1.1 	CONFERENCE COMMITTEE REPORT ON S. F. No. 2934
1.2 	A bill for an act
1.3 	relating to human services; establishing an office of addiction and recovery; 
1.4 	establishing the Minnesota board of recovery services; establishing title protection 
1.5 	for sober homes; modifying provisions governing disability services, aging services, 
1.6 	and behavioral health; modifying medical assistance eligibility requirements for 
1.7 	certain populations; making technical and conforming changes; establishing certain 
1.8 	grants; requiring reports; appropriating money;amending Minnesota Statutes 2022, 
1.9 	sections 4.046, subdivisions 6, 7, by adding a subdivision; 179A.54, by adding a 
1.10 	subdivision; 241.021, subdivision 1; 241.31, subdivision 5; 241.415; 245A.03, 
1.11 	subdivision 7; 245A.11, subdivisions 7, 7a; 245D.04, subdivision 3; 245G.01, by 
1.12 	adding subdivisions; 245G.02, subdivision 2; 245G.05, subdivision 1, by adding 
1.13 	a subdivision; 245G.06, subdivisions 1, 3, 4, by adding subdivisions; 245G.08, 
1.14 	subdivision 3; 245G.09, subdivision 3; 245G.22, subdivision 15; 245I.10, 
1.15 	subdivision 6; 246.54, subdivisions 1a, 1b; 252.27, subdivision 2a; 254B.01, 
1.16 	subdivision 8, by adding subdivisions; 254B.04, by adding a subdivision; 254B.05, 
1.17 	subdivisions 1, 5; 256.043, subdivisions 3, 3a; 256.9754; 256B.04, by adding a 
1.18 	subdivision; 256B.056, subdivision 3; 256B.057, subdivision 9; 256B.0625, 
1.19 	subdivisions 17, 17a, 18h, 22, by adding a subdivision; 256B.0638, subdivisions 
1.20 	2, 4, 5; 256B.0659, subdivisions 1, 12, 19, 24; 256B.073, subdivision 3, by adding 
1.21 	a subdivision; 256B.0759, subdivision 2; 256B.0911, subdivision 13; 256B.0913, 
1.22 	subdivisions 4, 5; 256B.0917, subdivision 1b; 256B.0922, subdivision 1; 
1.23 	256B.0949, subdivision 15; 256B.14, subdivision 2; 256B.434, by adding a 
1.24 	subdivision; 256B.49, subdivisions 11, 28; 256B.4905, subdivision 5a; 256B.4911, 
1.25 	by adding a subdivision; 256B.4912, by adding subdivisions; 256B.4914, 
1.26 	subdivisions 3, as amended, 4, 5, 5a, 5b, 5c, 5d, 5e, 8, 9, 10, 10a, 10c, 12, 14, by 
1.27 	adding a subdivision; 256B.492; 256B.5012, by adding subdivisions; 256B.766; 
1.28 	256B.85, subdivision 7, by adding a subdivision; 256B.851, subdivisions 5, 6; 
1.29 	256I.05, by adding subdivisions; 256M.42; 256R.02, subdivision 19; 256R.17, 
1.30 	subdivision 2; 256R.25; 256R.47; 256R.481; 256R.53, by adding subdivisions; 
1.31 	256S.15, subdivision 2; 256S.18, by adding a subdivision; 256S.19, subdivision 
1.32 	3; 256S.203, subdivisions 1, 2; 256S.205, subdivisions 3, 5; 256S.21; 256S.2101, 
1.33 	subdivisions 1, 2, by adding subdivisions; 256S.211, by adding subdivisions; 
1.34 	256S.212; 256S.213; 256S.214; 256S.215, subdivisions 2, 3, 4, 7, 8, 9, 10, 11, 12, 
1.35 	13, 14, 15, 16, 17; Laws 2019, chapter 63, article 3, section 1, as amended; Laws 
1.36 	2021, First Special Session chapter 7, article 16, section 28, as amended; article 
1.37 	17, sections 16; 20; proposing coding for new law in Minnesota Statutes, chapters 
1.38 	121A; 144A; 245; 245D; 254B; 256; 256I; 256S; 325F; repealing Minnesota 
1.39 	Statutes 2022, sections 245G.05, subdivision 2; 246.18, subdivisions 2, 2a; 
1.40 	256B.0638, subdivisions 1, 2, 3, 4, 5, 6; 256B.0759, subdivision 6; 256B.0917, 
1.41 	subdivisions 1a, 6, 7a, 13; 256B.4914, subdivision 9a; 256S.19, subdivision 4.
1.42 	May 18, 2023
2.1 	The Honorable Bobby Joe Champion
2.2 	President of the Senate
2.3 	The Honorable Melissa Hortman
2.4 	Speaker of the House of Representatives
2.5 	We, the undersigned conferees for S. F. No. 2934 report that we have agreed upon the 
2.6 	items in dispute and recommend as follows:
2.7 	That the House recede from its amendments and that S. F. No. 2934 be further amended 
2.8 	as follows:
2.9 	Delete everything after the enacting clause and insert:

2.10 	ARTICLE 1
2.11 	DISABILITY SERVICES

2.12 	Section 1. Minnesota Statutes 2022, section 179A.54, is amended by adding a subdivision 
2.13 	to read:
2.14 		Subd. 11.Home Care Orientation Trust. (a) The state and an exclusive representative 
2.15 	certified pursuant to this section may establish a joint labor and management trust, referred 
2.16 	to as the Home Care Orientation Trust, for the exclusive purpose of rendering voluntary 
2.17 	orientation training to individual providers of direct support services who are represented 
2.18 	by the exclusive representative.
2.19 	(b) Financial contributions by the state to the Home Care Orientation Trust must be 
2.20 	made by the state pursuant to a collective bargaining agreement negotiated under this section. 
2.21 	All such financial contributions by the state must be held in trust for the purpose of paying, 
2.22 	from principal, from income, or from both, the costs associated with developing, delivering, 
2.23 	and promoting voluntary orientation training for individual providers of direct support 
2.24 	services working under a collective bargaining agreement and providing services through 
2.25 	a covered program under section 256B.0711. The Home Care Orientation Trust must be 
2.26 	administered, managed, and otherwise controlled jointly by a board of trustees composed 
2.27 	of an equal number of trustees appointed by the state and trustees appointed by the exclusive 
2.28 	representative under this section. The trust shall not be an agent of either the state or of the 
2.29 	exclusive representative.
2.30 	(c) Trust administrative, management, legal, and financial services may be provided to 
2.31 	the board of trustees by a third-party administrator, financial management institution, other 
2.32 	appropriate entity, or any combination thereof, as designated by the board of trustees from 
2.33 	time to time, and those services must be paid from the money held in trust and created by 
2.34 	the state's financial contributions to the Home Care Orientation Trust.
3.1 	(d) The state is authorized to purchase liability insurance for members of the board of 
3.2 	trustees appointed by the state.
3.3 	(e) Financial contributions to or participation in the management or administration of 
3.4 	the Home Care Orientation Trust must not be considered an unfair labor practice under 
3.5 	section 179A.13, or a violation of Minnesota law.

3.6 	Sec. 2. Minnesota Statutes 2022, section 245A.03, subdivision 7, is amended to read:
3.7 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
3.8 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
3.9 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
3.10 	for a physical location that will not be the primary residence of the license holder for the 
3.11 	entire period of licensure. If a family child foster care home or family adult foster care home 
3.12 	license is issued during this moratorium, and the license holder changes the license holder's 
3.13 	primary residence away from the physical location of the foster care license, the 
3.14 	commissioner shall revoke the license according to section 245A.07. The commissioner 
3.15 	shall not issue an initial license for a community residential setting licensed under chapter 
3.16 	245D. When approving an exception under this paragraph, the commissioner shall consider 
3.17 	the resource need determination process in paragraph (h), the availability of foster care 
3.18 	licensed beds in the geographic area in which the licensee seeks to operate, the results of a 
3.19 	person's choices during their annual assessment and service plan review, and the 
3.20 	recommendation of the local county board. The determination by the commissioner is final 
3.21 	and not subject to appeal. Exceptions to the moratorium include:
3.22 	(1) foster care settings where at least 80 percent of the residents are 55 years of age or 
3.23 	older;
3.24 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
3.25 	community residential setting licenses replacing adult foster care licenses in existence on 
3.26 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
3.27 	(b);
3.28 	(3) new foster care licenses or community residential setting licenses determined to be 
3.29 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
3.30 	or regional treatment center; restructuring of state-operated services that limits the capacity 
3.31 	of state-operated facilities; or allowing movement to the community for people who no 
3.32 	longer require the level of care provided in state-operated facilities as provided under section 
3.33 	256B.092, subdivision 13, or 256B.49, subdivision 24;
4.1 	(4) new foster care licenses or community residential setting licenses determined to be 
4.2 	needed by the commissioner under paragraph (b) for persons requiring hospital-level care; 
4.3 	or
4.4 	(5) new foster care licenses or community residential setting licenses for people receiving 
4.5 	customized living or 24-hour customized living services under the brain injury or community 
4.6 	access for disability inclusion waiver plans under section 256B.49 or elderly waiver plan 
4.7 	under chapter 256S and residing in the customized living setting before July 1, 2022, for 
4.8 	which a license is required. A customized living service provider subject to this exception 
4.9 	may rebut the presumption that a license is required by seeking a reconsideration of the 
4.10 	commissioner's determination. The commissioner's disposition of a request for 
4.11 	reconsideration is final and not subject to appeal under chapter 14. The exception is available 
4.12 	until June 30 December 31, 2023. This exception is available when:
4.13 	(i) the person's customized living services are provided in a customized living service 
4.14 	setting serving four or fewer people under the brain injury or community access for disability 
4.15 	inclusion waiver plans under section 256B.49 in a single-family home operational on or 
4.16 	before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;
4.17 	(ii) the person's case manager provided the person with information about the choice of 
4.18 	service, service provider, and location of service, including in the person's home, to help 
4.19 	the person make an informed choice; and
4.20 	(iii) the person's services provided in the licensed foster care or community residential 
4.21 	setting are less than or equal to the cost of the person's services delivered in the customized 
4.22 	living setting as determined by the lead agency.
4.23 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
4.24 	community residential settings as defined under this subdivision. As part of the determination, 
4.25 	the commissioner shall consider the availability of foster care capacity in the area in which 
4.26 	the licensee seeks to operate, and the recommendation of the local county board. The 
4.27 	determination by the commissioner must be final. A determination of need is not required 
4.28 	for a change in ownership at the same address.
4.29 	(c) When an adult resident served by the program moves out of a foster home that is not 
4.30 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
4.31 	paragraph (f), or the adult community residential setting, the county shall immediately 
4.32 	inform the Department of Human Services Licensing Division. The department may decrease 
4.33 	the statewide licensed capacity for adult foster care settings.
5.1 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
5.2 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
5.3 	residents whose primary diagnosis is mental illness and the license holder is certified under 
5.4 	the requirements in subdivision 6a or section 245D.33.
5.5 	(e) A resource need determination process, managed at the state level, using the available 
5.6 	data required by section 144A.351, and other data and information shall be used to determine 
5.7 	where the reduced capacity determined under section 256B.493 will be implemented. The 
5.8 	commissioner shall consult with the stakeholders described in section 144A.351, and employ 
5.9 	a variety of methods to improve the state's capacity to meet the informed decisions of those 
5.10 	people who want to move out of corporate foster care or community residential settings, 
5.11 	long-term service needs within budgetary limits, including seeking proposals from service 
5.12 	providers or lead agencies to change service type, capacity, or location to improve services, 
5.13 	increase the independence of residents, and better meet needs identified by the long-term 
5.14 	services and supports reports and statewide data and information.
5.15 	(f) At the time of application and reapplication for licensure, the applicant and the license 
5.16 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
5.17 	required to inform the commissioner whether the physical location where the foster care 
5.18 	will be provided is or will be the primary residence of the license holder for the entire period 
5.19 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
5.20 	or license holder must notify the commissioner immediately. The commissioner shall print 
5.21 	on the foster care license certificate whether or not the physical location is the primary 
5.22 	residence of the license holder.
5.23 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
5.24 	primary residence of the license holder and that also provide services in the foster care home 
5.25 	that are covered by a federally approved home and community-based services waiver, as 
5.26 	authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human 
5.27 	services licensing division that the license holder provides or intends to provide these 
5.28 	waiver-funded services.
5.29 	(h) The commissioner may adjust capacity to address needs identified in section 
5.30 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
5.31 	delicense existing settings. Delicensing of settings will be accomplished through a process 
5.32 	identified in section 256B.493.
5.33 	(i) The commissioner must notify a license holder when its corporate foster care or 
5.34 	community residential setting licensed beds are reduced under this section. The notice of 
6.1 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
6.2 	mail or personal service. The notice must state why the licensed beds are reduced and must 
6.3 	inform the license holder of its right to request reconsideration by the commissioner. The 
6.4 	license holder's request for reconsideration must be in writing. If mailed, the request for 
6.5 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
6.6 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
6.7 	reconsideration is made by personal service, it must be received by the commissioner within 
6.8 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
6.9 	(j) The commissioner shall not issue an initial license for children's residential treatment 
6.10 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
6.11 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
6.12 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
6.13 	moratorium described in this paragraph. The commissioner has the authority to manage 
6.14 	existing statewide capacity for children's residential treatment services subject to the 
6.15 	moratorium under this paragraph and may issue an initial license for such facilities if the 
6.16 	initial license would not increase the statewide capacity for children's residential treatment 
6.17 	services subject to the moratorium under this paragraph.

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

6.19 	Sec. 3. Minnesota Statutes 2022, section 245A.11, subdivision 7, is amended to read:
6.20 		Subd. 7.Adult foster care; variance for alternate overnight supervision. (a) The 
6.21 	commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts 
6.22 	requiring a caregiver to be present in an adult foster care home during normal sleeping hours 
6.23 	to allow for alternative methods of overnight supervision. The commissioner may grant the 
6.24 	variance if the local county licensing agency recommends the variance and the county 
6.25 	recommendation includes documentation verifying that:
6.26 	(1) the county has approved the license holder's plan for alternative methods of providing 
6.27 	overnight supervision and determined the plan protects the residents' health, safety, and 
6.28 	rights;
6.29 	(2) the license holder has obtained written and signed informed consent from each 
6.30 	resident or each resident's legal representative documenting the resident's or legal 
6.31 	representative's agreement with the alternative method of overnight supervision; and
6.32 	(3) the alternative method of providing overnight supervision, which may include the 
6.33 	use of technology, is specified for each resident in the resident's: (i) individualized plan of 
7.1 	care; (ii) individual service plan under section 256B.092, subdivision 1b, if required; or (iii) 
7.2 	individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 
7.3 	19, if required.
7.4 	(b) To be eligible for a variance under paragraph (a), the adult foster care license holder 
7.5 	must not have had a conditional license issued under section 245A.06, or any other licensing 
7.6 	sanction issued under section 245A.07 during the prior 24 months based on failure to provide 
7.7 	adequate supervision, health care services, or resident safety in the adult foster care home.
7.8 	(c) A license holder requesting a variance under this subdivision to utilize technology 
7.9 	as a component of a plan for alternative overnight supervision may request the commissioner's 
7.10 	review in the absence of a county recommendation. Upon receipt of such a request from a 
7.11 	license holder, the commissioner shall review the variance request with the county.
7.12 	(d) A variance granted by the commissioner according to this subdivision before January 
7.13 	1, 2014, to a license holder for an adult foster care home must transfer with the license when 
7.14 	the license converts to a community residential setting license under chapter 245D. The 
7.15 	terms and conditions of the variance remain in effect as approved at the time the variance 
7.16 	was granted The variance requirements under this subdivision for alternative overnight 
7.17 	supervision do not apply to community residential settings licensed under chapter 245D.

7.18 	EFFECTIVE DATE. This section is effective January 1, 2024.

7.19 	Sec. 4. Minnesota Statutes 2022, section 245A.11, subdivision 7a, is amended to read:
7.20 		Subd. 7a.Alternate overnight supervision technology; adult foster care and 
7.21 	community residential setting licenses. (a) The commissioner may grant an applicant or 
7.22 	license holder an adult foster care or community residential setting license for a residence 
7.23 	that does not have a caregiver in the residence during normal sleeping hours as required 
7.24 	under Minnesota Rules, part 9555.5105, subpart 37, item B, or section 245D.02, subdivision 
7.25 	33b, but uses monitoring technology to alert the license holder when an incident occurs that 
7.26 	may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 
7.27 	holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 
7.28 	to 9555.6265, or applicable requirements under chapter 245D, and the requirements under 
7.29 	this subdivision. The license printed by the commissioner must state in bold and large font:
7.30 	(1) that the facility is under electronic monitoring; and
7.31 	(2) the telephone number of the county's common entry point for making reports of 
7.32 	suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
8.1 	(b) Applications for a license under this section must be submitted directly to the 
8.2 	Department of Human Services licensing division. The licensing division must immediately 
8.3 	notify the county licensing agency. The licensing division must collaborate with the county 
8.4 	licensing agency in the review of the application and the licensing of the program.
8.5 	(c) Before a license is issued by the commissioner, and for the duration of the license, 
8.6 	the applicant or license holder must establish, maintain, and document the implementation 
8.7 	of written policies and procedures addressing the requirements in paragraphs (d) through 
8.8 	(f).
8.9 	(d) The applicant or license holder must have policies and procedures that:
8.10 	(1) establish characteristics of target populations that will be admitted into the home, 
8.11 	and characteristics of populations that will not be accepted into the home;
8.12 	(2) explain the discharge process when a resident served by the program requires 
8.13 	overnight supervision or other services that cannot be provided by the license holder due 
8.14 	to the limited hours that the license holder is on site;
8.15 	(3) describe the types of events to which the program will respond with a physical 
8.16 	presence when those events occur in the home during time when staff are not on site, and 
8.17 	how the license holder's response plan meets the requirements in paragraph (e), clause (1) 
8.18 	or (2);
8.19 	(4) establish a process for documenting a review of the implementation and effectiveness 
8.20 	of the response protocol for the response required under paragraph (e), clause (1) or (2). 
8.21 	The documentation must include:
8.22 	(i) a description of the triggering incident;
8.23 	(ii) the date and time of the triggering incident;
8.24 	(iii) the time of the response or responses under paragraph (e), clause (1) or (2);
8.25 	(iv) whether the response met the resident's needs;
8.26 	(v) whether the existing policies and response protocols were followed; and
8.27 	(vi) whether the existing policies and protocols are adequate or need modification.
8.28 	When no physical presence response is completed for a three-month period, the license 
8.29 	holder's written policies and procedures must require a physical presence response drill to 
8.30 	be conducted for which the effectiveness of the response protocol under paragraph (e), 
8.31 	clause (1) or (2), will be reviewed and documented as required under this clause; and
9.1 	(5) establish that emergency and nonemergency phone numbers are posted in a prominent 
9.2 	location in a common area of the home where they can be easily observed by a person 
9.3 	responding to an incident who is not otherwise affiliated with the home.
9.4 	(e) The license holder must document and include in the license application which 
9.5 	response alternative under clause (1) or (2) is in place for responding to situations that 
9.6 	present a serious risk to the health, safety, or rights of residents served by the program:
9.7 	(1) response alternative (1) requires only the technology to provide an electronic 
9.8 	notification or alert to the license holder that an event is underway that requires a response. 
9.9 	Under this alternative, no more than ten minutes will pass before the license holder will be 
9.10 	physically present on site to respond to the situation; or
9.11 	(2) response alternative (2) requires the electronic notification and alert system under 
9.12 	alternative (1), but more than ten minutes may pass before the license holder is present on 
9.13 	site to respond to the situation. Under alternative (2), all of the following conditions are 
9.14 	met:
9.15 	(i) the license holder has a written description of the interactive technological applications 
9.16 	that will assist the license holder in communicating with and assessing the needs related to 
9.17 	the care, health, and safety of the foster care recipients. This interactive technology must 
9.18 	permit the license holder to remotely assess the well being of the resident served by the 
9.19 	program without requiring the initiation of the foster care recipient. Requiring the foster 
9.20 	care recipient to initiate a telephone call does not meet this requirement;
9.21 	(ii) the license holder documents how the remote license holder is qualified and capable 
9.22 	of meeting the needs of the foster care recipients and assessing foster care recipients' needs 
9.23 	under item (i) during the absence of the license holder on site;
9.24 	(iii) the license holder maintains written procedures to dispatch emergency response 
9.25 	personnel to the site in the event of an identified emergency; and
9.26 	(iv) each resident's individualized plan of care, support plan under sections 256B.0913, 
9.27 	subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision 15; and 256S.10, if required, 
9.28 	or individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 
9.29 	19, if required, identifies the maximum response time, which may be greater than ten minutes, 
9.30 	for the license holder to be on site for that resident.
9.31 	(f) Each resident's placement agreement, individual service agreement, and plan must 
9.32 	clearly state that the adult foster care or community residential setting license category is 
9.33 	a program without the presence of a caregiver in the residence during normal sleeping hours; 
10.1 	the protocols in place for responding to situations that present a serious risk to the health, 
10.2 	safety, or rights of residents served by the program under paragraph (e), clause (1) or (2); 
10.3 	and a signed informed consent from each resident served by the program or the person's 
10.4 	legal representative documenting the person's or legal representative's agreement with 
10.5 	placement in the program. If electronic monitoring technology is used in the home, the 
10.6 	informed consent form must also explain the following:
10.7 	(1) how any electronic monitoring is incorporated into the alternative supervision system;
10.8 	(2) the backup system for any electronic monitoring in times of electrical outages or 
10.9 	other equipment malfunctions;
10.10 	(3) how the caregivers or direct support staff are trained on the use of the technology;
10.11 	(4) the event types and license holder response times established under paragraph (e);
10.12 	(5) how the license holder protects each resident's privacy related to electronic monitoring 
10.13 	and related to any electronically recorded data generated by the monitoring system. A 
10.14 	resident served by the program may not be removed from a program under this subdivision 
10.15 	for failure to consent to electronic monitoring. The consent form must explain where and 
10.16 	how the electronically recorded data is stored, with whom it will be shared, and how long 
10.17 	it is retained; and
10.18 	(6) the risks and benefits of the alternative overnight supervision system.
10.19 	The written explanations under clauses (1) to (6) may be accomplished through 
10.20 	cross-references to other policies and procedures as long as they are explained to the person 
10.21 	giving consent, and the person giving consent is offered a copy.
10.22 	(g) Nothing in this section requires the applicant or license holder to develop or maintain 
10.23 	separate or duplicative policies, procedures, documentation, consent forms, or individual 
10.24 	plans that may be required for other licensing standards, if the requirements of this section 
10.25 	are incorporated into those documents.
10.26 	(h) The commissioner may grant variances to the requirements of this section according 
10.27 	to section 245A.04, subdivision 9.
10.28 	(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning 
10.29 	under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and 
10.30 	contractors affiliated with the license holder.
11.1 	(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to remotely 
11.2 	determine what action the license holder needs to take to protect the well-being of the foster 
11.3 	care recipient.
11.4 	(k) The commissioner shall evaluate license applications using the requirements in 
11.5 	paragraphs (d) to (f). The commissioner shall provide detailed application forms, including 
11.6 	a checklist of criteria needed for approval.
11.7 	(l) To be eligible for a license under paragraph (a), the adult foster care or community 
11.8 	residential setting license holder must not have had a conditional license issued under section 
11.9 	245A.06 or any licensing sanction under section 245A.07 during the prior 24 months based 
11.10 	on failure to provide adequate supervision, health care services, or resident safety in the 
11.11 	adult foster care home or community residential setting.
11.12 	(m) The commissioner shall review an application for an alternative overnight supervision 
11.13 	license within 60 days of receipt of the application. When the commissioner receives an 
11.14 	application that is incomplete because the applicant failed to submit required documents or 
11.15 	that is substantially deficient because the documents submitted do not meet licensing 
11.16 	requirements, the commissioner shall provide the applicant written notice that the application 
11.17 	is incomplete or substantially deficient. In the written notice to the applicant, the 
11.18 	commissioner shall identify documents that are missing or deficient and give the applicant 
11.19 	45 days to resubmit a second application that is substantially complete. An applicant's failure 
11.20 	to submit a substantially complete application after receiving notice from the commissioner 
11.21 	is a basis for license denial under section 245A.05. The commissioner shall complete 
11.22 	subsequent review within 30 days.
11.23 	(n) Once the application is considered complete under paragraph (m), the commissioner 
11.24 	will approve or deny an application for an alternative overnight supervision license within 
11.25 	60 days.
11.26 	(o) For the purposes of this subdivision, "supervision" means:
11.27 	(1) oversight by a caregiver or direct support staff as specified in the individual resident's 
11.28 	place agreement or support plan and awareness of the resident's needs and activities; and
11.29 	(2) the presence of a caregiver or direct support staff in a residence during normal sleeping 
11.30 	hours, unless a determination has been made and documented in the individual's support 
11.31 	plan that the individual does not require the presence of a caregiver or direct support staff 
11.32 	during normal sleeping hours.

11.33 	EFFECTIVE DATE. This section is effective January 1, 2024.

12.1 	Sec. 5. Minnesota Statutes 2022, section 245D.03, subdivision 1, is amended to read:
12.2 		Subdivision 1.Applicability. (a) The commissioner shall regulate the provision of home 
12.3 	and community-based services to persons with disabilities and persons age 65 and older 
12.4 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
12.5 	basic support services and intensive support services.
12.6 	(b) Basic support services provide the level of assistance, supervision, and care that is 
12.7 	necessary to ensure the health and welfare of the person and do not include services that 
12.8 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
12.9 	person. Basic support services include:
12.10 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
12.11 	subdivision 15, and under the brain injury, community alternative care, community access 
12.12 	for disability inclusion, developmental disabilities, and elderly waiver plans, excluding 
12.13 	out-of-home respite care provided to children in a family child foster care home licensed 
12.14 	under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license 
12.15 	holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8, 
12.16 	or successor provisions; and section 245D.061 or successor provisions, which must be 
12.17 	stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000, 
12.18 	subpart 4;
12.19 	(2) adult companion services as defined under the brain injury, community access for 
12.20 	disability inclusion, community alternative care, and elderly waiver plans, excluding adult 
12.21 	companion services provided under the Corporation for National and Community Services 
12.22 	Senior Companion Program established under the Domestic Volunteer Service Act of 1973, 
12.23 	Public Law 98-288;
12.24 	(3) personal support as defined under the developmental disabilities waiver plan;
12.25 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
12.26 	community access for disability inclusion and developmental disabilities waiver plans;
12.27 	(5) night supervision services as defined under the brain injury, community access for 
12.28 	disability inclusion, community alternative care, and developmental disabilities waiver 
12.29 	plans;
12.30 	(6) homemaker services as defined under the community access for disability inclusion, 
12.31 	brain injury, community alternative care, developmental disabilities, and elderly waiver 
12.32 	plans, excluding providers licensed by the Department of Health under chapter 144A and 
12.33 	those providers providing cleaning services only;
13.1 	(7) individual community living support under section 256S.13; and
13.2 	(8) individualized home supports services as defined under the brain injury, community 
13.3 	alternative care, and community access for disability inclusion, and developmental disabilities 
13.4 	waiver plans.
13.5 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
13.6 	to ensure the health and welfare of the person and services specifically directed toward the 
13.7 	training, habilitation, or rehabilitation of the person. Intensive support services include:
13.8 	(1) intervention services, including:
13.9 	(i) positive support services as defined under the brain injury and community access for 
13.10 	disability inclusion, community alternative care, and developmental disabilities waiver 
13.11 	plans;
13.12 	(ii) in-home or out-of-home crisis respite services as defined under the brain injury, 
13.13 	community access for disability inclusion, community alternative care, and developmental 
13.14 	disabilities waiver plans; and
13.15 	(iii) specialist services as defined under the current brain injury, community access for 
13.16 	disability inclusion, community alternative care, and developmental disabilities waiver 
13.17 	plans;
13.18 	(2) in-home support services, including:
13.19 	(i) in-home family support and supported living services as defined under the 
13.20 	developmental disabilities waiver plan;
13.21 	(ii) independent living services training as defined under the brain injury and community 
13.22 	access for disability inclusion waiver plans;
13.23 	(iii) semi-independent living services;
13.24 	(iv) individualized home support with training services as defined under the brain injury, 
13.25 	community alternative care, community access for disability inclusion, and developmental 
13.26 	disabilities waiver plans; and
13.27 	(v) individualized home support with family training services as defined under the brain 
13.28 	injury, community alternative care, community access for disability inclusion, and 
13.29 	developmental disabilities waiver plans;
13.30 	(3) residential supports and services, including:
14.1 	(i) supported living services as defined under the developmental disabilities waiver plan 
14.2 	provided in a family or corporate child foster care residence, a family adult foster care 
14.3 	residence, a community residential setting, or a supervised living facility;
14.4 	(ii) foster care services as defined in the brain injury, community alternative care, and 
14.5 	community access for disability inclusion waiver plans provided in a family or corporate 
14.6 	child foster care residence, a family adult foster care residence, or a community residential 
14.7 	setting;
14.8 	(iii) community residential services as defined under the brain injury, community 
14.9 	alternative care, community access for disability inclusion, and developmental disabilities 
14.10 	waiver plans provided in a corporate child foster care residence, a community residential 
14.11 	setting, or a supervised living facility;
14.12 	(iv) family residential services as defined in the brain injury, community alternative 
14.13 	care, community access for disability inclusion, and developmental disabilities waiver plans 
14.14 	provided in a family child foster care residence or a family adult foster care residence; and
14.15 	(v) residential services provided to more than four persons with developmental disabilities 
14.16 	in a supervised living facility, including ICFs/DD; and
14.17 	(vi) life sharing as defined in the brain injury, community alternative care, community 
14.18 	access for disability inclusion, and developmental disabilities waiver plans;
14.19 	(4) day services, including:
14.20 	(i) structured day services as defined under the brain injury waiver plan;
14.21 	(ii) day services under sections 252.41 to 252.46, and as defined under the brain injury, 
14.22 	community alternative care, community access for disability inclusion, and developmental 
14.23 	disabilities waiver plans;
14.24 	(iii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
14.25 	under the developmental disabilities waiver plan; and
14.26 	(iv) prevocational services as defined under the brain injury, community alternative care, 
14.27 	community access for disability inclusion, and developmental disabilities waiver plans; and
14.28 	(5) employment exploration services as defined under the brain injury, community 
14.29 	alternative care, community access for disability inclusion, and developmental disabilities 
14.30 	waiver plans;
15.1 	(6) employment development services as defined under the brain injury, community 
15.2 	alternative care, community access for disability inclusion, and developmental disabilities 
15.3 	waiver plans;
15.4 	(7) employment support services as defined under the brain injury, community alternative 
15.5 	care, community access for disability inclusion, and developmental disabilities waiver plans; 
15.6 	and
15.7 	(8) integrated community support as defined under the brain injury and community 
15.8 	access for disability inclusion waiver plans beginning January 1, 2021, and community 
15.9 	alternative care and developmental disabilities waiver plans beginning January 1, 2023.

15.10 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
15.11 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
15.12 	when federal approval is obtained.

15.13 	Sec. 6. [245D.261] COMMUNITY RESIDENTIAL SETTINGS; REMOTE 
15.14 	OVERNIGHT SUPERVISION.
15.15 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
15.16 	the meanings given, unless otherwise specified.
15.17 	(b) "Resident" means an adult residing in a community residential setting.
15.18 	(c) "Technology" means:
15.19 	(1) enabling technology, which is a device capable of live two-way communication or 
15.20 	engagement between a resident and direct support staff at a remote location; or
15.21 	(2) monitoring technology, which is the use of equipment to oversee, monitor, and 
15.22 	supervise an individual who receives medical assistance waiver or alternative care services 
15.23 	under section 256B.0913, 256B.092, or 256B.49 or chapter 256S.
15.24 		Subd. 2.Documentation of permissible remote overnight supervision. A license 
15.25 	holder providing remote overnight supervision in a community residential setting in lieu of 
15.26 	on-site direct support staff must comply with the requirements of this chapter, including 
15.27 	the requirement under section 245D.02, subdivision 33b, paragraph (a), clause (3), that the 
15.28 	absence of direct support staff from the community residential setting while services are 
15.29 	being delivered must be documented in the resident's support plan or support plan addendum.
15.30 		Subd. 3.Provider requirements for remote overnight supervision; commissioner 
15.31 	notification. (a) A license holder providing remote overnight supervision in a community 
15.32 	residential setting must:
16.1 	(1) use technology;
16.2 	(2) notify the commissioner of the community residential setting's intent to use technology 
16.3 	in lieu of on-site staff. The notification must:
16.4 	(i) indicate a start date for the use of technology; and
16.5 	(ii) attest that all requirements under this section are met and policies required under 
16.6 	subdivision 4 are available upon request;
16.7 	(3) clearly state in each person's support plan addendum that the community residential 
16.8 	setting is a program without the in-person presence of overnight direct support;
16.9 	(4) include with each person's support plan addendum the license holder's protocols for 
16.10 	responding to situations that present a serious risk to the health, safety, or rights of residents 
16.11 	served by the program; and
16.12 	(5) include in each person's support plan addendum the person's maximum permissible 
16.13 	response time as determined by the person's support team.
16.14 	(b) Upon being notified via technology that an incident has occurred that may jeopardize 
16.15 	the health, safety, or rights of a resident, the license holder must document an evaluation 
16.16 	of the need for the physical presence of a staff member. If a physical presence is needed, a 
16.17 	staff person, volunteer, or contractor must be on site to respond to the situation within the 
16.18 	resident's maximum permissible response time.
16.19 	(c) A license holder must notify the commissioner if remote overnight supervision 
16.20 	technology will no longer be used by the license holder.
16.21 	(d) Upon receipt of notification of use of remote overnight supervision or discontinuation 
16.22 	of use of remote overnight supervision by a license holder, the commissioner shall notify 
16.23 	the county licensing agency and update the license.
16.24 		Subd. 4.Required policies and procedures for remote overnight supervision. (a) A 
16.25 	license holder providing remote overnight supervision must have policies and procedures 
16.26 	that:
16.27 	(1) protect the residents' health, safety, and rights;
16.28 	(2) explain the discharge process if a person served by the program requires in-person 
16.29 	supervision or other services that cannot be provided by the license holder due to the limited 
16.30 	hours that direct support staff are on site, including information explaining that if a resident 
16.31 	provides informed consent to the use of monitoring technology but later revokes their 
17.1 	consent, the resident may be subject to a service termination in accordance with section 
17.2 	245D.10, subdivision 3a;
17.3 	(3) ensure that services may not be terminated for any person or resident currently served 
17.4 	by the program and receiving in-person services solely because the person declines to 
17.5 	provide informed consent to the initial change to the use of monitoring technology as required 
17.6 	under subdivision 5;
17.7 	(4) explain the backup system for technology in times of electrical outages or other 
17.8 	equipment malfunctions;
17.9 	(5) explain how the license holder trains the direct support staff on the use of the 
17.10 	technology; and
17.11 	(6) establish a plan for dispatching emergency response personnel to the site in the event 
17.12 	of an identified emergency.
17.13 	(b) Nothing in this section requires the license holder to develop or maintain separate 
17.14 	or duplicative policies, procedures, documentation, consent forms, or individual plans that 
17.15 	may be required for other licensing standards if the requirements of this section are 
17.16 	incorporated into those documents.
17.17 	(c) When no physical presence response is completed for a three-month period, the 
17.18 	license holder must conduct a physical presence response drill. The effectiveness of the 
17.19 	response protocol must be reviewed and documented.
17.20 		Subd. 5.Consent to use of monitoring technology. If a license holder uses monitoring 
17.21 	technology in a community residential setting, the license holder must obtain a signed 
17.22 	informed consent form from each resident served by the program or the resident's legal 
17.23 	representative documenting the resident's or legal representative's agreement to use of the 
17.24 	specific monitoring technology used in the setting. The informed consent form documenting 
17.25 	this agreement must also explain:
17.26 	(1) how the license holder uses monitoring technology to provide remote supervision;
17.27 	(2) the risks and benefits of using monitoring technology;
17.28 	(3) how the license holder protects each resident's privacy while monitoring technology 
17.29 	is being used in the setting; and
17.30 	(4) how the license holder protects each resident's privacy when the monitoring 
17.31 	technology system electronically records personally identifying data.

17.32 	EFFECTIVE DATE. This section is effective January 1, 2024.

18.1 	Sec. 7. [252.54] STATEWIDE DISABILITY EMPLOYMENT TECHNICAL 
18.2 	ASSISTANCE CENTER.
18.3 	The commissioner must establish a statewide technical assistance center to provide 
18.4 	resources and assistance to programs, people, and families to support individuals with 
18.5 	disabilities to achieve meaningful and competitive employment in integrated settings. Duties 
18.6 	of the technical assistance center include but are not limited to:
18.7 	(1) offering provider business model transition support to ensure ongoing access to 
18.8 	employment and day services;
18.9 	(2) identifying and providing training on innovative, promising, and emerging practices;
18.10 	(3) maintaining a resource clearinghouse to serve as a hub of information to ensure 
18.11 	programs, people, and families have access to high-quality materials and information;
18.12 	(4) fostering innovation and actionable progress by providing direct technical assistance 
18.13 	to programs; and
18.14 	(5) cultivating partnerships and mentorship across support programs, people, and families 
18.15 	in the exploration of and successful transition to competitive, integrated employment.

18.16 	Sec. 8. [252.55] LEAD AGENCY EMPLOYMENT FIRST CAPACITY BUILDING 
18.17 	GRANTS.
18.18 	The commissioner shall establish a grant program to expand lead agency capacity to 
18.19 	support people with disabilities to contemplate, explore, and maintain competitive, integrated 
18.20 	employment options. Allowable uses of money include:
18.21 	(1) enhancing resources and staffing to support people and families in understanding 
18.22 	employment options and navigating service options;
18.23 	(2) implementing and testing innovative approaches to better support people with 
18.24 	disabilities and their families in achieving competitive, integrated employment; and
18.25 	(3) other activities approved by the commissioner.

18.26 	Sec. 9. Minnesota Statutes 2022, section 256.01, subdivision 19, is amended to read:
18.27 		Subd. 19.Grants for case management supportive services to persons with HIV or 
18.28 	AIDS. The commissioner may award grants to eligible vendors for the development, 
18.29 	implementation, and evaluation of case management supportive services for individuals 
18.30 	infected with the human immunodeficiency virus. HIV/AIDS case management supportive
18.31 	services will be provided to increase access to cost effective health care services, to reduce 
19.1 	the risk of HIV transmission, to ensure that basic client needs are met, and to increase client 
19.2 	access to needed community supports or services.

19.3 	Sec. 10. [256.4764] LONG-TERM SERVICES AND SUPPORTS WORKFORCE 
19.4 	INCENTIVE GRANTS.
19.5 		Subdivision 1.Grant program established. The commissioner of human services shall 
19.6 	establish grants for long-term services and supports providers and facilities to assist with 
19.7 	recruiting and retaining direct support professionals.
19.8 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
19.9 	meanings given.
19.10 	(b) "Commissioner" means the commissioner of human services.
19.11 	(c) "Eligible employer" means an organization enrolled in a Minnesota health care 
19.12 	program that is:
19.13 	(1) a provider of home and community-based services under Minnesota Statutes, chapter 
19.14 	245D;
19.15 	(2) a facility certified as an intermediate care facility for persons with developmental 
19.16 	disabilities;
19.17 	(3) a nursing facility under section 256R.02, subdivision 33;
19.18 	(4) a provider of personal care assistance services under section 256B.0659;
19.19 	(5) a provider of community first services and supports under section 256B.85;
19.20 	(6) a provider of early intensive developmental and behavioral intervention services 
19.21 	under section 256B.0949;
19.22 	(7) a provider of home care services as defined under section 256B.0651, subdivision 
19.23 	1, paragraph (d);
19.24 	(8) an eligible financial management services provider serving people through 
19.25 	consumer-directed community supports under chapter 256S and sections 256B.092 and 
19.26 	256B.49, or consumer support grants under section 256.476; or
19.27 	(9) a provider of customized living services as defined in section 256S.02.
19.28 	(d) "Eligible worker" means a worker who earns $30 per hour or less and is currently 
19.29 	employed or recruited to be employed by an eligible employer.
20.1 		Subd. 3.Allowable uses of grant money. (a) Grantees must use grant money to provide 
20.2 	payments to eligible workers for the following purposes:
20.3 	(1) retention, recruitment, and incentive payments;
20.4 	(2) postsecondary loan and tuition payments;
20.5 	(3) child care costs;
20.6 	(4) transportation-related costs;
20.7 	(5) personal care assistant background study costs; and
20.8 	(6) other costs associated with retaining and recruiting workers, as approved by the 
20.9 	commissioner.
20.10 	(b) Eligible workers may receive cumulative payments up to $1,000 per year from the 
20.11 	workforce incentive grant account and all other state money intended for the same purpose.
20.12 	(c) The commissioner must develop a grant cycle distribution plan that allows for 
20.13 	equitable distribution of money among eligible employers. The commissioner's determination 
20.14 	of the grant awards and amounts is final and is not subject to appeal.
20.15 		Subd. 4.Attestation. As a condition of obtaining grant payments under this section, an 
20.16 	eligible employer must attest and agree to the following:
20.17 	(1) the employer is an eligible employer;
20.18 	(2) the total number of eligible employees;
20.19 	(3) the employer will distribute the entire value of the grant to eligible workers allowed 
20.20 	under this section;
20.21 	(4) the employer will create and maintain records under subdivision 6;
20.22 	(5) the employer will not use the money appropriated under this section for any purpose 
20.23 	other than the purposes permitted under this section; and
20.24 	(6) the entire value of any grant amounts will be distributed to eligible workers identified 
20.25 	by the employer.
20.26 		Subd. 5.Distribution plan; report. (a) Each grantee shall prepare, and upon request 
20.27 	submit to the commissioner, a distribution plan that specifies the amount of money the 
20.28 	grantee expects to receive and how that money will be distributed for recruitment and 
20.29 	retention purposes for eligible employees. Within 60 days of receiving the grant, the grantee 
20.30 	must post the distribution plan and leave it posted for a period of at least six months in an 
20.31 	area of the grantee's operation to which all direct support professionals have access.
21.1 	(b) Within 12 months of receiving a grant under this section, each grantee that receives 
21.2 	a grant shall submit a report to the commissioner that includes the following information:
21.3 	(1) a description of how grant money was distributed to eligible employees; and
21.4 	(2) the total dollar amount distributed.
21.5 	(c) Failure to submit the report under paragraph (b) may result in recoupment of grant 
21.6 	money.
21.7 		Subd. 6.Audits and recoupment. (a) The commissioner may perform an audit under 
21.8 	this section up to six years after a grant is awarded to ensure:
21.9 	(1) the grantee used the money solely for allowable purposes under subdivision 3;
21.10 	(2) the grantee was truthful when making attestations under subdivision 4; and
21.11 	(3) the grantee complied with the conditions of receiving a grant under this section.
21.12 	(b) If the commissioner determines that a grantee used grant money for purposes not 
21.13 	authorized under this section, the commissioner must treat any amount used for a purpose 
21.14 	not authorized under this section as an overpayment. The commissioner must recover any 
21.15 	overpayment.
21.16 		Subd. 7.Grants not to be considered income. (a) Notwithstanding any law to the 
21.17 	contrary, grant awards under this section must not be considered income, assets, or personal 
21.18 	property for purposes of determining eligibility or recertifying eligibility for:
21.19 	(1) child care assistance programs under chapter 119B;
21.20 	(2) general assistance, Minnesota supplemental aid, and food support under chapter 
21.21 	256D;
21.22 	(3) housing support under chapter 256I;
21.23 	(4) the Minnesota family investment program and diversionary work program under 
21.24 	chapter 256J; and
21.25 	(5) economic assistance programs under chapter 256P.
21.26 	(b) The commissioner must not consider grant awards under this section as income or 
21.27 	assets under section 256B.056, subdivision 1a, paragraph (a), 3, or 3c, or for persons with 
21.28 	eligibility determined under section 256B.057, subdivision 3, 3a, 3b, 4, or 9.
21.29 		Subd. 8.Income tax subtractions. (a) For the purposes of this section, "subtraction" 
21.30 	has the meaning given in section 290.0132, subdivision 1, and the rules in that subdivision 
21.31 	apply for this section. The definitions in section 290.01 apply to this section.
22.1 	(b) The amount of a payment received under this section is a subtraction.
22.2 	(c) Payments under this section and Laws 2021, First Special Session chapter 7, article 
22.3 	17, section 20, as amended, are excluded from income as defined in sections 290.0674, 
22.4 	subdivision 2a, and 290A.03, subdivision 3.
22.5 		Subd. 9.Account created. A workforce incentive grant account is created in the special 
22.6 	revenue fund. Appropriations made for grants and payments administered under this section 
22.7 	may be transferred to this account. Amounts in the account are appropriated to the 
22.8 	commissioner of human services. Appropriations transferred to this account cancel and are 
22.9 	returned to the fund of origin on the date the original appropriations would have lapsed.
22.10 		Subd. 10.Nursing facilities; applicable credit. The commissioner must treat grant 
22.11 	payments awarded under this section as an applicable credit as defined under section 256R.10, 
22.12 	subdivision 6.
22.13 		Subd. 11.Self-directed services workforce. Payments administered under this section, 
22.14 	including reimbursements for paid family medical leave premiums, do not constitute a 
22.15 	change in a term or condition for individual providers as defined in section 256B.0711 in 
22.16 	covered programs and are not subject to the state's obligation to meet and negotiate under 
22.17 	chapter 179A.

22.18 	Sec. 11. [256.4773] TECHNOLOGY FOR HOME GRANT.
22.19 		Subdivision 1.Establishment. The commissioner must establish a technology for home 
22.20 	grant program that provides assistive technology consultations and resources for people 
22.21 	with disabilities who want to stay in their own home, move to their own home, or remain 
22.22 	in a less restrictive residential setting. The grant program may be administered using a team 
22.23 	approach that allows multiple professionals to assess and meet a person's assistive technology 
22.24 	needs. The team may include but is not limited to occupational therapists, physical therapists, 
22.25 	speech therapists, nurses, and engineers.
22.26 		Subd. 2.Eligible applicants. An eligible applicant is a person who uses or is eligible 
22.27 	for home care services under section 256B.0651, home and community-based services under 
22.28 	section 256B.092 or 256B.49, personal care assistance under section 256B.0659, or 
22.29 	community first services and supports under section 256B.85, and who meets one of the 
22.30 	following conditions:
22.31 	(1) lives in the applicant's own home and may benefit from assistive technology for 
22.32 	safety, communication, community engagement, or independence;
23.1 	(2) is currently seeking to live in the applicant's own home and needs assistive technology 
23.2 	to meet that goal; or
23.3 	(3) resides in a residential setting under section 256B.4914, subdivision 3, and is seeking 
23.4 	to reduce reliance on paid staff to live more independently in the setting.
23.5 		Subd. 3.Allowable grant activities. The technology for home grant program must 
23.6 	provide at-home, in-person assistive technology consultation and technical assistance to 
23.7 	help people with disabilities live more independently. Allowable activities include but are 
23.8 	not limited to:
23.9 	(1) consultations in people's homes, workplaces, or community locations;
23.10 	(2) connecting people to resources to help them live in their own homes, transition to 
23.11 	their own homes, or live more independently in residential settings;
23.12 	(3) conducting training for and set up and installation of assistive technology; and
23.13 	(4) participating on a person's care team to develop a plan to ensure assistive technology 
23.14 	goals are met.
23.15 		Subd. 4.Data collection and outcomes. Grantees must provide data summaries to the 
23.16 	commissioner for the purpose of evaluating the effectiveness of the grant program. The 
23.17 	commissioner must identify outcome measures to evaluate program activities to assess 
23.18 	whether the grant programs help people transition to or remain in the least restrictive setting.

23.19 	Sec. 12. Minnesota Statutes 2022, section 256B.0659, subdivision 1, is amended to read:
23.20 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in 
23.21 	paragraphs (b) to (r) have the meanings given unless otherwise provided in text.
23.22 	(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility, 
23.23 	positioning, eating, and toileting.
23.24 	(c) "Behavior," effective January 1, 2010, means a category to determine the home care 
23.25 	rating and is based on the criteria found in this section. "Level I behavior" means physical 
23.26 	aggression towards toward self, others, or destruction of property that requires the immediate 
23.27 	response of another person.
23.28 	(d) "Complex health-related needs," effective January 1, 2010, means a category to 
23.29 	determine the home care rating and is based on the criteria found in this section.
23.30 	(e) "Critical activities of daily living," effective January 1, 2010, means transferring, 
23.31 	mobility, eating, and toileting.
24.1 	(f) "Dependency in activities of daily living" means a person requires assistance to begin 
24.2 	and complete one or more of the activities of daily living.
24.3 	(g) "Extended personal care assistance service" means personal care assistance services 
24.4 	included in a service plan under one of the home and community-based services waivers 
24.5 	authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which 
24.6 	exceed the amount, duration, and frequency of the state plan personal care assistance services 
24.7 	for participants who:
24.8 	(1) need assistance provided periodically during a week, but less than daily will not be 
24.9 	able to remain in their homes without the assistance, and other replacement services are 
24.10 	more expensive or are not available when personal care assistance services are to be reduced; 
24.11 	or
24.12 	(2) need additional personal care assistance services beyond the amount authorized by 
24.13 	the state plan personal care assistance assessment in order to ensure that their safety, health, 
24.14 	and welfare are provided for in their homes.
24.15 	(h) "Health-related procedures and tasks" means procedures and tasks that can be 
24.16 	delegated or assigned by a licensed health care professional under state law to be performed 
24.17 	by a personal care assistant.
24.18 	(i) "Instrumental activities of daily living" means activities to include meal planning and 
24.19 	preparation; basic assistance with paying bills; shopping for food, clothing, and other 
24.20 	essential items; performing household tasks integral to the personal care assistance services; 
24.21 	communication by telephone and other media; and traveling, including to medical 
24.22 	appointments and to participate in the community. For purposes of this paragraph, traveling 
24.23 	includes driving and accompanying the recipient in the recipient's chosen mode of 
24.24 	transportation and according to the recipient's personal care assistance care plan.
24.25 	(j) "Managing employee" has the same definition as Code of Federal Regulations, title 
24.26 	42, section 455.
24.27 	(k) "Qualified professional" means a professional providing supervision of personal care 
24.28 	assistance services and staff as defined in section 256B.0625, subdivision 19c.
24.29 	(l) "Personal care assistance provider agency" means a medical assistance enrolled 
24.30 	provider that provides or assists with providing personal care assistance services and includes 
24.31 	a personal care assistance provider organization, personal care assistance choice agency, 
24.32 	class A licensed nursing agency, and Medicare-certified home health agency.
25.1 	(m) "Personal care assistant" or "PCA" means an individual employed by a personal 
25.2 	care assistance agency who provides personal care assistance services.
25.3 	(n) "Personal care assistance care plan" means a written description of personal care 
25.4 	assistance services developed by the personal care assistance provider according to the 
25.5 	service plan.
25.6 	(o) "Responsible party" means an individual who is capable of providing the support 
25.7 	necessary to assist the recipient to live in the community.
25.8 	(p) "Self-administered medication" means medication taken orally, by injection, nebulizer, 
25.9 	or insertion, or applied topically without the need for assistance.
25.10 	(q) "Service plan" means a written summary of the assessment and description of the 
25.11 	services needed by the recipient.
25.12 	(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes, 
25.13 	Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage 
25.14 	reimbursement, health and dental insurance, life insurance, disability insurance, long-term 
25.15 	care insurance, uniform allowance, and contributions to employee retirement accounts.

25.16 	EFFECTIVE DATE. This section is effective 90 days following federal approval. The 
25.17 	commissioner of human services shall notify the revisor of statutes when federal approval 
25.18 	is obtained.

25.19 	Sec. 13. Minnesota Statutes 2022, section 256B.0659, subdivision 12, is amended to read:
25.20 		Subd. 12.Documentation of personal care assistance services provided. (a) Personal 
25.21 	care assistance services for a recipient must be documented daily by each personal care 
25.22 	assistant, on a time sheet form approved by the commissioner. All documentation may be 
25.23 	web-based, electronic, or paper documentation. The completed form must be submitted on 
25.24 	a monthly basis to the provider and kept in the recipient's health record.
25.25 	(b) The activity documentation must correspond to the personal care assistance care plan 
25.26 	and be reviewed by the qualified professional.
25.27 	(c) The personal care assistant time sheet must be on a form approved by the 
25.28 	commissioner documenting time the personal care assistant provides services in the home. 
25.29 	The following criteria must be included in the time sheet:
25.30 	(1) full name of personal care assistant and individual provider number;
25.31 	(2) provider name and telephone numbers;
26.1 	(3) full name of recipient and either the recipient's medical assistance identification 
26.2 	number or date of birth;
26.3 	(4) consecutive dates, including month, day, and year, and arrival and departure times 
26.4 	with a.m. or p.m. notations;
26.5 	(5) signatures of recipient or the responsible party;
26.6 	(6) personal signature of the personal care assistant;
26.7 	(7) any shared care provided, if applicable;
26.8 	(8) a statement that it is a federal crime to provide false information on personal care 
26.9 	service billings for medical assistance payments; and
26.10 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration; and
26.11 	(10) any time spent traveling, as described in subdivision 1, paragraph (i), including 
26.12 	start and stop times with a.m. and p.m. designations, the origination site, and the destination 
26.13 	site.

26.14 	EFFECTIVE DATE. This section is effective 90 days following federal approval. The 
26.15 	commissioner of human services shall notify the revisor of statutes when federal approval 
26.16 	is obtained.

26.17 	Sec. 14. Minnesota Statutes 2022, section 256B.0659, is amended by adding a subdivision 
26.18 	to read:
26.19 		Subd. 14a.Qualified professional; remote supervision. (a) For recipients with chronic 
26.20 	health conditions or severely compromised immune systems, a qualified professional may 
26.21 	conduct the supervision required under subdivision 14 via two-way interactive audio and 
26.22 	visual telecommunication if, at the recipient's request, the recipient's primary health care 
26.23 	provider:
26.24 	(1) determines that remote supervision is appropriate; and
26.25 	(2) documents the determination under clause (1) in a statement of need or other document 
26.26 	that is subsequently included in the recipient's personal care assistance care plan.
26.27 	(b) Notwithstanding any other provision of law, a care plan developed or amended via 
26.28 	remote supervision may be executed by electronic signature.
26.29 	(c) A personal care assistance provider agency must not conduct its first supervisory 
26.30 	visit for a recipient or complete its initial personal care assistance care plan via a remote 
26.31 	visit.
27.1 	(d) A recipient may request to return to in-person supervisory visits at any time.

27.2 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
27.3 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
27.4 	when federal approval is obtained.

27.5 	Sec. 15. Minnesota Statutes 2022, section 256B.0659, subdivision 19, is amended to read:
27.6 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) Under 
27.7 	personal care assistance choice, the recipient or responsible party shall:
27.8 	(1) recruit, hire, schedule, and terminate personal care assistants according to the terms 
27.9 	of the written agreement required under subdivision 20, paragraph (a);
27.10 	(2) develop a personal care assistance care plan based on the assessed needs and 
27.11 	addressing the health and safety of the recipient with the assistance of a qualified professional 
27.12 	as needed;
27.13 	(3) orient and train the personal care assistant with assistance as needed from the qualified 
27.14 	professional;
27.15 	(4) supervise and evaluate the personal care assistant with the qualified professional, 
27.16 	who is required to visit the recipient at least every 180 days;
27.17 	(5) monitor and verify in writing and report to the personal care assistance choice agency 
27.18 	the number of hours worked by the personal care assistant and the qualified professional;
27.19 	(6) engage in an annual reassessment as required in subdivision 3a to determine 
27.20 	continuing eligibility and service authorization; and
27.21 	(7) use the same personal care assistance choice provider agency if shared personal 
27.22 	assistance care is being used.; and
27.23 	(8) ensure that a personal care assistant driving the recipient under subdivision 1, 
27.24 	paragraph (i), has a valid driver's license and the vehicle used is registered and insured 
27.25 	according to Minnesota law.
27.26 	(b) The personal care assistance choice provider agency shall:
27.27 	(1) meet all personal care assistance provider agency standards;
27.28 	(2) enter into a written agreement with the recipient, responsible party, and personal 
27.29 	care assistants;
27.30 	(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal 
27.31 	care assistant; and
28.1 	(4) ensure arm's-length transactions without undue influence or coercion with the recipient 
28.2 	and personal care assistant.
28.3 	(c) The duties of the personal care assistance choice provider agency are to:
28.4 	(1) be the employer of the personal care assistant and the qualified professional for 
28.5 	employment law and related regulations including but not limited to purchasing and 
28.6 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
28.7 	and liability insurance, and submit any or all necessary documentation including but not 
28.8 	limited to workers' compensation, unemployment insurance, and labor market data required 
28.9 	under section 256B.4912, subdivision 1a;
28.10 	(2) bill the medical assistance program for personal care assistance services and qualified 
28.11 	professional services;
28.12 	(3) request and complete background studies that comply with the requirements for 
28.13 	personal care assistants and qualified professionals;
28.14 	(4) pay the personal care assistant and qualified professional based on actual hours of 
28.15 	services provided;
28.16 	(5) withhold and pay all applicable federal and state taxes;
28.17 	(6) verify and keep records of hours worked by the personal care assistant and qualified 
28.18 	professional;
28.19 	(7) make the arrangements and pay taxes and other benefits, if any, and comply with 
28.20 	any legal requirements for a Minnesota employer;
28.21 	(8) enroll in the medical assistance program as a personal care assistance choice agency; 
28.22 	and
28.23 	(9) enter into a written agreement as specified in subdivision 20 before services are 
28.24 	provided.

28.25 	EFFECTIVE DATE. This section is effective 90 days following federal approval. The 
28.26 	commissioner of human services shall notify the revisor of statutes when federal approval 
28.27 	is obtained.

28.28 	Sec. 16. Minnesota Statutes 2022, section 256B.0659, subdivision 24, is amended to read:
28.29 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
28.30 	assistance provider agency shall:
29.1 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
29.2 	of the required provider training;
29.3 	(2) comply with general medical assistance coverage requirements;
29.4 	(3) demonstrate compliance with law and policies of the personal care assistance program 
29.5 	to be determined by the commissioner;
29.6 	(4) comply with background study requirements;
29.7 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
29.8 	professional;
29.9 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
29.10 	or other electronic means to potential recipients, guardians, or family members;
29.11 	(7) pay the personal care assistant and qualified professional based on actual hours of 
29.12 	services provided;
29.13 	(8) withhold and pay all applicable federal and state taxes;
29.14 	(9) document that the agency uses a minimum of 72.5 percent of the revenue generated 
29.15 	by the medical assistance rate for personal care assistance services for employee personal 
29.16 	care assistant wages and benefits. The revenue generated by the qualified professional and 
29.17 	the reasonable costs associated with the qualified professional shall not be used in making 
29.18 	this calculation;
29.19 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
29.20 	compensation, liability insurance, and other benefits, if any;
29.21 	(11) enter into a written agreement under subdivision 20 before services are provided;
29.22 	(12) report suspected neglect and abuse to the common entry point according to section 
29.23 	256B.0651;
29.24 	(13) provide the recipient with a copy of the home care bill of rights at start of service;
29.25 	(14) request reassessments at least 60 days prior to the end of the current authorization 
29.26 	for personal care assistance services, on forms provided by the commissioner;
29.27 	(15) comply with the labor market reporting requirements described in section 256B.4912, 
29.28 	subdivision 1a; and
29.29 	(16) document that the agency uses the additional revenue due to the enhanced rate under 
29.30 	subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements 
29.31 	under subdivision 11, paragraph (d); and
30.1 	(17) ensure that a personal care assistant driving a recipient under subdivision 1, 
30.2 	paragraph (i), has a valid driver's license and the vehicle used is registered and insured 
30.3 	according to Minnesota law.

30.4 	EFFECTIVE DATE. This section is effective 90 days following federal approval. The 
30.5 	commissioner of human services shall notify the revisor of statutes when federal approval 
30.6 	is obtained.

30.7 	Sec. 17. Minnesota Statutes 2022, section 256B.0911, subdivision 13, is amended to read:
30.8 		Subd. 13.MnCHOICES assessor qualifications, training, and certification. (a) The 
30.9 	commissioner shall develop and implement a curriculum and an assessor certification 
30.10 	process.
30.11 	(b) MnCHOICES certified assessors must:
30.12 	(1) either have a bachelor's degree in social work, nursing with a public health nursing 
30.13 	certificate, or other closely related field with at least one year of home and community-based 
30.14 	experience or be a registered nurse with at least two years of home and community-based 
30.15 	experience; and
30.16 	(2) have received training and certification specific to assessment and consultation for 
30.17 	long-term care services in the state.
30.18 	(c) Certified assessors shall demonstrate best practices in assessment and support 
30.19 	planning, including person-centered planning principles, and have a common set of skills 
30.20 	that ensures consistency and equitable access to services statewide.
30.21 	(d) Certified assessors must be recertified every three years.

30.22 	Sec. 18. Minnesota Statutes 2022, section 256B.092, subdivision 1a, is amended to read:
30.23 		Subd. 1a.Case management services. (a) Each recipient of a home and community-based 
30.24 	waiver shall be provided case management services by qualified vendors as described in 
30.25 	the federally approved waiver application.
30.26 	(b) Case management service activities provided to or arranged for a person include:
30.27 	(1) development of the person-centered support plan under subdivision 1b;
30.28 	(2) informing the individual or the individual's legal guardian or conservator, or parent 
30.29 	if the person is a minor, of service options, including all service options available under the 
30.30 	waiver plan;
31.1 	(3) consulting with relevant medical experts or service providers;
31.2 	(4) assisting the person in the identification of potential providers of chosen services, 
31.3 	including:
31.4 	(i) providers of services provided in a non-disability-specific setting;
31.5 	(ii) employment service providers;
31.6 	(iii) providers of services provided in settings that are not controlled by a provider; and
31.7 	(iv) providers of financial management services;
31.8 	(5) assisting the person to access services and assisting in appeals under section 256.045;
31.9 	(6) coordination of services, if coordination is not provided by another service provider;
31.10 	(7) evaluation and monitoring of the services identified in the support plan, which must 
31.11 	incorporate at least one annual face-to-face visit by the case manager with each person; and
31.12 	(8) reviewing support plans and providing the lead agency with recommendations for 
31.13 	service authorization based upon the individual's needs identified in the support plan.
31.14 	(c) Case management service activities that are provided to the person with a 
31.15 	developmental disability shall be provided directly by county agencies or under contract. 
31.16 	If a county agency contracts for case management services, the county agency must provide 
31.17 	each recipient of home and community-based services who is receiving contracted case 
31.18 	management services with the contact information the recipient may use to file a grievance 
31.19 	with the county agency about the quality of the contracted services the recipient is receiving 
31.20 	from a county-contracted case manager. Case management services must be provided by a 
31.21 	public or private agency that is enrolled as a medical assistance provider determined by the 
31.22 	commissioner to meet all of the requirements in the approved federal waiver plans. Case 
31.23 	management services must not be provided to a recipient by a private agency that has a 
31.24 	financial interest in the provision of any other services included in the recipient's support 
31.25 	plan. For purposes of this section, "private agency" means any agency that is not identified 
31.26 	as a lead agency under section 256B.0911, subdivision 10.
31.27 	(d) Case managers are responsible for service provisions listed in paragraphs (a) and 
31.28 	(b). Case managers shall collaborate with consumers, families, legal representatives, and 
31.29 	relevant medical experts and service providers in the development and annual review of the 
31.30 	person-centered support plan and habilitation plan.
31.31 	(e) For persons who need a positive support transition plan as required in chapter 245D, 
31.32 	the case manager shall participate in the development and ongoing evaluation of the plan 
32.1 	with the expanded support team. At least quarterly, the case manager, in consultation with 
32.2 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
32.3 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
32.4 	identify whether the plan has been developed and implemented in a manner to achieve the 
32.5 	following within the required timelines:
32.6 	(1) phasing out the use of prohibited procedures;
32.7 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
32.8 	timeline; and
32.9 	(3) accomplishment of identified outcomes.
32.10 	If adequate progress is not being made, the case manager shall consult with the person's 
32.11 	expanded support team to identify needed modifications and whether additional professional 
32.12 	support is required to provide consultation.
32.13 	(f) The Department of Human Services shall offer ongoing education in case management 
32.14 	to case managers. Case managers shall receive no less than ten 20 hours of case management 
32.15 	education and disability-related training each year. The education and training must include 
32.16 	person-centered planning, informed choice, cultural competency, employment planning, 
32.17 	community living planning, self-direction options, and use of technology supports. By 
32.18 	August 1, 2024, all case managers must complete an employment support training course 
32.19 	identified by the commissioner of human services. For case managers hired after August 
32.20 	1, 2024, this training must be completed within the first six months of providing case 
32.21 	management services. For the purposes of this section, "person-centered planning" or 
32.22 	"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case 
32.23 	managers must document completion of training in a system identified by the commissioner.

32.24 	Sec. 19. Minnesota Statutes 2022, section 256B.0949, subdivision 15, is amended to read:
32.25 		Subd. 15.EIDBI provider qualifications. (a) A QSP must be employed by an agency 
32.26 	and be:
32.27 	(1) a licensed mental health professional who has at least 2,000 hours of supervised 
32.28 	clinical experience or training in examining or treating people with ASD or a related condition 
32.29 	or equivalent documented coursework at the graduate level by an accredited university in 
32.30 	ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child 
32.31 	development; or
32.32 	(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised 
32.33 	clinical experience or training in examining or treating people with ASD or a related condition 
33.1 	or equivalent documented coursework at the graduate level by an accredited university in 
33.2 	the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and 
33.3 	typical child development.
33.4 	(b) A level I treatment provider must be employed by an agency and:
33.5 	(1) have at least 2,000 hours of supervised clinical experience or training in examining 
33.6 	or treating people with ASD or a related condition or equivalent documented coursework 
33.7 	at the graduate level by an accredited university in ASD diagnostics, ASD developmental 
33.8 	and behavioral treatment strategies, and typical child development or an equivalent 
33.9 	combination of documented coursework or hours of experience; and
33.10 	(2) have or be at least one of the following:
33.11 	(i) a master's degree in behavioral health or child development or related fields including, 
33.12 	but not limited to, mental health, special education, social work, psychology, speech 
33.13 	pathology, or occupational therapy from an accredited college or university;
33.14 	(ii) a bachelor's degree in a behavioral health, child development, or related field 
33.15 	including, but not limited to, mental health, special education, social work, psychology, 
33.16 	speech pathology, or occupational therapy, from an accredited college or university, and 
33.17 	advanced certification in a treatment modality recognized by the department;
33.18 	(iii) a board-certified behavior analyst; or
33.19 	(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical 
33.20 	experience that meets all registration, supervision, and continuing education requirements 
33.21 	of the certification.
33.22 	(c) A level II treatment provider must be employed by an agency and must be:
33.23 	(1) a person who has a bachelor's degree from an accredited college or university in a 
33.24 	behavioral or child development science or related field including, but not limited to, mental 
33.25 	health, special education, social work, psychology, speech pathology, or occupational 
33.26 	therapy; and meets at least one of the following:
33.27 	(i) has at least 1,000 hours of supervised clinical experience or training in examining or 
33.28 	treating people with ASD or a related condition or equivalent documented coursework at 
33.29 	the graduate level by an accredited university in ASD diagnostics, ASD developmental and 
33.30 	behavioral treatment strategies, and typical child development or a combination of 
33.31 	coursework or hours of experience;
34.1 	(ii) has certification as a board-certified assistant behavior analyst from the Behavior 
34.2 	Analyst Certification Board;
34.3 	(iii) is a registered behavior technician as defined by the Behavior Analyst Certification 
34.4 	Board; or
34.5 	(iv) is certified in one of the other treatment modalities recognized by the department; 
34.6 	or
34.7 	(2) a person who has:
34.8 	(i) an associate's degree in a behavioral or child development science or related field 
34.9 	including, but not limited to, mental health, special education, social work, psychology, 
34.10 	speech pathology, or occupational therapy from an accredited college or university; and
34.11 	(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people 
34.12 	with ASD or a related condition. Hours worked as a mental health behavioral aide or level 
34.13 	III treatment provider may be included in the required hours of experience; or
34.14 	(3) a person who has at least 4,000 hours of supervised clinical experience in delivering 
34.15 	treatment to people with ASD or a related condition. Hours worked as a mental health 
34.16 	behavioral aide or level III treatment provider may be included in the required hours of 
34.17 	experience; or
34.18 	(4) a person who is a graduate student in a behavioral science, child development science, 
34.19 	or related field and is receiving clinical supervision by a QSP affiliated with an agency to 
34.20 	meet the clinical training requirements for experience and training with people with ASD 
34.21 	or a related condition; or
34.22 	(5) a person who is at least 18 years of age and who:
34.23 	(i) is fluent in a non-English language or is an individual certified by a Tribal Nation;
34.24 	(ii) completed the level III EIDBI training requirements; and
34.25 	(iii) receives observation and direction from a QSP or level I treatment provider at least 
34.26 	once a week until the person meets 1,000 hours of supervised clinical experience.
34.27 	(d) A level III treatment provider must be employed by an agency, have completed the 
34.28 	level III training requirement, be at least 18 years of age, and have at least one of the 
34.29 	following:
34.30 	(1) a high school diploma or commissioner of education-selected high school equivalency 
34.31 	certification;
35.1 	(2) fluency in a non-English language or Tribal Nation certification;
35.2 	(3) one year of experience as a primary personal care assistant, community health worker, 
35.3 	waiver service provider, or special education assistant to a person with ASD or a related 
35.4 	condition within the previous five years; or
35.5 	(4) completion of all required EIDBI training within six months of employment.

35.6 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
35.7 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
35.8 	when federal approval is obtained.

35.9 	Sec. 20. Minnesota Statutes 2022, section 256B.49, subdivision 13, is amended to read:
35.10 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
35.11 	shall be provided case management services by qualified vendors as described in the federally 
35.12 	approved waiver application. The case management service activities provided must include:
35.13 	(1) finalizing the person-centered written support plan within the timelines established 
35.14 	by the commissioner and section 256B.0911, subdivision 29;
35.15 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
35.16 	options, including all service options available under the waiver plans;
35.17 	(3) assisting the recipient in the identification of potential service providers of chosen 
35.18 	services, including:
35.19 	(i) available options for case management service and providers;
35.20 	(ii) providers of services provided in a non-disability-specific setting;
35.21 	(iii) employment service providers;
35.22 	(iv) providers of services provided in settings that are not community residential settings; 
35.23 	and
35.24 	(v) providers of financial management services;
35.25 	(4) assisting the recipient to access services and assisting with appeals under section 
35.26 	256.045; and
35.27 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
35.28 	plan.
36.1 	(b) The case manager may delegate certain aspects of the case management service 
36.2 	activities to another individual provided there is oversight by the case manager. The case 
36.3 	manager may not delegate those aspects which require professional judgment including:
36.4 	(1) finalizing the person-centered support plan;
36.5 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
36.6 	approved person-centered support plan; and
36.7 	(3) adjustments to the person-centered support plan.
36.8 	(c) Case management services must be provided by a public or private agency that is 
36.9 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
36.10 	the requirements in the approved federal waiver plans. Case management services must not 
36.11 	be provided to a recipient by a private agency that has any financial interest in the provision 
36.12 	of any other services included in the recipient's support plan. For purposes of this section, 
36.13 	"private agency" means any agency that is not identified as a lead agency under section 
36.14 	256B.0911, subdivision 10.
36.15 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
36.16 	the case manager shall participate in the development and ongoing evaluation of the plan 
36.17 	with the expanded support team. At least quarterly, the case manager, in consultation with 
36.18 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
36.19 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
36.20 	identify whether the plan has been developed and implemented in a manner to achieve the 
36.21 	following within the required timelines:
36.22 	(1) phasing out the use of prohibited procedures;
36.23 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
36.24 	timeline; and
36.25 	(3) accomplishment of identified outcomes.
36.26 	If adequate progress is not being made, the case manager shall consult with the person's 
36.27 	expanded support team to identify needed modifications and whether additional professional 
36.28 	support is required to provide consultation.
36.29 	(e) The Department of Human Services shall offer ongoing education in case management 
36.30 	to case managers. Case managers shall receive no less than ten 20 hours of case management 
36.31 	education and disability-related training each year. The education and training must include 
36.32 	person-centered planning, informed choice, cultural competency, employment planning, 
36.33 	community living planning, self-direction options, and use of technology supports. By 
37.1 	August 1, 2024, all case managers must complete an employment support training course 
37.2 	identified by the commissioner of human services. For case managers hired after August 
37.3 	1, 2024, this training must be completed within the first six months of providing case 
37.4 	management services. For the purposes of this section, "person-centered planning" or 
37.5 	"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case 
37.6 	managers shall document completion of training in a system identified by the commissioner.

37.7 	Sec. 21. Minnesota Statutes 2022, section 256B.4905, subdivision 4a, is amended to read:
37.8 		Subd. 4a.Informed choice in employment policy. It is the policy of this state that 
37.9 	working-age individuals who have disabilities:
37.10 	(1) can work and achieve competitive integrated employment with appropriate services 
37.11 	and supports, as needed;
37.12 	(2) make informed choices about their postsecondary education, work, and career goals; 
37.13 	and
37.14 	(3) will be offered the opportunity to make an informed choice, at least annually, to 
37.15 	pursue postsecondary education or to work and earn a competitive wage.; and
37.16 	(4) will be offered benefits planning assistance and supports to understand available 
37.17 	work incentive programs and to understand the impact of work on benefits.

37.18 	Sec. 22. [256B.4906] SUBMINIMUM WAGES IN HOME AND 
37.19 	COMMUNITY-BASED SERVICES REPORTING.
37.20 	(a) A provider of home and community-based services for people with developmental 
37.21 	disabilities under section 256B.092 or home and community-based services for people with 
37.22 	disabilities under section 256B.49 that holds a credential listed in clause (1) or (2) as of 
37.23 	August 1, 2023, must submit to the commissioner of human services data on individuals 
37.24 	who are currently being paid subminimum wages or were being paid subminimum wages 
37.25 	by the provider organization as of August 1, 2023:
37.26 	(1) a certificate through the United States Department of Labor under United States 
37.27 	Code, title 29, section 214(c), of the Fair Labor Standards Act authorizing the payment of 
37.28 	subminimum wages to workers with disabilities; or
37.29 	(2) a permit by the Minnesota Department of Labor and Industry under section 177.28.
37.30 	(b) The report required under paragraph (a) must include the following data about each 
37.31 	individual being paid subminimum wages:
38.1 	(1) name;
38.2 	(2) date of birth;
38.3 	(3) identified race and ethnicity;
38.4 	(4) disability type;
38.5 	(5) key employment status measures as determined by the commissioner; and
38.6 	(6) key community-life engagement measures as determined by the commissioner.
38.7 	(c) The information in paragraph (b) must be submitted in a format determined by the 
38.8 	commissioner.
38.9 	(d) A provider must submit the data required under this section annually on a date 
38.10 	specified by the commissioner. The commissioner must give a provider at least 30 calendar 
38.11 	days to submit the data following notice of the due date. If a provider fails to submit the 
38.12 	requested data by the date specified by the commissioner, the commissioner may delay 
38.13 	medical assistance reimbursement until the requested data is submitted.
38.14 	(e) Individually identifiable data submitted to the commissioner under this section are 
38.15 	considered private data on individuals as defined by section 13.02, subdivision 12.
38.16 	(f) The commissioner must analyze data annually for tracking employment and 
38.17 	community-life engagement outcomes.

38.18 	Sec. 23. Minnesota Statutes 2022, section 256B.4911, is amended by adding a subdivision 
38.19 	to read:
38.20 		Subd. 6.Services provided by parents and spouses. (a) This subdivision limits medical 
38.21 	assistance payments under the consumer-directed community supports option for personal 
38.22 	assistance services provided by a parent to the parent's minor child or by a participant's 
38.23 	spouse. This subdivision applies to the consumer-directed community supports option 
38.24 	available under all of the following:
38.25 	(1) alternative care program;
38.26 	(2) brain injury waiver;
38.27 	(3) community alternative care waiver;
38.28 	(4) community access for disability inclusion waiver;
38.29 	(5) developmental disabilities waiver; and
38.30 	(6) elderly waiver.
39.1 	(b) For the purposes of this subdivision, "parent" means a parent, stepparent, or legal 
39.2 	guardian of a minor.
39.3 	(c) If multiple parents are providing personal assistance services to their minor child or 
39.4 	children, each parent may provide up to 40 hours of personal assistance services in any 
39.5 	seven-day period regardless of the number of children served. The total number of hours 
39.6 	of medical assistance home and community-based services provided by all of the parents 
39.7 	must not exceed 80 hours in a seven-day period regardless of the number of children served.
39.8 	(d) If only one parent is providing personal assistance services to a minor child or 
39.9 	children, the parent may provide up to 60 hours of medical assistance home and 
39.10 	community-based services in a seven-day period regardless of the number of children served.
39.11 	(e) If a participant's spouse is providing personal assistance services, the spouse may 
39.12 	provide up to 60 hours of medical assistance home and community-based services in a 
39.13 	seven-day period.
39.14 	(f) This subdivision must not be construed to permit an increase in the total authorized 
39.15 	consumer-directed community supports budget for an individual.

39.16 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
39.17 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
39.18 	when federal approval is obtained.

39.19 	Sec. 24. Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision 
39.20 	to read:
39.21 		Subd. 1b.Direct support professional annual labor market survey. (a) The 
39.22 	commissioner shall develop and administer a survey of direct care staff who work for 
39.23 	organizations that provide services under the following programs:
39.24 	(1) home and community-based services for seniors under chapter 256S and section 
39.25 	256B.0913, home and community-based services for people with developmental disabilities 
39.26 	under section 256B.092, and home and community-based services for people with disabilities 
39.27 	under section 256B.49;
39.28 	(2) personal care assistance services under section 256B.0625, subdivision 19a; 
39.29 	community first services and supports under section 256B.85; nursing services and home 
39.30 	health services under section 256B.0625, subdivision 6a; home care nursing services under 
39.31 	section 256B.0625, subdivision 7; and
40.1 	(3) financial management services for participants who directly employ direct-care staff 
40.2 	through consumer support grants under section 256.476; the personal care assistance choice 
40.3 	program under section 256B.0659, subdivisions 18 to 20; community first services and 
40.4 	supports under section 256B.85; and the consumer-directed community supports option 
40.5 	available under the alternative care program, the brain injury waiver, the community 
40.6 	alternative care waiver, the community access for disability inclusion waiver, the 
40.7 	developmental disabilities waiver, the elderly waiver, and the Minnesota senior health 
40.8 	option, except financial management services providers are not required to submit the data 
40.9 	listed in subdivision 1a, clauses (7) to (11).
40.10 	(b) The survey must collect information about the individual experience of the direct-care 
40.11 	staff and any other information necessary to assess the overall economic viability and 
40.12 	well-being of the workforce.
40.13 	(c) For purposes of this subdivision, "direct-care staff" means employees, including 
40.14 	self-employed individuals and individuals directly employed by a participant in a 
40.15 	consumer-directed service delivery option, providing direct service to participants under 
40.16 	this section. Direct-care staff does not include executive, managerial, or administrative staff.
40.17 	(d) Individually identifiable data submitted to the commissioner under this section are 
40.18 	considered private data on individuals as defined by section 13.02, subdivision 12.
40.19 	(e) The commissioner shall analyze data submitted under this section annually to assess 
40.20 	the overall economic viability and well-being of the workforce and the impact of the state 
40.21 	of the workforce on access to services.

40.22 	Sec. 25. Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision 
40.23 	to read:
40.24 		Subd. 1c.Annual labor market report. The commissioner shall publish annual reports 
40.25 	on provider and state-level labor market data, including but not limited to the data outlined 
40.26 	in subdivisions 1a and 1b.

40.27 	Sec. 26. Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision 
40.28 	to read:
40.29 		Subd. 16.Rates established by the commissioner. For homemaker services eligible 
40.30 	for reimbursement under the developmental disabilities waiver, the brain injury waiver, the 
40.31 	community alternative care waiver, and the community access for disability inclusion waiver, 
41.1 	the commissioner must establish rates equal to the rates established under sections 256S.21 
41.2 	to 256S.215 for the corresponding homemaker services.

41.3 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
41.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
41.5 	when federal approval is obtained.

41.6 	Sec. 27. Minnesota Statutes 2022, section 256B.4914, subdivision 3, is amended to read:
41.7 		Subd. 3.Applicable services. (a) Applicable services are those authorized under the 
41.8 	state's home and community-based services waivers under sections 256B.092 and 256B.49, 
41.9 	including the following, as defined in the federally approved home and community-based 
41.10 	services plan:
41.11 	(1) 24-hour customized living;
41.12 	(2) adult day services;
41.13 	(3) adult day services bath;
41.14 	(4) community residential services;
41.15 	(5) customized living;
41.16 	(6) day support services;
41.17 	(7) employment development services;
41.18 	(8) employment exploration services;
41.19 	(9) employment support services;
41.20 	(10) family residential services;
41.21 	(11) individualized home supports;
41.22 	(12) individualized home supports with family training;
41.23 	(13) individualized home supports with training;
41.24 	(14) integrated community supports;
41.25 	(15) life sharing;
41.26 	(15) (16) night supervision;
41.27 	(16) (17) positive support services;
41.28 	(17) (18) prevocational services;
42.1 	(18) (19) residential support services;
42.2 	(19) (20) respite services;
42.3 	(20) (21) transportation services; and
42.4 	(21) (22) other services as approved by the federal government in the state home and 
42.5 	community-based services waiver plan.
42.6 	(b) Effective January 1, 2024, or upon federal approval, whichever is later, respite 
42.7 	services under paragraph (a), clause (20), are not an applicable service under this section.

42.8 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
42.9 	whichever is later, except that paragraph (b) is effective the day following final enactment. 
42.10 	The commissioner of human services shall notify the revisor of statutes when federal approval 
42.11 	is obtained.

42.12 	Sec. 28. Minnesota Statutes 2022, section 256B.4914, subdivision 4, is amended to read:
42.13 		Subd. 4.Data collection for rate determination. (a) Rates for applicable home and 
42.14 	community-based waivered services, including customized rates under subdivision 12, are 
42.15 	set by the rates management system.
42.16 	(b) Data and information in the rates management system must be used to calculate an 
42.17 	individual's rate.
42.18 	(c) Service providers, with information from the support plan and oversight by lead 
42.19 	agencies, shall provide values and information needed to calculate an individual's rate in 
42.20 	the rates management system. The determination of service levels must be part of a discussion 
42.21 	with members of the support team as defined in section 245D.02, subdivision 34. This 
42.22 	discussion must occur prior to the final establishment of each individual's rate. The values 
42.23 	and information include:
42.24 	(1) shared staffing hours;
42.25 	(2) individual staffing hours;
42.26 	(3) direct registered nurse hours;
42.27 	(4) direct licensed practical nurse hours;
42.28 	(5) staffing ratios;
42.29 	(6) information to document variable levels of service qualification for variable levels 
42.30 	of reimbursement in each framework;
43.1 	(7) shared or individualized arrangements for unit-based services, including the staffing 
43.2 	ratio;
43.3 	(8) number of trips and miles for transportation services; and
43.4 	(9) service hours provided through monitoring technology.
43.5 	(d) Updates to individual data must include:
43.6 	(1) data for each individual that is updated annually when renewing service plans; and
43.7 	(2) requests by individuals or lead agencies to update a rate whenever there is a change 
43.8 	in an individual's service needs, with accompanying documentation.
43.9 	(e) Lead agencies shall review and approve all services reflecting each individual's needs, 
43.10 	and the values to calculate the final payment rate for services with variables under 
43.11 	subdivisions 6 to 9a 9 for each individual. Lead agencies must notify the individual and the 
43.12 	service provider of the final agreed-upon values and rate, and provide information that is 
43.13 	identical to what was entered into the rates management system. If a value used was 
43.14 	mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead 
43.15 	agencies to correct it. Lead agencies must respond to these requests. When responding to 
43.16 	the request, the lead agency must consider:
43.17 	(1) meeting the health and welfare needs of the individual or individuals receiving 
43.18 	services by service site, identified in their support plan under section 245D.02, subdivision 
43.19 	4b, and any addendum under section 245D.02, subdivision 4c;
43.20 	(2) meeting the requirements for staffing under subdivision 2, paragraphs (h), (n), and 
43.21 	(o); and meeting or exceeding the licensing standards for staffing required under section 
43.22 	245D.09, subdivision 1; and
43.23 	(3) meeting the staffing ratio requirements under subdivision 2, paragraph (o), and 
43.24 	meeting or exceeding the licensing standards for staffing required under section 245D.31.

43.25 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
43.26 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
43.27 	when federal approval is obtained.

43.28 	Sec. 29. Minnesota Statutes 2022, section 256B.4914, subdivision 5, is amended to read:
43.29 		Subd. 5.Base wage index; establishment and updates. (a) The base wage index is 
43.30 	established to determine staffing costs associated with providing services to individuals 
43.31 	receiving home and community-based services. For purposes of calculating the base wage, 
43.32 	Minnesota-specific wages taken from job descriptions and standard occupational 
44.1 	classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational 
44.2 	Handbook must be used.
44.3 	(b) The commissioner shall update the base wage index in subdivision 5a, publish these 
44.4 	updated values, and load them into the rate management system as follows:
44.5 	(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics 
44.6 	available as of December 31, 2019;
44.7 	(2) on November January 1, 2024, based on wage data by SOC from the Bureau of Labor 
44.8 	Statistics available as of December 31, 2021 published in March 2022; and
44.9 	(3) on July January 1, 2026, and every two years thereafter, based on wage data by SOC 
44.10 	from the Bureau of Labor Statistics available 30 months and one daypublished in the spring 
44.11 	approximately 21 months prior to the scheduled update.

44.12 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
44.13 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
44.14 	when federal approval is obtained.

44.15 	Sec. 30. Minnesota Statutes 2022, section 256B.4914, subdivision 5a, is amended to read:
44.16 		Subd. 5a.Base wage index; calculations. The base wage index must be calculated as 
44.17 	follows:
44.18 	(1) for supervisory staff, 100 percent of the median wage for community and social 
44.19 	services specialist (SOC code 21-1099), with the exception of the supervisor of positive 
44.20 	supports professional, positive supports analyst, and positive supports specialist, which is 
44.21 	100 percent of the median wage for clinical counseling and school psychologist (SOC code 
44.22 	19-3031);
44.23 	(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC 
44.24 	code 29-1141);
44.25 	(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical 
44.26 	nurses (SOC code 29-2061);
44.27 	(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large 
44.28 	employers, with the exception of asleep-overnight staff for family residential services, which 
44.29 	is 36 percent of the minimum wage in Minnesota for large employers;
44.30 	(5) for residential direct care staff, the sum of:
45.1 	(i) 15 percent of the subtotal of 50 percent of the median wage for home health and 
45.2 	personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant 
45.3 	(SOC code 31-1131); and 20 percent of the median wage for social and human services 
45.4 	aide (SOC code 21-1093); and
45.5 	(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and 
45.6 	personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant 
45.7 	(SOC code 31-1014 31-1131); 20 percent of the median wage for psychiatric technician 
45.8 	(SOC code 29-2053); and 20 percent of the median wage for social and human services 
45.9 	aide (SOC code 21-1093);
45.10 	(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC 
45.11 	code 31-1131); and 30 percent of the median wage for home health and personal care aide 
45.12 	(SOC code 31-1120);
45.13 	(7) for day support services staff and prevocational services staff, 20 percent of the 
45.14 	median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for 
45.15 	psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social 
45.16 	and human services aide (SOC code 21-1093);
45.17 	(8) for positive supports analyst staff, 100 percent of the median wage for substance 
45.18 	abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);
45.19 	(9) for positive supports professional staff, 100 percent of the median wage for clinical 
45.20 	counseling and school psychologist (SOC code 19-3031);
45.21 	(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric 
45.22 	technicians (SOC code 29-2053);
45.23 	(11) for individualized home supports with family training staff, 20 percent of the median 
45.24 	wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community 
45.25 	social service specialist (SOC code 21-1099); 40 percent of the median wage for social and 
45.26 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
45.27 	technician (SOC code 29-2053);
45.28 	(12) for individualized home supports with training services staff, 40 percent of the 
45.29 	median wage for community social service specialist (SOC code 21-1099); 50 percent of 
45.30 	the median wage for social and human services aide (SOC code 21-1093); and ten percent 
45.31 	of the median wage for psychiatric technician (SOC code 29-2053);
46.1 	(13) for employment support services staff, 50 percent of the median wage for 
46.2 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
46.3 	community and social services specialist (SOC code 21-1099);
46.4 	(14) for employment exploration services staff, 50 percent of the median wage for 
46.5 	rehabilitation counselor (SOC code 21-1015) education, guidance, school, and vocational 
46.6 	counselor (SOC code 21-1012); and 50 percent of the median wage for community and 
46.7 	social services specialist (SOC code 21-1099);
46.8 	(15) for employment development services staff, 50 percent of the median wage for 
46.9 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
46.10 	of the median wage for community and social services specialist (SOC code 21-1099);
46.11 	(16) for individualized home support without training staff, 50 percent of the median 
46.12 	wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the 
46.13 	median wage for nursing assistant (SOC code 31-1131); and
46.14 	(17) for night supervision staff, 40 percent of the median wage for home health and 
46.15 	personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant 
46.16 	(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code 
46.17 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
46.18 	21-1093); and.
46.19 	(18) for respite staff, 50 percent of the median wage for home health and personal care 
46.20 	aide (SOC code 31-1131); and 50 percent of the median wage for nursing assistant (SOC 
46.21 	code 31-1014).

46.22 	EFFECTIVE DATE. The amendment to clause (5), item (ii), the amendment to clause 
46.23 	(14), and the amendment striking clause (18) are effective January 1, 2024, or upon federal 
46.24 	approval, whichever is later. The amendment to clause (4) is effective January 1, 2026, or 
46.25 	upon federal approval, whichever is later. The commissioner of human services shall notify 
46.26 	the revisor of statutes when federal approval is obtained.

46.27 	Sec. 31. Minnesota Statutes 2022, section 256B.4914, subdivision 5b, is amended to read:
46.28 		Subd. 5b.Standard component value adjustments. The commissioner shall update 
46.29 	the client and programming support, transportation, and program facility cost component 
46.30 	values as required in subdivisions 6 to 9a 9 and the rates identified in subdivision 19 for 
46.31 	changes in the Consumer Price Index. The commissioner shall adjust these values higher 
46.32 	or lower, publish these updated values, and load them into the rate management system as 
46.33 	follows:
47.1 	(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the 
47.2 	previous update to the data available on December 31, 2019;
47.3 	(2) on November January 1, 2024, by the percentage change in the CPI-U from the date 
47.4 	of the previous update to the data available as of December 31, 20212022; and
47.5 	(3) on July January 1, 2026, and every two years thereafter, by the percentage change 
47.6 	in the CPI-U from the date of the previous update to the data available 30 24 months and 
47.7 	one day prior to the scheduled update.

47.8 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
47.9 	whichever is later, except that the amendment striking the cross-reference to subdivision 
47.10 	9a and the amendments to clauses (2) and (3) are effective January 1, 2024, or upon federal 
47.11 	approval, whichever is later. The commissioner of human services shall notify the revisor 
47.12 	of statutes when federal approval is obtained.

47.13 	Sec. 32. Minnesota Statutes 2022, section 256B.4914, subdivision 6, is amended to read:
47.14 		Subd. 6. Residential support services; generally. (a) For purposes of this section, 
47.15 	residential support services includes 24-hour customized living services, community 
47.16 	residential services, customized living services, family residential services, and integrated 
47.17 	community supports.
47.18 	(b) A unit of service for residential support services is a day. Any portion of any calendar 
47.19 	day, within allowable Medicaid rules, where an individual spends time in a residential setting 
47.20 	is billable as a day. The number of days authorized for all individuals enrolling in residential 
47.21 	support services must include every day that services start and end.
47.22 	(c) When the available shared staffing hours in a residential setting are insufficient to 
47.23 	meet the needs of an individual who enrolled in residential support services after January 
47.24 	1, 2014, then individual staffing hours shall be used.

47.25 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
47.26 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
47.27 	when federal approval is obtained.

47.28 	Sec. 33. Minnesota Statutes 2022, section 256B.4914, subdivision 6a, is amended to read:
47.29 		Subd. 6a.Community residential services; component values and calculation of 
47.30 	payment rates. (a) Component values for community residential services are:
47.31 	(1) competitive workforce factor: 4.7 6.7 percent;
48.1 	(2) supervisory span of control ratio: 11 percent;
48.2 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
48.3 	(4) employee-related cost ratio: 23.6 percent;
48.4 	(5) general administrative support ratio: 13.25 percent;
48.5 	(6) program-related expense ratio: 1.3 percent; and
48.6 	(7) absence and utilization factor ratio: 3.9 percent.
48.7 	(b) Payments for community residential services must be calculated as follows:
48.8 	(1) determine the number of shared direct staffing and individual direct staffing hours 
48.9 	to meet a recipient's needs provided on site or through monitoring technology;
48.10 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
48.11 	provided in subdivisions 5 and 5a;
48.12 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
48.13 	product of one plus the competitive workforce factor;
48.14 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
48.15 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
48.16 	to the result of clause (3);
48.17 	(5) multiply the number of shared direct staffing and individual direct staffing hours 
48.18 	provided on site or through monitoring technology and nursing hours by the appropriate 
48.19 	staff wages;
48.20 	(6) multiply the number of shared direct staffing and individual direct staffing hours 
48.21 	provided on site or through monitoring technology and nursing hours by the product of the 
48.22 	supervision span of control ratio and the appropriate supervisory staff wage in subdivision 
48.23 	5a, clause (1);
48.24 	(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and 
48.25 	individual direct staffing hours provided through monitoring technology, and multiply the 
48.26 	result by one plus the employee vacation, sick, and training allowance ratio. This is defined 
48.27 	as the direct staffing cost;
48.28 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
48.29 	direct staffing and individual hours provided through monitoring technology, by one plus 
48.30 	the employee-related cost ratio;
49.1 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
49.2 	commissioner shall update the amount in this clause as specified in subdivision 5b;
49.3 	(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided 
49.4 	by 365 if customized for adapted transport, based on the resident with the highest assessed 
49.5 	need. The commissioner shall update the amounts in this clause as specified in subdivision 
49.6 	5b;
49.7 	(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing 
49.8 	and individual direct staffing hours provided through monitoring technology that was 
49.9 	excluded in clause (8);
49.10 	(12) sum the standard general administrative support ratio, the program-related expense 
49.11 	ratio, and the absence and utilization factor ratio;
49.12 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
49.13 	total payment amount; and
49.14 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
49.15 	to adjust for regional differences in the cost of providing services.

49.16 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
49.17 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
49.18 	when federal approval is obtained.

49.19 	Sec. 34. Minnesota Statutes 2022, section 256B.4914, subdivision 6b, is amended to read:
49.20 		Subd. 6b.Family residential services; component values and calculation of payment 
49.21 	rates. (a) Component values for family residential services are:
49.22 	(1) competitive workforce factor: 4.7 6.7 percent;
49.23 	(2) supervisory span of control ratio: 11 percent;
49.24 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
49.25 	(4) employee-related cost ratio: 23.6 percent;
49.26 	(5) general administrative support ratio: 3.3 percent;
49.27 	(6) program-related expense ratio: 1.3 percent; and
49.28 	(7) absence factor: 1.7 percent.
49.29 	(b) Payments for family residential services must be calculated as follows:
50.1 	(1) determine the number of shared direct staffing and individual direct staffing hours 
50.2 	to meet a recipient's needs provided on site or through monitoring technology;
50.3 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
50.4 	provided in subdivisions 5 and 5a;
50.5 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
50.6 	product of one plus the competitive workforce factor;
50.7 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
50.8 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
50.9 	to the result of clause (3);
50.10 	(5) multiply the number of shared direct staffing and individual direct staffing hours 
50.11 	provided on site or through monitoring technology and nursing hours by the appropriate 
50.12 	staff wages;
50.13 	(6) multiply the number of shared direct staffing and individual direct staffing hours 
50.14 	provided on site or through monitoring technology and nursing hours by the product of the 
50.15 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
50.16 	5a, clause (1);
50.17 	(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and 
50.18 	individual direct staffing hours provided through monitoring technology, and multiply the 
50.19 	result by one plus the employee vacation, sick, and training allowance ratio. This is defined 
50.20 	as the direct staffing cost;
50.21 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
50.22 	and individual direct staffing hours provided through monitoring technology, by one plus 
50.23 	the employee-related cost ratio;
50.24 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
50.25 	commissioner shall update the amount in this clause as specified in subdivision 5b;
50.26 	(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided 
50.27 	by 365 if customized for adapted transport, based on the resident with the highest assessed 
50.28 	need. The commissioner shall update the amounts in this clause as specified in subdivision 
50.29 	5b;
50.30 	(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing 
50.31 	and individual direct staffing hours provided through monitoring technology that was 
50.32 	excluded in clause (8);
51.1 	(12) sum the standard general administrative support ratio, the program-related expense 
51.2 	ratio, and the absence and utilization factor ratio;
51.3 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
51.4 	total payment rate; and
51.5 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
51.6 	to adjust for regional differences in the cost of providing services.

51.7 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
51.8 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
51.9 	when federal approval is obtained.

51.10 	Sec. 35. Minnesota Statutes 2022, section 256B.4914, subdivision 6c, is amended to read:
51.11 		Subd. 6c.Integrated community supports; component values and calculation of 
51.12 	payment rates.  (a) Component values for integrated community supports are:
51.13 	(1) competitive workforce factor: 4.7 6.7 percent;
51.14 	(2) supervisory span of control ratio: 11 percent;
51.15 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
51.16 	(4) employee-related cost ratio: 23.6 percent;
51.17 	(5) general administrative support ratio: 13.25 percent;
51.18 	(6) program-related expense ratio: 1.3 percent; and
51.19 	(7) absence and utilization factor ratio: 3.9 percent.
51.20 	(b) Payments for integrated community supports must be calculated as follows:
51.21 	(1) determine the number of shared direct staffing and individual direct staffing hours 
51.22 	to meet a recipient's needs. The base shared direct staffing hours must be eight hours divided 
51.23 	by the number of people receiving support in the integrated community support setting, and 
51.24 	the individual direct staffing hours must be the average number of direct support hours 
51.25 	provided directly to the service recipient;
51.26 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
51.27 	provided in subdivisions 5 and 5a;
51.28 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
51.29 	product of one plus the competitive workforce factor;
52.1 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
52.2 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
52.3 	to the result of clause (3);
52.4 	(5) multiply the number of shared direct staffing and individual direct staffing hours in 
52.5 	clause (1) by the appropriate staff wages;
52.6 	(6) multiply the number of shared direct staffing and individual direct staffing hours in 
52.7 	clause (1) by the product of the supervisory span of control ratio and the appropriate 
52.8 	supervisory staff wage in subdivision 5a, clause (1);
52.9 	(7) combine the results of clauses (5) and (6) and multiply the result by one plus the 
52.10 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
52.11 	cost;
52.12 	(8) for employee-related expenses, multiply the direct staffing cost by one plus the 
52.13 	employee-related cost ratio;
52.14 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
52.15 	commissioner shall update the amount in this clause as specified in subdivision 5b;
52.16 	(10) add the results of clauses (8) and (9);
52.17 	(11) add the standard general administrative support ratio, the program-related expense 
52.18 	ratio, and the absence and utilization factor ratio;
52.19 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
52.20 	total payment amount; and
52.21 	(13) adjust the result of clause (12) by a factor to be determined by the commissioner 
52.22 	to adjust for regional differences in the cost of providing services.

52.23 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
52.24 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
52.25 	when federal approval is obtained.

52.26 	Sec. 36. Minnesota Statutes 2022, section 256B.4914, subdivision 7a, is amended to read:
52.27 		Subd. 7a.Adult day services; component values and calculation of payment rates. (a) 
52.28 	Component values for adult day services are:
52.29 	(1) competitive workforce factor: 4.7 6.7 percent;
52.30 	(2) supervisory span of control ratio: 11 percent;
52.31 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
53.1 	(4) employee-related cost ratio: 23.6 percent;
53.2 	(5) program plan support ratio: 5.6 percent;
53.3 	(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision 
53.4 	5b;
53.5 	(7) general administrative support ratio: 13.25 percent;
53.6 	(8) program-related expense ratio: 1.8 percent; and
53.7 	(9) absence and utilization factor ratio: 9.4 percent.
53.8 	(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of 
53.9 	service is six or more hours of time spent providing direct service.
53.10 	(c) Payments for adult day services must be calculated as follows:
53.11 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
53.12 	needs;
53.13 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
53.14 	provided in subdivisions 5 and 5a;
53.15 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
53.16 	product of one plus the competitive workforce factor;
53.17 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
53.18 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
53.19 	to the result of clause (3);
53.20 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
53.21 	appropriate staff wage;
53.22 	(6) multiply the number of day program direct staffing hours by the product of the 
53.23 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
53.24 	5a, clause (1);
53.25 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
53.26 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
53.27 	rate;
53.28 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
53.29 	plan support ratio;
53.30 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
53.31 	employee-related cost ratio;
54.1 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
54.2 	the client programming and support ratio;
54.3 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
54.4 	to meet individual needs, updated as specified in subdivision 5b;
54.5 	(12) for adult day bath services, add $7.01 per 15 minute unit;
54.6 	(13) this is the subtotal rate;
54.7 	(14) sum the standard general administrative rate support ratio, the program-related 
54.8 	expense ratio, and the absence and utilization factor ratio;
54.9 	(15) divide the result of clause (13) by one minus the result of clause (14). This is the 
54.10 	total payment amount; and
54.11 	(16) adjust the result of clause (15) by a factor to be determined by the commissioner 
54.12 	to adjust for regional differences in the cost of providing services.

54.13 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
54.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
54.15 	when federal approval is obtained.

54.16 	Sec. 37. Minnesota Statutes 2022, section 256B.4914, subdivision 7b, is amended to read:
54.17 		Subd. 7b.Day support services; component values and calculation of payment 
54.18 	rates. (a) Component values for day support services are:
54.19 	(1) competitive workforce factor: 4.7 6.7 percent;
54.20 	(2) supervisory span of control ratio: 11 percent;
54.21 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
54.22 	(4) employee-related cost ratio: 23.6 percent;
54.23 	(5) program plan support ratio: 5.6 percent;
54.24 	(6) client programming and support ratio: 10.37 percent, updated as specified in 
54.25 	subdivision 5b;
54.26 	(7) general administrative support ratio: 13.25 percent;
54.27 	(8) program-related expense ratio: 1.8 percent; and
54.28 	(9) absence and utilization factor ratio: 9.4 percent.
54.29 	(b) A unit of service for day support services is 15 minutes.
55.1 	(c) Payments for day support services must be calculated as follows:
55.2 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
55.3 	needs;
55.4 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
55.5 	provided in subdivisions 5 and 5a;
55.6 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
55.7 	product of one plus the competitive workforce factor;
55.8 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
55.9 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
55.10 	to the result of clause (3);
55.11 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
55.12 	appropriate staff wage;
55.13 	(6) multiply the number of day program direct staffing hours by the product of the 
55.14 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
55.15 	5a, clause (1);
55.16 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
55.17 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
55.18 	rate;
55.19 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
55.20 	plan support ratio;
55.21 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
55.22 	employee-related cost ratio;
55.23 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
55.24 	the client programming and support ratio;
55.25 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
55.26 	to meet individual needs, updated as specified in subdivision 5b;
55.27 	(12) this is the subtotal rate;
55.28 	(13) sum the standard general administrative rate support ratio, the program-related 
55.29 	expense ratio, and the absence and utilization factor ratio;
55.30 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
55.31 	total payment amount; and
56.1 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
56.2 	to adjust for regional differences in the cost of providing services.

56.3 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
56.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
56.5 	when federal approval is obtained.

56.6 	Sec. 38. Minnesota Statutes 2022, section 256B.4914, subdivision 7c, is amended to read:
56.7 		Subd. 7c.Prevocational services; component values and calculation of payment 
56.8 	rates. (a) Component values for prevocational services are:
56.9 	(1) competitive workforce factor: 4.7 6.7 percent;
56.10 	(2) supervisory span of control ratio: 11 percent;
56.11 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
56.12 	(4) employee-related cost ratio: 23.6 percent;
56.13 	(5) program plan support ratio: 5.6 percent;
56.14 	(6) client programming and support ratio: 10.37 percent, updated as specified in 
56.15 	subdivision 5b;
56.16 	(7) general administrative support ratio: 13.25 percent;
56.17 	(8) program-related expense ratio: 1.8 percent; and
56.18 	(9) absence and utilization factor ratio: 9.4 percent.
56.19 	(b) A unit of service for prevocational services is either a day or 15 minutes. A day unit 
56.20 	of service is six or more hours of time spent providing direct service.
56.21 	(c) Payments for prevocational services must be calculated as follows:
56.22 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
56.23 	needs;
56.24 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
56.25 	provided in subdivisions 5 and 5a;
56.26 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
56.27 	product of one plus the competitive workforce factor;
56.28 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
56.29 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
56.30 	to the result of clause (3);
57.1 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
57.2 	appropriate staff wage;
57.3 	(6) multiply the number of day program direct staffing hours by the product of the 
57.4 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
57.5 	5a, clause (1);
57.6 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
57.7 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
57.8 	rate;
57.9 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
57.10 	plan support ratio;
57.11 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
57.12 	employee-related cost ratio;
57.13 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
57.14 	the client programming and support ratio;
57.15 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
57.16 	to meet individual needs, updated as specified in subdivision 5b;
57.17 	(12) this is the subtotal rate;
57.18 	(13) sum the standard general administrative rate support ratio, the program-related 
57.19 	expense ratio, and the absence and utilization factor ratio;
57.20 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
57.21 	total payment amount; and
57.22 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
57.23 	to adjust for regional differences in the cost of providing services.

57.24 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
57.25 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
57.26 	when federal approval is obtained.

57.27 	Sec. 39. Minnesota Statutes 2022, section 256B.4914, subdivision 8, is amended to read:
57.28 		Subd. 8. Unit-based services with programming; component values and calculation 
57.29 	of payment rates. (a) For the purpose of this section, unit-based services with programming 
57.30 	include employment exploration services, employment development services, employment 
57.31 	support services, individualized home supports with family training, individualized home 
58.1 	supports with training, and positive support services provided to an individual outside of 
58.2 	any service plan for a day program or residential support service.
58.3 	(b) Component values for unit-based services with programming are:
58.4 	(1) competitive workforce factor: 4.7 6.7 percent;
58.5 	(2) supervisory span of control ratio: 11 percent;
58.6 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
58.7 	(4) employee-related cost ratio: 23.6 percent;
58.8 	(5) program plan support ratio: 15.5 percent;
58.9 	(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision 
58.10 	5b;
58.11 	(7) general administrative support ratio: 13.25 percent;
58.12 	(8) program-related expense ratio: 6.1 percent; and
58.13 	(9) absence and utilization factor ratio: 3.9 percent.
58.14 	(c) A unit of service for unit-based services with programming is 15 minutes.
58.15 	(d) Payments for unit-based services with programming must be calculated as follows, 
58.16 	unless the services are reimbursed separately as part of a residential support services or day 
58.17 	program payment rate:
58.18 	(1) determine the number of units of service to meet a recipient's needs;
58.19 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
58.20 	provided in subdivisions 5 and 5a;
58.21 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
58.22 	product of one plus the competitive workforce factor;
58.23 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
58.24 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
58.25 	to the result of clause (3);
58.26 	(5) multiply the number of direct staffing hours by the appropriate staff wage;
58.27 	(6) multiply the number of direct staffing hours by the product of the supervisory span 
58.28 	of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
59.1 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
59.2 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
59.3 	rate;
59.4 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
59.5 	plan support ratio;
59.6 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
59.7 	employee-related cost ratio;
59.8 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
59.9 	the client programming and support ratio;
59.10 	(11) this is the subtotal rate;
59.11 	(12) sum the standard general administrative support ratio, the program-related expense 
59.12 	ratio, and the absence and utilization factor ratio;
59.13 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
59.14 	total payment amount;
59.15 	(14) for services provided in a shared manner, divide the total payment in clause (13) 
59.16 	as follows:
59.17 	(i) for employment exploration services, divide by the number of service recipients, not 
59.18 	to exceed five;
59.19 	(ii) for employment support services, divide by the number of service recipients, not to 
59.20 	exceed six; and
59.21 	(iii) for individualized home supports with training and individualized home supports 
59.22 	with family training, divide by the number of service recipients, not to exceed two three; 
59.23 	and
59.24 	(iv) for night supervision, divide by the number of service recipients, not to exceed two; 
59.25 	and
59.26 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
59.27 	to adjust for regional differences in the cost of providing services.

59.28 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
59.29 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
59.30 	when federal approval is obtained.

60.1 	Sec. 40. Minnesota Statutes 2022, section 256B.4914, subdivision 9, is amended to read:
60.2 		Subd. 9. Unit-based services without programming; component values and 
60.3 	calculation of payment rates. (a) For the purposes of this section, unit-based services 
60.4 	without programming include individualized home supports without training and night 
60.5 	supervision provided to an individual outside of any service plan for a day program or 
60.6 	residential support service. Unit-based services without programming do not include respite.
60.7 	(b) Component values for unit-based services without programming are:
60.8 	(1) competitive workforce factor: 4.7 6.7 percent;
60.9 	(2) supervisory span of control ratio: 11 percent;
60.10 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
60.11 	(4) employee-related cost ratio: 23.6 percent;
60.12 	(5) program plan support ratio: 7.0 percent;
60.13 	(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision 
60.14 	5b;
60.15 	(7) general administrative support ratio: 13.25 percent;
60.16 	(8) program-related expense ratio: 2.9 percent; and
60.17 	(9) absence and utilization factor ratio: 3.9 percent.
60.18 	(c) A unit of service for unit-based services without programming is 15 minutes.
60.19 	(d) Payments for unit-based services without programming must be calculated as follows 
60.20 	unless the services are reimbursed separately as part of a residential support services or day 
60.21 	program payment rate:
60.22 	(1) determine the number of units of service to meet a recipient's needs;
60.23 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
60.24 	provided in subdivisions 5 to 5a;
60.25 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
60.26 	product of one plus the competitive workforce factor;
60.27 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
60.28 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
60.29 	to the result of clause (3);
60.30 	(5) multiply the number of direct staffing hours by the appropriate staff wage;
61.1 	(6) multiply the number of direct staffing hours by the product of the supervisory span 
61.2 	of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
61.3 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
61.4 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
61.5 	rate;
61.6 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
61.7 	plan support ratio;
61.8 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
61.9 	employee-related cost ratio;
61.10 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
61.11 	the client programming and support ratio;
61.12 	(11) this is the subtotal rate;
61.13 	(12) sum the standard general administrative support ratio, the program-related expense 
61.14 	ratio, and the absence and utilization factor ratio;
61.15 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
61.16 	total payment amount;
61.17 	(14) for individualized home supports without training provided in a shared manner, 
61.18 	divide the total payment amount in clause (13) by the number of service recipients, not to 
61.19 	exceed two three; and
61.20 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
61.21 	to adjust for regional differences in the cost of providing services.

61.22 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
61.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
61.24 	when federal approval is obtained.

61.25 	Sec. 41. Minnesota Statutes 2022, section 256B.4914, subdivision 10, is amended to read:
61.26 		Subd. 10.Evaluation of information and data. (a) The commissioner shall, within 
61.27 	available resources, conduct research and gather data and information from existing state 
61.28 	systems or other outside sources on the following items:
61.29 	(1) differences in the underlying cost to provide services and care across the state;
62.1 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
62.2 	units of transportation for all day services, which must be collected from providers using 
62.3 	the rate management worksheet and entered into the rates management system; and
62.4 	(3) the distinct underlying costs for services provided by a license holder under sections 
62.5 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
62.6 	by a license holder certified under section 245D.33.
62.7 	(b) The commissioner, in consultation with stakeholders, shall review and evaluate the 
62.8 	following values already in subdivisions 6 to 9a 9, or issues that impact all services, including, 
62.9 	but not limited to:
62.10 	(1) values for transportation rates;
62.11 	(2) values for services where monitoring technology replaces staff time;
62.12 	(3) values for indirect services;
62.13 	(4) values for nursing;
62.14 	(5) values for the facility use rate in day services, and the weightings used in the day 
62.15 	service ratios and adjustments to those weightings;
62.16 	(6) values for workers' compensation as part of employee-related expenses;
62.17 	(7) values for unemployment insurance as part of employee-related expenses;
62.18 	(8) direct care workforce labor market measures;
62.19 	(9) any changes in state or federal law with a direct impact on the underlying cost of 
62.20 	providing home and community-based services;
62.21 	(10) outcome measures, determined by the commissioner, for home and community-based 
62.22 	services rates determined under this section; and
62.23 	(11) different competitive workforce factors by service, as determined under subdivision 
62.24 	10b.
62.25 	(c) The commissioner shall report to the chairs and the ranking minority members of 
62.26 	the legislative committees and divisions with jurisdiction over health and human services 
62.27 	policy and finance with the information and data gathered under paragraphs (a) and (b) on 
62.28 	January 15, 2021, with a full report, and a full report once every four years thereafter.
62.29 	(d) Beginning July 1, 2022, the commissioner shall renew analysis and implement 
62.30 	changes to the regional adjustment factors once every six years. Prior to implementation, 
63.1 	the commissioner shall consult with stakeholders on the methodology to calculate the 
63.2 	adjustment.

63.3 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
63.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
63.5 	when federal approval is obtained.

63.6 	Sec. 42. Minnesota Statutes 2022, section 256B.4914, subdivision 10a, is amended to 
63.7 	read:
63.8 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
63.9 	that wage values and component values in subdivisions 5 to 9a 9 reflect the cost to provide 
63.10 	the service. As determined by the commissioner, in consultation with stakeholders identified 
63.11 	in subdivision 17, a provider enrolled to provide services with rates determined under this 
63.12 	section must submit requested cost data to the commissioner to support research on the cost 
63.13 	of providing services that have rates determined by the disability waiver rates system. 
63.14 	Requested cost data may include, but is not limited to:
63.15 	(1) worker wage costs;
63.16 	(2) benefits paid;
63.17 	(3) supervisor wage costs;
63.18 	(4) executive wage costs;
63.19 	(5) vacation, sick, and training time paid;
63.20 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
63.21 	(7) administrative costs paid;
63.22 	(8) program costs paid;
63.23 	(9) transportation costs paid;
63.24 	(10) vacancy rates; and
63.25 	(11) other data relating to costs required to provide services requested by the 
63.26 	commissioner.
63.27 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
63.28 	year that ended not more than 18 months prior to the submission date. The commissioner 
63.29 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
63.30 	fails to submit required reporting data, the commissioner shall provide notice to providers 
63.31 	that have not provided required data 30 days after the required submission date, and a second 
64.1 	notice for providers who have not provided required data 60 days after the required 
64.2 	submission date. The commissioner shall temporarily suspend payments to the provider if 
64.3 	cost data is not received 90 days after the required submission date. Withheld payments 
64.4 	shall be made once data is received by the commissioner.
64.5 	(c) The commissioner shall conduct a random validation of data submitted under 
64.6 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
64.7 	in paragraph (a) and provide recommendations for adjustments to cost components.
64.8 	(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in 
64.9 	consultation with stakeholders identified in subdivision 17, may submit recommendations 
64.10 	on component values and inflationary factor adjustments to the chairs and ranking minority 
64.11 	members of the legislative committees with jurisdiction over human services once every 
64.12 	four years beginning January 1, 2021. The commissioner shall make recommendations in 
64.13 	conjunction with reports submitted to the legislature according to subdivision 10, paragraph 
64.14 	(c). The commissioner shall release cost data in an aggregate form. Cost data from individual 
64.15 	providers must not be released except as provided for in current law.
64.16 	(e) The commissioner shall release cost data in an aggregate form, and cost data from 
64.17 	individual providers shall not be released except as provided for in current law. The 
64.18 	commissioner shall use data collected in paragraph (a) to determine the compliance with 
64.19 	requirements identified under subdivision 10d. The commissioner shall identify providers 
64.20 	who have not met the thresholds identified under subdivision 10d on the Department of 
64.21 	Human Services website for the year for which the providers reported their costs.
64.22 	(f) The commissioner, in consultation with stakeholders identified in subdivision 17, 
64.23 	shall develop and implement a process for providing training and technical assistance 
64.24 	necessary to support provider submission of cost documentation required under paragraph 
64.25 	(a).

64.26 	EFFECTIVE DATE. This section is effective January 1, 2025, except that the 
64.27 	amendment striking the cross-reference to subdivision 9a is effective January 1, 2024, or 
64.28 	upon federal approval, whichever is later. The commissioner of human services shall notify 
64.29 	the revisor of statutes when federal approval is obtained.

64.30 	Sec. 43. Minnesota Statutes 2022, section 256B.4914, subdivision 10c, is amended to 
64.31 	read:
64.32 		Subd. 10c.Reporting and analysis of competitive workforce factor. (a) Beginning 
64.33 	February 1, 2021 2025, and every two years thereafter, the commissioner shall report to the 
65.1 	chairs and ranking minority members of the legislative committees and divisions with 
65.2 	jurisdiction over health and human services policy and finance an analysis of the competitive 
65.3 	workforce factor.
65.4 	(b) The report must include recommendations to update the competitive workforce factor 
65.5 	using:
65.6 	(1) the most recently available wage data by SOC code for the weighted average wage 
65.7 	for direct care staff for residential services and direct care staff for day services;
65.8 	(2) the most recently available wage data by SOC code of the weighted average wage 
65.9 	of comparable occupations; and
65.10 	(3) workforce data as required under subdivision 10b.
65.11 	(c) The commissioner shall not recommend an increase or decrease of the competitive 
65.12 	workforce factor from the current value by more than two percentage points. If, after a 
65.13 	biennial analysis for the next report, the competitive workforce factor is less than or equal 
65.14 	to zero, the commissioner shall recommend a competitive workforce factor of zero. This 
65.15 	subdivision expires June 30, 2031.

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

65.17 	Sec. 44. Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision 
65.18 	to read:
65.19 		Subd. 10d.Direct care staff; compensation. (a) A provider paid with rates determined 
65.20 	under subdivision 6 must use a minimum of 66 percent of the revenue generated by rates 
65.21 	determined under that subdivision for direct care staff compensation.
65.22 	(b) A provider paid with rates determined under subdivision 7 must use a minimum of 
65.23 	45 percent of the revenue generated by rates determined under that subdivision for direct 
65.24 	care compensation.
65.25 	(c) A provider paid with rates determined under subdivision 8 or 9 must use a minimum 
65.26 	of 60 percent of the revenue generated by rates determined under those subdivisions for 
65.27 	direct care compensation.
65.28 	(d) Compensation under this subdivision includes:
65.29 	(1) wages;
65.30 	(2) taxes and workers' compensation;
65.31 	(3) health insurance;
66.1 	(4) dental insurance;
66.2 	(5) vision insurance;
66.3 	(6) life insurance;
66.4 	(7) short-term disability insurance;
66.5 	(8) long-term disability insurance;
66.6 	(9) retirement spending;
66.7 	(10) tuition reimbursement;
66.8 	(11) wellness programs;
66.9 	(12) paid vacation time;
66.10 	(13) paid sick time; or
66.11 	(14) other items of monetary value provided to direct care staff.

66.12 	EFFECTIVE DATE. This section is effective January 1, 2025.

66.13 	Sec. 45. Minnesota Statutes 2022, section 256B.4914, subdivision 12, is amended to read:
66.14 		Subd. 12.Customization of rates for individuals.  (a) For persons determined to have 
66.15 	higher needs based on being deaf or hard-of-hearing, the direct-care costs must be increased 
66.16 	by an adjustment factor prior to calculating the rate under subdivisions 6 to 9a 9. The 
66.17 	customization rate with respect to deaf or hard-of-hearing persons shall be $2.50 per hour 
66.18 	for waiver recipients who meet the respective criteria as determined by the commissioner.
66.19 	(b) For the purposes of this section, "deaf and hard-of-hearing" means:
66.20 	(1) the person has a developmental disability and:
66.21 	(i) an assessment score which indicates a hearing impairment that is severe or that the 
66.22 	person has no useful hearing;
66.23 	(ii) an expressive communications score that indicates the person uses single signs or 
66.24 	gestures, uses an augmentative communication aid, or does not have functional 
66.25 	communication, or the person's expressive communications is unknown; and
66.26 	(iii) a communication score which indicates the person comprehends signs, gestures, 
66.27 	and modeling prompts or does not comprehend verbal, visual, or gestural communication, 
66.28 	or that the person's receptive communication score is unknown; or
67.1 	(2) the person receives long-term care services and has an assessment score that indicates 
67.2 	the person hears only very loud sounds, the person has no useful hearing, or a determination 
67.3 	cannot be made; and the person receives long-term care services and has an assessment that 
67.4 	indicates the person communicates needs with sign language, symbol board, written 
67.5 	messages, gestures, or an interpreter; communicates with inappropriate content, makes 
67.6 	garbled sounds or displays echolalia, or does not communicate needs.

67.7 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
67.8 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
67.9 	when federal approval is obtained.

67.10 	Sec. 46. Minnesota Statutes 2022, section 256B.4914, subdivision 14, is amended to read:
67.11 		Subd. 14.Exceptions. (a) In a format prescribed by the commissioner, lead agencies 
67.12 	must identify individuals with exceptional needs that cannot be met under the disability 
67.13 	waiver rate system. The commissioner shall use that information to evaluate and, if necessary, 
67.14 	approve an alternative payment rate for those individuals. Whether granted, denied, or 
67.15 	modified, the commissioner shall respond to all exception requests in writing. The 
67.16 	commissioner shall include in the written response the basis for the action and provide 
67.17 	notification of the right to appeal under paragraph (h).
67.18 	(b) Lead agencies must act on an exception request within 30 days and notify the initiator 
67.19 	of the request of their recommendation in writing. A lead agency shall submit all exception 
67.20 	requests along with its recommendation to the commissioner.
67.21 	(c) An application for a rate exception may be submitted for the following criteria:
67.22 	(1) an individual has service needs that cannot be met through additional units of service;
67.23 	(2) an individual's rate determined under subdivisions 6 to 9a 9 is so insufficient that it 
67.24 	has resulted in an individual receiving a notice of discharge from the individual's provider; 
67.25 	or
67.26 	(3) an individual's service needs, including behavioral changes, require a level of service 
67.27 	which necessitates a change in provider or which requires the current provider to propose 
67.28 	service changes beyond those currently authorized.
67.29 	(d) Exception requests must include the following information:
67.30 	(1) the service needs required by each individual that are not accounted for in subdivisions 
67.31 	6 to 9a 9;
68.1 	(2) the service rate requested and the difference from the rate determined in subdivisions 
68.2 	6 to 9a 9;
68.3 	(3) a basis for the underlying costs used for the rate exception and any accompanying 
68.4 	documentation; and
68.5 	(4) any contingencies for approval.
68.6 	(e) Approved rate exceptions shall be managed within lead agency allocations under 
68.7 	sections 256B.092 and 256B.49.
68.8 	(f) Individual disability waiver recipients, an interested party, or the license holder that 
68.9 	would receive the rate exception increase may request that a lead agency submit an exception 
68.10 	request. A lead agency that denies such a request shall notify the individual waiver recipient, 
68.11 	interested party, or license holder of its decision and the reasons for denying the request in 
68.12 	writing no later than 30 days after the request has been made and shall submit its denial to 
68.13 	the commissioner in accordance with paragraph (b). The reasons for the denial must be 
68.14 	based on the failure to meet the criteria in paragraph (c).
68.15 	(g) The commissioner shall determine whether to approve or deny an exception request 
68.16 	no more than 30 days after receiving the request. If the commissioner denies the request, 
68.17 	the commissioner shall notify the lead agency and the individual disability waiver recipient, 
68.18 	the interested party, and the license holder in writing of the reasons for the denial.
68.19 	(h) The individual disability waiver recipient may appeal any denial of an exception 
68.20 	request by either the lead agency or the commissioner, pursuant to sections 256.045 and 
68.21 	256.0451. When the denial of an exception request results in the proposed demission of a 
68.22 	waiver recipient from a residential or day habilitation program, the commissioner shall issue 
68.23 	a temporary stay of demission, when requested by the disability waiver recipient, consistent 
68.24 	with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary 
68.25 	stay shall remain in effect until the lead agency can provide an informed choice of 
68.26 	appropriate, alternative services to the disability waiver.
68.27 	(i) Providers may petition lead agencies to update values that were entered incorrectly 
68.28 	or erroneously into the rate management system, based on past service level discussions 
68.29 	and determination in subdivision 4, without applying for a rate exception.
68.30 	(j) The starting date for the rate exception will be the later of the date of the recipient's 
68.31 	change in support or the date of the request to the lead agency for an exception.
68.32 	(k) The commissioner shall track all exception requests received and their dispositions. 
68.33 	The commissioner shall issue quarterly public exceptions statistical reports, including the 
69.1 	number of exception requests received and the numbers granted, denied, withdrawn, and 
69.2 	pending. The report shall include the average amount of time required to process exceptions.
69.3 	(l) Approved rate exceptions remain in effect in all cases until an individual's needs 
69.4 	change as defined in paragraph (c).
69.5 	(m) Rates determined under subdivision 19 are ineligible for rate exceptions.

69.6 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
69.7 	whichever is later, except that paragraph (m) is effective January 1, 2026, or upon federal 
69.8 	approval, whichever is later. The commissioner of human services shall notify the revisor 
69.9 	of statutes when federal approval is obtained.

69.10 	Sec. 47. Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision 
69.11 	to read:
69.12 		Subd. 19.Payments for family residential and life sharing services. The commissioner 
69.13 	shall establish rates for family residential services and life sharing services based on a 
69.14 	person's assessed need, as described in the federally-approved waiver plans. Rates for life 
69.15 	sharing services must be ten percent higher than the corresponding family residential services 
69.16 	rate.

69.17 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
69.18 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
69.19 	when federal approval is obtained.

69.20 	Sec. 48. Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision 
69.21 	to read:
69.22 		Subd. 19.ICF/DD rate increase effective January 1, 2024. (a) Effective January 1, 
69.23 	2024, the daily operating payment rate for a class A intermediate care facility for persons 
69.24 	with developmental disabilities is increased by $40.
69.25 	(b) Effective January 1, 2024, the daily operating payment rate for a class B intermediate 
69.26 	care facility for persons with developmental disabilities is increased by $40.

69.27 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
69.28 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
69.29 	when federal approval is obtained.

70.1 	Sec. 49. Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision 
70.2 	to read:
70.3 		Subd. 20.ICF/DD minimum daily operating payment rates. (a) The minimum daily 
70.4 	operating payment rate for a class A intermediate care facility for persons with developmental 
70.5 	disabilities is $275.
70.6 	(b) The minimum daily operating payment rate for a class B intermediate care facility 
70.7 	for persons with developmental disabilities is $316.

70.8 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
70.9 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
70.10 	when federal approval is obtained.

70.11 	Sec. 50. Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision 
70.12 	to read:
70.13 		Subd. 21.ICF/DD rate increases after January 1, 2025. Beginning January 1, 2025, 
70.14 	and every year thereafter, the rates under this section must be updated for the percentage 
70.15 	change in the Consumer Price Index (CPI-U) from the previous July 1 to the data available 
70.16 	12 months and one day prior.

70.17 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval, 
70.18 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
70.19 	when federal approval is obtained.

70.20 	Sec. 51. Minnesota Statutes 2022, section 256B.85, subdivision 7, is amended to read:
70.21 		Subd. 7.Community first services and supports; covered services.  Services and 
70.22 	supports covered under CFSS include:
70.23 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of 
70.24 	daily living (IADLs), and health-related procedures and tasks through hands-on assistance 
70.25 	to accomplish the task or constant supervision and cueing to accomplish the task;
70.26 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to 
70.27 	accomplish activities of daily living, instrumental activities of daily living, or health-related 
70.28 	tasks;
70.29 	(3) expenditures for items, services, supports, environmental modifications, or goods, 
70.30 	including assistive technology. These expenditures must:
70.31 	(i) relate to a need identified in a participant's CFSS service delivery plan; and
71.1 	(ii) increase independence or substitute for human assistance, to the extent that 
71.2 	expenditures would otherwise be made for human assistance for the participant's assessed 
71.3 	needs;
71.4 	(4) observation and redirection for behavior or symptoms where there is a need for 
71.5 	assistance;
71.6 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices, 
71.7 	to ensure continuity of the participant's services and supports;
71.8 	(6) services provided by a consultation services provider as defined under subdivision 
71.9 	17, that is under contract with the department and enrolled as a Minnesota health care 
71.10 	program provider;
71.11 	(7) services provided by an FMS provider as defined under subdivision 13a, that is an 
71.12 	enrolled provider with the department;
71.13 	(8) CFSS services provided by a support worker who is a parent, stepparent, or legal 
71.14 	guardian of a participant under age 18, or who is the participant's spouse. These support 
71.15 	workers shall not: Covered services under this clause are subject to the limitations described 
71.16 	in subdivision 7b; and
71.17 	(i) provide any medical assistance home and community-based services in excess of 40 
71.18 	hours per seven-day period regardless of the number of parents providing services, 
71.19 	combination of parents and spouses providing services, or number of children who receive 
71.20 	medical assistance services; and
71.21 	(ii) have a wage that exceeds the current rate for a CFSS support worker including the 
71.22 	wage, benefits, and payroll taxes; and
71.23 	(9) worker training and development services as described in subdivision 18a.

71.24 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
71.25 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
71.26 	when federal approval is obtained.

71.27 	Sec. 52. Minnesota Statutes 2022, section 256B.85, is amended by adding a subdivision 
71.28 	to read:
71.29 		Subd. 7b.Services provided by parents and spouses. (a) This subdivision applies to 
71.30 	services and supports described in subdivision 7, clause (8).
71.31 	(b) If multiple parents are support workers providing CFSS services to their minor child 
71.32 	or children, each parent may provide up to 40 hours of medical assistance home and 
72.1 	community-based services in any seven-day period regardless of the number of children 
72.2 	served. The total number of hours of medical assistance home and community-based services 
72.3 	provided by all of the parents must not exceed 80 hours in a seven-day period regardless of 
72.4 	the number of children served.
72.5 	(c) If only one parent is a support worker providing CFSS services to the parent's minor 
72.6 	child or children, the parent may provide up to 60 hours of medical assistance home and 
72.7 	community-based services in a seven-day period regardless of the number of children served.
72.8 	(d) If a participant's spouse is a support worker providing CFSS services, the spouse 
72.9 	may provide up to 60 hours of medical assistance home and community-based services in 
72.10 	a seven-day period.
72.11 	(e) Paragraphs (b) to (d) must not be construed to permit an increase in either the total 
72.12 	authorized service budget for an individual or the total number of authorized service units.
72.13 	(f) A parent or participant's spouse must not receive a wage that exceeds the current rate 
72.14 	for a CFSS support worker, including wages, benefits, and payroll taxes.

72.15 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
72.16 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
72.17 	when federal approval is obtained.

72.18 	Sec. 53. Minnesota Statutes 2022, section 256B.851, subdivision 3, is amended to read:
72.19 		Subd. 3.Payment rates; base wage index. When initially establishing the base wage 
72.20 	component values, the commissioner must use the Minnesota-specific median wage for the 
72.21 	standard occupational classification (SOC) codes published by the Bureau of Labor Statistics 
72.22 	in the edition of the Occupational Handbook available January 1, published in March 2021. 
72.23 	The commissioner must calculate the base wage component values as follows for:
72.24 	(1) personal care assistance services, CFSS, extended personal care assistance services, 
72.25 	and extended CFSS. The base wage component value equals the median wage for personal 
72.26 	care aide (SOC code 31-1120);
72.27 	(2) enhanced rate personal care assistance services and enhanced rate CFSS. The base 
72.28 	wage component value equals the product of median wage for personal care aide (SOC 
72.29 	code 31-1120) and the value of the enhanced rate under section 256B.0659, subdivision 
72.30 	17a; and
72.31 	(3) qualified professional services and CFSS worker training and development. The base 
72.32 	wage component value equals the sum of 70 percent of the median wage for registered nurse 
73.1 	(SOC code 29-1141), 15 percent of the median wage for health care social worker (SOC 
73.2 	code 21-1099), and 15 percent of the median wage for social and human service assistant 
73.3 	(SOC code 21-1093).

73.4 	EFFECTIVE DATE. This section is effective January 1, 2024, or 90 days after federal 
73.5 	approval, whichever is later. The commissioner of human services shall notify the revisor 
73.6 	of statutes when federal approval is obtained.

73.7 	Sec. 54. Minnesota Statutes 2022, section 256B.851, subdivision 5, is amended to read:
73.8 		Subd. 5.Payment rates; component values. (a) The commissioner must use the 
73.9 	following component values:
73.10 	(1) employee vacation, sick, and training factor, 8.71 percent;
73.11 	(2) employer taxes and workers' compensation factor, 11.56 percent;
73.12 	(3) employee benefits factor, 12.04 percent;
73.13 	(4) client programming and supports factor, 2.30 percent;
73.14 	(5) program plan support factor, 7.00 percent;
73.15 	(6) general business and administrative expenses factor, 13.25 percent;
73.16 	(7) program administration expenses factor, 2.90 percent; and
73.17 	(8) absence and utilization factor, 3.90 percent.
73.18 	(b) For purposes of implementation, the commissioner shall use the following 
73.19 	implementation components:
73.20 	(1) personal care assistance services and CFSS: 75.45 88.19 percent;
73.21 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 75.45 88.19
73.22 	percent; and
73.23 	(3) qualified professional services and CFSS worker training and development: 75.45
73.24 	88.19 percent.
73.25 	(c) Effective January 1, 2025, for purposes of implementation, the commissioner shall 
73.26 	use the following implementation components:
73.27 	(1) personal care assistance services and CFSS: 92.08 percent;
73.28 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08 
73.29 	percent; and
74.1 	(3) qualified professional services and CFSS worker training and development: 92.08 
74.2 	percent.
74.3 	(d) The commissioner shall use the following worker retention components:
74.4 	(1) for workers who have provided fewer than 1,001 cumulative hours in personal care 
74.5 	assistance services or CFSS, the worker retention component is zero percent;
74.6 	(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal 
74.7 	care assistance services or CFSS, the worker retention component is 2.17 percent;
74.8 	(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal 
74.9 	care assistance services or CFSS, the worker retention component is 4.36 percent;
74.10 	(4) for workers who have provided between 6,001 and 10,000 cumulative hours in 
74.11 	personal care assistance services or CFSS, the worker retention component is 7.35 percent; 
74.12 	and
74.13 	(5) for workers who have provided more than 10,000 cumulative hours in personal care 
74.14 	assistance services or CFSS, the worker retention component is 10.81 percent.
74.15 	(e) The commissioner shall define the appropriate worker retention component based 
74.16 	on the total number of units billed for services rendered by the individual provider since 
74.17 	July 1, 2017. The worker retention component must be determined by the commissioner 
74.18 	for each individual provider and is not subject to appeal.

74.19 	EFFECTIVE DATE. The amendments to paragraph (b) are effective January 1, 2024, 
74.20 	or 90 days after federal approval, whichever is later. Paragraph (b) expires January 1, 2025, 
74.21 	or 90 days after federal approval of paragraph (c), whichever is later. Paragraphs (c) to (e) 
74.22 	are effective January 1, 2025, or 90 days after federal approval, whichever is later. The 
74.23 	commissioner of human services shall notify the revisor of statutes when federal approval 
74.24 	is obtained.

74.25 	Sec. 55. Minnesota Statutes 2022, section 256B.851, subdivision 6, is amended to read:
74.26 		Subd. 6.Payment rates; rate determination. (a) The commissioner must determine 
74.27 	the rate for personal care assistance services, CFSS, extended personal care assistance 
74.28 	services, extended CFSS, enhanced rate personal care assistance services, enhanced rate 
74.29 	CFSS, qualified professional services, and CFSS worker training and development as 
74.30 	follows:
74.31 	(1) multiply the appropriate total wage component value calculated in subdivision 4 by 
74.32 	one plus the employee vacation, sick, and training factor in subdivision 5;
75.1 	(2) for program plan support, multiply the result of clause (1) by one plus the program 
75.2 	plan support factor in subdivision 5;
75.3 	(3) for employee-related expenses, add the employer taxes and workers' compensation 
75.4 	factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is 
75.5 	employee-related expenses. Multiply the product of clause (2) by one plus the value for 
75.6 	employee-related expenses;
75.7 	(4) for client programming and supports, multiply the product of clause (3) by one plus 
75.8 	the client programming and supports factor in subdivision 5;
75.9 	(5) for administrative expenses, add the general business and administrative expenses 
75.10 	factor in subdivision 5, the program administration expenses factor in subdivision 5, and 
75.11 	the absence and utilization factor in subdivision 5;
75.12 	(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is 
75.13 	the hourly rate;
75.14 	(7) multiply the hourly rate by the appropriate implementation component under 
75.15 	subdivision 5. This is the adjusted hourly rate; and
75.16 	(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment 
75.17 	rate.
75.18 	(b) In processing claims, the commissioner shall incorporate the worker retention 
75.19 	component specified in subdivision 5, by multiplying one plus the total adjusted payment 
75.20 	rate by the appropriate worker retention component under subdivision 5, paragraph (d).
75.21 	(b) (c) The commissioner must publish the total adjusted final payment rates.

75.22 	EFFECTIVE DATE. This section is effective January 1, 2025, or 90 days after federal 
75.23 	approval, whichever is later. The commissioner of human services shall notify the revisor 
75.24 	of statutes when federal approval is obtained.

75.25 	Sec. 56. Minnesota Statutes 2022, section 256D.425, subdivision 1, is amended to read:
75.26 		Subdivision 1.Persons entitled to receive aid. A person who is aged, blind, or 18 years 
75.27 	of age or older and disabled and who is receiving supplemental security benefits under Title 
75.28 	XVI on the basis of age, blindness, or disability (or would be eligible for such benefits 
75.29 	except for excess income) is eligible for a payment under the Minnesota supplemental aid 
75.30 	program, if the person's net income is less than the standards in section 256D.44. A person 
75.31 	who is receiving benefits under the Minnesota supplemental aid program in the month prior 
75.32 	to becoming eligible under section 1619(b) of the Social Security Act is eligible for a 
76.1 	payment under the Minnesota supplemental aid program while they remain in section 1619(b) 
76.2 	status. Persons who are not receiving Supplemental Security Income benefits under Title 
76.3 	XVI of the Social Security Act or disability insurance benefits under Title II of the Social 
76.4 	Security Act due to exhausting time limited benefits are not eligible to receive benefits 
76.5 	under the MSA program. Persons who are not receiving Social Security or other maintenance 
76.6 	benefits for failure to meet or comply with the Social Security or other maintenance program 
76.7 	requirements are not eligible to receive benefits under the MSA program. Persons who are 
76.8 	found ineligible for Supplemental Security Income because of excess income, but whose 
76.9 	income is within the limits of the Minnesota supplemental aid program, must have blindness 
76.10 	or disability determined by the state medical review team.

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

76.12 	Sec. 57. Minnesota Statutes 2022, section 256S.2101, subdivision 1, is amended to read:
76.13 		Subdivision 1.Phase-in for disability waiver customized living rates. All rates and 
76.14 	rate components for community access for disability inclusion customized living and brain 
76.15 	injury customized living under section 256B.4914 shall must be the sum of ten 29.6 percent 
76.16 	of the rates calculated under sections 256S.211 to 256S.215 and 90 70.4 percent of the rates 
76.17 	calculated using the rate methodology in effect as of June 30, 2017.

76.18 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
76.19 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
76.20 	when federal approval is obtained.

76.21 	Sec. 58. Minnesota Statutes 2022, section 268.19, subdivision 1, is amended to read:
76.22 		Subdivision 1.Use of data. (a) Except as provided by this section, data gathered from 
76.23 	any person under the administration of the Minnesota Unemployment Insurance Law are 
76.24 	private data on individuals or nonpublic data not on individuals as defined in section 13.02, 
76.25 	subdivisions 9 and 12, and may not be disclosed except according to a district court order 
76.26 	or section 13.05. A subpoena is not considered a district court order. These data may be 
76.27 	disseminated to and used by the following agencies without the consent of the subject of 
76.28 	the data:
76.29 	(1) state and federal agencies specifically authorized access to the data by state or federal 
76.30 	law;
76.31 	(2) any agency of any other state or any federal agency charged with the administration 
76.32 	of an unemployment insurance program;
77.1 	(3) any agency responsible for the maintenance of a system of public employment offices 
77.2 	for the purpose of assisting individuals in obtaining employment;
77.3 	(4) the public authority responsible for child support in Minnesota or any other state in 
77.4 	accordance with section 256.978;
77.5 	(5) human rights agencies within Minnesota that have enforcement powers;
77.6 	(6) the Department of Revenue to the extent necessary for its duties under Minnesota 
77.7 	laws;
77.8 	(7) public and private agencies responsible for administering publicly financed assistance 
77.9 	programs for the purpose of monitoring the eligibility of the program's recipients;
77.10 	(8) the Department of Labor and Industry and the Commerce Fraud Bureau in the 
77.11 	Department of Commerce for uses consistent with the administration of their duties under 
77.12 	Minnesota law;
77.13 	(9) the Department of Human Services and the Office of Inspector General and its agents 
77.14 	within the Department of Human Services, including county fraud investigators, for 
77.15 	investigations related to recipient or provider fraud and employees of providers when the 
77.16 	provider is suspected of committing public assistance fraud;
77.17 	(10) the Department of Human Services for the purpose of evaluating medical assistance 
77.18 	services and supporting program improvement;
77.19 	(10) (11) local and state welfare agencies for monitoring the eligibility of the data subject 
77.20 	for assistance programs, or for any employment or training program administered by those 
77.21 	agencies, whether alone, in combination with another welfare agency, or in conjunction 
77.22 	with the department or to monitor and evaluate the statewide Minnesota family investment 
77.23 	program and other cash assistance programs, the Supplemental Nutrition Assistance Program, 
77.24 	and the Supplemental Nutrition Assistance Program Employment and Training program by 
77.25 	providing data on recipients and former recipients of Supplemental Nutrition Assistance 
77.26 	Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child 
77.27 	care assistance under chapter 119B, or medical programs under chapter 256B or 256L or 
77.28 	formerly codified under chapter 256D;
77.29 	(11) (12) local and state welfare agencies for the purpose of identifying employment, 
77.30 	wages, and other information to assist in the collection of an overpayment debt in an 
77.31 	assistance program;
78.1 	(12) (13) local, state, and federal law enforcement agencies for the purpose of ascertaining 
78.2 	the last known address and employment location of an individual who is the subject of a 
78.3 	criminal investigation;
78.4 	(13) (14) the United States Immigration and Customs Enforcement has access to data 
78.5 	on specific individuals and specific employers provided the specific individual or specific 
78.6 	employer is the subject of an investigation by that agency;
78.7 	(14) (15) the Department of Health for the purposes of epidemiologic investigations;
78.8 	(15) (16) the Department of Corrections for the purposes of case planning and internal 
78.9 	research for preprobation, probation, and postprobation employment tracking of offenders 
78.10 	sentenced to probation and preconfinement and postconfinement employment tracking of 
78.11 	committed offenders;
78.12 	(16) (17) the state auditor to the extent necessary to conduct audits of job opportunity 
78.13 	building zones as required under section 469.3201; and
78.14 	(17) (18) the Office of Higher Education for purposes of supporting program 
78.15 	improvement, system evaluation, and research initiatives including the Statewide 
78.16 	Longitudinal Education Data System.
78.17 	(b) Data on individuals and employers that are collected, maintained, or used by the 
78.18 	department in an investigation under section 268.182 are confidential as to data on individuals 
78.19 	and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3 
78.20 	and 13, and must not be disclosed except under statute or district court order or to a party 
78.21 	named in a criminal proceeding, administrative or judicial, for preparation of a defense.
78.22 	(c) Data gathered by the department in the administration of the Minnesota unemployment 
78.23 	insurance program must not be made the subject or the basis for any suit in any civil 
78.24 	proceedings, administrative or judicial, unless the action is initiated by the department.

78.25 	Sec. 59. PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED 
78.26 	COMMUNITIES.
78.27 		Subdivision 1.Establishment and authority. (a) The commissioner of human services 
78.28 	shall award grants to organizations that provide community-based services to rural or 
78.29 	underserved communities. The grants must be used to build organizational capacity to 
78.30 	provide home and community-based services in the state and to build new or expanded 
78.31 	infrastructure to access medical assistance reimbursement.
79.1 	(b) The commissioner shall conduct community engagement, provide technical assistance, 
79.2 	and establish a collaborative learning community related to the grants available under this 
79.3 	section and shall work with the commissioners of management and budget and administration 
79.4 	to mitigate barriers in accessing grant money.
79.5 	(c) The commissioner shall limit expenditures under this subdivision to the amount 
79.6 	appropriated for this purpose.
79.7 	(d) The commissioner shall give priority to organizations that provide culturally specific 
79.8 	and culturally responsive services or that serve historically underserved communities 
79.9 	throughout the state.
79.10 		Subd. 2.Eligibility. An eligible applicant for the capacity grants under subdivision 1 is 
79.11 	an organization or provider that serves, or will serve, rural or underserved communities 
79.12 	and:
79.13 	(1) provides, or will provide, home and community-based services in the state; or
79.14 	(2) serves, or will serve, as a connector for communities to available home and 
79.15 	community-based services.
79.16 		Subd. 3.Allowable grant activities.  Grants under this section must be used by recipients 
79.17 	for the following activities:
79.18 	(1) expanding existing services;
79.19 	(2) increasing access in rural or underserved areas;
79.20 	(3) creating new home and community-based organizations;
79.21 	(4) connecting underserved communities to benefits and available services; or
79.22 	(5) building new or expanded infrastructure to access medical assistance reimbursement.

79.23 	Sec. 60. NEW AMERICAN LEGAL, SOCIAL SERVICES, AND LONG-TERM 
79.24 	CARE WORKFORCE GRANT PROGRAM.
 79.25 		Subdivision 1.Definition. "New American" means an individual born abroad and the 
79.26 	individual's children, irrespective of immigration status.
79.27 		Subd. 2.Grant program established. The commissioner of human services shall 
79.28 	establish a new American legal, social services, and long-term care workforce grant program 
79.29 	for organizations that serve and support new Americans:
79.30 	(1) in seeking or maintaining legal or citizenship status to legally obtain or retain 
79.31 	employment in any field or industry; or
80.1 	(2) to provide specialized services and supports to new Americans to enter the long-term 
80.2 	care workforce.
80.3 		Subd. 3.Eligible grantees. (a) The commissioner shall select grantees as provided in 
80.4 	this subdivision.
80.5 	(b) Eligible applicants for a grant under this section must demonstrate the qualifications, 
80.6 	legal or other expertise, cultural competency, and experience in working with new Americans 
80.7 	necessary to perform the activities required under subdivision 4 statewide or in discreet 
80.8 	portions of the state.
80.9 	(c) Eligible applicants seeking to provide services include governmental units, federally 
80.10 	recognized Tribal Nations, nonprofit organizations as defined under section 501(c)(3) of 
80.11 	the Internal Revenue Code, for-profit organizations, and legal services organizations 
80.12 	specializing in obtaining visas for health care workers.
80.13 	(d) Eligible applicants seeking to provide supports for new Americans to obtain or 
80.14 	maintain employment must demonstrate expertise and capacity to provide training, peer 
80.15 	mentoring, supportive services, workforce development, and other services to develop and 
80.16 	implement strategies for recruiting and retaining qualified employees.
80.17 	(e) The commissioner shall prioritize:
80.18 	(1) for applicants providing legal or social services, organizations that serve populations 
80.19 	in areas of the state where worker shortages are most acute or for whom existing legal 
80.20 	services and social services during the legal process or while seeking qualified legal 
80.21 	assistance are unavailable or insufficient; and
80.22 	(2) for applicants providing supports for new Americans to obtain or maintain 
80.23 	employment in the long-term care workforce, applications from joint labor management 
80.24 	programs.
80.25 		Subd. 4.Allowable uses of grant money. (a) Organizations receiving grant money 
80.26 	under this section must provide one or more of the following:
80.27 	(1) intake, assessment, referral, orientation, legal advice, or representation to new 
80.28 	Americans to seek or maintain legal or citizenship status and secure or maintain legal 
80.29 	authorization for employment in the United States;
80.30 	(2) social services designed to help eligible populations meet their immediate basic needs 
80.31 	during the process of seeking or maintaining legal status and legal authorization for 
80.32 	employment, including but not limited to accessing housing, food, employment or 
80.33 	employment training, education, course fees, community orientation, transportation, child 
81.1 	care, and medical care. Social services may also include navigation services to address 
81.2 	ongoing needs once immediate basic needs have been met; or
81.3 	(3) specialized activities targeted to individuals to support recruitment and connection 
81.4 	to long-term care employment opportunities including:
81.5 	(i) developing connections to employment with long-term care employers and potential 
81.6 	employees;
81.7 	(ii) providing recruitment, training, guidance, mentorship, and other support services 
81.8 	necessary to encourage employment, employee retention, and successful community 
81.9 	integration;
81.10 	(iii) providing career education, wraparound support services, and job skills training in 
81.11 	high-demand health care and long-term care fields;
81.12 	(iv) paying for program expenses related to long-term care professions, including but 
81.13 	not limited to hiring instructors and navigators, space rentals, and supportive services to 
81.14 	help participants attend classes. Allowable uses for supportive services include but are not 
81.15 	limited to:
81.16 	(A) course fees;
81.17 	(B) child care costs;
81.18 	(C) transportation costs;
81.19 	(D) tuition fees;
81.20 	(E) financial coaching fees;
81.21 	(F) mental health supports; and
81.22 	(G) uniform costs incurred as a direct result of participating in classroom instruction or 
81.23 	training; or
81.24 	(v) repaying student loan debt directly incurred as a result of pursuing a qualifying course 
81.25 	of study or training.
81.26 		Subd. 5.Reporting. (a) Grant recipients under this section must collect and report to 
81.27 	the commissioner information on program participation and program outcomes. The 
81.28 	commissioner shall determine the form and timing of reports.
81.29 	(b) Grant recipients providing immigration legal services under this section must collect 
81.30 	and report to the commissioner data that are consistent with the requirements established 
82.1 	for the advisory committee established by the supreme court under Minnesota Statutes, 
82.2 	section 480.242, subdivision 1.
82.3 		Subd. 6.Impact study and evaluation. (a) The commissioner shall conduct a study of 
82.4 	the long-term care workforce portion of the grant program under this section to assess the 
82.5 	impacts on new Americans served by the grant program and may evaluate the following:
82.6 	(1) employee retention;
82.7 	(2) employee compensation;
82.8 	(3) career advancement and mobility;
82.9 	(4) career satisfaction; and
82.10 	(5) safety in the workplace.
82.11 	(b) By June 30, 2027, the commissioner shall submit a report to the chairs and ranking 
82.12 	minority members of the legislative committees and divisions with jurisdiction over human 
82.13 	services finance and policy on the impacts on new Americans engaged in the grant program, 
82.14 	based on the results of the evaluation under paragraph (a). Where feasible, the report must 
82.15 	include recommendations to improve the experience of new Americans in the long-term 
82.16 	care workforce.

82.17 	Sec. 61. SUPPORTED-DECISION-MAKING PROGRAMS.
82.18 		Subdivision 1.Authorization. The commissioner of human services shall award general 
82.19 	operating grants to public and private nonprofit organizations, counties, and Tribes to provide 
82.20 	and promote supported decision making.
82.21 		Subd. 2.Definitions. (a) For the purposes of this section, the terms in this section have 
82.22 	the meanings given.
82.23 	(b) "Supported decision making" has the meaning given in section 524.5-102, subdivision 
82.24 	16a.
82.25 	(c) "Supported-decision-making services" means services provided to help an individual 
82.26 	consider, access, or develop supported decision making, potentially as an alternative to 
82.27 	more restrictive forms of decision making, including guardianship and conservatorship. 
82.28 	The services may be provided to the individual, family members, or trusted support people. 
82.29 	The individual may currently be a person subject to guardianship or conservatorship, but 
82.30 	the services must not be used to help a person access a guardianship or conservatorship.
82.31 		Subd. 3.Grants. (a) The grants must be distributed as follows:
83.1 	(1) at least 75 percent of the grant money must be used to fund programs or organizations 
83.2 	that provide supported-decision-making services;
83.3 	(2) no more than 20 percent of the grant money may be used to fund county or Tribal 
83.4 	programs that provide supported-decision-making services; and
83.5 	(3) no more than five percent of the grant money may be used to fund programs or 
83.6 	organizations that do not provide supported-decision-making services but do promote the 
83.7 	use and advancement of supported decision making.
83.8 	(b) The grants must be distributed in a manner to promote racial and geographic diversity 
83.9 	in the populations receiving services as determined by the commissioner.
83.10 		Subd. 4.Evaluation and report. By December 1, 2024, the commissioner must submit 
83.11 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
83.12 	over human services finance and policy an interim report on the impact and outcomes of 
83.13 	the grants, including the number of grants awarded and the organizations receiving the 
83.14 	grants. The interim report must include any available evidence of how grantees were able 
83.15 	to increase utilization of supported decision making and reduce or avoid more restrictive 
83.16 	forms of decision making such as guardianship and conservatorship. By December 1, 2025, 
83.17 	the commissioner must submit to the chairs and ranking minority members of the legislative 
83.18 	committees with jurisdiction over human services finance and policy a final report on the 
83.19 	impact and outcomes of the grants, including any updated information from the interim 
83.20 	report and the total number of people served by the grants. The final report must also detail 
83.21 	how the money was used to achieve the requirements in subdivision 3, paragraph (b).
83.22 		Subd. 5.Applications. Any public or private nonprofit agency may apply to the 
83.23 	commissioner for a grant under subdivision 3, paragraph (a), clause (1) or (3). Any county 
83.24 	or Tribal agency in Minnesota may apply to the commissioner for a grant under subdivision 
83.25 	3, paragraph (a), clause (2). The application must be submitted in a form approved by the 
83.26 	commissioner.
83.27 		Subd. 6.Duties of grantees. Every public or private nonprofit agency, county, or Tribal 
83.28 	agency that receives a grant to provide or promote supported decision making must comply 
83.29 	with rules related to the administration of the grants.

83.30 	Sec. 62. APPROVAL OF CORPORATE FOSTER CARE MORATORIUM 
83.31 	EXCEPTIONS.
 83.32 	(a) The commissioner of human services may approve or deny corporate foster care 
83.33 	moratorium exceptions requested under Minnesota Statutes, section 245A.03, subdivision 
84.1 	7, paragraph (a), clause (5), prior to approval of a service provider's home and 
84.2 	community-based services license under Minnesota Statutes, chapter 245D. Approval of 
84.3 	the moratorium exception must not be construed as final approval of a service provider's 
84.4 	home and community-based services or community residential setting license.
84.5 	(b) Approval under paragraph (a) must be available only for service providers that have 
84.6 	requested a home and community-based services license under Minnesota Statutes, chapter 
84.7 	245D.
84.8 	(c) Approval under paragraph (a) must be rescinded if the service provider's application 
84.9 	for a home and community-based services or community residential setting license is denied.
84.10 	(d) This section expires December 31, 2023.

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

84.12 	Sec. 63. EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL 
84.13 	INTERVENTION LICENSURE STUDY.
 84.14 	(a) The commissioner of human services must review the medical assistance early 
84.15 	intensive developmental and behavioral intervention (EIDBI) service and evaluate the need 
84.16 	for licensure or other regulatory modifications. At a minimum, the evaluation must include:
84.17 	(1) an examination of current Department of Human Services-licensed programs that 
84.18 	are similar to EIDBI;
84.19 	(2) an environmental scan of licensure requirements for Medicaid autism programs in 
84.20 	other states; and
84.21 	(3) consideration of health and safety needs for populations with autism and related 
84.22 	conditions.
84.23 	(b) The commissioner must consult with interested stakeholders, including self-advocates 
84.24 	who use EIDBI services, EIDBI providers, parents of youth who use EIDBI services, and 
84.25 	advocacy organizations. The commissioner must convene stakeholder meetings to obtain 
84.26 	feedback on licensure or regulatory recommendations.

84.27 	Sec. 64. MEMORANDUMS OF UNDERSTANDING.
 84.28 	The memorandums of understanding with Service Employees International Union 
84.29 	Healthcare Minnesota and Iowa, submitted by the commissioner of management and budget 
84.30 	on February 27, 2023, are ratified.

85.1 	Sec. 65. SELF-DIRECTED WORKER CONTRACT RATIFICATION.
 85.2 	The labor agreement between the state of Minnesota and the Service Employees 
85.3 	International Union Healthcare Minnesota and Iowa, submitted to the Legislative 
85.4 	Coordinating Commission on February 27, 2023, is ratified.

85.5 	Sec. 66. BUDGET INCREASE FOR CONSUMER-DIRECTED COMMUNITY 
85.6 	SUPPORTS.
 85.7 	(a) Effective January 1, 2024, or upon federal approval, whichever is later, 
85.8 	consumer-directed community support budgets identified in the waiver plans under Minnesota 
85.9 	Statutes, sections 256B.092 and 256B.49, and chapter 256S; and the alternative care program 
85.10 	under Minnesota Statutes, section 256B.0913, must be increased by 8.49 percent.
85.11 	(b) Effective January 1, 2025, or upon federal approval, whichever is later, 
85.12 	consumer-directed community support budgets identified in the waiver plans under Minnesota 
85.13 	Statutes, sections 256B.092 and 256B.49, and chapter 256S; and the alternative care program 
85.14 	under Minnesota Statutes, section 256B.0913, must be increased by 4.53 percent.

85.15 	Sec. 67. DIRECT CARE SERVICE CORPS PILOT PROJECT.
 85.16 		Subdivision 1.Establishment. The Metropolitan Center for Independent Living must 
85.17 	develop a pilot project establishing the Minnesota Direct Care Service Corps. The pilot 
85.18 	project must utilize financial incentives to attract postsecondary students to work as personal 
85.19 	care assistants or direct support professionals. The Metropolitan Center for Independent 
85.20 	Living must establish the financial incentives and minimum work requirements to be eligible 
85.21 	for incentive payments. The financial incentive must increase with each semester that the 
85.22 	student participates in the Minnesota Direct Care Service Corps.
85.23 		Subd. 2.Pilot sites. (a) Pilot sites must include one postsecondary institution in the 
85.24 	seven-county metropolitan area and at least one postsecondary institution outside of the 
85.25 	seven-county metropolitan area. If more than one postsecondary institution outside the 
85.26 	metropolitan area is selected, one must be located in northern Minnesota and the other must 
85.27 	be located in southern Minnesota.
85.28 	(b) After satisfactorily completing the work requirements for a semester, the pilot site 
85.29 	or its fiscal agent must pay students the financial incentive developed for the pilot project.
85.30 		Subd. 3.Evaluation and report. (a) The Metropolitan Center for Independent Living 
85.31 	must contract with a third party to evaluate the pilot project's impact on health care costs, 
85.32 	retention of personal care assistants, and patients' and providers' satisfaction of care. The 
86.1 	evaluation must include the number of participants, the hours of care provided by participants, 
86.2 	and the retention of participants from semester to semester.
86.3 	(b) By January 15, 2025, the Metropolitan Center for Independent Living must report 
86.4 	the findings under paragraph (a) to the chairs and ranking minority members of the legislative 
86.5 	committees with jurisdiction over human services finance and policy.

86.6 	Sec. 68. RATE INCREASE FOR HOME CARE SERVICES.
 86.7 	(a) The commissioner of human services shall increase payment rates for  home health 
86.8 	agency services under Minnesota Statutes, section 256B.0653, by 14.99 percent from the 
86.9 	rates in effect on December 31, 2023.
86.10 	(b) The commissioner shall increase payment rates for home care nursing under 
86.11 	Minnesota Statutes, section 256B.0651, subdivision 2, clause (2), by 25 percent from the 
86.12 	rates in effect on December 31, 2023.

86.13 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
86.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
86.15 	when federal approval is obtained.

86.16 	Sec. 69. SPECIALIZED EQUIPMENT AND SUPPLIES LIMIT INCREASE.
 86.17 	Upon federal approval, the commissioner of human services must increase the annual 
86.18 	limit for specialized equipment and supplies under Minnesota's federally approved home 
86.19 	and community-based service waiver plans, alternative care, and essential community 
86.20 	supports to $10,000.

86.21 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
86.22 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
86.23 	when federal approval is obtained.

86.24 	Sec. 70. DIRECTION TO COMMISSIONER; APPLICATION OF INTERMEDIATE 
86.25 	CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES 
86.26 	RATE INCREASES.
 86.27 	The commissioner of human services shall apply the rate increases under Minnesota 
86.28 	Statutes, section 256B.5012, subdivisions 19 and 20, as follows:
86.29 	(1) apply Minnesota Statutes, section 256B.5012, subdivision 19; and
86.30 	(2) apply any required rate increase as required under Minnesota Statutes, section 
86.31 	256B.5012, subdivision 20, to the results of clause (1).

87.1 	Sec. 71. RATE INCREASE FOR CERTAIN DISABILITY WAIVER SERVICES.
 87.2 	The commissioner of human services shall increase payment rates for chore services 
87.3 	and home-delivered meals provided under Minnesota Statutes, sections 256B.092 and 
87.4 	256B.49, by 14.99 percent from the rates in effect on December 31, 2023.

87.5 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
87.6 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
87.7 	when federal approval is obtained.

87.8 	Sec. 72. RATE INCREASE FOR EARLY INTENSIVE DEVELOPMENTAL AND 
87.9 	BEHAVIORAL INTERVENTION BENEFIT SERVICES.
 87.10 	The commissioner of human services shall increase payment rates for early intensive 
87.11 	developmental and behavioral intervention services under Minnesota Statutes, section 
87.12 	256B.0949, by 14.99 percent from the rates in effect on December 31, 2023.

87.13 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
87.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
87.15 	when federal approval is obtained.

87.16 	Sec. 73. RATE INCREASE FOR INTERMEDIATE CARE FACILITIES FOR 
87.17 	PERSONS WITH DEVELOPMENTAL DISABILITIES DAY TRAINING AND 
87.18 	HABILITATION SERVICES.
 87.19 	The commissioner of human services shall increase payment rates for day training and 
87.20 	habilitation services under Minnesota Statutes, section 252.46, by 14.99 percent from the 
87.21 	rates in effect on December 31, 2023.

87.22 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
87.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
87.24 	when federal approval is obtained.

87.25 	Sec. 74. STUDY TO EXPAND ACCESS TO SERVICES FOR PEOPLE WITH 
87.26 	CO-OCCURRING BEHAVIORAL HEALTH CONDITIONS AND DISABILITIES.
 87.27 	The commissioner of human services, in consultation with stakeholders, must evaluate 
87.28 	options to expand services authorized under Minnesota's federally approved home and 
87.29 	community-based waivers, including positive support, crisis respite, respite, and specialist 
87.30 	services. The evaluation may include surveying community providers as to the barriers to 
87.31 	meeting people's needs and options to authorize services under Minnesota's medical assistance 
88.1 	state plan and strategies to decrease the number of people who remain in hospitals, jails, 
88.2 	and other acute or crisis settings when they no longer meet medical or other necessity criteria.

88.3 	Sec. 75. TEMPORARY GRANT FOR SMALL CUSTOMIZED LIVING 
88.4 	PROVIDERS.
 88.5 	(a) The commissioner of human services must establish a temporary grant for:
88.6 	(1) customized living providers that serve six or fewer people in a single-family home; 
88.7 	and
88.8 	(2) community residential service providers and integrated community supports providers 
88.9 	who transitioned from providing customized living or 24-hour customized living on or after 
88.10 	June 30, 2021.
88.11 	(b) Allowable uses of grant money include physical plant updates required for community 
88.12 	residential services or integrated community supports licensure, technical assistance to adapt 
88.13 	business models and meet policy and regulatory guidance, and other uses approved by the 
88.14 	commissioner. Allowable uses of grant money also include reimbursement for eligible costs 
88.15 	incurred by a community residential service provider or integrated community supports 
88.16 	provider directly related to the provider's transition from providing customized living or 
88.17 	24-hour customized living. License holders of eligible settings must apply for grant money 
88.18 	using an application process determined by the commissioner. Grant money approved by 
88.19 	the commissioner is a onetime award of up to $50,000 per eligible setting. To be considered 
88.20 	for grant money, eligible license holders must submit a grant application by June 30, 2024. 
88.21 	The commissioner may approve grant applications on a rolling basis.

88.22 	Sec. 76. DIRECTION TO COMMISSIONER; SUPPORTED-DECISION-MAKING 
88.23 	REIMBURSEMENT STUDY.
 88.24 	By December 15, 2024, the commissioner shall issue a report to the governor and the 
88.25 	chairs and ranking minority members of the legislative committees with jurisdiction over 
88.26 	human services finance and policy detailing how medical assistance service providers could 
88.27 	be reimbursed for providing supported-decision-making services. The report must detail 
88.28 	recommendations for all medical assistance programs, including all home and 
88.29 	community-based programs, to provide for reimbursement for supported-decision-making 
88.30 	services. The report must develop detailed provider requirements for reimbursement, 
88.31 	including the criteria necessary to provide high-quality services.  In developing provider 
88.32 	requirements, the commissioner shall consult with all relevant stakeholders, including 
88.33 	organizations currently providing supported-decision-making  services. The report must also 
89.1 	include strategies to promote equitable access to supported-decision-making services to 
89.2 	individuals who are Black, Indigenous, or People of Color; people from culturally specific 
89.3 	communities; people from rural communities; and other people who may experience barriers 
89.4 	to accessing medical assistance home and community-based services.

89.5 	Sec. 77. DIRECTION TO COMMISSIONER; SHARED SERVICES.
 89.6 	(a) By December 31, 2023, the commissioner of human services shall seek any necessary 
89.7 	changes to home and community-based services waiver plans regarding sharing services in 
89.8 	order to:
89.9 	(1) permit shared services for chore, homemaker, and night supervision;
89.10 	(2) permit existing shared services at higher ratios, including individualized home 
89.11 	supports without training, individualized home supports with training, and individualized 
89.12 	home supports with family training at a ratio of one staff person to three recipients;
89.13 	(3) ensure that individuals who are seeking to share services permitted under the waiver 
89.14 	plans in an own-home setting are not required to live in a licensed setting in order to share 
89.15 	services so long as all other requirements are met; and
89.16 	(4) issue guidance for shared services, including:
89.17 	(i) informed choice for all individuals sharing the services;
89.18 	(ii) guidance on how lead agencies and individuals shall determine that shared service 
89.19 	is appropriate to meet the needs, health, and safety of each individual for whom the lead 
89.20 	agency provides case management or care coordination; and
89.21 	(iii) guidance clarifying that an individual's decision to share services does not reduce 
89.22 	any determination of the individual's overall or assessed needs for services.
89.23 	(b) The commissioner shall develop or provide guidance outlining:
89.24 	(1) instructions for shared services support planning;
89.25 	(2) person-centered approaches and informed choice in shared services support planning; 
89.26 	and
89.27 	(3) required contents of shared services agreements.
89.28 	(c) The commissioner shall seek and utilize stakeholder input for any proposed changes 
89.29 	to waiver plans and any shared services guidance.

90.1 	Sec. 78. DIRECTION TO COMMISSIONER; DISABILITY WAIVER SHARED 
90.2 	SERVICES RATES.
 90.3 	The commissioner of human services shall establish a rate system for shared homemaker 
90.4 	services and shared chore services provided under Minnesota Statutes, sections 256B.092 
90.5 	and 256B.49. For two persons sharing services, the rate paid to a provider must not exceed 
90.6 	1-1/2 times the rate paid for serving a single individual, and for three persons sharing 
90.7 	services, the rate paid to a provider must not exceed two times the rate paid for serving a 
90.8 	single individual. These rates apply only when all of the criteria for the shared service have 
90.9 	been met.

90.10 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
90.11 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
90.12 	when approval is obtained.

90.13 	Sec. 79. INTERAGENCY EMPLOYMENT SUPPORTS ALIGNMENT STUDY.
 90.14 	The commissioners of human services, employment and economic development, and 
90.15 	education must conduct an interagency alignment study on employment supports for people 
90.16 	with disabilities. The study must evaluate:
90.17 	(1) service rates;
90.18 	(2) provider enrollment and monitoring standards; and
90.19 	(3) eligibility processes and people's lived experience transitioning between employment 
90.20 	programs.

90.21 	Sec. 80. MONITORING EMPLOYMENT OUTCOMES.
 90.22 	By January 15, 2025, the Departments of Human Services, Employment and Economic 
90.23 	Development, and Education must provide the chairs and ranking minority members of the 
90.24 	legislative committees with jurisdiction over health, human services, and labor finance and 
90.25 	policy with a plan for tracking employment outcomes for people with disabilities served by 
90.26 	programs administered by the agencies. This plan must include any needed changes to state 
90.27 	law to track supports received and outcomes across programs.

90.28 	Sec. 81. STUDY ON PRESUMPTIVE ELIGIBILITY FOR LONG-TERM SERVICES 
90.29 	AND SUPPORTS.
 90.30 	(a) The commissioner of human services must study presumptive financial and functional 
90.31 	eligibility for people with disabilities and older adults in the following programs:
91.1 	(1) medical assistance, alternative care, and essential community supports; and
91.2 	(2) home and community-based services.
91.3 	(b) The commissioner must evaluate the following in the study of presumptive eligibility 
91.4 	within the programs listed in paragraph (a):
91.5 	(1) current eligibility processes;
91.6 	(2) barriers to timely eligibility determinations; and
91.7 	(3) strategies to enhance access to home and community-based services in the least 
91.8 	restrictive setting.
91.9 	(c) By January 1, 2025, the commissioner must report recommendations and draft 
91.10 	legislation to the chairs and ranking minority members of the legislative committees with 
91.11 	jurisdiction over health and human services finance and policy.

91.12 	Sec. 82. ACUTE CARE TRANSITIONS ADVISORY COUNCIL.
 91.13 		Subdivision 1.Establishment. The commissioner of human services shall establish an 
91.14 	Acute Care Transitions Advisory Council to advise and assist the commissioner in 
91.15 	establishing and implementing a statewide vision and systemic approach to acute care 
91.16 	transitions in Minnesota.
91.17 		Subd. 2.Membership. (a) The Acute Care Transitions Advisory Council consists of 
91.18 	the following members:
91.19 	(1) two individuals or their representatives who have lived experiences with acute care 
91.20 	transitions;
91.21 	(2) two members representing home and community-based services providers;
91.22 	(3) two members representing the Minnesota Hospital Association;
91.23 	(4) one member representing the Minnesota Association of County Social Service 
91.24 	Administrators;
91.25 	(5) one member representing the Local Public Health Association;
91.26 	(6) one member representing a Tribal government;
91.27 	(7) one member representing the University of Minnesota;
91.28 	(8) one member representing the State Advisory Council on Mental Health and 
91.29 	Subcommittee on Children's Mental Health;
91.30 	(9) one member representing a public sector labor union;
92.1 	(10) one member representing the Minnesota County Attorney's Association;
92.2 	(11) one individual who has had an acute hospital stay initiated during a crisis;
92.3 	(12) one parent of a child who has had an acute hospital stay initiated during a crisis;
92.4 	(13) one individual who meets the definition of a caring professional;
92.5 	(14) the commissioner of human services or a designee;
92.6 	(15) the commissioner of health or a designee; and
92.7 	(16) the commissioner of education or a designee.
92.8 	(b) To the extent possible, the advisory council members must represent diverse 
92.9 	populations and different areas of the state.
92.10 	(c) A member of the legislature may not serve as a member of the advisory council.
92.11 		Subd. 3.Cochairs; convening first meeting. The commissioner of human services shall 
92.12 	convene the first meeting. Advisory council members must select advisory council cochairs 
92.13 	at the first meeting.
92.14 		Subd. 4.Compensation; expenses; reimbursement. Advisory council members must 
92.15 	be compensated and reimbursed for expenses as provided in Minnesota Statutes, section 
92.16 	15.059, subdivision 3.
92.17 		Subd. 5.Administrative support. The commissioner of human services shall provide 
92.18 	meeting space and administrative support to the advisory council.
92.19 		Subd. 6.Public and community engagement. The commissioner of human services 
92.20 	shall conduct public and community engagement to obtain information about barriers and 
92.21 	potential solutions to transitioning patients from acute care settings to more appropriate 
92.22 	nonacute care settings and must provide the information collected through public and 
92.23 	community engagement to the advisory council.
92.24 		Subd. 7.Duties. (a) By October 1, 2024, the advisory council shall develop and present 
92.25 	to the chairs and ranking minority members of the legislative committees and divisions with 
92.26 	jurisdiction over health and human services finance and policy and the commissioner of 
92.27 	human services an action plan for creating a systemic approach to acute care transitions for 
92.28 	Minnesotans. The action plan must include but is not limited to the following:
92.29 	(1) recommendations to improve regional capacity for acute care transitions, including 
92.30 	examining the roles and experience of counties and Tribes in delivering services and 
93.1 	identifying any conflicting and duplicative roles and responsibilities among health and 
93.2 	human services agencies, counties, and Tribes;
93.3 	(2) recommendations to create a measurement and evaluation system using 
93.4 	implementation science to analyze regional and statewide data in transitions and make 
93.5 	ongoing recommendations for policy and program improvement; and
93.6 	(3) statewide strategies for improving access to transitioning from acute care settings 
93.7 	with a focus on addressing geographic, racial, and ethnic disparities.
93.8 	(b) The advisory council may contract with a private entity or consultant as necessary 
93.9 	to complete its duties under this section, and is exempt from state procurement process 
93.10 	requirements under Minnesota Statutes, chapter 16C.
93.11 		Subd. 8.Limitations. (a) In developing the action plan, the advisory council shall take 
93.12 	into consideration the impact of its recommendations on:
93.13 	(1) the existing capacity of state agencies, including staffing needs, technology resources, 
93.14 	and existing agency responsibilities; and
93.15 	(2) the capacity of county and Tribal partners.
93.16 	(b) The advisory council shall not include in the action plan recommendations that may 
93.17 	result in loss of benefits for the individuals eligible for state health and human services 
93.18 	public programs or exacerbate health disparities and inequities in access to health care and 
93.19 	human services.
93.20 		Subd. 9.Expiration. The Acute Care Transitions Advisory Council expires October 2, 
93.21 	2024, or the day after submitting the action plan required under subdivision 7, whichever 
93.22 	is earlier.

93.23 	Sec. 83. OVERPAYMENTS FOR DISABILITY WAIVER CUSTOMIZED LIVING 
93.24 	SERVICES.
 93.25 	(a) Notwithstanding Minnesota Statutes, section 256B.064, or any other law to the 
93.26 	contrary, providers that received ineligible payments for customized living services under 
93.27 	the community access for disability inclusion or brain injury waivers for people under age 
93.28 	55 who were not residing in the setting before January 11, 2021, must not be required to 
93.29 	repay ineligible payments related to the age restrictions for customized living services 
93.30 	delivered between January 11, 2021, and July 1, 2023. The state must not sanction providers 
93.31 	for receipt of these ineligible payments or otherwise seek recovery of these payments.
94.1 	(b) The state must repay with state money any amount owed to the Centers for Medicare 
94.2 	and Medicaid Services for the federal financial participation amount received by the state 
94.3 	for ineligible payments identified in paragraph (a).
94.4 	(c) Nothing in this section prohibits the commissioner from recouping past claims due 
94.5 	to false claims or for reasons other than ineligible payments related to age restrictions for 
94.6 	disability waiver customized living services for people who were not residing in the setting 
94.7 	between January 11, 2021, and July 1, 2023, or from recouping future ineligible payments 
94.8 	for disability customized living services, including from providers who received the ineligible 
94.9 	payments described in paragraph (a).
94.10 	(d) The commissioner must update guidance and communicate with lead agencies and 
94.11 	customized living service providers to ensure that lead agencies and providers understand 
94.12 	the requirements for medical assistance disability waiver customized living service payments.

94.13 	Sec. 84. PERSONAL CARE ASSISTANCE COMPENSATION FOR SERVICES 
94.14 	PROVIDED BY A PARENT OR SPOUSE.
 94.15 	(a) Notwithstanding Minnesota Statutes, section 256B.0659, subdivisions 3, paragraph 
94.16 	(a), clause (a); 11, paragraph (c); and 19, paragraph (b), clause (3), a parent, stepparent, or 
94.17 	legal guardian of a minor who is a personal care assistance recipient or the spouse of a 
94.18 	personal care assistance recipient may provide and be paid for providing personal care 
94.19 	assistance services under medical assistance. The commissioner shall seek federal approval 
94.20 	for these payments. If federal approval is not received, the commissioner shall make payments 
94.21 	for services rendered, prior to federal disapproval, without federal financial participation.
94.22 	(b) This section expires November 11, 2023, or upon the expiration of federal approval, 
94.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
94.24 	when federal approval expires.

94.25 	EFFECTIVE DATE. This section is effective retroactively from May 12, 2023.

94.26 	Sec. 85. REPEALER.
 94.27 	(a) Minnesota Statutes 2022, section 256B.4914, subdivision 9a, is repealed.
94.28 	(b) Minnesota Statutes 2022, section 256B.4914, subdivision 6b, is repealed.

94.29 	EFFECTIVE DATE. Paragraph (a) is effective January 1, 2024, or upon federal 
94.30 	approval, whichever is later, and paragraph (b) is effective January 1, 2026, or upon federal 
94.31 	approval, whichever is later. The commissioner of human services shall notify the revisor 
94.32 	of statutes when federal approval is obtained.

95.1 	ARTICLE 2
95.2 	AGING SERVICES

95.3 	Section 1. Minnesota Statutes 2022, section 256.975, subdivision 6, is amended to read:
95.4 		Subd. 6.Indian Native American elders coordinator position. (a) The Minnesota 
95.5 	Board on Aging shall create an Indian a Native American elders coordinator position, and 
95.6 	shall hire staff as appropriations permit for the purposes of coordinating efforts with the 
95.7 	National Indian Council on Aging and developing facilitating the coordination and 
95.8 	development of a comprehensive statewide Tribal-based service system for Indian Native 
95.9 	American elders. An Indian elder is defined for purposes of this subdivision as an Indian 
95.10 	enrolled in a band or tribe who is 55 years or older.
95.11 	(b) For purposes of this subdivision, the following terms have the meanings given:
95.12 	(1) "Native American elder" means an individual enrolled in a federally recognized 
95.13 	Tribe and identified as an elder according to the requirements of the individual's home Tribe; 
95.14 	and
95.15 	(2) "Tribal government" means representatives of each of the 11 federally recognized 
95.16 	Native American Tribes located wholly or partially within the boundaries of the state of 
95.17 	Minnesota.
95.18 	(c) The statewide Tribal-based service system must may include the following 
95.19 	components:
95.20 	(1) an assessment of the program eligibility, examining the need to change the age-based 
95.21 	eligibility criteria to need-based eligibility criteria;
95.22 	(2) (1) a planning system that would plan to grant, or make recommendations for granting,
95.23 	federal and state funding for statewide Tribal-based Native American programs and services;
95.24 	(2) a plan to develop business initiatives involving Tribal members that will qualify for 
95.25 	federal- and state-funded elder service contracts;
95.26 	(3) a plan for statewide Tribal-based service focal points, senior centers, or community 
95.27 	centers for socialization and service accessibility for Indian Native American elders;
95.28 	(4) a plan to develop and implement statewide education and public awareness campaigns
95.29 	promotions, including awareness programs, sensitivity cultural sensitivity training, and 
95.30 	public education on Indian elder needs Native American elders;
96.1 	(5) a plan for statewide culturally appropriate information and referral services for Native 
96.2 	American elders, including legal advice and counsel and trained advocates and an Indian 
96.3 	elder newsletter;
96.4 	(6) a plan for a coordinated statewide Tribal-based health care system including health 
96.5 	promotion/prevention promotion and prevention, in-home service, long-term care service, 
96.6 	and health care services;
96.7 	(7) a plan for ongoing research involving Indian elders including needs assessment and 
96.8 	needs analysis; collection of significant data on Native American elders, including population, 
96.9 	health, socialization, mortality, homelessness, and economic status; and
96.10 	(8) information and referral services for legal advice or legal counsel; and
96.11 	(9) (8) a plan to coordinate services with existing organizations, including but not limited 
96.12 	to the state of Minnesota, the Council of Minnesota Indian Affairs Council, the Minnesota 
96.13 	Indian Council of Elders, the Minnesota Board on Aging, Wisdom Steps, and Minnesota
96.14 	Tribal governments.

96.15 	Sec. 2. Minnesota Statutes 2022, section 256.9754, is amended to read:
96.16 	256.9754 COMMUNITY SERVICES DEVELOPMENT LIVE WELL AT HOME
96.17 	GRANTS PROGRAM.
96.18 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
96.19 	meanings given.
96.20 	(a) "Community" means a town, township, city, or targeted neighborhood within a city, 
96.21 	or a consortium of towns, townships, cities, or targeted neighborhoods within cities.
96.22 	(b) "Core home and community-based services provider" means a Faith in Action, Living 
96.23 	at Home/Block Nurse, congregational nurse, or similar community-based program governed 
96.24 	by a board, the majority of whose members reside within the program's service area, that 
96.25 	organizes and uses volunteers and paid staff to deliver nonmedical services intended to 
96.26 	assist older adults to identify and manage risks and to maintain the older adults' community 
96.27 	living and integration in the community.
96.28 	(c) "Long-term services and supports" means any service available under the elderly 
96.29 	waiver program or alternative care grant programs, nursing facility services, transportation 
96.30 	services, caregiver support and respite care services, and other home and community-based 
96.31 	services identified as necessary either to maintain lifestyle choices for older adults or to 
96.32 	support older adults to remain in their own home.
97.1 	(b) (d) "Older adult services" means any services available under the elderly waiver 
97.2 	program or alternative care grant programs; nursing facility services; transportation services; 
97.3 	respite services; and other community-based services identified as necessary either to 
97.4 	maintain lifestyle choices for older Minnesotans, or to promote independence.
97.5 	(c) (e) "Older adult" refers to individuals 65 years of age and older.
97.6 		Subd. 2.Creation; purpose. (a) The community services development live well at home
97.7 	grants program is are created under the administration of the commissioner of human 
97.8 	services.
97.9 	(b) The purpose of projects selected by the commissioner of human services under this 
97.10 	section is to make strategic changes in the long-term services and supports system for older 
97.11 	adults and people with dementia, including statewide capacity for local service development 
97.12 	and technical assistance and statewide availability of home and community-based services 
97.13 	for older adult services, caregiver support and respite care services, and other supports in 
97.14 	Minnesota. These projects are intended to create incentives for new and expanded home 
97.15 	and community-based services in Minnesota in order to:
97.16 	(1) reach older adults early in the progression of older adults' need for long-term services 
97.17 	and supports, providing them with low-cost, high-impact services that will prevent or delay 
97.18 	the use of more costly services;
97.19 	(2) support older adults to live in the most integrated, least restrictive community setting;
97.20 	(3) support the informal caregivers of older adults;
97.21 	(4) develop and implement strategies to integrate long-term services and supports with 
97.22 	health care services, in order to improve the quality of care and enhance the quality of life 
97.23 	of older adults and older adults' informal caregivers;
97.24 	(5) ensure cost-effective use of financial and human resources;
97.25 	(6) build community-based approaches and community commitment to delivering 
97.26 	long-term services and supports for older adults in their own homes;
97.27 	(7) achieve a broad awareness and use of lower-cost in-home services as an alternative 
97.28 	to nursing homes and other residential services;
97.29 	(8) strengthen and develop additional home and community-based services and 
97.30 	alternatives to nursing homes and other residential services; and
97.31 	(9) strengthen programs that use volunteers.
98.1 	(c) The services provided by these projects are available to older adults who are eligible 
98.2 	for medical assistance and the elderly waiver under chapter 256S, the alternative care 
98.3 	program under section 256B.0913, or the essential community supports grant under section 
98.4 	256B.0922, and to older adults who have their own money to pay for services.
98.5 		Subd. 3.Provision of Community services development grants. The commissioner 
98.6 	shall make community services development grants available to communities, providers of 
98.7 	older adult services identified in subdivision 1, or to a consortium of providers of older 
98.8 	adult services, to establish older adult services. Grants may be provided for capital and other 
98.9 	costs including, but not limited to, start-up and training costs, equipment, and supplies 
98.10 	related to older adult services or other residential or service alternatives to nursing facility 
98.11 	care. Grants may also be made to renovate current buildings, provide transportation services, 
98.12 	fund programs that would allow older adults or individuals with a disability to stay in their 
98.13 	own homes by sharing a home, fund programs that coordinate and manage formal and 
98.14 	informal services to older adults in their homes to enable them to live as independently as 
98.15 	possible in their own homes as an alternative to nursing home care, or expand state-funded 
98.16 	programs in the area.
98.17 		Subd. 3a.Priority for other grants. The commissioner of health shall give priority to 
98.18 	a grantee selected under subdivision 3 when awarding technology-related grants, if the 
98.19 	grantee is using technology as part of the proposal unless that priority conflicts with existing 
98.20 	state or federal guidance related to grant awards by the Department of Health. The 
98.21 	commissioner of transportation shall give priority to a grantee under subdivision 3 when 
98.22 	distributing transportation-related funds to create transportation options for older adults 
98.23 	unless that preference conflicts with existing state or federal guidance related to grant awards 
98.24 	by the Department of Transportation.
98.25 		Subd. 3b.State waivers. The commissioner of health may waive applicable state laws 
98.26 	and rules for grantees under subdivision 3 on a time-limited basis if the commissioner of 
98.27 	health determines that a participating grantee requires a waiver in order to achieve 
98.28 	demonstration project goals.
98.29 		Subd. 3c.Caregiver support and respite care projects. (a) The commissioner shall 
98.30 	establish projects to expand the availability of caregiver support and respite care services 
98.31 	for family and other caregivers. The commissioner shall use a request for proposals to select 
98.32 	nonprofit entities to administer the projects. Projects must:
98.33 	(1) establish a local coordinated network of volunteer and paid respite workers;
98.34 	(2) coordinate assignment of respite care services to caregivers of older adults;
99.1 	(3) assure the health and safety of the older adults;
99.2 	(4) identify at-risk caregivers;
99.3 	(5) provide information, education, and training for caregivers in the designated 
99.4 	community; and
99.5 	(6) demonstrate the need in the proposed service area, particularly where nursing facility 
99.6 	closures have occurred or are occurring or areas with service needs identified by section 
99.7 	144A.351. Preference must be given for projects that reach underserved populations.
99.8 	(b) Projects must clearly describe:
99.9 	(1) how they will achieve their purpose;
99.10 	(2) the process for recruiting, training, and retraining volunteers; and
99.11 	(3) a plan to promote the project in the designated community, including outreach to 
99.12 	older adults needing the services.
99.13 	(c) Money for all projects under this subdivision may be used to:
99.14 	(1) hire a coordinator to develop a coordinated network of volunteer and paid respite 
99.15 	care services and assign workers to clients;
99.16 	(2) recruit and train volunteer providers;
99.17 	(3) provide information, training, and education to caregivers;
99.18 	(4) advertise the availability of the caregiver support and respite care project; and
99.19 	(5) purchase equipment to maintain a system of assigning workers to clients.
99.20 	(d) Volunteer and caregiver training must include resources on how to support an 
99.21 	individual with dementia.
99.22 	(e) Project money may not be used to supplant existing funding sources.
99.23 		Subd. 3d.Core home and community-based services projects. The commissioner 
99.24 	shall select and contract with core home and community-based services providers for projects 
99.25 	to provide services and supports to older adults both with and without family and other 
99.26 	informal caregivers using a request for proposals process. Projects must:
99.27 	(1) have a credible public or private nonprofit sponsor providing ongoing financial 
99.28 	support;
99.29 	(2) have a specific, clearly defined geographic service area;
100.1 	(3) use a practice framework designed to identify high-risk older adults and help them 
100.2 	take action to better manage their chronic conditions and maintain their community living;
100.3 	(4) have a team approach to coordination and care, ensuring that the older adult 
100.4 	participants, participants families, and the formal and informal providers are all part of 
100.5 	planning and providing services;
100.6 	(5) provide information, support services, homemaking services, counseling, and training 
100.7 	for the older adults and family caregivers;
100.8 	(6) encourage service area or neighborhood residents and local organizations to 
100.9 	collaborate in meeting the needs of older adults in their geographic service areas;
100.10 	(7) recruit, train, and direct the use of volunteers to provide informal services and other 
100.11 	appropriate support to older adults and their caregivers; and
100.12 	(8) provide coordination and management of formal and informal services to older adults 
100.13 	and older adults families using less expensive alternatives.
100.14 		Subd. 3e.Community service grants. The commissioner shall award contracts for 
100.15 	grants to public and private nonprofit agencies to establish services that strengthen a 
100.16 	community's ability to provide a system of home and community-based services for elderly 
100.17 	persons. The commissioner shall use a request for proposals process.
100.18 		Subd. 3f.Live Well at Home grant extensions.  (a) A current grantee under subdivision 
100.19 	3, 3c, 3d, or 3e may apply to the commissioner to receive on a noncompetitive basis up to 
100.20 	two years of additional funding.
100.21 	(b) To be eligible for a grant extension, a grant extension applicant must have been 
100.22 	awarded a grant under this section within the previous five years and provide at least one 
100.23 	eligible service in an underserved community. The grantee must submit to the commissioner 
100.24 	a letter of intent to continue providing the eligible service after the expiration of a grant 
100.25 	extension provided under this subdivision.
100.26 	(c) The commissioner of human services must give priority to submitted letters of intent 
100.27 	from grantees who have demonstrated success in providing chore services, homemaker 
100.28 	services, transportation services, grocery services, caregiver supports, service coordination, 
100.29 	or other home and community-based services to older adults in underserved communities.
100.30 	(d) Notwithstanding section 16B.98, subdivision 5, paragraph (b), the commissioner 
100.31 	may from within available appropriations extend a grant agreement up to two additional 
100.32 	years, not to exceed seven years, for grantees the commissioner determines can successfully 
101.1 	sustain the grantee's Live Well at Home project with the additional funds made available 
101.2 	through the grant agreement extension.
101.3 		Subd. 4.Eligibility. Grants may be awarded only to communities and providers or to a 
101.4 	consortium of providers that have a local match of 50 percent of the costs for the project in 
101.5 	the form of donations, local tax dollars, in-kind donations, fundraising, or other local matches.
101.6 		Subd. 5.Grant preference. The commissioner of human services shall give preference 
101.7 	when awarding grants under this section to areas where nursing facility closures have 
101.8 	occurred or are occurring or areas with service needs identified by section 144A.351. The 
101.9 	commissioner may award grants to the extent grant funds are available and to the extent 
101.10 	applications are approved by the commissioner. Denial of approval of an application in one 
101.11 	year does not preclude submission of an application in a subsequent year. The maximum 
101.12 	grant amount is limited to $750,000.

101.13 	Sec. 3. [256.9756] CAREGIVER RESPITE SERVICES GRANTS.
101.14 		Subdivision 1.Caregiver respite services grant program established. The Minnesota 
101.15 	Board on Aging must establish a caregiver respite services grant program to increase the 
101.16 	availability of respite services for family caregivers of people with dementia and older adults 
101.17 	and to provide information, education, and training to respite caregivers and volunteers 
101.18 	regarding caring for people with dementia. From the money made available for this purpose, 
101.19 	the board must award grants on a competitive basis to respite service providers, giving 
101.20 	priority to areas of the state where there is a high need of respite services.
101.21 		Subd. 2.Eligible uses. Grant recipients awarded grant money under this section must 
101.22 	use a portion of the grant award as determined by the board to provide free or subsidized 
101.23 	respite services for family caregivers of people with dementia and older adults.
101.24 		Subd. 3.Report. By January 15, 2026, the board shall submit a progress report about 
101.25 	the caregiver respite services grants in this section to the chairs and ranking minority members 
101.26 	of the legislative committees and divisions with jurisdiction over human services finance 
101.27 	and policy. The progress report must include metrics of the use of grant program money. 
101.28 	This subdivision expires upon submission of the report. The board shall notify the revisor 
101.29 	of statutes when the report is submitted.

102.1 	Sec. 4. Minnesota Statutes 2022, section 256B.0913, subdivision 4, is amended to read:
102.2 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients. (a) 
102.3 	Funding for services under the alternative care program is available to persons who meet 
102.4 	the following criteria:
102.5 	(1) the person is a citizen of the United States or a United States national;
102.6 	(2) the person has been determined by a community assessment under section 256B.0911 
102.7 	to be a person who would require the level of care provided in a nursing facility, as 
102.8 	determined under section 256B.0911, subdivision 26, but for the provision of services under 
102.9 	the alternative care program;
102.10 	(3) the person is age 65 or older;
102.11 	(4) the person would be eligible for medical assistance within 135 days of admission to 
102.12 	a nursing facility;
102.13 	(5) the person is not ineligible for the payment of long-term care services by the medical 
102.14 	assistance program due to an asset transfer penalty under section 256B.0595 or equity 
102.15 	interest in the home exceeding $500,000 as stated in section 256B.056;
102.16 	(6) the person needs long-term care services that are not funded through other state or 
102.17 	federal funding, or other health insurance or other third-party insurance such as long-term 
102.18 	care insurance;
102.19 	(7) except for individuals described in clause (8), the monthly cost of the alternative 
102.20 	care services funded by the program for this person does not exceed 75 percent of the 
102.21 	monthly limit described under section 256S.18. This monthly limit does not prohibit the 
102.22 	alternative care client from payment for additional services, but in no case may the cost of 
102.23 	additional services purchased under this section exceed the difference between the client's 
102.24 	monthly service limit defined under section 256S.04, and the alternative care program 
102.25 	monthly service limit defined in this paragraph. If care-related supplies and equipment or 
102.26 	environmental modifications and adaptations are or will be purchased for an alternative 
102.27 	care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive 
102.28 	months beginning with the month of purchase. If the monthly cost of a recipient's other 
102.29 	alternative care services exceeds the monthly limit established in this paragraph, the annual 
102.30 	cost of the alternative care services shall be determined. In this event, the annual cost of 
102.31 	alternative care services shall not exceed 12 times the monthly limit described in this 
102.32 	paragraph;
103.1 	(8) for individuals assigned a case mix classification A as described under section 
103.2 	256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies 
103.3 	in bathing, dressing, grooming, walking, and eating when the dependency score in eating 
103.4 	is three or greater as determined by an assessment performed under section 256B.0911, the 
103.5 	monthly cost of alternative care services funded by the program cannot exceed $593 per 
103.6 	month for all new participants enrolled in the program on or after July 1, 2011. This monthly 
103.7 	limit shall be applied to all other participants who meet this criteria at reassessment. This 
103.8 	monthly limit shall be increased annually as described in section 256S.18. This monthly 
103.9 	limit does not prohibit the alternative care client from payment for additional services, but 
103.10 	in no case may the cost of additional services purchased exceed the difference between the 
103.11 	client's monthly service limit defined in this clause and the limit described in clause (7) for 
103.12 	case mix classification A; and
103.13 	(9) the person is making timely payments of the assessed monthly fee. A person is 
103.14 	ineligible if payment of the fee is over 60 days past due, unless the person agrees to:
103.15 	(i) the appointment of a representative payee;
103.16 	(ii) automatic payment from a financial account;
103.17 	(iii) the establishment of greater family involvement in the financial management of 
103.18 	payments; or
103.19 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.; and
103.20 	(10) for a person participating in consumer-directed community supports, the person's 
103.21 	monthly service limit must be equal to the monthly service limits in clause (7), except that 
103.22 	a person assigned a case mix classification L must receive the monthly service limit for 
103.23 	case mix classification A.
103.24 	(b) The lead agency may extend the client's eligibility as necessary while making 
103.25 	arrangements to facilitate payment of past-due amounts and future premium payments. 
103.26 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
103.27 	reinstated for a period of 30 days.
103.28 	(c) Alternative care funding under this subdivision is not available for a person who is 
103.29 	a medical assistance recipient or who would be eligible for medical assistance without a 
103.30 	spenddown or waiver obligation. A person whose initial application for medical assistance 
103.31 	and the elderly waiver program is being processed may be served under the alternative care 
103.32 	program for a period up to 60 days. If the individual is found to be eligible for medical 
103.33 	assistance, medical assistance must be billed for services payable under the federally 
104.1 	approved elderly waiver plan and delivered from the date the individual was found eligible 
104.2 	for the federally approved elderly waiver plan. Notwithstanding this provision, alternative 
104.3 	care funds may not be used to pay for any service the cost of which: (i) is payable by medical 
104.4 	assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a 
104.5 	medical assistance income spenddown for a person who is eligible to participate in the 
104.6 	federally approved elderly waiver program under the special income standard provision.
104.7 	(d) Alternative care funding is not available for a person who resides in a licensed nursing 
104.8 	home, certified boarding care home, hospital, or intermediate care facility, except for case 
104.9 	management services which are provided in support of the discharge planning process for 
104.10 	a nursing home resident or certified boarding care home resident to assist with a relocation 
104.11 	process to a community-based setting.
104.12 	(e) Alternative care funding is not available for a person whose income is greater than 
104.13 	the maintenance needs allowance under section 256S.05, but equal to or less than 120 percent 
104.14 	of the federal poverty guideline effective July 1 in the fiscal year for which alternative care 
104.15 	eligibility is determined, who would be eligible for the elderly waiver with a waiver 
104.16 	obligation.

104.17 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
104.18 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
104.19 	when approval is obtained.

104.20 	Sec. 5. Minnesota Statutes 2022, section 256B.0913, subdivision 5, is amended to read:
104.21 		Subd. 5.Services covered under alternative care. Alternative care funding may be 
104.22 	used for payment of costs of:
104.23 	(1) adult day services and adult day services bath;
104.24 	(2) home care;
104.25 	(3) homemaker services;
104.26 	(4) personal care;
104.27 	(5) case management and conversion case management;
104.28 	(6) respite care;
104.29 	(7) specialized supplies and equipment;
104.30 	(8) home-delivered meals;
104.31 	(9) nonmedical transportation;
105.1 	(10) nursing services;
105.2 	(11) chore services;
105.3 	(12) companion services;
105.4 	(13) nutrition services;
105.5 	(14) family caregiver training and education;
105.6 	(15) coaching and counseling;
105.7 	(16) telehome care to provide services in their own homes in conjunction with in-home 
105.8 	visits;
105.9 	(17) consumer-directed community supports under the alternative care programs which 
105.10 	are available statewide and limited to the average monthly expenditures representative of 
105.11 	all alternative care program participants for the same case mix resident class assigned in 
105.12 	the most recent fiscal year for which complete expenditure data is available;
105.13 	(18) environmental accessibility and adaptations; and
105.14 	(19) discretionary services, for which lead agencies may make payment from their 
105.15 	alternative care program allocation for services not otherwise defined in this section or 
105.16 	section 256B.0625, following approval by the commissioner.
105.17 	Total annual payments for discretionary services for all clients served by a lead agency 
105.18 	must not exceed 25 percent of that lead agency's annual alternative care program base 
105.19 	allocation, except that when alternative care services receive federal financial participation 
105.20 	under the 1115 waiver demonstration, funding shall be allocated in accordance with 
105.21 	subdivision 17.

105.22 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
105.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
105.24 	when approval is obtained.

105.25 	Sec. 6. Minnesota Statutes 2022, section 256B.0917, subdivision 1b, is amended to read:
105.26 		Subd. 1b.Definitions. (a) For purposes of this section, the following terms have the 
105.27 	meanings given.
105.28 	(b) "Community" means a town; township; city; or targeted neighborhood within a city; 
105.29 	or a consortium of towns, townships, cities, or specific neighborhoods within a city.
105.30 	(c) "Core home and community-based services provider" means a Faith in Action, Living 
105.31 	at Home Block Nurse, Congregational Nurse, or similar community-based program governed 
106.1 	by a board, the majority of whose members reside within the program's service area, that 
106.2 	organizes and uses volunteers and paid staff to deliver nonmedical services intended to 
106.3 	assist older adults to identify and manage risks and to maintain their community living and 
106.4 	integration in the community.
106.5 	(d) "Eldercare development partnership" means a team of representatives of county 
106.6 	social service and public health agencies, the area agency on aging, local nursing home 
106.7 	providers, local home care providers, and other appropriate home and community-based 
106.8 	providers in the area agency's planning and service area.
106.9 	(e) (c) "Long-term services and supports" means any service available under the elderly 
106.10 	waiver program or alternative care grant programs, nursing facility services, transportation 
106.11 	services, caregiver support and respite care services, and other home and community-based 
106.12 	services identified as necessary either to maintain lifestyle choices for older adults or to 
106.13 	support them to remain in their own home.
106.14 	(f) (d) "Older adult" refers to an individual who is 65 years of age or older.

106.15 	Sec. 7. Minnesota Statutes 2022, section 256M.42, is amended to read:
106.16 	256M.42 ADULT PROTECTION GRANT ALLOCATIONS.
106.17 		Subdivision 1.Formula. (a) The commissioner shall allocate state money appropriated 
106.18 	under this section on an annual basis to each county board and tribal government approved 
106.19 	by the commissioner to assume county agency duties for adult protective services or as a 
106.20 	lead investigative agency protection under section 626.557on an annual basis in an amount 
106.21 	determined and to Tribal Nations that have voluntarily chosen by resolution of Tribal 
106.22 	government to participate in vulnerable adult protection programs according to the following 
106.23 	formula after the award of the amounts in paragraph (c):
106.24 	(1) 25 percent must be allocated to the responsible agency on the basis of the number 
106.25 	of reports of suspected vulnerable adult maltreatment under sections 626.557 and 626.5572, 
106.26 	when the county or tribe is responsible as determined by the most recent data of the 
106.27 	commissioner; and
106.28 	(2) 75 percent must be allocated to the responsible agency on the basis of the number 
106.29 	of screened-in reports for adult protective services or vulnerable adult maltreatment 
106.30 	investigations under sections 626.557 and 626.5572, when the county or tribe is responsible
106.31 	as determined by the most recent data of the commissioner.
106.32 	(b) The commissioner is precluded from changing the formula under this subdivision 
106.33 	or recommending a change to the legislature without public review and input.
107.1 	Notwithstanding paragraph (a), the commissioner must not award a county less than a 
107.2 	minimum allocation established by the commissioner.
107.3 	(c) To receive money under this subdivision, a participating Tribal Nation must apply 
107.4 	to the commissioner. Of the amount appropriated for purposes of this section, the 
107.5 	commissioner must award $100,000 to each federally recognized Tribal Nation that has 
107.6 	applied to the commissioner and has a Tribal resolution establishing a vulnerable adult 
107.7 	protection program. Money received by a Tribal Nation under this section must be used for 
107.8 	its vulnerable adult protection program.
107.9 		Subd. 2.Payment. The commissioner shall make allocations for the state fiscal year 
107.10 	starting July 1, 2019 2023, and to each county board or Tribal government on or before 
107.11 	October 10, 2019 2023. The commissioner shall make allocations under subdivision 1 to 
107.12 	each county board or Tribal government each year thereafter on or before July 10.
107.13 		Subd. 3.Prohibition on supplanting existing money Purpose of expenditures. Money 
107.14 	received under this section must be used for staffing for protection of vulnerable adults or 
107.15 	to meet the agency's duties under section 626.557 and to expand adult protective services
107.16 	to stop, prevent, and reduce risks of maltreatment for adults accepted for services under 
107.17 	section 626.557, or for multidisciplinary teams under section 626.5571. Money must not 
107.18 	be used to supplant current county or tribe expenditures for these purposes.
107.19 		Subd. 4.Required expenditures. State money must be used to expand, not supplant,  
107.20 	county or Tribal expenditures for the fiscal year 2023 base for adult protection programs, 
107.21 	service interventions, or multidisciplinary teams. A county receiving money under this 
107.22 	section must maintain a level of yearly county expenditures for adult protection services 
107.23 	under chapter 626 at least equal to that county's average expenditures for those services for 
107.24 	calendar years 2022 and 2023.
107.25 		Subd. 5.County performance on adult protection measures. The commissioner must 
107.26 	set vulnerable adult protection measures and standards for money received under this section. 
107.27 	The commissioner must require an underperforming county to demonstrate that the county 
107.28 	designated money allocated under this section for the purpose required and implemented a 
107.29 	reasonable strategy to improve adult protection performance, including the development of 
107.30 	a performance improvement plan and additional remedies identified by the commissioner. 
107.31 	The commissioner may redirect up to 20 percent of an underperforming county's money 
107.32 	under this section toward the performance improvement plan.
108.1 		Subd. 6.American Indian adult protection. Tribal Nations receiving money under 
108.2 	this section must establish vulnerable adult protection measures and standards and report 
108.3 	annually to the commissioner on these outcomes and the number of adults served.

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

108.5 	Sec. 8. Minnesota Statutes 2022, section 256R.17, subdivision 2, is amended to read:
108.6 		Subd. 2.Case mix indices. (a) The commissioner shall assign a case mix index to each 
108.7 	case mix classification based on the Centers for Medicare and Medicaid Services staff time 
108.8 	measurement study as determined by the commissioner of health under section 144.0724.
108.9 	(b) An index maximization approach shall be used to classify residents. "Index 
108.10 	maximization" has the meaning given in section 144.0724, subdivision 2, paragraph (c).

108.11 	Sec. 9. Minnesota Statutes 2022, section 256R.25, is amended to read:
108.12 	256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
108.13 	(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs 
108.14 	(b) to (o) (p).
108.15 	(b) For a facility licensed as a nursing home, the portion related to the provider surcharge 
108.16 	under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a 
108.17 	nursing home and a boarding care home, the portion related to the provider surcharge under 
108.18 	section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number 
108.19 	of nursing home beds divided by its total number of licensed beds.
108.20 	(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the 
108.21 	amount of the fee divided by the sum of the facility's resident days.
108.22 	(d) The portion related to development and education of resident and family advisory 
108.23 	councils under section 144A.33 is $5 per resident day divided by 365.
108.24 	(e) The portion related to scholarships is determined under section 256R.37.
108.25 	(f) The portion related to planned closure rate adjustments is as determined under section 
108.26 	256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
108.27 	(g) The portion related to consolidation rate adjustments shall be as determined under 
108.28 	section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.
108.29 	(h) The portion related to single-bed room incentives is as determined under section 
108.30 	256R.41.
109.1 	(i) The portions related to real estate taxes, special assessments, and payments made in 
109.2 	lieu of real estate taxes directly identified or allocated to the nursing facility are the allowable 
109.3 	amounts divided by the sum of the facility's resident days. Allowable costs under this 
109.4 	paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate 
109.5 	taxes shall not exceed the amount which the nursing facility would have paid to a city or 
109.6 	township and county for fire, police, sanitation services, and road maintenance costs had 
109.7 	real estate taxes been levied on that property for those purposes.
109.8 	(j) The portion related to employer health insurance costs is the allowable costs divided 
109.9 	by the sum of the facility's resident days.
109.10 	(k) The portion related to the Public Employees Retirement Association is the allowable 
109.11 	costs divided by the sum of the facility's resident days.
109.12 	(l) The portion related to quality improvement incentive payment rate adjustments is 
109.13 	the amount determined under section 256R.39.
109.14 	(m) The portion related to performance-based incentive payments is the amount 
109.15 	determined under section 256R.38.
109.16 	(n) The portion related to special dietary needs is the amount determined under section 
109.17 	256R.51.
109.18 	(o) The portion related to the rate adjustments for border city facilities is the amount 
109.19 	determined under section 256R.481.
109.20 	(p) The portion related to the rate adjustment for critical access nursing facilities is the 
109.21 	amount determined under section 256R.47.

109.22 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
109.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
109.24 	when federal approval is obtained.

109.25 	Sec. 10. Minnesota Statutes 2022, section 256R.47, is amended to read:
109.26 	256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING 
109.27 	FACILITIES.
109.28 	(a) The commissioner, in consultation with the commissioner of health, may designate 
109.29 	certain nursing facilities as critical access nursing facilities. The designation shall be granted 
109.30 	on a competitive basis, within the limits of funds appropriated for this purpose.
109.31 	(b) The commissioner shall request proposals from nursing facilities every two years. 
109.32 	Proposals must be submitted in the form and according to the timelines established by the 
110.1 	commissioner. In selecting applicants to designate, the commissioner, in consultation with 
110.2 	the commissioner of health, and with input from stakeholders, shall develop criteria designed 
110.3 	to preserve access to nursing facility services in isolated areas, rebalance long-term care, 
110.4 	and improve quality. To the extent practicable, the commissioner shall ensure an even 
110.5 	distribution of designations across the state.
110.6 	(c) The commissioner shall allow the benefits in clauses (1) to (5) For nursing facilities 
110.7 	designated as critical access nursing facilities:, the commissioner shall allow a supplemental 
110.8 	payment above a facility's operating payment rate as determined to be necessary by the 
110.9 	commissioner to maintain access to nursing facility services in isolated areas identified in 
110.10 	paragraph (b). The commissioner must approve the amounts of supplemental payments 
110.11 	through a memorandum of understanding. Supplemental payments to facilities under this 
110.12 	section must be in the form of time-limited rate adjustments included in the external fixed 
110.13 	costs payment rate under section 256R.25.
110.14 	(1) partial rebasing, with the commissioner allowing a designated facility operating 
110.15 	payment rates being the sum of up to 60 percent of the operating payment rate determined 
110.16 	in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of 
110.17 	the two portions being equal to 100 percent, of the operating payment rate that would have 
110.18 	been allowed had the facility not been designated. The commissioner may adjust these 
110.19 	percentages by up to 20 percent and may approve a request for less than the amount allowed;
110.20 	(2) enhanced payments for leave days. Notwithstanding section 256R.43, upon 
110.21 	designation as a critical access nursing facility, the commissioner shall limit payment for 
110.22 	leave days to 60 percent of that nursing facility's total payment rate for the involved resident, 
110.23 	and shall allow this payment only when the occupancy of the nursing facility, inclusive of 
110.24 	bed hold days, is equal to or greater than 90 percent;
110.25 	(3) two designated critical access nursing facilities, with up to 100 beds in active service, 
110.26 	may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part 
110.27 	4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner 
110.28 	of health shall consider each waiver request independently based on the criteria under 
110.29 	Minnesota Rules, part 4658.0040;
110.30 	(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall 
110.31 	be 40 percent of the amount that would otherwise apply; and
110.32 	(5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to 
110.33 	designated critical access nursing facilities.
111.1 	(d) Designation of a critical access nursing facility is for a maximum period of up to 
111.2 	two years, after which the benefits benefit allowed under paragraph (c) shall be removed. 
111.3 	Designated facilities may apply for continued designation.
111.4 	(e) This section is suspended and no state or federal funding shall be appropriated or 
111.5 	allocated for the purposes of this section from January 1, 2016, to December 31, 2019.
111.6 	(e) The memorandum of understanding required by paragraph (c) must state that the 
111.7 	designation of a critical access nursing facility must be removed if the facility undergoes a 
111.8 	change of ownership as defined in section 144A.06, subdivision 2.

111.9 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
111.10 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
111.11 	when federal approval is obtained.

111.12 	Sec. 11. Minnesota Statutes 2022, section 256R.53, is amended by adding a subdivision 
111.13 	to read:
111.14 		Subd. 3.Nursing facility in Red Wing. (a) The operating payment rate for a facility 
111.15 	located in the city of Red Wing at 1412 West 4th Street is the sum of its direct care costs 
111.16 	per standardized day, its other care-related costs per resident day, and its other operating 
111.17 	costs per day.
111.18 	(b) This subdivision expires June 30, 2025.

111.19 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
111.20 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
111.21 	when federal approval is obtained.

111.22 	Sec. 12. [256R.55] FINANCIALLY DISTRESSED NURSING FACILITY LOAN 
111.23 	PROGRAM.
111.24 		Subdivision 1.Financially distressed nursing facility loans. The commissioner of 
111.25 	human services shall establish a competitive financially distressed nursing facility loan 
111.26 	program to provide operating loans to eligible nursing facilities. The commissioner shall 
111.27 	initiate the application process for the loan described in this section at least once annually. 
111.28 	A second application process may be initiated each year at the discretion of the commissioner.
111.29 		Subd. 2.Eligibility. To be an eligible applicant for a loan under this section, a nursing 
111.30 	facility must submit to the commissioner of human services a loan application in the form 
111.31 	and according to the timelines established by the commissioner. In its loan application, a 
111.32 	loan applicant must demonstrate that:
112.1 	(1) the total net income of the nursing facility is not generating sufficient revenue to 
112.2 	cover the nursing facility's operating expenses;
112.3 	(2) the nursing facility is at risk of closure; and
112.4 	(3) additional operating revenue is necessary to either preserve access to nursing facility 
112.5 	services within the community or support people with complex, high-acuity support needs.
112.6 		Subd. 3.Approving loans. The commissioner must evaluate all loan applications on a 
112.7 	competitive basis and award loans to successful applicants within available appropriations 
112.8 	for this purpose. The commissioner's decisions are final and not subject to appeal.
112.9 		Subd. 4.Disbursement schedule. Successful loan applicants under this section may 
112.10 	receive loan disbursements as a lump sum, on an agreed upon disbursement schedule, or as 
112.11 	a time-limited line of credit. The commissioner shall approve disbursements to successful 
112.12 	loan applicants through a memorandum of understanding. Memoranda of understanding 
112.13 	must specify the amount and schedule of loan disbursements.
112.14 		Subd. 5.Loan administration. The commissioner may contract with an independent 
112.15 	third party to administer the loan program under this section.
112.16 		Subd. 6.Loan payments. The commissioner shall negotiate the terms of the loan 
112.17 	repayment, including the start of the repayment plan, the due date of the repayment, and 
112.18 	the frequency of the repayment installments. Repayment installments must not begin until 
112.19 	at least 18 months after the first disbursement date. The memoranda of understanding must 
112.20 	specify the amount and schedule of loan payments. The repayment term must not exceed 
112.21 	72 months. If any loan payment to the commissioner is not paid within the time specified 
112.22 	by the memoranda of understanding, the late payment must be assessed a penalty rate of 
112.23 	0.01 percent of the original loan amount each month the payment is past due. This late fee 
112.24 	is not an allowable cost on the department's cost report. The commissioner shall have the 
112.25 	power to abate penalties when discrepancies occur resulting from but not limited to 
112.26 	circumstances of error and mail delivery.
112.27 		Subd. 7.Loan repayment. (a) If a borrower is more than 60 calendar days delinquent 
112.28 	in the timely payment of a contractual payment under this section, the provisions in 
112.29 	paragraphs (b) to (e) apply.
112.30 	(b) The commissioner may withhold some or all of the amount of the delinquent loan 
112.31 	payment, together with any penalties due and owing on those amounts, from any money 
112.32 	the department owes to the borrower. The commissioner may, at the commissioner's 
112.33 	discretion, also withhold future contractual payments from any money the commissioner 
113.1 	owes the provider as those contractual payments become due and owing. The commissioner 
113.2 	may continue this withholding until the commissioner determines there is no longer any 
113.3 	need to do so.
113.4 	(c) The commissioner shall give prior notice of the commissioner's intention to withhold 
113.5 	by mail, facsimile, or email at least ten business days before the date of the first payment 
113.6 	period for which the withholding begins. The notice must be deemed received as of the date 
113.7 	of mailing or receipt of the facsimile or electronic notice. The notice must:
113.8 	(1) state the amount of the delinquent contractual payment;
113.9 	(2) state the amount of the withholding per payment period;
113.10 	(3) state the date on which the withholding is to begin;
113.11 	(4) state whether the commissioner intends to withhold future installments of the 
113.12 	provider's contractual payments; and
113.13 	(5) state other contents as the commissioner deems appropriate.
113.14 	(d) The commissioner, or the commissioner's designee, may enter into written settlement 
113.15 	agreements with a provider to resolve disputes and other matters involving unpaid loan 
113.16 	contractual payments or future loan contractual payments.
113.17 	(e) Notwithstanding any law to the contrary, all unpaid loans, plus any accrued penalties, 
113.18 	are overpayments for the purposes of section 256B.0641, subdivision 1. The current owner 
113.19 	of a nursing home or boarding care home is liable for the overpayment amount owed by a 
113.20 	former owner for any facility sold, transferred, or reorganized.
113.21 		Subd. 8.Audit. Loan money allocated under this section are subject to audit to determine 
113.22 	whether the money was spent as authorized under this section.
113.23 		Subd. 9.Carryforward. Notwithstanding section 16A.28, subdivision 3, any 
113.24 	appropriation for the purposes under this section carry forward and do not lapse until the 
113.25 	close of the fiscal year in which this section expires.
113.26 		Subd. 10.Expiration. This section expires June 30, 2029.

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

113.28 	Sec. 13. Minnesota Statutes 2022, section 256S.15, subdivision 2, is amended to read:
113.29 		Subd. 2.Foster care limit. The elderly waiver payment for the foster care service in 
113.30 	combination with the payment for all other elderly waiver services, including case 
113.31 	management, must not exceed the monthly case mix budget cap for the participant as 
114.1 	specified in sections 256S.18, subdivision 3, and 256S.19, subdivisions subdivision 3and 
114.2 	4.

114.3 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
114.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
114.5 	when approval is obtained.

114.6 	Sec. 14. Minnesota Statutes 2022, section 256S.18, is amended by adding a subdivision 
114.7 	to read:
114.8 		Subd. 3a.Monthly case mix budget caps for consumer-directed community 
114.9 	supports. The monthly case mix budget caps for each case mix classification for 
114.10 	consumer-directed community supports must be equal to the monthly case mix budget caps 
114.11 	in subdivision 3.

114.12 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
114.13 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
114.14 	when approval is obtained.

114.15 	Sec. 15. Minnesota Statutes 2022, section 256S.19, subdivision 3, is amended to read:
114.16 		Subd. 3.Calculation of monthly conversion budget cap without consumer-directed 
114.17 	community supports caps. (a) The elderly waiver monthly conversion budget cap for the 
114.18 	cost of elderly waiver services without consumer-directed community supports must be 
114.19 	based on the nursing facility case mix adjusted total payment rate of the nursing facility 
114.20 	where the elderly waiver applicant currently resides for the applicant's case mix classification 
114.21 	as determined according to section 256R.17.
114.22 	(b) The elderly waiver monthly conversion budget cap for the cost of elderly waiver 
114.23 	services without consumer-directed community supports shall must be calculated by 
114.24 	multiplying the applicable nursing facility case mix adjusted total payment rate by 365, 
114.25 	dividing by 12, and subtracting the participant's maintenance needs allowance.
114.26 	(c) A participant's initially approved monthly conversion budget cap for elderly waiver 
114.27 	services without consumer-directed community supports shall must be adjusted at least 
114.28 	annually as described in section 256S.18, subdivision 5.
114.29 	(d) Conversion budget caps for individuals participating in consumer-directed community 
114.30 	supports must be set as described in paragraphs (a) to (c).

115.1 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
115.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
115.3 	when approval is obtained.

115.4 	Sec. 16. Minnesota Statutes 2022, section 256S.21, is amended to read:
115.5 	256S.21 RATE SETTING; APPLICATION; EVALUATION.
115.6 		Subdivision 1.Application of rate setting. The paymentrate methodologies in sections 
115.7 	256S.2101 to 256S.215 apply to:
115.8 	(1) elderly waiver, elderly waiver customized living, and elderly waiver foster care under 
115.9 	this chapter;
115.10 	(2) alternative care under section 256B.0913;
115.11 	(3) essential community supports under section 256B.0922; and
115.12 	(4) community access for disability inclusion customized living and brain injury 
115.13 	customized living under section 256B.49.
115.14 		Subd. 2.Evaluation of rate setting. (a) Beginning January 1, 2024, and every two years 
115.15 	thereafter, the commissioner, in consultation with stakeholders, shall use all available data 
115.16 	and resources to evaluate the following rate setting elements:
115.17 	(1) the base wage index;
115.18 	(2) the factors and supervision wage components; and
115.19 	(3) the formulas to calculate adjusted base wages and rates.
115.20 	(b) Beginning January 15, 2026, and every two years thereafter, the commissioner shall 
115.21 	report to the chairs and ranking minority members of the legislative committees and divisions 
115.22 	with jurisdiction over health and human services finance and policy with a full report on 
115.23 	the information and data gathered under paragraph (a).
115.24 		Subd. 3.Cost reporting. (a) As determined by the commissioner, in consultation with 
115.25 	stakeholders, a provider enrolled to provide services with rates determined under this chapter 
115.26 	must submit requested cost data to the commissioner to support evaluation of the rate 
115.27 	methodologies in this chapter. Requested cost data may include but are not limited to:
115.28 	(1) worker wage costs;
115.29 	(2) benefits paid;
115.30 	(3) supervisor wage costs;
116.1 	(4) executive wage costs;
116.2 	(5) vacation, sick, and training time paid;
116.3 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
116.4 	(7) administrative costs paid;
116.5 	(8) program costs paid;
116.6 	(9) transportation costs paid;
116.7 	(10) vacancy rates; and
116.8 	(11) other data relating to costs required to provide services requested by the 
116.9 	commissioner.
116.10 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
116.11 	year that ended not more than 18 months prior to the submission date. The commissioner 
116.12 	shall provide each provider a 90-day notice prior to the provider's submission due date. If 
116.13 	by 30 days after the required submission date a provider fails to submit required reporting 
116.14 	data, the commissioner shall provide notice to the provider, and if by 60 days after the 
116.15 	required submission date a provider has not provided the required data, the commissioner 
116.16 	shall provide a second notice. The commissioner shall temporarily suspend payments to the 
116.17 	provider if cost data is not received 90 days after the required submission date. Withheld 
116.18 	payments must be made once data is received by the commissioner.
116.19 	(c) The commissioner shall coordinate the cost reporting activities required under this 
116.20 	section with the cost reporting activities directed under section 256B.4914, subdivision 10a.
116.21 	(d) The commissioner shall analyze cost documentation in paragraph (a) and, in 
116.22 	consultation with stakeholders, may submit recommendations on rate methodologies in this 
116.23 	chapter, including ways to monitor and enforce the spending requirements directed in section 
116.24 	256S.2101, subdivision 3, through the reports directed by subdivision 2.

116.25 	EFFECTIVE DATE. Subdivisions 1 and 2 are effective January 1, 2024, or upon 
116.26 	federal approval, whichever is later. Subdivision 3 is effective January 1, 2025. The 
116.27 	commissioner of human services shall notify the revisor of statutes when approval is obtained.

117.1 	Sec. 17. Minnesota Statutes 2022, section 256S.211, is amended to read:
117.2 	256S.211 RATE SETTING; RATE ESTABLISHMENT UPDATING RATES; 
117.3 	SPENDING REQUIREMENTS.
117.4 		Subdivision 1.Establishing base wages. When establishing and updating the base wages 
117.5 	according to section 256S.212, the commissioner shall use standard occupational 
117.6 	classification (SOC) codes from the Bureau of Labor Statistics as defined in the edition of 
117.7 	the Occupational Handbook published immediately prior to January 1, 2019, using 
117.8 	Minnesota-specific wages taken from job descriptions.
117.9 		Subd. 2.Establishing Updating rates. By January 1 of each year, On January 1, 2024,
117.10 	the commissioner shall establish factors, update component rates, and rates according to 
117.11 	sections 256S.213 and 256S.212 to256S.215, using base wages established according to 
117.12 	section 256S.212 the data referenced in subdivision 1.
117.13 		Subd. 3.Updating home-delivered meals rate. On January 1 of each year, the 
117.14 	commissioner must update the home-delivered meals rate in section 256S.215, subdivision 
117.15 	15, by the percent increase in the nursing facility dietary per diem using the two most recently 
117.16 	available nursing facility cost reports.
117.17 		Subd. 4.Spending requirements. (a) Except for community access for disability 
117.18 	inclusion customized living and brain injury customized living under section 256B.49, 
117.19 	home-delivered meals, and designated disproportionate share facilities under section 
117.20 	256S.205, at least 80 percent of the marginal increase in revenue from the implementation 
117.21 	of any rate adjustments under this section must be used to increase compensation-related 
117.22 	costs for employees directly employed by the provider.
117.23 	(b) For the purposes of this subdivision, compensation-related costs include:
117.24 	(1) wages and salaries;
117.25 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment 
117.26 	taxes, workers' compensation, and mileage reimbursement;
117.27 	(3) the employer's paid share of health and dental insurance, life insurance, disability 
117.28 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
117.29 	employee retirement accounts; and
117.30 	(4) benefits that address direct support professional workforce needs above and beyond 
117.31 	what employees were offered prior to the implementation of any rate adjustments under 
117.32 	this section, including any concurrent or subsequent adjustments to the base wage indices.
118.1 	(c) Compensation-related costs for persons employed in the central office of a corporation 
118.2 	or entity that has an ownership interest in the provider or exercises control over the provider, 
118.3 	or for persons paid by the provider under a management contract, do not count toward the 
118.4 	80 percent requirement under this subdivision.
118.5 	(d) A provider agency or individual provider that receives additional revenue subject to 
118.6 	the requirements of this subdivision shall prepare, and upon request submit to the 
118.7 	commissioner, a distribution plan that specifies the amount of money the provider expects 
118.8 	to receive that is subject to the requirements of this subdivision, including how that money 
118.9 	was or will be distributed to increase compensation-related costs for employees. Within 60 
118.10 	days of final implementation of the new phase-in proportion or adjustment to the base wage 
118.11 	indices subject to the requirements of this subdivision, the provider must post the distribution 
118.12 	plan and leave it posted for a period of at least six months in an area of the provider's 
118.13 	operation to which all employees have access. The posted distribution plan must include 
118.14 	instructions regarding how to contact the commissioner, or the commissioner's representative, 
118.15 	if an employee has not received the compensation-related increase described in the plan.

118.16 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
118.17 	whichever is later, except that subdivision 3 is effective July 1, 2023, or upon federal 
118.18 	approval, whichever is later. The commissioner of human services shall notify the revisor 
118.19 	of statutes when federal approval is obtained.

118.20 	Sec. 18. Minnesota Statutes 2022, section 256S.212, is amended to read:
118.21 	256S.212 RATE SETTING; BASE WAGE INDEX.
118.22 		Subdivision 1.Updating SOC codes. If any of the SOC codes and positions used in 
118.23 	this section are no longer available, the commissioner shall, in consultation with stakeholders, 
118.24 	select a new SOC code and position that is the closest match to the previously used SOC 
118.25 	position.
118.26 		Subd. 2.Home management and support services base wage. For customized living,
118.27 	and foster care, and residential care component services, the home management and support 
118.28 	services base wage equals 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
118.29 	MetroSA average wage for home health and personal and home care aide (SOC code 39-9021
118.30 	31-1120); 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average 
118.31 	wage for food preparation workers (SOC code 35-2021); and 33.34 percent of the 
118.32 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and 
118.33 	housekeeping cleaners (SOC code 37-2012).
119.1 		Subd. 3.Home care aide base wage. For customized living, and foster care, and 
119.2 	residential care component services, the home care aide base wage equals 50 75 percent of 
119.3 	the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home health
119.4 	and personal care aides (SOC code 31-1011 31-1120); and 50 25 percent of the 
119.5 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants 
119.6 	(SOC code 31-1014 31-1131).
119.7 		Subd. 4.Home health aide base wage. For customized living, and foster care, and 
119.8 	residential care component services, the home health aide base wage equals 20 33.33 percent 
119.9 	of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed 
119.10 	practical and licensed vocational nurses (SOC code 29-2061); and 80 33.33 percent of the 
119.11 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants 
119.12 	(SOC code 31-1014 31-1131); and 33.34 percent of the Minneapolis-St. Paul-Bloomington, 
119.13 	MN-WI MetroSA average wage for home health and personal care aides (SOC code 
119.14 	31-1120).
119.15 		Subd. 5.Medication setups by licensed nurse base wage. For customized living, and
119.16 	foster care, and residential care component services, the medication setups by licensed nurse 
119.17 	base wage equals ten 25 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
119.18 	average wage for licensed practical and licensed vocational nurses (SOC code 29-2061); 
119.19 	and 90 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average 
119.20 	wage for registered nurses (SOC code 29-1141).
119.21 		Subd. 6.Chore services base wage. The chore services base wage equals 100 50 percent 
119.22 	of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for landscaping 
119.23 	and groundskeeping workers (SOC code 37-3011); and 50 percent of the Minneapolis-St. 
119.24 	Paul-Bloomington, MN-WI MetroSA average wage for maids and housekeeping cleaners 
119.25 	(SOC code 37-2012).
119.26 		Subd. 7.Companion services base wage. The companion services base wage equals 
119.27 	50 80 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage 
119.28 	for home health and personal and home care aides (SOC code 39-9021 31-1120); and 50
119.29 	20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for 
119.30 	maids and housekeeping cleaners (SOC code 37-2012).
119.31 		Subd. 8.Homemaker services and assistance with personal care base wage. The 
119.32 	homemaker services and assistance with personal care base wage equals 60 50 percent of 
119.33 	the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home health 
119.34 	and personal and home care aide aides (SOC code 39-9021 31-1120); 20 and 50 percent of 
120.1 	the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants 
120.2 	(SOC code 31-1014 31-1131); and 20 percent of the Minneapolis-St. Paul-Bloomington, 
120.3 	MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012).
120.4 		Subd. 9.Homemaker services and cleaning base wage. The homemaker services and
120.5 	cleaning base wage equals 60 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
120.6 	MetroSA average wage for personal and home care aide (SOC code 39-9021); 20 percent 
120.7 	of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing 
120.8 	assistants (SOC code 31-1014); and 20 100 percent of the Minneapolis-St. Paul-Bloomington, 
120.9 	MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012).
120.10 		Subd. 10.Homemaker services and home management base wage. The homemaker 
120.11 	services and home management base wage equals 60 50 percent of the Minneapolis-St. 
120.12 	Paul-Bloomington, MN-WI MetroSA average wage for home health and personal and home
120.13 	care aide aides (SOC code 39-9021 31-1120); 20 and 50 percent of the Minneapolis-St. 
120.14 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
120.15 	31-1014 31-1131); and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
120.16 	MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012).
120.17 		Subd. 11.In-home respite care services base wage. The in-home respite care services 
120.18 	base wage equals five 15 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
120.19 	average wage for registered nurses (SOC code 29-1141); 75 percent of the Minneapolis-St. 
120.20 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants home health and 
120.21 	personal care aides (SOC code 31-1014 31-1120); and 20 ten percent of the Minneapolis-St. 
120.22 	Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed 
120.23 	vocational nurses (SOC code 29-2061).
120.24 		Subd. 12.Out-of-home respite care services base wage. The out-of-home respite care 
120.25 	services base wage equals five 15 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
120.26 	MetroSA average wage for registered nurses (SOC code 29-1141); 75 percent of the 
120.27 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
120.28 	home health and personal care aides (SOC code 31-1014 31-1120); and 20 ten percent of 
120.29 	the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical 
120.30 	and licensed vocational nurses (SOC code 29-2061).
120.31 		Subd. 13.Individual community living support base wage. The individual community 
120.32 	living support base wage equals 20 60 percent of the Minneapolis-St. Paul-Bloomington, 
120.33 	MN-WI MetroSA average wage for licensed practical and licensed vocational nurses social 
120.34 	and human services assistants (SOC code 29-2061 21-1093); and 80 40 percent of the 
121.1 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants 
121.2 	(SOC code 31-1014 31-1131).
121.3 		Subd. 14.Registered nurse base wage. The registered nurse base wage equals 100 
121.4 	percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for 
121.5 	registered nurses (SOC code 29-1141).
121.6 		Subd. 15.Social worker Unlicensed supervisor base wage. The social worker
121.7 	unlicensed supervisor base wage equals 100 percent of the Minneapolis-St. 
121.8 	Paul-Bloomington, MN-WI MetroSA average wage for medical and public health social
121.9 	first-line supervisors of personal service workers (SOC code 21-1022 39-1022).
121.10 		Subd. 16.Adult day services base wage. The adult day services base wage equals 75 
121.11 	percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home 
121.12 	health and personal care aides (SOC code 31-1120); and 25 percent of the Minneapolis-St. 
121.13 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
121.14 	31-1131).

121.15 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
121.16 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
121.17 	when approval is obtained.

121.18 	Sec. 19. Minnesota Statutes 2022, section 256S.213, is amended to read:
121.19 	256S.213 RATE SETTING; FACTORS.
121.20 		Subdivision 1.Payroll taxes and benefits factor. The payroll taxes and benefits factor 
121.21 	is the sum of net payroll taxes and benefits, divided by the sum of all salaries for all nursing 
121.22 	facilities on the most recent and available cost report.
121.23 		Subd. 2.General and administrative factor. The general and administrative factor is 
121.24 	the difference of net general and administrative expenses and administrative salaries, divided 
121.25 	by total operating expenses for all nursing facilities on the most recent and available cost 
121.26 	report 14.4 percent.
121.27 		Subd. 3.Program plan support factor. (a) The program plan support factor is 12.8 ten
121.28 	percent for the following services to cover the cost of direct service staff needed to provide 
121.29 	support for home and community-based the service when not engaged in direct contact with 
121.30 	participants.:
121.31 	(1) adult day services;
121.32 	(2) customized living; and
122.1 	(3) foster care.
122.2 	(b) The program plan support factor is 15.5 percent for the following services to cover 
122.3 	the cost of direct service staff needed to provide support for the service when not engaged 
122.4 	in direct contact with participants:
122.5 	(1) chore services;
122.6 	(2) companion services;
122.7 	(3) homemaker assistance with personal care;
122.8 	(4) homemaker cleaning;
122.9 	(5) homemaker home management;
122.10 	(6) in-home respite care;
122.11 	(7) individual community living support; and
122.12 	(8) out-of-home respite care.
122.13 		Subd. 4.Registered nurse management and supervision factor wage component. The 
122.14 	registered nurse management and supervision factor wage component equals 15 percent of 
122.15 	the registered nurse adjusted base wage as defined in section 256S.214.
122.16 		Subd. 5.Social worker Unlicensed supervisor supervision factor wage 
122.17 	component. The social worker unlicensed supervisor supervision factor wage component
122.18 	equals 15 percent of the social worker unlicensed supervisor adjusted base wage as defined 
122.19 	in section 256S.214.
122.20 		Subd. 6.Facility and equipment factor. The facility and equipment factor for adult 
122.21 	day services is 16.2 percent.
122.22 		Subd. 7.Food, supplies, and transportation factor. The food, supplies, and 
122.23 	transportation factor for adult day services is 24 percent.
122.24 		Subd. 8.Supplies and transportation factor. The supplies and transportation factor 
122.25 	for the following services is 1.56 percent:
122.26 	(1) chore services;
122.27 	(2) companion services;
122.28 	(3) homemaker assistance with personal care;
122.29 	(4) homemaker cleaning;
122.30 	(5) homemaker home management;
123.1 	(6) in-home respite care;
123.2 	(7) individual community support services; and
123.3 	(8) out-of-home respite care.
123.4 		Subd. 9.Absence factor. The absence factor for the following services is 4.5 percent:
123.5 	(1) adult day services;
123.6 	(2) chore services;
123.7 	(3) companion services;
123.8 	(4) homemaker assistance with personal care;
123.9 	(5) homemaker cleaning;
123.10 	(6) homemaker home management;
123.11 	(7) in-home respite care;
123.12 	(8) individual community living support; and
123.13 	(9) out-of-home respite care.

123.14 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
123.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
123.16 	when approval is obtained.

123.17 	Sec. 20. Minnesota Statutes 2022, section 256S.214, is amended to read:
123.18 	256S.214 RATE SETTING; ADJUSTED BASE WAGE.
123.19 	(a) For the purposes of section 256S.215, the adjusted base wage for each position equals 
123.20 	the position's base wage under section 256S.212 plus:
123.21 	(1) the position's base wage multiplied by the payroll taxes and benefits factor under 
123.22 	section 256S.213, subdivision 1;
123.23 	(2) the position's base wage multiplied by the general and administrative factor under 
123.24 	section 256S.213, subdivision 2; and
123.25 	(3) (2) the position's base wage multiplied by the applicable program plan support factor 
123.26 	under section 256S.213, subdivision 3.; and
123.27 	(3) the position's base wage multiplied by the absence factor under section 256S.213, 
123.28 	subdivision 9, if applicable.
124.1 	(b) If the base wage described in paragraph (a) is below $16.68, the base wage must 
124.2 	equal $16.68.

124.3 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
124.4 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
124.5 	when approval is obtained.

124.6 	Sec. 21. Minnesota Statutes 2022, section 256S.215, subdivision 2, is amended to read:
124.7 		Subd. 2.Home management and support services component rate. The component 
124.8 	rate for home management and support services is calculated as follows:
124.9 	(1) sum the home management and support services adjusted base wage plus and the 
124.10 	registered nurse management and supervision factor. wage component;
124.11 	(2) multiply the result of clause (1) by the general and administrative factor; and
124.12 	(3) sum the results of clauses (1) and (2).

124.13 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
124.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
124.15 	when approval is obtained.

124.16 	Sec. 22. Minnesota Statutes 2022, section 256S.215, subdivision 3, is amended to read:
124.17 		Subd. 3.Home care aide services component rate. The component rate for home care 
124.18 	aide services is calculated as follows:
124.19 	(1) sum the home health aide services adjusted base wage plus and the registered nurse 
124.20 	management and supervision factor. wage component;
124.21 	(2) multiply the result of clause (1) by the general and administrative factor; and
124.22 	(3) sum the results of clauses (1) and (2).

124.23 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
124.24 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
124.25 	when approval is obtained.

124.26 	Sec. 23. Minnesota Statutes 2022, section 256S.215, subdivision 4, is amended to read:
124.27 		Subd. 4.Home health aide services component rate. The component rate for home 
124.28 	health aide services is calculated as follows:
125.1 	(1) sum the home health aide services adjusted base wage plus and the registered nurse 
125.2 	management and supervision factor. wage component;
125.3 	(2) multiply the result of clause (1) by the general and administrative factor; and
125.4 	(3) sum the results of clauses (1) and (2).

125.5 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
125.6 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
125.7 	when approval is obtained.

125.8 	Sec. 24. Minnesota Statutes 2022, section 256S.215, subdivision 7, is amended to read:
125.9 		Subd. 7.Chore services rate. The 15-minute unit rate for chore services is calculated 
125.10 	as follows:
125.11 	(1) sum the chore services adjusted base wage and the social worker unlicensed supervisor
125.12 	supervision factor wage component; and
125.13 	(2) multiply the result of clause (1) by the general and administrative factor;
125.14 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
125.15 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.

125.16 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
125.17 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
125.18 	when approval is obtained.

125.19 	Sec. 25. Minnesota Statutes 2022, section 256S.215, subdivision 8, is amended to read:
125.20 		Subd. 8.Companion services rate. The 15-minute unit rate for companion services is 
125.21 	calculated as follows:
125.22 	(1) sum the companion services adjusted base wage and the social worker unlicensed 
125.23 	supervisor supervision factor wage component; and
125.24 	(2) multiply the result of clause (1) by the general and administrative factor;
125.25 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
125.26 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.

125.27 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
125.28 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
125.29 	when approval is obtained.

126.1 	Sec. 26. Minnesota Statutes 2022, section 256S.215, subdivision 9, is amended to read:
126.2 		Subd. 9.Homemaker services and assistance with personal care rate. The 15-minute 
126.3 	unit rate for homemaker services and assistance with personal care is calculated as follows:
126.4 	(1) sum the homemaker services and assistance with personal care adjusted base wage 
126.5 	and the registered nurse management and unlicensed supervisor supervision factor wage 
126.6 	component; and
126.7 	(2) multiply the result of clause (1) by the general and administrative factor;
126.8 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
126.9 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.

126.10 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
126.11 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
126.12 	when approval is obtained.

126.13 	Sec. 27. Minnesota Statutes 2022, section 256S.215, subdivision 10, is amended to read:
126.14 		Subd. 10.Homemaker services and cleaning rate. The 15-minute unit rate for 
126.15 	homemaker services and cleaning is calculated as follows:
126.16 	(1) sum the homemaker services and cleaning adjusted base wage and the registered 
126.17 	nurse management and unlicensed supervisor supervision factor wage component; and
126.18 	(2) multiply the result of clause (1) by the general and administrative factor;
126.19 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
126.20 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.

126.21 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
126.22 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
126.23 	when approval is obtained.

126.24 	Sec. 28. Minnesota Statutes 2022, section 256S.215, subdivision 11, is amended to read:
126.25 		Subd. 11.Homemaker services and home management rate. The 15-minute unit rate 
126.26 	for homemaker services and home management is calculated as follows:
126.27 	(1) sum the homemaker services and home management adjusted base wage and the
126.28 	registered nurse management and unlicensed supervisor supervision factor wage component; 
126.29 	and
127.1 	(2) multiply the result of clause (1) by the general and administrative factor;
127.2 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
127.3 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.

127.4 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
127.5 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
127.6 	when approval is obtained.

127.7 	Sec. 29. Minnesota Statutes 2022, section 256S.215, subdivision 12, is amended to read:
127.8 		Subd. 12.In-home respite care services rates. (a) The 15-minute unit rate for in-home 
127.9 	respite care services is calculated as follows:
127.10 	(1) sum the in-home respite care services adjusted base wage and the registered nurse 
127.11 	management and supervision factor wage component; and
127.12 	(2) multiply the result of clause (1) by the general and administrative factor;
127.13 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
127.14 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.
127.15 	(b) The in-home respite care services daily rate equals the in-home respite care services 
127.16 	15-minute unit rate multiplied by 18.

127.17 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
127.18 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
127.19 	when approval is obtained.

127.20 	Sec. 30. Minnesota Statutes 2022, section 256S.215, subdivision 13, is amended to read:
127.21 		Subd. 13.Out-of-home respite care services rates. (a) The 15-minute unit rate for 
127.22 	out-of-home respite care is calculated as follows:
127.23 	(1) sum the out-of-home respite care services adjusted base wage and the registered 
127.24 	nurse management and supervision factor wage component; and
127.25 	(2) multiply the result of clause (1) by the general and administrative factor;
127.26 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
127.27 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.
127.28 	(b) The out-of-home respite care services daily rate equals the 15-minute unit rate for 
127.29 	out-of-home respite care services multiplied by 18.

128.1 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
128.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
128.3 	when approval is obtained.

128.4 	Sec. 31. Minnesota Statutes 2022, section 256S.215, subdivision 14, is amended to read:
128.5 		Subd. 14.Individual community living support rate. The individual community living 
128.6 	support rate is calculated as follows:
128.7 	(1) sum the home care aide individual community living support adjusted base wage 
128.8 	and the social worker registered nurse management and supervision factor wage component; 
128.9 	and
128.10 	(2) multiply the result of clause (1) by the general and administrative factor;
128.11 	(3) multiply the result of clause (1) by the supplies and transportation factor; and
128.12 	(4) sum the results of clauses (1) to (3) and divide the result of clause (1) by four.

128.13 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
128.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
128.15 	when approval is obtained.

128.16 	Sec. 32. Minnesota Statutes 2022, section 256S.215, subdivision 15, is amended to read:
128.17 		Subd. 15.Home-delivered meals rate. Effective January 1, 2024, the home-delivered 
128.18 	meals rate equals $9.30 is $8.17, updated as directed in section 256S.211, subdivision 3. 
128.19 	The commissioner shall increase the home delivered meals rate every July 1 by the percent 
128.20 	increase in the nursing facility dietary per diem using the two most recent and available 
128.21 	nursing facility cost reports.

128.22 	EFFECTIVE DATE. This section is effective July 1, 2023, or upon federal approval, 
128.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
128.24 	when approval is obtained.

128.25 	Sec. 33. Minnesota Statutes 2022, section 256S.215, subdivision 16, is amended to read:
128.26 		Subd. 16.Adult day services rate. The 15-minute unit rate for adult day services, with 
128.27 	an assumed staffing ratio of one staff person to four participants, is the sum of is calculated 
128.28 	as follows:
128.29 	(1) one-sixteenth of the home care aide divide the adult day services adjusted base wage, 
128.30 	except that the general and administrative factor used to determine the home care aide 
129.1 	services adjusted base wage is 20 percent by five to reflect an assumed staffing ratio of one 
129.2 	to five;
129.3 	(2) one-fourth of the registered nurse management and supervision factor sum the result 
129.4 	of clause (1) and the registered nurse management and supervision wage component; and
129.5 	(3) $0.63 to cover the cost of meals. multiply the result of clause (2) by the general and 
129.6 	administrative factor;
129.7 	(4) multiply the result of clause (2) by the facility and equipment factor;
129.8 	(5) multiply the result of clause (2) by the food, supplies, and transportation factor; and
129.9 	(6) sum the results of clauses (2) to (5) and divide the result by four.

129.10 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
129.11 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
129.12 	when approval is obtained.

129.13 	Sec. 34. Minnesota Statutes 2022, section 256S.215, subdivision 17, is amended to read:
129.14 		Subd. 17.Adult day services bath rate. The 15-minute unit rate for adult day services 
129.15 	bath is the sum of calculated as follows:
129.16 	(1) one-fourth of the home care aide sum the adult day services adjusted base wage, 
129.17 	except that the general and administrative factor used to determine the home care aide 
129.18 	services adjusted base wage is 20 percent and the nurse management and supervision wage 
129.19 	component;
129.20 	(2) one-fourth of the registered nurse management and supervision multiply the result 
129.21 	of clause (1) by the general and administrative factor; and
129.22 	(3) $0.63 to cover the cost of meals. multiply the result of clause (1) by the facility and 
129.23 	equipment factor;
129.24 	(4) multiply the result of clause (1) by the food, supplies, and transportation factor; and
129.25 	(5) sum the results of clauses (1) to (4) and divide the result by four.

129.26 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
129.27 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
129.28 	when approval is obtained.

130.1 	Sec. 35. Laws 2021, chapter 30, article 12, section 5, as amended by Laws 2021, First 
130.2 	Special Session chapter 7, article 17, section 2, is amended to read:
130.3 	Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.
 130.4 	The Governor's Council on an Age-Friendly Minnesota, established in Executive Order 
130.5 	19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and 
130.6 	private partners' collaborative work on emergency preparedness, with a focus on older 
130.7 	adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic. 
130.8 	The Governor's Council on an Age-Friendly Minnesota is extended and expires June 30, 
130.9 	2024 2027.

130.10 	Sec. 36. Laws 2021, First Special Session chapter 7, article 17, section 8, is amended to 
130.11 	read:
130.12 	Sec. 8. AGE-FRIENDLY MINNESOTA.
 130.13 		Subdivision 1.Age-friendly community grants. (a) This act includes $0 in fiscal year 
130.14 	2022 and $875,000 in fiscal year 2023 for age-friendly community grants. The commissioner 
130.15 	of human services, in collaboration with the Minnesota Board on Aging and the Governor's 
130.16 	Council on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop 
130.17 	the age-friendly community grant program to help communities, including cities, counties, 
130.18 	other municipalities, Tribes, and collaborative efforts, to become age-friendly communities, 
130.19 	with an emphasis on structures, services, and community features necessary to support older 
130.20 	adult residents over the next decade, including but not limited to:
130.21 	(1) coordination of health and social services;
130.22 	(2) transportation access;
130.23 	(3) safe, affordable places to live;
130.24 	(4) reducing social isolation and improving wellness;
130.25 	(5) combating ageism and racism against older adults;
130.26 	(6) accessible outdoor space and buildings;
130.27 	(7) communication and information technology access; and
130.28 	(8) opportunities to stay engaged and economically productive.
130.29 	The general fund base in this act for this purpose is $875,000 in fiscal year 2024 and $0 in 
130.30 	fiscal year 2025.
131.1 	(b) All grant activities must be completed by March 31, 2024 2027.
131.2 	(c) This subdivision expires June 30, 2024 2027.
131.3 		Subd. 2.Technical assistance grants. (a) This act includes $0 in fiscal year 2022 and 
131.4 	$575,000 in fiscal year 2023 for technical assistance grants. The commissioner of human 
131.5 	services, in collaboration with the Minnesota Board on Aging and the Governor's Council 
131.6 	on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop the 
131.7 	age-friendly technical assistance grant program. The general fund base in this act for this 
131.8 	purpose is $575,000 in fiscal year 2024 and $0 in fiscal year 2025.
131.9 	(b) All grant activities must be completed by March 31, 2024 2027.
131.10 	(c) This subdivision expires June 30, 2024 2027.

131.11 	Sec. 37. DIRECTION TO COMMISSIONER; FUTURE PACE IMPLEMENTATION 
131.12 	FUNDING.
 131.13 	(a) The commissioner of human services shall work collaboratively with stakeholders 
131.14 	to undertake an actuarial analysis of Medicaid costs for nursing home eligible beneficiaries 
131.15 	for the purposes of establishing a monthly Medicaid capitation rate for the program of 
131.16 	all-inclusive care for the elderly (PACE). The analysis must include all sources of state 
131.17 	Medicaid expenditures for nursing home eligible beneficiaries, including but not limited to 
131.18 	capitation payments to plans and additional state expenditures to skilled nursing facilities 
131.19 	consistent with Code of Federal Regulations, chapter 42, part 447, and long-term care costs.
131.20 	(b) The commissioner shall also estimate the administrative costs associated with 
131.21 	implementing and monitoring PACE.
131.22 	(c) The commissioner shall provide a report to the chairs and ranking minority members 
131.23 	of the legislative committees with jurisdiction over health care finance on the actuarial 
131.24 	analysis, proposed capitation rate, and estimated administrative costs by March 1, 2024. 
131.25 	The commissioner shall recommend a financing mechanism and administrative framework 
131.26 	by September 1, 2024.
131.27 	(d) By September 1, 2024, the commissioner shall inform the chairs and ranking minority 
131.28 	members of the legislative committees with jurisdiction over health care finance on the 
131.29 	commissioner's progress toward developing a recommended financing mechanism. For 
131.30 	purposes of this section, the commissioner may issue or extend a request for proposal to an 
131.31 	outside vendor.

132.1 	Sec. 38. DIRECTION TO COMMISSIONER; CAREGIVER RESPITE SERVICES 
132.2 	GRANTS.
 132.3 	Beginning in fiscal year 2025, the commissioner of human services must continue the 
132.4 	respite services for older adults grant program established under Laws 2021, First Special 
132.5 	Session chapter 7, article 17, section 17, subdivision 3, under the authority granted under 
132.6 	Minnesota Statutes, section 256.9756. The commissioner may begin the grant application 
132.7 	process for awarding grants under Minnesota Statutes, section 256.9756, during fiscal year 
132.8 	2024 in order to facilitate the continuity of the grant program during the transition from a 
132.9 	temporary program to a permanent one.

132.10 	Sec. 39. DIRECTION TO COMMISSIONERS; SMALL PROVIDER REGULATORY 
132.11 	RELIEF.
 132.12 	The commissioners of human services and health must consult with assisted living 
132.13 	facility license holders who provide customized living and whose facilities are smaller than 
132.14 	11 beds to compile a list of regulatory requirements, compliance with which is particularly 
132.15 	difficult for small providers. The commissioners must provide the chairs and ranking minority 
132.16 	members of the legislative committees with jurisdiction over assisted living licensure and 
132.17 	customized living with recommendations, including draft legislation, to reduce the regulatory 
132.18 	burden on small providers.

132.19 	Sec. 40. RATE INCREASE FOR CERTAIN HOME AND COMMUNITY-BASED 
132.20 	SERVICES.
 132.21 	The commissioner of human services shall increase payment rates for community living 
132.22 	assistance and family caregiver services under Minnesota Statutes, sections 256B.0913 and 
132.23 	256B.0922, and chapter 256S by 14.99 percent from the rates in effect on December 31, 
132.24 	2023.

132.25 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
132.26 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
132.27 	when federal approval is obtained.

132.28 	Sec. 41. NURSING FACILITY RATE STUDY.
 132.29 	(a) The commissioner of human services shall contract with an independent organization 
132.30 	with subject matter expertise in nursing facility accounting to conduct a study of nursing 
132.31 	facility rates that includes:
133.1 	(1) a review of nursing facility rates of all states bordering Minnesota and the states 
133.2 	included in the Centers for Medicare and Medicaid Services Region V;
133.3 	(2) the data necessary to determine the total net income and the operating margin of a 
133.4 	nursing facility;
133.5 	(3) the data necessary to determine whether a nursing facility can generate sufficient 
133.6 	revenue to cover the nursing facility's operating expenses;
133.7 	(4) the average reimbursement rate per resident day in each state and the data used to 
133.8 	compute that rate;
133.9 	(5) facility-level data on all types of Medicaid payments to nursing facilities, including 
133.10 	but not limited to:
133.11 	(i) supplemental rate add-ons;
133.12 	(ii) rate components;
133.13 	(iii) data on the sources of the nonfederal share of spending necessary to determine the 
133.14 	net Medicaid payment at the facility level; and
133.15 	(iv) disclosure of transactions from a related party; and
133.16 	(6) any other information determined necessary by the commissioner to complete the 
133.17 	study.
133.18 	(b) Upon request, a nursing facility must provide information to the commissioner 
133.19 	pertaining to the nursing facility's financial operations.
133.20 	(c) By January 1, 2025, the commissioner shall submit a report to the chairs and ranking 
133.21 	minority members of the legislative committees and divisions with jurisdiction over human 
133.22 	services policy and finance recommending adjustments to the nursing facility rate 
133.23 	methodology under Minnesota Statutes, chapter 256R, based on the results of the study in 
133.24 	paragraph (a). The commissioner shall consult with the Office of the Legislative Auditor 
133.25 	Financial Audit Division and Program Evaluation Division on study design methods.

133.26 	Sec. 42. REVISOR INSTRUCTION.
 133.27 	The revisor of statutes shall change the headnote in Minnesota Statutes, section 
133.28 	256B.0917, from "HOME AND COMMUNITY-BASED SERVICES FOR OLDER 
133.29 	ADULTS" to "ELDERCARE DEVELOPMENT PARTNERSHIPS."

134.1 	Sec. 43. REPEALER.
 134.2 	(a) Minnesota Statutes 2022, section 256B.0917, subdivisions 1a, 6, 7a, and 13, are 
134.3 	repealed.
134.4 	(b) Minnesota Statutes 2022, sections 256S.19, subdivision 4; and 256S.2101, subdivision 
134.5 	2, are repealed.

134.6 	EFFECTIVE DATE. Paragraph (a) is effective July 1, 2023. Paragraph (b) is effective 
134.7 	January 1, 2024, or upon federal approval, whichever is later. The commissioner of human 
134.8 	services shall notify the revisor of statutes when approval is obtained.

134.9 	ARTICLE 3
134.10 	HEALTH CARE

134.11 	Section 1. Minnesota Statutes 2022, section 252.27, subdivision 2a, is amended to read:
134.12 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor child, 
134.13 	not including a child determined eligible for medical assistance without consideration of 
134.14 	parental income under the Tax Equity and Fiscal Responsibility Act (TEFRA) option or a 
134.15 	child accessing home and community-based waiver services, must contribute to the cost of 
134.16 	services used by making monthly payments on a sliding scale based on income, unless the 
134.17 	child is married or has been married, parental rights have been terminated, or the child's 
134.18 	adoption is subsidized according to chapter 259A or through title IV-E of the Social Security 
134.19 	Act. The parental contribution is a partial or full payment for medical services provided for 
134.20 	diagnostic, therapeutic, curing, treating, mitigating, rehabilitation, maintenance, and personal 
134.21 	care services as defined in United States Code, title 26, section 213, needed by the child 
134.22 	with a chronic illness or disability.
134.23 	(b) For households with adjusted gross income equal to or greater than 275 percent of 
134.24 	federal poverty guidelines, the parental contribution shall be computed by applying the 
134.25 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
134.26 	(1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty 
134.27 	guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental 
134.28 	contribution shall be determined using a sliding fee scale established by the commissioner 
134.29 	of human services which begins at 1.65 percent of adjusted gross income at 275 percent of 
134.30 	federal poverty guidelines and increases to 4.5 percent of adjusted gross income for those 
134.31 	with adjusted gross income up to 545 percent of federal poverty guidelines;
135.1 	(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines 
135.2 	and less than 675 percent of federal poverty guidelines, the parental contribution shall be 
135.3 	4.5 percent of adjusted gross income;
135.4 	(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty 
135.5 	guidelines and less than 975 percent of federal poverty guidelines, the parental contribution 
135.6 	shall be determined using a sliding fee scale established by the commissioner of human 
135.7 	services which begins at 4.5 percent of adjusted gross income at 675 percent of federal 
135.8 	poverty guidelines and increases to 5.99 percent of adjusted gross income for those with 
135.9 	adjusted gross income up to 975 percent of federal poverty guidelines; and
135.10 	(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty 
135.11 	guidelines, the parental contribution shall be 7.49 percent of adjusted gross income.
135.12 	If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 
135.13 	prior to calculating the parental contribution. If the child resides in an institution specified 
135.14 	in section 256B.35, the parent is responsible for the personal needs allowance specified 
135.15 	under that section in addition to the parental contribution determined under this section. 
135.16 	The parental contribution is reduced by any amount required to be paid directly to the child 
135.17 	pursuant to a court order, but only if actually paid.
135.18 	(c) The household size to be used in determining the amount of contribution under 
135.19 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
135.20 	child receiving services. Adjustments in the contribution amount due to annual changes in 
135.21 	the federal poverty guidelines shall be implemented on the first day of July following 
135.22 	publication of the changes.
135.23 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
135.24 	natural or adoptive parents determined according to the previous year's federal tax form, 
135.25 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
135.26 	have been used to purchase a home shall not be counted as income.
135.27 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
135.28 	for services is being determined. The contribution shall be made on a monthly basis effective 
135.29 	with the first month in which the child receives services. Annually upon redetermination 
135.30 	or at termination of eligibility, if the contribution exceeded the cost of services provided, 
135.31 	the local agency or the state shall reimburse that excess amount to the parents, either by 
135.32 	direct reimbursement if the parent is no longer required to pay a contribution, or by a 
135.33 	reduction in or waiver of parental fees until the excess amount is exhausted. All 
135.34 	reimbursements must include a notice that the amount reimbursed may be taxable income 
136.1 	if the parent paid for the parent's fees through an employer's health care flexible spending 
136.2 	account under the Internal Revenue Code, section 125, and that the parent is responsible 
136.3 	for paying the taxes owed on the amount reimbursed.
136.4 	(f) The monthly contribution amount must be reviewed at least every 12 months; when 
136.5 	there is a change in household size; and when there is a loss of or gain in income from one 
136.6 	month to another in excess of ten percent. The local agency shall mail a written notice 30 
136.7 	days in advance of the effective date of a change in the contribution amount. A decrease in 
136.8 	the contribution amount is effective in the month that the parent verifies a reduction in 
136.9 	income or change in household size.
136.10 	(g) Parents of a minor child who do not live with each other shall each pay the 
136.11 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
136.12 	child support payment actually paid on behalf of the child receiving services shall be deducted 
136.13 	from the adjusted gross income of the parent making the payment prior to calculating the 
136.14 	parental contribution under paragraph (b).
136.15 	(h) The contribution under paragraph (b) shall be increased by an additional five percent 
136.16 	if the local agency determines that insurance coverage is available but not obtained for the 
136.17 	child. For purposes of this section, "available" means the insurance is a benefit of employment 
136.18 	for a family member at an annual cost of no more than five percent of the family's annual 
136.19 	income. For purposes of this section, "insurance" means health and accident insurance 
136.20 	coverage, enrollment in a nonprofit health service plan, health maintenance organization, 
136.21 	self-insured plan, or preferred provider organization.
136.22 	Parents who have more than one child receiving services shall not be required to pay 
136.23 	more than the amount for the child with the highest expenditures. There shall be no resource 
136.24 	contribution from the parents. The parent shall not be required to pay a contribution in 
136.25 	excess of the cost of the services provided to the child, not counting payments made to 
136.26 	school districts for education-related services. Notice of an increase in fee payment must 
136.27 	be given at least 30 days before the increased fee is due.
136.28 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in 
136.29 	the 12 months prior to July 1:
136.30 	(1) the parent applied for insurance for the child;
136.31 	(2) the insurer denied insurance;
137.1 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a 
137.2 	complaint or appeal, in writing, to the commissioner of health or the commissioner of 
137.3 	commerce, or litigated the complaint or appeal; and
137.4 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
137.5 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
137.6 	A parent who has requested a reduction in the contribution amount under this paragraph 
137.7 	shall submit proof in the form and manner prescribed by the commissioner or county agency, 
137.8 	including, but not limited to, the insurer's denial of insurance, the written letter or complaint 
137.9 	of the parents, court documents, and the written response of the insurer approving insurance. 
137.10 	The determinations of the commissioner or county agency under this paragraph are not rules 
137.11 	subject to chapter 14.

137.12 	Sec. 2. Minnesota Statutes 2022, section 256B.04, is amended by adding a subdivision to 
137.13 	read:
137.14 		Subd. 26.Notice of employed persons with disabilities program. At the time of initial 
137.15 	enrollment and at least annually thereafter, the commissioner shall provide information on 
137.16 	the medical assistance program for employed persons with disabilities under section 
137.17 	256B.057, subdivision 9, to all medical assistance enrollees who indicate they have a 
137.18 	disability.

137.19 	Sec. 3. Minnesota Statutes 2022, section 256B.056, subdivision 3, is amended to read:
137.20 		Subd. 3.Asset limitations for certain individuals. (a) To be eligible for medical 
137.21 	assistance, a person must not individually own more than $3,000 in assets, or if a member 
137.22 	of a household with two family members, husband and wife, or parent and child, the 
137.23 	household must not own more than $6,000 in assets, plus $200 for each additional legal 
137.24 	dependent. In addition to these maximum amounts, an eligible individual or family may 
137.25 	accrue interest on these amounts, but they must be reduced to the maximum at the time of 
137.26 	an eligibility redetermination. The accumulation of the clothing and personal needs allowance 
137.27 	according to section 256B.35 must also be reduced to the maximum at the time of the 
137.28 	eligibility redetermination. The value of assets that are not considered in determining 
137.29 	eligibility for medical assistance is the value of those assets excluded under the Supplemental 
137.30 	Security Income program for aged, blind, and disabled persons, with the following 
137.31 	exceptions:
137.32 	(1) household goods and personal effects are not considered;
138.1 	(2) capital and operating assets of a trade or business that the local agency determines 
138.2 	are necessary to the person's ability to earn an income are not considered;
138.3 	(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security 
138.4 	Income program;
138.5 	(4) assets designated as burial expenses are excluded to the same extent excluded by the 
138.6 	Supplemental Security Income program. Burial expenses funded by annuity contracts or 
138.7 	life insurance policies must irrevocably designate the individual's estate as contingent 
138.8 	beneficiary to the extent proceeds are not used for payment of selected burial expenses;
138.9 	(5) for a person who no longer qualifies as an employed person with a disability due to 
138.10 	loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, 
138.11 	subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility 
138.12 	as an employed person with a disability, to the extent that the person's total assets remain 
138.13 	within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
138.14 	(6) a designated employment incentives asset account is disregarded when determining 
138.15 	eligibility for medical assistance for a person age 65 years or older under section 256B.055, 
138.16 	subdivision 7. An employment incentives asset account must only be designated by a person 
138.17 	who has been enrolled in medical assistance under section 256B.057, subdivision 9, for a 
138.18 	24-consecutive-month period. A designated employment incentives asset account contains 
138.19 	qualified assets owned by the person and the person's spouse in the last month of enrollment 
138.20 	in medical assistance under section 256B.057, subdivision 9. Qualified assets include 
138.21 	retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's 
138.22 	other nonexcluded liquid assets. An employment incentives asset account is no longer 
138.23 	designated when a person loses medical assistance eligibility for a calendar month or more 
138.24 	before turning age 65. A person who loses medical assistance eligibility before age 65 can 
138.25 	establish a new designated employment incentives asset account by establishing a new 
138.26 	24-consecutive-month period of enrollment under section 256B.057, subdivision 9. The 
138.27 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
138.28 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
138.29 	must be disregarded when determining eligibility for medical assistance under section 
138.30 	256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions 
138.31 	in section 256B.059; and
138.32 	(7) effective July 1, 2009, certain assets owned by American Indians are excluded as 
138.33 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
139.1 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
139.2 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
139.3 	(b) No asset limit shall apply to persons eligible under section sections256B.055, 
139.4 	subdivision 15, and 256B.057, subdivision 9.

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

139.6 	Sec. 4. Minnesota Statutes 2022, section 256B.057, subdivision 9, is amended to read:
139.7 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid for 
139.8 	a person who is employed and who:
139.9 	(1) but for excess earnings or assets, meets the definition of disabled under the 
139.10 	Supplemental Security Income program; and
139.11 	(2) meets the asset limits in paragraph (d); and
139.12 	(3) pays a premium and other obligations under paragraph (e).
139.13 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
139.14 	for medical assistance under this subdivision, a person must have more than $65 of earned 
139.15 	income. Earned income must have Medicare, Social Security, and applicable state and 
139.16 	federal taxes withheld. The person must document earned income tax withholding. Any 
139.17 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
139.18 	determinations.
139.19 	(c) After the month of enrollment, a person enrolled in medical assistance under this 
139.20 	subdivision who:
139.21 	(1) is temporarily unable to work and without receipt of earned income due to a medical 
139.22 	condition, as verified by a physician, advanced practice registered nurse, or physician 
139.23 	assistant; or
139.24 	(2) loses employment for reasons not attributable to the enrollee, and is without receipt 
139.25 	of earned income may retain eligibility for up to four consecutive months after the month 
139.26 	of job loss. To receive a four-month extension, enrollees must verify the medical condition 
139.27 	or provide notification of job loss. All other eligibility requirements must be met and the 
139.28 	enrollee must pay all calculated premium costs for continued eligibility.
139.29 	(d) For purposes of determining eligibility under this subdivision, a person's assets must 
139.30 	not exceed $20,000, excluding:
139.31 	(1) all assets excluded under section 256B.056;
140.1 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh 
140.2 	plans, and pension plans;
140.3 	(3) medical expense accounts set up through the person's employer; and
140.4 	(4) spousal assets, including spouse's share of jointly held assets.
140.5 	(e) All enrollees must pay a premium to be eligible for medical assistance under this 
140.6 	subdivision, except as provided under clause (5).
140.7 	(1) An enrollee must pay the greater of a $35 premium or the premium calculated based 
140.8 	on the person's gross earned and unearned income and the applicable family size using a 
140.9 	sliding fee scale established by the commissioner, which begins at one percent of income 
140.10 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for 
140.11 	those with incomes at or above 300 percent of the federal poverty guidelines.
140.12 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
140.13 	poverty guidelines shall be effective for premiums due in July of each year.
140.14 	(3) All enrollees who receive unearned income must pay one-half of one percent of 
140.15 	unearned income in addition to the premium amount, except as provided under clause (5).
140.16 	(4) Increases in benefits under title II of the Social Security Act shall not be counted as 
140.17 	income for purposes of this subdivision until July 1 of each year.
140.18 	(5) Effective July 1, 2009, American Indians are exempt from paying premiums as 
140.19 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
140.20 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
140.21 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
140.22 	(f) (e) A person's eligibility and premium shall be determined by the local county agency. 
140.23 	Premiums must be paid to the commissioner. All premiums are dedicated to the 
140.24 	commissioner.
140.25 	(g) (f) Any required premium shall be determined at application and redetermined at the 
140.26 	enrollee's six-month income review or when a change in income or household size is reported. 
140.27 	Enrollees must report any change in income or household size within ten days of when the 
140.28 	change occurs. A decreased premium resulting from a reported change in income or 
140.29 	household size shall be effective the first day of the next available billing month after the 
140.30 	change is reported. Except for changes occurring from annual cost-of-living increases, a 
140.31 	change resulting in an increased premium shall not affect the premium amount until the 
140.32 	next six-month review.
141.1 	(h) (g) Premium payment is due upon notification from the commissioner of the premium 
141.2 	amount required. Premiums may be paid in installments at the discretion of the commissioner.
141.3 	(i) (h) Nonpayment of the premium shall result in denial or termination of medical 
141.4 	assistance unless the person demonstrates good cause for nonpayment. "Good cause" means 
141.5 	an excuse for the enrollee's failure to pay the required premium when due because the 
141.6 	circumstances were beyond the enrollee's control or not reasonably foreseeable. The 
141.7 	commissioner shall determine whether good cause exists based on the weight of the 
141.8 	supporting evidence submitted by the enrollee to demonstrate good cause. Except when an 
141.9 	installment agreement is accepted by the commissioner, all persons disenrolled for 
141.10 	nonpayment of a premium must pay any past due premiums as well as current premiums 
141.11 	due prior to being reenrolled. Nonpayment shall include payment with a returned, refused, 
141.12 	or dishonored instrument. The commissioner may require a guaranteed form of payment as 
141.13 	the only means to replace a returned, refused, or dishonored instrument.
141.14 	(j) (i) For enrollees whose income does not exceed 200 percent of the federal poverty 
141.15 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the 
141.16 	enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph 
141.17 	(a).
141.18 	(j) The commissioner is authorized to determine that a premium amount was calculated 
141.19 	or billed in error, make corrections to financial records and billing systems, and refund 
141.20 	premiums collected in error.

141.21 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
141.22 	whichever occurs later, except that paragraph (j) is effective the day following final 
141.23 	enactment. The commissioner of human services shall notify the revisor of statutes when 
141.24 	federal approval is obtained.

141.25 	Sec. 5. Minnesota Statutes 2022, section 256B.0625, subdivision 17, is amended to read:
141.26 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
141.27 	means motor vehicle transportation provided by a public or private person that serves 
141.28 	Minnesota health care program beneficiaries who do not require emergency ambulance 
141.29 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
141.30 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
141.31 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
141.32 	emergency or nonemergency medical care when paid directly to an ambulance company, 
142.1 	nonemergency medical transportation company, or other recognized providers of 
142.2 	transportation services. Medical transportation must be provided by:
142.3 	(1) nonemergency medical transportation providers who meet the requirements of this 
142.4 	subdivision;
142.5 	(2) ambulances, as defined in section 144E.001, subdivision 2;
142.6 	(3) taxicabs that meet the requirements of this subdivision;
142.7 	(4) public transit, as defined in section 174.22, subdivision 7; or
142.8 	(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472, 
142.9 	subdivision 1, paragraph (h).
142.10 	(c) Medical assistance covers nonemergency medical transportation provided by 
142.11 	nonemergency medical transportation providers enrolled in the Minnesota health care 
142.12 	programs. All nonemergency medical transportation providers must comply with the 
142.13 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
142.14 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
142.15 	commissioner and reported on the claim as the individual who provided the service. All 
142.16 	nonemergency medical transportation providers shall bill for nonemergency medical 
142.17 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
142.18 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
142.19 	requirements outlined in this paragraph.
142.20 	(d) An organization may be terminated, denied, or suspended from enrollment if:
142.21 	(1) the provider has not initiated background studies on the individuals specified in 
142.22 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
142.23 	(2) the provider has initiated background studies on the individuals specified in section 
142.24 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
142.25 	(i) the commissioner has sent the provider a notice that the individual has been 
142.26 	disqualified under section 245C.14; and
142.27 	(ii) the individual has not received a disqualification set-aside specific to the special 
142.28 	transportation services provider under sections 245C.22 and 245C.23.
142.29 	(e) The administrative agency of nonemergency medical transportation must:
142.30 	(1) adhere to the policies defined by the commissioner;
143.1 	(2) pay nonemergency medical transportation providers for services provided to 
143.2 	Minnesota health care programs beneficiaries to obtain covered medical services;
143.3 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
143.4 	trips, and number of trips by mode; and
143.5 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
143.6 	administrative structure assessment tool that meets the technical requirements established 
143.7 	by the commissioner, reconciles trip information with claims being submitted by providers, 
143.8 	and ensures prompt payment for nonemergency medical transportation services.
143.9 	(f) Until the commissioner implements the single administrative structure and delivery 
143.10 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
143.11 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
143.12 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
143.13 	(g) The commissioner may use an order by the recipient's attending physician, advanced 
143.14 	practice registered nurse, physician assistant, or a medical or mental health professional to 
143.15 	certify that the recipient requires nonemergency medical transportation services. 
143.16 	Nonemergency medical transportation providers shall perform driver-assisted services for 
143.17 	eligible individuals, when appropriate. Driver-assisted service includes passenger pickup 
143.18 	at and return to the individual's residence or place of business, assistance with admittance 
143.19 	of the individual to the medical facility, and assistance in passenger securement or in securing 
143.20 	of wheelchairs, child seats, or stretchers in the vehicle.
143.21 	Nonemergency medical transportation providers must take clients to the health care 
143.22 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
143.23 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
143.24 	authorization from the local agency.
143.25 	Nonemergency medical transportation providers may not bill for separate base rates for 
143.26 	the continuation of a trip beyond the original destination. Nonemergency medical 
143.27 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
143.28 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
143.29 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
143.30 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
143.31 	services.
143.32 	(h) The administrative agency shall use the level of service process established by the 
143.33 	commissioner to determine the client's most appropriate mode of transportation. If public 
144.1 	transit or a certified transportation provider is not available to provide the appropriate service 
144.2 	mode for the client, the client may receive a onetime service upgrade.
144.3 	(i) The covered modes of transportation are:
144.4 	(1) client reimbursement, which includes client mileage reimbursement provided to 
144.5 	clients who have their own transportation, or to family or an acquaintance who provides 
144.6 	transportation to the client;
144.7 	(2) volunteer transport, which includes transportation by volunteers using their own 
144.8 	vehicle;
144.9 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
144.10 	or public transit. If a taxicab or public transit is not available, the client can receive 
144.11 	transportation from another nonemergency medical transportation provider;
144.12 	(4) assisted transport, which includes transport provided to clients who require assistance 
144.13 	by a nonemergency medical transportation provider;
144.14 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
144.15 	dependent on a device and requires a nonemergency medical transportation provider with 
144.16 	a vehicle containing a lift or ramp;
144.17 	(6) protected transport, which includes transport provided to a client who has received 
144.18 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
144.19 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
144.20 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
144.21 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
144.22 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
144.23 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
144.24 	a client in a prone or supine position.
144.25 	(j) The local agency shall be the single administrative agency and shall administer and 
144.26 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
144.27 	commissioner has developed, made available, and funded the web-based single administrative 
144.28 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
144.29 	agency's financial obligation is limited to funds provided by the state or federal government.
144.30 	(k) The commissioner shall:
144.31 	(1) verify that the mode and use of nonemergency medical transportation is appropriate;
144.32 	(2) verify that the client is going to an approved medical appointment; and
145.1 	(3) investigate all complaints and appeals.
145.2 	(l) The administrative agency shall pay for the services provided in this subdivision and 
145.3 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
145.4 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
145.5 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
145.6 	(m) Payments for nonemergency medical transportation must be paid based on the client's 
145.7 	assessed mode under paragraph (h), not the type of vehicle used to provide the service. The 
145.8 	medical assistance reimbursement rates for nonemergency medical transportation services 
145.9 	that are payable by or on behalf of the commissioner for nonemergency medical 
145.10 	transportation services are:
145.11 	(1) $0.22 per mile for client reimbursement;
145.12 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
145.13 	transport;
145.14 	(3) equivalent to the standard fare for unassisted transport when provided by public 
145.15 	transit, and $11 $12.10 for the base rate and $1.30 $1.43 per mile when provided by a 
145.16 	nonemergency medical transportation provider;
145.17 	(4) $13 $14.30 for the base rate and $1.30 $1.43 per mile for assisted transport;
145.18 	(5) $18 $19.80 for the base rate and $1.55 $1.70 per mile for lift-equipped/ramp transport;
145.19 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
145.20 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
145.21 	an additional attendant if deemed medically necessary.
145.22 	(n) The base rate for nonemergency medical transportation services in areas defined 
145.23 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
145.24 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
145.25 	services in areas defined under RUCA to be rural or super rural areas is:
145.26 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
145.27 	rate in paragraph (m), clauses (1) to (7); and
145.28 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
145.29 	rate in paragraph (m), clauses (1) to (7).
145.30 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
145.31 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
145.32 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
146.1 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
146.2 	a census-tract based classification system under which a geographical area is determined 
146.3 	to be urban, rural, or super rural.
146.4 	(q) The commissioner, when determining reimbursement rates for nonemergency medical 
146.5 	transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed 
146.6 	under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).
146.7 	(r) Effective for the first day of each calendar quarter in which the price of gasoline as 
146.8 	posted publicly by the United States Energy Information Administration exceeds $3.00 per 
146.9 	gallon, the commissioner shall adjust the rate paid per mile in paragraph (m) by one percent 
146.10 	up or down for every increase or decrease of ten cents for the price of gasoline. The increase 
146.11 	or decrease must be calculated using a base gasoline price of $3.00. The percentage increase 
146.12 	or decrease must be calculated using the average of the most recently available price of all 
146.13 	grades of gasoline for Minnesota as posted publicly by the United States Energy Information 
146.14 	Administration.

146.15 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
146.16 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
146.17 	when federal approval is obtained.

146.18 	Sec. 6. Minnesota Statutes 2022, section 256B.0625, subdivision 17a, is amended to read:
146.19 		Subd. 17a.Payment for ambulance services. (a) Medical assistance covers ambulance 
146.20 	services. Providers shall bill ambulance services according to Medicare criteria. 
146.21 	Nonemergency ambulance services shall not be paid as emergencies. Effective for services 
146.22 	rendered on or after July 1, 2001, medical assistance payments for ambulance services shall 
146.23 	be paid at the Medicare reimbursement rate or at the medical assistance payment rate in 
146.24 	effect on July 1, 2000, whichever is greater.
146.25 	(b) Effective for services provided on or after July 1, 2016, medical assistance payment 
146.26 	rates for ambulance services identified in this paragraph are increased by five percent. 
146.27 	Capitation payments made to managed care plans and county-based purchasing plans for 
146.28 	ambulance services provided on or after January 1, 2017, shall be increased to reflect this 
146.29 	rate increase. The increased rate described in this paragraph applies to ambulance service 
146.30 	providers whose base of operations as defined in section 144E.10 is located:
146.31 	(1) outside the metropolitan counties listed in section 473.121, subdivision 4, and outside 
146.32 	the cities of Duluth, Mankato, Moorhead, St. Cloud, and Rochester; or
146.33 	(2) within a municipality with a population of less than 1,000.
147.1 	(c) Effective for the first day of each calendar quarter in which the price of gasoline as 
147.2 	posted publicly by the United States Energy Information Administration exceeds $3.00 per 
147.3 	gallon, the commissioner shall adjust the rate paid per mile in paragraph (a) by one percent 
147.4 	up or down for every increase or decrease of ten cents for the price of gasoline. The increase 
147.5 	or decrease must be calculated using a base gasoline price of $3.00. The percentage increase 
147.6 	or decrease must be calculated using the average of the most recently available price of all 
147.7 	grades of gasoline for Minnesota as posted publicly by the United States Energy Information 
147.8 	Administration.
147.9 	(d) Managed care plans and county-based purchasing plans must provide a fuel adjustment 
147.10 	for ambulance services rates when fuel exceeds $3 per gallon. If, for any contract year, 
147.11 	federal approval is not received for this paragraph, the commissioner must adjust the 
147.12 	capitation rates paid to managed care plans and county-based purchasing plans for that 
147.13 	contract year to reflect the removal of this provision. Contracts between managed care plans 
147.14 	and county-based purchasing plans and providers to whom this paragraph applies must 
147.15 	allow recovery of payments from those providers if capitation rates are adjusted in accordance 
147.16 	with this paragraph. Payment recoveries must not exceed the amount equal to any increase 
147.17 	in rates that results from this paragraph. This paragraph expires if federal approval is not 
147.18 	received for this paragraph at any time.

147.19 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
147.20 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
147.21 	when federal approval is obtained.

147.22 	Sec. 7. Minnesota Statutes 2022, section 256B.0625, subdivision 17b, is amended to read:
147.23 		Subd. 17b.Documentation required. (a) As a condition for payment, nonemergency 
147.24 	medical transportation providers must document each occurrence of a service provided to 
147.25 	a recipient according to this subdivision. Providers must maintain odometer and other records 
147.26 	sufficient to distinguish individual trips with specific vehicles and drivers. The documentation 
147.27 	may be collected and maintained using electronic systems or software or in paper form but 
147.28 	must be made available and produced upon request. Program funds paid for transportation 
147.29 	that is not documented according to this subdivision shall be recovered by the department
147.30 	may be subject to recovery by the commissioner pursuant to section 256B.064.
147.31 	(b) A nonemergency medical transportation provider must compile transportation trip 
147.32 	records that are written in English and legible according to the standard of a reasonable 
147.33 	person and that meet include each of the following requirements elements:
148.1 	(1) the record must be in English and must be legible according to the standard of a 
148.2 	reasonable person;
148.3 	(2) (1) the recipient's name must be on each page of the record; and
148.4 	(3) each entry in the record must document:
148.5 	(i) the date on which the entry is made;
148.6 	(ii) (2) the date or dates the service is provided, if different than the date the entry was 
148.7 	made;
148.8 	(iii) (3) either the printed last name, first name, and middle initialname of the driver
148.9 	sufficient to distinguish the driver of service or the driver's provider number;
148.10 	(iv) (4) the date and the signature of the driver attesting to the following: "I certify that 
148.11 	I have accurately reported in this record the trip miles I actually drove and the dates and 
148.12 	times I actually drove them. I understand that misreporting the miles driven and hours 
148.13 	worked is fraud for which I could face criminal prosecution or civil proceedings." that the 
148.14 	record accurately represents the services provided and the actual miles driven, and 
148.15 	acknowledging that misreporting information that results in ineligible or excessive payments 
148.16 	may result in civil or criminal action;
148.17 	(v) (5) the date and the signature of the recipient or authorized party attesting to the 
148.18 	following: "I certify that I received the reported transportation service.", or the signature of 
148.19 	the provider of medical services certifying that the recipient was delivered to the provider
148.20 	that transportation services were provided as indicated on the transportation trip record, or 
148.21 	the signature of the medical services provider certifying that the recipient was transported 
148.22 	to the medical services provider destination. In the event that both the medical services 
148.23 	provider and the recipient or authorized party refuse or are unable to provide signatures, 
148.24 	the driver must document on the transportation trip record that signatures were requested 
148.25 	and not provided;
148.26 	(vi) (6) the address, or the description if the address is not available, of both the origin 
148.27 	and destination, and the mileage for the most direct route from the origin to the destination;
148.28 	(vii) (7) the name or number of the mode of transportation in which the service is 
148.29 	provided;
148.30 	(viii) (8) the license plate number of the vehicle used to transport the recipient;
148.31 	(ix) whether the service was ambulatory or nonambulatory;
148.32 	(x) (9) the time of the recipient pickup;
149.1 	and (10) the time of the recipient drop-off with "a.m." and "p.m." designations;
149.2 	(11) the odometer reading of the vehicle used to transport the recipient taken at the time 
149.3 	of pickup;
149.4 	(12) the odometer reading of the vehicle used to transport the recipient taken at the time 
149.5 	of drop-off;
149.6 	(xi) (13) the name of the extra attendant when an extra attendant is used to provide 
149.7 	special transportation service; and
149.8 	(xii) (14) the electronic source documentation indicating the method that was used to 
149.9 	calculate driving directions and mileage determine the most direct route.
149.10 	(c) In determining whether the commissioner will seek recovery, the documentation 
149.11 	requirements in this section apply retroactively to audit findings beginning January 1, 2020, 
149.12 	and to all audit findings thereafter.

149.13 	Sec. 8. Minnesota Statutes 2022, section 256B.0625, subdivision 18h, is amended to read:
149.14 		Subd. 18h.Nonemergency medical transportation provisions related to managed 
149.15 	care. (a) The following nonemergency medical transportation (NEMT) subdivisions apply 
149.16 	to managed care plans and county-based purchasing plans:
149.17 	(1) subdivision 17, paragraphs (a), (b), (i), and (n);
149.18 	(2) subdivision 18; and
149.19 	(3) subdivision 18a.
149.20 	(b) A nonemergency medical transportation provider must comply with the operating 
149.21 	standards for special transportation service specified in sections 174.29 to 174.30 and 
149.22 	Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire 
149.23 	vehicles are exempt from the requirements in this paragraph.
149.24 	(c) Managed care plans and county-based purchasing plans must provide a fuel adjustment 
149.25 	for NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval 
149.26 	is not received for this paragraph, the commissioner must adjust the capitation rates paid to 
149.27 	managed care plans and county-based purchasing plans for that contract year to reflect the 
149.28 	removal of this provision. Contracts between managed care plans and county-based 
149.29 	purchasing plans and providers to whom this paragraph applies must allow recovery of 
149.30 	payments from those providers if capitation rates are adjusted in accordance with this 
149.31 	paragraph. Payment recoveries must not exceed the amount equal to any increase in rates 
150.1 	that results from this paragraph. This paragraph expires if federal approval is not received 
150.2 	for this paragraph at any time.

150.3 	EFFECTIVE DATE. This section is effective January 1, 2024.

150.4 	Sec. 9. Minnesota Statutes 2022, section 256B.0625, subdivision 22, is amended to read:
150.5 		Subd. 22.Hospice care. Medical assistance covers hospice care services under Public 
150.6 	Law 99-272, section 9505, to the extent authorized by rule, except that a recipient age 21 
150.7 	or under who elects to receive hospice services does not waive coverage for services that 
150.8 	are related to the treatment of the condition for which a diagnosis of terminal illness has 
150.9 	been made. Hospice respite and end-of-life care under subdivision 22a are not hospice care 
150.10 	services under this subdivision.

150.11 	EFFECTIVE DATE. This section is effective January 1, 2024.

150.12 	Sec. 10. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
150.13 	to read:
150.14 		Subd. 22a.Residential hospice facility; hospice respite and end-of-life care for 
150.15 	children. (a) Medical assistance covers hospice respite and end-of-life care if the care is 
150.16 	for children who elect to receive hospice care delivered in a facility that is licensed under 
150.17 	sections 144A.75 to 144A.755 and that is a residential hospice facility under section 144A.75, 
150.18 	subdivision 13, paragraph (a). Hospice care services under subdivision 22 are not hospice 
150.19 	respite or end-of-life care under this subdivision.
150.20 	(b) The payment rates for coverage under this subdivision must be 100 percent of the 
150.21 	Medicare rate for continuous home care hospice services as published in the Centers for 
150.22 	Medicare and Medicaid Services annual final rule updating payments and policies for hospice 
150.23 	care. Payment for hospice respite and end-of-life care under this subdivision must be made 
150.24 	from state money, though the commissioner must seek to obtain federal financial participation 
150.25 	for the payments. Payment for hospice respite and end-of-life care must be paid to the 
150.26 	residential hospice facility and are not included in any limit or cap amount applicable to 
150.27 	hospice services payments to the elected hospice services provider.
150.28 	(c) Certification of the residential hospice facility by the federal Medicare program must 
150.29 	not be a requirement of medical assistance payment for hospice respite and end-of-life care 
150.30 	under this subdivision.

150.31 	EFFECTIVE DATE. This section is effective January 1, 2024.

151.1 	Sec. 11. Minnesota Statutes 2022, section 256B.073, subdivision 3, is amended to read:
151.2 		Subd. 3.Requirements. (a) In developing implementation requirements for electronic 
151.3 	visit verification, the commissioner shall ensure that the requirements:
151.4 	(1) are minimally administratively and financially burdensome to a provider;
151.5 	(2) are minimally burdensome to the service recipient and the least disruptive to the 
151.6 	service recipient in receiving and maintaining allowed services;
151.7 	(3) consider existing best practices and use of electronic visit verification;
151.8 	(4) are conducted according to all state and federal laws;
151.9 	(5) are effective methods for preventing fraud when balanced against the requirements 
151.10 	of clauses (1) and (2); and
151.11 	(6) are consistent with the Department of Human Services' policies related to covered 
151.12 	services, flexibility of service use, and quality assurance.
151.13 	(b) The commissioner shall make training available to providers on the electronic visit 
151.14 	verification system requirements.
151.15 	(c) The commissioner shall establish baseline measurements related to preventing fraud 
151.16 	and establish measures to determine the effect of electronic visit verification requirements 
151.17 	on program integrity.
151.18 	(d) The commissioner shall make a state-selected electronic visit verification system 
151.19 	available to providers of services.
151.20 	(e) The commissioner shall make available and publish on the agency website the name 
151.21 	and contact information for the vendor of the state-selected electronic visit verification 
151.22 	system and the other vendors that offer alternative electronic visit verification systems. The 
151.23 	information provided must state that the state-selected electronic visit verification system 
151.24 	is offered at no cost to the provider of services and that the provider may choose an alternative 
151.25 	system that may be at a cost to the provider.

151.26 	Sec. 12. Minnesota Statutes 2022, section 256B.073, is amended by adding a subdivision 
151.27 	to read:
151.28 		Subd. 5.Vendor requirements. (a) The vendor of the electronic visit verification system 
151.29 	selected by the commissioner and the vendor's affiliate must comply with the requirements 
151.30 	of this subdivision.
152.1 	(b) The vendor of the state-selected electronic visit verification system and the vendor's 
152.2 	affiliate must:
152.3 	(1) notify the provider of services that the provider may choose the state-selected 
152.4 	electronic visit verification system at no cost to the provider;
152.5 	(2) offer the state-selected electronic visit verification system to the provider of services 
152.6 	prior to offering any fee-based electronic visit verification system;
152.7 	(3) notify the provider of services that the provider may choose any fee-based electronic 
152.8 	visit verification system prior to offering the vendor's or its affiliate's fee-based electronic 
152.9 	visit verification system; and
152.10 	(4) when offering the state-selected electronic visit verification system, clearly 
152.11 	differentiate between the state-selected electronic visit verification system and the vendor's 
152.12 	or its affiliate's alternative fee-based system.
152.13 	(c) The vendor of the state-selected electronic visit verification system and the vendor's 
152.14 	affiliate must not use state data that are not available to other vendors of electronic visit 
152.15 	verification systems to promote or sell the vendor's or its affiliate's alternative electronic 
152.16 	visit verification system.
152.17 	(d) Upon request from the provider, the vendor of the state-selected electronic visit 
152.18 	verification system must provide proof of compliance with the requirements of paragraph 
152.19 	(b).
152.20 	(e) An agreement between the vendor of the state-selected electronic visit verification 
152.21 	system or its affiliate and a provider of services for an electronic visit verification system 
152.22 	that is not the state-selected system entered into on or after July 1, 2023, is subject to 
152.23 	immediate termination by the provider if the vendor violates any of the requirements of 
152.24 	paragraph (b).

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

152.26 	Sec. 13. Minnesota Statutes 2022, section 256B.14, subdivision 2, is amended to read:
152.27 		Subd. 2.Actions to obtain payment. The state agency shall promulgate rules to 
152.28 	determine the ability of responsible relatives to contribute partial or complete payment or 
152.29 	repayment of medical assistance furnished to recipients for whom they are responsible. All 
152.30 	medical assistance exclusions shall be allowed, and a resource limit of $10,000 for 
152.31 	nonexcluded resources shall be implemented. Above these limits, a contribution of one-third 
152.32 	of the excess resources shall be required. These rules shall not require payment or repayment 
153.1 	when payment would cause undue hardship to the responsible relative or that relative's 
153.2 	immediate family. These rules shall be consistent with the requirements of section 252.27
153.3 	for do not apply to parents of children whose eligibility for medical assistance was determined 
153.4 	without deeming of the parents' resources and income under the Tax Equity and Fiscal 
153.5 	Responsibility Act (TEFRA) option or to parents of children accessing home and 
153.6 	community-based waiver services. The county agency shall give the responsible relative 
153.7 	notice of the amount of the payment or repayment. If the state agency or county agency 
153.8 	finds that notice of the payment obligation was given to the responsible relative, but that 
153.9 	the relative failed or refused to pay, a cause of action exists against the responsible relative 
153.10 	for that portion of medical assistance granted after notice was given to the responsible 
153.11 	relative, which the relative was determined to be able to pay.
153.12 	The action may be brought by the state agency or the county agency in the county where 
153.13 	assistance was granted, for the assistance, together with the costs of disbursements incurred 
153.14 	due to the action.
153.15 	In addition to granting the county or state agency a money judgment, the court may, 
153.16 	upon a motion or order to show cause, order continuing contributions by a responsible 
153.17 	relative found able to repay the county or state agency. The order shall be effective only 
153.18 	for the period of time during which the recipient receives medical assistance from the county 
153.19 	or state agency.

153.20 	Sec. 14. Minnesota Statutes 2022, section 256B.766, is amended to read:
153.21 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
153.22 	(a) Effective for services provided on or after July 1, 2009, total payments for basic care 
153.23 	services, shall be reduced by three percent, except that for the period July 1, 2009, through 
153.24 	June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance 
153.25 	and general assistance medical care programs, prior to third-party liability and spenddown 
153.26 	calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services, 
153.27 	occupational therapy services, and speech-language pathology and related services as basic 
153.28 	care services. The reduction in this paragraph shall apply to physical therapy services, 
153.29 	occupational therapy services, and speech-language pathology and related services provided 
153.30 	on or after July 1, 2010.
153.31 	(b) Payments made to managed care plans and county-based purchasing plans shall be 
153.32 	reduced for services provided on or after October 1, 2009, to reflect the reduction effective 
153.33 	July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010, 
153.34 	to reflect the reduction effective July 1, 2010.
154.1 	(c) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
154.2 	total payments for outpatient hospital facility fees shall be reduced by five percent from the 
154.3 	rates in effect on August 31, 2011.
154.4 	(d) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
154.5 	total payments for ambulatory surgery centers facility fees, medical supplies and durable 
154.6 	medical equipment not subject to a volume purchase contract, prosthetics and orthotics, 
154.7 	renal dialysis services, laboratory services, public health nursing services, physical therapy 
154.8 	services, occupational therapy services, speech therapy services, eyeglasses not subject to 
154.9 	a volume purchase contract, hearing aids not subject to a volume purchase contract, and 
154.10 	anesthesia services shall be reduced by three percent from the rates in effect on August 31, 
154.11 	2011.
154.12 	(e) Effective for services provided on or after September 1, 2014, payments for 
154.13 	ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory 
154.14 	services, public health nursing services, eyeglasses not subject to a volume purchase contract, 
154.15 	and hearing aids not subject to a volume purchase contract shall be increased by three percent 
154.16 	and payments for outpatient hospital facility fees shall be increased by three percent. 
154.17 	Payments made to managed care plans and county-based purchasing plans shall not be 
154.18 	adjusted to reflect payments under this paragraph.
154.19 	(f) Payments for medical supplies and durable medical equipment not subject to a volume 
154.20 	purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through 
154.21 	June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable 
154.22 	medical equipment not subject to a volume purchase contract, and prosthetics and orthotics, 
154.23 	provided on or after July 1, 2015, shall be increased by three percent from the rates as 
154.24 	determined under paragraphs (i) and (j).
154.25 	(g) Effective for services provided on or after July 1, 2015, payments for outpatient 
154.26 	hospital facility fees, medical supplies and durable medical equipment not subject to a 
154.27 	volume purchase contract, prosthetics, and orthotics to a hospital meeting the criteria specified 
154.28 	in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent 
154.29 	from the rates in effect on June 30, 2015. Payments made to managed care plans and 
154.30 	county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
154.31 	(h) This section does not apply to physician and professional services, inpatient hospital 
154.32 	services, family planning services, mental health services, dental services, prescription 
154.33 	drugs, medical transportation, federally qualified health centers, rural health centers, Indian 
154.34 	health services, and Medicare cost-sharing.
155.1 	(i) Effective for services provided on or after July 1, 2015, the following categories of 
155.2 	medical supplies and durable medical equipment shall be individually priced items: enteral 
155.3 	nutrition and supplies, customized and other specialized tracheostomy tubes and supplies, 
155.4 	electric patient lifts, and durable medical equipment repair and service. This paragraph does 
155.5 	not apply to medical supplies and durable medical equipment subject to a volume purchase 
155.6 	contract, products subject to the preferred diabetic testing supply program, and items provided 
155.7 	to dually eligible recipients when Medicare is the primary payer for the item. The 
155.8 	commissioner shall not apply any medical assistance rate reductions to durable medical 
155.9 	equipment as a result of Medicare competitive bidding.
155.10 	(j) Effective for services provided on or after July 1, 2015, medical assistance payment 
155.11 	rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased 
155.12 	as follows:
155.13 	(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that 
155.14 	were subject to the Medicare competitive bid that took effect in January of 2009 shall be 
155.15 	increased by 9.5 percent; and
155.16 	(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on 
155.17 	the medical assistance fee schedule, whether or not subject to the Medicare competitive bid 
155.18 	that took effect in January of 2009, shall be increased by 2.94 percent, with this increase 
155.19 	being applied after calculation of any increased payment rate under clause (1).
155.20 	This paragraph does not apply to medical supplies and durable medical equipment subject 
155.21 	to a volume purchase contract, products subject to the preferred diabetic testing supply 
155.22 	program, items provided to dually eligible recipients when Medicare is the primary payer 
155.23 	for the item, and individually priced items identified in paragraph (i). Payments made to 
155.24 	managed care plans and county-based purchasing plans shall not be adjusted to reflect the 
155.25 	rate increases in this paragraph.
155.26 	(k) Effective for nonpressure support ventilators provided on or after January 1, 2016, 
155.27 	the rate shall be the lower of the submitted charge or the Medicare fee schedule rate. Effective 
155.28 	for pressure support ventilators provided on or after January 1, 2016, the rate shall be the 
155.29 	lower of the submitted charge or 47 percent above the Medicare fee schedule rate. For 
155.30 	payments made in accordance with this paragraph, if, and to the extent that, the commissioner 
155.31 	identifies that the state has received federal financial participation for ventilators in excess 
155.32 	of the amount allowed effective January 1, 2018, under United States Code, title 42, section 
155.33 	1396b(i)(27), the state shall repay the excess amount to the Centers for Medicare and 
155.34 	Medicaid Services with state funds and maintain the full payment rate under this paragraph.
156.1 	(l) Payment rates for durable medical equipment, prosthetics, orthotics or supplies, that 
156.2 	are subject to the upper payment limit in accordance with section 1903(i)(27) of the Social 
156.3 	Security Act, shall be paid the Medicare rate. Rate increases provided in this chapter shall 
156.4 	not be applied to the items listed in this paragraph.
156.5 	(m) For dates of service on or after July 1, 2023, through June 30, 2024, enteral nutrition 
156.6 	and supplies must be paid according to this paragraph. If sufficient data exists for a product 
156.7 	or supply, payment must be based upon the 50th percentile of the usual and customary 
156.8 	charges per product code submitted to the commissioner, using only charges submitted per 
156.9 	unit. Increases in rates resulting from the 50th percentile payment method must not exceed 
156.10 	150 percent of the previous fiscal year's rate per code and product combination. Data are 
156.11 	sufficient if: (1) the commissioner has at least 100 paid claim lines by at least ten different 
156.12 	providers for a given product or supply; or (2) in the absence of the data in clause (1), the 
156.13 	commissioner has at least 20 claim lines by at least five different providers for a product or 
156.14 	supply that does not meet the requirements of clause (1). If sufficient data are not available 
156.15 	to calculate the 50th percentile for enteral products or supplies, the payment rate must be 
156.16 	the payment rate in effect on June 30, 2023.
156.17 	(n) For dates of service on or after July 1, 2024, enteral nutrition and supplies must be 
156.18 	paid according to this paragraph and updated annually each January 1. If sufficient data 
156.19 	exists for a product or supply, payment must be based upon the 50th percentile of the usual 
156.20 	and customary charges per product code submitted to the commissioner for the previous 
156.21 	calendar year, using only charges submitted per unit. Increases in rates resulting from the 
156.22 	50th percentile payment method must not exceed 150 percent of the previous year's rate per 
156.23 	code and product combination. Data are sufficient if: (1) the commissioner has at least 100 
156.24 	paid claim lines by at least ten different providers for a given product or supply; or (2) in 
156.25 	the absence of the data in clause (1), the commissioner has at least 20 claim lines by at least 
156.26 	five different providers for a product or supply that does not meet the requirements of clause 
156.27 	(1). If sufficient data are not available to calculate the 50th percentile for enteral products 
156.28 	or supplies, the payment must be the manufacturer's suggested retail price of that product 
156.29 	or supply minus 20 percent. If the manufacturer's suggested retail price is not available, 
156.30 	payment must be the actual acquisition cost of that product or supply plus 20 percent.

157.1 	ARTICLE 4
157.2 	BEHAVIORAL HEALTH

157.3 	Section 1. Minnesota Statutes 2022, section 4.046, subdivision 6, is amended to read:
157.4 		Subd. 6.Office of Addiction and Recovery; director. The Office of Addiction and 
157.5 	Recovery is created in the Department of Management and Budget. The governor must 
157.6 	appoint an addiction and recovery director, who shall serve as chair of the subcabinet and 
157.7 	administer the Office of Addiction and Recovery. The director shall serve in the unclassified 
157.8 	service and shall report to the governor. The director must:
157.9 	(1) make efforts to break down silos and work across agencies to better target the state's 
157.10 	role in addressing addiction, treatment, and recovery for youth and adults;
157.11 	(2) assist in leading the subcabinet and the advisory council toward progress on 
157.12 	measurable goals that track the state's efforts in combatting addiction for youth and adults, 
157.13 	and preventing substance use and addiction among the state's youth population; and
157.14 	(3) establish and manage external partnerships and build relationships with communities, 
157.15 	community leaders, and those who have direct experience with addiction to ensure that all 
157.16 	voices of recovery are represented in the work of the subcabinet and advisory council.

157.17 	Sec. 2. Minnesota Statutes 2022, section 4.046, subdivision 7, is amended to read:
157.18 		Subd. 7.Staff and administrative support. The commissioner of human services
157.19 	management and budget, in coordination with other state agencies and boards as applicable, 
157.20 	must provide staffing and administrative support to the Office of Addiction and Recovery, 
157.21 	the addiction and recovery director, the subcabinet, and the advisory council established in 
157.22 	this section.

157.23 	Sec. 3. Minnesota Statutes 2022, section 245.91, subdivision 4, is amended to read:
157.24 		Subd. 4.Facility or program. "Facility" or "program" means a nonresidential or 
157.25 	residential program as defined in section 245A.02, subdivisions 10 and 14, and any agency, 
157.26 	facility, or program that provides services or treatment for mental illness, developmental 
157.27 	disability, substance use disorder, or emotional disturbance that is required to be licensed, 
157.28 	certified, or registered by the commissioner of human services, health, or education; a sober 
157.29 	home as defined in section 254B.01, subdivision 10; and an acute care inpatient facility that 
157.30 	provides services or treatment for mental illness, developmental disability, substance use 
157.31 	disorder, or emotional disturbance.

158.1 	Sec. 4. Minnesota Statutes 2022, section 245G.02, subdivision 2, is amended to read:
158.2 		Subd. 2.Exemption from license requirement. This chapter does not apply to a county 
158.3 	or recovery community organization that is providing a service for which the county or 
158.4 	recovery community organization is an eligible vendor under section 254B.05. This chapter 
158.5 	does not apply to an organization whose primary functions are information, referral, 
158.6 	diagnosis, case management, and assessment for the purposes of client placement, education, 
158.7 	support group services, or self-help programs. This chapter does not apply to the activities 
158.8 	of a licensed professional in private practice. A license holder providing the initial set of 
158.9 	substance use disorder services allowable under section 254A.03, subdivision 3, paragraph 
158.10 	(c), to an individual referred to a licensed nonresidential substance use disorder treatment 
158.11 	program after a positive screen for alcohol or substance misuse is exempt from sections 
158.12 	245G.05; 245G.06, subdivisions 1, 2 1a, and 4; 245G.07, subdivisions 1, paragraph (a), 
158.13 	clauses (2) to (4), and 2, clauses (1) to (7); and 245G.17.

158.14 	Sec. 5. Minnesota Statutes 2022, section 245G.09, subdivision 3, is amended to read:
158.15 		Subd. 3.Contents. Client records must contain the following:
158.16 	(1) documentation that the client was given information on client rights and 
158.17 	responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided 
158.18 	an orientation to the program abuse prevention plan required under section 245A.65, 
158.19 	subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record 
158.20 	must contain documentation that the client was provided educational information according 
158.21 	to section 245G.05, subdivision 1, paragraph (b);
158.22 	(2) an initial services plan completed according to section 245G.04;
158.23 	(3) a comprehensive assessment completed according to section 245G.05;
158.24 	(4) an assessment summary completed according to section 245G.05, subdivision 2;
158.25 	(5) an individual abuse prevention plan according to sections 245A.65, subdivision 2, 
158.26 	and 626.557, subdivision 14, when applicable;
158.27 	(6) an individual treatment plan according to section 245G.06, subdivisions 1and 2 and 
158.28 	1a;
158.29 	(7) documentation of treatment services, significant events, appointments, concerns, and 
158.30 	treatment plan reviews according to section 245G.06, subdivisions 2a, 2b, and 3; and
158.31 	(8) a summary at the time of service termination according to section 245G.06, 
158.32 	subdivision 4.

159.1 	Sec. 6. Minnesota Statutes 2022, section 245G.22, subdivision 15, as amended by 2023 
159.2 	H.F. No. 1403, article 1, section 17, if enacted, is amended to read:
159.3 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
159.4 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
159.5 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
159.6 	ten weeks following the day of service initiation, and at least 50 consecutive minutes per 
159.7 	month thereafter. As clinically appropriate, the program may offer these services cumulatively 
159.8 	and not consecutively in increments of no less than 15 minutes over the required time period, 
159.9 	and for a total of 60 minutes of treatment services over the time period, and must document 
159.10 	the reason for providing services cumulatively in the client's record. The program may offer 
159.11 	additional levels of service when deemed clinically necessary.
159.12 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
159.13 	the assessment must be completed within 21 days from the day of service initiation.

159.14 	EFFECTIVE DATE. This section is effective January 1, 2024.

159.15 	Sec. 7. Minnesota Statutes 2022, section 253B.10, subdivision 1, is amended to read:
159.16 		Subdivision 1.Administrative requirements. (a) When a person is committed, the 
159.17 	court shall issue a warrant or an order committing the patient to the custody of the head of 
159.18 	the treatment facility, state-operated treatment program, or community-based treatment 
159.19 	program. The warrant or order shall state that the patient meets the statutory criteria for 
159.20 	civil commitment.
159.21 	(b) The commissioner shall prioritize patients being admitted from jail or a correctional 
159.22 	institution who are:
159.23 	(1) ordered confined in a state-operated treatment program for an examination under 
159.24 	Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and
159.25 	20.02, subdivision 2;
159.26 	(2) under civil commitment for competency treatment and continuing supervision under 
159.27 	Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
159.28 	(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal 
159.29 	Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be 
159.30 	detained in a state-operated treatment program pending completion of the civil commitment 
159.31 	proceedings; or
160.1 	(4) committed under this chapter to the commissioner after dismissal of the patient's 
160.2 	criminal charges.
160.3 	Patients described in this paragraph must be admitted to a state-operated treatment program 
160.4 	within 48 hours. The commitment must be ordered by the court as provided in section 
160.5 	253B.09, subdivision 1, paragraph (d).
160.6 	(c) Upon the arrival of a patient at the designated treatment facility, state-operated 
160.7 	treatment program, or community-based treatment program, the head of the facility or 
160.8 	program shall retain the duplicate of the warrant and endorse receipt upon the original 
160.9 	warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must 
160.10 	be filed in the court of commitment. After arrival, the patient shall be under the control and 
160.11 	custody of the head of the facility or program.
160.12 	(d) Copies of the petition for commitment, the court's findings of fact and conclusions 
160.13 	of law, the court order committing the patient, the report of the court examiners, and the 
160.14 	prepetition report, and any medical and behavioral information available shall be provided 
160.15 	at the time of admission of a patient to the designated treatment facility or program to which 
160.16 	the patient is committed. Upon a patient's referral to the commissioner of human services 
160.17 	for admission pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment 
160.18 	facility, jail, or correctional facility that has provided care or supervision to the patient in 
160.19 	the previous two years shall, when requested by the treatment facility or commissioner, 
160.20 	provide copies of the patient's medical and behavioral records to the Department of Human 
160.21 	Services for purposes of preadmission planning. This information shall be provided by the 
160.22 	head of the treatment facility to treatment facility staff in a consistent and timely manner 
160.23 	and pursuant to all applicable laws.
160.24 	(e) Patients described in paragraph (b) must be admitted to a state-operated treatment 
160.25 	program within 48 hours of the Office of Medical Director, under section 246.018, or a 
160.26 	designee determining that a medically appropriate bed is available. This paragraph expires 
160.27 	on June 30, 2025.

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

160.29 	Sec. 8. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision to 
160.30 	read:
160.31 		Subd. 10.Sober home. A sober home is a cooperative living residence, a room and 
160.32 	board residence, an apartment, or any other living accommodation that:
160.33 	(1) provides temporary housing to persons with substance use disorders;
161.1 	(2) stipulates that residents must abstain from using alcohol or other illicit drugs or 
161.2 	substances not prescribed by a physician;
161.3 	(3) charges a fee for living there;
161.4 	(4) does not provide counseling or treatment services to residents;
161.5 	(5) promotes sustained recovery from substance use disorders; and
161.6 	(6) follows the sober living guidelines published by the federal Substance Abuse and 
161.7 	Mental Health Services Administration.

161.8 	Sec. 9. Minnesota Statutes 2022, section 254B.05, subdivision 1, is amended to read:
161.9 		Subdivision 1.Licensure required . (a) Programs licensed by the commissioner are 
161.10 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
161.11 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
161.12 	substance use disorder treatment, extended care, transitional residence, or outpatient treatment 
161.13 	services, and are licensed by tribal government are eligible vendors.
161.14 	(b) A licensed professional in private practice as defined in section 245G.01, subdivision 
161.15 	17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible 
161.16 	vendor of a comprehensive assessment and assessment summary provided according to 
161.17 	section 245G.05, and treatment services provided according to sections 245G.06 and 
161.18 	245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses 
161.19 	(1) to (6).
161.20 	(c) A county is an eligible vendor for a comprehensive assessment and assessment 
161.21 	summary when provided by an individual who meets the staffing credentials of section 
161.22 	245G.11, subdivisions 1 and 5, and completed according to the requirements of section 
161.23 	245G.05. A county is an eligible vendor of care coordination services when provided by an 
161.24 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and 
161.25 	provided according to the requirements of section 245G.07, subdivision 1, paragraph (a), 
161.26 	clause (5). A county is an eligible vendor of peer recovery services when the services are 
161.27 	provided by an individual who meets the requirements of section 245G.11, subdivision 8.
161.28 	(d) A recovery community organization that meets certification requirements identified 
161.29 	by the commissioner is an eligible vendor of peer support services.
161.30 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
161.31 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
161.32 	nonresidential substance use disorder treatment or withdrawal management program by the 
162.1 	commissioner or by tribal government or do not meet the requirements of subdivisions 1a 
162.2 	and 1b are not eligible vendors.

162.3 	Sec. 10. Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:
162.4 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
162.5 	use disorder services and service enhancements funded under this chapter.
162.6 	(b) Eligible substance use disorder treatment services include:
162.7 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
162.8 	245G.17, or applicable tribal license;
162.9 	(2) comprehensive assessments provided according to sections 245.4863, paragraph (a), 
162.10 	and 245G.05;
162.11 	(3) care coordination services provided according to section 245G.07, subdivision 1, 
162.12 	paragraph (a), clause (5);
162.13 	(4) peer recovery support services provided according to section 245G.07, subdivision 
162.14 	2, clause (8);
162.15 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
162.16 	services provided according to chapter 245F;
162.17 	(6) substance use disorder treatment services with medications for opioid use disorder 
162.18 	that are licensed according to sections 245G.01 to 245G.17 and 245G.22, or applicable 
162.19 	tribal license;
162.20 	(7) substance use disorder treatment with medications for opioid use disorder plus 
162.21 	enhanced treatment services that meet the requirements of clause (6) and provide nine hours 
162.22 	of clinical services each week;
162.23 	(8) (6) high, medium, and low intensity residential treatment services that are licensed 
162.24 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
162.25 	provide, respectively, 30, 15, and five hours of clinical services each week;
162.26 	(9) (7) hospital-based treatment services that are licensed according to sections 245G.01
162.27 	to 245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
162.28 	144.56;
162.29 	(10) (8) adolescent treatment programs that are licensed as outpatient treatment programs 
162.30 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
163.1 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
163.2 	applicable tribal license;
163.3 	(11) (9) high-intensity residential treatment services that are licensed according to sections 
163.4 	245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of 
163.5 	clinical services each week provided by a state-operated vendor or to clients who have been 
163.6 	civilly committed to the commissioner, present the most complex and difficult care needs, 
163.7 	and are a potential threat to the community; and
163.8 	(12) (10) room and board facilities that meet the requirements of subdivision 1a.
163.9 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
163.10 	of paragraph (b) and one of the following additional requirements:
163.11 	(1) programs that serve parents with their children if the program:
163.12 	(i) provides on-site child care during the hours of treatment activity that:
163.13 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
163.14 	9503; or
163.15 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
163.16 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
163.17 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
163.18 	licensed under chapter 245A as:
163.19 	(A) a child care center under Minnesota Rules, chapter 9503; or
163.20 	(B) a family child care home under Minnesota Rules, chapter 9502;
163.21 	(2) culturally specific or culturally responsive programs as defined in section 254B.01, 
163.22 	subdivision 4a;
163.23 	(3) disability responsive programs as defined in section 254B.01, subdivision 4b;
163.24 	(4) programs that offer medical services delivered by appropriately credentialed health 
163.25 	care staff in an amount equal to two hours per client per week if the medical needs of the 
163.26 	client and the nature and provision of any medical services provided are documented in the 
163.27 	client file; or
163.28 	(5) programs that offer services to individuals with co-occurring mental health and 
163.29 	substance use disorder problems if:
163.30 	(i) the program meets the co-occurring requirements in section 245G.20;
164.1 	(ii) 25 percent of the counseling staff are licensed mental health professionals under 
164.2 	section 245I.04, subdivision 2, or are students or licensing candidates under the supervision 
164.3 	of a licensed alcohol and drug counselor supervisor and mental health professional under 
164.4 	section 245I.04, subdivision 2, except that no more than 50 percent of the mental health 
164.5 	staff may be students or licensing candidates with time documented to be directly related 
164.6 	to provisions of co-occurring services;
164.7 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
164.8 	health diagnostic assessment within ten days of admission;
164.9 	(iv) the program has standards for multidisciplinary case review that include a monthly 
164.10 	review for each client that, at a minimum, includes a licensed mental health professional 
164.11 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
164.12 	(v) family education is offered that addresses mental health and substance use disorder 
164.13 	and the interaction between the two; and
164.14 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
164.15 	training annually.
164.16 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
164.17 	that provides arrangements for off-site child care must maintain current documentation at 
164.18 	the substance use disorder facility of the child care provider's current licensure to provide 
164.19 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
164.20 	must be deemed in compliance with the licensing requirements in section 245G.19.
164.21 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
164.22 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
164.23 	in paragraph (c), clause (4), items (i) to (iv).
164.24 	(f) Subject to federal approval, substance use disorder services that are otherwise covered 
164.25 	as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, 
164.26 	subdivision 3b. The use of telehealth to deliver services must be medically appropriate to 
164.27 	the condition and needs of the person being served. Reimbursement shall be at the same 
164.28 	rates and under the same conditions that would otherwise apply to direct face-to-face services.
164.29 	(g) For the purpose of reimbursement under this section, substance use disorder treatment 
164.30 	services provided in a group setting without a group participant maximum or maximum 
164.31 	client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one. 
164.32 	At least one of the attending staff must meet the qualifications as established under this 
165.1 	chapter for the type of treatment service provided. A recovery peer may not be included as 
165.2 	part of the staff ratio.
165.3 	(h) Payment for outpatient substance use disorder services that are licensed according 
165.4 	to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless 
165.5 	prior authorization of a greater number of hours is obtained from the commissioner.

165.6 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
165.7 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
165.8 	approval is obtained.

165.9 	Sec. 11. [254B.121] RATE METHODOLOGY; SUBSTANCE USE DISORDER 
165.10 	TREATMENT SERVICES WITH MEDICATIONS FOR OPIOID USE DISORDER.
165.11 		Subdivision 1.Rates established. Notwithstanding sections 254B.03, subdivision 9, 
165.12 	paragraph (a), clause (2); 254B.05, subdivision 5, paragraph (a); and 254B.12, subdivision 
165.13 	1, the commissioner shall use the rates in this section for substance use disorder treatment 
165.14 	services with medications for opioid use disorder.
165.15 		Subd. 2.Rate updates. Effective each January 1, the commissioner must update the 
165.16 	rates for substance use disorder treatment services with medications for opioid use disorder 
165.17 	that are licensed according to sections 245G.01 to 245G.17 and 245G.22, or applicable 
165.18 	Tribal license, to equal the corresponding Minnesota-specific, locality-adjusted Medicare 
165.19 	rates for the same or comparable services in the calendar year in which the services are 
165.20 	provided. This rate does not apply to federally qualified health centers, rural health centers, 
165.21 	Indian health services, and certified community behavioral health centers.
165.22 		Subd. 3.Nondrug weekly bundle annual limit. No more than 30 weekly nondrug 
165.23 	bundle charges are eligible for coverage in the first calendar year that an enrollee is being 
165.24 	treated by an opioid treatment provider and no more than 15 weekly nondrug bundle charges 
165.25 	are eligible for coverage in subsequent calendar years. The commissioner may override the 
165.26 	coverage limitation on the number of weekly nondrug bundle charges for an enrollee if the 
165.27 	provider obtains authorization to exceed the limit and documents the medical necessity, 
165.28 	services to be provided, and rationale for requiring the enrollee to report to the provider's 
165.29 	facility for a face-to-face encounter more frequently.

165.30 	EFFECTIVE DATE. This section is effective January 1, 2024, or upon federal approval, 
165.31 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
165.32 	approval is obtained.

166.1 	Sec. 12. [254B.17] WITHDRAWAL MANAGEMENT START-UP AND 
166.2 	CAPACITY-BUILDING GRANTS.
166.3 	The commissioner must establish start-up and capacity-building grants for prospective 
166.4 	or new withdrawal management programs licensed under chapter 245F that will meet 
166.5 	medically monitored or clinically monitored levels of care. Grants may be used for expenses 
166.6 	that are not reimbursable under Minnesota health care programs, including but not limited 
166.7 	to:
166.8 	(1) costs associated with hiring staff;
166.9 	(2) costs associated with staff retention;
166.10 	(3) the purchase of office equipment and supplies;
166.11 	(4) the purchase of software;
166.12 	(5) costs associated with obtaining applicable and required licenses;
166.13 	(6) business formation costs;
166.14 	(7) costs associated with staff training; and
166.15 	(8) the purchase of medical equipment and supplies necessary to meet health and safety 
166.16 	requirements.

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

166.18 	Sec. 13. [254B.18] SAFE RECOVERY SITES START-UP AND 
166.19 	CAPACITY-BUILDING GRANTS.
166.20 	(a) The commissioner of human services must establish start-up and capacity-building 
166.21 	grants for current or prospective harm reduction organizations to promote health, wellness, 
166.22 	safety, and recovery to people who are in active stages of substance use disorder. Grants 
166.23 	must be used to establish safe recovery sites that offer harm reduction services and supplies, 
166.24 	including but not limited to:
166.25 	(1) safe injection spaces;
166.26 	(2) sterile needle exchange;
166.27 	(3) opiate antagonist rescue kits;
166.28 	(4) fentanyl and other drug testing;
166.29 	(5) street outreach;
166.30 	(6) educational and referral services;
167.1 	(7) health, safety, and wellness services; and
167.2 	(8) access to hygiene and sanitation.
167.3 	(b) The commissioner must conduct local community outreach and engagement in 
167.4 	collaboration with newly established safe recovery sites. The commissioner must evaluate 
167.5 	the efficacy of safe recovery sites and collect data to measure health-related and public 
167.6 	safety outcomes.
167.7 	(c) The commissioner must prioritize grant applications for organizations that are 
167.8 	culturally specific or culturally responsive and that commit to serving individuals from 
167.9 	communities that are disproportionately impacted by the opioid epidemic, including:
167.10 	(1) Native American, American Indian, and Indigenous communities; and
167.11 	(2) Black, African American, and African-born communities.
167.12 	(d) For purposes of this section, a "culturally specific" or "culturally responsive" 
167.13 	organization is an organization that is designed to address the unique needs of individuals 
167.14 	who share a common language, racial, ethnic, or social background, and is governed with 
167.15 	significant input from individuals of that specific background.

167.16 	Sec. 14. [254B.181] SOBER HOMES.
167.17 		Subdivision 1.Requirements. All sober homes must comply with applicable state laws 
167.18 	and regulations and local ordinances related to maximum occupancy, fire safety, and 
167.19 	sanitation. In addition, all sober homes must:
167.20 	(1) maintain a supply of an opiate antagonist in the home and post information on proper 
167.21 	use;
167.22 	(2) have written policies regarding access to all prescribed medications;
167.23 	(3) have written policies regarding evictions;
167.24 	(4) return all property and medications to a person discharged from the home and retain 
167.25 	the items for a minimum of 60 days if the person did not collect them upon discharge. The 
167.26 	owner must make an effort to contact persons listed as emergency contacts for the discharged 
167.27 	person so that the items are returned;
167.28 	(5) document the names and contact information for persons to contact in case of an 
167.29 	emergency or upon discharge and notification of a family member, or other emergency 
167.30 	contact designated by the resident under certain circumstances, including but not limited to 
167.31 	death due to an overdose;
168.1 	(6) maintain contact information for emergency resources in the community to address 
168.2 	mental health and health emergencies;
168.3 	(7) have policies on staff qualifications and prohibition against fraternization;
168.4 	(8) have a policy on whether the use of medications for opioid use disorder is permissible;
168.5 	(9) have a fee schedule and refund policy;
168.6 	(10) have rules for residents;
168.7 	(11) have policies that promote resident participation in treatment, self-help groups, or 
168.8 	other recovery supports;
168.9 	(12) have policies requiring abstinence from alcohol and illicit drugs; and
168.10 	(13) distribute the sober home bill of rights.
168.11 		Subd. 2.Bill of rights. An individual living in a sober home has the right to:
168.12 	(1) have access to an environment that supports recovery;
168.13 	(2) have access to an environment that is safe and free from alcohol and other illicit 
168.14 	drugs or substances;
168.15 	(3) be free from physical and verbal abuse, neglect, financial exploitation, and all forms 
168.16 	of maltreatment covered under the Vulnerable Adults Act, sections 626.557 to 626.5572;
168.17 	(4) be treated with dignity and respect and to have personal property treated with respect;
168.18 	(5) have personal, financial, and medical information kept private and to be advised of 
168.19 	the sober home's policies and procedures regarding disclosure of such information;
168.20 	(6) access, while living in the residence, to other community-based support services as 
168.21 	needed;
168.22 	(7) be referred to appropriate services upon leaving the residence, if necessary;
168.23 	(8) retain personal property that does not jeopardize safety or health;
168.24 	(9) assert these rights personally or have them asserted by the individual's representative 
168.25 	or by anyone on behalf of the individual without retaliation;
168.26 	(10) be provided with the name, address, and telephone number of the ombudsman for 
168.27 	mental health, substance use disorder, and developmental disabilities and information about  
168.28 	the right to file a complaint;
168.29 	(11) be fully informed of these rights and responsibilities, as well as program policies 
168.30 	and procedures; and
169.1 	(12) not be required to perform services for the residence that are not included in the 
169.2 	usual expectations for all residents.
169.3 		Subd. 3.Complaints; ombudsman for mental health and developmental 
169.4 	disabilities. Any complaints about a sober home may be made to and reviewed or 
169.5 	investigated by the ombudsman for mental health and developmental disabilities, pursuant 
169.6 	to sections 245.91 and 245.94.
169.7 		Subd. 4.Private right of action. In addition to pursuing other remedies, an individual 
169.8 	may bring an action to recover damages caused by a violation of this section.

169.9 	Sec. 15. [254B.191] EVIDENCE-BASED TRAINING.
169.10 	The commissioner of human services must establish training opportunities for substance 
169.11 	use disorder treatment providers under Minnesota Statutes, chapters 245F and 245G, and 
169.12 	applicable Tribal licenses, to increase knowledge and develop skills to adopt evidence-based 
169.13 	and promising practices in substance use disorder treatment programs. Training opportunities 
169.14 	must support the transition to American Society of Addiction Medicine (ASAM) standards. 
169.15 	Training formats may include self or organizational assessments, virtual modules, one-to-one 
169.16 	coaching, self-paced courses, interactive hybrid courses, and in-person courses. Foundational 
169.17 	and skill-building training topics may include:
169.18 	(1) ASAM criteria;
169.19 	(2) person-centered and culturally responsive services;
169.20 	(3) medical and clinical decision making;
169.21 	(4) conducting assessments and appropriate level of care;
169.22 	(5) treatment and service planning;
169.23 	(6) identifying and overcoming systems challenges;
169.24 	(7) conducting clinical case reviews; and
169.25 	(8) appropriate and effective transfer and discharge.

169.26 	Sec. 16. Minnesota Statutes 2022, section 256B.0759, subdivision 2, is amended to read:
169.27 		Subd. 2.Provider participation. (a) Outpatient Programs licensed by the Department 
169.28 	of Human Services as nonresidential substance use disorder treatment providers may elect 
169.29 	to participate in the demonstration project and meet the requirements of subdivision 3. To 
169.30 	participate, a provider must notify the commissioner of the provider's intent to participate 
170.1 	in a format required by the commissioner and enroll as a demonstration project provider
170.2 	programs that receive payment under this chapter must enroll as demonstration project 
170.3 	providers and meet the requirements of subdivision 3 by January 1, 2025. Programs that do 
170.4 	not meet the requirements of this paragraph are ineligible for payment for services provided 
170.5 	under section 256B.0625.
170.6 	(b) Programs licensed by the Department of Human Services as residential treatment 
170.7 	programs according to section 245G.21 that receive payment under this chapter must enroll 
170.8 	as demonstration project providers and meet the requirements of subdivision 3 by January 
170.9 	1, 2024. Programs that do not meet the requirements of this paragraph are ineligible for 
170.10 	payment for services provided under section 256B.0625.
170.11 	(c) Programs licensed by the Department of Human Services as residential treatment 
170.12 	programs according to section 245G.21 that receive payment under this chapter and are 
170.13 	licensed as a hospital under sections 144.50 to 144.581 must enroll as demonstration project 
170.14 	providers and meet the requirements of subdivision 3 by January 1, 2025.
170.15 	(c) (d) Programs licensed by the Department of Human Services as withdrawal 
170.16 	management programs according to chapter 245F that receive payment under this chapter 
170.17 	must enroll as demonstration project providers and meet the requirements of subdivision 3 
170.18 	by January 1, 2024. Programs that do not meet the requirements of this paragraph are 
170.19 	ineligible for payment for services provided under section 256B.0625.
170.20 	(d) (e) Out-of-state residential substance use disorder treatment programs that receive 
170.21 	payment under this chapter must enroll as demonstration project providers and meet the 
170.22 	requirements of subdivision 3 by January 1, 2024. Programs that do not meet the requirements 
170.23 	of this paragraph are ineligible for payment for services provided under section 256B.0625.
170.24 	(e) (f) Tribally licensed programs may elect to participate in the demonstration project 
170.25 	and meet the requirements of subdivision 3. The Department of Human Services must 
170.26 	consult with Tribal nations to discuss participation in the substance use disorder 
170.27 	demonstration project.
170.28 	(f) (g) The commissioner shall allow providers enrolled in the demonstration project 
170.29 	before July 1, 2021, to receive applicable rate enhancements authorized under subdivision 
170.30 	4 for all services provided on or after the date of enrollment, except that the commissioner 
170.31 	shall allow a provider to receive applicable rate enhancements authorized under subdivision 
170.32 	4 for services provided on or after July 22, 2020, to fee-for-service enrollees, and on or after 
170.33 	January 1, 2021, to managed care enrollees, if the provider meets all of the following 
170.34 	requirements:
171.1 	(1) the provider attests that during the time period for which the provider is seeking the 
171.2 	rate enhancement, the provider took meaningful steps in their plan approved by the 
171.3 	commissioner to meet the demonstration project requirements in subdivision 3; and
171.4 	(2) the provider submits attestation and evidence, including all information requested 
171.5 	by the commissioner, of meeting the requirements of subdivision 3 to the commissioner in 
171.6 	a format required by the commissioner.
171.7 	(g) (h) The commissioner may recoup any rate enhancements paid under paragraph (f)
171.8 	(g) to a provider that does not meet the requirements of subdivision 3 by July 1, 2021.

171.9 	Sec. 17. Minnesota Statutes 2022, section 256I.05, is amended by adding a subdivision 
171.10 	to read:
171.11 		Subd. 1s.Supplemental rate; Douglas County. Notwithstanding the provisions of 
171.12 	subdivisions 1a and 1c, beginning July 1, 2023, a county agency shall negotiate a 
171.13 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per 
171.14 	month, including any legislatively authorized inflationary adjustments, for a housing support 
171.15 	provider located in Douglas County that operates a long-term residential facility with a total 
171.16 	of 74 beds that serve chemically dependent men and provide 24-hour-a-day supervision 
171.17 	and other support services.

171.18 	Sec. 18. Minnesota Statutes 2022, section 256I.05, is amended by adding a subdivision 
171.19 	to read:
171.20 		Subd. 1t.Supplemental rate; Crow Wing County. Notwithstanding the provisions of 
171.21 	subdivisions 1a and 1c, beginning July 1, 2023, a county agency shall negotiate a 
171.22 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per 
171.23 	month, including any legislatively authorized inflationary adjustments, for a housing support 
171.24 	provider located in Crow Wing County that operates a long-term residential facility with a 
171.25 	total of 90 beds that serves chemically dependent men and women and provides 
171.26 	24-hour-a-day supervision and other support services.

171.27 	Sec. 19. Minnesota Statutes 2022, section 256I.05, is amended by adding a subdivision 
171.28 	to read:
171.29 		Subd. 1u.Supplemental rate; Douglas County. Notwithstanding the provisions in this 
171.30 	section, beginning July 1, 2023, a county agency shall negotiate a supplemental rate for up 
171.31 	to 20 beds in addition to the rate specified in subdivision 1, not to exceed the maximum rate 
171.32 	allowed under subdivision 1a, including any legislatively authorized inflationary adjustments, 
172.1 	for a housing support provider located in Douglas County that operates two facilities and 
172.2 	provides room and board and supplementary services to adult males recovering from 
172.3 	substance use disorder, mental illness, or housing instability.

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

172.5 	Sec. 20. [325F.725] SOBER HOME TITLE PROTECTION.
172.6 	No person or entity may use the phrase "sober home," whether alone or in combination 
172.7 	with other words and whether orally or in writing, to advertise, market, or otherwise describe, 
172.8 	offer, or promote itself, or any housing, service, service package, or program that it provides 
172.9 	within this state, unless the person or entity meets the definition of a sober home in section 
172.10 	254B.01, subdivision 10, and meets the requirements of section 254B.181.

172.11 	Sec. 21. CULTURALLY RESPONSIVE RECOVERY COMMUNITY GRANTS.
 172.12 	The commissioner must establish start-up and capacity-building grants for prospective 
172.13 	or new recovery community organizations serving or intending to serve culturally specific 
172.14 	or population-specific recovery communities. Grants may be used for expenses that are not 
172.15 	reimbursable under Minnesota health care programs, including but not limited to:
172.16 	(1) costs associated with hiring and retaining staff;
172.17 	(2) staff training, purchasing office equipment and supplies;
172.18 	(3) purchasing software and website services;
172.19 	(4) costs associated with establishing nonprofit status;
172.20 	(5) rental and lease costs and community outreach; and
172.21 	(6) education and recovery events.

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

172.23 	Sec. 22. FAMILY TREATMENT START-UP AND CAPACITY-BUILDING 
172.24 	GRANTS.
 172.25 	The commissioner of human services must establish start-up and capacity-building grants 
172.26 	for prospective or new substance use disorder treatment programs that serve parents with 
172.27 	their children. Grants must be used for expenses that are not reimbursable under Minnesota 
172.28 	health care programs, including but not limited to:
172.29 	(1) physical plant upgrades to support larger family units;
173.1 	(2) supporting the expansion or development of programs that provide holistic services, 
173.2 	including trauma supports, conflict resolution, and parenting skills;
173.3 	(3) increasing awareness, education, and outreach utilizing culturally responsive 
173.4 	approaches to develop relationships between culturally specific communities and clinical 
173.5 	treatment provider programs; and
173.6 	(4) expanding culturally specific family programs and accommodating diverse family 
173.7 	units.

173.8 	Sec. 23. MEDICAL ASSISTANCE BEHAVIORAL HEALTH SYSTEM 
173.9 	TRANSFORMATION STUDY.
 173.10 	The commissioner of human services, in consultation with stakeholders, must evaluate 
173.11 	the feasibility, potential design, and federal authorities needed to cover traditional healing, 
173.12 	behavioral health services in correctional facilities, and contingency management under the 
173.13 	medical assistance program.

173.14 	Sec. 24. OPIOID TREATMENT PROGRAM WORK GROUP.
 173.15 	The commissioner of human services must convene a work group of community partners 
173.16 	to evaluate the opioid treatment program model under Minnesota Statutes, section 245G.22, 
173.17 	and to make recommendations on overall service design; simplification or improvement of 
173.18 	regulatory oversight; increasing access to opioid treatment programs and improving the 
173.19 	quality of care; addressing geographic, racial, and justice-related disparities for individuals 
173.20 	who utilize or may benefit from medications for opioid use disorder; and other related topics, 
173.21 	as determined by the work group. The commissioner must report the work group's 
173.22 	recommendations to the chairs and ranking minority members of the legislative committees 
173.23 	with jurisdiction over health and human services by January 15, 2024.

173.24 	Sec. 25. ENROLLMENT AND REQUIREMENTS FOR PEER RECOVERY 
173.25 	SUPPORT SERVICES VENDORS.
 173.26 	The commissioner of human services must consult with providers, counties, Tribes, 
173.27 	recovery community organizations, and the recovery community at large to develop 
173.28 	recommendations on whether entities seeking vendor eligibility for medical assistance peer 
173.29 	recovery support services should be subject to additional provider enrollment and oversight 
173.30 	requirements. The commissioner must submit recommendations to the chairs and ranking 
173.31 	minority members of the committees with jurisdiction over health and human services by 
173.32 	February 1, 2024. Recommendations must include the additional requirements that may be 
174.1 	needed and specify which entities would be subject to the additional requirements. 
174.2 	Recommendations must balance the goals of fostering cultures of accountability, applying 
174.3 	supportive supervision models, and increasing access to high-quality, culturally responsive 
174.4 	medical assistance peer recovery support services.

174.5 	Sec. 26. SOBER HOME SCAN.
 174.6 	The commissioner of human services shall conduct a survey to identify sober home 
174.7 	settings across the state and to collect information about the services they provide, their 
174.8 	funding sources, whether they specialize in serving specific populations, and other 
174.9 	information needed to inform policies to strengthen sober housing in the state. The 
174.10 	commissioner must collaborate with the Minnesota Association of Sober Homes, sober 
174.11 	home operators, the recovery community, behavioral health providers that work directly 
174.12 	with sober housing, and recovery community organizations to provide input and data for 
174.13 	this survey.

174.14 	Sec. 27. REVISOR INSTRUCTION.
 174.15 	The revisor of statutes shall renumber Minnesota Statutes, section 245G.01, subdivision 
174.16 	20b, as Minnesota Statutes, section 245G.01, subdivision 20d, and make any necessary 
174.17 	changes to cross-references.

174.18 	Sec. 28. REPEALER.
 174.19 	(a) Minnesota Statutes 2022, sections 245G.05, subdivision 2; 245G.06, subdivision 2; 
174.20 	and 256B.0759, subdivision 6, are repealed.
174.21 	(b) Minnesota Statutes 2022, section 246.18, subdivisions 2 and 2a, are repealed.

174.22 	EFFECTIVE DATE. Paragraph (a) is effective January 1, 2024. Paragraph (b) is 
174.23 	effective July 1, 2023.

174.24 	ARTICLE 5
174.25 	OPIOID EPIDEMIC RESPONSE AND OVERDOSE PREVENTION

174.26 	Section 1. [121A.224] OPIATE ANTAGONISTS.
174.27 	(a) A school district or charter school must maintain a supply of opiate antagonists, as 
174.28 	defined in section 604A.04, subdivision 1, at each school site to be administered in 
174.29 	compliance with section 151.37, subdivision 12.
175.1 	(b) Each school building must have at least two doses of a nasal opiate antagonist 
175.2 	available on site.
175.3 	(c) The commissioner of health shall identify resources, including at least one training 
175.4 	video, to help schools implement an opiate antagonist emergency response and make the 
175.5 	resources available for schools.
175.6 	(d) A school board may adopt a model plan for use, storage, and administration of opiate 
175.7 	antagonists.

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

175.9 	Sec. 2. Minnesota Statutes 2022, section 241.021, subdivision 1, is amended to read:
175.10 		Subdivision 1.Correctional facilities; inspection; licensing. (a) Except as provided 
175.11 	in paragraph (b), the commissioner of corrections shall inspect and license all correctional 
175.12 	facilities throughout the state, whether public or private, established and operated for the 
175.13 	detention and confinement of persons confined or incarcerated therein according to law 
175.14 	except to the extent that they are inspected or licensed by other state regulating agencies. 
175.15 	The commissioner shall promulgate pursuant to chapter 14, rules establishing minimum 
175.16 	standards for these facilities with respect to their management, operation, physical condition, 
175.17 	and the security, safety, health, treatment, and discipline of persons confined or incarcerated 
175.18 	therein. These minimum standards shall include but are not limited to specific guidance 
175.19 	pertaining to:
175.20 	(1) screening, appraisal, assessment, and treatment for persons confined or incarcerated 
175.21 	in correctional facilities with mental illness or substance use disorders;
175.22 	(2) a policy on the involuntary administration of medications;
175.23 	(3) suicide prevention plans and training;
175.24 	(4) verification of medications in a timely manner;
175.25 	(5) well-being checks;
175.26 	(6) discharge planning, including providing prescribed medications to persons confined 
175.27 	or incarcerated in correctional facilities upon release;
175.28 	(7) a policy on referrals or transfers to medical or mental health care in a noncorrectional 
175.29 	institution;
175.30 	(8) use of segregation and mental health checks;
175.31 	(9) critical incident debriefings;
176.1 	(10) clinical management of substance use disorders and opioid overdose emergency 
176.2 	procedures;
176.3 	(11) a policy regarding identification of persons with special needs confined or 
176.4 	incarcerated in correctional facilities;
176.5 	(12) a policy regarding the use of telehealth;
176.6 	(13) self-auditing of compliance with minimum standards;
176.7 	(14) information sharing with medical personnel and when medical assessment must be 
176.8 	facilitated;
176.9 	(15) a code of conduct policy for facility staff and annual training;
176.10 	(16) a policy on death review of all circumstances surrounding the death of an individual 
176.11 	committed to the custody of the facility; and
176.12 	(17) dissemination of a rights statement made available to persons confined or 
176.13 	incarcerated in licensed correctional facilities.
176.14 	No individual, corporation, partnership, voluntary association, or other private 
176.15 	organization legally responsible for the operation of a correctional facility may operate the 
176.16 	facility unless it possesses a current license from the commissioner of corrections. Private 
176.17 	adult correctional facilities shall have the authority of section 624.714, subdivision 13, if 
176.18 	the Department of Corrections licenses the facility with the authority and the facility meets 
176.19 	requirements of section 243.52.
176.20 	The commissioner shall review the correctional facilities described in this subdivision 
176.21 	at least once every two years, except as otherwise provided, to determine compliance with 
176.22 	the minimum standards established according to this subdivision or other Minnesota statute 
176.23 	related to minimum standards and conditions of confinement.
176.24 	The commissioner shall grant a license to any facility found to conform to minimum 
176.25 	standards or to any facility which, in the commissioner's judgment, is making satisfactory 
176.26 	progress toward substantial conformity and the standards not being met do not impact the 
176.27 	interests and well-being of the persons confined or incarcerated in the facility. A limited 
176.28 	license under subdivision 1a may be issued for purposes of effectuating a facility closure. 
176.29 	The commissioner may grant licensure up to two years. Unless otherwise specified by 
176.30 	statute, all licenses issued under this chapter expire at 12:01 a.m. on the day after the 
176.31 	expiration date stated on the license.
177.1 	The commissioner shall have access to the buildings, grounds, books, records, staff, and 
177.2 	to persons confined or incarcerated in these facilities. The commissioner may require the 
177.3 	officers in charge of these facilities to furnish all information and statistics the commissioner 
177.4 	deems necessary, at a time and place designated by the commissioner.
177.5 	All facility administrators of correctional facilities are required to report all deaths of 
177.6 	individuals who died while committed to the custody of the facility, regardless of whether 
177.7 	the death occurred at the facility or after removal from the facility for medical care stemming 
177.8 	from an incident or need for medical care at the correctional facility, as soon as practicable, 
177.9 	but no later than 24 hours of receiving knowledge of the death, including any demographic 
177.10 	information as required by the commissioner.
177.11 	All facility administrators of correctional facilities are required to report all other 
177.12 	emergency or unusual occurrences as defined by rule, including uses of force by facility 
177.13 	staff that result in substantial bodily harm or suicide attempts, to the commissioner of 
177.14 	corrections within ten days from the occurrence, including any demographic information 
177.15 	as required by the commissioner. The commissioner of corrections shall consult with the 
177.16 	Minnesota Sheriffs' Association and a representative from the Minnesota Association of 
177.17 	Community Corrections Act Counties who is responsible for the operations of an adult 
177.18 	correctional facility to define "use of force" that results in substantial bodily harm for 
177.19 	reporting purposes.
177.20 	The commissioner may require that any or all such information be provided through the 
177.21 	Department of Corrections detention information system. The commissioner shall post each 
177.22 	inspection report publicly and on the department's website within 30 days of completing 
177.23 	the inspection. The education program offered in a correctional facility for the confinement 
177.24 	or incarceration of juvenile offenders must be approved by the commissioner of education 
177.25 	before the commissioner of corrections may grant a license to the facility.
177.26 	(b) For juvenile facilities licensed by the commissioner of human services, the 
177.27 	commissioner may inspect and certify programs based on certification standards set forth 
177.28 	in Minnesota Rules. For the purpose of this paragraph, "certification" has the meaning given 
177.29 	it in section 245A.02.
177.30 	(c) Any state agency which regulates, inspects, or licenses certain aspects of correctional 
177.31 	facilities shall, insofar as is possible, ensure that the minimum standards it requires are 
177.32 	substantially the same as those required by other state agencies which regulate, inspect, or 
177.33 	license the same aspects of similar types of correctional facilities, although at different 
177.34 	correctional facilities.
178.1 	(d) Nothing in this section shall be construed to limit the commissioner of corrections' 
178.2 	authority to promulgate rules establishing standards of eligibility for counties to receive 
178.3 	funds under sections 401.01 to 401.16, or to require counties to comply with operating 
178.4 	standards the commissioner establishes as a condition precedent for counties to receive that 
178.5 	funding.
178.6 	(e) The department's inspection unit must report directly to a division head outside of 
178.7 	the correctional institutions division.

178.8 	Sec. 3. Minnesota Statutes 2022, section 241.31, subdivision 5, is amended to read:
178.9 		Subd. 5.Minimum standards. The commissioner of corrections shall establish minimum 
178.10 	standards for the size, area to be served, qualifications of staff, ratio of staff to client 
178.11 	population, and treatment programs for community corrections programs established pursuant 
178.12 	to this section. Plans and specifications for such programs, including proposed budgets must 
178.13 	first be submitted to the commissioner for approval prior to the establishment. Community 
178.14 	corrections programs must maintain a supply of opiate antagonists, as defined in section 
178.15 	604A.04, subdivision 1, at each correctional site to be administered in compliance with 
178.16 	section 151.37, subdivision 12. Each site must have at least two doses of an opiate antagonist 
178.17 	on site. Staff must be trained on how and when to administer opiate antagonists.

178.18 	Sec. 4. Minnesota Statutes 2022, section 241.415, is amended to read:
178.19 	241.415 RELEASE PLANS; SUBSTANCE ABUSE.
178.20 	The commissioner shall cooperate with community-based corrections agencies to 
178.21 	determine how best to address the substance abuse treatment needs of offenders who are 
178.22 	being released from prison. The commissioner shall ensure that an offender's prison release 
178.23 	plan adequately addresses the offender's needs for substance abuse assessment, treatment, 
178.24 	or other services following release, within the limits of available resources. The commissioner 
178.25 	must provide individuals with known or stated histories of opioid use disorder with 
178.26 	emergency opiate antagonist rescue kits upon release.

178.27 	Sec. 5. [245.891] OPIOID OVERDOSE SURGE ALERT SYSTEM.
178.28 	The commissioner must establish a voluntary, statewide opioid overdose surge text 
178.29 	message alert system, to prevent opioid overdose by cautioning people to refrain from 
178.30 	substance use or to use harm reduction strategies when there is an overdose surge in their 
178.31 	surrounding area. The alert system may include other forms of electronic alerts. The 
179.1 	commissioner may collaborate with local agencies, other state agencies, and harm reduction 
179.2 	organizations to promote and improve the surge alert system.

179.3 	Sec. 6. [245A.242] EMERGENCY OVERDOSE TREATMENT.
179.4 		Subdivision 1.Applicability. This section applies to the following licenses issued under 
179.5 	this chapter:
179.6 	(1) substance use disorder treatment programs licensed according to chapter 245G;
179.7 	(2) children's residential facility substance use disorder treatment programs licensed 
179.8 	according to Minnesota Rules, parts 2960.0010 to 2960.0220 and 2960.0430 to 2960.0490;
179.9 	(3) detoxification programs licensed according to Minnesota Rules, parts 9530.6510 to 
179.10 	9530.6590;
179.11 	(4) withdrawal management programs licensed according to chapter 245F; and
179.12 	(5) intensive residential treatment services or residential crisis stabilization licensed 
179.13 	according to chapter 245I and section 245I.23.
179.14 		Subd. 2.Emergency overdose treatment. A license holder must maintain a supply of 
179.15 	opiate antagonists as defined in section 604A.04, subdivision 1, available for emergency 
179.16 	treatment of opioid overdose and must have a written standing order protocol by a physician 
179.17 	who is licensed under chapter 147, advanced practice registered nurse who is licensed under 
179.18 	chapter 148, or physician assistant who is licensed under chapter 147A, that permits the 
179.19 	license holder to maintain a supply of opiate antagonists on site. A license holder must 
179.20 	require staff to undergo training in the specific mode of administration used at the program, 
179.21 	which may include intranasal administration, intramuscular injection, or both.

179.22 	Sec. 7. Minnesota Statutes 2022, section 245G.08, subdivision 3, is amended to read:
179.23 		Subd. 3.Standing order protocol Emergency overdose treatment. A license holder 
179.24 	that maintains a supply of naloxone available for emergency treatment of opioid overdose 
179.25 	must have a written standing order protocol by a physician who is licensed under chapter 
179.26 	147, advanced practice registered nurse who is licensed under chapter 148, or physician 
179.27 	assistant who is licensed under chapter 147A, that permits the license holder to maintain a 
179.28 	supply of naloxone on site. A license holder must require staff to undergo training in the 
179.29 	specific mode of administration used at the program, which may include intranasal 
179.30 	administration, intramuscular injection, or both. must follow the emergency overdose 
179.31 	treatment requirements in section 245A.242.

180.1 	Sec. 8. Minnesota Statutes 2022, section 256.042, subdivision 1, is amended to read:
180.2 		Subdivision 1.Establishment of the advisory council. (a) The Opiate Epidemic 
180.3 	Response Advisory Council is established to develop and implement a comprehensive and 
180.4 	effective statewide effort to address the opioid addiction and overdose epidemic in Minnesota. 
180.5 	The council shall focus on:
180.6 	(1) prevention and education, including public education and awareness for adults and 
180.7 	youth, prescriber education, the development and sustainability of opioid overdose prevention 
180.8 	and education programs, the role of adult protective services in prevention and response, 
180.9 	and providing financial support to local law enforcement agencies for opiate antagonist 
180.10 	programs;
180.11 	(2) training on the treatment of opioid addiction, including the use of all Food and Drug 
180.12 	Administration approved opioid addiction medications, detoxification, relapse prevention, 
180.13 	patient assessment, individual treatment planning, counseling, recovery supports, diversion 
180.14 	control, and other best practices;
180.15 	(3) the expansion and enhancement of a continuum of care for opioid-related substance 
180.16 	use disorders, including primary prevention, early intervention, treatment, recovery, and 
180.17 	aftercare services; and
180.18 	(4) the development of measures to assess and protect the ability of cancer patients and 
180.19 	survivors, persons battling life-threatening illnesses, persons suffering from severe chronic 
180.20 	pain, and persons at the end stages of life, who legitimately need prescription pain 
180.21 	medications, to maintain their quality of life by accessing these pain medications without 
180.22 	facing unnecessary barriers. The measures must also address the needs of individuals 
180.23 	described in this clause who are elderly or who reside in underserved or rural areas of the 
180.24 	state.
180.25 	(b) The council shall:
180.26 	(1) review local, state, and federal initiatives and activities related to education, 
180.27 	prevention, treatment, and services for individuals and families experiencing and affected 
180.28 	by opioid use disorder;
180.29 	(2) establish priorities to address the state's opioid epidemic, for the purpose of 
180.30 	recommending initiatives to fund;
180.31 	(3) recommend to the commissioner of human services specific projects and initiatives 
180.32 	to be funded;
181.1 	(4) ensure that available funding is allocated to align with other state and federal funding, 
181.2 	to achieve the greatest impact and ensure a coordinated state effort;
181.3 	(5) consult with the commissioners of human services, health, and management and 
181.4 	budget to develop measurable outcomes to determine the effectiveness of funds allocated;
181.5 	(6) develop recommendations for an administrative and organizational framework for 
181.6 	the allocation, on a sustainable and ongoing basis, of any money deposited into the separate 
181.7 	account under section 16A.151, subdivision 2, paragraph (f), in order to address the opioid 
181.8 	abuse and overdose epidemic in Minnesota and the areas of focus specified in paragraph 
181.9 	(a);
181.10 	(7) review reports, data, and performance measures submitted by municipalities under 
181.11 	subdivision 5; and
181.12 	(8) consult with relevant stakeholders, including lead agencies and municipalities, to 
181.13 	review and provide recommendations for necessary revisions to the reporting requirements 
181.14 	under subdivision 5 to ensure that the required reporting accurately measures progress in 
181.15 	addressing the harms of the opioid epidemic.; and
181.16 	(9) meet with each of the 11 federally recognized Minnesota Tribal Nations individually 
181.17 	on an annual basis in order to collaborate and communicate on shared issues and priorities.
181.18 	(c) The council, in consultation with the commissioner of management and budget, and 
181.19 	within available appropriations, shall select from projects awarded grants under section 
181.20 	256.043, subdivisions 3 and 3a, and municipality projects funded by direct payments received 
181.21 	as part of a statewide opioid settlement agreement, that include promising practices or 
181.22 	theory-based activities for which the commissioner of management and budget shall conduct 
181.23 	evaluations using experimental or quasi-experimental design. Grant proposals and 
181.24 	municipality projects that include promising practices or theory-based activities and are 
181.25 	selected for an evaluation shall be administered to support the experimental or 
181.26 	quasi-experimental evaluation. Grantees and municipalities shall collect and report 
181.27 	information that is needed to complete the evaluation. The commissioner of management 
181.28 	and budget, under section 15.08, may obtain additional relevant data to support the 
181.29 	experimental or quasi-experimental evaluation studies.
181.30 	(d) The council, in consultation with the commissioners of human services, health, public 
181.31 	safety, and management and budget, shall establish goals related to addressing the opioid 
181.32 	epidemic and determine a baseline against which progress shall be monitored and set 
181.33 	measurable outcomes, including benchmarks. The goals established must include goals for 
181.34 	prevention and public health, access to treatment, and multigenerational impacts. The council 
182.1 	shall use existing measures and data collection systems to determine baseline data against 
182.2 	which progress shall be measured. The council shall include the proposed goals, the 
182.3 	measurable outcomes, and proposed benchmarks to meet these goals in its initial report to 
182.4 	the legislature under subdivision 5, paragraph (a), due January 31, 2021.

182.5 	Sec. 9. Minnesota Statutes 2022, section 256.042, subdivision 2, is amended to read:
182.6 		Subd. 2.Membership. (a) The council shall consist of the following 19 20 voting 
182.7 	members, appointed by the commissioner of human services except as otherwise specified, 
182.8 	and three nonvoting members:
182.9 	(1) two members of the house of representatives, appointed in the following sequence: 
182.10 	the first from the majority party appointed by the speaker of the house and the second from 
182.11 	the minority party appointed by the minority leader. Of these two members, one member 
182.12 	must represent a district outside of the seven-county metropolitan area, and one member 
182.13 	must represent a district that includes the seven-county metropolitan area. The appointment 
182.14 	by the minority leader must ensure that this requirement for geographic diversity in 
182.15 	appointments is met;
182.16 	(2) two members of the senate, appointed in the following sequence: the first from the 
182.17 	majority party appointed by the senate majority leader and the second from the minority 
182.18 	party appointed by the senate minority leader. Of these two members, one member must 
182.19 	represent a district outside of the seven-county metropolitan area and one member must 
182.20 	represent a district that includes the seven-county metropolitan area. The appointment by 
182.21 	the minority leader must ensure that this requirement for geographic diversity in appointments 
182.22 	is met;
182.23 	(3) one member appointed by the Board of Pharmacy;
182.24 	(4) one member who is a physician appointed by the Minnesota Medical Association;
182.25 	(5) one member representing opioid treatment programs, sober living programs, or 
182.26 	substance use disorder programs licensed under chapter 245G;
182.27 	(6) one member appointed by the Minnesota Society of Addiction Medicine who is an 
182.28 	addiction psychiatrist;
182.29 	(7) one member representing professionals providing alternative pain management 
182.30 	therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;
182.31 	(8) one member representing nonprofit organizations conducting initiatives to address 
182.32 	the opioid epidemic, with the commissioner's initial appointment being a member 
183.1 	representing the Steve Rummler Hope Network, and subsequent appointments representing 
183.2 	this or other organizations;
183.3 	(9) one member appointed by the Minnesota Ambulance Association who is serving 
183.4 	with an ambulance service as an emergency medical technician, advanced emergency 
183.5 	medical technician, or paramedic;
183.6 	(10) one member representing the Minnesota courts who is a judge or law enforcement 
183.7 	officer;
183.8 	(11) one public member who is a Minnesota resident and who is in opioid addiction 
183.9 	recovery;
183.10 	(12) two members representing Indian tribes, one representing the Ojibwe tribes and 
183.11 	one representing the Dakota tribes;
183.12 	(13) one member representing an urban American Indian community;
183.13 	(13) (14) one public member who is a Minnesota resident and who is suffering from 
183.14 	chronic pain, intractable pain, or a rare disease or condition;
183.15 	(14) (15) one mental health advocate representing persons with mental illness;
183.16 	(15) (16) one member appointed by the Minnesota Hospital Association;
183.17 	(16) (17) one member representing a local health department; and
183.18 	(17) (18) the commissioners of human services, health, and corrections, or their designees, 
183.19 	who shall be ex officio nonvoting members of the council.
183.20 	(b) The commissioner of human services shall coordinate the commissioner's 
183.21 	appointments to provide geographic, racial, and gender diversity, and shall ensure that at 
183.22 	least one-half one-third of council members appointed by the commissioner reside outside 
183.23 	of the seven-county metropolitan area. Of the members appointed by the commissioner, to 
183.24 	the extent practicable, at least one member must represent a community of color 
183.25 	disproportionately affected by the opioid epidemic.
183.26 	(c) The council is governed by section 15.059, except that members of the council shall 
183.27 	serve three-year terms and shall receive no compensation other than reimbursement for 
183.28 	expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.
183.29 	(d) The chair shall convene the council at least quarterly, and may convene other meetings 
183.30 	as necessary. The chair shall convene meetings at different locations in the state to provide 
183.31 	geographic access, and shall ensure that at least one-half of the meetings are held at locations 
183.32 	outside of the seven-county metropolitan area.
184.1 	(e) The commissioner of human services shall provide staff and administrative services 
184.2 	for the advisory council.
184.3 	(f) The council is subject to chapter 13D.

184.4 	Sec. 10. Minnesota Statutes 2022, section 256.043, subdivision 3, is amended to read:
184.5 		Subd. 3.Appropriations from registration and license fee account. (a) The 
184.6 	appropriations in paragraphs (b) to (h) (n) shall be made from the registration and license 
184.7 	fee account on a fiscal year basis in the order specified.
184.8 	(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs 
184.9 	(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be 
184.10 	made accordingly.
184.11 	(c) $100,000 is appropriated to the commissioner of human services for grants for opiate 
184.12 	antagonist distribution. Grantees may utilize funds for opioid overdose prevention, 
184.13 	community asset mapping, education, and opiate antagonist distribution.
184.14 	(d) $2,000,000 is appropriated to the commissioner of human services for grants to Tribal 
184.15 	nations and five urban Indian communities for traditional healing practices for American 
184.16 	Indians and to increase the capacity of culturally specific providers in the behavioral health 
184.17 	workforce.
184.18 	(e) $400,000 is appropriated to the commissioner of human services for competitive 
184.19 	grants for opioid-focused Project ECHO programs.
184.20 	(f) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to the 
184.21 	commissioner of human services to administer the funding distribution and reporting 
184.22 	requirements in paragraph (o).
184.23 	(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated 
184.24 	to the commissioner of human services for safe recovery sites start-up and capacity building 
184.25 	grants under section 254B.18.
184.26 	(h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to 
184.27 	the commissioner of human services for the opioid overdose surge alert system under section 
184.28 	245.891.
184.29 	(c) (i) $300,000 is appropriated to the commissioner of management and budget for 
184.30 	evaluation activities under section 256.042, subdivision 1, paragraph (c).
185.1 	(d) (j)$249,000  $261,000 is appropriated to the commissioner of human services for 
185.2 	the provision of administrative services to the Opiate Epidemic Response Advisory Council 
185.3 	and for the administration of the grants awarded under paragraph (h) (n).
185.4 	(e) (k) $126,000 is appropriated to the Board of Pharmacy for the collection of the 
185.5 	registration fees under section 151.066.
185.6 	(f) (l) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
185.7 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
185.8 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
185.9 	(g) (m) After the appropriations in paragraphs (b) to (f) (l) are made, 50 percent of the 
185.10 	remaining amount is appropriated to the commissioner of human services for distribution 
185.11 	to county social service agencies and Tribal social service agency initiative projects 
185.12 	authorized under section 256.01, subdivision 14b, to provide child protection services to 
185.13 	children and families who are affected by addiction. The commissioner shall distribute this 
185.14 	money proportionally to county social service agencies and Tribal social service agency 
185.15 	initiative projects based on out-of-home placement episodes where parental drug abuse is 
185.16 	the primary reason for the out-of-home placement using data from the previous calendar 
185.17 	year. County social service agencies and Tribal social service agency initiative projects 
185.18 	receiving funds from the opiate epidemic response fund must annually report to the 
185.19 	commissioner on how the funds were used to provide child protection services, including 
185.20 	measurable outcomes, as determined by the commissioner. County social service agencies 
185.21 	and Tribal social service agency initiative projects must not use funds received under this 
185.22 	paragraph to supplant current state or local funding received for child protection services 
185.23 	for children and families who are affected by addiction.
185.24 	(h) (n) After the appropriations in paragraphs (b) to (g) (m) are made, the remaining 
185.25 	amount in the account is appropriated to the commissioner of human services to award 
185.26 	grants as specified by the Opiate Epidemic Response Advisory Council in accordance with 
185.27 	section 256.042, unless otherwise appropriated by the legislature.
185.28 	(i) (o) Beginning in fiscal year 2022 and each year thereafter, funds for county social 
185.29 	service agencies and Tribal social service agency initiative projects under paragraph (g)
185.30 	(m) and grant funds specified by the Opiate Epidemic Response Advisory Council under 
185.31 	paragraph (h) (n) may be distributed on a calendar year basis.
185.32 	(p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
185.33 	(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.

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

186.1 	Sec. 11. Minnesota Statutes 2022, section 256.043, subdivision 3a, is amended to read:
186.2 		Subd. 3a.Appropriations from settlement account. (a) The appropriations in paragraphs 
186.3 	(b) to (e) shall be made from the settlement account on a fiscal year basis in the order 
186.4 	specified.
186.5 	(b) If the balance in the registration and license fee account is not sufficient to fully fund 
186.6 	the appropriations specified in subdivision 3, paragraphs (b) to (f) (l), an amount necessary 
186.7 	to meet any insufficiency shall be transferred from the settlement account to the registration 
186.8 	and license fee account to fully fund the required appropriations.
186.9 	(c) $209,000 in fiscal year 2023 and $239,000 in fiscal year 2024 and subsequent fiscal 
186.10 	years are appropriated to the commissioner of human services for the administration of 
186.11 	grants awarded under paragraph (e). $276,000 in fiscal year 2023 and $151,000 in fiscal 
186.12 	year 2024 and subsequent fiscal years are appropriated to the commissioner of human 
186.13 	services to collect, collate, and report data submitted and to monitor compliance with 
186.14 	reporting and settlement expenditure requirements by grantees awarded grants under this 
186.15 	section and municipalities receiving direct payments from a statewide opioid settlement 
186.16 	agreement as defined in section 256.042, subdivision 6.
186.17 	(d) After any appropriations necessary under paragraphs (b) and (c) are made, an amount 
186.18 	equal to the calendar year allocation to Tribal social service agency initiative projects under 
186.19 	subdivision 3, paragraph (g) (m), is appropriated from the settlement account to the 
186.20 	commissioner of human services for distribution to Tribal social service agency initiative 
186.21 	projects to provide child protection services to children and families who are affected by 
186.22 	addiction. The requirements related to proportional distribution, annual reporting, and 
186.23 	maintenance of effort specified in subdivision 3, paragraph (g) (m), also apply to the 
186.24 	appropriations made under this paragraph.
186.25 	(e) After making the appropriations in paragraphs (b), (c), and (d), the remaining amount 
186.26 	in the account is appropriated to the commissioner of human services to award grants as 
186.27 	specified by the Opiate Epidemic Response Advisory Council in accordance with section 
186.28 	256.042.
186.29 	(f) Funds for Tribal social service agency initiative projects under paragraph (d) and 
186.30 	grant funds specified by the Opiate Epidemic Response Advisory Council under paragraph 
186.31 	(e) may be distributed on a calendar year basis.
186.32 	(g) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
186.33 	(d) and (e) are available for three years after the funds are appropriated.

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

187.2 	Sec. 12. [256I.052] OPIATE ANTAGONISTS.
187.3 	(a) Site-based or group housing support settings must maintain a supply of opiate 
187.4 	antagonists as defined in section 604A.04, subdivision 1, at each housing site to be 
187.5 	administered in compliance with section 151.37, subdivision 12.
187.6 	(b) Each site must have at least two doses of an opiate antagonist on site.
187.7 	(c) Staff on site must have training on how and when to administer opiate antagonists.

187.8 	Sec. 13. Laws 2019, chapter 63, article 3, section 1, as amended by Laws 2020, chapter 
187.9 	115, article 3, section 35, and Laws 2022, chapter 53, section 12, is amended to read:
187.10 	Section 1. APPROPRIATIONS.
 187.11 	(a) Board of Pharmacy; administration. $244,000 in fiscal year 2020 is appropriated 
187.12 	from the general fund to the Board of Pharmacy for onetime information technology and 
187.13 	operating costs for administration of licensing activities under Minnesota Statutes, section 
187.14 	151.066. This is a onetime appropriation.
187.15 	(b) Commissioner of human services; administration. $309,000 in fiscal year 2020 
187.16 	is appropriated from the general fund and $60,000 in fiscal year 2021 is appropriated from 
187.17 	the opiate epidemic response fund to the commissioner of human services for the provision 
187.18 	of administrative services to the Opiate Epidemic Response Advisory Council and for the 
187.19 	administration of the grants awarded under paragraphs (f), (g), and (h). The opiate epidemic 
187.20 	response fund base for this appropriation is $60,000 in fiscal year 2022, $60,000 in fiscal 
187.21 	year 2023, $60,000 in fiscal year 2024, and $0 in fiscal year 2025 .
187.22 	(c) Board of Pharmacy; administration. $126,000 in fiscal year 2020 is appropriated 
187.23 	from the general fund to the Board of Pharmacy for the collection of the registration fees 
187.24 	under section 151.066.
187.25 	(d) Commissioner of public safety; enforcement activities. $672,000 in fiscal year 
187.26 	2020 is appropriated from the general fund to the commissioner of public safety for the 
187.27 	Bureau of Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab 
187.28 	supplies and $288,000 is for special agent positions focused on drug interdiction and drug 
187.29 	trafficking.
187.30 	(e) Commissioner of management and budget; evaluation activities. $300,000 in 
187.31 	fiscal year 2020 is appropriated from the general fund and $300,000 in fiscal year 2021 is 
188.1 	appropriated from the opiate epidemic response fund to the commissioner of management 
188.2 	and budget for evaluation activities under Minnesota Statutes, section 256.042, subdivision 
188.3 	1, paragraph (c).
188.4 	(f) Commissioner of human services; grants for Project ECHO. $400,000 in fiscal 
188.5 	year 2020 is appropriated from the general fund and $400,000 in fiscal year 2021 is 
188.6 	appropriated from the opiate epidemic response fund to the commissioner of human services 
188.7 	for grants of $200,000 to CHI St. Gabriel's Health Family Medical Center for the 
188.8 	opioid-focused Project ECHO program and $200,000 to Hennepin Health Care for the 
188.9 	opioid-focused Project ECHO program. The opiate epidemic response fund base for this 
188.10 	appropriation is $400,000 in fiscal year 2022, $400,000 in fiscal year 2023, $400,000 in 
188.11 	fiscal year 2024, and $0 in fiscal year 20252024.
188.12 	(g) Commissioner of human services; opioid overdose prevention grant. $100,000 
188.13 	in fiscal year 2020 is appropriated from the general fund and $100,000 in fiscal year 2021 
188.14 	is appropriated from the opiate epidemic response fund to the commissioner of human 
188.15 	services for a grant to a nonprofit organization that has provided overdose prevention 
188.16 	programs to the public in at least 60 counties within the state, for at least three years, has 
188.17 	received federal funding before January 1, 2019, and is dedicated to addressing the opioid 
188.18 	epidemic. The grant must be used for opioid overdose prevention, community asset mapping, 
188.19 	education, and overdose antagonist distribution. The opiate epidemic response fund base 
188.20 	for this appropriation is $100,000 in fiscal year 2022, $100,000 in fiscal year 2023, $100,000
188.21 	in fiscal year 2024, and $0 in fiscal year 20252024.
188.22 	(h) Commissioner of human services; traditional healing. $2,000,000 in fiscal year 
188.23 	2020 is appropriated from the general fund and $2,000,000 in fiscal year 2021 is appropriated 
188.24 	from the opiate epidemic response fund to the commissioner of human services to award 
188.25 	grants to Tribal nations and five urban Indian communities for traditional healing practices 
188.26 	to American Indians and to increase the capacity of culturally specific providers in the 
188.27 	behavioral health workforce. The opiate epidemic response fund base for this appropriation 
188.28 	is $2,000,000 in fiscal year 2022, $2,000,000 in fiscal year 2023, $2,000,000 in fiscal year 
188.29 	2024, and $0 in fiscal year 20252024.
188.30 	(i) Board of Dentistry; continuing education. $11,000 in fiscal year 2020 is 
188.31 	appropriated from the state government special revenue fund to the Board of Dentistry to 
188.32 	implement the continuing education requirements under Minnesota Statutes, section 214.12, 
188.33 	subdivision 6.
189.1 	(j) Board of Medical Practice; continuing education. $17,000 in fiscal year 2020 is 
189.2 	appropriated from the state government special revenue fund to the Board of Medical Practice 
189.3 	to implement the continuing education requirements under Minnesota Statutes, section 
189.4 	214.12, subdivision 6.
189.5 	(k) Board of Nursing; continuing education. $17,000 in fiscal year 2020 is appropriated 
189.6 	from the state government special revenue fund to the Board of Nursing to implement the 
189.7 	continuing education requirements under Minnesota Statutes, section 214.12, subdivision 
189.8 	6.
189.9 	(l) Board of Optometry; continuing education. $5,000 in fiscal year 2020 is 
189.10 	appropriated from the state government special revenue fund to the Board of Optometry to 
189.11 	implement the continuing education requirements under Minnesota Statutes, section 214.12, 
189.12 	subdivision 6.
189.13 	(m) Board of Podiatric Medicine; continuing education. $5,000 in fiscal year 2020 
189.14 	is appropriated from the state government special revenue fund to the Board of Podiatric 
189.15 	Medicine to implement the continuing education requirements under Minnesota Statutes, 
189.16 	section 214.12, subdivision 6.
189.17 	(n) Commissioner of health; nonnarcotic pain management and wellness. $1,250,000 
189.18 	is appropriated in fiscal year 2020 from the general fund to the commissioner of health, to 
189.19 	provide funding for:
189.20 	(1) statewide mapping and assessment of community-based nonnarcotic pain management 
189.21 	and wellness resources; and
189.22 	(2) up to five demonstration projects in different geographic areas of the state to provide 
189.23 	community-based nonnarcotic pain management and wellness resources to patients and 
189.24 	consumers.
189.25 	The demonstration projects must include an evaluation component and scalability analysis. 
189.26 	The commissioner shall award the grant for the statewide mapping and assessment, and the 
189.27 	demonstration project grants, through a competitive request for proposal process. Grants 
189.28 	for statewide mapping and assessment and demonstration projects may be awarded 
189.29 	simultaneously. In awarding demonstration project grants, the commissioner shall give 
189.30 	preference to proposals that incorporate innovative community partnerships, are informed 
189.31 	and led by people in the community where the project is taking place, and are culturally 
189.32 	relevant and delivered by culturally competent providers. This is a onetime appropriation.
190.1 	(o) Commissioner of health; administration. $38,000 in fiscal year 2020 is appropriated 
190.2 	from the general fund to the commissioner of health for the administration of the grants 
190.3 	awarded in paragraph (n).

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

190.5 	Sec. 14. PUBLIC AWARENESS CAMPAIGN.
190.6 	(a) The commissioner of human services must establish a multitiered public awareness 
190.7 	and educational campaign on substance use disorders. The campaign must include strategies 
190.8 	to prevent substance use disorder, reduce stigma, and ensure people know how to access 
190.9 	treatment, recovery, and harm reduction services.
190.10 	(b) The commissioner must consult with communities disproportionately impacted by 
190.11 	substance use disorder to ensure the campaign focuses on lived experience and equity. The 
190.12 	commissioner may also consult and establish relationships with media and communication 
190.13 	experts, behavioral health professionals, state and local agencies, and community 
190.14 	organizations to design and implement the campaign.
190.15 	(c) The campaign must include awareness-raising and educational information using 
190.16 	multichannel marketing strategies, social media, virtual events, press releases, reports, and 
190.17 	targeted outreach. The commissioner must evaluate the effectiveness of the campaign and 
190.18 	modify outreach and strategies as needed.

190.19 	Sec. 15. HARM REDUCTION AND CULTURALLY SPECIFIC GRANTS.
 190.20 	(a) The commissioner of human services must establish grants for Tribal Nations or 
190.21 	culturally specific organizations to enhance and expand capacity to address the impacts of 
190.22 	the opioid epidemic in their respective communities. Grants may be used to purchase and 
190.23 	distribute harm reduction supplies, develop organizational capacity, and expand culturally 
190.24 	specific services.
190.25 	(b) Harm reduction grant funds must be used to promote safer practices and reduce the 
190.26 	transmission of infectious disease. Allowable expenses include syringes, fentanyl testing 
190.27 	supplies, disinfectants, opiate antagonist rescue kits, safe injection kits, safe smoking kits, 
190.28 	sharps disposal, wound-care supplies, medication lock boxes, FDA-approved home testing 
190.29 	kits for viral hepatitis and HIV, written educational and resource materials, and other supplies 
190.30 	approved by the commissioner.
190.31 	(c) Culturally specific organizational capacity grant funds must be used to develop and 
190.32 	improve organizational infrastructure to increase access to culturally specific services and 
191.1 	community building. Allowable expenses include funds for organizations to hire staff or 
191.2 	consultants who specialize in fundraising, grant writing, business development, and program 
191.3 	integrity or other identified organizational needs as approved by the commissioner.
191.4 	(d) Culturally specific service grant funds must be used to expand culturally specific 
191.5 	outreach and services. Allowable expenses include hiring or consulting with cultural advisors, 
191.6 	resources to support cultural traditions, and education to empower individuals and providers, 
191.7 	develop a sense of community, and develop a connection to ancestral roots.
191.8 	(e) Opiate antagonist training grant funds may be used to provide information and training 
191.9 	on safe storage and use of opiate antagonists. Training may be conducted via multiple 
191.10 	modalities, including but not limited to in-person, virtual, written, and video recordings.

191.11 	ARTICLE 6
191.12 	OPIOID PRESCRIBING IMPROVEMENT PROGRAM

191.13 	Section 1. Minnesota Statutes 2022, section 256B.0638, subdivision 1, is amended to read:
191.14 		Subdivision 1.Program established. The commissioner of human services, in 
191.15 	conjunction with the commissioner of health, shall coordinate and implement an opioid 
191.16 	prescribing improvement program to reduce opioid dependency and substance use by 
191.17 	Minnesotans due to the prescribing of opioid analgesics by health care providers and to 
191.18 	support patient-centered, compassionate care for Minnesotans who require treatment with 
191.19 	opioid analgesics.

191.20 	Sec. 2. Minnesota Statutes 2022, section 256B.0638, subdivision 2, is amended to read:
191.21 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
191.22 	have the meanings given them.
191.23 	(b) "Commissioner" means the commissioner of human services.
191.24 	(c) "Commissioners" means the commissioner of human services and the commissioner 
191.25 	of health.
191.26 	(d) "DEA" means the United States Drug Enforcement Administration.
191.27 	(e) "Minnesota health care program" means a public health care program administered 
191.28 	by the commissioner of human services under this chapter and chapter 256L, and the 
191.29 	Minnesota restricted recipient program.
192.1 	(f) "Opioid disenrollment standards" means parameters of opioid prescribing practices 
192.2 	that fall outside community standard thresholds for prescribing to such a degree that a 
192.3 	provider must be disenrolled as a medical assistance Minnesota health care program provider.
192.4 	(g) "Opioid prescriber" means a licensed health care provider who prescribes opioids to 
192.5 	medical assistance Minnesota health care program and MinnesotaCare enrollees under the 
192.6 	fee-for-service system or under a managed care or county-based purchasing plan.
192.7 	(h) "Opioid quality improvement standard thresholds" means parameters of opioid 
192.8 	prescribing practices that fall outside community standards for prescribing to such a degree 
192.9 	that quality improvement is required.
192.10 	(i) "Program" means the statewide opioid prescribing improvement program established 
192.11 	under this section.
192.12 	(j) "Provider group" means a clinic, hospital, or primary or specialty practice group that 
192.13 	employs, contracts with, or is affiliated with an opioid prescriber. Provider group does not 
192.14 	include a professional association supported by dues-paying members.
192.15 	(k) "Sentinel measures" means measures of opioid use that identify variations in 
192.16 	prescribing practices during the prescribing intervals.

192.17 	Sec. 3. Minnesota Statutes 2022, section 256B.0638, subdivision 4, is amended to read:
192.18 		Subd. 4.Program components. (a) The working group shall recommend to the 
192.19 	commissioners the components of the statewide opioid prescribing improvement program, 
192.20 	including, but not limited to, the following:
192.21 	(1) developing criteria for opioid prescribing protocols, including:
192.22 	(i) prescribing for the interval of up to four days immediately after an acute painful 
192.23 	event;
192.24 	(ii) prescribing for the interval of up to 45 days after an acute painful event; and
192.25 	(iii) prescribing for chronic pain, which for purposes of this program means pain lasting 
192.26 	longer than 45 days after an acute painful event;
192.27 	(2) developing sentinel measures;
192.28 	(3) developing educational resources for opioid prescribers about communicating with 
192.29 	patients about pain management and the use of opioids to treat pain;
192.30 	(4) developing opioid quality improvement standard thresholds and opioid disenrollment  
192.31 	standards for opioid prescribers and provider groups. In developing opioid disenrollment 
193.1 	standards, the standards may be described in terms of the length of time in which prescribing 
193.2 	practices fall outside community standards and the nature and amount of opioid prescribing 
193.3 	that fall outside community standards; and
193.4 	(5) addressing other program issues as determined by the commissioners.
193.5 	(b) The opioid prescribing protocols shall not apply to opioids prescribed for patients 
193.6 	who are experiencing pain caused by a malignant condition or who are receiving hospice 
193.7 	care or palliative care, or to opioids prescribed for substance use disorder treatment with 
193.8 	medications for opioid use disorder.
193.9 	(c) All opioid prescribers who prescribe opioids to Minnesota health care program 
193.10 	enrollees must participate in the program in accordance with subdivision 5. Any other 
193.11 	prescriber who prescribes opioids may comply with the components of this program described 
193.12 	in paragraph (a) on a voluntary basis.

193.13 	Sec. 4. Minnesota Statutes 2022, section 256B.0638, subdivision 5, is amended to read:
193.14 		Subd. 5.Program implementation. (a) The commissioner shall implement the programs 
193.15 	within the Minnesota health care quality improvement program to improve the health of 
193.16 	and quality of care provided to Minnesota health care program enrollees. The program must 
193.17 	be designed to support patient-centered care consistent with community standards of care. 
193.18 	The program must discourage unsafe tapering practices and patient abandonment by 
193.19 	providers. The commissioner shall annually collect and report to provider groups the sentinel 
193.20 	measures of data showing individual opioid prescribers' opioid prescribing patterns compared 
193.21 	to their anonymized peers. Provider groups shall distribute data to their affiliated, contracted, 
193.22 	or employed opioid prescribers.
193.23 	(b) The commissioner shall notify an opioid prescriber and all provider groups with 
193.24 	which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing 
193.25 	pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber 
193.26 	and any provider group that receives a notice under this paragraph shall submit to the 
193.27 	commissioner a quality improvement plan for review and approval by the commissioner 
193.28 	with the goal of bringing the opioid prescriber's prescribing practices into alignment with 
193.29 	community standards. A quality improvement plan must include:
193.30 	(1) components of the program described in subdivision 4, paragraph (a);
193.31 	(2) internal practice-based measures to review the prescribing practice of the opioid 
193.32 	prescriber and, where appropriate, any other opioid prescribers employed by or affiliated 
194.1 	with any of the provider groups with which the opioid prescriber is employed or affiliated; 
194.2 	and
194.3 	(3) appropriate use of the prescription monitoring program under section 152.126
194.4 	demonstration of patient-centered care consistent with community standards of care.
194.5 	(c) If, after a year from the commissioner's notice under paragraph (b), the opioid 
194.6 	prescriber's prescribing practices for treatment of acute or postacute pain do not improve 
194.7 	so that they are consistent with community standards, the commissioner shall may take one 
194.8 	or more of the following steps:
194.9 	(1) require the prescriber, the provider group, or both, to monitor prescribing practices 
194.10 	more frequently than annually;
194.11 	(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel 
194.12 	measures; or
194.13 	(3) require the opioid prescriber to participate in additional quality improvement efforts, 
194.14 	including but not limited to mandatory use of the prescription monitoring program established 
194.15 	under section 152.126.
194.16 	(d) Prescribers treating patients who are on chronic, high doses of opioids must meet 
194.17 	community standards of care, including performing regular assessments and addressing 
194.18 	unwarranted risks of opioid prescribing, but are not required to show measurable changes 
194.19 	in chronic pain prescribing thresholds within a certain period.
194.20 	(e) The commissioner shall dismiss a prescriber from participating in the opioid 
194.21 	prescribing quality improvement program on an annual basis when the prescriber 
194.22 	demonstrates that the prescriber's practices are patient-centered and reflect community 
194.23 	standards for safe and compassionate treatment of patients experiencing pain.
194.24 	(d) (f) The commissioner shall terminate from Minnesota health care programs may 
194.25 	investigate for possible disenrollment all opioid prescribers and provider groups whose 
194.26 	prescribing practices fall within the applicable opioid disenrollment standards.
194.27 	(e) (g) No physician, advanced practice registered nurse, or physician assistant, acting 
194.28 	in good faith based on the needs of the patient, may be disenrolled by the commissioner of 
194.29 	human services solely for prescribing a dosage that equates to an upward deviation from 
194.30 	morphine milligram equivalent dosage recommendations specified in state or federal opioid 
194.31 	prescribing guidelines or policies, or quality improvement thresholds established under this 
194.32 	section.

195.1 	Sec. 5. Minnesota Statutes 2022, section 256B.0638, is amended by adding a subdivision 
195.2 	to read:
195.3 		Subd. 6a.Waiver for certain provider groups. (a) This section does not apply to 
195.4 	prescribers employed by, or under contract or affiliated with, a provider group for which 
195.5 	the commissioner has granted a waiver from the requirements of this section.
195.6 	(b) The commissioner, in consultation with opioid prescribers, shall develop waiver 
195.7 	criteria for provider groups, and shall make waivers available beginning July 1, 2023. In 
195.8 	granting waivers, the commissioner shall consider whether the medical director of the 
195.9 	provider group and a majority of the practitioners within a provider group have specialty 
195.10 	training, fellowship training, or experience in treating chronic pain. Waivers under this 
195.11 	subdivision must be granted on an annual basis.

195.12 	Sec. 6. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; OPIOID 
195.13 	PRESCRIBING IMPROVEMENT PROGRAM SUNSET.
 195.14 	The commissioner of human services shall recommend criteria to provide for a sunset 
195.15 	of the opioid prescribing improvement program under Minnesota Statutes, section 256B.0638. 
195.16 	In developing sunset criteria, the commissioner shall consult with stakeholders including 
195.17 	but not limited to the Minnesota Medical Association, the Minnesota Society of Interventional 
195.18 	Pain Physicians, clinicians that practice pain management, addiction medicine, or mental 
195.19 	health, and either current or former Minnesota health care program enrollees who use or 
195.20 	have used opioid therapy to manage chronic pain. By January 15, 2024, the commissioner 
195.21 	shall submit recommended criteria to the chairs and ranking minority members of the 
195.22 	legislative committees with jurisdiction over health and human services finance and policy. 
195.23 	The opioid prescribing improvement program shall expire when the recommended criteria 
195.24 	developed according to this section are met, or on December 31, 2024, whichever is sooner.

195.25 	ARTICLE 7
195.26 	LICENSING

195.27 	Section 1. Minnesota Statutes 2022, section 245A.04, subdivision 7, is amended to read:
195.28 		Subd. 7.Grant of license; license extension. (a) If the commissioner determines that 
195.29 	the program complies with all applicable rules and laws, the commissioner shall issue a 
195.30 	license consistent with this section or, if applicable, a temporary change of ownership license 
195.31 	under section 245A.043. At minimum, the license shall state:
195.32 	(1) the name of the license holder;
196.1 	(2) the address of the program;
196.2 	(3) the effective date and expiration date of the license;
196.3 	(4) the type of license;
196.4 	(5) the maximum number and ages of persons that may receive services from the program; 
196.5 	and
196.6 	(6) any special conditions of licensure.
196.7 	(b) The commissioner may issue a license for a period not to exceed two years if:
196.8 	(1) the commissioner is unable to conduct the evaluation or observation required by 
196.9 	subdivision 4, paragraph (a), clause (4), because the program is not yet operational;
196.10 	(2) certain records and documents are not available because persons are not yet receiving 
196.11 	services from the program; and
196.12 	(3) the applicant complies with applicable laws and rules in all other respects.
196.13 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
196.14 	or persons will be placed or cared for in the licensed program.
196.15 	(d) Except as provided in paragraphs (f) and (g) (i) and (j), the commissioner shall not 
196.16 	issue or reissue a license if the applicant, license holder, or an affiliated controlling individual 
196.17 	has:
196.18 	(1) been disqualified and the disqualification was not set aside and no variance has been 
196.19 	granted;
196.20 	(2) been denied a license under this chapter, within the past two years;
196.21 	(3) had a license issued under this chapter revoked within the past five years; or
196.22 	(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement 
196.23 	for which payment is delinquent; or
196.24 	(5) (4) failed to submit the information required of an applicant under subdivision 1, 
196.25 	paragraph (f) or (g), after being requested by the commissioner.
196.26 	When a license issued under this chapter is revoked under clause (1) or (3), the license 
196.27 	holder and each affiliated controlling individual with a revoked license may not hold any 
196.28 	license under chapter 245A for five years following the revocation, and other licenses held 
196.29 	by the applicant, or license holder, or licenses affiliated with each controlling individual 
196.30 	shall also be revoked.
197.1 	(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license 
197.2 	affiliated with a license holder or controlling individual that had a license revoked within 
197.3 	the past five years if the commissioner determines that (1) the license holder or controlling 
197.4 	individual is operating the program in substantial compliance with applicable laws and rules, 
197.5 	and (2) the program's continued operation is in the best interests of the community being 
197.6 	served.
197.7 	(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response 
197.8 	to an application that is affiliated with an applicant, license holder, or controlling individual 
197.9 	that had an application denied within the past two years or a license revoked within the past 
197.10 	five years if the commissioner determines that (1) the applicant or controlling individual 
197.11 	has operated one or more programs in substantial compliance with applicable laws and 
197.12 	rules, and (2) the program's operation would be in the best interests of the community to be 
197.13 	served.
197.14 	(g) In determining whether a program's operation would be in the best interests of the 
197.15 	community to be served, the commissioner shall consider factors such as the number of 
197.16 	persons served, the availability of alternative services available in the surrounding 
197.17 	community, the management structure of the program, whether the program provides 
197.18 	culturally specific services, and other relevant factors.
197.19 	(e) (h) The commissioner shall not issue or reissue a license under this chapter if an 
197.20 	individual living in the household where the services will be provided as specified under 
197.21 	section 245C.03, subdivision 1, has been disqualified and the disqualification has not been 
197.22 	set aside and no variance has been granted.
197.23 	(f) (i) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued 
197.24 	under this chapter has been suspended or revoked and the suspension or revocation is under 
197.25 	appeal, the program may continue to operate pending a final order from the commissioner. 
197.26 	If the license under suspension or revocation will expire before a final order is issued, a 
197.27 	temporary provisional license may be issued provided any applicable license fee is paid 
197.28 	before the temporary provisional license is issued.
197.29 	(g) (j) Notwithstanding paragraph (f) (i), when a revocation is based on the 
197.30 	disqualification of a controlling individual or license holder, and the controlling individual 
197.31 	or license holder is ordered under section 245C.17 to be immediately removed from direct 
197.32 	contact with persons receiving services or is ordered to be under continuous, direct 
197.33 	supervision when providing direct contact services, the program may continue to operate 
197.34 	only if the program complies with the order and submits documentation demonstrating 
198.1 	compliance with the order. If the disqualified individual fails to submit a timely request for 
198.2 	reconsideration, or if the disqualification is not set aside and no variance is granted, the 
198.3 	order to immediately remove the individual from direct contact or to be under continuous, 
198.4 	direct supervision remains in effect pending the outcome of a hearing and final order from 
198.5 	the commissioner.
198.6 	(h) (k) For purposes of reimbursement for meals only, under the Child and Adult Care 
198.7 	Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, 
198.8 	part 226, relocation within the same county by a licensed family day care provider, shall 
198.9 	be considered an extension of the license for a period of no more than 30 calendar days or 
198.10 	until the new license is issued, whichever occurs first, provided the county agency has 
198.11 	determined the family day care provider meets licensure requirements at the new location.
198.12 	(i) (l) Unless otherwise specified by statute, all licenses issued under this chapter expire 
198.13 	at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
198.14 	apply for and be granted a new license to operate the program or the program must not be 
198.15 	operated after the expiration date.
198.16 	(j) (m) The commissioner shall not issue or reissue a license under this chapter if it has 
198.17 	been determined that a tribal licensing authority has established jurisdiction to license the 
198.18 	program or service.

198.19 	Sec. 2. Minnesota Statutes 2022, section 245A.07, is amended by adding a subdivision to 
198.20 	read:
198.21 		Subd. 2b.Immediate suspension of residential programs. For suspensions issued to 
198.22 	a licensed residential program as defined in section 245A.02, subdivision 14, the effective 
198.23 	date of the order may be delayed for up to 30 calendar days to provide for the continuity of 
198.24 	care of service recipients. The license holder must cooperate with the commissioner to 
198.25 	ensure service recipients receive continued care during the period of the delay and to facilitate 
198.26 	the transition of service recipients to new providers. In these cases, the suspension order 
198.27 	takes effect when all service recipients have been transitioned to a new provider or 30 days 
198.28 	after the suspension order was issued, whichever comes first.

198.29 	Sec. 3. Minnesota Statutes 2022, section 245A.07, is amended by adding a subdivision to 
198.30 	read:
198.31 		Subd. 2c.Immediate suspension for programs with multiple licensed service sites. (a) 
198.32 	For license holders that operate more than one service site under a single license, the 
198.33 	suspension order must be specific to the service site or sites where the commissioner 
199.1 	determines an order is required under subdivision 2. The order must not apply to other 
199.2 	service sites operated by the same license holder unless the commissioner has included in 
199.3 	the order an articulable basis for applying the order to other service sites.
199.4 	(b) If the commissioner has issued more than one license to the license holder under this 
199.5 	chapter, the suspension imposed under this section must be specific to the license for the 
199.6 	program at which the commissioner determines an order is required under subdivision 2. 
199.7 	The order must not apply to other licenses held by the same license holder if those programs 
199.8 	are being operated in substantial compliance with applicable law and rules.

199.9 	Sec. 4. Minnesota Statutes 2022, section 245A.10, subdivision 6, is amended to read:
199.10 		Subd. 6.License not issued until license or certification fee is paid. The commissioner 
199.11 	shall not issue or reissue a license or certification until the license or certification fee is paid. 
199.12 	The commissioner shall send a bill for the license or certification fee to the billing address 
199.13 	identified by the license holder. If the license holder does not submit the license or 
199.14 	certification fee payment by the due date, the commissioner shall send the license holder a 
199.15 	past due notice. If the license holder fails to pay the license or certification fee by the due 
199.16 	date on the past due notice, the commissioner shall send a final notice to the license holder 
199.17 	informing the license holder that the program license will expire on December 31 unless 
199.18 	the license fee is paid before December 31. If a license expires, the program is no longer 
199.19 	licensed and, unless exempt from licensure under section 245A.03, subdivision 2, must not 
199.20 	operate after the expiration date. After a license expires, if the former license holder wishes 
199.21 	to provide licensed services, the former license holder must submit a new license application 
199.22 	and application fee under subdivision 3.

199.23 	Sec. 5. Minnesota Statutes 2022, section 245A.10, is amended by adding a subdivision to 
199.24 	read:
199.25 		Subd. 9.License not reissued until outstanding debt is paid. The commissioner shall 
199.26 	not reissue a license or certification until the license holder has paid all outstanding debts 
199.27 	related to a licensing fine or settlement agreement for which payment is delinquent. If the 
199.28 	payment is past due, the commissioner shall send a past due notice informing the license 
199.29 	holder that the program license will expire on December 31 unless the outstanding debt is 
199.30 	paid before December 31. If a license expires, the program is no longer licensed and must 
199.31 	not operate after the expiration date. After a license expires, if the former license holder 
199.32 	wishes to provide licensed services, the former license holder must submit a new license 
199.33 	application and application fee under subdivision 3.

200.1 	Sec. 6. Minnesota Statutes 2022, section 245A.13, subdivision 1, is amended to read:
200.2 		Subdivision 1.Application. (a) In addition to any other remedy provided by law, the 
200.3 	commissioner may petition the district court in Ramsey County for an order directing the 
200.4 	controlling individuals of a residential or nonresidential program licensed or certified by 
200.5 	the commissioner to show cause why the commissioner should not be appointed receiver 
200.6 	to operate the program. The petition to the district court must contain proof by affidavit that 
200.7 	one or more of the following circumstances exists: (1) that the commissioner has either 
200.8 	begun proceedings to suspend or revoke a license or certification, has suspended or revoked 
200.9 	a license or certification, or has decided to deny an application for licensure or certification 
200.10 	of the program; or (2) it appears to the commissioner that the health, safety, or rights of the 
200.11 	residents or persons receiving care from the program may be in jeopardy because of the 
200.12 	manner in which the program may close, the program's financial condition, or violations 
200.13 	committed by the program of federal or state laws or rules. If the license holder, applicant, 
200.14 	or controlling individual operates more than one program, the commissioner's petition must 
200.15 	specify and be limited to the program for which it seeks receivership. The affidavit submitted 
200.16 	by the commissioner must set forth alternatives to receivership that have been considered, 
200.17 	including rate adjustments. The order to show cause is returnable not less than five days 
200.18 	after service is completed and must provide for personal service of a copy to the program 
200.19 	administrator and to the persons designated as agents by the controlling individuals to accept 
200.20 	service on their behalf.
200.21 	(1) the commissioner has commenced proceedings to suspend or revoke the program's 
200.22 	license or refused to renew the program's license;
200.23 	(2) there is a threat of imminent abandonment by the program or its controlling 
200.24 	individuals;
200.25 	(3) the program has shown a pattern of failure to meet ongoing financial obligations 
200.26 	such as failing to pay for food, pharmaceuticals, personnel costs, or required insurance;
200.27 	(4) the health, safety, or rights of the residents or persons receiving care from the program 
200.28 	appear to be in jeopardy due to the manner in which the program may close, the program's 
200.29 	financial condition, or violations of federal or state law or rules committed by the program; 
200.30 	or
200.31 	(5) the commissioner has notified the program or its controlling individuals that the 
200.32 	program's federal Medicare or Medicaid provider agreement will be terminated, revoked, 
200.33 	canceled, or not renewed.
201.1 	(b) If the license holder, applicant, or controlling individual operates more than one 
201.2 	program, the commissioner's petition must specify and be limited to the program for which 
201.3 	it seeks receivership.
201.4 	(c) The order to show cause shall be personally served on the program through its 
201.5 	authorized agent or, in the event the authorized agent cannot be located, on any controlling 
201.6 	individual for the program.

201.7 	Sec. 7. Minnesota Statutes 2022, section 245A.13, subdivision 2, is amended to read:
201.8 		Subd. 2.Appointment of receiver. (a) If the court finds that involuntary receivership 
201.9 	is necessary as a means of protecting the health, safety, or rights of persons being served 
201.10 	by the program, the court shall appoint the commissioner as receiver to operate the program. 
201.11 	The commissioner as receiver may contract with another entity or group to act as the 
201.12 	managing agent during the receivership period. The managing agent will be responsible for 
201.13 	the day-to-day operations of the program subject at all times to the review and approval of 
201.14 	the commissioner. A managing agent shall not:
201.15 	(1) be the license holder or controlling individual of the program;
201.16 	(2) have a financial interest in the program at the time of the receivership;
201.17 	(3) be otherwise affiliated with the program; or
201.18 	(4) have had a licensed program that has been ordered into receivership.
201.19 	(b) Notwithstanding state contracting requirements in chapter 16C, the commissioner 
201.20 	shall establish and maintain a list of qualified persons or entities with experience in delivering 
201.21 	services and with winding down programs under chapter 245A, 245D, or 245G, or other 
201.22 	service types licensed by the commissioner. The list shall be a resource for selecting a 
201.23 	managing agent, and the commissioner may update the list at any time.

201.24 	Sec. 8. Minnesota Statutes 2022, section 245A.13, subdivision 3, is amended to read:
201.25 		Subd. 3.Powers and duties of receiver. Within 36 months after the receivership order, 
201.26 	the receiver shall provide for the orderly transfer of the persons served by the program to 
201.27 	other programs or make other provisions to protect their health, safety, and rights. The 
201.28 	receiver or the managing agent shall correct or eliminate deficiencies in the program that 
201.29 	the commissioner determines endanger the health, safety, or welfare of the persons being 
201.30 	served by the program unless the correction or elimination of deficiencies at a residential 
201.31 	program involves major alteration in the structure of the physical plant. If the correction or 
201.32 	elimination of the deficiencies at a residential program requires major alterations in the 
202.1 	structure of the physical plant, the receiver shall take actions designed to result in the 
202.2 	immediate transfer of persons served by the residential program. During the period of the 
202.3 	receivership, the receiver and the managing agent shall operate the residential or 
202.4 	nonresidential program in a manner designed to preserve the health, safety, rights, adequate 
202.5 	care, and supervision of the persons served by the program. The receiver or the managing 
202.6 	agent may make contracts and incur lawful expenses. The receiver or the managing agent 
202.7 	shall collect incoming payments from all sources and apply them to the cost incurred in the 
202.8 	performance of the functions of the receivership including the fee set under subdivision 4. 
202.9 	No security interest in any real or personal property comprising the program or contained 
202.10 	within it, or in any fixture of the physical plant, shall be impaired or diminished in priority 
202.11 	by the receiver or the managing agent. (a) A receiver appointed pursuant to this section 
202.12 	shall, within 18 months after the receivership order, determine whether to close the program 
202.13 	or to make other provisions with the intent to keep the program open. If the receiver 
202.14 	determines that program closure is appropriate, the commissioner shall provide for the 
202.15 	orderly transfer of individuals served by the program to other programs or make other 
202.16 	provisions to protect the health, safety, and rights of individuals served by the program.
202.17 	(b) During the receivership, the receiver or the managing agent shall correct or eliminate 
202.18 	deficiencies in the program that the commissioner determines endanger the health, safety, 
202.19 	or welfare of the persons being served by the program unless the correction or elimination 
202.20 	of deficiencies at a residential program involves major alteration in the structure of the 
202.21 	physical plant. If the correction or elimination of the deficiencies at a residential program 
202.22 	requires major alterations in the structure of the physical plant, the receiver shall take actions 
202.23 	designed to result in the immediate transfer of persons served by the residential program. 
202.24 	During the period of the receivership, the receiver and the managing agent shall operate the 
202.25 	residential or nonresidential program in a manner designed to preserve the health, safety, 
202.26 	rights, adequate care, and supervision of the persons served by the program.
202.27 	(c) The receiver or the managing agent may make contracts and incur lawful expenses.
202.28 	(d) The receiver or the managing agent shall use the building, fixtures, furnishings, and 
202.29 	any accompanying consumable goods in the provision of care and services to the clients 
202.30 	during the receivership period. The receiver shall take action as is reasonably necessary to 
202.31 	protect or conserve the tangible assets or property during receivership.
202.32 	(e) The receiver or the managing agent shall collect incoming payments from all sources 
202.33 	and apply them to the cost incurred in the performance of the functions of the receivership, 
202.34 	including the fee set under subdivision 4. No security interest in any real or personal property 
203.1 	comprising the program or contained within it, or in any fixture of the physical plant, shall 
203.2 	be impaired or diminished in priority by the receiver or the managing agent.
203.3 	(f) The receiver has authority to hire, direct, manage, and discharge any employees of 
203.4 	the program, including management level staff for the program.
203.5 	(g) The commissioner, as the receiver appointed by the court, may hire a managing agent 
203.6 	to work on the commissioner's behalf to operate the program during the receivership. The 
203.7 	managing agent is entitled to a reasonable fee. The receiver and managing agent shall be 
203.8 	liable only in an official capacity for injury to persons and property by reason of the 
203.9 	conditions of the program. The receiver and managing agent shall not be personally liable, 
203.10 	except for gross negligence or intentional acts. The commissioner shall assist the managing 
203.11 	agent in carrying out the managing agent's duties.

203.12 	Sec. 9. Minnesota Statutes 2022, section 245A.13, subdivision 5, is amended to read:
203.13 		Subd. 5.Termination. An involuntary receivership terminates 36 18 months after the 
203.14 	date on which it was ordered or at any other time designated by the court or when any of 
203.15 	the following events occurs:
203.16 	(1) the commissioner determines that the program's license or certification application 
203.17 	should be granted or should not be suspended or revoked;
203.18 	(2) a new license or certification is granted to the program;
203.19 	(3) the commissioner determines that all persons residing in a residential program have 
203.20 	been provided with alternative residential programs or that all persons receiving services 
203.21 	in a nonresidential program have been referred to other programs; or
203.22 	(4) the court determines that the receivership is no longer necessary because the conditions 
203.23 	which gave rise to the receivership no longer exist.

203.24 	Sec. 10. Minnesota Statutes 2022, section 245A.13, subdivision 6, is amended to read:
203.25 		Subd. 6.Emergency procedure. (a) If it appears from the petition filed under subdivision 
203.26 	1, from an affidavit or affidavits filed with the petition, or from testimony of witnesses 
203.27 	under oath if the court determines it necessary, that there is probable cause to believe that 
203.28 	an emergency exists in a residential or nonresidential program, the court shall issue a 
203.29 	temporary order for appointment of a receiver within five two days after receipt of the 
203.30 	petition. Notice of the petition must be served on the program administrator and on the 
203.31 	persons designated as agents by the controlling individuals to accept service on their behalf. 
203.32 	A hearing on the petition must be held within five days after notice is served unless the 
204.1 	administrator or authorized agent consents to a later date. After the hearing, the court may 
204.2 	continue, modify, or terminate the temporary order.
204.3 	(b) Notice of the petition must be served on the authorized agent of the program that is 
204.4 	subject to the receivership petition or, if the authorized agent is not immediately available 
204.5 	for service, on at least one of the controlling individuals for the program. A hearing on the 
204.6 	petition must be held within five days after notice is served unless the authorized agent or 
204.7 	other controlling individual consents to a later date. After the hearing, the court may continue, 
204.8 	modify, or terminate the temporary order.

204.9 	Sec. 11. Minnesota Statutes 2022, section 245A.13, subdivision 7, is amended to read:
204.10 		Subd. 7.Rate recommendation. For any program receiving Medicaid funds and ordered 
204.11 	into receivership, the commissioner of human services may review rates of a residential or 
204.12 	nonresidential program participating in the medical assistance program which is in 
204.13 	receivership and that has needs or deficiencies documented by the Department of Health 
204.14 	or the Department of Human Services. If the commissioner of human services determines 
204.15 	that a review of the rate established under sections 256B.5012 and 256B.5013 is needed, 
204.16 	the commissioner shall:
204.17 	(1) review the order or determination that cites the deficiencies or needs; and
204.18 	(2) determine the need for additional staff, additional annual hours by type of employee, 
204.19 	and additional consultants, services, supplies, equipment, repairs, or capital assets necessary 
204.20 	to satisfy the needs or deficiencies.

204.21 	Sec. 12. Minnesota Statutes 2022, section 245A.13, subdivision 9, is amended to read:
204.22 		Subd. 9.Receivership accounting. The commissioner may use adjust Medicaid rates 
204.23 	and use Medicaid funds, including but not limited to waiver funds, and the medical assistance 
204.24 	account and funds for receivership cash flow, receivership administrative fees, and accounting 
204.25 	purposes, to the extent permitted by the state's approved Medicaid plan.

204.26 	ARTICLE 8
204.27 	DIRECT CARE AND TREATMENT

204.28 	Section 1. Minnesota Statutes 2022, section 15.01, is amended to read:
204.29 	15.01 DEPARTMENTS OF THE STATE.
204.30 	The following agencies are designated as the departments of the state government: the 
204.31 	Department of Administration;, the Department of Agriculture;, the Department of 
205.1 	Commerce;, the Department of Corrections;, the Department of Direct Care and Treatment,
205.2 	the Department of Education;, the Department of Employment and Economic Development;,
205.3 	the Department of Health;, the Department of Human Rights;, the Department of Human 
205.4 	Services, the Department of Information Technology Services;, the Department of Iron 
205.5 	Range Resources and Rehabilitation;, the Department of Labor and Industry;, the Department 
205.6 	of Management and Budget;, the Department of Military Affairs;, the Department of Natural 
205.7 	Resources;, the Department of Public Safety; the Department of Human Services;, the 
205.8 	Department of Revenue;, the Department of Transportation;, the Department of Veterans 
205.9 	Affairs;, and their successor departments.

205.10 	EFFECTIVE DATE. This section is effective January 1, 2025.

205.11 	Sec. 2. Minnesota Statutes 2022, section 15.06, subdivision 1, is amended to read:
205.12 		Subdivision 1.Applicability. This section applies to the following departments or 
205.13 	agencies: the Departments of Administration, Agriculture, Commerce, Corrections, Direct 
205.14 	Care and Treatment, Education, Employment and Economic Development, Health, Human 
205.15 	Rights, Human Services, Labor and Industry, Management and Budget, Natural Resources, 
205.16 	Public Safety, Human Services, Revenue, Transportation, and Veterans Affairs; the Housing 
205.17 	Finance and Pollution Control Agencies; the Office of Commissioner of Iron Range 
205.18 	Resources and Rehabilitation; the Department of Information Technology Services; the 
205.19 	Bureau of Mediation Services; and their successor departments and agencies. The heads of 
205.20 	the foregoing departments or agencies are "commissioners."

205.21 	EFFECTIVE DATE. This section is effective January 1, 2025.

205.22 	Sec. 3. Minnesota Statutes 2022, section 43A.08, subdivision 1a, is amended to read:
205.23 		Subd. 1a.Additional unclassified positions. Appointing authorities for the following 
205.24 	agencies may designate additional unclassified positions according to this subdivision: the 
205.25 	Departments of Administration;, Agriculture;, Commerce;, Corrections;, Direct Care and 
205.26 	Treatment, Education;, Employment and Economic Development;, Explore Minnesota 
205.27 	Tourism;, Management and Budget;, Health;, Human Rights;, Human Services, Labor and 
205.28 	Industry;, Natural Resources;, Public Safety;,Human Services; Revenue;, Transportation;,
205.29 	and Veterans Affairs; the Housing Finance and Pollution Control Agencies; the State Lottery; 
205.30 	the State Board of Investment; the Office of Administrative Hearings; the Department of 
205.31 	Information Technology Services; the Offices of the Attorney General, Secretary of State, 
205.32 	and State Auditor; the Minnesota State Colleges and Universities; the Minnesota Office of 
206.1 	Higher Education; the Perpich Center for Arts Education; and the Minnesota Zoological 
206.2 	Board.
206.3 	A position designated by an appointing authority according to this subdivision must 
206.4 	meet the following standards and criteria:
206.5 	(1) the designation of the position would not be contrary to other law relating specifically 
206.6 	to that agency;
206.7 	(2) the person occupying the position would report directly to the agency head or deputy 
206.8 	agency head and would be designated as part of the agency head's management team;
206.9 	(3) the duties of the position would involve significant discretion and substantial 
206.10 	involvement in the development, interpretation, and implementation of agency policy;
206.11 	(4) the duties of the position would not require primarily personnel, accounting, or other 
206.12 	technical expertise where continuity in the position would be important;
206.13 	(5) there would be a need for the person occupying the position to be accountable to, 
206.14 	loyal to, and compatible with, the governor and the agency head, the employing statutory 
206.15 	board or commission, or the employing constitutional officer;
206.16 	(6) the position would be at the level of division or bureau director or assistant to the 
206.17 	agency head; and
206.18 	(7) the commissioner has approved the designation as being consistent with the standards 
206.19 	and criteria in this subdivision.

206.20 	EFFECTIVE DATE. This section is effective January 1, 2025.

206.21 	Sec. 4. Minnesota Statutes 2022, section 245.037, is amended to read:
206.22 	245.037 MONEY COLLECTED AS RENT; STATE PROPERTY.
206.23 	(a) Notwithstanding any law to the contrary, money collected as rent under section 
206.24 	16B.24, subdivision 5, for state property at any of the regional treatment centers or state 
206.25 	nursing home facilities administered by the commissioner of human services is dedicated 
206.26 	to the regional treatment center or state nursing home from which it is generated. Any 
206.27 	balance remaining at the end of the fiscal year shall not cancel and is available until expended.
206.28 	(b) The commissioner may lease out any buildings or portions of buildings, units, or 
206.29 	lands acquired by the department that are not needed for the uses and purposes of the 
206.30 	department. Such authority to lease out buildings, units, and lands includes authority to 
206.31 	lease to employees of the department, notwithstanding section 16B.24, subdivision 5, 
207.1 	paragraph (c). The commissioner may set the prices and terms and conditions for leases 
207.2 	under this paragraph, and shall not make any such lease for a term of more than five years. 
207.3 	All money received from leases under this paragraph shall be credited to the fund from 
207.4 	which the property was acquired or through which the property is being maintained. Money 
207.5 	credited for leased property maintenance is appropriated to the commissioner for that purpose.
207.6 	(c) The commissioner may lease out any buildings or portions of buildings, units, or 
207.7 	lands acquired by the department to clients and employees of the department for the provision 
207.8 	of community-based services, notwithstanding section 16B.24, subdivision 5, paragraph 
207.9 	(c). The commissioner may set the prices and terms and conditions for leases under this 
207.10 	paragraph, and shall not make any such lease for a term of more than five years. All money 
207.11 	received from leases under this paragraph shall be credited to the fund from which the 
207.12 	property was acquired or through which the property is being maintained. Money credited 
207.13 	for leased property maintenance is appropriated to the commissioner for that purpose.

207.14 	Sec. 5. Minnesota Statutes 2022, section 246.54, subdivision 1a, is amended to read:
207.15 		Subd. 1a.Anoka-Metro Regional Treatment Center. (a) A county's payment of the 
207.16 	cost of care provided at Anoka-Metro Regional Treatment Center shall be according to the 
207.17 	following schedule:
207.18 	(1) zero percent for the first 30 days;
207.19 	(2) 20 percent for days 31 and over if the stay is determined to be clinically appropriate 
207.20 	for the client; and
207.21 	(3) 100 percent for each day during the stay, including the day of admission, when the 
207.22 	facility determines that it is clinically appropriate for the client to be discharged.
207.23 	(b) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent 
207.24 	of the cost of care for days over 31 for clients who meet the criteria in paragraph (a), clause 
207.25 	(2), the county shall be responsible for paying the state only the remaining amount. The 
207.26 	county shall not be entitled to reimbursement from the client, the client's estate, or from the 
207.27 	client's relatives, except as provided in section 246.53.
207.28 	(c) Between July 1, 2023, and June 30, 2025, the county is not responsible for the cost 
207.29 	of care under paragraph (a), clause (3), for a person who is committed as a person who has 
207.30 	a mental illness and is dangerous to the public under section 253B.18 and who is awaiting 
207.31 	transfer to another state-operated facility or program. This paragraph expires June 30, 2025.

208.1 	Sec. 6. Minnesota Statutes 2022, section 246.54, subdivision 1b, is amended to read:
208.2 		Subd. 1b.Community behavioral health hospitals. (a) A county's payment of the cost 
208.3 	of care provided at state-operated community-based behavioral health hospitals for adults 
208.4 	and children shall be according to the following schedule:
208.5 	(1) 100 percent for each day during the stay, including the day of admission, when the 
208.6 	facility determines that it is clinically appropriate for the client to be discharged; and
208.7 	(2) the county shall not be entitled to reimbursement from the client, the client's estate, 
208.8 	or from the client's relatives, except as provided in section 246.53.
208.9 	(b) Between July 1, 2023, and June 30, 2025, the county is not responsible for the cost 
208.10 	of care under paragraph (a), clause (1), for a person committed as a person who has a mental 
208.11 	illness and is dangerous to the public under section 253B.18 and who is awaiting transfer 
208.12 	to another state-operated facility or program. This paragraph expires June 30, 2025.
208.13 	(c) Notwithstanding any law to the contrary, the client is not responsible for payment 
208.14 	of the cost of care under this subdivision.

208.15 	Sec. 7. [246C.01] TITLE.
208.16 	This chapter may be cited as the "Department of Direct Care & Treatment Act."

208.17 	Sec. 8. [246C.02] DEPARTMENT OF DIRECT CARE AND TREATMENT; 
208.18 	ESTABLISHMENT.
208.19 	(a) The Department of Direct Care and Treatment is created. An executive board shall 
208.20 	head the Department of Direct Care and Treatment. The executive board shall develop and 
208.21 	maintain direct care and treatment in a manner consistent with applicable law, including 
208.22 	chapters 13, 245, 246, 246B, 252, 253, 253B, 253C, 253D, 254A, 254B, and 256. The 
208.23 	Department of Direct Care and Treatment shall provide direct care and treatment services 
208.24 	in coordination with counties and other vendors. Direct care and treatment services shall 
208.25 	include specialized inpatient programs at secure treatment facilities as defined in sections 
208.26 	253B.02, subdivision 18a, and 253D.02, subdivision 13; community preparation services; 
208.27 	regional treatment centers; enterprise services; consultative services; aftercare services; 
208.28 	community-based services and programs; transition services; nursing home services; and 
208.29 	other services consistent with the mission of the Department of Direct Care and Treatment.
208.30 	(b) "Community preparation services" means specialized inpatient or outpatient services 
208.31 	or programs operated outside of a secure environment but administered by a secure treatment 
208.32 	facility.

209.1 	EFFECTIVE DATE. This section is effective January 1, 2025.

209.2 	Sec. 9. [246C.03] TRANSITION OF AUTHORITY; DEVELOPMENT OF A BOARD.
209.3 		Subdivision 1.Authority until board is developed and powers defined. Upon the 
209.4 	effective date of this act, the commissioner of human services shall continue to exercise all 
209.5 	authorities and responsibilities under chapters 13, 245, 246, 246B, 252, 253, 253B, 253C, 
209.6 	253D, 254A, 254B, and 256, until legislation is effective that develops the Department of 
209.7 	Direct Care and Treatment executive board and defines the responsibilities and powers of 
209.8 	the Department of Direct Care and Treatment and its executive board.
209.9 		Subd. 2.Development of Department of Direct Care and Treatment Board. (a) The 
209.10 	commissioner of human services shall prepare legislation for introduction during the 2024 
209.11 	legislative session, with input from stakeholders the commissioner deems necessary, 
209.12 	proposing legislation for the creation and implementation of the Direct Care and Treatment 
209.13 	executive board and defining the responsibilities, powers, and function of the Department 
209.14 	of Direct Care and Treatment executive board.
209.15 	(b) The Department of Direct Care and Treatment executive board shall consist of no 
209.16 	more than five members, all appointed by the governor.
209.17 	(c) An executive board member's qualifications must be appropriate for overseeing a 
209.18 	complex behavioral health system, such as experience serving on a hospital or non-profit 
209.19 	board, serving as a public sector labor union representative, experience in delivery of 
209.20 	behavioral health services or care coordination, or working as a licensed health care provider, 
209.21 	in an allied health profession, or in health care administration.

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

209.23 	Sec. 10. [246C.04] TRANSFER OF DUTIES.
209.24 	(a) Section 15.039 applies to the transfer of duties required by this chapter.
209.25 	(b) The commissioner of administration, with the governor's approval, shall issue 
209.26 	reorganization orders under section 16B.37 as necessary to carry out the transfer of duties 
209.27 	required by section 246C.03. The provision of section 16B.37, subdivision 1, stating that 
209.28 	transfers under section 16B.37 may only be to an agency that has existed for at least one 
209.29 	year does not apply to transfers to an agency created by this chapter.
209.30 	(c) The initial salary for the health systems chief executive officer of the Department of 
209.31 	Direct Care and Treatment is the same as the salary for the health systems chief executive 
210.1 	officer of direct care and treatment at the Department of Human Services immediately before 
210.2 	July 1, 2024.

210.3 	Sec. 11. [246C.05] EMPLOYEE PROTECTIONS FOR ESTABLISHING THE NEW 
210.4 	DEPARTMENT OF DIRECT CARE AND TREATMENT.
210.5 	(a) Personnel whose duties relate to the functions assigned to the Department of Direct 
210.6 	Care and Treatment executive board in section 246C.03 are transferred to the Department 
210.7 	of Direct Care and Treatment effective 30 days after approval by the commissioner of direct 
210.8 	care and treatment.
210.9 	(b) Before the Department of Direct Care and Treatment executive board is appointed, 
210.10 	personnel whose duties relate to the functions in this section may be transferred beginning 
210.11 	July 1, 2024, with 30 days' notice from the commissioner of management and budget.
210.12 	(c) The following protections shall apply to employees who are transferred from the 
210.13 	Department of Human Services to the Department of Direct Care and Treatment:
210.14 	(1) No transferred employee shall have their employment status and job classification 
210.15 	altered as a result of the transfer.
210.16 	(2) Transferred employees who were represented by an exclusive representative prior 
210.17 	to the transfer shall continue to be represented by the same exclusive representative after 
210.18 	the transfer.
210.19 	(3) The applicable collective bargaining agreements with exclusive representatives shall 
210.20 	continue in full force and effect for such transferred employees after the transfer.
210.21 	(4) The state shall have the obligation to meet and negotiate with the exclusive 
210.22 	representatives of the transferred employees about any proposed changes affecting or relating 
210.23 	to the transferred employees' terms and conditions of employment to the extent such changes 
210.24 	are not addressed in the applicable collective bargaining agreement.
210.25 	(5) When an employee in a temporary unclassified position is transferred to the 
210.26 	Department of Direct Care and Treatment, the total length of time that the employee has 
210.27 	served in the appointment shall include all time served in the appointment at the transferring 
210.28 	agency and the time served in the appointment at the Department of Direct Care and 
210.29 	Treatment. An employee in a temporary unclassified position who was hired by a transferring 
210.30 	agency through an open competitive selection process in accordance with a policy enacted 
210.31 	by Minnesota Management and Budget shall be considered to have been hired through such 
210.32 	process after the transfer.
211.1 	(6) In the event that the state transfers ownership or control of any of the facilities, 
211.2 	services, or operations of the Department of Direct Care and Treatment to another entity, 
211.3 	whether private or public, by subcontracting, sale, assignment, lease, or other transfer, the 
211.4 	state shall require as a written condition of such transfer of ownership or control the following 
211.5 	provisions:
211.6 	(i) Employees who perform work in transferred facilities, services, or operations must 
211.7 	be offered employment with the entity acquiring ownership or control before the entity 
211.8 	offers employment to any individual who was not employed by the transferring agency at 
211.9 	the time of the transfer.
211.10 	(ii) The wage and benefit standards of such transferred employees must not be reduced 
211.11 	by the entity acquiring ownership or control through the expiration of the collective 
211.12 	bargaining agreement in effect at the time of the transfer or for a period of two years after 
211.13 	the transfer, whichever is longer.
211.14 	(d) There is no liability on the part of, and no cause of action arises against, the state of 
211.15 	Minnesota or its officers or agents for any action or inaction of any entity acquiring ownership 
211.16 	or control of any facilities, services, or operations of the Department of Direct Care and 
211.17 	Treatment.

211.18 	EFFECTIVE DATE. This section is effective July 1, 2024.

211.19 	Sec. 12. Minnesota Statutes 2022, section 252.50, subdivision 2, is amended to read:
211.20 		Subd. 2.Authorization to build or purchase. Within the limits of available 
211.21 	appropriations, the commissioner may build, purchase, or lease suitable buildings, at least 
211.22 	a portion of which must be used for state-operated, community-based programs. The 
211.23 	commissioner must develop the state-operated community residential facilities authorized 
211.24 	in the worksheets of the house of representatives appropriations and senate finance 
211.25 	committees. If financing through state general obligation bonds is not available, the 
211.26 	commissioner shall finance the purchase or construction of state-operated, community-based 
211.27 	facilities with the Minnesota Housing Finance Agency. The commissioner shall make 
211.28 	payments through the Department of Administration to the Minnesota Housing Finance 
211.29 	Agency in repayment of mortgage loans granted for the purposes of this section. Programs 
211.30 	must be adaptable to the needs of persons with developmental disabilities and residential 
211.31 	programs must be homelike.

212.1 	Sec. 13. TASK FORCE ON PRIORITY ADMISSIONS TO STATE-OPERATED 
212.2 	TREATMENT PROGRAMS.
 212.3 		Subdivision 1.Establishment; purpose. The Task Force on Priority Admissions to 
212.4 	State-Operated Treatment Programs is established to evaluate the impact of the requirements 
212.5 	for priority admissions under Minnesota Statutes, section 253B.10, subdivision 1, paragraph 
212.6 	(b) on:
212.7 	(1) the Department of Human Services;
212.8 	(2) individuals referred for admission and care at state-operated treatment programs, 
212.9 	including both individuals referred for priority admission under Minnesota Statutes, section 
212.10 	253B.10, subdivision 1, paragraph (b), and individuals not referred according to such priority 
212.11 	admissions requirements; and
212.12 	(3) the mental health system in Minnesota, including community hospitals.
212.13 		Subd. 2.Membership. (a) The task force shall consist of the following members, 
212.14 	appointed as follows:
212.15 	(1) a member appointed by the governor;
212.16 	(2) the commissioner of human services, or a designee;
212.17 	(3) a member representing Department of Human Services direct care and treatment 
212.18 	services who has experience with civil commitments, appointed by the commissioner of 
212.19 	human services;
212.20 	(4) the ombudsman for mental health and developmental disabilities;
212.21 	(5) a hospital representative, appointed by the Minnesota Hospital Association;
212.22 	(6) a county representative, appointed by the Association of Minnesota Counties;
212.23 	(7) a county social services representative, appointed by the Minnesota Association of 
212.24 	County Social Service Administrators;
212.25 	(8) a member appointed by the Minnesota Civil Commitment Defense Panel;
212.26 	(9) a county attorney, appointed by the Minnesota County Attorneys Association;
212.27 	(10) a county sheriff, appointed by the Minnesota Sheriffs' Association;
212.28 	(11) a member appointed by the Minnesota Psychiatric Society;
212.29 	(12) a member appointed by the Minnesota Association of Community Mental Health 
212.30 	Programs;
213.1 	(13) a member appointed by the National Alliance on Mental Illness Minnesota;
213.2 	(14) the Minnesota Attorney General;
213.3 	(15) three individuals from organizations representing racial and ethnic groups that are 
213.4 	overrepresented in the criminal justice system, appointed by the commissioner of corrections; 
213.5 	and
213.6 	(16) one member of the public with lived experience directly related to the task force's 
213.7 	purposes, appointed by the governor.
213.8 	(b) Appointments must be made no later than July 15, 2023.
213.9 	(c) Member compensation and reimbursement for expenses are governed by Minnesota 
213.10 	Statutes, section 15.059, subdivision 3.
213.11 	(d) A member of the legislature may not serve as a member of the task force.
213.12 		Subd. 3.Officers; meetings. (a) The commissioner of human services must convene 
213.13 	the first meeting of the task force no later than August 1, 2023.
213.14 	(b) The Attorney General and the commissioner of human services must serve as 
213.15 	co-chairs. The task force may elect other officers as necessary.
213.16 	(c) Task force meetings are subject to the Minnesota Open Meeting Law under Minnesota 
213.17 	Statutes, chapter 13D.
213.18 		Subd. 4.Administrative support. The commissioner of human services must provide 
213.19 	administrative support and staff assistance for the task force.
213.20 		Subd. 5.Data usage and privacy. Any data provided by executive agencies as part of 
213.21 	the work and report of the task force is subject to the requirements of the Minnesota 
213.22 	Government Data Practices Act under Minnesota Statutes, chapter 13, and all other applicable 
213.23 	data privacy laws.
213.24 		Subd. 6.Duties. The task force must:
213.25 	(1) evaluate the impact of the priority admissions required under Minnesota Statutes, 
213.26 	section 253B.10, subdivision 1, paragraph (b), on the ability of the state to serve all 
213.27 	individuals in need of care in state-operated treatment programs by analyzing:
213.28 	(i) the number of individuals admitted to state-operated treatment programs from jails 
213.29 	or correctional institutions according to the requirements of Minnesota Statutes, section 
213.30 	253B.10, subdivision 1, paragraph (b), since July 1, 2013;
214.1 	(ii) the number of individuals currently on waiting lists for admission to state-operated 
214.2 	treatment programs;
214.3 	(iii) the average length of time an individual admitted from a jail or correctional institution 
214.4 	waits for a medically appropriate bed in a state-operated treatment program, compared to 
214.5 	an individual admitted from another location, such as a community hospital or the individual's 
214.6 	home; and
214.7 	(iv) county-by-county trends over time for priority admissions under Minnesota Statutes, 
214.8 	section 253B.10, subdivision 1, paragraph (b);
214.9 	(2) analyze the impact of the priority admissions required under Minnesota Statutes, 
214.10 	section 253B.10, subdivision 1, paragraph (b), on the mental health system statewide, 
214.11 	including on community hospitals;
214.12 	(3) develop policy and funding recommendations for improvements or alternatives to 
214.13 	the current priority admissions requirement. Recommendations must ensure that 
214.14 	state-operated treatment programs have medical discretion to admit individuals with the 
214.15 	highest acuity and who may pose a risk to self and others, regardless of referral path; and
214.16 	(4) identify and recommend options for providing treatment to individuals referred 
214.17 	according to the priority admissions required under Minnesota Statutes, section 253B.10, 
214.18 	subdivision 1, paragraph (b), and other individuals in the community who require treatment 
214.19 	at state-operated treatment programs.
214.20 		Subd. 7.Report. No later than February 1, 2024, the task force must submit a written 
214.21 	report to the chairs and ranking minority members of the legislative committees with 
214.22 	jurisdiction over public safety and human services that includes recommendations on:
214.23 	(1) proposals to amend Minnesota Statutes, section 253B.10, subdivision 1, paragraph 
214.24 	(b), to improve the priority admissions requirements and process;
214.25 	(2) ways to ensure that state-operated treatment programs have medical discretion to 
214.26 	prioritize the admission of individuals with the most acute clinical and behavioral health 
214.27 	needs or who pose a risk to self and others, regardless of referral path;
214.28 	(3) additional ways to meet the treatment needs of individuals referred to state-operated 
214.29 	treatment programs according to the priority admissions required under Minnesota Statutes, 
214.30 	section 253B.10, subdivision 1, paragraph (b), and other individuals in the community who 
214.31 	require treatment at state-operated treatment programs; and
214.32 	(4) any other relevant findings, research, or analyses conducted or produced by the task 
214.33 	force under subdivision 6.
215.1 		Subd. 8.Expiration. The task force expires June 30, 2024.

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

215.3 	Sec. 14. REVISOR INSTRUCTION.
 215.4 	The revisor of statutes, in consultation with staff from the House Research Department; 
215.5 	House Fiscal Analysis; the Office of Senate Counsel, Research and Fiscal Analysis; and 
215.6 	the respective departments shall prepare legislation for introduction in the 2024 legislative 
215.7 	session proposing the statutory changes necessary to implement the transfers of duties that 
215.8 	this article requires.

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

215.10 	ARTICLE 9
215.11 	APPROPRIATIONS

215.12	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
215.13 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
215.14 	and for the purposes specified in this article. The appropriations are from the general fund, 
215.15 	or another named fund, and are available for the fiscal years indicated for each purpose. 
215.16 	The figures "2024" and "2025" used in this article mean that the appropriations listed under 
215.17 	them are available for the fiscal year ending June 30, 2024, or June 30, 2025, respectively. 
215.18 	"The first year" is fiscal year 2024. "The second year" is fiscal year 2025. "The biennium" 
215.19 	is fiscal years 2024 and 2025.

215.20				APPROPRIATIONS
	
215.21				Available for the Year
	
215.22				Ending June 30
	
215.23					2024
		2025

215.24
215.25	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

215.26	Subdivision 1.Total Appropriation
 	$
	6,926,209,000
	$
	7,181,099,000

215.27	Appropriations by Fund
	
215.28		2024
	2025
	
215.29	General
	6,924,445,000
	7,179,297,000
	
215.30	Health Care Access
	31,000
	69,000
	
215.31	Lottery Prize
	1,733,000
	1,733,000
	
216.1 	The amounts that may be spent for each 
216.2 	purpose are specified in the following 
216.3 	subdivisions.

216.4	Subd. 2.Central Office; Operations
 		24,607,000
		17,725,000
	
216.5 	(a) Grant Administration Carryforward.
216.6 	(1) Of this amount, $714,000 in fiscal year 
216.7 	2024 is available until June 30, 2027.
216.8 	(2) Of this amount, $140,000 in fiscal year 
216.9 	2025 is available until June 30, 2027.
216.10 	(3) Of this amount, $640,000 in fiscal year 
216.11 	2024 is available until June 30, 2029.
216.12 	(b) Base Level Adjustment. The general fund 
216.13 	base is increased by $7,249,000 in fiscal year 
216.14 	2026 and increased by $6,999,000 in fiscal 
216.15 	year 2027.

216.16	Subd. 3.Central Office; Children and Families
 		2,699,000
		-0-
	
216.17 	Grant Administration Carryforward. Of 
216.18 	this amount, $2,699,000 in fiscal year 2024 is 
216.19 	available until June 30, 2027.

216.20	Subd. 4.Central Office; Health Care
 		2,468,000
		3,439,000
	
216.21 	(a) Initial PACE Implementation Funding.
216.22 	$270,000 in fiscal year 2024 is to complete 
216.23 	the initial actuarial and administrative work 
216.24 	necessary to recommend a financing 
216.25 	mechanism for the operation of PACE under 
216.26 	Minnesota Statutes, section 256B.69, 
216.27 	subdivision 23, paragraph (e). This is a 
216.28 	onetime appropriation and is available until 
216.29 	June 30, 2025.
216.30 	(b) Base Level Adjustment. The general fund 
216.31 	base is increased by $3,322,000 in fiscal year 
216.32 	2026 and increased by $3,322,000 in fiscal 
216.33 	year 2027.

217.1
217.2	Subd. 5.Central Office; Aging and Disability 
Services
 		40,115,000
		11,995,000
	
217.3 	(a) Employment Supports Alignment Study.
217.4 	$50,000 in fiscal year 2024 and $200,000 in 
217.5 	fiscal year 2025 are to conduct an interagency 
217.6 	employment supports alignment study. The 
217.7 	base for this appropriation is $150,000 in fiscal 
217.8 	year 2026 and $100,000 in fiscal year 2027.
217.9 	(b) Case Management Training 
217.10 	Curriculum. $377,000 in fiscal year 2024 and 
217.11 	$377,000 in fiscal year 2025 are to develop 
217.12 	and implement a curriculum and training plan 
217.13 	to ensure all lead agency assessors and case 
217.14 	managers have the knowledge and skills 
217.15 	necessary to fulfill support planning and 
217.16 	coordination responsibilities for individuals 
217.17 	who use home and community-based disability 
217.18 	services and live in own-home settings. This 
217.19 	is a onetime appropriation.
217.20 	(c) Office of Ombudsperson for Long-Term 
217.21 	Care. $875,000 in fiscal year 2024 and 
217.22 	$875,000 in fiscal year 2025 are for additional 
217.23 	staff and associated direct costs in the Office 
217.24 	of Ombudsperson for Long-Term Care.
217.25 	(d) Direct Care Services Corps Pilot Project.
217.26 	$500,000 in fiscal year 2024 is from the 
217.27 	general fund for a grant to the Metropolitan 
217.28 	Center for Independent Living for the direct 
217.29 	care services corps pilot project. Up to $25,000 
217.30 	may be used by the Metropolitan Center for 
217.31 	Independent Living for administrative costs. 
217.32 	This is a onetime appropriation.
217.33 	(e) Research on Access to Long-Term Care 
217.34 	Services and Financing. Any unexpended 
217.35 	amount of the fiscal year 2023 appropriation 
218.1 	referenced in Laws 2021, First Special Session 
218.2 	chapter 7, article 17, section 16, estimated to 
218.3 	be $300,000, is canceled. The amount canceled 
218.4 	is appropriated in fiscal year 2024 for the same 
218.5 	purpose.
218.6 	(f) Native American Elder Coordinator.
218.7 	$441,000 in fiscal year 2024 and $441,000 in 
218.8 	fiscal year 2025 are for the Native American 
218.9 	elder coordinator position under Minnesota 
218.10 	Statutes, section 256.975, subdivision 6.
218.11 	(g) Grant Administration Carryforward.
218.12 	(1) Of this amount, $8,154,000 in fiscal year 
218.13 	2024 is available until June 30, 2027.
218.14 	(2) Of this amount, $1,071,000 in fiscal year 
218.15 	2025 is available until June 30, 2027.
218.16 	(3) Of this amount, $19,000,000 in fiscal year 
218.17 	2024 is available until June 30, 2029.
218.18 	(h) Base Level Adjustment. The general fund 
218.19 	base is increased by $8,189,000 in fiscal year 
218.20 	2026 and increased by $8,093,000 in fiscal 
218.21 	year 2027.

218.22
218.23
218.24	Subd. 6.Central Office; Behavioral Health, 
Housing, and Deaf and Hard of Hearing 
Services
 		9,573,000
		4,048,000
	
218.25 	(a) Evidence-Based Training for Substance 
218.26 	Use Disorder Provider Community.
218.27 	$150,000 in fiscal year 2024 and $150,000 in 
218.28 	fiscal year 2025 are for provider participation 
218.29 	in clinical training for the transition to 
218.30 	American Society of Addiction Medicine 
218.31 	standards.
218.32 	(b) Substance Use Disorder Public 
218.33 	Awareness Campaign. $1,584,000 in fiscal 
218.34 	year 2024 is to develop and establish a public 
219.1 	awareness campaign targeting the stigma of 
219.2 	opioid use disorders with the goal of 
219.3 	prevention and education of youth on the 
219.4 	dangers of opioids and other substance use. 
219.5 	Notwithstanding Minnesota Statutes, section 
219.6 	16A.28, this appropriation is available until 
219.7 	June 30, 2027. This is a onetime appropriation.
219.8 	(c) Evaluation of Recovery Site Grants.
219.9 	$100,000 in fiscal year 2025 is to provide 
219.10 	funding for evaluating the effectiveness of 
219.11 	recovery site grant efforts.
219.12 	(d) Grant Administration Carryforward.
219.13 	(1) Of this amount, $3,948,000 in fiscal year 
219.14 	2024 is available until June 30, 2027.
219.15 	(2) Of this amount, $1,183,000 in fiscal year 
219.16 	2024 is available until June 30, 2029.
219.17 	(e) Base Level Adjustment. The general fund 
219.18 	base is increased by $3,759,000 in fiscal year 
219.19 	2026 and increased by $3,659,000 in fiscal 
219.20 	year 2027.

219.21	Subd. 7.Forecasted Programs; Housing Support
 		783,000
		1,592,000

219.22	Subd. 8.Forecasted Programs; MinnesotaCare
 		31,000
		69,000
	
219.23 	This appropriation is from the health care 
219.24 	access fund.

219.25
219.26	Subd. 9.Forecasted Programs; Medical 
Assistance
 		5,672,632,000
		6,347,966,000

219.27
219.28	Subd. 10.Forecasted Programs; Alternative 
Care
 		48,042,000
		53,377,000
	
219.29 	Any money allocated to the alternative care 
219.30 	program that is not spent for the purposes 
219.31 	indicated does not cancel but must be 
219.32 	transferred to the medical assistance account.

220.1
220.2	Subd. 11.Forecasted Programs; Behavioral 
Health Fund
 		96,387,000
		98,417,000

220.3
220.4	Subd. 12.Grant Programs; Refugee Services 
Grants
 		7,000,000
		-0-
	
220.5 	New American Legal, Social Services, and 
220.6 	Long-Term Care Workforce Grant 
220.7 	Program. $7,000,000 in fiscal year 2024 is 
220.8 	for legal and social services grants. 
220.9 	Notwithstanding Minnesota Statutes, section 
220.10 	16A.28, this appropriation is available until 
220.11 	June 30, 2027. This is a onetime appropriation.

220.12
220.13	Subd. 13.Grant Programs; Other Long-Term 
Care Grants
 		152,387,000
		1,925,000
	
220.14 	(a) Provider Capacity Grant for Rural and 
220.15 	Underserved Communities. $17,148,000 in 
220.16 	fiscal year 2024 is for provider capacity grants 
220.17 	for rural and underserved communities. 
220.18 	Notwithstanding Minnesota Statutes, section 
220.19 	16A.28, this appropriation is available until 
220.20 	June 30, 2027. This is a onetime appropriation.
220.21 	(b) New American Legal, Social Services, 
220.22 	and Long-Term Care Grant Program.
220.23 	$28,316,000 in fiscal year 2024 is for 
220.24 	long-term care workforce grants for new 
220.25 	Americans. Notwithstanding Minnesota 
220.26 	Statutes, section 16A.28, this appropriation is 
220.27 	available until June 30, 2027. This is a onetime 
220.28 	appropriation.
220.29 	(c) Supported Decision Making Programs.
220.30 	$4,000,000 in fiscal year 2024 is for supported 
220.31 	decision making grants. This is a onetime 
220.32 	appropriation and is available until June 30, 
220.33 	2025.
220.34 	(d) Direct Support Professionals 
220.35 	Employee-Owned Cooperative Program.
221.1 	$350,000 in fiscal year 2024 is for a grant to 
221.2 	the Metropolitan Consortium of Community 
221.3 	Developers for the Direct Support 
221.4 	Professionals Employee-Owned Cooperative 
221.5 	program. The grantee must use the grant 
221.6 	amount for outreach and engagement, 
221.7 	managing a screening and selection process, 
221.8 	providing one-on-one technical assistance, 
221.9 	developing and providing training curricula 
221.10 	related to cooperative development and home 
221.11 	and community-based waiver services, 
221.12 	administration, reporting, and program 
221.13 	evaluation. This is a onetime appropriation 
221.14 	and is available until June 30, 2025.
221.15 	(e) Long-Term Services and Supports 
221.16 	Workforce Incentive Grants. $83,560,000 
221.17 	in fiscal year 2024 is for long-term services 
221.18 	and supports workforce incentive grants 
221.19 	administered according to Minnesota Statutes, 
221.20 	section 256.4764. Notwithstanding Minnesota 
221.21 	Statutes, section 16A.28, this appropriation is 
221.22 	available until June 30, 2029. This is a onetime 
221.23 	appropriation.
221.24 	(f) Base Level Adjustment. The general fund 
221.25 	base is $3,949,000 in fiscal year 2026 and 
221.26 	$3,949,000 in fiscal year 2027. Of these 
221.27 	amounts, $2,024,000 in fiscal year 2026 and 
221.28 	$2,024,000 in fiscal year 2027 are for PCA 
221.29 	background study grants.

221.30
221.31	Subd. 14.Grant Programs; Aging and Adult 
Services Grants
 		164,626,000
		34,795,000
	
221.32 	(a) Vulnerable Adult Act Redesign Phase 
221.33 	Two. $17,129,000 in fiscal year 2024 is for 
221.34 	adult protection grants to counties and Tribes 
221.35 	under Minnesota Statutes, section 256M.42. 
222.1 	Notwithstanding Minnesota Statutes, section 
222.2 	16A.28, this appropriation is available until 
222.3 	June 30, 2027. The base for this appropriation 
222.4 	is $866,000 in fiscal year 2026 and $867,000 
222.5 	in fiscal year 2027.
222.6 	(b) Caregiver Respite Services Grants.
222.7 	$1,800,000 in fiscal year 2025 is for caregiver 
222.8 	respite services grants under Minnesota 
222.9 	Statutes, section 256.9756. This is a onetime 
222.10 	appropriation.
222.11 	(c) Live Well at Home Grants. $4,575,000 
222.12 	in fiscal year 2024 is for live well at home 
222.13 	grants under Minnesota Statutes, section 
222.14 	256.9754, subdivision 3f. This is a onetime 
222.15 	appropriation and is available until June 30, 
222.16 	2025.
222.17 	(d) Senior Nutrition Program. $10,552,000 
222.18 	in fiscal year 2024 is for the senior nutrition 
222.19 	program. Notwithstanding Minnesota Statutes, 
222.20 	section 16A.28, this appropriation is available 
222.21 	until June 30, 2027. This is a onetime 
222.22 	appropriation.
222.23 	(e) Age-Friendly Community Grants.
222.24 	$3,000,000 in fiscal year 2024 is for the 
222.25 	continuation of age-friendly community grants 
222.26 	under Laws 2021, First Special Session 
222.27 	chapter 7, article 17, section 8, subdivision 1. 
222.28 	Notwithstanding Minnesota Statutes, section 
222.29 	16A.28, this is a onetime appropriation and is 
222.30 	available until June 30, 2027.
222.31 	(f) Age-Friendly Technical Assistance 
222.32 	Grants. $1,725,000 in fiscal year 2024 is for 
222.33 	the continuation of age-friendly technical 
222.34 	assistance grants under Laws 2021, First 
223.1 	Special Session chapter 7, article 17, section 
223.2 	8, subdivision 2. Notwithstanding Minnesota 
223.3 	Statutes, section 16A.28, this is a onetime 
223.4 	appropriation and is available until June 30, 
223.5 	2027.
223.6 	(g) Financially Distressed Nursing Facility 
223.7 	Loan Program. $93,200,000 in fiscal year 
223.8 	2024 is for the financially distressed nursing 
223.9 	facility loan program under Minnesota 
223.10 	Statutes, section 256R.55, and is available as 
223.11 	provided therein.
223.12 	(h) Base Level Adjustment. The general fund 
223.13 	base is $33,861,000 in fiscal year 2026 and 
223.14 	$33,862,000 in fiscal year 2027.

223.15	Subd. 15.Deaf and Hard-of-Hearing Grants
 		2,886,000
		2,886,000

223.16	Subd. 16.Grant Programs; Disabilities Grants
 		113,684,000
		30,377,000
	
223.17 	(a) Temporary Grants for Small 
223.18 	Customized Living Providers. $5,450,000 
223.19 	in fiscal year 2024 is for grants to assist small 
223.20 	customized living providers to transition to 
223.21 	community residential services licensure or 
223.22 	integrated community supports licensure. 
223.23 	Notwithstanding Minnesota Statutes, section 
223.24 	16A.28, this appropriation is available until 
223.25 	June 30, 2027. This is a onetime appropriation.
223.26 	(b) Lead Agency Capacity Building Grants.
223.27 	$444,000 in fiscal year 2024 and $2,396,000 
223.28 	in fiscal year 2025 are for grants to assist 
223.29 	organizations, counties, and Tribes to build 
223.30 	capacity for employment opportunities for 
223.31 	people with disabilities. The base for this 
223.32 	appropriation is $2,413,000 in fiscal year 2026 
223.33 	and $2,411,000 in fiscal year 2027.
224.1 	(c) Employment and Technical Assistance 
224.2 	Center Grants. $450,000 in fiscal year 2024 
224.3 	and $1,800,000 in fiscal year 2025 are for 
224.4 	employment and technical assistance grants 
224.5 	to assist organizations and employers in 
224.6 	promoting a more inclusive workplace for 
224.7 	people with disabilities.
224.8 	(d) Case Management Training Grants.
224.9 	$37,000 in fiscal year 2024 and $123,000 in 
224.10 	fiscal year 2025 are for grants to provide case 
224.11 	management training to organizations and 
224.12 	employers to support the state's disability 
224.13 	employment supports system. The base for 
224.14 	this appropriation is $45,000 in fiscal year 
224.15 	2026 and $45,000 in fiscal year 2027.
224.16 	(e) Self-Directed Bargaining Agreement; 
224.17 	Electronic Visit Verification Stipends.
224.18 	$6,095,000 in fiscal year 2024 is for onetime 
224.19 	stipends of $200 to bargaining members to 
224.20 	offset the potential costs related to people 
224.21 	using individual devices to access the 
224.22 	electronic visit verification system. Of this 
224.23 	amount, $5,600,000 is for stipends and 
224.24 	$495,000 is for administration. This is a 
224.25 	onetime appropriation and is available until 
224.26 	June 30, 2025.
224.27 	(f) Self-Directed Collective Bargaining 
224.28 	Agreement; Temporary Rate Increase 
224.29 	Memorandum of Understanding. $1,600,000 
224.30 	in fiscal year 2024 is for onetime stipends for 
224.31 	individual providers covered by the SEIU 
224.32 	collective bargaining agreement based on the 
224.33 	memorandum of understanding related to the 
224.34 	temporary rate increase in effect between 
224.35 	December 1, 2020, and February 7, 2021. Of 
225.1 	this amount, $1,400,000 of the appropriation 
225.2 	is for stipends and $200,000 is for 
225.3 	administration. This is a onetime 
225.4 	appropriation.
225.5 	(g) Self-Directed Collective Bargaining 
225.6 	Agreement; Retention Bonuses. $50,750,000 
225.7 	in fiscal year 2024 is for onetime retention 
225.8 	bonuses covered by the SEIU collective 
225.9 	bargaining agreement. Of this amount, 
225.10 	$50,000,000 is for retention bonuses and 
225.11 	$750,000 is for administration of the bonuses. 
225.12 	This is a onetime appropriation and is 
225.13 	available until June 30, 2025.
225.14 	(h) Self-Directed Bargaining Agreement; 
225.15 	Training Stipends. $2,100,000 in fiscal year 
225.16 	2024 and $100,000 in fiscal year 2025 are for 
225.17 	onetime stipends of $500 for collective 
225.18 	bargaining unit members who complete 
225.19 	designated, voluntary trainings made available 
225.20 	through or recommended by the State Provider 
225.21 	Cooperation Committee. Of this amount, 
225.22 	$2,000,000 in fiscal year 2024 is for stipends, 
225.23 	and $100,000 in fiscal year 2024 and $100,000 
225.24 	in fiscal year 2025 are for administration. This 
225.25 	is a onetime appropriation.
225.26 	(i) Self-Directed Bargaining Agreement; 
225.27 	Orientation Program. $2,000,000 in fiscal 
225.28 	year 2024 and $2,000,000 in fiscal year 2025 
225.29 	are for onetime $100 payments to collective 
225.30 	bargaining unit members who complete 
225.31 	voluntary orientation requirements. Of this 
225.32 	amount, $1,500,000 in fiscal year 2024 and 
225.33 	$1,500,000 in fiscal year 2025 are for the 
225.34 	onetime $100 payments, and $500,000 in 
225.35 	fiscal year 2024 and $500,000 in fiscal year 
226.1 	2025 are for orientation-related costs. This is 
226.2 	a onetime appropriation.
226.3 	(j) Self-Directed Bargaining Agreement; 
226.4 	Home Care Orientation Trust. $1,000,000 
226.5 	in fiscal year 2024 is for the Home Care 
226.6 	Orientation Trust under Minnesota Statutes, 
226.7 	section 179A.54, subdivision 11. The 
226.8 	commissioner shall disburse the appropriation 
226.9 	to the board of trustees of the Home Care 
226.10 	Orientation Trust for deposit into an account 
226.11 	designated by the board of trustees outside the 
226.12 	state treasury and state's accounting system. 
226.13 	This is a onetime appropriation.
226.14 	(k) HIV/AIDS Supportive Services.
226.15 	$12,100,000 in fiscal year 2024 is for grants 
226.16 	to community-based HIV/AIDS supportive 
226.17 	services providers as defined in Minnesota 
226.18 	Statutes, section 256.01, subdivision 19, and 
226.19 	for payment of allowed health care costs as 
226.20 	defined in Minnesota Statutes, section 
226.21 	256.935. This is a onetime appropriation and 
226.22 	is available until June 30, 2025.
226.23 	(l) Motion Analysis Advancements Clinical 
226.24 	Study and Patient Care. $400,000 is fiscal 
226.25 	year 2024 is for a grant to the Mayo Clinic 
226.26 	Motion Analysis Laboratory and Limb Lab 
226.27 	for continued research in motion analysis 
226.28 	advancements and patient care. This is a 
226.29 	onetime appropriation and is available through 
226.30 	June 30, 2025.
226.31 	(m) Grant to Family Voices in Minnesota.
226.32 	$75,000 in fiscal year 2024 and $75,000 in 
226.33 	fiscal year 2025 are for a grant to Family 
226.34 	Voices in Minnesota under Minnesota 
226.35 	Statutes, section 256.4776.
227.1 	(n) Parent-to-Parent Programs.
227.2 	(1) $550,000 in fiscal year 2024 and $550,000 
227.3 	in fiscal year 2025 are for grants to 
227.4 	organizations that provide services to 
227.5 	underserved communities with a high 
227.6 	prevalence of autism spectrum disorder. This 
227.7 	is a onetime appropriation and is available 
227.8 	until June 30, 2025.
227.9 	(2) The commissioner shall give priority to 
227.10 	organizations that provide culturally specific 
227.11 	and culturally responsive services.
227.12 	(3) Eligible organizations must:
227.13 	(i) conduct outreach and provide support to 
227.14 	newly identified parents or guardians of a child 
227.15 	with special health care needs;
227.16 	(ii) provide training to educate parents and 
227.17 	guardians in ways to support their child and 
227.18 	navigate the health, education, and human 
227.19 	services systems;
227.20 	(iii) facilitate ongoing peer support for parents 
227.21 	and guardians from trained volunteer support 
227.22 	parents; and
227.23 	(iv) communicate regularly with other 
227.24 	parent-to-parent programs and national 
227.25 	organizations to ensure that best practices are 
227.26 	implemented.
227.27 	(4) Grant recipients must use grant money for 
227.28 	the activities identified in clause (3).
227.29 	(5) For purposes of this paragraph, "special 
227.30 	health care needs" means disabilities, chronic 
227.31 	illnesses or conditions, health-related 
227.32 	educational or behavioral problems, or the risk 
228.1 	of developing disabilities, illnesses, conditions, 
228.2 	or problems.
228.3 	(6) Each grant recipient must report to the 
228.4 	commissioner of human services annually by 
228.5 	January 15 with measurable outcomes from 
228.6 	programs and services funded by this 
228.7 	appropriation the previous year including the 
228.8 	number of families served and the number of 
228.9 	volunteer support parents trained by the 
228.10 	organization's parent-to-parent program.
228.11 	(o) Self-Advocacy Grants for Persons with 
228.12 	Intellectual and Developmental Disabilities.
228.13 	$323,000 in fiscal year 2024 and $323,000 in 
228.14 	fiscal year 2025 are for self-advocacy grants 
228.15 	under Minnesota Statutes, section 256.477. 
228.16 	Of these amounts, $218,000 in fiscal year 
228.17 	2024 and $218,000 in fiscal year 2025 are for 
228.18 	the activities under Minnesota Statutes, section 
228.19 	256.477, subdivision 1, paragraph (a), clauses 
228.20 	(5) to (7), and for administrative costs, and 
228.21 	$105,000 in fiscal year 2024 and $105,000 in 
228.22 	fiscal year 2025 are for the activities under 
228.23 	Minnesota Statutes, section 256.477, 
228.24 	subdivision 2.
228.25 	(p) Technology for Home Grants. $300,000 
228.26 	in fiscal year 2024 and $300,000 in fiscal year 
228.27 	2025 are for technology for home grants under 
228.28 	Minnesota Statutes, section 256.4773.
228.29 	(q) Community Residential Setting 
228.30 	Transition. $500,000 in fiscal year 2024 is 
228.31 	for a grant to Hennepin County to expedite 
228.32 	approval of community residential setting 
228.33 	licenses subject to the corporate foster care 
228.34 	moratorium exception under Minnesota 
229.1 	Statutes, section 245A.03, subdivision 7, 
229.2 	paragraph (a), clause (5).
229.3 	(r) Base Level Adjustment. The general fund 
229.4 	base is $27,343,000 in fiscal year 2026 and 
229.5 	$27,016,000 in fiscal year 2027.

229.6
229.7	Subd. 17.Grant Programs; Adult Mental Health 
Grants
 		4,400,000
		-0-
	
229.8 	(a) Training for Peer Workforce. $4,000,000 
229.9 	in fiscal year 2024 is for peer workforce 
229.10 	training grants. Notwithstanding Minnesota 
229.11 	Statutes, section 16A.28, this is a onetime 
229.12 	appropriation and is available until June 30, 
229.13 	2027.
229.14 	(b) Family Enhancement Center Grant.
229.15 	$400,000 in fiscal year 2024 is for a grant to 
229.16 	the Family Enhancement Center to develop, 
229.17 	maintain, and expand community-based social 
229.18 	engagement and connection programs to help 
229.19 	families dealing with trauma and mental health 
229.20 	issues develop connections with each other 
229.21 	and their communities, including the NEST 
229.22 	parent monitoring program, the cook to 
229.23 	connect program, and the call to movement 
229.24 	initiative. This appropriation is onetime and 
229.25 	is available until June 30, 2025.

229.26
229.27	Subd. 18.Grant Programs; Chemical 
Dependency Treatment Support Grants

229.28	Appropriations by Fund
	
229.29	General
	54,691,000
	5,342,000
	
229.30	Lottery Prize
	1,733,000
	1,733,000
	
229.31 	(a) Culturally Specific Recovery 
229.32 	Community Organization Start-Up Grants.
229.33 	$4,000,000 in fiscal year 2024 is for culturally 
229.34 	specific recovery community organization 
229.35 	start-up grants. Notwithstanding Minnesota 
230.1 	Statutes, section 16A.28, this appropriation is 
230.2 	available until June 30, 2027. This is a onetime 
230.3 	appropriation.
230.4 	(b) Safe Recovery Sites. $14,537,000 in fiscal 
230.5 	year 2024 is from the general fund for start-up 
230.6 	and capacity-building grants for organizations 
230.7 	to establish safe recovery sites. 
230.8 	Notwithstanding Minnesota Statutes, section 
230.9 	16A.28, this appropriation is onetime and is 
230.10 	available until June 30, 2029.
230.11 	(c) Technical Assistance for Culturally 
230.12 	Specific Organizations; Culturally Specific 
230.13 	Services Grants. $4,000,000 in fiscal year 
230.14 	2024 is for grants to culturally specific 
230.15 	providers for technical assistance navigating 
230.16 	culturally specific and responsive substance 
230.17 	use and recovery programs. Notwithstanding 
230.18 	Minnesota Statutes, section 16A.28, this 
230.19 	appropriation is available until June 30, 2027.
230.20 	(d) Technical Assistance for Culturally 
230.21 	Specific Organizations; Culturally Specific 
230.22 	Grant Development Training. $400,000 in 
230.23 	fiscal year 2024 is for grants for up to four 
230.24 	trainings for community members and 
230.25 	culturally specific providers for grant writing 
230.26 	training for substance use and recovery-related 
230.27 	grants. Notwithstanding Minnesota Statutes, 
230.28 	section 16A.28, this is a onetime appropriation 
230.29 	and is available until June 30, 2027.
230.30 	(e) Harm Reduction Supplies for Tribal and 
230.31 	Culturally Specific Programs. $7,597,000 
230.32 	in fiscal year 2024 is from the general fund to 
230.33 	provide sole source grants to culturally 
230.34 	specific communities to purchase syringes, 
230.35 	testing supplies, and opiate antagonists. 
231.1 	Notwithstanding Minnesota Statutes, section 
231.2 	16A.28, this appropriation is available until 
231.3 	June 30, 2027. This is a onetime appropriation.
231.4 	(f) Families and Family Treatment 
231.5 	Capacity-Building and Start-Up Grants.
231.6 	$10,000,000 in fiscal year 2024 is from the 
231.7 	general fund for start-up and capacity-building 
231.8 	grants for family substance use disorder 
231.9 	treatment programs. Notwithstanding 
231.10 	Minnesota Statutes, section 16A.28, this 
231.11 	appropriation is available until June 30, 2029. 
231.12 	This is a onetime appropriation.
231.13 	(g) Start-Up and Capacity Building Grants 
231.14 	for Withdrawal Management. $500,000 in 
231.15 	fiscal year 2024 and $1,000,000 in fiscal year 
231.16 	2025 are for start-up and capacity building 
231.17 	grants for withdrawal management.
231.18 	(h) Recovery Community Organization 
231.19 	Grants. $4,300,000 in fiscal year 2024 is from 
231.20 	the general fund for grants to recovery 
231.21 	community organizations, as defined in 
231.22 	Minnesota Statutes, section 254B.01, 
231.23 	subdivision 8, that are current grantees as of 
231.24 	June 30, 2023. This is a onetime appropriation 
231.25 	and is available until June 30, 2025.
231.26 	(i) Opioid Overdose Prevention Grants.
231.27 	(1) $125,000 in fiscal year 2024 and $125,000 
231.28 	in fiscal year 2025 are from the general fund 
231.29 	for a grant to Ka Joog, a nonprofit organization 
231.30 	in Minneapolis, Minnesota, to be used for 
231.31 	collaborative outreach, education, and training 
231.32 	on opioid use and overdose, and distribution 
231.33 	of opiate antagonist kits in East African and 
232.1 	Somali communities in Minnesota. This is a 
232.2 	onetime appropriation.
232.3 	(2) $125,000 in fiscal year 2024 and $125,000 
232.4 	in fiscal year 2025 are from the general fund 
232.5 	for a grant to the Steve Rummler Hope 
232.6 	Network to be used for statewide outreach, 
232.7 	education, and training on opioid use and 
232.8 	overdose, and distribution of opiate antagonist 
232.9 	kits. This is a onetime appropriation.
232.10 	(3) $250,000 in fiscal year 2024 and $250,000 
232.11 	in fiscal year 2025 are from the general fund 
232.12 	for a grant to African Career Education and 
232.13 	Resource, Inc. to be used for collaborative 
232.14 	outreach, education, and training on opioid 
232.15 	use and overdose, and distribution of opiate 
232.16 	antagonist kits. This is a onetime 
232.17 	appropriation.
232.18 	(j) Problem Gambling. $225,000 in fiscal 
232.19 	year 2024 and $225,000 in fiscal year 2025 
232.20 	are from the lottery prize fund for a grant to a 
232.21 	state affiliate recognized by the National 
232.22 	Council on Problem Gambling. The affiliate 
232.23 	must provide services to increase public 
232.24 	awareness of problem gambling, education, 
232.25 	training for individuals and organizations that 
232.26 	provide effective treatment services to problem 
232.27 	gamblers and their families, and research 
232.28 	related to problem gambling.
232.29 	(k) Project ECHO. $1,310,000 in fiscal year 
232.30 	2024 and $1,295,000 in fiscal year 2025 are 
232.31 	from the general fund for a grant to Hennepin 
232.32 	Healthcare to expand the Project ECHO 
232.33 	program. The grant must be used to establish 
232.34 	at least four substance use disorder-focused 
232.35 	Project ECHO programs at Hennepin 
233.1 	Healthcare, expanding the grantee's capacity 
233.2 	to improve health and substance use disorder 
233.3 	outcomes for diverse populations of 
233.4 	individuals enrolled in medical assistance, 
233.5 	including but not limited to immigrants, 
233.6 	individuals who are homeless, individuals 
233.7 	seeking maternal and perinatal care, and other 
233.8 	underserved populations. The Project ECHO 
233.9 	programs funded under this section must be 
233.10 	culturally responsive, and the grantee must 
233.11 	contract with culturally and linguistically 
233.12 	appropriate substance use disorder service 
233.13 	providers who have expertise in focus areas, 
233.14 	based on the populations served. Grant funds 
233.15 	may be used for program administration, 
233.16 	equipment, provider reimbursement, and 
233.17 	staffing hours. This is a onetime appropriation.
233.18 	(l) White Earth Nation Substance Use 
233.19 	Disorder Digital Therapy Tool. $3,000,000 
233.20 	in fiscal year 2024 is from the general fund 
233.21 	for a grant to the White Earth Nation to 
233.22 	develop an individualized Native American 
233.23 	centric digital therapy tool with Pathfinder 
233.24 	Solutions. This is a onetime appropriation. 
233.25 	The grant must be used to:
233.26 	(1) develop a mobile application that is 
233.27 	culturally tailored to connecting substance use 
233.28 	disorder resources with White Earth Nation 
233.29 	members;
233.30 	(2) convene a planning circle with White Earth 
233.31 	Nation members to design the tool;
233.32 	(3) provide and expand White Earth 
233.33 	Nation-specific substance use disorder 
233.34 	services; and
234.1 	(4) partner with an academic research 
234.2 	institution to evaluate the efficacy of the 
234.3 	program.
234.4 	(m) Wellness in the Woods. $300,000 in 
234.5 	fiscal year 2024 and $300,000 in fiscal year 
234.6 	2025 are from the general fund for a grant to 
234.7 	Wellness in the Woods for daily peer support 
234.8 	and special sessions for individuals who are 
234.9 	in substance use disorder recovery, are 
234.10 	transitioning out of incarceration, or who have 
234.11 	experienced trauma. These are onetime 
234.12 	appropriations.
234.13 	(n) Base Level Adjustment. The general fund 
234.14 	base is $3,247,000 in fiscal year 2026 and 
234.15 	$3,247,000 in fiscal year 2027.

234.16
234.17	Subd. 19.Direct Care and Treatment - Transfer 
Authority
 					
234.18 	(a) Money appropriated for budget activities 
234.19 	under subdivisions 20 to 24 may be transferred 
234.20 	between budget activities and between years 
234.21 	of the biennium with the approval of the 
234.22 	commissioner of management and budget.
234.23 	(b) Ending balances in obsolete accounts in 
234.24 	the special revenue fund and other dedicated 
234.25 	accounts within direct care and treatment may 
234.26 	be transferred to other dedicated and gift fund 
234.27 	accounts within direct care and treatment for 
234.28 	client use and other client activities, with 
234.29 	approval of the commissioner of management 
234.30 	and budget. These transactions must be 
234.31 	completed by August 1, 2023.

234.32
234.33	Subd. 20.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		169,962,000
		177,152,000
	
234.34 	The commissioner responsible for operations 
234.35 	of direct care and treatment services, with the 
235.1 	approval of the commissioner of management 
235.2 	and budget, may transfer any balance in the 
235.3 	enterprise fund established for the community 
235.4 	addiction recovery enterprise program to the 
235.5 	general fund appropriation within this 
235.6 	subdivision. Any balance remaining after June 
235.7 	30, 2025, cancels to the general fund.

235.8
235.9	Subd. 21.Direct Care and Treatment - 
Community-Based Services
 		20,386,000
		21,164,000
	
235.10 	Base Level Adjustment. The general fund 
235.11 	base is $20,116,000 in fiscal year 2026 and 
235.12 	$20,116,000 in fiscal year 2027.

235.13
235.14	Subd. 22.Direct Care and Treatment - Forensic 
Services
 		141,020,000
		148,513,000

235.15
235.16	Subd. 23.Direct Care and Treatment - Sex 
Offender Program
 		115,920,000
		121,726,000

235.17
235.18	Subd. 24.Direct Care and Treatment - 
Operations
 		80,177,000
		96,858,000
	
235.19 	The general fund base is $70,063,000 in fiscal 
235.20 	year 2026 and $70,161,000 in fiscal year 2027.

235.21	Sec. 3. COUNCIL ON DISABILITY
 	$
	2,027,000
	$
	2,407,000
	
235.22 	Base Level Adjustment. The general fund 
235.23 	base is $2,406,000 in fiscal year 2026 and 
235.24 	$2,407,000 in fiscal year 2027.

235.25
235.26
235.27	Sec. 4. OFFICE OF THE OMBUDSMAN FOR 
MENTAL HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	3,441,000
	$
	3,644,000
	
235.28 	Department of Psychiatry Monitoring.
235.29 	$100,000 in fiscal year 2024 and $100,000 in 
235.30 	fiscal year 2025 are for monitoring the 
235.31 	Department of Psychiatry at the University of 
235.32 	Minnesota.

235.33
235.34	Sec. 5. COMMISSIONER OF MANAGEMENT 
AND BUDGET
 	$
	1,000,000
	$
	1,000,000
	
236.1 	Office of Addiction and Recovery.
236.2 	$1,000,000 in fiscal year 2024 and $1,000,000 
236.3 	in fiscal year 2025 are for the Office of 
236.4 	Addiction and Recovery.

236.5 	Sec. 6. Laws 2021, First Special Session chapter 7, article 16, section 28, as amended by 
236.6 	Laws 2022, chapter 40, section 1, is amended to read:
236.7 	Sec. 28. CONTINGENT APPROPRIATIONS.
 236.8 	Any appropriation in this act for a purpose included in Minnesota's initial state spending 
236.9 	plan as described in guidance issued by the Centers for Medicare and Medicaid Services 
236.10 	for implementation of section 9817 of the federal American Rescue Plan Act of 2021 is 
236.11 	contingent upon the initial approval of that purpose by the Centers for Medicare and Medicaid 
236.12 	Services, except for the rate increases specified in article 11, sections 12 and 19. This section 
236.13 	expires June 30, 2024.

236.14 	Sec. 7. Laws 2021, First Special Session chapter 7, article 17, section 16, is amended to 
236.15 	read:
236.16 	Sec. 16. RESEARCH ON ACCESS TO LONG-TERM CARE SERVICES AND 
236.17 	FINANCING.
 236.18 	(a) This act includes $400,000 in fiscal year 2022 and $300,000 in fiscal year 2023 for 
236.19 	an actuarial research study of public and private financing options for long-term services 
236.20 	and supports reform to increase access across the state. The commissioner of human services 
236.21 	must conduct the study. Of this amount, the commissioner may transfer up to $100,000 to 
236.22 	the commissioner of commerce for costs related to the requirements of the study. The general 
236.23 	fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year 
236.24 	2025.
236.25 	(b) All activities must be completed by June 30, 2024.

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

236.27 	Sec. 8. DIRECT CARE AND TREATMENT FISCAL YEAR 2023 
236.28 	APPROPRIATION.
 236.29 	$4,829,000 is appropriated in fiscal year 2023 to the commissioner of human services 
236.30 	for direct care and treatment programs. This is a onetime appropriation.

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

237.2 	Sec. 9. TRANSFERS.
 237.3 		Subdivision 1.Grants. The commissioner of human services, with the approval of the 
237.4 	commissioner of management and budget, may transfer unencumbered appropriation balances 
237.5 	for the biennium ending June 30, 2025, within fiscal years among the MFIP; general 
237.6 	assistance; medical assistance; MinnesotaCare; MFIP child care assistance under Minnesota 
237.7 	Statutes, section 119B.05; Minnesota supplemental aid program; housing support program; 
237.8 	the entitlement portion of Northstar Care for Children under Minnesota Statutes, chapter 
237.9 	256N; and the entitlement portion of the behavioral health fund between fiscal years of the 
237.10 	biennium. The commissioner shall inform the chairs and ranking minority members of the 
237.11 	legislative committees with jurisdiction over health and human services quarterly about 
237.12 	transfers made under this subdivision.
237.13 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
237.14 	may be transferred within the Department of Human Services as the commissioner considers 
237.15 	necessary, with the advance approval of the commissioner of management and budget. The 
237.16 	commissioners shall inform the chairs and ranking minority members of the legislative 
237.17 	committees with jurisdiction over health and human services finance quarterly about transfers 
237.18 	made under this section.

237.19 	Sec. 10. APPROPRIATIONS GIVEN EFFECT ONCE.
 237.20 	If an appropriation or transfer in this article is enacted more than once during the 2023 
237.21 	regular session, the appropriation or transfer must be given effect once.

237.22 	Sec. 11. EXPIRATION OF UNCODIFIED LANGUAGE.
 237.23 	All uncodified language contained in this article expires on June 30, 2025, unless a 
237.24 	different expiration date is explicit.

237.25 	Sec. 12. EFFECTIVE DATE.
 237.26 	This article is effective July 1, 2023, unless a different effective date is specified.
237.27 	Delete the title and insert:
237.28 	A bill for an act
237.29 	relating to human services; modifying provisions governing disability services, 
237.30 	aging services, health care, behavioral health, substance use disorder, the Opioid 
237.31 	Prescribing Improvement Program, human services licensing, and direct care and 
237.32 	treatment; establishing the Department of Direct Care and Treatment; making 
238.1 	technical and conforming changes; establishing certain grants; requiring reports; 
238.2 	appropriating money;amending Minnesota Statutes 2022, sections 4.046, 
238.3 	subdivisions 6, 7; 15.01; 15.06, subdivision 1; 43A.08, subdivision 1a; 179A.54, 
238.4 	by adding a subdivision; 241.021, subdivision 1; 241.31, subdivision 5; 241.415; 
238.5 	245.037; 245.91, subdivision 4; 245A.03, subdivision 7; 245A.04, subdivision 7; 
238.6 	245A.07, by adding subdivisions; 245A.10, subdivision 6, by adding a subdivision; 
238.7 	245A.11, subdivisions 7, 7a; 245A.13, subdivisions 1, 2, 3, 5, 6, 7, 9; 245D.03, 
238.8 	subdivision 1; 245G.02, subdivision 2; 245G.08, subdivision 3; 245G.09, 
238.9 	subdivision 3; 245G.22, subdivision 15, as amended if enacted; 246.54, subdivisions 
238.10 	1a, 1b; 252.27, subdivision 2a; 252.50, subdivision 2; 253B.10, subdivision 1; 
238.11 	254B.01, by adding a subdivision; 254B.05, subdivisions 1, 5; 256.01, subdivision 
238.12 	19; 256.042, subdivisions 1, 2; 256.043, subdivisions 3, 3a; 256.975, subdivision 
238.13 	6; 256.9754; 256B.04, by adding a subdivision; 256B.056, subdivision 3; 256B.057, 
238.14 	subdivision 9; 256B.0625, subdivisions 17, 17a, 17b, 18h, 22, by adding a 
238.15 	subdivision; 256B.0638, subdivisions 1, 2, 4, 5, by adding a subdivision; 
238.16 	256B.0659, subdivisions 1, 12, 19, 24, by adding a subdivision; 256B.073, 
238.17 	subdivision 3, by adding a subdivision; 256B.0759, subdivision 2; 256B.0911, 
238.18 	subdivision 13; 256B.0913, subdivisions 4, 5; 256B.0917, subdivision 1b; 
238.19 	256B.092, subdivision 1a; 256B.0949, subdivision 15; 256B.14, subdivision 2; 
238.20 	256B.49, subdivision 13; 256B.4905, subdivision 4a; 256B.4911, by adding a 
238.21 	subdivision; 256B.4912, by adding subdivisions; 256B.4914, subdivisions 3, as 
238.22 	amended, 4, 5, 5a, 5b, 6, 6a, 6b, 6c, 7a, 7b, 7c, 8, 9, 10, 10a, 10c, 12, 14, by adding 
238.23 	subdivisions; 256B.5012, by adding subdivisions; 256B.766; 256B.85, subdivision 
238.24 	7, by adding a subdivision; 256B.851, subdivisions 3, 5, 6; 256D.425, subdivision 
238.25 	1; 256I.05, by adding subdivisions; 256M.42; 256R.17, subdivision 2; 256R.25; 
238.26 	256R.47; 256R.53, by adding a subdivision; 256S.15, subdivision 2; 256S.18, by 
238.27 	adding a subdivision; 256S.19, subdivision 3; 256S.21; 256S.2101, subdivision 
238.28 	1; 256S.211; 256S.212; 256S.213; 256S.214; 256S.215, subdivisions 2, 3, 4, 7, 8, 
238.29 	9, 10, 11, 12, 13, 14, 15, 16, 17; 268.19, subdivision 1; Laws 2019, chapter 63, 
238.30 	article 3, section 1, as amended; Laws 2021, chapter 30, article 12, section 5, as 
238.31 	amended; Laws 2021, First Special Session chapter 7, article 16, section 28, as 
238.32 	amended; article 17, sections 8; 16; proposing coding for new law in Minnesota 
238.33 	Statutes, chapters 121A; 245; 245A; 245D; 252; 254B; 256; 256B; 256I; 256R; 
238.34 	325F; proposing coding for new law as Minnesota Statutes, chapter 246C; repealing 
238.35 	Minnesota Statutes 2022, sections 245G.05, subdivision 2; 245G.06, subdivision 
238.36 	2; 246.18, subdivisions 2, 2a; 256B.0759, subdivision 6; 256B.0917, subdivisions 
238.37 	1a, 6, 7a, 13; 256B.4914, subdivisions 6b, 9a; 256S.19, subdivision 4; 256S.2101, 
238.38 	subdivision 2.

239.1	We request the adoption of this report and repassage of the bill.
	
239.2	Senate Conferees:
........			
239.3	........
		........
	
239.4	John Hoffman
		Omar Fateh
	
239.5	........
			
239.6	Jim Abeler
			
239.7	House Conferees:
........			
239.8	........
		........
	
239.9	Mohamud Noor
		Peter Fischer
	
239.10	........
			
239.11	Dave Baker