1.1 	A bill for an act
1.2 	relating to state government; modifying provisions governing health care, health 
1.3 	insurance, health policy, emergency medical services, the Department of Health, 
1.4 	the Department of Human Services, MNsure, health care workforce, health-related 
1.5 	licensing boards, health care affordability and delivery, background studies, child 
1.6 	protection and welfare, child care licensing, behavioral health, economic assistance, 
1.7 	housing and homelessness, human services policy, the Minnesota Indian Family 
1.8 	Preservation Act, and the Department of Children, Youth, and Families; establishing 
1.9 	the Office of Emergency Medical Services; establishing the Minnesota African 
1.10 	American Family Preservation and Child Welfare Disproportionality Act; making 
1.11 	technical and conforming changes; requiring reports; imposing penalties; providing 
1.12 	appointments; making forecast adjustments; appropriating money;amending 
1.13 	Minnesota Statutes 2022, sections 16A.055, subdivision 1a, by adding a subdivision; 
1.14 	62A.0411; 62A.15, subdivision 4, by adding a subdivision; 62A.28, subdivision 
1.15 	2; 62D.02, subdivisions 4, 7; 62D.03, subdivision 1; 62D.05, subdivision 1; 62D.06, 
1.16 	subdivision 1; 62D.14, subdivision 1; 62D.19; 62D.20, subdivision 1; 62D.22, 
1.17 	subdivision 5; 62E.02, subdivision 3; 62J.49, subdivision 1; 62J.61, subdivision 
1.18 	5; 62M.01, subdivision 3; 62Q.097, by adding a subdivision; 62Q.14; 62V.02, by 
1.19 	adding subdivisions; 62V.03, subdivisions 1, 3; 62V.05, subdivisions 3, 6, 11, 12, 
1.20 	by adding a subdivision; 62V.051; 62V.06, subdivision 4; 62V.08; 62V.11, 
1.21 	subdivision 4; 103I.621, subdivisions 1, 2; 121A.15, subdivision 3, by adding a 
1.22 	subdivision; 144.05, subdivision 6, by adding a subdivision; 144.058; 144.0724, 
1.23 	subdivisions 2, 3a, 4, 6, 7, 8, 9, 11; 144.1464, subdivisions 1, 2, 3; 144.1501, 
1.24 	subdivision 5; 144.1911, subdivision 2; 144.212, by adding a subdivision; 144.216, 
1.25 	subdivision 2, by adding subdivisions; 144.218, by adding a subdivision; 144.292, 
1.26 	subdivision 6; 144.293, subdivisions 2, 4, 9, 10; 144.493, by adding a subdivision; 
1.27 	144.494, subdivision 2; 144.551, subdivision 1; 144.555, subdivisions 1a, 1b, 2, 
1.28 	by adding subdivisions; 144.605, by adding a subdivision; 144.99, subdivision 3; 
1.29 	144A.10, subdivisions 15, 16; 144A.44, subdivision 1; 144A.471, by adding a 
1.30 	subdivision; 144A.474, subdivision 13; 144A.61, subdivision 3a; 144A.70, 
1.31 	subdivisions 3, 5, 6, 7; 144A.71, subdivision 2, by adding a subdivision; 144A.72, 
1.32 	subdivision 1; 144A.73; 144E.001, subdivision 3a, by adding subdivisions; 
1.33 	144E.101, by adding a subdivision; 144E.16, subdivisions 5, 7; 144E.19, 
1.34 	subdivision 3; 144E.27, subdivisions 3, 5, 6; 144E.28, subdivisions 3, 5, 6, 8; 
1.35 	144E.285, subdivisions 1, 2, 4, 6, by adding subdivisions; 144E.287; 144E.305, 
1.36 	subdivision 3; 144G.08, subdivision 29; 144G.10, by adding a subdivision; 
1.37 	144G.16, subdivision 6; 146B.03, subdivision 7a; 146B.10, subdivisions 1, 3; 
1.38 	148.235, subdivision 10; 149A.02, subdivisions 3, 3b, 16, 23, 26a, 27, 35, 37c, by 
2.1 	adding subdivisions; 149A.03; 149A.65; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, 
2.2 	subdivisions 2, 4; 149A.72, subdivisions 3, 9; 149A.73, subdivision 1; 149A.74, 
2.3 	subdivision 1; 149A.93, subdivision 3; 149A.94, subdivisions 1, 3, 4; 149A.97, 
2.4 	subdivision 2; 151.01, subdivisions 23, 27; 151.065, by adding subdivisions; 
2.5 	151.066, subdivisions 1, 2, 3; 151.212, by adding a subdivision; 151.37, by adding 
2.6 	a subdivision; 151.74, subdivision 6; 152.22, subdivision 14, by adding a 
2.7 	subdivision; 152.25, subdivision 2; 152.27, subdivisions 2, 6, by adding a 
2.8 	subdivision; 176.175, subdivision 2; 214.025; 214.04, subdivision 2a; 214.29; 
2.9 	214.31; 214.355; 243.166, subdivision 7, as amended; 245.096; 245.462, 
2.10 	subdivision 6; 245.4663, subdivision 2; 245A.04, subdivision 10, by adding a 
2.11 	subdivision; 245A.043, subdivisions 2, 4, by adding subdivisions; 245A.07, 
2.12 	subdivision 6; 245A.10, subdivisions 1, as amended, 2, as amended; 245A.14, 
2.13 	subdivision 17; 245A.144; 245A.175; 245A.52, subdivision 2, by adding a 
2.14 	subdivision; 245A.66, subdivision 2; 245C.03, by adding a subdivision; 245C.05, 
2.15 	subdivision 5; 245C.08, subdivision 4; 245C.10, subdivision 18; 245C.14, 
2.16 	subdivision 1, by adding a subdivision; 245C.15, subdivisions 3, 4; 245C.22, 
2.17 	subdivision 4; 245C.24, subdivisions 2, 5; 245C.30, by adding a subdivision; 
2.18 	245E.08; 245F.09, subdivision 2; 245F.14, by adding a subdivision; 245F.17; 
2.19 	245G.07, subdivision 4; 245G.08, subdivisions 5, 6; 245G.10, by adding a 
2.20 	subdivision; 245G.22, subdivisions 6, 7; 245H.01, by adding subdivisions; 245H.08, 
2.21 	subdivision 1; 245H.14, subdivisions 1, 4; 245I.02, subdivisions 17, 19; 245I.10, 
2.22 	subdivision 9; 245I.11, subdivision 1, by adding a subdivision; 245I.20, subdivision 
2.23 	4; 245I.23, subdivision 14; 256.01, subdivision 41, by adding a subdivision; 
2.24 	256.029, as amended; 256.045, subdivisions 3b, as amended, 5, as amended, 7, as 
2.25 	amended; 256.0451, subdivisions 1, as amended, 22, 24; 256.046, subdivision 2, 
2.26 	as amended; 256.9657, subdivision 8, by adding a subdivision; 256.969, by adding 
2.27 	subdivisions; 256B.056, subdivisions 1a, 10; 256B.0622, subdivisions 2a, 3a, 7a, 
2.28 	7d; 256B.0623, subdivision 5; 256B.0625, subdivisions 12, 20, 39, by adding 
2.29 	subdivisions; 256B.0757, subdivisions 4a, 4d; 256B.0943, subdivision 12; 
2.30 	256B.0947, subdivision 5; 256B.79, subdivision 6; 256I.04, subdivision 2f; 256J.08, 
2.31 	subdivision 34a; 256J.28, subdivision 1; 256K.45, subdivision 2; 256L.01, by 
2.32 	adding subdivisions; 256L.04, subdivisions 1c, 7a, by adding a subdivision; 
2.33 	256L.07, subdivision 1; 256L.12, subdivision 7; 256N.22, subdivision 10; 256N.24, 
2.34 	subdivision 10; 256N.26, subdivisions 12, 13, 15, 16, 18, 21, 22; 256P.05, by 
2.35 	adding a subdivision; 256R.02, subdivision 20; 259.20, subdivision 2; 259.37, 
2.36 	subdivision 2; 259.52, subdivisions 2, 4; 259.53, by adding a subdivision; 259.79, 
2.37 	subdivision 1; 259.83, subdivision 4; 260.755, subdivisions 2a, 5, 14, 17a, by 
2.38 	adding subdivisions; 260.775; 260.785, subdivisions 1, 3; 260.810, subdivision 3; 
2.39 	260C.007, subdivisions 6, 26b; 260C.178, subdivisions 1, as amended, 7; 260C.201, 
2.40 	by adding a subdivision; 260C.202; 260C.209, subdivision 1; 260C.212, 
2.41 	subdivisions 1, 2; 260C.301, subdivision 1, as amended; 260C.329, subdivisions 
2.42 	3, 8; 260C.4411, by adding a subdivision; 260C.515, subdivision 4; 260C.607, 
2.43 	subdivisions 1, 6; 260C.611; 260C.613, subdivision 1; 260C.615, subdivision 1; 
2.44 	260D.01; 260E.03, subdivision 23, as amended; 260E.30, subdivision 3, as 
2.45 	amended; 260E.33, subdivision 2, as amended; 317A.811, subdivisions 1, 2, 4; 
2.46 	393.07, subdivision 10a; 518.17, by adding a subdivision; 519.05; 524.3-801, as 
2.47 	amended; Minnesota Statutes 2023 Supplement, sections 13.46, subdivision 4, as 
2.48 	amended; 15A.0815, subdivision 2; 43A.08, subdivision 1a; 62J.84, subdivision 
2.49 	10; 62Q.46, subdivision 1; 62Q.522, subdivision 1; 62V.13, subdivision 3; 
2.50 	119B.011, subdivision 15; 119B.16, subdivisions 1a, 1c; 119B.161, subdivision 
2.51 	2; 124D.142, subdivision 2, as amended; 142A.03, by adding a subdivision; 
2.52 	144.0526, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.1505, subdivision 
2.53 	2; 144.2252, subdivision 2; 144.2253; 144.587, subdivision 4; 144A.4791, 
2.54 	subdivision 10; 144E.101, subdivisions 6, 7, as amended; 145.561, subdivision 4; 
2.55 	151.555, subdivisions 1, 4, 5, 6, 7, 8, 9, 11, 12; 151.74, subdivision 3; 152.126, 
2.56 	subdivision 6; 152.28, subdivision 1; 245.4889, subdivision 1; 245A.02, subdivision 
2.57 	2c; 245A.03, subdivisions 2, as amended, 7, as amended; 245A.043, subdivision 
2.58 	3; 245A.07, subdivision 1, as amended; 245A.11, subdivision 7; 245A.16, 
3.1 	subdivisions 1, as amended, 11; 245A.211, subdivision 4; 245A.242, subdivision 
3.2 	2; 245A.50, subdivisions 3, 4; 245A.66, subdivision 4, as amended; 245C.02, 
3.3 	subdivisions 6a, 13e; 245C.033, subdivision 3; 245C.08, subdivision 1; 245C.10, 
3.4 	subdivision 15; 245C.15, subdivisions 2, 4a; 245C.31, subdivision 1; 245G.22, 
3.5 	subdivisions 2, 17; 245H.06, subdivisions 1, 2; 245H.08, subdivisions 4, 5; 
3.6 	254B.04, subdivision 1a; 256.01, subdivision 12b; 256.043, subdivisions 3, 3a; 
3.7 	256.045, subdivision 3, as amended; 256.046, subdivision 3; 256.0471, subdivision 
3.8 	1, as amended; 256.969, subdivision 2b; 256B.0622, subdivisions 7b, 8; 256B.0625, 
3.9 	subdivisions 3a, 5m, 9, 13e, as amended, 13f, 13k, 16; 256B.064, subdivision 4; 
3.10 	256B.0671, subdivision 5; 256B.0701, subdivision 6; 256B.0947, subdivision 7; 
3.11 	256B.764; 256D.01, subdivision 1a; 256E.38, subdivision 4; 256I.05, subdivisions 
3.12 	1a, 11; 256L.03, subdivisions 1, 5; 256M.42, by adding a subdivision; 256P.06, 
3.13 	subdivision 3; 259.83, subdivisions 1, 1b, 3a; 260.014, by adding a subdivision; 
3.14 	260.755, subdivisions 1a, 3, 3a, 5b, 20, 22; 260.758, subdivisions 2, 4, 5; 260.761; 
3.15 	260.762; 260.763, subdivisions 1, 4, 5; 260.765, subdivisions 2, 3a, 4b; 260.771, 
3.16 	subdivisions 1a, 1b, 1c, 2b, 2d, 6, by adding a subdivision; 260.773, subdivisions 
3.17 	1, 2, 3, 4, 5, 10, 11; 260.774, subdivisions 1, 2, 3; 260.781, subdivision 1; 260.786, 
3.18 	subdivision 2; 260.795, subdivision 1; 342.01, subdivision 63; 342.52, subdivision 
3.19 	3; 342.53; 342.54, subdivision 2; 342.55, subdivision 2; 518A.42, subdivision 3; 
3.20 	Laws 2023, chapter 22, section 4, subdivision 2; Laws 2023, chapter 57, article 1, 
3.21 	section 6; Laws 2023, chapter 70, article 1, section 35; article 11, section 13, 
3.22 	subdivision 8; article 12, section 30, subdivisions 2, 3; article 14, section 42, 
3.23 	subdivision 6; article 20, sections 2, subdivisions 5, 22, 24, 29, 31; 3, subdivision 
3.24 	2; 12, as amended; 23; Laws 2024, chapter 80, article 1, sections 38, subdivisions 
3.25 	1, 2, 5, 6, 7, 9; 96; article 2, sections 5, subdivision 21, by adding a subdivision; 
3.26 	6, subdivisions 2, 3, 3a, by adding a subdivision; 7, subdivision 2; 10, subdivisions 
3.27 	1, 6; 16, subdivision 1, by adding a subdivision; 30, subdivision 2; 31; 74; article 
3.28 	4, section 26; article 6, section 4; article 7, section 4; proposing coding for new 
3.29 	law in Minnesota Statutes, chapters 62D; 62J; 62Q; 62V; 137; 142A; 144; 144A; 
3.30 	144E; 145; 149A; 151; 214; 245C; 245H; 256B; 256L; 259; 260; 260D; 260E; 
3.31 	524; proposing coding for new law as Minnesota Statutes, chapters 142B; 142F; 
3.32 	332C; repealing Minnesota Statutes 2022, sections 62A.041, subdivision 3; 144.218, 
3.33 	subdivision 3; 144.497; 144E.001, subdivision 5; 144E.01; 144E.123, subdivision 
3.34 	5; 144E.27, subdivisions 1, 1a; 144E.50, subdivision 3; 245A.065; 245C.125; 
3.35 	256.01, subdivisions 12, 12a; 256D.19, subdivisions 1, 2; 256D.20, subdivisions 
3.36 	1, 2, 3, 4; 256D.23, subdivisions 1, 2, 3; 256R.02, subdivision 46; 260.755, 
3.37 	subdivision 13; Minnesota Statutes 2023 Supplement, sections 62J.312, subdivision 
3.38 	6; 62Q.522, subdivisions 3, 4; 144.0528, subdivision 5; 245C.08, subdivision 2; 
3.39 	Laws 2023, chapter 25, section 190, subdivision 10; Laws 2024, chapter 80, article 
3.40 	1, sections 38, subdivisions 3, 4, 11; 39; 43, subdivision 2; article 2, sections 1, 
3.41 	subdivision 11; 3, subdivision 3; 4, subdivision 4; 6, subdivision 4; 10, subdivision 
3.42 	4; 33; 69; article 7, sections 3; 9; Minnesota Rules, parts 2960.0620, subpart 3; 
3.43 	9502.0425, subparts 5, 10; 9545.0805, subpart 1; 9545.0845; 9560.0232, subpart 
3.44 	5.
3.45 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.46 	ARTICLE 1
3.47 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE FINANCE

3.48 	Section 1. Minnesota Statutes 2022, section 256.9657, is amended by adding a subdivision 
3.49 	to read:
3.50 		Subd. 2a.Teaching hospital surcharge. (a) Each teaching hospital shall pay to the 
3.51 	medical assistance account a surcharge equal to 0.01 percent of net non-Medicare patient 
4.1 	care revenue. The initial surcharge must be paid 60 days after both this subdivision and 
4.2 	section 256.969, subdivision 2g, have received federal approval, and subsequent surcharge 
4.3 	payments must be made annually in the form and manner specified by the commissioner.
4.4 	(b) The commissioner shall use revenue from the surcharge only to pay the nonfederal 
4.5 	share of the medical assistance supplemental payments described in section 256.969, 
4.6 	subdivision 2g, and to supplement, and not supplant, medical assistance reimbursement to 
4.7 	teaching hospitals. The surcharge must comply with Code of Federal Regulations, title 42, 
4.8 	section 433.63.
4.9 	(c) For purposes of this subdivision, "teaching hospital" means any Minnesota hospital, 
4.10 	except facilities of the federal Indian Health Service and regional treatment centers, with a 
4.11 	Centers for Medicare and Medicaid Services designation of "teaching hospital" as reported 
4.12 	on form CMS-2552-10, worksheet S-2, line 56, that is eligible for reimbursement under 
4.13 	section 256.969, subdivision 2g.

4.14 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval 
4.15 	of this section, the amendment in this act to section 256.969, subdivision 2b, and section 
4.16 	256.969, subdivision 2g, whichever is later. The commissioner of human services shall 
4.17 	notify the revisor of statutes when federal approval is obtained.

4.18 	Sec. 2. Minnesota Statutes 2023 Supplement, section 256.969, subdivision 2b, is amended 
4.19 	to read:
4.20 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
4.21 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
4.22 	to the following:
4.23 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
4.24 	methodology;
4.25 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
4.26 	under subdivision 25;
4.27 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
4.28 	distinct parts as defined by Medicare shall be paid according to the methodology under 
4.29 	subdivision 12; and
4.30 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
4.31 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
4.32 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
5.1 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
5.2 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
5.3 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
5.4 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
5.5 	period as other hospitals.
5.6 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
5.7 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
5.8 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
5.9 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
5.10 	manner similar to Medicare. The base year or years for the rates effective November 1, 
5.11 	2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, 
5.12 	ensuring that the total aggregate payments under the rebased system are equal to the total 
5.13 	aggregate payments that were made for the same number and types of services in the base 
5.14 	year. Separate budget neutrality calculations shall be determined for payments made to 
5.15 	critical access hospitals and payments made to hospitals paid under the DRG system. Only 
5.16 	the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being 
5.17 	rebased during the entire base period shall be incorporated into the budget neutrality 
5.18 	calculation.
5.19 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
5.20 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
5.21 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
5.22 	a five percent increase or decrease from the base year payments for any hospital. Any 
5.23 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
5.24 	shall maintain budget neutrality as described in paragraph (c).
5.25 	(e) For discharges occurring on or after November 1, 2014, the commissioner may make 
5.26 	additional adjustments to the rebased rates, and when evaluating whether additional 
5.27 	adjustments should be made, the commissioner shall consider the impact of the rates on the 
5.28 	following:
5.29 	(1) pediatric services;
5.30 	(2) behavioral health services;
5.31 	(3) trauma services as defined by the National Uniform Billing Committee;
5.32 	(4) transplant services;
6.1 	(5) obstetric services, newborn services, and behavioral health services provided by 
6.2 	hospitals outside the seven-county metropolitan area;
6.3 	(6) outlier admissions;
6.4 	(7) low-volume providers; and
6.5 	(8) services provided by small rural hospitals that are not critical access hospitals.
6.6 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
6.7 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
6.8 	admission is standardized by the applicable Medicare wage index and adjusted by the 
6.9 	hospital's disproportionate population adjustment;
6.10 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
6.11 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
6.12 	October 31, 2014;
6.13 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
6.14 	inpatient services covered by medical assistance; and
6.15 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
6.16 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
6.17 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
6.18 	program in effect during the base year or years. In determining hospital payment rates for 
6.19 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
6.20 	methods and allowable costs of the Medicare program in effect during the base year or 
6.21 	years.
6.22 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
6.23 	the rates established under paragraph (c), and any adjustments made to the rates under 
6.24 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
6.25 	total aggregate payments for the same number and types of services under the rebased rates 
6.26 	are equal to the total aggregate payments made during calendar year 2013.
6.27 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
6.28 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
6.29 	in hospital costs between the existing base year or years and the next base year or years. In 
6.30 	any year that inpatient claims volume falls below the threshold required to ensure a 
6.31 	statistically valid sample of claims, the commissioner may combine claims data from two 
6.32 	consecutive years to serve as the base year. Years in which inpatient claims volume is 
6.33 	reduced or altered due to a pandemic or other public health emergency shall not be used as 
7.1 	a base year or part of a base year if the base year includes more than one year. Changes in 
7.2 	costs between base years shall be measured using the lower of the hospital cost index defined 
7.3 	in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
7.4 	claim. The commissioner shall establish the base year for each rebasing period considering 
7.5 	the most recent year or years for which filed Medicare cost reports are available, except 
7.6 	that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019. 
7.7 	The estimated change in the average payment per hospital discharge resulting from a 
7.8 	scheduled rebasing must be calculated and made available to the legislature by January 15 
7.9 	of each year in which rebasing is scheduled to occur, and must include by hospital the 
7.10 	differential in payment rates compared to the individual hospital's costs.
7.11 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
7.12 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
7.13 	using a new cost-based methodology. The commissioner shall establish within the 
7.14 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
7.15 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
7.16 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
7.17 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
7.18 	decrease from the base year payments for any hospital, except a hospital that had payments 
7.19 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
7.20 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
7.21 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
7.22 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
7.23 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
7.24 	following criteria:
7.25 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
7.26 	shall have a rate set that equals 85 percent of their base year costs;
7.27 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
7.28 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
7.29 	base year costs; and
7.30 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
7.31 	shall have a rate set that equals 100 percent of their base year costs.
7.32 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
7.33 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
7.34 	methodology may include, but are not limited to:
8.1 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
8.2 	hospital's charges to the medical assistance program;
8.3 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
8.4 	hospital's payments received from the medical assistance program for the care of medical 
8.5 	assistance patients;
8.6 	(3) the ratio between the hospital's charges to the medical assistance program and the 
8.7 	hospital's payments received from the medical assistance program for the care of medical 
8.8 	assistance patients;
8.9 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
8.10 	(5) the proportion of that hospital's costs that are administrative and trends in 
8.11 	administrative costs; and
8.12 	(6) geographic location.
8.13 	(k) Subject to section 256.969, subdivision 2g, paragraph (i), effective for discharges 
8.14 	occurring on or after January 1, 2024, the rates paid to hospitals described in paragraph (a), 
8.15 	clauses (2) to (4), must include a rate factor specific to each hospital that qualifies for a 
8.16 	medical education and research cost distribution under section 62J.692, subdivision 4, 
8.17 	paragraph (a).

8.18 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval 
8.19 	of this section, section 256.969, subdivision 2g, and the teaching hospital surcharge described 
8.20 	in section 256.9657, subdivision 2a, whichever is later. The commissioner of human services 
8.21 	shall notify the revisor of statutes when federal approval is obtained.

8.22 	Sec. 3. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
8.23 	read:
8.24 		Subd. 2g.Annual supplemental payments; direct and indirect physician graduate 
8.25 	medical education. (a) For discharges occurring on or after January 1, 2025, the 
8.26 	commissioner shall determine and pay annual supplemental payments to all eligible hospitals 
8.27 	as provided in this subdivision for direct and indirect physician graduate medical education 
8.28 	cost reimbursement. A hospital must be an eligible hospital to receive an annual supplemental 
8.29 	payment under this subdivision.
8.30 	(b) The commissioner must use the following information to calculate the total cost of 
8.31 	direct graduate medical education incurred by each eligible hospital:
9.1 	(1) the total allowable direct graduate medical education cost, as calculated by adding 
9.2 	form CMS-2552-10, worksheet B, part 1, columns 21 and 22, line 202; and
9.3 	(2) the Medicaid share of total allowable direct graduate medical education cost 
9.4 	percentage, representing the allocation of total graduate medical education costs to Medicaid 
9.5 	based on the share of all Medicaid inpatient days, as reported on form CMS-2552-10, 
9.6 	worksheets S-2 and S-3, divided by the hospital's total inpatient days, as reported on 
9.7 	worksheet S-3.
9.8 	(c) The commissioner may obtain the information in paragraph (b) from an eligible 
9.9 	hospital upon request by the commissioner or from the eligible hospital's most recently filed 
9.10 	form CMS-2552-10.
9.11 	(d) The commissioner must use the following information to calculate the total allowable 
9.12 	indirect cost of graduate medical education incurred by each eligible hospital:
9.13 	(1) for eligible hospitals that are not children's hospitals, the indirect graduate medical 
9.14 	education amount attributable to Medicaid, calculated based on form CMS-2552-10, 
9.15 	worksheet E, part A, including:
9.16 	(i) the Medicare indirect medical education formula, using Medicaid variables;
9.17 	(ii) Medicaid payments for inpatient services under fee-for-service and managed care, 
9.18 	as determined by the commissioner in consultation with each eligible hospital;
9.19 	(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet E, part 
9.20 	A, line 4; and
9.21 	(iv) full-time employees, as determined by adding form CMS-2552-10, worksheet E, 
9.22 	part A, lines 10 and 11; and
9.23 	(2) for eligible hospitals that are children's hospitals:
9.24 	(i) the Medicare indirect medical education formula, using Medicaid variables;
9.25 	(ii) Medicaid payments for inpatient services under fee-for-service and managed care, 
9.26 	as determined by the commissioner in consultation with each eligible hospital;
9.27 	(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet S-3, 
9.28 	part 1; and
9.29 	(iv) full-time equivalent interns and residents, as determined by adding form 
9.30 	CMS-2552-10, worksheet E-4, lines 6, 10.01, and 15.01.
10.1 	(e) The commissioner shall determine each eligible hospital's maximum allowable 
10.2 	Medicaid direct graduate medical education supplemental payment amount by calculating 
10.3 	the sum of:
10.4 	(1) the total allowable direct graduate medical education costs determined under paragraph 
10.5 	(b), clause (1), multiplied by the Medicaid share of total allowable direct graduate medical 
10.6 	education cost percentage in paragraph (b), clause (2); and
10.7 	(2) the total allowable direct graduate medical education costs determined under paragraph 
10.8 	(b), clause (1), multiplied by the most recently updated Medicaid utilization percentage 
10.9 	from form CMS-2552-10, as submitted to Medicare by each eligible hospital.
10.10 	(f) The commissioner shall determine each eligible hospital's indirect graduate medical 
10.11 	education supplemental payment amount by multiplying the total allowable indirect cost 
10.12 	of graduate medical education amount calculated in paragraph (d) by:
10.13 	(1) 0.95 for prospective payment system, for hospitals that are not children's hospitals 
10.14 	and have fewer than 50 full-time equivalent trainees;
10.15 	(2) 1.0 for prospective payment system, for hospitals that are not children's hospitals 
10.16 	and have equal to or greater than 50 full-time equivalent trainees; and
10.17 	(3) 1.05 for children's hospitals.
10.18 	(g) An eligible hospital's annual supplemental payment under this subdivision equals 
10.19 	the sum of the amount calculated for the eligible hospital under paragraph (e) and the amount 
10.20 	calculated for the eligible hospital under paragraph (f).
10.21 	(h) The annual supplemental payments under this subdivision are contingent upon federal 
10.22 	approval and must conform with the requirements for permissible supplemental payments 
10.23 	for direct and indirect graduate medical education under all applicable federal laws.
10.24 	(i) An eligible hospital is only eligible for reimbursement under section 62J.692 for 
10.25 	nonphysician graduate medical education training costs that are not accounted for in the 
10.26 	calculation of an annual supplemental payment under this section. An eligible hospital must 
10.27 	not accept reimbursement under section 62J.692 for physician graduate medical education 
10.28 	training costs that are accounted for in the calculation of an annual supplemental payment 
10.29 	under this section.
10.30 	(j) For purposes of this subdivision, "children's hospital" means a Minnesota hospital 
10.31 	designated as a children's hospital under Medicare.
11.1 	(k) For purposes of this subdivision, "eligible hospital" means a hospital located in 
11.2 	Minnesota:
11.3 	(1) participating in Minnesota's medical assistance program;
11.4 	(2) that has received fee-for-service medical assistance payments in the payment year; 
11.5 	and
11.6 	(3) that is either:
11.7 	(i) eligible to receive graduate medical education payments from the Medicare program 
11.8 	under Code of Federal Regulations, title 42, section 413.75; or
11.9 	(ii) a children's hospital.

11.10 	EFFECTIVE DATE. This section is effective January 1, 2025, or upon federal approval 
11.11 	of this section, the amendment in this act to section 256.969, subdivision 2b, and the teaching 
11.12 	hospital surcharge described in section 256.9657, subdivision 2a, whichever is later. The 
11.13 	commissioner of human services shall notify the revisor of statutes when federal approval 
11.14 	is obtained.

11.15 	Sec. 4. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
11.16 	read:
11.17 		Subd. 32.Biological products for cell and gene therapy. (a) Effective July 1, 2024, 
11.18 	the commissioner shall provide separate reimbursement to hospitals for biological products 
11.19 	provided in the inpatient hospital setting as part of cell or gene therapy to treat rare diseases, 
11.20 	as defined in United States Code, title 21, section 360bb. This payment must be separate 
11.21 	from the diagnostic related group reimbursement for the inpatient admission or discharge 
11.22 	associated with a stay during which the patient received a product subject to this paragraph.
11.23 	(b) The commissioner shall establish the separate reimbursement rate for biological 
11.24 	products provided under paragraph (a) based on the methodology used for drugs administered 
11.25 	in an outpatient setting under section 256B.0625, subdivision 13e, paragraph (e).
11.26 	(c) Upon necessary federal approval of documentation required to enter into a value-based 
11.27 	arrangement under section 256B.0625, subdivision 13k, a drug manufacturer must enter 
11.28 	into a value-based arrangement with the commissioner in order for a biological product 
11.29 	provided in the inpatient hospital setting as part of cell or gene therapy to treat rare diseases 
11.30 	to remain paid under paragraph (a). Any such value-based arrangement that replaces the 
11.31 	payment in paragraph (a) will be effective 120 days after the date of the necessary federal 
12.1 	approval required to enter into the value-based arrangement under section 256B.0625, 
12.2 	subdivision 13k.

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

12.4 	Sec. 5. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as 
12.5 	amended by Laws 2024, chapter 85, section 66, is amended to read:
12.6 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
12.7 	be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the 
12.8 	usual and customary price charged to the public. The usual and customary price means the 
12.9 	lowest price charged by the provider to a patient who pays for the prescription by cash, 
12.10 	check, or charge account and includes prices the pharmacy charges to a patient enrolled in 
12.11 	a prescription savings club or prescription discount club administered by the pharmacy or 
12.12 	pharmacy chain. The amount of payment basis must be reduced to reflect all discount 
12.13 	amounts applied to the charge by any third-party provider/insurer agreement or contract for 
12.14 	submitted charges to medical assistance programs. The net submitted charge may not be 
12.15 	greater than the patient liability for the service. The professional dispensing fee shall be 
12.16 	$10.77 $11.55 for prescriptions filled with legend drugs meeting the definition of "covered 
12.17 	outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The 
12.18 	dispensing fee for intravenous solutions that must be compounded by the pharmacist shall 
12.19 	be $10.77 $11.55 per claim. The professional dispensing fee for prescriptions filled with 
12.20 	over-the-counter drugs meeting the definition of covered outpatient drugs shall be $10.77
12.21 	$11.55 for dispensed quantities equal to or greater than the number of units contained in 
12.22 	the manufacturer's original package. The professional dispensing fee shall be prorated based 
12.23 	on the percentage of the package dispensed when the pharmacy dispenses a quantity less 
12.24 	than the number of units contained in the manufacturer's original package. The pharmacy 
12.25 	dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered 
12.26 	outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units 
12.27 	contained in the manufacturer's original package and shall be prorated based on the 
12.28 	percentage of the package dispensed when the pharmacy dispenses a quantity less than the 
12.29 	number of units contained in the manufacturer's original package. The National Average 
12.30 	Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug. 
12.31 	For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient 
12.32 	cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for 
12.33 	a provider participating in the federal 340B Drug Pricing Program shall be either the 340B 
12.34 	Drug Pricing Program ceiling price established by the Health Resources and Services 
12.35 	Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as 
13.1 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in 
13.2 	the United States, not including prompt pay or other discounts, rebates, or reductions in 
13.3 	price, for the most recent month for which information is available, as reported in wholesale 
13.4 	price guides or other publications of drug or biological pricing data. The maximum allowable 
13.5 	cost of a multisource drug may be set by the commissioner and it shall be comparable to 
13.6 	the actual acquisition cost of the drug product and no higher than the NADAC of the generic 
13.7 	product. Establishment of the amount of payment for drugs shall not be subject to the 
13.8 	requirements of the Administrative Procedure Act.
13.9 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
13.10 	an automated drug distribution system meeting the requirements of section 151.58, or a 
13.11 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
13.12 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
13.13 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
13.14 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
13.15 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
13.16 	pharmacy must use a billing period not less than one calendar month or 30 days.
13.17 	(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota 
13.18 	Rules, part 6800.2700, is required to credit the department for the actual acquisition cost 
13.19 	of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective 
13.20 	billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that 
13.21 	is less than a 30-day supply.
13.22 	(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC 
13.23 	of the generic product or the maximum allowable cost established by the commissioner 
13.24 	unless prior authorization for the brand name product has been granted according to the 
13.25 	criteria established by the Drug Formulary Committee as required by subdivision 13f, 
13.26 	paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in 
13.27 	a manner consistent with section 151.21, subdivision 2.
13.28 	(e) The basis for determining the amount of payment for drugs administered in an 
13.29 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
13.30 	provider, 106 percent of the average sales price as determined by the United States 
13.31 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
13.32 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
13.33 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
13.34 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
13.35 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
14.1 	The commissioner shall discount the payment rate for drugs obtained through the federal 
14.2 	340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an 
14.3 	outpatient setting shall be made to the administering facility or practitioner. A retail or 
14.4 	specialty pharmacy dispensing a drug for administration in an outpatient setting is not 
14.5 	eligible for direct reimbursement.
14.6 	(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy 
14.7 	products that are lower than the ingredient cost formulas specified in paragraph (a). The 
14.8 	commissioner may require individuals enrolled in the health care programs administered 
14.9 	by the department to obtain specialty pharmacy products from providers with whom the 
14.10 	commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are 
14.11 	defined as those used by a small number of recipients or recipients with complex and chronic 
14.12 	diseases that require expensive and challenging drug regimens. Examples of these conditions 
14.13 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, 
14.14 	growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of 
14.15 	cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
14.16 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that 
14.17 	require complex care. The commissioner shall consult with the Formulary Committee to 
14.18 	develop a list of specialty pharmacy products subject to maximum allowable cost 
14.19 	reimbursement. In consulting with the Formulary Committee in developing this list, the 
14.20 	commissioner shall take into consideration the population served by specialty pharmacy 
14.21 	products, the current delivery system and standard of care in the state, and access to care 
14.22 	issues. The commissioner shall have the discretion to adjust the maximum allowable cost 
14.23 	to prevent access to care issues.
14.24 	(g) Home infusion therapy services provided by home infusion therapy pharmacies must 
14.25 	be paid at rates according to subdivision 8d.
14.26 	(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey 
14.27 	for all pharmacies that are physically located in the state of Minnesota that dispense outpatient 
14.28 	drugs under medical assistance. The commissioner shall ensure that the vendor has prior 
14.29 	experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the 
14.30 	department to dispense outpatient prescription drugs to fee-for-service members must 
14.31 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
14.32 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
14.33 	measure a single statewide cost of dispensing for specialty prescription drugs and a single 
14.34 	statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies 
14.35 	to measure the mean, mean weighted by total prescription volume, mean weighted by 
15.1 	medical assistance prescription volume, median, median weighted by total prescription 
15.2 	volume, and median weighted by total medical assistance prescription volume. The 
15.3 	commissioner shall post a copy of the final cost of dispensing survey report on the 
15.4 	department's website. The initial survey must be completed no later than January 1, 2021, 
15.5 	and repeated every three years. The commissioner shall provide a summary of the results 
15.6 	of each cost of dispensing survey and provide recommendations for any changes to the 
15.7 	dispensing fee to the chairs and ranking minority members of the legislative committees 
15.8 	with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section 
15.9 	256.01, subdivision 42, this paragraph does not expire.
15.10 	(i) The commissioner shall increase the ingredient cost reimbursement calculated in 
15.11 	paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to 
15.12 	the wholesale drug distributor tax under section 295.52.

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

15.14 	Sec. 6. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13k, is 
15.15 	amended to read:
15.16 		Subd. 13k.Value-based purchasing arrangements. (a) The commissioner may enter 
15.17 	into a value-based purchasing arrangement under medical assistance or MinnesotaCare, by 
15.18 	written arrangement with a drug manufacturer based on agreed-upon metrics. The 
15.19 	commissioner may contract with a vendor to implement and administer the value-based 
15.20 	purchasing arrangement. A value-based purchasing arrangement may include but is not 
15.21 	limited to rebates, discounts, price reductions, risk sharing, reimbursements, guarantees, 
15.22 	shared savings payments, withholds, or bonuses. A value-based purchasing arrangement 
15.23 	must provide at least the same value or discount in the aggregate as would claiming the 
15.24 	mandatory federal drug rebate under the Federal Social Security Act, section 1927.
15.25 	(b) Nothing in this section shall be interpreted as requiring a drug manufacturer or the 
15.26 	commissioner to enter into an arrangement as described in paragraph (a).
15.27 	(c) Nothing in this section shall be interpreted as altering or modifying medical assistance 
15.28 	coverage requirements under the federal Social Security Act, section 1927.
15.29 	(d) If the commissioner determines that a state plan amendment is necessary before 
15.30 	implementing a value-based purchasing arrangement, the commissioner shall request the 
15.31 	amendment and may delay implementing this provision until the amendment is approved.
15.32 	(e) The commissioner may provide separate reimbursement to hospitals for drugs provided 
15.33 	in the inpatient hospital setting as part of a value-based purchasing arrangement. This 
16.1 	payment must be separate from the diagnostic related group reimbursement for the inpatient 
16.2 	admission or discharge associated with a stay during which the patient received a drug under 
16.3 	this section. For payments made under this section, the hospital must not be reimbursed for 
16.4 	the drug under the payment methodology in section 256.969. The commissioner shall 
16.5 	establish the separate reimbursement rate for drugs provided under this section based on 
16.6 	the methodology used for drugs administered in an outpatient setting under section 
16.7 	256B.0625, subdivision 13e, paragraph (e).

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

16.10 	Sec. 7. CONTINGENT PROPOSAL TO FUND MEDICAL EDUCATION.
 16.11 	(a) If the federal Centers for Medicare and Medicaid Services deny the request by the 
16.12 	commissioner of human services to implement the teaching hospital surcharge under 
16.13 	Minnesota Statutes, section 256.9657, subdivision 2a, the commissioner of human services, 
16.14 	in cooperation with the commissioner of health, shall work with a third-party consultant 
16.15 	identified by the Health Care Workforce and Education Committee established by the 
16.16 	commissioner of health that has agreed to provide consulting services without charge to 
16.17 	Minnesota to develop a proposal to finance the nonfederal share of the medical assistance 
16.18 	supplemental payments described in Minnesota Statutes, section 256.969, subdivision 2g.
16.19 	(b) The proposal must be designed to:
16.20 	(1) enhance health care quality and the economic benefits that result from a well-trained 
16.21 	workforce;
16.22 	(2) ensure that Minnesota has trained a sufficient number of adult and pediatric primary 
16.23 	and specialty care physicians by 2030;
16.24 	(3) improve the cultural competence of and health care equity within the state's medical 
16.25 	workforce;
16.26 	(4) maintain and improve the quality of academic medical centers and teaching hospitals 
16.27 	within the state;
16.28 	(5) strengthen Minnesota's health care infrastructure; and
16.29 	(6) satisfy any requirements for approval by the federal Centers for Medicare and 
16.30 	Medicaid Services.
16.31 	(c) The commissioner of human services shall present the proposal to the chairs and 
16.32 	ranking minority members of the legislative committees with jurisdiction over medical 
17.1 	education within six months of federal denial of the request by the commissioner to 
17.2 	implement the teaching hospital surcharge.

17.3 	Sec. 8. COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE MODEL.
 17.4 		Subdivision 1.Model development. (a) The commissioner of human services, in 
17.5 	collaboration with the Association of Minnesota Counties and county-based purchasing 
17.6 	plans, shall develop a county-administered rural medical assistance (CARMA) model and 
17.7 	a detailed plan for implementing the CARMA model.
17.8 	(b) The CARMA model must be designed to achieve the following objectives:
17.9 	(1) provide a distinct county owned and administered alternative to the prepaid medical 
17.10 	assistance program;
17.11 	(2) facilitate greater integration of health care and social services to address social 
17.12 	determinants of health in rural communities, with the degree of integration of social services 
17.13 	varying with each county's needs and resources;
17.14 	(3) account for the smaller number of medical assistance enrollees and locally available 
17.15 	providers of behavioral health, oral health, specialty and tertiary care, nonemergency medical 
17.16 	transportation, and other health care services in rural communities; and
17.17 	(4) promote greater accountability for health outcomes, health equity, customer service, 
17.18 	community outreach, and cost of care.
17.19 		Subd. 2.County participation. The CARMA model must give each rural county the 
17.20 	option of applying to participate in the CARMA model as an alternative to participation in 
17.21 	the prepaid medical assistance program. The CARMA model must include a process for 
17.22 	the commissioner to determine whether and how a rural county can participate.
17.23 		Subd. 3.Report to the legislature. (a) The commissioner shall report recommendations 
17.24 	and an implementation plan for the CARMA model to the chairs and ranking minority 
17.25 	members of the legislative committees with jurisdiction over health care policy and finance 
17.26 	by January 15, 2025. The CARMA model and implementation plan must address the issues 
17.27 	and consider the recommendations identified in the document titled "Recommendations 
17.28 	Not Contingent on Outcome(s) of Current Litigation," attached to the September 13, 2022, 
17.29 	e-filing to the Second Judicial District Court (Correspondence for Judicial Approval Index 
17.30 	#102), that relates to the final contract decisions of the commissioner of human services 
17.31 	regarding South Country Health Alliance v. Minnesota Department of Human Services, No. 
17.32 	62-CV-22-907 (Ramsey Cnty. Dist. Ct. 2022).
18.1 	(b) The report must also identify the clarifications, approvals, and waivers that are needed 
18.2 	from the Centers for Medicare and Medicaid Services and include any draft legislation 
18.3 	necessary to implement the CARMA model.

18.4 	Sec. 9. REVISOR INSTRUCTION.
 18.5 	When the proposed rule published at Federal Register, volume 88, page 25313, becomes 
18.6 	effective, the revisor of statutes must change: (1) the reference in Minnesota Statutes, section 
18.7 	256B.06, subdivision 4, paragraph (d), from Code of Federal Regulations, title 8, section 
18.8 	103.12, to Code of Federal Regulations, title 42, section 435.4; and (2) the reference in 
18.9 	Minnesota Statutes, section 256L.04, subdivision 10, paragraph (a), from Code of Federal 
18.10 	Regulations, title 8, section 103.12, to Code of Federal Regulations, title 45, section 155.20. 
18.11 	The commissioner of human services shall notify the revisor of statutes when the proposed 
18.12 	rule published at Federal Register, volume 88, page 25313, becomes effective.

18.13 	ARTICLE 2
18.14 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE POLICY

18.15 	Section 1. Minnesota Statutes 2022, section 62M.01, subdivision 3, is amended to read:
18.16 		Subd. 3.Scope. (a) Nothing in this chapter applies to review of claims after submission 
18.17 	to determine eligibility for benefits under a health benefit plan. The appeal procedure 
18.18 	described in section 62M.06 applies to any complaint as defined under section 62Q.68, 
18.19 	subdivision 2, that requires a medical determination in its resolution.
18.20 	(b) Effective January 1, 2026, this chapter does not apply applies to managed care plans 
18.21 	or county-based purchasing plans when the plan is providing coverage to state public health 
18.22 	care program enrollees under chapter 256B or 256L.
18.23 	(c) Effective January 1, 2026, the following sections of this chapter apply to services 
18.24 	delivered through fee-for-service under chapters 256B and 256L: sections 62M.02, 
18.25 	subdivisions 1 to 5, 7 to 12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 
18.26 	62M.06, subdivisions 1 to 3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; and 62M.17, 
18.27 	subdivision 2.

18.28 	Sec. 2. Minnesota Statutes 2023 Supplement, section 256.0471, subdivision 1, as amended 
18.29 	by Laws 2024, chapter 80, article 1, section 76, is amended to read:
18.30 		Subdivision 1.Qualifying overpayment. Any overpayment for state-funded medical
18.31 	assistance under chapter 256B and state-funded MinnesotaCare under chapter 256L granted 
19.1 	pursuant to section 256.045, subdivision 10; chapter 256B for state-funded medical 
19.2 	assistance; and chapters 256D, 256I, 256K, and 256L for state-funded MinnesotaCare except 
19.3 	agency error claims, become a judgment by operation of law 90 days after the notice of 
19.4 	overpayment is personally served upon the recipient in a manner that is sufficient under
19.5 	rule 4.03(a) of the Rules of Civil Procedure for district courts, or by certified mail, return 
19.6 	receipt requested. This judgment shall be entitled to full faith and credit in this and any 
19.7 	other state.

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

19.9 	Sec. 3. Minnesota Statutes 2022, section 256.9657, subdivision 8, is amended to read:
19.10 		Subd. 8.Commissioner's duties. (a) Beginning October 1, 2023, the commissioner of 
19.11 	human services shall annually report to the chairs and ranking minority members of the 
19.12 	legislative committees with jurisdiction over health care policy and finance regarding the 
19.13 	provider surcharge program. The report shall include information on total billings, total 
19.14 	collections, and administrative expenditures for the previous fiscal year. This paragraph 
19.15 	expires January 1, 2032.
19.16 	(b) (a) The surcharge shall be adjusted by inflationary and caseload changes in future 
19.17 	bienniums to maintain reimbursement of health care providers in accordance with the 
19.18 	requirements of the state and federal laws governing the medical assistance program, 
19.19 	including the requirements of the Medicaid moratorium amendments of 1991 found in 
19.20 	Public Law No. 102-234.
19.21 	(c) (b) The commissioner shall request the Minnesota congressional delegation to support 
19.22 	a change in federal law that would prohibit federal disallowances for any state that makes 
19.23 	a good faith effort to comply with Public Law 102-234 by enacting conforming legislation 
19.24 	prior to the issuance of federal implementing regulations.

19.25 	Sec. 4. Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to 
19.26 	read:
19.27 		Subd. 2h.Alternate inpatient payment rate for a discharge. (a) Effective retroactively 
19.28 	from January 1, 2024, in any rate year in which a children's hospital discharge is included 
19.29 	in the federally required disproportionate share hospital payment audit, where the patient 
19.30 	discharged had resided in a children's hospital for over 20 years, the commissioner shall 
19.31 	compute an alternate inpatient rate for the children's hospital. The alternate payment rate 
19.32 	must be the rate computed under this section excluding the disproportionate share hospital 
19.33 	payment under subdivision 9, paragraph (d), clause (1), increased by an amount equal to 
20.1 	99 percent of what the disproportionate share hospital payment would have been under 
20.2 	subdivision 9, paragraph (d), clause (1), had the discharge been excluded.
20.3 	(b) In any rate year in which payment to a children's hospital is made using this alternate 
20.4 	payment rate, payments must not be made to the hospital under subdivisions 2e, 2f, and 9.

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

20.7 	Sec. 5. Minnesota Statutes 2022, section 256B.056, subdivision 1a, is amended to read:
20.8 		Subd. 1a.Income and assets generally. (a)(1) Unless specifically required by state law 
20.9 	or rule or federal law or regulation, the methodologies used in counting income and assets 
20.10 	to determine eligibility for medical assistance for persons whose eligibility category is based 
20.11 	on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental 
20.12 	Security Income program shall be used, except as provided under in clause (2) and
20.13 	subdivision 3, paragraph (a), clause (6).
20.14 	(2) State tax credits, rebates, and refunds must not be counted as income. State tax credits, 
20.15 	rebates, and refunds must not be counted as assets for a period of 12 months after the month 
20.16 	of receipt.
20.17 	(2) (3) Increases in benefits under title II of the Social Security Act shall not be counted 
20.18 	as income for purposes of this subdivision until July 1 of each year. Effective upon federal 
20.19 	approval, for children eligible under section 256B.055, subdivision 12, or for home and 
20.20 	community-based waiver services whose eligibility for medical assistance is determined 
20.21 	without regard to parental income, child support payments, including any payments made 
20.22 	by an obligor in satisfaction of or in addition to a temporary or permanent order for child 
20.23 	support, and Social Security payments are not counted as income.
20.24 	(b)(1) The modified adjusted gross income methodology as defined in United States 
20.25 	Code, title 42, section 1396a(e)(14), shall be used for eligibility categories based on:
20.26 	(i) children under age 19 and their parents and relative caretakers as defined in section 
20.27 	256B.055, subdivision 3a;
20.28 	(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;
20.29 	(iii) pregnant women as defined in section 256B.055, subdivision 6;
20.30 	(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision 
20.31 	1; and
20.32 	(v) adults without children as defined in section 256B.055, subdivision 15.
21.1 	For these purposes, a "methodology" does not include an asset or income standard, or 
21.2 	accounting method, or method of determining effective dates.
21.3 	(2) For individuals whose income eligibility is determined using the modified adjusted 
21.4 	gross income methodology in clause (1):
21.5 	(i) the commissioner shall subtract from the individual's modified adjusted gross income 
21.6 	an amount equivalent to five percent of the federal poverty guidelines; and
21.7 	(ii) the individual's current monthly income and household size is used to determine 
21.8 	eligibility for the 12-month eligibility period. If an individual's income is expected to vary 
21.9 	month to month, eligibility is determined based on the income predicted for the 12-month 
21.10 	eligibility period.

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

21.12 	Sec. 6. Minnesota Statutes 2022, section 256B.056, subdivision 10, is amended to read:
21.13 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who are 
21.14 	applying for the continuation of medical assistance coverage following the end of the 
21.15 	12-month postpartum period to update their income and asset information and to submit 
21.16 	any required income or asset verification.
21.17 	(b) The commissioner shall determine the eligibility of private-sector health care coverage 
21.18 	for infants less than one year of age eligible under section 256B.055, subdivision 10, or 
21.19 	256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is 
21.20 	determined to be cost-effective.
21.21 	(c) The commissioner shall verify assets and income for all applicants, and for all 
21.22 	recipients upon renewal.
21.23 	(d) The commissioner shall utilize information obtained through the electronic service 
21.24 	established by the secretary of the United States Department of Health and Human Services 
21.25 	and other available electronic data sources in Code of Federal Regulations, title 42, sections 
21.26 	435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish 
21.27 	standards to define when information obtained electronically is reasonably compatible with 
21.28 	information provided by applicants and enrollees, including use of self-attestation, to 
21.29 	accomplish real-time eligibility determinations and maintain program integrity.
21.30 	(e) Each person applying for or receiving medical assistance under section 256B.055, 
21.31 	subdivision 7, and any other person whose resources are required by law to be disclosed to 
21.32 	determine the applicant's or recipient's eligibility must authorize the commissioner to obtain 
22.1 	information from financial institutions to identify unreported accounts verify assets as 
22.2 	required in section 256.01, subdivision 18f. If a person refuses or revokes the authorization, 
22.3 	the commissioner may determine that the applicant or recipient is ineligible for medical 
22.4 	assistance. For purposes of this paragraph, an authorization to identify unreported accounts
22.5 	verify assets meets the requirements of the Right to Financial Privacy Act, United States 
22.6 	Code, title 12, chapter 35, and need not be furnished to the financial institution.
22.7 	(f) County and tribal agencies shall comply with the standards established by the 
22.8 	commissioner for appropriate use of the asset verification system specified in section 256.01, 
22.9 	subdivision 18f.

22.10 	Sec. 7. Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 8, is amended 
22.11 	to read:
22.12 		Subd. 8.Medical assistance payment for assertive community treatment and 
22.13 	intensive residential treatment services. (a) Payment for intensive residential treatment 
22.14 	services and assertive community treatment in this section shall be based on one daily rate 
22.15 	per provider inclusive of the following services received by an eligible client in a given 
22.16 	calendar day: all rehabilitative services under this section, staff travel time to provide 
22.17 	rehabilitative services under this section, and nonresidential crisis stabilization services 
22.18 	under section 256B.0624.
22.19 	(b) Except as indicated in paragraph (c), payment will not be made to more than one 
22.20 	entity for each client for services provided under this section on a given day. If services 
22.21 	under this section are provided by a team that includes staff from more than one entity, the 
22.22 	team must determine how to distribute the payment among the members.
22.23 	(c) The commissioner shall determine one rate for each provider that will bill medical 
22.24 	assistance for residential services under this section and one rate for each assertive community 
22.25 	treatment provider. If a single entity provides both services, one rate is established for the 
22.26 	entity's residential services and another rate for the entity's nonresidential services under 
22.27 	this section. A provider is not eligible for payment under this section without authorization 
22.28 	from the commissioner. The commissioner shall develop rates using the following criteria:
22.29 	(1) the provider's cost for services shall include direct services costs, other program 
22.30 	costs, and other costs determined as follows:
22.31 	(i) the direct services costs must be determined using actual costs of salaries, benefits, 
22.32 	payroll taxes, and training of direct service staff and service-related transportation;
23.1 	(ii) other program costs not included in item (i) must be determined as a specified 
23.2 	percentage of the direct services costs as determined by item (i). The percentage used shall 
23.3 	be determined by the commissioner based upon the average of percentages that represent 
23.4 	the relationship of other program costs to direct services costs among the entities that provide 
23.5 	similar services;
23.6 	(iii) physical plant costs calculated based on the percentage of space within the program 
23.7 	that is entirely devoted to treatment and programming. This does not include administrative 
23.8 	or residential space;
23.9 	(iv) assertive community treatment physical plant costs must be reimbursed as part of 
23.10 	the costs described in item (ii); and
23.11 	(v) subject to federal approval, up to an additional five percent of the total rate may be 
23.12 	added to the program rate as a quality incentive based upon the entity meeting performance 
23.13 	criteria specified by the commissioner;
23.14 	(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and 
23.15 	consistent with federal reimbursement requirements under Code of Federal Regulations, 
23.16 	title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and 
23.17 	Budget Circular Number A-122, relating to nonprofit entities;
23.18 	(3) the number of service units;
23.19 	(4) the degree to which clients will receive services other than services under this section; 
23.20 	and
23.21 	(5) the costs of other services that will be separately reimbursed.
23.22 	(d) The rate for intensive residential treatment services and assertive community treatment 
23.23 	must exclude the medical assistance room and board rate, as defined in section 256B.056, 
23.24 	subdivision 5d, and services not covered under this section, such as partial hospitalization, 
23.25 	home care, and inpatient services.
23.26 	(e) Physician services that are not separately billed may be included in the rate to the 
23.27 	extent that a psychiatrist, or other health care professional providing physician services 
23.28 	within their scope of practice, is a member of the intensive residential treatment services 
23.29 	treatment team. Physician services, whether billed separately or included in the rate, may 
23.30 	be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning 
23.31 	given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth 
23.32 	is used to provide intensive residential treatment services.
24.1 	(f) When services under this section are provided by an assertive community treatment 
24.2 	provider, case management functions must be an integral part of the team.
24.3 	(g) The rate for a provider must not exceed the rate charged by that provider for the 
24.4 	same service to other payors.
24.5 	(h) The rates for existing programs must be established prospectively based upon the 
24.6 	expenditures and utilization over a prior 12-month period using the criteria established in 
24.7 	paragraph (c). The rates for new programs must be established based upon estimated 
24.8 	expenditures and estimated utilization using the criteria established in paragraph (c).
24.9 	(i) Effective for the rate years beginning on and after January 1, 2024, rates for assertive 
24.10 	community treatment, adult residential crisis stabilization services, and intensive residential 
24.11 	treatment services must be annually adjusted for inflation using the Centers for Medicare 
24.12 	and Medicaid Services Medicare Economic Index, as forecasted in the fourth third quarter 
24.13 	of the calendar year before the rate year. The inflation adjustment must be based on the 
24.14 	12-month period from the midpoint of the previous rate year to the midpoint of the rate year 
24.15 	for which the rate is being determined.
24.16 	(j) Entities who discontinue providing services must be subject to a settle-up process 
24.17 	whereby actual costs and reimbursement for the previous 12 months are compared. In the 
24.18 	event that the entity was paid more than the entity's actual costs plus any applicable 
24.19 	performance-related funding due the provider, the excess payment must be reimbursed to 
24.20 	the department. If a provider's revenue is less than actual allowed costs due to lower 
24.21 	utilization than projected, the commissioner may reimburse the provider to recover its actual 
24.22 	allowable costs. The resulting adjustments by the commissioner must be proportional to the 
24.23 	percent of total units of service reimbursed by the commissioner and must reflect a difference 
24.24 	of greater than five percent.
24.25 	(k) A provider may request of the commissioner a review of any rate-setting decision 
24.26 	made under this subdivision.

24.27 	Sec. 8. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 9, is amended 
24.28 	to read:
24.29 		Subd. 9.Dental services. (a) Medical assistance covers medically necessary dental 
24.30 	services.
24.31 	(b) The following guidelines apply to dental services:
24.32 	(1) posterior fillings are paid at the amalgam rate;
25.1 	(2) application of sealants are covered once every five years per permanent molar; and
25.2 	(3) application of fluoride varnish is covered once every six months.
25.3 	(c) In addition to the services specified in paragraph (b) (a), medical assistance covers 
25.4 	the following services:
25.5 	(1) house calls or extended care facility calls for on-site delivery of covered services;
25.6 	(2) behavioral management when additional staff time is required to accommodate 
25.7 	behavioral challenges and sedation is not used;
25.8 	(3) oral or IV sedation, if the covered dental service cannot be performed safely without 
25.9 	it or would otherwise require the service to be performed under general anesthesia in a 
25.10 	hospital or surgical center; and
25.11 	(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but 
25.12 	no more than four times per year.
25.13 	(d) The commissioner shall not require prior authorization for the services included in 
25.14 	paragraph (c), clauses (1) to (3), and shall prohibit managed care and county-based purchasing 
25.15 	plans from requiring prior authorization for the services included in paragraph (c), clauses 
25.16 	(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.

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

25.18 	Sec. 9. Minnesota Statutes 2022, section 256B.0625, subdivision 12, is amended to read:
25.19 		Subd. 12.Eyeglasses, dentures, and prosthetic and orthotic devices. (a) Medical 
25.20 	assistance covers eyeglasses, dentures, and prosthetic and orthotic devices if prescribed by 
25.21 	a licensed practitioner.
25.22 	(b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner" 
25.23 	includes a physician, an advanced practice registered nurse, a physician assistant, or a 
25.24 	podiatrist.

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

25.26 	Sec. 10. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as 
25.27 	amended by Laws 2024, chapter 85, section 66, is amended to read:
25.28 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
25.29 	be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the 
25.30 	usual and customary price charged to the public. The usual and customary price means the 
26.1 	lowest price charged by the provider to a patient who pays for the prescription by cash, 
26.2 	check, or charge account and includes prices the pharmacy charges to a patient enrolled in 
26.3 	a prescription savings club or prescription discount club administered by the pharmacy or 
26.4 	pharmacy chain, unless the prescription savings club or prescription discount club is one 
26.5 	in which an individual pays a recurring monthly access fee for unlimited access to a defined 
26.6 	list of drugs for which the pharmacy does not bill the member or a payer on a 
26.7 	per-standard-transaction basis. The amount of payment basis must be reduced to reflect all 
26.8 	discount amounts applied to the charge by any third-party provider/insurer agreement or 
26.9 	contract for submitted charges to medical assistance programs. The net submitted charge 
26.10 	may not be greater than the patient liability for the service. The professional dispensing fee 
26.11 	shall be $10.77 for prescriptions filled with legend drugs meeting the definition of "covered 
26.12 	outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The 
26.13 	dispensing fee for intravenous solutions that must be compounded by the pharmacist shall 
26.14 	be $10.77 per claim. The professional dispensing fee for prescriptions filled with 
26.15 	over-the-counter drugs meeting the definition of covered outpatient drugs shall be $10.77 
26.16 	for dispensed quantities equal to or greater than the number of units contained in the 
26.17 	manufacturer's original package. The professional dispensing fee shall be prorated based 
26.18 	on the percentage of the package dispensed when the pharmacy dispenses a quantity less 
26.19 	than the number of units contained in the manufacturer's original package. The pharmacy 
26.20 	dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered 
26.21 	outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units 
26.22 	contained in the manufacturer's original package and shall be prorated based on the 
26.23 	percentage of the package dispensed when the pharmacy dispenses a quantity less than the 
26.24 	number of units contained in the manufacturer's original package. The National Average 
26.25 	Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug. 
26.26 	For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient 
26.27 	cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for 
26.28 	a provider participating in the federal 340B Drug Pricing Program shall be either the 340B 
26.29 	Drug Pricing Program ceiling price established by the Health Resources and Services 
26.30 	Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as 
26.31 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in 
26.32 	the United States, not including prompt pay or other discounts, rebates, or reductions in 
26.33 	price, for the most recent month for which information is available, as reported in wholesale 
26.34 	price guides or other publications of drug or biological pricing data. The maximum allowable 
26.35 	cost of a multisource drug may be set by the commissioner and it shall be comparable to 
26.36 	the actual acquisition cost of the drug product and no higher than the NADAC of the generic 
27.1 	product. Establishment of the amount of payment for drugs shall not be subject to the 
27.2 	requirements of the Administrative Procedure Act.
27.3 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
27.4 	an automated drug distribution system meeting the requirements of section 151.58, or a 
27.5 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
27.6 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
27.7 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
27.8 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
27.9 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
27.10 	pharmacy must use a billing period not less than one calendar month or 30 days.
27.11 	(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota 
27.12 	Rules, part 6800.2700, is required to credit the department for the actual acquisition cost 
27.13 	of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective 
27.14 	billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that 
27.15 	is less than a 30-day supply.
27.16 	(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC 
27.17 	of the generic product or the maximum allowable cost established by the commissioner 
27.18 	unless prior authorization for the brand name product has been granted according to the 
27.19 	criteria established by the Drug Formulary Committee as required by subdivision 13f, 
27.20 	paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in 
27.21 	a manner consistent with section 151.21, subdivision 2.
27.22 	(e) The basis for determining the amount of payment for drugs administered in an 
27.23 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
27.24 	provider, 106 percent of the average sales price as determined by the United States 
27.25 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
27.26 	federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost 
27.27 	set by the commissioner. If average sales price is unavailable, the amount of payment must 
27.28 	be lower of the usual and customary cost submitted by the provider, the wholesale acquisition 
27.29 	cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. 
27.30 	The commissioner shall discount the payment rate for drugs obtained through the federal 
27.31 	340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an 
27.32 	outpatient setting shall be made to the administering facility or practitioner. A retail or 
27.33 	specialty pharmacy dispensing a drug for administration in an outpatient setting is not 
27.34 	eligible for direct reimbursement.
28.1 	(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy 
28.2 	products that are lower than the ingredient cost formulas specified in paragraph (a). The 
28.3 	commissioner may require individuals enrolled in the health care programs administered 
28.4 	by the department to obtain specialty pharmacy products from providers with whom the 
28.5 	commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are 
28.6 	defined as those used by a small number of recipients or recipients with complex and chronic 
28.7 	diseases that require expensive and challenging drug regimens. Examples of these conditions 
28.8 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, 
28.9 	growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of 
28.10 	cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
28.11 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that 
28.12 	require complex care. The commissioner shall consult with the Formulary Committee to 
28.13 	develop a list of specialty pharmacy products subject to maximum allowable cost 
28.14 	reimbursement. In consulting with the Formulary Committee in developing this list, the 
28.15 	commissioner shall take into consideration the population served by specialty pharmacy 
28.16 	products, the current delivery system and standard of care in the state, and access to care 
28.17 	issues. The commissioner shall have the discretion to adjust the maximum allowable cost 
28.18 	to prevent access to care issues.
28.19 	(g) Home infusion therapy services provided by home infusion therapy pharmacies must 
28.20 	be paid at rates according to subdivision 8d.
28.21 	(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey 
28.22 	for all pharmacies that are physically located in the state of Minnesota that dispense outpatient 
28.23 	drugs under medical assistance. The commissioner shall ensure that the vendor has prior 
28.24 	experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the 
28.25 	department to dispense outpatient prescription drugs to fee-for-service members must 
28.26 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
28.27 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
28.28 	measure a single statewide cost of dispensing for specialty prescription drugs and a single 
28.29 	statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies 
28.30 	to measure the mean, mean weighted by total prescription volume, mean weighted by 
28.31 	medical assistance prescription volume, median, median weighted by total prescription 
28.32 	volume, and median weighted by total medical assistance prescription volume. The 
28.33 	commissioner shall post a copy of the final cost of dispensing survey report on the 
28.34 	department's website. The initial survey must be completed no later than January 1, 2021, 
28.35 	and repeated every three years. The commissioner shall provide a summary of the results 
29.1 	of each cost of dispensing survey and provide recommendations for any changes to the 
29.2 	dispensing fee to the chairs and ranking minority members of the legislative committees 
29.3 	with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section 
29.4 	256.01, subdivision 42, this paragraph does not expire.
29.5 	(i) The commissioner shall increase the ingredient cost reimbursement calculated in 
29.6 	paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to 
29.7 	the wholesale drug distributor tax under section 295.52.

29.8 	Sec. 11. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
29.9 	to read:
29.10 		Subd. 25c.Applicability of utilization review provisions. Effective January 1, 2026, 
29.11 	the following provisions of chapter 62M apply to the commissioner when delivering services 
29.12 	through fee-for-service under chapters 256B and 256L: sections 62M.02, subdivisions 1 to 
29.13 	5, 7 to 12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions 
29.14 	1 to 3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; and 62M.17, subdivision 2.

29.15 	Sec. 12. Minnesota Statutes 2023 Supplement, section 256B.0701, subdivision 6, is 
29.16 	amended to read:
29.17 		Subd. 6.Recuperative care facility rate. (a) The recuperative care facility rate is for 
29.18 	facility costs and must be paid from state money in an amount equal to the medical assistance 
29.19 	room and board MSA equivalent rate as defined in section 256I.03, subdivision 11a, at the 
29.20 	time the recuperative care services were provided. The eligibility standards in chapter 256I
29.21 	do not apply to the recuperative care facility rate. The recuperative care facility rate is only 
29.22 	paid when the recuperative care services rate is paid to a provider. Providers may opt to 
29.23 	only receive the recuperative care services rate.
29.24 	(b) Before a recipient is discharged from a recuperative care setting, the provider must 
29.25 	ensure that the recipient's medical condition is stabilized or that the recipient is being 
29.26 	discharged to a setting that is able to meet that recipient's needs.

29.27 	Sec. 13. Minnesota Statutes 2023 Supplement, section 256B.0947, subdivision 7, is 
29.28 	amended to read:
29.29 		Subd. 7.Medical assistance payment and rate setting. (a) Payment for services in this 
29.30 	section must be based on one daily encounter rate per provider inclusive of the following 
29.31 	services received by an eligible client in a given calendar day: all rehabilitative services, 
30.1 	supports, and ancillary activities under this section, staff travel time to provide rehabilitative 
30.2 	services under this section, and crisis response services under section 256B.0624.
30.3 	(b) Payment must not be made to more than one entity for each client for services 
30.4 	provided under this section on a given day. If services under this section are provided by a 
30.5 	team that includes staff from more than one entity, the team shall determine how to distribute 
30.6 	the payment among the members.
30.7 	(c) The commissioner shall establish regional cost-based rates for entities that will bill 
30.8 	medical assistance for nonresidential intensive rehabilitative mental health services. In 
30.9 	developing these rates, the commissioner shall consider:
30.10 	(1) the cost for similar services in the health care trade area;
30.11 	(2) actual costs incurred by entities providing the services;
30.12 	(3) the intensity and frequency of services to be provided to each client;
30.13 	(4) the degree to which clients will receive services other than services under this section; 
30.14 	and
30.15 	(5) the costs of other services that will be separately reimbursed.
30.16 	(d) The rate for a provider must not exceed the rate charged by that provider for the 
30.17 	same service to other payers.
30.18 	(e) Effective for the rate years beginning on and after January 1, 2024, rates must be 
30.19 	annually adjusted for inflation using the Centers for Medicare and Medicaid Services 
30.20 	Medicare Economic Index, as forecasted in the fourth third quarter of the calendar year 
30.21 	before the rate year. The inflation adjustment must be based on the 12-month period from 
30.22 	the midpoint of the previous rate year to the midpoint of the rate year for which the rate is 
30.23 	being determined.

30.24 	Sec. 14. Minnesota Statutes 2023 Supplement, section 256B.764, is amended to read:
30.25 	256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
30.26 	(a) Effective for services rendered on or after July 1, 2007, payment rates for family 
30.27 	planning services shall be increased by 25 percent over the rates in effect June 30, 2007, 
30.28 	when these services are provided by a community clinic as defined in section 145.9268, 
30.29 	subdivision 1.
30.30 	(b) Effective for services rendered on or after July 1, 2013, payment rates for family 
30.31 	planning services shall be increased by 20 percent over the rates in effect June 30, 2013, 
31.1 	when these services are provided by a community clinic as defined in section 145.9268, 
31.2 	subdivision 1. The commissioner shall adjust capitation rates to managed care and 
31.3 	county-based purchasing plans to reflect this increase, and shall require plans to pass on the 
31.4 	full amount of the rate increase to eligible community clinics, in the form of higher payment 
31.5 	rates for family planning services.
31.6 	(c) Effective for services provided on or after January 1, 2024, payment rates for family 
31.7 	planning, when such services are provided by an eligible community clinic as defined in 
31.8 	section 145.9268, subdivision 1, and abortion services shall be increased by 20 percent. 
31.9 	This increase does not apply to federally qualified health centers, rural health centers, or 
31.10 	Indian health services.

31.11 	Sec. 15. Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 1, is amended 
31.12 	to read:
31.13 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
31.14 	services reimbursed under chapter 256B, with the exception of special education services, 
31.15 	home care nursing services, adult dental care services other than services covered under 
31.16 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
31.17 	services, personal care assistance and case management services, community first services 
31.18 	and supports under section 256B.85, behavioral health home services under section 
31.19 	256B.0757, housing stabilization services under section 256B.051, and nursing home or 
31.20 	intermediate care facilities services.
31.21 	(b) Covered health services shall be expanded as provided in this section.
31.22 	(c) For the purposes of covered health services under this section, "child" means an 
31.23 	individual younger than 19 years of age.

31.24 	Sec. 16. Minnesota Statutes 2022, section 524.3-801, as amended by Laws 2024, chapter 
31.25 	79, article 9, section 20, is amended to read:
31.26 	524.3-801 NOTICE TO CREDITORS.
31.27 	(a) Unless notice has already been given under this section, upon appointment of a 
31.28 	general personal representative in informal proceedings or upon the filing of a petition for 
31.29 	formal appointment of a general personal representative, notice thereof, in the form prescribed 
31.30 	by court rule, shall be given under the direction of the court administrator by publication 
31.31 	once a week for two successive weeks in a legal newspaper in the county wherein the 
31.32 	proceedings are pending giving the name and address of the general personal representative 
32.1 	and notifying creditors of the estate to present their claims within four months after the date 
32.2 	of the court administrator's notice which is subsequently published or be forever barred, 
32.3 	unless they are entitled to further service of notice under paragraph (b) or (c).
32.4 	(b) The personal representative shall, within three months after the date of the first 
32.5 	publication of the notice, serve a copy of the notice upon each then known and identified 
32.6 	creditor in the manner provided in paragraph (c). If the decedent or a predeceased spouse 
32.7 	of the decedent received assistance for which a claim could be filed under section 246.53, 
32.8 	256B.15, 256D.16, or 261.04, notice to the commissioner of human services or direct care 
32.9 	and treatment executive board, as applicable, must be given under paragraph (d) instead of 
32.10 	under this paragraph or paragraph (c). A creditor is "known" if: (i) the personal representative 
32.11 	knows that the creditor has asserted a claim that arose during the decedent's life against 
32.12 	either the decedent or the decedent's estate; (ii) the creditor has asserted a claim that arose 
32.13 	during the decedent's life and the fact is clearly disclosed in accessible financial records 
32.14 	known and available to the personal representative; or (iii) the claim of the creditor would 
32.15 	be revealed by a reasonably diligent search for creditors of the decedent in accessible 
32.16 	financial records known and available to the personal representative. Under this section, a 
32.17 	creditor is "identified" if the personal representative's knowledge of the name and address 
32.18 	of the creditor will permit service of notice to be made under paragraph (c).
32.19 	(c) Unless the claim has already been presented to the personal representative or paid, 
32.20 	the personal representative shall serve a copy of the notice required by paragraph (b) upon 
32.21 	each creditor of the decedent who is then known to the personal representative and identified 
32.22 	either by delivery of a copy of the required notice to the creditor, or by mailing a copy of 
32.23 	the notice to the creditor by certified, registered, or ordinary first class mail addressed to 
32.24 	the creditor at the creditor's office or place of residence.
32.25 	(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a 
32.26 	predeceased spouse of the decedent received assistance for which a claim could be filed 
32.27 	under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the 
32.28 	attorney for the personal representative shall serve the commissioner or executive board, 
32.29 	as applicable, with notice in the manner prescribed in paragraph (c), or electronically in a 
32.30 	manner prescribed by the commissioner or executive board, as soon as practicable after the 
32.31 	appointment of the personal representative. The notice must state the decedent's full name, 
32.32 	date of birth, and Social Security number and, to the extent then known after making a 
32.33 	reasonably diligent inquiry, the full name, date of birth, and Social Security number for 
32.34 	each of the decedent's predeceased spouses. The notice may also contain a statement that, 
32.35 	after making a reasonably diligent inquiry, the personal representative has determined that 
33.1 	the decedent did not have any predeceased spouses or that the personal representative has 
33.2 	been unable to determine one or more of the previous items of information for a predeceased 
33.3 	spouse of the decedent. A copy of the notice to creditors must be attached to and be a part 
33.4 	of the notice to the commissioner or executive board.
33.5 	(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed 
33.6 	in this paragraph, no property subject to administration by the estate may be distributed by 
33.7 	the estate or the personal representative until 70 days after the date the notice is served on 
33.8 	the commissioner or executive board as provided in paragraph (c), unless the local agency 
33.9 	consents as provided for in clause (6). This restriction on distribution does not apply to the 
33.10 	personal representative's sale of real or personal property, but does apply to the net proceeds 
33.11 	the estate receives from these sales. The personal representative, or any person with personal 
33.12 	knowledge of the facts, may provide an affidavit containing the description of any real or 
33.13 	personal property affected by this paragraph and stating facts showing compliance with this 
33.14 	paragraph. If the affidavit describes real property, it may be filed or recorded in the office 
33.15 	of the county recorder or registrar of titles for the county where the real property is located. 
33.16 	This paragraph does not apply to proceedings under sections 524.3-1203 and 525.31, or 
33.17 	when a duly authorized agent of a county is acting as the personal representative of the 
33.18 	estate.
33.19 	(3) At any time before an order or decree is entered under section 524.3-1001 or 
33.20 	524.3-1002, or a closing statement is filed under section 524.3-1003, the personal 
33.21 	representative or the attorney for the personal representative may serve an amended notice 
33.22 	on the commissioner or executive board to add variations or other names of the decedent 
33.23 	or a predeceased spouse named in the notice, the name of a predeceased spouse omitted 
33.24 	from the notice, to add or correct the date of birth or Social Security number of a decedent 
33.25 	or predeceased spouse named in the notice, or to correct any other deficiency in a prior 
33.26 	notice. The amended notice must state the decedent's name, date of birth, and Social Security 
33.27 	number, the case name, case number, and district court in which the estate is pending, and 
33.28 	the date the notice being amended was served on the commissioner or executive board. If 
33.29 	the amendment adds the name of a predeceased spouse omitted from the notice, it must also 
33.30 	state that spouse's full name, date of birth, and Social Security number. The amended notice 
33.31 	must be served on the commissioner or executive board in the same manner as the original 
33.32 	notice. Upon service, the amended notice relates back to and is effective from the date the 
33.33 	notice it amends was served, and the time for filing claims arising under section 246.53, 
33.34 	256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended 
33.35 	notice. Claims filed during the 60-day period are undischarged and unbarred claims, may 
34.1 	be prosecuted by the entities entitled to file those claims in accordance with section 
34.2 	524.3-1004, and the limitations in section 524.3-1006 do not apply. The personal 
34.3 	representative or any person with personal knowledge of the facts may provide and file or 
34.4 	record an affidavit in the same manner as provided for in clause (1).
34.5 	(4) Within one year after the date an order or decree is entered under section 524.3-1001
34.6 	or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has 
34.7 	an interest in property that was subject to administration by the estate may serve an amended 
34.8 	notice on the commissioner or executive board to add variations or other names of the 
34.9 	decedent or a predeceased spouse named in the notice, the name of a predeceased spouse 
34.10 	omitted from the notice, to add or correct the date of birth or Social Security number of a 
34.11 	decedent or predeceased spouse named in the notice, or to correct any other deficiency in 
34.12 	a prior notice. The amended notice must be served on the commissioner or executive board 
34.13 	in the same manner as the original notice and must contain the information required for 
34.14 	amendments under clause (3). If the amendment adds the name of a predeceased spouse 
34.15 	omitted from the notice, it must also state that spouse's full name, date of birth, and Social 
34.16 	Security number. Upon service, the amended notice relates back to and is effective from 
34.17 	the date the notice it amends was served. If the amended notice adds the name of an omitted 
34.18 	predeceased spouse or adds or corrects the Social Security number or date of birth of the 
34.19 	decedent or a predeceased spouse already named in the notice, then, notwithstanding any 
34.20 	other laws to the contrary, claims against the decedent's estate on account of those persons 
34.21 	resulting from the amendment and arising under section 246.53, 256B.15, 256D.16, or 
34.22 	261.04 are undischarged and unbarred claims, may be prosecuted by the entities entitled to 
34.23 	file those claims in accordance with section 524.3-1004, and the limitations in section 
34.24 	524.3-1006 do not apply. The person filing the amendment or any other person with personal 
34.25 	knowledge of the facts may provide and file or record an affidavit describing affected real 
34.26 	or personal property in the same manner as clause (1).
34.27 	(5) After one year from the date an order or decree is entered under section 524.3-1001
34.28 	or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission, 
34.29 	or defect of any kind in the notice to the commissioner or executive board required under 
34.30 	this paragraph or in the process of service of the notice on the commissioner or executive 
34.31 	board, or the failure to serve the commissioner or executive board with notice as required 
34.32 	by this paragraph, makes any distribution of property by a personal representative void or 
34.33 	voidable. The distributee's title to the distributed property shall be free of any claims based 
34.34 	upon a failure to comply with this paragraph.
35.1 	(6) The local agency may consent to a personal representative's request to distribute 
35.2 	property subject to administration by the estate to distributees during the 70-day period after 
35.3 	service of notice on the commissioner or executive board. The local agency may grant or 
35.4 	deny the request in whole or in part and may attach conditions to its consent as it deems 
35.5 	appropriate. When the local agency consents to a distribution, it shall give the estate a written 
35.6 	certificate evidencing its consent to the early distribution of assets at no cost. The certificate 
35.7 	must include the name, case number, and district court in which the estate is pending, the 
35.8 	name of the local agency, describe the specific real or personal property to which the consent 
35.9 	applies, state that the local agency consents to the distribution of the specific property 
35.10 	described in the consent during the 70-day period following service of the notice on the 
35.11 	commissioner or executive board, state that the consent is unconditional or list all of the 
35.12 	terms and conditions of the consent, be dated, and may include other contents as may be 
35.13 	appropriate. The certificate must be signed by the director of the local agency or the director's 
35.14 	designees and is effective as of the date it is dated unless it provides otherwise. The signature 
35.15 	of the director or the director's designee does not require any acknowledgment. The certificate 
35.16 	shall be prima facie evidence of the facts it states, may be attached to or combined with a 
35.17 	deed or any other instrument of conveyance and, when so attached or combined, shall 
35.18 	constitute a single instrument. If the certificate describes real property, it shall be accepted 
35.19 	for recording or filing by the county recorder or registrar of titles in the county in which the 
35.20 	property is located. If the certificate describes real property and is not attached to or combined 
35.21 	with a deed or other instrument of conveyance, it shall be accepted for recording or filing 
35.22 	by the county recorder or registrar of titles in the county in which the property is located. 
35.23 	The certificate constitutes a waiver of the 70-day period provided for in clause (2) with 
35.24 	respect to the property it describes and is prima facie evidence of service of notice on the 
35.25 	commissioner or executive board. The certificate is not a waiver or relinquishment of any 
35.26 	claims arising under section 246.53, 256B.15, 256D.16, or 261.04, and does not otherwise 
35.27 	constitute a waiver of any of the personal representative's duties under this paragraph. 
35.28 	Distributees who receive property pursuant to a consent to an early distribution shall remain 
35.29 	liable to creditors of the estate as provided for by law.
35.30 	(7) All affidavits provided for under this paragraph:
35.31 	(i) shall be provided by persons who have personal knowledge of the facts stated in the 
35.32 	affidavit;
35.33 	(ii) may be filed or recorded in the office of the county recorder or registrar of titles in 
35.34 	the county in which the real property they describe is located for the purpose of establishing 
35.35 	compliance with the requirements of this paragraph; and
36.1 	(iii) are prima facie evidence of the facts stated in the affidavit.
36.2 	(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997. 
36.3 	Clause (5) also applies with respect to all notices served on the commissioner of human 
36.4 	services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55. All notices 
36.5 	served on the commissioner before July 1, 1997, pursuant to Laws 1996, chapter 451, article 
36.6 	2, section 55, shall be deemed to be legally sufficient for the purposes for which they were 
36.7 	intended, notwithstanding any errors, omissions or other defects.

36.8 	Sec. 17. DIRECTION TO COMMISSIONER; REIMBURSEMENT FOR 
36.9 	EXTRACORPOREAL MEMBRANE OXYGENATION CANNULATION AS AN 
36.10 	OUTPATIENT SERVICE.
 36.11 	The commissioner of human services, in consultation with providers and hospitals, shall 
36.12 	determine the feasibility of an outpatient reimbursement mechanism for medical assistance 
36.13 	coverage of extracorporeal membrane oxygenation (ECMO) cannulation performed outside 
36.14 	an inpatient hospital setting or in a self-contained mobile ECMO unit. If an outpatient 
36.15 	reimbursement mechanism is feasible, then the commissioner of human services shall 
36.16 	develop a recommended payment mechanism. By January 15, 2025, the commissioner of 
36.17 	human services shall submit a recommendation and the required legislative language to the 
36.18 	chairs and ranking minority members of the legislative committees with jurisdiction over 
36.19 	health care finance. If such a payment mechanism is infeasible, the commissioner of human 
36.20 	services shall submit an explanation as to why it is infeasible.

36.21 	ARTICLE 3
36.22 	HEALTH CARE

36.23 	Section 1. [62J.805] DEFINITIONS.
36.24 		Subdivision 1.Application. For purposes of sections 62J.805 to 62J.808, the following 
36.25 	terms have the meanings given.
36.26 		Subd. 2.Health care provider. "Health care provider" means:
36.27 	(1) a health professional who is licensed or registered by Minnesota to provide health 
36.28 	treatments and services within the professional's scope of practice and in accordance with 
36.29 	state law;
36.30 	(2) a group practice; or
36.31 	(3) a hospital.
37.1 		Subd. 3.Health plan. "Health plan" has the meaning given in section 62A.011, 
37.2 	subdivision 3.
37.3 		Subd. 4.Hospital. "Hospital" means a health care facility licensed as a hospital under 
37.4 	sections 144.50 to 144.56.
37.5 		Subd. 5.Group practice. "Group practice" has the meaning given to health care provider 
37.6 	group practice in section 145D.01, subdivision 1.
37.7 		Subd. 6.Medically necessary. "Medically necessary" means:
37.8 	(1) safe and effective;
37.9 	(2) not experimental or investigational, except as set forth in Code of Federal Regulations, 
37.10 	title 42, section 411.15(o);
37.11 	(3) furnished in accordance with acceptable medical standards of medical practice for 
37.12 	the diagnosis or treatment of the patient's condition or to improve the function of a  malformed 
37.13 	body member;
37.14 	(4) furnished in a setting appropriate to the patient's medical need and condition;
37.15 	(5) ordered and furnished by qualified personnel;
37.16 	(6) meets, but does not exceed, the patient's medical need; and
37.17 	(7) is at least as beneficial as an existing and available medically appropriate alternative.
37.18 		Subd. 7.Miscode. "Miscode" means a health care provider or a health care provider's 
37.19 	designee, using a coding system and for billing purposes, assigns a numeric or alphanumeric 
37.20 	code to a health treatment or service provided to a patient and the code assigned does not 
37.21 	accurately reflect the health treatment or service provided based on factors that include the 
37.22 	patient's diagnosis and the complexity of the patient's condition.
37.23 		Subd. 8.Payment. "Payment" includes co-payments and coinsurance and deductible 
37.24 	payments made by a patient.

37.25 	Sec. 2. [62J.806] POLICY FOR COLLECTION OF MEDICAL DEBT.
37.26 		Subdivision 1.Requirement. Each health care provider must make available to the 
37.27 	public the health care provider's policy for the collection of medical debt from patients. This 
37.28 	policy must be made available by:
37.29 	(1) clearly posting it on the health care provider's website, or for health professionals, 
37.30 	on the website of the health clinic, group practice, or hospital at which the health professional 
37.31 	is employed or under contract; and
38.1 	(2) providing a copy of the policy to any individual who requests it.
38.2 		Subd. 2.Content. A policy made available under this section must at least specify the 
38.3 	procedures followed by the health care provider for:
38.4 	(1) communicating with patients about the medical debt owed and collecting medical 
38.5 	debt;
38.6 	(2) referring medical debt to a collection agency or law firm for collection; and
38.7 	(3) identifying medical debt as uncollectible or satisfied, and ending collection activities.

38.8 	Sec. 3. [62J.807] DENIAL OF HEALTH TREATMENTS OR SERVICES DUE TO 
38.9 	OUTSTANDING MEDICAL DEBT.
38.10 	(a) A health care provider must not deny medically necessary health treatments or services 
38.11 	to a patient or any member of the patient's family or household because of outstanding or 
38.12 	previously outstanding medical debt owed by the patient or any member of the patient's 
38.13 	family or household to the health care provider, regardless of whether the health treatment 
38.14 	or service may be available from another health care provider.
38.15 	(b) As a condition of providing medically necessary health treatments or services in the 
38.16 	circumstances described in paragraph (a), a health care provider may require the patient to 
38.17 	enroll in a payment plan for the outstanding medical debt owed to the health care provider.

38.18 	Sec. 4. [62J.808] BILLING AND PAYMENT FOR MISCODED HEALTH 
38.19 	TREATMENTS AND SERVICES.
38.20 		Subdivision 1.Participation and cooperation required. Each health care provider 
38.21 	must participate in, and cooperate with, all processes and investigations to identify, review, 
38.22 	and correct the coding of health treatments and services that are miscoded by the health 
38.23 	care provider or a designee.
38.24 		Subd. 2.Notice; billing and payment during review. (a) When a health care provider 
38.25 	receives notice, other than notice from a health plan company as provided in paragraph (b), 
38.26 	or otherwise determines that a health treatment or service may have been miscoded, the 
38.27 	health care provider must notify the health plan company administering the patient's health 
38.28 	plan in a timely manner of the potentially miscoded health treatment or service.
38.29 	(b) When a health plan company receives notice, other than notice from a health care 
38.30 	provider as provided in paragraph (a), or otherwise determines that a health treatment or 
38.31 	service may have been miscoded, the health plan company must notify the health care 
39.1 	provider who provided the health treatment or service of the potentially miscoded health 
39.2 	treatment or service.
39.3 	(c) When a review of a potentially miscoded health treatment or service is commenced, 
39.4 	the health care provider and health plan company must notify the patient that a miscoding 
39.5 	review is being conducted and that the patient will not be billed for any health treatment or 
39.6 	service subject to the review and is not required to submit payments for any health treatment 
39.7 	or service subject to the review until the review is complete and any miscoded health 
39.8 	treatments or services are correctly coded.
39.9 	(d) While a review of a potentially miscoded health treatment or service is being 
39.10 	conducted, the health care provider and health plan company must not bill the patient for, 
39.11 	or accept payment from the patient for, any health treatment or service subject to the review.
39.12 		Subd. 3.Billing and payment after completion of review. The health care provider 
39.13 	and health plan company may bill the patient for, and accept payment from the patient for, 
39.14 	the health treatment or service that was subject to the miscoding review only after the review 
39.15 	is complete and any miscoded health treatments or services have been correctly coded.

39.16 	Sec. 5. Minnesota Statutes 2022, section 62V.02, is amended by adding a subdivision to 
39.17 	read:
39.18 		Subd. 7a.MinnesotaCare public option. "MinnesotaCare public option" or "public 
39.19 	option" has the meaning provided in section 256L.01, subdivision 5a.

39.20 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
39.21 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
39.22 	federal approval is obtained.

39.23 	Sec. 6. Minnesota Statutes 2022, section 62V.02, is amended by adding a subdivision to 
39.24 	read:
39.25 		Subd. 7b.MinnesotaCare public option enrollee. "MinnesotaCare public option 
39.26 	enrollee" or "public option enrollee" has the meaning provided in section 256L.01, 
39.27 	subdivision 5b.

39.28 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
39.29 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
39.30 	federal approval is obtained.

40.1 	Sec. 7. Minnesota Statutes 2022, section 62V.03, subdivision 1, is amended to read:
40.2 		Subdivision 1.Creation. MNsure is created as a board under section 15.012, paragraph 
40.3 	(a), to:
40.4 	(1) promote informed consumer choice, innovation, competition, quality, value, market 
40.5 	participation, affordability, suitable and meaningful choices, health improvement, care 
40.6 	management, reduction of health disparities, and portability of health plans and the public 
40.7 	option;
40.8 	(2) facilitate and simplify the comparison, choice, enrollment, and purchase of health 
40.9 	plans for individuals purchasing in the individual market through MNsure and, for employees 
40.10 	and employers purchasing in the small group market through MNsure, and for individuals 
40.11 	purchasing the public option;
40.12 	(3) assist small employers with access to small business health insurance tax credits and 
40.13 	to assist individuals with access to public health care programs, premium assistance tax 
40.14 	credits and cost-sharing reductions, and certificates of exemption from individual 
40.15 	responsibility requirements;
40.16 	(4) facilitate the integration and transition of individuals between public health care 
40.17 	programs, including the public option, and health plans in the individual or group market 
40.18 	and develop processes that, to the maximum extent possible, provide for continuous coverage; 
40.19 	and
40.20 	(5) establish and modify as necessary a name and brand for MNsure based on market 
40.21 	studies that show maximum effectiveness in attracting the uninsured and motivating them 
40.22 	to take action.; and
40.23 	(6) ensure simple, convenient, and understandable access to enrollment in the public 
40.24 	option through the MNsure website.

40.25 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
40.26 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
40.27 	federal approval is obtained.

40.28 	Sec. 8. Minnesota Statutes 2022, section 62V.03, subdivision 3, is amended to read:
40.29 		Subd. 3.Continued operation of a private marketplace. (a) Nothing in this chapter 
40.30 	shall be construed to prohibit: (1) a health carrier from offering outside of MNsure a health 
40.31 	plan to a qualified individual or qualified employer; and (2) a qualified individual from 
41.1 	enrolling in, or a qualified employer from selecting for its employees, a health plan offered 
41.2 	outside of MNsure.
41.3 	(b) Nothing in this chapter shall be construed to restrict the choice of a qualified individual 
41.4 	to enroll or not enroll in a qualified health plan, the public option, or to participate in MNsure. 
41.5 	Nothing in this chapter shall be construed to compel an individual to enroll in a qualified 
41.6 	health plan, the public option, or to participate in MNsure.
41.7 	(c) For purposes of this subdivision, "qualified individual" and "qualified employer" 
41.8 	have the meanings given in section 1312 of the Affordable Care Act, Public Law 111-148, 
41.9 	and further defined through amendments to the act and regulations issued under the act.

41.10 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
41.11 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
41.12 	federal approval is obtained.

41.13 	Sec. 9. Minnesota Statutes 2022, section 62V.05, subdivision 3, is amended to read:
41.14 		Subd. 3.Insurance producers. (a) By April 30, 2013, the board, in consultation with 
41.15 	the commissioner of commerce, shall establish certification requirements that must be met 
41.16 	by insurance producers in order to assist individuals and small employers with purchasing 
41.17 	coverage through MNsure. Prior to January 1, 2015, the board may amend the requirements, 
41.18 	only if necessary, due to a change in federal rules.
41.19 	(b) Certification requirements under paragraph (a) shall not exceed the requirements 
41.20 	established under Code of Federal Regulations, title 45, part section 155.220. Certification 
41.21 	shall include training on health plans available through MNsure, available tax credits and 
41.22 	cost-sharing arrangements, compliance with privacy and security standards, eligibility 
41.23 	verification processes, online enrollment tools, and basic information on available public 
41.24 	health care programs. Training required for certification under this subdivision shall qualify 
41.25 	for continuing education requirements for insurance producers required under chapter 60K, 
41.26 	and must comply with course approval requirements under chapter 45.
41.27 	(c) For enrollment in qualified health plans, producer compensation shall be established 
41.28 	by health carriers that provide health plans through MNsure. The structure of compensation 
41.29 	to insurance producers must be similar for health plans sold through MNsure and outside 
41.30 	MNsure.
41.31 	(d) Any insurance producer compensation structure established by a health carrier for 
41.32 	the small group market must include compensation for defined contribution plans that 
42.1 	involve multiple health carriers. The compensation offered must be commensurate with 
42.2 	other small group market defined health plans.
42.3 	(e) Any insurance producer assisting an individual or small employer with purchasing 
42.4 	coverage through MNsure must disclose, orally and in writing, to the individual or small 
42.5 	employer at the time of the first solicitation with the prospective purchaser the following:
42.6 	(1) the health carriers and qualified health plans offered through MNsure that the producer 
42.7 	is authorized to sell, and that the producer may not be authorized to sell all the qualified 
42.8 	health plans offered through MNsure;
42.9 	(2) that the producer may be receiving compensation from a health carrier for enrolling 
42.10 	the individual or small employer into a particular health plan; and
42.11 	(3) that information on all qualified health plans offered through MNsure and the public 
42.12 	option is available through the MNsure website.; and
42.13 	(4) that the producer may receive compensation from the state for enrolling an individual 
42.14 	in the public option.
42.15 	For purposes of this paragraph, "solicitation" means any contact by a producer, or any person 
42.16 	acting on behalf of a producer made for the purpose of selling or attempting to sell coverage 
42.17 	through MNsure. If the first solicitation is made by telephone, the disclosures required under 
42.18 	this paragraph need not be made in writing, but the fact that disclosure has been made must 
42.19 	be acknowledged on the application.
42.20 	(f) Beginning January 15, 2015, each health carrier that offers or sells qualified health 
42.21 	plans through MNsure shall report in writing to the board and the commissioner of commerce 
42.22 	the compensation and other incentives it offers or provides to insurance producers with 
42.23 	regard to each type of health plan the health carrier offers or sells both inside and outside 
42.24 	of MNsure. Each health carrier shall submit a report annually and upon any change to the 
42.25 	compensation or other incentives offered or provided to insurance producers.
42.26 	(g) Nothing in this chapter shall prohibit an insurance producer from offering professional 
42.27 	advice and recommendations to a small group purchaser based upon information provided 
42.28 	to the producer.
42.29 	(h) An insurance producer that offers health plans in the small group market shall notify 
42.30 	each small group purchaser of which group health plans qualify for Internal Revenue Service 
42.31 	approved section 125 tax benefits. The insurance producer shall also notify small group 
42.32 	purchasers of state law provisions that benefit small group plans when the employer agrees 
42.33 	to pay 50 percent or more of its employees' premium. Individuals who are eligible for 
43.1 	cost-effective medical assistance will count toward the 75 percent participation requirement 
43.2 	in section 62L.03, subdivision 3.
43.3 	(i) Nothing in this subdivision shall be construed to limit the licensure requirements or 
43.4 	regulatory functions of the commissioner of commerce under chapter 60K.
43.5 	(j) The board may establish certification requirements that must be met by insurance 
43.6 	producers in order to assist individuals with enrolling in the public option.
43.7 	(k) Health carriers must pay an insurance producer a $....... application assistance bonus 
43.8 	for each applicant the insurance producer successfully enrolls in the public option.

43.9 	EFFECTIVE DATE. This section is effective upon federal approval of the state's 
43.10 	section 1332 waiver request to establish a public option. The commissioner of commerce 
43.11 	shall notify the revisor of statutes when federal approval is obtained.

43.12 	Sec. 10. Minnesota Statutes 2022, section 62V.05, subdivision 6, is amended to read:
43.13 		Subd. 6.Appeals. (a) The board may conduct hearings, appoint hearing officers, and 
43.14 	recommend final orders related to appeals of any MNsure determinations, except for those 
43.15 	determinations identified in paragraph (d). An appeal by a health carrier regarding a specific 
43.16 	certification or selection determination made by MNsure under subdivision 5 must be 
43.17 	conducted as a contested case proceeding under chapter 14, with the report or order of the 
43.18 	administrative law judge constituting the final decision in the case, subject to judicial review 
43.19 	under sections 14.63 to 14.69. For other appeals, the board shall establish hearing processes 
43.20 	which provide for a reasonable opportunity to be heard and timely resolution of the appeal 
43.21 	and which are consistent with the requirements of federal law and guidance. An appealing 
43.22 	party may be represented by legal counsel at these hearings, but this is not a requirement.
43.23 	(b) MNsure may establish service-level agreements with state agencies to conduct 
43.24 	hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is 
43.25 	authorized to enter into service-level agreements for this purpose with MNsure.
43.26 	(c) For proceedings under this subdivision, MNsure may be represented by an attorney 
43.27 	who is an employee of MNsure.
43.28 	(d) This subdivision does not apply to appeals of determinations where a state agency 
43.29 	hearing is available under section 256.045.
43.30 	(e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as 
43.31 	defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of 
43.32 	the appellant's county of residence by serving a written copy of a notice of appeal upon 
44.1 	MNsure and any other adverse party of record within 30 days after the date MNsure issued 
44.2 	the order, the amended order, or order affirming the original order, and by filing the original 
44.3 	notice and proof of service with the court administrator of the district court. Service may 
44.4 	be made personally or by mail; service by mail is complete upon mailing; no filing fee shall 
44.5 	be required by the court administrator in appeals taken pursuant to this subdivision. MNsure 
44.6 	shall furnish all parties to the proceedings with a copy of the decision and a transcript of 
44.7 	any testimony, evidence, or other supporting papers from the hearing held before the appeals 
44.8 	examiner within 45 days after service of the notice of appeal.
44.9 	(f) Any party aggrieved by the failure of an adverse party to obey an order issued by 
44.10 	MNsure may compel performance according to the order in the manner prescribed in sections 
44.11 	586.01 to 586.12.
44.12 	(g) Any party may obtain a hearing at a special term of the district court by serving a 
44.13 	written notice of the time and place of the hearing at least ten days prior to the date of the 
44.14 	hearing. The court may consider the matter in or out of chambers, and shall take no new or 
44.15 	additional evidence unless it determines that such evidence is necessary for a more equitable 
44.16 	disposition of the appeal.
44.17 	(h) Any party aggrieved by the order of the district court may appeal the order as in 
44.18 	other civil cases. No costs or disbursements shall be taxed against any party nor shall any 
44.19 	filing fee or bond be required of any party.
44.20 	(i) If MNsure or district court orders eligibility for qualified health plan coverage through 
44.21 	MNsure, the MinnesotaCare public option,or eligibility for federal advance payment of 
44.22 	premium tax credits or cost-sharing reductions contingent upon full payment of respective 
44.23 	premiums, the premiums must be paid or provided pending appeal to the district court, court 
44.24 	of appeals, or supreme court. Provision of eligibility by MNsure pending appeal does not 
44.25 	render moot MNsure's position in a court of law.

44.26 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
44.27 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
44.28 	federal approval is obtained.

44.29 	Sec. 11. Minnesota Statutes 2022, section 62V.05, subdivision 11, is amended to read:
44.30 		Subd. 11.Prohibition on other product lines. MNsure is prohibited from certifying, 
44.31 	selecting, or offering products and policies of coverage that do not meet the definition of 
44.32 	health plan or dental plan as provided in section 62V.02. Nothing in this subdivision prevents 
44.33 	the commissioner of human services from offering the public option on the MNsure website.

45.1 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
45.2 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
45.3 	federal approval is obtained.

45.4 	Sec. 12. Minnesota Statutes 2022, section 62V.05, subdivision 12, is amended to read:
45.5 		Subd. 12.Reports on interagency agreements and intra-agency transfers. The 
45.6 	MNsure Board shall provide quarterly reports to the chairs and ranking minority members 
45.7 	of the legislative committees with jurisdiction over health and human services policy and 
45.8 	finance on: legislative reports on interagency agreements and intra-agency transfers according 
45.9 	to section 15.0395.
45.10 	(1) interagency agreements or service-level agreements and any renewals or extensions 
45.11 	of existing interagency or service-level agreements with a state department under section 
45.12 	15.01, state agency under section 15.012, or the Department of Information Technology 
45.13 	Services, with a value of more than $100,000, or related agreements with the same department 
45.14 	or agency with a cumulative value of more than $100,000; and
45.15 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
45.16 	agencies.
45.17 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
45.18 	amount, purpose, and effective date of the agreement, the duration of the agreement, and a 
45.19 	copy of the agreement.

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

45.21 	Sec. 13. Minnesota Statutes 2022, section 62V.05, is amended by adding a subdivision to 
45.22 	read:
45.23 		Subd. 13.MinnesotaCare public option. The board has the powers and duties provided 
45.24 	in section 62V.14, with respect to the MinnesotaCare public option.

45.25 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
45.26 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
45.27 	federal approval is obtained.

46.1 	Sec. 14. Minnesota Statutes 2022, section 62V.051, is amended to read:
46.2 	62V.051 MNSURE; CONSUMER RETROACTIVE APPOINTMENT OF A 
46.3 	NAVIGATOR OR PRODUCER PERMITTED.
46.4 	Notwithstanding any other law or rule to the contrary, for up to six months after the 
46.5 	effective date of the qualified health plan or coverage under the public option, MNsure must 
46.6 	permit a qualified health plan policyholder or public option enrollee, who has not designated 
46.7 	a navigator or an insurance producer, to retroactively appoint a navigator or insurance 
46.8 	producer. In the case of a qualified health plan, MNsure must provide notice of the retroactive 
46.9 	appointment to the health carrier. The health carrier must retroactively pay commissions to 
46.10 	the insurance producer if the producer can demonstrate that they were certified by MNsure 
46.11 	at the time of the original enrollment, were appointed by the selected health carrier at the 
46.12 	time of the enrollment, and that an agent of record agreement was executed prior to or at 
46.13 	the time of the effective date of the policy. MNsure must adopt a standard form of agent of 
46.14 	record agreement for purposes of this section. In the case of the public option, MNsure must 
46.15 	provide notice of the retroactive appointment to the managed care or county-based purchasing 
46.16 	plan, and the plan must retroactively pay commissions to the insurance producer if the 
46.17 	producer can demonstrate they were certified by MNsure at the time of the original 
46.18 	enrollment.

46.19 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
46.20 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
46.21 	federal approval is obtained.

46.22 	Sec. 15. Minnesota Statutes 2022, section 62V.06, subdivision 4, is amended to read:
46.23 		Subd. 4.Application and certification data. (a) Data submitted by an insurance producer 
46.24 	in an application for certification to sell a health plan or the public option through MNsure, 
46.25 	or submitted by an applicant seeking permission or a commission to act as a navigator or 
46.26 	in-person assister, are classified as follows:
46.27 	(1) at the time the application is submitted, all data contained in the application are 
46.28 	private data, as defined in section 13.02, subdivision 12, or nonpublic data as defined in 
46.29 	section 13.02, subdivision 9, except that the name of the applicant is public; and
46.30 	(2) upon a final determination related to the application for certification by MNsure, all 
46.31 	data contained in the application are public, with the exception of trade secret data as defined 
46.32 	in section 13.37.
47.1 	(b) Data created or maintained by a government entity as part of the evaluation of an 
47.2 	application are protected nonpublic data, as defined in section 13.02, subdivision 13, until 
47.3 	a final determination as to certification is made and all rights of appeal have been exhausted. 
47.4 	Upon a final determination and exhaustion of all rights of appeal, these data are public, with 
47.5 	the exception of trade secret data as defined in section 13.37 and data subject to 
47.6 	attorney-client privilege or other protection as provided in section 13.393.
47.7 	(c) If an application is denied, the public data must include the criteria used by the board 
47.8 	to evaluate the application and the specific reasons for the denial, and these data must be 
47.9 	published on the MNsure website.

47.10 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
47.11 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
47.12 	federal approval is obtained.

47.13 	Sec. 16. Minnesota Statutes 2022, section 62V.08, is amended to read:
47.14 	62V.08 REPORTS.
47.15 	(a) MNsure shall submit a report to the legislature by January 15, 2015 March 31, 2025, 
47.16 	and each January 15 March 31 thereafter, on: (1) the performance of MNsure operations; 
47.17 	(2) meeting MNsure responsibilities; (3) an accounting of MNsure budget activities; (4) 
47.18 	practices and procedures that have been implemented to ensure compliance with data 
47.19 	practices laws, and a description of any violations of data practices laws or procedures; and 
47.20 	(5) the effectiveness of the outreach and implementation activities of MNsure in reducing 
47.21 	the rate of uninsurance.
47.22 	(b) MNsure must publish its administrative and operational costs on a website to educate 
47.23 	consumers on those costs. The information published must include: (1) the amount of 
47.24 	premiums and federal premium subsidies collected; (2) the amount and source of revenue 
47.25 	received under section 62V.05, subdivision 1, paragraph (b), clause (3); (3) the amount and 
47.26 	source of any other fees collected for purposes of supporting operations; and (4) any misuse 
47.27 	of funds as identified in accordance with section 3.975. The website must be updated at 
47.28 	least annually.

47.29 	Sec. 17. Minnesota Statutes 2022, section 62V.11, subdivision 4, is amended to read:
47.30 		Subd. 4.Review of costs. The board shall submit for review the annual budget of MNsure 
47.31 	for the next fiscal year by March 15 31 of each year, beginning March 15, 2014 31, 2025.

48.1 	Sec. 18. Minnesota Statutes 2023 Supplement, section 62V.13, subdivision 3, is amended 
48.2 	to read:
48.3 		Subd. 3.Outreach letter and special enrollment period. (a) MNsure must provide a 
48.4 	written letter of the projected assessment under subdivision 2 to a taxpayer who indicates 
48.5 	to the commissioner of revenue that the taxpayer is interested in obtaining information on 
48.6 	access to health insurance.
48.7 	(b) MNsure must allow a special enrollment period for taxpayers who receive the outreach 
48.8 	letter in paragraph (a) and are determined eligible to enroll in a qualified health plan through 
48.9 	MNsure or in the public option. The triggering event for the special enrollment period is 
48.10 	the day the outreach letter under this subdivision is mailed to the taxpayer. An eligible 
48.11 	individual, and their dependents, have 65 days from the triggering event to select a qualifying 
48.12 	health plan or the public option and coverage for the qualifying health plan or the public 
48.13 	option is effective the first day of the month after plan selection.
48.14 	(c) Taxpayers who have a member of the taxpayer's household currently enrolled in a 
48.15 	qualified health plan through MNsure or in the public option are not eligible for the special 
48.16 	enrollment under paragraph (b).
48.17 	(d) MNsure must provide information to the general public about the easy enrollment 
48.18 	health insurance outreach program and the special enrollment period described in this 
48.19 	subdivision.

48.20 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
48.21 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
48.22 	federal approval is obtained.

48.23 	Sec. 19. [62V.14] PUBLIC OPTION; APPLICATION AND ENROLLMENT.
48.24 		Subdivision 1.Public option application. (a) An individual eligible for the public option 
48.25 	must be able to enroll in the public option on the MNsure website.
48.26 	(b) An individual must be able to apply for and, if eligible, enroll in the public option 
48.27 	by completing the application for a qualified health plan with premium tax credits or 
48.28 	cost-sharing reductions. An individual must provide information needed to confirm they 
48.29 	are not eligible for medical assistance under chapter 256B or MinnesotaCare under chapter 
48.30 	256L through an eligibility pathway other than the public option.
48.31 	(c) MNsure must ensure that individuals interested in applying for a qualified health 
48.32 	plan or the public option are able to compare coverage options in a simple, convenient, and 
49.1 	understandable manner on the MNsure website. The website must present the coverage 
49.2 	options in a comparable and standardized manner to the extent practicable.
49.3 	(d) The MNsure website must include clear and conspicuous language stating that 
49.4 	individuals can apply for the public option on the website.
49.5 		Subd. 2.Eligibility determinations. (a) MNsure shall process all public option 
49.6 	applications and make all eligibility determinations for the public option. MNsure shall 
49.7 	make all public option eligibility determinations in accordance with section 256L.04, 
49.8 	subdivision 15.
49.9 	(b) Eligibility for the public option is appealable to the MNsure board under this chapter 
49.10 	and Minnesota Rules, chapter 7700.
49.11 		Subd. 3.Administrative functions. MNsure shall provide administrative functions to 
49.12 	facilitate the offering of the public option by the commissioner of human services. These 
49.13 	functions include but are not limited to marketing, call center operations, and certification 
49.14 	of insurance producers. MNsure may provide additional administrative functions as requested 
49.15 	by the commissioner of human services.
49.16 		Subd. 4.Diversion of resources. MNsure may utilize existing resources, personnel, and 
49.17 	operations to carry out its duties under this section.
49.18 		Subd. 5.No limitation. Nothing in this section limits the rights of MinnesotaCare public 
49.19 	option enrollees or the commissioner of human services under chapter 256L.
49.20 		Subd. 6.Contracting authorization. The MNsure board may contract on a single-source 
49.21 	basis under section 16C.10, subdivision 1, with a third-party entity already providing 
49.22 	technical support to the board to develop and implement the technological requirements of 
49.23 	this section.

49.24 	EFFECTIVE DATE. This section is effective upon federal approval of the state's 
49.25 	section 1332 waiver application to establish a public option. The commissioner of commerce 
49.26 	shall notify the revisor of statutes when federal approval is obtained.

49.27 	Sec. 20. Minnesota Statutes 2023 Supplement, section 144.587, subdivision 4, is amended 
49.28 	to read:
49.29 		Subd. 4.Prohibited actions. (a) A hospital must not initiate one or more of the following 
49.30 	actions until the hospital determines that the patient is ineligible for charity care or denies 
49.31 	an application for charity care:
49.32 	(1) offering to enroll or enrolling the patient in a payment plan;
50.1 	(2) changing the terms of a patient's payment plan;
50.2 	(3) offering the patient a loan or line of credit, application materials for a loan or line of 
50.3 	credit, or assistance with applying for a loan or line of credit, for the payment of medical 
50.4 	debt;
50.5 	(4) referring a patient's debt for collections, including in-house collections, third-party 
50.6 	collections, revenue recapture, or any other process for the collection of debt; or
50.7 	(5) denying health care services to the patient or any member of the patient's household 
50.8 	because of outstanding medical debt, regardless of whether the services are deemed necessary 
50.9 	or may be available from another provider; or
50.10 	(6) (5) accepting a credit card payment of over $500 for the medical debt owed to the 
50.11 	hospital.
50.12 	(b) A violation of section 62J.807 is a violation of this section.

50.13 	Sec. 21. [145.076] INFORMED CONSENT REQUIRED FOR SENSITIVE 
50.14 	EXAMINATIONS.
50.15 		Subdivision 1.Definition. For the purposes of this section, "sensitive examination" 
50.16 	means a pelvic, breast, urogenital, or rectal examination.
50.17 		Subd. 2.Informed consent required; exceptions. A health professional, or a student 
50.18 	or resident participating in a course of instruction, clinical training, or a residency program 
50.19 	for a health profession, shall not perform a sensitive examination on an anesthetized or 
50.20 	unconscious patient unless:
50.21 	(1) the patient or the patient's legally authorized representative provided prior, written, 
50.22 	informed consent to the sensitive examination, and the sensitive examination is necessary 
50.23 	for preventive, diagnostic, or treatment purposes;
50.24 	(2) the patient or the patient's legally authorized representative provided prior, written, 
50.25 	informed consent to a surgical procedure or diagnostic examination, and the sensitive 
50.26 	examination is within the scope of care ordered for that surgical procedure or diagnostic 
50.27 	examination;
50.28 	(3) the patient is unconscious and incapable of providing informed consent, and the 
50.29 	sensitive examination is necessary for diagnostic or treatment purposes; or
50.30 	(4) a court ordered a sensitive examination to be performed for purposes of collection 
50.31 	of evidence.
51.1 		Subd. 3.Penalty; ground for disciplinary action. A person who violates this section 
51.2 	is subject to disciplinary action by the health-related licensing board regulating the person.

51.3 	EFFECTIVE DATE. This section is effective August 1, 2024, and applies to crimes 
51.4 	committed on or after that date.

51.5 	Sec. 22. Minnesota Statutes 2023 Supplement, section 151.74, subdivision 3, is amended 
51.6 	to read:
51.7 		Subd. 3.Access to urgent-need insulin. (a) MNsure shall develop an application form 
51.8 	to be used by an individual who is in urgent need of insulin. The application must ask the 
51.9 	individual to attest to the eligibility requirements described in subdivision 2. The form shall 
51.10 	be accessible through MNsure's website. MNsure shall also make the form available to 
51.11 	pharmacies and health care providers who prescribe or dispense insulin, hospital emergency 
51.12 	departments, urgent care clinics, and community health clinics. By submitting a completed, 
51.13 	signed, and dated application to a pharmacy, the individual attests that the information 
51.14 	contained in the application is correct.
51.15 	(b) If the individual is in urgent need of insulin, the individual may present a completed, 
51.16 	signed, and dated application form to a pharmacy. The individual must also:
51.17 	(1) have a valid insulin prescription; and
51.18 	(2) present the pharmacist with identification indicating Minnesota residency in the form 
51.19 	of a valid Minnesota identification card, driver's license or permit, individual taxpayer 
51.20 	identification number, or Tribal identification card as defined in section 171.072, paragraph 
51.21 	(b). If the individual in urgent need of insulin is under the age of 18, the individual's parent 
51.22 	or legal guardian must provide the pharmacist with proof of residency.
51.23 	(c) Upon receipt of a completed and signed application, the pharmacist shall dispense 
51.24 	the prescribed insulin in an amount that will provide the individual with a 30-day supply. 
51.25 	The pharmacy must notify the health care practitioner who issued the prescription order no 
51.26 	later than 72 hours after the insulin is dispensed.
51.27 	(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or 
51.28 	to the manufacturer's vendor a claim for payment that is in accordance with the National 
51.29 	Council for Prescription Drug Program standards for electronic claims processing, unless 
51.30 	the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin 
51.31 	as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the 
51.32 	manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the 
51.33 	pharmacy in an amount that covers the pharmacy's acquisition cost.
52.1 	(e) The pharmacy may collect an insulin co-payment from the individual to cover the 
52.2 	pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day 
52.3 	supply of insulin dispensed.
52.4 	(f) The pharmacy shall also provide each eligible individual with the information sheet 
52.5 	described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy 
52.6 	for the individual to contact if the individual is in need of accessing needs to access ongoing 
52.7 	insulin coverage options, including assistance in:
52.8 	(1) applying for medical assistance or MinnesotaCare;
52.9 	(2) applying for a qualified health plan offered through MNsure, subject to open and 
52.10 	special enrollment periods;
52.11 	(3) accessing information on providers who participate in prescription drug discount 
52.12 	programs, including providers who are authorized to participate in the 340B program under 
52.13 	section 340b of the federal Public Health Services Act, United States Code, title 42, section 
52.14 	256b; and
52.15 	(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance 
52.16 	programs, and other foundation-based programs.
52.17 	(g) The pharmacist shall retain a copy of the application form submitted by the individual 
52.18 	to the pharmacy for reporting and auditing purposes.
52.19 	(h) A manufacturer may submit to the commissioner of administration a request for 
52.20 	reimbursement in an amount not to exceed $35 for each 30-day supply of insulin the 
52.21 	manufacturer provides under paragraph (d). The commissioner of administration shall 
52.22 	determine the manner and format for submitting and processing requests for reimbursement. 
52.23 	After receiving a reimbursement request, the commissioner of administration shall reimburse 
52.24 	the manufacturer in an amount not to exceed $35 for each 30-day supply of insulin the 
52.25 	manufacturer provided under paragraph (d).

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

52.27 	Sec. 23. Minnesota Statutes 2022, section 151.74, subdivision 6, is amended to read:
52.28 		Subd. 6.Continuing safety net program; process. (a) The individual shall submit to 
52.29 	a pharmacy the statement of eligibility provided by the manufacturer under subdivision 5, 
52.30 	paragraph (b). Upon receipt of an individual's eligibility status, the pharmacy shall submit 
52.31 	an order containing the name of the insulin product and the daily dosage amount as contained 
52.32 	in a valid prescription to the product's manufacturer.
53.1 	(b) The pharmacy must include with the order to the manufacturer the following 
53.2 	information:
53.3 	(1) the pharmacy's name and shipping address;
53.4 	(2) the pharmacy's office telephone number, fax number, email address, and contact 
53.5 	name; and
53.6 	(3) any specific days or times when deliveries are not accepted by the pharmacy.
53.7 	(c) Upon receipt of an order from a pharmacy and the information described in paragraph 
53.8 	(b), the manufacturer shall send to the pharmacy a 90-day supply of insulin as ordered, 
53.9 	unless a lesser amount is requested in the order, at no charge to the individual or pharmacy.
53.10 	(d) Except as authorized under paragraph (e), the pharmacy shall provide the insulin to 
53.11 	the individual at no charge to the individual. The pharmacy shall not provide insulin received 
53.12 	from the manufacturer to any individual other than the individual associated with the specific 
53.13 	order. The pharmacy shall not seek reimbursement for the insulin received from the 
53.14 	manufacturer or from any third-party payer.
53.15 	(e) The pharmacy may collect a co-payment from the individual to cover the pharmacy's 
53.16 	costs for processing and dispensing in an amount not to exceed $50 for each 90-day supply 
53.17 	if the insulin is sent to the pharmacy.
53.18 	(f) The pharmacy may submit to a manufacturer a reorder for an individual if the 
53.19 	individual's eligibility statement has not expired. Upon receipt of a reorder from a pharmacy, 
53.20 	the manufacturer must send to the pharmacy an additional 90-day supply of the product, 
53.21 	unless a lesser amount is requested, at no charge to the individual or pharmacy if the 
53.22 	individual's eligibility statement has not expired.
53.23 	(g) Notwithstanding paragraph (c), a manufacturer may send the insulin as ordered 
53.24 	directly to the individual if the manufacturer provides a mail order service option.
53.25 	(h) A manufacturer may submit to the commissioner of administration a request for 
53.26 	reimbursement in an amount not to exceed $105 for each 90-day supply of insulin the 
53.27 	manufacturer provides under paragraphs (c) and (f). The commissioner of administration 
53.28 	shall determine the manner and format for submitting and processing requests for 
53.29 	reimbursement. After receiving a reimbursement request, the commissioner of administration 
53.30 	shall reimburse the manufacturer in an amount not to exceed $105 for each 90-day supply 
53.31 	of insulin the manufacturer provided under paragraphs (c) and (f). If the manufacturer 
53.32 	provides less than a 90-day supply of insulin under paragraphs (c) and (f), the manufacturer 
54.1 	may submit a request for reimbursement not to exceed $35 for each 30-day supply of insulin 
54.2 	provided.

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

54.4 	Sec. 24. [151.741] INSULIN MANUFACTURER REGISTRATION FEE.
54.5 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
54.6 	the meanings given.
54.7 	(b) "Board" means the Minnesota Board of Pharmacy under section 151.02.
54.8 	(c) "Manufacturer" means a manufacturer licensed under section 151.252 and engaged 
54.9 	in the manufacturing of prescription insulin.
54.10 		Subd. 2.Assessment of registration fee. (a) The board shall assess each manufacturer 
54.11 	an annual registration fee of $100,000, except as provided in paragraph (b). The board shall 
54.12 	notify each manufacturer of this requirement beginning November 1, 2024, and each 
54.13 	November 1 thereafter.
54.14 	(b) A manufacturer may request an exemption from the annual registration fee. The 
54.15 	Board of Pharmacy shall exempt a manufacturer from the annual registration fee if the 
54.16 	manufacturer can demonstrate to the board, in the form and manner specified by the board, 
54.17 	that sales of prescription insulin produced by that manufacturer and sold or delivered within 
54.18 	or into Minnesota totalled $2,000,000 or less in the previous calendar year.
54.19 		Subd. 3.Payment of the registration fee; deposit of fee. (a) Each manufacturer must 
54.20 	pay the registration fee by March 1, 2025, and by each March 1 thereafter. In the event of 
54.21 	a change in ownership of the manufacturer, the new owner must pay the registration fee 
54.22 	that the original owner would have been assessed had the original owner retained ownership. 
54.23 	The board may assess a late fee of ten percent per month or any portion of a month that the 
54.24 	registration fee is paid after the due date.
54.25 	(b) The registration fee, including any late fees, must be deposited in the insulin safety 
54.26 	net program account.
54.27 		Subd. 4.Insulin safety net program account. The insulin safety net program account 
54.28 	is established in the special revenue fund in the state treasury. Money in the account is 
54.29 	appropriated each fiscal year to:
54.30 	(1) the MNsure board in an amount sufficient to carry out assigned duties under section 
54.31 	151.74, subdivision 7; and
55.1 	(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board 
55.2 	in assessing and collecting the registration fee under this section and in administering the 
55.3 	insulin safety net program under section 151.74.
55.4 		Subd. 5.Insulin repayment account; annual transfer from health care access fund. (a) 
55.5 	The insulin repayment account is established in the special revenue fund in the state treasury. 
55.6 	Money in the account is appropriated each fiscal year to the commissioner of administration 
55.7 	to reimburse manufacturers for insulin dispensed under the insulin safety net program in 
55.8 	section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6, 
55.9 	paragraph (h), and to cover costs incurred by the commissioner in providing these 
55.10 	reimbursement payments.
55.11 	(b) By June 30, 2025, and each June 30 thereafter, the commissioner of administration 
55.12 	shall certify to the commissioner of management and budget the total amount expended in 
55.13 	the prior fiscal year for:
55.14 	(1) reimbursement to manufacturers for insulin dispensed under the insulin safety net 
55.15 	program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph 
55.16 	(h), and 6, paragraph (h); and
55.17 	(2) costs incurred by the commissioner of administration in providing the reimbursement 
55.18 	payments described in clause (1).
55.19 	(c) The commissioner of management and budget shall transfer from the health care 
55.20 	access fund to the special revenue fund, beginning July 1, 2025, and each July 1 thereafter, 
55.21 	an amount equal to the amount to which the commissioner of administration certified 
55.22 	pursuant to paragraph (b).
55.23 		Subd. 6.Contingent transfer by commissioner. If subdivisions 2 and 3, or the 
55.24 	application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any 
55.25 	reason in a court of competent jurisdiction, the invalidity of subdivisions 2 and 3 does not 
55.26 	affect other provisions of this act, and the commissioner of management and budget shall 
55.27 	annually transfer from the health care access fund to the insulin safety net program account 
55.28 	an amount sufficient to implement subdivision 4.

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

55.30 	Sec. 25. Minnesota Statutes 2022, section 176.175, subdivision 2, is amended to read:
55.31 		Subd. 2.Nonassignability. No claim for compensation or settlement of a claim for 
55.32 	compensation owned by an injured employee or dependents is assignable. Except as otherwise 
55.33 	provided in this chapter, any claim for compensation owned by an injured employee or 
56.1 	dependents is exempt from seizure or sale for the payment of any debt or liability, up to a 
56.2 	total amount of $1,000,000 per claim and subsequent award.

56.3 	Sec. 26. Minnesota Statutes 2022, section 256L.01, is amended by adding a subdivision 
56.4 	to read:
56.5 		Subd. 5a.MinnesotaCare public option. "MinnesotaCare public option" or "public 
56.6 	option" means health coverage provided under section 256L.29.

56.7 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
56.8 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
56.9 	federal approval is obtained.

56.10 	Sec. 27. Minnesota Statutes 2022, section 256L.01, is amended by adding a subdivision 
56.11 	to read:
56.12 		Subd. 5b.MinnesotaCare public option enrollee. "MinnesotaCare public option 
56.13 	enrollee" or "public option enrollee" means an individual enrolled in MinnesotaCare under 
56.14 	section 256L.04, subdivision 15.

56.15 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
56.16 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
56.17 	federal approval is obtained.

56.18 	Sec. 28. Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 5, is amended 
56.19 	to read:
56.20 		Subd. 5.Cost-sharing. (a) Co-payments, coinsurance, and deductibles do not apply to 
56.21 	children under the age of 21 and to American Indians as defined in Code of Federal 
56.22 	Regulations, title 42, section 600.5., but do apply to public option enrollees as provided in 
56.23 	section 256L.29.
56.24 	(b) The commissioner must adjust co-payments, coinsurance, and deductibles for covered 
56.25 	services in a manner sufficient to maintain the actuarial value of the benefit to 94 percent, 
56.26 	except as provided for public option enrollees under section 256L.29. The cost-sharing 
56.27 	changes described in this paragraph do not apply to eligible recipients or services exempt 
56.28 	from cost-sharing under state law. The cost-sharing changes described in this paragraph 
56.29 	shall not be implemented prior to January 1, 2016.
57.1 	(c) The cost-sharing changes authorized under paragraph (b) must satisfy the requirements 
57.2 	for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations, 
57.3 	title 42, sections 600.510 and 600.520.
57.4 	(d) Cost-sharing for prescription drugs and related medical supplies to treat chronic 
57.5 	disease must comply with the requirements of section 62Q.481.
57.6 	(e) Co-payments, coinsurance, and deductibles do not apply to additional diagnostic 
57.7 	services or testing that a health care provider determines an enrollee requires after a 
57.8 	mammogram, as specified under section 62A.30, subdivision 5.
57.9 	(f) Cost-sharing must not apply to drugs used for tobacco and nicotine cessation or to 
57.10 	tobacco and nicotine cessation services covered under section 256B.0625, subdivision 68.
57.11 	(g) Co-payments, coinsurance, and deductibles do not apply to pre-exposure prophylaxis 
57.12 	(PrEP) and postexposure prophylaxis (PEP) medications when used for the prevention or 
57.13 	treatment of the human immunodeficiency virus (HIV).

57.14 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
57.15 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
57.16 	federal approval is obtained.

57.17 	Sec. 29. Minnesota Statutes 2022, section 256L.04, subdivision 1c, is amended to read:
57.18 		Subd. 1c.General requirements. To be eligible for MinnesotaCare, a person must meet 
57.19 	the eligibility requirements of this section. A person eligible for MinnesotaCare shall with 
57.20 	an income less than or equal to 200 percent of the federal poverty guidelines must not be 
57.21 	considered a qualified individual under section 1312 of the Affordable Care Act, and is not 
57.22 	eligible for enrollment in a qualified health plan offered through MNsure under chapter 
57.23 	62V.

57.24 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
57.25 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
57.26 	federal approval is obtained.

57.27 	Sec. 30. Minnesota Statutes 2022, section 256L.04, subdivision 7a, is amended to read:
57.28 		Subd. 7a.Ineligibility. Adults whose income is greater than the limits established under 
57.29 	this section may not enroll in the MinnesotaCare program, except as public option enrollees 
57.30 	under subdivision 15.

58.1 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
58.2 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
58.3 	federal approval is obtained.

58.4 	Sec. 31. Minnesota Statutes 2022, section 256L.04, is amended by adding a subdivision 
58.5 	to read:
58.6 		Subd. 15.Persons eligible for the public option. (a) Families and individuals with 
58.7 	income above the maximum income eligibility limit specified in subdivision 1 or 7 who 
58.8 	meet all other MinnesotaCare eligibility requirements are eligible for the MinnesotaCare 
58.9 	public option, subject to the enrollment limits and additional requirements established under 
58.10 	section 256L.29. Families and individuals enrolled in the public option under this subdivision 
58.11 	are MinnesotaCare enrollees, and all provisions of this chapter applying generally to 
58.12 	MinnesotaCare enrollees apply to public option enrollees unless otherwise specified.
58.13 	(b) Families and individuals may enroll in MinnesotaCare under this subdivision only 
58.14 	during an annual open enrollment period or special enrollment period, as designated by 
58.15 	MNsure in compliance with Code of Federal Regulations, title 45, sections 155.410 and 
58.16 	155.420.

58.17 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
58.18 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
58.19 	federal approval is obtained.

58.20 	Sec. 32. Minnesota Statutes 2022, section 256L.07, subdivision 1, is amended to read:
58.21 		Subdivision 1.General requirements. Individuals enrolled in MinnesotaCare under 
58.22 	section 256L.04, subdivision 1, and individuals enrolled in MinnesotaCare under section 
58.23 	256L.04, subdivision 7, whose income increases above 200 percent of the federal poverty 
58.24 	guidelines, are no longer eligible for the program and shall must be disenrolled by the 
58.25 	commissioner, unless the individuals continue MinnesotaCare enrollment through the public 
58.26 	option. For persons disenrolled under this subdivision, MinnesotaCare coverage terminates 
58.27 	the last day of the calendar month in which the commissioner sends advance notice according 
58.28 	to Code of Federal Regulations, title 42, section 431.211, that indicates the income of a 
58.29 	family or individual exceeds program income limits.

58.30 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
58.31 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
58.32 	federal approval is obtained.

59.1 	Sec. 33. Minnesota Statutes 2022, section 256L.12, subdivision 7, is amended to read:
59.2 		Subd. 7.Managed care plan vendor requirements. The following requirements apply 
59.3 	to all counties or vendors who contract with the Department of Human Services to serve 
59.4 	MinnesotaCare recipients. Managed care plan contractors:
59.5 	(1) shall authorize and arrange for the provision of the full range of services listed in 
59.6 	section 256L.03 in order to ensure appropriate health care is delivered to enrollees;
59.7 	(2) shall accept the prospective, per capita payment or other contractually defined payment 
59.8 	from the commissioner in return for the provision and coordination of covered health care 
59.9 	services for eligible individuals enrolled in the program;
59.10 	(3) may contract with other health care and social service practitioners to provide services 
59.11 	to enrollees;
59.12 	(4) shall provide for an enrollee grievance process as required by the commissioner and 
59.13 	set forth in the contract with the department;
59.14 	(5) shall retain all revenue from enrollee co-payments;
59.15 	(6) shall accept all eligible MinnesotaCare enrollees, without regard to health status or 
59.16 	previous utilization of health services;
59.17 	(7) shall demonstrate capacity to accept financial risk according to requirements specified 
59.18 	in the contract with the department. A health maintenance organization licensed under 
59.19 	chapter 62D, or a nonprofit health plan licensed under chapter 62C, is not required to 
59.20 	demonstrate financial risk capacity, beyond that which is required to comply with chapters 
59.21 	62C and 62D; and
59.22 	(8) shall submit information as required by the commissioner, including data required 
59.23 	for assessing enrollee satisfaction, quality of care, cost, and utilization of services.; and
59.24 	(9) shall reimburse health care providers for services provided to MinnesotaCare public 
59.25 	option enrollees at payment rates equal to or greater than the fee-for-service Medicare 
59.26 	payment rate for the same service, or for a similar service if the specific service is not 
59.27 	reimbursed under Medicare.

59.28 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
59.29 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
59.30 	federal approval is obtained.

60.1 	Sec. 34. [256L.29] MINNESOTACARE PUBLIC OPTION.
60.2 		Subdivision 1.MinnesotaCare requirements. The public option is part of the 
60.3 	MinnesotaCare program and all provisions of this chapter apply to the public option, unless 
60.4 	otherwise specified. These provisions include but are not limited to those related to covered 
60.5 	health services under section 256L.03; eligibility of undocumented noncitizens under section 
60.6 	256L.04, subdivision 10; eligibility requirements under section 256L.07; and premium 
60.7 	payment methods under section 256L.15.
60.8 		Subd. 2.Application process and eligibility determination. Individuals shall apply 
60.9 	for coverage under the public option as provided in section 62V.14. Enrollment in the public 
60.10 	option is limited to individuals eligible under section 256L.04, subdivision 15. The Board 
60.11 	of Directors of MNsure shall process public option applications and determine eligibility 
60.12 	for the public option as provided in section 62V.14.
60.13 		Subd. 3.Premium scale. Public option enrollees shall pay premiums for individual or 
60.14 	family coverage, as applicable, according to the following premium scale:

60.15
60.16
60.17		Household Income as 
Percentage of Federal Poverty 
Guidelines
		
60.18
60.19	Greater Than or 
Equal to
	Not Exceeding
	Required Premium Contribution
as Percentage of Household Income
	
60.20	201%
	250%
	4.88%
	
60.21	251%
	300%
	6.38%
	
60.22	301%
	400%
	7.88%
	
60.23	401%
	500%
	8.5%
	
60.24	501%
	550%
	9.01%
	
60.25	551% and over
	No maximum
	10%
	
60.26 		Subd. 4.Cost-sharing. (a) Public option enrollees are subject to the MinnesotaCare 
60.27 	cost-sharing requirements established under section 256L.03, subdivision 5, except that:
60.28 	(1) cost-sharing applies to all public option enrollees and there are no exemptions from 
60.29 	cost-sharing for specific groups of individuals, including but not limited to: (i) children 
60.30 	under age 21; (ii) pregnant women; and (iii) American Indians as defined in Code of Federal 
60.31 	Regulations, title 42, section 600.5, who have incomes greater than or equal to 300 percent 
60.32 	of the federal poverty guidelines;
60.33 	(2) the commissioner shall set cost-sharing for public option enrollees at an actuarial 
60.34 	value of 94 percent, except that the actuarial value for public option enrollees with household 
60.35 	incomes above 400 percent of the federal poverty guidelines may be lower than 94 percent;
61.1 	(3) the deductibles specified in paragraph (b) apply; and
61.2 	(4) out-of-pocket maximums for public option enrollees must not exceed those outlined 
61.3 	in Code of Federal Regulations, title 45, section 156.130.
61.4 	(b) Public option enrollees are subject to the following annual deductibles:
61.5 	(1) for household incomes 401 percent to 500 percent of federal poverty guidelines, 
61.6 	$500;
61.7 	(2) for household incomes 501 percent to 600 percent of federal poverty guidelines, 
61.8 	$1,000; and
61.9 	(3) for household incomes 601 percent of federal poverty guidelines or above, $1,500.
61.10 	(c) No annual deductible applies to public option enrollees with household incomes not 
61.11 	exceeding 400 percent of the federal poverty guidelines.
61.12 		Subd. 5.Enrollment limits. Enrollment in the public option is subject to the following 
61.13 	limits:
61.14 	(1) for the 2028 plan year, there must not be any enrollment of individuals with household 
61.15 	incomes exceeding 400 percent of the federal poverty guidelines;
61.16 	(2) for the 2029 plan year, there must not be any enrollment of individuals with household 
61.17 	incomes exceeding 550 percent of the federal poverty guidelines; and
61.18 	(3) for the 2030 plan year and subsequent plan years, no enrollment limit.
61.19 		Subd. 6.Contracting and service delivery. (a) The commissioner may contract with 
61.20 	managed care and county-based purchasing plans for the delivery of services to public 
61.21 	option enrollees using a procurement process that is separate and unique from that used to 
61.22 	contract for the delivery of services to MinnesotaCare enrollees who are not public option 
61.23 	enrollees.
61.24 	(b) The commissioner shall establish public option participation requirements for managed 
61.25 	care and county-based purchasing plans. Public option enrollees are not considered 
61.26 	MinnesotaCare enrollees for the purpose of the participation requirement specified in section 
61.27 	256B.0644.

61.28 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
61.29 	whichever is later. The commissioner of commerce shall notify the revisor of statutes when 
61.30 	federal approval is obtained.

62.1 	Sec. 35. [332C.01] DEFINITIONS.
62.2 		Subdivision 1.Application. For purposes of this chapter, the following terms have the 
62.3 	meanings given.
62.4 		Subd. 2.Collecting party. "Collecting party" means a party engaged in the collection 
62.5 	of medical debt. Collecting party does not include banks, credit unions, public officers, 
62.6 	garnishees, and other parties complying with a court order or statutory obligation to garnish 
62.7 	or levy a debtor's property.
62.8 		Subd. 3.Debtor. "Debtor" means a person obligated or alleged to be obligated to pay 
62.9 	any debt.
62.10 		Subd. 4.Medical debt. "Medical debt" means debt incurred primarily for medically 
62.11 	necessary health treatment or services. Medical debt does not include debt charged to a 
62.12 	credit card unless the credit card is issued under a credit plan offered solely for the payment 
62.13 	of health care treatment or services.
62.14 		Subd. 5.Medically necessary. "Medically necessary" means medically necessary as 
62.15 	defined in section 62J.805, subdivision 6.
62.16 		Subd. 6.Person. "Person" means any individual, partnership, association, or corporation.

62.17 	Sec. 36. [332C.02] PROHIBITED PRACTICES.
62.18 	No collecting party shall:
62.19 	(1) in a collection letter, publication, invoice, or any oral or written communication, 
62.20 	threaten wage garnishment or legal suit by a particular lawyer, unless the collecting party 
62.21 	has actually retained the lawyer to do so;
62.22 	(2) use or employ sheriffs or any other officer authorized to serve legal papers in 
62.23 	connection with the collection of a claim, except when performing their legally authorized 
62.24 	duties;
62.25 	(3) use or threaten to use methods of collection which violate Minnesota law;
62.26 	(4) furnish legal advice to debtors or represent that the collecting party is competent or 
62.27 	able to furnish legal advice to debtors;
62.28 	(5) communicate with debtors in a misleading or deceptive manner by falsely using the 
62.29 	stationery of a lawyer, forms or instruments which only lawyers are authorized to prepare, 
62.30 	or instruments which simulate the form and appearance of judicial process;
63.1 	(6) publish or cause to be published any list of debtors, use shame cards or shame 
63.2 	automobiles, advertise or threaten to advertise for sale any claim as a means of forcing 
63.3 	payment thereof, or use similar devices or methods of intimidation;
63.4 	(7) operate under a name or in a manner which falsely implies the collecting party is a 
63.5 	branch of or associated with any department of federal, state, county, or local government 
63.6 	or an agency thereof;
63.7 	(8) transact business or hold itself out as a debt settlement company, debt management 
63.8 	company, debt adjuster, or any person who settles, adjusts, prorates, pools, liquidates, or 
63.9 	pays the indebtedness of a debtor, unless there is no charge to the debtor, or the pooling or 
63.10 	liquidation is done pursuant to court order or under the supervision of a creditor's committee;
63.11 	(9) unless an exemption in the law exists, violate Code of Federal Regulations, title 12, 
63.12 	part 1006, while attempting to collect on any account, bill, or other indebtedness. For 
63.13 	purposes of this section, Public Law 95-109 and Code of Federal Regulations, title 12, part 
63.14 	1006, apply to collecting parties;
63.15 	(10) communicate with a debtor by use of an automatic telephone dialing system or an 
63.16 	artificial or prerecorded voice after the debtor expressly informs the collecting party to cease 
63.17 	communication utilizing an automatic telephone dialing system or an artificial or prerecorded 
63.18 	voice. For purposes of this clause, an automatic telephone dialing system or an artificial or 
63.19 	prerecorded voice includes but is not limited to (i) artificial intelligence chat bots, and (ii) 
63.20 	the usage of the term under the Telephone Consumer Protection Act, United States Code, 
63.21 	title 47, section 227(b)(1)(A);
63.22 	(11) in collection letters or publications, or in any oral or written communication, imply 
63.23 	or suggest that medically necessary health treatment or services will be denied as a result 
63.24 	of a medical debt;
63.25 	(12) when a debtor has a listed telephone number, enlist the aid of a neighbor or third 
63.26 	party to request that the debtor contact the collecting party, except a person who resides 
63.27 	with the debtor or a third party with whom the debtor has authorized with the collecting 
63.28 	party to place the request. This clause does not apply to a call back message left at the 
63.29 	debtor's place of employment which is limited solely to the collecting party's telephone 
63.30 	number and name;
63.31 	(13) when attempting to collect a medical debt, fail to provide the debtor with the full 
63.32 	name of the collecting party, as registered with the secretary of state;
64.1 	(14) fail to return any amount of overpayment from a debtor to the debtor or to the state 
64.2 	of Minnesota pursuant to the requirements of chapter 345;
64.3 	(15) accept currency or coin as payment for a medical debt without issuing an original 
64.4 	receipt to the debtor and maintaining a duplicate receipt in the debtor's payment records;
64.5 	(16) attempt to collect any amount, including any interest, fee, charge, or expense 
64.6 	incidental to the charge-off obligation, from a debtor unless the amount is expressly 
64.7 	authorized by the agreement creating the medical debt or is otherwise permitted by law;
64.8 	(17) falsify any documents with the intent to deceive;
64.9 	(18) when initially contacting a Minnesota debtor by mail to collect a medical debt, fail 
64.10 	to include a disclosure on the contact notice, in a type size or font which is equal to or larger 
64.11 	than the largest other type of type size or font used in the text of the notice, that includes 
64.12 	and identifies the Office of the Minnesota Attorney General's general telephone number, 
64.13 	and states: "You have the right to hire your own attorney to represent you in this matter.";
64.14 	(19) commence legal action to collect a medical debt outside the limitations period set 
64.15 	forth in section 541.053;
64.16 	(20) report to a credit reporting agency any medical debt which the collecting party 
64.17 	knows or should know is or was originally owed to a health care provider, as defined in 
64.18 	section 62J.805, subdivision 2; or
64.19 	(21) challenge a debtor's claim of exemption to garnishment or levy in a manner that is 
64.20 	baseless, frivolous, or otherwise in bad faith.

64.21 	Sec. 37. [332C.03] MEDICAL DEBT CREDIT REPORTING PROHIBITED.
64.22 	(a) A collecting party is prohibited from reporting medical debt to a consumer reporting 
64.23 	agency.
64.24 	(b) A consumer reporting agency is prohibited from making a consumer report containing 
64.25 	an item of information that the consumer reporting agency knows or should know concerns: 
64.26 	(1) medical information; or (2) debt arising from: (i) the provision of medical care, treatment, 
64.27 	services, devices, medicines; or (ii) procedures to maintain, diagnose, or treat a person's 
64.28 	physical or mental health.
64.29 	(c) For purposes of this section, "consumer report," "consumer reporting agency," and 
64.30 	"medical information" have the meanings given them in the Fair Credit Reporting Act, 
64.31 	United States Code, title 15, section 1681a.
65.1 	(d) This section also applies to collection agencies and debt buyers licensed under Chapter 
65.2 	332.

65.3 	Sec. 38. [332C.04] DEFENDING MEDICAL DEBT CASES.
65.4 	A debtor who successfully defends against a claim for payment of medical debt that is 
65.5 	alleged by a collecting party must be awarded the debtor's costs, including a reasonable 
65.6 	attorney fee as determined by the court, incurred in defending against the collecting party's 
65.7 	claim for debt payment. For the purposes of this section, a resolution mutually agreed upon 
65.8 	by the debtor and collecting party is not a successful defense.

65.9 	Sec. 39. [332C.05] ENFORCEMENT.
65.10 	(a) The attorney general may enforce this chapter under section 8.31.
65.11 	(b) A collecting party that violates this chapter is strictly liable to the debtor in question 
65.12 	for the sum of:
65.13 	(1) actual damage sustained by the debtor as a result of the violation;
65.14 	(2) additional damages as the court may allow, but not exceeding $1,000 per violation; 
65.15 	and
65.16 	(3) in the case of any successful action to enforce the foregoing, the costs of the action, 
65.17 	together with a reasonable attorney fee as determined by the court.
65.18 	(c) A collecting party that willfully and maliciously violates this chapter is strictly liable 
65.19 	to the debtor for three times the sums allowable under paragraph (b), clauses (1) and (2).
65.20 	(d) The dollar amount limit under paragraph (b), clause (2), changes on July 1 of each 
65.21 	even-numbered year in an amount equal to changes made in the Consumer Price Index, 
65.22 	compiled by the United States Bureau of Labor Statistics. The Consumer Price Index for 
65.23 	December 2024 is the reference base index. If the Consumer Price Index is revised, the 
65.24 	percentage of change made under this section must be calculated on the basis of the revised 
65.25 	Consumer Price Index. If a Consumer Price Index revision changes the reference base index, 
65.26 	a revised reference base index must be determined by multiplying the reference base index 
65.27 	that is effective at the time by the rebasing factor furnished by the Bureau of Labor Statistics.
65.28 	(e) If the Consumer Price Index is superseded, the Consumer Price Index referred to in 
65.29 	this section is the Consumer Price Index represented by the Bureau of Labor Statistics as 
65.30 	most accurately reflecting changes in the prices paid by consumers for consumer goods and 
65.31 	services.
66.1 	(f) The attorney general must publish the base reference index under paragraph (c) in 
66.2 	the State Register no later than September 1, 2024. The attorney general must calculate and 
66.3 	then publish the revised Consumer Price Index under paragraph (c) in the State Register no 
66.4 	later than September 1 each even-numbered year.
66.5 	(g) An action brought under this section benefits the public.
66.6 	(h) A collecting party may not be held liable in any action brought under this section if 
66.7 	the collecting party shows by a preponderance of evidence that the violation:
66.8 	(1) was not intentional and resulted from a bona fide error made notwithstanding the 
66.9 	maintenance of procedures reasonably adopted to avoid any such error; or
66.10 	(2) was the result of inaccurate or incorrect information provided to the collecting party 
66.11 	by a health care provider, as defined in section 62J.805, subdivision 2; a health carrier, as 
66.12 	that term is defined in section 62A.011, subdivision 2; or another collecting party currently 
66.13 	or previously engaged in collection of the medical debt in question.

66.14 	Sec. 40. Minnesota Statutes 2022, section 519.05, is amended to read:
66.15 	519.05 LIABILITY OF HUSBAND AND WIFE SPOUSES.
66.16 	(a) A spouse is not liable to a creditor for any debts of the other spouse. Where husband 
66.17 	and wife are living together, they shall be jointly and severally liable for necessary medical 
66.18 	services that have been furnished to either spouse, including any claims arising under section 
66.19 	246.53, 256B.15, 256D.16, or 261.04, and necessary household articles and supplies furnished 
66.20 	to and used by the family. Notwithstanding this paragraph, in a proceeding under chapter 
66.21 	518 the court may apportion such debt between the spouses.
66.22 	(b) Either spouse may close a credit card account or other unsecured consumer line of 
66.23 	credit on which both spouses are contractually liable, by giving written notice to the creditor.
66.24 	(c) Nothing in this section prevents a claim against an estate.

66.25 	Sec. 41. REQUEST FOR FEDERAL WAIVER.
 66.26 	(a) The commissioner of commerce, in cooperation with the commissioner of human 
66.27 	services and the Board of Directors of MNsure, shall submit a section 1332 waiver pursuant 
66.28 	to United States Code, title 42, section 18052, to the Secretary of Health and Human Services, 
66.29 	to obtain federal approval to implement this act. The commissioner of commerce shall also 
66.30 	seek through the waiver federal approval for the state to:
67.1 	(1) continue receiving federal Medicaid payments for Medicaid-eligible individuals and 
67.2 	federal basic health program payments for basic health program-eligible MinnesotaCare 
67.3 	individuals; and
67.4 	(2) receive federal pass-through money equal to the value of premium tax credits and 
67.5 	cost-sharing reductions that MinnesotaCare public option enrollees with household incomes 
67.6 	greater than 200 percent of the federal poverty guidelines would otherwise have received.
67.7 	(b) The commissioner of commerce is authorized to contract for any analyses, 
67.8 	certification, data, or other information required to complete the section 1332 waiver 
67.9 	application in accordance with Code of Federal Regulations, title 33, part 108; Code of 
67.10 	Federal Regulations, title 155, part 1308; and any other applicable federal law. The 
67.11 	commissioner must cooperate with the federal government to obtain waiver approval under 
67.12 	this section, and may provide any information the commissioner determines to be necessary 
67.13 	and advisable for waiver approval to the Secretary of Health and Human Services and the 
67.14 	Secretary of the Treasury.

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

67.16 	ARTICLE 4
67.17 	HEALTH INSURANCE

67.18 	Section 1. Minnesota Statutes 2022, section 62A.0411, is amended to read:
67.19 	62A.0411 MATERNITY CARE.
67.20 		Subdivision 1.Minimum inpatient care. Every health plan as defined in section 62Q.01, 
67.21 	subdivision 3, that provides maternity benefits must, consistent with other coinsurance, 
67.22 	co-payment, deductible, and related contract terms, provide coverage of a minimum of 48 
67.23 	hours of inpatient care following a vaginal delivery and a minimum of 96 hours of inpatient 
67.24 	care following a caesarean section for a mother and her newborn. The health plan shall not 
67.25 	provide any compensation or other nonmedical remuneration to encourage a mother and 
67.26 	newborn to leave inpatient care before the duration minimums specified in this section.
67.27 		Subd. 1a.Medical facility transfer. (a) If a health care provider acting within the 
67.28 	provider's scope of practice recommends that either the mother or newborn be transferred 
67.29 	to a different medical facility, every health plan must provide the coverage required under 
67.30 	subdivision 1 for the mother, newborn, and newborn siblings at both medical facilities. The 
67.31 	coverage required under this subdivision includes but is not limited to expenses related to 
67.32 	transferring all individuals from one medical facility to a different medical facility.
68.1 	(b) The coverage required under this subdivision must be provided without cost sharing, 
68.2 	including but not limited to deductible, co-pay, or coinsurance. The coverage required under 
68.3 	this paragraph must be provided without any limitation that is not generally applicable to 
68.4 	other coverages under the plan.
68.5 	(c) Notwithstanding paragraph (b), a health plan that is a high-deductible health plan in 
68.6 	conjunction with a health savings account must include cost-sharing for the coverage required 
68.7 	under this subdivision at the minimum level necessary to preserve the enrollee's ability to 
68.8 	make tax-exempt contributions and withdrawals from the health savings account as provided 
68.9 	in section 223 of the Internal Revenue Code of 1986.
68.10 		Subd. 2.Minimum postdelivery outpatient care. (a) The health plan must also provide 
68.11 	coverage for postdelivery outpatient care to a mother and her newborn if the duration of 
68.12 	inpatient care is less than the minimums provided in this section.
68.13 	(b) Postdelivery care consists of a minimum of one home visit by a registered nurse. 
68.14 	Services provided by the registered nurse include, but are not limited to, parent education, 
68.15 	assistance and training in breast and bottle feeding, and conducting any necessary and 
68.16 	appropriate clinical tests. The home visit must be conducted within four days following the 
68.17 	discharge of the mother and her child.
68.18 		Subd. 3.Health plan defined. For purposes of this section, "health plan" has the meaning 
68.19 	given in section 62Q.01, subdivision 3, and county-based purchasing plans.

68.20 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all policies, 
68.21 	plans, certificates, and contracts offered, issued, or renewed on or after that date.

68.22 	Sec. 2. Minnesota Statutes 2022, section 62A.15, is amended by adding a subdivision to 
68.23 	read:
68.24 		Subd. 3d.Pharmacist. All benefits provided by a policy or contract referred to in 
68.25 	subdivision 1 relating to expenses incurred for medical treatment or services provided by 
68.26 	a licensed physician must include services provided by a licensed pharmacist, according to 
68.27 	the requirements of section 151.01, to the extent a licensed pharmacist's services are within 
68.28 	the pharmacist's scope of practice.

68.29 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to policies 
68.30 	or contracts offered, issued, or renewed on or after that date.

69.1 	Sec. 3. Minnesota Statutes 2022, section 62A.15, subdivision 4, is amended to read:
69.2 		Subd. 4.Denial of benefits. (a) No carrier referred to in subdivision 1 may, in the 
69.3 	payment of claims to employees in this state, deny benefits payable for services covered by 
69.4 	the policy or contract if the services are lawfully performed by a licensed chiropractor, a 
69.5 	licensed optometrist, a registered nurse meeting the requirements of subdivision 3a, a licensed 
69.6 	physician assistant, or a licensed acupuncture practitioner, or a licensed pharmacist.
69.7 	(b) When carriers referred to in subdivision 1 make claim determinations concerning 
69.8 	the appropriateness, quality, or utilization of chiropractic health care for Minnesotans, any 
69.9 	of these determinations that are made by health care professionals must be made by, or 
69.10 	under the direction of, or subject to the review of licensed doctors of chiropractic.
69.11 	(c) When a carrier referred to in subdivision 1 makes a denial of payment claim 
69.12 	determination concerning the appropriateness, quality, or utilization of acupuncture services 
69.13 	for individuals in this state performed by a licensed acupuncture practitioner, a denial of 
69.14 	payment claim determination that is made by a health professional must be made by, under 
69.15 	the direction of, or subject to the review of a licensed acupuncture practitioner.

69.16 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to policies 
69.17 	or contracts offered, issued, or renewed on or after that date.

69.18 	Sec. 4. Minnesota Statutes 2022, section 62A.28, subdivision 2, is amended to read:
69.19 		Subd. 2.Required coverage. (a) Every policy, plan, certificate, or contract referred to 
69.20 	in subdivision 1 issued or renewed after August 1, 1987, must provide coverage for scalp 
69.21 	hair prostheses, including all equipment and accessories necessary for regular use of scalp 
69.22 	hair prostheses, worn for hair loss suffered as a result of a health condition, including but 
69.23 	not limited to alopecia areata or the treatment for cancer, unless there is a clinical basis for 
69.24 	limitation.
69.25 	(b) The coverage required by this section is subject to the co-payment, coinsurance, 
69.26 	deductible, and other enrollee cost-sharing requirements that apply to similar types of items 
69.27 	under the policy, plan, certificate, or contract and may be limited to one prosthesis per 
69.28 	benefit year.
69.29 	(c) The coverage required by this section for scalp hair prostheses is limited to $1,000 
69.30 	per benefit year.
69.31 	(d) A scalp hair prosthesis must be prescribed by a doctor to be covered under this 
69.32 	section.

70.1 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all policies, 
70.2 	plans, certificates, and contracts offered, issued, or renewed on or after that date.

70.3 	Sec. 5. Minnesota Statutes 2022, section 62D.02, subdivision 4, is amended to read:
70.4 		Subd. 4.Health maintenance organization.  "Health maintenance organization" means 
70.5 	a foreign or domestic nonprofit corporation organized under chapter 317A, or a local 
70.6 	governmental unit as defined in subdivision 11, controlled and operated as provided in 
70.7 	sections 62D.01 to 62D.30, which provides, either directly or through arrangements with 
70.8 	providers or other persons, comprehensive health maintenance services, or arranges for the 
70.9 	provision of these services, to enrollees on the basis of a fixed prepaid sum without regard 
70.10 	to the frequency or extent of services furnished to any particular enrollee.

70.11 	Sec. 6. Minnesota Statutes 2022, section 62D.02, subdivision 7, is amended to read:
70.12 		Subd. 7.Comprehensive health maintenance services. "Comprehensive health 
70.13 	maintenance services" means a set of comprehensive health services which the enrollees 
70.14 	might reasonably require to be maintained in good health including as a minimum, but not 
70.15 	limited to, emergency care, emergency ground ambulance transportation services, inpatient 
70.16 	hospital and physician care, outpatient health services and preventive health services. 
70.17 	Elective, induced abortion, except as medically necessary to prevent the death of the mother, 
70.18 	whether performed in a hospital, other abortion facility or the office of a physician, shall 
70.19 	not be mandatory for any health maintenance organization.

70.20 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
70.21 	plans offered, sold, issued, or renewed on or after that date.

70.22 	Sec. 7. Minnesota Statutes 2022, section 62D.03, subdivision 1, is amended to read:
70.23 		Subdivision 1.Certificate of authority required. Notwithstanding any law of this state 
70.24 	to the contrary, any foreign or domestic nonprofit corporation organized to do so or a local 
70.25 	governmental unit may apply to the commissioner of health for a certificate of authority to 
70.26 	establish and operate a health maintenance organization in compliance with sections 62D.01 
70.27 	to 62D.30. No person shall establish or operate a health maintenance organization in this 
70.28 	state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic 
70.29 	consideration in conjunction with a health maintenance organization or health maintenance 
70.30 	contract unless the organization has a certificate of authority under sections 62D.01 to 
70.31 	62D.30.

71.1 	Sec. 8. Minnesota Statutes 2022, section 62D.05, subdivision 1, is amended to read:
71.2 		Subdivision 1.Authority granted. Any nonprofit corporation or local governmental 
71.3 	unit may, upon obtaining a certificate of authority as required in sections 62D.01 to 62D.30, 
71.4 	operate as a health maintenance organization.

71.5 	Sec. 9. Minnesota Statutes 2022, section 62D.06, subdivision 1, is amended to read:
71.6 		Subdivision 1.Governing body composition; enrollee advisory body. The governing 
71.7 	body of any health maintenance organization which is a nonprofit corporation may include 
71.8 	enrollees, providers, or other individuals; provided, however, that after a health maintenance 
71.9 	organization which is a nonprofit corporation has been authorized under sections 62D.01 
71.10 	to 62D.30 for one year, at least 40 percent of the governing body shall be composed of 
71.11 	enrollees and members elected by the enrollees and members from among the enrollees and 
71.12 	members. For purposes of this section, "member" means a consumer who receives health 
71.13 	care services through a self-insured contract that is administered by the health maintenance 
71.14 	organization or its related third-party administrator. The number of members elected to the 
71.15 	governing body shall not exceed the number of enrollees elected to the governing body. An 
71.16 	enrollee or member elected to the governing board may not be a person:
71.17 	(1) whose occupation involves, or before retirement involved, the administration of 
71.18 	health activities or the provision of health services;
71.19 	(2) who is or was employed by a health care facility as a licensed health professional; 
71.20 	or
71.21 	(3) who has or had a direct substantial financial or managerial interest in the rendering 
71.22 	of a health service, other than the payment of a reasonable expense reimbursement or 
71.23 	compensation as a member of the board of a health maintenance organization.
71.24 	After a health maintenance organization which is a local governmental unit has been 
71.25 	authorized under sections 62D.01 to 62D.30 for one year, an enrollee advisory body shall 
71.26 	be established. The enrollees who make up this advisory body shall be elected by the enrollees 
71.27 	from among the enrollees.

71.28 	Sec. 10. [62D.085] TRANSACTION OVERSIGHT.
71.29 		Subdivision 1.Insurance provisions applicable to health maintenance 
71.30 	organizations.  (a) Health maintenance organizations are subject to sections 60A.135, 
71.31 	60A.136, 60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with 
72.1 	the provisions of these sections applicable to insurers. For purposes of applying these sections 
72.2 	to health maintenance organizations, "commissioner" means the commissioner of health.
72.3 	(b) Health maintenance organizations are subject to all regulations implementing sections 
72.4 	60D.17, 60D.18, and 60D.20 in Minnesota Rules, chapter 2720, and must comply with the 
72.5 	provisions of sections 60D.17, 60D.18, and 60D.20 applicable to insurers, unless the 
72.6 	commissioner of health adopts rules to implement this subdivision.
72.7 		Subd. 2.Notice on transfers. No person may acquire all or substantially all of the assets 
72.8 	of a domestic nonprofit health maintenance organization through any means unless, at the 
72.9 	time the agreement is entered into, the person has filed with the commissioner and has sent 
72.10 	to the health maintenance organization a statement containing the information required by 
72.11 	section 60D.17, including its implementing regulations, and the agreement and acquisition 
72.12 	have been approved by the commissioner of health in the manner prescribed for regulatory 
72.13 	approval in section 60D.17. The acquisition of assets subject to this subdivision must be 
72.14 	treated as an acquisition of control for purposes of applying section 60D.17 and its 
72.15 	implementing regulations to this subdivision.

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

72.17 	Sec. 11. [62D.1071] COVERAGE OF LICENSED PHARMACIST SERVICES.
72.18 		Subdivision 1.Pharmacist. All benefits provided by a health maintenance contract 
72.19 	relating to expenses incurred for medical treatment or services provided by a licensed 
72.20 	physician must include services provided by a licensed pharmacist to the extent a licensed 
72.21 	pharmacist's services are within the pharmacist's scope of practice.
72.22 		Subd. 2.Denial of benefits. When paying claims for enrollees in Minnesota, a health 
72.23 	maintenance organization must not deny payment for medical services covered by an 
72.24 	enrollee's health maintenance contract if the services are lawfully performed by a licensed 
72.25 	pharmacist.
72.26 		Subd. 3.Medication therapy management. This section does not apply to or affect 
72.27 	the coverage or reimbursement for medication therapy management services under section 
72.28 	62Q.676 or 256B.0625, subdivisions 5, 13h, and 28a.

72.29 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
72.30 	plans offered, issued, or renewed on or after that date.

73.1 	Sec. 12. Minnesota Statutes 2022, section 62D.19, is amended to read:
73.2 	62D.19 UNREASONABLE EXPENSES.
73.3 	No health maintenance organization shall incur or pay for any expense of any nature 
73.4 	which is unreasonably high in relation to the value of the service or goods provided. The 
73.5 	commissioner of health shall implement and enforce this section by rules adopted under 
73.6 	this section.
73.7 	In an effort to achieve the stated purposes of sections 62D.01 to 62D.30, in order to 
73.8 	safeguard the underlying nonprofit status of health maintenance organizations, and in order 
73.9 	to ensure that the payment of health maintenance organization money to major participating 
73.10 	entities results in a corresponding benefit to the health maintenance organization and its 
73.11 	enrollees, when determining whether an organization has incurred an unreasonable expense 
73.12 	in relation to a major participating entity, due consideration shall be given to, in addition 
73.13 	to any other appropriate factors, whether the officers and trustees of the health maintenance 
73.14 	organization have acted with good faith and in the best interests of the health maintenance 
73.15 	organization in entering into, and performing under, a contract under which the health 
73.16 	maintenance organization has incurred an expense. The commissioner has standing to sue, 
73.17 	on behalf of a health maintenance organization, officers or trustees of the health maintenance 
73.18 	organization who have breached their fiduciary duty in entering into and performing such 
73.19 	contracts.

73.20 	Sec. 13. Minnesota Statutes 2022, section 62D.20, subdivision 1, is amended to read:
73.21 		Subdivision 1.Rulemaking. The commissioner of health may, pursuant to chapter 14, 
73.22 	promulgate such reasonable rules as are necessary or proper to carry out the provisions of 
73.23 	sections 62D.01 to 62D.30. Included among such rules shall be those which provide minimum 
73.24 	requirements for the provision of comprehensive health maintenance services, as defined 
73.25 	in section 62D.02, subdivision 7, and reasonable exclusions therefrom. Nothing in such 
73.26 	rules shall force or require a health maintenance organization to provide elective, induced 
73.27 	abortions, except as medically necessary to prevent the death of the mother, whether 
73.28 	performed in a hospital, other abortion facility, or the office of a physician; the rules shall 
73.29 	provide every health maintenance organization the option of excluding or including elective, 
73.30 	induced abortions, except as medically necessary to prevent the death of the mother, as part 
73.31 	of its comprehensive health maintenance services.

73.32 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
73.33 	plans offered, sold, issued, or renewed on or after that date.

74.1 	Sec. 14. Minnesota Statutes 2022, section 62D.22, subdivision 5, is amended to read:
74.2 		Subd. 5.Other state law. Except as otherwise provided in sections 62A.01 to 62A.42
74.3 	and 62D.01 to 62D.30, and except as they eliminate elective, induced abortions, wherever 
74.4 	performed, from health or maternity benefits, provisions of the insurance laws and provisions 
74.5 	of nonprofit health service plan corporation laws shall not be applicable to any health 
74.6 	maintenance organization granted a certificate of authority under sections 62D.01 to 62D.30.

74.7 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
74.8 	plans offered, sold, issued, or renewed on or after that date.

74.9 	Sec. 15. Minnesota Statutes 2022, section 62E.02, subdivision 3, is amended to read:
74.10 		Subd. 3.Health maintenance organization. "Health maintenance organization" means 
74.11 	a nonprofit corporation licensed and operated as provided in chapter 62D.

74.12 	Sec. 16. Minnesota Statutes 2022, section 62Q.097, is amended by adding a subdivision 
74.13 	to read:
74.14 		Subd. 3.Prohibited application questions. An application for provider credentialing 
74.15 	must not:
74.16 	(1) require the provider to disclose past health conditions;
74.17 	(2) require the provider to disclose current health conditions, if the provider is being 
74.18 	treated so that the condition does not affect the provider's ability to practice medicine; or
74.19 	(3) require the disclosure of any health conditions that would not affect the provider's 
74.20 	ability to practice medicine in a competent, safe, and ethical manner.

74.21 	EFFECTIVE DATE. This section applies to applications for provider credentialing 
74.22 	submitted to a health plan company on or after January 1, 2025.

74.23 	Sec. 17. Minnesota Statutes 2022, section 62Q.14, is amended to read:
74.24 	62Q.14 RESTRICTIONS ON ENROLLEE SERVICES.
74.25 	No health plan company may restrict the choice of an enrollee as to where the enrollee 
74.26 	receives services related to:
74.27 	(1) the voluntary planning of the conception and bearing of children, provided that this 
74.28 	clause does not refer to abortion services;
74.29 	(2) the diagnosis of infertility;
75.1 	(3) the testing and treatment of a sexually transmitted disease; and
75.2 	(4) the testing for AIDS or other HIV-related conditions.

75.3 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
75.4 	plans offered, sold, issued, or renewed on or after that date.

75.5 	Sec. 18. Minnesota Statutes 2023 Supplement, section 62Q.522, subdivision 1, is amended 
75.6 	to read:
75.7 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
75.8 	(b) "Closely held for-profit entity" means an entity that:
75.9 	(1) is not a nonprofit entity;
75.10 	(2) has more than 50 percent of the value of its ownership interest owned directly or 
75.11 	indirectly by five or fewer owners; and
75.12 	(3) has no publicly traded ownership interest.
75.13 	For purposes of this paragraph:
75.14 	(i) ownership interests owned by a corporation, partnership, limited liability company, 
75.15 	estate, trust, or similar entity are considered owned by that entity's shareholders, partners, 
75.16 	members, or beneficiaries in proportion to their interest held in the corporation, partnership, 
75.17 	limited liability company, estate, trust, or similar entity;
75.18 	(ii) ownership interests owned by a nonprofit entity are considered owned by a single 
75.19 	owner;
75.20 	(iii) ownership interests owned by all individuals in a family are considered held by a 
75.21 	single owner. For purposes of this item, "family" means brothers and sisters, including 
75.22 	half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
75.23 	(iv) if an individual or entity holds an option, warrant, or similar right to purchase an 
75.24 	ownership interest, the individual or entity is considered to be the owner of those ownership 
75.25 	interests.
75.26 	(c) (b) "Contraceptive method" means a drug, device, or other product approved by the 
75.27 	Food and Drug Administration to prevent unintended pregnancy.
75.28 	(d) (c) "Contraceptive service" means consultation, examination, procedures, and medical 
75.29 	services related to the prevention of unintended pregnancy, excluding vasectomies. This 
75.30 	includes but is not limited to voluntary sterilization procedures, patient education, counseling 
75.31 	on contraceptives, and follow-up services related to contraceptive methods or services, 
76.1 	management of side effects, counseling for continued adherence, and device insertion or 
76.2 	removal.
76.3 	(e) "Eligible organization" means an organization that opposes providing coverage for 
76.4 	some or all contraceptive methods or services on account of religious objections and that 
76.5 	is:
76.6 	(1) organized as a nonprofit entity and holds itself out to be religious; or
76.7 	(2) organized and operates as a closely held for-profit entity, and the organization's 
76.8 	owners or highest governing body has adopted, under the organization's applicable rules of 
76.9 	governance and consistent with state law, a resolution or similar action establishing that the 
76.10 	organization objects to covering some or all contraceptive methods or services on account 
76.11 	of the owners' sincerely held religious beliefs.
76.12 	(f) "Exempt organization" means an organization that is organized and operates as a 
76.13 	nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal 
76.14 	Revenue Code of 1986, as amended.
76.15 	(g) (d) "Medical necessity" includes but is not limited to considerations such as severity 
76.16 	of side effects, difference in permanence and reversibility of a contraceptive method or 
76.17 	service, and ability to adhere to the appropriate use of the contraceptive method or service, 
76.18 	as determined by the attending provider.
76.19 	(h) (e) "Therapeutic equivalent version" means a drug, device, or product that can be 
76.20 	expected to have the same clinical effect and safety profile when administered to a patient 
76.21 	under the conditions specified in the labeling, and that:
76.22 	(1) is approved as safe and effective;
76.23 	(2) is a pharmaceutical equivalent: (i) containing identical amounts of the same active 
76.24 	drug ingredient in the same dosage form and route of administration; and (ii) meeting 
76.25 	compendial or other applicable standards of strength, quality, purity, and identity;
76.26 	(3) is bioequivalent in that:
76.27 	(i) the drug, device, or product does not present a known or potential bioequivalence 
76.28 	problem and meets an acceptable in vitro standard; or
76.29 	(ii) if the drug, device, or product does present a known or potential bioequivalence 
76.30 	problem, it is shown to meet an appropriate bioequivalence standard;
76.31 	(4) is adequately labeled; and
76.32 	(5) is manufactured in compliance with current manufacturing practice regulations.

77.1 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
77.2 	plans offered, sold, issued, or renewed on or after that date.

77.3 	Sec. 19. [62Q.524] COVERAGE OF ABORTIONS AND ABORTION-RELATED 
77.4 	SERVICES.
77.5 		Subdivision 1.Definition. For purposes of this section, "abortion" means any medical 
77.6 	treatment intended to induce the termination of a pregnancy with a purpose other than 
77.7 	producing a live birth.
77.8 		Subd. 2.Required coverage. (a) A health plan must provide coverage for abortions and 
77.9 	abortion-related services, including preabortion services and follow-up services.
77.10 	(b) A health plan must not impose on the coverage under this section any co-payment, 
77.11 	coinsurance, deductible, or other enrollee cost-sharing that is greater than the cost-sharing 
77.12 	that applies to similar services covered under the health plan.
77.13 	(c) A health plan must not impose any limitation on the coverage under this section, 
77.14 	including but not limited to any utilization review, prior authorization, referral requirements, 
77.15 	restrictions, or delays, that is not generally applicable to other coverages under the plan.
77.16 		Subd. 3.Exclusion. This section does not apply to managed care organizations or 
77.17 	county-based purchasing plans when the plan provides coverage to public health care 
77.18 	program enrollees under chapter 256B or 256L.

77.19 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
77.20 	plans offered, sold, issued, or renewed on or after that date.

77.21 	Sec. 20. [62Q.585] GENDER-AFFIRMING CARE COVERAGE; MEDICALLY 
77.22 	NECESSARY CARE.
77.23 		Subdivision 1.Requirement. No health plan that covers physical or mental health 
77.24 	services may be offered, sold, issued, or renewed in this state that:
77.25 	(1) excludes coverage for medically necessary gender-affirming care; or
77.26 	(2) requires gender-affirming treatments to satisfy a definition of "medically necessary 
77.27 	care," "medical necessity," or any similar term that is more restrictive than the definition 
77.28 	provided in subdivision 2.
77.29 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
77.30 	meanings given.
78.1 	(b) "Gender-affirming care" means all medical, surgical, counseling, or referral services, 
78.2 	including telehealth services, that an individual may receive to support and affirm the 
78.3 	individual's gender identity or gender expression and that are legal under the laws of this 
78.4 	state.
78.5 	(c) "Health plan" has the meaning given in section 62Q.01, subdivision 3, but includes 
78.6 	the coverages listed in section 62A.011, subdivision 3, clauses (7) and (10).
78.7 	(d) "Medically necessary care" means health care services appropriate in terms of type, 
78.8 	frequency, level, setting, and duration to the enrollee's diagnosis or condition and diagnostic 
78.9 	testing and preventive services. Medically necessary care must be consistent with generally 
78.10 	accepted practice parameters as determined by health care providers in the same or similar 
78.11 	general specialty as typically manages the condition, procedure, or treatment at issue and 
78.12 	must:
78.13 	(1) help restore or maintain the enrollee's health; or
78.14 	(2) prevent deterioration of the enrollee's condition.

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

78.16 	Sec. 21. [62Q.665] COVERAGE FOR ORTHOTIC AND PROSTHETIC DEVICES.
78.17 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
78.18 	the meanings given.
78.19 	(b) "Accredited facility" means any entity that is accredited to provide comprehensive 
78.20 	orthotic or prosthetic devices or services by a Centers for Medicare and Medicaid Services 
78.21 	approved accrediting agency.
78.22 	(c) "Orthosis" means:
78.23 	(1) an external medical device that is:
78.24 	(i) custom-fabricated or custom-fitted to a specific patient based on the patient's unique 
78.25 	physical condition;
78.26 	(ii) applied to a part of the body to correct a deformity, provide support and protection, 
78.27 	restrict motion, improve function, or relieve symptoms of a disease, syndrome, injury, or 
78.28 	postoperative condition; and
78.29 	(iii) deemed medically necessary by a prescribing physician or licensed health care 
78.30 	provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies, 
78.31 	and services; and
79.1 	(2) any provision, repair, or replacement of a device that is furnished or performed by:
79.2 	(i) an accredited facility in comprehensive orthotic services; or
79.3 	(ii) a health care provider licensed in Minnesota and operating within the provider's 
79.4 	scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies, 
79.5 	or services.
79.6 	(d) "Orthotics" means:
79.7 	(1) the science and practice of evaluating, measuring, designing, fabricating, assembling, 
79.8 	fitting, adjusting, or servicing and providing the initial training necessary to accomplish the 
79.9 	fitting of an orthotic device for the support, correction, or alleviation of a neuromuscular 
79.10 	or musculoskeletal dysfunction, disease, injury, or deformity;
79.11 	(2) evaluation, treatment, and consultation related to an orthotic device;
79.12 	(3) basic observation of gait and postural analysis;
79.13 	(4) assessing and designing orthosis to maximize function and provide support and 
79.14 	alignment necessary to prevent or correct a deformity or to improve the safety and efficiency 
79.15 	of mobility and locomotion;
79.16 	(5) continuing patient care to assess the effect of an orthotic device on the patient's 
79.17 	tissues; and
79.18 	(6) proper fit and function of the orthotic device by periodic evaluation.
79.19 	(e) "Prosthesis" means:
79.20 	(1) an external medical device that is:
79.21 	(i) used to replace or restore a missing limb, appendage, or other external human body 
79.22 	part; and
79.23 	(ii) deemed medically necessary by a prescribing physician or licensed health care 
79.24 	provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies, 
79.25 	and services; and
79.26 	(2) any provision, repair, or replacement of a device that is furnished or performed by:
79.27 	(i) an accredited facility in comprehensive prosthetic services; or
79.28 	(ii) a health care provider licensed in Minnesota and operating within the provider's 
79.29 	scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies, 
79.30 	or services.
80.1 	(f) "Prosthetics" means:
80.2 	(1) the science and practice of evaluating, measuring, designing, fabricating, assembling, 
80.3 	fitting, aligning, adjusting, or servicing, as well as providing the initial training necessary 
80.4 	to accomplish the fitting of, a prosthesis through the replacement of external parts of a 
80.5 	human body lost due to amputation or congenital deformities or absences;
80.6 	(2) the generation of an image, form, or mold that replicates the patient's body segment 
80.7 	and that requires rectification of dimensions, contours, and volumes for use in the design 
80.8 	and fabrication of a socket to accept a residual anatomic limb to, in turn, create an artificial 
80.9 	appendage that is designed either to support body weight or to improve or restore function 
80.10 	or anatomical appearance, or both;
80.11 	(3) observational gait analysis and clinical assessment of the requirements necessary to 
80.12 	refine and mechanically fix the relative position of various parts of the prosthesis to maximize 
80.13 	function, stability, and safety of the patient;
80.14 	(4) providing and continuing patient care in order to assess the prosthetic device's effect 
80.15 	on the patient's tissues; and
80.16 	(5) assuring proper fit and function of the prosthetic device by periodic evaluation.
80.17 		Subd. 2.Coverage. (a) A health plan must provide coverage for orthotic and prosthetic 
80.18 	devices, supplies, and services, including repair and replacement, at least equal to the 
80.19 	coverage provided under federal law for health insurance for the aged and disabled under 
80.20 	sections 1832, 1833, and 1834 of the Social Security Act, United States Code, title 42, 
80.21 	sections 1395k, 1395l, and 1395m, but only to the extent consistent with this section.
80.22 	(b) A health plan must not subject orthotic and prosthetic benefits to separate financial 
80.23 	requirements that apply only with respect to those benefits. A health plan may impose 
80.24 	co-payment and coinsurance amounts on those benefits, except that any financial 
80.25 	requirements that apply to such benefits must not be more restrictive than the financial 
80.26 	requirements that apply to the health plan's medical and surgical benefits, including those 
80.27 	for internal restorative devices.
80.28 	(c) A health plan may limit the benefits for, or alter the financial requirements for, 
80.29 	out-of-network coverage of prosthetic and orthotic devices, except that the restrictions and 
80.30 	requirements that apply to those benefits must not be more restrictive than the financial 
80.31 	requirements that apply to the out-of-network coverage for the health plan's medical and 
80.32 	surgical benefits.
81.1 	(d) A health plan must cover orthoses and prostheses when furnished under an order by 
81.2 	a prescribing physician or licensed health care prescriber who has authority in Minnesota 
81.3 	to prescribe orthoses and prostheses, and that coverage for orthotic and prosthetic devices, 
81.4 	supplies, accessories, and services must include those devices or device systems, supplies, 
81.5 	accessories, and services that are customized to the covered individual's needs.
81.6 	(e) A health plan must cover orthoses and prostheses determined by the enrollee's provider 
81.7 	to be the most appropriate model that meets the medical needs of the enrollee for purposes 
81.8 	of performing physical activities, as applicable, including but not limited to running, biking, 
81.9 	and swimming, and maximizing the enrollee's limb function.
81.10 	(f) A health plan must cover orthoses and prostheses for showering or bathing.
81.11 		Subd. 3.Prior authorization. A health plan may require prior authorization for orthotic 
81.12 	and prosthetic devices, supplies, and services in the same manner and to the same extent as 
81.13 	prior authorization is required for any other covered benefit.

81.14 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all health 
81.15 	plans offered, issued, or renewed on or after that date.

81.16 	Sec. 22. [62Q.6651] MEDICAL NECESSITY AND NONDISCRIMINATION 
81.17 	STANDARDS FOR COVERAGE OF PROSTHETICS OR ORTHOTICS.
81.18 	(a) When performing a utilization review for a request for coverage of prosthetic or 
81.19 	orthotic benefits, a health plan company shall apply the most recent version of evidence-based 
81.20 	treatment and fit criteria as recognized by relevant clinical specialists.
81.21 	(b) A health plan company shall render utilization review determinations in a 
81.22 	nondiscriminatory manner and shall not deny coverage for habilitative or rehabilitative 
81.23 	benefits, including prosthetics or orthotics, solely on the basis of an enrollee's actual or 
81.24 	perceived disability.
81.25 	(c) A health plan company shall not deny a prosthetic or orthotic benefit for an individual 
81.26 	with limb loss or absence that would otherwise be covered for a nondisabled person seeking 
81.27 	medical or surgical intervention to restore or maintain the ability to perform the same 
81.28 	physical activity.
81.29 	(d) A health plan offered, issued, or renewed in Minnesota that offers coverage for 
81.30 	prosthetics and custom orthotic devices shall include language describing an enrollee's rights 
81.31 	pursuant to paragraphs (b) and (c) in its evidence of coverage and any benefit denial letters.
82.1 	(e) A health plan that provides coverage for prosthetic or orthotic services shall ensure 
82.2 	access to medically necessary clinical care and to prosthetic and custom orthotic devices 
82.3 	and technology from not less than two distinct prosthetic and custom orthotic providers in 
82.4 	the plan's provider network located in Minnesota. In the event that medically necessary 
82.5 	covered orthotics and prosthetics are not available from an in-network provider, the health 
82.6 	plan company shall provide processes to refer a member to an out-of-network provider and 
82.7 	shall fully reimburse the out-of-network provider at a mutually agreed upon rate less member 
82.8 	cost sharing determined on an in-network basis.
82.9 	(f) If coverage for prosthetic or custom orthotic devices is provided, payment shall be 
82.10 	made for the replacement of a prosthetic or custom orthotic device or for the replacement 
82.11 	of any part of the devices, without regard to continuous use or useful lifetime restrictions, 
82.12 	if an ordering health care provider determines that the provision of a replacement device, 
82.13 	or a replacement part of a device, is necessary because:
82.14 	(1) of a change in the physiological condition of the patient;
82.15 	(2) of an irreparable change in the condition of the device or in a part of the device; or
82.16 	(3) the condition of the device, or the part of the device, requires repairs and the cost of 
82.17 	the repairs would be more than 60 percent of the cost of a replacement device or of the part 
82.18 	being replaced.
82.19 	(g) Confirmation from a prescribing health care provider may be required if the prosthetic 
82.20 	or custom orthotic device or part being replaced is less than three years old.

82.21 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all health 
82.22 	plans offered, issued, or renewed on or after that date.

82.23 	Sec. 23. [62Q.666] INTERMITTENT CATHETERS.
82.24 		Subdivision 1.Required coverage. A health plan must provide coverage for intermittent 
82.25 	urinary catheters and insertion supplies if intermittent catheterization is recommended by 
82.26 	the enrollee's health care provider. At least 180 intermittent catheters per month with insertion 
82.27 	supplies must be covered unless a lesser amount is prescribed by the enrollee's health care 
82.28 	provider. A health plan providing coverage under the medical assistance program may be 
82.29 	required to provide coverage for more than 180 intermittent catheters per month with 
82.30 	insertion supplies.
82.31 		Subd. 2.Cost-sharing requirements. A health plan is prohibited from imposing a 
82.32 	deductible, co-payment, coinsurance, or other restriction on intermittent catheters and 
82.33 	insertion supplies that the health plan does not apply to durable medical equipment in general.

83.1 	EFFECTIVE DATE. This section is effective for any health plan issued or renewed 
83.2 	on or after January 1, 2025.

83.3 	Sec. 24. [62Q.679] RELIGIONS OBJECTIONS.
83.4 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
83.5 	(b) "Closely held for-profit entity" means an entity that is not a nonprofit entity, has 
83.6 	more than 50 percent of the value of its ownership interest owned directly or indirectly by 
83.7 	five or fewer owners, and has no publicly traded ownership interest. For purposes of this 
83.8 	paragraph:
83.9 	(1) ownership interests owned by a corporation, partnership, limited liability company, 
83.10 	estate, trust, or similar entity are considered owned by that entity's shareholders, partners, 
83.11 	members, or beneficiaries in proportion to their interest held in the corporation, partnership, 
83.12 	limited liability company, estate, trust, or similar entity;
83.13 	(2) ownership interests owned by a nonprofit entity are considered owned by a single 
83.14 	owner;
83.15 	(3) ownership interests owned by all individuals in a family are considered held by a 
83.16 	single owner. For purposes of this item, "family" means brothers and sisters including 
83.17 	half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
83.18 	(4) if an individual or entity holds an option, warrant, or similar right to purchase an 
83.19 	ownership interest, the individual or entity is considered to be the owner of those ownership 
83.20 	interests.
83.21 	(c) "Eligible organization" means an organization that opposes providing coverage under 
83.22 	section 62Q.522, 62Q.524, or 62Q.585 on account of religious objections and that is:
83.23 	(1) organized as a nonprofit entity and holds itself out to be religious; or
83.24 	(2) organized and operates as a closely held for-profit entity, and the organization's 
83.25 	owners or highest governing body has adopted, under the organization's applicable rules of 
83.26 	governance and consistent with state law, a resolution or similar action establishing that the 
83.27 	organization objects to covering some or all health benefits under section 62Q.522, 62Q.524, 
83.28 	or 62Q.585 on account of the owners' sincerely held religious beliefs.
83.29 	(d) "Exempt organization" means an organization that is organized and operates as a 
83.30 	nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal 
83.31 	Revenue Code of 1986, as amended.
84.1 		Subd. 2.Exemption. (a) An exempt organization is not required to provide coverage 
84.2 	under section 62Q.522, 62Q.524, or 62Q.585 if the exempt organization has religious 
84.3 	objections to the coverage. An exempt organization that chooses to not provide coverage 
84.4 	pursuant to this paragraph must notify employees as part of the hiring process and to all 
84.5 	employees at least 30 days before:
84.6 	(1) an employee enrolls in the health plan; or
84.7 	(2) the effective date of the health plan, whichever occurs first.
84.8 	(b) If the exempt organization provides partial coverage under section 62Q.522, 62Q.524, 
84.9 	or 62Q.585, the notice required under paragraph (a) must provide a list of the portions of 
84.10 	the coverage that the organization refuses to cover.
84.11 		Subd. 3.Accommodation for eligible organizations. (a) A health plan established or 
84.12 	maintained by an eligible organization complies with the coverage requirements of sections 
84.13 	62Q.522, 62Q.524, and 62Q.585, with respect to the health benefits identified in the notice 
84.14 	under this paragraph, if the eligible organization provides notice to any health plan company 
84.15 	the eligible organization contracts with that it is an eligible organization and that the eligible 
84.16 	organization has a religious objection to coverage for all or a subset of the health benefits 
84.17 	under sections 62Q.522, 62Q.524, and 62Q.585.
84.18 	(b) The notice from an eligible organization to a health plan company under paragraph 
84.19 	(a) must include: (1) the name of the eligible organization; (2) a statement that the eligible 
84.20 	organization objects to coverage for some or all of the health benefits under sections 62Q.522, 
84.21 	62Q.524, and 62Q.585, including a list of the health benefits the eligible organization objects 
84.22 	to, if applicable; and (3) the health plan name. The notice must be executed by a person 
84.23 	authorized to provide notice on behalf of the eligible organization.
84.24 	(c) An eligible organization must provide a copy of the notice under paragraph (a) to 
84.25 	prospective employees as part of the hiring process and to all employees at least 30 days 
84.26 	before:
84.27 	(1) an employee enrolls in the health plan; or
84.28 	(2) the effective date of the health plan, whichever occurs first.
84.29 	(d) A health plan company that receives a copy of the notice under paragraph (a) with 
84.30 	respect to a health plan established or maintained by an eligible organization must, for all 
84.31 	future enrollments in the health plan:
84.32 	(1) expressly exclude coverage for those health benefits identified in the notice under 
84.33 	paragraph (a) from the health plan; and
85.1 	(2) provide separate payments for any health benefits required to be covered under 
85.2 	sections 62Q.522, 62Q.524, and 62Q.585 for an enrollee as long as the enrollee remains 
85.3 	enrolled in the health plan.
85.4 	(e) The health plan company must not impose any cost-sharing requirements, including 
85.5 	co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or 
85.6 	other charge for the health benefits under section 62Q.522 on the enrollee. The health plan 
85.7 	company must not directly or indirectly impose any premium, fee, or other charge for the 
85.8 	health benefits under section 62Q.522, 62Q.524, or 62Q.585 on the eligible organization 
85.9 	or health plan.
85.10 	(f) On January 1, 2025, and every year thereafter a health plan company must notify the 
85.11 	commissioner, in a manner determined by the commissioner, of the number of eligible 
85.12 	organizations granted an accommodation under this subdivision.

85.13 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
85.14 	plans offered, sold, issued, or renewed on or after that date.

85.15 	Sec. 25. [214.41] PHYSICIAN WELLNESS PROGRAM.
85.16 		Subdivision 1.Definition. For the purposes of this section, "physician wellness program" 
85.17 	means a program of evaluation, counseling, or other modality to address an issue related to 
85.18 	career fatigue or wellness related to work stress for physicians licensed under chapter 147 
85.19 	that is administered by a statewide association that is exempt from taxation under United 
85.20 	States Code, title 26, section 501(c)(6), and that primarily represents physicians and 
85.21 	osteopaths of multiple specialties. Physician wellness program does not include the provision 
85.22 	of services intended to monitor for impairment under the authority of section 214.31.
85.23 		Subd. 2.Confidentiality. Any record of a person's participation in a physician wellness 
85.24 	program is confidential and not subject to discovery, subpoena, or a reporting requirement 
85.25 	to the applicable board, unless the person voluntarily provides for written release of the 
85.26 	information or the disclosure is required to meet the licensee's obligation to report according 
85.27 	to section 147.111.
85.28 		Subd. 3.Civil liability. Any person, agency, institution, facility, or organization employed 
85.29 	by, contracting with, or operating a physician wellness program is immune from civil liability 
85.30 	for any action related to their duties in connection with a physician wellness program when 
85.31 	acting in good faith.

86.1 	Sec. 26. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 3a, is 
86.2 	amended to read:
86.3 		Subd. 3a.Gender-affirming services. Medical assistance covers gender-affirming 
86.4 	servicescare, as defined in section 62Q.585.

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

86.6 	Sec. 27. Minnesota Statutes 2022, section 256B.0625, subdivision 12, is amended to read:
86.7 		Subd. 12.Eyeglasses, and dentures, and prosthetic and orthotic devices. (a) Medical 
86.8 	assistance covers eyeglasses, and dentures, and prosthetic and orthotic devices if prescribed 
86.9 	by a licensed practitioner.
86.10 	(b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner" 
86.11 	includes a physician, an advanced practice registered nurse, a physician assistant, or a 
86.12 	podiatrist.

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

86.14 	Sec. 28. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 16, is 
86.15 	amended to read:
86.16 		Subd. 16.Abortion services. Medical assistance covers abortion services determined 
86.17 	to be medically necessary by the treating provider and delivered in accordance with all 
86.18 	applicable Minnesota laws abortions and abortion-related services, including preabortion 
86.19 	services and follow-up services.

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

86.23 	Sec. 29. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
86.24 	to read:
86.25 		Subd. 72.Orthotic and prosthetic devices. Medical assistance covers orthotic and 
86.26 	prosthetic devices, supplies, and services according to section 256B.066.

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

87.1 	Sec. 30. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
87.2 	to read:
87.3 		Subd. 73.Scalp hair prostheses. Medical assistance covers scalp hair prostheses 
87.4 	prescribed for hair loss suffered as a result of treatment for cancer. Medical assistance must 
87.5 	meet the requirements that would otherwise apply to a health plan under section 62A.28, 
87.6 	except for the limitation on coverage required per benefit year set forth in section 62A.28, 
87.7 	subdivision 2, paragraph (c).

87.8 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to all policies, 
87.9 	plans, certificates, and contracts offered, issued, or renewed on or after that date.

87.10 	Sec. 31. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
87.11 	to read:
87.12 		Subd. 74.Intermittent catheters. Medical assistance covers intermittent urinary catheters 
87.13 	and insertion supplies if intermittent catheterization is recommended by the enrollee's health 
87.14 	care provider. Medical assistance must meet the requirements that would otherwise apply 
87.15 	to a health plan under section 62Q.665.

87.16 	Sec. 32. [256B.066] ORTHOTIC AND PROSTHETIC DEVICES, SUPPLIES, AND 
87.17 	SERVICES.
87.18 		Subdivision 1.Definitions.  All terms used in this section have the meanings given them 
87.19 	in section 62Q.665, subdivision 1.
87.20 		Subd. 2.Coverage requirements.  (a) Medical assistance covers orthotic and prosthetic 
87.21 	devices, supplies, and services:
87.22 	(1) furnished under an order by a prescribing physician or licensed health care prescriber 
87.23 	who has authority in Minnesota to prescribe orthoses and prostheses. Coverage for orthotic 
87.24 	and prosthetic devices, supplies, accessories, and services under this clause includes those 
87.25 	devices or device systems, supplies, accessories, and services that are customized to the 
87.26 	enrollee's needs;
87.27 	(2) determined by the enrollee's provider to be the most appropriate model that meets 
87.28 	the medical needs of the enrollee for purposes of performing physical activities, as applicable, 
87.29 	including but not limited to running, biking, and swimming, and maximizing the enrollee's 
87.30 	limb function; or
87.31 	(3) for showering or bathing.
88.1 	(b) The coverage set forth in paragraph (a) includes the repair and replacement of those 
88.2 	orthotic and prosthetic devices, supplies, and services described therein.
88.3 	(c) Coverage of a prosthetic or orthotic benefit must not be denied for an individual with 
88.4 	limb loss or absence that would otherwise be covered for a nondisabled person seeking 
88.5 	medical or surgical intervention to restore or maintain the ability to perform the same 
88.6 	physical activity.
88.7 	(d) If coverage for prosthetic or custom orthotic devices is provided, payment must be 
88.8 	made for the replacement of a prosthetic or custom orthotic device or for the replacement 
88.9 	of any part of the devices, without regard to useful lifetime restrictions, if an ordering health 
88.10 	care provider determines that the provision of a replacement device, or a replacement part 
88.11 	of a device, is necessary because:
88.12 	(1) of a change in the physiological condition of the enrollee;
88.13 	(2) of an irreparable change in the condition of the device or in a part of the device; or
88.14 	(3) the condition of the device, or the part of the device, requires repairs and the cost of 
88.15 	the repairs would be more than 60 percent of the cost of a replacement device or of the part 
88.16 	being replaced.
88.17 		Subd. 3.Restrictions on coverage. (a) Prior authorization may be required for orthotic 
88.18 	and prosthetic devices, supplies, and services.
88.19 	(b) A utilization review for a request for coverage of prosthetic or orthotic benefits must 
88.20 	apply the most recent version of evidence-based treatment and fit criteria as recognized by 
88.21 	relevant clinical specialists.
88.22 	(c) Utilization review determinations must be rendered in a nondiscriminatory manner 
88.23 	and shall not deny coverage for habilitative or rehabilitative benefits, including prosthetics 
88.24 	or orthotics, solely on the basis of an enrollee's actual or perceived disability.
88.25 	(d) Evidence of coverage and any benefit denial letters must include language describing 
88.26 	an enrollee's rights pursuant to paragraphs (b) and (c).
88.27 	(e) Confirmation from a prescribing health care provider may be required if the prosthetic 
88.28 	or custom orthotic device or part being replaced is less than three years old.
88.29 		Subd. 4.Managed care plan access to care.  (a) Managed care plans and county-based 
88.30 	purchasing plans subject to this section must ensure access to medically necessary clinical 
88.31 	care and to prosthetic and custom orthotic devices and technology from at least two distinct 
88.32 	prosthetic and custom orthotic providers in the plan's provider network located in Minnesota.
89.1 	(b) In the event that medically necessary covered orthotics and prosthetics are not 
89.2 	available from an in-network provider, the plan must provide processes to refer an enrollee 
89.3 	to an out-of-network provider and must fully reimburse the out-of-network provider at a 
89.4 	mutually agreed upon rate less enrollee cost sharing determined on an in-network basis.

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

89.6 	Sec. 33. Minnesota Statutes 2022, section 317A.811, subdivision 1, is amended to read:
89.7 		Subdivision 1.When required. (a) Except as provided in subdivision 6, the following 
89.8 	corporations shall notify the attorney general of their intent to dissolve, merge, consolidate, 
89.9 	or convert, or to transfer all or substantially all of their assets:
89.10 	(1) a corporation that holds assets for a charitable purpose as defined in section 501B.35, 
89.11 	subdivision 2; or
89.12 	(2) a corporation that is exempt under section 501(c)(3) of the Internal Revenue Code 
89.13 	of 1986, or any successor section.
89.14 	(b) Except as provided in subdivision 6, the following corporations shall notify the 
89.15 	attorney general of their intent to dissolve, merge, consolidate, convert, or transfer at least 
89.16 	ten percent of their assets:
89.17 	(1) a corporation that is a nonprofit health service plan corporation operating under 
89.18 	chapter 62C; or
89.19 	(2) a corporation that is a health maintenance organization operating under chapter 62D.
89.20 	(b) (c) The notice must include:
89.21 	(1) the purpose of the corporation that is giving the notice;
89.22 	(2) a list of assets owned or held by the corporation for charitable purposes;
89.23 	(3) a description of restricted assets and purposes for which the assets were received;
89.24 	(4) a description of debts, obligations, and liabilities of the corporation;
89.25 	(5) a description of tangible assets being converted to cash and the manner in which 
89.26 	they will be sold;
89.27 	(6) anticipated expenses of the transaction, including attorney fees;
89.28 	(7) a list of persons to whom assets will be transferred, if known, or the name of the 
89.29 	converted organization;
89.30 	(8) the purposes of persons receiving the assets or of the converted organization; and
90.1 	(9) the terms, conditions, or restrictions, if any, to be imposed on the transferred or 
90.2 	converted assets.
90.3 	The notice must be signed on behalf of the corporation by an authorized person.

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

90.5 	Sec. 34. Minnesota Statutes 2022, section 317A.811, subdivision 2, is amended to read:
90.6 		Subd. 2.Restriction on transfers. (a) Subject to subdivision 3, a corporation described 
90.7 	in subdivision 1, paragraph (a), may not transfer or convey assets as part of a dissolution, 
90.8 	merger, consolidation, or transfer of assets under section 317A.661, and it may not convert 
90.9 	until 45 days after it has given written notice to the attorney general, unless the attorney 
90.10 	general waives all or part of the waiting period.
90.11 	(b) Subject to subdivision 3, a corporation described in subdivision 1, paragraph (b), 
90.12 	may not transfer or convey assets as part of a dissolution, merger, consolidation, transfer 
90.13 	of assets under section 317A.661, or transfer of at least ten percent of its assets and it may 
90.14 	not convert until 45 days after it has given written notice to the attorney general, unless the 
90.15 	attorney general waives all or part of the waiting period.
90.16 	(c) For a notice given by a corporation described in subdivision 1, paragraph (b), the 
90.17 	attorney general may hold a public hearing with respect to the purpose for which the 
90.18 	corporation gave the notice. If the attorney general elects to hold a public hearing, the 
90.19 	attorney general must give at least seven days' notice of the hearing to the corporation filing 
90.20 	the statement and to the public.

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

90.22 	Sec. 35. Minnesota Statutes 2022, section 317A.811, subdivision 4, is amended to read:
90.23 		Subd. 4.Notice after transfer. When all or substantially all of the assets of a corporation 
90.24 	described in subdivision 1, paragraph (a), or at least ten percent of the assets of a corporation 
90.25 	described in subdivision 1, paragraph (b), have been transferred or conveyed following 
90.26 	expiration or waiver of the waiting period, the board shall deliver to the attorney general a 
90.27 	list of persons to whom the assets were transferred or conveyed. The list must include the 
90.28 	addresses of each person who received assets and show what assets the person received.

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

91.1 	Sec. 36. COMMISSIONER OF COMMERCE.
 91.2 	The commissioner of commerce shall consult with health plan companies, pharmacies, 
91.3 	and pharmacy benefit managers to develop guidance to implement coverage for the pharmacy 
91.4 	services required by sections 21 to 23.

91.5 	Sec. 37. TRANSITION.
 91.6 	(a) A health maintenance organization that has a certificate of authority under Minnesota 
91.7 	Statutes, chapter 62D, but that is not a nonprofit corporation organized under Minnesota 
91.8 	Statutes, chapter 317A, or a local governmental unit, as defined in Minnesota Statutes, 
91.9 	section 62D.02, subdivision 11:
91.10 	(1) must not offer, sell, issue, or renew any health maintenance contracts on or after 
91.11 	August 1, 2024;
91.12 	(2) may otherwise continue to operate as a health maintenance organization until 
91.13 	December 31, 2025; and
91.14 	(3) must provide notice to the health maintenance organization's enrollees as of August 
91.15 	1, 2024, of the date the health maintenance organization will cease to operate in this state 
91.16 	and any plans to transition enrollee coverage to another insurer. This notice must be provided 
91.17 	by October 1, 2024.
91.18 	(b) The commissioner of health must not issue or renew a certificate of authority to 
91.19 	operate as a health maintenance organization on or after August 1, 2024, unless the entity 
91.20 	seeking the certificate of authority meets the requirements for a health maintenance 
91.21 	organization under Minnesota Statutes, chapter 62D, in effect on or after August 1, 2024.

91.22 	Sec. 38. REPEALER.
 91.23 	(a) Minnesota Statutes 2022, section 62A.041, subdivision 3, is repealed.
91.24 	(b) Minnesota Statutes 2023 Supplement, section 62Q.522, subdivisions 3 and 4, are 
91.25 	repealed.

91.26 	EFFECTIVE DATE. This section is effective January 1, 2025, and applies to health 
91.27 	plans offered, sold, issued, or renewed on or after that date.

92.1 	ARTICLE 5
92.2 	DEPARTMENT OF HEALTH

92.3 	Section 1. Minnesota Statutes 2022, section 103I.621, subdivision 1, is amended to read:
92.4 		Subdivision 1.Permit. (a) Notwithstanding any department or agency rule to the contrary, 
92.5 	the commissioner shall issue, on request by the owner of the property and payment of the 
92.6 	permit fee, permits for the reinjection of water by a properly constructed well into the same 
92.7 	aquifer from which the water was drawn for the operation of a groundwater thermal exchange 
92.8 	device.
92.9 	(b) As a condition of the permit, an applicant must agree to allow inspection by the 
92.10 	commissioner during regular working hours for department inspectors.
92.11 	(c) Not more than 200 permits may be issued for small systems having maximum 
92.12 	capacities of 20 gallons per minute or less and that are compliant with the natural resource 
92.13 	water-use requirements under subdivision 2. The small systems are subject to inspection 
92.14 	twice a year.
92.15 	(d) Not more than ten 100 permits may be issued for larger systems having maximum 
92.16 	capacities from over 20 to 50 gallons per minute and that are compliant with the natural 
92.17 	resource water-use requirements under subdivision 2. The larger systems are subject to 
92.18 	inspection four times a year.
92.19 	(e) A person issued a permit must comply with this section for the permit to be valid.
92.20 	and permit conditions deemed necessary to protect public health and safety of the 
92.21 	groundwater, which conditions may include but are not limited to:
92.22 	(1) notification to the commissioner at intervals specified in the permit conditions;
92.23 	(2) system operation and maintenance;
92.24 	(3) system location and construction;
92.25 	(4) well location and construction;
92.26 	(5) signage requirements;
92.27 	(6) reports of system construction, performance, operation, and maintenance;
92.28 	(7) removal of the system upon termination of use or failure;
92.29 	(8) disclosure of the system at the time of property transfer;
92.30 	(9) requirements to obtain approval from the commissioner prior to deviation from the 
92.31 	approval plan and conditions;
93.1 	(10) groundwater level monitoring; and
93.2 	(11) groundwater quality monitoring.
93.3 	(f) The property owner or the property owner's agent must submit to the commissioner 
93.4 	a permit application on a form provided by the commissioner, or in a format approved by 
93.5 	the commissioner, that provides any information necessary to protect public health and 
93.6 	safety of the groundwater.
93.7 	(g) A permit granted under this section is not valid if a water-use permit is required for 
93.8 	the project and is not approved by the commissioner of natural resources.

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

93.10 	Sec. 2. Minnesota Statutes 2022, section 103I.621, subdivision 2, is amended to read:
93.11 		Subd. 2.Water-use requirements apply. Water-use permit requirements and penalties 
93.12 	under chapter 103F 103G and related rules adopted and enforced by the commissioner of 
93.13 	natural resources apply to groundwater thermal exchange permit recipients. A person who 
93.14 	violates a provision of this section is subject to enforcement or penalties for the noncomplying 
93.15 	activity that are available to the commissioner and the Pollution Control Agency.

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

93.17 	Sec. 3. Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 1, is amended 
93.18 	to read:
93.19 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
93.20 	apply.
93.21 	(b) "Advanced dental therapist" means an individual who is licensed as a dental therapist 
93.22 	under section 150A.06, and who is certified as an advanced dental therapist under section 
93.23 	150A.106.
93.24 	(c) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and 
93.25 	drug counselor under chapter 148F.
93.26 	(d) "Dental therapist" means an individual who is licensed as a dental therapist under 
93.27 	section 150A.06.
93.28 	(e) "Dentist" means an individual who is licensed to practice dentistry.
94.1 	(f) "Designated rural area" means a statutory and home rule charter city or township that 
94.2 	is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2, 
94.3 	excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
94.4 	(g) "Emergency circumstances" means those conditions that make it impossible for the 
94.5 	participant to fulfill the service commitment, including death, total and permanent disability, 
94.6 	or temporary disability lasting more than two years.
94.7 	(h) "Hospital nurse" means an individual who is licensed as a registered nurse and who 
94.8 	is providing direct patient care in a nonprofit hospital setting.
94.9 	(i) (h) "Mental health professional" means an individual providing clinical services in 
94.10 	the treatment of mental illness who is qualified in at least one of the ways specified in section 
94.11 	245.462, subdivision 18.
94.12 	(j) (i) "Medical resident" means an individual participating in a medical residency in 
94.13 	family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
94.14 	(k) (j) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse 
94.15 	anesthetist, advanced clinical nurse specialist, or physician assistant.
94.16 	(l) (k) "Nurse" means an individual who has completed training and received all licensing 
94.17 	or certification necessary to perform duties as a licensed practical nurse or registered nurse.
94.18 	(m) (l) "Nurse-midwife" means a registered nurse who has graduated from a program 
94.19 	of study designed to prepare registered nurses for advanced practice as nurse-midwives.
94.20 	(n) (m) "Nurse practitioner" means a registered nurse who has graduated from a program 
94.21 	of study designed to prepare registered nurses for advanced practice as nurse practitioners.
94.22 	(o) (n) "Pharmacist" means an individual with a valid license issued under chapter 151.
94.23 	(p) (o) "Physician" means an individual who is licensed to practice medicine in the areas 
94.24 	of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
94.25 	(q) (p) "Physician assistant" means a person licensed under chapter 147A.
94.26 	(r) (q) "Public health nurse" means a registered nurse licensed in Minnesota who has 
94.27 	obtained a registration certificate as a public health nurse from the Board of Nursing in 
94.28 	accordance with Minnesota Rules, chapter 6316.
94.29 	(s) (r) "Qualified educational loan" means a government, commercial, or foundation 
94.30 	loan for actual costs paid for tuition, reasonable education expenses, and reasonable living 
94.31 	expenses related to the graduate or undergraduate education of a health care professional.
95.1 	(t) (s) "Underserved urban community" means a Minnesota urban area or population 
95.2 	included in the list of designated primary medical care health professional shortage areas 
95.3 	(HPSAs), medically underserved areas (MUAs), or medically underserved populations 
95.4 	(MUPs) maintained and updated by the United States Department of Health and Human 
95.5 	Services.

95.6 	Sec. 4. Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 2, is amended 
95.7 	to read:
95.8 		Subd. 2.Creation of account Availability. (a) A health professional education loan 
95.9 	forgiveness program account is established. The commissioner of health shall use money 
95.10 	from the account to establish a appropriated for health professional education loan forgiveness 
95.11 	program in this section:
95.12 	(1) for medical residents, mental health professionals, and alcohol and drug counselors 
95.13 	agreeing to practice in designated rural areas or underserved urban communities or 
95.14 	specializing in the area of pediatric psychiatry;
95.15 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
95.16 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
95.17 	at the undergraduate level or the equivalent at the graduate level;
95.18 	(3) for nurses who agree to practice in a Minnesota nursing home; in an intermediate 
95.19 	care facility for persons with developmental disability; in a hospital if the hospital owns 
95.20 	and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked 
95.21 	by the nurse is in the nursing home; in an assisted living facility as defined in section 
95.22 	144G.08, subdivision 7; or for a home care provider as defined in section 144A.43, 
95.23 	subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing 
95.24 	field in a postsecondary program at the undergraduate level or the equivalent at the graduate 
95.25 	level;
95.26 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
95.27 	hours per year in their designated field in a postsecondary program at the undergraduate 
95.28 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
95.29 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
95.30 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
95.31 	technology, radiologic technology, and surgical technology;
95.32 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
95.33 	who agree to practice in designated rural areas;
96.1 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
96.2 	encounters to state public program enrollees or patients receiving sliding fee schedule 
96.3 	discounts through a formal sliding fee schedule meeting the standards established by the 
96.4 	United States Department of Health and Human Services under Code of Federal Regulations, 
96.5 	title 42, section 51, chapter 303; and
96.6 	(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct 
96.7 	care to patients at the nonprofit hospital.
96.8 	(b) Appropriations made to the account for health professional education loan forgiveness 
96.9 	in this section do not cancel and are available until expended, except that at the end of each 
96.10 	biennium, any remaining balance in the account that is not committed by contract and not 
96.11 	needed to fulfill existing commitments shall cancel to the fund.

96.12 	Sec. 5. Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 2, is amended 
96.13 	to read:
96.14 		Subd. 2.Creation of account. (a) A health professional education loan forgiveness 
96.15 	program account is established. The commissioner of health shall use money from the 
96.16 	account to establish a loan forgiveness program:
96.17 	(1) for medical residents, mental health professionals, and alcohol and drug counselors 
96.18 	agreeing to practice in designated rural areas or underserved urban communities or 
96.19 	specializing in the area of pediatric psychiatry;
96.20 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
96.21 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
96.22 	at the undergraduate level or the equivalent at the graduate level;
96.23 	(3) for nurses who agree to practice in a Minnesota nursing home; in an intermediate 
96.24 	care facility for persons with developmental disability; in a hospital if the hospital owns 
96.25 	and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked 
96.26 	by the nurse is in the nursing home; in an assisted living facility as defined in section 
96.27 	144G.08, subdivision 7; or for a home care provider as defined in section 144A.43, 
96.28 	subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing 
96.29 	field in a postsecondary program at the undergraduate level or the equivalent at the graduate 
96.30 	level;
96.31 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
96.32 	hours per year in their designated field in a postsecondary program at the undergraduate 
96.33 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
97.1 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
97.2 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
97.3 	technology, radiologic technology, and surgical technology;
97.4 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
97.5 	who agree to practice in designated rural areas; and
97.6 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
97.7 	encounters to state public program enrollees or patients receiving sliding fee schedule 
97.8 	discounts through a formal sliding fee schedule meeting the standards established by the 
97.9 	United States Department of Health and Human Services under Code of Federal Regulations, 
97.10 	title 42, section 51, chapter 303; and.
97.11 	(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct 
97.12 	care to patients at the nonprofit hospital.
97.13 	(b) Appropriations made to the account do not cancel and are available until expended, 
97.14 	except that at the end of each biennium, any remaining balance in the account that is not 
97.15 	committed by contract and not needed to fulfill existing commitments shall cancel to the 
97.16 	fund.

97.17 	Sec. 6. Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 3, is amended 
97.18 	to read:
97.19 		Subd. 3.Eligibility. (a) To be eligible to participate in the loan forgiveness program, an 
97.20 	individual must:
97.21 	(1) be a medical or dental resident; a licensed pharmacist; or be enrolled in a training or 
97.22 	education program to become a dentist, dental therapist, advanced dental therapist, mental 
97.23 	health professional, alcohol and drug counselor, pharmacist, public health nurse, midlevel 
97.24 	practitioner, registered nurse, or a licensed practical nurse. The commissioner may also 
97.25 	consider applications submitted by graduates in eligible professions who are licensed and 
97.26 	in practice; and
97.27 	(2) submit an application to the commissioner of health. A nurse applying under 
97.28 	subdivision 2, paragraph (a), clause (7), must also include proof that the applicant is employed 
97.29 	as a hospital nurse.
97.30 	(b) An applicant selected to participate must sign a contract to agree to serve a minimum 
97.31 	three-year full-time service obligation according to subdivision 2, which shall begin no later 
97.32 	than March 31 following completion of required training, with the exception of:
98.1 	(1) a nurse, who must agree to serve a minimum two-year full-time service obligation 
98.2 	according to subdivision 2, which shall begin no later than March 31 following completion 
98.3 	of required training; and
98.4 	(2) a nurse selected under subdivision 2, paragraph (a), clause (7), who must agree to 
98.5 	continue as a hospital nurse for a minimum two-year service obligation; and
98.6 	(3) (2) a nurse who agrees to teach according to subdivision 2, paragraph (a), clause (3), 
98.7 	who must sign a contract to agree to teach for a minimum of two years.

98.8 	Sec. 7. Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 4, is amended 
98.9 	to read:
98.10 		Subd. 4.Loan forgiveness. (a) The commissioner of health may select applicants each 
98.11 	year for participation in the loan forgiveness program, within the limits of available funding. 
98.12 	In considering applications, the commissioner shall give preference to applicants who 
98.13 	document diverse cultural competencies. The commissioner shall distribute available funds 
98.14 	for loan forgiveness proportionally among the eligible professions according to the vacancy 
98.15 	rate for each profession in the required geographic area, facility type, teaching area, patient 
98.16 	group, or specialty type specified in subdivision 2, except for hospital nurses. The 
98.17 	commissioner shall allocate funds for physician loan forgiveness so that 75 percent of the 
98.18 	funds available are used for rural physician loan forgiveness and 25 percent of the funds 
98.19 	available are used for underserved urban communities and pediatric psychiatry loan 
98.20 	forgiveness. If the commissioner does not receive enough qualified applicants each year to 
98.21 	use the entire allocation of funds for any eligible profession, the remaining funds may be 
98.22 	allocated proportionally among the other eligible professions according to the vacancy rate 
98.23 	for each profession in the required geographic area, patient group, or facility type specified 
98.24 	in subdivision 2. Applicants are responsible for securing their own qualified educational 
98.25 	loans. The commissioner shall select participants based on their suitability for practice 
98.26 	serving the required geographic area or facility type specified in subdivision 2, as indicated 
98.27 	by experience or training. The commissioner shall give preference to applicants closest to 
98.28 	completing their training. Except as specified in paragraph (c) (b), for each year that a 
98.29 	participant meets the service obligation required under subdivision 3, up to a maximum of 
98.30 	four years, the commissioner shall make annual disbursements directly to the participant 
98.31 	equivalent to 15 percent of the average educational debt for indebted graduates in their 
98.32 	profession in the year closest to the applicant's selection for which information is available, 
98.33 	not to exceed the balance of the participant's qualifying educational loans. Before receiving 
98.34 	loan repayment disbursements and as requested, the participant must complete and return 
99.1 	to the commissioner a confirmation of practice form provided by the commissioner verifying 
99.2 	that the participant is practicing as required under subdivisions 2 and 3. The participant 
99.3 	must provide the commissioner with verification that the full amount of loan repayment 
99.4 	disbursement received by the participant has been applied toward the designated loans. 
99.5 	After each disbursement, verification must be received by the commissioner and approved 
99.6 	before the next loan repayment disbursement is made. Participants who move their practice 
99.7 	remain eligible for loan repayment as long as they practice as required under subdivision 
99.8 	2.
99.9 	(b) For hospital nurses, the commissioner of health shall select applicants each year for 
99.10 	participation in the hospital nursing education loan forgiveness program, within limits of 
99.11 	available funding for hospital nurses. Before receiving the annual loan repayment 
99.12 	disbursement, the participant must complete and return to the commissioner a confirmation 
99.13 	of practice form provided by the commissioner, verifying that the participant continues to 
99.14 	meet the eligibility requirements under subdivision 3. The participant must provide the 
99.15 	commissioner with verification that the full amount of loan repayment disbursement received 
99.16 	by the participant has been applied toward the designated loans.
99.17 	(c) (b) For each year that a participant who is a nurse and who has agreed to teach 
99.18 	according to subdivision 2 meets the teaching obligation required in subdivision 3, the 
99.19 	commissioner shall make annual disbursements directly to the participant equivalent to 15 
99.20 	percent of the average annual educational debt for indebted graduates in the nursing 
99.21 	profession in the year closest to the participant's selection for which information is available, 
99.22 	not to exceed the balance of the participant's qualifying educational loans.

99.23 	Sec. 8. Minnesota Statutes 2022, section 144.1501, subdivision 5, is amended to read:
99.24 		Subd. 5.Penalty for nonfulfillment. If a participant does not fulfill the required 
99.25 	minimum commitment of service according to subdivision 3, the commissioner of health 
99.26 	shall collect from the participant the total amount paid to the participant under the loan 
99.27 	forgiveness program plus interest at a rate established according to section 270C.40. The 
99.28 	commissioner shall deposit the money collected in the health care access fund to be credited 
99.29 	to a dedicated account in the special revenue fund. The balance of the account is appropriated 
99.30 	annually to the commissioner for the health professional education loan forgiveness program 
99.31 	account established in subdivision 2. The commissioner shall allow waivers of all or part 
99.32 	of the money owed the commissioner as a result of a nonfulfillment penalty if emergency 
99.33 	circumstances prevented fulfillment of the minimum service commitment.

100.1 	Sec. 9. [144.1512] HOSPITAL NURSING EDUCATIONAL LOAN FORGIVENESS 
100.2 	PROGRAM.
100.3 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
100.4 	apply.
100.5 	(b) "Emergency circumstances" means those conditions that make it impossible for the 
100.6 	participant to fulfill the service commitment, including death, total and permanent disability, 
100.7 	or temporary disability lasting more than two years.
100.8 	(c) "Hospital nurse" means an individual who is licensed as a registered nurse and who 
100.9 	is providing direct patient care in a nonprofit hospital setting.
100.10 	(d) "Qualified educational loan" means a government, commercial, or foundation loan 
100.11 	for actual costs paid for tuition, reasonable education expenses, and reasonable living 
100.12 	expenses related to the graduate or undergraduate education of a health care professional.
100.13 		Subd. 2.Creation of account. (a) A hospital nursing education loan forgiveness program 
100.14 	account is established in the special revenue fund. The commissioner of health shall use 
100.15 	money from the account to establish a loan forgiveness program for licensed registered 
100.16 	nurses employed as hospital nurses by a nonprofit hospital and who provide direct care to 
100.17 	patients at the nonprofit hospital.
100.18 	(b) Money transferred to or deposited in the account does not cancel and is available 
100.19 	until expended. The balance of the account is appropriated annually to the commissioner 
100.20 	for the hospital nursing educational loan forgiveness program.
100.21 		Subd. 3.Eligibility. (a) To be eligible to participate in the hospital nursing educational 
100.22 	loan forgiveness program, an individual must: (1) be a hospital nurse who has been employed 
100.23 	as a hospital nurse for at least three years; (2) submit an application to the commissioner of 
100.24 	health; and (3) submit proof that the applicant is employed as a hospital nurse and has been 
100.25 	so employed for at least three years.
100.26 	(b) The commissioner must accept a signed work verification form from the applicant's 
100.27 	supervisor as proof of the applicant's tenure providing direct patient care in a nonprofit 
100.28 	hospital setting.
100.29 	(c) An applicant selected to participate in the loan forgiveness program must sign a 
100.30 	contract to agree to continue as a hospital nurse for a minimum two-year service obligation.
100.31 		Subd. 4.Loan forgiveness. (a) Within the limits of available funding, the commissioner 
100.32 	of health shall select applicants each year for participation in the loan forgiveness program. 
101.1 	If the total requests from eligible applicants exceeds the available funding, the commissioner 
101.2 	shall randomly select grantees from among eligible applicants.
101.3 	(b) Applicants are responsible for securing their own qualified educational loans.
101.4 	(c) For each year that a participant meets the service obligation required under subdivision 
101.5 	3, up to a maximum of four years, the commissioner shall make annual disbursements 
101.6 	directly to the participant equivalent to 15 percent of the average educational debt for 
101.7 	indebted graduates in their profession in the year closest to the applicant's selection for 
101.8 	which information is available, not to exceed the balance of the participant's qualifying 
101.9 	educational loans. Before receiving loan repayment disbursements and as requested, the 
101.10 	participant must complete and return to the commissioner a confirmation of practice form 
101.11 	provided by the commissioner verifying that the participant is practicing as required under 
101.12 	subdivisions 2 and 3.
101.13 	(d) The participant must provide the commissioner with verification that the full amount 
101.14 	of loan repayment disbursement received by the participant has been applied toward the 
101.15 	designated loans. After each disbursement, verification must be received by the commissioner 
101.16 	and approved before the next loan repayment disbursement is made.
101.17 	(e) Participants who move their practice remain eligible for loan repayment as long as 
101.18 	they practice as required under subdivisions 2 and 3.
101.19 		Subd. 5.Penalty for nonfulfillment. (a) If a participant does not fulfill the required 
101.20 	minimum commitment of service according to subdivision 3, the commissioner of health 
101.21 	shall collect from the participant the total amount paid to the participant under the loan 
101.22 	forgiveness program. The commissioner shall deposit the money collected from the 
101.23 	participant in the special revenue fund to be credited to the hospital nursing education loan 
101.24 	forgiveness program account established in subdivision 2.
101.25 	(b) The commissioner shall allow waivers of all or part of the money owed to the 
101.26 	commissioner as a result of a nonfulfillment penalty if the participant is unable to fulfill the 
101.27 	minimum service commitment due to emergency circumstances, life changes outside the 
101.28 	applicant's control, inability to obtain required hours as a result of a scheduling decision by 
101.29 	the hospital, or other circumstances as determined by the commissioner.
101.30 		Subd. 6.Rules. The commissioner may adopt rules to implement this section.

101.31 	Sec. 10. Minnesota Statutes 2022, section 144.555, subdivision 1a, is amended to read:
101.32 		Subd. 1a.Notice of closing, curtailing operations, relocating services, or ceasing to 
101.33 	offer certain services; hospitals. (a) The controlling persons of a hospital licensed under 
102.1 	sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health and,
102.2 	the public, and others at least 120 182 days before the hospital or hospital campus voluntarily 
102.3 	plans to implement one of the following scheduled actions listed in paragraph (b), unless 
102.4 	the controlling persons can demonstrate to the commissioner that meeting the advanced 
102.5 	notice requirement is not feasible and the commissioner approves a shorter advanced notice.
102.6 	(b) The following scheduled actions require advanced notice under paragraph (a):
102.7 	(1) cease ceasing operations;
102.8 	(2) curtail curtailing operations to the extent that patients must be relocated;
102.9 	(3) relocate relocating the provision of health services to another hospital or another 
102.10 	hospital campus; or
102.11 	(4) cease offering ceasing to offer maternity care and newborn care services, intensive 
102.12 	care unit services, inpatient mental health services, or inpatient substance use disorder 
102.13 	treatment services.
102.14 	(c) A notice required under this subdivision must comply with the requirements in 
102.15 	subdivision 1d.
102.16 	(b) (d) The commissioner shall cooperate with the controlling persons and advise them 
102.17 	about relocating the patients.

102.18 	Sec. 11. Minnesota Statutes 2022, section 144.555, subdivision 1b, is amended to read:
102.19 		Subd. 1b.Public hearing. Within 45 30 days after receiving notice under subdivision 
102.20 	1a, the commissioner shall conduct a public hearing on the scheduled cessation of operations, 
102.21 	curtailment of operations, relocation of health services, or cessation in offering health 
102.22 	services. The commissioner must provide adequate public notice of the hearing in a time 
102.23 	and manner determined by the commissioner. The controlling persons of the hospital or 
102.24 	hospital campus must participate in the public hearing. The public hearing must be held at 
102.25 	a location that is within ten miles of the hospital or hospital campus or with the 
102.26 	commissioner's approval as close as is practicable, and that is provided or arranged by the 
102.27 	hospital or hospital campus. Video conferencing technology must be used to allow members 
102.28 	of the public to view and participate in the hearing. The public hearing must include:
102.29 	(1) an explanation by the controlling persons of the reasons for ceasing or curtailing 
102.30 	operations, relocating health services, or ceasing to offer any of the listed health services;
103.1 	(2) a description of the actions that controlling persons will take to ensure that residents 
103.2 	in the hospital's or campus's service area have continued access to the health services being 
103.3 	eliminated, curtailed, or relocated;
103.4 	(3) an opportunity for public testimony on the scheduled cessation or curtailment of 
103.5 	operations, relocation of health services, or cessation in offering any of the listed health 
103.6 	services, and on the hospital's or campus's plan to ensure continued access to those health 
103.7 	services being eliminated, curtailed, or relocated; and
103.8 	(4) an opportunity for the controlling persons to respond to questions from interested 
103.9 	persons.

103.10 	Sec. 12. Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision 
103.11 	to read:
103.12 		Subd. 1d.Methods of providing notice; content of notice. (a) A notice required under 
103.13 	subdivision 1a must be provided to patients, hospital personnel, the public, local units of 
103.14 	government, and the commissioner of health using at least the following methods:
103.15 	(1) posting a notice of the proposed cessation of operations, curtailment, relocation of 
103.16 	health services, or cessation in offering health services at the main public entrance of the 
103.17 	hospital or hospital campus;
103.18 	(2) providing written notice to the commissioner of health, to the city council in the city 
103.19 	where the hospital or hospital campus is located, and to the county board in the county 
103.20 	where the hospital or hospital campus is located;
103.21 	(3) providing written notice to the local health department as defined in section 145A.02, 
103.22 	subdivision 8b, for the community where the hospital or hospital campus is located;
103.23 	(4) providing notice to the public through a written public announcement which must 
103.24 	be distributed to local media outlets;
103.25 	(5) providing written notice to existing patients of the hospital or hospital campus; and
103.26 	(6) notifying all personnel currently employed in the unit, hospital, or hospital campus 
103.27 	impacted by the proposed cessation, curtailment, or relocation.
103.28 	(b) A notice required under subdivision 1a must include:
103.29 	(1) a description of the proposed cessation of operations, curtailment, relocation of health 
103.30 	services, or cessation in offering health services. The description must include:
104.1 	(i) the number of beds, if any, that will be eliminated, repurposed, reassigned, or otherwise 
104.2 	reconfigured to serve populations or patients other than those currently served;
104.3 	(ii) the current number of beds in the impacted unit, hospital, or hospital campus, and 
104.4 	the number of beds in the impacted unit, hospital, or hospital campus after the proposed 
104.5 	cessation, curtailment, or relocation takes place;
104.6 	(iii) the number of existing patients who will be impacted by the proposed cessation, 
104.7 	curtailment, or relocation;
104.8 	(iv) any decrease in personnel, or relocation of personnel to a different unit, hospital, or 
104.9 	hospital campus, caused by the proposed cessation, curtailment, or relocation;
104.10 	(v) a description of the health services provided by the unit, hospital, or hospital campus 
104.11 	impacted by the proposed cessation, curtailment, or relocation; and
104.12 	(vi) identification of the three nearest available health care facilities where patients may 
104.13 	obtain the health services provided by the unit, hospital, or hospital campus impacted by 
104.14 	the proposed cessation, curtailment, or relocation, and any potential barriers to seamlessly 
104.15 	transition patients to receive services at one of these facilities. If the unit, hospital, or hospital 
104.16 	campus impacted by the proposed cessation, curtailment, or relocation serves medical 
104.17 	assistance or Medicare enrollees, the information required under this item must specify 
104.18 	whether any of the three nearest available facilities serves medical assistance or Medicare 
104.19 	enrollees; and
104.20 	(2) a telephone number, email address, and address for each of the following, to which 
104.21 	interested parties may offer comments on the proposed cessation, curtailment, or relocation:
104.22 	(i) the hospital or hospital campus; and
104.23 	(ii) the parent entity, if any, or the entity under contract, if any, that acts as the corporate 
104.24 	administrator of the hospital or hospital campus.

104.25 	Sec. 13. Minnesota Statutes 2022, section 144.555, subdivision 2, is amended to read:
104.26 		Subd. 2.Penalty; facilities other than hospitals. Failure to notify the commissioner 
104.27 	under subdivision 1, 1a, or 1c or failure to participate in a public hearing under subdivision 
104.28 	1b may result in issuance of a correction order under section 144.653, subdivision 5.

105.1 	Sec. 14. Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision 
105.2 	to read:
105.3 		Subd. 3.Penalties; hospitals. (a) Failure to participate in a public hearing under 
105.4 	subdivision 1b or failure to notify the commissioner under subdivision 1c may result in 
105.5 	issuance of a correction order under section 144.653, subdivision 5.
105.6 	(b) Notwithstanding any law to the contrary, the commissioner must impose on the 
105.7 	controlling persons of a hospital or hospital campus a fine of $20,000 for each failure to 
105.8 	provide notice to an individual or entity or at a location required under subdivision 1d, 
105.9 	paragraph (a). The cumulative fines imposed under this paragraph must not exceed $60,000 
105.10 	for any scheduled action requiring notice under subdivision 1a. The commissioner is not 
105.11 	required to issue a correction order before imposing a fine under this paragraph. Section 
105.12 	144.653, subdivision 8, applies to fines imposed under this paragraph.

105.13 	Sec. 15. [144.556] RIGHT OF FIRST REFUSAL; SALE OF HOSPITAL OR 
105.14 	HOSPITAL CAMPUS.
105.15 	(a) The controlling persons of a hospital licensed under sections 144.50 to 144.56 or a 
105.16 	hospital campus must not sell or convey the hospital or hospital campus, offer to sell or 
105.17 	convey the hospital or hospital campus to a person other than a local unit of government 
105.18 	listed in this paragraph, or voluntarily cease operations of the hospital or hospital campus 
105.19 	unless the controlling persons have first made a good faith offer to sell or convey the hospital 
105.20 	or hospital campus to the home rule charter or statutory city, county, town, or hospital 
105.21 	district in which the hospital or hospital campus is located.
105.22 	(b) The offer to sell or convey the hospital or hospital campus to a local unit of 
105.23 	government under paragraph (a) must be at a price that does not exceed the current fair 
105.24 	market value of the hospital or hospital campus. A party to whom an offer is made under 
105.25 	paragraph (a) must accept or decline the offer within 60 days of receipt. If the party to whom 
105.26 	the offer is made fails to respond within 60 days of receipt, the offer is deemed declined.

105.27 	Sec. 16. Minnesota Statutes 2022, section 144A.61, subdivision 3a, is amended to read:
105.28 		Subd. 3a.Competency evaluation program. (a) The commissioner of health shall 
105.29 	approve the competency evaluation program.
105.30 	(b) A competency evaluation must be administered to persons who desire to be listed 
105.31 	in the nursing assistant registry. The tests may only be administered by technical colleges, 
105.32 	community colleges, or other organizations approved by the Department of Health
106.1 	commissioner of health. The commissioner must ensure any written portions of the 
106.2 	competency evaluation are available in languages other than English that are commonly 
106.3 	spoken by persons who desire to be listed in the nursing assistant registry. The commissioner 
106.4 	may consult with the state demographer or the commissioner of employment and economic 
106.5 	development when identifying languages that are commonly spoken by persons who desire 
106.6 	to be listed in the nursing assistant registry.
106.7 	(c) The commissioner of health shall approve a nursing assistant for the registry without 
106.8 	requiring a competency evaluation if the nursing assistant is in good standing on a nursing 
106.9 	assistant registry in another state.

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

106.11 	Sec. 17. Minnesota Statutes 2022, section 144A.70, subdivision 3, is amended to read:
106.12 		Subd. 3.Controlling person. "Controlling person" means a business entity or entities, 
106.13 	officer, program administrator, or director, whose responsibilities include the direction of 
106.14 	the management or policies of a supplemental nursing services agency the management and 
106.15 	decision-making authority to establish or control business policy and all other policies of a 
106.16 	supplemental nursing services agency. Controlling person also means an individual who, 
106.17 	directly or indirectly, beneficially owns an interest in a corporation, partnership, or other 
106.18 	business association that is a controlling person.

106.19 	Sec. 18. Minnesota Statutes 2022, section 144A.70, subdivision 5, is amended to read:
106.20 		Subd. 5.Person. "Person" includes an individual, firm, corporation, partnership, limited 
106.21 	liability company, or association.

106.22 	Sec. 19. Minnesota Statutes 2022, section 144A.70, subdivision 6, is amended to read:
106.23 		Subd. 6.Supplemental nursing services agency. "Supplemental nursing services 
106.24 	agency" means a person, firm, corporation, partnership, limited liability company, or 
106.25 	association engaged for hire in the business of providing or procuring temporary employment 
106.26 	in health care facilities for nurses, nursing assistants, nurse aides, and orderlies. Supplemental 
106.27 	nursing services agency does not include an individual who only engages in providing the 
106.28 	individual's services on a temporary basis to health care facilities. Supplemental nursing 
106.29 	services agency does not include a professional home care agency licensed under section 
106.30 	144A.471 that only provides staff to other home care providers.

107.1 	Sec. 20. Minnesota Statutes 2022, section 144A.70, subdivision 7, is amended to read:
107.2 		Subd. 7.Oversight. The commissioner is responsible for the oversight of supplemental 
107.3 	nursing services agencies through annual semiannual unannounced surveys and follow-up 
107.4 	surveys, complaint investigations under sections 144A.51 to 144A.53, and other actions 
107.5 	necessary to ensure compliance with sections 144A.70 to 144A.74.

107.6 	Sec. 21. Minnesota Statutes 2022, section 144A.71, subdivision 2, is amended to read:
107.7 		Subd. 2.Application information and fee. The commissioner shall establish forms and 
107.8 	procedures for processing each supplemental nursing services agency registration application. 
107.9 	An application for a supplemental nursing services agency registration must include at least 
107.10 	the following:
107.11 	(1) the names and addresses of the owner or owners all owners and controlling persons
107.12 	of the supplemental nursing services agency;
107.13 	(2) if the owner is a corporation, copies of its articles of incorporation and current bylaws, 
107.14 	together with the names and addresses of its officers and directors;
107.15 	(3) satisfactory proof of compliance with section 144A.72, subdivision 1, clauses (5) to 
107.16 	(7) if the owner is a limited liability company, copies of its articles of organization and 
107.17 	operating agreement, together with the names and addresses of its officers and directors;
107.18 	(4) documentation that the supplemental nursing services agency has medical malpractice 
107.19 	insurance to insure against the loss, damage, or expense of a claim arising out of the death 
107.20 	or injury of any person as the result of negligence or malpractice in the provision of health 
107.21 	care services by the supplemental nursing services agency or by any employee of the agency;
107.22 	(5) documentation that the supplemental nursing services agency has an employee 
107.23 	dishonesty bond in the amount of $10,000;
107.24 	(6) documentation that the supplemental nursing services agency has insurance coverage 
107.25 	for workers' compensation for all nurses, nursing assistants, nurse aids, and orderlies provided 
107.26 	or procured by the agency;
107.27 	(7) documentation that the supplemental nursing services agency filed with the 
107.28 	commissioner of revenue: (i) the name and address of the bank, savings bank, or savings 
107.29 	association in which the supplemental nursing services agency deposits all employee income 
107.30 	tax withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aid, 
107.31 	or orderly whose income is derived from placement by the agency, if the agency purports 
107.32 	the income is not subject to withholding;
108.1 	(4) (8) any other relevant information that the commissioner determines is necessary to 
108.2 	properly evaluate an application for registration;
108.3 	(5) (9) a policy and procedure that describes how the supplemental nursing services 
108.4 	agency's records will be immediately available at all times to the commissioner and facility; 
108.5 	and
108.6 	(6) (10) a nonrefundable registration fee of $2,035.
108.7 	If a supplemental nursing services agency fails to provide the items in this subdivision 
108.8 	to the department, the commissioner shall immediately suspend or refuse to issue the 
108.9 	supplemental nursing services agency registration. The supplemental nursing services agency 
108.10 	may appeal the commissioner's findings according to section 144A.475, subdivisions 3a 
108.11 	and 7, except that the hearing must be conducted by an administrative law judge within 60 
108.12 	calendar days of the request for hearing assignment.

108.13 	Sec. 22. Minnesota Statutes 2022, section 144A.71, is amended by adding a subdivision 
108.14 	to read:
108.15 		Subd. 2a.Renewal applications. An applicant for registration renewal must complete 
108.16 	the registration application form supplied by the department. An application must be 
108.17 	submitted at least 60 days before the expiration of the current registration.

108.18 	Sec. 23. [144A.715] PENALTIES.
108.19 		Subdivision 1.Authority. The fines imposed under this section are in accordance with 
108.20 	section 144.653, subdivision 6.
108.21 		Subd. 2.Fines. Each violation of sections 144A.70 to 144A.74, not corrected at the time 
108.22 	of a follow-up survey, is subject to a fine. A fine must be assessed according to the schedules 
108.23 	established in the sections violated.
108.24 		Subd. 3.Failure to correct. If, upon a subsequent follow-up survey after a fine has been 
108.25 	imposed under subdivision 2, a violation is still not corrected, another fine shall be assessed. 
108.26 	The fine shall be double the amount of the previous fine.
108.27 		Subd. 4.Payment of fines. Payment of fines is due 15 business days from the registrant's 
108.28 	receipt of notice of the fine from the department.

108.29 	Sec. 24. Minnesota Statutes 2022, section 144A.72, subdivision 1, is amended to read:
108.30 		Subdivision 1.Minimum criteria. (a) The commissioner shall require that, as a condition 
108.31 	of registration:
109.1 	(1) all owners and controlling persons must complete a background study under section 
109.2 	144.057 and receive a clearance or set aside of any disqualification;
109.3 	(1) (2) the supplemental nursing services agency shall document that each temporary 
109.4 	employee provided to health care facilities currently meets the minimum licensing, training, 
109.5 	and continuing education standards for the position in which the employee will be working
109.6 	and verifies competency for the position. A violation of this provision may be subject to a 
109.7 	fine of $3,000;
109.8 	(2) (3) the supplemental nursing services agency shall comply with all pertinent 
109.9 	requirements relating to the health and other qualifications of personnel employed in health 
109.10 	care facilities;
109.11 	(3) (4) the supplemental nursing services agency must not restrict in any manner the 
109.12 	employment opportunities of its employees;. A violation of this provision may be subject 
109.13 	to a fine of $3,000;
109.14 	(4) the supplemental nursing services agency shall carry medical malpractice insurance 
109.15 	to insure against the loss, damage, or expense incident to a claim arising out of the death 
109.16 	or injury of any person as the result of negligence or malpractice in the provision of health 
109.17 	care services by the supplemental nursing services agency or by any employee of the agency;
109.18 	(5) the supplemental nursing services agency shall carry an employee dishonesty bond 
109.19 	in the amount of $10,000;
109.20 	(6) the supplemental nursing services agency shall maintain insurance coverage for 
109.21 	workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies provided 
109.22 	or procured by the agency;
109.23 	(7) the supplemental nursing services agency shall file with the commissioner of revenue: 
109.24 	(i) the name and address of the bank, savings bank, or savings association in which the 
109.25 	supplemental nursing services agency deposits all employee income tax withholdings; and 
109.26 	(ii) the name and address of any nurse, nursing assistant, nurse aide, or orderly whose income 
109.27 	is derived from placement by the agency, if the agency purports the income is not subject 
109.28 	to withholding;
109.29 	(8) (5) the supplemental nursing services agency must not, in any contract with any 
109.30 	employee or health care facility, require the payment of liquidated damages, employment 
109.31 	fees, or other compensation should the employee be hired as a permanent employee of a 
109.32 	health care facility;. A violation of this provision may be subject to a fine of $3,000;
110.1 	(9) (6) the supplemental nursing services agency shall document that each temporary 
110.2 	employee provided to health care facilities is an employee of the agency and is not an 
110.3 	independent contractor; and
110.4 	(10) (7) the supplemental nursing services agency shall retain all records for five calendar 
110.5 	years. All records of the supplemental nursing services agency must be immediately available 
110.6 	to the department.
110.7 	(b) In order to retain registration, the supplemental nursing services agency must provide 
110.8 	services to a health care facility during the year in Minnesota within the past 12 months
110.9 	preceding the supplemental nursing services agency's registration renewal date.

110.10 	Sec. 25. Minnesota Statutes 2022, section 144A.73, is amended to read:
110.11 	144A.73 COMPLAINT SYSTEM.
110.12 	The commissioner shall establish a system for reporting complaints against a supplemental 
110.13 	nursing services agency or its employees. Complaints may be made by any member of the 
110.14 	public. Complaints against a supplemental nursing services agency shall be investigated by 
110.15 	the Office of Health Facility Complaints commissioner of health under sections 144A.51
110.16 	to 144A.53.

110.17 	Sec. 26. Minnesota Statutes 2022, section 148.235, subdivision 10, is amended to read:
110.18 		Subd. 10.Administration of medications by unlicensed personnel in nursing 
110.19 	facilities. Notwithstanding the provisions of Minnesota Rules, part 4658.1360, subpart 2, 
110.20 	a graduate of a foreign nursing school who has successfully completed an approved 
110.21 	competency evaluation under the provisions of section 144A.61 is eligible to administer 
110.22 	medications in a nursing facility upon completion of a any medication training program for 
110.23 	unlicensed personnel offered through a postsecondary educational institution, which approved 
110.24 	by the commissioner of health that meets the requirements specified in Minnesota Rules, 
110.25 	part 4658.1360, subpart 2, item B, subitems (1) to (6).

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

110.27 	Sec. 27. Minnesota Statutes 2022, section 149A.02, subdivision 3, is amended to read:
110.28 		Subd. 3.Arrangements for disposition. "Arrangements for disposition" means any 
110.29 	action normally taken by a funeral provider in anticipation of or preparation for the 
110.30 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation, or, effective July 1, 
110.31 	2025, natural organic reduction of a dead human body.

111.1 	Sec. 28. Minnesota Statutes 2022, section 149A.02, subdivision 16, is amended to read:
111.2 		Subd. 16.Final disposition. "Final disposition" means the acts leading to and the 
111.3 	entombment, burial in a cemetery, alkaline hydrolysis, or cremation, or, effective July 1, 
111.4 	2025, natural organic reduction of a dead human body.

111.5 	Sec. 29. Minnesota Statutes 2022, section 149A.02, subdivision 26a, is amended to read:
111.6 		Subd. 26a.Inurnment. "Inurnment" means placing hydrolyzed or cremated remains in 
111.7 	a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.
111.8 	Effective July 1, 2025, inurnment also includes placing naturally reduced remains in a 
111.9 	naturally reduced remains container suitable for placement, burial, or shipment.

111.10 	Sec. 30. Minnesota Statutes 2022, section 149A.02, subdivision 27, is amended to read:
111.11 		Subd. 27.Licensee. "Licensee" means any person or entity that has been issued a license 
111.12 	to practice mortuary science, to operate a funeral establishment, to operate an alkaline 
111.13 	hydrolysis facility, or to operate a crematory, or, effective July 1, 2025, to operate a natural 
111.14 	organic reduction facility by the Minnesota commissioner of health.

111.15 	Sec. 31. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
111.16 	to read:
111.17 		Subd. 30b.Natural organic reduction or naturally reduce. "Natural organic reduction" 
111.18 	or "naturally reduce" means the contained, accelerated conversion of a dead human body 
111.19 	to soil. This subdivision is effective July 1, 2025.

111.20 	Sec. 32. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
111.21 	to read:
111.22 		Subd. 30c.Natural organic reduction facility. "Natural organic reduction facility" 
111.23 	means a structure, room, or other space in a building or real property where natural organic 
111.24 	reduction of a dead human body occurs. This subdivision is effective July 1, 2025.

111.25 	Sec. 33. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
111.26 	to read:
111.27 		Subd. 30d.Natural organic reduction vessel. "Natural organic reduction vessel" means 
111.28 	the enclosed container in which natural organic reduction takes place. This subdivision is 
111.29 	effective July 1, 2025.

112.1 	Sec. 34. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
112.2 	to read:
112.3 		Subd. 30e.Naturally reduced remains. "Naturally reduced remains" means the soil 
112.4 	remains following the natural organic reduction of a dead human body and the accompanying 
112.5 	plant material. This subdivision is effective July 1, 2025.

112.6 	Sec. 35. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
112.7 	to read:
112.8 		Subd. 30f.Naturally reduced remains container. "Naturally reduced remains container" 
112.9 	means a receptacle in which naturally reduced remains are placed. This subdivision is 
112.10 	effective July 1, 2025.

112.11 	Sec. 36. Minnesota Statutes 2022, section 149A.02, subdivision 35, is amended to read:
112.12 		Subd. 35.Processing. "Processing" means the removal of foreign objects, drying or 
112.13 	cooling, and the reduction of the hydrolyzed orremains, cremated remains, or, effective 
112.14 	July 1, 2025, naturally reduced remains by mechanical means including, but not limited to, 
112.15 	grinding, crushing, or pulverizing, to a granulated appearance appropriate for final 
112.16 	disposition.

112.17 	Sec. 37. Minnesota Statutes 2022, section 149A.02, subdivision 37c, is amended to read:
112.18 		Subd. 37c.Scattering. "Scattering" means the authorized dispersal of hydrolyzed or
112.19 	remains, cremated remains, or, effective July 1, 2025, naturally reduced remains in a defined 
112.20 	area of a dedicated cemetery or in areas where no local prohibition exists provided that the 
112.21 	hydrolyzed or, cremated, or naturally reduced remains are not distinguishable to the public, 
112.22 	are not in a container, and that the person who has control over disposition of the hydrolyzed 
112.23 	or, cremated, or naturally reduced remains has obtained written permission of the property 
112.24 	owner or governing agency to scatter on the property.

112.25 	Sec. 38. Minnesota Statutes 2022, section 149A.03, is amended to read:
112.26 	149A.03 DUTIES OF COMMISSIONER.
112.27 	The commissioner shall:
112.28 	(1) enforce all laws and adopt and enforce rules relating to the:
112.29 	(i) removal, preparation, transportation, arrangements for disposition, and final disposition 
112.30 	of dead human bodies;
113.1 	(ii) licensure and professional conduct of funeral directors, morticians, interns, practicum 
113.2 	students, and clinical students;
113.3 	(iii) licensing and operation of a funeral establishment;
113.4 	(iv) licensing and operation of an alkaline hydrolysis facility; and
113.5 	(v) licensing and operation of a crematory; and
113.6 	(vi) effective July 1, 2025, licensing and operation of a natural organic reduction facility;
113.7 	(2) provide copies of the requirements for licensure and permits to all applicants;
113.8 	(3) administer examinations and issue licenses and permits to qualified persons and other 
113.9 	legal entities;
113.10 	(4) maintain a record of the name and location of all current licensees and interns;
113.11 	(5) perform periodic compliance reviews and premise inspections of licensees;
113.12 	(6) accept and investigate complaints relating to conduct governed by this chapter;
113.13 	(7) maintain a record of all current preneed arrangement trust accounts;
113.14 	(8) maintain a schedule of application, examination, permit, and licensure fees, initial 
113.15 	and renewal, sufficient to cover all necessary operating expenses;
113.16 	(9) educate the public about the existence and content of the laws and rules for mortuary 
113.17 	science licensing and the removal, preparation, transportation, arrangements for disposition, 
113.18 	and final disposition of dead human bodies to enable consumers to file complaints against 
113.19 	licensees and others who may have violated those laws or rules;
113.20 	(10) evaluate the laws, rules, and procedures regulating the practice of mortuary science 
113.21 	in order to refine the standards for licensing and to improve the regulatory and enforcement 
113.22 	methods used; and
113.23 	(11) initiate proceedings to address and remedy deficiencies and inconsistencies in the 
113.24 	laws, rules, or procedures governing the practice of mortuary science and the removal, 
113.25 	preparation, transportation, arrangements for disposition, and final disposition of dead 
113.26 	human bodies.

113.27 	Sec. 39. [149A.56] LICENSE TO OPERATE A NATURAL ORGANIC REDUCTION 
113.28 	FACILITY.
113.29 		Subdivision 1.License requirement. This section is effective July 1, 2025. Except as 
113.30 	provided in section 149A.01, subdivision 3, no person shall maintain, manage, or operate 
114.1 	a place or premises devoted to or used in the holding and natural organic reduction of a 
114.2 	dead human body without possessing a valid license to operate a natural organic reduction 
114.3 	facility issued by the commissioner of health.
114.4 		Subd. 2.Requirements for natural organic reduction facility. (a) A natural organic 
114.5 	reduction facility licensed under this section must consist of:
114.6 	(1) a building or structure that complies with applicable local and state building codes, 
114.7 	zoning laws and ordinances, and environmental standards, and that contains one or more 
114.8 	natural organic reduction vessels for the natural organic reduction of dead human bodies;
114.9 	(2) a motorized mechanical device for processing naturally reduced remains; and
114.10 	(3) an appropriate refrigerated holding facility for dead human bodies awaiting natural 
114.11 	organic reduction.
114.12 	(b) A natural organic reduction facility licensed under this section may also contain a 
114.13 	display room for funeral goods.
114.14 		Subd. 3.Application procedure; documentation; initial inspection. (a) An applicant 
114.15 	for a license to operate a natural organic reduction facility shall submit a completed 
114.16 	application to the commissioner. A completed application includes:
114.17 	(1) a completed application form, as provided by the commissioner;
114.18 	(2) proof of business form and ownership; and
114.19 	(3) proof of liability insurance coverage or other financial documentation, as determined 
114.20 	by the commissioner, that demonstrates the applicant's ability to respond in damages for 
114.21 	liability arising from the ownership, maintenance, management, or operation of a natural 
114.22 	organic reduction facility.
114.23 	(b) Upon receipt of the application and appropriate fee, the commissioner shall review 
114.24 	and verify all information. Upon completion of the verification process and resolution of 
114.25 	any deficiencies in the application information, the commissioner shall conduct an initial 
114.26 	inspection of the premises to be licensed. After the inspection and resolution of any 
114.27 	deficiencies found and any reinspections as may be necessary, the commissioner shall make 
114.28 	a determination, based on all the information available, to grant or deny licensure. If the 
114.29 	commissioner's determination is to grant the license, the applicant shall be notified and the 
114.30 	license shall issue and remain valid for a period prescribed on the license, but not to exceed 
114.31 	one calendar year from the date of issuance of the license. If the commissioner's determination 
114.32 	is to deny the license, the commissioner must notify the applicant, in writing, of the denial 
114.33 	and provide the specific reason for denial.
115.1 		Subd. 4.Nontransferability of license. A license to operate a natural organic reduction 
115.2 	facility is not assignable or transferable and shall not be valid for any entity other than the 
115.3 	one named. Each license issued to operate a natural organic reduction facility is valid only 
115.4 	for the location identified on the license. A 50 percent or more change in ownership or 
115.5 	location of the natural organic reduction facility automatically terminates the license. Separate 
115.6 	licenses shall be required of two or more persons or other legal entities operating from the 
115.7 	same location.
115.8 		Subd. 5.Display of license. Each license to operate a natural organic reduction facility 
115.9 	must be conspicuously displayed in the natural organic reduction facility at all times. 
115.10 	"Conspicuous display" means in a location where a member of the general public within 
115.11 	the natural organic reduction facility is able to observe and read the license.
115.12 		Subd. 6.Period of licensure. All licenses to operate a natural organic reduction facility 
115.13 	issued by the commissioner are valid for a period of one calendar year beginning on July 1 
115.14 	and ending on June 30, regardless of the date of issuance.
115.15 		Subd. 7.Reporting changes in license information. Any change of license information 
115.16 	must be reported to the commissioner, on forms provided by the commissioner, no later 
115.17 	than 30 calendar days after the change occurs. Failure to report changes is grounds for 
115.18 	disciplinary action.
115.19 		Subd. 8.Licensing information. Section 13.41 applies to data collected and maintained 
115.20 	by the commissioner pursuant to this section.

115.21 	Sec. 40. [149A.57] RENEWAL OF LICENSE TO OPERATE A NATURAL 
115.22 	ORGANIC REDUCTION FACILITY.
115.23 		Subdivision 1.Renewal required. This section is effective July 1, 2025. All licenses 
115.24 	to operate a natural organic reduction facility issued by the commissioner expire on June 
115.25 	30 following the date of issuance of the license and must be renewed to remain valid.
115.26 		Subd. 2.Renewal procedure and documentation. (a) Licensees who wish to renew 
115.27 	their licenses must submit to the commissioner a completed renewal application no later 
115.28 	than June 30 following the date the license was issued. A completed renewal application 
115.29 	includes:
115.30 	(1) a completed renewal application form, as provided by the commissioner; and
115.31 	(2) proof of liability insurance coverage or other financial documentation, as determined 
115.32 	by the commissioner, that demonstrates the applicant's ability to respond in damages for 
116.1 	liability arising from the ownership, maintenance, management, or operation of a natural 
116.2 	organic reduction facility.
116.3 	(b) Upon receipt of the completed renewal application, the commissioner shall review 
116.4 	and verify the information. Upon completion of the verification process and resolution of 
116.5 	any deficiencies in the renewal application information, the commissioner shall make a 
116.6 	determination, based on all the information available, to reissue or refuse to reissue the 
116.7 	license. If the commissioner's determination is to reissue the license, the applicant shall be 
116.8 	notified and the license shall issue and remain valid for a period prescribed on the license, 
116.9 	but not to exceed one calendar year from the date of issuance of the license. If the 
116.10 	commissioner's determination is to refuse to reissue the license, section 149A.09, subdivision 
116.11 	2, applies.
116.12 		Subd. 3.Penalty for late filing. Renewal applications received after the expiration date 
116.13 	of a license will result in the assessment of a late filing penalty. The late filing penalty must 
116.14 	be paid before the reissuance of the license and received by the commissioner no later than 
116.15 	31 calendar days after the expiration date of the license.
116.16 		Subd. 4.Lapse of license. A license to operate a natural organic reduction facility shall 
116.17 	automatically lapse when a completed renewal application is not received by the 
116.18 	commissioner within 31 calendar days after the expiration date of a license, or a late filing 
116.19 	penalty assessed under subdivision 3 is not received by the commissioner within 31 calendar 
116.20 	days after the expiration of a license.
116.21 		Subd. 5.Effect of lapse of license. Upon the lapse of a license, the person to whom the 
116.22 	license was issued is no longer licensed to operate a natural organic reduction facility in 
116.23 	Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed 
116.24 	license holder from operating a natural organic reduction facility in Minnesota and may 
116.25 	pursue any additional lawful remedies as justified by the case.
116.26 		Subd. 6.Restoration of lapsed license. The commissioner may restore a lapsed license 
116.27 	upon receipt and review of a completed renewal application, receipt of the late filing penalty, 
116.28 	and reinspection of the premises, provided that the receipt is made within one calendar year 
116.29 	from the expiration date of the lapsed license and the cease and desist order issued by the 
116.30 	commissioner has not been violated. If a lapsed license is not restored within one calendar 
116.31 	year from the expiration date of the lapsed license, the holder of the lapsed license cannot 
116.32 	be relicensed until the requirements in section 149A.56 are met.
116.33 		Subd. 7.Reporting changes in license information. Any change of license information 
116.34 	must be reported to the commissioner, on forms provided by the commissioner, no later 
117.1 	than 30 calendar days after the change occurs. Failure to report changes is grounds for 
117.2 	disciplinary action.
117.3 		Subd. 8.Licensing information. Section 13.41 applies to data collected and maintained 
117.4 	by the commissioner pursuant to this section.

117.5 	Sec. 41. Minnesota Statutes 2022, section 149A.65, is amended by adding a subdivision 
117.6 	to read:
117.7 		Subd. 6a.Natural organic reduction facilities. This subdivision is effective July 1, 
117.8 	2025. The initial and renewal fee for a natural organic reduction facility is $425. The late 
117.9 	fee charge for a license renewal is $100.

117.10 	Sec. 42. Minnesota Statutes 2022, section 149A.70, subdivision 1, is amended to read:
117.11 		Subdivision 1.Use of titles. Only a person holding a valid license to practice mortuary 
117.12 	science issued by the commissioner may use the title of mortician, funeral director, or any 
117.13 	other title implying that the licensee is engaged in the business or practice of mortuary 
117.14 	science. Only the holder of a valid license to operate an alkaline hydrolysis facility issued 
117.15 	by the commissioner may use the title of alkaline hydrolysis facility, water cremation, 
117.16 	water-reduction, biocremation, green-cremation, resomation, dissolution, or any other title, 
117.17 	word, or term implying that the licensee operates an alkaline hydrolysis facility. Only the 
117.18 	holder of a valid license to operate a funeral establishment issued by the commissioner may 
117.19 	use the title of funeral home, funeral chapel, funeral service, or any other title, word, or 
117.20 	term implying that the licensee is engaged in the business or practice of mortuary science. 
117.21 	Only the holder of a valid license to operate a crematory issued by the commissioner may 
117.22 	use the title of crematory, crematorium, green-cremation, or any other title, word, or term 
117.23 	implying that the licensee operates a crematory or crematorium. Effective July 1, 2025,
117.24 	only the holder of a valid license to operate a natural organic reduction facility issued by 
117.25 	the commissioner may use the title of natural organic reduction facility, human composting, 
117.26 	or any other title, word, or term implying that the licensee operates a natural organic reduction 
117.27 	facility.

117.28 	Sec. 43. Minnesota Statutes 2022, section 149A.70, subdivision 2, is amended to read:
117.29 		Subd. 2.Business location. A funeral establishment, alkaline hydrolysis facility, or
117.30 	crematory, or, effective July 1, 2025, natural organic reduction facility shall not do business 
117.31 	in a location that is not licensed as a funeral establishment, alkaline hydrolysis facility, or
118.1 	crematory, or natural organic reduction facility and shall not advertise a service that is 
118.2 	available from an unlicensed location.

118.3 	Sec. 44. Minnesota Statutes 2022, section 149A.70, subdivision 3, is amended to read:
118.4 		Subd. 3.Advertising. No licensee, clinical student, practicum student, or intern shall 
118.5 	publish or disseminate false, misleading, or deceptive advertising. False, misleading, or 
118.6 	deceptive advertising includes, but is not limited to:
118.7 	(1) identifying, by using the names or pictures of, persons who are not licensed to practice 
118.8 	mortuary science in a way that leads the public to believe that those persons will provide 
118.9 	mortuary science services;
118.10 	(2) using any name other than the names under which the funeral establishment, alkaline 
118.11 	hydrolysis facility, or crematory, or, effective July 1, 2025, natural organic reduction facility
118.12 	is known to or licensed by the commissioner;
118.13 	(3) using a surname not directly, actively, or presently associated with a licensed funeral 
118.14 	establishment, alkaline hydrolysis facility, or crematory, or, effective July 1, 2025, natural 
118.15 	organic reduction facility, unless the surname had been previously and continuously used 
118.16 	by the licensed funeral establishment, alkaline hydrolysis facility, or crematory, or natural 
118.17 	organic reduction facility; and
118.18 	(4) using a founding or establishing date or total years of service not directly or 
118.19 	continuously related to a name under which the funeral establishment, alkaline hydrolysis 
118.20 	facility, or crematory, or, effective July 1, 2025, natural organic reduction facility is currently 
118.21 	or was previously licensed.
118.22 	Any advertising or other printed material that contains the names or pictures of persons 
118.23 	affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory, or, effective 
118.24 	July 1, 2025, natural organic reduction facility shall state the position held by the persons 
118.25 	and shall identify each person who is licensed or unlicensed under this chapter.

118.26 	Sec. 45. Minnesota Statutes 2022, section 149A.70, subdivision 5, is amended to read:
118.27 		Subd. 5.Reimbursement prohibited. No licensee, clinical student, practicum student, 
118.28 	or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other 
118.29 	reimbursement in consideration for recommending or causing a dead human body to be 
118.30 	disposed of by a specific body donation program, funeral establishment, alkaline hydrolysis 
118.31 	facility, crematory, mausoleum, or cemetery, or, effective July 1, 2025, natural organic 
118.32 	reduction facility.

119.1 	Sec. 46. Minnesota Statutes 2022, section 149A.71, subdivision 2, is amended to read:
119.2 		Subd. 2.Preventive requirements. (a) To prevent unfair or deceptive acts or practices, 
119.3 	the requirements of this subdivision must be met. This subdivision applies to natural organic 
119.4 	reduction and naturally reduced remains, goods, and services effective July 1, 2025.
119.5 	(b) Funeral providers must tell persons who ask by telephone about the funeral provider's 
119.6 	offerings or prices any accurate information from the price lists described in paragraphs (c) 
119.7 	to (e) and any other readily available information that reasonably answers the questions 
119.8 	asked.
119.9 	(c) Funeral providers must make available for viewing to people who inquire in person 
119.10 	about the offerings or prices of funeral goods or burial site goods, separate printed or 
119.11 	typewritten price lists using a ten-point font or larger. Each funeral provider must have a 
119.12 	separate price list for each of the following types of goods that are sold or offered for sale:
119.13 	(1) caskets;
119.14 	(2) alternative containers;
119.15 	(3) outer burial containers;
119.16 	(4) alkaline hydrolysis containers;
119.17 	(5) cremation containers;
119.18 	(6) hydrolyzed remains containers;
119.19 	(7) cremated remains containers;
119.20 	(8) markers; and
119.21 	(9) headstones.; and
119.22 	(10) naturally reduced remains containers.
119.23 	(d) Each separate price list must contain the name of the funeral provider's place of 
119.24 	business, address, and telephone number and a caption describing the list as a price list for 
119.25 	one of the types of funeral goods or burial site goods described in paragraph (c), clauses 
119.26 	(1) to (9) (10). The funeral provider must offer the list upon beginning discussion of, but 
119.27 	in any event before showing, the specific funeral goods or burial site goods and must provide 
119.28 	a photocopy of the price list, for retention, if so asked by the consumer. The list must contain, 
119.29 	at least, the retail prices of all the specific funeral goods and burial site goods offered which 
119.30 	do not require special ordering, enough information to identify each, and the effective date 
119.31 	for the price list. However, funeral providers are not required to make a specific price list 
120.1 	available if the funeral providers place the information required by this paragraph on the 
120.2 	general price list described in paragraph (e).
120.3 	(e) Funeral providers must give a printed price list, for retention, to persons who inquire 
120.4 	in person about the funeral goods, funeral services, burial site goods, or burial site services 
120.5 	or prices offered by the funeral provider. The funeral provider must give the list upon 
120.6 	beginning discussion of either the prices of or the overall type of funeral service or disposition 
120.7 	or specific funeral goods, funeral services, burial site goods, or burial site services offered 
120.8 	by the provider. This requirement applies whether the discussion takes place in the funeral 
120.9 	establishment or elsewhere. However, when the deceased is removed for transportation to 
120.10 	the funeral establishment, an in-person request for authorization to embalm does not, by 
120.11 	itself, trigger the requirement to offer the general price list. If the provider, in making an 
120.12 	in-person request for authorization to embalm, discloses that embalming is not required by 
120.13 	law except in certain special cases, the provider is not required to offer the general price 
120.14 	list. Any other discussion during that time about prices or the selection of funeral goods, 
120.15 	funeral services, burial site goods, or burial site services triggers the requirement to give 
120.16 	the consumer a general price list. The general price list must contain the following 
120.17 	information:
120.18 	(1) the name, address, and telephone number of the funeral provider's place of business;
120.19 	(2) a caption describing the list as a "general price list";
120.20 	(3) the effective date for the price list;
120.21 	(4) the retail prices, in any order, expressed either as a flat fee or as the prices per hour, 
120.22 	mile, or other unit of computation, and other information described as follows:
120.23 	(i) forwarding of remains to another funeral establishment, together with a list of the 
120.24 	services provided for any quoted price;
120.25 	(ii) receiving remains from another funeral establishment, together with a list of the 
120.26 	services provided for any quoted price;
120.27 	(iii) separate prices for each alkaline hydrolysis, natural organic reduction, or cremation 
120.28 	offered by the funeral provider, with the price including an alternative container or shroud 
120.29 	or alkaline hydrolysis facility or cremation container,; any alkaline hydrolysis, natural 
120.30 	organic reduction facility, or crematory charges,; and a description of the services and 
120.31 	container included in the price, where applicable, and the price of alkaline hydrolysis or 
120.32 	cremation where the purchaser provides the container;
121.1 	(iv) separate prices for each immediate burial offered by the funeral provider, including 
121.2 	a casket or alternative container, and a description of the services and container included 
121.3 	in that price, and the price of immediate burial where the purchaser provides the casket or 
121.4 	alternative container;
121.5 	(v) transfer of remains to the funeral establishment or other location;
121.6 	(vi) embalming;
121.7 	(vii) other preparation of the body;
121.8 	(viii) use of facilities, equipment, or staff for viewing;
121.9 	(ix) use of facilities, equipment, or staff for funeral ceremony;
121.10 	(x) use of facilities, equipment, or staff for memorial service;
121.11 	(xi) use of equipment or staff for graveside service;
121.12 	(xii) hearse or funeral coach;
121.13 	(xiii) limousine; and
121.14 	(xiv) separate prices for all cemetery-specific goods and services, including all goods 
121.15 	and services associated with interment and burial site goods and services and excluding 
121.16 	markers and headstones;
121.17 	(5) the price range for the caskets offered by the funeral provider, together with the 
121.18 	statement "A complete price list will be provided at the funeral establishment or casket sale 
121.19 	location." or the prices of individual caskets, as disclosed in the manner described in 
121.20 	paragraphs (c) and (d);
121.21 	(6) the price range for the alternative containers or shrouds offered by the funeral provider, 
121.22 	together with the statement "A complete price list will be provided at the funeral 
121.23 	establishment or alternative container sale location." or the prices of individual alternative 
121.24 	containers, as disclosed in the manner described in paragraphs (c) and (d);
121.25 	(7) the price range for the outer burial containers offered by the funeral provider, together 
121.26 	with the statement "A complete price list will be provided at the funeral establishment or 
121.27 	outer burial container sale location." or the prices of individual outer burial containers, as 
121.28 	disclosed in the manner described in paragraphs (c) and (d);
121.29 	(8) the price range for the alkaline hydrolysis container offered by the funeral provider, 
121.30 	together with the statement "A complete price list will be provided at the funeral 
121.31 	establishment or alkaline hydrolysis container sale location." or the prices of individual 
122.1 	alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c) and 
122.2 	(d);
122.3 	(9) the price range for the hydrolyzed remains container offered by the funeral provider, 
122.4 	together with the statement "A complete price list will be provided at the funeral 
122.5 	establishment or hydrolyzed remains container sale location." or the prices of individual 
122.6 	hydrolyzed remains container, as disclosed in the manner described in paragraphs (c) and 
122.7 	(d);
122.8 	(10) the price range for the cremation containers offered by the funeral provider, together 
122.9 	with the statement "A complete price list will be provided at the funeral establishment or 
122.10 	cremation container sale location." or the prices of individual cremation containers, as 
122.11 	disclosed in the manner described in paragraphs (c) and (d);
122.12 	(11) the price range for the cremated remains containers offered by the funeral provider, 
122.13 	together with the statement, "A complete price list will be provided at the funeral 
122.14 	establishment or cremated remains container sale location," or the prices of individual 
122.15 	cremation containers as disclosed in the manner described in paragraphs (c) and (d);
122.16 	(12) the price range for the naturally reduced remains containers offered by the funeral 
122.17 	provider, together with the statement, "A complete price list will be provided at the funeral 
122.18 	establishment or naturally reduced remains container sale location," or the prices of individual 
122.19 	naturally reduced remains containers as disclosed in the manner described in paragraphs 
122.20 	(c) and (d);
122.21 	(12) (13) the price for the basic services of funeral provider and staff, together with a 
122.22 	list of the principal basic services provided for any quoted price and, if the charge cannot 
122.23 	be declined by the purchaser, the statement "This fee for our basic services will be added 
122.24 	to the total cost of the funeral arrangements you select. (This fee is already included in our 
122.25 	charges for alkaline hydrolysis, natural organic reduction, direct cremations, immediate 
122.26 	burials, and forwarding or receiving remains.)" If the charge cannot be declined by the 
122.27 	purchaser, the quoted price shall include all charges for the recovery of unallocated funeral 
122.28 	provider overhead, and funeral providers may include in the required disclosure the phrase 
122.29 	"and overhead" after the word "services." This services fee is the only funeral provider fee 
122.30 	for services, facilities, or unallocated overhead permitted by this subdivision to be 
122.31 	nondeclinable, unless otherwise required by law;
122.32 	(13) (14) the price range for the markers and headstones offered by the funeral provider, 
122.33 	together with the statement "A complete price list will be provided at the funeral 
123.1 	establishment or marker or headstone sale location." or the prices of individual markers and 
123.2 	headstones, as disclosed in the manner described in paragraphs (c) and (d); and
123.3 	(14) (15) any package priced funerals offered must be listed in addition to and following 
123.4 	the information required in paragraph (e) and must clearly state the funeral goods and 
123.5 	services being offered, the price being charged for those goods and services, and the 
123.6 	discounted savings.
123.7 	(f) Funeral providers must give an itemized written statement, for retention, to each 
123.8 	consumer who arranges an at-need funeral or other disposition of human remains at the 
123.9 	conclusion of the discussion of the arrangements. The itemized written statement must be 
123.10 	signed by the consumer selecting the goods and services as required in section 149A.80. If 
123.11 	the statement is provided by a funeral establishment, the statement must be signed by the 
123.12 	licensed funeral director or mortician planning the arrangements. If the statement is provided 
123.13 	by any other funeral provider, the statement must be signed by an authorized agent of the 
123.14 	funeral provider. The statement must list the funeral goods, funeral services, burial site 
123.15 	goods, or burial site services selected by that consumer and the prices to be paid for each 
123.16 	item, specifically itemized cash advance items (these prices must be given to the extent then 
123.17 	known or reasonably ascertainable if the prices are not known or reasonably ascertainable, 
123.18 	a good faith estimate shall be given and a written statement of the actual charges shall be 
123.19 	provided before the final bill is paid), and the total cost of goods and services selected. At 
123.20 	the conclusion of an at-need arrangement, the funeral provider is required to give the 
123.21 	consumer a copy of the signed itemized written contract that must contain the information 
123.22 	required in this paragraph.
123.23 	(g) Upon receiving actual notice of the death of an individual with whom a funeral 
123.24 	provider has entered a preneed funeral agreement, the funeral provider must provide a copy 
123.25 	of all preneed funeral agreement documents to the person who controls final disposition of 
123.26 	the human remains or to the designee of the person controlling disposition. The person 
123.27 	controlling final disposition shall be provided with these documents at the time of the 
123.28 	person's first in-person contact with the funeral provider, if the first contact occurs in person 
123.29 	at a funeral establishment, alkaline hydrolysis facility, crematory, natural organic reduction 
123.30 	facility, or other place of business of the funeral provider. If the contact occurs by other 
123.31 	means or at another location, the documents must be provided within 24 hours of the first 
123.32 	contact.

124.1 	Sec. 47. Minnesota Statutes 2022, section 149A.71, subdivision 4, is amended to read:
124.2 		Subd. 4.Casket, alternate container, alkaline hydrolysis container, naturally reduced 
124.3 	remains container, and cremation container sales; records; required disclosures. Any 
124.4 	funeral provider who sells or offers to sell a casket, alternate container, alkaline hydrolysis 
124.5 	container, hydrolyzed remains container, cremation container, or cremated remains container, 
124.6 	or, effective July 1, 2025, naturally reduced remains container to the public must maintain 
124.7 	a record of each sale that includes the name of the purchaser, the purchaser's mailing address, 
124.8 	the name of the decedent, the date of the decedent's death, and the place of death. These 
124.9 	records shall be open to inspection by the regulatory agency. Any funeral provider selling 
124.10 	a casket, alternate container, or cremation container to the public, and not having charge of 
124.11 	the final disposition of the dead human body, shall provide a copy of the statutes and rules 
124.12 	controlling the removal, preparation, transportation, arrangements for disposition, and final 
124.13 	disposition of a dead human body. This subdivision does not apply to morticians, funeral 
124.14 	directors, funeral establishments, crematories, or wholesale distributors of caskets, alternate 
124.15 	containers, alkaline hydrolysis containers, or cremation containers.

124.16 	Sec. 48. Minnesota Statutes 2022, section 149A.72, subdivision 3, is amended to read:
124.17 		Subd. 3.Casket for alkaline hydrolysis, natural organic reduction, or cremation 
124.18 	provisions; deceptive acts or practices. In selling or offering to sell funeral goods or 
124.19 	funeral services to the public, it is a deceptive act or practice for a funeral provider to 
124.20 	represent that a casket is required for alkaline hydrolysis or, cremations, or, effective July 
124.21 	1, 2025, natural organic reduction by state or local law or otherwise.

124.22 	Sec. 49. Minnesota Statutes 2022, section 149A.72, subdivision 9, is amended to read:
124.23 		Subd. 9.Deceptive acts or practices. In selling or offering to sell funeral goods, funeral 
124.24 	services, burial site goods, or burial site services to the public, it is a deceptive act or practice 
124.25 	for a funeral provider to represent that federal, state, or local laws, or particular cemeteries, 
124.26 	alkaline hydrolysis facilities, or crematories, or, effective July 1, 2025, natural organic 
124.27 	reduction facilities require the purchase of any funeral goods, funeral services, burial site 
124.28 	goods, or burial site services when that is not the case.

124.29 	Sec. 50. Minnesota Statutes 2022, section 149A.73, subdivision 1, is amended to read:
124.30 		Subdivision 1.Casket for alkaline hydrolysis, natural organic reduction, or cremation 
124.31 	provisions; deceptive acts or practices. In selling or offering to sell funeral goods, funeral 
124.32 	services, burial site goods, or burial site services to the public, it is a deceptive act or practice 
125.1 	for a funeral provider to require that a casket be purchased for alkaline hydrolysis or,
125.2 	cremation, or, effective July 1, 2025, natural organic reduction.

125.3 	Sec. 51. Minnesota Statutes 2022, section 149A.74, subdivision 1, is amended to read:
125.4 		Subdivision 1.Services provided without prior approval; deceptive acts or 
125.5 	practices. In selling or offering to sell funeral goods or funeral services to the public, it is 
125.6 	a deceptive act or practice for any funeral provider to embalm a dead human body unless 
125.7 	state or local law or regulation requires embalming in the particular circumstances regardless 
125.8 	of any funeral choice which might be made, or prior approval for embalming has been 
125.9 	obtained from an individual legally authorized to make such a decision. In seeking approval 
125.10 	to embalm, the funeral provider must disclose that embalming is not required by law except 
125.11 	in certain circumstances; that a fee will be charged if a funeral is selected which requires 
125.12 	embalming, such as a funeral with viewing; and that no embalming fee will be charged if 
125.13 	the family selects a service which does not require embalming, such as direct alkaline 
125.14 	hydrolysis, direct cremation, or immediate burial, or, effective July 1, 2025, natural organic 
125.15 	reduction.

125.16 	Sec. 52. Minnesota Statutes 2022, section 149A.93, subdivision 3, is amended to read:
125.17 		Subd. 3.Disposition permit. A disposition permit is required before a body can be 
125.18 	buried, entombed, alkaline hydrolyzed, or cremated, or, effective July 1, 2025, naturally 
125.19 	reduced. No disposition permit shall be issued until a fact of death record has been completed 
125.20 	and filed with the state registrar of vital records.

125.21 	Sec. 53. Minnesota Statutes 2022, section 149A.94, subdivision 1, is amended to read:
125.22 		Subdivision 1.Generally. Every dead human body lying within the state, except 
125.23 	unclaimed bodies delivered for dissection by the medical examiner, those delivered for 
125.24 	anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through 
125.25 	the state for the purpose of disposition elsewhere; and the remains of any dead human body 
125.26 	after dissection or anatomical study, shall be decently buried or entombed in a public or 
125.27 	private cemetery, alkaline hydrolyzed, or cremated, or, effective July 1, 2025, naturally 
125.28 	reduced within a reasonable time after death. Where final disposition of a body will not be 
125.29 	accomplished, or, effective July 1, 2025, when natural organic reduction will not be initiated,
125.30 	within 72 hours following death or release of the body by a competent authority with 
125.31 	jurisdiction over the body, the body must be properly embalmed, refrigerated, or packed 
125.32 	with dry ice. A body may not be kept in refrigeration for a period exceeding six calendar 
126.1 	days, or packed in dry ice for a period that exceeds four calendar days, from the time of 
126.2 	death or release of the body from the coroner or medical examiner.

126.3 	Sec. 54. Minnesota Statutes 2022, section 149A.94, subdivision 3, is amended to read:
126.4 		Subd. 3.Permit required. No dead human body shall be buried, entombed, or cremated, 
126.5 	alkaline hydrolyzed, or, effective July 1, 2025, naturally reduced without a disposition 
126.6 	permit. The disposition permit must be filed with the person in charge of the place of final 
126.7 	disposition. Where a dead human body will be transported out of this state for final 
126.8 	disposition, the body must be accompanied by a certificate of removal.

126.9 	Sec. 55. Minnesota Statutes 2022, section 149A.94, subdivision 4, is amended to read:
126.10 		Subd. 4.Alkaline hydrolysis or, cremation, or natural organic reduction. Inurnment 
126.11 	of alkaline hydrolyzed or remains, cremated remains, or, effective July 1, 2025, naturally 
126.12 	reduced remains and release to an appropriate party is considered final disposition and no 
126.13 	further permits or authorizations are required for transportation, interment, entombment, or 
126.14 	placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

126.15 	Sec. 56. [149A.955] NATURAL ORGANIC REDUCTION FACILITIES AND 
126.16 	NATURAL ORGANIC REDUCTION.
126.17 		Subdivision 1.License required. This section is effective July 1, 2025. A dead human 
126.18 	body may only undergo natural organic reduction in this state at a natural organic reduction 
126.19 	facility licensed by the commissioner of health.
126.20 		Subd. 2.General requirements. Any building to be used as a natural organic reduction 
126.21 	facility must comply with all applicable local and state building codes, zoning laws and 
126.22 	ordinances, and environmental standards. A natural organic reduction facility must have on 
126.23 	site a natural organic reduction system approved by the commissioner and a motorized 
126.24 	mechanical device for processing naturally reduced remains and must have in the building 
126.25 	a refrigerated holding facility for the retention of dead human bodies awaiting natural organic 
126.26 	reduction. The holding facility must be secure from access by anyone except the authorized 
126.27 	personnel of the natural organic reduction facility, preserve the dignity of the remains, and 
126.28 	protect the health and safety of the natural organic reduction facility personnel.
126.29 		Subd. 3.Aerobic reduction vessel. A natural organic reduction facility must use as a 
126.30 	natural organic reduction vessel a contained reduction vessel that is designed to promote 
126.31 	aerobic reduction and that minimizes odors.
127.1 		Subd. 4.Unlicensed personnel. A licensed natural organic reduction facility may employ 
127.2 	unlicensed personnel, provided that all applicable provisions of this chapter are followed. 
127.3 	It is the duty of the licensed natural organic reduction facility to provide proper training for 
127.4 	all unlicensed personnel, and the licensed natural organic reduction facility shall be strictly 
127.5 	accountable for compliance with this chapter and other applicable state and federal regulations 
127.6 	regarding occupational and workplace health and safety.
127.7 		Subd. 5.Authorization to naturally reduce. No natural organic reduction facility shall 
127.8 	naturally reduce or cause to be naturally reduced any dead human body or identifiable body 
127.9 	part without receiving written authorization to do so from the person or persons who have 
127.10 	the legal right to control disposition as described in section 149A.80 or the person's legal 
127.11 	designee. The written authorization must include:
127.12 	(1) the name of the deceased and the date of death of the deceased;
127.13 	(2) a statement authorizing the natural organic reduction facility to naturally reduce the 
127.14 	body;
127.15 	(3) the name, address, phone number, relationship to the deceased, and signature of the 
127.16 	person or persons with the legal right to control final disposition or a legal designee;
127.17 	(4) directions for the disposition of any non-naturally reduced materials or items recovered 
127.18 	from the natural organic reduction vessel;
127.19 	(5) acknowledgment that some of the naturally reduced remains will be mechanically 
127.20 	reduced to a granulated appearance and included in the appropriate containers with the 
127.21 	naturally reduced remains; and
127.22 	(6) directions for the ultimate disposition of the naturally reduced remains.
127.23 		Subd. 6.Limitation of liability. The limitations in section 149A.95, subdivision 5, apply 
127.24 	to natural organic reduction facilities.
127.25 		Subd. 7.Acceptance of delivery of body. (a) No dead human body shall be accepted 
127.26 	for final disposition by natural organic reduction unless the body is:
127.27 	(1) wrapped in a container, such as a pouch or shroud, that is impermeable or 
127.28 	leak-resistant;
127.29 	(2) accompanied by a disposition permit issued pursuant to section 149A.93, subdivision 
127.30 	3, including a photocopy of the complete death record or a signed release authorizing natural 
127.31 	organic reduction received from a coroner or medical examiner; and
128.1 	(3) accompanied by a natural organic reduction authorization that complies with 
128.2 	subdivision 5.
128.3 	(b) A natural organic reduction facility shall refuse to accept delivery of the dead human 
128.4 	body:
128.5 	(1) where there is a known dispute concerning natural organic reduction of the body 
128.6 	delivered;
128.7 	(2) where there is a reasonable basis for questioning any of the representations made on 
128.8 	the written authorization to naturally reduce; or
128.9 	(3) for any other lawful reason.
128.10 	(c) When a container, pouch, or shroud containing a dead human body shows evidence 
128.11 	of leaking bodily fluid, the container, pouch, or shroud and the body must be returned to 
128.12 	the contracting funeral establishment, or the body must be transferred to a new container, 
128.13 	pouch, or shroud by a properly licensed individual.
128.14 	(d) If a dead human body is delivered to a natural organic reduction facility in a container, 
128.15 	pouch, or shroud that is not suitable for placement in a natural organic reduction vessel, the 
128.16 	transfer of the body to the vessel must be performed by a properly licensed individual.
128.17 		Subd. 8.Bodies awaiting natural organic reduction. A dead human body must be 
128.18 	placed in the natural organic reduction vessel to initiate the natural reduction process within 
128.19 	a reasonable time after death, pursuant to section 149A.94, subdivision 1.
128.20 		Subd. 9.Handling of dead human bodies. All natural organic reduction facility 
128.21 	employees handling the containers, pouches, or shrouds for dead human bodies shall use 
128.22 	universal precautions and otherwise exercise all reasonable precautions to minimize the 
128.23 	risk of transmitting any communicable disease from the body. No dead human body shall 
128.24 	be removed from the container, pouch, or shroud in which it is delivered to the natural 
128.25 	organic reduction facility without express written authorization of the person or persons 
128.26 	with legal right to control the disposition and only by a properly licensed individual. The 
128.27 	person or persons with the legal right to control the body or that person's noncompensated 
128.28 	designee may be involved with preparation of the body pursuant to section 149A.01, 
128.29 	subdivision 3, paragraph (c).
128.30 		Subd. 10.Identification of the body. All licensed natural organic reduction facilities 
128.31 	shall develop, implement, and maintain an identification procedure whereby dead human 
128.32 	bodies can be identified from the time the natural organic reduction facility accepts delivery 
128.33 	of the body until the naturally reduced remains are released to an authorized party. After 
129.1 	natural organic reduction, an identifying disk, tab, or other permanent label shall be placed 
129.2 	within the naturally reduced remains container or containers before the remains are released 
129.3 	from the natural organic reduction facility. Each identification disk, tab, or label shall have 
129.4 	a number that shall be recorded on all paperwork regarding the decedent. This procedure 
129.5 	shall be designed to reasonably ensure that the proper body is naturally reduced and that 
129.6 	the remains are returned to the appropriate party. Loss of all or part of the remains or the 
129.7 	inability to individually identify the remains is a violation of this subdivision.
129.8 		Subd. 11.Natural organic reduction vessel for human remains. A licensed natural 
129.9 	organic reduction facility shall knowingly naturally reduce only dead human bodies or 
129.10 	human remains in a natural organic reduction vessel.
129.11 		Subd. 12.Natural organic reduction procedures; privacy. The final disposition of 
129.12 	dead human bodies by natural organic reduction shall be done in privacy. Unless there is 
129.13 	written authorization from the person with the legal right to control the final disposition, 
129.14 	only authorized natural organic reduction facility personnel shall be permitted in the natural 
129.15 	organic reduction area while any human body is awaiting placement in a natural organic 
129.16 	reduction vessel, being removed from the vessel, or being processed for placement in a 
129.17 	naturally reduced remains container. This does not prohibit an in-person laying-in ceremony 
129.18 	to honor the deceased and the transition prior to the placement.
129.19 		Subd. 13.Natural organic reduction procedures; commingling of bodies 
129.20 	prohibited. Except with the express written permission of the person with the legal right 
129.21 	to control the final disposition, no natural organic reduction facility shall naturally reduce 
129.22 	more than one dead human body at the same time and in the same natural organic reduction 
129.23 	vessel or introduce a second dead human body into same natural organic reduction vessel 
129.24 	until reasonable efforts have been employed to remove all fragments of remains from the 
129.25 	preceding natural organic reduction. This subdivision does not apply where commingling 
129.26 	of human remains during natural organic reduction is otherwise provided by law. The fact 
129.27 	that there is incidental and unavoidable residue in the natural organic reduction vessel used 
129.28 	in a prior natural organic reduction is not a violation of this subdivision.
129.29 		Subd. 14.Natural organic reduction procedures; removal from natural organic 
129.30 	reduction vessel. Upon completion of the natural organic reduction process, reasonable 
129.31 	efforts shall be made to remove from the natural organic reduction vessel all the recoverable 
129.32 	naturally reduced remains. The naturally reduced remains shall be transported to the 
129.33 	processing area, and any non-naturally reducible materials or items shall be separated from 
129.34 	the naturally reduced remains and disposed of, in any lawful manner, by the natural organic 
129.35 	reduction facility.
130.1 		Subd. 15.Natural organic reduction procedures; processing naturally reduced 
130.2 	remains. The naturally reduced remains that remain intact shall be reduced by a motorized 
130.3 	mechanical processor to a granulated appearance. The granulated remains and the rest of 
130.4 	the naturally reduced remains shall be returned to a natural organic reduction vessel for 
130.5 	final reduction.
130.6 		Subd. 16.Natural organic reduction procedures; commingling of naturally reduced 
130.7 	remains prohibited. Except with the express written permission of the person with the 
130.8 	legal right to control the final deposition or otherwise provided by law, no natural organic 
130.9 	reduction facility shall mechanically process the naturally reduced remains of more than 
130.10 	one body at a time in the same mechanical processor or introduce the naturally reduced 
130.11 	remains of a second body into a mechanical processor until reasonable efforts have been 
130.12 	employed to remove all fragments of naturally reduced remains already in the processor. 
130.13 	The fact that there is incidental and unavoidable residue in the mechanical processor is not 
130.14 	a violation of this subdivision.
130.15 		Subd. 17.Natural organic reduction procedures; testing naturally reduced 
130.16 	remains. The natural organic reduction facility is responsible for:
130.17 	(1) ensuring that the materials in the natural organic reduction vessel naturally reach 
130.18 	and maintain a minimum temperature of 131 degrees Fahrenheit for a minimum of 72 
130.19 	consecutive hours during the process of natural organic reduction;
130.20 	(2) analyzing each instance of the naturally reduced remains for physical contaminants 
130.21 	that include but are not limited to intact bone, dental filings, and medical implants. Naturally 
130.22 	reduced remains must have less than 0.01 mg/kg dry weight of any physical contaminants;
130.23 	(3) collecting material samples for analysis that are representative of each instance of 
130.24 	natural organic reduction using a sampling method, such as those described in the U.S. 
130.25 	Composting Council 2002 Test Methods for the Examination of Composting and Compost, 
130.26 	Method 02.01-A through E;
130.27 	(4) developing and using a natural organic reduction process in which the naturally 
130.28 	reduced remains from the process does not exceed the following limits:
130.29 	(i) for fecal coliform, less than 1,000 most probable number per gram of total solids (dry 
130.30 	weight);
130.31 	(ii) for salmonella, less than three most probable number per four grams of total solids 
130.32 	(dry weight);
130.33 	(iii) for arsenic, less than or equal to 11 ppm;
131.1 	(iv) for cadmium, less than or equal to 7.1 ppm;
131.2 	(v) for lead, less than or equal to 150 ppm;
131.3 	(vi) for mercury, less than or equal to 8 ppm; and
131.4 	(vii) for selenium, less than or equal to 18 ppm;
131.5 	(5) analyzing, using a third-party laboratory, the natural organic reduction facility's 
131.6 	material samples of naturally reduced remains according to the following schedule:
131.7 	(i) the natural organic reduction facility must analyze each of the first 20 instances of 
131.8 	naturally reduced remains for the parameters identified in clause (4);
131.9 	(ii) if any of the first 20 instances of naturally reduced remains yield results exceeding 
131.10 	the limits identified in clause (4), the natural organic reduction facility must conduct 
131.11 	appropriate processes to correct the levels of the chemicals identified in clause (4) and have 
131.12 	the resultant remains tested to ensure they fall within the identified limits;
131.13 	(iii) if any of the first 20 instances of naturally reduced remains yield results exceeding 
131.14 	the limits identified in clause (4), the natural organic reduction facility must analyze each 
131.15 	additional instance of naturally reduced remains for the parameters identified in clause (4) 
131.16 	until a total of 20 samples, not including those from remains that were reprocessed under 
131.17 	item (ii), have yielded results within the limits of clause (4) on initial testing;
131.18 	(iv) after 20 material samples of naturally reduced remains have met the limits outlined 
131.19 	in clause (4), the natural organic reduction facility must analyze, at a minimum, 25 percent 
131.20 	of the natural organic reduction facility's monthly instances of naturally reduced remains 
131.21 	for the parameters identified in clause (4) until 80 total material samples of naturally reduced 
131.22 	remains have met the requirements of clause (4), not including any samples that required 
131.23 	reprocessing to meet those requirements; and
131.24 	(v) after 80 material samples of naturally reduced remains have met the limits of clause 
131.25 	(4), the natural organic reduction facility must analyze, at a minimum, one instance of 
131.26 	naturally reduced remains each month;
131.27 	(6) complying with any testing requirements established by the commissioner for content 
131.28 	parameters in addition to those specified in clause (4);
131.29 	(7) not releasing any naturally reduced remains that exceed the limits identified in clause 
131.30 	(4); and
131.31 	(8) preparing, maintaining, and providing upon request by the commissioner an annual 
131.32 	report each calendar year. The annual report must detail the natural organic reduction 
132.1 	facility's activities during the previous calendar year and must include the following 
132.2 	information:
132.3 	(i) name and address of the natural organic reduction facility;
132.4 	(ii) calendar year covered by the report;
132.5 	(iii) annual quantity of naturally reduced remains;
132.6 	(iv) results of any laboratory analyses of naturally reduced remains; and
132.7 	(v) any additional information requested by the commissioner.
132.8 		Subd. 18.Natural organic reduction procedures; use of more than one naturally 
132.9 	reduced remains container. If the naturally reduced remains are to be separated into two 
132.10 	or more naturally reduced remains containers according to the directives provided in the 
132.11 	written authorization for natural organic reduction, all of the containers shall contain duplicate 
132.12 	identification disks, tabs, or permanent labels and all paperwork regarding the given body 
132.13 	shall include a notation of the number of and disposition of each container, as provided in 
132.14 	the written authorization.
132.15 		Subd. 19.Natural organic reduction procedures; disposition of accumulated 
132.16 	residue. Every natural organic reduction facility shall provide for the removal and disposition 
132.17 	of any accumulated residue from any natural organic reduction vessel, mechanical processor, 
132.18 	or other equipment used in natural organic reduction. Disposition of accumulated residue 
132.19 	shall be by any lawful manner deemed appropriate.
132.20 		Subd. 20.Natural organic reduction procedures; release of naturally reduced 
132.21 	remains. Following completion of the natural organic reduction process, the inurned naturally 
132.22 	reduced remains shall be released according to the instructions given on the written 
132.23 	authorization for natural organic reduction. If the remains are to be shipped, they must be 
132.24 	securely packaged and transported by a method that has an internal tracing system available 
132.25 	and which provides a receipt signed by the person accepting delivery. Where there is a 
132.26 	dispute over release or disposition of the naturally reduced remains, a natural organic 
132.27 	reduction facility may deposit the naturally reduced remains in accordance with the directives 
132.28 	of a court of competent jurisdiction pending resolution of the dispute or retain the naturally 
132.29 	reduced remains until the person with the legal right to control disposition presents 
132.30 	satisfactory indication that the dispute is resolved. A natural organic reduction facility must 
132.31 	make every effort to ensure naturally reduced remains are not sold or used for commercial 
132.32 	purposes.
133.1 		Subd. 21.Unclaimed naturally reduced remains. If, after 30 calendar days following 
133.2 	the inurnment, the naturally reduced remains are not claimed or disposed of according to 
133.3 	the written authorization for natural organic reduction, the natural organic reduction facility 
133.4 	shall give written notice, by certified mail, to the person with the legal right to control the 
133.5 	final disposition or a legal designee, that the naturally reduced remains are unclaimed and 
133.6 	requesting further release directions. Should the naturally reduced remains be unclaimed 
133.7 	120 calendar days following the mailing of the written notification, the natural organic 
133.8 	reduction facility may return the remains to the earth respectfully in any lawful manner 
133.9 	deemed appropriate.
133.10 		Subd. 22.Required records. Every natural organic reduction facility shall create and 
133.11 	maintain on its premises or other business location in Minnesota an accurate record of every 
133.12 	natural organic reduction provided. The record shall include all of the following information 
133.13 	for each natural organic reduction:
133.14 	(1) the name of the person or funeral establishment delivering the body for natural 
133.15 	organic reduction;
133.16 	(2) the name of the deceased and the identification number assigned to the body;
133.17 	(3) the date of acceptance of delivery;
133.18 	(4) the names of the operator of the natural organic reduction process and mechanical 
133.19 	processor operator;
133.20 	(5) the times and dates that the body was placed in and removed from the natural organic 
133.21 	reduction vessel;
133.22 	(6) the time and date that processing and inurnment of the naturally reduced remains 
133.23 	was completed;
133.24 	(7) the time, date, and manner of release of the naturally reduced remains;
133.25 	(8) the name and address of the person who signed the authorization for natural organic 
133.26 	reduction;
133.27 	(9) all supporting documentation, including any transit or disposition permits, a photocopy 
133.28 	of the death record, and the authorization for natural organic reduction; and
133.29 	(10) the type of natural organic reduction vessel.
133.30 		Subd. 23.Retention of records. Records required under subdivision 21 shall be 
133.31 	maintained for a period of three calendar years after the release of the naturally reduced 
133.32 	remains. Following this period and subject to any other laws requiring retention of records, 
134.1 	the natural organic reduction facility may then place the records in storage or reduce them 
134.2 	to microfilm, a digital format, or any other method that can produce an accurate reproduction 
134.3 	of the original record, for retention for a period of ten calendar years from the date of release 
134.4 	of the naturally reduced remains. At the end of this period and subject to any other laws 
134.5 	requiring retention of records, the natural organic reduction facility may destroy the records 
134.6 	by shredding, incineration, or any other manner that protects the privacy of the individuals 
134.7 	identified.

134.8 	Sec. 57. STILLBIRTH PREVENTION THROUGH TRACKING FETAL 
134.9 	MOVEMENT PILOT PROGRAM.
 134.10 		Subdivision 1.Grant. The commissioner of health shall issue a grant to a grant recipient 
134.11 	to support a stillbirth prevention through tracking fetal movement pilot program and to 
134.12 	provide evidence of the efficacy of tracking fetal movements in preventing stillbirths in 
134.13 	Minnesota. The pilot program shall operate in fiscal years 2025, 2026, and 2027.
134.14 		Subd. 2.Use of grant funds. The grant recipient must use grant funds:
134.15 	(1) for activities to ensure that expectant parents in Minnesota receive information about 
134.16 	the importance of tracking fetal movement in the third trimester of pregnancy, by providing 
134.17 	evidence-based information to organizations that include but are not limited to community 
134.18 	organizations, hospitals, birth centers, maternal health providers, and higher education 
134.19 	institutions that educate maternal health providers;
134.20 	(2) to provide maternal health providers and expectant parents in Minnesota with access 
134.21 	to free, evidence-based educational materials on fetal movement tracking, including 
134.22 	brochures, posters, reminder cards, continuing education materials, and digital resources;
134.23 	(3) to assist in raising awareness with health care providers about:
134.24 	(i) the availability of free fetal movement tracking education for providers through an 
134.25 	initial education campaign;
134.26 	(ii) the importance of tracking fetal movement in the third trimester of pregnancy by 
134.27 	offering at least three to five webinars and conferences per year; and
134.28 	(iii) the importance of tracking fetal movement in the third trimester of pregnancy through 
134.29 	provider participation in a public relations campaign; and
134.30 	(4) to assist in raising public awareness about the availability of free fetal movement 
134.31 	tracking resources through social media marketing and traditional marketing throughout 
134.32 	Minnesota.
135.1 		Subd. 3.Data-sharing and monitoring. (a) During the operation of the pilot program, 
135.2 	the grant recipient shall provide the following information to the commissioner on at least 
135.3 	a quarterly basis:
135.4 	(1) the number of educational materials distributed under the pilot program, broken 
135.5 	down by zip code and the type of facility or organization that ordered the materials, including 
135.6 	hospitals, birth centers, maternal health clinics, WIC clinics, and community organizations;
135.7 	(2) the number of fetal movement tracking application downloads that may be attributed 
135.8 	to the pilot program, broken down by zip code;
135.9 	(3) the reach of and engagement with marketing materials provided under the pilot 
135.10 	program; and
135.11 	(4) provider attendance and participation in awareness-raising events under the pilot 
135.12 	program, such as webinars and conferences.
135.13 	(b) Each year during the pilot program and at the conclusion of the pilot program, the 
135.14 	grant recipient shall provide the commissioner with an annual report that includes information 
135.15 	on how the pilot program has affected:
135.16 	(1) fetal death rates in Minnesota;
135.17 	(2) fetal death rates in Minnesota among American Indian, Black, Hispanic, and Asian 
135.18 	Pacific Islander populations; and
135.19 	(3) fetal death rates by region in Minnesota.
135.20 		Subd. 4.Reports. The commissioner must submit to the legislative committees with 
135.21 	jurisdiction over public health an interim report and a final report on the operation of the 
135.22 	pilot program. The interim report must be submitted by December 1, 2025, and the final 
135.23 	report must be submitted by December 1, 2027. Each report must at least describe the pilot 
135.24 	program's operations and provide information, to the extent available, on the effectiveness 
135.25 	of the pilot program in preventing stillbirths in Minnesota, including lessons learned in 
135.26 	implementing the pilot program and recommendations for future action.

135.27 	ARTICLE 6
135.28 	DEPARTMENT OF HEALTH POLICY

135.29 	Section 1. Minnesota Statutes 2022, section 62D.14, subdivision 1, is amended to read:
135.30 		Subdivision 1.Examination authority. The commissioner of health may make an 
135.31 	examination of the affairs of any health maintenance organization and its contracts, 
136.1 	agreements, or other arrangements with any participating entity as often as the commissioner 
136.2 	of health deems necessary for the protection of the interests of the people of this state, but 
136.3 	not less frequently than once every three five years. Examinations of participating entities 
136.4 	pursuant to this subdivision shall be limited to their dealings with the health maintenance 
136.5 	organization and its enrollees, except that examinations of major participating entities may 
136.6 	include inspection of the entity's financial statements kept in the ordinary course of business. 
136.7 	The commissioner may require major participating entities to submit the financial statements 
136.8 	directly to the commissioner. Financial statements of major participating entities are subject 
136.9 	to the provisions of section 13.37, subdivision 1, clause (b), upon request of the major 
136.10 	participating entity or the health maintenance organization with which it contracts.

136.11 	Sec. 2. [62J.461] 340B COVERED ENTITY REPORT.
136.12 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
136.13 	apply.
136.14 	(b) "340B covered entity" or "covered entity" means a covered entity as defined in United 
136.15 	States Code, title 42, section 256b(a)(4), with a service address in Minnesota as of January 
136.16 	1 of the reporting year. 340B covered entity includes all entity types and grantees. All 
136.17 	facilities that are identified as child sites or grantee associated sites under the federal 340B 
136.18 	Drug Pricing Program are considered part of the 340B covered entity.
136.19 	(c) "340B Drug Pricing Program" or "340B program" means the drug discount program 
136.20 	established under United States Code, title 42, section 256b.
136.21 	(d) "340B entity type" is the designation of the 340B covered entity according to the 
136.22 	entity types specified in United States Code, title 42, section 256b(a)(4).
136.23 	(e) "340B ID" is the unique identification number provided by the Health Resources 
136.24 	and Services Administration to identify a 340B-eligible entity in the 340B Office of Pharmacy 
136.25 	Affairs Information System.
136.26 	(f) "Contract pharmacy" means a pharmacy with which a 340B covered entity has an 
136.27 	arrangement to dispense drugs purchased under the 340B Drug Pricing Program.
136.28 	(g) "Pricing unit" means the smallest dispensable amount of a prescription drug product 
136.29 	that can be dispensed or administered.
136.30 		Subd. 2.Current registration. Beginning April 1, 2024, each 340B covered entity must 
136.31 	maintain a current registration with the commissioner in a form and manner prescribed by 
136.32 	the commissioner. The registration must include the following information:
137.1 	(1) the name of the 340B covered entity;
137.2 	(2) the 340B ID of the 340B covered entity;
137.3 	(3) the servicing address of the 340B covered entity; and
137.4 	(4) the 340B entity type of the 340B covered entity.
137.5 		Subd. 3.Reporting by covered entities to the commissioner. (a) Each 340B covered 
137.6 	entity shall report to the commissioner by April 1, 2024, and by April 1 of each year 
137.7 	thereafter, the following information for transactions conducted by the 340B covered entity 
137.8 	or on its behalf, and related to its participation in the federal 340B program for the previous 
137.9 	calendar year:
137.10 	(1) the aggregated acquisition cost for prescription drugs obtained under the 340B 
137.11 	program;
137.12 	(2) the aggregated payment amount received for drugs obtained under the 340B program 
137.13 	and dispensed or administered to patients;
137.14 	(3) the number of pricing units dispensed or administered for prescription drugs described 
137.15 	in clause (2); and
137.16 	(4) the aggregated payments made:
137.17 	(i) to contract pharmacies to dispense drugs obtained under the 340B program;
137.18 	(ii) to any other entity that is not the covered entity and is not a contract pharmacy for 
137.19 	managing any aspect of the covered entity's 340B program; and
137.20 	(iii) for all other expenses related to administering the 340B program.
137.21 	The information under clauses (2) and (3) must be reported by payer type, including but 
137.22 	not limited to commercial insurance, medical assistance, MinnesotaCare, and Medicare, in 
137.23 	the form and manner prescribed by the commissioner.
137.24 	(b) For covered entities that are hospitals, the information required under paragraph (a), 
137.25 	clauses (1) to (3), must also be reported at the national drug code level for the 50 most 
137.26 	frequently dispensed or administered drugs by the facility under the 340B program.
137.27 	(c) Data submitted to the commissioner under paragraphs (a) and (b) are classified as 
137.28 	nonpublic data, as defined in section 13.02, subdivision 9.
137.29 		Subd. 4.Enforcement and exceptions. (a) Any health care entity subject to reporting 
137.30 	under this section that fails to provide data in the form and manner prescribed by the 
137.31 	commissioner is subject to a fine paid to the commissioner of up to $500 for each day the 
138.1 	data are past due. Any fine levied against the entity under this subdivision is subject to the 
138.2 	contested case and judicial review provisions of sections 14.57 and 14.69.
138.3 	(b) The commissioner may grant an entity an extension of or exemption from the reporting 
138.4 	obligations under this subdivision, upon a showing of good cause by the entity.
138.5 		Subd. 5.Reports to the legislature. By November 15, 2024, and by November 15 of 
138.6 	each year thereafter, the commissioner shall submit to the chairs and ranking minority 
138.7 	members of the legislative committees with jurisdiction over health care finance and policy, 
138.8 	a report that aggregates the data submitted under subdivision 3, paragraphs (a) and (b). The 
138.9 	data shall be aggregated in a manner that prevents the identification of an individual entity 
138.10 	and any entity's specific data value reported for an individual data element, except that the 
138.11 	following shall be included in the report:
138.12 	(1) the information submitted under subdivision 2; and
138.13 	(2) for each 340B entity identified in subdivision 2, that entity's 340B net revenue as 
138.14 	calculated using the data submitted under subdivision 3, paragraph (a), with net revenue 
138.15 	being subdivision 3, paragraph (a), clause (2), less the sum of subdivision 3, paragraph (a), 
138.16 	clauses (1) and (4).

138.17 	Sec. 3. Minnesota Statutes 2022, section 62J.61, subdivision 5, is amended to read:
138.18 		Subd. 5.Biennial review of rulemaking procedures and rules Opportunity for 
138.19 	comment. The commissioner shall biennially seek comments from affected parties maintain 
138.20 	an email address for submission of comments from interested parties to provide input about 
138.21 	the effectiveness of and continued need for the rulemaking procedures set out in subdivision 
138.22 	2 and about the quality and effectiveness of rules adopted using these procedures. The 
138.23 	commissioner shall seek comments by holding a meeting and by publishing a notice in the 
138.24 	State Register that contains the date, time, and location of the meeting and a statement that 
138.25 	invites oral or written comments. The notice must be published at least 30 days before the 
138.26 	meeting date. The commissioner shall write a report summarizing the comments and shall 
138.27 	submit the report to the Minnesota Health Data Institute and to the Minnesota Administrative 
138.28 	Uniformity Committee by January 15 of every even-numbered year may seek additional 
138.29 	input and provide additional opportunities for input as needed.

139.1 	Sec. 4. Minnesota Statutes 2023 Supplement, section 62J.84, subdivision 10, is amended 
139.2 	to read:
139.3 		Subd. 10.Notice of prescription drugs of substantial public interest. (a) No later than 
139.4 	January 31, 2024, and quarterly thereafter, the commissioner shall produce and post on the 
139.5 	department's website a list of prescription drugs that the commissioner determines to represent 
139.6 	a substantial public interest and for which the commissioner intends to request data under 
139.7 	subdivisions 11 to 14, subject to paragraph (c). The commissioner shall base its inclusion 
139.8 	of prescription drugs on any information the commissioner determines is relevant to providing 
139.9 	greater consumer awareness of the factors contributing to the cost of prescription drugs in 
139.10 	the state, and the commissioner shall consider drug product families that include prescription 
139.11 	drugs:
139.12 	(1) that triggered reporting under subdivision 3 or 4 during the previous calendar quarter;
139.13 	(2) for which average claims paid amounts exceeded 125 percent of the price as of the 
139.14 	claim incurred date during the most recent calendar quarter for which claims paid amounts 
139.15 	are available; or
139.16 	(3) that are identified by members of the public during a public comment process.
139.17 	(b) Not sooner than 30 days after publicly posting the list of prescription drugs under 
139.18 	paragraph (a), the department shall notify, via email, reporting entities registered with the 
139.19 	department of the requirement to report under subdivisions 11 to 14.
139.20 	(c) The commissioner must not designate more than 500 prescription drugs as having a 
139.21 	substantial public interest in any one notice.
139.22 	(d) Notwithstanding subdivision 16, the commissioner is exempt from chapter 14, 
139.23 	including section 14.386, in implementing this subdivision.

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

139.25 	Sec. 5. Minnesota Statutes 2022, section 144.05, subdivision 6, is amended to read:
139.26 		Subd. 6.Reports on interagency agreements and intra-agency transfers. The 
139.27 	commissioner of health shall provide quarterly reports to the chairs and ranking minority 
139.28 	members of the legislative committees with jurisdiction over health and human services 
139.29 	policy and finance on:
139.30 	(1) interagency agreements or service-level agreements and any renewals or extensions 
139.31 	of existing interagency or service-level agreements with a state department under section 
139.32 	15.01, state agency under section 15.012, or the Department of Information Technology 
140.1 	Services, with a value of more than $100,000, or related agreements with the same department 
140.2 	or agency with a cumulative value of more than $100,000; and
140.3 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
140.4 	agencies.
140.5 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
140.6 	amount, purpose, and effective date of the agreement, and duration of the agreement, and 
140.7 	a copy of the agreement.

140.8 	Sec. 6. Minnesota Statutes 2023 Supplement, section 144.0526, subdivision 1, is amended 
140.9 	to read:
140.10 		Subdivision 1.Establishment. The commissioner of health shall establish the Minnesota 
140.11 	One Health Antimicrobial Stewardship Collaborative. The commissioner shall appoint hire
140.12 	a director to execute operations, conduct health education, and provide technical assistance.

140.13 	Sec. 7. Minnesota Statutes 2022, section 144.058, is amended to read:
140.14 	144.058 INTERPRETER SERVICES QUALITY INITIATIVE.
140.15 	(a) The commissioner of health shall establish a voluntary statewide roster, and develop 
140.16 	a plan for a registry and certification process for interpreters who provide high quality, 
140.17 	spoken language health care interpreter services. The roster, registry, and certification 
140.18 	process shall be based on the findings and recommendations set forth by the Interpreter 
140.19 	Services Work Group required under Laws 2007, chapter 147, article 12, section 13.
140.20 	(b) By January 1, 2009, the commissioner shall establish a roster of all available 
140.21 	interpreters to address access concerns, particularly in rural areas.
140.22 	(c) By January 15, 2010, the commissioner shall:
140.23 	(1) develop a plan for a registry of spoken language health care interpreters, including:
140.24 	(i) development of standards for registration that set forth educational requirements, 
140.25 	training requirements, demonstration of language proficiency and interpreting skills, 
140.26 	agreement to abide by a code of ethics, and a criminal background check;
140.27 	(ii) recommendations for appropriate alternate requirements in languages for which 
140.28 	testing and training programs do not exist;
140.29 	(iii) recommendations for appropriate fees; and
141.1 	(iv) recommendations for establishing and maintaining the standards for inclusion in 
141.2 	the registry; and
141.3 	(2) develop a plan for implementing a certification process based on national testing and 
141.4 	certification processes for spoken language interpreters 12 months after the establishment 
141.5 	of a national certification process.
141.6 	(d) The commissioner shall consult with the Interpreter Stakeholder Group of the Upper 
141.7 	Midwest Translators and Interpreters Association for advice on the standards required to 
141.8 	plan for the development of a registry and certification process.
141.9 	(e) The commissioner shall charge an annual fee of $50 to include an interpreter in the 
141.10 	roster. Fee revenue shall be deposited in the state government special revenue fund. All fees 
141.11 	are nonrefundable.

141.12 	Sec. 8. Minnesota Statutes 2022, section 144.0724, subdivision 2, is amended to read:
141.13 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
141.14 	given.
141.15 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
141.16 	periods in the MDS assessment process. This look-back period is also called the observation 
141.17 	or assessment period.
141.18 	(b) "Case mix index" means the weighting factors assigned to the RUG-IVcase mix 
141.19 	reimbursement classifications determined by an assessment.
141.20 	(c) "Index maximization" means classifying a resident who could be assigned to more 
141.21 	than one category, to the category with the highest case mix index.
141.22 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
141.23 	and functional status elements, that include common definitions and coding categories 
141.24 	specified by the Centers for Medicare and Medicaid Services and designated by the 
141.25 	Department of Health.
141.26 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
141.27 	person authorized to pay the nursing home expenses of the resident, a representative of the 
141.28 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
141.29 	other individual designated by the resident.
141.30 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
141.31 	facility's residents according to their clinical and functional status identified in data supplied 
141.32 	by the facility's Minimum Data Set.
142.1 	(g) (f) "Activities of daily living" includes personal hygiene, dressing, bathing, 
142.2 	transferring, bed mobility, locomotion, eating, and toileting.
142.3 	(h) (g) "Nursing facility level of care determination" means the assessment process that 
142.4 	results in a determination of a resident's or prospective resident's need for nursing facility 
142.5 	level of care as established in subdivision 11 for purposes of medical assistance payment 
142.6 	of long-term care services for:
142.7 	(1) nursing facility services under section 256B.434 or chapter 256R;
142.8 	(2) elderly waiver services under chapter 256S;
142.9 	(3) CADI and BI waiver services under section 256B.49; and
142.10 	(4) state payment of alternative care services under section 256B.0913.

142.11 	Sec. 9. Minnesota Statutes 2022, section 144.0724, subdivision 3a, is amended to read:
142.12 		Subd. 3a.Resident reimbursement case mix reimbursement classifications beginning 
142.13 	January 1, 2012. (a) Beginning January 1, 2012, Resident reimbursement case mix 
142.14 	reimbursement classifications shall be based on the Minimum Data Set, version 3.0 
142.15 	assessment instrument, or its successor version mandated by the Centers for Medicare and 
142.16 	Medicaid Services that nursing facilities are required to complete for all residents. The 
142.17 	commissioner of health shall establish resident classifications according to the RUG-IV, 
142.18 	48 group, resource utilization groups. Resident classification must be established based on 
142.19 	the individual items on the Minimum Data Set, which must be completed according to the 
142.20 	Long Term Care Facility Resident Assessment Instrument User's Manual Version 3.0 or its 
142.21 	successor issued by the Centers for Medicare and Medicaid Services. Case mix 
142.22 	reimbursement classifications shall also be based on assessments required under subdivision 
142.23 	4. Assessments must be completed according to the Long Term Care Facility Resident 
142.24 	Assessment Instrument User's Manual Version 3.0 or a successor manual issued by the 
142.25 	Centers for Medicare and Medicaid Services. The optional state assessment must be 
142.26 	completed according to the OSA Manual Version 1.0 v.2.
142.27 	(b) Each resident must be classified based on the information from the Minimum Data 
142.28 	Set according to the general categories issued by the Minnesota Department of Health, 
142.29 	utilized for reimbursement purposes.

142.30 	Sec. 10. Minnesota Statutes 2022, section 144.0724, subdivision 4, is amended to read:
142.31 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and electronically 
142.32 	submit to the federal database MDS assessments that conform with the assessment schedule 
143.1 	defined by the Long Term Care Facility Resident Assessment Instrument User's Manual, 
143.2 	version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The 
143.3 	commissioner of health may substitute successor manuals or question and answer documents 
143.4 	published by the United States Department of Health and Human Services, Centers for 
143.5 	Medicare and Medicaid Services, to replace or supplement the current version of the manual 
143.6 	or document.
143.7 	(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987 
143.8 	(OBRA) used to determine a case mix reimbursement classification for reimbursement
143.9 	include:
143.10 	(1) a new admission comprehensive assessment, which must have an assessment reference 
143.11 	date (ARD) within 14 calendar days after admission, excluding readmissions;
143.12 	(2) an annual comprehensive assessment, which must have an ARD within 92 days of 
143.13 	a previous quarterly review assessment or a previous comprehensive assessment, which 
143.14 	must occur at least once every 366 days;
143.15 	(3) a significant change in status comprehensive assessment, which must have an ARD 
143.16 	within 14 days after the facility determines, or should have determined, that there has been 
143.17 	a significant change in the resident's physical or mental condition, whether an improvement 
143.18 	or a decline, and regardless of the amount of time since the last comprehensive assessment 
143.19 	or quarterly review assessment;
143.20 	(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the 
143.21 	previous quarterly review assessment or a previous comprehensive assessment;
143.22 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
143.23 	being corrected is the current one being used for RUG reimbursement classification;
143.24 	(6) any significant correction to a prior quarterly review assessment, if the assessment 
143.25 	being corrected is the current one being used for RUG reimbursement classification; and
143.26 	(7) a required significant change in status assessment when:
143.27 	(i) all speech, occupational, and physical therapies have ended. If the most recent OBRA 
143.28 	comprehensive or quarterly assessment completed does not result in a rehabilitation case 
143.29 	mix classification, then the significant change in status assessment is not required. The ARD 
143.30 	of this assessment must be set on day eight after all therapy services have ended; and
143.31 	(ii) isolation for an infectious disease has ended. If isolation was not coded on the most 
143.32 	recent OBRA comprehensive or quarterly assessment completed, then the significant change 
144.1 	in status assessment is not required. The ARD of this assessment must be set on day 15 after 
144.2 	isolation has ended; and
144.3 	(8) (7) any modifications to the most recent assessments under clauses (1) to (7) (6).
144.4 	(c) The optional state assessment must accompany all OBRA assessments. The optional 
144.5 	state assessment is also required to determine reimbursement when:
144.6 	(i) all speech, occupational, and physical therapies have ended. If the most recent optional 
144.7 	state assessment completed does not result in a rehabilitation case mix reimbursement 
144.8 	classification, then the optional state assessment is not required. The ARD of this assessment 
144.9 	must be set on day eight after all therapy services have ended; and
144.10 	(ii) isolation for an infectious disease has ended. If isolation was not coded on the most 
144.11 	recent optional state assessment completed, then the optional state assessment is not required. 
144.12 	The ARD of this assessment must be set on day 15 after isolation has ended.
144.13 	(c) (d) In addition to the assessments listed in paragraph paragraphs (b) and (c), the 
144.14 	assessments used to determine nursing facility level of care include the following:
144.15 	(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by 
144.16 	the Senior LinkAge Line or other organization under contract with the Minnesota Board on 
144.17 	Aging; and
144.18 	(2) a nursing facility level of care determination as provided for under section 256B.0911, 
144.19 	subdivision 26, as part of a face-to-face long-term care consultation assessment completed 
144.20 	under section 256B.0911, by a county, tribe, or managed care organization under contract 
144.21 	with the Department of Human Services.

144.22 	Sec. 11. Minnesota Statutes 2022, section 144.0724, subdivision 6, is amended to read:
144.23 		Subd. 6.Penalties for late or nonsubmission. (a) A facility that fails to complete or 
144.24 	submit an assessment according to subdivisions 4 and 5 for a RUG-IV case mix 
144.25 	reimbursement classification within seven days of the time requirements listed in the 
144.26 	Long-Term Care Facility Resident Assessment Instrument User's Manual when the 
144.27 	assessment is due is subject to a reduced rate for that resident. The reduced rate shall be the 
144.28 	lowest rate for that facility. The reduced rate is effective on the day of admission for new 
144.29 	admission assessments, on the ARD for significant change in status assessments, or on the 
144.30 	day that the assessment was due for all other assessments and continues in effect until the 
144.31 	first day of the month following the date of submission and acceptance of the resident's 
144.32 	assessment.
145.1 	(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days 
145.2 	are equal to or greater than 0.1 percent of the total operating costs on the facility's most 
145.3 	recent annual statistical and cost report, a facility may apply to the commissioner of human 
145.4 	services for a reduction in the total penalty amount. The commissioner of human services, 
145.5 	in consultation with the commissioner of health, may, at the sole discretion of the 
145.6 	commissioner of human services, limit the penalty for residents covered by medical assistance 
145.7 	to ten days.

145.8 	Sec. 12. Minnesota Statutes 2022, section 144.0724, subdivision 7, is amended to read:
145.9 		Subd. 7.Notice of resident reimbursement case mix reimbursement classification. (a) 
145.10 	The commissioner of health shall provide to a nursing facility a notice for each resident of 
145.11 	the classification established under subdivision 1. The notice must inform the resident of 
145.12 	the case mix reimbursement classification assigned, the opportunity to review the 
145.13 	documentation supporting the classification, the opportunity to obtain clarification from the 
145.14 	commissioner, and the opportunity to request a reconsideration of the classification, and 
145.15 	the address and telephone number of the Office of Ombudsman for Long-Term Care. The 
145.16 	commissioner must transmit the notice of resident classification by electronic means to the 
145.17 	nursing facility. The nursing facility is responsible for the distribution of the notice to each 
145.18 	resident or the resident's representative. This notice must be distributed within three business 
145.19 	days after the facility's receipt.
145.20 	(b) If a facility submits a modifying modified assessment resulting in a change in the 
145.21 	case mix reimbursement classification, the facility must provide a written notice to the 
145.22 	resident or the resident's representative regarding the item or items that were modified and 
145.23 	the reason for the modifications. The written notice must be provided within three business 
145.24 	days after distribution of the resident case mix reimbursement classification notice.

145.25 	Sec. 13. Minnesota Statutes 2022, section 144.0724, subdivision 8, is amended to read:
145.26 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, or
145.27 	resident's representative, or the nursing facility, or the boarding care home may request that 
145.28 	the commissioner of health reconsider the assigned reimbursement case mix reimbursement
145.29 	classification and any item or items changed during the audit process. The request for 
145.30 	reconsideration must be submitted in writing to the commissioner of health.
145.31 	(b) For reconsideration requests initiated by the resident or the resident's representative:
146.1 	(1) The resident or the resident's representative must submit in writing a reconsideration 
146.2 	request to the facility administrator within 30 days of receipt of the resident classification 
146.3 	notice. The written request must include the reasons for the reconsideration request.
146.4 	(2) Within three business days of receiving the reconsideration request, the nursing 
146.5 	facility must submit to the commissioner of health a completed reconsideration request 
146.6 	form, a copy of the resident's or resident's representative's written request, and all supporting 
146.7 	documentation used to complete the assessment being consideredreconsidered. If the facility 
146.8 	fails to provide the required information, the reconsideration will be completed with the 
146.9 	information submitted and the facility cannot make further reconsideration requests on this 
146.10 	classification.
146.11 	(3) Upon written request and within three business days, the nursing facility must give 
146.12 	the resident or the resident's representative a copy of the assessment being reconsidered and 
146.13 	all supporting documentation used to complete the assessment. Notwithstanding any law 
146.14 	to the contrary, the facility may not charge a fee for providing copies of the requested 
146.15 	documentation. If a facility fails to provide the required documents within this time, it is 
146.16 	subject to the issuance of a correction order and penalty assessment under sections 144.653
146.17 	and 144A.10. Notwithstanding those sections, any correction order issued under this 
146.18 	subdivision must require that the nursing facility immediately comply with the request for 
146.19 	information, and as of the date of the issuance of the correction order, the facility shall 
146.20 	forfeit to the state a $100 fine for the first day of noncompliance, and an increase in the 
146.21 	$100 fine by $50 increments for each day the noncompliance continues.
146.22 	(c) For reconsideration requests initiated by the facility:
146.23 	(1) The facility is required to inform the resident or the resident's representative in writing 
146.24 	that a reconsideration of the resident's case mix reimbursement classification is being 
146.25 	requested. The notice must inform the resident or the resident's representative:
146.26 	(i) of the date and reason for the reconsideration request;
146.27 	(ii) of the potential for a case mix reimbursement classification change and subsequent 
146.28 	rate change;
146.29 	(iii) of the extent of the potential rate change;
146.30 	(iv) that copies of the request and supporting documentation are available for review; 
146.31 	and
146.32 	(v) that the resident or the resident's representative has the right to request a 
146.33 	reconsideration also.
147.1 	(2) Within 30 days of receipt of the audit exit report or resident classification notice, the 
147.2 	facility must submit to the commissioner of health a completed reconsideration request 
147.3 	form, all supporting documentation used to complete the assessment being reconsidered, 
147.4 	and a copy of the notice informing the resident or the resident's representative that a 
147.5 	reconsideration of the resident's classification is being requested.
147.6 	(3) If the facility fails to provide the required information, the reconsideration request 
147.7 	may be denied and the facility may not make further reconsideration requests on this 
147.8 	classification.
147.9 	(d) Reconsideration by the commissioner must be made by individuals not involved in 
147.10 	reviewing the assessment, audit, or reconsideration that established the disputed classification. 
147.11 	The reconsideration must be based upon the assessment that determined the classification 
147.12 	and upon the information provided to the commissioner of health under paragraphs (a) to 
147.13 	(c). If necessary for evaluating the reconsideration request, the commissioner may conduct 
147.14 	on-site reviews. Within 15 business days of receiving the request for reconsideration, the 
147.15 	commissioner shall affirm or modify the original resident classification. The original 
147.16 	classification must be modified if the commissioner determines that the assessment resulting 
147.17 	in the classification did not accurately reflect characteristics of the resident at the time of 
147.18 	the assessment. The commissioner must transmit the reconsideration classification notice 
147.19 	by electronic means to the nursing facility. The nursing facility is responsible for the 
147.20 	distribution of the notice to the resident or the resident's representative. The notice must be 
147.21 	distributed by the nursing facility within three business days after receipt. A decision by 
147.22 	the commissioner under this subdivision is the final administrative decision of the agency 
147.23 	for the party requesting reconsideration.
147.24 	(e) The case mix reimbursement classification established by the commissioner shall be 
147.25 	the classification which applies to the resident while the request for reconsideration is 
147.26 	pending. If a request for reconsideration applies to an assessment used to determine nursing 
147.27 	facility level of care under subdivision 4, paragraph (c) (d), the resident shall continue to 
147.28 	be eligible for nursing facility level of care while the request for reconsideration is pending.
147.29 	(f) The commissioner may request additional documentation regarding a reconsideration 
147.30 	necessary to make an accurate reconsideration determination.
147.31 	(g) Data collected as part of the reconsideration process under this section is classified 
147.32 	as private data on individuals and nonpublic data pursuant to section 13.02. Notwithstanding 
147.33 	the classification of these data as private or nonpublic, the commissioner is authorized to 
148.1 	share these data with the U.S. Centers for Medicare and Medicaid Services and the 
148.2 	commissioner of human services as necessary for reimbursement purposes.

148.3 	Sec. 14. Minnesota Statutes 2022, section 144.0724, subdivision 9, is amended to read:
148.4 		Subd. 9.Audit authority. (a) The commissioner shall audit the accuracy of resident 
148.5 	assessments performed under section 256R.17 through any of the following: desk audits; 
148.6 	on-site review of residents and their records; and interviews with staff, residents, or residents' 
148.7 	families. The commissioner shall reclassify a resident if the commissioner determines that 
148.8 	the resident was incorrectly classified.
148.9 	(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
148.10 	(c) A facility must grant the commissioner access to examine the medical records relating 
148.11 	to the resident assessments selected for audit under this subdivision. The commissioner may 
148.12 	also observe and speak to facility staff and residents.
148.13 	(d) The commissioner shall consider documentation under the time frames for coding 
148.14 	items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment 
148.15 	Instrument User's Manual or OSA Manual version 1.0 v.2 published by the Centers for 
148.16 	Medicare and Medicaid Services.
148.17 	(e) The commissioner shall develop an audit selection procedure that includes the 
148.18 	following factors:
148.19 	(1) Each facility shall be audited annually. If a facility has two successive audits in which 
148.20 	the percentage of change is five percent or less and the facility has not been the subject of 
148.21 	a special audit in the past 36 months, the facility may be audited biannually. A stratified 
148.22 	sample of 15 percent, with a minimum of ten assessments, of the most current assessments 
148.23 	shall be selected for audit. If more than 20 percent of the RUG-IV case mix reimbursement
148.24 	classifications are changed as a result of the audit, the audit shall be expanded to a second 
148.25 	15 percent sample, with a minimum of ten assessments. If the total change between the first 
148.26 	and second samples is 35 percent or greater, the commissioner may expand the audit to all 
148.27 	of the remaining assessments.
148.28 	(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility 
148.29 	again within six months. If a facility has two expanded audits within a 24-month period, 
148.30 	that facility will be audited at least every six months for the next 18 months.
148.31 	(3) The commissioner may conduct special audits if the commissioner determines that 
148.32 	circumstances exist that could alter or affect the validity of case mix reimbursement
148.33 	classifications of residents. These circumstances include, but are not limited to, the following:
149.1 	(i) frequent changes in the administration or management of the facility;
149.2 	(ii) an unusually high percentage of residents in a specific case mix reimbursement
149.3 	classification;
149.4 	(iii) a high frequency in the number of reconsideration requests received from a facility;
149.5 	(iv) frequent adjustments of case mix reimbursement classifications as the result of 
149.6 	reconsiderations or audits;
149.7 	(v) a criminal indictment alleging provider fraud;
149.8 	(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;
149.9 	(vii) an atypical pattern of scoring minimum data set items;
149.10 	(viii) nonsubmission of assessments;
149.11 	(ix) late submission of assessments; or
149.12 	(x) a previous history of audit changes of 35 percent or greater.
149.13 	(f) If the audit results in a case mix reimbursement classification change, the 
149.14 	commissioner must transmit the audit classification notice by electronic means to the nursing 
149.15 	facility within 15 business days of completing an audit. The nursing facility is responsible 
149.16 	for distribution of the notice to each resident or the resident's representative. This notice 
149.17 	must be distributed by the nursing facility within three business days after receipt. The 
149.18 	notice must inform the resident of the case mix reimbursement classification assigned, the 
149.19 	opportunity to review the documentation supporting the classification, the opportunity to 
149.20 	obtain clarification from the commissioner, the opportunity to request a reconsideration of 
149.21 	the classification, and the address and telephone number of the Office of Ombudsman for 
149.22 	Long-Term Care.

149.23 	Sec. 15. Minnesota Statutes 2022, section 144.0724, subdivision 11, is amended to read:
149.24 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance payment 
149.25 	of long-term care services, a recipient must be determined, using assessments defined in 
149.26 	subdivision 4, to meet one of the following nursing facility level of care criteria:
149.27 	(1) the person requires formal clinical monitoring at least once per day;
149.28 	(2) the person needs the assistance of another person or constant supervision to begin 
149.29 	and complete at least four of the following activities of living: bathing, bed mobility, dressing, 
149.30 	eating, grooming, toileting, transferring, and walking;
150.1 	(3) the person needs the assistance of another person or constant supervision to begin 
150.2 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
150.3 	(4) the person has significant difficulty with memory, using information, daily decision 
150.4 	making, or behavioral needs that require intervention;
150.5 	(5) the person has had a qualifying nursing facility stay of at least 90 days;
150.6 	(6) the person meets the nursing facility level of care criteria determined 90 days after 
150.7 	admission or on the first quarterly assessment after admission, whichever is later; or
150.8 	(7) the person is determined to be at risk for nursing facility admission or readmission 
150.9 	through a face-to-face long-term care consultation assessment as specified in section 
150.10 	256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, tribe, or managed care 
150.11 	organization under contract with the Department of Human Services. The person is 
150.12 	considered at risk under this clause if the person currently lives alone or will live alone or 
150.13 	be homeless without the person's current housing and also meets one of the following criteria:
150.14 	(i) the person has experienced a fall resulting in a fracture;
150.15 	(ii) the person has been determined to be at risk of maltreatment or neglect, including 
150.16 	self-neglect; or
150.17 	(iii) the person has a sensory impairment that substantially impacts functional ability 
150.18 	and maintenance of a community residence.
150.19 	(b) The assessment used to establish medical assistance payment for nursing facility 
150.20 	services must be the most recent assessment performed under subdivision 4, paragraph
150.21 	paragraphs (b) and (c), that occurred no more than 90 calendar days before the effective 
150.22 	date of medical assistance eligibility for payment of long-term care services. In no case 
150.23 	shall medical assistance payment for long-term care services occur prior to the date of the 
150.24 	determination of nursing facility level of care.
150.25 	(c) The assessment used to establish medical assistance payment for long-term care 
150.26 	services provided under chapter 256S and section 256B.49 and alternative care payment 
150.27 	for services provided under section 256B.0913 must be the most recent face-to-face 
150.28 	assessment performed under section 256B.0911, subdivisions 17 to 21, 23, 24, 27, or 28, 
150.29 	that occurred no more than 60 calendar days before the effective date of medical assistance 
150.30 	eligibility for payment of long-term care services.

151.1 	Sec. 16. Minnesota Statutes 2022, section 144.1464, subdivision 1, is amended to read:
151.2 		Subdivision 1.Summer internships. The commissioner of health, through a contract 
151.3 	with a nonprofit organization as required by subdivision 4, shall award grants, within 
151.4 	available appropriations, to hospitals, clinics, nursing facilities, assisted living facilities,
151.5 	and home care providers to establish a secondary and postsecondary summer health care 
151.6 	intern program. The purpose of the program is to expose interested secondary and 
151.7 	postsecondary pupils to various careers within the health care profession.

151.8 	Sec. 17. Minnesota Statutes 2022, section 144.1464, subdivision 2, is amended to read:
151.9 		Subd. 2.Criteria. (a) The commissioner, through the organization under contract, shall 
151.10 	award grants to hospitals, clinics, nursing facilities, assisted living facilities, and home care 
151.11 	providers that agree to:
151.12 	(1) provide secondary and postsecondary summer health care interns with formal exposure 
151.13 	to the health care profession;
151.14 	(2) provide an orientation for the secondary and postsecondary summer health care 
151.15 	interns;
151.16 	(3) pay one-half the costs of employing the secondary and postsecondary summer health 
151.17 	care intern;
151.18 	(4) interview and hire secondary and postsecondary pupils for a minimum of six weeks 
151.19 	and a maximum of 12 weeks; and
151.20 	(5) employ at least one secondary student for each postsecondary student employed, to 
151.21 	the extent that there are sufficient qualifying secondary student applicants.
151.22 	(b) In order to be eligible to be hired as a secondary summer health intern by a hospital, 
151.23 	clinic, nursing facility, assisted living facility, or home care provider, a pupil must:
151.24 	(1) intend to complete high school graduation requirements and be between the junior 
151.25 	and senior year of high school; and
151.26 	(2) be from a school district in proximity to the facility.
151.27 	(c) In order to be eligible to be hired as a postsecondary summer health care intern by 
151.28 	a hospital or clinic, a pupil must:
151.29 	(1) intend to complete a health care training program or a two-year or four-year degree 
151.30 	program and be planning on enrolling in or be enrolled in that training program or degree 
151.31 	program; and
152.1 	(2) be enrolled in a Minnesota educational institution or be a resident of the state of 
152.2 	Minnesota; priority must be given to applicants from a school district or an educational 
152.3 	institution in proximity to the facility.
152.4 	(d) Hospitals, clinics, nursing facilities, assisted living facilities, and home care providers 
152.5 	awarded grants may employ pupils as secondary and postsecondary summer health care 
152.6 	interns beginning on or after June 15, 1993, if they agree to pay the intern, during the period 
152.7 	before disbursement of state grant money, with money designated as the facility's 50 percent 
152.8 	contribution towards internship costs.

152.9 	Sec. 18. Minnesota Statutes 2022, section 144.1464, subdivision 3, is amended to read:
152.10 		Subd. 3.Grants. The commissioner, through the organization under contract, shall 
152.11 	award separate grants to hospitals, clinics, nursing facilities, and home care providers meeting 
152.12 	the requirements of subdivision 2. The grants must be used to pay one-half of the costs of 
152.13 	employing secondary and postsecondary pupils in a hospital, clinic, nursing facility, assisted 
152.14 	living facilities, or home care setting during the course of the program. No more than 50 
152.15 	percent of the participants may be postsecondary students, unless the program does not 
152.16 	receive enough qualified secondary applicants per fiscal year. No more than five pupils may 
152.17 	be selected from any secondary or postsecondary institution to participate in the program 
152.18 	and no more than one-half of the number of pupils selected may be from the seven-county 
152.19 	metropolitan area.

152.20 	Sec. 19. Minnesota Statutes 2023 Supplement, section 144.1505, subdivision 2, is amended 
152.21 	to read:
152.22 		Subd. 2.Programs. (a) For advanced practice provider clinical training expansion grants, 
152.23 	the commissioner of health shall award health professional training site grants to eligible 
152.24 	physician assistant, advanced practice registered nurse, pharmacy, dental therapy, and mental 
152.25 	health professional programs to plan and implement expanded clinical training. A planning 
152.26 	grant shall not exceed $75,000, and a three-year training grant shall not exceed $150,000 
152.27 	for the first year, $100,000 for the second year, and $50,000 for the third year $300,000 per 
152.28 	program project. The commissioner may provide a one-year, no-cost extension for grants.
152.29 	(b) For health professional rural and underserved clinical rotations grants, the 
152.30 	commissioner of health shall award health professional training site grants to eligible 
152.31 	physician, physician assistant, advanced practice registered nurse, pharmacy, dentistry, 
152.32 	dental therapy, and mental health professional programs to augment existing clinical training 
152.33 	programs to add rural and underserved rotations or clinical training experiences, such as 
153.1 	credential or certificate rural tracks or other specialized training. For physician and dentist 
153.2 	training, the expanded training must include rotations in primary care settings such as 
153.3 	community clinics, hospitals, health maintenance organizations, or practices in rural 
153.4 	communities.
153.5 	(c) Funds may be used for:
153.6 	(1) establishing or expanding rotations and clinical training;
153.7 	(2) recruitment, training, and retention of students and faculty;
153.8 	(3) connecting students with appropriate clinical training sites, internships, practicums, 
153.9 	or externship activities;
153.10 	(4) travel and lodging for students;
153.11 	(5) faculty, student, and preceptor salaries, incentives, or other financial support;
153.12 	(6) development and implementation of cultural competency training;
153.13 	(7) evaluations;
153.14 	(8) training site improvements, fees, equipment, and supplies required to establish, 
153.15 	maintain, or expand a training program; and
153.16 	(9) supporting clinical education in which trainees are part of a primary care team model.

153.17 	Sec. 20. Minnesota Statutes 2022, section 144.1911, subdivision 2, is amended to read:
153.18 		Subd. 2.Definitions. (a) For the purposes of this section, the following terms have the 
153.19 	meanings given.
153.20 	(b) "Commissioner" means the commissioner of health.
153.21 	(c) "Immigrant international medical graduate" means an international medical graduate 
153.22 	who was born outside the United States, now resides permanently in the United States or 
153.23 	who has entered the United States on a temporary status based on urgent humanitarian or 
153.24 	significant public benefit reasons, and who did not enter the United States on a J1 or similar 
153.25 	nonimmigrant visa following acceptance into a United States medical residency or fellowship 
153.26 	program.
153.27 	(d) "International medical graduate" means a physician who received a basic medical 
153.28 	degree or qualification from a medical school located outside the United States and Canada.
153.29 	(e) "Minnesota immigrant international medical graduate" means an immigrant 
153.30 	international medical graduate who has lived in Minnesota for at least two years.
154.1 	(f) "Rural community" means a statutory and home rule charter city or township that is 
154.2 	outside the seven-county metropolitan area as defined in section 473.121, subdivision 2, 
154.3 	excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
154.4 	(g) "Underserved community" means a Minnesota area or population included in the 
154.5 	list of designated primary medical care health professional shortage areas, medically 
154.6 	underserved areas, or medically underserved populations (MUPs) maintained and updated 
154.7 	by the United States Department of Health and Human Services.

154.8 	Sec. 21. Minnesota Statutes 2022, section 144.212, is amended by adding a subdivision 
154.9 	to read:
154.10 		Subd. 5a.Replacement. "Replacement" means a completion, addition, removal, or 
154.11 	change made to certification items on a vital record after a vital event is registered and a 
154.12 	record is established that has no notation of a change on a certificate and seals the prior vital 
154.13 	record.

154.14 	Sec. 22. Minnesota Statutes 2022, section 144.216, subdivision 2, is amended to read:
154.15 		Subd. 2.Status of foundling reports. A report registered under subdivision 1 shall 
154.16 	constitute the record of birth for the child. Information about the newborn shall be registered 
154.17 	by the state registrar in accordance with Minnesota Rules, part 4601.0600, subpart 4, item 
154.18 	C. If the child is identified and a record of birth is found or obtained, the report registered 
154.19 	under subdivision 1 shall be confidential pursuant to section 13.02, subdivision 3, and shall 
154.20 	not be disclosed except pursuant to court order.

154.21 	Sec. 23. Minnesota Statutes 2022, section 144.216, is amended by adding a subdivision 
154.22 	to read:
154.23 		Subd. 3.Reporting safe place newborns. Hospitals that receive a newborn under section 
154.24 	145.902 shall report the birth of the newborn to the Office of Vital Records within five days 
154.25 	after receiving the newborn. Information about the newborn shall be registered by the state 
154.26 	registrar in accordance with Minnesota Rules, part 4601.0600, subpart 4, item C.

154.27 	Sec. 24. Minnesota Statutes 2022, section 144.216, is amended by adding a subdivision 
154.28 	to read:
154.29 		Subd. 4.Status of safe place birth reports and registrations. (a) Information about a 
154.30 	safe place newborn registered under subdivision 3 shall constitute the record of birth for 
154.31 	the child. The record shall be confidential pursuant to section 13.02, subdivision 3. 
155.1 	Information on the birth record or a birth certificate issued from the birth record shall be 
155.2 	disclosed only to the responsible social services agency or pursuant to a court order.
155.3 	(b) Information about a safe place newborn registered under subdivision 3 shall constitute 
155.4 	the record of birth for the child. If the safe place newborn was born in a hospital and it is 
155.5 	known that a record of birth was registered, filed, or amended, the original birth record 
155.6 	registered under section 144.215 shall be replaced pursuant to section 144.218, subdivision 
155.7 	6.

155.8 	Sec. 25. Minnesota Statutes 2022, section 144.218, is amended by adding a subdivision 
155.9 	to read:
155.10 		Subd. 6.Safe place newborn; birth record. If a safe place infant birth is registered 
155.11 	pursuant to section 144.216, subdivision 4, paragraph (b), the state registrar shall issue a 
155.12 	replacement birth record free of information that identifies a parent. The prior vital record 
155.13 	shall be confidential pursuant to section 13.02, subdivision 3, and shall not be disclosed 
155.14 	except pursuant to a court order.

155.15 	Sec. 26. Minnesota Statutes 2022, section 144.493, is amended by adding a subdivision 
155.16 	to read:
155.17 		Subd. 2a.Thrombectomy-capable stroke center. A hospital meets the criteria for a 
155.18 	thrombectomy-capable stroke center if the hospital has been certified as a 
155.19 	thrombectomy-capable stroke center by the joint commission or another nationally recognized 
155.20 	accreditation entity or is a primary stroke center that is not certified as a thrombectomy-based 
155.21 	capable stroke center but the hospital has attained a level of stroke care distinction by offering 
155.22 	mechanical endovascular therapies and has been certified by a department approved certifying 
155.23 	body that is a nationally recognized guidelines-based organization.

155.24 	Sec. 27. Minnesota Statutes 2022, section 144.494, subdivision 2, is amended to read:
155.25 		Subd. 2.Designation. A hospital that voluntarily meets the criteria for a comprehensive 
155.26 	stroke center, thrombectomy-capable stroke center, primary stroke center, or acute stroke 
155.27 	ready hospital may apply to the commissioner for designation, and upon the commissioner's 
155.28 	review and approval of the application, shall be designated as a comprehensive stroke center, 
155.29 	a thrombectomy-capable stroke center, a primary stroke center, or an acute stroke ready 
155.30 	hospital for a three-year period. If a hospital loses its certification as a comprehensive stroke 
155.31 	center or primary stroke center from the joint commission or other nationally recognized 
155.32 	accreditation entity, or no longer participates in the Minnesota stroke registry program, its 
156.1 	Minnesota designation shall be immediately withdrawn. Prior to the expiration of the 
156.2 	three-year designation period, a hospital seeking to remain part of the voluntary acute stroke 
156.3 	system may reapply to the commissioner for designation.

156.4 	Sec. 28. Minnesota Statutes 2022, section 144.551, subdivision 1, is amended to read:
156.5 		Subdivision 1.Restricted construction or modification. (a) The following construction 
156.6 	or modification may not be commenced:
156.7 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
156.8 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
156.9 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
156.10 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
156.11 	state; and
156.12 	(2) the establishment of a new hospital.
156.13 	(b) This section does not apply to:
156.14 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
156.15 	facility that is a national referral center engaged in substantial programs of patient care, 
156.16 	medical research, and medical education meeting state and national needs that receives more 
156.17 	than 40 percent of its patients from outside the state of Minnesota;
156.18 	(2) a project for construction or modification for which a health care facility held an 
156.19 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
156.20 	certificate;
156.21 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
156.22 	appeal results in an order reversing the denial;
156.23 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
156.24 	section 2;
156.25 	(5) a project involving consolidation of pediatric specialty hospital services within the 
156.26 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
156.27 	of pediatric specialty hospital beds among the hospitals being consolidated;
156.28 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
156.29 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
156.30 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
156.31 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
156.32 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
157.1 	(7) the relocation or redistribution of hospital beds within a hospital building or 
157.2 	identifiable complex of buildings provided the relocation or redistribution does not result 
157.3 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
157.4 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
157.5 	state or a region of the state;
157.6 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
157.7 	involves the transfer of beds from a closed facility site or complex to an existing site or 
157.8 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
157.9 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
157.10 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
157.11 	health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution 
157.12 	does not involve the construction of a new hospital building; and (v) the transferred beds 
157.13 	are used first to replace within the hospital corporate system the total number of beds 
157.14 	previously used in the closed facility site or complex for mental health services and substance 
157.15 	use disorder services. Only after the hospital corporate system has fulfilled the requirements 
157.16 	of this item may the remainder of the available capacity of the closed facility site or complex 
157.17 	be transferred for any other purpose;
157.18 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
157.19 	County that primarily serves adolescents and that receives more than 70 percent of its 
157.20 	patients from outside the state of Minnesota;
157.21 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
157.22 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
157.23 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
157.24 	construction of the initial building or as the result of future expansion, will not exceed 70
157.25 	100 licensed hospital beds, or the combined licensed capacity of the hospitals, whichever 
157.26 	is less;
157.27 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
157.28 	the commissioner of human services to a new or existing facility, building, or complex 
157.29 	operated by the commissioner of human services; from one regional treatment center site 
157.30 	to another; or from one building or site to a new or existing building or site on the same 
157.31 	campus;
157.32 	(12) the construction or relocation of hospital beds operated by a hospital having a 
157.33 	statutory obligation to provide hospital and medical services for the indigent that does not 
157.34 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
158.1 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
158.2 	Medical Center to Regions Hospital under this clause;
158.3 	(13) a construction project involving the addition of up to 31 new beds in an existing 
158.4 	nonfederal hospital in Beltrami County;
158.5 	(14) a construction project involving the addition of up to eight new beds in an existing 
158.6 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
158.7 	(15) a construction project involving the addition of 20 new hospital beds in an existing 
158.8 	hospital in Carver County serving the southwest suburban metropolitan area;
158.9 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
158.10 	of up to two psychiatric facilities or units for children provided that the operation of the 
158.11 	facilities or units have received the approval of the commissioner of human services;
158.12 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
158.13 	services in an existing hospital in Itasca County;
158.14 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
158.15 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
158.16 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
158.17 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
158.18 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
158.19 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
158.20 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
158.21 	to the extent that the critical access hospital does not seek to exceed the maximum number 
158.22 	of beds permitted such hospital under federal law;
158.23 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
158.24 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
158.25 	(i) the project, including each hospital or health system that will own or control the entity 
158.26 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
158.27 	Council as of March 1, 2006;
158.28 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
158.29 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
158.30 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
158.31 	have been found to be in the public interest by the commissioner of health as of April 1, 
158.32 	2005;
159.1 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
159.2 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
159.3 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
159.4 	services, and emergency room services;
159.5 	(iv) the new hospital:
159.6 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
159.7 	needs of the Maple Grove service area and the surrounding communities currently being 
159.8 	served by the hospital or health system that will own or control the entity that will hold the 
159.9 	new hospital license;
159.10 	(B) will provide uncompensated care;
159.11 	(C) will provide mental health services, including inpatient beds;
159.12 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
159.13 	occupations and have a commitment to providing clinical training programs for physicians 
159.14 	and other health care providers;
159.15 	(E) will demonstrate a commitment to quality care and patient safety;
159.16 	(F) will have an electronic medical records system, including physician order entry;
159.17 	(G) will provide a broad range of senior services;
159.18 	(H) will provide emergency medical services that will coordinate care with regional 
159.19 	providers of trauma services and licensed emergency ambulance services in order to enhance 
159.20 	the continuity of care for emergency medical patients; and
159.21 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
159.22 	the control of the entity holding the new hospital license; and
159.23 	(v) as of 30 days following submission of a written plan, the commissioner of health 
159.24 	has not determined that the hospitals or health systems that will own or control the entity 
159.25 	that will hold the new hospital license are unable to meet the criteria of this clause;
159.26 	(21) a project approved under section 144.553;
159.27 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
159.28 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
159.29 	is approved by the Cass County Board;
160.1 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
160.2 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
160.3 	a separately licensed 13-bed skilled nursing facility;
160.4 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
160.5 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
160.6 	who are under 21 years of age on the date of admission. The commissioner conducted a 
160.7 	public interest review of the mental health needs of Minnesota and the Twin Cities 
160.8 	metropolitan area in 2008. No further public interest review shall be conducted for the 
160.9 	construction or expansion project under this clause;
160.10 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
160.11 	commissioner finds the project is in the public interest after the public interest review 
160.12 	conducted under section 144.552 is complete;
160.13 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
160.14 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
160.15 	admission, if the commissioner finds the project is in the public interest after the public 
160.16 	interest review conducted under section 144.552 is complete;
160.17 	(ii) this project shall serve patients in the continuing care benefit program under section 
160.18 	256.9693. The project may also serve patients not in the continuing care benefit program; 
160.19 	and
160.20 	(iii) if the project ceases to participate in the continuing care benefit program, the 
160.21 	commissioner must complete a subsequent public interest review under section 144.552. If 
160.22 	the project is found not to be in the public interest, the license must be terminated six months 
160.23 	from the date of that finding. If the commissioner of human services terminates the contract 
160.24 	without cause or reduces per diem payment rates for patients under the continuing care 
160.25 	benefit program below the rates in effect for services provided on December 31, 2015, the 
160.26 	project may cease to participate in the continuing care benefit program and continue to 
160.27 	operate without a subsequent public interest review;
160.28 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
160.29 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
160.30 	date of admission;
160.31 	(28) a project to add 55 licensed beds in an existing safety net, level I trauma center 
160.32 	hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which 
160.33 	15 beds are to be used for inpatient mental health and 40 are to be used for other services. 
160.34 	In addition, five unlicensed observation mental health beds shall be added;
161.1 	(29) upon submission of a plan to the commissioner for public interest review under 
161.2 	section 144.552 and the addition of the 15 inpatient mental health beds specified in clause 
161.3 	(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I 
161.4 	trauma center hospital in Ramsey County as designated under section 383A.91, subdivision 
161.5 	5. Five of the 45 additional beds authorized under this clause must be designated for use 
161.6 	for inpatient mental health and must be added to the hospital's bed capacity before the 
161.7 	remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed 
161.8 	beds under this clause prior to completion of the public interest review, provided the hospital 
161.9 	submits its plan by the 2021 deadline and adheres to the timelines for the public interest 
161.10 	review described in section 144.552;
161.11 	(30) upon submission of a plan to the commissioner for public interest review under 
161.12 	section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital 
161.13 	in Hennepin County that exclusively provides care to patients who are under 21 years of 
161.14 	age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital 
161.15 	may add licensed beds under this clause prior to completion of the public interest review, 
161.16 	provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for 
161.17 	the public interest review described in section 144.552;
161.18 	(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen 
161.19 	County that: (i) is designated as a critical access hospital under section 144.1483, clause 
161.20 	(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of 
161.21 	fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of 
161.22 	licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding 
161.23 	section 144.552, a public interest review is not required for a project authorized under this 
161.24 	clause;
161.25 	(32) upon submission of a plan to the commissioner for public interest review under 
161.26 	section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's 
161.27 	hospital in St. Paul that is part of an independent pediatric health system with freestanding 
161.28 	inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric 
161.29 	inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add 
161.30 	licensed beds under this clause prior to completion of the public interest review, provided 
161.31 	the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public 
161.32 	interest review described in section 144.552; or
161.33 	(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda 
161.34 	hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is 
161.35 	in the public interest after the public interest review conducted under section 144.552 is 
162.1 	complete. Following the completion of the construction project, the commissioner of health 
162.2 	shall monitor the hospital, including by assessing the hospital's case mix and payer mix, 
162.3 	patient transfers, and patient diversions. The hospital must have an intake and assessment 
162.4 	area. The hospital must accommodate patients with acute mental health needs, whether they 
162.5 	walk up to the facility, are delivered by ambulances or law enforcement, or are transferred 
162.6 	from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The 
162.7 	hospital must annually submit de-identified data to the department in the format and manner 
162.8 	defined by the commissioner.

162.9 	Sec. 29. Minnesota Statutes 2022, section 144.551, subdivision 1, is amended to read:
162.10 		Subdivision 1.Restricted construction or modification. (a) The following construction 
162.11 	or modification may not be commenced:
162.12 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
162.13 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
162.14 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
162.15 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
162.16 	state; and
162.17 	(2) the establishment of a new hospital.
162.18 	(b) This section does not apply to:
162.19 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
162.20 	facility that is a national referral center engaged in substantial programs of patient care, 
162.21 	medical research, and medical education meeting state and national needs that receives more 
162.22 	than 40 percent of its patients from outside the state of Minnesota;
162.23 	(2) a project for construction or modification for which a health care facility held an 
162.24 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
162.25 	certificate;
162.26 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
162.27 	appeal results in an order reversing the denial;
162.28 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
162.29 	section 2;
162.30 	(5) a project involving consolidation of pediatric specialty hospital services within the 
162.31 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
162.32 	of pediatric specialty hospital beds among the hospitals being consolidated;
163.1 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
163.2 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
163.3 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
163.4 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
163.5 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
163.6 	(7) the relocation or redistribution of hospital beds within a hospital building or 
163.7 	identifiable complex of buildings provided the relocation or redistribution does not result 
163.8 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
163.9 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
163.10 	state or a region of the state;
163.11 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
163.12 	involves the transfer of beds from a closed facility site or complex to an existing site or 
163.13 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
163.14 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
163.15 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
163.16 	health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution 
163.17 	does not involve the construction of a new hospital building; and (v) the transferred beds 
163.18 	are used first to replace within the hospital corporate system the total number of beds 
163.19 	previously used in the closed facility site or complex for mental health services and substance 
163.20 	use disorder services. Only after the hospital corporate system has fulfilled the requirements 
163.21 	of this item may the remainder of the available capacity of the closed facility site or complex 
163.22 	be transferred for any other purpose;
163.23 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
163.24 	County that primarily serves adolescents and that receives more than 70 percent of its 
163.25 	patients from outside the state of Minnesota;
163.26 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
163.27 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
163.28 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
163.29 	construction of the initial building or as the result of future expansion, will not exceed 70 
163.30 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
163.31 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
163.32 	the commissioner of human services to a new or existing facility, building, or complex 
163.33 	operated by the commissioner of human services; from one regional treatment center site 
164.1 	to another; or from one building or site to a new or existing building or site on the same 
164.2 	campus;
164.3 	(12) the construction or relocation of hospital beds operated by a hospital having a 
164.4 	statutory obligation to provide hospital and medical services for the indigent that does not 
164.5 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
164.6 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
164.7 	Medical Center to Regions Hospital under this clause;
164.8 	(13) a construction project involving the addition of up to 31 new beds in an existing 
164.9 	nonfederal hospital in Beltrami County;
164.10 	(14) a construction project involving the addition of up to eight new beds in an existing 
164.11 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
164.12 	(15) a construction project involving the addition of 20 new hospital beds in an existing 
164.13 	hospital in Carver County serving the southwest suburban metropolitan area;
164.14 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
164.15 	of up to two psychiatric facilities or units for children provided that the operation of the 
164.16 	facilities or units have received the approval of the commissioner of human services;
164.17 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
164.18 	services in an existing hospital in Itasca County;
164.19 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
164.20 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
164.21 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
164.22 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
164.23 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
164.24 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
164.25 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
164.26 	to the extent that the critical access hospital does not seek to exceed the maximum number 
164.27 	of beds permitted such hospital under federal law;
164.28 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
164.29 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
164.30 	(i) the project, including each hospital or health system that will own or control the entity 
164.31 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
164.32 	Council as of March 1, 2006;
165.1 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
165.2 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
165.3 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
165.4 	have been found to be in the public interest by the commissioner of health as of April 1, 
165.5 	2005;
165.6 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
165.7 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
165.8 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
165.9 	services, and emergency room services;
165.10 	(iv) the new hospital:
165.11 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
165.12 	needs of the Maple Grove service area and the surrounding communities currently being 
165.13 	served by the hospital or health system that will own or control the entity that will hold the 
165.14 	new hospital license;
165.15 	(B) will provide uncompensated care;
165.16 	(C) will provide mental health services, including inpatient beds;
165.17 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
165.18 	occupations and have a commitment to providing clinical training programs for physicians 
165.19 	and other health care providers;
165.20 	(E) will demonstrate a commitment to quality care and patient safety;
165.21 	(F) will have an electronic medical records system, including physician order entry;
165.22 	(G) will provide a broad range of senior services;
165.23 	(H) will provide emergency medical services that will coordinate care with regional 
165.24 	providers of trauma services and licensed emergency ambulance services in order to enhance 
165.25 	the continuity of care for emergency medical patients; and
165.26 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
165.27 	the control of the entity holding the new hospital license; and
165.28 	(v) as of 30 days following submission of a written plan, the commissioner of health 
165.29 	has not determined that the hospitals or health systems that will own or control the entity 
165.30 	that will hold the new hospital license are unable to meet the criteria of this clause;
165.31 	(21) a project approved under section 144.553;
166.1 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
166.2 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
166.3 	is approved by the Cass County Board;
166.4 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
166.5 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
166.6 	a separately licensed 13-bed skilled nursing facility;
166.7 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
166.8 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
166.9 	who are under 21 years of age on the date of admission. The commissioner conducted a 
166.10 	public interest review of the mental health needs of Minnesota and the Twin Cities 
166.11 	metropolitan area in 2008. No further public interest review shall be conducted for the 
166.12 	construction or expansion project under this clause;
166.13 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
166.14 	commissioner finds the project is in the public interest after the public interest review 
166.15 	conducted under section 144.552 is complete;
166.16 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
166.17 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
166.18 	admission, if the commissioner finds the project is in the public interest after the public 
166.19 	interest review conducted under section 144.552 is complete;
166.20 	(ii) this project shall serve patients in the continuing care benefit program under section 
166.21 	256.9693. The project may also serve patients not in the continuing care benefit program; 
166.22 	and
166.23 	(iii) if the project ceases to participate in the continuing care benefit program, the 
166.24 	commissioner must complete a subsequent public interest review under section 144.552. If 
166.25 	the project is found not to be in the public interest, the license must be terminated six months 
166.26 	from the date of that finding. If the commissioner of human services terminates the contract 
166.27 	without cause or reduces per diem payment rates for patients under the continuing care 
166.28 	benefit program below the rates in effect for services provided on December 31, 2015, the 
166.29 	project may cease to participate in the continuing care benefit program and continue to 
166.30 	operate without a subsequent public interest review;
166.31 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
166.32 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
166.33 	date of admission;
167.1 	(28) a project to add 55 licensed beds in an existing safety net, level I trauma center 
167.2 	hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which 
167.3 	15 beds are to be used for inpatient mental health and 40 are to be used for other services. 
167.4 	In addition, five unlicensed observation mental health beds shall be added;
167.5 	(29) upon submission of a plan to the commissioner for public interest review under 
167.6 	section 144.552 and the addition of the 15 inpatient mental health beds specified in clause 
167.7 	(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I 
167.8 	trauma center hospital in Ramsey County as designated under section 383A.91, subdivision 
167.9 	5. Five of the 45 additional beds authorized under this clause must be designated for use 
167.10 	for inpatient mental health and must be added to the hospital's bed capacity before the 
167.11 	remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed 
167.12 	beds under this clause prior to completion of the public interest review, provided the hospital 
167.13 	submits its plan by the 2021 deadline and adheres to the timelines for the public interest 
167.14 	review described in section 144.552;
167.15 	(30) upon submission of a plan to the commissioner for public interest review under 
167.16 	section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital 
167.17 	in Hennepin County that exclusively provides care to patients who are under 21 years of 
167.18 	age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital 
167.19 	may add licensed beds under this clause prior to completion of the public interest review, 
167.20 	provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for 
167.21 	the public interest review described in section 144.552;
167.22 	(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen 
167.23 	County that: (i) is designated as a critical access hospital under section 144.1483, clause 
167.24 	(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of 
167.25 	fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of 
167.26 	licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding 
167.27 	section 144.552, a public interest review is not required for a project authorized under this 
167.28 	clause;
167.29 	(32) upon submission of a plan to the commissioner for public interest review under 
167.30 	section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's 
167.31 	hospital in St. Paul that is part of an independent pediatric health system with freestanding 
167.32 	inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric 
167.33 	inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add 
167.34 	licensed beds under this clause prior to completion of the public interest review, provided 
168.1 	the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public 
168.2 	interest review described in section 144.552; or
168.3 	(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda 
168.4 	hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is 
168.5 	in the public interest after the public interest review conducted under section 144.552 is 
168.6 	complete. Following the completion of the construction project, the commissioner of health 
168.7 	shall monitor the hospital, including by assessing the hospital's case mix and payer mix, 
168.8 	patient transfers, and patient diversions. The hospital must have an intake and assessment 
168.9 	area. The hospital must accommodate patients with acute mental health needs, whether they 
168.10 	walk up to the facility, are delivered by ambulances or law enforcement, or are transferred 
168.11 	from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The 
168.12 	hospital must annually submit de-identified data to the department in the format and manner 
168.13 	defined by the commissioner.; or
168.14 	(34) a project involving the relocation of up to 26 licensed long-term acute care hospital 
168.15 	beds from an existing long-term care hospital located in Hennepin County with a licensed 
168.16 	capacity prior to the relocation of 92 beds to dedicated space on the campus of an existing 
168.17 	safety net, level I trauma center hospital in Ramsey County as designated under section 
168.18 	383A.91, subdivision 5, provided both the commissioner finds the project is in the public 
168.19 	interest after the public interest review conducted under section 144.552 is complete and 
168.20 	the relocated beds continue to be used as long-term acute care hospital beds after the 
168.21 	relocation.

168.22 	Sec. 30. Minnesota Statutes 2022, section 144.605, is amended by adding a subdivision 
168.23 	to read:
168.24 		Subd. 10.Chapter 16C waiver. Pursuant to subdivisions 4, paragraph (b), and 5, 
168.25 	paragraph (b), the commissioner of administration may waive provisions of chapter 16C 
168.26 	for the purposes of approving contracts for independent clinical teams.

168.27 	Sec. 31. Minnesota Statutes 2022, section 144.99, subdivision 3, is amended to read:
168.28 		Subd. 3.Correction orders. (a) The commissioner may issue correction orders that 
168.29 	require a person to correct a violation of the statutes, rules, and other actions listed in 
168.30 	subdivision 1. The correction order must state the deficiencies that constitute the violation; 
168.31 	the specific statute, rule, or other action; and the time by which the violation must be 
168.32 	corrected.
169.1 	(b) If the person believes that the information contained in the commissioner's correction 
169.2 	order is in error, the person may ask the commissioner to reconsider the parts of the order 
169.3 	that are alleged to be in error. The request must be in writing, delivered to the commissioner 
169.4 	by certified mail within seven 15 calendar days after receipt of the order, and:
169.5 	(1) specify which parts of the order for corrective action are alleged to be in error;
169.6 	(2) explain why they are in error; and
169.7 	(3) provide documentation to support the allegation of error.
169.8 	The commissioner must respond to requests made under this paragraph within 15 calendar 
169.9 	days after receiving a request. A request for reconsideration does not stay the correction 
169.10 	order; however, after reviewing the request for reconsideration, the commissioner may 
169.11 	provide additional time to comply with the order if necessary. The commissioner's disposition 
169.12 	of a request for reconsideration is final.

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

169.14 	Sec. 32. Minnesota Statutes 2022, section 144A.10, subdivision 15, is amended to read:
169.15 		Subd. 15.Informal dispute resolution. The commissioner shall respond in writing to 
169.16 	a request from a nursing facility certified under the federal Medicare and Medicaid programs 
169.17 	for an informal dispute resolution within 30 days of the exit date of the facility's survey ten 
169.18 	calendar days of the facility's receipt of the notice of deficiencies. The commissioner's 
169.19 	response shall identify the commissioner's decision regarding the continuation of each 
169.20 	deficiency citation challenged by the nursing facility, as well as a statement of any changes 
169.21 	in findings, level of severity or scope, and proposed remedies or sanctions for each deficiency 
169.22 	citation.

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

169.24 	Sec. 33. Minnesota Statutes 2022, section 144A.10, subdivision 16, is amended to read:
169.25 		Subd. 16.Independent informal dispute resolution. (a) Notwithstanding subdivision 
169.26 	15, a facility certified under the federal Medicare or Medicaid programs that has been 
169.27 	assessed a civil money penalty as provided by Code of Federal Regulations, title 42, section 
169.28 	488.430, may request from the commissioner, in writing, an independent informal dispute 
169.29 	resolution process regarding any deficiency citation issued to the facility. The facility must 
169.30 	specify in its written request each deficiency citation that it disputes. The commissioner 
169.31 	shall provide a hearing under sections 14.57 to 14.62. Upon the written request of the facility, 
169.32 	the parties must submit the issues raised to arbitration by an administrative law judge submit 
170.1 	its request in writing within ten calendar days of receiving notice that a civil money penalty 
170.2 	will be imposed.
170.3 	(b) The facility and commissioner have the right to be represented by an attorney at the 
170.4 	hearing.
170.5 	(c) An independent informal dispute resolution may not be requested for any deficiency 
170.6 	that is the subject of an active informal dispute resolution requested under subdivision 15. 
170.7 	The facility must withdraw its informal dispute resolution prior to requesting independent 
170.8 	informal dispute resolution.
170.9 	(b) Upon (d) Within five calendar days of receipt of a written request for an arbitration 
170.10 	proceeding independent informal dispute resolution, the commissioner shall file with the 
170.11 	Office of Administrative Hearings a request for the appointment of an arbitrator
170.12 	administrative law judge from the Office of Administrative Hearings and simultaneously 
170.13 	serve the facility with notice of the request. The arbitrator for the dispute shall be an 
170.14 	administrative law judge appointed by the Office of Administrative Hearings. The disclosure 
170.15 	provisions of section 572B.12 and the notice provisions of section 572B.15, subsection (c), 
170.16 	apply. The facility and the commissioner have the right to be represented by an attorney.
170.17 	(e) An independent informal dispute resolution proceeding shall be scheduled to occur 
170.18 	within 30 calendar days of the commissioner's request to the Office of Administrative 
170.19 	Hearings, unless the parties agree otherwise or the chief administrative law judge deems 
170.20 	the timing to be unreasonable. The independent informal dispute resolution process must 
170.21 	be completed within 60 calendar days of the facility's request.
170.22 	(c) (f) Five working days in advance of the scheduled proceeding, the commissioner 
170.23 	and the facility may present must submit written statements and arguments, documentary 
170.24 	evidence, depositions, and oral statements and arguments at the arbitration proceeding. Oral 
170.25 	statements and arguments may be made by telephone any other materials supporting their 
170.26 	position to the administrative law judge.
170.27 	(g) The independent informal dispute resolution proceeding shall be informal and 
170.28 	conducted in a manner so as to allow the parties to fully present their positions and respond 
170.29 	to the opposing party's positions. This may include presentation of oral statements and 
170.30 	arguments at the proceeding.
170.31 	(d) (h) Within ten working days of the close of the arbitration proceeding, the 
170.32 	administrative law judge shall issue findings and recommendations regarding each of the 
170.33 	deficiencies in dispute. The findings shall be one or more of the following:
171.1 	(1) Supported in full. The citation is supported in full, with no deletion of findings and 
171.2 	no change in the scope or severity assigned to the deficiency citation.
171.3 	(2) Supported in substance. The citation is supported, but one or more findings are 
171.4 	deleted without any change in the scope or severity assigned to the deficiency.
171.5 	(3) Deficient practice cited under wrong requirement of participation. The citation is 
171.6 	amended by moving it to the correct requirement of participation.
171.7 	(4) Scope not supported. The citation is amended through a change in the scope assigned 
171.8 	to the citation.
171.9 	(5) Severity not supported. The citation is amended through a change in the severity 
171.10 	assigned to the citation.
171.11 	(6) No deficient practice. The citation is deleted because the findings did not support 
171.12 	the citation or the negative resident outcome was unavoidable. The findings of the arbitrator 
171.13 	are not binding on the commissioner.
171.14 	(i) The findings and recommendations of the administrative law judge are not binding 
171.15 	on the commissioner.
171.16 	(j) Within ten calendar days of receiving the administrative law judge's findings and 
171.17 	recommendations, the commissioner shall issue a recommendation to the Center for Medicare 
171.18 	and Medicaid Services.
171.19 	(e) (k) The commissioner shall reimburse the Office of Administrative Hearings for the 
171.20 	costs incurred by that office for the arbitration proceeding. The facility shall reimburse the 
171.21 	commissioner for the proportion of the costs that represent the sum of deficiency citations 
171.22 	supported in full under paragraph (d), clause (1), or in substance under paragraph (d), clause 
171.23 	(2), divided by the total number of deficiencies disputed. A deficiency citation for which 
171.24 	the administrative law judge's sole finding is that the deficient practice was cited under the 
171.25 	wrong requirements of participation shall not be counted in the numerator or denominator 
171.26 	in the calculation of the proportion of costs.

171.27 	EFFECTIVE DATE. This section is effective October 1, 2024, or upon federal approval, 
171.28 	whichever is later, and applies to appeals of deficiencies which are issued after October 1, 
171.29 	2024, or on or after the date upon which federal approval is obtained, whichever is later. 
171.30 	The commissioner of health shall notify the revisor of statutes when federal approval is 
171.31 	obtained.

172.1 	Sec. 34. Minnesota Statutes 2022, section 144A.44, subdivision 1, is amended to read:
172.2 		Subdivision 1.Statement of rights. (a) A client who receives home care services in the 
172.3 	community or in an assisted living facility licensed under chapter 144G has these rights:
172.4 	(1) receive written information, in plain language, about rights before receiving services, 
172.5 	including what to do if rights are violated;
172.6 	(2) receive care and services according to a suitable and up-to-date plan, and subject to 
172.7 	accepted health care, medical or nursing standards and person-centered care, to take an 
172.8 	active part in developing, modifying, and evaluating the plan and services;
172.9 	(3) be told before receiving services the type and disciplines of staff who will be providing 
172.10 	the services, the frequency of visits proposed to be furnished, other choices that are available 
172.11 	for addressing home care needs, and the potential consequences of refusing these services;
172.12 	(4) be told in advance of any recommended changes by the provider in the service plan 
172.13 	and to take an active part in any decisions about changes to the service plan;
172.14 	(5) refuse services or treatment;
172.15 	(6) know, before receiving services or during the initial visit, any limits to the services 
172.16 	available from a home care provider;
172.17 	(7) be told before services are initiated what the provider charges for the services; to 
172.18 	what extent payment may be expected from health insurance, public programs, or other 
172.19 	sources, if known; and what charges the client may be responsible for paying;
172.20 	(8) know that there may be other services available in the community, including other 
172.21 	home care services and providers, and to know where to find information about these 
172.22 	services;
172.23 	(9) choose freely among available providers and to change providers after services have 
172.24 	begun, within the limits of health insurance, long-term care insurance, medical assistance, 
172.25 	other health programs, or public programs;
172.26 	(10) have personal, financial, and medical information kept private, and to be advised 
172.27 	of the provider's policies and procedures regarding disclosure of such information;
172.28 	(11) access the client's own records and written information from those records in 
172.29 	accordance with sections 144.291 to 144.298;
172.30 	(12) be served by people who are properly trained and competent to perform their duties;
173.1 	(13) be treated with courtesy and respect, and to have the client's property treated with 
173.2 	respect;
173.3 	(14) be free from physical and verbal abuse, neglect, financial exploitation, and all forms 
173.4 	of maltreatment covered under the Vulnerable Adults Act and the Maltreatment of Minors 
173.5 	Act;
173.6 	(15) reasonable, advance notice of changes in services or charges;
173.7 	(16) know the provider's reason for termination of services;
173.8 	(17) at least ten calendar days' advance notice of the termination of a service by a home 
173.9 	care provider, except at least 30 calendar days' advance notice of the service termination 
173.10 	shall be given by a home care provider for services provided to a client residing in an assisted 
173.11 	living facility as defined in section 144G.08, subdivision 7. This clause does not apply in 
173.12 	cases where:
173.13 	(i) the client engages in conduct that significantly alters the terms of the service plan 
173.14 	with the home care provider;
173.15 	(ii) the client, person who lives with the client, or others create an abusive or unsafe 
173.16 	work environment for the person providing home care services; or
173.17 	(iii) an emergency or a significant change in the client's condition has resulted in service 
173.18 	needs that exceed the current service plan and that cannot be safely met by the home care 
173.19 	provider;
173.20 	(18) a coordinated transfer when there will be a change in the provider of services;
173.21 	(19) complain to staff and others of the client's choice about services that are provided, 
173.22 	or fail to be provided, and the lack of courtesy or respect to the client or the client's property 
173.23 	and the right to recommend changes in policies and services, free from retaliation including 
173.24 	the threat of termination of services;
173.25 	(20) know how to contact an individual associated with the home care provider who is 
173.26 	responsible for handling problems and to have the home care provider investigate and 
173.27 	attempt to resolve the grievance or complaint;
173.28 	(21) know the name and address of the state or county agency to contact for additional 
173.29 	information or assistance; and
173.30 	(22) assert these rights personally, or have them asserted by the client's representative 
173.31 	or by anyone on behalf of the client, without retaliation; and.
174.1 	(23) place an electronic monitoring device in the client's or resident's space in compliance 
174.2 	with state requirements.
174.3 	(b) When providers violate the rights in this section, they are subject to the fines and 
174.4 	license actions in sections 144A.474, subdivision 11, and 144A.475.
174.5 	(c) Providers must do all of the following:
174.6 	(1) encourage and assist in the fullest possible exercise of these rights;
174.7 	(2) provide the names and telephone numbers of individuals and organizations that 
174.8 	provide advocacy and legal services for clients and residents seeking to assert their rights;
174.9 	(3) make every effort to assist clients or residents in obtaining information regarding 
174.10 	whether Medicare, medical assistance, other health programs, or public programs will pay 
174.11 	for services;
174.12 	(4) make reasonable accommodations for people who have communication disabilities, 
174.13 	or those who speak a language other than English; and
174.14 	(5) provide all information and notices in plain language and in terms the client or 
174.15 	resident can understand.
174.16 	(d) No provider may require or request a client or resident to waive any of the rights 
174.17 	listed in this section at any time or for any reasons, including as a condition of initiating 
174.18 	services or entering into an assisted living contract.

174.19 	Sec. 35. Minnesota Statutes 2022, section 144A.471, is amended by adding a subdivision 
174.20 	to read:
174.21 		Subd. 1a.Licensure under other law. A home care licensee must not provide sleeping 
174.22 	accommodations as a provision of home care services. For purposes of this subdivision, the 
174.23 	provision of sleeping accommodations and assisted living services under section 144G.08, 
174.24 	subdivision 9, requires assisted living licensure under chapter 144G.

174.25 	Sec. 36. Minnesota Statutes 2022, section 144A.474, subdivision 13, is amended to read:
174.26 		Subd. 13.Home care surveyor training. (a) Before conducting a home care survey, 
174.27 	each home care surveyor must receive training on the following topics:
174.28 	(1) Minnesota home care licensure requirements;
174.29 	(2) Minnesota home care bill of rights;
174.30 	(3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors;
175.1 	(4) principles of documentation;
175.2 	(5) survey protocol and processes;
175.3 	(6) Offices of the Ombudsman roles;
175.4 	(7) Office of Health Facility Complaints;
175.5 	(8) Minnesota landlord-tenant and housing with services laws;
175.6 	(9) types of payors for home care services; and
175.7 	(10) Minnesota Nurse Practice Act for nurse surveyors.
175.8 	(b) Materials used for the training in paragraph (a) shall be posted on the department 
175.9 	website. Requisite understanding of these topics will be reviewed as part of the quality 
175.10 	improvement plan in section 144A.483.

175.11 	Sec. 37. Minnesota Statutes 2023 Supplement, section 144A.4791, subdivision 10, is 
175.12 	amended to read:
175.13 		Subd. 10.Termination of service plan. (a) If a home care provider terminates a service 
175.14 	plan with a client, and the client continues to need home care services, the home care provider 
175.15 	shall provide the client and the client's representative, if any, with a written notice of 
175.16 	termination which includes the following information:
175.17 	(1) the effective date of termination;
175.18 	(2) the reason for termination;
175.19 	(3) for clients age 18 or older, a statement that the client may contact the Office of 
175.20 	Ombudsman for Long-Term Care to request an advocate to assist regarding the termination 
175.21 	and contact information for the office, including the office's central telephone number;
175.22 	(4) a list of known licensed home care providers in the client's immediate geographic 
175.23 	area;
175.24 	(5) a statement that the home care provider will participate in a coordinated transfer of 
175.25 	care of the client to another home care provider, health care provider, or caregiver, as 
175.26 	required by the home care bill of rights, section 144A.44, subdivision 1, clause (17); and
175.27 	(6) the name and contact information of a person employed by the home care provider 
175.28 	with whom the client may discuss the notice of termination; and.
175.29 	(7) if applicable, a statement that the notice of termination of home care services does 
175.30 	not constitute notice of termination of any housing contract.
176.1 	(b) When the home care provider voluntarily discontinues services to all clients, the 
176.2 	home care provider must notify the commissioner, lead agencies, and ombudsman for 
176.3 	long-term care about its clients and comply with the requirements in this subdivision.

176.4 	Sec. 38. Minnesota Statutes 2022, section 144E.16, subdivision 7, is amended to read:
176.5 		Subd. 7.Stroke transport protocols. Regional emergency medical services programs 
176.6 	and any ambulance service licensed under this chapter must develop stroke transport 
176.7 	protocols. The protocols must include standards of care for triage and transport of acute 
176.8 	stroke patients within a specific time frame from symptom onset until transport to the most 
176.9 	appropriate designated acute stroke ready hospital, primary stroke center, 
176.10 	thrombectomy-capable stroke center, or comprehensive stroke center.

176.11 	Sec. 39. Minnesota Statutes 2022, section 144G.08, subdivision 29, is amended to read:
176.12 		Subd. 29.Licensed health professional. "Licensed health professional" means a person 
176.13 	licensed in Minnesota to practice a profession described in section 214.01, subdivision 2, 
176.14 	other than a registered nurse or licensed practical nurse, who provides assisted living services 
176.15 	within the scope of practice of that person's health occupation license, registration, or 
176.16 	certification as a regulated person who is licensed by an appropriate Minnesota state board 
176.17 	or agency.

176.18 	Sec. 40. Minnesota Statutes 2022, section 144G.10, is amended by adding a subdivision 
176.19 	to read:
176.20 		Subd. 5.Protected title; restriction on use. (a) Effective January 1, 2026, no person 
176.21 	or entity may use the phrase "assisted living," whether alone or in combination with other 
176.22 	words and whether orally or in writing, to: advertise; market; or otherwise describe, offer, 
176.23 	or promote itself, or any housing, service, service package, or program that it provides 
176.24 	within this state, unless the person or entity is a licensed assisted living facility that meets 
176.25 	the requirements of this chapter. A person or entity entitled to use the phrase "assisted living" 
176.26 	shall use the phrase only in the context of its participation that meets the requirements of 
176.27 	this chapter.
176.28 	(b) Effective January 1, 2026, the licensee's name for a new assisted living facility may 
176.29 	not include the terms "home care" or "nursing home."

177.1 	Sec. 41. Minnesota Statutes 2022, section 144G.16, subdivision 6, is amended to read:
177.2 		Subd. 6.Requirements for notice and transfer. A provisional licensee whose license 
177.3 	is denied must comply with the requirements for notification and the coordinated move of 
177.4 	residents in sections 144G.52 and 144G.55. If the license denial is upheld by the 
177.5 	reconsideration process, the licensee must submit a draft closure plan as required by section 
177.6 	144G.57 within ten calendar days of receipt of the reconsideration decision and submit a 
177.7 	final plan within 30 days.

177.8 	Sec. 42. Minnesota Statutes 2023 Supplement, section 145.561, subdivision 4, is amended 
177.9 	to read:
177.10 		Subd. 4.988 telecommunications fee. (a) In compliance with the National Suicide 
177.11 	Hotline Designation Act of 2020, the commissioner shall impose a monthly statewide fee 
177.12 	on each subscriber of a wireline, wireless, or IP-enabled voice service at a rate that provides
177.13 	must pay a monthly fee to provide for the robust creation, operation, and maintenance of a 
177.14 	statewide 988 suicide prevention and crisis system.
177.15 	(b) The commissioner shall annually recommend to the Public Utilities Commission an 
177.16 	adequate and appropriate fee to implement this section. The amount of the fee must comply 
177.17 	with the limits in paragraph (c). The commissioner shall provide telecommunication service 
177.18 	providers and carriers a minimum of 45 days' notice of each fee change.
177.19 	(c) (b) The amount of the 988 telecommunications fee must not be more than 25 is 12
177.20 	cents per month on or after January 1, 2024, for each consumer access line, including trunk 
177.21 	equivalents as designated by the commission Public Utilities Commission pursuant to section 
177.22 	403.11, subdivision 1. The 988 telecommunications fee must be the same for all subscribers.
177.23 	(d) (c) Each wireline, wireless, and IP-enabled voice telecommunication service provider 
177.24 	shall collect the 988 telecommunications fee and transfer the amounts collected to the 
177.25 	commissioner of public safety in the same manner as provided in section 403.11, subdivision 
177.26 	1, paragraph (d).
177.27 	(e) (d) The commissioner of public safety shall deposit the money collected from the 
177.28 	988 telecommunications fee to the 988 special revenue account established in subdivision 
177.29 	3.
177.30 	(f) (e) All 988 telecommunications fee revenue must be used to supplement, and not 
177.31 	supplant, federal, state, and local funding for suicide prevention.
178.1 	(g) (f) The 988 telecommunications fee amount shall be adjusted as needed to provide 
178.2 	for continuous operation of the lifeline centers and 988 hotline, volume increases, and 
178.3 	maintenance.
178.4 	(h) (g) The commissioner shall annually report to the Federal Communications 
178.5 	Commission on revenue generated by the 988 telecommunications fee.

178.6 	EFFECTIVE DATE. This section is effective September 1, 2024.

178.7 	Sec. 43. Minnesota Statutes 2022, section 146B.03, subdivision 7a, is amended to read:
178.8 		Subd. 7a.Supervisors. (a) A technician must have been licensed in Minnesota or in a 
178.9 	jurisdiction with which Minnesota has reciprocity for at least:
178.10 	(1) two years as a tattoo technician licensed under section 146B.03, subdivision 4, 6, or 
178.11 	8, in order to supervise a temporary tattoo technician; or
178.12 	(2) one year as a body piercing technician licensed under section 146B.03, subdivision 
178.13 	4, 6, or 8, or must have performed at least 500 body piercings, in order to supervise a 
178.14 	temporary body piercing technician.
178.15 	(b) Any technician who agrees to supervise more than two temporary tattoo technicians 
178.16 	during the same time period, or more than four body piercing technicians during the same 
178.17 	time period, must provide to the commissioner a supervisory plan that describes how the 
178.18 	technician will provide supervision to each temporary technician in accordance with section 
178.19 	146B.01, subdivision 28.
178.20 	(c) The supervisory plan must include, at a minimum:
178.21 	(1) the areas of practice under supervision;
178.22 	(2) the anticipated supervision hours per week;
178.23 	(3) the anticipated duration of the training period; and
178.24 	(4) the method of providing supervision if there are multiple technicians being supervised 
178.25 	during the same time period.
178.26 	(d) If the supervisory plan is terminated before completion of the technician's supervised 
178.27 	practice, the supervisor must notify the commissioner in writing within 14 days of the change 
178.28 	in supervision and include an explanation of why the plan was not completed.
178.29 	(e) The commissioner may refuse to approve as a supervisor a technician who has been 
178.30 	disciplined in Minnesota or in another jurisdiction after considering the criteria in section 
178.31 	146B.02, subdivision 10, paragraph (b).

179.1 	Sec. 44. Minnesota Statutes 2022, section 146B.10, subdivision 1, is amended to read:
179.2 		Subdivision 1. Licensing fees. (a) The fee for the initial technician licensure application
179.3 	and biennial licensure renewal application is $420.
179.4 	(b) The fee for temporary technician licensure application is $240.
179.5 	(c) The fee for the temporary guest artist license application is $140.
179.6 	(d) The fee for a dual body art technician license application is $420.
179.7 	(e) The fee for a provisional establishment license application required in section 146B.02, 
179.8 	subdivision 5, paragraph (c), is $1,500.
179.9 	(f) The fee for an initial establishment license application and the two-year license 
179.10 	renewal period application required in section 146B.02, subdivision 2, paragraph (b), is 
179.11 	$1,500.
179.12 	(g) The fee for a temporary body art establishment event permit application is $200.
179.13 	(h) The commissioner shall prorate the initial two-year technician license fee based on 
179.14 	the number of months in the initial licensure period. The commissioner shall prorate the 
179.15 	first renewal fee for the establishment license based on the number of months from issuance 
179.16 	of the provisional license to the first renewal.
179.17 	(i) The fee for verification of licensure to other states is $25.
179.18 	(j) The fee to reissue a provisional establishment license that relocates prior to inspection 
179.19 	and removal of provisional status is $350. The expiration date of the provisional license 
179.20 	does not change.
179.21 	(k) (j) The fee to change an establishment name or establishment type, such as tattoo, 
179.22 	piercing, or dual, is $50.

179.23 	Sec. 45. Minnesota Statutes 2022, section 146B.10, subdivision 3, is amended to read:
179.24 		Subd. 3.Deposit. Fees collected by the commissioner under this section must be deposited 
179.25 	in the state government special revenue fund. All fees are nonrefundable.

179.26 	Sec. 46. Minnesota Statutes 2022, section 149A.02, subdivision 3b, is amended to read:
179.27 		Subd. 3b.Burial site services. "Burial site services" means any services sold or offered 
179.28 	for sale directly to the public for use in connection with the final disposition of a dead human 
179.29 	body but does not include services provided under a transportation protection agreement.

180.1 	Sec. 47. Minnesota Statutes 2022, section 149A.02, subdivision 23, is amended to read:
180.2 		Subd. 23.Funeral services. (a) "Funeral services" means any services which may be 
180.3 	used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis, cremation, 
180.4 	or other final disposition; and (2) arrange, supervise, or conduct the funeral ceremony or 
180.5 	the final disposition of dead human bodies.
180.6 	(b) Funeral service does not include a transportation protection agreement.

180.7 	Sec. 48. Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision 
180.8 	to read:
180.9 		Subd. 38a.Transportation protection agreement. "Transportation protection agreement" 
180.10 	means an agreement that is primarily for the purpose of transportation and subsequent 
180.11 	transportation of the remains of a dead human body.

180.12 	Sec. 49. Minnesota Statutes 2022, section 149A.65, is amended to read:
180.13 	149A.65 FEES.
180.14 		Subdivision 1.Generally. This section establishes the application fees for registrations, 
180.15 	examinations, initial and renewal licenses, and late fees authorized under the provisions of 
180.16 	this chapter.
180.17 		Subd. 2.Mortuary science fees. Fees for mortuary science are:
180.18 	(1) $75 for the initial and renewal registration of a mortuary science intern;
180.19 	(2) $125 for the mortuary science examination;
180.20 	(3) $200 for issuance of initial and renewal mortuary science licenses license applications;
180.21 	(4) $100 late fee charge for a license renewal application; and
180.22 	(5) $250 for issuing a an application for mortuary science license by endorsement.
180.23 		Subd. 3.Funeral directors. The license renewal application fee for funeral directors is 
180.24 	$200. The late fee charge for a license renewal is $100.
180.25 		Subd. 4.Funeral establishments. The initial and renewal application fee for funeral 
180.26 	establishments is $425. The late fee charge for a license renewal is $100.
180.27 		Subd. 5.Crematories. The initial and renewal application fee for a crematory is $425. 
180.28 	The late fee charge for a license renewal is $100.
181.1 		Subd. 6.Alkaline hydrolysis facilities. The initial and renewal application fee for an 
181.2 	alkaline hydrolysis facility is $425. The late fee charge for a license renewal is $100.
181.3 		Subd. 7.State government special revenue fund. Fees collected by the commissioner 
181.4 	under this section must be deposited in the state treasury and credited to the state government 
181.5 	special revenue fund. All fees are nonrefundable.

181.6 	Sec. 50. Minnesota Statutes 2022, section 149A.97, subdivision 2, is amended to read:
181.7 		Subd. 2.Scope and requirements. This section shall not apply to a transportation 
181.8 	protection agreement or to any funeral goods or burial site goods purchased and delivered, 
181.9 	either at purchase or within a commercially reasonable amount of time thereafter. When 
181.10 	prior to the death of any person, that person or another, on behalf of that person, enters into 
181.11 	any transaction, makes a contract, or any series or combination of transactions or contracts 
181.12 	with a funeral provider lawfully doing business in Minnesota, other than an insurance 
181.13 	company licensed to do business in Minnesota selling approved insurance or annuity 
181.14 	products, by the terms of which, goods or services related to the final disposition of that 
181.15 	person will be furnished at-need, then the total of all money paid by the terms of the 
181.16 	transaction, contract, or series or combination of transactions or contracts shall be held in 
181.17 	trust for the purpose for which it has been paid. The person for whose benefit the money 
181.18 	was paid shall be known as the beneficiary, the person or persons who paid the money shall 
181.19 	be known as the purchaser, and the funeral provider shall be known as the depositor.

181.20 	Sec. 51. Minnesota Statutes 2022, section 152.22, is amended by adding a subdivision to 
181.21 	read:
181.22 		Subd. 19.Veteran. "Veteran" means an individual who satisfies the requirements in 
181.23 	section 197.447 and is receiving care from the United States Department of Veterans Affairs.

181.24 	Sec. 52. Minnesota Statutes 2022, section 152.25, subdivision 2, is amended to read:
181.25 		Subd. 2.Range of compounds and dosages; report. The commissioner shall review 
181.26 	and publicly report the existing medical and scientific literature regarding the range of 
181.27 	recommended dosages for each qualifying condition and the range of chemical compositions 
181.28 	of any plant of the genus cannabis that will likely be medically beneficial for each of the 
181.29 	qualifying medical conditions. The commissioner shall make this information available to 
181.30 	patients with qualifying medical conditions beginning December 1, 2014, and update the 
181.31 	information annually every three years. The commissioner may consult with the independent 
181.32 	laboratory under contract with the manufacturer or other experts in reporting the range of 
182.1 	recommended dosages for each qualifying medical condition, the range of chemical 
182.2 	compositions that will likely be medically beneficial, and any risks of noncannabis drug 
182.3 	interactions. The commissioner shall consult with each manufacturer on an annual basis on 
182.4 	medical cannabis offered by the manufacturer. The list of medical cannabis offered by a 
182.5 	manufacturer shall be published on the Department of Health website.

182.6 	Sec. 53. Minnesota Statutes 2022, section 152.27, is amended by adding a subdivision to 
182.7 	read:
182.8 		Subd. 3a.Application procedure for veterans. (a) Beginning July 1, 2024, the 
182.9 	commissioner shall establish an alternative certification procedure for veterans to confirm 
182.10 	that the veteran has been diagnosed with a qualifying medical condition.
182.11 	(b) A patient who is also a veteran and is seeking to enroll in the registry program must 
182.12 	submit a copy of the patient's veteran health identification card issued by the United States 
182.13 	Department of Veterans Affairs and an application established by the commissioner to 
182.14 	certify that the patient has been diagnosed with a qualifying medical condition.

182.15 	Sec. 54. Minnesota Statutes 2022, section 152.27, subdivision 6, is amended to read:
182.16 		Subd. 6.Patient enrollment. (a) After receipt of a patient's application, application fees, 
182.17 	and signed disclosure, the commissioner shall enroll the patient in the registry program and 
182.18 	issue the patient and patient's registered designated caregiver or parent, legal guardian, or 
182.19 	spouse, if applicable, a registry verification. The commissioner shall approve or deny a 
182.20 	patient's application for participation in the registry program within 30 days after the 
182.21 	commissioner receives the patient's application and application fee. The commissioner may 
182.22 	approve applications up to 60 days after the receipt of a patient's application and application 
182.23 	fees until January 1, 2016. A patient's enrollment in the registry program shall only be 
182.24 	denied if the patient:
182.25 	(1) does not have certification from a health care practitioner, or if the patient is a veteran 
182.26 	receiving care from the United States Department of Veterans Affairs, the documentation 
182.27 	required under subdivision 3a, that the patient has been diagnosed with a qualifying medical 
182.28 	condition;
182.29 	(2) has not signed and returned the disclosure form required under subdivision 3, 
182.30 	paragraph (c), to the commissioner;
182.31 	(3) does not provide the information required;
183.1 	(4) has previously been removed from the registry program for violations of section 
183.2 	152.30 or 152.33; or
183.3 	(5) provides false information.
183.4 	(b) The commissioner shall give written notice to a patient of the reason for denying 
183.5 	enrollment in the registry program.
183.6 	(c) Denial of enrollment into the registry program is considered a final decision of the 
183.7 	commissioner and is subject to judicial review under the Administrative Procedure Act 
183.8 	pursuant to chapter 14.
183.9 	(d) A patient's enrollment in the registry program may only be revoked upon the death 
183.10 	of the patient or if a patient violates a requirement under section 152.30 or 152.33.
183.11 	(e) The commissioner shall develop a registry verification to provide to the patient, the 
183.12 	health care practitioner identified in the patient's application, and to the manufacturer. The 
183.13 	registry verification shall include:
183.14 	(1) the patient's name and date of birth;
183.15 	(2) the patient registry number assigned to the patient; and
183.16 	(3) the name and date of birth of the patient's registered designated caregiver, if any, or 
183.17 	the name of the patient's parent, legal guardian, or spouse if the parent, legal guardian, or 
183.18 	spouse will be acting as a caregiver.

183.19 	Sec. 55. Minnesota Statutes 2023 Supplement, section 152.28, subdivision 1, is amended 
183.20 	to read:
183.21 		Subdivision 1.Health care practitioner duties. (a) Prior to a patient's enrollment in 
183.22 	the registry program, a health care practitioner shall:
183.23 	(1) determine, in the health care practitioner's medical judgment, whether a patient suffers 
183.24 	from a qualifying medical condition, and, if so determined, provide the patient with a 
183.25 	certification of that diagnosis;
183.26 	(2) advise patients, registered designated caregivers, and parents, legal guardians, or 
183.27 	spouses who are acting as caregivers of the existence of any nonprofit patient support groups 
183.28 	or organizations;
183.29 	(3) provide explanatory information from the commissioner to patients with qualifying 
183.30 	medical conditions, including disclosure to all patients about the experimental nature of 
183.31 	therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the 
184.1 	proposed treatment; the application and other materials from the commissioner; and provide 
184.2 	patients with the Tennessen warning as required by section 13.04, subdivision 2; and
184.3 	(4) agree to continue treatment of the patient's qualifying medical condition and report 
184.4 	medical findings to the commissioner.
184.5 	(b) Upon notification from the commissioner of the patient's enrollment in the registry 
184.6 	program, the health care practitioner shall:
184.7 	(1) participate in the patient registry reporting system under the guidance and supervision 
184.8 	of the commissioner;
184.9 	(2) report health records of the patient throughout the ongoing treatment of the patient 
184.10 	to the commissioner in a manner determined by the commissioner and in accordance with 
184.11 	subdivision 2;
184.12 	(3) determine, on a yearly basis every three years, if the patient continues to suffer from 
184.13 	a qualifying medical condition and, if so, issue the patient a new certification of that 
184.14 	diagnosis; and
184.15 	(4) otherwise comply with all requirements developed by the commissioner.
184.16 	(c) A health care practitioner may utilize telehealth, as defined in section 62A.673, 
184.17 	subdivision 2, for certifications and recertifications.
184.18 	(d) Nothing in this section requires a health care practitioner to participate in the registry 
184.19 	program.

184.20 	Sec. 56. Minnesota Statutes 2022, section 256R.02, subdivision 20, is amended to read:
184.21 		Subd. 20.Facility average case mix index. "Facility average case mix index" or "CMI" 
184.22 	means a numerical score that describes the relative resource use for all residents within the 
184.23 	case mix classifications under the resource utilization group (RUG) classification system 
184.24 	prescribed by the commissioner based on an assessment of each resident. The facility average 
184.25 	CMI shall be computed as the standardized days divided by the sum of the facility's resident 
184.26 	days. The case mix indices used shall be based on the system prescribed in section 256R.17.

184.27 	Sec. 57. Minnesota Statutes 2022, section 259.52, subdivision 2, is amended to read:
184.28 		Subd. 2.Requirement to search registry before adoption petition can be granted; 
184.29 	proof of search. No petition for adoption may be granted unless the agency supervising 
184.30 	the adoptive placement, the birth mother of the child, the putative father who registered or 
184.31 	the legal father, or, in the case of a stepparent or relative adoption, the county agency 
185.1 	responsible for the report required under section 259.53, subdivision 1, requests that the 
185.2 	commissioner of health search the registry to determine whether a putative father is registered 
185.3 	in relation to a child who is or may be the subject of an adoption petition. The search required 
185.4 	by this subdivision must be conducted no sooner than 31 days following the birth of the 
185.5 	child. A search of the registry may be proven by the production of a certified copy of the 
185.6 	registration form or by a certified statement of the commissioner of health that after a search 
185.7 	no registration of a putative father in relation to a child who is or may be the subject of an 
185.8 	adoption petition could be located. The filing of a certified copy of an order from a juvenile 
185.9 	protection matter under chapter 260C containing a finding that certification of the requisite 
185.10 	search of the Minnesota Fathers' Adoption Registry was filed with the court in that matter 
185.11 	shall also constitute proof of search. Certification that the Minnesota Fathers' Adoption 
185.12 	Registry has been searched must be filed with the court prior to entry of any final order of 
185.13 	adoption. In addition to the search required by this subdivision, the agency supervising the 
185.14 	adoptive placement, the birth mother of the child, or, in the case of a stepparent or relative 
185.15 	adoption, the social services agency responsible for the report under section 259.53, 
185.16 	subdivision 1, or the responsible social services agency that is a petitioner in a juvenile 
185.17 	protection matter under chapter 260C may request that the commissioner of health search 
185.18 	the registry at any time. Search requirements of this section do not apply when the responsible 
185.19 	social services agency is proceeding under Safe Place for Newborns, section 260C.139.

185.20 	Sec. 58. Minnesota Statutes 2022, section 259.52, subdivision 4, is amended to read:
185.21 		Subd. 4.Classification of registry data. (a) Data in the fathers' adoption registry, 
185.22 	including all data provided in requesting the search of the registry, are private data on 
185.23 	individuals, as defined in section 13.02, subdivision 2, and are nonpublic data with respect 
185.24 	to data not on individuals, as defined in section 13.02, subdivision 9. Data in the registry 
185.25 	may be released to:
185.26 	(1) a person who is required to search the registry under subdivision 2, if the data relate 
185.27 	to the child who is or may be the subject of the adoption petition;
185.28 	(2) the mother of the child listed on the putative father's registration form who the 
185.29 	commissioner of health is required to notify under subdivision 1, paragraph (c);
185.30 	(3) the putative father who registered himself or the legal father;
185.31 	(4) a public authority as provided in subdivision 3; or
186.1 	(4) (5) an attorney who has signed an affidavit from the commissioner of health attesting 
186.2 	that the attorney represents the birth mother, the putative or legal father, or the prospective 
186.3 	adoptive parents.
186.4 	(b) A person who receives data under this subdivision may use the data only for purposes 
186.5 	authorized under this section or other law.

186.6 	Sec. 59. Minnesota Statutes 2023 Supplement, section 342.54, subdivision 2, is amended 
186.7 	to read:
186.8 		Subd. 2.Duties related to the registry program. The Division of Medical Cannabis 
186.9 	must:
186.10 	(1) administer the registry program according to section 342.52;
186.11 	(2) provide information to patients enrolled in the registry program on the existence of 
186.12 	federally approved clinical trials for the treatment of the patient's qualifying medical condition 
186.13 	with medical cannabis flower or medical cannabinoid products as an alternative to enrollment 
186.14 	in the registry program;
186.15 	(3) maintain safety criteria with which patients must comply as a condition of participation 
186.16 	in the registry program to prevent patients from undertaking any task under the influence 
186.17 	of medical cannabis flower or medical cannabinoid products that would constitute negligence 
186.18 	or professional malpractice;
186.19 	(4) review and publicly report on existing medical and scientific literature regarding the 
186.20 	range of recommended dosages for each qualifying medical condition, the range of chemical 
186.21 	compositions of medical cannabis flower and medical cannabinoid products that will likely 
186.22 	be medically beneficial for each qualifying medical condition, and any risks of noncannabis 
186.23 	drug interactions. This information must be updated by December 1 of each year every three 
186.24 	years. The office may consult with an independent laboratory under contract with the office 
186.25 	or other experts in reporting and updating this information; and
186.26 	(5) annually consult with cannabis businesses about medical cannabis that the businesses 
186.27 	cultivate, manufacture, and offer for sale and post on the Division of Medical Cannabis 
186.28 	website a list of the medical cannabis flower and medical cannabinoid products offered for 
186.29 	sale by each medical cannabis retailer.

186.30 	EFFECTIVE DATE. This section is effective March 1, 2025.

187.1 	Sec. 60. Minnesota Statutes 2023 Supplement, section 342.55, subdivision 2, is amended 
187.2 	to read:
187.3 		Subd. 2.Duties upon patient's enrollment in registry program. Upon receiving 
187.4 	notification from the Division of Medical Cannabis of the patient's enrollment in the registry 
187.5 	program, a health care practitioner must:
187.6 	(1) participate in the patient registry reporting system under the guidance and supervision 
187.7 	of the Division of Medical Cannabis;
187.8 	(2) report to the Division of Medical Cannabis patient health records throughout the 
187.9 	patient's ongoing treatment in a manner determined by the office and in accordance with 
187.10 	subdivision 4;
187.11 	(3) determine on a yearly basis, every three years, if the patient continues to have a 
187.12 	qualifying medical condition and, if so, issue the patient a new certification of that diagnosis. 
187.13 	The patient assessment conducted under this clause may be conducted via telehealth, as 
187.14 	defined in section 62A.673, subdivision 2; and
187.15 	(4) otherwise comply with requirements established by the Office of Cannabis 
187.16 	Management and the Division of Medical Cannabis.

187.17 	EFFECTIVE DATE. This section is effective March 1, 2025.

187.18 	Sec. 61. REVISOR INSTRUCTION.
 187.19 	The revisor of statutes shall substitute the term "employee" with the term "staff" in the 
187.20 	following sections of Minnesota Statutes and make any grammatical changes needed without 
187.21 	changing the meaning of the sentence: Minnesota Statutes, sections 144G.08, subdivisions 
187.22 	18 and 36; 144G.13, subdivision 1, paragraph (c); 144G.20, subdivisions 1, 2, and 21; 
187.23 	144G.30, subdivision 5; 144G.42, subdivision 8; 144G.45, subdivision 2; 144G.60, 
187.24 	subdivisions 1, paragraph (c), and 3, paragraph (a); 144G.63, subdivision 2, paragraph (a), 
187.25 	clause (9); 144G.64, paragraphs (a), clauses (2), (3), and (5), and (c); 144G.70, subdivision 
187.26 	7; and 144G.92, subdivisions 1 and 3.

187.27 	Sec. 62. REPEALER; 340B COVERED ENTITY REPORT.
 187.28 	(a) Minnesota Statutes 2022, sections 144.218, subdivision 3; 144.497; and 256R.02, 
187.29 	subdivision 46, are repealed.
187.30 	(b) Minnesota Statutes 2023 Supplement, sections 62J.312, subdivision 6; and 144.0528, 
187.31 	subdivision 5, are repealed.

188.1 	ARTICLE 7
188.2 	EMERGENCY MEDICAL SERVICES

188.3 	Section 1. Minnesota Statutes 2023 Supplement, section 15A.0815, subdivision 2, is 
188.4 	amended to read:
188.5 		Subd. 2.Agency head salaries. The salary for a position listed in this subdivision shall 
188.6 	be determined by the Compensation Council under section 15A.082. The commissioner of 
188.7 	management and budget must publish the salaries on the department's website. This 
188.8 	subdivision applies to the following positions:
188.9 	Commissioner of administration;
188.10 	Commissioner of agriculture;
188.11 	Commissioner of education;
188.12 	Commissioner of children, youth, and families;
188.13 	Commissioner of commerce;
188.14 	Commissioner of corrections;
188.15 	Commissioner of health;
188.16 	Commissioner, Minnesota Office of Higher Education;
188.17 	Commissioner, Minnesota IT Services;
188.18 	Commissioner, Housing Finance Agency;
188.19 	Commissioner of human rights;
188.20 	Commissioner of human services;
188.21 	Commissioner of labor and industry;
188.22 	Commissioner of management and budget;
188.23 	Commissioner of natural resources;
188.24 	Commissioner, Pollution Control Agency;
188.25 	Commissioner of public safety;
188.26 	Commissioner of revenue;
188.27 	Commissioner of employment and economic development;
188.28 	Commissioner of transportation;
189.1 	Commissioner of veterans affairs;
189.2 	Executive director of the Gambling Control Board;
189.3 	Executive director of the Minnesota State Lottery;
189.4 	Commissioner of Iron Range resources and rehabilitation;
189.5 	Commissioner, Bureau of Mediation Services;
189.6 	Ombudsman for mental health and developmental disabilities;
189.7 	Ombudsperson for corrections;
189.8 	Chair, Metropolitan Council;
189.9 	Chair, Metropolitan Airports Commission;
189.10 	School trust lands director;
189.11 	Executive director of pari-mutuel racing; and
189.12 	Commissioner, Public Utilities Commission.; and
189.13 	Director of the Office of Emergency Medical Services.

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

189.15 	Sec. 2. Minnesota Statutes 2023 Supplement, section 43A.08, subdivision 1a, is amended 
189.16 	to read:
189.17 		Subd. 1a.Additional unclassified positions. Appointing authorities for the following 
189.18 	agencies may designate additional unclassified positions according to this subdivision: the 
189.19 	Departments of Administration; Agriculture; Children, Youth, and Families; Commerce; 
189.20 	Corrections; Direct Care and Treatment; Education; Employment and Economic 
189.21 	Development; Explore Minnesota Tourism; Management and Budget; Health; Human 
189.22 	Rights; Human Services; Labor and Industry; Natural Resources; Public Safety; Revenue; 
189.23 	Transportation; and Veterans Affairs; the Housing Finance and Pollution Control Agencies; 
189.24 	the State Lottery; the State Board of Investment; the Office of Administrative Hearings; the 
189.25 	Department of Information Technology Services; the Offices of the Attorney General, 
189.26 	Secretary of State, and State Auditor; the Minnesota State Colleges and Universities; the 
189.27 	Minnesota Office of Higher Education; the Perpich Center for Arts Education; and the 
189.28 	Minnesota Zoological Board; and the Office of Emergency Medical Services.
189.29 	A position designated by an appointing authority according to this subdivision must 
189.30 	meet the following standards and criteria:
190.1 	(1) the designation of the position would not be contrary to other law relating specifically 
190.2 	to that agency;
190.3 	(2) the person occupying the position would report directly to the agency head or deputy 
190.4 	agency head and would be designated as part of the agency head's management team;
190.5 	(3) the duties of the position would involve significant discretion and substantial 
190.6 	involvement in the development, interpretation, and implementation of agency policy;
190.7 	(4) the duties of the position would not require primarily personnel, accounting, or other 
190.8 	technical expertise where continuity in the position would be important;
190.9 	(5) there would be a need for the person occupying the position to be accountable to, 
190.10 	loyal to, and compatible with, the governor and the agency head, the employing statutory 
190.11 	board or commission, or the employing constitutional officer;
190.12 	(6) the position would be at the level of division or bureau director or assistant to the 
190.13 	agency head; and
190.14 	(7) the commissioner has approved the designation as being consistent with the standards 
190.15 	and criteria in this subdivision.

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

190.17 	Sec. 3. Minnesota Statutes 2022, section 62J.49, subdivision 1, is amended to read:
190.18 		Subdivision 1.Establishment. The director of the Office of Emergency Medical Services 
190.19 	Regulatory Board established under chapter 144 144E shall establish a financial data 
190.20 	collection system for all ambulance services licensed in this state. To establish the financial 
190.21 	database, the Emergency Medical Services Regulatory Board director may contract with 
190.22 	an entity that has experience in ambulance service financial data collection.

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

190.24 	Sec. 4. Minnesota Statutes 2022, section 144E.001, subdivision 3a, is amended to read:
190.25 		Subd. 3a.Ambulance service personnel. "Ambulance service personnel" means 
190.26 	individuals who are authorized by a licensed ambulance service to provide emergency care 
190.27 	for the ambulance service and are:
190.28 	(1) EMTs, AEMTs, or paramedics;
190.29 	(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing nursing, and 
190.30 	have passed a paramedic practical skills test, as approved by the board and administered by 
191.1 	an educational program approved by the board been approved by the ambulance service 
191.2 	medical director; (ii) on the roster of an ambulance service on or before January 1, 2000; 
191.3 	or (iii) after petitioning the board, deemed by the board to have training and skills equivalent 
191.4 	to an EMT, as determined on a case-by-case basis; or (iv) certified as a certified flight 
191.5 	registered nurse or certified emergency nurse; or
191.6 	(3) Minnesota licensed physician assistants who are: (i) EMTs, are currently practicing 
191.7 	as physician assistants, and have passed a paramedic practical skills test, as approved by 
191.8 	the board and administered by an educational program approved by the board been approved 
191.9 	by the ambulance service medical director; (ii) on the roster of an ambulance service on or 
191.10 	before January 1, 2000; or (iii) after petitioning the board, deemed by the board to have 
191.11 	training and skills equivalent to an EMT, as determined on a case-by-case basis.

191.12 	Sec. 5. Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision 
191.13 	to read:
191.14 		Subd. 16.Director. "Director" means the director of the Office of Emergency Medical 
191.15 	Services.

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

191.17 	Sec. 6. Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision 
191.18 	to read:
191.19 		Subd. 17.Office. "Office" means the Office of Emergency Medical Services.

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

191.21 	Sec. 7. [144E.011] OFFICE OF EMERGENCY MEDICAL SERVICES.
191.22 		Subdivision 1.Establishment. The Office of Emergency Medical Services is established 
191.23 	with the powers and duties established in law. In administering this chapter, the office must 
191.24 	promote the public health and welfare, protect the safety of the public, and effectively 
191.25 	regulate and support the operation of the emergency medical services system in this state.
191.26 		Subd. 2.Director. The governor must appoint a director for the office with the advice 
191.27 	and consent of the senate. The director must be in the unclassified service and must serve 
191.28 	at the pleasure of the governor. The salary of the director shall be determined according to 
191.29 	section 15A.0815. The director shall direct the activities of the office.
191.30 		Subd. 3.Powers and duties. The director has the following powers and duties:
192.1 	(1) administer and enforce this chapter and adopt rules as needed to implement this 
192.2 	chapter. Rules for which notice is published in the State Register before July 1, 2026, may 
192.3 	be adopted using the expedited rulemaking process in section 14.389;
192.4 	(2) license ambulance services in Minnesota and regulate their operation;
192.5 	(3) establish and modify primary service areas;
192.6 	(4) designate an ambulance service as authorized to provide service in a primary service 
192.7 	area and to remove an ambulance service's authorization to provide service in a primary 
192.8 	service area;
192.9 	(5) register medical response units in Minnesota and regulate their operation;
192.10 	(6) certify emergency medical technicians, advanced emergency medical technicians, 
192.11 	community emergency medical technicians, paramedics, and community paramedics and 
192.12 	register emergency medical responders;
192.13 	(7) approve education programs for ambulance service personnel and emergency medical 
192.14 	responders and administer qualifications for instructors of education programs;
192.15 	(8) administer grant programs related to emergency medical services;
192.16 	(9) report to the legislature by February 15 each year on the work of the office and the 
192.17 	advisory councils in the previous calendar year and with recommendations for any needed 
192.18 	policy changes related to emergency medical services, including but not limited to improving 
192.19 	access to emergency medical services, improving service delivery by ambulance services 
192.20 	and medical response units, and improving the effectiveness of the state's emergency medical 
192.21 	services system. The director must develop the reports and recommendations in consultation 
192.22 	with the office's deputy directors and advisory councils;
192.23 	(10) investigate complaints against and hold hearings regarding ambulance services, 
192.24 	ambulance service personnel, and emergency medical responders and impose disciplinary 
192.25 	action or otherwise resolve complaints; and
192.26 	(11) perform other duties related to the provision of emergency medical services in 
192.27 	Minnesota.
192.28 		Subd. 4.Employees. The director may employ personnel in the classified service and 
192.29 	unclassified personnel as necessary to carry out the duties of this chapter.
192.30 		Subd. 5.Work plan. The director must prepare a work plan to guide the work of the 
192.31 	office. The work plan must be updated biennially.

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

193.1 	Sec. 8. [144E.015] MEDICAL SERVICES DIVISION.
193.2 	A Medical Services Division is created in the Office of Emergency Medical Services. 
193.3 	The Medical Services Division shall be under the supervision of a deputy director of medical 
193.4 	services appointed by the director. The deputy director of medical services must be a 
193.5 	physician licensed under chapter 147. The deputy director, under the direction of the director, 
193.6 	shall enforce and coordinate the laws, rules, and policies assigned by the director, which 
193.7 	may include overseeing the clinical aspects of prehospital medical care and education 
193.8 	programs for emergency medical service personnel.

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

193.10 	Sec. 9. [144E.016] AMBULANCE SERVICES DIVISION.
193.11 	An Ambulance Services Division is created in the Office of Emergency Medical Services. 
193.12 	The Ambulance Services Division shall be under the supervision of a deputy director of 
193.13 	ambulance services appointed by the director. The deputy director, under the direction of 
193.14 	the director, shall enforce and coordinate the laws, rules, and policies assigned by the director, 
193.15 	which may include operating standards and licensing of ambulance services, registration 
193.16 	and operation of medical response units, establishment and modification of primary service 
193.17 	areas, authorization of ambulance services to provide service in a primary service area and 
193.18 	revocation of such authorization, coordination of ambulance services within regions and 
193.19 	across the state, and administration of grants.

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

193.21 	Sec. 10. [144E.017] EMERGENCY MEDICAL SERVICE PROVIDERS DIVISION.
193.22 	An Emergency Medical Service Providers Division is created in the Office of Emergency 
193.23 	Medical Services. The Emergency Medical Service Providers Division shall be under the 
193.24 	supervision of a deputy director of emergency medical service providers appointed by the 
193.25 	director. The deputy director, under the direction of the director, shall enforce and coordinate 
193.26 	the laws, rules, and policies assigned by the director, which may include certification and 
193.27 	registration of individual emergency medical service providers; overseeing worker safety, 
193.28 	worker well-being, and working conditions; implementation of education programs; and 
193.29 	administration of grants.

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

194.1 	Sec. 11. [144E.03] EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL.
194.2 		Subdivision 1.Establishment; membership. The Emergency Medical Services Advisory 
194.3 	Council is established and consists of the following members:
194.4 	(1) one emergency medical technician currently practicing with a licensed ambulance 
194.5 	service, appointed by the Minnesota Ambulance Association;
194.6 	(2) one paramedic currently practicing with a licensed ambulance service or a medical 
194.7 	response unit, appointed jointly by the Minnesota Professional Fire Fighters Association 
194.8 	and the Minnesota Ambulance Association;
194.9 	(3) one medical director of a licensed ambulance service, appointed by the National 
194.10 	Association of EMS Physicians, Minnesota Chapter;
194.11 	(4) one firefighter currently serving as an emergency medical responder, appointed by 
194.12 	the Minnesota State Fire Chiefs Association;
194.13 	(5) one registered nurse who is certified or currently practicing as a flight nurse, appointed 
194.14 	jointly by the regional emergency services boards of the designated regional emergency 
194.15 	medical services systems;
194.16 	(6) one hospital administrator, appointed by the Minnesota Hospital Association;
194.17 	(7) one social worker, appointed by the Board of Social Work;
194.18 	(8) one member of a federally recognized Tribal Nation in Minnesota, appointed by the 
194.19 	Minnesota Indian Affairs Council;
194.20 	(9) three public members, appointed by the governor;
194.21 	(10) one member with experience working as an employee organization representative 
194.22 	representing emergency medical service providers, appointed by an employee organization 
194.23 	representing emergency medical service providers;
194.24 	(11) one member representing a local government, appointed by the Coalition of Greater 
194.25 	Minnesota Cities;
194.26 	(12) one member representing a local government in the seven-county metropolitan area, 
194.27 	appointed by the League of Minnesota Cities;
194.28 	(13) one member of the house of representatives and one member of the senate, appointed 
194.29 	according to subdivision 2; and
194.30 	(14) the commissioner of health and commissioner of public safety or their designees 
194.31 	as ex officio members.
195.1 		Subd. 2.Legislative members. The speaker of the house must appoint one member of 
195.2 	the house of representatives to serve on the advisory council and the senate majority leader 
195.3 	must appoint one member of the senate to serve on the advisory council. Legislative members 
195.4 	appointed under this subdivision serve until successors are appointed. Legislative members 
195.5 	may receive per diem compensation and reimbursement for expenses according to the rules 
195.6 	of their respective bodies.
195.7 		Subd. 3.Terms, compensation, removal, vacancies, and expiration. Compensation 
195.8 	and reimbursement for expenses for members appointed under subdivision 1, clauses (1) 
195.9 	to (12); removal of members; filling of vacancies of members; and, except for initial 
195.10 	appointments, membership terms are governed by section 15.059. Notwithstanding section 
195.11 	15.059, subdivision 6, the advisory council does not expire.
195.12 		Subd. 4.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
195.13 	from among its membership and may elect other officers as the advisory council deems 
195.14 	necessary.
195.15 	(b) The advisory council must meet quarterly or at the call of the chair.
195.16 	(c) Meetings of the advisory council are subject to chapter 13D.
195.17 		Subd. 5.Duties. The advisory council must review and make recommendations to the 
195.18 	director and the deputy director of ambulance services on the administration of this chapter, 
195.19 	the regulation of ambulance services and medical response units, the operation of the 
195.20 	emergency medical services system in the state, and other topics as directed by the director.

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

195.22 	Sec. 12. [144E.035] EMERGENCY MEDICAL SERVICES PHYSICIAN ADVISORY 
195.23 	COUNCIL.
195.24 		Subdivision 1.Establishment; membership. The Emergency Medical Services Physician 
195.25 	Advisory Council is established and consists of the following members:
195.26 	(1) eight physicians who meet the qualifications for medical directors in section 144E.265, 
195.27 	subdivision 1, with one physician appointed by each of the regional emergency services 
195.28 	boards of the designated regional emergency medical services systems;
195.29 	(2) one physician who meets the qualifications for medical directors in section 144E.265, 
195.30 	subdivision 1, appointed by the Minnesota State Fire Chiefs Association;
195.31 	(3) one physician who is board-certified in pediatrics, appointed by the Minnesota 
195.32 	Emergency Medical Services for Children program; and
196.1 	(4) the medical director member of the Emergency Medical Services Advisory Council 
196.2 	appointed under section 144E.03, subdivision 1, clause (3).
196.3 		Subd. 2.Terms, compensation, removal, vacancies, and expiration. Compensation 
196.4 	and reimbursement for expenses, removal of members, filling of vacancies of members, 
196.5 	and, except for initial appointments, membership terms are governed by section 15.059. 
196.6 	Notwithstanding section 15.059, subdivision 6, the advisory council does not expire.
196.7 		Subd. 3.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
196.8 	from among its membership and may elect other officers as it deems necessary.
196.9 	(b) The advisory council must meet twice per year or upon the call of the chair.
196.10 	(c) Meetings of the advisory council are subject to chapter 13D.
196.11 		Subd. 4.Duties. The advisory council must:
196.12 	(1) review and make recommendations to the director and deputy director of medical 
196.13 	services on clinical aspects of prehospital medical care. In doing so, the advisory council 
196.14 	must incorporate information from medical literature, advances in bedside clinical practice, 
196.15 	and advisory council member experience; and
196.16 	(2) serve as subject matter experts for the director and deputy director of medical services 
196.17 	on evolving topics in clinical medicine, including but not limited to infectious disease, 
196.18 	pharmaceutical and equipment shortages, and implementation of new therapeutics.

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

196.20 	Sec. 13. [144E.04] LABOR AND EMERGENCY MEDICAL SERVICE PROVIDERS 
196.21 	ADVISORY COUNCIL.
196.22 		Subdivision 1.Establishment; membership. The Labor and Emergency Medical Service 
196.23 	Providers Advisory Council is established and consists of the following members:
196.24 	(1) one emergency medical service provider of any type from each of the designated 
196.25 	regional emergency medical services systems, appointed by their respective regional 
196.26 	emergency services boards;
196.27 	(2) one emergency medical technician instructor, appointed by an employee organization 
196.28 	representing emergency medical service providers;
196.29 	(3) two members with experience working as an employee organization representative 
196.30 	representing emergency medical service providers, appointed by an employee organization 
196.31 	representing emergency medical service providers;
197.1 	(4) one emergency medical service provider based in a fire department, appointed jointly 
197.2 	by the Minnesota State Fire Chiefs Association and the Minnesota Professional Fire Fighters 
197.3 	Association; and
197.4 	(5) one emergency medical service provider not based in a fire department, appointed 
197.5 	by the League of Minnesota Cities.
197.6 		Subd. 2.Terms, compensation, removal, vacancies, and expiration. Compensation 
197.7 	and reimbursement for expenses for members appointed under subdivision 1; removal of 
197.8 	members; filling of vacancies of members; and, except for initial appointments, membership 
197.9 	terms are governed by section 15.059. Notwithstanding section 15.059, subdivision 6, the 
197.10 	advisory council does not expire.
197.11 		Subd. 3.Officers; meetings. (a) The advisory council must elect a chair and vice-chair 
197.12 	from among its membership and may elect other officers as the advisory council deems 
197.13 	necessary.
197.14 	(b) The advisory council must meet quarterly or at the call of the chair.
197.15 	(c) Meetings of the advisory council are subject to chapter 13D.
197.16 		Subd. 4.Duties. The advisory council must review and make recommendations to the 
197.17 	director and deputy director of emergency medical service providers on the laws, rules, and 
197.18 	policies assigned to the Emergency Medical Service Providers Division and other topics as 
197.19 	directed by the director.

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

197.21 	Sec. 14. Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 6, is amended 
197.22 	to read:
197.23 		Subd. 6.Basic life support. (a) Except as provided in paragraph (f) or subdivision 6a, 
197.24 	a basic life-support ambulance shall be staffed by at least two EMTs, one of whom individuals 
197.25 	who meet one of the following requirements: (1) are certified as an EMT; (2) are a Minnesota 
197.26 	registered nurse who meets the qualification requirements in section 144E.001, subdivision 
197.27 	3a, clause (2); or (3) are a Minnesota licensed physician assistant who meets the qualification 
197.28 	requirements in section 144E.001, subdivision 3a, clause (3). One of the individuals staffing 
197.29 	a basic life-support ambulance must accompany the patient and provide a level of care so 
197.30 	as to ensure that:
197.31 	(1) (i) life-threatening situations and potentially serious injuries are recognized;
197.32 	(2) (ii) patients are protected from additional hazards;
198.1 	(3) (iii) basic treatment to reduce the seriousness of emergency situations is administered; 
198.2 	and
198.3 	(4) (iv) patients are transported to an appropriate medical facility for treatment.
198.4 	(b) A basic life-support service shall provide basic airway management.
198.5 	(c) A basic life-support service shall provide automatic defibrillation.
198.6 	(d) A basic life-support service shall administer opiate antagonists consistent with 
198.7 	protocols established by the service's medical director.
198.8 	(e) A basic life-support service licensee's medical director may authorize ambulance 
198.9 	service personnel to perform intravenous infusion and use equipment that is within the 
198.10 	licensure level of the ambulance service. Ambulance service personnel must be properly 
198.11 	trained. Documentation of authorization for use, guidelines for use, continuing education, 
198.12 	and skill verification must be maintained in the licensee's files.
198.13 	(f) For emergency ambulance calls and interfacility transfers, an ambulance service may 
198.14 	staff its basic life-support ambulances with one EMT individual who meets the qualification 
198.15 	requirements in paragraph (a), who must accompany the patient, and one registered 
198.16 	emergency medical responder driver. For purposes of this paragraph, "ambulance service" 
198.17 	means either an ambulance service whose primary service area is mainly located outside 
198.18 	the metropolitan counties listed in section 473.121, subdivision 4, and outside the cities of 
198.19 	Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an ambulance service based in 
198.20 	a community with a population of less than 2,500.
198.21 	(g) In order for a registered nurse to staff a basic life-support ambulance as a driver, the 
198.22 	registered nurse must have successfully completed a certified emergency vehicle operators 
198.23 	program.

198.24 	Sec. 15. Minnesota Statutes 2022, section 144E.101, is amended by adding a subdivision 
198.25 	to read:
198.26 		Subd. 6a.Variance; staffing of basic life-support ambulance. (a) Upon application 
198.27 	from an ambulance service that includes evidence demonstrating hardship, the board may 
198.28 	grant a variance from the staff requirements in subdivision 6, paragraph (a), and may 
198.29 	authorize a basic life-support ambulance to be staffed, for all emergency calls and interfacility 
198.30 	transfers, with one individual who meets the qualification requirements in paragraph (b) to 
198.31 	drive the ambulance and one individual who meets the qualification requirements in 
198.32 	subdivision 6, paragraph (a), and who must accompany the patient. The variance applies to 
199.1 	basic life-support ambulances until the ambulance service renews its license. When the 
199.2 	variance expires, the ambulance service may apply for a new variance under this subdivision.
199.3 	(b) In order to drive an ambulance under a variance granted under this subdivision, an 
199.4 	individual must:
199.5 	(1) hold a valid driver's license from any state;
199.6 	(2) have attended an emergency vehicle driving course approved by the ambulance 
199.7 	service;
199.8 	(3) have completed a course on cardiopulmonary resuscitation approved by the ambulance 
199.9 	service; and
199.10 	(4) register with the board according to a process established by the board.
199.11 	(c) If an individual serving as a driver under this subdivision commits or has a record 
199.12 	of committing an act listed in section 144E.27, subdivision 5, paragraph (a), the board may 
199.13 	temporarily suspend or prohibit the individual from driving an ambulance or place conditions 
199.14 	on the individual's ability to drive an ambulance using the procedures and authority in 
199.15 	section 144E.27, subdivisions 5 and 6.

199.16 	Sec. 16. Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 7, as amended 
199.17 	by Laws 2024, chapter 85, section 32, is amended to read:
199.18 		Subd. 7.Advanced life support. (a) Except as provided in paragraphs (f) and (g), an 
199.19 	advanced life-support ambulance shall be staffed by at least:
199.20 	(1) one EMT or one AEMT and one paramedic;
199.21 	(2) one EMT or one AEMT and one registered nurse who: (i) is an EMT or an AEMT, 
199.22 	is currently practicing nursing, and has passed a paramedic practical skills test approved by 
199.23 	the board and administered by an education program has been approved by the ambulance 
199.24 	service medical director; or (ii) is certified as a certified flight registered nurse or certified 
199.25 	emergency nurse; or
199.26 	(3) one EMT or one AEMT and one physician assistant who is an EMT or an AEMT, 
199.27 	is currently practicing as a physician assistant, and has passed a paramedic practical skills 
199.28 	test approved by the board and administered by an education program has been approved 
199.29 	by the ambulance service medical director.
199.30 	(b) An advanced life-support service shall provide basic life support, as specified under 
199.31 	subdivision 6, paragraph (a), advanced airway management, manual defibrillation, 
200.1 	administration of intravenous fluids and pharmaceuticals, and administration of opiate 
200.2 	antagonists.
200.3 	(c) In addition to providing advanced life support, an advanced life-support service may 
200.4 	staff additional ambulances to provide basic life support according to subdivision 6 and 
200.5 	section 144E.103, subdivision 1.
200.6 	(d) An ambulance service providing advanced life support shall have a written agreement 
200.7 	with its medical director to ensure medical control for patient care 24 hours a day, seven 
200.8 	days a week. The terms of the agreement shall include a written policy on the administration 
200.9 	of medical control for the service. The policy shall address the following issues:
200.10 	(1) two-way communication for physician direction of ambulance service personnel;
200.11 	(2) patient triage, treatment, and transport;
200.12 	(3) use of standing orders; and
200.13 	(4) the means by which medical control will be provided 24 hours a day.
200.14 	The agreement shall be signed by the licensee's medical director and the licensee or the 
200.15 	licensee's designee and maintained in the files of the licensee.
200.16 	(e) When an ambulance service provides advanced life support, the authority of a 
200.17 	paramedic, Minnesota registered nurse-EMT, or Minnesota registered physician 
200.18 	assistant-EMT to determine the delivery of patient care prevails over the authority of an 
200.19 	EMT.
200.20 	(f) Upon application from an ambulance service that includes evidence demonstrating 
200.21 	hardship, the board may grant a variance from the staff requirements in paragraph (a), clause 
200.22 	(1), and may authorize an advanced life-support ambulance to be staffed by a registered 
200.23 	emergency medical responder driver with a paramedic for all emergency calls and interfacility 
200.24 	transfers. The variance shall apply to advanced life-support ambulance services until the 
200.25 	ambulance service renews its license. When the variance expires, an ambulance service 
200.26 	may apply for a new variance under this paragraph. This paragraph applies only to an 
200.27 	ambulance service whose primary service area is mainly located outside the metropolitan 
200.28 	counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato, 
200.29 	Moorhead, Rochester, and St. Cloud, or an ambulance service based in a community with 
200.30 	a population of less than 1,000 persons.
200.31 	(g) After an initial emergency ambulance call, each subsequent emergency ambulance 
200.32 	response, until the initial ambulance is again available, and interfacility transfers, may be 
200.33 	staffed by one registered emergency medical responder driver and an EMT or paramedic. 
201.1 	This paragraph applies only to an ambulance service whose primary service area is mainly 
201.2 	located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside 
201.3 	the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance service 
201.4 	based in a community with a population of less than 1,000 persons.
201.5 	(h) In order for a registered nurse to staff an advanced life-support ambulance as a driver, 
201.6 	the registered nurse must have successfully completed a certified emergency vehicle operators 
201.7 	program.

201.8 	Sec. 17. [144E.105] ALTERNATIVE EMS RESPONSE MODEL PILOT PROGRAM.
201.9 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
201.10 	the meanings given.
201.11 	(b) "Partnering ambulance services" means the basic life support ambulance service and 
201.12 	the advanced life support ambulance service that partner to jointly respond to emergency 
201.13 	ambulance calls under the pilot program.
201.14 	(c) "Pilot program" means the alternative EMS response model pilot program established 
201.15 	under this section.
201.16 		Subd. 2.Pilot program established. The board must establish and administer an 
201.17 	alternative EMS response model pilot program. Under the pilot program, the board may 
201.18 	authorize basic life support ambulance services to partner with advanced life support 
201.19 	ambulance services to provide expanded advanced life support service intercept capability 
201.20 	and staffing support for emergency ambulance calls.
201.21 		Subd. 3.Application. A basic life support ambulance service that wishes to participate 
201.22 	in the pilot program must apply to the board. An application from a basic life support 
201.23 	ambulance service must be submitted jointly with the advanced life support ambulance 
201.24 	service with which the basic life support ambulance service proposes to partner. The 
201.25 	application must identify the ambulance services applying to be partnering ambulance 
201.26 	services and must include:
201.27 	(1) approval to participate in the pilot program from the medical directors of the proposed 
201.28 	partnering ambulance services;
201.29 	(2) procedures the basic life support ambulance service will implement to respond to 
201.30 	emergency ambulance calls when the basic life support ambulance service is unable to meet 
201.31 	the minimum staffing requirements under section 144E.101, subdivision 6, and the partnering 
201.32 	advanced life support ambulance service is unavailable to jointly respond to emergency 
201.33 	ambulance calls;
202.1 	(3) an agreement between the proposed partnering ambulance services specifying which 
202.2 	ambulance service is responsible for:
202.3 	(i) workers' compensation insurance;
202.4 	(ii) motor vehicle insurance; and
202.5 	(iii) billing, identifying which if any ambulance service will bill the patient or the patient's 
202.6 	insurer and specifying how payments received will be distributed among the proposed 
202.7 	partnering ambulance services;
202.8 	(4) communication procedures to coordinate and make known the real-time availability 
202.9 	of the advanced life support ambulance service to its proposed partnering basic life support 
202.10 	ambulance services and public safety answering points;
202.11 	(5) an acknowledgment that the proposed partnering ambulance services must coordinate 
202.12 	compliance with the prehospital care data requirements in section 144E.123; and
202.13 	(6) an acknowledgment that the proposed partnering ambulance services remain 
202.14 	responsible for providing continual service as required under section 144E.101, subdivision 
202.15 	3.
202.16 		Subd. 4.Operation. Under the pilot program, an advanced life support ambulance 
202.17 	service may partner with one or more basic life support ambulance services. Under this 
202.18 	partnership, the advanced life support ambulance service and basic life support ambulance 
202.19 	service must jointly respond to emergency ambulance calls originating in the primary service 
202.20 	area of the basic life support ambulance service. The advanced life support ambulance 
202.21 	service must respond to emergency ambulance calls with either an ambulance or a 
202.22 	nontransporting vehicle fully equipped with the advanced life support complement of 
202.23 	equipment and medications required for that nontransporting vehicle by that ambulance 
202.24 	service's medical director.
202.25 		Subd. 5.Staffing. (a) When responding to an emergency ambulance call and when an 
202.26 	ambulance or nontransporting vehicle from the partnering advanced life support ambulance 
202.27 	service is confirmed to be available and is responding to the call:
202.28 	(1) the basic life support ambulance must be staffed with a minimum of one emergency 
202.29 	medical technician; and
202.30 	(2) the advanced life support ambulance or nontransporting vehicle must be staffed with 
202.31 	a minimum of one paramedic.
203.1 	(b) The staffing specified in paragraph (a) is deemed to satisfy the staffing requirements 
203.2 	in section 144E.101, subdivisions 6 and 7.
203.3 		Subd. 6.Medical director oversight. The medical director for an ambulance service 
203.4 	participating in the pilot program retains responsibility for the ambulance service personnel 
203.5 	of their ambulance service. When a paramedic from the partnering advanced life support 
203.6 	ambulance service makes contact with the patient, the standing orders; clinical policies; 
203.7 	protocols; and triage, treatment, and transportation guidelines for the advanced life support 
203.8 	ambulance service must direct patient care related to the encounter.
203.9 		Subd. 7.Waivers and variances. The board may issue any waivers of or variances to 
203.10 	this chapter or Minnesota Rules, chapter 4690, to partnering ambulance services that are 
203.11 	needed to implement the pilot program, provided the waiver or variance does not adversely 
203.12 	affect the public health or welfare.
203.13 		Subd. 8.Data and evaluation. In administering the pilot program, the board shall collect 
203.14 	from partnering ambulance services data needed to evaluate the impacts of the pilot program 
203.15 	on response times, patient outcomes, and patient experience for emergency ambulance calls.
203.16 		Subd. 9.Transfer of authority. Effective January 1, 2025, the duties and authority 
203.17 	assigned to the board in this section are transferred to the director.
203.18 		Subd. 10.Expiration. This section expires June 30, 2026.

203.19 	Sec. 18. Minnesota Statutes 2022, section 144E.16, subdivision 5, is amended to read:
203.20 		Subd. 5.Local government's powers. (a) Local units of government may, with the 
203.21 	approval of the board director, establish standards for ambulance services which impose 
203.22 	additional requirements upon such services. Local units of government intending to impose 
203.23 	additional requirements shall consider whether any benefit accruing to the public health 
203.24 	would outweigh the costs associated with the additional requirements.
203.25 	(b) Local units of government that desire to impose additional requirements shall, prior 
203.26 	to adoption of relevant ordinances, rules, or regulations, furnish the board director with a 
203.27 	copy of the proposed ordinances, rules, or regulations, along with information that 
203.28 	affirmatively substantiates that the proposed ordinances, rules, or regulations:
203.29 	(1) will in no way conflict with the relevant rules of the board office;
203.30 	(2) will establish additional requirements tending to protect the public health;
203.31 	(3) will not diminish public access to ambulance services of acceptable quality; and
204.1 	(4) will not interfere with the orderly development of regional systems of emergency 
204.2 	medical care.
204.3 	(c) The board director shall base any decision to approve or disapprove local standards 
204.4 	upon whether or not the local unit of government in question has affirmatively substantiated 
204.5 	that the proposed ordinances, rules, or regulations meet the criteria specified in paragraph 
204.6 	(b).

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

204.8 	Sec. 19. Minnesota Statutes 2022, section 144E.19, subdivision 3, is amended to read:
204.9 		Subd. 3.Temporary suspension. (a) In addition to any other remedy provided by law, 
204.10 	the board director may temporarily suspend the license of a licensee after conducting a 
204.11 	preliminary inquiry to determine whether the boarddirector believes that the licensee has 
204.12 	violated a statute or rule that the board director is empowered to enforce and determining 
204.13 	that the continued provision of service by the licensee would create an imminent risk to 
204.14 	public health or harm to others.
204.15 	(b) A temporary suspension order prohibiting a licensee from providing ambulance 
204.16 	service shall give notice of the right to a preliminary hearing according to paragraph (d) 
204.17 	and shall state the reasons for the entry of the temporary suspension order.
204.18 	(c) Service of a temporary suspension order is effective when the order is served on the 
204.19 	licensee personally or by certified mail, which is complete upon receipt, refusal, or return 
204.20 	for nondelivery to the most recent address provided to the board director for the licensee.
204.21 	(d) At the time the board director issues a temporary suspension order, the board director
204.22 	shall schedule a hearing, to be held before a group of its members designated by the board,
204.23 	that shall begin within 60 days after issuance of the temporary suspension order or within 
204.24 	15 working days of the date of the board's director's receipt of a request for a hearing from 
204.25 	a licensee, whichever is sooner. The hearing shall be on the sole issue of whether there is 
204.26 	a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under 
204.27 	this paragraph is not subject to chapter 14.
204.28 	(e) Evidence presented by the board director or licensee may be in the form of an affidavit. 
204.29 	The licensee or the licensee's designee may appear for oral argument.
204.30 	(f) Within five working days of the hearing, the board director shall issue its order and, 
204.31 	if the suspension is continued, notify the licensee of the right to a contested case hearing 
204.32 	under chapter 14.
205.1 	(g) If a licensee requests a contested case hearing within 30 days after receiving notice 
205.2 	under paragraph (f), the boarddirector shall initiate a contested case hearing according to 
205.3 	chapter 14. The administrative law judge shall issue a report and recommendation within 
205.4 	30 days after the closing of the contested case hearing record. The board director shall issue 
205.5 	a final order within 30 days after receipt of the administrative law judge's report.

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

205.7 	Sec. 20. Minnesota Statutes 2022, section 144E.27, subdivision 3, is amended to read:
205.8 		Subd. 3.Renewal. (a) The board may renew the registration of an emergency medical 
205.9 	responder who:
205.10 	(1) successfully completes a board-approved refresher course; and
205.11 	(2) successfully completes a course in cardiopulmonary resuscitation approved by the 
205.12 	board or by the licensee's medical director. This course may be a component of a 
205.13 	board-approved refresher course; and
205.14 	(2) (3) submits a completed renewal application to the board before the registration 
205.15 	expiration date.
205.16 	(b) The board may renew the lapsed registration of an emergency medical responder 
205.17 	who:
205.18 	(1) successfully completes a board-approved refresher course; and
205.19 	(2) successfully completes a course in cardiopulmonary resuscitation approved by the 
205.20 	board or by the licensee's medical director. This course may be a component of a 
205.21 	board-approved refresher course; and
205.22 	(2) (3) submits a completed renewal application to the board within 12 48 months after 
205.23 	the registration expiration date.

205.24 	Sec. 21. Minnesota Statutes 2022, section 144E.27, subdivision 5, is amended to read:
205.25 		Subd. 5.Denial, suspension, revocation; emergency medical responders and 
205.26 	drivers. (a) This subdivision applies to individuals seeking registration or registered as an 
205.27 	emergency medical responder and to individuals seeking registration or registered as a driver 
205.28 	of a basic life-support ambulance under section 144E.101, subdivision 6a. The board may 
205.29 	deny, suspend, revoke, place conditions on, or refuse to renew the registration of an individual 
205.30 	who the board determines:
206.1 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, an 
206.2 	agreement for corrective action, or an order that the board issued or is otherwise empowered 
206.3 	to enforce;
206.4 	(2) misrepresents or falsifies information on an application form for registration;
206.5 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
206.6 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
206.7 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
206.8 	alcohol;
206.9 	(4) is actually or potentially unable to provide emergency medical services or drive an 
206.10 	ambulance with reasonable skill and safety to patients by reason of illness, use of alcohol, 
206.11 	drugs, chemicals, or any other material, or as a result of any mental or physical condition;
206.12 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
206.13 	defraud, or harm the public, or demonstrating a willful or careless disregard for the health, 
206.14 	welfare, or safety of the public;
206.15 	(6) maltreats or abandons a patient;
206.16 	(7) violates any state or federal controlled substance law;
206.17 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
206.18 	causing harm to the public, including any departure from or failure to conform to the 
206.19 	minimum standards of acceptable and prevailing practice without actual injury having to 
206.20 	be established;
206.21 	(9) for emergency medical responders, provides emergency medical services under 
206.22 	lapsed or nonrenewed credentials;
206.23 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
206.24 	jurisdiction or by another regulatory authority;
206.25 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
206.26 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
206.27 	to a patient; or
206.28 	(12) makes a false statement or knowingly provides false information to the board, or 
206.29 	fails to cooperate with an investigation of the board as required by section 144E.30.
206.30 	(b) Before taking action under paragraph (a), the board shall give notice to an individual 
206.31 	of the right to a contested case hearing under chapter 14. If an individual requests a contested 
207.1 	case hearing within 30 days after receiving notice, the board shall initiate a contested case 
207.2 	hearing according to chapter 14.
207.3 	(c) The administrative law judge shall issue a report and recommendation within 30 
207.4 	days after closing the contested case hearing record. The board shall issue a final order 
207.5 	within 30 days after receipt of the administrative law judge's report.
207.6 	(d) After six months from the board's decision to deny, revoke, place conditions on, or 
207.7 	refuse renewal of an individual's registration for disciplinary action, the individual shall 
207.8 	have the opportunity to apply to the board for reinstatement.

207.9 	Sec. 22. Minnesota Statutes 2022, section 144E.27, subdivision 5, is amended to read:
207.10 		Subd. 5.Denial, suspension, revocation. (a) The boarddirector may deny, suspend, 
207.11 	revoke, place conditions on, or refuse to renew the registration of an individual who the 
207.12 	boarddirector determines:
207.13 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, an 
207.14 	agreement for corrective action, or an order that the boarddirector issued or is otherwise 
207.15 	empowered to enforce;
207.16 	(2) misrepresents or falsifies information on an application form for registration;
207.17 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
207.18 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
207.19 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
207.20 	alcohol;
207.21 	(4) is actually or potentially unable to provide emergency medical services with 
207.22 	reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals, 
207.23 	or any other material, or as a result of any mental or physical condition;
207.24 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
207.25 	defraud, or harm the public, or demonstrating a willful or careless disregard for the health, 
207.26 	welfare, or safety of the public;
207.27 	(6) maltreats or abandons a patient;
207.28 	(7) violates any state or federal controlled substance law;
207.29 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
207.30 	causing harm to the public, including any departure from or failure to conform to the 
207.31 	minimum standards of acceptable and prevailing practice without actual injury having to 
207.32 	be established;
208.1 	(9) provides emergency medical services under lapsed or nonrenewed credentials;
208.2 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
208.3 	jurisdiction or by another regulatory authority;
208.4 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
208.5 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
208.6 	to a patient; or
208.7 	(12) makes a false statement or knowingly provides false information to the board
208.8 	director, or fails to cooperate with an investigation of the boarddirector as required by 
208.9 	section 144E.30.; or
208.10 	(13) fails to engage with the health professionals services program or diversion program 
208.11 	required under section 144E.287 after being referred to the program, violates the terms of 
208.12 	the program participation agreement, or leaves the program except upon fulfilling the terms 
208.13 	for successful completion of the program as set forth in the participation agreement.
208.14 	(b) Before taking action under paragraph (a), the boarddirector shall give notice to an 
208.15 	individual of the right to a contested case hearing under chapter 14. If an individual requests 
208.16 	a contested case hearing within 30 days after receiving notice, the boarddirector shall initiate 
208.17 	a contested case hearing according to chapter 14.
208.18 	(c) The administrative law judge shall issue a report and recommendation within 30 
208.19 	days after closing the contested case hearing record. The boarddirector shall issue a final 
208.20 	order within 30 days after receipt of the administrative law judge's report.
208.21 	(d) After six months from the board'sdirector's decision to deny, revoke, place conditions 
208.22 	on, or refuse renewal of an individual's registration for disciplinary action, the individual 
208.23 	shall have the opportunity to apply to the boarddirector for reinstatement.

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

208.25 	Sec. 23. Minnesota Statutes 2022, section 144E.27, subdivision 6, is amended to read:
208.26 		Subd. 6.Temporary suspension; emergency medical responders and drivers. (a) 
208.27 	This subdivision applies to emergency medical responders registered under this section and 
208.28 	to individuals registered as drivers of basic life-support ambulances under section 144E.101, 
208.29 	subdivision 6a. In addition to any other remedy provided by law, the board may temporarily 
208.30 	suspend the registration of an individual after conducting a preliminary inquiry to determine 
208.31 	whether the board believes that the individual has violated a statute or rule that the board 
209.1 	is empowered to enforce and determining that the continued provision of service by the 
209.2 	individual would create an imminent risk to public health or harm to others.
209.3 	(b) A temporary suspension order prohibiting an individual from providing emergency 
209.4 	medical care or from driving a basic life-support ambulance shall give notice of the right 
209.5 	to a preliminary hearing according to paragraph (d) and shall state the reasons for the entry 
209.6 	of the temporary suspension order.
209.7 	(c) Service of a temporary suspension order is effective when the order is served on the 
209.8 	individual personally or by certified mail, which is complete upon receipt, refusal, or return 
209.9 	for nondelivery to the most recent address provided to the board for the individual.
209.10 	(d) At the time the board issues a temporary suspension order, the board shall schedule 
209.11 	a hearing, to be held before a group of its members designated by the board, that shall begin 
209.12 	within 60 days after issuance of the temporary suspension order or within 15 working days 
209.13 	of the date of the board's receipt of a request for a hearing from the individual, whichever 
209.14 	is sooner. The hearing shall be on the sole issue of whether there is a reasonable basis to 
209.15 	continue, modify, or lift the temporary suspension. A hearing under this paragraph is not 
209.16 	subject to chapter 14.
209.17 	(e) Evidence presented by the board or the individual may be in the form of an affidavit. 
209.18 	The individual or the individual's designee may appear for oral argument.
209.19 	(f) Within five working days of the hearing, the board shall issue its order and, if the 
209.20 	suspension is continued, notify the individual of the right to a contested case hearing under 
209.21 	chapter 14.
209.22 	(g) If an individual requests a contested case hearing within 30 days after receiving 
209.23 	notice under paragraph (f), the board shall initiate a contested case hearing according to 
209.24 	chapter 14. The administrative law judge shall issue a report and recommendation within 
209.25 	30 days after the closing of the contested case hearing record. The board shall issue a final 
209.26 	order within 30 days after receipt of the administrative law judge's report.

209.27 	Sec. 24. Minnesota Statutes 2022, section 144E.28, subdivision 3, is amended to read:
209.28 		Subd. 3.Reciprocity. The board may certify an individual who possesses a current 
209.29 	National Registry of Emergency Medical Technicians registration certification from another 
209.30 	jurisdiction if the individual submits a board-approved application form. The board 
209.31 	certification classification shall be the same as the National Registry's classification. 
209.32 	Certification shall be for the duration of the applicant's registration certification period in 
209.33 	another jurisdiction, not to exceed two years.

210.1 	Sec. 25. Minnesota Statutes 2022, section 144E.28, subdivision 5, is amended to read:
210.2 		Subd. 5.Denial, suspension, revocation. (a) The boarddirector may deny certification 
210.3 	or take any action authorized in subdivision 4 against an individual who the boarddirector 
210.4 	determines:
210.5 	(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, or 
210.6 	an order that the boarddirector issued or is otherwise authorized or empowered to enforce, 
210.7 	or agreement for corrective action;
210.8 	(2) misrepresents or falsifies information on an application form for certification;
210.9 	(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor 
210.10 	relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any 
210.11 	misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or 
210.12 	alcohol;
210.13 	(4) is actually or potentially unable to provide emergency medical services with 
210.14 	reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals, 
210.15 	or any other material, or as a result of any mental or physical condition;
210.16 	(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive, 
210.17 	defraud, or harm the public or demonstrating a willful or careless disregard for the health, 
210.18 	welfare, or safety of the public;
210.19 	(6) maltreats or abandons a patient;
210.20 	(7) violates any state or federal controlled substance law;
210.21 	(8) engages in unprofessional conduct or any other conduct which has the potential for 
210.22 	causing harm to the public, including any departure from or failure to conform to the 
210.23 	minimum standards of acceptable and prevailing practice without actual injury having to 
210.24 	be established;
210.25 	(9) provides emergency medical services under lapsed or nonrenewed credentials;
210.26 	(10) is subject to a denial, corrective, disciplinary, or other similar action in another 
210.27 	jurisdiction or by another regulatory authority;
210.28 	(11) engages in conduct with a patient that is sexual or may reasonably be interpreted 
210.29 	by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning 
210.30 	to a patient; or
211.1 	(12) makes a false statement or knowingly provides false information to the boarddirector 
211.2 	or fails to cooperate with an investigation of the boarddirector as required by section 
211.3 	144E.30.; or
211.4 	(13) fails to engage with the health professionals services program or diversion program 
211.5 	required under section 144E.287 after being referred to the program, violates the terms of 
211.6 	the program participation agreement, or leaves the program except upon fulfilling the terms 
211.7 	for successful completion of the program as set forth in the participation agreement.
211.8 	(b) Before taking action under paragraph (a), the boarddirector shall give notice to an 
211.9 	individual of the right to a contested case hearing under chapter 14. If an individual requests 
211.10 	a contested case hearing within 30 days after receiving notice, the boarddirector shall initiate 
211.11 	a contested case hearing according to chapter 14 and no disciplinary action shall be taken 
211.12 	at that time.
211.13 	(c) The administrative law judge shall issue a report and recommendation within 30 
211.14 	days after closing the contested case hearing record. The boarddirector shall issue a final 
211.15 	order within 30 days after receipt of the administrative law judge's report.
211.16 	(d) After six months from the board'sdirector's decision to deny, revoke, place conditions 
211.17 	on, or refuse renewal of an individual's certification for disciplinary action, the individual 
211.18 	shall have the opportunity to apply to the boarddirector for reinstatement.

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

211.20 	Sec. 26. Minnesota Statutes 2022, section 144E.28, subdivision 6, is amended to read:
211.21 		Subd. 6.Temporary suspension. (a) In addition to any other remedy provided by law, 
211.22 	the board director may temporarily suspend the certification of an individual after conducting 
211.23 	a preliminary inquiry to determine whether the board director believes that the individual 
211.24 	has violated a statute or rule that the board director is empowered to enforce and determining 
211.25 	that the continued provision of service by the individual would create an imminent risk to 
211.26 	public health or harm to others.
211.27 	(b) A temporary suspension order prohibiting an individual from providing emergency 
211.28 	medical care shall give notice of the right to a preliminary hearing according to paragraph 
211.29 	(d) and shall state the reasons for the entry of the temporary suspension order.
211.30 	(c) Service of a temporary suspension order is effective when the order is served on the 
211.31 	individual personally or by certified mail, which is complete upon receipt, refusal, or return 
211.32 	for nondelivery to the most recent address provided to the board director for the individual.
212.1 	(d) At the time the board director issues a temporary suspension order, the board director
212.2 	shall schedule a hearing, to be held before a group of its members designated by the board,
212.3 	that shall begin within 60 days after issuance of the temporary suspension order or within 
212.4 	15 working days of the date of the board's director's receipt of a request for a hearing from 
212.5 	the individual, whichever is sooner. The hearing shall be on the sole issue of whether there 
212.6 	is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under 
212.7 	this paragraph is not subject to chapter 14.
212.8 	(e) Evidence presented by the board director or the individual may be in the form of an 
212.9 	affidavit. The individual or individual's designee may appear for oral argument.
212.10 	(f) Within five working days of the hearing, the board director shall issue its order and, 
212.11 	if the suspension is continued, notify the individual of the right to a contested case hearing 
212.12 	under chapter 14.
212.13 	(g) If an individual requests a contested case hearing within 30 days of receiving notice 
212.14 	under paragraph (f), the board director shall initiate a contested case hearing according to 
212.15 	chapter 14. The administrative law judge shall issue a report and recommendation within 
212.16 	30 days after the closing of the contested case hearing record. The board director shall issue 
212.17 	a final order within 30 days after receipt of the administrative law judge's report.

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

212.19 	Sec. 27. Minnesota Statutes 2022, section 144E.28, subdivision 8, is amended to read:
212.20 		Subd. 8.Reinstatement. (a) Within four years of a certification expiration date, a person 
212.21 	whose certification has expired under subdivision 7, paragraph (d), may have the certification 
212.22 	reinstated upon submission of:
212.23 	(1) evidence to the board of training equivalent to the continuing education requirements 
212.24 	of subdivision 7 or, for community paramedics, evidence to the board of training equivalent 
212.25 	to the continuing education requirements of subdivision 9, paragraph (c); and
212.26 	(2) a board-approved application form.
212.27 	(b) If more than four years have passed since a certificate expiration date, an applicant 
212.28 	must complete the initial certification process required under subdivision 1.
212.29 	(c) Beginning July 1, 2024, through December 31, 2025, and notwithstanding paragraph 
212.30 	(b), a person whose certification as an EMT, AEMT, paramedic, or community paramedic 
212.31 	expired more than four years ago but less than ten years ago may have the certification 
212.32 	reinstated upon submission of:
213.1 	(1) evidence to the board of the training required under paragraph (a), clause (1). This 
213.2 	training must have been completed within the 24 months prior to the date of the application 
213.3 	for reinstatement;
213.4 	(2) a board-approved application form; and
213.5 	(3) a recommendation from an ambulance service medical director.
213.6 	This paragraph expires December 31, 2025.

213.7 	Sec. 28. Minnesota Statutes 2022, section 144E.285, subdivision 1, is amended to read:
213.8 		Subdivision 1.Approval required. (a) All education programs for an EMR, EMT, 
213.9 	AEMT, or paramedic must be approved by the board.
213.10 	(b) To be approved by the board, an education program must:
213.11 	(1) submit an application prescribed by the board that includes:
213.12 	(i) type and length of course to be offered;
213.13 	(ii) names, addresses, and qualifications of the program medical director, program 
213.14 	education coordinator, and instructors;
213.15 	(iii) names and addresses of clinical sites, including a contact person and telephone 
213.16 	number;
213.17 	(iv) (iii) admission criteria for students; and
213.18 	(v) (iv) materials and equipment to be used;
213.19 	(2) for each course, implement the most current version of the United States Department 
213.20 	of Transportation EMS Education Standards, or its equivalent as determined by the board 
213.21 	applicable to EMR, EMT, AEMT, or paramedic education;
213.22 	(3) have a program medical director and a program coordinator;
213.23 	(4) utilize instructors who meet the requirements of section 144E.283 for teaching at 
213.24 	least 50 percent of the course content. The remaining 50 percent of the course may be taught 
213.25 	by guest lecturers approved by the education program coordinator or medical director;
213.26 	(5) have at least one instructor for every ten students at the practical skill stations;
213.27 	(6) maintain a written agreement with a licensed hospital or licensed ambulance service 
213.28 	designating a clinical training site;
213.29 	(7) (5) retain documentation of program approval by the board, course outline, and 
213.30 	student information;
214.1 	(8) (6) notify the board of the starting date of a course prior to the beginning of a course;
214.2 	and
214.3 	(9) (7) submit the appropriate fee as required under section 144E.29; and.
214.4 	(10) maintain a minimum average yearly pass rate as set by the board on an annual basis. 
214.5 	The pass rate will be determined by the percent of candidates who pass the exam on the 
214.6 	first attempt. An education program not meeting this yearly standard shall be placed on 
214.7 	probation and shall be on a performance improvement plan approved by the board until 
214.8 	meeting the pass rate standard. While on probation, the education program may continue 
214.9 	providing classes if meeting the terms of the performance improvement plan as determined 
214.10 	by the board. If an education program having probation status fails to meet the pass rate 
214.11 	standard after two years in which an EMT initial course has been taught, the board may 
214.12 	take disciplinary action under subdivision 5.

214.13 	Sec. 29. Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision 
214.14 	to read:
214.15 		Subd. 1a.EMR education program requirements. The National EMS Education 
214.16 	Standards established by the National Highway Traffic Safety Administration of the United 
214.17 	States Department of Transportation specify the minimum requirements for knowledge and 
214.18 	skills for emergency medical responders. An education program applying for approval to 
214.19 	teach EMRs must comply with the requirements under subdivision 1, paragraph (b). A 
214.20 	medical director of an emergency medical responder group may establish additional 
214.21 	knowledge and skill requirements for EMRs.

214.22 	Sec. 30. Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision 
214.23 	to read:
214.24 		Subd. 1b.EMT education program requirements. In addition to the requirements 
214.25 	under subdivision 1, paragraph (b), an education program applying for approval to teach 
214.26 	EMTs must:
214.27 	(1) include in the application prescribed by the board the names and addresses of clinical 
214.28 	sites, including a contact person and telephone number;
214.29 	(2) maintain a written agreement with at least one clinical training site that is of a type 
214.30 	recognized by the National EMS Education Standards established by the National Highway 
214.31 	Traffic Safety Administration; and
215.1 	(3) maintain a minimum average yearly pass rate as set by the board. An education 
215.2 	program not meeting this standard must be placed on probation and must comply with a 
215.3 	performance improvement plan approved by the board until the program meets the pass 
215.4 	rate standard. While on probation, the education program may continue to provide classes 
215.5 	if the program meets the terms of the performance improvement plan, as determined by the 
215.6 	board. If an education program that is on probation status fails to meet the pass rate standard 
215.7 	after two years in which an EMT initial course has been taught, the board may take 
215.8 	disciplinary action under subdivision 5.

215.9 	Sec. 31. Minnesota Statutes 2022, section 144E.285, subdivision 2, is amended to read:
215.10 		Subd. 2.AEMT and paramedic education program requirements. (a) In addition to 
215.11 	the requirements under subdivision 1, paragraph (b), an education program applying for 
215.12 	approval to teach AEMTs and paramedics must:
215.13 	(1) be administered by an educational institution accredited by the Commission of 
215.14 	Accreditation of Allied Health Education Programs (CAAHEP).;
215.15 	(2) include in the application prescribed by the board the names and addresses of clinical 
215.16 	sites, including a contact person and telephone number; and
215.17 	(3) maintain a written agreement with a licensed hospital or licensed ambulance service 
215.18 	designating a clinical training site.
215.19 	(b) An AEMT and paramedic education program that is administered by an educational 
215.20 	institution not accredited by CAAHEP, but that is in the process of completing the 
215.21 	accreditation process, may be granted provisional approval by the board upon verification 
215.22 	of submission of its self-study report and the appropriate review fee to CAAHEP.
215.23 	(c) An educational institution that discontinues its participation in the accreditation 
215.24 	process must notify the board immediately and provisional approval shall be withdrawn.
215.25 	(d) This subdivision does not apply to a paramedic education program when the program 
215.26 	is operated by an advanced life-support ambulance service licensed by the Emergency 
215.27 	Medical Services Regulatory Board under this chapter, and the ambulance service meets 
215.28 	the following criteria:
215.29 	(1) covers a rural primary service area that does not contain a hospital within the primary 
215.30 	service area or contains a hospital within the primary service area that has been designated 
215.31 	as a critical access hospital under section 144.1483, clause (9);
216.1 	(2) has tax-exempt status in accordance with the Internal Revenue Code, section 
216.2 	501(c)(3);
216.3 	(3) received approval before 1991 from the commissioner of health to operate a paramedic 
216.4 	education program;
216.5 	(4) operates an AEMT and paramedic education program exclusively to train paramedics 
216.6 	for the local ambulance service; and
216.7 	(5) limits enrollment in the AEMT and paramedic program to five candidates per 
216.8 	biennium.

216.9 	Sec. 32. Minnesota Statutes 2022, section 144E.285, subdivision 4, is amended to read:
216.10 		Subd. 4.Reapproval. An education program shall apply to the board for reapproval at 
216.11 	least three months 30 days prior to the expiration date of its approval and must:
216.12 	(1) submit an application prescribed by the board specifying any changes from the 
216.13 	information provided for prior approval and any other information requested by the board 
216.14 	to clarify incomplete or ambiguous information presented in the application; and
216.15 	(2) comply with the requirements under subdivision 1, paragraph (b), clauses (2) to (10).
216.16 	(7);
216.17 	(3) be subject to a site visit by the board;
216.18 	(4) for education programs that teach EMRs, comply with the requirements in subdivision 
216.19 	1a;
216.20 	(5) for education programs that teach EMTs, comply with the requirements in subdivision 
216.21 	1b; and
216.22 	(6) for education programs that teach AEMTs and paramedics, comply with the 
216.23 	requirements in subdivision 2 and maintain accreditation with CAAHEP.

216.24 	Sec. 33. Minnesota Statutes 2022, section 144E.285, subdivision 6, is amended to read:
216.25 		Subd. 6.Temporary suspension. (a) In addition to any other remedy provided by law, 
216.26 	the board director may temporarily suspend approval of the education program after 
216.27 	conducting a preliminary inquiry to determine whether the board director believes that the 
216.28 	education program has violated a statute or rule that the board director is empowered to 
216.29 	enforce and determining that the continued provision of service by the education program 
216.30 	would create an imminent risk to public health or harm to others.
217.1 	(b) A temporary suspension order prohibiting the education program from providing 
217.2 	emergency medical care training shall give notice of the right to a preliminary hearing 
217.3 	according to paragraph (d) and shall state the reasons for the entry of the temporary 
217.4 	suspension order.
217.5 	(c) Service of a temporary suspension order is effective when the order is served on the 
217.6 	education program personally or by certified mail, which is complete upon receipt, refusal, 
217.7 	or return for nondelivery to the most recent address provided to the board director for the 
217.8 	education program.
217.9 	(d) At the time the board director issues a temporary suspension order, the board director
217.10 	shall schedule a hearing, to be held before a group of its members designated by the board,
217.11 	that shall begin within 60 days after issuance of the temporary suspension order or within 
217.12 	15 working days of the date of the board's director's receipt of a request for a hearing from 
217.13 	the education program, whichever is sooner. The hearing shall be on the sole issue of whether 
217.14 	there is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing 
217.15 	under this paragraph is not subject to chapter 14.
217.16 	(e) Evidence presented by the board director or the individual may be in the form of an 
217.17 	affidavit. The education program or counsel of record may appear for oral argument.
217.18 	(f) Within five working days of the hearing, the board director shall issue its order and, 
217.19 	if the suspension is continued, notify the education program of the right to a contested case 
217.20 	hearing under chapter 14.
217.21 	(g) If an education program requests a contested case hearing within 30 days of receiving 
217.22 	notice under paragraph (f), the board director shall initiate a contested case hearing according 
217.23 	to chapter 14. The administrative law judge shall issue a report and recommendation within 
217.24 	30 days after the closing of the contested case hearing record. The board director shall issue 
217.25 	a final order within 30 days after receipt of the administrative law judge's report.

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

217.27 	Sec. 34. Minnesota Statutes 2022, section 144E.287, is amended to read:
217.28 	144E.287 DIVERSION PROGRAM.
217.29 	The board director shall either conduct a health professionals service services program 
217.30 	under sections 214.31 to 214.37 or contract for a diversion program under section 214.28
217.31 	for professionals regulated by the board under this chapter who are unable to perform their 
217.32 	duties with reasonable skill and safety by reason of illness, use of alcohol, drugs, chemicals, 
217.33 	or any other materials, or as a result of any mental, physical, or psychological condition.

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

218.2 	Sec. 35. Minnesota Statutes 2022, section 144E.305, subdivision 3, is amended to read:
218.3 		Subd. 3.Immunity. (a) An individual, licensee, health care facility, business, or 
218.4 	organization is immune from civil liability or criminal prosecution for submitting in good 
218.5 	faith a report to the boarddirector under subdivision 1 or 2 or for otherwise reporting in 
218.6 	good faith to the boarddirector violations or alleged violations of sections 144E.001 to 
218.7 	144E.33. Reports are classified as confidential data on individuals or protected nonpublic 
218.8 	data under section 13.02 while an investigation is active. Except for the board'sdirector's 
218.9 	final determination, all communications or information received by or disclosed to the board
218.10 	director relating to disciplinary matters of any person or entity subject to the board'sdirector's 
218.11 	regulatory jurisdiction are confidential and privileged and any disciplinary hearing shall be 
218.12 	closed to the public.
218.13 	(b) Members of the board The director, persons employed by the board director, persons 
218.14 	engaged in the investigation of violations and in the preparation and management of charges 
218.15 	of violations of sections 144E.001 to 144E.33 on behalf of the board director, and persons 
218.16 	participating in the investigation regarding charges of violations are immune from civil 
218.17 	liability and criminal prosecution for any actions, transactions, or publications, made in 
218.18 	good faith, in the execution of, or relating to, their duties under sections 144E.001 to 144E.33.
218.19 	(c) For purposes of this section, a member of the board is considered a state employee 
218.20 	under section 3.736, subdivision 9.

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

218.22 	Sec. 36. Minnesota Statutes 2023 Supplement, section 152.126, subdivision 6, is amended 
218.23 	to read:
218.24 		Subd. 6.Access to reporting system data. (a) Except as indicated in this subdivision, 
218.25 	the data submitted to the board under subdivision 4 is private data on individuals as defined 
218.26 	in section 13.02, subdivision 12, and not subject to public disclosure.
218.27 	(b) Except as specified in subdivision 5, the following persons shall be considered 
218.28 	permissible users and may access the data submitted under subdivision 4 in the same or 
218.29 	similar manner, and for the same or similar purposes, as those persons who are authorized 
218.30 	to access similar private data on individuals under federal and state law:
219.1 	(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has 
219.2 	delegated the task of accessing the data, to the extent the information relates specifically to 
219.3 	a current patient, to whom the prescriber is:
219.4 	(i) prescribing or considering prescribing any controlled substance;
219.5 	(ii) providing emergency medical treatment for which access to the data may be necessary;
219.6 	(iii) providing care, and the prescriber has reason to believe, based on clinically valid 
219.7 	indications, that the patient is potentially abusing a controlled substance; or
219.8 	(iv) providing other medical treatment for which access to the data may be necessary 
219.9 	for a clinically valid purpose and the patient has consented to access to the submitted data, 
219.10 	and with the provision that the prescriber remains responsible for the use or misuse of data 
219.11 	accessed by a delegated agent or employee;
219.12 	(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has 
219.13 	delegated the task of accessing the data, to the extent the information relates specifically to 
219.14 	a current patient to whom that dispenser is dispensing or considering dispensing any 
219.15 	controlled substance and with the provision that the dispenser remains responsible for the 
219.16 	use or misuse of data accessed by a delegated agent or employee;
219.17 	(3) a licensed dispensing practitioner or licensed pharmacist to the extent necessary to 
219.18 	determine whether corrections made to the data reported under subdivision 4 are accurate;
219.19 	(4) a licensed pharmacist who is providing pharmaceutical care for which access to the 
219.20 	data may be necessary to the extent that the information relates specifically to a current 
219.21 	patient for whom the pharmacist is providing pharmaceutical care: (i) if the patient has 
219.22 	consented to access to the submitted data; or (ii) if the pharmacist is consulted by a prescriber 
219.23 	who is requesting data in accordance with clause (1);
219.24 	(5) an individual who is the recipient of a controlled substance prescription for which 
219.25 	data was submitted under subdivision 4, or a guardian of the individual, parent or guardian 
219.26 	of a minor, or health care agent of the individual acting under a health care directive under 
219.27 	chapter 145C. For purposes of this clause, access by individuals includes persons in the 
219.28 	definition of an individual under section 13.02;
219.29 	(6) personnel or designees of a health-related licensing board listed in section 214.01, 
219.30 	subdivision 2, or of the Office of Emergency Medical Services Regulatory Board, assigned 
219.31 	to conduct a bona fide investigation of a complaint received by that board or office that 
219.32 	alleges that a specific licensee is impaired by use of a drug for which data is collected under 
220.1 	subdivision 4, has engaged in activity that would constitute a crime as defined in section 
220.2 	152.025, or has engaged in the behavior specified in subdivision 5, paragraph (a);
220.3 	(7) personnel of the board engaged in the collection, review, and analysis of controlled 
220.4 	substance prescription information as part of the assigned duties and responsibilities under 
220.5 	this section;
220.6 	(8) authorized personnel under contract with the board, or under contract with the state 
220.7 	of Minnesota and approved by the board, who are engaged in the design, evaluation, 
220.8 	implementation, operation, or maintenance of the prescription monitoring program as part 
220.9 	of the assigned duties and responsibilities of their employment, provided that access to data 
220.10 	is limited to the minimum amount necessary to carry out such duties and responsibilities, 
220.11 	and subject to the requirement of de-identification and time limit on retention of data specified 
220.12 	in subdivision 5, paragraphs (d) and (e);
220.13 	(9) federal, state, and local law enforcement authorities acting pursuant to a valid search 
220.14 	warrant;
220.15 	(10) personnel of the Minnesota health care programs assigned to use the data collected 
220.16 	under this section to identify and manage recipients whose usage of controlled substances 
220.17 	may warrant restriction to a single primary care provider, a single outpatient pharmacy, and 
220.18 	a single hospital;
220.19 	(11) personnel of the Department of Human Services assigned to access the data pursuant 
220.20 	to paragraph (k);
220.21 	(12) personnel of the health professionals services program established under section 
220.22 	214.31, to the extent that the information relates specifically to an individual who is currently 
220.23 	enrolled in and being monitored by the program, and the individual consents to access to 
220.24 	that information. The health professionals services program personnel shall not provide this 
220.25 	data to a health-related licensing board or the Emergency Medical Services Regulatory 
220.26 	Board, except as permitted under section 214.33, subdivision 3;
220.27 	(13) personnel or designees of a health-related licensing board other than the Board of 
220.28 	Pharmacy listed in section 214.01, subdivision 2, assigned to conduct a bona fide 
220.29 	investigation of a complaint received by that board that alleges that a specific licensee is 
220.30 	inappropriately prescribing controlled substances as defined in this section. For the purposes 
220.31 	of this clause, the health-related licensing board may also obtain utilization data; and
221.1 	(14) personnel of the board specifically assigned to conduct a bona fide investigation 
221.2 	of a specific licensee or registrant. For the purposes of this clause, the board may also obtain 
221.3 	utilization data.
221.4 	(c) By July 1, 2017, every prescriber licensed by a health-related licensing board listed 
221.5 	in section 214.01, subdivision 2, practicing within this state who is authorized to prescribe 
221.6 	controlled substances for humans and who holds a current registration issued by the federal 
221.7 	Drug Enforcement Administration, and every pharmacist licensed by the board and practicing 
221.8 	within the state, shall register and maintain a user account with the prescription monitoring 
221.9 	program. Data submitted by a prescriber, pharmacist, or their delegate during the registration 
221.10 	application process, other than their name, license number, and license type, is classified 
221.11 	as private pursuant to section 13.02, subdivision 12.
221.12 	(d) Notwithstanding paragraph (b), beginning January 1, 2021, a prescriber or an agent 
221.13 	or employee of the prescriber to whom the prescriber has delegated the task of accessing 
221.14 	the data, must access the data submitted under subdivision 4 to the extent the information 
221.15 	relates specifically to the patient:
221.16 	(1) before the prescriber issues an initial prescription order for a Schedules II through 
221.17 	IV opiate controlled substance to the patient; and
221.18 	(2) at least once every three months for patients receiving an opiate for treatment of 
221.19 	chronic pain or participating in medically assisted treatment for an opioid addiction.
221.20 	(e) Paragraph (d) does not apply if:
221.21 	(1) the patient is receiving palliative care, or hospice or other end-of-life care;
221.22 	(2) the patient is being treated for pain due to cancer or the treatment of cancer;
221.23 	(3) the prescription order is for a number of doses that is intended to last the patient five 
221.24 	days or less and is not subject to a refill;
221.25 	(4) the prescriber and patient have a current or ongoing provider/patient relationship of 
221.26 	a duration longer than one year;
221.27 	(5) the prescription order is issued within 14 days following surgery or three days 
221.28 	following oral surgery or follows the prescribing protocols established under the opioid 
221.29 	prescribing improvement program under section 256B.0638;
221.30 	(6) the controlled substance is prescribed or administered to a patient who is admitted 
221.31 	to an inpatient hospital;
222.1 	(7) the controlled substance is lawfully administered by injection, ingestion, or any other 
222.2 	means to the patient by the prescriber, a pharmacist, or by the patient at the direction of a 
222.3 	prescriber and in the presence of the prescriber or pharmacist;
222.4 	(8) due to a medical emergency, it is not possible for the prescriber to review the data 
222.5 	before the prescriber issues the prescription order for the patient; or
222.6 	(9) the prescriber is unable to access the data due to operational or other technological 
222.7 	failure of the program so long as the prescriber reports the failure to the board.
222.8 	(f) Only permissible users identified in paragraph (b), clauses (1), (2), (3), (4), (7), (8), 
222.9 	(10), and (11), may directly access the data electronically. No other permissible users may 
222.10 	directly access the data electronically. If the data is directly accessed electronically, the 
222.11 	permissible user shall implement and maintain a comprehensive information security program 
222.12 	that contains administrative, technical, and physical safeguards that are appropriate to the 
222.13 	user's size and complexity, and the sensitivity of the personal information obtained. The 
222.14 	permissible user shall identify reasonably foreseeable internal and external risks to the 
222.15 	security, confidentiality, and integrity of personal information that could result in the 
222.16 	unauthorized disclosure, misuse, or other compromise of the information and assess the 
222.17 	sufficiency of any safeguards in place to control the risks.
222.18 	(g) The board shall not release data submitted under subdivision 4 unless it is provided 
222.19 	with evidence, satisfactory to the board, that the person requesting the information is entitled 
222.20 	to receive the data.
222.21 	(h) The board shall maintain a log of all persons who access the data for a period of at 
222.22 	least three years and shall ensure that any permissible user complies with paragraph (c) 
222.23 	prior to attaining direct access to the data.
222.24 	(i) Section 13.05, subdivision 6, shall apply to any contract the board enters into pursuant 
222.25 	to subdivision 2. A vendor shall not use data collected under this section for any purpose 
222.26 	not specified in this section.
222.27 	(j) The board may participate in an interstate prescription monitoring program data 
222.28 	exchange system provided that permissible users in other states have access to the data only 
222.29 	as allowed under this section, and that section 13.05, subdivision 6, applies to any contract 
222.30 	or memorandum of understanding that the board enters into under this paragraph.
222.31 	(k) With available appropriations, the commissioner of human services shall establish 
222.32 	and implement a system through which the Department of Human Services shall routinely 
222.33 	access the data for the purpose of determining whether any client enrolled in an opioid 
223.1 	treatment program licensed according to chapter 245A has been prescribed or dispensed a 
223.2 	controlled substance in addition to that administered or dispensed by the opioid treatment 
223.3 	program. When the commissioner determines there have been multiple prescribers or multiple 
223.4 	prescriptions of controlled substances, the commissioner shall:
223.5 	(1) inform the medical director of the opioid treatment program only that the 
223.6 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
223.7 	controlled substances; and
223.8 	(2) direct the medical director of the opioid treatment program to access the data directly, 
223.9 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
223.10 	review.
223.11 	If determined necessary, the commissioner of human services shall seek a federal waiver 
223.12 	of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 
223.13 	2.34, paragraph (c), prior to implementing this paragraph.
223.14 	(l) The board shall review the data submitted under subdivision 4 on at least a quarterly 
223.15 	basis and shall establish criteria, in consultation with the advisory task force, for referring 
223.16 	information about a patient to prescribers and dispensers who prescribed or dispensed the 
223.17 	prescriptions in question if the criteria are met.
223.18 	(m) The board shall conduct random audits, on at least a quarterly basis, of electronic 
223.19 	access by permissible users, as identified in paragraph (b), clauses (1), (2), (3), (4), (7), (8), 
223.20 	(10), and (11), to the data in subdivision 4, to ensure compliance with permissible use as 
223.21 	defined in this section. A permissible user whose account has been selected for a random 
223.22 	audit shall respond to an inquiry by the board, no later than 30 days after receipt of notice 
223.23 	that an audit is being conducted. Failure to respond may result in deactivation of access to 
223.24 	the electronic system and referral to the appropriate health licensing board, or the 
223.25 	commissioner of human services, for further action. The board shall report the results of 
223.26 	random audits to the chairs and ranking minority members of the legislative committees 
223.27 	with jurisdiction over health and human services policy and finance and government data 
223.28 	practices.
223.29 	(n) A permissible user who has delegated the task of accessing the data in subdivision 
223.30 	4 to an agent or employee shall audit the use of the electronic system by delegated agents 
223.31 	or employees on at least a quarterly basis to ensure compliance with permissible use as 
223.32 	defined in this section. When a delegated agent or employee has been identified as 
223.33 	inappropriately accessing data, the permissible user must immediately remove access for 
224.1 	that individual and notify the board within seven days. The board shall notify all permissible 
224.2 	users associated with the delegated agent or employee of the alleged violation.
224.3 	(o) A permissible user who delegates access to the data submitted under subdivision 4 
224.4 	to an agent or employee shall terminate that individual's access to the data within three 
224.5 	business days of the agent or employee leaving employment with the permissible user. The 
224.6 	board may conduct random audits to determine compliance with this requirement.

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

224.8 	Sec. 37. Minnesota Statutes 2022, section 214.025, is amended to read:
224.9 	214.025 COUNCIL OF HEALTH BOARDS.
224.10 	The health-related licensing boards may establish a Council of Health Boards consisting 
224.11 	of representatives of the health-related licensing boards and the Emergency Medical Services 
224.12 	Regulatory Board. When reviewing legislation or legislative proposals relating to the 
224.13 	regulation of health occupations, the council shall include the commissioner of health or a 
224.14 	designee and the director of the Office of Emergency Medical Services or a designee.

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

224.16 	Sec. 38. Minnesota Statutes 2022, section 214.04, subdivision 2a, is amended to read:
224.17 		Subd. 2a.Performance of executive directors. The governor may request that a 
224.18 	health-related licensing board or the Emergency Medical Services Regulatory Board review 
224.19 	the performance of the board's executive director. Upon receipt of the request, the board 
224.20 	must respond by establishing a performance improvement plan or taking disciplinary or 
224.21 	other corrective action, including dismissal. The board shall include the governor's 
224.22 	representative as a voting member of the board in the board's discussions and decisions 
224.23 	regarding the governor's request. The board shall report to the governor on action taken by 
224.24 	the board, including an explanation if no action is deemed necessary.

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

224.26 	Sec. 39. Minnesota Statutes 2022, section 214.29, is amended to read:
224.27 	214.29 PROGRAM REQUIRED.
224.28 	Each health-related licensing board, including the Emergency Medical Services 
224.29 	Regulatory Board under chapter 144E, shall either conduct a health professionals service 
224.30 	program under sections 214.31 to 214.37 or contract for a diversion program under section 
224.31 	214.28.

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

225.2 	Sec. 40. Minnesota Statutes 2022, section 214.31, is amended to read:
225.3 	214.31 AUTHORITY.
225.4 	Two or more of the health-related licensing boards listed in section 214.01, subdivision 
225.5 	2, may jointly conduct a health professionals services program to protect the public from 
225.6 	persons regulated by the boards who are unable to practice with reasonable skill and safety 
225.7 	by reason of illness, use of alcohol, drugs, chemicals, or any other materials, or as a result 
225.8 	of any mental, physical, or psychological condition. The program does not affect a board's 
225.9 	authority to discipline violations of a board's practice act. For purposes of sections 214.31
225.10 	to 214.37, the emergency medical services regulatory board shall be included in the definition 
225.11 	of a health-related licensing board under chapter 144E.

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

225.13 	Sec. 41. Minnesota Statutes 2022, section 214.355, is amended to read:
225.14 	214.355 GROUNDS FOR DISCIPLINARY ACTION.
225.15 	Each health-related licensing board, including the Emergency Medical Services 
225.16 	Regulatory Board under chapter 144E, shall consider it grounds for disciplinary action if a 
225.17 	regulated person violates the terms of the health professionals services program participation 
225.18 	agreement or leaves the program except upon fulfilling the terms for successful completion 
225.19 	of the program as set forth in the participation agreement.

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

225.21 	Sec. 42. INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL 
225.22 	SERVICES ADVISORY COUNCIL.
 225.23 	(a) Initial appointments of members to the Emergency Medical Services Advisory 
225.24 	Council must be made by January 1, 2025. The terms of initial appointees shall be determined 
225.25 	by lot by the secretary of state and shall be as follows:
225.26 	(1) eight members shall serve two-year terms; and
225.27 	(2) eight members shall serve three-year terms.
225.28 	(b) The medical director appointee must convene the first meeting of the Emergency 
225.29 	Medical Services Advisory Council by February 1, 2025.

226.1 	Sec. 43. INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL 
226.2 	SERVICES PHYSICIAN ADVISORY COUNCIL.
 226.3 	(a) Initial appointments of members to the Emergency Medical Services Physician 
226.4 	Advisory Council must be made by January 1, 2025. The terms of initial appointees shall 
226.5 	be determined by lot by the secretary of state and shall be as follows:
226.6 	(1) five members shall serve two-year terms;
226.7 	(2) five members shall serve three-year terms; and
226.8 	(3) the term for the medical director appointee to the Emergency Medical Services 
226.9 	Physician Advisory Council shall coincide with that member's term on the Emergency 
226.10 	Medical Services Advisory Council.
226.11 	(b) The medical director appointee must convene the first meeting of the Emergency 
226.12 	Medical Services Physician Advisory Council by February 1, 2025.

226.13 	Sec. 44. INITIAL MEMBERS AND FIRST MEETING; LABOR AND EMERGENCY 
226.14 	MEDICAL SERVICE PROVIDERS ADVISORY COUNCIL.
 226.15 	(a) Initial appointments of members to the Labor and Emergency Medical Service 
226.16 	Providers Advisory Council must be made by January 1, 2025. The terms of initial appointees 
226.17 	shall be determined by lot by the secretary of state and shall be as follows:
226.18 	(1) six members shall serve two-year terms; and
226.19 	(2) seven members shall serve three-year terms.
226.20 	(b) The emergency medical technician instructor appointee must convene the first meeting 
226.21 	of the Labor and Emergency Medical Service Providers Advisory Council by February 1, 
226.22 	2025.

226.23 	Sec. 45. TRANSITION.
 226.24 		Subdivision 1.Appointment of director; operation of office. No later than October 
226.25 	1, 2024, the governor shall appoint a director-designee of the Office of Emergency Medical 
226.26 	Services. The individual appointed as the director-designee of the Office of Emergency 
226.27 	Medical Services shall become the governor's appointee as director of the Office of 
226.28 	Emergency Medical Services on January 1, 2025. Effective January 1, 2025, the 
226.29 	responsibilities to regulate emergency medical services in Minnesota under Minnesota 
226.30 	Statutes, chapter 144E, and Minnesota Rules, chapter 4690, are transferred from the 
227.1 	Emergency Medical Services Regulatory Board to the Office of Emergency Medical Services 
227.2 	and the director of the Office of Emergency Medical Services.
227.3 		Subd. 2.Transfer of responsibilities. Minnesota Statutes, section 15.039, applies to 
227.4 	the transfer of responsibilities from the Emergency Medical Services Regulatory Board to 
227.5 	the Office of Emergency Medical Services required by this act. The commissioner of 
227.6 	administration, with the approval of the governor, may issue reorganization orders under 
227.7 	Minnesota Statutes, section 16B.37, as necessary to carry out the transfer of responsibilities 
227.8 	required by this act. The provision of Minnesota Statutes, section 16B.37, subdivision 1, 
227.9 	which states that transfers under that section may be made only to an agency that has been 
227.10 	in existence for at least one year, does not apply to transfers in this act to the Office of 
227.11 	Emergency Medical Services.

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

227.13 	Sec. 46. REVISOR INSTRUCTION.
 227.14 	(a) In Minnesota Statutes, chapter 144E, the revisor of statutes shall replace "board" 
227.15 	with "director"; "board's" with "director's"; "Emergency Medical Services Regulatory Board" 
227.16 	or "Minnesota Emergency Medical Services Regulatory Board" with "director"; and 
227.17 	"board-approved" with "director-approved," except that:
227.18 	(1) in Minnesota Statutes, section 144E.11, the revisor of statutes shall not modify the 
227.19 	term "county board," "community health board," or "community health boards";
227.20 	(2) in Minnesota Statutes, sections 144E.40, subdivision 2; 144E.42, subdivision 2; 
227.21 	144E.44; and 144E.45, subdivision 2, the revisor of statutes shall not modify the term "State 
227.22 	Board of Investment"; and
227.23 	(3) in Minnesota Statutes, sections 144E.50 and 144E.52, the revisor of statutes shall 
227.24 	not modify the term "regional emergency medical services board," "regional board," "regional 
227.25 	emergency medical services board's," or "regional boards."
227.26 	(b) In the following sections of Minnesota Statutes, the revisor of statutes shall replace 
227.27 	"Emergency Medical Services Regulatory Board" with "director of the Office of Emergency 
227.28 	Medical Services": sections 13.717, subdivision 10; 62J.49, subdivision 2; 144.604; 144.608; 
227.29 	147.09; 156.12, subdivision 2; 169.686, subdivision 3; and 299A.41, subdivision 4.
227.30 	(c) In the following sections of Minnesota Statutes, the revisor of statutes shall replace 
227.31 	"Emergency Medical Services Regulatory Board" with "Office of Emergency Medical 
227.32 	Services": sections 144.603 and 161.045, subdivision 3.
228.1 	(d) In making the changes specified in this section, the revisor of statutes may make 
228.2 	technical and other necessary changes to sentence structure to preserve the meaning of the 
228.3 	text.

228.4 	Sec. 47. REPEALER.
 228.5 	(a) Minnesota Statutes 2022, sections 144E.001, subdivision 5; 144E.01; 144E.123, 
228.6 	subdivision 5; and 144E.50, subdivision 3, are repealed.
228.7 	(b) Minnesota Statutes 2022, section 144E.27, subdivisions 1 and 1a, are repealed.

228.8 	EFFECTIVE DATE. Paragraph (a) is effective January 1, 2025.

228.9 	ARTICLE 8
228.10 	PHARMACY BOARD AND PRACTICE

228.11 	Section 1. Minnesota Statutes 2023 Supplement, section 62Q.46, subdivision 1, is amended 
228.12 	to read:
228.13 		Subdivision 1.Coverage for preventive items and services. (a) "Preventive items and 
228.14 	services" has the meaning specified in the Affordable Care Act. Preventive items and services 
228.15 	includes:
228.16 	(1) evidence-based items or services that have in effect a rating of A or B in the current 
228.17 	recommendations of the United States Preventive Services Task Force with respect to the 
228.18 	individual involved;
228.19 	(2) immunizations for routine use in children, adolescents, and adults that have in effect 
228.20 	a recommendation from the Advisory Committee on Immunization Practices of the Centers 
228.21 	for Disease Control and Prevention with respect to the individual involved. For purposes 
228.22 	of this clause, a recommendation from the Advisory Committee on Immunization Practices 
228.23 	of the Centers for Disease Control and Prevention is considered in effect after the 
228.24 	recommendation has been adopted by the Director of the Centers for Disease Control and 
228.25 	Prevention, and a recommendation is considered to be for routine use if the recommendation 
228.26 	is listed on the Immunization Schedules of the Centers for Disease Control and Prevention;
228.27 	(3) with respect to infants, children, and adolescents, evidence-informed preventive care 
228.28 	and screenings provided for in comprehensive guidelines supported by the Health Resources 
228.29 	and Services Administration;
228.30 	(4) with respect to women, additional preventive care and screenings that are not listed 
228.31 	with a rating of A or B by the United States Preventive Services Task Force but that are 
229.1 	provided for in comprehensive guidelines supported by the Health Resources and Services 
229.2 	Administration;
229.3 	(5) all contraceptive methods established in guidelines published by the United States 
229.4 	Food and Drug Administration;
229.5 	(6) screenings for human immunodeficiency virus for:
229.6 	(i) all individuals at least 15 years of age but less than 65 years of age; and
229.7 	(ii) all other individuals with increased risk of human immunodeficiency virus infection 
229.8 	according to guidance from the Centers for Disease Control;
229.9 	(7) all preexposure prophylaxis when used for the prevention or treatment of human 
229.10 	immunodeficiency virus, including but not limited to all preexposure prophylaxis, as defined 
229.11 	in any guidance by the United States Preventive Services Task Force or the Centers for 
229.12 	Disease Control, including the June 11, 2019, Preexposure Prophylaxis for the Prevention 
229.13 	of HIV Infection United States Preventive Services Task Force Recommendation Statement; 
229.14 	and
229.15 	(8) all postexposure prophylaxis when used for the prevention or treatment of human 
229.16 	immunodeficiency virus, including but not limited to all postexposure prophylaxis as defined 
229.17 	in any guidance by the United States Preventive Services Task Force or the Centers for 
229.18 	Disease Control.
229.19 	(b) A health plan company must provide coverage for preventive items and services at 
229.20 	a participating provider without imposing cost-sharing requirements, including a deductible, 
229.21 	coinsurance, or co-payment. Nothing in this section prohibits a health plan company that 
229.22 	has a network of providers from excluding coverage or imposing cost-sharing requirements 
229.23 	for preventive items or services that are delivered by an out-of-network provider.
229.24 	(c) A health plan company is not required to provide coverage for any items or services 
229.25 	specified in any recommendation or guideline described in paragraph (a) if the 
229.26 	recommendation or guideline is no longer included as a preventive item or service as defined 
229.27 	in paragraph (a). Annually, a health plan company must determine whether any additional 
229.28 	items or services must be covered without cost-sharing requirements or whether any items 
229.29 	or services are no longer required to be covered.
229.30 	(d) Nothing in this section prevents a health plan company from using reasonable medical 
229.31 	management techniques to determine the frequency, method, treatment, or setting for a 
229.32 	preventive item or service to the extent not specified in the recommendation or guideline.
230.1 	(e) A health plan shall not require prior authorization or step therapy for preexposure 
230.2 	prophylaxis or postexposure prophylaxis, except that: if the United States Food and Drug 
230.3 	Administration has approved one or more therapeutic equivalents of a drug, device, or 
230.4 	product for the prevention of HIV, this paragraph does not require a health plan to cover 
230.5 	all of the therapeutically equivalent versions without prior authorization or step therapy, if 
230.6 	at least one therapeutically equivalent version is covered without prior authorization or step 
230.7 	therapy.
230.8 	(e) (f) This section does not apply to grandfathered plans.
230.9 	(f) (g) This section does not apply to plans offered by the Minnesota Comprehensive 
230.10 	Health Association.

230.11 	EFFECTIVE DATE. This section is effective January 1, 2026, and applies to health 
230.12 	plans offered, issued, or renewed on or after that date.

230.13 	Sec. 2. Minnesota Statutes 2022, section 151.01, subdivision 23, is amended to read:
230.14 		Subd. 23.Practitioner. "Practitioner" means a licensed doctor of medicine, licensed 
230.15 	doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of 
230.16 	dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed 
230.17 	advanced practice registered nurse, or licensed physician assistant. For purposes of sections 
230.18 	151.15, subdivision 4; 151.211, subdivision 3; 151.252, subdivision 3; 151.37, subdivision 
230.19 	2, paragraph (b); and 151.461, "practitioner" also means a dental therapist authorized to 
230.20 	dispense and administer under chapter 150A. For purposes of sections 151.252, subdivision 
230.21 	3, and 151.461, "practitioner" also means a pharmacist authorized to prescribe 
230.22 	self-administered hormonal contraceptives, nicotine replacement medications, or opiate 
230.23 	antagonists under section 151.37, subdivision 14, 15, or 16, or authorized to prescribe drugs 
230.24 	to prevent the acquisition of human immunodeficiency virus (HIV) under section 151.37, 
230.25 	subdivision 17.

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

230.27 	Sec. 3. Minnesota Statutes 2022, section 151.01, subdivision 27, is amended to read:
230.28 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
230.29 	(1) interpretation and evaluation of prescription drug orders;
230.30 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by a 
230.31 	manufacturer or packager of nonprescription drugs or commercially packaged legend drugs 
230.32 	and devices);
231.1 	(3) participation in clinical interpretations and monitoring of drug therapy for assurance 
231.2 	of safe and effective use of drugs, including the performance of ordering and performing
231.3 	laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of 
231.4 	1988, United States Code, title 42, section 263a et seq., provided that a pharmacist may 
231.5 	interpret the results of laboratory tests but may modify A pharmacist may collect specimens, 
231.6 	interpret results, notify the patient of results, and refer the patient to other health care 
231.7 	providers for follow-up care and may initiate, modify, or discontinue drug therapy only
231.8 	pursuant to a protocol or collaborative practice agreement. A pharmacist may delegate the 
231.9 	authority to administer tests under this clause to a pharmacy technician or pharmacy intern. 
231.10 	A pharmacy technician or pharmacy intern may perform tests authorized under this clause 
231.11 	if the technician or intern is working under the direct supervision of a pharmacist;
231.12 	(4) participation in drug and therapeutic device selection; drug administration for first 
231.13 	dosage and medical emergencies; intramuscular and subcutaneous drug administration under 
231.14 	a prescription drug order; drug regimen reviews; and drug or drug-related research;
231.15 	(5) drug administration, through intramuscular and subcutaneous administration used 
231.16 	to treat mental illnesses as permitted under the following conditions:
231.17 	(i) upon the order of a prescriber and the prescriber is notified after administration is 
231.18 	complete; or
231.19 	(ii) pursuant to a protocol or collaborative practice agreement as defined by section 
231.20 	151.01, subdivisions 27b and 27c, and participation in the initiation, management, 
231.21 	modification, administration, and discontinuation of drug therapy is according to the protocol 
231.22 	or collaborative practice agreement between the pharmacist and a dentist, optometrist, 
231.23 	physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered 
231.24 	nurse authorized to prescribe, dispense, and administer under section 148.235. Any changes 
231.25 	in drug therapy or medication administration made pursuant to a protocol or collaborative 
231.26 	practice agreement must be documented by the pharmacist in the patient's medical record 
231.27 	or reported by the pharmacist to a practitioner responsible for the patient's care;
231.28 	(6) participation in administration of influenza vaccines andinitiating, ordering, and 
231.29 	administering influenza and COVID-19 or SARS-CoV-2 vaccines authorized or approved 
231.30 	by the United States Food and Drug Administration related to COVID-19 or SARS-CoV-2
231.31 	to all eligible individuals six three years of age and older and all other United States Food 
231.32 	and Drug Administration approved vaccines to patients 13six years of age and older by 
231.33 	written protocol with a physician licensed under chapter 147, a physician assistant authorized 
231.34 	to prescribe drugs under chapter 147A, or an advanced practice registered nurse authorized 
232.1 	to prescribe drugs under section 148.235, provided that according to the federal Advisory 
232.2 	Committee on Immunization Practices recommendation. A pharmacist may delegate the 
232.3 	authority to administer vaccines under this clause to a pharmacy technician or pharmacy 
232.4 	intern who has completed training in vaccine administration if:
232.5 	(i) the protocol includes, at a minimum:
232.6 	(A) the name, dose, and route of each vaccine that may be given;
232.7 	(B) the patient population for whom the vaccine may be given;
232.8 	(C) contraindications and precautions to the vaccine;
232.9 	(D) the procedure for handling an adverse reaction;
232.10 	(E) the name, signature, and address of the physician, physician assistant, or advanced 
232.11 	practice registered nurse;
232.12 	(F) a telephone number at which the physician, physician assistant, or advanced practice 
232.13 	registered nurse can be contacted; and
232.14 	(G) the date and time period for which the protocol is valid;
232.15 	(ii) (i) the pharmacist has and the pharmacy technician or pharmacy intern have
232.16 	successfully completed a program approved by the Accreditation Council for Pharmacy 
232.17 	Education (ACPE) specifically for the administration of immunizations or a program 
232.18 	approved by the board;
232.19 	(iii) (ii) the pharmacist utilizes and the pharmacy technician or pharmacy intern utilize
232.20 	the Minnesota Immunization Information Connection to assess the immunization status of 
232.21 	individuals prior to the administration of vaccines, except when administering influenza 
232.22 	vaccines to individuals age nine three and older;
232.23 	(iv) (iii) the pharmacist reports the administration of the immunization to the Minnesota 
232.24 	Immunization Information Connection; and
232.25 	(v) the pharmacist complies with guidelines for vaccines and immunizations established 
232.26 	by the federal Advisory Committee on Immunization Practices, except that a pharmacist 
232.27 	does not need to comply with those portions of the guidelines that establish immunization 
232.28 	schedules when administering a vaccine pursuant to a valid, patient-specific order issued 
232.29 	by a physician licensed under chapter 147, a physician assistant authorized to prescribe 
232.30 	drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe 
232.31 	drugs under section 148.235, provided that the order is consistent with the United States 
232.32 	Food and Drug Administration approved labeling of the vaccine;
233.1 	(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician, 
233.2 	or pharmacy intern informs the patient and any adult caregiver accompanying the patient 
233.3 	of the importance of a well-child visit with a pediatrician or other licensed primary care 
233.4 	provider; and
233.5 	(v) in the case of a pharmacy technician administering vaccinations while being 
233.6 	supervised by a licensed pharmacist, which supervision must be in-person and must not be 
233.7 	done through telehealth as defined under section 62A.673, subdivision 2:
233.8 	(A) the pharmacist is readily and immediately available to the immunizing pharmacy 
233.9 	technician;
233.10 	(B) the pharmacy technician has a current certificate in basic cardiopulmonary 
233.11 	resuscitation; and
233.12 	(C) the pharmacy technician has completed a minimum of two hours of ACPE-approved, 
233.13 	immunization-related continuing pharmacy education as part of the pharmacy technician's 
233.14 	two-year continuing education schedule;
233.15 	(7) participation in the initiation, management, modification, and discontinuation of 
233.16 	drug therapy according to a written protocol or collaborative practice agreement between: 
233.17 	(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician 
233.18 	assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more 
233.19 	physician assistants authorized to prescribe, dispense, and administer under chapter 147A, 
233.20 	or advanced practice registered nurses authorized to prescribe, dispense, and administer 
233.21 	under section 148.235. Any changes in drug therapy made pursuant to a protocol or 
233.22 	collaborative practice agreement must be documented by the pharmacist in the patient's 
233.23 	medical record or reported by the pharmacist to a practitioner responsible for the patient's 
233.24 	care;
233.25 	(8) participation in the storage of drugs and the maintenance of records;
233.26 	(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and 
233.27 	devices;
233.28 	(10) offering or performing those acts, services, operations, or transactions necessary 
233.29 	in the conduct, operation, management, and control of a pharmacy;
233.30 	(11) participation in the initiation, management, modification, and discontinuation of 
233.31 	therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
233.32 	(i) a written protocol as allowed under clause (7); or
234.1 	(ii) a written protocol with a community health board medical consultant or a practitioner 
234.2 	designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
234.3 	(12) prescribing self-administered hormonal contraceptives; nicotine replacement 
234.4 	medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant 
234.5 	to section 151.37, subdivision 14, 15, or 16; and
234.6 	(13) participation in the placement of drug monitoring devices according to a prescription, 
234.7 	protocol, or collaborative practice agreement.

234.8 	Sec. 4. Minnesota Statutes 2022, section 151.01, subdivision 27, is amended to read:
234.9 		Subd. 27.Practice of pharmacy. "Practice of pharmacy" means:
234.10 	(1) interpretation and evaluation of prescription drug orders;
234.11 	(2) compounding, labeling, and dispensing drugs and devices (except labeling by a 
234.12 	manufacturer or packager of nonprescription drugs or commercially packaged legend drugs 
234.13 	and devices);
234.14 	(3) participation in clinical interpretations and monitoring of drug therapy for assurance 
234.15 	of safe and effective use of drugs, including the performance of laboratory tests that are 
234.16 	waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code, 
234.17 	title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory 
234.18 	tests but may modify drug therapy only pursuant to a protocol or collaborative practice 
234.19 	agreement;
234.20 	(4) participation in drug and therapeutic device selection; drug administration for first 
234.21 	dosage and medical emergencies; intramuscular and subcutaneous drug administration under 
234.22 	a prescription drug order; drug regimen reviews; and drug or drug-related research;
234.23 	(5) drug administration, through intramuscular and subcutaneous administration used 
234.24 	to treat mental illnesses as permitted under the following conditions:
234.25 	(i) upon the order of a prescriber and the prescriber is notified after administration is 
234.26 	complete; or
234.27 	(ii) pursuant to a protocol or collaborative practice agreement as defined by section 
234.28 	151.01, subdivisions 27b and 27c, and participation in the initiation, management, 
234.29 	modification, administration, and discontinuation of drug therapy is according to the protocol 
234.30 	or collaborative practice agreement between the pharmacist and a dentist, optometrist, 
234.31 	physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered 
234.32 	nurse authorized to prescribe, dispense, and administer under section 148.235. Any changes 
235.1 	in drug therapy or medication administration made pursuant to a protocol or collaborative 
235.2 	practice agreement must be documented by the pharmacist in the patient's medical record 
235.3 	or reported by the pharmacist to a practitioner responsible for the patient's care;
235.4 	(6) participation in administration of influenza vaccines and vaccines approved by the 
235.5 	United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all 
235.6 	eligible individuals six years of age and older and all other vaccines to patients 13 years of 
235.7 	age and older by written protocol with a physician licensed under chapter 147, a physician 
235.8 	assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered 
235.9 	nurse authorized to prescribe drugs under section 148.235, provided that:
235.10 	(i) the protocol includes, at a minimum:
235.11 	(A) the name, dose, and route of each vaccine that may be given;
235.12 	(B) the patient population for whom the vaccine may be given;
235.13 	(C) contraindications and precautions to the vaccine;
235.14 	(D) the procedure for handling an adverse reaction;
235.15 	(E) the name, signature, and address of the physician, physician assistant, or advanced 
235.16 	practice registered nurse;
235.17 	(F) a telephone number at which the physician, physician assistant, or advanced practice 
235.18 	registered nurse can be contacted; and
235.19 	(G) the date and time period for which the protocol is valid;
235.20 	(ii) the pharmacist has successfully completed a program approved by the Accreditation 
235.21 	Council for Pharmacy Education specifically for the administration of immunizations or a 
235.22 	program approved by the board;
235.23 	(iii) the pharmacist utilizes the Minnesota Immunization Information Connection to 
235.24 	assess the immunization status of individuals prior to the administration of vaccines, except 
235.25 	when administering influenza vaccines to individuals age nine and older;
235.26 	(iv) the pharmacist reports the administration of the immunization to the Minnesota 
235.27 	Immunization Information Connection; and
235.28 	(v) the pharmacist complies with guidelines for vaccines and immunizations established 
235.29 	by the federal Advisory Committee on Immunization Practices, except that a pharmacist 
235.30 	does not need to comply with those portions of the guidelines that establish immunization 
235.31 	schedules when administering a vaccine pursuant to a valid, patient-specific order issued 
235.32 	by a physician licensed under chapter 147, a physician assistant authorized to prescribe 
236.1 	drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe 
236.2 	drugs under section 148.235, provided that the order is consistent with the United States 
236.3 	Food and Drug Administration approved labeling of the vaccine;
236.4 	(7) participation in the initiation, management, modification, and discontinuation of 
236.5 	drug therapy according to a written protocol or collaborative practice agreement between: 
236.6 	(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician 
236.7 	assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more 
236.8 	physician assistants authorized to prescribe, dispense, and administer under chapter 147A, 
236.9 	or advanced practice registered nurses authorized to prescribe, dispense, and administer 
236.10 	under section 148.235. Any changes in drug therapy made pursuant to a protocol or 
236.11 	collaborative practice agreement must be documented by the pharmacist in the patient's 
236.12 	medical record or reported by the pharmacist to a practitioner responsible for the patient's 
236.13 	care;
236.14 	(8) participation in the storage of drugs and the maintenance of records;
236.15 	(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and 
236.16 	devices;
236.17 	(10) offering or performing those acts, services, operations, or transactions necessary 
236.18 	in the conduct, operation, management, and control of a pharmacy;
236.19 	(11) participation in the initiation, management, modification, and discontinuation of 
236.20 	therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
236.21 	(i) a written protocol as allowed under clause (7); or
236.22 	(ii) a written protocol with a community health board medical consultant or a practitioner 
236.23 	designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
236.24 	(12) prescribing self-administered hormonal contraceptives; nicotine replacement 
236.25 	medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant 
236.26 	to section 151.37, subdivision 14, 15, or 16; and
236.27 	(13) participation in the placement of drug monitoring devices according to a prescription, 
236.28 	protocol, or collaborative practice agreement.;
236.29 	(14) prescribing, dispensing, and administering drugs for preventing the acquisition of 
236.30 	human immunodeficiency virus (HIV) if the pharmacist meets the requirements in section 
236.31 	151.37, subdivision 17; and
237.1 	(15) ordering, conducting, and interpreting laboratory tests necessary for therapies that 
237.2 	use drugs for preventing the acquisition of HIV, if the pharmacist meets the requirements 
237.3 	in section 151.37, subdivision 17.

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

237.5 	Sec. 5. Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to 
237.6 	read:
237.7 		Subd. 4a.Application and fee; relocation. A person who is registered with or licensed 
237.8 	by the board must submit a new application to the board before relocating the physical 
237.9 	location of the person's business. An application must be submitted for each affected license. 
237.10 	The application must set forth the proposed change of location on a form established by the 
237.11 	board. If the licensee or registrant remitted payment for the full amount during the state's 
237.12 	fiscal year, the relocation application fee is the same as the application fee in subdivision 
237.13 	1, except that the fees in clauses (6) to (9) and (11) to (16) are reduced by $5,000 and the 
237.14 	fee in clause (16) is reduced by $55,000. If the application is made within 60 days before 
237.15 	the date of the original license or registration expiration, the applicant must pay the full 
237.16 	application fee provided in subdivision 1. Upon approval of an application for a relocation, 
237.17 	the board shall issue a new license or registration.

237.18 	Sec. 6. Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to 
237.19 	read:
237.20 		Subd. 4b.Application and fee; change of ownership. A person who is registered with 
237.21 	or licensed by the board must submit a new application to the board before changing the 
237.22 	ownership of the licensee or registrant. An application must be submitted for each affected 
237.23 	license. The application must set forth the proposed change of ownership on a form 
237.24 	established by the board. If the licensee or registrant remitted payment for the full amount 
237.25 	during the state's fiscal year, the application fee is the same as the application fee in 
237.26 	subdivision 1, except that the fees in clauses (6) to (9) and (11) to (16) are reduced by $5,000 
237.27 	and the fee in clause (16) is reduced by $55,000. If the application is made within 60 days 
237.28 	before the date of the original license or registration expiration, the applicant must pay the 
237.29 	full application fee provided in subdivision 1. Upon approval of an application for a change 
237.30 	of ownership, the board shall issue a new license or registration.

238.1 	Sec. 7. Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to 
238.2 	read:
238.3 		Subd. 8.Transfer of licenses. Licenses and registrations granted by the board are not 
238.4 	transferable.

238.5 	Sec. 8. Minnesota Statutes 2022, section 151.066, subdivision 1, is amended to read:
238.6 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
238.7 	the meanings given to them in this subdivision.
238.8 	(b) "Manufacturer" means a manufacturer licensed under section 151.252that is engaged 
238.9 	in the manufacturing of an opiate, excluding those exclusively licensed to manufacture 
238.10 	medical gas.
238.11 	(c) "Opiate" means any opiate-containing controlled substance listed in section 152.02, 
238.12 	subdivisions 3 to 5, that is distributed, delivered, sold, or dispensed into or within this state.
238.13 	(d) "Third-party logistics provider" means a third-party logistics provider licensed under 
238.14 	section 151.471.
238.15 	(e) "Wholesaler" means a wholesale drug distributor licensed under section 151.47that 
238.16 	is engaged in the wholesale drug distribution of an opiate, excluding those exclusively 
238.17 	licensed to distribute medical gas.

238.18 	Sec. 9. Minnesota Statutes 2022, section 151.066, subdivision 2, is amended to read:
238.19 		Subd. 2.Reporting requirements. (a) By March 1 of each year, beginning March 1, 
238.20 	2020, each manufacturer and each wholesaler must report to the board every sale, delivery, 
238.21 	or other distribution within or into this state of any opiate that is made to any practitioner, 
238.22 	pharmacy, hospital, veterinary hospital, or other person who is permitted by section 151.37 
238.23 	to possess controlled substances for administration or dispensing to patients that occurred 
238.24 	during the previous calendar year. Reporting must be in the automation of reports and 
238.25 	consolidated orders system format unless otherwise specified by the board. If no reportable 
238.26 	distributions occurred for a given year, notification must be provided to the board in a 
238.27 	manner specified by the board. If a manufacturer or wholesaler fails to provide information 
238.28 	required under this paragraph on a timely basis, the board may assess an administrative 
238.29 	penalty of $500 per day. This penalty shall not be considered a form of disciplinary action.
238.30 	(b) By March 1 of each year, beginning March 1, 2020, each owner of a pharmacy with 
238.31 	at least one location within this state must report to the board any intracompany delivery 
238.32 	or distribution into this state, of any opiate, to the extent that those deliveries and distributions 
239.1 	are not reported to the board by a licensed wholesaler owned by, under contract to, or 
239.2 	otherwise operating on behalf of the owner of the pharmacy. Reporting must be in the 
239.3 	manner and format specified by the board for deliveries and distributions that occurred 
239.4 	during the previous calendar year. The report must include the name of the manufacturer 
239.5 	or wholesaler from which the owner of the pharmacy ultimately purchased the opiate, and 
239.6 	the amount and date that the purchase occurred.
239.7 	(c) By March 1 of each year, beginning March 1, 2025, each third-party logistics provider 
239.8 	must report to the board any delivery or distribution into this state of any opiate, to the 
239.9 	extent that those deliveries and distributions are not reported to the board by a licensed 
239.10 	wholesaler or manufacturer. Reporting must be in the manner and format specified by the 
239.11 	board for deliveries and distributions that occurred during the previous calendar year.

239.12 	Sec. 10. Minnesota Statutes 2022, section 151.066, subdivision 3, is amended to read:
239.13 		Subd. 3.Determination of an opiate product registration fee. (a) The board shall 
239.14 	annually assess an opiate product registration fee on any manufacturer of an opiate that 
239.15 	annually sells, delivers, or distributes an opiate within or into the state in a quantity of 
239.16 	2,000,000 or more units as reported to the board under subdivision 2.
239.17 	(b) For purposes of assessing the annual registration fee under this section and 
239.18 	determining the number of opiate units a manufacturer sold, delivered, or distributed within 
239.19 	or into the state, the board shall not consider any opiate that is used for substance use disorder 
239.20 	treatment with medications for opioid use disorder.
239.21 	(c) The annual registration fee for each manufacturer meeting the requirement under 
239.22 	paragraph (a) is $250,000.
239.23 	(d) In conjunction with the data reported under this section, and notwithstanding section 
239.24 	152.126, subdivision 6, the board may use the data reported under section 152.126, 
239.25 	subdivision 4, to determine which manufacturers meet the requirement under paragraph (a) 
239.26 	and are required to pay the registration fees under this subdivision.
239.27 	(e) By April 1 of each year, beginning April 1, 2020, the board shall notify a manufacturer 
239.28 	that the manufacturer meets the requirement in paragraph (a) and is required to pay the 
239.29 	annual registration fee in accordance with section 151.252, subdivision 1, paragraph (b).
239.30 	(f) A manufacturer may dispute the board's determination that the manufacturer must 
239.31 	pay the registration fee no later than 30 days after the date of notification. However, the 
239.32 	manufacturer must still remit the fee as required by section 151.252, subdivision 1, paragraph 
239.33 	(b). The dispute must be filed with the board in the manner and using the forms specified 
240.1 	by the board. A manufacturer must submit, with the required forms, data satisfactory to the 
240.2 	board that demonstrates that the assessment of the registration fee was incorrect. The board 
240.3 	must make a decision concerning a dispute no later than 60 days after receiving the required 
240.4 	dispute forms. If the board determines that the manufacturer has satisfactorily demonstrated 
240.5 	that the fee was incorrectly assessed, the board must refund the amount paid in error.
240.6 	(g) For purposes of this subdivision, a unit means the individual dosage form of the 
240.7 	particular drug product that is prescribed to the patient. One unit equals one tablet, capsule, 
240.8 	patch, syringe, milliliter, or gram.
240.9 	(h) For the purposes of this subdivision, an opiate's units will be assigned to the 
240.10 	manufacturer holding the New Drug Application (NDA) or Abbreviated New Drug 
240.11 	Application (ANDA), as listed by the United States Food and Drug Administration.

240.12 	Sec. 11. Minnesota Statutes 2022, section 151.212, is amended by adding a subdivision 
240.13 	to read:
240.14 		Subd. 4.Accessible prescription drug container labels. (a) A pharmacy must inform 
240.15 	each patient for whom a prescription drug is dispensed that an accessible prescription drug 
240.16 	container label is available to any patient who identifies as a person who is blind, visually 
240.17 	impaired, or otherwise disabled, upon request of the patient or the patient's representative, 
240.18 	at no additional cost.
240.19 	(b) If a patient requests an accessible container label, the pharmacy shall provide the 
240.20 	patient with an audible, large print, or braille prescription drug container label depending 
240.21 	on the need and preference of the patient.
240.22 	(c) The accessible container label must:
240.23 	(1) be affixed on the container;
240.24 	(2) be available in a timely manner comparable to other patient wait time;
240.25 	(3) last for at least the duration of the prescription;
240.26 	(4) conform with the format-specific best practices established by the United States 
240.27 	Access Board;
240.28 	(5) contain the information required under subdivisions 1 and 2; and
240.29 	(6) be compatible with a prescription reader if a reader is provided.
240.30 	(d) This subdivision does not apply to prescription drugs dispensed and administered 
240.31 	by a correctional institution.
241.1 	(e) For purposes of this subdivision, "prescription reader" means a device that is designed 
241.2 	to audibly convey the information contained on the label of a prescription drug container.

241.3 	Sec. 12. Minnesota Statutes 2022, section 151.37, is amended by adding a subdivision to 
241.4 	read:
241.5 		Subd. 17.Drugs for preventing the acquisition of HIV. (a) A pharmacist is authorized 
241.6 	to prescribe and administer drugs to prevent the acquisition of human immunodeficiency 
241.7 	virus (HIV) in accordance with this subdivision.
241.8 	(b) By January 1, 2025, the Board of Pharmacy shall develop a standardized protocol 
241.9 	for a pharmacist to follow in prescribing the drugs described in paragraph (a). In developing 
241.10 	the protocol, the board may consult with community health advocacy groups, the Board of 
241.11 	Medical Practice, the Board of Nursing, the commissioner of health, professional pharmacy 
241.12 	associations, and professional associations for physicians, physician assistants, and advanced 
241.13 	practice registered nurses.
241.14 	(c) Before a pharmacist is authorized to prescribe a drug described in paragraph (a), the 
241.15 	pharmacist must successfully complete a training program specifically developed for 
241.16 	prescribing drugs for preventing the acquisition of HIV that is offered by a college of 
241.17 	pharmacy, a continuing education provider that is accredited by the Accreditation Council 
241.18 	for Pharmacy Education, or a program approved by the board. To maintain authorization 
241.19 	to prescribe, the pharmacist shall complete continuing education requirements as specified 
241.20 	by the board.
241.21 	(d) Before prescribing a drug described in paragraph (a), the pharmacist shall follow the 
241.22 	appropriate standardized protocol developed under paragraph (b) and, if appropriate, may 
241.23 	dispense to a patient a drug described in paragraph (a).
241.24 	(e) Before dispensing a drug described in paragraph (a) that is prescribed by the 
241.25 	pharmacist, the pharmacist must provide counseling to the patient on the use of the drugs 
241.26 	and must provide the patient with a fact sheet that includes the indications and 
241.27 	contraindications for the use of these drugs, the appropriate method for using these drugs, 
241.28 	the need for medical follow up, and any additional information listed in Minnesota Rules, 
241.29 	part 6800.0910, subpart 2, that is required to be provided to a patient during the counseling 
241.30 	process.
241.31 	(f) A pharmacist is prohibited from delegating the prescribing authority provided under 
241.32 	this subdivision to any other person. A pharmacist intern registered under section 151.101 
241.33 	may prepare the prescription, but before the prescription is processed or dispensed, a 
242.1 	pharmacist authorized to prescribe under this subdivision must review, approve, and sign 
242.2 	the prescription.
242.3 	(g) Nothing in this subdivision prohibits a pharmacist from participating in the initiation, 
242.4 	management, modification, and discontinuation of drug therapy according to a protocol as 
242.5 	authorized in this section and in section 151.01, subdivision 27.

242.6 	EFFECTIVE DATE. This section is effective January 1, 2025, except that paragraph 
242.7 	(b) is effective the day following final enactment.

242.8 	Sec. 13. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 1, is amended 
242.9 	to read:
242.10 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
242.11 	subdivision have the meanings given.
242.12 	(b) "Central repository" means a wholesale distributor that meets the requirements under 
242.13 	subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this 
242.14 	section.
242.15 	(c) "Distribute" means to deliver, other than by administering or dispensing.
242.16 	(d) "Donor" means:
242.17 	(1) a health care facility as defined in this subdivision an individual at least 18 years of 
242.18 	age, provided that the drug or medical supply that is donated was obtained legally and meets 
242.19 	the requirements of this section for donation; or
242.20 	(2) a skilled nursing facility licensed under chapter 144A; any entity legally authorized 
242.21 	to possess medicine with a license or permit in good standing in the state in which it is 
242.22 	located, without further restrictions, including but not limited to a health care facility, skilled 
242.23 	nursing facility, assisted living facility, pharmacy, wholesaler, and drug manufacturer.
242.24 	(3) an assisted living facility licensed under chapter 144G;
242.25 	(4) a pharmacy licensed under section 151.19, and located either in the state or outside 
242.26 	the state;
242.27 	(5) a drug wholesaler licensed under section 151.47;
242.28 	(6) a drug manufacturer licensed under section 151.252; or
242.29 	(7) an individual at least 18 years of age, provided that the drug or medical supply that 
242.30 	is donated was obtained legally and meets the requirements of this section for donation.
243.1 	(e) "Drug" means any prescription drug that has been approved for medical use in the 
243.2 	United States, is listed in the United States Pharmacopoeia or National Formulary, and 
243.3 	meets the criteria established under this section for donation; or any over-the-counter 
243.4 	medication that meets the criteria established under this section for donation. This definition 
243.5 	includes cancer drugs and antirejection drugs, but does not include controlled substances, 
243.6 	as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed 
243.7 	to a patient registered with the drug's manufacturer in accordance with federal Food and 
243.8 	Drug Administration requirements.
243.9 	(f) "Health care facility" means:
243.10 	(1) a physician's office or health care clinic where licensed practitioners provide health 
243.11 	care to patients;
243.12 	(2) a hospital licensed under section 144.50;
243.13 	(3) a pharmacy licensed under section 151.19 and located in Minnesota; or
243.14 	(4) a nonprofit community clinic, including a federally qualified health center; a rural 
243.15 	health clinic; public health clinic; or other community clinic that provides health care utilizing 
243.16 	a sliding fee scale to patients who are low-income, uninsured, or underinsured.
243.17 	(g) "Local repository" means a health care facility that elects to accept donated drugs 
243.18 	and medical supplies and meets the requirements of subdivision 4.
243.19 	(h) "Medical supplies" or "supplies" means any prescription or nonprescription medical 
243.20 	supplies needed to administer a drug.
243.21 	(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is 
243.22 	sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or 
243.23 	unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose 
243.24 	packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules, 
243.25 	part 6800.3750.
243.26 	(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that 
243.27 	it does not include a veterinarian.

243.28 	Sec. 14. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 4, is amended 
243.29 	to read:
243.30 		Subd. 4.Local repository requirements. (a) To be eligible for participation in the 
243.31 	medication repository program, a health care facility must agree to comply with all applicable 
243.32 	federal and state laws, rules, and regulations pertaining to the medication repository program, 
244.1 	drug storage, and dispensing. The facility must also agree to maintain in good standing any 
244.2 	required state license or registration that may apply to the facility.
244.3 	(b) A local repository may elect to participate in the program by submitting the following 
244.4 	information to the central repository on a form developed by the board and made available 
244.5 	on the board's website:
244.6 	(1) the name, street address, and telephone number of the health care facility and any 
244.7 	state-issued license or registration number issued to the facility, including the issuing state 
244.8 	agency;
244.9 	(2) the name and telephone number of a responsible pharmacist or practitioner who is 
244.10 	employed by or under contract with the health care facility; and
244.11 	(3) a statement signed and dated by the responsible pharmacist or practitioner indicating 
244.12 	that the health care facility meets the eligibility requirements under this section and agrees 
244.13 	to comply with this section.
244.14 	(c) Participation in the medication repository program is voluntary. A local repository 
244.15 	may withdraw from participation in the medication repository program at any time by 
244.16 	providing written notice to the central repository on a form developed by the board and 
244.17 	made available on the board's website. The central repository shall provide the board with 
244.18 	a copy of the withdrawal notice within ten business days from the date of receipt of the 
244.19 	withdrawal notice.

244.20 	Sec. 15. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 5, is amended 
244.21 	to read:
244.22 		Subd. 5.Individual eligibility and application requirements. (a) To be eligible for 
244.23 	the medication repository program At the time of or before receiving donated drugs or 
244.24 	supplies as a new eligible patient, an individual must submit to a local repository an electronic 
244.25 	or physical intake application form that is signed by the individual and attests that the 
244.26 	individual:
244.27 	(1) is a resident of Minnesota;
244.28 	(2) is uninsured and is not enrolled in the medical assistance program under chapter 
244.29 	256B or the MinnesotaCare program under chapter 256L, has no prescription drug coverage, 
244.30 	or is underinsured;
244.31 	(3) acknowledges that the drugs or medical supplies to be received through the program 
244.32 	may have been donated; and
245.1 	(4) consents to a waiver of the child-resistant packaging requirements of the federal 
245.2 	Poison Prevention Packaging Act.
245.3 	(b) Upon determining that an individual is eligible for the program, the local repository 
245.4 	shall furnish the individual with an identification card. The card shall be valid for one year 
245.5 	from the date of issuance and may be used at any local repository. A new identification card 
245.6 	may be issued upon expiration once the individual submits a new application form.
245.7 	(c) (b) The local repository shall send a copy of the intake application form to the central 
245.8 	repository by regular mail, facsimile, or secured email within ten days from the date the 
245.9 	application is approved by the local repository.
245.10 	(d) (c) The board shall develop and make available on the board's website an application 
245.11 	form and the format for the identification card.

245.12 	Sec. 16. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 6, is amended 
245.13 	to read:
245.14 		Subd. 6.Standards and procedures for accepting donations of drugs and supplies. (a) 
245.15 	Notwithstanding any other law or rule, a donor may donate drugs or medical supplies to 
245.16 	the central repository or a local repository if the drug or supply meets the requirements of 
245.17 	this section as determined by a pharmacist or practitioner who is employed by or under 
245.18 	contract with the central repository or a local repository.
245.19 	(b) A drug is eligible for donation under the medication repository program if the 
245.20 	following requirements are met:
245.21 	(1) the donation is accompanied by a medication repository donor form described under 
245.22 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
245.23 	donor's knowledge in accordance with paragraph (d);
245.24 	(2) (1) the drug's expiration date is at least six months after the date the drug was donated. 
245.25 	If a donated drug bears an expiration date that is less than six months from the donation 
245.26 	date, the drug may be accepted and distributed if the drug is in high demand and can be 
245.27 	dispensed for use by a patient before the drug's expiration date;
245.28 	(3) (2) the drug is in its original, sealed, unopened, tamper-evident packaging that includes 
245.29 	the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging 
245.30 	is unopened;
245.31 	(4) (3) the drug or the packaging does not have any physical signs of tampering, 
245.32 	misbranding, deterioration, compromised integrity, or adulteration;
246.1 	(5) (4) the drug does not require storage temperatures other than normal room temperature 
246.2 	as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being 
246.3 	donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located 
246.4 	in Minnesota; and
246.5 	(6) (5) the drug is not a controlled substance.
246.6 	(c) A medical supply is eligible for donation under the medication repository program 
246.7 	if the following requirements are met:
246.8 	(1) the supply has no physical signs of tampering, misbranding, or alteration and there 
246.9 	is no reason to believe it has been adulterated, tampered with, or misbranded;
246.10 	(2) the supply is in its original, unopened, sealed packaging; and
246.11 	(3) the donation is accompanied by a medication repository donor form described under 
246.12 	paragraph (d) that is signed by an individual who is authorized by the donor to attest to the 
246.13 	donor's knowledge in accordance with paragraph (d); and
246.14 	(4) (3) if the supply bears an expiration date, the date is at least six months later than 
246.15 	the date the supply was donated. If the donated supply bears an expiration date that is less 
246.16 	than six months from the date the supply was donated, the supply may be accepted and 
246.17 	distributed if the supply is in high demand and can be dispensed for use by a patient before 
246.18 	the supply's expiration date.
246.19 	(d) The board shall develop the medication repository donor form and make it available 
246.20 	on the board's website. The form must state that to the best of the donor's knowledge the 
246.21 	donated drug or supply has been properly stored under appropriate temperature and humidity 
246.22 	conditions and that the drug or supply has never been opened, used, tampered with, 
246.23 	adulterated, or misbranded. Prior to the first donation from a new donor, a central repository 
246.24 	or local repository shall verify and record the following information on the donor form:
246.25 	(1) the donor's name, address, phone number, and license number, if applicable;
246.26 	(2) that the donor will only make donations in accordance with the program;
246.27 	(3) to the best of the donor's knowledge, only drugs or supplies that have been properly 
246.28 	stored under appropriate temperature and humidity conditions will be donated; and
246.29 	(4) to the best of the donor's knowledge, only drugs or supplies that have never been 
246.30 	opened, used, tampered with, adulterated, or misbranded will be donated.
246.31 	(e) Notwithstanding any other law or rule, a central repository or a local repository may 
246.32 	receive donated drugs from donors. Donated drugs and supplies may be shipped or delivered 
247.1 	to the premises of the central repository or a local repository, and shall be inspected by a 
247.2 	pharmacist or an authorized practitioner who is employed by or under contract with the 
247.3 	repository and who has been designated by the repository to accept donations prior to 
247.4 	dispensing. A drop box must not be used to deliver or accept donations.
247.5 	(f) The central repository and local repository shall maintain a written or electronic 
247.6 	inventory of all drugs and supplies donated to the repository upon acceptance of each drug 
247.7 	or supply. For each drug, the inventory must include the drug's name, strength, quantity, 
247.8 	manufacturer, expiration date, and the date the drug was donated. For each medical supply, 
247.9 	the inventory must include a description of the supply, its manufacturer, the date the supply 
247.10 	was donated, and, if applicable, the supply's brand name and expiration date. The board 
247.11 	may waive the requirement under this paragraph if an entity is under common ownership 
247.12 	or control with a central repository or local repository and either the entity or the repository 
247.13 	maintains an inventory containing all the information required under this paragraph.

247.14 	Sec. 17. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 7, is amended 
247.15 	to read:
247.16 		Subd. 7.Standards and procedures for inspecting and storing donated drugs and 
247.17 	supplies. (a) A pharmacist or authorized practitioner who is employed by or under contract 
247.18 	with the central repository or a local repository shall inspect all donated drugs and supplies 
247.19 	before the drug or supply is dispensed to determine, to the extent reasonably possible in the 
247.20 	professional judgment of the pharmacist or practitioner, that the drug or supply is not 
247.21 	adulterated or misbranded, has not been tampered with, is safe and suitable for dispensing, 
247.22 	has not been subject to a recall, and meets the requirements for donation. The pharmacist 
247.23 	or practitioner who inspects the drugs or supplies shall sign an inspection record stating that 
247.24 	the requirements for donation have been met. If a local repository receives drugs and supplies 
247.25 	from the central repository, the local repository does not need to reinspect the drugs and 
247.26 	supplies.
247.27 	(b) The central repository and local repositories shall store donated drugs and supplies 
247.28 	in a secure storage area under environmental conditions appropriate for the drug or supply 
247.29 	being stored. Donated drugs and supplies may not be stored with nondonated inventory.
247.30 	(c) The central repository and local repositories shall dispose of all drugs and medical 
247.31 	supplies that are not suitable for donation in compliance with applicable federal and state 
247.32 	statutes, regulations, and rules concerning hazardous waste.
247.33 	(d) In the event that controlled substances or drugs that can only be dispensed to a patient 
247.34 	registered with the drug's manufacturer are shipped or delivered to a central or local repository 
248.1 	for donation, the shipment delivery must be documented by the repository and returned 
248.2 	immediately to the donor or the donor's representative that provided the drugs.
248.3 	(e) Each repository must develop drug and medical supply recall policies and procedures. 
248.4 	If a repository receives a recall notification, the repository shall destroy all of the drug or 
248.5 	medical supply in its inventory that is the subject of the recall and complete a record of 
248.6 	destruction form in accordance with paragraph (f). If a drug or medical supply that is the 
248.7 	subject of a Class I or Class II recall has been dispensed, the repository shall immediately 
248.8 	notify the recipient of the recalled drug or medical supply. A drug that potentially is subject 
248.9 	to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug 
248.10 	is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
248.11 	(f) A record of destruction of donated drugs and supplies that are not dispensed under 
248.12 	subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation 
248.13 	shall be maintained by the repository for at least two years. For each drug or supply destroyed, 
248.14 	the record shall include the following information:
248.15 	(1) the date of destruction;
248.16 	(2) the name, strength, and quantity of the drug destroyed; and
248.17 	(3) the name of the person or firm that destroyed the drug.
248.18 	No other record of destruction is required.

248.19 	Sec. 18. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 8, is amended 
248.20 	to read:
248.21 		Subd. 8.Dispensing requirements. (a) Donated prescription drugs and supplies may 
248.22 	be dispensed if the drugs or supplies are prescribed by a practitioner for use by an eligible 
248.23 	individual and are dispensed by a pharmacist or practitioner. A repository shall dispense 
248.24 	drugs and supplies to eligible individuals in the following priority order: (1) individuals 
248.25 	who are uninsured; (2) individuals with no prescription drug coverage; and (3) individuals 
248.26 	who are underinsured. A repository shall dispense donated drugs in compliance with 
248.27 	applicable federal and state laws and regulations for dispensing drugs, including all 
248.28 	requirements relating to packaging, labeling, record keeping, drug utilization review, and 
248.29 	patient counseling.
248.30 	(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner 
248.31 	shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date 
248.32 	of expiration. Drugs or supplies that have expired or appear upon visual inspection to be 
248.33 	adulterated, misbranded, or tampered with in any way must not be dispensed or administered.
249.1 	(c) Before a the first drug or supply is dispensed or administered to an individual, the 
249.2 	individual must sign a an electronic or physical drug repository recipient form acknowledging 
249.3 	that the individual understands the information stated on the form. The board shall develop 
249.4 	the form and make it available on the board's website. The form must include the following 
249.5 	information:
249.6 	(1) that the drug or supply being dispensed or administered has been donated and may 
249.7 	have been previously dispensed;
249.8 	(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure 
249.9 	that the drug or supply has not expired, has not been adulterated or misbranded, and is in 
249.10 	its original, unopened packaging; and
249.11 	(3) that the dispensing pharmacist, the dispensing or administering practitioner, the 
249.12 	central repository or local repository, the Board of Pharmacy, and any other participant of 
249.13 	the medication repository program cannot guarantee the safety of the drug or medical supply 
249.14 	being dispensed or administered and that the pharmacist or practitioner has determined that 
249.15 	the drug or supply is safe to dispense or administer based on the accuracy of the donor's 
249.16 	form submitted with the donated drug or medical supply and the visual inspection required 
249.17 	to be performed by the pharmacist or practitioner before dispensing or administering.

249.18 	Sec. 19. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 9, is amended 
249.19 	to read:
249.20 		Subd. 9.Handling fees. (a) The central or local repository may charge the individual 
249.21 	receiving a drug or supply a handling fee of no more than 250 percent of the medical 
249.22 	assistance program dispensing fee for each drug or medical supply dispensed or administered 
249.23 	by that repository.
249.24 	(b) A repository that dispenses or administers a drug or medical supply through the 
249.25 	medication repository program shall not receive reimbursement under the medical assistance 
249.26 	program or the MinnesotaCare program for that dispensed or administered drug or supply.
249.27 	(c) A supply or handling fee must not be charged to an individual enrolled in the medical 
249.28 	assistance or MinnesotaCare program.

250.1 	Sec. 20. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 11, is amended 
250.2 	to read:
250.3 		Subd. 11.Forms and record-keeping requirements. (a) The following forms developed 
250.4 	for the administration of this program shall be utilized by the participants of the program 
250.5 	and shall be available on the board's website:
250.6 	(1) intake application form described under subdivision 5;
250.7 	(2) local repository participation form described under subdivision 4;
250.8 	(3) local repository withdrawal form described under subdivision 4;
250.9 	(4) medication repository donor form described under subdivision 6;
250.10 	(5) record of destruction form described under subdivision 7; and
250.11 	(6) medication repository recipient form described under subdivision 8.
250.12 	Participants may use substantively similar electronic or physical forms.
250.13 	(b) All records, including drug inventory, inspection, and disposal of donated drugs and 
250.14 	medical supplies, must be maintained by a repository for a minimum of two years. Records 
250.15 	required as part of this program must be maintained pursuant to all applicable practice acts.
250.16 	(c) Data collected by the medication repository program from all local repositories shall 
250.17 	be submitted quarterly or upon request to the central repository. Data collected may consist 
250.18 	of the information, records, and forms required to be collected under this section.
250.19 	(d) The central repository shall submit reports to the board as required by the contract 
250.20 	or upon request of the board.

250.21 	Sec. 21. Minnesota Statutes 2023 Supplement, section 151.555, subdivision 12, is amended 
250.22 	to read:
250.23 		Subd. 12.Liability. (a) The manufacturer of a drug or supply is not subject to criminal 
250.24 	or civil liability for injury, death, or loss to a person or to property for causes of action 
250.25 	described in clauses (1) and (2). A manufacturer is not liable for:
250.26 	(1) the intentional or unintentional alteration of the drug or supply by a party not under 
250.27 	the control of the manufacturer; or
250.28 	(2) the failure of a party not under the control of the manufacturer to transfer or 
250.29 	communicate product or consumer information or the expiration date of the donated drug 
250.30 	or supply.
251.1 	(b) A health care facility participating in the program, a pharmacist dispensing a drug 
251.2 	or supply pursuant to the program, a practitioner dispensing or administering a drug or 
251.3 	supply pursuant to the program, or a donor of a drug or medical supply, or a person or entity 
251.4 	that facilitates any of the above is immune from civil liability for an act or omission that 
251.5 	causes injury to or the death of an individual to whom the drug or supply is dispensed and 
251.6 	no disciplinary action by a health-related licensing board shall be taken against a pharmacist 
251.7 	or practitioner person or entity so long as the drug or supply is donated, accepted, distributed, 
251.8 	and dispensed according to the requirements of this section. This immunity does not apply 
251.9 	if the act or omission involves reckless, wanton, or intentional misconduct, or malpractice 
251.10 	unrelated to the quality of the drug or medical supply.

251.11 	Sec. 22. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13f, is 
251.12 	amended to read:
251.13 		Subd. 13f.Prior authorization. (a) The Formulary Committee shall review and 
251.14 	recommend drugs which require prior authorization. The Formulary Committee shall 
251.15 	establish general criteria to be used for the prior authorization of brand-name drugs for 
251.16 	which generically equivalent drugs are available, but the committee is not required to review 
251.17 	each brand-name drug for which a generically equivalent drug is available.
251.18 	(b) Prior authorization may be required by the commissioner before certain formulary 
251.19 	drugs are eligible for payment. The Formulary Committee may recommend drugs for prior 
251.20 	authorization directly to the commissioner. The commissioner may also request that the 
251.21 	Formulary Committee review a drug for prior authorization. Before the commissioner may 
251.22 	require prior authorization for a drug:
251.23 	(1) the commissioner must provide information to the Formulary Committee on the 
251.24 	impact that placing the drug on prior authorization may have on the quality of patient care 
251.25 	and on program costs, information regarding whether the drug is subject to clinical abuse 
251.26 	or misuse, and relevant data from the state Medicaid program if such data is available;
251.27 	(2) the Formulary Committee must review the drug, taking into account medical and 
251.28 	clinical data and the information provided by the commissioner; and
251.29 	(3) the Formulary Committee must hold a public forum and receive public comment for 
251.30 	an additional 15 days.
251.31 	The commissioner must provide a 15-day notice period before implementing the prior 
251.32 	authorization.
252.1 	(c) Except as provided in subdivision 13j, prior authorization shall not be required or 
252.2 	utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness 
252.3 	if:
252.4 	(1) there is no generically equivalent drug available; and
252.5 	(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or
252.6 	(3) the drug is part of the recipient's current course of treatment.
252.7 	This paragraph applies to any multistate preferred drug list or supplemental drug rebate 
252.8 	program established or administered by the commissioner. Prior authorization shall 
252.9 	automatically be granted for 60 days for brand name drugs prescribed for treatment of mental 
252.10 	illness within 60 days of when a generically equivalent drug becomes available, provided 
252.11 	that the brand name drug was part of the recipient's course of treatment at the time the 
252.12 	generically equivalent drug became available.
252.13 	(d) Prior authorization must not be required for liquid methadone if only one version of 
252.14 	liquid methadone is available. If more than one version of liquid methadone is available, 
252.15 	the commissioner shall ensure that at least one version of liquid methadone is available 
252.16 	without prior authorization.
252.17 	(e) Prior authorization may be required for an oral liquid form of a drug, except as 
252.18 	described in paragraph (d). A prior authorization request under this paragraph must be 
252.19 	automatically approved within 24 hours if the drug is being prescribed for a Food and Drug 
252.20 	Administration-approved condition for a patient who utilizes an enteral tube for feedings 
252.21 	or medication administration, even if the patient has current or prior claims for pills for that 
252.22 	condition. If more than one version of the oral liquid form of a drug is available, the 
252.23 	commissioner may select the version that is able to be approved for a Food and Drug 
252.24 	Administration-approved condition for a patient who utilizes an enteral tube for feedings 
252.25 	or medication administration. This paragraph applies to any multistate preferred drug list 
252.26 	or supplemental drug rebate program established or administered by the commissioner. The 
252.27 	commissioner shall design and implement a streamlined prior authorization form for patients 
252.28 	who utilize an enteral tube for feedings or medication administration and are prescribed an 
252.29 	oral liquid form of a drug. The commissioner may require prior authorization for brand 
252.30 	name drugs whenever a generically equivalent product is available, even if the prescriber 
252.31 	specifically indicates "dispense as written-brand necessary" on the prescription as required 
252.32 	by section 151.21, subdivision 2.
252.33 	(f) Notwithstanding this subdivision, the commissioner may automatically require prior 
252.34 	authorization, for a period not to exceed 180 days, for any drug that is approved by the 
253.1 	United States Food and Drug Administration on or after July 1, 2005. The 180-day period 
253.2 	begins no later than the first day that a drug is available for shipment to pharmacies within 
253.3 	the state. The Formulary Committee shall recommend to the commissioner general criteria 
253.4 	to be used for the prior authorization of the drugs, but the committee is not required to 
253.5 	review each individual drug. In order to continue prior authorizations for a drug after the 
253.6 	180-day period has expired, the commissioner must follow the provisions of this subdivision.
253.7 	(g) Prior authorization under this subdivision shall comply with section 62Q.184.
253.8 	(h) Any step therapy protocol requirements established by the commissioner must comply 
253.9 	with section 62Q.1841.
253.10 	(i) Notwithstanding any law to the contrary, prior authorization or step therapy shall not 
253.11 	be required or utilized for any class of drugs that is approved by the United States Food and 
253.12 	Drug Administration for the treatment or prevention of HIV and AIDS.

253.13 	EFFECTIVE DATE. This section is effective January 1, 2026.

253.14 	Sec. 23. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision 
253.15 	to read:
253.16 		Subd. 13l.Vaccines and laboratory tests provided by pharmacists. (a) Medical 
253.17 	assistance covers vaccines initiated, ordered, or administered by a licensed pharmacist, 
253.18 	according to the requirements of section 151.01, subdivision 27, clause (6), at no less than 
253.19 	the rate for which the same services are covered when provided by any other licensed 
253.20 	practitioner.
253.21 	(b) Medical assistance covers laboratory tests ordered and performed by a licensed 
253.22 	pharmacist, according to the requirements of section 151.01, subdivision 27, clause (3), at 
253.23 	no less than the rate for which the same services are covered when provided by any other 
253.24 	licensed practitioner.

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

253.28 	Sec. 24. Minnesota Statutes 2022, section 256B.0625, subdivision 39, is amended to read:
253.29 		Subd. 39.Childhood immunizations. Providers who administer pediatric vaccines 
253.30 	within the scope of their licensure, and who are enrolled as a medical assistance provider, 
253.31 	must enroll in the pediatric vaccine administration program established by section 13631 
253.32 	of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay for 
254.1 	administration of the vaccine to children eligible for medical assistance. Medical assistance 
254.2 	does not pay for vaccines that are available at no cost from the pediatric vaccine 
254.3 	administration program unless the vaccines qualify for 100 percent federal funding or are 
254.4 	mandated by the Centers for Medicare and Medicaid Services to be covered outside of the 
254.5 	Vaccines for Children program.

254.6 	Sec. 25. RULEMAKING; BOARD OF PHARMACY.
 254.7 	The Board of Pharmacy must amend Minnesota Rules, part 6800.3400, to permit and 
254.8 	promote the inclusion of the following on a prescription label:
254.9 	(1) the complete and unabbreviated generic name of the drug; and
254.10 	(2) instructions written in plain language explaining the patient-specific indications for 
254.11 	the drug.
254.12 	The Board of Pharmacy must comply with Minnesota Statutes, section 14.389, in adopting 
254.13 	the amendment to the rule.

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

254.15 	ARTICLE 9
254.16 	BEHAVIORAL HEALTH

254.17 	Section 1. Minnesota Statutes 2022, section 245.462, subdivision 6, is amended to read:
254.18 		Subd. 6.Community support services program. "Community support services program" 
254.19 	means services, other than inpatient or residential treatment services, provided or coordinated 
254.20 	by an identified program and staff under the treatment supervision of a mental health 
254.21 	professional designed to help adults with serious and persistent mental illness to function 
254.22 	and remain in the community. A community support services program includes:
254.23 	(1) client outreach,
254.24 	(2) medication monitoring,
254.25 	(3) assistance in independent living skills,
254.26 	(4) development of employability and work-related opportunities,
254.27 	(5) crisis assistance,
254.28 	(6) psychosocial rehabilitation,
254.29 	(7) help in applying for government benefits, and
255.1 	(8) housing support services.
255.2 	The community support services program must be coordinated with the case management 
255.3 	services specified in section 245.4711. A program that meets the accreditation standards 
255.4 	for Clubhouse International model programs meets the requirements of this subdivision.

255.5 	Sec. 2. Minnesota Statutes 2022, section 245.4663, subdivision 2, is amended to read:
255.6 		Subd. 2.Eligible providers. In order to be eligible for a grant under this section, a mental 
255.7 	health provider must:
255.8 	(1) provide at least 25 percent of the provider's yearly patient encounters to state public 
255.9 	program enrollees or patients receiving sliding fee schedule discounts through a formal 
255.10 	sliding fee schedule meeting the standards established by the United States Department of 
255.11 	Health and Human Services under Code of Federal Regulations, title 42, section 51c.303; 
255.12 	or
255.13 	(2) primarily serve underrepresented communities as defined in section 148E.010, 
255.14 	subdivision 20.; or
255.15 	(3) provide services to people in a city or township that is not within the seven-county 
255.16 	metropolitan area as defined in section 473.121, subdivision 2, and is not the city of Duluth, 
255.17 	Mankato, Moorhead, Rochester, or St. Cloud.

255.18 	Sec. 3. Minnesota Statutes 2023 Supplement, section 245.4889, subdivision 1, is amended 
255.19 	to read:
255.20 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
255.21 	make grants from available appropriations to assist:
255.22 	(1) counties;
255.23 	(2) Indian tribes;
255.24 	(3) children's collaboratives under section 124D.23 or 245.493; or
255.25 	(4) mental health service providers.
255.26 	(b) The following services are eligible for grants under this section:
255.27 	(1) services to children with emotional disturbances as defined in section 245.4871, 
255.28 	subdivision 15, and their families;
255.29 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
255.30 	age 21 and their families;
256.1 	(3) respite care services for children with emotional disturbances or severe emotional 
256.2 	disturbances who are at risk of out-of-home placement or residential treatment or 
256.3 	hospitalization, who are already in out-of-home placement in family foster settings as defined 
256.4 	in chapter 245A and at risk of change in out-of-home placement or placement in a residential 
256.5 	facility or other higher level of care, who have utilized crisis services or emergency room 
256.6 	services, or who have experienced a loss of in-home staffing support. Allowable activities 
256.7 	and expenses for respite care services are defined under subdivision 4. A child is not required 
256.8 	to have case management services to receive respite care services. Counties must work to 
256.9 	provide regular access to regularly scheduled respite care;
256.10 	(4) children's mental health crisis services;
256.11 	(5) child-, youth-, and family-specific mobile response and stabilization services models;
256.12 	(6) mental health services for people from cultural and ethnic minorities, including 
256.13 	supervision of clinical trainees who are Black, indigenous, or people of color;
256.14 	(7) children's mental health screening and follow-up diagnostic assessment and treatment;
256.15 	(8) services to promote and develop the capacity of providers to use evidence-based 
256.16 	practices in providing children's mental health services;
256.17 	(9) school-linked mental health services under section 245.4901;
256.18 	(10) building evidence-based mental health intervention capacity for children birth to 
256.19 	age five;
256.20 	(11) suicide prevention and counseling services that use text messaging statewide;
256.21 	(12) mental health first aid training;
256.22 	(13) training for parents, collaborative partners, and mental health providers on the 
256.23 	impact of adverse childhood experiences and trauma and development of an interactive 
256.24 	website to share information and strategies to promote resilience and prevent trauma;
256.25 	(14) transition age services to develop or expand mental health treatment and supports 
256.26 	for adolescents and young adults 26 years of age or younger;
256.27 	(15) early childhood mental health consultation;
256.28 	(16) evidence-based interventions for youth at risk of developing or experiencing a first 
256.29 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
256.30 	psychosis;
256.31 	(17) psychiatric consultation for primary care practitioners; and
257.1 	(18) providers to begin operations and meet program requirements when establishing a 
257.2 	new children's mental health program. These may be start-up grants.
257.3 	(c) Services under paragraph (b) must be designed to help each child to function and 
257.4 	remain with the child's family in the community and delivered consistent with the child's 
257.5 	treatment plan. Transition services to eligible young adults under this paragraph must be 
257.6 	designed to foster independent living in the community.
257.7 	(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party 
257.8 	reimbursement sources, if applicable.
257.9 	(e) The commissioner may establish and design a pilot program to expand the mobile 
257.10 	response and stabilization services model for children, youth, and families. The commissioner 
257.11 	may use grant funding to consult with a qualified expert entity to assist in the formulation 
257.12 	of measurable outcomes and explore and position the state to submit a Medicaid state plan 
257.13 	amendment to scale the model statewide.

257.14 	Sec. 4. Minnesota Statutes 2022, section 245I.02, subdivision 17, is amended to read:
257.15 		Subd. 17.Functional assessment. "Functional assessment" means the assessment of a 
257.16 	client's current level of functioning relative to functioning that is appropriate for someone 
257.17 	the client's age. For a client five years of age or younger, a functional assessment is the 
257.18 	Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age, 
257.19 	a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII). 
257.20 	For a client 18 years of age or older, a functional assessment is the functional assessment 
257.21 	described in section 245I.10, subdivision 9.

257.22 	Sec. 5. Minnesota Statutes 2022, section 245I.02, subdivision 19, is amended to read:
257.23 		Subd. 19.Level of care assessment. "Level of care assessment" means the level of care 
257.24 	decision support tool appropriate to the client's age. For a client five years of age or younger, 
257.25 	a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For 
257.26 	a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service 
257.27 	Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment 
257.28 	is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) 
257.29 	or another tool authorized by the commissioner.

257.30 	Sec. 6. Minnesota Statutes 2022, section 245I.10, subdivision 9, is amended to read:
257.31 		Subd. 9.Functional assessment; required elements. (a) When a license holder is 
257.32 	completing a functional assessment for an adult client, the license holder must:
258.1 	(1) complete a functional assessment of the client after completing the client's diagnostic 
258.2 	assessment;
258.3 	(2) use a collaborative process that allows the client and the client's family and other 
258.4 	natural supports, the client's referral sources, and the client's providers to provide information 
258.5 	about how the client's symptoms of mental illness impact the client's functioning;
258.6 	(3) if applicable, document the reasons that the license holder did not contact the client's 
258.7 	family and other natural supports;
258.8 	(4) assess and document how the client's symptoms of mental illness impact the client's 
258.9 	functioning in the following areas:
258.10 	(i) the client's mental health symptoms;
258.11 	(ii) the client's mental health service needs;
258.12 	(iii) the client's substance use;
258.13 	(iv) the client's vocational and educational functioning;
258.14 	(v) the client's social functioning, including the use of leisure time;
258.15 	(vi) the client's interpersonal functioning, including relationships with the client's family 
258.16 	and other natural supports;
258.17 	(vii) the client's ability to provide self-care and live independently;
258.18 	(viii) the client's medical and dental health;
258.19 	(ix) the client's financial assistance needs; and
258.20 	(x) the client's housing and transportation needs;
258.21 	(5) include a narrative summarizing the client's strengths, resources, and all areas of 
258.22 	functional impairment;
258.23 	(6) (5) complete the client's functional assessment before the client's initial individual 
258.24 	treatment plan unless a service specifies otherwise; and
258.25 	(7) (6) update the client's functional assessment with the client's current functioning 
258.26 	whenever there is a significant change in the client's functioning or at least every 180 365
258.27 	days, unless a service specifies otherwise.
258.28 	(b) A license holder may use any available, validated measurement tool, including but 
258.29 	not limited to the Daily Living Activities-20, when completing the required elements of a 
258.30 	functional assessment under this subdivision.

259.1 	Sec. 7. Minnesota Statutes 2022, section 245I.11, subdivision 1, is amended to read:
259.2 		Subdivision 1.Generally. (a) If a license holder is licensed as a residential program, 
259.3 	stores or administers client medications, or observes clients self-administer medications, 
259.4 	the license holder must ensure that a staff person who is a registered nurse or licensed 
259.5 	prescriber is responsible for overseeing storage and administration of client medications 
259.6 	and observing as a client self-administers medications, including training according to 
259.7 	section 245I.05, subdivision 6, and documenting the occurrence according to section 245I.08, 
259.8 	subdivision 5.
259.9 	(b) For purposes of this section, "observed self-administration" means the preparation 
259.10 	and administration of a medication by a client to themselves under the direct supervision 
259.11 	of a registered nurse or a staff member to whom a registered nurse delegates supervision 
259.12 	duty. Observed self-administration does not include a client's use of a medication that they 
259.13 	keep in their own possession while participating in a program.

259.14 	Sec. 8. Minnesota Statutes 2022, section 245I.11, is amended by adding a subdivision to 
259.15 	read:
259.16 		Subd. 6.Medication administration in children's day treatment settings. (a) For a 
259.17 	program providing children's day treatment services under section 256B.0943, the license 
259.18 	holder must maintain policies and procedures that state whether the program will store 
259.19 	medication and administer or allow observed self-administration.
259.20 	(b) For a program providing children's day treatment services under section 256B.0943 
259.21 	that does not store medications but allows clients to use a medication that they keep in their 
259.22 	own possession while participating in a program, the license holder must maintain 
259.23 	documentation from a licensed prescriber regarding the safety of medications held by clients, 
259.24 	including:
259.25 	(1) an evaluation that the client is capable of holding and administering the medication 
259.26 	safely;
259.27 	(2) an evaluation of whether the medication is prone to diversion, misuse, or self-injury; 
259.28 	and
259.29 	(3) any conditions under which the license holder should no longer allow the client to 
259.30 	maintain the medication in their own possession.

260.1 	Sec. 9. Minnesota Statutes 2022, section 245I.20, subdivision 4, is amended to read:
260.2 		Subd. 4.Minimum staffing standards. (a) A certification holder's treatment team must 
260.3 	consist of at least four mental health professionals. At least two of the mental health 
260.4 	professionals must be employed by or under contract with the mental health clinic for a 
260.5 	minimum of 35 hours per week each. Each of the two mental health professionals must 
260.6 	specialize in a different mental health discipline.
260.7 	(b) The treatment team must include:
260.8 	(1) a physician qualified as a mental health professional according to section 245I.04, 
260.9 	subdivision 2, clause (4), or a nurse qualified as a mental health professional according to 
260.10 	section 245I.04, subdivision 2, clause (1); and
260.11 	(2) a psychologist qualified as a mental health professional according to section 245I.04, 
260.12 	subdivision 2, clause (3).
260.13 	(c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical 
260.14 	services at least:
260.15 	(1) eight hours every two weeks if the mental health clinic has over 25.0 full-time 
260.16 	equivalent treatment team members;
260.17 	(2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent 
260.18 	treatment team members;
260.19 	(3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent 
260.20 	treatment team members; or
260.21 	(4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent 
260.22 	treatment team members or only provides in-home services to clients.
260.23 	(d) The certification holder must maintain a record that demonstrates compliance with 
260.24 	this subdivision.

260.25 	Sec. 10. Minnesota Statutes 2022, section 245I.23, subdivision 14, is amended to read:
260.26 		Subd. 14.Weekly team meetings. (a) The license holder must hold weekly team meetings 
260.27 	and ancillary meetings according to this subdivision.
260.28 	(b) A mental health professional or certified rehabilitation specialist must hold at least 
260.29 	one team meeting each calendar week and. The mental health professional or certified 
260.30 	rehabilitation specialist must lead and be physically present at the team meeting, except as 
260.31 	permitted under paragraph (e). All treatment team members, including treatment team 
261.1 	members who work on a part-time or intermittent basis, must participate in a minimum of 
261.2 	one team meeting during each calendar week when the treatment team member is working 
261.3 	for the license holder. The license holder must document all weekly team meetings, including 
261.4 	the names of meeting attendees, and indicate whether the meeting was conducted remotely 
261.5 	under paragraph (e).
261.6 	(c) If a treatment team member cannot participate in a weekly team meeting, the treatment 
261.7 	team member must participate in an ancillary meeting. A mental health professional, certified 
261.8 	rehabilitation specialist, clinical trainee, or mental health practitioner who participated in 
261.9 	the most recent weekly team meeting may lead the ancillary meeting. During the ancillary 
261.10 	meeting, the treatment team member leading the ancillary meeting must review the 
261.11 	information that was shared at the most recent weekly team meeting, including revisions 
261.12 	to client treatment plans and other information that the treatment supervisors exchanged 
261.13 	with treatment team members. The license holder must document all ancillary meetings, 
261.14 	including the names of meeting attendees.
261.15 	(d) If a treatment team member working only one shift during a week cannot participate 
261.16 	in a weekly team meeting or participate in an ancillary meeting, the treatment team member 
261.17 	must read the minutes of the weekly team meeting required to be documented in paragraph 
261.18 	(b). The treatment team member must sign to acknowledge receipt of this information, and 
261.19 	document pertinent information or questions. The mental health professional or certified 
261.20 	rehabilitation specialist must review any documented questions or pertinent information 
261.21 	before the next weekly team meeting.
261.22 	(e) A license holder may permit a mental health professional or certified rehabilitation 
261.23 	specialist to lead the weekly meeting remotely due to medical or weather conditions. If the 
261.24 	conditions that do not permit physical presence persist for longer than one week, the license 
261.25 	holder must request a variance to conduct additional meetings remotely.

261.26 	Sec. 11. Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 1a, is amended 
261.27 	to read:
261.28 		Subd. 1a.Client eligibility. (a) Persons eligible for benefits under Code of Federal 
261.29 	Regulations, title 25, part 20, who meet the income standards of section 256B.056, 
261.30 	subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health 
261.31 	fund services. State money appropriated for this paragraph must be placed in a separate 
261.32 	account established for this purpose.
261.33 	(b) Persons with dependent children who are determined to be in need of substance use 
261.34 	disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in 
262.1 	need of chemical dependency treatment pursuant to a case plan under section 260C.201, 
262.2 	subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment 
262.3 	services. Treatment services must be appropriate for the individual or family, which may 
262.4 	include long-term care treatment or treatment in a facility that allows the dependent children 
262.5 	to stay in the treatment facility. The county shall pay for out-of-home placement costs, if 
262.6 	applicable.
262.7 	(c) Notwithstanding paragraph (a), persons any person enrolled in medical assistance 
262.8 	are or MinnesotaCare is eligible for room and board services under section 254B.05, 
262.9 	subdivision 5, paragraph (b), clause (12) (9).
262.10 	(d) A client is eligible to have substance use disorder treatment paid for with funds from 
262.11 	the behavioral health fund when the client:
262.12 	(1) is eligible for MFIP as determined under chapter 256J;
262.13 	(2) is eligible for medical assistance as determined under Minnesota Rules, parts 
262.14 	9505.0010 to 9505.0150;
262.15 	(3) is eligible for general assistance, general assistance medical care, or work readiness 
262.16 	as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or
262.17 	(4) has income that is within current household size and income guidelines for entitled 
262.18 	persons, as defined in this subdivision and subdivision 7.
262.19 	(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have 
262.20 	a third-party payment source are eligible for the behavioral health fund if the third-party 
262.21 	payment source pays less than 100 percent of the cost of treatment services for eligible 
262.22 	clients.
262.23 	(f) A client is ineligible to have substance use disorder treatment services paid for with 
262.24 	behavioral health fund money if the client:
262.25 	(1) has an income that exceeds current household size and income guidelines for entitled 
262.26 	persons as defined in this subdivision and subdivision 7; or
262.27 	(2) has an available third-party payment source that will pay the total cost of the client's 
262.28 	treatment.
262.29 	(g) A client who is disenrolled from a state prepaid health plan during a treatment episode 
262.30 	is eligible for continued treatment service that is paid for by the behavioral health fund until 
262.31 	the treatment episode is completed or the client is re-enrolled in a state prepaid health plan 
262.32 	if the client:
263.1 	(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance 
263.2 	medical care; or
263.3 	(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local 
263.4 	agency under section 254B.04.
263.5 	(h) When a county commits a client under chapter 253B to a regional treatment center 
263.6 	for substance use disorder services and the client is ineligible for the behavioral health fund, 
263.7 	the county is responsible for the payment to the regional treatment center according to 
263.8 	section 254B.05, subdivision 4.
263.9 	(i) Persons enrolled in MinnesotaCare are eligible for room and board services when 
263.10 	provided through intensive residential treatment services and residential crisis services under 
263.11 	section 256B.0622.

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

263.15 	Sec. 12. [256B.0617] MENTAL HEALTH SERVICES PROVIDER 
263.16 	CERTIFICATION.
263.17 	(a) The commissioner of human services shall establish an initial provider entity 
263.18 	application and certification and recertification processes to determine whether a provider 
263.19 	entity has administrative and clinical infrastructures that meet the certification requirements. 
263.20 	This process shall apply to providers of the following services:
263.21 	(1) children's intensive behavioral health services under section 256B.0946; and
263.22 	(2) intensive nonresidential rehabilitative mental health services under section 256B.0947.
263.23 	(b) The commissioner shall recertify a provider entity every three years using the 
263.24 	individual provider's certification anniversary or the calendar year end. The commissioner 
263.25 	may approve a recertification extension in the interest of sustaining services when a certain 
263.26 	date for recertification is identified.
263.27 	(c) The commissioner shall establish a process for decertification of a provider entity 
263.28 	and shall require corrective action, medical assistance repayment, or decertification of a 
263.29 	provider entity that no longer meets the requirements in this section or that fails to meet the 
263.30 	clinical quality standards or administrative standards provided by the commissioner in the 
263.31 	application and certification process.
264.1 	(d) The commissioner must provide the following to provider entities for the certification, 
264.2 	recertification, and decertification processes:
264.3 	(1) a structured listing of required provider certification criteria;
264.4 	(2) a formal written letter with a determination of certification, recertification, or 
264.5 	decertification signed by the commissioner or the appropriate division director; and
264.6 	(3) a formal written communication outlining the process for necessary corrective action 
264.7 	and follow-up by the commissioner signed by the commissioner or their designee, if 
264.8 	applicable. In the case of corrective action, the commissioner may schedule interim 
264.9 	recertification site reviews to confirm certification or decertification.

264.10 	EFFECTIVE DATE. This section is effective July 1, 2024, and the commissioner of 
264.11 	human services must implement all requirements of this section by September 1, 2024.

264.12 	Sec. 13. Minnesota Statutes 2022, section 256B.0622, subdivision 2a, is amended to read:
264.13 		Subd. 2a.Eligibility for assertive community treatment. (a) An eligible client for 
264.14 	assertive community treatment is an individual who meets the following criteria as assessed 
264.15 	by an ACT team:
264.16 	(1) is age 18 or older. Individuals ages 16 and 17 may be eligible upon approval by the 
264.17 	commissioner;
264.18 	(2) has a primary diagnosis of schizophrenia, schizoaffective disorder, major depressive 
264.19 	disorder with psychotic features, other psychotic disorders, or bipolar disorder. Individuals 
264.20 	with other psychiatric illnesses may qualify for assertive community treatment if they have 
264.21 	a serious mental illness and meet the criteria outlined in clauses (3) and (4), but no more 
264.22 	than ten percent of an ACT team's clients may be eligible based on this criteria. Individuals 
264.23 	with a primary diagnosis of a substance use disorder, intellectual developmental disabilities, 
264.24 	borderline personality disorder, antisocial personality disorder, traumatic brain injury, or 
264.25 	an autism spectrum disorder are not eligible for assertive community treatment;
264.26 	(3) has significant functional impairment as demonstrated by at least one of the following 
264.27 	conditions:
264.28 	(i) significant difficulty consistently performing the range of routine tasks required for 
264.29 	basic adult functioning in the community or persistent difficulty performing daily living 
264.30 	tasks without significant support or assistance;
264.31 	(ii) significant difficulty maintaining employment at a self-sustaining level or significant 
264.32 	difficulty consistently carrying out the head-of-household responsibilities; or
265.1 	(iii) significant difficulty maintaining a safe living situation;
265.2 	(4) has a need for continuous high-intensity services as evidenced by at least two of the 
265.3 	following:
265.4 	(i) two or more psychiatric hospitalizations or residential crisis stabilization services in 
265.5 	the previous 12 months;
265.6 	(ii) frequent utilization of mental health crisis services in the previous six months;
265.7 	(iii) 30 or more consecutive days of psychiatric hospitalization in the previous 24 months;
265.8 	(iv) intractable, persistent, or prolonged severe psychiatric symptoms;
265.9 	(v) coexisting mental health and substance use disorders lasting at least six months;
265.10 	(vi) recent history of involvement with the criminal justice system or demonstrated risk 
265.11 	of future involvement;
265.12 	(vii) significant difficulty meeting basic survival needs;
265.13 	(viii) residing in substandard housing, experiencing homelessness, or facing imminent 
265.14 	risk of homelessness;
265.15 	(ix) significant impairment with social and interpersonal functioning such that basic 
265.16 	needs are in jeopardy;
265.17 	(x) coexisting mental health and physical health disorders lasting at least six months;
265.18 	(xi) residing in an inpatient or supervised community residence but clinically assessed 
265.19 	to be able to live in a more independent living situation if intensive services are provided;
265.20 	(xii) requiring a residential placement if more intensive services are not available; or
265.21 	(xiii) difficulty effectively using traditional office-based outpatient services;
265.22 	(5) there are no indications that other available community-based services would be 
265.23 	equally or more effective as evidenced by consistent and extensive efforts to treat the 
265.24 	individual; and
265.25 	(6) in the written opinion of a licensed mental health professional, has the need for mental 
265.26 	health services that cannot be met with other available community-based services, or is 
265.27 	likely to experience a mental health crisis or require a more restrictive setting if assertive 
265.28 	community treatment is not provided.
266.1 	(b) An individual meets the criteria for assertive community treatment under this section 
266.2 	if they have participated within the last year or are currently in a first episode of psychosis 
266.3 	program if the individual:
266.4 	(1) meets the eligibility requirements outlined in paragraph (a), clauses (1), (2), (5), and 
266.5 	(6);
266.6 	(2) is currently participating in a first episode of psychosis program under section 
266.7 	245.4905; and
266.8 	(3) needs the level of intensity provided by an ACT team, in the opinion of the individual's 
266.9 	first episode of psychosis program, in order to prevent crisis services, hospitalization, 
266.10 	homelessness, and involvement with the criminal justice system.

266.11 	Sec. 14. Minnesota Statutes 2022, section 256B.0622, subdivision 3a, is amended to read:
266.12 		Subd. 3a.Provider certification and contract requirements for assertive community 
266.13 	treatment. (a) The assertive community treatment provider must:
266.14 	(1) have a contract with the host county to provide assertive community treatment 
266.15 	services; and
266.16 	(2) have each ACT team be certified by the state following the certification process and 
266.17 	procedures developed by the commissioner. The certification process determines whether 
266.18 	the ACT team meets the standards for assertive community treatment under this section, 
266.19 	the standards in chapter 245I as required in section 245I.011, subdivision 5, and minimum 
266.20 	program fidelity standards as measured by a nationally recognized fidelity tool approved 
266.21 	by the commissioner. Recertification must occur at least every three years.
266.22 	(b) An ACT team certified under this subdivision must meet the following standards:
266.23 	(1) have capacity to recruit, hire, manage, and train required ACT team members;
266.24 	(2) have adequate administrative ability to ensure availability of services;
266.25 	(3) ensure flexibility in service delivery to respond to the changing and intermittent care 
266.26 	needs of a client as identified by the client and the individual treatment plan;
266.27 	(4) keep all necessary records required by law;
266.28 	(5) be an enrolled Medicaid provider; and
266.29 	(6) establish and maintain a quality assurance plan to determine specific service outcomes 
266.30 	and the client's satisfaction with services.
267.1 	(c) The commissioner may intervene at any time and decertify an ACT team with cause. 
267.2 	The commissioner shall establish a process for decertification of an ACT team and shall 
267.3 	require corrective action, medical assistance repayment, or decertification of an ACT team 
267.4 	that no longer meets the requirements in this section or that fails to meet the clinical quality 
267.5 	standards or administrative standards provided by the commissioner in the application and 
267.6 	certification process. The decertification is subject to appeal to the state.

267.7 	Sec. 15. Minnesota Statutes 2022, section 256B.0622, subdivision 7a, is amended to read:
267.8 		Subd. 7a.Assertive community treatment team staff requirements and roles. (a) 
267.9 	The required treatment staff qualifications and roles for an ACT team are:
267.10 	(1) the team leader:
267.11 	(i) shall be a mental health professional. Individuals who are not licensed but who are 
267.12 	eligible for licensure and are otherwise qualified may also fulfill this role but must obtain 
267.13 	full licensure within 24 months of assuming the role of team leader;
267.14 	(ii) must be an active member of the ACT team and provide some direct services to 
267.15 	clients;
267.16 	(iii) must be a single full-time staff member, dedicated to the ACT team, who is 
267.17 	responsible for overseeing the administrative operations of the team, providing treatment 
267.18 	supervision of services in conjunction with the psychiatrist or psychiatric care provider, and 
267.19 	supervising team members to ensure delivery of best and ethical practices; and
267.20 	(iv) must be available to provide ensure that overall treatment supervision to the ACT 
267.21 	team is available after regular business hours and on weekends and holidays. The team 
267.22 	leader may delegate this duty to another and is provided by a qualified member of the ACT 
267.23 	team;
267.24 	(2) the psychiatric care provider:
267.25 	(i) must be a mental health professional permitted to prescribe psychiatric medications 
267.26 	as part of the mental health professional's scope of practice. The psychiatric care provider 
267.27 	must have demonstrated clinical experience working with individuals with serious and 
267.28 	persistent mental illness;
267.29 	(ii) shall collaborate with the team leader in sharing overall clinical responsibility for 
267.30 	screening and admitting clients; monitoring clients' treatment and team member service 
267.31 	delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects, 
268.1 	and health-related conditions; actively collaborating with nurses; and helping provide 
268.2 	treatment supervision to the team;
268.3 	(iii) shall fulfill the following functions for assertive community treatment clients: 
268.4 	provide assessment and treatment of clients' symptoms and response to medications, including 
268.5 	side effects; provide brief therapy to clients; provide diagnostic and medication education 
268.6 	to clients, with medication decisions based on shared decision making; monitor clients' 
268.7 	nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and 
268.8 	community visits;
268.9 	(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized 
268.10 	for mental health treatment and shall communicate directly with the client's inpatient 
268.11 	psychiatric care providers to ensure continuity of care;
268.12 	(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per 
268.13 	50 clients. Part-time psychiatric care providers shall have designated hours to work on the 
268.14 	team, with sufficient blocks of time on consistent days to carry out the provider's clinical, 
268.15 	supervisory, and administrative responsibilities. No more than two psychiatric care providers 
268.16 	may share this role; and
268.17 	(vi) shall provide psychiatric backup to the program after regular business hours and on 
268.18 	weekends and holidays. The psychiatric care provider may delegate this duty to another 
268.19 	qualified psychiatric provider;
268.20 	(3) the nursing staff:
268.21 	(i) shall consist of one to three registered nurses or advanced practice registered nurses, 
268.22 	of whom at least one has a minimum of one-year experience working with adults with 
268.23 	serious mental illness and a working knowledge of psychiatric medications. No more than 
268.24 	two individuals can share a full-time equivalent position;
268.25 	(ii) are responsible for managing medication, administering and documenting medication 
268.26 	treatment, and managing a secure medication room; and
268.27 	(iii) shall develop strategies, in collaboration with clients, to maximize taking medications 
268.28 	as prescribed; screen and monitor clients' mental and physical health conditions and 
268.29 	medication side effects; engage in health promotion, prevention, and education activities; 
268.30 	communicate and coordinate services with other medical providers; facilitate the development 
268.31 	of the individual treatment plan for clients assigned; and educate the ACT team in monitoring 
268.32 	psychiatric and physical health symptoms and medication side effects;
268.33 	(4) the co-occurring disorder specialist:
269.1 	(i) shall be a full-time equivalent co-occurring disorder specialist who has received 
269.2 	specific training on co-occurring disorders that is consistent with national evidence-based 
269.3 	practices. The training must include practical knowledge of common substances and how 
269.4 	they affect mental illnesses, the ability to assess substance use disorders and the client's 
269.5 	stage of treatment, motivational interviewing, and skills necessary to provide counseling to 
269.6 	clients at all different stages of change and treatment. The co-occurring disorder specialist 
269.7 	may also be an individual who is a licensed alcohol and drug counselor as described in 
269.8 	section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience, 
269.9 	and other requirements in section 245G.11, subdivision 5. No more than two co-occurring 
269.10 	disorder specialists may occupy this role; and
269.11 	(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients. 
269.12 	The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT 
269.13 	team members on co-occurring disorders;
269.14 	(5) the vocational specialist:
269.15 	(i) shall be a full-time vocational specialist who has at least one-year experience providing 
269.16 	employment services or advanced education that involved field training in vocational services 
269.17 	to individuals with mental illness. An individual who does not meet these qualifications 
269.18 	may also serve as the vocational specialist upon completing a training plan approved by the 
269.19 	commissioner;
269.20 	(ii) shall provide or facilitate the provision of vocational services to clients. The vocational 
269.21 	specialist serves as a consultant and educator to fellow ACT team members on these services; 
269.22 	and
269.23 	(iii) must not refer individuals to receive any type of vocational services or linkage by 
269.24 	providers outside of the ACT team;
269.25 	(6) the mental health certified peer specialist:
269.26 	(i) shall be a full-time equivalent. No more than two individuals can share this position. 
269.27 	The mental health certified peer specialist is a fully integrated team member who provides 
269.28 	highly individualized services in the community and promotes the self-determination and 
269.29 	shared decision-making abilities of clients. This requirement may be waived due to workforce 
269.30 	shortages upon approval of the commissioner;
269.31 	(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery, 
269.32 	self-advocacy, and self-direction, promote wellness management strategies, and assist clients 
269.33 	in developing advance directives; and
270.1 	(iii) must model recovery values, attitudes, beliefs, and personal action to encourage 
270.2 	wellness and resilience, provide consultation to team members, promote a culture where 
270.3 	the clients' points of view and preferences are recognized, understood, respected, and 
270.4 	integrated into treatment, and serve in a manner equivalent to other team members;
270.5 	(7) the program administrative assistant shall be a full-time office-based program 
270.6 	administrative assistant position assigned to solely work with the ACT team, providing a 
270.7 	range of supports to the team, clients, and families; and
270.8 	(8) additional staff:
270.9 	(i) shall be based on team size. Additional treatment team staff may include mental 
270.10 	health professionals; clinical trainees; certified rehabilitation specialists; mental health 
270.11 	practitioners; or mental health rehabilitation workers. These individuals shall have the 
270.12 	knowledge, skills, and abilities required by the population served to carry out rehabilitation 
270.13 	and support functions; and
270.14 	(ii) shall be selected based on specific program needs or the population served.
270.15 	(b) Each ACT team must clearly document schedules for all ACT team members.
270.16 	(c) Each ACT team member must serve as a primary team member for clients assigned 
270.17 	by the team leader and are responsible for facilitating the individual treatment plan process 
270.18 	for those clients. The primary team member for a client is the responsible team member 
270.19 	knowledgeable about the client's life and circumstances and writes the individual treatment 
270.20 	plan. The primary team member provides individual supportive therapy or counseling, and 
270.21 	provides primary support and education to the client's family and support system.
270.22 	(d) Members of the ACT team must have strong clinical skills, professional qualifications, 
270.23 	experience, and competency to provide a full breadth of rehabilitation services. Each staff 
270.24 	member shall be proficient in their respective discipline and be able to work collaboratively 
270.25 	as a member of a multidisciplinary team to deliver the majority of the treatment, 
270.26 	rehabilitation, and support services clients require to fully benefit from receiving assertive 
270.27 	community treatment.
270.28 	(e) Each ACT team member must fulfill training requirements established by the 
270.29 	commissioner.

271.1 	Sec. 16. Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 7b, is 
271.2 	amended to read:
271.3 		Subd. 7b.Assertive community treatment program size and opportunities scores. (a)
271.4 	Each ACT team shall maintain an annual average caseload that does not exceed 100 clients. 
271.5 	Staff-to-client ratios shall be based on team size as follows: must demonstrate that the team 
271.6 	attained a passing score according to the most recently issued Tool for Measurement of 
271.7 	Assertive Community Treatment (TMACT).
271.8 	(1) a small ACT team must:
271.9 	(i) employ at least six but no more than seven full-time treatment team staff, excluding 
271.10 	the program assistant and the psychiatric care provider;
271.11 	(ii) serve an annual average maximum of no more than 50 clients;
271.12 	(iii) ensure at least one full-time equivalent position for every eight clients served;
271.13 	(iv) schedule ACT team staff on weekdays and on-call duty to provide crisis services 
271.14 	and deliver services after hours when staff are not working;
271.15 	(v) provide crisis services during business hours if the small ACT team does not have 
271.16 	sufficient staff numbers to operate an after-hours on-call system. During all other hours, 
271.17 	the ACT team may arrange for coverage for crisis assessment and intervention services 
271.18 	through a reliable crisis-intervention provider as long as there is a mechanism by which the 
271.19 	ACT team communicates routinely with the crisis-intervention provider and the on-call 
271.20 	ACT team staff are available to see clients face-to-face when necessary or if requested by 
271.21 	the crisis-intervention services provider;
271.22 	(vi) adjust schedules and provide staff to carry out the needed service activities in the 
271.23 	evenings or on weekend days or holidays, when necessary;
271.24 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
271.25 	provider is not regularly scheduled to work. If availability of the ACT team's psychiatric 
271.26 	care provider during all hours is not feasible, alternative psychiatric prescriber backup must 
271.27 	be arranged and a mechanism of timely communication and coordination established in 
271.28 	writing; and
271.29 	(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each 
271.30 	week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time 
271.31 	equivalent nursing, one full-time co-occurring disorder specialist, one full-time equivalent 
271.32 	mental health certified peer specialist, one full-time vocational specialist, one full-time 
271.33 	program assistant, and at least one additional full-time ACT team member who has mental 
272.1 	health professional, certified rehabilitation specialist, clinical trainee, or mental health 
272.2 	practitioner status; and
272.3 	(2) a midsize ACT team shall:
272.4 	(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry 
272.5 	time for 51 clients, with an additional two hours for every six clients added to the team, 1.5 
272.6 	to two full-time equivalent nursing staff, one full-time co-occurring disorder specialist, one 
272.7 	full-time equivalent mental health certified peer specialist, one full-time vocational specialist, 
272.8 	one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT 
272.9 	members, with at least one dedicated full-time staff member with mental health professional 
272.10 	status. Remaining team members may have mental health professional, certified rehabilitation 
272.11 	specialist, clinical trainee, or mental health practitioner status;
272.12 	(ii) employ seven or more treatment team full-time equivalents, excluding the program 
272.13 	assistant and the psychiatric care provider;
272.14 	(iii) serve an annual average maximum caseload of 51 to 74 clients;
272.15 	(iv) ensure at least one full-time equivalent position for every nine clients served;
272.16 	(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays 
272.17 	and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum 
272.18 	specifications, staff are regularly scheduled to provide the necessary services on a 
272.19 	client-by-client basis in the evenings and on weekends and holidays;
272.20 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
272.21 	when staff are not working;
272.22 	(vii) have the authority to arrange for coverage for crisis assessment and intervention 
272.23 	services through a reliable crisis-intervention provider as long as there is a mechanism by 
272.24 	which the ACT team communicates routinely with the crisis-intervention provider and the 
272.25 	on-call ACT team staff are available to see clients face-to-face when necessary or if requested 
272.26 	by the crisis-intervention services provider; and
272.27 	(viii) arrange for and provide psychiatric backup during all hours the psychiatric care 
272.28 	provider is not regularly scheduled to work. If availability of the psychiatric care provider 
272.29 	during all hours is not feasible, alternative psychiatric prescriber backup must be arranged 
272.30 	and a mechanism of timely communication and coordination established in writing;
272.31 	(3) a large ACT team must:
273.1 	(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week 
273.2 	per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff, 
273.3 	one full-time co-occurring disorder specialist, one full-time equivalent mental health certified 
273.4 	peer specialist, one full-time vocational specialist, one full-time program assistant, and at 
273.5 	least two additional full-time equivalent ACT team members, with at least one dedicated 
273.6 	full-time staff member with mental health professional status. Remaining team members 
273.7 	may have mental health professional or mental health practitioner status;
273.8 	(ii) employ nine or more treatment team full-time equivalents, excluding the program 
273.9 	assistant and psychiatric care provider;
273.10 	(iii) serve an annual average maximum caseload of 75 to 100 clients;
273.11 	(iv) ensure at least one full-time equivalent position for every nine individuals served;
273.12 	(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the 
273.13 	second shift providing services at least 12 hours per day weekdays. For weekends and 
273.14 	holidays, the team must operate and schedule ACT team staff to work one eight-hour shift, 
273.15 	with a minimum of two staff each weekend day and every holiday;
273.16 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
273.17 	when staff are not working; and
273.18 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
273.19 	provider is not regularly scheduled to work. If availability of the ACT team psychiatric care 
273.20 	provider during all hours is not feasible, alternative psychiatric backup must be arranged 
273.21 	and a mechanism of timely communication and coordination established in writing.
273.22 	(b) An ACT team of any size may have a staff-to-client ratio that is lower than the 
273.23 	requirements described in paragraph (a) upon approval by the commissioner, but may not 
273.24 	exceed a one-to-ten staff-to-client ratio.

273.25 	Sec. 17. Minnesota Statutes 2022, section 256B.0622, subdivision 7d, is amended to read:
273.26 		Subd. 7d.Assertive community treatment assessment and individual treatment 
273.27 	plan. (a) An initial assessment shall be completed the day of the client's admission to 
273.28 	assertive community treatment by the ACT team leader or the psychiatric care provider, 
273.29 	with participation by designated ACT team members and the client. The initial assessment 
273.30 	must include obtaining or completing a standard diagnostic assessment according to section 
273.31 	245I.10, subdivision 6, and completing a 30-day individual treatment plan. The team leader, 
273.32 	psychiatric care provider, or other mental health professional designated by the team leader 
274.1 	or psychiatric care provider, must update the client's diagnostic assessment at least annually
274.2 	as required under section 245I.10, subdivision 2, paragraphs (f) and (g).
274.3 	(b) A functional assessment must be completed according to section 245I.10, subdivision 
274.4 	9. Each part of the functional assessment areas shall be completed by each respective team 
274.5 	specialist or an ACT team member with skill and knowledge in the area being assessed.
274.6 	(c) Between 30 and 45 days after the client's admission to assertive community treatment, 
274.7 	the entire ACT team must hold a comprehensive case conference, where all team members, 
274.8 	including the psychiatric provider, present information discovered from the completed 
274.9 	assessments and provide treatment recommendations. The conference must serve as the 
274.10 	basis for the first individual treatment plan, which must be written by the primary team 
274.11 	member.
274.12 	(d) The client's psychiatric care provider, primary team member, and individual treatment 
274.13 	team members shall assume responsibility for preparing the written narrative of the results 
274.14 	from the psychiatric and social functioning history timeline and the comprehensive 
274.15 	assessment.
274.16 	(e) The primary team member and individual treatment team members shall be assigned 
274.17 	by the team leader in collaboration with the psychiatric care provider by the time of the first 
274.18 	treatment planning meeting or 30 days after admission, whichever occurs first.
274.19 	(f) Individual treatment plans must be developed through the following treatment planning 
274.20 	process:
274.21 	(1) The individual treatment plan shall be developed in collaboration with the client and 
274.22 	the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT 
274.23 	team shall evaluate, together with each client, the client's needs, strengths, and preferences 
274.24 	and develop the individual treatment plan collaboratively. The ACT team shall make every 
274.25 	effort to ensure that the client and the client's family and natural supports, with the client's 
274.26 	consent, are in attendance at the treatment planning meeting, are involved in ongoing 
274.27 	meetings related to treatment, and have the necessary supports to fully participate. The 
274.28 	client's participation in the development of the individual treatment plan shall be documented.
274.29 	(2) The client and the ACT team shall work together to formulate and prioritize the 
274.30 	issues, set goals, research approaches and interventions, and establish the plan. The plan is 
274.31 	individually tailored so that the treatment, rehabilitation, and support approaches and 
274.32 	interventions achieve optimum symptom reduction, help fulfill the personal needs and 
274.33 	aspirations of the client, take into account the cultural beliefs and realities of the individual, 
275.1 	and improve all the aspects of psychosocial functioning that are important to the client. The 
275.2 	process supports strengths, rehabilitation, and recovery.
275.3 	(3) Each client's individual treatment plan shall identify service needs, strengths and 
275.4 	capacities, and barriers, and set specific and measurable short- and long-term goals for each 
275.5 	service need. The individual treatment plan must clearly specify the approaches and 
275.6 	interventions necessary for the client to achieve the individual goals, when the interventions 
275.7 	shall happen, and identify which ACT team member shall carry out the approaches and 
275.8 	interventions.
275.9 	(4) The primary team member and the individual treatment team, together with the client 
275.10 	and the client's family and natural supports with the client's consent, are responsible for 
275.11 	reviewing and rewriting the treatment goals and individual treatment plan whenever there 
275.12 	is a major decision point in the client's course of treatment or at least every six months.
275.13 	(5) The primary team member shall prepare a summary that thoroughly describes in 
275.14 	writing the client's and the individual treatment team's evaluation of the client's progress 
275.15 	and goal attainment, the effectiveness of the interventions, and the satisfaction with services 
275.16 	since the last individual treatment plan. The client's most recent diagnostic assessment must 
275.17 	be included with the treatment plan summary.
275.18 	(6) The individual treatment plan and review must be approved or acknowledged by the 
275.19 	client, the primary team member, the team leader, the psychiatric care provider, and all 
275.20 	individual treatment team members. A copy of the approved individual treatment plan must 
275.21 	be made available to the client.

275.22 	Sec. 18. Minnesota Statutes 2022, section 256B.0623, subdivision 5, is amended to read:
275.23 		Subd. 5.Qualifications of provider staff.  Adult rehabilitative mental health services 
275.24 	must be provided by qualified individual provider staff of a certified provider entity. 
275.25 	Individual provider staff must be qualified as:
275.26 	(1) a mental health professional who is qualified according to section 245I.04, subdivision 
275.27 	2;
275.28 	(2) a certified rehabilitation specialist who is qualified according to section 245I.04, 
275.29 	subdivision 8;
275.30 	(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
275.31 	(4) a mental health practitioner qualified according to section 245I.04, subdivision 4;
276.1 	(5) a mental health certified peer specialist who is qualified according to section 245I.04, 
276.2 	subdivision 10; or
276.3 	(6) a mental health rehabilitation worker who is qualified according to section 245I.04, 
276.4 	subdivision 14.; or
276.5 	(7) a licensed occupational therapist, as defined in section 148.6402, subdivision 14.

276.6 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
276.7 	of human services must notify the revisor of statutes when federal approval is obtained.

276.8 	Sec. 19. Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 5m, is 
276.9 	amended to read:
276.10 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
276.11 	assistance covers services provided by a not-for-profit certified community behavioral health 
276.12 	clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.
276.13 	(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an 
276.14 	eligible service is delivered using the CCBHC daily bundled rate system for medical 
276.15 	assistance payments as described in paragraph (c). The commissioner shall include a quality 
276.16 	incentive payment in the CCBHC daily bundled rate system as described in paragraph (e). 
276.17 	There is no county share for medical assistance services when reimbursed through the 
276.18 	CCBHC daily bundled rate system.
276.19 	(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC 
276.20 	payments under medical assistance meets the following requirements:
276.21 	(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each 
276.22 	CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable 
276.23 	CCBHC costs divided by the total annual number of CCBHC visits. For calculating the 
276.24 	payment rate, total annual visits include visits covered by medical assistance and visits not 
276.25 	covered by medical assistance. Allowable costs include but are not limited to the salaries 
276.26 	and benefits of medical assistance providers; the cost of CCBHC services provided under 
276.27 	section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as 
276.28 	insurance or supplies needed to provide CCBHC services;
276.29 	(2) payment shall be limited to one payment per day per medical assistance enrollee 
276.30 	when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement 
276.31 	if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph 
276.32 	(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or 
276.33 	licensed agency employed by or under contract with a CCBHC;
277.1 	(3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735, 
277.2 	subdivision 3, shall be established by the commissioner using a provider-specific rate based 
277.3 	on the newly certified CCBHC's audited historical cost report data adjusted for the expected 
277.4 	cost of delivering CCBHC services. Estimates are subject to review by the commissioner 
277.5 	and must include the expected cost of providing the full scope of CCBHC services and the 
277.6 	expected number of visits for the rate period;
277.7 	(4) the commissioner shall rebase CCBHC rates once every two years following the last 
277.8 	rebasing and no less than 12 months following an initial rate or a rate change due to a change 
277.9 	in the scope of services. For CCBHCs certified after September 31, 2020, and before January 
277.10 	1, 2021, the commissioner shall rebase rates according to this clause beginning for dates of 
277.11 	service provided on January 1, 2024;
277.12 	(5) the commissioner shall provide for a 60-day appeals process after notice of the results 
277.13 	of the rebasing;
277.14 	(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal 
277.15 	Medicaid rate is not eligible for the CCBHC rate methodology;
277.16 	(7) payments for CCBHC services to individuals enrolled in managed care shall be 
277.17 	coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall 
277.18 	complete the phase-out of CCBHC wrap payments within 60 days of the implementation 
277.19 	of the CCBHC daily bundled rate system in the Medicaid Management Information System 
277.20 	(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments 
277.21 	due made payable to CCBHCs no later than 18 months thereafter;
277.22 	(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each 
277.23 	provider-specific rate by the Medicare Economic Index for primary care services. This 
277.24 	update shall occur each year in between rebasing periods determined by the commissioner 
277.25 	in accordance with clause (4). CCBHCs must provide data on costs and visits to the state 
277.26 	annually using the CCBHC cost report established by the commissioner; and
277.27 	(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of 
277.28 	services when such changes are expected to result in an adjustment to the CCBHC payment 
277.29 	rate by 2.5 percent or more. The CCBHC must provide the commissioner with information 
277.30 	regarding the changes in the scope of services, including the estimated cost of providing 
277.31 	the new or modified services and any projected increase or decrease in the number of visits 
277.32 	resulting from the change. Estimated costs are subject to review by the commissioner. Rate 
277.33 	adjustments for changes in scope shall occur no more than once per year in between rebasing 
277.34 	periods per CCBHC and are effective on the date of the annual CCBHC rate update.
278.1 	(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC 
278.2 	providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of 
278.3 	this requirement on the rate of access to the services delivered by CCBHC providers. If, for 
278.4 	any contract year, federal approval is not received for this paragraph, the commissioner 
278.5 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
278.6 	plans for that contract year to reflect the removal of this provision. Contracts between 
278.7 	managed care plans and county-based purchasing plans and providers to whom this paragraph 
278.8 	applies must allow recovery of payments from those providers if capitation rates are adjusted 
278.9 	in accordance with this paragraph. Payment recoveries must not exceed the amount equal 
278.10 	to any increase in rates that results from this provision. This paragraph expires if federal 
278.11 	approval is not received for this paragraph at any time.
278.12 	(e) The commissioner shall implement a quality incentive payment program for CCBHCs 
278.13 	that meets the following requirements:
278.14 	(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric 
278.15 	thresholds for performance metrics established by the commissioner, in addition to payments 
278.16 	for which the CCBHC is eligible under the CCBHC daily bundled rate system described in 
278.17 	paragraph (c);
278.18 	(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement 
278.19 	year to be eligible for incentive payments;
278.20 	(3) each CCBHC shall receive written notice of the criteria that must be met in order to 
278.21 	receive quality incentive payments at least 90 days prior to the measurement year; and
278.22 	(4) a CCBHC must provide the commissioner with data needed to determine incentive 
278.23 	payment eligibility within six months following the measurement year. The commissioner 
278.24 	shall notify CCBHC providers of their performance on the required measures and the 
278.25 	incentive payment amount within 12 months following the measurement year.
278.26 	(f) All claims to managed care plans for CCBHC services as provided under this section 
278.27 	shall be submitted directly to, and paid by, the commissioner on the dates specified no later 
278.28 	than January 1 of the following calendar year, if:
278.29 	(1) one or more managed care plans does not comply with the federal requirement for 
278.30 	payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42, 
278.31 	section 447.45(b), and the managed care plan does not resolve the payment issue within 30 
278.32 	days of noncompliance; and
279.1 	(2) the total amount of clean claims not paid in accordance with federal requirements 
279.2 	by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims 
279.3 	eligible for payment by managed care plans.
279.4 	If the conditions in this paragraph are met between January 1 and June 30 of a calendar 
279.5 	year, claims shall be submitted to and paid by the commissioner beginning on January 1 of 
279.6 	the following year. If the conditions in this paragraph are met between July 1 and December 
279.7 	31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning 
279.8 	on July 1 of the following year.
279.9 	(g) Peer services provided by a CCBHC certified under section 245.735 are a covered 
279.10 	service under medical assistance when a licensed mental health professional or alcohol and 
279.11 	drug counselor determines that peer services are medically necessary. Eligibility under this 
279.12 	subdivision for peer services provided by a CCBHC supersede eligibility standards under 
279.13 	sections 256B.0615, 256B.0616, and 245G.07, subdivision 2, clause (8).

279.14 	Sec. 20. Minnesota Statutes 2022, section 256B.0625, subdivision 20, is amended to read:
279.15 		Subd. 20.Mental health case management. (a) To the extent authorized by rule of the 
279.16 	state agency, medical assistance covers case management services to persons with serious 
279.17 	and persistent mental illness and children with severe emotional disturbance. Services 
279.18 	provided under this section must meet the relevant standards in sections 245.461 to 245.4887, 
279.19 	the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 
279.20 	9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
279.21 	(b) Entities meeting program standards set out in rules governing family community 
279.22 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
279.23 	assistance reimbursement for case management services for children with severe emotional 
279.24 	disturbance when these services meet the program standards in Minnesota Rules, parts 
279.25 	9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
279.26 	(c) Medical assistance and MinnesotaCare payment for mental health case management 
279.27 	shall be made on a monthly basis. In order to receive payment for an eligible child, the 
279.28 	provider must document at least a face-to-face contact either in person or by interactive 
279.29 	video that meets the requirements of subdivision 20b with the child, the child's parents, or 
279.30 	the child's legal representative. To receive payment for an eligible adult, the provider must 
279.31 	document:
279.32 	(1) at least a face-to-face contact with the adult or the adult's legal representative either 
279.33 	in person or by interactive video that meets the requirements of subdivision 20b; or
280.1 	(2) at least a telephone contact or contact via secure electronic message, if preferred by 
280.2 	the adult client, with the adult or the adult's legal representative and document a face-to-face 
280.3 	contact either in person or by interactive video that meets the requirements of subdivision 
280.4 	20b with the adult or the adult's legal representative within the preceding two months.
280.5 	(d) Payment for mental health case management provided by county or state staff shall 
280.6 	be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph 
280.7 	(b), with separate rates calculated for child welfare and mental health, and within mental 
280.8 	health, separate rates for children and adults.
280.9 	(e) Payment for mental health case management provided by Indian health services or 
280.10 	by agencies operated by Indian tribes may be made according to this section or other relevant 
280.11 	federally approved rate setting methodology.
280.12 	(f) Payment for mental health case management provided by vendors who contract with 
280.13 	a county must be calculated in accordance with section 256B.076, subdivision 2. Payment 
280.14 	for mental health case management provided by vendors who contract with a Tribe must 
280.15 	be based on a monthly rate negotiated by the Tribe. The rate must not exceed the rate charged 
280.16 	by the vendor for the same service to other payers. If the service is provided by a team of 
280.17 	contracted vendors, the team shall determine how to distribute the rate among its members. 
280.18 	No reimbursement received by contracted vendors shall be returned to the county or tribe, 
280.19 	except to reimburse the county or tribe for advance funding provided by the county or tribe 
280.20 	to the vendor.
280.21 	(g) If the service is provided by a team which includes contracted vendors, tribal staff, 
280.22 	and county or state staff, the costs for county or state staff participation in the team shall be 
280.23 	included in the rate for county-provided services. In this case, the contracted vendor, the 
280.24 	tribal agency, and the county may each receive separate payment for services provided by 
280.25 	each entity in the same month. In order to prevent duplication of services, each entity must 
280.26 	document, in the recipient's file, the need for team case management and a description of 
280.27 	the roles of the team members.
280.28 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
280.29 	mental health case management shall be provided by the recipient's county of responsibility, 
280.30 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
280.31 	used to match other federal funds. If the service is provided by a tribal agency, the nonfederal 
280.32 	share, if any, shall be provided by the recipient's tribe. When this service is paid by the state 
280.33 	without a federal share through fee-for-service, 50 percent of the cost shall be provided by 
280.34 	the recipient's county of responsibility.
281.1 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance 
281.2 	and MinnesotaCare include mental health case management. When the service is provided 
281.3 	through prepaid capitation, the nonfederal share is paid by the state and the county pays no 
281.4 	share.
281.5 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider 
281.6 	that does not meet the reporting or other requirements of this section. The county of 
281.7 	responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, 
281.8 	is responsible for any federal disallowances. The county or tribe may share this responsibility 
281.9 	with its contracted vendors.
281.10 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
281.11 	expenditures under this section to repay the special revenue maximization account under 
281.12 	section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
281.13 	(1) the costs of developing and implementing this section; and
281.14 	(2) programming the information systems.
281.15 	(l) Payments to counties and tribal agencies for case management expenditures under 
281.16 	this section shall only be made from federal earnings from services provided under this 
281.17 	section. When this service is paid by the state without a federal share through fee-for-service, 
281.18 	50 percent of the cost shall be provided by the state. Payments to county-contracted vendors 
281.19 	shall include the federal earnings, the state share, and the county share.
281.20 	(m) Case management services under this subdivision do not include therapy, treatment, 
281.21 	legal, or outreach services.
281.22 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
281.23 	and the recipient's institutional care is paid by medical assistance, payment for case 
281.24 	management services under this subdivision is limited to the lesser of:
281.25 	(1) the last 180 days of the recipient's residency in that facility and may not exceed more 
281.26 	than six months in a calendar year; or
281.27 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
281.28 	(o) Payment for case management services under this subdivision shall not duplicate 
281.29 	payments made under other program authorities for the same purpose.
281.30 	(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting 
281.31 	licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week, 
282.1 	mental health targeted case management services must actively support identification of 
282.2 	community alternatives for the recipient and discharge planning.

282.3 	Sec. 21. Minnesota Statutes 2023 Supplement, section 256B.0671, subdivision 5, is 
282.4 	amended to read:
282.5 		Subd. 5.Child and family psychoeducation services. (a) Medical assistance covers
282.6 	child and family psychoeducation services provided to a child up to age 21 with and the 
282.7 	child's family members when determined to be medically necessary due to a diagnosed
282.8 	mental health condition when or diagnosed mental illness identified in the child's individual 
282.9 	treatment plan and provided by a mental health professional who is qualified under section 
282.10 	245I.04, subdivision 2, and practicing within the scope of practice under section 245I.04, 
282.11 	subdivision 3, or a clinical trainee who has determined it medically necessary to involve 
282.12 	family members in the child's care is qualified under section 245I.04, subdivision 6, and 
282.13 	practicing within the scope of practice under section 245I.04, subdivision 7.
282.14 	(b) "Child and family psychoeducation services" means information or demonstration 
282.15 	provided to an individual or family as part of an individual, family, multifamily group, or 
282.16 	peer group session to explain, educate, and support the child and family in understanding 
282.17 	a child's symptoms of mental illness, the impact on the child's development, and needed 
282.18 	components of treatment and skill development so that the individual, family, or group can 
282.19 	help the child to prevent relapse, prevent the acquisition of comorbid disorders, and achieve 
282.20 	optimal mental health and long-term resilience.
282.21 	(c) Child and family psychoeducation services include individual, family, or group skills 
282.22 	development or training to:
282.23 	(1) support the development of psychosocial skills that are medically necessary to 
282.24 	rehabilitate the child to an age-appropriate developmental trajectory when the child's 
282.25 	development was disrupted by a mental health condition or diagnosed mental illness; or
282.26 	(2) enable the child to self-monitor, compensate for, cope with, counteract, or replace 
282.27 	skills deficits or maladaptive skills acquired over the course of the child's mental health 
282.28 	condition or mental illness.
282.29 	(d) Skills development or training delivered to a child or the child's family under this 
282.30 	subdivision must be targeted to the specific deficits related to the child's mental health 
282.31 	condition or mental illness and must be prescribed in the child's individual treatment plan. 
282.32 	Group skills training may be provided to multiple recipients who, because of the nature of 
283.1 	their emotional, behavioral, or social functional ability, may benefit from interaction in a 
283.2 	group setting.

283.3 	Sec. 22. Minnesota Statutes 2022, section 256B.0943, subdivision 12, is amended to read:
283.4 		Subd. 12.Excluded services. The following services are not eligible for medical 
283.5 	assistance payment as children's therapeutic services and supports:
283.6 	(1) service components of children's therapeutic services and supports simultaneously 
283.7 	provided by more than one provider entity unless prior authorization is obtained;
283.8 	(2) treatment by multiple providers within the same agency at the same clock time, 
283.9 	unless one service is delivered to the child and the other service is delivered to child's family 
283.10 	or treatment team without the child present;
283.11 	(3) children's therapeutic services and supports provided in violation of medical assistance 
283.12 	policy in Minnesota Rules, part 9505.0220;
283.13 	(4) mental health behavioral aide services provided by a personal care assistant who is 
283.14 	not qualified as a mental health behavioral aide and employed by a certified children's 
283.15 	therapeutic services and supports provider entity;
283.16 	(5) service components of CTSS that are the responsibility of a residential or program 
283.17 	license holder, including foster care providers under the terms of a service agreement or 
283.18 	administrative rules governing licensure; and
283.19 	(6) adjunctive activities that may be offered by a provider entity but are not otherwise 
283.20 	covered by medical assistance, including:
283.21 	(i) a service that is primarily recreation oriented or that is provided in a setting that is 
283.22 	not medically supervised. This includes sports activities, exercise groups, activities such as 
283.23 	craft hours, leisure time, social hours, meal or snack time, trips to community activities, 
283.24 	and tours;
283.25 	(ii) a social or educational service that does not have or cannot reasonably be expected 
283.26 	to have a therapeutic outcome related to the client's emotional disturbance;
283.27 	(iii) prevention or education programs provided to the community; and
283.28 	(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.

284.1 	Sec. 23. Minnesota Statutes 2022, section 256B.0947, subdivision 5, is amended to read:
284.2 		Subd. 5.Standards for intensive nonresidential rehabilitative providers. (a) Services 
284.3 	must meet the standards in this section and chapter 245I as required in section 245I.011, 
284.4 	subdivision 5.
284.5 	(b) The treatment team must have specialized training in providing services to the specific 
284.6 	age group of youth that the team serves. An individual treatment team must serve youth 
284.7 	who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14 
284.8 	years of age or older and under 21 years of age.
284.9 	(c) The treatment team for intensive nonresidential rehabilitative mental health services 
284.10 	comprises both permanently employed core team members and client-specific team members 
284.11 	as follows:
284.12 	(1) Based on professional qualifications and client needs, clinically qualified core team 
284.13 	members are assigned on a rotating basis as the client's lead worker to coordinate a client's 
284.14 	care. The core team must comprise at least four full-time equivalent direct care staff and 
284.15 	must minimally include:
284.16 	(i) a mental health professional who serves as team leader to provide administrative 
284.17 	direction and treatment supervision to the team;
284.18 	(ii) an advanced-practice registered nurse with certification in psychiatric or mental 
284.19 	health care or a board-certified child and adolescent psychiatrist, either of which must be 
284.20 	credentialed to prescribe medications;
284.21 	(iii) a licensed alcohol and drug counselor who is also trained in mental health 
284.22 	interventions; and
284.23 	(iv)(iii) a mental health certified peer specialist who is qualified according to section 
284.24 	245I.04, subdivision 10, and is also a former children's mental health consumer.; and
284.25 	(iv) a co-occurring disorder specialist who meets the requirements under section 
284.26 	256B.0622, subdivision 7a, paragraph (a), clause (4), who will provide or facilitate the 
284.27 	provision of co-occurring disorder treatment to clients.
284.28 	(2) The core team may also include any of the following:
284.29 	(i) additional mental health professionals;
284.30 	(ii) a vocational specialist;
285.1 	(iii) an educational specialist with knowledge and experience working with youth 
285.2 	regarding special education requirements and goals, special education plans, and coordination 
285.3 	of educational activities with health care activities;
285.4 	(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
285.5 	(v) a clinical trainee qualified according to section 245I.04, subdivision 6;
285.6 	(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;
285.7 	(vii) a case management service provider, as defined in section 245.4871, subdivision 
285.8 	4;
285.9 	(viii) a housing access specialist; and
285.10 	(ix) a family peer specialist as defined in subdivision 2, paragraph (j).
285.11 	(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc 
285.12 	members not employed by the team who consult on a specific client and who must accept 
285.13 	overall clinical direction from the treatment team for the duration of the client's placement 
285.14 	with the treatment team and must be paid by the provider agency at the rate for a typical 
285.15 	session by that provider with that client or at a rate negotiated with the client-specific 
285.16 	member. Client-specific treatment team members may include:
285.17 	(i) the mental health professional treating the client prior to placement with the treatment 
285.18 	team;
285.19 	(ii) the client's current substance use counselor, if applicable;
285.20 	(iii) a lead member of the client's individualized education program team or school-based 
285.21 	mental health provider, if applicable;
285.22 	(iv) a representative from the client's health care home or primary care clinic, as needed 
285.23 	to ensure integration of medical and behavioral health care;
285.24 	(v) the client's probation officer or other juvenile justice representative, if applicable; 
285.25 	and
285.26 	(vi) the client's current vocational or employment counselor, if applicable.
285.27 	(d) The treatment supervisor shall be an active member of the treatment team and shall 
285.28 	function as a practicing clinician at least on a part-time basis. The treatment team shall meet 
285.29 	with the treatment supervisor at least weekly to discuss recipients' progress and make rapid 
285.30 	adjustments to meet recipients' needs. The team meeting must include client-specific case 
286.1 	reviews and general treatment discussions among team members. Client-specific case 
286.2 	reviews and planning must be documented in the individual client's treatment record.
286.3 	(e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment 
286.4 	team position.
286.5 	(f) The treatment team shall serve no more than 80 clients at any one time. Should local 
286.6 	demand exceed the team's capacity, an additional team must be established rather than 
286.7 	exceed this limit.
286.8 	(g) Nonclinical staff shall have prompt access in person or by telephone to a mental 
286.9 	health practitioner, clinical trainee, or mental health professional. The provider shall have 
286.10 	the capacity to promptly and appropriately respond to emergent needs and make any 
286.11 	necessary staffing adjustments to ensure the health and safety of clients.
286.12 	(h) The intensive nonresidential rehabilitative mental health services provider shall 
286.13 	participate in evaluation of the assertive community treatment for youth (Youth ACT) model 
286.14 	as conducted by the commissioner, including the collection and reporting of data and the 
286.15 	reporting of performance measures as specified by contract with the commissioner.
286.16 	(i) A regional treatment team may serve multiple counties.

286.17 	Sec. 24. Laws 2023, chapter 70, article 1, section 35, is amended to read:
286.18 	Sec. 35. Minnesota Statutes 2022, section 256B.761, is amended to read:
286.19 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
286.20 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
286.21 	management provided to psychiatric patients, outpatient mental health services, day treatment 
286.22 	services, home-based mental health services, and family community support services shall 
286.23 	be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 
286.24 	1999 charges.
286.25 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
286.26 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
286.27 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, 
286.28 	with at least 33 percent of the clients receiving rehabilitation services in the most recent 
286.29 	calendar year who are medical assistance recipients, will be increased by 38 percent, when 
286.30 	those services are provided within the comprehensive outpatient rehabilitation facility and 
286.31 	provided to residents of nursing facilities owned by the entity.
287.1 	(c) In addition to rate increases otherwise provided, the commissioner may restructure 
287.2 	coverage policy and rates to improve access to adult rehabilitative mental health services 
287.3 	under section 256B.0623 and related mental health support services under section 256B.021, 
287.4 	subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected 
287.5 	state share of increased costs due to this paragraph is transferred from adult mental health 
287.6 	grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent 
287.7 	base adjustment for subsequent fiscal years. Payments made to managed care plans and 
287.8 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
287.9 	the rate changes described in this paragraph.
287.10 	(d) Any ratables effective before July 1, 2015, do not apply to early intensive 
287.11 	developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.
287.12 	(e) Effective for services rendered on or after January 1, 2024, payment rates for 
287.13 	behavioral health services included in the rate analysis required by Laws 2021, First Special 
287.14 	Session chapter 7, article 17, section 18, except for adult day treatment services under section 
287.15 	256B.0671, subdivision 3; early intensive developmental and behavioral intervention services 
287.16 	under section 256B.0949; and substance use disorder services under chapter 254B, must be 
287.17 	increased by three percent from the rates in effect on December 31, 2023. Effective for 
287.18 	services rendered on or after January 1, 2025, payment rates for behavioral health services 
287.19 	included in the rate analysis required by Laws 2021, First Special Session chapter 7, article 
287.20 	17, section 18, except for adult day treatment services under section 256B.0671, subdivision 
287.21 	3; early intensive developmental behavioral intervention services under section 256B.0949; 
287.22 	and substance use disorder services under chapter 254B, must be annually adjusted according 
287.23 	to the change from the midpoint of the previous rate year to the midpoint of the rate year 
287.24 	for which the rate is being determined using the Centers for Medicare and Medicaid Services 
287.25 	Medicare Economic Index as forecasted in the fourth quarter of the calendar year before 
287.26 	the rate year. For payments made in accordance with this paragraph, if and to the extent 
287.27 	that the commissioner identifies that the state has received federal financial participation 
287.28 	for behavioral health services in excess of the amount allowed under United States Code, 
287.29 	title 42, section 447.321, the state shall repay the excess amount to the Centers for Medicare 
287.30 	and Medicaid Services with state money and maintain the full payment rate under this 
287.31 	paragraph. This paragraph does not apply to federally qualified health centers, rural health 
287.32 	centers, Indian health services, certified community behavioral health clinics, cost-based 
287.33 	rates, and rates that are negotiated with the county. This paragraph expires upon legislative 
287.34 	implementation of the new rate methodology resulting from the rate analysis required by 
287.35 	Laws 2021, First Special Session chapter 7, article 17, section 18.
288.1 	(f) Effective January 1, 2024, the commissioner shall increase capitation payments made 
288.2 	to managed care plans and county-based purchasing plans to reflect the behavioral health 
288.3 	service rate increase provided in paragraph (e). Managed care and county-based purchasing 
288.4 	plans must use the capitation rate increase provided under this paragraph to increase payment 
288.5 	rates to behavioral health services providers. The commissioner must monitor the effect of 
288.6 	this rate increase on enrollee access to behavioral health services. If for any contract year 
288.7 	federal approval is not received for this paragraph, the commissioner must adjust the 
288.8 	capitation rates paid to managed care plans and county-based purchasing plans for that 
288.9 	contract year to reflect the removal of this provision. Contracts between managed care plans 
288.10 	and county-based purchasing plans and providers to whom this paragraph applies must 
288.11 	allow recovery of payments from those providers if capitation rates are adjusted in accordance 
288.12 	with this paragraph. Payment recoveries must not exceed the amount equal to any increase 
288.13 	in rates that results from this provision.

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

288.17 	Sec. 25. DIRECTION TO THE COMMISSIONER; MEDICAL ASSISTANCE RATE 
288.18 	INCREASES.
 288.19 		Subdivision 1.Rate increases; services. The commissioner of human services shall 
288.20 	increase payment rates under the medical assistance program for:
288.21 	(1) residential substance use disorder services rendered on or after January 1, 2025;
288.22 	(2) inpatient behavioral health services provided by hospitals paid under the 
288.23 	diagnosis-related group methodology, for discharges occurring on or after January 1, 2025;
288.24 	(3) behavioral health home services under Minnesota Statutes, section 256B.0757, 
288.25 	rendered on or after January 1, 2025;
288.26 	(4) physician and professional services for mental health and substance use disorder 
288.27 	rendered on or after January 1, 2025; and
288.28 	(5) services under Minnesota Statutes, section 256B.761, billed and coded under 
288.29 	Healthcare Common Procedure Coding System H, S, and T codes, and rendered on or after 
288.30 	January 1, 2025.
288.31 		Subd. 2.Rate increases; amount. The total amount of the rate increases under 
288.32 	subdivision 1 must be equal to $5,727,000 in fiscal year 2025, $6,541,000 in fiscal year 
288.33 	2026, and $7,520,000 in fiscal year 2027.

289.1 	Sec. 26. FIRST EPISODE PSYCHOSIS COORDINATED SPECIALITY CARE 
289.2 	MEDICAL ASSISTANCE BENEFIT.
 289.3 	(a) The commissioner of human services must develop a First Episode Psychosis 
289.4 	Coordinated Specialty Care (FEP-CSC) medical assistance benefit.
289.5 	(b) The benefit must cover medically necessary treatment. Services must include:
289.6 	(1) assertive outreach and engagement strategies encouraging individuals' involvement;
289.7 	(2) person-centered care, delivered in the home and community, extending beyond 
289.8 	typical hours of operation, such as evenings and weekends;
289.9 	(3) crisis planning and intervention;
289.10 	(4) team leadership from a mental health professional who provides ongoing consultation 
289.11 	to the team members, coordinates admission screening, and leads the weekly team meetings 
289.12 	to facilitate case review and entry to the program;
289.13 	(5) employment and education services that enable individuals to function in workplace 
289.14 	and educational settings that support individual preferences;
289.15 	(6) family education and support that builds on an individual's identified family and 
289.16 	natural support systems;
289.17 	(7) individual and group psychotherapy that include but are not limited to cognitive 
289.18 	behavioral therapies;
289.19 	(8) care coordination services in clinic, community, and home settings to assist individuals 
289.20 	with practical problem solving, such as securing transportation, addressing housing and 
289.21 	other basic needs, managing money, obtaining medical care, and coordinating care with 
289.22 	other providers; and
289.23 	(9) pharmacotherapy, medication management, and primary care coordination provided 
289.24 	by a mental health professional who is permitted to prescribe psychiatric medications.
289.25 	(c) An eligible recipient is an individual who:
289.26 	(1) is between the ages of 15 and 40;
289.27 	(2) is experiencing early signs of psychosis with the duration of onset being less than 
289.28 	two years; and
289.29 	(3) has been on antipsychotic medications for less than a total of 12 months.
290.1 	(d) By December 1, 2026, the commissioner must submit a report to the chairs and 
290.2 	ranking minority members of the legislative committees with jurisdiction over human 
290.3 	services policy and finance. The report must include:
290.4 	(1) an overview of the recommended benefit;
290.5 	(2) eligibility requirements;
290.6 	(3) program standards;
290.7 	(4) a reimbursement methodology that covers team-based bundled costs;
290.8 	(5) performance evaluation criteria for programs; and
290.9 	(6) draft legislation with the statutory changes necessary to implement the benefit.

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

290.11 	Sec. 27. MEDICAL ASSISTANCE CHILDREN'S RESIDENTIAL MENTAL 
290.12 	HEALTH CRISIS STABILIZATION.
 290.13 	(a) The commissioner of human services must consult with providers, advocates, Tribal 
290.14 	Nations, counties, people with lived experience as or with a child in a mental health crisis, 
290.15 	and other interested community members to develop a covered benefit under medical 
290.16 	assistance to provide residential mental health crisis stabilization for children. The benefit 
290.17 	must:
290.18 	(1) consist of evidence-based promising practices, or culturally responsive treatment 
290.19 	services for children under the age of 21 experiencing a mental health crisis;
290.20 	(2) embody an integrative care model that supports individuals experiencing a mental 
290.21 	health crisis who may also be experiencing co-occurring conditions;
290.22 	(3) qualify for federal financial participation; and
290.23 	(4) include services that support children and families, including but not limited to:
290.24 	(i) an assessment of the child's immediate needs and factors that led to the mental health 
290.25 	crisis;
290.26 	(ii) individualized care to address immediate needs and restore the child to a precrisis 
290.27 	level of functioning;
290.28 	(iii) 24-hour on-site staff and assistance;
290.29 	(iv) supportive counseling and clinical services;
291.1 	(v) skills training and positive support services, as identified in the child's individual 
291.2 	crisis stabilization plan;
291.3 	(vi) referrals to other service providers in the community as needed and to support the 
291.4 	child's transition from residential crisis stabilization services;
291.5 	(vii) development of an individualized and culturally responsive crisis response action 
291.6 	plan; and
291.7 	(viii) assistance to access and store medication.
291.8 	(b) When developing the new benefit, the commissioner must make recommendations 
291.9 	for providers to be reimbursed for room and board.
291.10 	(c) The commissioner must consult with or contract with rate-setting experts to develop 
291.11 	a prospective data-based rate methodology for the children's residential mental health crisis 
291.12 	stabilization benefit.
291.13 	(d) No later than October 1, 2025, the commissioner must submit to the chairs and 
291.14 	ranking minority members of the legislative committees with jurisdiction over human 
291.15 	services policy and finance a report detailing the children's residential mental health crisis 
291.16 	stabilization benefit and must include:
291.17 	(1) eligibility criteria, clinical and service requirements, provider standards, licensing 
291.18 	requirements, and reimbursement rates;
291.19 	(2) the process for community engagement, community input, and crisis models studied 
291.20 	in other states;
291.21 	(3) a deadline for the commissioner to submit a state plan amendment to the Centers for 
291.22 	Medicare and Medicaid Services; and
291.23 	(4) draft legislation with the statutory changes necessary to implement the benefit.

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

291.25 	Sec. 28. MEDICAL ASSISTANCE CLUBHOUSE BENEFIT ANALYSIS.
 291.26 	The commissioner of human services must conduct an analysis to identify existing or 
291.27 	pending Medicaid Clubhouse benefits in other states, federal authorities used, populations 
291.28 	served, service and reimbursement design, and accreditation standards. By December 1, 
291.29 	2025, the commissioner must submit a report to the chairs and ranking minority members 
291.30 	of the legislative committees with jurisdiction over health and human services finance and 
292.1 	policy. The report must include a comparative analysis of Medicaid Clubhouse programs 
292.2 	and recommendations for designing a medical assistance benefit in Minnesota.

292.3 	Sec. 29. STUDY ON MEDICAL ASSISTANCE CHILDREN'S INTENSIVE 
292.4 	RESIDENTIAL TREATMENT BENEFIT.
 292.5 	(a) The commissioner of human services must consult with providers, advocates, Tribal 
292.6 	Nations, counties, people with lived experience as or with a child experiencing mental health 
292.7 	conditions, and other interested community members to develop a medical assistance state 
292.8 	plan covered benefit to provide intensive residential mental health services for children and 
292.9 	youth. The benefit must:
292.10 	(1) consist of evidence-based promising practices and culturally responsive treatment 
292.11 	services for children under the age of 21;
292.12 	(2) adapt to an integrative care model that supports individuals experiencing mental 
292.13 	health and co-occurring conditions;
292.14 	(3) qualify for federal financial participation; and
292.15 	(4) include services that support children, youth, and families, including but not limited 
292.16 	to:
292.17 	(i) assessment;
292.18 	(ii) individual treatment planning;
292.19 	(iii) 24-hour on-site staff and assistance;
292.20 	(iv) supportive counseling and clinical services; and
292.21 	(v) referrals to other service providers in the community as needed and to support 
292.22 	transition to the family home or own home.
292.23 	(b) When developing the new benefit, the commissioner must make recommendations 
292.24 	for providers to be reimbursed for room and board.
292.25 	(c) The commissioner must consult with or contract with rate-setting experts to develop 
292.26 	a prospective data-based rate methodology for the children's intensive residential mental 
292.27 	health services.
292.28 	(d) No later than August 1, 2026, the commissioner must submit to the chairs and ranking 
292.29 	minority members of the legislative committees with jurisdiction over human services policy 
292.30 	and finance a report detailing the proposed benefit, including:
293.1 	(1) eligibility criteria, clinical and service requirements, provider standards, licensing 
293.2 	requirements, and reimbursement rates;
293.3 	(2) the process for community engagement, community input, and residential models 
293.4 	studied in other states;
293.5 	(3) a deadline for the commissioner to submit a state plan amendment to the Centers for 
293.6 	Medicare and Medicaid Services; and
293.7 	(4) draft legislation with the statutory changes necessary to implement the benefit.

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

293.9 	Sec. 30. REVISOR INSTRUCTION.
 293.10 	The revisor of statutes, in consultation with the Office of Senate Counsel, Research and 
293.11 	Fiscal Analysis; the House Research Department; and the commissioner of human services 
293.12 	shall prepare legislation for the 2025 legislative session to recodify Minnesota Statutes, 
293.13 	section 256B.0622, to move provisions related to assertive community treatment and intensive 
293.14 	residential treatment services into separate sections of statute. The revisor shall correct any 
293.15 	cross-references made necessary by this recodification.

293.16 	Sec. 31. REPEALER.
 293.17 	Minnesota Rules, part 2960.0620, subpart 3, is repealed.

293.18 	ARTICLE 10
293.19 	CHILD PROTECTION AND WELFARE

293.20 	Section 1. Minnesota Statutes 2023 Supplement, section 256.01, subdivision 12b, is 
293.21 	amended to read:
293.22 		Subd. 12b.Department of Human Services systemic critical incident review team. (a) 
293.23 	The commissioner may establish a Department of Human Services systemic critical incident 
293.24 	review team to review critical incidents reported as required under section 626.557 for 
293.25 	which the Department of Human Services is responsible under section 626.5572, subdivision 
293.26 	13; chapter 245D; or Minnesota Rules, chapter 9544; or child fatalities and near fatalities 
293.27 	that occur in licensed facilities and are not due to natural causes. When reviewing a critical 
293.28 	incident, the systemic critical incident review team shall identify systemic influences to the 
293.29 	incident rather than determine the culpability of any actors involved in the incident. The 
293.30 	systemic critical incident review may assess the entire critical incident process from the 
293.31 	point of an entity reporting the critical incident through the ongoing case management 
294.1 	process. Department staff shall lead and conduct the reviews and may utilize county staff 
294.2 	as reviewers. The systemic critical incident review process may include but is not limited 
294.3 	to:
294.4 	(1) data collection about the incident and actors involved. Data may include the relevant 
294.5 	critical services; the service provider's policies and procedures applicable to the incident; 
294.6 	the community support plan as defined in section 245D.02, subdivision 4b, for the person 
294.7 	receiving services; or an interview of an actor involved in the critical incident or the review 
294.8 	of the critical incident. Actors may include:
294.9 	(i) staff of the provider agency;
294.10 	(ii) lead agency staff administering home and community-based services delivered by 
294.11 	the provider;
294.12 	(iii) Department of Human Services staff with oversight of home and community-based 
294.13 	services;
294.14 	(iv) Department of Health staff with oversight of home and community-based services;
294.15 	(v) members of the community including advocates, legal representatives, health care 
294.16 	providers, pharmacy staff, or others with knowledge of the incident or the actors in the 
294.17 	incident; and
294.18 	(vi) staff from the Office of the Ombudsman for Mental Health and Developmental 
294.19 	Disabilities and the Office of Ombudsman for Long-Term Care;
294.20 	(2) systemic mapping of the critical incident. The team conducting the systemic mapping 
294.21 	of the incident may include any actors identified in clause (1), designated representatives 
294.22 	of other provider agencies, regional teams, and representatives of the local regional quality 
294.23 	council identified in section 256B.097; and
294.24 	(3) analysis of the case for systemic influences.
294.25 	Data collected by the critical incident review team shall be aggregated and provided to 
294.26 	regional teams, participating regional quality councils, and the commissioner. The regional 
294.27 	teams and quality councils shall analyze the data and make recommendations to the 
294.28 	commissioner regarding systemic changes that would decrease the number and severity of 
294.29 	critical incidents in the future or improve the quality of the home and community-based 
294.30 	service system.
294.31 	(b) Cases selected for the systemic critical incident review process shall be selected by 
294.32 	a selection committee among the following critical incident categories:
295.1 	(1) cases of caregiver neglect identified in section 626.5572, subdivision 17;
295.2 	(2) cases involving financial exploitation identified in section 626.5572, subdivision 9;
295.3 	(3) incidents identified in section 245D.02, subdivision 11;
295.4 	(4) behavior interventions identified in Minnesota Rules, part 9544.0110;
295.5 	(5) service terminations reported to the department in accordance with section 245D.10, 
295.6 	subdivision 3a; and
295.7 	(6) other incidents determined by the commissioner.
295.8 	(c) The systemic critical incident review under this section shall not replace the process 
295.9 	for screening or investigating cases of alleged maltreatment of an adult under section 626.557
295.10 	or of a child under chapter 260E. The department may select cases for systemic critical 
295.11 	incident review, under the jurisdiction of the commissioner, reported for suspected 
295.12 	maltreatment and closed following initial or final disposition.
295.13 	(d) The proceedings and records of the review team are confidential data on individuals 
295.14 	or protected nonpublic data as defined in section 13.02, subdivisions 3 and 13. Data that 
295.15 	document a person's opinions formed as a result of the review are not subject to discovery 
295.16 	or introduction into evidence in a civil or criminal action against a professional, the state, 
295.17 	or a county agency arising out of the matters that the team is reviewing. Information, 
295.18 	documents, and records otherwise available from other sources are not immune from 
295.19 	discovery or use in a civil or criminal action solely because the information, documents, 
295.20 	and records were assessed or presented during proceedings of the review team. A person 
295.21 	who presented information before the systemic critical incident review team or who is a 
295.22 	member of the team shall not be prevented from testifying about matters within the person's 
295.23 	knowledge. In a civil or criminal proceeding, a person shall not be questioned about opinions 
295.24 	formed by the person as a result of the review.
295.25 	(e) By October 1 of each year, the commissioner shall prepare an annual public report 
295.26 	containing the following information:
295.27 	(1) the number of cases reviewed under each critical incident category identified in 
295.28 	paragraph (b) and a geographical description of where cases under each category originated;
295.29 	(2) an aggregate summary of the systemic themes from the critical incidents examined 
295.30 	by the critical incident review team during the previous year;
295.31 	(3) a synopsis of the conclusions, incident analyses, or exploratory activities taken in 
295.32 	regard to the critical incidents examined by the critical incident review team; and
296.1 	(4) recommendations made to the commissioner regarding systemic changes that could 
296.2 	decrease the number and severity of critical incidents in the future or improve the quality 
296.3 	of the home and community-based service system.

296.4 	EFFECTIVE DATE. This section is effective July 1, 2025.

296.5 	Sec. 2. Minnesota Statutes 2022, section 256N.26, subdivision 12, is amended to read:
296.6 		Subd. 12.Treatment of Supplemental Security Income. (a) If a child placed in foster 
296.7 	care receives benefits through Supplemental Security Income (SSI) at the time of foster 
296.8 	care placement or subsequent to placement in foster care, the financially responsible agency 
296.9 	may apply to be the payee for the child for the duration of the child's placement in foster 
296.10 	care. If a child continues to be eligible for SSI after finalization of the adoption or transfer 
296.11 	of permanent legal and physical custody and is determined to be eligible for a payment 
296.12 	under Northstar Care for Children, a permanent caregiver may choose to receive payment 
296.13 	from both programs simultaneously. The permanent caregiver is responsible to report the 
296.14 	amount of the payment to the Social Security Administration and the SSI payment will be 
296.15 	reduced as required by the Social Security Administration.
296.16 	(b) If a financially responsible agency applies to be the payee for a child who receives 
296.17 	benefits through SSI, or receives the benefits under this subdivision on behalf of a child, 
296.18 	the financially responsible agency must provide written notice by certified mail, return 
296.19 	receipt requested to:
296.20 	(1) the child, if the child is 13 years of age or older;
296.21 	(2) the child's next of kin;
296.22 	(3) the guardian ad litem;
296.23 	(4) the legally responsible agency; and
296.24 	(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
296.25 	(c) If a financially responsible agency receives benefits under this subdivision on behalf 
296.26 	of a child 13 years of age or older, the legally responsible agency and the guardian ad litem 
296.27 	must disclose this information to the child in person in a manner that best helps the child 
296.28 	understand the information. This paragraph does not apply in circumstances where the child 
296.29 	is living outside of Minnesota.
296.30 	(d) If a financially responsible agency receives the benefits under this subdivision on 
296.31 	behalf of a child, it cannot use those funds for any other purpose than the care of that child. 
296.32 	The financially responsible agency must not commingle any benefits received under this 
297.1 	subdivision and must not put the benefits received on behalf of a child under this subdivision 
297.2 	into a general fund.
297.3 	(e) If a financially responsible agency receives any benefits under this subdivision, it 
297.4 	must keep a record of:
297.5 	(1) the total dollar amount it received on behalf of all children it receives benefits for;
297.6 	(2) the total number of children it applied to be a payee for; and
297.7 	(3) the total number of children it received benefits for.
297.8 	(f) By January 1 of each year, each financially responsible agency must submit a report 
297.9 	to the commissioner of human services that includes the information required under paragraph 
297.10 	(c). By January 31 of each year, the commissioner must submit a report to the chairs and 
297.11 	ranking minority members of the legislative committees with jurisdiction over child 
297.12 	protection that compiles the information provided to the commissioner by each financially 
297.13 	responsible agency under paragraph (e); subdivision 13, paragraph (e); and section 
297.14 	260C.4411, subdivision 3, paragraph (d). This paragraph expires January 31, 2034.

297.15 	Sec. 3. Minnesota Statutes 2022, section 256N.26, subdivision 13, is amended to read:
297.16 		Subd. 13.Treatment of retirement survivor's disability insurance, veteran's benefits, 
297.17 	railroad retirement benefits, and black lung benefits. (a) If a child placed in foster care 
297.18 	receives retirement survivor's disability insurance, veteran's benefits, railroad retirement 
297.19 	benefits, or black lung benefits at the time of foster care placement or subsequent to 
297.20 	placement in foster care, the financially responsible agency may apply to be the payee for 
297.21 	the child for the duration of the child's placement in foster care. If it is anticipated that a 
297.22 	child will be eligible to receive retirement survivor's disability insurance, veteran's benefits, 
297.23 	railroad retirement benefits, or black lung benefits after finalization of the adoption or 
297.24 	assignment of permanent legal and physical custody, the permanent caregiver shall apply 
297.25 	to be the payee of those benefits on the child's behalf.
297.26 	(b) If the financially responsible agency applies to be the payee for a child who receives 
297.27 	retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits, 
297.28 	or black lung benefits, or receives the benefits under this subdivision on behalf of a child, 
297.29 	the financially responsible agency must provide written notice by certified mail, return 
297.30 	receipt requested to:
297.31 	(1) the child, if the child is 13 years of age or older;
297.32 	(2) the child's next of kin;
298.1 	(3) the guardian ad litem;
298.2 	(4) the legally responsible agency; and
298.3 	(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
298.4 	(c) If a financially responsible agency receives benefits under this subdivision on behalf 
298.5 	of a child 13 years of age or older, the legally responsible agency and the guardian ad litem 
298.6 	must disclose this information to the child in person in a manner that best helps the child 
298.7 	understand the information. This paragraph does not apply in circumstances where the child 
298.8 	is living outside of Minnesota.
298.9 	(d) If a financially responsible agency receives the benefits under this subdivision on 
298.10 	behalf of a child, it cannot use those funds for any other purpose than the care of that child. 
298.11 	The financially responsible agency must not commingle any benefits received under this 
298.12 	subdivision and must not put the benefits received on behalf of a child under this subdivision 
298.13 	into a general fund.
298.14 	(e) If a financially responsible agency receives any benefits under this subdivision, it 
298.15 	must keep a record of:
298.16 	(1) the total dollar amount it received on behalf of all children it receives benefits for;
298.17 	(2) the total number of children it applied to be a payee for; and
298.18 	(3) the total number of children it received benefits for.
298.19 	(f) By January 1 of each year, each financially responsible agency must submit a report 
298.20 	to the commissioner of human services that includes the information required under paragraph 
298.21 	(e).

298.22 	Sec. 4. Minnesota Statutes 2023 Supplement, section 260.014, is amended by adding a 
298.23 	subdivision to read:
298.24 		Subd. 5.Carryforward authority.  Funds appropriated under this section are available 
298.25 	for two fiscal years.

298.26 	Sec. 5. Minnesota Statutes 2022, section 260C.4411, is amended by adding a subdivision 
298.27 	to read:
298.28 		Subd. 3.Notice. (a) If the county of financial responsibility under section 256G.02 or 
298.29 	Tribal agency authorized under section 256.01, subdivision 14b, receives any benefits under 
298.30 	subdivision 2 on behalf of a child, it must provide written notice by certified mail, return 
298.31 	receipt requested to:
299.1 	(1) the child, if the child is 13 years of age or older;
299.2 	(2) the child's next of kin;
299.3 	(3) the guardian ad litem;
299.4 	(4) the legally responsible agency as defined in section 256N.02, subdivision 14; and
299.5 	(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
299.6 	(b) If the county of financial responsibility under section 256G.02 or Tribal agency 
299.7 	authorized under section 256.01, subdivision 14b, receives benefits under subdivision 2 on 
299.8 	behalf of a child 13 years of age or older, the legally responsible agency as defined in section 
299.9 	256N.02, subdivision 14, and the guardian ad litem must disclose this information to the 
299.10 	child in person in a manner that best helps the child understand the information. This 
299.11 	paragraph does not apply in circumstances where the child is living outside of Minnesota.
299.12 	(c) If the county of financial responsibility under section 256G.02 or Tribal agency 
299.13 	authorized under section 256.01, subdivision 14b, receives the benefits under subdivision 
299.14 	2 on behalf of a child, it cannot use those funds for any other purpose than the care of that 
299.15 	child. The county of financial responsibility or Tribal agency must not commingle any 
299.16 	benefits received under subdivision 2 and must not put the benefits received on behalf of a 
299.17 	child under subdivision 2 into a general fund.
299.18 	(d) If the county of financial responsibility under section 256G.02 or Tribal agency 
299.19 	authorized under section 256.01, subdivision 14b, receives any benefits under subdivision 
299.20 	2, it must keep a record of the total dollar amount it received on behalf of all children it 
299.21 	receives benefits for and the total number of children it receives benefits for. By January 1 
299.22 	of each year, the county of financial responsibility and Tribal agency must submit a report 
299.23 	to the commissioner of human services that includes the information required under this 
299.24 	paragraph.

299.25 	Sec. 6. [260E.021] CHILD PROTECTION ADVISORY COUNCIL.
299.26 		Subdivision 1.Membership. The Child Protection Advisory Council consists of 24 
299.27 	members, appointed as follows:
299.28 	(1) the commissioner of human services or a designee;
299.29 	(2) the commissioner of children, youth, and families or a designee;
299.30 	(3) the ombudsperson for foster youth or a designee;
300.1 	(4) two members of the house of representatives, one appointed by the speaker of the 
300.2 	house and one appointed by the minority leader of the house of representatives;
300.3 	(5) two members of the senate, one appointed by the senate majority leader and one 
300.4 	appointed by the senate minority leader;
300.5 	(6) a representative from the Association of Minnesota Counties appointed by the 
300.6 	association;
300.7 	(7) two members representing county social services agencies appointed by the Minnesota 
300.8 	Association of County Social Service Administrators, one from a county outside the 
300.9 	seven-county metropolitan area and one from a county within the seven-county metropolitan 
300.10 	area;
300.11 	(8) one member with experience working and advocating for children with disabilities 
300.12 	in the child welfare system, appointed by the Minnesota Council on Disability;
300.13 	(9) two members appointed by Indian Child Welfare Advisory Council, one from a 
300.14 	county outside the seven-county metropolitan area and one from a county within the 
300.15 	seven-county metropolitan area;
300.16 	(10) one member appointed by the ombudsperson of American Indian Families;
300.17 	(11) one member appointed by the Children's Alliance;
300.18 	(12) three members appointed by the ombudsperson for families;
300.19 	(13) two members from the Children's Justice Task Force, one with experience as an 
300.20 	attorney or judge working in the child welfare system and one with experience as a peace 
300.21 	officer working in the child welfare system; and
300.22 	(14) four members of the public appointed by the governor, including:
300.23 	(i) one member 18 years of age or older who has lived experience with the child welfare 
300.24 	system;
300.25 	(ii) one member 18 years of age or older who has lived experience with the child welfare 
300.26 	system as a parent or caregiver;
300.27 	(iii) one member who is an advocate who has experience working within the child welfare 
300.28 	system and who has experience working with members of the LGBTQ+ community or 
300.29 	persons who are Black, Indigenous, or people of color; and
300.30 	(iv) one member with experience working as a pediatrician or nurse specializing in child 
300.31 	abuse.
301.1 		Subd. 2.Council administration. (a) For members appointed under subdivision 1, 
301.2 	clauses (6) to (14), section 15.059, subdivisions 1 to 4, apply.
301.3 	(b) The commissioner of administration shall provide the advisory council with staff 
301.4 	support, office space, and access to office equipment and services.
301.5 		Subd. 3.Meetings. (a) The advisory council must meet at least quarterly but may meet 
301.6 	more frequently at the call of the chairperson or at the request of a majority of advisory 
301.7 	council members.
301.8 	(b) Meetings of the advisory council are subject to the Minnesota Open Meeting Law 
301.9 	under chapter 13D.
301.10 		Subd. 4.Chairperson. (a) The advisory council must elect a chairperson from among 
301.11 	the members of the executive committee and other officers as it deems necessary and in 
301.12 	accordance with the advisory council's operating procedures.
301.13 	(b) The advisory council is governed by an executive committee elected by the members 
301.14 	of the advisory council.
301.15 	(c) The advisory council shall appoint an executive director. The advisory council may 
301.16 	delegate to the executive director any powers and duties under this section that do not require 
301.17 	advisory council approval. The executive director serves in the unclassified service and 
301.18 	may be removed at any time by a majority vote of the advisory council. The executive 
301.19 	director may employ and direct staff necessary to carry out advisory council mandates, 
301.20 	policies, activities, and objectives.
301.21 	(d) The executive committee may appoint additional subcommittees and work groups 
301.22 	as necessary to fulfill the duties of the advisory council.
301.23 		Subd. 5.Duties. (a) The advisory council must:
301.24 	(1) conduct reviews of the child mortality review processes originally completed by the 
301.25 	state or counties or through a third-party audit;
301.26 	(2) review child welfare data provided by the Department of Human Services and 
301.27 	counties;
301.28 	(3) review and provide guidance on the Family First Prevention Services Act 
301.29 	implementation; and
301.30 	(4) work with the commissioner of human services to evaluate child protection grants 
301.31 	to address disparities in child welfare pursuant to section 256E.28.
302.1 	(b) The advisory council may collect additional topic areas for study and evaluation 
302.2 	from the public. For the advisory council to study and evaluate a topic, the topic must be 
302.3 	approved for study and evaluation by the advisory council.
302.4 	(c) Legislative members may not deliberate about or vote on decisions related to the 
302.5 	issuance of grants of state money.
302.6 		Subd. 6.Report. By January 1, 2025, and annually thereafter, the advisory council must 
302.7 	submit a report to the chairs and ranking minority members of the legislative committees 
302.8 	with jurisdiction over child protection and child welfare on the advisory council's activities 
302.9 	under subdivision 5 and other issues on which the advisory council may choose to report.
302.10 		Subd. 7.Expiration. The Child Protection Advisory Council expires June 30, 2027.

302.11 	Sec. 7. [260E.39] CHILD FATALITY AND NEAR FATALITY REVIEW.
302.12 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
302.13 	the meanings given.
302.14 	(b) "Critical incident" means a child fatality or near fatality in which maltreatment was 
302.15 	a known or suspected contributing cause.
302.16 	(c) "Joint review" means the critical incident review conducted by the child mortality 
302.17 	review panel jointly with the local review team under subdivision 4, paragraph (b).
302.18 	(d) "Local review" means the local critical incident review conducted by the local review 
302.19 	team under subdivision 4, paragraph (c).
302.20 	(e) "Local review team" means a local child mortality review team established under 
302.21 	subdivision 2.
302.22 	(f) "Panel" means the child mortality review panel established under subdivision 3.
302.23 		Subd. 2.Local child mortality review teams. (a) Each county shall establish a 
302.24 	multidisciplinary local child mortality review team and shall participate in local critical 
302.25 	incident reviews that are based on safety science principles to support a culture of learning. 
302.26 	The local welfare agency's child protection team may serve as the local review team. The 
302.27 	local review team shall include but not be limited to professionals with knowledge of the 
302.28 	critical incident being reviewed.
302.29 	(b) The local review team shall conduct reviews of critical incidents jointly with the 
302.30 	child mortality review panel or as otherwise required under subdivision 4, paragraph (c).
303.1 		Subd. 3.Child mortality review panel; establishment and membership. (a) The 
303.2 	commissioner shall establish a child mortality review panel to review critical incidents 
303.3 	attributed to child maltreatment. The purpose of the panel is to identify systemic changes 
303.4 	to improve child safety and well-being and recommend modifications in statutes, rules, 
303.5 	policies, and procedures.
303.6 	(b) The panel shall consist of:
303.7 	(1) the commissioner of children, youth, and families or a designee;
303.8 	(2) the commissioner of human services or a designee;
303.9 	(3) the commissioner of health or a designee;
303.10 	(4) the commissioner of education or a designee;
303.11 	(5) a judge appointed by the Minnesota judicial branch; and
303.12 	(6) other members appointed by the governor, including but not limited to:
303.13 	(i) a physician who is a medical examiner;
303.14 	(ii) a physician who is a child abuse specialist pediatrician;
303.15 	(iii) a county attorney who works on child protection cases;
303.16 	(iv) two current child protection supervisors for local welfare agencies, each of whom 
303.17 	has previous experience as a frontline child protection worker;
303.18 	(v) a current local welfare agency director who has previous experience as a frontline 
303.19 	child protection worker or supervisor;
303.20 	(vi) two current child protection supervisors or directors for Tribal child welfare agencies, 
303.21 	each of whom has previous experience as a frontline child protection worker or supervisor;
303.22 	(vii) a county public health worker; and
303.23 	(viii) a member representing law enforcement.
303.24 	(c) The governor shall designate one member as chair of the panel from the members 
303.25 	listed in paragraph (b), clauses (5) and (6).
303.26 	(d) Members of the panel shall serve terms of four years for an unlimited number of 
303.27 	terms. A member of the panel may be removed by the appointing authority for the member.
303.28 	(e) The commissioner shall employ an executive director for the panel to provide 
303.29 	administrative support to the panel and the chair, including providing the panel with critical 
303.30 	incident notices submitted by local welfare agencies; compile and synthesize information 
304.1 	for the panel; draft recommendations and reports for the panel's final approval; and conduct 
304.2 	or otherwise direct training and consultation under subdivision 7.
304.3 		Subd. 4.Critical incident review process. (a) A local welfare agency that has determined 
304.4 	that maltreatment was the cause of or a contributing factor in a critical incident must notify 
304.5 	the commissioner of children, youth, and families and the executive director of the panel 
304.6 	within three business days of making the determination.
304.7 	(b) The panel shall conduct a joint review with the local review team for:
304.8 	(1) any critical incident relating to a family, child, or caregiver involved in a local welfare 
304.9 	agency family assessment or investigation within the 12 months preceding the critical 
304.10 	incident;
304.11 	(2) a critical incident the governor or commissioner directs the panel to review; and
304.12 	(3) any other critical incident the panel chooses for review.
304.13 	(c) The local review team must review all critical incident cases not subject to joint 
304.14 	review under paragraph (b).
304.15 	(d) Within 120 days of initiating a joint review or local review of a critical incident, 
304.16 	except as provided under paragraph (h), the panel or local review team shall complete the 
304.17 	joint review or local review and compile a report. The report must include any systemic 
304.18 	learnings that may increase child safety and well-being, and may include policy or practice 
304.19 	considerations for systems changes that may improve child well-being and safety.
304.20 	(e) A local review team must provide its report following a local review to the panel 
304.21 	within three business days after the report is complete. After receiving the local review team 
304.22 	report, the panel may conduct a further joint review.
304.23 	(f) Following the panel's joint review or after receiving a local review team report, the 
304.24 	panel may make recommendations to any state or local agency, branch of government, or 
304.25 	system partner to improve child safety and well-being.
304.26 	(g) The commissioner shall conduct additional information gathering as requested by 
304.27 	the panel or the local review team. The commissioner must conduct information gathering 
304.28 	for all cases for which the panel requests assistance. The commissioner shall compile a 
304.29 	summary report for each critical incident for which information gathering is conducted and 
304.30 	provide the report to the panel and the local welfare agency that reported the critical incident.
304.31 	(h) If the panel or local review team requests information gathering from the 
304.32 	commissioner, the panel or local review team may conduct the joint review or local review 
305.1 	and compile the report under paragraph (d) after receiving the commissioner's summary 
305.2 	information gathering report. The timeline for a local or joint review under paragraph (d) 
305.3 	may be extended if the panel or local review team requests additional information gathering 
305.4 	to complete their review. If the local review team extends the timeline for its review and 
305.5 	report, the local welfare agency must notify the executive director of the panel of the 
305.6 	extension and the expected completion date.
305.7 	(i) The review of any critical incident shall proceed as specified in this section, regardless 
305.8 	of the status of any pending litigation or other active investigation.
305.9 		Subd. 5.Critical incident reviews; data practices and immunity. (a) In conducting 
305.10 	reviews, the panel, the local review team, and the commissioner shall have access to not 
305.11 	public data under chapter 13 maintained by state agencies, statewide systems, or political 
305.12 	subdivisions that are related to the child's critical incident or circumstances surrounding the 
305.13 	care of the child. The panel, the local review team, and the commissioner shall also have 
305.14 	access to records of private hospitals as necessary to carry out the duties prescribed by this 
305.15 	section. A state agency, statewide system, or political subdivision shall provide the data 
305.16 	upon request from the commissioner. Not public data may be shared with members of the 
305.17 	panel, a local review team, or the commissioner in connection with an individual case.
305.18 	(b) Notwithstanding the data's classification in the possession of any other agency, data 
305.19 	acquired by a local review team, the panel, or the commissioner in the exercise of their 
305.20 	duties are protected nonpublic or confidential data as defined in section 13.02 but may be 
305.21 	disclosed as necessary to carry out the duties of the review team, panel, or commissioner. 
305.22 	The data are not subject to subpoena or discovery.
305.23 	(c) The commissioner shall disclose information regarding a critical incident upon request 
305.24 	but shall not disclose data that was classified as confidential or private data on decedents 
305.25 	under section 13.10 or private, confidential, or protected nonpublic data in the disseminating 
305.26 	agency, except that the commissioner may disclose local social service agency data as 
305.27 	provided in section 260E.35 on individual cases involving a critical incident with a person 
305.28 	served by the local social service agency prior to the date of the critical incident.
305.29 	(d) A person attending a local review team or child mortality review panel meeting shall 
305.30 	not disclose what transpired at the meeting except to carry out the purposes of the local 
305.31 	review team or panel. The commissioner shall not disclose what transpired during the 
305.32 	information gathering process except to carry out the duties of the commissioner. The 
305.33 	proceedings and records of the local review team, the panel, and the commissioner are 
305.34 	protected nonpublic data as defined in section 13.02, subdivision 13, and are not subject to 
306.1 	discovery or introduction into evidence in a civil or criminal action. Information, documents, 
306.2 	and records otherwise available from other sources are not immune from discovery or use 
306.3 	in a civil or criminal action solely because they were presented during proceedings of the 
306.4 	local review team, the panel, or the commissioner.
306.5 	(e) A person who presented information before the local review team, the panel, or the 
306.6 	commissioner or who is a member of the local review team or the panel, or an employee 
306.7 	conducting information gathering as designated by the commissioner, shall not be prevented 
306.8 	from testifying about matters within the person's knowledge. However, in a civil or criminal 
306.9 	proceeding, a person may not be questioned about the person's presentation of information 
306.10 	to the local review team, the panel, or the commissioner, or about the information reviewed 
306.11 	or discussed during a critical incident review or the information gathering process, any 
306.12 	conclusions drawn or recommendations made related to information gathering or a critical 
306.13 	incident review, or opinions formed by the person as a result of the panel or review team 
306.14 	meetings.
306.15 	(f) A person who presented information before the local review team, the panel, or the 
306.16 	commissioner, who is a member of the local review team or the panel, or who is an employee 
306.17 	conducting information gathering as designated by the commissioner, is immune from any 
306.18 	civil or criminal liability that might otherwise result from the person's presentation or 
306.19 	statements if the person was acting in good faith and assisting with information gathering 
306.20 	or in a critical incident review under this section.
306.21 		Subd. 6.Child mortality review panel; annual report. Beginning December 15, 2026, 
306.22 	and on or before December 15 annually thereafter, the commissioner shall publish a report 
306.23 	of the child mortality review panel. The report shall include but not be limited to de-identified 
306.24 	summary data on the number of critical incidents reported to the panel, the number of critical 
306.25 	incidents reviewed by the panel and local review teams, and systemic learnings identified 
306.26 	by the panel or local review teams during the period covered by the report. The report shall 
306.27 	also include recommendations on improving the child protection system, including 
306.28 	modifications to statutes, rules, policies, and procedures. The panel may make 
306.29 	recommendations to the legislature or any state or local agency at any time, outside of the 
306.30 	annual report.
306.31 		Subd. 7.Local welfare agency critical incident review training. The commissioner 
306.32 	shall provide training and support to local review teams and the panel to assist with local 
306.33 	or joint review processes and procedures. The commissioner shall also provide consultation 
306.34 	to local review teams and the panel conducting local or joint reviews pursuant to this section.
307.1 		Subd. 8.Culture of learning and improvement. The local review teams and panel 
307.2 	shall advance and support a culture of learning and improvement within Minnesota's child 
307.3 	welfare system.

307.4 	EFFECTIVE DATE. This section is effective July 1, 2025.

307.5 	Sec. 8. Minnesota Statutes 2023 Supplement, section 518A.42, subdivision 3, is amended 
307.6 	to read:
307.7 		Subd. 3.Exception. (a) This section The minimum basic support amount under 
307.8 	subdivision 2 does not apply to an obligor who is incarcerated or is a recipient of a general 
307.9 	assistance grant, Supplemental Security Income, temporary assistance for needy families 
307.10 	(TANF) grant, or comparable state-funded Minnesota family investment program (MFIP) 
307.11 	benefits.
307.12 	(b) The minimum basic support amount under subdivision 2 does not apply to an obligor 
307.13 	who is a recipient of:
307.14 	(1) a general assistance grant;
307.15 	(2) Supplement Security Income;
307.16 	(3) a Temporary Assistances for Needy Families (TANF) grant; or
307.17 	(4) comparable state-funded Minnesota family investment program (MFIP) benefits.
307.18 	(b) (c) If the court finds the obligor receives no income and completely lacks the ability 
307.19 	to earn income, the minimum basic support amount under this subdivision 2 does not apply.
307.20 	(c) (d) If the obligor's basic support amount is reduced below the minimum basic support 
307.21 	amount due to the application of the parenting expense adjustment, the minimum basic 
307.22 	support amount under this subdivision 2 does not apply and the lesser amount is the guideline 
307.23 	basic support.

307.24 	Sec. 9. Laws 2023, chapter 70, article 14, section 42, subdivision 6, is amended to read:
307.25 		Subd. 6.Community Resource Center Advisory Council; establishment and 
307.26 	duties. (a) The commissioner, in consultation with other relevant state agencies, shall appoint 
307.27 	members to the Community Resource Center Advisory Council.
307.28 	(b) Membership must be demographically and geographically diverse and include:
307.29 	(1) parents and family members with lived experience who lack opportunities;
307.30 	(2) community-based organizations serving families who lack opportunities;
308.1 	(3) Tribal and urban American Indian representatives;
308.2 	(4) county government representatives;
308.3 	(5) school and school district representatives; and
308.4 	(6) state partner representatives.
308.5 	(c) Duties of the Community Resource Center Advisory Council include but are not 
308.6 	limited to:
308.7 	(1) advising the commissioner on the development and funding of a network of 
308.8 	community resource centers;
308.9 	(2) advising the commissioner on the development of requests for proposals and grant 
308.10 	award processes;
308.11 	(3) advising the commissioner on the development of program outcomes and 
308.12 	accountability measures; and
308.13 	(4) advising the commissioner on ongoing governance and necessary support in the 
308.14 	implementation of community resource centers.
308.15 	(d) Compensation for members of the Community Resource Center Advisory Council 
308.16 	is governed by Minnesota Statutes, section 15.0575.

308.17 	Sec. 10. CHILD PROTECTION ADVISORY COUNCIL; INITIAL TERMS AND 
308.18 	APPOINTMENTS AND FIRST MEETING.
 308.19 		Subdivision 1.Initial appointments. Appointing authorities for the Child Protection 
308.20 	Advisory Council under Minnesota Statutes, section 260E.021, must appoint members to 
308.21 	the council by August 1, 2024.
308.22 		Subd. 2.Terms. Members appointed under Minnesota Statutes, section 260E.021, 
308.23 	subdivision 1, clauses (7), (8), and (9), serve a term that is coterminous with the governor. 
308.24 	Members appointed under Minnesota Statutes, section 260E.021, subdivision 1, clauses 
308.25 	(10) and (12), serve a term that ends one year after the governor's term. Members appointed 
308.26 	under Minnesota Statutes, section 260E.021, subdivision 1, clauses (6), (11), and (13), serve 
308.27 	a term that ends two years after the governor's term. Members appointed under Minnesota 
308.28 	Statutes, section 260E.021, subdivision 1, clause (14), serve a term that ends three years 
308.29 	after the governor's term.
308.30 		Subd. 3.Chair; first meeting. The commissioner of human services or the 
308.31 	commissioner's designee will serve as chair until the council elects a chair. The commissioner 
309.1 	must convene the first meeting of the council by September 15, 2024. The council must 
309.2 	elect its executive committee and its chair at its first meeting.

309.3 	Sec. 11. DIRECTION TO COMMISSIONER; CHILD MALTREATMENT 
309.4 	REPORTING SYSTEMS REVIEW AND RECOMMENDATIONS.
 309.5 	The commissioner of children, youth, and families must review current child maltreatment 
309.6 	reporting processes and systems in various states and evaluate the costs and benefits of each 
309.7 	reviewed state's system. In consultation with stakeholders, including but not limited to 
309.8 	counties, Tribes, and organizations with expertise in child maltreatment prevention and 
309.9 	child protection, the commissioner must develop recommendations on implementing a 
309.10 	statewide child abuse and neglect reporting system in Minnesota and outline the benefits, 
309.11 	challenges, and costs of such a transition. By June 1, 2025, the commissioner must submit 
309.12 	a report detailing the commissioner's recommendations to the chairs and ranking minority 
309.13 	members of the legislative committees with jurisdiction over child protection. The 
309.14 	commissioner must also publish the report on the department's website.

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

309.16 	Sec. 12. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; CHILD 
309.17 	WELFARE WORKFORCE SYSTEM IMPROVEMENTS.
 309.18 	When designing, developing, and implementing a data-driven, federally compliant 
309.19 	Comprehensive Child Welfare Information System, the commissioner of human services 
309.20 	must ensure that the system can do the following:
309.21 	(1) allow counties to track various financial information, including benefits received by 
309.22 	counties on behalf of children in the child protection system;
309.23 	(2) allow counties to track all fees received by counties from parents with children in 
309.24 	out-of-home placements;
309.25 	(3) provide ombudspersons with direct access to nonprivileged information necessary 
309.26 	for the discharge of the ombudsperson's duties, including specific child protection case 
309.27 	information;
309.28 	(4) provide comprehensive statewide data reports; and
309.29 	(5) track demographic information about children in the child protection system, including 
309.30 	disability, ethnicity, economic status, and cultural identity.

310.1 	Sec. 13. PREVENTING NONRELATIVE FOSTER CARE PLACEMENT GRANTS.
 310.2 	(a) The commissioner of children, youth, and families must award grants to eligible 
310.3 	community-based nonprofit organizations to provide culturally competent supports to relative 
310.4 	caregivers who are caring for relative children and connection to local and statewide 
310.5 	resources.
310.6 	(b) Grant funds must be used to serve relative caregivers caring for children from 
310.7 	communities that are disproportionately overrepresented in the child welfare system based 
310.8 	on available data, as determined by the commissioner.
310.9 	(c) Grant funds may be used to assess relative caregiver and child needs, provide 
310.10 	connection to local and statewide culturally competent resources, and provide culturally 
310.11 	competent case management to assist with complex cases. Grant funds may also be used to 
310.12 	provide culturally competent supports to reduce the need for child welfare involvement or 
310.13 	risk of child welfare involvement and increase family stability by preventing nonrelative 
310.14 	foster care placement.
310.15 	(d) For purposes of this section, "relative" has the meaning given in Minnesota Statutes, 
310.16 	section 260C.007, subdivision 27.

310.17 	Sec. 14. REPEALER.
 310.18 	(a) Minnesota Statutes 2022, section 256.01, subdivisions 12 and 12a, are repealed.
310.19 	(b) Minnesota Rules, part 9560.0232, subpart 5, is repealed.

310.20 	EFFECTIVE DATE. This section is effective July 1, 2025.

310.21 	ARTICLE 11
310.22 	ECONOMIC SUPPORTS

310.23 	Section 1. [142F.103] CAMPUS-BASED EMPLOYMENT AND TRAINING 
310.24 	PROGRAM FOR STUDENTS ENROLLED IN HIGHER EDUCATION.
310.25 		Subdivision 1.Designation. (a) Within six months of the effective date of this section, 
310.26 	the Board of Trustees of Minnesota State Colleges and Universities must, and the Board of 
310.27 	Regents of the University of Minnesota is requested to, submit an application to the 
310.28 	commissioner of human services verifying whether each MNSCU institution meets the 
310.29 	requirements to be a campus-based employment and training program that qualifies for the 
310.30 	student exemption for Supplemental Nutrition Assistance Program (SNAP) eligibility, as 
310.31 	described in the Code of Federal Regulations, title 7, section 273.5(b)(11)(iv).
311.1 	(b) An institution of higher education must be designated as a campus-based employment 
311.2 	and training program by the commissioner of human services if that institution meets the 
311.3 	requirements set forth in the guidance under subdivision 3. The commissioner of human 
311.4 	services must maintain a list of approved programs on its website.
311.5 		Subd. 2.Student eligibility. A student is eligible to participate in a campus-based 
311.6 	employment and training program under this section if the student is enrolled in:
311.7 	(1) a public two-year community or technical college and received a state grant under 
311.8 	section 136A.121, received a federal Pell grant, or has a student aid index of $0 or less;
311.9 	(2) a Tribal college as defined in section 136A.62 and received a state grant under section 
311.10 	136A.121, received a federal Pell grant, or has a student aid index of $0 or less; or
311.11 	(3) a public four-year university and received a state grant under section 136A.121, 
311.12 	received a federal Pell grant, or has a student aid index of $0 or less.
311.13 		Subd. 3.Guidance. Within three months of the effective date of this section and annually 
311.14 	thereafter, the commissioner of human services, in consultation with the commissioner of 
311.15 	higher education, must issue guidance to counties, Tribal Nations, Tribal colleges, and 
311.16 	Minnesota public postsecondary institutions that:
311.17 	(1) clarifies the state and federal eligibility requirements for campus-based employment 
311.18 	and training programs for low-income households;
311.19 	(2) clarifies the application process for campus-based employment and training programs 
311.20 	for low-income households including but not limited to providing a list of the supporting 
311.21 	documents required for program approval;
311.22 	(3) clarifies how students in an institution of higher education approved as a campus-based 
311.23 	employment and training program for low-income households qualify for a SNAP student 
311.24 	exemption; and
311.25 	(4) clarifies the SNAP eligibility criteria for students that qualify for a SNAP student 
311.26 	exemption under this section.
311.27 		Subd. 4.Application. Within three months of the effective date of this section, the 
311.28 	commissioner of human services, in consultation with the commissioner of higher education, 
311.29 	must design an application for institutions of higher education to apply for a campus-based 
311.30 	employment and training program designation.
311.31 		Subd. 5.Notice. At the beginning of each academic semester, an institution of higher 
311.32 	education with a designated campus-based employment and training program must send a 
312.1 	letter to students eligible under this section to inform them that they may qualify for SNAP 
312.2 	benefits and direct them to resources to apply. The letter under this subdivision shall serve 
312.3 	as proof of a student's enrollment in a campus-based employment and training program.

312.4 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
312.5 	of human services must notify the revisor of statutes when federal approval is obtained.

312.6 	Sec. 2. [142F.16] MINNESOTA FOOD BANK PROGRAM.
312.7 	The Minnesota food bank program is established in the Department of Human Services. 
312.8 	The commissioner of human services shall distribute money appropriated to the Minnesota 
312.9 	food bank program to all regional food banks the commissioner contracts with for the 
312.10 	purposes of The Emergency Food Assistance Program (TEFAP).The commissioner shall 
312.11 	distribute money under this section in accordance with the federal TEFAP formula and 
312.12 	guidelines of the United States Department of Agriculture. Money distributed under this 
312.13 	section must be used by all regional food banks to purchase food that will be distributed 
312.14 	free of charge to TEFAP partner agencies. Money distributed under this section must also 
312.15 	cover the handling and delivery fees typically paid by food shelves to food banks to ensure 
312.16 	costs associated with money under this section are not incurred at the local level.

312.17 	Sec. 3. Minnesota Statutes 2023 Supplement, section 256E.38, subdivision 4, is amended 
312.18 	to read:
312.19 		Subd. 4.Eligible uses of grant money. An eligible applicant that receives grant money 
312.20 	under this section shall use the money to purchase diapers and wipes and may use up to 
312.21 	four ten percent of the money for administrative costs.

312.22 	Sec. 4. TRANSFER TO DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES.
 312.23 	The responsibilities for the campus-based employment and training program for students 
312.24 	enrolled in higher education under Minnesota Statutes, section 142F.103, and the Minnesota 
312.25 	food bank program under Minnesota Statutes, section 142F.16, must transfer from the 
312.26 	commissioner of human services to the commissioner of children, youth, and families. 
312.27 	Minnesota Statutes, sections 142F.103 and 142F.16, are incorporated into the transfer of 
312.28 	duties and responsibilities in Laws 2023, chapter 70, article 12, section 30, and the 
312.29 	commissioner shall give the notices of when the transfer is effective as required by Laws 
312.30 	2023, chapter 70, article 12, section 30, subdivision 1.

313.1 	ARTICLE 12
313.2 	HOUSING AND HOMELESSNESS

313.3 	Section 1. PREGNANT AND PARENTING HOMELESS YOUTH STUDY.
 313.4 	(a) The commissioner of human services must contract with the Wilder Foundation to 
313.5 	conduct a study of:
313.6 	(1) the statewide numbers and unique needs of pregnant and parenting youth experiencing 
313.7 	homelessness; and
313.8 	(2) best practices in supporting pregnant and parenting homeless youth within 
313.9 	programming, emergency shelter, and housing settings.
313.10 	(b) The Wilder Foundation must submit a final report to the commissioner by December 
313.11 	31, 2025. The commissioner shall submit the report to the chairs and ranking minority 
313.12 	members of the legislative committees with jurisdiction over homeless youth services finance 
313.13 	and policy.

313.14 	Sec. 2. REVIVAL AND REENACTMENT.
 313.15 	Minnesota Statutes 2022, section 256B.051, subdivision 7, is revived and reenacted 
313.16 	effective retroactively from August 1, 2023. The time-limited supplemental rate reduction 
313.17 	in Minnesota Statutes 2022, section 256B.051, subdivision 7, does not restart when the 
313.18 	subdivision is revived and reenacted. Any time frames within or dependent on the subdivision 
313.19 	are based on the original effective date in Laws 2017, First Special Session chapter 6, article 
313.20 	2, section 10.

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

313.22 	Sec. 3. REPEALER.
 313.23 	Laws 2023, chapter 25, section 190, subdivision 10, is repealed.

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

313.25 	ARTICLE 13
313.26 	CHILD CARE LICENSING

313.27 	Section 1. [142B.171] CHILD CARE WEIGHTED RISK SYSTEM.
313.28 		Subdivision 1.Implementation. The commissioner shall develop and implement a child 
313.29 	care weighted risk system that provides a tiered licensing enforcement framework for child 
313.30 	care licensing requirements in this chapter or Minnesota Rules, chapter 9502 or 9503.
314.1 		Subd. 2. Documented technical assistance.  (a) In lieu of a correction order under section 
314.2 	142B.16, the commissioner shall provide documented technical assistance to a family child 
314.3 	care or child care center license holder if the commissioner finds that:
314.4 	(1) the license holder has failed to comply with a requirement in this chapter or Minnesota 
314.5 	Rules, chapter 9502 or 9503, that the commissioner determines to be low risk as determined 
314.6 	by the child care weighted risk system;
314.7 	(2) the noncompliance does not imminently endanger the health, safety, or rights of the 
314.8 	persons served by the program; and
314.9 	(3) the license holder did not receive documented technical assistance or a correction 
314.10 	order for the same violation at the license holder's most recent annual licensing inspection.
314.11 	(b) Documented technical assistance must include communication from the commissioner 
314.12 	to the child care provider that:
314.13 	(1) states the conditions that constitute a violation of a law or rule;
314.14 	(2) references the specific law or rule violated; and
314.15 	(3) explains remedies for correcting the violation.
314.16 	(c) The commissioner shall not publicly publish documented technical assistance on the 
314.17 	department's website.

314.18 	Sec. 2. Minnesota Statutes 2023 Supplement, section 245A.50, subdivision 3, is amended 
314.19 	to read:
314.20 		Subd. 3.First aid. (a) Before initial licensure and before caring for a child, license 
314.21 	holders, second adult caregivers, and substitutes must be trained in pediatric first aid. The 
314.22 	first aid training must have been provided by an individual approved to provide first aid 
314.23 	instruction. First aid training may be less than eight hours and persons qualified to provide 
314.24 	first aid training include individuals approved as first aid instructors. License holders, second 
314.25 	adult caregivers, and substitutes must repeat pediatric first aid training every two years
314.26 	within 90 days of the date the training was initially taken. License holders, second adult 
314.27 	caregivers, and substitutes must not let the training expire.
314.28 	(b) Video training reviewed and approved by the county licensing agency satisfies the 
314.29 	training requirement of this subdivision.

315.1 	Sec. 3. Minnesota Statutes 2023 Supplement, section 245A.50, subdivision 4, is amended 
315.2 	to read:
315.3 		Subd. 4.Cardiopulmonary resuscitation. (a) Before initial licensure and before caring 
315.4 	for a child, license holders, second adult caregivers, and substitutes must be trained in 
315.5 	pediatric cardiopulmonary resuscitation (CPR), including CPR techniques for infants and 
315.6 	children, and in the treatment of obstructed airways. The CPR training must have been 
315.7 	provided by an individual approved to provide CPR instruction. License holders, second 
315.8 	adult caregivers, and substitutes must repeat pediatric CPR training at least once every two 
315.9 	years within 90 days of the date the training was initially taken, and the training must 
315.10 	document the training be documented in the license holder's records. License holders, second 
315.11 	adult caregivers, and substitutes must not let the training expire.
315.12 	(b) Persons providing CPR training must use CPR training that has been developed:
315.13 	(1) by the American Heart Association or the American Red Cross and incorporates 
315.14 	psychomotor skills to support the instruction; or
315.15 	(2) using nationally recognized, evidence-based guidelines for CPR training and 
315.16 	incorporates psychomotor skills to support the instruction.

315.17 	Sec. 4. REPEALER.
 315.18 	Minnesota Statutes 2022, section 245A.065, is repealed.

315.19 	ARTICLE 14
315.20 	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES

315.21 	Section 1. [142A.045] CHILDREN, YOUTH, AND FAMILIES 
315.22 	INTERGOVERNMENTAL ADVISORY COMMITTEE.
315.23 	(a) An intergovernmental advisory committee is established to provide advice, 
315.24 	consultation, and recommendations to the commissioner on the planning, design, 
315.25 	administration, funding, and evaluation of services to children, youth, and families. 
315.26 	Notwithstanding section 15.059, the commissioner, the Association of Minnesota Counties, 
315.27 	and the Minnesota Association of County Social Services Administrators must codevelop 
315.28 	and execute a process to administer the committee that ensures each county is represented. 
315.29 	The committee must meet at least quarterly and special meetings may be called by the 
315.30 	committee chair or a majority of the members.
316.1 	(b) Subject to section 15.059, the commissioner may reimburse committee members or 
316.2 	their alternates for allowable expenses while engaged in their official duties as committee 
316.3 	members.
316.4 	(c) Notwithstanding section 15.059, the intergovernmental advisory committee does not 
316.5 	expire.

316.6 	Sec. 2. [142B.47] TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT 
316.7 	DEATH AND ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE 
316.8 	PROVIDERS.
316.9 	(a) Licensed child foster care providers that care for infants or children through five 
316.10 	years of age must document that before caregivers assist in the care of infants or children 
316.11 	through five years of age, they are instructed on the standards in section 142B.46 and receive 
316.12 	training on reducing the risk of sudden unexpected infant death and abusive head trauma 
316.13 	from shaking infants and young children. This section does not apply to emergency relative 
316.14 	placement under section 142B.06. The training on reducing the risk of sudden unexpected 
316.15 	infant death and abusive head trauma may be provided as:
316.16 	(1) orientation training to child foster care providers who care for infants or children 
316.17 	through five years of age under Minnesota Rules, part 2960.3070, subpart 1; or
316.18 	(2) in-service training to child foster care providers who care for infants or children 
316.19 	through five years of age under Minnesota Rules, part 2960.3070, subpart 2.
316.20 	(b) Training required under this section must be at least one hour in length and must be 
316.21 	completed at least once every five years. At a minimum, the training must address the risk 
316.22 	factors related to sudden unexpected infant death and abusive head trauma, means of reducing 
316.23 	the risk of sudden unexpected infant death and abusive head trauma, and license holder 
316.24 	communication with parents regarding reducing the risk of sudden unexpected infant death 
316.25 	and abusive head trauma.
316.26 	(c) Training for child foster care providers must be approved by the county or private 
316.27 	licensing agency that is responsible for monitoring the child foster care provider under 
316.28 	section 142B.30. The approved training fulfills, in part, training required under Minnesota 
316.29 	Rules, part 2960.3070.

317.1 	Sec. 3. Minnesota Statutes 2022, section 245A.10, subdivision 1, as amended by Laws 
317.2 	2024, chapter 80, article 2, section 48, is amended to read:
317.3 		Subdivision 1.Application or license fee required, programs exempt from fee. (a) 
317.4 	Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation of 
317.5 	applications and inspection of programs which are licensed under this chapter.
317.6 	(b) Except as provided under subdivision 2, no application or license fee shall be charged 
317.7 	for a child foster residence setting, adult foster care, or a community residential setting.

317.8 	Sec. 4. Minnesota Statutes 2022, section 245A.10, subdivision 2, as amended by Laws 
317.9 	2024, chapter 80, article 2, section 49, is amended to read:
317.10 		Subd. 2.County fees for applications and licensing inspections. (a) For purposes of 
317.11 	adult foster care and child foster residence setting licensing and licensing the physical plant 
317.12 	of a community residential setting, under this chapter, a county agency may charge a fee to 
317.13 	a corporate applicant or corporate license holder to recover the actual cost of licensing 
317.14 	inspections, not to exceed $500 annually.
317.15 	(b) Counties may elect to reduce or waive the fees in paragraph (a) under the following 
317.16 	circumstances:
317.17 	(1) in cases of financial hardship;
317.18 	(2) if the county has a shortage of providers in the county's area; or
317.19 	(3) for new providers.

317.20 	Sec. 5. Minnesota Statutes 2022, section 245A.144, is amended to read:
317.21 	245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT DEATH 
317.22 	AND ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE PROVIDERS.
317.23 	(a) Licensed child foster care providers that care for infants or children through five 
317.24 	years of age must document that before staff persons and caregivers assist in the care of 
317.25 	infants or children through five years of age, they are instructed on the standards in section 
317.26 	245A.1435142B.46 and receive training on reducing the risk of sudden unexpected infant 
317.27 	death and abusive head trauma from shaking infants and young children. This section does 
317.28 	not apply to emergency relative placement under section 245A.035. The training on reducing 
317.29 	the risk of sudden unexpected infant death and abusive head trauma may be provided as:
317.30 	(1) orientation training to child foster care providers, who care for infants or children 
317.31 	through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
318.1 	(2) in-service training to child foster care providers, who care for infants or children 
318.2 	through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
318.3 	(b) Training required under this section must be at least one hour in length and must be 
318.4 	completed at least once every five years. At a minimum, the training must address the risk 
318.5 	factors related to sudden unexpected infant death and abusive head trauma, means of reducing 
318.6 	the risk of sudden unexpected infant death and abusive head trauma, and license holder 
318.7 	communication with parents regarding reducing the risk of sudden unexpected infant death 
318.8 	and abusive head trauma.
318.9 	(c) Training for child foster care providers must be approved by the county or private 
318.10 	licensing agency that is responsible for monitoring the child foster care provider under 
318.11 	section 245A.16. The approved training fulfills, in part, training required under Minnesota 
318.12 	Rules, part 2960.3070.

318.13 	Sec. 6. Minnesota Statutes 2023 Supplement, section 245A.16, subdivision 1, as amended 
318.14 	by Laws 2024, chapter 80, article 2, section 65, is amended to read:
318.15 		Subdivision 1.Delegation of authority to agencies. (a) County agencies that have been 
318.16 	designated by the commissioner to perform licensing functions and activities under section 
318.17 	245A.04; to recommend denial of applicants under section 245A.05; to issue correction 
318.18 	orders, to issue variances, and recommend a conditional license under section 245A.06; or 
318.19 	to recommend suspending or revoking a license or issuing a fine under section 245A.07, 
318.20 	shall comply with rules and directives of the commissioner governing those functions and 
318.21 	with this section. The following variances are excluded from the delegation of variance 
318.22 	authority and may be issued only by the commissioner:
318.23 	(1) dual licensure of family child foster care and family adult foster care, dual licensure 
318.24 	of child foster residence setting and community residential setting, and dual licensure of 
318.25 	family adult foster care and family child care;
318.26 	(2) until the responsibility for family child foster care transfers to the commissioner of 
318.27 	children, youth, and families under Laws 2023, chapter 70, article 12, section 30, dual 
318.28 	licensure of family child foster care and family adult foster care;
318.29 	(3) until the responsibility for family child care transfers to the commissioner of children, 
318.30 	youth, and families under Laws 2023, chapter 70, article 12, section 30, dual licensure of 
318.31 	family adult foster care and family child care;
318.32 	(4) adult foster care maximum capacity;
318.33 	(3) (5) adult foster care minimum age requirement;
319.1 	(4) (6) child foster care maximum age requirement;
319.2 	(5) (7) variances regarding disqualified individuals;
319.3 	(6) (8) the required presence of a caregiver in the adult foster care residence during 
319.4 	normal sleeping hours;
319.5 	(7) (9) variances to requirements relating to chemical use problems of a license holder 
319.6 	or a household member of a license holder; and
319.7 	(8) (10) variances to section 142B.46 for the use of a cradleboard for a cultural 
319.8 	accommodation.
319.9 	(b) Once the respective responsibilities transfer from the commissioner of human services 
319.10 	to the commissioner of children, youth, and families, under Laws 2023, chapter 70, article 
319.11 	12, section 30, the commissioners of human services and children, youth, and families must 
319.12 	both approve a variance for dual licensure of family child foster care and family adult foster 
319.13 	care or family adult foster care and family child care. Variances under this paragraph are 
319.14 	excluded from the delegation of variance authority and may be issued only by both 
319.15 	commissioners.
319.16 	(b) (c) For family adult day services programs, the commissioner may authorize licensing 
319.17 	reviews every two years after a licensee has had at least one annual review.
319.18 	(c) (d) A license issued under this section may be issued for up to two years.
319.19 	(d) (e) During implementation of chapter 245D, the commissioner shall consider:
319.20 	(1) the role of counties in quality assurance;
319.21 	(2) the duties of county licensing staff; and
319.22 	(3) the possible use of joint powers agreements, according to section 471.59, with counties 
319.23 	through which some licensing duties under chapter 245D may be delegated by the 
319.24 	commissioner to the counties.
319.25 	Any consideration related to this paragraph must meet all of the requirements of the corrective 
319.26 	action plan ordered by the federal Centers for Medicare and Medicaid Services.
319.27 	(e) (f) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
319.28 	successor provisions; and section 245D.061 or successor provisions, for family child foster 
319.29 	care programs providing out-of-home respite, as identified in section 245D.03, subdivision 
319.30 	1, paragraph (b), clause (1), is excluded from the delegation of authority to county agencies.

320.1 	Sec. 7. Minnesota Statutes 2022, section 245A.175, is amended to read:
320.2 	245A.175 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL 
320.3 	HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
320.4 	Prior to a nonemergency placement of a child in a foster care home, the child foster care 
320.5 	license holder and caregivers in foster family and treatment foster care settings, and all staff 
320.6 	providing care in foster residence settings must complete two hours of training that addresses 
320.7 	the causes, symptoms, and key warning signs of mental health disorders; cultural 
320.8 	considerations; and effective approaches for dealing with a child's behaviors. At least one 
320.9 	hour of the annual training requirement for the foster family license holder and caregivers, 
320.10 	and foster residence staff must be on children's mental health issues and treatment. Except 
320.11 	for providers and services under chapter 245D, the annual training must also include at least 
320.12 	one hour of training on fetal alcohol spectrum disorders, which must be counted toward the 
320.13 	12 hours of required in-service training per year. Short-term substitute caregivers are exempt 
320.14 	from these requirements. Training curriculum shall be approved by the commissioner of 
320.15 	human services.

320.16 	Sec. 8. Minnesota Statutes 2023 Supplement, section 245A.66, subdivision 4, as amended 
320.17 	by Laws 2024, chapter 80, article 2, section 73, is amended to read:
320.18 		Subd. 4.Ongoing training requirement. (a) In addition to the orientation training 
320.19 	required by the applicable licensing rules and statutes, children's residential facility license 
320.20 	holders must provide a training annually on the maltreatment of minors reporting 
320.21 	requirements and definitions in chapter 260E to each mandatory reporter, as described in 
320.22 	section 260E.06, subdivision 1.
320.23 	(b) In addition to the orientation training required by the applicable licensing rules and 
320.24 	statutes, all foster residence setting staff and volunteers that are mandatory reporters as 
320.25 	described in section 260E.06, subdivision 1, must complete training each year on the 
320.26 	maltreatment of minors reporting requirements and definitions in chapter 260E.

320.27 	Sec. 9. Minnesota Statutes 2022, section 256.029, as amended by Laws 2024, chapter 80, 
320.28 	article 1, section 66, is amended to read:
320.29 	256.029 DOMESTIC VIOLENCE INFORMATIONAL BROCHURE.
320.30 	(a) The commissioner shall provide a domestic violence informational brochure that 
320.31 	provides information about the existence of domestic violence waivers for eligible public 
320.32 	assistance applicants to all applicants of general assistance, medical assistance, and 
320.33 	MinnesotaCare. The brochure must explain that eligible applicants may be temporarily 
321.1 	waived from certain program requirements due to domestic violence. The brochure must 
321.2 	provide information about services and other programs to help victims of domestic violence.
321.3 	(b) The brochure must be funded with TANF funds.
321.4 	(c) The commissioner must work with the commissioner of children, youth, and families 
321.5 	to create a brochure that meets the requirements of this section and section 142G.05.

321.6 	Sec. 10. Minnesota Statutes 2023 Supplement, section 256.043, subdivision 3, is amended 
321.7 	to read:
321.8 		Subd. 3.Appropriations from registration and license fee account. (a) The 
321.9 	appropriations in paragraphs (b) to (n) shall be made from the registration and license fee 
321.10 	account on a fiscal year basis in the order specified.
321.11 	(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs 
321.12 	(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be 
321.13 	made accordingly.
321.14 	(c) $100,000 is appropriated to the commissioner of human services for grants for opiate 
321.15 	antagonist distribution. Grantees may utilize funds for opioid overdose prevention, 
321.16 	community asset mapping, education, and opiate antagonist distribution.
321.17 	(d) $2,000,000 is appropriated to the commissioner of human services for grants to Tribal 
321.18 	nations and five urban Indian communities for traditional healing practices for American 
321.19 	Indians and to increase the capacity of culturally specific providers in the behavioral health 
321.20 	workforce.
321.21 	(e) $400,000 is appropriated to the commissioner of human services for competitive 
321.22 	grants for opioid-focused Project ECHO programs.
321.23 	(f) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to the 
321.24 	commissioner of human services to administer the funding distribution and reporting 
321.25 	requirements in paragraph (o).
321.26 	(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated 
321.27 	to the commissioner of human services for safe recovery sites start-up and capacity building 
321.28 	grants under section 254B.18.
321.29 	(h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to 
321.30 	the commissioner of human services for the opioid overdose surge alert system under section 
321.31 	245.891.
322.1 	(i) $300,000 is appropriated to the commissioner of management and budget for 
322.2 	evaluation activities under section 256.042, subdivision 1, paragraph (c).
322.3 	(j) $261,000 is appropriated to the commissioner of human services for the provision of 
322.4 	administrative services to the Opiate Epidemic Response Advisory Council and for the 
322.5 	administration of the grants awarded under paragraph (n).
322.6 	(k) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration 
322.7 	fees under section 151.066.
322.8 	(l) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
322.9 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
322.10 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
322.11 	(m) After the appropriations in paragraphs (b) to (l) are made, 50 percent of the remaining 
322.12 	amount is appropriated to the commissioner of human services children, youth, and families
322.13 	for distribution to county social service agencies and Tribal social service agency initiative 
322.14 	projects authorized under section 256.01, subdivision 14b, to provide child protection 
322.15 	services to children and families who are affected by addiction. The commissioner shall 
322.16 	distribute this money proportionally to county social service agencies and Tribal social 
322.17 	service agency initiative projects based on out-of-home placement episodes where parental 
322.18 	drug abuse is the primary reason for the out-of-home placement using data from the previous 
322.19 	calendar year. County social service agencies and Tribal social service agency initiative 
322.20 	projects receiving funds from the opiate epidemic response fund must annually report to 
322.21 	the commissioner on how the funds were used to provide child protection services, including 
322.22 	measurable outcomes, as determined by the commissioner. County social service agencies 
322.23 	and Tribal social service agency initiative projects must not use funds received under this 
322.24 	paragraph to supplant current state or local funding received for child protection services 
322.25 	for children and families who are affected by addiction.
322.26 	(n) After the appropriations in paragraphs (b) to (m) are made, the remaining amount in 
322.27 	the account is appropriated to the commissioner of human services to award grants as 
322.28 	specified by the Opiate Epidemic Response Advisory Council in accordance with section 
322.29 	256.042, unless otherwise appropriated by the legislature.
322.30 	(o) Beginning in fiscal year 2022 and each year thereafter, funds for county social service 
322.31 	agencies and Tribal social service agency initiative projects under paragraph (m) and grant 
322.32 	funds specified by the Opiate Epidemic Response Advisory Council under paragraph (n) 
322.33 	may be distributed on a calendar year basis.
323.1 	(p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
323.2 	(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.

323.3 	Sec. 11. Minnesota Statutes 2023 Supplement, section 256.043, subdivision 3a, is amended 
323.4 	to read:
323.5 		Subd. 3a.Appropriations from settlement account. (a) The appropriations in paragraphs 
323.6 	(b) to (e) shall be made from the settlement account on a fiscal year basis in the order 
323.7 	specified.
323.8 	(b) If the balance in the registration and license fee account is not sufficient to fully fund 
323.9 	the appropriations specified in subdivision 3, paragraphs (b) to (l), an amount necessary to 
323.10 	meet any insufficiency shall be transferred from the settlement account to the registration 
323.11 	and license fee account to fully fund the required appropriations.
323.12 	(c) $209,000 in fiscal year 2023 and $239,000 in fiscal year 2024 and subsequent fiscal 
323.13 	years are appropriated to the commissioner of human services for the administration of 
323.14 	grants awarded under paragraph (e). $276,000 in fiscal year 2023 and $151,000 in fiscal 
323.15 	year 2024 and subsequent fiscal years are appropriated to the commissioner of human 
323.16 	services to collect, collate, and report data submitted and to monitor compliance with 
323.17 	reporting and settlement expenditure requirements by grantees awarded grants under this 
323.18 	section and municipalities receiving direct payments from a statewide opioid settlement 
323.19 	agreement as defined in section 256.042, subdivision 6.
323.20 	(d) After any appropriations necessary under paragraphs (b) and (c) are made, an amount 
323.21 	equal to the calendar year allocation to Tribal social service agency initiative projects under 
323.22 	subdivision 3, paragraph (m), is appropriated from the settlement account to the commissioner 
323.23 	of human services children, youth, and families for distribution to Tribal social service 
323.24 	agency initiative projects to provide child protection services to children and families who 
323.25 	are affected by addiction. The requirements related to proportional distribution, annual 
323.26 	reporting, and maintenance of effort specified in subdivision 3, paragraph (m), also apply 
323.27 	to the appropriations made under this paragraph.
323.28 	(e) After making the appropriations in paragraphs (b), (c), and (d), the remaining amount 
323.29 	in the account is appropriated to the commissioner of human services to award grants as 
323.30 	specified by the Opiate Epidemic Response Advisory Council in accordance with section 
323.31 	256.042.
324.1 	(f) Funds for Tribal social service agency initiative projects under paragraph (d) and 
324.2 	grant funds specified by the Opiate Epidemic Response Advisory Council under paragraph 
324.3 	(e) may be distributed on a calendar year basis.
324.4 	(g) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
324.5 	(d) and (e) are available for three years after the funds are appropriated.

324.6 	Sec. 12. Minnesota Statutes 2023 Supplement, section 256.045, subdivision 3, as amended 
324.7 	by Laws 2024, chapter 79, article 3, section 3, and Laws 2024, chapter 80, article 1, section 
324.8 	67, is amended to read:
324.9 		Subd. 3.State agency hearings. (a) State agency hearings are available for the following:
324.10 	(1) any person:
324.11 	(i) applying for, receiving or having received public assistance, medical care, or a program 
324.12 	of social services administered by the commissioner or a county agency on behalf of the 
324.13 	commissioner; and
324.14 	(ii) whose application for assistance is denied, not acted upon with reasonable promptness, 
324.15 	or whose assistance is suspended, reduced, terminated, or claimed to have been incorrectly 
324.16 	paid;
324.17 	(2) any patient or relative aggrieved by an order of the commissioner under section 
324.18 	252.27;
324.19 	(3) a party aggrieved by a ruling of a prepaid health plan;
324.20 	(4) except as provided under chapter 245C, any individual or facility determined by a 
324.21 	lead investigative agency to have maltreated a vulnerable adult under section 626.557 after 
324.22 	they have exercised their right to administrative reconsideration under section 626.557;
324.23 	(5) any person to whom a right of appeal according to this section is given by other 
324.24 	provision of law;
324.25 	(6) an applicant aggrieved by an adverse decision to an application for a hardship waiver 
324.26 	under section 256B.15;
324.27 	(7) an applicant aggrieved by an adverse decision to an application or redetermination 
324.28 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
324.29 	(8) except as provided under chapter 245A, an individual or facility determined to have 
324.30 	maltreated a minor under chapter 260E, after the individual or facility has exercised the 
324.31 	right to administrative reconsideration under chapter 260E;
325.1 	(8) (9) except as provided under chapter 245Cand except for a subject of a background 
325.2 	study that the commissioner has conducted on behalf of another agency for a program or 
325.3 	facility not otherwise overseen by the commissioner, an individual disqualified under sections 
325.4 	245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23, 
325.5 	on the basis of serious or recurring maltreatment; a preponderance of the evidence that the 
325.6 	individual has committed an act or acts that meet the definition of any of the crimes listed 
325.7 	in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section 
325.8 	260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment 
325.9 	determination under clause (4) or (8) or section 142A.20, subdivision 3, clause (4), and a 
325.10 	disqualification under this clause in which the basis for a disqualification is serious or 
325.11 	recurring maltreatment, shall be consolidated into a single fair hearing. In such cases, the 
325.12 	scope of review by the human services judge shall include both the maltreatment 
325.13 	determination and the disqualification. The failure to exercise the right to an administrative 
325.14 	reconsideration shall not be a bar to a hearing under this section if federal law provides an 
325.15 	individual the right to a hearing to dispute a finding of maltreatment;
325.16 	(9) (10) any person with an outstanding debt resulting from receipt of public assistance 
325.17 	administered by the commissioner or medical care who is contesting a setoff claim by the 
325.18 	Department of Human Services or a county agency. The scope of the appeal is the validity 
325.19 	of the claimant agency's intention to request a setoff of a refund under chapter 270A against 
325.20 	the debt;
325.21 	(10) (11) a person issued a notice of service termination under section 245D.10, 
325.22 	subdivision 3a, by a licensed provider of any residential supports or services listed in section 
325.23 	245D.03, subdivision 1, paragraphs (b) and (c), that is not otherwise subject to appeal under 
325.24 	subdivision 4a;
325.25 	(11) (12) an individual disability waiver recipient based on a denial of a request for a 
325.26 	rate exception under section 256B.4914;
325.27 	(12) (13) a person issued a notice of service termination under section 245A.11, 
325.28 	subdivision 11, that is not otherwise subject to appeal under subdivision 4a; or
325.29 	(13) (14) a recovery community organization seeking medical assistance vendor eligibility 
325.30 	under section 254B.01, subdivision 8, that is aggrieved by a membership or accreditation 
325.31 	determination and that believes the organization meets the requirements under section 
325.32 	254B.05, subdivision 1, paragraph (d), clauses (1) to (10). The scope of the review by the 
325.33 	human services judge shall be limited to whether the organization meets each of the 
325.34 	requirements under section 254B.05, subdivision 1, paragraph (d), clauses (1) to (10).
326.1 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (8), or (9), 
326.2 	is the only administrative appeal to the final agency determination specifically, including 
326.3 	a challenge to the accuracy and completeness of data under section 13.04. Hearings requested 
326.4 	under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or 
326.5 	after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged 
326.6 	to have maltreated a resident prior to October 1, 1995, shall be held as a contested case 
326.7 	proceeding under the provisions of chapter 14. Hearings requested under paragraph (a), 
326.8 	clause (8), apply only to incidents of maltreatment that occur on or after July 1, 1997. A 
326.9 	hearing for an individual or facility under paragraph (a), clause (4), (8), or (9), is only 
326.10 	available when there is no district court action pending. If such action is filed in district 
326.11 	court while an administrative review is pending that arises out of some or all of the events 
326.12 	or circumstances on which the appeal is based, the administrative review must be suspended 
326.13 	until the judicial actions are completed. If the district court proceedings are completed, 
326.14 	dismissed, or overturned, the matter may be considered in an administrative hearing.
326.15 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
326.16 	administrative appeal.
326.17 	(d) The scope of hearings involving claims to foster care payments under  section 142A.20, 
326.18 	subdivision 2, clause (2), shall be limited to the issue of whether the county is legally 
326.19 	responsible for a child's placement under court order or voluntary placement agreement 
326.20 	and, if so, the correct amount of foster care payment to be made on the child's behalf and 
326.21 	shall not include review of the propriety of the county's child protection determination or 
326.22 	child placement decision.
326.23 	(d) (e) The scope of hearings under paragraph (a), clauses (11) and (13), shall be limited 
326.24 	to whether the proposed termination of services is authorized under section 245D.10, 
326.25 	subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements 
326.26 	of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a, 
326.27 	paragraphs (d) and (e), were met. If the appeal includes a request for a temporary stay of 
326.28 	termination of services, the scope of the hearing shall also include whether the case 
326.29 	management provider has finalized arrangements for a residential facility, a program, or 
326.30 	services that will meet the assessed needs of the recipient by the effective date of the service 
326.31 	termination.
326.32 	(e) (f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor 
326.33 	under contract with a county agency to provide social services is not a party and may not 
326.34 	request a hearing under this section, except if assisting a recipient as provided in subdivision 
326.35 	4.
327.1 	(f) (g) An applicant or recipient is not entitled to receive social services beyond the 
327.2 	services prescribed under chapter 256M or other social services the person is eligible for 
327.3 	under state law.
327.4 	(g) (h) The commissioner may summarily affirm the county or state agency's proposed 
327.5 	action without a hearing when the sole issue is an automatic change due to a change in state 
327.6 	or federal law, except in matters covered by paragraph (h) (i).
327.7 	(h) (i) When the subject of an administrative review is a matter within the jurisdiction 
327.8 	of the direct care and treatment executive board as a part of the board's powers and duties 
327.9 	under chapter 246C, the executive board may summarily affirm the county or state agency's 
327.10 	proposed action without a hearing when the sole issue is an automatic change due to a 
327.11 	change in state or federal law.
327.12 	(i) (j) Unless federal or Minnesota law specifies a different time frame in which to file 
327.13 	an appeal, an individual or organization specified in this section may contest the specified 
327.14 	action, decision, or final disposition before the state agency by submitting a written request 
327.15 	for a hearing to the state agency within 30 days after receiving written notice of the action, 
327.16 	decision, or final disposition, or within 90 days of such written notice if the applicant, 
327.17 	recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision 
327.18 	13, why the request was not submitted within the 30-day time limit. The individual filing 
327.19 	the appeal has the burden of proving good cause by a preponderance of the evidence.

327.20 	Sec. 13. Minnesota Statutes 2022, section 256.045, subdivision 3b, as amended by Laws 
327.21 	2024, chapter 80, article 1, section 68, is amended to read:
327.22 		Subd. 3b.Standard of evidence for maltreatment and disqualification hearings. (a) 
327.23 	The state human services judge shall determine that maltreatment has occurred if a 
327.24 	preponderance of evidence exists to support the final disposition under section 626.557 and 
327.25 	chapter 260E. For purposes of hearings regarding disqualification, the state human services 
327.26 	judge shall affirm the proposed disqualification in an appeal under subdivision 3, paragraph 
327.27 	(a), clause (9), if a preponderance of the evidence shows the individual has:
327.28 	(1) committed maltreatment under section 626.557 or chapter 260E that is serious or 
327.29 	recurring;
327.30 	(2) committed an act or acts meeting the definition of any of the crimes listed in section 
327.31 	245C.15, subdivisions 1 to 4; or
328.1 	(3) failed to make required reports under section 626.557 or chapter 260E, for incidents 
328.2 	in which the final disposition under section 626.557 or chapter 260E was substantiated 
328.3 	maltreatment that was serious or recurring.
328.4 	(b) If the disqualification is affirmed, the state human services judge shall determine 
328.5 	whether the individual poses a risk of harm in accordance with the requirements of section 
328.6 	245C.22, and whether the disqualification should be set aside or not set aside. In determining 
328.7 	whether the disqualification should be set aside, the human services judge shall consider 
328.8 	all of the characteristics that cause the individual to be disqualified, including those 
328.9 	characteristics that were not subject to review under paragraph (a), in order to determine 
328.10 	whether the individual poses a risk of harm. A decision to set aside a disqualification that 
328.11 	is the subject of the hearing constitutes a determination that the individual does not pose a 
328.12 	risk of harm and that the individual may provide direct contact services in the individual 
328.13 	program specified in the set aside.
328.14 	(c) If a disqualification is based solely on a conviction or is conclusive for any reason 
328.15 	under section 245C.29, the disqualified individual does not have a right to a hearing under 
328.16 	this section.
328.17 	(d) The state human services judge shall recommend an order to the commissioner of 
328.18 	health,; education,; children, youth, and families; or human services, as applicable, who 
328.19 	shall issue a final order. The commissioner shall affirm, reverse, or modify the final 
328.20 	disposition. Any order of the commissioner issued in accordance with this subdivision is 
328.21 	conclusive upon the parties unless appeal is taken in the manner provided in subdivision 7. 
328.22 	In any licensing appeal under chapters 245A and 245C and sections 144.50 to 144.58 and 
328.23 	144A.02 to 144A.482, the commissioner's determination as to maltreatment is conclusive, 
328.24 	as provided under section 245C.29.

328.25 	Sec. 14. Minnesota Statutes 2022, section 256.045, subdivision 5, as amended by Laws 
328.26 	2024, chapter 79, article 3, section 4, is amended to read:
328.27 		Subd. 5.Orders of the commissioner of human services. (a) Except as provided for 
328.28 	under subdivision 5a for matters under the jurisdiction of the direct care and treatment 
328.29 	executive board and for hearings held under section 142A.20, subdivision 2, a state human 
328.30 	services judge shall conduct a hearing on the appeal and shall recommend an order to the 
328.31 	commissioner of human services. The recommended order must be based on all relevant 
328.32 	evidence and must not be limited to a review of the propriety of the state or county agency's 
328.33 	action. A human services judge may take official notice of adjudicative facts. The 
328.34 	commissioner of human services may accept the recommended order of a state human 
329.1 	services judge and issue the order to the county agency and the applicant, recipient, former 
329.2 	recipient, or prepaid health plan. The commissioner on refusing to accept the recommended 
329.3 	order of the state human services judge, shall notify the petitioner, the agency, or prepaid 
329.4 	health plan of that fact and shall state reasons therefor and shall allow each party ten days' 
329.5 	time to submit additional written argument on the matter. After the expiration of the ten-day 
329.6 	period, the commissioner shall issue an order on the matter to the petitioner, the agency, or 
329.7 	prepaid health plan.
329.8 	(b) A party aggrieved by an order of the commissioner may appeal under subdivision 
329.9 	7, or request reconsideration by the commissioner within 30 days after the date the 
329.10 	commissioner issues the order. The commissioner may reconsider an order upon request of 
329.11 	any party or on the commissioner's own motion. A request for reconsideration does not stay 
329.12 	implementation of the commissioner's order. The person seeking reconsideration has the 
329.13 	burden to demonstrate why the matter should be reconsidered. The request for reconsideration 
329.14 	may include legal argument and proposed additional evidence supporting the request. If 
329.15 	proposed additional evidence is submitted, the person must explain why the proposed 
329.16 	additional evidence was not provided at the time of the hearing. If reconsideration is granted, 
329.17 	the other participants must be sent a copy of all material submitted in support of the request 
329.18 	for reconsideration and must be given ten days to respond. Upon reconsideration, the 
329.19 	commissioner may issue an amended order or an order affirming the original order.
329.20 	(c) Any order of the commissioner issued under this subdivision shall be conclusive 
329.21 	upon the parties unless appeal is taken in the manner provided by subdivision 7. Any order 
329.22 	of the commissioner is binding on the parties and must be implemented by the state agency, 
329.23 	a county agency, or a prepaid health plan according to subdivision 3a, until the order is 
329.24 	reversed by the district court, or unless the commissioner or a district court orders monthly 
329.25 	assistance or aid or services paid or provided under subdivision 10.
329.26 	(d) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor 
329.27 	under contract with a county agency to provide social services is not a party and may not 
329.28 	request a hearing or seek judicial review of an order issued under this section, unless assisting 
329.29 	a recipient as provided in subdivision 4. A prepaid health plan is a party to an appeal under 
329.30 	subdivision 3a, but cannot seek judicial review of an order issued under this section.

329.31 	Sec. 15. Minnesota Statutes 2022, section 256.045, subdivision 7, as amended by Laws 
329.32 	2024, chapter 79, article 3, section 7, is amended to read:
329.33 		Subd. 7.Judicial review. Except for a prepaid health plan, any party who is aggrieved 
329.34 	by an order of the commissioner of human services,; the commissioner of health; or the 
330.1 	commissioner of children, youth, and families in appeals within the commissioner's 
330.2 	jurisdiction under subdivision 3b,; or the direct care and treatment executive board in appeals 
330.3 	within the jurisdiction of the executive board under subdivision 5a may appeal the order to 
330.4 	the district court of the county responsible for furnishing assistance, or, in appeals under 
330.5 	subdivision 3b, the county where the maltreatment occurred, by serving a written copy of 
330.6 	a notice of appeal upon the applicable commissioner or executive board and any adverse 
330.7 	party of record within 30 days after the date the commissioner or executive board issued 
330.8 	the order, the amended order, or order affirming the original order, and by filing the original 
330.9 	notice and proof of service with the court administrator of the district court. Service may 
330.10 	be made personally or by mail; service by mail is complete upon mailing; no filing fee shall 
330.11 	be required by the court administrator in appeals taken pursuant to this subdivision, with 
330.12 	the exception of appeals taken under subdivision 3b. The applicable commissioner or 
330.13 	executive board may elect to become a party to the proceedings in the district court. Except 
330.14 	for appeals under subdivision 3b, any party may demand that the commissioner or executive 
330.15 	board furnish all parties to the proceedings with a copy of the decision, and a transcript of 
330.16 	any testimony, evidence, or other supporting papers from the hearing held before the human 
330.17 	services judge, by serving a written demand upon the applicable commissioner or executive 
330.18 	board within 30 days after service of the notice of appeal. Any party aggrieved by the failure 
330.19 	of an adverse party to obey an order issued by the commissioner or executive board under 
330.20 	subdivisions 5 or 5a may compel performance according to the order in the manner prescribed 
330.21 	in sections 586.01 to 586.12.

330.22 	Sec. 16. Minnesota Statutes 2022, section 256.0451, subdivision 1, as amended by Laws 
330.23 	2024, chapter 80, article 1, section 72, is amended to read:
330.24 		Subdivision 1.Scope. (a) The requirements in this section apply to all fair hearings and 
330.25 	appeals under section sections 142A.20, subdivision 2, and256.045, subdivision 3, paragraph 
330.26 	(a), clauses (1), (2), (3), (5), (6), (7), (8), (11) (10), and (13) (12). Except as provided in 
330.27 	subdivisions 3 and 19, the requirements under this section apply to fair hearings and appeals 
330.28 	under section 256.045, subdivision 3, paragraph (a), clauses (4), (8), (9), (10), and (12) (11).
330.29 	(b) For purposes of this section, "person" means an individual who, on behalf of 
330.30 	themselves or their household, is appealing or disputing or challenging an action, a decision, 
330.31 	or a failure to act, by an agency in the human services system. When a person involved in 
330.32 	a proceeding under this section is represented by an attorney or by an authorized 
330.33 	representative, the term "person" also means the person's attorney or authorized 
330.34 	representative. Any notice sent to the person involved in the hearing must also be sent to 
330.35 	the person's attorney or authorized representative.
331.1 	(c) For purposes of this section, "agency" means the county human services agency, the 
331.2 	state human services agency, and, where applicable, any entity involved under a contract, 
331.3 	subcontract, grant, or subgrant with the state agency or with a county agency, that provides 
331.4 	or operates programs or services in which appeals are governed by section 256.045.

331.5 	Sec. 17. Minnesota Statutes 2022, section 256.0451, subdivision 22, is amended to read:
331.6 		Subd. 22.Decisions. A timely, written decision must be issued in every appeal. Each 
331.7 	decision must contain a clear ruling on the issues presented in the appeal hearing and should 
331.8 	contain a ruling only on questions directly presented by the appeal and the arguments raised 
331.9 	in the appeal.
331.10 	(a) A written decision must be issued within 90 days of the date the person involved 
331.11 	requested the appeal unless a shorter time is required by law. An additional 30 days is 
331.12 	provided in those cases where the commissioner refuses to accept the recommended decision. 
331.13 	In appeals of maltreatment determinations or disqualifications filed pursuant to section 
331.14 	256.045, subdivision 3, paragraph (a), clause (4), (8), or (9), or (10), that also give rise to 
331.15 	possible licensing actions, the 90-day period for issuing final decisions does not begin until 
331.16 	the later of the date that the licensing authority provides notice to the appeals division that 
331.17 	the authority has made the final determination in the matter or the date the appellant files 
331.18 	the last appeal in the consolidated matters.
331.19 	(b) The decision must contain both findings of fact and conclusions of law, clearly 
331.20 	separated and identified. The findings of fact must be based on the entire record. Each 
331.21 	finding of fact made by the human services judge shall be supported by a preponderance 
331.22 	of the evidence unless a different standard is required under the regulations of a particular 
331.23 	program. The "preponderance of the evidence" means, in light of the record as a whole, the 
331.24 	evidence leads the human services judge to believe that the finding of fact is more likely to 
331.25 	be true than not true. The legal claims or arguments of a participant do not constitute either 
331.26 	a finding of fact or a conclusion of law, except to the extent the human services judge adopts 
331.27 	an argument as a finding of fact or conclusion of law.
331.28 	The decision shall contain at least the following:
331.29 	(1) a listing of the date and place of the hearing and the participants at the hearing;
331.30 	(2) a clear and precise statement of the issues, including the dispute under consideration 
331.31 	and the specific points which must be resolved in order to decide the case;
331.32 	(3) a listing of the material, including exhibits, records, reports, placed into evidence at 
331.33 	the hearing, and upon which the hearing decision is based;
332.1 	(4) the findings of fact based upon the entire hearing record. The findings of fact must 
332.2 	be adequate to inform the participants and any interested person in the public of the basis 
332.3 	of the decision. If the evidence is in conflict on an issue which must be resolved, the findings 
332.4 	of fact must state the reasoning used in resolving the conflict;
332.5 	(5) conclusions of law that address the legal authority for the hearing and the ruling, and 
332.6 	which give appropriate attention to the claims of the participants to the hearing;
332.7 	(6) a clear and precise statement of the decision made resolving the dispute under 
332.8 	consideration in the hearing; and
332.9 	(7) written notice of the right to appeal to district court or to request reconsideration, 
332.10 	and of the actions required and the time limits for taking appropriate action to appeal to 
332.11 	district court or to request a reconsideration.
332.12 	(c) The human services judge shall not independently investigate facts or otherwise rely 
332.13 	on information not presented at the hearing. The human services judge may not contact 
332.14 	other agency personnel, except as provided in subdivision 18. The human services judge's 
332.15 	recommended decision must be based exclusively on the testimony and evidence presented 
332.16 	at the hearing, and legal arguments presented, and the human services judge's research and 
332.17 	knowledge of the law.
332.18 	(d) The commissioner will review the recommended decision and accept or refuse to 
332.19 	accept the decision according to section 142A.20, subdivision 3, or256.045, subdivision 
332.20 	5.

332.21 	Sec. 18. Minnesota Statutes 2022, section 256.0451, subdivision 24, is amended to read:
332.22 		Subd. 24.Reconsideration. (a) Reconsideration may be requested within 30 days of 
332.23 	the date of the commissioner's final order. If reconsideration is requested under section
332.24 	142A.20, subdivision 3, or256.045, subdivision 5, the other participants in the appeal shall 
332.25 	be informed of the request. The person seeking reconsideration has the burden to demonstrate 
332.26 	why the matter should be reconsidered. The request for reconsideration may include legal 
332.27 	argument and may include proposed additional evidence supporting the request. The other 
332.28 	participants shall be sent a copy of all material submitted in support of the request for 
332.29 	reconsideration and must be given ten days to respond.
332.30 	(b) When the requesting party raises a question as to the appropriateness of the findings 
332.31 	of fact, the commissioner shall review the entire record.
332.32 	(c) When the requesting party questions the appropriateness of a conclusion of law, the 
332.33 	commissioner shall consider the recommended decision, the decision under reconsideration, 
333.1 	and the material submitted in connection with the reconsideration. The commissioner shall 
333.2 	review the remaining record as necessary to issue a reconsidered decision.
333.3 	(d) The commissioner shall issue a written decision on reconsideration in a timely fashion. 
333.4 	The decision must clearly inform the parties that this constitutes the final administrative 
333.5 	decision, advise the participants of the right to seek judicial review, and the deadline for 
333.6 	doing so.

333.7 	Sec. 19. Minnesota Statutes 2022, section 256.046, subdivision 2, as amended by Laws 
333.8 	2024, chapter 80, article 1, section 75, is amended to read:
333.9 		Subd. 2.Combined hearing. (a) The human services judge may combine a fair hearing 
333.10 	under section 142A.20 or 256.045 and administrative fraud disqualification hearing under 
333.11 	this section or section 142A.27 into a single hearing if the factual issues arise out of the 
333.12 	same, or related, circumstances; the commissioner of human services has jurisdiction over 
333.13 	at least one of the hearings; and the individual receives prior notice that the hearings will 
333.14 	be combined. If the administrative fraud disqualification hearing and fair hearing are 
333.15 	combined, the time frames for administrative fraud disqualification hearings specified in 
333.16 	Code of Federal Regulations, title 7, section 273.16, apply. If the individual accused of 
333.17 	wrongfully obtaining assistance is charged under section 256.98 for the same act or acts 
333.18 	which are the subject of the hearing, the individual may request that the hearing be delayed 
333.19 	until the criminal charge is decided by the court or withdrawn.
333.20 	(b) The human services judge must conduct any hearings under section 142A.20 or 
333.21 	142A.27 pursuant to the relevant laws and rules governing children, youth, and families 
333.22 	judges.

333.23 	Sec. 20. Minnesota Statutes 2023 Supplement, section 256M.42, is amended by adding a 
333.24 	subdivision to read:
333.25 		Subd. 7.Adult protection grant allocation under Reform 2020. The requirements of 
333.26 	subdivisions 2 to 6 apply to the Reform 2020 adult protection state grants in Minnesota 
333.27 	Statutes 2013 Supplement, section 256M.40, subdivision 1, and Laws 2013, chapter 108, 
333.28 	article 15. The Reform 2020 state adult protection grant must be allocated annually consistent 
333.29 	with the calendar year 2023 allocation made under section 256M.40.

333.30 	Sec. 21. Laws 2023, chapter 70, article 12, section 30, subdivision 2, is amended to read:
333.31 		Subd. 2.Department of Human Services. The powers and duties of the Department 
333.32 	of Human Services with respect to the following responsibilities and related elements are 
334.1 	transferred to the Department of Children, Youth, and Families according to Minnesota 
334.2 	Statutes, section 15.039:
334.3 	(1) family services and community-based collaboratives under Minnesota Statutes, 
334.4 	section 124D.23;
334.5 	(2) child care programs under Minnesota Statutes, chapter 119B;
334.6 	(3) Parent Aware quality rating and improvement system under Minnesota Statutes, 
334.7 	section 124D.142;
334.8 	(4) migrant child care services under Minnesota Statutes, section 256M.50;
334.9 	(5) early childhood and school-age professional development training under Laws 2007, 
334.10 	chapter 147, article 2, section 56;
334.11 	(6) licensure of family child care and child care centers, child foster care, and private 
334.12 	child placing agencies under Minnesota Statutes, chapter 245A;
334.13 	(7) certification of license-exempt child care centers under Minnesota Statutes, chapter 
334.14 	245H;
334.15 	(8) program integrity and fraud related to the Child Care Assistance Program (CCAP), 
334.16 	the Minnesota Family Investment Program (MFIP), and the Supplemental Nutrition 
334.17 	Assistance Program (SNAP) under Minnesota Statutes, chapters 119B and 245E;
334.18 	(9) SNAP under Minnesota Statutes, sections 256D.60 to 256D.63;
334.19 	(10) electronic benefit transactions under Minnesota Statutes, sections 256.9862, 
334.20 	256.9863, 256.9865, 256.987, 256.9871, 256.9872, and 256J.77;
334.21 	(11) Minnesota food assistance program under Minnesota Statutes, section 256D.64;
334.22 	(12) Minnesota food shelf program under Minnesota Statutes, section 256E.34;
334.23 	(13) MFIP and Temporary Assistance for Needy Families (TANF) under Minnesota 
334.24 	Statutes, sections 256.9864 and 256.9865 and chapters 256J and 256P;
334.25 	(14) Diversionary Work Program (DWP) under Minnesota Statutes, section 256J.95;
334.26 	(15) resettlement programs under Minnesota Statutes, section 256B.06, subdivision 6
334.27 	American Indian food sovereignty program under Minnesota Statutes, section 256E.342;
334.28 	(16) child abuse under Minnesota Statutes, chapter 256E;
334.29 	(17) reporting of the maltreatment of minors under Minnesota Statutes, chapter 260E;
335.1 	(18) children in voluntary foster care for treatment under Minnesota Statutes, chapter 
335.2 	260D;
335.3 	(19) juvenile safety and placement under Minnesota Statutes, chapter 260C;
335.4 	(20) the Minnesota Indian Family Preservation Act under Minnesota Statutes, sections 
335.5 	260.751 to 260.835;
335.6 	(21) the Interstate Compact for Juveniles under Minnesota Statutes, section 260.515, 
335.7 	and the Interstate Compact on the Placement of Children under Minnesota Statutes, sections 
335.8 	260.851 to 260.93;
335.9 	(22) adoption under Minnesota Statutes, sections 259.20 to 259.89;
335.10 	(23) Northstar Care for Children under Minnesota Statutes, chapter 256N;
335.11 	(24) child support under Minnesota Statutes, chapters 13, 13B, 214, 256, 256J, 257, 259, 
335.12 	518, 518A, 518C, 551, 552, 571, and 588, and Minnesota Statutes, section 609.375;
335.13 	(25) community action programs under Minnesota Statutes, sections 256E.30 to 256E.32; 
335.14 	and
335.15 	(26) Family Assets for Independence in Minnesota under Minnesota Statutes, section 
335.16 	256E.35.;
335.17 	(27) capital for emergency food distribution facilities under Laws 2023, chapter 70, 
335.18 	article 20, section 2, subdivision 24, paragraph (i);
335.19 	(28) community resource centers under Laws 2023, chapter 70, article 14, section 42;
335.20 	(29) diaper distribution grant program under Minnesota Statutes, section 256E.38;
335.21 	(30) emergency services program under Minnesota Statutes, section 256E.36;
335.22 	(31) emergency shelter facilities grants under Laws 2023, chapter 70, article 11, section 
335.23 	14;
335.24 	(32) Family First Prevention Services Act support and development grant program under 
335.25 	Minnesota Statutes, section 256.4793;
335.26 	(33) Family First Prevention Services Act kinship navigator program under Minnesota 
335.27 	Statutes, section 256.4794;
335.28 	(34) family first prevention and early intervention allocation program under Minnesota 
335.29 	Statutes, section 260.014;
336.1 	(35) grants for prepared meals food relief under Laws 2023, chapter 70, article 12, section 
336.2 	33;
336.3 	(36) Homeless Youth Act under Minnesota Statutes, sections 256K.45 to 256K.451;
336.4 	(37) homeless youth cash stipend pilot under Laws 2023, chapter 70, article 11, section 
336.5 	13;
336.6 	(38) independent living skills for foster youth under Laws 2023, chapter 70, article 14, 
336.7 	section 41;
336.8 	(39) legacy adoption assistance under Minnesota Statutes, chapter 259A;
336.9 	(40) quality parenting initiative grant program under Minnesota Statutes, section 
336.10 	245.0962;
336.11 	(41) relative custody assistance under Minnesota Statutes, section 257.85;
336.12 	(42) reimbursement to counties and Tribes for certain out-of-home placements under 
336.13 	Minnesota Statutes, section 477A.0126;
336.14 	(43) safe harbor shelter and housing under Minnesota Statutes, section 256K.47;
336.15 	(44) shelter-linked youth mental health grants under Minnesota Statutes, section 256K.46;
336.16 	(45) Supplemental Nutrition Assistance Program outreach under Minnesota Statutes, 
336.17 	section 256D.65; and
336.18 	(46) transitional housing programs under Minnesota Statutes, section 256E.33.

336.19 	Sec. 22. Laws 2023, chapter 70, article 12, section 30, subdivision 3, is amended to read:
336.20 		Subd. 3.Department of Education. The powers and duties of the Department of 
336.21 	Education with respect to the following responsibilities and related elements are transferred 
336.22 	to the Department of Children, Youth, and Families according to Minnesota Statutes, section 
336.23 	15.039:
336.24 	(1) Head Start Program and Early Head Start under Minnesota Statutes, sections 119A.50
336.25 	to 119A.545;
336.26 	(2) the early childhood screening program under Minnesota Statutes, sections 121A.16
336.27 	to 121A.19;
336.28 	(3) early learning scholarships under Minnesota Statutes, section 124D.165;
336.29 	(4) the interagency early childhood intervention system under Minnesota Statutes, 
336.30 	sections 125A.259 to 125A.48;
337.1 	(5) voluntary prekindergarten programs and school readiness plus programs under 
337.2 	Minnesota Statutes, section 124D.151;
337.3 	(6) early childhood family education programs under Minnesota Statutes, sections 
337.4 	124D.13 to 124D.135;
337.5 	(7) school readiness under Minnesota Statutes, sections 124D.15 to 124D.16; and
337.6 	(8) after-school community learning programs under Minnesota Statutes, section 
337.7 	124D.2211.; and
337.8 	(9) grow your own program under Minnesota Statutes, section 122A.731.

337.9 	Sec. 23. Laws 2024, chapter 80, article 1, section 38, subdivision 1, is amended to read:
337.10 		Subdivision 1.Children, youth, and families judges; appointment Hearings held by 
337.11 	the Department of Human Services. The commissioner of children, youth, and families 
337.12 	may appoint one or more state children, youth, and families judges to conduct hearings and 
337.13 	recommend orders in accordance with subdivisions 2, 3, and 5. Children, youth, and families 
337.14 	judges designated pursuant to this section may administer oaths and shall be under the 
337.15 	control and supervision of the commissioner of children, youth, and families and shall not 
337.16 	be a part of the Office of Administrative Hearings established pursuant to sections 14.48 to 
337.17 	14.56. The commissioner shall only appoint as a full-time children, youth, and families 
337.18 	judge an individual who is licensed to practice law in Minnesota and who is:
337.19 	(1) in active status;
337.20 	(2) an inactive resident;
337.21 	(3) retired;
337.22 	(4) on disabled status; or
337.23 	(5) on retired senior status.
337.24 	All state agency hearings under subdivision 2 must be heard by a human services judge 
337.25 	pursuant to sections 256.045 and 256.0451.

337.26 	Sec. 24. Laws 2024, chapter 80, article 1, section 38, subdivision 2, is amended to read:
337.27 		Subd. 2.State agency hearings. (a) State agency hearings are available for the following:
337.28 	(1) any person:
338.1 	(i) applying for, receiving, or having received public assistance or a program of social 
338.2 	services administered by the commissioner or a county agency on behalf of the commissioner 
338.3 	or the federal Food and Nutrition Act; and
338.4 	(ii) whose application for assistance is denied, not acted upon with reasonable promptness, 
338.5 	or whose assistance is suspended, reduced, terminated, or claimed to have been incorrectly 
338.6 	paid;
338.7 	(2) any person whose claim for foster care payment according to a placement of the 
338.8 	child resulting from a child protection assessment under chapter 260E is denied or not acted 
338.9 	upon with reasonable promptness, regardless of funding source;
338.10 	(3) any person to whom a right of appeal according to this section is given by other 
338.11 	provision of law; and
338.12 	(4) except as provided under chapter 142B, an individual or facility determined to have 
338.13 	maltreated a minor under chapter 260E, after the individual or facility has exercised the 
338.14 	right to administrative reconsideration under chapter 260E;
338.15 	(5) except as provided under chapter 245C, an individual disqualified under sections 
338.16 	245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23, 
338.17 	on the basis of serious or recurring maltreatment; of a preponderance of the evidence that 
338.18 	the individual has committed an act or acts that meet the definition of any of the crimes 
338.19 	listed in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under 
338.20 	section 260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment 
338.21 	determination under clause (4) and a disqualification under this clause in which the basis 
338.22 	for a disqualification is serious or recurring maltreatment shall be consolidated into a single 
338.23 	fair hearing. In such cases, the scope of review by the children, youth, and families judge 
338.24 	shall include both the maltreatment determination and the disqualification. The failure to 
338.25 	exercise the right to an administrative reconsideration shall not be a bar to a hearing under 
338.26 	this section if federal law provides an individual the right to a hearing to dispute a finding 
338.27 	of maltreatment; and
338.28 	(6) (4) any person with an outstanding debt resulting from receipt of public assistance 
338.29 	or the federal Food and Nutrition Act who is contesting a setoff claim by the commissioner 
338.30 	of children, youth, and families or a county agency. The scope of the appeal is the validity 
338.31 	of the claimant agency's intention to request a setoff of a refund under chapter 270A against 
338.32 	the debt.
338.33 	(b) The hearing for an individual or facility under paragraph (a), clause (4) or (5), is the 
338.34 	only administrative appeal to the final agency determination specifically, including a 
339.1 	challenge to the accuracy and completeness of data under section 13.04. A hearing for an 
339.2 	individual or facility under paragraph (a), clause (4) or (5), is only available when there is 
339.3 	no district court action pending. If such action is filed in district court while an administrative 
339.4 	review is pending that arises out of some or all of the events or circumstances on which the 
339.5 	appeal is based, the administrative review must be suspended until the judicial actions are 
339.6 	completed. If the district court proceedings are completed, dismissed, or overturned, the 
339.7 	matter may be considered in an administrative hearing.
339.8 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
339.9 	administrative appeal.
339.10 	(d) The scope of hearings involving claims to foster care payments under paragraph (a), 
339.11 	clause (2), shall be limited to the issue of whether the county is legally responsible for a 
339.12 	child's placement under court order or voluntary placement agreement and, if so, the correct 
339.13 	amount of foster care payment to be made on the child's behalf and shall not include review 
339.14 	of the propriety of the county's child protection determination or child placement decision.
339.15 	(e) An applicant or recipient is not entitled to receive social services beyond the services 
339.16 	prescribed under chapter 256M or other social services the person is eligible for under state 
339.17 	law.
339.18 	(f) The commissioner may summarily affirm the county or state agency's proposed action 
339.19 	without a hearing when the sole issue is an automatic change due to a change in state or 
339.20 	federal law.
339.21 	(g) Unless federal or Minnesota law specifies a different time frame in which to file an 
339.22 	appeal, an individual or organization specified in this section may contest the specified 
339.23 	action, decision, or final disposition before the state agency by submitting a written request 
339.24 	for a hearing to the state agency within 30 days after receiving written notice of the action, 
339.25 	decision, or final disposition or within 90 days of such written notice if the applicant, 
339.26 	recipient, patient, or relative shows good cause, as defined in section 142A.21, subdivision 
339.27 	13, why the request was not submitted within the 30-day time limit. The individual filing 
339.28 	the appeal has the burden of proving good cause by a preponderance of the evidence.

339.29 	Sec. 25. Laws 2024, chapter 80, article 1, section 38, subdivision 5, is amended to read:
339.30 		Subd. 5.Orders of the commissioner of children, youth, and families. (a) A state 
339.31 	children, youth, and families human services judge shall conduct a hearing on the an appeal
339.32 	of a matter listed in subdivision 2 and shall recommend an order to the commissioner of 
339.33 	children, youth, and families. The recommended order must be based on all relevant evidence 
340.1 	and must not be limited to a review of the propriety of the state or county agency's action. 
340.2 	A children, youth, and families state human services judge may take official notice of 
340.3 	adjudicative facts. The commissioner of children, youth, and families may accept the 
340.4 	recommended order of a state children, youth, and families human services judge and issue 
340.5 	the order to the county agency and the applicant, recipient, or former recipient. If the 
340.6 	commissioner refuses to accept the recommended order of the state children, youth, and 
340.7 	families human services judge, the commissioner shall notify the petitioner or the agency 
340.8 	of the commissioner's refusal and shall state reasons for the refusal. The commissioner shall 
340.9 	allow each party ten days' time to submit additional written argument on the matter. After 
340.10 	the expiration of the ten-day period, the commissioner shall issue an order on the matter to 
340.11 	the petitioner and the agency.
340.12 	(b) A party aggrieved by an order of the commissioner may appeal under subdivision 7
340.13 	5 or request reconsideration by the commissioner within 30 days after the date the 
340.14 	commissioner issues the order. The commissioner may reconsider an order upon request of 
340.15 	any party or on the commissioner's own motion. A request for reconsideration does not stay 
340.16 	implementation of the commissioner's order. The person seeking reconsideration has the 
340.17 	burden to demonstrate why the matter should be reconsidered. The request for reconsideration 
340.18 	may include legal argument and proposed additional evidence supporting the request. If 
340.19 	proposed additional evidence is submitted, the person must explain why the proposed 
340.20 	additional evidence was not provided at the time of the hearing. If reconsideration is granted, 
340.21 	the other participants must be sent a copy of all material submitted in support of the request 
340.22 	for reconsideration and must be given ten days to respond. Upon reconsideration, the 
340.23 	commissioner may issue an amended order or an order affirming the original order.
340.24 	(c) Any order of the commissioner issued under this subdivision shall be conclusive 
340.25 	upon the parties unless appeal is taken in the manner provided by subdivision 7 5. Any order 
340.26 	of the commissioner is binding on the parties and must be implemented by the state agency 
340.27 	or a county agency until the order is reversed by the district court or unless the commissioner 
340.28 	or a district court orders monthly assistance or aid or services paid or provided under 
340.29 	subdivision 10 8.
340.30 	(d) A vendor under contract with a county agency to provide social services is not a 
340.31 	party and may not request a hearing or seek judicial review of an order issued under this 
340.32 	section, unless assisting a recipient as provided in section 256.045, subdivision 4.

341.1 	Sec. 26. Laws 2024, chapter 80, article 1, section 38, subdivision 6, is amended to read:
341.2 		Subd. 6.Additional powers of commissioner; subpoenas. (a) The commissioner may 
341.3 	initiate a review of any action or decision of a county agency and direct that the matter be 
341.4 	presented to a state children, youth, and families human services judge for a hearing held 
341.5 	under subdivision 2 or 3 section 256.045, subdivision 3b. In all matters dealing with children, 
341.6 	youth, and families committed by law to the discretion of the county agency, the 
341.7 	commissioner's judgment may be substituted for that of the county agency. The commissioner 
341.8 	may order an independent examination when appropriate.
341.9 	(b) Any party to a hearing held pursuant to subdivision 2 or 3 section 256.045, subdivision 
341.10 	3b, may request that the commissioner issue a subpoena to compel the attendance of witnesses 
341.11 	and the production of records at the hearing. A local agency may request that the 
341.12 	commissioner issue a subpoena to compel the release of information from third parties prior 
341.13 	to a request for a hearing under section 142A.21 upon a showing of relevance to such a 
341.14 	proceeding. The issuance, service, and enforcement of subpoenas under this subdivision is 
341.15 	governed by section 357.22 and the Minnesota Rules of Civil Procedure.
341.16 	(c) The commissioner may issue a temporary order staying a proposed demission by a 
341.17 	residential facility licensed under chapter 142B:
341.18 	(1) while an appeal by a recipient under subdivision 3 is pending; or
341.19 	(2) for the period of time necessary for the case management provider to implement the 
341.20 	commissioner's order.

341.21 	Sec. 27. Laws 2024, chapter 80, article 1, section 38, subdivision 7, is amended to read:
341.22 		Subd. 7.Judicial review. Any party who is aggrieved by an order of the commissioner 
341.23 	of children, youth, and families may appeal the order to the district court of the county 
341.24 	responsible for furnishing assistance, or, in appeals under section 256.045, subdivision 3
341.25 	3b, the county where the maltreatment occurred, by serving a written copy of a notice of 
341.26 	appeal upon the commissioner and any adverse party of record within 30 days after the date 
341.27 	the commissioner issued the order, the amended order, or order affirming the original order, 
341.28 	and by filing the original notice and proof of service with the court administrator of the 
341.29 	district court. Service may be made personally or by mail; service by mail is complete upon 
341.30 	mailing. The court administrator shall not require a filing fee in appeals taken pursuant to 
341.31 	this subdivision, except for appeals taken under section 256.045, subdivision 3 3b. The 
341.32 	commissioner may elect to become a party to the proceedings in the district court. Except 
341.33 	for appeals under section 256.045, subdivision 3 3b, any party may demand that the 
342.1 	commissioner furnish all parties to the proceedings with a copy of the decision, and a 
342.2 	transcript of any testimony, evidence, or other supporting papers from the hearing held 
342.3 	before the children, youth, and families state human services judge, by serving a written 
342.4 	demand upon the commissioner within 30 days after service of the notice of appeal. Any 
342.5 	party aggrieved by the failure of an adverse party to obey an order issued by the commissioner 
342.6 	under subdivision 5 may compel performance according to the order in the manner prescribed 
342.7 	in sections 586.01 to 586.12.

342.8 	Sec. 28. Laws 2024, chapter 80, article 1, section 38, subdivision 9, is amended to read:
342.9 		Subd. 9.Appeal. Any party aggrieved by the order of the district court may appeal the 
342.10 	order as in other civil cases. Except for appeals under section 256.045, subdivision 3 3b, 
342.11 	no costs or disbursements shall be taxed against any party nor shall any filing fee or bond 
342.12 	be required of any party.

342.13 	Sec. 29. Laws 2024, chapter 80, article 1, section 96, is amended to read:
342.14 	Sec. 96. REVISOR INSTRUCTION.
 342.15 	The revisor of statutes must renumber sections or subdivisions in Column A as Column 
342.16 	B.

342.17		Column A
	Column B
	
342.18		256.01, subdivision 12
	142A.03, subdivision 7
	
342.19		256.01, subdivision 12a
	142A.03, subdivision 8
	
342.20		256.01, subdivision 15
	142A.03, subdivision 10
	
342.21		256.01, subdivision 36
	142A.03, subdivision 22
	
342.22		256.0112, subdivision 10
	142A.07, subdivision 8
	
342.23		256.019, subdivision 2
	142A.28, subdivision 2
	
342.24		256.4793
	142A.45
	
342.25		256.4794
	142A.451
	
342.26		256.82
	142A.418
	
342.27		256.9831
	142A.13, subdivision 14
	
342.28		256.9862, subdivision 1
	142A.13, subdivision 10
	
342.29		256.9862, subdivision 2
	142A.13, subdivision 11
	
342.30		256.9863
	142A.13, subdivision 5
	
342.31		256.9865, subdivision 1
	142A.13, subdivision 6
	
342.32		256.9865, subdivision 2
	142A.13, subdivision 7
	
342.33		256.9865, subdivision 3
	142A.13, subdivision 8
	
343.1		256.9865, subdivision 4
	142A.13, subdivision 9
	
343.2		256.987, subdivision 2
	142A.13, subdivision 2
	
343.3		256.987, subdivision 3
	142A.13, subdivision 3
	
343.4		256.987, subdivision 4
	142A.13, subdivision 4
	
343.5		256.9871
	142A.13, subdivision 12
	
343.6		256.9872
	142A.13, subdivision 13
	
343.7		256.997
	142A.30
	
343.8		256.998
	142A.29
	
343.9		256B.06, subdivision 6
	142A.40
	
343.10		256E.20
	142A.41
	
343.11		256E.21
	142A.411
	
343.12		256E.22
	142A.412
	
343.13		256E.24
	142A.413
	
343.14		256E.25
	142A.414
	
343.15		256E.26
	142A.415
	
343.16		256E.27
	142A.416
	
343.17		256E.28
	142A.417
	
343.18		256E.38
	142A.42
	
343.19		256N.001
	142A.60
	
343.20		256N.01
	142A.601
	
343.21		256N.02
	142A.602
	
343.22		256N.20
	142A.603
	
343.23		256N.21
	142A.604
	
343.24		256N.22
	142A.605
	
343.25		256N.23
	142A.606
	
343.26		256N.24
	142A.607
	
343.27		256N.25
	142A.608
	
343.28		256N.26
	142A.609
	
343.29		256N.261
	142A.61
	
343.30		256N.27
	142A.611
	
343.31		256N.28
	142A.612
	
343.32		257.175
	142A.03, subdivision 32
	
343.33		257.33, subdivision 1
	142A.03, subdivision 33
	
343.34		257.33, subdivision 2
	142A.03, subdivision 34
	
343.35		260.014
	142A.452
	
343.36		299A.72
	142A.75
	
343.37		299A.73
	142A.43
	
343.38		299A.95
	142A.76
	
344.1 	The revisor of statutes must correct any statutory cross-references consistent with this 
344.2 	renumbering.

344.3 	Sec. 30. Laws 2024, chapter 80, article 2, section 5, subdivision 21, is amended to read:
344.4 		Subd. 21.Plan for transfer of clients and records upon closure. (a) Except for license 
344.5 	holders who reside on the premises and child care providers, an applicant for initial or 
344.6 	continuing licensure or certification must submit a written plan indicating how the program
344.7 	or private agency will ensure the transfer of clients and records for both open and closed 
344.8 	cases if the program closes. The plan must provide for managing private and confidential 
344.9 	information concerning the clients of the program clients or private agency. The plan must 
344.10 	also provide for notifying affected clients of the closure at least 25 days prior to closure, 
344.11 	including information on how to access their records. A controlling individual of the program 
344.12 	or private agency must annually review and sign the plan.
344.13 	(b) Plans for the transfer of open cases and case records must specify arrangements the 
344.14 	program or private agency will make to transfer clients to another provider or county agency 
344.15 	for continuation of services and to transfer the case record with the client.
344.16 	(c) Plans for the transfer of closed case records must be accompanied by a signed 
344.17 	agreement or other documentation indicating that a county or a similarly licensed provider 
344.18 	has agreed to accept and maintain the program's or private agency's closed case records and 
344.19 	to provide follow-up services as necessary to affected clients.

344.20 	Sec. 31. Laws 2024, chapter 80, article 2, section 7, subdivision 2, is amended to read:
344.21 		Subd. 2.County fees for applications and licensing inspections. (a) A county agency 
344.22 	may charge a license fee to an applicant or license holder not to exceed $50 for a one-year 
344.23 	license or $100 for a two-year license.
344.24 	(b) Counties may allow providers to pay the applicant fee in paragraph (a) on an 
344.25 	installment basis for up to one year. If the provider is receiving child care assistance payments 
344.26 	from the state, the provider may have the fee under paragraph (a) deducted from the child 
344.27 	care assistance payments for up to one year and the state shall reimburse the county for the 
344.28 	county fees collected in this manner.
344.29 	(c) For purposes of child foster care licensing under this chapter, a county agency may 
344.30 	charge a fee to a corporate applicant or corporate license holder to recover the actual cost 
344.31 	of licensing inspections, not to exceed $500 annually.
345.1 	(d) Counties may elect to reduce or waive the fees in paragraph (c) under the following 
345.2 	circumstances:
345.3 	(1) in cases of financial hardship;
345.4 	(2) if the county has a shortage of providers in the county's area; or
345.5 	(3) for new providers.

345.6 	Sec. 32. Laws 2024, chapter 80, article 2, section 10, subdivision 6, is amended to read:
345.7 		Subd. 6.Appeal of multiple sanctions. (a) When the license holder appeals more than 
345.8 	one licensing action or sanction that were simultaneously issued by the commissioner, the 
345.9 	license holder shall specify the actions or sanctions that are being appealed.
345.10 	(b) If there are different timelines prescribed in statutes for the licensing actions or 
345.11 	sanctions being appealed, the license holder must submit the appeal within the longest of 
345.12 	those timelines specified in statutes.
345.13 	(c) The appeal must be made in writing by certified mail or, by personal service, or 
345.14 	through the provider licensing and reporting hub. If mailed, the appeal must be postmarked 
345.15 	and sent to the commissioner within the prescribed timeline with the first day beginning 
345.16 	the day after the license holder receives the certified letter. If a request is made by personal 
345.17 	service, it must be received by the commissioner within the prescribed timeline with the 
345.18 	first day beginning the day after the license holder receives the certified letter. If the appeal 
345.19 	is made through the provider hub, the appeal must be received by the commissioner within 
345.20 	the prescribed timeline with the first day beginning the day after the commissioner issued 
345.21 	the order through the hub.
345.22 	(d) When there are different timelines prescribed in statutes for the appeal of licensing 
345.23 	actions or sanctions simultaneously issued by the commissioner, the commissioner shall 
345.24 	specify in the notice to the license holder the timeline for appeal as specified under paragraph 
345.25 	(b).

345.26 	Sec. 33. Laws 2024, chapter 80, article 2, section 16, subdivision 1, is amended to read:
345.27 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and private 
345.28 	agencies that have been designated or licensed by the commissioner to perform licensing 
345.29 	functions and activities under section 142B.10and background studies for family child care
345.30 	under chapter 245C; to recommend denial of applicants under section 142B.15; to issue 
345.31 	correction orders, to issue variances, and to recommend a conditional license under section 
345.32 	142B.16; or to recommend suspending or revoking a license or issuing a fine under section 
346.1 	142B.18, shall comply with rules and directives of the commissioner governing those 
346.2 	functions and with this section. The following variances are excluded from the delegation 
346.3 	of variance authority and may be issued only by the commissioner:
346.4 	(1) dual licensure of family child care and family child foster care, dual licensure of 
346.5 	family child foster care and family adult foster care, dual licensure of child foster residence 
346.6 	setting and community residential setting, and dual licensure of family adult foster care and 
346.7 	family child care;
346.8 	(2) child foster care maximum age requirement;
346.9 	(3) variances regarding disqualified individuals;
346.10 	(4) variances to requirements relating to chemical use problems of a license holder or a 
346.11 	household member of a license holder; and
346.12 	(5) variances to section 142B.74 for a time-limited period. If the commissioner grants 
346.13 	a variance under this clause, the license holder must provide notice of the variance to all 
346.14 	parents and guardians of the children in care.
346.15 	(b) The commissioners of human services and children, youth, and families must both 
346.16 	approve a variance for dual licensure of family child foster care and family adult foster care 
346.17 	or family adult foster care and family child care. Variances under this paragraph are excluded 
346.18 	from the delegation of variance authority and may be issued only by both commissioners.
346.19 	(c) Except as provided in section 142B.41, subdivision 4, paragraph (e), a county agency 
346.20 	must not grant a license holder a variance to exceed the maximum allowable family child 
346.21 	care license capacity of 14 children.
346.22 	(b) (d) A county agency that has been designated by the commissioner to issue family 
346.23 	child care variances must:
346.24 	(1) publish the county agency's policies and criteria for issuing variances on the county's 
346.25 	public website and update the policies as necessary; and
346.26 	(2) annually distribute the county agency's policies and criteria for issuing variances to 
346.27 	all family child care license holders in the county.
346.28 	(c) (e) Before the implementation of NETStudy 2.0, county agencies must report 
346.29 	information about disqualification reconsiderations under sections 245C.25 and 245C.27, 
346.30 	subdivision 2, paragraphs (a) and (b), and variances granted under paragraph (a), clause 
346.31 	(5), to the commissioner at least monthly in a format prescribed by the commissioner.
347.1 	(d) (f) For family child care programs, the commissioner shall require a county agency 
347.2 	to conduct one unannounced licensing review at least annually.
347.3 	(e) (g) A license issued under this section may be issued for up to two years.
347.4 	(f) (h) A county agency shall report to the commissioner, in a manner prescribed by the 
347.5 	commissioner, the following information for a licensed family child care program:
347.6 	(1) the results of each licensing review completed, including the date of the review, and 
347.7 	any licensing correction order issued;
347.8 	(2) any death, serious injury, or determination of substantiated maltreatment; and
347.9 	(3) any fires that require the service of a fire department within 48 hours of the fire. The 
347.10 	information under this clause must also be reported to the state fire marshal within two 
347.11 	business days of receiving notice from a licensed family child care provider.

347.12 	Sec. 34. Laws 2024, chapter 80, article 2, section 30, subdivision 2, is amended to read:
347.13 		Subd. 2.Maltreatment of minors ongoing training requirement. (a) In addition to 
347.14 	the orientation training required by the applicable licensing rules and statutes, private 
347.15 	child-placing agency license holders must provide a training annually on the maltreatment 
347.16 	of minors reporting requirements and definitions in chapter 260E to each mandatory reporter, 
347.17 	as described in section 260E.06, subdivision 1.
347.18 	(b) In addition to the orientation training required by the applicable licensing rules and 
347.19 	statutes, all family child foster care license holders and caregivers and foster residence 
347.20 	setting staff and volunteers who are mandatory reporters as described in section 260E.06, 
347.21 	subdivision 1, must complete training each year on the maltreatment of minors reporting 
347.22 	requirements and definitions in chapter 260E.

347.23 	Sec. 35. Laws 2024, chapter 80, article 2, section 31, is amended to read:
347.24 	Sec. 31. 142B.80 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL 
347.25 	HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
347.26 	Prior to a nonemergency placement of a child in a foster care home, the child foster care 
347.27 	license holder and caregivers in foster family and treatment foster care settings, and all staff 
347.28 	providing care in foster residence settings must complete two hours of training that addresses 
347.29 	the causes, symptoms, and key warning signs of mental health disorders; cultural 
347.30 	considerations; and effective approaches for dealing with a child's behaviors. At least one 
347.31 	hour of the annual training requirement for the foster family license holder and caregivers, 
348.1 	and foster residence staff must be on children's mental health issues and treatment. Except 
348.2 	for providers and services under chapter 245D, the annual training must also include at least 
348.3 	one hour of training on fetal alcohol spectrum disorders, which must be counted toward the 
348.4 	12 hours of required in-service training per year. Short-term substitute caregivers are exempt 
348.5 	from these requirements. Training curriculum shall be approved by the commissioner of 
348.6 	children, youth, and families.

348.7 	Sec. 36. Laws 2024, chapter 80, article 2, section 74, is amended to read:
348.8 	Sec. 74. REVISOR INSTRUCTION.
 348.9 	The revisor of statutes must renumber sections or subdivisions in column A as column 
348.10 	B.

348.11		Column A
	Column B
	
348.12		245A.02, subdivision 2c
	142B.01, subdivision 3
	
348.13		245A.02, subdivision 6a
	142B.01, subdivision 11
	
348.14		245A.02, subdivision 6b
	142B.01, subdivision 12
	
348.15		245A.02, subdivision 10a
	142B.01, subdivision 22
	
348.16		245A.02, subdivision 12
	142B.01, subdivision 23
	
348.17		245A.02, subdivision 16
	142B.01, subdivision 26
	
348.18		245A.02, subdivision 17
	142B.01, subdivision 27
	
348.19		245A.02, subdivision 18
	142B.01, subdivision 28
	
348.20		245A.02, subdivision 19
	142B.01, subdivision 13
	
348.21		245A.03, subdivision 2a
	142B.05, subdivision 3
	
348.22		245A.03, subdivision 2b
	142B.05, subdivision 4
	
348.23		245A.03, subdivision 4
	142B.05, subdivision 6
	
348.24		245A.03, subdivision 4a
	142B.05, subdivision 7
	
348.25		245A.03, subdivision 8
	142B.05, subdivision 10
	
348.26		245A.035
	142B.06
	
348.27		245A.04, subdivision 9a
	142B.10, subdivision 17
	
348.28		245A.04, subdivision 10
	142B.10, subdivision 18
	
348.29		245A.06, subdivision 8
	142B.16, subdivision 5
	
348.30		245A.06, subdivision 9
	142B.16, subdivision 6
	
348.31		245A.065
	142B.17
	
348.32		245A.07, subdivision 4
	142B.18, subdivision 6
	
348.33		245A.07, subdivision 5
	142B.18, subdivision 7
	
348.34		245A.14, subdivision 3
	142B.41, subdivision 3
	
348.35		245A.14, subdivision 4
	142B.41, subdivision 4
	
349.1		245A.14, subdivision 4a
	142B.41, subdivision 5
	
349.2		245A.14, subdivision 6
	142B.41, subdivision 6
	
349.3		245A.14, subdivision 8
	142B.41, subdivision 7
	
349.4		245A.14, subdivision 10
	142B.41, subdivision 8
	
349.5		245A.14, subdivision 11
	142B.41, subdivision 9
	
349.6		245A.14, subdivision 15
	142B.41, subdivision 11
	
349.7		245A.14, subdivision 16
	142B.41, subdivision 12
	
349.8		245A.14, subdivision 17
	142B.41, subdivision 13
	
349.9		245A.1434
	142B.60
	
349.10		245A.144
	142B.47
	
349.11		245A.1445
	142B.48
	
349.12		245A.145
	142B.61
	
349.13		245A.146, subdivision 2
	142B.45, subdivision 2
	
349.14		245A.146, subdivision 3
	142B.45, subdivision 3
	
349.15		245A.146, subdivision 4
	142B.45, subdivision 4
	
349.16		245A.146, subdivision 5
	142B.45, subdivision 5
	
349.17		245A.146, subdivision 6
	142B.45, subdivision 6
	
349.18		245A.147
	142B.75
	
349.19		245A.148
	142B.76
	
349.20		245A.149
	142B.77
	
349.21		245A.15
	142B.78
	
349.22		245A.1511
	142B.79
	
349.23		245A.152
	142B.62
	
349.24		245A.16, subdivision 7
	142B.30, subdivision 7
	
349.25		245A.16, subdivision 9
	142B.30, subdivision 9
	
349.26		245A.16, subdivision 11
	142B.30, subdivision 11
	
349.27		245A.23
	142B.63
	
349.28		245A.40
	142B.65
	
349.29		245A.41
	142B.66
	
349.30		245A.42
	142B.67
	
349.31		245A.50
	142B.70
	
349.32		245A.51
	142B.71
	
349.33		245A.52
	142B.72
	
349.34		245A.53
	142B.74
	
349.35		245A.66, subdivision 2
	142B.54, subdivision 2
	
349.36		245A.66, subdivision 3
	142B.54, subdivision 3
	
350.1 	The revisor of statutes must correct any statutory cross-references consistent with this 
350.2 	renumbering.

350.3 	Sec. 37. Laws 2024, chapter 80, article 4, section 26, is amended to read:
350.4 	Sec. 26. REVISOR INSTRUCTION.
 350.5 	(a) The revisor of statutes shall renumber each section of Minnesota Statutes listed in 
350.6 	column A with the number listed in column B. The revisor shall also make necessary 
350.7 	cross-reference changes consistent with the renumbering. The revisor shall also make any 
350.8 	technical, language, and other changes necessitated by the renumbering and cross-reference 
350.9 	changes in this act.

350.10	Column A
	Column B
	
350.11	119A.50
	142D.12
	
350.12	119A.52
	142D.121
	
350.13	119A.53
	142D.122
	
350.14	119A.535
	142D.123
	
350.15	119A.5411
	142D.124
	
350.16	119A.545
	142D.125
	
350.17	119B.195
	142D.30
	
350.18	119B.196
	142D.24
	
350.19	119B.25
	142D.20
	
350.20	119B.251
	142D.31
	
350.21	119B.252
	142D.32
	
350.22	119B.27
	142D.21
	
350.23	119B.28
	142D.22
	
350.24	119B.29
	142D.23
	
350.25	121A.16
	142D.09
	
350.26	121A.17
	142D.091
	
350.27	121A.18
	142D.092
	
350.28	121A.19
	142D.093
	
350.29	122A.731
	142D.33
	
350.30	124D.13
	142D.10
	
350.31	124D.135
	142D.11
	
350.32	124D.141
	142D.16
	
350.33	124D.142
	142D.13
	
350.34	124D.15
	142D.05
	
350.35	124D.151
	142D.08
	
351.1	124D.16
	142D.06
	
351.2	124D.165
	142D.25
	
351.3	124D.2211
	142D.14
	
351.4	124D.23
	142D.15
	
351.5 	(b) The revisor of statutes shall codify Laws 2017, First Special Session chapter 5, article 
351.6 	8, section 9, as amended by article 4, section 25, as Minnesota Statutes, section 142D.07.
351.7 	(c) The revisor of statutes shall change "commissioner of education" to "commissioner 
351.8 	of children, youth, and families" and change "Department of Education" to "Department of 
351.9 	Children, Youth, and Families" as necessary in Minnesota Statutes, chapters 119A and 120 
351.10 	to 129C, to reflect the changes in this act and Laws 2023, chapter 70, article 12. The revisor 
351.11 	shall also make any technical, language, and other changes resulting from the change of 
351.12 	term to the statutory language, sentence structure, or both, if necessary to preserve the 
351.13 	meaning of the text.

351.14 	Sec. 38. Laws 2024, chapter 80, article 6, section 4, is amended to read:
351.15 	Sec. 4. REVISOR INSTRUCTION.
 351.16 	(a) The revisor of statutes must renumber each section of Minnesota Statutes in Column 
351.17 	A with the number in Column B.

351.18		Column A
	Column B
	
351.19		245.771
	142F.05
	
351.20		256D.60
	142F.10
	
351.21		256D.61
	142F.11
	
351.22		256D.62
	142F.101
	
351.23		256D.63
	142F.102
	
351.24		256D.64
	142F.13
	
351.25		256D.65
	142F.12
	
351.26		256E.30
	142F.30
	
351.27		256E.31
	142F.301
	
351.28		256E.32
	142F.302
	
351.29		256E.33
	142F.51
	
351.30		256E.34
	142F.14
	
351.31		256E.342
	142F.15
	
351.32		256E.35
	142F.20
	
351.33		256E.36
	142F.52
	
351.34		256K.45
	142F.55
	
352.1		256K.451
	142F.56
	
352.2		256K.46
	142F.57
	
352.3		256K.47
	142F.58
	
352.4 	(b) The revisor of statutes must correct any statutory cross-references consistent with 
352.5 	this renumbering.

352.6 	Sec. 39. Laws 2024, chapter 80, article 7, section 4, is amended to read:
352.7 	Sec. 4. Minnesota Statutes 2022, section 256J.09, is amended by adding a subdivision to 
352.8 	read:
352.9 		Subd. 11.Domestic violence informational brochure. (a) The commissioner shall 
352.10 	provide a domestic violence informational brochure that provides information about the 
352.11 	existence of domestic violence waivers to all MFIP applicants. The brochure must explain 
352.12 	that eligible applicants may be temporarily waived from certain program requirements due 
352.13 	to domestic violence. The brochure must provide information about services and other 
352.14 	programs to help victims of domestic violence.
352.15 	(b) The brochure must be funded with TANF funds.
352.16 	(c) The commissioner must work with the commissioner of human services to create a 
352.17 	brochure that meets the requirements of this section and section 256.029.

352.18 	Sec. 40. CHILD FOSTER RESIDENCE SETTINGS TO STAY AT THE 
352.19 	DEPARTMENT OF HUMAN SERVICES.
 352.20 	The responsibility to license child foster residence settings as defined in Minnesota 
352.21 	Statutes, section 245A.02, subdivision 6e, does not transfer to the Department of Children, 
352.22 	Youth, and Families under Laws 2023, chapter 70, article 12, section 30, and remains with 
352.23 	the Department of Human Services.

352.24 	Sec. 41. DIRECTION TO THE COMMISSIONER OF CHILDREN, YOUTH, AND 
352.25 	FAMILIES; COORDINATION OF SERVICES FOR CHILDREN WITH 
352.26 	DISABILITIES AND MENTAL HEALTH.
 352.27 	The commissioner shall designate a department leader to be responsible for coordination 
352.28 	of services and outcomes around children's mental health and for children with or at risk 
352.29 	for disabilities within and between the Department of Children, Youth, and Families; the 
352.30 	Department of Human Services; and related agencies.

353.1 	Sec. 42. REPEALER.
 353.2 	(a) Laws 2024, chapter 80, article 1, sections 38, subdivisions 3, 4, and 11; 39; and 43, 
353.3 	subdivision 2; Laws 2024, chapter 80, article 2, sections 1, subdivision 11; 3, subdivision 
353.4 	3; 4, subdivision 4; 10, subdivision 4; 33; and 69; and Laws 2024, chapter 80, article 7, 
353.5 	sections 3; and 9, are repealed.
353.6 	(b) Minnesota Rules, part 9545.0845, is repealed.

353.7 	Sec. 43. EFFECTIVE DATE; TRANSFER OF RESPONSIBILITIES.
 353.8 	(a) This article is effective July 1, 2024.
353.9 	(b) Notwithstanding paragraph (a), the powers and responsibilities transferred under this 
353.10 	article are effective upon notice of the commissioner of children, youth, and families to the 
353.11 	commissioners of administration, management and budget, and other relevant departments 
353.12 	along with the secretary of the senate, the chief clerk of the house of representatives, and 
353.13 	the chairs and ranking minority members of relevant legislative committees and divisions, 
353.14 	pursuant to Laws 2023, chapter 70, article 12, section 30, subdivision 1.
353.15 	(c) By August 1, 2025, the commissioners of human services and children, youth, and 
353.16 	families shall notify the chairs and ranking minority members of relevant legislative 
353.17 	committees and divisions and the revisor of statutes of any sections of this article or programs 
353.18 	to be transferred that are waiting for federal approval to become effective pursuant to Laws 
353.19 	2023, chapter 70, article 12, section 30, subdivision 1, paragraph (b).

353.20 	ARTICLE 15
353.21 	MINNESOTA INDIAN FAMILY PRESERVATION ACT

353.22 	Section 1. Minnesota Statutes 2022, section 259.20, subdivision 2, is amended to read:
353.23 		Subd. 2.Other applicable law. (a) Portions of chapters 245A, 245C, 257, 260, and 
353.24 	317A may also affect the adoption of a particular child.
353.25 	(b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter 21, 
353.26 	sections 1901-1923, may also and the Minnesota Indian Family Preservation Act under 
353.27 	sections 260.751 to 260.835 apply in the adoption of an Indian child, and may preempt 
353.28 	specific provisions of this chapter as described in section 259.201.
353.29 	(c) Consistent with section 245C.33 and Public Law 109-248, a completed background 
353.30 	study is required before the approval of any foster or adoptive placement in a related or an 
353.31 	unrelated home.

354.1 	Sec. 2. [259.201] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE 
354.2 	ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
354.3 	Adoption proceedings under this chapter that involve an Indian child are child custody 
354.4 	proceedings governed by the Indian Child Welfare Act, United States Code, title 25, sections 
354.5 	1901 to 1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; 
354.6 	by section 259.20, subdivision 2, paragraph (b); and by this chapter when not inconsistent 
354.7 	with the federal Indian Child Welfare Act and the Minnesota Indian Family Preservation 
354.8 	Act.

354.9 	Sec. 3. Minnesota Statutes 2023 Supplement, section 260.755, subdivision 1a, is amended 
354.10 	to read:
354.11 		Subd. 1a.Active efforts. (a) "Active efforts" means a rigorous and concerted level of 
354.12 	effort to preserve the Indian child's family that is ongoing throughout the involvement of 
354.13 	the child-placing agency to continuously involve the Indian child's Tribe and that uses the
354.14 	or the petitioner with the Indian child. Active efforts require the engagement of the Indian 
354.15 	child, the Indian child's parents, the Indian custodian, the extended family, and the Tribe in 
354.16 	using the prevailing social and cultural values, conditions, and way of life of the Indian 
354.17 	child's Tribe to: (1) preserve the Indian child's family and; (2) prevent placement of an 
354.18 	Indian child and,; (3) if placement occurs, to return the Indian child to the Indian child's 
354.19 	family at the earliest possible time; and (4) where a permanent change in parental rights or 
354.20 	custody are necessary, ensure the Indian child retains meaningful connections to the Indian 
354.21 	child's family, extended family, and Tribe.
354.22 	(b) Active efforts under section for all Indian child placements includes this section and 
354.23 	sections 260.012 and260.762and require a higher standard than reasonable efforts as defined 
354.24 	in section 260.012 to preserve the family, prevent breakup of the family, and reunify the 
354.25 	family. Active efforts include reasonable efforts as required by Title IV-E of the Social 
354.26 	Security Act, United States Code, title 42, sections 670 to 679c are required for all Indian 
354.27 	child placement proceedings and for all voluntary Indian child placements that involve a 
354.28 	child-placing agency regardless of whether the reasonable efforts would have been relieved 
354.29 	under section 260.012.

354.30 	Sec. 4. Minnesota Statutes 2022, section 260.755, subdivision 2a, is amended to read:
354.31 		Subd. 2a.Best interests of an Indian child. "Best interests of an Indian child" means 
354.32 	compliance with the federal Indian Child Welfare Act and the Minnesota Indian Family 
354.33 	Preservation Act to preserve and maintain an Indian child's family. The best interests of an 
355.1 	Indian child support the Indian child's sense of belonging to family, extended family, and 
355.2 	Tribe. The best interests of an Indian child are interwoven with the best interests of the 
355.3 	Indian child's Tribe.

355.4 	Sec. 5. Minnesota Statutes 2023 Supplement, section 260.755, subdivision 3, is amended 
355.5 	to read:
355.6 		Subd. 3.Child placement proceeding. (a) "Child placement proceeding" includes a 
355.7 	judicial proceeding which could result in:
355.8 	(1) "adoptive placement," meaning the permanent placement of an Indian child for 
355.9 	adoption, including an action resulting in a final decree of adoption;
355.10 	(2) "involuntary foster care placement," meaning an action removing an Indian child 
355.11 	from the child's parents or Indian custodian for temporary placement in a foster home, 
355.12 	institution, or the home of a guardian. The parent or Indian custodian cannot have the Indian 
355.13 	child returned upon demand, but parental rights have not been terminated;
355.14 	(3) "preadoptive placement," meaning the temporary placement of an Indian child in a 
355.15 	foster home or institution after the termination of parental rights, before or instead of adoptive 
355.16 	placement; or
355.17 	(4) "termination of parental rights," meaning an action resulting in the termination of 
355.18 	the parent-child relationship under section 260C.301.
355.19 	(b) The term child placement proceeding is a domestic relations proceeding that includes 
355.20 	all placements where Indian children are placed out-of-home or away from the care, custody, 
355.21 	and control of their parent or parents or Indian custodian that do not implicate custody 
355.22 	between the parents. Child placement proceeding also includes any placement based upon 
355.23 	juvenile status offenses, but does not include a placement based upon an act which if 
355.24 	committed by an adult would be deemed a crime, or upon an award of custody in a divorce 
355.25 	proceeding to one of the parents.

355.26 	Sec. 6. Minnesota Statutes 2023 Supplement, section 260.755, subdivision 3a, is amended 
355.27 	to read:
355.28 		Subd. 3a.Child-placing agency. "Child-placing agency" means a public, private, or 
355.29 	nonprofit legal entity: (1) providing assistance to a an Indian child and the Indian child's 
355.30 	parent or parents or Indian custodian; or (2) placing a an Indian child in foster care or for 
355.31 	adoption on a voluntary or involuntary basis.

356.1 	Sec. 7. Minnesota Statutes 2022, section 260.755, subdivision 5, is amended to read:
356.2 		Subd. 5.Demand. "Demand" means a written and notarized statement signed by a parent 
356.3 	or Indian custodian of a an Indian child which requests the return of the Indian child who 
356.4 	has been voluntarily placed in foster care.

356.5 	Sec. 8. Minnesota Statutes 2023 Supplement, section 260.755, subdivision 5b, is amended 
356.6 	to read:
356.7 		Subd. 5b.Extended family member. "Extended family member" is as defined by the 
356.8 	law or custom of the Indian child's Tribe or, in the absence of any law or custom of the 
356.9 	Tribe, is a person who has reached the age of 18 and who is the Indian child's grandparent, 
356.10 	aunt or uncle, brother or sister, brother-in-law or sister-in-law, niece or nephew, first or 
356.11 	second cousin, or stepparent. For the purposes of provision of active efforts and foster care 
356.12 	and permanency placement decisions, the legal parent, guardian, or custodian of the Indian 
356.13 	child's sibling is not an extended family member or relative of an Indian child unless they 
356.14 	are independently related to the Indian child or recognized by the Indian child's Tribe as an 
356.15 	extended family member.

356.16 	Sec. 9. Minnesota Statutes 2022, section 260.755, subdivision 14, is amended to read:
356.17 		Subd. 14.Parent. "Parent" means the biological parent of an Indian child, or any Indian
356.18 	person who has lawfully adopted an Indian child, including a person who has adopted a an 
356.19 	Indian child by Tribal law or custom. Parent includes a father as defined by Tribal law or 
356.20 	custom. Parent does not include an unmarried father whose paternity has not been 
356.21 	acknowledged or established. Paternity has been acknowledged when an unmarried father 
356.22 	takes any action to hold himself out as the biological father of an Indian child.

356.23 	Sec. 10. Minnesota Statutes 2022, section 260.755, is amended by adding a subdivision 
356.24 	to read:
356.25 		Subd. 15a.Petitioner. "Petitioner" means one or more individuals other than a parent 
356.26 	or Indian custodian who has filed a petition or motion seeking a grant of temporary or 
356.27 	permanent guardianship, custody, or adoption of an Indian child.

356.28 	Sec. 11. Minnesota Statutes 2022, section 260.755, subdivision 17a, is amended to read:
356.29 		Subd. 17a.Qualified expert witness. "Qualified expert witness" means an individual 
356.30 	who (1) has specific knowledge of the Indian child's tribe's culture and customs, or meets 
356.31 	the criteria in section 260.771, subdivision 6, paragraph (d), and (2) provides testimony as 
357.1 	required by the Indian Child Welfare Act of 1978, United States Code, title 25, section 
357.2 	1912, and the Minnesota Indian Family Preservation Act, regarding out-of-home placement 
357.3 	or termination of parental rights child placement or permanency proceedings relating to an 
357.4 	Indian child.

357.5 	Sec. 12. Minnesota Statutes 2023 Supplement, section 260.755, subdivision 20, is amended 
357.6 	to read:
357.7 		Subd. 20.Tribal court. "Tribal court" means a court with jurisdiction over child custody 
357.8 	proceedings and which is either a court of Indian offenses, or a court established and operated 
357.9 	under the code or custom of an Indian Tribe, or any other administrative body of a Tribe 
357.10 	which is vested with authority over child custody proceedings.

357.11 	Sec. 13. Minnesota Statutes 2022, section 260.755, is amended by adding a subdivision 
357.12 	to read:
357.13 		Subd. 20a.Tribal representative. "Tribal representative" means a representative 
357.14 	designated by and acting on behalf of a Tribe in connection with an Indian child placement 
357.15 	proceeding as defined in subdivision 3.  It is not required that the designated representative 
357.16 	be an attorney to represent the Tribe in these matters.  An individual appearing as a Tribal 
357.17 	representative on behalf of a Tribe and participating in a court proceeding under this chapter 
357.18 	is not engaged in the unauthorized practice of law.

357.19 	Sec. 14. Minnesota Statutes 2023 Supplement, section 260.755, subdivision 22, is amended 
357.20 	to read:
357.21 		Subd. 22.Voluntary foster care placement. "Voluntary foster care placement" means 
357.22 	a decision in which there has been participation by a child-placing agency resulting in the 
357.23 	temporary placement of an Indian child away from the home of the Indian child's parents 
357.24 	or Indian custodian in a foster home, institution, or the home of a guardian, and the parent 
357.25 	or Indian custodian may have the Indian child returned upon demand.

357.26 	Sec. 15. Minnesota Statutes 2023 Supplement, section 260.758, subdivision 2, is amended 
357.27 	to read:
357.28 		Subd. 2.Temporary emergency jurisdiction of state courts. (a) The child-placing 
357.29 	agency, petitioner, or court shall ensure that the emergency removal or placement terminates 
357.30 	immediately when removal or placement is no longer necessary to prevent imminent physical 
357.31 	damage or harm to the Indian child. The child-placing agency, petitioner, or court shall 
358.1 	expeditiously initiate a child placement proceeding subject to the provisions of sections 
358.2 	260.751 to 260.835, transfer the Indian child to the jurisdiction of the appropriate Indian 
358.3 	Tribe, or return the Indian child to the Indian child's parent or Indian custodian as may be 
358.4 	appropriate.
358.5 	(b) If the Indian child is a resident of or is domiciled on a reservation but temporarily 
358.6 	located off the reservation, a court of this state has only temporary emergency jurisdiction 
358.7 	until the Indian child is transferred to the jurisdiction of the appropriate Indian Tribe unless 
358.8 	the Indian child's Tribe has expressly declined to exercise its jurisdiction, or the Indian child 
358.9 	is returned to the Indian child's parent or Indian custodian.

358.10 	Sec. 16. Minnesota Statutes 2023 Supplement, section 260.758, subdivision 4, is amended 
358.11 	to read:
358.12 		Subd. 4.Emergency proceeding requirements. (a) The court shall hold a hearing no 
358.13 	later than 72 hours, excluding weekends and holidays, after the emergency removal of the 
358.14 	Indian child. The court shall determine whether the emergency removal continues to be 
358.15 	necessary to prevent imminent physical damage or harm to the Indian child.
358.16 	(b) The court shall hold additional hearings whenever new information indicates that 
358.17 	the emergency situation has ended and must determine at any court hearing during the 
358.18 	emergency proceeding to determine whether the emergency removal or placement is no 
358.19 	longer necessary to prevent imminent physical damage or harm to the Indian child.

358.20 	Sec. 17. Minnesota Statutes 2023 Supplement, section 260.758, subdivision 5, is amended 
358.21 	to read:
358.22 		Subd. 5.Termination of emergency removal or placement. (a) An emergency removal 
358.23 	or placement of an Indian child must immediately terminate once the child-placing agency 
358.24 	or court possesses sufficient evidence to determine that the emergency removal or placement 
358.25 	is no longer necessary to prevent imminent physical damage or harm to the Indian child 
358.26 	and the Indian child shall be immediately returned to the custody of the Indian child's parent 
358.27 	or Indian custodian.
358.28 	(b) An emergency removal or placement ends when the Indian child is transferred to 
358.29 	the jurisdiction of the Indian child's Tribe, or when the court orders, after service upon the 
358.30 	Indian child's parents, Indian custodian, and Indian child's Tribe, that placement of the 
358.31 	Indian child shall be placed in foster care upon a determination supported by clear and 
358.32 	convincing evidence, including testimony by a qualified expert witness, that custody of the 
359.1 	Indian child by the Indian child's parent or Indian custodian is likely to result in serious 
359.2 	emotional or physical damage to the Indian child.
359.3 	(c) In no instance shall emergency removal or emergency placement of an Indian child 
359.4 	extend beyond 30 days unless the court finds by a showing of clear and convincing evidence 
359.5 	that: (1) continued emergency removal or placement is necessary to prevent imminent 
359.6 	physical damage or harm to the Indian child; (2) the court has been unable to transfer the 
359.7 	proceeding to the jurisdiction of the Indian child's Tribal court; and (3) it has not been 
359.8 	possible to initiate a child placement proceeding with all of the protections under sections 
359.9 	260.751 to 260.835, including obtaining the testimony of a qualified expert witness.

359.10 	Sec. 18. Minnesota Statutes 2023 Supplement, section 260.761, is amended to read:
359.11 	260.761 INQUIRY OF TRIBAL LINEAGE; NOTICE TO TRIBES, PARENTS, 
359.12 	AND INDIAN CUSTODIANS; ACCESS TO FILES.
359.13 		Subdivision 1.Inquiry of Tribal lineage. (a) The child-placing agency or individual
359.14 	petitioner shall inquire of the child, the child's parents and custodians, and other appropriate 
359.15 	persons whether there is any reason to believe that a child brought to the agency's attention 
359.16 	may have lineage to an Indian Tribe. This inquiry shall occur at the time the child comes 
359.17 	to the attention of the child-placing agency or individual petitioner and shall continue 
359.18 	throughout the involvement of the child-placing agency or individual petitioner.
359.19 	(b) In any child placement proceeding, the court shall inquire of the child, the child's 
359.20 	parents, custodian, and any person participating in the proceedings whether the child has 
359.21 	any American Indian heritage or lineage to an Indian Tribe. The inquiry shall be made at 
359.22 	the commencement of the proceeding and all responses must be on the record. The court 
359.23 	must instruct the parties to inform the court if they subsequently receive information that 
359.24 	provides reason to believe the child is an Indian child.
359.25 	(c) If there is reason to believe the child is an Indian child, but the court does not have 
359.26 	sufficient evidence to determine whether the child is an Indian child, the court shall:
359.27 	(1) confirm with a report, declaration, or testimony in the record that the child-placing 
359.28 	agency or petitioner used due diligence to identify and work with all of the Tribes for which 
359.29 	there is reason to believe the child may be a member of or eligible for membership to verify 
359.30 	whether the child is an Indian child; and
359.31 	(2) proceed with the case as if the child is an Indian child until it is determined on the 
359.32 	record that the child does not meet the definition of Indian child.
360.1 		Subd. 2.Notice to Tribes of services or court proceedings involving an Indian 
360.2 	child. (a) When a child-placing agency or petitioner has information that a family assessment, 
360.3 	investigation, or noncaregiver sex trafficking assessment being conducted may involve an 
360.4 	Indian child, the child-placing agency or petitioner shall notify the Indian child's Tribe of 
360.5 	the family assessment, investigation, or noncaregiver sex trafficking assessment according 
360.6 	to section 260E.18. The child-placing agency or petitioner shall provide initial notice by 
360.7 	telephone and by email or facsimile and shall include the child's full name and date of birth; 
360.8 	the full names and dates of birth of the child's biological parents; and if known the full 
360.9 	names and dates of birth of the child's grandparents and of the child's Indian custodian. If 
360.10 	information regarding the child's grandparents or Indian custodian is not immediately 
360.11 	available, the child-placing agency or petitioner shall continue to request this information 
360.12 	and shall notify the Tribe when it is received. Notice shall be provided to all Tribes to which 
360.13 	the child may have any Tribal lineage. The child-placing agency or petitioner shall request 
360.14 	that the Tribe or a designated Tribal representative participate in evaluating the family 
360.15 	circumstances, identifying family and Tribal community resources, and developing case 
360.16 	plans. The child-placing agency or petitioner shall continue to include the Tribe in service 
360.17 	planning and updates as to the progress of the case.
360.18 	(b) When a child-placing agency or petitioner has information that a child receiving 
360.19 	services may be an Indian child, the child-placing agency or petitioner shall notify the Tribe 
360.20 	by telephone and by email or facsimile of the child's full name and date of birth, the full 
360.21 	names and dates of birth of the child's biological parents, and, if known, the full names and 
360.22 	dates of birth of the child's grandparents and of the child's Indian custodian. This notification 
360.23 	must be provided for the Tribe to determine if the child is a member or eligible for Tribal 
360.24 	membership, and the child-placing agency or petitioner must provide this notification to 
360.25 	the Tribe within seven days of receiving information that the child may be an Indian child. 
360.26 	If information regarding the child's grandparents or Indian custodian is not available within 
360.27 	the seven-day period, the child-placing agency or petitioner shall continue to request this 
360.28 	information and shall notify the Tribe when it is received. Notice shall be provided to all 
360.29 	Tribes to which the child may have any Tribal lineage.
360.30 	(c) In all child placement proceedings, when a court has reason to believe that a child 
360.31 	placed in emergency protective care is an Indian child, the court administrator or a designee 
360.32 	shall, as soon as possible and before a hearing takes place, notify the Tribal social services 
360.33 	agency by telephone and by email or facsimile of the date, time, and location of the 
360.34 	emergency protective care or other initial hearing. The court shall make efforts to allow 
360.35 	appearances by telephone or video conference for Tribal representatives, parents, and Indian 
361.1 	custodians allow appearances by telephone, video conference, or other electronic medium 
361.2 	for Tribal representatives, the Indian child's parents, or the Indian custodian.
361.3 	(d) In all child placement proceedings, except for adoptive or preadoptive placement 
361.4 	proceedings, when a court has reason to believe the child is an Indian child, the child-placing 
361.5 	agency or individual petitioner shall effect service of any petition governed by sections 
361.6 	260.751 to 260.835 provide notice of the proceedings and a copy of any petition to the 
361.7 	Indian child's parents, Indian custodian, and the Indian child's Tribe and shall effect service 
361.8 	of any notice and petition governed by sections 260.751 to 260.835 upon the parent, Indian 
361.9 	custodian, and the Indian child's Tribe by certified mail or registered mail, return receipt 
361.10 	requested upon the Indian child's parents, Indian custodian, and Indian child's Tribe at least 
361.11 	10 days before the admit-deny hearing is held. If the identity or location of the Indian child's 
361.12 	parents or Indian custodian and or Tribe cannot be determined, the child-placing agency or 
361.13 	petitioner shall provide the notice required in this paragraph to the United States Secretary 
361.14 	of the Interior, Bureau of Indian Affairs by certified or registered mail, return receipt 
361.15 	requested. Where service is only accomplished through the United States Secretary of the 
361.16 	Interior, Bureau of Indian Affairs, the initial hearing shall not be held until 20 days after 
361.17 	notice upon the Tribe or the Secretary of the Interior.
361.18 	(e) Notice under this subdivision must be in clear and understandable language and 
361.19 	include the following:
361.20 	(1) the child's name, date of birth, and birth place;
361.21 	(2) all names known for the parents and Indian custodian, including maiden, married, 
361.22 	former names, and aliases, correctly spelled;
361.23 	(3) the dates of birth, birth place, and Tribal enrollment numbers of the Indian child, the 
361.24 	Indian child's parents, and the Indian custodian, if known;
361.25 	(4) the full names, dates of birth, birth places, and Tribal enrollment or affiliation 
361.26 	information of direct lineal ancestors of the child, other extended family members, and 
361.27 	custodians of the child, if known;
361.28 	(5) the name of any and all Indian Tribes in which the child is or may be a member or 
361.29 	eligible for membership in; and
361.30 	(6) statements setting out:
361.31 	(i) the name of the petitioner and name and address of the petitioner's attorney;
361.32 	(ii) the right of any parent or Indian custodian of the Indian child, to intervene in the 
361.33 	child placement proceedings, if not already a party;
362.1 	(iii) the right of the Indian child's Tribe to intervene in the proceedings at any time;
362.2 	(iv) the right of the Indian child, the Indian child's parent, and the Indian custodian to 
362.3 	court-appointed counsel if they meet the requirements in section 611.17;
362.4 	(v) the right to be granted, upon request, up to 20 additional days to prepare for the 
362.5 	child-placement proceedings;
362.6 	(vi) the right of the Indian child's parent, the Indian custodian, and the Indian child's 
362.7 	Tribe to petition the court for transfer of the proceedings to Tribal court;
362.8 	(vii) the mailing addresses and telephone numbers of the court and information related 
362.9 	to all parental and custodial rights of the parent or Indian custodian; and
362.10 	(viii) that all parties must maintain confidentiality of all information contained in the 
362.11 	notice and must not provide the information to anyone other than their attorney.
362.12 	(e) (f) A Tribe, the Indian child's parents, or the Indian custodian may request up to 20 
362.13 	additional days to prepare for the admit-deny initial hearing. The court shall allow 
362.14 	appearances by telephone, video conference, or other electronic medium for Tribal 
362.15 	representatives, the Indian child's parents, or the Indian custodian.
362.16 	(f) (g) A child-placing agency or individual petitioner must provide the notices required 
362.17 	under this subdivision at the earliest possible time to facilitate involvement of the Indian 
362.18 	child's Tribe. Nothing in this subdivision is intended to hinder the ability of the child-placing 
362.19 	agency, individual petitioner, and the court to respond to an emergency situation. Lack of 
362.20 	participation by a Tribe shall not prevent the Tribe from intervening in services and 
362.21 	proceedings at a later date. A Tribe may participate in a case at any time. At any stage of 
362.22 	the child-placing agency's agency or petitioner's involvement with an Indian child, the 
362.23 	child-placing agency or petitioner shall provide full cooperation to the Tribal social services 
362.24 	agency, including disclosure of all data concerning the Indian child. Nothing in this 
362.25 	subdivision relieves the child-placing agency or petitioner of satisfying the notice 
362.26 	requirements in state or federal law.
362.27 	(h) The court shall allow appearances by telephone, video conference, or other electronic 
362.28 	means for Tribal representatives at all hearings and trials. The court shall allow appearances 
362.29 	by telephone, video conference, or other electronic means for the Indian child's parents or 
362.30 	Indian custodian for all hearings, except that the court may require an in-person appearance 
362.31 	for trials or other evidentiary or contested hearings.
362.32 		Subd. 3.Notice of potential preadoptive or adoptive placement. In any adoptive or 
362.33 	preadoptive placement proceeding, including voluntary proceedings, where any party or 
363.1 	participant has reason to believe that a child who is the subject of an adoptive or preadoptive 
363.2 	placement proceeding is or may be an "Indian child," as defined in section 260.755, 
363.3 	subdivision 8, and United States Code, title 25, section 1903(4), the child-placing agency 
363.4 	or individual petitioner shall notify the Indian child's Tribe by registered mail or certified 
363.5 	mail with return receipt requested of the pending proceeding and of the right of intervention 
363.6 	under subdivision 6. If the identity or location of the Indian child's Tribe cannot be 
363.7 	determined, the notice must be given to the United States Secretary of Interior in like manner. 
363.8 	No preadoptive or adoptive placement proceeding may be held until at least 20 days after 
363.9 	receipt of the notice by the Tribe or the secretary. Upon request, the Tribe must be granted 
363.10 	up to 20 additional days to prepare for the proceeding. The child-placing agency or individual
363.11 	petitioner shall include in the notice the identity of the birth parents and Indian child absent 
363.12 	written objection by the birth parents. The child-placing agency or petitioner shall inform 
363.13 	the birth parents of the Indian child of any services available to the Indian child through the 
363.14 	child's Tribal social services agency, including child placement services, and shall 
363.15 	additionally provide the birth parents of the Indian child with all information sent from the 
363.16 	Tribal social services agency in response to the notice.
363.17 		Subd. 4.Unknown father. If the child-placing agency, individual petitioner, the court, 
363.18 	or any party has reason to believe that a child who is the subject of a child placement 
363.19 	proceeding is or may be an Indian child but the father of the child is unknown and has not 
363.20 	registered with the fathers' adoption registry pursuant to section 259.52, the child-placing 
363.21 	agency or individual petitioner shall provide to the Tribe believed to be the Indian child's 
363.22 	Tribe information sufficient to enable the Tribe to determine the child's eligibility for 
363.23 	membership in the Tribe, including, but not limited to, the legal and maiden name of the 
363.24 	birth mother, her date of birth, the names and dates of birth of her parents and grandparents, 
363.25 	and, if available, information pertaining to the possible identity, Tribal affiliation, or location 
363.26 	of the birth father. If the identity or location of the Indian child's Tribe cannot be determined, 
363.27 	the notice must be given to the United States Secretary of Interior in like manner.
363.28 		Subd. 5.Proof of service of notice upon Tribe or secretary. In cases where a 
363.29 	child-placing agency or party to an adoptive placement knows or has reason to believe that 
363.30 	a child is or may be an Indian child, proof of service upon the Indian child's Tribe or the 
363.31 	secretary of interior must be filed with the adoption petition.
363.32 		Subd. 6.Indian Tribe's right of intervention. In any child placement proceeding under 
363.33 	sections 260.751 to 260.835, the Indian child's Tribe shall have a right to intervene at any 
363.34 	point in the proceeding.
364.1 		Subd. 6a.Indian Tribe's access to files. At any stage of the child-placing agency's
364.2 	agency or petitioner's involvement with an Indian child, the child-placing agency or petitioner 
364.3 	shall, upon request, give the Tribal social services agency full cooperation including access 
364.4 	to all files concerning the Indian child. If the files contain confidential or private data, the 
364.5 	child-placing agency or petitioner may require execution of an agreement with the Tribal 
364.6 	social services agency to maintain the data according to statutory provisions applicable to 
364.7 	the data.

364.8 	Sec. 19. Minnesota Statutes 2023 Supplement, section 260.762, is amended to read:
364.9 	260.762 DUTY TO PREVENT OUT-OF-HOME CHILD PLACEMENT, 
364.10 	PRESERVE THE CHILD'S FAMILY, AND PROMOTE FAMILY REUNIFICATION; 
364.11 	ACTIVE EFFORTS.
364.12 		Subdivision 1.Active efforts. Active efforts includes acknowledging traditional helping 
364.13 	and healing systems of an Indian child's Tribe and using these systems as the core to help 
364.14 	and heal the Indian child and family regardless of whether the Indian child's Tribe has 
364.15 	intervened in the proceedings. Active efforts are not required to prevent voluntary 
364.16 	out-of-home placement and to effect voluntary permanency for the Indian child.
364.17 		Subd. 2.Requirements for child-placing agencies and individual petitioners. A 
364.18 	child-placing agency or individual petitioner shall:
364.19 	(1) work with the Indian child's Tribe and family to develop an alternative plan to 
364.20 	out-of-home placement;
364.21 	(2) before making a decision that may affect an Indian child's safety and well-being or 
364.22 	when contemplating out-of-home placement of an Indian child, seek guidance from the 
364.23 	Indian child's Tribe on family structure, how the family can seek help, what family and 
364.24 	Tribal resources are available, and what barriers the family faces at that time that could 
364.25 	threaten its preservation; and
364.26 	(3) request participation of the Indian child's Tribe at the earliest possible time and 
364.27 	request the Tribe's active participation throughout the case.
364.28 		Subd. 2a.Required findings that active efforts were provided. (a) A court shall not 
364.29 	order a child placement, termination of parental rights, guardianship to the commissioner 
364.30 	of human services under section 260C.325, or temporary or permanent change in custody 
364.31 	of an Indian child unless the court finds that the child-placing agency or petitioner 
364.32 	demonstrated that active efforts were made to preserve the Indian child's family. Active 
364.33 	efforts to preserve the Indian child's family include efforts to prevent placement of the Indian 
365.1 	child to correct the conditions that led to the placement by ensuring remedial services and 
365.2 	rehabilitative programs designed to prevent the breakup of the family were provided in a 
365.3 	manner consistent with the prevailing social and cultural conditions of the Indian child's 
365.4 	Tribe and in partnership with the Indian child, the Indian child's parents, the Indian custodian, 
365.5 	extended family members, and Tribe, and that these efforts have proved unsuccessful.
365.6 	(b) The court, in determining whether active efforts were made to preserve the Indian 
365.7 	child's family for purposes of child placement or permanency, shall ensure the provision of 
365.8 	active efforts designed to correct the conditions that led to the placement of the Indian child 
365.9 	and shall make findings regarding whether the following activities were appropriate and 
365.10 	necessary, and whether the child-placing agency or petitioner ensured appropriate and 
365.11 	meaningful services were available based upon the family's specific needs, whether listed 
365.12 	in this paragraph or not:
365.13 	(1) whether active efforts were made at the earliest point possible to inquire into the 
365.14 	child's heritage, to identify any federally recognized Indian Tribe the child may be affiliated 
365.15 	with, to notify all potential Tribes at the earliest point possible, and to request participation 
365.16 	of the Indian child's Tribe;
365.17 	(2) whether a Tribally designated representative with substantial knowledge of the 
365.18 	prevailing social and cultural standards and child-rearing practices within the Tribal 
365.19 	community was provided an opportunity to consult with and be involved in any investigations 
365.20 	or assessments of the family's circumstances, participate in identifying the family's needs, 
365.21 	and participate in development of any plan to keep the Indian child safely in the home, 
365.22 	identify services designed to prevent the breakup of the Indian child's family, and to reunify 
365.23 	the Indian child's family as soon as safety can be assured if out-of-home placement has 
365.24 	occurred;
365.25 	(3) whether the Tribal representative was provided with all information available 
365.26 	regarding the proceeding, and whether it was requested that the Tribal representative assist 
365.27 	in identifying services designed to prevent the breakup of the Indian child's family and to 
365.28 	reunify the Indian child's family as soon as safety can be assured if out-of-home placement 
365.29 	has occurred;
365.30 	(4) whether, before making a decision that may affect an Indian child's safety and 
365.31 	well-being or when contemplating placement of an Indian child, guidance from the Indian 
365.32 	child's Tribe was sought regarding family structure, how the family can seek help, what 
365.33 	family and Tribal resources are available, and what barriers the family faces that could 
365.34 	threaten the family's preservation;
366.1 	(5) whether a Tribal representative was consulted to determine and arrange for visitation 
366.2 	in the most natural setting that ensures the Indian child's safety, when the Indian child's 
366.3 	safety requires supervised visitation;
366.4 	(6) whether early and ongoing efforts occurred to identify, locate, and include extended 
366.5 	family members as supports for the Indian child and the Indian child's family;
366.6 	(7) whether continued active efforts were made to identify and place the Indian child in 
366.7 	a home that is compliant with the placement preferences in sections 260.751 to 260.835, 
366.8 	including whether extended family members were consulted to provide support to the Indian 
366.9 	child and Indian child's parents; to inform the child-placing agency, petitioner, and court 
366.10 	as to cultural connections and family structure; to assist in identifying appropriate cultural 
366.11 	services and supports for the Indian child and Indian child's parents; and to identify and 
366.12 	serve as placement and permanency resources for the Indian child.  If there was difficulty 
366.13 	contacting or engaging extended family members, whether assistance was sought from the 
366.14 	Tribe, the Department of Human Services, or other agencies with expertise in working with 
366.15 	Indian families;
366.16 	(8) whether services and resources were provided to extended family members who are 
366.17 	considered the primary placement option for an Indian child, as agreed upon by the 
366.18 	child-placing agency or petitioner and the Tribe, to overcome licensing and other barriers 
366.19 	to providing care to an Indian child. The need for services or resources shall not be a basis 
366.20 	to exclude an extended family member from consideration as a primary placement. Services 
366.21 	and resources include but are not limited to child care assistance, financial assistance, 
366.22 	housing resources, emergency resources, and foster care licensing assistance and resources;
366.23 	(9) whether concrete services and access to both Tribal and non-Tribal services were 
366.24 	provided to the Indian child's parents and Indian custodian and, where necessary, members 
366.25 	of the Indian child's extended family members who provide support to the Indian child and 
366.26 	the Indian child's parents; and whether these services were provided in an ongoing manner 
366.27 	throughout the child-placing agency or petitioner's involvement with the Indian family to 
366.28 	directly assist the Indian family in accessing and utilizing services to maintain the Indian 
366.29 	family, or to reunify the Indian family as soon as safety can be assured if out-of-home 
366.30 	placement has occurred. Services include but are not limited to financial assistance, food, 
366.31 	housing, health care, transportation, in-home services, community support services, and 
366.32 	specialized services; and
366.33 	(10) whether visitation occurred whenever possible in the home of the Indian child's 
366.34 	parent, Indian custodian, or extended family member or in another noninstitutional setting 
367.1 	in order to keep the Indian child in close contact with the Indian child's parents, siblings, 
367.2 	and other relatives regardless of the Indian child's age and to allow the Indian child and 
367.3 	those with whom the Indian child visits to have natural, unsupervised interaction when 
367.4 	consistent with protecting the child's safety.
367.5 		Subd. 2b.Adoptions. For adoptions under chapter 259, the court may find that active 
367.6 	efforts were made to prevent placement of an Indian child or to reunify the Indian child 
367.7 	with the Indian child's parents upon a finding that: (1) subdivision 2a, paragraph (b), clauses 
367.8 	(1) to (4), were met; (2) the Indian child's parent knowingly and voluntarily consented to 
367.9 	placement of the Indian child for adoption on the record as described in section 260.765, 
367.10 	subdivision 3a; (3) fraud was not present, and the Indian child's parent was not under duress; 
367.11 	(4) the Indian child's parent was offered and declined services that would enable the Indian 
367.12 	child's parent to maintain custody of the Indian child; and (5) the Indian child's parent was 
367.13 	counseled on alternatives to adoption, and adoption contact agreements.
367.14 		Subd. 3.Required findings that active efforts were provided. (a) Any party seeking 
367.15 	to affect a termination of parental rights, other permanency action, or a placement where 
367.16 	custody of an Indian child may be temporarily or permanently transferred to a person or 
367.17 	entity who is not the Indian child's parent or Indian custodian, and where the Indian child's 
367.18 	parent or Indian custodian cannot have the Indian child returned to their care upon demand, 
367.19 	must satisfy the court that active efforts have been made to provide remedial services and 
367.20 	rehabilitative programs designed to prevent the breakup of the Indian family and that these 
367.21 	efforts have proved unsuccessful.
367.22 	(b) A court shall not order an out-of-home or permanency placement for an Indian child 
367.23 	unless the court finds that the child-placing agency made active efforts to, as required by 
367.24 	section 260.012 and this section, provide remedial services and rehabilitative programs 
367.25 	designed to prevent the breakup of the Indian child's family, and that these efforts have 
367.26 	proved unsuccessful. To the extent possible, active efforts must be provided in a manner 
367.27 	consistent with the prevailing social and cultural conditions of the Indian child's Tribe and 
367.28 	in partnership with the Indian child, Indian parents, extended family, and Tribe.
367.29 	(c) Regardless of whether the Indian child's Tribe has intervened in the proceedings, the 
367.30 	court, in determining whether the child-placing agency made active efforts to preserve the 
367.31 	Indian child's family for purposes of out-of-home placement and permanency, shall ensure 
367.32 	the provision of active efforts designed to correct the conditions that led to the out-of-home 
367.33 	placement of the Indian child and shall make findings regarding whether the following 
367.34 	activities were appropriate and necessary, and whether the child-placing agency made 
368.1 	appropriate and meaningful services, whether listed in this paragraph or not, available to 
368.2 	the family based upon that family's specific needs:
368.3 	(1) whether the child-placing agency made efforts at the earliest point possible to (i) 
368.4 	identify whether a child may be an Indian child as defined in section 260.755, subdivision 
368.5 	8; and (ii) identify and request participation of the Indian child's Tribe at the earliest point 
368.6 	possible and throughout the investigation or assessment, case planning, provision of services, 
368.7 	and case completion;
368.8 	(2) whether the child-placing agency requested that a Tribally designated representative 
368.9 	with substantial knowledge of prevailing social and cultural standards and child-rearing 
368.10 	practices within the Tribal community evaluate the circumstances of the Indian child's 
368.11 	family, provided the Tribally designated representative with all information available 
368.12 	regarding the case, and requested that the Tribally designated representative assist in 
368.13 	developing a case plan that uses Tribal and Indian community resources;
368.14 	(3) whether the child-placing agency provided concrete services and access to both 
368.15 	Tribal and non-Tribal services to members of the Indian child's family, including but not 
368.16 	limited to financial assistance, food, housing, health care, transportation, in-home services, 
368.17 	community support services, and specialized services; and whether these services are being 
368.18 	provided in an ongoing manner throughout the agency's involvement with the family, to 
368.19 	directly assist the family in accessing and utilizing services to maintain the Indian family, 
368.20 	or reunify the Indian family as soon as safety can be assured if out-of-home placement has 
368.21 	occurred;
368.22 	(4) whether the child-placing agency made early and ongoing efforts to identify, locate, 
368.23 	and include extended family members;
368.24 	(5) whether the child-placing agency notified and consulted with the Indian child's 
368.25 	extended family members, as identified by the child, the child's parents, or the Tribe; whether 
368.26 	extended family members were consulted to provide support to the child and parents, to 
368.27 	inform the child-placing agency and court as to cultural connections and family structure, 
368.28 	to assist in identifying appropriate cultural services and supports for the child and parents, 
368.29 	and to identify and serve as a placement and permanency resource for the child; and if there 
368.30 	was difficulty contacting or engaging with extended family members, whether assistance 
368.31 	was sought from the Tribe, the Department of Human Services, or other agencies with 
368.32 	expertise in working with Indian families;
368.33 	(6) whether the child-placing agency provided services and resources to relatives who 
368.34 	are considered the primary placement option for an Indian child, as agreed by the 
369.1 	child-placing agency and the Tribe, to overcome barriers to providing care to an Indian 
369.2 	child. Services and resources shall include but are not limited to child care assistance, 
369.3 	financial assistance, housing resources, emergency resources, and foster care licensing 
369.4 	assistance and resources; and
369.5 	(7) whether the child-placing agency arranged for visitation to occur, whenever possible, 
369.6 	in the home of the Indian child's parent, Indian custodian, or other family member or in 
369.7 	another noninstitutional setting, in order to keep the child in close contact with parents, 
369.8 	siblings, and other relatives regardless of the child's age and to allow the child and those 
369.9 	with whom the child visits to have natural, unsupervised interaction when consistent with 
369.10 	protecting the child's safety; and whether the child-placing agency consulted with a Tribal 
369.11 	representative to determine and arrange for visitation in the most natural setting that ensures 
369.12 	the child's safety, when the child's safety requires supervised visitation.

369.13 	Sec. 20. Minnesota Statutes 2023 Supplement, section 260.763, subdivision 1, is amended 
369.14 	to read:
369.15 		Subdivision 1.Indian Tribe jurisdiction. (a) An Indian Tribe has exclusive jurisdiction 
369.16 	over all child placement proceedings involving an Indian child who resides or is domiciled 
369.17 	within the reservation of the Tribe, except where jurisdiction is otherwise vested in the state 
369.18 	by existing federal law. The child-placing agencies and the courts shall defer to a Tribal 
369.19 	determination of the Tribe's exclusive jurisdiction when an Indian child resides or is 
369.20 	domiciled within the reservation of the Tribe.
369.21 	(b) Where an Indian child is a ward of the Tribal court, the Indian Tribe retains exclusive 
369.22 	jurisdiction, notwithstanding the residence or domicile of the child unless the Tribe agrees 
369.23 	to allow concurrent jurisdiction with the state.
369.24 	(c) An Indian Tribe and the state of Minnesota share concurrent jurisdiction over a child 
369.25 	placement proceeding involving an Indian child who resides or is domiciled outside of the 
369.26 	reservation of the Tribe, or if the Tribe agrees to concurrent jurisdiction.

369.27 	Sec. 21. Minnesota Statutes 2023 Supplement, section 260.763, subdivision 4, is amended 
369.28 	to read:
369.29 		Subd. 4.Transfer of proceedings.  In any child placement proceeding, upon a motion 
369.30 	or request by the Indian child's parent, Indian custodian, or Tribe, the court, in the absence 
369.31 	of good cause to the contrary, shall transfer the proceeding to the jurisdiction of the Tribe 
369.32 	absent objection by either of the Indian child's parent or the Indian custodian. The petition
369.33 	motion or request to transfer may be filed made by the Indian child's parent, the Indian 
370.1 	custodian, or the Indian child's Tribe at any stage in the proceedings by: (1) filing a written 
370.2 	motion with the court and serving the motion upon the other parties; or (2) making a request 
370.3 	on the record during the hearing, which shall be reflected in the court's findings. A request 
370.4 	or motion to transfer made by a Tribal representative of the Indian child's Tribe under this 
370.5 	subdivision shall not be considered the unauthorized practice of law. The transfer is subject 
370.6 	to declination by the Tribal court of the Tribe.

370.7 	Sec. 22. Minnesota Statutes 2023 Supplement, section 260.763, subdivision 5, is amended 
370.8 	to read:
370.9 		Subd. 5.Good cause to deny transfer. (a) Establishing good cause to deny transfer of 
370.10 	jurisdiction to a Tribal court is a fact-specific inquiry to be determined on a case-by-case 
370.11 	basis. Socioeconomic conditions and the perceived adequacy of Tribal or Bureau of Indian 
370.12 	Affairs social services or judicial systems must not be considered in a determination that 
370.13 	good cause exists. The party opposed to transfer of jurisdiction to a Tribal court has the 
370.14 	burden to prove by clear and convincing evidence that good cause to deny transfer exists. 
370.15 	Opposition to a motion to transfer jurisdiction to Tribal court must be in writing and must 
370.16 	be served upon all parties.
370.17 	(b) Upon a motion or request by an Indian child's parent, Indian custodian, or Tribe, the 
370.18 	court may find good cause to deny transfer to Tribal court if shall transfer jurisdiction to a 
370.19 	Tribal court unless the court determines that there is good cause to deny transfer based on 
370.20 	the following:
370.21 	(1) the Indian child's Tribe does not have a Tribal court or any other administrative body 
370.22 	of a Tribe vested with authority over child placement proceedings, as defined in section 
370.23 	260.755, subdivision 3, to which the case can be transferred, and no other Tribal court has 
370.24 	been designated by the Indian child's Tribe; or
370.25 	(2) the evidence necessary to decide the case could not be adequately presented in the 
370.26 	Tribal court without undue hardship to the parties or the witnesses and the Tribal court is 
370.27 	unable to mitigate the hardship by any means permitted in the Tribal court's rules. Without 
370.28 	evidence of undue hardship, travel distance alone is not a basis for denying a transfer.

370.29 	Sec. 23. Minnesota Statutes 2023 Supplement, section 260.765, subdivision 2, is amended 
370.30 	to read:
370.31 		Subd. 2.Notice. When an Indian child is voluntarily placed in foster care out of the care 
370.32 	of the Indian child's parent or Indian custodian, the child-placing agency involved in the 
370.33 	decision to place the Indian child shall give notice as described in section 260.761 of the 
371.1 	placement to the Indian child's parent, parents, Indian custodian, and the Tribal social 
371.2 	services agency within seven days of placement, excluding weekends and holidays.
371.3 	If a child-placing agency makes a temporary voluntary foster care placement pending 
371.4 	a decision on adoption by a an Indian child's parent or Indian custodian, notice of the 
371.5 	placement shall be given to the Indian child's parents, Tribal social services agency, and 
371.6 	the Indian custodian upon the filing of a petition for termination of parental rights or three 
371.7 	months following the temporary placement, whichever occurs first.

371.8 	Sec. 24. Minnesota Statutes 2023 Supplement, section 260.765, subdivision 3a, is amended 
371.9 	to read:
371.10 		Subd. 3a.Court requirements for consent. Where any parent or Indian custodian 
371.11 	voluntarily consents to a foster care child placement or to termination of parental rights or 
371.12 	adoption, the consent shall not be valid unless executed in writing and recorded before a 
371.13 	judge and accompanied by the presiding judge's finding that the terms and consequences 
371.14 	of the consent were fully explained in detail and were fully understood by the parent or 
371.15 	Indian custodian. The court shall also find that either the parent or Indian custodian fully 
371.16 	understood the explanation in English or that it was interpreted into a language the parent 
371.17 	or Indian custodian understood. Any consent given prior to, or within ten days after, the 
371.18 	birth of an Indian child shall not be valid.

371.19 	Sec. 25. Minnesota Statutes 2023 Supplement, section 260.765, subdivision 4b, is amended 
371.20 	to read:
371.21 		Subd. 4b.Collateral attack; vacation of decree and return of custody; 
371.22 	limitations. After the entry of a final decree of adoption of an Indian child in any state 
371.23 	court, the Indian child's parent may withdraw consent upon the grounds that consent was 
371.24 	obtained through fraud or duress and may petition the court to vacate the decree. Upon a 
371.25 	finding that consent was obtained through fraud or duress, the court shall vacate the decree 
371.26 	and return the Indian child to the Indian child's parent. No adoption that has been effective 
371.27 	for at least two years may be invalidated under the provisions of this subdivision unless 
371.28 	otherwise permitted under a provision of state law.

371.29 	Sec. 26. Minnesota Statutes 2023 Supplement, section 260.771, subdivision 1a, is amended 
371.30 	to read:
371.31 		Subd. 1a.Active efforts. In any child placement proceeding, the child-placing agency 
371.32 	or individual petitioner shall ensure that appropriate active efforts as described in section 
372.1 	260.762 are provided to the Indian child's parent or parents, Indian custodian, and family 
372.2 	to support reunification and preservation of the Indian child's placement with and relationship 
372.3 	to the Indian child's extended family.

372.4 	Sec. 27. Minnesota Statutes 2023 Supplement, section 260.771, subdivision 1b, is amended 
372.5 	to read:
372.6 		Subd. 1b.Placement preference. In any child placement proceeding, the child-placing 
372.7 	agency or individual petitioner shall follow the placement preferences described in section 
372.8 	260.773 or, where preferred placement is not available even with the provision of active 
372.9 	efforts, shall follow section 260.773, subdivisions 12 to 15.

372.10 	Sec. 28. Minnesota Statutes 2023 Supplement, section 260.771, subdivision 1c, is amended 
372.11 	to read:
372.12 		Subd. 1c.Identification of extended family members. Any child-placing agency or 
372.13 	individual petitioner considering placement of an Indian child shall make ensure active 
372.14 	efforts are made to identify and locate siblings and extended family members and to explore 
372.15 	placement with an extended family member and facilitate continued involvement in the 
372.16 	Indian child's life members and ensure the Indian child's relationship with the Indian child's 
372.17 	extended family and Tribe.

372.18 	Sec. 29. Minnesota Statutes 2023 Supplement, section 260.771, subdivision 2b, is amended 
372.19 	to read:
372.20 		Subd. 2b.Appointment of counsel. (a) In any state court child placement proceeding, 
372.21 	including but not limited to any proceeding where the petitioner or another party seeks to 
372.22 	temporarily or permanently remove an Indian child from the Indian child's parent or parents 
372.23 	or Indian custodian, the Indian child's parent or parents or Indian custodian shall have the 
372.24 	right to be represented by an attorney. If the parent or parents or Indian custodian cannot 
372.25 	afford an attorney and meet the requirements of section 611.17, an attorney will be appointed 
372.26 	to represent them.
372.27 	(b) In any state court child placement proceeding, any Indian child ten years of age or 
372.28 	older shall have the right to court-appointed counsel. The court may appoint counsel for 
372.29 	any Indian child under ten years of age in any state court child placement proceeding if the 
372.30 	court determines that appointment is appropriate and in the best interest of the Indian child.
372.31 	(c) If the court appoints counsel to represent a person pursuant to this subdivision, the 
372.32 	court shall appoint counsel to represent the person prior to the first hearing on the petition, 
373.1 	but may appoint counsel at any stage of the proceeding if the court deems it necessary. The 
373.2 	court shall not appoint a public defender to represent the person unless such appointment 
373.3 	is authorized by section 611.14.

373.4 	Sec. 30. Minnesota Statutes 2023 Supplement, section 260.771, subdivision 2d, is amended 
373.5 	to read:
373.6 		Subd. 2d.Tribal access to files and other documents. At any subsequent stage of the 
373.7 	child-placing agency or petitioner's involvement with an Indian child, the child-placing 
373.8 	agency or individual petitioner shall, upon request, give the Tribal social services agency 
373.9 	full cooperation including access to all files concerning the Indian child. If the files contain 
373.10 	confidential or private data, the child-placing agency or individual petitioner may require 
373.11 	execution of an agreement with the Tribal social services agency specifying that the Tribal 
373.12 	social services agency shall maintain the data according to statutory provisions applicable 
373.13 	to the data.

373.14 	Sec. 31. Minnesota Statutes 2023 Supplement, section 260.771, is amended by adding a 
373.15 	subdivision to read:
373.16 		Subd. 2e.Participation of Indian child's Tribe in court proceedings. (a) In any child 
373.17 	placement proceeding that involves an Indian child, any Tribe that the Indian child may be 
373.18 	eligible for membership in, as determined by the Tribe, is a party to the proceedings without 
373.19 	the need to file a motion.
373.20 	(b) An Indian child's Tribe, Tribal representative, or attorney representing the Tribe:
373.21 	(1) may appear remotely at hearings by telephone, video conference, or other electronic 
373.22 	medium without prior request;
373.23 	(2) is not required to use the court's electronic filing and service system and may use 
373.24 	United States mail, facsimile, or other alternative method for filing and service;
373.25 	(3) may file documents with the court using an alternative method that the clerk of court 
373.26 	shall accept and file electronically;
373.27 	(4) is exempt from any filing fees required under section 357.021; and
373.28 	(5) is exempt from the pro hac vice requirements of Rule 5 of the Minnesota General 
373.29 	Rules of Practice.

374.1 	Sec. 32. Minnesota Statutes 2023 Supplement, section 260.771, subdivision 6, is amended 
374.2 	to read:
374.3 		Subd. 6.Qualified expert witness and evidentiary requirements. (a) In an any
374.4 	involuntary foster care placement proceeding, the court must determine by clear and 
374.5 	convincing evidence, including testimony of a qualified expert witness, that continued 
374.6 	custody of the Indian child by the parent or Indian custodian is likely to result in serious 
374.7 	emotional damage or serious physical damage to the Indian child.
374.8 	In a termination of parental rights proceeding, the court must determine by evidence 
374.9 	beyond a reasonable doubt, including testimony of a qualified expert witness, that continued 
374.10 	custody of the Indian child by the parent or Indian custodian is likely to result in serious 
374.11 	emotional damage or serious physical damage to the Indian child.
374.12 	In an involuntary permanent transfer of legal and physical custody proceeding, permanent 
374.13 	custody to the agency proceeding, temporary custody to the agency, or other permanency 
374.14 	proceeding, the court must determine by clear and convincing evidence, including testimony 
374.15 	of a qualified expert witness, that the continued custody of the Indian child by the Indian 
374.16 	child's parent or parents or Indian custodian is likely to result in serious emotional damage 
374.17 	or serious physical damage to the Indian child. Qualified expert witness testimony is not 
374.18 	required where custody is transferred to the Indian child's parent.
374.19 	Testimony of a qualified expert witness shall be provided for involuntary foster care
374.20 	child placement and permanency proceedings independently.
374.21 	(b) The child-placing agency, individual petitioner, or any other party shall make diligent 
374.22 	efforts to locate and present to the court a qualified expert witness designated by the Indian 
374.23 	child's Tribe. The qualifications of a qualified expert witness designated by the Indian child's 
374.24 	Tribe are not subject to a challenge in Indian child placement proceedings.
374.25 	(c) If a party cannot obtain testimony from a Tribally designated qualified expert witness, 
374.26 	the party shall submit to the court the diligent efforts made to obtain a Tribally designated 
374.27 	qualified expert witness.
374.28 	(d) If clear and convincing evidence establishes that a party's diligent efforts cannot 
374.29 	produce testimony from a Tribally designated qualified expert witness, the party shall 
374.30 	demonstrate to the court that a proposed qualified expert witness is, in descending order of 
374.31 	preference:
375.1 	(1) a member of the Indian child's Tribe who is recognized by the Indian child's Tribal 
375.2 	community as knowledgeable in Tribal customs as they pertain to family organization and 
375.3 	child-rearing practices; or
375.4 	(2) an Indian person from an Indian community who has substantial experience in the 
375.5 	delivery of child and family services to Indians and extensive knowledge of prevailing social 
375.6 	and cultural standards and contemporary and traditional child-rearing practices of the Indian 
375.7 	child's Tribe.
375.8 	If clear and convincing evidence establishes that diligent efforts have been made to obtain 
375.9 	a qualified expert witness who meets the criteria in clause (1) or (2), but those efforts have 
375.10 	not been successful, a party may use an expert witness, as defined by the Minnesota Rules 
375.11 	of Evidence, rule 702, who has substantial experience in providing services to Indian families 
375.12 	and who has substantial knowledge of prevailing social and cultural standards and 
375.13 	child-rearing practices within the Indian community. The court or any party may request 
375.14 	the assistance of the Indian child's Tribe or the Bureau of Indian Affairs agency serving the 
375.15 	Indian child's Tribe in locating persons qualified to serve as expert witnesses.
375.16 	(e) The court may allow alternative methods of participation and testimony in state court 
375.17 	proceedings by a qualified expert witness, such as participation or testimony by telephone, 
375.18 	videoconferencing video conference, or other methods electronic medium.

375.19 	Sec. 33. Minnesota Statutes 2023 Supplement, section 260.773, subdivision 1, is amended 
375.20 	to read:
375.21 		Subdivision 1.Least restrictive setting. In all proceedings where custody of the Indian 
375.22 	child may be removed from the Indian child's parent or Indian custodian, the Indian child 
375.23 	shall be placed in the least restrictive setting which most approximates a family and in which 
375.24 	the Indian child's special needs, if any, may be met. The Indian child shall also be placed 
375.25 	within reasonable proximity to the Indian child's home, taking into account any special 
375.26 	needs of the Indian child.

375.27 	Sec. 34. Minnesota Statutes 2023 Supplement, section 260.773, subdivision 2, is amended 
375.28 	to read:
375.29 		Subd. 2.Tribe's order of placement recognized. In the case of a placement under 
375.30 	subdivision 3 or 4, if the Indian child's Tribe has established a different order of placement 
375.31 	preference by resolution, the child-placing agency or petitioner and the court shall recognize 
375.32 	the Indian child's Tribe's order of placement in the form provided by the Tribe.

376.1 	Sec. 35. Minnesota Statutes 2023 Supplement, section 260.773, subdivision 3, is amended 
376.2 	to read:
376.3 		Subd. 3.Placement options preferences for temporary proceedings. Preference shall 
376.4 	be given, in the absence of good cause to the contrary, to a placement with:
376.5 	(1) a noncustodial parent or Indian custodian;
376.6 	(2) a member of the Indian child's extended family;
376.7 	(3) a foster home licensed, approved, or specified by the Indian child's Tribe;
376.8 	(4) an Indian foster home licensed or approved by an authorized non-Indian licensing 
376.9 	authority; or
376.10 	(5) an institution for children approved by an Indian Tribe or operated by an Indian 
376.11 	organization which has a program suitable to meet the Indian child's needs.

376.12 	Sec. 36. Minnesota Statutes 2023 Supplement, section 260.773, subdivision 4, is amended 
376.13 	to read:
376.14 		Subd. 4.Placement preference preferences for permanent proceedings. In any 
376.15 	adoptive placement, transfer of custody placement, or other permanency placement of an 
376.16 	Indian child, a preference shall be given, in the absence of good cause to the contrary, to a 
376.17 	placement with:
376.18 	(1) the Indian child's noncustodial parent or Indian custodian;
376.19 	(2) a member of the Indian child's extended family;
376.20 	(3) other members of the Indian child's Tribe; or
376.21 	(4) other persons or entities recognized as appropriate to be a permanency resource for 
376.22 	the Indian child, by the Indian child's parent or parents, Indian custodian, or Indian Tribe.

376.23 	Sec. 37. Minnesota Statutes 2023 Supplement, section 260.773, subdivision 5, is amended 
376.24 	to read:
376.25 		Subd. 5.Suitability of placement. The county child-placing agency and petitioner shall 
376.26 	defer to the judgment of the Indian child's Tribe as to the suitability of a placement.

377.1 	Sec. 38. Minnesota Statutes 2023 Supplement, section 260.773, subdivision 10, is amended 
377.2 	to read:
377.3 		Subd. 10.Exceptions to placement preferences. The court shall follow the placement 
377.4 	preferences in subdivisions 1 to 9, except as follows:
377.5 	(1) where a parent evidences a desire for anonymity, the child-placing agency or petitioner 
377.6 	and the court shall give weight to the parent's desire for anonymity in applying the 
377.7 	preferences. A parent's desire for anonymity does not excuse the application of sections 
377.8 	260.751 to 260.835; or
377.9 	(2) where the court determines there is good cause based on:
377.10 	(i) the reasonable request of the Indian child's parents, if one or both parents attest that 
377.11 	they have reviewed the placement options that comply with the order of placement 
377.12 	preferences;
377.13 	(ii) the reasonable request of the Indian child if the Indian child is able to understand 
377.14 	and comprehend the decision that is being made;
377.15 	(iii) the testimony of a qualified expert designated by the Indian child's Tribe and, if 
377.16 	necessary, testimony from an expert witness who meets qualifications of section 260.771, 
377.17 	subdivision 6, paragraph (d), clause (2), that supports placement outside the order of 
377.18 	placement preferences due to extraordinary physical or emotional needs of the Indian child 
377.19 	that require highly specialized services; or
377.20 	(iv) the testimony by the child-placing agency or petitioner that a diligent search has 
377.21 	been conducted that did not locate any available, suitable families for the Indian child that 
377.22 	meet the placement preference criteria.

377.23 	Sec. 39. Minnesota Statutes 2023 Supplement, section 260.773, subdivision 11, is amended 
377.24 	to read:
377.25 		Subd. 11.Factors considered in determining placement. Testimony of the Indian 
377.26 	child's bonding or attachment to a foster family alone, without the existence of at least one 
377.27 	of the factors in subdivision 10, clause (2), shall not be considered good cause to keep an 
377.28 	Indian child in a lower preference or nonpreference placement. Ease of visitation and 
377.29 	facilitation of relationship with the Indian child's parents, Indian custodian, extended family, 
377.30 	or Tribe may be considered when determining placement.

378.1 	Sec. 40. Minnesota Statutes 2023 Supplement, section 260.774, subdivision 1, is amended 
378.2 	to read:
378.3 		Subdivision 1.Improper removal. In any proceeding where custody of the Indian child 
378.4 	was improperly removed from the parent or parents Indian custodian or where the petitioner 
378.5 	has improperly retained custody after a visit or other temporary relinquishment of custody, 
378.6 	the court shall decline jurisdiction over the petition and shall immediately return the Indian 
378.7 	child to the Indian child's parent or parents or Indian custodian unless returning the Indian 
378.8 	child to the Indian child's parent or parents or Indian custodian would subject the Indian 
378.9 	child to a substantial and immediate danger or threat of such danger.

378.10 	Sec. 41. Minnesota Statutes 2023 Supplement, section 260.774, subdivision 2, is amended 
378.11 	to read:
378.12 		Subd. 2.Invalidation. (a) Any order for out-of-home child placement, transfer of custody, 
378.13 	termination of parental rights, or other permanent change in custody of an Indian child shall 
378.14 	be invalidated upon a showing, by a preponderance of the evidence, that a violation of any 
378.15 	one of the provisions in section 260.761, 260.762, 260.763, 260.765, 260.771, 260.773, or 
378.16 	260.7745 has occurred.
378.17 	(b) The Indian child, the Indian child's parent or parents, guardian, Indian custodian, or 
378.18 	Indian Tribe may file a petition or motion to invalidate under this subdivision.
378.19 	(c) Upon a finding that a violation of one of the provisions in section 260.761, 260.762, 
378.20 	260.763, 260.765, 260.771, 260.773, or 260.7745 has occurred, the court shall:
378.21 	(1) dismiss the petition without prejudice; and
378.22 	(2) return the Indian child to the care, custody, and control of the parent or parents or 
378.23 	Indian custodian, unless the Indian child would be subjected to imminent physical damage 
378.24 	or harm.; and
378.25 	(3) determine whether the Indian child's parent or Indian custodian has been assessed 
378.26 	placement costs and order reimbursement of those costs.
378.27 	(d) Upon a finding that a willful, intentional, knowing, or reckless violation of one of 
378.28 	the provisions in section 260.761, 260.762, 260.763, 260.765, 260.771, 260.773, or 260.7745 
378.29 	has occurred, the court may consider whether sanctions, reasonable costs, and attorney fees 
378.30 	should be imposed against the offending party.

379.1 	Sec. 42. Minnesota Statutes 2023 Supplement, section 260.774, subdivision 3, is amended 
379.2 	to read:
379.3 		Subd. 3.Return of custody following adoption. (a) Whenever a final decree of adoption 
379.4 	of an Indian child has been vacated, set aside, or there is a termination of the parental rights 
379.5 	of the adoptive parents to the Indian child, a biological parent or prior Indian custodian may 
379.6 	petition for return of custody and the court shall grant the petition unless there is a showing, 
379.7 	in proceedings subject to the provision of sections 260.751 to 260.835, that the return of 
379.8 	custody is not in the best interests of the Indian child.
379.9 	(b) The county attorney, Indian child, Indian child's Tribe, Indian custodian, or a an 
379.10 	Indian child's parent whose parental rights were terminated under a previous order of the 
379.11 	court may file a petition for the return of custody.
379.12 	(c) A petition for return of custody may be filed in court when:
379.13 	(1) the parent or Indian custodian has corrected the conditions that led to an order 
379.14 	terminating parental rights;
379.15 	(2) the parent or Indian custodian is willing and has the capability to provide day-to-day 
379.16 	care and maintain the health, safety, and welfare of the Indian child; and
379.17 	(3) the adoption has been vacated, set aside, or termination of the parental rights of the 
379.18 	adoptive parents to the Indian child has occurred.
379.19 	(d) A petition for reestablishment of the legal parent and child relationship for aan Indian 
379.20 	child who has not been adopted must meet the requirements in section 260C.329.

379.21 	Sec. 43. Minnesota Statutes 2022, section 260.775, is amended to read:
379.22 	260.775 PLACEMENT RECORDS.
379.23 	(a) The commissioner of human services shall publish annually an inventory of all Indian 
379.24 	children in residential facilities. The inventory shall include, by county and statewide, 
379.25 	information on legal status, living arrangement, age, sex, Tribe in which the Indian child is 
379.26 	a member or eligible for membership, accumulated length of time in foster care, and other 
379.27 	demographic information deemed appropriate concerning all Indian children in residential 
379.28 	facilities. The report must also state the extent to which authorized child-placing agencies 
379.29 	comply with the order of preference described in United States Code, title 25, section 1901, 
379.30 	et seq. The commissioner shall include the information required under this paragraph in the 
379.31 	annual report on child maltreatment and on children in out-of-home placement under section 
379.32 	257.0725.
380.1 	(b) This section expires January 1, 2032.

380.2 	Sec. 44. Minnesota Statutes 2023 Supplement, section 260.781, subdivision 1, is amended 
380.3 	to read:
380.4 		Subdivision 1.Court decree information. (a) A state court entering a final decree or 
380.5 	order in an Indian child adoptive placement shall provide the Department of Human Services 
380.6 	and the child's Tribal social services agency with a copy of the decree or order together with 
380.7 	such other information to show:
380.8 	(1) the name and Tribal affiliation of the Indian child;
380.9 	(2) the names and addresses of the biological parents and Indian custodian, if any;
380.10 	(3) the names and addresses of the adoptive parents; and
380.11 	(4) the identity of any agency having files or information relating to the adoptive 
380.12 	placement.
380.13 	If the court records contain an affidavit of the biological or adoptive parent or parents 
380.14 	or Indian custodian requesting anonymity, the court shall delete the name and address of 
380.15 	the biological or adoptive parents or Indian custodian from the information sent to the Indian 
380.16 	child's Tribal social services agency. The court shall include the affidavit with the other 
380.17 	information provided to the Minnesota Department of Human Services and the Secretary 
380.18 	of the Interior. The Minnesota Department of Human Services shall and the Secretary of 
380.19 	the Interior is requested to ensure that the confidentiality of the information is maintained 
380.20 	and the information shall not be subject to the Freedom of Information Act, United States 
380.21 	Code, title 5, section 552, as amended.
380.22 	(b) For:
380.23 	(1) disclosure of information for enrollment membership of an Indian child in the Tribe;
380.24 	(2) determination of member rights or benefits; or
380.25 	(3) certification of entitlement to membership upon the request of the adopted Indian 
380.26 	child over the age of eighteen, the adoptive or foster parents of an Indian child, or an Indian 
380.27 	Tribe,
380.28 	the Secretary of the Interior is requested to disclose any other necessary information for the 
380.29 	membership of an Indian child in the Tribe in which the Indian child may be eligible for 
380.30 	membership or for determining any rights or benefits associated with that membership. 
380.31 	Where the documents relating to the Indian child contain an affidavit from the biological 
380.32 	parent or parents Indian custodian requesting anonymity, the Secretary of the Interior is 
381.1 	requested to certify to the Indian child's Tribe, where the information warrants, that the 
381.2 	Indian child's parentage and other circumstances of birth entitle the Indian child to 
381.3 	membership under the criteria established by the Tribe.

381.4 	Sec. 45. Minnesota Statutes 2022, section 260.785, subdivision 1, is amended to read:
381.5 		Subdivision 1.Primary support grants. The commissioner shall establish direct grants 
381.6 	to Indian Tribes, Indian organizations, and Tribal social services agency programs located 
381.7 	off-reservation that serve Indian children and their families to provide primary support for 
381.8 	Indian child welfare programs to implement the Minnesota Indian Family Preservation Act.

381.9 	Sec. 46. Minnesota Statutes 2022, section 260.785, subdivision 3, is amended to read:
381.10 		Subd. 3.Compliance grants. The commissioner shall establish direct grants to an Indian 
381.11 	child welfare defense corporation, as defined in Minnesota Statutes 1996, section 611.216, 
381.12 	subdivision 1a, to promote statewide compliance with the Minnesota Indian Family 
381.13 	Preservation Act and the Indian Child Welfare Act, United States Code, title 25, section 
381.14 	1901, et seq. The commissioner shall give priority consideration to applicants with 
381.15 	demonstrated capability of providing legal advocacy services statewide.

381.16 	Sec. 47. Minnesota Statutes 2023 Supplement, section 260.786, subdivision 2, is amended 
381.17 	to read:
381.18 		Subd. 2.Purposes. Money must be used to address staffing for responding to notifications 
381.19 	under the federal Indian Child Welfare Act and the Minnesota Indian Family Preservation 
381.20 	Act, to the extent necessary, or to provide other child protection and child welfare services. 
381.21 	Money must not be used to supplant current Tribal expenditures for these purposes.

381.22 	Sec. 48. Minnesota Statutes 2023 Supplement, section 260.795, subdivision 1, is amended 
381.23 	to read:
381.24 		Subdivision 1.Types of services. (a) Eligible Indian child welfare services provided 
381.25 	under primary support grants include:
381.26 	(1) placement prevention and reunification services;
381.27 	(2) family-based services;
381.28 	(3) individual and family counseling;
381.29 	(4) access to professional individual, group, and family counseling;
381.30 	(5) crisis intervention and crisis counseling;
382.1 	(6) development of foster and adoptive placement resources, including recruitment, 
382.2 	licensing, and support;
382.3 	(7) court advocacy;
382.4 	(8) training and consultation to county and private social services agencies regarding 
382.5 	the federal Indian Child Welfare Act and the Minnesota Indian Family Preservation Act;
382.6 	(9) advocacy in working with the county and private social services agencies, and 
382.7 	activities to help provide access to agency services, including but not limited to 24-hour 
382.8 	caretaker and homemaker services, day care, emergency shelter care up to 30 days in 12 
382.9 	months, access to emergency financial assistance, and arrangements to provide temporary 
382.10 	respite care to a family for up to 72 hours consecutively or 30 days in 12 months;
382.11 	(10) transportation services to the child and parents to prevent placement or reunite the 
382.12 	family; and
382.13 	(11) other activities and services approved by the commissioner that further the goals 
382.14 	of the federal Indian Child Welfare Act and the Minnesota Indian Family Preservation Act, 
382.15 	including but not limited to recruitment of Indian staff for child-placing agencies and licensed 
382.16 	child-placing agencies. The commissioner may specify the priority of an activity and service 
382.17 	based on its success in furthering these goals.
382.18 	(b) Eligible services provided under special focus grants include:
382.19 	(1) permanency planning activities that meet the special needs of Indian families;
382.20 	(2) teenage pregnancy;
382.21 	(3) independent living skills;
382.22 	(4) family and community involvement strategies to combat child abuse and chronic 
382.23 	neglect of children;
382.24 	(5) coordinated child welfare and mental health services to Indian families;
382.25 	(6) innovative approaches to assist Indian youth to establish better self-image, decrease 
382.26 	isolation, and decrease the suicide rate;
382.27 	(7) expanding or improving services by packaging and disseminating information on 
382.28 	successful approaches or by implementing models in Indian communities relating to the 
382.29 	development or enhancement of social structures that increase family self-reliance and links 
382.30 	with existing community resources;
383.1 	(8) family retrieval services to help adopted individuals reestablish legal affiliation with 
383.2 	the Indian Tribe; and
383.3 	(9) other activities and services approved by the commissioner that further the goals of 
383.4 	the federal Indian Child Welfare Act and the Minnesota Indian Family Preservation Act. 
383.5 	The commissioner may specify the priority of an activity and service based on its success 
383.6 	in furthering these goals.
383.7 	(c) The commissioner shall give preference to programs that use Indian staff, contract 
383.8 	with Indian organizations or Tribes, or whose application is a joint effort between the Indian 
383.9 	and non-Indian community to achieve the goals of the federal Indian Child Welfare Act 
383.10 	and the Minnesota Indian Family Preservation Act. Programs must have input and support 
383.11 	from the Indian community.

383.12 	Sec. 49. Minnesota Statutes 2022, section 260.810, subdivision 3, is amended to read:
383.13 		Subd. 3.Final report. A final evaluation report must be submitted by each approved 
383.14 	program to the commissioner. It must include client outcomes, cost and effectiveness in 
383.15 	meeting the goals of the Minnesota Indian Family Preservation Act and permanency planning 
383.16 	goals. The commissioner must compile the final reports into one document and provide a 
383.17 	copy to each Tribe.

383.18 	Sec. 50. Minnesota Statutes 2022, section 260C.007, subdivision 26b, is amended to read:
383.19 		Subd. 26b.Relative of an Indian child. "Relative of an Indian child" means a person 
383.20 	who is a member of the Indian child's family as defined in the Indian Child Welfare Act of 
383.21 	1978, United States Code, title 25, section 1903, paragraphs (2), (6), and (9), and who is an 
383.22 	extended family member as defined in section 260.755, subdivision 5b, of the Minnesota 
383.23 	Indian Family Preservation Act.

383.24 	Sec. 51. Minnesota Statutes 2022, section 260C.178, subdivision 1, as amended by Laws 
383.25 	2024, chapter 80, article 8, section 24, is amended to read:
383.26 		Subdivision 1.Hearing and release requirements. (a) If a child was taken into custody 
383.27 	under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a 
383.28 	hearing within 72 hours of the time that the child was taken into custody, excluding 
383.29 	Saturdays, Sundays, and holidays, to determine whether the child should continue to be in 
383.30 	custody.
383.31 	(b) Unless there is reason to believe that the child would endanger self or others or not 
383.32 	return for a court hearing, or that the child's health or welfare would be immediately 
384.1 	endangered, the child shall be released to the custody of a parent, guardian, custodian, or 
384.2 	other suitable person, subject to reasonable conditions of release including, but not limited 
384.3 	to, a requirement that the child undergo a chemical use assessment as provided in section 
384.4 	260C.157, subdivision 1.
384.5 	(c) If the court determines that there is reason to believe that the child would endanger 
384.6 	self or others or not return for a court hearing, or that the child's health or welfare would be 
384.7 	immediately endangered if returned to the care of the parent or guardian who has custody 
384.8 	and from whom the child was removed, the court shall order the child:
384.9 	(1) into the care of the child's noncustodial parent and order the noncustodial parent to 
384.10 	comply with any conditions that the court determines appropriate to ensure the safety and 
384.11 	care of the child, including requiring the noncustodial parent to cooperate with paternity 
384.12 	establishment proceedings if the noncustodial parent has not been adjudicated the child's 
384.13 	father; or
384.14 	(2) into foster care as defined in section 260C.007, subdivision 18, under the legal 
384.15 	responsibility of the responsible social services agency or responsible probation or corrections 
384.16 	agency for the purposes of protective care as that term is used in the juvenile court rules. 
384.17 	The court shall not give the responsible social services legal custody and order a trial home 
384.18 	visit at any time prior to adjudication and disposition under section 260C.201, subdivision 
384.19 	1, paragraph (a), clause (3), but may order the child returned to the care of the parent or 
384.20 	guardian who has custody and from whom the child was removed and order the parent or 
384.21 	guardian to comply with any conditions the court determines to be appropriate to meet the 
384.22 	safety, health, and welfare of the child.
384.23 	(d) In determining whether the child's health or welfare would be immediately 
384.24 	endangered, the court shall consider whether the child would reside with a perpetrator of 
384.25 	domestic child abuse.
384.26 	(e) The court, before determining whether a child should be placed in or continue in 
384.27 	foster care under the protective care of the responsible agency, shall also make a 
384.28 	determination, consistent with section 260.012 as to whether reasonable efforts were made 
384.29 	to prevent placement or whether reasonable efforts to prevent placement are not required. 
384.30 	In the case of an Indian child, the court shall determine whether active efforts, according 
384.31 	to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25, 
384.32 	section 1912(d), were made to prevent placement. The court shall enter a finding that the 
384.33 	responsible social services agency has made reasonable efforts to prevent placement when 
384.34 	the agency establishes either:
385.1 	(1) that the agency has actually provided services or made efforts in an attempt to prevent 
385.2 	the child's removal but that such services or efforts have not proven sufficient to permit the 
385.3 	child to safely remain in the home; or
385.4 	(2) that there are no services or other efforts that could be made at the time of the hearing 
385.5 	that could safely permit the child to remain home or to return home. The court shall not 
385.6 	make a reasonable efforts determination under this clause unless the court is satisfied that 
385.7 	the agency has sufficiently demonstrated to the court that there were no services or other 
385.8 	efforts that the agency was able to provide at the time of the hearing enabling the child to 
385.9 	safely remain home or to safely return home. When reasonable efforts to prevent placement 
385.10 	are required and there are services or other efforts that could be ordered that would permit 
385.11 	the child to safely return home, the court shall order the child returned to the care of the 
385.12 	parent or guardian and the services or efforts put in place to ensure the child's safety. When 
385.13 	the court makes a prima facie determination that one of the circumstances under paragraph 
385.14 	(g) exists, the court shall determine that reasonable efforts to prevent placement and to 
385.15 	return the child to the care of the parent or guardian are not required.
385.16 	(f) If the court finds the social services agency's preventive or reunification efforts have 
385.17 	not been reasonable but further preventive or reunification efforts could not permit the child 
385.18 	to safely remain at home, the court may nevertheless authorize or continue the removal of 
385.19 	the child.
385.20 	(g) The court may not order or continue the foster care placement of the child unless the 
385.21 	court makes explicit, individualized findings that continued custody of the child by the 
385.22 	parent or guardian would be contrary to the welfare of the child and that placement is in the 
385.23 	best interest of the child.
385.24 	(h) At the emergency removal hearing, or at any time during the course of the proceeding, 
385.25 	and upon notice and request of the county attorney, the court shall determine whether a 
385.26 	petition has been filed stating a prima facie case that:
385.27 	(1) the parent has subjected a child to egregious harm as defined in section 260C.007, 
385.28 	subdivision 14;
385.29 	(2) the parental rights of the parent to another child have been involuntarily terminated;
385.30 	(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph 
385.31 	(a), clause (2);
385.32 	(4) the parents' custodial rights to another child have been involuntarily transferred to a 
385.33 	relative under a juvenile protection proceeding or a similar process of another jurisdiction;
386.1 	(5) the parent has committed sexual abuse as defined in section 260E.03, against the 
386.2 	child or another child of the parent;
386.3 	(6) the parent has committed an offense that requires registration as a predatory offender 
386.4 	under section 243.166, subdivision 1b, paragraph (a) or (b); or
386.5 	(7) the provision of services or further services for the purpose of reunification is futile 
386.6 	and therefore unreasonable.
386.7 	(i) When a petition to terminate parental rights is required under section 260C.301, 
386.8 	subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to 
386.9 	proceed with a termination of parental rights petition, and has instead filed a petition to 
386.10 	transfer permanent legal and physical custody to a relative under section 260C.507, the 
386.11 	court shall schedule a permanency hearing within 30 days of the filing of the petition.
386.12 	(j) If the county attorney has filed a petition under section 260C.307, the court shall 
386.13 	schedule a trial under section 260C.163 within 90 days of the filing of the petition except 
386.14 	when the county attorney determines that the criminal case shall proceed to trial first under 
386.15 	section 260C.503, subdivision 2, paragraph (c).
386.16 	(k) If the court determines the child should be ordered into foster care and the child's 
386.17 	parent refuses to give information to the responsible social services agency regarding the 
386.18 	child's father or relatives of the child, the court may order the parent to disclose the names, 
386.19 	addresses, telephone numbers, and other identifying information to the responsible social 
386.20 	services agency for the purpose of complying with sections 260C.150, 260C.151, 260C.212, 
386.21 	260C.215, 260C.219, and 260C.221.
386.22 	(l) If a child ordered into foster care has siblings, whether full, half, or step, who are 
386.23 	also ordered into foster care, the court shall inquire of the responsible social services agency 
386.24 	of the efforts to place the children together as required by section 260C.212, subdivision 2, 
386.25 	paragraph (d), if placement together is in each child's best interests, unless a child is in 
386.26 	placement for treatment or a child is placed with a previously noncustodial parent who is 
386.27 	not a parent to all siblings. If the children are not placed together at the time of the hearing, 
386.28 	the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place 
386.29 	the siblings together, as required under section 260.012. If any sibling is not placed with 
386.30 	another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing 
386.31 	contact among the siblings as required under section 260C.212, subdivision 1, unless it is 
386.32 	contrary to the safety or well-being of any of the siblings to do so.
386.33 	(m) When the court has ordered the child into the care of a noncustodial parent or in 
386.34 	foster care, the court may order a chemical dependency evaluation, mental health evaluation, 
387.1 	medical examination, and parenting assessment for the parent as necessary to support the 
387.2 	development of a plan for reunification required under subdivision 7 and section 260C.212, 
387.3 	subdivision 1, or the child protective services plan under section 260E.26, and Minnesota 
387.4 	Rules, part 9560.0228.
387.5 	(n) When the court has ordered an Indian child into an emergency child placement, the 
387.6 	Indian child shall be placed according to the placement preferences in the Minnesota Indian 
387.7 	Family Preservation Act, section 260.773.

387.8 	Sec. 52. Minnesota Statutes 2022, section 260D.01, is amended to read:
387.9 	260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
387.10 	(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for 
387.11 	treatment" provisions of the Juvenile Court Act.
387.12 	(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary 
387.13 	foster care for treatment upon the filing of a report or petition required under this chapter. 
387.14 	All obligations of the responsible social services agency to a child and family in foster care 
387.15 	contained in chapter 260C not inconsistent with this chapter are also obligations of the 
387.16 	agency with regard to a child in foster care for treatment under this chapter.
387.17 	(c) This chapter shall be construed consistently with the mission of the children's mental 
387.18 	health service system as set out in section 245.487, subdivision 3, and the duties of an agency 
387.19 	under sections 256B.092 and 260C.157 and Minnesota Rules, parts 9525.0004 to 9525.0016, 
387.20 	to meet the needs of a child with a developmental disability or related condition. This 
387.21 	chapter:
387.22 	(1) establishes voluntary foster care through a voluntary foster care agreement as the 
387.23 	means for an agency and a parent to provide needed treatment when the child must be in 
387.24 	foster care to receive necessary treatment for an emotional disturbance or developmental 
387.25 	disability or related condition;
387.26 	(2) establishes court review requirements for a child in voluntary foster care for treatment 
387.27 	due to emotional disturbance or developmental disability or a related condition;
387.28 	(3) establishes the ongoing responsibility of the parent as legal custodian to visit the 
387.29 	child, to plan together with the agency for the child's treatment needs, to be available and 
387.30 	accessible to the agency to make treatment decisions, and to obtain necessary medical, 
387.31 	dental, and other care for the child;
388.1 	(4) applies to voluntary foster care when the child's parent and the agency agree that the 
388.2 	child's treatment needs require foster care either:
388.3 	(i) due to a level of care determination by the agency's screening team informed by the 
388.4 	child's diagnostic and functional assessment under section 245.4885; or
388.5 	(ii) due to a determination regarding the level of services needed by the child by the 
388.6 	responsible social services agency's screening team under section 256B.092, and Minnesota 
388.7 	Rules, parts 9525.0004 to 9525.0016; and
388.8 	(5) includes the requirements for a child's placement in sections 260C.70 to 260C.714, 
388.9 	when the juvenile treatment screening team recommends placing a child in a qualified 
388.10 	residential treatment program, except as modified by this chapter.
388.11 	(d) This chapter does not apply when there is a current determination under chapter 
388.12 	260E that the child requires child protective services or when the child is in foster care for 
388.13 	any reason other than treatment for the child's emotional disturbance or developmental 
388.14 	disability or related condition. When there is a determination under chapter 260E that the 
388.15 	child requires child protective services based on an assessment that there are safety and risk 
388.16 	issues for the child that have not been mitigated through the parent's engagement in services 
388.17 	or otherwise, or when the child is in foster care for any reason other than the child's emotional 
388.18 	disturbance or developmental disability or related condition, the provisions of chapter 260C 
388.19 	apply.
388.20 	(e) The paramount consideration in all proceedings concerning a child in voluntary foster 
388.21 	care for treatment is the safety, health, and the best interests of the child. The purpose of 
388.22 	this chapter is:
388.23 	(1) to ensure that a child with a disability is provided the services necessary to treat or 
388.24 	ameliorate the symptoms of the child's disability;
388.25 	(2) to preserve and strengthen the child's family ties whenever possible and in the child's 
388.26 	best interests, approving the child's placement away from the child's parents only when the 
388.27 	child's need for care or treatment requires out-of-home placement and the child cannot be 
388.28 	maintained in the home of the parent; and
388.29 	(3) to ensure that the child's parent retains legal custody of the child and associated 
388.30 	decision-making authority unless the child's parent willfully fails or is unable to make 
388.31 	decisions that meet the child's safety, health, and best interests. The court may not find that 
388.32 	the parent willfully fails or is unable to make decisions that meet the child's needs solely 
388.33 	because the parent disagrees with the agency's choice of foster care facility, unless the 
389.1 	agency files a petition under chapter 260C, and establishes by clear and convincing evidence 
389.2 	that the child is in need of protection or services.
389.3 	(f) The legal parent-child relationship shall be supported under this chapter by maintaining 
389.4 	the parent's legal authority and responsibility for ongoing planning for the child and by the 
389.5 	agency's assisting the parent, when necessary, to exercise the parent's ongoing right and 
389.6 	obligation to visit or to have reasonable contact with the child. Ongoing planning means:
389.7 	(1) actively participating in the planning and provision of educational services, medical, 
389.8 	and dental care for the child;
389.9 	(2) actively planning and participating with the agency and the foster care facility for 
389.10 	the child's treatment needs;
389.11 	(3) planning to meet the child's need for safety, stability, and permanency, and the child's 
389.12 	need to stay connected to the child's family and community;
389.13 	(4) engaging with the responsible social services agency to ensure that the family and 
389.14 	permanency team under section 260C.706 consists of appropriate family members. For 
389.15 	purposes of voluntary placement of a child in foster care for treatment under chapter 260D, 
389.16 	prior to forming the child's family and permanency team, the responsible social services 
389.17 	agency must consult with the child's parent or legal guardian, the child if the child is 14 
389.18 	years of age or older, and, if applicable, the child's Tribe to obtain recommendations regarding 
389.19 	which individuals to include on the team and to ensure that the team is family-centered and 
389.20 	will act in the child's best interests. If the child, child's parents, or legal guardians raise 
389.21 	concerns about specific relatives or professionals, the team should not include those 
389.22 	individuals unless the individual is a treating professional or an important connection to the 
389.23 	youth as outlined in the case or crisis plan; and
389.24 	(5) for a voluntary placement under this chapter in a qualified residential treatment 
389.25 	program, as defined in section 260C.007, subdivision 26d, for purposes of engaging in a 
389.26 	relative search as provided in section 260C.221, the county agency must consult with the 
389.27 	child's parent or legal guardian, the child if the child is 14 years of age or older, and, if 
389.28 	applicable, the child's Tribe to obtain recommendations regarding which adult relatives the 
389.29 	county agency should notify. If the child, child's parents, or legal guardians raise concerns 
389.30 	about specific relatives, the county agency should not notify those relatives.
389.31 	(g) The provisions of section 260.012 to ensure placement prevention, family 
389.32 	reunification, and all active and reasonable effort requirements of that section apply. This 
389.33 	chapter shall be construed consistently with the requirements of the Indian Child Welfare 
390.1 	Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the 
390.2 	Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

390.3 	Sec. 53. [260D.011] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE 
390.4 	ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
390.5 	Proceedings under this chapter concerning an Indian child are child custody proceedings 
390.6 	governed by the Indian Child Welfare Act, United States Code, title 25, sections 1901 to 
390.7 	1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; and 
390.8 	by this chapter when not inconsistent with the federal Indian Child Welfare Act or the 
390.9 	Minnesota Indian Family Preservation Act.

390.10 	Sec. 54. [260E.015] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE 
390.11 	ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
390.12 	Proceedings under this chapter concerning an Indian child are child custody proceedings 
390.13 	governed by the Indian Child Welfare Act, United States Code, title 25, sections 1901 to 
390.14 	1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; and 
390.15 	by this chapter when not inconsistent with the federal Indian Child Welfare Act or the 
390.16 	Minnesota Indian Family Preservation Act.

390.17 	Sec. 55. [524.5-2011] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE 
390.18 	ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
390.19 	Proceedings under this chapter concerning an Indian child are child custody proceedings  
390.20 	governed by the Indian Child Welfare Act, United States Code, title 25, sections 1901 to 
390.21 	1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; and 
390.22 	by this chapter when not inconsistent with the federal Indian Child Welfare Act or the 
390.23 	Minnesota Indian Family Preservation Act.

390.24 	Sec. 56. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; STUDY OF 
390.25 	CHILD PLACEMENT AND PERMANENCY; PRACTICE RECOMMENDATIONS.
 390.26 		Subdivision 1.Study parameters. By September 1, 2024, the commissioner of human 
390.27 	services shall contract with an independent consultant to evaluate the effects of child 
390.28 	placement in foster care and out-of-home settings on the safety, permanency, and well-being 
390.29 	of the child. The study must be designed to evaluate the system overall for a child's placement 
390.30 	and permanency. The study shall identify and evaluate factors designed to ensure emotional 
390.31 	and physical safety of the child in the context of child placement and permanency dispositions 
391.1 	and shall include an analysis of structuring out-of-home placement decisions, reunification 
391.2 	timelines, and service provisions to best allow the parents to engage in positive parenting 
391.3 	of the child. The goal is to determine guidelines for when to place a child out-of-home, who 
391.4 	to place the child with, when and how to keep the child connected to family and community, 
391.5 	and what timelines support building a stable base for the child's parents to engage in necessary 
391.6 	treatment, including but not limited to substance use or mental health treatment, before 
391.7 	undertaking parenting responsibilities.
391.8 	(b) The study shall take into account the educational and behavioral development, mental 
391.9 	health functioning, and placement stability of the child. The study shall also take into 
391.10 	consideration the social, financial, and whole health of the family unit.
391.11 		Subd. 2.Collaboration with interested parties. The consultant shall design the study 
391.12 	with an advisory group consisting of:
391.13 	(1) the commissioner of human services, or a designee;
391.14 	(2) the commissioner of children, youth, and families, or a designee;
391.15 	(3) the ombudsperson for foster youth, or a designee;
391.16 	(4) a representative from the Association of Minnesota Counties appointed by the 
391.17 	association;
391.18 	(5) two members representing county social services agencies, one from the seven-county 
391.19 	metropolitan area and one from Greater Minnesota;
391.20 	(6) one member appointed by the Minnesota Council on Disability;
391.21 	(7) one member appointed by the Indian Child Welfare Advisory Council;
391.22 	(8) one member appointed by the Ombudsperson for American Indian Families;
391.23 	(9) one member appointed by the Children's Alliance;
391.24 	(10) up to four members appointed by the ombudsperson for families;
391.25 	(11) up to four members from the Children's Justice Task Force; and
391.26 	(12) members of the public appointed by the governor representing:
391.27 	(i) one member 18 years of age who has lived experience with the child welfare system;
391.28 	(ii) one member 18 years of age or older who has lived experience with the child welfare 
391.29 	system as a parent or caregiver;
391.30 	(iii) one member who is working with or advocating for children with disabilities;
392.1 	(iv) one member with experience working with or advocating for LGBTQ youth;
392.2 	(v) one member working with or advocating for Indigenous children;
392.3 	(vi) one member working with or advocating for black children or youth;
392.4 	(vii) one member working with or advocating for other children of color;
392.5 	(viii) one member who is an attorney representing children in child placement 
392.6 	proceedings;
392.7 	(ix) one member who is a Tribal attorney in child placement proceedings;
392.8 	(x) one member who is an attorney representing parents in child placement proceedings;
392.9 	(xi) one member with experience in children's mental health;
392.10 	(xii) one member with experience in adult mental health; and
392.11 	(xiii) one member who is a substance abuse professional.
392.12 		Subd. 3.Report. By September 1, 2027, the consultant shall submit a final report to the 
392.13 	commissioner of human services and to the chairs and ranking minority members of the 
392.14 	legislative committees with jurisdiction over health and human services. The final report 
392.15 	must include a recommendation on the optimal time frame for child placement in foster 
392.16 	care or out-of-home placement. The commissioner of human services shall include a report 
392.17 	on needed statutory changes as a result of the consultant's report.

392.18 	Sec. 57. REPEALER.
 392.19 	Minnesota Statutes 2022, section 260.755, subdivision 13, is repealed.

392.20 	ARTICLE 16
392.21 	MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD 
392.22 	WELFARE DISPROPORTIONALITY ACT

392.23 	Section 1. [260.61] CITATION.
392.24 	Sections 260.61 to 260.695 may be cited as the "Minnesota African American Family 
392.25 	Preservation and Child Welfare Disproportionality Act."

392.26 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
392.27 	section 19 of this article.

393.1 	Sec. 2. [260.62] PURPOSES.
393.2 	(a) The purposes of the Minnesota African American Family Preservation and Child 
393.3 	Welfare Disproportionality Act are to:
393.4 	(1) protect the best interests of African American and disproportionately represented 
393.5 	children;
393.6 	(2) promote the stability and security of African American and disproportionately 
393.7 	represented children and their families by establishing minimum standards to prevent the 
393.8 	arbitrary and unnecessary removal of African American and disproportionately represented 
393.9 	children from their families; and
393.10 	(3) improve permanency outcomes, including family reunification, for African American 
393.11 	and disproportionately represented children.
393.12 	(b) Nothing in this legislation is intended to interfere with the protections of the Indian 
393.13 	Child Welfare Act of 1978, United States Code, title 25, sections 1901 to 1963.

393.14 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
393.15 	section 19 of this article.

393.16 	Sec. 3. [260.63] DEFINITIONS.
393.17 		Subdivision 1.Scope. The definitions in this section apply to sections 260.61 to 260.695.
393.18 		Subd. 2.Active efforts. "Active efforts" means a rigorous and concerted level of effort 
393.19 	that the responsible social services agency must continuously make throughout the time 
393.20 	that the responsible social services agency is involved with an African American or a 
393.21 	disproportionately represented child and the child's family. To provide active efforts to 
393.22 	preserve an African American or a disproportionately represented child's family, the 
393.23 	responsible social services agency must continuously involve an African American or a 
393.24 	disproportionately represented child's family in all services for the family, including case 
393.25 	planning and choosing services and providers, and inform the family of the ability to request 
393.26 	a case review by the commissioner under section 260.694. When providing active efforts, 
393.27 	a responsible social services agency must consider an African American or a 
393.28 	disproportionately represented family's social and cultural values at all times while providing 
393.29 	services to the African American or disproportionately represented child and family. Active 
393.30 	efforts includes continuous efforts to preserve an African American or a disproportionately 
393.31 	represented child's family and to prevent the out-of-home placement of an African American 
393.32 	or a disproportionately represented child. If an African American or a disproportionately 
393.33 	represented child enters out-of-home placement, the responsible social services agency must 
394.1 	make active efforts to reunify the African American or disproportionately represented child 
394.2 	with the child's family as soon as possible. Active efforts sets a higher standard for the 
394.3 	responsible social services agency than reasonable efforts to preserve the child's family, 
394.4 	prevent the child's out-of-home placement, and reunify the child with the child's family. 
394.5 	Active efforts includes the provision of reasonable efforts as required by Title IV-E of the 
394.6 	Social Security Act, United States Code, title 42, sections 670 to 679c.
394.7 		Subd. 3.Adoptive placement. "Adoptive placement" means the permanent placement 
394.8 	of an African American or a disproportionately represented child made by the responsible 
394.9 	social services agency upon a fully executed adoption placement agreement, including the 
394.10 	signatures of the adopting parent, the responsible social services agency, and the 
394.11 	commissioner of human services according to section 260C.613, subdivision 1.
394.12 		Subd. 4.African American child. "African American child" means a child having 
394.13 	origins in Africa, including a child of two or more races who has at least one parent with 
394.14 	origins in Africa.
394.15 		Subd. 5.Best interests of the African American or disproportionately represented 
394.16 	child. The "best interests of the African American or disproportionately represented child" 
394.17 	means providing a culturally informed practice lens that acknowledges, utilizes, and embraces 
394.18 	the African American or disproportionately represented child's community and cultural 
394.19 	norms and allows the child to remain safely at home with the child's family. The best interests 
394.20 	of the African American or disproportionately represented child support the child's sense 
394.21 	of belonging to the child's family, extended family, kin, and cultural community.
394.22 		Subd. 6.Child placement proceeding. (a) "Child placement proceeding" means any 
394.23 	judicial proceeding that could result in:
394.24 	(1) an adoptive placement;
394.25 	(2) a foster care placement;
394.26 	(3) a preadoptive placement; or
394.27 	(4) a termination of parental rights.
394.28 	(b) Judicial proceedings under this subdivision include a child's placement based upon 
394.29 	a child's juvenile status offense but do not include a child's placement based upon:
394.30 	(1) an act which if committed by an adult would be deemed a crime; or
394.31 	(2) an award of child custody in a divorce proceeding to one of the child's parents.
395.1 		Subd. 7.Commissioner. "Commissioner" means the commissioner of human services 
395.2 	or the commissioner's designee.
395.3 		Subd. 8.Custodian. "Custodian" means any person who is under a legal obligation to 
395.4 	provide care and support for an African American or a disproportionately represented child, 
395.5 	or who is in fact providing daily care and support for an African American or a 
395.6 	disproportionately represented child. This subdivision does not impose a legal obligation 
395.7 	upon a person who is not otherwise legally obligated to provide a child with necessary food, 
395.8 	clothing, shelter, education, or medical care.
395.9 		Subd. 9.Disproportionality. "Disproportionality" means the overrepresentation of 
395.10 	African American children and other disproportionately represented children in Minnesota's 
395.11 	child welfare system population as compared to the representation of those children in 
395.12 	Minnesota's total child population.
395.13 		Subd. 10.Disproportionately represented child. "Disproportionately represented child" 
395.14 	means a child whose race, culture, ethnicity, or low-income socioeconomic status is 
395.15 	disproportionately encountered, engaged, or identified in the child welfare system as 
395.16 	compared to the representation in Minnesota's total child population.
395.17 		Subd. 11.Egregious harm. "Egregious harm" has the meaning given in section 260E.03, 
395.18 	subdivision 5.
395.19 		Subd. 12.Foster care placement. "Foster care placement" means the court-ordered 
395.20 	removal of an African American or a disproportionately represented child from the child's 
395.21 	home with the child's parent or legal custodian and the temporary placement of the child in 
395.22 	a foster home, in shelter care or a facility, or in the home of a guardian, when the parent or 
395.23 	legal custodian cannot have the child returned upon demand, but the parent's parental rights 
395.24 	have not been terminated. A foster care placement includes an order placing the child under 
395.25 	the guardianship of the commissioner, pursuant to section 260C.325, prior to an adoption 
395.26 	being finalized.
395.27 		Subd. 13.Imminent physical damage or harm. "Imminent physical damage or harm" 
395.28 	means that a child is threatened with immediate and present conditions that are 
395.29 	life-threatening or likely to result in abandonment, sexual abuse, or serious physical injury.
395.30 		Subd. 14.Responsible social services agency. "Responsible social services agency" 
395.31 	has the meaning given in section 260C.007, subdivision 27a.
395.32 		Subd. 15.Parent. "Parent" means the biological parent of an African American or a 
395.33 	disproportionately represented child or any person who has legally adopted an African 
396.1 	American or a disproportionately represented child who, prior to the adoption, was considered 
396.2 	a relative to the child, as defined in subdivision 16. Parent includes an unmarried father 
396.3 	whose paternity has been acknowledged or established and a putative father. Paternity has 
396.4 	been acknowledged when an unmarried father takes any action to hold himself out as the 
396.5 	biological father of a child.
396.6 		Subd. 16.Preadoptive placement. "Preadoptive placement" means a responsible social 
396.7 	services agency's placement of an African American or a disproportionately represented 
396.8 	child with the child's family or kin when the child is under the guardianship of the 
396.9 	commissioner for the purpose of adoption but an adoptive placement agreement for the 
396.10 	child has not been fully executed.
396.11 		Subd. 17.Relative. "Relative" means:
396.12 	(1) an individual related to the child by blood, marriage, or adoption;
396.13 	(2) a legal parent, guardian, or custodian of the child's sibling;
396.14 	(3) an individual who is an important friend of the child or child's family with whom 
396.15 	the child has resided or has had significant contact; or
396.16 	(4) an individual who the child or the child's family identify as related to the child's 
396.17 	family.
396.18 		Subd. 18.Safety network. "Safety network" means a group of individuals identified by 
396.19 	the parent and child, when appropriate, that is accountable for developing, implementing, 
396.20 	sustaining, supporting, or improving a safety plan to protect the safety and well-being of a 
396.21 	child.
396.22 		Subd. 19.Sexual abuse. "Sexual abuse" has the meaning given in section 260E.03, 
396.23 	subdivision 20.
396.24 		Subd. 20.Termination of parental rights. "Termination of parental rights" means an 
396.25 	action resulting in the termination of the parent-child relationship under section 260C.301.

396.26 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
396.27 	section 19 of this article.

396.28 	Sec. 4. [260.64] DUTY TO PREVENT OUT-OF-HOME PLACEMENT AND 
396.29 	PROMOTE FAMILY REUNIFICATION.
396.30 		Subdivision 1.Active efforts. A responsible social services agency shall make active 
396.31 	efforts to prevent the out-of-home placement of an African American or a disproportionately 
396.32 	represented child, eliminate the need for a child's removal from the child's home, and reunify 
397.1 	an African American or a disproportionately represented child with the child's family as 
397.2 	soon as practicable.
397.3 		Subd. 2.Safety plan. (a) Prior to petitioning the court to remove an African American 
397.4 	or a disproportionately represented child from the child's home, a responsible social services 
397.5 	agency must work with the child's family to allow the child to remain in the child's home 
397.6 	while implementing a safety plan based on the family's needs. The responsible social services 
397.7 	agency must:
397.8 	(1) make active efforts to engage the child's parent or custodian and the child, when 
397.9 	appropriate;
397.10 	(2) assess the family's cultural and economic needs;
397.11 	(3) hold a family group consultation meeting and connect the family with supports to 
397.12 	establish a safety network for the family; and
397.13 	(4) provide support, guidance, and input to assist the family and the family's safety 
397.14 	network with developing the safety plan.
397.15 	(b) The safety plan must:
397.16 	(1) address the specific allegations impacting the child's safety in the home. If neglect 
397.17 	is alleged, the safety plan must incorporate economic services and supports to address the 
397.18 	family's specific needs and prevent neglect;
397.19 	(2) incorporate family and community support to ensure the child's safety while keeping 
397.20 	the family intact; and
397.21 	(3) be adjusted as needed to address the child's and family's ongoing needs and support.
397.22 	(c) The responsible social services agency is not required to establish a safety plan in a 
397.23 	case with allegations of sexual abuse or egregious harm.
397.24 		Subd. 3.Out-of-home placement prohibited. Unless the court finds by clear and 
397.25 	convincing evidence that the child would be at risk of serious emotional damage or serious 
397.26 	physical damage if the child were to remain in the child's home, a court shall not order a 
397.27 	foster care or permanent out-of-home placement of an African American or a 
397.28 	disproportionately represented child alleged to be in need of protection or services. At each 
397.29 	hearing regarding an African American or a disproportionately represented child who is 
397.30 	alleged or adjudicated to be in need of child protective services, the court shall review 
397.31 	whether the responsible social services agency has provided active efforts to the child and 
397.32 	the child's family and shall require the responsible social services agency to provide evidence 
398.1 	and documentation that demonstrates that the agency is providing culturally informed, 
398.2 	strength-based, community-involved, and community-based services to the child and the 
398.3 	child's family.
398.4 		Subd. 4.Required findings that active efforts were provided. When determining 
398.5 	whether the responsible social services agency has made active efforts to preserve the child's 
398.6 	family, the court shall make findings regarding whether the responsible social services 
398.7 	agency made appropriate and meaningful services available to the child's family based upon 
398.8 	the family's specific needs. If a court determines that the responsible social services agency 
398.9 	did not make active efforts to preserve the family as required by this section, the court shall 
398.10 	order the responsible social services agency to immediately provide active efforts to the 
398.11 	child and child's family to preserve the family.

398.12 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
398.13 	section 19 of this article.

398.14 	Sec. 5. [260.641] ENSURING FREQUENT VISITATION FOR AFRICAN 
398.15 	AMERICAN AND DISPROPORTIONATELY REPRESENTED CHILDREN IN 
398.16 	OUT-OF-HOME PLACEMENT.
398.17 	A responsible social services agency must engage in best practices related to visitation 
398.18 	when an African American or a disproportionately represented child is in out-of-home 
398.19 	placement. When the child is in out-of-home placement, the responsible social services 
398.20 	agency shall make active efforts to facilitate regular and frequent visitation between the 
398.21 	child and the child's parents or custodians, the child's siblings, and the child's relatives. If 
398.22 	visitation is infrequent between the child and the child's parents, custodians, siblings, or 
398.23 	relatives, the responsible social services agency shall make active efforts to increase the 
398.24 	frequency of visitation and address any barriers to visitation.

398.25 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
398.26 	section 19 of this article.

398.27 	Sec. 6. [260.65] NONCUSTODIAL PARENTS; TEMPORARY OUT-OF-HOME 
398.28 	PLACEMENT.
398.29 		Subdivision 1.Active efforts required; responsible social services agency. Prior to 
398.30 	or within 48 hours of the removal of an African American or a disproportionately represented 
398.31 	child from the child's home, the responsible social services agency must make active efforts 
398.32 	to identify and locate the child's noncustodial or nonadjudicated parent and the child's 
398.33 	relatives to notify the child's parent and relatives that the child is or will be placed in foster 
399.1 	care and provide the child's parent and relatives with a list of legal resources. The notice to 
399.2 	the child's noncustodial or nonadjudicated parent and relatives must also include the 
399.3 	information required under section 260C.221, subdivision 2. The responsible social services 
399.4 	agency must maintain detailed records of the agency's efforts to notify parents and relatives 
399.5 	under this section.
399.6 		Subd. 2.Placement with noncustodial or nonadjudicated parent. (a) Notwithstanding 
399.7 	the provisions of section 260C.219, the responsible social services agency must assess an 
399.8 	African American or a disproportionately represented child's noncustodial or nonadjudicated 
399.9 	parent's ability to care for the child before placing the child in foster care. If a child's 
399.10 	noncustodial or nonadjudicated parent is willing and able to provide daily care for the 
399.11 	African American or disproportionately represented child temporarily or permanently, the 
399.12 	court shall order that the child be placed in the home of the noncustodial or nonadjudicated 
399.13 	parent pursuant to section 260C.178 or 260C.201, subdivision 1. The responsible social 
399.14 	services agency must make active efforts to assist a noncustodial or nonadjudicated parent 
399.15 	with remedying any issues that may prevent the child from being placed with the noncustodial 
399.16 	or nonadjudicated parent.
399.17 	(b) If an African American or a disproportionately represented child's noncustodial or 
399.18 	nonadjudicated parent is unwilling or unable to provide daily care for the child and the court 
399.19 	has determined that the child's continued placement in the home of the child's noncustodial 
399.20 	or nonadjudicated parent would endanger the child's health, safety, or welfare, the child's 
399.21 	parent, custodian, or the child, when appropriate, has the right to select one or more relatives 
399.22 	who may be willing and able to provide temporary care for the child. The responsible social 
399.23 	services agency must place the child with a selected relative after assessing the relative's 
399.24 	willingness and ability to provide daily care for the child. If selected relatives are not available 
399.25 	or there is a documented safety concern with the relative placement, the responsible social 
399.26 	services agency shall consider additional relatives for the child's placement.
399.27 		Subd. 3.Informal kinship care agreement. The responsible social services agency 
399.28 	must inform selected relatives and the child's parent or custodian of the difference between 
399.29 	informal kinship care arrangements and court-ordered foster care. If a selected relative and 
399.30 	the child's parent or custodian request an informal kinship care arrangement for a child's 
399.31 	placement instead of court-ordered foster care and such an arrangement will maintain the 
399.32 	child's safety and well-being, the responsible social services agency shall comply with the 
399.33 	request and inform the court of the plan for the child. The court shall honor the request to 
399.34 	forego a court-ordered foster care placement of the child in favor of an informal kinship 
400.1 	care arrangement, unless the court determines that the request is not in the best interests of 
400.2 	the African American or disproportionately represented child.
400.3 		Subd. 4.Active efforts; child foster care licensure process. The responsible social 
400.4 	services agency must make active efforts to support relatives with whom a child is placed 
400.5 	in completing the child foster care licensure process and addressing barriers, disqualifications, 
400.6 	or other issues affecting the relatives' licensure, including but not limited to assisting relatives 
400.7 	with requesting reconsideration of a disqualification under section 245C.21.
400.8 		Subd. 5.Future placement not prohibited. The decision by a relative not to be 
400.9 	considered as an African American or a disproportionately represented child's foster care 
400.10 	or temporary placement option shall not be a basis for the responsible social services agency 
400.11 	or the court to rule out the relative for placement in the future or for denying the relative's 
400.12 	request to be considered or selected as a foster care or permanent placement for the child.

400.13 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
400.14 	section 19 of this article.

400.15 	Sec. 7. [260.66] EMERGENCY REMOVAL.
400.16 		Subdivision 1.Emergency removal or placement permitted. Nothing in this section 
400.17 	shall be construed to prevent the emergency removal of an African American or a 
400.18 	disproportionately represented child's parent or custodian or the emergency placement of 
400.19 	the child in a foster setting in order to prevent imminent physical damage or harm to the 
400.20 	child.
400.21 		Subd. 2.Petition for emergency removal; placement requirements. A petition for a 
400.22 	court order authorizing the emergency removal or continued emergency placement of an 
400.23 	African American or a disproportionately represented child or the petition's accompanying 
400.24 	documents must contain a statement of the risk of imminent physical damage or harm to 
400.25 	the African American or disproportionately represented child and any evidence that the 
400.26 	emergency removal or placement continues to be necessary to prevent imminent physical 
400.27 	damage or harm to the child. The petition or its accompanying documents must also contain 
400.28 	the following information:
400.29 	(1) the name, age, and last known address of the child;
400.30 	(2) the name and address of the child's parents and custodians, or, if unknown, a detailed 
400.31 	explanation of efforts made to locate and contact them;
400.32 	(3) the steps taken to provide notice to the child's parents and custodians about the 
400.33 	emergency proceeding;
401.1 	(4) a specific and detailed account of the circumstances that led the agency responsible 
401.2 	for the emergency removal of the child to take that action; and
401.3 	(5) a statement of the efforts that have been taken to assist the child's parents or custodians 
401.4 	so that the child may safely be returned to their custody.
401.5 		Subd. 3.Emergency proceeding requirements. (a) The court shall hold a hearing no 
401.6 	later than 72 hours, excluding weekends and holidays, after the emergency removal of an 
401.7 	African American or a disproportionately represented child. The court shall determine 
401.8 	whether the emergency removal continues to be necessary to prevent imminent physical 
401.9 	damage or harm to the child.
401.10 	(b) The court shall hold additional hearings whenever new information indicates that 
401.11 	the emergency situation has ended. At any court hearing after the emergency proceeding, 
401.12 	the court must determine whether the emergency removal or placement is no longer necessary 
401.13 	to prevent imminent physical damage or harm to the child.
401.14 	(c) Notwithstanding section 260C.163, subdivision 3, and the provisions of Minnesota 
401.15 	Rules of Juvenile Protection Procedure, rule 25, a parent or custodian of an African American 
401.16 	or a disproportionately represented child who is subject to an emergency hearing under this 
401.17 	section and Minnesota Rules of Juvenile Protection Procedure, rule 30, must be represented 
401.18 	by counsel. The court must appoint qualified counsel to represent a parent if the parent 
401.19 	meets the eligibility requirements in section 611.17.
401.20 		Subd. 4.Termination of emergency removal or placement. (a) An emergency removal 
401.21 	or placement of an African American or a disproportionately represented child must 
401.22 	immediately terminate once the responsible social services agency or court possesses 
401.23 	sufficient evidence to determine that the emergency removal or placement is no longer 
401.24 	necessary to prevent imminent physical damage or harm to the child and the child shall be 
401.25 	immediately returned to the custody of the child's parent or custodian. The responsible social 
401.26 	services agency or court shall ensure that the emergency removal or placement terminates 
401.27 	immediately when the removal or placement is no longer necessary to prevent imminent 
401.28 	physical damage or harm to the African American or disproportionately represented child.
401.29 	(b) An emergency removal or placement ends when the court orders, after service upon 
401.30 	the African American or disproportionately represented child's parents or custodian, that 
401.31 	the child shall be placed in foster care upon a determination supported by clear and 
401.32 	convincing evidence that custody of the child by the child's parent or custodian is likely to 
401.33 	result in serious emotional or physical damage to the child.
402.1 	(c) In no instance shall emergency removal or emergency placement of an African 
402.2 	American or a disproportionately represented child extend beyond 30 days unless the court 
402.3 	finds by a showing of clear and convincing evidence that:
402.4 	(1) continued emergency removal or placement is necessary to prevent imminent physical 
402.5 	damage or harm to the child; and
402.6 	(2) it has not been possible to initiate a child placement proceeding with all of the 
402.7 	protections under sections 260.61 to 260.68.

402.8 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
402.9 	section 19 of this article.

402.10 	Sec. 8. [260.67] TRANSFER OF PERMANENT LEGAL AND PHYSICAL 
402.11 	CUSTODY; TERMINATION OF PARENTAL RIGHTS; CHILD PLACEMENT 
402.12 	PROCEEDINGS.
402.13 		Subdivision 1.Preference for transfer of permanent legal and physical custody. If 
402.14 	an African American or a disproportionately represented child cannot be returned to the 
402.15 	child's parent, the court shall, if possible, transfer permanent legal and physical custody of 
402.16 	the child to:
402.17 	(1) a noncustodial parent under section 260C.515, subdivision 4, if the child cannot 
402.18 	return to the care of the parent or custodian from whom the child was removed or who had 
402.19 	legal custody at the time that the child was placed in foster care; or
402.20 	(2) a willing and able relative, according to the requirements of section 260C.515, 
402.21 	subdivision 4, if the court determines that reunification with the child's family is not an 
402.22 	appropriate permanency option for the child. Prior to the court ordering a transfer of 
402.23 	permanent legal and physical custody to a relative who is not a parent, the responsible social 
402.24 	services agency must inform the relative of Northstar kinship assistance benefits and 
402.25 	eligibility requirements and of the relative's ability to apply for benefits on behalf of the 
402.26 	child under chapter 256N.
402.27 		Subd. 2.Termination of parental rights restrictions. (a) A court shall not terminate 
402.28 	the parental rights of a parent of an African American or a disproportionately represented 
402.29 	child based solely on the parent's failure to complete case plan requirements.
402.30 	(b) A court shall not terminate the parental rights of a parent of an African American or 
402.31 	a disproportionately represented child in a child placement proceeding unless the allegations 
402.32 	against the parent involve sexual abuse; egregious harm as defined in section 260C.007, 
402.33 	subdivision 14; murder in the first, second, or third degree under section 609.185, 609.19, 
403.1 	or 609.195; murder of an unborn child in the first, second, or third degree under section 
403.2 	609.2661, 609.2662, or 609.2663; manslaughter of an unborn child in the first or second 
403.3 	degree under section 609.2664 or 609.2665; domestic assault by strangulation under section 
403.4 	609.2247; felony domestic assault under section 609.2242 or 609.2243; kidnapping under 
403.5 	section 609.25; solicitation, inducement, and promotion of prostitution under section 609.322, 
403.6 	subdivision 1, and subdivision 1a if one or more aggravating factors are present; criminal 
403.7 	sexual conduct under sections 609.342 to 609.3451; engaging in, hiring, or agreeing to hire 
403.8 	a minor to engage in prostitution under section 609.324, subdivision 1; solicitation of children 
403.9 	to engage in sexual conduct under section 609.352; possession of pornographic work 
403.10 	involving minors under section 617.247; malicious punishment or neglect or endangerment 
403.11 	of a child under section 609.377 or 609.378; use of a minor in sexual performance under 
403.12 	section 617.246; or failing to protect a child from an overt act or condition that constitutes 
403.13 	egregious harm.
403.14 	(c) Nothing in this subdivision precludes the court from terminating the parental rights 
403.15 	of a parent of an African American or a disproportionately represented child if the parent  
403.16 	desires to voluntarily terminate the parent's own parental rights for good cause under section 
403.17 	260C.301, subdivision 1, paragraph (a).
403.18 		Subd. 3.Appeals. Notwithstanding the Minnesota Rules of Juvenile Protection Procedure, 
403.19 	rule 47.02, subdivision 2, a parent of an African American or a disproportionately represented 
403.20 	child whose parental rights have been terminated may appeal the decision within 90 days 
403.21 	of the service of notice by the court administrator of the filing of the court's order.

403.22 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
403.23 	section 19 of this article.

403.24 	Sec. 9. [260.68] RESPONSIBLE SOCIAL SERVICES AGENCY CONDUCT AND 
403.25 	CASE REVIEW.
403.26 		Subdivision 1.Responsible social services agency conduct. (a) A responsible social 
403.27 	services agency employee who has duties related to child protection shall not knowingly:
403.28 	(1) make untrue statements about any case involving a child alleged to be in need of 
403.29 	protection or services;
403.30 	(2) intentionally withhold any information that may be material to a case involving a 
403.31 	child alleged to be in need of protection or services; or
403.32 	(3) fabricate or falsify any documentation or evidence relating to a case involving a child 
403.33 	alleged to be in need of protection or services.
404.1 	(b) Any of the actions listed in paragraph (a) shall constitute grounds for adverse 
404.2 	employment action.
404.3 		Subd. 2.Commissioner notification. (a) When a responsible social services agency 
404.4 	makes a maltreatment determination involving an African American or a disproportionately 
404.5 	represented child or places an African American or a disproportionately represented child 
404.6 	in a foster care placement, the agency shall, within seven days of making a maltreatment 
404.7 	determination or initiating the child's foster care placement, notify the commissioner of the 
404.8 	maltreatment determination or foster care placement and of the steps that the agency has 
404.9 	taken to investigate and remedy the conditions that led to the maltreatment determination 
404.10 	or foster care placement. Upon receiving this notice, the commissioner shall review the 
404.11 	responsible social services agency's handling of the child's case to ensure that the case plan 
404.12 	and services address the unique needs of the child and the child's family and that the agency 
404.13 	is making active efforts to reunify and preserve the child's family. At all stages of a case 
404.14 	involving an African American or a disproportionately represented child, the responsible 
404.15 	social services agency shall, upon request, fully cooperate with the commissioner and, as 
404.16 	appropriate and as permitted under statute, provide access to all relevant case files.
404.17 	(b) In any adoptive or preadoptive placement proceeding involving an African American 
404.18 	or a disproportionately represented child under the guardianship of the commissioner, the 
404.19 	responsible social services agency shall notify the commissioner of the pending proceeding 
404.20 	and of the right of intervention. The notice must include the identity of the child and the 
404.21 	child's parents whose parental rights were terminated or who consented to the child's 
404.22 	adoption. Upon receipt of the notice, the commissioner shall review the case to ensure that 
404.23 	the requirements of this act have been met. When the responsible social services agency 
404.24 	has identified a nonrelative as an African American or a disproportionately represented 
404.25 	child's adoptive placement, no preadoptive or adoptive placement proceeding may be held 
404.26 	until at least 30 days after the commissioner receives the required notice or until an adoption 
404.27 	home study can be completed for a relative adoption, whichever occurs first. If the 
404.28 	commissioner requests additional time to prepare for the proceeding, the district court must 
404.29 	grant the commissioner up to 30 additional days to prepare for the proceeding. In cases in 
404.30 	which a responsible social services agency or party to a preadoptive or adoptive placement 
404.31 	knows or has reason to believe that a child is or may be African American or a 
404.32 	disproportionately represented child, proof of service upon the commissioner must be filed 
404.33 	with the adoption petition.
404.34 		Subd. 3.Case review. (a) Each responsible social services agency shall conduct a review 
404.35 	of all child protection cases handled by the agency every 24 months, after establishing a 
405.1 	2024 baseline. The responsible social services agency shall report the agency's findings to 
405.2 	the county board, related child welfare committees, the Children's Justice Initiative team, 
405.3 	the commissioner, and community stakeholders within six months of gathering the relevant 
405.4 	case data. The case review must include:
405.5 	(1) the number of African American and disproportionately represented children 
405.6 	represented in the county child welfare system;
405.7 	(2) the number and sources of maltreatment reports received and reports screened in for 
405.8 	investigation or referred for family assessment and the race of the children and parents or 
405.9 	custodians involved in each report;
405.10 	(3) the number and race of children and parents or custodians who receive in-home 
405.11 	preventive case management services;
405.12 	(4) the number and race of children whose parents or custodians are referred to 
405.13 	community-based, culturally appropriate, strength-based, or trauma-informed services;
405.14 	(5) the number and race of children removed from their homes;
405.15 	(6) the number and race of children reunified with their parents or custodians;
405.16 	(7) the number and race of children whose parents or custodians are offered family group 
405.17 	decision-making services;
405.18 	(8) the number and race of children whose parents or custodians are offered the parent 
405.19 	support outreach program;
405.20 	(9) the number and race of children in foster care or out-of-home placement at the time 
405.21 	that the data is gathered;
405.22 	(10) the number and race of children who achieve permanency through a transfer of 
405.23 	permanent legal and physical custody to a relative, a legal guardianship, or an adoption; 
405.24 	and
405.25 	(11) the number and race of children who are under the guardianship of the commissioner 
405.26 	or awaiting a permanency disposition.
405.27 	(b) The required case review must also:
405.28 	(1) identify barriers to reunifying children with their families;
405.29 	(2) identify the family conditions that led to the out-of-home placement;
405.30 	(3) identify any barriers to accessing culturally informed mental health or substance use 
405.31 	disorder treatment services for the parents or children;
406.1 	(4) document efforts to identify fathers and maternal and paternal relatives and to provide 
406.2 	services to custodial and noncustodial fathers, if appropriate; and
406.3 	(5) document and summarize court reviews of active efforts.
406.4 	(c) Any responsible social services agency that has a case review showing 
406.5 	disproportionality and disparities in child welfare outcomes for African American and other 
406.6 	disproportionately represented children and families, compared to the agency's overall 
406.7 	outcomes, must develop a remediation plan to be approved by the commissioner. The 
406.8 	responsible social services agency must develop the plan within 30 days of finding the 
406.9 	disproportionality or disparities and must make measurable improvements within 12 months 
406.10 	of the date that the commissioner approves the remediation plan. A responsible social 
406.11 	services agency may request assistance from the commissioner to develop a remediation 
406.12 	plan. The remediation plan must include measurable outcomes to identify, address, and 
406.13 	reduce the factors that led to the disproportionality and disparities in the agency's child 
406.14 	welfare outcomes and include information about how the responsible social services agency 
406.15 	will achieve and document trauma-informed, positive child well-being outcomes through 
406.16 	remediation efforts.

406.17 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
406.18 	section 19 of this article.

406.19 	Sec. 10. [260.69] CULTURAL COMPETENCY TRAINING FOR INDIVIDUALS 
406.20 	WORKING WITH AFRICAN AMERICAN AND DISPROPORTIONATELY 
406.21 	REPRESENTED CHILDREN.
406.22 		Subdivision 1.Applicability. The commissioner of human services must collaborate 
406.23 	with the Children's Justice Initiative to ensure that cultural competency training is given to 
406.24 	individuals working in the child welfare system, including child welfare workers, supervisors, 
406.25 	attorneys, juvenile court judges, and family law judges.
406.26 		Subd. 2.Training. (a) The commissioner must develop training content and establish 
406.27 	the frequency of trainings.
406.28 	(b) The cultural competency training under this section is required prior to or within six 
406.29 	months of beginning work with any African American or disproportionately represented 
406.30 	child and their family. A responsible social services agency staff person who is unable to 
406.31 	complete the cultural competency training prior to working with African American or 
406.32 	disproportionately represented children and their families must work with a qualified staff 
406.33 	person within the agency who has completed cultural competency training until the person 
407.1 	is able to complete the required training. The training must be available by January 1, 2027, 
407.2 	and must:
407.3 	(1) be provided by an African American individual or individual from a community that 
407.4 	is disproportionately represented in the child welfare system who is knowledgeable about 
407.5 	African American and other disproportionately represented social and cultural norms and 
407.6 	historical trauma;
407.7 	(2) raise awareness and increase a person's competency to value diversity, conduct a 
407.8 	self-assessment, manage the dynamics of difference, acquire cultural knowledge, and adapt 
407.9 	to diversity and the cultural contexts of communities served;
407.10 	(3) include instruction on effectively developing a safety plan and instruction on engaging 
407.11 	a safety network; and
407.12 	(4) be accessible and comprehensive and include the ability to ask questions.
407.13 	(c) The training may be provided in a series of segments, either in person or online.
407.14 		Subd. 3.Update. The commissioner must provide an update to the chairs and ranking 
407.15 	minority members of the legislative committees with jurisdiction over child protection by 
407.16 	July 1, 2027, on the rollout of the training under subdivision 1 and the content and 
407.17 	accessibility of the training under subdivision 2.

407.18 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
407.19 	section 19 of this article.

407.20 	Sec. 11. [260.691] AFRICAN AMERICAN CHILD WELL-BEING ADVISORY 
407.21 	COUNCIL.
407.22 		Subdivision 1.Duties. The African American Child Well-Being Advisory Council must:
407.23 	(1) review annual reports related to African American children involved in the child 
407.24 	welfare system. These reports may include, but are not limited to the maltreatment, 
407.25 	out-of-home placement, and permanency of African American children;
407.26 	(2) assist in and make recommendations to the commissioner for developing strategies 
407.27 	to reduce maltreatment determinations, prevent unnecessary out-of-home placement, promote 
407.28 	culturally appropriate foster care and shelter or facility placement decisions and settings for 
407.29 	African American children in need of out-of-home placement, ensure timely achievement 
407.30 	of permanency, and improve child welfare outcomes for African American children and 
407.31 	their families;
408.1 	(3) review summary reports on targeted case reviews prepared by the commissioner to 
408.2 	ensure that responsible social services agencies meet the needs of African American children 
408.3 	and their families. Based on data collected from those reviews, the council will assist the 
408.4 	commissioner with developing strategies needed to improve any identified child welfare 
408.5 	outcomes, including but not limited to maltreatment, out-of-home placement, and permanency 
408.6 	for African American children;
408.7 	(4) assist the Cultural and Ethnic Communities Leadership Council with making 
408.8 	recommendations to the commissioner and the legislature for public policy and statutory 
408.9 	changes that specifically consider the needs of African American children and their families 
408.10 	involved in the child welfare system;
408.11 	(5) advise the commissioner on stakeholder engagement strategies and actions that the 
408.12 	commissioner and responsible social services agencies may take to improve child welfare 
408.13 	outcomes for African American children and their families;
408.14 	(6) assist the commissioner with developing strategies for public messaging and 
408.15 	communication related to racial disproportionality and disparities in child welfare outcomes 
408.16 	for African American children and their families;
408.17 	(7) assist the commissioner with identifying and developing internal and external 
408.18 	partnerships to support adequate access to services and resources for African American 
408.19 	children and their families, including but not limited to housing assistance, employment 
408.20 	assistance, food and nutrition support, health care, child care assistance, and educational 
408.21 	support and training; and
408.22 	(8) assist the commissioner with developing strategies to promote the development of 
408.23 	a culturally diverse and representative child welfare workforce in Minnesota that includes 
408.24 	professionals who are reflective of the community served and who have been directly 
408.25 	impacted by lived experiences within the child welfare system. The council must also assist 
408.26 	the commissioner in exploring strategies and partnerships to address education and training 
408.27 	needs, hiring, recruitment, retention, and professional advancement practices.
408.28 		Subd. 2.Annual report. By January 1, 2026, and annually thereafter, the council shall 
408.29 	report to the chairs and ranking minority members of the legislative committees with 
408.30 	jurisdiction over child protection on the council's activities under subdivision 1 and other 
408.31 	issues on which the council chooses to report. The report may include recommendations 
408.32 	for statutory changes to improve the child protection system and child welfare outcomes 
408.33 	for African American children and families.

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

409.1 	Sec. 12. [260.692] AFRICAN AMERICAN CHILD WELL-BEING UNIT.
409.2 		Subdivision 1.Duties. The African American Child Well-Being Unit, currently 
409.3 	established by the commissioner, must:
409.4 	(1) assist with the development of African American cultural competency training and 
409.5 	review child welfare curriculum in the Minnesota Child Welfare Training Academy to 
409.6 	ensure that responsible social services agency staff and other child welfare professionals 
409.7 	are appropriately prepared to engage with African American children and their families and 
409.8 	to support family preservation and reunification;
409.9 	(2) provide technical assistance, including on-site technical assistance, and case 
409.10 	consultation to responsible social services agencies to assist agencies with implementing 
409.11 	and complying with the Minnesota African American Family Preservation and Child Welfare 
409.12 	Disproportionality Act;
409.13 	(3) monitor individual county and statewide disaggregated and nondisaggregated data 
409.14 	to identify trends and patterns in child welfare outcomes, including but not limited to 
409.15 	reporting, maltreatment, out-of-home placement, and permanency of African American 
409.16 	children and develop strategies to address disproportionality and disparities in the child 
409.17 	welfare system;
409.18 	(4) develop and implement a system for conducting case reviews when the commissioner 
409.19 	receives reports of noncompliance with the Minnesota African American Family Preservation 
409.20 	and Child Welfare Disproportionality Act or when requested by the parent or custodian of 
409.21 	an African American child. Case reviews may include but are not limited to a review of 
409.22 	placement prevention efforts, safety planning, case planning and service provision by the 
409.23 	responsible social services agency, relative placement consideration, and permanency 
409.24 	planning;
409.25 	(5) establish and administer a request for proposals process for African American and 
409.26 	disproportionately represented family preservation grants under section 260.693, monitor 
409.27 	grant activities, and provide technical assistance to grantees;
409.28 	(6) in coordination with the African American Child Well-Being Advisory Council, 
409.29 	coordinate services and create internal and external partnerships to support adequate access 
409.30 	to services and resources for African American children and their families, including but 
409.31 	not limited to housing assistance, employment assistance, food and nutrition support, health 
409.32 	care, child care assistance, and educational support and training; and
410.1 	(7) develop public messaging and communication to inform the public about racial 
410.2 	disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities, 
410.3 	and resources available to African American children and their families involved in the 
410.4 	child welfare system.
410.5 		Subd. 2.Case reviews. (a) The African American Child Well-Being Unit must conduct 
410.6 	systemic case reviews to monitor targeted child welfare outcomes, including but not limited 
410.7 	to maltreatment, out-of-home placement, and permanency of African American children.
410.8 	(b) The reviews under this subdivision must be conducted using a random sampling of 
410.9 	representative child welfare cases stratified for certain case related factors, including but 
410.10 	not limited to case type, maltreatment type, if the case involves out-of-home placement, 
410.11 	and other demographic variables. In conducting the reviews, unit staff may use court records 
410.12 	and documents, information from the social services information system, and other available 
410.13 	case file information to complete the case reviews.
410.14 	(c) The frequency of the reviews and the number of cases, child welfare outcomes, and 
410.15 	selected counties reviewed will be determined by the unit in consultation with the African 
410.16 	American Child Well-Being Advisory Council, with consideration given to the availability 
410.17 	of unit resources needed to conduct the reviews.
410.18 	(d) The unit must monitor all case reviews and use the collective case review information 
410.19 	and data to generate summary case review reports, ensure compliance with the Minnesota 
410.20 	African American Family Preservation and Child Welfare Disproportionality Act, and 
410.21 	identify trends or patterns in child welfare outcomes for African American children.
410.22 		Subd. 3.Reports. The African American Child Well-Being Unit must provide regular 
410.23 	updates on unit activities, including summary reports of case reviews, to the African 
410.24 	American Child Well-Being Advisory Council, and must publish an annual census of African 
410.25 	American children in out-of-home placements statewide. The annual census must include 
410.26 	data on the types of placements, age and sex of the children, how long the children have 
410.27 	been in out-of-home placements, and other relevant demographic information.

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

410.29 	Sec. 13. [260.693] AFRICAN AMERICAN AND DISPROPORTIONATELY 
410.30 	REPRESENTED FAMILY PRESERVATION GRANTS.
410.31 		Subdivision 1.Primary support grants. The commissioner shall establish direct grants 
410.32 	to organizations, service providers, and programs owned and led by African Americans and 
410.33 	other individuals from communities disproportionately represented in the child welfare 
411.1 	system to provide services and support for African American and disproportionately 
411.2 	represented children and their families involved in Minnesota's child welfare system, 
411.3 	including supporting existing eligible services and facilitating the development of new 
411.4 	services and providers, to create a more expansive network of service providers available 
411.5 	for African American and disproportionately represented children and their families.
411.6 		Subd. 2.Eligible services. (a) Services eligible for grants under this section include but 
411.7 	are not limited to:
411.8 	(1) child out-of-home placement prevention and reunification services;
411.9 	(2) family-based services and reunification therapy;
411.10 	(3) culturally specific individual and family counseling;
411.11 	(4) court advocacy;
411.12 	(5) training and consultation to responsible social services agencies and private social 
411.13 	services agencies regarding this act;
411.14 	(6) development and promotion of culturally informed, affirming, and responsive 
411.15 	community-based prevention and family preservation services that target the children, youth, 
411.16 	families, and communities of African American and African heritage experiencing the 
411.17 	highest disparities, disproportionality, and overrepresentation in the Minnesota child welfare 
411.18 	system;
411.19 	(7) culturally affirming and responsive services that work with children and families in 
411.20 	their communities to address their needs and ensure child and family safety and well-being 
411.21 	within a culturally appropriate lens and framework;
411.22 	(8) services to support informal kinship care arrangements; and
411.23 	(9) other activities and services approved by the commissioner that further the goals of 
411.24 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
411.25 	Act, including but not limited to the recruitment of African American staff and staff from 
411.26 	other communities disproportionately represented in the child welfare system to work for 
411.27 	responsible social services agencies and licensed child-placing agencies.
411.28 	(b) The commissioner may specify the priority of an activity and service based on its 
411.29 	success in furthering these goals. The commissioner shall give preference to programs and 
411.30 	service providers that are located in or serve counties with the highest rates of child welfare 
411.31 	disproportionality for African American and other disproportionately represented children 
411.32 	and their families and employ staff who represent the population primarily served.
412.1 		Subd. 3.Ineligible services. Grant money may not be used to supplant funding for 
412.2 	existing services or for the following purposes:
412.3 	(1) child day care that is necessary solely because of the employment or training for 
412.4 	employment of a parent or another relative with whom the child is living;
412.5 	(2) foster care maintenance or difficulty of care payments;
412.6 	(3) residential treatment facility payments;
412.7 	(4) adoption assistance or Northstar kinship assistance payments under chapter 259A 
412.8 	or 256N;
412.9 	(5) public assistance payments for Minnesota family investment program assistance, 
412.10 	supplemental aid, medical assistance, general assistance, general assistance medical care, 
412.11 	or community health services; or
412.12 	(6) administrative costs for income maintenance staff.
412.13 		Subd. 4.Requests for proposals. The commissioner shall request proposals for grants 
412.14 	under subdivisions 1, 2, and 3 and specify the information and criteria required.

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

412.16 	Sec. 14. Minnesota Statutes 2022, section 260C.329, subdivision 3, is amended to read:
412.17 		Subd. 3.Petition. The county attorney or, a parent whose parental rights were terminated 
412.18 	under a previous order of the court, an African American or a disproportionately represented 
412.19 	child who is ten years of age or older, the responsible social services agency, or a guardian 
412.20 	ad litem may file a petition for the reestablishment of the legal parent and child relationship. 
412.21 	A parent filing a petition under this section shall pay a filing fee in the amount required 
412.22 	under section 357.021, subdivision 2, clause (1). The filing fee may be waived pursuant to 
412.23 	chapter 563 in cases of indigency. A petition for the reestablishment of the legal parent and 
412.24 	child relationship may be filed when:
412.25 	(1) in cases where the county attorney is the petitioning party, both the responsible social 
412.26 	services agency and the county attorney agree that reestablishment of the legal parent and 
412.27 	child relationship is in the child's best interests;
412.28 	(2) (1) the parent has corrected the conditions that led to an order terminating parental 
412.29 	rights;
412.30 	(3) (2) the parent is willing and has the capability to provide day-to-day care and maintain 
412.31 	the health, safety, and welfare of the child;
413.1 	(4) the child has been in foster care for at least 48 months after the court issued the order 
413.2 	terminating parental rights;
413.3 	(5) (3) the child has not been adopted; and
413.4 	(6) (4) the child is not the subject of a written adoption placement agreement between 
413.5 	the responsible social services agency and the prospective adoptive parent, as required under 
413.6 	Minnesota Rules, part 9560.0060, subpart 2.

413.7 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
413.8 	section 19 of this article.

413.9 	Sec. 15. Minnesota Statutes 2022, section 260C.329, subdivision 8, is amended to read:
413.10 		Subd. 8.Hearing. The court may grant the petition ordering the reestablishment of the 
413.11 	legal parent and child relationship only if it finds by clear and convincing evidence that:
413.12 	(1) reestablishment of the legal parent and child relationship is in the child's best interests;
413.13 	(2) the child has not been adopted;
413.14 	(3) the child is not the subject of a written adoption placement agreement between the 
413.15 	responsible social services agency and the prospective adoptive parent, as required under 
413.16 	Minnesota Rules, part 9560.0060, subpart 2;
413.17 	(4) at least 48 months have elapsed following a final order terminating parental rights 
413.18 	and the child remains in foster care;
413.19 	(5) (4) the child desires to reside with the parent;
413.20 	(6) (5) the parent has corrected the conditions that led to an order terminating parental 
413.21 	rights; and
413.22 	(7) (6) the parent is willing and has the capability to provide day-to-day care and maintain 
413.23 	the health, safety, and welfare of the child.

413.24 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
413.25 	section 19 of this article.

413.26 	Sec. 16. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; 
413.27 	DISAGGREGATE DATA.
 413.28 	The commissioner of human services must establish a process to improve the 
413.29 	disaggregation of data to monitor child welfare outcomes for African American and other 
414.1 	disproportionately represented children in the child welfare system. The commissioner must 
414.2 	begin disaggregating data by January 1, 2027.

414.3 	EFFECTIVE DATE. This section is effective July 1, 2026.

414.4 	Sec. 17. CHILD WELFARE COMPLIANCE AND FEEDBACK PORTAL.
 414.5 	The commissioner of human services shall develop, maintain, and administer a publicly 
414.6 	accessible online compliance and feedback portal to receive reports of noncompliance with 
414.7 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
414.8 	Act under Minnesota Statutes, sections 260.61 to 260.69, and other statutes related to child 
414.9 	maltreatment, safety, and placement. Reports received through the portal must be transferred 
414.10 	for review and further action to the appropriate unit or department within the Department 
414.11 	of Human Services, including but not limited to the African American Child Well-Being 
414.12 	Unit.

414.13 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
414.14 	section 19 of this article.

414.15 	Sec. 18. DIRECTION TO COMMISSIONER; MAINTAINING CONNECTIONS 
414.16 	IN FOSTER CARE BEST PRACTICES.
 414.17 	The commissioner of human services shall develop and publish guidance on best practices 
414.18 	for ensuring that African American and disproportionately represented children in foster 
414.19 	care maintain connections and relationships with their parents, custodians, and extended 
414.20 	relative and kin network. The commissioner shall also develop and publish best practice 
414.21 	guidance on engaging and assessing noncustodial and nonadjudicated parents to care for 
414.22 	their African American or disproportionately represented children who cannot remain with 
414.23 	the children's custodial parents.

414.24 	EFFECTIVE DATE. This section is effective July 1, 2026, except as provided under 
414.25 	section 19 of this article.

414.26 	Sec. 19. MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND 
414.27 	CHILD WELFARE DISPROPORTIONALITY ACT; PILOT PROGRAMS.
 414.28 	(a) The commissioner of human services must establish a pilot program that implements 
414.29 	sections 1 to 17 in Hennepin and Ramsey Counties.
414.30 	(b) The commissioner of human services must report on the outcomes of the pilot 
414.31 	program, including the number of participating families, the rate of children in out-of-home 
415.1 	placement, and the measures taken to prevent out-of-home placement for each participating 
415.2 	family to the chairs and ranking minority members of the legislative committees with 
415.3 	jurisdiction over child welfare.
415.4 	(c) Sections 1 to 17 are effective July 1, 2024, for purposes of this pilot program.
415.5 	(d) This section expires July 1, 2027.

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

415.7 	Sec. 20. MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND 
415.8 	CHILD WELFARE DISPROPORTIONALITY ACT; WORKING GROUP.
 415.9 	(a) The commissioner of human services must establish a working group to provide 
415.10 	guidance and oversight for the Minnesota African American Family Preservation and Child 
415.11 	Welfare Disproportionality Act pilot programs in Hennepin and Ramsey Counties.
415.12 	(b) The members of the working group must include representatives from the Association 
415.13 	of Minnesota Counties, Hennepin County, Ramsey County, the Department of Human 
415.14 	Services, and community organizations with experience in child welfare.
415.15 	(c) The working group must provide oversight of the pilot programs and evaluate the 
415.16 	cost of the pilot program. The working group must also assess future costs of implementing 
415.17 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
415.18 	Act statewide.
415.19 	(d) By June 30, 2026, the working group must develop an implementation plan and best 
415.20 	practices for the Minnesota African American Family Preservation and Child Welfare 
415.21 	Disproportionality Act to go into effect statewide.

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

415.23 	Sec. 21. APPROPRIATIONS; MINNESOTA AFRICAN AMERICAN FAMILY 
415.24 	PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT.
 415.25 	(a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the 
415.26 	commissioner of human services for grants to Hennepin and Ramsey Counties to implement 
415.27 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
415.28 	Act pilot programs. This is a onetime appropriation and is available through June 30, 2026.
415.29 	(b) $1,000,000 in fiscal year 2025 is appropriated from the general fund to the 
415.30 	commissioner of human services for the African American and disproportionately represented 
415.31 	family preservation grant program in Minnesota Statutes, section 260.693.
416.1 	(c) $1,029,000 in fiscal year 2025 is appropriated from the general fund to the 
416.2 	commissioner of human services for the African American Child Well-Being Unit to hire 
416.3 	full-time staff members.

416.4 	ARTICLE 17
416.5 	CHILDREN AND FAMILIES POLICY

416.6 	Section 1. Minnesota Statutes 2023 Supplement, section 119B.011, subdivision 15, is 
416.7 	amended to read:
416.8 		Subd. 15.Income. "Income" means earned income as defined under section 256P.01, 
416.9 	subdivision 3,; unearned income as defined under section 256P.01, subdivision 8,; income 
416.10 	under Minnesota Rules, part 3400.0170; and public assistance cash benefits, including the 
416.11 	Minnesota family investment program, work benefit, Minnesota supplemental aid, general 
416.12 	assistance, refugee cash assistance, at-home infant child care subsidy payments, and child 
416.13 	support and maintenance distributed to the family under section 256.741, subdivision 2a.
416.14 	The following are deducted from income: funds used to pay for health insurance 
416.15 	premiums for family members, and child or spousal support paid to or on behalf of a person 
416.16 	or persons who live outside of the household. Income sources not included in this subdivision 
416.17 	and; section 256P.06, subdivision 3,; and Minnesota Rules, part 3400.0170, are not counted 
416.18 	as income.

416.19 	Sec. 2. Minnesota Statutes 2023 Supplement, section 119B.16, subdivision 1a, is amended 
416.20 	to read:
416.21 		Subd. 1a.Fair hearing allowed for providers. (a) This subdivision applies to providers 
416.22 	caring for children receiving child care assistance.
416.23 	(b) A provider may request a fair hearing according to sections 256.045 and 256.046 
416.24 	only if a county agency or the commissioner:
416.25 	(1) denies or revokes a provider's authorization, unless the action entitles the provider 
416.26 	to:
416.27 	(i) an administrative review under section 119B.161; or
416.28 	(ii) a contested case hearing or an administrative reconsideration under section 245.095;
416.29 	(2) assigns responsibility for an overpayment to a provider under section 119B.11, 
416.30 	subdivision 2a;
417.1 	(3) establishes an overpayment for failure to comply with section 119B.125, subdivision 
417.2 	6;
417.3 	(4) seeks monetary recovery or recoupment under section 245E.02, subdivision 4, 
417.4 	paragraph (c), clause (2);
417.5 	(5) ends a provider's rate differential under section 119B.13, subdivision 3a or 3b;
417.6 	(5) (6) initiates an administrative fraud disqualification hearing; or
417.7 	(6) (7) issues a payment and the provider disagrees with the amount of the payment.
417.8 	(c) A provider may request a fair hearing by submitting a written request to the 
417.9 	Department of Human Services, Appeals Division state agency. A provider's request must 
417.10 	be received by the Appeals Division state agency no later than 30 days after the date a 
417.11 	county or the commissioner mails sends the notice under subdivision 1c.
417.12 	(d) The provider's appeal request must contain the following:
417.13 	(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the 
417.14 	dollar amount involved for each disputed item;
417.15 	(2) the computation the provider believes to be correct, if applicable;
417.16 	(3) the statute or rule relied on for each disputed item; and
417.17 	(4) the name, address, and telephone number of the person at the provider's place of 
417.18 	business with whom contact may be made regarding the appeal.

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

417.20 	Sec. 3. Minnesota Statutes 2023 Supplement, section 119B.16, subdivision 1c, is amended 
417.21 	to read:
417.22 		Subd. 1c.Notice to providers. (a) Before taking an action appealable under subdivision 
417.23 	1a, paragraph (b), clauses (1) to (5), a county agency or the commissioner must mail send
417.24 	written notice to the provider against whom the action is being taken. Unless otherwise 
417.25 	specified under this chapter, chapter 245E, or Minnesota Rules, chapter 3400, a county 
417.26 	agency or the commissioner must mail send the written notice at least 15 calendar days 
417.27 	before the adverse action's effective date. If the appealable action is a denial of an 
417.28 	authorization under subdivision 1a, paragraph (b), clause (1), the provider's notice is effective 
417.29 	on the date the notice is sent.
417.30 	(b) The notice of adverse action in paragraph (a) shall state (1) the factual basis for the 
417.31 	county agency or department's determination, (2) the action the county agency or department 
418.1 	intends to take, (3) the dollar amount of the monetary recovery or recoupment, if known, 
418.2 	and (4) the provider's right to appeal the department's proposed action.
418.3 	(c) Notice requirements for administrative fraud disqualifications under subdivision 1a, 
418.4 	paragraph (b), clause (6), are set forth in section 256.046, subdivision 3.
418.5 	(d) A provider must receive notices that include:
418.6 	(1) the right to appeal if a county issues a payment and the provider disagrees with the 
418.7 	amount of the payment under subdivision 1a, paragraph (b), clause (7), at the time of 
418.8 	authorization and reauthorization under section 119B.125, subdivision 1; and
418.9 	(2) the amount of each payment when a payment is issued.
418.10 	(e) A provider's request to appeal a payment amount must be received by the state agency 
418.11 	no later than 30 days after the date a county sends the notice informing the provider of its 
418.12 	payment amount.

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

418.14 	Sec. 4. Minnesota Statutes 2023 Supplement, section 119B.161, subdivision 2, is amended 
418.15 	to read:
418.16 		Subd. 2.Notice. (a) The commissioner must mail send written notice to a provider within 
418.17 	five days of suspending payment or denying or revoking the provider's authorization under 
418.18 	subdivision 1.
418.19 	(b) The notice must:
418.20 	(1) state the provision under which the commissioner is denying, revoking, or suspending 
418.21 	the provider's authorization or suspending payment to the provider;
418.22 	(2) set forth the general allegations leading to the denial, revocation, or suspension of 
418.23 	the provider's authorization. The notice need not disclose any specific information concerning 
418.24 	an ongoing investigation;
418.25 	(3) state that the denial, revocation, or suspension of the provider's authorization is for 
418.26 	a temporary period and explain the circumstances under which the action expires; and
418.27 	(4) inform the provider of the right to submit written evidence and argument for 
418.28 	consideration by the commissioner.
418.29 	(c) Notwithstanding Minnesota Rules, part 3400.0185, if the commissioner suspends 
418.30 	payment to a provider under chapter 245E or denies or revokes a provider's authorization 
418.31 	under section 119B.13, subdivision 6, paragraph (d), clause (1) or (2), a county agency or 
419.1 	the commissioner must send notice of service authorization closure to each affected family. 
419.2 	The notice sent to an affected family is effective on the date the notice is created.

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

419.4 	Sec. 5. Minnesota Statutes 2022, section 121A.15, subdivision 3, is amended to read:
419.5 		Subd. 3.Exemptions from immunizations. (a) If a person is at least seven years old 
419.6 	and has not been immunized against pertussis, the person must not be required to be 
419.7 	immunized against pertussis.
419.8 	(b) If a person is at least 18 years old and has not completed a series of immunizations 
419.9 	against poliomyelitis, the person must not be required to be immunized against poliomyelitis.
419.10 	(c) If a statement, signed by a physician, is submitted to the administrator or other person 
419.11 	having general control and supervision of the school or child care facility stating that an 
419.12 	immunization is contraindicated for medical reasons or that laboratory confirmation of the 
419.13 	presence of adequate immunity exists, the immunization specified in the statement need 
419.14 	not be required.
419.15 	(d) If a notarized statement signed by the minor child's parent or guardian or by the 
419.16 	emancipated person is submitted to the administrator or other person having general control 
419.17 	and supervision of the school or child care facility stating that the person has not been 
419.18 	immunized as prescribed in subdivision 1 because of the conscientiously held beliefs of the 
419.19 	parent or guardian of the minor child or of the emancipated person, the immunizations 
419.20 	specified in the statement shall not be required. This statement must also be forwarded to 
419.21 	the commissioner of the Department of Health. This paragraph does not apply to a child 
419.22 	enrolling or enrolled in a child care center or family child care program that adopts a policy 
419.23 	under subdivision 3b.
419.24 	(e) If the person is under 15 months, the person is not required to be immunized against 
419.25 	measles, rubella, or mumps.
419.26 	(f) If a person is at least five years old and has not been immunized against haemophilus 
419.27 	influenzae type b, the person is not required to be immunized against haemophilus influenzae 
419.28 	type b.
419.29 	(g) If a person who is not a Minnesota resident enrolls in a Minnesota school online 
419.30 	learning course or program that delivers instruction to the person only by computer and 
419.31 	does not provide any teacher or instructor contact time or require classroom attendance, the 
419.32 	person is not subject to the immunization, statement, and other requirements of this section.

420.1 	Sec. 6. Minnesota Statutes 2022, section 121A.15, is amended by adding a subdivision to 
420.2 	read:
420.3 		Subd. 3b.Child care programs. A child care center licensed under chapter 245A and 
420.4 	Minnesota Rules, chapter 9503, and a family child care provider licensed under chapter 
420.5 	245A and Minnesota Rules, chapter 9502, may adopt a policy prohibiting a child over two 
420.6 	months of age from enrolling or remaining enrolled in the child care center or family child 
420.7 	care program if the child:
420.8 	(1) has not been immunized in accordance with subdivision 1 or 2 and in accordance 
420.9 	with Minnesota Rules, chapter 4604; and
420.10 	(2) is not exempt from immunizations under subdivision 3, paragraph (a), (c), (e), or (f).

420.11 	Sec. 7. Minnesota Statutes 2023 Supplement, section 124D.142, subdivision 2, as amended 
420.12 	by Laws 2024, chapter 80, article 4, section 10, is amended to read:
420.13 		Subd. 2.System components. (a) The standards-based voluntary quality rating and 
420.14 	improvement system includes:
420.15 	(1) effective July 1, 2026, at least a one-star rating for all programs licensed under 
420.16 	Minnesota Rules, chapter 9502 or 9503, or Tribally licensed that do not opt out of the system 
420.17 	under paragraph (b) and that are not:
420.18 	(i) the subject of a finding of fraud for which the program or individual is currently 
420.19 	serving a penalty or exclusion;
420.20 	(ii) prohibited from receiving public funds under section 245.095, regardless of whether 
420.21 	the action is under appeal;
420.22 	(iii) under revocation, suspension, temporary immediate suspension, or decertification, 
420.23 	or is operating under a conditional license, regardless of whether the action is under appeal; 
420.24 	or
420.25 	(iv) the subject of suspended, denied, or terminated payments to a provider under section 
420.26 	119B.13, subdivision 6, paragraph (d), clause (1) or (2); 245E.02, subdivision 4, paragraph 
420.27 	(c), clause (4); or 256.98, subdivision 1, regardless of whether the action is under appeal;
420.28 	(2) quality opportunities in order to improve the educational outcomes of children so 
420.29 	that they are ready for school;
420.30 	(3) a framework based on the Minnesota quality rating system rating tool and a common 
420.31 	set of child outcome and program standards informed by evaluation results;
421.1 	(4) a tool to increase the number of publicly funded and regulated early learning and 
421.2 	care services in both public and private market programs that are high quality;
421.3 	(5) voluntary participation ensuring that if a program or provider chooses to participate, 
421.4 	the program or provider will be rated and may receive public funding associated with the 
421.5 	rating; and
421.6 	(6) tracking progress toward statewide access to high-quality early learning and care 
421.7 	programs, progress toward the number of low-income children whose parents can access 
421.8 	quality programs, and progress toward increasing the number of children who are fully 
421.9 	prepared to enter kindergarten.
421.10 	(b) By July 1, 2026, the commissioner of children, youth, and families shall establish a 
421.11 	process by which a program may opt out of the rating under paragraph (a), clause (1). The 
421.12 	commissioner shall consult with Tribes to develop a process for rating Tribally licensed 
421.13 	programs that is consistent with the goal outlined in paragraph (a), clause (1).

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

421.15 	Sec. 8. Minnesota Statutes 2023 Supplement, section 144.2252, subdivision 2, is amended 
421.16 	to read:
421.17 		Subd. 2.Release of original birth record. (a) The state registrar must provide to an 
421.18 	adopted person who is 18 years of age or older or a person related to the adopted person a 
421.19 	copy of the adopted person's original birth record and any evidence of the adoption previously 
421.20 	filed with the state registrar. To receive a copy of an original birth record under this 
421.21 	subdivision, the adopted person or person related to the adopted person must make the 
421.22 	request to the state registrar in writing. The copy of the original birth record must clearly 
421.23 	indicate that it may not be used for identification purposes. All procedures, fees, and waiting 
421.24 	periods applicable to a nonadopted person's request for a copy of a birth record apply in the 
421.25 	same manner as requests made under this section.
421.26 	(b) If a contact preference form is attached to the original birth record as authorized 
421.27 	under section 144.2253, the state registrar must provide a copy of the contact preference 
421.28 	form along with the copy of the adopted person's original birth record.
421.29 	(c) The state registrar shall provide a transcript of an adopted person's original birth 
421.30 	record to an authorized representative of a federally recognized American Indian Tribe for 
421.31 	the sole purpose of determining the adopted person's eligibility for enrollment or membership. 
421.32 	Information contained in the birth record may not be used to provide the adopted person 
422.1 	information about the person's birth parents, except as provided in this section or section 
422.2 	259.83.
422.3 	(d) For a replacement birth record issued under section 144.218, the adopted person or 
422.4 	a person related to the adopted person may obtain from the state registrar copies of the order 
422.5 	or decree of adoption, certificate of adoption, or decree issued under section 259.60, as filed 
422.6 	with the state registrar.
422.7 	(e) The state registrar may request assistance from the commissioner of human services 
422.8 	if needed to discharge duties under this section, as authorized under section 259.79.

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

422.10 	Sec. 9. Minnesota Statutes 2023 Supplement, section 144.2253, is amended to read:
422.11 	144.2253 BIRTH PARENT CONTACT PREFERENCE FORM.
422.12 	(a) The commissioner must make available to the public a contact preference form as 
422.13 	described in paragraph (b).
422.14 	(b) The contact preference form must provide the following information to be completed 
422.15 	at the option of a birth parent:
422.16 	(1) "I would like to be contacted."
422.17 	(2) "I would prefer to be contacted only through an intermediary."
422.18 	(3) "I prefer not to be contacted at this time. If I decide later that I would like to be 
422.19 	contacted, I will submit an updated contact preference form to the Minnesota Department 
422.20 	of Health."
422.21 	(c) A contact preference form must include space where the birth parent may include 
422.22 	information that the birth parent feels is important for the adopted person to know.
422.23 	(d) If a birth parent of an adopted person submits a completed contact preference form 
422.24 	to the commissioner, the commissioner must:
422.25 	(1) match the contact preference form to the adopted person's original birth record. The 
422.26 	commissioner may request assistance from the commissioner of human services if needed 
422.27 	to discharge duties under this clause, as authorized under section 259.79; and
422.28 	(2) attach the contact preference form to the original birth record as required under 
422.29 	section 144.2252.
423.1 	(e) A contact preference form submitted to the commissioner under this section is private 
423.2 	data on an individual as defined in section 13.02, subdivision 12, except that the contact 
423.3 	preference form may be released as provided under section 144.2252, subdivision 2.

423.4 	EFFECTIVE DATE. This section is effective August 1, 20...

423.5 	Sec. 10. Minnesota Statutes 2022, section 243.166, subdivision 7, as amended by Laws 
423.6 	2024, chapter 79, article 9, section 5, is amended to read:
423.7 		Subd. 7.Use of data. (a) Except as otherwise provided in subdivision 4b or 7a or sections 
423.8 	244.052 and 299C.093, the data provided under this section is private data on individuals 
423.9 	under section 13.02, subdivision 12.
423.10 	(b) The data may be used only by law enforcement and corrections agencies for law 
423.11 	enforcement and corrections purposes. Law enforcement or a corrections agent may disclose 
423.12 	the status of an individual as a predatory offender to a child protection worker with a local 
423.13 	welfare agency for purposes of doing a family investigation or assessment under chapter 
423.14 	260E. A corrections agent may also disclose the status of an individual as a predatory 
423.15 	offender to comply with section 244.057.
423.16 	(c) The commissioner of human services is authorized to have access to the data for 
423.17 	purposes of completing background studies under chapter 245C.
423.18 	(d) The direct care and treatment executive board is authorized to have access to data 
423.19 	for any service, program, or facility owned or operated by the state of Minnesota and under 
423.20 	the programmatic direction and fiscal control of the executive board for purposes described 
423.21 	in section 246.13, subdivision 2, paragraph (b).

423.22 	Sec. 11. Minnesota Statutes 2023 Supplement, section 245A.03, subdivision 7, as amended 
423.23 	by Laws 2024, chapter 85, section 53, and Laws 2024, chapter 80, article 2, section 37, is 
423.24 	amended to read:
423.25 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
423.26 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, which 
423.27 	does not include child foster residence settings with residential program certifications for 
423.28 	compliance with the Family First Prevention Services Act under section 245A.25, subdivision 
423.29 	1, paragraph (a), or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
423.30 	9555.6265, under this chapter for a physical location that will not be the primary residence 
423.31 	of the license holder for the entire period of licensure. If a child foster residence setting that 
423.32 	was previously exempt from the licensing moratorium under this paragraph has its Family 
424.1 	First Prevention Services Act certification rescinded under section 245A.25, subdivision 9, 
424.2 	orif a family adult foster care home license is issued during this moratorium, and the license 
424.3 	holder changes the license holder's primary residence away from the physical location of 
424.4 	the foster care license, the commissioner shall revoke the license according to section 
424.5 	245A.07. The commissioner shall not issue an initial license for a community residential 
424.6 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
424.7 	the commissioner shall consider the resource need determination process in paragraph (h), 
424.8 	the availability of foster care licensed beds in the geographic area in which the licensee 
424.9 	seeks to operate, the results of a person's choices during their annual assessment and service 
424.10 	plan review, and the recommendation of the local county board. The determination by the 
424.11 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
424.12 	(1) a license for a person in a foster care setting that is not the primary residence of the 
424.13 	license holder and where at least 80 percent of the residents are 55 years of age or older;
424.14 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
424.15 	community residential setting licenses replacing adult foster care licenses in existence on 
424.16 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
424.17 	(b);
424.18 	(3) new foster care licenses or community residential setting licenses determined to be 
424.19 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
424.20 	or regional treatment center; restructuring of state-operated services that limits the capacity 
424.21 	of state-operated facilities; or allowing movement to the community for people who no 
424.22 	longer require the level of care provided in state-operated facilities as provided under section 
424.23 	256B.092, subdivision 13, or 256B.49, subdivision 24;
424.24 	(4) new foster care licenses or community residential setting licenses determined to be 
424.25 	needed by the commissioner under paragraph (b) for persons requiring hospital-level care; 
424.26 	or
424.27 	(5) new foster care licenses or community residential setting licenses for people receiving 
424.28 	customized living or 24-hour customized living services under the brain injury or community 
424.29 	access for disability inclusion waiver plans under section 256B.49 or elderly waiver plan 
424.30 	under chapter 256S and residing in the customized living setting for which a license is 
424.31 	required. A customized living service provider subject to this exception may rebut the 
424.32 	presumption that a license is required by seeking a reconsideration of the commissioner's 
424.33 	determination. The commissioner's disposition of a request for reconsideration is final and 
425.1 	not subject to appeal under chapter 14. The exception is available until December 31, 2023. 
425.2 	This exception is available when:
425.3 	(i) the person's customized living services are provided in a customized living service 
425.4 	setting serving four or fewer people in a single-family home operational on or before June 
425.5 	30, 2021. Operational is defined in section 256B.49, subdivision 28;
425.6 	(ii) the person's case manager provided the person with information about the choice of 
425.7 	service, service provider, and location of service, including in the person's home, to help 
425.8 	the person make an informed choice; and
425.9 	(iii) the person's services provided in the licensed foster care or community residential 
425.10 	setting are less than or equal to the cost of the person's services delivered in the customized 
425.11 	living setting as determined by the lead agency.
425.12 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
425.13 	community residential settings as defined under this subdivision. As part of the determination, 
425.14 	the commissioner shall consider the availability of foster care capacity in the area in which 
425.15 	the licensee seeks to operate, and the recommendation of the local county board. The 
425.16 	determination by the commissioner must be final. A determination of need is not required 
425.17 	for a change in ownership at the same address.
425.18 	(c) When an adult resident served by the program moves out of a foster home that is not 
425.19 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
425.20 	paragraph (f), or the adult community residential setting, the county shall immediately 
425.21 	inform the Department of Human Services Licensing Division. The department may decrease 
425.22 	the statewide licensed capacity for adult foster care settings.
425.23 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
425.24 	established in paragraph (c) shall must be exempt if the license holder's beds are occupied 
425.25 	by residents whose primary diagnosis is mental illness and the license holder is certified 
425.26 	under the requirements in subdivision 6a or section 245D.33.
425.27 	(e) A resource need determination process, managed at the state level, using the available 
425.28 	data required by section 144A.351, and other data and information shall be used to determine 
425.29 	where the reduced capacity determined under section 256B.493 will be implemented. The 
425.30 	commissioner shall consult with the stakeholders described in section 144A.351, and employ 
425.31 	a variety of methods to improve the state's capacity to meet the informed decisions of those 
425.32 	people who want to move out of corporate foster care or community residential settings, 
425.33 	long-term service needs within budgetary limits, including seeking proposals from service 
425.34 	providers or lead agencies to change service type, capacity, or location to improve services, 
426.1 	increase the independence of residents, and better meet needs identified by the long-term 
426.2 	services and supports reports and statewide data and information.
426.3 	(f) At the time of application and reapplication for licensure, the applicant and the license 
426.4 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
426.5 	required to inform the commissioner whether the physical location where the foster care 
426.6 	will be provided is or will be the primary residence of the license holder for the entire period 
426.7 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
426.8 	or license holder must notify the commissioner immediately. The commissioner shall print 
426.9 	on the foster care license certificate whether or not the physical location is the primary 
426.10 	residence of the license holder.
426.11 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
426.12 	primary residence of the license holder and that also provide services in the foster care home 
426.13 	that are covered by a federally approved home and community-based services waiver, as 
426.14 	authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human 
426.15 	services licensing division that the license holder provides or intends to provide these 
426.16 	waiver-funded services.
426.17 	(h) The commissioner may adjust capacity to address needs identified in section 
426.18 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
426.19 	delicense existing settings. Delicensing of settings will be accomplished through a process 
426.20 	identified in section 256B.493.
426.21 	(i) The commissioner must notify a license holder when its corporate foster care or 
426.22 	community residential setting licensed beds are reduced under this section. The notice of 
426.23 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
426.24 	mail or personal service. The notice must state why the licensed beds are reduced and must 
426.25 	inform the license holder of its right to request reconsideration by the commissioner. The 
426.26 	license holder's request for reconsideration must be in writing. If mailed, the request for 
426.27 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
426.28 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
426.29 	reconsideration is made by personal service, it must be received by the commissioner within 
426.30 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
426.31 	(j) The commissioner shall not issue an initial license for children's residential treatment 
426.32 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
426.33 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
426.34 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
427.1 	moratorium described in this paragraph. The commissioner has the authority to manage 
427.2 	existing statewide capacity for children's residential treatment services subject to the 
427.3 	moratorium under this paragraph and may issue an initial license for such facilities if the 
427.4 	initial license would not increase the statewide capacity for children's residential treatment 
427.5 	services subject to the moratorium under this paragraph.

427.6 	Sec. 12. Minnesota Statutes 2023 Supplement, section 256.046, subdivision 3, is amended 
427.7 	to read:
427.8 		Subd. 3.Administrative disqualification of child care providers caring for children 
427.9 	receiving child care assistance. (a) The department shall pursue an administrative 
427.10 	disqualification, if the child care provider is accused of committing an intentional program 
427.11 	violation, in lieu of a criminal action when it has not been pursued. Intentional program 
427.12 	violations include intentionally making false or misleading statements; intentionally 
427.13 	misrepresenting, concealing, or withholding facts; and repeatedly and intentionally violating 
427.14 	program regulations under chapters 119B and 245E. Intent may be proven by demonstrating 
427.15 	a pattern of conduct that violates program rules under chapters 119B and 245E.
427.16 	(b) To initiate an administrative disqualification, the commissioner must mail send
427.17 	written notice by certified mail using a signature-verified confirmed delivery method to the 
427.18 	provider against whom the action is being taken. Unless otherwise specified under chapter 
427.19 	119B or 245E or Minnesota Rules, chapter 3400, the commissioner must mail send the 
427.20 	written notice at least 15 calendar days before the adverse action's effective date. The notice 
427.21 	shall state (1) the factual basis for the agency's determination, (2) the action the agency 
427.22 	intends to take, (3) the dollar amount of the monetary recovery or recoupment, if known, 
427.23 	and (4) the provider's right to appeal the agency's proposed action.
427.24 	(c) The provider may appeal an administrative disqualification by submitting a written 
427.25 	request to the Department of Human Services, Appeals Division state agency. A provider's 
427.26 	request must be received by the Appeals Division state agency no later than 30 days after 
427.27 	the date the commissioner mails the notice.
427.28 	(d) The provider's appeal request must contain the following:
427.29 	(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the 
427.30 	dollar amount involved for each disputed item;
427.31 	(2) the computation the provider believes to be correct, if applicable;
427.32 	(3) the statute or rule relied on for each disputed item; and
428.1 	(4) the name, address, and telephone number of the person at the provider's place of 
428.2 	business with whom contact may be made regarding the appeal.
428.3 	(e) On appeal, the issuing agency bears the burden of proof to demonstrate by a 
428.4 	preponderance of the evidence that the provider committed an intentional program violation.
428.5 	(f) The hearing is subject to the requirements of sections 256.045 and 256.0451. The 
428.6 	human services judge may combine a fair hearing and administrative disqualification hearing 
428.7 	into a single hearing if the factual issues arise out of the same or related circumstances and 
428.8 	the provider receives prior notice that the hearings will be combined.
428.9 	(g) A provider found to have committed an intentional program violation and is 
428.10 	administratively disqualified shall must be disqualified, for a period of three years for the 
428.11 	first offense and permanently for any subsequent offense, from receiving any payments 
428.12 	from any child care program under chapter 119B.
428.13 	(h) Unless a timely and proper appeal made under this section is received by the 
428.14 	department, the administrative determination of the department is final and binding.

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

428.16 	Sec. 13. Minnesota Statutes 2022, section 256J.08, subdivision 34a, is amended to read:
428.17 		Subd. 34a.Family violence. (a) "Family violence" means the following, if committed 
428.18 	against a family or household member by a family or household member:
428.19 	(1) physical harm, bodily injury, or assault;
428.20 	(2) the infliction of fear of imminent physical harm, bodily injury, or assault; or
428.21 	(3) terroristic threats, within the meaning of section 609.713, subdivision 1; criminal 
428.22 	sexual conduct, within the meaning of section 609.342, 609.343, 609.344, 609.345, or 
428.23 	609.3451; or interference with an emergency call within the meaning of section 609.78, 
428.24 	subdivision 2.
428.25 	(b) For the purposes of family violence, "family or household member" means:
428.26 	(1) spouses and former spouses;
428.27 	(2) parents and children;
428.28 	(3) persons related by blood;
428.29 	(4) persons who are residing together or who have resided together in the past;
429.1 	(5) persons who have a child in common regardless of whether they have been married 
429.2 	or have lived together at any time;
429.3 	(6) a man and woman if the woman is pregnant and the man is alleged to be the father, 
429.4 	regardless of whether they have been married or have lived together at anytime; and
429.5 	(7) persons involved in a current or past significant romantic or sexual relationship.

429.6 	Sec. 14. Minnesota Statutes 2022, section 256J.28, subdivision 1, is amended to read:
429.7 		Subdivision 1.Expedited issuance of the Supplemental Nutrition Assistance Program 
429.8 	(SNAP) benefits. The following households are entitled to expedited issuance of SNAP 
429.9 	benefits assistance:
429.10 	(1) households with less than $150 in monthly gross income provided their liquid assets 
429.11 	do not exceed $100;
429.12 	(2) migrant or seasonal farm worker households who are destitute as defined in Code 
429.13 	of Federal Regulations, title 7, subtitle B, chapter 2, subchapter C, part 273, section 273.10, 
429.14 	paragraph (e)(3), provided their liquid assets do not exceed $100; and
429.15 	(3) eligible households whose combined monthly gross income and liquid resources are 
429.16 	less than the household's monthly rent or mortgage and utilities.
429.17 	For any month an individual receives expedited SNAP benefits, the individual is not 
429.18 	eligible for the MFIP food portion of assistance.

429.19 	Sec. 15. Minnesota Statutes 2022, section 256N.22, subdivision 10, is amended to read:
429.20 		Subd. 10.Assigning a successor relative custodian for a child's Northstar kinship 
429.21 	assistance. (a) In the event of the death or incapacity of the relative custodian, eligibility 
429.22 	for Northstar kinship assistance and title IV-E assistance, if applicable, is not affected if the 
429.23 	relative custodian is replaced by a successor named in the Northstar kinship assistance 
429.24 	benefit agreement. Northstar kinship assistance shall must be paid to a named successor 
429.25 	who is not the child's legal parent, biological parent or stepparent, or other adult living in 
429.26 	the home of the legal parent, biological parent, or stepparent.
429.27 	(b) In order to receive Northstar kinship assistance, a named successor must:
429.28 	(1) meet the background study requirements in subdivision 4;
429.29 	(2) renegotiate the agreement consistent with section 256N.25, subdivision 2, including 
429.30 	cooperating with an assessment under section 256N.24;
430.1 	(3) be ordered by the court to be the child's legal relative custodian in a modification 
430.2 	proceeding under section 260C.521, subdivision 2; and
430.3 	(4) satisfy the requirements in this paragraph within one year of the relative custodian's 
430.4 	death or incapacity unless the commissioner certifies that the named successor made 
430.5 	reasonable attempts to satisfy the requirements within one year and failure to satisfy the 
430.6 	requirements was not the responsibility of the named successor.
430.7 	(c) Payment of Northstar kinship assistance to the successor guardian may be temporarily 
430.8 	approved through the policies, procedures, requirements, and deadlines under section 
430.9 	256N.28, subdivision 2. Ongoing payment shall begin in the month when all the requirements 
430.10 	in paragraph (b) are satisfied.
430.11 	(d) Continued payment of Northstar kinship assistance may occur in the event of the 
430.12 	death or incapacity of the relative custodian when:
430.13 	(1) no successor has been named in the benefit agreement when or a named successor 
430.14 	is not able or willing to accept custody or guardianship of the child; and
430.15 	(2) the commissioner gives written consent to an individual who is a guardian or custodian 
430.16 	appointed by a court for the child upon the death of both relative custodians in the case of 
430.17 	assignment of custody to two individuals, or the sole relative custodian in the case of 
430.18 	assignment of custody to one individual, unless the child is under the custody of a county, 
430.19 	tribal, or child-placing agency.
430.20 	(e) Temporary assignment of Northstar kinship assistance may be approved for a 
430.21 	maximum of six consecutive months from the death or incapacity of the relative custodian 
430.22 	or custodians as provided in paragraph (a) and must adhere to the policies, procedures, 
430.23 	requirements, and deadlines under section 256N.28, subdivision 2, that are prescribed by 
430.24 	the commissioner. If a court has not appointed a permanent legal guardian or custodian 
430.25 	within six months, the Northstar kinship assistance must terminate and must not be resumed.
430.26 	(f) Upon assignment of assistance payments under paragraphs (d) and (e), assistance 
430.27 	must be provided from funds other than title IV-E.

430.28 	Sec. 16. Minnesota Statutes 2022, section 256N.24, subdivision 10, is amended to read:
430.29 		Subd. 10.Caregiver requests for reassessments. (a) A caregiver may initiate a 
430.30 	reassessment request for an eligible child in writing to the financially responsible agency 
430.31 	or, if there is no financially responsible agency, the agency designated by the commissioner. 
430.32 	The written request must include the reason for the request and the name, address, and 
430.33 	contact information of the caregivers. The caregiver may request a reassessment if at least 
431.1 	six months have elapsed since any previous assessment or reassessment. For an eligible 
431.2 	foster child, a foster parent may request reassessment in less than six months with written 
431.3 	documentation that there have been significant changes in the child's needs that necessitate 
431.4 	an earlier reassessment.
431.5 	(b) A caregiver may request a reassessment of an at-risk child for whom an adoption 
431.6 	assistance agreement has been executed if the caregiver has satisfied the commissioner with 
431.7 	written documentation from a qualified expert that the potential disability upon which 
431.8 	eligibility for the agreement was based has manifested itself, consistent with section 256N.25, 
431.9 	subdivision 3, paragraph (b).
431.10 	(c) If the reassessment cannot be completed within 30 days of the caregiver's request, 
431.11 	the agency responsible for reassessment must notify the caregiver of the reason for the delay 
431.12 	and a reasonable estimate of when the reassessment can be completed.
431.13 	(d) Notwithstanding any provision to the contrary in paragraph (a) or subdivision 9, 
431.14 	when a Northstar kinship assistance agreement or adoption assistance agreement under 
431.15 	section 256N.25 has been signed by all parties, no reassessment may be requested or 
431.16 	conducted until the court finalizes the transfer of permanent legal and physical custody or 
431.17 	finalizes the adoption, or the assistance agreement expires according to section 256N.25, 
431.18 	subdivision 1.

431.19 	Sec. 17. Minnesota Statutes 2022, section 256N.26, subdivision 15, is amended to read:
431.20 		Subd. 15.Payments. (a) Payments to caregivers or youth under Northstar Care for 
431.21 	Children must be made monthly. Consistent with section 256N.24, subdivision 13, the 
431.22 	financially responsible agency must send the caregiver or youth the required written notice 
431.23 	within 15 days of a completed assessment or reassessment.
431.24 	(b) Unless paragraph (c) or, (d), or (e) applies, the financially responsible agency shall 
431.25 	pay foster parents directly for eligible children in foster care.
431.26 	(c) When the legally responsible agency is different than the financially responsible 
431.27 	agency, the legally responsible agency may make the payments to the caregiver or youth, 
431.28 	provided payments are made on a timely basis. The financially responsible agency must 
431.29 	pay the legally responsible agency on a timely basis. Caregivers must have access to the 
431.30 	financially and legally responsible agencies' records of the transaction, consistent with the 
431.31 	retention schedule for the payments.
431.32 	(d) For eligible children in foster care, the financially responsible agency may pay the 
431.33 	foster parent's payment for a licensed child-placing agency instead of paying the foster 
432.1 	parents directly. The licensed child-placing agency must timely pay the foster parents and 
432.2 	maintain records of the transaction. Caregivers must have access to the financially responsible 
432.3 	agency's records of the transaction and the child-placing agency's records of the transaction, 
432.4 	consistent with the retention schedule for the payments.
432.5 	(e) If a foster youth aged 18 to 21 years old is placed in an unlicensed supervised 
432.6 	independent living setting, payments must be made directly to the youth or to a vendor if 
432.7 	the legally responsible agency determines it to be in the youth's best interests. If the legally 
432.8 	responsible agency has reason to believe that the youth is being financially exploited or at 
432.9 	risk of being financially exploited in the approved unlicensed supervised independent living 
432.10 	setting, the legally responsible agency shall advise the financially responsible agency to 
432.11 	make the payments to a vendor.

432.12 	Sec. 18. Minnesota Statutes 2022, section 256N.26, subdivision 16, is amended to read:
432.13 		Subd. 16.Effect of benefit on other aid. Payments received under this section must 
432.14 	not be considered as income for child care assistance under chapter 119B or any other 
432.15 	financial benefit. Consistent with section 256J.24, a child or youth receiving a maintenance 
432.16 	payment under Northstar Care for Children is excluded from any Minnesota family 
432.17 	investment program assistance unit.

432.18 	Sec. 19. Minnesota Statutes 2022, section 256N.26, subdivision 18, is amended to read:
432.19 		Subd. 18.Overpayments. The commissioner has the authority to collect any amount 
432.20 	of foster care payment, adoption assistance, or Northstar kinship assistance paid to a caregiver 
432.21 	or youth in excess of the payment due. Payments covered by this subdivision include basic 
432.22 	maintenance needs payments, supplemental difficulty of care payments, and reimbursement 
432.23 	of home and vehicle modifications under subdivision 10. Prior to any collection, the 
432.24 	commissioner or the commissioner's designee shall notify the caregiver or youth in writing, 
432.25 	including:
432.26 	(1) the amount of the overpayment and an explanation of the cause of overpayment;
432.27 	(2) clarification of the corrected amount;
432.28 	(3) a statement of the legal authority for the decision;
432.29 	(4) information about how the caregiver can correct the overpayment;
432.30 	(5) if repayment is required, when the payment is due and a person to contact to review 
432.31 	a repayment plan;
433.1 	(6) a statement that the caregiver or youth has a right to a fair hearing review by the 
433.2 	department; and
433.3 	(7) the procedure for seeking a fair hearing review by the department.

433.4 	Sec. 20. Minnesota Statutes 2022, section 256N.26, subdivision 21, is amended to read:
433.5 		Subd. 21.Correct and true information. The caregiver or youth must be investigated 
433.6 	for fraud if the caregiver or youth reports information the caregiver or youth knows is untrue, 
433.7 	the caregiver or youth fails to notify the commissioner of changes that may affect eligibility, 
433.8 	or the agency administering the program receives relevant information that the caregiver 
433.9 	or youth did not report.

433.10 	Sec. 21. Minnesota Statutes 2022, section 256N.26, subdivision 22, is amended to read:
433.11 		Subd. 22.Termination notice for caregiver or youth. The agency that issues the 
433.12 	maintenance payment shall provide the child's caregiver or the youth with written notice of 
433.13 	termination of payment. Termination notices must be sent at least 15 days before the final 
433.14 	payment or, in the case of an unplanned termination, the notice is sent within three days of 
433.15 	the end of the payment. The written notice must minimally include the following:
433.16 	(1) the date payment will end;
433.17 	(2) the reason payments will end and the event that is the basis to terminate payment;
433.18 	(3) a statement that the provider caregiver or youth has a right to a fair hearing review 
433.19 	by the department consistent with section 256.045, subdivision 3;
433.20 	(4) the procedure to request a fair hearing; and
433.21 	(5) the name, telephone number, and email address of a contact person at the agency.

433.22 	Sec. 22. Minnesota Statutes 2022, section 256P.05, is amended by adding a subdivision 
433.23 	to read:
433.24 		Subd. 4.Rental income. Rental income is subject to the requirements of this section.

433.25 	Sec. 23. Minnesota Statutes 2023 Supplement, section 256P.06, subdivision 3, is amended 
433.26 	to read:
433.27 		Subd. 3.Income inclusions. The following must be included in determining the income 
433.28 	of an assistance unit:
433.29 	(1) earned income; and
434.1 	(2) unearned income, which includes:
434.2 	(i) interest and dividends from investments and savings;
434.3 	(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;
434.4 	(iii) proceeds from rent and contract for deed payments in excess of the principal and 
434.5 	interest portion owed on property;
434.6 	(iv) income from trusts, excluding special needs and supplemental needs trusts;
434.7 	(v) interest income from loans made by the participant or household;
434.8 	(vi) cash prizes and winnings;
434.9 	(vii) unemployment insurance income that is received by an adult member of the 
434.10 	assistance unit unless the individual receiving unemployment insurance income is:
434.11 	(A) 18 years of age and enrolled in a secondary school; or
434.12 	(B) 18 or 19 years of age, a caregiver, and is enrolled in school at least half-time;
434.13 	(viii) for the purposes of programs under chapters 256D and 256I, retirement, survivors, 
434.14 	and disability insurance payments;
434.15 	(ix) retirement benefits;
434.16 	(x) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I, 
434.17 	and 256J;
434.18 	(xi) income from members of the United States armed forces unless excluded from 
434.19 	income taxes according to federal or state law;
434.20 	(xii) for the purposes of programs under chapters 119B, 256D, and 256I, all child support 
434.21 	payments;
434.22 	(xiii) for the purposes of programs under chapter 256J, the amount of child support 
434.23 	received that exceeds $100 for assistance units with one child and $200 for assistance units 
434.24 	with two or more children;
434.25 	(xiv) spousal support;
434.26 	(xv) workers' compensation; and
434.27 	(xvi) for the purposes of programs under chapters 119B and 256J, the amount of 
434.28 	retirement, survivors, and disability insurance payments that exceeds the applicable monthly 
434.29 	federal maximum Supplemental Security Income payments.

435.1 	Sec. 24. Minnesota Statutes 2022, section 259.37, subdivision 2, is amended to read:
435.2 		Subd. 2.Disclosure to birth parents and adoptive parents. An agency shall provide 
435.3 	a disclosure statement written in clear, plain language to be signed by the prospective 
435.4 	adoptive parents and birth parents, except that in intercountry adoptions, the signatures of 
435.5 	birth parents are not required. The disclosure statement must contain the following 
435.6 	information:
435.7 	(1) fees charged to the adoptive parent, including any policy on sliding scale fees or fee 
435.8 	waivers and an itemization of the amount that will be charged for the adoption study, 
435.9 	counseling, postplacement services, family of origin searches, birth parent expenses 
435.10 	authorized under section 259.55, or any other services;
435.11 	(2) timeline for the adoptive parent to make fee payments;
435.12 	(3) likelihood, given the circumstances of the prospective adoptive parent and any specific 
435.13 	program to which the prospective adoptive parent is applying, that an adoptive placement 
435.14 	may be made and the estimated length of time for making an adoptive placement. These 
435.15 	estimates must be based on adoptive placements made with prospective parents in similar 
435.16 	circumstances applying to a similar program with the agency during the immediately 
435.17 	preceding three to five years. If an agency has not been in operation for at least three years, 
435.18 	it must provide summary data based on whatever adoptive placements it has made and may 
435.19 	include a statement about the kind of efforts it will make to achieve an adoptive placement, 
435.20 	including a timetable it will follow in seeking a child. The estimates must include a statement 
435.21 	that the agency cannot guarantee placement of a child or a time by which a child will be 
435.22 	placed;
435.23 	(4) a statement of the services the agency will provide the birth and adoptive parents;
435.24 	(5) a statement prepared by the commissioner under section 259.39 that explains the 
435.25 	child placement and adoption process and the respective legal rights and responsibilities of 
435.26 	the birth parent and prospective adoptive parent during the process including a statement 
435.27 	that the prospective adoptive parent is responsible for filing an adoption petition not later 
435.28 	than 12 months after the child is placed in the prospective adoptive home;
435.29 	(6) a statement regarding any information the agency may have about attorney referral 
435.30 	services, or about obtaining assistance with completing legal requirements for an adoption; 
435.31 	and
435.32 	(7) a statement regarding the right of an adopted person to request and obtain a copy of 
435.33 	the adopted person's original birth record at the age and circumstances specified in section 
436.1 	144.2253 and the right of the birth parent named on the adopted person's original birth 
436.2 	record to file a contact preference form with the state registrar pursuant to section 144.2253; 
436.3 	and
436.4 	(7) (8) an acknowledgment to be signed by the birth parent and prospective adoptive 
436.5 	parent that they have received, read, and had the opportunity to ask questions of the agency 
436.6 	about the contents of the disclosure statement.

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

436.8 	Sec. 25. Minnesota Statutes 2022, section 259.53, is amended by adding a subdivision to 
436.9 	read:
436.10 		Subd. 7.Supportive parenting services for parents with disabilities. (a) A court or 
436.11 	agency shall not deny a prospective parent the ability to proceed with an adoption due to 
436.12 	the prospective parent's disability. A person who raises a prospective parent's disability as 
436.13 	a basis for denying an adoption has the burden to prove by clear and convincing evidence 
436.14 	that specific behaviors of the prospective parent would endanger the health or safety of the 
436.15 	child. If the person meets the burden, the prospective parent with a disability shall have the 
436.16 	opportunity to demonstrate how implementing supportive services would alleviate any 
436.17 	concerns.
436.18 	(b) The court may require the agency that conducted the postplacement assessment and 
436.19 	filed the report with the court under subdivision 2 to provide the opportunity to use supportive 
436.20 	parenting services to a prospective parent, conduct a new postplacement assessment that is 
436.21 	inclusive of the prospective parent's use of supportive parenting services, and file a revised 
436.22 	report with the court under subdivision 2. This paragraph does not confer additional 
436.23 	responsibility to the agency to provide supportive parenting services directly to the 
436.24 	prospective parent. Within a reasonable period of time, the prospective parent has the right 
436.25 	to a court hearing to review the need for continuing services.
436.26 	(c) If a court denies or limits the ability of a prospective parent with a disability to adopt 
436.27 	a child, the court shall make specific written findings stating the basis for the determination 
436.28 	and why providing supportive parenting services is not a reasonable accommodation that 
436.29 	could prevent the denial or limitation.
436.30 	(d) For purposes of this subdivision, "disability" and "supportive parenting services" 
436.31 	have the meanings given in section 260C.201, subdivision 13.

436.32 	EFFECTIVE DATE. This section is effective August 1, 2024, and applies to pleadings 
436.33 	and motions pending on or after that date.

437.1 	Sec. 26. Minnesota Statutes 2022, section 259.79, subdivision 1, is amended to read:
437.2 		Subdivision 1.Content. (a) The adoption records of the commissioner's agents and 
437.3 	licensed child-placing agencies shall contain copies of all relevant legal documents, 
437.4 	responsibly collected genetic, medical and social history of the child and the child's birth 
437.5 	parents, the child's placement record, copies of all pertinent agreements, contracts, and 
437.6 	correspondence relevant to the adoption, and copies of all reports and recommendations 
437.7 	made to the court.
437.8 	(b) The commissioner of human services shall maintain a permanent record of all 
437.9 	adoptions granted in district court in Minnesota regarding children who are:
437.10 	(1) under guardianship of the commissioner or a licensed child-placing agency according 
437.11 	to section 260C.317 or 260C.515, subdivision 3;
437.12 	(2) placed by the commissioner, commissioner's agent, or licensed child-placing agency 
437.13 	after a consent to adopt according to section 259.24 or under an agreement conferring 
437.14 	authority to place for adoption according to section 259.25; or
437.15 	(3) adopted after a direct adoptive placement approved by the district court under section 
437.16 	259.47.
437.17 	Each record shall contain identifying information about the child, the birth or legal 
437.18 	parents, and adoptive parents, including race where such data is available. The record must 
437.19 	also contain: (1) the date the child was legally freed for adoption; (2) the date of the adoptive 
437.20 	placement; (3) the name of the placing agency; (4) the county where the adoptive placement 
437.21 	occurred; (5) the date that the petition to adopt was filed; (6) the county where the petition 
437.22 	to adopt was filed; and (7) the date and county where the adoption decree was granted.
437.23 	(c) Identifying information contained in the adoption record shall must be confidential 
437.24 	and shall must be disclosed only pursuant to section 259.61 or, for adoption records 
437.25 	maintained by the commissioner of human services, upon request from the commissioner 
437.26 	of health or state registrar pursuant to sections 144.2252 and 144.2253.

437.27 	Sec. 27. Minnesota Statutes 2023 Supplement, section 259.83, subdivision 1, is amended 
437.28 	to read:
437.29 		Subdivision 1.Services provided. (a) Agencies shall provide assistance and counseling 
437.30 	services upon receiving a request for current information from adoptive parents, birth parents, 
437.31 	or adopted persons aged 18 years of age and older, or adult siblings of adopted persons. 
437.32 	The agency shall contact the other adult persons or the adoptive parents of a minor child in 
437.33 	a personal and confidential manner to determine whether there is a desire to receive or share 
438.1 	information or to have contact. If there is such a desire, the agency shall provide the services 
438.2 	requested. The agency shall provide services to adult genetic siblings if there is no known 
438.3 	violation of the confidentiality of a birth parent or if the birth parent gives written consent
438.4 	complete the search request within six months of the request being made. If the agency is 
438.5 	unable to complete the search request within the specified time frame, the agency shall 
438.6 	inform the requester of the status of the request and include a reasonable estimate of when 
438.7 	the request can be completed.
438.8 	(b) Upon a request for assistance or services from an adoptive parent of a minor child, 
438.9 	birth parent, or an adopted person 18 years of age or older, the agency must inform the 
438.10 	person:
438.11 	(1) about the right of an adopted person to request and obtain a copy of the adopted 
438.12 	person's original birth record at the age and circumstances specified in section 144.2253; 
438.13 	and
438.14 	(2) about the right of the birth parent named on the adopted person's original birth record 
438.15 	to file a contact preference form with the state registrar pursuant to section 144.2253.
438.16 	In When making or supervising an adoptive placements placement, the agency must provide 
438.17 	in writing to the birth parents listed on the original birth record the information required 
438.18 	under this section paragraph and section 259.37, subdivision 2, clause (7).

438.19 	Sec. 28. Minnesota Statutes 2023 Supplement, section 259.83, subdivision 1b, is amended 
438.20 	to read:
438.21 		Subd. 1b.Genetic Siblings. (a) A person who is at least 18 years of age who was adopted 
438.22 	or, because of a termination of parental rights, who was committed to the guardianship of 
438.23 	the commissioner of human services, whether adopted or and not, adopted must upon request 
438.24 	be advised of other siblings who were adopted or who were committed to the guardianship 
438.25 	of the commissioner of human services and not adopted.
438.26 	(b) The agency must provide assistance must be provided by the county or placing agency 
438.27 	of to the person requesting information to the extent that information is available in the 
438.28 	existing records at the Department of Human Services required to be kept under section 
438.29 	259.79. If the sibling received services from another agency, the agencies must share 
438.30 	necessary information in order to locate the other siblings and to offer services, as requested. 
438.31 	Upon the determination that parental rights with respect to another sibling were terminated, 
438.32 	identifying information and contact must be provided only upon mutual consent. A reasonable 
438.33 	fee may be imposed by the county or placing agency.

439.1 	Sec. 29. Minnesota Statutes 2023 Supplement, section 259.83, subdivision 3a, is amended 
439.2 	to read:
439.3 		Subd. 3a.Birth parent identifying information. (a) This subdivision applies to adoptive 
439.4 	placements where an adopted person does not have a record of live birth registered in this 
439.5 	state. Upon written request by an adopted person 18 years of age or older, the agency 
439.6 	responsible for or supervising the placement must provide to the requester the following 
439.7 	identifying information related to the birth parents listed on that adopted person's original 
439.8 	birth record, to the extent the information is available:
439.9 	(1) each of the birth parent's names; and
439.10 	(2) each of the birth parent's birthdate and birthplace.
439.11 	(b) The agency may charge a reasonable fee to the requester for providing the required 
439.12 	information under paragraph (a).
439.13 	(c) The agency, acting in good faith and in a lawful manner in disclosing the identifying 
439.14 	information under this subdivision, is not civilly liable for such disclosure.

439.15 	Sec. 30. Minnesota Statutes 2022, section 259.83, subdivision 4, is amended to read:
439.16 		Subd. 4.Confidentiality. Agencies shall provide adoptive parents, birth parents and 
439.17 	adult siblings, and adopted persons aged 19 18 years and over reasonable assistance in a 
439.18 	manner consistent with state and federal laws, rules, and regulations regarding the 
439.19 	confidentiality and privacy of child welfare and adoption records.

439.20 	Sec. 31. Minnesota Statutes 2022, section 260C.007, subdivision 6, is amended to read:
439.21 		Subd. 6.Child in need of protection or services. "Child in need of protection or 
439.22 	services" means a child who is in need of protection or services because the child:
439.23 	(1) is abandoned or without parent, guardian, or custodian;
439.24 	(2)(i) has been a victim of physical or sexual abuse as defined in section 260E.03, 
439.25 	subdivision 18 or 20, (ii) resides with or has resided with a victim of child abuse as defined 
439.26 	in subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or 
439.27 	would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or child 
439.28 	abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment as 
439.29 	defined in subdivision 15;
440.1 	(3) is without necessary food, clothing, shelter, education, or other required care for the 
440.2 	child's physical or mental health or morals because the child's parent, guardian, or custodian 
440.3 	is unable or unwilling to provide that care;
440.4 	(4) is without the special care made necessary by a physical, mental, or emotional 
440.5 	condition because the child's parent, guardian, or custodian is unable or unwilling to provide 
440.6 	that care;
440.7 	(5) is medically neglected, which includes, but is not limited to, the withholding of 
440.8 	medically indicated treatment from an infant with a disability with a life-threatening 
440.9 	condition. The term "withholding of medically indicated treatment" means the failure to 
440.10 	respond to the infant's life-threatening conditions by providing treatment, including 
440.11 	appropriate nutrition, hydration, and medication which, in the treating physician's, advanced 
440.12 	practice registered nurse's, or physician assistant's reasonable medical judgment, will be 
440.13 	most likely to be effective in ameliorating or correcting all conditions, except that the term 
440.14 	does not include the failure to provide treatment other than appropriate nutrition, hydration, 
440.15 	or medication to an infant when, in the treating physician's, advanced practice registered 
440.16 	nurse's, or physician assistant's reasonable medical judgment:
440.17 	(i) the infant is chronically and irreversibly comatose;
440.18 	(ii) the provision of the treatment would merely prolong dying, not be effective in 
440.19 	ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be 
440.20 	futile in terms of the survival of the infant; or
440.21 	(iii) the provision of the treatment would be virtually futile in terms of the survival of 
440.22 	the infant and the treatment itself under the circumstances would be inhumane;
440.23 	(6) is one whose parent, guardian, or other custodian for good cause desires to be relieved 
440.24 	of the child's care and custody, including a child who entered foster care under a voluntary 
440.25 	placement agreement between the parent and the responsible social services agency under 
440.26 	section 260C.227;
440.27 	(7) has been placed for adoption or care in violation of law;
440.28 	(8) is without proper parental care because of the emotional, mental, or physical disability, 
440.29 	or state of immaturity of the child's parent, guardian, or other custodian. A child is not 
440.30 	considered to be without proper parental care based solely on the disability of the child's 
440.31 	parent, guardian, or custodian;
441.1 	(9) is one whose behavior, condition, or environment is such as to be injurious or 
441.2 	dangerous to the child or others. An injurious or dangerous environment may include, but 
441.3 	is not limited to, the exposure of a child to criminal activity in the child's home;
441.4 	(10) is experiencing growth delays, which may be referred to as failure to thrive, that 
441.5 	have been diagnosed by a physician and are due to parental neglect;
441.6 	(11) is a sexually exploited youth;
441.7 	(12) has committed a delinquent act or a juvenile petty offense before becoming ten 
441.8 	years old;
441.9 	(13) is a runaway;
441.10 	(14) is a habitual truant;
441.11 	(15) has been found incompetent to proceed or has been found not guilty by reason of 
441.12 	mental illness or mental deficiency in connection with a delinquency proceeding, a 
441.13 	certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a 
441.14 	proceeding involving a juvenile petty offense; or
441.15 	(16) has a parent whose parental rights to one or more other children were involuntarily 
441.16 	terminated or whose custodial rights to another child have been involuntarily transferred to 
441.17 	a relative and there is a case plan prepared by the responsible social services agency 
441.18 	documenting a compelling reason why filing the termination of parental rights petition under 
441.19 	section 260C.503, subdivision 2, is not in the best interests of the child.

441.20 	Sec. 32. Minnesota Statutes 2022, section 260C.178, subdivision 7, is amended to read:
441.21 		Subd. 7.Out-of-home placement Case plan. (a) When the court has ordered the child 
441.22 	into the care of a parent under subdivision 1, paragraph (c), clause (1), the child protective 
441.23 	services plan under section 260E.26 must be filed within 30 days of the filing of the juvenile 
441.24 	protection petition under section 260C.141, subdivision 1.
441.25 	(a) (b) When the court orders the child into foster care under subdivision 1, paragraph 
441.26 	(c), clause (2), and not into the care of a parent, an out-of-home placement plan required 
441.27 	under section 260C.212shall must be filed with the court within 30 days of the filing of a 
441.28 	juvenile protection petition under section 260C.141, subdivision 1, when the court orders 
441.29 	emergency removal of the child under this section, or filed with the petition if the petition 
441.30 	is a review of a voluntary placement under section 260C.141, subdivision 2.
441.31 	(b) (c) Upon the filing of the child protective services plan under section 260E.26 or 
441.32 	out-of-home placement plan which that has been developed jointly with the parent and in 
442.1 	consultation with others as required under section 260C.212, subdivision 1, the court may 
442.2 	approve implementation of the plan by the responsible social services agency based on the 
442.3 	allegations contained in the petition and any evaluations, examinations, or assessments 
442.4 	conducted under subdivision 1, paragraph (l) (m). The court shall send written notice of the 
442.5 	approval of the child protective services plan or out-of-home placement plan to all parties 
442.6 	and the county attorney or may state such approval on the record at a hearing. A parent may 
442.7 	agree to comply with the terms of the plan filed with the court.
442.8 	(c) (d) The responsible social services agency shall make reasonable efforts to engage 
442.9 	both parents of the child in case planning. The responsible social service agency shall report 
442.10 	the results of its efforts to engage the child's parents in the child protective services plan or 
442.11 	out-of-home placement plan filed with the court. The agency shall notify the court of the 
442.12 	services it will provide or efforts it will attempt under the plan notwithstanding the parent's 
442.13 	refusal to cooperate or disagreement with the services. The parent may ask the court to 
442.14 	modify the plan to require different or additional services requested by the parent, but which 
442.15 	the agency refused to provide. The court may approve the plan as presented by the agency 
442.16 	or may modify the plan to require services requested by the parent. The court's approval 
442.17 	shall must be based on the content of the petition.
442.18 	(d) (e) Unless the parent agrees to comply with the terms of the child protective services 
442.19 	plan or out-of-home placement plan, the court may not order a parent to comply with the 
442.20 	provisions of the plan until the court finds the child is in need of protection or services and 
442.21 	orders disposition under section 260C.201, subdivision 1. However, the court may find that 
442.22 	the responsible social services agency has made reasonable efforts for reunification if the 
442.23 	agency makes efforts to implement the terms of an the child protective services plan or
442.24 	out-of-home placement plan approved under this section.

442.25 	Sec. 33. Minnesota Statutes 2022, section 260C.201, is amended by adding a subdivision 
442.26 	to read:
442.27 		Subd. 13.Supportive parenting services. (a) A person or agency shall not file a petition 
442.28 	alleging that a child is in need of protection or services on the basis of a parent's disability. 
442.29 	To make a prima facie showing that a child protection matter exists, the petitioner must 
442.30 	demonstrate in the petition that the child is in need of protection or services due to specific 
442.31 	behaviors of a parent or household member. The local agency or court must offer a parent 
442.32 	with a disability the opportunity to use supportive parenting services to assist the parent if 
442.33 	the petitioner makes a prima facie showing that through specific behaviors, a parent with a 
442.34 	disability cannot provide for the child's safety, health, or welfare. If a court removes a child 
443.1 	from a parent's home, the court shall make specific written findings stating the basis for 
443.2 	removing the child and why providing supportive parenting services is not a reasonable 
443.3 	accommodation that could prevent the child's out-of-home placement.
443.4 	(b) For purposes of this subdivision, "supportive parenting services" means services that 
443.5 	may assist a parent with a disability in the effective use of techniques and methods to enable 
443.6 	the parent to discharge the parent's responsibilities to a child as successfully as a parent who 
443.7 	does not have a disability, including nonvisual techniques for a parent who is blind.
443.8 	(c) For purposes of this subdivision, "disability" means:
443.9 	(1) physical or mental impairment that substantially limits one or more of a parent's 
443.10 	major life activities;
443.11 	(2) a record of having a physical or mental impairment that substantially limits one or 
443.12 	more of a parent's major life activities; or
443.13 	(3) being regarded as having a physical or mental impairment that substantially limits 
443.14 	one or more of a parent's major life activities.
443.15 	(d) The term "disability" must be construed in accordance with the ADA Amendments 
443.16 	Act of 2008, Public Law 110-325.

443.17 	EFFECTIVE DATE. This section is effective August 1, 2024, and applies to pleadings 
443.18 	and motions pending on or after that date.

443.19 	Sec. 34. Minnesota Statutes 2022, section 260C.202, is amended to read:
443.20 	260C.202 COURT REVIEW OF FOSTER CARE DISPOSITION.
443.21 		Subdivision 1.Court review for a child in the home of a parent under protective 
443.22 	supervision. If the court orders a child into the home of a parent under the protective 
443.23 	supervision of the responsible social services agency or child-placing agency under section 
443.24 	260C.201, subdivision 1, paragraph (a), clause (1), the court shall review the child protective 
443.25 	services plan under section 260E.26 at least every 90 days. The court shall notify the parents 
443.26 	of the provisions of sections 260C.503 to 260C.521, as required under juvenile court rules.
443.27 		Subd. 2.Court review for a child placed in foster care. (a) If the court orders a child 
443.28 	placed in foster care, the court shall review the out-of-home placement plan and the child's 
443.29 	placement at least every 90 days as required in juvenile court rules to determine whether 
443.30 	continued out-of-home placement is necessary and appropriate or whether the child should 
443.31 	be returned home.
444.1 	(b) This review is not required if the court has returned the child home, ordered the child 
444.2 	permanently placed away from the parent under sections 260C.503 to 260C.521, or 
444.3 	terminated rights under section 260C.301. Court review for a child permanently placed 
444.4 	away from a parent, including where the child is under guardianship of the commissioner, 
444.5 	shall be is governed by section 260C.607.
444.6 	(c) When a child is placed in a qualified residential treatment program setting as defined 
444.7 	in section 260C.007, subdivision 26d, the responsible social services agency must submit 
444.8 	evidence to the court as specified in section 260C.712.
444.9 	(b) (d) No later than three months after the child's placement in foster care, the court 
444.10 	shall review agency efforts to search for and notify relatives pursuant to section 260C.221, 
444.11 	and order that the agency's efforts begin immediately, or continue, if the agency has failed 
444.12 	to perform, or has not adequately performed, the duties under that section. The court must 
444.13 	order the agency to continue to appropriately engage relatives who responded to the notice 
444.14 	under section 260C.221 in placement and case planning decisions and to consider relatives 
444.15 	for foster care placement consistent with section 260C.221. Notwithstanding a court's finding 
444.16 	that the agency has made reasonable efforts to search for and notify relatives under section 
444.17 	260C.221, the court may order the agency to continue making reasonable efforts to search 
444.18 	for, notify, engage, and consider relatives who came to the agency's attention after sending 
444.19 	the initial notice under section 260C.221.
444.20 	(c) (e) The court shall review the out-of-home placement plan and may modify the plan 
444.21 	as provided under section 260C.201, subdivisions 6 and 7.
444.22 	(d) (f) When the court transfers the custody of a child to a responsible social services 
444.23 	agency resulting in foster care or protective supervision with a noncustodial parent under 
444.24 	subdivision 1, the court shall notify the parents of the provisions of sections 260C.204 and 
444.25 	260C.503 to 260C.521, as required under juvenile court rules.
444.26 	(e) (g) When a child remains in or returns to foster care pursuant to section 260C.451
444.27 	and the court has jurisdiction pursuant to section 260C.193, subdivision 6, paragraph (c), 
444.28 	the court shall at least annually conduct the review required under section 260C.203.

444.29 	Sec. 35. Minnesota Statutes 2022, section 260C.209, subdivision 1, is amended to read:
444.30 		Subdivision 1.Subjects. The responsible social services agency may have access to the 
444.31 	criminal history and history of child and adult maltreatment on the following individuals:
444.32 	(1) a noncustodial parent or nonadjudicated parent who is being assessed for purposes 
444.33 	of providing day-to-day care of a child temporarily or permanently under section 260C.219
445.1 	and any member of the parent's household who is over the age of 13 when there is a 
445.2 	reasonable cause to believe that the parent or household member over age 13 has a criminal 
445.3 	history or a history of maltreatment of a child or vulnerable adult which that would endanger 
445.4 	the child's health, safety, or welfare;
445.5 	(2) an individual whose suitability for relative placement under section 260C.221 is 
445.6 	being determined and any member of the relative's individual's household who is over the 
445.7 	age of 13 when:
445.8 	(i) the relative must be licensed for foster care; or
445.9 	(i) the individual is being considered for relative placement under section 260C.221;
445.10 	(ii) the background study is required under section 259.53, subdivision 2; or
445.11 	(iii) the agency or the commissioner has reasonable cause to believe the relative or 
445.12 	household member over the age of 13 has a criminal history which would not make a petition 
445.13 	to transfer of permanent legal and physical custody to the relative under individual has been 
445.14 	filed according to section 260C.515, subdivision 4, in the child's best interest paragraph (d), 
445.15 	and the individual is not pursuing Northstar kinship assistance eligibility for the child under 
445.16 	chapter 256N; and
445.17 	(3) a parent, following an out-of-home placement, when the responsible social services 
445.18 	agency has reasonable cause to believe that the parent has been convicted of a crime directly 
445.19 	related to the parent's capacity to maintain the child's health, safety, or welfare or the parent 
445.20 	is the subject of an open investigation of, or has been the subject of a substantiated allegation 
445.21 	of, child or vulnerable-adult maltreatment within the past ten years.
445.22 	"Reasonable cause" means that the agency has received information or a report from the 
445.23 	subject or a third person that creates an articulable suspicion that the individual has a history 
445.24 	that may pose a risk to the health, safety, or welfare of the child. The information or report 
445.25 	must be specific to the potential subject of the background check and shall must not be 
445.26 	based on the race, religion, ethnic background, age, class, or lifestyle of the potential subject.

445.27 	Sec. 36. Minnesota Statutes 2022, section 260C.212, subdivision 1, is amended to read:
445.28 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan shall 
445.29 	be prepared within 30 days after any child is placed in foster care by court order or a 
445.30 	voluntary placement agreement between the responsible social services agency and the 
445.31 	child's parent pursuant to section 260C.227 or chapter 260D.
446.1 	(b) An out-of-home placement plan means a written document individualized to the 
446.2 	needs of the child and the child's parents or guardians that is prepared by the responsible 
446.3 	social services agency jointly with the child's parents or guardians and in consultation with 
446.4 	the child's guardian ad litem; the child's tribe, if the child is an Indian child; the child's foster 
446.5 	parent or representative of the foster care facility; and, when appropriate, the child. When 
446.6 	a child is age 14 or older, the child may include two other individuals on the team preparing 
446.7 	the child's out-of-home placement plan. The child may select one member of the case 
446.8 	planning team to be designated as the child's advisor and to advocate with respect to the 
446.9 	application of the reasonable and prudent parenting standards. The responsible social services 
446.10 	agency may reject an individual selected by the child if the agency has good cause to believe 
446.11 	that the individual would not act in the best interest of the child. For a child in voluntary 
446.12 	foster care for treatment under chapter 260D, preparation of the out-of-home placement 
446.13 	plan shall additionally include the child's mental health treatment provider. For a child 18 
446.14 	years of age or older, the responsible social services agency shall involve the child and the 
446.15 	child's parents as appropriate. As appropriate, the plan shall be:
446.16 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
446.17 	(2) ordered by the court, either as presented or modified after hearing, under section 
446.18 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
446.19 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem, 
446.20 	a representative of the child's tribe, the responsible social services agency, and, if possible, 
446.21 	the child.
446.22 	(c) The out-of-home placement plan shall be explained by the responsible social services 
446.23 	agency to all persons involved in the plan's implementation, including the child who has 
446.24 	signed the plan, and shall set forth:
446.25 	(1) a description of the foster care home or facility selected, including how the 
446.26 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
446.27 	least restrictive, most family-like setting available that is in close proximity to the home of 
446.28 	the child's parents or guardians when the case plan goal is reunification; and how the 
446.29 	placement is consistent with the best interests and special needs of the child according to 
446.30 	the factors under subdivision 2, paragraph (b);
446.31 	(2) the specific reasons for the placement of the child in foster care, and when 
446.32 	reunification is the plan, a description of the problems or conditions in the home of the 
446.33 	parent or parents that necessitated removal of the child from home and the changes the 
446.34 	parent or parents must make for the child to safely return home;
447.1 	(3) a description of the services offered and provided to prevent removal of the child 
447.2 	from the home and to reunify the family including:
447.3 	(i) the specific actions to be taken by the parent or parents of the child to eliminate or 
447.4 	correct the problems or conditions identified in clause (2), and the time period during which 
447.5 	the actions are to be taken; and
447.6 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to 
447.7 	achieve a safe and stable home for the child including social and other supportive services 
447.8 	to be provided or offered to the parent or parents or guardian of the child, the child, and the 
447.9 	residential facility during the period the child is in the residential facility;
447.10 	(4) a description of any services or resources that were requested by the child or the 
447.11 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
447.12 	in the residential facility, and whether those services or resources were provided and if not, 
447.13 	the basis for the denial of the services or resources;
447.14 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined in 
447.15 	section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not 
447.16 	placed together in foster care, and whether visitation is consistent with the best interest of 
447.17 	the child, during the period the child is in foster care;
447.18 	(6) when a child cannot return to or be in the care of either parent, documentation of 
447.19 	steps to finalize adoption as the permanency plan for the child through reasonable efforts 
447.20 	to place the child for adoption pursuant to section 260C.605. At a minimum, the 
447.21 	documentation must include consideration of whether adoption is in the best interests of 
447.22 	the child and child-specific recruitment efforts such as a relative search, consideration of 
447.23 	relatives for adoptive placement, and the use of state, regional, and national adoption 
447.24 	exchanges to facilitate orderly and timely placements in and outside of the state. A copy of 
447.25 	this documentation shall be provided to the court in the review required under section 
447.26 	260C.317, subdivision 3, paragraph (b);
447.27 	(7) when a child cannot return to or be in the care of either parent, documentation of 
447.28 	steps to finalize the transfer of permanent legal and physical custody to a relative as the 
447.29 	permanency plan for the child. This documentation must support the requirements of the 
447.30 	kinship placement agreement under section 256N.22 and must include the reasonable efforts 
447.31 	used to determine that it is not appropriate for the child to return home or be adopted, and 
447.32 	reasons why permanent placement with a relative through a Northstar kinship assistance 
447.33 	arrangement is in the child's best interest; how the child meets the eligibility requirements 
447.34 	for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's 
448.1 	relative foster parent and reasons why the relative foster parent chose not to pursue adoption, 
448.2 	if applicable; and agency efforts to discuss with the child's parent or parents the permanent 
448.3 	transfer of permanent legal and physical custody or the reasons why these efforts were not 
448.4 	made;
448.5 	(8) efforts to ensure the child's educational stability while in foster care for a child who 
448.6 	attained the minimum age for compulsory school attendance under state law and is enrolled 
448.7 	full time in elementary or secondary school, or instructed in elementary or secondary 
448.8 	education at home, or instructed in an independent study elementary or secondary program, 
448.9 	or incapable of attending school on a full-time basis due to a medical condition that is 
448.10 	documented and supported by regularly updated information in the child's case plan. 
448.11 	Educational stability efforts include:
448.12 	(i) efforts to ensure that the child remains in the same school in which the child was 
448.13 	enrolled prior to placement or upon the child's move from one placement to another, including 
448.14 	efforts to work with the local education authorities to ensure the child's educational stability 
448.15 	and attendance; or
448.16 	(ii) if it is not in the child's best interest to remain in the same school that the child was 
448.17 	enrolled in prior to placement or move from one placement to another, efforts to ensure 
448.18 	immediate and appropriate enrollment for the child in a new school;
448.19 	(9) the educational records of the child including the most recent information available 
448.20 	regarding:
448.21 	(i) the names and addresses of the child's educational providers;
448.22 	(ii) the child's grade level performance;
448.23 	(iii) the child's school record;
448.24 	(iv) a statement about how the child's placement in foster care takes into account 
448.25 	proximity to the school in which the child is enrolled at the time of placement; and
448.26 	(v) any other relevant educational information;
448.27 	(10) the efforts by the responsible social services agency to ensure the oversight and 
448.28 	continuity of health care services for the foster child, including:
448.29 	(i) the plan to schedule the child's initial health screens;
448.30 	(ii) how the child's known medical problems and identified needs from the screens, 
448.31 	including any known communicable diseases, as defined in section 144.4172, subdivision 
448.32 	2, shall be monitored and treated while the child is in foster care;
449.1 	(iii) how the child's medical information shall be updated and shared, including the 
449.2 	child's immunizations;
449.3 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
449.4 	including the role of the parent, the agency, and the foster parent;
449.5 	(v) who is responsible for oversight of the child's prescription medications;
449.6 	(vi) how physicians or other appropriate medical and nonmedical professionals shall be 
449.7 	consulted and involved in assessing the health and well-being of the child and determine 
449.8 	the appropriate medical treatment for the child; and
449.9 	(vii) the responsibility to ensure that the child has access to medical care through either 
449.10 	medical insurance or medical assistance;
449.11 	(11) the health records of the child including information available regarding:
449.12 	(i) the names and addresses of the child's health care and dental care providers;
449.13 	(ii) a record of the child's immunizations;
449.14 	(iii) the child's known medical problems, including any known communicable diseases 
449.15 	as defined in section 144.4172, subdivision 2;
449.16 	(iv) the child's medications; and
449.17 	(v) any other relevant health care information such as the child's eligibility for medical 
449.18 	insurance or medical assistance;
449.19 	(12) an independent living plan for a child 14 years of age or older, developed in 
449.20 	consultation with the child. The child may select one member of the case planning team to 
449.21 	be designated as the child's advisor and to advocate with respect to the application of the 
449.22 	reasonable and prudent parenting standards in subdivision 14. The plan should include, but 
449.23 	not be limited to, the following objectives:
449.24 	(i) educational, vocational, or employment planning;
449.25 	(ii) health care planning and medical coverage;
449.26 	(iii) transportation including, where appropriate, assisting the child in obtaining a driver's 
449.27 	license;
449.28 	(iv) money management, including the responsibility of the responsible social services 
449.29 	agency to ensure that the child annually receives, at no cost to the child, a consumer report 
449.30 	as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies 
449.31 	in the report;
450.1 	(v) planning for housing;
450.2 	(vi) social and recreational skills;
450.3 	(vii) establishing and maintaining connections with the child's family and community; 
450.4 	and
450.5 	(viii) regular opportunities to engage in age-appropriate or developmentally appropriate 
450.6 	activities typical for the child's age group, taking into consideration the capacities of the 
450.7 	individual child;
450.8 	(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic 
450.9 	and assessment information, specific services relating to meeting the mental health care 
450.10 	needs of the child, and treatment outcomes;
450.11 	(14) for a child 14 years of age or older, a signed acknowledgment that describes the 
450.12 	child's rights regarding education, health care, visitation, safety and protection from 
450.13 	exploitation, and court participation; receipt of the documents identified in section 260C.452; 
450.14 	and receipt of an annual credit report. The acknowledgment shall state that the rights were 
450.15 	explained in an age-appropriate manner to the child; and
450.16 	(15) for a child placed in a qualified residential treatment program, the plan must include 
450.17 	the requirements in section 260C.708.
450.18 	(d) The parent or parents or guardian and the child each shall have the right to legal 
450.19 	counsel in the preparation of the case plan and shall be informed of the right at the time of 
450.20 	placement of the child. The child shall also have the right to a guardian ad litem. If unable 
450.21 	to employ counsel from their own resources, the court shall appoint counsel upon the request 
450.22 	of the parent or parents or the child or the child's legal guardian. The parent or parents may 
450.23 	also receive assistance from any person or social services agency in preparation of the case 
450.24 	plan.
450.25 	(e) Before an out-of-home placement plan is signed by the parent or parents or guardian 
450.26 	of the child, the responsible social services agency must provide the parent or parents or 
450.27 	guardian with a one- to two-page summary of the plan using a form developed by the 
450.28 	commissioner. The out-of-home placement plan summary must clearly summarize the plan's 
450.29 	contents under paragraph (c) and list the requirements and responsibilities for the parent or 
450.30 	parents or guardian using plain language. The summary must be updated and provided to 
450.31 	the parent or parents or guardian when the out-of-home placement plan is updated under 
450.32 	subdivision 1a.
451.1 	(e) (f) After the plan has been agreed upon by the parties involved or approved or ordered 
451.2 	by the court, the foster parents shall be fully informed of the provisions of the case plan and 
451.3 	shall be provided a copy of the plan.
451.4 	(f) (g) Upon the child's discharge from foster care, the responsible social services agency 
451.5 	must provide the child's parent, adoptive parent, or permanent legal and physical custodian, 
451.6 	and the child, if the child is 14 years of age or older, with a current copy of the child's health 
451.7 	and education record. If a child meets the conditions in subdivision 15, paragraph (b), the 
451.8 	agency must also provide the child with the child's social and medical history. The responsible 
451.9 	social services agency may give a copy of the child's health and education record and social 
451.10 	and medical history to a child who is younger than 14 years of age, if it is appropriate and 
451.11 	if subdivision 15, paragraph (b), applies.

451.12 	Sec. 37. Minnesota Statutes 2022, section 260C.212, subdivision 2, is amended to read:
451.13 		Subd. 2.Placement decisions based on best interests of the child. (a) The policy of 
451.14 	the state of Minnesota is to ensure that the child's best interests are met by requiring an 
451.15 	individualized determination of the needs of the child in consideration of paragraphs (a) to 
451.16 	(f), and of how the selected placement will serve the current and future needs of the child 
451.17 	being placed. The authorized child-placing agency shall place a child, released by court 
451.18 	order or by voluntary release by the parent or parents, in a family foster home selected by 
451.19 	considering placement with relatives in the following order:
451.20 	(1) with an individual who is related to the child by blood, marriage, or adoption, 
451.21 	including the legal parent, guardian, or custodian of the child's sibling; or
451.22 	(2) with an individual who is an important friend of the child or of the child's parent or 
451.23 	custodian, including an individual with whom the child has resided or had significant contact 
451.24 	or who has a significant relationship to the child or the child's parent or custodian.
451.25 	For an Indian child, the agency shall follow the order of placement preferences in the Indian 
451.26 	Child Welfare Act of 1978, United States Code, title 25, section 1915.
451.27 	(b) Among the factors the agency shall consider in determining the current and future 
451.28 	needs of the child are the following:
451.29 	(1) the child's current functioning and behaviors;
451.30 	(2) the medical needs of the child;
451.31 	(3) the educational needs of the child;
451.32 	(4) the developmental needs of the child;
452.1 	(5) the child's history and past experience;
452.2 	(6) the child's religious and cultural needs;
452.3 	(7) the child's connection with a community, school, and faith community;
452.4 	(8) the child's interests and talents;
452.5 	(9) the child's current and long-term needs regarding relationships with parents, siblings, 
452.6 	relatives, and other caretakers;
452.7 	(10) the reasonable preference of the child, if the court, or the child-placing agency in 
452.8 	the case of a voluntary placement, deems the child to be of sufficient age to express 
452.9 	preferences; and
452.10 	(11) for an Indian child, the best interests of an Indian child as defined in section 260.755, 
452.11 	subdivision 2a.
452.12 	When placing a child in foster care or in a permanent placement based on an individualized 
452.13 	determination of the child's needs, the agency must not use one factor in this paragraph to 
452.14 	the exclusion of all others, and the agency shall consider that the factors in paragraph (b) 
452.15 	may be interrelated.
452.16 	(c) Placement of a child cannot be delayed or denied based on race, color, or national 
452.17 	origin of the foster parent or the child.
452.18 	(d) Siblings should be placed together for foster care and adoption at the earliest possible 
452.19 	time unless it is documented that a joint placement would be contrary to the safety or 
452.20 	well-being of any of the siblings or unless it is not possible after reasonable efforts by the 
452.21 	responsible social services agency. In cases where siblings cannot be placed together, the 
452.22 	agency is required to provide frequent visitation or other ongoing interaction between 
452.23 	siblings unless the agency documents that the interaction would be contrary to the safety 
452.24 	or well-being of any of the siblings.
452.25 	(e) Except for emergency placement as provided for in section 245A.035, The following 
452.26 	requirements must be satisfied before the approval of a foster or adoptive placement in a 
452.27 	related or unrelated home: (1) a completed background study under section 245C.08; and 
452.28 	(2) a completed review of the written home study required under section 260C.215, 
452.29 	subdivision 4, clause (5), or 260C.611, to assess the capacity of the prospective foster or 
452.30 	adoptive parent to ensure the placement will meet the needs of the individual child. For 
452.31 	adoptive placements in a related or unrelated home, the home must meet the requirements 
452.32 	of section 260C.611.
453.1 	(f) The agency must determine whether colocation with a parent who is receiving services 
453.2 	in a licensed residential family-based substance use disorder treatment program is in the 
453.3 	child's best interests according to paragraph (b) and include that determination in the child's 
453.4 	case plan under subdivision 1. The agency may consider additional factors not identified 
453.5 	in paragraph (b). The agency's determination must be documented in the child's case plan 
453.6 	before the child is colocated with a parent.
453.7 	(g) The agency must establish a juvenile treatment screening team under section 260C.157 
453.8 	to determine whether it is necessary and appropriate to recommend placing a child in a 
453.9 	qualified residential treatment program, as defined in section 260C.007, subdivision 26d.
453.10 	(h) A child in foster care must not be placed in an unlicensed emergency relative 
453.11 	placement under section 245A.035 or licensed family foster home when the responsible 
453.12 	social services agency is aware that a prospective foster parent, license applicant, license 
453.13 	holder, or adult household member has a permanent disqualification under section 245C.15, 
453.14 	subdivision 4a, paragraphs (a) and (b).

453.15 	Sec. 38. Minnesota Statutes 2022, section 260C.301, subdivision 1, as amended by Laws 
453.16 	2024, chapter 80, article 8, section 27, is amended to read:
453.17 		Subdivision 1.Voluntary and involuntary. The juvenile court may upon petition, 
453.18 	terminate all rights of a parent to a child:
453.19 	(a) with the written consent of a parent who for good cause desires to terminate parental 
453.20 	rights; or
453.21 	(b) if it finds that one or more of the following conditions exist:
453.22 	(1) that the parent has abandoned the child;
453.23 	(2) that the parent has substantially, continuously, or repeatedly refused or neglected to 
453.24 	comply with the duties imposed upon that parent by the parent and child relationship, 
453.25 	including but not limited to providing the child with necessary food, clothing, shelter, 
453.26 	education, and other care and control necessary for the child's physical, mental, or emotional 
453.27 	health and development, if the parent is physically and financially able, and either reasonable 
453.28 	efforts by the social services agency have failed to correct the conditions that formed the 
453.29 	basis of the petition or reasonable efforts would be futile and therefore unreasonable;
453.30 	(3) that a parent has been ordered to contribute to the support of the child or financially 
453.31 	aid in the child's birth and has continuously failed to do so without good cause. This clause 
453.32 	shall not be construed to state a grounds for termination of parental rights of a noncustodial 
454.1 	parent if that parent has not been ordered to or cannot financially contribute to the support 
454.2 	of the child or aid in the child's birth;
454.3 	(4) (3) that a parent is palpably unfit to be a party to the parent and child relationship 
454.4 	because of a consistent pattern of specific conduct before the child or of specific conditions 
454.5 	directly relating to the parent and child relationship either of which are determined by the 
454.6 	court to be of a duration or nature that renders the parent unable, for the reasonably 
454.7 	foreseeable future, to care appropriately for the ongoing physical, mental, or emotional 
454.8 	needs of the child. It is presumed that a parent is palpably unfit to be a party to the parent 
454.9 	and child relationship upon a showing that the parent's parental rights to one or more other 
454.10 	children were involuntarily terminated or that the parent's custodial rights to another child 
454.11 	have been involuntarily transferred to a relative under a juvenile protection proceeding or 
454.12 	a similar process of another jurisdiction;
454.13 	(5) (4) that following the child's placement out of the home, reasonable efforts, under 
454.14 	the direction of the court, have failed to correct the conditions leading to the child's 
454.15 	placement. It is presumed that reasonable efforts under this clause have failed upon a showing 
454.16 	that:
454.17 	(i) a child has resided out of the parental home under court order for a cumulative period 
454.18 	of 12 months within the preceding 22 months. In the case of a child under age eight at the 
454.19 	time the petition was filed alleging the child to be in need of protection or services, the 
454.20 	presumption arises when the child has resided out of the parental home under court order 
454.21 	for six months unless the parent has maintained regular contact with the child and the parent 
454.22 	is complying with the out-of-home placement plan;
454.23 	(ii) the court has approved the out-of-home placement plan required under section 
454.24 	260C.212 and filed with the court under section 260C.178;
454.25 	(iii) conditions leading to the out-of-home placement have not been corrected. It is 
454.26 	presumed that conditions leading to a child's out-of-home placement have not been corrected 
454.27 	upon a showing that the parent or parents have not substantially complied with the court's 
454.28 	orders and a reasonable case plan; and
454.29 	(iv) reasonable efforts have been made by the social services agency to rehabilitate the 
454.30 	parent and reunite the family.
454.31 	This clause does not prohibit the termination of parental rights prior to one year, or in 
454.32 	the case of a child under age eight, prior to six months after a child has been placed out of 
454.33 	the home.
455.1 	It is also presumed that reasonable efforts have failed under this clause upon a showing 
455.2 	that:
455.3 	(A) the parent has been diagnosed as chemically dependent by a professional certified 
455.4 	to make the diagnosis;
455.5 	(B) the parent has been required by a case plan to participate in a chemical dependency 
455.6 	treatment program;
455.7 	(C) the treatment programs offered to the parent were culturally, linguistically, and 
455.8 	clinically appropriate;
455.9 	(D) the parent has either failed two or more times to successfully complete a treatment 
455.10 	program or has refused at two or more separate meetings with a caseworker to participate 
455.11 	in a treatment program; and
455.12 	(E) the parent continues to abuse chemicals.
455.13 	(6) (5) that a child has experienced egregious harm in the parent's care which that is of 
455.14 	a nature, duration, or chronicity that indicates a lack of regard for the child's well-being, 
455.15 	such that a reasonable person would believe it contrary to the best interest of the child or 
455.16 	of any child to be in the parent's care;
455.17 	(7) (6) that in the case of a child born to a mother who was not married to the child's 
455.18 	father when the child was conceived nor when the child was born the person is not entitled 
455.19 	to notice of an adoption hearing under section 259.49 and the person has not registered with 
455.20 	the fathers' adoption registry under section 259.52;
455.21 	(8) (7) that the child is neglected and in foster care; or
455.22 	(9) (8) that the parent has been convicted of a crime listed in section 260.012, paragraph 
455.23 	(g), clauses (1) to (5).
455.24 	In an action involving an American Indian child, sections 260.751 to 260.835 and the 
455.25 	Indian Child Welfare Act, United States Code, title 25, sections 1901 to 1923, control to 
455.26 	the extent that the provisions of this section are inconsistent with those laws.

455.27 	Sec. 39. Minnesota Statutes 2022, section 260C.515, subdivision 4, is amended to read:
455.28 		Subd. 4.Transfer of permanent legal and physical custody to relative. (a) The court 
455.29 	may order a transfer of permanent legal and physical custody to:
455.30 	(1) a parent. The court must find that the parent understands a transfer of permanent 
455.31 	legal and physical custody includes permanent, ongoing responsibility for the protection, 
456.1 	education, care, and control of the child and decision making on behalf of the child until 
456.2 	adulthood; or
456.3 	(2) a fit and willing relative in the best interests of the child according to the following
456.4 	requirements: in paragraph (b).
456.5 	(1) (b) An order for transfer of permanent legal and physical custody to a relative shall
456.6 	must only be made after the court has reviewed the suitability of the prospective legal and 
456.7 	physical custodian;, including a summary of information obtained from required background 
456.8 	studies under section 245C.33 or 260C.209, if the court finds the permanency disposition 
456.9 	to be in the child's best interests.
456.10 	(2) In transferring permanent legal and physical custody to a relative, the juvenile court 
456.11 	shall follow the standards applicable under this chapter and chapter 260, and the procedures 
456.12 	in the Minnesota Rules of Juvenile Protection Procedure;. The court must issue written 
456.13 	findings that include the following:
456.14 	(1) the prospective legal and physical custodian understands that:
456.15 	(3) (i) a transfer of permanent legal and physical custody includes permanent, ongoing 
456.16 	responsibility for the protection, education, care, and control of the child and decision 
456.17 	making on behalf of the child until adulthood; and
456.18 	(4) (ii) a permanent legal and physical custodian may shall not return a child to the 
456.19 	permanent care of a parent from whom the court removed custody without the court's 
456.20 	approval and without notice to the responsible social services agency;
456.21 	(2) transfer of permanent legal and physical custody and receipt of Northstar kinship 
456.22 	assistance under chapter 256N, when requested and the child is eligible, are in the child's 
456.23 	best interests;
456.24 	(3) when the agency files the petition under paragraph (c) or supports the petition filed 
456.25 	under paragraph (d), adoption is not in the child's best interests based on the determinations 
456.26 	in the kinship placement agreement required under section 256N.22, subdivision 2;
456.27 	(4) the agency made efforts to discuss adoption with the child's parent or parents, or the 
456.28 	agency did not make efforts to discuss adoption and the reasons why efforts were not made; 
456.29 	and
456.30 	(5) there are reasons to separate siblings during placement, if applicable.
456.31 	(5) (c) The responsible social services agency may file a petition naming a fit and willing 
456.32 	relative as a proposed permanent legal and physical custodian. A petition for transfer of 
457.1 	permanent legal and physical custody to a relative who is not a parent shall include facts 
457.2 	upon which the court can determine suitability of the proposed custodian, including a 
457.3 	summary of results from required background studies completed under section 245C.33. 
457.4 	The petition must be accompanied by a kinship placement agreement under section 256N.22, 
457.5 	subdivision 2, between the agency and proposed permanent legal and physical custodian;.
457.6 	(6) (d) Another party to the permanency proceeding regarding the child may file a petition 
457.7 	to transfer permanent legal and physical custody to a relative. The petition must include 
457.8 	facts upon which the court can make the determination determinations required under clause 
457.9 	(7) and paragraph (b), including suitability of the proposed custodian and, if completed, a 
457.10 	summary of results from required background studies completed under section 245C.33 or 
457.11 	260C.209. If background studies have not been completed at the time of filing the petition, 
457.12 	they must be completed and a summary of results provided to the court prior to the court 
457.13 	granting the petition or finalizing the order according to paragraph (e). The petition must 
457.14 	be filed not no later than the date for the required admit-deny hearing under section 260C.507; 
457.15 	or if the agency's petition is filed under section 260C.503, subdivision 2, the petition must 
457.16 	be filed not later than 30 days prior to the trial required under section 260C.509;.
457.17 	(7) where a petition is for transfer of permanent legal and physical custody to a relative 
457.18 	who is not a parent, the court must find that:
457.19 	(i) transfer of permanent legal and physical custody and receipt of Northstar kinship 
457.20 	assistance under chapter 256N, when requested and the child is eligible, are in the child's 
457.21 	best interests;
457.22 	(ii) adoption is not in the child's best interests based on the determinations in the kinship 
457.23 	placement agreement required under section 256N.22, subdivision 2;
457.24 	(iii) the agency made efforts to discuss adoption with the child's parent or parents, or 
457.25 	the agency did not make efforts to discuss adoption and the reasons why efforts were not 
457.26 	made; and
457.27 	(iv) there are reasons to separate siblings during placement, if applicable;
457.28 	(8) (e) The court may:
457.29 	(1) defer finalization of an order transferring permanent legal and physical custody to a 
457.30 	relative when deferring finalization is necessary to determine eligibility for Northstar kinship 
457.31 	assistance under chapter 256N;
457.32 	(9) the court may (2) finalize a permanent transfer of permanent legal and physical and 
457.33 	legal custody to a relative regardless of eligibility for Northstar kinship assistance under 
458.1 	chapter 256N, provided that the court has reviewed the suitability of the proposed custodian, 
458.2 	including the summary of background study results, consistent with paragraph (b); and
458.3 	(10) the juvenile court may (3) following a transfer of permanent legal and physical 
458.4 	custody to a relative, maintain jurisdiction over the responsible social services agency, the 
458.5 	parents or guardian of the child, the child, and the permanent legal and physical custodian 
458.6 	for purposes of ensuring appropriate services are delivered to the child and permanent legal 
458.7 	custodian for the purpose of ensuring conditions ordered by the court related to the care and 
458.8 	custody of the child are met.

458.9 	Sec. 40. Minnesota Statutes 2022, section 260C.607, subdivision 1, is amended to read:
458.10 		Subdivision 1.Review hearings. (a) The court shall conduct a review of the responsible 
458.11 	social services agency's reasonable efforts to finalize adoption for any child under the 
458.12 	guardianship of the commissioner and of the progress of the case toward adoption at least 
458.13 	every 90 days after the court issues an order that the commissioner is the guardian of the 
458.14 	child.
458.15 	(b) The review of progress toward adoption shall continue notwithstanding that an appeal 
458.16 	is made of the order for guardianship or termination of parental rights.
458.17 	(c) The agency's reasonable efforts to finalize the adoption must continue during the 
458.18 	pendency of the appeal under paragraph (b) or subdivision 6, paragraph (h), and all progress 
458.19 	toward adoption shall continue except that the court may not finalize an adoption while the 
458.20 	appeal is pending.

458.21 	Sec. 41. Minnesota Statutes 2022, section 260C.607, subdivision 6, is amended to read:
458.22 		Subd. 6.Motion and hearing to order adoptive placement. (a) At any time after the 
458.23 	district court orders the child under the guardianship of the commissioner of human services, 
458.24 	but not later than 30 days after receiving notice required under section 260C.613, subdivision 
458.25 	1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's 
458.26 	foster parent may file a motion for an order for adoptive placement of a child who is under 
458.27 	the guardianship of the commissioner if the relative or the child's foster parent:
458.28 	(1) has an adoption home study under section 259.41 or 260C.611 approving the relative 
458.29 	or foster parent for adoption. If the relative or foster parent does not have an adoption home 
458.30 	study, an affidavit attesting to efforts to complete an adoption home study may be filed with 
458.31 	the motion instead. The affidavit must be signed by the relative or foster parent and the 
458.32 	responsible social services agency or licensed child-placing agency completing the adoption 
459.1 	home study. The relative or foster parent must also have been a resident of Minnesota for 
459.2 	at least six months before filing the motion; the court may waive the residency requirement 
459.3 	for the moving party if there is a reasonable basis to do so; or
459.4 	(2) is not a resident of Minnesota, but has an approved adoption home study by an agency 
459.5 	licensed or approved to complete an adoption home study in the state of the individual's 
459.6 	residence and the study is filed with the motion for adoptive placement. If the relative or 
459.7 	foster parent does not have an adoption home study in the relative or foster parent's state 
459.8 	of residence, an affidavit attesting to efforts to complete an adoption home study may be 
459.9 	filed with the motion instead. The affidavit must be signed by the relative or foster parent 
459.10 	and the agency completing the adoption home study.
459.11 	(b) The motion shall must be filed with the court conducting reviews of the child's 
459.12 	progress toward adoption under this section. The motion and supporting documents must 
459.13 	make a prima facie showing that the agency has been unreasonable in failing to make the 
459.14 	requested adoptive placement. The motion must be served according to the requirements 
459.15 	for motions under the Minnesota Rules of Juvenile Protection Procedure and shall must be 
459.16 	made on all individuals and entities listed in subdivision 2.
459.17 	(c) If the motion and supporting documents do not make a prima facie showing for the 
459.18 	court to determine whether the agency has been unreasonable in failing to make the requested 
459.19 	adoptive placement, the court shall dismiss the motion. If the court determines a prima facie 
459.20 	basis is made, the court shall set the matter for evidentiary hearing.
459.21 	(d) At the evidentiary hearing, the responsible social services agency shall proceed first 
459.22 	with evidence about the reason for not making the adoptive placement proposed by the 
459.23 	moving party. When the agency presents evidence regarding the child's current relationship 
459.24 	with the identified adoptive placement resource, the court must consider the agency's efforts 
459.25 	to support the child's relationship with the moving party consistent with section 260C.221. 
459.26 	The moving party then has the burden of proving by a preponderance of the evidence that 
459.27 	the agency has been unreasonable in failing to make the adoptive placement.
459.28 	(e) The court shall review and enter findings regarding whether the agency, in making 
459.29 	an adoptive placement decision for the child:
459.30 	(1) considered relatives for adoptive placement in the order specified under section 
459.31 	260C.212, subdivision 2, paragraph (a); and
459.32 	(2) assessed how the identified adoptive placement resource and the moving party are 
459.33 	each able to meet the child's current and future needs, based on an individualized 
460.1 	determination of the child's needs, as required under sections 260C.212, subdivision 2, and 
460.2 	260C.613, subdivision 1, paragraph (b).
460.3 	(f) At the conclusion of the evidentiary hearing, if the court finds that the agency has 
460.4 	been unreasonable in failing to make the adoptive placement and that the moving party is 
460.5 	the most suitable adoptive home to meet the child's needs using the factors in section 
460.6 	260C.212, subdivision 2, paragraph (b), the court may:
460.7 	(1) order the responsible social services agency to make an adoptive placement in the 
460.8 	home of the moving party if the moving party has an approved adoption home study; or
460.9 	(2) order the responsible social services agency to place the child in the home of the 
460.10 	moving party upon approval of an adoption home study. The agency must promote and 
460.11 	support the child's ongoing visitation and contact with the moving party until the child is 
460.12 	placed in the moving party's home. The agency must provide an update to the court after 
460.13 	90 days, including progress and any barriers encountered. If the moving party does not have 
460.14 	an approved adoption home study within 180 days, the moving party and the agency must 
460.15 	inform the court of any barriers to obtaining the approved adoption home study during a 
460.16 	review hearing under this section. If the court finds that the moving party is unable to obtain 
460.17 	an approved adoption home study, the court must dismiss the order for adoptive placement 
460.18 	under this subdivision and order the agency to continue making reasonable efforts to finalize 
460.19 	the adoption of the child as required under section 260C.605.
460.20 	(g) If, in order to ensure that a timely adoption may occur, the court orders the responsible 
460.21 	social services agency to make an adoptive placement under this subdivision, the agency 
460.22 	shall:
460.23 	(1) make reasonable efforts to obtain a fully executed adoption placement agreement, 
460.24 	including assisting the moving party with the adoption home study process;
460.25 	(2) work with the moving party regarding eligibility for adoption assistance as required 
460.26 	under chapter 256N; and
460.27 	(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval 
460.28 	of the adoptive placement through the Interstate Compact on the Placement of Children.
460.29 	(h) Denial or granting of a motion for an order for adoptive placement after an evidentiary 
460.30 	hearing is an order which that may be appealed by the responsible social services agency, 
460.31 	the moving party, the child, when age ten or over, the child's guardian ad litem, and any 
460.32 	individual who had a fully executed adoption placement agreement regarding the child at 
460.33 	the time the motion was filed if the court's order has the effect of terminating the adoption 
461.1 	placement agreement. An appeal shall must be conducted according to the requirements of 
461.2 	the Rules of Juvenile Protection Procedure. Pursuant to subdivision 1, paragraph (c), the 
461.3 	court shall not finalize an adoption while an appeal is pending.

461.4 	Sec. 42. Minnesota Statutes 2022, section 260C.611, is amended to read:
461.5 	260C.611 ADOPTION STUDY REQUIRED.
461.6 	(a) An adoption study under section 259.41 approving placement of the child in the 
461.7 	home of the prospective adoptive parent shall must be completed before placing any child 
461.8 	under the guardianship of the commissioner in a home for adoption. If a prospective adoptive 
461.9 	parent has a current child foster care license under chapter 245A and is seeking to adopt a 
461.10 	foster child who is placed in the prospective adoptive parent's home and is under the 
461.11 	guardianship of the commissioner according to section 260C.325, subdivision 1, the child 
461.12 	foster care home study meets the requirements of this section for an approved adoption 
461.13 	home study if:
461.14 	(1) the written home study on which the foster care license was based is completed in 
461.15 	the commissioner's designated format, consistent with the requirements in sections 259.41, 
461.16 	subdivision 2; and 260C.215, subdivision 4, clause (5); and Minnesota Rules, part 2960.3060, 
461.17 	subpart 4;
461.18 	(2) the background studies on each prospective adoptive parent and all required household 
461.19 	members were completed according to section 245C.33;
461.20 	(3) the commissioner has not issued, within the last three years, a sanction on the license 
461.21 	under section 245A.07 or an order of a conditional license under section 245A.06 within 
461.22 	the last three years, or the commissioner has determined it to be in the child's best interests 
461.23 	to allow the child foster care home study to meet requirements of an approved adoption 
461.24 	home study upon review of the legally responsible agency's adoptive placement decision; 
461.25 	and
461.26 	(4) the legally responsible agency determines that the individual needs of the child are 
461.27 	being met by the prospective adoptive parent through an assessment under section 256N.24, 
461.28 	subdivision 2, or a documented placement decision consistent with section 260C.212, 
461.29 	subdivision 2.
461.30 	(b) If a prospective adoptive parent has previously held a foster care license or adoptive 
461.31 	home study, any update necessary to the foster care license, or updated or new adoptive 
461.32 	home study, if not completed by the licensing authority responsible for the previous license 
462.1 	or home study, shall include collateral information from the previous licensing or approving 
462.2 	agency, if available.

462.3 	Sec. 43. Minnesota Statutes 2022, section 260C.613, subdivision 1, is amended to read:
462.4 		Subdivision 1.Adoptive placement decisions. (a) The responsible social services agency 
462.5 	has exclusive authority to make an adoptive placement of decision for a child under the 
462.6 	guardianship of the commissioner. The child shall be considered is legally placed for adoption 
462.7 	when the adopting parent, the agency, and the commissioner have fully executed an adoption 
462.8 	placement agreement on the form prescribed by the commissioner.
462.9 	(b) The responsible social services agency shall use an individualized determination of 
462.10 	the child's current and future needs, pursuant to section 260C.212, subdivision 2, paragraph 
462.11 	(b), to determine the most suitable adopting parent for the child in the child's best interests. 
462.12 	The responsible social services agency must consider adoptive placement of the child with 
462.13 	relatives in the order specified in section 260C.212, subdivision 2, paragraph (a).
462.14 	(c) The responsible social services agency shall notify the court and parties entitled to 
462.15 	notice under section 260C.607, subdivision 2, when there is a fully executed adoption 
462.16 	placement agreement for the child.
462.17 	(d) Pursuant to section 260C.615, subdivision 1, paragraph (b), clause (4), the responsible 
462.18 	social services agency shall immediately notify the commissioner if the agency learns of 
462.19 	any new or previously undisclosed criminal or maltreatment information involving an 
462.20 	adoptive placement of a child under guardianship of the commissioner.
462.21 	(d) (e) In the event a party to an adoption placement agreement terminates the agreement, 
462.22 	the responsible social services agency shall notify the court, the parties entitled to notice 
462.23 	under section 260C.607, subdivision 2, and the commissioner that the agreement and the 
462.24 	adoptive placement have terminated.

462.25 	Sec. 44. Minnesota Statutes 2022, section 260C.615, subdivision 1, is amended to read:
462.26 		Subdivision 1.Duties. (a) For any child who is under the guardianship of the 
462.27 	commissioner, the commissioner has the exclusive rights to consent to:
462.28 	(1) the medical care plan for the treatment of a child who is at imminent risk of death 
462.29 	or who has a chronic disease that, in a physician's judgment, will result in the child's death 
462.30 	in the near future including a physician's order not to resuscitate or intubate the child; and
463.1 	(2) the child donating a part of the child's body to another person while the child is living; 
463.2 	the decision to donate a body part under this clause shall take into consideration the child's 
463.3 	wishes and the child's culture.
463.4 	(b) In addition to the exclusive rights under paragraph (a), the commissioner has a duty 
463.5 	to:
463.6 	(1) process any complete and accurate request for home study and placement through 
463.7 	the Interstate Compact on the Placement of Children under section 260.851;
463.8 	(2) process any complete and accurate application for adoption assistance forwarded by 
463.9 	the responsible social services agency according to chapter 256N;
463.10 	(3) review and process an adoption placement agreement forwarded to the commissioner 
463.11 	by the responsible social services agency and return it to the agency in a timely fashion; 
463.12 	and
463.13 	(4) review new or previously undisclosed information received from the agency or other 
463.14 	individuals or entities that may impact the health, safety, or well-being of a child who is 
463.15 	the subject of a fully executed adoption placement agreement; and
463.16 	(4) (5) maintain records as required in chapter 259.

463.17 	Sec. 45. Minnesota Statutes 2022, section 260E.03, subdivision 23, as amended by Laws 
463.18 	2024, chapter 80, article 8, section 33, is amended to read:
463.19 		Subd. 23.Threatened injury. (a) "Threatened injury" means a statement, overt act, 
463.20 	condition, or status that represents a substantial risk of physical or sexual abuse or mental 
463.21 	injury.
463.22 	(b) Threatened injury includes, but is not limited to, exposing a child to a person 
463.23 	responsible for the child's care, as defined in subdivision 17, who has:
463.24 	(1) subjected a child to, or failed to protect a child from, an overt act or condition that 
463.25 	constitutes egregious harm under subdivision 5 or a similar law of another jurisdiction;
463.26 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
463.27 	(b), clause (4), or a similar law of another jurisdiction;
463.28 	(3) committed an act that resulted in an involuntary termination of parental rights under 
463.29 	section 260C.301, or a similar law of another jurisdiction; or
464.1 	(4) committed an act that resulted in the involuntary transfer of permanent legal and 
464.2 	physical custody of a child to a relative or parent under section 260C.515, subdivision 4, 
464.3 	or a similar law of another jurisdiction.
464.4 	(c) A child is the subject of a report of threatened injury when the local welfare agency 
464.5 	receives birth match data under section 260E.14, subdivision 4, from the Department of 
464.6 	Human Services.

464.7 	Sec. 46. Minnesota Statutes 2022, section 393.07, subdivision 10a, is amended to read:
464.8 		Subd. 10a.Expedited issuance of SNAP benefits. The commissioner of human services 
464.9 	shall continually monitor the expedited issuance of SNAP benefits to ensure that each county 
464.10 	complies with federal regulations and that households eligible for expedited issuance of 
464.11 	SNAP benefits are identified, processed, and certified within the time frames prescribed in 
464.12 	federal regulations.
464.13 	County SNAP benefits offices shall screen applicants on the day of application. 
464.14 	Applicants who meet the federal criteria for expedited issuance and have an immediate need 
464.15 	for food assistance shall receive within five working days the issuance of SNAP benefits.
464.16 	The local SNAP agency shall conspicuously post in each SNAP office a notice of the 
464.17 	availability of and the procedure for applying for expedited issuance and verbally advise 
464.18 	each applicant of the availability of the expedited process.

464.19 	Sec. 47. Minnesota Statutes 2022, section 518.17, is amended by adding a subdivision to 
464.20 	read:
464.21 		Subd. 2a.Parents with disabilities. (a) A court shall not deny nor restrict a parent's 
464.22 	parenting time or custody due to the parent's disability. A party raising disability as a basis 
464.23 	for denying or restricting parenting time has the burden to prove by clear and convincing 
464.24 	evidence that a parent's specific behaviors during parenting time would endanger the health 
464.25 	or safety of the child. If the party meets the burden, a parent with a disability shall have the 
464.26 	opportunity to demonstrate how implementing supportive services can alleviate any concerns. 
464.27 	The court may require a parent with a disability to use supportive parenting services to 
464.28 	facilitate parenting time.
464.29 	(b) If a court denies or limits the right of a parent with a disability to custody of a child 
464.30 	or visitation with a child, the court shall make specific written findings stating the basis for 
464.31 	the denial or limitation and why providing supportive parenting services is not a reasonable 
465.1 	accommodation that could prevent denying or limiting the parent's custody or parenting 
465.2 	time.
465.3 	(c) For purposes of this subdivision, "disability" and "supportive parenting services" 
465.4 	have the meanings given in section 260C.201, subdivision 13.

465.5 	EFFECTIVE DATE. This section is effective August 1, 2024, and applies to pleadings 
465.6 	and motions pending on or after that date.

465.7 	ARTICLE 18
465.8 	DEPARTMENT OF HUMAN SERVICES POLICY

465.9 	Section 1. Minnesota Statutes 2023 Supplement, section 13.46, subdivision 4, as amended 
465.10 	by Laws 2024, chapter 80, article 8, section 4, is amended to read:
465.11 		Subd. 4.Licensing data. (a) As used in this subdivision:
465.12 	(1) "licensing data" are all data collected, maintained, used, or disseminated by the 
465.13 	welfare system pertaining to persons licensed or registered or who apply for licensure or 
465.14 	registration or who formerly were licensed or registered under the authority of the 
465.15 	commissioner of human services;
465.16 	(2) "client" means a person who is receiving services from a licensee or from an applicant 
465.17 	for licensure; and
465.18 	(3) "personal and personal financial data" are Social Security numbers, identity of and 
465.19 	letters of reference, insurance information, reports from the Bureau of Criminal 
465.20 	Apprehension, health examination reports, and social/home studies.
465.21 	(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, license 
465.22 	holders, certification holders, and former licensees are public: name, address, telephone 
465.23 	number of licensees, email addresses except for family child foster care, date of receipt of 
465.24 	a completed application, dates of licensure, licensed capacity, type of client preferred, 
465.25 	variances granted, record of training and education in child care and child development, 
465.26 	type of dwelling, name and relationship of other family members, previous license history, 
465.27 	class of license, the existence and status of complaints, and the number of serious injuries 
465.28 	to or deaths of individuals in the licensed program as reported to the commissioner of human 
465.29 	services; the commissioner of children, youth, and families; the local social services agency; 
465.30 	or any other county welfare agency. For purposes of this clause, a serious injury is one that 
465.31 	is treated by a physician.
466.1 	(ii) Except as provided in item (v), when a correction order, an order to forfeit a fine, 
466.2 	an order of license suspension, an order of temporary immediate suspension, an order of 
466.3 	license revocation, an order of license denial, or an order of conditional license has been 
466.4 	issued, or a complaint is resolved, the following data on current and former licensees and 
466.5 	applicants are public: the general nature of the complaint or allegations leading to the 
466.6 	temporary immediate suspension; the substance and investigative findings of the licensing 
466.7 	or maltreatment complaint, licensing violation, or substantiated maltreatment; the existence 
466.8 	of settlement negotiations; the record of informal resolution of a licensing violation; orders 
466.9 	of hearing; findings of fact; conclusions of law; specifications of the final correction order, 
466.10 	fine, suspension, temporary immediate suspension, revocation, denial, or conditional license 
466.11 	contained in the record of licensing action; whether a fine has been paid; and the status of 
466.12 	any appeal of these actions.
466.13 	(iii) When a license denial under section 142A.15 or 245A.05 or a sanction under section 
466.14 	142B.18 or 245A.07 is based on a determination that a license holder, applicant, or controlling 
466.15 	individual is responsible for maltreatment under section 626.557 or chapter 260E, the identity 
466.16 	of the applicant, license holder, or controlling individual as the individual responsible for 
466.17 	maltreatment is public data at the time of the issuance of the license denial or sanction.
466.18 	(iv) When a license denial under section 142A.15 or 245A.05 or a sanction under section 
466.19 	142B.18 or 245A.07 is based on a determination that a license holder, applicant, or controlling 
466.20 	individual is disqualified under chapter 245C, the identity of the license holder, applicant, 
466.21 	or controlling individual as the disqualified individual is public data at the time of the 
466.22 	issuance of the licensing sanction or denial. If the applicant, license holder, or controlling 
466.23 	individual requests reconsideration of the disqualification and the disqualification is affirmed, 
466.24 	the reason for the disqualification and the reason to not set aside the disqualification are 
466.25 	private data.
466.26 	(v) A correction order or fine issued to a child care provider for a licensing violation is 
466.27 	private data on individuals under section 13.02, subdivision 12, or nonpublic data under 
466.28 	section 13.02, subdivision 9, if the correction order or fine is seven years old or older.
466.29 	(2) For applicants who withdraw their application prior to licensure or denial of a license, 
466.30 	the following data are public: the name of the applicant, the city and county in which the 
466.31 	applicant was seeking licensure, the dates of the commissioner's receipt of the initial 
466.32 	application and completed application, the type of license sought, and the date of withdrawal 
466.33 	of the application.
467.1 	(3) For applicants who are denied a license, the following data are public: the name and 
467.2 	address of the applicant, the city and county in which the applicant was seeking licensure, 
467.3 	the dates of the commissioner's receipt of the initial application and completed application, 
467.4 	the type of license sought, the date of denial of the application, the nature of the basis for 
467.5 	the denial, the existence of settlement negotiations, the record of informal resolution of a 
467.6 	denial, orders of hearings, findings of fact, conclusions of law, specifications of the final 
467.7 	order of denial, and the status of any appeal of the denial.
467.8 	(4) When maltreatment is substantiated under section 626.557 or chapter 260E and the 
467.9 	victim and the substantiated perpetrator are affiliated with a program licensed under chapter 
467.10 	142B or 245A; the commissioner of human services; commissioner of children, youth, and 
467.11 	families; local social services agency; or county welfare agency may inform the license 
467.12 	holder where the maltreatment occurred of the identity of the substantiated perpetrator and 
467.13 	the victim.
467.14 	(5) Notwithstanding clause (1), for child foster care, only the name of the license holder 
467.15 	and the status of the license are public if the county attorney has requested that data otherwise 
467.16 	classified as public data under clause (1) be considered private data based on the best interests 
467.17 	of a child in placement in a licensed program.
467.18 	(c) The following are private data on individuals under section 13.02, subdivision 12, 
467.19 	or nonpublic data under section 13.02, subdivision 9: personal and personal financial data 
467.20 	on family day care program and family foster care program applicants and licensees and 
467.21 	their family members who provide services under the license.
467.22 	(d) The following are private data on individuals: the identity of persons who have made 
467.23 	reports concerning licensees or applicants that appear in inactive investigative data, and the 
467.24 	records of clients or employees of the licensee or applicant for licensure whose records are 
467.25 	received by the licensing agency for purposes of review or in anticipation of a contested 
467.26 	matter. The names of reporters of complaints or alleged violations of licensing standards 
467.27 	under chapters 142B, 245A, 245B, 245C, and 245D, and applicable rules and alleged 
467.28 	maltreatment under section 626.557 and chapter 260E, are confidential data and may be 
467.29 	disclosed only as provided in section 260E.21, subdivision 4; 260E.35; or 626.557, 
467.30 	subdivision 12b.
467.31 	(e) Data classified as private, confidential, nonpublic, or protected nonpublic under this 
467.32 	subdivision become public data if submitted to a court or administrative law judge as part 
467.33 	of a disciplinary proceeding in which there is a public hearing concerning a license which 
467.34 	has been suspended, immediately suspended, revoked, or denied.
468.1 	(f) Data generated in the course of licensing investigations that relate to an alleged 
468.2 	violation of law are investigative data under subdivision 3.
468.3 	(g) Data that are not public data collected, maintained, used, or disseminated under this 
468.4 	subdivision that relate to or are derived from a report as defined in section 260E.03, or 
468.5 	626.5572, subdivision 18, are subject to the destruction provisions of sections 260E.35, 
468.6 	subdivision 6, and 626.557, subdivision 12b.
468.7 	(h) Upon request, not public data collected, maintained, used, or disseminated under 
468.8 	this subdivision that relate to or are derived from a report of substantiated maltreatment as 
468.9 	defined in section 626.557 or chapter 260E may be exchanged with the Department of 
468.10 	Health for purposes of completing background studies pursuant to section 144.057 and with 
468.11 	the Department of Corrections for purposes of completing background studies pursuant to 
468.12 	section 241.021.
468.13 	(i) Data on individuals collected according to licensing activities under chapters 142B, 
468.14 	245A, and 245C, data on individuals collected by the commissioner of human services 
468.15 	according to investigations under section 626.557 and chapters 142B, 245A, 245B, 245C, 
468.16 	245D, and 260E may be shared with the Department of Human Rights, the Department of 
468.17 	Health, the Department of Corrections, the ombudsman for mental health and developmental 
468.18 	disabilities, and the individual's professional regulatory board when there is reason to believe 
468.19 	that laws or standards under the jurisdiction of those agencies may have been violated or 
468.20 	the information may otherwise be relevant to the board's regulatory jurisdiction. Background 
468.21 	study data on an individual who is the subject of a background study under chapter 245C 
468.22 	for a licensed service for which the commissioner of human services or children, youth, 
468.23 	and families is the license holder may be shared with the commissioner and the 
468.24 	commissioner's delegate by the licensing division. Unless otherwise specified in this chapter, 
468.25 	the identity of a reporter of alleged maltreatment or licensing violations may not be disclosed.
468.26 	(j) In addition to the notice of determinations required under sections 260E.24, 
468.27 	subdivisions 5 and 7, and 260E.30, subdivision 6, paragraphs (b), (c), (d), (e), and (f), if the 
468.28 	commissioner of children, youth, and families or the local social services agency has 
468.29 	determined that an individual is a substantiated perpetrator of maltreatment of a child based 
468.30 	on sexual abuse, as defined in section 260E.03, and the commissioner or local social services 
468.31 	agency knows that the individual is a person responsible for a child's care in another facility, 
468.32 	the commissioner or local social services agency shall notify the head of that facility of this 
468.33 	determination. The notification must include an explanation of the individual's available 
468.34 	appeal rights and the status of any appeal. If a notice is given under this paragraph, the 
469.1 	government entity making the notification shall provide a copy of the notice to the individual 
469.2 	who is the subject of the notice.
469.3 	(k) All not public data collected, maintained, used, or disseminated under this subdivision 
469.4 	and subdivision 3 may be exchanged between the Department of Human Services, Licensing 
469.5 	Division, and the Department of Corrections for purposes of regulating services for which 
469.6 	the Department of Human Services and the Department of Corrections have regulatory 
469.7 	authority.

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

469.9 	Sec. 2. Minnesota Statutes 2023 Supplement, section 245A.02, subdivision 2c, is amended 
469.10 	to read:
469.11 		Subd. 2c.Annual or annually; family child care and family child foster care. For 
469.12 	the purposes of family child care under sections 245A.50 to 245A.53 and family child foster 
469.13 	care training, "annual" or "annually" means each calendar year.

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

469.15 	Sec. 3. Minnesota Statutes 2023 Supplement, section 245A.03, subdivision 2, as amended 
469.16 	by Laws 2024, chapter 85, section 52, and Laws 2024, chapter 80, article 2, section 35, is 
469.17 	amended to read:
469.18 		Subd. 2.Exclusion from licensure. (a) This chapter does not apply to:
469.19 	(1) residential or nonresidential programs that are provided to a person by an individual 
469.20 	who is related;
469.21 	(2) nonresidential programs that are provided by an unrelated individual to persons from 
469.22 	a single related family;
469.23 	(3) residential or nonresidential programs that are provided to adults who do not misuse 
469.24 	substances or have a substance use disorder, a mental illness, a developmental disability, a 
469.25 	functional impairment, or a physical disability;
469.26 	(4) sheltered workshops or work activity programs that are certified by the commissioner 
469.27 	of employment and economic development;
469.28 	(5) programs operated by a public school for children 33 months or older;
469.29 	(6) nonresidential programs primarily for children that provide care or supervision for 
469.30 	periods of less than three hours a day while the child's parent or legal guardian is in the 
470.1 	same building as the nonresidential program or present within another building that is 
470.2 	directly contiguous to the building in which the nonresidential program is located;
470.3 	(7) nursing homes or hospitals licensed by the commissioner of health except as specified 
470.4 	under section 245A.02;
470.5 	(8) board and lodge facilities licensed by the commissioner of health that do not provide 
470.6 	children's residential services under Minnesota Rules, chapter 2960, mental health or 
470.7 	substance use disorder treatment;
470.8 	(9) programs licensed by the commissioner of corrections;
470.9 	(10) recreation programs for children or adults that are operated or approved by a park 
470.10 	and recreation board whose primary purpose is to provide social and recreational activities;
470.11 	(11) noncertified boarding care homes unless they provide services for five or more 
470.12 	persons whose primary diagnosis is mental illness or a developmental disability;
470.13 	(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art 
470.14 	programs, and nonresidential programs for children provided for a cumulative total of less 
470.15 	than 30 days in any 12-month period;
470.16 	(13) residential programs for persons with mental illness, that are located in hospitals;
470.17 	(14) camps licensed by the commissioner of health under Minnesota Rules, chapter 
470.18 	4630;
470.19 	(15) mental health outpatient services for adults with mental illness or children with 
470.20 	emotional disturbance;
470.21 	(16) residential programs serving school-age children whose sole purpose is cultural or 
470.22 	educational exchange, until the commissioner adopts appropriate rules;
470.23 	(17) community support services programs as defined in section 245.462, subdivision 
470.24 	6, and family community support services as defined in section 245.4871, subdivision 17;
470.25 	(18) settings registered under chapter 144D which provide home care services licensed 
470.26 	by the commissioner of health to fewer than seven adults assisted living facilities licensed 
470.27 	by the commissioner of health under chapter 144G;
470.28 	(19) substance use disorder treatment activities of licensed professionals in private 
470.29 	practice as defined in section 245G.01, subdivision 17;
471.1 	(20) consumer-directed community support service funded under the Medicaid waiver 
471.2 	for persons with developmental disabilities when the individual who provided the service 
471.3 	is:
471.4 	(i) the same individual who is the direct payee of these specific waiver funds or paid by 
471.5 	a fiscal agent, fiscal intermediary, or employer of record; and
471.6 	(ii) not otherwise under the control of a residential or nonresidential program that is 
471.7 	required to be licensed under this chapter when providing the service;
471.8 	(21) a county that is an eligible vendor under section 254B.05 to provide care coordination 
471.9 	and comprehensive assessment services;
471.10 	(22) a recovery community organization that is an eligible vendor under section 254B.05 
471.11 	to provide peer recovery support services; or
471.12 	(23) programs licensed by the commissioner of children, youth, and families in chapter 
471.13 	142B.
471.14 	(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a 
471.15 	building in which a nonresidential program is located if it shares a common wall with the 
471.16 	building in which the nonresidential program is located or is attached to that building by 
471.17 	skyway, tunnel, atrium, or common roof.
471.18 	(b) (c) Except for the home and community-based services identified in section 245D.03, 
471.19 	subdivision 1, nothing in this chapter shall be construed to require licensure for any services 
471.20 	provided and funded according to an approved federal waiver plan where licensure is 
471.21 	specifically identified as not being a condition for the services and funding.

471.22 	Sec. 4. Minnesota Statutes 2022, section 245A.04, is amended by adding a subdivision to 
471.23 	read:
471.24 		Subd. 7b.Notification to commissioner of changes in key staff positions; children's 
471.25 	residential facilities and detoxification programs. (a) A license holder must notify the 
471.26 	commissioner within five business days of a change or vacancy in a key staff position under 
471.27 	paragraphs (b) or (c). The license holder must notify the commissioner of the staffing change 
471.28 	or vacancy on a form approved by the commissioner and include the name of the staff person 
471.29 	now assigned to the key staff position and the staff person's qualifications for the position.
471.30 	(b) The key staff position for a children's residential facility licensed according to 
471.31 	Minnesota Rules, parts 2960.0130 to 2960.0220, is a program director; and
472.1 	(c) The key staff positions for a detoxification program licensed according to Minnesota 
472.2 	Rules, parts 9530.6510 to 9530.6590, are:
472.3 	(1) a program director as required by Minnesota Rules, part 9530.6560, subpart 1;
472.4 	(2) a registered nurse as required by Minnesota Rules, part 9530.6560, subpart 4; and
472.5 	(3) a medical director as required by Minnesota Rules, part 9530.6560, subpart 5.

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

472.7 	Sec. 5. Minnesota Statutes 2022, section 245A.04, subdivision 10, is amended to read:
472.8 		Subd. 10.Adoption agency; additional requirements. In addition to the other 
472.9 	requirements of this section, an individual or organization applying for a license to place 
472.10 	children for adoption must:
472.11 	(1) incorporate as a nonprofit corporation under chapter 317A;
472.12 	(2) file with the application for licensure a copy of the disclosure form required under 
472.13 	section 259.37, subdivision 2;
472.14 	(3) provide evidence that a bond has been obtained and will be continuously maintained 
472.15 	throughout the entire operating period of the agency, to cover the cost of transfer of records 
472.16 	to and storage of records by the agency which has agreed, according to rule established by 
472.17 	the commissioner, to receive the applicant agency's records if the applicant agency voluntarily 
472.18 	or involuntarily ceases operation and fails to provide for proper transfer of the records. The 
472.19 	bond must be made in favor of the agency which has agreed to receive the records; and
472.20 	(4) submit a certified audit financial review completed by an accountant to the 
472.21 	commissioner each year the license is renewed as required under section 245A.03, subdivision 
472.22 	1.

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

472.24 	Sec. 6. Minnesota Statutes 2022, section 245A.043, subdivision 2, is amended to read:
472.25 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
472.26 	in ownership, the commissioner shall require submission of a new license application. This 
472.27 	subdivision does not apply to a licensed program or service located in a home where the 
472.28 	license holder resides. A change in ownership occurs when:
472.29 	(1) except as provided in paragraph (b), the license holder sells or transfers 100 percent 
472.30 	of the property, stock, or assets;
473.1 	(2) the license holder merges with another organization;
473.2 	(3) the license holder consolidates with two or more organizations, resulting in the 
473.3 	creation of a new organization;
473.4 	(4) there is a change to the federal tax identification number associated with the license 
473.5 	holder; or
473.6 	(5) except as provided in paragraph (b), all controlling individuals associated with for
473.7 	the original application license have changed.
473.8 	(b) Notwithstanding For changes under paragraph (a), clauses (1) and or (5), no change 
473.9 	in ownership has occurred and a new license application is not required if at least one 
473.10 	controlling individual has been listed affiliated as a controlling individual for the license 
473.11 	for at least the previous 12 months immediately preceding the change.

473.12 	Sec. 7. Minnesota Statutes 2023 Supplement, section 245A.043, subdivision 3, is amended 
473.13 	to read:
473.14 		Subd. 3.Standard change of ownership process. (a) When a change in ownership is 
473.15 	proposed and the party intends to assume operation without an interruption in service longer 
473.16 	than 60 days after acquiring the program or service, the license holder must provide the 
473.17 	commissioner with written notice of the proposed change on a form provided by the 
473.18 	commissioner at least 60 90 days before the anticipated date of the change in ownership. 
473.19 	For purposes of this subdivision and subdivision 4 section, "party" means the party that 
473.20 	intends to operate the service or program.
473.21 	(b) The party must submit a license application under this chapter on the form and in 
473.22 	the manner prescribed by the commissioner at least 30 90 days before the change in 
473.23 	ownership is anticipated to be complete, and must include documentation to support the 
473.24 	upcoming change. The party must comply with background study requirements under chapter 
473.25 	245C and shall pay the application fee required under section 245A.10.
473.26 	(c) A party that intends to assume operation without an interruption in service longer 
473.27 	than 60 days after acquiring the program or service is exempt from the requirements of 
473.28 	sections 245G.03, subdivision 2, paragraph (b), and 254B.03, subdivision 2, paragraphs (c) 
473.29 	and (d).
473.30 	(c) (d) The commissioner may streamline application procedures when the party is an 
473.31 	existing license holder under this chapter and is acquiring a program licensed under this 
473.32 	chapter or service in the same service class as one or more licensed programs or services 
473.33 	the party operates and those licenses are in substantial compliance. For purposes of this 
474.1 	subdivision, "substantial compliance" means within the previous 12 months the commissioner 
474.2 	did not (1) issue a sanction under section 245A.07 against a license held by the party, or 
474.3 	(2) make a license held by the party conditional according to section 245A.06.
474.4 	(d) Except when a temporary change in ownership license is issued pursuant to 
474.5 	subdivision 4 (e) While the standard change of ownership process is pending, the existing 
474.6 	license holder is solely remains responsible for operating the program according to applicable 
474.7 	laws and rules until a license under this chapter is issued to the party.
474.8 	(e) (f) If a licensing inspection of the program or service was conducted within the 
474.9 	previous 12 months and the existing license holder's license record demonstrates substantial 
474.10 	compliance with the applicable licensing requirements, the commissioner may waive the 
474.11 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
474.12 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
474.13 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
474.14 	inspected for compliance with the building code or that no inspection was deemed warranted.
474.15 	(f) (g) If the party is seeking a license for a program or service that has an outstanding 
474.16 	action under section 245A.06 or 245A.07, the party must submit a letter written plan as part 
474.17 	of the application process identifying how the party has or will come into full compliance 
474.18 	with the licensing requirements.
474.19 	(g) (h) The commissioner shall evaluate the party's application according to section 
474.20 	245A.04, subdivision 6. If the commissioner determines that the party has remedied or 
474.21 	demonstrates the ability to remedy the outstanding actions under section 245A.06 or 245A.07
474.22 	and has determined that the program otherwise complies with all applicable laws and rules, 
474.23 	the commissioner shall issue a license or conditional license under this chapter. A conditional 
474.24 	license issued under this section is final and not subject to reconsideration under section 
474.25 	245A.06, subdivision 4. The conditional license remains in effect until the commissioner 
474.26 	determines that the grounds for the action are corrected or no longer exist.
474.27 	(h) (i) The commissioner may deny an application as provided in section 245A.05. An 
474.28 	applicant whose application was denied by the commissioner may appeal the denial according 
474.29 	to section 245A.05.
474.30 	(i) (j) This subdivision does not apply to a licensed program or service located in a home 
474.31 	where the license holder resides.

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

475.1 	Sec. 8. Minnesota Statutes 2022, section 245A.043, is amended by adding a subdivision 
475.2 	to read:
475.3 		Subd. 3a.Emergency change in ownership process. (a) In the event of a death of a 
475.4 	license holder or sole controlling individual or a court order or other event that results in 
475.5 	the license holder being inaccessible or unable to operate the program or service, a party 
475.6 	may submit a request to the commissioner to allow the party to assume operation of the 
475.7 	program or service under an emergency change in ownership process to ensure persons 
475.8 	continue to receive services while the commissioner evaluates the party's license application.
475.9 	(b) To request the emergency change of ownership process, the party must immediately:
475.10 	(1) notify the commissioner of the event resulting in the inability of the license holder 
475.11 	to operate the program and of the party's intent to assume operations; and
475.12 	(2) provide the commissioner with documentation that demonstrates the party has a legal 
475.13 	or legitimate ownership interest in the program or service if applicable and is able to operate 
475.14 	the program or service.
475.15 	(c) If the commissioner approves the party to continue operating the program or service 
475.16 	under an emergency change in ownership process, the party must:
475.17 	(1) request to be added as a controlling individual or license holder to the existing license;
475.18 	(2) notify persons receiving services of the emergency change in ownership in a manner 
475.19 	approved by the commissioner;
475.20 	(3) submit an application for a new license within 30 days of approval;
475.21 	(4) comply with the background study requirements under chapter 245C; and
475.22 	(5) pay the application fee required under section 245A.10.
475.23 	(d) While the emergency change of ownership process is pending, a party approved 
475.24 	under this subdivision is responsible for operating the program under the existing license 
475.25 	according to applicable laws and rules until a new license under this chapter is issued.
475.26 	(e) The provisions in subdivision 3, paragraphs (c), (d), and (f) to (i) apply to this 
475.27 	subdivision.
475.28 	(f) Once a party is issued a new license or has decided not to seek a new license, the 
475.29 	commissioner must close the existing license.
475.30 	(g) This subdivision applies to any program or service licensed under this chapter.

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

476.1 	Sec. 9. Minnesota Statutes 2022, section 245A.043, subdivision 4, is amended to read:
476.2 		Subd. 4.Temporary change in ownership transitional license. (a) After receiving the 
476.3 	party's application pursuant to subdivision 3, upon the written request of the existing license 
476.4 	holder and the party, the commissioner may issue a temporary change in ownership license 
476.5 	to the party while the commissioner evaluates the party's application. Until a decision is 
476.6 	made to grant or deny a license under this chapter, the existing license holder and the party 
476.7 	shall both be responsible for operating the program or service according to applicable laws 
476.8 	and rules, and the sale or transfer of the existing license holder's ownership interest in the 
476.9 	licensed program or service does not terminate the existing license.
476.10 	(b) The commissioner may issue a temporary change in ownership license when a license 
476.11 	holder's death, divorce, or other event affects the ownership of the program and an applicant 
476.12 	seeks to assume operation of the program or service to ensure continuity of the program or 
476.13 	service while a license application is evaluated.
476.14 	(c) This subdivision applies to any program or service licensed under this chapter.
476.15 	If a party's application under subdivision 2 is for a satellite license for a community 
476.16 	residential setting under section 245D.23 or day services facility under 245D.27 and if the 
476.17 	party already holds an active license to provide services under chapter 245D, the 
476.18 	commissioner may issue a temporary transitional license to the party for the community 
476.19 	residential setting or day services facility while the commissioner evaluates the party's 
476.20 	application. Until a decision is made to grant or deny a community residential setting or 
476.21 	day services facility satellite license, the party must be solely responsible for operating the 
476.22 	program according to applicable laws and rules, and the existing license must be closed. 
476.23 	The temporary transitional license expires after 12 months from the date it was issued or 
476.24 	upon issuance of the community residential setting or day services facility satellite license, 
476.25 	whichever occurs first.

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

476.27 	Sec. 10. Minnesota Statutes 2022, section 245A.043, is amended by adding a subdivision 
476.28 	to read:
476.29 		Subd. 5.Failure to comply. If the commissioner finds that the applicant or license holder 
476.30 	has not fully complied with this section, the commissioner may impose a licensing sanction 
476.31 	under section 245A.05, 245A.06, or 245A.07.

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

477.1 	Sec. 11. Minnesota Statutes 2023 Supplement, section 245A.07, subdivision 1, as amended 
477.2 	by Laws 2024, chapter 80, article 2, section 44, is amended to read:
477.3 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
477.4 	under section 245A.06, the commissioner may suspend or revoke the license, impose a fine, 
477.5 	or secure an injunction against the continuing operation of the program of a license holder 
477.6 	who does not comply with applicable law or rule.
477.7 	When applying sanctions authorized under this section, the commissioner shall consider 
477.8 	the nature, chronicity, or severity of the violation of law or rule and the effect of the violation 
477.9 	on the health, safety, or rights of persons served by the program.
477.10 	(b) If a license holder appeals the suspension or revocation of a license and the license 
477.11 	holder continues to operate the program pending a final order on the appeal, the commissioner 
477.12 	shall issue the license holder a temporary provisional license. The commissioner may include 
477.13 	terms the license holder must follow pending a final order on the appeal.Unless otherwise 
477.14 	specified by the commissioner, variances in effect on the date of the license sanction under 
477.15 	appeal continue under the temporary provisional license. If a license holder fails to comply 
477.16 	with applicable law or rule while operating under a temporary provisional license, the 
477.17 	commissioner may impose additional sanctions under this section and section 245A.06, and 
477.18 	may terminate any prior variance. If a temporary provisional license is set to expire, a new 
477.19 	temporary provisional license shall be issued to the license holder upon payment of any fee 
477.20 	required under section 245A.10. The temporary provisional license shall expire on the date 
477.21 	the final order is issued. If the license holder prevails on the appeal, a new nonprovisional 
477.22 	license shall be issued for the remainder of the current license period.
477.23 	(c) If a license holder is under investigation and the license issued under this chapter is 
477.24 	due to expire before completion of the investigation, the program shall be issued a new 
477.25 	license upon completion of the reapplication requirements and payment of any applicable 
477.26 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
477.27 	against the new license under this section, section 245A.06, or 245A.08.
477.28 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
477.29 	holder prior to the completion of any investigation shall not preclude the commissioner 
477.30 	from issuing a licensing sanction under this section or section 245A.06 at the conclusion 
477.31 	of the investigation.

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

478.1 	Sec. 12. Minnesota Statutes 2022, section 245A.07, subdivision 6, is amended to read:
478.2 		Subd. 6.Appeal of multiple sanctions. (a) When the license holder appeals more than 
478.3 	one licensing action or sanction that were simultaneously issued by the commissioner, the 
478.4 	license holder shall specify the actions or sanctions that are being appealed.
478.5 	(b) If there are different timelines prescribed in statutes for the licensing actions or 
478.6 	sanctions being appealed, the license holder must submit the appeal within the longest of 
478.7 	those timelines specified in statutes.
478.8 	(c) The appeal must be made in writing by certified mail or, by personal service, or 
478.9 	through the provider licensing and reporting hub. If mailed, the appeal must be postmarked 
478.10 	and sent to the commissioner within the prescribed timeline with the first day beginning 
478.11 	the day after the license holder receives the certified letter. If a request is made by personal 
478.12 	service, it must be received by the commissioner within the prescribed timeline with the 
478.13 	first day beginning the day after the license holder receives the certified letter. If the appeal 
478.14 	is made through the provider licensing and reporting hub, it must be received by the 
478.15 	commissioner within the prescribed timeline with the first day beginning the day after the 
478.16 	commissioner issued the order through the hub.
478.17 	(d) When there are different timelines prescribed in statutes for the appeal of licensing 
478.18 	actions or sanctions simultaneously issued by the commissioner, the commissioner shall 
478.19 	specify in the notice to the license holder the timeline for appeal as specified under paragraph 
478.20 	(b).

478.21 	Sec. 13. Minnesota Statutes 2023 Supplement, section 245A.11, subdivision 7, is amended 
478.22 	to read:
478.23 		Subd. 7.Adult foster care and community residential setting; variance for alternate 
478.24 	overnight supervision. (a) The commissioner may grant a variance under section 245A.04, 
478.25 	subdivision 9, to statute or rule parts requiring a caregiver to be present in an adult foster 
478.26 	care home or a community residential setting during normal sleeping hours to allow for 
478.27 	alternative methods of overnight supervision. The commissioner may grant the variance if 
478.28 	the local county licensing agency recommends the variance and the county recommendation 
478.29 	includes documentation verifying that:
478.30 	(1) the county has approved the license holder's plan for alternative methods of providing 
478.31 	overnight supervision and determined the plan protects the residents' health, safety, and 
478.32 	rights;
479.1 	(2) the license holder has obtained written and signed informed consent from each 
479.2 	resident or each resident's legal representative documenting the resident's or legal 
479.3 	representative's agreement with the alternative method of overnight supervision; and
479.4 	(3) the alternative method of providing overnight supervision, which may include the 
479.5 	use of technology, is specified for each resident in the resident's: (i) individualized plan of 
479.6 	care; (ii) individual service support plan under section 256B.092, subdivision 1b, if required; 
479.7 	or (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, 
479.8 	subpart 19, if required.
479.9 	(b) To be eligible for a variance under paragraph (a), the adult foster care or community 
479.10 	residential setting license holder must not have had a conditional license issued under section 
479.11 	245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24 
479.12 	months based on failure to provide adequate supervision, health care services, or resident 
479.13 	safety in the adult foster care home or a community residential setting.
479.14 	(c) A license holder requesting a variance under this subdivision to utilize technology 
479.15 	as a component of a plan for alternative overnight supervision may request the commissioner's 
479.16 	review in the absence of a county recommendation. Upon receipt of such a request from a 
479.17 	license holder, the commissioner shall review the variance request with the county.
479.18 	(d) The variance requirements under this subdivision for alternative overnight supervision 
479.19 	do not apply to community residential settings licensed under chapter 245D.

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

479.21 	Sec. 14. Minnesota Statutes 2022, section 245A.14, subdivision 17, is amended to read:
479.22 		Subd. 17.Reusable water bottles or cups. Notwithstanding any law to the contrary, a 
479.23 	licensed child care center may provide drinking water to a child in a reusable water bottle 
479.24 	or reusable cup if the center develops and ensures implementation of a written policy that 
479.25 	at a minimum includes the following procedures:
479.26 	(1) each day the water bottle or cup is used, the child care center cleans and sanitizes 
479.27 	the water bottle or cup using procedures that comply with the Food Code under Minnesota 
479.28 	Rules, chapter 4626, or allows the child's parent or legal guardian to bring the water bottle 
479.29 	or cup home;
479.30 	(2) a water bottle or cup is assigned to a specific child and labeled with the child's first 
479.31 	and last name;
480.1 	(3) water bottles and cups are stored in a manner that reduces the risk of a child using 
480.2 	the wrong water bottle or cup; and
480.3 	(4) a water bottle or cup is used only for water.

480.4 	Sec. 15. Minnesota Statutes 2023 Supplement, section 245A.16, subdivision 1, as amended 
480.5 	by Laws 2024, chapter 80, article 2, section 65, is amended to read:
480.6 		Subdivision 1.Delegation of authority to agencies. (a) County agencies that have been 
480.7 	designated by the commissioner to perform licensing functions and activities under section 
480.8 	245A.04; to recommend denial of applicants under section 245A.05; to issue correction 
480.9 	orders, to issue variances, and recommend a conditional license under section 245A.06; or 
480.10 	to recommend suspending or revoking a license or issuing a fine under section 245A.07, 
480.11 	shall comply with rules and directives of the commissioner governing those functions and 
480.12 	with this section. The following variances are excluded from the delegation of variance 
480.13 	authority and may be issued only by the commissioner:
480.14 	(1) dual licensure of family child foster care and family adult foster care, dual licensure 
480.15 	of child foster residence setting and community residential setting, and dual licensure of 
480.16 	family adult foster care and family child care;
480.17 	(2) adult foster care or community residential settingmaximum capacity;
480.18 	(3) adult foster care or community residential settingminimum age requirement;
480.19 	(4) child foster care maximum age requirement;
480.20 	(5) variances regarding disqualified individuals;
480.21 	(6) the required presence of a caregiver in the adult foster care residence during normal 
480.22 	sleeping hours;
480.23 	(7) variances to requirements relating to chemical use problems of a license holder or a 
480.24 	household member of a license holder; and
480.25 	(8) variances to section 142B.46 for the use of a cradleboard for a cultural 
480.26 	accommodation.
480.27 	(b) For family adult day services programs, the commissioner may authorize licensing 
480.28 	reviews every two years after a licensee has had at least one annual review.
480.29 	(c) A license issued under this section may be issued for up to two years.
480.30 	(d) During implementation of chapter 245D, the commissioner shall consider:
480.31 	(1) the role of counties in quality assurance;
481.1 	(2) the duties of county licensing staff; and
481.2 	(3) the possible use of joint powers agreements, according to section 471.59, with counties 
481.3 	through which some licensing duties under chapter 245D may be delegated by the 
481.4 	commissioner to the counties.
481.5 	Any consideration related to this paragraph must meet all of the requirements of the corrective 
481.6 	action plan ordered by the federal Centers for Medicare and Medicaid Services.
481.7 	(e) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
481.8 	successor provisions; and section 245D.061 or successor provisions, for family child foster 
481.9 	care programs providing out-of-home respite, as identified in section 245D.03, subdivision 
481.10 	1, paragraph (b), clause (1), is excluded from the delegation of authority to county agencies.

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

481.12 	Sec. 16. Minnesota Statutes 2023 Supplement, section 245A.16, subdivision 11, is amended 
481.13 	to read:
481.14 		Subd. 11.Electronic checklist use by family child care licensors. County and private 
481.15 	agency staff who perform family child care delegated licensing functions must use the 
481.16 	commissioner's electronic licensing checklist in the manner prescribed by the commissioner.

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

481.18 	Sec. 17. Minnesota Statutes 2023 Supplement, section 245A.211, subdivision 4, is amended 
481.19 	to read:
481.20 		Subd. 4.Contraindicated physical restraints. A license or certification holder must 
481.21 	not implement a restraint on a person receiving services in a program in a way that is 
481.22 	contraindicated for any of the person's known medical or psychological conditions. Prior 
481.23 	to using restraints on a person, the license or certification holder must assess and document 
481.24 	a determination of any with a known medical or psychological conditions that restraints are 
481.25 	contraindicated for, the license or certification holder must document the contraindication
481.26 	and the type of restraints that will not be used on the person based on this determination.

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

481.28 	Sec. 18. Minnesota Statutes 2023 Supplement, section 245A.242, subdivision 2, is amended 
481.29 	to read:
481.30 		Subd. 2.Emergency overdose treatment. (a) A license holder must maintain a supply 
481.31 	of opiate antagonists as defined in section 604A.04, subdivision 1, available for emergency 
482.1 	treatment of opioid overdose and must have a written standing order protocol by a physician 
482.2 	who is licensed under chapter 147, advanced practice registered nurse who is licensed under 
482.3 	chapter 148, or physician assistant who is licensed under chapter 147A, that permits the 
482.4 	license holder to maintain a supply of opiate antagonists on site. A license holder must 
482.5 	require staff to undergo training in the specific mode of administration used at the program, 
482.6 	which may include intranasal administration, intramuscular injection, or both.
482.7 	(b) Notwithstanding any requirements to the contrary in Minnesota Rules, chapters 2960 
482.8 	and 9530, and Minnesota Statutes, chapters 245F, 245G, and 245I:
482.9 	(1) emergency opiate antagonist medications are not required to be stored in a locked 
482.10 	area and staff and adult clients may carry this medication on them and store it in an unlocked 
482.11 	location;
482.12 	(2) staff persons who only administer emergency opiate antagonist medications only 
482.13 	require the training required by paragraph (a), which any knowledgeable trainer may provide. 
482.14 	The trainer is not required to be a registered nurse or part of an accredited educational 
482.15 	institution; and
482.16 	(3) nonresidential substance use disorder treatment programs that do not administer 
482.17 	client medications beyond emergency opiate antagonist medications are not required to 
482.18 	have the policies and procedures required in section 245G.08, subdivisions 5 and 6, and 
482.19 	must instead describe the program's procedures for administering opiate antagonist 
482.20 	medications in the license holder's description of health care services under section 245G.08, 
482.21 	subdivision 1.

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

482.23 	Sec. 19. Minnesota Statutes 2022, section 245A.52, subdivision 2, is amended to read:
482.24 		Subd. 2.Door to attached garage. Notwithstanding Minnesota Rules, part 9502.0425, 
482.25 	subpart 5, day care residences with an attached garage are not required to have a self-closing 
482.26 	door to the residence. The door to the residence may be (a) If there is an opening between 
482.27 	an  attached garage and a day care residence, there must be a door that is:
482.28 	(1) a solid wood bonded-core door at least 1-3/8 inches thick;
482.29 	(2) a steel insulated door if the door is at least 1-3/8 inches thick.; or
482.30 	(3) a door with a fire protection rating of 20 minutes.
482.31 	(b) The separation wall on the garage side between the residence and garage must consist 
482.32 	of 1/2-inch-thick gypsum wallboard or its equivalent.

483.1 	Sec. 20. Minnesota Statutes 2022, section 245A.52, is amended by adding a subdivision 
483.2 	to read:
483.3 		Subd. 8.Stairways. (a) All stairways must meet the requirements in this subdivision.
483.4 	(b) Stairways of four or more steps must have handrails on at least one side.
483.5 	(c) Any open area between the handrail and stair tread must be enclosed with a protective 
483.6 	guardrail as specified in the State Building Code. At open risers, openings located more 
483.7 	than 30 inches or 762 millimeters as measured vertically to the floor or grade below must 
483.8 	not permit the passage of a sphere four inches or 102 millimeters in diameter.
483.9 	(d) Gates or barriers must be used when children aged six to 18 months are in care.
483.10 	(e) Stairways must be well lit, in good repair, and free of clutter and obstructions.

483.11 	Sec. 21. Minnesota Statutes 2022, section 245A.66, subdivision 2, is amended to read:
483.12 		Subd. 2.Child care centers; risk reduction plan. (a) Child care centers licensed under 
483.13 	this chapter and Minnesota Rules, chapter 9503, must develop a risk reduction plan that 
483.14 	identifies the general risks to children served by the child care center. The license holder 
483.15 	must establish procedures to minimize identified risks, train staff on the procedures, and 
483.16 	annually review the procedures.
483.17 	(b) The risk reduction plan must include an assessment of risk to children the center 
483.18 	serves or intends to serve and identify specific risks based on the outcome of the assessment. 
483.19 	The assessment of risk must be based on the following:
483.20 	(1) an assessment of the risks presented by the physical plant where the licensed services 
483.21 	are provided, including an evaluation of the following factors: the condition and design of 
483.22 	the facility and its outdoor space, bathrooms, storage areas, and accessibility of medications 
483.23 	and cleaning products that are harmful to children when children are not supervised and the 
483.24 	existence of areas that are difficult to supervise; and
483.25 	(2) an assessment of the risks presented by the environment for each facility and for 
483.26 	each site, including an evaluation of the following factors: the type of grounds and terrain 
483.27 	surrounding the building and the proximity to hazards, busy roads, and publicly accessed 
483.28 	businesses.
483.29 	(c) The risk reduction plan must include a statement of measures that will be taken to 
483.30 	minimize the risk of harm presented to children for each risk identified in the assessment 
483.31 	required under paragraph (b) related to the physical plant and environment. At a minimum, 
483.32 	the stated measures must include the development and implementation of specific policies 
484.1 	and procedures or reference to existing policies and procedures that minimize the risks 
484.2 	identified.
484.3 	(d) In addition to any program-specific risks identified in paragraph (b), the plan must 
484.4 	include development and implementation of specific policies and procedures or refer to 
484.5 	existing policies and procedures that minimize the risk of harm or injury to children, 
484.6 	including:
484.7 	(1) closing children's fingers in doors, including cabinet doors;
484.8 	(2) leaving children in the community without supervision;
484.9 	(3) children leaving the facility without supervision;
484.10 	(4) caregiver dislocation of children's elbows;
484.11 	(5) burns from hot food or beverages, whether served to children or being consumed by 
484.12 	caregivers, and the devices used to warm food and beverages;
484.13 	(6) injuries from equipment, such as scissors and glue guns;
484.14 	(7) sunburn;
484.15 	(8) feeding children foods to which they are allergic;
484.16 	(9) children falling from changing tables; and
484.17 	(10) children accessing dangerous items or chemicals or coming into contact with residue 
484.18 	from harmful cleaning products.
484.19 	(e) The plan shall prohibit the accessibility of hazardous items to children.
484.20 	(f) The plan must include specific policies and procedures to ensure adequate supervision 
484.21 	of children at all times as defined under section 245A.02, subdivision 18, with particular 
484.22 	emphasis on:
484.23 	(1) times when children are transitioned from one area within the facility to another;
484.24 	(2) nap-time supervision, including infant crib rooms as specified under section 245A.02, 
484.25 	subdivision 18, which requires that when an infant is placed in a crib to sleep, supervision 
484.26 	occurs when a staff person is within sight or hearing of the infant. When supervision of a 
484.27 	crib room is provided by sight or hearing, the center must have a plan to address the other 
484.28 	supervision components;
484.29 	(3) child drop-off and pick-up times;
485.1 	(4) supervision during outdoor play and on community activities, including but not 
485.2 	limited to field trips and neighborhood walks;
485.3 	(5) supervision of children in hallways; and
485.4 	(6) supervision of school-age children when using the restroom and visiting the child's 
485.5 	personal storage space.; and
485.6 	(7) supervision of preschool children when using an individual, private restroom within 
485.7 	the classroom.

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

485.9 	Sec. 22. Minnesota Statutes 2023 Supplement, section 245C.02, subdivision 6a, is amended 
485.10 	to read:
485.11 		Subd. 6a.Child care background study subject. (a) "Child care background study 
485.12 	subject" means an individual who is affiliated with a licensed child care center, certified 
485.13 	license-exempt child care center, licensed family child care program, or legal nonlicensed 
485.14 	child care provider authorized under chapter 119B, and who is:
485.15 	(1) employed by a child care provider for compensation;
485.16 	(2) assisting in the care of a child for a child care provider;
485.17 	(3) a person applying for licensure, certification, or enrollment;
485.18 	(4) a controlling individual as defined in section 245A.02, subdivision 5a;
485.19 	(5) an individual 13 years of age or older who lives in the household where the licensed 
485.20 	program will be provided and who is not receiving licensed services from the program;
485.21 	(6) an individual ten to 12 years of age who lives in the household where the licensed 
485.22 	services will be provided when the commissioner has reasonable cause as defined in section 
485.23 	245C.02, subdivision 15;
485.24 	(7) an individual who, without providing direct contact services at a licensed program, 
485.25 	certified program, or program authorized under chapter 119B, may have unsupervised access 
485.26 	to a child receiving services from a program when the commissioner has reasonable cause 
485.27 	as defined in section 245C.02, subdivision 15; or
485.28 	(8) a volunteer, contractor providing services for hire in the program, prospective 
485.29 	employee, or other individual who has unsupervised physical access to a child served by a 
485.30 	program and who is not under supervision by an individual listed in clause (1) or (5), 
485.31 	regardless of whether the individual provides program services.; or
486.1 	(9) an authorized agent in a license-exempt certified child care center as defined in 
486.2 	section 245H.01, subdivision 2a.
486.3 	(b) Notwithstanding paragraph (a), an individual who is providing services that are not 
486.4 	part of the child care program is not required to have a background study if:
486.5 	(1) the child receiving services is signed out of the child care program for the duration 
486.6 	that the services are provided;
486.7 	(2) the licensed child care center, certified license-exempt child care center, licensed 
486.8 	family child care program, or legal nonlicensed child care provider authorized under chapter 
486.9 	119B has obtained advanced written permission from the parent authorizing the child to 
486.10 	receive the services, which is maintained in the child's record;
486.11 	(3) the licensed child care center, certified license-exempt child care center, licensed 
486.12 	family child care program, or legal nonlicensed child care provider authorized under chapter 
486.13 	119B maintains documentation on site that identifies the individual service provider and 
486.14 	the services being provided; and
486.15 	(4) the licensed child care center, certified license-exempt child care center, licensed 
486.16 	family child care program, or legal nonlicensed child care provider authorized under chapter 
486.17 	119B ensures that the service provider does not have unsupervised access to a child not 
486.18 	receiving the provider's services.

486.19 	EFFECTIVE DATE. This section is effective October 1, 2024.

486.20 	Sec. 23. Minnesota Statutes 2023 Supplement, section 245C.02, subdivision 13e, is 
486.21 	amended to read:
486.22 		Subd. 13e.NETStudy 2.0. (a) "NETStudy 2.0" means the commissioner's system that 
486.23 	replaces both NETStudy and the department's internal background study processing system. 
486.24 	NETStudy 2.0 is designed to enhance protection of children and vulnerable adults by 
486.25 	improving the accuracy of background studies through fingerprint-based criminal record 
486.26 	checks and expanding the background studies to include a review of information from the 
486.27 	Minnesota Court Information System and the national crime information database. NETStudy 
486.28 	2.0 is also designed to increase efficiencies in and the speed of the hiring process by:
486.29 	(1) providing access to and updates from public web-based data related to employment 
486.30 	eligibility;
486.31 	(2) decreasing the need for repeat studies through electronic updates of background 
486.32 	study subjects' criminal records;
487.1 	(3) supporting identity verification using subjects' Social Security numbers and 
487.2 	photographs;
487.3 	(4) using electronic employer notifications;
487.4 	(5) issuing immediate verification of subjects' eligibility to provide services as more 
487.5 	studies are completed under the NETStudy 2.0 system; and
487.6 	(6) providing electronic access to certain notices for entities and background study 
487.7 	subjects.
487.8 	(b) Information obtained by entities from public web-based data through NETStudy 2.0 
487.9 	under paragraph (a), clause (1), or any other source that is not direct correspondence from 
487.10 	the commissioner is not a notice of disqualification from the commissioner under this 
487.11 	chapter.

487.12 	Sec. 24. Minnesota Statutes 2022, section 245C.03, is amended by adding a subdivision 
487.13 	to read:
487.14 		Subd. 16.Individuals affiliated with a Head Start program. When initiated by the 
487.15 	Head Start program, including Tribal Head Start programs, the commissioner shall conduct 
487.16 	a background study on any individual who is affiliated with a Head Start program.

487.17 	Sec. 25. Minnesota Statutes 2023 Supplement, section 245C.033, subdivision 3, is amended 
487.18 	to read:
487.19 		Subd. 3.Procedure; maltreatment and state licensing agency data. (a) For requests 
487.20 	paid directly by the guardian or conservator, requests for maltreatment and state licensing 
487.21 	agency data checks must be submitted by the guardian or conservator to the commissioner 
487.22 	on the form or in the manner prescribed by the commissioner. Upon receipt of a signed 
487.23 	informed consent and payment under section 245C.10, the commissioner shall complete 
487.24 	the maltreatment and state licensing agency checks. Upon completion of the checks, the 
487.25 	commissioner shall provide the requested information to the courts on the form or in the 
487.26 	manner prescribed by the commissioner.
487.27 	(b) For requests paid by the court based on the in forma pauperis status of the guardian 
487.28 	or conservator, requests for maltreatment and state licensing agency data checks must be 
487.29 	submitted by the court to the commissioner on the form or in the manner prescribed by the 
487.30 	commissioner. The form will serve as certification that the individual has been granted in 
487.31 	forma pauperis status. Upon receipt of a signed data request consent form from the court, 
487.32 	the commissioner shall initiate the maltreatment and state licensing agency checks. Upon 
488.1 	completion of the checks, the commissioner shall provide the requested information to the 
488.2 	courts on the form or in the manner prescribed by the commissioner.

488.3 	Sec. 26. [245C.041] EMERGENCY WAIVER TO TEMPORARILY MODIFY 
488.4 	BACKGROUND STUDY REQUIREMENTS.
488.5 	(a) In the event of an emergency identified by the commissioner, the commissioner may 
488.6 	temporarily waive or modify provisions in this chapter, except that the commissioner shall 
488.7 	not waive or modify:
488.8 	(1) disqualification standards in section 245C.14 or 245C.15; or
488.9 	(2) any provision regarding the scope of individuals required to be subject to a background 
488.10 	study conducted under this chapter.
488.11 	(b) For the purposes of this section, an emergency may include, but is not limited to a 
488.12 	public health emergency, environmental emergency, natural disaster, or other unplanned 
488.13 	event that the commissioner has determined prevents the requirements in this chapter from 
488.14 	being met. This authority shall not exceed the amount of time needed to respond to the 
488.15 	emergency and reinstate the requirements of this chapter. The commissioner has the authority 
488.16 	to establish the process and time frame for returning to full compliance with this chapter. 
488.17 	The commissioner shall determine the length of time an emergency study is valid.
488.18 	(c) At the conclusion of the emergency, entities must submit a new, compliant background 
488.19 	study application and fee for each individual who was the subject of background study 
488.20 	affected by the powers created in this section, referred to as an "emergency study" to have 
488.21 	a new study that fully complies with this chapter within a time frame and notice period 
488.22 	established by the commissioner.

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

488.24 	Sec. 27. Minnesota Statutes 2022, section 245C.05, subdivision 5, is amended to read:
488.25 		Subd. 5.Fingerprints and photograph. (a) Notwithstanding paragraph (b) (c), for 
488.26 	background studies conducted by the commissioner for child foster care, children's residential 
488.27 	facilities, adoptions, or a transfer of permanent legal and physical custody of a child, the 
488.28 	subject of the background study, who is 18 years of age or older, shall provide the 
488.29 	commissioner with a set of classifiable fingerprints obtained from an authorized agency for 
488.30 	a national criminal history record check.
488.31 	(b) Notwithstanding paragraph (c), for background studies conducted by the commissioner 
488.32 	for Head Start programs, the subject of the background study shall provide the commissioner 
489.1 	with a set of classifiable fingerprints obtained from an authorized agency for a national 
489.2 	criminal history record check.
489.3 	(b) (c) For background studies initiated on or after the implementation of NETStudy 
489.4 	2.0, except as provided under subdivision 5a, every subject of a background study must 
489.5 	provide the commissioner with a set of the background study subject's classifiable fingerprints 
489.6 	and photograph. The photograph and fingerprints must be recorded at the same time by the 
489.7 	authorized fingerprint collection vendor or vendors and sent to the commissioner through 
489.8 	the commissioner's secure data system described in section 245C.32, subdivision 1a, 
489.9 	paragraph (b).
489.10 	(c) (d) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal 
489.11 	Apprehension and, when specifically required by law, submitted to the Federal Bureau of 
489.12 	Investigation for a national criminal history record check.
489.13 	(d) (e) The fingerprints must not be retained by the Department of Public Safety, Bureau 
489.14 	of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will 
489.15 	not retain background study subjects' fingerprints.
489.16 	(e) (f) The authorized fingerprint collection vendor or vendors shall, for purposes of 
489.17 	verifying the identity of the background study subject, be able to view the identifying 
489.18 	information entered into NETStudy 2.0 by the entity that initiated the background study, 
489.19 	but shall not retain the subject's fingerprints, photograph, or information from NETStudy 
489.20 	2.0. The authorized fingerprint collection vendor or vendors shall retain no more than the 
489.21 	name and date and time the subject's fingerprints were recorded and sent, only as necessary 
489.22 	for auditing and billing activities.
489.23 	(f) (g) For any background study conducted under this chapter, the subject shall provide 
489.24 	the commissioner with a set of classifiable fingerprints when the commissioner has reasonable 
489.25 	cause to require a national criminal history record check as defined in section 245C.02, 
489.26 	subdivision 15a.

489.27 	Sec. 28. Minnesota Statutes 2023 Supplement, section 245C.08, subdivision 1, is amended 
489.28 	to read:
489.29 		Subdivision 1.Background studies conducted by Department of Human Services. (a) 
489.30 	For a background study conducted by the Department of Human Services, the commissioner 
489.31 	shall review:
490.1 	(1) information related to names of substantiated perpetrators of maltreatment of 
490.2 	vulnerable adults that has been received by the commissioner as required under section 
490.3 	626.557, subdivision 9c, paragraph (j);
490.4 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
490.5 	programs, and from findings of maltreatment of minors as indicated through the social 
490.6 	service information system;
490.7 	(3) information from juvenile courts as required in subdivision 4 for individuals listed 
490.8 	in section 245C.03, subdivision 1, paragraph (a), for studies under this chapter when there 
490.9 	is reasonable cause;
490.10 	(4) information from the Bureau of Criminal Apprehension, including information 
490.11 	regarding a background study subject's registration in Minnesota as a predatory offender 
490.12 	under section 243.166;
490.13 	(5) except as provided in clause (6), information received as a result of submission of 
490.14 	fingerprints for a national criminal history record check, as defined in section 245C.02, 
490.15 	subdivision 13c, when the commissioner has reasonable cause for a national criminal history 
490.16 	record check as defined under section 245C.02, subdivision 15a, or as required under section 
490.17 	144.057, subdivision 1, clause (2);
490.18 	(6) for a background study related to a child foster family setting application for licensure, 
490.19 	foster residence settings, children's residential facilities, a transfer of permanent legal and 
490.20 	physical custody of a child under sections 260C.503 to 260C.515, or adoptions, and for a 
490.21 	background study required for family child care, certified license-exempt child care, child 
490.22 	care centers, and legal nonlicensed child care authorized under chapter 119B, the 
490.23 	commissioner shall also review:
490.24 	(i) information from the child abuse and neglect registry for any state in which the 
490.25 	background study subject has resided for the past five years;
490.26 	(ii) when the background study subject is 18 years of age or older, or a minor under 
490.27 	section 245C.05, subdivision 5a, paragraph (c), information received following submission 
490.28 	of fingerprints for a national criminal history record check; and
490.29 	(iii) when the background study subject is 18 years of age or older or a minor under 
490.30 	section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified 
490.31 	license-exempt child care, licensed child care centers, and legal nonlicensed child care 
490.32 	authorized under chapter 119B, information obtained using non-fingerprint-based data 
490.33 	including information from the criminal and sex offender registries for any state in which 
491.1 	the background study subject resided for the past five years and information from the national 
491.2 	crime information database and the national sex offender registry;
491.3 	(7) for a background study required for family child care, certified license-exempt child 
491.4 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
491.5 	chapter 119B, the background study shall also include, to the extent practicable, a name 
491.6 	and date-of-birth search of the National Sex Offender Public website; and
491.7 	(8) for a background study required for treatment programs for sexual psychopathic 
491.8 	personalities or sexually dangerous persons, the background study shall only include a 
491.9 	review of the information required under paragraph (a), clauses (1) to (4).
491.10 	(b) Except as otherwise provided in this paragraph, notwithstanding expungement by a 
491.11 	court, the commissioner may consider information obtained under paragraph (a), clauses 
491.12 	(3) and (4), unless:
491.13 	(1) the commissioner received notice of the petition for expungement and the court order 
491.14 	for expungement is directed specifically to the commissioner; or
491.15 	(2) the commissioner received notice of the expungement order issued pursuant to section 
491.16 	609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically 
491.17 	to the commissioner.
491.18 	The commissioner may not consider information obtained under paragraph (a), clauses (3) 
491.19 	and (4), or from any other source that identifies a violation of chapter 152 without 
491.20 	determining if the offense involved the possession of marijuana or tetrahydrocannabinol 
491.21 	and, if so, whether the person received a grant of expungement or order of expungement, 
491.22 	or the person was resentenced to a lesser offense. If the person received a grant of 
491.23 	expungement or order of expungement, the commissioner may not consider information 
491.24 	related to that violation but may consider any other relevant information arising out of the 
491.25 	same incident.
491.26 	(c) The commissioner shall also review criminal case information received according 
491.27 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
491.28 	to individuals who have already been studied under this chapter and who remain affiliated 
491.29 	with the agency that initiated the background study.
491.30 	(d) When the commissioner has reasonable cause to believe that the identity of a 
491.31 	background study subject is uncertain, the commissioner may require the subject to provide 
491.32 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
491.33 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
492.1 	shall not be saved by the commissioner after they have been used to verify the identity of 
492.2 	the background study subject against the particular criminal record in question.
492.3 	(e) The commissioner may inform the entity that initiated a background study under 
492.4 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

492.5 	Sec. 29. Minnesota Statutes 2022, section 245C.08, subdivision 4, is amended to read:
492.6 		Subd. 4.Juvenile court records. (a) For a background study conducted by the 
492.7 	Department of Human Services, the commissioner shall review records from the juvenile 
492.8 	courts for an individual studied under section 245C.03, subdivision 1, paragraph (a), this 
492.9 	chapter when the commissioner has reasonable cause.
492.10 	(b) For a background study conducted by a county agency for family child care before 
492.11 	the implementation of NETStudy 2.0, the commissioner shall review records from the 
492.12 	juvenile courts for individuals listed in section 245C.03, subdivision 1, who are ages 13 
492.13 	through 23 living in the household where the licensed services will be provided. The 
492.14 	commissioner shall also review records from juvenile courts for any other individual listed 
492.15 	under section 245C.03, subdivision 1, when the commissioner has reasonable cause.
492.16 	(c) (b) The juvenile courts shall help with the study by giving the commissioner existing 
492.17 	juvenile court records relating to delinquency proceedings held on individuals described in 
492.18 	section 245C.03, subdivision 1, paragraph (a), who are subjects of studies under this chapter
492.19 	when requested pursuant to this subdivision.
492.20 	(d) (c) For purposes of this chapter, a finding that a delinquency petition is proven in 
492.21 	juvenile court shall be considered a conviction in state district court.
492.22 	(e) (d) Juvenile courts shall provide orders of involuntary and voluntary termination of 
492.23 	parental rights under section 260C.301 to the commissioner upon request for purposes of 
492.24 	conducting a background study under this chapter.

492.25 	Sec. 30. Minnesota Statutes 2023 Supplement, section 245C.10, subdivision 15, is amended 
492.26 	to read:
492.27 		Subd. 15.Guardians and conservators. (a) The commissioner shall recover the cost 
492.28 	of conducting maltreatment and state licensing agency checks for guardians and conservators 
492.29 	under section 245C.033 through a fee of no more than $50. The fees collected under this 
492.30 	subdivision are appropriated to the commissioner for the purpose of conducting maltreatment 
492.31 	and state licensing agency checks.
493.1 	(b) The fee must be paid directly to and in the manner prescribed by the commissioner 
493.2 	before any maltreatment and state licensing agency checks under section 245C.033 may be 
493.3 	conducted.
493.4 	(c) Notwithstanding paragraph (b), the court shall pay the fee for an applicant who has 
493.5 	been granted in forma pauperis status upon receipt of the invoice from the commissioner.

493.6 	Sec. 31. Minnesota Statutes 2022, section 245C.10, subdivision 18, is amended to read:
493.7 		Subd. 18.Applicants, licensees, and other occupations regulated by commissioner 
493.8 	of health. The applicant or license holder is responsible for paying to the Department of 
493.9 	Human Services all fees associated with the preparation of the fingerprints, the criminal 
493.10 	records check consent form, and, through a fee of no more than $44 per study, the criminal 
493.11 	background check.

493.12 	Sec. 32. Minnesota Statutes 2022, section 245C.14, subdivision 1, is amended to read:
493.13 		Subdivision 1.Disqualification from direct contact. (a) The commissioner shall 
493.14 	disqualify an individual who is the subject of a background study from any position allowing 
493.15 	direct contact with persons receiving services from the license holder or entity identified in 
493.16 	section 245C.03, upon receipt of information showing, or when a background study 
493.17 	completed under this chapter shows any of the following:
493.18 	(1) a conviction of, admission to, or Alford plea to one or more crimes listed in section 
493.19 	245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor, 
493.20 	or misdemeanor level crime;
493.21 	(2) a preponderance of the evidence indicates the individual has committed an act or 
493.22 	acts that meet the definition of any of the crimes listed in section 245C.15, regardless of 
493.23 	whether the preponderance of the evidence is for a felony, gross misdemeanor, or 
493.24 	misdemeanor level crime; or
493.25 	(3) an investigation results in an administrative determination listed under section 
493.26 	245C.15, subdivision 4, paragraph (b).; or
493.27 	(4) the individual's parental rights have been terminated under section 260C.301, 
493.28 	subdivision 1, paragraph (b), or section 260C.301, subdivision 3.
493.29 	(b) No individual who is disqualified following a background study under section 
493.30 	245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with 
493.31 	persons served by a program or entity identified in section 245C.03, unless the commissioner 
493.32 	has provided written notice under section 245C.17 stating that:
494.1 	(1) the individual may remain in direct contact during the period in which the individual 
494.2 	may request reconsideration as provided in section 245C.21, subdivision 2;
494.3 	(2) the commissioner has set aside the individual's disqualification for that program or 
494.4 	entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or
494.5 	(3) the license holder has been granted a variance for the disqualified individual under 
494.6 	section 245C.30.
494.7 	(c) Notwithstanding paragraph (a), for the purposes of a background study affiliated 
494.8 	with a licensed family foster setting, the commissioner shall disqualify an individual who 
494.9 	is the subject of a background study from any position allowing direct contact with persons 
494.10 	receiving services from the license holder or entity identified in section 245C.03, upon 
494.11 	receipt of information showing or when a background study completed under this chapter 
494.12 	shows reason for disqualification under section 245C.15, subdivision 4a.

494.13 	Sec. 33. Minnesota Statutes 2022, section 245C.14, is amended by adding a subdivision 
494.14 	to read:
494.15 		Subd. 5.Basis for disqualification. Information obtained by entities from public 
494.16 	web-based data through NETStudy 2.0 or any other source that is not direct correspondence 
494.17 	from the commissioner is not a notice of disqualification from the commissioner under this 
494.18 	chapter.

494.19 	Sec. 34. Minnesota Statutes 2023 Supplement, section 245C.15, subdivision 2, is amended 
494.20 	to read:
494.21 		Subd. 2.15-year disqualification. (a) An individual is disqualified under section 245C.14 
494.22 	if: (1) less than 15 years have passed since the discharge of the sentence imposed, if any, 
494.23 	for the offense; and (2) the individual has committed a felony-level violation of any of the 
494.24 	following offenses: sections 152.021, subdivision 1 or 2b, (aggravated controlled substance 
494.25 	crime in the first degree; sale crimes); 152.022, subdivision 1 (controlled substance crime 
494.26 	in the second degree; sale crimes); 152.023, subdivision 1 (controlled substance crime in 
494.27 	the third degree; sale crimes); 152.024, subdivision 1 (controlled substance crime in the 
494.28 	fourth degree; sale crimes); 152.0263, subdivision 1 (possession of cannabis in the first 
494.29 	degree); 152.0264, subdivision 1 (sale of cannabis in the first degree); 152.0265, subdivision 
494.30 	1 (cultivation of cannabis in the first degree);169A.24 (first-degree driving while impaired); 
494.31 	256.98 (wrongfully obtaining assistance); 260B.425 (criminal jurisdiction for contributing 
494.32 	to status as a juvenile petty offender or delinquency); 260C.425 (criminal jurisdiction for 
494.33 	contributing to need for protection or services); 268.182 (fraud); 393.07, subdivision 10, 
495.1 	paragraph (c) (federal SNAP fraud); 518B.01, subdivision 14 (violation of an order for 
495.2 	protection); 609.165 (felon ineligible to possess firearm); 609.2112, 609.2113, or 609.2114
495.3 	(criminal vehicular homicide or injury); 609.215 (suicide); 609.223 or 609.2231 (assault in 
495.4 	the third or fourth degree); repeat offenses under 609.224 (assault in the fifth degree); 
495.5 	609.229 (crimes committed for benefit of a gang); 609.2325 (criminal abuse of a vulnerable 
495.6 	adult); 609.2335 (financial exploitation of a vulnerable adult); 609.235 (use of drugs to 
495.7 	injure or facilitate crime); 609.24 (simple robbery); 609.247, subdivision 4 (carjacking in 
495.8 	the third degree); 609.255 (false imprisonment); 609.2664 (manslaughter of an unborn child 
495.9 	in the first degree); 609.2665 (manslaughter of an unborn child in the second degree); 
495.10 	609.267 (assault of an unborn child in the first degree); 609.2671 (assault of an unborn child 
495.11 	in the second degree); 609.268 (injury or death of an unborn child in the commission of a 
495.12 	crime); 609.27 (coercion); 609.275 (attempt to coerce); 609.466 (medical assistance fraud); 
495.13 	609.495 (aiding an offender); 609.498, subdivision 1 or 1b (aggravated first-degree or 
495.14 	first-degree tampering with a witness); 609.52 (theft); 609.521 (possession of shoplifting 
495.15 	gear); 609.522 (organized retail theft); 609.525 (bringing stolen goods into Minnesota); 
495.16 	609.527 (identity theft); 609.53 (receiving stolen property); 609.535 (issuance of dishonored 
495.17 	checks); 609.562 (arson in the second degree); 609.563 (arson in the third degree); 609.582
495.18 	(burglary); 609.59 (possession of burglary tools); 609.611 (insurance fraud); 609.625
495.19 	(aggravated forgery); 609.63 (forgery); 609.631 (check forgery; offering a forged check); 
495.20 	609.635 (obtaining signature by false pretense); 609.66 (dangerous weapons); 609.67
495.21 	(machine guns and short-barreled shotguns); 609.687 (adulteration); 609.71 (riot); 609.713
495.22 	(terroristic threats); 609.746 (interference with privacy); 609.82 (fraud in obtaining credit); 
495.23 	609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving a 
495.24 	minor; repeat offenses under 617.241 (obscene materials and performances; distribution 
495.25 	and exhibition prohibited; penalty); or 624.713 (certain persons not to possess firearms).
495.26 	(b) An individual is disqualified under section 245C.14 if less than 15 years has passed 
495.27 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
495.28 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
495.29 	(c) An individual is disqualified under section 245C.14 if less than 15 years has passed 
495.30 	since the termination of the individual's parental rights under section 260C.301, subdivision 
495.31 	1, paragraph (b), or subdivision 3.
495.32 	(d) An individual is disqualified under section 245C.14 if less than 15 years has passed 
495.33 	since the discharge of the sentence imposed for an offense in any other state or country, the 
495.34 	elements of which are substantially similar to the elements of the offenses listed in paragraph 
496.1 	(a) or since the termination of parental rights in any other state or country, the elements of 
496.2 	which are substantially similar to the elements listed in paragraph (c).
496.3 	(e) If the individual studied commits one of the offenses listed in paragraph (a), but the 
496.4 	sentence or level of offense is a gross misdemeanor or misdemeanor, the individual is 
496.5 	disqualified but the disqualification look-back period for the offense is the period applicable 
496.6 	to the gross misdemeanor or misdemeanor disposition.
496.7 	(f) When a disqualification is based on a judicial determination other than a conviction, 
496.8 	the disqualification period begins from the date of the court order. When a disqualification 
496.9 	is based on an admission, the disqualification period begins from the date of an admission 
496.10 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
496.11 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
496.12 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
496.13 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
496.14 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

496.15 	Sec. 35. Minnesota Statutes 2022, section 245C.15, subdivision 3, is amended to read:
496.16 		Subd. 3.Ten-year disqualification. (a) An individual is disqualified under section 
496.17 	245C.14 if: (1) less than ten years have passed since the discharge of the sentence imposed, 
496.18 	if any, for the offense; and (2) the individual has committed a gross misdemeanor-level 
496.19 	violation of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 
496.20 	260B.425 (criminal jurisdiction for contributing to status as a juvenile petty offender or 
496.21 	delinquency); 260C.425 (criminal jurisdiction for contributing to need for protection or 
496.22 	services); 268.182 (fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 
496.23 	609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.221 or 609.222
496.24 	(assault in the first or second degree); 609.223 or 609.2231 (assault in the third or fourth 
496.25 	degree); 609.224 (assault in the fifth degree); 609.224, subdivision 2, paragraph (c) (assault 
496.26 	in the fifth degree by a caregiver against a vulnerable adult); 609.2242 and 609.2243
496.27 	(domestic assault); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of 
496.28 	residents or patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal 
496.29 	neglect of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 
496.30 	609.234 (failure to report maltreatment of a vulnerable adult); 609.265 (abduction); 609.275
496.31 	(attempt to coerce); 609.324, subdivision 1a (other prohibited acts; minor engaged in 
496.32 	prostitution); 609.33 (disorderly house); 609.377 (malicious punishment of a child); 609.378
496.33 	(neglect or endangerment of a child); 609.466 (medical assistance fraud); 609.52 (theft); 
496.34 	609.522 (organized retail theft); 609.525 (bringing stolen goods into Minnesota); 609.527
497.1 	(identity theft); 609.53 (receiving stolen property); 609.535 (issuance of dishonored checks); 
497.2 	609.582 (burglary); 609.59 (possession of burglary tools); 609.611 (insurance fraud); 609.631
497.3 	(check forgery; offering a forged check); 609.66 (dangerous weapons); 609.71 (riot); 609.72, 
497.4 	subdivision 3 (disorderly conduct against a vulnerable adult); repeat offenses under 609.746
497.5 	(interference with privacy);609.749, subdivision 2 (harassment); 609.82 (fraud in obtaining 
497.6 	credit); 609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving 
497.7 	a minor; 617.241 (obscene materials and performances); 617.243 (indecent literature, 
497.8 	distribution); 617.293 (harmful materials; dissemination and display to minors prohibited); 
497.9 	or Minnesota Statutes 2012, section 609.21; or violation of an order for protection under 
497.10 	section 518B.01, subdivision 14.
497.11 	(b) An individual is disqualified under section 245C.14 if less than ten years has passed 
497.12 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
497.13 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
497.14 	(c) An individual is disqualified under section 245C.14 if less than ten years has passed 
497.15 	since the discharge of the sentence imposed for an offense in any other state or country, the 
497.16 	elements of which are substantially similar to the elements of any of the offenses listed in 
497.17 	paragraph (a).
497.18 	(d) If the individual studied commits one of the offenses listed in paragraph (a), but the 
497.19 	sentence or level of offense is a misdemeanor disposition, the individual is disqualified but 
497.20 	the disqualification lookback period for the offense is the period applicable to misdemeanors.
497.21 	(e) When a disqualification is based on a judicial determination other than a conviction, 
497.22 	the disqualification period begins from the date of the court order. When a disqualification 
497.23 	is based on an admission, the disqualification period begins from the date of an admission 
497.24 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
497.25 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
497.26 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
497.27 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
497.28 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

497.29 	Sec. 36. Minnesota Statutes 2022, section 245C.15, subdivision 4, is amended to read:
497.30 		Subd. 4.Seven-year disqualification. (a) An individual is disqualified under section 
497.31 	245C.14 if: (1) less than seven years has passed since the discharge of the sentence imposed, 
497.32 	if any, for the offense; and (2) the individual has committed a misdemeanor-level violation 
497.33 	of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 260B.425 
497.34 	(criminal jurisdiction for contributing to status as a juvenile petty offender or delinquency); 
498.1 	260C.425 (criminal jurisdiction for contributing to need for protection or services); 268.182 
498.2 	(fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 609.2112, 609.2113, 
498.3 	or 609.2114 (criminal vehicular homicide or injury); 609.221 (assault in the first degree); 
498.4 	609.222 (assault in the second degree); 609.223 (assault in the third degree); 609.2231
498.5 	(assault in the fourth degree); 609.224 (assault in the fifth degree); 609.2242 (domestic 
498.6 	assault); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure to report 
498.7 	maltreatment of a vulnerable adult); 609.2672 (assault of an unborn child in the third degree); 
498.8 	609.27 (coercion); violation of an order for protection under 609.3232 (protective order 
498.9 	authorized; procedures; penalties); 609.466 (medical assistance fraud); 609.52 (theft); 
498.10 	609.522 (organized retail theft); 609.525 (bringing stolen goods into Minnesota); 609.527
498.11 	(identity theft); 609.53 (receiving stolen property); 609.535 (issuance of dishonored checks); 
498.12 	609.611 (insurance fraud); 609.66 (dangerous weapons); 609.665 (spring guns); 609.746
498.13 	(interference with privacy); 609.79 (obscene or harassing telephone calls); 609.795 (letter, 
498.14 	telegram, or package; opening; harassment); 609.82 (fraud in obtaining credit); 609.821
498.15 	(financial transaction card fraud); 617.23 (indecent exposure), not involving a minor; 617.293
498.16 	(harmful materials; dissemination and display to minors prohibited); or Minnesota Statutes 
498.17 	2012, section 609.21; or violation of an order for protection under section 518B.01 (Domestic 
498.18 	Abuse Act).
498.19 	(b) An individual is disqualified under section 245C.14 if less than seven years has 
498.20 	passed since a determination or disposition of the individual's:
498.21 	(1) failure to make required reports under section 260E.06 or 626.557, subdivision 3, 
498.22 	for incidents in which: (i) the final disposition under section 626.557 or chapter 260E was 
498.23 	substantiated maltreatment, and (ii) the maltreatment was recurring or serious; or
498.24 	(2) substantiated serious or recurring maltreatment of a minor under chapter 260E, a 
498.25 	vulnerable adult under section 626.557, or serious or recurring maltreatment in any other 
498.26 	state, the elements of which are substantially similar to the elements of maltreatment under 
498.27 	section 626.557 or chapter 260E for which: (i) there is a preponderance of evidence that 
498.28 	the maltreatment occurred, and (ii) the subject was responsible for the maltreatment.
498.29 	(c) An individual is disqualified under section 245C.14 if less than seven years has 
498.30 	passed since the individual's aiding and abetting, attempt, or conspiracy to commit any of 
498.31 	the offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota 
498.32 	Statutes.
498.33 	(d) An individual is disqualified under section 245C.14 if less than seven years has 
498.34 	passed since the discharge of the sentence imposed for an offense in any other state or 
499.1 	country, the elements of which are substantially similar to the elements of any of the offenses 
499.2 	listed in paragraphs (a) and (b).
499.3 	(e) When a disqualification is based on a judicial determination other than a conviction, 
499.4 	the disqualification period begins from the date of the court order. When a disqualification 
499.5 	is based on an admission, the disqualification period begins from the date of an admission 
499.6 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
499.7 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
499.8 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
499.9 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
499.10 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
499.11 	(f) An individual is disqualified under section 245C.14 if less than seven years has passed 
499.12 	since the individual was disqualified under section 256.98, subdivision 8.

499.13 	Sec. 37. Minnesota Statutes 2023 Supplement, section 245C.15, subdivision 4a, is amended 
499.14 	to read:
499.15 		Subd. 4a.Licensed family foster setting disqualifications. (a) Notwithstanding 
499.16 	subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting, 
499.17 	regardless of how much time has passed, an individual is disqualified under section 245C.14 
499.18 	if the individual committed an act that resulted in a felony-level conviction for sections: 
499.19 	609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder 
499.20 	in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in 
499.21 	the second degree); 609.2112 (criminal vehicular homicide); 609.221 (assault in the first 
499.22 	degree); 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse); 
499.23 	609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense 
499.24 	under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or 
499.25 	neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325 
499.26 	(criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245 
499.27 	(aggravated robbery); 609.247, subdivision 2 or 3 (carjacking in the first or second degree); 
499.28 	609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder of an unborn child 
499.29 	in the first degree); 609.2662 (murder of an unborn child in the second degree); 609.2663 
499.30 	(murder of an unborn child in the third degree); 609.2664 (manslaughter of an unborn child 
499.31 	in the first degree); 609.2665 (manslaughter of an unborn child in the second degree); 
499.32 	609.267 (assault of an unborn child in the first degree); 609.2671 (assault of an unborn child 
499.33 	in the second degree); 609.268 (injury or death of an unborn child in the commission of a 
499.34 	crime); 609.322, subdivision 1 (solicitation, inducement, and promotion of prostitution; sex 
500.1 	trafficking in the first degree); 609.324, subdivision 1 (other prohibited acts; engaging in, 
500.2 	hiring, or agreeing to hire minor to engage in prostitution); 609.342 (criminal sexual conduct 
500.3 	in the first degree); 609.343 (criminal sexual conduct in the second degree); 609.344 (criminal 
500.4 	sexual conduct in the third degree); 609.345 (criminal sexual conduct in the fourth degree); 
500.5 	609.3451 (criminal sexual conduct in the fifth degree); 609.3453 (criminal sexual predatory 
500.6 	conduct); 609.3458 (sexual extortion); 609.352 (solicitation of children to engage in sexual 
500.7 	conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of 
500.8 	a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary in the first 
500.9 	degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246 (use of 
500.10 	minors in sexual performance prohibited); or 617.247 (possession of pictorial representations 
500.11 	of minors).
500.12 	(b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated 
500.13 	with a licensed family foster setting, an individual is disqualified under section 245C.14, 
500.14 	regardless of how much time has passed, if the individual:
500.15 	(1) committed an action under paragraph (e) that resulted in death or involved sexual 
500.16 	abuse, as defined in section 260E.03, subdivision 20;
500.17 	(2) committed an act that resulted in a gross misdemeanor-level conviction for section 
500.18 	609.3451 (criminal sexual conduct in the fifth degree);
500.19 	(3) committed an act against or involving a minor that resulted in a felony-level conviction 
500.20 	for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the 
500.21 	third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree); 
500.22 	or
500.23 	(4) committed an act that resulted in a misdemeanor or gross misdemeanor-level 
500.24 	conviction for section 617.293 (dissemination and display of harmful materials to minors).
500.25 	(c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed 
500.26 	family foster setting, an individual is disqualified under section 245C.14 if fewer than 20 
500.27 	years have passed since the termination of the individual's parental rights under section 
500.28 	260C.301, subdivision 1, paragraph (b), or if the individual consented to a termination of 
500.29 	parental rights under section 260C.301, subdivision 1, paragraph (a), to settle a petition to 
500.30 	involuntarily terminate parental rights. An individual is disqualified under section 245C.14 
500.31 	if fewer than 20 years have passed since the termination of the individual's parental rights 
500.32 	in any other state or country, where the conditions for the individual's termination of parental 
500.33 	rights are substantially similar to the conditions in section 260C.301, subdivision 1, paragraph 
500.34 	(b).
501.1 	(d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed 
501.2 	family foster setting, an individual is disqualified under section 245C.14 if fewer than five 
501.3 	years have passed since a felony-level violation for sections: 152.021 (controlled substance 
501.4 	crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023 
501.5 	(controlled substance crime in the third degree); 152.024 (controlled substance crime in the 
501.6 	fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing 
501.7 	controlled substances across state borders); 152.0262, subdivision 1, paragraph (b) 
501.8 	(possession of substance with intent to manufacture methamphetamine); 152.0263, 
501.9 	subdivision 1 (possession of cannabis in the first degree); 152.0264, subdivision 1 (sale of 
501.10 	cannabis in the first degree); 152.0265, subdivision 1 (cultivation of cannabis in the first 
501.11 	degree);152.027, subdivision 6, paragraph (c) (sale or possession of synthetic cannabinoids); 
501.12 	152.096 (conspiracies prohibited); 152.097 (simulated controlled substances); 152.136
501.13 	(anhydrous ammonia; prohibited conduct; criminal penalties; civil liabilities); 152.137
501.14 	(methamphetamine-related crimes involving children or vulnerable adults); 169A.24 (felony 
501.15 	first-degree driving while impaired); 243.166 (violation of predatory offender registration 
501.16 	requirements); 609.2113 (criminal vehicular operation; bodily harm); 609.2114 (criminal 
501.17 	vehicular operation; unborn child); 609.228 (great bodily harm caused by distribution of 
501.18 	drugs); 609.2325 (criminal abuse of a vulnerable adult not resulting in the death of a 
501.19 	vulnerable adult); 609.233 (criminal neglect); 609.235 (use of drugs to injure or facilitate 
501.20 	a crime); 609.24 (simple robbery); 609.247, subdivision 4 (carjacking in the third degree); 
501.21 	609.322, subdivision 1a (solicitation, inducement, and promotion of prostitution; sex 
501.22 	trafficking in the second degree); 609.498, subdivision 1 (tampering with a witness in the 
501.23 	first degree); 609.498, subdivision 1b (aggravated first-degree witness tampering); 609.562 
501.24 	(arson in the second degree); 609.563 (arson in the third degree); 609.582, subdivision 2 
501.25 	(burglary in the second degree); 609.66 (felony dangerous weapons); 609.687 (adulteration); 
501.26 	609.713 (terroristic threats); 609.749, subdivision 3, 4, or 5 (felony-level harassment or 
501.27 	stalking); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); or 
501.28 	624.713 (certain people not to possess firearms).
501.29 	(e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a 
501.30 	background study affiliated with a licensed family child foster care license, an individual 
501.31 	is disqualified under section 245C.14 if fewer than five years have passed since:
501.32 	(1) a felony-level violation for an act not against or involving a minor that constitutes: 
501.33 	section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third 
501.34 	degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the 
501.35 	fifth degree);
502.1 	(2) a violation of an order for protection under section 518B.01, subdivision 14;
502.2 	(3) a determination or disposition of the individual's failure to make required reports 
502.3 	under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition 
502.4 	under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment 
502.5 	was recurring or serious;
502.6 	(4) a determination or disposition of the individual's substantiated serious or recurring 
502.7 	maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or 
502.8 	serious or recurring maltreatment in any other state, the elements of which are substantially 
502.9 	similar to the elements of maltreatment under chapter 260E or section 626.557 and meet 
502.10 	the definition of serious maltreatment or recurring maltreatment;
502.11 	(5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in 
502.12 	the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect); 
502.13 	609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child); 
502.14 	609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or
502.15 	(6) committing an act against or involving a minor that resulted in a misdemeanor-level 
502.16 	violation of section 609.224, subdivision 1 (assault in the fifth degree).
502.17 	(f) For purposes of this subdivision, the disqualification begins from:
502.18 	(1) the date of the alleged violation, if the individual was not convicted;
502.19 	(2) the date of conviction, if the individual was convicted of the violation but not 
502.20 	committed to the custody of the commissioner of corrections; or
502.21 	(3) the date of release from prison, if the individual was convicted of the violation and 
502.22 	committed to the custody of the commissioner of corrections.
502.23 	Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation 
502.24 	of the individual's supervised release, the disqualification begins from the date of release 
502.25 	from the subsequent incarceration.
502.26 	(g) An individual's aiding and abetting, attempt, or conspiracy to commit any of the 
502.27 	offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota 
502.28 	Statutes, permanently disqualifies the individual under section 245C.14. An individual is 
502.29 	disqualified under section 245C.14 if fewer than five years have passed since the individual's 
502.30 	aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs 
502.31 	(d) and (e).
503.1 	(h) An individual's offense in any other state or country, where the elements of the 
503.2 	offense are substantially similar to any of the offenses listed in paragraphs (a) and (b), 
503.3 	permanently disqualifies the individual under section 245C.14. An individual is disqualified 
503.4 	under section 245C.14 if fewer than five years have passed since an offense in any other 
503.5 	state or country, the elements of which are substantially similar to the elements of any 
503.6 	offense listed in paragraphs (d) and (e).

503.7 	Sec. 38. Minnesota Statutes 2022, section 245C.22, subdivision 4, is amended to read:
503.8 		Subd. 4.Risk of harm; set aside. (a) The commissioner may set aside the disqualification 
503.9 	if the commissioner finds that the individual has submitted sufficient information to 
503.10 	demonstrate that the individual does not pose a risk of harm to any person served by the 
503.11 	applicant, license holder, or other entities as provided in this chapter.
503.12 	(b) In determining whether the individual has met the burden of proof by demonstrating 
503.13 	the individual does not pose a risk of harm, the commissioner shall consider:
503.14 	(1) the nature, severity, and consequences of the event or events that led to the 
503.15 	disqualification;
503.16 	(2) whether there is more than one disqualifying event;
503.17 	(3) the age and vulnerability of the victim at the time of the event;
503.18 	(4) the harm suffered by the victim;
503.19 	(5) vulnerability of persons served by the program;
503.20 	(6) the similarity between the victim and persons served by the program;
503.21 	(7) the time elapsed without a repeat of the same or similar event;
503.22 	(8) documentation of successful completion by the individual studied of training or 
503.23 	rehabilitation pertinent to the event; and
503.24 	(9) any other information relevant to reconsideration.
503.25 	(c) For an individual seeking a child foster care license who is a relative of the child, 
503.26 	the commissioner shall consider the importance of maintaining the child's relationship with 
503.27 	relatives as an additional significant factor in determining whether a background study 
503.28 	disqualification should be set aside.
503.29 	(c) (d) If the individual requested reconsideration on the basis that the information relied 
503.30 	upon to disqualify the individual was incorrect or inaccurate and the commissioner determines 
503.31 	that the information relied upon to disqualify the individual is correct, the commissioner 
504.1 	must also determine if the individual poses a risk of harm to persons receiving services in 
504.2 	accordance with paragraph (b).
504.3 	(d) (e) For an individual seeking employment in the substance use disorder treatment 
504.4 	field, the commissioner shall set aside the disqualification if the following criteria are met:
504.5 	(1) the individual is not disqualified for a crime of violence as listed under section 
504.6 	624.712, subdivision 5, except for the following crimes: crimes listed under section 152.021, 
504.7 	subdivision 2 or 2a; 152.022, subdivision 2; 152.023, subdivision 2; 152.024; or 152.025;
504.8 	(2) the individual is not disqualified under section 245C.15, subdivision 1;
504.9 	(3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph 
504.10 	(b);
504.11 	(4) the individual provided documentation of successful completion of treatment, at least 
504.12 	one year prior to the date of the request for reconsideration, at a program licensed under 
504.13 	chapter 245G, and has had no disqualifying crimes or conduct under section 245C.15 after 
504.14 	the successful completion of treatment;
504.15 	(5) the individual provided documentation demonstrating abstinence from controlled 
504.16 	substances, as defined in section 152.01, subdivision 4, for the period of one year prior to 
504.17 	the date of the request for reconsideration; and
504.18 	(6) the individual is seeking employment in the substance use disorder treatment field.

504.19 	Sec. 39. Minnesota Statutes 2022, section 245C.24, subdivision 2, is amended to read:
504.20 		Subd. 2.Permanent bar to set aside a disqualification. (a) Except as provided in 
504.21 	paragraphs (b) to (f) (g), the commissioner may not set aside the disqualification of any 
504.22 	individual disqualified pursuant to this chapter, regardless of how much time has passed, 
504.23 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
504.24 	1.
504.25 	(b) For an individual in the substance use disorder or corrections field who was 
504.26 	disqualified for a crime or conduct listed under section 245C.15, subdivision 1, and whose 
504.27 	disqualification was set aside prior to July 1, 2005, the commissioner must consider granting 
504.28 	a variance pursuant to section 245C.30 for the license holder for a program dealing primarily 
504.29 	with adults. A request for reconsideration evaluated under this paragraph must include a 
504.30 	letter of recommendation from the license holder that was subject to the prior set-aside 
504.31 	decision addressing the individual's quality of care to children or vulnerable adults and the 
504.32 	circumstances of the individual's departure from that service.
505.1 	(c) If an individual who requires a background study for nonemergency medical 
505.2 	transportation services under section 245C.03, subdivision 12, was disqualified for a crime 
505.3 	or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have 
505.4 	passed since the discharge of the sentence imposed, the commissioner may consider granting 
505.5 	a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this 
505.6 	paragraph must include a letter of recommendation from the employer. This paragraph does 
505.7 	not apply to a person disqualified based on a violation of sections 243.166; 609.185 to 
505.8 	609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3, 
505.9 	clause (1); 617.246; or 617.247.
505.10 	(d) When a licensed foster care provider adopts an individual who had received foster 
505.11 	care services from the provider for over six months, and the adopted individual is required 
505.12 	to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause 
505.13 	(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30 
505.14 	to permit the adopted individual with a permanent disqualification to remain affiliated with 
505.15 	the license holder under the conditions of the variance when the variance is recommended 
505.16 	by the county of responsibility for each of the remaining individuals in placement in the 
505.17 	home and the licensing agency for the home.
505.18 	(e) For an individual 18 years of age or older affiliated with a licensed family foster 
505.19 	setting, the commissioner must not set aside or grant a variance for the disqualification of 
505.20 	any individual disqualified pursuant to this chapter, regardless of how much time has passed, 
505.21 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
505.22 	4a, paragraphs (a) and (b).
505.23 	(f) In connection with a family foster setting license, the commissioner may grant a 
505.24 	variance to the disqualification for an individual who is under 18 years of age at the time 
505.25 	the background study is submitted.
505.26 	(g) In connection with foster residence settings and children's residential facilities, the 
505.27 	commissioner must not set aside or grant a variance for the disqualification of any individual 
505.28 	disqualified pursuant to this chapter, regardless of how much time has passed, if the individual 
505.29 	was disqualified for a crime or conduct listed in section 245C.15, subdivision 4a, paragraph 
505.30 	(a) or (b).

505.31 	Sec. 40. Minnesota Statutes 2022, section 245C.24, subdivision 5, is amended to read:
505.32 		Subd. 5.Five-year bar to set aside or variance disqualification; children's residential 
505.33 	facilities, foster residence settings. The commissioner shall not set aside or grant a variance 
505.34 	for the disqualification of an individual in connection with a license for a children's residential 
506.1 	facility or foster residence setting who was convicted of a felony within the past five years 
506.2 	for: (1) physical assault or battery; or (2) a drug-related offense.

506.3 	Sec. 41. Minnesota Statutes 2022, section 245C.30, is amended by adding a subdivision 
506.4 	to read:
506.5 		Subd. 1b.Child foster care variances. For an individual seeking a child foster care 
506.6 	license who is a relative of the child, the commissioner shall consider the importance of 
506.7 	maintaining the child's relationship with relatives as an additional significant factor in 
506.8 	determining whether the individual should be granted a variance.

506.9 	Sec. 42. Minnesota Statutes 2022, section 245E.08, is amended to read:
506.10 	245E.08 REPORTING OF SUSPECTED FRAUDULENT ACTIVITY.
506.11 	(a) A person who, in good faith, makes a report of or testifies in any action or proceeding 
506.12 	in which financial misconduct is alleged, and who is not involved in, has not participated 
506.13 	in, or has not aided and abetted, conspired, or colluded in the financial misconduct, shall 
506.14 	have immunity from any liability, civil or criminal, that results by reason of the person's 
506.15 	report or testimony. For the purpose of any proceeding, the good faith of any person reporting 
506.16 	or testifying under this provision shall be presumed.
506.17 	(b) If a person that is or has been involved in, participated in, aided and abetted, conspired, 
506.18 	or colluded in the financial misconduct reports the financial misconduct, the department 
506.19 	may consider that person's report and assistance in investigating the misconduct as a 
506.20 	mitigating factor in the department's pursuit of civil, criminal, or administrative remedies.
506.21 	(c) After an investigation is complete, the reporter's name must be kept confidential. 
506.22 	The subject of the report may compel disclosure of the reporter's name only with the consent 
506.23 	of the reporter or upon a written finding by a district court that the report was false and there 
506.24 	is evidence that the report was made in bad faith. This paragraph does not alter disclosure 
506.25 	responsibilities or obligations under the Rules of Criminal Procedure, except that when the 
506.26 	identity of the reporter is relevant to a criminal prosecution the district court shall conduct 
506.27 	an in-camera review before determining whether to order disclosure of the reporter's identity.

506.28 	Sec. 43. Minnesota Statutes 2022, section 245F.09, subdivision 2, is amended to read:
506.29 		Subd. 2.Protective procedures plan. A license holder must have a written policy and 
506.30 	procedure that establishes the protective procedures that program staff must follow when 
506.31 	a patient is in imminent danger of harming self or others. The policy must be appropriate 
507.1 	to the type of facility and the level of staff training. The protective procedures policy must 
507.2 	include:
507.3 	(1) an approval signed and dated by the program director and medical director prior to 
507.4 	implementation. Any changes to the policy must also be approved, signed, and dated by the 
507.5 	current program director and the medical director prior to implementation;
507.6 	(2) which protective procedures the license holder will use to prevent patients from 
507.7 	imminent danger of harming self or others;
507.8 	(3) the emergency conditions under which the protective procedures are permitted to be 
507.9 	used, if any;
507.10 	(4) the patient's health conditions that limit the specific procedures that may be used and 
507.11 	alternative means of ensuring safety;
507.12 	(5) emergency resources the program staff must contact when a patient's behavior cannot 
507.13 	be controlled by the procedures established in the policy;
507.14 	(6) the training that staff must have before using any protective procedure;
507.15 	(7) documentation of approved therapeutic holds;
507.16 	(8) the use of law enforcement personnel as described in subdivision 4;
507.17 	(9) standards governing emergency use of seclusion. Seclusion must be used only when 
507.18 	less restrictive measures are ineffective or not feasible. The standards in items (i) to (vii) 
507.19 	must be met when seclusion is used with a patient:
507.20 	(i) seclusion must be employed solely for the purpose of preventing a patient from 
507.21 	imminent danger of harming self or others;
507.22 	(ii) seclusion rooms must be equipped in a manner that prevents patients from self-harm 
507.23 	using projections, windows, electrical fixtures, or hard objects, and must allow the patient 
507.24 	to be readily observed without being interrupted;
507.25 	(iii) seclusion must be authorized by the program director, a licensed physician, a 
507.26 	registered nurse, or a licensed physician assistant. If one of these individuals is not present 
507.27 	in the facility, the program director or a licensed physician, registered nurse, or physician 
507.28 	assistant must be contacted and authorization must be obtained within 30 minutes of initiating 
507.29 	seclusion, according to written policies;
507.30 	(iv) patients must not be placed in seclusion for more than 12 hours at any one time;
508.1 	(v) once the condition of a patient in seclusion has been determined to be safe enough 
508.2 	to end continuous observation, a patient in seclusion must be observed at a minimum of 
508.3 	every 15 minutes for the duration of seclusion and must always be within hearing range of 
508.4 	program staff;
508.5 	(vi) a process for program staff to use to remove a patient to other resources available 
508.6 	to the facility if seclusion does not sufficiently assure patient safety; and
508.7 	(vii) a seclusion area may be used for other purposes, such as intensive observation, if 
508.8 	the room meets normal standards of care for the purpose and if the room is not locked; and
508.9 	(10) physical holds may only be used when less restrictive measures are not feasible. 
508.10 	The standards in items (i) to (iv) must be met when physical holds are used with a patient:
508.11 	(i) physical holds must be employed solely for preventing a patient from imminent 
508.12 	danger of harming self or others;
508.13 	(ii) physical holds must be authorized by the program director, a licensed physician, a 
508.14 	registered nurse, or a physician assistant. If one of these individuals is not present in the 
508.15 	facility, the program director or a licensed physician, registered nurse, or physician assistant 
508.16 	must be contacted and authorization must be obtained within 30 minutes of initiating a 
508.17 	physical hold, according to written policies;
508.18 	(iii) the patient's health concerns must be considered in deciding whether to use physical 
508.19 	holds and which holds are appropriate for the patient; and
508.20 	(iv) only approved holds may be utilized. Prone and contraindicated holds are not allowed 
508.21 	according to section 245A.211 and must not be authorized.

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

508.23 	Sec. 44. Minnesota Statutes 2022, section 245F.14, is amended by adding a subdivision 
508.24 	to read:
508.25 		Subd. 8.Notification to commissioner of changes in key staff positions. A license 
508.26 	holder must notify the commissioner within five business days of a change or vacancy in a 
508.27 	key staff position. The key positions are a program director as required by subdivision 1, a 
508.28 	registered nurse as required by subdivision 4, and a medical director as required by 
508.29 	subdivision 5. The license holder must notify the commissioner of the staffing change or 
508.30 	vacancy on a form approved by the commissioner and include the name of the staff person 
508.31 	now assigned to the key staff position and the staff person's qualifications for the position.

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

509.1 	Sec. 45. Minnesota Statutes 2022, section 245F.17, is amended to read:
509.2 	245F.17 PERSONNEL FILES.
509.3 	A license holder must maintain a separate personnel file for each staff member. At a 
509.4 	minimum, the file must contain:
509.5 	(1) a completed application for employment signed by the staff member that contains 
509.6 	the staff member's qualifications for employment and documentation related to the applicant's 
509.7 	background study data, as defined in chapter 245C;
509.8 	(2) documentation of the staff member's current professional license or registration, if 
509.9 	relevant;
509.10 	(3) documentation of orientation and subsequent training; and
509.11 	(4) documentation of a statement of freedom from substance use problems; and
509.12 	(5) an annual job performance evaluation.

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

509.14 	Sec. 46. Minnesota Statutes 2022, section 245G.07, subdivision 4, is amended to read:
509.15 		Subd. 4.Location of service provision. The license holder may provide services at any 
509.16 	of the license holder's licensed locations or at another suitable location including a school, 
509.17 	government building, medical or behavioral health facility, or social service organization, 
509.18 	upon notification and approval of the commissioner. If services are provided off site from 
509.19 	the licensed site, the reason for the provision of services remotely must be documented. 
509.20 	The license holder may provide additional services under subdivision 2, clauses (2) to (5), 
509.21 	off-site if the license holder includes a policy and procedure detailing the off-site location 
509.22 	as a part of the treatment service description and the program abuse prevention plan.
509.23 	(a) The license holder must provide all treatment services a client receives at one of the 
509.24 	license holder's substance use disorder treatment licensed locations or at a location allowed 
509.25 	under paragraphs (b) to (f). If the services are provided at the locations in paragraphs (b) to 
509.26 	(d), the license holder must document in the client record the location services were provided.
509.27 	(b) The license holder may provide nonresidential individual treatment services at a 
509.28 	client's home or place of residence.
509.29 	(c) If the license holder provides treatment services by telehealth, the services must be 
509.30 	provided according to this paragraph:
510.1 	(1) the license holder must maintain a licensed physical location in Minnesota where 
510.2 	the license holder must offer all treatment services in subdivision 1, paragraph (a), clauses 
510.3 	(1) to (4), physically in person to each client;
510.4 	(2) the license holder must meet all requirements for the provision of telehealth in sections 
510.5 	254B.05, subdivision 5, paragraph (f), and 256B.0625, subdivision 3b. The license holder 
510.6 	must document all items in section 256B.0625, subdivision 3b, paragraph (c), for each client 
510.7 	receiving services by telehealth, regardless of payment type or whether the client is a medical 
510.8 	assistance enrollee;
510.9 	(3) the license holder may provide treatment services by telehealth to clients individually;
510.10 	(4) the license holder may provide treatment services by telehealth to a group of clients 
510.11 	that are each in a separate physical location;
510.12 	(5) the license holder must not provide treatment services remotely by telehealth to a 
510.13 	group of clients meeting together in person;
510.14 	(6) clients and staff may join an in-person group by telehealth if a staff qualified to 
510.15 	provide the treatment service is physically present with the group of clients meeting together 
510.16 	in person; and
510.17 	(7) the qualified professional providing a residential group treatment service by telehealth 
510.18 	must be physically present on-site at the licensed residential location while the service is 
510.19 	being provided.
510.20 	(d) The license holder may provide the additional treatment services under subdivision 
510.21 	2, clauses (2) to (5) and (8), away from the licensed location at a suitable location appropriate 
510.22 	to the treatment service.
510.23 	(e) Upon written approval from the commissioner for each satellite location, the license 
510.24 	holder may provide nonresidential treatment services at satellite locations that are in a 
510.25 	school, jail, or nursing home. A satellite location may only provide services to students of 
510.26 	the school, inmates of the jail, or residents of the nursing home. Schools, jails, and nursing 
510.27 	homes are exempt from the licensing requirements in section 245A.04, subdivision 2a, to 
510.28 	document compliance with building codes, fire and safety codes, health rules, and zoning 
510.29 	ordinances.
510.30 	(f) The commissioner may approve other suitable locations as satellite locations for 
510.31 	nonresidential treatment services. The commissioner may require satellite locations under 
510.32 	this paragraph to meet all applicable licensing requirements. The license holder may not 
510.33 	have more than two satellite locations per license under this paragraph.
511.1 	(g) The license holder must provide the commissioner access to all files, documentation, 
511.2 	staff persons, and any other information the commissioner requires at the main licensed 
511.3 	location for all clients served at any location under paragraphs (b) to (f).
511.4 	(h) Notwithstanding sections 245A.65, subdivision 2, and 626.557, subdivision 14, a 
511.5 	program abuse prevention plan is not required for satellite or other locations under paragraphs 
511.6 	(b) to (e). An individual abuse prevention plan is still required for any client that is a 
511.7 	vulnerable adult as defined in section 626.5572, subdivision 21.

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

511.9 	Sec. 47. Minnesota Statutes 2022, section 245G.08, subdivision 5, is amended to read:
511.10 		Subd. 5.Administration of medication and assistance with self-medication. (a) A 
511.11 	license holder must meet the requirements in this subdivision if a service provided includes 
511.12 	the administration of medication.
511.13 	(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a 
511.14 	licensed practitioner or a registered nurse the task of administration of medication or assisting 
511.15 	with self-medication, must:
511.16 	(1) successfully complete a medication administration training program for unlicensed 
511.17 	personnel through an accredited Minnesota postsecondary educational institution. A staff 
511.18 	member's completion of the course must be documented in writing and placed in the staff 
511.19 	member's personnel file;
511.20 	(2) be trained according to a formalized training program that is taught by a registered 
511.21 	nurse and offered by the license holder. The training must include the process for 
511.22 	administration of naloxone, if naloxone is kept on site. A staff member's completion of the 
511.23 	training must be documented in writing and placed in the staff member's personnel records; 
511.24 	or
511.25 	(3) demonstrate to a registered nurse competency to perform the delegated activity. A 
511.26 	registered nurse must be employed or contracted to develop the policies and procedures for 
511.27 	administration of medication or assisting with self-administration of medication, or both.
511.28 	(c) A registered nurse must provide supervision as defined in section 148.171, subdivision 
511.29 	23. The registered nurse's supervision must include, at a minimum, monthly on-site 
511.30 	supervision or more often if warranted by a client's health needs. The policies and procedures 
511.31 	must include:
512.1 	(1) a provision that a delegation of administration of medication is limited to a method 
512.2 	a staff member has been trained to administer and limited to:
512.3 	(i) a medication that is administered orally, topically, or as a suppository, an eye drop, 
512.4 	an ear drop, an inhalant, or an intranasal; and
512.5 	(ii) an intramuscular injection of naloxone an opiate antagonist as defined in section 
512.6 	604A.04, subdivision 1, or epinephrine;
512.7 	(2) a provision that each client's file must include documentation indicating whether 
512.8 	staff must conduct the administration of medication or the client must self-administer 
512.9 	medication, or both;
512.10 	(3) a provision that a client may carry emergency medication such as nitroglycerin as 
512.11 	instructed by the client's physician, advanced practice registered nurse, or physician assistant;
512.12 	(4) a provision for the client to self-administer medication when a client is scheduled to 
512.13 	be away from the facility;
512.14 	(5) a provision that if a client self-administers medication when the client is present in 
512.15 	the facility, the client must self-administer medication under the observation of a trained 
512.16 	staff member;
512.17 	(6) a provision that when a license holder serves a client who is a parent with a child, 
512.18 	the parent may only administer medication to the child under a staff member's supervision;
512.19 	(7) requirements for recording the client's use of medication, including staff signatures 
512.20 	with date and time;
512.21 	(8) guidelines for when to inform a nurse of problems with self-administration of 
512.22 	medication, including a client's failure to administer, refusal of a medication, adverse 
512.23 	reaction, or error; and
512.24 	(9) procedures for acceptance, documentation, and implementation of a prescription, 
512.25 	whether written, verbal, telephonic, or electronic.

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

512.27 	Sec. 48. Minnesota Statutes 2022, section 245G.08, subdivision 6, is amended to read:
512.28 		Subd. 6.Control of drugs. A license holder must have and implement written policies 
512.29 	and procedures developed by a registered nurse that contain:
513.1 	(1) a requirement that each drug must be stored in a locked compartment. A Schedule 
513.2 	II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked 
513.3 	compartment, permanently affixed to the physical plant or medication cart;
513.4 	(2) a system which accounts for all scheduled drugs each shift;
513.5 	(3) a procedure for recording the client's use of medication, including the signature of 
513.6 	the staff member who completed the administration of the medication with the time and 
513.7 	date;
513.8 	(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
513.9 	(5) a statement that only authorized personnel are permitted access to the keys to a locked 
513.10 	compartment;
513.11 	(6) a statement that no legend drug supply for one client shall be given to another client; 
513.12 	and
513.13 	(7) a procedure for monitoring the available supply of naloxone an opiate antagonist as 
513.14 	defined in section 604A.04, subdivision 1, on site, and replenishing the naloxone supply 
513.15 	when needed, and destroying naloxone according to clause (4).

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

513.17 	Sec. 49. Minnesota Statutes 2022, section 245G.10, is amended by adding a subdivision 
513.18 	to read:
513.19 		Subd. 6.Notification to commissioner of changes in key staff positions. A license 
513.20 	holder must notify the commissioner within five business days of a change or vacancy in a 
513.21 	key staff position. The key positions are a treatment director as required by subdivision 1, 
513.22 	an alcohol and drug counselor supervisor as required by subdivision 2, and a registered 
513.23 	nurse as required by section 245G.08, subdivision 5, paragraph (c). The license holder must 
513.24 	notify the commissioner of the staffing change or vacancy on a form approved by the 
513.25 	commissioner and include the name of the staff person now assigned to the key staff position 
513.26 	and the staff person's qualifications for the position.

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

513.28 	Sec. 50. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 2, is amended 
513.29 	to read:
513.30 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
513.31 	have the meanings given them.
514.1 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
514.2 	diverted from intended use of the medication.
514.3 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
514.4 	addiction to a person who is not a client of the program that is administering or dispensing 
514.5 	the medication.
514.6 	(d) "Medical director" means a practitioner licensed to practice medicine in the 
514.7 	jurisdiction that the opioid treatment program is located who assumes responsibility for 
514.8 	administering all medical services performed by the program, either by performing the 
514.9 	services directly or by delegating specific responsibility to a practitioner of the opioid 
514.10 	treatment program.
514.11 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
514.12 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
514.13 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
514.14 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
514.15 	title 42, section 8.12, and includes programs licensed under this chapter.
514.16 	(h) "Practitioner" means a staff member holding a current, unrestricted license to practice 
514.17 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
514.18 	and is currently registered with the Drug Enforcement Administration to order or dispense 
514.19 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
514.20 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
514.21 	nurse and physician assistant if the staff member receives a variance by the state opioid 
514.22 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
514.23 	Health Services Administration.
514.24 	(i) "Unsupervised use" or "take-home" means the use of a medication for the treatment 
514.25 	of opioid use disorder dispensed for use by a client outside of the program setting.

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

514.27 	Sec. 51. Minnesota Statutes 2022, section 245G.22, subdivision 6, is amended to read:
514.28 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
514.29 	medication used for the treatment of opioid use disorder to the illicit market, medication 
514.30 	dispensed to a client for unsupervised use shall be subject to the requirements of this 
514.31 	subdivision. Any client in an opioid treatment program may receive a single unsupervised 
514.32 	use dose for a day that the clinic is closed for business, including Sundays and state and 
515.1 	federal holidays their individualized take-home doses as ordered for days that the clinic is 
515.2 	closed for business, on one weekend day (e.g., Sunday) and state and federal holidays, no 
515.3 	matter their length of time in treatment, as allowed under Code of Federal Regulations, title 
515.4 	42, part 8.12 (i)(1).
515.5 	(b) For take-home doses beyond those allowed by paragraph (a), a practitioner with
515.6 	authority to prescribe must review and document the criteria in this paragraph and paragraph 
515.7 	(c) the Code of Federal Regulations, title 42, part 8.12 (i)(2), when determining whether 
515.8 	dispensing medication for a client's unsupervised use is safe and it is appropriate to 
515.9 	implement, increase, or extend the amount of time between visits to the program. The criteria 
515.10 	are:
515.11 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
515.12 	and alcohol;
515.13 	(2) regularity of program attendance;
515.14 	(3) absence of serious behavioral problems at the program;
515.15 	(4) absence of known recent criminal activity such as drug dealing;
515.16 	(5) stability of the client's home environment and social relationships;
515.17 	(6) length of time in comprehensive maintenance treatment;
515.18 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
515.19 	the client's home; and
515.20 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
515.21 	of program attendance outweighs the potential risks of diversion or unsupervised use.
515.22 	(c) The determination, including the basis of the determination must be documented by 
515.23 	a practitioner in the client's medical record.

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

515.25 	Sec. 52. Minnesota Statutes 2022, section 245G.22, subdivision 7, is amended to read:
515.26 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
515.27 	medical director or prescribing practitioner assesses and, determines, and documents that 
515.28 	a client meets the criteria in subdivision 6 and may be dispensed a medication used for the 
515.29 	treatment of opioid addiction, the restrictions in this subdivision must be followed when 
515.30 	the medication to be dispensed is methadone hydrochloride. The results of the assessment 
515.31 	must be contained in the client file. The number of unsupervised use medication doses per 
516.1 	week in paragraphs (b) to (d) is in addition to the number of unsupervised use medication 
516.2 	doses a client may receive for days the clinic is closed for business as allowed by subdivision 
516.3 	6, paragraph (a) and that a patient is safely able to manage unsupervised doses of methadone, 
516.4 	the number of take-home doses the client receives must be limited by the number allowed 
516.5 	by the Code of Federal Regulations, title 42, part 8.12 (i)(3).
516.6 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
516.7 	be limited to a maximum of a single dose each week and the client shall ingest all other 
516.8 	doses under direct supervision.
516.9 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
516.10 	limited to two doses per week.
516.11 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
516.12 	exceed three doses per week.
516.13 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
516.14 	unsupervised use medication supply.
516.15 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
516.16 	unsupervised use medication supply.
516.17 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
516.18 	unsupervised use medication supply, but must make monthly visits to the program.

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

516.20 	Sec. 53. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 17, is amended 
516.21 	to read:
516.22 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
516.23 	policies and procedures required in this subdivision.
516.24 	(b) For a program that is not open every day of the year, the license holder must maintain 
516.25 	a policy and procedure that covers requirements under section 245G.22, subdivisions 6 and 
516.26 	7. Unsupervised use of medication used for the treatment of opioid use disorder for days 
516.27 	that the program is closed for business, including but not limited to Sundays on one weekend 
516.28 	day and state and federal holidays, must meet the requirements under section 245G.22, 
516.29 	subdivisions 6 and 7.
516.30 	(c) The license holder must maintain a policy and procedure that includes specific 
516.31 	measures to reduce the possibility of diversion. The policy and procedure must:
517.1 	(1) specifically identify and define the responsibilities of the medical and administrative 
517.2 	staff for performing diversion control measures; and
517.3 	(2) include a process for contacting no less than five percent of clients who have 
517.4 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
517.5 	paragraph (a), to require clients to physically return to the program each month. The system 
517.6 	must require clients to return to the program within a stipulated time frame and turn in all 
517.7 	unused medication containers related to opioid use disorder treatment. The license holder 
517.8 	must document all related contacts on a central log and the outcome of the contact for each 
517.9 	client in the client's record. The medical director must be informed of each outcome that 
517.10 	results in a situation in which a possible diversion issue was identified.
517.11 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
517.12 	administered, and dispensed according to applicable state and federal regulations and the 
517.13 	standards set by applicable accreditation entities. If a medication order requires assessment 
517.14 	by the person administering or dispensing the medication to determine the amount to be 
517.15 	administered or dispensed, the assessment must be completed by an individual whose 
517.16 	professional scope of practice permits an assessment. For the purposes of enforcement of 
517.17 	this paragraph, the commissioner has the authority to monitor the person administering or 
517.18 	dispensing the medication for compliance with state and federal regulations and the relevant 
517.19 	standards of the license holder's accreditation agency and may issue licensing actions 
517.20 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
517.21 	determination of noncompliance.
517.22 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.
517.23 	(f) Notwithstanding paragraph (e), from July 1, 2023, to June 30, 2024, a counselor in 
517.24 	an opioid treatment program may supervise up to 60 clients. The license holder may continue 
517.25 	to serve a client who was receiving services at the program on June 30, 2024, at a counselor 
517.26 	to client ratio of up to one to 60 and is not required to discharge any clients in order to return 
517.27 	to the counselor to client ratio of one to 50. The license holder may not, however, serve a 
517.28 	new client after June 30, 2024, unless the counselor who would supervise the new client is 
517.29 	supervising fewer than 50 existing clients.

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

518.1 	Sec. 54. Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision 
518.2 	to read:
518.3 		Subd. 6a.Infant. "Infant" means a child who is at least six weeks old but less than 16 
518.4 	months old.

518.5 	EFFECTIVE DATE. This section is effective October 1, 2024.

518.6 	Sec. 55. Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision 
518.7 	to read:
518.8 		Subd. 6b.Preschooler. "Preschooler" means a child who is at least 33 months old but 
518.9 	who has not yet attended the first day of kindergarten.

518.10 	EFFECTIVE DATE. This section is effective October 1, 2024.

518.11 	Sec. 56. Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision 
518.12 	to read:
518.13 		Subd. 6c.School-age child. "School-age child" means a child who is of sufficient age 
518.14 	to have attended the first day of kindergarten or is eligible to enter kindergarten within four 
518.15 	months and:
518.16 	(1) is no more than 13 years old;
518.17 	(2) remains eligible for child care assistance under section 119B.09, subdivision 1, 
518.18 	paragraph (e); or
518.19 	(3) attends a certified center that serves only school-age children in a setting that has 
518.20 	students enrolled in no grade higher than grade 8.

518.21 	EFFECTIVE DATE. This section is effective October 1, 2024.

518.22 	Sec. 57. Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision 
518.23 	to read:
518.24 		Subd. 8a.Toddler. "Toddler" means a child who is at least 16 months old but less than 
518.25 	33 months old.

518.26 	EFFECTIVE DATE. This section is effective October 1, 2024.

519.1 	Sec. 58. Minnesota Statutes 2023 Supplement, section 245H.06, subdivision 1, is amended 
519.2 	to read:
519.3 		Subdivision 1.Correction order and conditional certification requirements. (a) If 
519.4 	the applicant or certification holder failed fails to comply with a law or rule, the commissioner 
519.5 	may issue a correction order. The correction order must state:
519.6 	(1) the condition that constitutes a violation of the law or rule;
519.7 	(2) the specific law or rule violated; and
519.8 	(3) the time allowed to correct each violation.
519.9 	(b) The commissioner may issue a correction order to the applicant or certification holder 
519.10 	through the provider licensing and reporting hub. If the certification holder fails to comply 
519.11 	with a law or rule, the commissioner may issue a conditional certification. When issuing a 
519.12 	conditional certification, the commissioner shall consider the nature, chronicity, or severity 
519.13 	of the violation of law or rule and the effect of the violation on the health, safety, or rights 
519.14 	of persons served by the program. The conditional order must state:
519.15 	(1) the conditions that constitute a violation of the law or rule;
519.16 	(2) the specific law or rule violated;
519.17 	(3) the time allowed to correct each violation; and
519.18 	(4) the length and terms of the conditional certification, and the reasons for making the 
519.19 	certification conditional.
519.20 	(c) Nothing in this section prohibits the commissioner from decertifying a center under 
519.21 	section 245H.07 before issuing a correction order or conditional certification.
519.22 	(d) The commissioner may issue a correction order or conditional certification to the 
519.23 	applicant or certification holder through the provider licensing and reporting hub.

519.24 	EFFECTIVE DATE. This section is effective October 1, 2024.

519.25 	Sec. 59. Minnesota Statutes 2023 Supplement, section 245H.06, subdivision 2, is amended 
519.26 	to read:
519.27 		Subd. 2.Reconsideration request. (a) If the applicant or certification holder believes 
519.28 	that the commissioner's correction order or conditional certification is erroneous, the applicant 
519.29 	or certification holder may ask the commissioner to reconsider the part of the correction 
519.30 	order or conditional certification that is allegedly erroneous. A request for reconsideration 
519.31 	must be made in writing and postmarked or submitted through the provider licensing and 
520.1 	reporting hub and sent to the commissioner within 20 calendar days after the applicant or 
520.2 	certification holder received the correction order or conditional certification, and must:
520.3 	(1) specify the part of the correction order or conditional certification that is allegedly 
520.4 	erroneous;
520.5 	(2) explain why the specified part is erroneous; and
520.6 	(3) include documentation to support the allegation of error.
520.7 	(b) A request for reconsideration of a correction order does not stay any provision or 
520.8 	requirement of the correction order. The commissioner's disposition of a request for 
520.9 	reconsideration is final and not subject to appeal.
520.10 	(c) A timely request for reconsideration of a conditional certification shall stay imposition 
520.11 	of the terms of the conditional certification until the commissioner issues a decision on the 
520.12 	request for reconsideration.
520.13 	(c) (d) Upon implementation of the provider licensing and reporting hub, the provider 
520.14 	must use the hub to request reconsideration. If the order is issued through the provider hub, 
520.15 	the request must be received by the commissioner within 20 calendar days from the date 
520.16 	the commissioner issued the order through the hub.

520.17 	EFFECTIVE DATE. This section is effective October 1, 2024.

520.18 	Sec. 60. Minnesota Statutes 2022, section 245H.08, subdivision 1, is amended to read:
520.19 		Subdivision 1.Staffing requirements. (a) Except as provided in paragraph (b), during 
520.20 	hours of operation, a certified center must have a director or designee on site who is 
520.21 	responsible for overseeing implementation of written policies relating to the management 
520.22 	and control of the daily activities of the program, ensuring the health and safety of program 
520.23 	participants, and supervising staff and volunteers.
520.24 	(b) When the director is absent, a certified center must designate a staff person who is 
520.25 	at least 18 years old to fulfill the director's responsibilities under this subdivision to ensure 
520.26 	continuity of program oversight. The designee does not have to meet the director 
520.27 	qualifications in subdivision 2 but must be aware of their designation and responsibilities 
520.28 	under this subdivision.

520.29 	EFFECTIVE DATE. This section is effective October 1, 2024.

521.1 	Sec. 61. Minnesota Statutes 2023 Supplement, section 245H.08, subdivision 4, is amended 
521.2 	to read:
521.3 		Subd. 4.Maximum group size. (a) For a child six weeks old through 16 months old an 
521.4 	infant, the maximum group size shall be no more than eight children.
521.5 	(b) For a child 16 months old through 33 months old toddler, the maximum group size 
521.6 	shall be no more than 14 children.
521.7 	(c) For a child 33 months old through prekindergarten preschooler, a the maximum 
521.8 	group size shall be no more than 20 children.
521.9 	(d) For a child in kindergarten through 13 years old school-age child, a the maximum 
521.10 	group size shall be no more than 30 children.
521.11 	(e) The maximum group size applies at all times except during group activity coordination 
521.12 	time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and 
521.13 	special activity including a film, guest speaker, indoor large muscle activity, or holiday 
521.14 	program.
521.15 	(f) Notwithstanding paragraph (d), a certified center may continue to serve a child 14 
521.16 	years of age or older if one of the following conditions is true:
521.17 	(1) the child remains eligible for child care assistance under section 119B.09, subdivision 
521.18 	1, paragraph (e); or
521.19 	(2) the certified center serves only school-age children in a setting that has students 
521.20 	enrolled in no grade higher than 8th grade.

521.21 	EFFECTIVE DATE. This section is effective October 1, 2024.

521.22 	Sec. 62. Minnesota Statutes 2023 Supplement, section 245H.08, subdivision 5, is amended 
521.23 	to read:
521.24 		Subd. 5.Ratios. (a) The minimally acceptable staff-to-child ratios are:

521.25	six weeks old through 16 months old infants
	1:4
	
521.26	16 months old through 33 months old toddlers
	1:7
	
521.27
521.28	33 months old through prekindergarten
preschoolers
	1:10
	
521.29
521.30	kindergarten through 13 years old school-age 
children
	1:15
	
521.31 	(b) Kindergarten includes a child of sufficient age to have attended the first day of 
521.32 	kindergarten or who is eligible to enter kindergarten within the next four months.
522.1 	(c) (b) For mixed mixed-age groups, the ratio for the age group of the youngest child 
522.2 	applies.
522.3 	(d) Notwithstanding paragraph (a), a certified center may continue to serve a child 14 
522.4 	years of age or older if one of the following conditions is true:
522.5 	(1) the child remains eligible for child care assistance under section 119B.09, subdivision 
522.6 	1, paragraph (e); or
522.7 	(2) the certified center serves only school-age children in a setting that has students 
522.8 	enrolled in no grade higher than 8th grade.

522.9 	EFFECTIVE DATE. This section is effective October 1, 2024.

522.10 	Sec. 63. Minnesota Statutes 2022, section 245H.14, subdivision 1, is amended to read:
522.11 		Subdivision 1.First aid and cardiopulmonary resuscitation. (a) Before having 
522.12 	unsupervised direct contact with a child, but within the first 90 days of employment for
522.13 	after the first date of direct contact with a child, the director and, all staff persons, and within 
522.14 	90 days after the first date of direct contact with a child for substitutes, and unsupervised 
522.15 	volunteers, each person must successfully complete pediatric first aid and pediatric 
522.16 	cardiopulmonary resuscitation (CPR) training, unless the training has been completed within 
522.17 	the previous two calendar years. Staff must complete the pediatric first aid and pediatric 
522.18 	CPR training at least every other calendar year and the center must document the training 
522.19 	in the staff person's personnel record.
522.20 	(b) Training completed under this subdivision may be used to meet the in-service training 
522.21 	requirements under subdivision 6.

522.22 	EFFECTIVE DATE. This section is effective October 1, 2024.

522.23 	Sec. 64. Minnesota Statutes 2022, section 245H.14, subdivision 4, is amended to read:
522.24 		Subd. 4.Child development. The certified center must ensure that the director and all 
522.25 	staff persons complete child development and learning training within 90 days of employment 
522.26 	and every second calendar year thereafter. Substitutes and unsupervised volunteers must 
522.27 	complete child development and learning training within 90 days after the first date of direct 
522.28 	contact with a child and every second calendar year thereafter. Before having unsupervised 
522.29 	direct contact with a child, but within 90 days after the first date of direct contact with a 
522.30 	child, the director, all staff persons, substitutes, and unsupervised volunteers must complete 
522.31 	child development and learning training. Child development and learning training must be 
522.32 	repeated every second calendar year thereafter. The director and staff persons not including 
523.1 	substitutes must complete at least two hours of training on child development. The training 
523.2 	for substitutes and unsupervised volunteers is not required to be of a minimum length. For 
523.3 	purposes of this subdivision, "child development and learning training" means how a child 
523.4 	develops physically, cognitively, emotionally, and socially and learns as part of the child's 
523.5 	family, culture, and community.

523.6 	EFFECTIVE DATE. This section is effective October 1, 2024.

523.7 	Sec. 65. [245H.19] CHILDREN'S RECORDS.
523.8 	(a) A certification holder must maintain a record for each child enrolled in the certification 
523.9 	holder's program. The record must contain:
523.10 	(1) the child's full name, birth date, and home address;
523.11 	(2) the name and telephone number of the child's parents or legal guardians;
523.12 	(3) the name and telephone number of at least one emergency contact person other than 
523.13 	the child's parents who can be reached in an emergency or when there is an injury requiring 
523.14 	medical attention and who is authorized to pick up the child; and
523.15 	(4) the names and telephone numbers of any additional persons authorized by the parents 
523.16 	or legal guardians to pick up the child from the center.
523.17 	(b) The certification holder must maintain in the child's record and ensure that during 
523.18 	all hours of operation staff can access the following information:
523.19 	(1) immunization information as required under section 245H.13, subdivision 2;
523.20 	(2) medication administration documentation as required under section 245H.13, 
523.21 	subdivision 3; and
523.22 	(3) documentation of any known allergy as required under section 245H.13, subdivision 
523.23 	4.

523.24 	EFFECTIVE DATE. This section is effective October 1, 2024.

523.25 	Sec. 66. Minnesota Statutes 2023 Supplement, section 256B.064, subdivision 4, is amended 
523.26 	to read:
523.27 		Subd. 4.Notice. (a) The department shall serve the notice required under subdivision 2 
523.28 	by certified mail at using a signature-verified confirmed delivery method to the address 
523.29 	submitted to the department by the individual or entity. Service is complete upon mailing.
524.1 	(b) The department shall give notice in writing to a recipient placed in the Minnesota 
524.2 	restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200. 
524.3 	The department shall send the notice by first class mail to the recipient's current address on 
524.4 	file with the department. A recipient placed in the Minnesota restricted recipient program 
524.5 	may contest the placement by submitting a written request for a hearing to the department 
524.6 	within 90 days of the notice being mailed.

524.7 	Sec. 67. Minnesota Statutes 2022, section 256B.0757, subdivision 4a, is amended to read:
524.8 		Subd. 4a.Behavioral health home services provider requirements. A behavioral 
524.9 	health home services provider must:
524.10 	(1) be an enrolled Minnesota Health Care Programs provider;
524.11 	(2) provide a medical assistance covered primary care or behavioral health service;
524.12 	(3) utilize an electronic health record;
524.13 	(4) utilize an electronic patient registry that contains data elements required by the 
524.14 	commissioner;
524.15 	(5) demonstrate the organization's capacity to administer screenings approved by the 
524.16 	commissioner for substance use disorder or alcohol and tobacco use;
524.17 	(6) demonstrate the organization's capacity to refer an individual to resources appropriate 
524.18 	to the individual's screening results;
524.19 	(7) have policies and procedures to track referrals to ensure that the referral met the 
524.20 	individual's needs;
524.21 	(8) conduct a brief needs assessment when an individual begins receiving behavioral 
524.22 	health home services. The brief needs assessment must be completed with input from the 
524.23 	individual and the individual's identified supports. The brief needs assessment must address 
524.24 	the individual's immediate safety and transportation needs and potential barriers to 
524.25 	participating in behavioral health home services;
524.26 	(9) conduct a health wellness assessment within 60 days after intake that contains all 
524.27 	required elements identified by the commissioner;
524.28 	(10) conduct a health action plan that contains all required elements identified by the 
524.29 	commissioner. The plan must be completed within 90 days after intake and must be updated 
524.30 	at least once every six months, or more frequently if significant changes to an individual's 
524.31 	needs or goals occur;
525.1 	(11) agree to cooperate with and participate in the state's monitoring and evaluation of 
525.2 	behavioral health home services; and
525.3 	(12) obtain the individual's written consent to begin receiving behavioral health home 
525.4 	services using a form approved by the commissioner.

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

525.6 	Sec. 68. Minnesota Statutes 2022, section 256B.0757, subdivision 4d, is amended to read:
525.7 		Subd. 4d.Behavioral health home services delivery standards. (a) A behavioral health 
525.8 	home services provider must meet the following service delivery standards:
525.9 	(1) establish and maintain processes to support the coordination of an individual's primary 
525.10 	care, behavioral health, and dental care;
525.11 	(2) maintain a team-based model of care, including regular coordination and 
525.12 	communication between behavioral health home services team members;
525.13 	(3) use evidence-based practices that recognize and are tailored to the medical, social, 
525.14 	economic, behavioral health, functional impairment, cultural, and environmental factors 
525.15 	affecting the individual's health and health care choices;
525.16 	(4) use person-centered planning practices to ensure the individual's health action plan 
525.17 	accurately reflects the individual's preferences, goals, resources, and optimal outcomes for 
525.18 	the individual and the individual's identified supports;
525.19 	(5) use the patient registry to identify individuals and population subgroups requiring 
525.20 	specific levels or types of care and provide or refer the individual to needed treatment, 
525.21 	intervention, or services;
525.22 	(6) utilize the Department of Human Services Partner Portal to identify past and current 
525.23 	treatment or services and identify potential gaps in care using a tool approved by the 
525.24 	commissioner;
525.25 	(7) deliver services consistent with the standards for frequency and face-to-face contact 
525.26 	required by the commissioner;
525.27 	(8) ensure that a diagnostic assessment is completed for each individual receiving 
525.28 	behavioral health home services within six months of the start of behavioral health home 
525.29 	services;
525.30 	(9) deliver services in locations and settings that meet the needs of the individual;
526.1 	(10) provide a central point of contact to ensure that individuals and the individual's 
526.2 	identified supports can successfully navigate the array of services that impact the individual's 
526.3 	health and well-being;
526.4 	(11) have capacity to assess an individual's readiness for change and the individual's 
526.5 	capacity to integrate new health care or community supports into the individual's life;
526.6 	(12) offer or facilitate the provision of wellness and prevention education on 
526.7 	evidenced-based curriculums specific to the prevention and management of common chronic 
526.8 	conditions;
526.9 	(13) help an individual set up and prepare for medical, behavioral health, social service, 
526.10 	or community support appointments, including accompanying the individual to appointments 
526.11 	as appropriate, and providing follow-up with the individual after these appointments;
526.12 	(14) offer or facilitate the provision of health coaching related to chronic disease 
526.13 	management and how to navigate complex systems of care to the individual, the individual's 
526.14 	family, and identified supports;
526.15 	(15) connect an individual, the individual's family, and identified supports to appropriate 
526.16 	support services that help the individual overcome access or service barriers, increase 
526.17 	self-sufficiency skills, and improve overall health;
526.18 	(16) provide effective referrals and timely access to services; and
526.19 	(17) establish a continuous quality improvement process for providing behavioral health 
526.20 	home services.
526.21 	(b) The behavioral health home services provider must also create a plan, in partnership 
526.22 	with the individual and the individual's identified supports, to support the individual after 
526.23 	discharge from a hospital, residential treatment program, or other setting. The plan must 
526.24 	include protocols for:
526.25 	(1) maintaining contact between the behavioral health home services team member, the 
526.26 	individual, and the individual's identified supports during and after discharge;
526.27 	(2) linking the individual to new resources as needed;
526.28 	(3) reestablishing the individual's existing services and community and social supports; 
526.29 	and
526.30 	(4) following up with appropriate entities to transfer or obtain the individual's service 
526.31 	records as necessary for continued care.
527.1 	(c) If the individual is enrolled in a managed care plan, a behavioral health home services 
527.2 	provider must:
527.3 	(1) notify the behavioral health home services contact designated by the managed care 
527.4 	plan within 30 days of when the individual begins behavioral health home services; and
527.5 	(2) adhere to the managed care plan communication and coordination requirements 
527.6 	described in the behavioral health home services manual.
527.7 	(d) Before terminating behavioral health home services, the behavioral health home 
527.8 	services provider must:
527.9 	(1) provide a 60-day notice of termination of behavioral health home services to all 
527.10 	individuals receiving behavioral health home services, the commissioner, and managed care 
527.11 	plans, if applicable; and
527.12 	(2) refer individuals receiving behavioral health home services to a new behavioral 
527.13 	health home services provider.

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

527.15 	Sec. 69. Minnesota Statutes 2023 Supplement, section 256D.01, subdivision 1a, is amended 
527.16 	to read:
527.17 		Subd. 1a.Standards. (a) A principal objective in providing general assistance is to 
527.18 	provide for single adults, childless couples, or children as defined in section 256D.02, 
527.19 	subdivision 2b, ineligible for federal programs who are unable to provide for themselves. 
527.20 	The minimum standard of assistance determines the total amount of the general assistance 
527.21 	grant without separate standards for shelter, utilities, or other needs.
527.22 	(b) The standard of assistance for an assistance unit consisting of a recipient who is 
527.23 	childless and unmarried or living apart from children and spouse and who does not live with 
527.24 	a parent or parents or a legal custodian, or consisting of a childless couple, is $350 per month 
527.25 	effective October 1, 2024, and must be adjusted by a percentage equal to the change in the 
527.26 	consumer price index as of January 1 every year, beginning October 1, 2025.
527.27 	(c) For an assistance unit consisting of a single adult who lives with a parent or parents, 
527.28 	the general assistance standard of assistance is $350 per month effective October 1, 2023
527.29 	2024, and must be adjusted by a percentage equal to the change in the consumer price index 
527.30 	as of January 1 every year, beginning October 1, 2025. Benefits received by a responsible 
527.31 	relative of the assistance unit under the Supplemental Security Income program, a workers' 
527.32 	compensation program, the Minnesota supplemental aid program, or any other program 
528.1 	based on the responsible relative's disability, and any benefits received by a responsible 
528.2 	relative of the assistance unit under the Social Security retirement program, may not be 
528.3 	counted in the determination of eligibility or benefit level for the assistance unit. Except as 
528.4 	provided below, the assistance unit is ineligible for general assistance if the available 
528.5 	resources or the countable income of the assistance unit and the parent or parents with whom 
528.6 	the assistance unit lives are such that a family consisting of the assistance unit's parent or 
528.7 	parents, the parent or parents' other family members and the assistance unit as the only or 
528.8 	additional minor child would be financially ineligible for general assistance. For the purposes 
528.9 	of calculating the countable income of the assistance unit's parent or parents, the calculation 
528.10 	methods must follow the provisions under section 256P.06.

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

528.12 	Sec. 70. Minnesota Statutes 2022, section 256I.04, subdivision 2f, is amended to read:
528.13 		Subd. 2f.Required services. (a) In licensed and registered authorized settings under 
528.14 	subdivision 2a, providers shall ensure that participants have at a minimum:
528.15 	(1) food preparation and service for three nutritional meals a day on site;
528.16 	(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
528.17 	(3) housekeeping, including cleaning and lavatory supplies or service; and
528.18 	(4) maintenance and operation of the building and grounds, including heat, water, garbage 
528.19 	removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair 
528.20 	and maintain equipment and facilities.
528.21 	(b) In addition, when providers serve participants described in subdivision 1, paragraph 
528.22 	(c), the providers are required to assist the participants in applying for continuing housing 
528.23 	support payments before the end of the eligibility period.

528.24 	Sec. 71. Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 1a, is amended 
528.25 	to read:
528.26 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
528.27 	subdivision 3, the agency may negotiate a payment not to exceed $494.91 for other services 
528.28 	necessary to provide room and board if the residence is licensed by or registered by the 
528.29 	Department of Health, or licensed by the Department of Human Services to provide services 
528.30 	in addition to room and board, and if the provider of services is not also concurrently 
528.31 	receiving funding for services for a recipient in the residence under the following programs 
528.32 	or funding sources: (1) home and community-based waiver services under chapter 256S or 
529.1 	section 256B.0913, 256B.092, or 256B.49; (2) personal care assistance under section 
529.2 	256B.0659; (3) community first services and supports under section 256B.85; or (4) services 
529.3 	for adults with mental illness grants under section 245.73. If funding is available for other 
529.4 	necessary services through a home and community-based waiver under chapter 256S, or 
529.5 	section 256B.0913, 256B.092, or 256B.49; personal care assistance services under section 
529.6 	256B.0659; community first services and supports under section 256B.85; or services for 
529.7 	adults with mental illness grants under section 245.73, then the housing support rate is 
529.8 	limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case may 
529.9 	the supplementary service rate exceed $494.91. The registration and licensure requirement 
529.10 	does not apply to establishments which are exempt from state licensure because they are 
529.11 	located on Indian reservations and for which the tribe has prescribed health and safety 
529.12 	requirements. Service payments under this section may be prohibited under rules to prevent 
529.13 	the supplanting of federal funds with state funds.
529.14 	(b) The commissioner is authorized to make cost-neutral transfers from the housing 
529.15 	support fund for beds under this section to other funding programs administered by the 
529.16 	department after consultation with the agency in which the affected beds are located. The 
529.17 	commissioner may also make cost-neutral transfers from the housing support fund to agencies 
529.18 	for beds permanently removed from the housing support census under a plan submitted by 
529.19 	the agency and approved by the commissioner. The commissioner shall report the amount 
529.20 	of any transfers under this provision annually to the legislature.
529.21 	(c) (b) Agencies must not negotiate supplementary service rates with providers of housing 
529.22 	support that are licensed as board and lodging with special services and that do not encourage 
529.23 	a policy of sobriety on their premises and make referrals to available community services 
529.24 	for volunteer and employment opportunities for residents.

529.25 	Sec. 72. Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 11, is amended 
529.26 	to read:
529.27 		Subd. 11.Transfer of emergency shelter funds Cost-neutral transfers from the 
529.28 	housing support fund. (a) The commissioner is authorized to make cost-neutral transfers 
529.29 	from the housing support fund for beds under this section to other funding programs 
529.30 	administered by the department after consultation with the agency in which the affected 
529.31 	beds are located.
529.32 	(b) The commissioner may also make cost-neutral transfers from the housing support 
529.33 	fund to agencies for beds removed from the housing support census under a plan submitted 
529.34 	by the agency and approved by the commissioner.
530.1 	(a) (c) The commissioner shall make a cost-neutral transfer of funding from the housing 
530.2 	support fund to the agency for emergency shelter beds removed from the housing support 
530.3 	census under a biennial plan submitted by the agency and approved by the commissioner.
530.4 	Plans submitted under this paragraph must include anticipated and actual outcomes for 
530.5 	persons experiencing homelessness in emergency shelters.
530.6 	The plan (d) Plans submitted under paragraph (b) or (c) must describe: (1) anticipated 
530.7 	and actual outcomes for persons experiencing homelessness in emergency shelters; (2)
530.8 	improved efficiencies in administration; (3) (2) requirements for individual eligibility; and 
530.9 	(4) (3) plans for quality assurance monitoring and quality assurance outcomes. The 
530.10 	commissioner shall review the agency plan plans to monitor implementation and outcomes 
530.11 	at least biennially, and more frequently if the commissioner deems necessary.
530.12 	(b) The (e) Funding under paragraph (a) (b), (c), or (d) may be used for the provision 
530.13 	of room and board or supplemental services according to section 256I.03, subdivisions 14a 
530.14 	and 14b. Providers must meet the requirements of section 256I.04, subdivisions 2a to 2f. 
530.15 	Funding must be allocated annually, and the room and board portion of the allocation shall 
530.16 	be adjusted according to the percentage change in the housing support room and board rate. 
530.17 	The room and board portion of the allocation shall be determined at the time of transfer.
530.18 	The commissioner or agency may return beds to the housing support fund with 180 days' 
530.19 	notice, including financial reconciliation.

530.20 	Sec. 73. Minnesota Statutes 2022, section 260E.30, subdivision 3, as amended by Laws 
530.21 	2024, chapter 80, article 8, section 41, is amended to read:
530.22 		Subd. 3.Nonmaltreatment mistake. (a) If paragraph (b) applies, rather than making a 
530.23 	determination of substantiated maltreatment by the individual, the commissioner of children, 
530.24 	youth, and families shall determine that the individual made a nonmaltreatment mistake.
530.25 	(b) A nonmaltreatment mistake occurs when:
530.26 	(1) at the time of the incident, the individual was performing duties identified in the 
530.27 	facility's child care program plan required under Minnesota Rules, part 9503.0045;
530.28 	(2) (1) the individual has not been determined responsible for a similar incident that 
530.29 	resulted in a finding of maltreatment for at least seven years;
530.30 	(3) (2) the individual has not been determined to have committed a similar 
530.31 	nonmaltreatment mistake under this paragraph for at least four years;
531.1 	(4) (3) any injury to a child resulting from the incident, if treated, is treated only with 
531.2 	remedies that are available over the counter, whether ordered by a medical professional or 
531.3 	not; and
531.4 	(5) (4) except for the period when the incident occurred, the facility and the individual 
531.5 	providing services were both in compliance with all licensing and certification requirements 
531.6 	relevant to the incident.
531.7 	(c) This subdivision only applies to child care centers certified under chapter 245H and 
531.8 	licensed under Minnesota Rules, chapter 9503.

531.9 	EFFECTIVE DATE. This section is effective October 1, 2024.

531.10 	Sec. 74. Minnesota Statutes 2022, section 260E.33, subdivision 2, as amended by Laws 
531.11 	2024, chapter 80, article 8, section 44, is amended to read:
531.12 		Subd. 2.Request for reconsideration. (a) Except as provided under subdivision 5, an 
531.13 	individual or facility that the commissioner of human services; commissioner of children, 
531.14 	youth, and families; a local welfare agency; or the commissioner of education determines 
531.15 	has maltreated a child, an interested person acting on behalf of the child, regardless of the 
531.16 	determination, who contests the investigating agency's final determination regarding 
531.17 	maltreatment may request the investigating agency to reconsider its final determination 
531.18 	regarding maltreatment. The request for reconsideration must be submitted in writing or 
531.19 	submitted in the provider licensing and reporting hub to the investigating agency within 15 
531.20 	calendar days after receipt of notice of the final determination regarding maltreatment or, 
531.21 	if the request is made by an interested person who is not entitled to notice, within 15 days 
531.22 	after receipt of the notice by the parent or guardian of the child. If mailed, the request for 
531.23 	reconsideration must be postmarked and sent to the investigating agency within 15 calendar 
531.24 	days of the individual's or facility's receipt of the final determination. If the request for 
531.25 	reconsideration is made by personal service, it must be received by the investigating agency 
531.26 	within 15 calendar days after the individual's or facility's receipt of the final determination.
531.27 	Upon implementation of the provider licensing and reporting hub, the individual or facility 
531.28 	must use the hub to request reconsideration. The reconsideration must be received by the 
531.29 	commissioner within 15 calendar days of the individual's receipt of the notice of 
531.30 	disqualification.
531.31 	(b) An individual who was determined to have maltreated a child under this chapter and 
531.32 	who was disqualified on the basis of serious or recurring maltreatment under sections 
531.33 	245C.14 and 245C.15 may request reconsideration of the maltreatment determination and 
531.34 	the disqualification. The request for reconsideration of the maltreatment determination and 
532.1 	the disqualification must be submitted within 30 calendar days of the individual's receipt 
532.2 	of the notice of disqualification under sections 245C.16 and 245C.17. If mailed, the request 
532.3 	for reconsideration of the maltreatment determination and the disqualification must be 
532.4 	postmarked and sent to the investigating agency within 30 calendar days of the individual's 
532.5 	receipt of the maltreatment determination and notice of disqualification. If the request for 
532.6 	reconsideration is made by personal service, it must be received by the investigating agency 
532.7 	within 30 calendar days after the individual's receipt of the notice of disqualification.

532.8 	Sec. 75. Laws 2024, chapter 80, article 2, section 5, is amended by adding a subdivision 
532.9 	to read:
532.10 		Subd. 23.Family child foster care annual program evaluation. Upon implementation 
532.11 	of a continuous license process for family child foster care, the annual program evaluation 
532.12 	required under Minnesota Rules, part 2960.3100, subpart 1, item G, must be conducted 
532.13 	utilizing the electronic licensing inspection checklist information and the provider licensing 
532.14 	and reporting hub in a manner prescribed by the commissioner.

532.15 	Sec. 76. Laws 2024, chapter 80, article 2, section 6, subdivision 2, is amended to read:
532.16 		Subd. 2.Change in ownership. (a) If the commissioner determines that there is a change 
532.17 	in ownership, the commissioner shall require submission of a new license application. This 
532.18 	subdivision does not apply to a licensed program or service located in a home where the 
532.19 	license holder resides. A change in ownership occurs when:
532.20 	(1) except as provided in paragraph (b), the license holder sells or transfers 100 percent 
532.21 	of the property, stock, or assets;
532.22 	(2) the license holder merges with another organization;
532.23 	(3) the license holder consolidates with two or more organizations, resulting in the 
532.24 	creation of a new organization;
532.25 	(4) there is a change to the federal tax identification number associated with the license 
532.26 	holder; or
532.27 	(5) except as provided in paragraph (b),all controlling individuals associated with for
532.28 	the original application license have changed.
532.29 	(b) Notwithstanding For changes under paragraph (a), clauses (1) and (5) clause (1) or 
532.30 	(5), no change in ownership has occurred and a new license application is not required if 
532.31 	at least one controlling individual has been listed affiliated as a controlling individual for 
532.32 	the license for at least the previous 12 months immediately preceding the change.

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

533.2 	Sec. 77. Laws 2024, chapter 80, article 2, section 6, subdivision 3, is amended to read:
533.3 		Subd. 3.Standard change of ownership process. (a) When a change in ownership is 
533.4 	proposed and the party intends to assume operation without an interruption in service longer 
533.5 	than 60 days after acquiring the program or service, the license holder must provide the 
533.6 	commissioner with written notice of the proposed change on a form provided by the 
533.7 	commissioner at least 60 90 days before the anticipated date of the change in ownership. 
533.8 	For purposes of this subdivision and subdivision 4 section, "party" means the party that 
533.9 	intends to operate the service or program.
533.10 	(b) The party must submit a license application under this chapter on the form and in 
533.11 	the manner prescribed by the commissioner at least 30 90 days before the change in 
533.12 	ownership is anticipated to be complete and must include documentation to support the 
533.13 	upcoming change. The party must comply with background study requirements under chapter 
533.14 	245C and shall pay the application fee required under section 245A.10.
533.15 	(c) The commissioner may streamline application procedures when the party is an existing 
533.16 	license holder under this chapter and is acquiring a program licensed under this chapter or 
533.17 	service in the same service class as one or more licensed programs or services the party 
533.18 	operates and those licenses are in substantial compliance. For purposes of this subdivision, 
533.19 	"substantial compliance" means within the previous 12 months the commissioner did not 
533.20 	(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make 
533.21 	a license held by the party conditional according to section 245A.06.
533.22 	(d) Except when a temporary change in ownership license is issued pursuant to 
533.23 	subdivision 4 While the standard change of ownership process is pending, the existing 
533.24 	license holder is solely remains responsible for operating the program according to applicable 
533.25 	laws and rules until a license under this chapter is issued to the party.
533.26 	(e) If a licensing inspection of the program or service was conducted within the previous 
533.27 	12 months and the existing license holder's license record demonstrates substantial 
533.28 	compliance with the applicable licensing requirements, the commissioner may waive the 
533.29 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
533.30 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
533.31 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
533.32 	inspected for compliance with the building code or that no inspection was deemed warranted.
534.1 	(f) If the party is seeking a license for a program or service that has an outstanding action 
534.2 	under section 245A.06 or 245A.07, the party must submit a letter as part of the application 
534.3 	process identifying how the party has or will come into full compliance with the licensing 
534.4 	requirements.
534.5 	(g) The commissioner shall evaluate the party's application according to section 245A.04, 
534.6 	subdivision 6. If the commissioner determines that the party has remedied or demonstrates 
534.7 	the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has 
534.8 	determined that the program otherwise complies with all applicable laws and rules, the 
534.9 	commissioner shall issue a license or conditional license under this chapter. A conditional 
534.10 	license issued under this section is final and not subject to reconsideration under section 
534.11 	142B.16, subdivision 4. The conditional license remains in effect until the commissioner 
534.12 	determines that the grounds for the action are corrected or no longer exist.
534.13 	(h) The commissioner may deny an application as provided in section 245A.05. An 
534.14 	applicant whose application was denied by the commissioner may appeal the denial according 
534.15 	to section 245A.05.
534.16 	(i) This subdivision does not apply to a licensed program or service located in a home 
534.17 	where the license holder resides.

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

534.19 	Sec. 78. Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision 
534.20 	to read:
534.21 		Subd. 3a.Emergency change in ownership process.  (a) In the event of a death of a 
534.22 	license holder or sole controlling individual or a court order or other event that results in 
534.23 	the license holder being inaccessible or unable to operate the program or service, a party 
534.24 	may submit a request to the commissioner to allow the party to assume operation of the 
534.25 	program or service under an emergency change in ownership process to ensure persons 
534.26 	continue to receive services while the commissioner evaluates the party's license application.
534.27 	(b) To request the emergency change of ownership process, the party must immediately:
534.28 	(1) notify the commissioner of the event resulting in the inability of the license holder 
534.29 	to operate the program and of the party's intent to assume operations; and
534.30 	(2) provide the commissioner with documentation that demonstrates the party has a legal 
534.31 	or legitimate ownership interest in the program or service if applicable and is able to operate 
534.32 	the program or service.
535.1 	(c) If the commissioner approves the party to continue operating the program or service 
535.2 	under an emergency change in ownership process, the party must:
535.3 	(1) request to be added as a controlling individual or license holder to the existing license;
535.4 	(2) notify persons receiving services of the emergency change in ownership in a manner 
535.5 	approved by the commissioner;
535.6 	(3) submit an application for a new license within 30 days of approval;
535.7 	(4) comply with the background study requirements under chapter 245C; and
535.8 	(5) pay the application fee required under section 142B.12.
535.9 	(d) While the emergency change of ownership process is pending, a party approved 
535.10 	under this subdivision is responsible for operating the program under the existing license 
535.11 	according to applicable laws and rules until a new license under this chapter is issued.
535.12 	(e) The provisions in subdivision 3, paragraphs (c) and (g) to (h), apply to this subdivision.
535.13 	(f) Once a party is issued a new license or has decided not to seek a new license, the 
535.14 	commissioner must close the existing license.
535.15 	(g) This subdivision applies to any program or service licensed under this chapter.

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

535.17 	Sec. 79. Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision 
535.18 	to read:
535.19 		Subd. 5.Failure to comply. If the commissioner finds that the applicant or license holder 
535.20 	has not fully complied with this section, the commissioner may impose a licensing sanction 
535.21 	under section 142B.15, 142B.16, or 142B.18.

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

535.23 	Sec. 80. Laws 2024, chapter 80, article 2, section 10, subdivision 1, is amended to read:
535.24 		Subdivision 1.Sanctions; appeals; license. (a) In addition to making a license conditional 
535.25 	under section 142B.16, the commissioner may suspend or revoke the license, impose a fine, 
535.26 	or secure an injunction against the continuing operation of the program of a license holder 
535.27 	who:
535.28 	(1) does not comply with applicable law or rule;
536.1 	(2) has nondisqualifying background study information, as described in section 245C.05, 
536.2 	subdivision 4, that reflects on the license holder's ability to safely provide care to foster 
536.3 	children; or
536.4 	(3) has an individual living in the household where the licensed services are provided 
536.5 	or is otherwise subject to a background study, and the individual has nondisqualifying 
536.6 	background study information, as described in section 245C.05, subdivision 4, that reflects 
536.7 	on the license holder's ability to safely provide care to foster children.
536.8 	When applying sanctions authorized under this section, the commissioner shall consider 
536.9 	the nature, chronicity, or severity of the violation of law or rule and the effect of the violation 
536.10 	on the health, safety, or rights of persons served by the program.
536.11 	(b) If a license holder appeals the suspension or revocation of a license and the license 
536.12 	holder continues to operate the program pending a final order on the appeal, the commissioner 
536.13 	shall issue the license holder a temporary provisional license. Unless otherwise specified 
536.14 	by the commissioner, variances in effect on the date of the license sanction under appeal 
536.15 	continue under the temporary provisional license. The commissioner may include terms the 
536.16 	license holder must follow pending a final order on the appeal.If a license holder fails to 
536.17 	comply with applicable law or rule while operating under a temporary provisional license, 
536.18 	the commissioner may impose additional sanctions under this section and section 142B.16
536.19 	and may terminate any prior variance. If a temporary provisional license is set to expire, a 
536.20 	new temporary provisional license shall be issued to the license holder upon payment of 
536.21 	any fee required under section 142B.12. The temporary provisional license shall expire on 
536.22 	the date the final order is issued. If the license holder prevails on the appeal, a new 
536.23 	nonprovisional license shall be issued for the remainder of the current license period.
536.24 	(c) If a license holder is under investigation and the license issued under this chapter is 
536.25 	due to expire before completion of the investigation, the program shall be issued a new 
536.26 	license upon completion of the reapplication requirements and payment of any applicable 
536.27 	license fee. Upon completion of the investigation, a licensing sanction may be imposed 
536.28 	against the new license under this section or section 142B.16 or 142B.20.
536.29 	(d) Failure to reapply or closure of a license issued under this chapter by the license 
536.30 	holder prior to the completion of any investigation shall not preclude the commissioner 
536.31 	from issuing a licensing sanction under this section or section 142B.16 at the conclusion of 
536.32 	the investigation.

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

537.1 	Sec. 81. Laws 2024, chapter 80, article 2, section 10, subdivision 6, is amended to read:
537.2 		Subd. 6.Appeal of multiple sanctions. (a) When the license holder appeals more than 
537.3 	one licensing action or sanction that were simultaneously issued by the commissioner, the 
537.4 	license holder shall specify the actions or sanctions that are being appealed.
537.5 	(b) If there are different timelines prescribed in statutes for the licensing actions or 
537.6 	sanctions being appealed, the license holder must submit the appeal within the longest of 
537.7 	those timelines specified in statutes.
537.8 	(c) The appeal must be made in writing by certified mail or, personal service, or through 
537.9 	the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent 
537.10 	to the commissioner within the prescribed timeline with the first day beginning the day after 
537.11 	the license holder receives the certified letter. If a request is made by personal service, it 
537.12 	must be received by the commissioner within the prescribed timeline with the first day 
537.13 	beginning the day after the license holder receives the certified letter. If the appeal is made 
537.14 	through the provider hub, the appeal must be received by the commissioner within the 
537.15 	prescribed timeline with the first day beginning the day after the commissioner issued the 
537.16 	order through the hub.
537.17 	(d) When there are different timelines prescribed in statutes for the appeal of licensing 
537.18 	actions or sanctions simultaneously issued by the commissioner, the commissioner shall 
537.19 	specify in the notice to the license holder the timeline for appeal as specified under paragraph 
537.20 	(b).

537.21 	Sec. 82. Laws 2024, chapter 80, article 2, section 16, is amended by adding a subdivision 
537.22 	to read:
537.23 		Subd. 9.Licensed child-placing agency personnel requirements. (a) A licensed 
537.24 	child-placing agency must have an individual designated on staff or contract who supervises 
537.25 	the agency's casework. Supervising an agency's casework includes but is not limited to:
537.26 	(1) reviewing and approving each written home study the agency completes on 
537.27 	prospective foster parents or applicants to adopt;
537.28 	(2) ensuring ongoing compliance with licensing requirements; and
537.29 	(3) overseeing staff and ensuring they have the training and resources needed to perform 
537.30 	their responsibilities.
537.31 	(b) The individual who supervises the agency's casework must meet at least one of the 
537.32 	following qualifications:
538.1 	(1) is a licensed social worker, licensed graduate social worker, licensed independent 
538.2 	social worker, or licensed independent clinical social worker;
538.3 	(2) is a trained culturally competent professional with experience in a relevant field; or
538.4 	(3) is a licensed clinician with experience in a related field, including a clinician licensed 
538.5 	by a health-related licensing board under section 214.01, subdivision 2.
538.6 	(c) The commissioner may grant a variance under section 142B.10, subdivision 16, to 
538.7 	the requirements in this section.

538.8 	Sec. 83. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FAMILY 
538.9 	CHILD FOSTER CARE CONTINUOUS LICENSES.
 538.10 	The commissioner of human services shall develop a continuous license process for 
538.11 	family child foster care licenses. The continuous license process shall be incorporated into 
538.12 	the development of the electronic licensing inspection checklist information and provider 
538.13 	licensing and reporting hub for family child foster care.

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

538.15 	Sec. 84. REVISOR INSTRUCTION.
 538.16 	The revisor of statutes shall renumber Minnesota Statutes, section 256D.21, as Minnesota 
538.17 	Statutes, section 261.004.

538.18 	Sec. 85. REPEALER.
 538.19 	(a) Minnesota Statutes 2022, sections 245C.125; 256D.19, subdivisions 1 and 2; 256D.20, 
538.20 	subdivisions 1, 2, 3, and 4; and 256D.23, subdivisions 1, 2, and 3, are repealed.
538.21 	(b) Minnesota Statutes 2023 Supplement, section 245C.08, subdivision 2, is repealed.
538.22 	(c) Minnesota Rules, parts 9502.0425, subparts 5 and 10; and 9545.0805, subpart 1, are 
538.23 	repealed.
538.24 	(d) Laws 2024, chapter 80, article 2, section 6, subdivision 4, is repealed.

538.25 	EFFECTIVE DATE. The repeal of Minnesota Rules, part 9545.0805, subpart 1, is 
538.26 	effective July 1, 2024. Except for the repeal of Minnesota Statutes 2022, section 245C.125, 
538.27 	paragraph (a) is effective the day following final enactment.

539.1 	ARTICLE 19
539.2 	MISCELLANEOUS

539.3 	Section 1. Minnesota Statutes 2022, section 16A.055, subdivision 1a, is amended to read:
539.4 		Subd. 1a.Additional duties Program evaluation and organizational development 
539.5 	services. The commissioner may assist state agencies by providing analytical, statistical, 
539.6 	program evaluation using experimental or quasi-experimental design, and organizational 
539.7 	development services to state agencies in order to assist the agency to achieve the agency's 
539.8 	mission and to operate efficiently and effectively. For purposes of this section, "experimental 
539.9 	design" means a method of evaluating the impact of a service that uses random assignment 
539.10 	to assign participants into groups that respectively receive the studied service and those that 
539.11 	receive service as usual, so that any difference in outcomes found at the end of the evaluation 
539.12 	can be attributed to the studied service; and "quasi-experimental design" means a method 
539.13 	of evaluating the impact of a service that uses strategies other than random assignment to 
539.14 	establish statistically similar groups that respectively receive the service and those that 
539.15 	receive service as usual, so that any difference in outcomes found at the end of the evaluation 
539.16 	can be attributed to the studied service.

539.17 	Sec. 2. Minnesota Statutes 2022, section 16A.055, is amended by adding a subdivision to 
539.18 	read:
539.19 		Subd. 1b.Consultation to develop performance measures for grants. (a) The 
539.20 	commissioner must, in consultation with the commissioners of health, human services, and 
539.21 	children, youth, and families, develop an ongoing consultation schedule to create, review, 
539.22 	and revise, as necessary, performance measures, data collection, and program evaluation 
539.23 	plans for all state-funded grants administered by the commissioners of health, human 
539.24 	services, and children, youth, and families that distribute at least $1,000,000 annually.
539.25 	(b) Following the development of the ongoing consultation schedule under paragraph 
539.26 	(a), the commissioner and the commissioner of the administering agency must conduct a 
539.27 	grant program consultation in accordance with the ongoing consultation schedule. Each 
539.28 	grant program consultation must include a review of performance measures, data collection, 
539.29 	program evaluation plans, and reporting for each grant program. Following each consultation, 
539.30 	the commissioner and the commissioner of the administering agency may revise evaluation 
539.31 	metrics of a grant program. The commissioner may provide continuing support to the grant 
539.32 	program in accordance with subdivision 1a.

540.1 	Sec. 3. [137.095] EVIDENCE IN SUPPORT OF APPROPRIATION.
540.2 		Subdivision 1.Written report. Prior to the introduction of a bill proposing to appropriate 
540.3 	money to the Board of Regents of the University of Minnesota to benefit the University of 
540.4 	Minnesota's health sciences programs, the proponents of the bill must submit a written 
540.5 	report to the chairs and ranking minority members of the legislative committees with 
540.6 	jurisdiction over higher education and health and human services policy and finance setting 
540.7 	out the information required by this section. The University of Minnesota's health sciences 
540.8 	programs include the schools of medicine, nursing, public health, pharmacy, dentistry, and 
540.9 	veterinary medicine.
540.10 		Subd. 2.Contents of report. The report required under this section must include the 
540.11 	following information as specifically as possible:
540.12 	(1) the dollar amount requested;
540.13 	(2) how the requested dollar amount was calculated;
540.14 	(3) the necessity for the appropriation's purpose to be funded by public funds;
540.15 	(4) a funds flow analysis supporting the necessity analysis required by clause (3);
540.16 	(5) University of Minnesota budgeting considerations and decisions impacting the 
540.17 	necessity analysis required by clause (3);
540.18 	(6) all goals, outcomes, and purposes of the appropriation;
540.19 	(7) performance measures as defined by the University of Minnesota that the University 
540.20 	of Minnesota will utilize to ensure the funds are dedicated to the successful achievement 
540.21 	of the goals, outcomes, and purposes identified in clause (6); and
540.22 	(8) the extent to which the appropriation advances recruitment from, and training for 
540.23 	and retention of, health professionals from and in greater Minnesota and from underserved 
540.24 	communities in metropolitan areas.
540.25 		Subd. 3.Certifications for academic health. A report submitted under this section 
540.26 	must include, in addition to the information listed in subdivision 2, a certification, by the 
540.27 	University of Minnesota Vice President and Budget Director, that:
540.28 	(1) the appropriation will not be used to cover academic health clinical revenue deficits;
540.29 	(2) the goals, outcomes, and purposes of the appropriation are aligned with state goals 
540.30 	for population health improvement; and
541.1 	(3) the appropriation is aligned with the University of Minnesota's strategic plan for its 
541.2 	health sciences programs, including but not limited to shared goals and strategies for the 
541.3 	health professional schools.
541.4 		Subd. 4.Right to request. The chair of a standing committee in either house of the 
541.5 	legislature may request and obtain the reports required under this section from the chair of 
541.6 	a legislative committee with jurisdiction over higher education or health and human services 
541.7 	policy and finance.

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

541.9 	Sec. 4. Minnesota Statutes 2023 Supplement, section 142A.03, is amended by adding a 
541.10 	subdivision to read:
541.11 		Subd. 2a.Grant consultation. The commissioner must consult with the commissioner 
541.12 	of management and budget to create, review, and revise grant program performance measures 
541.13 	and to evaluate grant programs administered by the commissioner in accordance with section 
541.14 	16A.055, subdivisions 1a and 1b.

541.15 	Sec. 5. Minnesota Statutes 2022, section 144.05, is amended by adding a subdivision to 
541.16 	read:
541.17 		Subd. 8.Grant consultation. The commissioner must consult with the commissioner 
541.18 	of management and budget to create, review, and revise grant program performance measures 
541.19 	and to evaluate grant programs administered by the commissioner in accordance with section 
541.20 	16A.055, subdivisions 1a and 1b.

541.21 	Sec. 6. Minnesota Statutes 2022, section 144.292, subdivision 6, is amended to read:
541.22 		Subd. 6.Cost. (a) When a patient requests a copy of the patient's record for purposes of 
541.23 	reviewing current medical care, the provider must not charge a fee.
541.24 	(b) When a provider or its representative makes copies of patient records upon a patient's 
541.25 	request under this section, the provider or its representative may charge the patient or the 
541.26 	patient's representative no more than 75 cents per page, plus $10 for time spent retrieving 
541.27 	and copying the records, unless other law or a rule or contract provide for a lower maximum 
541.28 	charge. This limitation does not apply to x-rays. The provider may charge a patient no more 
541.29 	than the actual cost of reproducing x-rays, plus no more than $10 for the time spent retrieving 
541.30 	and copying the x-rays the following amount, unless other law or a rule or contract provide 
541.31 	for a lower maximum charge:
542.1 	(1) for paper copies, $1 per page, plus $10 for time spent retrieving and copying the 
542.2 	records;
542.3 	(2) for x-rays, a total of $30 for retrieving and reproducing x-rays; and
542.4 	(3) for electronic copies, a total of $20 for retrieving the records.
542.5 	(c) The respective maximum charges of 75 cents per page and $10 for time provided in 
542.6 	this subdivision are in effect for calendar year 1992 and may be adjusted annually each 
542.7 	calendar year as provided in this subdivision. The permissible maximum charges shall 
542.8 	change each year by an amount that reflects the change, as compared to the previous year, 
542.9 	in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 
542.10 	published by the Department of Labor. For any copies of paper records provided under 
542.11 	paragraph (b), clause (1), a provider or the provider's representative may not charge more 
542.12 	than a total of:
542.13 	(1) $10 if there are no records available;
542.14 	(2) $30 for copies of records of up to 25 pages;
542.15 	(3) $50 for copies of records of up to 100 pages;
542.16 	(4) $50, plus an additional 20 cents per page for pages 101 and above; or
542.17 	(5) $500 for any request.
542.18 	(d) A provider or its representative may charge the a $10 retrieval fee, but must not 
542.19 	charge a per page fee or x-ray fee to provide copies of records requested by a patient or the 
542.20 	patient's authorized representative if the request for copies of records is for purposes of 
542.21 	appealing a denial of Social Security disability income or Social Security disability benefits 
542.22 	under title II or title XVI of the Social Security Act; except that no fee shall be charged to 
542.23 	a patient who is receiving public assistance, or to a patient who is represented by an attorney 
542.24 	on behalf of a civil legal services program or a volunteer attorney program based on 
542.25 	indigency. Notwithstanding the foregoing, a provider or its representative must not charge 
542.26 	a fee, including a retrieval fee, to provide copies of records requested by a patient or the 
542.27 	patient's authorized representative if the request for copies of records is for purposes of 
542.28 	appealing a denial of Social Security disability income or Social Security disability benefits 
542.29 	under title II or title XVI of the Social Security Act when the patient is receiving public 
542.30 	assistance, represented by an attorney on behalf of a civil legal services program, or 
542.31 	represented by a volunteer attorney program based on indigency. The patient or the patient's 
542.32 	representative must submit one of the following to show that they are entitled to receive 
542.33 	records without charge under this paragraph:
543.1 	(1) a public assistance statement from the county or state administering assistance;
543.2 	(2) a request for records on the letterhead of the civil legal services program or volunteer 
543.3 	attorney program based on indigency; or
543.4 	(3) a benefits statement from the Social Security Administration.
543.5 	For the purpose of further appeals, a patient may receive no more than two medical record 
543.6 	updates without charge, but only for medical record information previously not provided.
543.7 	For purposes of this paragraph, a patient's authorized representative does not include units 
543.8 	of state government engaged in the adjudication of Social Security disability claims.

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

543.10 	Sec. 7. [144.2925] CONSTRUCTION.
543.11 	Sections 144.291 to 144.298 shall be construed to protect the privacy of a patient's health 
543.12 	records in a more stringent manner than provided in Code of Federal Regulations, title 45, 
543.13 	part 164. For purposes of this section, "more stringent" has the meaning given to that term 
543.14 	in Code of Federal Regulations, title 45, section 160.202, with respect to a use or disclosure 
543.15 	or the need for express legal permission from an individual to disclose individually 
543.16 	identifiable health information.

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

543.18 	Sec. 8. Minnesota Statutes 2022, section 144.293, subdivision 2, is amended to read:
543.19 		Subd. 2.Patient consent to release of records. A provider, or a person who receives 
543.20 	health records from a provider, may not release a patient's health records to a person without:
543.21 	(1) a signed and dated consent from the patient or the patient's legally authorized 
543.22 	representative authorizing the release;
543.23 	(2) specific authorization in Minnesota law; or
543.24 	(3) a representation from a provider that holds a signed and dated consent from the 
543.25 	patient authorizing the release.

543.26 	EFFECTIVE DATE. This section is effective the day following final enactment and 
543.27 	applies to health records released on or after that date.

544.1 	Sec. 9. Minnesota Statutes 2022, section 144.293, subdivision 4, is amended to read:
544.2 		Subd. 4.Duration of consent. Except as provided in this section, a consent is valid for 
544.3 	one year or for a period specified in the consent or for a different period provided by 
544.4 	Minnesota law.

544.5 	EFFECTIVE DATE. This section is effective the day following final enactment and 
544.6 	applies to health records released on or after that date.

544.7 	Sec. 10. Minnesota Statutes 2022, section 144.293, subdivision 9, is amended to read:
544.8 		Subd. 9.Documentation of release. (a) In cases where a provider releases health records 
544.9 	without patient consent as authorized by Minnesota law, the release must be documented 
544.10 	in the patient's health record. In the case of a release under section 144.294, subdivision 2, 
544.11 	the documentation must include the date and circumstances under which the release was 
544.12 	made, the person or agency to whom the release was made, and the records that were released.
544.13 	(b) When a health record is released using a representation from a provider that holds a 
544.14 	consent from the patient, the releasing provider shall document:
544.15 	(1) the provider requesting the health records;
544.16 	(2) the identity of the patient;
544.17 	(3) the health records requested; and
544.18 	(4) the date the health records were requested.

544.19 	EFFECTIVE DATE. This section is effective the day following final enactment and 
544.20 	applies to health records released on or after that date.

544.21 	Sec. 11. Minnesota Statutes 2022, section 144.293, subdivision 10, is amended to read:
544.22 		Subd. 10.Warranties regarding consents, requests, and disclosures. (a) When 
544.23 	requesting health records using consent, a person warrants that the consent:
544.24 	(1) contains no information known to the person to be false; and
544.25 	(2) accurately states the patient's desire to have health records disclosed or that there is 
544.26 	specific authorization in Minnesota law.
544.27 	(b) When requesting health records using consent, or a representation of holding a 
544.28 	consent, a provider warrants that the request:
544.29 	(1) contains no information known to the provider to be false;
545.1 	(2) accurately states the patient's desire to have health records disclosed or that there is 
545.2 	specific authorization in Minnesota law; and
545.3 	(3) does not exceed any limits imposed by the patient in the consent.
545.4 	(c) When disclosing health records, a person releasing health records warrants that the 
545.5 	person:
545.6 	(1) has complied with the requirements of this section regarding disclosure of health 
545.7 	records;
545.8 	(2) knows of no information related to the request that is false; and
545.9 	(3) has complied with the limits set by the patient in the consent.

545.10 	EFFECTIVE DATE. This section is effective the day following final enactment and 
545.11 	applies to health records released on or after that date.

545.12 	Sec. 12. Minnesota Statutes 2022, section 152.22, subdivision 14, is amended to read:
545.13 		Subd. 14.Qualifying medical condition. "Qualifying medical condition" means a 
545.14 	diagnosis of any of the following conditions:
545.15 	(1) cancer, if the underlying condition or treatment produces one or more of the following:
545.16 	(i) severe or chronic pain;
545.17 	(ii) nausea or severe vomiting; or
545.18 	(iii) cachexia or severe wasting;
545.19 	(2) glaucoma;
545.20 	(3) human immunodeficiency virus or acquired immune deficiency syndrome;
545.21 	(4) Tourette's syndrome;
545.22 	(5) amyotrophic lateral sclerosis;
545.23 	(6) seizures, including those characteristic of epilepsy;
545.24 	(7) severe and persistent muscle spasms, including those characteristic of multiple 
545.25 	sclerosis;
545.26 	(8) inflammatory bowel disease, including Crohn's disease;
545.27 	(9) terminal illness, with a probable life expectancy of under one year, if the illness or 
545.28 	its treatment produces one or more of the following:
545.29 	(i) severe or chronic pain;
546.1 	(ii) nausea or severe vomiting; or
546.2 	(iii) cachexia or severe wasting; or
546.3 	(10) any other medical condition or its treatment approved by the commissioner that is:
546.4 	(i)  approved by a patient's health care practitioner; or
546.5 	(ii) if the patient is a veteran receiving care from the United States Department of Veterans 
546.6 	Affairs, certified under section 152.27, subdivision 3a.

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

546.8 	Sec. 13. Minnesota Statutes 2022, section 152.27, subdivision 2, is amended to read:
546.9 		Subd. 2.Commissioner duties. (a) The commissioner shall:
546.10 	(1) give notice of the program to health care practitioners in the state who are eligible 
546.11 	to serve as health care practitioners and explain the purposes and requirements of the 
546.12 	program;
546.13 	(2) allow each health care practitioner who meets or agrees to meet the program's 
546.14 	requirements and who requests to participate, to be included in the registry program to 
546.15 	collect data for the patient registry;
546.16 	(3) provide explanatory information and assistance to each health care practitioner in 
546.17 	understanding the nature of therapeutic use of medical cannabis within program requirements;
546.18 	(4) create and provide a certification to be used by a health care practitioner for the 
546.19 	practitioner to certify whether a patient has been diagnosed with a qualifying medical 
546.20 	condition and include in the certification an option for the practitioner to certify whether 
546.21 	the patient, in the health care practitioner's medical opinion, is developmentally or physically 
546.22 	disabled and, as a result of that disability, the patient requires assistance in administering 
546.23 	medical cannabis or obtaining medical cannabis from a distribution facility;
546.24 	(5) supervise the participation of the health care practitioner in conducting patient 
546.25 	treatment and health records reporting in a manner that ensures stringent security and 
546.26 	record-keeping requirements and that prevents the unauthorized release of private data on 
546.27 	individuals as defined by section 13.02;
546.28 	(6) develop safety criteria for patients with a qualifying medical condition as a 
546.29 	requirement of the patient's participation in the program, to prevent the patient from 
546.30 	undertaking any task under the influence of medical cannabis that would constitute negligence 
546.31 	or professional malpractice on the part of the patient; and
547.1 	(7) conduct research and studies based on data from health records submitted to the 
547.2 	registry program and submit reports on intermediate or final research results to the legislature 
547.3 	and major scientific journals. The commissioner may contract with a third party to complete 
547.4 	the requirements of this clause. Any reports submitted must comply with section 152.28, 
547.5 	subdivision 2.
547.6 	(b) The commissioner may add a delivery method under section 152.22, subdivision 6, 
547.7 	or add, remove, or modify a qualifying medical condition under section 152.22, subdivision 
547.8 	14, upon a petition from a member of the public or the task force on medical cannabis 
547.9 	therapeutic research or as directed by law. The commissioner shall evaluate all petitions to 
547.10 	add a qualifying medical condition or to remove or modify an existing qualifying medical 
547.11 	condition submitted by the task force on medical cannabis therapeutic research or as directed 
547.12 	by law and may make the addition, removal, or modification if the commissioner determines 
547.13 	the addition, removal, or modification is warranted based on the best available evidence 
547.14 	and research. If the commissioner wishes to add a delivery method under section 152.22, 
547.15 	subdivision 6, or add or remove a qualifying medical condition under section 152.22, 
547.16 	subdivision 14, the commissioner must notify the chairs and ranking minority members of 
547.17 	the legislative policy committees having jurisdiction over health and public safety of the 
547.18 	addition or removal and the reasons for its addition or removal, including any written 
547.19 	comments received by the commissioner from the public and any guidance received from 
547.20 	the task force on medical cannabis research, by January 15 of the year in which the 
547.21 	commissioner wishes to make the change. The change shall be effective on August 1 of that 
547.22 	year, unless the legislature by law provides otherwise.

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

547.24 	Sec. 14. Minnesota Statutes 2022, section 152.27, is amended by adding a subdivision to 
547.25 	read:
547.26 		Subd. 3a.Application procedure for veterans. (a) Beginning July 1, 2024, the 
547.27 	commissioner shall establish an alternative certification procedure for veterans to enroll in 
547.28 	the patient registry program.
547.29 	(b) A patient who is a veteran receiving care from the United States Department of 
547.30 	Veterans Affairs and is seeking to enroll in the registry program must submit a copy of the 
547.31 	patient's veteran health identification card issued by the United States Department of Veterans 
547.32 	Affairs and an application established by the commissioner to confirm that veteran has been 
547.33 	diagnosed with a condition that may benefit from the therapeutic use of medical cannabis.

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

548.1 	Sec. 15. Minnesota Statutes 2022, section 152.27, subdivision 6, is amended to read:
548.2 		Subd. 6.Patient enrollment. (a) After receipt of a patient's application, application fees, 
548.3 	and signed disclosure, the commissioner shall enroll the patient in the registry program and 
548.4 	issue the patient and patient's registered designated caregiver or parent, legal guardian, or 
548.5 	spouse, if applicable, a registry verification. The commissioner shall approve or deny a 
548.6 	patient's application for participation in the registry program within 30 days after the 
548.7 	commissioner receives the patient's application and application fee. The commissioner may 
548.8 	approve applications up to 60 days after the receipt of a patient's application and application 
548.9 	fees until January 1, 2016. A patient's enrollment in the registry program shall only be 
548.10 	denied if the patient:
548.11 	(1) does not have certification from a health care practitioner or, if the patient is a veteran 
548.12 	receiving care from the United States Department of Veterans Affairs, the documentation 
548.13 	required under subdivision 3a that the patient has been diagnosed with a qualifying medical 
548.14 	condition;
548.15 	(2) has not signed and returned the disclosure form required under subdivision 3, 
548.16 	paragraph (c), to the commissioner;
548.17 	(3) does not provide the information required;
548.18 	(4) has previously been removed from the registry program for violations of section 
548.19 	152.30 or 152.33; or
548.20 	(5) provides false information.
548.21 	(b) The commissioner shall give written notice to a patient of the reason for denying 
548.22 	enrollment in the registry program.
548.23 	(c) Denial of enrollment into the registry program is considered a final decision of the 
548.24 	commissioner and is subject to judicial review under the Administrative Procedure Act 
548.25 	pursuant to chapter 14.
548.26 	(d) A patient's enrollment in the registry program may only be revoked upon the death 
548.27 	of the patient or if a patient violates a requirement under section 152.30 or 152.33.
548.28 	(e) The commissioner shall develop a registry verification to provide to the patient, the 
548.29 	health care practitioner identified in the patient's application, and to the manufacturer. The 
548.30 	registry verification shall include:
548.31 	(1) the patient's name and date of birth;
548.32 	(2) the patient registry number assigned to the patient; and
549.1 	(3) the name and date of birth of the patient's registered designated caregiver, if any, or 
549.2 	the name of the patient's parent, legal guardian, or spouse if the parent, legal guardian, or 
549.3 	spouse will be acting as a caregiver.

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

549.5 	Sec. 16. Minnesota Statutes 2022, section 245.096, is amended to read:
549.6 	245.096 CHANGES TO GRANT PROGRAMS.
549.7 	Prior to implementing any substantial changes to a grant funding formula disbursed 
549.8 	through allocations administered by the commissioner, the commissioner must provide a 
549.9 	report on the nature of the changes, the effect the changes will have, whether any funding 
549.10 	will change, and other relevant information, to the chairs and ranking minority members of 
549.11 	the legislative committees with jurisdiction over human services. The report must be provided 
549.12 	prior to the start of a regular session, and the proposed changes cannot be implemented until 
549.13 	after the adjournment of that regular session.

549.14 	Sec. 17. Minnesota Statutes 2023 Supplement, section 245C.31, subdivision 1, is amended 
549.15 	to read:
549.16 		Subdivision 1.Board determines disciplinary or corrective action. (a) The 
549.17 	commissioner shall notify a health-related licensing board as defined in section 214.01, 
549.18 	subdivision 2, if the commissioner determines that an individual who is licensed by the 
549.19 	health-related licensing board and who is included on the board's roster list provided in 
549.20 	accordance with subdivision 3a is responsible for substantiated maltreatment under section 
549.21 	626.557 or chapter 260E, in accordance with subdivision 2. Upon receiving notification
549.22 	Except as provided in paragraph (b), instead of the commissioner making a decision regarding 
549.23 	disqualification based on maltreatment for any study subject who is regulated by a 
549.24 	health-related licensing board, the health-related licensing board shall make a determination 
549.25 	as to whether to impose disciplinary or corrective action under chapter 214.
549.26 	(b) The prohibition on disqualification in paragraph (a) does not apply to a background 
549.27 	study of an individual regulated by a health-related licensing board if the individual's study 
549.28 	is related to child foster care, adult foster care, or family child care licensure.

549.29 	Sec. 18. Minnesota Statutes 2022, section 256.01, is amended by adding a subdivision to 
549.30 	read:
549.31 		Subd. 2c.Grant consultation. The commissioner must consult with the commissioner 
549.32 	of management and budget to create, review, and revise grant program performance measures 
550.1 	and to evaluate grant programs administered by the commissioner in accordance with section 
550.2 	16A.055, subdivisions 1a and 1b.

550.3 	Sec. 19. Minnesota Statutes 2022, section 256.01, subdivision 41, is amended to read:
550.4 		Subd. 41.Reports on interagency agreements and intra-agency transfers. (a) 
550.5 	Beginning July 1, 2024, the commissioner of human services shall provide quarterly reports 
550.6 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
550.7 	over health and human services policy and finance on:
550.8 	(1) interagency agreements or service-level agreements and any renewals or extensions 
550.9 	of existing interagency or service-level agreements with a state department under section 
550.10 	15.01, state agency under section 15.012, or the Department of Information Technology 
550.11 	Services, with a value of more than $100,000, or related agreements with the same department 
550.12 	or agency with a cumulative value of more than $100,000; and
550.13 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
550.14 	agencies.
550.15 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
550.16 	amount, purpose, and effective date of the agreement, the duration of the agreement, and a 
550.17 	copy of the agreement.
550.18 	(b) This subdivision expires December 31, 2034.

550.19 	Sec. 20. Minnesota Statutes 2022, section 256B.79, subdivision 6, is amended to read:
550.20 		Subd. 6.Report. (a) By January 31, 2021 2025, and every two years thereafter, the 
550.21 	commissioner shall report to the chairs and ranking minority members of the legislative 
550.22 	committees with jurisdiction over health and human services policy and finance on the 
550.23 	status and outcomes of the grant program. The report must:
550.24 	(1) describe the capacity of collaboratives receiving grants under this section;
550.25 	(2) contain aggregate information about enrollees served within targeted populations;
550.26 	(3) describe the utilization of enhanced prenatal services;
550.27 	(4) for enrollees identified with maternal substance use disorders, describe the utilization 
550.28 	of substance use treatment and dispositions of any child protection cases;
550.29 	(5) contain data on outcomes within targeted populations and compare these outcomes 
550.30 	to outcomes statewide, using standard categories of race and ethnicity; and
551.1 	(6) include recommendations for continuing the program or sustaining improvements 
551.2 	through other means.
551.3 	(b) This subdivision expires December 31, 2034.

551.4 	Sec. 21. Minnesota Statutes 2022, section 256K.45, subdivision 2, is amended to read:
551.5 		Subd. 2.Homeless youth report. (a) The commissioner shall prepare a biennial report, 
551.6 	beginning in February 2015 January 1, 2025, which provides meaningful information to 
551.7 	the chairs and ranking minority members of the legislative committees having with
551.8 	jurisdiction over the issue of homeless youth, that includes, but is not limited to: (1) a list 
551.9 	of the areas of the state with the greatest need for services and housing for homeless youth, 
551.10 	and the level and nature of the needs identified; (2) details about grants made, including 
551.11 	shelter-linked youth mental health grants under section 256K.46; (3) the distribution of 
551.12 	funds throughout the state based on population need; (4) follow-up information, if available, 
551.13 	on the status of homeless youth and whether they have stable housing two years after services 
551.14 	are provided; and (5) any other outcomes for populations served to determine the 
551.15 	effectiveness of the programs and use of funding.
551.16 	(b) This subdivision expires December 31, 2034.

551.17 	Sec. 22. Minnesota Statutes 2023 Supplement, section 342.01, subdivision 63, is amended 
551.18 	to read:
551.19 		Subd. 63.Qualifying medical condition. "Qualifying medical condition" means a 
551.20 	diagnosis of any of the following conditions:
551.21 	(1) Alzheimer's disease;
551.22 	(2) autism spectrum disorder that meets the requirements of the fifth edition of the 
551.23 	Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric 
551.24 	Association;
551.25 	(3) cancer, if the underlying condition or treatment produces one or more of the following:
551.26 	(i) severe or chronic pain;
551.27 	(ii) nausea or severe vomiting; or
551.28 	(iii) cachexia or severe wasting;
551.29 	(4) chronic motor or vocal tic disorder;
551.30 	(5) chronic pain;
552.1 	(6) glaucoma;
552.2 	(7) human immunodeficiency virus or acquired immune deficiency syndrome;
552.3 	(8) intractable pain as defined in section 152.125, subdivision 1, paragraph (c);
552.4 	(9) obstructive sleep apnea;
552.5 	(10) post-traumatic stress disorder;
552.6 	(11) Tourette's syndrome;
552.7 	(12) amyotrophic lateral sclerosis;
552.8 	(13) seizures, including those characteristic of epilepsy;
552.9 	(14) severe and persistent muscle spasms, including those characteristic of multiple 
552.10 	sclerosis;
552.11 	(15) inflammatory bowel disease, including Crohn's disease;
552.12 	(16) irritable bowel syndrome;
552.13 	(17) obsessive-compulsive disorder;
552.14 	(18) sickle cell disease;
552.15 	(19) terminal illness, with a probable life expectancy of under one year, if the illness or 
552.16 	its treatment produces one or more of the following:
552.17 	(i) severe or chronic pain;
552.18 	(ii) nausea or severe vomiting; or
552.19 	(iii) cachexia or severe wasting; or
552.20 	(20) any other medical condition or its treatment approved by the office that is:
552.21 	(i) approved by a patient's health care practitioner; or
552.22 	(ii) if the patient is a veteran receiving care from the United States Department of Veterans 
552.23 	Affairs, certified under section 342.52, subdivision 3.

552.24 	EFFECTIVE DATE. This section is effective March 1, 2025.

552.25 	Sec. 23. Minnesota Statutes 2023 Supplement, section 342.52, subdivision 3, is amended 
552.26 	to read:
552.27 		Subd. 3.Application procedure for veterans. (a) The Division of Medical Cannabis
552.28 	office shall establish an alternative certification procedure for veterans who receive care 
553.1 	from the United States Department of Veterans Affairs to confirm that the veteran has been 
553.2 	diagnosed with a qualifying medical condition enroll in the patient registry program.
553.3 	(b) A patient who is also a veteran receiving care from the United States Department of 
553.4 	Veterans Affairs and is seeking to enroll in the registry program must submit to the Division 
553.5 	of Medical Cannabis office a copy of the patient's veteran health identification card issued 
553.6 	by the United States Department of Veterans Affairs and an application established by the 
553.7 	Division of Medical Cannabis that includes the information identified in subdivision 2, 
553.8 	paragraph (a), and the additional information required by the Division of Medical Cannabis 
553.9 	to certify that the patient has been diagnosed with a qualifying medical condition office to 
553.10 	confirm that veteran has been diagnosed with a condition that may benefit from the 
553.11 	therapeutic use of medical cannabis.

553.12 	EFFECTIVE DATE. This section is effective March 1, 2025.

553.13 	Sec. 24. Minnesota Statutes 2023 Supplement, section 342.53, is amended to read:
553.14 	342.53 DUTIES OF OFFICE OF CANNABIS MANAGEMENT; REGISTRY 
553.15 	PROGRAM.
553.16 	The office may add an allowable form of medical cannabinoid product, and may add or 
553.17 	modify a qualifying medical condition upon its own initiative, upon a petition from a member 
553.18 	of the public or from the Cannabis Advisory Council or as directed by law. The office must 
553.19 	evaluate all petitions and must make the addition or modification if the office determines 
553.20 	that the addition or modification is warranted by the best available evidence and research. 
553.21 	If the office wishes to add an allowable form or add or modify a qualifying medical condition, 
553.22 	the office must notify the chairs and ranking minority members of the legislative committees 
553.23 	and divisions with jurisdiction over health finance and policy by January 15 of the year in 
553.24 	which the change becomes effective. In this notification, the office must specify the proposed 
553.25 	addition or modification, the reasons for the addition or modification, any written comments 
553.26 	received by the office from the public about the addition or modification, and any guidance 
553.27 	received from the Cannabis Advisory Council. An addition or modification by the office 
553.28 	under this subdivision becomes effective on August 1 of that year unless the legislature by 
553.29 	law provides otherwise.

553.30 	EFFECTIVE DATE. This section is effective March 1, 2025.

553.31 	Sec. 25. Laws 2023, chapter 70, article 11, section 13, subdivision 8, is amended to read:
553.32 		Subd. 8.Expiration. This section expires June 30, 2027 2028.

554.1 	Sec. 26. ANNUAL REPORT TO LEGISLATURE; USE OF APPROPRIATION 
554.2 	FUNDS.
 554.3 	By December 15, 2025, and every year thereafter, the Board of Regents of the University 
554.4 	of Minnesota must submit a report to the chairs and ranking minority members of the 
554.5 	legislative committees with primary jurisdiction over higher education and health and human 
554.6 	services policy and finance on the use of all appropriations for the benefit of the University 
554.7 	of Minnesota's health sciences programs, including:
554.8 	(1) material changes to the funds flow analysis required by Minnesota Statutes, section 
554.9 	137.095, subdivision 2, clause (4);
554.10 	(2) changes to the University of Minnesota's anticipated uses of each appropriation;
554.11 	(3) the results of the performance measures required by Minnesota Statutes, section 
554.12 	137.095, subdivision 2, clause (7); and
554.13 	(4) current and anticipated achievement of the goals, outcomes, and purposes of each 
554.14 	appropriation.

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

554.16 	Sec. 27. DIRECTION TO COMMISSIONER OF HEALTH; HEALTH 
554.17 	PROFESSIONS WORKFORCE ADVISORY COUNCIL.
 554.18 		Subdivision 1.Health professions workforce advisory council. The commissioner of 
554.19 	health, in consultation with the University of Minnesota and the Minnesota State HealthForce 
554.20 	Center of Excellence, shall provide recommendations to the legislature for the creation of 
554.21 	a health professions workforce advisory council to:
554.22 	(1) research and advise the legislature and the Minnesota Office of Higher Education 
554.23 	on the status of the health workforce who are in training and on the need for additional or 
554.24 	different training opportunities;
554.25 	(2) provide information and analysis on health workforce needs and trends, upon request, 
554.26 	to the legislature, any state department, or any other entity the advisory council deems 
554.27 	appropriate;
554.28 	(3) review and comment on legislation relevant to Minnesota's health workforce; and
554.29 	(4) study and provide recommendations regarding the following:
554.30 	(i) health workforce supply, including:
554.31 	(A) employment trends and demand;
555.1 	(B) strategies that entities in Minnesota are using or may use to address health workforce 
555.2 	shortages, recruitment, and retention; and
555.3 	(C) future investments to increase the supply of health care professionals, with particular 
555.4 	focus on critical areas of need within Minnesota;
555.5 	(ii) options for training and educating the health workforce, including:
555.6 	(A) increasing the diversity of health professions workers to reflect Minnesota's 
555.7 	communities;
555.8 	(B) addressing the maldistribution of primary, mental health, nursing, and dental providers 
555.9 	in greater Minnesota and in underserved communities in metropolitan areas;
555.10 	(C) increasing interprofessional training and clinical practice;
555.11 	(D) addressing the need for increased quality faculty to train an increased workforce; 
555.12 	and
555.13 	(E) developing advancement paths or career ladders for health care professionals;
555.14 	(iii) increasing funding for strategies to diversify and address gaps in the health workforce, 
555.15 	including:
555.16 	(A) increasing access to financing for graduate medical education;
555.17 	(B) expanding pathway programs to increase awareness of the health care professions 
555.18 	among high school, undergraduate, and community college students and engaging the current 
555.19 	health workforce in those programs;
555.20 	(C) reducing or eliminating tuition for entry-level health care positions that offer 
555.21 	opportunities for future advancement in high-demand settings and expanding other existing 
555.22 	financial support programs such as loan forgiveness and scholarship programs;
555.23 	(D) incentivizing recruitment from greater Minnesota and recruitment and retention for 
555.24 	providers practicing in greater Minnesota and in underserved communities in metropolitan 
555.25 	areas; and
555.26 	(E) expanding existing programs, or investing in new programs, that provide wraparound 
555.27 	support services to the existing health care workforce, especially people of color and 
555.28 	professionals from other underrepresented identities, to acquire training and advance within 
555.29 	the health care workforce; and
555.30 	(iv) other Minnesota health workforce priorities as determined by the advisory council.
556.1 		Subd. 2.Report to the legislature. On or before February 1, 2025, the commissioner 
556.2 	of health shall submit a report to the chairs and ranking minority members of the legislative 
556.3 	committees with jurisdiction over health and human services and higher education finance 
556.4 	and policy with recommendations for the creation of a health professions workforce advisory 
556.5 	council as described in subdivision 1. The report must include recommendations regarding:
556.6 	(1) membership of the advisory council;
556.7 	(2) funding sources and estimated costs for the advisory council;
556.8 	(3) existing sources of workforce data for the advisory council to perform its duties;
556.9 	(4) necessity for and options to obtain new data for the advisory council to perform its 
556.10 	duties;
556.11 	(5) additional duties of the advisory council;
556.12 	(6) proposed legislation to establish the advisory council;
556.13 	(7) similar health workforce advisory councils in other states; and
556.14 	(8) advisory council reporting requirements.

556.15 	Sec. 28. REQUEST FOR INFORMATION; EVALUATION OF STATEWIDE 
556.16 	HEALTH CARE NEEDS AND CAPACITY AND PROJECTIONS OF FUTURE 
556.17 	HEALTH CARE NEEDS.
 556.18 	(a) By November 1, 2024, the commissioner of health must publish a request for 
556.19 	information to assist the commissioner in a future comprehensive evaluation of current 
556.20 	health care needs and capacity in Minnesota and projections of future health care needs in 
556.21 	Minnesota based on population and provider characteristics. The request for information:
556.22 	(1) must provide guidance on defining the scope of the study and assist in answering 
556.23 	methodological questions that will inform the development of a request for proposals to 
556.24 	contract for performance of the study; and
556.25 	(2) may address topics that include but are not limited to how to define health care 
556.26 	capacity, expectations for capacity by geography or service type, how to consider health 
556.27 	centers that have areas of particular expertise or services that generally have a higher margin, 
556.28 	how hospital-based services should be considered as compared with evolving 
556.29 	nonhospital-based services, the role of technology in service delivery, health care workforce 
556.30 	supply issues, and other issues related to data or methods.
557.1 	(b) By February 1, 2025, the commissioner must submit a report to the chairs and ranking 
557.2 	minority members of the legislative committees with jurisdiction over health care, with the 
557.3 	results of the request for information and recommendations regarding conducting a 
557.4 	comprehensive evaluation of current health care needs and capacity in Minnesota and 
557.5 	projections of future health care needs in the state.

557.6 	ARTICLE 20
557.7 	FORECAST ADJUSTMENTS

557.8	Section 1. HUMAN SERVICES FORECAST ADJUSTMENTS.
 	
557.9 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
557.10 	parentheses, subtracted from the appropriations in Laws 2023, chapter 61, article 9, and 
557.11 	Laws 2023, chapter 70, article 20, to the commissioner of human services from the general 
557.12 	fund or other named fund for the purposes specified in section 2 and are available for the 
557.13 	fiscal years indicated for each purpose. The figures "2024" and "2025" used in this article 
557.14 	mean that the addition to or subtraction from the appropriation listed under them is available 
557.15 	for the fiscal year ending June 30, 2024, or June 30, 2025, respectively.

557.16				APPROPRIATIONS
	
557.17				Available for the Year
	
557.18				Ending June 30
	
557.19					2024
		2025

557.20
557.21	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

557.22	Subdivision 1.Total Appropriation
 	$
	137,604,000
	$
	329,432,000

557.23	Appropriations by Fund
	
557.24	General Fund
	139,746,000
	325,606,000
	
557.25
557.26	Health Care Access 
Fund
	10,542,000
	6,224,000
	
557.27	Federal TANF
	(12,684,000)
	(2,398,000)

557.28	Subd. 2.Forecasted Programs

557.29	(a) MFIP/DWP

557.30	Appropriations by Fund
	
557.31	General Fund
	(5,990,000)
	(2,793,000)
	
557.32	Federal TANF
	(12,684,000)
	(2,398,000)

558.1	(b) MFIP Child Care Assistance
		(36,726,000)
		(26,004,000)

558.2	(c) General Assistance
		(567,000)
		292,000

558.3	(d) Minnesota Supplemental Aid
		1,424,000
		1,500,000

558.4	(e) Housing Support
		11,200,000
		14,667,000

558.5	(f) Northstar Care for Children
		(3,697,000)
		(11,309,000)

558.6	(g) MinnesotaCare
		10,542,000
		6,224,000
	
558.7 	These appropriations are from the health care 
558.8 	access fund.

558.9	(h) Medical Assistance
		180,321,000
		352,357,000

558.10	(i) Behavioral Health Fund
		(6,219,000)
		(3,104,000)

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

558.12 	ARTICLE 21
558.13 	APPROPRIATIONS

558.14	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
558.15 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
558.16 	parentheses, subtracted from the appropriations in Laws 2023, chapter 61, article 9; Laws 
558.17 	2023, chapter 70, article 20; and Laws 2023, chapter 74, section 6, to the agencies and for 
558.18 	the purposes specified in this article. The appropriations are from the general fund or other 
558.19 	named fund and are available for the fiscal years indicated for each purpose. The figures 
558.20 	"2024" and "2025" used in this article mean that the addition to or subtraction from the 
558.21 	appropriation listed under them is available for the fiscal year ending June 30, 2024, or June 
558.22 	30, 2025, respectively. Base adjustments mean the addition to or subtraction from the base 
558.23 	level adjustment set in Laws 2023, chapter 61, article 9; Laws 2023, chapter 70, article 20; 
558.24 	and Laws 2023, chapter 74, section 6. Supplemental appropriations and reductions to 
558.25 	appropriations for the fiscal year ending June 30, 2024, are effective the day following final 
558.26 	enactment unless a different effective date is explicit.

558.27				APPROPRIATIONS
	
558.28				Available for the Year
	
558.29				Ending June 30
	
558.30					2024
		2025

558.31
558.32	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

558.33	Subdivision 1.Total Appropriation
 	$
	(9,587,000)
	$
	43,057,000

559.1	Appropriations by Fund
	
559.2		2024
	2025
	
559.3	General
	(7,912,000)
	41,682,000
	
559.4	Health Care Access
	(1,675,000)
	1,375,000
	
559.5 	The amounts that may be spent for each 
559.6 	purpose are specified in the following 
559.7 	subdivisions.

559.8	Subd. 2.Central Office; Operations

559.9	Appropriations by Fund
	
559.10	General
	2,369,000
	8,039,000
	
559.11	Health Care Access
	-0-
	572,000
	
559.12	Federal TANF
	(990,000)
	(1,094,000)
	
559.13 	(a) Social Services Information System 
559.14 	(SSIS). $10,084,000 in fiscal year 2025 is for 
559.15 	information technology improvements to the 
559.16 	SSIS. This is a onetime appropriation.
559.17 	(b) Extended Availability. $136,000 of the 
559.18 	general fund appropriation in fiscal year 2025 
559.19 	is available until June 30, 2027.
559.20 	(c) Base Level Adjustment. The general fund 
559.21 	base is increased by $4,569,000 in fiscal year 
559.22 	2026 and $4,511,000 in fiscal year 2027. The 
559.23 	health care access fund base is increased by 
559.24 	$115,000 in fiscal year 2026 and $115,000 in 
559.25 	fiscal year 2027.

559.26	Subd. 3.Central Office; Children and Families

559.27	Appropriations by Fund
	
559.28	General
	2,598,000
	7,665,000
	
559.29	Federal TANF
	990,000
	1,094,000
	
559.30 	(a) Child Protection Advisory Council.
559.31 	$466,000 in fiscal year 2025 is from the 
559.32 	general fund for the Child Protection Advisory 
559.33 	Council under Minnesota Statutes, section 
560.1 	260E.021. This is a onetime appropriation and 
560.2 	is available through June 30, 2027.
560.3 	(b) Pregnant and Parenting Homeless 
560.4 	Youth Study. $150,000 in fiscal year 2025 is 
560.5 	from the general fund for a grant to the Wilder 
560.6 	Foundation to study the statewide numbers 
560.7 	and unique needs of pregnant and parenting 
560.8 	youth experiencing homelessness and best 
560.9 	practices in supporting those youth within 
560.10 	programming, emergency shelter, and housing 
560.11 	settings. This is a onetime appropriation and 
560.12 	is available until June 30, 2026.
560.13 	(c) Minnesota African American Family 
560.14 	Preservation and Child Welfare 
560.15 	Disproportionality. $1,132,000 in fiscal year 
560.16 	2025 is for the African American Child 
560.17 	Well-Being Unit to hire full-time staff 
560.18 	members. This is a onetime appropriation.
560.19 	(d) Base Level Adjustment. The general fund 
560.20 	base is increased by $5,208,000 in fiscal year 
560.21 	2026 and $5,208,000 in fiscal year 2027.

560.22	Subd. 4.Central Office; Health Care

560.23	Appropriations by Fund
	
560.24	General
	(3,216,000)
	3,752,000
	
560.25	Health Care Access
	(1,675,000)
	1,675,000
	
560.26 	Base Level Adjustment. The general fund 
560.27 	base is increased by $154,000 in fiscal year 
560.28 	2026 and $96,000 in fiscal year 2027.

560.29
560.30	Subd. 5.Central Office; Behavioral Health, Deaf 
and Hard-of-Hearing, and Housing Services
 		(136,000)
		1,863,000
	
560.31 	Medical Assistance Mental Health Benefit 
560.32 	Development. $1,727,000 in fiscal year 2025 
560.33 	is to: (1) conduct an analysis to identify 
560.34 	existing or pending Medicaid Clubhouse 
561.1 	benefits in other states, federal authorities 
561.2 	used, populations served, service and 
561.3 	reimbursement design, and accreditation 
561.4 	standards; (2) consult with providers, 
561.5 	advocates, Tribal Nations, counties, people 
561.6 	with lived experience as or with a child 
561.7 	experiencing mental health conditions, and 
561.8 	other interested community members to 
561.9 	develop a medical assistance state plan 
561.10 	covered benefit to provide intensive residential 
561.11 	mental health services for children and youth; 
561.12 	(3) consult with providers, advocates, Tribal 
561.13 	Nations, counties, people with lived 
561.14 	experience as or with a child in a mental health 
561.15 	crisis, and other interested community 
561.16 	members to develop a covered benefit under 
561.17 	medical assistance to provide residential 
561.18 	mental health crisis stabilization for children; 
561.19 	and (4) develop a First Episode Psychosis 
561.20 	Coordinated Specialty Care (FEP-CSC) 
561.21 	medical assistance benefit. This is a onetime 
561.22 	appropriation and is available until June 30, 
561.23 	2027.

561.24	Subd. 6.Forecasted Programs; MinnesotaCare
 		-0-
		144,000
	
561.25 	(a) This appropriation is from the health care 
561.26 	access fund.
561.27 	(b) Base Level Adjustment. The health care 
561.28 	access fund base is increased by $696,000 in 
561.29 	fiscal year 2026 and $1,189,000 in fiscal year 
561.30 	2027.

561.31
561.32	Subd. 7.Forecasted Programs; Medical 
Assistance

561.33	Appropriations by Fund
	
561.34	General
	-0-
	7,059,000
	
561.35	Health Care Access
	-0-
	(1,016,000)
	
562.1 	Base Level Adjustment. The health care 
562.2 	access fund base is decreased by $1,111,000 
562.3 	in fiscal year 2026 and $1,604,000 in fiscal 
562.4 	year 2027.

562.5
562.6	Subd. 8.Forecasted Programs; Behavioral 
Health Fund
 		-0-
		127,000

562.7
562.8	Subd. 9.Grant Programs; Child Care 
Development Grants
 		-0-
		1,000,000
	
562.9 	(a) Professional Development for Child 
562.10 	Care Provider Associate Credential 
562.11 	Coursework. $500,000 in fiscal year 2025 is 
562.12 	for distribution to child care resource and 
562.13 	referral programs to coordinate professional 
562.14 	development opportunities for child care 
562.15 	providers under Minnesota Statutes, section 
562.16 	119B.19, subdivision 7, clause (5), for training 
562.17 	related to obtaining a child development 
562.18 	associate credential. This is a onetime 
562.19 	appropriation and is available through June 
562.20 	30, 2027. Notwithstanding Minnesota Statutes, 
562.21 	section 16B.98, subdivision 14, the amount 
562.22 	for administrative costs under this paragraph 
562.23 	is $0.
562.24 	(b) Child Care Improvement Grants.
562.25 	$500,000 in fiscal year 2025 is for the child 
562.26 	care improvement grant program under 
562.27 	Minnesota Statutes, section 119B.25, 
562.28 	subdivision 3, paragraph (a), clause (7). This 
562.29 	is a onetime appropriation. Notwithstanding 
562.30 	Minnesota Statutes, section 16B.98, 
562.31 	subdivision 14, the amount for administrative 
562.32 	costs under this paragraph is $0.

563.1
563.2	Subd. 10.Grant Programs; Children's Services 
Grants
 		-0-
		550,000
	
563.3 	Kinship Navigation Grant Program.
563.4 	$550,000 in fiscal year 2025 is for the kinship 
563.5 	navigator grant program under Minnesota 
563.6 	Statutes, section 256E.40. This is a onetime 
563.7 	appropriation. Notwithstanding Minnesota 
563.8 	Statutes, section 16B.98, subdivision 14, the 
563.9 	amount for administrative costs under this 
563.10 	paragraph is $0.

563.11
563.12	Subd. 11.Grant Programs; Children and 
Community Support Grants
 		-0-
		(1,704,000)
	
563.13 	Minnesota African American Family 
563.14 	Preservation and Child Welfare 
563.15 	Disproportionality. $1,000,000 in fiscal year 
563.16 	2025 is for the African American and 
563.17 	disproportionately represented family 
563.18 	preservation grant program under Minnesota 
563.19 	Statutes, section 260.693. This is a onetime 
563.20 	appropriation. Notwithstanding Minnesota 
563.21 	Statutes, section 16B.98, subdivision 14, the 
563.22 	amount for administrative costs under this 
563.23 	paragraph is $0.

563.24
563.25	Subd. 12.Grant Programs; Children and 
Economic Support Grants
 		-0-
		6,111,000
	
563.26 	(a) American Indian Food Sovereignty 
563.27 	Funding Program. $1,000,000 in fiscal year 
563.28 	2025 is for the American Indian food 
563.29 	sovereignty funding program under Minnesota 
563.30 	Statutes, section 256E.342. This is a onetime 
563.31 	appropriation and is available until June 30, 
563.32 	2026. Notwithstanding Minnesota Statutes, 
563.33 	section 16B.98, subdivision 14, the amount 
563.34 	for administrative costs under this paragraph 
563.35 	is $0.
564.1 	(b) Minnesota Food Bank Program.
564.2 	$4,000,000 in fiscal year 2025 is for the 
564.3 	Minnesota food bank program under 
564.4 	Minnesota Statutes, section 256D.66. This is 
564.5 	a onetime appropriation. Notwithstanding 
564.6 	Minnesota Statutes, section 16B.98, 
564.7 	subdivision 14, the amount for administrative 
564.8 	costs under this paragraph is $0.
564.9 	(c) Emergency Services Program.
564.10 	$1,000,000 in fiscal year 2025 is for 
564.11 	emergency services grants under Minnesota 
564.12 	Statutes, section 256E.36. The commissioner 
564.13 	must distribute grants under this paragraph to 
564.14 	eligible entities to meet emerging, critical, and 
564.15 	immediate homelessness response needs that 
564.16 	have arisen since receiving an emergency 
564.17 	services grant award for fiscal years 2024 and 
564.18 	2025, including: (1) supporting overnight 
564.19 	emergency shelter or daytime service capacity 
564.20 	with a demonstrated and significant increase 
564.21 	in the number of persons served in fiscal year 
564.22 	2024 compared to the prior fiscal year; or (2) 
564.23 	maintaining existing overnight emergency 
564.24 	shelter bed or daytime service capacity with 
564.25 	a demonstrated and significant risk of closure 
564.26 	before April 30, 2025. This is a onetime 
564.27 	appropriation and is available until June 30, 
564.28 	2027. Notwithstanding Minnesota Statutes, 
564.29 	section 16B.98, subdivision 14, the amount 
564.30 	for administrative costs under this paragraph 
564.31 	is $0.
564.32 	(d) Base Level Adjustment. The general fund 
564.33 	base is decreased by $2,593,000 in fiscal year 
564.34 	2026 and $2,593,000 in fiscal year 2027.

565.1
565.2	Subd. 13.Grant Programs; Fraud Prevention 
Grants
 		-0-
		3,018,000

565.3	Subd. 14.Grant Programs; Health Care Grants
 		-0-
		1,500,000
	
565.4 	Comunidades Latinas Unidas En Servercio 
565.5 	Certified Community Behavioral Health 
565.6 	Clinic Services. $1,500,000 in fiscal year 
565.7 	2025 is for a payment to Comunidades Latinas 
565.8 	Unidas En Servercio (CLUES) to provide 
565.9 	comprehensive integrated health care through 
565.10 	the certified community behavioral health 
565.11 	clinic (CCBHC) model of service delivery as 
565.12 	required under Minnesota Statutes, section 
565.13 	245.735. Funds must be used to provide 
565.14 	evidence-based services under the CCBHC 
565.15 	service model and must not be used to 
565.16 	supplant available medical assistance funding. 
565.17 	By June 30, 2026, CLUES must report to the 
565.18 	commissioner of human services on:
565.19 	(1) the number of people served;
565.20 	(2) outcomes for people served; and
565.21 	(3) whether the funding reduced behavioral 
565.22 	health racial and ethnic disparities.
565.23 	This is a onetime appropriation and is 
565.24 	available until June 30, 2026. Notwithstanding 
565.25 	Minnesota Statutes, section 16B.98, 
565.26 	subdivision 14, the amount for administrative 
565.27 	costs under this paragraph is $0.

565.28
565.29	Subd. 15.Grant Programs; Adult Mental Health 
Grants
 		(9,527,000)
		311,000
	
565.30 	Youable Emotional Health. $311,000 in 
565.31 	fiscal year 2025 is for a grant to Youable 
565.32 	Emotional Health for day treatment 
565.33 	transportation costs on nonschool days, student 
565.34 	nutrition, and student learning experiences 
566.1 	such as technology, arts, and outdoor activity. 
566.2 	This is a onetime appropriation. In accordance 
566.3 	with Minnesota Statutes, section 16B.98, 
566.4 	subdivision 14, the commissioner may use 
566.5 	$11,000 of this appropriation for 
566.6 	administrative costs.

566.7
566.8	Subd. 16.Grant Programs; Child Mental Health 
Grants
 		-0-
		8,500,000
	
566.9 	(a) Ramsey County Youth Mental Health 
566.10 	Urgency Room. $1,500,000 in fiscal year 
566.11 	2025 is for a grant to Ramsey County for the 
566.12 	ongoing operation of the youth mental health 
566.13 	urgency room established in Laws 2022, 
566.14 	chapter 99, article 1, section 44. This is a 
566.15 	onetime appropriation. Notwithstanding 
566.16 	Minnesota Statutes, section 16B.98, 
566.17 	subdivision 14, the amount for administrative 
566.18 	costs under this paragraph is $0.
566.19 	(b) School-Linked Behavioral Health 
566.20 	Grants. $3,000,000 in fiscal year 2025 is for 
566.21 	school-linked behavioral health grants under 
566.22 	Minnesota Statutes, section 245.4901. This is 
566.23 	a onetime appropriation. Notwithstanding 
566.24 	Minnesota Statutes, section 16B.98, 
566.25 	subdivision 14, the amount for administrative 
566.26 	costs under this paragraph is $0.
566.27 	(c) Early Childhood Mental Health 
566.28 	Consultation Grants. $1,000,000 in fiscal 
566.29 	year 2025 is for early childhood mental health 
566.30 	consultation grants under Minnesota Statutes, 
566.31 	section 245.4889, subdivision 1, paragraph 
566.32 	(b), clause (15). This is a onetime 
566.33 	appropriation. Notwithstanding Minnesota 
566.34 	Statutes, section 16B.98, subdivision 14, the 
566.35 	amount for administrative costs is $0.
567.1 	(d) Respite Care Services. $3,000,000 in 
567.2 	fiscal year 2025 is for respite care services 
567.3 	under Minnesota Statutes, section 245.4889, 
567.4 	subdivision 1, paragraph (b), clause (3). This 
567.5 	is a onetime appropriation and is available 
567.6 	until June 30, 2027. Notwithstanding 
567.7 	Minnesota Statutes, section 16B.98, 
567.8 	subdivision 14, the amount for administrative 
567.9 	costs under this paragraph is $0.

567.10
567.11	Subd. 17.Direct Care and Treatment; Mental 
Health and Substance Abuse
 		-0-
		(6,109,000)
	
567.12 	Base Level Adjustments. The general fund 
567.13 	base is decreased by $7,566,000 in fiscal year 
567.14 	2026 and $7,566,000 in fiscal year 2027.

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

567.16	Sec. 3. COMMISSIONER OF HEALTH

567.17	Subdivision 1.Total Appropriation
 	$
	(541,000)
	$
	(469,000)

567.18	Appropriations by Fund
	
567.19		2024
	2025
	
567.20	General
	(545,000)
	2,267,000
	
567.21
567.22	State Government 
Special Revenue
	4,000
	(2,736,000)
	
567.23 	The amount that may be spent for each 
567.24 	purpose is specified in the following 
567.25 	subdivision.

567.26	Subd. 2.Health Improvement
 		(545,000)
		1,415,000
	
567.27 	(a) Stillbirth Prevention Grant. $210,000 in 
567.28 	fiscal year 2025 is for a grant to Healthy Birth 
567.29 	Day, Inc., to operate a stillbirth prevention 
567.30 	through tracking fetal movement pilot 
567.31 	program. This is a onetime appropriation and 
567.32 	is available until June 30, 2028. In accordance 
567.33 	with Minnesota Statutes, section 16B.98, 
567.34 	subdivision 14, the commissioner may use 
568.1 	$10,000 of this appropriation for 
568.2 	administrative costs.
568.3 	(b) Grant to Minnesota Medical Association 
568.4 	to Address Health Care Worker 
568.5 	Well-Being. $526,000 in fiscal year 2025 is 
568.6 	for a grant to the Minnesota Medical 
568.7 	Association to: (1) create and conduct an 
568.8 	awareness and education campaign focused 
568.9 	on burnout and well-being of health care 
568.10 	workers, designed to reduce the stigma of 
568.11 	receiving mental health services; (2) encourage 
568.12 	health care workers who are experiencing 
568.13 	workplace-related fatigue to receive the care 
568.14 	they need; and (3) normalize the process for 
568.15 	seeking help. The Minnesota Medical 
568.16 	Association's campaign under this paragraph 
568.17 	must be targeted to health care professionals, 
568.18 	including physicians, nurses, and other 
568.19 	members of the health care team, and must 
568.20 	include resources for health care professionals 
568.21 	seeking to address burnout and well-being. 
568.22 	This is a onetime appropriation. In accordance 
568.23 	with Minnesota Statutes, section 16B.98, 
568.24 	subdivision 14, the commissioner may use 
568.25 	$26,000 of this appropriation for 
568.26 	administrative costs.
568.27 	(c) Grant to Chosen Vessels Midwifery 
568.28 	Services. $263,000 in fiscal year 2025 is for 
568.29 	a grant to Chosen Vessels Midwifery Services 
568.30 	for a program to provide education, support, 
568.31 	and encouragement for African American 
568.32 	mothers to breastfeed their infants for the first 
568.33 	year of life or longer. Chosen Vessel 
568.34 	Midwifery Services must combine the midwife 
568.35 	model of care with the cultural tradition of 
569.1 	mutual aid to inspire African American 
569.2 	women to breastfeed their infants and to 
569.3 	provide support to those that do. This is a 
569.4 	onetime appropriation and is available until 
569.5 	June 30, 2026. In accordance with Minnesota 
569.6 	Statutes, section 16B.98, subdivision 14, the 
569.7 	commissioner may use $13,000 of this 
569.8 	appropriation for administrative costs.
569.9 	(d) American Indian Birth Center Planning 
569.10 	Grant. $368,000 in fiscal year 2025 is for a 
569.11 	grant to the Birth Justice Collaborative to plan 
569.12 	for and engage the community in the 
569.13 	development of an American Indian-focused 
569.14 	birth center to improve access to culturally 
569.15 	centered prenatal and postpartum care with 
569.16 	the goal of improving maternal and child 
569.17 	health outcomes. The Birth Justice 
569.18 	Collaborative must report to the commissioner 
569.19 	on the plan to develop an American 
569.20 	Indian-focused birth center. This is a onetime 
569.21 	appropriation. In accordance with Minnesota 
569.22 	Statutes, section 16B.98, subdivision 14, the 
569.23 	commissioner may use $18,000 of this 
569.24 	appropriation for administrative costs.
569.25 	(e) Grant to Birth Justice Collaborative for 
569.26 	African American-Focused Homeplace 
569.27 	Model. $263,000 in fiscal year 2025 is for a 
569.28 	grant to the Birth Justice Collaborative for 
569.29 	planning and community engagement to 
569.30 	develop a replicable African 
569.31 	American-focused Homeplace model. The 
569.32 	model's purpose must be to improve access to 
569.33 	culturally centered healing and care during 
569.34 	pregnancy and the postpartum period, with 
569.35 	the goal of improving maternal and child 
570.1 	health outcomes. The Birth Justice 
570.2 	Collaborative must report to the commissioner 
570.3 	on the needs of and plan to develop an African 
570.4 	American-focused Homeplace model in 
570.5 	Hennepin County. The report must outline 
570.6 	potential state and public partnerships and 
570.7 	financing strategies and must provide a 
570.8 	timeline for development. This is a onetime 
570.9 	appropriation. In accordance with Minnesota 
570.10 	Statutes, section 16B.98, subdivision 14, the 
570.11 	commissioner may use $13,000 of this 
570.12 	appropriation for administrative costs.
570.13 	(f) Hospital Nursing Loan Forgiveness.
570.14 	$5,317,000 in fiscal year 2025 is for the 
570.15 	hospital nursing educational loan forgiveness 
570.16 	program under Minnesota Statutes, section 
570.17 	144.1512.
570.18 	(g) Base Level Adjustment. The general fund 
570.19 	base is decreased by $220,000 in fiscal year 
570.20 	2026 and $50,000 in fiscal year 2027.

570.21	Subd. 3.Health Protection

570.22	Appropriations by Fund
	
570.23	General
	-0-
	852,000
	
570.24
570.25	State Government 
Special Revenue
	4,000
	(2,736,000)
	
570.26 	(a) Translation of Competency Evaluation 
570.27 	for Nursing Assistant Registry. $20,000 
570.28 	from the general fund in fiscal year 2025 is 
570.29 	for translation of competency evaluation 
570.30 	materials for the nursing assistant registry. 
570.31 	This is a onetime appropriation.
570.32 	(b) Medication Training Program Review 
570.33 	for Graduates of Foreign Nursing Schools.
570.34 	$451,000 from the general fund in fiscal year 
570.35 	2025 is for medication training program 
571.1 	review for medication training programs and 
571.2 	graduates of foreign nursing schools. This 
571.3 	appropriation is available until June 30, 2027. 
571.4 	The general fund base for this appropriation 
571.5 	is $49,000 in fiscal year 2026 and $49,000 in 
571.6 	fiscal year 2027.
571.7 	(c) Base Level Adjustment. The general fund 
571.8 	base is increased by $430,000 in fiscal year 
571.9 	2026 and $225,000 in fiscal year 2027. The 
571.10 	state government special revenue fund base is 
571.11 	decreased by $2,791,000 in fiscal year 2026 
571.12 	and $2,860,000 in fiscal year 2027.

571.13	Sec. 4. BOARD OF PHARMACY

571.14	Appropriations by Fund
	
571.15	General
	600,000
	-0-
	
571.16
571.17	State Government 
Special Revenue
	-0-
	49,000
	
571.18 	(a) Legal Costs. $600,000 in fiscal year 2024 
571.19 	is from the general fund for legal costs. This 
571.20 	is a onetime appropriation.
571.21 	(b) Base Level Adjustment. The state 
571.22 	government special revenue fund base is 
571.23 	increased by $27,000 in fiscal year 2026 and 
571.24 	$27,000 in fiscal year 2027.

571.25
571.26	Sec. 5. RARE DISEASE ADVISORY 
COUNCIL
 	$
	-0-
	$
	342,000
	
571.27 	This is a onetime appropriation and is 
571.28 	available until June 30, 2027.

571.29	Sec. 6. COMMISSIONER OF EDUCATION
 	$
	1,882,000
	$
	1,715,000
	
571.30 	(a) Summer EBT. $1,882,000 in fiscal year 
571.31 	2024 and $1,542,000 in fiscal year 2025 are 
571.32 	for administration of the summer electronic 
571.33 	benefits transfer program under Public Law 
571.34 	117-328. Any unexpended amount in fiscal 
572.1 	year 2024 does not cancel and is available in 
572.2 	fiscal year 2025. The base for this 
572.3 	appropriation is $572,000 in fiscal year 2026 
572.4 	and $572,000 in fiscal year 2027.
572.5 	(b) Base Level Adjustment. The general fund 
572.6 	base is increased by $917,000 in fiscal year 
572.7 	2026 and $917,000 in fiscal year 2027.

572.8
572.9	Sec. 7. COMMISSIONER OF MANAGEMENT 
AND BUDGET

572.10	Appropriations by Fund
	
572.11		2024
	2025
	
572.12	General
	-0-
	(232,000)
	
572.13	Health Care Access
	-0-
	300,000
	
572.14 	(a) Insulin safety net program. $300,000 in 
572.15 	fiscal year 2025 is from the health care access 
572.16 	fund for the insulin safety net program in 
572.17 	Minnesota Statutes, section 151.74.
572.18 	(b) Transfer. The commissioner must transfer 
572.19 	from the health care access fund to the insulin 
572.20 	safety net program account in the special 
572.21 	revenue fund the amount certified by the 
572.22 	commissioner of administration under 
572.23 	Minnesota Statutes, section 151.741, 
572.24 	subdivision 5, paragraph (b), estimated to be 
572.25 	$300,000 in fiscal year 2025, for 
572.26 	reimbursement to manufacturers for insulin 
572.27 	dispensed under the insulin safety net program 
572.28 	in Minnesota Statutes, section 151.74. The 
572.29 	base for this transfer is estimated to be 
572.30 	$300,000 in fiscal year 2026 and $300,000 in 
572.31 	fiscal year 2027.
572.32 	(c) Base Level Adjustment. The health care 
572.33 	access fund base is increased by $300,000 in 
572.34 	fiscal year 2026 and $300,000 in fiscal year 
572.35 	2027.

573.1
573.2	Sec. 8. COMMISSIONER OF CHILDREN, 
YOUTH, AND FAMILIES
 	$
	-0-
	$
	3,279,000
	
573.3 	Base Level Adjustment. The general fund 
573.4 	base is increased by $7,183,000 in fiscal year 
573.5 	2026 and $6,833,000 in fiscal year 2027.

573.6	Sec. 9. COMMISSIONER OF COMMERCE
 					
573.7 	(a) Defrayal of Costs for Mandated 
573.8 	Coverage of Prosthetic Devices. The general 
573.9 	fund base is increased by $558,000 in fiscal 
573.10 	year 2026 and $539,000 in fiscal year 2027. 
573.11 	The base includes $520,000 in fiscal year 2026 
573.12 	and $540,000 in fiscal year 2027 for defrayal 
573.13 	costs for mandated coverage of prosthetic 
573.14 	devices and $38,000 in fiscal year 2026 and 
573.15 	$19,000 in fiscal year 2027 for administrative 
573.16 	costs to implement mandated coverage of 
573.17 	prosthetic devices.
573.18 	(b) Defrayal of Costs for Mandated 
573.19 	Coverage of Abortions and 
573.20 	Abortion-Related Services. The general fund 
573.21 	base is increased by $338,000 in fiscal year 
573.22 	2026 and $319,000 in fiscal year 2027. The 
573.23 	base includes $300,000 in fiscal year 2026 and 
573.24 	$300,000 in fiscal year 2027 for defrayal costs 
573.25 	for mandated coverage of abortions and 
573.26 	abortion-related services and $38,000 in fiscal 
573.27 	year 2026 and $19,000 in fiscal year 2027 for 
573.28 	administrative costs to implement mandated 
573.29 	coverage of abortions and abortion-related 
573.30 	services.

573.31
573.32	Sec. 10. OFFICE OF THE OMBUDSPERSON 
FOR FAMILY CHILD CARE PROVIDERS
 					
573.33 	Child Care and Development Block Grant 
573.34 	Allocation. The commissioner of human 
573.35 	services must allocate $350,000 in fiscal year 
574.1 	2025, and each fiscal year thereafter from the 
574.2 	child care and development block grant to the 
574.3 	Ombudsperson for Family Child Care 
574.4 	Providers under Minnesota Statutes, section 
574.5 	245.975.

574.6
574.7	Sec. 11. CHILD PROTECTION ADVISORY 
COUNCIL
 	$
	-0-
	$
	464,000
	
574.8 	Child Protection Advisory Council.
574.9 	$464,000 in fiscal year 2025 is for the Child 
574.10 	Protection Advisory Council under Minnesota 
574.11 	Statutes, section 260E.021. This is a onetime 
574.12 	appropriation and is available through June 
574.13 	30, 2027.

574.14	Sec. 12. ATTORNEY GENERAL.
 	$
	-0-
	$
	73,000
	
574.15 	(a) Health Maintenance Organization 
574.16 	Regulatory Requirements. $73,000 in fiscal 
574.17 	year 2025 is for transaction review and related 
574.18 	investigatory and enforcement actions for 
574.19 	filings required under Minnesota Statutes, 
574.20 	section 317A.811, subdivision 1.
574.21 	(b) Base Level Adjustment. The general fund 
574.22 	base is increased by $73,000 in fiscal year 
574.23 	2026 and $73,000 in fiscal year 2027.

574.24 	Sec. 13. Laws 2023, chapter 22, section 4, subdivision 2, is amended to read:
574.25 		Subd. 2.Grants to navigators.
 574.26 	(a) $1,936,000 in fiscal year 2024 is 
574.27 	appropriated from the health care access fund 
574.28 	to the commissioner of human services for 
574.29 	grants to organizations with a MNsure grant 
574.30 	services navigator assister contract in good 
574.31 	standing as of the date of enactment. The grant 
574.32 	payment to each organization must be in 
574.33 	proportion to the number of medical assistance 
575.1 	and MinnesotaCare enrollees each 
575.2 	organization assisted that resulted in a 
575.3 	successful enrollment in the second quarter of 
575.4 	fiscal years 2020 and 2023, as determined by 
575.5 	MNsure's navigator payment process. This is 
575.6 	a onetime appropriation and is available until 
575.7 	June 30, 2025.
575.8 	(b) $3,000,000 in fiscal year 2024 is 
575.9 	appropriated from the health care access fund 
575.10 	to the commissioner of human services for 
575.11 	grants to organizations with a MNsure grant 
575.12 	services navigator assister contract for 
575.13 	successful enrollments in medical assistance 
575.14 	and MinnesotaCare. This is a onetime 
575.15 	appropriation and is available until June 30, 
575.16 	2025.

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

575.18 	Sec. 14. Laws 2023, chapter 57, article 1, section 6, is amended to read:
575.19 	Sec. 6. PREMIUM SECURITY ACCOUNT TRANSFER; OUT.
 575.20 	$275,775,000 $284,605,000 in fiscal year 2026 is transferred from the premium security 
575.21 	plan account under Minnesota Statutes, section 62E.25, subdivision 1, to the general fund. 
575.22 	This is a onetime transfer.

575.23 	Sec. 15. Laws 2023, chapter 70, article 20, section 2, subdivision 5, is amended to read:

575.24	Subd. 5.Central Office; Health Care

575.25	Appropriations by Fund
	
575.26	General
	35,807,000
	31,349,000
	
575.27	Health Care Access
	30,668,000
	50,168,000
	
575.28 	(a) Medical assistance and MinnesotaCare 
575.29 	accessibility improvements. $4,000,000
575.30 	$784,000 in fiscal year 2024 is and $3,216,000 
575.31 	in fiscal year 2025 are from the general fund 
575.32 	for interactive voice response upgrades and 
576.1 	translation services for medical assistance and 
576.2 	MinnesotaCare enrollees with limited English 
576.3 	proficiency. This appropriation is available 
576.4 	until June 30, 2025 2027.
576.5 	(b) Transforming service delivery. $155,000 
576.6 	in fiscal year 2024 and $180,000 in fiscal year 
576.7 	2025 are from the general fund for 
576.8 	transforming service delivery projects.
576.9 	(c) Improving the Minnesota eligibility 
576.10 	technology system functionality. $1,604,000 
576.11 	in fiscal year 2024 and $711,000 in fiscal year 
576.12 	2025 are from the general fund for improving 
576.13 	the Minnesota eligibility technology system 
576.14 	functionality. The base for this appropriation 
576.15 	is $1,421,000 in fiscal year 2026 and $0 in 
576.16 	fiscal year 2027.
576.17 	(d) Actuarial and economic analyses.
576.18 	$2,500,000 $825,000 in fiscal year 2024 is 
576.19 	from the health care access fund for actuarial 
576.20 	and economic analyses and $1,675,000 in 
576.21 	fiscal year 2025 is from the health care access 
576.22 	fund to prepare and submit a state innovation 
576.23 	waiver under section 1332 of the federal 
576.24 	Affordable Care Act for a Minnesota public 
576.25 	option health care plan; community 
576.26 	engagement; project management; information 
576.27 	technology consultation for eligibility and 
576.28 	enrollment processes; updating the actuarial 
576.29 	and economic analyses completed in 2023; 
576.30 	and consultation to develop strategies for 
576.31 	outreach and communication with populations 
576.32 	ineligible for the existing MinnesotaCare 
576.33 	program. This is a onetime appropriation and 
576.34 	is available until June 30, 2025 2027.
577.1 	(e) Contingent appropriation for Minnesota 
577.2 	public option health care plan. $22,000,000 
577.3 	in fiscal year 2025 is from the health care 
577.4 	access fund to implement a Minnesota public 
577.5 	option health care plan. This is a onetime 
577.6 	appropriation and is available upon approval 
577.7 	of a state innovation waiver under section 
577.8 	1332 of the federal Affordable Care Act. This 
577.9 	appropriation is available until June 30
577.10 	December 31, 2027.
577.11 	(f) Carryforward authority. Notwithstanding 
577.12 	Minnesota Statutes, section 16A.28, 
577.13 	subdivision 3, $2,367,000 of the appropriation 
577.14 	in fiscal year 2024 is available until June 30, 
577.15 	2027.
577.16 	(g) Base level adjustment. The general fund 
577.17 	base is $32,315,000 in fiscal year 2026 and 
577.18 	$27,536,000 in fiscal year 2027. The health 
577.19 	care access fund base is $28,168,000 in fiscal 
577.20 	year 2026 and $28,168,000 in fiscal year 2027.

577.21 	Sec. 16. Laws 2023, chapter 70, article 20, section 2, subdivision 22, is amended to read:

577.22
577.23	Subd. 22.Grant Programs; Children's Services 
Grants

577.24	Appropriations by Fund
	
577.25	General
	86,212,000
	85,063,000
	
577.26	Federal TANF
	140,000
	140,000
	
577.27 	(a) Title IV-E Adoption Assistance. The 
577.28 	commissioner shall allocate funds from the 
577.29 	state's savings from the Fostering Connections 
577.30 	to Success and Increasing Adoptions Act's 
577.31 	expanded eligibility for Title IV-E adoption 
577.32 	assistance as required in Minnesota Statutes, 
577.33 	section 256N.261, and as allowable under 
577.34 	federal law. Additional savings to the state as 
578.1 	a result of the Fostering Connections to 
578.2 	Success and Increasing Adoptions Act's 
578.3 	expanded eligibility for Title IV-E adoption 
578.4 	assistance is for postadoption, foster care, 
578.5 	adoption, and kinship services, including a 
578.6 	parent-to-parent support network and as 
578.7 	allowable under federal law.
578.8 	(b) Mille Lacs Band of Ojibwe American 
578.9 	Indian child welfare initiative. $3,337,000 
578.10 	in fiscal year 2024 and $5,294,000 in fiscal 
578.11 	year 2025 are from the general fund for the 
578.12 	Mille Lacs Band of Ojibwe to join the 
578.13 	American Indian child welfare initiative. The 
578.14 	base for this appropriation is $7,893,000 in 
578.15 	fiscal year 2026 and $7,893,000 in fiscal year 
578.16 	2027.
578.17 	(c) Leech Lake Band of Ojibwe American 
578.18 	Indian child welfare initiative. $1,848,000 
578.19 	in fiscal year 2024 and $1,848,000 in fiscal 
578.20 	year 2025 are from the general fund for the 
578.21 	Leech Lake Band of Ojibwe to participate in 
578.22 	the American Indian child welfare initiative.
578.23 	(d) Red Lake Band of Chippewa American 
578.24 	Indian child welfare initiative. $3,000,000 
578.25 	in fiscal year 2024 and $3,000,000 in fiscal 
578.26 	year 2025 are from the general fund for the 
578.27 	Red Lake Band of Chippewa to participate in 
578.28 	the American Indian child welfare initiative.
578.29 	(e) White Earth Nation American Indian 
578.30 	child welfare initiative. $3,776,000 in fiscal 
578.31 	year 2024 and $3,776,000 in fiscal year 2025 
578.32 	are from the general fund for the White Earth 
578.33 	Nation to participate in the American Indian 
578.34 	child welfare initiative.
579.1 	(f) Indian Child welfare grants. $4,405,000 
579.2 	in fiscal year 2024 and $4,405,000 in fiscal 
579.3 	year 2025 are from the general fund for Indian 
579.4 	child welfare grants under Minnesota Statutes, 
579.5 	section 260.785. The base for this 
579.6 	appropriation is $4,640,000 in fiscal year 2026 
579.7 	and $4,640,000 in fiscal year 2027.
579.8 	(g) Child welfare staff allocation for Tribes.
579.9 	$799,000 in fiscal year 2024 and $799,000 in 
579.10 	fiscal year 2025 are from the general fund for 
579.11 	grants to Tribes for child welfare staffing 
579.12 	under Minnesota Statutes, section 260.786.
579.13 	(h) Grants for kinship navigator services. 
579.14 	$764,000 in fiscal year 2024 and $764,000 in 
579.15 	fiscal year 2025 are from the general fund for 
579.16 	grants for kinship navigator services and 
579.17 	grants to Tribal Nations for kinship navigator 
579.18 	services under Minnesota Statutes, section 
579.19 	256.4794. The base for this appropriation is 
579.20 	$506,000 in fiscal year 2026 and $507,000 in 
579.21 	fiscal year 2027.
579.22 	(i) Family first prevention and early 
579.23 	intervention assessment response grants. 
579.24 	$4,000,000 in fiscal year 2024 and $6,112,000 
579.25 	in fiscal year 2025 are from the general fund 
579.26 	for family assessment response grants under 
579.27 	Minnesota Statutes, section 260.014. The base 
579.28 	for this appropriation is $6,000,000 in fiscal 
579.29 	year 2026 and $6,000,000 in fiscal year 2027.
579.30 	(j) Grants for evidence-based prevention 
579.31 	and early intervention services. $4,329,000 
579.32 	in fiscal year 2024 and $4,100,000 in fiscal 
579.33 	year 2025 are from the general fund for grants 
579.34 	to support evidence-based prevention and early 
580.1 	intervention services under Minnesota 
580.2 	Statutes, section 256.4793.
580.3 	(k) Grant to administer pool of qualified 
580.4 	individuals for assessments. $250,000 in 
580.5 	fiscal year 2024 and $250,000 in fiscal year 
580.6 	2025 are from the general fund for grants to 
580.7 	establish and manage a pool of state-funded 
580.8 	qualified individuals to conduct assessments 
580.9 	for out-of-home placement of a child in a 
580.10 	qualified residential treatment program.
580.11 	(l) Quality parenting initiative grant 
580.12 	program. $100,000 in fiscal year 2024 and 
580.13 	$100,000 in fiscal year 2025 are from the 
580.14 	general fund for a grant to Quality Parenting 
580.15 	Initiative Minnesota under Minnesota Statutes, 
580.16 	section 245.0962.
580.17 	(m) STAY in the community grants.
580.18 	$1,579,000 in fiscal year 2024 and $2,247,000 
580.19 	in fiscal year 2025 are from the general fund 
580.20 	for the STAY in the community program 
580.21 	under Minnesota Statutes, section 260C.452. 
580.22 	This is a onetime appropriation and is 
580.23 	available until June 30, 2027.
580.24 	(n) Grants for community resource centers.
580.25 	$5,657,000 in fiscal year 2024 is from the 
580.26 	general fund for grants to establish a network 
580.27 	of community resource centers. This is a 
580.28 	onetime appropriation and is available until 
580.29 	June 30, 2027.
580.30 	(o) Family assets for independence in 
580.31 	Minnesota. $1,405,000 in fiscal year 2024 
580.32 	and $1,391,000 in fiscal year 2025 are from 
580.33 	the general fund for the family assets for 
580.34 	independence in Minnesota program, under 
581.1 	Minnesota Statutes, section 256E.35. This is 
581.2 	a onetime appropriation and is available until 
581.3 	June 30, 2027.
581.4 	(p) (o)Base level adjustment. The general 
581.5 	fund base is $85,280,000 in fiscal year 2026 
581.6 	and $85,281,000 in fiscal year 2027.

581.7 	Sec. 17. Laws 2023, chapter 70, article 20, section 2, subdivision 24, is amended to read:

581.8
581.9	Subd. 24.Grant Programs; Children and 
Economic Support Grants
 		212,877,000
		78,333,000
	
581.10 	(a) Fraud prevention initiative start-up 
581.11 	grants. $400,000 in fiscal year 2024 is for 
581.12 	start-up grants to the Red Lake Nation, White 
581.13 	Earth Nation, and Mille Lacs Band of Ojibwe 
581.14 	to develop a fraud prevention program. This 
581.15 	is a onetime appropriation and is available 
581.16 	until June 30, 2025.
581.17 	(b) American Indian food sovereignty 
581.18 	funding program. $3,000,000 in fiscal year 
581.19 	2024 and $3,000,000 in fiscal year 2025 are 
581.20 	for Minnesota Statutes, section 256E.342. This 
581.21 	appropriation is available until June 30, 2025. 
581.22 	The base for this appropriation is $2,000,000 
581.23 	in fiscal year 2026 and $2,000,000 in fiscal 
581.24 	year 2027.
581.25 	(c) Hennepin County grants to provide 
581.26 	services to people experiencing 
581.27 	homelessness. $11,432,000 in fiscal year 2024 
581.28 	is for grants to maintain capacity for shelters 
581.29 	and services provided to persons experiencing 
581.30 	homelessness in Hennepin County. Of this 
581.31 	amount:
581.32 	(1) $4,500,000 is for a grant to Avivo Village;
582.1 	(2) $2,000,000 is for a grant to the American 
582.2 	Indian Community Development Corporation 
582.3 	Homeward Bound shelter;
582.4 	(3) $1,650,000 is for a grant to the Salvation 
582.5 	Army Harbor Lights shelter;
582.6 	(4) $500,000 is for a grant to Agate Housing 
582.7 	and Services;
582.8 	(5) $1,400,000 is for a grant to Catholic 
582.9 	Charities of St. Paul and Minneapolis;
582.10 	(6) $450,000 is for a grant to Simpson 
582.11 	Housing; and
582.12 	(7) $932,000 is for a grant to Hennepin 
582.13 	County.
582.14 	Nothing shall preclude an eligible organization 
582.15 	receiving funding under this paragraph from 
582.16 	applying for and receiving funding under 
582.17 	Minnesota Statutes, section 256E.33, 256E.36, 
582.18 	256K.45, or 256K.47, nor does receiving 
582.19 	funding under this paragraph count against 
582.20 	any eligible organization in the competitive 
582.21 	processes related to those grant programs 
582.22 	under Minnesota Statutes, section 256E.33, 
582.23 	256E.36, 256K.45, or 256K.47.
582.24 	(d) Diaper distribution grant program. 
582.25 	$545,000 in fiscal year 2024 and $553,000 in 
582.26 	fiscal year 2025 are for a grant to the Diaper 
582.27 	Bank of Minnesota under Minnesota Statutes, 
582.28 	section 256E.38.
582.29 	(e) Prepared meals food relief. $1,654,000 
582.30 	in fiscal year 2024 and $1,638,000 in fiscal 
582.31 	year 2025 are for prepared meals food relief 
582.32 	grants. This is a onetime appropriation.
583.1 	(f) Emergency shelter facilities. $98,456,000 
583.2 	in fiscal year 2024 is for grants to eligible 
583.3 	applicants for emergency shelter facilities. 
583.4 	This is a onetime appropriation and is 
583.5 	available until June 30, 2028.
583.6 	(g) Homeless youth cash stipend pilot 
583.7 	project. $5,302,000 in fiscal year 2024 is for 
583.8 	a grant to Youthprise for the homeless youth 
583.9 	cash stipend pilot project. The grant must be 
583.10 	used to provide cash stipends to homeless 
583.11 	youth, provide cash incentives for stipend 
583.12 	recipients to participate in periodic surveys, 
583.13 	provide youth-designed optional services, and 
583.14 	complete a legislative report. This is a onetime 
583.15 	appropriation and is available until June 30, 
583.16 	2028.
583.17 	(h) Heading Home Ramsey County 
583.18 	continuum of care grants. $11,432,000 in 
583.19 	fiscal year 2024 is for grants to maintain 
583.20 	capacity for shelters and services provided to 
583.21 	people experiencing homelessness in Ramsey 
583.22 	County. Of this amount:
583.23 	(1) $2,286,000 is for a grant to Catholic 
583.24 	Charities of St. Paul and Minneapolis;
583.25 	(2) $1,498,000 is for a grant to More Doors;
583.26 	(3) $1,734,000 is for a grant to Interfaith 
583.27 	Action Project Home;
583.28 	(4) $2,248,000 is for a grant to Ramsey 
583.29 	County;
583.30 	(5) $689,000 is for a grant to Radias Health;
583.31 	(6) $493,000 is for a grant to The Listening 
583.32 	House;
584.1 	(7) $512,000 is for a grant to Face to Face; 
584.2 	and
584.3 	(8) $1,972,000 is for a grant to the city of St. 
584.4 	Paul.
584.5 	Nothing shall preclude an eligible organization 
584.6 	receiving funding under this paragraph from 
584.7 	applying for and receiving funding under 
584.8 	Minnesota Statutes, section 256E.33, 256E.36, 
584.9 	256K.45, or 256K.47, nor does receiving 
584.10 	funding under this paragraph count against 
584.11 	any eligible organization in the competitive 
584.12 	processes related to those grant programs 
584.13 	under Minnesota Statutes, section 256E.33, 
584.14 	256E.36, 256K.45, or 256K.47.
584.15 	(i) Capital for emergency food distribution 
584.16 	facilities. $7,000,000 in fiscal year 2024 is for 
584.17 	improving and expanding the infrastructure 
584.18 	of food shelf facilities. Grant money must be 
584.19 	made available to nonprofit organizations, 
584.20 	federally recognized Tribes, and local units of 
584.21 	government. This is a onetime appropriation 
584.22 	and is available until June 30, 2027.
584.23 	(j) Emergency services program grants.
584.24 	$15,250,000 in fiscal year 2024 and 
584.25 	$14,750,000 in fiscal year 2025 are for 
584.26 	emergency services grants under Minnesota 
584.27 	Statutes, section 256E.36. Any unexpended 
584.28 	amount in the first year does not cancel and 
584.29 	is available in the second year. The base for 
584.30 	this appropriation is $25,000,000 in fiscal year 
584.31 	2026 and $30,000,000 in fiscal year 2027.
584.32 	(k) Homeless Youth Act grants. $15,136,000 
584.33 	in fiscal year 2024 and $15,136,000 in fiscal 
584.34 	year 2025 are for grants under Minnesota 
585.1 	Statutes, section 256K.45, subdivision 1. Any 
585.2 	unexpended amount in the first year does not 
585.3 	cancel and is available in the second year.
585.4 	(l) Transitional housing programs.
585.5 	$3,000,000 in fiscal year 2024 and $3,000,000 
585.6 	in fiscal year 2025 are for transitional housing 
585.7 	programs under Minnesota Statutes, section 
585.8 	256E.33. Any unexpended amount in the first 
585.9 	year does not cancel and is available in the 
585.10 	second year.
585.11 	(m) Safe harbor shelter and housing grants.
585.12 	$2,125,000 in fiscal year 2024 and $2,125,000 
585.13 	in fiscal year 2025 are for grants under 
585.14 	Minnesota Statutes, section 256K.47. Any 
585.15 	unexpended amount in the first year does not 
585.16 	cancel and is available in the second year. The 
585.17 	base for this appropriation is $1,250,000 in 
585.18 	fiscal year 2026 and $1,250,000 in fiscal year 
585.19 	2027.
585.20 	(n) Supplemental nutrition assistance 
585.21 	program (SNAP) outreach. $1,000,000 in 
585.22 	fiscal year 2024 and $1,000,000 in fiscal year 
585.23 	2025 are for the SNAP outreach program 
585.24 	under Minnesota Statutes, section 256D.65. 
585.25 	The base for this appropriation is $500,000 in 
585.26 	fiscal year 2026 and $500,000 in fiscal year 
585.27 	2027.
585.28 	(o) Family Assets for Independence in 
585.29 	Minnesota. $1,405,000 in fiscal year 2024 
585.30 	and $1,391,000 in fiscal year 2025 are from 
585.31 	the general fund for the family assets for 
585.32 	independence in Minnesota program, under 
585.33 	Minnesota Statutes, section 256E.35. This is 
585.34 	a onetime appropriation and is available until 
585.35 	June 30, 2027.
586.1 	(p) Minnesota Food Assistance Program.
586.2 	Unexpended funds for the Minnesota food 
586.3 	assistance program for fiscal year 2024 are 
586.4 	available until June 30, 2025.
586.5 	(o) (q)Base level adjustment. The general 
586.6 	fund base is $83,179,000 in fiscal year 2026 
586.7 	and $88,179,000 in fiscal year 2027.

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

586.9 	Sec. 18. Laws 2023, chapter 70, article 20, section 2, subdivision 29, is amended to read:

586.10
586.11	Subd. 29.Grant Programs; Adult Mental Health 
Grants
 		132,327,000
		121,270,000
	
586.12 	(a) Mobile crisis grants to Tribal Nations. 
586.13 	$1,000,000 in fiscal year 2024 and $1,000,000 
586.14 	in fiscal year 2025 are for mobile crisis grants 
586.15 	under Minnesota Statutes section, sections
586.16 	245.4661, subdivision 9, paragraph (b), clause 
586.17 	(15), and 245.4889, subdivision 1, paragraph 
586.18 	(b), clause (4), to Tribal Nations.
586.19 	(b) Mental health provider supervision 
586.20 	grant program. $1,500,000 in fiscal year 
586.21 	2024 and $1,500,000 in fiscal year 2025 are 
586.22 	for the mental health provider supervision 
586.23 	grant program under Minnesota Statutes, 
586.24 	section 245.4663.
586.25 	(c) Minnesota State University, Mankato 
586.26 	community behavioral health center. 
586.27 	$750,000 in fiscal year 2024 and $750,000 in 
586.28 	fiscal year 2025 are for a grant to the Center 
586.29 	for Rural Behavioral Health at Minnesota State 
586.30 	University, Mankato to establish a community 
586.31 	behavioral health center and training clinic. 
586.32 	The community behavioral health center must 
586.33 	provide comprehensive, culturally specific, 
586.34 	trauma-informed, practice- and 
587.1 	evidence-based, person- and family-centered 
587.2 	mental health and substance use disorder 
587.3 	treatment services in Blue Earth County and 
587.4 	the surrounding region to individuals of all 
587.5 	ages, regardless of an individual's ability to 
587.6 	pay or place of residence. The community 
587.7 	behavioral health center and training clinic 
587.8 	must also provide training and workforce 
587.9 	development opportunities to students enrolled 
587.10 	in the university's training programs in the 
587.11 	fields of social work, counseling and student 
587.12 	personnel, alcohol and drug studies, 
587.13 	psychology, and nursing. Upon request, the 
587.14 	commissioner must make information 
587.15 	regarding the use of this grant funding 
587.16 	available to the chairs and ranking minority 
587.17 	members of the legislative committees with 
587.18 	jurisdiction over behavioral health. This is a 
587.19 	onetime appropriation and is available until 
587.20 	June 30, 2027.
587.21 	(d) White Earth Nation; adult mental health 
587.22 	initiative. $300,000 in fiscal year 2024 and 
587.23 	$300,000 in fiscal year 2025 are for adult 
587.24 	mental health initiative grants to the White 
587.25 	Earth Nation. This is a onetime appropriation.
587.26 	(e) Mobile crisis grants. $8,472,000 in fiscal 
587.27 	year 2024 and $8,380,000 in fiscal year 2025 
587.28 	are for the mobile crisis grants under 
587.29 	Minnesota Statutes, section sections245.4661, 
587.30 	subdivision 9, paragraph (b), clause (15), and 
587.31 	245.4889, subdivision 1, paragraph (b), clause 
587.32 	(4). This is a onetime appropriation and is 
587.33 	available until June 30, 2027.
588.1 	(f) Base level adjustment. The general fund 
588.2 	base is $121,980,000 in fiscal year 2026 and 
588.3 	$121,980,000 in fiscal year 2027.

588.4 	Sec. 19. Laws 2023, chapter 70, article 20, section 2, subdivision 31, as amended by Laws 
588.5 	2023, chapter 75, section 12, is amended to read:

588.6
588.7	Subd. 31.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		-0-
		6,109,000
	
588.8 	(a) Keeping Nurses at the Bedside Act; 
588.9 	contingent appropriation. The appropriation 
588.10 	in this subdivision is contingent upon 
588.11 	legislative enactment by the 93rd Legislature 
588.12 	of provisions substantially similar to 2023 S.F. 
588.13 	No. 1561, the second engrossment, article 2.
588.14 	(b)Base level adjustment. The general fund 
588.15 	base is increased by $7,566,000 in fiscal year 
588.16 	2026 and increased by $7,566,000 in fiscal 
588.17 	year 2027.

588.18 	Sec. 20. Laws 2023, chapter 70, article 20, section 3, subdivision 2, is amended to read:

588.19	Subd. 2.Health Improvement

588.20	Appropriations by Fund
	
588.21	General
	229,600,000
	210,030,000
	
588.22
588.23	State Government 
Special Revenue
	12,392,000
	12,682,000
	
588.24	Health Care Access
	49,051,000
	53,290,000
	
588.25	Federal TANF
	11,713,000
	11,713,000
	
588.26 	(a) Studies of telehealth expansion and 
588.27 	payment parity. $1,200,000 in fiscal year 
588.28 	2024 is from the general fund for studies of 
588.29 	telehealth expansion and payment parity. This 
588.30 	is a onetime appropriation and is available 
588.31 	until June 30, 2025.
588.32 	(b) Advancing equity through capacity 
588.33 	building and resource allocation grant 
589.1 	program. $916,000 in fiscal year 2024 and 
589.2 	$916,000 in fiscal year 2025 are from the 
589.3 	general fund for grants under Minnesota 
589.4 	Statutes, section 144.9821. This is a onetime 
589.5 	appropriation.
589.6 	(c) Grant to Minnesota Community Health 
589.7 	Worker Alliance. $971,000 in fiscal year 
589.8 	2024 and $971,000 in fiscal year 2025 are 
589.9 	from the general fund for Minnesota Statutes, 
589.10 	section 144.1462.
589.11 	(d) Community solutions for healthy child 
589.12 	development grants. $2,730,000 in fiscal year 
589.13 	2024 and $2,730,000 in fiscal year 2025 are 
589.14 	from the general fund for grants under 
589.15 	Minnesota Statutes, section 145.9257. The 
589.16 	base for this appropriation is $2,415,000 in 
589.17 	fiscal year 2026 and $2,415,000 in fiscal year 
589.18 	2027.
589.19 	(e) Comprehensive Overdose and Morbidity 
589.20 	Prevention Act. $9,794,000 in fiscal year 
589.21 	2024 and $10,458,000 in fiscal year 2025 are 
589.22 	from the general fund for comprehensive 
589.23 	overdose and morbidity prevention strategies 
589.24 	under Minnesota Statutes, section 144.0528. 
589.25 	The base for this appropriation is $10,476,000 
589.26 	in fiscal year 2026 and $10,476,000 in fiscal 
589.27 	year 2027.
589.28 	(f) Emergency preparedness and response.
589.29 	$10,486,000 in fiscal year 2024 and 
589.30 	$14,314,000 in fiscal year 2025 are from the 
589.31 	general fund for public health emergency 
589.32 	preparedness and response, the sustainability 
589.33 	of the strategic stockpile, and COVID-19 
589.34 	pandemic response transition. The base for 
590.1 	this appropriation is $11,438,000 in fiscal year 
590.2 	2026 and $11,362,000 in fiscal year 2027.
590.3 	(g) Healthy Beginnings, Healthy Families.
590.4 	(1) $8,440,000 in fiscal year 2024 and 
590.5 	$7,305,000 in fiscal year 2025 are from the 
590.6 	general fund for grants under Minnesota 
590.7 	Statutes, sections 145.9571 to 145.9576. The 
590.8 	base for this appropriation is $1,500,000 in 
590.9 	fiscal year 2026 and $1,500,000 in fiscal year 
590.10 	2027. (2) Of the amount in clause (1), 
590.11 	$400,000 in fiscal year 2024 is to support the 
590.12 	transition from implementation of activities 
590.13 	under Minnesota Statutes, section 145.4235, 
590.14 	to implementation of activities under 
590.15 	Minnesota Statutes, sections 145.9571 to 
590.16 	145.9576. The commissioner shall award four 
590.17 	sole-source grants of $100,000 each to Face 
590.18 	to Face, Cradle of Hope, Division of Indian 
590.19 	Work, and Minnesota Prison Doula Project. 
590.20 	The amount in this clause is a onetime 
590.21 	appropriation.
590.22 	(h) Help Me Connect. $463,000 in fiscal year 
590.23 	2024 and $921,000 in fiscal year 2025 are 
590.24 	from the general fund for the Help Me 
590.25 	Connect program under Minnesota Statutes, 
590.26 	section 145.988.
590.27 	(i) Home visiting. $2,000,000 in fiscal year 
590.28 	2024 and $2,000,000 in fiscal year 2025 are 
590.29 	from the general fund for home visiting under 
590.30 	Minnesota Statutes, section 145.87, to provide 
590.31 	home visiting to priority populations under 
590.32 	Minnesota Statutes, section 145.87, 
590.33 	subdivision 1, paragraph (e).
590.34 	(j) No Surprises Act enforcement.
590.35 	$1,210,000 in fiscal year 2024 and $1,090,000 
591.1 	in fiscal year 2025 are from the general fund 
591.2 	for implementation of the federal No Surprises 
591.3 	Act under Minnesota Statutes, section 
591.4 	62Q.021, and an assessment of the feasibility 
591.5 	of a statewide provider directory. The general 
591.6 	fund base for this appropriation is $855,000 
591.7 	in fiscal year 2026 and $855,000 in fiscal year 
591.8 	2027.
591.9 	(k) Office of African American Health.
591.10 	$1,000,000 in fiscal year 2024 and $1,000,000 
591.11 	in fiscal year 2025 are from the general fund 
591.12 	for grants under the authority of the Office of 
591.13 	African American Health under Minnesota 
591.14 	Statutes, section 144.0756.
591.15 	(l) Office of American Indian Health.
591.16 	$1,000,000 in fiscal year 2024 and $1,000,000 
591.17 	in fiscal year 2025 are from the general fund 
591.18 	for grants under the authority of the Office of 
591.19 	American Indian Health under Minnesota 
591.20 	Statutes, section 144.0757.
591.21 	(m) Public health system transformation 
591.22 	grants. (1) $9,844,000 in fiscal year 2024 and 
591.23 	$9,844,000 in fiscal year 2025 are from the 
591.24 	general fund for grants under Minnesota 
591.25 	Statutes, section 145A.131, subdivision 1, 
591.26 	paragraph (f).
591.27 	(2) $535,000 in fiscal year 2024 and $535,000 
591.28 	in fiscal year 2025 are from the general fund 
591.29 	for grants under Minnesota Statutes, section 
591.30 	145A.14, subdivision 2b.
591.31 	(3) $321,000 in fiscal year 2024 and $321,000 
591.32 	in fiscal year 2025 are from the general fund 
591.33 	for grants under Minnesota Statutes, section 
591.34 	144.0759.
592.1 	(n) Health care workforce. (1) $1,010,000 
592.2 	in fiscal year 2024 and $2,550,000 in fiscal 
592.3 	year 2025 are from the health care access fund 
592.4 	for rural training tracks and rural clinicals 
592.5 	grants under Minnesota Statutes, sections 
592.6 	144.1505 and 144.1507. The base for this 
592.7 	appropriation is $4,060,000 in fiscal year 2026 
592.8 	and $3,600,000 in fiscal year 2027.
592.9 	(2) $420,000 in fiscal year 2024 and $420,000 
592.10 	in fiscal year 2025 are from the health care 
592.11 	access fund for immigrant international 
592.12 	medical graduate training grants under 
592.13 	Minnesota Statutes, section 144.1911.
592.14 	(3) $5,654,000 in fiscal year 2024 and 
592.15 	$5,550,000 in fiscal year 2025 are from the 
592.16 	health care access fund for site-based clinical 
592.17 	training grants under Minnesota Statutes, 
592.18 	section 144.1508. The base for this 
592.19 	appropriation is $4,657,000 in fiscal year 2026 
592.20 	and $3,451,000 in fiscal year 2027.
592.21 	(4) $1,000,000 in fiscal year 2024 and 
592.22 	$1,000,000 in fiscal year 2025 are from the 
592.23 	health care access fund for mental health for 
592.24 	health care professional grants. This is a 
592.25 	onetime appropriation and is available until 
592.26 	June 30, 2027.
592.27 	(5) $502,000 in fiscal year 2024 and $502,000 
592.28 	in fiscal year 2025 are from the health care 
592.29 	access fund for workforce research and data 
592.30 	analysis of shortages, maldistribution of health 
592.31 	care providers in Minnesota, and the factors 
592.32 	that influence decisions of health care 
592.33 	providers to practice in rural areas of 
592.34 	Minnesota.
593.1 	(o) School health. $800,000 in fiscal year 
593.2 	2024 and $1,300,000 in fiscal year 2025 are 
593.3 	from the general fund for grants under 
593.4 	Minnesota Statutes, section 145.903. The base 
593.5 	for this appropriation is $2,300,000 in fiscal 
593.6 	year 2026 and $2,300,000 in fiscal year 2027.
593.7 	(p) Long COVID. $3,146,000 in fiscal year 
593.8 	2024 and $3,146,000 in fiscal year 2025 are 
593.9 	from the general fund for grants and to 
593.10 	implement Minnesota Statutes, section 
593.11 	145.361.
593.12 	(q) Workplace safety grants. $4,400,000 in 
593.13 	fiscal year 2024 is from the general fund for 
593.14 	grants to health care entities to improve 
593.15 	employee safety or security. This is a onetime 
593.16 	appropriation and is available until June 30, 
593.17 	2027. The commissioner may use up to ten 
593.18 	percent of this appropriation for 
593.19 	administration.
593.20 	(r) Clinical dental education innovation 
593.21 	grants. $1,122,000 in fiscal year 2024 and 
593.22 	$1,122,000 in fiscal year 2025 are from the 
593.23 	general fund for clinical dental education 
593.24 	innovation grants under Minnesota Statutes, 
593.25 	section 144.1913.
593.26 	(s) Emmett Louis Till Victims Recovery 
593.27 	Program. $500,000 in fiscal year 2024 is from 
593.28 	the general fund for a grant to the Emmett 
593.29 	Louis Till Victims Recovery Program. The 
593.30 	commissioner must not use any of this 
593.31 	appropriation for administration. This is a 
593.32 	onetime appropriation and is available until 
593.33 	June 30, 2025.
594.1 	(t) Center for health care affordability.
594.2 	$2,752,000 in fiscal year 2024 and $3,989,000 
594.3 	in fiscal year 2025 are from the general fund 
594.4 	to establish a center for health care 
594.5 	affordability and to implement Minnesota 
594.6 	Statutes, section 62J.312. The general fund 
594.7 	base for this appropriation is $3,988,000 in 
594.8 	fiscal year 2026 and $3,988,000 in fiscal year 
594.9 	2027.
594.10 	(u) Federally qualified health centers 
594.11 	apprenticeship program. $690,000 in fiscal 
594.12 	year 2024 and $690,000 in fiscal year 2025 
594.13 	are from the general fund for grants under 
594.14 	Minnesota Statutes, section 145.9272.
594.15 	(v) Alzheimer's public information 
594.16 	program. $80,000 in fiscal year 2024 and 
594.17 	$80,000 in fiscal year 2025 are from the 
594.18 	general fund for grants to community-based 
594.19 	organizations to co-create culturally specific 
594.20 	messages to targeted communities and to 
594.21 	promote public awareness materials online 
594.22 	through diverse media channels.
594.23 	(w) Keeping Nurses at the Bedside Act; 
594.24 	contingent appropriation Nurse and Patient 
594.25 	Safety Act.The appropriations in this 
594.26 	paragraph are contingent upon legislative 
594.27 	enactment of 2023 Senate File 1384 by the 
594.28 	93rd Legislature. The appropriations in this 
594.29 	paragraph are available until June 30, 2027.
594.30 	(1) $5,317,000 in fiscal year 2024 and 
594.31 	$5,317,000 in fiscal year 2025 are is from the 
594.32 	general fund for loan forgiveness under 
594.33 	Minnesota Statutes, section 144.1501, for 
594.34 	eligible nurses who have agreed to work as 
594.35 	hospital nurses in accordance with Minnesota 
595.1 	Statutes, section 144.1501, subdivision 2, 
595.2 	paragraph (a), clause (7).
595.3 	(2) $66,000 in fiscal year 2024 and $66,000 
595.4 	in fiscal year 2025 are from the general fund 
595.5 	for loan forgiveness under Minnesota Statutes, 
595.6 	section 144.1501, for eligible nurses who have 
595.7 	agreed to teach in accordance with Minnesota 
595.8 	Statutes, section 144.1501, subdivision 2, 
595.9 	paragraph (a), clause (3).
595.10 	(3) $545,000 in fiscal year 2024 and $879,000 
595.11 	in fiscal year 2025 are from the general fund 
595.12 	to administer Minnesota Statutes, section 
595.13 	144.7057; to perform the evaluation duties 
595.14 	described in Minnesota Statutes, section 
595.15 	144.7058; to continue prevention of violence 
595.16 	in health care program activities; to analyze 
595.17 	potential links between adverse events and 
595.18 	understaffing; to convene stakeholder groups 
595.19 	and create a best practices toolkit; and for a 
595.20 	report on the current status of the state's 
595.21 	nursing workforce employed by hospitals. The 
595.22 	base for this appropriation is $624,000 in fiscal 
595.23 	year 2026 and $454,000 in fiscal year 2027.
595.24 	(x) Supporting healthy development of 
595.25 	babies. $260,000 in fiscal year 2024 and 
595.26 	$260,000 in fiscal year 2025 are from the 
595.27 	general fund for a grant to the Amherst H. 
595.28 	Wilder Foundation for the African American 
595.29 	Babies Coalition initiative. The base for this 
595.30 	appropriation is $520,000 in fiscal year 2026 
595.31 	and $0 in fiscal year 2027. Any appropriation 
595.32 	in fiscal year 2026 is available until June 30, 
595.33 	2027. This paragraph expires on June 30, 
595.34 	2027.
596.1 	(y) Health professional education loan 
596.2 	forgiveness. $2,780,000 in fiscal year 2024 
596.3 	is from the general fund for eligible mental 
596.4 	health professional loan forgiveness under 
596.5 	Minnesota Statutes, section 144.1501. This is 
596.6 	a onetime appropriation. The commissioner 
596.7 	may use up to ten percent of this appropriation 
596.8 	for administration.
596.9 	(z) Primary care residency expansion grant 
596.10 	program. $400,000 in fiscal year 2024 and 
596.11 	$400,000 in fiscal year 2025 are from the 
596.12 	general fund for a psychiatry resident under 
596.13 	Minnesota Statutes, section 144.1506.
596.14 	(aa) Pediatric primary care mental health 
596.15 	training grant program. $1,000,000 in fiscal 
596.16 	year 2024 and $1,000,000 in fiscal year 2025 
596.17 	are from the general fund for grants under 
596.18 	Minnesota Statutes, section 144.1509. The 
596.19 	commissioner may use up to ten percent of 
596.20 	this appropriation for administration.
596.21 	(bb) Mental health cultural community 
596.22 	continuing education grant program. 
596.23 	$500,000 in fiscal year 2024 and $500,000 in 
596.24 	fiscal year 2025 are from the general fund for 
596.25 	grants under Minnesota Statutes, section 
596.26 	144.1511. The commissioner may use up to 
596.27 	ten percent of this appropriation for 
596.28 	administration.
596.29 	(cc) Labor trafficking services grant 
596.30 	program. $500,000 in fiscal year 2024 and 
596.31 	$500,000 in fiscal year 2025 are from the 
596.32 	general fund for grants under Minnesota 
596.33 	Statutes, section 144.3885.
597.1 	(dd) Palliative Care Advisory Council. 
597.2 	$40,000 $44,000 in fiscal year 2024 and 
597.3 	$40,000 $44,000 in fiscal year 2025 are from 
597.4 	the general fund for grants under Minnesota 
597.5 	Statutes, section 144.059.
597.6 	(ee) Analysis of a universal health care 
597.7 	financing system. $1,815,000 in fiscal year 
597.8 	2024 and $580,000 in fiscal year 2025 are 
597.9 	from the general fund to the commissioner to 
597.10 	contract for an analysis of the benefits and 
597.11 	costs of a legislative proposal for a universal 
597.12 	health care financing system and a similar 
597.13 	analysis of the current health care financing 
597.14 	system. The base for this appropriation is 
597.15 	$580,000 in fiscal year 2026 and $0 in fiscal 
597.16 	year 2027. This appropriation is available until 
597.17 	June 30, 2027.
597.18 	(ff) Charitable assets public interest review.
597.19 	(1) The appropriations under this paragraph 
597.20 	are contingent upon legislative enactment of 
597.21 	2023 House File 402 by the 93rd Legislature.
597.22 	(2) $1,584,000 in fiscal year 2024 and 
597.23 	$769,000 in fiscal year 2025 are from the 
597.24 	general fund to review certain health care 
597.25 	entity transactions; to conduct analyses of the 
597.26 	impacts of health care transactions on health 
597.27 	care cost, quality, and competition; and to 
597.28 	issue public reports on health care transactions 
597.29 	in Minnesota and their impacts. The base for 
597.30 	this appropriation is $710,000 in fiscal year 
597.31 	2026 and $710,000 in fiscal year 2027.
597.32 	(gg) Study of the development of a statewide 
597.33 	registry for provider orders for 
597.34 	life-sustaining treatment. $365,000 in fiscal 
597.35 	year 2024 and $365,000 in fiscal year 2025 
598.1 	are is from the general fund for a study of the 
598.2 	development of a statewide registry for 
598.3 	provider orders for life-sustaining treatment. 
598.4 	This is a onetime appropriation.
598.5 	(hh) Task Force on Pregnancy Health and 
598.6 	Substance Use Disorders. $199,000 in fiscal 
598.7 	year 2024 and $100,000 in fiscal year 2025 
598.8 	are from the general fund for the Task Force 
598.9 	on Pregnancy Health and Substance Use 
598.10 	Disorders. This is a onetime appropriation and 
598.11 	is available until June 30, 2025.
598.12 	(ii) 988 Suicide and crisis lifeline. $4,000,000 
598.13 	in fiscal year 2024 is from the general fund 
598.14 	for 988 national suicide prevention lifeline 
598.15 	grants under Minnesota Statutes, section 
598.16 	145.561. This is a onetime appropriation.
598.17 	(jj) Equitable Health Care Task Force.
598.18 	$779,000 in fiscal year 2024 and $749,000 in 
598.19 	fiscal year 2025 are from the general fund for 
598.20 	the Equitable Health Care Task Force. This is 
598.21 	a onetime appropriation.
598.22 	(kk) Psychedelic Medicine Task Force.
598.23 	$338,000 in fiscal year 2024 and $171,000 in 
598.24 	fiscal year 2025 are from the general fund for 
598.25 	the Psychedelic Medicine Task Force. This is 
598.26 	a onetime appropriation.
598.27 	(ll) Medical education and research costs.
598.28 	$300,000 in fiscal year 2024 and $300,000 in 
598.29 	fiscal year 2025 are from the general fund for 
598.30 	the medical education and research costs 
598.31 	program under Minnesota Statutes, section 
598.32 	62J.692.
598.33 	(mm) Special Guerilla Unit Veterans grant 
598.34 	program. $250,000 in fiscal year 2024 and 
599.1 	$250,000 in fiscal year 2025 are from the 
599.2 	general fund for a grant to the Special 
599.3 	Guerrilla Units Veterans and Families of the 
599.4 	United States of America to offer 
599.5 	programming and culturally specific and 
599.6 	specialized assistance to support the health 
599.7 	and well-being of Special Guerilla Unit 
599.8 	Veterans. The base for this appropriation is 
599.9 	$500,000 in fiscal year 2026 and $0 in fiscal 
599.10 	year 2027. Any amount appropriated in fiscal 
599.11 	year 2026 is available until June 30, 2027. 
599.12 	This paragraph expires June 30, 2027.
599.13 	(nn) Safe harbor regional navigator. 
599.14 	$300,000 in fiscal year 2024 and $300,000 in 
599.15 	fiscal year 2025 are for a regional navigator 
599.16 	in northwestern Minnesota. The commissioner 
599.17 	may use up to ten percent of this appropriation 
599.18 	for administration.
599.19 	(oo) Network adequacy. $798,000 in fiscal 
599.20 	year 2024 and $491,000 in fiscal year 2025 
599.21 	are from the general fund for reviews of 
599.22 	provider networks under Minnesota Statutes, 
599.23 	section 62K.10, to determine network 
599.24 	adequacy.
599.25 	(pp) Grant to Minnesota Alliance for 
599.26 	Volunteer Advancement. $278,000 in fiscal 
599.27 	year 2024 is from the general fund for a grant 
599.28 	to the Minnesota Alliance for Volunteer 
599.29 	Advancement to administer needs-based 
599.30 	volunteerism subgrants targeting 
599.31 	underresourced nonprofit organizations in 
599.32 	greater Minnesota. Subgrants must be used to 
599.33 	support the ongoing efforts of selected 
599.34 	organizations to address and minimize 
599.35 	disparities in access to human services through 
600.1 	increased volunteerism. Subgrant applicants 
600.2 	must demonstrate that the populations to be 
600.3 	served by the subgrantee are underserved or 
600.4 	suffer from or are at risk of homelessness, 
600.5 	hunger, poverty, lack of access to health care, 
600.6 	or deficits in education. The Minnesota 
600.7 	Alliance for Volunteer Advancement must 
600.8 	give priority to organizations that are serving 
600.9 	the needs of vulnerable populations. This is a 
600.10 	onetime appropriation and is available until 
600.11 	June 30, 2025.
600.12 	(pp) (qq)(1) TANF Appropriations. TANF 
600.13 	funds must be used as follows:
600.14 	(i) $3,579,000 in fiscal year 2024 and 
600.15 	$3,579,000 in fiscal year 2025 are from the 
600.16 	TANF fund for home visiting and nutritional 
600.17 	services listed under Minnesota Statutes, 
600.18 	section 145.882, subdivision 7, clauses (6) and 
600.19 	(7). Funds must be distributed to community 
600.20 	health boards according to Minnesota Statutes, 
600.21 	section 145A.131, subdivision 1;
600.22 	(ii) $2,000,000 in fiscal year 2024 and 
600.23 	$2,000,000 in fiscal year 2025 are from the 
600.24 	TANF fund for decreasing racial and ethnic 
600.25 	disparities in infant mortality rates under 
600.26 	Minnesota Statutes, section 145.928, 
600.27 	subdivision 7;
600.28 	(iii) $4,978,000 in fiscal year 2024 and 
600.29 	$4,978,000 in fiscal year 2025 are from the 
600.30 	TANF fund for the family home visiting grant 
600.31 	program under Minnesota Statutes, section 
600.32 	145A.17. $4,000,000 of the funding in fiscal 
600.33 	year 2024 and $4,000,000 in fiscal year 2025 
600.34 	must be distributed to community health 
600.35 	boards under Minnesota Statutes, section 
601.1 	145A.131, subdivision 1. $978,000 of the 
601.2 	funding in fiscal year 2024 and $978,000 in 
601.3 	fiscal year 2025 must be distributed to Tribal 
601.4 	governments under Minnesota Statutes, section 
601.5 	145A.14, subdivision 2a;
601.6 	(iv) $1,156,000 in fiscal year 2024 and 
601.7 	$1,156,000 in fiscal year 2025 are from the 
601.8 	TANF fund for sexual and reproductive health 
601.9 	services grants under Minnesota Statutes, 
601.10 	section 145.925; and
601.11 	(v) the commissioner may use up to 6.23 
601.12 	percent of the funds appropriated from the 
601.13 	TANF fund each fiscal year to conduct the 
601.14 	ongoing evaluations required under Minnesota 
601.15 	Statutes, section 145A.17, subdivision 7, and 
601.16 	training and technical assistance as required 
601.17 	under Minnesota Statutes, section 145A.17, 
601.18 	subdivisions 4 and 5.
601.19 	(2) TANF Carryforward. Any unexpended 
601.20 	balance of the TANF appropriation in the first 
601.21 	year does not cancel but is available in the 
601.22 	second year.
601.23 	(qq) (rr)Base level adjustments. The general 
601.24 	fund base is $197,644,000 in fiscal year 2026 
601.25 	and $195,714,000 in fiscal year 2027. The 
601.26 	health care access fund base is $53,354,000 
601.27 	in fiscal year 2026 and $50,962,000 in fiscal 
601.28 	year 2027.

601.29 	Sec. 21. Laws 2023, chapter 70, article 20, section 12, as amended by Laws 2023, chapter 
601.30 	75, section 13, is amended to read:

601.31
601.32	Sec. 12. COMMISSIONER OF 
MANAGEMENT AND BUDGET
 	$
	12,932,000
	$
	3,412,000
	
601.33 	(a) Outcomes and evaluation consultation. 
601.34 	$450,000 in fiscal year 2024 and $450,000 in 
602.1 	fiscal year 2025 are for outcomes and 
602.2 	evaluation consultation requirements.
602.3 	(b) Department of Children, Youth, and 
602.4 	Families. $11,931,000 in fiscal year 2024 and 
602.5 	$2,066,000 in fiscal year 2025 are to establish 
602.6 	the Department of Children, Youth, and 
602.7 	Families. This is a onetime appropriation.
602.8 	(c) Keeping Nurses at the Bedside Act 
602.9 	impact evaluation; contingent 
602.10 	appropriation. $232,000 in fiscal year 2025 
602.11 	is for the Keeping Nurses at the Bedside Act 
602.12 	impact evaluation. This appropriation is 
602.13 	contingent upon legislative enactment by the 
602.14 	93rd Legislature of a provision substantially 
602.15 	similar to the impact evaluation provision in 
602.16 	2023 S.F. No. 2995, the third engrossment, 
602.17 	article 3, section 22. This is a onetime 
602.18 	appropriation and is available until June 30, 
602.19 	2029.
602.20 	(d) (c)Health care subcabinet. $551,000 in 
602.21 	fiscal year 2024 and $664,000 in fiscal year 
602.22 	2025 are to hire an executive director for the 
602.23 	health care subcabinet and to provide staffing 
602.24 	and administrative support for the health care 
602.25 	subcabinet.
602.26 	(e) (d)Base level adjustment. The general 
602.27 	fund base is $1,114,000 in fiscal year 2026 
602.28 	and $1,114,000 in fiscal year 2027.

602.29 	Sec. 22. Laws 2023, chapter 70, article 20, section 23, is amended to read:
602.30 	Sec. 23. TRANSFERS.
 602.31 		Subdivision 1.Grants. The commissioner of human services and commissioner of 
602.32 	children, youth, and families, with the approval of the commissioner of management and 
602.33 	budget, may transfer unencumbered appropriation balances for the biennium ending June 
603.1 	30, 2025, within fiscal years among MFIP; general assistance; medical assistance; 
603.2 	MinnesotaCare; MFIP child care assistance under Minnesota Statutes, section 119B.05; 
603.3 	Minnesota supplemental aid program; housing support program; the entitlement portion of 
603.4 	Northstar Care for Children under Minnesota Statutes, chapter 256N; and the entitlement 
603.5 	portion of the behavioral health fund between fiscal years of the biennium. The commissioner 
603.6 	shall report to the chairs and ranking minority members of the legislative committees with 
603.7 	jurisdiction over health and human services quarterly about transfers made under this 
603.8 	subdivision.
603.9 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
603.10 	may be transferred within and between the Department of Human Services and the 
603.11 	Department of Children, Youth, and Families as the commissioners consider necessary, 
603.12 	with the advance approval of the commissioner of management and budget. The 
603.13 	commissioners shall report to the chairs and ranking minority members of the legislative 
603.14 	committees with jurisdiction over health and human services finance quarterly about transfers 
603.15 	made under this section.

603.16 	Sec. 23. INDIRECT COSTS NOT TO FUND PROGRAMS.
 603.17 	The commissioner of health shall not use indirect cost allocations to pay for the 
603.18 	operational costs of any program for which the commissioner is responsible.

603.19 	Sec. 24. EXPIRATION OF UNCODIFIED LANGUAGE.
 603.20 	All uncodified language contained in this article expires on June 30, 2025, unless a 
603.21 	different expiration date is explicit.

APPENDIX 

Repealed Minnesota Statutes: S4699-1 

62A.041 MATERNITY BENEFITS.Subd. 3.Abortion. 
For the purposes of this section, the term "maternity benefits" shall not include elective, induced abortion whether performed in a hospital, other abortion facility, or the office of a physician. 

This section applies to policies and contracts issued, delivered, or renewed after August 1, 1985, that cover Minnesota residents. 

62J.312 CENTER FOR HEALTH CARE AFFORDABILITY.Subd. 6.340B covered entity report. 
(a) Beginning April 1, 2024, each 340B covered entity, as defined by section 340B(a)(4) of the Public Health Service Act, must report to the commissioner of health by April 1 of each year the following information related to its participation in the federal 340B program for the previous calendar year: 

(1) the National Provider Identification (NPI) number; 

(2) the name of the 340B covered entity; 

(3) the servicing address of the 340B covered entity; 

(4) the classification of the 340B covered entity; 

(5) the aggregated acquisition cost for prescription drugs obtained under the 340B program; 

(6) the aggregated payment amount received for drugs obtained under the 340B program and dispensed to patients; 

(7) the aggregated payment made to pharmacies under contract to dispense drugs obtained under the 340B program; and 

(8) the number of claims for prescription drugs described in clause (6). 

(b) The information required under paragraph (a) must be reported by payer type, including commercial insurance, medical assistance and MinnesotaCare, and Medicare, in the form and manner defined by the commissioner. For covered entities that are hospitals, the information required under paragraph (a), clauses (5) to (8), must also be reported at the national drug code level for the 50 most frequently dispensed drugs by the facility under the 340B program. 

(c) Data submitted under paragraph (a) must include prescription drugs dispensed by outpatient facilities that are identified as child facilities under the federal 340B program based on their inclusion on the hospital's Medicare cost report. 

(d) Data submitted to the commissioner under paragraph (a) must be classified as nonpublic data as defined in section 13.02, subdivision 9. 

(e) Beginning November 15, 2024, and by November 15 of each year thereafter, the commissioner shall prepare a report that aggregates the data submitted under paragraph (a). The commissioner shall submit this report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care finance and policy. 

62Q.522 COVERAGE OF CONTRACEPTIVE METHODS AND SERVICES.Subd. 3.Exemption. 
(a) An exempt organization is not required to cover contraceptives or contraceptive services if the exempt organization has religious objections to the coverage. An exempt organization that chooses to not provide coverage for some or all contraceptives and contraceptive services must notify employees as part of the hiring process and to all employees at least 30 days before: 

(1) an employee enrolls in the health plan; or 

(2) the effective date of the health plan, whichever occurs first. 

(b) If the exempt organization provides coverage for some contraceptive methods or services, the notice required under paragraph (a) must provide a list of the contraceptive methods or services the organization refuses to cover. 

Subd. 4.Accommodation for eligible organizations. 
(a) A health plan established or maintained by an eligible organization complies with the requirements of subdivision 2 to provide coverage of contraceptive methods and services, with respect to the contraceptive methods or services identified in the notice under this paragraph, if the eligible organization provides notice to any health plan company the eligible organization contracts with that it is an eligible organization and that the eligible organization has a religious objection to coverage for all or a subset of contraceptive methods or services. 

(b) The notice from an eligible organization to a health plan company under paragraph (a) must include: (1) the name of the eligible organization; (2) a statement that it objects to coverage for some or all of contraceptive methods or services, including a list of the contraceptive methods or services the eligible organization objects to, if applicable; and (3) the health plan name. The notice must be executed by a person authorized to provide notice on behalf of the eligible organization. 

(c) An eligible organization must provide a copy of the notice under paragraph (a) to prospective employees as part of the hiring process and to all employees at least 30 days before: 

(1) an employee enrolls in the health plan; or 

(2) the effective date of the health plan, whichever occurs first. 

(d) A health plan company that receives a copy of the notice under paragraph (a) with respect to a health plan established or maintained by an eligible organization must, for all future enrollments in the health plan: 

(1) expressly exclude coverage for those contraceptive methods or services identified in the notice under paragraph (a) from the health plan; and 

(2) provide separate payments for any contraceptive methods or services required to be covered under subdivision 2 for enrollees as long as the enrollee remains enrolled in the health plan. 

(e) The health plan company must not impose any cost-sharing requirements, including co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or other charge for contraceptive services or methods on the eligible organization, health plan, or enrollee. 

(f) On January 1, 2024, and every year thereafter a health plan company must notify the commissioner, in a manner determined by the commissioner, of the number of eligible organizations granted an accommodation under this subdivision. 

144.0528 COMPREHENSIVE DRUG OVERDOSE AND MORBIDITY PREVENTION ACT.Subd. 5.Promotion; administration.  
In fiscal years 2026 and beyond, the commissioner may spend up to 25 percent of the total funding appropriated for the comprehensive drug overdose and morbidity program in each fiscal year to promote, administer, support, and evaluate the programs authorized under this section and to provide technical assistance to program grantees. 

144.218 REPLACEMENT BIRTH RECORDS.Subd. 3.Subsequent marriage of birth parents. 
If, in cases in which a record of birth has been registered pursuant to section 144.215 and the birth parents of the child marry after the birth of the child, a replacement record of birth shall be registered upon presentation of a certified copy of the marriage certificate of the birth parents, and either a recognition of parentage or court adjudication of paternity. The original record of birth is confidential, pursuant to section 13.02, subdivision 3, and shall not be disclosed except pursuant to court order. 

144.497 ST ELEVATION MYOCARDIAL INFARCTION.
The commissioner of health shall assess and report on the quality of care provided in the state for ST elevation myocardial infarction response and treatment. The commissioner shall: 

(1) utilize and analyze data provided by ST elevation myocardial infarction receiving centers to the ACTION Registry-Get with the guidelines or an equivalent data platform that does not identify individuals or associate specific ST elevation myocardial infarction heart attack events with an identifiable individual; 

(2) annually post a summary report of the data in aggregate form on the Department of Health website; and 

(3) coordinate to the extent possible with national voluntary health organizations involved in ST elevation myocardial infarction heart attack quality improvement to encourage ST elevation myocardial infarction receiving centers to report data consistent with nationally recognized guidelines on the treatment of individuals with confirmed ST elevation myocardial infarction heart attacks within the state and encourage sharing of information among health care providers on ways to improve the quality of care of ST elevation myocardial infarction patients in Minnesota. 

144E.001 DEFINITIONS.Subd. 5.Board. 
"Board" means the Emergency Medical Services Regulatory Board. 

144E.01 EMERGENCY MEDICAL SERVICES REGULATORY BOARD.Subdivision 1.Membership. 
(a) The Emergency Medical Services Regulatory Board consists of the following members, all of whom must work in Minnesota, except for the person listed in clause (14): 

(1) an emergency physician certified by the American Board of Emergency Physicians; 

(2) a representative of Minnesota hospitals; 

(3) a representative of fire chiefs; 

(4) a full-time firefighter who serves as an emergency medical responder on or within a nontransporting or nonregistered agency and who is a member of a professional firefighter's union; 

(5) a volunteer firefighter who serves as an emergency medical responder on or within a nontransporting or nonregistered agency; 

(6) an attendant currently practicing on a licensed ambulance service who is a paramedic or an emergency medical technician; 

(7) an ambulance director for a licensed ambulance service; 

(8) a representative of sheriffs; 

(9) a member of a community health board to represent community health services; 

(10) two representatives of regional emergency medical services programs, one of whom must be from the metropolitan regional emergency medical services program; 

(11) a registered nurse currently practicing in a hospital emergency department; 

(12) a pediatrician, certified by the American Board of Pediatrics, with experience in emergency medical services; 

(13) a family practice physician who is currently involved in emergency medical services; 

(14) a public member who resides in Minnesota; and 

(15) the commissioners of health and public safety or their designees. 

(b) The governor shall appoint members under paragraph (a). Appointments under paragraph (a), clauses (1) to (9) and (11) to (13), are subject to the advice and consent of the senate. In making appointments under paragraph (a), clauses (1) to (9) and (11) to (13), the governor shall consider recommendations of the American College of Emergency Physicians, the Minnesota Hospital Association, the Minnesota and State Fire Chief's Association, the Minnesota Ambulance Association, the Minnesota Emergency Medical Services Association, the Minnesota State Sheriff's Association, the Association of Minnesota Counties, the Minnesota Nurses Association, and the Minnesota chapter of the Academy of Pediatrics. 

(c) At least seven members appointed under paragraph (a) must reside outside of the seven-county metropolitan area, as defined in section 473.121. 

Subd. 2.Ex officio members. 
The speaker of the house and the Committee on Rules and Administration of the senate shall appoint one representative and one senator to serve as ex officio, nonvoting members. 

Subd. 3.Chair. 
The governor shall designate one of the members appointed under subdivision 1 as chair of the board. 

Subd. 4.Compensation; terms. 
Membership terms, compensation, and removal of members appointed under subdivision 1, are governed by section 15.0575. 

Subd. 5.Staff. 
The board shall appoint an executive director who shall serve in the unclassified service and may appoint other staff. The service of the executive director shall be subject to the terms described in section 214.04, subdivision 2a. 

Subd. 6.Duties of board. 
(a) The Emergency Medical Services Regulatory Board shall: 

(1) administer and enforce the provisions of this chapter and other duties as assigned to the board; 

(2) advise applicants for state or federal emergency medical services funds, review and comment on such applications, and approve the use of such funds unless otherwise required by federal law; 

(3) make recommendations to the legislature on improving the access, delivery, and effectiveness of the state's emergency medical services delivery system; and 

(4) establish procedures for investigating, hearing, and resolving complaints against emergency medical services providers. 

(b) The Emergency Medical Services Board may prepare an initial work plan, which may be updated biennially. The work plan may include provisions to: 

(1) prepare an emergency medical services assessment which addresses issues affecting the statewide delivery system; 

(2) establish a statewide public information and education system regarding emergency medical services; 

(3) create, in conjunction with the Department of Public Safety, a statewide injury and trauma prevention program; and 

(4) designate an annual emergency medical services personnel recognition day. 

Subd. 7.Conflict of interest. 
No member of the Emergency Medical Services Board may participate or vote in board proceedings in which the member has a direct conflict of interest, financial or otherwise. 

144E.123 PREHOSPITAL CARE DATA.Subd. 5.Working group. 
By October 1, 2011, the board must convene a working group composed of six members, three of which must be appointed by the board and three of which must be appointed by the Minnesota Ambulance Association, to redesign the board's policies related to collection of data from licenses. The issues to be considered include, but are not limited to, the following: user-friendly reporting requirements; data sets; improved accuracy of reported information; appropriate use of information gathered through the reporting system; and methods for minimizing the financial impact of data reporting on licenses, particularly for rural volunteer services. The working group must report its findings and recommendations to the board no later than July 1, 2012. 

144E.27 EDUCATION PROGRAMS; BOARD APPROVAL.Subdivision 1.Education program instructor. 
 An education program instructor must be an emergency medical responder, EMT, AEMT, paramedic, physician, physician assistant, or registered nurse. 

Subd. 1a.Approval required. 
(a) All education programs for an emergency medical responder must be approved by the board. 

(b) To be approved by the board, an education program must: 

(1) submit an application prescribed by the board that includes: 

(i) type and length of course to be offered; 

(ii) names, addresses, and qualifications of the program medical director, program education coordinator, and instructors; 

(iii) admission criteria for students; and 

(iv) materials and equipment to be used; 

(2) for each course, implement the most current version of the United States Department of Transportation EMS Education Standards, or its equivalent as determined by the board applicable to Emergency Medical Responder registration education; 

(3) have a program medical director and a program coordinator; 

(4) have at least one instructor for every ten students at the practical skill stations; 

(5) retain documentation of program approval by the board, course outline, and student information; and 

(6) submit the appropriate fee as required under section 144E.29. 

(c) The National EMS Education Standards by the NHTSA, United States Department of Transportation contains the minimal entry level of knowledge and skills for emergency medical responders. Medical directors of emergency medical responder groups may expand the knowledge and skill set. 

144E.50 EMERGENCY MEDICAL SERVICES FUND.Subd. 3.Definition. 
For purposes of this section, "board" means the Emergency Medical Services Regulatory Board. 

245A.065 CHILD CARE FIX-IT TICKET.
(a) In lieu of a correction order under section 245A.06, the commissioner shall issue a fix-it ticket to a family child care or child care center license holder if the commissioner finds that: 

(1) the license holder has failed to comply with a requirement in this chapter or Minnesota Rules, chapter 9502 or 9503, that the commissioner determines to be eligible for a fix-it ticket; 

(2) the violation does not imminently endanger the health, safety, or rights of the persons served by the program; 

(3) the license holder did not receive a fix-it ticket or correction order for the violation at the license holder's last licensing inspection; 

(4) the violation can be corrected at the time of inspection or within 48 hours, excluding Saturdays, Sundays, and holidays; and 

(5) the license holder corrects the violation at the time of inspection or agrees to correct the violation within 48 hours, excluding Saturdays, Sundays, and holidays. 

(b) The fix-it ticket must state: 

(1) the conditions that constitute a violation of the law or rule; 

(2) the specific law or rule violated; and 

(3) that the violation was corrected at the time of inspection or must be corrected within 48 hours, excluding Saturdays, Sundays, and holidays. 

(c) The commissioner shall not publicly publish a fix-it ticket on the department's website. 

(d) Within 48 hours, excluding Saturdays, Sundays, and holidays, of receiving a fix-it ticket, the license holder must correct the violation and within one week submit evidence to the licensing agency that the violation was corrected. 

(e) If the violation is not corrected at the time of inspection or within 48 hours, excluding Saturdays, Sundays, and holidays, or the evidence submitted is insufficient to establish that the license holder corrected the violation, the commissioner must issue a correction order for the violation of Minnesota law or rule identified in the fix-it ticket according to section 245A.06. 

245C.08 BACKGROUND STUDY; COMMISSIONER REVIEWS.Subd. 2.Background studies conducted by a county agency for family child care. 
(a) Before the implementation of NETStudy 2.0, for a background study conducted by a county agency for family child care services, the commissioner shall review: 

(1) information from the county agency's record of substantiated maltreatment of adults and the maltreatment of minors; 

(2) information from juvenile courts as required in subdivision 4 for: 

(i) individuals listed in section 245C.03, subdivision 1, paragraph (a), who are ages 13 through 23 living in the household where the licensed services will be provided; and 

(ii) any other individual listed under section 245C.03, subdivision 1, when there is reasonable cause; and 

(3) information from the Bureau of Criminal Apprehension. 

(b) If the individual has resided in the county for less than five years, the study shall include the records specified under paragraph (a) for the previous county or counties of residence for the past five years. 

(c) Notwithstanding expungement by a court, the county agency may consider information obtained under paragraph (a), clause (3), unless: 

(1) the commissioner received notice of the petition for expungement and the court order for expungement is directed specifically to the commissioner; or 

(2) the commissioner received notice of the expungement order issued pursuant to section 609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically to the commissioner. 

245C.125 BACKGROUND STUDY; HEAD START PROGRAMS.
(a) Head Start programs that receive funds under section 119A.52 may contract with the commissioner to: 

(1) conduct background studies on individuals affiliated with a Head Start program; and 

(2) obtain background study data on individuals affiliated with a Head Start program. 

(b) The commissioner must include a national criminal history record check in a background study conducted under paragraph (a). 

(c) A Head Start program site that does not contract with the commissioner, is not licensed, and is not registered to receive payments under chapter 119B is exempt from the relevant requirements in this chapter. Nothing in this section supersedes requirements for background studies in this chapter or chapter 119B or 245H that relate to licensed child care programs or programs registered to receive payments under chapter 119B. For a background study conducted under this section to be transferable to other child care entities, the study must include all components of studies for a certified license-exempt child care center under this chapter. 

256.01 COMMISSIONER OF HUMAN SERVICES; POWERS, DUTIES.Subd. 12.Child mortality review panel. 
(a) The commissioner shall establish a child mortality review panel to review deaths of children in Minnesota, including deaths attributed to maltreatment or in which maltreatment may be a contributing cause and to review near fatalities as defined in section 260E.35. The commissioners of health, education, and public safety and the attorney general shall each designate a representative to the child mortality review panel. Other panel members shall be appointed by the commissioner, including a board-certified pathologist and a physician who is a coroner or a medical examiner. The purpose of the panel shall be to make recommendations to the state and to county agencies for improving the child protection system, including modifications in statute, rule, policy, and procedure. 

(b) The commissioner may require a county agency to establish a local child mortality review panel. The commissioner may establish procedures for conducting local reviews and may require that all professionals with knowledge of a child mortality case participate in the local review. In this section, "professional" means a person licensed to perform or a person performing a specific service in the child protective service system. "Professional" includes law enforcement personnel, social service agency attorneys, educators, and social service, health care, and mental health care providers. 

(c) If the commissioner of human services has reason to believe that a child's death was caused by maltreatment or that maltreatment was a contributing cause, the commissioner has access to not public data under chapter 13 maintained by state agencies, statewide systems, or political subdivisions that are related to the child's death or circumstances surrounding the care of the child. The commissioner shall also have access to records of private hospitals as necessary to carry out the duties prescribed by this section. Access to data under this paragraph is limited to police investigative data; autopsy records and coroner or medical examiner investigative data; hospital, public health, or other medical records of the child; hospital and other medical records of the child's parent that relate to prenatal care; and records created by social service agencies that provided services to the child or family within three years preceding the child's death. A state agency, statewide system, or political subdivision shall provide the data upon request of the commissioner. Not public data may be shared with members of the state or local child mortality review panel in connection with an individual case. 

(d) Notwithstanding the data's classification in the possession of any other agency, data acquired by a local or state child mortality review panel in the exercise of its duties is protected nonpublic or confidential data as defined in section 13.02, but may be disclosed as necessary to carry out the purposes of the review panel. The data is not subject to subpoena or discovery. The commissioner may disclose conclusions of the review panel, but shall not disclose data that was classified as confidential or private data on decedents, under section 13.10, or private, confidential, or protected nonpublic data in the disseminating agency, except that the commissioner may disclose local social service agency data as provided in section 260E.35, on individual cases involving a fatality or near fatality of a person served by the local social service agency prior to the date of death. 

(e) A person attending a child mortality review panel meeting shall not disclose what transpired at the meeting, except to carry out the purposes of the mortality review panel. The proceedings and records of the mortality review panel are protected nonpublic data as defined in section 13.02, subdivision 13, and are not subject to discovery or introduction into evidence in a civil or criminal action against a professional, the state or a county agency, arising out of the matters the panel is reviewing. Information, documents, and records otherwise available from other sources are not immune from discovery or use in a civil or criminal action solely because they were presented during proceedings of the review panel. A person who presented information before the review panel or who is a member of the panel shall not be prevented from testifying about matters within the person's knowledge. However, in a civil or criminal proceeding a person shall not be questioned about the person's presentation of information to the review panel or opinions formed by the person as a result of the review meetings. 

Subd. 12a.Department of Human Services child fatality and near fatality review team. 
(a) The commissioner shall establish a Department of Human Services child fatality and near fatality review team to review child fatalities and near fatalities due to child maltreatment and child fatalities and near fatalities that occur in licensed facilities and are not due to natural causes. The review team shall assess the entire child protection services process from the point of a mandated reporter reporting the alleged maltreatment through the ongoing case management process. Department staff shall lead and conduct on-site local reviews and utilize supervisors from local county and tribal child welfare agencies as peer reviewers. The review process must focus on critical elements of the case and on the involvement of the child and family with the county or tribal child welfare agency. The review team shall identify necessary program improvement planning to address any practice issues identified and training and technical assistance needs of the local agency. Summary reports of each review shall be provided to the state child mortality review panel when completed. 

(b) A member of the child fatality and near fatality review team shall not disclose what transpired during the review, except to carry out the duties of the child fatality and near fatality review team. The proceedings and records of the child fatality and near fatality review team are protected nonpublic data as defined in section 13.02, subdivision 13, and are not subject to discovery or introduction into evidence in a civil or criminal action against a professional, the state, or a county agency arising out of the matters the team is reviewing. Information, documents, and records otherwise available from other sources are not immune from discovery or use in a civil or criminal action solely because they were assessed or presented during proceedings of the review team. A person who presented information before the review team or who is a member of the team shall not be prevented from testifying about matters within the person's knowledge. In a civil or criminal proceeding a person shall not be questioned about the person's presentation of information to the review team or opinions formed by the person as a result of the review. 

256D.19 ABOLITION OF TOWNSHIP SYSTEM OF POOR RELIEF.Subdivision 1.Town system abolished. 
The town system for caring for the poor in each of the counties in which it is in effect is hereby abolished. The local social services agency of each county shall administer general assistance under the provisions of Laws 1973, chapter 650, article 21. 

Subd. 2.Local social services agencies duty. 
All local social services agencies affected by Laws 1973, chapter 650, article 21 are hereby authorized to take over for the county as of January 1, 1974, the ownership of all case records relating to the administration of poor relief. 

256D.20 TRANSFER OF TOWN EMPLOYEES.Subdivision 1.Rules for merit system. 
The term "merit system" as used herein shall mean the rules for a merit system of personnel administration for employees of local social services agencies adopted by the commissioner of human services in accordance with the provisions of section 393.07, including the merit system established for Hennepin County pursuant to Laws 1965, chapter 855, as amended, the federal Social Security article as amended, and merit system standards and regulations issued by the federal Social Security Board and the United States Children's Bureau. 

Subd. 2.Designation of employees. 
All employees of any municipality or town who are engaged full time in poor relief work therein on January 1, 1974 shall be retained as employees of the county and placed under the jurisdiction of its local social services agency. 

All transferred employees shall be blanketed into the merit system with comparable status, classification, longevity, and seniority, and subject to the administrative requirements of the local social services agency. Employees with permanent status under any civil service provision on January 1, 1974, shall be granted permanent status under the merit system at comparable classifications and in accordance with work assignments made under the authority of the local social services agency as provided by the merit system rules. 

The determination of proper job allocation shall be the responsibility of the personnel officer or director as provided under merit system rules applicable to the county involved with the right of appeal of allocation to the Merit System Council or personnel board by any employee affected by this transfer. 

All transferred employees shall receive salaries for the classification to which they are allocated in accordance with the schedule in effect for local social services agency employees and at a salary step which they normally would have received had they been employed by the local social services agency for the same period of service they had previously served under the civil service provisions of any municipality or town; provided, however, that no salary shall be reduced as a result of the transfer. 

All accumulated sick leave of transferred employees in the amount of 60 days or less shall be transferred to the records of the local social services agency and such accumulated sick leave shall be the legal liability of the local social services agency. All accumulated sick leave in excess of 60 days shall be paid in cash to transferred employees by the municipality or town by which they were employed prior to their transfer, at the time of transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to transfer, for all or part of the accumulated sick leave. 

Subd. 3.Merit system transfer.  
Employees of municipalities and towns engaged in the work of administering poor relief who are not covered by civil service provisions shall be blanketed into the merit system subject to a qualifying examination. Employees with one year or more service shall be subject to a qualifying examination and those with less than one year's service shall be subject to an open competitive examination. 

Subd. 4.Disbursement of vacation time.  
All vacation leave of employees referred to in subdivision 2, accumulated prior to their transfer to county employment shall be paid in cash to them by the municipality or town by which they were employed prior to their transfer, and at the time of their transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to such transfer, for all or part of the accumulated vacation time. 

256D.23 TEMPORARY COUNTY ASSISTANCE PROGRAM.Subdivision 1.Program established. 
Minnesota residents who meet the income and resource standards of section 256D.01, subdivision 1a, but do not qualify for cash benefits under sections 256D.01 to 256D.21, may qualify for a county payment under this section. 

Subd. 2.Payment amount, duration, and method. 
(a) A county may make a payment of up to $203 for a single individual and up to $260 for a married couple under the terms of this subdivision. 

(b) Payments to an individual or married couple may only be made once in a calendar year. If the applicant qualifies for a payment as a result of an emergency, as defined by the county, the payment shall be made within ten working days of the date of application. If the applicant does not qualify under the county definition of emergency, the payment shall be made at the beginning of the second month following the month of application, and the applicant must receive the payment in person at the local agency office. 

(c) Payments may be made in the form of cash or as vendor payments for rent and utilities. If vendor payments are made, they shall be equal to $203 for a single individual or $260 for a married couple, or the actual amount of rent and utilities, whichever is less. 

(d) Each county must develop policies and procedures as necessary to implement this section. 

(e) Payments under this section are not an entitlement. No county is required to make a payment in excess of the amount available to the county under subdivision 3. 

Subd. 3.State allocation to counties. 
The commissioner shall allocate to each county on an annual basis the amount specifically appropriated for payments under this section. The allocation shall be based on each county's proportionate share of state fiscal year 1994 work readiness expenditures. 

256R.02 DEFINITIONS.Subd. 46.Resource utilization group. 
"Resource utilization groups" or "RUG" has the meaning given in section 144.0724, subdivision 2, paragraph (f). 

260.755 DEFINITIONS.Subd. 13.Local social services agency. 
"Local social services agency" means the local agency under the authority of the county welfare or human services board or county board of commissioners which is responsible for human services. 

Repealed Minnesota Session Laws: S4699-1 

Laws 2023, chapter 25, section 190, subdivision 10
Sec. 190. REPEALER. Subd. 10.Obsolete subdivision. Minnesota Statutes 2022, section 256B.051, subdivision 7, is repealed.Laws 2024, chapter 80, article 1, section 38 Subdivisions 3, 4, 11, 
Sec. 38. [142A.20] ADMINISTRATIVE AND JUDICIAL REVIEW OF CHILDREN, YOUTH, AND FAMILIES MATTERS.Subd. 3.Standard of evidence for maltreatment and disqualification hearings. 
(a) The state children, youth, and families judge shall determine that maltreatment has occurred if a preponderance of evidence exists to support the final disposition under chapter 260E or section 626.557. For purposes of hearings regarding disqualification, the state children, youth, and families judge shall affirm the proposed disqualification in an appeal under subdivision 2, paragraph (a), clause (5), if a preponderance of the evidence shows the individual has: 

(1) committed maltreatment under section 626.557 or chapter 260E that is serious or recurring; 

(2) committed an act or acts meeting the definition of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or 

(3) failed to make required reports under section 626.557 or chapter 260E, for incidents in which the final disposition under section 626.557 or chapter 260E was substantiated maltreatment that was serious or recurring. 

(b) If the disqualification is affirmed, the state children, youth, and families judge shall determine whether the individual poses a risk of harm in accordance with the requirements of section 245C.22, and whether the disqualification should be set aside or not set aside. In determining whether the disqualification should be set aside, the children, youth, and families judge shall consider all of the characteristics that cause the individual to be disqualified, including those characteristics that were not subject to review under paragraph (a), in order to determine whether the individual poses a risk of harm. A decision to set aside a disqualification that is the subject of the hearing constitutes a determination that the individual does not pose a risk of harm and that the individual may provide direct contact services in the individual program specified in the set aside. 

(c) If a disqualification is based solely on a conviction or is conclusive for any reason under section 245C.29, the disqualified individual does not have a right to a hearing under this section. 

(d) The state children, youth, and families judge shall recommend an order to the commissioner of health; education; children, youth, and families; or human services, as applicable, who shall issue a final order. The commissioner shall affirm, reverse, or modify the final disposition. Any order of the commissioner issued in accordance with this subdivision is conclusive upon the parties unless appeal is taken in the manner provided in subdivision 7. In any licensing appeal under chapters 142B and 245C and sections 144.50 to 144.58 and 144A.02 to 144A.482, the commissioner's determination as to maltreatment is conclusive, as provided under section 245C.29. 

Subd. 4.Conduct of hearings. 
(a) All hearings held pursuant to subdivision 2 or 3 shall be conducted according to the provisions of the federal Social Security Act and the regulations implemented in accordance with that act to enable this state to qualify for federal grants-in-aid and according to the rules and written policies of the commissioner. County agencies shall install equipment necessary to conduct telephone hearings. A state children, youth, and families judge may schedule a telephone conference hearing when the distance or time required to travel to the county agency offices will cause a delay in the issuance of an order, or to promote efficiency, or at the mutual request of the parties. Hearings may be conducted by telephone conferences unless the applicant, recipient, former recipient, person, or facility contesting maltreatment objects. A children, youth, and families judge may grant a request for a hearing in person by holding the hearing by interactive video technology or in person. The children, youth, and families judge must hear the case in person if the person asserts that either the person or a witness has a physical or mental disability that would impair the person's or witness's ability to fully participate in a hearing held by interactive video technology. The hearing shall not be held earlier than five days after filing of the required notice with the county or state agency. The state children, youth, and families judge shall notify all interested persons of the time, date, and location of the hearing at least five days before the date of the hearing. Interested persons may be represented by legal counsel or other representative of their choice, including a provider of therapy services, at the hearing and may appear personally, testify and offer evidence, and examine and cross-examine witnesses. The applicant, recipient, former recipient, person, or facility contesting maltreatment shall have the opportunity to examine the contents of the case file and all documents and records to be used by the county or state agency at the hearing at a reasonable time before the date of the hearing and during the hearing. In hearings under subdivision 2, paragraph (a), clauses (4) and (5), either party may subpoena the private data relating to the investigation prepared by the agency under section 626.557 or chapter 260E that are not otherwise accessible under section 13.04, provided the identity of the reporter may not be disclosed. 

(b) The private data obtained by subpoena in a hearing under subdivision 2, paragraph (a), clause (2), must be subject to a protective order that prohibits its disclosure for any other purpose outside the hearing provided for in this section without prior order of the district court. Disclosure without court order is punishable by a sentence of not more than 90 days imprisonment or a fine of not more than $1,000, or both. These restrictions on the use of private data do not prohibit access to the data under section 13.03, subdivision 6. Except for appeals under subdivision 2, paragraph (a), clause (2), upon request, the county agency shall provide reimbursement for transportation, child care, photocopying, medical assessment, witness fee, and other necessary and reasonable costs incurred by the applicant, recipient, or former recipient in connection with the appeal. All evidence, except that privileged by law, commonly accepted by reasonable people in the conduct of their affairs as having probative value with respect to the issues, shall be submitted at the hearing and the hearing shall not be "a contested case" within the meaning of section 14.02, subdivision 3. The agency must present its evidence prior to or at the hearing and may not submit evidence after the hearing except by agreement of the parties at the hearing, provided the petitioner has the opportunity to respond. 

(c) In hearings under subdivision 2, paragraph (a), clauses (2) and (5), involving determinations of maltreatment or disqualification made by more than one county agency, by a county agency and a state agency, or by more than one state agency, the hearings may be consolidated into a single fair hearing upon the consent of all parties and the state children, youth, and families judge. 

Subd. 11.Interagency agreement with DHS. 
The commissioner of children, youth, and families may enter into an agreement with the commissioner of human services so that the commissioner of human services may conduct hearings and recommend and issue orders on behalf of the commissioner of children, youth, and families in accordance with this section. 

Laws 2024, chapter 80, article 1, section 39
Sec. 39. [142A.21] HEARING PROCEDURES.Subdivision 1.Scope. 
(a) The requirements in this section apply to all fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clauses (1), (2), (3), and (6). Except as provided in subdivisions 3 and 19, the requirements under this section apply to fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clause (2). 

(b) For purposes of this section, "person" means an individual who, on behalf of themselves or their household, is appealing, disputing, or challenging an action, a decision, or a failure to act by an agency in the children, youth, and families system. When a person involved in a proceeding under this section is represented by an attorney or by an authorized representative, the term "person" also means the person's attorney or authorized representative. Any notice sent to the person involved in the hearing must also be sent to the person's attorney or authorized representative. 

(c) For purposes of this section, "agency" means the county human services agency, the Department of Children, Youth, and Families, and, where applicable, any entity involved under a contract, subcontract, grant, or subgrant with the state agency or with a county agency, that provides or operates programs or services in which appeals are governed by section 142A.20. 

Subd. 2.Access to files. 
A person involved in a fair hearing appeal has the right of access to the person's complete case files and to examine all private welfare data on the person that has been generated, collected, stored, or disseminated by the agency. A person involved in a fair hearing appeal has the right to a free copy of all documents in the case file involved in a fair hearing appeal. For purposes of this section, "case file" means the information, documents, and data, in whatever form, that have been generated, collected, stored, or disseminated by the agency in connection with the person and the program or service involved. 

Subd. 3.Agency appeal summary. 
(a) Except in fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clauses (4) and (5), the agency involved in an appeal must prepare a state agency appeal summary for each fair hearing appeal. The state agency appeal summary shall be mailed or otherwise delivered to the person who is involved in the appeal at least three working days before the date of the hearing. The state agency appeal summary must also be mailed or otherwise delivered to the department's Appeals Office at least three working days before the date of the fair hearing appeal. 

(b) In addition, the children, youth, and families judge shall confirm that the state agency appeal summary is mailed or otherwise delivered to the person involved in the appeal as required under paragraph (a). The person involved in the fair hearing should be provided, through the state agency appeal summary or other reasonable methods, appropriate information about the procedures for the fair hearing and an adequate opportunity to prepare. These requirements apply equally to the state agency or an entity under contract when involved in the appeal. 

(c) The contents of the state agency appeal summary must be adequate to inform the person involved in the appeal of the evidence on which the agency relies and the legal basis for the agency's action or determination. 

Subd. 4.Enforcing access to files. 
A person involved in a fair hearing appeal may enforce the right of access to data and copies of the case file by making a request to the children, youth, and families judge. The children, youth, and families judge will make an appropriate order enforcing the person's rights under the Minnesota Government Data Practices Act, including but not limited to, ordering access to files, data, and documents; continuing a hearing to allow adequate time for access to data; or prohibiting use by the agency of files, data, or documents that have been generated, collected, stored, or disseminated without compliance with the Minnesota Government Data Practices Act and that have not been provided to the person involved in the appeal. 

Subd. 5.Prehearing conferences. 
(a) The children, youth, and families judge prior to a fair hearing appeal may hold a prehearing conference to further the interests of justice or efficiency and must include the person involved in the appeal. A person involved in a fair hearing appeal or the agency may request a prehearing conference. The prehearing conference may be conducted by telephone, in person, or in writing. The prehearing conference may address the following: 

(1) disputes regarding access to files, evidence, subpoenas, or testimony; 

(2) the time required for the hearing or any need for expedited procedures or decision; 

(3) identification or clarification of legal or other issues that may arise at the hearing; 

(4) identification of and possible agreement to factual issues; and 

(5) scheduling and any other matter that will aid in the proper and fair functioning of the hearing. 

(b) The children, youth, and families judge shall make a record or otherwise contemporaneously summarize the prehearing conference in writing, which shall be sent to both the person involved in the hearing, the person's attorney or authorized representative, and the agency. A children, youth, and families judge may make and issue rulings and orders while the appeal is pending. During the pendency of the appeal, these rulings and orders are not subject to a request for reconsideration or appeal. These rulings and orders are subject to review under subdivision 24 and section 142A.20, subdivision 7. 

Subd. 6.Appeal request for emergency assistance or urgent matter. 
(a) When an appeal involves an application for emergency assistance, the agency involved shall mail or otherwise deliver the state agency appeal summary to the department's Appeals Office within two working days of receiving the request for an appeal. A person may also request that a fair hearing be held on an emergency basis when the issue requires an immediate resolution. The children, youth, and families judge shall schedule the fair hearing on the earliest available date according to the urgency of the issue involved. Issuance of the recommended decision after an emergency hearing shall be expedited. 

(b) The commissioner shall issue a written decision within five working days of receiving the recommended decision, shall immediately inform the parties of the outcome by telephone, and shall mail the decision no later than two working days following the date of the decision. 

Subd. 7.Continuance, rescheduling, or adjourning a hearing. 
(a) A person involved in a fair hearing, or the agency, may request a continuance, a rescheduling, or an adjournment of a hearing for a reasonable period of time. The grounds for granting a request for a continuance, a rescheduling, or adjournment of a hearing include, but are not limited to, the following: 

(1) to reasonably accommodate the appearance of a witness; 

(2) to ensure that the person has adequate opportunity for preparation and for presentation of evidence and argument; 

(3) to ensure that the person or the agency has adequate opportunity to review, evaluate, and respond to new evidence, or where appropriate, to require that the person or agency review, evaluate, and respond to new evidence; 

(4) to permit the person involved and the agency to negotiate toward resolution of some or all of the issues where both agree that additional time is needed; 

(5) to permit the agency to reconsider a previous action or determination; 

(6) to permit or to require the performance of actions not previously taken; and 

(7) to provide additional time or to permit or require additional activity by the person or agency as the interests of fairness may require. 

(b) Requests for continuances or for rescheduling may be made orally or in writing. The person or agency requesting the continuance or rescheduling must first make reasonable efforts to contact the other participants in the hearing or their representatives and seek to obtain an agreement on the request. Requests for continuance or rescheduling should be made no later than three working days before the scheduled date of the hearing, unless there is a good cause as specified in subdivision 13. Granting a continuance or rescheduling may be conditioned upon a waiver by the requester of applicable time limits but should not cause unreasonable delay. 

Subd. 8.Subpoenas. 
(a) A person involved in a fair hearing or the agency may request a subpoena for a witness, for evidence, or for both. A reasonable number of subpoenas shall be issued to require the attendance and the testimony of witnesses, and the production of evidence relating to any issue of fact in the appeal hearing. The request for a subpoena must show a need for the subpoena and the general relevance to the issues involved. The subpoena shall be issued in the name of the department and shall be served and enforced as provided in section 357.22 and the Minnesota Rules of Civil Procedure. 

(b) An individual or entity served with a subpoena may petition the children, youth, and families judge in writing to vacate or modify a subpoena. The children, youth, and families judge shall resolve such a petition in a prehearing conference involving all parties and shall make a written decision. A subpoena may be vacated or modified if the children, youth, and families judge determines that the testimony or evidence sought does not relate with reasonable directness to the issues of the fair hearing appeal; that the subpoena is unreasonable, over broad, or oppressive; that the evidence sought is repetitious or cumulative; or that the subpoena has not been served reasonably in advance of the time when the appeal hearing will be held. 

Subd. 9.No ex parte contact. 
The children, youth, and families judge shall not have ex parte contact on substantive issues with the agency or with any person or witness in a fair hearing appeal. No employee of the department or agency shall review, interfere with, change, or attempt to influence the recommended decision of the children, youth, and families judge in any fair hearing appeal, except through the procedure allowed in subdivision 18. The limitations in this subdivision do not affect the commissioner's authority to review or reconsider decisions or make final decisions. 

Subd. 10.Telephone or face-to-face hearing. 
A fair hearing appeal may be conducted by telephone, by other electronic media, or by an in-person, face-to-face hearing. At the request of the person involved in a fair hearing appeal or their representative, a face-to-face hearing shall be conducted with all participants personally present before the children, youth, and families judge. 

Subd. 11.Hearing facilities and equipment. 
The children, youth, and families judge shall conduct the hearing in the county where the person involved resides, unless an alternate location is mutually agreed upon before the hearing, or unless the person has agreed to a hearing by telephone. Hearings under section 142A.20, subdivision 2, paragraph (a), clauses (4) and (5), must be conducted in the county where the determination was made, unless an alternate location is mutually agreed upon before the hearing. The hearing room shall be of sufficient size and layout to adequately accommodate both the number of individuals participating in the hearing and any identified special needs of any individual participating in the hearing. The children, youth, and families judge shall ensure that all communication and recording equipment that is necessary to conduct the hearing and to create an adequate record is present and functioning properly. If any necessary communication or recording equipment fails or ceases to operate effectively, the children, youth, and families judge shall take any steps necessary, including stopping or adjourning the hearing, until the necessary equipment is present and functioning properly. All reasonable efforts shall be undertaken to prevent and avoid any delay in the hearing process caused by defective communication or recording equipment. 

Subd. 12.Interpreter and translation services. 
The children, youth, and families judge has a duty to inquire and to determine whether any participant in the hearing needs the services of an interpreter or translator in order to participate in or to understand the hearing process. Necessary interpreter or translation services must be provided at no charge to the person involved in the hearing. If it appears that interpreter or translation services are needed but are not available for the scheduled hearing, the children, youth, and families judge shall continue or postpone the hearing until appropriate services can be provided. 

Subd. 13.Failure to appear; good cause. 
If a person involved in a fair hearing appeal fails to appear at the hearing, the children, youth, and families judge may dismiss the appeal. The children, youth, and families judge may reopen the appeal if within ten working days after the date of the dismissal the person files information in writing with the children, youth, and families judge to show good cause for not appearing. Good cause can be shown when there is: 

(1) a death or serious illness in the person's family; 

(2) a personal injury or illness that reasonably prevents the person from attending the hearing; 

(3) an emergency, crisis, or unforeseen event that reasonably prevents the person from attending the hearing; 

(4) an obligation or responsibility of the person that a reasonable person, in the conduct of one's affairs, could reasonably determine takes precedence over attending the hearing; 

(5) lack of or failure to receive timely notice of the hearing in the preferred language of the person involved in the hearing; and 

(6) excusable neglect, excusable inadvertence, excusable mistake, or other good cause as determined by the children, youth, and families judge. 

Subd. 14.Commencement of hearing. 
The children, youth, and families judge shall begin each hearing by describing the process to be followed in the hearing, including the swearing in of witnesses, how testimony and evidence are presented, the order of examining and cross-examining witnesses, and the opportunity for an opening statement and a closing statement. The children, youth, and families judge shall identify for the participants the issues to be addressed at the hearing and shall explain to the participants the burden of proof that applies to the person involved and the agency. The children, youth, and families judge shall confirm, prior to proceeding with the hearing, that the state agency appeal summary, if required under subdivision 3, has been properly completed and provided to the person involved in the hearing, and that the person has been provided documents and an opportunity to review the case file, as provided in this section. 

Subd. 15.Conduct of the hearing. 
The children, youth, and families judge shall act in a fair and impartial manner at all times. At the beginning of the hearing the agency must designate one person as their representative who shall be responsible for presenting the agency's evidence and questioning any witnesses. The children, youth, and families judge shall make sure that the person and the agency are provided sufficient time to present testimony and evidence, to confront and cross-examine all adverse witnesses, and to make any relevant statement at the hearing. The children, youth, and families judge shall make reasonable efforts to explain the hearing process to persons who are not represented and shall ensure that the hearing is conducted fairly and efficiently. Upon the reasonable request of the person or the agency involved, the children, youth, and families judge may direct witnesses to remain outside the hearing room, except during their individual testimony. The children, youth, and families judge shall not terminate the hearing before affording the person and the agency a complete opportunity to submit all admissible evidence and reasonable opportunity for oral or written statement. If a hearing lasts longer than anticipated, the hearing shall be rescheduled or continued from day-to-day until completion. Hearings that have been continued shall be timely scheduled to minimize delay in the disposition of the appeal. 

Subd. 16.Scope of issues addressed at the hearing. 
The hearing shall address the correctness and legality of the agency's action and shall not be limited simply to a review of the propriety of the agency's action. The person involved may raise and present evidence on all legal claims or defenses arising under state or federal law as a basis for appealing or disputing an agency action but not constitutional claims beyond the jurisdiction of the fair hearing. The children, youth, and families judge may take official notice of adjudicative facts. 

Subd. 17.Burden of persuasion. 
The burden of persuasion is governed by specific state or federal law and regulations that apply to the subject of the hearing. If there is no specific law, then the participant in the hearing who asserts the truth of a claim is under the burden to persuade the children, youth, and families judge that the claim is true. 

Subd. 18.Inviting comment by department. 
The children, youth, and families judge or the commissioner may determine that a written comment by the department about the policy implications of a specific legal issue could help resolve a pending appeal. Such a written policy comment from the department shall be obtained only by a written request that is also sent to the person involved and to the agency or its representative. When such a written comment is received, both the person involved in the hearing and the agency shall have adequate opportunity to review, evaluate, and respond to the written comment, including submission of additional testimony or evidence, and cross-examination concerning the written comment. 

Subd. 19.Developing the record. 
The children, youth, and families judge shall accept all evidence, except evidence privileged by law, that is commonly accepted by reasonable people in the conduct of their affairs as having probative value on the issues to be addressed at the hearing. Except in fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clauses (4) and (5), in cases involving medical issues such as a diagnosis, a physician's report, or a review team's decision, the children, youth, and families judge shall consider whether it is necessary to have a medical assessment other than that of the individual making the original decision. When necessary, the children, youth, and families judge shall require an additional assessment be obtained at agency expense and made part of the hearing record. The children, youth, and families judge shall ensure for all cases that the record is sufficiently complete to make a fair and accurate decision. 

Subd. 20.Unrepresented persons. 
In cases involving unrepresented persons, the children, youth, and families judge shall take appropriate steps to identify and develop in the hearing relevant facts necessary for making an informed and fair decision. These steps may include, but are not limited to, asking questions of witnesses and referring the person to a legal services office. An unrepresented person shall be provided an adequate opportunity to respond to testimony or other evidence presented by the agency at the hearing. The children, youth, and families judge shall ensure that an unrepresented person has a full and reasonable opportunity at the hearing to establish a record for appeal. 

Subd. 21.Closing of the record. 
The agency must present its evidence prior to or at the hearing. The agency shall not be permitted to submit evidence after the hearing except by agreement at the hearing between the person involved, the agency, and the children, youth, and families judge. If evidence is submitted after the hearing, based on such an agreement, the person involved and the agency must be allowed sufficient opportunity to respond to the evidence. When necessary, the record shall remain open to permit a person to submit additional evidence on the issues presented at the hearing. 

Subd. 22.Decisions. 
(a) A timely, written decision must be issued in every appeal. Each decision must contain a clear ruling on the issues presented in the appeal hearing and should contain a ruling only on questions directly presented by the appeal and the arguments raised in the appeal. 

(b) A written decision must be issued within 90 days of the date the person involved requested the appeal unless a shorter time is required by law. An additional 30 days is provided in those cases where the commissioner refuses to accept the recommended decision. In appeals of maltreatment determinations or disqualifications filed pursuant to section 142A.20, subdivision 2, paragraph (a), clause (4) or (5), that also give rise to possible licensing actions, the 90-day period for issuing final decisions does not begin until the later of the date that the licensing authority provides notice to the appeals division that the authority has made the final determination in the matter or the date the appellant files the last appeal in the consolidated matters. 

(c) The decision must contain both findings of fact and conclusions of law, clearly separated and identified. The findings of fact must be based on the entire record. Each finding of fact made by the children, youth, and families judge shall be supported by a preponderance of the evidence unless a different standard is required under the regulations of a particular program. The "preponderance of the evidence" means, in light of the record as a whole, the evidence leads the children, youth, and families judge to believe that the finding of fact is more likely to be true than not true. The legal claims or arguments of a participant do not constitute either a finding of fact or a conclusion of law, except to the extent the children, youth, and families judge adopts an argument as a finding of fact or conclusion of law. 

(d) The decision shall contain at least the following: 

(1) a listing of the date and place of the hearing and the participants at the hearing; 

(2) a clear and precise statement of the issues, including the dispute under consideration and the specific points that must be resolved in order to decide the case; 

(3) a listing of the material, including exhibits, records, reports, placed into evidence at the hearing, and upon which the hearing decision is based; 

(4) the findings of fact based upon the entire hearing record. The findings of fact must be adequate to inform the participants and any interested person in the public of the basis of the decision. If the evidence is in conflict on an issue that must be resolved, the findings of fact must state the reasoning used in resolving the conflict; 

(5) conclusions of law that address the legal authority for the hearing and the ruling and give appropriate attention to the claims of the participants to the hearing; 

(6) a clear and precise statement of the decision made resolving the dispute under consideration in the hearing; and 

(7) written notice of the right to appeal to district court or to request reconsideration, and of the actions required and the time limits for taking appropriate action to appeal to district court or to request a reconsideration. 

(e) The children, youth, and families judge shall not independently investigate facts or otherwise rely on information not presented at the hearing. The children, youth, and families judge may not contact other agency personnel, except as provided in subdivision 18. The children, youth, and families judge's recommended decision must be based exclusively on the testimony and evidence presented at the hearing, and legal arguments presented, and the children, youth, and families judge's research and knowledge of the law. 

(f) The commissioner will review the recommended decision and accept or refuse to accept the decision according to section 142A.20, subdivision 5. 

Subd. 23.Refusal to accept recommended orders. 
(a) If the commissioner refuses to accept the recommended order from the children, youth, and families judge, the person involved, the person's attorney or authorized representative, and the agency shall be sent a copy of the recommended order, a detailed explanation of the basis for refusing to accept the recommended order, and the proposed modified order. 

(b) The person involved and the agency shall have at least ten business days to respond to the proposed modification of the recommended order. The person involved and the agency may submit a legal argument concerning the proposed modification, and may propose to submit additional evidence that relates to the proposed modified order. 

Subd. 24.Reconsideration. 
(a) Reconsideration may be requested within 30 days of the date of the commissioner's final order. If reconsideration is requested under section 142A.20, subdivision 5, the other participants in the appeal shall be informed of the request. The person seeking reconsideration has the burden to demonstrate why the matter should be reconsidered. The request for reconsideration may include legal argument and may include proposed additional evidence supporting the request. The other participants shall be sent a copy of all material submitted in support of the request for reconsideration and must be given ten days to respond. 

(b) When the requesting party raises a question as to the appropriateness of the findings of fact, the commissioner shall review the entire record. 

(c) When the requesting party questions the appropriateness of a conclusion of law, the commissioner shall consider the recommended decision, the decision under reconsideration, and the material submitted in connection with the reconsideration. The commissioner shall review the remaining record as necessary to issue a reconsidered decision. 

(d) The commissioner shall issue a written decision on reconsideration in a timely fashion. The decision must clearly inform the parties that this constitutes the final administrative decision, advise the participants of the right to seek judicial review, and the deadline for doing so. 

Subd. 25.Access to appeal decisions. 
Appeal decisions must be maintained in a manner so that the public has ready access to previous decisions on particular topics, subject to appropriate procedures for safeguarding names, personal identifying information, and other private data on the individual persons involved in the appeal. 

Laws 2024, chapter 80, article 1, section 43, subdivision 2
Sec. 43. [142A.27] ADMINISTRATIVE FRAUD DISQUALIFICATION HEARINGS.Subd. 2.Combined hearing. 
The children, youth, and families judge may combine a fair hearing under section 142A.20 and administrative fraud disqualification hearing under this section into a single hearing if the factual issues arise out of the same, or related, circumstances and the individual receives prior notice that the hearings will be combined. If the administrative fraud disqualification hearing and fair hearing are combined, the time frames for administrative fraud disqualification hearings specified in Code of Federal Regulations, title 7, section 273.16, apply. If the individual accused of wrongfully obtaining assistance is charged under section 142A.25 or 256.98 for the same act or acts that are the subject of the hearing, the individual may request that the hearing be delayed until the criminal charge is decided by the court or withdrawn. 

(b) A human services judge may combine a fair hearing and administrative fraud disqualification hearing pursuant to section 142A.27, subdivision 2, or 256.046, subdivision 2, if either is under the jurisdiction of the commissioner of human services or the commissioner of children, youth, and families. 

Laws 2024, chapter 80, article 2, section 1, subdivision 11
Section 1. [142B.01] DEFINITIONS.Subd. 11.Foster residence setting. 
"Foster residence setting" has the meaning given in Minnesota Rules, part 2960.3010, subpart 26, and includes settings licensed by the commissioner of children, youth, and families or the commissioner of corrections. 

Laws 2024, chapter 80, article 2, section 10, subdivision 4
Sec. 10. [142B.18] SANCTIONS.Subd. 4.Immediate suspension of residential programs. 
For suspensions issued to a licensed residential program as defined in section 142B.01, subdivision 24, the effective date of the order may be delayed for up to 30 calendar days to provide for the continuity of care of service recipients. The license holder must cooperate with the commissioner to ensure service recipients receive continued care during the period of the delay and to facilitate the transition of service recipients to new providers. In these cases, the suspension order takes effect when all service recipients have been transitioned to a new provider or 30 days after the suspension order was issued, whichever comes first. 

Laws 2024, chapter 80, article 2, section 3, subdivision 3
Sec. 3. [142B.03] SYSTEMS AND RECORDS.Subd. 3.First date of working in a setting; documentation requirements. 
Foster residence setting license holders must document the first date that a person who is a background study subject begins working in the license holder's setting. If the license holder does not maintain documentation of each background study subject's first date of working in the setting in the license holder's personnel files, the license holder must provide documentation to the commissioner that contains the first date that each background study subject began working in the license holder's program upon the commissioner's request. 

Laws 2024, chapter 80, article 2, section 33
Sec. 33. Minnesota Statutes 2022, section 245A.02, subdivision 6e, is amended to read:Subd. 6e.Foster residence setting. 
"Foster residence setting" has the meaning given in Minnesota Rules, part 2960.3010, subpart 26, and includes settings licensed by the commissioner of human services children, youth, and families or the commissioner of corrections. 

Laws 2024, chapter 80, article 2, section 4, subdivision 4
Sec. 4. [142B.05] WHO MUST BE LICENSED.Subd. 4.Licensing moratorium. 
(a) The commissioner shall not issue an initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, under this chapter for a physical location that will not be the primary residence of the license holder for the entire period of licensure. If a family child foster care home license is issued during this moratorium and the license holder changes the license holder's primary residence away from the physical location of the foster care license, the commissioner shall revoke the license according to section 142B.18. When approving an exception under this paragraph, the commissioner shall consider the resource need determination process in paragraph (e), the availability of foster care licensed beds in the geographic area in which the licensee seeks to operate, the results of a person's choices during their annual assessment and service plan review, and the recommendation of the local county board. The determination by the commissioner is final and not subject to appeal. Exceptions to the moratorium include: 

(1) foster care licenses replacing foster care licenses in existence on May 15, 2009, and determined to be needed by the commissioner under paragraph (b); and 

(2) new foster care licenses determined to be needed by the commissioner under paragraph (b) for persons requiring hospital-level care. 

(b) The commissioner shall determine the need for newly licensed foster care homes. As part of the determination, the commissioner shall consider the availability of foster care capacity in the area in which the licensee seeks to operate, and the recommendation of the local county board. The determination by the commissioner must be final. A determination of need is not required for a change in ownership at the same address. 

(c) At the time of application and reapplication for licensure, the applicant and the license holder that are subject to the moratorium or an exclusion established in paragraph (a) are required to inform the commissioner whether the physical location where the foster care will be provided is or will be the primary residence of the license holder for the entire period of licensure. If the primary residence of the applicant or license holder changes, the applicant or license holder must notify the commissioner immediately. The commissioner shall print on the foster care license certificate whether or not the physical location is the primary residence of the license holder. 

(d) License holders of foster care homes identified under paragraph (c) that are not the primary residence of the license holder and that also provide services in the foster care home that are covered by a federally approved home and community-based services waiver, as authorized under chapter 256S or section 256B.092 or 256B.49, must inform the children, youth, and families licensing division that the license holder provides or intends to provide these waiver-funded services. 

(e) The commissioner may adjust capacity to address needs identified in section 144A.351. Under this authority, the commissioner may approve new licensed settings or delicense existing settings. Delicensing of settings will be accomplished through a process identified in section 256B.493. 

Laws 2024, chapter 80, article 2, section 6, subdivision 4
Sec. 6. [142B.11] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP.Subd. 4.Temporary change in ownership license. 
(a) After receiving the party's application pursuant to subdivision 3, upon the written request of the existing license holder and the party, the commissioner may issue a temporary change in ownership license to the party while the commissioner evaluates the party's application. Until a decision is made to grant or deny a license under this chapter, the existing license holder and the party shall both be responsible for operating the program or service according to applicable laws and rules, and the sale or transfer of the existing license holder's ownership interest in the licensed program or service does not terminate the existing license. 

(b) The commissioner may issue a temporary change in ownership license when a license holder's death, divorce, or other event affects the ownership of the program and an applicant seeks to assume operation of the program or service to ensure continuity of the program or service while a license application is evaluated. 

(c) This subdivision applies to any program or service licensed under this chapter. 

Laws 2024, chapter 80, article 2, section 69
Sec. 69. Minnesota Statutes 2022, section 245A.25, subdivision 1, is amended to read:Subdivision 1.Certification scope and applicability. 
(a) This section establishes the requirements that a children's residential facility or child foster residence setting must meet to be certified for the purposes of Title IV-E funding requirements as: 

(1) a qualified residential treatment program; 

(2) a residential setting specializing in providing care and supportive services for youth who have been or are at risk of becoming victims of sex trafficking or commercial sexual exploitation; 

(3) a residential setting specializing in providing prenatal, postpartum, or parenting support for youth; or 

(4) a supervised independent living setting for youth who are 18 years of age or older. 

(b) This section does not apply to a foster family setting in which the license holder resides in the foster home. 

(c) Children's residential facilities licensed as detention settings according to Minnesota Rules, parts 2960.0230 to 2960.0290, or secure programs according to Minnesota Rules, parts 2960.0300 to 2960.0420, may not be certified under this section. 

(d) For purposes of this section, "license holder" means an individual, organization, or government entity that was issued a children's residential facility or foster residence setting license by the commissioner of human services under this chapter; by the commissioner of children, youth, and families under chapter 142B; or by the commissioner of corrections under chapter 241. 

(e) Certifications issued under this section for foster residence settings may only be issued by the commissioner of human services and are not delegated to county or private licensing agencies under section 245A.16. 

Laws 2024, chapter 80, article 7, section 3
Sec. 3. Minnesota Statutes 2022, section 256J.08, subdivision 32, is amended to read:Subd. 32.Fair hearing or hearing. 
"Fair hearing" or "hearing" means the evidentiary hearing conducted by the department human services of children, youth, and families judge to resolve disputes as specified in section 256J.40, or if not applicable, section 256.045. 

Laws 2024, chapter 80, article 7, section 9
Sec. 9. Minnesota Statutes 2023 Supplement, section 256J.40, is amended to read:256J.40 FAIR HEARINGS.
Caregivers receiving a notice of intent to sanction or a notice of adverse action that includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or termination of benefits may request a fair hearing. A request for a fair hearing must be submitted in writing to the county agency or to the commissioner and must be mailed within 30 days after a participant or former participant receives written notice of the agency's action or within 90 days when a participant or former participant shows good cause for not submitting the request within 30 days. A former participant who receives a notice of adverse action due to an overpayment may appeal the adverse action according to the requirements in this section. Issues that may be appealed are: 

(1) the amount of the assistance payment; 

(2) a suspension, reduction, denial, or termination of assistance; 

(3) the basis for an overpayment, the calculated amount of an overpayment, and the level of recoupment; 

(4) the eligibility for an assistance payment; and 

(5) the use of protective or vendor payments under section 256J.39, subdivision 2, clauses (1) to (3). 

 A county agency must not reduce, suspend, or terminate payment when an aggrieved participant requests a fair hearing prior to the effective date of the adverse action or within ten days of the mailing of the notice of adverse action, whichever is later, unless the participant requests in writing not to receive continued assistance pending a hearing decision. Assistance issued pending a fair hearing is subject to recovery under section 256P.08 when as a result of the fair hearing decision the participant is determined ineligible for assistance or the amount of the assistance received. A county agency may increase or reduce an assistance payment while an appeal is pending when the circumstances of the participant change and are not related to the issue on appeal. The commissioner's order is binding on a county agency. No additional notice is required to enforce the commissioner's order. 

A county agency shall reimburse appellants for reasonable and necessary expenses of attendance at the hearing, such as child care and transportation costs and for the transportation expenses of the appellant's witnesses and representatives to and from the hearing. Reasonable and necessary expenses do not include legal fees. Fair hearings must be conducted at a reasonable time and date by an impartial human services children, youth, and families judge employed by the department. The hearing may be conducted by telephone or at a site that is readily accessible to persons with disabilities. 

The appellant may introduce new or additional evidence relevant to the issues on appeal. Recommendations of the human services children, youth, and families judge and decisions of the commissioner must be based on evidence in the hearing record and are not limited to a review of the county agency action. 

2960.0620USE OF PSYCHOTROPIC MEDICATIONS. Subp. 3.Monitoring for tardive dyskinesia.  
The license holder, under the direction of a medically licensed person, must monitor for tardive dyskinesia at least every three months if a resident is prescribed antipsychotic medication or amoxapine and must document the monitoring. A resident prescribed antipsychotic medication or amoxapine for more than 90 days must be checked for tardive dyskinesia at least 30 and 60 days after discontinuation of the antipsychotic medication or amoxapine. Monitoring must include use of a standardized rating scale and examination procedure. The license holder must provide the assessments to the physician for review if the results meet criteria that require physician review. 

9502.0425PHYSICAL ENVIRONMENT. Subp. 5.Occupancy separations.  
Day care residences with an attached garage must have a self-closing, tight fitting solid wood bonded core door at least 1-3/8 inch thick, or door with a fire protection rating of 20 minutes or greater and a separation wall consisting of 5/8 inch thick gypsum wallboard or its equivalent on the garage side between the residence and garage. 

Subp. 10.Stairways.  
All stairways must meet the following conditions. 

A.
 Stairways of three or more steps must have handrails. 

B.
 Any open area between the handrail and stair tread must be enclosed with a protective guardrail as specified in the State Building Code. The back of the stair risers must be enclosed. 

C.
 Gates or barriers must be used when children between the ages of 6 and 18 months are in care. 

D.
 Stairways must be well-lighted, in good repair, and free of clutter and obstructions. 

9545.0805PERSONNEL. Subpart 1.Supervision by a licensed independent social worker or independent clinical social worker.  
An independent social worker or independent clinical social worker as defined in Minnesota Statutes, section 148B.21, must supervise an agency's case work. Supervising an agency's case work includes reviewing and approving each written home study the agency completes on prospective foster parents or applicants to adopt. An agency can meet the supervision requirement by complying with item A, B, C, or D. 

A.
 The agency's chief executive officer is a licensed independent social worker or independent clinical social worker and supervises staff members providing case work. 

B.
 The person who does the case work is licensed as an independent social worker or independent clinical social worker. 

C.
 The agency contracts with a licensed independent social worker or independent clinical social worker to supervise staff members' case work. 

D.
 The agency may retain a supervisor with education or experience comparable to the requirements stated in item A, B, or C if one of the exceptions in Minnesota Statutes, section 148B.28, applies. 

9545.0845PLAN FOR TRANSFER OF RECORDS. 
An applicant for initial or continuing licensure must submit a written plan indicating how the agency will provide for the transfer of records on both open and closed cases if the agency closes. The plan must provide for managing private and confidential information on agency clients, according to Minnesota Statutes, section 259.79. A controlling individual of the agency must sign the plan. 

A.
 Plans for the transfer of open cases and case records must specify arrangements the agency will make to transfer clients to another agency or county for continuation of services and to transfer the case record with the client. 

B.
 Plans for the transfer of closed adoption records must be accompanied by a signed agreement or other documentation indicating that a county or licensed child placing agency has agreed to accept and maintain the agency's closed case records and to provide follow-up services to affected clients. 

9560.0232ADMINISTRATIVE REQUIREMENTS. Subp. 5.Child mortality review panel. A.
 For purposes of this subpart, "local review panel" means a local multidisciplinary child mortality review panel. 

B.
 Under the commissioner's authority in Minnesota Statutes, section 256.01, subdivision 12, paragraph (b), each county shall establish a local review panel and shall participate on the local review panel. The local agency's child protection team may serve as the local review panel. The local review panel shall require participation by professional representatives, including professionals with knowledge of the child mortality case being reviewed. 

C.
 The local review panel shall: 

(1)
 have access to not public data under Minnesota Statutes, section 256.01, subdivision 12, paragraph (c), maintained by state agencies, statewide systems, or political subdivisions that are related to a child's death or circumstances surrounding the care of the child; 

(2)
 conduct a local review of the case within 60 days of the death of a child if: 

(a)
 the death was caused by maltreatment; 

(b)
 the manner of death was due to sudden infant death syndrome or was other than by natural causes, and the child was a member of a family receiving social services from a local agency, a member of a family that received social services during the year before the child's death, or a member of a family that was the subject of a child protection assessment; or 

(c)
 the death occurred in a facility licensed by the department if the manner of death was by other than natural causes; and 

(3)
 submit a report of the review to the department within 30 days of completing subitem (2). 

A review may be delayed if there is pending litigation or an active assessment or investigation. 

D.
 Under Minnesota Statutes, section 256.01, subdivision 12, paragraph (d): 

(1)
 data acquired by the local review panel in the exercise of its duty is protected nonpublic or confidential data as defined in Minnesota Statutes, section 13.02, but may be disclosed as necessary to carry out the purposes of the local review panel. The data is not subject to subpoena or discovery; and 

(2)
 the commissioner may disclose conclusions of the local review panel, but shall not disclose data classified as confidential or private on decedents under Minnesota Statutes, section 13.10, or data classified as private, confidential, or protected nonpublic in the disseminating agency. 

E.
 Persons attending the local review panel meeting, members of the local review panel, persons who presented information to the local review panel, and all data, information, documents, and records pertaining to the local review panel must comply with the requirements under Minnesota Statutes, section 256.01, subdivision 12, paragraph (e). 

F.
 When the department notifies the local agency that a state review will be conducted under Minnesota Statutes, section 256.01, subdivision 12, paragraph (a), the local agency shall submit a copy of the social services file within five working days.