1.1 	A bill for an act
1.2 	relating to state government; modifying provisions governing disability services, 
1.3 	aging services, behavioral health, opioid overdose prevention and opiate epidemic 
1.4 	response, the opioid prescribing improvement program, the Department of Direct 
1.5 	Care and Treatment, human services licensing, and self-directed worker contract 
1.6 	ratification; requiring reports; appropriating money;amending Minnesota Statutes 
1.7 	2022, sections 4.046, subdivisions 6, 7; 15.01; 15.06, subdivision 1; 16A.151, 
1.8 	subdivision 2; 43A.08, subdivision 1a; 151.065, subdivision 7; 177.24, by adding 
1.9 	a subdivision; 179A.54, by adding a subdivision; 241.021, subdivision 1; 241.31, 
1.10 	subdivision 5; 241.415; 245.91, subdivision 4; 245A.03, subdivision 7; 245A.04, 
1.11 	subdivision 7; 245A.07, by adding subdivisions; 245A.10, subdivisions 3, 6, by 
1.12 	adding a subdivision; 245A.11, subdivisions 7, 7a; 245A.13, subdivisions 1, 2, 3, 
1.13 	6, 7, 9; 245D.03, subdivision 1; 245G.01, by adding subdivisions; 245G.02, 
1.14 	subdivision 2; 245G.05, subdivision 1, by adding a subdivision; 245G.06, 
1.15 	subdivisions 1, 3, 4, by adding subdivisions; 245G.08, subdivision 3; 245G.09, 
1.16 	subdivision 3; 245G.22, subdivision 15; 245I.10, subdivision 6; 252.44; 253B.10, 
1.17 	subdivision 1; 254B.01, by adding subdivisions; 254B.04, by adding a subdivision; 
1.18 	254B.05, subdivision 5; 256.042, subdivisions 2, 4; 256.043, subdivisions 3, 3a; 
1.19 	256.482, by adding a subdivision; 256.975, subdivision 6; 256.9754; 256B.056, 
1.20 	subdivision 3; 256B.057, subdivision 9; 256B.0638, subdivisions 1, 2, 4, 5, by 
1.21 	adding a subdivision; 256B.0659, subdivisions 1, 12, 19, 24, by adding a 
1.22 	subdivision; 256B.0759, subdivision 2; 256B.0911, subdivision 13; 256B.0917, 
1.23 	subdivision 1b; 256B.092, subdivision 1a; 256B.0949, subdivision 15; 256B.49, 
1.24 	subdivision 13; 256B.4905, subdivision 4a; 256B.4914, subdivisions 3, 5, 5a, 5b, 
1.25 	6, 10a, 14, by adding subdivisions; 256B.5012, by adding a subdivision; 256B.851, 
1.26 	subdivisions 3, 5, 6; 256D.425, subdivision 1; 256M.42; 256R.13, subdivision 1; 
1.27 	256R.17, subdivision 2; 256R.25; 256R.47; 256R.53, by adding a subdivision; 
1.28 	256S.211; 256S.214; 256S.215, subdivision 15; 268.19, subdivision 1; Laws 2019, 
1.29 	chapter 63, article 3, section 1, as amended; Laws 2021, chapter 30, article 12, 
1.30 	section 5, as amended; Laws 2021, First Special Session chapter 7, article 16, 
1.31 	section 28, as amended; article 17, sections 8; 16; proposing coding for new law 
1.32 	in Minnesota Statutes, chapters 121A; 245D; 252; 254B; 256; 256B; 256I; 
1.33 	proposing coding for new law as Minnesota Statutes, chapter 246C; repealing 
1.34 	Minnesota Statutes 2022, sections 245G.06, subdivision 2; 246.18, subdivisions 
1.35 	2, 2a; 256B.0759, subdivision 6; 256B.0917, subdivisions 1a, 6, 7a, 13; 256B.4914, 
1.36 	subdivision 6b; 256S.2101, subdivisions 1, 2.
2.1 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.2 	ARTICLE 1
2.3 	DISABILITY SERVICES

2.4 	Section 1. Minnesota Statutes 2022, section 177.24, is amended by adding a subdivision 
2.5 	to read:
2.6 		Subd. 6.Special certificate prohibition. (a) On or after August 1, 2026, employers 
2.7 	must not hire any new employee with a disability at a wage that is less than the highest 
2.8 	applicable minimum wage, regardless of whether the employer holds a special certificate 
2.9 	from the United States Department of Labor under section 14(c) of the federal Fair Labor 
2.10 	Standards Act.
2.11 	(b) On or after August 1, 2028, an employer must not pay an employee with a disability 
2.12 	less than the highest applicable minimum wage, regardless of whether the employer holds 
2.13 	a special certificate from the United States Department of Labor under section 14(c) of the 
2.14 	federal Fair Labor Standards Act.

2.15 	Sec. 2. Minnesota Statutes 2022, section 179A.54, is amended by adding a subdivision to 
2.16 	read:
2.17 		Subd. 11.Home Care Orientation Trust. (a) The state and an exclusive representative 
2.18 	certified pursuant to this section may establish a joint labor and management trust, referred 
2.19 	to as the Home Care Orientation Trust, for the exclusive purpose of rendering voluntary 
2.20 	orientation training to individual providers of direct support services who are represented 
2.21 	by the exclusive representative.
2.22 	(b) Financial contributions made by the state to the Home Care Orientation Trust shall 
2.23 	be made pursuant to a collective bargaining agreement negotiated under this section. All 
2.24 	such financial contributions made by the state shall be held in trust for the purpose of paying 
2.25 	from principle, from interest, or from both, the costs associated with developing, delivering, 
2.26 	and promoting voluntary orientation training for individual providers of direct support 
2.27 	services working under a collective bargaining agreement and providing services through 
2.28 	a covered program under section 256B.0711. The Home Care Orientation Trust shall be 
2.29 	administered, managed, and otherwise controlled jointly by a board of trustees composed 
2.30 	of an equal number of trustees appointed by the state and trustees appointed by the exclusive 
2.31 	representative under this section. The trust shall not be an agent of either the state or the 
2.32 	exclusive representative.
3.1 	(c) Trust administrative, management, legal, and financial services may be provided by 
3.2 	the board of trustees by a third-party administrator, financial management institution, or 
3.3 	other appropriate entity, as designated by the board of trustees from time to time, and those 
3.4 	services shall be paid from the money held in trust and created by the state's financial 
3.5 	contributions to the Home Care Orientation Trust.
3.6 	(d) The state is authorized to purchase liability insurance for members of the board of 
3.7 	trustees appointed by the state.
3.8 	(e) Financial contributions to, and participation in, the administration and management 
3.9 	of the Home Care Orientation Trust shall not be considered an unfair labor practice under 
3.10 	section 179A.13, or a violation of Minnesota law.

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

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

6.25 	Sec. 4. Minnesota Statutes 2022, section 245A.10, subdivision 3, is amended to read:
6.26 		Subd. 3.Application fee for initial license or certification. (a) For fees required under 
6.27 	subdivision 1, an applicant for an initial license or certification issued by the commissioner 
6.28 	shall submit a $500 application fee with each new application required under this subdivision. 
6.29 	An applicant for an initial day services facility license under chapter 245D shall submit a 
6.30 	$250 application fee with each new application. The application fee shall not be prorated, 
6.31 	is nonrefundable, and is in lieu of the annual license or certification fee that expires on 
6.32 	December 31. The commissioner shall not process an application until the application fee 
6.33 	is paid.
7.1 	(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license to 
7.2 	provide services at a specific location.
7.3 	(1) For a license to provide home and community-based services to persons with 
7.4 	disabilities or age 65 and older under chapter 245D, an applicant shall submit an application 
7.5 	to provide services statewide. Notwithstanding paragraph (a), applications received by the 
7.6 	commissioner between July 1, 2013, and December 31, 2013, for licensure of services 
7.7 	provided under chapter 245D must include an application fee that is equal to the annual 
7.8 	license renewal fee under subdivision 4, paragraph (b), or $500, whichever is less. 
7.9 	Applications received by the commissioner after January 1, 2014, must include the application 
7.10 	fee required under paragraph (a). Applicants who meet the modified application criteria 
7.11 	identified in section 245A.042, subdivision 2, are exempt from paying an application fee.
7.12 	(2) For a license to provide independent living assistance for youth under section 245A.22, 
7.13 	an applicant shall submit a single application to provide services statewide.
7.14 	(3) For a license for a private agency to provide foster care or adoption services under 
7.15 	Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single application 
7.16 	to provide services statewide.
7.17 	(c) The initial application fee charged under this subdivision does not include the 
7.18 	temporary license surcharge under section 16E.22.

7.19 	Sec. 5. Minnesota Statutes 2022, section 245A.11, subdivision 7, is amended to read:
7.20 		Subd. 7.Adult foster care; variance for alternate overnight supervision. (a) The 
7.21 	commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts 
7.22 	requiring a caregiver to be present in an adult foster care home during normal sleeping hours 
7.23 	to allow for alternative methods of overnight supervision. The commissioner may grant the 
7.24 	variance if the local county licensing agency recommends the variance and the county 
7.25 	recommendation includes documentation verifying that:
7.26 	(1) the county has approved the license holder's plan for alternative methods of providing 
7.27 	overnight supervision and determined the plan protects the residents' health, safety, and 
7.28 	rights;
7.29 	(2) the license holder has obtained written and signed informed consent from each 
7.30 	resident or each resident's legal representative documenting the resident's or legal 
7.31 	representative's agreement with the alternative method of overnight supervision; and
7.32 	(3) the alternative method of providing overnight supervision, which may include the 
7.33 	use of technology, is specified for each resident in the resident's: (i) individualized plan of 
8.1 	care; (ii) individual service plan under section 256B.092, subdivision 1b, if required; or (iii) 
8.2 	individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 
8.3 	19, if required.
8.4 	(b) To be eligible for a variance under paragraph (a), the adult foster care license holder 
8.5 	must not have had a conditional license issued under section 245A.06, or any other licensing 
8.6 	sanction issued under section 245A.07 during the prior 24 months based on failure to provide 
8.7 	adequate supervision, health care services, or resident safety in the adult foster care home.
8.8 	(c) A license holder requesting a variance under this subdivision to utilize technology 
8.9 	as a component of a plan for alternative overnight supervision may request the commissioner's 
8.10 	review in the absence of a county recommendation. Upon receipt of such a request from a 
8.11 	license holder, the commissioner shall review the variance request with the county.
8.12 	(d) A variance granted by the commissioner according to this subdivision before January 
8.13 	1, 2014, to a license holder for an adult foster care home must transfer with the license when 
8.14 	the license converts to a community residential setting license under chapter 245D. The 
8.15 	terms and conditions of the variance remain in effect as approved at the time the variance 
8.16 	was granted The variance requirements under this subdivision for alternative overnight 
8.17 	supervision do not apply to community residential settings licensed under chapter 245D.

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

8.19 	Sec. 6. Minnesota Statutes 2022, section 245A.11, subdivision 7a, is amended to read:
8.20 		Subd. 7a.Alternate overnight supervision technology; adult foster care and 
8.21 	community residential setting licenses. (a) The commissioner may grant an applicant or 
8.22 	license holder an adult foster care or community residential setting license for a residence 
8.23 	that does not have a caregiver in the residence during normal sleeping hours as required 
8.24 	under Minnesota Rules, part 9555.5105, subpart 37, item B, or section 245D.02, subdivision 
8.25 	33b, but uses monitoring technology to alert the license holder when an incident occurs that 
8.26 	may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 
8.27 	holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 
8.28 	to 9555.6265, or applicable requirements under chapter 245D, and the requirements under 
8.29 	this subdivision. The license printed by the commissioner must state in bold and large font:
8.30 	(1) that the facility is under electronic monitoring; and
8.31 	(2) the telephone number of the county's common entry point for making reports of 
8.32 	suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
9.1 	(b) Applications for a license under this section must be submitted directly to the 
9.2 	Department of Human Services licensing division. The licensing division must immediately 
9.3 	notify the county licensing agency. The licensing division must collaborate with the county 
9.4 	licensing agency in the review of the application and the licensing of the program.
9.5 	(c) Before a license is issued by the commissioner, and for the duration of the license, 
9.6 	the applicant or license holder must establish, maintain, and document the implementation 
9.7 	of written policies and procedures addressing the requirements in paragraphs (d) through 
9.8 	(f).
9.9 	(d) The applicant or license holder must have policies and procedures that:
9.10 	(1) establish characteristics of target populations that will be admitted into the home, 
9.11 	and characteristics of populations that will not be accepted into the home;
9.12 	(2) explain the discharge process when a resident served by the program requires 
9.13 	overnight supervision or other services that cannot be provided by the license holder due 
9.14 	to the limited hours that the license holder is on site;
9.15 	(3) describe the types of events to which the program will respond with a physical 
9.16 	presence when those events occur in the home during time when staff are not on site, and 
9.17 	how the license holder's response plan meets the requirements in paragraph (e), clause (1) 
9.18 	or (2);
9.19 	(4) establish a process for documenting a review of the implementation and effectiveness 
9.20 	of the response protocol for the response required under paragraph (e), clause (1) or (2). 
9.21 	The documentation must include:
9.22 	(i) a description of the triggering incident;
9.23 	(ii) the date and time of the triggering incident;
9.24 	(iii) the time of the response or responses under paragraph (e), clause (1) or (2);
9.25 	(iv) whether the response met the resident's needs;
9.26 	(v) whether the existing policies and response protocols were followed; and
9.27 	(vi) whether the existing policies and protocols are adequate or need modification.
9.28 	When no physical presence response is completed for a three-month period, the license 
9.29 	holder's written policies and procedures must require a physical presence response drill to 
9.30 	be conducted for which the effectiveness of the response protocol under paragraph (e), 
9.31 	clause (1) or (2), will be reviewed and documented as required under this clause; and
10.1 	(5) establish that emergency and nonemergency phone numbers are posted in a prominent 
10.2 	location in a common area of the home where they can be easily observed by a person 
10.3 	responding to an incident who is not otherwise affiliated with the home.
10.4 	(e) The license holder must document and include in the license application which 
10.5 	response alternative under clause (1) or (2) is in place for responding to situations that 
10.6 	present a serious risk to the health, safety, or rights of residents served by the program:
10.7 	(1) response alternative (1) requires only the technology to provide an electronic 
10.8 	notification or alert to the license holder that an event is underway that requires a response. 
10.9 	Under this alternative, no more than ten minutes will pass before the license holder will be 
10.10 	physically present on site to respond to the situation; or
10.11 	(2) response alternative (2) requires the electronic notification and alert system under 
10.12 	alternative (1), but more than ten minutes may pass before the license holder is present on 
10.13 	site to respond to the situation. Under alternative (2), all of the following conditions are 
10.14 	met:
10.15 	(i) the license holder has a written description of the interactive technological applications 
10.16 	that will assist the license holder in communicating with and assessing the needs related to 
10.17 	the care, health, and safety of the foster care recipients. This interactive technology must 
10.18 	permit the license holder to remotely assess the well being of the resident served by the 
10.19 	program without requiring the initiation of the foster care recipient. Requiring the foster 
10.20 	care recipient to initiate a telephone call does not meet this requirement;
10.21 	(ii) the license holder documents how the remote license holder is qualified and capable 
10.22 	of meeting the needs of the foster care recipients and assessing foster care recipients' needs 
10.23 	under item (i) during the absence of the license holder on site;
10.24 	(iii) the license holder maintains written procedures to dispatch emergency response 
10.25 	personnel to the site in the event of an identified emergency; and
10.26 	(iv) each resident's individualized plan of care, support plan under sections 256B.0913, 
10.27 	subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision 15; and 256S.10, if required, 
10.28 	or individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 
10.29 	19, if required, identifies the maximum response time, which may be greater than ten minutes, 
10.30 	for the license holder to be on site for that resident.
10.31 	(f) Each resident's placement agreement, individual service agreement, and plan must 
10.32 	clearly state that the adult foster care or community residential setting license category is 
10.33 	a program without the presence of a caregiver in the residence during normal sleeping hours; 
11.1 	the protocols in place for responding to situations that present a serious risk to the health, 
11.2 	safety, or rights of residents served by the program under paragraph (e), clause (1) or (2); 
11.3 	and a signed informed consent from each resident served by the program or the person's 
11.4 	legal representative documenting the person's or legal representative's agreement with 
11.5 	placement in the program. If electronic monitoring technology is used in the home, the 
11.6 	informed consent form must also explain the following:
11.7 	(1) how any electronic monitoring is incorporated into the alternative supervision system;
11.8 	(2) the backup system for any electronic monitoring in times of electrical outages or 
11.9 	other equipment malfunctions;
11.10 	(3) how the caregivers or direct support staff are trained on the use of the technology;
11.11 	(4) the event types and license holder response times established under paragraph (e);
11.12 	(5) how the license holder protects each resident's privacy related to electronic monitoring 
11.13 	and related to any electronically recorded data generated by the monitoring system. A 
11.14 	resident served by the program may not be removed from a program under this subdivision 
11.15 	for failure to consent to electronic monitoring. The consent form must explain where and 
11.16 	how the electronically recorded data is stored, with whom it will be shared, and how long 
11.17 	it is retained; and
11.18 	(6) the risks and benefits of the alternative overnight supervision system.
11.19 	The written explanations under clauses (1) to (6) may be accomplished through 
11.20 	cross-references to other policies and procedures as long as they are explained to the person 
11.21 	giving consent, and the person giving consent is offered a copy.
11.22 	(g) Nothing in this section requires the applicant or license holder to develop or maintain 
11.23 	separate or duplicative policies, procedures, documentation, consent forms, or individual 
11.24 	plans that may be required for other licensing standards, if the requirements of this section 
11.25 	are incorporated into those documents.
11.26 	(h) The commissioner may grant variances to the requirements of this section according 
11.27 	to section 245A.04, subdivision 9.
11.28 	(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning 
11.29 	under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and 
11.30 	contractors affiliated with the license holder.
12.1 	(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to remotely 
12.2 	determine what action the license holder needs to take to protect the well-being of the foster 
12.3 	care recipient.
12.4 	(k) The commissioner shall evaluate license applications using the requirements in 
12.5 	paragraphs (d) to (f). The commissioner shall provide detailed application forms, including 
12.6 	a checklist of criteria needed for approval.
12.7 	(l) To be eligible for a license under paragraph (a), the adult foster care or community 
12.8 	residential setting license holder must not have had a conditional license issued under section 
12.9 	245A.06 or any licensing sanction under section 245A.07 during the prior 24 months based 
12.10 	on failure to provide adequate supervision, health care services, or resident safety in the 
12.11 	adult foster care home or community residential setting.
12.12 	(m) The commissioner shall review an application for an alternative overnight supervision 
12.13 	license within 60 days of receipt of the application. When the commissioner receives an 
12.14 	application that is incomplete because the applicant failed to submit required documents or 
12.15 	that is substantially deficient because the documents submitted do not meet licensing 
12.16 	requirements, the commissioner shall provide the applicant written notice that the application 
12.17 	is incomplete or substantially deficient. In the written notice to the applicant, the 
12.18 	commissioner shall identify documents that are missing or deficient and give the applicant 
12.19 	45 days to resubmit a second application that is substantially complete. An applicant's failure 
12.20 	to submit a substantially complete application after receiving notice from the commissioner 
12.21 	is a basis for license denial under section 245A.05. The commissioner shall complete 
12.22 	subsequent review within 30 days.
12.23 	(n) Once the application is considered complete under paragraph (m), the commissioner 
12.24 	will approve or deny an application for an alternative overnight supervision license within 
12.25 	60 days.
12.26 	(o) For the purposes of this subdivision, "supervision" means:
12.27 	(1) oversight by a caregiver or direct support staff as specified in the individual resident's 
12.28 	place agreement or support plan and awareness of the resident's needs and activities; and
12.29 	(2) the presence of a caregiver or direct support staff in a residence during normal sleeping 
12.30 	hours, unless a determination has been made and documented in the individual's support 
12.31 	plan that the individual does not require the presence of a caregiver or direct support staff 
12.32 	during normal sleeping hours.

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

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

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

16.13 	Sec. 8. [245D.261] COMMUNITY RESIDENTIAL SETTINGS; REMOTE 
16.14 	OVERNIGHT SUPERVISION.
16.15 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
16.16 	the meanings given them, unless otherwise specified.
16.17 	(b) "Resident" means an adult residing in a community residential setting.
16.18 	(c) "Technology" means:
16.19 	(1) enabling technology, which is a device capable of live, two-way communication or 
16.20 	engagement between a resident and direct support staff at a remote location; or
16.21 	(2) monitoring technology, which is the use of equipment to oversee, monitor, and 
16.22 	supervise an individual who receives medical assistance waiver or alternative care services 
16.23 	under section 256B.0913, 256B.092, or 256B.49 or chapter 256S.
16.24 		Subd. 2.Documentation of permissible remote overnight supervision. A license 
16.25 	holder providing remote overnight supervision in a community residential setting in lieu of 
16.26 	on-site direct support staff must comply with the requirements of this chapter, including 
16.27 	the requirement under section 245D.02, subdivision 33b, paragraph (a), clause (3), that the 
16.28 	absence of direct support staff from the community residential setting while services are 
16.29 	being delivered must be documented in the resident's support plan or support plan addendum.
16.30 		Subd. 3.Provider requirements for remote overnight supervision; commissioner 
16.31 	notification. (a) A license holder providing remote overnight supervision in a community 
16.32 	residential setting must:
17.1 	(1) use technology;
17.2 	(2) notify the commissioner of the community residential setting's intent to use technology 
17.3 	in lieu of on-site staff. The notification must:
17.4 	(i) indicate a start date for the use of technology; and
17.5 	(ii) attest that all requirements under this section are met and policies required under 
17.6 	subdivision 4 are available upon request;
17.7 	(3) clearly state in each person's support plan addendum that the community residential 
17.8 	setting is a program without the in-person presence of overnight direct support;
17.9 	(4) include with each person's support plan addendum the license holder's protocols for 
17.10 	responding to situations that present a serious risk to the health, safety, or rights of residents 
17.11 	served by the program; and
17.12 	(5) include in each person's support plan addendum the person's maximum permissible 
17.13 	response time as determined by the person's support team.
17.14 	(b) Upon being notified via technology that an incident has occurred that may jeopardize 
17.15 	the health, safety, or rights of a resident, the license holder must conduct an evaluation of 
17.16 	the need for the physical presence of a staff member. If a physical presence is needed, a 
17.17 	staff person, volunteer, or contractor must be on site to respond to the situation within the 
17.18 	resident's maximum permissible response time.
17.19 	(c) A license holder must notify the commissioner if remote overnight supervision 
17.20 	technology will no longer be used by the license holder.
17.21 	(d) When no physical presence response is completed for a three-month period, the 
17.22 	license holder must conduct a physical presence response drill. The effectiveness of the 
17.23 	response protocol must be reviewed and documented.
17.24 	(e) Upon receipt of notification of use of remote overnight supervision or discontinuation 
17.25 	of use of remote overnight supervision by a license holder, the commissioner shall notify 
17.26 	the county licensing agency and update the license.
17.27 		Subd. 4.Required policies and procedures for remote overnight supervision. (a) A 
17.28 	license holder providing remote overnight supervision must have policies and procedures 
17.29 	that:
17.30 	(1) protect the residents' health, safety, and rights;
18.1 	(2) explain the discharge process if a person served by the program requires in-person 
18.2 	supervision or other services that cannot be provided by the license holder due to the limited 
18.3 	hours that direct support staff are on site;
18.4 	(3) explain the backup system for technology in times of electrical outages or other 
18.5 	equipment malfunctions;
18.6 	(4) explain how the license holder trains the direct support staff on the use of the 
18.7 	technology; and
18.8 	(5) establish a plan for dispatching emergency response personnel to the site in the event 
18.9 	of an identified emergency.
18.10 	(b) Nothing in this section requires the license holder to develop or maintain separate 
18.11 	or duplicative policies, procedures, documentation, consent forms, or individual plans that 
18.12 	may be required for other licensing standards if the requirements of this section are 
18.13 	incorporated into those documents.
18.14 		Subd. 5.Consent to use of monitoring technology. If a license holder uses monitoring 
18.15 	technology in a community residential setting, the license holder must obtain a signed 
18.16 	informed consent form from each resident served by the program or the resident's legal 
18.17 	representative documenting the resident's or legal representative's agreement to use of the 
18.18 	specific monitoring technology used in the setting. The informed consent form documenting 
18.19 	this agreement must also explain:
18.20 	(1) how the license holder uses monitoring technology to provide remote supervision;
18.21 	(2) the risks and benefits of using monitoring technology;
18.22 	(3) how the license holder protects each resident's privacy while monitoring technology 
18.23 	is being used in the setting; and
18.24 	(4) how the license holder protects each resident's privacy when the monitoring 
18.25 	technology system electronically records personally identifying data.

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

18.27 	Sec. 9. Minnesota Statutes 2022, section 252.44, is amended to read:
18.28 	252.44 LEAD AGENCY BOARD RESPONSIBILITIES.
18.29 	When the need for day services in a county or Tribe has been determined under section 
18.30 	252.28, the board of commissioners for that lead agency shall:
19.1 	(1) authorize the delivery of services according to the support plans and support plan 
19.2 	addendums required as part of the lead agency's provision of case management services 
19.3 	under sections 256B.0913, subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision 
19.4 	15; and 256S.10 and Minnesota Rules, parts 9525.0004 to 9525.0036;
19.5 	(2) ensure that transportation is provided or arranged by the vendor in the most efficient 
19.6 	and reasonable way possible; and
19.7 	(3) monitor and evaluate the cost and effectiveness of the services.;
19.8 	(4) ensure that on or after August 1, 2026, employers do not hire any new employee at 
19.9 	a wage that is less than the highest applicable minimum wage, regardless of whether the 
19.10 	employer holds a special certificate from the United States Department of Labor under 
19.11 	section 14(c) of the federal Fair Labor Standards Act; and
19.12 	(5) ensure that on or after August 1, 2028, any day service program, including county, 
19.13 	Tribal, or privately funded day services, pay employees with disabilities the highest applicable 
19.14 	minimum wage, regardless of whether the employer holds a special certificate from the 
19.15 	United States Department of Labor under section 14(c) of the federal Fair Labor Standards 
19.16 	Act.

19.17 	Sec. 10. [252.54] STATEWIDE DISABILITY EMPLOYMENT TECHNICAL 
19.18 	ASSISTANCE CENTER.
19.19 	The commissioner must establish a statewide technical assistance center to provide 
19.20 	resources and assistance to programs, people, and families to support individuals with 
19.21 	disabilities to achieve meaningful and competitive employment in integrated settings. Duties 
19.22 	of the technical assistance center include but are not limited to:
19.23 	(1) offering provider business model transition support to ensure ongoing access to 
19.24 	employment and day services;
19.25 	(2) identifying and providing training on innovative, promising, and emerging practices;
19.26 	(3) maintaining a resource clearinghouse to serve as a hub of information to ensure 
19.27 	programs, people, and families have access to high-quality materials and information;
19.28 	(4) fostering innovation and actionable progress by providing direct technical assistance 
19.29 	to programs; and
19.30 	(5) cultivating partnerships and mentorship across support programs, people, and families 
19.31 	in the exploration of and successful transition to competitive, integrated employment.

20.1 	Sec. 11. [252.55] LEAD AGENCY EMPLOYMENT FIRST CAPACITY BUILDING 
20.2 	GRANTS.
20.3 	The commissioner shall establish a grant program to expand lead agency capacity to 
20.4 	support people with disabilities to contemplate, explore, and maintain competitive, integrated 
20.5 	employment options. Allowable uses of money include:
20.6 	(1) enhancing resources and staffing to support people and families in understanding 
20.7 	employment options and navigating service options;
20.8 	(2) implementing and testing innovative approaches to better support people with 
20.9 	disabilities and their families in achieving competitive, integrated employment; and
20.10 	(3) other activities approved by the commissioner.

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

20.12 	Sec. 12. Minnesota Statutes 2022, section 256.482, is amended by adding a subdivision 
20.13 	to read:
20.14 		Subd. 9.Report to legislature. On or before January 15, 2025, and annually on January 
20.15 	15 thereafter, the Minnesota Council on Disability shall submit a report to the chair and 
20.16 	ranking minority members of the legislative committees with jurisdiction over state 
20.17 	government finance and local government specifying the number of cities and counties that 
20.18 	received training or technical assistance on website accessibility, the outcomes of website 
20.19 	accessibility training and outreach, the costs incurred by cities and counties to make website 
20.20 	accessibility improvements, and any other information that the council deems relevant.

20.21 	Sec. 13. Minnesota Statutes 2022, section 256B.056, subdivision 3, is amended to read:
20.22 		Subd. 3.Asset limitations for certain individuals. (a) To be eligible for medical 
20.23 	assistance, a person must not individually own more than $3,000 in assets, or if a member 
20.24 	of a household with two family members, husband and wife, or parent and child, the 
20.25 	household must not own more than $6,000 in assets, plus $200 for each additional legal 
20.26 	dependent. In addition to these maximum amounts, an eligible individual or family may 
20.27 	accrue interest on these amounts, but they must be reduced to the maximum at the time of 
20.28 	an eligibility redetermination. The accumulation of the clothing and personal needs allowance 
20.29 	according to section 256B.35 must also be reduced to the maximum at the time of the 
20.30 	eligibility redetermination. The value of assets that are not considered in determining 
20.31 	eligibility for medical assistance is the value of those assets excluded under the Supplemental 
21.1 	Security Income program for aged, blind, and disabled persons, with the following 
21.2 	exceptions:
21.3 	(1) household goods and personal effects are not considered;
21.4 	(2) capital and operating assets of a trade or business that the local agency determines 
21.5 	are necessary to the person's ability to earn an income are not considered;
21.6 	(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security 
21.7 	Income program;
21.8 	(4) assets designated as burial expenses are excluded to the same extent excluded by the 
21.9 	Supplemental Security Income program. Burial expenses funded by annuity contracts or 
21.10 	life insurance policies must irrevocably designate the individual's estate as contingent 
21.11 	beneficiary to the extent proceeds are not used for payment of selected burial expenses;
21.12 	(5) for a person who no longer qualifies as an employed person with a disability due to 
21.13 	loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, 
21.14 	subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility 
21.15 	as an employed person with a disability, to the extent that the person's total assets remain 
21.16 	within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
21.17 	(6) a designated employment incentives asset account is disregarded when determining 
21.18 	eligibility for medical assistance for a person age 65 years or older under section 256B.055, 
21.19 	subdivision 7. An employment incentives asset account must only be designated by a person 
21.20 	who has been enrolled in medical assistance under section 256B.057, subdivision 9, for a 
21.21 	24-consecutive-month period. A designated employment incentives asset account contains 
21.22 	qualified assets owned by the person and the person's spouse in the last month of enrollment 
21.23 	in medical assistance under section 256B.057, subdivision 9. Qualified assets include 
21.24 	retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's 
21.25 	other nonexcluded liquid assets. An employment incentives asset account is no longer 
21.26 	designated when a person loses medical assistance eligibility for a calendar month or more 
21.27 	before turning age 65. A person who loses medical assistance eligibility before age 65 can 
21.28 	establish a new designated employment incentives asset account by establishing a new 
21.29 	24-consecutive-month period of enrollment under section 256B.057, subdivision 9. The 
21.30 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
21.31 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
21.32 	must be disregarded when determining eligibility for medical assistance under section 
21.33 	256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions 
21.34 	in section 256B.059; and
22.1 	(7) effective July 1, 2009, certain assets owned by American Indians are excluded as 
22.2 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
22.3 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
22.4 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
22.5 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
22.6 	15.

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

22.8 	Sec. 14. Minnesota Statutes 2022, section 256B.057, subdivision 9, is amended to read:
22.9 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid for 
22.10 	a person who is employed and who:
22.11 	(1) but for excess earnings or assets, meets the definition of disabled under the 
22.12 	Supplemental Security Income program;
22.13 	(2) meets the asset limits in paragraph (d); and
22.14 	(3) pays a premium and other obligations under paragraph (e).
22.15 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
22.16 	for medical assistance under this subdivision, a person must have more than $65 of earned 
22.17 	income. Earned income must have Medicare, Social Security, and applicable state and 
22.18 	federal taxes withheld. The person must document earned income tax withholding. Any 
22.19 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
22.20 	determinations.
22.21 	(c) After the month of enrollment, a person enrolled in medical assistance under this 
22.22 	subdivision who:
22.23 	(1) is temporarily unable to work and without receipt of earned income due to a medical 
22.24 	condition, as verified by a physician, advanced practice registered nurse, or physician 
22.25 	assistant; or
22.26 	(2) loses employment for reasons not attributable to the enrollee, and is without receipt 
22.27 	of earned income may retain eligibility for up to four consecutive months after the month 
22.28 	of job loss. To receive a four-month extension, enrollees must verify the medical condition 
22.29 	or provide notification of job loss. All other eligibility requirements must be met and the 
22.30 	enrollee must pay all calculated premium costs for continued eligibility.
22.31 	(d) For purposes of determining eligibility under this subdivision, a person's assets must 
22.32 	not exceed $20,000, excluding:
23.1 	(1) all assets excluded under section 256B.056;
23.2 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh 
23.3 	plans, and pension plans;
23.4 	(3) medical expense accounts set up through the person's employer; and
23.5 	(4) spousal assets, including spouse's share of jointly held assets.
23.6 	(e) All enrollees must pay a premium to be eligible for medical assistance under this 
23.7 	subdivision, except as provided under clause (5).
23.8 	(1) An enrollee must pay the greater of a $35 premium or the premium calculated based 
23.9 	on the person's gross earned and unearned income and the applicable family size using a 
23.10 	sliding fee scale established by the commissioner, which begins at one percent of income 
23.11 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for 
23.12 	those with incomes at or above 300 percent of the federal poverty guidelines.
23.13 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
23.14 	poverty guidelines shall be effective for premiums due in July of each year.
23.15 	(3) All enrollees who receive unearned income must pay one-half of one percent of 
23.16 	unearned income in addition to the premium amount, except as provided under clause (5).
23.17 	(4) Increases in benefits under title II of the Social Security Act shall not be counted as 
23.18 	income for purposes of this subdivision until July 1 of each year.
23.19 	(5) Effective July 1, 2009, American Indians are exempt from paying premiums as 
23.20 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
23.21 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
23.22 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
23.23 	(f) A person's eligibility and premium shall be determined by the local county agency. 
23.24 	Premiums must be paid to the commissioner. All premiums are dedicated to the 
23.25 	commissioner.
23.26 	(g) Any required premium shall be determined at application and redetermined at the 
23.27 	enrollee's six-month income review or when a change in income or household size is reported. 
23.28 	Enrollees must report any change in income or household size within ten days of when the 
23.29 	change occurs. A decreased premium resulting from a reported change in income or 
23.30 	household size shall be effective the first day of the next available billing month after the 
23.31 	change is reported. Except for changes occurring from annual cost-of-living increases, a 
24.1 	change resulting in an increased premium shall not affect the premium amount until the 
24.2 	next six-month review.
24.3 	(h) Premium payment is due upon notification from the commissioner of the premium 
24.4 	amount required. Premiums may be paid in installments at the discretion of the commissioner.
24.5 	(i) Nonpayment of the premium shall result in denial or termination of medical assistance 
24.6 	unless the person demonstrates good cause for nonpayment. "Good cause" means an excuse 
24.7 	for the enrollee's failure to pay the required premium when due because the circumstances 
24.8 	were beyond the enrollee's control or not reasonably foreseeable. The commissioner shall 
24.9 	determine whether good cause exists based on the weight of the supporting evidence 
24.10 	submitted by the enrollee to demonstrate good cause. Except when an installment agreement 
24.11 	is accepted by the commissioner, all persons disenrolled for nonpayment of a premium must 
24.12 	pay any past due premiums as well as current premiums due prior to being reenrolled. 
24.13 	Nonpayment shall include payment with a returned, refused, or dishonored instrument. The 
24.14 	commissioner may require a guaranteed form of payment as the only means to replace a 
24.15 	returned, refused, or dishonored instrument.
24.16 	(j) The commissioner is authorized to determine that a premium amount was calculated 
24.17 	or billed in error, make corrections to financial records and billing systems, and refund 
24.18 	premiums collected in error.
24.19 	(j) (k) For enrollees whose income does not exceed 200 percent of the federal poverty 
24.20 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the 
24.21 	enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph 
24.22 	(a).

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

24.24 	Sec. 15. Minnesota Statutes 2022, section 256B.0659, subdivision 1, is amended to read:
24.25 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in 
24.26 	paragraphs (b) to (r) have the meanings given unless otherwise provided in text.
24.27 	(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility, 
24.28 	positioning, eating, and toileting.
24.29 	(c) "Behavior," effective January 1, 2010, means a category to determine the home care 
24.30 	rating and is based on the criteria found in this section. "Level I behavior" means physical 
24.31 	aggression towards toward self, others, or destruction of property that requires the immediate 
24.32 	response of another person.
25.1 	(d) "Complex health-related needs," effective January 1, 2010, means a category to 
25.2 	determine the home care rating and is based on the criteria found in this section.
25.3 	(e) "Critical activities of daily living," effective January 1, 2010, means transferring, 
25.4 	mobility, eating, and toileting.
25.5 	(f) "Dependency in activities of daily living" means a person requires assistance to begin 
25.6 	and complete one or more of the activities of daily living.
25.7 	(g) "Extended personal care assistance service" means personal care assistance services 
25.8 	included in a service plan under one of the home and community-based services waivers 
25.9 	authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which 
25.10 	exceed the amount, duration, and frequency of the state plan personal care assistance services 
25.11 	for participants who:
25.12 	(1) need assistance provided periodically during a week, but less than daily will not be 
25.13 	able to remain in their homes without the assistance, and other replacement services are 
25.14 	more expensive or are not available when personal care assistance services are to be reduced; 
25.15 	or
25.16 	(2) need additional personal care assistance services beyond the amount authorized by 
25.17 	the state plan personal care assistance assessment in order to ensure that their safety, health, 
25.18 	and welfare are provided for in their homes.
25.19 	(h) "Health-related procedures and tasks" means procedures and tasks that can be 
25.20 	delegated or assigned by a licensed health care professional under state law to be performed 
25.21 	by a personal care assistant.
25.22 	(i) "Instrumental activities of daily living" means activities to include meal planning and 
25.23 	preparation; basic assistance with paying bills; shopping for food, clothing, and other 
25.24 	essential items; performing household tasks integral to the personal care assistance services; 
25.25 	communication by telephone and other media; and traveling, including to medical 
25.26 	appointments and to participate in the community. For purposes of this paragraph, traveling 
25.27 	includes driving and accompanying the recipient in the recipient's chosen mode of 
25.28 	transportation and according to the recipient's personal care assistance care plan.
25.29 	(j) "Managing employee" has the same definition as Code of Federal Regulations, title 
25.30 	42, section 455.
25.31 	(k) "Qualified professional" means a professional providing supervision of personal care 
25.32 	assistance services and staff as defined in section 256B.0625, subdivision 19c.
26.1 	(l) "Personal care assistance provider agency" means a medical assistance enrolled 
26.2 	provider that provides or assists with providing personal care assistance services and includes 
26.3 	a personal care assistance provider organization, personal care assistance choice agency, 
26.4 	class A licensed nursing agency, and Medicare-certified home health agency.
26.5 	(m) "Personal care assistant" or "PCA" means an individual employed by a personal 
26.6 	care assistance agency who provides personal care assistance services.
26.7 	(n) "Personal care assistance care plan" means a written description of personal care 
26.8 	assistance services developed by the personal care assistance provider according to the 
26.9 	service plan.
26.10 	(o) "Responsible party" means an individual who is capable of providing the support 
26.11 	necessary to assist the recipient to live in the community.
26.12 	(p) "Self-administered medication" means medication taken orally, by injection, nebulizer, 
26.13 	or insertion, or applied topically without the need for assistance.
26.14 	(q) "Service plan" means a written summary of the assessment and description of the 
26.15 	services needed by the recipient.
26.16 	(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes, 
26.17 	Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage 
26.18 	reimbursement, health and dental insurance, life insurance, disability insurance, long-term 
26.19 	care insurance, uniform allowance, and contributions to employee retirement accounts.

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

26.23 	Sec. 16. Minnesota Statutes 2022, section 256B.0659, subdivision 12, is amended to read:
26.24 		Subd. 12.Documentation of personal care assistance services provided. (a) Personal 
26.25 	care assistance services for a recipient must be documented daily by each personal care 
26.26 	assistant, on a time sheet form approved by the commissioner. All documentation may be 
26.27 	web-based, electronic, or paper documentation. The completed form must be submitted on 
26.28 	a monthly basis to the provider and kept in the recipient's health record.
26.29 	(b) The activity documentation must correspond to the personal care assistance care plan 
26.30 	and be reviewed by the qualified professional.
27.1 	(c) The personal care assistant time sheet must be on a form approved by the 
27.2 	commissioner documenting time the personal care assistant provides services in the home. 
27.3 	The following criteria must be included in the time sheet:
27.4 	(1) full name of personal care assistant and individual provider number;
27.5 	(2) provider name and telephone numbers;
27.6 	(3) full name of recipient and either the recipient's medical assistance identification 
27.7 	number or date of birth;
27.8 	(4) consecutive dates, including month, day, and year, and arrival and departure times 
27.9 	with a.m. or p.m. notations;
27.10 	(5) signatures of recipient or the responsible party;
27.11 	(6) personal signature of the personal care assistant;
27.12 	(7) any shared care provided, if applicable;
27.13 	(8) a statement that it is a federal crime to provide false information on personal care 
27.14 	service billings for medical assistance payments; and
27.15 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.; and
27.16 	(10) any time spent traveling, as described in subdivision 1, paragraph (i), including 
27.17 	start and stop times with a.m. and p.m. designations, the origination site, and the destination 
27.18 	site.

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

27.22 	Sec. 17. Minnesota Statutes 2022, section 256B.0659, is amended by adding a subdivision 
27.23 	to read:
27.24 		Subd. 14a.Qualified professional; remote supervision. (a) For recipients with chronic 
27.25 	health conditions or severely compromised immune systems, a qualified professional may 
27.26 	conduct the supervision required under subdivision 14 via two-way interactive audio and 
27.27 	visual telecommunication if, at the recipient's request, the recipient's primary health care 
27.28 	provider:
27.29 	(1) determines that remote supervision is appropriate; and
27.30 	(2) documents the determination under clause (1) in a statement of need or other document 
27.31 	that is subsequently included in the recipient's personal care assistance care plan.
28.1 	(b) Notwithstanding any other provision of law, a care plan developed or amended via 
28.2 	remote supervision may be executed by electronic signature.
28.3 	(c) A personal care assistance provider agency must not conduct its first supervisory 
28.4 	visit for a recipient and complete its initial personal care assistance care plan via a remote 
28.5 	visit.
28.6 	(d) A recipient may request to return to in-person supervisory visits at any time.

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

28.10 	Sec. 18. Minnesota Statutes 2022, section 256B.0659, subdivision 19, is amended to read:
28.11 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) Under 
28.12 	personal care assistance choice, the recipient or responsible party shall:
28.13 	(1) recruit, hire, schedule, and terminate personal care assistants according to the terms 
28.14 	of the written agreement required under subdivision 20, paragraph (a);
28.15 	(2) develop a personal care assistance care plan based on the assessed needs and 
28.16 	addressing the health and safety of the recipient with the assistance of a qualified professional 
28.17 	as needed;
28.18 	(3) orient and train the personal care assistant with assistance as needed from the qualified 
28.19 	professional;
28.20 	(4) supervise and evaluate the personal care assistant with the qualified professional, 
28.21 	who is required to visit the recipient at least every 180 days;
28.22 	(5) monitor and verify in writing and report to the personal care assistance choice agency 
28.23 	the number of hours worked by the personal care assistant and the qualified professional;
28.24 	(6) engage in an annual reassessment as required in subdivision 3a to determine 
28.25 	continuing eligibility and service authorization; and
28.26 	(7) use the same personal care assistance choice provider agency if shared personal 
28.27 	assistance care is being used.; and
28.28 	(8) ensure that a personal care assistant driving the recipient under subdivision 1, 
28.29 	paragraph (i), has a valid driver's license and the vehicle used is registered and insured 
28.30 	according to Minnesota law.
28.31 	(b) The personal care assistance choice provider agency shall:
29.1 	(1) meet all personal care assistance provider agency standards;
29.2 	(2) enter into a written agreement with the recipient, responsible party, and personal 
29.3 	care assistants;
29.4 	(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal 
29.5 	care assistant; and
29.6 	(4) ensure arm's-length transactions without undue influence or coercion with the recipient 
29.7 	and personal care assistant.
29.8 	(c) The duties of the personal care assistance choice provider agency are to:
29.9 	(1) be the employer of the personal care assistant and the qualified professional for 
29.10 	employment law and related regulations including but not limited to purchasing and 
29.11 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
29.12 	and liability insurance, and submit any or all necessary documentation including but not 
29.13 	limited to workers' compensation, unemployment insurance, and labor market data required 
29.14 	under section 256B.4912, subdivision 1a;
29.15 	(2) bill the medical assistance program for personal care assistance services and qualified 
29.16 	professional services;
29.17 	(3) request and complete background studies that comply with the requirements for 
29.18 	personal care assistants and qualified professionals;
29.19 	(4) pay the personal care assistant and qualified professional based on actual hours of 
29.20 	services provided;
29.21 	(5) withhold and pay all applicable federal and state taxes;
29.22 	(6) verify and keep records of hours worked by the personal care assistant and qualified 
29.23 	professional;
29.24 	(7) make the arrangements and pay taxes and other benefits, if any, and comply with 
29.25 	any legal requirements for a Minnesota employer;
29.26 	(8) enroll in the medical assistance program as a personal care assistance choice agency; 
29.27 	and
29.28 	(9) enter into a written agreement as specified in subdivision 20 before services are 
29.29 	provided.

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

30.4 	Sec. 19. Minnesota Statutes 2022, section 256B.0659, subdivision 24, is amended to read:
30.5 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
30.6 	assistance provider agency shall:
30.7 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
30.8 	of the required provider training;
30.9 	(2) comply with general medical assistance coverage requirements;
30.10 	(3) demonstrate compliance with law and policies of the personal care assistance program 
30.11 	to be determined by the commissioner;
30.12 	(4) comply with background study requirements;
30.13 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
30.14 	professional;
30.15 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
30.16 	or other electronic means to potential recipients, guardians, or family members;
30.17 	(7) pay the personal care assistant and qualified professional based on actual hours of 
30.18 	services provided;
30.19 	(8) withhold and pay all applicable federal and state taxes;
30.20 	(9) document that the agency uses a minimum of 72.5 percent of the revenue generated 
30.21 	by the medical assistance rate for personal care assistance services for employee personal 
30.22 	care assistant wages and benefits. The revenue generated by the qualified professional and 
30.23 	the reasonable costs associated with the qualified professional shall not be used in making 
30.24 	this calculation;
30.25 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
30.26 	compensation, liability insurance, and other benefits, if any;
30.27 	(11) enter into a written agreement under subdivision 20 before services are provided;
30.28 	(12) report suspected neglect and abuse to the common entry point according to section 
30.29 	256B.0651;
30.30 	(13) provide the recipient with a copy of the home care bill of rights at start of service;
31.1 	(14) request reassessments at least 60 days prior to the end of the current authorization 
31.2 	for personal care assistance services, on forms provided by the commissioner;
31.3 	(15) comply with the labor market reporting requirements described in section 256B.4912, 
31.4 	subdivision 1a; and
31.5 	(16) document that the agency uses the additional revenue due to the enhanced rate under 
31.6 	subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements 
31.7 	under subdivision 11, paragraph (d).; and
31.8 	(17) ensure that a personal care assistant driving a recipient under subdivision 1, 
31.9 	paragraph (i), has a valid driver's license and the vehicle used is registered and insured 
31.10 	according to Minnesota law.

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

31.14 	Sec. 20. Minnesota Statutes 2022, section 256B.0911, subdivision 13, is amended to read:
31.15 		Subd. 13.MnCHOICES assessor qualifications, training, and certification. (a) The 
31.16 	commissioner shall develop and implement a curriculum and an assessor certification 
31.17 	process.
31.18 	(b) MnCHOICES certified assessors must:
31.19 	(1) either have a bachelor's degree in social work, nursing with a public health nursing 
31.20 	certificate, or other closely related field with at least one year of home and community-based 
31.21 	experience or be a registered nurse with at least two years of home and community-based 
31.22 	experience; and
31.23 	(2) have received training and certification specific to assessment and consultation for 
31.24 	long-term care services in the state.
31.25 	(c) Certified assessors shall demonstrate best practices in assessment and support 
31.26 	planning, including person-centered planning principles, and have a common set of skills 
31.27 	that ensures consistency and equitable access to services statewide.
31.28 	(d) Certified assessors must be recertified every three years.

32.1 	Sec. 21. Minnesota Statutes 2022, section 256B.092, subdivision 1a, is amended to read:
32.2 		Subd. 1a.Case management services. (a) Each recipient of a home and community-based 
32.3 	waiver shall be provided case management services by qualified vendors as described in 
32.4 	the federally approved waiver application.
32.5 	(b) Case management service activities provided to or arranged for a person include:
32.6 	(1) development of the person-centered support plan under subdivision 1b;
32.7 	(2) informing the individual or the individual's legal guardian or conservator, or parent 
32.8 	if the person is a minor, of service options, including all service options available under the 
32.9 	waiver plan;
32.10 	(3) consulting with relevant medical experts or service providers;
32.11 	(4) assisting the person in the identification of potential providers of chosen services, 
32.12 	including:
32.13 	(i) providers of services provided in a non-disability-specific setting;
32.14 	(ii) employment service providers;
32.15 	(iii) providers of services provided in settings that are not controlled by a provider; and
32.16 	(iv) providers of financial management services;
32.17 	(5) assisting the person to access services and assisting in appeals under section 256.045;
32.18 	(6) coordination of services, if coordination is not provided by another service provider;
32.19 	(7) evaluation and monitoring of the services identified in the support plan, which must 
32.20 	incorporate at least one annual face-to-face visit by the case manager with each person; and
32.21 	(8) reviewing support plans and providing the lead agency with recommendations for 
32.22 	service authorization based upon the individual's needs identified in the support plan.
32.23 	(c) Case management service activities that are provided to the person with a 
32.24 	developmental disability shall be provided directly by county agencies or under contract. 
32.25 	If a county agency contracts for case management services, the county agency must provide 
32.26 	each recipient of home and community-based services who is receiving contracted case 
32.27 	management services with the contact information the recipient may use to file a grievance 
32.28 	with the county agency about the quality of the contracted services the recipient is receiving 
32.29 	from a county-contracted case manager. Case management services must be provided by a 
32.30 	public or private agency that is enrolled as a medical assistance provider determined by the 
32.31 	commissioner to meet all of the requirements in the approved federal waiver plans. Case 
33.1 	management services must not be provided to a recipient by a private agency that has a 
33.2 	financial interest in the provision of any other services included in the recipient's support 
33.3 	plan. For purposes of this section, "private agency" means any agency that is not identified 
33.4 	as a lead agency under section 256B.0911, subdivision 10.
33.5 	(d) Case managers are responsible for service provisions listed in paragraphs (a) and 
33.6 	(b). Case managers shall collaborate with consumers, families, legal representatives, and 
33.7 	relevant medical experts and service providers in the development and annual review of the 
33.8 	person-centered support plan and habilitation plan.
33.9 	(e) For persons who need a positive support transition plan as required in chapter 245D, 
33.10 	the case manager shall participate in the development and ongoing evaluation of the plan 
33.11 	with the expanded support team. At least quarterly, the case manager, in consultation with 
33.12 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
33.13 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
33.14 	identify whether the plan has been developed and implemented in a manner to achieve the 
33.15 	following within the required timelines:
33.16 	(1) phasing out the use of prohibited procedures;
33.17 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
33.18 	timeline; and
33.19 	(3) accomplishment of identified outcomes.
33.20 	If adequate progress is not being made, the case manager shall consult with the person's 
33.21 	expanded support team to identify needed modifications and whether additional professional 
33.22 	support is required to provide consultation.
33.23 	(f) The Department of Human Services shall offer ongoing education in case management 
33.24 	to case managers. Case managers shall receive no less than ten 20 hours of case management 
33.25 	education and disability-related training each year. The education and training must include 
33.26 	person-centered planning, informed choice, cultural competency, employment planning, 
33.27 	community living planning, self-direction options, and use of technology supports. By 
33.28 	August 1, 2024, all case managers must complete an employment support training course 
33.29 	identified by the commissioner of human services. For case managers hired after August 
33.30 	1, 2024, this training must be completed within the first six months of providing case 
33.31 	management services. For the purposes of this section, "person-centered planning" or 
33.32 	"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case 
33.33 	managers must document completion of training in a system identified by the commissioner.

34.1 	Sec. 22. Minnesota Statutes 2022, section 256B.0949, subdivision 15, is amended to read:
34.2 		Subd. 15.EIDBI provider qualifications. (a) A QSP must be employed by an agency 
34.3 	and be:
34.4 	(1) a licensed mental health professional who has at least 2,000 hours of supervised 
34.5 	clinical experience or training in examining or treating people with ASD or a related condition 
34.6 	or equivalent documented coursework at the graduate level by an accredited university in 
34.7 	ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child 
34.8 	development; or
34.9 	(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised 
34.10 	clinical experience or training in examining or treating people with ASD or a related condition 
34.11 	or equivalent documented coursework at the graduate level by an accredited university in 
34.12 	the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and 
34.13 	typical child development.
34.14 	(b) A level I treatment provider must be employed by an agency and:
34.15 	(1) have at least 2,000 hours of supervised clinical experience or training in examining 
34.16 	or treating people with ASD or a related condition or equivalent documented coursework 
34.17 	at the graduate level by an accredited university in ASD diagnostics, ASD developmental 
34.18 	and behavioral treatment strategies, and typical child development or an equivalent 
34.19 	combination of documented coursework or hours of experience; and
34.20 	(2) have or be at least one of the following:
34.21 	(i) a master's degree in behavioral health or child development or related fields including, 
34.22 	but not limited to, mental health, special education, social work, psychology, speech 
34.23 	pathology, or occupational therapy from an accredited college or university;
34.24 	(ii) a bachelor's degree in a behavioral health, child development, or related field 
34.25 	including, but not limited to, mental health, special education, social work, psychology, 
34.26 	speech pathology, or occupational therapy, from an accredited college or university, and 
34.27 	advanced certification in a treatment modality recognized by the department;
34.28 	(iii) a board-certified behavior analyst; or
34.29 	(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical 
34.30 	experience that meets all registration, supervision, and continuing education requirements 
34.31 	of the certification.
34.32 	(c) A level II treatment provider must be employed by an agency and must be:
35.1 	(1) a person who has a bachelor's degree from an accredited college or university in a 
35.2 	behavioral or child development science or related field including, but not limited to, mental 
35.3 	health, special education, social work, psychology, speech pathology, or occupational 
35.4 	therapy; and meets at least one of the following:
35.5 	(i) has at least 1,000 hours of supervised clinical experience or training in examining or 
35.6 	treating people with ASD or a related condition or equivalent documented coursework at 
35.7 	the graduate level by an accredited university in ASD diagnostics, ASD developmental and 
35.8 	behavioral treatment strategies, and typical child development or a combination of 
35.9 	coursework or hours of experience;
35.10 	(ii) has certification as a board-certified assistant behavior analyst from the Behavior 
35.11 	Analyst Certification Board;
35.12 	(iii) is a registered behavior technician as defined by the Behavior Analyst Certification 
35.13 	Board; or
35.14 	(iv) is certified in one of the other treatment modalities recognized by the department; 
35.15 	or
35.16 	(2) a person who has:
35.17 	(i) an associate's degree in a behavioral or child development science or related field 
35.18 	including, but not limited to, mental health, special education, social work, psychology, 
35.19 	speech pathology, or occupational therapy from an accredited college or university; and
35.20 	(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people 
35.21 	with ASD or a related condition. Hours worked as a mental health behavioral aide or level 
35.22 	III treatment provider may be included in the required hours of experience; or
35.23 	(3) a person who has at least 4,000 hours of supervised clinical experience in delivering 
35.24 	treatment to people with ASD or a related condition. Hours worked as a mental health 
35.25 	behavioral aide or level III treatment provider may be included in the required hours of 
35.26 	experience; or
35.27 	(4) a person who is a graduate student in a behavioral science, child development science, 
35.28 	or related field and is receiving clinical supervision by a QSP affiliated with an agency to 
35.29 	meet the clinical training requirements for experience and training with people with ASD 
35.30 	or a related condition; or
35.31 	(5) a person who is at least 18 years of age and who:
35.32 	(i) is fluent in a non-English language or is an individual certified by a Tribal nation;
36.1 	(ii) completed the level III EIDBI training requirements; and
36.2 	(iii) receives observation and direction from a QSP or level I treatment provider at least 
36.3 	once a week until the person meets 1,000 hours of supervised clinical experience.
36.4 	(d) A level III treatment provider must be employed by an agency, have completed the 
36.5 	level III training requirement, be at least 18 years of age, and have at least one of the 
36.6 	following:
36.7 	(1) a high school diploma or commissioner of education-selected high school equivalency 
36.8 	certification;
36.9 	(2) fluency in a non-English language or Tribal nation certification;
36.10 	(3) one year of experience as a primary personal care assistant, community health worker, 
36.11 	waiver service provider, or special education assistant to a person with ASD or a related 
36.12 	condition within the previous five years; or
36.13 	(4) completion of all required EIDBI training within six months of employment.

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

36.17 	Sec. 23. Minnesota Statutes 2022, section 256B.49, subdivision 13, is amended to read:
36.18 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
36.19 	shall be provided case management services by qualified vendors as described in the federally 
36.20 	approved waiver application. The case management service activities provided must include:
36.21 	(1) finalizing the person-centered written support plan within the timelines established 
36.22 	by the commissioner and section 256B.0911, subdivision 29;
36.23 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
36.24 	options, including all service options available under the waiver plans;
36.25 	(3) assisting the recipient in the identification of potential service providers of chosen 
36.26 	services, including:
36.27 	(i) available options for case management service and providers;
36.28 	(ii) providers of services provided in a non-disability-specific setting;
36.29 	(iii) employment service providers;
37.1 	(iv) providers of services provided in settings that are not community residential settings; 
37.2 	and
37.3 	(v) providers of financial management services;
37.4 	(4) assisting the recipient to access services and assisting with appeals under section 
37.5 	256.045; and
37.6 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
37.7 	plan.
37.8 	(b) The case manager may delegate certain aspects of the case management service 
37.9 	activities to another individual provided there is oversight by the case manager. The case 
37.10 	manager may not delegate those aspects which require professional judgment including:
37.11 	(1) finalizing the person-centered support plan;
37.12 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
37.13 	approved person-centered support plan; and
37.14 	(3) adjustments to the person-centered support plan.
37.15 	(c) Case management services must be provided by a public or private agency that is 
37.16 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
37.17 	the requirements in the approved federal waiver plans. Case management services must not 
37.18 	be provided to a recipient by a private agency that has any financial interest in the provision 
37.19 	of any other services included in the recipient's support plan. For purposes of this section, 
37.20 	"private agency" means any agency that is not identified as a lead agency under section 
37.21 	256B.0911, subdivision 10.
37.22 	(d) For persons who need a positive support transition plan as required in chapter 245D, 
37.23 	the case manager shall participate in the development and ongoing evaluation of the plan 
37.24 	with the expanded support team. At least quarterly, the case manager, in consultation with 
37.25 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
37.26 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
37.27 	identify whether the plan has been developed and implemented in a manner to achieve the 
37.28 	following within the required timelines:
37.29 	(1) phasing out the use of prohibited procedures;
37.30 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
37.31 	timeline; and
37.32 	(3) accomplishment of identified outcomes.
38.1 	If adequate progress is not being made, the case manager shall consult with the person's 
38.2 	expanded support team to identify needed modifications and whether additional professional 
38.3 	support is required to provide consultation.
38.4 	(e) The Department of Human Services shall offer ongoing education in case management 
38.5 	to case managers. Case managers shall receive no less than ten 20 hours of case management 
38.6 	education and disability-related training each year. The education and training must include 
38.7 	person-centered planning, informed choice, cultural competency, employment planning, 
38.8 	community living planning, self-direction options, and use of technology supports. By 
38.9 	August 1, 2024, all case managers must complete an employment support training course 
38.10 	identified by the commissioner of human services. For case managers hired after August 
38.11 	1, 2024, this training must be completed within the first six months of providing case 
38.12 	management services. For the purposes of this section, "person-centered planning" or 
38.13 	"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case 
38.14 	managers shall document completion of training in a system identified by the commissioner.

38.15 	Sec. 24. Minnesota Statutes 2022, section 256B.4905, subdivision 4a, is amended to read:
38.16 		Subd. 4a.Informed choice in employment policy. It is the policy of this state that 
38.17 	working-age individuals who have disabilities:
38.18 	(1) can work and achieve competitive integrated employment with appropriate services 
38.19 	and supports, as needed;
38.20 	(2) make informed choices about their postsecondary education, work, and career goals; 
38.21 	and
38.22 	(3) will be offered the opportunity to make an informed choice, at least annually, to 
38.23 	pursue postsecondary education or to work and earn a competitive wage.; and
38.24 	(4) will be offered benefits planning assistance and supports to understand available 
38.25 	work incentive programs and to understand the impact of work on benefits.

38.26 	Sec. 25. [256B.4906] SUBMINIMUM WAGES IN HOME AND 
38.27 	COMMUNITY-BASED SERVICES PROHIBITION; REQUIREMENTS.
38.28 		Subdivision 1.Subminimum wage outcome reporting. (a) A provider of home and 
38.29 	community-based services for people with developmental disabilities under section 256B.092 
38.30 	or home and community-based services for people with disabilities under section 256B.49 
38.31 	that holds a credential listed in clause (1) or (2) as of August 1, 2023, must submit to the 
38.32 	commissioner of human services data on individuals who are currently being paid 
39.1 	subminimum wages or were being paid subminimum wages by the provider organization 
39.2 	as of August 1, 2023:
39.3 	(1) a certificate through the United States Department of Labor under United States 
39.4 	Code, title 29, section 214(c), of the Fair Labor Standards Act authorizing the payment of 
39.5 	subminimum wages to workers with disabilities; or
39.6 	(2) a permit by the Minnesota Department of Labor and Industry under section 177.28.
39.7 	(b) The report required under paragraph (a) must include the following data about each 
39.8 	individual being paid subminimum wages:
39.9 	(1) name;
39.10 	(2) date of birth;
39.11 	(3) identified race and ethnicity;
39.12 	(4) disability type;
39.13 	(5) key employment status measures as determined by the commissioner; and
39.14 	(6) key community-life engagement measures as determined by the commissioner.
39.15 	(c) The information in paragraph (b) must be submitted in a format determined by the 
39.16 	commissioner.
39.17 	(d) A provider must submit the data required under this section annually on a date 
39.18 	specified by the commissioner. The commissioner must give a provider at least 30 calendar 
39.19 	days to submit the data following notice of the due date. If a provider fails to submit the 
39.20 	requested data by the date specified by the commissioner, the commissioner may delay 
39.21 	medical assistance reimbursement until the requested data is submitted.
39.22 	(e) Individually identifiable data submitted to the commissioner under this section are 
39.23 	considered private data on individuals as defined by section 13.02, subdivision 12.
39.24 	(f) The commissioner must analyze data annually for tracking employment and 
39.25 	community-life engagement outcomes.
39.26 		Subd. 2.Prohibition of subminimum wages. Providers of home and community-based 
39.27 	services are prohibited from paying a person with a disability wages below the state minimum 
39.28 	wage pursuant to section 177.24, or below the prevailing local minimum wage on the basis 
39.29 	of the person's disability. A special certificate authorizing the payment of less than the 
39.30 	minimum wage to a person with a disability issued pursuant to a law of this state or to a 
39.31 	federal law is without effect as of August 1, 2028.

40.1 	Sec. 26. Minnesota Statutes 2022, section 256B.4914, subdivision 3, is amended to read:
40.2 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
40.3 	home and community-based services waivers under sections 256B.092 and 256B.49, 
40.4 	including the following, as defined in the federally approved home and community-based 
40.5 	services plan:
40.6 	(1) 24-hour customized living;
40.7 	(2) adult day services;
40.8 	(3) adult day services bath;
40.9 	(4) community residential services;
40.10 	(5) customized living;
40.11 	(6) day support services;
40.12 	(7) employment development services;
40.13 	(8) employment exploration services;
40.14 	(9) employment support services;
40.15 	(10) family residential services;
40.16 	(11) individualized home supports;
40.17 	(12) individualized home supports with family training;
40.18 	(13) individualized home supports with training;
40.19 	(14) integrated community supports;
40.20 	(15) life sharing;
40.21 	(15) (16) night supervision;
40.22 	(16) (17) positive support services;
40.23 	(17) (18) prevocational services;
40.24 	(18) (19) residential support services;
40.25 	(19) (20) respite services;
40.26 	(20) (21) transportation services; and
40.27 	(21) (22) other services as approved by the federal government in the state home and 
40.28 	community-based services waiver plan.

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

41.4 	Sec. 27. Minnesota Statutes 2022, section 256B.4914, subdivision 5, is amended to read:
41.5 		Subd. 5.Base wage index; establishment and updates. (a) The base wage index is 
41.6 	established to determine staffing costs associated with providing services to individuals 
41.7 	receiving home and community-based services. For purposes of calculating the base wage, 
41.8 	Minnesota-specific wages taken from job descriptions and standard occupational 
41.9 	classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational 
41.10 	Handbook must be used.
41.11 	(b) The commissioner shall update the base wage index in subdivision 5a, publish these 
41.12 	updated values, and load them into the rate management system as follows:
41.13 	(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics 
41.14 	available as of December 31, 2019;
41.15 	(2) on November January 1, 2024, based on wage data by SOC from the Bureau of Labor 
41.16 	Statistics available as of December 31, 2021 published in March 2022; and
41.17 	(3) on July January 1, 2026, and every two years thereafter, based on wage data by SOC 
41.18 	from the Bureau of Labor Statistics available 30 months and one daypublished in March, 
41.19 	22 months prior to the scheduled update.

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

41.23 	Sec. 28. Minnesota Statutes 2022, section 256B.4914, subdivision 5a, is amended to read:
41.24 		Subd. 5a.Base wage index; calculations. The base wage index must be calculated as 
41.25 	follows:
41.26 	(1) for supervisory staff, 100 percent of the median wage for community and social 
41.27 	services specialist (SOC code 21-1099), with the exception of the supervisor of positive 
41.28 	supports professional, positive supports analyst, and positive supports specialist, which is 
41.29 	100 percent of the median wage for clinical counseling and school psychologist (SOC code 
41.30 	19-3031);
42.1 	(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC 
42.2 	code 29-1141);
42.3 	(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical 
42.4 	nurses (SOC code 29-2061);
42.5 	(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large 
42.6 	employers, with the exception of asleep-overnight staff for family residential services, which 
42.7 	is 36 percent of the minimum wage in Minnesota for large employers;
42.8 	(5) for residential direct care staff, the sum of:
42.9 	(i) 15 percent of the subtotal of 50 percent of the median wage for home health and 
42.10 	personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant 
42.11 	(SOC code 31-1131); and 20 percent of the median wage for social and human services 
42.12 	aide (SOC code 21-1093); and
42.13 	(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and 
42.14 	personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant 
42.15 	(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
42.16 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
42.17 	21-1093);
42.18 	(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC 
42.19 	code 31-1131); and 30 percent of the median wage for home health and personal care aide 
42.20 	(SOC code 31-1120);
42.21 	(7) for day support services staff and prevocational services staff, 20 percent of the 
42.22 	median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for 
42.23 	psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social 
42.24 	and human services aide (SOC code 21-1093);
42.25 	(8) for positive supports analyst staff, 100 percent of the median wage for substance 
42.26 	abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);
42.27 	(9) for positive supports professional staff, 100 percent of the median wage for clinical 
42.28 	counseling and school psychologist (SOC code 19-3031);
42.29 	(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric 
42.30 	technicians (SOC code 29-2053);
42.31 	(11) for individualized home supports with family training staff, 20 percent of the median 
42.32 	wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community 
43.1 	social service specialist (SOC code 21-1099); 40 percent of the median wage for social and 
43.2 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
43.3 	technician (SOC code 29-2053);
43.4 	(12) for individualized home supports with training services staff, 40 percent of the 
43.5 	median wage for community social service specialist (SOC code 21-1099); 50 percent of 
43.6 	the median wage for social and human services aide (SOC code 21-1093); and ten percent 
43.7 	of the median wage for psychiatric technician (SOC code 29-2053);
43.8 	(13) for employment support services staff, 50 percent of the median wage for 
43.9 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
43.10 	community and social services specialist (SOC code 21-1099);
43.11 	(14) for employment exploration services staff, 50 percent of the median wage for 
43.12 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
43.13 	community and social services specialist (SOC code 21-1099);
43.14 	(15) for employment development services staff, 50 percent of the median wage for 
43.15 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
43.16 	of the median wage for community and social services specialist (SOC code 21-1099);
43.17 	(16) for individualized home support without training staff, 50 percent of the median 
43.18 	wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the 
43.19 	median wage for nursing assistant (SOC code 31-1131);
43.20 	(17) for night supervision staff, 40 percent of the median wage for home health and 
43.21 	personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant 
43.22 	(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code 
43.23 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
43.24 	21-1093); and
43.25 	(18) for respite staff, 50 percent of the median wage for home health and personal care 
43.26 	aide (SOC code 31-1131); and 50 percent of the median wage for nursing assistant (SOC 
43.27 	code 31-1014).

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

44.1 	Sec. 29. Minnesota Statutes 2022, section 256B.4914, subdivision 5b, is amended to read:
44.2 		Subd. 5b.Standard component value adjustments. The commissioner shall update 
44.3 	the client and programming support, transportation, and program facility cost component 
44.4 	values as required in subdivisions 6 to 9a and the rates identified in subdivision 19 for 
44.5 	changes in the Consumer Price Index. The commissioner shall adjust these values higher 
44.6 	or lower, publish these updated values, and load them into the rate management system as 
44.7 	follows:
44.8 	(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the 
44.9 	previous update to the data available on December 31, 2019;
44.10 	(2) on November January 1, 2024, by the percentage change in the CPI-U from the date 
44.11 	of the previous update to the data available as of December 31, 20212022; and
44.12 	(3) on July January 1, 2026, and every two years thereafter, by the percentage change 
44.13 	in the CPI-U from the date of the previous update to the data available 30 months and one 
44.14 	day prior to the scheduled update.

44.15 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
44.16 	whichever is later, except that the amendments to clauses (2) and (3), are effective January 
44.17 	1, 2024, or upon federal approval, whichever is later. The commissioner of human services 
44.18 	shall notify the revisor of statutes when federal approval is obtained.

44.19 	Sec. 30. Minnesota Statutes 2022, section 256B.4914, subdivision 6, is amended to read:
44.20 		Subd. 6. Residential support services; generally. (a) For purposes of this section, 
44.21 	residential support services includes 24-hour customized living services, community 
44.22 	residential services, customized living services, family residential services, and integrated 
44.23 	community supports.
44.24 	(b) A unit of service for residential support services is a day. Any portion of any calendar 
44.25 	day, within allowable Medicaid rules, where an individual spends time in a residential setting 
44.26 	is billable as a day. The number of days authorized for all individuals enrolling in residential 
44.27 	support services must include every day that services start and end.
44.28 	(c) When the available shared staffing hours in a residential setting are insufficient to 
44.29 	meet the needs of an individual who enrolled in residential support services after January 
44.30 	1, 2014, then individual staffing hours shall be used.

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

45.4 	Sec. 31. Minnesota Statutes 2022, section 256B.4914, subdivision 10a, is amended to 
45.5 	read:
45.6 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
45.7 	that wage values and component values in subdivisions 5 to 9a reflect the cost to provide 
45.8 	the service. As determined by the commissioner, in consultation with stakeholders identified 
45.9 	in subdivision 17, a provider enrolled to provide services with rates determined under this 
45.10 	section must submit requested cost data to the commissioner to support research on the cost 
45.11 	of providing services that have rates determined by the disability waiver rates system. 
45.12 	Requested cost data may include, but is not limited to:
45.13 	(1) worker wage costs;
45.14 	(2) benefits paid;
45.15 	(3) supervisor wage costs;
45.16 	(4) executive wage costs;
45.17 	(5) vacation, sick, and training time paid;
45.18 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
45.19 	(7) administrative costs paid;
45.20 	(8) program costs paid;
45.21 	(9) transportation costs paid;
45.22 	(10) vacancy rates; and
45.23 	(11) other data relating to costs required to provide services requested by the 
45.24 	commissioner.
45.25 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
45.26 	year that ended not more than 18 months prior to the submission date. The commissioner 
45.27 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
45.28 	fails to submit required reporting data, the commissioner shall provide notice to providers 
45.29 	that have not provided required data 30 days after the required submission date, and a second 
45.30 	notice for providers who have not provided required data 60 days after the required 
45.31 	submission date. The commissioner shall temporarily suspend payments to the provider if 
46.1 	cost data is not received 90 days after the required submission date. Withheld payments 
46.2 	shall be made once data is received by the commissioner.
46.3 	(c) The commissioner shall conduct a random validation of data submitted under 
46.4 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
46.5 	in paragraph (a) and provide recommendations for adjustments to cost components.
46.6 	(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in 
46.7 	consultation with stakeholders identified in subdivision 17, may submit recommendations 
46.8 	on component values and inflationary factor adjustments to the chairs and ranking minority 
46.9 	members of the legislative committees with jurisdiction over human services once every 
46.10 	four years beginning January 1, 2021. The commissioner shall make recommendations in 
46.11 	conjunction with reports submitted to the legislature according to subdivision 10, paragraph 
46.12 	(c). The commissioner shall release cost data in an aggregate form. Cost data from individual 
46.13 	providers must not be released except as provided for in current law.
46.14 	(e) The commissioner shall release cost data in an aggregate form, and cost data from 
46.15 	individual providers shall not be released except as provided for in current law. The 
46.16 	commissioner shall use data collected in paragraph (a) to determine the compliance with 
46.17 	requirements identified under subdivision 10d. The commissioner shall identify providers 
46.18 	who have not met the thresholds identified under subdivision 10d on the Department of 
46.19 	Human Services website for the year for which the providers reported their costs.
46.20 	(f) The commissioner, in consultation with stakeholders identified in subdivision 17, 
46.21 	shall develop and implement a process for providing training and technical assistance 
46.22 	necessary to support provider submission of cost documentation required under paragraph 
46.23 	(a).

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

46.25 	Sec. 32. Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision 
46.26 	to read:
46.27 		Subd. 10d.Direct care staff; compensation. (a) A provider paid with rates determined 
46.28 	under subdivision 6 must use a minimum of 66 percent of the revenue generated by rates 
46.29 	determined under that subdivision for direct care staff compensation.
46.30 	(b) A provider paid with rates determined under subdivision 7 must use a minimum of 
46.31 	45 percent of the revenue generated by rates determined under that subdivision for direct 
46.32 	care compensation.
47.1 	(c) A provider paid with rates determined under subdivision 8 or 9 must use a minimum 
47.2 	of 60 percent of the revenue generated by rates determined under those subdivisions for 
47.3 	direct care compensation.
47.4 	(d) Compensation under this subdivision includes:
47.5 	(1) wages;
47.6 	(2) taxes and workers' compensation;
47.7 	(3) health insurance;
47.8 	(4) dental insurance;
47.9 	(5) vision insurance;
47.10 	(6) life insurance;
47.11 	(7) short-term disability insurance;
47.12 	(8) long-term disability insurance;
47.13 	(9) retirement spending;
47.14 	(10) tuition reimbursement;
47.15 	(11) wellness programs;
47.16 	(12) paid vacation time;
47.17 	(13) paid sick time; or
47.18 	(14) other items of monetary value provided to direct care staff.

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

47.20 	Sec. 33. Minnesota Statutes 2022, section 256B.4914, subdivision 14, is amended to read:
47.21 		Subd. 14.Exceptions. (a) In a format prescribed by the commissioner, lead agencies 
47.22 	must identify individuals with exceptional needs that cannot be met under the disability 
47.23 	waiver rate system. The commissioner shall use that information to evaluate and, if necessary, 
47.24 	approve an alternative payment rate for those individuals. Whether granted, denied, or 
47.25 	modified, the commissioner shall respond to all exception requests in writing. The 
47.26 	commissioner shall include in the written response the basis for the action and provide 
47.27 	notification of the right to appeal under paragraph (h).
48.1 	(b) Lead agencies must act on an exception request within 30 days and notify the initiator 
48.2 	of the request of their recommendation in writing. A lead agency shall submit all exception 
48.3 	requests along with its recommendation to the commissioner.
48.4 	(c) An application for a rate exception may be submitted for the following criteria:
48.5 	(1) an individual has service needs that cannot be met through additional units of service;
48.6 	(2) an individual's rate determined under subdivisions 6 to 9a is so insufficient that it 
48.7 	has resulted in an individual receiving a notice of discharge from the individual's provider; 
48.8 	or
48.9 	(3) an individual's service needs, including behavioral changes, require a level of service 
48.10 	which necessitates a change in provider or which requires the current provider to propose 
48.11 	service changes beyond those currently authorized.
48.12 	(d) Exception requests must include the following information:
48.13 	(1) the service needs required by each individual that are not accounted for in subdivisions 
48.14 	6 to 9a;
48.15 	(2) the service rate requested and the difference from the rate determined in subdivisions 
48.16 	6 to 9a;
48.17 	(3) a basis for the underlying costs used for the rate exception and any accompanying 
48.18 	documentation; and
48.19 	(4) any contingencies for approval.
48.20 	(e) Approved rate exceptions shall be managed within lead agency allocations under 
48.21 	sections 256B.092 and 256B.49.
48.22 	(f) Individual disability waiver recipients, an interested party, or the license holder that 
48.23 	would receive the rate exception increase may request that a lead agency submit an exception 
48.24 	request. A lead agency that denies such a request shall notify the individual waiver recipient, 
48.25 	interested party, or license holder of its decision and the reasons for denying the request in 
48.26 	writing no later than 30 days after the request has been made and shall submit its denial to 
48.27 	the commissioner in accordance with paragraph (b). The reasons for the denial must be 
48.28 	based on the failure to meet the criteria in paragraph (c).
48.29 	(g) The commissioner shall determine whether to approve or deny an exception request 
48.30 	no more than 30 days after receiving the request. If the commissioner denies the request, 
48.31 	the commissioner shall notify the lead agency and the individual disability waiver recipient, 
48.32 	the interested party, and the license holder in writing of the reasons for the denial.
49.1 	(h) The individual disability waiver recipient may appeal any denial of an exception 
49.2 	request by either the lead agency or the commissioner, pursuant to sections 256.045 and 
49.3 	256.0451. When the denial of an exception request results in the proposed demission of a 
49.4 	waiver recipient from a residential or day habilitation program, the commissioner shall issue 
49.5 	a temporary stay of demission, when requested by the disability waiver recipient, consistent 
49.6 	with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary 
49.7 	stay shall remain in effect until the lead agency can provide an informed choice of 
49.8 	appropriate, alternative services to the disability waiver.
49.9 	(i) Providers may petition lead agencies to update values that were entered incorrectly 
49.10 	or erroneously into the rate management system, based on past service level discussions 
49.11 	and determination in subdivision 4, without applying for a rate exception.
49.12 	(j) The starting date for the rate exception will be the later of the date of the recipient's 
49.13 	change in support or the date of the request to the lead agency for an exception.
49.14 	(k) The commissioner shall track all exception requests received and their dispositions. 
49.15 	The commissioner shall issue quarterly public exceptions statistical reports, including the 
49.16 	number of exception requests received and the numbers granted, denied, withdrawn, and 
49.17 	pending. The report shall include the average amount of time required to process exceptions.
49.18 	(l) Approved rate exceptions remain in effect in all cases until an individual's needs 
49.19 	change as defined in paragraph (c).
49.20 	(m) Rates determined under subdivision 19 are ineligible for rate exceptions.

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

49.24 	Sec. 34. Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision 
49.25 	to read:
49.26 		Subd. 19.Payments for family residential and life sharing services. The commissioner 
49.27 	shall establish rates for family residential services and life sharing services based on a 
49.28 	person's assessed need, as described in the federally-approved waiver plans. Rates for life 
49.29 	sharing services must be ten percent higher than the corresponding family residential services 
49.30 	rate.

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

50.1 	Sec. 35. Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision 
50.2 	to read:
50.3 		Subd. 19.ICF/DD rate transition. (a) Effective January 1, 2024, the minimum daily 
50.4 	operating rate for intermediate care facilities for persons with developmental disabilities is 
50.5 	$260.00.
50.6 	(b) Beginning January 1, 2026, and every two years thereafter, the rate in paragraph (a) 
50.7 	must be updated for the percentage change in the Consumer Price Index (CPI-U) from the 
50.8 	date of the previous CPI-U update to the data available 12 months and one day prior to the 
50.9 	scheduled update.

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

50.13 	Sec. 36. Minnesota Statutes 2022, section 256B.851, subdivision 3, is amended to read:
50.14 		Subd. 3.Payment rates; base wage index. When initially establishing the base wage 
50.15 	component values, the commissioner must use the Minnesota-specific median wage for the 
50.16 	standard occupational classification (SOC) codes published by the Bureau of Labor Statistics 
50.17 	in the edition of the Occupational Handbook available January 1, published in March 2021. 
50.18 	The commissioner must calculate the base wage component values as follows for:
50.19 	(1) personal care assistance services, CFSS, extended personal care assistance services, 
50.20 	and extended CFSS. The base wage component value equals the median wage for personal 
50.21 	care aide (SOC code 31-1120);
50.22 	(2) enhanced rate personal care assistance services and enhanced rate CFSS. The base 
50.23 	wage component value equals the product of median wage for personal care aide (SOC 
50.24 	code 31-1120) and the value of the enhanced rate under section 256B.0659, subdivision 
50.25 	17a; and
50.26 	(3) qualified professional services and CFSS worker training and development. The base 
50.27 	wage component value equals the sum of 70 percent of the median wage for registered nurse 
50.28 	(SOC code 29-1141), 15 percent of the median wage for health care social worker (SOC 
50.29 	code 21-1099), and 15 percent of the median wage for social and human service assistant 
50.30 	(SOC code 21-1093).

50.31 	EFFECTIVE DATE. This section is effective January 1, 2024, or within 90 days of 
50.32 	federal approval, whichever is later. The commissioner of human services shall notify the 
50.33 	revisor of statutes when federal approval is obtained.

51.1 	Sec. 37. Minnesota Statutes 2022, section 256B.851, subdivision 5, is amended to read:
51.2 		Subd. 5.Payment rates; component values. (a) The commissioner must use the 
51.3 	following component values:
51.4 	(1) employee vacation, sick, and training factor, 8.71 percent;
51.5 	(2) employer taxes and workers' compensation factor, 11.56 percent;
51.6 	(3) employee benefits factor, 12.04 percent;
51.7 	(4) client programming and supports factor, 2.30 percent;
51.8 	(5) program plan support factor, 7.00 percent;
51.9 	(6) general business and administrative expenses factor, 13.25 percent;
51.10 	(7) program administration expenses factor, 2.90 percent; and
51.11 	(8) absence and utilization factor, 3.90 percent.
51.12 	(b) For purposes of implementation, the commissioner shall use the following 
51.13 	implementation components:
51.14 	(1) personal care assistance services and CFSS: 75.45 88.66 percent;
51.15 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 75.45 88.66
51.16 	percent; and
51.17 	(3) qualified professional services and CFSS worker training and development: 75.45
51.18 	88.66 percent.
51.19 	(c) Effective January 1, 2025, for purposes of implementation, the commissioner shall 
51.20 	use the following implementation components:
51.21 	(1) personal care assistance services and CFSS: 92.08 percent;
51.22 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08 
51.23 	percent; and
51.24 	(3) qualified professional services and CFSS worker training and development: 92.08 
51.25 	percent.
51.26 	(d) The commissioner shall use the following worker retention components:
51.27 	(1) for workers who have provided fewer than 1,001 cumulative hours in personal care 
51.28 	assistance services or CFSS, the worker retention component is zero percent;
52.1 	(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal 
52.2 	care assistance services or CFSS, the worker retention component is 2.17 percent;
52.3 	(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal 
52.4 	care assistance services or CFSS, the worker retention component is 4.36 percent;
52.5 	(4) for workers who have provided between 6,001 and 10,000 cumulative hours in 
52.6 	personal care assistance services or CFSS, the worker retention component is 7.35 percent; 
52.7 	and
52.8 	(5) for workers who have provided more than 10,000 cumulative hours in personal care 
52.9 	assistance services or CFSS, the worker retention component is 10.81 percent.
52.10 	(e) The commissioner shall define the appropriate worker retention component based 
52.11 	on the total number of units billed for services rendered by the individual provider since 
52.12 	July 1, 2017. The worker retention component must be determined by the commissioner 
52.13 	for each individual provider and is not subject to appeal.

52.14 	EFFECTIVE DATE. The amendments to paragraph (b) are effective January 1, 2024, 
52.15 	or within 90 days of federal approval, whichever is later. Paragraph (b) expires January 1, 
52.16 	2025, or within 90 days of federal approval of paragraph (c), whichever is later. Paragraphs 
52.17 	(c) to (e) are effective January 1, 2025, or within 90 days of federal approval, whichever is 
52.18 	later. The commissioner of human services shall notify the revisor of statutes when federal 
52.19 	approval is obtained.

52.20 	Sec. 38. Minnesota Statutes 2022, section 256B.851, subdivision 6, is amended to read:
52.21 		Subd. 6.Payment rates; rate determination. (a) The commissioner must determine 
52.22 	the rate for personal care assistance services, CFSS, extended personal care assistance 
52.23 	services, extended CFSS, enhanced rate personal care assistance services, enhanced rate 
52.24 	CFSS, qualified professional services, and CFSS worker training and development as 
52.25 	follows:
52.26 	(1) multiply the appropriate total wage component value calculated in subdivision 4 by 
52.27 	one plus the employee vacation, sick, and training factor in subdivision 5;
52.28 	(2) for program plan support, multiply the result of clause (1) by one plus the program 
52.29 	plan support factor in subdivision 5;
52.30 	(3) for employee-related expenses, add the employer taxes and workers' compensation 
52.31 	factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is 
53.1 	employee-related expenses. Multiply the product of clause (2) by one plus the value for 
53.2 	employee-related expenses;
53.3 	(4) for client programming and supports, multiply the product of clause (3) by one plus 
53.4 	the client programming and supports factor in subdivision 5;
53.5 	(5) for administrative expenses, add the general business and administrative expenses 
53.6 	factor in subdivision 5, the program administration expenses factor in subdivision 5, and 
53.7 	the absence and utilization factor in subdivision 5;
53.8 	(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is 
53.9 	the hourly rate;
53.10 	(7) multiply the hourly rate by the appropriate implementation component under 
53.11 	subdivision 5. This is the adjusted hourly rate; and
53.12 	(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment 
53.13 	rate.
53.14 	(b) In processing claims, the commissioner shall incorporate the worker retention 
53.15 	component specified in subdivision 5, by multiplying one plus the total adjusted payment 
53.16 	rate by the appropriate worker retention component under subdivision 5, paragraph (d).
53.17 	(b) (c) The commissioner must publish the total adjusted final payment rates.

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

53.21 	Sec. 39. Minnesota Statutes 2022, section 256D.425, subdivision 1, is amended to read:
53.22 		Subdivision 1.Persons entitled to receive aid. A person who is aged, blind, or 18 years 
53.23 	of age or older and disabled and who is receiving supplemental security benefits under Title 
53.24 	XVI on the basis of age, blindness, or disability (or would be eligible for such benefits 
53.25 	except for excess income) is eligible for a payment under the Minnesota supplemental aid 
53.26 	program, if the person's net income is less than the standards in section 256D.44. A person 
53.27 	who is receiving benefits under the Minnesota supplemental aid program in the month prior 
53.28 	to becoming eligible under section 1619(b) of the Social Security Act is eligible for a 
53.29 	payment under the Minnesota supplemental aid program while they remain in section 1619(b) 
53.30 	status. Persons who are not receiving Supplemental Security Income benefits under Title 
53.31 	XVI of the Social Security Act or disability insurance benefits under Title II of the Social 
53.32 	Security Act due to exhausting time limited benefits are not eligible to receive benefits 
54.1 	under the MSA program. Persons who are not receiving Social Security or other maintenance 
54.2 	benefits for failure to meet or comply with the Social Security or other maintenance program 
54.3 	requirements are not eligible to receive benefits under the MSA program. Persons who are 
54.4 	found ineligible for Supplemental Security Income because of excess income, but whose 
54.5 	income is within the limits of the Minnesota supplemental aid program, must have blindness 
54.6 	or disability determined by the state medical review team.

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

54.8 	Sec. 40. Minnesota Statutes 2022, section 268.19, subdivision 1, is amended to read:
54.9 		Subdivision 1.Use of data. (a) Except as provided by this section, data gathered from 
54.10 	any person under the administration of the Minnesota Unemployment Insurance Law are 
54.11 	private data on individuals or nonpublic data not on individuals as defined in section 13.02, 
54.12 	subdivisions 9 and 12, and may not be disclosed except according to a district court order 
54.13 	or section 13.05. A subpoena is not considered a district court order. These data may be 
54.14 	disseminated to and used by the following agencies without the consent of the subject of 
54.15 	the data:
54.16 	(1) state and federal agencies specifically authorized access to the data by state or federal 
54.17 	law;
54.18 	(2) any agency of any other state or any federal agency charged with the administration 
54.19 	of an unemployment insurance program;
54.20 	(3) any agency responsible for the maintenance of a system of public employment offices 
54.21 	for the purpose of assisting individuals in obtaining employment;
54.22 	(4) the public authority responsible for child support in Minnesota or any other state in 
54.23 	accordance with section 256.978;
54.24 	(5) human rights agencies within Minnesota that have enforcement powers;
54.25 	(6) the Department of Revenue to the extent necessary for its duties under Minnesota 
54.26 	laws;
54.27 	(7) public and private agencies responsible for administering publicly financed assistance 
54.28 	programs for the purpose of monitoring the eligibility of the program's recipients;
54.29 	(8) the Department of Labor and Industry and the Commerce Fraud Bureau in the 
54.30 	Department of Commerce for uses consistent with the administration of their duties under 
54.31 	Minnesota law;
55.1 	(9) the Department of Human Services and the Office of Inspector General and its agents 
55.2 	within the Department of Human Services, including county fraud investigators, for 
55.3 	investigations related to recipient or provider fraud and employees of providers when the 
55.4 	provider is suspected of committing public assistance fraud;
55.5 	(10) the Department of Human Services for the purpose of evaluating medical assistance 
55.6 	services and supporting program improvement;
55.7 	(10) (11) local and state welfare agencies for monitoring the eligibility of the data subject 
55.8 	for assistance programs, or for any employment or training program administered by those 
55.9 	agencies, whether alone, in combination with another welfare agency, or in conjunction 
55.10 	with the department or to monitor and evaluate the statewide Minnesota family investment 
55.11 	program and other cash assistance programs, the Supplemental Nutrition Assistance Program, 
55.12 	and the Supplemental Nutrition Assistance Program Employment and Training program by 
55.13 	providing data on recipients and former recipients of Supplemental Nutrition Assistance 
55.14 	Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child 
55.15 	care assistance under chapter 119B, or medical programs under chapter 256B or 256L or 
55.16 	formerly codified under chapter 256D;
55.17 	(11) (12) local and state welfare agencies for the purpose of identifying employment, 
55.18 	wages, and other information to assist in the collection of an overpayment debt in an 
55.19 	assistance program;
55.20 	(12) (13) local, state, and federal law enforcement agencies for the purpose of ascertaining 
55.21 	the last known address and employment location of an individual who is the subject of a 
55.22 	criminal investigation;
55.23 	(13) (14) the United States Immigration and Customs Enforcement has access to data 
55.24 	on specific individuals and specific employers provided the specific individual or specific 
55.25 	employer is the subject of an investigation by that agency;
55.26 	(14) (15) the Department of Health for the purposes of epidemiologic investigations;
55.27 	(15) (16) the Department of Corrections for the purposes of case planning and internal 
55.28 	research for preprobation, probation, and postprobation employment tracking of offenders 
55.29 	sentenced to probation and preconfinement and postconfinement employment tracking of 
55.30 	committed offenders;
55.31 	(16) (17) the state auditor to the extent necessary to conduct audits of job opportunity 
55.32 	building zones as required under section 469.3201; and
56.1 	(17) (18) the Office of Higher Education for purposes of supporting program 
56.2 	improvement, system evaluation, and research initiatives including the Statewide 
56.3 	Longitudinal Education Data System.
56.4 	(b) Data on individuals and employers that are collected, maintained, or used by the 
56.5 	department in an investigation under section 268.182 are confidential as to data on individuals 
56.6 	and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3 
56.7 	and 13, and must not be disclosed except under statute or district court order or to a party 
56.8 	named in a criminal proceeding, administrative or judicial, for preparation of a defense.
56.9 	(c) Data gathered by the department in the administration of the Minnesota unemployment 
56.10 	insurance program must not be made the subject or the basis for any suit in any civil 
56.11 	proceedings, administrative or judicial, unless the action is initiated by the department.

56.12 	Sec. 41. Laws 2021, First Special Session chapter 7, article 17, section 16, is amended to 
56.13 	read:
56.14 	Sec. 16. RESEARCH ON ACCESS TO LONG-TERM CARE SERVICES AND 
56.15 	FINANCING.
 56.16 	(a) This act includes $400,000 in fiscal year 2022 and $300,000 in fiscal year 2023 for 
56.17 	an actuarial research study of public and private financing options for long-term services 
56.18 	and supports reform to increase access across the state. Any unexpended amount in fiscal 
56.19 	year 2023 is available through June 30, 2024. The commissioner of human services must 
56.20 	conduct the study. Of this amount, the commissioner may transfer up to $100,000 to the 
56.21 	commissioner of commerce for costs related to the requirements of the study. The general 
56.22 	fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year 
56.23 	2025.
56.24 	(b) All activities must be completed by June 30, 2024.

56.25 	Sec. 42. HOME AND COMMUNITY-BASED WORKFORCE INCENTIVE FUND 
56.26 	GRANTS.
 56.27 		Subdivision 1.Grant program established. The commissioner of human services shall 
56.28 	establish grants for disability and home and community-based providers to assist with 
56.29 	recruiting and retaining direct support and frontline workers.
56.30 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
56.31 	meanings given.
57.1 	(b) "Commissioner" means the commissioner of human services.
57.2 	(c) "Eligible employer" means an organization enrolled in a Minnesota health care 
57.3 	program or providing housing services and is:
57.4 	(1) a provider of home and community-based services under Minnesota Statutes, chapter 
57.5 	245D; or
57.6 	(2) a facility certified as an intermediate care facility for persons with developmental 
57.7 	disabilities.
57.8 	(d) "Eligible worker" means a worker who earns $30 per hour or less and is currently 
57.9 	employed or recruited to be employed by an eligible employer.
57.10 		Subd. 3.Allowable uses of grant money. (a) Grantees must use grant money to provide 
57.11 	payments to eligible workers for the following purposes:
57.12 	(1) retention, recruitment, and incentive payments;
57.13 	(2) postsecondary loan and tuition payments;
57.14 	(3) child care costs;
57.15 	(4) transportation-related costs; and
57.16 	(5) other costs associated with retaining and recruiting workers, as approved by the 
57.17 	commissioner.
57.18 	(b) Eligible workers may receive payments up to $1,000 per year from the home and 
57.19 	community-based workforce incentive fund.
57.20 	(c) The commissioner must develop a grant cycle distribution plan that allows for 
57.21 	equitable distribution of money among eligible employers. The commissioner's determination 
57.22 	of the grant awards and amounts is final and is not subject to appeal.
57.23 		Subd. 4.Attestation. As a condition of obtaining grant payments under this section, an 
57.24 	eligible employer must attest and agree to the following:
57.25 	(1) the employer is an eligible employer;
57.26 	(2) the total number of eligible employees;
57.27 	(3) the employer will distribute the entire value of the grant to eligible workers allowed 
57.28 	under this section;
57.29 	(4) the employer will create and maintain records under subdivision 6;
58.1 	(5) the employer will not use the money appropriated under this section for any purpose 
58.2 	other than the purposes permitted under this section; and
58.3 	(6) the entire value of any grant amounts will be distributed to eligible workers identified 
58.4 	by the employer.
58.5 		Subd. 5.Distribution plan; report. (a) A provider agency or individual provider that 
58.6 	receives a grant under subdivision 4 shall prepare, and upon request submit to the 
58.7 	commissioner, a distribution plan that specifies the amount of money the provider expects 
58.8 	to receive and how that money will be distributed for recruitment and retention purposes 
58.9 	for eligible employees. Within 60 days of receiving the grant, the provider must post the 
58.10 	distribution plan and leave it posted for a period of at least six months in an area of the 
58.11 	provider's operation to which all direct support professionals have access.
58.12 	(b) Within 12 months of receiving a grant under this section, each provider agency or 
58.13 	individual provider that receives a grant under subdivision 4 shall submit a report to the 
58.14 	commissioner that includes the following information:
58.15 	(1) a description of how grant money was distributed to eligible employees; and
58.16 	(2) the total dollar amount distributed.
58.17 	(c) Failure to submit the report under paragraph (b) may result in recoupment of grant 
58.18 	money.
58.19 		Subd. 6.Audits and recoupment. (a) The commissioner may perform an audit under 
58.20 	this section up to six years after a grant is awarded to ensure:
58.21 	(1) the grantee used the money solely for allowable purposes under subdivision 3;
58.22 	(2) the grantee was truthful when making attestations under subdivision 4; and
58.23 	(3) the grantee complied with the conditions of receiving a grant under this section.
58.24 	(b) If the commissioner determines that a grantee used grant money for purposes not 
58.25 	authorized under this section, the commissioner must treat any amount used for a purpose 
58.26 	not authorized under this section as an overpayment. The commissioner must recover any 
58.27 	overpayment.
58.28 		Subd. 7.Grants not to be considered income. (a) Notwithstanding any law to the 
58.29 	contrary, grant awards under this section must not be considered income, assets, or personal 
58.30 	property for purposes of determining eligibility or recertifying eligibility for:
58.31 	(1) child care assistance programs under Minnesota Statutes, chapter 119B;
59.1 	(2) general assistance, Minnesota supplemental aid, and food support under Minnesota 
59.2 	Statutes, chapter 256D;
59.3 	(3) housing support under Minnesota Statutes, chapter 256I;
59.4 	(4) the Minnesota family investment program and diversionary work program under 
59.5 	Minnesota Statutes, chapter 256J; and
59.6 	(5) economic assistance programs under Minnesota Statutes, chapter 256P.
59.7 	(b) The commissioner must not consider grant awards under this section as income or 
59.8 	assets under Minnesota Statutes, section 256B.056, subdivision 1a, paragraph (a), 3, or 3c, 
59.9 	or for persons with eligibility determined under Minnesota Statutes, section 256B.057, 
59.10 	subdivision 3, 3a, 3b, 4, or 9.

59.11 	Sec. 43. NEW AMERICAN LEGAL AND SOCIAL SERVICES WORKFORCE 
59.12 	GRANT PROGRAM.
59.13 		Subdivision 1.Definition. "Eligible workers" means persons who require legal services 
59.14 	to seek or maintain status and secure or maintain legal authorization for employment.
59.15 		Subd. 2.Grant program established. The commissioner of human services shall 
59.16 	establish a new American legal and social services workforce grant program for organizations 
59.17 	that assist eligible workers:
59.18 	(1) in seeking or maintaining legal or citizenship status to become or remain legally 
59.19 	authorized for employment in any field or industry, including but not limited to the long-term 
59.20 	care workforce; or
59.21 	(2) to provide supports during the legal process or while seeking qualified legal assistance.
59.22 		Subd. 3.Distribution of grants. The commissioner shall ensure that grant money is 
59.23 	awarded to organizations and entities that demonstrate that they have the qualifications, 
59.24 	experience, expertise, cultural competency, and geographic reach to offer legal or social 
59.25 	services under this section to eligible workers. In distributing grant awards, the commissioner 
59.26 	shall prioritize organizations or entities serving populations for whom existing legal services 
59.27 	and social services for the purposes listed in subdivision 2 are unavailable or insufficient.
59.28 		Subd. 4.Eligible grantees. Organizations or entities eligible to receive grant money 
59.29 	under this section include local governmental units, federally recognized Tribal Nations, 
59.30 	and nonprofit organizations as defined under section 501(c)(3) of the Internal Revenue Code 
59.31 	that provide legal or social services to eligible populations. Priority should be given to 
60.1 	organizations and entities that serve populations in areas of the state where worker shortages 
60.2 	are most acute.
60.3 		Subd. 5.Grantee duties. Organizations or entities receiving grant money under this 
60.4 	section must provide services that include the following activities:
60.5 	(1) intake, assessment, referral, orientation, legal advice, or representation to eligible 
60.6 	workers to seek or maintain legal or citizenship status and secure or maintain legal 
60.7 	authorization for employment in the United States; or
60.8 	(2) social services designed to help eligible populations meet their immediate basic needs 
60.9 	during the process of seeking or maintaining legal status and legal authorization for 
60.10 	employment, including but not limited to accessing housing, food, employment or 
60.11 	employment training, education, course fees, community orientation, transportation, child 
60.12 	care, and medical care. Social services may also include navigation services to address 
60.13 	ongoing needs once immediate basic needs have been met and repaying student loan debt 
60.14 	directly incurred as a result of pursuing a qualifying course of study or training.
60.15 		Subd. 6.Reporting. (a) Grant recipients under this section must collect and report to 
60.16 	the commissioner information on program participation and program outcomes. The 
60.17 	commissioner shall determine the form and timing of reports.
60.18 	(b) Grant recipients providing immigration legal services under this section must collect 
60.19 	and report to the commissioner data that are consistent with the requirements established 
60.20 	for the advisory committee established by the supreme court under Minnesota Statutes, 
60.21 	section 480.242, subdivision 1.

60.22 	Sec. 44. SUPPORTING NEW AMERICANS IN THE LONG-TERM CARE 
60.23 	WORKFORCE GRANTS.
 60.24 		Subdivision 1.Definition. For the purposes of this section, "new American" means an 
60.25 	individual born abroad and the individual's children, irrespective of immigration status.
60.26 		Subd. 2.Grant program established. The commissioner of human services shall 
60.27 	establish a grant program for organizations that support immigrants, refugees, and new 
60.28 	Americans interested in entering the long-term care workforce.
60.29 		Subd. 3.Eligibility. (a) The commissioner shall select projects for funding under this 
60.30 	section. An eligible applicant for the grant program in subdivision 1 is an:
61.1 	(1) organization or provider that is experienced in working with immigrants, refugees, 
61.2 	and people born outside of the United States and that demonstrates cultural competency; 
61.3 	or
61.4 	(2) organization or provider with the expertise and capacity to provide training, peer 
61.5 	mentoring, supportive services, and workforce development or other services to develop 
61.6 	and implement strategies for recruiting and retaining qualified employees.
61.7 	(b) The commissioner shall prioritize applications from joint labor management programs.
61.8 		Subd. 4.Allowable grant activities.  Money allocated under this section must be used 
61.9 	to:
61.10 	(1) support immigrants, refugees, or new Americans to obtain or maintain employment 
61.11 	in the long-term care workforce;
61.12 	(2) develop connections to employment with long-term care employers and potential 
61.13 	employees;
61.14 	(3) provide recruitment, training, guidance, mentorship, and other support services 
61.15 	necessary to encourage employment, employee retention, and successful community 
61.16 	integration;
61.17 	(4) provide career education, wraparound support services, and job skills training in 
61.18 	high-demand health care and long-term care fields;
61.19 	(5) pay for program expenses, including but not limited to hiring instructors and 
61.20 	navigators, space rentals, and supportive services to help participants attend classes. 
61.21 	Allowable uses for supportive services include but are not limited to:
61.22 	(i) course fees;
61.23 	(ii) child care costs;
61.24 	(iii) transportation costs;
61.25 	(iv) tuition fees;
61.26 	(v) financial coaching fees; or
61.27 	(vi) mental health supports and uniforms costs incurred as a direct result of participating 
61.28 	in classroom instruction or training; or
61.29 	(6) repay student loan debt directly incurred as a result of pursuing a qualifying course 
61.30 	of study or training.

62.1 	Sec. 45. PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED 
62.2 	COMMUNITIES.
62.3 		Subdivision 1.Establishment and authority. (a) The commissioner of human services 
62.4 	shall award grants to organizations that provide community-based services to rural or 
62.5 	underserved communities. The grants must be used to build organizational capacity to 
62.6 	provide home and community-based services in the state and to build new or expanded 
62.7 	infrastructure to access medical assistance reimbursement.
62.8 	(b) The commissioner shall conduct community engagement, provide technical assistance, 
62.9 	and establish a collaborative learning community related to the grants available under this 
62.10 	section and shall work with the commissioners of management and budget and administration 
62.11 	to mitigate barriers in accessing grant money.
62.12 	(c) The commissioner shall limit expenditures under this subdivision to the amount 
62.13 	appropriated for this purpose.
62.14 	(d) The commissioner shall give priority to organizations that provide culturally specific 
62.15 	and culturally responsive services or that serve historically underserved communities 
62.16 	throughout the state.
62.17 		Subd. 2.Eligibility. An eligible applicant for the capacity grants under subdivision 1 is 
62.18 	an organization or provider that serves, or will serve, rural or underserved communities 
62.19 	and:
62.20 	(1) provides, or will provide, home and community-based services in the state; or
62.21 	(2) serves, or will serve, as a connector for communities to available home and 
62.22 	community-based services.
62.23 		Subd. 3.Allowable grant activities.  Grants under this section must be used by recipients 
62.24 	for the following activities:
62.25 	(1) expanding existing services;
62.26 	(2) increasing access in rural or underserved areas;
62.27 	(3) creating new home and community-based organizations;
62.28 	(4) connecting underserved communities to benefits and available services; or
62.29 	(5) building new or expanded infrastructure to access medical assistance reimbursement.

63.1 	Sec. 46. APPROVAL OF CORPORATE FOSTER CARE MORATORIUM 
63.2 	EXCEPTIONS.
 63.3 	(a) The commissioner of human services may approve or deny corporate foster care 
63.4 	moratorium exceptions requested under Minnesota Statutes, section 245A.03, subdivision 
63.5 	7, paragraph (a), clause (5), prior to approval of a service provider's home and 
63.6 	community-based services license under Minnesota Statutes, chapter 245D. Approval of 
63.7 	the moratorium exception must not be construed as final approval of a service provider's 
63.8 	home and community-based services or community residential setting license.
63.9 	(b) Approval under paragraph (a) must be available only for service providers that have 
63.10 	requested a home and community-based services license under Minnesota Statutes, chapter 
63.11 	245D.
63.12 	(c) Approval under paragraph (a) must be rescinded if the service provider's application 
63.13 	for a home and community-based services or community residential setting license is denied.
63.14 	(d) This section expires December 31, 2023.

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

63.16 	Sec. 47. BUDGET INCREASE FOR CONSUMER-DIRECTED COMMUNITY 
63.17 	SUPPORTS.
 63.18 	(a) Effective January 1, 2024, or upon federal approval, whichever is later, 
63.19 	consumer-directed community support budgets identified in the waiver plans under Minnesota 
63.20 	Statutes, sections 256B.092 and 256B.49, and chapter 256S, and the alternative care program 
63.21 	under Minnesota Statutes, section 256B.0913, must be increased by 8.49 percent.
63.22 	(b) Effective January 1, 2025, or upon federal approval, whichever is later, 
63.23 	consumer-directed community support budgets identified in the waiver plans under Minnesota 
63.24 	Statutes, sections 256B.092 and 256B.49, and chapter 256S, and the alternative care program 
63.25 	under Minnesota Statutes, section 256B.0913, must be increased by 4.53 percent.

63.26 	Sec. 48. EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL 
63.27 	INTERVENTION LICENSURE STUDY.
 63.28 	(a) The commissioner of human services must review the medical assistance early 
63.29 	intensive developmental and behavioral intervention (EIDBI) service and evaluate the need 
63.30 	for licensure or other regulatory modifications. At a minimum, the evaluation must include:
64.1 	(1) an examination of current Department of Human Services-licensed programs that 
64.2 	are similar to EIDBI;
64.3 	(2) an environmental scan of licensure requirements for Medicaid autism programs in 
64.4 	other states; and
64.5 	(3) consideration of health and safety needs for populations with autism and related 
64.6 	conditions.
64.7 	(b) The commissioner must consult with interested stakeholders, including self-advocates 
64.8 	who use EIDBI services, EIDBI providers, parents of youth who use EIDBI services, and 
64.9 	advocacy organizations. The commissioner must convene stakeholder meetings to obtain 
64.10 	feedback on licensure or regulatory recommendations.

64.11 	Sec. 49. STUDY TO EXPAND ACCESS TO SERVICES FOR PEOPLE WITH 
64.12 	CO-OCCURRING BEHAVIORAL HEALTH CONDITIONS AND DISABILITIES.
 64.13 	The commissioner of human services, in consultation with stakeholders, must evaluate 
64.14 	options to expand services authorized under Minnesota's federally approved home and 
64.15 	community-based waivers, including positive support, crisis respite, respite, and specialist 
64.16 	services. The evaluation may include options to authorize services under Minnesota's medical 
64.17 	assistance state plan and strategies to decrease the number of people who remain in hospitals, 
64.18 	jails, and other acute or crisis settings when they no longer meet medical or other necessity 
64.19 	criteria.

64.20 	Sec. 50. SELF-DIRECTED WORKER CONTRACT RATIFICATION.
 64.21 	The labor agreement between the state of Minnesota and the Service Employees 
64.22 	International Union Healthcare Minnesota and Iowa, submitted to the Legislative 
64.23 	Coordinating Commission on February 27, 2023, is ratified.

64.24 	Sec. 51. MEMORANDUMS OF UNDERSTANDING.
 64.25 	The memorandums of understanding with the Service Employees International Union 
64.26 	Healthcare Minnesota and Iowa, submitted by the commissioner of management and budget 
64.27 	on February 27, 2023, are ratified.

64.28 	Sec. 52. SPECIALIZED EQUIPMENT AND SUPPLIES LIMIT INCREASE.
 64.29 	Upon federal approval, the commissioner of human services must increase the annual 
64.30 	limit for specialized equipment and supplies under Minnesota's federally approved home 
65.1 	and community-based service waiver plans, alternative care, and essential community 
65.2 	supports to $10,000.

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

65.6 	Sec. 53. INTERAGENCY EMPLOYMENT SUPPORTS ALIGNMENT STUDY.
 65.7 	The commissioners of human services, employment and economic development, and 
65.8 	education must conduct an interagency alignment study on employment supports for people 
65.9 	with disabilities. The study must evaluate:
65.10 	(1) service rates;
65.11 	(2) provider enrollment and monitoring standards; and
65.12 	(3) eligibility processes and people's lived experience transitioning between employment 
65.13 	programs.

65.14 	Sec. 54. MONITORING EMPLOYMENT OUTCOMES.
 65.15 	By January 15, 2025, the Departments of Human Services, Employment and Economic 
65.16 	Development, and Education must provide the chairs and ranking minority members of the 
65.17 	legislative committees with jurisdiction over health, human services, and labor with a plan 
65.18 	for tracking employment outcomes for people with disabilities served by programs 
65.19 	administered by the agencies. This plan must include any needed changes to state law to 
65.20 	track supports received and outcomes across programs.

65.21 	Sec. 55. PHASE-OUT OF THE USE OF SUBMINIMUM WAGE FOR MEDICAL 
65.22 	ASSISTANCE DISABILITY SERVICES.
 65.23 	The commissioner of human services must seek all necessary amendments to Minnesota's 
65.24 	federally approved disability waiver plans to require that people receiving prevocational or 
65.25 	employment support services are compensated at or above the state minimum wage or at 
65.26 	or above the prevailing local minimum wage no later than August 1, 2028.

65.27 	Sec. 56. RATE INCREASE FOR CERTAIN DISABILITY WAIVER SERVICES.
 65.28 	The commissioner of human services shall increase payment rates for chore services, 
65.29 	homemaker services, and home-delivered meals provided under Minnesota Statutes, sections 
65.30 	256B.092 and 256B.49, by 15.8 percent from the rates in effect on December 31, 2023.

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

66.4 	Sec. 57. RATE INCREASE FOR EARLY INTENSIVE DEVELOPMENTAL AND 
66.5 	BEHAVIORAL INTERVENTION BENEFIT SERVICES.
 66.6 	The commissioner of human services shall increase payment rates for early intensive 
66.7 	developmental and behavioral intervention services under Minnesota Statutes, section 
66.8 	256B.0949, by 15.8 percent from the rates in effect on December 31, 2023.

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

66.12 	Sec. 58. RATE INCREASE FOR HOME CARE SERVICES.
 66.13 	The commissioner of human services shall increase payment rates for home health 
66.14 	services and home care nursing services under Minnesota Statutes, section 256B.0651, 
66.15 	subdivision 2, clauses (1) and (3); respiratory therapy under Minnesota Rules, part 9505.0295, 
66.16 	subpart 2, item E; and home health agency services under Minnesota Statutes, section 
66.17 	256B.0653, by 15.8 percent from the rates in effect on December 31, 2023.

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

66.21 	Sec. 59. RATE INCREASE FOR INTERMEDIATE CARE FACILITIES FOR 
66.22 	PERSONS WITH DEVELOPMENTAL DISABILITIES DAY TRAINING AND 
66.23 	HABILITATION SERVICES.
 66.24 	The commissioner of human services shall increase payment rates for day training and 
66.25 	habilitation services under Minnesota Statutes, section 252.46, by 15.8 percent from the 
66.26 	rates in effect on December 31, 2023.

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

67.1 	Sec. 60. STUDY ON PRESUMPTIVE ELIGIBILITY FOR LONG-TERM SERVICES 
67.2 	AND SUPPORTS.
 67.3 	(a) The commissioner of human services must study presumptive functional eligibility 
67.4 	for people with disabilities and older adults in the following programs:
67.5 	(1) medical assistance, alternative care, and essential community supports; and
67.6 	(2) home and community-based services.
67.7 	(b) The commissioner must evaluate the following in the study of presumptive eligibility 
67.8 	within the programs listed in paragraph (a):
67.9 	(1) current eligibility processes;
67.10 	(2) barriers to timely eligibility determinations; and
67.11 	(3) strategies to enhance access to home and community-based services in the least 
67.12 	restrictive setting.
67.13 	(c) By January 1, 2025, the commissioner must report recommendations and draft 
67.14 	legislation to the chairs and ranking minority members of the legislative committees with 
67.15 	jurisdiction over health and human services finance and policy.

67.16 	Sec. 61. SYSTEMIC REVIEW OF ACUTE CARE HOSPITALIZATIONS STUDY.
 67.17 	(a) The commissioner of human services must conduct a systemic review of acute care 
67.18 	hospitalizations for older adults on medical assistance and people on medical assistance 
67.19 	with disabilities and behavioral health conditions. The review must include:
67.20 	(1) an analysis of reimbursement rates to support people with complex support needs;
67.21 	(2) a survey of other states' policies, models, and service options to reduce and respond 
67.22 	to acute care hospitalizations;
67.23 	(3) systemic critical incident reviews of people who are hospitalized in acute care 
67.24 	hospitals for longer than 90 days in order to determine systemic, regulatory, staff training, 
67.25 	or other reoccurring barriers keeping individuals from returning to the community or lower 
67.26 	levels of care; and
67.27 	(4) a comparison of different methods to increase and enhance statewide provider capacity 
67.28 	to support people with complex needs.
67.29 	(b) The commissioner must submit a report to the chairs and ranking minority members 
67.30 	of the legislative committees and divisions with jurisdiction over health and human services 
68.1 	policy and finance by January 15, 2025. The report must include proposed legislation 
68.2 	necessary to enact the report's recommendations.

68.3 	Sec. 62. REPEALER.
 68.4 	Minnesota Statutes 2022, section 256B.4914, subdivision 6b, is repealed.

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

68.8 	ARTICLE 2
68.9 	AGING SERVICES

68.10 	Section 1. Minnesota Statutes 2022, section 256.975, subdivision 6, is amended to read:
68.11 		Subd. 6.Indian Native American elders coordinator position. (a) The Minnesota 
68.12 	Board on Aging shall create an Indian a Native American elders coordinator position, and 
68.13 	shall hire staff as appropriations permit for the purposes of coordinating efforts with the 
68.14 	National Indian Council on Aging and developing facilitating the coordination and 
68.15 	development of a comprehensive statewide Tribal-based service system for Indian Native 
68.16 	American elders. An Indian elder is defined for purposes of this subdivision as an Indian 
68.17 	enrolled in a band or tribe who is 55 years or older.
68.18 	(b) For purposes of this subdivision, the following terms have the meanings given:
68.19 	(1) "Native American elder" means an individual enrolled in a federally recognized 
68.20 	Tribe and identified as an elder according to the requirements of the individual's home Tribe; 
68.21 	and
68.22 	(2) "Tribal government" means representatives of each of the 11 federally recognized 
68.23 	Native American Tribes located wholly or partially within the boundaries of the state of 
68.24 	Minnesota.
68.25 	(c) The statewide Tribal-based service system must may include the following 
68.26 	components:
68.27 	(1) an assessment of the program eligibility, examining the need to change the age-based 
68.28 	eligibility criteria to need-based eligibility criteria;
68.29 	(2) (1) a planning system that would plan to grant, or make recommendations for granting,
68.30 	federal and state funding for statewide Tribal-based Native American programs and services;
69.1 	(2) a plan to develop business initiatives involving Tribal members that will qualify for 
69.2 	federal- and state-funded elder service contracts;
69.3 	(3) a plan for statewide Tribal-based service focal points, senior centers, or community 
69.4 	centers for socialization and service accessibility for Indian Native American elders;
69.5 	(4) a plan to develop and implement statewide education and public awareness campaigns
69.6 	promotions, including awareness programs, sensitivity cultural sensitivity training, and 
69.7 	public education on Indian elder needs Native American elders;
69.8 	(5) a plan for statewide culturally appropriate information and referral services for Native 
69.9 	American elders, including legal advice and counsel and trained advocates and an Indian 
69.10 	elder newsletter;
69.11 	(6) a plan for a coordinated statewide Tribal-based health care system including health 
69.12 	promotion/prevention promotion and prevention, in-home service, long-term care service, 
69.13 	and health care services;
69.14 	(7) a plan for ongoing research involving Indian elders including needs assessment and 
69.15 	needs analysis; collection of significant data on Native American elders, including population, 
69.16 	health, socialization, mortality, homelessness, and economic status; and
69.17 	(8) information and referral services for legal advice or legal counsel; and
69.18 	(9) (8) a plan to coordinate services with existing organizations, including but not limited 
69.19 	to the state of Minnesota, the Council of Minnesota Indian Affairs Council, the Minnesota 
69.20 	Indian Council of Elders, the Minnesota Board on Aging, Wisdom Steps, and Minnesota
69.21 	Tribal governments.

69.22 	Sec. 2. Minnesota Statutes 2022, section 256.9754, is amended to read:
69.23 	256.9754 COMMUNITY SERVICES DEVELOPMENT LIVE WELL AT HOME
69.24 	GRANTS PROGRAM.
69.25 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
69.26 	meanings given.
69.27 	(a) "Community" means a town, township, city, or targeted neighborhood within a city, 
69.28 	or a consortium of towns, townships, cities, or targeted neighborhoods within cities.
69.29 	(b) "Core home and community-based services provider" means a Faith in Action, Living 
69.30 	at Home/Block Nurse, congregational nurse, or similar community-based program governed 
69.31 	by a board, the majority of whose members reside within the program's service area, that 
69.32 	organizes and uses volunteers and paid staff to deliver nonmedical services intended to 
70.1 	assist older adults to identify and manage risks and to maintain their community living and 
70.2 	integration in the community.
70.3 	(c) "Long-term services and supports" means any service available under the elderly 
70.4 	waiver program or alternative care grant programs, nursing facility services, transportation 
70.5 	services, caregiver support and respite care services, and other home and community-based 
70.6 	services identified as necessary either to maintain lifestyle choices for older adults or to 
70.7 	support them to remain in their own home.
70.8 	(b) (d) "Older adult services" means any services available under the elderly waiver 
70.9 	program or alternative care grant programs; nursing facility services; transportation services; 
70.10 	respite services; and other community-based services identified as necessary either to 
70.11 	maintain lifestyle choices for older Minnesotans, or to promote independence.
70.12 	(c) (e) "Older adult" refers to individuals 65 years of age and older.
70.13 		Subd. 2.Creation; purpose. (a) The community services development live well at home
70.14 	grants program is are created under the administration of the commissioner of human 
70.15 	services.
70.16 	(b) The purpose of projects selected by the commissioner of human services under this 
70.17 	section is to make strategic changes in the long-term services and supports system for older 
70.18 	adults and people with dementia, including statewide capacity for local service development 
70.19 	and technical assistance, and statewide availability of home and community-based services 
70.20 	for older adult services, caregiver support and respite care services, and other supports in 
70.21 	Minnesota. These projects are intended to create incentives for new and expanded home 
70.22 	and community-based services in Minnesota in order to:
70.23 	(1) reach older adults early in the progression of their need for long-term services and 
70.24 	supports, providing them with low-cost, high-impact services that will prevent or delay the 
70.25 	use of more costly services;
70.26 	(2) support older adults to live in the most integrated, least restrictive community setting;
70.27 	(3) support the informal caregivers of older adults;
70.28 	(4) develop and implement strategies to integrate long-term services and supports with 
70.29 	health care services, in order to improve the quality of care and enhance the quality of life 
70.30 	of older adults and their informal caregivers;
70.31 	(5) ensure cost-effective use of financial and human resources;
71.1 	(6) build community-based approaches and community commitment to delivering 
71.2 	long-term services and supports for older adults in their own homes;
71.3 	(7) achieve a broad awareness and use of lower-cost in-home services as an alternative 
71.4 	to nursing homes and other residential services;
71.5 	(8) strengthen and develop additional home and community-based services and 
71.6 	alternatives to nursing homes and other residential services; and
71.7 	(9) strengthen programs that use volunteers.
71.8 	(c) The services provided by these projects are available to older adults who are eligible 
71.9 	for medical assistance and the elderly waiver under chapter 256S, the alternative care 
71.10 	program under section 256B.0913, or the essential community supports grant under section 
71.11 	256B.0922, and to persons who have their own money to pay for services.
71.12 		Subd. 3.Provision of Community services development grants. The commissioner 
71.13 	shall make community services development grants available to communities, providers of 
71.14 	older adult services identified in subdivision 1, or to a consortium of providers of older 
71.15 	adult services, to establish older adult services. Grants may be provided for capital and other 
71.16 	costs including, but not limited to, start-up and training costs, equipment, and supplies 
71.17 	related to older adult services or other residential or service alternatives to nursing facility 
71.18 	care. Grants may also be made to renovate current buildings, provide transportation services, 
71.19 	fund programs that would allow older adults or individuals with a disability to stay in their 
71.20 	own homes by sharing a home, fund programs that coordinate and manage formal and 
71.21 	informal services to older adults in their homes to enable them to live as independently as 
71.22 	possible in their own homes as an alternative to nursing home care, or expand state-funded 
71.23 	programs in the area.
71.24 		Subd. 3a.Priority for other grants. The commissioner of health shall give priority to 
71.25 	a grantee selected under subdivision 3 when awarding technology-related grants, if the 
71.26 	grantee is using technology as part of the proposal unless that priority conflicts with existing 
71.27 	state or federal guidance related to grant awards by the Department of Health. The 
71.28 	commissioner of transportation shall give priority to a grantee under subdivision 3 when 
71.29 	distributing transportation-related funds to create transportation options for older adults 
71.30 	unless that preference conflicts with existing state or federal guidance related to grant awards 
71.31 	by the Department of Transportation.
71.32 		Subd. 3b.State waivers. The commissioner of health may waive applicable state laws 
71.33 	and rules for grantees under subdivision 3 on a time-limited basis if the commissioner of 
72.1 	health determines that a participating grantee requires a waiver in order to achieve 
72.2 	demonstration project goals.
72.3 		Subd. 3c.Caregiver support and respite care projects. (a) The commissioner shall 
72.4 	establish projects to expand the availability of caregiver support and respite care services 
72.5 	for family and other caregivers. The commissioner shall use a request for proposals to select 
72.6 	nonprofit entities to administer the projects. Projects must:
72.7 	(1) establish a local coordinated network of volunteer and paid respite workers;
72.8 	(2) coordinate assignment of respite care services to caregivers of older adults;
72.9 	(3) assure the health and safety of the older adults;
72.10 	(4) identify at-risk caregivers;
72.11 	(5) provide information, education, and training for caregivers in the designated 
72.12 	community; and
72.13 	(6) demonstrate the need in the proposed service area, particularly where nursing facility 
72.14 	closures have occurred or are occurring or areas with service needs identified by section 
72.15 	144A.351. Preference must be given for projects that reach underserved populations.
72.16 	(b) Projects must clearly describe:
72.17 	(1) how they will achieve their purpose;
72.18 	(2) the process for recruiting, training, and retraining volunteers; and
72.19 	(3) a plan to promote the project in the designated community, including outreach to 
72.20 	persons needing the services.
72.21 	(c) Money for all projects under this subdivision may be used to:
72.22 	(1) hire a coordinator to develop a coordinated network of volunteer and paid respite 
72.23 	care services and assign workers to clients;
72.24 	(2) recruit and train volunteer providers;
72.25 	(3) provide information, training, and education to caregivers;
72.26 	(4) advertise the availability of the caregiver support and respite care project; and
72.27 	(5) purchase equipment to maintain a system of assigning workers to clients.
72.28 	(d) Volunteer and caregiver training must include resources on how to support an 
72.29 	individual with dementia.
72.30 	(e) Project money may not be used to supplant existing funding sources.
73.1 		Subd. 3d.Core home and community-based services projects. The commissioner 
73.2 	shall select and contract with core home and community-based services providers for projects 
73.3 	to provide services and supports to older adults both with and without family and other 
73.4 	informal caregivers using a request for proposals process. Projects must:
73.5 	(1) have a credible public or private nonprofit sponsor providing ongoing financial 
73.6 	support;
73.7 	(2) have a specific, clearly defined geographic service area;
73.8 	(3) use a practice framework designed to identify high-risk older adults and help them 
73.9 	take action to better manage their chronic conditions and maintain their community living;
73.10 	(4) have a team approach to coordination and care, ensuring that the older adult 
73.11 	participants, their families, and the formal and informal providers are all part of planning 
73.12 	and providing services;
73.13 	(5) provide information, support services, homemaking services, counseling, and training 
73.14 	for the older adults and family caregivers;
73.15 	(6) encourage service area or neighborhood residents and local organizations to 
73.16 	collaborate in meeting the needs of older adults in their geographic service areas;
73.17 	(7) recruit, train, and direct the use of volunteers to provide informal services and other 
73.18 	appropriate support to older adults and their caregivers; and
73.19 	(8) provide coordination and management of formal and informal services to older adults 
73.20 	and their families using less expensive alternatives.
73.21 		Subd. 3e.Community service grants. The commissioner shall award contracts for 
73.22 	grants to public and private nonprofit agencies to establish services that strengthen a 
73.23 	community's ability to provide a system of home and community-based services for elderly 
73.24 	persons. The commissioner shall use a request for proposals process.
73.25 		Subd. 4.Eligibility. Grants may be awarded only to communities and providers or to a 
73.26 	consortium of providers that have a local match of 50 percent of the costs for the project in 
73.27 	the form of donations, local tax dollars, in-kind donations, fundraising, or other local matches.
73.28 		Subd. 5.Grant preference. The commissioner of human services shall give preference 
73.29 	when awarding grants under this section to areas where nursing facility closures have 
73.30 	occurred or are occurring or areas with service needs identified by section 144A.351. The 
73.31 	commissioner may award grants to the extent grant funds are available and to the extent 
73.32 	applications are approved by the commissioner. Denial of approval of an application in one 
74.1 	year does not preclude submission of an application in a subsequent year. The maximum 
74.2 	grant amount is limited to $750,000.

74.3 	Sec. 3. [256.9756] CAREGIVER RESPITE SERVICES GRANTS.
74.4 		Subdivision 1.Caregiver respite services grant program established. The 
74.5 	commissioner of human services must establish a caregiver respite services grant program 
74.6 	to increase the availability of respite services for family caregivers of people with dementia 
74.7 	and older adults and to provide information, education, and training to respite caregivers 
74.8 	and volunteers regarding caring for people with dementia. From the money made available 
74.9 	for this purpose, the commissioner must award grants on a competitive basis to respite 
74.10 	service providers, giving priority to areas of the state where there is a high need of respite 
74.11 	services.
74.12 		Subd. 2.Eligible uses. Grant recipients awarded grant money under this section must 
74.13 	use a portion of the grant award as determined by the commissioner to provide free or 
74.14 	subsidized respite services for family caregivers of people with dementia and older adults.
74.15 		Subd. 3.Report. By January 15, 2026, and every other January 15 thereafter, the 
74.16 	commissioner shall submit a progress report about the caregiver respite services grants in 
74.17 	this section to the chairs and ranking minority members of the legislative committees with 
74.18 	jurisdiction over human services finance and policy. The progress report must include 
74.19 	metrics of the use of the grant program money.

74.20 	Sec. 4. Minnesota Statutes 2022, section 256B.0917, subdivision 1b, is amended to read:
74.21 		Subd. 1b.Definitions. (a) For purposes of this section, the following terms have the 
74.22 	meanings given.
74.23 	(b) "Community" means a town; township; city; or targeted neighborhood within a city; 
74.24 	or a consortium of towns, townships, cities, or specific neighborhoods within a city.
74.25 	(c) "Core home and community-based services provider" means a Faith in Action, Living 
74.26 	at Home Block Nurse, Congregational Nurse, or similar community-based program governed 
74.27 	by a board, the majority of whose members reside within the program's service area, that 
74.28 	organizes and uses volunteers and paid staff to deliver nonmedical services intended to 
74.29 	assist older adults to identify and manage risks and to maintain their community living and 
74.30 	integration in the community.
74.31 	(d) (b) "Eldercare development partnership" means a team of representatives of county 
74.32 	social service and public health agencies, the area agency on aging, local nursing home 
75.1 	providers, local home care providers, and other appropriate home and community-based 
75.2 	providers in the area agency's planning and service area.
75.3 	(e) (c) "Long-term services and supports" means any service available under the elderly 
75.4 	waiver program or alternative care grant programs, nursing facility services, transportation 
75.5 	services, caregiver support and respite care services, and other home and community-based 
75.6 	services identified as necessary either to maintain lifestyle choices for older adults or to 
75.7 	support them to remain in their own home.
75.8 	(f) (d) "Older adult" refers to an individual who is 65 years of age or older.

75.9 	Sec. 5. Minnesota Statutes 2022, section 256M.42, is amended to read:
75.10 	256M.42 ADULT PROTECTION GRANT ALLOCATIONS.
75.11 		Subdivision 1.Formula. (a) The commissioner shall allocate state money appropriated 
75.12 	under this section on an annual basis to each county board and tribal government approved 
75.13 	by the commissioner to assume county agency duties for adult protective services or as a 
75.14 	lead investigative agency protection under section 626.557on an annual basis in an amount 
75.15 	determined and to Tribal Nations that have voluntarily chosen by resolution of Tribal 
75.16 	government to participate in vulnerable adult protection programs according to the following 
75.17 	formula after the award of the amounts in paragraph (c):
75.18 	(1) 25 percent must be allocated to the responsible agency on the basis of the number 
75.19 	of reports of suspected vulnerable adult maltreatment under sections 626.557 and 626.5572, 
75.20 	when the county or tribe is responsible as determined by the most recent data of the 
75.21 	commissioner; and
75.22 	(2) 75 percent must be allocated to the responsible agency on the basis of the number 
75.23 	of screened-in reports for adult protective services or vulnerable adult maltreatment 
75.24 	investigations under sections 626.557 and 626.5572, when the county or tribe is responsible
75.25 	as determined by the most recent data of the commissioner.
75.26 	(b) The commissioner is precluded from changing the formula under this subdivision 
75.27 	or recommending a change to the legislature without public review and input.
75.28 	Notwithstanding this subdivision, no county must be awarded less than a minimum allocation 
75.29 	established by the commissioner.
75.30 	(c) To receive money under this subdivision, a participating Tribal Nation must apply 
75.31 	to the commissioner. Of the amount appropriated for purposes of this section, the 
75.32 	commissioner must award $100,000 to each federally recognized Tribal Nation with a Tribal 
76.1 	resolution establishing a vulnerable adult protection program. Money received by a Tribal 
76.2 	Nation under this section must be used for its vulnerable adult protection program.
76.3 		Subd. 2.Payment. The commissioner shall make allocations for the state fiscal year 
76.4 	starting July 1, 2019 2023, and to each county board or Tribal government on or before 
76.5 	October 10, 2019 2023. The commissioner shall make allocations under subdivision 1 to 
76.6 	each county board or Tribal government each year thereafter on or before July 10.
76.7 		Subd. 3.Prohibition on supplanting existing money Purpose of expenditures. Money 
76.8 	received under this section must be used for staffing for protection of vulnerable adults or
76.9 	to meet the agency's duties under section 626.557 and to expand adult protective services
76.10 	to stop, prevent, and reduce risks of maltreatment for adults accepted for services under 
76.11 	section 626.557 or for multidisciplinary teams under section 626.5571. Money must not be 
76.12 	used to supplant current county or tribe expenditures for these purposes.
76.13 		Subd. 4.Required expenditures. State money must be used to expand, not supplant, 
76.14 	county or Tribal expenditures for the fiscal year 2023 base for adult protection programs, 
76.15 	service interventions, or multidisciplinary teams. This prohibition on county or Tribal 
76.16 	expenditures supplanting state money ends July 1, 2027.
76.17 		Subd. 5.County performance on adult protection measures. The commissioner must 
76.18 	set vulnerable adult protection measures and standards for money received under this section. 
76.19 	The commissioner must require an underperforming county to demonstrate that the county 
76.20 	designated money allocated under this section for the purpose required and implemented a 
76.21 	reasonable strategy to improve adult protection performance, including the development of 
76.22 	a performance improvement plan and additional remedies identified by the commissioner. 
76.23 	The commissioner may redirect up to 20 percent of an underperforming county's money 
76.24 	under this section toward the performance improvement plan.
76.25 		Subd. 6.American Indian adult protection. Tribal Nations shall establish vulnerable 
76.26 	adult protection measures and standards and report annually to the commissioner on these 
76.27 	outcomes and the number of adults served.

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

76.29 	Sec. 6. Minnesota Statutes 2022, section 256R.13, subdivision 1, is amended to read:
76.30 		Subdivision 1.Audit authority. (a) The commissioner shall provide for an audit of the 
76.31 	cost and statistical data of nursing facilities participating as vendors of medical assistance. 
76.32 	The commissioner shall select for audit at least 15 percent of the nursing facilities' data 
76.33 	reported at random or using factors including, but not limited to: data reported to the public 
77.1 	as criteria for rating nursing facilities; data used to set limits for other medical assistance 
77.2 	programs or vendors of services to nursing facilities; change in ownership; frequent changes 
77.3 	in administration in excess of normal turnover rates; complaints to the commissioner of 
77.4 	health about care, safety, or rights; where previous inspections or reinspections under section 
77.5 	144A.10 have resulted in correction orders related to care, safety, or rights; or where persons 
77.6 	involved in ownership or administration of the facility have been indicted for alleged criminal 
77.7 	activity.
77.8 	(b) The commissioner shall meet the 15 percent requirement by either conducting an 
77.9 	audit focused on an individual nursing facility, a group of facilities, or targeting specific 
77.10 	data categories in multiple nursing facilities. These audits may be conducted on site at the 
77.11 	nursing facility, at office space used by a nursing facility or a nursing facility's parent 
77.12 	organization, or at the commissioner's office. Data being audited may be collected 
77.13 	electronically, in person, or by any other means the commissioner finds acceptable.
77.14 	(c) Within the limits of available appropriations, the commissioner may contract with a 
77.15 	third party to conduct audits as necessary in order to meet the requirements of this subdivision 
77.16 	and the notice of rates requirement under section 256R.09, subdivision 1.

77.17 	EFFECTIVE DATE. This section is effective for rate years beginning January 1, 2024.

77.18 	Sec. 7. Minnesota Statutes 2022, section 256R.17, subdivision 2, is amended to read:
77.19 		Subd. 2.Case mix indices. (a) The commissioner shall assign a case mix index to each 
77.20 	case mix classification based on the Centers for Medicare and Medicaid Services staff time 
77.21 	measurement study as determined by the commissioner of health under section 144.0724.
77.22 	(b) An index maximization approach shall be used to classify residents. "Index 
77.23 	maximization" has the meaning given in section 144.0724, subdivision 2, paragraph (c).

77.24 	Sec. 8. Minnesota Statutes 2022, section 256R.25, is amended to read:
77.25 	256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
77.26 	(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs 
77.27 	(b) to (o) (p).
77.28 	(b) For a facility licensed as a nursing home, the portion related to the provider surcharge 
77.29 	under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a 
77.30 	nursing home and a boarding care home, the portion related to the provider surcharge under 
77.31 	section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number 
77.32 	of nursing home beds divided by its total number of licensed beds.
78.1 	(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the 
78.2 	amount of the fee divided by the sum of the facility's resident days.
78.3 	(d) The portion related to development and education of resident and family advisory 
78.4 	councils under section 144A.33 is $5 per resident day divided by 365.
78.5 	(e) The portion related to scholarships is determined under section 256R.37.
78.6 	(f) The portion related to planned closure rate adjustments is as determined under section 
78.7 	256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
78.8 	(g) The portion related to consolidation rate adjustments shall be as determined under 
78.9 	section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.
78.10 	(h) The portion related to single-bed room incentives is as determined under section 
78.11 	256R.41.
78.12 	(i) The portions related to real estate taxes, special assessments, and payments made in 
78.13 	lieu of real estate taxes directly identified or allocated to the nursing facility are the allowable 
78.14 	amounts divided by the sum of the facility's resident days. Allowable costs under this 
78.15 	paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate 
78.16 	taxes shall not exceed the amount which the nursing facility would have paid to a city or 
78.17 	township and county for fire, police, sanitation services, and road maintenance costs had 
78.18 	real estate taxes been levied on that property for those purposes.
78.19 	(j) The portion related to employer health insurance costs is the allowable costs divided 
78.20 	by the sum of the facility's resident days.
78.21 	(k) The portion related to the Public Employees Retirement Association is the allowable 
78.22 	costs divided by the sum of the facility's resident days.
78.23 	(l) The portion related to quality improvement incentive payment rate adjustments is 
78.24 	the amount determined under section 256R.39.
78.25 	(m) The portion related to performance-based incentive payments is the amount 
78.26 	determined under section 256R.38.
78.27 	(n) The portion related to special dietary needs is the amount determined under section 
78.28 	256R.51.
78.29 	(o) The portion related to the rate adjustments for border city facilities is the amount 
78.30 	determined under section 256R.481.
78.31 	(p) The portion related to the rate adjustment for critical access nursing facilities is the 
78.32 	amount determined under section 256R.47.

79.1 	Sec. 9. Minnesota Statutes 2022, section 256R.47, is amended to read:
79.2 	256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING 
79.3 	FACILITIES.
79.4 	(a) The commissioner, in consultation with the commissioner of health, may designate 
79.5 	certain nursing facilities as critical access nursing facilities. The designation shall be granted 
79.6 	on a competitive basis, within the limits of funds appropriated for this purpose.
79.7 	(b) The commissioner shall request proposals from nursing facilities every two years. 
79.8 	Proposals must be submitted in the form and according to the timelines established by the 
79.9 	commissioner. In selecting applicants to designate, the commissioner, in consultation with 
79.10 	the commissioner of health, and with input from stakeholders, shall develop criteria designed 
79.11 	to preserve access to nursing facility services in isolated areas, rebalance long-term care, 
79.12 	and improve quality. To the extent practicable, the commissioner shall ensure an even 
79.13 	distribution of designations across the state.
79.14 	(c) The commissioner shall allow the benefits in clauses (1) to (5) For nursing facilities 
79.15 	designated as critical access nursing facilities:, the commissioner shall allow a supplemental 
79.16 	payment above a facility's operating payment rate as determined to be necessary by the 
79.17 	commissioner to maintain access to nursing facility services in isolated areas identified in 
79.18 	paragraph (b). The commissioner must approve the amounts of supplemental payments 
79.19 	through a memorandum of understanding. Supplemental payments to facilities under this 
79.20 	section must be in the form of time-limited rate adjustments included in the external fixed 
79.21 	costs payment rate under section 256R.25.
79.22 	(1) partial rebasing, with the commissioner allowing a designated facility operating 
79.23 	payment rates being the sum of up to 60 percent of the operating payment rate determined 
79.24 	in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of 
79.25 	the two portions being equal to 100 percent, of the operating payment rate that would have 
79.26 	been allowed had the facility not been designated. The commissioner may adjust these 
79.27 	percentages by up to 20 percent and may approve a request for less than the amount allowed;
79.28 	(2) enhanced payments for leave days. Notwithstanding section 256R.43, upon 
79.29 	designation as a critical access nursing facility, the commissioner shall limit payment for 
79.30 	leave days to 60 percent of that nursing facility's total payment rate for the involved resident, 
79.31 	and shall allow this payment only when the occupancy of the nursing facility, inclusive of 
79.32 	bed hold days, is equal to or greater than 90 percent;
79.33 	(3) two designated critical access nursing facilities, with up to 100 beds in active service, 
79.34 	may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part 
80.1 	4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner 
80.2 	of health shall consider each waiver request independently based on the criteria under 
80.3 	Minnesota Rules, part 4658.0040;
80.4 	(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall 
80.5 	be 40 percent of the amount that would otherwise apply; and
80.6 	(5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to 
80.7 	designated critical access nursing facilities.
80.8 	(d) Designation of a critical access nursing facility is for a maximum period of up to 
80.9 	two years, after which the benefits benefit allowed under paragraph (c) shall be removed. 
80.10 	Designated facilities may apply for continued designation.
80.11 	(e) This section is suspended and no state or federal funding shall be appropriated or 
80.12 	allocated for the purposes of this section from January 1, 2016, to December 31, 2019.
80.13 	(e) The memorandum of understanding required by paragraph (c) must state that the 
80.14 	designation of a critical access nursing facility must be removed if the facility undergoes a 
80.15 	change of ownership as defined in section 144A.06, subdivision 2.

80.16 	Sec. 10. Minnesota Statutes 2022, section 256R.53, is amended by adding a subdivision 
80.17 	to read:
80.18 		Subd. 3.Nursing facility in Red Wing. (a) The operating payment rate for a facility 
80.19 	located in the city of Red Wing at 1412 West 4th Street is the sum of its direct care costs 
80.20 	per standardized day, its other care-related costs per resident day, and its other operating 
80.21 	costs per day.
80.22 	(b) This subdivision expires June 30, 2025.

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

80.24 	Sec. 11. Minnesota Statutes 2022, section 256S.211, is amended to read:
80.25 	256S.211 RATE SETTING; RATE ESTABLISHMENT UPDATING RATES; 
80.26 	EVALUATION; COST REPORTING.
80.27 		Subdivision 1.Establishing base wages. When establishing the base wages according 
80.28 	to section 256S.212, the commissioner shall use standard occupational classification (SOC) 
80.29 	codes from the Bureau of Labor Statistics as defined in the edition of the Occupational 
80.30 	Handbook published immediately prior to January 1, 2019, using Minnesota-specific wages 
80.31 	taken from job descriptions.
81.1 		Subd. 2.Establishing Updating rates. By January 1 of each year, The commissioner 
81.2 	shall establish factors, update component rates, and rates effective January 1, 2024, according 
81.3 	to sections 256S.213 and 256S.212 to256S.215, using the factor and base wages established 
81.4 	according to section 256S.212 values the commissioner used to establish rates effective 
81.5 	January 1, 2019.
81.6 		Subd. 3.Spending requirements. (a) Except for community access for disability 
81.7 	inclusion customized living and brain injury customized living under section 256B.49, at 
81.8 	least 80 percent of the marginal increase in revenue from the implementation of any rate 
81.9 	adjustments under this section must be used to increase compensation-related costs for 
81.10 	employees directly employed by the provider.
81.11 	(b) For the purposes of this subdivision, compensation-related costs include:
81.12 	(1) wages and salaries;
81.13 	(2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment 
81.14 	taxes, workers' compensation, and mileage reimbursement;
81.15 	(3) the employer's paid share of health and dental insurance, life insurance, disability 
81.16 	insurance, long-term care insurance, uniform allowance, pensions, and contributions to 
81.17 	employee retirement accounts; and
81.18 	(4) benefits that address direct support professional workforce needs above and beyond 
81.19 	what employees were offered prior to the implementation of any rate adjustments under 
81.20 	this section, including any concurrent or subsequent adjustments to the base wage indices.
81.21 	(c) Compensation-related costs for persons employed in the central office of a corporation 
81.22 	or entity that has an ownership interest in the provider or exercises control over the provider, 
81.23 	or for persons paid by the provider under a management contract, do not count toward the 
81.24 	80 percent requirement under this subdivision.
81.25 	(d) A provider agency or individual provider that receives additional revenue subject to 
81.26 	the requirements of this subdivision shall prepare, and upon request submit to the 
81.27 	commissioner, a distribution plan that specifies the amount of money the provider expects 
81.28 	to receive that is subject to the requirements of this subdivision, including how that money 
81.29 	was or will be distributed to increase compensation-related costs for employees. Within 60 
81.30 	days of final implementation of the new phase-in proportion or adjustment to the base wage 
81.31 	indices subject to the requirements of this subdivision, the provider must post the distribution 
81.32 	plan and leave it posted for a period of at least six months in an area of the provider's 
81.33 	operation to which all employees have access. The posted distribution plan must include 
82.1 	instructions regarding how to contact the commissioner, or the commissioner's representative, 
82.2 	if an employee has not received the compensation-related increase described in the plan.
82.3 		Subd. 4.Evaluation of rate setting. (a) Beginning January 1, 2024, and every two years 
82.4 	thereafter, the commissioner, in consultation with stakeholders, shall use all available data 
82.5 	and resources to evaluate the following rate setting elements:
82.6 	(1) the base wage index;
82.7 	(2) the factors and supervision wage components; and
82.8 	(3) the formulas to calculate adjusted base wages and rates.
82.9 	(b) Beginning January 15, 2026, and every two years thereafter, the commissioner shall 
82.10 	report to the chairs and ranking minority members of the legislative committees and divisions 
82.11 	with jurisdiction over health and human services finance and policy with a full report on 
82.12 	the information and data gathered under paragraph (a).
82.13 		Subd. 5.Cost reporting. (a) As determined by the commissioner, in consultation with 
82.14 	stakeholders, a provider enrolled to provide services with rates determined under this chapter 
82.15 	must submit requested cost data to the commissioner to support evaluation of the rate 
82.16 	methodologies in this chapter. Requested cost data may include but is not limited to:
82.17 	(1) worker wage costs;
82.18 	(2) benefits paid;
82.19 	(3) supervisor wage costs;
82.20 	(4) executive wage costs;
82.21 	(5) vacation, sick, and training time paid;
82.22 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
82.23 	(7) administrative costs paid;
82.24 	(8) program costs paid;
82.25 	(9) transportation costs paid;
82.26 	(10) vacancy rates; and
82.27 	(11) other data relating to costs required to provide services requested by the 
82.28 	commissioner.
82.29 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
82.30 	year that ended not more than 18 months prior to the submission date. The commissioner 
83.1 	shall provide each provider a 90-day notice prior to the provider's submission due date. If 
83.2 	by 30 days after the required submission date a provider fails to submit required reporting 
83.3 	data, the commissioner shall provide notice to the provider, and if by 60 days after the 
83.4 	required submission date a provider has not provided the required data the commissioner 
83.5 	shall provide a second notice. The commissioner shall temporarily suspend payments to the 
83.6 	provider if cost data are not received 90 days after the required submission date. Withheld 
83.7 	payments must be made once data is received by the commissioner.
83.8 	(c) The commissioner shall coordinate the cost reporting activities required under this 
83.9 	section with the cost reporting activities directed under section 256B.4914, subdivision 10a.
83.10 	(d) The commissioner shall analyze cost documentation in paragraph (a) and, in 
83.11 	consultation with stakeholders, may submit recommendations on rate methodologies in this 
83.12 	chapter, including ways to monitor and enforce the spending requirements directed in 
83.13 	subdivision 3, through the reports directed by subdivision 4.

83.14 	EFFECTIVE DATE. Subdivisions 2 to 4 are effective January 1, 2024, or upon federal 
83.15 	approval, whichever is later. The commissioner of human services shall notify the revisor 
83.16 	of statutes when federal approval is obtained. Subdivision 5 is effective January 1, 2025.

83.17 	Sec. 12. Minnesota Statutes 2022, section 256S.214, is amended to read:
83.18 	256S.214 RATE SETTING; ADJUSTED BASE WAGE.
83.19 	(a) For the purposes of section 256S.215, the adjusted base wage for each position equals 
83.20 	the position's base wage under section 256S.212 plus:
83.21 	(1) the position's base wage multiplied by the payroll taxes and benefits factor under 
83.22 	section 256S.213, subdivision 1;
83.23 	(2) the position's base wage multiplied by the general and administrative factor under 
83.24 	section 256S.213, subdivision 2; and
83.25 	(3) the position's base wage multiplied by the program plan support factor under section 
83.26 	256S.213, subdivision 3.
83.27 	(b) If the base wage described in paragraph (a) is below $16.96, the base wage shall 
83.28 	equal $16.96.

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

84.1 	Sec. 13. Minnesota Statutes 2022, section 256S.215, subdivision 15, is amended to read:
84.2 		Subd. 15.Home-delivered meals rate. The home-delivered meals rate equals $9.30 is 
84.3 	the rate in effect on July 1, 2023, adjusted by 15.8 percent. The commissioner shall increase 
84.4 	the home delivered meals rate every July 1 by the percent increase in the nursing facility 
84.5 	dietary per diem using the two most recent and available nursing facility cost reports.

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

84.7 	Sec. 14. Laws 2021, chapter 30, article 12, section 5, as amended by Laws 2021, First 
84.8 	Special Session chapter 7, article 17, section 2, is amended to read:
84.9 	Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.
 84.10 	The Governor's Council on an Age-Friendly Minnesota, established in Executive Order 
84.11 	19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and 
84.12 	private partners' collaborative work on emergency preparedness, with a focus on older 
84.13 	adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic. 
84.14 	The Governor's Council on an Age-Friendly Minnesota is extended and expires June 30, 
84.15 	2024 2027.

84.16 	Sec. 15. Laws 2021, First Special Session chapter 7, article 17, section 8, is amended to 
84.17 	read:
84.18 	Sec. 8. AGE-FRIENDLY MINNESOTA.
 84.19 		Subdivision 1.Age-friendly community grants. (a) This act includes $0 in fiscal year 
84.20 	2022 and $875,000 in fiscal year 2023 for age-friendly community grants. The commissioner 
84.21 	of human services, in collaboration with the Minnesota Board on Aging and the Governor's 
84.22 	Council on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop 
84.23 	the age-friendly community grant program to help communities, including cities, counties, 
84.24 	other municipalities, Tribes, and collaborative efforts, to become age-friendly communities, 
84.25 	with an emphasis on structures, services, and community features necessary to support older 
84.26 	adult residents over the next decade, including but not limited to:
84.27 	(1) coordination of health and social services;
84.28 	(2) transportation access;
84.29 	(3) safe, affordable places to live;
84.30 	(4) reducing social isolation and improving wellness;
85.1 	(5) combating ageism and racism against older adults;
85.2 	(6) accessible outdoor space and buildings;
85.3 	(7) communication and information technology access; and
85.4 	(8) opportunities to stay engaged and economically productive.
85.5 	The general fund base in this act for this purpose is $875,000 in fiscal year 2024 and $0
85.6 	$3,000,000 in fiscal year 2025.
85.7 	(b) All grant activities must be completed by March 31, 2024 2027.
85.8 	(c) This subdivision expires June 30, 2024 2027.
85.9 		Subd. 2.Technical assistance grants. (a) This act includes $0 in fiscal year 2022 and 
85.10 	$575,000 in fiscal year 2023 for technical assistance grants. The commissioner of human 
85.11 	services, in collaboration with the Minnesota Board on Aging and the Governor's Council 
85.12 	on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop the 
85.13 	age-friendly technical assistance grant program. The general fund base in this act for this 
85.14 	purpose is $575,000 in fiscal year 2024 and $0 $1,725,000 in fiscal year 2025.
85.15 	(b) All grant activities must be completed by March 31, 2024 2027.
85.16 	(c) This subdivision expires June 30, 2024 2027.

85.17 	Sec. 16. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; CAREGIVER 
85.18 	RESPITE SERVICES GRANTS.
 85.19 	Beginning in fiscal year 2025, the commissioner of human services must continue the 
85.20 	respite services for older adults grant program established under Laws 2021, First Special 
85.21 	Session chapter 7, article 17, section 17, subdivision 3, under the authority granted under 
85.22 	Minnesota Statutes, section 256.9756. The commissioner may begin the grant application 
85.23 	process for awarding grants under Minnesota Statutes, section 256.9756, during fiscal year 
85.24 	2024 in order to facilitate the continuity of the grant program during the transition from a 
85.25 	temporary program to a permanent one.

85.26 	Sec. 17. DIRECTION TO COMMISSIONER; FUTURE PACE IMPLEMENTATION 
85.27 	FUNDING.
 85.28 	(a) The commissioner of human services shall work collaboratively with stakeholders 
85.29 	to undertake an actuarial analysis of Medicaid costs for nursing home eligible beneficiaries 
85.30 	for the purposes of establishing a monthly Medicaid capitation rate for the program of 
85.31 	all-inclusive care for the elderly (PACE). The analysis must include all sources of state 
86.1 	Medicaid expenditures for nursing home eligible beneficiaries, including but not limited to 
86.2 	capitation payments to plans and additional state expenditures to skilled nursing facilities 
86.3 	consistent with Code of Federal Regulations, chapter 42, part 447, and long-term care costs.
86.4 	(b) The commissioner shall also estimate the administrative costs associated with 
86.5 	implementing and monitoring PACE.
86.6 	(c) The commissioner shall provide a report to the chairs and ranking minority members 
86.7 	of the legislative committees with jurisdiction over health care finance on the actuarial 
86.8 	analysis, proposed capitation rate, and estimated administrative costs by December 15, 
86.9 	2023. The commissioner shall recommend a financing mechanism and administrative 
86.10 	framework by July 1, 2024.
86.11 	(d) By September 1, 2024, the commissioner shall inform the chairs and ranking minority 
86.12 	members of the legislative committees with jurisdiction over health care finance on the 
86.13 	commissioner's progress toward developing a recommended financing mechanism. For 
86.14 	purposes of this section, the commissioner may issue or extend a request for proposal to an 
86.15 	outside vendor.

86.16 	Sec. 18. RATE INCREASE FOR CERTAIN HOME AND COMMUNITY-BASED 
86.17 	SERVICES.
 86.18 	The commissioner of human services shall increase payment rates for community living 
86.19 	assistance and family caregiver services under Minnesota Statutes, sections 256B.0913 and 
86.20 	256B.0922, and chapter 256S by 15.8 percent from the rates in effect on December 31, 
86.21 	2023.

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

86.25 	Sec. 19. TEMPORARY GRANT FOR SMALL CUSTOMIZED LIVING 
86.26 	PROVIDERS.
 86.27 	The commissioner of human services must establish a temporary grant for customized 
86.28 	living providers that serve six or fewer people in a single-family home and that are 
86.29 	transitioning to community residential setting licensure or integrated community supports 
86.30 	licensure. Allowable uses of grant money include physical plant updates required for 
86.31 	community residential setting or integrated community supports licensure, technical 
86.32 	assistance to adapt business models and meet policy and regulatory guidance, and other 
87.1 	uses approved by the commissioner. License holders of eligible settings must apply for 
87.2 	grant money using an application process determined by the commissioner. Grant money 
87.3 	approved by the commissioner is a onetime award of up to $20,000 per eligible setting. To 
87.4 	be considered for grant money, eligible license holders must submit a grant application by 
87.5 	June 30, 2024. The commissioner may approve grant applications on a rolling basis.

87.6 	Sec. 20. REVISOR INSTRUCTION.
 87.7 	The revisor of statutes shall change the headnote in Minnesota Statutes, section 
87.8 	256B.0917, from "HOME AND COMMUNITY-BASED SERVICES FOR OLDER 
87.9 	ADULTS" to "ELDERCARE DEVELOPMENT PARTNERSHIPS."

87.10 	Sec. 21. REPEALER.
 87.11 	(a) Minnesota Statutes 2022, section 256S.2101, subdivisions 1 and 2, are repealed.
87.12 	(b) Minnesota Statutes 2022, section 256B.0917, subdivisions 1a, 6, 7a, and 13, are 
87.13 	repealed.

87.14 	EFFECTIVE DATE. Paragraph (a) is effective January 1, 2024.

87.15 	ARTICLE 3
87.16 	BEHAVIORAL HEALTH

87.17 	Section 1. Minnesota Statutes 2022, section 4.046, subdivision 6, is amended to read:
87.18 		Subd. 6.Office of Addiction and recoveryRecovery; director. The Office of Addiction 
87.19 	and Recovery is created in the Department of Management and Budget. The governor must 
87.20 	appoint an addiction and recovery director, who shall serve as chair of the subcabinet and 
87.21 	administer the Office of Addiction and Recovery. The director shall serve in the unclassified 
87.22 	service and shall report to the governor. The director must:
87.23 	(1) make efforts to break down silos and work across agencies to better target the state's 
87.24 	role in addressing addiction, treatment, and recovery for youth and adults;
87.25 	(2) assist in leading the subcabinet and the advisory council toward progress on 
87.26 	measurable goals that track the state's efforts in combatting addiction for youth and adults, 
87.27 	and preventing substance use and addiction among the state's youth population; and
87.28 	(3) establish and manage external partnerships and build relationships with communities, 
87.29 	community leaders, and those who have direct experience with addiction to ensure that all 
87.30 	voices of recovery are represented in the work of the subcabinet and advisory council.

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

88.7 	Sec. 3. Minnesota Statutes 2022, section 245.91, subdivision 4, is amended to read:
88.8 		Subd. 4.Facility or program. "Facility" or "program" means a nonresidential or 
88.9 	residential program as defined in section 245A.02, subdivisions 10 and 14, and any agency, 
88.10 	facility, or program that provides services or treatment for mental illness, developmental 
88.11 	disability, substance use disorder, or emotional disturbance that is required to be licensed, 
88.12 	certified, or registered by the commissioner of human services, health, or education; a sober 
88.13 	home under section 254B.18; and an acute care inpatient facility that provides services or 
88.14 	treatment for mental illness, developmental disability, substance use disorder, or emotional 
88.15 	disturbance.

88.16 	Sec. 4. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to 
88.17 	read:
88.18 		Subd. 4a.American Society of Addiction Medicine criteria or ASAM 
88.19 	criteria. "American Society of Addiction Medicine criteria" or "ASAM criteria" has the 
88.20 	meaning provided in section 254B.01, subdivision 2a.

88.21 	Sec. 5. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to 
88.22 	read:
88.23 		Subd. 20c.Protective factors. "Protective factors" means the actions or efforts a person 
88.24 	can take to reduce the negative impact of certain issues, such as substance use disorders, 
88.25 	mental health disorders, and risk of suicide. Protective factors include connecting to positive 
88.26 	supports in the community, a nutritious diet, exercise, attending counseling or 12-step 
88.27 	groups, and taking appropriate medications.

88.28 	Sec. 6. Minnesota Statutes 2022, section 245G.02, subdivision 2, is amended to read:
88.29 		Subd. 2.Exemption from license requirement. This chapter does not apply to a county 
88.30 	or recovery community organization that is providing a service for which the county or 
88.31 	recovery community organization is an eligible vendor under section 254B.05. This chapter 
89.1 	does not apply to an organization whose primary functions are information, referral, 
89.2 	diagnosis, case management, and assessment for the purposes of client placement, education, 
89.3 	support group services, or self-help programs. This chapter does not apply to the activities 
89.4 	of a licensed professional in private practice. A license holder providing the initial set of 
89.5 	substance use disorder services allowable under section 254A.03, subdivision 3, paragraph 
89.6 	(c), to an individual referred to a licensed nonresidential substance use disorder treatment 
89.7 	program after a positive screen for alcohol or substance misuse is exempt from sections 
89.8 	245G.05; 245G.06, subdivisions 1, 1a, 2, and 4; 245G.07, subdivisions 1, paragraph (a), 
89.9 	clauses (2) to (4), and 2, clauses (1) to (7); and 245G.17.

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

89.11 	Sec. 7. Minnesota Statutes 2022, section 245G.05, subdivision 1, is amended to read:
89.12 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
89.13 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
89.14 	counselor within three five calendar days from the day of service initiation for a residential 
89.15 	program or within three calendar days on which a treatment session has been provided of 
89.16 	the day of service initiation for a client by the end of the fifth day on which a treatment 
89.17 	service is provided in a nonresidential program. The number of days to complete the 
89.18 	comprehensive assessment excludes the day of service initiation. If the comprehensive 
89.19 	assessment is not completed within the required time frame, the person-centered reason for 
89.20 	the delay and the planned completion date must be documented in the client's file. The 
89.21 	comprehensive assessment is complete upon a qualified staff member's dated signature. If 
89.22 	the client received a comprehensive assessment that authorized the treatment service, an 
89.23 	alcohol and drug counselor may use the comprehensive assessment for requirements of this 
89.24 	subdivision but must document a review of the comprehensive assessment and update the 
89.25 	comprehensive assessment as clinically necessary to ensure compliance with this subdivision 
89.26 	within applicable timelines. The comprehensive assessment must include sufficient 
89.27 	information to complete the assessment summary according to subdivision 2 and the 
89.28 	individual treatment plan according to section 245G.06. The comprehensive assessment 
89.29 	must include information about the client's needs that relate to substance use and personal 
89.30 	strengths that support recovery, including:
89.31 	(1) age, sex, cultural background, sexual orientation, living situation, economic status, 
89.32 	and level of education;
89.33 	(2) a description of the circumstances on the day of service initiation;
90.1 	(3) a list of previous attempts at treatment for substance misuse or substance use disorder, 
90.2 	compulsive gambling, or mental illness;
90.3 	(4) a list of substance use history including amounts and types of substances used, 
90.4 	frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. 
90.5 	For each substance used within the previous 30 days, the information must include the date 
90.6 	of the most recent use and address the absence or presence of previous withdrawal symptoms;
90.7 	(5) specific problem behaviors exhibited by the client when under the influence of 
90.8 	substances;
90.9 	(6) the client's desire for family involvement in the treatment program, family history 
90.10 	of substance use and misuse, history or presence of physical or sexual abuse, and level of 
90.11 	family support;
90.12 	(7) physical and medical concerns or diagnoses, current medical treatment needed or 
90.13 	being received related to the diagnoses, and whether the concerns need to be referred to an 
90.14 	appropriate health care professional;
90.15 	(8) mental health history, including symptoms and the effect on the client's ability to 
90.16 	function; current mental health treatment; and psychotropic medication needed to maintain 
90.17 	stability. The assessment must utilize screening tools approved by the commissioner pursuant 
90.18 	to section 245.4863 to identify whether the client screens positive for co-occurring disorders;
90.19 	(9) arrests and legal interventions related to substance use;
90.20 	(10) a description of how the client's use affected the client's ability to function 
90.21 	appropriately in work and educational settings;
90.22 	(11) ability to understand written treatment materials, including rules and the client's 
90.23 	rights;
90.24 	(12) a description of any risk-taking behavior, including behavior that puts the client at 
90.25 	risk of exposure to blood-borne or sexually transmitted diseases;
90.26 	(13) social network in relation to expected support for recovery;
90.27 	(14) leisure time activities that are associated with substance use;
90.28 	(15) whether the client is pregnant and, if so, the health of the unborn child and the 
90.29 	client's current involvement in prenatal care;
90.30 	(16) whether the client recognizes needs related to substance use and is willing to follow 
90.31 	treatment recommendations; and
91.1 	(17) information from a collateral contact may be included, but is not required.
91.2 	(b) If the client is identified as having opioid use disorder or seeking treatment for opioid 
91.3 	use disorder, the program must provide educational information to the client concerning:
91.4 	(1) risks for opioid use disorder and dependence;
91.5 	(2) treatment options, including the use of a medication for opioid use disorder;
91.6 	(3) the risk of and recognizing opioid overdose; and
91.7 	(4) the use, availability, and administration of naloxone to respond to opioid overdose.
91.8 	(c) The commissioner shall develop educational materials that are supported by research 
91.9 	and updated periodically. The license holder must use the educational materials that are 
91.10 	approved by the commissioner to comply with this requirement.
91.11 	(d) If the comprehensive assessment is completed to authorize treatment service for the 
91.12 	client, at the earliest opportunity during the assessment interview the assessor shall determine 
91.13 	if:
91.14 	(1) the client is in severe withdrawal and likely to be a danger to self or others;
91.15 	(2) the client has severe medical problems that require immediate attention; or
91.16 	(3) the client has severe emotional or behavioral symptoms that place the client or others 
91.17 	at risk of harm.
91.18 	If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the 
91.19 	assessment interview and follow the procedures in the program's medical services plan 
91.20 	under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The 
91.21 	assessment interview may resume when the condition is resolved. An alcohol and drug 
91.22 	counselor must sign and date the comprehensive assessment review and update.

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

91.24 	Sec. 8. Minnesota Statutes 2022, section 245G.05, is amended by adding a subdivision to 
91.25 	read:
91.26 		Subd. 3.Comprehensive assessment requirements. (a) A comprehensive assessment 
91.27 	must meet the requirements under section 245I.10, subdivision 6, paragraphs (b) and (c). 
91.28 	It must also include:
91.29 	(1) a diagnosis of a substance use disorder or a finding that the client does not meet the 
91.30 	criteria for a substance use disorder;
92.1 	(2) a determination of whether the individual screens positive for co-occurring mental 
92.2 	health disorders using a screening tool approved by the commissioner pursuant to section 
92.3 	245.4863;
92.4 	(3) a risk rating and summary to support the risk ratings within each of the dimensions 
92.5 	listed in section 254B.04, subdivision 4; and
92.6 	(4) a recommendation for the ASAM level of care identified in section 254B.19, 
92.7 	subdivision 1.
92.8 	(b) If the individual is assessed for opioid use disorder, the program must provide 
92.9 	educational material to the client within 24 hours of service initiation on:
92.10 	(1) risks for opioid use disorder and dependence;
92.11 	(2) treatment options, including the use of a medication for opioid use disorder;
92.12 	(3) the risk and recognition of opioid overdose; and
92.13 	(4) the use, availability, and administration of an opiate antagonist to respond to opioid 
92.14 	overdose.
92.15 	If the client is identified as having opioid use disorder at a later point, the required educational 
92.16 	material must be provided at that point. The license holder must use the educational materials 
92.17 	that are approved by the commissioner to comply with this requirement.

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

92.19 	Sec. 9. Minnesota Statutes 2022, section 245G.06, subdivision 1, is amended to read:
92.20 		Subdivision 1.General. Each client must have a person-centered individual treatment 
92.21 	plan developed by an alcohol and drug counselor within ten days from the day of service 
92.22 	initiation for a residential program and within five calendar days,by the end of the tenth 
92.23 	day on which a treatment session has been provided from the day of service initiation for 
92.24 	a client in a nonresidential program, not to exceed 30 days. Opioid treatment programs must 
92.25 	complete the individual treatment plan within 21 days from the day of service initiation.
92.26 	The number of days to complete the individual treatment plan excludes the day of service 
92.27 	initiation. The individual treatment plan must be signed by the client and the alcohol and 
92.28 	drug counselor and document the client's involvement in the development of the plan. The 
92.29 	individual treatment plan is developed upon the qualified staff member's dated signature. 
92.30 	Treatment planning must include ongoing assessment of client needs. An individual treatment 
92.31 	plan must be updated based on new information gathered about the client's condition, the 
92.32 	client's level of participation, and on whether methods identified have the intended effect. 
93.1 	A change to the plan must be signed by the client and the alcohol and drug counselor. If the 
93.2 	client chooses to have family or others involved in treatment services, the client's individual 
93.3 	treatment plan must include how the family or others will be involved in the client's treatment. 
93.4 	If a client is receiving treatment services or an assessment via telehealth and the alcohol 
93.5 	and drug counselor documents the reason the client's signature cannot be obtained, the 
93.6 	alcohol and drug counselor may document the client's verbal approval or electronic written 
93.7 	approval of the treatment plan or change to the treatment plan in lieu of the client's signature.

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

93.9 	Sec. 10. Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision 
93.10 	to read:
93.11 		Subd. 1a.Individual treatment plan contents and process. (a) After completing a 
93.12 	client's comprehensive assessment, the license holder must complete an individual treatment 
93.13 	plan. The license holder must:
93.14 	(1) base the client's individual treatment plan on the client's comprehensive assessment;
93.15 	(2) use a person-centered, culturally appropriate planning process that allows the client's 
93.16 	family and other natural supports to observe and participate in the client's individual treatment 
93.17 	services, assessments, and treatment planning;
93.18 	(3) identify the client's treatment goals in relation to any or all of the applicable ASAM 
93.19 	six dimensions identified in section 254B.04, subdivision 4, to ensure measurable treatment 
93.20 	objectives, a treatment strategy, and a schedule for accomplishing the client's treatment 
93.21 	goals and objectives;
93.22 	(4) document in the treatment plan the ASAM level of care identified in section 254B.19, 
93.23 	subdivision 1, under which the client is receiving services;
93.24 	(5) identify the participants involved in the client's treatment planning. The client must 
93.25 	participate in the client's treatment planning. If applicable, the license holder must document 
93.26 	the reasons that the license holder did not involve the client's family or other natural supports 
93.27 	in the client's treatment planning;
93.28 	(6) identify resources to refer the client to when the client's needs will be addressed 
93.29 	concurrently by another provider; and
93.30 	(7) identify maintenance strategy goals and methods designed to address relapse 
93.31 	prevention and to strengthen the client's protective factors.

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

94.1 	Sec. 11. Minnesota Statutes 2022, section 245G.06, subdivision 3, is amended to read:
94.2 		Subd. 3. Treatment plan review.  A treatment plan review must be entered in a client's 
94.3 	file weekly or after each treatment service, whichever is less frequent, completed by the 
94.4 	alcohol and drug counselor responsible for the client's treatment plan. The review must 
94.5 	indicate the span of time covered by the review and each of the six dimensions listed in 
94.6 	section 245G.05, subdivision 2, paragraph (c). The review and must:
94.7 	(1) address each goal in the document client goals addressed since the last treatment 
94.8 	plan review and whether the identified methods to address the goals arecontinue to be 
94.9 	effective;
94.10 	(2) include document monitoring of any physical and mental health problems and include 
94.11 	toxicology results for alcohol and substance use, when available;
94.12 	(3) document the participation of others involved in the individual's treatment planning, 
94.13 	including when services are offered to the client's family or significant others;
94.14 	(4) if changes to the treatment plan are determined to be necessary, document staff 
94.15 	recommendations for changes in the methods identified in the treatment plan and whether 
94.16 	the client agrees with the change; and
94.17 	(5) include a review and evaluation of the individual abuse prevention plan according 
94.18 	to section 245A.65.; and
94.19 	(6) document any referrals made since the previous treatment plan review.

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

94.21 	Sec. 12. Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision 
94.22 	to read:
94.23 		Subd. 3a.Frequency of treatment plan reviews. (a) A license holder must ensure that 
94.24 	the alcohol and drug counselor responsible for a client's treatment plan completes and 
94.25 	documents a treatment plan review that meets the requirements of subdivision 3 in each 
94.26 	client's file, according to the frequencies required in this subdivision. All ASAM levels 
94.27 	referred to in this chapter are those described in section 254B.19, subdivision 1.
94.28 	(b) For a client receiving residential ASAM level 3.3 or 3.5 high-intensity services or 
94.29 	residential hospital-based services, a treatment plan review must be completed once every 
94.30 	14 days.
95.1 	(c) For a client receiving residential ASAM level 3.1 low-intensity services or any other 
95.2 	residential level not listed in paragraph (b), a treatment plan review must be completed once 
95.3 	every 30 days.
95.4 	(d) For a client receiving nonresidential ASAM level 2.5 partial hospitalization services, 
95.5 	a treatment plan review must be completed once every 14 days.
95.6 	(e) For a client receiving nonresidential ASAM level 1.0 outpatient or 2.1 intensive 
95.7 	outpatient services or any other nonresidential level not included in paragraph (d), a treatment 
95.8 	plan review must be completed once every 30 days.
95.9 	(f) For a client receiving nonresidential opioid treatment program services according to 
95.10 	section 245G.22, a treatment plan review must be completed weekly for the ten weeks 
95.11 	following completion of the treatment plan and monthly thereafter. Treatment plan reviews 
95.12 	must be completed more frequently when clinical needs warrant.
95.13 	(g) Notwithstanding paragraphs (e) and (f), for a client in a nonresidential program with 
95.14 	a treatment plan that clearly indicates less than five hours of skilled treatment services will 
95.15 	be provided to the client each month, a treatment plan review must be completed once every 
95.16 	90 days.

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

95.18 	Sec. 13. Minnesota Statutes 2022, section 245G.06, subdivision 4, is amended to read:
95.19 		Subd. 4.Service discharge summary. (a) An alcohol and drug counselor must write a 
95.20 	service discharge summary for each client. The service discharge summary must be 
95.21 	completed within five days of the client's service termination. A copy of the client's service 
95.22 	discharge summary must be provided to the client upon the client's request.
95.23 	(b) The service discharge summary must be recorded in the six dimensions listed in 
95.24 	section 245G.05, subdivision 2, paragraph (c) 254B.04, subdivision 4, and include the 
95.25 	following information:
95.26 	(1) the client's issues, strengths, and needs while participating in treatment, including 
95.27 	services provided;
95.28 	(2) the client's progress toward achieving each goal identified in the individual treatment 
95.29 	plan;
95.30 	(3) a risk description according to section 245G.05254B.04, subdivision 4;
95.31 	(4) the reasons for and circumstances of service termination. If a program discharges a 
95.32 	client at staff request, the reason for discharge and the procedure followed for the decision 
96.1 	to discharge must be documented and comply with the requirements in section 245G.14, 
96.2 	subdivision 3, clause (3);
96.3 	(5) the client's living arrangements at service termination;
96.4 	(6) continuing care recommendations, including transitions between more or less intense 
96.5 	services, or more frequent to less frequent services, and referrals made with specific attention 
96.6 	to continuity of care for mental health, as needed; and
96.7 	(7) service termination diagnosis.

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

96.9 	Sec. 14. Minnesota Statutes 2022, section 245G.09, subdivision 3, is amended to read:
96.10 		Subd. 3.Contents. Client records must contain the following:
96.11 	(1) documentation that the client was given information on client rights and 
96.12 	responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided 
96.13 	an orientation to the program abuse prevention plan required under section 245A.65, 
96.14 	subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record 
96.15 	must contain documentation that the client was provided educational information according 
96.16 	to section 245G.05, subdivision 13, paragraph (b);
96.17 	(2) an initial services plan completed according to section 245G.04;
96.18 	(3) a comprehensive assessment completed according to section 245G.05;
96.19 	(4) an assessment summary completed according to section 245G.05, subdivision 2;
96.20 	(5) (4) an individual abuse prevention plan according to sections 245A.65, subdivision 
96.21 	2, and 626.557, subdivision 14, when applicable;
96.22 	(6) (5) an individual treatment plan according to section 245G.06, subdivisions 1 and 
96.23 	2;
96.24 	(7) (6) documentation of treatment services, significant events, appointments, concerns, 
96.25 	and treatment plan reviews according to section 245G.06, subdivisions 2a, 2b, and 3, and 
96.26 	3a; and
96.27 	(8) (7) a summary at the time of service termination according to section 245G.06, 
96.28 	subdivision 4.

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

97.1 	Sec. 15. Minnesota Statutes 2022, section 245G.22, subdivision 15, is amended to read:
97.2 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
97.3 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
97.4 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
97.5 	ten weeks following the day of service initiation, and at least 50 consecutive minutes per 
97.6 	month thereafter. As clinically appropriate, the program may offer these services cumulatively 
97.7 	and not consecutively in increments of no less than 15 minutes over the required time period, 
97.8 	and for a total of 60 minutes of treatment services over the time period, and must document 
97.9 	the reason for providing services cumulatively in the client's record. The program may offer 
97.10 	additional levels of service when deemed clinically necessary meet the requirements in 
97.11 	section 245G.07, subdivision 1, paragraph (a), and must document each time the client was 
97.12 	offered an individual or group counseling service. If the individual or group counseling 
97.13 	service was offered but not provided to the client, the license holder must document the 
97.14 	reason the service was not provided. If the service was provided, the license holder must 
97.15 	ensure that the service is documented according to the requirements in section 245G.06, 
97.16 	subdivision 2a .
97.17 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
97.18 	the assessment must be completed within 21 days from the day of service initiation.
97.19 	(c) Notwithstanding the requirements of individual treatment plans set forth in section 
97.20 	245G.06:
97.21 	(1) treatment plan contents for a maintenance client are not required to include goals 
97.22 	the client must reach to complete treatment and have services terminated;
97.23 	(2) treatment plans for a client in a taper or detox status must include goals the client 
97.24 	must reach to complete treatment and have services terminated; and
97.25 	(3) for the ten weeks following the day of service initiation for all new admissions, 
97.26 	readmissions, and transfers, a weekly treatment plan review must be documented once the 
97.27 	treatment plan is completed. Subsequently, the counselor must document treatment plan 
97.28 	reviews in the six dimensions at least once monthly or, when clinical need warrants, more 
97.29 	frequently.

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

97.31 	Sec. 16. Minnesota Statutes 2022, section 245I.10, subdivision 6, is amended to read:
97.32 		Subd. 6.Standard diagnostic assessment; required elements. (a) Only a mental health 
97.33 	professional or a clinical trainee may complete a standard diagnostic assessment of a client. 
98.1 	A standard diagnostic assessment of a client must include a face-to-face interview with a 
98.2 	client and a written evaluation of the client. The assessor must complete a client's standard 
98.3 	diagnostic assessment within the client's cultural context. An alcohol and drug counselor 
98.4 	may gather and document the information in paragraphs (b) and (c) when completing a 
98.5 	comprehensive assessment according to section 245G.05.
98.6 	(b) When completing a standard diagnostic assessment of a client, the assessor must 
98.7 	gather and document information about the client's current life situation, including the 
98.8 	following information:
98.9 	(1) the client's age;
98.10 	(2) the client's current living situation, including the client's housing status and household 
98.11 	members;
98.12 	(3) the status of the client's basic needs;
98.13 	(4) the client's education level and employment status;
98.14 	(5) the client's current medications;
98.15 	(6) any immediate risks to the client's health and safety, including withdrawal symptoms, 
98.16 	medical conditions, and behavioral and emotional symptoms;
98.17 	(7) the client's perceptions of the client's condition;
98.18 	(8) the client's description of the client's symptoms, including the reason for the client's 
98.19 	referral;
98.20 	(9) the client's history of mental health and substance use disorder treatment; and
98.21 	(10) cultural influences on the client.; and
98.22 	(11) substance use history, if applicable, including:
98.23 	(i) amounts and types of substances, frequency and duration, route of administration, 
98.24 	periods of abstinence, and circumstances of relapse; and
98.25 	(ii) the impact to functioning when under the influence of substances, including legal 
98.26 	interventions.
98.27 	(c) If the assessor cannot obtain the information that this paragraph requires without 
98.28 	retraumatizing the client or harming the client's willingness to engage in treatment, the 
98.29 	assessor must identify which topics will require further assessment during the course of the 
98.30 	client's treatment. The assessor must gather and document information related to the following 
98.31 	topics:
99.1 	(1) the client's relationship with the client's family and other significant personal 
99.2 	relationships, including the client's evaluation of the quality of each relationship;
99.3 	(2) the client's strengths and resources, including the extent and quality of the client's 
99.4 	social networks;
99.5 	(3) important developmental incidents in the client's life;
99.6 	(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
99.7 	(5) the client's history of or exposure to alcohol and drug usage and treatment; and
99.8 	(6) the client's health history and the client's family health history, including the client's 
99.9 	physical, chemical, and mental health history.
99.10 	(d) When completing a standard diagnostic assessment of a client, an assessor must use 
99.11 	a recognized diagnostic framework.
99.12 	(1) When completing a standard diagnostic assessment of a client who is five years of 
99.13 	age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic 
99.14 	Classification of Mental Health and Development Disorders of Infancy and Early Childhood 
99.15 	published by Zero to Three.
99.16 	(2) When completing a standard diagnostic assessment of a client who is six years of 
99.17 	age or older, the assessor must use the current edition of the Diagnostic and Statistical 
99.18 	Manual of Mental Disorders published by the American Psychiatric Association.
99.19 	(3) When completing a standard diagnostic assessment of a client who is five years of 
99.20 	age or younger, an assessor must administer the Early Childhood Service Intensity Instrument 
99.21 	(ECSII) to the client and include the results in the client's assessment.
99.22 	(4) When completing a standard diagnostic assessment of a client who is six to 17 years 
99.23 	of age, an assessor must administer the Child and Adolescent Service Intensity Instrument 
99.24 	(CASII) to the client and include the results in the client's assessment.
99.25 	(5) When completing a standard diagnostic assessment of a client who is 18 years of 
99.26 	age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria 
99.27 	in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders 
99.28 	published by the American Psychiatric Association to screen and assess the client for a 
99.29 	substance use disorder.
99.30 	(e) When completing a standard diagnostic assessment of a client, the assessor must 
99.31 	include and document the following components of the assessment:
99.32 	(1) the client's mental status examination;
100.1 	(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources; 
100.2 	vulnerabilities; safety needs, including client information that supports the assessor's findings 
100.3 	after applying a recognized diagnostic framework from paragraph (d); and any differential 
100.4 	diagnosis of the client; and
100.5 	(3) an explanation of: (i) how the assessor diagnosed the client using the information 
100.6 	from the client's interview, assessment, psychological testing, and collateral information 
100.7 	about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths; 
100.8 	and (v) the client's responsivity factors.
100.9 	(f) When completing a standard diagnostic assessment of a client, the assessor must 
100.10 	consult the client and the client's family about which services that the client and the family 
100.11 	prefer to treat the client. The assessor must make referrals for the client as to services required 
100.12 	by law.

100.13 	Sec. 17. Minnesota Statutes 2022, section 253B.10, subdivision 1, is amended to read:
100.14 		Subdivision 1.Administrative requirements. (a) When a person is committed, the 
100.15 	court shall issue a warrant or an order committing the patient to the custody of the head of 
100.16 	the treatment facility, state-operated treatment program, or community-based treatment 
100.17 	program. The warrant or order shall state that the patient meets the statutory criteria for 
100.18 	civil commitment.
100.19 	(b) The commissioner shall prioritize civilly committed patients who are determined by 
100.20 	the Office of Medical Director or a designee to require emergency admission to a 
100.21 	state-operated treatment program, as well as patients being admitted from jail or a correctional 
100.22 	institution who are:
100.23 	(1) ordered confined in a state-operated treatment program for an examination under 
100.24 	Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and
100.25 	20.02, subdivision 2;
100.26 	(2) under civil commitment for competency treatment and continuing supervision under 
100.27 	Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
100.28 	(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal 
100.29 	Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be 
100.30 	detained in a state-operated treatment program pending completion of the civil commitment 
100.31 	proceedings; or
100.32 	(4) committed under this chapter to the commissioner after dismissal of the patient's 
100.33 	criminal charges.
101.1 	Patients described in this paragraph must be admitted to a state-operated treatment program 
101.2 	within 48 hours of the Office of Medical Director or a designee determining that a medically 
101.3 	appropriate bed is available. The commitment must be ordered by the court as provided in 
101.4 	section 253B.09, subdivision 1, paragraph (d).
101.5 	(c) Upon the arrival of a patient at the designated treatment facility, state-operated 
101.6 	treatment program, or community-based treatment program, the head of the facility or 
101.7 	program shall retain the duplicate of the warrant and endorse receipt upon the original 
101.8 	warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must 
101.9 	be filed in the court of commitment. After arrival, the patient shall be under the control and 
101.10 	custody of the head of the facility or program.
101.11 	(d) Copies of the petition for commitment, the court's findings of fact and conclusions 
101.12 	of law, the court order committing the patient, the report of the court examiners, and the 
101.13 	prepetition report, and any medical and behavioral information available shall be provided 
101.14 	at the time of admission of a patient to the designated treatment facility or program to which 
101.15 	the patient is committed. Upon a patient's referral to the commissioner of human services 
101.16 	for admission pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment 
101.17 	facility, jail, or correctional facility that has provided care or supervision to the patient in 
101.18 	the previous two years shall, when requested by the treatment facility or commissioner, 
101.19 	provide copies of the patient's medical and behavioral records to the Department of Human 
101.20 	Services for purposes of preadmission planning. This information shall be provided by the 
101.21 	head of the treatment facility to treatment facility staff in a consistent and timely manner 
101.22 	and pursuant to all applicable laws.

101.23 	Sec. 18. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision 
101.24 	to read:
101.25 		Subd. 2a.American Society of Addiction Medicine criteria or ASAM 
101.26 	criteria. "American Society of Addiction Medicine criteria" or "ASAM" means the clinical 
101.27 	guidelines for purposes of assessment, treatment, placement, and transfer or discharge of 
101.28 	individuals with substance use disorders. The ASAM criteria are contained in the current 
101.29 	edition of the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and 
101.30 	Co-Occurring Conditions.

102.1 	Sec. 19. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision 
102.2 	to read:
102.3 		Subd. 9.Skilled treatment services. "Skilled treatment services" has the meaning given 
102.4 	for the "treatment services" described in section 245G.07, subdivisions 1, paragraph (a), 
102.5 	clauses (1) to (4), and 2, clauses (1) to (6). Skilled treatment services must be provided by 
102.6 	qualified professionals as identified in section 245G.07, subdivision 3.

102.7 	Sec. 20. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision 
102.8 	to read:
102.9 		Subd. 10.Sober home. A sober home is a cooperative living residence, a room and 
102.10 	board residence, an apartment, or any other living accommodation that:
102.11 	(1) provides temporary housing to persons with substance use disorders;
102.12 	(2) stipulates that residents must abstain from using alcohol or other illicit drugs or 
102.13 	substances not prescribed by a physician and meet other requirements as a condition of 
102.14 	living in the home;
102.15 	(3) charges a fee for living there;
102.16 	(4) does not provide counseling or treatment services to residents; and
102.17 	(5) promotes sustained recovery from substance use disorders.

102.18 	Sec. 21. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision 
102.19 	to read:
102.20 		Subd. 11.Comprehensive assessment. "Comprehensive assessment" means a 
102.21 	person-centered, trauma-informed assessment that:
102.22 	(1) is completed for a substance use disorder diagnosis, treatment planning, and 
102.23 	determination of client eligibility for substance use disorder treatment services;
102.24 	(2) meets the requirements in section 245G.05; and
102.25 	(3) is completed by an alcohol and drug counselor qualified according to section 245G.11, 
102.26 	subdivision 5.

102.27 	Sec. 22. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision 
102.28 	to read:
102.29 		Subd. 4.Assessment criteria and risk descriptions. (a) The level of care determination 
102.30 	must follow criteria approved by the commissioner.
103.1 	(b) Dimension 1: Acute intoxication and withdrawal potential. A vendor must use the 
103.2 	following criteria in Dimension 1 to determine a client's acute intoxication and withdrawal 
103.3 	potential, the client's ability to cope with withdrawal symptoms, and the client's current 
103.4 	state of intoxication.
103.5 	"0" The client displays full functioning with good ability to tolerate and cope with 
103.6 	withdrawal discomfort, and the client shows no signs or symptoms of intoxication or 
103.7 	withdrawal or diminishing signs or symptoms.
103.8 	"1" The client can tolerate and cope with withdrawal discomfort. The client displays 
103.9 	mild-to-moderate intoxication or signs and symptoms interfering with daily functioning but 
103.10 	does not immediately endanger self or others. The client poses a minimal risk of severe 
103.11 	withdrawal.
103.12 	"2" The client has some difficulty tolerating and coping with withdrawal discomfort. 
103.13 	The client's intoxication may be severe, but the client responds to support and treatment 
103.14 	such that the client does not immediately endanger self or others. The client displays moderate 
103.15 	signs and symptoms of withdrawal with moderate risk of severe withdrawal.
103.16 	"3" The client tolerates and copes with withdrawal discomfort poorly. The client has 
103.17 	severe intoxication, such that the client endangers self or others, or intoxication has not 
103.18 	abated with less intensive services. The client displays severe signs and symptoms of 
103.19 	withdrawal, has a risk of severe-but-manageable withdrawal, or has worsening withdrawal 
103.20 	despite detoxification at a less intensive level.
103.21 	"4" The client is incapacitated with severe signs and symptoms. The client displays 
103.22 	severe withdrawal and is a danger to self or others.
103.23 	(c) Dimension 2: biomedical conditions and complications. The vendor must use the 
103.24 	following criteria in Dimension 2 to determine a client's biomedical conditions and 
103.25 	complications, the degree to which any physical disorder of the client would interfere with 
103.26 	treatment for substance use, and the client's ability to tolerate any related discomfort. If the 
103.27 	client is pregnant, the provider must determine the impact of continued substance use on 
103.28 	the unborn child.
103.29 	"0" The client displays full functioning with good ability to cope with physical discomfort.
103.30 	"1" The client tolerates and copes with physical discomfort and is able to get the services 
103.31 	that the client needs.
104.1 	"2" The client has difficulty tolerating and coping with physical problems or has other 
104.2 	biomedical problems that interfere with recovery and treatment. The client neglects or does 
104.3 	not seek care for serious biomedical problems.
104.4 	"3" The client tolerates and copes poorly with physical problems or has poor general 
104.5 	health. The client neglects the client's medical problems without active assistance.
104.6 	"4" The client is unable to participate in substance use disorder treatment and has severe 
104.7 	medical problems, has a condition that requires immediate intervention, or is incapacitated.
104.8 	(d) Dimension 3: Emotional, behavioral, and cognitive conditions and complications. 
104.9 	The vendor must use the following criteria in Dimension 3 to determine a client's emotional, 
104.10 	behavioral, and cognitive conditions and complications; the degree to which any condition 
104.11 	or complication is likely to interfere with treatment for substance use or with functioning 
104.12 	in significant life areas; and the likelihood of harm to self or others.
104.13 	"0" The client has good impulse control and coping skills and presents no risk of harm 
104.14 	to self or others. The client functions in all life areas and displays no emotional, behavioral, 
104.15 	or cognitive problems or the problems are stable.
104.16 	"1" The client has impulse control and coping skills. The client presents a mild to 
104.17 	moderate risk of harm to self or others or displays symptoms of emotional, behavioral, or 
104.18 	cognitive problems. The client has a mental health diagnosis and is stable. The client 
104.19 	functions adequately in significant life areas.
104.20 	"2" The client has difficulty with impulse control and lacks coping skills. The client has 
104.21 	thoughts of suicide or harm to others without means, however, the thoughts may interfere 
104.22 	with participation in some activities. The client has difficulty functioning in significant life 
104.23 	areas. The client has moderate symptoms of emotional, behavioral, or cognitive problems. 
104.24 	The client is able to participate in most treatment activities.
104.25 	"3" The client has a severe lack of impulse control and coping skills. The client also has 
104.26 	frequent thoughts of suicide or harm to others including a plan and the means to carry out 
104.27 	the plan. In addition, the client is severely impaired in significant life areas and has severe 
104.28 	symptoms of emotional, behavioral, or cognitive problems that interfere with the client's 
104.29 	participation in treatment activities.
104.30 	"4" The client has severe emotional or behavioral symptoms that place the client or 
104.31 	others at acute risk of harm. The client also has intrusive thoughts of harming self or others. 
104.32 	The client is unable to participate in treatment activities.
105.1 	(e) Dimension 4: Readiness for change. The vendor must use the following criteria in 
105.2 	Dimension 4 to determine a client's readiness for change and the support necessary to keep 
105.3 	the client involved in treatment services.
105.4 	"0" The client admits problems and is cooperative, motivated, ready to change, committed 
105.5 	to change, and engaged in treatment as a responsible participant.
105.6 	"1" The client is motivated with active reinforcement to explore treatment and strategies 
105.7 	for change but ambivalent about illness or need for change.
105.8 	"2" The client displays verbal compliance but lacks consistent behaviors, has low 
105.9 	motivation for change, and is passively involved in treatment.
105.10 	"3" The client displays inconsistent compliance, displays minimal awareness of either 
105.11 	the client's addiction or mental disorder, and is minimally cooperative.
105.12 	"4" The client is:
105.13 	(i) noncompliant with treatment and has no awareness of addiction or mental disorder 
105.14 	and does not want or is unwilling to explore change or is in total denial of the client's illness 
105.15 	and its implications; or
105.16 	(ii) the client is dangerously oppositional to the extent that the client is a threat of 
105.17 	imminent harm to self and others.
105.18 	(f) Dimension 5: Relapse, continued use, and continued problem potential. The vendor 
105.19 	must use the following criteria in Dimension 5 to determine a client's relapse, continued 
105.20 	use, and continued problem potential and the degree to which the client recognizes relapse 
105.21 	issues and has the skills to prevent relapse of either substance use or mental health problems.
105.22 	"0" The client recognizes risk well and is able to manage potential problems.
105.23 	"1" The client recognizes relapse issues and prevention strategies but displays some 
105.24 	vulnerability for further substance use or mental health problems.
105.25 	"2" The client has:
105.26 	(i) minimal recognition and understanding of relapse and recidivism issues and displays 
105.27 	moderate vulnerability for further substance use or mental health problems; or
105.28 	(ii) some coping skills inconsistently applied.
105.29 	"3" The client has poor recognition and understanding of relapse and recidivism issues 
105.30 	and displays moderately high vulnerability for further substance use or mental health 
105.31 	problems. The client has few coping skills and rarely applies coping skills.
106.1 	"4" The client has no coping skills to arrest mental health or addiction illnesses or prevent 
106.2 	relapse. The client has no recognition or understanding of relapse and recidivism issues and 
106.3 	displays high vulnerability for further substance use disorder or mental health problems.
106.4 	(g) Dimension 6: Recovery environment. The vendor must use the following criteria in 
106.5 	Dimension 6 to determine a client's recovery environment, whether the areas of the client's 
106.6 	life are supportive of or antagonistic to treatment participation and recovery.
106.7 	"0" The client is engaged in structured meaningful activity and has a supportive significant 
106.8 	other, family, and living environment.
106.9 	"1" The client has passive social network support, or family and significant other are 
106.10 	not interested in the client's recovery. The client is engaged in structured meaningful activity.
106.11 	"2" The client is engaged in structured, meaningful activity, but peers, family, significant 
106.12 	other, and living environment are unsupportive, or there is criminal justice involvement by 
106.13 	the client or among the client's peers, by a significant other, or in the client's living 
106.14 	environment.
106.15 	"3" The client is not engaged in structured meaningful activity, and the client's peers, 
106.16 	family, significant other, and living environment are unsupportive, or there is significant 
106.17 	criminal justice system involvement.
106.18 	"4" The client has:
106.19 	(i) a chronically antagonistic significant other, living environment, family, or peer group 
106.20 	or a long-term criminal justice involvement that is harmful to recovery or treatment progress; 
106.21 	or
106.22 	(ii) an actively antagonistic significant other, family, work, or living environment that 
106.23 	poses an immediate threat to the client's safety and well-being.

106.24 	Sec. 23. Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:
106.25 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
106.26 	use disorder services and service enhancements funded under this chapter.
106.27 	(b) Eligible substance use disorder treatment services include:
106.28 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
106.29 	245G.17, or applicable tribal license; those licensed, as applicable, according to chapter 
106.30 	245G or applicable Tribal license and provided according to the following ASAM levels 
106.31 	of care:
107.1 	(i) ASAM level 0.5 early intervention services provided according to section 254B.19, 
107.2 	subdivision 1, clause (1);
107.3 	(ii) ASAM level 1.0 outpatient services provided according to section 254B.19, 
107.4 	subdivision 1, clause (2);
107.5 	(iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19, 
107.6 	subdivision 1, clause (3);
107.7 	(iv) ASAM level 2.5 partial hospitalization services provided according to section 
107.8 	254B.19, subdivision 1, clause (4);
107.9 	(v) ASAM level 3.1 clinically managed low-intensity residential services provided 
107.10 	according to section 254B.19, subdivision 1, clause (5);
107.11 	(vi) ASAM level 3.3 clinically managed population-specific high-intensity residential 
107.12 	services provided according to section 254B.19, subdivision 1, clause (6); and
107.13 	(vii) ASAM level 3.5 clinically managed high-intensity residential services provided 
107.14 	according to section 254B.19, subdivision 1, clause (7);
107.15 	(2) comprehensive assessments provided according to sections 245.4863, paragraph (a), 
107.16 	and 245G.05;
107.17 	(3) care treatment coordination services provided according to section 245G.07, 
107.18 	subdivision 1, paragraph (a), clause (5);
107.19 	(4) peer recovery support services provided according to section 245G.07, subdivision 
107.20 	2, clause (8);
107.21 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
107.22 	services provided according to chapter 245F;
107.23 	(6) substance use disorder treatment services with medications for opioid use disorder 
107.24 	that are provided in an opioid treatment program licensed according to sections 245G.01 
107.25 	to 245G.17 and 245G.22, or applicable tribal license;
107.26 	(7) substance use disorder treatment with medications for opioid use disorder plus 
107.27 	enhanced treatment services that meet the requirements of clause (6) and provide nine hours 
107.28 	of clinical services each week;
107.29 	(8) high, medium, and low intensity residential treatment services that are licensed 
107.30 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
107.31 	provide, respectively, 30, 15, and five hours of clinical services each week;
108.1 	(9) (7) hospital-based treatment services that are licensed according to sections 245G.01
108.2 	to 245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
108.3 	144.56;
108.4 	(10) (8) adolescent treatment programs that are licensed as outpatient treatment programs 
108.5 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
108.6 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
108.7 	applicable tribal license;
108.8 	(11) high-intensity residential treatment (9) ASAM 3.5 clinically managed high-intensity 
108.9 	residential services that are licensed according to sections 245G.01 to 245G.17 and 245G.21
108.10 	or applicable tribal license, which provide 30 hours of clinical services each week ASAM 
108.11 	level of care 3.5 according to section 254B.19, subdivision 1, clause (7), and is provided 
108.12 	by a state-operated vendor or to clients who have been civilly committed to the commissioner, 
108.13 	present the most complex and difficult care needs, and are a potential threat to the community; 
108.14 	and
108.15 	(12) (10) room and board facilities that meet the requirements of subdivision 1a.
108.16 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
108.17 	of paragraph (b) and one of the following additional requirements:
108.18 	(1) programs that serve parents with their children if the program:
108.19 	(i) provides on-site child care during the hours of treatment activity that:
108.20 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
108.21 	9503; or
108.22 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
108.23 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
108.24 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
108.25 	licensed under chapter 245A as:
108.26 	(A) a child care center under Minnesota Rules, chapter 9503; or
108.27 	(B) a family child care home under Minnesota Rules, chapter 9502;
108.28 	(2) culturally specific or culturally responsive programs as defined in section 254B.01, 
108.29 	subdivision 4a;
108.30 	(3) disability responsive programs as defined in section 254B.01, subdivision 4b;
109.1 	(4) programs that offer medical services delivered by appropriately credentialed health 
109.2 	care staff in an amount equal to two hours per client per week if the medical needs of the 
109.3 	client and the nature and provision of any medical services provided are documented in the 
109.4 	client file; or
109.5 	(5) programs that offer services to individuals with co-occurring mental health and 
109.6 	substance use disorder problems if:
109.7 	(i) the program meets the co-occurring requirements in section 245G.20;
109.8 	(ii) 25 percent of the counseling staff are licensed mental health professionals under 
109.9 	section 245I.04, subdivision 2, or are students or licensing candidates under the supervision 
109.10 	of a licensed alcohol and drug counselor supervisor and mental health professional under 
109.11 	section 245I.04, subdivision 2, except that no more than 50 percent of the mental health 
109.12 	staff may be students or licensing candidates with time documented to be directly related 
109.13 	to provisions of co-occurring services;
109.14 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
109.15 	health diagnostic assessment within ten days of admission;
109.16 	(iv) the program has standards for multidisciplinary case review that include a monthly 
109.17 	review for each client that, at a minimum, includes a licensed mental health professional 
109.18 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
109.19 	(v) family education is offered that addresses mental health and substance use disorder 
109.20 	and the interaction between the two; and
109.21 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
109.22 	training annually.
109.23 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
109.24 	that provides arrangements for off-site child care must maintain current documentation at 
109.25 	the substance use disorder facility of the child care provider's current licensure to provide 
109.26 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
109.27 	must be deemed in compliance with the licensing requirements in section 245G.19.
109.28 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
109.29 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
109.30 	in paragraph (c), clause (4), items (i) to (iv).
109.31 	(f) Subject to federal approval, substance use disorder services that are otherwise covered 
109.32 	as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, 
109.33 	subdivision 3b. The use of telehealth to deliver services must be medically appropriate to 
110.1 	the condition and needs of the person being served. Reimbursement shall be at the same 
110.2 	rates and under the same conditions that would otherwise apply to direct face-to-face services.
110.3 	(g) For the purpose of reimbursement under this section, substance use disorder treatment 
110.4 	services provided in a group setting without a group participant maximum or maximum 
110.5 	client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one. 
110.6 	At least one of the attending staff must meet the qualifications as established under this 
110.7 	chapter for the type of treatment service provided. A recovery peer may not be included as 
110.8 	part of the staff ratio.
110.9 	(h) Payment for outpatient substance use disorder services that are licensed according 
110.10 	to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless 
110.11 	prior authorization of a greater number of hours is obtained from the commissioner.
110.12 	(i) Payment for substance use disorder services under this section must start from the 
110.13 	day of service initiation, when the comprehensive assessment is completed within the 
110.14 	required timelines.

110.15 	EFFECTIVE DATE. Paragraph (b), clause (1), items (i) to (iv), are effective January 
110.16 	1, 2025, or upon federal approval, whichever is later. Paragraph (b), clause (1), items (v) 
110.17 	to (vii), are effective January 1, 2024, or upon federal approval, whichever is later. Paragraph 
110.18 	(b), clauses (2) to (10), are effective January 1, 2024.

110.19 	Sec. 24. [254B.17] WITHDRAWAL MANAGEMENT START-UP AND 
110.20 	CAPACITY-BUILDING GRANTS.
110.21 	The commissioner must establish start-up and capacity-building grants for prospective 
110.22 	or new withdrawal management programs licensed under chapter 245F that will meet 
110.23 	medically monitored or clinically monitored levels of care. Grants may be used for expenses 
110.24 	that are not reimbursable under Minnesota health care programs, including but not limited 
110.25 	to:
110.26 	(1) costs associated with hiring staff;
110.27 	(2) costs associated with staff retention;
110.28 	(3) the purchase of office equipment and supplies;
110.29 	(4) the purchase of software;
110.30 	(5) costs associated with obtaining applicable and required licenses;
110.31 	(6) business formation costs;
111.1 	(7) costs associated with staff training; and
111.2 	(8) the purchase of medical equipment and supplies necessary to meet health and safety 
111.3 	requirements.

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

111.5 	Sec. 25. [254B.18] SOBER HOMES.
111.6 		Subdivision 1.Requirements. All sober homes must comply with applicable state laws 
111.7 	and regulations and local ordinances related to maximum occupancy, fire safety, and 
111.8 	sanitation. All sober homes must register with the Department of Human Services. In 
111.9 	addition, all sober homes must:
111.10 	(1) maintain a supply of an opiate antagonist in the home;
111.11 	(2) have trained staff that can administer an opiate antagonist;
111.12 	(3) have written policies regarding access to all prescribed medications;
111.13 	(4) have written policies regarding evictions;
111.14 	(5) have staff training and policies regarding co-occurring mental illnesses;
111.15 	(6) not prohibit prescribed medications taken as directed by a licensed prescriber, such 
111.16 	as pharmacotherapies specifically approved by the Food and Drug Administration (FDA) 
111.17 	for treatment of opioid use disorder and other medications with FDA-approved indications 
111.18 	for the treatment of co-occurring disorders; and
111.19 	(7) return all property and medications to a person discharged from the home and retain 
111.20 	the items for a minimum of 60 days if the person did not collect them upon discharge. The 
111.21 	owner must make every effort to contact persons listed as emergency contacts for the 
111.22 	discharged person so that the items are returned.
111.23 		Subd. 2.Certification. (a) The commissioner shall establish a certification program for 
111.24 	sober homes. Certification is mandatory for sober homes receiving any federal, state, or 
111.25 	local funding. The certification requirements must include:
111.26 	(1) health and safety standards, including separate sleeping and bathroom facilities for 
111.27 	people who identify as men and people who identify as women, written policies on how to 
111.28 	accommodate residents who do not identify as a man or woman, and verification that the 
111.29 	home meets fire and sanitation ordinances;
111.30 	(2) intake admission procedures, including documentation of names and contact 
111.31 	information for persons to contact in case of an emergency or upon discharge and notification 
112.1 	of a family member, or other emergency contact designated by the resident under certain 
112.2 	circumstances, including but not limited to death due to an overdose;
112.3 	(3) an assessment of potential resident needs and appropriateness of the residence to 
112.4 	meet these needs;
112.5 	(4) a resident bill of rights, including a right to a refund if discharged;
112.6 	(5) policies to address mental health and health emergencies, to prevent a person from 
112.7 	hurting themselves or others, including contact information for emergency resources in the 
112.8 	community;
112.9 	(6) policies on staff qualifications and prohibition against fraternization;
112.10 	(7) drug-testing procedures and requirements;
112.11 	(8) policies to mitigate medication misuse, including policies for:
112.12 	(i) securing medication;
112.13 	(ii) house staff providing medication at specified times to residents;
112.14 	(iii) medication counts with staff and residents;
112.15 	(iv) storing and providing prescribed medications and documenting when a person 
112.16 	accesses their prescribed medications; and
112.17 	(v) ensuring that medications cannot be accessed by other residents;
112.18 	(9) a policy on medications for opioid use disorder;
112.19 	(10) having an opiate antagonist on site and in a conspicuous location;
112.20 	(11) prohibiting charging exorbitant fees above standard costs for lab tests;
112.21 	(12) discharge procedures, including involuntary discharge procedures that ensure at 
112.22 	least a 24-hours notice prior to filing an eviction action. The notice must include the reasons 
112.23 	for the involuntary discharge and a warning that an eviction action may become public as 
112.24 	soon as it is filed, making finding future housing more difficult;
112.25 	(13) a policy on referrals to substance use disorder treatment services, mental health 
112.26 	services, peer support services, and support groups;
112.27 	(14) training for staff on opiate antagonists, mental health crises, de-escalation, 
112.28 	person-centered planning, creating a crisis plan, and becoming a culturally informed and 
112.29 	responsive sober home;
112.30 	(15) a fee schedule and refund policy;
113.1 	(16) copies of all forms provided to residents;
113.2 	(17) rules for residents;
113.3 	(18) background checks of staff and administrators;
113.4 	(19) policies that promote recovery by requiring resident participation in treatment, 
113.5 	self-help groups or other recovery supports; and
113.6 	(20) policies requiring abstinence from alcohol and illicit drugs.
113.7 	(b) Certifications must be renewed every three years.
113.8 		Subd. 3.Registry. The commissioner shall create a registry containing a listing of sober 
113.9 	homes that have met the certification requirements. The registry must include each sober 
113.10 	home city and zip code, maximum resident capacity, and whether the setting serves a specific 
113.11 	population based on race, ethnicity, national origin, sexual orientation, gender identity, or 
113.12 	physical ability.
113.13 		Subd. 4.Bill of rights. An individual living in a sober home has the right to:
113.14 	(1) access to an environment that supports recovery;
113.15 	(2) access to an environment that is safe and free from alcohol and other illicit drugs or 
113.16 	substances;
113.17 	(3) be free from physical and verbal abuse, neglect, financial exploitation, and all forms 
113.18 	of maltreatment covered under the Vulnerable Adults Act, sections 626.557 to 626.5572;
113.19 	(4) be treated with dignity and respect and to have personal property treated with respect;
113.20 	(5) have personal, financial, and medical information kept private and to be advised of 
113.21 	the sober home's policies and procedures regarding disclosure of such information;
113.22 	(6) access, while living in the residence, to other community-based support services as 
113.23 	needed;
113.24 	(7) be referred to appropriate services upon leaving the residence, if necessary;
113.25 	(8) retain personal property that does not jeopardize safety or health;
113.26 	(9) assert these rights personally or have them asserted by the individual's representative 
113.27 	or by anyone on behalf of the individual without retaliation;
113.28 	(10) be provided with the name, address, and telephone number of the ombudsman for 
113.29 	mental health, substance use disorder, and developmental disabilities and information about 
113.30 	the right to file a complaint;
114.1 	(11) be fully informed of these rights and responsibilities, as well as program policies 
114.2 	and procedures; and
114.3 	(12) not be required to perform services for the residence that are not included in the 
114.4 	usual expectations for all residents.
114.5 		Subd. 5.Private right of action. In addition to pursuing other remedies, an individual 
114.6 	may bring an action to recover damages caused by a violation of this section. The court 
114.7 	shall award a resident who prevails in an action under this section double damages, costs, 
114.8 	disbursements, reasonable attorney fees, and any equitable relief the court deems appropriate.
114.9 		Subd. 6.Complaints; ombudsman for mental health and developmental 
114.10 	disabilities. Any complaints about a sober home may be made to and reviewed or 
114.11 	investigated by the ombudsman for mental health and developmental disabilities, pursuant 
114.12 	to sections 245.91 and 245.94.

114.13 	Sec. 26. [254B.19] AMERICAN SOCIETY OF ADDICTION MEDICINE 
114.14 	STANDARDS OF CARE.
114.15 		Subdivision 1.Level of care requirements. For each client assigned an ASAM level 
114.16 	of care, eligible vendors must implement the standards set by the ASAM for the respective 
114.17 	level of care. Additionally, vendors must meet the following requirements:
114.18 	(1) for ASAM level 0.5 early intervention targeting individuals who are at risk of 
114.19 	developing a substance-related problem but may not have a diagnosed substance use disorder, 
114.20 	early intervention services may include individual or group counseling, treatment 
114.21 	coordination, peer recovery support, screening brief intervention, and referral to treatment 
114.22 	provided according to section 254A.03, subdivision 3, paragraph (c).
114.23 	(2) for ASAM level 1.0 outpatient clients, adults must receive up to eight hours per week 
114.24 	of skilled treatment services and adolescents must receive up to five hours per week. Services 
114.25 	must be licensed according to section 245G.20 and meet requirements under section 
114.26 	256B.0759. Peer recovery and treatment coordination may be provided beyond the hourly 
114.27 	skilled treatment service hours allowable per week.
114.28 	(3) for ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours 
114.29 	per week of skilled treatment services and adolescents must receive six or more hours per 
114.30 	week. Vendors must be licensed according to section 245G.20 and must meet requirements 
114.31 	under section 256B.0759. Peer recovery services and treatment coordination may be provided 
114.32 	beyond the hourly skilled treatment service hours allowable per week. If clinically indicated 
115.1 	on the client's treatment plan, this service may be provided in conjunction with room and 
115.2 	board according to section 254B.05, subdivision 1a.
115.3 	(4) for ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or 
115.4 	more of skilled treatment services. Services must be licensed according to section 245G.20 
115.5 	and must meet requirements under section 256B.0759. Level 2.5 is for clients who need 
115.6 	daily monitoring in a structured setting, as directed by the individual treatment plan and in 
115.7 	accordance with the limitations in section 254B.05, subdivision 5, paragraph (h). If clinically 
115.8 	indicated on the client's treatment plan, this service may be provided in conjunction with 
115.9 	room and board according to section 254B.05, subdivision 1a.
115.10 	(5) for ASAM level 3.1 clinically managed low-intensity residential clients, programs 
115.11 	must provide at least 5 hours of skilled treatment services per week according to each client's 
115.12 	specific treatment schedule, as directed by the individual treatment plan. Programs must be 
115.13 	licensed according to section 245G.20 and must meet requirements under section 256B.0759.
115.14 	(6) for ASAM level 3.3 clinically managed population-specific high-intensity residential 
115.15 	clients, programs must be licensed according to section 245G.20 and must meet requirements 
115.16 	under section 256B.0759. Programs must have 24-hour staffing coverage. Programs must 
115.17 	be enrolled as a disability responsive program as described in section 254B.01, subdivision 
115.18 	4b, and must specialize in serving persons with a traumatic brain injury or a cognitive 
115.19 	impairment so significant, and the resulting level of impairment so great, that outpatient or 
115.20 	other levels of residential care would not be feasible or effective. Programs must provide, 
115.21 	at minimum, daily skilled treatment services seven days a week according to each client's 
115.22 	specific treatment schedule, as directed by the individual treatment plan.
115.23 	(7) for ASAM level 3.5 clinically managed high-intensity residential clients, services 
115.24 	must be licensed according to section 245G.20 and must meet requirements under section 
115.25 	256B.0759. Programs must have 24-hour staffing coverage and provide, at minimum, daily 
115.26 	skilled treatment services seven days a week according to each client's specific treatment 
115.27 	schedule, as directed by the individual treatment plan.
115.28 	(8) for ASAM level withdrawal management 3.2 clinically managed clients, withdrawal 
115.29 	management must be provided according to chapter 245F.
115.30 	(9) for ASAM level withdrawal management 3.7 medically monitored clients, withdrawal 
115.31 	management must be provided according to chapter 245F.
115.32 		Subd. 2.Patient referral arrangement agreement. The license holder must maintain 
115.33 	documentation of a formal patient referral arrangement agreement for each of the following 
115.34 	ASAM levels of care not provided by the license holder:
116.1 	(1) level 1.0 outpatient;
116.2 	(2) level 2.1 intensive outpatient;
116.3 	(3) level 2.5 partial hospitalization;
116.4 	(4) level 3.1 clinically managed low-intensity residential;
116.5 	(5) level 3.3 clinically managed population-specific high-intensity residential;
116.6 	(6) level 3.5 clinically managed high-intensity residential;
116.7 	(7) level withdrawal management 3.2 clinically managed residential withdrawal 
116.8 	management; and
116.9 	(8) level withdrawal management 3.7 medically monitored inpatient withdrawal 
116.10 	management.
116.11 		Subd. 3.Evidence-based practices. All services delivered within the ASAM levels of 
116.12 	care referenced in subdivision 1, clauses (1) to (7), must have documentation of the 
116.13 	evidence-based practices being utilized as referenced in the most current edition of the 
116.14 	ASAM criteria.
116.15 		Subd. 4.Program outreach plan. Eligible vendors providing services under ASAM 
116.16 	levels of care referenced in subdivision 1, clauses (2) to (7), must have a program outreach 
116.17 	plan. The treatment director must document a review and update the plan annually. The 
116.18 	program outreach plan must include treatment coordination strategies and processes to 
116.19 	ensure seamless transitions across the continuum of care. The plan must include how the 
116.20 	provider will:
116.21 	(1) increase the awareness of early intervention treatment services, including but not 
116.22 	limited to the services defined in section 254A.03, subdivision 3, paragraph (c);
116.23 	(2) coordinate, as necessary, with certified community behavioral health clinics when 
116.24 	a license holder is located in a geographic region served by a certified community behavioral 
116.25 	health clinic;
116.26 	(3) establish a referral arrangement agreement with a withdrawal management program 
116.27 	licensed under chapter 245F when a license holder is located in a geographic region in which 
116.28 	a withdrawal management program is licensed under chapter 245F. If a withdrawal 
116.29 	management program licensed under chapter 245F is not geographically accessible, the 
116.30 	plan must include how the provider will address the client's need for this level of care;
116.31 	(4) coordinate with inpatient acute care hospitals, including emergency departments, 
116.32 	hospital outpatient clinics, urgent care centers, residential crisis settings, medical 
117.1 	detoxification inpatient facilities and ambulatory detoxification providers in the area served 
117.2 	by the provider to help transition individuals from emergency department or hospital settings 
117.3 	and minimize the time between assessment and treatment;
117.4 	(5) develop and maintain collaboration with local county and Tribal human services 
117.5 	agencies; and
117.6 	(6) collaborate with primary care and mental health settings.

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

117.8 	Sec. 27. Minnesota Statutes 2022, section 256B.0759, subdivision 2, is amended to read:
117.9 		Subd. 2.Provider participation. (a) Outpatient Programs licensed by the Department 
117.10 	of Human Services as nonresidential substance use disorder treatment providers may elect 
117.11 	to participate in the demonstration project and meet the requirements of subdivision 3. To 
117.12 	participate, a provider must notify the commissioner of the provider's intent to participate 
117.13 	in a format required by the commissioner and enroll as a demonstration project provider
117.14 	programs that receive payment under this chapter must enroll as demonstration project 
117.15 	providers and meet the requirements of subdivision 3 by January 1, 2025. Programs that do 
117.16 	not meet the requirements of this paragraph are ineligible for payment for services provided 
117.17 	under section 256B.0625.
117.18 	(b) Programs licensed by the Department of Human Services as residential treatment 
117.19 	programs according to section 245G.21 that receive payment under this chapter must enroll 
117.20 	as demonstration project providers and meet the requirements of subdivision 3 by January 
117.21 	1, 2024. Programs that do not meet the requirements of this paragraph are ineligible for 
117.22 	payment for services provided under section 256B.0625.
117.23 	(c) Programs licensed by the Department of Human Services as residential treatment 
117.24 	programs according to section 245G.21 that receive payment under this chapter and are 
117.25 	licensed as a hospital under sections 144.50 to 144.581 must enroll as demonstration project 
117.26 	providers and meet the requirements of subdivision 3 by January 1, 2025.
117.27 	(c) (d) Programs licensed by the Department of Human Services as withdrawal 
117.28 	management programs according to chapter 245F that receive payment under this chapter 
117.29 	must enroll as demonstration project providers and meet the requirements of subdivision 3 
117.30 	by January 1, 2024. Programs that do not meet the requirements of this paragraph are 
117.31 	ineligible for payment for services provided under section 256B.0625.
117.32 	(d) (e) Out-of-state residential substance use disorder treatment programs that receive 
117.33 	payment under this chapter must enroll as demonstration project providers and meet the 
118.1 	requirements of subdivision 3 by January 1, 2024. Programs that do not meet the requirements 
118.2 	of this paragraph are ineligible for payment for services provided under section 256B.0625.
118.3 	(e) (f) Tribally licensed programs may elect to participate in the demonstration project 
118.4 	and meet the requirements of subdivision 3. The Department of Human Services must 
118.5 	consult with Tribal nations to discuss participation in the substance use disorder 
118.6 	demonstration project.
118.7 	(f) (g) The commissioner shall allow providers enrolled in the demonstration project 
118.8 	before July 1, 2021, to receive applicable rate enhancements authorized under subdivision 
118.9 	4 for all services provided on or after the date of enrollment, except that the commissioner 
118.10 	shall allow a provider to receive applicable rate enhancements authorized under subdivision 
118.11 	4 for services provided on or after July 22, 2020, to fee-for-service enrollees, and on or after 
118.12 	January 1, 2021, to managed care enrollees, if the provider meets all of the following 
118.13 	requirements:
118.14 	(1) the provider attests that during the time period for which the provider is seeking the 
118.15 	rate enhancement, the provider took meaningful steps in their plan approved by the 
118.16 	commissioner to meet the demonstration project requirements in subdivision 3; and
118.17 	(2) the provider submits attestation and evidence, including all information requested 
118.18 	by the commissioner, of meeting the requirements of subdivision 3 to the commissioner in 
118.19 	a format required by the commissioner.
118.20 	(g) (h) The commissioner may recoup any rate enhancements paid under paragraph (f)
118.21 	(g) to a provider that does not meet the requirements of subdivision 3 by July 1, 2021.

118.22 	Sec. 28. EVIDENCE-BASED TRAINING.
118.23 	The commissioner of human services must establish training opportunities for substance 
118.24 	use disorder treatment providers under Minnesota Statutes, chapters 245F and 245G, and 
118.25 	applicable Tribal licenses, to increase knowledge and develop skills to adopt evidence-based 
118.26 	and promising practices in substance use disorder treatment programs. Training opportunities 
118.27 	must support the transition to American Society of Addiction Medicine (ASAM) standards. 
118.28 	Training formats may include self or organizational assessments, virtual modules, one-to-one 
118.29 	coaching, self-paced courses, interactive hybrid courses, and in-person courses. Foundational 
118.30 	and skill-building training topics may include:
118.31 	(1) ASAM criteria;
118.32 	(2) person-centered and culturally responsive services;
119.1 	(3) medical and clinical decision making;
119.2 	(4) conducting assessments and appropriate level of care;
119.3 	(5) treatment and service planning;
119.4 	(6) identifying and overcoming systems challenges;
119.5 	(7) conducting clinical case reviews; and
119.6 	(8) appropriate and effective transfer and discharge.

119.7 	Sec. 29. FAMILY TREATMENT START-UP AND CAPACITY-BUILDING 
119.8 	GRANTS.
 119.9 	The commissioner of human services must establish start-up and capacity-building grants 
119.10 	for prospective or new substance use disorder treatment programs that serve parents with 
119.11 	their children. Grants must be used for expenses that are not reimbursable under Minnesota 
119.12 	health care programs, including but not limited to:
119.13 	(1) physical plant upgrades to support larger family units;
119.14 	(2) supporting the expansion or development of programs that provide holistic services, 
119.15 	including trauma supports, conflict resolution, and parenting skills;
119.16 	(3) increasing awareness, education, and outreach utilizing culturally responsive 
119.17 	approaches to develop relationships between culturally specific communities and clinical 
119.18 	treatment provider programs; and
119.19 	(4) expanding culturally specific family programs and accommodating diverse family 
119.20 	units.

119.21 	Sec. 30. SAFE RECOVERY SITES START-UP AND CAPACITY-BUILDING 
119.22 	GRANTS.
 119.23 	(a) The commissioner of human services must establish start-up and capacity-building 
119.24 	grants for current or prospective harm reduction organizations to promote health, wellness, 
119.25 	safety, and recovery to people who are in active stages of substance use disorder. Grants 
119.26 	must be used to establish safe recovery sites that offer harm reduction services and supplies, 
119.27 	including but not limited to:
119.28 	(1) safe injection spaces;
119.29 	(2) sterile needle exchange;
119.30 	(3) opiate antagonist rescue kits;
120.1 	(4) fentanyl and other drug testing;
120.2 	(5) street outreach;
120.3 	(6) educational and referral services;
120.4 	(7) health, safety, and wellness services; and
120.5 	(8) access to hygiene and sanitation.
120.6 	(b) The commissioner must conduct local community outreach and engagement in 
120.7 	collaboration with newly established safe recovery sites. The commissioner must evaluate 
120.8 	the efficacy of safe recovery sites and collect data to measure health-related and public 
120.9 	safety outcomes.
120.10 	(c) The commissioner must prioritize grant applications for organizations that are 
120.11 	culturally specific or culturally responsive and that commit to serving individuals from 
120.12 	communities that are disproportionately impacted by the opioid epidemic, including:
120.13 	(1) Native American, American Indian, and Indigenous communities; and
120.14 	(2) Black, African American, and African-born communities.
120.15 	(d) For purposes of this section, a "culturally specific" or "culturally responsive" 
120.16 	organization is an organization that is designed to address the unique needs of individuals 
120.17 	who share a common language, racial, ethnic, or social background, and is governed with 
120.18 	significant input from individuals of that specific background.

120.19 	Sec. 31. PUBLIC AWARENESS CAMPAIGN.
120.20 	(a) The commissioner of human services must establish a multitiered public awareness 
120.21 	and educational campaign on substance use disorders. The campaign must include strategies 
120.22 	to prevent substance use disorder, reduce stigma, and ensure people know how to access 
120.23 	treatment, recovery, and harm reduction services.
120.24 	(b) The commissioner must consult with communities disproportionately impacted by 
120.25 	substance use disorder to ensure the campaign focuses on lived experience and equity. The 
120.26 	commissioner may also consult and establish relationships with media and communication 
120.27 	experts, behavioral health professionals, state and local agencies, and community 
120.28 	organizations to design and implement the campaign.
120.29 	(c) The campaign must include awareness-raising and educational information using 
120.30 	multichannel marketing strategies, social media, virtual events, press releases, reports, and 
121.1 	targeted outreach. The commissioner must evaluate the effectiveness of the campaign and 
121.2 	modify outreach and strategies as needed.

121.3 	Sec. 32. REVISED PAYMENT METHODOLOGY FOR OPIOID TREATMENT 
121.4 	PROGRAMS.
 121.5 	The commissioner of human services must revise the payment methodology for substance 
121.6 	use services with medications for opioid use disorder under Minnesota Statutes, section 
121.7 	254B.05, subdivision 5, paragraph (b), clause (6). Payment must occur only if the provider 
121.8 	renders the service or services billed on that date of service or, in the case of drugs and 
121.9 	drug-related services, within a week as defined by the commissioner. The revised payment 
121.10 	methodology must include a weekly bundled rate that includes the costs of drugs, drug 
121.11 	administration and observation, drug packaging and preparation, and nursing time. The 
121.12 	bundled weekly rate must be based on the Medicare rate. The commissioner must seek all 
121.13 	necessary waivers, state plan amendments, and federal authorities required to implement 
121.14 	the revised payment methodology.

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 federal approval is obtained.

121.18 	Sec. 33. MEDICAL ASSISTANCE BEHAVIORAL HEALTH SYSTEM 
121.19 	TRANSFORMATION STUDY.
 121.20 	The commissioner of human services, in consultation with stakeholders, must evaluate 
121.21 	the feasibility, potential design, and federal authorities needed to cover traditional healing, 
121.22 	behavioral health services in correctional facilities, and contingency management under the 
121.23 	medical assistance program.

121.24 	Sec. 34. OPIOID TREATMENT PROGRAM WORK GROUP.
 121.25 	The commissioner of human services must convene a work group of community partners 
121.26 	to evaluate the opioid treatment program model under Minnesota Statutes, section 245G.22, 
121.27 	and to make recommendations on overall service design; simplification or improvement of 
121.28 	regulatory oversight; increasing access to opioid treatment programs and improving the 
121.29 	quality of care; addressing geographic, racial, and justice-related disparities for individuals 
121.30 	who utilize or may benefit from medications for opioid use disorder; and other related topics, 
121.31 	as determined by the work group. The commissioner must report the work group's 
122.1 	recommendations to the chairs and ranking minority members of the legislative committees 
122.2 	with jurisdiction over health and human services by January 15, 2024.

122.3 	Sec. 35. REVISOR INSTRUCTION.
 122.4 	The revisor of statutes shall renumber Minnesota Statutes, section 245G.01, subdivision 
122.5 	20b, as Minnesota Statutes, section 245G.01, subdivision 20d, and make any other necessary 
122.6 	changes to subdivision numbers or cross-references.

122.7 	Sec. 36. REPEALER.
 122.8 	(a) Minnesota Statutes 2022, sections 245G.06, subdivision 2; and 256B.0759, subdivision 
122.9 	6, are repealed.
122.10 	(b) Minnesota Statutes 2022, section 246.18, subdivisions 2 and 2a, are repealed.

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

122.13 	ARTICLE 4
122.14 	OPIOID OVERDOSE PREVENTION AND OPIATE EPIDEMIC RESPONSE

122.15 	Section 1. Minnesota Statutes 2022, section 16A.151, subdivision 2, is amended to read:
122.16 		Subd. 2.Exceptions. (a) If a state official litigates or settles a matter on behalf of specific 
122.17 	injured persons or entities, this section does not prohibit distribution of money to the specific 
122.18 	injured persons or entities on whose behalf the litigation or settlement efforts were initiated. 
122.19 	If money recovered on behalf of injured persons or entities cannot reasonably be distributed 
122.20 	to those persons or entities because they cannot readily be located or identified or because 
122.21 	the cost of distributing the money would outweigh the benefit to the persons or entities, the 
122.22 	money must be paid into the general fund.
122.23 	(b) Money recovered on behalf of a fund in the state treasury other than the general fund 
122.24 	may be deposited in that fund.
122.25 	(c) This section does not prohibit a state official from distributing money to a person or 
122.26 	entity other than the state in litigation or potential litigation in which the state is a defendant 
122.27 	or potential defendant.
122.28 	(d) State agencies may accept funds as directed by a federal court for any restitution or 
122.29 	monetary penalty under United States Code, title 18, section 3663(a)(3), or United States 
122.30 	Code, title 18, section 3663A(a)(3). Funds received must be deposited in a special revenue 
123.1 	account and are appropriated to the commissioner of the agency for the purpose as directed 
123.2 	by the federal court.
123.3 	(e) Tobacco settlement revenues as defined in section 16A.98, subdivision 1, paragraph 
123.4 	(t), may be deposited as provided in section 16A.98, subdivision 12.
123.5 	(f) Any money received by the state resulting from a settlement agreement or an assurance 
123.6 	of discontinuance entered into by the attorney general of the state, or a court order in litigation 
123.7 	brought by the attorney general of the state, on behalf of the state or a state agency, related 
123.8 	to alleged violations of consumer fraud laws in the marketing, sale, or distribution of opioids 
123.9 	in this state or other alleged illegal actions that contributed to the excessive use of opioids, 
123.10 	must be deposited in the settlement account established in the opiate epidemic response 
123.11 	fund under section 256.043, subdivision 1. This paragraph does not apply to attorney fees 
123.12 	and costs awarded to the state or the Attorney General's Office, to contract attorneys hired 
123.13 	by the state or Attorney General's Office, or to other state agency attorneys.
123.14 	(g) Notwithstanding paragraph (f), if money is received from a settlement agreement or 
123.15 	an assurance of discontinuance entered into by the attorney general of the state or a court 
123.16 	order in litigation brought by the attorney general of the state on behalf of the state or a state 
123.17 	agency against a consulting firm working for an opioid manufacturer or opioid wholesale 
123.18 	drug distributor, the commissioner shall deposit any money received into the settlement 
123.19 	account established within the opiate epidemic response fund under section 256.042, 
123.20 	subdivision 1. Notwithstanding section 256.043, subdivision 3a, paragraph (a), any amount 
123.21 	deposited into the settlement account in accordance with this paragraph shall be appropriated 
123.22 	to the commissioner of human services to award as grants as specified by the opiate epidemic 
123.23 	response advisory council in accordance with section 256.043, subdivision 3a, paragraph 
123.24 	(d) as specified in section 256.043, subdivision 3a.

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

123.26 	Sec. 2. [121A.224] OPIATE ANTAGONISTS.
123.27 	(a) A school district or charter school must maintain a supply of opiate antagonists, as 
123.28 	defined in section 604A.04, subdivision 1, at each school site to be administered in 
123.29 	compliance with section 151.37, subdivision 12.
123.30 	(b) Each school building must have at least two doses of a nasal opiate antagonist 
123.31 	available on site.
123.32 	(c) The commissioner of health must develop and disseminate to schools a short training 
123.33 	video about how and when to administer a nasal opiate antagonist. The person having control 
124.1 	of the school building must ensure that at least one staff member trained on how and when 
124.2 	to administer a nasal opiate antagonist is on site when the school building is open to students, 
124.3 	staff, or the public, including before school, after school, or during weekend activities.

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

124.5 	Sec. 3. Minnesota Statutes 2022, section 151.065, subdivision 7, is amended to read:
124.6 		Subd. 7.Deposit of fees. (a) The license fees collected under this section, with the 
124.7 	exception of the fees identified in paragraphs (b) and (c), shall be deposited in the state 
124.8 	government special revenue fund.
124.9 	(b) $5,000 of each fee collected under subdivision 1, clauses (6) to (9), and (11) to (15), 
124.10 	and subdivision 3, clauses (4) to (7), and (9) to (13), and $55,000 of each fee collected under 
124.11 	subdivision 1, clause (16), and subdivision 3, clause (14), shall be deposited in the opiate 
124.12 	epidemic response fund established in section 256.043.
124.13 	(c) If the fees collected under subdivision 1, clause (16), or subdivision 3, clause (14), 
124.14 	are reduced under section 256.043, $5,000 of the reduced fee shall be deposited in the opiate 
124.15 	epidemic response fund in section 256.043.

124.16 	Sec. 4. Minnesota Statutes 2022, section 241.021, subdivision 1, is amended to read:
124.17 		Subdivision 1.Correctional facilities; inspection; licensing. (a) Except as provided 
124.18 	in paragraph (b), the commissioner of corrections shall inspect and license all correctional 
124.19 	facilities throughout the state, whether public or private, established and operated for the 
124.20 	detention and confinement of persons confined or incarcerated therein according to law 
124.21 	except to the extent that they are inspected or licensed by other state regulating agencies. 
124.22 	The commissioner shall promulgate pursuant to chapter 14, rules establishing minimum 
124.23 	standards for these facilities with respect to their management, operation, physical condition, 
124.24 	and the security, safety, health, treatment, and discipline of persons confined or incarcerated 
124.25 	therein. These minimum standards shall include but are not limited to specific guidance 
124.26 	pertaining to:
124.27 	(1) screening, appraisal, assessment, and treatment for persons confined or incarcerated 
124.28 	in correctional facilities with mental illness or substance use disorders;
124.29 	(2) a policy on the involuntary administration of medications;
124.30 	(3) suicide prevention plans and training;
124.31 	(4) verification of medications in a timely manner;
125.1 	(5) well-being checks;
125.2 	(6) discharge planning, including providing prescribed medications to persons confined 
125.3 	or incarcerated in correctional facilities upon release;
125.4 	(7) a policy on referrals or transfers to medical or mental health care in a noncorrectional 
125.5 	institution;
125.6 	(8) use of segregation and mental health checks;
125.7 	(9) critical incident debriefings;
125.8 	(10) clinical management of substance use disorders and opioid overdose emergency 
125.9 	procedures;
125.10 	(11) a policy regarding identification of persons with special needs confined or 
125.11 	incarcerated in correctional facilities;
125.12 	(12) a policy regarding the use of telehealth;
125.13 	(13) self-auditing of compliance with minimum standards;
125.14 	(14) information sharing with medical personnel and when medical assessment must be 
125.15 	facilitated;
125.16 	(15) a code of conduct policy for facility staff and annual training;
125.17 	(16) a policy on death review of all circumstances surrounding the death of an individual 
125.18 	committed to the custody of the facility; and
125.19 	(17) dissemination of a rights statement made available to persons confined or 
125.20 	incarcerated in licensed correctional facilities.
125.21 	No individual, corporation, partnership, voluntary association, or other private 
125.22 	organization legally responsible for the operation of a correctional facility may operate the 
125.23 	facility unless it possesses a current license from the commissioner of corrections. Private 
125.24 	adult correctional facilities shall have the authority of section 624.714, subdivision 13, if 
125.25 	the Department of Corrections licenses the facility with the authority and the facility meets 
125.26 	requirements of section 243.52.
125.27 	The commissioner shall review the correctional facilities described in this subdivision 
125.28 	at least once every two years, except as otherwise provided, to determine compliance with 
125.29 	the minimum standards established according to this subdivision or other Minnesota statute 
125.30 	related to minimum standards and conditions of confinement.
126.1 	The commissioner shall grant a license to any facility found to conform to minimum 
126.2 	standards or to any facility which, in the commissioner's judgment, is making satisfactory 
126.3 	progress toward substantial conformity and the standards not being met do not impact the 
126.4 	interests and well-being of the persons confined or incarcerated in the facility. A limited 
126.5 	license under subdivision 1a may be issued for purposes of effectuating a facility closure. 
126.6 	The commissioner may grant licensure up to two years. Unless otherwise specified by 
126.7 	statute, all licenses issued under this chapter expire at 12:01 a.m. on the day after the 
126.8 	expiration date stated on the license.
126.9 	The commissioner shall have access to the buildings, grounds, books, records, staff, and 
126.10 	to persons confined or incarcerated in these facilities. The commissioner may require the 
126.11 	officers in charge of these facilities to furnish all information and statistics the commissioner 
126.12 	deems necessary, at a time and place designated by the commissioner.
126.13 	All facility administrators of correctional facilities are required to report all deaths of 
126.14 	individuals who died while committed to the custody of the facility, regardless of whether 
126.15 	the death occurred at the facility or after removal from the facility for medical care stemming 
126.16 	from an incident or need for medical care at the correctional facility, as soon as practicable, 
126.17 	but no later than 24 hours of receiving knowledge of the death, including any demographic 
126.18 	information as required by the commissioner.
126.19 	All facility administrators of correctional facilities are required to report all other 
126.20 	emergency or unusual occurrences as defined by rule, including uses of force by facility 
126.21 	staff that result in substantial bodily harm or suicide attempts, to the commissioner of 
126.22 	corrections within ten days from the occurrence, including any demographic information 
126.23 	as required by the commissioner. The commissioner of corrections shall consult with the 
126.24 	Minnesota Sheriffs' Association and a representative from the Minnesota Association of 
126.25 	Community Corrections Act Counties who is responsible for the operations of an adult 
126.26 	correctional facility to define "use of force" that results in substantial bodily harm for 
126.27 	reporting purposes.
126.28 	The commissioner may require that any or all such information be provided through the 
126.29 	Department of Corrections detention information system. The commissioner shall post each 
126.30 	inspection report publicly and on the department's website within 30 days of completing 
126.31 	the inspection. The education program offered in a correctional facility for the confinement 
126.32 	or incarceration of juvenile offenders must be approved by the commissioner of education 
126.33 	before the commissioner of corrections may grant a license to the facility.
127.1 	(b) For juvenile facilities licensed by the commissioner of human services, the 
127.2 	commissioner may inspect and certify programs based on certification standards set forth 
127.3 	in Minnesota Rules. For the purpose of this paragraph, "certification" has the meaning given 
127.4 	it in section 245A.02.
127.5 	(c) Any state agency which regulates, inspects, or licenses certain aspects of correctional 
127.6 	facilities shall, insofar as is possible, ensure that the minimum standards it requires are 
127.7 	substantially the same as those required by other state agencies which regulate, inspect, or 
127.8 	license the same aspects of similar types of correctional facilities, although at different 
127.9 	correctional facilities.
127.10 	(d) Nothing in this section shall be construed to limit the commissioner of corrections' 
127.11 	authority to promulgate rules establishing standards of eligibility for counties to receive 
127.12 	funds under sections 401.01 to 401.16, or to require counties to comply with operating 
127.13 	standards the commissioner establishes as a condition precedent for counties to receive that 
127.14 	funding.
127.15 	(e) The department's inspection unit must report directly to a division head outside of 
127.16 	the correctional institutions division.

127.17 	Sec. 5. Minnesota Statutes 2022, section 241.31, subdivision 5, is amended to read:
127.18 		Subd. 5.Minimum standards. The commissioner of corrections shall establish minimum 
127.19 	standards for the size, area to be served, qualifications of staff, ratio of staff to client 
127.20 	population, and treatment programs for community corrections programs established pursuant 
127.21 	to this section. Plans and specifications for such programs, including proposed budgets must 
127.22 	first be submitted to the commissioner for approval prior to the establishment. Community 
127.23 	corrections programs must maintain a supply of opiate antagonists, as defined in section 
127.24 	604A.04, subdivision 1, at each correctional site to be administered in compliance with 
127.25 	section 151.37, subdivision 12. Each site must have at least two doses of an opiate antagonist 
127.26 	on site. Staff must be trained on how and when to administer opiate antagonists.

127.27 	Sec. 6. Minnesota Statutes 2022, section 241.415, is amended to read:
127.28 	241.415 RELEASE PLANS; SUBSTANCE ABUSE.
127.29 	The commissioner shall cooperate with community-based corrections agencies to 
127.30 	determine how best to address the substance abuse treatment needs of offenders who are 
127.31 	being released from prison. The commissioner shall ensure that an offender's prison release 
127.32 	plan adequately addresses the offender's needs for substance abuse assessment, treatment, 
128.1 	or other services following release, within the limits of available resources. The commissioner 
128.2 	must provide individuals with known or stated histories of opioid use disorder with 
128.3 	emergency opiate antagonist rescue kits upon release.

128.4 	Sec. 7. Minnesota Statutes 2022, section 245G.08, subdivision 3, is amended to read:
128.5 		Subd. 3.Standing order protocol Emergency overdose treatment. A license holder 
128.6 	that maintains must maintain a supply of naloxone opiate antagonists as defined in section 
128.7 	604A.04, subdivision 1, available for emergency treatment of opioid overdose and must 
128.8 	have a written standing order protocol by a physician who is licensed under chapter 147, 
128.9 	advanced practice registered nurse who is licensed under chapter 148, or physician assistant 
128.10 	who is licensed under chapter 147A, that permits the license holder to maintain a supply of 
128.11 	naloxoneopiate antagonists on site. A license holder must require staff to undergo training 
128.12 	in the specific mode of administration used at the program, which may include intranasal 
128.13 	administration, intramuscular injection, or both.

128.14 	Sec. 8. Minnesota Statutes 2022, section 256.042, subdivision 2, is amended to read:
128.15 		Subd. 2.Membership. (a) The council shall consist of the following 19 30 voting 
128.16 	members, appointed by the commissioner of human services except as otherwise specified, 
128.17 	and three nonvoting members:
128.18 	(1) two members of the house of representatives, appointed in the following sequence: 
128.19 	the first from the majority party appointed by the speaker of the house and the second from 
128.20 	the minority party appointed by the minority leader. Of these two members, one member 
128.21 	must represent a district outside of the seven-county metropolitan area, and one member 
128.22 	must represent a district that includes the seven-county metropolitan area. The appointment 
128.23 	by the minority leader must ensure that this requirement for geographic diversity in 
128.24 	appointments is met;
128.25 	(2) two members of the senate, appointed in the following sequence: the first from the 
128.26 	majority party appointed by the senate majority leader and the second from the minority 
128.27 	party appointed by the senate minority leader. Of these two members, one member must 
128.28 	represent a district outside of the seven-county metropolitan area and one member must 
128.29 	represent a district that includes the seven-county metropolitan area. The appointment by 
128.30 	the minority leader must ensure that this requirement for geographic diversity in appointments 
128.31 	is met;
128.32 	(3) one member appointed by the Board of Pharmacy;
129.1 	(4) one member who is a physician appointed by the Minnesota Medical Association;
129.2 	(5) one member representing opioid treatment programs, sober living programs, or 
129.3 	substance use disorder programs licensed under chapter 245G;
129.4 	(6) one member appointed by the Minnesota Society of Addiction Medicine who is an 
129.5 	addiction psychiatrist;
129.6 	(7) one member representing professionals providing alternative pain management 
129.7 	therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;
129.8 	(8) one member representing nonprofit organizations conducting initiatives to address 
129.9 	the opioid epidemic, with the commissioner's initial appointment being a member 
129.10 	representing the Steve Rummler Hope Network, and subsequent appointments representing 
129.11 	this or other organizations;
129.12 	(9) one member appointed by the Minnesota Ambulance Association who is serving 
129.13 	with an ambulance service as an emergency medical technician, advanced emergency 
129.14 	medical technician, or paramedic;
129.15 	(10) one member representing the Minnesota courts who is a judge or law enforcement 
129.16 	officer;
129.17 	(11) one public member who is a Minnesota resident and who is in opioid addiction 
129.18 	recovery;
129.19 	(12) two 11 members representing Indian tribes, one representing the Ojibwe tribes and 
129.20 	one representing the Dakota tribes each of Minnesota's Tribal Nations;
129.21 	(13) two members representing urban American Indian populations;
129.22 	(13) (14) one public member who is a Minnesota resident and who is suffering from 
129.23 	chronic pain, intractable pain, or a rare disease or condition;
129.24 	(14) (15) one mental health advocate representing persons with mental illness;
129.25 	(15) (16) one member appointed by the Minnesota Hospital Association;
129.26 	(16) (17) one member representing a local health department; and
129.27 	(17) (18) the commissioners of human services, health, and corrections, or their designees, 
129.28 	who shall be ex officio nonvoting members of the council.
129.29 	(b) The commissioner of human services shall coordinate the commissioner's 
129.30 	appointments to provide geographic, racial, and gender diversity, and shall ensure that at 
129.31 	least one-half one-third of council members appointed by the commissioner reside outside 
130.1 	of the seven-county metropolitan area. Of the members appointed by the commissioner, to 
130.2 	the extent practicable, at least one member must represent a community of color 
130.3 	disproportionately affected by the opioid epidemic.
130.4 	(c) The council is governed by section 15.059, except that members of the council shall 
130.5 	serve three-year terms and shall receive no compensation other than reimbursement for 
130.6 	expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.
130.7 	(d) The chair shall convene the council at least quarterly, and may convene other meetings 
130.8 	as necessary. The chair shall convene meetings at different locations in the state to provide 
130.9 	geographic access, and shall ensure that at least one-half of the meetings are held at locations 
130.10 	outside of the seven-county metropolitan area.
130.11 	(e) The commissioner of human services shall provide staff and administrative services 
130.12 	for the advisory council.
130.13 	(f) The council is subject to chapter 13D.

130.14 	Sec. 9. Minnesota Statutes 2022, section 256.042, subdivision 4, is amended to read:
130.15 		Subd. 4.Grants. (a) The commissioner of human services shall submit a report of the 
130.16 	grants proposed by the advisory council to be awarded for the upcoming calendar year to 
130.17 	the chairs and ranking minority members of the legislative committees with jurisdiction 
130.18 	over health and human services policy and finance, by December 1 of each year, beginning 
130.19 	December 1, 2022. This paragraph expires upon the expiration of the advisory council.
130.20 	(b) The grants shall be awarded to proposals selected by the advisory council that address 
130.21 	the priorities in subdivision 1, paragraph (a), clauses (1) to (4), unless otherwise appropriated 
130.22 	by the legislature. The advisory council shall determine grant awards and funding amounts 
130.23 	based on the funds appropriated to the commissioner under section 256.043, subdivision 3, 
130.24 	paragraph (h), and subdivision 3a, paragraph (d). The commissioner shall award the grants 
130.25 	from the opiate epidemic response fund and administer the grants in compliance with section 
130.26 	16B.97. No more than ten percent of the grant amount may be used by a grantee for 
130.27 	administration. The commissioner must award at least 50 percent of grants to projects that 
130.28 	include a focus on addressing the opioid crisis in Black and Indigenous communities and 
130.29 	communities of color.

131.1 	Sec. 10. Minnesota Statutes 2022, section 256.043, subdivision 3, is amended to read:
131.2 		Subd. 3.Appropriations from registration and license fee account. (a) The 
131.3 	appropriations in paragraphs (b) to (h) (k) shall be made from the registration and license 
131.4 	fee account on a fiscal year basis in the order specified.
131.5 	(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs 
131.6 	(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be 
131.7 	made accordingly.
131.8 	(c) $100,000 is appropriated to the commissioner of human services for grants for opiate 
131.9 	antagonist distribution. Grantees may utilize funds for opioid overdose prevention, 
131.10 	community asset mapping, education, and opiate antagonist distribution.
131.11 	(d) $2,000,000 is appropriated to the commissioner of human services for grants to Tribal 
131.12 	nations and five urban Indian communities for traditional healing practices for American 
131.13 	Indians and to increase the capacity of culturally specific providers in the behavioral health 
131.14 	workforce.
131.15 	(e) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to 
131.16 	the commissioner of human services to administer the funding distribution and reporting 
131.17 	requirements in paragraph (j).
131.18 	(c) (f) $300,000 is appropriated to the commissioner of management and budget for 
131.19 	evaluation activities under section 256.042, subdivision 1, paragraph (c).
131.20 	(d) (g) $249,000 is in fiscal year 2023, $375,000 in fiscal year 2024, and $315,000 each 
131.21 	year thereafter are appropriated to the commissioner of human services for the provision 
131.22 	of administrative services to the Opiate Epidemic Response Advisory Council and for the 
131.23 	administration of the grants awarded under paragraph (h) (k).
131.24 	(e) (h) $126,000 is appropriated to the Board of Pharmacy for the collection of the 
131.25 	registration fees under section 151.066.
131.26 	(f) (i) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
131.27 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
131.28 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
131.29 	(g) (j) After the appropriations in paragraphs (b) to (f) (i) are made, 50 percent of the 
131.30 	remaining amount is appropriated to the commissioner of human services for distribution 
131.31 	to county social service agencies and Tribal social service agency initiative projects 
131.32 	authorized under section 256.01, subdivision 14b, to provide child protection services to 
131.33 	children and families who are affected by addiction. The commissioner shall distribute this 
132.1 	money proportionally to county social service agencies and Tribal social service agency 
132.2 	initiative projects based on out-of-home placement episodes where parental drug abuse is 
132.3 	the primary reason for the out-of-home placement using data from the previous calendar 
132.4 	year. County social service agencies and Tribal social service agency initiative projects 
132.5 	receiving funds from the opiate epidemic response fund must annually report to the 
132.6 	commissioner on how the funds were used to provide child protection services, including 
132.7 	measurable outcomes, as determined by the commissioner. County social service agencies 
132.8 	and Tribal social service agency initiative projects must not use funds received under this 
132.9 	paragraph to supplant current state or local funding received for child protection services 
132.10 	for children and families who are affected by addiction.
132.11 	(h) (k) After the appropriations in paragraphs (b) to (g) (j) are made, the remaining 
132.12 	amount in the account is appropriated to the commissioner of human services to award 
132.13 	grants as specified by the Opiate Epidemic Response Advisory Council in accordance with 
132.14 	section 256.042, unless otherwise appropriated by the legislature.
132.15 	(i) (l) Beginning in fiscal year 2022 and each year thereafter, funds for county social 
132.16 	service agencies and Tribal social service agency initiative projects under paragraph (g) (j)
132.17 	and grant funds specified by the Opiate Epidemic Response Advisory Council under 
132.18 	paragraph (h) (k) may be distributed on a calendar year basis.
132.19 	(m) Notwithstanding section 16A.28, funds appropriated in paragraphs (c), (d), (j), and 
132.20 	(k) do not cancel.

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

132.22 	Sec. 11. Minnesota Statutes 2022, section 256.043, subdivision 3a, is amended to read:
132.23 		Subd. 3a.Appropriations from settlement account. (a) The appropriations in paragraphs 
132.24 	(b) to (e) shall be made from the settlement account on a fiscal year basis in the order 
132.25 	specified.
132.26 	(b) If the balance in the registration and license fee account is not sufficient to fully fund 
132.27 	the appropriations specified in subdivision 3, paragraphs (b) to (f), an amount necessary to 
132.28 	meet any insufficiency shall be transferred from the settlement account to the registration 
132.29 	and license fee account to fully fund the required appropriations.
132.30 	(c) $209,000 in fiscal year 2023 and $239,000 in fiscal year 2024 and subsequent fiscal 
132.31 	years are appropriated to the commissioner of human services for the administration of 
132.32 	grants awarded under paragraph (e). $276,000 in fiscal year 2023 and $151,000 in fiscal 
132.33 	year 2024 and subsequent fiscal years are appropriated to the commissioner of human 
133.1 	services to collect, collate, and report data submitted and to monitor compliance with 
133.2 	reporting and settlement expenditure requirements by grantees awarded grants under this 
133.3 	section and municipalities receiving direct payments from a statewide opioid settlement 
133.4 	agreement as defined in section 256.042, subdivision 6.
133.5 	(d) After any appropriations necessary under paragraphs (b) and (c) are made, an amount 
133.6 	equal to the calendar year allocation to Tribal social service agency initiative projects under 
133.7 	subdivision 3, paragraph (g), is appropriated from the settlement account to the commissioner 
133.8 	of human services for distribution to Tribal social service agency initiative projects to 
133.9 	provide child protection services to children and families who are affected by addiction. 
133.10 	The requirements related to proportional distribution, annual reporting, and maintenance 
133.11 	of effort specified in subdivision 3, paragraph (g), also apply to the appropriations made 
133.12 	under this paragraph.
133.13 	(e) After making the appropriations in paragraphs (b), (c), and (d), the remaining amount 
133.14 	in the account is appropriated to the commissioner of human services to award grants as 
133.15 	specified by the Opiate Epidemic Response Advisory Council in accordance with section 
133.16 	256.042.
133.17 	(f) Funds for Tribal social service agency initiative projects under paragraph (d) and 
133.18 	grant funds specified by the Opiate Epidemic Response Advisory Council under paragraph 
133.19 	(e) may be distributed on a calendar year basis.
133.20 	(g) Notwithstanding section 16A.28, funds appropriated in paragraphs (d) and (e) do 
133.21 	not cancel.

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

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

134.1 	Sec. 13. Laws 2019, chapter 63, article 3, section 1, as amended by Laws 2020, chapter 
134.2 	115, article 3, section 35, and Laws 2022, chapter 53, section 12, is amended to read:
134.3 	Section 1. APPROPRIATIONS.
 134.4 	(a) Board of Pharmacy; administration. $244,000 in fiscal year 2020 is appropriated 
134.5 	from the general fund to the Board of Pharmacy for onetime information technology and 
134.6 	operating costs for administration of licensing activities under Minnesota Statutes, section 
134.7 	151.066. This is a onetime appropriation.
134.8 	(b) Commissioner of human services; administration. $309,000 in fiscal year 2020 
134.9 	is appropriated from the general fund and $60,000 in fiscal year 2021 is appropriated from 
134.10 	the opiate epidemic response fund to the commissioner of human services for the provision 
134.11 	of administrative services to the Opiate Epidemic Response Advisory Council and for the 
134.12 	administration of the grants awarded under paragraphs (f), (g), and (h). The opiate epidemic 
134.13 	response fund base for this appropriation is $60,000 in fiscal year 2022, $60,000 in fiscal 
134.14 	year 2023, $60,000 in fiscal year 2024, and $0 in fiscal year 2025.
134.15 	(c) Board of Pharmacy; administration. $126,000 in fiscal year 2020 is appropriated 
134.16 	from the general fund to the Board of Pharmacy for the collection of the registration fees 
134.17 	under section 151.066.
134.18 	(d) Commissioner of public safety; enforcement activities. $672,000 in fiscal year 
134.19 	2020 is appropriated from the general fund to the commissioner of public safety for the 
134.20 	Bureau of Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab 
134.21 	supplies and $288,000 is for special agent positions focused on drug interdiction and drug 
134.22 	trafficking.
134.23 	(e) Commissioner of management and budget; evaluation activities. $300,000 in 
134.24 	fiscal year 2020 is appropriated from the general fund and $300,000 in fiscal year 2021 is 
134.25 	appropriated from the opiate epidemic response fund to the commissioner of management 
134.26 	and budget for evaluation activities under Minnesota Statutes, section 256.042, subdivision 
134.27 	1, paragraph (c).
134.28 	(f) Commissioner of human services; grants for Project ECHO. $400,000 in fiscal 
134.29 	year 2020 is appropriated from the general fund and $400,000 in fiscal year 2021 is 
134.30 	appropriated from the opiate epidemic response fund to the commissioner of human services 
134.31 	for grants of $200,000 to CHI St. Gabriel's Health Family Medical Center for the 
134.32 	opioid-focused Project ECHO program and $200,000 to Hennepin Health Care for the 
134.33 	opioid-focused Project ECHO program. The opiate epidemic response fund base for this 
135.1 	appropriation is $400,000 in fiscal year 2022, $400,000 in fiscal year 2023, $400,000 in 
135.2 	fiscal year 2024, and $0 in fiscal year 2025.
135.3 	(g) Commissioner of human services; opioid overdose prevention grant. $100,000 
135.4 	in fiscal year 2020 is appropriated from the general fund and $100,000 in fiscal year 2021 
135.5 	is appropriated from the opiate epidemic response fund to the commissioner of human 
135.6 	services for a grant to a nonprofit organization that has provided overdose prevention 
135.7 	programs to the public in at least 60 counties within the state, for at least three years, has 
135.8 	received federal funding before January 1, 2019, and is dedicated to addressing the opioid 
135.9 	epidemic. The grant must be used for opioid overdose prevention, community asset mapping, 
135.10 	education, and overdose antagonist distribution. The opiate epidemic response fund base 
135.11 	for this appropriation is $100,000 in fiscal year 2022, $100,000 in fiscal year 2023, $100,000 
135.12 	in fiscal year 2024, and $0 in fiscal year 2025.
135.13 	(h) Commissioner of human services; traditional healing. $2,000,000 in fiscal year 
135.14 	2020 is appropriated from the general fund and $2,000,000 in fiscal year 2021 is appropriated 
135.15 	from the opiate epidemic response fund to the commissioner of human services to award 
135.16 	grants to Tribal nations and five urban Indian communities for traditional healing practices 
135.17 	to American Indians and to increase the capacity of culturally specific providers in the 
135.18 	behavioral health workforce. The opiate epidemic response fund base for this appropriation 
135.19 	is $2,000,000 in fiscal year 2022, $2,000,000 in fiscal year 2023, $2,000,000 in fiscal year 
135.20 	2024, and $0 in fiscal year 2025.
135.21 	(i) Board of Dentistry; continuing education. $11,000 in fiscal year 2020 is 
135.22 	appropriated from the state government special revenue fund to the Board of Dentistry to 
135.23 	implement the continuing education requirements under Minnesota Statutes, section 214.12, 
135.24 	subdivision 6.
135.25 	(j) Board of Medical Practice; continuing education. $17,000 in fiscal year 2020 is 
135.26 	appropriated from the state government special revenue fund to the Board of Medical Practice 
135.27 	to implement the continuing education requirements under Minnesota Statutes, section 
135.28 	214.12, subdivision 6.
135.29 	(k) Board of Nursing; continuing education. $17,000 in fiscal year 2020 is appropriated 
135.30 	from the state government special revenue fund to the Board of Nursing to implement the 
135.31 	continuing education requirements under Minnesota Statutes, section 214.12, subdivision 
135.32 	6.
135.33 	(l) Board of Optometry; continuing education. $5,000 in fiscal year 2020 is 
135.34 	appropriated from the state government special revenue fund to the Board of Optometry to 
136.1 	implement the continuing education requirements under Minnesota Statutes, section 214.12, 
136.2 	subdivision 6.
136.3 	(m) Board of Podiatric Medicine; continuing education. $5,000 in fiscal year 2020 
136.4 	is appropriated from the state government special revenue fund to the Board of Podiatric 
136.5 	Medicine to implement the continuing education requirements under Minnesota Statutes, 
136.6 	section 214.12, subdivision 6.
136.7 	(n) Commissioner of health; nonnarcotic pain management and wellness. $1,250,000 
136.8 	is appropriated in fiscal year 2020 from the general fund to the commissioner of health, to 
136.9 	provide funding for:
136.10 	(1) statewide mapping and assessment of community-based nonnarcotic pain management 
136.11 	and wellness resources; and
136.12 	(2) up to five demonstration projects in different geographic areas of the state to provide 
136.13 	community-based nonnarcotic pain management and wellness resources to patients and 
136.14 	consumers.
136.15 	The demonstration projects must include an evaluation component and scalability analysis. 
136.16 	The commissioner shall award the grant for the statewide mapping and assessment, and the 
136.17 	demonstration project grants, through a competitive request for proposal process. Grants 
136.18 	for statewide mapping and assessment and demonstration projects may be awarded 
136.19 	simultaneously. In awarding demonstration project grants, the commissioner shall give 
136.20 	preference to proposals that incorporate innovative community partnerships, are informed 
136.21 	and led by people in the community where the project is taking place, and are culturally 
136.22 	relevant and delivered by culturally competent providers. This is a onetime appropriation.
136.23 	(o) Commissioner of health; administration. $38,000 in fiscal year 2020 is appropriated 
136.24 	from the general fund to the commissioner of health for the administration of the grants 
136.25 	awarded in paragraph (n).

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

136.27 	Sec. 14. OPIOID OVERDOSE SURGE ALERT SYSTEM.
 136.28 	The commissioner of human services must establish a voluntary, statewide opioid 
136.29 	overdose surge text message alert system, to prevent opioid overdose by cautioning people 
136.30 	to refrain from substance use or to use harm reduction strategies when there is an overdose 
136.31 	surge in their surrounding area. The alert system may include other forms of electronic 
136.32 	alerts. The commissioner may collaborate with local agencies, other state agencies, and 
136.33 	harm reduction organizations to promote and improve the surge alert system.

137.1 	Sec. 15. HARM REDUCTION AND CULTURALLY SPECIFIC GRANTS.
 137.2 	(a) The commissioner of human services must establish grants for Tribal Nations or 
137.3 	culturally specific organizations to enhance and expand capacity to address the impacts of 
137.4 	the opioid epidemic in their respective communities. Grants may be used to purchase and 
137.5 	distribute harm reduction supplies, develop organizational capacity, and expand culturally 
137.6 	specific services.
137.7 	(b) Harm reduction grant funds must be used to promote safer practices and reduce the 
137.8 	transmission of infectious disease. Allowable expenses include syringes, fentanyl testing 
137.9 	supplies, disinfectants, opiate antagonist rescue kits, safe injection kits, safe smoking kits, 
137.10 	sharps disposal, wound-care supplies, medication lock boxes, FDA-approved home testing 
137.11 	kits for viral hepatitis and HIV, written educational and resource materials, and other supplies 
137.12 	approved by the commissioner.
137.13 	(c) Culturally specific organizational capacity grant funds must be used to develop and 
137.14 	improve organizational infrastructure to increase access to culturally specific services and 
137.15 	community building. Allowable expenses include funds for organizations to hire staff or 
137.16 	consultants who specialize in fundraising, grant writing, business development, and program 
137.17 	integrity or other identified organizational needs as approved by the commissioner.
137.18 	(d) Culturally specific service grant funds must be used to expand culturally specific 
137.19 	outreach and services. Allowable expenses include hiring or consulting with cultural advisors, 
137.20 	resources to support cultural traditions, and education to empower individuals and providers, 
137.21 	develop a sense of community, and develop a connection to ancestral roots.

137.22 	Sec. 16. REPEALER.
 137.23 	Minnesota Statutes 2022, section 256.043, subdivision 4, is repealed.

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

137.25 	ARTICLE 5
137.26 	OPIOID PRESCRIBING IMPROVEMENT PROGRAM

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

138.3 	Sec. 2. Minnesota Statutes 2022, section 256B.0638, subdivision 2, is amended to read:
138.4 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
138.5 	have the meanings given them.
138.6 	(b) "Commissioner" means the commissioner of human services.
138.7 	(c) "Commissioners" means the commissioner of human services and the commissioner 
138.8 	of health.
138.9 	(d) "DEA" means the United States Drug Enforcement Administration.
138.10 	(e) "Minnesota health care program" means a public health care program administered 
138.11 	by the commissioner of human services under this chapter and chapter 256L, and the 
138.12 	Minnesota restricted recipient program.
138.13 	(f) "Opioid disenrollment sanction standards" means parameters clinical indicators 
138.14 	defined by the Opioid Prescribing Work Group of opioid prescribing practices that fall 
138.15 	outside community standard thresholds for prescribing to such a degree that a provider must 
138.16 	be disenrolled may be subject to sanctions under section 256B.064 as a medical assistance
138.17 	Minnesota health care program provider.
138.18 	(g) "Opioid prescriber" means a licensed health care provider who prescribes opioids to 
138.19 	medical assistance Minnesota health care program and MinnesotaCare enrollees under the 
138.20 	fee-for-service system or under a managed care or county-based purchasing plan.
138.21 	(h) "Opioid quality improvement standard thresholds" means parameters of opioid 
138.22 	prescribing practices that fall outside community standards for prescribing to such a degree 
138.23 	that quality improvement is required.
138.24 	(i) "Program" means the statewide opioid prescribing improvement program established 
138.25 	under this section.
138.26 	(j) "Provider group" means a clinic, hospital, or primary or specialty practice group that 
138.27 	employs, contracts with, or is affiliated with an opioid prescriber. Provider group does not 
138.28 	include a professional association supported by dues-paying members.
138.29 	(k) "Sentinel measures" means measures of opioid use that identify variations in 
138.30 	prescribing practices during the prescribing intervals.

139.1 	Sec. 3. Minnesota Statutes 2022, section 256B.0638, subdivision 4, is amended to read:
139.2 		Subd. 4.Program components. (a) The working group shall recommend to the 
139.3 	commissioners the components of the statewide opioid prescribing improvement program, 
139.4 	including, but not limited to, the following:
139.5 	(1) developing criteria for opioid prescribing protocols, including:
139.6 	(i) prescribing for the interval of up to four days immediately after an acute painful 
139.7 	event;
139.8 	(ii) prescribing for the interval of up to 45 days after an acute painful event; and
139.9 	(iii) prescribing for chronic pain, which for purposes of this program means pain lasting 
139.10 	longer than 45 days after an acute painful event;
139.11 	(2) developing sentinel measures;
139.12 	(3) developing educational resources for opioid prescribers about communicating with 
139.13 	patients about pain management and the use of opioids to treat pain;
139.14 	(4) developing opioid quality improvement standard thresholds and opioid disenrollment
139.15 	sanction standards for opioid prescribers and provider groups. In developing opioid 
139.16 	disenrollment standards, the standards may be described in terms of the length of time in 
139.17 	which prescribing practices fall outside community standards and the nature and amount 
139.18 	of opioid prescribing that fall outside community standards; and
139.19 	(5) addressing other program issues as determined by the commissioners.
139.20 	(b) The opioid prescribing protocols shall not apply to opioids prescribed for patients 
139.21 	who are experiencing pain caused by a malignant condition or who are receiving hospice 
139.22 	care or palliative care, or to opioids prescribed for substance use disorder treatment with 
139.23 	medications for opioid use disorder.
139.24 	(c) All opioid prescribers who prescribe opioids to Minnesota health care program 
139.25 	enrollees must participate in the program in accordance with subdivision 5. Any other 
139.26 	prescriber who prescribes opioids may comply with the components of this program described 
139.27 	in paragraph (a) on a voluntary basis.

139.28 	Sec. 4. Minnesota Statutes 2022, section 256B.0638, subdivision 5, is amended to read:
139.29 		Subd. 5.Program implementation. (a) The commissioner shall implement the programs 
139.30 	within the Minnesota health care quality improvement program to improve the health of 
139.31 	and quality of care provided to Minnesota health care program enrollees. The program must 
140.1 	be designed to support patient-centered care consistent with community standards of care. 
140.2 	The program must discourage unsafe tapering practices and patient abandonment by 
140.3 	providers. The commissioner shall annually collect and report to provider groups the sentinel 
140.4 	measures of data showing individual opioid prescribers' opioid prescribing patterns compared 
140.5 	to their anonymized peers. Provider groups shall distribute data to their affiliated, contracted, 
140.6 	or employed opioid prescribers.
140.7 	(b) The commissioner shall notify an opioid prescriber and all provider groups with 
140.8 	which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing 
140.9 	pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber 
140.10 	and any provider group that receives a notice under this paragraph shall submit to the 
140.11 	commissioner a quality improvement plan for review and approval by the commissioner 
140.12 	with the goal of bringing the opioid prescriber's prescribing practices into alignment with 
140.13 	community standards. A quality improvement plan must include:
140.14 	(1) components of the program described in subdivision 4, paragraph (a);
140.15 	(2) internal practice-based measures to review the prescribing practice of the opioid 
140.16 	prescriber and, where appropriate, any other opioid prescribers employed by or affiliated 
140.17 	with any of the provider groups with which the opioid prescriber is employed or affiliated; 
140.18 	and
140.19 	(3) appropriate use of the prescription monitoring program under section 152.126
140.20 	demonstration of patient-centered care consistent with community standards of care.
140.21 	(c) If, after a year from the commissioner's notice under paragraph (b), the opioid 
140.22 	prescriber's prescribing practices for treatment of acute or postacute pain do not improve 
140.23 	so that they are consistent with community standards, the commissioner shall may take one 
140.24 	or more of the following steps:
140.25 	(1) require the prescriber, the provider group, or both, to monitor prescribing practices 
140.26 	more frequently than annually;
140.27 	(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel 
140.28 	measures; or
140.29 	(3) require the opioid prescriber to participate in additional quality improvement efforts, 
140.30 	including but not limited to mandatory use of the prescription monitoring program established 
140.31 	under section 152.126.
140.32 	(d) Prescribers treating patients who are on chronic, high doses of opioids must meet 
140.33 	community standards of care, including performing regular assessments and addressing 
141.1 	unwarranted risks of opioid prescribing, but are not required to show measurable changes 
141.2 	in chronic pain prescribing thresholds within a certain period.
141.3 	(e) The commissioner shall dismiss a prescriber from participating in the opioid 
141.4 	prescribing quality improvement program on an annual basis when the prescriber 
141.5 	demonstrates that the prescriber's practices are patient-centered and reflect community 
141.6 	standards for safe and compassionate treatment of patients experiencing pain.
141.7 	(d) (f) The commissioner shall terminate from Minnesota health care programs may 
141.8 	investigate for possible sanctions under section 256B.064 all opioid prescribers and provider 
141.9 	groups whose prescribing practices fall within the applicable opioid disenrollment sanction
141.10 	standards.
141.11 	(e) (g) No physician, advanced practice registered nurse, or physician assistant, acting 
141.12 	in good faith based on the needs of the patient, may be disenrolled by the commissioner of 
141.13 	human services solely for prescribing a dosage that equates to an upward deviation from 
141.14 	morphine milligram equivalent dosage recommendations specified in state or federal opioid 
141.15 	prescribing guidelines or policies, or quality improvement thresholds established under this 
141.16 	section.

141.17 	Sec. 5. Minnesota Statutes 2022, section 256B.0638, is amended by adding a subdivision 
141.18 	to read:
141.19 		Subd. 6a.Waiver for certain provider groups. (a) This section does not apply to 
141.20 	prescribers employed by, or under contract or affiliated with, a provider group for which 
141.21 	the commissioner has granted a waiver from the requirements of this section.
141.22 	(b) The commissioner, in consultation with opioid prescribers, shall develop waiver 
141.23 	criteria for provider groups, and shall make waivers available beginning July 1, 2023. In 
141.24 	granting waivers, the commissioner shall consider whether the medical director of the 
141.25 	provider group and a majority of the practitioners within a provider group have specialty 
141.26 	training, fellowship training, or experience in treating chronic pain. Waivers under this 
141.27 	subdivision shall be granted on an annual basis.

141.28 	Sec. 6. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; OPIOID 
141.29 	PRESCRIBING IMPROVEMENT PROGRAM SUNSET.
 141.30 	The commissioner of human services shall recommend criteria to provide for a sunset 
141.31 	of the opioid prescribing improvement program under Minnesota Statutes, section 256B.0638. 
141.32 	In developing sunset criteria, the commissioner shall consult with stakeholders including 
142.1 	but not limited to clinicians that practice pain management, addiction medicine, or mental 
142.2 	health, and either current or former Minnesota health care program enrollees who use or 
142.3 	have used opioid therapy to manage chronic pain. By January 15, 2024, the commissioner 
142.4 	shall submit recommended criteria to the chairs and ranking minority members of the 
142.5 	legislative committees with jurisdiction over health and human services finance and policy.

142.6 	ARTICLE 6
142.7 	DEPARTMENT OF DIRECT CARE AND TREATMENT

142.8 	Section 1. Minnesota Statutes 2022, section 15.01, is amended to read:
142.9 	15.01 DEPARTMENTS OF THE STATE.
142.10 	The following agencies are designated as the departments of the state government: the 
142.11 	Department of Administration;, the Department of Agriculture;, the Department of 
142.12 	Commerce;, the Department of Corrections;, the Department of Direct Care and Treatment,
142.13 	the Department of Education;, the Department of Employment and Economic Development;,
142.14 	the Department of Health;, the Department of Human Rights;, the Department of Human 
142.15 	Services, the Department of Information Technology Services;, the Department of Iron 
142.16 	Range Resources and Rehabilitation;, the Department of Labor and Industry;, the Department 
142.17 	of Management and Budget;, the Department of Military Affairs;, the Department of Natural 
142.18 	Resources;, the Department of Public Safety; the Department of Human Services;, the 
142.19 	Department of Revenue;, the Department of Transportation;, the Department of Veterans 
142.20 	Affairs;, and their successor departments.

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

142.22 	Sec. 2. Minnesota Statutes 2022, section 15.06, subdivision 1, is amended to read:
142.23 		Subdivision 1.Applicability. This section applies to the following departments or 
142.24 	agencies: the Departments of Administration, Agriculture, Commerce, Corrections, Direct 
142.25 	Care and Treatment, Education, Employment and Economic Development, Health, Human 
142.26 	Rights, Human Services, Labor and Industry, Management and Budget, Natural Resources, 
142.27 	Public Safety, Human Services, Revenue, Transportation, and Veterans Affairs; the Housing 
142.28 	Finance and Pollution Control Agencies; the Office of Commissioner of Iron Range 
142.29 	Resources and Rehabilitation; the Department of Information Technology Services; the 
142.30 	Bureau of Mediation Services; and their successor departments and agencies. The heads of 
142.31 	the foregoing departments or agencies are "commissioners."

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

143.1 	Sec. 3. Minnesota Statutes 2022, section 43A.08, subdivision 1a, is amended to read:
143.2 		Subd. 1a.Additional unclassified positions. Appointing authorities for the following 
143.3 	agencies may designate additional unclassified positions according to this subdivision: the 
143.4 	Departments of Administration;, Agriculture;, Commerce;, Corrections;, Direct Care and 
143.5 	Treatment, Education;, Employment and Economic Development;, Explore Minnesota 
143.6 	Tourism;, Management and Budget;, Health;, Human Rights;, Human Services, Labor and 
143.7 	Industry;, Natural Resources;, Public Safety;,Human Services; Revenue;, Transportation;,
143.8 	and Veterans Affairs; the Housing Finance and Pollution Control Agencies; the State Lottery; 
143.9 	the State Board of Investment; the Office of Administrative Hearings; the Department of 
143.10 	Information Technology Services; the Offices of the Attorney General, Secretary of State, 
143.11 	and State Auditor; the Minnesota State Colleges and Universities; the Minnesota Office of 
143.12 	Higher Education; the Perpich Center for Arts Education; and the Minnesota Zoological 
143.13 	Board.
143.14 	A position designated by an appointing authority according to this subdivision must 
143.15 	meet the following standards and criteria:
143.16 	(1) the designation of the position would not be contrary to other law relating specifically 
143.17 	to that agency;
143.18 	(2) the person occupying the position would report directly to the agency head or deputy 
143.19 	agency head and would be designated as part of the agency head's management team;
143.20 	(3) the duties of the position would involve significant discretion and substantial 
143.21 	involvement in the development, interpretation, and implementation of agency policy;
143.22 	(4) the duties of the position would not require primarily personnel, accounting, or other 
143.23 	technical expertise where continuity in the position would be important;
143.24 	(5) there would be a need for the person occupying the position to be accountable to, 
143.25 	loyal to, and compatible with, the governor and the agency head, the employing statutory 
143.26 	board or commission, or the employing constitutional officer;
143.27 	(6) the position would be at the level of division or bureau director or assistant to the 
143.28 	agency head; and
143.29 	(7) the commissioner has approved the designation as being consistent with the standards 
143.30 	and criteria in this subdivision.

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

144.1 	Sec. 4. [246C.01] TITLE.
144.2 	This chapter may be cited as the "Department of Direct Care & Treatment Act."

144.3 	Sec. 5. [246C.02] DEPARTMENT OF DIRECT CARE AND TREATMENT; 
144.4 	ESTABLISHMENT.
144.5 	(a) The Department of Direct Care and Treatment is created. An executive board shall 
144.6 	head the Department of Direct Care and Treatment. The executive board shall develop and 
144.7 	maintain direct care and treatment in a manner consistent with applicable law, including 
144.8 	chapters 13, 245, 246, 246B, 252, 253, 253B, 253C, 253D, 254A, 254B, and 256. The 
144.9 	Department of Direct Care and Treatment shall provide direct care and treatment services 
144.10 	in coordination with counties and other vendors. Direct care and treatment services shall 
144.11 	include specialized inpatient programs at secure treatment facilities as defined in sections 
144.12 	253B.02, subdivision 18a, and 253D.02, subdivision 13; community preparation services; 
144.13 	regional treatment centers; enterprise services; consultative services; aftercare services; 
144.14 	community-based services and programs; transition services; nursing home services; and 
144.15 	other services consistent with the mission of the Department of Direct Care and Treatment.
144.16 	(b) "Community preparation services" means specialized inpatient or outpatient services 
144.17 	or programs operated outside of a secure environment but administered by a secure treatment 
144.18 	facility.

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

144.20 	Sec. 6. [246C.03] TRANSITION OF AUTHORITY; DEVELOPMENT OF A BOARD.
144.21 		Subdivision 1.Authority until board is developed and powers defined. Upon the 
144.22 	effective date of this act, the commissioner of human services shall continue to exercise all 
144.23 	authorities and responsibilities under chapters 13, 245, 246, 246B, 252, 253, 253B, 253C, 
144.24 	253D, 254A, 254B, and 256, until legislation is effective that develops the Department of 
144.25 	Direct Care and Treatment executive board and defines the responsibilities and powers of 
144.26 	the Department of Direct Care and Treatment and its executive board.
144.27 		Subd. 2.Development of Department of Direct Care and Treatment Board. (a) The 
144.28 	commissioner of human services shall prepare legislation for introduction during the 2024 
144.29 	legislative session, with input from stakeholders the commissioner deems necessary, 
144.30 	proposing legislation for the creation and implementation of the Direct Care and Treatment 
144.31 	executive board and defining the responsibilities, powers, and function of the Department 
144.32 	of Direct Care and Treatment executive board.
145.1 	(b) The Department of Direct Care and Treatment executive board shall consist of no 
145.2 	more than five members, all appointed by the governor.
145.3 	(c) An executive board member's qualifications must be appropriate for overseeing a 
145.4 	complex behavioral health system, such as experience serving on a hospital or non-profit 
145.5 	board or working as a licensed health care provider, in an allied health profession, or in 
145.6 	health care administration.

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

145.8 	Sec. 7. [246C.04] TRANSFER OF DUTIES.
145.9 	(a) Section 15.039 applies to the transfer of duties required by this chapter.
145.10 	(b) The commissioner of administration, with the governor's approval, shall issue 
145.11 	reorganization orders under section 16B.37 as necessary to carry out the transfer of duties 
145.12 	required by section 246C.03. The provision of section 16B.37, subdivision 1, stating that 
145.13 	transfers under section 16B.37 may only be to an agency that has existed for at least one 
145.14 	year does not apply to transfers to an agency created by this chapter.
145.15 	(c) The initial salary for the health systems chief executive officer of the Department of 
145.16 	Direct Care and Treatment is the same as the salary for the health systems chief executive 
145.17 	officer of direct care and treatment at the Department of Human Services immediately before 
145.18 	July 1, 2024.

145.19 	Sec. 8. [246C.05] EMPLOYEE PROTECTIONS FOR ESTABLISHING THE NEW 
145.20 	DEPARTMENT OF DIRECT CARE AND TREATMENT.
145.21 	(a) Personnel whose duties relate to the functions assigned to the Department of Direct 
145.22 	Care and Treatment executive board in section 246C.03 are transferred to the Department 
145.23 	of Direct Care and Treatment effective 30 days after approval by the commissioner of direct 
145.24 	care and treatment.
145.25 	(b) Before the Department of Direct Care and Treatment executive board is appointed, 
145.26 	personnel whose duties relate to the functions in this section may be transferred beginning 
145.27 	July 1, 2024, with 30 days' notice from the commissioner of management and budget.
145.28 	(c) The following protections shall apply to employees who are transferred from the 
145.29 	Department of Human Services to the Department of Direct Care and Treatment:
145.30 	(1) No transferred employee shall have their employment status and job classification 
145.31 	altered as a result of the transfer.
146.1 	(2) Transferred employees who were represented by an exclusive representative prior 
146.2 	to the transfer shall continue to be represented by the same exclusive representative after 
146.3 	the transfer.
146.4 	(3) The applicable collective bargaining agreements with exclusive representatives shall 
146.5 	continue in full force and effect for such transferred employees after the transfer.
146.6 	(4) The state shall have the obligation to meet and negotiate with the exclusive 
146.7 	representatives of the transferred employees about any proposed changes affecting or relating 
146.8 	to the transferred employees' terms and conditions of employment to the extent such changes 
146.9 	are not addressed in the applicable collective bargaining agreement.
146.10 	(5) When an employee in a temporary unclassified position is transferred to the 
146.11 	Department of Direct Care and Treatment, the total length of time that the employee has 
146.12 	served in the appointment shall include all time served in the appointment at the transferring 
146.13 	agency and the time served in the appointment at the Department of Direct Care and 
146.14 	Treatment. An employee in a temporary unclassified position who was hired by a transferring 
146.15 	agency through an open competitive selection process in accordance with a policy enacted 
146.16 	by Minnesota Management and Budget shall be considered to have been hired through such 
146.17 	process after the transfer.
146.18 	(6) In the event that the state transfers ownership or control of any of the facilities, 
146.19 	services, or operations of the Department of Direct Care and Treatment to another entity, 
146.20 	whether private or public, by subcontracting, sale, assignment, lease, or other transfer, the 
146.21 	state shall require as a written condition of such transfer of ownership or control the following 
146.22 	provisions:
146.23 	(i) Employees who perform work in transferred facilities, services, or operations must 
146.24 	be offered employment with the entity acquiring ownership or control before the entity 
146.25 	offers employment to any individual who was not employed by the transferring agency at 
146.26 	the time of the transfer.
146.27 	(ii) The wage and benefit standards of such transferred employees must not be reduced 
146.28 	by the entity acquiring ownership or control through the expiration of the collective 
146.29 	bargaining agreement in effect at the time of the transfer or for a period of two years after 
146.30 	the transfer, whichever is longer.
146.31 	(d) There is no liability on the part of, and no cause of action arises against, the state of 
146.32 	Minnesota or its officers or agents for any action or inaction of any entity acquiring ownership 
146.33 	or control of any facilities, services, or operations of the Department of Direct Care and 
146.34 	Treatment.

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

147.2 	Sec. 9. REVISOR INSTRUCTION.
 147.3 	The revisor of statutes, in consultation with staff from the House Research Department; 
147.4 	House Fiscal Analysis; the Office of Senate Counsel, Research and Fiscal Analysis; and 
147.5 	the respective departments shall prepare legislation for introduction in the 2024 legislative 
147.6 	session proposing the statutory changes necessary to implement the transfers of duties that 
147.7 	this article requires.

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

147.9 	ARTICLE 7
147.10 	LICENSING

147.11 	Section 1. Minnesota Statutes 2022, section 245A.04, subdivision 7, is amended to read:
147.12 		Subd. 7.Grant of license; license extension. (a) If the commissioner determines that 
147.13 	the program complies with all applicable rules and laws, the commissioner shall issue a 
147.14 	license consistent with this section or, if applicable, a temporary change of ownership license 
147.15 	under section 245A.043. At minimum, the license shall state:
147.16 	(1) the name of the license holder;
147.17 	(2) the address of the program;
147.18 	(3) the effective date and expiration date of the license;
147.19 	(4) the type of license;
147.20 	(5) the maximum number and ages of persons that may receive services from the program; 
147.21 	and
147.22 	(6) any special conditions of licensure.
147.23 	(b) The commissioner may issue a license for a period not to exceed two years if:
147.24 	(1) the commissioner is unable to conduct the evaluation or observation required by 
147.25 	subdivision 4, paragraph (a), clause (4), because the program is not yet operational;
147.26 	(2) certain records and documents are not available because persons are not yet receiving 
147.27 	services from the program; and
147.28 	(3) the applicant complies with applicable laws and rules in all other respects.
148.1 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
148.2 	or persons will be placed or cared for in the licensed program.
148.3 	(d) Except as provided in paragraphs (f) and (g) (i) and (j), the commissioner shall not 
148.4 	issue or reissue a license if the applicant, license holder, or an affiliated controlling individual 
148.5 	has:
148.6 	(1) been disqualified and the disqualification was not set aside and no variance has been 
148.7 	granted;
148.8 	(2) been denied a license under this chapter, within the past two years;
148.9 	(3) had a license issued under this chapter revoked within the past five years; or
148.10 	(4) an outstanding debt related to a license fee, licensing fine, or settlement agreement 
148.11 	for which payment is delinquent; or
148.12 	(5) (4) failed to submit the information required of an applicant under subdivision 1, 
148.13 	paragraph (f) or (g), after being requested by the commissioner.
148.14 	When a license issued under this chapter is revoked under clause (1) or (3), the license 
148.15 	holder and each affiliated controlling individual with a revoked license may not hold any 
148.16 	license under chapter 245A for five years following the revocation, and other licenses held 
148.17 	by the applicant, or license holder, or licenses affiliated with each controlling individual 
148.18 	shall also be revoked.
148.19 	(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license 
148.20 	affiliated with a license holder or controlling individual that had a license revoked within 
148.21 	the past five years if the commissioner determines that (1) the license holder or controlling 
148.22 	individual is operating the program in substantial compliance with applicable laws and rules, 
148.23 	and (2) the program's continued operation is in the best interests of the community being 
148.24 	served.
148.25 	(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response 
148.26 	to an application that is affiliated with an applicant, license holder, or controlling individual 
148.27 	that had an application denied within the past two years or a license revoked within the past 
148.28 	five years if the commissioner determines that (1) the applicant or controlling individual 
148.29 	has operated one or more programs in substantial compliance with applicable laws and 
148.30 	rules, and (2) the program's operation would be in the best interests of the community to be 
148.31 	served.
148.32 	(g) In determining whether a program's operation would be in the best interests of the 
148.33 	community to be served, the commissioner shall consider factors such as the number of 
149.1 	persons served, the availability of alternative services available in the surrounding 
149.2 	community, the management structure of the program, whether the program provides 
149.3 	culturally specific services, and other relevant factors.
149.4 	(e) (h) The commissioner shall not issue or reissue a license under this chapter if an 
149.5 	individual living in the household where the services will be provided as specified under 
149.6 	section 245C.03, subdivision 1, has been disqualified and the disqualification has not been 
149.7 	set aside and no variance has been granted.
149.8 	(f) (i) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued 
149.9 	under this chapter has been suspended or revoked and the suspension or revocation is under 
149.10 	appeal, the program may continue to operate pending a final order from the commissioner. 
149.11 	If the license under suspension or revocation will expire before a final order is issued, a 
149.12 	temporary provisional license may be issued provided any applicable license fee is paid 
149.13 	before the temporary provisional license is issued.
149.14 	(g) (j) Notwithstanding paragraph (f) (i), when a revocation is based on the 
149.15 	disqualification of a controlling individual or license holder, and the controlling individual 
149.16 	or license holder is ordered under section 245C.17 to be immediately removed from direct 
149.17 	contact with persons receiving services or is ordered to be under continuous, direct 
149.18 	supervision when providing direct contact services, the program may continue to operate 
149.19 	only if the program complies with the order and submits documentation demonstrating 
149.20 	compliance with the order. If the disqualified individual fails to submit a timely request for 
149.21 	reconsideration, or if the disqualification is not set aside and no variance is granted, the 
149.22 	order to immediately remove the individual from direct contact or to be under continuous, 
149.23 	direct supervision remains in effect pending the outcome of a hearing and final order from 
149.24 	the commissioner.
149.25 	(h) (k) For purposes of reimbursement for meals only, under the Child and Adult Care 
149.26 	Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, 
149.27 	part 226, relocation within the same county by a licensed family day care provider, shall 
149.28 	be considered an extension of the license for a period of no more than 30 calendar days or 
149.29 	until the new license is issued, whichever occurs first, provided the county agency has 
149.30 	determined the family day care provider meets licensure requirements at the new location.
149.31 	(i) (l) Unless otherwise specified by statute, all licenses issued under this chapter expire 
149.32 	at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
149.33 	apply for and be granted a new license to operate the program or the program must not be 
149.34 	operated after the expiration date.
150.1 	(j) (m) The commissioner shall not issue or reissue a license under this chapter if it has 
150.2 	been determined that a tribal licensing authority has established jurisdiction to license the 
150.3 	program or service.

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

150.14 	Sec. 3. Minnesota Statutes 2022, section 245A.07, is amended by adding a subdivision to 
150.15 	read:
150.16 		Subd. 2c.Immediate suspension for programs with multiple licensed service sites. (a) 
150.17 	For license holders that operate more than one service site under a single license, the 
150.18 	suspension order must be specific to the service site or sites where the commissioner 
150.19 	determines an order is required under subdivision 2. The order must not apply to other 
150.20 	service sites operated by the same license holder unless the commissioner has included in 
150.21 	the order an articulable basis for applying the order to other service sites.
150.22 	(b) If the commissioner has issued more than one license to the license holder under this 
150.23 	chapter, the suspension imposed under this section must be specific to the license for the 
150.24 	program at which the commissioner determines an order is required under subdivision 2. 
150.25 	The order must not apply to other licenses held by the same license holder if those programs 
150.26 	are being operated in substantial compliance with applicable law and rules.

150.27 	Sec. 4. Minnesota Statutes 2022, section 245A.10, subdivision 6, is amended to read:
150.28 		Subd. 6.License not issued until license or certification fee is paid. The commissioner 
150.29 	shall not issue or reissue a license or certification until the license or certification fee is paid. 
150.30 	The commissioner shall send a bill for the license or certification fee to the billing address 
150.31 	identified by the license holder. If the license holder does not submit the license or 
150.32 	certification fee payment by the due date, the commissioner shall send the license holder a 
151.1 	past due notice. If the license holder fails to pay the license or certification fee by the due 
151.2 	date on the past due notice, the commissioner shall send a final notice to the license holder 
151.3 	informing the license holder that the program license will expire on December 31 unless 
151.4 	the license fee is paid before December 31. If a license expires, the program is no longer 
151.5 	licensed and, unless exempt from licensure under section 245A.03, subdivision 2, must not 
151.6 	operate after the expiration date. After a license expires, if the former license holder wishes 
151.7 	to provide licensed services, the former license holder must submit a new license application 
151.8 	and application fee under subdivision 3.

151.9 	Sec. 5. Minnesota Statutes 2022, section 245A.10, is amended by adding a subdivision to 
151.10 	read:
151.11 		Subd. 9.License not reissued until outstanding debt is paid. The commissioner shall 
151.12 	not reissue a license or certification until the license holder has paid all outstanding debts 
151.13 	related to a licensing fine or settlement agreement for which payment is delinquent. If the 
151.14 	payment is past due, the commissioner shall send a past due notice informing the license 
151.15 	holder that the program license will expire on December 31 unless the outstanding debt is 
151.16 	paid before December 31. If a license expires, the program is no longer licensed and must 
151.17 	not operate after the expiration date. After a license expires, if the former license holder 
151.18 	wishes to provide licensed services, the former license holder must submit a new license 
151.19 	application and application fee under subdivision 3.

151.20 	Sec. 6. Minnesota Statutes 2022, section 245A.13, subdivision 1, is amended to read:
151.21 		Subdivision 1.Application. (a) In addition to any other remedy provided by law, the 
151.22 	commissioner may petition the district court in Ramsey County for an order directing the 
151.23 	controlling individuals of a residential or nonresidential program licensed or certified by 
151.24 	the commissioner to show cause why the commissioner should not be appointed receiver 
151.25 	to operate the program. The petition to the district court must contain proof by affidavit that 
151.26 	one or more of the following circumstances exists: (1) that the commissioner has either 
151.27 	begun proceedings to suspend or revoke a license or certification, has suspended or revoked 
151.28 	a license or certification, or has decided to deny an application for licensure or certification 
151.29 	of the program; or (2) it appears to the commissioner that the health, safety, or rights of the 
151.30 	residents or persons receiving care from the program may be in jeopardy because of the 
151.31 	manner in which the program may close, the program's financial condition, or violations 
151.32 	committed by the program of federal or state laws or rules. If the license holder, applicant, 
151.33 	or controlling individual operates more than one program, the commissioner's petition must 
151.34 	specify and be limited to the program for which it seeks receivership. The affidavit submitted 
152.1 	by the commissioner must set forth alternatives to receivership that have been considered, 
152.2 	including rate adjustments. The order to show cause is returnable not less than five days 
152.3 	after service is completed and must provide for personal service of a copy to the program 
152.4 	administrator and to the persons designated as agents by the controlling individuals to accept 
152.5 	service on their behalf.
152.6 	(1) the commissioner has commenced proceedings to suspend or revoke the program's 
152.7 	license or refused to renew the program's license;
152.8 	(2) there is a threat of imminent abandonment by the program or its controlling 
152.9 	individuals;
152.10 	(3) the program has shown a pattern of failure to meet ongoing financial obligations 
152.11 	such as failing to pay for food, pharmaceuticals, personnel costs, or required insurance;
152.12 	(4) the health, safety, or rights of the residents or persons receiving care from the program 
152.13 	appear to be in jeopardy due to the manner in which the program may close, the program's 
152.14 	financial condition, or violations of federal or state law or rules committed by the program; 
152.15 	or
152.16 	(5) the commissioner has notified the program or its controlling individuals that the 
152.17 	program's federal Medicare or Medicaid provider agreement will be terminated, revoked, 
152.18 	canceled, or not renewed.
152.19 	(b) If the license holder, applicant, or controlling individual operates more than one 
152.20 	program, the commissioner's petition must specify and be limited to the program for which 
152.21 	it seeks receivership.
152.22 	(c) The order to show cause shall be personally served on the program through its 
152.23 	authorized agent or, in the event the authorized agent cannot be located, on any controlling 
152.24 	individual for the program.

152.25 	Sec. 7. Minnesota Statutes 2022, section 245A.13, subdivision 2, is amended to read:
152.26 		Subd. 2.Appointment of receiver. (a) If the court finds that involuntary receivership 
152.27 	is necessary as a means of protecting the health, safety, or rights of persons being served 
152.28 	by the program, the court shall appoint the commissioner as receiver to operate the program. 
152.29 	The commissioner as receiver may contract with another entity or group to act as the 
152.30 	managing agent during the receivership period. The managing agent will be responsible for 
152.31 	the day-to-day operations of the program subject at all times to the review and approval of 
152.32 	the commissioner. A managing agent shall not:
153.1 	(1) be the license holder or controlling individual of the program;
153.2 	(2) have a financial interest in the program at the time of the receivership;
153.3 	(3) be otherwise affiliated with the program; or
153.4 	(4) have had a licensed program that has been ordered into receivership.
153.5 	(b) Notwithstanding state contracting requirements in chapter 16C, the commissioner 
153.6 	shall establish and maintain a list of qualified persons or entities with experience in delivering 
153.7 	services and with winding down programs under chapter 245A, 245D, or 245G, or other 
153.8 	service types licensed by the commissioner. The list shall be a resource for selecting a 
153.9 	managing agent, and the commissioner may update the list at any time.

153.10 	Sec. 8. Minnesota Statutes 2022, section 245A.13, subdivision 3, is amended to read:
153.11 		Subd. 3.Powers and duties of receiver. Within 36 months after the receivership order, 
153.12 	the receiver shall provide for the orderly transfer of the persons served by the program to 
153.13 	other programs or make other provisions to protect their health, safety, and rights. The 
153.14 	receiver or the managing agent shall correct or eliminate deficiencies in the program that 
153.15 	the commissioner determines endanger the health, safety, or welfare of the persons being 
153.16 	served by the program unless the correction or elimination of deficiencies at a residential 
153.17 	program involves major alteration in the structure of the physical plant. If the correction or 
153.18 	elimination of the deficiencies at a residential program requires major alterations in the 
153.19 	structure of the physical plant, the receiver shall take actions designed to result in the 
153.20 	immediate transfer of persons served by the residential program. During the period of the 
153.21 	receivership, the receiver and the managing agent shall operate the residential or 
153.22 	nonresidential program in a manner designed to preserve the health, safety, rights, adequate 
153.23 	care, and supervision of the persons served by the program. The receiver or the managing 
153.24 	agent may make contracts and incur lawful expenses. The receiver or the managing agent 
153.25 	shall collect incoming payments from all sources and apply them to the cost incurred in the 
153.26 	performance of the functions of the receivership including the fee set under subdivision 4. 
153.27 	No security interest in any real or personal property comprising the program or contained 
153.28 	within it, or in any fixture of the physical plant, shall be impaired or diminished in priority 
153.29 	by the receiver or the managing agent. (a) A receiver appointed pursuant to this section 
153.30 	shall, within 18 months after the receivership order, determine whether to close the program 
153.31 	or to make other provisions with the intent to keep the program open. If the receiver 
153.32 	determines that program closure is appropriate, the commissioner shall provide for the 
153.33 	orderly transfer of individuals served by the program to other programs or make other 
153.34 	provisions to protect the health, safety, and rights of individuals served by the program.
154.1 	(b) During the receivership, the receiver or the managing agent shall correct or eliminate 
154.2 	deficiencies in the program that the commissioner determines endanger the health, safety, 
154.3 	or welfare of the persons being served by the program unless the correction or elimination 
154.4 	of deficiencies at a residential program involves major alteration in the structure of the 
154.5 	physical plant. If the correction or elimination of the deficiencies at a residential program 
154.6 	requires major alterations in the structure of the physical plant, the receiver shall take actions 
154.7 	designed to result in the immediate transfer of persons served by the residential program. 
154.8 	During the period of the receivership, the receiver and the managing agent shall operate the 
154.9 	residential or nonresidential program in a manner designed to preserve the health, safety, 
154.10 	rights, adequate care, and supervision of the persons served by the program.
154.11 	(c) The receiver or the managing agent may make contracts and incur lawful expenses.
154.12 	(d) The receiver or the managing agent shall use the building, fixtures, furnishings, and 
154.13 	any accompanying consumable goods in the provision of care and services to the clients 
154.14 	during the receivership period. The receiver shall take action as is reasonably necessary to 
154.15 	protect or conserve the tangible assets or property during receivership.
154.16 	(e) The receiver or the managing agent shall collect incoming payments from all sources 
154.17 	and apply them to the cost incurred in the performance of the functions of the receivership, 
154.18 	including the fee set under subdivision 4. No security interest in any real or personal property 
154.19 	comprising the program or contained within it, or in any fixture of the physical plant, shall 
154.20 	be impaired or diminished in priority by the receiver or the managing agent.
154.21 	(f) The receiver has authority to hire, direct, manage, and discharge any employees of 
154.22 	the program, including management level staff for the program.
154.23 	(g) The commissioner, as the receiver appointed by the court, may hire a managing agent 
154.24 	to work on the commissioner's behalf to operate the program during the receivership. The 
154.25 	managing agent is entitled to a reasonable fee. The receiver and managing agent shall be 
154.26 	liable only in an official capacity for injury to persons and property by reason of the 
154.27 	conditions of the program. The receiver and managing agent shall not be personally liable, 
154.28 	except for gross negligence or intentional acts. The commissioner shall assist the managing 
154.29 	agent in carrying out the managing agent's duties.

154.30 	Sec. 9. Minnesota Statutes 2022, section 245A.13, subdivision 6, is amended to read:
154.31 		Subd. 6.Emergency procedure. (a) If it appears from the petition filed under subdivision 
154.32 	1, from an affidavit or affidavits filed with the petition, or from testimony of witnesses 
154.33 	under oath if the court determines it necessary, that there is probable cause to believe that 
155.1 	an emergency exists in a residential or nonresidential program, the court shall issue a 
155.2 	temporary order for appointment of a receiver within five two days after receipt of the 
155.3 	petition. Notice of the petition must be served on the program administrator and on the 
155.4 	persons designated as agents by the controlling individuals to accept service on their behalf. 
155.5 	A hearing on the petition must be held within five days after notice is served unless the 
155.6 	administrator or authorized agent consents to a later date. After the hearing, the court may 
155.7 	continue, modify, or terminate the temporary order.
155.8 	(b) Notice of the petition must be served on the authorized agent of the program that is 
155.9 	subject to the receivership petition or, if the authorized agent is not immediately available 
155.10 	for service, on at least one of the controlling individuals for the program. A hearing on the 
155.11 	petition must be held within five days after notice is served unless the authorized agent or 
155.12 	other controlling individual consents to a later date. After the hearing, the court may continue, 
155.13 	modify, or terminate the temporary order.

155.14 	Sec. 10. Minnesota Statutes 2022, section 245A.13, subdivision 7, is amended to read:
155.15 		Subd. 7.Rate recommendation. For any program receiving Medicaid funds and ordered 
155.16 	into receivership, the commissioner of human services may review rates of a residential or 
155.17 	nonresidential program participating in the medical assistance program which is in 
155.18 	receivership and that has needs or deficiencies documented by the Department of Health 
155.19 	or the Department of Human Services. If the commissioner of human services determines 
155.20 	that a review of the rate established under sections 256B.5012 and 256B.5013 is needed, 
155.21 	the commissioner shall:
155.22 	(1) review the order or determination that cites the deficiencies or needs; and
155.23 	(2) determine the need for additional staff, additional annual hours by type of employee, 
155.24 	and additional consultants, services, supplies, equipment, repairs, or capital assets necessary 
155.25 	to satisfy the needs or deficiencies.

155.26 	Sec. 11. Minnesota Statutes 2022, section 245A.13, subdivision 9, is amended to read:
155.27 		Subd. 9.Receivership accounting. The commissioner may use adjust Medicaid rates 
155.28 	and use Medicaid funds, including but not limited to waiver funds, and the medical assistance 
155.29 	account and funds for receivership cash flow, receivership administrative fees, and accounting 
155.30 	purposes, to the extent permitted by the state's approved Medicaid plan.

156.1 	ARTICLE 8
156.2 	APPROPRIATIONS

156.3	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
156.4 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
156.5 	and for the purposes specified in this article. The appropriations are from the general fund, 
156.6 	or another named fund, and are available for the fiscal years indicated for each purpose. 
156.7 	The figures "2024" and "2025" used in this article mean that the appropriations listed under 
156.8 	them are available for the fiscal year ending June 30, 2024, or June 30, 2025, respectively. 
156.9 	"The first year" is fiscal year 2024. "The second year" is fiscal year 2025. "The biennium" 
156.10 	is fiscal years 2024 and 2025.

156.11				APPROPRIATIONS
	
156.12				Available for the Year
	
156.13				Ending June 30
	
156.14					2024
		2025

156.15
156.16	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

156.17	Subdivision 1.Total Appropriation
 	$
	6,824,051,000
	$
	7,263,031,000

156.18	Appropriations by Fund
	
156.19		2024
	2025
	
156.20	General
	6,815,172,000
	7,258,069,000
	
156.21	Lottery Prize
	1,733,000
	1,733,000
	
156.22
156.23	Opiate Epidemic 
Response
	500,000
	-0-
	
156.24 	The amounts that may be spent for each 
156.25 	purpose are specified in the following 
156.26 	subdivisions.

156.27	Subd. 2.Central Office; Operations

156.28	Appropriations by Fund
	
156.29	General
	65,613,000
	16,057,000
	
156.30 	(a) Staffing Costs. Appropriations for staffing 
156.31 	costs in this subdivision are available until 
156.32 	June 30, 2027.
157.1 	(b) Base Level Adjustment. The general fund 
157.2 	base is $4,975,000 in fiscal year 2026 and 
157.3 	$4,868,000 in fiscal year 2027.

157.4	Subd. 3.Central Office; Children and Families

157.5	Appropriations by Fund
	
157.6	General
	1,073,000
	3,693,000
	
157.7 	Staffing Costs. Appropriations for staffing 
157.8 	costs in this subdivision are available until 
157.9 	June 30, 2027.

157.10	Subd. 4.Central Office; Health Care
 		2,039,000
		2,122,000
	
157.11 	(a) Staffing Costs. Appropriations for staffing 
157.12 	costs in this subdivision are available until 
157.13 	June 30, 2027.
157.14 	(b) Base Level Adjustment. The general fund 
157.15 	base is $900,000 in fiscal year 2026 and 
157.16 	$900,000 in fiscal year 2027.
157.17 	(c) Initial PACE Implementation Funding.
157.18 	$150,000 in fiscal year 2024 is to complete 
157.19 	the initial actuarial and administrative work 
157.20 	necessary to recommend a financing 
157.21 	mechanism for the operation of PACE under 
157.22 	Minnesota Statutes, section 256B.69, 
157.23 	subdivision 23, paragraph (e). This is a 
157.24 	onetime appropriation.

157.25
157.26	Subd. 5.Central Office; Continuing Care for 
Older Adults
 		14,120,000
		21,666,000
	
157.27 	(a) Staffing Costs. Appropriations for staffing 
157.28 	costs in this subdivision are available until 
157.29 	June 30, 2027.
157.30 	(b) Research on Access to Long-Term Care 
157.31 	Services. $700,000 in fiscal year 2024 is to 
157.32 	support an actuarial research study of public 
157.33 	and private financing options for long-term 
158.1 	services and supports reform to increase access 
158.2 	across the state. This is a onetime 
158.3 	appropriation.
158.4 	(c) Employment Supports Alignment Study.
158.5 	$50,000 in fiscal year 2024 and $200,000 in 
158.6 	fiscal year 2025 are to conduct an interagency 
158.7 	employment supports alignment study. The 
158.8 	base for this appropriation is $150,000 in fiscal 
158.9 	year 2026 and $100,000 in fiscal year 2027.
158.10 	(d) Case Management Training 
158.11 	Curriculum. $377,000 in fiscal year 2024 and 
158.12 	$377,000 fiscal year 2025 are to develop and 
158.13 	implement a curriculum and training plan to 
158.14 	ensure all lead agency assessors and case 
158.15 	managers have the knowledge and skills 
158.16 	necessary to fulfill support planning and 
158.17 	coordination responsibilities for individuals 
158.18 	who use home and community-based disability 
158.19 	services and live in own-home settings. These 
158.20 	are onetime appropriations.
158.21 	(e) Parent-to-Parent Programs. (1) $625,000 
158.22 	in fiscal year 2024 and $625,000 in fiscal year 
158.23 	2025 are for grants to organizations supporting 
158.24 	the organizations' parent-to-parent programs 
158.25 	for families of children with special health 
158.26 	care needs. This is a onetime appropriation 
158.27 	and is available until June 30, 2025.
158.28 	(2) Of this amount, $500,000 in fiscal year 
158.29 	2024 and $500,000 in fiscal year 2025 are for 
158.30 	grants to organizations that provide services 
158.31 	to underserved communities with a high 
158.32 	prevalence of autism spectrum disorder. The 
158.33 	commissioner shall give priority to 
158.34 	organizations that provide culturally specific 
158.35 	and culturally responsive services.
159.1 	(3) Eligible organizations must:
159.2 	(i) conduct outreach and provide support to 
159.3 	newly identified parents or guardians of a child 
159.4 	with special health care needs;
159.5 	(ii) provide training to educate parents and 
159.6 	guardians in ways to support their child and 
159.7 	navigate the health, education, and human 
159.8 	services systems;
159.9 	(iii) facilitate ongoing peer support for parents 
159.10 	and guardians from trained volunteer support 
159.11 	parents; and
159.12 	(iv) communicate regularly with other 
159.13 	parent-to-parent programs and national 
159.14 	organizations to ensure that best practices are 
159.15 	implemented.
159.16 	(4) Grant recipients must use grant money for 
159.17 	the activities identified in clause (3).
159.18 	(5) For purposes of this section, "special health 
159.19 	care needs" means disabilities, chronic 
159.20 	illnesses or conditions, health-related 
159.21 	educational or behavioral problems, or the risk 
159.22 	of developing disabilities, illnesses, conditions, 
159.23 	or problems.
159.24 	(6) Each grant recipient must report to the 
159.25 	commissioner of human services annually by 
159.26 	January 15 with measurable outcomes from 
159.27 	programs and services funded by this 
159.28 	appropriation the previous year including the 
159.29 	number of families served and the number of 
159.30 	volunteer support parents trained by the 
159.31 	organization's parent-to-parent program.
159.32 	(f) Direct Care Service Corps Pilot Project.
159.33 	$500,000 in fiscal year 2024 is for a grant to 
160.1 	HealthForce Minnesota at Winona State 
160.2 	University for purposes of the direct care 
160.3 	service corps pilot project. Up to $25,000 may 
160.4 	be used by HealthForce Minnesota for 
160.5 	administrative costs. This is a onetime 
160.6 	appropriation.
160.7 	(g) Native American Elder Coordinator.
160.8 	$441,000 in fiscal year 2024 and $441,000 in 
160.9 	fiscal year 2025 are for the Native American 
160.10 	elder coordinator position under Minnesota 
160.11 	Statutes, section 256.975, subdivision 6. The 
160.12 	base for this appropriation is $441,000 in fiscal 
160.13 	year 2026 and $441,000 in fiscal year 2027.
160.14 	(h) Office of Ombudsman for Long-Term 
160.15 	Care. $500,000 in fiscal year 2024 and 
160.16 	$500,000 in fiscal year 2025 are for additional 
160.17 	staff and associated costs in the Office of 
160.18 	Ombudsman for Long-Term Care.
160.19 	(i) Base Level Adjustment. The general fund 
160.20 	base is $6,476,000 in fiscal year 2026 and 
160.21 	$6,378,000 in fiscal year 2027.

160.22
160.23
160.24	Subd. 6.Central Office; Behavioral Health, 
Housing, and Deaf and Hard of Hearing 
Services
 		6,415,000
		7,838,000
	
160.25 	(a) Staffing Costs. Appropriations for staffing 
160.26 	costs in this subdivision are available until 
160.27 	June 30, 2027.
160.28 	(b) Competency-based Training Funding 
160.29 	for Substance Use Disorder Provider 
160.30 	Community. $300,000 in fiscal year 2024 and 
160.31 	$300,000 in fiscal year 2025 are for provider 
160.32 	participation in clinical training for the 
160.33 	transition to American Society of Addiction 
160.34 	Medicine standards. This is a onetime 
160.35 	appropriation.
161.1 	(c) Public Awareness Campaign. $1,200,000 
161.2 	in fiscal year 2024 is to develop and establish 
161.3 	a public awareness campaign targeting the 
161.4 	stigma of opioid use disorders with the goal 
161.5 	of prevention and education of youth on the 
161.6 	dangers of opioids and other substance use. 
161.7 	This is a onetime appropriation.
161.8 	(d) Bad Batch Overdose Surge Text Alert 
161.9 	System. $1,000,000 in fiscal year 2024 and 
161.10 	$250,000 in fiscal year 2025 are for 
161.11 	development and ongoing funding for a text 
161.12 	alert system notifying the public in real time 
161.13 	of bad batch overdoses. This is a onetime 
161.14 	appropriation.
161.15 	(e) Evaluation of Recovery Site Grants.
161.16 	$300,000 in fiscal year 2025 is to provide 
161.17 	funding for evaluating the effectiveness of 
161.18 	recovery site grant efforts. This is a onetime 
161.19 	appropriation.
161.20 	(f) Office of Addiction and Recovery.
161.21 	$750,000 in fiscal year 2024 and $750,000 in 
161.22 	fiscal year 2025 are for the Office of Addiction 
161.23 	and Recovery.
161.24 	(g) Base Level Adjustment. The general fund 
161.25 	base is $2,667,000 in fiscal year 2026 and 
161.26 	$2,567,000 in fiscal year 2027.

161.27
161.28	Subd. 7.Forecasted Programs; Medical 
Assistance
 		5,654,675,000
		6,359,727,000

161.29	Subd. 8.Forecasted Programs; Alternative Care
 		47,793,000
		51,035,000
	
161.30 	Any money allocated to the alternative care 
161.31 	program that is not spent for the purposes 
161.32 	indicated does not cancel but must be 
161.33 	transferred to the medical assistance account.

162.1
162.2	Subd. 9.Forecasted Programs; Behavioral 
Health Fund
 		96,387,000
		98,417,000

162.3
162.4	Subd. 10.Grant Programs; Children and 
Economic Support Grants
 		1,000,000
		-0-
	
162.5 	Minnesota Alliance for Volunteer 
162.6 	Advancement. (1) $1,000,000 in fiscal year 
162.7 	2024 is for a grant to the Minnesota Alliance 
162.8 	for Volunteer Advancement to administer 
162.9 	needs-based volunteerism subgrants that:
162.10 	(i) target underresourced nonprofit 
162.11 	organizations in greater Minnesota to support 
162.12 	selected organizations' ongoing efforts to 
162.13 	address and minimize disparities in access to 
162.14 	human services through increased 
162.15 	volunteerism; and
162.16 	(ii) demonstrate that the populations to be 
162.17 	served by the subgrantee are considered 
162.18 	underserved or suffer from or are at risk of 
162.19 	homelessness, hunger, poverty, lack of access 
162.20 	to health care, or deficits in education.
162.21 	(2) The Minnesota Alliance for Volunteer 
162.22 	Advancement shall give priority to 
162.23 	organizations that are serving the needs of 
162.24 	vulnerable populations. By December 15, 
162.25 	2025, the Minnesota Alliance for Volunteer 
162.26 	Advancement shall report data on outcomes 
162.27 	from the subgrants and recommendations for 
162.28 	improving and sustaining volunteer efforts 
162.29 	statewide to the chairs and ranking minority 
162.30 	members of the legislative committees and 
162.31 	divisions with jurisdiction over human 
162.32 	services. This is a onetime appropriation and 
162.33 	is available until June 30, 2025.

163.1
163.2	Subd. 11.Grant Programs; Refugee Services 
Grants
 		3,000,000
		5,000,000
	
163.3 	New American Legal and Social Services 
163.4 	Workforce Grant Program. $3,000,000 in 
163.5 	fiscal year 2024 and $5,000,000 in fiscal year 
163.6 	2025 are for legal and social services grants. 
163.7 	This is a onetime appropriation.

163.8
163.9	Subd. 12.Grant Programs; Other Long-Term 
Care Grants
 		44,772,000
		38,925,000
	
163.10 	(a) Provider Capacity Grants for Rural and 
163.11 	Underserved Communities. $24,000,000 in 
163.12 	fiscal year 2025 is for provider capacity grants 
163.13 	for rural and underserved communities. This 
163.14 	is a onetime appropriation.
163.15 	(b) Supporting New Americans in the 
163.16 	Long-Term Care Workforce Grants.
163.17 	$25,759,000 in fiscal year 2024 and 
163.18 	$13,000,000 in fiscal year 2025 are for 
163.19 	supporting new Americans in the long-term 
163.20 	care workforce grants. This is a onetime 
163.21 	appropriation.
163.22 	(c) Base Level Adjustment. The general fund 
163.23 	base is $1,925,000 in fiscal year 2026 and 
163.24 	$1,925,000 in fiscal year 2027.

163.25
163.26	Subd. 13.Grant Programs; Aging and Adult 
Services Grants
 		97,599,000
		49,520,000
	
163.27 	(a) Age-Friendly Community Grants.
163.28 	$1,000,000 in fiscal year 2025 is for the 
163.29 	continuation of age-friendly community grants 
163.30 	under Laws 2021, First Special Session 
163.31 	chapter 7, article 17, section 8, subdivision 1. 
163.32 	The base for this appropriation is $1,000,000 
163.33 	in fiscal year 2026, $1,000,000 in fiscal year 
163.34 	2027, and $0 in fiscal year 2028. This 
163.35 	appropriation is available until June 30, 2027.
164.1 	(b) Age-Friendly Technical Assistance 
164.2 	Grants. $575,000 in fiscal year 2025 is for 
164.3 	the continuation of age-friendly technical 
164.4 	assistance grants under Laws 2021, First 
164.5 	Special Session chapter 7, article 17, section 
164.6 	8, subdivision 2. The base for this 
164.7 	appropriation is $575,000 in fiscal year 2026, 
164.8 	$575,000 in fiscal year 2027, and $0 in fiscal 
164.9 	year 2028. This appropriation is available until 
164.10 	June 30, 2027.
164.11 	(c) Senior Nutrition Program. $4,500,000 
164.12 	in fiscal year 2024 is for the senior nutrition 
164.13 	program under Minnesota Statutes, section 
164.14 	256.9752. This is a onetime appropriation and 
164.15 	is available until June 30, 2025.
164.16 	(d) Live Well at Home Grants. $4,500,000 
164.17 	in fiscal year 2024 is for live well at home 
164.18 	grants under Minnesota Statutes, section 
164.19 	256.9754. This is a onetime appropriation and 
164.20 	is available until June 30, 2025.
164.21 	(e) Caregiver Respite Services Grants.
164.22 	$1,800,000 in fiscal year 2025 is for caregiver 
164.23 	respite services grants under Minnesota 
164.24 	Statutes, section 256.9756. This is a onetime 
164.25 	appropriation.
164.26 	(f) Base Level Adjustment. The general fund 
164.27 	base is $32,995,000 in fiscal year 2026 and 
164.28 	$32,995,000 in fiscal year 2027.

164.29
164.30	Subd. 14.Grant Programs; Deaf and Hard of 
Hearing Grants
 		2,886,000
		2,886,000

164.31	Subd. 15.Grant Programs; Disabilities Grants
 		160,792,000
		29,533,000
	
164.32 	(a) Transition Grants for Small Customized 
164.33 	Living Providers. $8,450,000 in fiscal year 
164.34 	2024 is for grants to assist transitions of small 
165.1 	customized living providers as defined under 
165.2 	Minnesota Statutes, section 245D.24. This is 
165.3 	a onetime appropriation and is available 
165.4 	through June 30, 2025.
165.5 	(b) Lead Agency Capacity Building Grants.
165.6 	$500,000 in fiscal year 2024 and $2,500,000 
165.7 	in fiscal year 2025 are for grants to assist 
165.8 	organizations, counties, and Tribes to build 
165.9 	capacity for employment opportunities for 
165.10 	people with disabilities.
165.11 	(c) Employment and Technical Assistance 
165.12 	Center Grants. $450,000 in fiscal year 2024 
165.13 	and $1,800,000 in fiscal year 2025 are for 
165.14 	employment and technical assistance grants 
165.15 	to assist organizations and employers in 
165.16 	promoting a more inclusive workplace for 
165.17 	people with disabilities.
165.18 	(d) Case Management Training Grants.
165.19 	$37,000 in fiscal year 2024 and $123,000 in 
165.20 	fiscal year 2025 are for grants to provide case 
165.21 	management training to organizations and 
165.22 	employers to support the state's disability 
165.23 	employment supports system. The base for 
165.24 	this appropriation is $45,000 in fiscal year 
165.25 	2026 and $45,000 in fiscal year 2027.
165.26 	(e) Electronic Visit Verification Stipends.
165.27 	$6,095,000 in fiscal year 2024 is for onetime 
165.28 	stipends of $200 to bargaining members to 
165.29 	offset the potential costs related to people 
165.30 	using individual devices to access the 
165.31 	electronic visit verification system. $5,600,000 
165.32 	of the appropriation is for stipends and the 
165.33 	remaining amount is for administration of the 
165.34 	stipends. This is a onetime appropriation and 
165.35 	is available until June 30, 2025.
166.1 	(f) Self-Directed Collective Bargaining 
166.2 	Agreement; Temporary Rate Increase 
166.3 	Memorandum of Understanding. $1,600,000 
166.4 	in fiscal year 2024 is for onetime stipends for 
166.5 	individual providers covered by the SEIU 
166.6 	collective bargaining agreement based on the 
166.7 	memorandum of understanding related to the 
166.8 	temporary rate increase in effect between 
166.9 	December 1, 2020, and February 7, 2021. 
166.10 	$1,400,000 of the appropriation is for stipends 
166.11 	and the remaining amount is for administration 
166.12 	of the stipends. This is a onetime 
166.13 	appropriation.
166.14 	(g) Self-Directed Collective Bargaining 
166.15 	Agreement; Retention Bonuses. $50,750,000 
166.16 	in fiscal year 2024 is for onetime retention 
166.17 	bonuses covered by the SEIU collective 
166.18 	bargaining agreement. $50,000,000 of the 
166.19 	appropriation is for retention bonuses and the 
166.20 	remaining amount is for administration of the 
166.21 	bonuses. This is a onetime appropriation and 
166.22 	is available until June 30, 2025.
166.23 	(h) Training Stipends. $2,100,000 in fiscal 
166.24 	year 2024 and $100,000 in fiscal year 2025 
166.25 	are for onetime stipends of $500 for collective 
166.26 	bargaining unit members who complete 
166.27 	designated, voluntary trainings made available 
166.28 	through or recommended by the State Provider 
166.29 	Cooperation Committee. $2,000,000 of the 
166.30 	appropriation is for stipends and the remaining 
166.31 	amount in both fiscal year 2024 and fiscal 
166.32 	2025 is for the administration of stipends. This 
166.33 	is a onetime appropriation.
166.34 	(i) Orientation Program. $2,000,000 in fiscal 
166.35 	year 2024 and $2,000,000 in fiscal year 2025 
167.1 	are for onetime $100 payments for collective 
167.2 	bargaining unit members who complete 
167.3 	voluntary orientation requirements. $1,500,000 
167.4 	in fiscal year 2024 and $1,500,000 in fiscal 
167.5 	year 2025 are for the onetime payments, while 
167.6 	$500,000 in fiscal year 2024 and $500,000 in 
167.7 	fiscal year 2025 are for orientation-related 
167.8 	costs. This is a onetime appropriation.
167.9 	(j) HIV/AIDS Support Services. $24,200,000 
167.10 	in fiscal year 2024 is for grants to 
167.11 	community-based HIV/AIDS support services 
167.12 	providers and for payment of allowed health 
167.13 	care costs as defined in Minnesota Statutes, 
167.14 	section 256.9365. This is a onetime 
167.15 	appropriation and is available through June 
167.16 	30, 2027.
167.17 	(k) Home Care Orientation Trust.
167.18 	$1,000,000 in fiscal year 2024 is for the Home 
167.19 	Care Orientation Trust in Article 10 of the 
167.20 	2023-2025 collective bargaining agreement 
167.21 	between the state of Minnesota and Service 
167.22 	Employees International Union Healthcare 
167.23 	Minnesota and Iowa. The commissioner shall 
167.24 	disburse the appropriation to the board of 
167.25 	trustees of the Home Care Orientation Trust 
167.26 	for deposit into an account designed by the 
167.27 	board of trustees outside of the state treasury 
167.28 	and state's accounting system. This is a 
167.29 	onetime appropriation.
167.30 	(l) Home and Community-Based Workforce 
167.31 	Incentive Fund Grants. $33,300,000 in fiscal 
167.32 	year 2024 is for home and community-based 
167.33 	workforce incentive fund grants. This is a 
167.34 	onetime appropriation and is available until 
167.35 	June 30, 2026.
168.1 	(m) Community Residential Setting 
168.2 	Transition. $500,000 in fiscal year 2024 is 
168.3 	for a grant to Hennepin County to expedite 
168.4 	approval of community residential setting 
168.5 	licenses subject to the corporate foster care 
168.6 	moratorium exception under Minnesota 
168.7 	Statutes, section 245A.03, subdivision 7, 
168.8 	paragraph (a), clause (5).
168.9 	(n) Base Level Adjustment. The base is 
168.10 	$27,355,000 in fiscal year 2026 and 
168.11 	$27,030,000 in fiscal year 2027.

168.12
168.13	Subd. 16.Grant Programs; Adult Mental Health 
Grants
 		1,500,000
		1,500,000
	
168.14 	African American Child Wellness Institute.
168.15 	$3,000,000 in fiscal year 2024 is for a grant 
168.16 	to the African American Child Wellness 
168.17 	Institute, a culturally specific African 
168.18 	American mental health service provider that 
168.19 	is a licensed community mental health center 
168.20 	specializing in services for African American 
168.21 	children and families of all ages. The grant 
168.22 	must be used to support the center in offering 
168.23 	culturally specific, comprehensive, 
168.24 	trauma-informed, practice- and 
168.25 	evidence-based, person- and family-centered 
168.26 	mental health and substance use disorder 
168.27 	services; supervision and training; and care 
168.28 	coordination regardless of ability to pay or 
168.29 	place of residence. This is a onetime 
168.30 	appropriation.

168.31
168.32	Subd. 17.Grant Programs; Chemical 
Dependency Treatment Support Grants

168.33	Appropriations by Fund
	
168.34	General
	89,788,000
	6,497,000
	
169.1	Lottery Prize
	1,733,000
	1,733,000
	
169.2
169.3	Opiate Epidemic 
Response
	500,000
	-0-
	
169.4 	(a) Safe Recovery Sites. $55,491,000 in fiscal 
169.5 	year 2024 is from the general fund for start-up 
169.6 	and capacity-building grants for organizations 
169.7 	to establish safe recovery sites. This 
169.8 	appropriation is onetime and is available until 
169.9 	June 30, 2025.
169.10 	(b) Culturally Specific Services Grants.
169.11 	$4,000,000 in fiscal year 2024 is from the 
169.12 	general fund for grants to culturally specific 
169.13 	providers for technical assistance navigating 
169.14 	culturally specific and responsive substance 
169.15 	use and recovery programs. This is a onetime 
169.16 	appropriation.
169.17 	(c) Culturally Specific Grant Development 
169.18 	Trainings. $200,000 in fiscal year 2024 and 
169.19 	$200,000 in fiscal year 2025 are from the 
169.20 	general fund for up to four trainings for 
169.21 	community members and culturally specific 
169.22 	providers for grant writing training for 
169.23 	substance use and recovery programs. This is 
169.24 	onetime appropriation.
169.25 	(d) Harm Reduction Supplies for Tribal 
169.26 	and Culturally Specific Programs.
169.27 	$8,000,000 in fiscal year 2024 is from the 
169.28 	general fund to provide sole source grants to 
169.29 	culturally specific communities to purchase 
169.30 	syringes, testing supplies, and opiate 
169.31 	antagonists. This is a onetime appropriation.
169.32 	(e) Families and family Treatment 
169.33 	Capacity-building and Start-up Grants.
169.34 	$10,000,000 in fiscal year 2024 is from the 
169.35 	general fund for start-up and capacity-building 
170.1 	grants for family substance use disorder 
170.2 	treatment programs. Any unexpended funds 
170.3 	are available until June 30, 2029. This is a 
170.4 	onetime appropriation.
170.5 	(f) Minnesota State University, Mankato 
170.6 	Community Behavioral Health Center.
170.7 	$750,000 in fiscal year 2024 and $750,000 in 
170.8 	fiscal year 2025 are from the general fund for 
170.9 	a grant to the Center for Rural Behavioral 
170.10 	Health at Minnesota State University, Mankato 
170.11 	to establish a community behavioral health 
170.12 	center and training clinic. The community 
170.13 	behavioral health center must provide 
170.14 	comprehensive, culturally specific, 
170.15 	trauma-informed, practice- and 
170.16 	evidence-based, person- and family-centered 
170.17 	mental health and substance use disorder 
170.18 	treatment services in Blue Earth County and 
170.19 	the surrounding region. The center must 
170.20 	provide the services to individuals of all ages, 
170.21 	regardless of ability to pay or place of 
170.22 	residence. The community behavioral health 
170.23 	center and training clinic must also provide 
170.24 	training and workforce development 
170.25 	opportunities to students enrolled in the 
170.26 	university's training programs in the fields of 
170.27 	social work, counseling and student personnel, 
170.28 	alcohol and drug studies, psychology, and 
170.29 	nursing. The commissioner shall make 
170.30 	information regarding the use of this grant 
170.31 	funding available to the chairs and ranking 
170.32 	minority members of the legislative 
170.33 	committees with jurisdiction over health and 
170.34 	human services. Any unspent money from the 
170.35 	fiscal year 2024 appropriation is available in 
171.1 	fiscal year 2025. These are onetime 
171.2 	appropriations.
171.3 	(g) Wellness in the Woods. $250,000 in fiscal 
171.4 	year 2024 and $250,000 in fiscal year 2025 
171.5 	are from the general fund for a grant to 
171.6 	Wellness in the Woods for daily peer support 
171.7 	and special sessions for individuals who are 
171.8 	in substance use disorder recovery, are 
171.9 	transitioning out of incarceration, or who have 
171.10 	experienced trauma. These are onetime 
171.11 	appropriations.
171.12 	(h) Recovery Community Organization 
171.13 	Grants. $4,300,000 in fiscal year 2024 is from 
171.14 	the general fund for grants to recovery 
171.15 	community organizations, as defined in 
171.16 	Minnesota Statutes, section 254B.01, 
171.17 	subdivision 8, that are current grantees as of 
171.18 	June 30, 2023. This is a onetime appropriation 
171.19 	and is available until June 30, 2025.
171.20 	(i) Opioid Overdose Prevention Grants.
171.21 	$500,000 in fiscal year 2024 and $500,000 in 
171.22 	fiscal year 2025 are from the general fund for 
171.23 	a grant to Ka Joog, a nonprofit organization 
171.24 	in Minneapolis, Minnesota, to be used for 
171.25 	collaborative outreach, education, and training 
171.26 	on opioid use and overdose, and distribution 
171.27 	of opiate antagonist kits in East African and 
171.28 	Somali communities in Minnesota. This is a 
171.29 	onetime appropriation.
171.30 	(j) Problem Gambling. $225,000 in fiscal 
171.31 	year 2024 and $225,000 in fiscal year 2025 
171.32 	are from the lottery prize fund for a grant to a 
171.33 	state affiliate recognized by the National 
171.34 	Council on Problem Gambling. The affiliate 
171.35 	must provide services to increase public 
172.1 	awareness of problem gambling, education, 
172.2 	training for individuals and organizations that 
172.3 	provide effective treatment services to problem 
172.4 	gamblers and their families, and research 
172.5 	related to problem gambling.
172.6 	(k) Project ECHO. $1,500,000 in fiscal year 
172.7 	2024 and $1,500,000 in fiscal year 2025 are 
172.8 	from the general fund for a grant to Hennepin 
172.9 	Healthcare to expand the Project ECHO 
172.10 	program. The grant must be used to establish 
172.11 	at least four substance use disorder-focused 
172.12 	Project ECHO programs at Hennepin 
172.13 	Healthcare, expanding the grantee's capacity 
172.14 	to improve health and substance use disorder 
172.15 	outcomes for diverse populations of 
172.16 	individuals enrolled in medical assistance, 
172.17 	including but not limited to immigrants, 
172.18 	individuals who are homeless, individuals 
172.19 	seeking maternal and perinatal care, and other 
172.20 	underserved populations. The Project ECHO 
172.21 	programs funded under this section must be 
172.22 	culturally responsive, and the grantee must 
172.23 	contract with culturally and linguistically 
172.24 	appropriate substance use disorder service 
172.25 	providers who have expertise in focus areas, 
172.26 	based on the populations served. Grant funds 
172.27 	may be used for program administration, 
172.28 	equipment, provider reimbursement, and 
172.29 	staffing hours. This is a onetime appropriation.
172.30 	(l) Base Level Adjustment. The general fund 
172.31 	base is $3,247,000 in fiscal year 2026 and 
172.32 	$3,247,000 in fiscal year 2027.

172.33
172.34	Subd. 18.Direct Care and Treatment - Transfer 
Authority
 					
173.1 	(a) Money appropriated for budget activities 
173.2 	under subdivisions 19 to 23 may be transferred 
173.3 	between budget activities and between years 
173.4 	of the biennium with the approval of the 
173.5 	commissioner of management and budget.
173.6 	(b) Ending balances in obsolete accounts in 
173.7 	the special revenue fund and other dedicated 
173.8 	accounts within direct care and treatment may 
173.9 	be transferred to other dedicated and gift fund 
173.10 	accounts within direct care and treatment for 
173.11 	client use and other client activities, with 
173.12 	approval of the commissioner of management 
173.13 	and budget. These transactions must be 
173.14 	completed by August 1, 2023.

173.15
173.16	Subd. 19.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		169,962,000
		177,152,000
	
173.17 	The commissioner responsible for operations 
173.18 	of direct care and treatment services, with the 
173.19 	approval of the commissioner of management 
173.20 	and budget, may transfer any balance in the 
173.21 	enterprise fund established for the community 
173.22 	addiction recovery enterprise program to the 
173.23 	general fund appropriation within this 
173.24 	subdivision. Any balance remaining after June 
173.25 	30, 2025, cancels to the general fund.

173.26
173.27	Subd. 20.Direct Care and Treatment - 
Community-Based Services
 		20,386,000
		21,164,,000
	
173.28 	Base Level Adjustment. The general fund 
173.29 	base is $20,452,000 in fiscal year 2026 and 
173.30 	$20,452,000 in fiscal year 2027.

173.31
173.32	Subd. 21.Direct Care and Treatment - Forensic 
Services
 		141,020,000
		148,513,000

173.33
173.34	Subd. 22.Direct Care and Treatment - Sex 
Offender Program
 		115,920,000
		121,726,000

174.1
174.2	Subd. 23.Direct Care and Treatment - 
Operations
 		78,432,000
		95,098,000
	
174.3 	The general fund base is $65,263,000 in fiscal 
174.4 	year 2026 and $65,263,000 in fiscal year 2027.

174.5	Sec. 3. COUNCIL ON DISABILITY
 	$
	1,902,000
	$
	2,282,000
	
174.6 	(a) Council on Disability; Accessibility 
174.7 	Standards Training. (1) $250,000 in fiscal 
174.8 	year 2024 and $250,000 in fiscal year 2025 
174.9 	are for the Minnesota Council on Disability 
174.10 	to select, appoint, and compensate employees 
174.11 	to perform the following tasks:
174.12 	(i) in consultation with the League of 
174.13 	Minnesota Cities and the Association of 
174.14 	Minnesota Counties, provide a statewide 
174.15 	training module for cities and counties on how 
174.16 	to conform local government websites to 
174.17 	accessibility standards;
174.18 	(ii) provide outreach, training, and technical 
174.19 	assistance for local government officials and 
174.20 	staff on website accessibility; and
174.21 	(iii) track and compile information about the 
174.22 	outcomes of the activities described in clauses 
174.23 	(1) and (2) and the costs of implementation 
174.24 	for cities and counties to make website 
174.25 	accessibility improvements.
174.26 	(2) The training module described under 
174.27 	paragraph (a), clause (1), must be developed 
174.28 	and made available to counties and cities on 
174.29 	or before July 1, 2024.
174.30 	(3) This is a onetime appropriation.
174.31 	(b) Base Level Adjustment. The general fund 
174.32 	base is $2,032,000 in fiscal year 2026 and 
174.33 	$2,032,000 in fiscal year 2027.

175.1
175.2
175.3	Sec. 4. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	3,441,000
	$
	3,644,000

175.4
175.5	Sec. 5. MINNESOTA MANAGEMENT AND 
BUDGET
 		1,000,000
		1,000,000
	
175.6 	(a) Office of Addiction and Recovery.
175.7 	$750,000 in fiscal year 2024 and $750,000 in 
175.8 	fiscal year 2025 are for the Office of Addiction 
175.9 	and Recovery.
175.10 	(b) Youth Substance Use and Addiction 
175.11 	Recovery Office. $250,000 in fiscal year 2024 
175.12 	and $250,000 in fiscal year 2025 are for the 
175.13 	Youth Substance Use and Addiction Recovery 
175.14 	Office.

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

175.24 	Sec. 7. APPROPRIATION; NURSING FACILITY GRANTS.
 175.25 	(a) $10,000,000 in fiscal year 2024 and $10,000,000 in fiscal year 2025 are appropriated 
175.26 	from the general fund to the commissioner of human services for grants to nursing facilities. 
175.27 	This is a onetime appropriation.
175.28 	(b) To be eligible to receive a grant under this section, a nursing facility must apply to 
175.29 	the commissioner on the forms and according to the timelines established by the 
175.30 	commissioner. The commissioner must develop an expedited application process that 
175.31 	includes a form allowing applicants to meet the requirements of this section in as timely a 
175.32 	manner as possible. The commissioner must allow the use of electronic submission of 
175.33 	application forms and accept electronic signatures.
176.1 	(c) An eligible nursing facility must receive a grant in an amount equal to half of the 
176.2 	facility's estimated lost revenue from March 15, 2020, to January 31, 2022.
176.3 	(d) A nursing facility must attest to the commissioner that the grant money will be used 
176.4 	to:
176.5 	(1) pay down debt accrued from March 15, 2020, to January 31, 2022;
176.6 	(2) pay for steps taken to mitigate the effects of the COVID-19 pandemic; or
176.7 	(3) hire or retain staff.
176.8 	(e) A nursing facility that receives a grant under this section must prepare, and submit 
176.9 	to the commissioner upon request, a plan that specifies the total amount of grant money the 
176.10 	facility expects to receive and how that money will be used to meet the requirements of 
176.11 	paragraph (d).
176.12 	(f) The commissioner must not treat grant money received under this section as an 
176.13 	applicable credit for the purposes of setting total payment rates under Minnesota Statutes, 
176.14 	chapter 256R.

176.15 	Sec. 8. DIRECT CARE AND TREATMENT FISCAL YEAR 2023 
176.16 	APPROPRIATION.
 176.17 	$4,829,000 is appropriated in fiscal year 2023 to the commissioner of human services 
176.18 	for operation of direct care and treatment programs. This is a onetime appropriation.

176.19 	Sec. 9. TRANSFERS.
 176.20 		Subdivision 1.Grants. The commissioner of human services, with the approval of the 
176.21 	commissioner of management and budget, may transfer unencumbered appropriation balances 
176.22 	for the biennium ending June 30, 2025, within fiscal years among the MFIP; general 
176.23 	assistance; medical assistance; MinnesotaCare; MFIP child care assistance under Minnesota 
176.24 	Statutes, section 119B.05; Minnesota supplemental aid program; housing support program; 
176.25 	the entitlement portion of Northstar Care for Children under Minnesota Statutes, chapter 
176.26 	256N; and the entitlement portion of the behavioral health fund between fiscal years of the 
176.27 	biennium. The commissioner shall inform the chairs and ranking minority members of the 
176.28 	legislative committees with jurisdiction over health and human services quarterly about 
176.29 	transfers made under this subdivision.
176.30 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
176.31 	may be transferred within the Department of Human Services as the commissioner considers 
177.1 	necessary, with the advance approval of the commissioner of management and budget. The 
177.2 	commissioners shall inform the chairs and ranking minority members of the legislative 
177.3 	committees with jurisdiction over health and human services finance quarterly about transfers 
177.4 	made under this section.

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

177.8 	Sec. 11. FINANCIAL REVIEW OF NONPROFIT GRANT RECIPIENTS 
177.9 	REQUIRED.
 177.10 		Subdivision 1.Financial review required. (a) Before awarding a competitive, 
177.11 	legislatively named, single-source, or sole-source grant to a nonprofit organization under 
177.12 	this act, the grantor must require the applicant to submit financial information sufficient for 
177.13 	the grantor to document and assess the applicant's current financial standing and management. 
177.14 	Items of significant concern must be addressed with the applicant and resolved to the 
177.15 	satisfaction of the grantor before a grant is awarded. The grantor must document the material 
177.16 	requested and reviewed; whether the applicant had a significant operating deficit, a deficit 
177.17 	in unrestricted net assets, or insufficient internal controls; whether and how the applicant 
177.18 	resolved the grantor's concerns; and the grantor's final decision. This documentation must 
177.19 	be maintained in the grantor's files.
177.20 	(b) At a minimum, the grantor must require each applicant to provide the following 
177.21 	information:
177.22 	(1) the applicant's most recent Form 990, Form 990-EZ, or Form 990-N filed with the 
177.23 	Internal Revenue Service. If the applicant has not been in existence long enough or is not 
177.24 	required to file Form 990, Form 990-EZ, or Form 990-N, the applicant must demonstrate 
177.25 	to the grantor that the applicant is exempt and must instead submit documentation of internal 
177.26 	controls and the applicant's most recent financial statement prepared in accordance with 
177.27 	generally accepted accounting principles and approved by the applicant's board of directors 
177.28 	or trustees, or if there is no such board, by the applicant's managing group;
177.29 	(2) evidence of registration and good standing with the secretary of state under Minnesota 
177.30 	Statutes, chapter 317A, or other applicable law;
177.31 	(3) unless exempt under Minnesota Statutes, section 309.515, evidence of registration 
177.32 	and good standing with the attorney general under Minnesota Statutes, chapter 309; and
178.1 	(4) if required under Minnesota Statutes, section 309.53, subdivision 3, the applicant's 
178.2 	most recent audited financial statement prepared in accordance with generally accepted 
178.3 	accounting principles.
178.4 		Subd. 2.Authority to postpone or forgo. Notwithstanding any contrary provision in 
178.5 	this act, a grantor that identifies an area of significant concern regarding the financial standing 
178.6 	or management of a legislatively named applicant may postpone or forgo awarding the 
178.7 	grant.
178.8 		Subd. 3.Authority to award subject to additional assistance and oversight. A grantor 
178.9 	that identifies an area of significant concern regarding an applicant's financial standing or 
178.10 	management may award a grant to the applicant if the grantor provides or the grantee 
178.11 	otherwise obtains additional technical assistance, as needed, and the grantor imposes 
178.12 	additional requirements in the grant agreement. Additional requirements may include but 
178.13 	are not limited to enhanced monitoring, additional reporting, or other reasonable requirements 
178.14 	imposed by the grantor to protect the interests of the state.
178.15 		Subd. 4.Relation to other law and policy. The requirements in this section are in 
178.16 	addition to any other requirements imposed by law, the commissioner of administration 
178.17 	under Minnesota Statutes, sections 16B.97 and 16B.98, or agency policy.

178.18 	Sec. 12. EXPIRATION OF UNCODIFIED LANGUAGE.
 178.19 	All uncodified language contained in this article expires on June 30, 2025, unless a 
178.20 	different expiration date is explicit.

APPENDIX 

Repealed Minnesota Statutes: UES2934-2 

245G.06 INDIVIDUAL TREATMENT PLAN.Subd. 2.Plan contents. 
An individual treatment plan must be recorded in the six dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue identified in the assessment summary, prioritized according to the client's needs and focus, and must include: 

(1) specific goals and methods to address each identified need in the comprehensive assessment summary, including amount, frequency, and anticipated duration of treatment service. The methods must be appropriate to the client's language, reading skills, cultural background, and strengths; 

(2) resources to refer the client to when the client's needs are to be addressed concurrently by another provider; and 

(3) goals the client must reach to complete treatment and terminate services. 

246.18 DISPOSAL OF FUNDS.Subd. 2.Behavioral health fund. 
Money received by a substance use disorder treatment facility operated by a regional treatment center or nursing home under the jurisdiction of the commissioner of human services must be deposited in the state treasury and credited to the behavioral health fund. Money in the behavioral health fund is appropriated to the commissioner to operate substance use disorder programs. 

Subd. 2a.Disposition of interest for the behavioral health fund. 
Beginning July 1, 1991, interest earned on cash balances on deposit with the commissioner of management and budget derived from receipts from substance use disorder programs affiliated with state-operated facilities under the commissioner of human services must be deposited in the state treasury and credited to a substance use disorder account under subdivision 2. Any interest earned is appropriated to the commissioner to operate substance use disorder programs according to subdivision 2. 

256B.0759 SUBSTANCE USE DISORDER DEMONSTRATION PROJECT.Subd. 6.Medium intensity residential program participation. 
Medium intensity residential programs that qualify to participate in the demonstration project shall use the specified base payment rate of $132.90 per day, and shall be eligible for the rate increases specified in subdivision 4. 

256B.0917 HOME AND COMMUNITY-BASED SERVICES FOR OLDER ADULTS.Subd. 1a.Home and community-based services for older adults. 
(a) The purpose of projects selected by the commissioner of human services under this section is to make strategic changes in the long-term services and supports system for older adults including statewide capacity for local service development and technical assistance, and statewide availability of home and community-based services for older adult services, caregiver support and respite care services, and other supports in the state of Minnesota. These projects are intended to create incentives for new and expanded home and community-based services in Minnesota in order to: 

(1) reach older adults early in the progression of their need for long-term services and supports, providing them with low-cost, high-impact services that will prevent or delay the use of more costly services; 

(2) support older adults to live in the most integrated, least restrictive community setting; 

(3) support the informal caregivers of older adults; 

(4) develop and implement strategies to integrate long-term services and supports with health care services, in order to improve the quality of care and enhance the quality of life of older adults and their informal caregivers; 

(5) ensure cost-effective use of financial and human resources; 

(6) build community-based approaches and community commitment to delivering long-term services and supports for older adults in their own homes; 

(7) achieve a broad awareness and use of lower-cost in-home services as an alternative to nursing homes and other residential services; 

(8) strengthen and develop additional home and community-based services and alternatives to nursing homes and other residential services; and 

(9) strengthen programs that use volunteers. 

(b) The services provided by these projects are available to older adults who are eligible for medical assistance and the elderly waiver under chapter 256S, the alternative care program under section 256B.0913, or essential community supports grant under section 256B.0922, and to persons who have their own funds to pay for services. 

Subd. 6.Caregiver support and respite care projects. 
(a) The commissioner shall establish projects to expand the availability of caregiver support and respite care services for family and other caregivers. The commissioner shall use a request for proposals to select nonprofit entities to administer the projects. Projects shall: 

(1) establish a local coordinated network of volunteer and paid respite workers; 

(2) coordinate assignment of respite care services to caregivers of older adults; 

(3) assure the health and safety of the older adults; 

(4) identify at-risk caregivers; 

(5) provide information, education, and training for caregivers in the designated community; and 

(6) demonstrate the need in the proposed service area particularly where nursing facility closures have occurred or are occurring or areas with service needs identified by section 144A.351. Preference must be given for projects that reach underserved populations. 

(b) Projects must clearly describe: 

(1) how they will achieve their purpose; 

(2) the process for recruiting, training, and retraining volunteers; and 

(3) a plan to promote the project in the designated community, including outreach to persons needing the services. 

(c) Funds for all projects under this subdivision may be used to: 

(1) hire a coordinator to develop a coordinated network of volunteer and paid respite care services and assign workers to clients; 

(2) recruit and train volunteer providers; 

(3) provide information, training, and education to caregivers; 

(4) advertise the availability of the caregiver support and respite care project; and 

(5) purchase equipment to maintain a system of assigning workers to clients. 

(d) Project funds may not be used to supplant existing funding sources. 

Subd. 7a.Core home and community-based services. 
The commissioner shall select and contract with core home and community-based services providers for projects to provide services and supports to older adults both with and without family and other informal caregivers using a request for proposals process. Projects must: 

(1) have a credible, public, or private nonprofit sponsor providing ongoing financial support; 

(2) have a specific, clearly defined geographic service area; 

(3) use a practice framework designed to identify high-risk older adults and help them take action to better manage their chronic conditions and maintain their community living; 

(4) have a team approach to coordination and care, ensuring that the older adult participants, their families, and the formal and informal providers are all part of planning and providing services; 

(5) provide information, support services, homemaking services, counseling, and training for the older adults and family caregivers; 

(6) encourage service area or neighborhood residents and local organizations to collaborate in meeting the needs of older adults in their geographic service areas; 

(7) recruit, train, and direct the use of volunteers to provide informal services and other appropriate support to older adults and their caregivers; and 

(8) provide coordination and management of formal and informal services to older adults and their families using less expensive alternatives. 

Subd. 13.Community service grants. 
The commissioner shall award contracts for grants to public and private nonprofit agencies to establish services that strengthen a community's ability to provide a system of home and community-based services for elderly persons. The commissioner shall use a request for proposal process. The commissioner shall give preference when awarding grants under this section to areas where nursing facility closures have occurred or are occurring or to areas with service needs identified under section 144A.351. 

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.Subd. 6b.Family residential services; component values and calculation of payment rates. 
(a) Component values for family residential services are: 

(1) competitive workforce factor: 4.7 percent; 

(2) supervisory span of control ratio: 11 percent; 

(3) employee vacation, sick, and training allowance ratio: 8.71 percent; 

(4) employee-related cost ratio: 23.6 percent; 

(5) general administrative support ratio: 3.3 percent; 

(6) program-related expense ratio: 1.3 percent; and 

(7) absence factor: 1.7 percent. 

(b) Payments for family residential services must be calculated as follows: 

(1) determine the number of shared direct staffing and individual direct staffing hours to meet a recipient's needs provided on site or through monitoring technology; 

(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in subdivisions 5 and 5a; 

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one plus the competitive workforce factor; 

(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3); 

(5) multiply the number of shared direct staffing and individual direct staffing hours provided on site or through monitoring technology and nursing hours by the appropriate staff wages; 

(6) multiply the number of shared direct staffing and individual direct staffing hours provided on site or through monitoring technology and nursing hours by the product of the supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1); 

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and individual direct staffing hours provided through monitoring technology, and multiply the result by one plus the employee vacation, sick, and training allowance ratio. This is defined as the direct staffing cost; 

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared and individual direct staffing hours provided through monitoring technology, by one plus the employee-related cost ratio; 

(9) for client programming and supports, add $2,260.21 divided by 365. The commissioner shall update the amount in this clause as specified in subdivision 5b; 

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided by 365 if customized for adapted transport, based on the resident with the highest assessed need. The commissioner shall update the amounts in this clause as specified in subdivision 5b; 

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing and individual direct staffing hours provided through monitoring technology that was excluded in clause (8); 

(12) sum the standard general administrative support ratio, the program-related expense ratio, and the absence and utilization factor ratio; 

(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment rate; and 

(14) adjust the result of clause (13) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services. 

256S.2101 RATE SETTING; PHASE-IN.Subdivision 1.Phase-in for disability waiver customized living rates. 
All rates and rate components for community access for disability inclusion customized living and brain injury customized living under section 256B.4914 shall be the sum of ten percent of the rates calculated under sections 256S.211 to 256S.215 and 90 percent of the rates calculated using the rate methodology in effect as of June 30, 2017. 

Subd. 2.Phase-in for elderly waiver rates.  
Except for home-delivered meals as described in section 256S.215, subdivision 15, all rates and rate components for elderly waiver, elderly waiver customized living, and elderly waiver foster care under this chapter; alternative care under section 256B.0913; and essential community supports under section 256B.0922 shall be the sum of 18.8 percent of the rates calculated under sections 256S.211 to 256S.215, and 81.2 percent of the rates calculated using the rate methodology in effect as of June 30, 2017. The rate for home-delivered meals shall be the sum of the service rate in effect as of January 1, 2019, and the increases described in section 256S.215, subdivision 15.