1.1 	A bill for an act
1.2 	relating to human services; modifying and establishing laws regarding disability 
1.3 	services, aging services, and substance use disorder treatment services; modifying 
1.4 	assisted living facility licensing standards; modernizing language in Deaf and 
1.5 	Hard-of-Hearing Services Act; expanding application of bloodborne pathogen 
1.6 	testing to nonsecure direct care and treatment programming; making technical 
1.7 	corrections and repealing obsolete language; limiting rent increases in certain 
1.8 	low-income rental projects receiving low-income housing tax credits;amending 
1.9 	Minnesota Statutes 2022, sections 144A.20, subdivision 4; 144G.08, subdivision 
1.10 	7; 144G.30, subdivision 5; 144G.45, subdivision 3; 148F.025, subdivision 2; 
1.11 	245A.11, subdivision 2; 245D.071, subdivisions 3, 4; 245D.081, subdivisions 2, 
1.12 	3; 245D.09, subdivision 3; 245D.091, subdivisions 3, 4; 245D.10, subdivision 1; 
1.13 	245F.02, subdivisions 17, 21; 245F.08, subdivision 3; 245F.15, subdivision 7; 
1.14 	245G.01, subdivisions 13b, 24, by adding subdivisions; 245G.031, subdivision 2; 
1.15 	245G.04, by adding a subdivision; 245G.07, subdivisions 3, 3a; 245G.11, 
1.16 	subdivision 7; 245G.22, subdivision 6; 246.71, subdivisions 3, 4, 5; 246.711; 
1.17 	246.712, subdivisions 1, 2; 246.713; 246.714; 246.715, subdivisions 1, 2, 3; 
1.18 	246.716, subdivisions 1, 2; 246.717; 246.72; 246.721; 246.722; 254A.03, 
1.19 	subdivision 1; 256.975, subdivision 7e; 256B.0759, subdivision 4; 256B.0911, 
1.20 	subdivisions 12, 17, 18, 20, 24, 25; 256B.092, by adding a subdivision; 256B.49, 
1.21 	by adding a subdivision; 256B.4905, subdivision 12; 256B.69, subdivision 5k, by 
1.22 	adding a subdivision; 256B.85, subdivisions 2, 6, 6a, 11, 17, 20, by adding a 
1.23 	subdivision; 256C.21; 256C.23, subdivisions 1a, 2, 2a, 2b, 2c, 6, 7, by adding a 
1.24 	subdivision; 256C.233, subdivisions 1, 2; 256C.24, subdivisions 1, 2, 3; 256C.26; 
1.25 	256C.261; 256C.28, subdivision 1; 256R.08, subdivision 1, by adding a subdivision; 
1.26 	256S.205, subdivision 5, by adding a subdivision; 325F.722, subdivision 1, by 
1.27 	adding subdivisions; 402A.16, subdivision 2; 462A.222, by adding a subdivision; 
1.28 	Minnesota Statutes 2023 Supplement, sections 245G.05, subdivisions 1, 3; 245G.06, 
1.29 	subdivisions 1, 3, 3a, 4; 245G.07, subdivision 2; 245G.09, subdivision 3; 245G.11, 
1.30 	subdivision 10; 245G.22, subdivisions 2, 17; 254A.19, subdivision 3; 254B.04, 
1.31 	subdivision 6, by adding a subdivision; 254B.05, subdivisions 1, 5; 254B.181, 
1.32 	subdivision 1; 254B.19, subdivision 1; 256B.057, subdivision 9; 256B.0759, 
1.33 	subdivision 2; 256B.4914, subdivisions 4, 10, 10a; 256B.85, subdivision 13a; 
1.34 	Laws 2021, First Special Session chapter 7, article 13, section 75; Laws 2023, 
1.35 	chapter 61, article 8, section 13, subdivision 2; repealing Minnesota Statutes 2022, 
1.36 	sections 245G.011, subdivision 5; 245G.22, subdivisions 4, 7; 252.34; 256.01, 
1.37 	subdivisions 39, 41; 256.975, subdivisions 7f, 7g; 256B.79, subdivision 6; 256K.45, 
1.38 	subdivision 2; 256R.18; 325F.722, subdivisions 2, 3, 9.
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 144G.45, subdivision 3, is amended to read:
2.5 		Subd. 3.Local laws apply. Assisted living facilities shall comply with all applicable 
2.6 	state and local governing laws, regulations, standards, ordinances, and codes for fire safety, 
2.7 	building, and zoning requirements, except a facility with a licensed resident capacity of six 
2.8 	or fewer is exempt from rental licensing regulations imposed by any town, municipality, 
2.9 	or county.

2.10 	Sec. 2. Minnesota Statutes 2022, section 245A.11, subdivision 2, is amended to read:
2.11 		Subd. 2.Permitted single-family residential use. (a) Residential programs with a 
2.12 	licensed capacity of six or fewer persons shall be considered a permitted single-family 
2.13 	residential use of property for the purposes of zoning and other land use regulations, except 
2.14 	that a residential program whose primary purpose is to treat juveniles who have violated 
2.15 	criminal statutes relating to sex offenses or have been adjudicated delinquent on the basis 
2.16 	of conduct in violation of criminal statutes relating to sex offenses shall not be considered 
2.17 	a permitted use. This exception shall not apply to residential programs licensed before July 
2.18 	1, 1995. Programs otherwise allowed under this subdivision shall not be prohibited by 
2.19 	operation of restrictive covenants or similar restrictions, regardless of when entered into, 
2.20 	which cannot be met because of the nature of the licensed program, including provisions 
2.21 	which require the home's occupants be related, and that the home must be occupied by the 
2.22 	owner, or similar provisions.
2.23 	(b) Unless otherwise provided in any town, municipal, or county zoning regulation, 
2.24 	licensed residential services provided to more than four persons with developmental 
2.25 	disabilities in a supervised living facility, including intermediate care facilities for persons 
2.26 	with developmental disabilities, with a licensed capacity of seven to eight persons shall be 
2.27 	considered a permitted single-family residential use of property for the purposes of zoning 
2.28 	and other land use regulations. A town, municipal, or county zoning authority may require 
2.29 	a conditional use or special use permit to assure proper maintenance and operation of the 
2.30 	residential program. Conditions imposed on the residential program must not be more 
2.31 	restrictive than those imposed on other conditional uses or special uses of residential property 
2.32 	in the same zones, unless the additional conditions are necessary to protect the health and 
2.33 	safety of the persons being served by the program. This paragraph expires July 1, 2023.
3.1 	(b) A residential program as defined in section 245D.02, subdivision 4a, with a licensed 
3.2 	capacity of six or fewer persons that is actively serving residents for which it is licensed is 
3.3 	exempt from rental licensing regulations imposed by any town, municipality, or county.

3.4 	Sec. 3. Minnesota Statutes 2022, section 245D.071, subdivision 3, is amended to read:
3.5 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service initiation 
3.6 	the license holder must complete a preliminary support plan addendum based on the support 
3.7 	plan.
3.8 	(b) Within the scope of services, the license holder must, at a minimum, complete 
3.9 	assessments in the following areas before the 45-day planning meeting providing 45 days 
3.10 	of service or within 60 calendar days of service initiation, whichever is shorter:
3.11 	(1) the person's ability to self-manage health and medical needs to maintain or improve 
3.12 	physical, mental, and emotional well-being, including, when applicable, allergies, seizures, 
3.13 	choking, special dietary needs, chronic medical conditions, self-administration of medication 
3.14 	or treatment orders, preventative screening, and medical and dental appointments;
3.15 	(2) the person's ability to self-manage personal safety to avoid injury or accident in the 
3.16 	service setting, including, when applicable, risk of falling, mobility, regulating water 
3.17 	temperature, community survival skills, water safety skills, and sensory disabilities; and
3.18 	(3) the person's ability to self-manage symptoms or behavior that may otherwise result 
3.19 	in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension 
3.20 	or termination of services by the license holder, or other symptoms or behaviors that may 
3.21 	jeopardize the health and welfare of the person or others.
3.22 	Assessments must produce information about the person that describes the person's overall 
3.23 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be 
3.24 	based on the person's status within the last 12 months at the time of service initiation. 
3.25 	Assessments based on older information must be documented and justified. Assessments 
3.26 	must be conducted annually at a minimum or within 30 days of a written request from the 
3.27 	person or the person's legal representative or case manager. The results must be reviewed 
3.28 	by the support team or expanded support team as part of a service plan review.
3.29 	(c) Before providing 45 days of service or within 60 calendar days of service initiation, 
3.30 	whichever is shorter, the license holder must meethold an initial planning meeting with the 
3.31 	person, the person's legal representative, the case manager, other members of the support 
3.32 	team or expanded support team, and other people as identified by the person or the person's 
3.33 	legal representative to determine the following based on information obtained from the 
4.1 	assessments identified in paragraph (b), the person's identified needs in the support plan, 
4.2 	and the requirements in subdivision 4 and section 245D.07, subdivision 1a:
4.3 	(1) the scope of the services to be provided to support the person's daily needs and 
4.4 	activities;
4.5 	(2) the person's desired outcomes and the supports necessary to accomplish the person's 
4.6 	desired outcomes;
4.7 	(3) the person's preferences for how services and supports are provided, including how 
4.8 	the provider will support the person to have control of the person's schedule;
4.9 	(4) whether the current service setting is the most integrated setting available and 
4.10 	appropriate for the person;
4.11 	(5) opportunities to develop and maintain essential and life-enriching skills, abilities, 
4.12 	strengths, interests, and preferences;
4.13 	(6) opportunities for community access, participation, and inclusion in preferred 
4.14 	community activities;
4.15 	(7) opportunities to develop and strengthen personal relationships with other persons of 
4.16 	the person's choice in the community;
4.17 	(8) opportunities to seek competitive employment and work at competitively paying 
4.18 	jobs in the community; and
4.19 	(9) how services must be coordinated across other providers licensed under this chapter 
4.20 	serving the person and members of the support team or expanded support team to ensure 
4.21 	continuity of care and coordination of services for the person.
4.22 	(d) A discussion of how technology might be used to meet the person's desired outcomes 
4.23 	must be included in the 45-day initial planning meeting. The support plan or support plan 
4.24 	addendum must include a summary of this discussion. The summary must include a statement 
4.25 	regarding any decision that is made regarding the use of technology and a description of 
4.26 	any further research that needs to be completed before a decision regarding the use of 
4.27 	technology can be made. Nothing in this paragraph requires that the support plan include 
4.28 	the use of technology for the provision of services.

4.29 	Sec. 4. Minnesota Statutes 2022, section 245D.071, subdivision 4, is amended to read:
4.30 		Subd. 4.Service outcomes and supports. (a) Within ten working days of the 45-day
4.31 	initial planning meeting, the license holder must develop a service plan that documents the 
4.32 	service outcomes and supports based on the assessments completed under subdivision 3 
5.1 	and the requirements in section 245D.07, subdivision 1a. The outcomes and supports must 
5.2 	be included in the support plan addendum.
5.3 	(b) The license holder must document the supports and methods to be implemented to 
5.4 	support the person and accomplish outcomes related to acquiring, retaining, or improving 
5.5 	skills and physical, mental, and emotional health and well-being. The documentation must 
5.6 	include:
5.7 	(1) the methods or actions that will be used to support the person and to accomplish the 
5.8 	service outcomes, including information about:
5.9 	(i) any changes or modifications to the physical and social environments necessary when 
5.10 	the service supports are provided;
5.11 	(ii) any equipment and materials required; and
5.12 	(iii) techniques that are consistent with the person's communication mode and learning 
5.13 	style;
5.14 	(2) the measurable and observable criteria for identifying when the desired outcome has 
5.15 	been achieved and how data will be collected;
5.16 	(3) the projected starting date for implementing the supports and methods and the date 
5.17 	by which progress towards accomplishing the outcomes will be reviewed and evaluated; 
5.18 	and
5.19 	(4) the names of the staff or position responsible for implementing the supports and 
5.20 	methods.
5.21 	(c) Within 20 working days of the 45-day initial planning meeting, the license holder 
5.22 	must submit to and obtain dated signatures from the person or the person's legal representative 
5.23 	and case manager to document completion and approval of the assessment and support plan 
5.24 	addendum. If, within ten working days of the submission of the assessment or support plan 
5.25 	addendum, the person or the person's legal representative or case manager has not signed 
5.26 	and returned to the license holder the assessment and support plan addendum or has not 
5.27 	proposed written modifications to the license holder's submission, the submission is deemed 
5.28 	approved and the assessment and support plan addendum become effective and remain in 
5.29 	effect until the legal representative or case manager submits a written request to revise the 
5.30 	assessment or support plan addendum.

6.1 	Sec. 5. Minnesota Statutes 2022, section 245D.081, subdivision 2, is amended to read:
6.2 		Subd. 2.Coordination and evaluation of individual service delivery. (a) Delivery 
6.3 	and evaluation of services provided by the license holder must be coordinated by a designated 
6.4 	staff person. Except as provided in clause (3), the designated coordinator must provide 
6.5 	supervision, support, and evaluation of activities that include:
6.6 	(1) oversight of the license holder's responsibilities assigned in the person's support plan 
6.7 	and the support plan addendum;
6.8 	(2) taking the action necessary to facilitate the accomplishment of the outcomes according 
6.9 	to the requirements in section 245D.07;
6.10 	(3) instruction and assistance to direct support staff implementing the support plan and 
6.11 	the service outcomes, including direct observation of service delivery sufficient to assess 
6.12 	staff competency. The designated coordinator may delegate the direct observation and 
6.13 	competency assessment of the service delivery activities of direct support staff to an 
6.14 	individual whom the designated coordinator has previously deemed competent in those 
6.15 	activities; and
6.16 	(4) evaluation of the effectiveness of service delivery, methodologies, and progress on 
6.17 	the person's outcomes based on the measurable and observable criteria for identifying when 
6.18 	the desired outcome has been achieved according to the requirements in section 245D.07.
6.19 	(b) The license holder must ensure that the designated coordinator is competent to 
6.20 	perform the required duties identified in paragraph (a) through education, training, and work 
6.21 	experience relevant to the primary disability of persons served by the license holder and 
6.22 	the individual persons for whom the designated coordinator is responsible. The designated 
6.23 	coordinator must have the skills and ability necessary to develop effective plans and to 
6.24 	design and use data systems to measure effectiveness of services and supports. The license 
6.25 	holder must verify and document competence according to the requirements in section 
6.26 	245D.09, subdivision 3. The designated coordinator must minimally have:
6.27 	(1) a baccalaureate degree in a field related to human services, and one year of full-time 
6.28 	work experience providing direct care services to persons with disabilities or persons age 
6.29 	65 and older;
6.30 	(2) an associate degree in a field related to human services, and two years of full-time 
6.31 	work experience providing direct care services to persons with disabilities or persons age 
6.32 	65 and older;
7.1 	(3) a diploma in a field related to human services from an accredited postsecondary 
7.2 	institution and three years of full-time work experience providing direct care services to 
7.3 	persons with disabilities or persons age 65 and older; or
7.4 	(4) a minimum of 50 hours of education and training related to human services and 
7.5 	disabilities; and
7.6 	(5) four years of full-time work experience providing direct care services to persons 
7.7 	with disabilities or persons age 65 and older under the supervision of a staff person who 
7.8 	meets the qualifications identified in clauses (1) to (3).

7.9 	Sec. 6. Minnesota Statutes 2022, section 245D.081, subdivision 3, is amended to read:
7.10 		Subd. 3.Program management and oversight. (a) The license holder must designate 
7.11 	a managerial staff person or persons to provide program management and oversight of the 
7.12 	services provided by the license holder. The designated manager is responsible for the 
7.13 	following:
7.14 	(1) maintaining a current understanding of the licensing requirements sufficient to ensure 
7.15 	compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph 
7.16 	(e), and when applicable, as identified in section 256B.04, subdivision 21, paragraph (g);
7.17 	(2) ensuring the duties of the designated coordinator are fulfilled according to the 
7.18 	requirements in subdivision 2;
7.19 	(3) ensuring the program implements corrective action identified as necessary by the 
7.20 	program following review of incident and emergency reports according to the requirements 
7.21 	in section 245D.11, subdivision 2, clause (7). An internal review of incident reports of 
7.22 	alleged or suspected maltreatment must be conducted according to the requirements in 
7.23 	section 245A.65, subdivision 1, paragraph (b);
7.24 	(4) evaluation of satisfaction of persons served by the program, the person's legal 
7.25 	representative, if any, and the case manager, with the service delivery and progress toward 
7.26 	accomplishing outcomes identified in sections 245D.07 and 245D.071, and ensuring and 
7.27 	protecting each person's rights as identified in section 245D.04;
7.28 	(5) ensuring staff competency requirements are met according to the requirements in 
7.29 	section 245D.09, subdivision 3, and ensuring staff orientation and training is provided 
7.30 	according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
7.31 	(6) ensuring corrective action is taken when ordered by the commissioner and that the 
7.32 	terms and conditions of the license and any variances are met; and
8.1 	(7) evaluating the information identified in clauses (1) to (6) to develop, document, and 
8.2 	implement ongoing program improvements.
8.3 	(b) The designated manager must be competent to perform the duties as required and 
8.4 	must minimally meet the education and training requirements identified in subdivision 2, 
8.5 	paragraph (b), and have a minimum of three years of supervisory level experience in a 
8.6 	program providing direct support services to persons with disabilities or persons age 65 and 
8.7 	older.

8.8 	Sec. 7. Minnesota Statutes 2022, section 245D.09, subdivision 3, is amended to read:
8.9 		Subd. 3.Staff qualifications. (a) The license holder must ensure that staff providing 
8.10 	direct support, or staff who have responsibilities related to supervising or managing the 
8.11 	provision of direct support service, are competent as demonstrated through skills and 
8.12 	knowledge training, experience, and education relevant to the primary disability of the 
8.13 	person and to meet the person's needs and additional requirements as written in the support 
8.14 	plan or support plan addendum, or when otherwise required by the case manager or the 
8.15 	federal waiver plan. The license holder must verify and maintain evidence of staff 
8.16 	competency, including documentation of:
8.17 	(1) education and experience qualifications relevant to the job responsibilities assigned 
8.18 	to the staff and to the primary disability of persons served by the program, including a valid 
8.19 	degree and transcript, or a current license, registration, or certification, when a degree or 
8.20 	licensure, registration, or certification is required by this chapter or in the support plan or 
8.21 	support plan addendum;
8.22 	(2) demonstrated competency in the orientation and training areas required under this 
8.23 	chapter, and when applicable, completion of continuing education required to maintain 
8.24 	professional licensure, registration, or certification requirements. Competency in these areas 
8.25 	is determined by the license holder through knowledge testing or observed skill assessment 
8.26 	conducted by the trainer or instructor or by an individual who has been previously deemed 
8.27 	competent by the trainer or instructor in the area being assessed; and
8.28 	(3) except for a license holder who is the sole direct support staff, periodic performance 
8.29 	evaluations completed by the license holder of the direct support staff person's ability to 
8.30 	perform the job functions based on direct observation.
8.31 	(b) Staff under 18 years of age may not perform overnight duties or administer 
8.32 	medication.

9.1 	Sec. 8. Minnesota Statutes 2022, section 245D.091, subdivision 3, is amended to read:
9.2 		Subd. 3.Positive support analyst qualifications. (a) A positive support analyst providing 
9.3 	positive support services as identified in section 245D.03, subdivision 1, paragraph (c), 
9.4 	clause (1), item (i), must have competencies in one of the following areas as required under 
9.5 	the brain injury, community access for disability inclusion, community alternative care, and 
9.6 	developmental disabilities waiver plans or successor plans:
9.7 	(1) have obtained a baccalaureate degree, master's degree, or PhD in either a social 
9.8 	services discipline or nursing;
9.9 	(2) meet the qualifications of a mental health practitioner as defined in section 245.462, 
9.10 	subdivision 17; or
9.11 	(3) be a board-certified behavior analyst or board-certified assistant behavior analyst by 
9.12 	the Behavior Analyst Certification Board, Incorporated.
9.13 	(b) In addition, a positive support analyst must:
9.14 	(1) have four years of supervised experience conducting functional behavior assessments 
9.15 	and designing, implementing, and evaluating effectiveness of positive practices behavior 
9.16 	support strategies for people working with individuals who exhibit challenging behaviors 
9.17 	as well as co-occurring mental disorders and neurocognitive disorder;
9.18 	(2) have received training prior to hire or within 90 calendar days of hire that includes:
9.19 	(i) ten hours of instruction in functional assessment and functional analysis;
9.20 	(ii) 20 hours of instruction in the understanding of the function of behavior;
9.21 	(iii) ten hours of instruction on design of positive practices behavior support strategies;
9.22 	(iv) 20 hours of instruction preparing written intervention strategies, designing data 
9.23 	collection protocols, training other staff to implement positive practice strategies, 
9.24 	summarizing and reporting program evaluation data, analyzing program evaluation data to 
9.25 	identify design flaws in behavioral interventions or failures in implementation fidelity, and 
9.26 	recommending enhancements based on evaluation data; and
9.27 	(v) eight hours of instruction on principles of person-centered thinking;
9.28 	(3) be determined by a positive support professional to have the training and prerequisite 
9.29 	skills required to provide positive practice strategies as well as behavior reduction approved 
9.30 	and permitted intervention to the person who receives positive support; and
9.31 	(4) be under the direct supervision of a positive support professional.
10.1 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
10.2 	shall substitute for meeting the qualifications listed in paragraph (b).

10.3 	EFFECTIVE DATE. This section is effective July 1, 2024, or upon federal approval, 
10.4 	whichever occurs first. The commissioner of human services shall inform the revisor of 
10.5 	statutes when federal approval is obtained.

10.6 	Sec. 9. Minnesota Statutes 2022, section 245D.091, subdivision 4, is amended to read:
10.7 		Subd. 4.Positive support specialist qualifications. (a) A positive support specialist 
10.8 	providing positive support services as identified in section 245D.03, subdivision 1, paragraph 
10.9 	(c), clause (1), item (i), must have competencies in one of the following areas as required 
10.10 	under the brain injury, community access for disability inclusion, community alternative 
10.11 	care, and developmental disabilities waiver plans or successor plans:
10.12 	(1) have an associate's degree in either a social services discipline or nursing; or
10.13 	(2) have two years of supervised experience working with individuals who exhibit 
10.14 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
10.15 	(b) In addition, a behavior specialist must:
10.16 	(1) have received training prior to hire or within 90 calendar days of hire that includes:
10.17 	(i) a minimum of four hours of training in functional assessment;
10.18 	(ii) 20 hours of instruction in the understanding of the function of behavior;
10.19 	(iii) ten hours of instruction on design of positive practices behavioral support strategies; 
10.20 	and
10.21 	(iv) eight hours of instruction on principles of person-centered thinking;
10.22 	(2) be determined by a positive support professional to have the training and prerequisite 
10.23 	skills required to provide positive practices strategies as well as behavior reduction approved 
10.24 	intervention to the person who receives positive support; and
10.25 	(3) be under the direct supervision of a positive support professional.
10.26 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
10.27 	shall substitute for meeting the qualifications listed in paragraphs (a) and (b).

10.28 	EFFECTIVE DATE. This section is effective July 1, 2024, or upon federal approval, 
10.29 	whichever occurs first. The commissioner of human services shall inform the revisor of 
10.30 	statutes when federal approval is obtained.

11.1 	Sec. 10. Minnesota Statutes 2022, section 245D.10, subdivision 1, is amended to read:
11.2 		Subdivision 1.Policy and procedure requirements.  A license holder providing either 
11.3 	basic or intensive supports and services must establish, enforce, and maintain policies and 
11.4 	procedures as required in this chapter, chapter 245A, and other applicable state and federal 
11.5 	laws and regulations governing the provision of home and community-based services 
11.6 	licensed according to this chapter. A license holder must use forms provided by the 
11.7 	commissioner to report service suspensions and service terminations under subdivisions 3 
11.8 	and 3a.

11.9 	EFFECTIVE DATE. This section is effective August 1, 2024.

11.10 	Sec. 11. Minnesota Statutes 2023 Supplement, section 256B.057, subdivision 9, is amended 
11.11 	to read:
11.12 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid for 
11.13 	a person who is employed and who:
11.14 	(1) but for excess earnings or assets meets the definition of disabled under the 
11.15 	Supplemental Security Income program; and
11.16 	(2) pays a premium and other obligations under paragraph (e).
11.17 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
11.18 	for medical assistance under this subdivision, a person must have more than $65 of earned 
11.19 	income, be receiving an unemployment insurance benefit under chapter 268 that the person 
11.20 	began receiving while eligible under this subdivision, or be receiving family and medical 
11.21 	leave benefits under chapter 268B that the person began receiving while eligible under this 
11.22 	subdivision. Earned income must have Medicare, Social Security, and applicable state and 
11.23 	federal taxes withheld. The person must document earned income tax withholding. Any 
11.24 	spousal income shall be disregarded for purposes of eligibility and premium determinations.
11.25 	(c) After the month of enrollment, a person enrolled in medical assistance under this 
11.26 	subdivision who would otherwise be ineligible and be disenrolled due to one of the following 
11.27 	circumstances may retain eligibility for up to four consecutive months after a month of job 
11.28 	loss if the person:
11.29 	(1) is temporarily unable to work and without receipt of earned income due to a medical 
11.30 	condition, as verified by a physician, advanced practice registered nurse, or physician 
11.31 	assistant; or
12.1 	(2) loses employment for reasons not attributable to the enrollee, and is without receipt 
12.2 	of earned income.
12.3 	To receive a four-month extension of continued eligibility under this paragraph, enrollees 
12.4 	must verify the medical condition or provide notification of job loss, continue to meet all 
12.5 	other eligibility requirements, and continue to pay all calculated premium costs.
12.6 	(d) All enrollees must pay a premium to be eligible for medical assistance under this 
12.7 	subdivision, except as provided under clause (5).
12.8 	(1) An enrollee must pay the greater of a $35 premium or the premium calculated based 
12.9 	on the person's gross earned and unearned income and the applicable family size using a 
12.10 	sliding fee scale established by the commissioner, which begins at one percent of income 
12.11 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for 
12.12 	those with incomes at or above 300 percent of the federal poverty guidelines.
12.13 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
12.14 	poverty guidelines shall be effective for premiums due in July of each year.
12.15 	(3) All enrollees who receive unearned income must pay one-half of one percent of 
12.16 	unearned income in addition to the premium amount, except as provided under clause (5).
12.17 	(4) Increases in benefits under title II of the Social Security Act shall not be counted as 
12.18 	income for purposes of this subdivision until July 1 of each year.
12.19 	(5) Effective July 1, 2009, American Indians are exempt from paying premiums as 
12.20 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
12.21 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
12.22 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
12.23 	(e) A person's eligibility and premium shall be determined by the local county agency. 
12.24 	Premiums must be paid to the commissioner. All premiums are dedicated to the 
12.25 	commissioner.
12.26 	(f) Any required premium shall be determined at application and redetermined at the 
12.27 	enrollee's six-month12-month income review or when a change in income or household 
12.28 	size is reported. Enrollees must report any change in income or household size within ten
12.29 	30 days of when the change occurs. A decreased premium resulting from a reported change 
12.30 	in income or household size shall be effective the first day of the next available billing 
12.31 	month after the change is reported. Except for changes occurring from annual cost-of-living 
12.32 	increases, a change resulting in an increased premium shall not affect the premium amount 
12.33 	until the next six-month 12-month review.
13.1 	(g) Premium payment is due upon notification from the commissioner of the premium 
13.2 	amount required. Premiums may be paid in installments at the discretion of the commissioner.
13.3 	(h) Nonpayment of the premium shall result in denial or termination of medical assistance 
13.4 	unless the person demonstrates good cause for nonpayment. "Good cause" means an excuse 
13.5 	for the enrollee's failure to pay the required premium when due because the circumstances 
13.6 	were beyond the enrollee's control or not reasonably foreseeable. The commissioner shall 
13.7 	determine whether good cause exists based on the weight of the supporting evidence 
13.8 	submitted by the enrollee to demonstrate good cause. Except when an installment agreement 
13.9 	is accepted by the commissioner, all persons disenrolled for nonpayment of a premium must 
13.10 	pay any past due premiums as well as current premiums due prior to being reenrolled. 
13.11 	Nonpayment shall include payment with a returned, refused, or dishonored instrument. The 
13.12 	commissioner may require a guaranteed form of payment as the only means to replace a 
13.13 	returned, refused, or dishonored instrument.
13.14 	(i) For enrollees whose income does not exceed 200 percent of the federal poverty 
13.15 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the 
13.16 	enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph 
13.17 	(a).
13.18 	(j) The commissioner is authorized to determine that a premium amount was calculated 
13.19 	or billed in error, make corrections to financial records and billing systems, and refund 
13.20 	premiums collected in error.

13.21 	Sec. 12. Minnesota Statutes 2022, section 256B.0911, subdivision 12, is amended to read:
13.22 		Subd. 12.Exception to use of MnCHOICES assessment; contracted assessors. (a)
13.23 	A lead agency that has not implemented MnCHOICES assessments and uses contracted 
13.24 	assessors as of January 1, 2022, is not subject to the requirements of subdivisions 11, clauses 
13.25 	(7) to (9); 13; 14, paragraphs (a) to (c); 16 to 21; 23; 24; and 29 to 31.
13.26 	(b) This subdivision expires upon statewide implementation of MnCHOICES assessments. 
13.27 	The commissioner shall notify the revisor of statutes when statewide implementation has 
13.28 	occurred.

13.29 	Sec. 13. Minnesota Statutes 2022, section 256B.0911, subdivision 17, is amended to read:
13.30 		Subd. 17.MnCHOICES assessments. (a) A person requesting long-term care 
13.31 	consultation services must be visited by a long-term care consultation team within 20 
13.32 	calendar working days after the date on which an assessment was requested or recommended. 
14.1 	Assessments must be conducted according to this subdivision and subdivisions 19 to 21, 
14.2 	23, 24, and 29 to 31.
14.3 	(b) Lead agencies shall use certified assessors to conduct the assessment.
14.4 	(c) For a person with complex health care needs, a public health or registered nurse from 
14.5 	the team must be consulted.
14.6 	(d) The lead agency must use the MnCHOICES assessment provided by the commissioner 
14.7 	to complete a comprehensive, conversation-based, person-centered assessment. The 
14.8 	assessment must include the health, psychological, functional, environmental, and social 
14.9 	needs of the individual necessary to develop a person-centered assessment summary that 
14.10 	meets the individual's needs and preferences.
14.11 	(e) Except as provided in subdivision 24, an assessment must be conducted by a certified 
14.12 	assessor in an in-person conversational interview with the person being assessed.

14.13 	Sec. 14. Minnesota Statutes 2022, section 256B.0911, subdivision 18, is amended to read:
14.14 		Subd. 18.Exception to use of MnCHOICES assessments; long-term care consultation 
14.15 	team visit; notice. (a) Until statewide implementation of MnCHOICES assessments, The 
14.16 	requirement under subdivision 17, paragraph (a), does not apply to an assessment of a person 
14.17 	requesting personal care assistance services or community first services and supports. The 
14.18 	commissioner shall provide at least a 90-day notice to lead agencies prior to the effective 
14.19 	date of statewide implementation.
14.20 	(b) This subdivision expires upon statewide implementation of MnCHOICES assessments. 
14.21 	The commissioner shall notify the revisor of statutes when statewide implementation has 
14.22 	occurred.

14.23 	Sec. 15. Minnesota Statutes 2022, section 256B.0911, subdivision 20, is amended to read:
14.24 		Subd. 20.MnCHOICES assessments; duration of validity. (a) An assessment that is 
14.25 	completed as part of an eligibility determination for multiple programs for the alternative 
14.26 	care, elderly waiver, developmental disabilities, community access for disability inclusion, 
14.27 	community alternative care, and brain injury waiver programs under chapter 256S and 
14.28 	sections 256B.0913, 256B.092, and 256B.49 is valid to establish service eligibility for no 
14.29 	more than 60 365 calendar days after the date of the assessment.
14.30 	(b) The effective eligibility start date for programs in paragraph (a) can never be prior 
14.31 	to the date of assessment. If an assessment was completed more than 60 days before the 
14.32 	effective waiver or alternative care program eligibility start date, assessment and support 
15.1 	plan information must be updated and documented in the department's Medicaid Management 
15.2 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
15.3 	state plan services, the effective date of eligibility for programs included in paragraph (a) 
15.4 	cannot be prior to the completion date of the most recent updated assessment.
15.5 	(c) If an eligibility update is completed within 90 days of the previous assessment and 
15.6 	documented in the department's Medicaid Management Information System (MMIS), the 
15.7 	effective date of eligibility for programs included in paragraph (a) is the date of the previous 
15.8 	in-person assessment when all other eligibility requirements are met.

15.9 	Sec. 16. Minnesota Statutes 2022, section 256B.0911, subdivision 24, is amended to read:
15.10 		Subd. 24.Remote reassessments. (a) Assessments performed according to subdivisions 
15.11 	17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the 
15.12 	requirements of this subdivision. Remote reassessments conducted by interactive video or 
15.13 	telephone may substitute for in-person reassessments.
15.14 	(b) For services provided by the developmental disabilities waiver under section 
15.15 	256B.092, and the community access for disability inclusion, community alternative care, 
15.16 	and brain injury waiver programs under section 256B.49, remote reassessments may be 
15.17 	substituted for two consecutive reassessments if followed by an in-person reassessment.
15.18 	(c) For services provided by alternative care under section 256B.0913, essential 
15.19 	community supports under section 256B.0922, and the elderly waiver under chapter 256S, 
15.20 	remote reassessments may be substituted for one reassessment if followed by an in-person 
15.21 	reassessment.
15.22 	(b) For personal care assistance provided under section 256B.0659 and community first 
15.23 	services and supports provided under section 256B.85, remote reassessments may be 
15.24 	substituted for two consecutive reassessments if followed by an in-person reassessment.
15.25 	(d) (c) A remote reassessment is permitted only if the lead agency provides informed 
15.26 	choice and the person being reassessed or the person's legal representative provides informed 
15.27 	consent for a remote assessment. Lead agencies must document that informed choice was 
15.28 	offered.
15.29 	(e) (d) The person being reassessed, or the person's legal representative, may refuse a 
15.30 	remote reassessment at any time.
15.31 	(f) (e) During a remote reassessment, if the certified assessor determines an in-person 
15.32 	reassessment is necessary in order to complete the assessment, the lead agency shall schedule 
15.33 	an in-person reassessment.
16.1 	(g) (f) All other requirements of an in-person reassessment apply to a remote 
16.2 	reassessment, including updates to a person's support plan.

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

16.6 	Sec. 17. Minnesota Statutes 2022, section 256B.0911, subdivision 25, is amended to read:
16.7 		Subd. 25.Reassessments for Rule 185 case management and waiver services. (a) 
16.8 	Unless otherwise required by federal law, the county agency is not required to conduct or 
16.9 	arrange for an annual needs reassessment by a certified assessor for people receiving Rule 
16.10 	185 case management under Minnesota Rules, part 9525.0016. The case manager who 
16.11 	works on behalf of the person to identify the person's needs and to minimize the impact of 
16.12 	the disability on the person's life must instead develop a person-centered service plan based 
16.13 	on the person's assessed needs and preferences. The person-centered service plan must be 
16.14 	reviewed annually for persons with developmental disabilities who are receiving only case 
16.15 	management services under Minnesota Rules, part 9525.0016, and who make an informed 
16.16 	choice to decline an assessment under this section.
16.17 	(b) Unless otherwise required by federal law, the county agency is not required to conduct 
16.18 	or arrange for an annual needs reassessment by a certified assessor for people with no 
16.19 	significant changes in function or needs who are receiving the following services:
16.20 	(1) alternative care services under section 256B.0913;
16.21 	(2) developmental disability waiver services under section 256B.092;
16.22 	(3) essential community supports under section 256B.0922;
16.23 	(4) community access for disability inclusion, community alternative care, and brain 
16.24 	injury waiver services under section 256B.49; and
16.25 	(5) elderly waiver services under chapter 256S.
16.26 	(c) The county agency shall conduct or arrange for a needs reassessment for persons 
16.27 	described in paragraph (b) once every three years. The person or the person's legal 
16.28 	representative may request a needs reassessment at any time. The county agency must 
16.29 	annually review the person-centered services plan and reauthorize services. A person or the 
16.30 	person's legal representative must make an informed choice to decline an annual needs 
16.31 	reassessment under this section.

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

17.4 	Sec. 18. Minnesota Statutes 2022, section 256B.092, is amended by adding a subdivision 
17.5 	to read:
17.6 		Subd. 3a.Authorization of technology services. (a) Lead agencies must not implement 
17.7 	additional requirements, in addition to those required by the commissioner, that could result 
17.8 	in the delay of approval or implementation of technology.
17.9 	(b) For individuals receiving waiver services under this section, approval or denial of 
17.10 	technology must occur within 30 business days of the receipt of the initial request. If denied, 
17.11 	the lead agency must submit a notice of action form clearly stating the reason for the denial, 
17.12 	including information describing why the technology is not appropriate to meet the 
17.13 	individual's assessed need.

17.14 	Sec. 19. Minnesota Statutes 2022, section 256B.49, is amended by adding a subdivision 
17.15 	to read:
17.16 		Subd. 16b.Authorization of technology services. (a) Lead agencies must not implement 
17.17 	additional requirements, in addition to those required by the commissioner, that could result 
17.18 	in the delay of approval or implementation of technology.
17.19 	(b) For individuals receiving waiver services under this section, approval or denial of 
17.20 	technology must occur within 30 business days of the receipt of the initial request. If denied, 
17.21 	the lead agency must submit a notice of action form clearly stating the reason for the denial, 
17.22 	including information describing why the technology is not appropriate to meet the 
17.23 	individual's assessed need.

17.24 	Sec. 20. Minnesota Statutes 2022, section 256B.4905, subdivision 12, is amended to read:
17.25 		Subd. 12.Informed choice in and technology prioritization in implementation for 
17.26 	disability waiver services. The commissioner of human services shall ensure that:
17.27 	(1) disability waivers under sections 256B.092 and 256B.49 support the presumption 
17.28 	that all adults who have disabilities and children who have disabilities may use assistive 
17.29 	technology, remote supports, or both to enhance the adult's or child's independence and 
17.30 	quality of life; and
18.1 	(2) each individual accessing waiver services is offered, after an informed 
18.2 	decision-making process and during a person-centered planning process, the opportunity 
18.3 	to choose assistive technology, remote support, or both prior to the commissioner offering 
18.4 	or reauthorizing services that utilize direct support staff to ensure equitable access.

18.5 	Sec. 21. Minnesota Statutes 2023 Supplement, section 256B.4914, subdivision 4, is 
18.6 	amended to read:
18.7 		Subd. 4.Data collection for rate determination. (a) Rates for applicable home and 
18.8 	community-based waivered services, including customized rates under subdivision 12, are 
18.9 	set by the rates management system.
18.10 	(b) Data and information in the rates management system must be used to calculate an 
18.11 	individual's rate.
18.12 	(c) Service providers, with information from the support plan and oversight by lead 
18.13 	agencies, shall provide values and information needed to calculate an individual's rate in 
18.14 	the rates management system. Lead agencies must use forms provided by the commissioner 
18.15 	to collect this information. The determination of service levels must be part of a discussion 
18.16 	with members of the support team as defined in section 245D.02, subdivision 34. This 
18.17 	discussion must occur prior to the final establishment of each individual's rate. The values 
18.18 	and information include:
18.19 	(1) shared staffing hours;
18.20 	(2) individual staffing hours;
18.21 	(3) direct registered nurse hours;
18.22 	(4) direct licensed practical nurse hours;
18.23 	(5) staffing ratios;
18.24 	(6) information to document variable levels of service qualification for variable levels 
18.25 	of reimbursement in each framework;
18.26 	(7) shared or individualized arrangements for unit-based services, including the staffing 
18.27 	ratio;
18.28 	(8) number of trips and miles for transportation services; and
18.29 	(9) service hours provided through monitoring technology.
18.30 	(d) Updates to individual data must include:
18.31 	(1) data for each individual that is updated annually when renewing service plans; and
19.1 	(2) requests by individuals or lead agencies to update a rate whenever there is a change 
19.2 	in an individual's service needs, with accompanying documentation.
19.3 	(e) Lead agencies shall review and approve all services reflecting each individual's needs, 
19.4 	and the values to calculate the final payment rate for services with variables under 
19.5 	subdivisions 6 to 9 for each individual. Lead agencies must notify the individual and the 
19.6 	service provider of the final agreed-upon values and rate, and provide information that is 
19.7 	identical to what was entered into the rates management system. If a value used was 
19.8 	mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead 
19.9 	agencies to correct it. Lead agencies must respond to these requests. When responding to 
19.10 	the request, the lead agency must consider:
19.11 	(1) meeting the health and welfare needs of the individual or individuals receiving 
19.12 	services by service site, identified in their support plan under section 245D.02, subdivision 
19.13 	4b, and any addendum under section 245D.02, subdivision 4c;
19.14 	(2) meeting the requirements for staffing under subdivision 2, paragraphs (h), (n), and 
19.15 	(o); and meeting or exceeding the licensing standards for staffing required under section 
19.16 	245D.09, subdivision 1; and
19.17 	(3) meeting the staffing ratio requirements under subdivision 2, paragraph (o), and 
19.18 	meeting or exceeding the licensing standards for staffing required under section 245D.31.

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

19.20 	Sec. 22. Minnesota Statutes 2022, section 256B.85, subdivision 2, is amended to read:
19.21 		Subd. 2.Definitions. (a) For the purposes of this section and section 256B.851, the terms 
19.22 	defined in this subdivision have the meanings given.
19.23 	(b) "Activities of daily living" or "ADLs" means:
19.24 	(1) dressing, including assistance with choosing, applying, and changing clothing and 
19.25 	applying special appliances, wraps, or clothing;
19.26 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
19.27 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail 
19.28 	care, except for recipients who are diabetic or have poor circulation;
19.29 	(3) bathing, including assistance with basic personal hygiene and skin care;
19.30 	(4) eating, including assistance with hand washing and applying orthotics required for 
19.31 	eating, transfers, or feeding;
20.1 	(5) transfers, including assistance with transferring the participant from one seating or 
20.2 	reclining area to another;
20.3 	(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility 
20.4 	does not include providing transportation for a participant;
20.5 	(7) positioning, including assistance with positioning or turning a participant for necessary 
20.6 	care and comfort; and
20.7 	(8) toileting, including assistance with bowel or bladder elimination and care, transfers, 
20.8 	mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing 
20.9 	the perineal area, inspection of the skin, and adjusting clothing.
20.10 	(c) "Agency-provider model" means a method of CFSS under which a qualified agency 
20.11 	provides services and supports through the agency's own employees and policies. The agency 
20.12 	must allow the participant to have a significant role in the selection and dismissal of support 
20.13 	workers of their choice for the delivery of their specific services and supports.
20.14 	(d) "Behavior" means a description of a need for services and supports used to determine 
20.15 	the home care rating and additional service units. The presence of Level I behavior is used 
20.16 	to determine the home care rating.
20.17 	(e) "Budget model" means a service delivery method of CFSS that allows the use of a 
20.18 	service budget and assistance from a financial management services (FMS) provider for a 
20.19 	participant to directly employ support workers and purchase supports and goods.
20.20 	(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that 
20.21 	has been ordered by a physician, advanced practice registered nurse, or physician's assistant 
20.22 	and is specified in an assessment summary, including:
20.23 	(1) tube feedings requiring:
20.24 	(i) a gastrojejunostomy tube; or
20.25 	(ii) continuous tube feeding lasting longer than 12 hours per day;
20.26 	(2) wounds described as:
20.27 	(i) stage III or stage IV;
20.28 	(ii) multiple wounds;
20.29 	(iii) requiring sterile or clean dressing changes or a wound vac; or
20.30 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
20.31 	care;
21.1 	(3) parenteral therapy described as:
21.2 	(i) IV therapy more than two times per week lasting longer than four hours for each 
21.3 	treatment; or
21.4 	(ii) total parenteral nutrition (TPN) daily;
21.5 	(4) respiratory interventions, including:
21.6 	(i) oxygen required more than eight hours per day;
21.7 	(ii) respiratory vest more than one time per day;
21.8 	(iii) bronchial drainage treatments more than two times per day;
21.9 	(iv) sterile or clean suctioning more than six times per day;
21.10 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
21.11 	as BiPAP and CPAP; and
21.12 	(vi) ventilator dependence under section 256B.0651;
21.13 	(5) insertion and maintenance of catheter, including:
21.14 	(i) sterile catheter changes more than one time per month;
21.15 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
21.16 	times per day; or
21.17 	(iii) bladder irrigations;
21.18 	(6) bowel program more than two times per week requiring more than 30 minutes to 
21.19 	perform each time;
21.20 	(7) neurological intervention, including:
21.21 	(i) seizures more than two times per week and requiring significant physical assistance 
21.22 	to maintain safety; or
21.23 	(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse, 
21.24 	or physician's assistant and requiring specialized assistance from another on a daily basis; 
21.25 	and
21.26 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
21.27 	hands-on assistance and interventions in six to eight activities of daily living.
21.28 	(g) "Community first services and supports" or "CFSS" means the assistance and supports 
21.29 	program under this section needed for accomplishing activities of daily living, instrumental 
21.30 	activities of daily living, and health-related tasks through hands-on assistance to accomplish 
22.1 	the task or constant supervision and cueing to accomplish the task, or the purchase of goods 
22.2 	as defined in subdivision 7, clause (3), that replace the need for human assistance.
22.3 	(h) "Community first services and supports service delivery plan" or "CFSS service 
22.4 	delivery plan" means a written document detailing the services and supports chosen by the 
22.5 	participant to meet assessed needs that are within the approved CFSS service authorization, 
22.6 	as determined in subdivision 8. Services and supports are based on the support plan identified 
22.7 	in sections 256B.092, subdivision 1b, and 256S.10.
22.8 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
22.9 	organization that provides assistance to the participant in making informed choices about 
22.10 	CFSS services in general and self-directed tasks in particular, and in developing a 
22.11 	person-centered CFSS service delivery plan to achieve quality service outcomes.
22.12 	(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
22.13 	(k) "Dependency" in activities of daily living means a person requires hands-on assistance 
22.14 	or constant supervision and cueing to accomplish one or more of the activities of daily living 
22.15 	every day or on the days during the week that the activity is performed; however, a child 
22.16 	must not be found to be dependent in an activity of daily living if, because of the child's 
22.17 	age, an adult would either perform the activity for the child or assist the child with the 
22.18 	activity and the assistance needed is the assistance appropriate for a typical child of the 
22.19 	same age.
22.20 	(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are 
22.21 	included in the CFSS service delivery plan through one of the home and community-based 
22.22 	services waivers and as approved and authorized under chapter 256S and sections 256B.092, 
22.23 	subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state 
22.24 	plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
22.25 	(m) "Financial management services provider" or "FMS provider" means a qualified 
22.26 	organization required for participants using the budget model under subdivision 13 that is 
22.27 	an enrolled provider with the department to provide vendor fiscal/employer agent financial 
22.28 	management services (FMS).
22.29 	(n) "Health-related procedures and tasks" means procedures and tasks related to the 
22.30 	specific assessed health needs of a participant that can be taught or assigned by a 
22.31 	state-licensed health care or mental health professional and performed by a support worker.
22.32 	(o) "Instrumental activities of daily living" means activities related to living independently 
22.33 	in the community, including but not limited to: meal planning, preparation, and cooking; 
23.1 	shopping for food, clothing, or other essential items; laundry; housecleaning; assistance 
23.2 	with medications; managing finances; communicating needs and preferences during activities; 
23.3 	arranging supports; and assistance with traveling around and participating in the community, 
23.4 	including traveling to medical appointments. For purposes of this paragraph, traveling 
23.5 	includes driving and accompanying the recipient in the recipient's chosen mode of 
23.6 	transportation and according to the individual CFSS service delivery plan.
23.7 	(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 10.
23.8 	(q) "Legal representative" means parent of a minor, a court-appointed guardian, or 
23.9 	another representative with legal authority to make decisions about services and supports 
23.10 	for the participant. Other representatives with legal authority to make decisions include but 
23.11 	are not limited to a health care agent or an attorney-in-fact authorized through a health care 
23.12 	directive or power of attorney.
23.13 	(r) "Level I behavior" means physical aggression toward self or others or destruction of 
23.14 	property that requires the immediate response of another person.
23.15 	(s) "Medication assistance" means providing verbal or visual reminders to take regularly 
23.16 	scheduled medication, and includes any of the following supports listed in clauses (1) to 
23.17 	(3) and other types of assistance, except that a support worker must not determine medication 
23.18 	dose or time for medication or inject medications into veins, muscles, or skin:
23.19 	(1) under the direction of the participant or the participant's representative, bringing 
23.20 	medications to the participant including medications given through a nebulizer, opening a 
23.21 	container of previously set-up medications, emptying the container into the participant's 
23.22 	hand, opening and giving the medication in the original container to the participant, or 
23.23 	bringing to the participant liquids or food to accompany the medication;
23.24 	(2) organizing medications as directed by the participant or the participant's representative; 
23.25 	and
23.26 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
23.27 	(t) "Participant" means a person who is eligible for CFSS.
23.28 	(u) "Participant's representative" means a parent, family member, advocate, or other 
23.29 	adult authorized by the participant or participant's legal representative, if any, to serve as a 
23.30 	representative in connection with the provision of CFSS. If the participant is unable to assist 
23.31 	in the selection of a participant's representative, the legal representative shall appoint one.
23.32 	(v) "Person-centered planning process" means a process that is directed by the participant 
23.33 	to plan for CFSS services and supports.
24.1 	(w) "Service budget" means the authorized dollar amount used for the budget model or 
24.2 	for the purchase of goods.
24.3 	(x) "Shared services" means the provision of CFSS services by the same CFSS support 
24.4 	worker to two or three participants who voluntarily enter into a written agreement to receive 
24.5 	services at the same time, in the same setting, and through the same agency-provider or 
24.6 	FMS provider.
24.7 	(y) "Support worker" means a qualified and trained employee of the agency-provider 
24.8 	as required by subdivision 11b or of the participant employer under the budget model as 
24.9 	required by subdivision 14 who has direct contact with the participant and provides services 
24.10 	as specified within the participant's CFSS service delivery plan.
24.11 	(z) "Unit" means the increment of service based on hours or minutes identified in the 
24.12 	service agreement.
24.13 	(aa) "Vendor fiscal employer agent" means an agency that provides financial management 
24.14 	services.
24.15 	(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share 
24.16 	of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
24.17 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
24.18 	long-term care insurance, uniform allowance, contributions to employee retirement accounts, 
24.19 	or other forms of employee compensation and benefits.
24.20 	(cc) "Worker training and development" means services provided according to subdivision 
24.21 	18a for developing workers' skills as required by the participant's individual CFSS service 
24.22 	delivery plan that are arranged for or provided by the agency-provider or purchased by the 
24.23 	participant employer. These services include training, education, direct observation and 
24.24 	supervision, and evaluation and coaching of job skills and tasks, including supervision of 
24.25 	health-related tasks or behavioral supports.

24.26 	Sec. 23. Minnesota Statutes 2022, section 256B.85, subdivision 6, is amended to read:
24.27 		Subd. 6.Community first services and supports service delivery plan. (a) The CFSS 
24.28 	service delivery plan must be developed and evaluated through a person-centered planning 
24.29 	process by the participant, or the participant's representative or legal representative who 
24.30 	may be assisted by a consultation services provider. The CFSS service delivery plan must 
24.31 	reflect the services and supports that are important to the participant and for the participant 
24.32 	to meet the needs assessed by the certified assessor and identified in the support plan 
24.33 	identified in sections 256B.092, subdivision 1b, and 256S.10. The CFSS service delivery 
25.1 	plan must be reviewed by the participant, the consultation services provider, and the 
25.2 	agency-provider or FMS provider prior to starting services and at least annually upon 
25.3 	reassessment, or when there is a significant change in the participant's condition, or a change 
25.4 	in the need for services and supports.
25.5 	(b) The commissioner shall establish the format and criteria for the CFSS service delivery 
25.6 	plan.
25.7 	(c) The CFSS service delivery plan must be person-centered and:
25.8 	(1) specify the consultation services provider, agency-provider, or FMS provider selected 
25.9 	by the participant;
25.10 	(2) reflect the setting in which the participant resides that is chosen by the participant;
25.11 	(3) reflect the participant's strengths and preferences;
25.12 	(4) include the methods and supports used to address the needs as identified through an 
25.13 	assessment of functional needs;
25.14 	(5) include the participant's identified goals and desired outcomes;
25.15 	(6) reflect the services and supports, paid and unpaid, that will assist the participant to 
25.16 	achieve identified goals, including the costs of the services and supports, and the providers 
25.17 	of those services and supports, including natural supports;
25.18 	(7) identify the amount and frequency of face-to-face supports and amount and frequency 
25.19 	of remote supports and technology that will be used;
25.20 	(8) identify risk factors and measures in place to minimize them, including individualized 
25.21 	backup plans;
25.22 	(9) be understandable to the participant and the individuals providing support;
25.23 	(10) identify the individual or entity responsible for monitoring the plan;
25.24 	(11) be finalized and agreed to in writing by the participant and signed by individuals 
25.25 	and providers responsible for its implementation;
25.26 	(12) be distributed to the participant and other people involved in the plan;
25.27 	(13) prevent the provision of unnecessary or inappropriate care;
25.28 	(14) include a detailed budget for expenditures for budget model participants or 
25.29 	participants under the agency-provider model if purchasing goods; and
26.1 	(15) include a plan for worker training and development provided according to 
26.2 	subdivision 18a detailing what service components will be used, when the service components 
26.3 	will be used, how they will be provided, and how these service components relate to the 
26.4 	participant's individual needs and CFSS support worker services.
26.5 	(d) The CFSS service delivery plan must describe the units or dollar amount available 
26.6 	to the participant. The total units of agency-provider services or the service budget amount 
26.7 	for the budget model include both annual totals and a monthly average amount that cover 
26.8 	the number of months of the service agreement. The amount used each month may vary, 
26.9 	but additional funds must not be provided above the annual service authorization amount, 
26.10 	determined according to subdivision 8, unless a change in condition is assessed and 
26.11 	authorized by the certified assessor and documented in the support plan and CFSS service 
26.12 	delivery plan.
26.13 	(e) In assisting with the development or modification of the CFSS service delivery plan 
26.14 	during the authorization time period, the consultation services provider shall:
26.15 	(1) consult with the FMS provider on the spending budget when applicable; and
26.16 	(2) consult with the participant or participant's representative, agency-provider, and case 
26.17 	manager or care coordinator.
26.18 	(f) The CFSS service delivery plan must be approved by the consultation services provider
26.19 	lead agency for participants without a case manager or care coordinator who is responsible 
26.20 	for authorizing services. A case manager or care coordinator must approve the plan for a 
26.21 	waiver or alternative care program participant.

26.22 	Sec. 24. Minnesota Statutes 2022, section 256B.85, subdivision 6a, is amended to read:
26.23 		Subd. 6a.Person-centered planning process. The person-centered planning process 
26.24 	must:
26.25 	(1) include people chosen by the participant;
26.26 	(2) provide necessary information and support to ensure that the participant directs the 
26.27 	process to the maximum extent possible, and is enabled to make informed choices and 
26.28 	decisions;
26.29 	(3) be timely and occur at times and locations convenient to the participant;
26.30 	(4) reflect cultural considerations of the participant;
27.1 	(5) include within the process strategies for solving conflict or disagreement, including 
27.2 	clear conflict-of-interest guidelines as identified in Code of Federal Regulations, title 42, 
27.3 	section 441.500 441.540, for all planning;
27.4 	(6) provide the participant choices of the services and supports the participant receives 
27.5 	and the staff providing those services and supports;
27.6 	(7) include a method for the participant to request updates to the plan; and
27.7 	(8) record the alternative home and community-based settings that were considered by 
27.8 	the participant.

27.9 	Sec. 25. Minnesota Statutes 2022, section 256B.85, subdivision 11, is amended to read:
27.10 		Subd. 11.Agency-provider model. (a) The agency-provider model includes services 
27.11 	provided by support workers and staff providing worker training and development services 
27.12 	who are employed by an agency-provider that meets the criteria established by the 
27.13 	commissioner, including required training.
27.14 	(b) The agency-provider shall allow the participant to have a significant role in the 
27.15 	selection and dismissal of the support workers for the delivery of the services and supports 
27.16 	specified in the participant's CFSS service delivery plan. The agency must make a reasonable 
27.17 	effort to fulfill the participant's request for the participant's preferred support worker.
27.18 	(c) A participant may use authorized units of CFSS services as needed within a service 
27.19 	agreement that is not greater than 12 months. Using authorized units in a flexible manner 
27.20 	in either the agency-provider model or the budget model does not increase the total amount 
27.21 	of services and supports authorized for a participant or included in the participant's CFSS 
27.22 	service delivery plan.
27.23 	(d) A participant may share CFSS services. Two or three CFSS participants may share 
27.24 	services at the same time provided by the same support worker.
27.25 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated 
27.26 	by the medical assistance payment for CFSS for support worker wages and benefits, except 
27.27 	all of the revenue generated by a medical assistance rate increase due to a collective 
27.28 	bargaining agreement under section 179A.54 must be used for support worker wages and 
27.29 	benefits. The agency-provider must document how this requirement is being met. The 
27.30 	revenue generated by the worker training and development services and the reasonable costs 
27.31 	associated with the worker training and development services must not be used in making 
27.32 	this calculation.
28.1 	(f) The agency-provider model must be used by participants who are restricted by the 
28.2 	Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 
28.3 	9505.2245.
28.4 	(g) Participants purchasing goods under this model, along with support worker services, 
28.5 	must:
28.6 	(1) specify the goods in the CFSS service delivery plan and detailed budget for 
28.7 	expenditures that must be approved by the consultation services provider lead agency, case 
28.8 	manager, or care coordinator; and
28.9 	(2) use the FMS provider for the billing and payment of such goods.
28.10 	(h) The agency provider is responsible for ensuring that any worker driving a participant 
28.11 	under subdivision 2, paragraph (o), has a valid driver's license and the vehicle used is 
28.12 	registered and insured according to Minnesota law.

28.13 	Sec. 26. Minnesota Statutes 2023 Supplement, section 256B.85, subdivision 13a, is 
28.14 	amended to read:
28.15 		Subd. 13a.Financial management services. (a) Services provided by an FMS provider 
28.16 	include but are not limited to: filing and payment of federal and state payroll taxes and 
28.17 	premiums on behalf of the participant; initiating and complying with background study 
28.18 	requirements under chapter 245C and maintaining documentation of background study 
28.19 	requests and results; billing for approved CFSS services with authorized funds; monitoring 
28.20 	expenditures; accounting for and disbursing CFSS funds; providing assistance in obtaining 
28.21 	and filing for liability, workers' compensation, family and medical benefit insurance, and 
28.22 	unemployment coverage; and providing participant instruction and technical assistance to 
28.23 	the participant in fulfilling employer-related requirements in accordance with section 3504 
28.24 	of the Internal Revenue Code and related regulations and interpretations, including Code 
28.25 	of Federal Regulations, title 26, section 31.3504-1.
28.26 	(b) Agency-provider services shall not be provided by the FMS provider.
28.27 	(c) The FMS provider shall provide service functions as determined by the commissioner 
28.28 	for budget model participants that include but are not limited to:
28.29 	(1) assistance with the development of the detailed budget for expenditures portion of 
28.30 	the CFSS service delivery plan as requested by the consultation services provider or 
28.31 	participant;
28.32 	(2) data recording and reporting of participant spending;
29.1 	(3) other duties established by the department, including with respect to providing 
29.2 	assistance to the participant, participant's representative, or legal representative in performing 
29.3 	employer responsibilities regarding support workers. The support worker shall not be 
29.4 	considered the employee of the FMS provider; and
29.5 	(4) billing, payment, and accounting of approved expenditures for goods.
29.6 	(d) The FMS provider shall obtain an assurance statement from the participant employer 
29.7 	agreeing to follow state and federal regulations and CFSS policies regarding employment 
29.8 	of support workers.
29.9 	(e) The FMS provider shall:
29.10 	(1) not limit or restrict the participant's choice of service or support providers or service 
29.11 	delivery models consistent with any applicable state and federal requirements;
29.12 	(2) provide the participant, consultation services provider, and case manager or care 
29.13 	coordinator, if applicable, with a monthly written summary of the spending for services and 
29.14 	supports that were billed against the spending budget;
29.15 	(3) be knowledgeable of state and federal employment regulations, including those under 
29.16 	the Fair Labor Standards Act of 1938, and comply with the requirements under chapter 
29.17 	268B and section 3504 of the Internal Revenue Code and related regulations and 
29.18 	interpretations, including Code of Federal Regulations, title 26, section 31.3504-1, regarding 
29.19 	agency employer tax liability for vendor fiscal/employer agent, and any requirements 
29.20 	necessary to process employer and employee deductions, provide appropriate and timely 
29.21 	submission of employer tax liabilities, and maintain documentation to support medical 
29.22 	assistance claims;
29.23 	(4) have current and adequate liability insurance and bonding and sufficient cash flow 
29.24 	as determined by the commissioner and have on staff or under contract a certified public 
29.25 	accountant or an individual with a baccalaureate degree in accounting;
29.26 	(5) assume fiscal accountability for state funds designated for the program and be held 
29.27 	liable for any overpayments or violations of applicable statutes or rules, including but not 
29.28 	limited to the Minnesota False Claims Act, chapter 15C;
29.29 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
29.30 	supports expenditures for any goods purchased and maintain time records of support workers. 
29.31 	The documentation and time records must be maintained for a minimum of five years from 
29.32 	the claim date and be available for audit or review upon request by the commissioner. Claims 
29.33 	submitted by the FMS provider to the commissioner for payment must correspond with 
30.1 	services, amounts, and time periods as authorized in the participant's service budget and 
30.2 	service plan and must contain specific identifying information as determined by the 
30.3 	commissioner; and
30.4 	(7) provide written notice to the participant or the participant's representative at least 30 
30.5 	calendar days before a proposed service termination becomes effective, except in cases 
30.6 	where:
30.7 	(i) the participant engages in conduct that significantly alters the terms of the CFSS 
30.8 	service delivery plan with the FMS;
30.9 	(ii) the participant or other persons at the setting where services are being provided 
30.10 	engage in conduct that creates an imminent risk of harm to the support worker or other staff; 
30.11 	or
30.12 	(iii) an emergency or a significant change in the participant's condition occurs within a 
30.13 	24-hour period that results in the participant's service needs exceeding the participant's 
30.14 	identified needs in the current CFSS service delivery plan so that the plan cannot safely 
30.15 	meet the participant's needs.
30.16 	(f) The commissioner shall:
30.17 	(1) establish rates and payment methodology for the FMS provider;
30.18 	(2) identify a process to ensure quality and performance standards for the FMS provider 
30.19 	and ensure statewide access to FMS providers; and
30.20 	(3) establish a uniform protocol for delivering and administering CFSS services to be 
30.21 	used by eligible FMS providers.

30.22 	Sec. 27. Minnesota Statutes 2022, section 256B.85, subdivision 17, is amended to read:
30.23 		Subd. 17.Consultation services duties.  Consultation services is a required service that 
30.24 	includes:
30.25 	(1) entering into a written agreement with the participant, participant's representative, 
30.26 	or legal representative that includes but is not limited to the details of services, service 
30.27 	delivery methods, dates of services, and contact information;
30.28 	(2) providing an initial and annual orientation to CFSS information and policies, including 
30.29 	selecting a service model;
30.30 	(3) assisting with accessing FMS providers or agency-providers;
31.1 	(4) providing assistance with the development, implementation, management, 
31.2 	documentation, and evaluation of the person-centered CFSS service delivery plan;
31.3 	(5) approving the CFSS service delivery plan for a participant without a case manager 
31.4 	or care coordinator who is responsible for authorizing services;
31.5 	(6) (5) maintaining documentation of the approved CFSS service delivery plan;
31.6 	(7) (6) distributing copies of the final CFSS service delivery plan to the participant and 
31.7 	to the agency-provider or FMS provider, case manager or care coordinator, and other 
31.8 	designated parties;
31.9 	(8) (7) assisting to fulfill responsibilities and requirements of CFSS, including modifying 
31.10 	CFSS service delivery plans and changing service models;
31.11 	(9) (8) if requested, providing consultation on recruiting, selecting, training, managing, 
31.12 	directing, supervising, and evaluating support workers;
31.13 	(10) (9) evaluating services upon receiving information from an FMS provider indicating 
31.14 	spending or participant employer concerns;
31.15 	(11) (10) reviewing the use of and access to informal and community supports, goods, 
31.16 	or resources;
31.17 	(12) (11) a semiannual review of services if the participant does not have a case manager 
31.18 	or care coordinator and when the support worker is a paid parent of a minor participant or 
31.19 	the participant's spouse;
31.20 	(13) (12) collecting and reporting of data as required by the department;
31.21 	(14) (13) providing the participant with a copy of the participant protections under 
31.22 	subdivision 20 at the start of consultation services;
31.23 	(15) (14) providing assistance to resolve issues of noncompliance with the requirements 
31.24 	of CFSS;
31.25 	(16) (15) providing recommendations to the commissioner for changes to services when 
31.26 	support to participants to resolve issues of noncompliance have been unsuccessful; and
31.27 	(17) (16) other duties as assigned by the commissioner.

31.28 	Sec. 28. Minnesota Statutes 2022, section 256B.85, is amended by adding a subdivision 
31.29 	to read:
31.30 		Subd. 18b.Worker training and development services; remote visits. (a) Except as 
31.31 	provided in paragraph (b), the worker training and development services specified in 
32.1 	subdivision 18a, paragraph (c), clauses (3) and (4), may be provided to recipients with 
32.2 	chronic health conditions or severely compromised immune systems via two-way interactive 
32.3 	audio and visual telecommunications if, at the recipient's request, the recipient's primary 
32.4 	health care provider:
32.5 	(1) determines that remote worker training and development services are appropriate; 
32.6 	and
32.7 	(2) documents the determination under clause (1) in a statement of need or other document 
32.8 	that is subsequently included in the recipient's CFSS service delivery plan.
32.9 	(b) The worker training and development services specified in subdivision 18a, paragraph 
32.10 	(c), clause (3), provided at the start of services or the start of employment of a new support 
32.11 	worker must not be conducted via two-way interactive audio and visual telecommunications.
32.12 	(c) A recipient may request to return to in-person worker training and development 
32.13 	services at any time.

32.14 	EFFECTIVE DATE. This section is effective July 1, 2024, or upon federal approval, 
32.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
32.16 	when federal approval is obtained.

32.17 	Sec. 29. Minnesota Statutes 2022, section 256B.85, subdivision 20, is amended to read:
32.18 		Subd. 20.Participant protections. (a) All CFSS participants have the protections 
32.19 	identified in this subdivision.
32.20 	(b) Participants or participant's representatives must be provided with adequate 
32.21 	information, counseling, training, and assistance, as needed, to ensure that the participant 
32.22 	is able to choose and manage services, models, and budgets. This information must be 
32.23 	provided by the consultation services provider at the time of the initial or annual orientation 
32.24 	to CFSS, at the time of reassessment, or when requested by the participant or participant's 
32.25 	representative. This information must explain:
32.26 	(1) person-centered planning;
32.27 	(2) the range and scope of participant choices, including the differences between the 
32.28 	agency-provider model and the budget model, available CFSS providers, and other services 
32.29 	available in the community to meet the participant's needs;
32.30 	(3) the process for changing plans, services, and budgets;
32.31 	(4) identifying and assessing appropriate services; and
33.1 	(5) risks to and responsibilities of the participant under the budget model.
33.2 	(c) The consultation services provider must ensure that the participant chooses freely 
33.3 	between the agency-provider model and the budget model and among available 
33.4 	agency-providers and that the participant may change agency-providers after services have 
33.5 	begun.
33.6 	(d) A participant who appeals a reduction in previously authorized CFSS services may 
33.7 	continue previously authorized services pending an appeal in accordance with section 
33.8 	256.045.
33.9 	(e) If the units of service or budget allocation for CFSS are reduced, denied, or terminated, 
33.10 	the commissioner must provide notice of the reasons for the reduction in the participant's 
33.11 	notice of denial, termination, or reduction.
33.12 	(f) If all or part of a CFSS service delivery plan is denied approval by the consultation 
33.13 	services provider lead agency, the consultation services provider lead agency must provide 
33.14 	a notice that describes the basis of the denial.

33.15 	Sec. 30. Laws 2021, First Special Session chapter 7, article 13, section 75, is amended to 
33.16 	read:
33.17 	Sec. 75. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; WAIVER 
33.18 	REIMAGINE AND INFORMED CHOICE STAKEHOLDER CONSULTATION.
 33.19 		Subdivision 1.Stakeholder consultation; generally. (a) The commissioner of human 
33.20 	services must consult with and seek input and assistance from stakeholders concerning 
33.21 	potential adjustments to the streamlined service menu from waiver reimagine phase I and 
33.22 	to the existing rate exemption criteria and process.
33.23 	(b) The commissioner of human services must consult with and, seek input and assistance 
33.24 	from, and collaborate with stakeholders concerning the development and implementation 
33.25 	of waiver reimagine phase II, including criteria and a process for individualized budget 
33.26 	exemptions, and how waiver reimagine phase II can support and expand informed choice 
33.27 	and informed decision making, including integrated employment, independent living, and 
33.28 	self-direction, consistent with Minnesota Statutes, section 256B.4905.
33.29 	(c) The commissioner of human services must consult with, seek input and assistance 
33.30 	from, and collaborate with stakeholders concerning the implementation and revisions of 
33.31 	the MnCHOICES 2.0 assessment tool.
34.1 		Subd. 2.Public stakeholder engagement. The commissioner must offer a public method 
34.2 	to regularly receive input and concerns from people with disabilities and their families about 
34.3 	waiver reimagine phase II. The commissioner shall provide regular quarterly public updates 
34.4 	on policy development and on how recent stakeholder input was used throughout the is 
34.5 	being incorporated into the current development and implementation of waiver reimagine 
34.6 	phase II.
34.7 		Subd. 3.Waiver Reimagine Advisory Committee. (a) The commissioner must convene, 
34.8 	at regular intervals throughout the development and implementation of waiver reimagine 
34.9 	phase II, a Waiver Reimagine Advisory Committee that consists of a group of diverse, 
34.10 	representative stakeholders. The commissioner must solicit and endeavor to include racially, 
34.11 	ethnically, and geographically diverse membership from each of the following groups:
34.12 	(1) people with disabilities who use waiver services;
34.13 	(2) family members of people who use waiver services;
34.14 	(3) disability and behavioral health advocates;
34.15 	(4) lead agency representatives; and
34.16 	(5) waiver service providers.
34.17 	(b) The assistant commissioner of aging and disability services must attend and participate 
34.18 	in meetings of the Waiver Reimagine Advisory Committee.
34.19 	(c) The Waiver Reimagine Advisory Committee must have the opportunity to assist
34.20 	collaborate in a meaningful way in developing and providing feedback on proposed plans 
34.21 	for waiver reimagine components, including an individual budget methodology, criteria 
34.22 	and a process for individualized budget exemptions, the consolidation of the four current 
34.23 	home and community-based waiver service programs into two-waiver programs, the role 
34.24 	of assessments and the MnCHOICES 2.0 assessment tool in determining service needs and 
34.25 	individual budgets, and other aspects of waiver reimagine phase II.
34.26 	(c) (d) The Waiver Reimagine Advisory Committee must have an opportunity to assist 
34.27 	in the development of and provide feedback on proposed adjustments and modifications to 
34.28 	the streamlined menu of services and the existing rate exception criteria and process.
34.29 		Subd. 4.Required report. Prior to seeking federal approval for any aspect of waiver 
34.30 	reimagine phase II and in consultation collaboration with the Waiver Reimagine Advisory 
34.31 	Committee, the commissioner must submit to the chairs and ranking minority members of 
34.32 	the legislative committees and divisions with jurisdiction over health and human services 
34.33 	a report on plans for waiver reimagine phase II. The report must also include any plans to 
35.1 	adjust or modify the streamlined menu of services or, the existing rate exemption criteria 
35.2 	or process, the proposed individual budget ranges, and the role of MnCHOICES 2.0 
35.3 	assessment tool in determining service needs and individual budget ranges.
35.4 		Subd. 5.Transition process. (a) Prior to implementation of wavier reimagine phase II, 
35.5 	the commissioner must establish a process to assist people who use waiver services and 
35.6 	lead agencies transition to a two-waiver system with an individual budget methodology.
35.7 	(b) The commissioner must ensure that the new waiver service menu and individual 
35.8 	budgets allow people to live in their own home, family home, or any home and 
35.9 	community-based setting of their choice. The commissioner must ensure, within available 
35.10 	resources and subject to state and federal regulations and law, that waiver reimagine does 
35.11 	not result in unintended service disruptions.
35.12 		Subd. 6.Online support planning tool. The commissioner must develop an online 
35.13 	support planning and tracking tool for people using disability waiver services that allows 
35.14 	access to the total budget available to the person, the services for which they are eligible, 
35.15 	and the services they have chosen and used. The commissioner must explore operability 
35.16 	options that would facilitate real-time tracking of a person's remaining available budget 
35.17 	throughout the service year. The online support planning tool must provide information in 
35.18 	an accessible format to support the person's informed choice. The commissioner must seek 
35.19 	input from people with disabilities about the online support planning tool prior to its 
35.20 	implementation.
35.21 		Subd. 7.Curriculum and training. The commissioner must develop and implement a 
35.22 	curriculum and training plan to ensure all lead agency assessors and case managers have 
35.23 	the knowledge and skills necessary to comply with informed decision making for people 
35.24 	who used home and community-based disability waivers. Training and competency 
35.25 	evaluations must be completed annually by all staff responsible for case management as 
35.26 	described in Minnesota Statutes, sections 256B.092, subdivision 1a, paragraph (f), and 
35.27 	256B.49, subdivision 13, paragraph (e).

35.28 	Sec. 31. ASSISTIVE TECHNOLOGY LEAD AGENCY PARTNERSHIPS.
 35.29 	(a) Lead agencies may establish partnerships with enrolled medical assistance providers 
35.30 	of home and community-based services under Minnesota Statutes, sections 256B.0913, 
35.31 	256B.092, 256B.093, or 256B.49, or Minnesota Statutes, chapter 256S, to evaluate the 
35.32 	benefits of informed choice in accessing the following existing assistive technology home 
35.33 	and community-based waiver services:
36.1 	(1) assistive technology;
36.2 	(2) specialized equipment and supplies;
36.3 	(3) environmental accessibility adaptations;
36.4 	(4) client and caregiver training;
36.5 	(5) 24-hour emergency assistance; or
36.6 	(6) any other cost-effective, allowable waiver services and benefits related to assistive 
36.7 	technology.
36.8 	(b) Lead agencies may prioritize eligible individuals who desire to participate in the 
36.9 	partnership authorized by this section, using existing home and community-based waiver 
36.10 	criteria under Minnesota Statutes, chapters 256B and 256S, which may include but are not 
36.11 	limited to:
36.12 	(1) significant clinical acuity due to one or more chronic medical conditions;
36.13 	(2) multiple emergency room visits or inpatient admissions during the prior 365 days;
36.14 	(3) a diagnosis of a behavioral or complex chronic condition;
36.15 	(4) challenges in finding nonemergency medical transportation in the individual's region; 
36.16 	or
36.17 	(5) an inability to find available primary care providers.
36.18 	(c) Lead agencies must ensure individuals who choose to participate have informed 
36.19 	choice in accessing the services and must adhere to conflict free case management 
36.20 	requirements.
36.21 	(d) Lead agencies may identify efficiencies, as well as utilize an alternative, 
36.22 	evidence-based methodology that results in expedited review and approval for service 
36.23 	authorizations, provide evidence-based cost data and quality analysis to the commissioner, 
36.24 	and collect feedback on the use of technology systems from home and community-based 
36.25 	waiver services recipients, family caregivers, and any other interested community partners.

36.26 	Sec. 32. COMMUNITY ACCESS FOR DISABILITY INCLUSION WAIVER 
36.27 	CUSTOMIZED LIVING SERVICES PROVIDERS LOCATED IN HENNEPIN 
36.28 	COUNTY.
 36.29 	The community access for disability inclusion (CADI) waiver customized living and 
36.30 	24-hour customized living size and age limitation does not apply to two housing settings 
36.31 	located in the city of Minneapolis that are financed by low-income housing tax credits 
37.1 	created in calendar years 2005 and 2011 and in which 24-hour customized living services 
37.2 	are provided to residents enrolled in the CADI waiver by Clare Housing.

37.3 	ARTICLE 2
37.4 	DEAF, DEAFBLIND, AND HARD-OF-HEARING SERVICES

37.5 	Section 1. Minnesota Statutes 2022, section 256C.21, is amended to read:
37.6 	256C.21 DEAF, DEAFBLIND, AND HARD-OF-HEARING SERVICES ACT; 
37.7 	CITATION.
37.8 	Sections 256C.21 to 256C.26 256C.261 may be cited as the "Deaf, DeafBlind, and 
37.9 	Hard-of-Hearing Services Act."

37.10 	EFFECTIVE DATE. This section is effective August 1, 2024.

37.11 	Sec. 2. Minnesota Statutes 2022, section 256C.23, subdivision 1a, is amended to read:
37.12 		Subd. 1a.Culturally affirmative. "Culturally affirmative" describes services that are 
37.13 	designed and delivered within the context of the culture, identity, language, communication, 
37.14 	and life experiences of a person persons who isare deaf, a person persons who isare 
37.15 	deafblind, and a person persons who is are hard-of-hearing.

37.16 	EFFECTIVE DATE. This section is effective August 1, 2024.

37.17 	Sec. 3. Minnesota Statutes 2022, section 256C.23, is amended by adding a subdivision to 
37.18 	read:
37.19 		Subd. 1b.Linguistically affirmative. "Linguistically affirmative" describes services 
37.20 	that are designed and delivered within the context of the language and communication 
37.21 	experiences of persons who are deaf, persons who are deafblind, and persons who are 
37.22 	hard-of-hearing.

37.23 	EFFECTIVE DATE. This section is effective August 1, 2024.

37.24 	Sec. 4. Minnesota Statutes 2022, section 256C.23, subdivision 2, is amended to read:
37.25 		Subd. 2.Deaf. "Deaf" means a hearing loss of such severity that the individual must 
37.26 	depend where the person communicates primarily on visual communication such as through
37.27 	American Sign Language or other another signed language, visual and manual means of 
37.28 	communication such as signing systems in English or, Cued Speech, reading and writing, 
37.29 	speech reading, and gestures or other visual communication.

38.1 	EFFECTIVE DATE. This section is effective August 1, 2024.

38.2 	Sec. 5. Minnesota Statutes 2022, section 256C.23, subdivision 2a, is amended to read:
38.3 		Subd. 2a.Hard-of-hearing. "Hard-of-hearing" means a hearing loss resulting in a 
38.4 	functional loss of hearing, but not to the extent that the individual must depend where the 
38.5 	person does not communicate primarily upon through visual communication.

38.6 	EFFECTIVE DATE. This section is effective August 1, 2024.

38.7 	Sec. 6. Minnesota Statutes 2022, section 256C.23, subdivision 2b, is amended to read:
38.8 		Subd. 2b.Deafblind. "Deafblind" means any combination of vision and hearing loss 
38.9 	which interferes with acquiring information from the environment to the extent that 
38.10 	compensatory where the person uses visual, auditory, or tactile strategies and skills are 
38.11 	necessary such as the use of a tactile form of a visual or spoken language to access that
38.12 	communication, information from the environment, or other information.

38.13 	EFFECTIVE DATE. This section is effective August 1, 2024.

38.14 	Sec. 7. Minnesota Statutes 2022, section 256C.23, subdivision 2c, is amended to read:
38.15 		Subd. 2c.Interpreting services. "Interpreting services" means services that include:
38.16 	(1) interpreting between a spoken language, such as English, and a visual language, such 
38.17 	as American Sign Language or another signed language;
38.18 	(2) interpreting between a spoken language and a visual representation of a spoken 
38.19 	language, such as Cued Speech and or signing systems in English;
38.20 	(3) interpreting within one language where the interpreter uses natural gestures and
38.21 	silently repeats the spoken message, replacing some words or phrases to give higher visibility 
38.22 	on the lips make the message more readable;
38.23 	(4) interpreting using low vision or tactile methods, signing systems, or signed languages
38.24 	for persons who have a combined hearing and vision loss or are deafblind; and
38.25 	(5) interpreting from one communication mode or language into another communication 
38.26 	mode or language that is linguistically and culturally appropriate for the participants in the 
38.27 	communication exchange.

38.28 	EFFECTIVE DATE. This section is effective August 1, 2024.

39.1 	Sec. 8. Minnesota Statutes 2022, section 256C.23, subdivision 6, is amended to read:
39.2 		Subd. 6.Real-time captioning. "Real-time captioning" means a method of captioning 
39.3 	in which a caption is captions are simultaneously prepared and displayed or transmitted at 
39.4 	the time of origination by specially trained real-time captioners.

39.5 	EFFECTIVE DATE. This section is effective August 1, 2024.

39.6 	Sec. 9. Minnesota Statutes 2022, section 256C.23, subdivision 7, is amended to read:
39.7 		Subd. 7.Family and community intervener. "Family and community intervener" 
39.8 	means a paraprofessional,person who is specifically trained in deafblindness, who and
39.9 	works one-on-one with a child who is deafblind to provide critical connections access to 
39.10 	language, communication, people, and the environment.

39.11 	EFFECTIVE DATE. This section is effective August 1, 2024.

39.12 	Sec. 10. Minnesota Statutes 2022, section 256C.233, subdivision 1, is amended to read:
39.13 		Subdivision 1.Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing State Services 
39.14 	Division. The commissioners of commerce, education, employment and economic 
39.15 	development, and health shall advise partner with the commissioner of human services on 
39.16 	the interagency activities of the Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing 
39.17 	State Services Division. This division addresses the developmental and social-emotional 
39.18 	needs of provides services for persons who are deaf, persons who are deafblind, and persons 
39.19 	who are hard-of-hearing through a statewide network of programs, services, and supports. 
39.20 	This division also advocates on behalf of and provides information and training about how 
39.21 	to best serve persons who are deaf, persons who are deafblind, and persons who are 
39.22 	hard-of-hearing. The commissioner of human services shall coordinate the work of the 
39.23 	interagency advisers and partners, receive legislative appropriations for the division, and 
39.24 	provide grants through the division for programs, services, and supports for persons who 
39.25 	are deaf, persons who are deafblind, and persons who are hard-of-hearing in identified areas 
39.26 	of need such as deafblind services, family services, interpreting services, and mental health 
39.27 	services.

39.28 	EFFECTIVE DATE. This section is effective August 1, 2024.

39.29 	Sec. 11. Minnesota Statutes 2022, section 256C.233, subdivision 2, is amended to read:
39.30 		Subd. 2.Responsibilities. The Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing 
39.31 	State Services Division shall:
40.1 	(1) establish and maintain a statewide network of regional culturally and linguistically 
40.2 	affirmative services for Minnesotans who are deaf, Minnesotans who are deafblind, and 
40.3 	Minnesotans who are hard-of-hearing;
40.4 	(2) work across divisions within the Department of Human Services, as well as with 
40.5 	other agencies and counties, to ensure that there is an understanding of:
40.6 	(i) the communication access challenges faced by persons who are deaf, persons who 
40.7 	are deafblind, and persons who are hard-of-hearing;
40.8 	(ii) the best practices for accommodating and mitigating addressing communication 
40.9 	access challenges; and
40.10 	(iii) the legal requirements for providing access to and effective communication with 
40.11 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing;
40.12 	(3) assess the supply and demand statewide for interpreter interpreting services and 
40.13 	real-time captioning services, implement strategies to provide greater access to these services 
40.14 	in areas without sufficient supply, and build the base of partner with interpreting service 
40.15 	providers and real-time captioning service providers across the state;
40.16 	(4) maintain a statewide information resource that includes contact information and 
40.17 	professional certification credentials certifications of interpreting service providers and 
40.18 	real-time captioning service providers;
40.19 	(5) provide culturally and linguistically affirmative mental health services to persons 
40.20 	who are deaf, persons who are deafblind, and persons who are hard-of-hearing who:
40.21 	(i) use a visual language such as American Sign Language, another sign language, or a 
40.22 	tactile form of a visual language; or
40.23 	(ii) otherwise need culturally and linguistically affirmative therapeutic mental health
40.24 	services;
40.25 	(6) research and develop best practices and recommendations for emerging issues; and
40.26 	(7) provide as much information as practicable on the division's stand-alone website in 
40.27 	American Sign Language; and.
40.28 	(8) report to the chairs and ranking minority members of the legislative committees with 
40.29 	jurisdiction over human services biennially, beginning on January 1, 2019, on the following:
40.30 	(i) the number of regional service center staff, the location of the office of each staff 
40.31 	person, other service providers with which they are colocated, the number of people served 
40.32 	by each staff person and a breakdown of whether each person was served on-site or off-site, 
41.1 	and for those served off-site, a list of locations where services were delivered and the number 
41.2 	who were served in-person and the number who were served via technology;
41.3 	(ii) the amount and percentage of the division budget spent on reasonable 
41.4 	accommodations for staff;
41.5 	(iii) the number of people who use demonstration equipment and consumer evaluations 
41.6 	of the experience;
41.7 	(iv) the number of training sessions provided by division staff, the topics covered, the 
41.8 	number of participants, and consumer evaluations, including a breakdown by delivery 
41.9 	method such as in-person or via technology;
41.10 	(v) the number of training sessions hosted at a division location provided by another 
41.11 	service provider, the topics covered, the number of participants, and consumer evaluations, 
41.12 	including a breakdown by delivery method such as in-person or via technology;
41.13 	(vi) for each grant awarded, the amount awarded to the grantee and a summary of the 
41.14 	grantee's results, including consumer evaluations of the services or products provided;
41.15 	(vii) the number of people on waiting lists for any services provided by division staff 
41.16 	or for services or equipment funded through grants awarded by the division;
41.17 	(viii) the amount of time staff spent driving to appointments to deliver direct one-to-one 
41.18 	client services in locations outside of the regional service centers; and
41.19 	(ix) the regional needs and feedback on addressing service gaps identified by the advisory 
41.20 	committees.

41.21 	EFFECTIVE DATE. This section is effective August 1, 2024.

41.22 	Sec. 12. Minnesota Statutes 2022, section 256C.24, subdivision 1, is amended to read:
41.23 		Subdivision 1.Location. The Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing 
41.24 	State Services Division shall establish at least six regional service centers for persons who 
41.25 	are deaf, persons who are deafblind, and persons who are hard-of-hearing. The centers shall 
41.26 	be distributed regionally to provide access for persons who are deaf, persons who are 
41.27 	deafblind, and persons who are hard-of-hearing in all parts of the state.

41.28 	EFFECTIVE DATE. This section is effective August 1, 2024.

41.29 	Sec. 13. Minnesota Statutes 2022, section 256C.24, subdivision 2, is amended to read:
41.30 		Subd. 2.Responsibilities. Each regional service center shall:
42.1 	(1) employ qualified staff to work with persons who are deaf, persons who are deafblind, 
42.2 	and persons who are hard-of-hearing;
42.3 	(1) (2) establish connections and collaborations and explore colocating with other public 
42.4 	and private entities providing services to persons who are deaf, persons who are deafblind, 
42.5 	and persons who are hard-of-hearing in the region;
42.6 	(2) (3) for those in need of services, assist in coordinating services between service 
42.7 	providers and persons who are deaf, persons who are deafblind, and persons who are 
42.8 	hard-of-hearing, and the persons' families, and make referrals to the services needed;
42.9 	(3) employ staff trained to work with persons who are deaf, persons who are deafblind, 
42.10 	and persons who are hard-of-hearing;
42.11 	(4) if adequate or accessible services are not available from another public or private 
42.12 	service provider in the region, provide individual culturally and linguistically affirmative 
42.13 	assistance with service supports and solutions to persons who are deaf, persons who are 
42.14 	deafblind, and persons who are hard-of-hearing, and the persons' families. Individual 
42.15 	culturally affirmative assistance may be provided using technology only in areas of the state 
42.16 	where a person has access to sufficient quality telecommunications or broadband services 
42.17 	to allow effective communication. When a person who is deaf, a person who is deafblind, 
42.18 	or a person who is hard-of-hearing does not have access to sufficient telecommunications 
42.19 	or broadband service, individual assistance shall be available in person;
42.20 	(5) identify regional training and resource needs, work with deaf and hard-of-hearing 
42.21 	services training staff, and collaborate with others to and deliver training and resources for 
42.22 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing, and 
42.23 	the persons' families, and other service providers about subjects including the persons' rights 
42.24 	under the law, American Sign Language, and the impact of hearing loss and options for 
42.25 	accommodating it;
42.26 	(6) have a mobile or permanent lab where persons who are deaf, persons who are 
42.27 	deafblind, and persons who are hard-of-hearing can try a selection of modern assistive 
42.28 	technology, telecommunications equipment, and other technology and equipment to 
42.29 	determine what would best meet the persons' needs;
42.30 	(7) collaborate with the Resource Center for the Deaf and Hard-of-Hearing Persons, 
42.31 	other divisions of the Department of Education and local school districts to develop and 
42.32 	deliver programs and services for provide information and resources to families with children 
42.33 	who are deaf, children who are deafblind, or children who are hard-of-hearing and to support
42.34 	school personnel serving these children;
43.1 	(8) provide training, resources, and consultation to the social service or income 
43.2 	maintenance staff employed by counties or by organizations with whom counties contract 
43.3 	for services to ensure that human services providers about communication barriers which 
43.4 	prevent access and other needs of persons who are deaf, persons who are deafblind, and 
43.5 	persons who are hard-of-hearing from using services are removed;
43.6 	(9) provide training to human service agencies in the region regarding program access 
43.7 	for persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing;
43.8 	(10) (9) assess the ongoing need and supply of services for persons who are deaf, persons 
43.9 	who are deafblind, and persons who are hard-of-hearing in all parts of the state,; annually 
43.10 	consult with the division's advisory committees to identify regional needs and solicit feedback 
43.11 	on addressing service gaps,; and cooperate collaborate with public and private service 
43.12 	providers to develop these services on service solutions;
43.13 	(11) (10) provide culturally and linguistically affirmative mental health services to 
43.14 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing who:
43.15 	(i) use a visual language such as American Sign Language, another sign language, or a 
43.16 	tactile form of a visual language; or
43.17 	(ii) otherwise need culturally and linguistically affirmative therapeutic mental health
43.18 	services; and
43.19 	(12) (11) establish partnerships with state and regional entities statewide that have the 
43.20 	technological capacity to provide Minnesotans with virtual access to the division's services 
43.21 	and division-sponsored training via through technology.

43.22 	EFFECTIVE DATE. This section is effective August 1, 2024.

43.23 	Sec. 14. Minnesota Statutes 2022, section 256C.24, subdivision 3, is amended to read:
43.24 		Subd. 3.Advisory committee. The director of the Deaf, DeafBlind, and Hard-of-Hearing
43.25 	Hard of Hearing State Services Division shall appoint eight advisory committees of up to 
43.26 	nine persons per advisory committee. Each committee shall represent a specific region of 
43.27 	the state. The director shall determine the boundaries of each advisory committee region. 
43.28 	The committees shall advise the director on the needs of persons who are deaf, persons who 
43.29 	are deafblind, and persons who are hard-of-hearing and service gaps in the region of the 
43.30 	state the committee represents. Members shall include persons who are deaf, persons who 
43.31 	are deafblind, and persons who are hard-of-hearing, persons who have communication 
43.32 	disabilities, parents of children who are deaf, parents of children who are deafblind, and 
43.33 	parents of children who are hard-of-hearing, parents of children who have communication 
44.1 	disabilities, and representatives of county and regional human services, including 
44.2 	representatives of private service providers. At least 50 percent of the members must be 
44.3 	deaf or deafblind or hard-of-hearing or have a communication disability. Committee members 
44.4 	shall serve for a three-year term, and may be appointed to. Committee members shall serve 
44.5 	no more than three consecutive terms and no more than nine years in total. Each advisory 
44.6 	committee shall elect a chair. The director of the Deaf, DeafBlind, and Hard-of-Hearing
44.7 	Hard of Hearing State Services Division shall may assign staff to serve as nonvoting members 
44.8 	of the committee. Members shall not receive a per diem. Otherwise, the compensation, 
44.9 	removal of members, and filling of vacancies on the committee shall be as provided in 
44.10 	section 15.0575.

44.11 	EFFECTIVE DATE. This section is effective August 1, 2024.

44.12 	Sec. 15. Minnesota Statutes 2022, section 256C.26, is amended to read:
44.13 	256C.26 EMPLOYMENT SERVICES.
44.14 	The commissioner of employment and economic development shall work with the Deaf, 
44.15 	DeafBlind, and Hard-of-Hearing Hard of Hearing State Services Division to develop and 
44.16 	implement a plan to deal with the underemployment of persons who are deaf, persons who 
44.17 	are deafblind, and persons who are hard-of-hearing persons.

44.18 	EFFECTIVE DATE. This section is effective August 1, 2024.

44.19 	Sec. 16. Minnesota Statutes 2022, section 256C.261, is amended to read:
44.20 	256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND.
44.21 	(a) The commissioner of human services shall use at least 35 60 percent of the deafblind 
44.22 	services biennial base level grant funding for programs, services, and other supports for a 
44.23 	child adults who are deafblind and for children who is are deafblind and the child's family
44.24 	children's families. The commissioner shall use at least 25 percent of the deafblind services 
44.25 	biennial base level grant funding for services and other supports for an adult who is deafblind.
44.26 	The commissioner shall award grants for the purposes of:
44.27 	(1) providing programs, services, and supports to persons who are deafblind; and.
44.28 	(2) developing and providing training to counties and the network of senior citizen 
44.29 	service providers. The purpose of the training grants is to teach counties how to use existing 
44.30 	programs that capture federal financial participation to meet the needs of eligible persons 
44.31 	who are deafblind and to build capacity of senior service programs to meet the needs of 
44.32 	seniors with a dual sensory hearing and vision loss.
45.1 	(b) The commissioner may make grants:
45.2 	(1) for services and training provided by organizations to persons who are deafblind; 
45.3 	and
45.4 	(2) to develop and administer consumer-directed services. for persons who are deafblind; 
45.5 	and
45.6 	(3) to develop and provide training to counties and service providers on how to meet 
45.7 	the needs of persons who are deafblind.
45.8 	(c) Consumer-directed services shall must be provided in whole by grant-funded 
45.9 	providers. The Deaf and Hard-of-Hearing Services Division's regional service centers shall 
45.10 	not provide any aspect of a grant-funded consumer-directed services program.
45.11 	(d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant under 
45.12 	paragraph (a).
45.13 	(e) (d) Deafblind service providers may, but are not required to, provide intervenor
45.14 	intervener services as part of the service package provided with grant funds under this 
45.15 	section. Intervener services include services provided by a family and community intervener 
45.16 	as described in paragraph (f) (e).
45.17 	(f) (e) The family and community intervener, as defined in section 256C.23, subdivision 
45.18 	7, provides services to open channels of communication between the child and others; 
45.19 	facilitates the development or use of receptive and expressive communication skills by the 
45.20 	child; and develops and maintains a trusting, interactive relationship that promotes social 
45.21 	and emotional well-being. The family and community intervener also provides access to 
45.22 	information and the environment, and facilitates opportunities for learning and development. 
45.23 	A family and community intervener must have specific training in deafblindness, building 
45.24 	language and communication skills, and intervention strategies.

45.25 	EFFECTIVE DATE. This section is effective August 1, 2024.

45.26 	Sec. 17. Minnesota Statutes 2022, section 256C.28, subdivision 1, is amended to read:
45.27 		Subdivision 1.Membership. (a) The Commission of the Deaf, DeafBlind and Hard of 
45.28 	Hearing consists of seven ten members appointed at large and one member each from each
45.29 	up to five advisory committee committees established under section 256C.24, subdivision 
45.30 	3. At least 50 percent of the voting members must be deaf or deafblind or hard-of-hearing. 
45.31 	Members shall include persons who are deaf, deafblind, and hard-of-hearing, parents at 
45.32 	least one parent or guardian of children a person who are is deaf, deafblind, and or
46.1 	hard-of-hearing, and representatives of county and regional human services, including 
46.2 	representatives of private service providers. The commissioners of education, health, human 
46.3 	rights, and employment and economic development and the director of the Deaf and 
46.4 	Hard-of-Hearing Services Division in the Department of Human Services, or their designees, 
46.5 	shall serve as ex officio, nonvoting members of the commission. The commission may 
46.6 	appoint additional ex officio members from other bureaus, divisions, or sections of state 
46.7 	departments directly concerned with the provision of services to persons who are deaf, 
46.8 	deafblind, or hard-of-hearing.
46.9 	(b) CommissionVoting members of the commission are appointed by the governor for 
46.10 	a four-year term and until successors are appointed and qualify. CommissionVoting members 
46.11 	of the commission shall serve no more than three consecutive full terms, and no more than 
46.12 	12 years in total.
46.13 	(c) Annually, by January 31, the commission shall select one member as chair and one 
46.14 	member as vice-chair to serve until January 31 of the following year or until the commission 
46.15 	selects a new chair or vice-chair, whichever occurs later.

46.16 	ARTICLE 3
46.17 	AGING SERVICES

46.18 	Section 1. Minnesota Statutes 2022, section 144A.20, subdivision 4, is amended to read:
46.19 		Subd. 4.Assisted living director qualifications; ongoing training. (a) The Board of 
46.20 	Executives for Long Term Services and Supports may issue licenses to qualified persons 
46.21 	as an assisted living director and shall approve training and examinations. No license shall 
46.22 	be issued to a person as an assisted living director unless that person:
46.23 	(1) is eligible for licensure;
46.24 	(2) has applied for licensure under this subdivision within six months 30 days of hire; 
46.25 	and
46.26 	(3) has satisfactorily met standards set by the board or is scheduled to complete the 
46.27 	training in paragraph (b) within one year of hire. The standards shall be designed to assure 
46.28 	that assisted living directors are individuals who, by training or experience, are qualified to 
46.29 	serve as assisted living directors.
46.30 	(b) In order to be qualified to serve as an assisted living director, an individual must:
47.1 	(1) have completed an approved training course and passed an examination approved 
47.2 	by the board that is designed to test for competence and that includes assisted living facility 
47.3 	laws in Minnesota; or
47.4 	(2)(i) currently be licensed in the state of Minnesota as a nursing home administrator or 
47.5 	have been validated as a qualified health services executive by the National Association of 
47.6 	Long Term Care Administrator Boards; and
47.7 	(ii) have core knowledge of assisted living facility laws; or.
47.8 	(3) apply for licensure by July 1, 2021, and satisfy one of the following:
47.9 	(i) have a higher education degree in nursing, social services, or mental health, or another 
47.10 	professional degree with training specific to management and regulatory compliance;
47.11 	(ii) have at least three years of supervisory, management, or operational experience and 
47.12 	higher education training applicable to an assisted living facility;
47.13 	(iii) have completed at least 1,000 hours of an executive in training program provided 
47.14 	by an assisted living director licensed under this subdivision; or
47.15 	(iv) have managed a housing with services establishment operating under assisted living 
47.16 	title protection for at least three years.
47.17 	(c) An assisted living director must receive at least 30 hours of training continuing 
47.18 	education every two years on topics relevant to the operation of an assisted living facility 
47.19 	and the needs of its residents. An assisted living director must maintain records of the 
47.20 	training required by this paragraph for at least the most recent three-year period and must 
47.21 	provide these records to Department of Health surveyors upon request. Continuing education 
47.22 	earned to maintain another professional license, such as a nursing home administrator license, 
47.23 	nursing license, social worker license, mental health professional license, or real estate 
47.24 	license, may be used to satisfy this requirement when the continuing education is relevant 
47.25 	to the assisted living services offered and residents served at the assisted living facility.

47.26 	Sec. 2. Minnesota Statutes 2022, section 144G.08, subdivision 7, is amended to read:
47.27 		Subd. 7.Assisted living facility. (a) "Assisted living facility" means a facility that 
47.28 	provides sleeping accommodations and assisted living services to one or more adults. 
47.29 	Assisted living facility includes assisted living facility with dementia care, and.
47.30 	(b) Assisted living facility does not include:
47.31 	(1) emergency shelter, transitional housing, or any other residential units serving 
47.32 	exclusively or primarily homeless individuals, as defined under section 116L.361;
48.1 	(2) a nursing home licensed under chapter 144A;
48.2 	(3) a hospital, certified boarding care, or supervised living facility licensed under sections 
48.3 	144.50 to 144.56;
48.4 	(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 
48.5 	9520.0500 to 9520.0670, or under chapter 245D, 245G, or 245I;
48.6 	(5) services and residential settings licensed under chapter 245A, including adult foster 
48.7 	care and services and settings governed under the standards in chapter 245D;
48.8 	(6) a private home in which the residents are related by kinship, law, or affinity with the 
48.9 	provider of services;
48.10 	(7) a duly organized condominium, cooperative, and common interest community, or 
48.11 	owners' association of the condominium, cooperative, and common interest community 
48.12 	where at least 80 percent of the units that comprise the condominium, cooperative, or 
48.13 	common interest community are occupied by individuals who are the owners, members, or 
48.14 	shareholders of the units;
48.15 	(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;
48.16 	(9) a setting offering services conducted by and for the adherents of any recognized 
48.17 	church or religious denomination for its members exclusively through spiritual means or 
48.18 	by prayer for healing;
48.19 	(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with 
48.20 	low-income housing tax credits pursuant to United States Code, title 26, section 42, and 
48.21 	units financed by the Minnesota Housing Finance Agency that are intended to serve 
48.22 	individuals with disabilities or individuals who are homeless, except for those developments 
48.23 	that market or hold themselves out as assisted living facilities and provide assisted living 
48.24 	services;
48.25 	(11) rental housing developed under United States Code, title 42, section 1437, or United 
48.26 	States Code, title 12, section 1701q;
48.27 	(12) rental housing designated for occupancy by only elderly or elderly and disabled 
48.28 	residents under United States Code, title 42, section 1437e, or rental housing for qualifying 
48.29 	families under Code of Federal Regulations, title 24, section 983.56;
48.30 	(13) rental housing funded under United States Code, title 42, chapter 89, or United 
48.31 	States Code, title 42, section 8011;
48.32 	(14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b); or
49.1 	(15) any establishment that exclusively or primarily serves as a shelter or temporary 
49.2 	shelter for victims of domestic or any other form of violence.
49.3 	(c) Notwithstanding paragraphs (a) and (b), assisted living facility includes a facility, 
49.4 	setting, or development, however funded, that markets or holds itself out as assisted living, 
49.5 	an assisted living facility, an assisted living facility with dementia care, memory care, or a 
49.6 	memory care facility.

49.7 	Sec. 3. Minnesota Statutes 2022, section 144G.30, subdivision 5, is amended to read:
49.8 		Subd. 5.Correction orders. (a) A correction order may be issued whenever the 
49.9 	commissioner finds upon survey or during a complaint investigation that a facility, a 
49.10 	managerial official, an agent of the facility, or an employee of the facility is not in compliance 
49.11 	with this chapter. The correction order shall cite the specific statute and document areas of 
49.12 	noncompliance and the time allowed for correction.
49.13 	(b) The commissioner shall mail or email copies of any correction order to the facility 
49.14 	within 30 calendar days after the survey exit date. A copy of each correction order and 
49.15 	copies of any documentation supplied to the commissioner shall be kept on file by the 
49.16 	facility and public documents shall be made available for viewing by any person upon 
49.17 	request. Copies may be kept electronically.
49.18 	(c) By the correction order date, the facility must:
49.19 	(1) document in the facility's records any action taken to comply with the correction 
49.20 	order. The commissioner may request a copy of this documentation and the facility's action 
49.21 	to respond to the correction order in future surveys, upon a complaint investigation, and as 
49.22 	otherwise needed.; and
49.23 	(2) post or otherwise make available, in a manner or location readily accessible to 
49.24 	residents and others, the most recent plan of correction documenting the actions taken by 
49.25 	the facility to comply with the correction order.
49.26 	(d) After the plan of correction is posted or otherwise made available under paragraph 
49.27 	(c), clause (2), the facility must provide a copy of the facility's most recent plan of correction 
49.28 	to any individual who requests it. A copy of the most recent plan of correction must be 
49.29 	provided within 30 days after the request and in a format determined by the facility, except 
49.30 	the facility must make reasonable accommodations in providing the plan of correction in 
49.31 	another format upon request.

49.32 	EFFECTIVE DATE. This section is effective August 1, 2024, and applies to correction 
49.33 	orders issued on or after that date.

50.1 	Sec. 4. Minnesota Statutes 2022, section 256.975, subdivision 7e, is amended to read:
50.2 		Subd. 7e.Long-term care options counseling for assisted living at critical care 
50.3 	transitions. (a) The purpose of long-term care options counseling for assisted living is to 
50.4 	support persons with current or anticipated long-term care needs in making informed choices 
50.5 	among options that include the most cost-effective and least restrictive settings. Prospective 
50.6 	residents maintain the right to choose assisted living if that option is their preference.
50.7 	Reaching people before a crisis and during care transitions is important to ensure quality 
50.8 	of care and life, prevent unnecessary hospitalizations and readmissions, reduce the burden 
50.9 	on the health care system, reduce costs, and support personal preferences.
50.10 	(b) Licensed assisted living facilities shall inform each prospective resident or the 
50.11 	prospective resident's designated or legal representative of the availability of long-term care 
50.12 	options counseling for assisted living and the need to receive and verify the counseling prior 
50.13 	to signing a contract. Long-term care options counseling for assisted living is provided as 
50.14 	determined by the commissioner of human services. The service is delivered under a 
50.15 	partnership between lead agencies as defined in subdivision 10, paragraph (g), and the Area 
50.16 	Agencies on Aging, and is a point of entry to a combination of telephone-based long-term 
50.17 	care options counseling provided by Senior LinkAge Line and in-person long-term care 
50.18 	consultation provided by lead agencies. The point of entry service must be provided within 
50.19 	five working days of the request of the prospective resident as follows Counseling must be 
50.20 	delivered by Senior LinkAge Line either by telephone or in-person. Counseling must:
50.21 	(1) the counseling shall be conducted with the prospective resident, or in the alternative, 
50.22 	the resident's designated or legal representative, if:
50.23 	(i) the resident verbally requests; or
50.24 	(ii) the assisted living facility has documentation of the designated or legal representative's 
50.25 	authority to enter into a lease or contract on behalf of the prospective resident and accepts 
50.26 	the documentation in good faith;
50.27 	(2) the counseling shall (1) be performed in a manner that provides objective and complete 
50.28 	information;
50.29 	(3) the counseling must (2) include a review of the prospective resident's reasons for 
50.30 	considering assisted living services, the prospective resident's person's personal goals, a
50.31 	discussion of the prospective resident's person's immediate and projected long-term care 
50.32 	needs, and alternative community services or settings that may meet the prospective resident's
50.33 	person's needs; and
51.1 	(4) the prospective resident must be informed of the availability of an in-person visit 
51.2 	from a long-term care consultation team member at no charge to the prospective resident 
51.3 	to assist the prospective resident in assessment and planning to meet the prospective resident's 
51.4 	long-term care needs; and
51.5 	(5) verification of counseling shall be generated and provided to the prospective resident 
51.6 	by Senior LinkAge Line upon completion of the telephone-based counseling (3) include 
51.7 	the counseling and referral protocols in subdivision 7, paragraph (b), clauses (11) to (13).
51.8 	(c) An assisted living facility licensed under chapter 144G shall:
51.9 	(1) must inform each prospective resident or the prospective resident's designated or 
51.10 	legal representative of the availability of and contact information for long-term care options 
51.11 	counseling services under this subdivision; by providing Senior LinkAge Line information 
51.12 	at the facility tour.
51.13 	(2) receive a copy of the verification of counseling prior to executing a contract with 
51.14 	the prospective resident; and
51.15 	(3) retain a copy of the verification of counseling as part of the resident's file.
51.16 	(d) Emergency admissions to licensed assisted living facilities prior to consultation under 
51.17 	paragraph (b) are permitted according to policies established by the commissioner. Prior to 
51.18 	discharge, hospitals must refer older adults who are at risk of nursing home placement to 
51.19 	the Senior LinkAge Line for long-term care options counseling. Hospitals must make these 
51.20 	referrals using referral protocols and processes developed under subdivision 7.

51.21 	EFFECTIVE DATE. This section is effective August 1, 2024.

51.22 	Sec. 5. Minnesota Statutes 2022, section 256B.69, is amended by adding a subdivision to 
51.23 	read:
51.24 		Subd. 6h.Continuity of care for seniors receiving personal assistance. (a) If an 
51.25 	individual 65 years of age or older is receiving personal assistance from the same agency 
51.26 	continuously during the six months prior to being newly enrolled with any managed care 
51.27 	or county-based purchasing plan, the managed care plan or county-based purchasing plan 
51.28 	with which the individual is newly enrolled must offer the agency a contract for the purposes 
51.29 	of allowing the enrollee to receive any personal assistance covered under the terms of the 
51.30 	plan from the enrollee's current agency, provided the enrollee continues to live in the service 
51.31 	area of the enrollee's current agency.
52.1 	(b) This subdivision applies only if the enrollee's current agency agrees to accept as 
52.2 	payment in full the managed care plan's or county-based purchasing plan's in-network 
52.3 	reimbursement rate for the same covered service at the time the service is provided, and 
52.4 	agrees to enter into a managed care plan's or county-based purchasing plan's contract for 
52.5 	personal assistance.
52.6 	(c) For the purposes of this subdivision, "agency" means any of the following:
52.7 	(1) an agency provider as described in section 256B.85;
52.8 	(2) a financial management services provider for an enrollee who directly employs direct 
52.9 	care staff through the community first services and supports budget model or through the 
52.10 	consumer-directed community supports option available under the elderly waiver; or
52.11 	(3) a personal care assistance provider agency as defined under section 256B.0659, 
52.12 	subdivision 1, paragraph (l).
52.13 	(d) For the purposes of this subdivision, "personal assistance" means any of the following:
52.14 	(1) community first services and supports, extended community first services and 
52.15 	supports, or enhanced rate community first services and supports under section 256B.85;
52.16 	(2) personal assistance provided through the consumer-directed community supports 
52.17 	option available under the elderly waiver; or
52.18 	(3) personal care assistance services, extended personal care assistance services, or 
52.19 	enhanced rate personal care assistance services under section 256B.0659.

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

52.21 	Sec. 6. Minnesota Statutes 2022, section 256R.08, subdivision 1, is amended to read:
52.22 		Subdivision 1.Reporting of financial statements. (a) No later than February 1 of each 
52.23 	year, a nursing facility must:
52.24 	(1) provide the state agency with a copy of its audited financial statements or its working 
52.25 	trial balance;
52.26 	(2) provide the state agency with a copy of its audited financial statements for each year 
52.27 	an audit is conducted;
52.28 	(2) (3) provide the state agency with a statement of ownership for the facility;
52.29 	(3) (4) provide the state agency with separate, audited financial statements or and working 
52.30 	trial balances for every other facility owned in whole or in part by an individual or entity 
52.31 	that has an ownership interest in the facility;
53.1 	(5) provide the state agency with information regarding whether the licensee or a general 
53.2 	partner, director, or officer of the licensee controls or has an ownership interest of five 
53.3 	percent or more in a related organization that provides any services, facilities, or supplies 
53.4 	to the nursing facility;
53.5 	(4) (6) upon request, provide the state agency with separate, audited financial statements 
53.6 	or and working trial balances for every organization with which the facility conducts business 
53.7 	and which is owned in whole or in part by an individual or entity which has an ownership 
53.8 	interest in the facility;
53.9 	(5) (7) provide the state agency with copies of leases, purchase agreements, and other 
53.10 	documents related to the lease or purchase of the nursing facility; and
53.11 	(6) (8) upon request, provide the state agency with copies of leases, purchase agreements, 
53.12 	and other documents related to the acquisition of equipment, goods, and services which are 
53.13 	claimed as allowable costs.
53.14 	(b) If the licensee or the general partner, director, or officer of the licensee controls or 
53.15 	has an interest as described in paragraph (a), clause (5), the licensee must disclose all services, 
53.16 	facilities, or supplies provided to the nursing facility; the number of individuals who provide 
53.17 	services, facilities, or supplies at the nursing facility; and any other information requested 
53.18 	by the state agency.
53.19 	(b) (c) Audited financial statements submitted under paragraph paragraphs (a) and (b) 
53.20 	must include a balance sheet, income statement, statement of the rate or rates charged to 
53.21 	private paying residents, statement of retained earnings, statement of cash flows, notes to 
53.22 	the financial statements, audited applicable supplemental information, and the public 
53.23 	accountant's report. Public accountants must conduct audits in accordance with chapter 
53.24 	326A. The cost of an audit must not be an allowable cost unless the nursing facility submits 
53.25 	its audited financial statements in the manner otherwise specified in this subdivision. A 
53.26 	nursing facility must permit access by the state agency to the public accountant's audit work 
53.27 	papers that support the audited financial statements submitted under paragraph paragraphs
53.28 	(a) and (b).
53.29 	(c) (d) Documents or information provided to the state agency pursuant to this subdivision 
53.30 	must be public unless prohibited by the Health Insurance Portability and Accountability 
53.31 	Act or any other federal or state regulation. Data, notes, and preliminary drafts of reports 
53.32 	created, collected, and maintained by the audit offices of government entities, or persons 
53.33 	performing audits for government entities, and relating to an audit or investigation are 
53.34 	confidential data on individuals or protected nonpublic data until the final report has been 
54.1 	published or the audit or investigation is no longer being pursued actively, except that the 
54.2 	data must be disclosed as required to comply with section 6.67 or 609.456.
54.3 	(d) (e) If the requirements of paragraphs (a) and, (b), and (c) are not met, the 
54.4 	reimbursement rate may be reduced to 80 percent of the rate in effect on the first day of the 
54.5 	fourth calendar month after the close of the reporting period and the reduction must continue 
54.6 	until the requirements are met.
54.7 	(f) Licensees must provide the information required in this section to the commissioner 
54.8 	in a manner prescribed by the commissioner.
54.9 	(g) For purposes of this section, "related organization" and "control" have the meanings 
54.10 	given in section 256R.02, subdivision 43.

54.11 	EFFECTIVE DATE. This section is effective August 1, 2024.

54.12 	Sec. 7. Minnesota Statutes 2022, section 256R.08, is amended by adding a subdivision to 
54.13 	read:
54.14 		Subd. 5.Notice of costs associated with leases, rent, and use of land or other real 
54.15 	property by nursing homes. (a) Nursing homes must annually report to the commissioner, 
54.16 	in a manner determined by the commissioner, their cost associated with leases, rent, and 
54.17 	use of land or other real property and any other related information requested by the state 
54.18 	agency.
54.19 	(b) A nursing facility that violates this subdivision is subject to the penalties and 
54.20 	procedures under section 256R.04, subdivision 7.

54.21 	EFFECTIVE DATE. This section is effective August 1, 2024.

54.22 	Sec. 8. Minnesota Statutes 2022, section 256S.205, subdivision 5, is amended to read:
54.23 		Subd. 5.Rate adjustment; rate floor. (a) Notwithstanding the 24-hour customized 
54.24 	living monthly service rate limits under section 256S.202, subdivision 2, and the component 
54.25 	service rates established under section 256S.201, subdivision 4, the commissioner must 
54.26 	establish a rate floor equal to $119 per resident per day for 24-hour customized living 
54.27 	services provided to an elderly waiver participant in a designated disproportionate share 
54.28 	facility.
54.29 	(b) The commissioner must apply the rate floor to the services described in paragraph 
54.30 	(a) provided during the rate year.
55.1 	(c) The commissioner must adjust the rate floor by the same amount and at the same 
55.2 	time as any adjustment to the 24-hour customized living monthly service rate limits under 
55.3 	section 256S.202, subdivision 2.
55.4 	(d) The commissioner shall not implement the rate floor under this section if the 
55.5 	customized living rates established under sections 256S.21 to 256S.215 will be implemented 
55.6 	at 100 percent on January 1 of the year following an application year.

55.7 	Sec. 9. Minnesota Statutes 2022, section 256S.205, is amended by adding a subdivision 
55.8 	to read:
55.9 		Subd. 7.Expiration. This section expires on the first December 31 that occurs at least 
55.10 	23 months following the effective date of the repeal, expiration, or removal of all rate 
55.11 	phase-in provisions in section 256S.2101. The commissioner of human services shall inform 
55.12 	the revisor of statutes when this section expires.

55.13 	Sec. 10. Minnesota Statutes 2022, section 325F.722, subdivision 1, is amended to read:
55.14 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
55.15 	the meanings given.
55.16 	(b) "Assisted living services" has the meaning given in section 144G.08, subdivision 9.
55.17 	(c) "Exempt setting" means a setting that in which assisted living services are provided 
55.18 	but which is exempted from assisted living facility licensure under section 144G.08, 
55.19 	subdivision 7, paragraph (b), clauses (10) to (13).
55.20 	(c) (d) "Resident" means a person residing in an exempt setting.
55.21 	(e) "Subsidized assisted living contract" means a legal agreement between a resident 
55.22 	and an exempt setting for housing and, if applicable, assisted living services.

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

55.24 	Sec. 11. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
55.25 	to read:
55.26 		Subd. 10.Responsibility for housing and services. An exempt setting must comply 
55.27 	with section 144G.40, subdivision 1.

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

56.1 	Sec. 12. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
56.2 	to read:
56.3 		Subd. 11.Facility restrictions. An exempt setting must comply with section 144G.42, 
56.4 	subdivision 3, except this subdivision does not apply to an exempt setting owned or operated 
56.5 	by a county or other unit of government.

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

56.7 	Sec. 13. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
56.8 	to read:
56.9 		Subd. 12.Handling residents' finances and property. An exempt setting must comply 
56.10 	with section 144G.42, subdivision 4.

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

56.12 	Sec. 14. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
56.13 	to read:
56.14 		Subd. 13.Contract requirements. An exempt setting may not offer or provide housing 
56.15 	or assisted living services unless it has executed a written subsidized assisted living contract 
56.16 	that complies with section 144G.50, except for:
56.17 	(1) section 144G.50, subdivision 2, paragraph (b), clause (2);
56.18 	(2) section 144G.50, subdivision 2, paragraph (c), clause (1); and
56.19 	(3) section 144G.50, subdivision 4.

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

56.21 	Sec. 15. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
56.22 	to read:
56.23 		Subd. 14.Contract terminations. An exempt setting initiating a termination of a 
56.24 	subsidized assisted living contract must comply with section 144G.52, and Minnesota Rules, 
56.25 	part 4659.0120.

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

57.1 	Sec. 16. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
57.2 	to read:
57.3 		Subd. 15.Nonrenewal of housing. An exempt setting that declines to renew a resident's 
57.4 	housing under a subsidized assisted living contract must comply with the provisions of 
57.5 	section 144G.53, and Minnesota Rules, part 4659.0200.

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

57.7 	Sec. 17. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
57.8 	to read:
57.9 		Subd. 16.Appeals of contract terminations. A resident has the right to appeal a 
57.10 	termination of a subsidized assisted living contract and the provisions of section 144G.54, 
57.11 	and Minnesota Rules, part 4659.0210, subparts 1 to 3, apply to the appeal, except:
57.12 	(1) the resident or an individual acting on the resident's behalf must submit the request 
57.13 	for an appeal directly to the Office of Administrative Hearings; and
57.14 	(2) the administrative law judge shall decide on the appeal and issue an order.

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

57.16 	Sec. 18. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
57.17 	to read:
57.18 		Subd. 17.Coordinated moves. An exempt setting that terminates a subsidized assisted 
57.19 	living contract, reduces services to the extent that a resident needs to move or obtain a new 
57.20 	service provider, or conducts a planned closure under subdivision 19, must comply with 
57.21 	section 144G.55, subdivisions 1 to 3 and 5.

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

57.23 	Sec. 19. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
57.24 	to read:
57.25 		Subd. 18.Transfer of resident within the facility. If an exempt setting seeks to transfer 
57.26 	a resident to a different location within the exempt setting, the exempt setting must comply 
57.27 	with section 144G.56, subdivisions 2 to 7.

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

58.1 	Sec. 20. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
58.2 	to read:
58.3 		Subd. 19.Planned closure. In the event that an exempt setting elects to voluntarily close 
58.4 	the setting, the exempt setting must comply with section 144G.57, subdivisions 1 to 5, and 
58.5 	Minnesota Rules, part 4659.0130, subpart 1, items A and B, and subpart 2, items A to D, 
58.6 	except:
58.7 	(1) the exempt setting is not required to notify the commissioner of health of the planned 
58.8 	closure, submit a proposed closure plan to the commissioner, or receive approval of a closure 
58.9 	plan from the commissioner before closing; and
58.10 	(2) the exempt setting must personally deliver or mail the notice required under section 
58.11 	144G.57, subdivision 5.

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

58.13 	Sec. 21. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
58.14 	to read:
58.15 		Subd. 20.Subsidized assisted living bill of rights. Section 144G.91 applies to residents 
58.16 	of exempt settings.

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

58.18 	Sec. 22. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
58.19 	to read:
58.20 		Subd. 21.Retaliation prohibited. An exempt setting must comply with section 144G.92.

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

58.22 	Sec. 23. Minnesota Statutes 2022, section 325F.722, is amended by adding a subdivision 
58.23 	to read:
58.24 		Subd. 22.Notice of legal and advocacy services. An exempt setting must comply with 
58.25 	section 144G.93.

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

59.1 	Sec. 24. Minnesota Statutes 2022, section 462A.222, is amended by adding a subdivision 
59.2 	to read:
59.3 		Subd. 5.Limitation on rental increases. This subdivision applies to any project that 
59.4 	is restricted to seniors, as defined by section 462A.37, subdivision 1, paragraph (h), and 
59.5 	that receives low-income housing tax credits provided under section 42 of the Internal 
59.6 	Revenue Code of 1986, as amended. The rent in any rent-restricted unit in a project may 
59.7 	not increase in any 12-month period by a percentage more than the greater of:
59.8 	(1) the percentage that benefit amounts for Social Security or Supplemental Security 
59.9 	Income recipients were increased pursuant to United States Code, title 42, sections 415(i) 
59.10 	and 1382f, in the preceding 12-month period, minus one percent; or
59.11 	(2) zero percent.

59.12 	Sec. 25. REPEALER.
 59.13 	(a) Minnesota Statutes 2022, section 256.975, subdivisions 7f and 7g, are repealed.
59.14 	(b) Minnesota Statutes 2022, section 325F.722, subdivisions 2, 3, and 9, are repealed.
59.15 	(c) Minnesota Statutes 2022, section 256R.18, is repealed.

59.16 	EFFECTIVE DATE. Paragraph (a) is effective August 1, 2024. Paragraph (b) is effective 
59.17 	January 1, 2025. Paragraph (c) is effective July 1, 2024.

59.18 	ARTICLE 4
59.19 	SUBSTANCE USE DISORDER SERVICES

59.20 	Section 1. Minnesota Statutes 2022, section 148F.025, subdivision 2, is amended to read:
59.21 		Subd. 2.Education requirements for licensure. An applicant for licensure must submit 
59.22 	evidence satisfactory to the board that the applicant has:
59.23 	(1) received a bachelor's or master's degree from an accredited school or educational 
59.24 	program; and
59.25 	(2) received 18 semester credits or 270 clock hours of academic course work and 880 
59.26 	clock hours of supervised alcohol and drug counseling practicum from an accredited school 
59.27 	or education program. The course work and practicum do not have to be part of the bachelor's 
59.28 	degree earned under clause (1). The academic course work must be in the following areas:
59.29 	(i) an overview of the transdisciplinary foundations of alcohol and drug counseling, 
59.30 	including theories of chemical dependency, the continuum of care, and the process of change;
60.1 	(ii) pharmacology of substance abuse disorders and the dynamics of addiction, including 
60.2 	substance use disorder treatment with medications for opioid use disorder;
60.3 	(iii) professional and ethical responsibilities;
60.4 	(iv) multicultural aspects of chemical dependency;
60.5 	(v) co-occurring disorders; and
60.6 	(vi) the core functions defined in section 148F.01, subdivision 10.

60.7 	Sec. 2. Minnesota Statutes 2022, section 245F.02, subdivision 17, is amended to read:
60.8 		Subd. 17.Peer recovery support services. "Peer recovery support services" means 
60.9 	mentoring and education, advocacy, and nonclinical recovery support provided by a recovery 
60.10 	peer services provided according to section 245F.08, subdivision 3.

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

60.12 	Sec. 3. Minnesota Statutes 2022, section 245F.02, subdivision 21, is amended to read:
60.13 		Subd. 21.Recovery peer. "Recovery peer" means a person who has progressed in the 
60.14 	person's own recovery from substance use disorder and is willing to serve as a peer to assist 
60.15 	others in their recovery and is qualified according to section 245F.15, subdivision 7.

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

60.17 	Sec. 4. Minnesota Statutes 2022, section 245F.08, subdivision 3, is amended to read:
60.18 		Subd. 3.Peer recovery support services. (a) Peers in recovery serve as mentors or 
60.19 	recovery-support partners for individuals in recovery, and may provide encouragement, 
60.20 	self-disclosure of recovery experiences, transportation to appointments, assistance with 
60.21 	finding resources that will help locate housing, job search resources, and assistance finding 
60.22 	and participating in support groups.
60.23 	(b) Peer recovery support services are provided by a recovery peer and must be supervised 
60.24 	by the responsible staff person.
60.25 	Peer recovery support services must meet the requirements in section 245G.07, 
60.26 	subdivision 2, clause (8), and must be provided by a person who is qualified according to 
60.27 	the requirements in section 245F.15, subdivision 7.

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

61.1 	Sec. 5. Minnesota Statutes 2022, section 245F.15, subdivision 7, is amended to read:
61.2 		Subd. 7.Recovery peer qualifications. Recovery peers must:
61.3 	(1) be at least 21 years of age and have a high school diploma or its equivalent;
61.4 	(2) have a minimum of one year in recovery from substance use disorder;
61.5 	(3) have completed a curriculum designated by the commissioner that teaches specific 
61.6 	skills and training in the domains of ethics and boundaries, advocacy, mentoring and 
61.7 	education, and recovery and wellness support; and
61.8 	(4) receive supervision in areas specific to the domains of their role by qualified 
61.9 	supervisory staff.
61.10 	(1) meet the qualifications in section 245I.04, subdivision 18; and
61.11 	(2) provide services according to the scope of practice established in section 245I.04, 
61.12 	subdivision 19, under the supervision of an alcohol and drug counselor.

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

61.14 	Sec. 6. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to 
61.15 	read:
61.16 		Subd. 8a.Clinical trainee. "Clinical trainee" means a staff person who is qualified 
61.17 	according to section 245I.04, subdivision 6, and who is working under the supervision of 
61.18 	a mental health professional.

61.19 	Sec. 7. Minnesota Statutes 2022, section 245G.01, subdivision 13b, is amended to read:
61.20 		Subd. 13b.Guest speaker. "Guest speaker" means an individual who is not an alcohol 
61.21 	and drug counselor qualified according to section 245G.11, subdivision 5 a qualified 
61.22 	professional; is not qualified according to the commissioner's list of professionals under 
61.23 	section 245G.07, subdivision 3; and who works under the direct observation of an alcohol 
61.24 	and drug counselor a qualified professional to present to clients on topics in which the guest 
61.25 	speaker has expertise and that the license holder has determined to be beneficial to a client's 
61.26 	recovery. Tribally licensed programs have autonomy to identify the qualifications of their 
61.27 	guest speakers.

62.1 	Sec. 8. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to 
62.2 	read:
62.3 		Subd. 17a.Mental health professional. "Mental health professional" means a staff 
62.4 	person who is qualified under section 245I.04, subdivision 2.

62.5 	Sec. 9. Minnesota Statutes 2022, section 245G.01, subdivision 24, is amended to read:
62.6 		Subd. 24.Substance use disorder treatment. "Substance use disorder treatment" means 
62.7 	treatment of a substance use disorder, including the process of assessment of a client's needs, 
62.8 	development of planned methods, including interventions or services to address a client's 
62.9 	needs, provision of services, facilitation of services provided by other service providers, 
62.10 	and ongoing reassessment by a qualified professional individual when indicated. The goal 
62.11 	of substance use disorder treatment is to assist or support the client's efforts to recover from 
62.12 	a substance use disorder.

62.13 	Sec. 10. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision 
62.14 	to read:
62.15 		Subd. 30.Qualified professional. "Qualified Professional" means:
62.16 	(1) a clinical trainee; or
62.17 	(2) an individual who has a current individual scope of practice and at least 12 hours of 
62.18 	training in addiction, co-occurring disorders, or substance use disorder diagnosis and 
62.19 	treatment prior to working in any treatment program licensed under this chapter, and is 
62.20 	either a licensed alcohol and drug counselor, a mental health professional, or a registered 
62.21 	nurse.

62.22 	Sec. 11. Minnesota Statutes 2022, section 245G.031, subdivision 2, is amended to read:
62.23 		Subd. 2.Qualifying accreditation; determination of same and similar standards. (a) 
62.24 	The commissioner must accept a qualifying accreditation from an accrediting body listed 
62.25 	in paragraph (c) after determining, in consultation with the accrediting body and license 
62.26 	holders, which of the accrediting body's standards that are the same as or similar to the 
62.27 	licensing requirements in this chapter. In determining whether standards of an accrediting 
62.28 	body are the same as or similar to licensing requirements under this chapter, the commissioner 
62.29 	shall give due consideration to the existence of a standard that aligns in whole or in part to 
62.30 	a licensing standard.
63.1 	(b) Upon request by a license holder, the commissioner may allow the accrediting body 
63.2 	to monitor for compliance with licensing requirements under this chapter that are determined 
63.3 	to be neither the same as nor similar to those of the accrediting body.
63.4 	(c) For purposes of this section, "accrediting body" means The Joint Commission, the 
63.5 	Commission on Accreditation of Rehabilitation Facilities, or the ASAM Level of Care 
63.6 	Certification Program.
63.7 	(d) Qualifying accreditation only applies to the license holder's licensed programs that 
63.8 	are included in the accrediting body's survey during each survey period.

63.9 	Sec. 12. Minnesota Statutes 2022, section 245G.04, is amended by adding a subdivision 
63.10 	to read:
63.11 		Subd. 3.Opioid educational material. (a) If a client is identified as having opioid use 
63.12 	issues, the license holder must provide opioid educational material to the client on the day 
63.13 	of service initiation. The license holder must use the opioid educational material approved 
63.14 	by the commissioner that contains information on:
63.15 	(1) risks for opioid use disorder and dependence;
63.16 	(2) treatment options, including the use of a medication for opioid use disorder;
63.17 	(3) the risk and recognition of opioid overdose; and
63.18 	(4) the use, availability, and administration of an opiate antagonist to respond to opioid 
63.19 	overdose.
63.20 	(b) If the client is identified as having opioid use issues at a later date, the required 
63.21 	educational material must be provided at that time.

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

63.23 	Sec. 13. Minnesota Statutes 2023 Supplement, section 245G.05, subdivision 1, is amended 
63.24 	to read:
63.25 		Subdivision 1.Comprehensive assessment. A comprehensive assessment of the client's 
63.26 	substance use disorder must be administered face-to-face by an alcohol and drug counselor
63.27 	a qualified professional within five calendar days from the day of service initiation for a 
63.28 	residential program or by the end of the fifth day on which a treatment service is provided 
63.29 	in a nonresidential program. The number of days to complete the comprehensive assessment 
63.30 	excludes the day of service initiation. If the comprehensive assessment is not completed 
63.31 	within the required time frame, the person-centered reason for the delay and the planned 
64.1 	completion date must be documented in the client's file. The comprehensive assessment is 
64.2 	complete upon a qualified staff member's professional's dated signature. If the client received 
64.3 	a comprehensive assessment that authorized the treatment service, an alcohol and drug 
64.4 	counselor a qualified professional may use the comprehensive assessment for requirements 
64.5 	of this subdivision but must document a review of the comprehensive assessment and update 
64.6 	the comprehensive assessment as clinically necessary to ensure compliance with this 
64.7 	subdivision within applicable timelines. An alcohol and drug counselor A qualified 
64.8 	professional must sign and date the comprehensive assessment review and update.

64.9 	Sec. 14. Minnesota Statutes 2023 Supplement, section 245G.05, subdivision 3, is amended 
64.10 	to read:
64.11 		Subd. 3.Comprehensive assessment requirements. (a) A comprehensive assessment 
64.12 	must meet the requirements under section 245I.10, subdivision 6, paragraphs (b) and (c). 
64.13 	It must also include:
64.14 	(1) a diagnosis of a substance use disorder or a finding that the client does not meet the 
64.15 	criteria for a substance use disorder;
64.16 	(2) a determination of whether the individual screens positive for co-occurring mental 
64.17 	health disorders using a screening tool approved by the commissioner pursuant to section 
64.18 	245.4863;
64.19 	(3) a risk rating and summary to support the risk ratings within each of the dimensions 
64.20 	listed in section 254B.04, subdivision 4; and
64.21 	(4) a recommendation for the ASAM level of care identified in section 254B.19, 
64.22 	subdivision 1.
64.23 	(b) If the individual is assessed for opioid use disorder, the program must provide 
64.24 	educational material to the client within 24 hours of service initiation on:
64.25 	(1) risks for opioid use disorder and dependence;
64.26 	(2) treatment options, including the use of a medication for opioid use disorder;
64.27 	(3) the risk and recognition of opioid overdose; and
64.28 	(4) the use, availability, and administration of an opiate antagonist to respond to opioid 
64.29 	overdose.
64.30 	If the client is identified as having opioid use disorder at a later point, the required educational 
64.31 	material must be provided at that point. The license holder must use the educational materials 
64.32 	that are approved by the commissioner to comply with this requirement.

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

65.2 	Sec. 15. Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 1, is amended 
65.3 	to read:
65.4 		Subdivision 1.General. Each client must have a person-centered individual treatment 
65.5 	plan developed by an alcohol and drug counselor a qualified professional within ten days 
65.6 	from the day of service initiation for a residential program, by the end of the tenth day on 
65.7 	which a treatment session has been provided from the day of service initiation for a client 
65.8 	in a nonresidential program, not to exceed 30 days. Opioid treatment programs must complete 
65.9 	the individual treatment plan within 21 days from the day of service initiation. The number 
65.10 	of days to complete the individual treatment plan excludes the day of service initiation. The 
65.11 	individual treatment plan must be signed by the client and the alcohol and drug counselor
65.12 	qualified professional and document the client's involvement in the development of the 
65.13 	plan. The individual treatment plan is developed upon the qualified staff member's
65.14 	professional's dated signature. Treatment planning must include ongoing assessment of 
65.15 	client needs. An individual treatment plan must be updated based on new information 
65.16 	gathered about the client's condition, the client's level of participation, and on whether 
65.17 	methods identified have the intended effect. A change to the plan must be signed by the 
65.18 	client and the alcohol and drug counselor qualified professional. If the client chooses to 
65.19 	have family or others involved in treatment services, the client's individual treatment plan 
65.20 	must include how the family or others will be involved in the client's treatment. If a client 
65.21 	is receiving treatment services or an assessment via telehealth and the alcohol and drug 
65.22 	counselor qualified professional documents the reason the client's signature cannot be 
65.23 	obtained, the alcohol and drug counselor qualified professional may document the client's 
65.24 	verbal approval or electronic written approval of the treatment plan or change to the treatment 
65.25 	plan in lieu of the client's signature.

65.26 	Sec. 16. Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 3, is amended 
65.27 	to read:
65.28 		Subd. 3. Treatment plan review.  A treatment plan review must be completed by the 
65.29 	alcohol and drug counselor qualified professional responsible for the client's treatment plan. 
65.30 	The review must indicate the span of time covered by the review and must:
65.31 	(1) document client goals addressed since the last treatment plan review and whether 
65.32 	the identified methods continue to be effective;
66.1 	(2) document monitoring of any physical and mental health problems and include 
66.2 	toxicology results for alcohol and substance use, when available;
66.3 	(3) document the participation of others involved in the individual's treatment planning, 
66.4 	including when services are offered to the client's family or significant others;
66.5 	(4) if changes to the treatment plan are determined to be necessary, document staff 
66.6 	recommendations for changes in the methods identified in the treatment plan and whether 
66.7 	the client agrees with the change;
66.8 	(5) include a review and evaluation of the individual abuse prevention plan according 
66.9 	to section 245A.65; and
66.10 	(6) document any referrals made since the previous treatment plan review.

66.11 	Sec. 17. Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 3a, is amended 
66.12 	to read:
66.13 		Subd. 3a.Frequency of treatment plan reviews. (a) A license holder must ensure that 
66.14 	the alcohol and drug counselor qualified professional responsible for a client's treatment 
66.15 	plan completes and documents a treatment plan review that meets the requirements of 
66.16 	subdivision 3 in each client's file, according to the frequencies required in this subdivision. 
66.17 	All ASAM levels referred to in this chapter are those described in section 254B.19, 
66.18 	subdivision 1.
66.19 	(b) For a client receiving residential ASAM level 3.3 or 3.5 high-intensity services or 
66.20 	residential hospital-based services, a treatment plan review must be completed once every 
66.21 	14 days.
66.22 	(c) For a client receiving residential ASAM level 3.1 low-intensity services or any other 
66.23 	residential level not listed in paragraph (b), a treatment plan review must be completed once 
66.24 	every 30 days.
66.25 	(d) For a client receiving nonresidential ASAM level 2.5 partial hospitalization services, 
66.26 	a treatment plan review must be completed once every 14 days.
66.27 	(e) For a client receiving nonresidential ASAM level 1.0 outpatient or 2.1 intensive 
66.28 	outpatient services or any other nonresidential level not included in paragraph (d), a treatment 
66.29 	plan review must be completed once every 30 days.
66.30 	(f) For a client receiving nonresidential opioid treatment program services according to 
66.31 	section 245G.22:
67.1 	(1) a treatment plan review must be completed weekly for the ten weeks following 
67.2 	completion of the treatment plan; and
67.3 	(2) monthly thereafter.
67.4 	Treatment plan reviews must be completed more frequently when clinical needs warrant.
67.5 	(g) Notwithstanding paragraphs (e) and (f), clause (2), for a client in a nonresidential 
67.6 	program with a treatment plan that clearly indicates less than five hours of skilled treatment 
67.7 	services will be provided to the client each month, a treatment plan review must be completed 
67.8 	once every 90 days. Treatment plan reviews must be completed more frequently when 
67.9 	clinical needs warrant.

67.10 	Sec. 18. Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 4, is amended 
67.11 	to read:
67.12 		Subd. 4.Service discharge summary. (a) An alcohol and drug counselor A qualified 
67.13 	professional must write a service discharge summary for each client. The service discharge 
67.14 	summary must be completed within five days of the client's service termination. A copy of 
67.15 	the client's service discharge summary must be provided to the client upon the client's 
67.16 	request.
67.17 	(b) The service discharge summary must be recorded in the six dimensions listed in 
67.18 	section 254B.04, subdivision 4, and include the following information:
67.19 	(1) the client's issues, strengths, and needs while participating in treatment, including 
67.20 	services provided;
67.21 	(2) the client's progress toward achieving each goal identified in the individual treatment 
67.22 	plan;
67.23 	(3) a risk rating and description for each of the ASAM six dimensions;
67.24 	(4) the reasons for and circumstances of service termination. If a program discharges a 
67.25 	client at staff request, the reason for discharge and the procedure followed for the decision 
67.26 	to discharge must be documented and comply with the requirements in section 245G.14, 
67.27 	subdivision 3, clause (3);
67.28 	(5) the client's living arrangements at service termination;
67.29 	(6) continuing care recommendations, including transitions between more or less intense 
67.30 	services, or more frequent to less frequent services, and referrals made with specific attention 
67.31 	to continuity of care for mental health, as needed; and
68.1 	(7) service termination diagnosis.

68.2 	Sec. 19. Minnesota Statutes 2023 Supplement, section 245G.07, subdivision 2, is amended 
68.3 	to read:
68.4 		Subd. 2.Additional treatment service. A license holder may provide or arrange the 
68.5 	following additional treatment service as a part of the client's individual treatment plan:
68.6 	(1) relationship counseling provided by a qualified professional individual to help the 
68.7 	client identify the impact of the client's substance use disorder on others and to help the 
68.8 	client and persons in the client's support structure identify and change behaviors that 
68.9 	contribute to the client's substance use disorder;
68.10 	(2) therapeutic recreation to allow the client to participate in recreational activities 
68.11 	without the use of mood-altering chemicals and to plan and select leisure activities that do 
68.12 	not involve the inappropriate use of chemicals;
68.13 	(3) stress management and physical well-being to help the client reach and maintain an 
68.14 	appropriate level of health, physical fitness, and well-being;
68.15 	(4) living skills development to help the client learn basic skills necessary for independent 
68.16 	living;
68.17 	(5) employment or educational services to help the client become financially independent;
68.18 	(6) socialization skills development to help the client live and interact with others in a 
68.19 	positive and productive manner;
68.20 	(7) room, board, and supervision at the treatment site to provide the client with a safe 
68.21 	and appropriate environment to gain and practice new skills; and
68.22 	(8) peer recovery support services provided by an individual in recovery qualified 
68.23 	according to section 245I.04, subdivision 18. Peer support services include education; 
68.24 	advocacy; mentoring through self-disclosure of personal recovery experiences; attending 
68.25 	recovery and other support groups with a client; accompanying the client to appointments 
68.26 	that support recovery; assistance accessing resources to obtain housing, employment, 
68.27 	education, and advocacy services; and nonclinical recovery support to assist the transition 
68.28 	from treatment into the recovery community.

68.29 	Sec. 20. Minnesota Statutes 2022, section 245G.07, subdivision 3, is amended to read:
68.30 		Subd. 3.Counselors Qualified professionals. All treatment services, except peer 
68.31 	recovery support services and treatment coordination, must be provided by an alcohol and 
69.1 	drug counselor qualified according to section 245G.11, subdivision 5 a qualified professional, 
69.2 	unless the individual providing the service is specifically qualified according to the accepted 
69.3 	credential required to provide the service. The commissioner shall maintain a current list 
69.4 	of professionals qualified to provide treatment services.

69.5 	Sec. 21. Minnesota Statutes 2022, section 245G.07, subdivision 3a, is amended to read:
69.6 		Subd. 3a.Use of guest speakers. (a) The license holder may allow a guest speaker to 
69.7 	present information to clients as part of a treatment service provided by an alcohol and drug 
69.8 	counselor a qualified professional, according to the requirements of this subdivision.
69.9 	(b) An alcohol and drug counselor A qualified professional must visually observe and 
69.10 	listen to the presentation of information by a guest speaker the entire time the guest speaker 
69.11 	presents information to the clients. The alcohol and drug counselor qualified professional
69.12 	is responsible for all information the guest speaker presents to the clients.
69.13 	(c) The presentation of information by a guest speaker constitutes a direct contact service, 
69.14 	as defined in section 245C.02, subdivision 11.
69.15 	(d) The license holder must provide the guest speaker with all training required for staff 
69.16 	members. If the guest speaker provides direct contact services one day a month or less, the 
69.17 	license holder must only provide the guest speaker with orientation training on the following 
69.18 	subjects before the guest speaker provides direct contact services:
69.19 	(1) mandatory reporting of maltreatment, as specified in sections 245A.65, 626.557, and 
69.20 	626.5572 and chapter 260E;
69.21 	(2) applicable client confidentiality rules and regulations;
69.22 	(3) ethical standards for client interactions; and
69.23 	(4) emergency procedures.

69.24 	Sec. 22. Minnesota Statutes 2023 Supplement, section 245G.09, subdivision 3, is amended 
69.25 	to read:
69.26 		Subd. 3.Contents. Client records must contain the following:
69.27 	(1) documentation that the client was given information on client rights and 
69.28 	responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided 
69.29 	an orientation to the program abuse prevention plan required under section 245A.65, 
69.30 	subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record 
70.1 	must contain documentation that the client was provided educational information according 
70.2 	to section 245G.05 245G.04, subdivision 3, paragraph (b);
70.3 	(2) an initial services plan completed according to section 245G.04;
70.4 	(3) a comprehensive assessment completed according to section 245G.05;
70.5 	(4) an individual abuse prevention plan according to sections 245A.65, subdivision 2, 
70.6 	and 626.557, subdivision 14, when applicable;
70.7 	(5) an individual treatment plan according to section 245G.06, subdivisions 1 and 1a;
70.8 	(6) documentation of treatment services, significant events, appointments, concerns, and 
70.9 	treatment plan reviews according to section 245G.06, subdivisions 2a, 2b, 3, and 3a; and
70.10 	(7) a summary at the time of service termination according to section 245G.06, 
70.11 	subdivision 4.

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

70.13 	Sec. 23. Minnesota Statutes 2022, section 245G.11, subdivision 7, is amended to read:
70.14 		Subd. 7.Treatment coordination provider qualifications. (a) Treatment coordination 
70.15 	must be provided by qualified staff. An individual is qualified to provide treatment 
70.16 	coordination if the individual meets the qualifications of an alcohol and drug counselor 
70.17 	under subdivision 5 or if the individual:
70.18 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
70.19 	(2) is knowledgeable about local community resources and how to use those resources 
70.20 	for the benefit of the client;
70.21 	(3) has successfully completed 30 hours of classroom instruction on treatment 
70.22 	coordination for an individual with substance use disorder has completed specific training 
70.23 	on substance use and co-occurring disorders that is consistent with national evidence-based 
70.24 	practices; and
70.25 	(4) has either meets one of the following criteria:
70.26 	(i) has a bachelor's degree in one of the behavioral sciences or related fields and at least 
70.27 	1,000 hours of supervised experience working with individuals with substance use disorder; 
70.28 	or
70.29 	(ii) is a mental health practitioner; or
71.1 	(iii) has a current certification as an alcohol and drug counselor, level I, by the Upper 
71.2 	Midwest Indian Council on Addictive Disorders; and.
71.3 	(5) has at least 2,000 hours of supervised experience working with individuals with 
71.4 	substance use disorder.
71.5 	(b) A treatment coordinator must receive at least one hour of supervision regarding 
71.6 	individual service delivery from an alcohol and drug counselor, or a mental health 
71.7 	professional who has substance use treatment and assessments within the scope of their 
71.8 	practice, on a monthly basis.

71.9 	Sec. 24. Minnesota Statutes 2023 Supplement, section 245G.11, subdivision 10, is amended 
71.10 	to read:
71.11 		Subd. 10.Student interns and former students. (a) A qualified staff member must 
71.12 	supervise and be responsible for a treatment service performed by a student intern and must 
71.13 	review and sign each assessment, individual treatment plan, and treatment plan review 
71.14 	prepared by a student intern.
71.15 	(b) An alcohol and drug counselor must supervise and be responsible for a treatment 
71.16 	service performed by a former student and must review and sign each assessment, individual 
71.17 	treatment plan, and treatment plan review prepared by the former student.
71.18 	(c) A student intern or former student must receive the orientation and training required 
71.19 	in section 245G.13, subdivisions 1, clause (7), and 2. No more than 50 percent of the 
71.20 	treatment staff may be students, student interns or former students, or licensing candidates
71.21 	with time documented to be directly related to the provision of treatment services for which 
71.22 	the staff are authorized.

71.23 	Sec. 25. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 2, is amended 
71.24 	to read:
71.25 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
71.26 	have the meanings given them.
71.27 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
71.28 	diverted from intended use of the medication.
71.29 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
71.30 	addiction to a person who is not a client of the program that is administering or dispensing 
71.31 	the medication.
72.1 	(d) "Medical director" means a practitioner licensed to practice medicine in the 
72.2 	jurisdiction that the opioid treatment program is located who assumes responsibility for 
72.3 	administering all medical services performed by the program, either by performing the 
72.4 	services directly or by delegating specific responsibility to a practitioner of the opioid 
72.5 	treatment program.
72.6 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
72.7 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
72.8 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
72.9 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
72.10 	title 42, section 8.12, and includes programs licensed under this chapter.
72.11 	(h) "Practitioner" means a staff member holding a current, unrestricted license to practice 
72.12 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
72.13 	and is currently registered with the Drug Enforcement Administration to order or dispense 
72.14 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
72.15 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
72.16 	nurse and physician assistant if the staff member receives a variance by the state opioid 
72.17 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
72.18 	Health Services Administration.
72.19 	(i) "Unsupervised use" means the use of a medication for the treatment of opioid use 
72.20 	disorder dispensed for use by a client outside of the program setting.

72.21 	Sec. 26. Minnesota Statutes 2022, section 245G.22, subdivision 6, is amended to read:
72.22 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
72.23 	medication used for the treatment of opioid use disorder to the illicit market, medication 
72.24 	dispensed to a client for unsupervised use shall be subject to the requirements of this 
72.25 	subdivision. Any client in an opioid treatment program may receive a single unsupervised 
72.26 	use dose for a day that the clinic is closed for business, including Sundays and state and 
72.27 	federal holidays individualized unsupervised use doses as ordered for days that the clinic 
72.28 	is closed for business, including one weekend day and state and federal holidays, no matter 
72.29 	the client's length of time in treatment, as allowed under Code of Federal Regulations, title 
72.30 	42, section 8.12(i)(1).
72.31 	(b) For unsupervised use doses beyond those allowed in paragraph (a), a practitioner 
72.32 	with authority to prescribe must review and document the criteria in this paragraph and 
72.33 	paragraph (c)Code of Federal Regulations, title 42, section 8.12(i)(2), when determining 
73.1 	whether dispensing medication for a client's unsupervised use is safe and when it is 
73.2 	appropriate to implement, increase, or extend the amount of time between visits to the 
73.3 	program. The criteria are:
73.4 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
73.5 	and alcohol;
73.6 	(2) regularity of program attendance;
73.7 	(3) absence of serious behavioral problems at the program;
73.8 	(4) absence of known recent criminal activity such as drug dealing;
73.9 	(5) stability of the client's home environment and social relationships;
73.10 	(6) length of time in comprehensive maintenance treatment;
73.11 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
73.12 	the client's home; and
73.13 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
73.14 	of program attendance outweighs the potential risks of diversion or unsupervised use.
73.15 	(c) The determination, including the basis of the determination must be documented in 
73.16 	the client's medical record.

73.17 	Sec. 27. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 17, is amended 
73.18 	to read:
73.19 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
73.20 	policies and procedures required in this subdivision.
73.21 	(b) For a program that is not open every day of the year, the license holder must maintain 
73.22 	a policy and procedure that covers requirements under section 245G.22, subdivisions 6 and 
73.23 	7subdivision 6. Unsupervised use of medication used for the treatment of opioid use disorder 
73.24 	for days that the program is closed for business, including but not limited to Sundays one 
73.25 	weekend day and state and federal holidays, must meet the requirements under section 
73.26 	245G.22, subdivisions 6 and 7subdivision 6.
73.27 	(c) The license holder must maintain a policy and procedure that includes specific 
73.28 	measures to reduce the possibility of diversion. The policy and procedure must:
73.29 	(1) specifically identify and define the responsibilities of the medical and administrative 
73.30 	staff for performing diversion control measures; and
74.1 	(2) include a process for contacting no less than five percent of clients who have 
74.2 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
74.3 	paragraph (a), to require clients to physically return to the program each month. The system 
74.4 	must require clients to return to the program within a stipulated time frame and turn in all 
74.5 	unused medication containers related to opioid use disorder treatment. The license holder 
74.6 	must document all related contacts on a central log and the outcome of the contact for each 
74.7 	client in the client's record. The medical director must be informed of each outcome that 
74.8 	results in a situation in which a possible diversion issue was identified.
74.9 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
74.10 	administered, and dispensed according to applicable state and federal regulations and the 
74.11 	standards set by applicable accreditation entities. If a medication order requires assessment 
74.12 	by the person administering or dispensing the medication to determine the amount to be 
74.13 	administered or dispensed, the assessment must be completed by an individual whose 
74.14 	professional scope of practice permits an assessment. For the purposes of enforcement of 
74.15 	this paragraph, the commissioner has the authority to monitor the person administering or 
74.16 	dispensing the medication for compliance with state and federal regulations and the relevant 
74.17 	standards of the license holder's accreditation agency and may issue licensing actions 
74.18 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
74.19 	determination of noncompliance.
74.20 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.
74.21 	(f) Notwithstanding paragraph (e), From July 1, 2023, to June 30, 2024, a counselor in 
74.22 	an opioid treatment program may supervise up to 60 clients. The license holder may continue 
74.23 	to serve a client who was receiving services at the program on June 30, 2024, at a counselor 
74.24 	to client ratio of up to one to 60 and is not required to discharge any clients in order to return 
74.25 	to the counselor to client ratio of one to 50. The license holder may not, however, serve a 
74.26 	new client after June 30, 2024, unless the counselor who would supervise the new client is 
74.27 	supervising fewer than 50 existing clients.

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

74.29 	Sec. 28. Minnesota Statutes 2023 Supplement, section 254A.19, subdivision 3, is amended 
74.30 	to read:
74.31 		Subd. 3.Comprehensive assessments.  (a) An eligible vendor under section 254B.05
74.32 	conducting a comprehensive assessment for an individual seeking treatment shall approve
74.33 	recommend the nature, intensity level, and duration of treatment service if a need for services 
74.34 	is indicated, but the individual assessed can access any enrolled provider that is licensed to 
75.1 	provide the level of service authorized, including the provider or program that completed 
75.2 	the assessment. If an individual is enrolled in a prepaid health plan, the individual must 
75.3 	comply with any provider network requirements or limitations.
75.4 	(b) When a comprehensive assessment is completed while the individual is in a substance 
75.5 	use disorder treatment program, the comprehensive assessment must meet the requirements 
75.6 	of section 245G.05.
75.7 	(c) When a comprehensive assessment is completed for purposes of payment under 
75.8 	section 254B.05, subdivision 1, paragraphs (b), (c), or (h), or if the assessment is completed 
75.9 	prior to service initiation by a licensed substance use disorder treatment program licensed 
75.10 	under chapter 245G or applicable Tribal license, the assessor must:
75.11 	(1) include all components under section 245G.05, subdivision 3;
75.12 	(2) provide the assessment within five days of request or refer the individual to other 
75.13 	locations where they may access this service sooner;
75.14 	(3) provide information on payment options for substance use disorder services when 
75.15 	the individual is uninsured or underinsured;
75.16 	(4) provide the individual with a notice of privacy practices;
75.17 	(5) provide a copy of the completed comprehensive assessment, upon request;
75.18 	(6) provide resources and contact information for the level of care being recommended; 
75.19 	and
75.20 	(7) provide an individual diagnosed with an opioid use disorder with educational material 
75.21 	approved by the commissioner that contains information on:
75.22 	(i) risks for opioid use disorder and opioid dependence;
75.23 	(ii) treatment options, including the use of a medication for opioid use disorder;
75.24 	(iii) the risk and recognition of opioid overdose; and
75.25 	(iv) the use, availability, and administration of an opiate antagonist to respond to opioid 
75.26 	overdose.

75.27 	Sec. 29. Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 6, is amended 
75.28 	to read:
75.29 		Subd. 6.Local agency to determine client financial eligibility. (a) The local agency 
75.30 	shall determine a client's financial eligibility for the behavioral health fund according to 
75.31 	section 254B.04, subdivision 1a, with the income calculated prospectively for one year from 
76.1 	the date of comprehensive assessment request. The local agency shall pay for eligible clients 
76.2 	according to chapter 256G. The local agency shall enter the financial eligibility span within 
76.3 	ten calendar days of request. Client eligibility must be determined using only forms prescribed 
76.4 	by the departmentcommissioner unless the local agency has a reasonable basis for believing 
76.5 	that the information submitted on a form is false. To determine a client's eligibility, the local 
76.6 	agency must determine the client's income, the size of the client's household, the availability 
76.7 	of a third-party payment source, and a responsible relative's ability to pay for the client's 
76.8 	substance use disorder treatment.
76.9 	(b) A client who is a minor child must not be deemed to have income available to pay 
76.10 	for substance use disorder treatment, unless the minor child is responsible for payment under 
76.11 	section 144.347 for substance use disorder treatment services sought under section 144.343, 
76.12 	subdivision 1.
76.13 	(c) The local agency must determine the client's household size as follows:
76.14 	(1) if the client is a minor child, the household size includes the following persons living 
76.15 	in the same dwelling unit:
76.16 	(i) the client;
76.17 	(ii) the client's birth or adoptive parents; and
76.18 	(iii) the client's siblings who are minors; and
76.19 	(2) if the client is an adult, the household size includes the following persons living in 
76.20 	the same dwelling unit:
76.21 	(i) the client;
76.22 	(ii) the client's spouse;
76.23 	(iii) the client's minor children; and
76.24 	(iv) the client's spouse's minor children.
76.25 	For purposes of this paragraph, household size includes a person listed in clauses (1) and 
76.26 	(2) who is in an out-of-home placement if a person listed in clause (1) or (2) is contributing 
76.27 	to the cost of care of the person in out-of-home placement.
76.28 	(d) The local agency must determine the client's current prepaid health plan enrollment, 
76.29 	the availability of a third-party payment source, including the availability of total payment, 
76.30 	partial payment, and amount of co-payment.
77.1 	(e) The local agency must provide the required eligibility information to the department 
77.2 	in the manner specified by the department.
77.3 	(f) The local agency shall require the client and policyholder to conditionally assign to 
77.4 	the department the client and policyholder's rights and the rights of minor children to benefits 
77.5 	or services provided to the client if the department is required to collect from a third-party 
77.6 	pay source.
77.7 	(g) The local agency must redetermine a client's eligibility for the behavioral health fund 
77.8 	every 12 months.
77.9 	(h) A client, responsible relative, and policyholder must provide income or wage 
77.10 	verification, household size verification, and must make an assignment of third-party payment 
77.11 	rights under paragraph (f). If a client, responsible relative, or policyholder does not comply 
77.12 	with the provisions of this subdivision, the client is ineligible for behavioral health fund 
77.13 	payment for substance use disorder treatment, and the client and responsible relative must 
77.14 	be obligated to pay for the full cost of substance use disorder treatment services provided 
77.15 	to the client.

77.16 	Sec. 30. Minnesota Statutes 2023 Supplement, section 254B.04, is amended by adding a 
77.17 	subdivision to read:
77.18 		Subd. 6a.Span of eligibility. The local agency must enter the financial eligibility span 
77.19 	within five business days of a request. If the comprehensive assessment is completed within 
77.20 	the timelines required under chapter 245G, then the span of eligibility must begin on the 
77.21 	date services were initiated.  If the comprehensive assessment is not completed within the 
77.22 	timelines required under chapter 245G, then the span of eligibility must begin on the date 
77.23 	the comprehensive assessment was completed.

77.24 	Sec. 31. Minnesota Statutes 2023 Supplement, section 254B.05, subdivision 1, is amended 
77.25 	to read:
77.26 		Subdivision 1.Licensure or certification required. (a) Programs licensed by the 
77.27 	commissioner are eligible vendors. Hospitals may apply for and receive licenses to be 
77.28 	eligible vendors, notwithstanding the provisions of section 245A.03. American Indian 
77.29 	programs that provide substance use disorder treatment, extended care, transitional residence, 
77.30 	or outpatient treatment services, and are licensed by Tribal government are eligible vendors.
77.31 	(b) A licensed professional in private practice as defined in section 245G.01, subdivision 
77.32 	17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible 
78.1 	vendor of a comprehensive assessment and assessment summary provided according to 
78.2 	section 245G.05, and treatment services provided according to sections 245G.06 and 
78.3 	245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses 
78.4 	(1) to (6).
78.5 	(c) A county is an eligible vendor for a comprehensive assessment and assessment 
78.6 	summary when provided by an individual who meets the staffing credentials of section 
78.7 	245G.11, subdivisions 1 and 5, and completed according to the requirements of section 
78.8 	245G.05. A county is an eligible vendor of care coordination services when provided by an 
78.9 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and 
78.10 	provided according to the requirements of section 245G.07, subdivision 1, paragraph (a), 
78.11 	clause (5). A county is an eligible vendor of peer recovery services when the services are 
78.12 	provided by an individual who meets the requirements of section 245G.11, subdivision 8.
78.13 	(d) A recovery community organization that meets the requirements of clauses (1) to 
78.14 	(10) and meets membership certification or accreditation requirements of the Association 
78.15 	of Recovery Community Organizations,Alliance for Recovery Centered Organizations, the 
78.16 	Council on Accreditation of Peer Recovery Support Services, or a Minnesota statewide 
78.17 	recovery community organization identified by the commissioner is an eligible vendor of 
78.18 	peer support services. Eligible vendors under this paragraph must:
78.19 	(1) be nonprofit organizations;
78.20 	(2) be led and governed by individuals in the recovery community, with more than 50 
78.21 	percent of the board of directors or advisory board members self-identifying as people in 
78.22 	personal recovery from substance use disorders;
78.23 	(3) primarily focus on recovery from substance use disorders, with missions and visions 
78.24 	that support this primary focus;
78.25 	(4) be grassroots and reflective of and engaged with the community served;
78.26 	(5) be accountable to the recovery community through processes that promote the 
78.27 	involvement and engagement of, and consultation with, people in recovery and their families, 
78.28 	friends, and recovery allies;
78.29 	(6) provide nonclinical peer recovery support services, including but not limited to 
78.30 	recovery support groups, recovery coaching, telephone recovery support, skill-building 
78.31 	groups, and harm-reduction activities;
79.1 	(7) allow for and support opportunities for all paths toward recovery and refrain from 
79.2 	excluding anyone based on their chosen recovery path, which may include but is not limited 
79.3 	to harm reduction paths, faith-based paths, and nonfaith-based paths;
79.4 	(8) be purposeful in meeting the diverse needs of Black, Indigenous, and people of color 
79.5 	communities, including board and staff development activities, organizational practices, 
79.6 	service offerings, advocacy efforts, and culturally informed outreach and service plans;
79.7 	(9) be stewards of recovery-friendly language that is supportive of and promotes recovery 
79.8 	across diverse geographical and cultural contexts and reduces stigma; and
79.9 	(10) maintain an employee and volunteer code of ethics and easily accessible grievance 
79.10 	procedures posted in physical spaces, on websites, or on program policies or forms.
79.11 	(e) Recovery community organizations approved by the commissioner before June 30, 
79.12 	2023, shall retain their designation as recovery community organizations.
79.13 	(f) A recovery community organization that is aggrieved by an accreditation or 
79.14 	membership determination and believes it meets the requirements under paragraph (d) may 
79.15 	appeal the determination under section 256.045, subdivision 3, paragraph (a), clause (15), 
79.16 	for reconsideration as an eligible vendor.
79.17 	(g) All recovery community organizations must be certified or accredited by an entity 
79.18 	listed in paragraph (d) by January 1, 2025.
79.19 	(g) (h) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
79.20 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
79.21 	nonresidential substance use disorder treatment or withdrawal management program by the 
79.22 	commissioner or by Tribal government or do not meet the requirements of subdivisions 1a 
79.23 	and 1b are not eligible vendors.
79.24 	(h) (i) Hospitals, federally qualified health centers, and rural health clinics are eligible 
79.25 	vendors of a comprehensive assessment when the comprehensive assessment is completed 
79.26 	according to section 245G.05 and by an individual who meets the criteria of an alcohol and 
79.27 	drug counselor according to section 245G.11, subdivision 5. The alcohol and drug counselor 
79.28 	must be individually enrolled with the commissioner and reported on the claim as the 
79.29 	individual who provided the service.

80.1 	Sec. 32. Minnesota Statutes 2023 Supplement, section 254B.05, subdivision 5, is amended 
80.2 	to read:
80.3 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
80.4 	use disorder services and service enhancements funded under this chapter.
80.5 	(b) Eligible substance use disorder treatment services include:
80.6 	(1) those licensed, as applicable, according to chapter 245G or applicable Tribal license 
80.7 	and provided according to the following ASAM levels of care:
80.8 	(i) ASAM level 0.5 early intervention services provided according to section 254B.19, 
80.9 	subdivision 1, clause (1);
80.10 	(ii) ASAM level 1.0 outpatient services provided according to section 254B.19, 
80.11 	subdivision 1, clause (2);
80.12 	(iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19, 
80.13 	subdivision 1, clause (3);
80.14 	(iv) ASAM level 2.5 partial hospitalization services provided according to section 
80.15 	254B.19, subdivision 1, clause (4);
80.16 	(v) ASAM level 3.1 clinically managed low-intensity residential services provided 
80.17 	according to section 254B.19, subdivision 1, clause (5), at a base payment rate of $166.13 
80.18 	per day;
80.19 	(vi) ASAM level 3.3 clinically managed population-specific high-intensity residential 
80.20 	services provided according to section 254B.19, subdivision 1, clause (6), at a base payment 
80.21 	rate of $224.06 per day; and
80.22 	(vii) ASAM level 3.5 clinically managed high-intensity residential services provided 
80.23 	according to section 254B.19, subdivision 1, clause (7), at a base payment rate of $224.06 
80.24 	per day;
80.25 	(2) comprehensive assessments provided according to sections 245.4863, paragraph (a), 
80.26 	and 245G.05 section 254A.19, subdivision 3;
80.27 	(3) treatment coordination services provided according to section 245G.07, subdivision 
80.28 	1, paragraph (a), clause (5);
80.29 	(4) peer recovery support services provided according to section 245G.07, subdivision 
80.30 	2, clause (8);
80.31 	(5) withdrawal management services provided according to chapter 245F;
81.1 	(6) hospital-based treatment services that are licensed according to sections 245G.01 to 
81.2 	245G.17 or applicable Tribal license and licensed as a hospital under sections 144.50 to 
81.3 	144.56;
81.4 	(7) substance use disorder treatment services with medications for opioid use disorder 
81.5 	provided in an opioid treatment program licensed according to sections 245G.01 to 245G.17 
81.6 	and 245G.22, or under an applicable Tribal license;
81.7 	(7) (8) adolescent treatment programs that are licensed as outpatient treatment programs 
81.8 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
81.9 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
81.10 	applicable Tribal license;
81.11 	(8) (9) ASAM 3.5 clinically managed high-intensity residential services that are licensed 
81.12 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable Tribal license, which 
81.13 	provide ASAM level of care 3.5 according to section 254B.19, subdivision 1, clause (7), 
81.14 	and are provided by a state-operated vendor or to clients who have been civilly committed 
81.15 	to the commissioner, present the most complex and difficult care needs, and are a potential 
81.16 	threat to the community; and
81.17 	(9) (10) room and board facilities that meet the requirements of subdivision 1a.
81.18 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
81.19 	of paragraph (b) and one of the following additional requirements:
81.20 	(1) programs that serve parents with their children if the program:
81.21 	(i) provides on-site child care during the hours of treatment activity that:
81.22 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
81.23 	9503; or
81.24 	(B) is licensed under chapter 245A and sections 245G.01 to 245G.19; or
81.25 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
81.26 	licensed under chapter 245A as:
81.27 	(A) a child care center under Minnesota Rules, chapter 9503; or
81.28 	(B) a family child care home under Minnesota Rules, chapter 9502;
81.29 	(2) culturally specific or culturally responsive programs as defined in section 254B.01, 
81.30 	subdivision 4a;
81.31 	(3) disability responsive programs as defined in section 254B.01, subdivision 4b;
82.1 	(4) programs that offer medical services delivered by appropriately credentialed health 
82.2 	care staff in an amount equal to two hours per client per week if the medical needs of the 
82.3 	client and the nature and provision of any medical services provided are documented in the 
82.4 	client file; or
82.5 	(5) programs that offer services to individuals with co-occurring mental health and 
82.6 	substance use disorder problems if:
82.7 	(i) the program meets the co-occurring requirements in section 245G.20;
82.8 	(ii) 25 percent of the counseling staff are licensed mental health professionals under 
82.9 	section 245I.04, subdivision 2, or are students or licensing candidates under the supervision 
82.10 	of a licensed alcohol and drug counselor supervisor and mental health professional under 
82.11 	section 245I.04, subdivision 2, except that no more than 50 percent of the mental health 
82.12 	staff may be students or licensing candidates with time documented to be directly related 
82.13 	to provisions of co-occurring services;
82.14 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
82.15 	health diagnostic assessment within ten days of admission;
82.16 	(iv) the program has standards for multidisciplinary case review that include a monthly 
82.17 	review for each client that, at a minimum, includes a licensed mental health professional 
82.18 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
82.19 	(v) family education is offered that addresses mental health and substance use disorder 
82.20 	and the interaction between the two; and
82.21 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
82.22 	training annually.
82.23 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
82.24 	that provides arrangements for off-site child care must maintain current documentation at 
82.25 	the substance use disorder facility of the child care provider's current licensure to provide 
82.26 	child care services.
82.27 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
82.28 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
82.29 	in paragraph (c), clause (4), items (i) to (iv).
82.30 	(f) Subject to federal approval, substance use disorder services that are otherwise covered 
82.31 	as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, 
82.32 	subdivision 3b. The use of telehealth to deliver services must be medically appropriate to 
83.1 	the condition and needs of the person being served. Reimbursement shall be at the same 
83.2 	rates and under the same conditions that would otherwise apply to direct face-to-face services.
83.3 	(g) For the purpose of reimbursement under this section, substance use disorder treatment 
83.4 	services provided in a group setting without a group participant maximum or maximum 
83.5 	client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one. 
83.6 	At least one of the attending staff must meet the qualifications as established under this 
83.7 	chapter for the type of treatment service provided. A recovery peer may not be included as 
83.8 	part of the staff ratio.
83.9 	(h) Payment for outpatient substance use disorder services that are licensed according 
83.10 	to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless 
83.11 	prior authorization of a greater number of hours is obtained from the commissioner.
83.12 	(i) Payment for substance use disorder services under this section must start from the 
83.13 	day of service initiation, when the comprehensive assessment is completed within the 
83.14 	required timelines.

83.15 	EFFECTIVE DATE. This section is effective August 1, 2024, except the amendments 
83.16 	to paragraph (b), clause (1), items (v) to (vii), are effective August 1, 2024, or upon federal 
83.17 	approval, whichever occurs later. The commissioner of human services shall inform the 
83.18 	revisor of statutes when federal approval is obtained.

83.19 	Sec. 33. Minnesota Statutes 2023 Supplement, section 254B.181, subdivision 1, is amended 
83.20 	to read:
83.21 		Subdivision 1.Requirements. All sober homes must comply with applicable state laws 
83.22 	and regulations and local ordinances related to maximum occupancy, fire safety, and 
83.23 	sanitation. In addition, all sober homes must:
83.24 	(1) maintain a supply of an opiate antagonist in the home in a conspicuous location and 
83.25 	post information on proper use;
83.26 	(2) have written policies regarding access to all prescribed medications;
83.27 	(3) have written policies regarding evictions;
83.28 	(4) return all property and medications to a person discharged from the home and retain 
83.29 	the items for a minimum of 60 days if the person did not collect them upon discharge. The 
83.30 	owner must make an effort to contact persons listed as emergency contacts for the discharged 
83.31 	person so that the items are returned;
84.1 	(5) document the names and contact information for persons to contact in case of an 
84.2 	emergency or upon discharge and notification of a family member, or other emergency 
84.3 	contact designated by the resident under certain circumstances, including but not limited to 
84.4 	death due to an overdose;
84.5 	(6) maintain contact information for emergency resources in the community to address 
84.6 	mental health and health emergencies;
84.7 	(7) have policies on staff qualifications and prohibition against fraternization;
84.8 	(8) have a policy on whether the use of medications for opioid use disorder is permissible
84.9 	permit residents to use, as directed by a licensed prescriber, legally prescribed and dispensed 
84.10 	or administered pharmacotherapies approved by the United States Food and Drug 
84.11 	Administration for the treatment of opioid use disorder and other medications approved by 
84.12 	the United States Food and Drug Administration to treat co-occurring substance use disorders 
84.13 	and mental health conditions;
84.14 	(9) have a fee schedule and refund policy;
84.15 	(10) have rules for residents;
84.16 	(11) have policies that promote resident participation in treatment, self-help groups, or 
84.17 	other recovery supports;
84.18 	(12) have policies requiring abstinence from alcohol and illicit drugs; and
84.19 	(13) distribute the sober home bill of rights.

84.20 	Sec. 34. Minnesota Statutes 2023 Supplement, section 254B.19, subdivision 1, is amended 
84.21 	to read:
84.22 		Subdivision 1.Level of care requirements. For each client assigned an ASAM level 
84.23 	of care, eligible vendors must implement the standards set by the ASAM for the respective 
84.24 	level of care. Additionally, vendors must meet the following requirements:
84.25 	(1) For ASAM level 0.5 early intervention targeting individuals who are at risk of 
84.26 	developing a substance-related problem but may not have a diagnosed substance use disorder, 
84.27 	early intervention services may include individual or group counseling, treatment 
84.28 	coordination, peer recovery support, screening brief intervention, and referral to treatment 
84.29 	provided according to section 254A.03, subdivision 3, paragraph (c).
84.30 	(2) For ASAM level 1.0 outpatient clients, adults must receive up to eight hours per 
84.31 	week of skilled treatment services and adolescents must receive up to five hours per week. 
84.32 	Services must be licensed according to section 245G.20 and meet requirements under section 
85.1 	256B.0759. Peer recovery and treatment coordination may be provided beyond the hourly 
85.2 	skilled treatment service hours allowable per week.
85.3 	(3) For ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours 
85.4 	per week of skilled treatment services and adolescents must receive six or more hours per 
85.5 	week. Vendors must be licensed according to section 245G.20 and must meet requirements 
85.6 	under section 256B.0759. Peer recovery services and treatment coordination may be provided 
85.7 	beyond the hourly skilled treatment service hours allowable per week. If clinically indicated 
85.8 	on the client's treatment plan, this service may be provided in conjunction with room and 
85.9 	board according to section 254B.05, subdivision 1a.
85.10 	(4) For ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or 
85.11 	more of skilled treatment services. Services must be licensed according to section 245G.20 
85.12 	and must meet requirements under section 256B.0759. Level 2.5 is for clients who need 
85.13 	daily monitoring in a structured setting, as directed by the individual treatment plan and in 
85.14 	accordance with the limitations in section 254B.05, subdivision 5, paragraph (h). If clinically 
85.15 	indicated on the client's treatment plan, this service may be provided in conjunction with 
85.16 	room and board according to section 254B.05, subdivision 1a.
85.17 	(5) For ASAM level 3.1 clinically managed low-intensity residential clients, programs 
85.18 	must provide at least 5 between nine and 19 hours of skilled treatment services per week 
85.19 	according to each client's specific treatment schedule, as directed by the individual treatment 
85.20 	plan. Programs must be licensed according to section 245G.20 and must meet requirements 
85.21 	under section 256B.0759.
85.22 	(6) For ASAM level 3.3 clinically managed population-specific high-intensity residential 
85.23 	clients, programs must be licensed according to section 245G.20 and must meet requirements 
85.24 	under section 256B.0759. Programs must have 24-hour staffing coverage. Programs must 
85.25 	be enrolled as a disability responsive program as described in section 254B.01, subdivision 
85.26 	4b, and must specialize in serving persons with a traumatic brain injury or a cognitive 
85.27 	impairment so significant, and the resulting level of impairment so great, that outpatient or 
85.28 	other levels of residential care would not be feasible or effective. Programs must provide,
85.29 	at a minimum, daily skilled treatment services seven days a20 or more hours of skilled 
85.30 	treatment services per week according to each client's specific treatment schedule, as directed 
85.31 	by the individual treatment plan.
85.32 	(7) For ASAM level 3.5 clinically managed high-intensity residential clients, services 
85.33 	must be licensed according to section 245G.20 and must meet requirements under section 
85.34 	256B.0759. Programs must have 24-hour staffing coverage and provide, at a minimum, 
86.1 	daily skilled treatment services seven days a 20 or more hours of skilled treatment services 
86.2 	per week according to each client's specific treatment schedule, as directed by the individual 
86.3 	treatment plan.
86.4 	(8) For ASAM level withdrawal management 3.2 clinically managed clients, withdrawal 
86.5 	management must be provided according to chapter 245F.
86.6 	(9) For ASAM level withdrawal management 3.7 medically monitored clients, withdrawal 
86.7 	management must be provided according to chapter 245F.

86.8 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
86.9 	of human services shall notify the revisor of statutes when federal approval has been obtained.

86.10 	Sec. 35. Minnesota Statutes 2023 Supplement, section 256B.0759, subdivision 2, is 
86.11 	amended to read:
86.12 		Subd. 2.Provider participation. (a) Programs licensed by the Department of Human 
86.13 	Services as nonresidential substance use disorder treatment programs that receive payment 
86.14 	under this chapter must enroll as demonstration project providers and meet the requirements 
86.15 	of subdivision 3 by January 1, 2025. Programs that do not meet the requirements of this 
86.16 	paragraph are ineligible for payment for services provided under section 256B.0625.
86.17 	(b) Programs licensed by the Department of Human Services as residential treatment 
86.18 	programs according to section 245G.21 that receive payment under this chapter must enroll 
86.19 	as demonstration project providers and meet the requirements of subdivision 3 by January 
86.20 	1, 2024. Programs that do not meet the requirements of this paragraph are ineligible for 
86.21 	payment for services provided under section 256B.0625.
86.22 	(c) Programs licensed by the Department of Human Services as residential treatment 
86.23 	programs according to section 245G.21 that receive payment under this chapter and, are 
86.24 	licensed as a hospital under sections 144.50 to 144.581must, and provide only ASAM 3.7 
86.25 	medically monitored inpatient level of care are not required to enroll as demonstration 
86.26 	project providers and meet the requirements of subdivision 3 by January 1, 2025. Programs 
86.27 	meeting these criteria must submit evidence of providing the required level of care to the 
86.28 	commissioner to be exempt from enrolling in the demonstration.
86.29 	(d) Programs licensed by the Department of Human Services as withdrawal management 
86.30 	programs according to chapter 245F that receive payment under this chapter must enroll as 
86.31 	demonstration project providers and meet the requirements of subdivision 3 by January 1, 
86.32 	2024. Programs that do not meet the requirements of this paragraph are ineligible for payment 
86.33 	for services provided under section 256B.0625.
87.1 	(e) Out-of-state residential substance use disorder treatment programs that receive 
87.2 	payment under this chapter must enroll as demonstration project providers and meet the 
87.3 	requirements of subdivision 3 by January 1, 2024. Programs that do not meet the requirements 
87.4 	of this paragraph are ineligible for payment for services provided under section 256B.0625.
87.5 	(f) Tribally licensed programs may elect to participate in the demonstration project and 
87.6 	meet the requirements of subdivision 3. The Department of Human Services must consult 
87.7 	with Tribal Nations to discuss participation in the substance use disorder demonstration 
87.8 	project.
87.9 	(g) The commissioner shall allow providers enrolled in the demonstration project before 
87.10 	July 1, 2021, to receive applicable rate enhancements authorized under subdivision 4 for 
87.11 	all services provided on or after the date of enrollment, except that the commissioner shall 
87.12 	allow a provider to receive applicable rate enhancements authorized under subdivision 4 
87.13 	for services provided on or after July 22, 2020, to fee-for-service enrollees, and on or after 
87.14 	January 1, 2021, to managed care enrollees, if the provider meets all of the following 
87.15 	requirements:
87.16 	(1) the provider attests that during the time period for which the provider is seeking the 
87.17 	rate enhancement, the provider took meaningful steps in their plan approved by the 
87.18 	commissioner to meet the demonstration project requirements in subdivision 3; and
87.19 	(2) the provider submits attestation and evidence, including all information requested 
87.20 	by the commissioner, of meeting the requirements of subdivision 3 to the commissioner in 
87.21 	a format required by the commissioner.
87.22 	(h) The commissioner may recoup any rate enhancements paid under paragraph (g) to 
87.23 	a provider that does not meet the requirements of subdivision 3 by July 1, 2021.

87.24 	Sec. 36. Minnesota Statutes 2022, section 256B.0759, subdivision 4, is amended to read:
87.25 		Subd. 4.Provider payment rates. (a) Payment rates for participating providers must 
87.26 	be increased for services provided to medical assistance enrollees. To receive a rate increase, 
87.27 	participating providers must meet demonstration project requirements and provide evidence 
87.28 	of formal referral arrangements with providers delivering step-up or step-down levels of 
87.29 	care. Providers that have enrolled in the demonstration project but have not met the provider 
87.30 	standards under subdivision 3 as of July 1, 2022, are not eligible for a rate increase under 
87.31 	this subdivision until the date that the provider meets the provider standards in subdivision 
87.32 	3. Services provided from July 1, 2022, to the date that the provider meets the provider 
87.33 	standards under subdivision 3 shall be reimbursed at rates according to section 254B.05, 
88.1 	subdivision 5, paragraph (b). Rate increases paid under this subdivision to a provider for 
88.2 	services provided between July 1, 2021, and July 1, 2022, are not subject to recoupment 
88.3 	when the provider is taking meaningful steps to meet demonstration project requirements 
88.4 	that are not otherwise required by law, and the provider provides documentation to the 
88.5 	commissioner, upon request, of the steps being taken.
88.6 	(b) The commissioner may temporarily suspend payments to the provider according to 
88.7 	section 256B.04, subdivision 21, paragraph (d), if the provider does not meet the requirements 
88.8 	in paragraph (a). Payments withheld from the provider must be made once the commissioner 
88.9 	determines that the requirements in paragraph (a) are met.
88.10 	(c) For substance use disorder services under section 254B.05, subdivision 5, paragraph 
88.11 	(b), clause (8), provided on or after July 1, 2020, payment rates must be increased by 25 
88.12 	percent over the rates in effect on December 31, 2019.
88.13 	(d) (c) For outpatient individual and group substance use disorder services under section 
88.14 	254B.05, subdivision 5, paragraph (b), clauses clause (1), (6), and (7), and adolescent 
88.15 	treatment programs that are licensed as outpatient treatment programs according to sections 
88.16 	245G.01 to 245G.18, provided on or after January 1, 2021, payment rates must be increased 
88.17 	by 20 percent over the rates in effect on December 31, 2020.
88.18 	(e) (d) Effective January 1, 2021, and contingent on annual federal approval, managed 
88.19 	care plans and county-based purchasing plans must reimburse providers of the substance 
88.20 	use disorder services meeting the criteria described in paragraph (a) who are employed by 
88.21 	or under contract with the plan an amount that is at least equal to the fee-for-service base 
88.22 	rate payment for the substance use disorder services described in paragraphs paragraph (c) 
88.23 	and (d). The commissioner must monitor the effect of this requirement on the rate of access 
88.24 	to substance use disorder services and residential substance use disorder rates. Capitation 
88.25 	rates paid to managed care organizations and county-based purchasing plans must reflect 
88.26 	the impact of this requirement. This paragraph expires if federal approval is not received 
88.27 	at any time as required under this paragraph.
88.28 	(f) (e) Effective July 1, 2021, contracts between managed care plans and county-based 
88.29 	purchasing plans and providers to whom paragraph (e) (d) applies must allow recovery of 
88.30 	payments from those providers if, for any contract year, federal approval for the provisions 
88.31 	of paragraph (e) (d) is not received, and capitation rates are adjusted as a result. Payment 
88.32 	recoveries must not exceed the amount equal to any decrease in rates that results from this 
88.33 	provision.
89.1 	(f) For substance use disorder services with medications for opioid use disorder under 
89.2 	section 254B.05, subdivision 5, clause (7), provided on or after January 1, 2021, payment 
89.3 	rates must be increased by 20 percent over the rates in effect on December 31, 2020. Upon 
89.4 	implementation of new rates according to section 254B.121, the 20 percent increase will 
89.5 	no longer apply.

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

89.7 	Sec. 37. REPEALER.
 89.8 	Minnesota Statutes 2022, section 245G.22, subdivisions 4 and 7, are repealed.

89.9 	ARTICLE 5
89.10 	DIRECT CARE AND TREATMENT

89.11 	Section 1. Minnesota Statutes 2022, section 246.71, subdivision 3, is amended to read:
89.12 		Subd. 3.Patient. "Patient" means any person who is receiving treatment from or 
89.13 	committed to a secure state-operated treatment facility program, including the Minnesota 
89.14 	Sex Offender Program.

89.15 	Sec. 2. Minnesota Statutes 2022, section 246.71, subdivision 4, is amended to read:
89.16 		Subd. 4.Employee of a secure treatment facility state-operated treatment program
89.17 	or employee. "Employee of a secure treatment facility state-operated treatment program" 
89.18 	or "employee" means an employee of the Minnesota Security Hospital or a secure treatment 
89.19 	facility operated by the Minnesota Sex Offender Program any state-operated treatment 
89.20 	program.

89.21 	Sec. 3. Minnesota Statutes 2022, section 246.71, subdivision 5, is amended to read:
89.22 		Subd. 5.Secure treatment facility State-operated treatment program. "Secure 
89.23 	treatment facility State-operated treatment program" means the Minnesota Security Hospital 
89.24 	and the Minnesota Sex Offender Program facility in Moose Lake and any portion of the 
89.25 	Minnesota Sex Offender Program operated by the Minnesota Sex Offender Program at the 
89.26 	Minnesota Security Hospital any state-operated treatment program under the jurisdiction 
89.27 	of the executive board, including the Minnesota Sex Offender Program, community 
89.28 	behavioral health hospitals, crisis centers, residential facilities, outpatient services, and other 
89.29 	community-based services under the executive board's control.

90.1 	Sec. 4. Minnesota Statutes 2022, section 246.711, is amended to read:
90.2 	246.711 CONDITIONS FOR APPLICABILITY OF PROCEDURES.
90.3 		Subdivision 1.Request for procedures. An employee of a secure treatment facility
90.4 	state-operated treatment program may request that the procedures of sections 246.71 to 
90.5 	246.722 be followed when the employee may have experienced a significant exposure to a 
90.6 	patient.
90.7 		Subd. 2.Conditions. The secure treatment facility state-operated treatment program
90.8 	shall follow the procedures in sections 246.71 to 246.722 when all of the following conditions 
90.9 	are met:
90.10 	(1) a licensed physician, advanced practice registered nurse, or physician assistant 
90.11 	determines that a significant exposure has occurred following the protocol under section 
90.12 	246.721;
90.13 	(2) the licensed physician, advanced practice registered nurse, or physician assistant for 
90.14 	the employee needs the patient's blood-borne pathogens test results to begin, continue, 
90.15 	modify, or discontinue treatment in accordance with the most current guidelines of the 
90.16 	United States Public Health Service, because of possible exposure to a blood-borne pathogen; 
90.17 	and
90.18 	(3) the employee consents to providing a blood sample for testing for a blood-borne 
90.19 	pathogen.

90.20 	Sec. 5. Minnesota Statutes 2022, section 246.712, subdivision 1, is amended to read:
90.21 		Subdivision 1.Information to patient. (a) Before seeking any consent required by the 
90.22 	procedures under sections 246.71 to 246.722, a secure treatment facility state-operated 
90.23 	treatment program shall inform the patient that the patient's blood-borne pathogen test 
90.24 	results, without the patient's name or other uniquely identifying information, shall be reported 
90.25 	to the employee if requested and that test results collected under sections 246.71 to 246.722
90.26 	are for medical purposes as set forth in section 246.718 and may not be used as evidence 
90.27 	in any criminal proceedings or civil proceedings, except for procedures under sections 
90.28 	144.4171 to 144.4186.
90.29 	(b) The secure treatment facility state-operated treatment program shall inform the patient 
90.30 	of the insurance protections in section 72A.20, subdivision 29.
91.1 	(c) The secure treatment facility state-operated treatment program shall inform the patient 
91.2 	that the patient may refuse to provide a blood sample and that the patient's refusal may result 
91.3 	in a request for a court order to require the patient to provide a blood sample.
91.4 	(d) The secure treatment facility state-operated treatment program shall inform the patient 
91.5 	that the secure treatment facility state-operated treatment program will advise the employee 
91.6 	of a secure treatment facility state-operated treatment program of the confidentiality 
91.7 	requirements and penalties before the employee's health care provider discloses any test 
91.8 	results.

91.9 	Sec. 6. Minnesota Statutes 2022, section 246.712, subdivision 2, is amended to read:
91.10 		Subd. 2.Information to secure treatment facility state-operated treatment program
91.11 	employee. (a) Before disclosing any information about the patient, the secure treatment 
91.12 	facility state-operated treatment program shall inform the employee of a secure treatment 
91.13 	facility state-operated treatment program of the confidentiality requirements of section 
91.14 	246.719 and that the person may be subject to penalties for unauthorized release of test 
91.15 	results about the patient under section 246.72.
91.16 	(b) The secure treatment facility state-operated treatment program shall inform the 
91.17 	employee of the insurance protections in section 72A.20, subdivision 29.

91.18 	Sec. 7. Minnesota Statutes 2022, section 246.713, is amended to read:
91.19 	246.713 DISCLOSURE OF POSITIVE BLOOD-BORNE PATHOGEN TEST 
91.20 	RESULTS.
91.21 	If the conditions of sections 246.711 and 246.712 are met, the secure treatment facility
91.22 	state-operated treatment program shall ask the patient if the patient has ever had a positive 
91.23 	test for a blood-borne pathogen. The secure treatment facility state-operated treatment 
91.24 	program must attempt to get existing test results under this section before taking any steps 
91.25 	to obtain a blood sample or to test for blood-borne pathogens. The secure treatment facility
91.26 	state-operated treatment program shall disclose the patient's blood-borne pathogen test 
91.27 	results to the employee without the patient's name or other uniquely identifying information.

91.28 	Sec. 8. Minnesota Statutes 2022, section 246.714, is amended to read:
91.29 	246.714 CONSENT PROCEDURES GENERALLY.
91.30 	(a) For purposes of sections 246.71 to 246.722, whenever the secure treatment facility
91.31 	state-operated treatment program is required to seek consent, the secure treatment facility
92.1 	state-operated treatment program shall obtain consent from a patient or a patient's 
92.2 	representative consistent with other law applicable to consent.
92.3 	(b) Consent is not required if the secure treatment facility state-operated treatment 
92.4 	program has made reasonable efforts to obtain the representative's consent and consent 
92.5 	cannot be obtained within 24 hours of a significant exposure.
92.6 	(c) If testing of available blood occurs without consent because the patient is unconscious 
92.7 	or unable to provide consent, and a representative cannot be located, the secure treatment 
92.8 	facility state-operated treatment program shall provide the information required in section 
92.9 	246.712 to the patient or representative whenever it is possible to do so.
92.10 	(d) If a patient dies before an opportunity to consent to blood collection or testing under 
92.11 	sections 246.71 to 246.722, the secure treatment facility state-operated treatment program
92.12 	does not need consent of the patient's representative for purposes of sections 246.71 to 
92.13 	246.722.

92.14 	Sec. 9. Minnesota Statutes 2022, section 246.715, subdivision 1, is amended to read:
92.15 		Subdivision 1.Procedures with consent. If a sample of the patient's blood is available, 
92.16 	the secure treatment facility state-operated treatment program shall ensure that blood is 
92.17 	tested for blood-borne pathogens with the consent of the patient, provided the conditions 
92.18 	in sections 246.711 and 246.712 are met.

92.19 	Sec. 10. Minnesota Statutes 2022, section 246.715, subdivision 2, is amended to read:
92.20 		Subd. 2.Procedures without consent. If the patient has provided a blood sample, but 
92.21 	does not consent to blood-borne pathogens testing, the secure treatment facility state-operated 
92.22 	treatment program shall ensure that the blood is tested for blood-borne pathogens if the 
92.23 	employee requests the test, provided all of the following criteria are met:
92.24 	(1) the employee and secure treatment facility state-operated treatment program have 
92.25 	documented exposure to blood or body fluids during performance of the employee's work 
92.26 	duties;
92.27 	(2) a licensed physician, advanced practice registered nurse, or physician assistant has 
92.28 	determined that a significant exposure has occurred under section 246.711 and has 
92.29 	documented that blood-borne pathogen test results are needed for beginning, modifying, 
92.30 	continuing, or discontinuing medical treatment for the employee as recommended by the 
92.31 	most current guidelines of the United States Public Health Service;
93.1 	(3) the employee provides a blood sample for testing for blood-borne pathogens as soon 
93.2 	as feasible;
93.3 	(4) the secure treatment facility state-operated treatment program asks the patient to 
93.4 	consent to a test for blood-borne pathogens and the patient does not consent;
93.5 	(5) the secure treatment facility state-operated treatment program has provided the patient 
93.6 	and the employee with all of the information required by section 246.712; and
93.7 	(6) the secure treatment facility state-operated treatment program has informed the 
93.8 	employee of the confidentiality requirements of section 246.719 and the penalties for 
93.9 	unauthorized release of patient information under section 246.72.

93.10 	Sec. 11. Minnesota Statutes 2022, section 246.715, subdivision 3, is amended to read:
93.11 		Subd. 3.Follow-up. The secure treatment facility state-operated treatment program shall 
93.12 	inform the patient whose blood was tested of the results. The secure treatment facility
93.13 	state-operated treatment program shall inform the employee's health care provider of the 
93.14 	patient's test results without the patient's name or other uniquely identifying information.

93.15 	Sec. 12. Minnesota Statutes 2022, section 246.716, subdivision 1, is amended to read:
93.16 		Subdivision 1.Procedures with consent. (a) If a blood sample is not otherwise available, 
93.17 	the secure treatment facility state-operated treatment program shall obtain consent from the 
93.18 	patient before collecting a blood sample for testing for blood-borne pathogens. The consent 
93.19 	process shall include informing the patient that the patient may refuse to provide a blood 
93.20 	sample and that the patient's refusal may result in a request for a court order under subdivision 
93.21 	2 to require the patient to provide a blood sample.
93.22 	(b) If the patient consents to provide a blood sample, the secure treatment facility
93.23 	state-operated treatment program shall collect a blood sample and ensure that the sample 
93.24 	is tested for blood-borne pathogens.
93.25 	(c) The secure treatment facility state-operated treatment program shall inform the 
93.26 	employee's health care provider about the patient's test results without the patient's name 
93.27 	or other uniquely identifying information. The secure treatment facility state-operated 
93.28 	treatment program shall inform the patient of the test results.
93.29 	(d) If the patient refuses to provide a blood sample for testing, the secure treatment 
93.30 	facility state-operated treatment program shall inform the employee of the patient's refusal.

94.1 	Sec. 13. Minnesota Statutes 2022, section 246.716, subdivision 2, is amended to read:
94.2 		Subd. 2.Procedures without consent. (a) A secure treatment facility state-operated 
94.3 	treatment program or an employee of a secure treatment facility state-operated treatment 
94.4 	program may bring a petition for a court order to require a patient to provide a blood sample 
94.5 	for testing for blood-borne pathogens. The petition shall be filed in the district court in the 
94.6 	county where the patient is receiving treatment from the secure treatment facility
94.7 	state-operated treatment program. The secure treatment facility state-operated treatment 
94.8 	program shall serve the petition on the patient three days before a hearing on the petition. 
94.9 	The petition shall include one or more affidavits attesting that:
94.10 	(1) the secure treatment facility state-operated treatment program followed the procedures 
94.11 	in sections 246.71 to 246.722 and attempted to obtain blood-borne pathogen test results 
94.12 	according to those sections;
94.13 	(2) a licensed physician, advanced practice registered nurse, or physician assistant 
94.14 	knowledgeable about the most current recommendations of the United States Public Health 
94.15 	Service has determined that a significant exposure has occurred to the employee of a secure 
94.16 	treatment facility state-operated treatment program under section 246.721; and
94.17 	(3) a physician, advanced practice registered nurse, or physician assistant has documented 
94.18 	that the employee has provided a blood sample and consented to testing for blood-borne 
94.19 	pathogens and blood-borne pathogen test results are needed for beginning, continuing, 
94.20 	modifying, or discontinuing medical treatment for the employee under section 246.721.
94.21 	(b) Facilities shall cooperate with petitioners in providing any necessary affidavits to 
94.22 	the extent that facility staff can attest under oath to the facts in the affidavits.
94.23 	(c) The court may order the patient to provide a blood sample for blood-borne pathogen 
94.24 	testing if:
94.25 	(1) there is probable cause to believe the employee of a secure treatment facility
94.26 	state-operated treatment program has experienced a significant exposure to the patient;
94.27 	(2) the court imposes appropriate safeguards against unauthorized disclosure that must 
94.28 	specify the persons who have access to the test results and the purposes for which the test 
94.29 	results may be used;
94.30 	(3) a licensed physician, advanced practice registered nurse, or physician assistant for 
94.31 	the employee of a secure treatment facility state-operated treatment program needs the test 
94.32 	results for beginning, continuing, modifying, or discontinuing medical treatment for the 
94.33 	employee; and
95.1 	(4) the court finds a compelling need for the test results. In assessing compelling need, 
95.2 	the court shall weigh the need for the court-ordered blood collection and test results against 
95.3 	the interests of the patient, including, but not limited to, privacy, health, safety, or economic 
95.4 	interests. The court shall also consider whether involuntary blood collection and testing 
95.5 	would serve the public interests.
95.6 	(d) The court shall conduct the proceeding in camera unless the petitioner or the patient 
95.7 	requests a hearing in open court and the court determines that a public hearing is necessary 
95.8 	to the public interest and the proper administration of justice.
95.9 	(e) The patient may arrange for counsel in any proceeding brought under this subdivision.

95.10 	Sec. 14. Minnesota Statutes 2022, section 246.717, is amended to read:
95.11 	246.717 NO DISCRIMINATION.
95.12 	A secure treatment facility state-operated treatment program shall not withhold care or 
95.13 	treatment on the requirement that the patient consent to blood-borne pathogen testing under 
95.14 	sections 246.71 to 246.722.

95.15 	Sec. 15. Minnesota Statutes 2022, section 246.72, is amended to read:
95.16 	246.72 PENALTY FOR UNAUTHORIZED RELEASE OF INFORMATION.
95.17 	Unauthorized release of the patient's name or other uniquely identifying information 
95.18 	under sections 246.71 to 246.722 is subject to the remedies and penalties under sections 
95.19 	13.08 and 13.09. This section does not preclude private causes of action against an individual, 
95.20 	state agency, statewide system, political subdivision, or person responsible for releasing 
95.21 	private data, or confidential or private information on the inmate patient.

95.22 	Sec. 16. Minnesota Statutes 2022, section 246.721, is amended to read:
95.23 	246.721 PROTOCOL FOR EXPOSURE TO BLOOD-BORNE PATHOGENS.
95.24 	(a) A secure treatment facility state-operated treatment program shall follow applicable 
95.25 	Occupational Safety and Health Administration guidelines under Code of Federal 
95.26 	Regulations, title 29, part 1910.1030, for blood-borne pathogens.
95.27 	(b) Every secure treatment facility state-operated treatment program shall adopt and 
95.28 	follow a postexposure protocol for employees at a secure treatment facility state-operated 
95.29 	treatment program who have experienced a significant exposure. The postexposure protocol 
95.30 	must adhere to the most current recommendations of the United States Public Health Service 
95.31 	and include, at a minimum, the following:
96.1 	(1) a process for employees to report an exposure in a timely fashion;
96.2 	(2) a process for an infectious disease specialist, or a licensed physician, advanced 
96.3 	practice registered nurse, or physician assistant who is knowledgeable about the most current 
96.4 	recommendations of the United States Public Health Service in consultation with an infectious 
96.5 	disease specialist, (i) to determine whether a significant exposure to one or more blood-borne 
96.6 	pathogens has occurred, and (ii) to provide, under the direction of a licensed physician, 
96.7 	advanced practice registered nurse, or physician assistant, a recommendation or 
96.8 	recommendations for follow-up treatment appropriate to the particular blood-borne pathogen 
96.9 	or pathogens for which a significant exposure has been determined;
96.10 	(3) if there has been a significant exposure, a process to determine whether the patient 
96.11 	has a blood-borne pathogen through disclosure of test results, or through blood collection 
96.12 	and testing as required by sections 246.71 to 246.722;
96.13 	(4) a process for providing appropriate counseling prior to and following testing for a 
96.14 	blood-borne pathogen regarding the likelihood of blood-borne pathogen transmission and 
96.15 	follow-up recommendations according to the most current recommendations of the United 
96.16 	States Public Health Service, recommendations for testing, and treatment;
96.17 	(5) a process for providing appropriate counseling under clause (4) to the employee of 
96.18 	a secure treatment facility state-operated treatment program and to the patient; and
96.19 	(6) compliance with applicable state and federal laws relating to data practices, 
96.20 	confidentiality, informed consent, and the patient bill of rights.

96.21 	Sec. 17. Minnesota Statutes 2022, section 246.722, is amended to read:
96.22 	246.722 IMMUNITY.
96.23 	A secure treatment facility state-operated treatment program, licensed physician, advanced 
96.24 	practice registered nurse, physician assistant, and designated health care personnel are 
96.25 	immune from liability in any civil, administrative, or criminal action relating to the disclosure 
96.26 	of test results of a patient to an employee of a secure treatment facility state-operated 
96.27 	treatment program and the testing of a blood sample from the patient for blood-borne 
96.28 	pathogens if a good faith effort has been made to comply with sections 246.71 to 246.722.

96.29 	Sec. 18. Laws 2023, chapter 61, article 8, section 13, subdivision 2, is amended to read:
96.30 		Subd. 2.Membership. (a) The task force shall consist of the following members, 
96.31 	appointed as follows:
97.1 	(1) a member appointed by the governor;
97.2 	(2) the commissioner of human services, or a designee;
97.3 	(3) a member representing Department of Human Services direct care and treatment 
97.4 	services who has experience with civil commitments, appointed by the commissioner of 
97.5 	human services;
97.6 	(4) the ombudsman for mental health and developmental disabilities;
97.7 	(5) a hospital representative, appointed by the Minnesota Hospital Association;
97.8 	(6) a county representative, appointed by the Association of Minnesota Counties;
97.9 	(7) a county social services representative, appointed by the Minnesota Association of 
97.10 	County Social Service Administrators;
97.11 	(8) a member appointed by the Minnesota Civil Commitment Defense Panel Hennepin 
97.12 	County Commitment Defense Project;
97.13 	(9) a county attorney, appointed by the Minnesota County Attorneys Association;
97.14 	(10) a county sheriff, appointed by the Minnesota Sheriffs' Association;
97.15 	(11) a member appointed by the Minnesota Psychiatric Society;
97.16 	(12) a member appointed by the Minnesota Association of Community Mental Health 
97.17 	Programs;
97.18 	(13) a member appointed by the National Alliance on Mental Illness Minnesota;
97.19 	(14) the Minnesota Attorney General;
97.20 	(15) three individuals from organizations representing racial and ethnic groups that are 
97.21 	overrepresented in the criminal justice system, appointed by the commissioner of corrections; 
97.22 	and
97.23 	(16) one member of the public with lived experience directly related to the task force's 
97.24 	purposes, appointed by the governor.
97.25 	(b) Appointments must be made no later than July 15, 2023.
97.26 	(c) Member compensation and reimbursement for expenses are governed by Minnesota 
97.27 	Statutes, section 15.059, subdivision 3.
97.28 	(d) A member of the legislature may not serve as a member of the task force.

98.1 	ARTICLE 6
98.2 	MISCELLANEOUS

98.3 	Section 1. Minnesota Statutes 2022, section 254A.03, subdivision 1, is amended to read:
98.4 		Subdivision 1.Alcohol and Other Drug Abuse Section. There is hereby created an 
98.5 	Alcohol and Other Drug Abuse Section in the Department of Human Services. This section 
98.6 	shall be headed by a director. The commissioner may place the director's position in the 
98.7 	unclassified service if the position meets the criteria established in section 43A.08, 
98.8 	subdivision 1a. The section shall:
98.9 	(1) conduct and foster basic research relating to the cause, prevention and methods of 
98.10 	diagnosis, treatment and recovery of persons with substance misuse and substance use 
98.11 	disorder;
98.12 	(2) coordinate and review all activities and programs of all the various state departments 
98.13 	as they relate to problems associated with substance misuse and substance use disorder;
98.14 	(3) develop, demonstrate, and disseminate new methods and techniques for prevention, 
98.15 	early intervention, treatment and recovery support for substance misuse and substance use 
98.16 	disorder;
98.17 	(4) gather facts and information about substance misuse and substance use disorder, and 
98.18 	about the efficiency and effectiveness of prevention, treatment, and recovery support services 
98.19 	from all comprehensive programs, including programs approved or licensed by the 
98.20 	commissioner of human services or the commissioner of health or accredited by the Joint 
98.21 	Commission on Accreditation of Hospitals. The state authority is authorized to require 
98.22 	information from comprehensive programs which is reasonable and necessary to fulfill 
98.23 	these duties. When required information has been previously furnished to a state or local 
98.24 	governmental agency, the state authority shall collect the information from the governmental 
98.25 	agency. The state authority shall disseminate facts and summary information about problems 
98.26 	associated with substance misuse and substance use disorder to public and private agencies, 
98.27 	local governments, local and regional planning agencies, and the courts for guidance to and 
98.28 	assistance in prevention, treatment and recovery support;
98.29 	(5) inform and educate the general public on substance misuse and substance use disorder;
98.30 	(6) serve as the state authority concerning substance misuse and substance use disorder 
98.31 	by monitoring the conduct of diagnosis and referral services, research and comprehensive 
98.32 	programs. The state authority shall submit a biennial report to the governor and the legislature
98.33 	containing a description of public services delivery and recommendations concerning 
99.1 	increase of coordination and quality of services, and decrease of service duplication and 
99.2 	cost;
99.3 	(7) establish a state plan which shall set forth goals and priorities for a comprehensive 
99.4 	continuum of care for substance misuse and substance use disorder for Minnesota. All state 
99.5 	agencies operating substance misuse or substance use disorder programs or administering 
99.6 	state or federal funds for such programs shall annually set their program goals and priorities 
99.7 	in accordance with the state plan. Each state agency shall annually submit its plans and 
99.8 	budgets to the state authority for review. The state authority shall certify whether proposed 
99.9 	services comply with the comprehensive state plan and advise each state agency of review 
99.10 	findings;
99.11 	(8) make contracts with and grants to public and private agencies and organizations, 
99.12 	both profit and nonprofit, and individuals, using federal funds, and state funds as authorized 
99.13 	to pay for costs of state administration, including evaluation, statewide programs and services, 
99.14 	research and demonstration projects, and American Indian programs;
99.15 	(9) receive and administer money available for substance misuse and substance use 
99.16 	disorder programs under the alcohol, drug abuse, and mental health services block grant, 
99.17 	United States Code, title 42, sections 300X to 300X-9;
99.18 	(10) solicit and accept any gift of money or property for purposes of Laws 1973, chapter 
99.19 	572, and any grant of money, services, or property from the federal government, the state, 
99.20 	any political subdivision thereof, or any private source;
99.21 	(11) with respect to substance misuse and substance use disorder programs serving the 
99.22 	American Indian community, establish guidelines for the employment of personnel with 
99.23 	considerable practical experience in substance misuse and substance use disorder, and 
99.24 	understanding of social and cultural problems related to substance misuse and substance 
99.25 	use disorder, in the American Indian community.

99.26 	Sec. 2. Minnesota Statutes 2023 Supplement, section 256B.4914, subdivision 10, is 
99.27 	amended to read:
99.28 		Subd. 10.Evaluation of information and data. (a) The commissioner shall, within 
99.29 	available resources, conduct research and gather data and information from existing state 
99.30 	systems or other outside sources on the following items:
99.31 	(1) differences in the underlying cost to provide services and care across the state;
100.1 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
100.2 	units of transportation for all day services, which must be collected from providers using 
100.3 	the rate management worksheet and entered into the rates management system; and
100.4 	(3) the distinct underlying costs for services provided by a license holder under sections 
100.5 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
100.6 	by a license holder certified under section 245D.33.
100.7 	(b) The commissioner, in consultation with stakeholders, shall review and evaluate the 
100.8 	following values already in subdivisions 6 to 9, or issues that impact all services, including, 
100.9 	but not limited to:
100.10 	(1) values for transportation rates;
100.11 	(2) values for services where monitoring technology replaces staff time;
100.12 	(3) values for indirect services;
100.13 	(4) values for nursing;
100.14 	(5) values for the facility use rate in day services, and the weightings used in the day 
100.15 	service ratios and adjustments to those weightings;
100.16 	(6) values for workers' compensation as part of employee-related expenses;
100.17 	(7) values for unemployment insurance as part of employee-related expenses;
100.18 	(8) direct care workforce labor market measures;
100.19 	(9) any changes in state or federal law with a direct impact on the underlying cost of 
100.20 	providing home and community-based services;
100.21 	(10) outcome measures, determined by the commissioner, for home and community-based 
100.22 	services rates determined under this section; and
100.23 	(11) different competitive workforce factors by service, as determined under subdivision 
100.24 	10b.
100.25 	(c) The commissioner shall report to the chairs and the ranking minority members of 
100.26 	the legislative committees and divisions with jurisdiction over health and human services 
100.27 	policy and finance with the information and data gathered under paragraphs (a) and (b) on 
100.28 	January 15, 2021, with a full report, and a full report once every four years thereafter.
100.29 	(d) (c) Beginning July 1, 2022, the commissioner shall renew analysis and implement 
100.30 	changes to the regional adjustment factors once every six years. Prior to implementation, 
101.1 	the commissioner shall consult with stakeholders on the methodology to calculate the 
101.2 	adjustment.

101.3 	Sec. 3. Minnesota Statutes 2023 Supplement, section 256B.4914, subdivision 10a, is 
101.4 	amended to read:
101.5 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
101.6 	that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the 
101.7 	service. As determined by the commissioner, in consultation with stakeholders identified 
101.8 	in subdivision 17, a provider enrolled to provide services with rates determined under this 
101.9 	section must submit requested cost data to the commissioner to support research on the cost 
101.10 	of providing services that have rates determined by the disability waiver rates system. 
101.11 	Requested cost data may include, but is not limited to:
101.12 	(1) worker wage costs;
101.13 	(2) benefits paid;
101.14 	(3) supervisor wage costs;
101.15 	(4) executive wage costs;
101.16 	(5) vacation, sick, and training time paid;
101.17 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
101.18 	(7) administrative costs paid;
101.19 	(8) program costs paid;
101.20 	(9) transportation costs paid;
101.21 	(10) vacancy rates; and
101.22 	(11) other data relating to costs required to provide services requested by the 
101.23 	commissioner.
101.24 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
101.25 	year that ended not more than 18 months prior to the submission date. The commissioner 
101.26 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
101.27 	fails to submit required reporting data, the commissioner shall provide notice to providers 
101.28 	that have not provided required data 30 days after the required submission date, and a second 
101.29 	notice for providers who have not provided required data 60 days after the required 
101.30 	submission date. The commissioner shall temporarily suspend payments to the provider if 
102.1 	cost data is not received 90 days after the required submission date. Withheld payments 
102.2 	shall be made once data is received by the commissioner.
102.3 	(c) The commissioner shall conduct a random validation of data submitted under 
102.4 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
102.5 	in paragraph (a) and provide recommendations for adjustments to cost components.
102.6 	(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in 
102.7 	consultation with stakeholders identified in subdivision 17, may submit recommendations 
102.8 	on component values and inflationary factor adjustments to the chairs and ranking minority 
102.9 	members of the legislative committees with jurisdiction over human services once every 
102.10 	four years beginning January 1, 2021. The commissioner shall make recommendations in 
102.11 	conjunction with reports submitted to the legislature according to subdivision 10, paragraph 
102.12 	(c). The commissioner shall release cost data in an aggregate form. Cost data from individual 
102.13 	providers must not be released except as provided for in current law.
102.14 	(e) The commissioner shall use data collected in paragraph (a) to determine the 
102.15 	compliance with requirements identified under subdivision 10d. The commissioner shall 
102.16 	identify providers who have not met the thresholds identified under subdivision 10d on the 
102.17 	Department of Human Services website for the year for which the providers reported their 
102.18 	costs.

102.19 	Sec. 4. Minnesota Statutes 2022, section 256B.69, subdivision 5k, is amended to read:
102.20 		Subd. 5k.Actuarial soundness. (a) Rates paid to managed care plans and county-based 
102.21 	purchasing plans shall satisfy requirements for actuarial soundness. In order to comply with 
102.22 	this subdivision, the rates must:
102.23 	(1) be neither inadequate nor excessive;
102.24 	(2) satisfy federal requirements;
102.25 	(3) in the case of contracts with incentive arrangements, not exceed 105 percent of the 
102.26 	approved capitation payments attributable to the enrollees or services covered by the incentive 
102.27 	arrangement;
102.28 	(4) be developed in accordance with generally accepted actuarial principles and practices;
102.29 	(5) be appropriate for the populations to be covered and the services to be furnished 
102.30 	under the contract; and
103.1 	(6) be certified as meeting the requirements of federal regulations by actuaries who meet 
103.2 	the qualification standards established by the American Academy of Actuaries and follow 
103.3 	the practice standards established by the Actuarial Standards Board.
103.4 	(b) Each year within 30 days of the establishment of plan rates the commissioner shall 
103.5 	report to the chairs and ranking minority members of the senate Health and Human Services 
103.6 	Budget Division and the house of representatives Health Care and Human Services Finance 
103.7 	Division to certify how each of these conditions have been met by the new payment rates.

103.8 	Sec. 5. Minnesota Statutes 2022, section 402A.16, subdivision 2, is amended to read:
103.9 		Subd. 2.Duties. The Human Services Performance Council shall:
103.10 	(1) hold meetings at least quarterly that are in compliance with Minnesota's Open Meeting 
103.11 	Law under chapter 13D;
103.12 	(2) annually review the annual performance data submitted by counties or service delivery 
103.13 	authorities;
103.14 	(3) review and advise the commissioner on department procedures related to the 
103.15 	implementation of the performance management system and system process requirements 
103.16 	and on barriers to process improvement in human services delivery;
103.17 	(4) advise the commissioner on the training and technical assistance needs of county or 
103.18 	service delivery authority and department personnel;
103.19 	(5) review instances in which a county or service delivery authority has not made adequate 
103.20 	progress on a performance improvement plan and make recommendations to the 
103.21 	commissioner under section 402A.18;
103.22 	(6) consider appeals from counties or service delivery authorities that are in the remedies 
103.23 	process and make recommendations to the commissioner on resolving the issue;
103.24 	(7) convene working groups to update and develop outcomes, measures, and performance 
103.25 	thresholds for the performance management system and, on an annual basis, present these 
103.26 	recommendations to the commissioner, including recommendations on when a particular 
103.27 	essential human services program has a balanced set of program measures in place;
103.28 	(8) make recommendations on human services administrative rules or statutes that could 
103.29 	be repealed in order to improve service delivery; and
103.30 	(9) provide information to stakeholders on the council's role and regularly collect 
103.31 	stakeholder input on performance management system performance; and.
104.1 	(10) submit an annual report to the legislature and the commissioner, which includes a 
104.2 	comprehensive report on the performance of individual counties or service delivery 
104.3 	authorities as it relates to system measures; a list of counties or service delivery authorities 
104.4 	that have been required to create performance improvement plans and the areas identified 
104.5 	for improvement as part of the remedies process; a summary of performance improvement 
104.6 	training and technical assistance activities offered to the county personnel by the department; 
104.7 	recommendations on administrative rules or state statutes that could be repealed in order to 
104.8 	improve service delivery; recommendations for system improvements, including updates 
104.9 	to system outcomes, measures, and thresholds; and a response from the commissioner.

104.10 	Sec. 6. REPEALER.
 104.11 	Minnesota Statutes 2022, sections 245G.011, subdivision 5; 252.34; 256.01, subdivisions 
104.12 	39 and 41; 256B.79, subdivision 6; and 256K.45, subdivision 2, are repealed.

APPENDIX 

Repealed Minnesota Statutes: S4399-1 

245G.011 BEHAVIORAL HEALTH CRISIS FACILITIES GRANTS.Subd. 5.Report. 
The commissioner shall report to the legislative committees with jurisdiction over mental health issues and capital investment. The report is due by February 15 of each odd-numbered year and must include information on the projects funded and the programs and services provided in those facilities. 

245G.22 OPIOID TREATMENT PROGRAMS.Subd. 4.High dose requirements. 
A client being administered or dispensed a dose beyond that set forth in subdivision 6, paragraph (a), that exceeds 150 milligrams of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, must meet face-to-face with a prescribing practitioner. The meeting must occur before the administration or dispensing of the increased medication dose. 

Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. 
(a) If a medical director or prescribing practitioner assesses and determines that a client meets the criteria in subdivision 6 and may be dispensed a medication used for the treatment of opioid addiction, the restrictions in this subdivision must be followed when the medication to be dispensed is methadone hydrochloride. The results of the assessment must be contained in the client file. The number of unsupervised use medication doses per week in paragraphs (b) to (d) is in addition to the number of unsupervised use medication doses a client may receive for days the clinic is closed for business as allowed by subdivision 6, paragraph (a). 

(b) During the first 90 days of treatment, the unsupervised use medication supply must be limited to a maximum of a single dose each week and the client shall ingest all other doses under direct supervision. 

(c) In the second 90 days of treatment, the unsupervised use medication supply must be limited to two doses per week. 

(d) In the third 90 days of treatment, the unsupervised use medication supply must not exceed three doses per week. 

(e) In the remaining months of the first year, a client may be given a maximum six-day unsupervised use medication supply. 

(f) After one year of continuous treatment, a client may be given a maximum two-week unsupervised use medication supply. 

(g) After two years of continuous treatment, a client may be given a maximum one-month unsupervised use medication supply, but must make monthly visits to the program. 

252.34 REPORT BY COMMISSIONER OF HUMAN SERVICES.
Beginning January 1, 2013, the commissioner of human services shall provide a biennial report to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and funding. The report must provide a summary of overarching goals and priorities for persons with disabilities, including the status of how each of the following programs administered by the commissioner is supporting the overarching goals and priorities: 

(1) home and community-based services waivers for persons with disabilities under sections 256B.092 and 256B.49; 

(2) home care services under section 256B.0652; and 

(3) other relevant programs and services as determined by the commissioner. 

256.01 COMMISSIONER OF HUMAN SERVICES; POWERS, DUTIES.Subd. 39.Dedicated funds report. 
By October 1, 2014, and with each February forecast thereafter, the commissioner of human services must provide to the chairs and ranking minority members of the house of representatives and senate committees with jurisdiction over health and human services finance a report of all dedicated funds and accounts. The report must include the name of the dedicated fund or account; a description of its purpose, and the legal citation for its creation; the beginning balance, projected receipts, and expenditures; and the ending balance for each fund and account. 

Subd. 41.Reports on interagency agreements and intra-agency transfers. 
The commissioner of human services shall provide quarterly reports to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance on: 

(1) interagency agreements or service-level agreements and any renewals or extensions of existing interagency or service-level agreements with a state department under section 15.01, state agency under section 15.012, or the Department of Information Technology Services, with a value of more than $100,000, or related agreements with the same department or agency with a cumulative value of more than $100,000; and 

(2) transfers of appropriations of more than $100,000 between accounts within or between agencies. 

The report must include the statutory citation authorizing the agreement, transfer or dollar amount, purpose, and effective date of the agreement, the duration of the agreement, and a copy of the agreement. 

256.975 MINNESOTA BOARD ON AGING.Subd. 7f.Exemptions from long-term care options counseling for assisted living. 
Individuals shall be exempt from the requirements outlined in subdivision 7e in the following circumstances: 

(1) the individual is seeking a lease-only arrangement in a subsidized housing setting; 

(2) the individual has previously received a long-term care consultation assessment under section 256B.0911. In this instance, the assessor who completes the long-term care consultation assessment will issue a verification code and provide it to the individual; 

(3) the individual is receiving or is being evaluated for hospice services from a hospice provider licensed under sections 144A.75 to 144A.755; or 

(4) the individual has used financial planning services and created a long-term care plan as defined by the commissioner in the 12 months prior to signing a lease or contract with a licensed assisted living facility. 

Subd. 7g.Long-term care options counseling at hospital discharge. 
(a) Hospitals shall refer all individuals described in paragraph (b) prior to discharge from an inpatient hospital stay to the Senior LinkAge Line for long-term care options counseling. Hospitals shall make these referrals using referral protocols and processes developed under subdivision 7. The purpose of the counseling is to support persons with current or anticipated long-term care needs in making informed choices among options that include the most cost-effective and least restrictive setting. 

(b) The individuals who shall be referred under paragraph (a) include older adults who are at risk of nursing home placement. Protocols for identifying at-risk individuals shall be developed under subdivision 7, paragraph (b), clause (12). 

(c) Counseling provided under this subdivision shall meet the requirements for the consultation required under subdivision 7e. 

256B.79 INTEGRATED CARE FOR HIGH-RISK PREGNANT WOMEN.Subd. 6.Report. 
By January 31, 2021, and every two years thereafter, the commissioner shall report to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance on the status and outcomes of the grant program. The report must: 

(1) describe the capacity of collaboratives receiving grants under this section; 

(2) contain aggregate information about enrollees served within targeted populations; 

(3) describe the utilization of enhanced prenatal services; 

(4) for enrollees identified with maternal substance use disorders, describe the utilization of substance use treatment and dispositions of any child protection cases; 

(5) contain data on outcomes within targeted populations and compare these outcomes to outcomes statewide, using standard categories of race and ethnicity; and 

(6) include recommendations for continuing the program or sustaining improvements through other means. 

256K.45 HOMELESS YOUTH ACT.Subd. 2.Homeless youth report. 
The commissioner shall prepare a biennial report, beginning in February 2015, which provides meaningful information to the legislative committees having jurisdiction over the issue of homeless youth, that includes, but is not limited to: (1) a list of the areas of the state with the greatest need for services and housing for homeless youth, and the level and nature of the needs identified; (2) details about grants made, including shelter-linked youth mental health grants under section 256K.46; (3) the distribution of funds throughout the state based on population need; (4) follow-up information, if available, on the status of homeless youth and whether they have stable housing two years after services are provided; and (5) any other outcomes for populations served to determine the effectiveness of the programs and use of funding. 

256R.18 REPORT BY COMMISSIONER OF HUMAN SERVICES.
(a) Beginning January 1, 2019, the commissioner shall provide to the house of representatives and senate committees with jurisdiction over nursing facility payment rates a biennial report on the effectiveness of the reimbursement system in improving quality, restraining costs, and any other features of the system as determined by the commissioner. 

(b) This section expires January 1, 2026. 

325F.722 CONSUMER PROTECTIONS FOR EXEMPT SETTINGS.Subd. 2.Contracts. 
(a) Every exempt setting must execute a written contract with a resident or the resident's representative and must operate in accordance with the terms of the contract. The resident or the resident's representative must be given a complete copy of the contract and all supporting documents and attachments and any changes whenever changes are made. 

(b) The contract must include at least the following elements in itself or through supporting documents or attachments: 

(1) the name, street address, and mailing address of the exempt setting; 

(2) the name and mailing address of the owner or owners of the exempt setting and, if the owner or owners are not natural persons, identification of the type of business entity of the owner or owners; 

(3) the name and mailing address of the managing agent, through management agreement or lease agreement, of the exempt setting, if different from the owner or owners; 

(4) the name and address of at least one natural person who is authorized to accept service of process on behalf of the owner or owners and managing agent; 

(5) a statement identifying the license number of the home care provider that provides services to some or all of the residents and that is either the setting itself or another entity with which the setting has an arrangement; 

(6) the term of the contract; 

(7) an itemization and description of the housing and, if applicable, services to be provided to the resident; 

(8) a conspicuous notice informing the resident of the policy concerning the conditions under which and the process through which the contract may be modified, amended, or terminated; 

(9) a description of the exempt setting's complaint resolution process available to residents including the toll-free complaint line for the Office of Ombudsman for Long-Term Care; 

(10) the individual designated as the resident's representative, if any; 

(11) the exempt setting's referral procedures if the contract is terminated; 

(12) a statement regarding the ability of a resident to receive services from providers with whom the exempt setting does not have an arrangement; 

(13) a statement regarding the availability of public funds for payment for residence or services; and 

(14) a statement regarding the availability of and contact information for long-term care consultation services under section 256B.0911 in the county in which the exempt setting is located. 

(c) The contract must include a statement regarding: 

(1) the ability of a resident to furnish and decorate the resident's unit within the terms of the lease; 

(2) a resident's right to access food at any time; 

(3) a resident's right to choose the resident's visitors and times of visits; 

(4) a resident's right to choose a roommate if sharing a unit; and 

(5) a resident's right to have and use a lockable door to the resident's unit. The exempt setting must provide the locks on the unit. Only a staff member with a specific need to enter the unit shall have keys, and advance notice must be given to the resident before entrance by the staff member, when possible. 

(d) A restriction of a resident's rights under this subdivision is allowed only if determined necessary for health and safety reasons identified by a home care provider's registered nurse in an initial assessment or reassessment, as defined under section 144A.4791, subdivision 8, and documented in the written service plan under section 144A.4791, subdivision 9. Any restrictions of those rights for people served under section 256B.49 and chapter 256S must be documented in the resident's support plan, as defined under sections 256B.49, subdivision 15, and 256S.10. 

(e) The contract and related documents executed by each resident or resident's representative must be maintained by the exempt setting in files from the date of execution until three years after the contract is terminated. 

Subd. 3.Termination of contract. 
An exempt setting must include with notice of termination of contract information about how to contact the ombudsman for long-term care, including the address and telephone number, along with a statement of how to request problem-solving assistance. 

Subd. 9.Remedy. 
A state agency must make a good faith effort to reasonably resolve any dispute with an exempt setting before seeking any additional enforcement actions regarding the exempt setting's compliance with the requirements of this section. No private right of action may be maintained as provided under section 8.31, subdivision 3a.