 	the individual's needs;
789.3 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
789.4 	the individual's condition or prevent further regression so that services will no longer be 
789.5 	needed;
789.6 	(6) utilized and exhausted other community-based mental health services, or clinical 
789.7 	evidence indicates that such services cannot provide the level of care needed; and
789.8 	(7) was referred for treatment in a psychiatric residential treatment facility by a qualified
789.9 	mental health professional licensed as defined in who is qualified according to section 
789.10 	245.4871, subdivision 27, clauses (1) to (6) 245I.04, subdivision 2.
789.11 	(b) The commissioner shall provide oversight and review the use of referrals for clients 
789.12 	admitted to psychiatric residential treatment facilities to ensure that eligibility criteria, 
789.13 	clinical services, and treatment planning reflect clinical, state, and federal standards for 
789.14 	psychiatric residential treatment facility level of care. The commissioner shall coordinate 
789.15 	the production of a statewide list of children and youth who meet the medical necessity 
789.16 	criteria for psychiatric residential treatment facility level of care and who are awaiting 
789.17 	admission. The commissioner and any recipient of the list shall not use the statewide list to 
789.18 	direct admission of children and youth to specific facilities.

789.19 	Sec. 81. Minnesota Statutes 2020, section 256B.0943, subdivision 1, is amended to read:
789.20 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
789.21 	meanings given them.
789.22 	(a) "Children's therapeutic services and supports" means the flexible package of mental 
789.23 	health services for children who require varying therapeutic and rehabilitative levels of 
789.24 	intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871, 
789.25 	subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision 
789.26 	20. The services are time-limited interventions that are delivered using various treatment 
789.27 	modalities and combinations of services designed to reach treatment outcomes identified 
789.28 	in the individual treatment plan.
789.29 	(b) "Clinical supervision" means the overall responsibility of the mental health 
789.30 	professional for the control and direction of individualized treatment planning, service 
789.31 	delivery, and treatment review for each client. A mental health professional who is an 
789.32 	enrolled Minnesota health care program provider accepts full professional responsibility 
790.1 	for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, 
790.2 	and oversees or directs the supervisee's work.
790.3 	(c) (b) "Clinical trainee" means a mental health practitioner who meets the qualifications 
790.4 	specified in Minnesota Rules, part 9505.0371, subpart 5, item C staff person who is qualified 
790.5 	according to section 245I.04, subdivision 6.
790.6 	(d) (c) "Crisis assistance planning" has the meaning given in section 245.4871, subdivision 
790.7 	9a. Crisis assistance entails the development of a written plan to assist a child's family to 
790.8 	contend with a potential crisis and is distinct from the immediate provision of crisis 
790.9 	intervention services.
790.10 	(e) (d) "Culturally competent provider" means a provider who understands and can 
790.11 	utilize to a client's benefit the client's culture when providing services to the client. A provider 
790.12 	may be culturally competent because the provider is of the same cultural or ethnic group 
790.13 	as the client or the provider has developed the knowledge and skills through training and 
790.14 	experience to provide services to culturally diverse clients.
790.15 	(f) (e) "Day treatment program" for children means a site-based structured mental health 
790.16 	program consisting of psychotherapy for three or more individuals and individual or group 
790.17 	skills training provided by a multidisciplinary team, under the clinicaltreatment supervision 
790.18 	of a mental health professional.
790.19 	(g) (f) "Standard diagnostic assessment" has the meaning given in Minnesota Rules, part 
790.20 	9505.0372, subpart 1 means the assessment described in 245I.10, subdivision 6.
790.21 	(h) (g) "Direct service time" means the time that a mental health professional, clinical 
790.22 	trainee, mental health practitioner, or mental health behavioral aide spends face-to-face with 
790.23 	a client and the client's family or providing covered telemedicine services. Direct service 
790.24 	time includes time in which the provider obtains a client's history, develops a client's 
790.25 	treatment plan, records individual treatment outcomes, or provides service components of 
790.26 	children's therapeutic services and supports. Direct service time does not include time doing 
790.27 	work before and after providing direct services, including scheduling or maintaining clinical 
790.28 	records.
790.29 	(i) (h) "Direction of mental health behavioral aide" means the activities of a mental 
790.30 	health professional, clinical trainee, or mental health practitioner in guiding the mental 
790.31 	health behavioral aide in providing services to a client. The direction of a mental health 
790.32 	behavioral aide must be based on the client's individualized individual treatment plan and 
790.33 	meet the requirements in subdivision 6, paragraph (b), clause (5).
791.1 	(j) (i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 
791.2 	15.
791.3 	(k) (j) "Individual behavioral plan" means a plan of intervention, treatment, and services 
791.4 	for a child written by a mental health professional or a clinical trainee or mental health 
791.5 	practitioner, under the clinical treatment supervision of a mental health professional, to 
791.6 	guide the work of the mental health behavioral aide. The individual behavioral plan may 
791.7 	be incorporated into the child's individual treatment plan so long as the behavioral plan is 
791.8 	separately communicable to the mental health behavioral aide.
791.9 	(l) (k) "Individual treatment plan" has the meaning given in Minnesota Rules, part 
791.10 	9505.0371, subpart 7 means the plan described in section 245I.10, subdivisions 7 and 8.
791.11 	(m) (l) "Mental health behavioral aide services" means medically necessary one-on-one 
791.12 	activities performed by a trained paraprofessional qualified as provided in subdivision 7, 
791.13 	paragraph (b), clause (3) mental health behavioral aide qualified according to section 245I.04, 
791.14 	subdivision 16, to assist a child retain or generalize psychosocial skills as previously trained 
791.15 	by a mental health professional, clinical trainee, or mental health practitioner and as described 
791.16 	in the child's individual treatment plan and individual behavior plan. Activities involve 
791.17 	working directly with the child or child's family as provided in subdivision 9, paragraph 
791.18 	(b), clause (4).
791.19 	(m) "Mental health certified family peer specialist" means a staff person who is qualified 
791.20 	according to section 245I.04, subdivision 12.
791.21 	(n) "Mental health practitioner" has the meaning given in section 245.462, subdivision 
791.22 	17, except that a practitioner working in a day treatment setting may qualify as a mental 
791.23 	health practitioner if the practitioner holds a bachelor's degree in one of the behavioral 
791.24 	sciences or related fields from an accredited college or university, and: (1) has at least 2,000 
791.25 	hours of clinically supervised experience in the delivery of mental health services to clients 
791.26 	with mental illness; (2) is fluent in the language, other than English, of the cultural group 
791.27 	that makes up at least 50 percent of the practitioner's clients, completes 40 hours of training 
791.28 	on the delivery of services to clients with mental illness, and receives clinical supervision 
791.29 	from a mental health professional at least once per week until meeting the required 2,000 
791.30 	hours of supervised experience; or (3) receives 40 hours of training on the delivery of 
791.31 	services to clients with mental illness within six months of employment, and clinical 
791.32 	supervision from a mental health professional at least once per week until meeting the 
791.33 	required 2,000 hours of supervised experience means a staff person who is qualified according 
791.34 	to section 245I.04, subdivision 4.
792.1 	(o) "Mental health professional" means an individual as defined in Minnesota Rules, 
792.2 	part 9505.0370, subpart 18 a staff person who is qualified according to section 245I.04, 
792.3 	subdivision 2.
792.4 	(p) "Mental health service plan development" includes:
792.5 	(1) the development, review, and revision of a child's individual treatment plan, as 
792.6 	provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of the client 
792.7 	or client's parents, primary caregiver, or other person authorized to consent to mental health 
792.8 	services for the client, and including arrangement of treatment and support activities specified 
792.9 	in the individual treatment plan; and
792.10 	(2) administering and reporting the standardized outcome measurement instruments, 
792.11 	determined and updated by the commissioner measurements in section 245I.10, subdivision 
792.12 	6, paragraph (d), clauses (3) and (4), and other standardized outcome measurements approved 
792.13 	by the commissioner, as periodically needed to evaluate the effectiveness of treatment for 
792.14 	children receiving clinical services and reporting outcome measures, as required by the 
792.15 	commissioner.
792.16 	(q) "Mental illness," for persons at least age 18 but under age 21, has the meaning given 
792.17 	in section 245.462, subdivision 20, paragraph (a).
792.18 	(r) "Psychotherapy" means the treatment of mental or emotional disorders or 
792.19 	maladjustment by psychological means. Psychotherapy may be provided in many modalities 
792.20 	in accordance with Minnesota Rules, part 9505.0372, subpart 6, including patient and/or 
792.21 	family psychotherapy; family psychotherapy; psychotherapy for crisis; group psychotherapy; 
792.22 	or multiple-family psychotherapy. Beginning with the American Medical Association's 
792.23 	Current Procedural Terminology, standard edition, 2014, the procedure "individual 
792.24 	psychotherapy" is replaced with "patient and/or family psychotherapy," a substantive change 
792.25 	that permits the therapist to work with the client's family without the client present to obtain 
792.26 	information about the client or to explain the client's treatment plan to the family. 
792.27 	Psychotherapy is appropriate for crisis response when a child has become dysregulated or 
792.28 	experienced new trauma since the diagnostic assessment was completed and needs 
792.29 	psychotherapy to address issues not currently included in the child's individual treatment 
792.30 	plan described in section 256B.0671, subdivision 11.
792.31 	(s) "Rehabilitative services" or "psychiatric rehabilitation services" means a series or 
792.32 	multidisciplinary combination of psychiatric and psychosocial interventions to: (1) restore 
792.33 	a child or adolescent to an age-appropriate developmental trajectory that had been disrupted 
792.34 	by a psychiatric illness; or (2) enable the child to self-monitor, compensate for, cope with, 
793.1 	counteract, or replace psychosocial skills deficits or maladaptive skills acquired over the 
793.2 	course of a psychiatric illness. Psychiatric rehabilitation services for children combine 
793.3 	coordinated psychotherapy to address internal psychological, emotional, and intellectual 
793.4 	processing deficits, and skills training to restore personal and social functioning. Psychiatric 
793.5 	rehabilitation services establish a progressive series of goals with each achievement building 
793.6 	upon a prior achievement. Continuing progress toward goals is expected, and rehabilitative 
793.7 	potential ceases when successive improvement is not observable over a period of time.
793.8 	(t) "Skills training" means individual, family, or group training, delivered by or under 
793.9 	the supervision of a mental health professional, designed to facilitate the acquisition of 
793.10 	psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate 
793.11 	developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child 
793.12 	to self-monitor, compensate for, cope with, counteract, or replace skills deficits or 
793.13 	maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject 
793.14 	to the service delivery requirements under subdivision 9, paragraph (b), clause (2).
793.15 	(u) "Treatment supervision" means the supervision described in section 245I.06.

793.16 	Sec. 82. Minnesota Statutes 2020, section 256B.0943, subdivision 2, is amended to read:
793.17 		Subd. 2.Covered service components of children's therapeutic services and 
793.18 	supports. (a) Subject to federal approval, medical assistance covers medically necessary 
793.19 	children's therapeutic services and supports as defined in this section that when the services 
793.20 	are provided by an eligible provider entity certified under subdivision 4 provides to a client 
793.21 	eligible under subdivision 3 and meeting the standards in this section. The provider entity 
793.22 	must make reasonable and good faith efforts to report individual client outcomes to the 
793.23 	commissioner, using instruments and protocols approved by the commissioner.
793.24 	(b) The service components of children's therapeutic services and supports are:
793.25 	(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis, 
793.26 	and group psychotherapy;
793.27 	(2) individual, family, or group skills training provided by a mental health professional, 
793.28 	clinical trainee, or mental health practitioner;
793.29 	(3) crisis assistance planning;
793.30 	(4) mental health behavioral aide services;
793.31 	(5) direction of a mental health behavioral aide;
793.32 	(6) mental health service plan development; and
794.1 	(7) children's day treatment.

794.2 	Sec. 83. Minnesota Statutes 2020, section 256B.0943, subdivision 3, is amended to read:
794.3 		Subd. 3.Determination of client eligibility. (a) A client's eligibility to receive children's 
794.4 	therapeutic services and supports under this section shall be determined based on a standard 
794.5 	diagnostic assessment by a mental health professional or a mental health practitioner who 
794.6 	meets the requirements of a clinical trainee as defined in Minnesota Rules, part 9505.0371, 
794.7 	subpart 5, item C, clinical trainee that is performed within one year before the initial start 
794.8 	of service. The standard diagnostic assessment must meet the requirements for a standard 
794.9 	or extended diagnostic assessment as defined in Minnesota Rules, part 9505.0372, subpart 
794.10 	1, items B and C, and:
794.11 	(1) include current diagnoses, including any differential diagnosis, in accordance with 
794.12 	all criteria for a complete diagnosis and diagnostic profile as specified in the current edition 
794.13 	of the Diagnostic and Statistical Manual of the American Psychiatric Association, or, for 
794.14 	children under age five, as specified in the current edition of the Diagnostic Classification 
794.15 	of Mental Health Disorders of Infancy and Early Childhood;
794.16 	(2) (1) determine whether a child under age 18 has a diagnosis of emotional disturbance 
794.17 	or, if the person is between the ages of 18 and 21, whether the person has a mental illness;
794.18 	(3) (2) document children's therapeutic services and supports as medically necessary to 
794.19 	address an identified disability, functional impairment, and the individual client's needs and 
794.20 	goals; and
794.21 	(4) (3) be used in the development of the individualized individual treatment plan; and.
794.22 	(5) be completed annually until age 18. For individuals between age 18 and 21, unless 
794.23 	a client's mental health condition has changed markedly since the client's most recent 
794.24 	diagnostic assessment, annual updating is necessary. For the purpose of this section, 
794.25 	"updating" means an adult diagnostic update as defined in Minnesota Rules, part 9505.0371, 
794.26 	subpart 2, item E.
794.27 	(b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to 
794.28 	five days of day treatment under this section based on a hospital's medical history and 
794.29 	presentation examination of the client.

794.30 	Sec. 84. Minnesota Statutes 2020, section 256B.0943, subdivision 4, is amended to read:
794.31 		Subd. 4.Provider entity certification. (a) The commissioner shall establish an initial 
794.32 	provider entity application and certification process and recertification process to determine 
795.1 	whether a provider entity has an administrative and clinical infrastructure that meets the 
795.2 	requirements in subdivisions 5 and 6. A provider entity must be certified for the three core 
795.3 	rehabilitation services of psychotherapy, skills training, and crisis assistance planning. The 
795.4 	commissioner shall recertify a provider entity at least every three years. The commissioner 
795.5 	shall establish a process for decertification of a provider entity and shall require corrective 
795.6 	action, medical assistance repayment, or decertification of a provider entity that no longer 
795.7 	meets the requirements in this section or that fails to meet the clinical quality standards or 
795.8 	administrative standards provided by the commissioner in the application and certification 
795.9 	process.
795.10 	(b) For purposes of this section, a provider entity must meet the standards in this section 
795.11 	and chapter 245I, as required by section 245I.011, subdivision 5, and be:
795.12 	(1) an Indian health services facility or a facility owned and operated by a tribe or tribal 
795.13 	organization operating as a 638 facility under Public Law 93-638 certified by the state;
795.14 	(2) a county-operated entity certified by the state; or
795.15 	(3) a noncounty entity certified by the state.

795.16 	Sec. 85. Minnesota Statutes 2020, section 256B.0943, subdivision 5, is amended to read:
795.17 		Subd. 5.Provider entity administrative infrastructure requirements. (a) To be an 
795.18 	eligible provider entity under this section, a provider entity must have an administrative 
795.19 	infrastructure that establishes authority and accountability for decision making and oversight 
795.20 	of functions, including finance, personnel, system management, clinical practice, and 
795.21 	individual treatment outcomes measurement. An eligible provider entity shall demonstrate 
795.22 	the availability, by means of employment or contract, of at least one backup mental health 
795.23 	professional in the event of the primary mental health professional's absence. The provider 
795.24 	must have written policies and procedures that it reviews and updates every three years and 
795.25 	distributes to staff initially and upon each subsequent update.
795.26 	(b) The administrative infrastructure written In addition to the policies and procedures 
795.27 	required in section 245I.03, the policies and procedures must include:
795.28 	(1) personnel procedures, including a process for: (i) recruiting, hiring, training, and 
795.29 	retention of culturally and linguistically competent providers; (ii) conducting a criminal 
795.30 	background check on all direct service providers and volunteers; (iii) investigating, reporting, 
795.31 	and acting on violations of ethical conduct standards; (iv) investigating, reporting, and acting 
795.32 	on violations of data privacy policies that are compliant with federal and state laws; (v) 
795.33 	utilizing volunteers, including screening applicants, training and supervising volunteers, 
796.1 	and providing liability coverage for volunteers; and (vi) documenting that each mental 
796.2 	health professional, mental health practitioner, or mental health behavioral aide meets the 
796.3 	applicable provider qualification criteria, training criteria under subdivision 8, and clinical 
796.4 	supervision or direction of a mental health behavioral aide requirements under subdivision 
796.5 	6;
796.6 	(2) (1) fiscal procedures, including internal fiscal control practices and a process for 
796.7 	collecting revenue that is compliant with federal and state laws; and
796.8 	(3) (2) a client-specific treatment outcomes measurement system, including baseline 
796.9 	measures, to measure a client's progress toward achieving mental health rehabilitation goals. 
796.10 	Effective July 1, 2017, to be eligible for medical assistance payment, a provider entity must 
796.11 	report individual client outcomes to the commissioner, using instruments and protocols 
796.12 	approved by the commissioner; and
796.13 	(4) a process to establish and maintain individual client records. The client's records 
796.14 	must include:
796.15 	(i) the client's personal information;
796.16 	(ii) forms applicable to data privacy;
796.17 	(iii) the client's diagnostic assessment, updates, results of tests, individual treatment 
796.18 	plan, and individual behavior plan, if necessary;
796.19 	(iv) documentation of service delivery as specified under subdivision 6;
796.20 	(v) telephone contacts;
796.21 	(vi) discharge plan; and
796.22 	(vii) if applicable, insurance information.
796.23 	(c) A provider entity that uses a restrictive procedure with a client must meet the 
796.24 	requirements of section 245.8261.

796.25 	Sec. 86. Minnesota Statutes 2020, section 256B.0943, subdivision 5a, is amended to read:
796.26 		Subd. 5a.Background studies. The requirements for background studies under this
796.27 	section 245I.011, subdivision 4, paragraph (d), may be met by a children's therapeutic 
796.28 	services and supports services agency through the commissioner's NETStudy system as 
796.29 	provided under sections 245C.03, subdivision 7, and 245C.10, subdivision 8.

797.1 	Sec. 87. Minnesota Statutes 2020, section 256B.0943, subdivision 6, is amended to read:
797.2 		Subd. 6.Provider entity clinical infrastructure requirements. (a) To be an eligible 
797.3 	provider entity under this section, a provider entity must have a clinical infrastructure that 
797.4 	utilizes diagnostic assessment, individualized individual treatment plans, service delivery, 
797.5 	and individual treatment plan review that are culturally competent, child-centered, and 
797.6 	family-driven to achieve maximum benefit for the client. The provider entity must review, 
797.7 	and update as necessary, the clinical policies and procedures every three years, must distribute 
797.8 	the policies and procedures to staff initially and upon each subsequent update, and must 
797.9 	train staff accordingly.
797.10 	(b) The clinical infrastructure written policies and procedures must include policies and 
797.11 	procedures for meeting the requirements in this subdivision:
797.12 	(1) providing or obtaining a client's standard diagnostic assessment, including a standard 
797.13 	diagnostic assessment performed by an outside or independent clinician, that identifies acute 
797.14 	and chronic clinical disorders, co-occurring medical conditions, and sources of psychological 
797.15 	and environmental problems, including baselines, and a functional assessment. The functional 
797.16 	assessment component must clearly summarize the client's individual strengths and needs.
797.17 	When required components of the standard diagnostic assessment, such as baseline measures,
797.18 	are not provided in an outside or independent assessment or when baseline measures cannot 
797.19 	be attained in a one-session standard diagnostic assessment immediately, the provider entity 
797.20 	must determine the missing information within 30 days and amend the child's standard 
797.21 	diagnostic assessment or incorporate the baselines information into the child's individual 
797.22 	treatment plan;
797.23 	(2) developing an individual treatment plan that:;
797.24 	(i) is based on the information in the client's diagnostic assessment and baselines;
797.25 	(ii) identified goals and objectives of treatment, treatment strategy, schedule for 
797.26 	accomplishing treatment goals and objectives, and the individuals responsible for providing 
797.27 	treatment services and supports;
797.28 	(iii) is developed after completion of the client's diagnostic assessment by a mental health 
797.29 	professional or clinical trainee and before the provision of children's therapeutic services 
797.30 	and supports;
797.31 	(iv) is developed through a child-centered, family-driven, culturally appropriate planning 
797.32 	process, including allowing parents and guardians to observe or participate in individual 
797.33 	and family treatment services, assessment, and treatment planning;
798.1 	(v) is reviewed at least once every 90 days and revised to document treatment progress 
798.2 	on each treatment objective and next goals or, if progress is not documented, to document 
798.3 	changes in treatment; and
798.4 	(vi) is signed by the clinical supervisor and by the client or by the client's parent or other 
798.5 	person authorized by statute to consent to mental health services for the client. A client's 
798.6 	parent may approve the client's individual treatment plan by secure electronic signature or 
798.7 	by documented oral approval that is later verified by written signature;
798.8 	(3) developing an individual behavior plan that documents treatment strategies and 
798.9 	describes interventions to be provided by the mental health behavioral aide. The individual 
798.10 	behavior plan must include:
798.11 	(i) detailed instructions on the treatment strategies to be provided psychosocial skills to 
798.12 	be practiced;
798.13 	(ii) time allocated to each treatment strategy intervention;
798.14 	(iii) methods of documenting the child's behavior;
798.15 	(iv) methods of monitoring the child's progress in reaching objectives; and
798.16 	(v) goals to increase or decrease targeted behavior as identified in the individual treatment 
798.17 	plan;
798.18 	(4) providing clinical treatment supervision plans for mental health practitioners and 
798.19 	mental health behavioral aides. A mental health professional must document the clinical 
798.20 	supervision the professional provides by cosigning individual treatment plans and making 
798.21 	entries in the client's record on supervisory activities. The clinical supervisor also shall 
798.22 	document supervisee-specific supervision in the supervisee's personnel file. Clinical staff 
798.23 	according to section 245I.06. Treatment supervision does not include the authority to make 
798.24 	or terminate court-ordered placements of the child. A clinical treatment supervisor must be 
798.25 	available for urgent consultation as required by the individual client's needs or the situation. 
798.26 	Clinical supervision may occur individually or in a small group to discuss treatment and 
798.27 	review progress toward goals. The focus of clinical supervision must be the client's treatment 
798.28 	needs and progress and the mental health practitioner's or behavioral aide's ability to provide 
798.29 	services;
798.30 	(4a) meeting day treatment program conditions in items (i) to (iii) and (ii):
798.31 	(i) the clinical treatment supervisor must be present and available on the premises more 
798.32 	than 50 percent of the time in a provider's standard working week during which the supervisee 
798.33 	is providing a mental health service; and
799.1 	(ii) the diagnosis and the client's individual treatment plan or a change in the diagnosis 
799.2 	or individual treatment plan must be made by or reviewed, approved, and signed by the 
799.3 	clinical supervisor; and
799.4 	(iii) (ii) every 30 days, the clinical treatment supervisor must review and sign the record 
799.5 	indicating the supervisor has reviewed the client's care for all activities in the preceding 
799.6 	30-day period;
799.7 	(4b) meeting the clinical treatment supervision standards in items (i) to (iv) and (ii) for 
799.8 	all other services provided under CTSS:
799.9 	(i) medical assistance shall reimburse for services provided by a mental health practitioner 
799.10 	who is delivering services that fall within the scope of the practitioner's practice and who 
799.11 	is supervised by a mental health professional who accepts full professional responsibility;
799.12 	(ii) medical assistance shall reimburse for services provided by a mental health behavioral 
799.13 	aide who is delivering services that fall within the scope of the aide's practice and who is 
799.14 	supervised by a mental health professional who accepts full professional responsibility and 
799.15 	has an approved plan for clinical supervision of the behavioral aide. Plans must be developed 
799.16 	in accordance with supervision standards defined in Minnesota Rules, part 9505.0371, 
799.17 	subpart 4, items A to D;
799.18 	(iii) (i) the mental health professional is required to be present at the site of service 
799.19 	delivery for observation as clinically appropriate when the clinical trainee, mental health 
799.20 	practitioner, or mental health behavioral aide is providing CTSS services; and
799.21 	(iv) (ii) when conducted, the on-site presence of the mental health professional must be 
799.22 	documented in the child's record and signed by the mental health professional who accepts 
799.23 	full professional responsibility;
799.24 	(5) providing direction to a mental health behavioral aide. For entities that employ mental 
799.25 	health behavioral aides, the clinical treatment supervisor must be employed by the provider 
799.26 	entity or other provider certified to provide mental health behavioral aide services to ensure 
799.27 	necessary and appropriate oversight for the client's treatment and continuity of care. The 
799.28 	mental health professional or mental health practitioner staff giving direction must begin 
799.29 	with the goals on the individualized individual treatment plan, and instruct the mental health 
799.30 	behavioral aide on how to implement therapeutic activities and interventions that will lead 
799.31 	to goal attainment. The professional or practitioner staff giving direction must also instruct 
799.32 	the mental health behavioral aide about the client's diagnosis, functional status, and other 
799.33 	characteristics that are likely to affect service delivery. Direction must also include 
799.34 	determining that the mental health behavioral aide has the skills to interact with the client 
800.1 	and the client's family in ways that convey personal and cultural respect and that the aide 
800.2 	actively solicits information relevant to treatment from the family. The aide must be able 
800.3 	to clearly explain or demonstrate the activities the aide is doing with the client and the 
800.4 	activities' relationship to treatment goals. Direction is more didactic than is supervision and 
800.5 	requires the professional or practitioner staff providing it to continuously evaluate the mental 
800.6 	health behavioral aide's ability to carry out the activities of the individualized individual
800.7 	treatment plan and the individualized individual behavior plan. When providing direction, 
800.8 	the professional or practitioner staff must:
800.9 	(i) review progress notes prepared by the mental health behavioral aide for accuracy and 
800.10 	consistency with diagnostic assessment, treatment plan, and behavior goals and the 
800.11 	professional or practitioner staff must approve and sign the progress notes;
800.12 	(ii) identify changes in treatment strategies, revise the individual behavior plan, and 
800.13 	communicate treatment instructions and methodologies as appropriate to ensure that treatment 
800.14 	is implemented correctly;
800.15 	(iii) demonstrate family-friendly behaviors that support healthy collaboration among 
800.16 	the child, the child's family, and providers as treatment is planned and implemented;
800.17 	(iv) ensure that the mental health behavioral aide is able to effectively communicate 
800.18 	with the child, the child's family, and the provider; and
800.19 	(v) record the results of any evaluation and corrective actions taken to modify the work 
800.20 	of the mental health behavioral aide; and
800.21 	(vi) ensure the immediate accessibility of a mental health professional, clinical trainee, 
800.22 	or mental health practitioner to the behavioral aide during service delivery;
800.23 	(6) providing service delivery that implements the individual treatment plan and meets 
800.24 	the requirements under subdivision 9; and
800.25 	(7) individual treatment plan review. The review must determine the extent to which 
800.26 	the services have met each of the goals and objectives in the treatment plan. The review 
800.27 	must assess the client's progress and ensure that services and treatment goals continue to 
800.28 	be necessary and appropriate to the client and the client's family or foster family. Revision 
800.29 	of the individual treatment plan does not require a new diagnostic assessment unless the 
800.30 	client's mental health status has changed markedly. The updated treatment plan must be 
800.31 	signed by the clinical supervisor and by the client, if appropriate, and by the client's parent 
800.32 	or other person authorized by statute to give consent to the mental health services for the 
800.33 	child.

801.1 	Sec. 88. Minnesota Statutes 2020, section 256B.0943, subdivision 7, is amended to read:
801.2 		Subd. 7.Qualifications of individual and team providers. (a) An individual or team 
801.3 	provider working within the scope of the provider's practice or qualifications may provide 
801.4 	service components of children's therapeutic services and supports that are identified as 
801.5 	medically necessary in a client's individual treatment plan.
801.6 	(b) An individual provider must be qualified as a:
801.7 	(1) a mental health professional as defined in subdivision 1, paragraph (o); or
801.8 	(2) a clinical trainee;
801.9 	(3) mental health practitioner or clinical trainee. The mental health practitioner or clinical 
801.10 	trainee must work under the clinical supervision of a mental health professional; or
801.11 	(4) mental health certified family peer specialist; or
801.12 	(3) a (5) mental health behavioral aide working under the clinical supervision of a mental 
801.13 	health professional to implement the rehabilitative mental health services previously 
801.14 	introduced by a mental health professional or practitioner and identified in the client's 
801.15 	individual treatment plan and individual behavior plan.
801.16 	(A) A level I mental health behavioral aide must:
801.17 	(i) be at least 18 years old;
801.18 	(ii) have a high school diploma or commissioner of education-selected high school 
801.19 	equivalency certification or two years of experience as a primary caregiver to a child with 
801.20 	severe emotional disturbance within the previous ten years; and
801.21 	(iii) meet preservice and continuing education requirements under subdivision 8.
801.22 	(B) A level II mental health behavioral aide must:
801.23 	(i) be at least 18 years old;
801.24 	(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering 
801.25 	clinical services in the treatment of mental illness concerning children or adolescents or 
801.26 	complete a certificate program established under subdivision 8a; and
801.27 	(iii) meet preservice and continuing education requirements in subdivision 8.
801.28 	(c) A day treatment multidisciplinary team must include at least one mental health 
801.29 	professional or clinical trainee and one mental health practitioner.

802.1 	Sec. 89. Minnesota Statutes 2020, section 256B.0943, subdivision 9, is amended to read:
802.2 		Subd. 9.Service delivery criteria. (a) In delivering services under this section, a certified 
802.3 	provider entity must ensure that:
802.4 	(1) each individual provider's caseload size permits the provider to deliver services to 
802.5 	both clients with severe, complex needs and clients with less intensive needs. the provider's 
802.6 	caseload size should reasonably enable the provider to play an active role in service planning, 
802.7 	monitoring, and delivering services to meet the client's and client's family's needs, as specified 
802.8 	in each client's individual treatment plan;
802.9 	(2) site-based programs, including day treatment programs, provide staffing and facilities 
802.10 	to ensure the client's health, safety, and protection of rights, and that the programs are able 
802.11 	to implement each client's individual treatment plan; and
802.12 	(3) a day treatment program is provided to a group of clients by a multidisciplinary team 
802.13 	under the clinical treatment supervision of a mental health professional. The day treatment 
802.14 	program must be provided in and by: (i) an outpatient hospital accredited by the Joint 
802.15 	Commission on Accreditation of Health Organizations and licensed under sections 144.50 
802.16 	to 144.55; (ii) a community mental health center under section 245.62; or (iii) an entity that 
802.17 	is certified under subdivision 4 to operate a program that meets the requirements of section 
802.18 	245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day 
802.19 	treatment program must stabilize the client's mental health status while developing and 
802.20 	improving the client's independent living and socialization skills. The goal of the day 
802.21 	treatment program must be to reduce or relieve the effects of mental illness and provide 
802.22 	training to enable the client to live in the community. The program must be available 
802.23 	year-round at least three to five days per week, two or three hours per day, unless the normal 
802.24 	five-day school week is shortened by a holiday, weather-related cancellation, or other 
802.25 	districtwide reduction in a school week. A child transitioning into or out of day treatment 
802.26 	must receive a minimum treatment of one day a week for a two-hour time block. The 
802.27 	two-hour time block must include at least one hour of patient and/or family or group 
802.28 	psychotherapy. The remainder of the structured treatment program may include patient 
802.29 	and/or family or group psychotherapy, and individual or group skills training, if included 
802.30 	in the client's individual treatment plan. Day treatment programs are not part of inpatient 
802.31 	or residential treatment services. When a day treatment group that meets the minimum group 
802.32 	size requirement temporarily falls below the minimum group size because of a member's 
802.33 	temporary absence, medical assistance covers a group session conducted for the group 
802.34 	members in attendance. A day treatment program may provide fewer than the minimally 
803.1 	required hours for a particular child during a billing period in which the child is transitioning 
803.2 	into, or out of, the program.
803.3 	(b) To be eligible for medical assistance payment, a provider entity must deliver the 
803.4 	service components of children's therapeutic services and supports in compliance with the 
803.5 	following requirements:
803.6 	(1) patient and/or family, family, and group psychotherapy must be delivered as specified 
803.7 	in Minnesota Rules, part 9505.0372, subpart 6. psychotherapy to address the child's 
803.8 	underlying mental health disorder must be documented as part of the child's ongoing 
803.9 	treatment. A provider must deliver, or arrange for, medically necessary psychotherapy, 
803.10 	unless the child's parent or caregiver chooses not to receive it. When a provider delivering 
803.11 	other services to a child under this section deems it not medically necessary to provide 
803.12 	psychotherapy to the child for a period of 90 days or longer, the provider entity must 
803.13 	document the medical reasons why psychotherapy is not necessary. When a provider 
803.14 	determines that a child needs psychotherapy but psychotherapy cannot be delivered due to 
803.15 	a shortage of licensed mental health professionals in the child's community, the provider 
803.16 	must document the lack of access in the child's medical record;
803.17 	(2) individual, family, or group skills training must be provided by a mental health 
803.18 	professional or a mental health practitioner who is delivering services that fall within the 
803.19 	scope of the provider's practice and is supervised by a mental health professional who 
803.20 	accepts full professional responsibility for the training. Skills training is subject to the 
803.21 	following requirements:
803.22 	(i) a mental health professional, clinical trainee, or mental health practitioner shall provide 
803.23 	skills training;
803.24 	(ii) skills training delivered to a child or the child's family must be targeted to the specific 
803.25 	deficits or maladaptations of the child's mental health disorder and must be prescribed in 
803.26 	the child's individual treatment plan;
803.27 	(iii) the mental health professional delivering or supervising the delivery of skills training 
803.28 	must document any underlying psychiatric condition and must document how skills training 
803.29 	is being used in conjunction with psychotherapy to address the underlying condition;
803.30 	(iv) skills training delivered to the child's family must teach skills needed by parents to 
803.31 	enhance the child's skill development, to help the child utilize daily life skills taught by a 
803.32 	mental health professional, clinical trainee, or mental health practitioner, and to develop or 
803.33 	maintain a home environment that supports the child's progressive use of skills;
804.1 	(v) group skills training may be provided to multiple recipients who, because of the 
804.2 	nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from 
804.3 	interaction in a group setting, which must be staffed as follows:
804.4 	(A) one mental health professional or one, clinical trainee, or mental health practitioner 
804.5 	under supervision of a licensed mental health professional must work with a group of three 
804.6 	to eight clients; or
804.7 	(B) any combination of two mental health professionals, two clinical trainees, or mental 
804.8 	health practitioners under supervision of a licensed mental health professional, or one mental 
804.9 	health professional or clinical trainee and one mental health practitioner must work with a 
804.10 	group of nine to 12 clients;
804.11 	(vi) a mental health professional, clinical trainee, or mental health practitioner must have 
804.12 	taught the psychosocial skill before a mental health behavioral aide may practice that skill 
804.13 	with the client; and
804.14 	(vii) for group skills training, when a skills group that meets the minimum group size 
804.15 	requirement temporarily falls below the minimum group size because of a group member's 
804.16 	temporary absence, the provider may conduct the session for the group members in 
804.17 	attendance;
804.18 	(3) crisis assistance planning to a child and family must include development of a written 
804.19 	plan that anticipates the particular factors specific to the child that may precipitate a 
804.20 	psychiatric crisis for the child in the near future. The written plan must document actions 
804.21 	that the family should be prepared to take to resolve or stabilize a crisis, such as advance 
804.22 	arrangements for direct intervention and support services to the child and the child's family. 
804.23 	Crisis assistance planning must include preparing resources designed to address abrupt or 
804.24 	substantial changes in the functioning of the child or the child's family when sudden change 
804.25 	in behavior or a loss of usual coping mechanisms is observed, or the child begins to present 
804.26 	a danger to self or others;
804.27 	(4) mental health behavioral aide services must be medically necessary treatment services, 
804.28 	identified in the child's individual treatment plan and individual behavior plan, which are 
804.29 	performed minimally by a paraprofessional qualified according to subdivision 7, paragraph 
804.30 	(b), clause (3), and which are designed to improve the functioning of the child in the 
804.31 	progressive use of developmentally appropriate psychosocial skills. Activities involve 
804.32 	working directly with the child, child-peer groupings, or child-family groupings to practice, 
804.33 	repeat, reintroduce, and master the skills defined in subdivision 1, paragraph (t), as previously 
804.34 	taught by a mental health professional, clinical trainee, or mental health practitioner including:
805.1 	(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions 
805.2 	so that the child progressively recognizes and responds to the cues independently;
805.3 	(ii) performing as a practice partner or role-play partner;
805.4 	(iii) reinforcing the child's accomplishments;
805.5 	(iv) generalizing skill-building activities in the child's multiple natural settings;
805.6 	(v) assigning further practice activities; and
805.7 	(vi) intervening as necessary to redirect the child's target behavior and to de-escalate 
805.8 	behavior that puts the child or other person at risk of injury.
805.9 	To be eligible for medical assistance payment, mental health behavioral aide services must 
805.10 	be delivered to a child who has been diagnosed with an emotional disturbance or a mental 
805.11 	illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must 
805.12 	implement treatment strategies in the individual treatment plan and the individual behavior 
805.13 	plan as developed by the mental health professional, clinical trainee, or mental health 
805.14 	practitioner providing direction for the mental health behavioral aide. The mental health 
805.15 	behavioral aide must document the delivery of services in written progress notes. Progress 
805.16 	notes must reflect implementation of the treatment strategies, as performed by the mental 
805.17 	health behavioral aide and the child's responses to the treatment strategies; and
805.18 	(5) direction of a mental health behavioral aide must include the following:
805.19 	(i) ongoing face-to-face observation of the mental health behavioral aide delivering 
805.20 	services to a child by a mental health professional or mental health practitioner for at least 
805.21 	a total of one hour during every 40 hours of service provided to a child; and
805.22 	(ii) immediate accessibility of the mental health professional, clinical trainee, or mental 
805.23 	health practitioner to the mental health behavioral aide during service provision;
805.24 	(6) (5) mental health service plan development must be performed in consultation with 
805.25 	the child's family and, when appropriate, with other key participants in the child's life by 
805.26 	the child's treating mental health professional or clinical trainee or by a mental health 
805.27 	practitioner and approved by the treating mental health professional. Treatment plan drafting 
805.28 	consists of development, review, and revision by face-to-face or electronic communication. 
805.29 	The provider must document events, including the time spent with the family and other key 
805.30 	participants in the child's life to review, revise, and sign approve the individual treatment 
805.31 	plan. Notwithstanding Minnesota Rules, part 9505.0371, subpart 7, Medical assistance 
805.32 	covers service plan development before completion of the child's individual treatment plan. 
805.33 	Service plan development is covered only if a treatment plan is completed for the child. If 
806.1 	upon review it is determined that a treatment plan was not completed for the child, the 
806.2 	commissioner shall recover the payment for the service plan development; and.
806.3 	(7) to be eligible for payment, a diagnostic assessment must be complete with regard to 
806.4 	all required components, including multiple assessment appointments required for an 
806.5 	extended diagnostic assessment and the written report. Dates of the multiple assessment 
806.6 	appointments must be noted in the client's clinical record.

806.7 	Sec. 90. Minnesota Statutes 2020, section 256B.0943, subdivision 11, is amended to read:
806.8 		Subd. 11.Documentation and billing. (a) A provider entity must document the services 
806.9 	it provides under this section. The provider entity must ensure that documentation complies 
806.10 	with Minnesota Rules, parts 9505.2175 and 9505.2197. Services billed under this section 
806.11 	that are not documented according to this subdivision shall be subject to monetary recovery 
806.12 	by the commissioner. Billing for covered service components under subdivision 2, paragraph 
806.13 	(b), must not include anything other than direct service time.
806.14 	(b) An individual mental health provider must promptly document the following in a 
806.15 	client's record after providing services to the client:
806.16 	(1) each occurrence of the client's mental health service, including the date, type, start 
806.17 	and stop times, scope of the service as described in the child's individual treatment plan, 
806.18 	and outcome of the service compared to baselines and objectives;
806.19 	(2) the name, dated signature, and credentials of the person who delivered the service;
806.20 	(3) contact made with other persons interested in the client, including representatives 
806.21 	of the courts, corrections systems, or schools. The provider must document the name and 
806.22 	date of each contact;
806.23 	(4) any contact made with the client's other mental health providers, case manager, 
806.24 	family members, primary caregiver, legal representative, or the reason the provider did not 
806.25 	contact the client's family members, primary caregiver, or legal representative, if applicable;
806.26 	(5) required clinical supervision directly related to the identified client's services and 
806.27 	needs, as appropriate, with co-signatures of the supervisor and supervisee; and
806.28 	(6) the date when services are discontinued and reasons for discontinuation of services.

806.29 	Sec. 91. Minnesota Statutes 2020, section 256B.0946, subdivision 1, is amended to read:
806.30 		Subdivision 1.Required covered service components. (a) Effective May 23, 2013, 
806.31 	and Subject to federal approval, medical assistance covers medically necessary intensive 
807.1 	treatment services described under paragraph (b) that when the services are provided by a 
807.2 	provider entity eligible under subdivision 3 to a client eligible under subdivision 2 who is 
807.3 	placed in a foster home licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or 
807.4 	placed in a foster home licensed under the regulations established by a federally recognized 
807.5 	Minnesota tribe certified under and meeting the standards in this section. The provider entity 
807.6 	must make reasonable and good faith efforts to report individual client outcomes to the 
807.7 	commissioner, using instruments and protocols approved by the commissioner.
807.8 	(b) Intensive treatment services to children with mental illness residing in foster family 
807.9 	settings that comprise specific required service components provided in clauses (1) to (5) 
807.10 	are reimbursed by medical assistance when they meet the following standards:
807.11 	(1) psychotherapy provided by a mental health professional as defined in Minnesota 
807.12 	Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota 
807.13 	Rules, part 9505.0371, subpart 5, item C;
807.14 	(2) crisis assistance provided according to standards for children's therapeutic services 
807.15 	and supports in section 256B.0943 planning;
807.16 	(3) individual, family, and group psychoeducation services, defined in subdivision 1a, 
807.17 	paragraph (q), provided by a mental health professional or a clinical trainee;
807.18 	(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental 
807.19 	health professional or a clinical trainee; and
807.20 	(5) service delivery payment requirements as provided under subdivision 4.

807.21 	Sec. 92. Minnesota Statutes 2020, section 256B.0946, subdivision 1a, is amended to read:
807.22 		Subd. 1a.Definitions. For the purposes of this section, the following terms have the 
807.23 	meanings given them.
807.24 	(a) "Clinical care consultation" means communication from a treating clinician to other 
807.25 	providers working with the same client to inform, inquire, and instruct regarding the client's 
807.26 	symptoms, strategies for effective engagement, care and intervention needs, and treatment 
807.27 	expectations across service settings, including but not limited to the client's school, social 
807.28 	services, day care, probation, home, primary care, medication prescribers, disabilities 
807.29 	services, and other mental health providers and to direct and coordinate clinical service 
807.30 	components provided to the client and family.
807.31 	(b) "Clinical supervision" means the documented time a clinical supervisor and supervisee 
807.32 	spend together to discuss the supervisee's work, to review individual client cases, and for 
808.1 	the supervisee's professional development. It includes the documented oversight and 
808.2 	supervision responsibility for planning, implementation, and evaluation of services for a 
808.3 	client's mental health treatment.
808.4 	(c) "Clinical supervisor" means the mental health professional who is responsible for 
808.5 	clinical supervision.
808.6 	(d) (b) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371, 
808.7 	subpart 5, item C; means a staff person who is qualified according to section 245I.04, 
808.8 	subdivision 6.
808.9 	(e) (c) "Crisis assistance planning" has the meaning given in section 245.4871, subdivision 
808.10 	9a, including the development of a plan that addresses prevention and intervention strategies 
808.11 	to be used in a potential crisis, but does not include actual crisis intervention.
808.12 	(f) (d) "Culturally appropriate" means providing mental health services in a manner that 
808.13 	incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370, 
808.14 	subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural 
808.15 	strengths and resources to promote overall wellness.
808.16 	(g) (e) "Culture" means the distinct ways of living and understanding the world that are 
808.17 	used by a group of people and are transmitted from one generation to another or adopted 
808.18 	by an individual.
808.19 	(h) (f) "Standard diagnostic assessment" has the meaning given in Minnesota Rules, part 
808.20 	9505.0370, subpart 11 means the assessment described in section 245I.10, subdivision 6.
808.21 	(i) (g) "Family" means a person who is identified by the client or the client's parent or 
808.22 	guardian as being important to the client's mental health treatment. Family may include, 
808.23 	but is not limited to, parents, foster parents, children, spouse, committed partners, former 
808.24 	spouses, persons related by blood or adoption, persons who are a part of the client's 
808.25 	permanency plan, or persons who are presently residing together as a family unit.
808.26 	(j) (h) "Foster care" has the meaning given in section 260C.007, subdivision 18.
808.27 	(k) (i) "Foster family setting" means the foster home in which the license holder resides.
808.28 	(l) (j) "Individual treatment plan" has the meaning given in Minnesota Rules, part 
808.29 	9505.0370, subpart 15 means the plan described in section 245I.10, subdivisions 7 and 8.
808.30 	(m) "Mental health practitioner" has the meaning given in section 245.462, subdivision 
808.31 	17, and a mental health practitioner working as a clinical trainee according to Minnesota 
808.32 	Rules, part 9505.0371, subpart 5, item C.
809.1 	(k) "Mental health certified family peer specialist" means a staff person who is qualified 
809.2 	according to section 245I.04, subdivision 12.
809.3 	(n) (l) "Mental health professional" has the meaning given in Minnesota Rules, part 
809.4 	9505.0370, subpart 18 means a staff person who is qualified according to section 245I.04, 
809.5 	subdivision 2.
809.6 	(o) (m) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370, 
809.7 	subpart 20 section 245I.02, subdivision 29.
809.8 	(p) (n) "Parent" has the meaning given in section 260C.007, subdivision 25.
809.9 	(q) (o) "Psychoeducation services" means information or demonstration provided to an 
809.10 	individual, family, or group to explain, educate, and support the individual, family, or group 
809.11 	in understanding a child's symptoms of mental illness, the impact on the child's development, 
809.12 	and needed components of treatment and skill development so that the individual, family, 
809.13 	or group can help the child to prevent relapse, prevent the acquisition of comorbid disorders, 
809.14 	and achieve optimal mental health and long-term resilience.
809.15 	(r) (p) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370, 
809.16 	subpart 27 means the treatment described in section 256B.0671, subdivision 11.
809.17 	(s) (q) "Team consultation and treatment planning" means the coordination of treatment 
809.18 	plans and consultation among providers in a group concerning the treatment needs of the 
809.19 	child, including disseminating the child's treatment service schedule to all members of the 
809.20 	service team. Team members must include all mental health professionals working with the 
809.21 	child, a parent, the child unless the team lead or parent deem it clinically inappropriate, and 
809.22 	at least two of the following: an individualized education program case manager; probation 
809.23 	agent; children's mental health case manager; child welfare worker, including adoption or 
809.24 	guardianship worker; primary care provider; foster parent; and any other member of the 
809.25 	child's service team.
809.26 	(r) "Trauma" has the meaning given in section 245I.02, subdivision 38.
809.27 	(s) "Treatment supervision" means the supervision described under section 245I.06.

809.28 	Sec. 93. Minnesota Statutes 2020, section 256B.0946, subdivision 2, is amended to read:
809.29 		Subd. 2.Determination of client eligibility. An eligible recipient is an individual, from 
809.30 	birth through age 20, who is currently placed in a foster home licensed under Minnesota 
809.31 	Rules, parts 2960.3000 to 2960.3340, or placed in a foster home licensed under the 
809.32 	regulations established by a federally recognized Minnesota tribe, and has received: (1) a 
810.1 	standard diagnostic assessment and an evaluation of level of care needed, as defined in 
810.2 	paragraphs (a) and (b). within 180 days before the start of service that documents that 
810.3 	intensive treatment services are medically necessary within a foster family setting to 
810.4 	ameliorate identified symptoms and functional impairments; and (2) a level of care 
810.5 	assessment as defined in section 245I.02, subdivision 19, that demonstrates that the individual 
810.6 	requires intensive intervention without 24-hour medical monitoring, and a functional 
810.7 	assessment as defined in section 245I.02, subdivision 17. The level of care assessment and 
810.8 	the functional assessment must include information gathered from the placing county, tribe, 
810.9 	or case manager.
810.10 	(a) The diagnostic assessment must:
810.11 	(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be 
810.12 	conducted by a mental health professional or a clinical trainee;
810.13 	(2) determine whether or not a child meets the criteria for mental illness, as defined in 
810.14 	Minnesota Rules, part 9505.0370, subpart 20;
810.15 	(3) document that intensive treatment services are medically necessary within a foster 
810.16 	family setting to ameliorate identified symptoms and functional impairments;
810.17 	(4) be performed within 180 days before the start of service; and
810.18 	(5) be completed as either a standard or extended diagnostic assessment annually to 
810.19 	determine continued eligibility for the service.
810.20 	(b) The evaluation of level of care must be conducted by the placing county, tribe, or 
810.21 	case manager in conjunction with the diagnostic assessment as described by Minnesota 
810.22 	Rules, part 9505.0372, subpart 1, item B, using a validated tool approved by the 
810.23 	commissioner of human services and not subject to the rulemaking process, consistent with 
810.24 	section 245.4885, subdivision 1, paragraph (d), the result of which evaluation demonstrates 
810.25 	that the child requires intensive intervention without 24-hour medical monitoring. The 
810.26 	commissioner shall update the list of approved level of care tools annually and publish on 
810.27 	the department's website.

810.28 	Sec. 94. Minnesota Statutes 2020, section 256B.0946, subdivision 3, is amended to read:
810.29 		Subd. 3.Eligible mental health services providers. (a) Eligible providers for intensive 
810.30 	children's mental health services in a foster family setting must be certified by the state and 
810.31 	have a service provision contract with a county board or a reservation tribal council and 
810.32 	must be able to demonstrate the ability to provide all of the services required in this section
810.33 	and meet the standards in chapter 245I, as required in section 245I.011, subdivision 5.
811.1 	(b) For purposes of this section, a provider agency must be:
811.2 	(1) a county-operated entity certified by the state;
811.3 	(2) an Indian Health Services facility operated by a tribe or tribal organization under 
811.4 	funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the 
811.5 	Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
811.6 	(3) a noncounty entity.
811.7 	(c) Certified providers that do not meet the service delivery standards required in this 
811.8 	section shall be subject to a decertification process.
811.9 	(d) For the purposes of this section, all services delivered to a client must be provided 
811.10 	by a mental health professional or a clinical trainee.

811.11 	Sec. 95. Minnesota Statutes 2020, section 256B.0946, subdivision 4, is amended to read:
811.12 		Subd. 4.Service delivery payment requirements. (a) To be eligible for payment under 
811.13 	this section, a provider must develop and practice written policies and procedures for 
811.14 	intensive treatment in foster care, consistent with subdivision 1, paragraph (b), and comply 
811.15 	with the following requirements in paragraphs (b) to (n) (l).
811.16 	(b) A qualified clinical supervisor, as defined in and performing in compliance with 
811.17 	Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and 
811.18 	provision of services described in this section.
811.19 	(c) Each client receiving treatment services must receive an extended diagnostic 
811.20 	assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within 30 
811.21 	days of enrollment in this service unless the client has a previous extended diagnostic 
811.22 	assessment that the client, parent, and mental health professional agree still accurately 
811.23 	describes the client's current mental health functioning.
811.24 	(d) (b) Each previous and current mental health, school, and physical health treatment 
811.25 	provider must be contacted to request documentation of treatment and assessments that the 
811.26 	eligible client has received. This information must be reviewed and incorporated into the 
811.27 	standard diagnostic assessment and team consultation and treatment planning review process.
811.28 	(e) (c) Each client receiving treatment must be assessed for a trauma history, and the 
811.29 	client's treatment plan must document how the results of the assessment will be incorporated 
811.30 	into treatment.
812.1 	(d) The level of care assessment as defined in section 245I.02, subdivision 19, and 
812.2 	functional assessment as defined in section 245I.02, subdivision 17, must be updated at 
812.3 	least every 90 days or prior to discharge from the service, whichever comes first.
812.4 	(f) (e) Each client receiving treatment services must have an individual treatment plan 
812.5 	that is reviewed, evaluated, and signed approved every 90 days using the team consultation 
812.6 	and treatment planning process, as defined in subdivision 1a, paragraph (s).
812.7 	(g) (f) Clinical care consultation, as defined in subdivision 1a, paragraph (a), must be 
812.8 	provided in accordance with the client's individual treatment plan.
812.9 	(h) (g) Each client must have a crisis assistance plan within ten days of initiating services 
812.10 	and must have access to clinical phone support 24 hours per day, seven days per week, 
812.11 	during the course of treatment. The crisis plan must demonstrate coordination with the local 
812.12 	or regional mobile crisis intervention team.
812.13 	(i) (h) Services must be delivered and documented at least three days per week, equaling 
812.14 	at least six hours of treatment per week, unless reduced units of service are specified on the 
812.15 	treatment plan as part of transition or on a discharge plan to another service or level of care. 
812.16 	Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
812.17 	(j) (i) Location of service delivery must be in the client's home, day care setting, school, 
812.18 	or other community-based setting that is specified on the client's individualized treatment 
812.19 	plan.
812.20 	(k) (j) Treatment must be developmentally and culturally appropriate for the client.
812.21 	(l) (k) Services must be delivered in continual collaboration and consultation with the 
812.22 	client's medical providers and, in particular, with prescribers of psychotropic medications, 
812.23 	including those prescribed on an off-label basis. Members of the service team must be aware 
812.24 	of the medication regimen and potential side effects.
812.25 	(m) (l) Parents, siblings, foster parents, and members of the child's permanency plan 
812.26 	must be involved in treatment and service delivery unless otherwise noted in the treatment 
812.27 	plan.
812.28 	(n) (m) Transition planning for the child must be conducted starting with the first 
812.29 	treatment plan and must be addressed throughout treatment to support the child's permanency 
812.30 	plan and postdischarge mental health service needs.

813.1 	Sec. 96. Minnesota Statutes 2020, section 256B.0946, subdivision 6, is amended to read:
813.2 		Subd. 6.Excluded services. (a) Services in clauses (1) to (7) are not covered under this 
813.3 	section and are not eligible for medical assistance payment as components of intensive 
813.4 	treatment in foster care services, but may be billed separately:
813.5 	(1) inpatient psychiatric hospital treatment;
813.6 	(2) mental health targeted case management;
813.7 	(3) partial hospitalization;
813.8 	(4) medication management;
813.9 	(5) children's mental health day treatment services;
813.10 	(6) crisis response services under section 256B.0944 256B.0624; and
813.11 	(7) transportation.; and
813.12 	(8) mental health certified family peer specialist services under section 256B.0616.
813.13 	(b) Children receiving intensive treatment in foster care services are not eligible for 
813.14 	medical assistance reimbursement for the following services while receiving intensive 
813.15 	treatment in foster care:
813.16 	(1) psychotherapy and skills training components of children's therapeutic services and 
813.17 	supports under section 256B.0625, subdivision 35b 256B.0943;
813.18 	(2) mental health behavioral aide services as defined in section 256B.0943, subdivision 
813.19 	1, paragraph (m) (l);
813.20 	(3) home and community-based waiver services;
813.21 	(4) mental health residential treatment; and
813.22 	(5) room and board costs as defined in section 256I.03, subdivision 6.

813.23 	Sec. 97. Minnesota Statutes 2020, section 256B.0947, subdivision 1, is amended to read:
813.24 		Subdivision 1.Scope. Effective November 1, 2011, and Subject to federal approval, 
813.25 	medical assistance covers medically necessary, intensive nonresidential rehabilitative mental 
813.26 	health services as defined in subdivision 2, for recipients as defined in subdivision 3, when 
813.27 	the services are provided by an entity meeting the standards in this section. The provider 
813.28 	entity must make reasonable and good faith efforts to report individual client outcomes to 
813.29 	the commissioner, using instruments and protocols approved by the commissioner.

814.1 	Sec. 98. Minnesota Statutes 2020, section 256B.0947, subdivision 2, is amended to read:
814.2 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
814.3 	given them.
814.4 	(a) "Intensive nonresidential rehabilitative mental health services" means child 
814.5 	rehabilitative mental health services as defined in section 256B.0943, except that these 
814.6 	services are provided by a multidisciplinary staff using a total team approach consistent 
814.7 	with assertive community treatment, as adapted for youth, and are directed to recipients 
814.8 	ages 16, 17, 18, 19, or 20 with a serious mental illness or co-occurring mental illness and 
814.9 	substance abuse addiction who require intensive services to prevent admission to an inpatient 
814.10 	psychiatric hospital or placement in a residential treatment facility or who require intensive 
814.11 	services to step down from inpatient or residential care to community-based care.
814.12 	(b) "Co-occurring mental illness and substance abuse addiction use disorder" means a 
814.13 	dual diagnosis of at least one form of mental illness and at least one substance use disorder. 
814.14 	Substance use disorders include alcohol or drug abuse or dependence, excluding nicotine 
814.15 	use.
814.16 	(c) "Standard diagnostic assessment" has the meaning given to it in Minnesota Rules, 
814.17 	part 9505.0370, subpart 11. A diagnostic assessment must be provided according to 
814.18 	Minnesota Rules, part 9505.0372, subpart 1, and for this section must incorporate a 
814.19 	determination of the youth's necessary level of care using a standardized functional 
814.20 	assessment instrument approved and periodically updated by the commissioner means the 
814.21 	assessment described in section 245I.10, subdivision 6.
814.22 	(d) "Education specialist" means an individual with knowledge and experience working 
814.23 	with youth regarding special education requirements and goals, special education plans, 
814.24 	and coordination of educational activities with health care activities.
814.25 	(e) "Housing access support" means an ancillary activity to help an individual find, 
814.26 	obtain, retain, and move to safe and adequate housing. Housing access support does not 
814.27 	provide monetary assistance for rent, damage deposits, or application fees.
814.28 	(f) "Integrated dual disorders treatment" means the integrated treatment of co-occurring 
814.29 	mental illness and substance use disorders by a team of cross-trained clinicians within the 
814.30 	same program, and is characterized by assertive outreach, stage-wise comprehensive 
814.31 	treatment, treatment goal setting, and flexibility to work within each stage of treatment.
814.32 	(g) (d) "Medication education services" means services provided individually or in 
814.33 	groups, which focus on:
815.1 	(1) educating the client and client's family or significant nonfamilial supporters about 
815.2 	mental illness and symptoms;
815.3 	(2) the role and effects of medications in treating symptoms of mental illness; and
815.4 	(3) the side effects of medications.
815.5 	Medication education is coordinated with medication management services and does not 
815.6 	duplicate it. Medication education services are provided by physicians, pharmacists, or 
815.7 	registered nurses with certification in psychiatric and mental health care.
815.8 	(h) "Peer specialist" means an employed team member who is a mental health certified 
815.9 	peer specialist according to section 256B.0615 and also a former children's mental health 
815.10 	consumer who:
815.11 	(1) provides direct services to clients including social, emotional, and instrumental 
815.12 	support and outreach;
815.13 	(2) assists younger peers to identify and achieve specific life goals;
815.14 	(3) works directly with clients to promote the client's self-determination, personal 
815.15 	responsibility, and empowerment;
815.16 	(4) assists youth with mental illness to regain control over their lives and their 
815.17 	developmental process in order to move effectively into adulthood;
815.18 	(5) provides training and education to other team members, consumer advocacy 
815.19 	organizations, and clients on resiliency and peer support; and
815.20 	(6) meets the following criteria:
815.21 	(i) is at least 22 years of age;
815.22 	(ii) has had a diagnosis of mental illness, as defined in Minnesota Rules, part 9505.0370, 
815.23 	subpart 20, or co-occurring mental illness and substance abuse addiction;
815.24 	(iii) is a former consumer of child and adolescent mental health services, or a former or 
815.25 	current consumer of adult mental health services for a period of at least two years;
815.26 	(iv) has at least a high school diploma or equivalent;
815.27 	(v) has successfully completed training requirements determined and periodically updated 
815.28 	by the commissioner;
815.29 	(vi) is willing to disclose the individual's own mental health history to team members 
815.30 	and clients; and
816.1 	(vii) must be free of substance use problems for at least one year.
816.2 	(e) "Mental health professional" means a staff person who is qualified according to 
816.3 	section 245I.04, subdivision 2.
816.4 	(i) (f) "Provider agency" means a for-profit or nonprofit organization established to 
816.5 	administer an assertive community treatment for youth team.
816.6 	(j) (g) "Substance use disorders" means one or more of the disorders defined in the 
816.7 	diagnostic and statistical manual of mental disorders, current edition.
816.8 	(k) (h) "Transition services" means:
816.9 	(1) activities, materials, consultation, and coordination that ensures continuity of the 
816.10 	client's care in advance of and in preparation for the client's move from one stage of care 
816.11 	or life to another by maintaining contact with the client and assisting the client to establish 
816.12 	provider relationships;
816.13 	(2) providing the client with knowledge and skills needed posttransition;
816.14 	(3) establishing communication between sending and receiving entities;
816.15 	(4) supporting a client's request for service authorization and enrollment; and
816.16 	(5) establishing and enforcing procedures and schedules.
816.17 	A youth's transition from the children's mental health system and services to the adult 
816.18 	mental health system and services and return to the client's home and entry or re-entry into 
816.19 	community-based mental health services following discharge from an out-of-home placement 
816.20 	or inpatient hospital stay.
816.21 	(l) (i) "Treatment team" means all staff who provide services to recipients under this 
816.22 	section.
816.23 	(m) (j) "Family peer specialist" means a staff person who is qualified under section 
816.24 	256B.0616.

816.25 	Sec. 99. Minnesota Statutes 2020, section 256B.0947, subdivision 3, is amended to read:
816.26 		Subd. 3.Client eligibility. An eligible recipient is an individual who:
816.27 	(1) is age 16, 17, 18, 19, or 20; and
816.28 	(2) is diagnosed with a serious mental illness or co-occurring mental illness and substance 
816.29 	abuse addiction use disorder, for which intensive nonresidential rehabilitative mental health 
816.30 	services are needed;
817.1 	(3) has received a level-of-care determination, using an instrument approved by the 
817.2 	commissioner level of care assessment as defined in section 245I.02, subdivision 19, that 
817.3 	indicates a need for intensive integrated intervention without 24-hour medical monitoring 
817.4 	and a need for extensive collaboration among multiple providers;
817.5 	(4) has received a functional assessment as defined in section 245I.02, subdivision 17, 
817.6 	that indicates functional impairment and a history of difficulty in functioning safely and 
817.7 	successfully in the community, school, home, or job; or who is likely to need services from 
817.8 	the adult mental health system within the next two years; and
817.9 	(5) has had a recent standard diagnostic assessment, as provided in Minnesota Rules, 
817.10 	part 9505.0372, subpart 1, by a mental health professional who is qualified under Minnesota 
817.11 	Rules, part 9505.0371, subpart 5, item A, that documents that intensive nonresidential 
817.12 	rehabilitative mental health services are medically necessary to ameliorate identified 
817.13 	symptoms and functional impairments and to achieve individual transition goals.

817.14 	Sec. 100. Minnesota Statutes 2020, section 256B.0947, subdivision 3a, is amended to 
817.15 	read:
817.16 		Subd. 3a.Required service components. (a) Subject to federal approval, medical 
817.17 	assistance covers all medically necessary intensive nonresidential rehabilitative mental 
817.18 	health services and supports, as defined in this section, under a single daily rate per client. 
817.19 	Services and supports must be delivered by an eligible provider under subdivision 5 to an 
817.20 	eligible client under subdivision 3.
817.21 	(b) (a) Intensive nonresidential rehabilitative mental health services, supports, and 
817.22 	ancillary activities are covered by the a single daily rate per client must include the following, 
817.23 	as needed by the individual client:
817.24 	(1) individual, family, and group psychotherapy;
817.25 	(2) individual, family, and group skills training, as defined in section 256B.0943, 
817.26 	subdivision 1, paragraph (t);
817.27 	(3) crisis assistance planning as defined in section 245.4871, subdivision 9a, which 
817.28 	includes recognition of factors precipitating a mental health crisis, identification of behaviors 
817.29 	related to the crisis, and the development of a plan to address prevention, intervention, and 
817.30 	follow-up strategies to be used in the lead-up to or onset of, and conclusion of, a mental 
817.31 	health crisis; crisis assistance does not mean crisis response services or crisis intervention 
817.32 	services provided in section 256B.0944;
818.1 	(4) medication management provided by a physician or an advanced practice registered 
818.2 	nurse with certification in psychiatric and mental health care;
818.3 	(5) mental health case management as provided in section 256B.0625, subdivision 20;
818.4 	(6) medication education services as defined in this section;
818.5 	(7) care coordination by a client-specific lead worker assigned by and responsible to the 
818.6 	treatment team;
818.7 	(8) psychoeducation of and consultation and coordination with the client's biological, 
818.8 	adoptive, or foster family and, in the case of a youth living independently, the client's 
818.9 	immediate nonfamilial support network;
818.10 	(9) clinical consultation to a client's employer or school or to other service agencies or 
818.11 	to the courts to assist in managing the mental illness or co-occurring disorder and to develop 
818.12 	client support systems;
818.13 	(10) coordination with, or performance of, crisis intervention and stabilization services 
818.14 	as defined in section 256B.0944 256B.0624;
818.15 	(11) assessment of a client's treatment progress and effectiveness of services using 
818.16 	standardized outcome measures published by the commissioner;
818.17 	(12) (11) transition services as defined in this section;
818.18 	(13) integrated dual disorders treatment as defined in this section (12) co-occurring 
818.19 	substance use disorder treatment as defined in section 245I.02, subdivision 11; and
818.20 	(14) (13) housing access support that assists clients to find, obtain, retain, and move to 
818.21 	safe and adequate housing. Housing access support does not provide monetary assistance 
818.22 	for rent, damage deposits, or application fees.
818.23 	(c) (b) The provider shall ensure and document the following by means of performing 
818.24 	the required function or by contracting with a qualified person or entity:
818.25 	(1) client access to crisis intervention services, as defined in section 256B.0944
818.26 	256B.0624, and available 24 hours per day and seven days per week;.
818.27 	(2) completion of an extended diagnostic assessment, as defined in Minnesota Rules, 
818.28 	part 9505.0372, subpart 1, item C; and
818.29 	(3) determination of the client's needed level of care using an instrument approved and 
818.30 	periodically updated by the commissioner.

819.1 	Sec. 101. Minnesota Statutes 2020, section 256B.0947, subdivision 5, is amended to read:
819.2 		Subd. 5.Standards for intensive nonresidential rehabilitative providers. (a) Services 
819.3 	must be provided by a provider entity as provided in subdivision 4 meet the standards in 
819.4 	this section and chapter 245I as required in section 245I.011, subdivision 5.
819.5 	(b) The treatment team for intensive nonresidential rehabilitative mental health services 
819.6 	comprises both permanently employed core team members and client-specific team members 
819.7 	as follows:
819.8 	(1) The core treatment team is an entity that operates under the direction of an 
819.9 	independently licensed mental health professional, who is qualified under Minnesota Rules, 
819.10 	part 9505.0371, subpart 5, item A, and that assumes comprehensive clinical responsibility 
819.11 	for clients. Based on professional qualifications and client needs, clinically qualified core 
819.12 	team members are assigned on a rotating basis as the client's lead worker to coordinate a 
819.13 	client's care. The core team must comprise at least four full-time equivalent direct care staff 
819.14 	and must minimally include, but is not limited to:
819.15 	(i) an independently licensed a mental health professional, qualified under Minnesota 
819.16 	Rules, part 9505.0371, subpart 5, item A, who serves as team leader to provide administrative 
819.17 	direction and clinical treatment supervision to the team;
819.18 	(ii) an advanced-practice registered nurse with certification in psychiatric or mental 
819.19 	health care or a board-certified child and adolescent psychiatrist, either of which must be 
819.20 	credentialed to prescribe medications;
819.21 	(iii) a licensed alcohol and drug counselor who is also trained in mental health 
819.22 	interventions; and
819.23 	(iv) a mental health certified peer specialist as defined in subdivision 2, paragraph (h)
819.24 	who is qualified according to section 245I.04, subdivision 10, and is also a former children's 
819.25 	mental health consumer.
819.26 	(2) The core team may also include any of the following:
819.27 	(i) additional mental health professionals;
819.28 	(ii) a vocational specialist;
819.29 	(iii) an educational specialist with knowledge and experience working with youth on 
819.30 	special education requirements and goals, special education plans, and coordination of 
819.31 	educational activities with health care activities;
819.32 	(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
820.1 	(v) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
820.2 	(vi) a mental health practitioner, as defined in section 245.4871, subdivision 26 qualified 
820.3 	according to section 245I.04, subdivision 4;
820.4 	(vi) (vii) a case management service provider, as defined in section 245.4871, subdivision 
820.5 	4;
820.6 	(vii) (viii) a housing access specialist; and
820.7 	(viii) (ix) a family peer specialist as defined in subdivision 2, paragraph (m).
820.8 	(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc 
820.9 	members not employed by the team who consult on a specific client and who must accept 
820.10 	overall clinical direction from the treatment team for the duration of the client's placement 
820.11 	with the treatment team and must be paid by the provider agency at the rate for a typical 
820.12 	session by that provider with that client or at a rate negotiated with the client-specific 
820.13 	member. Client-specific treatment team members may include:
820.14 	(i) the mental health professional treating the client prior to placement with the treatment 
820.15 	team;
820.16 	(ii) the client's current substance abuse use counselor, if applicable;
820.17 	(iii) a lead member of the client's individualized education program team or school-based 
820.18 	mental health provider, if applicable;
820.19 	(iv) a representative from the client's health care home or primary care clinic, as needed 
820.20 	to ensure integration of medical and behavioral health care;
820.21 	(v) the client's probation officer or other juvenile justice representative, if applicable; 
820.22 	and
820.23 	(vi) the client's current vocational or employment counselor, if applicable.
820.24 	(c) The clinical treatment supervisor shall be an active member of the treatment team 
820.25 	and shall function as a practicing clinician at least on a part-time basis. The treatment team 
820.26 	shall meet with the clinical treatment supervisor at least weekly to discuss recipients' progress 
820.27 	and make rapid adjustments to meet recipients' needs. The team meeting must include 
820.28 	client-specific case reviews and general treatment discussions among team members. 
820.29 	Client-specific case reviews and planning must be documented in the individual client's 
820.30 	treatment record.
820.31 	(d) The staffing ratio must not exceed ten clients to one full-time equivalent treatment 
820.32 	team position.
821.1 	(e) The treatment team shall serve no more than 80 clients at any one time. Should local 
821.2 	demand exceed the team's capacity, an additional team must be established rather than 
821.3 	exceed this limit.
821.4 	(f) Nonclinical staff shall have prompt access in person or by telephone to a mental 
821.5 	health practitioner, clinical trainee, or mental health professional. The provider shall have 
821.6 	the capacity to promptly and appropriately respond to emergent needs and make any 
821.7 	necessary staffing adjustments to ensure the health and safety of clients.
821.8 	(g) The intensive nonresidential rehabilitative mental health services provider shall 
821.9 	participate in evaluation of the assertive community treatment for youth (Youth ACT) model 
821.10 	as conducted by the commissioner, including the collection and reporting of data and the 
821.11 	reporting of performance measures as specified by contract with the commissioner.
821.12 	(h) A regional treatment team may serve multiple counties.

821.13 	Sec. 102. Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:
821.14 		Subd. 6.Service standards. The standards in this subdivision apply to intensive 
821.15 	nonresidential rehabilitative mental health services.
821.16 	(a) The treatment team must use team treatment, not an individual treatment model.
821.17 	(b) Services must be available at times that meet client needs.
821.18 	(c) Services must be age-appropriate and meet the specific needs of the client.
821.19 	(d) The initial functional assessment must be completed within ten days of intake and
821.20 	level of care assessment as defined in section 245I.02, subdivision 19, and functional 
821.21 	assessment as defined in section 245I.02, subdivision 17, must be updated at least every six 
821.22 	months90 days or prior to discharge from the service, whichever comes first.
821.23 	(e) The treatment team must complete an individual treatment plan must for each client, 
821.24 	according to section 245I.10, subdivisions 7 and 8, and the individual treatment plan must:
821.25 	(1) be based on the information in the client's diagnostic assessment and baselines;
821.26 	(2) identify goals and objectives of treatment, a treatment strategy, a schedule for 
821.27 	accomplishing treatment goals and objectives, and the individuals responsible for providing 
821.28 	treatment services and supports;
821.29 	(3) be developed after completion of the client's diagnostic assessment by a mental health 
821.30 	professional or clinical trainee and before the provision of children's therapeutic services 
821.31 	and supports;
822.1 	(4) be developed through a child-centered, family-driven, culturally appropriate planning 
822.2 	process, including allowing parents and guardians to observe or participate in individual 
822.3 	and family treatment services, assessments, and treatment planning;
822.4 	(5) be reviewed at least once every six months and revised to document treatment progress 
822.5 	on each treatment objective and next goals or, if progress is not documented, to document 
822.6 	changes in treatment;
822.7 	(6) be signed by the clinical supervisor and by the client or by the client's parent or other 
822.8 	person authorized by statute to consent to mental health services for the client. A client's 
822.9 	parent may approve the client's individual treatment plan by secure electronic signature or 
822.10 	by documented oral approval that is later verified by written signature;
822.11 	(7) (1) be completed in consultation with the client's current therapist and key providers 
822.12 	and provide for ongoing consultation with the client's current therapist to ensure therapeutic 
822.13 	continuity and to facilitate the client's return to the community. For clients under the age of 
822.14 	18, the treatment team must consult with parents and guardians in developing the treatment 
822.15 	plan;
822.16 	(8) (2) if a need for substance use disorder treatment is indicated by validated assessment:
822.17 	(i) identify goals, objectives, and strategies of substance use disorder treatment;
822.18 	(ii) develop a schedule for accomplishing substance use disorder treatment goals and 
822.19 	objectives; and
822.20 	(iii) identify the individuals responsible for providing substance use disorder treatment 
822.21 	services and supports;
822.22 	(ii) be reviewed at least once every 90 days and revised, if necessary;
822.23 	(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by 
822.24 	the client's parent or other person authorized by statute to consent to mental health treatment 
822.25 	and substance use disorder treatment for the client; and
822.26 	(10) (3) provide for the client's transition out of intensive nonresidential rehabilitative 
822.27 	mental health services by defining the team's actions to assist the client and subsequent 
822.28 	providers in the transition to less intensive or "stepped down" services.; and
822.29 	(4) notwithstanding section 245I.10, subdivision 8, be reviewed at least every 90 days 
822.30 	and revised to document treatment progress or, if progress is not documented, to document 
822.31 	changes in treatment.
823.1 	(f) The treatment team shall actively and assertively engage the client's family members 
823.2 	and significant others by establishing communication and collaboration with the family and 
823.3 	significant others and educating the family and significant others about the client's mental 
823.4 	illness, symptom management, and the family's role in treatment, unless the team knows or 
823.5 	has reason to suspect that the client has suffered or faces a threat of suffering any physical 
823.6 	or mental injury, abuse, or neglect from a family member or significant other.
823.7 	(g) For a client age 18 or older, the treatment team may disclose to a family member, 
823.8 	other relative, or a close personal friend of the client, or other person identified by the client, 
823.9 	the protected health information directly relevant to such person's involvement with the 
823.10 	client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the 
823.11 	client is present, the treatment team shall obtain the client's agreement, provide the client 
823.12 	with an opportunity to object, or reasonably infer from the circumstances, based on the 
823.13 	exercise of professional judgment, that the client does not object. If the client is not present 
823.14 	or is unable, by incapacity or emergency circumstances, to agree or object, the treatment 
823.15 	team may, in the exercise of professional judgment, determine whether the disclosure is in 
823.16 	the best interests of the client and, if so, disclose only the protected health information that 
823.17 	is directly relevant to the family member's, relative's, friend's, or client-identified person's 
823.18 	involvement with the client's health care. The client may orally agree or object to the 
823.19 	disclosure and may prohibit or restrict disclosure to specific individuals.
823.20 	(h) The treatment team shall provide interventions to promote positive interpersonal 
823.21 	relationships.

823.22 	Sec. 103. Minnesota Statutes 2020, section 256B.0947, subdivision 7, is amended to read:
823.23 		Subd. 7.Medical assistance payment and rate setting. (a) Payment for services in this 
823.24 	section must be based on one daily encounter rate per provider inclusive of the following 
823.25 	services received by an eligible client in a given calendar day: all rehabilitative services, 
823.26 	supports, and ancillary activities under this section, staff travel time to provide rehabilitative 
823.27 	services under this section, and crisis response services under section 256B.0944 256B.0624.
823.28 	(b) Payment must not be made to more than one entity for each client for services 
823.29 	provided under this section on a given day. If services under this section are provided by a 
823.30 	team that includes staff from more than one entity, the team shall determine how to distribute 
823.31 	the payment among the members.
823.32 	(c) The commissioner shall establish regional cost-based rates for entities that will bill 
823.33 	medical assistance for nonresidential intensive rehabilitative mental health services. In 
823.34 	developing these rates, the commissioner shall consider:
824.1 	(1) the cost for similar services in the health care trade area;
824.2 	(2) actual costs incurred by entities providing the services;
824.3 	(3) the intensity and frequency of services to be provided to each client;
824.4 	(4) the degree to which clients will receive services other than services under this section; 
824.5 	and
824.6 	(5) the costs of other services that will be separately reimbursed.
824.7 	(d) The rate for a provider must not exceed the rate charged by that provider for the 
824.8 	same service to other payers.

824.9 	Sec. 104. Minnesota Statutes 2020, section 256B.0949, subdivision 2, is amended to read:
824.10 		Subd. 2.Definitions. (a) The terms used in this section have the meanings given in this 
824.11 	subdivision.
824.12 	(b) "Agency" means the legal entity that is enrolled with Minnesota health care programs 
824.13 	as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide 
824.14 	EIDBI services and that has the legal responsibility to ensure that its employees or contractors 
824.15 	carry out the responsibilities defined in this section. Agency includes a licensed individual 
824.16 	professional who practices independently and acts as an agency.
824.17 	(c) "Autism spectrum disorder or a related condition" or "ASD or a related condition" 
824.18 	means either autism spectrum disorder (ASD) as defined in the current version of the 
824.19 	Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found 
824.20 	to be closely related to ASD, as identified under the current version of the DSM, and meets 
824.21 	all of the following criteria:
824.22 	(1) is severe and chronic;
824.23 	(2) results in impairment of adaptive behavior and function similar to that of a person 
824.24 	with ASD;
824.25 	(3) requires treatment or services similar to those required for a person with ASD; and
824.26 	(4) results in substantial functional limitations in three core developmental deficits of 
824.27 	ASD: social or interpersonal interaction; functional communication, including nonverbal 
824.28 	or social communication; and restrictive or repetitive behaviors or hyperreactivity or 
824.29 	hyporeactivity to sensory input; and may include deficits or a high level of support in one 
824.30 	or more of the following domains:
824.31 	(i) behavioral challenges and self-regulation;
825.1 	(ii) cognition;
825.2 	(iii) learning and play;
825.3 	(iv) self-care; or
825.4 	(v) safety.
825.5 	(d) "Person" means a person under 21 years of age.
825.6 	(e) "Clinical supervision" means the overall responsibility for the control and direction 
825.7 	of EIDBI service delivery, including individual treatment planning, staff supervision, 
825.8 	individual treatment plan progress monitoring, and treatment review for each person. Clinical 
825.9 	supervision is provided by a qualified supervising professional (QSP) who takes full 
825.10 	professional responsibility for the service provided by each supervisee.
825.11 	(f) "Commissioner" means the commissioner of human services, unless otherwise 
825.12 	specified.
825.13 	(g) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive 
825.14 	evaluation of a person to determine medical necessity for EIDBI services based on the 
825.15 	requirements in subdivision 5.
825.16 	(h) "Department" means the Department of Human Services, unless otherwise specified.
825.17 	(i) "Early intensive developmental and behavioral intervention benefit" or "EIDBI 
825.18 	benefit" means a variety of individualized, intensive treatment modalities approved and 
825.19 	published by the commissioner that are based in behavioral and developmental science 
825.20 	consistent with best practices on effectiveness.
825.21 	(j) "Generalizable goals" means results or gains that are observed during a variety of 
825.22 	activities over time with different people, such as providers, family members, other adults, 
825.23 	and people, and in different environments including, but not limited to, clinics, homes, 
825.24 	schools, and the community.
825.25 	(k) "Incident" means when any of the following occur:
825.26 	(1) an illness, accident, or injury that requires first aid treatment;
825.27 	(2) a bump or blow to the head; or
825.28 	(3) an unusual or unexpected event that jeopardizes the safety of a person or staff, 
825.29 	including a person leaving the agency unattended.
825.30 	(l) "Individual treatment plan" or "ITP" means the person-centered, individualized written 
825.31 	plan of care that integrates and coordinates person and family information from the CMDE 
826.1 	for a person who meets medical necessity for the EIDBI benefit. An individual treatment 
826.2 	plan must meet the standards in subdivision 6.
826.3 	(m) "Legal representative" means the parent of a child who is under 18 years of age, a 
826.4 	court-appointed guardian, or other representative with legal authority to make decisions 
826.5 	about service for a person. For the purpose of this subdivision, "other representative with 
826.6 	legal authority to make decisions" includes a health care agent or an attorney-in-fact 
826.7 	authorized through a health care directive or power of attorney.
826.8 	(n) "Mental health professional" has the meaning given in means a staff person who is 
826.9 	qualified according to section 245.4871, subdivision 27, clauses (1) to (6) 245I.04, 
826.10 	subdivision 2.
826.11 	(o) "Person-centered" means a service that both responds to the identified needs, interests, 
826.12 	values, preferences, and desired outcomes of the person or the person's legal representative 
826.13 	and respects the person's history, dignity, and cultural background and allows inclusion and 
826.14 	participation in the person's community.
826.15 	(p) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II, or 
826.16 	level III treatment provider.

826.17 	Sec. 105. Minnesota Statutes 2020, section 256B.0949, subdivision 4, is amended to read:
826.18 		Subd. 4.Diagnosis. (a) A diagnosis of ASD or a related condition must:
826.19 	(1) be based upon current DSM criteria including direct observations of the person and 
826.20 	information from the person's legal representative or primary caregivers;
826.21 	(2) be completed by either (i) a licensed physician or advanced practice registered nurse 
826.22 	or (ii) a mental health professional; and
826.23 	(3) meet the requirements of Minnesota Rules, part 9505.0372, subpart 1, items B and 
826.24 	C a standard diagnostic assessment according to section 245I.10, subdivision 6.
826.25 	(b) Additional assessment information may be considered to complete a diagnostic 
826.26 	assessment including specialized tests administered through special education evaluations 
826.27 	and licensed school personnel, and from professionals licensed in the fields of medicine, 
826.28 	speech and language, psychology, occupational therapy, and physical therapy. A diagnostic 
826.29 	assessment may include treatment recommendations.

827.1 	Sec. 106. Minnesota Statutes 2020, section 256B.0949, subdivision 5a, is amended to 
827.2 	read:
827.3 		Subd. 5a.Comprehensive multidisciplinary evaluation provider qualification. A 
827.4 	CMDE provider must:
827.5 	(1) be a licensed physician, advanced practice registered nurse, a mental health 
827.6 	professional, or a mental health practitioner who meets the requirements of a clinical trainee 
827.7 	as defined in Minnesota Rules, part 9505.0371, subpart 5, item C who is qualified according 
827.8 	to section 245I.04, subdivision 6;
827.9 	(2) have at least 2,000 hours of clinical experience in the evaluation and treatment of 
827.10 	people with ASD or a related condition or equivalent documented coursework at the graduate 
827.11 	level by an accredited university in the following content areas: ASD or a related condition 
827.12 	diagnosis, ASD or a related condition treatment strategies, and child development; and
827.13 	(3) be able to diagnose, evaluate, or provide treatment within the provider's scope of 
827.14 	practice and professional license.

827.15 	Sec. 107. Minnesota Statutes 2020, section 256B.25, subdivision 3, is amended to read:
827.16 		Subd. 3.Payment exceptions. The limitation in subdivision 2 shall not apply to:
827.17 	(1) payment of Minnesota supplemental assistance funds to recipients who reside in 
827.18 	facilities which are involved in litigation contesting their designation as an institution for 
827.19 	treatment of mental disease;
827.20 	(2) payment or grants to a boarding care home or supervised living facility licensed by 
827.21 	the Department of Human Services under Minnesota Rules, parts 2960.0130 to 2960.0220 
827.22 	or,2960.0580 to 2960.0700, or9520.0500 to 9520.0670, or under chapter 245G or 245I, 
827.23 	or payment to recipients who reside in these facilities;
827.24 	(3) payments or grants to a boarding care home or supervised living facility which are 
827.25 	ineligible for certification under United States Code, title 42, sections 1396-1396p;
827.26 	(4) payments or grants otherwise specifically authorized by statute or rule.

827.27 	Sec. 108. Minnesota Statutes 2020, section 256B.761, is amended to read:
827.28 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
827.29 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
827.30 	management provided to psychiatric patients, outpatient mental health services, day treatment 
827.31 	services, home-based mental health services, and family community support services shall 
828.1 	be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 
828.2 	1999 charges.
828.3 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
828.4 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
828.5 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, 
828.6 	with at least 33 percent of the clients receiving rehabilitation services in the most recent 
828.7 	calendar year who are medical assistance recipients, will be increased by 38 percent, when 
828.8 	those services are provided within the comprehensive outpatient rehabilitation facility and 
828.9 	provided to residents of nursing facilities owned by the entity.
828.10 	(c) The commissioner shall establish three levels of payment for mental health diagnostic 
828.11 	assessment, based on three levels of complexity. The aggregate payment under the tiered 
828.12 	rates must not exceed the projected aggregate payments for mental health diagnostic 
828.13 	assessment under the previous single rate. The new rate structure is effective January 1, 
828.14 	2011, or upon federal approval, whichever is later.
828.15 	(d) (c) In addition to rate increases otherwise provided, the commissioner may restructure 
828.16 	coverage policy and rates to improve access to adult rehabilitative mental health services 
828.17 	under section 256B.0623 and related mental health support services under section 256B.021, 
828.18 	subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected 
828.19 	state share of increased costs due to this paragraph is transferred from adult mental health 
828.20 	grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent 
828.21 	base adjustment for subsequent fiscal years. Payments made to managed care plans and 
828.22 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
828.23 	the rate changes described in this paragraph.
828.24 	(e) (d) Any ratables effective before July 1, 2015, do not apply to early intensive 
828.25 	developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

828.26 	Sec. 109. Minnesota Statutes 2020, section 256B.763, is amended to read:
828.27 	256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
828.28 	(a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment 
828.29 	rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:
828.30 	(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
828.31 	(2) community mental health centers under section 256B.0625, subdivision 5; and
829.1 	(3) mental health clinics and centers certified under Minnesota Rules, parts 9520.0750 
829.2 	to 9520.0870 section 245I.20, or hospital outpatient psychiatric departments that are 
829.3 	designated as essential community providers under section 62Q.19.
829.4 	(b) This increase applies to group skills training when provided as a component of 
829.5 	children's therapeutic services and support, psychotherapy, medication management, 
829.6 	evaluation and management, diagnostic assessment, explanation of findings, psychological 
829.7 	testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.
829.8 	(c) This increase does not apply to rates that are governed by section 256B.0625, 
829.9 	subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated 
829.10 	with the county, rates that are established by the federal government, or rates that increased 
829.11 	between January 1, 2004, and January 1, 2005.
829.12 	(d) The commissioner shall adjust rates paid to prepaid health plans under contract with 
829.13 	the commissioner to reflect the rate increases provided in paragraphs (a), (e), and (f). The 
829.14 	prepaid health plan must pass this rate increase to the providers identified in paragraphs (a), 
829.15 	(e), (f), and (g).
829.16 	(e) Payment rates shall be increased by 23.7 percent over the rates in effect on December 
829.17 	31, 2007, for:
829.18 	(1) medication education services provided on or after January 1, 2008, by adult 
829.19 	rehabilitative mental health services providers certified under section 256B.0623; and
829.20 	(2) mental health behavioral aide services provided on or after January 1, 2008, by 
829.21 	children's therapeutic services and support providers certified under section 256B.0943.
829.22 	(f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by 
829.23 	children's therapeutic services and support providers certified under section 256B.0943 and 
829.24 	not already included in paragraph (a), payment rates shall be increased by 23.7 percent over 
829.25 	the rates in effect on December 31, 2007.
829.26 	(g) Payment rates shall be increased by 2.3 percent over the rates in effect on December 
829.27 	31, 2007, for individual and family skills training provided on or after January 1, 2008, by 
829.28 	children's therapeutic services and support providers certified under section 256B.0943.
829.29 	(h) For services described in paragraphs (b), (e), and (g) and rendered on or after July 
829.30 	1, 2017, payment rates for mental health clinics and centers certified under Minnesota Rules, 
829.31 	parts 9520.0750 to 9520.0870 section 245I.20, that are not designated as essential community 
829.32 	providers under section 62Q.19 shall be equal to payment rates for mental health clinics 
829.33 	and centers certified under Minnesota Rules, parts 9520.0750 to 9520.0870 section 245I.20, 
830.1 	that are designated as essential community providers under section 62Q.19. In order to 
830.2 	receive increased payment rates under this paragraph, a provider must demonstrate a 
830.3 	commitment to serve low-income and underserved populations by:
830.4 	(1) charging for services on a sliding-fee schedule based on current poverty income 
830.5 	guidelines; and
830.6 	(2) not restricting access or services because of a client's financial limitation.

830.7 	Sec. 110. Minnesota Statutes 2020, section 256P.01, subdivision 6a, is amended to read:
830.8 		Subd. 6a.Qualified professional. (a) For illness, injury, or incapacity, a "qualified 
830.9 	professional" means a licensed physician, physician assistant, advanced practice registered 
830.10 	nurse, physical therapist, occupational therapist, or licensed chiropractor, according to their 
830.11 	scope of practice.
830.12 	(b) For developmental disability, learning disability, and intelligence testing, a "qualified 
830.13 	professional" means a licensed physician, physician assistant, advanced practice registered 
830.14 	nurse, licensed independent clinical social worker, licensed psychologist, certified school 
830.15 	psychologist, or certified psychometrist working under the supervision of a licensed 
830.16 	psychologist.
830.17 	(c) For mental health, a "qualified professional" means a licensed physician, advanced 
830.18 	practice registered nurse, or qualified mental health professional under section 245.462, 
830.19 	subdivision 18, clauses (1) to (6) 245I.04, subdivision 2.
830.20 	(d) For substance use disorder, a "qualified professional" means a licensed physician, a 
830.21 	qualified mental health professional under section 245.462, subdivision 18, clauses (1) to 
830.22 	(6), or an individual as defined in section 245G.11, subdivision 3, 4, or 5.

830.23 	Sec. 111. Minnesota Statutes 2020, section 295.50, subdivision 9b, is amended to read:
830.24 		Subd. 9b.Patient services. (a) "Patient services" means inpatient and outpatient services 
830.25 	and other goods and services provided by hospitals, surgical centers, or health care providers. 
830.26 	They include the following health care goods and services provided to a patient or consumer:
830.27 	(1) bed and board;
830.28 	(2) nursing services and other related services;
830.29 	(3) use of hospitals, surgical centers, or health care provider facilities;
830.30 	(4) medical social services;
831.1 	(5) drugs, biologicals, supplies, appliances, and equipment;
831.2 	(6) other diagnostic or therapeutic items or services;
831.3 	(7) medical or surgical services;
831.4 	(8) items and services furnished to ambulatory patients not requiring emergency care; 
831.5 	and
831.6 	(9) emergency services.
831.7 	(b) "Patient services" does not include:
831.8 	(1) services provided to nursing homes licensed under chapter 144A;
831.9 	(2) examinations for purposes of utilization reviews, insurance claims or eligibility, 
831.10 	litigation, and employment, including reviews of medical records for those purposes;
831.11 	(3) services provided to and by community residential mental health facilities licensed 
831.12 	under section 245I.23 or Minnesota Rules, parts 9520.0500 to 9520.0670, and to and by 
831.13 	residential treatment programs for children with severe emotional disturbance licensed or 
831.14 	certified under chapter 245A;
831.15 	(4) services provided under the following programs: day treatment services as defined 
831.16 	in section 245.462, subdivision 8; assertive community treatment as described in section 
831.17 	256B.0622; adult rehabilitative mental health services as described in section 256B.0623; 
831.18 	adult crisis response services as described in section 256B.0624; and children's therapeutic 
831.19 	services and supports as described in section 256B.0943; and children's mental health crisis 
831.20 	response services as described in section 256B.0944;
831.21 	(5) services provided to and by community mental health centers as defined in section 
831.22 	245.62, subdivision 2;
831.23 	(6) services provided to and by assisted living programs and congregate housing 
831.24 	programs;
831.25 	(7) hospice care services;
831.26 	(8) home and community-based waivered services under chapter 256S and sections 
831.27 	256B.49 and 256B.501;
831.28 	(9) targeted case management services under sections 256B.0621; 256B.0625, 
831.29 	subdivisions 20, 20a, 33, and 44; and 256B.094; and
831.30 	(10) services provided to the following: supervised living facilities for persons with 
831.31 	developmental disabilities licensed under Minnesota Rules, parts 4665.0100 to 4665.9900; 
832.1 	housing with services establishments required to be registered under chapter 144D; board 
832.2 	and lodging establishments providing only custodial services that are licensed under chapter 
832.3 	157 and registered under section 157.17 to provide supportive services or health supervision 
832.4 	services; adult foster homes as defined in Minnesota Rules, part 9555.5105; day training 
832.5 	and habilitation services for adults with developmental disabilities as defined in section 
832.6 	252.41, subdivision 3; boarding care homes as defined in Minnesota Rules, part 4655.0100; 
832.7 	adult day care services as defined in section 245A.02, subdivision 2a; and home health 
832.8 	agencies as defined in Minnesota Rules, part 9505.0175, subpart 15, or licensed under 
832.9 	chapter 144A.

832.10 	Sec. 112. Minnesota Statutes 2020, section 325F.721, subdivision 1, is amended to read:
832.11 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
832.12 	the meanings given them.
832.13 	(b) "Covered setting" means an unlicensed setting providing sleeping accommodations 
832.14 	to one or more adult residents, at least 80 percent of which are 55 years of age or older, and 
832.15 	offering or providing, for a fee, supportive services. For the purposes of this section, covered 
832.16 	setting does not mean:
832.17 	(1) emergency shelter, transitional housing, or any other residential units serving 
832.18 	exclusively or primarily homeless individuals, as defined under section 116L.361;
832.19 	(2) a nursing home licensed under chapter 144A;
832.20 	(3) a hospital, certified boarding care, or supervised living facility licensed under sections 
832.21 	144.50 to 144.56;
832.22 	(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 
832.23 	9520.0500 to 9520.0670, or under chapter 245Dor,245G, or 245I;
832.24 	(5) services and residential settings licensed under chapter 245A, including adult foster 
832.25 	care and services and settings governed under the standards in chapter 245D;
832.26 	(6) private homes in which the residents are related by kinship, law, or affinity with the 
832.27 	providers of services;
832.28 	(7) a duly organized condominium, cooperative, and common interest community, or 
832.29 	owners' association of the condominium, cooperative, and common interest community 
832.30 	where at least 80 percent of the units that comprise the condominium, cooperative, or 
832.31 	common interest community are occupied by individuals who are the owners, members, or 
832.32 	shareholders of the units;
833.1 	(8) temporary family health care dwellings as defined in sections 394.307 and 462.3593;
833.2 	(9) settings offering services conducted by and for the adherents of any recognized 
833.3 	church or religious denomination for its members exclusively through spiritual means or 
833.4 	by prayer for healing;
833.5 	(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with 
833.6 	low-income housing tax credits pursuant to United States Code, title 26, section 42, and 
833.7 	units financed by the Minnesota Housing Finance Agency that are intended to serve 
833.8 	individuals with disabilities or individuals who are homeless, except for those developments 
833.9 	that market or hold themselves out as assisted living facilities and provide assisted living 
833.10 	services;
833.11 	(11) rental housing developed under United States Code, title 42, section 1437, or United 
833.12 	States Code, title 12, section 1701q;
833.13 	(12) rental housing designated for occupancy by only elderly or elderly and disabled 
833.14 	residents under United States Code, title 42, section 1437e, or rental housing for qualifying 
833.15 	families under Code of Federal Regulations, title 24, section 983.56;
833.16 	(13) rental housing funded under United States Code, title 42, chapter 89, or United 
833.17 	States Code, title 42, section 8011; or
833.18 	(14) an assisted living facility licensed under chapter 144G.
833.19 	(c) "'I'm okay' check services" means providing a service to, by any means, check on 
833.20 	the safety of a resident.
833.21 	(d) "Resident" means a person entering into written contract for housing and services 
833.22 	with a covered setting.
833.23 	(e) "Supportive services" means:
833.24 	(1) assistance with laundry, shopping, and household chores;
833.25 	(2) housekeeping services;
833.26 	(3) provision of meals or assistance with meals or food preparation;
833.27 	(4) help with arranging, or arranging transportation to, medical, social, recreational, 
833.28 	personal, or social services appointments; or
833.29 	(5) provision of social or recreational services.
833.30 	Arranging for services does not include making referrals or contacting a service provider 
833.31 	in an emergency.

834.1 	Sec. 113. REPEALER.
 834.2 	(a) Minnesota Statutes 2020, sections 245.462, subdivision 4a; 245.4879, subdivision 
834.3 	2; 245.62, subdivisions 3 and 4; 245.69, subdivision 2; 256B.0615, subdivision 2; 256B.0616, 
834.4 	subdivision 2; 256B.0622, subdivisions 3 and 5a; 256B.0623, subdivisions 7, 8, 10, and 11; 
834.5 	256B.0625, subdivisions 5l, 35a, 35b, 61, 62, and 65; 256B.0943, subdivisions 8 and 10; 
834.6 	256B.0944; and 256B.0946, subdivision 5, are repealed.
834.7 	(b) Minnesota Rules, parts 9505.0370; 9505.0371; 9505.0372; 9520.0010; 9520.0020; 
834.8 	9520.0030; 9520.0040; 9520.0050; 9520.0060; 9520.0070; 9520.0080; 9520.0090; 
834.9 	9520.0100; 9520.0110; 9520.0120; 9520.0130; 9520.0140; 9520.0150; 9520.0160; 
834.10 	9520.0170; 9520.0180; 9520.0190; 9520.0200; 9520.0210; 9520.0230; 9520.0750; 
834.11 	9520.0760; 9520.0770; 9520.0780; 9520.0790; 9520.0800; 9520.0810; 9520.0820; 
834.12 	9520.0830; 9520.0840; 9520.0850; 9520.0860; and 9520.0870, are repealed.

834.13 	Sec. 114. EFFECTIVE DATE.
 834.14 	Unless otherwise stated, this article is effective July 1, 2022, or upon federal approval, 
834.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
834.16 	when federal approval is obtained.

834.17 	ARTICLE 20
834.18 	FORECAST ADJUSTMENTS

834.19	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
 	
834.20 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
834.21 	shown in parentheses, are subtracted from the appropriations in Laws 2019, First Special 
834.22 	Session chapter 9, article 14, from the general fund, or any other fund named, to the 
834.23 	commissioner of human services for the purposes specified in this article, to be available 
834.24 	for the fiscal year indicated for each purpose. The figure "2021" used in this article means 
834.25 	that the appropriations listed are available for the fiscal year ending June 30, 2021.

834.26				APPROPRIATIONS
	
834.27				Available for the Year
	
834.28				Ending June 30
	
834.29					2021

834.30
834.31	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

834.32	Subdivision 1.Total Appropriation
 	$
	(816,996,000)

835.1	Appropriations by Fund
	
835.2		2021
		
835.3	General
	(745,266,000)
		
835.4	Health Care Access
	(36,893,000)
		
835.5	Federal TANF
	(34,837,000)

835.6	Subd. 2.Forecasted Programs
 					
835.7
835.8
835.9835.10
	(a) Minnesota Family 
Investment Program 
(MFIP)/Diversionary Work 
Program (DWP)

835.11	Appropriations by Fund
	
835.12		2021
		
835.13	General
	59,004,000
		
835.14	Federal TANF
	(34,843,000)

835.15	(b) MFIP Child Care Assistance
		(54,158,000)

835.16	(c) General Assistance
		3,925,000

835.17	(d) Minnesota Supplemental Aid
		3,849,000

835.18	(e) Housing Support
		3,022,000

835.19	(f) Northstar Care for Children
		(8,639,000)

835.20	(g) MinnesotaCare
		(36,893,000)
			
835.21 	This appropriation is from the health care 
835.22 	access fund.

835.23	(h) Medical Assistance

835.24	Appropriations by Fund
	
835.25		2021
		
835.26	General
	(694,938,000)
		
835.27	Health Care Access
	-0-

835.28	(i) Alternative Care
		247,000

835.29
835.30	(j) Consolidated Chemical Dependency 
Treatment Fund (CCDTF) Entitlement
		(57,578,000)

835.31	Subd. 3.Technical Activities
 		6,000
			
835.32 	This appropriation is from the federal TANF 
835.33 	fund.

836.1 	Sec. 3. EFFECTIVE DATE.
 836.2 	Sections 1 and 2 are effective the day following final enactment.

836.3 	ARTICLE 21
836.4 	APPROPRIATIONS

836.5	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
836.6 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
836.7 	and for the purposes specified in this article. The appropriations are from the general fund, 
836.8 	or another named fund, and are available for the fiscal years indicated for each purpose. 
836.9 	The figures "2022" and "2023" used in this article mean that the appropriations listed under 
836.10 	them are available for the fiscal year ending June 30, 2022, or June 30, 2023, respectively. 
836.11 	"The first year" is fiscal year 2022. "The second year" is fiscal year 2023. "The biennium" 
836.12 	is fiscal years 2022 and 2023.

836.13				APPROPRIATIONS
	
836.14				Available for the Year
	
836.15				Ending June 30
	
836.16					2022
		2023

836.17
836.18	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

836.19	Subdivision 1.Total Appropriation
 	$
	9,104,404,000
	$
	9,590,575,000

836.20	Appropriations by Fund
	
836.21		2022
	2023
	
836.22	General
	7,945,812,000
	8,456,923,000
	
836.23
836.24	State Government 
Special Revenue
	4,299,000
	4,299,000
	
836.25	Health Care Access
	867,214,000
	845,520,000
	
836.26	Federal TANF
	282,623,000
	278,803,000
	
836.27	Lottery Prize
	1,896,000
	1,896,000
	
836.28
836.29	Opiate Epidemic 
Response
	2,560,000
	2,560,000
	
836.30 	The amounts that may be spent for each 
836.31 	purpose are specified in the following 
836.32 	subdivisions.

836.33	Subd. 2.TANF Maintenance of Effort
 					
837.1 	(a) Nonfederal Expenditures. The 
837.2 	commissioner shall ensure that sufficient 
837.3 	qualified nonfederal expenditures are made 
837.4 	each year to meet the state's maintenance of 
837.5 	effort (MOE) requirements of the TANF block 
837.6 	grant specified under Code of Federal 
837.7 	Regulations, title 45, section 263.1. In order 
837.8 	to meet these basic TANF/MOE requirements, 
837.9 	the commissioner may report as TANF/MOE 
837.10 	expenditures only nonfederal money expended 
837.11 	for allowable activities listed in the following 
837.12 	clauses:
837.13 	(1) MFIP cash, diversionary work program, 
837.14 	and food assistance benefits under Minnesota 
837.15 	Statutes, chapter 256J;
837.16 	(2) the child care assistance programs under 
837.17 	Minnesota Statutes, sections 119B.03 and 
837.18 	119B.05, and county child care administrative 
837.19 	costs under Minnesota Statutes, section 
837.20 	119B.15;
837.21 	(3) state and county MFIP administrative costs 
837.22 	under Minnesota Statutes, chapters 256J and 
837.23 	256K;
837.24 	(4) state, county, and tribal MFIP employment 
837.25 	services under Minnesota Statutes, chapters 
837.26 	256J and 256K;
837.27 	(5) expenditures made on behalf of legal 
837.28 	noncitizen MFIP recipients who qualify for 
837.29 	the MinnesotaCare program under Minnesota 
837.30 	Statutes, chapter 256L;
837.31 	(6) qualifying working family credit 
837.32 	expenditures under Minnesota Statutes, section 
837.33 	290.0671;
838.1 	(7) qualifying Minnesota education credit 
838.2 	expenditures under Minnesota Statutes, section 
838.3 	290.0674; and
838.4 	(8) qualifying Head Start expenditures under 
838.5 	Minnesota Statutes, section 119A.50.
838.6 	(b) Nonfederal Expenditures; Reporting.
838.7 	For the activities listed in paragraph (a), 
838.8 	clauses (2) to (8), the commissioner may 
838.9 	report only expenditures that are excluded 
838.10 	from the definition of assistance under Code 
838.11 	of Federal Regulations, title 45, section 
838.12 	260.31.
838.13 	(c) Certain Expenditures Required. The 
838.14 	commissioner shall ensure that the MOE used 
838.15 	by the commissioner of management and 
838.16 	budget for the February and November 
838.17 	forecasts required under Minnesota Statutes, 
838.18 	section 16A.103, contains expenditures under 
838.19 	paragraph (a), clause (1), equal to at least 16 
838.20 	percent of the total required under Code of 
838.21 	Federal Regulations, title 45, section 263.1.
838.22 	(d) Limitation; Exceptions. The 
838.23 	commissioner must not claim an amount of 
838.24 	TANF/MOE in excess of the 75 percent 
838.25 	standard in Code of Federal Regulations, title 
838.26 	45, section 263.1(a)(2), except:
838.27 	(1) to the extent necessary to meet the 80 
838.28 	percent standard under Code of Federal 
838.29 	Regulations, title 45, section 263.1(a)(1), if it 
838.30 	is determined by the commissioner that the 
838.31 	state will not meet the TANF work 
838.32 	participation target rate for the current year;
838.33 	(2) to provide any additional amounts under 
838.34 	Code of Federal Regulations, title 45, section 
839.1 	264.5, that relate to replacement of TANF 
839.2 	funds due to the operation of TANF penalties; 
839.3 	and
839.4 	(3) to provide any additional amounts that may 
839.5 	contribute to avoiding or reducing TANF work 
839.6 	participation penalties through the operation 
839.7 	of the excess MOE provisions of Code of 
839.8 	Federal Regulations, title 45, section 
839.9 	261.43(a)(2).
839.10 	(e) Supplemental Expenditures. For the 
839.11 	purposes of paragraph (d), the commissioner 
839.12 	may supplement the MOE claim with working 
839.13 	family credit expenditures or other qualified 
839.14 	expenditures to the extent such expenditures 
839.15 	are otherwise available after considering the 
839.16 	expenditures allowed in this subdivision.
839.17 	(f) Reduction of Appropriations; Exception.
839.18 	The requirement in Minnesota Statutes, section 
839.19 	256.011, subdivision 3, that federal grants or 
839.20 	aids secured or obtained under that subdivision 
839.21 	be used to reduce any direct appropriations 
839.22 	provided by law, does not apply if the grants 
839.23 	or aids are federal TANF funds.
839.24 	(g) IT Appropriations Generally. This 
839.25 	appropriation includes funds for information 
839.26 	technology projects, services, and support. 
839.27 	Notwithstanding Minnesota Statutes, section 
839.28 	16E.0466, funding for information technology 
839.29 	project costs shall be incorporated into the 
839.30 	service level agreement and paid to the Office 
839.31 	of MN.IT Services by the Department of 
839.32 	Human Services under the rates and 
839.33 	mechanism specified in that agreement.
840.1 	(h) Receipts for Systems Project.
840.2 	Appropriations and federal receipts for 
840.3 	information systems projects for MAXIS, 
840.4 	PRISM, MMIS, ISDS, METS, and SSIS must 
840.5 	be deposited in the state systems account 
840.6 	authorized in Minnesota Statutes, section 
840.7 	256.014. Money appropriated for computer 
840.8 	projects approved by the commissioner of the 
840.9 	Office of MN.IT Services, funded by the 
840.10 	legislature, and approved by the commissioner 
840.11 	of management and budget may be transferred 
840.12 	from one project to another and from 
840.13 	development to operations as the 
840.14 	commissioner of human services considers 
840.15 	necessary. Any unexpended balance in the 
840.16 	appropriation for these projects does not 
840.17 	cancel and is available for ongoing 
840.18 	development and operations.
840.19 	(i) Federal SNAP Education and Training 
840.20 	Grants. Federal funds available during fiscal 
840.21 	years 2022 and 2023 for Supplemental 
840.22 	Nutrition Assistance Program Education and 
840.23 	Training and SNAP Quality Control 
840.24 	Performance Bonus grants are appropriated 
840.25 	to the commissioner of human services for the 
840.26 	purposes allowable under the terms of the 
840.27 	federal award. This paragraph is effective the 
840.28 	day following final enactment.

840.29	Subd. 3.Information Technology
 					
840.30 	(a) IT Appropriations Generally. This 
840.31 	appropriation includes funds for information 
840.32 	technology projects, services, and support. 
840.33 	Notwithstanding Minnesota Statutes, section 
840.34 	16E.0466, funding for information technology 
840.35 	project costs shall be incorporated into the 
841.1 	service level agreement and paid to the Office 
841.2 	of MN.IT Services by the Department of 
841.3 	Human Services under the rates and 
841.4 	mechanism specified in that agreement.
841.5 	(b) Receipts for Systems Project.
841.6 	Appropriations and federal receipts for 
841.7 	information systems projects for MAXIS, 
841.8 	PRISM, MMIS, ISDS, METS, and SSIS must 
841.9 	be deposited in the state systems account 
841.10 	authorized in Minnesota Statutes, section 
841.11 	256.014. Money appropriated for computer 
841.12 	projects approved by the commissioner of the 
841.13 	Office of MN.IT Services, funded by the 
841.14 	legislature, and approved by the commissioner 
841.15 	of management and budget may be transferred 
841.16 	from one project to another and from 
841.17 	development to operations as the 
841.18 	commissioner of human services considers 
841.19 	necessary. Any unexpended balance in the 
841.20 	appropriation for these projects does not 
841.21 	cancel and is available for ongoing 
841.22 	development and operations.

841.23	Subd. 4.Central Office; Operations

841.24	Appropriations by Fund
	
841.25	General
	175,025,000
	168,967,000
	
841.26
841.27	State Government 
Special Revenue
	4,174,000
	4,174,000
	
841.28	Health Care Access
	16,966,000
	16,966,000
	
841.29	Federal TANF
	100,000
	100,000
	
841.30 	(a) Administrative Recovery; Set-Aside. The 
841.31 	commissioner may invoice local entities 
841.32 	through the SWIFT accounting system as an 
841.33 	alternative means to recover the actual cost of 
841.34 	administering the following provisions:
842.1 	(1) Minnesota Statutes, section 125A.744, 
842.2 	subdivision 3;
842.3 	(2) Minnesota Statutes, section 245.495, 
842.4 	paragraph (b);
842.5 	(3) Minnesota Statutes, section 256B.0625, 
842.6 	subdivision 20, paragraph (k);
842.7 	(4) Minnesota Statutes, section 256B.0924, 
842.8 	subdivision 6, paragraph (g);
842.9 	(5) Minnesota Statutes, section 256B.0945, 
842.10 	subdivision 4, paragraph (d); and
842.11 	(6) Minnesota Statutes, section 256F.10, 
842.12 	subdivision 6, paragraph (b).
842.13 	(b) Background Studies. (1) $2,074,000 in 
842.14 	fiscal year 2022 is from the general fund to 
842.15 	provide a credit to providers who paid for 
842.16 	emergency background studies in NETStudy 
842.17 	2.0.
842.18 	(2) $2,061,000 in fiscal year 2022 is from the 
842.19 	general fund to cover the costs of reprocessing 
842.20 	emergency studies conducted under 
842.21 	interagency agreements with other agencies.
842.22 	(c) Personal Care Assistance Compensation 
842.23 	for Services Provided by a Parent or 
842.24 	Spouse. $349,000 in fiscal year 2022 is from 
842.25 	the general fund for compensation for personal 
842.26 	care assistance services provided by a parent 
842.27 	or spouse under Laws 2020, Fifth Special 
842.28 	Session chapter 3, article 10, section 3, as 
842.29 	amended.
842.30 	(d) Family Foster Setting Background 
842.31 	Studies. $338,000 in fiscal year 2022 and 
842.32 	$349,000 in fiscal year 2023 are from the 
842.33 	general fund for costs related to implementing 
843.1 	and administering licensed family foster 
843.2 	setting background study requirements.
843.3 	(e) Cultural and Ethnic Communities 
843.4 	Leadership Council. $18,000 in fiscal year 
843.5 	2022 and $62,000 in fiscal year 2023 are from 
843.6 	the general fund for the Cultural and Ethnic 
843.7 	Communities Leadership Council.
843.8 	(f) Ombudsperson for Child Care 
843.9 	Providers. $120,000 in fiscal year 2022 and 
843.10 	$126,000 in fiscal year 2023 are for an 
843.11 	ombudsperson for child care providers under 
843.12 	Minnesota Statutes, section 119B.27.
843.13 	(g) Base Level Adjustment. The general fund 
843.14 	base is $163,421,000 in fiscal year 2024 and 
843.15 	$162,260,000 in fiscal year 2025.

843.16	Subd. 5.Central Office; Children and Families

843.17	Appropriations by Fund
	
843.18	General
	18,382,000
	18,407,000
	
843.19	Federal TANF
	2,582,000
	2,582,000
	
843.20 	(a) Financial Institution Data Match and 
843.21 	Payment of Fees. The commissioner is 
843.22 	authorized to allocate up to $310,000 in fiscal 
843.23 	year 2022 and $310,000 in fiscal year 2023 
843.24 	from the systems special revenue account to 
843.25 	make payments to financial institutions in 
843.26 	exchange for performing data matches 
843.27 	between account information held by financial 
843.28 	institutions and the public authority's database 
843.29 	of child support obligors as authorized by 
843.30 	Minnesota Statutes, section 13B.06, 
843.31 	subdivision 7.
843.32 	(b) Base Level Adjustment. The general fund 
843.33 	base is $18,677,000 in fiscal year 2024 and 
843.34 	$18,677,000 in fiscal year 2025.

844.1	Subd. 6.Central Office; Health Care

844.2	Appropriations by Fund
	
844.3	General
	26,005,000
	23,992,000
	
844.4	Health Care Access
	28,168,000
	28,168,000
	
844.5 	(a) Case Management Benefit Study for 
844.6 	American Indians. $200,000 in fiscal year 
844.7 	2022 is from the general fund for a contract 
844.8 	to conduct fiscal analysis and development of 
844.9 	standards for a targeted case management 
844.10 	benefit for American Indians. The 
844.11 	commissioner of human services must consult 
844.12 	the Minnesota Indian Affairs Council in the 
844.13 	development of any request for proposal and 
844.14 	in the evaluation of responses. This is a 
844.15 	onetime appropriation. Any unencumbered 
844.16 	balance remaining from the first year does not 
844.17 	cancel and is available for the second year of 
844.18 	the biennium.
844.19 	(b) Integrated Care for High-Risk Pregnant 
844.20 	Women Grant Program. $106,000 in fiscal 
844.21 	year 2022 and $122,000 in fiscal year 2023 
844.22 	are from the general fund for administration 
844.23 	of the integrated care for high-risk pregnant 
844.24 	women grant program under Minnesota 
844.25 	Statutes, section 256B.79.
844.26 	(c) Studies on Health Care Delivery.
844.27 	$700,000 in fiscal year 2022 and $300,000 in 
844.28 	fiscal year 2023 are from the general fund for 
844.29 	the commissioner of human services to 
844.30 	develop a legislative proposal for a public 
844.31 	option program and to compare and report to 
844.32 	the legislature on delivery and payment system 
844.33 	models to deliver services to MinnesotaCare 
844.34 	enrollees and certain medical assistance 
844.35 	enrollees.
845.1 	(d) Base Level Adjustment. The general fund 
845.2 	base is $24,036,000 in fiscal year 2024 and 
845.3 	$24,034,000 in fiscal year 2025.

845.4
845.5	Subd. 7.Central Office; Continuing Care for 
Older Adults

845.6	Appropriations by Fund
	
845.7	General
	18,873,000
	18,900,000
	
845.8
845.9	State Government 
Special Revenue
	125,000
	125,000
	
845.10 	(a) Assisted Living Survey. $2,593,000 in 
845.11 	fiscal year 2022 and $2,593,000 in fiscal year 
845.12 	2023 are from the general fund for 
845.13 	development and administration of a resident 
845.14 	experience survey and family survey for all 
845.15 	assisted living facilities according to 
845.16 	Minnesota Statutes, section 256B.439, 
845.17 	subdivision 3c. These appropriations are 
845.18 	available in either year of the biennium.
845.19 	(b) Base Level Adjustment. The general fund 
845.20 	base is $18,859,000 in fiscal year 2024 and 
845.21 	$18,900,000 in fiscal year 2025.

845.22	Subd. 8.Central Office; Community Supports

845.23	Appropriations by Fund
	
845.24	General
	35,294,000
	35,846,000
	
845.25	Lottery Prize
	163,000
	163,000
	
845.26
845.27	Opioid Epidemic 
Response
	60,000
	60,000
	
845.28 	(a) Study of Self Directed Tiered Wage 
845.29 	Structure. $25,000 in fiscal year 2022 is from 
845.30 	the general fund for a study of the feasibility 
845.31 	of a tiered wage structure for individual 
845.32 	providers. This is a onetime appropriation. 
845.33 	This appropriation is available only if the labor 
845.34 	agreement between the state of Minnesota and 
845.35 	the Service Employees International Union 
846.1 	Healthcare Minnesota under Minnesota 
846.2 	Statutes, section 179A.54, is approved under 
846.3 	Minnesota Statutes, section 3.855.
846.4 	(b) Substance Use Disorder Treatment 
846.5 	Paperwork Reduction. $234,000 in fiscal 
846.6 	year 2022 and $201,000 in fiscal year 2023 
846.7 	are from the general fund for a contract with 
846.8 	a vendor to develop, assess, and recommend 
846.9 	systems improvements to minimize regulatory 
846.10 	paperwork and improve systems for licensed 
846.11 	substance use disorder programs. This is a 
846.12 	onetime appropriation.
846.13 	(c) Case Management and Substance Use 
846.14 	Disorder Treatment Rate Methodology 
846.15 	Analysis. $500,000 in fiscal year 2022 and 
846.16 	$200,000 in fiscal year 2023 are from the 
846.17 	general fund for the fiscal analysis needed to 
846.18 	establish federally compliant payment 
846.19 	methodologies for all medical 
846.20 	assistance-funded case management services, 
846.21 	including substance use disorder treatment 
846.22 	rates. This is a onetime appropriation.
846.23 	(d) Substance Use Disorder Community of 
846.24 	Practice. $250,000 in fiscal year 2022 and 
846.25 	$250,000 in fiscal year 2023 are from the 
846.26 	general fund for the commissioner of human 
846.27 	services to establish and administer the 
846.28 	substance use disorder community of practice, 
846.29 	including providing compensation for 
846.30 	community of practice participants.
846.31 	(e) Sober Housing Program 
846.32 	Recommendations Development. $90,000 
846.33 	in fiscal year 2022 is from the general fund 
846.34 	for developing recommendations related to 
846.35 	sober housing programs and completing and 
847.1 	submitting a report on the recommendations 
847.2 	to the legislature.
847.3 	(f) Base Level Adjustment. The general fund 
847.4 	base is $34,257,000 in fiscal year 2024 and 
847.5 	$34,289,000 in fiscal year 2025. The opiate 
847.6 	epidemic response fund base is $60,000 in 
847.7 	fiscal year 2024 and $0 in fiscal year 2025.

847.8	Subd. 9.Forecasted Programs; MFIP/DWP

847.9	Appropriations by Fund
	
847.10	General
	92,588,000
	91,668,000
	
847.11	Federal TANF
	104,285,000
	104,410,000

847.12
847.13	Subd. 10.Forecasted Programs; MFIP Child 
Care Assistance.
 		103,347,000
		110,788,000

847.14
847.15	Subd. 11.Forecasted Programs; General 
Assistance.
 		53,574,000
		52,835,000
	
847.16 	(a) General Assistance Standard. The 
847.17 	commissioner shall set the monthly standard 
847.18 	of assistance for general assistance units 
847.19 	consisting of an adult recipient who is 
847.20 	childless and unmarried or living apart from 
847.21 	parents or a legal guardian at $203. The 
847.22 	commissioner may reduce this amount 
847.23 	according to Laws 1997, chapter 85, article 3, 
847.24 	section 54.
847.25 	(b) Emergency General Assistance Limit.
847.26 	The amount appropriated for emergency 
847.27 	general assistance is limited to no more than 
847.28 	$6,729,812 in fiscal year 2022 and $6,729,812 
847.29 	in fiscal year 2023. Funds to counties shall be 
847.30 	allocated by the commissioner using the 
847.31 	allocation method under Minnesota Statutes, 
847.32 	section 256D.06.

847.33
847.34	Subd. 12.Forecasted Programs; Minnesota 
Supplemental Aid
 		51,779,000
		52,486,000

848.1
848.2	Subd. 13.Forecasted Programs; Housing 
Support
 		184,005,000
		191,966,000

848.3
848.4	Subd. 14.Forecasted Programs; Northstar Care 
for Children
 		110,583,000
		121,246,000

848.5	Subd. 15.Forecasted Programs; MinnesotaCare
 		207,437,000
		184,822,000
	
848.6 	Generally. This appropriation is from the 
848.7 	health care access fund.

848.8
848.9	Subd. 16.Forecasted Programs; Medical 
Assistance

848.10	Appropriations by Fund
	
848.11	General
	6,058,256,000
	6,577,278,000
	
848.12	Health Care Access
	611,178,000
	612,099,000
	
848.13 	Behavioral Health Services. $1,000,000 in 
848.14 	fiscal year 2022 and $1,000,000 in fiscal year 
848.15 	2023 are for behavioral health services 
848.16 	provided by hospitals identified under 
848.17 	Minnesota Statutes, section 256.969, 
848.18 	subdivision 2b, paragraph (a), clause (4). The 
848.19 	increase in payments shall be made by 
848.20 	increasing the adjustment under Minnesota 
848.21 	Statutes, section 256.969, subdivision 2b, 
848.22 	paragraph (e), clause (2).

848.23
848.24	Subd. 17.Forecasted Programs; Alternative 
Care
 		45,669,000
		45,656,000
	
848.25 	Alternative Care Transfer. Any money 
848.26 	allocated to the alternative care program that 
848.27 	is not spent for the purposes indicated does 
848.28 	not cancel but must be transferred to the 
848.29 	medical assistance account.

848.30
848.31	Subd. 18.Forecasted Programs; Behavioral 
Health Fund
 		132,377,000
		116,706,000
	
848.32 	(a) Grants to Tribal Governments.
848.33 	$28,873,377 in fiscal year 2022 is from the 
848.34 	general fund to satisfy the value of 
848.35 	overpayments owed by the Leech Lake Band 
849.1 	of Ojibwe and White Earth Band of Chippewa 
849.2 	to repay overpayments for medication-assisted 
849.3 	treatment services between fiscal year 2014 
849.4 	and fiscal year 2019. The grant to the Leech 
849.5 	Lake Band of Ojibwe shall be $14,666,122 
849.6 	and the grant to the White Earth Band of 
849.7 	Chippewa shall be $14,207,215. This is a 
849.8 	onetime appropriation.
849.9 	(b) Institutions for Mental Disease 
849.10 	Payments. $8,328,000 in fiscal year 2022 is 
849.11 	from the general fund for the commissioner 
849.12 	of human services to reimburse counties for 
849.13 	the amount identified by the commissioner for 
849.14 	the statewide county share of costs for which 
849.15 	federal funds were claimed, but were not 
849.16 	eligible for federal funding for substance use 
849.17 	disorder services provided in institutions for 
849.18 	mental disease, for claims paid between 
849.19 	January 1, 2014, and June 30, 2019. The 
849.20 	commissioner of human services shall allocate 
849.21 	this appropriation between counties in the 
849.22 	amount identified by the department that is 
849.23 	owed by each county. Prior to a county 
849.24 	receiving reimbursement, the county must pay 
849.25 	in full any unpaid consolidated chemical 
849.26 	dependency treatment fund invoiced county 
849.27 	share. This is a onetime appropriation.

849.28
849.29	Subd. 19.Grant Programs; Support Services 
Grants

849.30	Appropriations by Fund
	
849.31	General
	8,715,000
	8,715,000
	
849.32	Federal TANF
	96,312,000
	96,311,000

850.1
850.2	Subd. 20.Grant Programs; BSF Child Care 
Grants.
 		53,350,000
		53,362,000
	
850.3 	Base Level Adjustment. The general fund 
850.4 	base is $53,366,000 in fiscal year 2024 and 
850.5 	$53,366,000 in fiscal year 2025.

850.6
850.7	Subd. 21.Grant Programs; Child Care 
Development Grants.
 		2,317,000
		2,257,000
	
850.8 	(a) TEACH Grant Program. $500,000 in 
850.9 	fiscal year 2022 and $500,000 in fiscal year 
850.10 	2023 are for TEACH program grants under 
850.11 	Minnesota Statutes, section 136A.128.
850.12 	(b) Peer Mentoring Program for Licensed 
850.13 	Family Child Care Providers. $30,000 in 
850.14 	fiscal year 2022 and $20,000 in fiscal year 
850.15 	2023 are for a grant to the Minnesota Child 
850.16 	Care Provider Information Network for 
850.17 	establishing a peer mentoring program for 
850.18 	licensed family child care providers in the 
850.19 	state. The grant money must be used to revise 
850.20 	and update peer mentoring program curricula, 
850.21 	recruit and train mentors and program 
850.22 	participants, and support mentors and active 
850.23 	mentoring. The Minnesota Child Care 
850.24 	Provider Information Network must submit 
850.25 	to the commissioner an initial report 
850.26 	describing the program's implementation 
850.27 	progress and financial accounting by 
850.28 	September 1, 2022, and a final report must be 
850.29 	submitted by June 30, 2023. Any unexpended 
850.30 	balance in the first year does not cancel and 
850.31 	is available in the second year. This is a 
850.32 	onetime appropriation.
850.33 	(c) Report on Foster Children Participation 
850.34 	in Early Childhood Programs. $50,000 in 
850.35 	fiscal year 2022 is for interim and final reports 
851.1 	on foster children's participation in early 
851.2 	childhood programs. This is a onetime 
851.3 	appropriation and is available until June 30, 
851.4 	2023.
851.5 	(d) Child Care Center Regulation 
851.6 	Modernization. $577,000 in fiscal year 2022 
851.7 	and $741,000 in fiscal year 2023 are for the 
851.8 	child care center regulation modernization 
851.9 	project. This is a onetime appropriation and 
851.10 	remains available until June 30, 2024.
851.11 	(e) Family Child Care Regulation 
851.12 	Modernization. $478,000 in fiscal year 2022 
851.13 	and $642,000 in fiscal year 2023 are for the 
851.14 	family child care regulation modernization 
851.15 	project. This is a onetime appropriation and 
851.16 	remains available until June 30, 2024.
851.17 	(f) Base Level Adjustment. The general fund 
851.18 	base is $2,237,000 in fiscal year 2024 and 
851.19 	$2,237,000 in fiscal year 2025.

851.20
851.21	Subd. 22.Grant Programs; Child Support 
Enforcement Grants
 		50,000
		50,000

851.22
851.23	Subd. 23.Grant Programs; Children's Services 
Grants

851.24	Appropriations by Fund
	
851.25	General
	52,133,000
	51,848,000
	
851.26	Federal TANF
	140,000
	140,000
	
851.27 	(a) Title IV-E Adoption Assistance. The 
851.28 	commissioner shall allocate funds from the 
851.29 	Title IV-E reimbursement to the state from 
851.30 	the Fostering Connections to Success and 
851.31 	Increasing Adoptions Act for adoptive, foster, 
851.32 	and kinship families as required in Minnesota 
851.33 	Statutes, section 256N.261.
852.1 	(b) Indian Child Welfare Training.
852.2 	$1,012,000 in fiscal year 2022 and $993,000 
852.3 	in fiscal year 2023 are from the general fund 
852.4 	for the establishment and operation of the 
852.5 	Tribal Training and Certification Partnership 
852.6 	at the University of Minnesota-Duluth to 
852.7 	provide training, establish federal Indian Child 
852.8 	Welfare Act and Minnesota Family 
852.9 	Preservation Act training requirements for 
852.10 	county child welfare workers, and develop 
852.11 	indigenous child welfare training for American 
852.12 	Indian Tribes. The base for this appropriation 
852.13 	is $1,053,000 in fiscal year 2024 and 
852.14 	$1,053,000 in fiscal year 2025.
852.15 	(c) Parent Support for Better Outcomes 
852.16 	Grants. $150,000 in fiscal year 2022 and 
852.17 	$150,000 in fiscal year 2023 are from the 
852.18 	general fund for grants to Minnesota One-Stop 
852.19 	for Communities to provide mentoring, 
852.20 	guidance, and support services to parents 
852.21 	navigating the child welfare system in 
852.22 	Minnesota, in order to promote the 
852.23 	development of safe, stable, and healthy 
852.24 	families. Grant money may be used for parent 
852.25 	mentoring, peer-to-peer support groups, 
852.26 	housing support services, training, staffing, 
852.27 	and administrative costs.

852.28
852.29	Subd. 24.Grant Programs; Children and 
Community Service Grants
 		60,251,000
		60,856,000

852.30
852.31	Subd. 25.Grant Programs; Children and 
Economic Support Grants
 		34,240,000
		34,240,000
	
852.32 	(a) Minnesota Food Assistance Program.
852.33 	Unexpended funds for the Minnesota food 
852.34 	assistance program for fiscal year 2022 do not 
852.35 	cancel but are available for this purpose in 
852.36 	fiscal year 2023.
853.1 	(b) Emergency Shelters. $2,500,000 in fiscal 
853.2 	year 2022 and $2,500,000 in fiscal year 2023 
853.3 	are for short-term housing facilities to increase 
853.4 	the supply and improve the condition of 
853.5 	shelters for individuals and families without 
853.6 	a permanent residence. The commissioner 
853.7 	shall ensure that a portion of the funds are 
853.8 	expended to provide for short-term housing 
853.9 	facilities for tribes and shall ensure equitable 
853.10 	geographic distribution of funds. This 
853.11 	appropriation is available until June 30, 2026.
853.12 	(c) Emergency Services Grants. $9,000,000 
853.13 	in fiscal year 2022 and $9,000,000 in fiscal 
853.14 	year 2023 are to provide emergency services 
853.15 	grants under Minnesota Statutes, section 
853.16 	256E.36.

853.17	Subd. 26.Grant Programs; Health Care Grants

853.18	Appropriations by Fund
	
853.19	General
	4,811,000
	4,811,000
	
853.20	Health Care Access
	3,465,000
	3,465,000
	
853.21 	Integrated Care for High Risk Pregnancies 
853.22 	Initiative. $1,100,000 in fiscal year 2022 and 
853.23 	$1,100,000 in fiscal year 2023 are from the 
853.24 	general fund for the commissioner of human 
853.25 	services to enter into a contract with the 
853.26 	Integrated Care for High Risk Pregnancies 
853.27 	(ICHRP) initiative to provide support to the 
853.28 	integrated care for high-risk pregnant women 
853.29 	grant program under Minnesota Statutes, 
853.30 	section 256B.79.

853.31
853.32	Subd. 27.Grant Programs; Other Long-Term 
Care Grants
 		1,925,000
		1,925,000

853.33
853.34	Subd. 28.Grant Programs; Aging and Adult 
Services Grants
 		32,495,000
		32,495,000

854.1
854.2	Subd. 29.Grant Programs; Deaf and 
Hard-of-Hearing Grants
 		2,886,000
		2,886,000

854.3	Subd. 30.Grant Programs; Disabilities Grants
 		20,251,000
		18,863,000
	
854.4 	Training Stipends for Direct Support 
854.5 	Services Providers. $1,000,000 in fiscal year 
854.6 	2022 is from the general fund for stipends for 
854.7 	individual providers of direct support services 
854.8 	as defined in Minnesota Statutes, section 
854.9 	256B.0711, subdivision 1. These stipends are 
854.10 	available to individual providers who have 
854.11 	completed designated voluntary trainings 
854.12 	made available through the State-Provider 
854.13 	Cooperation Committee formed by the State 
854.14 	of Minnesota and the Service Employees 
854.15 	International Union Healthcare Minnesota. 
854.16 	Any unspent appropriation in fiscal year 2022 
854.17 	is available in fiscal year 2023. This is a 
854.18 	onetime appropriation. This appropriation is 
854.19 	available only if the labor agreement between 
854.20 	the state of Minnesota and the Service 
854.21 	Employees International Union Healthcare 
854.22 	Minnesota under Minnesota Statutes, section 
854.23 	179A.54, is approved under Minnesota 
854.24 	Statutes, section 3.855.

854.25
854.26	Subd. 31.Grant Programs; Housing Support 
Grants
 		11,364,000
		11,364,000
	
854.27 	Long-Term Homeless Supportive Services.
854.28 	$1,000,000 in fiscal year 2022 and $1,000,000 
854.29 	in fiscal year 2023 are for long-term homeless 
854.30 	supportive services under Minnesota Statutes, 
854.31 	section 256K.26.

854.32
854.33	Subd. 32.Grant Programs; Adult Mental Health 
Grants

855.1	Appropriations by Fund
	
855.2	General
	84,073,000
	84,074,000
	
855.3
855.4	Opiate Epidemic 
Response
	2,000,000
	2,000,000
	
855.5 	(a) Culturally and Linguistically 
855.6 	Appropriate Services Implementation 
855.7 	Grants. $750,000 in fiscal year 2022 and 
855.8 	$750,000 in fiscal year 2023 are from the 
855.9 	general fund for grants to substance use 
855.10 	disorder treatment providers to implement 
855.11 	culturally and linguistically appropriate 
855.12 	services standards, according to the 
855.13 	implementation and transition plan developed 
855.14 	by the commissioner. This is a onetime 
855.15 	appropriation.
855.16 	(b) Base Level Adjustment. The general fund 
855.17 	base is $83,324,000 in fiscal year 2024 and 
855.18 	$83,324,000 in fiscal year 2025. The opiate 
855.19 	epidemic response fund base is $2,000,000 in 
855.20 	fiscal year 2024 and $0 in fiscal year 2025.

855.21
855.22	Subd. 33.Grant Programs; Child Mental Health 
Grants
 		28,703,000
		28,703,000
	
855.23 	(a) Children's Residential Facilities.
855.24 	$3,000,000 in fiscal year 2022 and $3,000,000 
855.25 	in fiscal year 2023 are to reimburse counties 
855.26 	and Tribal governments for a portion of the 
855.27 	costs of treatment in children's residential 
855.28 	facilities. The commissioner shall distribute 
855.29 	the appropriation on an annual basis to 
855.30 	counties and Tribal governments 
855.31 	proportionally based on a methodology 
855.32 	developed by the commissioner. Of this 
855.33 	appropriation, $100,000 in fiscal year 2022 
855.34 	and $100,000 in fiscal year 2023 are available 
855.35 	to the commissioner for administrative 
855.36 	expenses and $70,000 in fiscal year 2022 is 
856.1 	available to the commissioner for the 
856.2 	children's mental health residential treatment 
856.3 	work group.
856.4 	(b) Base Level Adjustment. The general fund 
856.5 	base is $28,726,000 in fiscal year 2024 and 
856.6 	$28,726,000 in fiscal year 2025.

856.7
856.8	Subd. 34.Grant Programs; Chemical 
Dependency Treatment Support Grants

856.9	Appropriations by Fund
	
856.10	General
	2,846,000
	2,845,000
	
856.11	Lottery Prize
	1,733,000
	1,733,000
	
856.12
856.13	Opiate Epidemic 
Response
	500,000
	500,000
	
856.14 	(a) Problem Gambling. $225,000 in fiscal 
856.15 	year 2022 and $225,000 in fiscal year 2023 
856.16 	are from the lottery prize fund for a grant to 
856.17 	the state affiliate recognized by the National 
856.18 	Council on Problem Gambling. The affiliate 
856.19 	must provide services to increase public 
856.20 	awareness of problem gambling, education, 
856.21 	training for individuals and organizations 
856.22 	providing effective treatment services to 
856.23 	problem gamblers and their families, and 
856.24 	research related to problem gambling.
856.25 	(b) Recovery Community Organization 
856.26 	Grants. $573,000 in fiscal year 2022 and 
856.27 	$571,000 in fiscal year 2023 are from the 
856.28 	general fund for grants to recovery community 
856.29 	organizations, as defined in Minnesota 
856.30 	Statutes, section 254B.01, subdivision 8, to 
856.31 	provide for costs and community-based peer 
856.32 	recovery support services that are not 
856.33 	otherwise eligible for reimbursement under 
856.34 	Minnesota Statutes, section 254B.05, as part 
857.1 	of the continuum of care for substance use 
857.2 	disorders.
857.3 	(c) Base Level Adjustment. The general fund 
857.4 	base is $2,636,000 in fiscal year 2024 and 
857.5 	$2,636,000 in fiscal year 2025. The opiate 
857.6 	epidemic response fund base is $500,000 in 
857.7 	fiscal year 2024 and $0 in fiscal year 2025.

857.8
857.9	Subd. 35.Direct Care and Treatment - 
Generally
 					
857.10 	Transfer Authority. Money appropriated to 
857.11 	budget activities under this subdivision and 
857.12 	subdivisions 36 to 40 may be transferred 
857.13 	between budget activities and between years 
857.14 	of the biennium with the approval of the 
857.15 	commissioner of management and budget.

857.16
857.17	Subd. 36.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		139,946,000
		144,103,000
	
857.18 	(a) Transfer Authority. Money appropriated 
857.19 	to support the continued operations of the 
857.20 	Community Addiction Recovery Enterprise 
857.21 	(C.A.R.E.) program may be transferred to the 
857.22 	enterprise fund for C.A.R.E.
857.23 	(b) Operating Adjustment. $2,307,000 in 
857.24 	fiscal year 2022 and $2,453,000 in fiscal year 
857.25 	2023 are for the Community Addiction 
857.26 	Recovery Enterprise program. The 
857.27 	commissioner may transfer $2,307,000 in 
857.28 	fiscal year 2022 and $2,453,000 in fiscal year 
857.29 	2023 to the enterprise fund for Community 
857.30 	Addiction Recovery Enterprise.

857.31
857.32	Subd. 37.Direct Care and Treatment - 
Community-Based Services
 		18,771,000
		19,752,000
	
857.33 	(a) Transfer Authority. Money appropriated 
857.34 	to support the continued operations of the 
857.35 	Minnesota State Operated Community 
858.1 	Services (MSOCS) program may be 
858.2 	transferred to the enterprise fund for MSOCS.
858.3 	(b) Operating Adjustment. $1,519,000 in 
858.4 	fiscal year 2022 and $2,541,000 in fiscal year 
858.5 	2023 are for the Minnesota State Operated 
858.6 	Community Services program. The 
858.7 	commissioner may transfer $1,519,000 in 
858.8 	fiscal year 2022 and $2,541,000 in fiscal year 
858.9 	2023 to the enterprise fund for Minnesota State 
858.10 	Operated Community Services.

858.11
858.12	Subd. 38.Direct Care and Treatment - Forensic 
Services
 		119,854,000
		122,206,000

858.13
858.14	Subd. 39.Direct Care and Treatment - Sex 
Offender Program
 		97,570,000
		99,917,000
	
858.15 	Transfer Authority. Money appropriated for 
858.16 	the Minnesota sex offender program may be 
858.17 	transferred between fiscal years of the 
858.18 	biennium with the approval of the 
858.19 	commissioner of management and budget.

858.20
858.21	Subd. 40.Direct Care and Treatment - 
Operations
 		63,504,000
		65,910,000

858.22	Subd. 41.Technical Activities
 		79,204,000
		78,260,000
	
858.23 	(a) Generally. This appropriation is from the 
858.24 	federal TANF fund.
858.25 	(b) Base Level Adjustment. The TANF fund 
858.26 	base is $71,493,000 in fiscal year 2024 and 
858.27 	$71,493,000 in fiscal year 2025.

858.28	Sec. 3. COMMISSIONER OF HEALTH

858.29	Subdivision 1.Total Appropriation
 	$
	259,373,000
	$
	251,881,000

858.30	Appropriations by Fund
	
858.31		2022
	2023
	
858.32	General
	156,337,000
	150,554,000
	
858.33
858.34	State Government 
Special Revenue
	54,465,000
	53,356,000
	
859.1	Health Care Access
	36,858,000
	36,258,000
	
859.2	Federal TANF
	11,713,000
	11,713,000
	
859.3 	The amounts that may be spent for each 
859.4 	purpose are specified in the following 
859.5 	subdivisions.

859.6	Subd. 2.Health Improvement

859.7	Appropriations by Fund
	
859.8	General
	113,697,000
	112,692,000
	
859.9859.10
	State Government 
Special Revenue
	9,103,000
	7,777,000
	
859.11	Health Care Access
	36,858,000
	36,258,000
	
859.12	Federal TANF
	11,713,000
	11,713,000
	
859.13 	(a) TANF Appropriations. (1) $3,579,000 in 
859.14 	fiscal year 2022 and $3,579,000 in fiscal year 
859.15 	2023 are from the TANF fund for home 
859.16 	visiting and nutritional services listed under 
859.17 	Minnesota Statutes, section 145.882, 
859.18 	subdivision 7, clauses (6) and (7). Funds must 
859.19 	be distributed to community health boards 
859.20 	according to Minnesota Statutes, section 
859.21 	145A.131, subdivision 1;
859.22 	(2) $2,000,000 in fiscal year 2022 and 
859.23 	$2,000,000 in fiscal year 2023 are from the 
859.24 	TANF fund for decreasing racial and ethnic 
859.25 	disparities in infant mortality rates under 
859.26 	Minnesota Statutes, section 145.928, 
859.27 	subdivision 7;
859.28 	(3) $4,978,000 in fiscal year 2022 and 
859.29 	$4,978,000 in fiscal year 2023 are from the 
859.30 	TANF fund for the family home visiting grant 
859.31 	program according to Minnesota Statutes, 
859.32 	section 145A.17. $4,000,000 of the funding 
859.33 	in each fiscal year must be distributed to 
859.34 	community health boards according to 
859.35 	Minnesota Statutes, section 145A.131, 
860.1 	subdivision 1. $978,000 of the funding in each 
860.2 	fiscal year must be distributed to tribal 
860.3 	governments according to Minnesota Statutes, 
860.4 	section 145A.14, subdivision 2a;
860.5 	(4) $1,156,000 in fiscal year 2022 and 
860.6 	$1,156,000 in fiscal year 2023 are from the 
860.7 	TANF fund for family planning grants under 
860.8 	Minnesota Statutes, section 145.925; and
860.9 	(5) the commissioner may use up to 6.23 
860.10 	percent of the funds appropriated from the 
860.11 	TANF fund each fiscal year to conduct the 
860.12 	ongoing evaluations required under Minnesota 
860.13 	Statutes, section 145A.17, subdivision 7, and 
860.14 	training and technical assistance as required 
860.15 	under Minnesota Statutes, section 145A.17, 
860.16 	subdivisions 4 and 5.
860.17 	(b) TANF Carryforward. Any unexpended 
860.18 	balance of the TANF appropriation in the first 
860.19 	year of the biennium does not cancel but is 
860.20 	available for the second year.
860.21 	(c) Maternal Morbidity and Death Studies.
860.22 	$198,000 in fiscal year 2022 and $198,000 in 
860.23 	fiscal year 2023 are from the general fund to 
860.24 	be used to conduct maternal morbidity studies 
860.25 	and maternal death studies under Minnesota 
860.26 	Statutes, sections 145.901 and 145.9013.
860.27 	(d) Comprehensive Advanced Life Support 
860.28 	Educational Program. $100,000 in fiscal 
860.29 	year 2022 and $100,000 in fiscal year 2023 
860.30 	are from the general fund for the 
860.31 	comprehensive advanced life support 
860.32 	educational program under Minnesota Statutes, 
860.33 	section 144.6062. This is a onetime 
860.34 	appropriation.
861.1 	(e) Local Public Health Grants. $2,978,000 
861.2 	in fiscal year 2022 and $2,978,000 in fiscal 
861.3 	year 2023 are from the general fund for local 
861.4 	public health grants under Minnesota Statutes, 
861.5 	section 145A.131. The base for this 
861.6 	appropriation is $2,500,000 in fiscal year 2024 
861.7 	and $2,500,000 in fiscal year 2025.
861.8 	(f) Public Health Infrastructure and Health 
861.9 	Equity and Outreach. $5,000,000 in fiscal 
861.10 	year 2022 and $5,000,000 in fiscal year 2023 
861.11 	are from the general fund for purposes of 
861.12 	Minnesota Statutes, sections 144.0661 to 
861.13 	144.0663, and to build public health 
861.14 	infrastructure at the state and local levels to 
861.15 	address current and future public health 
861.16 	emergencies, conduct outreach to underserved 
861.17 	communities in the state experiencing health 
861.18 	disparities, and build systems at the state and 
861.19 	local levels with the goals of reducing and 
861.20 	eliminating health disparities in these 
861.21 	communities. A community health board or 
861.22 	local unit of government must use any funds 
861.23 	provided under this paragraph to supplement 
861.24 	and not supplant local funds being used for 
861.25 	public health purposes.
861.26 	(g) Mental Health Cultural Community 
861.27 	Continuing Education. $500,000 in fiscal 
861.28 	year 2022 and $500,000 in fiscal year 2023 
861.29 	are from the general fund for the mental health 
861.30 	cultural community continuing education grant 
861.31 	program.
861.32 	(h) Health Professional Education Loan 
861.33 	Forgiveness Program. $3,000,000 in fiscal 
861.34 	year 2022 and $3,000,000 in fiscal year 2023 
861.35 	are from the general fund for loan forgiveness 
862.1 	under the health professional education loan 
862.2 	forgiveness program under Minnesota Statutes, 
862.3 	section 144.1501, for individuals who: (1) are 
862.4 	eligible alcohol and drug counselors or eligible 
862.5 	mental health professionals, as defined in 
862.6 	Minnesota Statutes, section 144.1501, 
862.7 	subdivision 1; and (2) are Black, indigenous, 
862.8 	or people of color, or members of an 
862.9 	underrepresented community as defined in 
862.10 	Minnesota Statutes, section 148E.010, 
862.11 	subdivision 20. Loan forgiveness shall be 
862.12 	provided according to this paragraph 
862.13 	notwithstanding the priorities and distribution 
862.14 	requirements for loan forgiveness in 
862.15 	Minnesota Statutes, section 144.1501.
862.16 	(i) Birth Records; Homeless Youth. $72,000 
862.17 	in fiscal year 2022 and $32,000 in fiscal year 
862.18 	2023 are from the general fund for 
862.19 	administration and issuance of certified birth 
862.20 	records and statements of no vital record found 
862.21 	to homeless youth under Minnesota Statutes, 
862.22 	section 144.2255.
862.23 	(j) Trauma-Informed Gun Violence 
862.24 	Reduction Pilot Program. $100,000 in fiscal 
862.25 	year 2022 is from the general fund for the 
862.26 	trauma-informed gun violence reduction pilot 
862.27 	program.
862.28 	(k) Home Visiting for Pregnant Women and 
862.29 	Families with Young Children. $2,500,000 
862.30 	in fiscal year 2022 and $2,500,000 in fiscal 
862.31 	year 2023 are from the general fund for grants 
862.32 	for home visiting services under Minnesota 
862.33 	Statutes, section 145.87.
862.34 	(l) Supporting Healthy Development of 
862.35 	Babies During Pregnancy and Postpartum.
863.1 	$279,000 in fiscal year 2022 and $279,000 in 
863.2 	fiscal year 2023 are from the general fund for 
863.3 	a grant to the Amherst H. Wilder Foundation 
863.4 	for the African American Babies Coalition 
863.5 	initiative for community-driven training and 
863.6 	education on best practices to support healthy 
863.7 	development of babies during pregnancy and 
863.8 	postpartum. Grant funds must be used to build 
863.9 	capacity in, train, educate, or improve 
863.10 	practices among individuals, from youth to 
863.11 	elders, serving families with members who 
863.12 	are Black, indigenous, or people of color, 
863.13 	during pregnancy and postpartum. Of this 
863.14 	appropriation, $19,000 in fiscal year 2022 and 
863.15 	$19,000 in fiscal year 2023 are for the 
863.16 	commissioner to use for administration. This 
863.17 	is a onetime appropriation. Any unexpended 
863.18 	balance in the first year of the biennium does 
863.19 	not cancel and is available in the second year 
863.20 	of the biennium.
863.21 	(m) Dignity in Pregnancy and Childbirth.
863.22 	$1,695,000 in fiscal year 2022 and $908,000 
863.23 	in fiscal year 2023 are from the general fund 
863.24 	for purposes of Minnesota Statutes, section 
863.25 	144.1461. Of this appropriation, $845,000 in 
863.26 	fiscal year 2022 is for a grant to the University 
863.27 	of Minnesota School of Public Health's Center 
863.28 	for Antiracism Research for Health Equity, to 
863.29 	develop a model curriculum on anti-racism 
863.30 	and implicit bias for use by hospitals with 
863.31 	obstetric care and birth centers to provide 
863.32 	continuing education to staff caring for 
863.33 	pregnant or postpartum women. The model 
863.34 	curriculum must be evidence-based and must 
863.35 	meet the criteria in Minnesota Statutes, section 
863.36 	144.1461, subdivision 2, paragraph (a). The 
864.1 	base for this appropriation is $907,000 in fiscal 
864.2 	year 2024 and $860,000 in fiscal year 2025.
864.3 	(n) Recommendations to Expand Access to 
864.4 	Data from the All-Payer Claims Database.
864.5 	$55,000 in fiscal year 2022 is from the general 
864.6 	fund for the commissioner to develop 
864.7 	recommendations to expand access to data 
864.8 	from the all-payer claims database under 
864.9 	Minnesota Statutes, section 62U.04, to 
864.10 	additional outside entities for public health or 
864.11 	research purposes.
864.12 	(o) Base Level Adjustments. The general 
864.13 	fund base is $110,762,000 in fiscal year 2024 
864.14 	and $111,787,000 in fiscal year 2025. The 
864.15 	state government special revenue fund base is 
864.16 	$7,777,000 in fiscal year 2024 and $7,777,000 
864.17 	in fiscal year 2025. The health care access 
864.18 	fund base is $36,858,000 in fiscal year 2024 
864.19 	and $36,258,000 in fiscal year 2025.

864.20	Subd. 3.Health Protection

864.21	Appropriations by Fund
	
864.22	General
	31,070,000
	26,283,000
	
864.23
864.24	State Government 
Special Revenue
	45,362,000
	45,579,000
	
864.25 	(a) Lead Risk Assessments and Lead 
864.26 	Orders. $1,530,000 in fiscal year 2022 and 
864.27 	$1,314,000 in fiscal year 2023 are from the 
864.28 	general fund for implementation of the 
864.29 	requirements for conducting lead risk 
864.30 	assessments under Minnesota Statutes, section 
864.31 	144.9504, subdivision 2, and for issuance of 
864.32 	lead orders under Minnesota Statutes, section 
864.33 	144.9504, subdivision 5.
864.34 	(b) Hospital Closure or Curtailment of 
864.35 	Operations. $10,000 in fiscal year 2022 and 
865.1 	$1,000 in fiscal year 2023 are from the general 
865.2 	fund for purposes of Minnesota Statutes, 
865.3 	section 144.555, subdivisions 1a, 1b, and 2.
865.4 	(c) Transfer; Public Health Response 
865.5 	Contingency Account. The commissioner 
865.6 	shall transfer $4,343,000 in fiscal year 2022 
865.7 	from the general fund to the public health 
865.8 	response contingency account established in 
865.9 	Minnesota Statutes, section 144.4199. This is 
865.10 	a onetime transfer.
865.11 	(d) Skin Lightening Products Public 
865.12 	Awareness and Education Grant Program.
865.13 	$100,000 in fiscal year 2022 and $100,000 in 
865.14 	fiscal year 2023 are from the general fund for 
865.15 	a skin lightening products public awareness 
865.16 	and education grant program. This is a onetime 
865.17 	appropriation.
865.18 	(e) Base Level Adjustments. The general 
865.19 	fund base is $26,183,000 in fiscal year 2024 
865.20 	and $26,183,000 in fiscal year 2025. The state 
865.21 	government special revenue fund base is 
865.22 	$45,579,000 in fiscal year 2024 and 
865.23 	$45,579,000 in fiscal year 2025.

865.24	Subd. 4.Health Operations
 		11,570,000
		11,579,000

865.25	Sec. 4. HEALTH-RELATED BOARDS

865.26	Subdivision 1.Total Appropriation
 	$
	27,535,000
	$
	26,960,000

865.27	Appropriations by Fund
	
865.28
865.29	State Government 
Special Revenue
	27,459,000
	26,884,000
	
865.30	Health Care Access
	76,000
	76,000
	
865.31 	This appropriation is from the state 
865.32 	government special revenue fund unless 
865.33 	specified otherwise. The amounts that may be 
866.1 	spent for each purpose are specified in the 
866.2 	following subdivisions.

866.3
866.4	Subd. 2.Board of Behavioral Health and 
Therapy
 		877,000
		875,000

866.5	Subd. 3.Board of Chiropractic Examiners
 		666,000
		666,000

866.6	Subd. 4.Board of Dentistry
 		4,228,000
		3,753,000
	
866.7 	(a) Administrative Services Unit - Operating 
866.8 	Costs. Of this appropriation, $2,738,000 in 
866.9 	fiscal year 2022 and $2,263,000 in fiscal year 
866.10 	2023 are for operating costs of the 
866.11 	administrative services unit. The 
866.12 	administrative services unit may receive and 
866.13 	expend reimbursements for services it 
866.14 	performs for other agencies.
866.15 	(b) Administrative Services Unit - Volunteer 
866.16 	Health Care Provider Program. Of this 
866.17 	appropriation, $150,000 in fiscal year 2022 
866.18 	and $150,000 in fiscal year 2023 are to pay 
866.19 	for medical professional liability coverage 
866.20 	required under Minnesota Statutes, section 
866.21 	214.40.
866.22 	(c) Administrative Services Unit - 
866.23 	Retirement Costs. Of this appropriation, 
866.24 	$475,000 in fiscal year 2022 is a onetime 
866.25 	appropriation to the administrative services 
866.26 	unit to pay for the retirement costs of 
866.27 	health-related board employees. This funding 
866.28 	may be transferred to the health board 
866.29 	incurring retirement costs. Any board that has 
866.30 	an unexpended balance for an amount 
866.31 	transferred under this paragraph shall transfer 
866.32 	the unexpended amount to the administrative 
866.33 	services unit. These funds are available either 
866.34 	year of the biennium.
867.1 	(d) Administrative Services Unit - Contested 
867.2 	Cases and Other Legal Proceedings. Of this 
867.3 	appropriation, $200,000 in fiscal year 2022 
867.4 	and $200,000 in fiscal year 2023 are for costs 
867.5 	of contested case hearings and other 
867.6 	unanticipated costs of legal proceedings 
867.7 	involving health-related boards funded under 
867.8 	this section. Upon certification by a 
867.9 	health-related board to the administrative 
867.10 	services unit that costs will be incurred and 
867.11 	that there is insufficient money available to 
867.12 	pay for the costs out of money currently 
867.13 	available to that board, the administrative 
867.14 	services unit is authorized to transfer money 
867.15 	from this appropriation to the board for 
867.16 	payment of those costs with the approval of 
867.17 	the commissioner of management and budget. 
867.18 	The commissioner of management and budget 
867.19 	must require any board that has an unexpended 
867.20 	balance for an amount transferred under this 
867.21 	paragraph to transfer the unexpended amount 
867.22 	to the administrative services unit to be 
867.23 	deposited in the state government special 
867.24 	revenue fund.

867.25
867.26	Subd. 5.Board of Dietetics and Nutrition 
Practice
 		164,000
		164,000

867.27
867.28	Subd. 6.Board of Executives for Long Term 
Services and Supports
 		693,000
		635,000

867.29	Subd. 7.Board of Marriage and Family Therapy
 		413,000
		410,000

867.30	Subd. 8.Board of Medical Practice
 		5,912,000
		5,868,000
	
867.31 	Health Professional Services Program. This 
867.32 	appropriation includes $1,002,000 in fiscal 
867.33 	year 2022 and $1,002,000 in fiscal year 2023 
867.34 	for the health professional services program.

867.35	Subd. 9.Board of Nursing
 		5,345,000
		5,355,000

868.1
868.2	Subd. 10.Board of Occupational Therapy 
Practice
 		456,000
		456,000

868.3	Subd. 11.Board of Optometry
 		238,000
		238,000

868.4	Subd. 12.Board of Pharmacy
 		4,479,000
		4,479,000

868.5	Appropriations by Fund
	
868.6
868.7	State Government 
Special Revenue
	4,403,000
	4,403,000
	
868.8	Health Care Access
	76,000
	76,000
	
868.9 	Base Level Adjustment. The health care 
868.10 	access fund base is $76,000 in fiscal year 
868.11 	2024, $38,000 in fiscal year 2025, and $0 in 
868.12 	fiscal year 2026.

868.13	Subd. 13.Board of Physical Therapy
 		564,000
		564,000

868.14	Subd. 14.Board of Podiatric Medicine
 		214,000
		214,000

868.15	Subd. 15.Board of Psychology
 		1,362,000
		1,360,000

868.16	Subd. 16.Board of Social Work
 		1,561,000
		1,560,000

868.17	Subd. 17.Board of Veterinary Medicine
 		363,000
		363,000

868.18
868.19	Sec. 5. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	4,453,000
	$
	3,829,000
	
868.20 	(a) Cooper/Sams Volunteer Ambulance 
868.21 	Program. $950,000 in fiscal year 2022 and 
868.22 	$950,000 in fiscal year 2023 are for the 
868.23 	Cooper/Sams volunteer ambulance program 
868.24 	under Minnesota Statutes, section 144E.40.
868.25 	(1) Of this amount, $861,000 in fiscal year 
868.26 	2022 and $861,000 in fiscal year 2023 are for 
868.27 	the ambulance service personnel longevity 
868.28 	award and incentive program under Minnesota 
868.29 	Statutes, section 144E.40.
868.30 	(2) Of this amount, $89,000 in fiscal year 2022 
868.31 	and $89,000 in fiscal year 2023 are for the 
868.32 	operations of the ambulance service personnel 
869.1 	longevity award and incentive program under 
869.2 	Minnesota Statutes, section 144E.40.
869.3 	(b) EMSRB Operations. $1,880,000 in fiscal 
869.4 	year 2022 and $1,880,000 in fiscal year 2023 
869.5 	are for board operations.
869.6 	(c) Regional Grants. $1,235,000 in fiscal year 
869.7 	2022 and $585,000 in fiscal year 2023 are for 
869.8 	regional emergency medical services 
869.9 	programs, to be distributed equally to the eight 
869.10 	emergency medical service regions under 
869.11 	Minnesota Statutes, section 144E.52.
869.12 	(d) Ambulance Training Grants. $361,000 
869.13 	in fiscal year 2022 and $361,000 in fiscal year 
869.14 	2023 are for training grants under Minnesota 
869.15 	Statutes, section 144E.35.

869.16	Sec. 6. COUNCIL ON DISABILITY
 	$
	1,022,000
	$
	1,038,000

869.17
869.18
869.19	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	2,487,000
	$
	2,536,000
	
869.20 	Department of Psychiatry Monitoring.
869.21 	$100,000 in fiscal year 2022 and $100,000 in 
869.22 	fiscal year 2023 are for monitoring the 
869.23 	Department of Psychiatry at the University of 
869.24 	Minnesota.

869.25	Sec. 8. OMBUDSPERSONS FOR FAMILIES
 	$
	733,000
	$
	744,000

869.26	Sec. 9. ATTORNEY GENERAL
 	$
	200,000
	$
	200,000
	
869.27 	Excessive Drug Price Increases. This 
869.28 	appropriation is for costs of expert witnesses 
869.29 	and investigations under Minnesota Statutes, 
869.30 	section 62J.844. This is a onetime 
869.31 	appropriation.

870.1 	Sec. 10. Laws 2019, First Special Session chapter 9, article 14, section 3, as amended by 
870.2 	Laws 2019, First Special Session chapter 12, section 6, is amended to read:

870.3	Sec. 3. COMMISSIONER OF HEALTH

870.5870.4
	Subdivision 1.Total Appropriation
 	$
	231,829,000
	$
	236,188,000
233,584,000

870.6	Appropriations by Fund
	
870.7		2020
	2021
	
870.9870.8
	General
	124,381,000
	126,276,000
125,881,000
	
870.10
870.11	State Government 
Special Revenue
	58,450,000
	61,367,000
59,158,000
	
870.12	Health Care Access
	37,285,000
	36,832,000
	
870.13	Federal TANF
	11,713,000
	11,713,000
	
870.14 	The amounts that may be spent for each 
870.15 	purpose are specified in the following 
870.16 	subdivisions.

870.17	Subd. 2.Health Improvement

870.18	Appropriations by Fund
	
870.20870.19
	General
	94,980,000
	96,117,000
95,722,000
	
870.21
870.22	State Government 
Special Revenue
	7,614,000
	7,558,000
6,924,000
	
870.23	Health Care Access
	37,285,000
	36,832,000
	
870.24	Federal TANF
	11,713,000
	11,713,000
	
870.25 	(a) TANF Appropriations. (1) $3,579,000 in 
870.26 	fiscal year 2020 and $3,579,000 in fiscal year 
870.27 	2021 are from the TANF fund for home 
870.28 	visiting and nutritional services under 
870.29 	Minnesota Statutes, section 145.882, 
870.30 	subdivision 7, clauses (6) and (7). Funds must 
870.31 	be distributed to community health boards 
870.32 	according to Minnesota Statutes, section 
870.33 	145A.131, subdivision 1;
870.34 	(2) $2,000,000 in fiscal year 2020 and 
870.35 	$2,000,000 in fiscal year 2021 are from the 
870.36 	TANF fund for decreasing racial and ethnic 
871.1 	disparities in infant mortality rates under 
871.2 	Minnesota Statutes, section 145.928, 
871.3 	subdivision 7;
871.4 	(3) $4,978,000 in fiscal year 2020 and 
871.5 	$4,978,000 in fiscal year 2021 are from the 
871.6 	TANF fund for the family home visiting grant 
871.7 	program under Minnesota Statutes, section 
871.8 	145A.17. $4,000,000 of the funding in each 
871.9 	fiscal year must be distributed to community 
871.10 	health boards according to Minnesota Statutes, 
871.11 	section 145A.131, subdivision 1. $978,000 of 
871.12 	the funding in each fiscal year must be 
871.13 	distributed to tribal governments according to 
871.14 	Minnesota Statutes, section 145A.14, 
871.15 	subdivision 2a;
871.16 	(4) $1,156,000 in fiscal year 2020 and 
871.17 	$1,156,000 in fiscal year 2021 are from the 
871.18 	TANF fund for family planning grants under 
871.19 	Minnesota Statutes, section 145.925; and
871.20 	(5) The commissioner may use up to 6.23 
871.21 	percent of the amounts appropriated from the 
871.22 	TANF fund each year to conduct the ongoing 
871.23 	evaluations required under Minnesota Statutes, 
871.24 	section 145A.17, subdivision 7, and training 
871.25 	and technical assistance as required under 
871.26 	Minnesota Statutes, section 145A.17, 
871.27 	subdivisions 4 and 5.
871.28 	(b) TANF Carryforward. Any unexpended 
871.29 	balance of the TANF appropriation in the first 
871.30 	year of the biennium does not cancel but is 
871.31 	available for the second year.
871.32 	(c) Comprehensive Suicide Prevention.
871.33 	$2,730,000 in fiscal year 2020 and $2,730,000 
871.34 	in fiscal year 2021 are from the general fund 
872.1 	for a comprehensive, community-based suicide 
872.2 	prevention strategy. The funds are allocated 
872.3 	as follows:
872.4 	(1) $955,000 in fiscal year 2020 and $955,000 
872.5 	in fiscal year 2021 are for community-based 
872.6 	suicide prevention grants authorized in 
872.7 	Minnesota Statutes, section 145.56, 
872.8 	subdivision 2. Specific emphasis must be 
872.9 	placed on those communities with the greatest 
872.10 	disparities. The base for this appropriation is 
872.11 	$1,291,000 in fiscal year 2022 and $1,291,000 
872.12 	in fiscal year 2023;
872.13 	(2) $683,000 in fiscal year 2020 and $683,000 
872.14 	in fiscal year 2021 are to support 
872.15 	evidence-based training for educators and 
872.16 	school staff and purchase suicide prevention 
872.17 	curriculum for student use statewide, as 
872.18 	authorized in Minnesota Statutes, section 
872.19 	145.56, subdivision 2. The base for this 
872.20 	appropriation is $913,000 in fiscal year 2022 
872.21 	and $913,000 in fiscal year 2023;
872.22 	(3) $137,000 in fiscal year 2020 and $137,000 
872.23 	in fiscal year 2021 are to implement the Zero 
872.24 	Suicide framework with up to 20 behavioral 
872.25 	and health care organizations each year to treat 
872.26 	individuals at risk for suicide and support 
872.27 	those individuals across systems of care upon 
872.28 	discharge. The base for this appropriation is 
872.29 	$205,000 in fiscal year 2022 and $205,000 in 
872.30 	fiscal year 2023;
872.31 	(4) $955,000 in fiscal year 2020 and $955,000 
872.32 	in fiscal year 2021 are to develop and fund a 
872.33 	Minnesota-based network of National Suicide 
872.34 	Prevention Lifeline, providing statewide 
872.35 	coverage. The base for this appropriation is 
873.1 	$1,321,000 in fiscal year 2022 and $1,321,000 
873.2 	in fiscal year 2023; and
873.3 	(5) the commissioner may retain up to 18.23 
873.4 	percent of the appropriation under this 
873.5 	paragraph to administer the comprehensive 
873.6 	suicide prevention strategy.
873.7 	(d) Statewide Tobacco Cessation. $1,598,000 
873.8 	in fiscal year 2020 and $2,748,000 in fiscal 
873.9 	year 2021 are from the general fund for 
873.10 	statewide tobacco cessation services under 
873.11 	Minnesota Statutes, section 144.397. The base 
873.12 	for this appropriation is $2,878,000 in fiscal 
873.13 	year 2022 and $2,878,000 in fiscal year 2023.
873.14 	(e) Health Care Access Survey. $225,000 in 
873.15 	fiscal year 2020 and $225,000 in fiscal year 
873.16 	2021 are from the health care access fund to 
873.17 	continue and improve the Minnesota Health 
873.18 	Care Access Survey. These appropriations 
873.19 	may be used in either year of the biennium.
873.20 	(f) Community Solutions for Healthy Child 
873.21 	Development Grant Program. $1,000,000 
873.22 	in fiscal year 2020 and $1,000,000 in fiscal 
873.23 	year 2021 are for the community solutions for 
873.24 	healthy child development grant program to 
873.25 	promote health and racial equity for young 
873.26 	children and their families under article 11, 
873.27 	section 107. The commissioner may use up to 
873.28 	23.5 percent of the total appropriation for 
873.29 	administration. The base for this appropriation 
873.30 	is $1,000,000 in fiscal year 2022, $1,000,000 
873.31 	in fiscal year 2023, and $0 in fiscal year 2024.
873.32 	(g) Domestic Violence and Sexual Assault 
873.33 	Prevention Program. $375,000 in fiscal year 
873.34 	2020 and $375,000 in fiscal year 2021 are 
874.1 	from the general fund for the domestic 
874.2 	violence and sexual assault prevention 
874.3 	program under article 11, section 108. This is 
874.4 	a onetime appropriation.
874.5 	(h) Skin Lightening Products Public 
874.6 	Awareness Grant Program. $100,000 in 
874.7 	fiscal year 2020 and $100,000 in fiscal year 
874.8 	2021 are from the general fund for a skin 
874.9 	lightening products public awareness and 
874.10 	education grant program. This is a onetime 
874.11 	appropriation.
874.12 	(i) Cannabinoid Products Workgroup.
874.13 	$8,000 in fiscal year 2020 is from the state 
874.14 	government special revenue fund for the 
874.15 	cannabinoid products workgroup. This is a 
874.16 	onetime appropriation.
874.17 	(j) Base Level Adjustments. The general fund 
874.18 	base is $96,742,000 in fiscal year 2022 and 
874.19 	$96,742,000 in fiscal year 2023. The health 
874.20 	care access fund base is $37,432,000 in fiscal 
874.21 	year 2022 and $36,832,000 in fiscal year 2023.

874.22	Subd. 3.Health Protection

874.23	Appropriations by Fund
	
874.24	General
	18,803,000
	19,774,000
	
874.25
874.26	State Government 
Special Revenue
	50,836,000
	53,809,000
52,234,000
	
874.27 	(a) Public Health Laboratory Equipment.
874.28 	$840,000 in fiscal year 2020 and $655,000 in 
874.29 	fiscal year 2021 are from the general fund for 
874.30 	equipment for the public health laboratory. 
874.31 	This is a onetime appropriation and is 
874.32 	available until June 30, 2023.
874.33 	(b) Base Level Adjustment. The general fund 
874.34 	base is $19,119,000 in fiscal year 2022 and 
875.1 	$19,119,000 in fiscal year 2023. The state 
875.2 	government special revenue fund base is 
875.3 	$53,782,000 in fiscal year 2022 and 
875.4 	$53,782,000 in fiscal year 2023.

875.5	Subd. 4.Health Operations
 		10,598,000
		10,385,000
	
875.6 	Base Level Adjustment. The general fund 
875.7 	base is $10,912,000 in fiscal year 2022 and 
875.8 	$10,912,000 in fiscal year 2023.

875.9 	EFFECTIVE DATE. This section is effective the day following final enactment and 
875.10 	the reductions in subdivisions 1 to 3 are onetime reductions.

875.11 	Sec. 11. APPROPRIATION; MINNESOTA FAMILY INVESTMENT PROGRAM 
875.12 	SUPPLEMENTAL PAYMENT.
 875.13 	$24,235,000 in fiscal year 2021 is appropriated from the TANF fund to the commissioner 
875.14 	of human services to provide a onetime cash benefit of up to $750 for each household 
875.15 	enrolled in the Minnesota family investment program or diversionary work program under 
875.16 	Minnesota Statutes, chapter 256J, at the time that the cash benefit is distributed. The 
875.17 	commissioner shall distribute these funds through existing systems and in a manner that 
875.18 	minimizes the burden to families. This is a onetime appropriation.

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

875.20 	Sec. 12. APPROPRIATION; REFINANCING OF EMERGENCY CHILD CARE 
875.21 	GRANTS; CANCELLATION.
 875.22 	$26,622,626 in fiscal year 2021 is appropriated from the coronavirus relief federal fund 
875.23 	to the commissioner of human services for fiscal year 2020 to replace a portion of the general 
875.24 	fund appropriation in Laws 2020, chapter 71, article 1, section 2, subdivision 9. The general 
875.25 	fund appropriation that is replaced by coronavirus relief funds under this section is canceled 
875.26 	to the general fund. This is a onetime appropriation.

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

876.1 	Sec. 13. CANCELLATION; TRANSFER FROM STATE GOVERNMENT SPECIAL 
876.2 	REVENUE FUND TO GENERAL FUND.
 876.3 	The $77,000 transfer each year from the state government special revenue fund to the 
876.4 	general fund under Laws 2008, chapter 364, section 17, paragraph (b), is canceled. This 
876.5 	section does not expire.

876.6 	EFFECTIVE DATE. This section is effective June 30, 2021.

876.7 	Sec. 14. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; CHILD 
876.8 	CARE AND DEVELOPMENT BLOCK GRANT ALLOCATION.
 876.9 	(a) The commissioner of human services shall allocate $212,400,000 from the child care 
876.10 	and development block grant amount in the federal fund as follows:
876.11 	(1) $1,435,000 for the quality rating and improvement system's evaluation and equity 
876.12 	report under Minnesota Statutes, section 124D.142, subdivisions 3 and 4; and
876.13 	(2) the remaining amount to reprioritize the basic sliding fee program waiting list under 
876.14 	Minnesota Statutes, section 119B.03, to increase child care assistance rates for legal, 
876.15 	nonlicensed family child care providers under Minnesota Statutes, section 119B.13, 
876.16 	subdivision 1a, and to increase child care assistance rates under Minnesota Statutes, section 
876.17 	119B.13, subdivision 1, paragraph (a), to the 50th percentile of the most recent market rate 
876.18 	survey. The commissioner may not increase the rate differential percentage established 
876.19 	under Minnesota Statutes, section 119B.13, subdivision 3a or 3b.
876.20 	(b) Each year, an amount equal to at least 88 percent of the federal discretionary funding 
876.21 	in the Child Care and Development Block Grant of 2014, Public Law 113-186, in federal 
876.22 	fiscal year 2018 above the amounts authorized in federal fiscal year 2017, not to exceed the 
876.23 	cost of rate adjustments, shall be allocated to pay the cost of rate adjustments based on the 
876.24 	most recent market survey.
876.25 	(c) When increased federal discretionary child care and development block grant funding 
876.26 	is used to pay for the rate increase under paragraph (a), the commissioner, in consultation 
876.27 	with the commissioner of management and budget, may adjust the amount of working family 
876.28 	credit expenditures as needed to meet the state's maintenance of effort requirements for the 
876.29 	TANF block grant.

877.1 	Sec. 15. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; CHILD 
877.2 	CARE STABILIZATION.
 877.3 	The commissioner shall allocate $325,000,000 from the child care and development 
877.4 	block grant amount in the federal fund for the following purposes:
877.5 	(1) $1,500,000 for the Children's Cabinet to conduct an evaluation of the use of federal 
877.6 	money on early care and learning programs;
877.7 	(2) $500,000 to award grants to community-based organizations working with family, 
877.8 	friend, and neighbor caregivers, with a particular emphasis on such caregivers serving 
877.9 	children from low-income families, families of color, Tribal communities, or families with 
877.10 	limited English language proficiency, to promote healthy development, social-emotional 
877.11 	learning, early literacy, and school readiness;
877.12 	(3) $100,000 for a grant program to test strategies by which family child care providers 
877.13 	could share services;
877.14 	(4) $500,000 for competitive grants to expand access to child care for children with 
877.15 	disabilities;
877.16 	(5) $5,000,000 for child care improvement grants under Minnesota Statutes, section 
877.17 	119B.25;
877.18 	(6) $5,000,000 for administering the monthly grants under clause (7); and
877.19 	(7) the remaining amount to award monthly grants, between July 1, 2021, and June 30, 
877.20 	2023, to providers of early care and education to support the stability of the sector with 
877.21 	providers required to direct 75 percent of such grants to employees or other individuals 
877.22 	providing early care and education services.

877.23 	Sec. 16. FEDERAL FUNDS FOR VACCINE ACTIVITIES; APPROPRIATION.
 877.24 	Federal funds made available to the commissioner of health for vaccine activities are 
877.25 	appropriated to the commissioner for that purpose and shall be used to support work under 
877.26 	Minnesota Statutes, sections 144.067 to 144.069.

877.27 	Sec. 17. FEDERAL FUNDS REPLACEMENT; APPROPRIATION.
 877.28 	Notwithstanding any law to the contrary, the commissioner of management and budget 
877.29 	must determine whether the expenditures authorized under this act are eligible uses of federal 
877.30 	funding received under the Coronavirus State Fiscal Recovery Fund or any other federal 
877.31 	funds received by the state under the American Rescue Plan Act, Public Law 117-2. If the 
878.1 	commissioner of management and budget determines an expenditure is eligible for funding 
878.2 	under Public Law 117-2, the amount of the eligible expenditure is appropriated from the 
878.3 	account where those amounts have been deposited and the corresponding general fund 
878.4 	amounts appropriated under this act are canceled to the general fund.

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

878.6 	Sec. 18. TRANSFERS; HUMAN SERVICES.
 878.7 		Subdivision 1.Grants. The commissioner of human services, with the approval of the 
878.8 	commissioner of management and budget, may transfer unencumbered appropriation balances 
878.9 	for the biennium ending June 30, 2023, within fiscal years among the MFIP, general 
878.10 	assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota 
878.11 	Statutes, section 119B.05, Minnesota supplemental aid program, group residential housing 
878.12 	program, the entitlement portion of Northstar Care for Children under Minnesota Statutes, 
878.13 	chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment 
878.14 	fund, and between fiscal years of the biennium. The commissioner shall inform the chairs 
878.15 	and ranking minority members of the senate Health and Human Services Finance Division 
878.16 	and the house of representatives Health Finance and Policy Committee and Human Services 
878.17 	Finance and Policy Committee quarterly about transfers made under this subdivision.
878.18 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
878.19 	may be transferred within the Department of Human Services as the commissioners consider 
878.20 	necessary, with the advance approval of the commissioner of management and budget. The 
878.21 	commissioner shall inform the chairs and ranking minority members of the senate Health 
878.22 	and Human Services Finance Division and the house of representatives Health Finance and 
878.23 	Policy Committee and Human Services Finance and Policy Committee quarterly about 
878.24 	transfers made under this subdivision.

878.25 	Sec. 19. TRANSFERS; HEALTH.
 878.26 	Positions, salary money, and nonsalary administrative money may be transferred within 
878.27 	the Department of Health as the commissioner considers necessary, with the advance 
878.28 	approval of the commissioner of management and budget. The commissioner shall inform 
878.29 	the chairs and ranking minority members of the legislative committees with jurisdiction 
878.30 	over health and human services finance quarterly about transfers made under this section.

879.1 	Sec. 20. INDIRECT COSTS NOT TO FUND PROGRAMS.
 879.2 	The commissioners of health and human services shall not use indirect cost allocations 
879.3 	to pay for the operational costs of any program for which they are responsible.

879.4 	Sec. 21. APPROPRIATION ENACTED MORE THAN ONCE.
 879.5 	If an appropriation in this act is enacted more than once in the 2021 legislative session, 
879.6 	the appropriation must be given effect only once.

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

879.8 	Sec. 22. EXPIRATION OF UNCODIFIED LANGUAGE.
 879.9 	All uncodified language contained in this article expires on June 30, 2023, unless a 
879.10 	different expiration date is explicit.

879.11 	Sec. 23. REPEALER.
 879.12 	Minnesota Statutes 2020, section 16A.724, subdivision 2, is repealed effective June 30, 
879.13 	2025.

879.14 	Sec. 24. EFFECTIVE DATE.
 879.15 	This article is effective July 1, 2021, unless a different effective date is specified.

APPENDIX 

Repealed Minnesota Statutes: H2128-2 

16A.724 HEALTH CARE ACCESS FUND.Subd. 2.Transfers. 
(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under section 256B.04, subdivision 25. 

(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures. 

62A.67 SHORT TITLE.
Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act." 

62A.671 DEFINITIONS.Subdivision 1.Applicability. 
For purposes of sections 62A.67 to 62A.672, the terms defined in this section have the meanings given. 

Subd. 2.Distant site. 
"Distant site" means a site at which a licensed health care provider is located while providing health care services or consultations by means of telemedicine. 

Subd. 3.Health care provider. 
"Health care provider" has the meaning provided in section 62A.63, subdivision 2. 

Subd. 4.Health carrier. 
"Health carrier" has the meaning provided in section 62A.011, subdivision 2. 

Subd. 5.Health plan. 
"Health plan" means a health plan as defined in section 62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental plans that provide indemnity-based benefits, regardless of expenses incurred and are designed to pay benefits directly to the policyholder. 

Subd. 6.Licensed health care provider. 
"Licensed health care provider" means a health care provider who is: 

(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and 

(2) authorized within their respective scope of practice to provide the particular service with no supervision or under general supervision. 

Subd. 7.Originating site. 
"Originating site" means a site including, but not limited to, a health care facility at which a patient is located at the time health care services are provided to the patient by means of telemedicine. 

Subd. 8.Store-and-forward technology. 
"Store-and-forward technology" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site without the patient being present, or the delivery of telemedicine that does not occur in real time via synchronous transmissions. 

Subd. 9.Telemedicine. 
"Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. A communication between a licensed health care provider and a patient that consists solely of an e-mail or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care. 

62A.672 COVERAGE OF TELEMEDICINE SERVICES.Subdivision 1.Coverage of telemedicine. 
(a) A health plan sold, issued, or renewed by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall include coverage for telemedicine benefits in the same manner as any other benefits covered under the policy, plan, or contract, and shall comply with the regulations of this section. 

(b) Nothing in this section shall be construed to: 

(1) require a health carrier to provide coverage for services that are not medically necessary; 

(2) prohibit a health carrier from establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service via telemedicine for which the health carrier does not already reimburse other health care providers for delivering via telemedicine, so long as the criteria are not unduly burdensome or unreasonable for the particular service; or 

(3) prevent a health carrier from requiring a health care provider to agree to certain documentation or billing practices designed to protect the health carrier or patients from fraudulent claims so long as the practices are not unduly burdensome or unreasonable for the particular service. 

Subd. 2.Parity between telemedicine and in-person services. 
A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient. 

Subd. 3.Reimbursement for telemedicine services. 
(a) A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider. 

(b) It is not a violation of this subdivision for a health carrier to include a deductible, co-payment, or coinsurance requirement for a health care service provided via telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact. 

62J.63 CENTER FOR HEALTH CARE PURCHASING IMPROVEMENT.Subd. 3.Report. 
The commissioner of health must report annually to the legislature and the governor on the operations, activities, and impacts of the center. The report must be posted on the Department of Health website and must be available to the public. The report must include a description of the state's efforts to develop and use more common strategies for health care performance measurement and health care purchasing. The report must also include an assessment of the impacts of these efforts, especially in promoting greater transparency of health care costs and quality, and greater accountability for health care results and improvement. 

119B.04 FEDERAL CHILD CARE AND DEVELOPMENT FUND.Subdivision 1.Commissioner to administer program. 
The commissioner is authorized and directed to receive, administer, and expend funds available under the child care and development fund under Public Law 104-193, Title VI. 

Subd. 2.Rulemaking authority. 
The commissioner may adopt rules under chapter 14 to administer the child care and development fund. 

119B.125 PROVIDER REQUIREMENTS.Subd. 5.Provisional payment. 
After a county receives a completed application from a provider, the county may issue provisional authorization and payment to the provider during the time needed to determine whether to give final authorization to the provider. 

144.0721 ASSESSMENTS OF CARE AND SERVICES TO NURSING HOME RESIDENTS.Subdivision 1.Appropriateness and quality. 
Until the date of implementation of the revised case mix system based on the minimum data set, the commissioner of health shall assess the appropriateness and quality of care and services furnished to private paying residents in nursing homes and boarding care homes that are certified for participation in the medical assistance program under United States Code, title 42, sections 1396-1396p. These assessments shall be conducted until the date of implementation of the revised case mix system with the exception of provisions requiring recommendations for changes in the level of care provided to the private paying residents. 

144.0722 RESIDENT REIMBURSEMENT CLASSIFICATIONS.Subdivision 1.Resident reimbursement classifications. 
The commissioner of health shall establish resident reimbursement classifications based upon the assessments of residents of nursing homes and boarding care homes conducted under section 144.0721, or under rules established by the commissioner of human services under chapter 256R. The reimbursement classifications established by the commissioner must conform to the rules established by the commissioner of human services. 

Subd. 2.Notice of resident reimbursement classification. 
The commissioner of health shall notify each resident, and the nursing home or boarding care home in which the resident resides, of the reimbursement classification established under subdivision 1. The notice must inform the resident of the classification that was assigned, the opportunity to review the documentation supporting the classification, the opportunity to obtain clarification from the commissioner, and the opportunity to request a reconsideration of the classification. The notice of resident classification must be sent by first-class mail. The individual resident notices may be sent to the resident's nursing home or boarding care home for distribution to the resident. The nursing home or boarding care home is responsible for the distribution of the notice to each resident, to the person responsible for the payment of the resident's nursing home expenses, or to another person designated by the resident. This notice must be distributed within three working days after the facility's receipt of the notices from the department. 

Subd. 2a.Semiannual assessment by nursing facilities. 
Notwithstanding Minnesota Rules, part 9549.0059, subpart 2, item B, the individual dependencies items 21 to 24 and 28 are required to be completed in accordance with the Facility Manual for Completing Case Mix Requests for Classification, July 1987, issued by the Minnesota Department of Health. 

Subd. 3.Request for reconsideration. 
The resident or the nursing home or boarding care home may request that the commissioner reconsider the assigned reimbursement classification. The request for reconsideration must be submitted in writing to the commissioner within 30 days of the receipt of the notice of resident classification. For reconsideration requests submitted by or on behalf of the resident, the time period for submission of the request begins as of the date the resident or the resident's representative receives the classification notice. The request for reconsideration must include the name of the resident, the name and address of the facility in which the resident resides, the reasons for the reconsideration, the requested classification changes, and documentation supporting the requested classification. The documentation accompanying the reconsideration request is limited to documentation establishing that the needs of the resident at the time of the assessment resulting in the disputed classification justify a change of classification. 

Subd. 3a.Access to information. 
Upon written request, the nursing home or boarding care home must give the resident or the resident's representative a copy of the assessment form and the other documentation that was given to the department to support the assessment findings. The nursing home or boarding care home shall also provide access to and a copy of other information from the resident's record that has been requested by or on behalf of the resident to support a resident's reconsideration request. A copy of any requested material must be provided within three working days of receipt of a written request for the information. If a facility fails to provide the material within this time, it is subject to the issuance of a correction order and penalty assessment under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order issued under this subdivision must require that the facility immediately comply with the request for information and that as of the date of the issuance of the correction order, the facility shall forfeit to the state a $100 fine the first day of noncompliance, and an increase in the $100 fine by $50 increments for each day the noncompliance continues. For the purposes of this section, "representative" includes the resident's guardian or conservator, the person authorized to pay the nursing home expenses of the resident, a representative of the nursing home ombudsman's office whose assistance has been requested, or any other individual designated by the resident. 

Subd. 3b.Facility's request for reconsideration. 
In addition to the information required in subdivision 3, a reconsideration request from a nursing home or boarding care home must contain the following information: the date the resident reimbursement classification notices were received by the facility; the date the classification notices were distributed to the resident or the resident's representative; and a copy of a notice sent to the resident or to the resident's representative. This notice must tell the resident or the resident's representative that a reconsideration of the resident's classification is being requested, the reason for the request, that the resident's rate will change if the request is approved by the department and the extent of the change, that copies of the facility's request and supporting documentation are available for review, and that the resident also has the right to request a reconsideration. If the facility fails to provide this information with the reconsideration request, the request must be denied, and the facility may not make further reconsideration requests on that specific reimbursement classification. 

Subd. 4.Reconsideration. 
The commissioner's reconsideration must be made by individuals not involved in reviewing the assessment that established the disputed classification. The reconsideration must be based upon the initial assessment and upon the information provided to the commissioner under subdivision 3. If necessary for evaluating the reconsideration request, the commissioner may conduct on-site reviews. In its discretion, the commissioner may review the reimbursement classifications assigned to all residents in the facility. Within 15 working days of receiving the request for reconsideration, the commissioner shall affirm or modify the original resident classification. The original classification must be modified if the commissioner determines that the assessment resulting in the classification did not accurately reflect the needs of the resident at the time of the assessment. The resident and the nursing home or boarding care home shall be notified within five working days after the decision is made. The commissioner's decision under this subdivision is the final administrative decision of the agency. 

Subd. 5.Audit authority. 
The Department of Health may audit assessments of nursing home and boarding care home residents. These audits may be in addition to the assessments completed by the department under section 144.0721. The audits may be conducted at the facility, and the department may conduct the audits on an unannounced basis. 

144.0724 RESIDENT REIMBURSEMENT CLASSIFICATION.Subd. 10.Transition. 
After implementation of this section, reconsiderations requested for classifications made under section 144.0722, subdivision 1, shall be determined under section 144.0722, subdivision 3. 

144.693 MEDICAL MALPRACTICE CLAIMS; REPORTS.Subdivision 1.Insurers' reports to commissioner. 
On or before September 1, 1976, and on or before March 1 and September 1 of each year thereafter, each insurer providing professional liability insurance to one or more hospitals, outpatient surgery centers, or health maintenance organizations, shall submit to the state commissioner of health a report listing by facility or organization all claims which have been closed by or filed with the insurer during the period ending December 31 of the previous year or June 30 of the current year. The report shall contain, but not be limited to, the following information: 

(1) the total number of claims made against each facility or organization which were filed or closed during the reporting period; 

(2) the date each new claim was filed with the insurer; 

(3) the allegations contained in each claim filed during the reporting period; 

(4) the disposition and closing date of each claim closed during the reporting period; 

(5) the dollar amount of the award or settlement for each claim closed during the reporting period; and 

(6) any other information the commissioner of health may, by rule, require. 

Any hospital, outpatient surgery center, or health maintenance organization which is self insured shall be considered to be an insurer for the purposes of this section and shall comply with the reporting provisions of this section. 

A report from an insurer submitted pursuant to this section is private data, as defined in section 13.02, subdivision 12, accessible to the facility or organization which is the subject of the data, and to its authorized agents. Any data relating to patient records which is reported to the state commissioner of health pursuant to this section shall be reported in the form of summary data, as defined in section 13.02, subdivision 19. 

Subd. 2.Report to legislature. 
The state commissioner of health shall collect and review the data reported pursuant to subdivision 1. On December 1, 1976, and on January 2 of each year thereafter, the state commissioner of health shall report to the legislature the findings related to the incidence and size of malpractice claims against hospitals, outpatient surgery centers, and health maintenance organizations, and shall make any appropriate recommendations to reduce the incidence and size of the claims. Data published by the state commissioner of health pursuant to this subdivision with respect to malpractice claims information shall be summary data within the meaning of section 13.02, subdivision 19. 

Subd. 3.Access to insurers' records. 
The state commissioner of health shall have access to the records of any insurer relating to malpractice claims made against hospitals, outpatient surgery centers, and health maintenance organizations in years prior to 1976 if the commissioner determines the records are necessary to fulfill the duties of the commissioner under Laws 1976, chapter 325. 

245.462 DEFINITIONS.Subd. 4a.Clinical supervision. 
"Clinical supervision" means the oversight responsibility for individual treatment plans and individual mental health service delivery, including that provided by the case manager. Clinical supervision must be accomplished by full or part-time employment of or contracts with mental health professionals. Clinical supervision must be documented by the mental health professional cosigning individual treatment plans and by entries in the client's record regarding supervisory activities. 

245.4871 DEFINITIONS.Subd. 32a.Responsible social services agency. 
"Responsible social services agency" is defined in section 260C.007, subdivision 27a. 

245.4879 EMERGENCY SERVICES.Subd. 2.Specific requirements. 
(a) The county board shall require that all service providers of emergency services to the child with an emotional disturbance provide immediate direct access to a mental health professional during regular business hours. For evenings, weekends, and holidays, the service may be by direct toll-free telephone access to a mental health professional, a mental health practitioner, or until January 1, 1991, a designated person with training in human services who receives clinical supervision from a mental health professional. 

(b) The commissioner may waive the requirement in paragraph (a) that the evening, weekend, and holiday service be provided by a mental health professional or mental health practitioner after January 1, 1991, if the county documents that: 

(1) mental health professionals or mental health practitioners are unavailable to provide this service; 

(2) services are provided by a designated person with training in human services who receives clinical supervision from a mental health professional; and 

(3) the service provider is not also the provider of fire and public safety emergency services. 

(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the evening, weekend, and holiday service not be provided by the provider of fire and public safety emergency services if: 

(1) every person who will be providing the first telephone contact has received at least eight hours of training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner; 

(2) every person who will be providing the first telephone contact will annually receive at least four hours of continued training on emergency mental health services reviewed by the state advisory council on mental health and then approved by the commissioner; 

(3) the local social service agency has provided public education about available emergency mental health services and can assure potential users of emergency services that their calls will be handled appropriately; 

(4) the local social service agency agrees to provide the commissioner with accurate data on the number of emergency mental health service calls received; 

(5) the local social service agency agrees to monitor the frequency and quality of emergency services; and 

(6) the local social service agency describes how it will comply with paragraph (d). 

(d) When emergency service during nonbusiness hours is provided by anyone other than a mental health professional, a mental health professional must be available on call for an emergency assessment and crisis intervention services, and must be available for at least telephone consultation within 30 minutes. 

245.62 COMMUNITY MENTAL HEALTH CENTER.Subd. 3.Clinical supervisor. 
All community mental health center services shall be provided under the clinical supervision of a licensed psychologist licensed under sections 148.88 to 148.98, or a physician who is board certified or eligible for board certification in psychiatry, and who is licensed under section 147.02. 

Subd. 4.Rules. 
The commissioner shall promulgate rules to establish standards for the designation of an agency as a community mental health center. These standards shall include, but are not limited to: 

(1) provision of mental health services in the prevention, identification, treatment and aftercare of emotional disorders, chronic and acute mental illness, developmental disabilities, and alcohol and drug abuse and dependency, including the services listed in section 245.61 except detoxification services; 

(2) establishment of a community mental health center board pursuant to section 245.66; and 

(3) approval pursuant to section 245.69, subdivision 2. 

245.69 ADDITIONAL DUTIES OF COMMISSIONER.Subd. 2.Approval of centers and clinics. 
The commissioner of human services has the authority to approve or disapprove public and private mental health centers and public and private mental health clinics for the purposes of section 62A.152, subdivision 2. For the purposes of this subdivision the commissioner shall promulgate rules in accordance with sections 14.001 to 14.69. The rules shall require each applicant to pay a fee to cover costs of processing applications and determining compliance with the rules and this subdivision. The commissioner may contract with any state agency, individual, corporation or association to which the commissioner shall delegate all but final approval and disapproval authority to determine compliance or noncompliance. 

(a) Each approved mental health center and each approved mental health clinic shall have a multidisciplinary team of professional staff persons as required by rule. A mental health center or mental health clinic may provide the staffing required by rule by means of written contracts with professional persons or with other health care providers. Any personnel qualifications developed by rule shall be consistent with any personnel standards developed pursuant to chapter 214. 

(b) Each approved mental health clinic and each approved mental health center shall establish a written treatment plan for each outpatient for whom services are reimbursable through insurance or public assistance. The treatment plan shall be developed in accordance with the rules and shall include a patient history, treatment goals, a statement of diagnosis and a treatment strategy. The clinic or center shall provide access to hospital admission as a bed patient as needed by any outpatient. The clinic or center shall ensure ongoing consultation among and availability of all members of the multidisciplinary team. 

(c) As part of the required consultation, members of the multidisciplinary team shall meet at least twice monthly to conduct case reviews, peer consultations, treatment plan development and in-depth case discussion. Written minutes of these meetings shall be kept at the clinic or center for three years. 

(d) Each approved center or clinic shall establish mechanisms for quality assurance and submit documentation concerning the mechanisms to the commissioner as required by rule, including: 

(1) continuing education of each professional staff person; 

(2) an ongoing internal utilization and peer review plan and procedures; 

(3) mechanisms of staff supervision; and 

(4) procedures for review by the commissioner or a delegate. 

(e) The commissioner shall disapprove an applicant, or withdraw approval of a clinic or center, which the commissioner finds does not comply with the requirements of the rules or this subdivision. A clinic or center which is disapproved or whose approval is withdrawn is entitled to a contested case hearing and judicial review pursuant to sections 14.01 to 14.69. 

(f) Data on individuals collected by approved clinics and centers, including written minutes of team meetings, is private data on individuals within the welfare system as provided in chapter 13. 

(g) Each center or clinic that is approved and in compliance with the commissioner's existing rule on July 1, 1980, is approved for purposes of section 62A.152, subdivision 2, until rules are promulgated to implement this section. 

245.735 EXCELLENCE IN MENTAL HEALTH DEMONSTRATION PROJECT.Subdivision 1.Excellence in Mental Health demonstration project. 
The commissioner shall develop and execute projects to reform the mental health system by participating in the Excellence in Mental Health demonstration project. 

Subd. 2.Federal proposal. 
The commissioner shall develop and submit to the United States Department of Health and Human Services a proposal for the Excellence in Mental Health demonstration project. The proposal shall include any necessary state plan amendments, waivers, requests for new funding, realignment of existing funding, and other authority necessary to implement the projects specified in subdivision 3. 

Subd. 4.Public participation. 
In developing and implementing CCBHCs under subdivision 3, the commissioner shall consult, collaborate, and partner with stakeholders, including but not limited to mental health providers, substance use disorder treatment providers, advocacy organizations, licensed mental health professionals, counties, tribes, hospitals, other health care providers, and Minnesota public health care program enrollees who receive mental health services and their families. 

245C.10 BACKGROUND STUDY; FEES.Subd. 2.Supplemental nursing services agencies. 
The commissioner shall recover the cost of the background studies initiated by supplemental nursing services agencies registered under section 144A.71, subdivision 1, through a fee of no more than $20 per study charged to the agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 2a.Occupations regulated by commissioner of health. 
The commissioner shall set fees to recover the cost of combined background studies and criminal background checks initiated by applicants, licensees, and certified practitioners regulated under sections 148.511 to 148.5198 and chapter 153A. The fees collected under this subdivision shall be deposited in the special revenue fund and are appropriated to the commissioner for the purpose of conducting background studies and criminal background checks. 

Subd. 3.Personal care provider organizations. 
The commissioner shall recover the cost of background studies initiated by a personal care provider organization under sections 256B.0651 to 256B.0654 and 256B.0659 through a fee of no more than $20 per study charged to the organization responsible for submitting the background study form. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 4.Temporary personnel agencies, educational programs, and professional services agencies. 
The commissioner shall recover the cost of the background studies initiated by temporary personnel agencies, educational programs, and professional services agencies that initiate background studies under section 245C.03, subdivision 4, through a fee of no more than $20 per study charged to the agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 5.Adult foster care and family adult day services. 
The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 1, for the purposes of adult foster care and family adult day services licensing, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 6.Unlicensed home and community-based waiver providers of service to seniors and individuals with disabilities. 
The commissioner shall recover the cost of background studies initiated by unlicensed home and community-based waiver providers of service to seniors and individuals with disabilities under section 256B.4912 through a fee of no more than $20 per study. 

Subd. 7.Private agencies. 
The commissioner shall recover the cost of conducting background studies under section 245C.33 for studies initiated by private agencies for the purpose of adoption through a fee of no more than $70 per study charged to the private agency. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 8.Children's therapeutic services and supports providers. 
The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 7, for the purposes of children's therapeutic services and supports under section 256B.0943, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 9.Human services licensed programs. 
The commissioner shall recover the cost of background studies required under section 245C.03, subdivision 1, for all programs that are licensed by the commissioner, except child foster care when the applicant or license holder resides in the home where child foster care services are provided, family child care, child care centers, certified license-exempt child care centers, and legal nonlicensed child care authorized under chapter 119B, through a fee of no more than $20 per study charged to the license holder. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 9a.Child care programs. 
The commissioner shall recover the cost of a background study required for family child care, certified license-exempt child care centers, licensed child care centers, and legal nonlicensed child care providers authorized under chapter 119B through a fee of no more than $40 per study charged to the license holder. A fee of no more than $20 per study shall be charged for studies conducted under section 245C.05, subdivision 5a, paragraph (a). The fees collected under this subdivision are appropriated to the commissioner to conduct background studies. 

Subd. 10.Community first services and supports organizations. 
The commissioner shall recover the cost of background studies initiated by an agency-provider delivering services under section 256B.85, subdivision 11, or a financial management services provider providing service functions under section 256B.85, subdivision 13, through a fee of no more than $20 per study, charged to the organization responsible for submitting the background study form. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 11.Providers of housing support. 
The commissioner shall recover the cost of background studies initiated by providers of housing support under section 256I.04 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 12.Child protection workers or social services staff having responsibility for child protective duties. 
The commissioner shall recover the cost of background studies initiated by county social services agencies and local welfare agencies for individuals who are required to have a background study under section 626.559, subdivision 1b, through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 13.Providers of special transportation service. 
The commissioner shall recover the cost of background studies initiated by providers of special transportation service under section 174.30 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

Subd. 14.Children's residential facilities. 
The commissioner shall recover the cost of background studies initiated by a licensed children's residential facility through a fee of no more than $51 per study. Fees collected under this subdivision are appropriated to the commissioner for purposes of conducting background studies. 

Subd. 16.Providers of housing support services. 
The commissioner shall recover the cost of background studies initiated by providers of housing support services under section 256B.051 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. 

256B.0596 MENTAL HEALTH CASE MANAGEMENT.256B.0596 MENTAL HEALTH CASE MANAGEMENT.
Counties shall contract with eligible providers willing to provide mental health case management services under section 256B.0625, subdivision 20. In order to be eligible, in addition to general provider requirements under this chapter, the provider must: 

(1) be willing to provide the mental health case management services; and 

(2) have a minimum of at least one contact with the client per week. This section is not intended to limit the ability of a county to provide its own mental health case management services. 

256B.0596 MENTAL HEALTH CASE MANAGEMENT.
Counties shall contract with eligible providers willing to provide mental health case management services under section 256B.0625, subdivision 20. In order to be eligible, in addition to general provider requirements under this chapter, the provider must: 

(1) be willing to provide the mental health case management services; and 

(2) have a minimum of at least one contact with the client per week. This section is not intended to limit the ability of a county to provide its own mental health case management services. 

256B.0615 MENTAL HEALTH CERTIFIED PEER SPECIALIST.Subd. 2.Establishment. 
The commissioner of human services shall establish a certified peer specialist program model, which: 

(1) provides nonclinical peer support counseling by certified peer specialists; 

(2) provides a part of a wraparound continuum of services in conjunction with other community mental health services; 

(3) is individualized to the consumer; and 

(4) promotes socialization, recovery, self-sufficiency, self-advocacy, development of natural supports, and maintenance of skills learned in other support services. 

256B.0616 MENTAL HEALTH CERTIFIED FAMILY PEER SPECIALIST.Subd. 2.Establishment. 
The commissioner of human services shall establish a certified family peer specialists program model which: 

(1) provides nonclinical family peer support counseling, building on the strengths of families and helping them achieve desired outcomes; 

(2) collaborates with others providing care or support to the family; 

(3) provides nonadversarial advocacy; 

(4) promotes the individual family culture in the treatment milieu; 

(5) links parents to other parents in the community; 

(6) offers support and encouragement; 

(7) assists parents in developing coping mechanisms and problem-solving skills; 

(8) promotes resiliency, self-advocacy, development of natural supports, and maintenance of skills learned in other support services; 

(9) establishes and provides peer-led parent support groups; and 

(10) increases the child's ability to function better within the child's home, school, and community by educating parents on community resources, assisting with problem solving, and educating parents on mental illnesses. 

256B.0622 ASSERTIVE COMMUNITY TREATMENT AND INTENSIVE RESIDENTIAL TREATMENT SERVICES.Subd. 3.Eligibility for intensive residential treatment services. 
An eligible client for intensive residential treatment services is an individual who: 

(1) is age 18 or older; 

(2) is eligible for medical assistance; 

(3) is diagnosed with a mental illness; 

(4) because of a mental illness, has substantial disability and functional impairment in three or more of the areas listed in section 245.462, subdivision 11a, so that self-sufficiency is markedly reduced; 

(5) has one or more of the following: a history of recurring or prolonged inpatient hospitalizations in the past year, significant independent living instability, homelessness, or very frequent use of mental health and related services yielding poor outcomes; and 

(6) in the written opinion of a licensed mental health professional, has the need for mental health services that cannot be met with other available community-based services, or is likely to experience a mental health crisis or require a more restrictive setting if intensive rehabilitative mental health services are not provided. 

Subd. 5a.Standards for intensive residential rehabilitative mental health services. 
(a) The standards in this subdivision apply to intensive residential mental health services. 

(b) The provider of intensive residential treatment services must have sufficient staff to provide 24-hour-per-day coverage to deliver the rehabilitative services described in the treatment plan and to safely supervise and direct the activities of clients, given the client's level of behavioral and psychiatric stability, cultural needs, and vulnerability. The provider must have the capacity within the facility to provide integrated services for chemical dependency, illness management services, and family education, when appropriate. 

(c) At a minimum: 

(1) staff must provide direction and supervision whenever clients are present in the facility; 

(2) staff must remain awake during all work hours; 

(3) there must be a staffing ratio of at least one to nine clients for each day and evening shift. If more than nine clients are present at the residential site, there must be a minimum of two staff during day and evening shifts, one of whom must be a mental health practitioner or mental health professional; 

(4) if services are provided to clients who need the services of a medical professional, the provider shall ensure that these services are provided either by the provider's own medical staff or through referral to a medical professional; and 

(5) the provider must ensure the timely availability of a licensed registered nurse, either directly employed or under contract, who is responsible for ensuring the effectiveness and safety of medication administration in the facility and assessing clients for medication side effects and drug interactions. 

(d) Services must be provided by qualified staff as defined in section 256B.0623, subdivision 5, who are trained and supervised according to section 256B.0623, subdivision 6, except that mental health rehabilitation workers acting as overnight staff are not required to comply with section 256B.0623, subdivision 5, paragraph (a), clause (4), item (iv). 

(e) The clinical supervisor must be an active member of the intensive residential services treatment team. The team must meet with the clinical supervisor at least weekly to discuss clients' progress and make rapid adjustments to meet clients' needs. The team meeting shall include client-specific case reviews and general treatment discussions among team members. Client-specific case reviews and planning must be documented in the client's treatment record. 

(f) Treatment staff must have prompt access in person or by telephone to a mental health practitioner or mental health professional. The provider must have the capacity to promptly and appropriately respond to emergent needs and make any necessary staffing adjustments to ensure the health and safety of clients. 

(g) The initial functional assessment must be completed within ten days of intake and updated at least every 30 days, or prior to discharge from the service, whichever comes first. 

(h) The initial individual treatment plan must be completed within 24 hours of admission. Within ten days of admission, the initial treatment plan must be refined and further developed, except for providers certified according to Minnesota Rules, parts 9533.0010 to 9533.0180. The individual treatment plan must be reviewed with the client and updated at least monthly. 

256B.0623 ADULT REHABILITATIVE MENTAL HEALTH SERVICES COVERED.Subd. 7.Personnel file. 
The adult rehabilitative mental health services provider entity must maintain a personnel file on each staff. Each file must contain: 

(1) an annual performance review; 

(2) a summary of on-site service observations and charting review; 

(3) a criminal background check of all direct service staff; 

(4) evidence of academic degree and qualifications; 

(5) a copy of professional license; 

(6) any job performance recognition and disciplinary actions; 

(7) any individual staff written input into own personnel file; 

(8) all clinical supervision provided; and 

(9) documentation of compliance with continuing education requirements. 

Subd. 8.Diagnostic assessment. 
Providers of adult rehabilitative mental health services must complete a diagnostic assessment as defined in section 245.462, subdivision 9, within five days after the recipient's second visit or within 30 days after intake, whichever occurs first. In cases where a diagnostic assessment is available that reflects the recipient's current status, and has been completed within three years preceding admission, an adult diagnostic assessment update must be completed. An update shall include a face-to-face interview with the recipient and a written summary by a mental health professional of the recipient's current mental health status and service needs. If the recipient's mental health status has changed significantly since the adult's most recent diagnostic assessment, a new diagnostic assessment is required. 

Subd. 10.Individual treatment plan. 
All providers of adult rehabilitative mental health services must develop and implement an individual treatment plan for each recipient. The provisions in clauses (1) and (2) apply: 

(1) Individual treatment plan means a plan of intervention, treatment, and services for an individual recipient written by a mental health professional or by a mental health practitioner under the clinical supervision of a mental health professional. The individual treatment plan must be based on diagnostic and functional assessments. To the extent possible, the development and implementation of a treatment plan must be a collaborative process involving the recipient, and with the permission of the recipient, the recipient's family and others in the recipient's support system. Providers of adult rehabilitative mental health services must develop the individual treatment plan within 30 calendar days of intake. The treatment plan must be updated at least every six months thereafter, or more often when there is significant change in the recipient's situation or functioning, or in services or service methods to be used, or at the request of the recipient or the recipient's legal guardian. 

(2) The individual treatment plan must include: 

(i) a list of problems identified in the assessment; 

(ii) the recipient's strengths and resources; 

(iii) concrete, measurable goals to be achieved, including time frames for achievement; 

(iv) specific objectives directed toward the achievement of each one of the goals; 

(v) documentation of participants in the treatment planning. The recipient, if possible, must be a participant. The recipient or the recipient's legal guardian must sign the treatment plan, or documentation must be provided why this was not possible. A copy of the plan must be given to the recipient or legal guardian. Referral to formal services must be arranged, including specific providers where applicable; 

(vi) cultural considerations, resources, and needs of the recipient must be included; 

(vii) planned frequency and type of services must be initiated; and 

(viii) clear progress notes on outcome of goals. 

(3) The individual community support plan defined in section 245.462, subdivision 12, may serve as the individual treatment plan if there is involvement of a mental health case manager, and with the approval of the recipient. The individual community support plan must include the criteria in clause (2). 

Subd. 11.Recipient file. 
Providers of adult rehabilitative mental health services must maintain a file for each recipient that contains the following information: 

(1) diagnostic assessment or verification of its location that is current and that was reviewed by a mental health professional who is employed by or under contract with the provider entity; 

(2) functional assessments; 

(3) individual treatment plans signed by the recipient and the mental health professional, or if the recipient refused to sign the plan, the date and reason stated by the recipient as to why the recipient would not sign the plan; 

(4) recipient history; 

(5) signed release forms; 

(6) recipient health information and current medications; 

(7) emergency contacts for the recipient; 

(8) case records which document the date of service, the place of service delivery, signature of the person providing the service, nature, extent and units of service, and place of service delivery; 

(9) contacts, direct or by telephone, with recipient's family or others, other providers, or other resources for service coordination; 

(10) summary of recipient case reviews by staff; and 

(11) written information by the recipient that the recipient requests be included in the file. 

256B.0625 COVERED SERVICES.Subd. 5l.Intensive mental health outpatient treatment. 
Medical assistance covers intensive mental health outpatient treatment for dialectical behavioral therapy. The commissioner shall establish: 

(1) certification procedures to ensure that providers of these services are qualified; and 

(2) treatment protocols including required service components and criteria for admission, continued treatment, and discharge. 

Subd. 18c.Nonemergency Medical Transportation Advisory Committee. 
(a) The Nonemergency Medical Transportation Advisory Committee shall advise the commissioner on the administration of nonemergency medical transportation covered under medical assistance. The advisory committee shall meet at least quarterly the first year following January 1, 2015, and at least biannually thereafter and may meet more frequently as required by the commissioner. The advisory committee shall annually elect a chair from among its members, who shall work with the commissioner or the commissioner's designee to establish the agenda for each meeting. The commissioner, or the commissioner's designee, shall attend all advisory committee meetings. 

(b) The Nonemergency Medical Transportation Advisory Committee shall advise and make recommendations to the commissioner on: 

(1) updates to the nonemergency medical transportation policy manual; 

(2) other aspects of the nonemergency medical transportation system, as requested by the commissioner; and 

(3) other aspects of the nonemergency medical transportation system, as requested by: 

(i) a committee member, who may request an item to be placed on the agenda for a future meeting. The request may be considered by the committee and voted upon. If the motion carries, the meeting agenda item may be developed for presentation to the committee; and 

(ii) a member of the public, who may approach the committee by letter or e-mail requesting that an item be placed on a future meeting agenda. The request may be considered by the committee and voted upon. If the motion carries, the agenda item may be developed for presentation to the committee. 

(c) The Nonemergency Medical Transportation Advisory Committee shall coordinate its activities with the Minnesota Council on Transportation Access established under section 174.285. The chair of the advisory committee, or the chair's designee, shall attend all meetings of the Minnesota Council on Transportation Access. 

(d) The Nonemergency Medical Transportation Advisory Committee shall expire December 1, 2019. 

Subd. 18d.Advisory committee members. 
(a) The Nonemergency Medical Transportation Advisory Committee consists of: 

(1) four voting members who represent counties, utilizing the rural urban commuting area classification system. As defined in subdivision 17, these members shall be designated as follows: 

(i) two counties within the 11-county metropolitan area; 

(ii) one county representing the rural area of the state; and 

(iii) one county representing the super rural area of the state. 

The Association of Minnesota Counties shall appoint one county within the 11-county metropolitan area and one county representing the super rural area of the state. The Minnesota Inter-County Association shall appoint one county within the 11-county metropolitan area and one county representing the rural area of the state; 

(2) three voting members who represent medical assistance recipients, including persons with physical and developmental disabilities, persons with mental illness, seniors, children, and low-income individuals; 

(3) five voting members who represent providers that deliver nonemergency medical transportation services to medical assistance enrollees, one of whom is a taxicab owner or operator; 

(4) two voting members of the house of representatives, one from the majority party and one from the minority party, appointed by the speaker of the house, and two voting members from the senate, one from the majority party and one from the minority party, appointed by the Subcommittee on Committees of the Committee on Rules and Administration; 

(5) one voting member who represents demonstration providers as defined in section 256B.69, subdivision 2; 

(6) one voting member who represents an organization that contracts with state or local governments to coordinate transportation services for medical assistance enrollees; 

(7) one voting member who represents the Minnesota State Council on Disability; 

(8) the commissioner of transportation or the commissioner's designee, who shall serve as a voting member; 

(9) one voting member appointed by the Minnesota Ambulance Association; and 

(10) one voting member appointed by the Minnesota Hospital Association. 

(b) Members of the advisory committee shall not be employed by the Department of Human Services. Members of the advisory committee shall receive no compensation. 

Subd. 18e.Single administrative structure and delivery system. 
 The commissioner, in coordination with the commissioner of transportation, shall implement a single administrative structure and delivery system for nonemergency medical transportation, beginning the latter of the date the single administrative assessment tool required in this subdivision is available for use, as determined by the commissioner or by July 1, 2016. 

In coordination with the Department of Transportation, the commissioner shall develop and authorize a web-based single administrative structure and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee assessment process for nonemergency medical transportation services. The web-based tool shall facilitate the transportation eligibility determination process initiated by clients and client advocates; shall include an accessible automated intake and assessment process and real-time identification of level of service eligibility; and shall authorize an appropriate and auditable mode of transportation authorization. The tool shall provide a single framework for reconciling trip information with claiming and collecting complaints regarding inappropriate level of need determinations, inappropriate transportation modes utilized, and interference with accessing nonemergency medical transportation. The web-based single administrative structure shall operate on a trial basis for one year from implementation and, if approved by the commissioner, shall be permanent thereafter. The commissioner shall seek input from the Nonemergency Medical Transportation Advisory Committee to ensure the software is effective and user-friendly and make recommendations regarding funding of the single administrative system. 

Subd. 18h.Managed care. 
(a) The following subdivisions apply to managed care plans and county-based purchasing plans: 

(1) subdivision 17, paragraphs (a), (b), (i), and (n); 

(2) subdivision 18; and 

(3) subdivision 18a. 

(b) A nonemergency medical transportation provider must comply with the operating standards for special transportation service specified in sections 174.29 to 174.30 and Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirements in this paragraph. 

Subd. 35a.Children's mental health crisis response services. 
Medical assistance covers children's mental health crisis response services according to section 256B.0944. 

Subd. 35b.Children's therapeutic services and supports. 
Medical assistance covers children's therapeutic services and supports according to section 256B.0943. 

Subd. 61.Family psychoeducation services. 
Effective July 1, 2013, or upon federal approval, whichever is later, medical assistance covers family psychoeducation services provided to a child up to age 21 with a diagnosed mental health condition when identified in the child's individual treatment plan and provided by a licensed mental health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who has determined it medically necessary to involve family members in the child's care. For the purposes of this subdivision, "family psychoeducation services" means information or demonstration provided to an individual or family as part of an individual, family, multifamily group, or peer group session to explain, educate, and support the child and family in understanding a child's symptoms of mental illness, the impact on the child's development, and needed components of treatment and skill development so that the individual, family, or group can help the child to prevent relapse, prevent the acquisition of comorbid disorders, and achieve optimal mental health and long-term resilience. 

Subd. 62.Mental health clinical care consultation. 
Effective July 1, 2013, or upon federal approval, whichever is later, medical assistance covers clinical care consultation for a person up to age 21 who is diagnosed with a complex mental health condition or a mental health condition that co-occurs with other complex and chronic conditions, when described in the person's individual treatment plan and provided by a licensed mental health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the purposes of this subdivision, "clinical care consultation" means communication from a treating mental health professional to other providers or educators not under the clinical supervision of the treating mental health professional who are working with the same client to inform, inquire, and instruct regarding the client's symptoms; strategies for effective engagement, care, and intervention needs; and treatment expectations across service settings; and to direct and coordinate clinical service components provided to the client and family. 

Subd. 65.Outpatient mental health services. 
Medical assistance covers diagnostic assessment, explanation of findings, and psychotherapy according to Minnesota Rules, part 9505.0372, when the mental health services are performed by a mental health practitioner working as a clinical trainee according to section 245.462, subdivision 17, paragraph (g). 

256B.0916 EXPANSION OF HOME AND COMMUNITY-BASED SERVICES.Subd. 2.Distribution of funds; partnerships. 
(a) Beginning with fiscal year 2000, the commissioner shall distribute all funding available for home and community-based waiver services for persons with developmental disabilities to individual counties or to groups of counties that form partnerships to jointly plan, administer, and authorize funding for eligible individuals. The commissioner shall encourage counties to form partnerships that have a sufficient number of recipients and funding to adequately manage the risk and maximize use of available resources. 

(b) Counties must submit a request for funds and a plan for administering the program as required by the commissioner. The plan must identify the number of clients to be served, their ages, and their priority listing based on: 

(1) requirements in Minnesota Rules, part 9525.1880; and 

(2) statewide priorities identified in section 256B.092, subdivision 12. 

The plan must also identify changes made to improve services to eligible persons and to improve program management. 

(c) In allocating resources to counties, priority must be given to groups of counties that form partnerships to jointly plan, administer, and authorize funding for eligible individuals and to counties determined by the commissioner to have sufficient waiver capacity to maximize resource use. 

(d) Within 30 days after receiving the county request for funds and plans, the commissioner shall provide a written response to the plan that includes the level of resources available to serve additional persons. 

(e) Counties are eligible to receive medical assistance administrative reimbursement for administrative costs under criteria established by the commissioner. 

(f) The commissioner shall manage waiver allocations in such a manner as to fully use available state and federal waiver appropriations. 

Subd. 3.Failure to develop partnerships or submit a plan. 
(a) By October 1 of each year the commissioner shall notify the county board if any county determined by the commissioner to have insufficient capacity to maximize use of available resources fails to develop a partnership with other counties or fails to submit a plan as required in subdivision 2. The commissioner shall provide needed technical assistance to a county or group of counties that fails to form a partnership or submit a plan. If a county has not joined a county partnership or submitted a plan within 30 days following the notice by the commissioner of its failure, the commissioner shall require and assist that county to develop a plan or contract with another county or group of counties to plan and administer the waiver services program in that county. 

(b) Counties may request technical assistance, management information, and administrative support from the commissioner at any time. The commissioner shall respond to county requests within 30 days. Priority shall be given to activities that support the administrative needs of newly formed county partnerships. 

Subd. 4.Allowed reserve. 
Counties or groups of counties participating in partnerships that have submitted a plan under this section may develop an allowed reserve amount to meet crises and other unmet needs of current home and community-based waiver recipients. The amount of the allowed reserve shall be a county specific amount based upon documented past experience and projected need for the coming year described in an allowed reserve plan submitted for approval to the commissioner with the allocation request for the fiscal year. 

Subd. 5.Allocation of new diversions and priorities for reassignment of resources for developmental disabilities. 
(a) The commissioner shall monitor county utilization of allocated resources and, as appropriate, reassign resources not utilized. 

(b) Effective July 1, 2002, the commissioner shall authorize the spending of new diversion resources beginning January 1 of each year. 

(c) Effective July 1, 2002, the commissioner shall manage the reassignment of waiver resources that occur from persons who have left the waiver in a manner that results in the cost reduction equivalent to delaying the reuse of those waiver resources by 180 days. 

(d) Priority consideration for reassignment of resources shall be given to counties that form partnerships. In addition to the priorities listed in Minnesota Rules, part 9525.1880, the commissioner shall also give priority consideration to persons whose living situations are unstable due to the age or incapacity of the primary caregiver and to children to avoid out-of-home placement. 

Subd. 8.Financial and wait-list data reporting. 
(a) The commissioner shall make available financial and waiting list information on the department's website. 

(b) The financial information must include: 

(1) the most recent end of session forecast available for the disability home and community-based waiver programs authorized under sections 256B.092 and 256B.49; and 

(2) the most current financial information, updated at least monthly for the disability home and community-based waiver program authorized under section 256B.092 and three disability home and community-based waiver programs authorized under section 256B.49 for each county and tribal agency, including: 

(i) the amount of resources allocated; 

(ii) the amount of resources authorized for participants; and 

(iii) the amount of allocated resources not authorized and the amount not used as provided in subdivision 12, and section 256B.49, subdivision 27. 

(c) The waiting list information must be provided quarterly beginning August 1, 2016, and must include at least: 

(1) the number of persons screened and waiting for services listed by urgency category, the number of months on the wait list, age group, and the type of services requested by those waiting; 

(2) the number of persons beginning waiver services who were on the waiting list, and the number of persons beginning waiver services who were not on the waiting list; 

(3) the number of persons who left the waiting list but did not begin waiver services; and 

(4) the number of persons on the waiting list with approved funding but without a waiver service agreement and the number of days from funding approval until a service agreement is effective for each person. 

(d) By December 1 of each year, the commissioner shall compile a report posted on the department's website that includes: 

(1) the financial information listed in paragraph (b) for the most recently completed allocation period; 

(2) for the previous four quarters, the waiting list information listed in paragraph (c); 

(3) for a 12-month period ending October 31, a list of county and tribal agencies required to submit a corrective action plan under subdivisions 11 and 12, and section 256B.49, subdivisions 26 and 27; and 

(4) for a 12-month period ending October 31, a list of the county and tribal agencies from which resources were moved as authorized in section 256B.092, subdivision 12, and section 256B.49, subdivision 11a, the amount of resources taken from each agency, the counties that were given increased resources as a result, and the amounts provided. 

Subd. 11.Excess spending. 
County and tribal agencies are responsible for spending in excess of the allocation made by the commissioner. In the event a county or tribal agency spends in excess of the allocation made by the commissioner for a given allocation period, they must submit a corrective action plan to the commissioner for approval. The plan must state the actions the agency will take to correct their overspending for the two years following the period when the overspending occurred. The commissioner shall recoup spending in excess of the allocation only in cases where statewide spending exceeds the appropriation designated for the home and community-based services waivers. Nothing in this subdivision shall be construed as reducing the county's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to them for that purpose. 

Subd. 12.Use of waiver allocations. 
County and tribal agencies are responsible for spending the annual allocation made by the commissioner. In the event a county or tribal agency spends less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services. If a county or tribe does not submit a plan when required or implement the changes required, the commissioner shall assure access to waiver services within the county's or tribe's available allocation and take other actions needed to assure that all waiver participants in that county or tribe are receiving appropriate waiver services to meet their needs. 

256B.0924 TARGETED CASE MANAGEMENT SERVICES.Subd. 4a.Targeted case management through interactive video. 
(a) Subject to federal approval, contact made for targeted case management by interactive video shall be eligible for payment under subdivision 6 if: 

(1) the person receiving targeted case management services is residing in: 

(i) a hospital; 

(ii) a nursing facility; or 

(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging establishment or lodging establishment that provides supportive services or health supervision services according to section 157.17 that is staffed 24 hours a day, seven days a week; 

(2) interactive video is in the best interests of the person and is deemed appropriate by the person receiving targeted case management or the person's legal guardian, the case management provider, and the provider operating the setting where the person is residing; 

(3) the use of interactive video is approved as part of the person's written personal service or case plan; and 

(4) interactive video is used for up to, but not more than, 50 percent of the minimum required face-to-face contact. 

(b) The person receiving targeted case management or the person's legal guardian has the right to choose and consent to the use of interactive video under this subdivision and has the right to refuse the use of interactive video at any time. 

(c) The commissioner shall establish criteria that a targeted case management provider must attest to in order to demonstrate the safety or efficacy of delivering the service via interactive video. The attestation may include that the case management provider has: 

(1) written policies and procedures specific to interactive video services that are regularly reviewed and updated; 

(2) policies and procedures that adequately address client safety before, during, and after the interactive video services are rendered; 

(3) established protocols addressing how and when to discontinue interactive video services; and 

(4) established a quality assurance process related to interactive video services. 

(d) As a condition of payment, the targeted case management provider must document the following for each occurrence of targeted case management provided by interactive video: 

(1) the time the service began and the time the service ended, including an a.m. and p.m. designation; 

(2) the basis for determining that interactive video is an appropriate and effective means for delivering the service to the person receiving case management services; 

(3) the mode of transmission of the interactive video services and records evidencing that a particular mode of transmission was utilized; 

(4) the location of the originating site and the distant site; and 

(5) compliance with the criteria attested to by the targeted case management provider as provided in paragraph (c). 

256B.0943 CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.Subd. 8.Required preservice and continuing education. 
(a) A provider entity shall establish a plan to provide preservice and continuing education for staff. The plan must clearly describe the type of training necessary to maintain current skills and obtain new skills and that relates to the provider entity's goals and objectives for services offered. 

(b) A provider that employs a mental health behavioral aide under this section must require the mental health behavioral aide to complete 30 hours of preservice training. The preservice training must include parent team training. The preservice training must include 15 hours of in-person training of a mental health behavioral aide in mental health services delivery and eight hours of parent team training. Curricula for parent team training must be approved in advance by the commissioner. Components of parent team training include: 

(1) partnering with parents; 

(2) fundamentals of family support; 

(3) fundamentals of policy and decision making; 

(4) defining equal partnership; 

(5) complexities of the parent and service provider partnership in multiple service delivery systems due to system strengths and weaknesses; 

(6) sibling impacts; 

(7) support networks; and 

(8) community resources. 

(c) A provider entity that employs a mental health practitioner and a mental health behavioral aide to provide children's therapeutic services and supports under this section must require the mental health practitioner and mental health behavioral aide to complete 20 hours of continuing education every two calendar years. The continuing education must be related to serving the needs of a child with emotional disturbance in the child's home environment and the child's family. 

(d) The provider entity must document the mental health practitioner's or mental health behavioral aide's annual completion of the required continuing education. The documentation must include the date, subject, and number of hours of the continuing education, and attendance records, as verified by the staff member's signature, job title, and the instructor's name. The provider entity must keep documentation for each employee, including records of attendance at professional workshops and conferences, at a central location and in the employee's personnel file. 

Subd. 10.Service authorization. 
Children's therapeutic services and supports are subject to authorization criteria and standards published by the commissioner according to section 256B.0625, subdivision 25. 

256B.0944 CHILDREN'S MENTAL HEALTH CRISIS RESPONSE SERVICES.Subdivision 1.Definitions. 
For purposes of this section, the following terms have the meanings given them. 

(a) "Mental health crisis" means a child's behavioral, emotional, or psychiatric situation that, but for the provision of crisis response services to the child, would likely result in significantly reduced levels of functioning in primary activities of daily living, an emergency situation, or the child's placement in a more restrictive setting, including, but not limited to, inpatient hospitalization. 

(b) "Mental health emergency" means a child's behavioral, emotional, or psychiatric situation that causes an immediate need for mental health services and is consistent with section 62Q.55. A physician, mental health professional, or crisis mental health practitioner determines a mental health crisis or emergency for medical assistance reimbursement with input from the client and the client's family, if possible. 

(c) "Mental health crisis assessment" means an immediate face-to-face assessment by a physician, mental health professional, or mental health practitioner under the clinical supervision of a mental health professional, following a screening that suggests the child may be experiencing a mental health crisis or mental health emergency situation. 

(d) "Mental health mobile crisis intervention services" means face-to-face, short-term intensive mental health services initiated during a mental health crisis or mental health emergency. Mental health mobile crisis services must help the recipient cope with immediate stressors, identify and utilize available resources and strengths, and begin to return to the recipient's baseline level of functioning. Mental health mobile services must be provided on site by a mobile crisis intervention team outside of an inpatient hospital setting. 

(e) "Mental health crisis stabilization services" means individualized mental health services provided to a recipient following crisis intervention services that are designed to restore the recipient to the recipient's prior functional level. The individual treatment plan recommending mental health crisis stabilization must be completed by the intervention team or by staff after an inpatient or urgent care visit. Mental health crisis stabilization services may be provided in the recipient's home, the home of a family member or friend of the recipient, schools, another community setting, or a short-term supervised, licensed residential program if the service is not included in the facility's cost pool or per diem. Mental health crisis stabilization is not reimbursable when provided as part of a partial hospitalization or day treatment program. 

Subd. 2.Medical assistance coverage. 
Medical assistance covers medically necessary children's mental health crisis response services, subject to federal approval, if provided to an eligible recipient under subdivision 3, by a qualified provider entity under subdivision 4 or a qualified individual provider working within the provider's scope of practice, and identified in the recipient's individual crisis treatment plan under subdivision 8. 

Subd. 3.Eligibility. 
An eligible recipient is an individual who: 

(1) is eligible for medical assistance; 

(2) is under age 18 or between the ages of 18 and 21; 

(3) is screened as possibly experiencing a mental health crisis or mental health emergency where a mental health crisis assessment is needed; 

(4) is assessed as experiencing a mental health crisis or mental health emergency, and mental health mobile crisis intervention or mental health crisis stabilization services are determined to be medically necessary; and 

(5) meets the criteria for emotional disturbance or mental illness. 

Subd. 4.Provider entity standards. 
(a) A crisis intervention and crisis stabilization provider entity must meet the administrative and clinical standards specified in section 256B.0943, subdivisions 5 and 6, meet the standards listed in paragraph (b), and be: 

(1) an Indian health service facility or facility owned and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638 facility; 

(2) a county board-operated entity; or 

(3) a provider entity that is under contract with the county board in the county where the potential crisis or emergency is occurring. 

(b) The children's mental health crisis response services provider entity must: 

(1) ensure that mental health crisis assessment and mobile crisis intervention services are available 24 hours a day, seven days a week; 

(2) directly provide the services or, if services are subcontracted, the provider entity must maintain clinical responsibility for services and billing; 

(3) ensure that crisis intervention services are provided in a manner consistent with sections 245.487 to 245.4889; and 

(4) develop and maintain written policies and procedures regarding service provision that include safety of staff and recipients in high-risk situations. 

Subd. 4a.Alternative provider standards. 
If a provider entity demonstrates that, due to geographic or other barriers, it is not feasible to provide mobile crisis intervention services 24 hours a day, seven days a week, according to the standards in subdivision 4, paragraph (b), clause (1), the commissioner may approve a crisis response provider based on an alternative plan proposed by a provider entity. The alternative plan must: 

(1) result in increased access and a reduction in disparities in the availability of crisis services; and 

(2) provide mobile services outside of the usual nine-to-five office hours and on weekends and holidays. 

Subd. 5.Mobile crisis intervention staff qualifications. 
(a) To provide children's mental health mobile crisis intervention services, a mobile crisis intervention team must include: 

(1) at least two mental health professionals as defined in section 256B.0943, subdivision 1, paragraph (o); or 

(2) a combination of at least one mental health professional and one mental health practitioner as defined in section 245.4871, subdivision 26, with the required mental health crisis training and under the clinical supervision of a mental health professional on the team. 

(b) The team must have at least two people with at least one member providing on-site crisis intervention services when needed. Team members must be experienced in mental health assessment, crisis intervention techniques, and clinical decision making under emergency conditions and have knowledge of local services and resources. The team must recommend and coordinate the team's services with appropriate local resources, including the county social services agency, mental health service providers, and local law enforcement, if necessary. 

Subd. 6.Initial screening and crisis assessment planning. 
(a) Before initiating mobile crisis intervention services, a screening of the potential crisis situation must be conducted. The screening may use the resources of crisis assistance and emergency services as defined in sections 245.4871, subdivision 14, and 245.4879, subdivisions 1 and 2. The screening must gather information, determine whether a crisis situation exists, identify the parties involved, and determine an appropriate response. 

(b) If a crisis exists, a crisis assessment must be completed. A crisis assessment must evaluate any immediate needs for which emergency services are needed and, as time permits, the recipient's current life situation, sources of stress, mental health problems and symptoms, strengths, cultural considerations, support network, vulnerabilities, and current functioning. 

(c) If the crisis assessment determines mobile crisis intervention services are needed, the intervention services must be provided promptly. As the opportunity presents itself during the intervention, at least two members of the mobile crisis intervention team must confer directly or by telephone about the assessment, treatment plan, and actions taken and needed. At least one of the team members must be on site providing crisis intervention services. If providing on-site crisis intervention services, a mental health practitioner must seek clinical supervision as required under subdivision 9. 

(d) The mobile crisis intervention team must develop an initial, brief crisis treatment plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention. The plan must address the needs and problems noted in the crisis assessment and include measurable short-term goals, cultural considerations, and frequency and type of services to be provided to achieve the goals and reduce or eliminate the crisis. The crisis treatment plan must be updated as needed to reflect current goals and services. The team must involve the client and the client's family in developing and implementing the plan. 

(e) The team must document in progress notes which short-term goals have been met and when no further crisis intervention services are required. 

(f) If the client's crisis is stabilized, but the client needs a referral for mental health crisis stabilization services or to other services, the team must provide a referral to these services. If the recipient has a case manager, planning for other services must be coordinated with the case manager. 

Subd. 7.Crisis stabilization services. 
Crisis stabilization services must be provided by a mental health professional or a mental health practitioner, as defined in section 245.462, subdivision 17, who works under the clinical supervision of a mental health professional and for a crisis stabilization services provider entity and must meet the following standards: 

(1) a crisis stabilization treatment plan must be developed which meets the criteria in subdivision 8; 

(2) services must be delivered according to the treatment plan and include face-to-face contact with the recipient by qualified staff for further assessment, help with referrals, updating the crisis stabilization treatment plan, supportive counseling, skills training, and collaboration with other service providers in the community; and 

(3) mental health practitioners must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years. 

Subd. 8.Treatment plan. 
(a) The individual crisis stabilization treatment plan must include, at a minimum: 

(1) a list of problems identified in the assessment; 

(2) a list of the recipient's strengths and resources; 

(3) concrete, measurable short-term goals and tasks to be achieved, including time frames for achievement of the goals; 

(4) specific objectives directed toward the achievement of each goal; 

(5) documentation of the participants involved in the service planning; 

(6) planned frequency and type of services initiated; 

(7) a crisis response action plan if a crisis should occur; and 

(8) clear progress notes on the outcome of goals. 

(b) The client, if clinically appropriate, must be a participant in the development of the crisis stabilization treatment plan. The client or the client's legal guardian must sign the service plan or documentation must be provided why this was not possible. A copy of the plan must be given to the client and the client's legal guardian. The plan should include services arranged, including specific providers where applicable. 

(c) A treatment plan must be developed by a mental health professional or mental health practitioner under the clinical supervision of a mental health professional. A written plan must be completed within 24 hours of beginning services with the client. 

Subd. 9.Supervision. 
(a) A mental health practitioner may provide crisis assessment and mobile crisis intervention services if the following clinical supervision requirements are met: 

(1) the mental health provider entity must accept full responsibility for the services provided; 

(2) the mental health professional of the provider entity, who is an employee or under contract with the provider entity, must be immediately available by telephone or in person for clinical supervision; 

(3) the mental health professional is consulted, in person or by telephone, during the first three hours when a mental health practitioner provides on-site service; and 

(4) the mental health professional must review and approve the tentative crisis assessment and crisis treatment plan, document the consultation, and sign the crisis assessment and treatment plan within the next business day. 

(b) If the mobile crisis intervention services continue into a second calendar day, a mental health professional must contact the client face-to-face on the second day to provide services and update the crisis treatment plan. The on-site observation must be documented in the client's record and signed by the mental health professional. 

Subd. 10.Client record. 
The provider must maintain a file for each client that complies with the requirements under section 256B.0943, subdivision 11, and contains the following information: 

(1) individual crisis treatment plans signed by the recipient, mental health professional, and mental health practitioner who developed the crisis treatment plan, or if the recipient refused to sign the plan, the date and reason stated by the recipient for not signing the plan; 

(2) signed release of information forms; 

(3) recipient health information and current medications; 

(4) emergency contacts for the recipient; 

(5) case records that document the date of service, place of service delivery, signature of the person providing the service, and the nature, extent, and units of service. Direct or telephone contact with the recipient's family or others should be documented; 

(6) required clinical supervision by mental health professionals; 

(7) summary of the recipient's case reviews by staff; and 

(8) any written information by the recipient that the recipient wants in the file. 

Subd. 11.Excluded services. 
The following services are excluded from reimbursement under this section: 

(1) room and board services; 

(2) services delivered to a recipient while admitted to an inpatient hospital; 

(3) transportation services under children's mental health crisis response service; 

(4) services provided and billed by a provider who is not enrolled under medical assistance to provide children's mental health crisis response services; 

(5) crisis response services provided by a residential treatment center to clients in their facility; 

(6) services performed by volunteers; 

(7) direct billing of time spent "on call" when not delivering services to a recipient; 

(8) provider service time included in case management reimbursement; 

(9) outreach services to potential recipients; and 

(10) a mental health service that is not medically necessary. 

256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.Subd. 5.Service authorization. 
The commissioner will administer authorizations for services under this section in compliance with section 256B.0625, subdivision 25. 

256B.097 STATE QUALITY ASSURANCE, QUALITY IMPROVEMENT, AND LICENSING SYSTEM.Subdivision 1.Scope. 
(a) In order to improve the quality of services provided to Minnesotans with disabilities and to meet the requirements of the federally approved home and community-based waivers under section 1915c of the Social Security Act, a State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving disability services is enacted. This system is a partnership between the Department of Human Services and the State Quality Council established under subdivision 3. 

(b) This system is a result of the recommendations from the Department of Human Services' licensing and alternative quality assurance study mandated under Laws 2005, First Special Session chapter 4, article 7, section 57, and presented to the legislature in February 2007. 

(c) The disability services eligible under this section include: 

(1) the home and community-based services waiver programs for persons with developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, including brain injuries and services for those who qualify for nursing facility level of care or hospital facility level of care and any other services licensed under chapter 245D; 

(2) home care services under section 256B.0651; 

(3) family support grants under section 252.32; 

(4) consumer support grants under section 256.476; 

(5) semi-independent living services under section 252.275; and 

(6) services provided through an intermediate care facility for the developmentally disabled. 

(d) For purposes of this section, the following definitions apply: 

(1) "commissioner" means the commissioner of human services; 

(2) "council" means the State Quality Council under subdivision 3; 

(3) "Quality Assurance Commission" means the commission under section 256B.0951; and 

(4) "system" means the State Quality Assurance, Quality Improvement and Licensing System under this section. 

Subd. 2.Duties of commissioner of human services. 
(a) The commissioner of human services shall establish the State Quality Council under subdivision 3. 

(b) The commissioner shall initially delegate authority to perform licensing functions and activities according to section 245A.16 to a host county in Region 10. The commissioner must not license or reimburse a participating facility, program, or service located in Region 10 if the commissioner has received notification from the host county that the facility, program, or service has failed to qualify for licensure. 

(c) The commissioner may conduct random licensing inspections based on outcomes adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services eligible under this section. The role of the random inspections is to verify that the system protects the safety and well-being of persons served and maintains the availability of high-quality services for persons with disabilities. 

(d) The commissioner shall ensure that the federal home and community-based waiver requirements are met and that incidents that may have jeopardized safety and health or violated services-related assurances, civil and human rights, and other protections designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and acted upon in a timely manner. 

(e) The commissioner shall seek a federal waiver by July 1, 2012, to allow intermediate care facilities for persons with developmental disabilities to participate in this system. 

Subd. 3.State Quality Council. 
(a) There is hereby created a State Quality Council which must define regional quality councils, and carry out a community-based, person-directed quality review component, and a comprehensive system for effective incident reporting, investigation, analysis, and follow-up. 

(b) By August 1, 2011, the commissioner of human services shall appoint the members of the initial State Quality Council. Members shall include representatives from the following groups: 

(1) disability service recipients and their family members; 

(2) during the first four years of the State Quality Council, there must be at least three members from the Region 10 stakeholders. As regional quality councils are formed under subdivision 4, each regional quality council shall appoint one member; 

(3) disability service providers; 

(4) disability advocacy groups; and 

(5) county human services agencies and staff from the Department of Human Services and Ombudsman for Mental Health and Developmental Disabilities. 

(c) Members of the council who do not receive a salary or wages from an employer for time spent on council duties may receive a per diem payment when performing council duties and functions. 

(d) The State Quality Council shall: 

(1) assist the Department of Human Services in fulfilling federally mandated obligations by monitoring disability service quality and quality assurance and improvement practices in Minnesota; 

(2) establish state quality improvement priorities with methods for achieving results and provide an annual report to the legislative committees with jurisdiction over policy and funding of disability services on the outcomes, improvement priorities, and activities undertaken by the commission during the previous state fiscal year; 

(3) identify issues pertaining to financial and personal risk that impede Minnesotans with disabilities from optimizing choice of community-based services; and 

(4) recommend to the chairs and ranking minority members of the legislative committees with jurisdiction over human services and civil law by January 15, 2014, statutory and rule changes related to the findings under clause (3) that promote individualized service and housing choices balanced with appropriate individualized protection. 

(e) The State Quality Council, in partnership with the commissioner, shall: 

(1) approve and direct implementation of the community-based, person-directed system established in this section; 

(2) recommend an appropriate method of funding this system, and determine the feasibility of the use of Medicaid, licensing fees, as well as other possible funding options; 

(3) approve measurable outcomes in the areas of health and safety, consumer evaluation, education and training, providers, and systems; 

(4) establish variable licensure periods not to exceed three years based on outcomes achieved; and 

(5) in cooperation with the Quality Assurance Commission, design a transition plan for licensed providers from Region 10 into the alternative licensing system. 

(f) The State Quality Council shall notify the commissioner of human services that a facility, program, or service has been reviewed by quality assurance team members under subdivision 4, paragraph (b), clause (13), and qualifies for a license. 

(g) The State Quality Council, in partnership with the commissioner, shall establish an ongoing review process for the system. The review shall take into account the comprehensive nature of the system which is designed to evaluate the broad spectrum of licensed and unlicensed entities that provide services to persons with disabilities. The review shall address efficiencies and effectiveness of the system. 

(h) The State Quality Council may recommend to the commissioner certain variances from the standards governing licensure of programs for persons with disabilities in order to improve the quality of services so long as the recommended variances do not adversely affect the health or safety of persons being served or compromise the qualifications of staff to provide services. 

(i) The safety standards, rights, or procedural protections referenced under subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make recommendations to the commissioner or to the legislature in the report required under paragraph (c) regarding alternatives or modifications to the safety standards, rights, or procedural protections referenced under subdivision 2, paragraph (c). 

(j) The State Quality Council may hire staff to perform the duties assigned in this subdivision. 

Subd. 4.Regional quality councils. 
(a) The commissioner shall establish, as selected by the State Quality Council, regional quality councils of key stakeholders, including regional representatives of: 

(1) disability service recipients and their family members; 

(2) disability service providers; 

(3) disability advocacy groups; and 

(4) county human services agencies and staff from the Department of Human Services and Ombudsman for Mental Health and Developmental Disabilities. 

(b) Each regional quality council shall: 

(1) direct and monitor the community-based, person-directed quality assurance system in this section; 

(2) approve a training program for quality assurance team members under clause (13); 

(3) review summary reports from quality assurance team reviews and make recommendations to the State Quality Council regarding program licensure; 

(4) make recommendations to the State Quality Council regarding the system; 

(5) resolve complaints between the quality assurance teams, counties, providers, persons receiving services, their families, and legal representatives; 

(6) analyze and review quality outcomes and critical incident data reporting incidents of life safety concerns immediately to the Department of Human Services licensing division; 

(7) provide information and training programs for persons with disabilities and their families and legal representatives on service options and quality expectations; 

(8) disseminate information and resources developed to other regional quality councils; 

(9) respond to state-level priorities; 

(10) establish regional priorities for quality improvement; 

(11) submit an annual report to the State Quality Council on the status, outcomes, improvement priorities, and activities in the region; 

(12) choose a representative to participate on the State Quality Council and assume other responsibilities consistent with the priorities of the State Quality Council; and 

(13) recruit, train, and assign duties to members of quality assurance teams, taking into account the size of the service provider, the number of services to be reviewed, the skills necessary for the team members to complete the process, and ensure that no team member has a financial, personal, or family relationship with the facility, program, or service being reviewed or with anyone served at the facility, program, or service. Quality assurance teams must be comprised of county staff, persons receiving services or the person's families, legal representatives, members of advocacy organizations, providers, and other involved community members. Team members must complete the training program approved by the regional quality council and must demonstrate performance-based competency. Team members may be paid a per diem and reimbursed for expenses related to their participation in the quality assurance process. 

(c) The commissioner shall monitor the safety standards, rights, and procedural protections for the monitoring of psychotropic medications and those identified under sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause (7); and 626.557; and chapter 260E. 

(d) The regional quality councils may hire staff to perform the duties assigned in this subdivision. 

(e) The regional quality councils may charge fees for their services. 

(f) The quality assurance process undertaken by a regional quality council consists of an evaluation by a quality assurance team of the facility, program, or service. The process must include an evaluation of a random sample of persons served. The sample must be representative of each service provided. The sample size must be at least five percent but not less than two persons served. All persons must be given the opportunity to be included in the quality assurance process in addition to those chosen for the random sample. 

(g) A facility, program, or service may contest a licensing decision of the regional quality council as permitted under chapter 245A. 

Subd. 5.Annual survey of service recipients. 
The commissioner, in consultation with the State Quality Council, shall conduct an annual independent statewide survey of service recipients, randomly selected, to determine the effectiveness and quality of disability services. The survey must be consistent with the system performance expectations of the Centers for Medicare and Medicaid Services (CMS) Quality Framework. The survey must analyze whether desired outcomes for persons with different demographic, diagnostic, health, and functional needs, who are receiving different types of services in different settings and with different costs, have been achieved. Annual statewide and regional reports of the results must be published and used to assist regions, counties, and providers to plan and measure the impact of quality improvement activities. 

Subd. 6.Mandated reporters. 
Members of the State Quality Council under subdivision 3, the regional quality councils under subdivision 4, and quality assurance team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as defined in sections 260E.06, subdivision 1, and 626.5572, subdivision 16. 

256B.49 HOME AND COMMUNITY-BASED SERVICE WAIVERS FOR PERSONS WITH DISABILITIES.Subd. 26.Excess allocations. 
 Effective July 1, 2018, county and tribal agencies will be responsible for spending in excess of the annual allocation made by the commissioner. In the event a county or tribal agency spends in excess of the allocation made by the commissioner for a given allocation period, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The plan must state the actions the agency will take to correct its overspending for the two years following the period when the overspending occurred. The commissioner shall recoup funds spent in excess of the allocation only in cases when statewide spending exceeds the appropriation designated for the home and community-based services waivers. Nothing in this subdivision shall be construed as reducing the county or tribe's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to it for that purpose. 

Subd. 27.Use of waiver allocations. 
(a) Effective until June 30, 2018, county and tribal agencies are responsible for authorizing the annual allocation made by the commissioner. In the event a county or tribal agency authorizes less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services. 

(b) Effective July 1, 2018, county and tribal agencies are responsible for spending the annual allocation made by the commissioner. In the event a county or tribal agency spends less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services. 

(c) If a county or tribe does not submit a plan when required or implement the changes required, the commissioner shall assure access to waiver services within the county or tribe's available allocation, and take other actions needed to assure that all waiver participants in that county or tribe are receiving appropriate waiver services to meet their needs. 

256D.051 SNAP EMPLOYMENT AND TRAINING PROGRAM.Subdivision 1.SNAP employment and training program. 
The commissioner shall implement a SNAP employment and training program in order to meet the SNAP employment and training participation requirements of the United States Department of Agriculture. Unless exempt under subdivision 3a, each adult recipient in the unit must participate in the SNAP employment and training program each month that the person is eligible for SNAP benefits. The person's participation in SNAP employment and training services must begin no later than the first day of the calendar month following the determination of eligibility for SNAP benefits. With the county agency's consent, and to the extent of available resources, the person may voluntarily continue to participate in SNAP employment and training services for up to three additional consecutive months immediately following termination of SNAP benefits in order to complete the provisions of the person's employability development plan. 

Subd. 1a.Notices and sanctions. 
(a) At the time the county agency notifies the household that it is eligible for SNAP benefits, the county agency must inform all mandatory employment and training services participants as identified in subdivision 1 in the household that they must comply with all SNAP employment and training program requirements each month, including the requirement to attend an initial orientation to the SNAP employment and training program and that SNAP eligibility will end unless the participants comply with the requirements specified in the notice. 

(b) A participant who fails without good cause to comply with SNAP employment and training program requirements of this section, including attendance at orientation, will lose SNAP eligibility for the following periods: 

(1) for the first occurrence, for one month or until the person complies with the requirements not previously complied with, whichever is longer; 

(2) for the second occurrence, for three months or until the person complies with the requirements not previously complied with, whichever is longer; or 

(3) for the third and any subsequent occurrence, for six months or until the person complies with the requirements not previously complied with, whichever is longer. 

If the participant is not the SNAP head of household, the person shall be considered an ineligible household member for SNAP purposes. If the participant is the SNAP head of household, the entire household is ineligible for SNAP as provided in Code of Federal Regulations, title 7, section 273.7(g). "Good cause" means circumstances beyond the control of the participant, such as illness or injury, illness or injury of another household member requiring the participant's presence, a household emergency, or the inability to obtain child care for children between the ages of six and 12 or to obtain transportation needed in order for the participant to meet the SNAP employment and training program participation requirements. 

(c) The county agency shall mail or hand deliver a notice to the participant not later than five days after determining that the participant has failed without good cause to comply with SNAP employment and training program requirements which specifies the requirements that were not complied with, the factual basis for the determination of noncompliance, and the right to reinstate eligibility upon a showing of good cause for failure to meet the requirements. The notice must ask the reason for the noncompliance and identify the participant's appeal rights. The notice must request that the participant inform the county agency if the participant believes that good cause existed for the failure to comply and must state that the county agency intends to terminate eligibility for SNAP benefits due to failure to comply with SNAP employment and training program requirements. 

(d) If the county agency determines that the participant did not comply during the month with all SNAP employment and training program requirements that were in effect, and if the county agency determines that good cause was not present, the county must provide a ten-day notice of termination of SNAP benefits. The amount of SNAP benefits that are withheld from the household and determination of the impact of the sanction on other household members is governed by Code of Federal Regulations, title 7, section 273.7. 

(e) The participant may appeal the termination of SNAP benefits under the provisions of section 256.045. 

Subd. 2.County agency duties. 
(a) The county agency shall provide to SNAP benefit recipients a SNAP employment and training program. The program must include: 

(1) orientation to the SNAP employment and training program; 

(2) an individualized employability assessment and an individualized employability development plan that includes assessment of literacy, ability to communicate in the English language, educational and employment history, and that estimates the length of time it will take the participant to obtain employment. The employability assessment and development plan must be completed in consultation with the participant, must assess the participant's assets, barriers, and strengths, and must identify steps necessary to overcome barriers to employment. A copy of the employability development plan must be provided to the registrant; 

(3) referral to available accredited remedial or skills training programs designed to address participant's barriers to employment; 

(4) referral to available programs that provide subsidized or unsubsidized employment as necessary; 

(5) a job search program, including job seeking skills training; and 

(6) other activities, to the extent of available resources designed by the county agency to prepare the participant for permanent employment. 

In order to allow time for job search, the county agency may not require an individual to participate in the SNAP employment and training program for more than 32 hours a week. The county agency shall require an individual to spend at least eight hours a week in job search or other SNAP employment and training program activities. 

(b) The county agency shall prepare an annual plan for the operation of its SNAP employment and training program. The plan must be submitted to and approved by the commissioner of employment and economic development. The plan must include: 

(1) a description of the services to be offered by the county agency; 

(2) a plan to coordinate the activities of all public entities providing employment-related services in order to avoid duplication of effort and to provide services more efficiently; 

(3) a description of the factors that will be taken into account when determining a client's employability development plan; and 

(4) provisions to ensure that the county agency's employment and training service provider provides each recipient with an orientation, employability assessment, and employability development plan as specified in paragraph (a), clauses (1) and (2), within 30 days of the recipient's eligibility for assistance. 

Subd. 2a.Duties of commissioner. 
In addition to any other duties imposed by law, the commissioner shall: 

(1) based on this section and section 256D.052 and Code of Federal Regulations, title 7, section 273.7, supervise the administration of SNAP employment and training services to county agencies; 

(2) disburse money appropriated for SNAP employment and training services to county agencies based upon the county's costs as specified in section 256D.051, subdivision 6c; 

(3) accept and supervise the disbursement of any funds that may be provided by the federal government or from other sources for use in this state for SNAP employment and training services; 

(4) cooperate with other agencies including any agency of the United States or of another state in all matters concerning the powers and duties of the commissioner under this section and section 256D.052; and 

(5) in cooperation with the commissioner of employment and economic development, ensure that each component of an employment and training program carried out under this section is delivered through a statewide workforce development system, unless the component is not available locally through such a system. 

Subd. 3.Participant duties. 
In order to receive SNAP assistance, a registrant shall: (1) cooperate with the county agency in all aspects of the SNAP employment and training program; (2) accept any suitable employment, including employment offered through the Job Training Partnership Act, and other employment and training options; and (3) participate in SNAP employment and training activities assigned by the county agency. The county agency may terminate assistance to a registrant who fails to cooperate in the SNAP employment and training program, as provided in subdivision 1a. 

Subd. 3a.Requirement to register work. 
(a) To the extent required under Code of Federal Regulations, title 7, section 273.7(a), each applicant for and recipient of SNAP benefits is required to register for work as a condition of eligibility for SNAP benefits. Applicants and recipients are registered by signing an application or annual reapplication for SNAP benefits, and must be informed that they are registering for work by signing the form. 

(b) The commissioner shall determine, within federal requirements, persons required to participate in the SNAP employment and training program. 

(c) The following SNAP benefit recipients are exempt from mandatory participation in SNAP employment and training services: 

(1) recipients of benefits under the Minnesota family investment program, Minnesota supplemental aid program, or the general assistance program; 

(2) a child; 

(3) a recipient over age 55; 

(4) a recipient who has a mental or physical illness, injury, or incapacity which is expected to continue for at least 30 days and which impairs the recipient's ability to obtain or retain employment as evidenced by professional certification or the receipt of temporary or permanent disability benefits issued by a private or government source; 

(5) a parent or other household member responsible for the care of either a dependent child in the household who is under age six or a person in the household who is professionally certified as having a physical or mental illness, injury, or incapacity. Only one parent or other household member may claim exemption under this provision; 

(6) a recipient receiving unemployment insurance or who has applied for unemployment insurance and has been required to register for work with the Department of Employment and Economic Development as part of the unemployment insurance application process; 

(7) a recipient participating each week in a drug addiction or alcohol abuse treatment and rehabilitation program, provided the operators of the treatment and rehabilitation program, in consultation with the county agency, recommend that the recipient not participate in the SNAP employment and training program; 

(8) a recipient employed or self-employed for 30 or more hours per week at employment paying at least minimum wage, or who earns wages from employment equal to or exceeding 30 hours multiplied by the federal minimum wage; or 

(9) a student enrolled at least half time in any school, training program, or institution of higher education. When determining if a student meets this criteria, the school's, program's or institution's criteria for being enrolled half time shall be used. 

Subd. 3b.Orientation. 
The county agency or its employment and training service provider must provide an orientation to SNAP employment and training services to each nonexempt SNAP benefit recipient within 30 days of the date that SNAP eligibility is determined. The orientation must inform the participant of the requirement to participate in services, the date, time, and address to report to for services, the name and telephone number of the SNAP employment and training service provider, the consequences for failure without good cause to comply, the services and support services available through SNAP employment and training services and other providers of similar services, and must encourage the participant to view the SNAP benefits program as a temporary means of supplementing the family's food needs until the family achieves self-sufficiency through employment. The orientation may be provided through audio-visual methods, but the participant must have the opportunity for face-to-face interaction with county agency staff. 

Subd. 6b.Federal reimbursement. 
(a) Federal financial participation from the United States Department of Agriculture for SNAP employment and training expenditures that are eligible for reimbursement through the SNAP employment and training program are dedicated funds and are annually appropriated to the commissioner of human services for the operation of the SNAP employment and training program. 

(b) The appropriation must be used for skill attainment through employment, training, and support services for SNAP participants. 

(c) Federal financial participation for the nonstate portion of SNAP employment and training costs must be paid to the county agency or service provider that incurred the costs. 

Subd. 6c.Program funding. 
Within the limits of available resources, the commissioner shall reimburse the actual costs of county agencies and their employment and training service providers for the provision of SNAP employment and training services, including participant support services, direct program services, and program administrative activities. The cost of services for each county's SNAP employment and training program shall not exceed the annual allocated amount. No more than 15 percent of program funds may be used for administrative activities. The county agency may expend county funds in excess of the limits of this subdivision without state reimbursement. 

Program funds shall be allocated based on the county's average number of SNAP eligible cases as compared to the statewide total number of such cases. The average number of cases shall be based on counts of cases as of March 31, June 30, September 30, and December 31 of the previous calendar year. The commissioner may reallocate unexpended money appropriated under this section to those county agencies that demonstrate a need for additional funds. 

Subd. 7.Registrant status. 
A registrant under this section is not an employee for the purposes of workers' compensation, unemployment benefits, retirement, or civil service laws, and shall not perform work ordinarily performed by a regular public employee. 

Subd. 8.Voluntary quit. 
A person who is required to participate in SNAP employment and training services is not eligible for SNAP benefits if, without good cause, the person refuses a legitimate offer of, or quits, suitable employment within 60 days before the date of application. A person who is required to participate in SNAP employment and training services and, without good cause, voluntarily quits suitable employment or refuses a legitimate offer of suitable employment while receiving SNAP benefits shall be terminated from the SNAP program as specified in subdivision 1a. 

Subd. 9.Subcontractors. 
A county agency may, at its option, subcontract any or all of the duties under this section to a public or private entity approved by the commissioner of employment and economic development. 

Subd. 18.Work experience placements. 
(a) To the extent of available resources, each county agency must establish and operate a work experience component in the SNAP employment and training program for recipients who are subject to a federal limit of three months of SNAP eligibility in any 36-month period. The purpose of the work experience component is to enhance the participant's employability, self-sufficiency, and to provide meaningful, productive work activities. 

(b) The commissioner shall assist counties in the design and implementation of these components. The commissioner must ensure that job placements under a work experience component comply with section 256J.72. Written or oral concurrence with job duties of persons placed under the community work experience program shall be obtained from the appropriate exclusive bargaining representative. 

(c) Worksites developed under this section are limited to projects that serve a useful public service such as health, social service, environmental protection, education, urban and rural development and redevelopment, welfare, recreation, public facilities, public safety, community service, services to aged citizens or citizens with a disability, and child care. To the extent possible, the prior training, skills, and experience of a recipient must be used in making appropriate work experience assignments. 

(d) Structured, supervised volunteer work with an agency or organization that is monitored by the county service provider may, with the approval of the county agency, be used as a work experience placement. 

(e) As a condition of placing a person receiving SNAP benefits in a program under this subdivision, the county agency shall first provide the recipient the opportunity: 

(1) for placement in suitable subsidized or unsubsidized employment through participation in job search under section 256D.051; or 

(2) for placement in suitable employment through participation in on-the-job training, if such employment is available. 

(f) The county agency shall limit the maximum monthly number of hours that any participant may work in a work experience placement to a number equal to the amount of the family's monthly SNAP benefit allotment divided by the greater of the federal minimum wage or the applicable state minimum wage. 

After a participant has been assigned to a position for nine months, the participant may not continue in that assignment unless the maximum number of hours a participant works is no greater than the amount of the SNAP benefit divided by the rate of pay for individuals employed in the same or similar occupations by the same employer at the same site. 

(g) The participant's employability development plan must include the length of time needed in the work experience program, the need to continue job seeking activities while participating in work experience, and the participant's employment goals. 

(h) After each six months of a recipient's participation in a work experience job placement, and at the conclusion of each work experience assignment under this section, the county agency shall reassess and revise, as appropriate, the participant's employability development plan. 

(i) A participant has good cause for failure to cooperate with a work experience job placement if, in the judgment of the employment and training service provider, the reason for failure is reasonable and justified. Good cause for purposes of this section is defined in subdivision 1a, paragraph (b). 

(j) A recipient who has failed without good cause to participate in or comply with the work experience job placement shall be terminated from participation in work experience job activities. If the recipient is not exempt from mandatory SNAP employment and training program participation under subdivision 3a, the recipient will be assigned to other mandatory program activities. If the recipient is exempt from mandatory participation but is participating as a volunteer, the person shall be terminated from the SNAP employment and training program. 

256D.052 LITERACY TRAINING FOR RECIPIENTS.Subd. 3.Participant literacy transportation costs. 
Within the limits of the state appropriation the county agency must provide transportation to enable Supplemental Nutrition Assistance Program (SNAP) employment and training participants to participate in literacy training under this section. The state shall reimburse county agencies for the costs of providing transportation under this section up to the amount of the state appropriation. Counties must make every effort to ensure that child care is available as needed by recipients who are pursuing literacy training. 

256J.08 DEFINITIONS.Subd. 10.Budget month. 
"Budget month" means the calendar month which the county agency uses to determine the income or circumstances of an assistance unit to calculate the amount of the assistance payment in the payment month. 

Subd. 53.Lump sum. 
"Lump sum" means nonrecurring income that is not excluded in section 256J.21. 

Subd. 61.Monthly income test. 
"Monthly income test" means the test used to determine ongoing eligibility and the assistance payment amount according to section 256J.21. 

Subd. 62.Nonrecurring income. 
"Nonrecurring income" means a form of income which is received: 

(1) only one time or is not of a continuous nature; or 

(2) in a prospective payment month but is no longer received in the corresponding retrospective payment month. 

Subd. 81.Retrospective budgeting. 
"Retrospective budgeting" means a method of determining the amount of the assistance payment in which the payment month is the second month after the budget month. 

Subd. 83.Significant change. 
"Significant change" means a decline in gross income of the amount of the disregard as defined in section 256P.03 or more from the income used to determine the grant for the current month. 

256J.21 INCOME LIMITATIONS.Subdivision 1.Income inclusions. 
To determine MFIP eligibility, the county agency must evaluate income received by members of an assistance unit, or by other persons whose income is considered available to the assistance unit, and only count income that is available to the member of the assistance unit. Income is available if the individual has legal access to the income. All payments, unless specifically excluded in subdivision 2, must be counted as income. The county agency shall verify the income of all MFIP recipients and applicants. 

Subd. 2.Income exclusions. 
The following must be excluded in determining a family's available income: 

(1) payments for basic care, difficulty of care, and clothing allowances received for providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 to 9555.6265, 9560.0521, and 9560.0650 to 9560.0654, payments for family foster care for children under section 260C.4411 or chapter 256N, and payments received and used for care and maintenance of a third-party beneficiary who is not a household member; 

(2) reimbursements for employment training received through the Workforce Investment Act of 1998, United States Code, title 20, chapter 73, section 9201; 

(3) reimbursement for out-of-pocket expenses incurred while performing volunteer services, jury duty, employment, or informal carpooling arrangements directly related to employment; 

(4) all educational assistance, except the county agency must count graduate student teaching assistantships, fellowships, and other similar paid work as earned income and, after allowing deductions for any unmet and necessary educational expenses, shall count scholarships or grants awarded to graduate students that do not require teaching or research as unearned income; 

(5) loans, regardless of purpose, from public or private lending institutions, governmental lending institutions, or governmental agencies; 

(6) loans from private individuals, regardless of purpose, provided an applicant or participant documents that the lender expects repayment; 

(7)(i) state income tax refunds; and 

(ii) federal income tax refunds; 

(8)(i) federal earned income credits; 

(ii) Minnesota working family credits; 

(iii) state homeowners and renters credits under chapter 290A; and 

(iv) federal or state tax rebates; 

(9) funds received for reimbursement, replacement, or rebate of personal or real property when these payments are made by public agencies, awarded by a court, solicited through public appeal, or made as a grant by a federal agency, state or local government, or disaster assistance organizations, subsequent to a presidential declaration of disaster; 

(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial expenses, or to repair or replace insured property; 

(11) reimbursements for medical expenses that cannot be paid by medical assistance; 

(12) payments by a vocational rehabilitation program administered by the state under chapter 268A, except those payments that are for current living expenses; 

(13) in-kind income, including any payments directly made by a third party to a provider of goods and services; 

(14) assistance payments to correct underpayments, but only for the month in which the payment is received; 

(15) payments for short-term emergency needs under section 256J.626, subdivision 2; 

(16) funeral and cemetery payments as provided by section 256.935; 

(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar month; 

(18) any form of energy assistance payment made through Public Law 97-35, Low-Income Home Energy Assistance Act of 1981, payments made directly to energy providers by other public and private agencies, and any form of credit or rebate payment issued by energy providers; 

(19) Supplemental Security Income (SSI), including retroactive SSI payments and other income of an SSI recipient; 

(20) Minnesota supplemental aid, including retroactive payments; 

(21) proceeds from the sale of real or personal property; 

(22) adoption or kinship assistance payments under chapter 256N or 259A and Minnesota permanency demonstration title IV-E waiver payments; 

(23) state-funded family subsidy program payments made under section 252.32 to help families care for children with developmental disabilities, consumer support grant funds under section 256.476, and resources and services for a disabled household member under one of the home and community-based waiver services programs under chapter 256B; 

(24) interest payments and dividends from property that is not excluded from and that does not exceed the asset limit; 

(25) rent rebates; 

(26) income earned by a minor caregiver, minor child through age 6, or a minor child who is at least a half-time student in an approved elementary or secondary education program; 

(27) income earned by a caregiver under age 20 who is at least a half-time student in an approved elementary or secondary education program; 

(28) MFIP child care payments under section 119B.05; 

(29) all other payments made through MFIP to support a caregiver's pursuit of greater economic stability; 

(30) income a participant receives related to shared living expenses; 

(31) reverse mortgages; 

(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42, chapter 13A, sections 1771 to 1790; 

(33) benefits provided by the women, infants, and children (WIC) nutrition program, United States Code, title 42, chapter 13A, section 1786; 

(34) benefits from the National School Lunch Act, United States Code, title 42, chapter 13, sections 1751 to 1769e; 

(35) relocation assistance for displaced persons under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12, chapter 13, sections 1701 to 1750jj; 

(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part 2, sections 2271 to 2322; 

(37) war reparations payments to Japanese Americans and Aleuts under United States Code, title 50, sections 1989 to 1989d; 

(38) payments to veterans or their dependents as a result of legal settlements regarding Agent Orange or other chemical exposure under Public Law 101-239, section 10405, paragraph (a)(2)(E); 

(39) income that is otherwise specifically excluded from MFIP consideration in federal law, state law, or federal regulation; 

(40) security and utility deposit refunds; 

(41) American Indian tribal land settlements excluded under Public Laws 98-123, 98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs reservations and payments to members of the White Earth Band, under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407; 

(42) all income of the minor parent's parents and stepparents when determining the grant for the minor parent in households that include a minor parent living with parents or stepparents on MFIP with other children; 

(43) income of the minor parent's parents and stepparents equal to 200 percent of the federal poverty guideline for a family size not including the minor parent and the minor parent's child in households that include a minor parent living with parents or stepparents not on MFIP when determining the grant for the minor parent. The remainder of income is deemed as specified in section 256J.37, subdivision 1b; 

(44) payments made to children eligible for relative custody assistance under section 257.85; 

(45) vendor payments for goods and services made on behalf of a client unless the client has the option of receiving the payment in cash; 

(46) the principal portion of a contract for deed payment; 

(47) cash payments to individuals enrolled for full-time service as a volunteer under AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps National, and AmeriCorps NCCC; 

(48) housing assistance grants under section 256J.35, paragraph (a); and 

(49) child support payments of up to $100 for an assistance unit with one child and up to $200 for an assistance unit with two or more children. 

256J.30 APPLICANT AND PARTICIPANT REQUIREMENTS AND RESPONSIBILITIES.Subd. 5.Monthly MFIP household reports. 
Each assistance unit with a member who has earned income or a recent work history, and each assistance unit that has income deemed to it from a financially responsible person must complete a monthly MFIP household report form. "Recent work history" means the individual received earned income in the report month or any of the previous three calendar months even if the earnings are excluded. To be complete, the MFIP household report form must be signed and dated by the caregivers no earlier than the last day of the reporting period. All questions required to determine assistance payment eligibility must be answered, and documentation of earned income must be included. 

Subd. 7.Due date of MFIP household report form. 
An MFIP household report form must be received by the county agency by the eighth calendar day of the month following the reporting period covered by the form. When the eighth calendar day of the month falls on a weekend or holiday, the MFIP household report form must be received by the county agency the first working day that follows the eighth calendar day. 

Subd. 8.Late MFIP household report forms. 
(a) Paragraphs (b) to (e) apply to the reporting requirements in subdivision 7. 

(b) When the county agency receives an incomplete MFIP household report form, the county agency must immediately return the incomplete form and clearly state what the caregiver must do for the form to be complete. 

(c) The automated eligibility system must send a notice of proposed termination of assistance to the assistance unit if a complete MFIP household report form is not received by a county agency. The automated notice must be mailed to the caregiver by approximately the 16th of the month. When a caregiver submits an incomplete form on or after the date a notice of proposed termination has been sent, the termination is valid unless the caregiver submits a complete form before the end of the month. 

(d) An assistance unit required to submit an MFIP household report form is considered to have continued its application for assistance if a complete MFIP household report form is received within a calendar month after the month in which the form was due and assistance shall be paid for the period beginning with the first day of that calendar month. 

(e) A county agency must allow good cause exemptions from the reporting requirements under subdivision 5 when any of the following factors cause a caregiver to fail to provide the county agency with a completed MFIP household report form before the end of the month in which the form is due: 

(1) an employer delays completion of employment verification; 

(2) a county agency does not help a caregiver complete the MFIP household report form when the caregiver asks for help; 

(3) a caregiver does not receive an MFIP household report form due to mistake on the part of the department or the county agency or due to a reported change in address; 

(4) a caregiver is ill, or physically or mentally incapacitated; or 

(5) some other circumstance occurs that a caregiver could not avoid with reasonable care which prevents the caregiver from providing a completed MFIP household report form before the end of the month in which the form is due. 

256J.33 PROSPECTIVE AND RETROSPECTIVE MFIP ELIGIBILITY.Subd. 3.Retrospective eligibility. 
After the first two months of MFIP eligibility, a county agency must continue to determine whether an assistance unit is prospectively eligible for the payment month by looking at all factors other than income and then determine whether the assistance unit is retrospectively income eligible by applying the monthly income test to the income from the budget month. When the monthly income test is not satisfied, the assistance payment must be suspended when ineligibility exists for one month or ended when ineligibility exists for more than one month. 

Subd. 4.Monthly income test. 
A county agency must apply the monthly income test retrospectively for each month of MFIP eligibility. An assistance unit is not eligible when the countable income equals or exceeds the MFIP standard of need or the family wage level for the assistance unit. The income applied against the monthly income test must include: 

(1) gross earned income from employment, prior to mandatory payroll deductions, voluntary payroll deductions, wage authorizations, and after the disregards in section 256J.21, subdivision 4, and the allocations in section 256J.36, unless the employment income is specifically excluded under section 256J.21, subdivision 2; 

(2) gross earned income from self-employment less deductions for self-employment expenses in section 256J.37, subdivision 5, but prior to any reductions for personal or business state and federal income taxes, personal FICA, personal health and life insurance, and after the disregards in section 256J.21, subdivision 4, and the allocations in section 256J.36; 

(3) unearned income after deductions for allowable expenses in section 256J.37, subdivision 9, and allocations in section 256J.36, unless the income has been specifically excluded in section 256J.21, subdivision 2; 

(4) gross earned income from employment as determined under clause (1) which is received by a member of an assistance unit who is a minor child or minor caregiver and less than a half-time student; 

(5) child support received by an assistance unit, excluded under section 256J.21, subdivision 2, clause (49), or section 256P.06, subdivision 3, clause (2), item (xvi); 

(6) spousal support received by an assistance unit; 

(7) the income of a parent when that parent is not included in the assistance unit; 

(8) the income of an eligible relative and spouse who seek to be included in the assistance unit; and 

(9) the unearned income of a minor child included in the assistance unit. 

Subd. 5.When to terminate assistance. 
When an assistance unit is ineligible for MFIP assistance for two consecutive months, the county agency must terminate MFIP assistance. 

256J.34 CALCULATING ASSISTANCE PAYMENTS.Subdivision 1.Prospective budgeting. 
A county agency must use prospective budgeting to calculate the assistance payment amount for the first two months for an applicant who has not received assistance in this state for at least one payment month preceding the first month of payment under a current application. Notwithstanding subdivision 3, paragraph (a), clause (2), a county agency must use prospective budgeting for the first two months for a person who applies to be added to an assistance unit. Prospective budgeting is not subject to overpayments or underpayments unless fraud is determined under section 256.98. 

(a) The county agency must apply the income received or anticipated in the first month of MFIP eligibility against the need of the first month. The county agency must apply the income received or anticipated in the second month against the need of the second month. 

(b) When the assistance payment for any part of the first two months is based on anticipated income, the county agency must base the initial assistance payment amount on the information available at the time the initial assistance payment is made. 

(c) The county agency must determine the assistance payment amount for the first two months of MFIP eligibility by budgeting both recurring and nonrecurring income for those two months. 

Subd. 2.Retrospective budgeting. 
The county agency must use retrospective budgeting to calculate the monthly assistance payment amount after the payment for the first two months has been made under subdivision 1. 

Subd. 3.Additional uses of retrospective budgeting. 
Notwithstanding subdivision 1, the county agency must use retrospective budgeting to calculate the monthly assistance payment amount for the first two months under paragraphs (a) and (b). 

(a) The county agency must use retrospective budgeting to determine the amount of the assistance payment in the first two months of MFIP eligibility: 

(1) when an assistance unit applies for assistance for the same month for which assistance has been interrupted, the interruption in eligibility is less than one payment month, the assistance payment for the preceding month was issued in this state, and the assistance payment for the immediately preceding month was determined retrospectively; or 

(2) when a person applies in order to be added to an assistance unit, that assistance unit has received assistance in this state for at least the two preceding months, and that person has been living with and has been financially responsible for one or more members of that assistance unit for at least the two preceding months. 

(b) Except as provided in clauses (1) to (4), the county agency must use retrospective budgeting and apply income received in the budget month by an assistance unit and by a financially responsible household member who is not included in the assistance unit against the MFIP standard of need or family wage level to determine the assistance payment to be issued for the payment month. 

(1) When a source of income ends prior to the third payment month, that income is not considered in calculating the assistance payment for that month. When a source of income ends prior to the fourth payment month, that income is not considered when determining the assistance payment for that month. 

(2) When a member of an assistance unit or a financially responsible household member leaves the household of the assistance unit, the income of that departed household member is not budgeted retrospectively for any full payment month in which that household member does not live with that household and is not included in the assistance unit. 

(3) When an individual is removed from an assistance unit because the individual is no longer a minor child, the income of that individual is not budgeted retrospectively for payment months in which that individual is not a member of the assistance unit, except that income of an ineligible child in the household must continue to be budgeted retrospectively against the child's needs when the parent or parents of that child request allocation of their income against any unmet needs of that ineligible child. 

(4) When a person ceases to have financial responsibility for one or more members of an assistance unit, the income of that person is not budgeted retrospectively for the payment months which follow the month in which financial responsibility ends. 

Subd. 4.Significant change in gross income. 
The county agency must recalculate the assistance payment when an assistance unit experiences a significant change, as defined in section 256J.08, resulting in a reduction in the gross income received in the payment month from the gross income received in the budget month. The county agency must issue a supplemental assistance payment based on the county agency's best estimate of the assistance unit's income and circumstances for the payment month. Supplemental assistance payments that result from significant changes are limited to two in a 12-month period regardless of the reason for the change. Notwithstanding any other statute or rule of law, supplementary assistance payments shall not be made when the significant change in income is the result of receipt of a lump sum, receipt of an extra paycheck, business fluctuation in self-employment income, or an assistance unit member's participation in a strike or other labor action. 

256J.37 TREATMENT OF INCOME AND LUMP SUMS.Subd. 10.Treatment of lump sums. 
(a) The agency must treat lump-sum payments as earned or unearned income. If the lump-sum payment is included in the category of income identified in subdivision 9, it must be treated as unearned income. A lump sum is counted as income in the month received and budgeted either prospectively or retrospectively depending on the budget cycle at the time of receipt. When an individual receives a lump-sum payment, that lump sum must be combined with all other earned and unearned income received in the same budget month, and it must be applied according to paragraphs (a) to (c). A lump sum may not be carried over into subsequent months. Any funds that remain in the third month after the month of receipt are counted in the asset limit. 

(b) For a lump sum received by an applicant during the first two months, prospective budgeting is used to determine the payment and the lump sum must be combined with other earned or unearned income received and budgeted in that prospective month. 

(c) For a lump sum received by a participant after the first two months of MFIP eligibility, the lump sum must be combined with other income received in that budget month, and the combined amount must be applied retrospectively against the applicable payment month. 

(d) When a lump sum, combined with other income under paragraphs (b) and (c), is less than the MFIP transitional standard for the appropriate payment month, the assistance payment must be reduced according to the amount of the countable income. When the countable income is greater than the MFIP standard or family wage level, the assistance payment must be suspended for the payment month. 

256S.20 CUSTOMIZED LIVING SERVICES; POLICY.Subd. 2.Customized living services requirements. 
Customized living services and 24-hour customized living services may only be provided in a building that is registered as a housing with services establishment under chapter 144D. 

9505.0275EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT. Subpart 1.Definition.  
"Early and periodic screening, diagnosis, and treatment service" means a service provided to a recipient under age 21 to identify a potentially disabling condition and to provide diagnosis and treatment for a condition identified according to the requirements of the Code of Federal Regulations, title 42, section 441.55 and parts 9505.1693 to 9505.1748. 

Subp. 2.Duties of provider.  
The provider shall sign a provider agreement stating that the provider will provide screening services according to standards in parts 9505.1693 to 9505.1748 and Code of Federal Regulations, title 42, sections 441.50 to 441.62. 

9505.0370DEFINITIONS. Subpart 1.Scope.  
For parts 9505.0370 to 9505.0372, the following terms have the meanings given them. 

Subp. 2.Adult day treatment.  
"Adult day treatment" or "adult day treatment program" means a structured program of treatment and care. 

Subp. 3.Child.  
"Child" means a person under 18 years of age. 

Subp. 4.Client.  
"Client" means an eligible recipient who is determined to have or who is being assessed for a mental illness as specified in part 9505.0371. 

Subp. 5.Clinical summary.  
"Clinical summary" means a written description of a clinician's formulation of the cause of the client's mental health symptoms, the client's prognosis, and the likely consequences of the symptoms; how the client meets the criteria for the diagnosis by describing the client's symptoms, the duration of symptoms, and functional impairment; an analysis of the client's other symptoms, strengths, relationships, life situations, cultural influences, and health concerns and their potential interaction with the diagnosis and formulation of the client's mental health condition; and alternative diagnoses that were considered and ruled out. 

Subp. 6.Clinical supervision.  
"Clinical supervision" means the documented time a clinical supervisor and supervisee spend together to discuss the supervisee's work, to review individual client cases, and for the supervisee's professional development. It includes the documented oversight and supervision responsibility for planning, implementation, and evaluation of services for a client's mental health treatment. 

Subp. 7.Clinical supervisor.  
"Clinical supervisor" means the mental health professional who is responsible for clinical supervision. 

Subp. 8.Cultural competence or culturally competent.  
"Cultural competence" or "culturally competent" means the mental health provider's: 

A. 
awareness of the provider's own cultural background, and the related assumptions, values, biases, and preferences that influence assessment and intervention processes; 

B. 
ability and will to respond to the unique needs of an individual client that arise from the client's culture; 

C. 
ability to utilize the client's culture as a resource and as a means to optimize mental health care; and 

D. 
willingness to seek educational, consultative, and learning experiences to expand knowledge of and increase effectiveness with culturally diverse populations. 

Subp. 9.Cultural influences.  
"Cultural influences" means historical, geographical, and familial factors that affect assessment and intervention processes. Cultural influences that are relevant to the client may include the client's: 

A. 
racial or ethnic self-identification;  

B. 
experience of cultural bias as a stressor; 

C. 
immigration history and status; 

D. 
level of acculturation; 

E. 
time orientation; 

F. 
social orientation; 

G. 
verbal communication style; 

H. 
locus of control; 

I. 
spiritual beliefs; and 

J. 
health beliefs and the endorsement of or engagement in culturally specific healing practices. 

Subp. 10.Culture.  
"Culture" means the distinct ways of living and understanding the world that are used by a group of people and are transmitted from one generation to another or adopted by an individual. 

Subp. 11.Diagnostic assessment.  
"Diagnostic assessment" means a written assessment that documents a clinical and functional face-to-face evaluation of the client's mental health, including the nature, severity and impact of behavioral difficulties, functional impairment, and subjective distress of the client, and identifies the client's strengths and resources. 

Subp. 12.Dialectical behavior therapy.  
"Dialectical behavior therapy" means an evidence-based treatment approach provided in an intensive outpatient treatment program using a combination of individualized rehabilitative and psychotherapeutic interventions. A dialectical behavior therapy program is certified by the commissioner and involves the following service components: individual dialectical behavior therapy, group skills training, telephone coaching, and team consultation meetings. 

Subp. 13.Explanation of findings.  
"Explanation of findings" means the explanation of a client's diagnostic assessment, psychological testing, treatment program, and consultation with culturally informed mental health consultants as required under parts 9520.0900 to 9520.0926, or other accumulated data and recommendations to the client, client's family, primary caregiver, or other responsible persons. 

Subp. 14.Family.  
"Family" means a person who is identified by the client or the client's parent or guardian as being important to the client's mental health treatment. Family may include, but is not limited to, parents, children, spouse, committed partners, former spouses, persons related by blood or adoption, or persons who are presently residing together as a family unit. 

Subp. 15.Individual treatment plan.  
"Individual treatment plan" means a written plan that outlines and defines the course of treatment. It delineates the goals, measurable objectives, target dates for achieving specific goals, main participants in treatment process, and recommended services that are based on the client's diagnostic assessment and other meaningful data that are needed to aid the client's recovery and enhance resiliency. 

Subp. 16.Medication management.  
"Medication management" means a service that determines the need for or effectiveness of the medication prescribed for the treatment of a client's symptoms of a mental illness. 

Subp. 17.Mental health practitioner.  
"Mental health practitioner" means a person who is qualified according to part 9505.0371, subpart 5, items B and C, and provides mental health services to a client with a mental illness under the clinical supervision of a mental health professional. 

Subp. 18.Mental health professional.  
"Mental health professional" means a person who is enrolled to provide medical assistance services and is qualified according to part 9505.0371, subpart 5, item A. 

Subp. 19.Mental health telemedicine.  
"Mental health telemedicine" has the meaning given in Minnesota Statutes, section 256B.0625, subdivision 46. 

Subp. 20.Mental illness.  
"Mental illness" has the meaning given in Minnesota Statutes, section 245.462, subdivision 20. "Mental illness" includes "emotional disturbance" as defined in Minnesota Statutes, section 245.4871, subdivision 15. 

Subp. 21.Multidisciplinary staff.  
"Multidisciplinary staff" means a group of individuals from diverse disciplines who come together to provide services to clients under part 9505.0372, subparts 8, 9, and 10. 

Subp. 22.Neuropsychological assessment.  
"Neuropsychological assessment" means a specialized clinical assessment of the client's underlying cognitive abilities related to thinking, reasoning, and judgment that is conducted by a qualified neuropsychologist. 

Subp. 23.Neuropsychological testing.  
"Neuropsychological testing" means administering standardized tests and measures designed to evaluate the client's ability to attend to, process, interpret, comprehend, communicate, learn and recall information; and use problem-solving and judgment. 

Subp. 24.Partial hospitalization program.  
"Partial hospitalization program" means a provider's time-limited, structured program of psychotherapy and other therapeutic services, as defined in United States Code, title 42, chapter 7, subchapter XVIII, part E, section 1395x, (ff), that is provided in an outpatient hospital facility or community mental health center that meets Medicare requirements to provide partial hospitalization services. 

Subp. 25.Primary caregiver.  
"Primary caregiver" means a person, other than the facility staff, who has primary legal responsibility for providing the client with food, clothing, shelter, direction, guidance, and nurturance. 

Subp. 26.Psychological testing.  
"Psychological testing" means the use of tests or other psychometric instruments to determine the status of the recipient's mental, intellectual, and emotional functioning. 

Subp. 27.Psychotherapy.  
"Psychotherapy" means treatment of a client with mental illness that applies the most appropriate psychological, psychiatric, psychosocial, or interpersonal method that conforms to prevailing community standards of professional practice to meet the mental health needs of the client. 

Subp. 28.Supervisee.  
"Supervisee" means an individual who requires clinical supervision because the individual does not meet mental health professional standards in part 9505.0371, subpart 5, item A. 

9505.0371MEDICAL ASSISTANCE COVERAGE REQUIREMENTS FOR OUTPATIENT MENTAL HEALTH SERVICES. Subpart 1.Purpose.  
This part describes the requirements that outpatient mental health services must meet to receive medical assistance reimbursement. 

Subp. 2.Client eligibility for mental health services.  
The following requirements apply to mental health services: 

A. 
The provider must use a diagnostic assessment as specified in part 9505.0372 to determine a client's eligibility for mental health services under this part, except: 

(1) 
prior to completion of a client's initial diagnostic assessment, a client is eligible for: 

(a) 
one explanation of findings; 

(b) 
one psychological testing; and 

(c) 
either one individual psychotherapy session, one family psychotherapy session, or one group psychotherapy session; and 

(2) 
for a client who is not currently receiving mental health services covered by medical assistance, a crisis assessment as specified in Minnesota Statutes, section 256B.0624 or 256B.0944, conducted in the past 60 days may be used to allow up to ten sessions of mental health services within a 12-month period. 

B. 
A brief diagnostic assessment must meet the requirements of part 9505.0372, subpart 1, item D, and: 

(1) 
may be used to allow up to ten sessions of mental health services as specified in part 9505.0372 within a 12-month period before a standard or extended diagnostic assessment is required when the client is: 

(a) 
a new client; or 

(b) 
an existing client who has had fewer than ten sessions of psychotherapy in the previous 12 months and is projected to need fewer than ten sessions of psychotherapy in the next 12 months, or who only needs medication management; and 

(2) 
may be used for a subsequent annual assessment, if based upon the client's treatment history and the provider's clinical judgment, the client will need ten or fewer sessions of mental health services in the upcoming 12-month period; and 

(3) 
must not be used for: 

(a) 
a client or client's family who requires a language interpreter to participate in the assessment unless the client meets the requirements of subitem (1), unit (b), or (2); or 

(b) 
more than ten sessions of mental health services in a 12-month period. If, after completion of ten sessions of mental health services, the mental health professional determines the need for additional sessions, a standard assessment or extended assessment must be completed. 

C. 
For a child, a new standard or extended diagnostic assessment must be completed: 

(1) 
when the child does not meet the criteria for a brief diagnostic assessment; 

(2) 
at least annually following the initial diagnostic assessment, if: 

(a) 
additional services are needed; and 

(b) 
the child does not meet criteria for brief assessment; 

(3) 
when the child's mental health condition has changed markedly since the child's most recent diagnostic assessment; or 

(4) 
when the child's current mental health condition does not meet criteria of the child's current diagnosis. 

D. 
For an adult, a new standard diagnostic assessment or extended diagnostic assessment must be completed: 

(1) 
when the adult does not meet the criteria for a brief diagnostic assessment or an adult diagnostic assessment update; 

(2) 
at least every three years following the initial diagnostic assessment for an adult who receives mental health services; 

(3) 
when the adult's mental health condition has changed markedly since the adult's most recent diagnostic assessment; or 

(4) 
when the adult's current mental health condition does not meet criteria of the current diagnosis. 

E. 
An adult diagnostic assessment update must be completed at least annually unless a new standard or extended diagnostic assessment is performed. An adult diagnostic assessment update must include an update of the most recent standard or extended diagnostic assessment and any recent adult diagnostic assessment updates that have occurred since the last standard or extended diagnostic assessment. 

Subp. 3.Authorization for mental health services.  
Mental health services under this part are subject to authorization criteria and standards published by the commissioner according to Minnesota Statutes, section 256B.0625, subdivision 25. 

Subp. 4.Clinical supervision.  A. 
Clinical supervision must be based on each supervisee's written supervision plan and must: 

(1) 
promote professional knowledge, skills, and values development; 

(2) 
model ethical standards of practice; 

(3) 
promote cultural competency by: 

(a) 
developing the supervisee's knowledge of cultural norms of behavior for individual clients and generally for the clients served by the supervisee regarding the client's cultural influences, age, class, gender, sexual orientation, literacy, and mental or physical disability; 

(b) 
addressing how the supervisor's and supervisee's own cultures and privileges affect service delivery; 

(c) 
developing the supervisee's ability to assess their own cultural competence and to identify when consultation or referral of the client to another provider is needed; and 

(d) 
emphasizing the supervisee's commitment to maintaining cultural competence as an ongoing process; 

(4) 
recognize that the client's family has knowledge about the client and will continue to play a role in the client's life and encourage participation among the client, client's family, and providers as treatment is planned and implemented; and 

(5) 
monitor, evaluate, and document the supervisee's performance of assessment, treatment planning, and service delivery. 

B. 
Clinical supervision must be conducted by a qualified supervisor using individual or group supervision. Individual or group face-to-face supervision may be conducted via electronic communications that utilize interactive telecommunications equipment that includes at a minimum audio and video equipment for two-way, real-time, interactive communication between the supervisor and supervisee, and meet the equipment and connection standards of part 9505.0370, subpart 19. 

(1) 
Individual supervision means one or more designated clinical supervisors and one supervisee. 

(2) 
Group supervision means one clinical supervisor and two to six supervisees in face-to-face supervision. 

C. 
The supervision plan must be developed by the supervisor and the supervisee. The plan must be reviewed and updated at least annually. For new staff the plan must be completed and implemented within 30 days of the new staff person's employment. The supervision plan must include: 

(1) 
the name and qualifications of the supervisee and the name of the agency in which the supervisee is being supervised; 

(2) 
the name, licensure, and qualifications of the supervisor; 

(3) 
the number of hours of individual and group supervision to be completed by the supervisee including whether supervision will be in person or by some other method approved by the commissioner; 

(4) 
the policy and method that the supervisee must use to contact the clinical supervisor during service provision to a supervisee; 

(5) 
procedures that the supervisee must use to respond to client emergencies; and 

(6) 
authorized scope of practices, including: 

(a) 
description of the supervisee's service responsibilities; 

(b) 
description of client population; and 

(c) 
treatment methods and modalities. 

D. 
 Clinical supervision must be recorded in the supervisee's supervision record. The documentation must include: 

(1) 
date and duration of supervision; 

(2) 
identification of supervision type as individual or group supervision; 

(3) 
name of the clinical supervisor; 

(4) 
subsequent actions that the supervisee must take; and 

(5) 
date and signature of the clinical supervisor. 

E. 
Clinical supervision pertinent to client treatment changes must be recorded by a case notation in the client record after supervision occurs. 

Subp. 5.Qualified providers.  
Medical assistance covers mental health services according to part 9505.0372 when the services are provided by mental health professionals or mental health practitioners qualified under this subpart. 

A. 
A mental health professional must be qualified in one of the following ways: 

(1) 
in clinical social work, a person must be licensed as an independent clinical social worker by the Minnesota Board of Social Work under Minnesota Statutes, chapter 148D until August 1, 2011, and thereafter under Minnesota Statutes, chapter 148E; 

(2) 
in psychology, a person licensed by the Minnesota Board of Psychology under Minnesota Statutes, sections 148.88 to 148.98, who has stated to the board competencies in the diagnosis and treatment of mental illness; 

(3) 
in psychiatry, a physician licensed under Minnesota Statutes, chapter 147, who is certified by the American Board of Psychiatry and Neurology or is eligible for board certification; 

(4) 
in marriage and family therapy, a person licensed as a marriage and family therapist by the Minnesota Board of Marriage and Family Therapy under Minnesota Statutes, sections 148B.29 to 148B.39, and defined in parts 5300.0100 to 5300.0350; 

(5) 
in professional counseling, a person licensed as a professional clinical counselor by the Minnesota Board of Behavioral Health and Therapy under Minnesota Statutes, section 148B.5301;  

(6) 
a tribally approved mental health care professional, who meets the standards in Minnesota Statutes, section 256B.02, subdivision 7, paragraphs (b) and (c), and who is serving a federally recognized Indian tribe; or 

(7) 
in psychiatric nursing, a registered nurse who is licensed under Minnesota Statutes, sections 148.171 to 148.285, and meets one of the following criteria: 

(a) 
is certified as a clinical nurse specialist; 

(b) 
for children, is certified as a nurse practitioner in child or adolescent or family psychiatric and mental health nursing by a national nurse certification organization; or 

(c) 
for adults, is certified as a nurse practitioner in adult or family psychiatric and mental health nursing by a national nurse certification organization. 

B. 
A mental health practitioner for a child client must have training working with children. A mental health practitioner for an adult client must have training working with adults. A mental health practitioner must be qualified in at least one of the following ways: 

(1) 
holds a bachelor's degree in one of the behavioral sciences or related fields from an accredited college or university; and 

(a) 
has at least 2,000 hours of supervised experience in the delivery of mental health services to clients with mental illness; or 

(b) 
is fluent in the non-English language of the cultural group to which at least 50 percent of the practitioner's clients belong, completes 40 hours of training in the delivery of services to clients with mental illness, and receives clinical supervision from a mental health professional at least once a week until the requirements of 2,000 hours of supervised experience are met; 

(2) 
has at least 6,000 hours of supervised experience in the delivery of mental health services to clients with mental illness. Hours worked as a mental health behavioral aide I or II under Minnesota Statutes, section 256B.0943, subdivision 7, may be included in the 6,000 hours of experience for child clients; 

(3) 
is a graduate student in one of the mental health professional disciplines defined in item A and is formally assigned by an accredited college or university to an agency or facility for clinical training; 

(4) 
holds a master's or other graduate degree in one of the mental health professional disciplines defined in item A from an accredited college or university; or 

(5) 
is an individual who meets the standards in Minnesota Statutes, section 256B.02, subdivision 7, paragraphs (b) and (c), who is serving a federally recognized Indian tribe. 

C. 
Medical assistance covers diagnostic assessment, explanation of findings, and psychotherapy performed by a mental health practitioner working as a clinical trainee when: 

(1) 
the mental health practitioner is: 

(a) 
complying with requirements for licensure or board certification as a mental health professional, as defined in item A, including supervised practice in the delivery of mental health services for the treatment of mental illness; or 

(b) 
a student in a bona fide field placement or internship under a program leading to completion of the requirements for licensure as a mental health professional defined in item A; and 

(2) 
the mental health practitioner's clinical supervision experience is helping the practitioner gain knowledge and skills necessary to practice effectively and independently. This may include supervision of: 

(a) 
direct practice; 

(b) 
treatment team collaboration; 

(c) 
continued professional learning; and 

(d) 
job management. 

D. 
A clinical supervisor must: 

(1) 
be a mental health professional licensed as specified in item A; 

(2) 
hold a license without restrictions that has been in good standing for at least one year while having performed at least 1,000 hours of clinical practice; 

(3) 
be approved, certified, or in some other manner recognized as a qualified clinical supervisor by the person's professional licensing board, when this is a board requirement; 

(4) 
be competent as demonstrated by experience and graduate-level training in the area of practice and the activities being supervised; 

(5) 
not be the supervisee's blood or legal relative or cohabitant, or someone who has acted as the supervisee's therapist within the past two years; 

(6) 
have experience and skills that are informed by advanced training, years of experience, and mastery of a range of competencies that demonstrate the following: 

(a) 
capacity to provide services that incorporate best practice; 

(b) 
ability to recognize and evaluate competencies in supervisees; 

(c) 
ability to review assessments and treatment plans for accuracy and appropriateness; 

(d) 
ability to give clear direction to mental health staff related to alternative strategies when a client is struggling with moving towards recovery; and 

(e) 
ability to coach, teach, and practice skills with supervisees; 

(7) 
accept full professional liability for a supervisee's direction of a client's mental health services; 

(8) 
instruct a supervisee in the supervisee's work, and oversee the quality and outcome of the supervisee's work with clients; 

(9) 
review, approve, and sign the diagnostic assessment, individual treatment plans, and treatment plan reviews of clients treated by a supervisee; 

(10) 
review and approve the progress notes of clients treated by the supervisee according to the supervisee's supervision plan; 

(11) 
apply evidence-based practices and research-informed models to treat clients; 

(12) 
be employed by or under contract with the same agency as the supervisee; 

(13) 
develop a clinical supervision plan for each supervisee; 

(14) 
ensure that each supervisee receives the guidance and support needed to provide treatment services in areas where the supervisee practices; 

(15) 
establish an evaluation process that identifies the performance and competence of each supervisee; and 

(16) 
document clinical supervision of each supervisee and securely maintain the documentation record. 

Subp. 6.Release of information.  
Providers who receive a request for client information and providers who request client information must: 

A. 
comply with data practices and medical records standards in Minnesota Statutes, chapter 13, and Code of Federal Regulations, title 45, part 164; and 

B. 
subject to the limitations in item A, promptly provide client information, including a written diagnostic assessment, to other providers who are treating the client to ensure that the client will get services without undue delay. 

Subp. 7.Individual treatment plan.  
Except as provided in subpart 2, item A, subitem (1), a medical assistance payment is available only for services provided in accordance with the client's written individual treatment plan (ITP). The client must be involved in the development, review, and revision of the client's ITP. For all mental health services, except as provided in subpart 2, item A, subitem (1), and medication management, the ITP and subsequent revisions of the ITP must be signed by the client before treatment begins. The mental health professional or practitioner shall request the client, or other person authorized by statute to consent to mental health services for the client, to sign the client's ITP or revision of the ITP. In the case of a child, the child's parent, primary caregiver, or other person authorized by statute to consent to mental health services for the child shall be asked to sign the child's ITP and revisions of the ITP. If the client or authorized person refuses to sign the plan or a revision of the plan, the mental health professional or mental health practitioner shall note on the plan the refusal to sign the plan and the reason or reasons for the refusal. A client's individual treatment plan must be: 

A. 
based on the client's current diagnostic assessment; 

B. 
developed by identifying the client's service needs and considering relevant cultural influences to identify planned interventions that contain specific treatment goals and measurable objectives for the client; and 

C. 
reviewed at least once every 90 days, and revised as necessary. Revisions to the initial individual treatment plan do not require a new diagnostic assessment unless the client's mental health status has changed markedly as provided in subpart 2. 

Subp. 8.Documentation.  
To obtain medical assistance payment for an outpatient mental health service, a mental health professional or a mental health practitioner must promptly document: 

A. 
in the client's mental health record: 

(1) 
each occurrence of service to the client including the date, type of service, start and stop time, scope of the mental health service, name and title of the person who gave the service, and date of documentation; and 

(2) 
all diagnostic assessments and other assessments, psychological test results, treatment plans, and treatment plan reviews; 

B. 
the provider's contact with persons interested in the client such as representatives of the courts, corrections systems, or schools, or the client's other mental health providers, case manager, family, primary caregiver, legal representative, including the name and date of the contact or, if applicable, the reason the client's family, primary caregiver, or legal representative was not contacted; and 

C. 
dates that treatment begins and ends and reason for the discontinuation of the mental health service. 

Subp. 9.Service coordination.  
The provider must coordinate client services as authorized by the client as follows: 

A. 
When a recipient receives mental health services from more than one mental health provider, each provider must coordinate mental health services they provide to the client with other mental health service providers to ensure services are provided in the most efficient manner to achieve maximum benefit for the client. 

B. 
The mental health provider must coordinate mental health care with the client's physical health provider. 

Subp. 10.Telemedicine services.  
Mental health services in part 9505.0372 covered as direct face-to-face services may be provided via two-way interactive video if it is medically appropriate to the client's condition and needs. The interactive video equipment and connection must comply with Medicare standards that are in effect at the time of service. The commissioner may specify parameters within which mental health services can be provided via telemedicine. 

9505.0372COVERED SERVICES. Subpart 1.Diagnostic assessment.  
Medical assistance covers four types of diagnostic assessments when they are provided in accordance with the requirements in this subpart. 

A. 
To be eligible for medical assistance payment, a diagnostic assessment must: 

(1) 
identify a mental health diagnosis and recommended mental health services, which are the factual basis to develop the recipient's mental health services and treatment plan; or 

(2) 
include a finding that the client does not meet the criteria for a mental health disorder. 

B. 
A standard diagnostic assessment must include a face-to-face interview with the client and contain a written evaluation of a client by a mental health professional or practitioner working under clinical supervision as a clinical trainee according to part 9505.0371, subpart 5, item C. The standard diagnostic assessment must be done within the cultural context of the client and must include relevant information about: 

(1) 
the client's current life situation, including the client's: 

(a) 
age; 

(b) 
current living situation, including household membership and housing status; 

(c) 
basic needs status including economic status; 

(d) 
education level and employment status; 

(e) 
significant personal relationships, including the client's evaluation of relationship quality; 

(f) 
strengths and resources, including the extent and quality of social networks; 

(g) 
belief systems; 

(h) 
contextual nonpersonal factors contributing to the client's presenting concerns; 

(i) 
general physical health and relationship to client's culture; and 

(j) 
current medications; 

(2) 
the reason for the assessment, including the client's: 

(a) 
perceptions of the client's condition; 

(b) 
description of symptoms, including reason for referral; 

(c) 
history of mental health treatment, including review of the client's records; 

(d) 
important developmental incidents; 

(e) 
maltreatment, trauma, or abuse issues; 

(f) 
history of alcohol and drug usage and treatment; 

(g) 
health history and family health history, including physical, chemical, and mental health history; and 

(h) 
cultural influences and their impact on the client; 

(3) 
the client's mental status examination; 

(4) 
the assessment of client's needs based on the client's baseline measurements, symptoms, behavior, skills, abilities, resources, vulnerabilities, and safety needs; 

(5) 
the screenings used to determine the client's substance use, abuse, or dependency and other standardized screening instruments determined by the commissioner; 

(6) 
assessment methods and use of standardized assessment tools by the provider as determined and periodically updated by the commissioner; 

(7) 
the client's clinical summary, recommendations, and prioritization of needed mental health, ancillary or other services, client and family participation in assessment and service preferences, and referrals to services required by statute or rule; and 

(8) 
the client data that is adequate to support the findings on all axes of the current edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association; and any differential diagnosis. 

C. 
An extended diagnostic assessment must include a face-to-face interview with the client and contain a written evaluation of a client by a mental health professional or practitioner working under clinical supervision as a clinical trainee according to part 9505.0371, subpart 5, item C. The face-to-face interview is conducted over three or more assessment appointments because the client's complex needs necessitate significant additional assessment time. Complex needs are those caused by acuity of psychotic disorder; cognitive or neurocognitive impairment; need to consider past diagnoses and determine their current applicability; co-occurring substance abuse use disorder; or disruptive or changing environments, communication barriers, or cultural considerations as documented in the assessment. For child clients, the appointments may be conducted outside the diagnostician's office for face-to-face consultation and information gathering with family members, doctors, caregivers, teachers, and other providers, with or without the child present, and may involve directly observing the child in various settings that the child frequents such as home, school, or care settings. To complete the diagnostic assessment with adult clients, the appointments may be conducted outside of the diagnostician's office for face-to-face assessment with the adult client. The appointment may involve directly observing the adult client in various settings that the adult frequents, such as home, school, job, service settings, or community settings. The appointments may include face-to-face meetings with the adult client and the client's family members, doctors, caregivers, teachers, social support network members, recovery support resource representatives, and other providers for consultation and information gathering for the diagnostic assessment. The components of an extended diagnostic assessment include the following relevant information: 

(1) 
for children under age 5: 

(a) 
utilization of the DC:0-3R diagnostic system for young children; 

(b) 
an early childhood mental status exam that assesses the client's developmental, social, and emotional functioning and style both within the family and with the examiner and includes: 

i. 
physical appearance including dysmorphic features; 

ii. 
reaction to new setting and people and adaptation during evaluation; 

iii. 
self-regulation, including sensory regulation, unusual behaviors, activity level, attention span, and frustration tolerance; 

iv. 
physical aspects, including motor function, muscle tone, coordination, tics, abnormal movements, and seizure activity; 

v. 
vocalization and speech production, including expressive and receptive language; 

vi. 
thought, including fears, nightmares, dissociative states, and hallucinations; 

vii. 
affect and mood, including modes of expression, range, responsiveness, duration, and intensity; 

viii. 
play, including structure, content, symbolic functioning, and modulation of aggression; 

ix. 
cognitive functioning; and 

x. 
relatedness to parents, other caregivers, and examiner; and 

(c) 
other assessment tools as determined and periodically revised by the commissioner; 

(2) 
for children ages 5 to 18, completion of other assessment standards for children as determined and periodically revised by the commissioner; and 

(3) 
for adults, completion of other assessment standards for adults as determined and periodically revised by the commissioner. 

D. 
A brief diagnostic assessment must include a face-to-face interview with the client and a written evaluation of the client by a mental health professional or practitioner working under clinical supervision as a clinical trainee according to part 9505.0371, subpart 5, item C. The professional or practitioner must gather initial background information using the components of a standard diagnostic assessment in item B, subitems (1), (2), unit (b), (3), and (5), and draw a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's immediate needs or presenting problem. Treatment sessions conducted under authorization of a brief assessment may be used to gather additional information necessary to complete a standard diagnostic assessment or an extended diagnostic assessment. 

E. 
Adult diagnostic assessment update includes a face-to-face interview with the client, and contains a written evaluation of the client by a mental health professional or practitioner working under clinical supervision as a clinical trainee according to part 9505.0371, subpart 5, item C, who reviews a standard or extended diagnostic assessment. The adult diagnostic assessment update must update the most recent assessment document in writing in the following areas: 

(1) 
review of the client's life situation, including an interview with the client about the client's current life situation, and a written update of those parts where significant new or changed information exists, and documentation where there has not been significant change; 

(2) 
review of the client's presenting problems, including an interview with the client about current presenting problems and a written update of those parts where there is significant new or changed information, and note parts where there has not been significant change; 

(3) 
screenings for substance use, abuse, or dependency and other screenings as determined by the commissioner; 

(4) 
the client's mental health status examination; 

(5) 
assessment of client's needs based on the client's baseline measurements, symptoms, behavior, skills, abilities, resources, vulnerabilities, and safety needs; 

(6) 
the client's clinical summary, recommendations, and prioritization of needed mental health, ancillary, or other services, client and family participation in assessment and service preferences, and referrals to services required by statute or rule; and 

(7) 
the client's diagnosis on all axes of the current edition of the Diagnostic and Statistical Manual and any differential diagnosis. 

Subp. 2.Neuropsychological assessment.  
A neuropsychological assessment must include a face-to-face interview with the client, the interpretation of the test results, and preparation and completion of a report. A client is eligible for a neuropsychological assessment if at least one of the following criteria is met: 

A. 
There is a known or strongly suspected brain disorder based on medical history or neurological evaluation such as a history of significant head trauma, brain tumor, stroke, seizure disorder, multiple sclerosis, neurodegenerative disorders, significant exposure to neurotoxins, central nervous system infections, metabolic or toxic encephalopathy, fetal alcohol syndrome, or congenital malformations of the brain; or 

B. 
In the absence of a medically verified brain disorder based on medical history or neurological evaluation, there are cognitive or behavioral symptoms that suggest that the client has an organic condition that cannot be readily attributed to functional psychopathology, or suspected neuropsychological impairment in addition to functional psychopathology. Examples include: 

(1) 
poor memory or impaired problem solving; 

(2) 
change in mental status evidenced by lethargy, confusion, or disorientation; 

(3) 
deterioration in level of functioning; 

(4) 
marked behavioral or personality change;  

(5) 
in children or adolescents, significant delays in academic skill acquisition or poor attention relative to peers; 

(6) 
in children or adolescents, significant plateau in expected development of cognitive, social, emotional, or physical function, relative to peers; and 

(7) 
in children or adolescents, significant inability to develop expected knowledge, skills, or abilities as required to adapt to new or changing cognitive, social, emotional, or physical demands. 

C. 
If neither criterion in item A nor B is fulfilled, neuropsychological evaluation is not indicated. 

D. 
The neuropsychological assessment must be conducted by a neuropsychologist with competence in the area of neuropsychological assessment as stated to the Minnesota Board of Psychology who: 

(1) 
was awarded a diploma by the American Board of Clinical Neuropsychology, the American Board of Professional Neuropsychology, or the American Board of Pediatric Neuropsychology; 

(2) 
earned a doctoral degree in psychology from an accredited university training program: 

(a) 
completed an internship, or its equivalent, in a clinically relevant area of professional psychology; 

(b) 
completed the equivalent of two full-time years of experience and specialized training, at least one which is at the postdoctoral level, in the study and practices of clinical neuropsychology and related neurosciences supervised by a clinical neuropsychologist; and 

(c) 
holds a current license to practice psychology independently in accordance with Minnesota Statutes, sections 148.88 to 148.98; 

(3) 
is licensed or credentialed by another state's board of psychology examiners in the specialty of neuropsychology using requirements equivalent to requirements specified by one of the boards named in subitem (1); or 

(4) 
was approved by the commissioner as an eligible provider of neuropsychological assessment prior to December 31, 2010. 

Subp. 3.Neuropsychological testing.  A. 
Medical assistance covers neuropsychological testing when the client has either: 

(1) 
a significant mental status change that is not a result of a metabolic disorder that has failed to respond to treatment;  

(2) 
in children or adolescents, a significant plateau in expected development of cognitive, social, emotional, or physical function, relative to peers; 

(3) 
in children or adolescents, significant inability to develop expected knowledge, skills, or abilities, as required to adapt to new or changing cognitive, social, physical, or emotional demands; or 

(4) 
a significant behavioral change, memory loss, or suspected neuropsychological impairment in addition to functional psychopathology, or other organic brain injury or one of the following: 

(a) 
traumatic brain injury; 

(b) 
stroke; 

(c) 
brain tumor; 

(d) 
substance abuse or dependence; 

(e) 
cerebral anoxic or hypoxic episode; 

(f) 
central nervous system infection or other infectious disease; 

(g) 
neoplasms or vascular injury of the central nervous system; 

(h) 
neurodegenerative disorders; 

(i) 
demyelinating disease; 

(j) 
extrapyramidal disease; 

(k) 
exposure to systemic or intrathecal agents or cranial radiation known to be associated with cerebral dysfunction;  

(l) 
systemic medical conditions known to be associated with cerebral dysfunction, including renal disease, hepatic encephalopathy, cardiac anomaly, sickle cell disease, and related hematologic anomalies, and autoimmune disorders such as lupus, erythematosis, or celiac disease; 

(m) 
congenital genetic or metabolic disorders known to be associated with cerebral dysfunction, such as phenylketonuria, craniofacial syndromes, or congenital hydrocephalus; 

(n) 
severe or prolonged nutrition or malabsorption syndromes; or 

(o) 
a condition presenting in a manner making it difficult for a clinician to distinguish between: 

i. 
the neurocognitive effects of a neurogenic syndrome such as dementia or encephalopathy; and 

ii. 
a major depressive disorder when adequate treatment for major depressive disorder has not resulted in improvement in neurocognitive function, or another disorder such as autism, selective mutism, anxiety disorder, or reactive attachment disorder. 

B. 
Neuropsychological testing must be administered or clinically supervised by a neuropsychologist qualified as defined in subpart 2, item D. 

C. 
Neuropsychological testing is not covered when performed: 

(1) 
primarily for educational purposes; 

(2) 
primarily for vocational counseling or training; 

(3) 
for personnel or employment testing; 

(4) 
as a routine battery of psychological tests given at inpatient admission or continued stay; or 

(5) 
for legal or forensic purposes. 

Subp. 4.Psychological testing.  
Psychological testing must meet the following requirements: 

A. 
The psychological testing must: 

(1) 
be administered or clinically supervised by a licensed psychologist with competence in the area of psychological testing as stated to the Minnesota Board of Psychology; and 

(2) 
be validated in a face-to-face interview between the client and a licensed psychologist or a mental health practitioner working as a clinical psychology trainee as required by part 9505.0371, subpart 5, item C, under the clinical supervision of a licensed psychologist according to part 9505.0371, subpart 5, item A, subitem (2). 

B. 
The administration, scoring, and interpretation of the psychological tests must be done under the clinical supervision of a licensed psychologist when performed by a technician, psychometrist, or psychological assistant or as part of a computer-assisted psychological testing program. 

C. 
The report resulting from the psychological testing must be: 

(1) 
signed by the psychologist conducting the face-to-face interview; 

(2) 
placed in the client's record; and 

(3) 
released to each person authorized by the client. 

Subp. 5.Explanations of findings.  
To be eligible for medical assistance payment, the mental health professional providing the explanation of findings must obtain the authorization of the client or the client's representative to release the information as required in part 9505.0371, subpart 6. Explanation of findings is provided to the client, client's family, and caregivers, or to other providers to help them understand the results of the testing or diagnostic assessment, better understand the client's illness, and provide professional insight needed to carry out a plan of treatment. An explanation of findings is not paid separately when the results of psychological testing or a diagnostic assessment are explained to the client or the client's representative as part of the psychological testing or a diagnostic assessment. 

Subp. 6.Psychotherapy.  
Medical assistance covers psychotherapy as conducted by a mental health professional or a mental health practitioner as defined in part 9505.0371, subpart 5, item C, as provided in this subpart. 

A. 
Individual psychotherapy is psychotherapy designed for one client. 

B. 
Family psychotherapy is designed for the client and one or more family members or the client's primary caregiver whose participation is necessary to accomplish the client's treatment goals. Family members or primary caregivers participating in a therapy session do not need to be eligible for medical assistance. For purposes of this subpart, the phrase "whose participation is necessary to accomplish the client's treatment goals" does not include shift or facility staff members at the client's residence. Medical assistance payment for family psychotherapy is limited to face-to-face sessions at which the client is present throughout the family psychotherapy session unless the mental health professional believes the client's absence from the family psychotherapy session is necessary to carry out the client's individual treatment plan. If the client is excluded, the mental health professional must document the reason for and the length of time of the exclusion. The mental health professional must also document the reason or reasons why a member of the client's family is excluded. 

C. 
Group psychotherapy is appropriate for individuals who because of the nature of their emotional, behavioral, or social dysfunctions can derive mutual benefit from treatment in a group setting. For a group of three to eight persons, one mental health professional or practitioner is required to conduct the group. For a group of nine to 12 persons, a team of at least two mental health professionals or two mental health practitioners or one mental health professional and one mental health practitioner is required to co-conduct the group. Medical assistance payment is limited to a group of no more than 12 persons. 

D. 
A multiple-family group psychotherapy session is eligible for medical assistance payment if the psychotherapy session is designed for at least two but not more than five families. Multiple-family group psychotherapy is clearly directed toward meeting the identified treatment needs of each client as indicated in client's treatment plan. If the client is excluded, the mental health professional or practitioner must document the reason for and the length of the time of the exclusion. The mental health professional or practitioner must document the reasons why a member of the client's family is excluded. 

Subp. 7.Medication management.  
The determination or evaluation of the effectiveness of a client's prescribed drug must be carried out by a physician or by an advanced practice registered nurse, as defined in Minnesota Statutes, sections 148.171 to 148.285, who is qualified in psychiatric nursing. 

Subp. 8.Adult day treatment.  
Adult day treatment payment limitations include the following conditions. 

A. 
Adult day treatment must consist of at least one hour of group psychotherapy, and must include group time focused on rehabilitative interventions, or other therapeutic services that are provided by a multidisciplinary staff. Adult day treatment is an intensive psychotherapeutic treatment. The services must stabilize the client's mental health status, and develop and improve the client's independent living and socialization skills. The goal of adult day treatment is to reduce or relieve the effects of mental illness so that an individual is able to benefit from a lower level of care and to enable the client to live and function more independently in the community. Day treatment services are not a part of inpatient or residential treatment services. 

B. 
To be eligible for medical assistance payment, a day treatment program must: 

(1) 
be reviewed by and approved by the commissioner; 

(2) 
be provided to a group of clients by a multidisciplinary staff under the clinical supervision of a mental health professional; 

(3) 
be available to the client at least two days a week for at least three consecutive hours per day. The day treatment may be longer than three hours per day, but medical assistance must not reimburse a provider for more than 15 hours per week; 

(4) 
include group psychotherapy done by a mental health professional, or mental health practitioner qualified according to part 9505.0371, subpart 5, item C, and rehabilitative interventions done by a mental health professional or mental health practitioner daily; 

(5) 
be included in the client's individual treatment plan as necessary and appropriate. The individual treatment plan must include attainable, measurable goals as they relate to services and must be completed before the first day treatment session. The vendor must review the recipient's progress and update the treatment plan at least every 30 days until the client is discharged and include an available discharge plan for the client in the treatment plan; and 

(6) 
document the interventions provided and the client's response daily. 

C. 
To be eligible for adult day treatment, a recipient must: 

(1) 
be 18 years of age or older; 

(2) 
not be residing in a nursing facility, hospital, institute of mental disease, or regional treatment center, unless the recipient has an active discharge plan that indicates a move to an independent living arrangement within 180 days; 

(3) 
have a diagnosis of mental illness as determined by a diagnostic assessment; 

(4) 
have the capacity to engage in the rehabilitative nature, the structured setting, and the therapeutic parts of psychotherapy and skills activities of a day treatment program and demonstrate measurable improvements in the recipient's functioning related to the recipient's mental illness that would result from participating in the day treatment program; 

(5) 
have at least three areas of functional impairment as determined by a functional assessment with the domains prescribed by Minnesota Statutes, section 245.462, subdivision 11a;  

(6) 
have a level of care determination that supports the need for the level of intensity and duration of a day treatment program; and 

(7) 
be determined to need day treatment by a mental health professional who must deem the day treatment services medically necessary. 

D. 
The following services are not covered by medical assistance if they are provided by a day treatment program: 

(1) 
a service that is primarily recreation-oriented or that is provided in a setting that is not medically supervised. This includes: sports activities, exercise groups, craft hours, leisure time, social hours, meal or snack time, trips to community activities, and tours; 

(2) 
a social or educational service that does not have or cannot reasonably be expected to have a therapeutic outcome related to the client's mental illness; 

(3) 
consultation with other providers or service agency staff about the care or progress of a client; 

(4) 
prevention or education programs provided to the community; 

(5) 
day treatment for recipients with primary diagnoses of alcohol or other drug abuse; 

(6) 
day treatment provided in the client's home; 

(7) 
psychotherapy for more than two hours daily; and 

(8) 
participation in meal preparation and eating that is not part of a clinical treatment plan to address the client's eating disorder. 

Subp. 9.Partial hospitalization.  
Partial hospitalization is a covered service when it is an appropriate alternative to inpatient hospitalization for a client who is experiencing an acute episode of mental illness that meets the criteria for an inpatient hospital admission as specified in part 9505.0520, subpart 1, and who has the family and community resources necessary and appropriate to support the client's residence in the community. Partial hospitalization consists of multiple intensive short-term therapeutic services provided by a multidisciplinary staff to treat the client's mental illness. 

Subp. 10.Dialectical behavior therapy (DBT).  
Dialectical behavior therapy (DBT) treatment services must meet the following criteria: 

A. 
DBT must be provided according to this subpart and Minnesota Statutes, section 256B.0625, subdivision 5l. 

B. 
DBT is an outpatient service that is determined to be medically necessary by either: (1) a mental health professional qualified according to part 9505.0371, subpart 5, or (2) a mental health practitioner working as a clinical trainee according to part 9505.0371, subpart 5, item C, who is under the clinical supervision of a mental health professional according to part 9505.0371, subpart 5, item D, with specialized skill in dialectical behavior therapy. The treatment recommendation must be based upon a comprehensive evaluation that includes a diagnostic assessment and functional assessment of the client, and review of the client's prior treatment history. Treatment services must be provided pursuant to the client's individual treatment plan and provided to a client who satisfies the criteria in item C. 

C. 
To be eligible for DBT, a client must: 

(1) 
be 18 years of age or older; 

(2) 
have mental health needs that cannot be met with other available community-based services or that must be provided concurrently with other community-based services; 

(3) 
meet one of the following criteria: 

(a) 
have a diagnosis of borderline personality disorder; or 

(b) 
have multiple mental health diagnoses and exhibit behaviors characterized by impulsivity, intentional self-harm behavior, and be at significant risk of death, morbidity, disability, or severe dysfunction across multiple life areas; 

(4) 
understand and be cognitively capable of participating in DBT as an intensive therapy program and be able and willing to follow program policies and rules assuring safety of self and others; and 

(5) 
be at significant risk of one or more of the following if DBT is not provided: 

(a) 
mental health crisis; 

(b) 
requiring a more restrictive setting such as hospitalization; 

(c) 
decompensation; or 

(d) 
engaging in intentional self-harm behavior. 

D. 
The treatment components of DBT are individual therapy and group skills as follows: 

(1) 
Individual DBT combines individualized rehabilitative and psychotherapeutic interventions to treat suicidal and other dysfunctional behaviors and reinforce the use of adaptive skillful behaviors. The therapist must: 

(a) 
identify, prioritize, and sequence behavioral targets; 

(b) 
treat behavioral targets; 

(c) 
generalize DBT skills to the client's natural environment through telephone coaching outside of the treatment session; 

(d) 
measure the client's progress toward DBT targets; 

(e) 
help the client manage crisis and life-threatening behaviors; and 

(f) 
help the client learn and apply effective behaviors when working with other treatment providers. 

(2) 
Individual DBT therapy is provided by a mental health professional or a mental health practitioner working as a clinical trainee, according to part 9505.0371, subpart 5, item C, under the supervision of a licensed mental health professional according to part 9505.0371, subpart 5, item D. 

(3) 
Group DBT skills training combines individualized psychotherapeutic and psychiatric rehabilitative interventions conducted in a group format to reduce the client's suicidal and other dysfunctional coping behaviors and restore function by teaching the client adaptive skills in the following areas: 

(a) 
mindfulness; 

(b) 
interpersonal effectiveness; 

(c) 
emotional regulation; and 

(d) 
distress tolerance. 

(4) 
Group DBT skills training is provided by two mental health professionals, or by a mental health professional cofacilitating with a mental health practitioner. 

(5) 
The need for individual DBT skills training must be determined by a mental health professional or a mental health practitioner working as a clinical trainee, according to part 9505.0371, subpart 5, item C, under the supervision of a licensed mental health professional according to part 9505.0371, subpart 5, item D. 

E. 
A program must be certified by the commissioner as a DBT provider. To qualify for certification, a provider must: 

(1) 
hold current accreditation as a DBT program from a nationally recognized certification body approved by the commissioner or submit to the commissioner's inspection and provide evidence that the DBT program's policies, procedures, and practices will continuously meet the requirements of this subpart; 

(2) 
be enrolled as a MHCP provider;  

(3) 
collect and report client outcomes as specified by the commissioner; and 

(4) 
have a manual that outlines the DBT program's policies, procedures, and practices which meet the requirements of this subpart. 

F. 
The DBT treatment team must consist of persons who are trained in DBT treatment. The DBT treatment team may include persons from more than one agency. Professional and clinical affiliations with the DBT team must be delineated: 

(1) 
A DBT team leader must: 

(a) 
be a mental health professional employed by, affiliated with, or contracted by a DBT program certified by the commissioner; 

(b) 
have appropriate competencies and working knowledge of the DBT principles and practices; and 

(c) 
have knowledge of and ability to apply the principles and DBT practices that are consistent with evidence-based practices. 

(2) 
DBT team members who provide individual DBT or group skills training must: 

(a) 
be a mental health professional or be a mental health practitioner, who is employed by, affiliated with, or contracted with a DBT program certified by the commissioner; 

(b) 
have or obtain appropriate competencies and working knowledge of DBT principles and practices within the first six months of becoming a part of the DBT program; 

(c) 
have or obtain knowledge of and ability to apply the principles and practices of DBT consistently with evidence-based practices within the first six months of working at the DBT program; 

(d) 
participate in DBT consultation team meetings; and 

(e) 
require mental health practitioners to have ongoing clinical supervision by a mental health professional who has appropriate competencies and working knowledge of DBT principles and practices. 

Subp. 11.Noncovered services.  
The mental health services in items A to J are not eligible for medical assistance payment under this part: 

A. 
a mental health service that is not medically necessary; 

B. 
a neuropsychological assessment carried out by a person other than a neuropsychologist who is qualified according to part 9505.0372, subpart 2, item D; 

C. 
a service ordered by a court that is solely for legal purposes and not related to the recipient's diagnosis or treatment for mental illness; 

D. 
services dealing with external, social, or environmental factors that do not directly address the recipient's physical or mental health; 

E. 
a service that is only for a vocational purpose or an educational purpose that is not mental health related; 

F. 
staff training that is not related to a client's individual treatment plan or plan of care; 

G. 
child and adult protection services; 

H. 
fund-raising activities; 

I. 
community planning; and 

J. 
client transportation. 

9505.1693SCOPE AND PURPOSE. 
Parts 9505.1693 to 9505.1748 govern the early and periodic screening, diagnosis, and treatment (EPSDT) program. 

Parts 9505.1693 to 9505.1748 must be read in conjunction with section 1905(a)(4)(B) of the Social Security Act, as amended through December 31, 1981, and the Code of Federal Regulations, title 42, part 441, subpart B, as amended through October 1, 1987, and section 6403 of the Omnibus Budget Reconciliation Act of 1989. The purpose of the EPSDT program is to identify potentially disabling conditions in children eligible for medical assistance, to provide diagnosis and treatment for conditions identified, and to encourage parents and their children to use health care services when necessary. 

9505.1696DEFINITIONS. Subpart 1.Applicability.  
As used in parts 9505.1693 to 9505.1748, the following terms have the meanings given them. 

Subp. 2.Child.  
"Child" means a person who is eligible for early and periodic screening, diagnosis, and treatment under part 9505.1699. 

Subp. 3.Community health clinic.  
"Community health clinic" means a clinic that provides services by or under the supervision of a physician and that: 

A.
 is incorporated as a nonprofit corporation under Minnesota Statutes, chapter 317A; 

B.
 is exempt from federal income tax under Internal Revenue Code of 1986, section 501(c)(3), as amended through December 31, 1987; 

C.
 is established to provide health services to low-income population groups; and 

D.
 has written clinic policies describing the services provided by the clinic and concerning (1) the medical management of health problems, including problems that require referral to physicians, (2) emergency health services, and (3) the maintenance and review of health records by the physician. 

Subp. 4.Department.  
"Department" means the Minnesota Department of Human Services. 

Subp. 5.Diagnosis.  
"Diagnosis" means the identification and determination of the nature or cause of a disease or abnormality through the use of a health history; physical, developmental, and psychological examination; and laboratory tests. 

Subp. 6.Early and periodic screening clinic or EPS clinic.  
"Early and periodic screening clinic" or "EPS clinic" means an individual or facility that is approved by the Minnesota Department of Health under parts 4615.0900 to 4615.2000. 

Subp. 7.Early and periodic screening, diagnosis, and treatment program or EPSDT program.  
"Early and periodic screening, diagnosis, and treatment program" or "EPSDT program" means the program that provides screening, diagnosis, and treatment under parts 9505.1693 to 9505.1748; Code of Federal Regulations, title 42, section 441.55, as amended through October 1, 1986; and Minnesota Statutes, section 256B.02, subdivision 8, paragraph (12). 

Subp. 8.EPSDT clinic.  
"EPSDT clinic" means a facility supervised by a physician that provides screening according to parts 9505.1693 to 9505.1748 or an EPS clinic. 

Subp. 9.EPSDT provider agreement.  
"EPSDT provider agreement" means the agreement required by part 9505.1703, subpart 2. 

Subp. 11.Follow-up.  
"Follow-up" means efforts by a local agency to ensure that a screening requested for a child is provided to that child and that diagnosis and treatment indicated as necessary by a screening are also provided to that child. 

Subp. 12.Head Start agency.  
"Head Start agency" refers to the child development program administered by the United States Department of Health and Human Services, Office of Administration for Children, Youth and Families. 

Subp. 13.Local agency.  
"Local agency" means the county welfare board, multicounty welfare board, or human service agency established in Minnesota Statutes, section 256B.02, subdivision 6, and Minnesota Statutes, chapter 393. 

Subp. 14.Medical assistance.  
"Medical assistance" means the program authorized by title XIX of the Social Security Act and Minnesota Statutes, chapters 256 and 256B. 

Subp. 15.Outreach.  
"Outreach" means efforts by the department or a local agency to inform eligible persons about early and periodic screening, diagnosis, and treatment or to encourage persons to use the EPSDT program. 

Subp. 16.Parent.  
"Parent" refers to the genetic or adoptive parent of a child. 

Subp. 17.Physician.  
"Physician" means a person who is licensed to provide health services within the scope of the person's profession under Minnesota Statutes, chapter 147. 

Subp. 18.Prepaid health plan.  
"Prepaid health plan" means a health insurer licensed and operating under Minnesota Statutes, chapters 60A, 62A, and 62C, and a health maintenance organization licensed and operating under Minnesota Statutes, chapter 62D to provide health services to recipients of medical assistance entitlements. 

Subp. 19.Public health nursing service.  
"Public health nursing service" means the nursing program provided by a community health board under Minnesota Statutes, section 145A.04, subdivisions 1 and 1a. 

Subp. 20.Screening.  
"Screening" means the use of quick, simple procedures to separate apparently well children from those who need further examination for possible physical, developmental, or psychological problems. 

Subp. 21.Skilled professional medical personnel and supporting staff.  
"Skilled professional medical personnel" and "supporting staff" means persons as defined by Code of Federal Regulations, title 42, section 432.2, as amended through October 1, 1987. 

Subp. 22.Treatment.  
"Treatment" means the prevention, correction, or amelioration of a disease or abnormality identified by screening or diagnosis. 

9505.1699ELIGIBILITY TO BE SCREENED. 
A person under age 21 who is eligible for medical assistance is eligible for the EPSDT program. 

9505.1701CHOICE OF PROVIDER. Subpart 1.Choice of screening provider.  
Except as provided by subpart 3, a child or parent of a child who requests screening may choose any screening provider who has signed an EPSDT provider agreement and a medical assistance provider agreement. 

Subp. 2.Choice of diagnosis and treatment provider.  
Except as provided by subpart 3, a child or parent of a child may choose any diagnosis and treatment provider as provided by part 9505.0190. 

Subp. 3.Exception to subparts 1 and 2.  
A child who is enrolled in a prepaid health plan must receive screening, diagnosis, and treatment from that plan. 

9505.1703ELIGIBILITY TO PROVIDE SCREENING. Subpart 1.Providers.  
An EPSDT clinic or a community health clinic shall be approved for medical assistance reimbursement for EPSDT services if it complies with the requirements of parts 9505.1693 to 9505.1748. A Head Start agency shall be approved as provided by subpart 2. 

Subp. 2.EPSDT provider agreement.  
To be eligible to provide screening and receive reimbursement under the EPSDT program, an individual or facility must sign an EPSDT provider agreement provided by the department and a medical assistance provider agreement under part 9505.0195 or be a prepaid health plan. 

Subp. 3.Terms of EPSDT provider agreement.  
The EPSDT provider agreement required by subpart 2 must state that the provider must: 

A.
 screen children according to parts 9505.1693 to 9505.1748; 

B.
 report all findings of the screenings on EPSDT screening forms; and 

C.
 refer children for diagnosis and treatment if a referral is indicated by the screening. 

The EPSDT provider agreement also must state that the department will provide training according to part 9505.1712 and will train and consult with the provider on billing and reporting procedures. 

9505.1706REIMBURSEMENT. Subpart 1.Maximum payment rates.  
Payment rates shall be as provided by part 9505.0445, item M. 

Subp. 2.Eligibility for reimbursement; Head Start agency.  
A Head Start agency may complete all the screening components under part 9505.1718, subparts 2 to 14 or those components that have not been completed by another provider within the six months before completion of the screening components by the Head Start agency. A Head Start agency that completes the previously incomplete screening components must document on the EPSDT screening form that the other screening components of part 9505.1718, subparts 2 to 14, have been completed by another provider. 

The department shall reimburse a Head Start agency for those screening components of part 9505.1718, subparts 2 to 14, that the Head Start agency has provided. The amount of reimbursement must be the same as a Head Start agency's usual and customary cost for each screening component or the maximum fee determined under subpart 1, whichever is lower. 

Subp. 3.Prepaid health plan.  
A prepaid health plan is not eligible for a separate payment for screening. The early and periodic screening, diagnosis, and treatment screening must be a service included within the prepaid capitation rate specified in its contract with the department. 

9505.1712TRAINING. 
The department must train the staff of an EPSDT clinic that is supervised by a physician on how to comply with the procedures required by part 9505.1718 if the EPSDT clinic requests the training. 

9505.1715COMPLIANCE WITH SURVEILLANCE AND UTILIZATION REVIEW. 
A screening provider must comply with the surveillance and utilization review requirements of parts 9505.2160 to 9505.2245. 

9505.1718SCREENING STANDARDS FOR AN EPSDT CLINIC. Subpart 1.Requirement.  
An early and periodic screening, diagnosis, and treatment screening must meet the requirements of subparts 2 to 15 except as provided by part 9505.1706, subpart 2. 

Subp. 2.Health and developmental history.  
A history of a child's health and development must be obtained from the child, parent of the child, or an adult who is familiar with the child's health history. The history must include information on sexual development, lead and tuberculosis exposure, nutrition intake, chemical abuse, and social, emotional, and mental health status. 

Subp. 3.Assessment of physical growth.  
The child's height or length and the child's weight must be measured and the results plotted on a growth grid based on data from the National Center for Health Statistics (NCHS). The head circumference of a child up to 36 months of age or a child whose growth in head circumference appears to deviate from the expected circumference for that child must be measured and plotted on an NCHS-based growth grid. 

Subp. 4.Physical examination.  
The following must be checked according to accepted medical procedures: pulse; respiration; blood pressure; head; eyes; ears; nose; mouth; pharynx; neck; chest; heart; lungs; abdomen; spine; genitals; extremities; joints; muscle tone; skin; and neurological condition. 

Subp. 5.Vision.  
A child must be checked for a family history of maternal and neonatal infection and ocular abnormalities. A child must be observed for pupillary reflex; the presence of nystagmus; and muscle balance, which includes an examination for esotropia, exotropia, phorias, and extraocular movements. The external parts of a child's eyes must be examined including the lids, conjunctiva, cornea, iris, and pupils. A child or parent of the child must be asked whether he or she has concerns about the child's vision. 

Subp. 6.Vision of a child age three or older.  
In addition to the requirements of subpart 5, the visual acuity of a child age three years or older must be checked by use of the Screening Test for Young Children and Retardates (STYCAR) or the Snellen Alphabet Chart. 

Subp. 7.Hearing.  
A child must be checked for a family history of hearing disability or loss, delay of language acquisition or history of such delay, the ability to determine the direction of a sound, and a history of repeated otitis media during early life. A child or parent of the child must be asked whether he or she has any concerns regarding the child's hearing. 

Subp. 8.Hearing of a child age three or older.  
In addition to the requirements of subpart 7, a child age three or older must receive a pure tone audiometric test or referral for the test if the examination under subpart 7 indicates the test is needed. 

Subp. 9.Development.  
A child must be screened for the following according to the screening provider's standard procedures: fine and gross motor development, speech and language development, social development, cognitive development, and self-help skills. Standardized tests that are used in screening must be culturally sensitive and have norms for the age range tested, written procedures for administration and for scoring and interpretation that are statistically reliable and valid. The provider must use a combination of the child's health and developmental history and standardized test or clinical judgment to determine the child's developmental status or need for further assessment. 

Subp. 10.Sexual development.  
A child must be evaluated to determine whether the child's sexual development is consistent with the child's chronological age. A female must receive a breast examination and pelvic examination when indicated. A male must receive a testicular examination when indicated. If it is in the best interest of a child, counseling on normal sexual development, information on birth control and sexually transmitted diseases, and prescriptions and tests must be offered to a child. If it is in the best interest of a child, a screening provider may refer the child to other resources for counseling or a pelvic examination. 

Subp. 11.Nutrition.  
When the assessment of a child's physical growth performed according to subpart 3 indicates a nutritional risk condition, the child must be referred for further assessment, receive nutritional counseling, or be referred to a nutrition program such as the Special Supplemental Food Program for Women, Infants, and Children; food stamps or food support; Expanded Food and Nutrition Education Program; or Head Start. 

Subp. 12.Immunizations.  
The immunization status of a child must be compared to the "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition. Immunizations that the comparison shows are needed must be offered to the child and given to the child if the child or parent of the child accepts the offer. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is developed and distributed by the Minnesota Department of Health, 717 Delaware Street Southeast, Minneapolis, Minnesota 55440. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is incorporated by reference and is available at the State Law Library, Judicial Center, 25 Rev. Dr. Martin Luther King Jr. Blvd., Saint Paul, Minnesota 55155. It is subject to frequent change. 

Subp. 13.Laboratory tests.  
Laboratory tests must be done according to items A to F. 

A.
 A Mantoux test must be administered yearly to a child whose health history indicates ongoing exposure to tuberculosis, unless the child has previously tested positive. A child who tests positive must be referred for diagnosis and treatment. 

B.
 A child aged one to five years must initially be screened for lead through the use of either an erythrocyte protoporphyrin (EP) test or a direct blood lead screening test until December 31, 1992. Beginning January 1, 1993, a child age one to five must initially be screened using a direct blood lead screening test. Either capillary or venous blood may be used as the specimen for the direct blood lead test. Blood tests must be performed at a minimum of once at 12 months of age and once at 24 months of age or whenever the history indicates that there are risk factors for lead poisoning. When the result of the EP or capillary blood test is greater than the maximum allowable level set by the Centers for Disease Control of the United States Public Health Service, the child must be referred for a venous blood lead test. A child with a venous blood lead level greater than the maximum allowable level set by the Centers for Disease Control must be referred for diagnosis and treatment. 

C.
 The urine of a child must be tested for the presence of glucose, ketones, protein, and other abnormalities. A female at or near the age of four and a female at or near the age of ten must be tested for bacteriuria. 

D.
 Either a microhematocrit determination or a hemoglobin concentration test for anemia must be done. 

E.
 A test for sickle cell or other hemoglobinopathy, or abnormal blood conditions must be offered to a child who is at risk of such abnormalities and who has not yet been tested. These tests must be provided if accepted or requested by the child or parent of the child. If the tests identify a hemoglobin abnormality or other abnormal blood condition, the child must be referred for genetic counseling. 

F.
 Other laboratory tests such as those for cervical cancer, sexually transmitted diseases, pregnancy, and parasites must be performed when indicated by a child's medical or family history. 

Subp. 14.Oral examination.  
An oral examination of a child's mouth must be performed to detect deterioration of hard tissue, and inflammation or swelling of soft tissue. Counseling about the systemic use of fluoride must be given to a child when fluoride is not available through the community water supply or school programs. 

Subp. 14a.Health education and health counseling.  
Health education and health counseling concerning the child's health must be offered to the child who is being screened and to the child's parent or representative. The health education and health counseling are for the purposes of assisting the child or the parent or representative of the child to understand the expected growth and development of the child and of informing the child or the parent or representative of the child about the benefits of healthy lifestyles and about practices to promote accident and disease prevention. 

Subp. 15.Schedule of age related screening standards.  
An early and periodic screening, diagnosis, and treatment screening for a child at a specific age must include, at a minimum, the screening requirements of subparts 2 to 14 as provided by the following schedule: 

Schedule of age related screening standards 

A.
 Infancy: 

	Standards	Ages	
								
		By 1 month	2 months	4 months	6 months	9 months	12 months	
								
	Health History	X	X	X	X	X	X	
								
	Assessment of Physical Growth:							
	Height	X	X	X	X	X	X	
	Weight	X	X	X	X	X	X	
	Head Circumference	X	X	X	X	X	X	
	Physical Examination	X	X	X	X	X	X	
	Vision	X	X	X	X	X	X	
	Hearing	X	X	X	X	X	X	
								
	Development	X	X	X	X	X	X	
								
	Health Education/Counseling	X	X	X	X	X	X	
								
	Sexual Development	X	X	X	X	X	X	
								
	Nutrition	X	X	X	X	X	X	
								
	Immunizations/Review		X	X	X	X	X	
								
	Laboratory Tests:							
	Tuberculin	if history indicates		
	Lead Absorption	if history indicates	X	
	Urinalysis	←	←	←	X	←	←	
	Hematocrit or Hemoglobin	←	←	←	←	X	X	
	Sickle Cell		at parent's or child's request	
	Other Laboratory Tests		as indicated	
								
	Oral Examination	X	X	X	X	X	X	

X = Procedure to be completed. 

← = Procedure to be completed if not done at the previous visit, or on the first visit. 

B.
 Early Childhood: 

	Standards	Ages	
							
		15 months	18 months	24 months	3years	4years	
							
	Health History	X	X	X	X	X	
							
	Assessment of Physical Growth:						
	Height	X	X	X	X	X	
	Weight	X	X	X	X	X	
	Head Circumference	X	X	X	X	X	
	Physical Examination	X	X	X	X	X	
	Vision	X	X	X	X	X	
	Hearing	X	X	X	X	X	
	Blood Pressure				X	X	
							
	Development	X	X	X	X	X	
							
	Health Education/Counseling	X	X	X	X	X	
							
	Sexual Development	X	X	X	X	X	
							
	Nutrition	X	X	X	X	X	
							
	Immunizations/Review	X	X	X	X	X	
							
	Laboratory Tests:						
	Tuberculin	if history indicates	
	Lead Absorption	if history indicates	X	if history indicates	
	Urinalysis	←	←	X	←	←	
	Bacteriuria (females)					X	
	Hematocrit or Hemoglobin	←	←	←	←	←	
	Sickle Cell	at parent's or child's request	
	Other Laboratory Tests	as indicated	
							
	Oral Examination	X	X	X	X	X	

X = Procedure to be completed. 

← = Procedure to be completed if not done at the previous visit, or on the first visit. 

C.
 Late childhood: 

	Standards	Ages	
							
		5 years	6 years	8 years	10 years	12 years	
							
	Health History	X	X	X	X	X	
							
	Assessment of Physical Growth:						
	Height	X	X	X	X	X	
	Weight	X	X	X	X	X	
	Physical Examination	X	X	X	X	X	
	Vision	X	X	X	X	X	
	Hearing	X	X	X	X	X	
	Blood Pressure	X	X	X	X	X	
							
	Development	X	X	X	X	X	
							
	Health Education/Counseling	X	X	X	X	X	
							
	Sexual Development	X	X	X	X	X	
							
	Nutrition	X	X	X	X	X	
							
	Immunizations/Review	X	X	X	X	X	
							
	Laboratory Tests:						
	Tuberculin	if history indicates	
	Lead Absorption	if history indicates	
	Urinalysis	←	←	X	←	←	
	Bacteriuria (females)	←	←	X	←	←	
	Hemoglobin or Hematocrit	←	←	X	←		
	Sickle Cell	at parent's or child's request	
	Other Laboratory Tests	as indicated	
							
	Oral Examination	X	X	X	X	X	

X = Procedure to be completed. 

← = Procedure to be completed if not done at the previous visit, or on the first visit. 

D.
 Adolescence: 

	Standards	Ages	
						
		14 years	16 years	18 years	20 years	
						
	Health History	X	X	X	X	
						
	Assessment of Physical Growth:					
	Height	X	X	X	X	
	Weight	X	X	X	X	
	Physical Examination	X	X	X	X	
	Vision	X	X	X	X	
	Hearing	X	X	X	X	
	Blood Pressure	X	X	X	X	
						
	Development	X	X	X	X	
						
	Health Education/Counseling	X	X	X	X	
						
	Sexual Development	X	X	X	X	
						
	Nutrition	X	X	X	X	
						
	Immunizations/Review	X	X	X	X	
						
	Laboratory Tests:					
	Tuberculin	if history indicates	
	Lead Absorption	if history indicates	
	Urinalysis	←		X		
	Bacteriuria (females)	←		←		
	Hemoglobin or Hematocrit	←		X		
	Sickle Cell	at parent's or child's request	
	Other Laboratory Tests	as indicated	
						
	Oral Examination	X		X		

X = Procedure to be completed. 

← = Procedure to be completed if not done at the previous visit, or on the first visit. 

Subp. 15a.Additional screenings.  
A child may have a partial or complete screening between the ages specified in the schedule under subpart 15 if the screening is medically necessary or a concern develops about the child's health or development. 

9505.1724PROVISION OF DIAGNOSIS AND TREATMENT. 
Diagnosis and treatment identified as needed under part 9505.1718 shall be eligible for medical assistance payment subject to the provisions of parts 9505.0170 to 9505.0475. 

9505.1727INFORMING. 
A local agency must inform each child or parent of a child about the EPSDT program no later than 60 days after the date the child is determined to be eligible for medical assistance. The information about the EPSDT program must be given orally and in writing, indicate the purpose and benefits of the EPSDT program, indicate that the EPSDT program is without cost to the child or parent of the child while the child is eligible for medical assistance, state the types of medical and dental services available under the EPSDT program, and state that the transportation and appointment scheduling assistance required under part 9505.1730 is available. 

The department must send a written notice to a child or parent of a child who has been screened informing the child or parent that the child should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years after age four. 

Each year, on the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to a child or parent of a child who has never been screened informing the child or parent that the child is eligible to be screened. 

9505.1730ASSISTANCE WITH OBTAINING A SCREENING. 
Within ten working days of receiving a request for screening from a child or parent of a child, a local agency must give or mail to the child or parent of the child: 

A.
 a written list of EPSDT clinics in the area in which the child lives; and 

B.
 a written offer of help in making a screening appointment and in transporting the child to the site of the screening. 

If the child or parent of the child requests help, the local agency must provide it. 

Transportation under this item must be provided according to part 9505.0140, subpart 1. 

9505.1733ASSISTANCE WITH OBTAINING DIAGNOSIS AND TREATMENT. 
An EPSDT clinic must notify a child or parent of a child who is referred for diagnosis and treatment that the local agency will provide names and addresses of diagnosis and treatment providers and will help with appointment scheduling and transportation to the diagnosis and treatment provider. The notice must be on a form provided by the department and must be given to the child or parent of the child on the day the child is screened. 

If a child or parent of a child asks a local agency for assistance with obtaining diagnosis and treatment, the local agency must provide that assistance within ten working days of the date of the request. 

9505.1736SPECIAL NOTIFICATION REQUIREMENT. 
A local agency must effectively inform an individual who is blind or deaf, or who cannot read or understand the English language, about the EPSDT program. 

9505.1739CHILDREN IN FOSTER CARE. Subpart 1.Dependent or neglected state wards.  
The local agency must provide early and periodic screening, diagnosis, and treatment services for a child in foster care who is a dependent or neglected state ward under parts 9560.0410 to 9560.0470, and who is eligible for medical assistance unless the early and periodic screening, diagnosis, and treatment services are not in the best interest of the child. 

Subp. 2.Other children in foster care.  
The local agency must discuss the EPSDT program with a parent of a child in foster care who is under the legal custody or protective supervision of the local agency or whose parent has entered into a voluntary placement agreement with the local agency. The local agency must help the parent decide whether to accept early and periodic screening, diagnosis, and treatment services for the child. If a parent cannot be consulted, the local agency must decide whether to accept early and periodic screening, diagnosis, and treatment services for the child and must document the reasons for the decision. 

Subp. 3.Assistance with appointment scheduling and transportation.  
The local agency must help a child in foster care with appointment scheduling and transportation for screening, diagnosis, and treatment as provided by parts 9505.1730 to 9505.1733. 

Subp. 4.Notification.  
The department must send a written notice to the local agency stating that a child in foster care who has been screened should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years thereafter. 

Each year, by the anniversary of the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to the local agency that a child in foster care who has never been screened is eligible to be screened. 

If a written notice under this subpart pertains to a child who is a dependent or neglected state ward, the local agency must proceed according to subpart 1. The local agency must proceed according to subpart 2 if the written notice pertains to a child who is not a dependent or neglected state ward. 

9505.1742DOCUMENTATION. 
The local agency must document compliance with parts 9505.1693 to 9505.1748 on forms provided by the department. 

9505.1745INTERAGENCY COORDINATION. 
The local agency must coordinate the EPSDT program with other programs that provide health services to children as provided by Code of Federal Regulations, title 42, section 441.61(c), as amended through October 1, 1986. Examples of such agencies are a public health nursing service, a Head Start agency, and a school district. 

9505.1748CONTRACTS FOR ADMINISTRATIVE SERVICES. Subpart 1.Authority.  
A local agency may contract with a county public health nursing service, a community health clinic, a Head Start agency, a community action agency, or a school district for early and periodic screening, diagnosis, and treatment administrative services. Early and periodic screening, diagnosis, and treatment administrative services include outreach; notification; appointment scheduling and transportation; follow-up; and documentation. For purposes of this subpart, "community action agency" means an entity defined in Minnesota Statutes, section 256E.31, subdivision 1, and "school district" means a school district as defined in Minnesota Statutes, section 120A.05, subdivisions 5, 10, and 14. 

Subp. 2.Federal financial participation.  
The percent of federal financial participation for salaries, fringe benefits, and travel of skilled professional medical personnel and their supporting staff shall be paid as provided by Code of Federal Regulations, title 42, section 433.15(b)(5), as amended through October 1, 1986. 

Subp. 3.State reimbursement.  
State reimbursement for contracts for EPSDT administrative services under this part shall be as provided by Minnesota Statutes, section 256B.19, subdivision 1, except for the provisions under subdivision 1 that pertain to a prepaid health plan. 

Subp. 4.Approval.  
A contract for administrative services must be approved by the local agency and submitted to the department for approval by November 1 of the year before the beginning of the calendar year in which the contract will be effective. A contract must contain items A to L to be approved by the department for reimbursement: 

A.
 names of the contracting parties; 

B.
 purpose of the contract; 

C.
 beginning and ending dates of the contract; 

D.
 amount of the contract, budget breakdown, and a clause that stipulates that the department's procedures for certifying expenditures will be followed by the local agency; 

E.
 the method by which the contract may be amended or terminated; 

F.
 a clause that stipulates that the contract will be renegotiated if federal or state program regulations or federal financial reimbursement regulations change; 

G.
 a clause that stipulates that the contracting parties will provide program and fiscal records and maintain all nonpublic data required by the contract according to the Minnesota Government Data Practices Act and will cooperate with state and federal program reviews; 

H.
 a description of the services contracted for and the agency that will perform them; 

I.
 methods by which the local agency will monitor and evaluate the contract; 

J.
 signatures of the representatives of the contracting parties with the authority to obligate the parties by contract and dates of those signatures; 

K.
 a clause that stipulates that the services provided under contract must be performed by or under the supervision of skilled medical personnel; and 

L.
 a clause that stipulates that the contracting parties will comply with state and federal requirements for the receipt of medical assistance funds. 

9520.0010STATUTORY AUTHORITY AND PURPOSE. 
Parts 9520.0010 to 9520.0230 provide methods and procedures relating to the establishment and operation of area-wide, comprehensive, community-based mental health, developmental disability, and chemical dependency programs under state grant-in-aid as provided under Minnesota Statutes, sections 245.61 to 245.69. Minnesota Statutes, sections 245.61 to 245.69 are entitled The Community Mental Health Services Act. For purposes of these parts, "community mental health services" includes services to persons who have mental or emotional disorders or other psychiatric disabilities, developmental disabilities, and chemical dependency, including drug abuse and alcoholism. 

9520.0020BOARD DUTIES. 
The community mental health board has the responsibility for ensuring the planning, development, implementation, coordination, and evaluation of the community comprehensive mental health program for the mentally ill/behaviorally disabled, developmentally disabled, and chemically dependent populations in the geographic area it serves. It also has the responsibility for ensuring delivery of services designated by statute. 

9520.0030DEFINITIONS. 
Parts 9520.0040 and 9520.0050 also set forth definitions of community mental health centers and community mental health clinics. 

9520.0040COMMUNITY MENTAL HEALTH CENTER. 
A community mental health center means an agency which includes all of the following: 

A.
 Established under the provision of Minnesota Statutes, sections 245.61 to 245.69. 

B.
 Provides as a minimum the following services for individuals with mental or emotional disorders, developmental disabilities, alcoholism, drug abuse, and other psychiatric conditions. The extent of each service to be provided by the center shall be indicated in the program plan, which is to reflect the problems, needs, and resources of the community served: 

(1)
 collaborative and cooperative services with public health and other groups for programs of prevention of mental illness, developmental disability, alcoholism, drug abuse, and other psychiatric disorders; 

(2)
 informational and educational services to schools, courts, health and welfare agencies, both public and private; 

(3)
 informational and educational services to the general public, lay, and professional groups; 

(4)
 consultative services to schools, courts, and health and welfare agencies, both public and private; 

(5)
 outpatient diagnostic and treatment services; and 

(6)
 rehabilitative services, particularly for those who have received prior treatment in an inpatient facility. 

C.
 Provides or contracts for detoxification, evaluation, and referral for chemical dependency services (Minnesota Statutes, section 254A.08). 

D.
 Provides specific coordination for mentally ill/behaviorally disabled, developmental disability, and chemical dependency programs. (Minnesota Statutes, sections 254A.07 and 245.61). 

E.
 Has a competent multidisciplinary mental health/developmental disability/chemical dependency professional team whose members meet the professional standards in their respective fields. 

F.
 The professional mental health team is qualified by specific mental health training and experience and shall include as a minimum the services of each of the following: 

(1)
 a licensed physician, who has completed an approved residency program in psychiatry; and 

(2)
 a doctoral clinical, counseling, or health care psychologist, who is licensed under Minnesota Statutes, sections 148.88 to 148.98; and one or both of the following: 

(3)
 a clinical social worker with a master's degree in social work from an accredited college or university; and/or 

(4)
 a clinical psychiatric nurse with a master's degree from an accredited college or university and is registered under Minnesota Statutes, section 148.171. The master's degree shall be in psychiatric nursing or a related psychiatric nursing program such as public health nursing with mental health major, maternal and child health with mental health major, etc. 

G.
 The multidisciplinary staff shall be sufficient in number to implement and operate the described program of the center. In addition to the above, this team should include other professionals, paraprofessionals, and disciplines, particularly in the preventive and rehabilitative components of the program, subject to review and approval of job descriptions and qualifications by the commissioner. If any of the minimum required professional staff are not immediately available, the commissioner may approve and make grants for the operation of the center, provided that the board and director can show evidence acceptable to the commissioner that they are making sincere, reasonable, and ongoing efforts to acquire such staff and show evidence of how the specialized functions of the required professionals are being met. The services being rendered by employed personnel shall be consistent with their professional discipline. 

9520.0050COMMUNITY MENTAL HEALTH CLINIC. Subpart 1.Definitions.  
A community mental health clinic is an agency which devotes, as its major service, at least two-thirds of its resources for outpatient mental health diagnosis, treatment, and consultation by a multidisciplinary professional mental health team. The multidisciplinary professional mental health team is qualified by special mental health training and experience and shall include as a minimum the services of each of the following: 

A.
 a licensed physician, who has completed an approved residency program in psychiatry; and 

B.
 a doctoral clinical, or counseling or health care psychologist who is licensed under Minnesota Statutes, sections 148.88 to 148.98; and one or both of the following: 

C.
 a clinical social worker with a master's degree in social work from an accredited college or university; and/or 

D.
 a clinical psychiatric nurse with a master's degree from an accredited college or university and is registered under Minnesota Statutes, section 148.171. The master's degree shall be in psychiatric nursing or a related psychiatric nursing program such as public health with a mental health major, maternal and child health with a mental health major. 

Subp. 2.Other members of multidisciplinary team.  
The multidisciplinary team shall be sufficient in number to implement and operate the described program of the clinic. In addition to the above, this team should include other professionals, paraprofessionals and disciplines, particularly in the preventive and rehabilitative components of the program, subject to review and approval of job descriptions and qualifications by the commissioner. 

Subp. 3.Efforts to acquire staff.  
If any of the minimum required professional staff are not immediately available, the commissioner may approve and make grants for the operation of the clinic, provided that the board and director can show evidence acceptable to the commissioner that they are making sincere, reasonable, and ongoing efforts to acquire such staff and evidence of how the specialized functions of the required professional positions are being met. The services being rendered by employed personnel shall be consistent with their professional discipline. 

9520.0060ANNUAL PLAN AND BUDGET. 
On or before the date designated by the commissioner, each year the chair of the community mental health board or director of the community mental health program, provided for in Minnesota Statutes, section 245.62, shall submit an annual plan identifying program priorities in accordance with state grant-in-aid guidelines, and a budget on prescribed report forms for the next state fiscal year, together with the recommendations of the community mental health board, to the commissioner of human services for approval as provided under Minnesota Statutes, section 245.63. 

9520.0070FISCAL AFFILIATES. 
Other providers of community mental health services may affiliate with the community mental health center and may be approved and eligible for state grant-in-aid funds. The state funding for other community mental health services shall be contingent upon appropriate inclusion in the center's community mental health plan for the continuum of community mental health services and conformity with the state's appropriate disability plan for mental health, developmental disability, or chemical dependency. Fiscal affiliates (funded contracting agencies) providing specialized services under contract must meet all rules and standards that apply to the services they are providing. 

9520.0080OTHER REQUIRED REPORTS. 
The program director of the community mental health program shall provide the commissioner of human services with such reports of program activities as the commissioner may require. 

9520.0090FUNDING. 
All state community mental health funding shall go directly to the community mental health board or to a human service board established pursuant to Laws of Minnesota 1975, chapter 402, which itself provides or contracts with another agency to provide the community mental health program. Such programs must meet the standards and rules for community mental health programs as enunciated in parts 9520.0010 to 9520.0230 in accordance with Laws of Minnesota 1975, chapter 402. 

9520.0100OPERATION OF OTHER PROGRAMS. 
When the governing authority of the community mental health program operates other programs, services, or activities, only the community mental health center program shall be subject to these parts. 

9520.0110APPLICATIONS AND AGREEMENTS BY LOCAL COUNTIES. 
New applications for state assistance or applications for renewal of support must be accompanied by an agreement executed by designated signatories on behalf of the participating counties that specifies the involved counties, the amount and source of local funds in each case, and the period of support. The local funds to be used to match state grant-in-aid must be assured in writing on Department of Human Services forms by the local funding authority(ies). 

9520.0120USE OF MATCHING FUNDS. 
Funds utilized by the director as authorized by the community mental health board to match a state grant-in-aid must be available to that director for expenditures for the same general purpose as the state grant-in-aid funds. 

9520.0130QUARTERLY REPORTS. 
The director of the community mental health program shall, within 20 days after the end of the quarter, submit quarterly prescribed reports to the commissioner of human services (controller's office), containing all receipts, expenditures, and cash balance, subject to an annual audit by the commissioner or his/her designee. 

9520.0140PAYMENTS. 
Payments on approved grants will be made subsequent to the department's receipt of the program's quarterly reporting forms, unless the commissioner of human services has determined that funds allocated to a program are not needed for that program. Payments shall be in an amount of at least equal to the quarterly allocation minus any unexpended balance from the previous quarter providing this payment does not exceed the program grant award. In the event the program does not report within the prescribed time, the department will withhold the process of the program's payment until the next quarterly cycle. 

9520.0150FEES. 
No fees shall be charged until the director with approval of the community mental health board has established fee schedules for the services rendered and they have been submitted to the commissioner of human services at least two months prior to the effective date thereof and have been approved by him/her. All fees shall conform to the approved schedules, which are accessible to the public. 

9520.0160SUPPLEMENTAL AWARDS. 
The commissioner of human services may make supplemental awards to the community mental health boards. 

9520.0170WITHDRAWAL OF FUNDS. 
The commissioner of human services may withdraw funds from any program that is not administered in accordance with its approved plan and budget. Written notice of such intended action will be provided to the director and community mental health board. Opportunity for hearing before the commissioner or his/her designee shall be provided. 

9520.0180BUDGET TRANSFERS. 
Community mental health boards may make budget transfers within specified limits during any fiscal year without prior approval of the department. The specified limit which can be transferred in any fiscal year between program activity budgets shall be up to ten percent or up to $5,000 whichever is less. Transfers within an activity can be made into or out of line items with a specified limit of up to ten percent or up to $5,000 whichever is less. No line item can be increased or decreased by more than $5,000 or ten percent in a fiscal year without prior approval of the commissioner. Transfers above the specified limits can be made with prior approval from the commissioner. All transfers within and into program budget activities and/or line items must have prior approval by the community mental health board and this approval must be reflected in the minutes of its meeting, it must be reported to the commissioner with the reasons therefor, including a statement of how the transfer will affect program objectives. 

9520.0190BUDGET ADJUSTMENTS. 
Budget adjustments made necessary by funding limitations shall be made by the commissioner and provided in writing to the director and board of the community mental health center. 

9520.0200CENTER DIRECTOR. 
Every community mental health board receiving state funds for a community mental health program shall have a center director, who is the full-time qualified professional staff member who serves as the executive officer. To be considered qualified, the individual must have professional training to at least the level of graduate degree in his/her clinical and/or administrative discipline, which is relevant to MH-DD-CD and a minimum of two years experience in community mental health programs. The center director is responsible for the planning/design, development, coordination, and evaluation of a comprehensive, area-wide program and for the overall administration of services operated by the board. 

The center director shall be appointed by the community mental health board and shall be approved by the commissioner of human services. 

9520.0210DEADLINE FOR APPROVAL OR DENIAL OF REQUEST FOR APPROVAL STATUS. 
The commissioner shall approve or deny, in whole or in part, an application for state financial assistance within 90 days of receipt of the grant-in-aid application or by the beginning of the state fiscal year, whichever is the later. 

9520.0230ADVISORY COMMITTEE. Subpart 1.Purpose.  
To assist the community mental health board in meeting its responsibilities as described in Minnesota Statutes, section 245.68 and to provide opportunity for broad community representation necessary for effective comprehensive mental health, developmental disability, and chemical dependency program planning, each community mental health board shall appoint a separate advisory committee in at least the three disability areas of mental health, developmental disability, and chemical dependency. 

Subp. 2.Membership.  
The advisory committees shall consist of residents of the geographic area served who are interested and knowledgeable in the area governed by such committee. 

Subp. 3.Nominations for membership.  
Nominations for appointments as members of the advisory committees are to be made to the community mental health board from agencies, organizations, groups, and individuals within the area served by the community mental health center. Appointments to the advisory committees are made by the community mental health board. 

Subp. 4.Board member on committee.  
One community mental health board member shall serve on each advisory committee. 

Subp. 5.Nonprovider members.  
Each advisory committee shall have at least one-half of its membership composed of individuals who are not providers of services to the three disability groups. 

Subp. 6.Representative membership.  
Membership of each advisory committee shall generally reflect the population distribution of the service delivery area of the community mental health center. 

Subp. 7.Chairperson appointed.  
The community mental health board shall appoint a chairperson for each advisory committee. The chairperson shall not be a community mental health board member nor a staff member. The power to appoint the chairperson may be delegated by the community mental health board to the individual advisory committee. 

Subp. 8.Committee responsibility to board.  
Each advisory committee shall be directly responsible to the community mental health board. Direct communication shall be effected and maintained through contact between the chairperson of the particular advisory committee, or his/her designee, and the chairperson of the community mental health board, or his/her designee. 

Subp. 9.Staff.  
Staff shall be assigned by the director to serve the staffing needs of each advisory committee. 

Subp. 10.Study groups and task forces.  
Each advisory committee may appoint study groups and task forces upon consultation with the community mental health board. It is strongly recommended that specific attention be given to the aging and children and youth populations. 

Subp. 11.Quarterly meetings required.  
Each advisory committee shall meet at least quarterly. 

Subp. 12.Annual report required.  
Each advisory committee must make a formal written and oral report on its work to the community mental health board at least annually. 

Subp. 13.Minutes.  
Each advisory committee shall submit copies of minutes of their meetings to the community mental health board and to the Department of Human Services (respective disability group program divisions). 

Subp. 14.Duties of advisory committee.  
The advisory committees shall be charged by the community mental health board with assisting in the identification of the community's needs for mentally ill/behaviorally disabled, developmental disability, and chemical dependency programs. The advisory committee also assists the community mental health board in determining priorities for the community programs. Based on the priorities, each advisory committee shall recommend to the community mental health board ways in which the limited available community resources (work force, facilities, and finances) can be put to maximum and optimal use. 

Subp. 15.Recommendations.  
The advisory committee recommendations made to the community mental health board shall be included as a separate section in the grant-in-aid request submitted to the Department of Human Services by the community mental health board. 

Subp. 16.Assessment of programs.  
 The advisory committees shall assist the community mental health board in assessing the programs carried on by the community mental health board, and make recommendations regarding the reordering of priorities and modifying of programs where necessary. 

9520.0750PURPOSE. 
Parts 9520.0750 to 9520.0870 establish standards for approval of mental health centers and mental health clinics for purposes of insurance and subscriber contract reimbursement under Minnesota Statutes, section 62A.152. 

9520.0760DEFINITIONS. Subpart 1.Scope.  
As used in parts 9520.0760 to 9520.0870, the following terms have the meanings given them. 

Subp. 2.Application.  
"Application" means the formal statement by a center to the commissioner, on the forms created for this purpose, requesting recognition as meeting the requirements of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. 

Subp. 3.Approval.  
"Approval" means the determination by the commissioner that the applicant center has met the minimum standards of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870, and is therefore eligible to claim reimbursement for outpatient clinical services under the terms of Minnesota Statutes, section 62A.152. Approval of a center under these parts does not mean approval of a multidisciplinary staff person of such center to claim reimbursement from medical assistance or other third-party payors when practicing privately. Approval of a center under these parts does not mean approval of such center to claim reimbursement from medical assistance. 

Subp. 4.Case review.  
"Case review" means a consultation process thoroughly examining a client's condition and treatment. It includes review of the client's reason for seeking treatment, diagnosis and assessment, and the individual treatment plan; review of the appropriateness, duration, and outcome of treatment provided; and treatment recommendations. 

Subp. 5.Center.  
"Center" means a public or private health and human services facility which provides clinical services in the treatment of mental illness. It is an abbreviated term used in place of "mental health center" or "mental health clinic" throughout parts 9520.0750 to 9520.0870. 

Subp. 6.Client.  
"Client" means a person accepted by the center to receive clinical services in the diagnosis and treatment of mental illness. 

Subp. 7.Clinical services.  
"Clinical services" means services provided to a client to diagnose, describe, predict, and explain that client's status relative to a disabling condition or problem, and where necessary, to treat the client to reduce impairment due to that condition. Clinical services also include individual treatment planning, case review, record keeping required for treatment, peer review, and supervision. 

Subp. 8.Commissioner.  
"Commissioner" means the commissioner of the Minnesota Department of Human Services or a designated representative. 

Subp. 9.Competent.  
"Competent" means having sufficient knowledge of and proficiency in a specific mental illness assessment or treatment service, technique, method, or procedure, documented by experience, education, training, and certification, to be able to provide it to a client with little or no supervision. 

Subp. 10.Consultation.  
"Consultation" means the process of deliberating or conferring between multidisciplinary staff regarding a client and the client's treatment. 

Subp. 11.Deferral.  
"Deferral" means the determination by the commissioner that the applicant center does not meet the minimum standards of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870 and is not approved, but is granted a period of time to comply with these standards and receive a second review without reapplication. 

Subp. 12.Department.  
"Department" means the Minnesota Department of Human Services. 

Subp. 13.Disapproval or withdrawal of approval.  
"Disapproval" or "withdrawal of approval" means a determination by the commissioner that the applicant center does not meet the minimum standards of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. 

Subp. 14.Discipline.  
"Discipline" means a branch of professional knowledge or skill acquired through a specific course of study and training and usually documented by a specific educational degree or certification of proficiency. Examples of the mental health disciplines include but are not limited to psychiatry, psychology, clinical social work, and psychiatric nursing. 

Subp. 15.Documentation.  
"Documentation" means the automatically or manually produced and maintained evidence that can be read by person or machine, and that will attest to the compliance with requirements of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. 

Subp. 16.Individual treatment plan.  
"Individual treatment plan" means a written plan of intervention and treatment developed on the basis of assessment results for a specific client, and updated as necessary. The plan specifies the goals and objectives in measurable terms, states the treatment strategy, and identifies responsibilities of multidisciplinary staff. 

Subp. 17.Mental health practitioner.  
"Mental health practitioner" means a staff person providing clinical services in the treatment of mental illness who is qualified in at least one of the following ways: 

A.
 by having a bachelor's degree in one of the behavioral sciences or related fields from an accredited college or university and 2,000 hours of supervised experience in the delivery of clinical services in the treatment of mental illness; 

B.
 by having 6,000 hours of supervised experience in the delivery of clinical services in the treatment of mental illness; 

C.
 by being a graduate student in one of the behavioral sciences or related fields formally assigned to the center for clinical training by an accredited college or university; or 

D.
 by having a master's or other graduate degree in one of the behavioral sciences or related fields from an accredited college or university. 

Documentation of compliance with part 9520.0800, subpart 4, item B is required for designation of work as supervised experience in the delivery of clinical services. Documentation of the accreditation of a college or university shall be a listing in Accredited Institutions of Postsecondary Education Programs, Candidates for the year the degree was issued. The master's degree in behavioral sciences or related fields shall include a minimum of 28 semester hours of graduate course credit in mental health theory and supervised clinical training, as documented by an official transcript. 

Subp. 18.Mental health professional.  
"Mental health professional" has the meaning given in Minnesota Statutes, section 245.462, subdivision 18. 

Subp. 19.Mental illness.  
"Mental illness" means a condition which results in an inability to interpret the environment realistically and in impaired functioning in primary aspects of daily living such as personal relations, living arrangements, work, and recreation, and which is listed in the clinical manual of the International Classification of Diseases (ICD-9-CM), Ninth Revision (1980), code range 290.0-302.99 or 306.0-316, or the corresponding code in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), Third Edition (1980), Axes I, II or III. These publications are available from the State Law Library. 

Subp. 20.Multidisciplinary staff.  
"Multidisciplinary staff" means the mental health professionals and mental health practitioners employed by or under contract to the center to provide outpatient clinical services in the treatment of mental illness. 

Subp. 21.Serious violations of policies and procedures.  
"Serious violations of policies and procedures" means a violation which threatens the health, safety, or rights of clients or center staff; the repeated nonadherence to center policies and procedures; and the nonadherence to center policies and procedures which result in noncompliance with Minnesota Statutes, section 245.69, subdivision 2 and parts 9520.0760 to 9520.0870. 

Subp. 22.Treatment strategy.  
"Treatment strategy" means the particular form of service delivery or intervention which specifically addresses the client's characteristics and mental illness, and describes the process for achievement of individual treatment plan goals. 

9520.0770ORGANIZATIONAL STRUCTURE OF CENTER. Subpart 1.Basic unit.  
The center or the facility of which it is a unit shall be legally constituted as a partnership, corporation, or government agency. The center shall be either the entire facility or a clearly identified unit within the facility which is administratively and clinically separate from the rest of the facility. All business shall be conducted in the name of the center or facility, except medical assistance billing by individually enrolled providers when the center is not enrolled. 

Subp. 2.Purpose, services.  
The center shall document that the prevention, diagnosis, and treatment of mental illness are the main purposes of the center. If the center is a unit within a facility, the rest of the facility shall not provide clinical services in the outpatient treatment of mental illness. The facility may provide services other than clinical services in the treatment of mental illness, including medical services, chemical dependency services, social services, training, and education. The provision of these additional services is not reviewed in granting approval to the center under parts 9520.0760 to 9520.0870. 

Subp. 3.Governing body.  
The center shall have a governing body. The governing body shall provide written documentation of its source of authority. The governing body shall be legally responsible for the implementation of the standards set forth in Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870 through the establishment of written policy and procedures. 

Subp. 4.Chart or statement of organization.  
The center shall have an organizational chart or statement which specifies the relationships among the governing body, any administrative and support staff, mental health professional staff, and mental health practitioner staff; their respective areas of responsibility; the lines of authority involved; the formal liaison between administrative and clinical staff; and the relationship of the center to the rest of the facility and any additional services provided. 

9520.0780SECONDARY LOCATIONS. Subpart 1.Main and satellite offices.  
The center shall notify the commissioner of all center locations. If there is more than one center location, the center shall designate one as the main office and all secondary locations as satellite offices. The main office as a unit and the center as a whole shall be in compliance with part 9520.0810. The main office shall function as the center records and documentation storage area and house most administrative functions for the center. Each satellite office shall: 

A.
 be included as a part of the legally constituted entity; 

B.
 adhere to the same clinical and administrative policies and procedures as the main office; 

C.
 operate under the authority of the center's governing body; 

D.
 store all center records and the client records of terminated clients at the main office; 

E.
 ensure that a mental health professional is at the satellite office and competent to supervise and intervene in the clinical services provided there, whenever the satellite office is open; 

F.
 ensure that its multidisciplinary staff have access to and interact with main center staff for consultation, supervision, and peer review; and 

G.
 ensure that clients have access to all clinical services provided in the treatment of mental illness and the multidisciplinary staff of the center. 

Subp. 2.Noncompliance.  
If the commissioner determines that a secondary location is not in compliance with subpart 1, it is not a satellite office. Outpatient clinical services in the treatment of mental illness delivered by the center or facility of which it is a unit shall cease at that location, or the application shall be disapproved. 

9520.0790MINIMUM TREATMENT STANDARDS. Subpart 1.Multidisciplinary approach.  
The center shall document that services are provided in a multidisciplinary manner. That documentation shall include evidence that staff interact in providing clinical services, that the services provided to a client involve all needed disciplines represented on the center staff, and that staff participate in case review and consultation procedures as described in subpart 6. 

Subp. 2.Intake and case assignment.  
The center shall establish an intake or admission procedure which outlines the intake process, including the determination of the appropriateness of accepting a person as a client by reviewing the client's condition and need for treatment, the clinical services offered by the center, and other available resources. The center shall document that case assignment for assessment, diagnosis, and treatment is made to a multidisciplinary staff person who is competent in the service, in the recommended treatment strategy and in treating the individual client characteristics. Responsibility for each case shall remain with a mental health professional. 

Subp. 3.Assessment and diagnostic process.  
The center shall establish an assessment and diagnostic process that determines the client's condition and need for clinical services. The assessment of each client shall include clinical consideration of the client's general physical, medical, developmental, family, social, psychiatric, and psychological history and current condition. The diagnostic statement shall include the diagnosis based on the codes in the International Classification of Diseases or the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders and refer to the pertinent assessment data. The diagnosis shall be by or under the supervision of and signed by a psychiatrist or licensed psychologist. The diagnostic assessment, as defined by Minnesota Statutes, sections 245.462, subdivision 9, for adults, and 245.4871, subdivision 11, for children, must be provided by a licensed mental health professional in accordance with Minnesota Statutes, section 245.467, subdivision 2. 

Subp. 4.Treatment planning.  
The individual treatment plan, based upon a diagnostic assessment of mental illness, shall be jointly developed by the client and the mental health professional. This planning procedure shall ensure that the client has been informed in the following areas: assessment of the client condition; treatment alternatives; possible outcomes and side effects of treatment; treatment recommendations; approximate length, cost, and hoped-for outcome of treatment; the client's rights and responsibilities in implementation of the individual treatment plan; staff rights and responsibilities in the treatment process; the Government Data Practices Act; and procedures for reporting grievances and alleged violation of client rights. If the client is considering chemotherapy, hospitalization, or other medical treatment, the appropriate medical staff person shall inform the client of the treatment alternatives, the effects of the medical procedures, and possible side effects. Clinical services shall be appropriate to the condition, age, sex, socioeconomic, and ethnic background of the client, and provided in the least restrictive manner. Clinical services shall be provided according to the individual treatment plan and existing professional codes of ethics. 

Subp. 5.Client record.  
The center shall maintain a client record for each client. The record must document the assessment process, the development and updating of the treatment plan, the treatment provided and observed client behaviors and response to treatment, and serve as data for the review and evaluation of the treatment provided to a client. The record shall include: 

A.
 a statement of the client's reason for seeking treatment; 

B.
 a record of the assessment process and assessment data; 

C.
 the initial diagnosis based upon the assessment data; 

D.
 the individual treatment plan; 

E.
 a record of all medication prescribed or administered by multidisciplinary staff; 

F.
 documentation of services received by the client, including consultation and progress notes; 

G.
 when necessary, the client's authorization to release private information, and client information obtained from outside sources; 

H.
 at the closing of the case, a statement of the reason for termination, current client condition, and the treatment outcome; and 

I.
 correspondence and other necessary information. 

Subp. 6.Consultation; case review.  
The center shall establish standards for case review and encourage the ongoing consultation among multidisciplinary staff. The multidisciplinary staff shall attend staff meetings at least twice monthly for a minimum of four hours per month, or a minimum of two hours per month if the multidisciplinary staff person provides clinical services in the treatment of mental illness less than 15 hours per week. The purpose of these meetings shall be case review and consultation. Written minutes of the meeting shall be maintained at the center for at least three years after the meeting. 

Subp. 7.Referrals.  
If the necessary treatment or the treatment desired by the client is not available at the center, the center shall facilitate appropriate referrals. The multidisciplinary staff person shall discuss with the client the reason for the referral, potential treatment resources, and what the process will involve. The staff person shall assist in the process to ensure continuity of the planned treatment. 

Subp. 8.Emergency service.  
The center shall ensure that clinical services to treat mental illness are available to clients on an emergency basis. 

Subp. 9.Access to hospital.  
The center shall document that it has access to hospital admission for psychiatric inpatient care, and shall provide that access when needed by a client. This requirement for access does not require direct hospital admission privileges on the part of qualified multidisciplinary staff. 

9520.0800MINIMUM QUALITY ASSURANCE STANDARDS. Subpart 1.Policies and procedures.  
The center shall develop written policies and procedures and shall document the implementation of these policies and procedures for each treatment standard and each quality assurance standard in subparts 2 to 7. The policies shall be approved by the governing body. The procedures shall indicate what actions or accomplishments are to be performed, who is responsible for each action, and any documentation or required forms. Multidisciplinary staff shall have access to a copy of the policies and procedures at all times. 

Subp. 2.Peer review.  
The center shall have a multidisciplinary peer review system to assess the manner in which multidisciplinary staff provide clinical services in the treatment of mental illness. Peer review shall include the examination of clinical services to determine if the treatment provided was effective, necessary, and sufficient and of client records to determine if the recorded information is necessary and sufficient. The system shall ensure review of a randomly selected sample of five percent or six cases, whichever is less, of the annual caseload of each mental health professional by other mental health professional staff. Peer review findings shall be discussed with staff involved in the case and followed up by any necessary corrective action. Peer review records shall be maintained at the center. 

Subp. 3.Internal utilization review.  
The center shall have a system of internal utilization review to examine the quality and efficiency of resource usage and clinical service delivery. The center shall develop and carry out a review procedure consistent with its size and organization which includes collection or review of information, analysis or interpretation of information, and application of findings to center operations. The review procedure shall minimally include, within any three year period of time, review of the appropriateness of intake, the provision of certain patterns of services, and the duration of treatment. Criteria may be established for treatment length and the provision of services for certain client conditions. Utilization review records shall be maintained, with an annual report to the governing body for applicability of findings to center operations. 

Subp. 4.Staff supervision.  
Staff supervision: 

A.
 The center shall have a clinical evaluation and supervision procedure which identifies each multidisciplinary staff person's areas of competence and documents that each multidisciplinary staff person receives the guidance and support needed to provide clinical services for the treatment of mental illness in the areas they are permitted to practice. 

B.
 A mental health professional shall be responsible for the supervision of the mental health practitioner, including approval of the individual treatment plan and bimonthly case review of every client receiving clinical services from the practitioner. This supervision shall include a minimum of one hour of face-to-face, client-specific supervisory contact for each 40 hours of clinical services in the treatment of mental illness provided by the practitioner. 

Subp. 5.Continuing education.  
The center shall require that each multidisciplinary staff person attend a minimum of 36 clock hours every two years of academic or practical course work and training. This education shall augment job-related knowledge, understanding, and skills to update or enhance staff competencies in the delivery of clinical services to treat mental illness. Continued licensure as a mental health professional may be substituted for the continuing education requirement of this subpart. 

Subp. 6.Violations of standards.  
The center shall have procedures for the reporting and investigating of alleged unethical, illegal, or grossly negligent acts, and of the serious violation of written policies and procedures. The center shall document that the reported behaviors have been reviewed and that responsible disciplinary or corrective action has been taken if the behavior was substantiated. The procedures shall address both client and staff reporting of complaints or grievances regarding center procedures, staff, and services. Clients and staff shall be informed they may file the complaint with the department if it was not resolved to mutual satisfaction. The center shall have procedures for the reporting of suspected abuse or neglect of clients, in accordance with Minnesota Statutes, sections 611A.32, subdivision 5; 626.556; and 626.557. 

Subp. 7.Data classification.  
Client information compiled by the center, including client records and minutes of case review and consultation meetings, shall be protected as private data under the Minnesota Government Data Practices Act. 

9520.0810MINIMUM STAFFING STANDARDS. Subpart 1.Required staff.  
Required staff: 

A.
 The multidisciplinary staff of a center shall consist of at least four mental health professionals. At least two of the mental health professionals shall each be employed or under contract for a minimum of 35 hours a week by the center. Those two mental health professionals shall be of different disciplines. 

B.
 The mental health professional staff shall include a psychiatrist and a licensed psychologist. 

C.
 The mental health professional employed or under contract to the center to meet the requirement of item B shall be at the main office of the center and providing clinical services in the treatment of mental illness at least eight hours every two weeks. 

Subp. 2.Additional staff; staffing balance.  
Additional mental health professional staff may be employed by or under contract to the center provided that no single mental health discipline or combination of allied fields shall comprise more than 60 percent of the full-time equivalent mental health professional staff. This provision does not apply to a center with fewer than six full-time equivalent mental health professional staff. Mental health practitioners may also be employed by or under contract to a center to provide clinical services for the treatment of mental illness in their documented area of competence. Mental health practitioners shall not comprise more than 25 percent of the full-time equivalent multidisciplinary staff. In determination of full-time equivalence, only time spent in clinical services for the treatment of mental illness shall be considered. 

Subp. 3.Multidisciplinary staff records.  
The center shall maintain records sufficient to document that the center has determined and verified the clinical service qualifications of each multidisciplinary staff person, and sufficient to document each multidisciplinary staff person's terms of employment. 

Subp. 4.Credentialed occupations.  
The center shall adhere to the qualifications and standards specified by rule for any human service occupation credentialed under Minnesota Statutes, section 214.13 and employed by or under contract to the center. 

9520.0820APPLICATION PROCEDURES. Subpart 1.Form.  
A facility seeking approval as a center for insurance reimbursement of its outpatient clinical services in treatment of mental illness must make formal application to the commissioner for such approval. The application form for this purpose may be obtained from the Mental Illness Program Division of the department. The application form shall require only information which is required by statute or rule, and shall require the applicant center to explain and provide documentation of compliance with the minimum standards in Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. 

Subp. 2.Fee.  
Each application shall be accompanied by payment of the nonrefundable application fee. The fee shall be established and adjusted in accordance with Minnesota Statutes, section 16A.128 to cover the costs to the department in implementing Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. 

Subp. 3.Completed application.  
The application is considered complete on the date the application fee and all information required in the application form are received by the department. 

Subp. 4.Coordinator.  
The center shall designate in the application a mental health professional as the coordinator for issues surrounding compliance with parts 9520.0760 to 9520.0870. 

9520.0830REVIEW OF APPLICANT CENTERS. Subpart 1.Site visit.  
The formal review shall begin after the completed application has been received, and shall include an examination of the written application and a visit to the center. The applicant center shall be offered a choice of site visit dates, with at least one date falling within 60 days of the date on which the department receives the complete application. The site visit shall include interviews with multidisciplinary staff and examination of a random sample of client records, consultation minutes, quality assurance reports, and multidisciplinary staff records. 

Subp. 2.Documentation.  
If implementation of a procedure is too recent to be reliably documented, a written statement of the planned implementation shall be accepted as documentation on the initial application. The evidence of licensure or accreditation through another regulating body shall be accepted as documentation of a specific procedure when the required minimum standard of that body is the same or higher than a specific provision of parts 9520.0760 to 9520.0870. 

9520.0840DECISION ON APPLICATION. Subpart 1.Written report.  
Upon completion of the site visit, a report shall be written. The report shall include a statement of findings, a recommendation to approve, defer, or disapprove the application, and the reasons for the recommendation. 

Subp. 2.Written notice to center.  
The applicant center shall be sent written notice of approval, deferral, or disapproval within 30 days of the completion of the site visit. If the decision is a deferral or a disapproval, the notice shall indicate the specific areas of noncompliance. 

Subp. 3.Noncompliance with statutes and rules.  
An application shall be disapproved or deferred if it is the initial application of a center, when the applicant center is not in compliance with Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. 

Subp. 4.Deferral of application.  
If an application is deferred, the length of deferral shall not exceed 180 days. If the areas of noncompliance stated in the deferral notice are not satisfactorily corrected by the end of the deferral period, the application shall be disapproved. The applicant center shall allow the commissioner to inspect the center at any time during the deferral period, whether or not the site visit has been announced in advance. A site visit shall occur only during normal working hours of the center and shall not disrupt the normal functioning of the center. At any time during the deferral period, the applicant center may submit documentation indicating correction of noncompliance. The application shall then be approved or disapproved. At any time during the deferral period, the applicant center may submit a written request to the commissioner to change the application status to disapproval. The request shall be complied with within 14 days of receiving this written request. The applicant center is not an approved center for purposes of Minnesota Statutes, section 62A.152 during a deferral period. 

Subp. 5.Effective date of decision.  
The effective date of a decision is the date the commissioner signs a letter notifying the applicant center of that decision. 

9520.0850APPEALS. 
If an application is disapproved or approval is withdrawn, a contested case hearing and judicial review as provided in Minnesota Statutes, sections 14.48 to 14.69, may be requested by the center within 30 days of the commissioner's decision. 

9520.0860POSTAPPROVAL REQUIREMENTS. Subpart 1.Duration of approval.  
Initial approval of an application is valid for 12 months from the effective date, subsequent approvals for 24 months, except when approval is withdrawn according to the criteria in subpart 4. 

Subp. 2.Reapplication.  
The center shall contact the department for reapplication forms, and submit the completed application at least 90 days prior to the expected expiration date. If an approved center has met the conditions of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870, including reapplication when required, its status as an approved center shall remain in effect pending department processing of the reapplication. 

Subp. 3.Restrictions.  
The approval is issued only for the center named in the application and is not transferable or assignable to another center. The approval is issued only for the center location named in the application and is not transferable or assignable to another location. If the commissioner is notified in writing at least 30 days in advance of a change in center location and can determine that compliance with all provisions of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870 are maintained, the commissioner shall continue the approval of the center at the new location. 

Subp. 4.Noncompliance.  
Changes in center organization, staffing, treatment, or quality assurance procedures that affect the ability of the center to comply with the minimum standards of Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870 shall be reported in writing by the center to the commissioner within 15 days of occurrence. Review of the change shall be conducted by the commissioner. A center with changes resulting in noncompliance in minimum standards shall receive written notice and may have up to 180 days to correct the areas of noncompliance before losing approval status. Interim procedures to resolve the noncompliance on a temporary basis shall be developed and submitted in writing to the commissioner for approval within 30 days of the commissioner's determination of the noncompliance. Nonreporting within 15 days of occurrence of a change that results in noncompliance, failure to develop an approved interim procedure within 30 days of the determination of the noncompliance, or nonresolution of the noncompliance within 180 days shall result in the immediate withdrawal of approval status. 

Serious violation of policies or procedures, professional association or board sanctioning or loss of licensure for unethical practices, or the conviction of violating a state or federal statute shall be reported in writing by the center to the commissioner within ten days of the substantiation of such behavior. Review of this report and the action taken by the center shall be conducted by the commissioner. Approval shall be withdrawn immediately unless the commissioner determines that: the center acted with all proper haste and thoroughness in investigating the behavior, the center acted with all proper haste and thoroughness in taking appropriate disciplinary and corrective action, and that no member of the governing body was a party to the behavior. Failure to report such behavior within ten days of its substantiation shall result in immediate withdrawal of approval. 

Subp. 5.Compliance reports.  
The center may be required to submit written information to the department during the approval period to document that the center has maintained compliance with the rule and center procedures. The center shall allow the commissioner to inspect the center at any time during the approval period, whether or not the site visit has been announced in advance. A site visit shall occur only during normal working hours of the center and shall not disrupt the normal functioning of the center. 

9520.0870VARIANCES. Subpart 1.When allowed.  
The standards and procedures established by parts 9520.0760 to 9520.0860 may be varied by the commissioner. Standards and procedures established by statute shall not be varied. 

Subp. 2.Request procedure.  
A request for a variance must be submitted in writing to the commissioner, accompanying or following the submission of a completed application for approval under Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. The request shall state: 

A.
 the standard or procedure to be varied; 

B.
 the specific reasons why the standard or procedure cannot be or should not be complied with; and 

C.
 the equivalent standard or procedure the center will establish to achieve the intent of the standard or procedure to be varied. 

Subp. 3.Decision procedure.  
Upon receiving the variance request, the commissioner shall consult with a panel of experts in the mental health disciplines regarding the request. Criteria for granting a variance shall be the commissioner's determination that subpart 2, items A to C are met. Hardship shall not be a sufficient reason to grant a variance. No variance shall be granted that would threaten the health, safety, or rights of clients. Variances granted by the commissioner shall specify in writing the alternative standards or procedures to be implemented and any specific conditions or limitations imposed on the variance by the commissioner. Variances denied by the commissioner shall specify in writing the reason for the denial. 

Subp. 4.Notification.  
The commissioner shall send the center a written notice granting or not granting the variance within 90 days of receiving the written variance request. This notice shall not be construed as approval or disapproval of the center under Minnesota Statutes, section 245.69, subdivision 2, and parts 9520.0760 to 9520.0870. 

9530.6800ASSESSMENT OF NEED FOR TREATMENT PROGRAMS. Subpart 1.Assessment of need required for licensure.  
Before a license or a provisional license may be issued, the need for the chemical dependency treatment or rehabilitation program must be determined by the commissioner. Need for an additional or expanded chemical dependency treatment program must be determined, in part, based on the recommendation of the county board of commissioners of the county in which the program will be located and the documentation submitted by the applicant at the time of application. 

If the county board fails to submit a statement to the commissioner within 60 days of the county board's receipt of the written request from an applicant, as required under part 9530.6810, the commissioner shall determine the need for the applicant's proposed chemical dependency treatment program based on the documentation submitted by the applicant at the time of application. 

Subp. 2.Documentation of need requirements.  
An applicant for licensure under parts 9530.2500 to 9530.4000 and Minnesota Statutes, chapter 245G, must submit the documentation in items A and B to the commissioner with the application for licensure: 

A.
 The applicant must submit documentation that it has requested the county board of commissioners of the county in which the chemical dependency treatment program will be located to submit to the commissioner both a written statement that supports or does not support the need for the program and documentation of the rationale used by the county board to make its determination. 

B.
 The applicant must submit a plan for attracting an adequate number of clients to maintain its proposed program capacity, including: 

(1)
 a description of the geographic area to be served; 

(2)
 a description of the target population to be served; 

(3)
 documentation that the capacity or program designs of existing programs are not sufficient to meet the service needs of the chemically abusing or chemically dependent target population if that information is available to the applicant; 

(4)
 a list of referral sources, with an estimation as to the number of clients the referral source will refer to the applicant's program in the first year of operation; and 

(5)
 any other information available to the applicant that supports the need for new or expanded chemical dependency treatment capacity. 

9530.6810COUNTY BOARD RESPONSIBILITY TO REVIEW PROGRAM NEED. 
When an applicant for licensure under parts 9530.2500 to 9530.4000 or Minnesota Statutes, chapter 245G, requests a written statement of support for a proposed chemical dependency treatment program from the county board of commissioners of the county in which the proposed program is to be located, the county board, or the county board's designated representative, shall submit a statement to the commissioner that either supports or does not support the need for the applicant's program. The county board's statement must be submitted in accordance with items A and B: 

A.
 the statement must be submitted within 60 days of the county board's receipt of a written request from the applicant for licensure; and 

B.
 the statement must include the rationale used by the county board to make its determination.