1.1 	A bill for an act
1.2 	relating to human services; modifying provisions relating to aging and older adult 
1.3 	services, disability services, long-term services and supports reform, substance 
1.4 	use disorder treatment, housing supports, health care, direct care and treatment 
1.5 	services, and the Department of Health; establishing the Department of Direct 
1.6 	Care and Treatment; making conforming changes; establishing grants; requiring 
1.7 	reports; appropriating money;amending Minnesota Statutes 2024, sections 10.65, 
1.8 	subdivision 2; 15.01; 15.06, subdivision 1; 15A.0815, subdivision 2; 15A.082, 
1.9 	subdivisions 1, 3, 7; 43A.08, subdivisions 1, 1a; 43A.241; 144.0724, subdivisions 
1.10 	2, 11, by adding a subdivision; 144A.01, subdivision 4; 144A.071, subdivisions 
1.11 	4a, 4d; 144A.161, subdivision 10; 144A.1888; 144A.351, subdivision 1; 144A.474, 
1.12 	subdivision 11; 144A.4799; 144G.08, subdivision 15; 144G.31, subdivision 8; 
1.13 	144G.52, subdivisions 1, 2, 3, 8; 144G.54, subdivisions 3, 7; 144G.55, subdivision 
1.14 	1; 179A.54, by adding a subdivision; 245.021; 245.073; 245A.042, by adding a 
1.15 	subdivision; 245A.06, subdivisions 1a, 2; 245C.16, subdivision 1; 245D.091, 
1.16 	subdivisions 2, 3; 245D.12; 245G.01, subdivision 13b, by adding subdivisions; 
1.17 	245G.02, subdivision 2; 245G.05, subdivision 1; 245G.07, subdivisions 1, 3, 4, 
1.18 	by adding subdivisions; 245G.11, subdivision 6, by adding a subdivision; 245G.22, 
1.19 	subdivisions 11, 15; 246.13, subdivision 1; 246B.01, by adding a subdivision; 
1.20 	246C.01; 246C.015, subdivision 3, by adding a subdivision; 246C.02, subdivision 
1.21 	1; 246C.04, subdivisions 2, 3; 246C.07, subdivisions 1, 2, 8; 246C.08; 246C.09, 
1.22 	subdivision 3; 246C.091, subdivisions 2, 3, 4; 252.021, by adding a subdivision; 
1.23 	252.32, subdivision 3; 252.50, subdivision 5; 253.195, by adding a subdivision; 
1.24 	253B.02, subdivisions 3, 4c, by adding a subdivision; 253B.03, subdivision 7; 
1.25 	253B.041, subdivision 4; 253B.09, subdivision 3a; 253B.18, subdivision 6; 
1.26 	253B.19, subdivision 2; 253B.20, subdivision 2; 253D.02, subdivision 3, by adding 
1.27 	a subdivision; 254B.01, subdivision 10; 254B.04, subdivision 1a; 254B.05, 
1.28 	subdivisions 1, 4, 5, by adding a subdivision; 254B.06, by adding a subdivision; 
1.29 	254B.09, subdivision 2; 254B.19, subdivision 1; 256.01, subdivision 29, by adding 
1.30 	subdivisions; 256.042, subdivision 4; 256.043, subdivisions 3, 3a; 256.045, 
1.31 	subdivisions 6, 7, by adding a subdivision; 256.476, subdivision 4; 256.9657, 
1.32 	subdivision 1; 256.9752, subdivisions 2, 3; 256B.04, subdivision 21; 256B.0625, 
1.33 	subdivisions 5m, 17; 256B.0659, subdivision 17a; 256B.0757, subdivision 4c; 
1.34 	256B.0761, subdivision 4; 256B.0911, subdivisions 1, 10, 13, 14, 24, 26, by adding 
1.35 	subdivisions; 256B.092, subdivision 1a; 256B.0924, subdivision 6; 256B.0949, 
1.36 	subdivisions 2, 13, 15, 16, 16a, by adding a subdivision; 256B.431, subdivision 
1.37 	30; 256B.434, subdivision 4; 256B.49, subdivisions 12, 13, 18, by adding 
1.38 	subdivisions; 256B.4914, subdivisions 3, 5, 5a, 5b, 6a, 6b, 6c, 7a, 7b, 7c, 8, 9, by 
2.1 	adding subdivisions; 256B.761; 256B.766; 256B.85, subdivisions 2, 5, 7, 7a, 8, 
2.2 	8a, 11, 13, 16, 17a, by adding a subdivision; 256B.851, subdivisions 5, 6, 7, by 
2.3 	adding subdivisions; 256G.09, subdivision 3; 256I.05, by adding subdivisions; 
2.4 	256R.02, subdivisions 18, 19, 22, by adding subdivisions; 256R.10, subdivision 
2.5 	8; 256R.23, subdivisions 5, 7, 8; 256R.24, subdivision 3; 256R.25; 256R.26, 
2.6 	subdivision 9; 256R.27, subdivisions 2, 3; 256R.43; 256S.205, subdivisions 2, 3, 
2.7 	5; 260E.14, subdivision 1; 352.91, subdivisions 2a, 3c, 3d, 4a; 524.3-801; 611.43, 
2.8 	by adding a subdivision; 611.46, subdivision 1; 611.55, by adding a subdivision; 
2.9 	611.57, subdivision 2; 626.5572, subdivision 13; Laws 2021, chapter 30, article 
2.10 	12, section 5, as amended; Laws 2021, First Special Session chapter 7, article 13, 
2.11 	sections 73; 75, subdivision 6, as amended; Laws 2023, chapter 61, article 1, 
2.12 	section 61, subdivision 4; article 9, section 2, subdivisions 13, 16, as amended; 
2.13 	Laws 2024, chapter 127, article 49, section 9, subdivisions 1, 8, 9, by adding a 
2.14 	subdivision; article 50, section 41, subdivision 2; article 53, section 2, subdivisions 
2.15 	13, 15; proposing coding for new law in Minnesota Statutes, chapters 145D; 245A; 
2.16 	245D; 246; 246C; 256; 256R; repealing Minnesota Statutes 2024, sections 
2.17 	144A.071, subdivision 4c; 245A.042, subdivisions 2, 3, 4; 245G.01, subdivision 
2.18 	20d; 245G.07, subdivision 2; 246B.01, subdivision 2; 246C.015, subdivisions 5a, 
2.19 	6; 246C.06, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10; 246C.07, subdivisions 4, 5; 
2.20 	252.021, subdivision 2; 253.195, subdivision 2; 253B.02, subdivision 7b; 253D.02, 
2.21 	subdivision 7a; 254B.01, subdivisions 5, 15; 254B.18; 256.045, subdivision 1a; 
2.22 	256B.0949, subdivision 9; 256G.02, subdivision 5a; 256R.02, subdivision 38; 
2.23 	256R.12, subdivision 10; 256R.23, subdivision 6; 256R.36; 256R.40; 256R.41; 
2.24 	256R.481; 256S.205, subdivision 7; Laws 2023, chapter 59, article 3, section 11; 
2.25 	Laws 2024, chapter 79, article 1, section 20; Laws 2024, chapter 125, article 5, 
2.26 	sections 40; 41; Laws 2024, chapter 127, article 46, section 39; article 50, sections 
2.27 	40; 41, subdivisions 1, 3.
2.28 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.29 	ARTICLE 1
2.30 	AGING AND OLDER ADULT SERVICES

2.31 	Section 1. Minnesota Statutes 2024, section 144.0724, subdivision 2, is amended to read:
2.32 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
2.33 	given.
2.34 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
2.35 	periods in the MDS assessment process. This look-back period is also called the observation 
2.36 	or assessment period.
2.37 	(b) "Case mix index" means the weighting factors assigned to the case mix reimbursement 
2.38 	classifications determined by an assessment.
2.39 	(c) "Index maximization" means classifying a resident who could be assigned to more 
2.40 	than one category, to the category with the highest case mix index.
2.41 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
2.42 	and functional status elements, that include common definitions and coding categories 
3.1 	specified by the Centers for Medicare and Medicaid Services and designated by the 
3.2 	Department of Health.
3.3 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
3.4 	person authorized to pay the nursing home expenses of the resident, a representative of the 
3.5 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
3.6 	other individual designated by the resident.
3.7 	(f) "Activities of daily living" or "ADL" includes personal hygiene, dressing, bathing, 
3.8 	transferring, bed mobility, locomotion, eating, and toileting.
3.9 	(g) "Nursing facility level of care determination" means the assessment process that 
3.10 	results in a determination of a resident's or prospective resident's need for nursing facility 
3.11 	level of care as established in subdivision 11 for purposes of medical assistance payment 
3.12 	of long-term care services for:
3.13 	(1) nursing facility services under chapter 256R;
3.14 	(2) elderly waiver services under chapter 256S;
3.15 	(3) CADI and BI waiver services under section 256B.49; and
3.16 	(4) state payment of alternative care services under section 256B.0913.
3.17 	(h) "Patient Driven Payment Model" or "PDPM" means the case mix reimbursement 
3.18 	classification system for residents in nursing facilities according to the resident's condition, 
3.19 	the resident's diagnosis, and the care the resident is receiving as reflected in data supplied 
3.20 	in the facility's MDS with an ARD on or after October 1, 2025.
3.21 	(i) "Resource utilization group" or "RUG" means the case mix reimbursement 
3.22 	classification system for residents in nursing facilities according to the resident's clinical 
3.23 	and functional status as reflected in data supplied by the facility's MDS with an ARD on or 
3.24 	before September 30, 2025.

3.25 	EFFECTIVE DATE. This section is effective October 1, 2025, and applies to 
3.26 	assessments conducted on or after that date.

3.27 	Sec. 2. Minnesota Statutes 2024, section 144A.071, subdivision 4a, is amended to read:
3.28 		Subd. 4a.Exceptions for replacement beds.  It is in the best interest of the state to 
3.29 	ensure that nursing homes and boarding care homes continue to meet the physical plant 
3.30 	licensing and certification requirements by permitting certain construction projects. Facilities 
3.31 	should be maintained in condition to satisfy the physical and emotional needs of residents 
3.32 	while allowing the state to maintain control over nursing home expenditure growth.
4.1 	The commissioner of health in coordination with the commissioner of human services, 
4.2 	may approve the renovation, replacement, upgrading, or relocation of a nursing home or 
4.3 	boarding care home, under the following conditions:
4.4 	(a) to license or certify beds in a new facility constructed to replace a facility or to make 
4.5 	repairs in an existing facility that was destroyed or damaged after June 30, 1987, by fire, 
4.6 	lightning, or other hazard provided:
4.7 	(i) destruction was not caused by the intentional act of or at the direction of a controlling 
4.8 	person of the facility;
4.9 	(ii) at the time the facility was destroyed or damaged the controlling persons of the 
4.10 	facility maintained insurance coverage for the type of hazard that occurred in an amount 
4.11 	that a reasonable person would conclude was adequate;
4.12 	(iii) the net proceeds from an insurance settlement for the damages caused by the hazard 
4.13 	are applied to the cost of the new facility or repairs;
4.14 	(iv) the number of licensed and certified beds in the new facility does not exceed the 
4.15 	number of licensed and certified beds in the destroyed facility; and
4.16 	(v) the commissioner determines that the replacement beds are needed to prevent an 
4.17 	inadequate supply of beds.
4.18 	Project construction costs incurred for repairs authorized under this clause shall not be 
4.19 	considered in the dollar threshold amount defined in subdivision 2;
4.20 	(b) to license or certify beds that are moved from one location to another within a nursing 
4.21 	home facility, provided the total costs of remodeling performed in conjunction with the 
4.22 	relocation of beds does not exceed $1,000,000;
4.23 	(c) to license or certify beds in a project recommended for approval under section 
4.24 	144A.073;
4.25 	(d) to license or certify beds that are moved from an existing state nursing home to a 
4.26 	different state facility, provided there is no net increase in the number of state nursing home 
4.27 	beds;
4.28 	(e) to certify and license as nursing home beds boarding care beds in a certified boarding 
4.29 	care facility if the beds meet the standards for nursing home licensure, or in a facility that 
4.30 	was granted an exception to the moratorium under section 144A.073, and if the cost of any 
4.31 	remodeling of the facility does not exceed $1,000,000. If boarding care beds are licensed 
4.32 	as nursing home beds, the number of boarding care beds in the facility must not increase 
5.1 	beyond the number remaining at the time of the upgrade in licensure. The provisions 
5.2 	contained in section 144A.073 regarding the upgrading of the facilities do not apply to 
5.3 	facilities that satisfy these requirements;
5.4 	(f) to license and certify up to 40 beds transferred from an existing facility owned and 
5.5 	operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the 
5.6 	same location as the existing facility that will serve persons with Alzheimer's disease and 
5.7 	other related disorders. The transfer of beds may occur gradually or in stages, provided the 
5.8 	total number of beds transferred does not exceed 40. At the time of licensure and certification 
5.9 	of a bed or beds in the new unit, the commissioner of health shall delicense and decertify 
5.10 	the same number of beds in the existing facility. As a condition of receiving a license or 
5.11 	certification under this clause, the facility must make a written commitment to the 
5.12 	commissioner of human services that it will not seek to receive an increase in its 
5.13 	property-related payment rate as a result of the transfers allowed under this paragraph;
5.14 	(g) (f) to license and certify nursing home beds to replace currently licensed and certified 
5.15 	boarding care beds which may be located either in a remodeled or renovated boarding care 
5.16 	or nursing home facility or in a remodeled, renovated, newly constructed, or replacement 
5.17 	nursing home facility within the identifiable complex of health care facilities in which the 
5.18 	currently licensed boarding care beds are presently located, provided that the number of 
5.19 	boarding care beds in the facility or complex are decreased by the number to be licensed as 
5.20 	nursing home beds and further provided that, if the total costs of new construction, 
5.21 	replacement, remodeling, or renovation exceed ten percent of the appraised value of the 
5.22 	facility or $200,000, whichever is less, the facility makes a written commitment to the 
5.23 	commissioner of human services that it will not seek to receive an increase in its 
5.24 	property-related payment rate by reason of the new construction, replacement, remodeling, 
5.25 	or renovation. The provisions contained in section 144A.073 regarding the upgrading of 
5.26 	facilities do not apply to facilities that satisfy these requirements;
5.27 	(h) (g) to license as a nursing home and certify as a nursing facility a facility that is 
5.28 	licensed as a boarding care facility but not certified under the medical assistance program, 
5.29 	but only if the commissioner of human services certifies to the commissioner of health that 
5.30 	licensing the facility as a nursing home and certifying the facility as a nursing facility will 
5.31 	result in a net annual savings to the state general fund of $200,000 or more;
5.32 	(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing home 
5.33 	beds in a facility that was licensed and in operation prior to January 1, 1992;
6.1 	(j) to license and certify new nursing home beds to replace beds in a facility acquired 
6.2 	by the Minneapolis Community Development Agency as part of redevelopment activities 
6.3 	in a city of the first class, provided the new facility is located within three miles of the site 
6.4 	of the old facility. Operating and property costs for the new facility must be determined and 
6.5 	allowed under section 256B.431 or 256B.434 or chapter 256R;
6.6 	(k) to license and certify up to 20 new nursing home beds in a community-operated 
6.7 	hospital and attached convalescent and nursing care facility with 40 beds on April 21, 1991, 
6.8 	that suspended operation of the hospital in April 1986. The commissioner of human services 
6.9 	shall provide the facility with the same per diem property-related payment rate for each 
6.10 	additional licensed and certified bed as it will receive for its existing 40 beds;
6.11 	(l) (h) to license or certify beds in renovation, replacement, or upgrading projects as 
6.12 	defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the 
6.13 	facility's remodeling projects do not exceed $1,000,000;
6.14 	(m) to license and certify beds that are moved from one location to another for the 
6.15 	purposes of converting up to five four-bed wards to single or double occupancy rooms in 
6.16 	a nursing home that, as of January 1, 1993, was county-owned and had a licensed capacity 
6.17 	of 115 beds;
6.18 	(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified nursing 
6.19 	facility located in Minneapolis to layaway all of its licensed and certified nursing home 
6.20 	beds. These beds may be relicensed and recertified in a newly constructed teaching nursing 
6.21 	home facility affiliated with a teaching hospital upon approval by the legislature. The 
6.22 	proposal must be developed in consultation with the interagency committee on long-term 
6.23 	care planning. The beds on layaway status shall have the same status as voluntarily delicensed 
6.24 	and decertified beds, except that beds on layaway status remain subject to the surcharge in 
6.25 	section 256.9657. This layaway provision expires July 1, 1998;
6.26 	(o) to allow a project which will be completed in conjunction with an approved 
6.27 	moratorium exception project for a nursing home in southern Cass County and which is 
6.28 	directly related to that portion of the facility that must be repaired, renovated, or replaced, 
6.29 	to correct an emergency plumbing problem for which a state correction order has been 
6.30 	issued and which must be corrected by August 31, 1993;
6.31 	(p) (i) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified 
6.32 	nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to the 
6.33 	commissioner, up to 30 of the facility's licensed and certified beds by converting three-bed 
6.34 	wards to single or double occupancy. Beds on layaway status shall have the same status as 
7.1 	voluntarily delicensed and decertified beds except that beds on layaway status remain subject 
7.2 	to the surcharge in section 256.9657, remain subject to the license application and renewal 
7.3 	fees under section 144A.07 and shall be subject to a $100 per bed reactivation fee. In 
7.4 	addition, at any time within three years of the effective date of the layaway, the beds on 
7.5 	layaway status may be:;
7.6 	(1) relicensed and recertified upon relocation and reactivation of some or all of the beds 
7.7 	to an existing licensed and certified facility or facilities located in Pine River, Brainerd, or 
7.8 	International Falls; provided that the total project construction costs related to the relocation 
7.9 	of beds from layaway status for any facility receiving relocated beds may not exceed the 
7.10 	dollar threshold provided in subdivision 2 unless the construction project has been approved 
7.11 	through the moratorium exception process under section 144A.073;
7.12 	(2) relicensed and recertified, upon reactivation of some or all of the beds within the 
7.13 	facility which placed the beds in layaway status, if the commissioner has determined a need 
7.14 	for the reactivation of the beds on layaway status.
7.15 	The property-related payment rate of a facility placing beds on layaway status must be 
7.16 	adjusted by the incremental change in its rental per diem after recalculating the rental per 
7.17 	diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related 
7.18 	payment rate for a facility relicensing and recertifying beds from layaway status must be 
7.19 	adjusted by the incremental change in its rental per diem after recalculating its rental per 
7.20 	diem using the number of beds after the relicensing to establish the facility's capacity day 
7.21 	divisor, which shall be effective the first day of the month following the month in which 
7.22 	the relicensing and recertification became effective. Any beds remaining on layaway status 
7.23 	more than three years after the date the layaway status became effective must be removed 
7.24 	from layaway status and immediately delicensed and decertified;
7.25 	(q) to license and certify beds in a renovation and remodeling project to convert 12 
7.26 	four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing 
7.27 	home that, as of January 1, 1994, met the following conditions: the nursing home was located 
7.28 	in Ramsey County; had a licensed capacity of 154 beds; and had been ranked among the 
7.29 	top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total 
7.30 	project construction cost estimate for this project must not exceed the cost estimate submitted 
7.31 	in connection with the 1993 moratorium exception process;
7.32 	(r) to license and certify up to 117 beds that are relocated from a licensed and certified 
7.33 	138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds 
7.34 	located in South St. Paul, provided that the nursing facility and hospital are owned by the 
8.1 	same or a related organization and that prior to the date the relocation is completed the 
8.2 	hospital ceases operation of its inpatient hospital services at that hospital. After relocation, 
8.3 	the nursing facility's status shall be the same as it was prior to relocation. The nursing 
8.4 	facility's property-related payment rate resulting from the project authorized in this paragraph 
8.5 	shall become effective no earlier than April 1, 1996. For purposes of calculating the 
8.6 	incremental change in the facility's rental per diem resulting from this project, the allowable 
8.7 	appraised value of the nursing facility portion of the existing health care facility physical 
8.8 	plant prior to the renovation and relocation may not exceed $2,490,000;
8.9 	(s) to license and certify two beds in a facility to replace beds that were voluntarily 
8.10 	delicensed and decertified on June 28, 1991;
8.11 	(t) (j) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed nursing 
8.12 	home and 21-bed boarding care home facility in Minneapolis, notwithstanding the licensure 
8.13 	and certification after July 1, 1995, of the Minneapolis facility as a 147-bed nursing home 
8.14 	facility after completion of a construction project approved in 1993 under section 144A.073, 
8.15 	to be laid away upon 30 days' prior written notice to the commissioner. Beds on layaway 
8.16 	status shall have the same status as voluntarily delicensed or decertified beds except that 
8.17 	they shall remain subject to the surcharge in section 256.9657. The 16 beds on layaway 
8.18 	status may be relicensed as nursing home beds and recertified at any time within five years 
8.19 	of the effective date of the layaway upon relocation of some or all of the beds to a licensed 
8.20 	and certified facility located in Watertown, provided that the total project construction costs 
8.21 	related to the relocation of beds from layaway status for the Watertown facility may not 
8.22 	exceed the dollar threshold provided in subdivision 2 unless the construction project has 
8.23 	been approved through the moratorium exception process under section 144A.073.;
8.24 	The property-related payment rate of the facility placing beds on layaway status must 
8.25 	be adjusted by the incremental change in its rental per diem after recalculating the rental 
8.26 	per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related 
8.27 	payment rate for the facility relicensing and recertifying beds from layaway status must be 
8.28 	adjusted by the incremental change in its rental per diem after recalculating its rental per 
8.29 	diem using the number of beds after the relicensing to establish the facility's capacity day 
8.30 	divisor, which shall be effective the first day of the month following the month in which 
8.31 	the relicensing and recertification became effective. Any beds remaining on layaway status 
8.32 	more than five years after the date the layaway status became effective must be removed 
8.33 	from layaway status and immediately delicensed and decertified;
8.34 	(u) to license and certify beds that are moved within an existing area of a facility or to 
8.35 	a newly constructed addition which is built for the purpose of eliminating three- and four-bed 
9.1 	rooms and adding space for dining, lounge areas, bathing rooms, and ancillary service areas 
9.2 	in a nursing home that, as of January 1, 1995, was located in Fridley and had a licensed 
9.3 	capacity of 129 beds;
9.4 	(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County to 
9.5 	a 160-bed facility in Crow Wing County, provided all the affected beds are under common 
9.6 	ownership;
9.7 	(w) to license and certify a total replacement project of up to 49 beds located in Norman 
9.8 	County that are relocated from a nursing home destroyed by flood and whose residents were 
9.9 	relocated to other nursing homes. The operating cost payment rates for the new nursing 
9.10 	facility shall be determined based on the interim and settle-up payment provisions of section 
9.11 	256R.27 and the reimbursement provisions of chapter 256R. Property-related reimbursement 
9.12 	rates shall be determined under section 256R.26, taking into account any federal or state 
9.13 	flood-related loans or grants provided to the facility;
9.14 	(x) to license and certify to the licensee of a nursing home in Polk County that was 
9.15 	destroyed by flood in 1997 replacement projects with a total of up to 129 beds, with at least 
9.16 	25 beds to be located in Polk County and up to 104 beds distributed among up to three other 
9.17 	counties. These beds may only be distributed to counties with fewer than the median number 
9.18 	of age intensity adjusted beds per thousand, as most recently published by the commissioner 
9.19 	of human services. If the licensee chooses to distribute beds outside of Polk County under 
9.20 	this paragraph, prior to distributing the beds, the commissioner of health must approve the 
9.21 	location in which the licensee plans to distribute the beds. The commissioner of health shall 
9.22 	consult with the commissioner of human services prior to approving the location of the 
9.23 	proposed beds. The licensee may combine these beds with beds relocated from other nursing 
9.24 	facilities as provided in section 144A.073, subdivision 3c. The operating payment rates for 
9.25 	the new nursing facilities shall be determined based on the interim and settle-up payment 
9.26 	provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. Property-related 
9.27 	reimbursement rates shall be determined under section 256R.26. If the replacement beds 
9.28 	permitted under this paragraph are combined with beds from other nursing facilities, the 
9.29 	rates shall be calculated as the weighted average of rates determined as provided in this 
9.30 	paragraph and section 256R.50;
9.31 	(y) to license and certify beds in a renovation and remodeling project to convert 13 
9.32 	three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and add 
9.33 	improvements in a nursing home that, as of January 1, 1994, met the following conditions: 
9.34 	the nursing home was located in Ramsey County, was not owned by a hospital corporation, 
9.35 	had a licensed capacity of 64 beds, and had been ranked among the top 15 applicants by 
10.1 	the 1993 moratorium exceptions advisory review panel. The total project construction cost 
10.2 	estimate for this project must not exceed the cost estimate submitted in connection with the 
10.3 	1993 moratorium exception process;
10.4 	(z) to license and certify up to 150 nursing home beds to replace an existing 285 bed 
10.5 	nursing facility located in St. Paul. The replacement project shall include both the renovation 
10.6 	of existing buildings and the construction of new facilities at the existing site. The reduction 
10.7 	in the licensed capacity of the existing facility shall occur during the construction project 
10.8 	as beds are taken out of service due to the construction process. Prior to the start of the 
10.9 	construction process, the facility shall provide written information to the commissioner of 
10.10 	health describing the process for bed reduction, plans for the relocation of residents, and 
10.11 	the estimated construction schedule. The relocation of residents shall be in accordance with 
10.12 	the provisions of law and rule;
10.13 	(aa) to allow the commissioner of human services to license an additional 36 beds to 
10.14 	provide residential services for the physically disabled under Minnesota Rules, parts 
10.15 	9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that 
10.16 	the total number of licensed and certified beds at the facility does not increase;
10.17 	(bb) to license and certify a new facility in St. Louis County with 44 beds constructed 
10.18 	to replace an existing facility in St. Louis County with 31 beds, which has resident rooms 
10.19 	on two separate floors and an antiquated elevator that creates safety concerns for residents 
10.20 	and prevents nonambulatory residents from residing on the second floor. The project shall 
10.21 	include the elimination of three- and four-bed rooms;
10.22 	(cc) (k) to license and certify four beds in a 16-bed certified boarding care home in 
10.23 	Minneapolis to replace beds that were voluntarily delicensed and decertified on or before 
10.24 	March 31, 1992. The licensure and certification is conditional upon the facility periodically 
10.25 	assessing and adjusting its resident mix and other factors which may contribute to a potential 
10.26 	institution for mental disease declaration. The commissioner of human services shall retain 
10.27 	the authority to audit the facility at any time and shall require the facility to comply with 
10.28 	any requirements necessary to prevent an institution for mental disease declaration, including 
10.29 	delicensure and decertification of beds, if necessary; or
10.30 	(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 80 
10.31 	beds as part of a renovation project. The renovation must include construction of an addition 
10.32 	to accommodate ten residents with beginning and midstage dementia in a self-contained 
10.33 	living unit; creation of three resident households where dining, activities, and support spaces 
11.1 	are located near resident living quarters; designation of four beds for rehabilitation in a 
11.2 	self-contained area; designation of 30 private rooms; and other improvements;
11.3 	(ee) to license and certify beds in a facility that has undergone replacement or remodeling 
11.4 	as part of a planned closure under section 256R.40;
11.5 	(ff) to license and certify a total replacement project of up to 124 beds located in Wilkin 
11.6 	County that are in need of relocation from a nursing home significantly damaged by flood. 
11.7 	The operating cost payment rates for the new nursing facility shall be determined based on 
11.8 	the interim and settle-up payment provisions of section 256R.27 and the reimbursement 
11.9 	provisions of chapter 256R. Property-related reimbursement rates shall be determined under 
11.10 	section 256R.26, taking into account any federal or state flood-related loans or grants 
11.11 	provided to the facility;
11.12 	(gg) to allow the commissioner of human services to license an additional nine beds to 
11.13 	provide residential services for the physically disabled under Minnesota Rules, parts 
11.14 	9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the 
11.15 	total number of licensed and certified beds at the facility does not increase;
11.16 	(hh) to license and certify up to 120 new nursing facility beds to replace beds in a facility 
11.17 	in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the new 
11.18 	facility is located within four miles of the existing facility and is in Anoka County. Operating 
11.19 	and property rates shall be determined and allowed under chapter 256R and Minnesota 
11.20 	Rules, parts 9549.0010 to 9549.0080; or
11.21 	(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County that, 
11.22 	as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit 
11.23 	nursing facility located in the city of Columbia Heights or its affiliate. The transfer is effective 
11.24 	when the receiving facility notifies the commissioner in writing of the number of beds 
11.25 	accepted. The commissioner shall place all transferred beds on layaway status held in the 
11.26 	name of the receiving facility. The layaway adjustment provisions of section 256B.431, 
11.27 	subdivision 30, do not apply to this layaway. The receiving facility may only remove the 
11.28 	beds from layaway for recertification and relicensure at the receiving facility's current site, 
11.29 	or at a newly constructed facility located in Anoka County. The receiving facility must 
11.30 	receive statutory authorization before removing these beds from layaway status, or may 
11.31 	remove these beds from layaway status if removal from layaway status is part of a 
11.32 	moratorium exception project approved by the commissioner under section 144A.073.
11.33 	(l) to license or certify beds under provisions coded in this subdivision before the 
11.34 	enactment of this law as paragraphs (f), (i) to (k), (m) to (bb), and (dd) to (ii).

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

12.2 	Sec. 3. Minnesota Statutes 2024, section 144A.071, subdivision 4d, is amended to read:
12.3 		Subd. 4d.Consolidation of nursing facilities. (a) The commissioner of health, in 
12.4 	consultation with the commissioner of human services, may approve a request for net savings 
12.5 	from a consolidation of nursing facilities which includes to be applied to reduce the costs 
12.6 	of a moratorium exception project application under section 144A.073, subdivision 2. For 
12.7 	purposes of this subdivision, "consolidation" means the closure of one or more facilities 
12.8 	and the upgrading of the physical plant of the remaining nursing facility or facilities, the 
12.9 	costs of which exceed the threshold project limit under subdivision 2, clause (a). The 
12.10 	commissioners shall consider the criteria in this section, section 144A.073, and section 
12.11 	256R.40, in approving or rejecting a consolidation proposal. In the event the commissioners 
12.12 	approve the request, the commissioner of human services shall calculate an external fixed 
12.13 	costs rate adjustment according to clauses (1) to (3):.
12.14 	(1) the closure of beds shall not be eligible for a planned closure rate adjustment under 
12.15 	section 256R.40, subdivision 5;
12.16 	(2) the construction project permitted in this clause shall not be eligible for a threshold 
12.17 	project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception 
12.18 	adjustment under section 144A.073; and
12.19 	(3) the payment rate for external fixed costs for a remaining facility or facilities shall 
12.20 	be increased by an amount equal to 65 percent of the projected net cost savings to the state 
12.21 	calculated in paragraph (b), divided by the state's medical assistance percentage of medical 
12.22 	assistance dollars, and then divided by estimated medical assistance resident days, as 
12.23 	determined in paragraph (c), of the remaining nursing facility or facilities in the request in 
12.24 	this paragraph. The rate adjustment is effective on the first day of the month of January or 
12.25 	July, whichever date occurs first following both the completion of the construction upgrades 
12.26 	in the consolidation plan and the complete closure of the facility or facilities designated for 
12.27 	closure in the consolidation plan. If more than one facility is receiving upgrades in the 
12.28 	consolidation plan, each facility's date of construction completion must be evaluated 
12.29 	separately.
12.30 	(b) For purposes of calculating the net cost savings to the state, the commissioner shall 
12.31 	consider clauses (1) to (7) (6):
13.1 	(1) the annual savings from estimated medical assistance payments from the net number 
13.2 	of beds closed taking into consideration only beds that are in active service on the date of 
13.3 	the request and that have been in active service for at least three years;
13.4 	(2) the estimated annual cost of increased case load of individuals receiving services 
13.5 	under the elderly waiver;
13.6 	(3) the estimated annual cost of elderly waiver recipients receiving support under housing 
13.7 	support under chapter 256I;
13.8 	(4) the estimated annual cost of increased case load of individuals receiving services 
13.9 	under the alternative care program;
13.10 	(5) the annual loss of license surcharge payments on closed beds; and
13.11 	(6) the savings from not paying planned closure rate adjustments that the facilities would 
13.12 	otherwise be eligible for under section 256R.40; and
13.13 	(7) (6) the savings from not paying external fixed costs payment rate adjustments
13.14 	providing a rate adjustment from submission of renovation costs that would otherwise be 
13.15 	eligible as threshold projects under section 256B.434, subdivision 4f.
13.16 	(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical 
13.17 	assistance resident days of the remaining facility or facilities shall be computed assuming 
13.18 	95 percent occupancy multiplied by the historical percentage of medical assistance resident 
13.19 	days of the remaining facility or facilities, as reported on the facility's or facilities' most 
13.20 	recent nursing facility statistical and cost report filed before the plan of closure is submitted, 
13.21 	multiplied by 365.
13.22 	(d) (c) For purposes of calculating net cost of savings to the state in paragraph (b), the 
13.23 	average occupancy percentages will be those reported on the facility's or facilities' most 
13.24 	recent nursing facility statistical and cost report filed before the plan of closure is submitted, 
13.25 	and the average payment rates shall be calculated based on the approved payment rates in 
13.26 	effect at the time the consolidation request is submitted.
13.27 	(e) To qualify for the external fixed costs payment rate adjustment under this subdivision, 
13.28 	the closing facilities shall:
13.29 	(1) submit an application for closure according to section 256R.40, subdivision 2; and
13.30 	(2) follow the resident relocation provisions of section 144A.161.
13.31 	(f) (d) The county or counties in which a facility or facilities are closed under this 
13.32 	subdivision shall not be eligible for designation as a hardship area under subdivision 3 for 
14.1 	five years from the date of the approval of the proposed consolidation. The applicant shall 
14.2 	notify the county of this limitation and the county shall acknowledge this in a letter of 
14.3 	support.
14.4 	(g) Projects approved on or after March 1, 2020, are not subject to paragraph (a), clauses 
14.5 	(2) and (3), and paragraph (c). The 65 (e) Sixty-five percent of the projected net cost savings 
14.6 	to the state calculated in paragraph (b) must be applied to the moratorium cost of the project 
14.7 	and the remainder must be added to the moratorium funding under section 144A.073, 
14.8 	subdivision 11.
14.9 	(h) (f) Consolidation project applications not approved by the commissioner prior to 
14.10 	March 1, 2020, are subject to the moratorium process under section 144A.073, subdivision 
14.11 	2. Upon request by the applicant, the commissioner may extend this deadline to August 1, 
14.12 	2020, so long as the facilities, bed numbers, and counties specified in the original application 
14.13 	are not altered. Proposals from facilities seeking approval for a consolidation project prior 
14.14 	to March 1, 2020, must be received by the commissioner no later than January 1, 2020. This 
14.15 	paragraph expires August 1, 2020.

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

14.17 	Sec. 4. Minnesota Statutes 2024, section 144A.161, subdivision 10, is amended to read:
14.18 		Subd. 10.Facility closure rate adjustment. Upon the request of a closing facility, the 
14.19 	commissioner of human services must allow the facility a closure rate adjustment equal to 
14.20 	a 50 percent payment rate increase to reimburse relocation costs or other costs related to 
14.21 	facility closure. This rate increase is effective on the date the facility's occupancy decreases 
14.22 	to 90 percent of capacity days after the written notice of closure is distributed under 
14.23 	subdivision 5 and shall remain in effect for a period of up to 60 days. The commissioner 
14.24 	shall delay the implementation of rate adjustments under section 256R.40, subdivisions 5
14.25 	and 6, to offset the cost of this rate adjustment.

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

14.27 	Sec. 5. Minnesota Statutes 2024, section 144A.1888, is amended to read:
14.28 	144A.1888 REUSE OF FACILITIES.
14.29 	Notwithstanding any local ordinance related to development, planning, or zoning to the 
14.30 	contrary, the conversion or reuse of a nursing home that closes or that curtails, reduces, or 
14.31 	changes operations shall be considered a conforming use permitted under local law, provided 
14.32 	that the facility is converted to another long-term care service approved by a regional 
15.1 	planning group under section 256R.40 that serves a smaller number of persons than the 
15.2 	number of persons served before the closure or curtailment, reduction, or change in 
15.3 	operations.

15.4 	Sec. 6. Minnesota Statutes 2024, section 256.9657, subdivision 1, is amended to read:
15.5 		Subdivision 1.Nursing home license surcharge. (a) Effective July 1, 1993, each 
15.6 	non-state-operated nursing home licensed under chapter 144A shall pay to the commissioner 
15.7 	an annual surcharge according to the schedule in subdivision 4. The surcharge shall be 
15.8 	calculated as $620 $2,815 per licensed bed. If the number of licensed beds is reduced, the 
15.9 	surcharge shall be based on the number of remaining licensed beds the second month 
15.10 	following the receipt of timely notice by the commissioner of human services that beds 
15.11 	have been delicensed. The nursing home must notify the commissioner of health in writing 
15.12 	when beds are delicensed. The commissioner of health must notify the commissioner of 
15.13 	human services within ten working days after receiving written notification. If the notification 
15.14 	is received by the commissioner of human services by the 15th of the month, the invoice 
15.15 	for the second following month must be reduced to recognize the delicensing of beds. Beds 
15.16 	on layaway status continue to be subject to the surcharge. The commissioner of human 
15.17 	services must acknowledge a medical care surcharge appeal within 30 days of receipt of 
15.18 	the written appeal from the provider.
15.19 	(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.
15.20 	(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased to 
15.21 	$990.
15.22 	(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased to 
15.23 	$2,815.
15.24 	(e) (b) The commissioner may reduce, and may subsequently restore, the surcharge 
15.25 	under paragraph (d) (a) based on the commissioner's determination of a permissible surcharge.

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

15.27 	Sec. 7. [256.9746] AGE-FRIENDLY MINNESOTA COUNCIL.
15.28 		Subdivision 1.Establishment. The Age-Friendly Minnesota Council is established to 
15.29 	coordinate work across sectors, including state government, nonprofits, communities, 
15.30 	businesses, and others, to ensure the state is an age-friendly state.
15.31 		Subd. 2.Membership. (a) The council consists of 15 voting members.
16.1 	(b) Each of the following commissioners and multimember state agencies must designate 
16.2 	an Age-Friendly Minnesota lead and appoint that designee to serve as a council member:
16.3 	(1) the Minnesota Board on Aging;
16.4 	(2) the commissioner of commerce;
16.5 	(3) the commissioner of employment and economic development;
16.6 	(4) the commissioner of health;
16.7 	(5) the commissioner of housing;
16.8 	(6) the commissioner of human services;
16.9 	(7) the commissioner of transportation;
16.10 	(8) the commissioner of veterans affairs; and
16.11 	(9) the Metropolitan Council.
16.12 	(c) The governor shall appoint six additional public members to represent older adults 
16.13 	in communities experiencing disparities, direct service caregivers, businesses, experts on 
16.14 	aging, local governments, and Tribal communities. The appointment, terms, compensation, 
16.15 	and removal of public members shall be as provided in section 15.059.
16.16 	(d) Other state agencies and boards may participate on the council in a nonvoting capacity.
16.17 		Subd. 3.Chairperson; executive committee. (a) The council shall elect a chairperson 
16.18 	and other officers as it deems necessary and in accordance with the council's operating 
16.19 	procedures.
16.20 	(b) The council shall be governed by an executive committee elected by the members 
16.21 	of the council. One member of the executive committee must be the council chairperson.
16.22 	(c) The executive committee may appoint additional subcommittees and work groups 
16.23 	as necessary to fulfill the duties of the council.
16.24 		Subd. 4.Meetings. (a) The council shall meet at the call of the chairperson or at the 
16.25 	request of a majority of council members. The council must meet at least quarterly. Meetings 
16.26 	of the council are subject to section 13D.01, and notice of its meetings is governed by section 
16.27 	13D.04.
16.28 	(b) Notwithstanding section 13D.01, the council may conduct a meeting of its members 
16.29 	by telephone or other electronic means so long as:
17.1 	(1) all members of the council participating in the meeting, wherever their physical 
17.2 	location, can hear one another and can hear all discussion and testimony;
17.3 	(2) members of the public present at the regular meeting location of the council can hear 
17.4 	all discussion and all votes of members of the council and participate in testimony;
17.5 	(3) at least one member of the council is physically present at the regular meeting location; 
17.6 	and
17.7 	(4) each member's vote on each issue is identified and recorded by a roll call.
17.8 	(c) Each member of the council participating in a meeting by telephone or other electronic 
17.9 	means is considered present at the meeting for the purposes of determining a quorum and 
17.10 	participating in all proceedings. If telephone or another electronic means is used to conduct 
17.11 	a meeting, the council, to the extent practicable, shall allow a person to monitor the meeting 
17.12 	from a remote location. If telephone or another electronic means is used to conduct a regular, 
17.13 	special, or emergency meeting, the council shall provide notice of the regular meeting 
17.14 	location, that some members may participate by electronic means, and of the option to 
17.15 	monitor the meeting electronically from a remote location.
17.16 		Subd. 5.Duties. (a) The council's duties may include but are not limited to:
17.17 	(1) elevating the voice of older adults in developing the vision and action plan for an 
17.18 	age-friendly state;
17.19 	(2) engaging with the community, including older adults, caregivers, businesses, experts, 
17.20 	advocacy organizations, and other interested parties, to provide recommendations and update 
17.21 	interested parties on the council's recommendations;
17.22 	(3) identifying opportunities for and barriers to collaboration and coordination among 
17.23 	services and state agencies responsible for funding and administering programs and 
17.24 	public-private partnerships;
17.25 	(4) promoting equity and making progress toward equitable outcomes by examining 
17.26 	programs, policies, and practices to ensure they address disparities experienced by older 
17.27 	adults in greater Minnesota, older adults of color, and indigenous older adults;
17.28 	(5) catalyzing age-friendly work at the local level, engaging with and empowering older 
17.29 	adults, local constituents, elected officials, and other interested parties to create change in 
17.30 	every community;
17.31 	(6) establishing a statewide framework that allows for local flexibility to tap into the 
17.32 	potential presented by our aging communities and elevates aging across all of Minnesota;
18.1 	(7) reviewing, awarding, and monitoring grants under section 256.9747;
18.2 	(8) assessing and examining relevant programs, policies, practices, and services to make 
18.3 	budget and policy recommendations to establish age-friendly policies in law with appropriate 
18.4 	financial support to ensure Minnesota continues to lead on age-friendly initiatives; and
18.5 	(9) making budget and policy recommendations to the governor, commissioners, boards, 
18.6 	other state agencies, and the legislature to further the council's mission to ensure the state 
18.7 	is an age-friendly state.
18.8 	(b) The council may accept technical assistance and in-kind services from outside 
18.9 	organizations for purposes consistent with the council's role and authority.
18.10 		Subd. 6.Administration. The Minnesota Board on Aging and Department of Human 
18.11 	Services shall provide staffing and administrative support to the council.
18.12 		Subd. 7.Annual report. Beginning January 1, 2026, and every two years thereafter, 
18.13 	the council shall publish a public report on the council's activities, the uses and measurable 
18.14 	outcomes of the grant activities funded under section 256.9747, the council's 
18.15 	recommendations, proposed changes to statutes or rules, and other issues the council may 
18.16 	choose to report.

18.17 	Sec. 8. [256.9747] AGE-FRIENDLY MINNESOTA GRANTS.
18.18 		Subdivision 1.Age-friendly community grants. The commissioner of human services, 
18.19 	in collaboration with the Minnesota Board on Aging and the Age-Friendly Minnesota 
18.20 	Council, shall develop the age-friendly community grant program to help communities, 
18.21 	including cities, counties, other municipalities, Tribes, and collaborative efforts become 
18.22 	age-friendly communities, with an emphasis on structures, services, and community features 
18.23 	necessary to support older adult residents, including but not limited to:
18.24 	(1) coordination of health and social services;
18.25 	(2) transportation access;
18.26 	(3) safe, affordable places to live;
18.27 	(4) reducing social isolation and improving wellness;
18.28 	(5) combating ageism and racism against older adults;
18.29 	(6) accessible outdoor space and buildings;
18.30 	(7) communication and information technology access; and
18.31 	(8) opportunities to stay engaged and economically productive.
19.1 		Subd. 2.Age-friendly technical assistance grants. The commissioner of human services, 
19.2 	in collaboration with the Minnesota Board on Aging and the Age-Friendly Minnesota 
19.3 	Council, shall develop the age-friendly technical assistance grant program to support 
19.4 	communities and organizations who need assistance in applying for age-friendly community 
19.5 	grants and implementing various aspects of their grant-funded projects.

19.6 	Sec. 9. Minnesota Statutes 2024, section 256.9752, subdivision 2, is amended to read:
19.7 		Subd. 2.Authority. The Minnesota Board on Aging shall allocate to area agencies on 
19.8 	aging the state and federal funds which are received for the senior nutrition programs of 
19.9 	congregate dining and home-delivered meals in a manner consistent with federal 
19.10 	requirements.

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

19.12 	Sec. 10. Minnesota Statutes 2024, section 256.9752, subdivision 3, is amended to read:
19.13 		Subd. 3.Nutrition support services. (a) Funds allocated to an area agency on aging 
19.14 	for nutrition support services may be used for the following:
19.15 	(1) transportation of home-delivered meals and purchased food and medications to the 
19.16 	residence of a senior citizen;
19.17 	(2) expansion of home-delivered meals into unserved and underserved areas;
19.18 	(3) transportation to supermarkets or delivery of groceries from supermarkets to homes;
19.19 	(4) vouchers for food purchases at selected restaurants in isolated rural areas;
19.20 	(5) the Supplemental Nutrition Assistance Program (SNAP) outreach;
19.21 	(6) transportation of seniors to congregate dining sites;
19.22 	(7) nutrition screening assessments and counseling as needed by individuals with special 
19.23 	dietary needs, performed by a licensed dietitian or nutritionist; and
19.24 	(8) other appropriate services which support senior nutrition programs, including new 
19.25 	service delivery models; and
19.26 	(9) innovative models of providing healthy and nutritious meals to seniors, including 
19.27 	through partnerships with schools, restaurants, and other community partners.
19.28 	(b) An area agency on aging may transfer unused funding for nutrition support services 
19.29 	to fund congregate dining services and home-delivered meals, but state funds transferred 
19.30 	under this paragraph are not subject to federal requirements.

20.1 	Sec. 11. Minnesota Statutes 2024, section 256B.431, subdivision 30, is amended to read:
20.2 		Subd. 30.Bed layaway and delicensure. (a) For rate years beginning on or after July 
20.3 	1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway 
20.4 	shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph 
20.5 	(c), and calculation of the rental per diem, have those beds given the same effect as if the 
20.6 	beds had been delicensed so long as the beds remain on layaway. At the time of a layaway, 
20.7 	a facility may change its single bed election for use in calculating capacity days under 
20.8 	Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be 
20.9 	effective the first day of the month of January or July, whichever occurs first following the 
20.10 	date on which the layaway of the beds becomes effective under section 144A.071, subdivision 
20.11 	4b.
20.12 	(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to 
20.13 	the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under 
20.14 	that section or chapter that has placed beds on layaway shall, for so long as the beds remain 
20.15 	on layaway, be allowed to:
20.16 	(1) aggregate the applicable investment per bed limits based on the number of beds 
20.17 	licensed immediately prior to entering the alternative payment system;
20.18 	(2) retain or change the facility's single bed election for use in calculating capacity days 
20.19 	under Minnesota Rules, part 9549.0060, subpart 11; and
20.20 	(3) establish capacity days based on the number of beds immediately prior to the layaway 
20.21 	and the number of beds after the layaway.
20.22 	The commissioner shall increase the facility's property payment rate by the incremental 
20.23 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
20.24 	diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and 
20.25 	(3). If a facility reimbursed under section 256B.434 or chapter 256R completes a moratorium 
20.26 	exception project after its base year, the base year property rate shall be the moratorium 
20.27 	project property rate. The base year rate shall be inflated by the factors in Minnesota Statutes 
20.28 	2024, section 256B.434, subdivision 4, paragraph (c). The property payment rate increase 
20.29 	shall be effective the first day of the month of January or July, whichever occurs first 
20.30 	following the date on which the layaway of the beds becomes effective.
20.31 	(c) If a nursing facility removes a bed from layaway status in accordance with section 
20.32 	144A.071, subdivision 4b, the commissioner shall establish capacity days based on the 
20.33 	number of licensed and certified beds in the facility not on layaway and shall reduce the 
20.34 	nursing facility's property payment rate in accordance with paragraph (b).
21.1 	(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision 
21.2 	to the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under 
21.3 	that section or chapter that has delicensed beds after July 1, 2000, by giving notice of the 
21.4 	delicensure to the commissioner of health according to the notice requirements in section 
21.5 	144A.071, subdivision 4b, shall be allowed to:
21.6 	(1) aggregate the applicable investment per bed limits based on the number of beds 
21.7 	licensed immediately prior to entering the alternative payment system;
21.8 	(2) retain or change the facility's single bed election for use in calculating capacity days 
21.9 	under Minnesota Rules, part 9549.0060, subpart 11; and
21.10 	(3) establish capacity days based on the number of beds immediately prior to the 
21.11 	delicensure and the number of beds after the delicensure.
21.12 	The commissioner shall increase the facility's property payment rate by the incremental 
21.13 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
21.14 	diem applying only the changes resulting from the delicensure of beds and clauses (1), (2), 
21.15 	and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
21.16 	project after its base year, the base year property rate shall be the moratorium project property 
21.17 	rate. The base year rate shall be inflated by the factors in Minnesota Statutes 2024, section 
21.18 	256B.434, subdivision 4, paragraph (c). The property payment rate increase shall be effective 
21.19 	the first day of the month of January or July, whichever occurs first following the date on 
21.20 	which the delicensure of the beds becomes effective.
21.21 	(e) For nursing facilities reimbursed under this section, section 256B.434, or chapter 
21.22 	256R, any beds placed on layaway shall not be included in calculating facility occupancy 
21.23 	as it pertains to leave days defined in Minnesota Rules, part 9505.0415.
21.24 	(f) For nursing facilities reimbursed under this section, section 256B.434, or chapter 
21.25 	256R, the rental rate calculated after placing beds on layaway may not be less than the rental 
21.26 	rate prior to placing beds on layaway.
21.27 	(g) A nursing facility receiving a rate adjustment as a result of this section shall comply 
21.28 	with section 256R.06, subdivision 5.
21.29 	(h) A facility that does not utilize the space made available as a result of bed layaway 
21.30 	or delicensure under this subdivision to reduce the number of beds per room or provide 
21.31 	more common space for nursing facility uses or perform other activities related to the 
21.32 	operation of the nursing facility shall have its property rate increase calculated under this 
21.33 	subdivision reduced by the ratio of the square footage made available that is not used for 
22.1 	these purposes to the total square footage made available as a result of bed layaway or 
22.2 	delicensure.
22.3 	(i) The commissioner must not adjust the property payment rates under this subdivision 
22.4 	for beds placed in or removed from layaway on or after July 1, 2025.

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

22.6 	Sec. 12. Minnesota Statutes 2024, section 256B.434, subdivision 4, is amended to read:
22.7 		Subd. 4.Alternate rates for nursing facilities. Effective for the rate years beginning 
22.8 	on and after January 1, 2019 2026, a nursing facility's property payment rate for the second 
22.9 	and subsequent years of a facility's contract under this section are is the facility's previous 
22.10 	rate year's property payment rate plus an inflation adjustment. The index for the inflation 
22.11 	adjustment must be based on the change in the Consumer Price Index-All Items (United 
22.12 	States City average) (CPI-U) forecasted by the Reports and Forecasts Division of the 
22.13 	Department of Human Services, as forecasted in the fourth quarter of the calendar year 
22.14 	preceding the rate year. The inflation adjustment must be based on the 12-month period 
22.15 	from the midpoint of the previous rate year to the midpoint of the rate year for which the 
22.16 	rate is being determined.

22.17 	Sec. 13. Minnesota Statutes 2024, section 256R.02, subdivision 18, is amended to read:
22.18 		Subd. 18.Employer health insurance costs. "Employer health insurance costs" means:
22.19 	(1) premium expenses for group coverage;
22.20 	(2) actual expenses incurred for self-insured plans, including actual claims paid, stop-loss 
22.21 	premiums, and plan fees. Actual expenses incurred for self-insured plans does not include 
22.22 	allowances for future funding unless the plan meets the Medicare provider reimbursement 
22.23 	manual requirements for reporting on a premium basis when the Medicare provider 
22.24 	reimbursement manual regulations define the actual costs; and
22.25 	(3) employer contributions to employer-sponsored individual coverage health 
22.26 	reimbursement arrangements as provided by Code of Federal Regulations, title 45, section 
22.27 	146.123, employee health reimbursement accounts, and health savings accounts.

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

22.29 	Sec. 14. Minnesota Statutes 2024, section 256R.02, subdivision 19, is amended to read:
22.30 		Subd. 19.External fixed costs. "External fixed costs" means costs related to the nursing 
22.31 	home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122; 
23.1 	family advisory council fee under section 144A.33; scholarships under section 256R.37; 
23.2 	planned closure rate adjustments under section 256R.40; consolidation rate adjustments 
23.3 	under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d; 
23.4 	single-bed room incentives under section 256R.41; property taxes, special assessments, and 
23.5 	payments in lieu of taxes; employer health insurance costs; quality improvement incentive 
23.6 	payment rate adjustments under section 256R.39; performance-based incentive payments 
23.7 	under section 256R.38; special dietary needs under section 256R.51; Public Employees 
23.8 	Retirement Association employer costs; and border city rate adjustments under section 
23.9 	256R.481 the items described in section 256R.25.

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

23.11 	Sec. 15. Minnesota Statutes 2024, section 256R.02, subdivision 22, is amended to read:
23.12 		Subd. 22.Fringe benefit costs. "Fringe benefit costs" means the costs for group life,;
23.13 	dental,; workers' compensation,; short- and long-term disability,; long-term care insurance,;
23.14 	accident insurance,; supplemental insurance,; legal assistance insurance,; profit sharing,;
23.15 	child care costs,; health insurance costs not covered under subdivision 18, including costs 
23.16 	associated with eligible part-time employee family members or retirees,; and pension and 
23.17 	retirement plan contributions, except for the Public Employees Retirement Association 
23.18 	costs.

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

23.20 	Sec. 16. Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision 
23.21 	to read:
23.22 		Subd. 36a.Patient driven payment model or PDPM. "Patient driven payment model" 
23.23 	or "PDPM" has the meaning given in section 144.0724, subdivision 2.

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

23.25 	Sec. 17. Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision 
23.26 	to read:
23.27 		Subd. 45a.Resource utilization group or RUG. "Resource utilization group" or "RUG" 
23.28 	has the meaning given in section 144.0724, subdivision 2.

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

24.1 	Sec. 18. Minnesota Statutes 2024, section 256R.10, subdivision 8, is amended to read:
24.2 		Subd. 8.Employer health insurance costs. (a) Employer health insurance costs are 
24.3 	allowable for (1) all nursing facility employees and (2) the spouse and dependents of those 
24.4 	nursing facility employees who are employed on average at least 30 hours per week.
24.5 	(b) Effective for the rate year beginning on January 1, 2026, the annual reimbursement 
24.6 	cap for health insurance costs is $14,703, as adjusted according to paragraph (c). The 
24.7 	allowable costs for health insurance must not exceed the reimbursement cap multiplied by 
24.8 	the annual average month end number of allowed enrolled nursing facility employees from 
24.9 	the applicable cost report period. For shared employees, the allowable number of enrolled 
24.10 	employees includes only the nursing facility percentage of any shared allowed enrolled 
24.11 	employees. The allowable number of enrolled employees must not include non-nursing 
24.12 	facility employees or individuals who elect COBRA continuation coverage.
24.13 	(c) Effective for rate years beginning on or after January 1, 2026, the commissioner shall 
24.14 	adjust the annual reimbursement cap for employer health insurance costs by the previous 
24.15 	year's cap plus an inflation adjustment. The commissioner must index for the inflation based 
24.16 	on the change in the Consumer Price Index (all items-urban) (CPI-U) forecasted by the 
24.17 	Reports and Forecast Division of the Department of Human Services in the fourth quarter 
24.18 	of the calendar year preceding the rate year. The commissioner must base the inflation 
24.19 	adjustment on the 12-month period from the second quarter of the previous cost report year 
24.20 	to the second quarter of the cost report year for which the cap is being applied.
24.21 	(b)(d) The commissioner must not treat employer contributions to employer-sponsored 
24.22 	individual coverage health reimbursement arrangements as allowable costs if the facility 
24.23 	does not provide the commissioner copies of the employer-sponsored individual coverage 
24.24 	health reimbursement arrangement plan documents and documentation of any health 
24.25 	insurance premiums and associated co-payments reimbursed under the arrangement. 
24.26 	Documentation of reimbursements must denote any reimbursements for health insurance 
24.27 	premiums or associated co-payments incurred by the spouses or dependents of nursing 
24.28 	facility employees who work on average less than 30 hours per week.

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

24.30 	Sec. 19. Minnesota Statutes 2024, section 256R.23, subdivision 5, is amended to read:
24.31 		Subd. 5.Determination of total care-related payment rate limits. (a) The commissioner 
24.32 	must determine each facility's total care-related payment rate limit by:
25.1 	(1) multiplying the facility's quality score, as determined under section 256R.16, 
25.2 	subdivision 1, by 0.5625;
25.3 	(2) adding 89.375 to the amount determined in clause (1), and dividing the total by 100; 
25.4 	and
25.5 	(3) multiplying the amount determined in clause (2) by the median total care-related 
25.6 	cost per day.
25.7 	(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31, 
25.8 	2029, the commissioner must determine each facility's total care-related payment rate limit 
25.9 	by:
25.10 	(1) multiplying the facility's quality score, as determined under section 256R.16, 
25.11 	subdivision 1, by 2.0;
25.12 	(2) subtracting 40 from the amount determined in clause (1), and dividing the total by 
25.13 	100; and
25.14 	(3) multiplying the amount determined in clause (2) by the median total care-related 
25.15 	cost per day.
25.16 	This paragraph expires January 1, 2030.

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

25.18 	Sec. 20. Minnesota Statutes 2024, section 256R.23, subdivision 7, is amended to read:
25.19 		Subd. 7.Determination of direct care payment rates. (a) A facility's direct care 
25.20 	payment rate equals the lesser of (1) the facility's direct care costs per standardized day, or 
25.21 	(2) the facility's direct care costs per standardized day divided by its cost to limit ratio.
25.22 	(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31, 
25.23 	2029, a facility's direct care payment rate equals the lesser of (1) the facility's direct care 
25.24 	costs per standardized day, (2) the facility's direct care costs per standardized day divided 
25.25 	by its cost to limit ratio, or (3) 104 percent of the previous year's direct care payment rate. 
25.26 	This paragraph expires January 1, 2030.

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

25.28 	Sec. 21. Minnesota Statutes 2024, section 256R.23, subdivision 8, is amended to read:
25.29 		Subd. 8.Determination of other care-related payment rates. (a) A facility's other 
25.30 	care-related payment rate equals the lesser of (1) the facility's other care-related cost per 
26.1 	resident day, or (2) the facility's other care-related cost per resident day divided by its cost 
26.2 	to limit ratio.
26.3 	(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31, 
26.4 	2029, a facility's other care-related payment rate equals the lesser of (1) the facility's other 
26.5 	care-related cost per resident day, (2) the facility's other care-related cost per resident day 
26.6 	divided by its cost to limit ratio, or (3) 104 percent of the previous year's other care-related 
26.7 	payment rate. This paragraph expires January 1, 2030.

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

26.9 	Sec. 22. Minnesota Statutes 2024, section 256R.24, subdivision 3, is amended to read:
26.10 		Subd. 3.Determination of the other operating payment rate. (a) A facility's other 
26.11 	operating payment rate equals 105 percent of the median other operating cost per day.
26.12 	(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31, 
26.13 	2029, a facility's other operating payment rate equals the lesser of 105 percent of the median 
26.14 	other operating cost per day or 104 percent of the previous year's other operating payment 
26.15 	rate. This paragraph expires January 1, 2030.

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

26.17 	Sec. 23. Minnesota Statutes 2024, section 256R.25, is amended to read:
26.18 	256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
26.19 		Subdivision 1.Determination of external fixed cost payment rate. (a) The payment 
26.20 	rate for external fixed costs is the sum of the amounts in paragraphs (b) to (p) subdivisions 
26.21 	2 to 14.
26.22 		Subd. 2.Provider surcharges. (b) For a facility licensed as a nursing home, the portion 
26.23 	related to the provider surcharge under section 256.9657 is equal to $8.86 per resident day. 
26.24 	For a facility licensed as both a nursing home and a boarding care home, the portion related 
26.25 	to the provider surcharge under section 256.9657 is equal to $8.86 per resident day multiplied 
26.26 	by the result of its number of nursing home beds divided by its total number of licensed 
26.27 	beds.
26.28 		Subd. 3.Licensure fees. (c) The portion related to the licensure fee under section 144.122, 
26.29 	paragraph (d), is the amount of the fee divided by the sum of the facility's resident days.
27.1 		Subd. 4.Advisory councils. (d) The portion related to development and education of 
27.2 	resident and family advisory councils under section 144A.33 is $5 per resident day divided 
27.3 	by 365.
27.4 		Subd. 5.Scholarships. (e) The portion related to scholarships is determined under section 
27.5 	256R.37.
27.6 	(f) The portion related to planned closure rate adjustments is as determined under section 
27.7 	256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
27.8 		Subd. 6.Consolidation. (g) The portion related to consolidation rate adjustments shall
27.9 	be as determined under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and 
27.10 	(6), and 4dis the amount specified in section 256R.405.
27.11 	(h) The portion related to single-bed room incentives is as determined under section 
27.12 	256R.41.
27.13 		Subd. 7.Taxes. (i) The portions related to real estate taxes, special assessments, and 
27.14 	payments made in lieu of real estate taxes directly identified or allocated to the nursing 
27.15 	facility are the allowable amounts divided by the sum of the facility's resident days. Allowable 
27.16 	costs under this paragraph for payments made by a nonprofit nursing facility that are in lieu 
27.17 	of real estate taxes shall not exceed the amount which the nursing facility would have paid 
27.18 	to a city or township and county for fire, police, sanitation services, and road maintenance 
27.19 	costs had real estate taxes been levied on that property for those purposes.
27.20 		Subd. 8.Health insurance. (j) The portion related to employer health insurance costs 
27.21 	is the allowable costs divided by the sum of the facility's resident days.
27.22 		Subd. 9.Public employees retirement. (k) The portion related to the Public Employees 
27.23 	Retirement Association is the allowable costs divided by the sum of the facility's resident 
27.24 	days.
27.25 		Subd. 10.Quality improvement incentives. (l) The portion related to quality 
27.26 	improvement incentive payment rate adjustments is the amount determined under section 
27.27 	256R.39.
27.28 		Subd. 11.Performance-based incentives. (m) The portion related to performance-based 
27.29 	incentive payments is the amount determined under section 256R.38.
27.30 		Subd. 12.Special diets. (n) The portion related to special dietary needs is the amount 
27.31 	determined under section 256R.51.
28.1 	(o) The portion related to the rate adjustments for border city facilities is the amount 
28.2 	determined under section 256R.481.
28.3 		Subd. 13.Critical access facilities. (p) The portion related to the rate adjustment for 
28.4 	critical access nursing facilities is the amount determined under section 256R.47.
28.5 		Subd. 14.Workforce standards. The portion related to implementation of the rules 
28.6 	implemented by the Nursing Home Workforce Standards Board is the amount determined 
28.7 	under section 256R.532.

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

28.9 	Sec. 24. Minnesota Statutes 2024, section 256R.26, subdivision 9, is amended to read:
28.10 		Subd. 9.Transition period. (a) A facility's property payment rate is the property rate 
28.11 	established for the facility under sections 256B.431 and 256B.434 until the facility's property 
28.12 	rate is transitioned upon completion of any project authorized under section 144A.071, 
28.13 	subdivision 3 or 4d; or 144A.073, subdivision 3, to the fair rental value property rate 
28.14 	calculated under this chapter.
28.15 	(b) Effective the first day of the first month of the calendar quarter after the completion 
28.16 	of the project described in paragraph (a), the commissioner shall transition a facility to the 
28.17 	property payment rate calculated under this chapter. The initial rate year ends on December 
28.18 	31 and may be less than a full 12-month period. The commissioner shall schedule an appraisal 
28.19 	within 90 days of the commissioner receiving notification from the facility that the project 
28.20 	is completed. The commissioner shall apply the property payment rate determined after the 
28.21 	appraisal retroactively to the first day of the first month of the calendar quarter after the 
28.22 	completion of the project.
28.23 	(c) Upon a facility's transition to the fair rental value property rates calculated under this 
28.24 	chapter, the facility's total property payment rate under subdivision 8 shall be the only 
28.25 	payment for costs related to capital assets, including depreciation, interest and lease expenses 
28.26 	for all depreciable assets, including movable equipment, land improvements, and land. 
28.27 	Facilities with property payment rates established under subdivisions 1 to 8 are not eligible 
28.28 	for planned closure rate adjustments under Minnesota Statutes 2024, section 256R.40; 
28.29 	consolidation rate adjustments under section 144A.071, subdivisions 4c, paragraph (a), 
28.30 	clauses (5) (1) and (6) (2), and 4d; single-bed room incentives under Minnesota Statutes 
28.31 	2024, section 256R.41; and the property rate inflation adjustment under Minnesota Statutes 
28.32 	2024, section 256B.434, subdivision 4. The commissioner shall remove any of these 
29.1 	incentives from the facility's existing rate upon the facility transitioning to the fair rental 
29.2 	value property rates calculated under this chapter.

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

29.4 	Sec. 25. Minnesota Statutes 2024, section 256R.27, subdivision 2, is amended to read:
29.5 		Subd. 2.Determination of interim payment rates. (a) The nursing facility shall submit 
29.6 	an interim cost report in a format similar to the Minnesota Statistical and Cost Report and 
29.7 	other supporting information as required by this chapter for the reporting year in which the 
29.8 	nursing facility plans to begin operation at least 60 days before the first day a resident is 
29.9 	admitted to the newly constructed nursing facility bed. The interim cost report must include 
29.10 	the nursing facility's anticipated interim costs and anticipated interim resident days for each 
29.11 	resident class in the interim cost report. The anticipated interim resident days for each 
29.12 	resident class is multiplied by the weight for that resident class to determine the anticipated 
29.13 	interim standardized days as defined in section 256R.02, subdivision 50, and resident days 
29.14 	as defined in section 256R.02, subdivision 45, for the reporting period.
29.15 	(b) The interim payment rates are determined according to sections 256R.21 to 256R.25, 
29.16 	except that:
29.17 	(1) the anticipated interim costs and anticipated interim resident days reported on the 
29.18 	interim cost report and the anticipated interim standardized days as defined by section 
29.19 	256R.02, subdivision 50, must be used for the interim;
29.20 	(2) the commissioner shall use anticipated interim costs and anticipated interim 
29.21 	standardized days in determining the allowable historical direct care cost per standardized 
29.22 	day as determined under section 256R.23, subdivision 2;
29.23 	(3) the commissioner shall use anticipated interim costs and anticipated interim resident 
29.24 	days in determining the allowable historical other care-related cost per resident day as 
29.25 	determined under section 256R.23, subdivision 3;
29.26 	(4) the commissioner shall use anticipated interim costs and anticipated interim resident 
29.27 	days to determine the allowable historical external fixed costs per day under section 256R.25, 
29.28 	paragraphs (b) to (k) subdivisions 2 to 9;
29.29 	(5) the total care-related payment rate limits established in section 256R.23, subdivision 
29.30 	5, and in effect at the beginning of the interim period must be increased by ten percent; and
29.31 	(6) the other operating payment rate as determined under section 256R.24 in effect for 
29.32 	the rate year must be used for the other operating cost per day.

30.1 	Sec. 26. Minnesota Statutes 2024, section 256R.27, subdivision 3, is amended to read:
30.2 		Subd. 3.Determination of settle-up payment rates. (a) When the interim payment 
30.3 	rates begin between May 1 and September 30, the nursing facility shall file settle-up cost 
30.4 	reports for the period from the beginning of the interim payment rates through September 
30.5 	30 of the following year.
30.6 	(b) When the interim payment rates begin between October 1 and April 30, the nursing 
30.7 	facility shall file settle-up cost reports for the period from the beginning of the interim 
30.8 	payment rates to the first September 30 following the beginning of the interim payment 
30.9 	rates.
30.10 	(c) The settle-up payment rates are determined according to sections 256R.21 to 256R.25, 
30.11 	except that:
30.12 	(1) the allowable costs and resident days reported on the settle-up cost report and the 
30.13 	standardized days as defined by section 256R.02, subdivision 50, must be used for the 
30.14 	interim and settle-up period;
30.15 	(2) the commissioner shall use the allowable costs and standardized days in clause (1) 
30.16 	to determine the allowable historical direct care cost per standardized day as determined 
30.17 	under section 256R.23, subdivision 2;
30.18 	(3) the commissioner shall use the allowable costs and the allowable resident days to 
30.19 	determine both the allowable historical other care-related cost per resident day as determined 
30.20 	under section 256R.23, subdivision 3;
30.21 	(4) the commissioner shall use the allowable costs and the allowable resident days to 
30.22 	determine the allowable historical external fixed costs per day under section 256R.25, 
30.23 	paragraphs (b) to (k) subdivisions 2 to 9;
30.24 	(5) the total care-related payment limits established in section 256R.23, subdivision 5, 
30.25 	are the limits for the settle-up reporting periods. If the interim period includes more than 
30.26 	one July 1 date, the commissioner shall use the total care-related payment rate limit 
30.27 	established in section 256R.23, subdivision 5, increased by ten percent for the second July 
30.28 	1 date; and
30.29 	(6) the other operating payment rate as determined under section 256R.24 in effect for 
30.30 	the rate year must be used for the other operating cost per day.

31.1 	Sec. 27. [256R.405] CONSOLIDATION RATES.
31.2 		Subdivision 1.Consolidation rates; generally. The external fixed costs payment rate 
31.3 	for nursing facilities that have completed a state-approved consolidation project must include 
31.4 	a consolidation rate adjustment. A facility's consolidation rate adjustment expires upon 
31.5 	transition to a fair rental value property payment rate under section 256R.26, subdivision 
31.6 	9. The commissioner must inform the revisor of statutes when a facility's consolidation rate 
31.7 	adjustment specified under this section expires. This subdivision expires upon the expiration 
31.8 	of all other subdivisions of this section.
31.9 		Subd. 2.Owatonna. The consolidation rate for the nursing facility located at 2255 30th 
31.10 	Street Northwest in Owatonna is $33.88.
31.11 		Subd. 3.Red Wing. The consolidation rate for the nursing facility located at 213 Pioneer 
31.12 	Road in Red Wing is $73.69.
31.13 		Subd. 4.White Bear Lake. The consolidation rate for the nursing facility located at 
31.14 	1891 Florence Street in White Bear Lake is $25.56.
31.15 		Subd. 5.St. Paul. The consolidation rate for the nursing facility located at 200 Earl 
31.16 	Street in St. Paul is $68.01.
31.17 		Subd. 6.Cambridge. The consolidation rate for the nursing facility located at 135 Fern 
31.18 	Street North in Cambridge is $24.30.
31.19 		Subd. 7.Maple Plain. The consolidation rate for the nursing facility located at 4848 
31.20 	Gateway Boulevard in Maple Plain is $38.76.
31.21 		Subd. 8.Maplewood. The consolidation rate for the nursing facility located at 1438 
31.22 	County Road C East in Maplewood is $55.63.
31.23 		Subd. 9.Apple Valley. The consolidation rate for the nursing facility located at 14650 
31.24 	Garrett Avenue in Apple Valley is $26.99.

31.25 	Sec. 28. Minnesota Statutes 2024, section 256R.43, is amended to read:
31.26 	256R.43 BED HOLDS.
31.27 	The commissioner shall limit payment for leave days in a nursing facility to 30 percent 
31.28 	of that nursing facility's total payment rate for the involved resident, and shall allow this 
31.29 	payment only when the occupancy of the nursing facility, inclusive of bed hold days, is 
31.30 	equal to or greater than 96 percent, notwithstanding Minnesota Rules, part 9505.0415. For 
31.31 	the purpose of establishing leave day payments, the commissioner shall determine occupancy 
32.1 	based on the number of licensed and certified beds in the facility that are not in layaway 
32.2 	status.

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

32.4 	Sec. 29. [256R.531] PATIENT DRIVEN PAYMENT MODEL PHASE-IN.
32.5 		Subdivision 1.PDPM phase-in. Effective October 1, 2025, through December 31, 2028, 
32.6 	for each facility, the commissioner must determine an adjustment to its total payment rate 
32.7 	as determined under sections 256R.21 and 256R.27 to phase in the transition from the 
32.8 	RUG-IV case mix classification system to the patient driven payment model (PDPM) case 
32.9 	mix classification system.
32.10 		Subd. 1a.Definition. "Medical assistance facility average case mix index" means the 
32.11 	facility average case mix index for the subset of a facility's residents that includes only 
32.12 	medical assistance recipients.
32.13 		Subd. 2.PDPM phase-in rate adjustment. A facility's PDPM phase-in rate adjustment 
32.14 	to its total payment rate is equal to:
32.15 	(1) the blended medical assistance case mix adjusted direct care payment rate determined 
32.16 	in subdivision 6; minus
32.17 	(2) the PDPM medical assistance case mix adjusted direct care payment rate determined 
32.18 	in section 256R.23, subdivision 7.
32.19 		Subd. 3.RUG-IV standardized days and RUG-IV facility case mix index. (a) Effective 
32.20 	October 1, 2025, through December 31, 2027, for each facility, the commissioner must 
32.21 	determine the RUG-IV standardized days and RUG-IV medical assistance facility average 
32.22 	case mix index.
32.23 	(b) For the rate year beginning January 1, 2028, only:
32.24 	(1) for each facility, the commissioner must determine both the RUG-IV facility average 
32.25 	case mix index and the RUG-IV medical assistance facility average case mix index using 
32.26 	resident days by the case mix classification on the facility's September 30, 2025, Minnesota 
32.27 	Statistical and Cost Report; and
32.28 	(2) for each facility, the commissioner must determine the RUG-IV standardized days 
32.29 	by multiplying the facility's resident days on the facility's September 30, 2026, Minnesota 
32.30 	Statistical and Cost Report by the facility's RUG-IV facility average case mix index 
32.31 	determined under clause (1).
33.1 		Subd. 4.RUG-IV medical assistance case mix adjusted direct care payment rate. The 
33.2 	commissioner must determine a facility's RUG-IV medical assistance case mix adjusted 
33.3 	direct care payment rate as the product of:
33.4 	(1) the facility's RUG-IV direct care payment rate determined in section 256R.23, 
33.5 	subdivision 7, using the RUG-IV standardized days determined in subdivision 3; and
33.6 	(2) the corresponding RUG-IV medical assistance facility average case mix index 
33.7 	determined in subdivision 3.
33.8 		Subd. 5.PDPM medical assistance case mix adjusted direct care payment rate. The 
33.9 	commissioner must determine a facility's PDPM case mix adjusted direct care payment rate 
33.10 	as the product of:
33.11 	(1) the facility's direct care payment rate determined in section 256R.23, subdivision 7; 
33.12 	and
33.13 	(2) the corresponding medical assistance facility average case mix index.
33.14 		Subd. 6.Blended medical assistance case mix adjusted direct care payment rate. The 
33.15 	commissioner must determine a facility's blended medical assistance case mix adjusted 
33.16 	direct care payment rate as the sum of:
33.17 	(1) the RUG-IV medical assistance case mix adjusted direct care payment rate determined 
33.18 	in subdivision 4 multiplied by the following percentages:
33.19 	(i) after September 30, 2025, through  December 31, 2026, 75 percent;
33.20 	(ii) after December 31, 2026, through December 31, 2027, 50 percent; and
33.21 	(iii) after December 31, 2027, through December 31, 2028, 25 percent; and
33.22 	(2) the PDPM medical assistance case mix adjusted direct care payment rate determined 
33.23 	in subdivision 5 multiplied by the following percentages:
33.24 	(i) after September 30, 2025, through December 31, 2026, 25 percent;
33.25 	(ii) after December 31, 2026, through December 31, 2027, 50 percent; and
33.26 	(iii) after December 31, 2027, through December 31, 2028, 75 percent.
33.27 		Subd. 7.Expiration. This section expires January 1, 2029.

33.28 	EFFECTIVE DATE. This section is effective October 1, 2025.

34.1 	Sec. 30. [256R.532] NURSING FACILITY RATE ADD-ON FOR WORKFORCE 
34.2 	STANDARDS.
34.3 	(a) Effective for rate years beginning on and after January 1, 2028, or upon federal 
34.4 	approval, whichever is later, the commissioner shall annually provide a rate add-on amount 
34.5 	for nursing facilities reimbursed under this chapter for the initial standards for wages for 
34.6 	nursing home workers adopted by the Nursing Home Workforce Standards Board in 
34.7 	Minnesota Rules, parts 5200.2060 to 5200.2090, pursuant to section 181.213, subdivision 
34.8 	2, paragraph (c). The add-on amount is equal to:
34.9 	(1) $3.93 per resident day, effective January 1, 2028, through December 31, 2028; and
34.10 	(2) $8.55 per resident day, effective January 1, 2029.
34.11 	(b) Effective upon federal approval, the commissioner must determine the add-on amount 
34.12 	for subsequent rate years in consultation with the commissioner of labor and industry.

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

34.14 	Sec. 31. Minnesota Statutes 2024, section 256S.205, subdivision 2, is amended to read:
34.15 		Subd. 2.Rate adjustment application. (a) Effective through September 30, 2023, a 
34.16 	facility may apply to the commissioner for an initial designation as a disproportionate share 
34.17 	facility. Applications must be submitted annually between September 1 and September 30. 
34.18 	The applying facility must apply in a manner determined by the commissioner. The applying 
34.19 	facility must document each of the following on the application:
34.20 	(1) the number of customized living residents in the facility on September 1 of the 
34.21 	application year, broken out by specific waiver program; and
34.22 	(2) the total number of people residing in the facility on September 1 of the application 
34.23 	year.
34.24 	(b) Effective October 1, 2023, the commissioner must not process any new initial 
34.25 	applications for disproportionate share facilities after the September 1 through September 
34.26 	30, 2023, application period.
34.27 	(c) A facility that receives received rate floor payments in rate year 2024 may submit 
34.28 	an annual application under this subdivision to maintain its designation as a disproportionate 
34.29 	share facility for rate year 2025.

35.1 	Sec. 32. Minnesota Statutes 2024, section 256S.205, subdivision 3, is amended to read:
35.2 		Subd. 3.Rate adjustment eligibility criteria. (a) Effective through September 30, 2023,
35.3 	Only facilities satisfying all of the following conditions on September 1 of the application 
35.4 	year are eligible for designation as a disproportionate share facility:
35.5 	(1) at least 83.5 percent of the residents of the facility are customized living residents; 
35.6 	and
35.7 	(2) at least 70 percent of the customized living residents are elderly waiver participants.
35.8 	(b) A facility determined eligible for the disproportionate share rate adjustment in 
35.9 	application year 2023 and receiving payments in rate year 2024 is eligible to receive payments 
35.10 	in rate year 2025 years beginning on or after January 1, 2025, only if the commissioner 
35.11 	determines that the facility continues to meet the eligibility requirements under this 
35.12 	subdivision as determined by the application process under subdivision 2, paragraph (c).

35.13 	Sec. 33. Minnesota Statutes 2024, section 256S.205, subdivision 5, is amended to read:
35.14 		Subd. 5.Rate adjustment; rate floor. (a) Effective through December 31, 2025,
35.15 	Notwithstanding the 24-hour customized living monthly service rate limits under section 
35.16 	256S.202, subdivision 2, and the component service rates established under section 256S.201, 
35.17 	subdivision 4, the commissioner must establish a rate floor equal to $141 per resident per 
35.18 	day for 24-hour customized living services provided to an elderly waiver participant in a 
35.19 	designated disproportionate share facility.
35.20 	(b) The commissioner must apply the rate floor to the services described in paragraph 
35.21 	(a) provided during the rate year.

35.22 	Sec. 34. Laws 2021, chapter 30, article 12, section 5, as amended by Laws 2021, First 
35.23 	Special Session chapter 7, article 17, section 2, and Laws 2023, chapter 61, article 2, section 
35.24 	35, is amended to read:
35.25 	Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.
 35.26 	The Governor's Council on an Age-Friendly Minnesota, established in Executive Order 
35.27 	19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and 
35.28 	private partners' collaborative work on emergency preparedness, with a focus on older 
35.29 	adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic. 
35.30 	The Governor's Council on an Age-Friendly Minnesota is extended and expires June 30, 
35.31 	2027 2025.

36.1 	Sec. 35. AGE-FRIENDLY MINNESOTA COUNCIL; CONTINUATION OF 
36.2 	APPOINTMENTS AND DESIGNATION OF INITIAL TERMS.
 36.3 		Subdivision 1.Continuation of appointments. Each member of the Governor's Council 
36.4 	on an Age-Friendly Minnesota, established in Executive Order 19-38, serving on June 30, 
36.5 	2025, shall be deemed appointed to the Age-Friendly Minnesota Council by the applicable 
36.6 	appointing authority under Minnesota Statutes, section 256.9746, effective July 1, 2025.
36.7 		Subd. 2.First meeting. The individual who was serving as chairperson of the Governor's 
36.8 	Council on an Age-Friendly Minnesota, established in Executive Order 19-38, as of June 
36.9 	30, 2025, must convene the first meeting of the Age-Friendly Minnesota Council no later 
36.10 	than July 9, 2025. The former chairperson of the Governor's Council on an Age-Friendly 
36.11 	Minnesota shall preside over the first meeting until the Age-Friendly Minnesota Council 
36.12 	elects a chairperson.
36.13 		Subd. 3.Designation of initial terms. The governor must notify the secretary of state 
36.14 	which initial public members of the Age-Friendly Minnesota Council will have terms 
36.15 	coterminous with that of the governor or request that the secretary of state randomly 
36.16 	determine which initial public members will have terms coterminous with the governor's 
36.17 	term.

36.18 	Sec. 36. DIRECTION TO THE COMMISSIONER; IMPACT STUDY OF REPEAL 
36.19 	OF DISPROPORTIONATE SHARE PAYMENTS.
 36.20 	(a) The commissioner of human services must conduct a study of the impact of the repeal 
36.21 	of Minnesota Statutes, section 256S.205, on those facilities that received a rate floor payment 
36.22 	in rate year 2025. For each facility that received a rate floor payment in rate year 2025, the 
36.23 	commissioner must determine:
36.24 	(1)  how many facilities remain operational on September 1, 2026;
36.25 	(2)  the total number of residents of the facility on September 1, 2026;
36.26 	(3) the proportion of residents of the facility who are customized living residents on 
36.27 	September 1, 2026;
36.28 	(4) the proportion of residents who are elderly waiver participants on September 1, 2026; 
36.29 	and
36.30 	(5) the difference by facility between the results under clauses (1) to (4) and the same 
36.31 	or similar information submitted by the facility on its rate year 2025 application.
37.1 	(b) The commissioner must solicit from each provider a summary of its financial position 
37.2 	as of September 1, 2026, as compared to its financial position on September 1, 2025, and 
37.3 	a statement of the facility's change in operational margin between September 1, 2025, and 
37.4 	September 1, 2026. The controlling individual of a facility that submits a financial summary 
37.5 	and statement of the facility's change in operational margin must attest to the accuracy of 
37.6 	the financial summary and statement.
37.7 	(c) By January 1, 2027, the commissioner must submit to the chairs and ranking minority 
37.8 	members of the legislative committees with jurisdiction over human services a report 
37.9 	summarizing the data on the impact of the repeal of Minnesota Statutes, section 256S.205, 
37.10 	on those facilities that received a rate floor payment in rate year 2025.
37.11 	(d) The definitions in Minnesota Statutes 2024, section 256S.205, apply to this section.

37.12 	Sec. 37. REPEALER.
 37.13 	(a) Minnesota Statutes 2024, sections 144A.071, subdivision 4c; 256R.02, subdivision 
37.14 	38; 256R.40; 256R.41; and 256R.481, are repealed.
37.15 	(b) Minnesota Statutes 2024, sections 256R.12, subdivision 10; and 256R.36, are repealed.
37.16 	(c) Minnesota Statutes 2024, section 256R.23, subdivision 6, is repealed.
37.17 	(d) Minnesota Statutes 2024, section 256S.205, subdivision 7, is repealed.

37.18 	EFFECTIVE DATE. Paragraph (a) is effective January 1, 2026. Paragraphs (b) and 
37.19 	(d) are effective the day following final enactment. Paragraph (c) is effective October 1, 
37.20 	2025.

37.21 	ARTICLE 2
37.22 	DISABILITY SERVICES

37.23 	Section 1. Minnesota Statutes 2024, section 144.0724, subdivision 2, is amended to read:
37.24 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
37.25 	given.
37.26 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
37.27 	periods in the MDS assessment process. This look-back period is also called the observation 
37.28 	or assessment period.
37.29 	(b) "Case mix index" means the weighting factors assigned to the case mix reimbursement 
37.30 	classifications determined by an assessment.
38.1 	(c) "Index maximization" means classifying a resident who could be assigned to more 
38.2 	than one category, to the category with the highest case mix index.
38.3 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
38.4 	and functional status elements, that include common definitions and coding categories 
38.5 	specified by the Centers for Medicare and Medicaid Services and designated by the 
38.6 	Department of Health.
38.7 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
38.8 	person authorized to pay the nursing home expenses of the resident, a representative of the 
38.9 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
38.10 	other individual designated by the resident.
38.11 	(f) "Activities of daily living" includes personal hygiene, dressing, bathing, transferring, 
38.12 	bed mobility, locomotion, eating, and toileting.
38.13 	(g) "Nursing facility level of care determination" means the assessment process that 
38.14 	results in a determination of a resident's or prospective resident's need for nursing facility 
38.15 	level of care as established in subdivision 11 for purposes of medical assistance payment 
38.16 	of long-term care services for:
38.17 	(1) nursing facility services under chapter 256R;
38.18 	(2) elderly waiver services under chapter 256S; and
38.19 	(3) CADI and BI waiver services under section 256B.49; and
38.20 	(4) (3) state payment of alternative care services under section 256B.0913.

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

38.24 	Sec. 2. Minnesota Statutes 2024, section 144.0724, subdivision 11, is amended to read:
38.25 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance payment 
38.26 	of long-term care services specified in subdivision 2, paragraph (g), a recipient must be 
38.27 	determined, using assessments defined in subdivision 4, to meet one of the following nursing 
38.28 	facility level of care criteria:
38.29 	(1) the person requires formal clinical monitoring at least once per day;
39.1 	(2) the person needs the assistance of another person or constant supervision to begin 
39.2 	and complete at least four of the following activities of living: bathing, bed mobility, dressing, 
39.3 	eating, grooming, toileting, transferring, and walking;
39.4 	(3) the person needs the assistance of another person or constant supervision to begin 
39.5 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
39.6 	(4) the person has significant difficulty with memory, using information, daily decision 
39.7 	making, or behavioral needs that require intervention;
39.8 	(5) the person has had a qualifying nursing facility stay of at least 90 days;
39.9 	(6) the person meets the nursing facility level of care criteria determined 90 days after 
39.10 	admission or on the first quarterly assessment after admission, whichever is later; or
39.11 	(7) the person is determined to be at risk for nursing facility admission or readmission 
39.12 	through a face-to-face long-term care consultation assessment as specified in section 
39.13 	256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, tribe, or managed care 
39.14 	organization under contract with the Department of Human Services. The person is 
39.15 	considered at risk under this clause if the person currently lives alone or will live alone or 
39.16 	be homeless without the person's current housing and also meets one of the following criteria:
39.17 	(i) the person has experienced a fall resulting in a fracture;
39.18 	(ii) the person has been determined to be at risk of maltreatment or neglect, including 
39.19 	self-neglect; or
39.20 	(iii) the person has a sensory impairment that substantially impacts functional ability 
39.21 	and maintenance of a community residence.
39.22 	(b) The assessment used to establish medical assistance payment for nursing facility 
39.23 	services must be the most recent assessment performed under subdivision 4, paragraphs (b) 
39.24 	and (c), that occurred no more than 90 calendar days before the effective date of medical 
39.25 	assistance eligibility for payment of long-term care services. In no case shall medical 
39.26 	assistance payment for long-term care services occur prior to the date of the determination 
39.27 	of nursing facility level of care.
39.28 	(c) The assessment used to establish medical assistance payment for long-term care 
39.29 	services provided under chapter 256S and section 256B.49 and alternative care payment 
39.30 	for services provided under section 256B.0913 must be the most recent face-to-face 
39.31 	assessment performed under section 256B.0911, subdivisions 17 to 21, 23, 24, 27, or 28, 
39.32 	that occurred no more than 60 calendar days before the effective date of medical assistance 
39.33 	eligibility for payment of long-term care services.

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

40.4 	Sec. 3. Minnesota Statutes 2024, section 144.0724, is amended by adding a subdivision 
40.5 	to read:
40.6 		Subd. 11a.Determination of nursing facility level of care for the brain injury and 
40.7 	community access for disability inclusion waivers. (a) Effective January 1, 2026, or upon 
40.8 	federal approval, whichever is later, a person must be determined to meet one of the following 
40.9 	nursing facility level of care criteria to be eligible for the brain injury and community access 
40.10 	for disability inclusion waivers under section 256B.49:
40.11 	(1) the person requires the assistance of another person or constant supervision to begin 
40.12 	and complete at least four of the following activities of daily living: bathing, bed mobility, 
40.13 	dressing, eating, grooming, toileting, transferring, or walking;
40.14 	(2) the person needs the assistance of another person or constant supervision to begin 
40.15 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled; 
40.16 	or
40.17 	(3) the person has significant difficulty with memory, using information, daily decision 
40.18 	making, or behavioral needs that require the person to be constantly supervised or require 
40.19 	interventions that cannot be scheduled.
40.20 	(b) Nursing facility level of care determinations for purposes of initial and ongoing 
40.21 	access to the brain injury and community access for disability inclusion waiver programs 
40.22 	must be conducted by a certified assessor under section 256B.0911.

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

40.24 	Sec. 4. Minnesota Statutes 2024, section 144A.351, subdivision 1, is amended to read:
40.25 		Subdivision 1.Report requirements. (a) The commissioners of health and human 
40.26 	services, with the cooperation of counties and in consultation with stakeholders, including 
40.27 	persons who need or are using long-term care services and supports, lead agencies, regional 
40.28 	entities, senior, disability, and mental health organization representatives, service providers, 
40.29 	and community members shall compile data regarding the status of the full range of long-term 
40.30 	care services and supports for the elderly and children and adults with disabilities and mental 
40.31 	illnesses in Minnesota. The compiled data shall include:
40.32 	(1) demographics and need for long-term care services and supports in Minnesota;
41.1 	(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances, 
41.2 	and corrective action plans;
41.3 	(3) status of long-term care services and related mental health services, housing options, 
41.4 	and supports by county and region including:
41.5 	(i) changes in availability of the range of long-term care services and housing options;
41.6 	(ii) access problems, including access to the least restrictive and most integrated services 
41.7 	and settings, regarding long-term care services; and
41.8 	(iii) comparative measures of long-term care services availability, including serving 
41.9 	people in their home areas near family, and changes over time; and
41.10 	(4) recommendations regarding goals for the future of long-term care services and 
41.11 	supports, policy and fiscal changes, and resource development and transition needs.; and
41.12 	(5) the following information on the availability of integrated community supports, 
41.13 	updated within 30 days of the end of each of four three-month reporting periods, which 
41.14 	begin on January 1 of each year:
41.15 	(i) the average number of integrated community supports beds occupied, per month, for 
41.16 	the preceding reporting period;
41.17 	(ii) the average number of integrated community supports beds available, per month, 
41.18 	for the preceding reporting period;
41.19 	(iii) the number of integrated community supports setting applications being reviewed 
41.20 	by the commissioner of human services as of the final day of the reporting period; and
41.21 	(vi) the average time of review for integrated community supports setting applications 
41.22 	submitted during the preceding quarter.
41.23 	(b) The commissioners of health and human services shall make the compiled data 
41.24 	available on at least one of the department's websites.

41.25 	Sec. 5. Minnesota Statutes 2024, section 179A.54, is amended by adding a subdivision to 
41.26 	read:
41.27 		Subd. 12.Minnesota Caregiver Retirement Fund Trust. (a) The state and an exclusive 
41.28 	representative certified pursuant to this section may establish a joint labor and management 
41.29 	trust, referred to as the Minnesota Caregiver  Retirement Fund Trust, for the exclusive 
41.30 	purpose of creating, implementing, and administering a retirement program for individual 
41.31 	providers of direct support services who are represented by the exclusive representative.
42.1 	(b) The state must make financial contributions to the Minnesota Caregiver  Retirement 
42.2 	Fund Trust pursuant to a collective bargaining agreement negotiated under this section. The 
42.3 	financial contributions by the state must be held in trust for the purpose of paying, from 
42.4 	principal, income, or both, the costs associated with creating, implementing, and 
42.5 	administering a defined contribution or other individual account retirement program for 
42.6 	individual providers of direct support services working under a collective bargaining 
42.7 	agreement and providing services through a covered program under section 256B.0711. A 
42.8 	board of trustees composed of an equal number of trustees appointed by the governor and 
42.9 	trustees appointed by the exclusive representative under this section must administer, manage, 
42.10 	and otherwise jointly control the Minnesota Caregiver Retirement Fund Trust. The trust 
42.11 	must not be an agent of either the state or the exclusive representative.
42.12 	(c) A third-party administrator, financial management institution, other appropriate 
42.13 	entity, or any combination thereof may provide trust administrative, management, legal, 
42.14 	and financial services to the board of trustees as designated by the board of trustees from 
42.15 	time to time. The services must be paid from the money held in trust and created by the 
42.16 	state's financial contributions to the Minnesota Caregiver Retirement Fund Trust.
42.17 	(d) The state is authorized to purchase liability insurance for members of the board of 
42.18 	trustees appointed by the governor.
42.19 	(e) Financial contributions to or participation in the management or administration of 
42.20 	the Minnesota Caregiver Retirement Fund Trust must not be considered an unfair labor 
42.21 	practice under section 179A.13, or a violation of Minnesota law.
42.22 	(f) Nothing in this section shall be construed to authorize the creation of a defined benefit 
42.23 	retirement plan or program.

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

42.25 	Sec. 6. Minnesota Statutes 2024, section 245A.042, is amended by adding a subdivision 
42.26 	to read:
42.27 		Subd. 5.Compliance education required. The commissioner must make licensing 
42.28 	compliance education available to all license holders operating programs licensed under 
42.29 	both this chapter and chapter 245D. The licensing compliance education must include clear 
42.30 	and accessible explanations of achieving and maintaining compliance with the relevant 
42.31 	licensing requirements under this chapter and chapter 245D.

43.1 	Sec. 7. Minnesota Statutes 2024, section 245A.06, subdivision 1a, is amended to read:
43.2 		Subd. 1a.Correction orders and conditional licenses for programs licensed as home 
43.3 	and community-based services. (a) For programs licensed under both this chapter and 
43.4 	chapter 245D, if the license holder operates more than one service site under a single license 
43.5 	governed by chapter 245D, the correction order or order of conditional license issued under 
43.6 	this section shall be specific to the service site or sites at which the violations of applicable 
43.7 	law or rules occurred. The order shall not apply to other service sites governed by chapter 
43.8 	245D and operated by the same license holder unless the commissioner has included in the 
43.9 	order the articulable basis for applying the order to another service site.
43.10 	(b) If the commissioner has issued more than one license to the license holder under this 
43.11 	chapter, the conditions imposed order issued under this section shall be specific to the license 
43.12 	for the program at which the violations of applicable law or rules occurred and shall not 
43.13 	apply to other licenses held by the same license holder if those programs are being operated 
43.14 	in substantial compliance with applicable law and rules.
43.15 	(c) Prior to issuing an order of conditional license under this section to a license holder 
43.16 	operating a program licensed under both this chapter and chapter 245D, the commissioner 
43.17 	must inform the license holder that the next audit or investigation may lead to an order of 
43.18 	conditional license if the provider fails to correct the violations specified in a prior correction 
43.19 	order or has any new violations. Nothing in this paragraph limits the commissioner's authority 
43.20 	to take immediate action under section 245A.07 to prevent or correct actions by the license 
43.21 	holder that imminently endanger the health, safety, or rights of the persons served by the 
43.22 	program.
43.23 	(d) The commissioner may reduce the length of time of a conditional license for a license 
43.24 	holder operating a program licensed under both this chapter and chapter 245D if the license 
43.25 	holder demonstrates compliance or progress toward compliance before the conditional 
43.26 	license period expires.
43.27 	(e) By January 1, 2026, and annually thereafter, the commissioner must provide a report 
43.28 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
43.29 	over chapter 245D licensing on the number of correction orders and orders of conditional 
43.30 	license issued to license holders who operate programs licensed under both this chapter and 
43.31 	chapter 245D. The report must include aggregated data on the zip codes of locations, number 
43.32 	of employees, license effective dates for any license holders subject to correction orders 
43.33 	and orders of conditional license, and the commissioner's efforts to offer collaborative safety 
43.34 	process improvements to license holders under section 245A.042 and this subdivision.

44.1 	Sec. 8. Minnesota Statutes 2024, section 245A.06, subdivision 2, is amended to read:
44.2 		Subd. 2.Reconsideration of correction orders. (a) If the applicant or license holder 
44.3 	believes that the contents of the commissioner's correction order are in error, the applicant 
44.4 	or license holder may ask the Department of Human Services to reconsider the parts of the 
44.5 	correction order that are alleged to be in error. The request for reconsideration must be made 
44.6 	in writing and must be postmarked and sent to the commissioner within 20 calendar days 
44.7 	after receipt of the correction order by the applicant or license holder or submitted in the 
44.8 	provider licensing and reporting hub within 20 calendar days from the date the commissioner 
44.9 	issued the order through the hub, and:
44.10 	(1) specify the parts of the correction order that are alleged to be in error;
44.11 	(2) explain why they are in error; and
44.12 	(3) include documentation to support the allegation of error.
44.13 	Upon implementation of the provider licensing and reporting hub, the provider must use 
44.14 	the hub to request reconsideration. A request for reconsideration does not stay any provisions 
44.15 	or requirements of the correction order. The commissioner's disposition of a request for 
44.16 	reconsideration is final and not subject to appeal under chapter 14.
44.17 	(b) This paragraph applies only to licensed family child care providers. A licensed family 
44.18 	child care provider who requests reconsideration of a correction order under paragraph (a) 
44.19 	may also request, on a form and in the manner prescribed by the commissioner, that the 
44.20 	commissioner expedite the review if:
44.21 	(1) the provider is challenging a violation and provides a description of how complying 
44.22 	with the corrective action for that violation would require the substantial expenditure of 
44.23 	funds or a significant change to their program; and
44.24 	(2) describes what actions the provider will take in lieu of the corrective action ordered 
44.25 	to ensure the health and safety of children in care pending the commissioner's review of the 
44.26 	correction order.
44.27 	(b) Notwithstanding paragraph (a), when a request for reconsideration is denied, the 
44.28 	commissioner must offer the option of mediation for a license holder operating a program 
44.29 	licensed under both this chapter and chapter 245D, if a license holder further disputes the 
44.30 	commissioner's correction order. The costs of the mediation option under this paragraph 
44.31 	must be paid by the license holder.

45.1 	Sec. 9. [245A.142] EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL 
45.2 	INTERVENTION PROVISIONAL LICENSURE.
45.3 		Subdivision 1.Definitions. The definitions in section 256B.0949, subdivision 2, apply 
45.4 	to this section.
45.5 		Subd. 2.Regulatory powers. The commissioner shall regulate early intensive 
45.6 	developmental and behavioral intervention (EIDBI) agencies pursuant to this section.
45.7 		Subd. 3.Provisional license. (a) Beginning on January 1, 2026, the commissioner shall 
45.8 	begin issuing provisional licenses to agencies enrolled under chapter 256B to provide EIDBI 
45.9 	services.
45.10 	(b) Agencies enrolled prior to July 1, 2025, have until March 31, 2026, to submit an 
45.11 	application for provisional licensure on the forms and in the manner prescribed by the 
45.12 	commissioner.
45.13 	(c) Beginning April 1, 2026, an agency must not operate if it has not submitted an 
45.14 	application for provisional licensure under this section. The commissioner shall disenroll 
45.15 	an agency from providing EIDBI services under chapter 256B if the agency fails to submit 
45.16 	an application for provisional licensure by March 31, 2026, or a complete application by 
45.17 	July 1, 2026.
45.18 	(d) The commissioner must determine whether a provisional license applicant complies 
45.19 	with all applicable rules and laws and either issue a provisional license to the applicant or 
45.20 	deny the application by December 31, 2026.
45.21 	(e) A provisional license is effective until comprehensive EIDBI agency licensure 
45.22 	standards are in effect unless the provisional license is revoked.
45.23 	(f) Beginning January 1, 2027, an agency providing EIDBI services must not operate in 
45.24 	Minnesota unless provisionally licensed under this section.
45.25 		Subd. 4.Provisional license regulatory functions. The commissioner may:
45.26 	(1) enter the physical premises of an agency without advance notice in accordance with 
45.27 	section 245A.04, subdivision 5;
45.28 	(2) investigate reports of maltreatment;
45.29 	(3) investigate complaints against agencies;
45.30 	(4) take action on a license pursuant to sections 245A.06 and 245A.07;
45.31 	(5) deny an application for provisional licensure pursuant to section 245A.05; and
46.1 	(6) take other action reasonably required to accomplish the purposes of this section.
46.2 		Subd. 5.Provisional license requirements. A provisional license holder must:
46.3 	(1) identify all controlling individuals, as defined in section 245A.02, subdivision 5a, 
46.4 	of the agency;
46.5 	(2) provide documented disclosures surrounding the use of billing agencies or other 
46.6 	consultants, available to the department upon request;
46.7 	(3) establish provider policies and procedures related to staff training, staff qualifications, 
46.8 	quality assurance, and service activities;
46.9 	(4) document contracts with independent contractors for qualified supervising 
46.10 	professionals, including the number of hours contracted and responsibilities, available to 
46.11 	the department upon request; and
46.12 	(5) comply with section 256B.0949, including exceptions to qualifications, standards, 
46.13 	and requirements granted by the commissioner under section 256B.0949, subdivision 17.
46.14 		Subd. 6.Reconsideration requests and appeals. An applicant or provisional license 
46.15 	holder has reconsideration and appeal rights under sections 245A.05, 245A.06, and 245A.07.
46.16 		Subd. 7.Disenrollment. The commissioner shall disenroll an agency from providing 
46.17 	EIDBI services under chapter 256B if:
46.18 	(1) the agency's application has been suspended or denied under subdivision 2 or the 
46.19 	agency's provisional license has been revoked; and
46.20 	(2) if the agency appealed the application suspension or denial or the provisional license 
46.21 	revocation, the commissioner has issued a final order on the appeal.

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

46.23 	Sec. 10. Minnesota Statutes 2024, section 245C.16, subdivision 1, is amended to read:
46.24 		Subdivision 1.Determining immediate risk of harm. (a) If the commissioner determines 
46.25 	that the individual studied has a disqualifying characteristic, the commissioner shall review 
46.26 	the information immediately available and make a determination as to the subject's immediate 
46.27 	risk of harm to persons served by the program where the individual studied will have direct 
46.28 	contact with, or access to, people receiving services.
46.29 	(b) The commissioner shall consider all relevant information available, including the 
46.30 	following factors in determining the immediate risk of harm:
46.31 	(1) the recency of the disqualifying characteristic;
47.1 	(2) the recency of discharge from probation for the crimes;
47.2 	(3) the number of disqualifying characteristics;
47.3 	(4) the intrusiveness or violence of the disqualifying characteristic;
47.4 	(5) the vulnerability of the victim involved in the disqualifying characteristic;
47.5 	(6) the similarity of the victim to the persons served by the program where the individual 
47.6 	studied will have direct contact;
47.7 	(7) whether the individual has a disqualification from a previous background study that 
47.8 	has not been set aside;
47.9 	(8) if the individual has a disqualification which may not be set aside because it is a 
47.10 	permanent bar under section 245C.24, subdivision 1, or the individual is a child care 
47.11 	background study subject who has a felony-level conviction for a drug-related offense in 
47.12 	the last five years, the commissioner may order the immediate removal of the individual 
47.13 	from any position allowing direct contact with, or access to, persons receiving services from 
47.14 	the program and from working in a children's residential facility or foster residence setting; 
47.15 	and
47.16 	(9) if the individual has a disqualification which may not be set aside because it is a 
47.17 	permanent bar under section 245C.24, subdivision 2, or the individual is a child care 
47.18 	background study subject who has a felony-level conviction for a drug-related offense during 
47.19 	the last five years, the commissioner may order the immediate removal of the individual 
47.20 	from any position allowing direct contact with or access to persons receiving services from 
47.21 	the center and from working in a licensed child care center or certified license-exempt child 
47.22 	care center.
47.23 	(c) This section does not apply when the subject of a background study is regulated by 
47.24 	a health-related licensing board as defined in chapter 214, and the subject is determined to 
47.25 	be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
47.26 	(d) This section does not apply to a background study related to an initial application 
47.27 	for a child foster family setting license.
47.28 	(e) Except for paragraph (f), this section does not apply to a background study that is 
47.29 	also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a 
47.30 	personal care assistant or a qualified professional as defined in section 256B.0659, 
47.31 	subdivision 1, or to a background study for an individual providing early intensive 
47.32 	developmental and behavioral intervention services under section 256B.0949.
48.1 	(f) If the commissioner has reason to believe, based on arrest information or an active 
48.2 	maltreatment investigation, that an individual poses an imminent risk of harm to persons 
48.3 	receiving services, the commissioner may order that the person be continuously supervised 
48.4 	or immediately removed pending the conclusion of the maltreatment investigation or criminal 
48.5 	proceedings.

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

48.7 	Sec. 11. Minnesota Statutes 2024, section 245D.091, subdivision 2, is amended to read:
48.8 		Subd. 2.Positive support professional qualifications. A positive support professional 
48.9 	providing positive support services as identified in section 245D.03, subdivision 1, paragraph 
48.10 	(c), clause (1), item (i), must have competencies in the following areas as required under 
48.11 	the brain injury, community access for disability inclusion, community alternative care, and 
48.12 	developmental disabilities waiver plans or successor plans:
48.13 	(1) ethical considerations;
48.14 	(2) functional assessment;
48.15 	(3) functional analysis;
48.16 	(4) measurement of behavior and interpretation of data;
48.17 	(5) selecting intervention outcomes and strategies;
48.18 	(6) behavior reduction and elimination strategies that promote least restrictive approved 
48.19 	alternatives;
48.20 	(7) data collection;
48.21 	(8) staff and caregiver training;
48.22 	(9) support plan monitoring;
48.23 	(10) co-occurring mental disorders or neurocognitive disorder;
48.24 	(11) demonstrated expertise with populations being served; and
48.25 	(12) must be a:
48.26 	(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board 
48.27 	of Psychology competencies in the above identified areas;
48.28 	(ii) clinical social worker licensed as an independent clinical social worker under chapter 
48.29 	148D, or a person with a master's degree in social work from an accredited college or 
49.1 	university, with at least 4,000 hours of post-master's supervised experience in the delivery 
49.2 	of clinical services in the areas identified in clauses (1) to (11);
49.3 	(iii) physician licensed under chapter 147 and certified by the American Board of 
49.4 	Psychiatry and Neurology or eligible for board certification in psychiatry with competencies 
49.5 	in the areas identified in clauses (1) to (11);
49.6 	(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39 
49.7 	with at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
49.8 	services who has demonstrated competencies in the areas identified in clauses (1) to (11);
49.9 	(v) person with a master's degree from an accredited college or university in one of the 
49.10 	behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised 
49.11 	experience in the delivery of clinical services with demonstrated competencies in the areas 
49.12 	identified in clauses (1) to (11);
49.13 	(vi) person with a master's degree or PhD in one of the behavioral sciences or related 
49.14 	fields with demonstrated expertise in positive support services, as determined by the person's 
49.15 	needs as outlined in the person's assessment summary; or
49.16 	(vii) registered nurse who is licensed under sections 148.171 to 148.285, and who is 
49.17 	certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and 
49.18 	mental health nursing by a national nurse certification organization, or who has a master's 
49.19 	degree in nursing or one of the behavioral sciences or related fields from an accredited 
49.20 	college or university or its equivalent, with at least 4,000 hours of post-master's supervised 
49.21 	experience in the delivery of clinical services; or
49.22 	(viii) person who has completed a competency-based training program as determined 
49.23 	by the commissioner.

49.24 	Sec. 12. Minnesota Statutes 2024, section 245D.091, subdivision 3, is amended to read:
49.25 		Subd. 3.Positive support analyst qualifications. (a) A positive support analyst providing 
49.26 	positive support services as identified in section 245D.03, subdivision 1, paragraph (c), 
49.27 	clause (1), item (i), must have competencies in one of the following areas satisfy one of the 
49.28 	following requirements as required under the brain injury, community access for disability 
49.29 	inclusion, community alternative care, and developmental disabilities waiver plans or 
49.30 	successor plans:
49.31 	(1) have obtained a baccalaureate degree, master's degree, or PhD in either a social 
49.32 	services discipline or nursing;
50.1 	(2) meet the qualifications of a mental health practitioner as defined in section 245.462, 
50.2 	subdivision 17; or
50.3 	(3) be a board-certified behavior analyst or board-certified assistant behavior analyst by 
50.4 	the Behavior Analyst Certification Board, Incorporated; or
50.5 	(4) have completed a competency-based training program as determined by the 
50.6 	commissioner.
50.7 	(b) In addition, a positive support analyst must:
50.8 	(1) either have two years of supervised experience conducting functional behavior 
50.9 	assessments and designing, implementing, and evaluating effectiveness of positive practices 
50.10 	behavior support strategies for people who exhibit challenging behaviors as well as 
50.11 	co-occurring mental disorders and neurocognitive disorder, or for those who have obtained 
50.12 	a baccalaureate degree in one of the behavioral sciences or related fields, demonstrated 
50.13 	expertise in positive support services;
50.14 	(2) have received training prior to hire or within 90 calendar days of hire that includes:
50.15 	(i) ten hours of instruction in functional assessment and functional analysis;
50.16 	(ii) 20 hours of instruction in the understanding of the function of behavior;
50.17 	(iii) ten hours of instruction on design of positive practices behavior support strategies;
50.18 	(iv) 20 hours of instruction preparing written intervention strategies, designing data 
50.19 	collection protocols, training other staff to implement positive practice strategies, 
50.20 	summarizing and reporting program evaluation data, analyzing program evaluation data to 
50.21 	identify design flaws in behavioral interventions or failures in implementation fidelity, and 
50.22 	recommending enhancements based on evaluation data; and
50.23 	(v) eight hours of instruction on principles of person-centered thinking;
50.24 	(3) be determined by a positive support professional to have the training and prerequisite 
50.25 	skills required to provide positive practice strategies as well as behavior reduction approved 
50.26 	and permitted intervention to the person who receives positive support; and
50.27 	(4) be under the direct supervision of a positive support professional.
50.28 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
50.29 	shall substitute for meeting the qualifications listed in paragraph (b).

51.1 	Sec. 13. Minnesota Statutes 2024, section 245D.12, is amended to read:
51.2 	245D.12 INTEGRATED COMMUNITY SUPPORTS; SETTING CAPACITY 
51.3 	REPORT.
51.4 		Subdivision 1.Setting capacity report. (a) The license holder providing integrated 
51.5 	community support, as defined in section 245D.03, subdivision 1, paragraph (c), clause (8), 
51.6 	must submit a setting capacity report to the commissioner to ensure the identified location 
51.7 	of service delivery meets the criteria of the home and community-based service requirements 
51.8 	as specified in section 256B.492.
51.9 	(b) The license holder shall provide the setting capacity report on the forms and in the 
51.10 	manner prescribed by the commissioner. The report must include:
51.11 	(1) the address of the multifamily housing building where the license holder delivers 
51.12 	integrated community supports and owns, leases, or has a direct or indirect financial 
51.13 	relationship with the property owner;
51.14 	(2) the total number of living units in the multifamily housing building described in 
51.15 	clause (1) where integrated community supports are delivered;
51.16 	(3) the total number of living units in the multifamily housing building described in 
51.17 	clause (1), including the living units identified in clause (2);
51.18 	(4) the total number of people who could reside in the living units in the multifamily 
51.19 	housing building described in clause (2) and receive integrated community supports; and
51.20 	(5) the percentage of living units that are controlled by the license holder in the 
51.21 	multifamily housing building by dividing clause (2) by clause (3).
51.22 	(c) Only one license holder may deliver integrated community supports at the address 
51.23 	of the multifamily housing building.
51.24 		Subd. 2.Setting approval moratorium. (a) The commissioner must not approve an 
51.25 	integrated community supports setting for which a setting capacity report was submitted 
51.26 	between July 1, 2025, and June 30, 2027.
51.27 	(b) The commissioner may approve exceptions to the approval moratorium under this 
51.28 	subdivision if the commissioner determines:
51.29 	(1) a new integrated community supports setting is needed to provide integrated 
51.30 	community supports for a person requiring hospital-level care;
52.1 	(2) a new integrated community supports setting is needed for a licensed assisted living 
52.2 	facility that is closing or converting from an assisted living facility license to a licensed 
52.3 	integrated community supports provider;
52.4 	(3) a new integrated community supports setting with specialized qualities, including 
52.5 	wheelchair accessible units, specialized equipment, or other unique qualities is needed to 
52.6 	meet the needs of a client identified by the local county board; or
52.7 	(4) a new integrated community supports setting has funding from the Minnesota Housing 
52.8 	Finance Agency or the United States Department of Housing and Urban Development.
52.9 	(c) When approving an exception under this subdivision, the commissioner shall consider: 
52.10 	the availability of approved integrated community supports settings in the geographic area 
52.11 	where the licensee seeks to operate, including the number of living units approved and the 
52.12 	total number of people who could reside in the approved living units while receiving 
52.13 	integrated community services; the results of a person's choices during the person's annual 
52.14 	assessment and service plan review; and the recommendation of the local county board. 
52.15 	The approval or denial of an exception by the commissioner is final and is not subject to 
52.16 	appeal.

52.17 	Sec. 14. [245D.13] OUT-OF-HOME RESPITE CARE SERVICES FOR CHILDREN.
52.18 		Subdivision 1.Licensed setting required. A license holder with a home and 
52.19 	community-based services license providing out-of-home respite care services for children 
52.20 	may do so only in a licensed setting, unless exempt under subdivision 2. For the purposes 
52.21 	of this section, "respite care services" has the meaning given in section 245A.02, subdivision 
52.22 	15.
52.23 		Subd. 2.Exemption from licensed setting requirement. (a) The exemption under this 
52.24 	subdivision does not apply to the provision of respite care services to a child in foster care 
52.25 	under chapter 260C or 260D.
52.26 	(b) A license holder with a home and community-based services license may provide 
52.27 	out-of-home respite care services for children in an unlicensed residential setting if:
52.28 	(1) all background studies are completed according to the requirements in chapter 245C;
52.29 	(2) a child's case manager conducts and documents an assessment of the residential 
52.30 	setting and its environment before services are provided and at least once each calendar 
52.31 	year thereafter if services continue to be provided at that residence. The assessment must 
52.32 	ensure that the setting is suitable for the child receiving respite care services. The assessment 
52.33 	must be conducted and documented in the manner prescribed by the commissioner;
53.1 	(3) the child's legal representative visits the residence and signs and dates a statement 
53.2 	authorizing services in the residence before services are provided and at least once each 
53.3 	calendar year thereafter if services continue to be provided at that residence;
53.4 	(4) the services are provided in a residential setting that is not licensed to provide any 
53.5 	other licensed services;
53.6 	(5) the services are provided to no more than four children at any one time. Each child 
53.7 	must have an individual bedroom, except two siblings may share a bedroom;
53.8 	(6) the services are not provided to children and adults over the age of 21 in the same 
53.9 	residence at the same time;
53.10 	(7) the services are not provided to a single family for more than 46 calendar days in a 
53.11 	calendar year and no more than ten consecutive days;
53.12 	(8) the license holder's license was not made conditional, suspended, or revoked during 
53.13 	the previous 24 months; and
53.14 	(9) each individual in the residence at the time services are provided, other than 
53.15 	individuals receiving services, is an employee, as defined under section 245C.02, of the 
53.16 	license holder and has had a background study completed under chapter 245C. No other 
53.17 	household members or other individuals may be present in the residence while services are 
53.18 	provided.
53.19 	(c) A child may not receive out-of-home respite care services in more than two unlicensed 
53.20 	residential settings in a calendar year.
53.21 	(d) The license holder must ensure the requirements in this section are met.
53.22 		Subd. 3.Documentation requirements. The license holder must maintain documentation 
53.23 	of the following:
53.24 	(1) background studies completed under chapter 245C;
53.25 	(2) service recipient records indicating the calendar dates and times when services were 
53.26 	provided;
53.27 	(3) the case manager's initial residential setting assessment and each residential assessment 
53.28 	completed thereafter; and
53.29 	(4) the legal representative's approval of the residential setting before services are 
53.30 	provided and each year thereafter.

54.1 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
54.2 	whichever is later. The commissioner of human services shall inform the revisor of statutes 
54.3 	when federal approval is obtained.

54.4 	Sec. 15. Minnesota Statutes 2024, section 252.32, subdivision 3, is amended to read:
54.5 		Subd. 3.Amount of support grant; use. (a) Support grant amounts shall be determined 
54.6 	by the county social service agency. Services and items purchased with a support grant 
54.7 	must:
54.8 	(1) be over and above the normal costs of caring for the dependent if the dependent did 
54.9 	not have a disability, including adaptive or one-on-one swimming lessons for drowning 
54.10 	prevention for a dependent younger than 12 years of age whose disability puts the dependent 
54.11 	at a higher risk of drowning according to the Centers for Disease Control Vital Statistics 
54.12 	System;
54.13 	(2) be directly attributable to the dependent's disabling condition; and
54.14 	(3) enable the family to delay or prevent the out-of-home placement of the dependent.
54.15 	(b) The design and delivery of services and items purchased under this section must be 
54.16 	provided in the least restrictive environment possible, consistent with the needs identified 
54.17 	in the individual service plan.
54.18 	(c) Items and services purchased with support grants must be those for which there are 
54.19 	no other public or private funds available to the family. Fees assessed to parents for health 
54.20 	or human services that are funded by federal, state, or county dollars are not reimbursable 
54.21 	through this program.
54.22 	(d) In approving or denying applications, the county shall consider the following factors:
54.23 	(1) the extent and areas of the functional limitations of a child with a disability;
54.24 	(2) the degree of need in the home environment for additional support; and
54.25 	(3) the potential effectiveness of the grant to maintain and support the person in the 
54.26 	family environment.
54.27 	(e) The maximum monthly grant amount shall be $250 per eligible dependent, or $3,000 
54.28 	per eligible dependent per state fiscal year, within the limits of available funds and as 
54.29 	adjusted by any legislatively authorized cost of living adjustment. The county social service 
54.30 	agency may consider the dependent's Supplemental Security Income in determining the 
54.31 	amount of the support grant.
55.1 	(f) Any adjustments to their monthly grant amount must be based on the needs of the 
55.2 	family and funding availability.

55.3 	Sec. 16. Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to 
55.4 	read:
55.5 		Subd. 30a.State certified MnCHOICES assessor team. (a) To facilitate the timely 
55.6 	processing of long-term care consultation assessments under section 256B.0911, the 
55.7 	commissioner must establish and maintain a team of assessors certified according to section 
55.8 	256B.0911, subdivision 13. Members of the state assessment team are authorized to conduct 
55.9 	assessments under section 256B.0911 throughout the state. The commissioner may deploy 
55.10 	members of the state assessment team to lead agencies with significant backlogs of pending 
55.11 	or incomplete long-term care consultation assessments to temporarily supplement the 
55.12 	capacity of the lead agency.
55.13 	(b) The commissioner may deploy a state assessment team member to a hospital, nursing 
55.14 	facility, intermediate care facility, or state-operated facility to expedite an assessment of a 
55.15 	person who:
55.16 	(1) is awaiting release or discharge because the person does not meet the applicable 
55.17 	admission criteria or level of care criteria for the setting, but the setting cannot identify a 
55.18 	setting to which the patient could be safely released or discharged without an assessment; 
55.19 	or
55.20 	(2) requests transition assistance under section 256B.0911, subdivision 27 or 28.
55.21 	If the commissioner deploys a state assessment team member under this paragraph, the 
55.22 	commissioner may require any organization receiving grant funds from the MNsure board 
55.23 	of directors that support the organization's medical assistance and MinnesotaCare enrollment 
55.24 	work to deploy an in-person assistor or navigator to assist the person being assessed in 
55.25 	expediting the person's application for medical assistance or MinnesotaCare.
55.26 	(c) Nothing in the subdivision shall be construed to relieve a lead agency of its obligations 
55.27 	under section 256B.0911, subdivision 14, paragraph (b), to have sufficient numbers of 
55.28 	certified assessors employed by the lead agency or under contract with the lead agency to 
55.29 	provide long-term consultation assessment and support planning within the timelines and 
55.30 	parameters required under section 256B.0911.

56.1 	Sec. 17. Minnesota Statutes 2024, section 256.476, subdivision 4, is amended to read:
56.2 		Subd. 4.Support grants; criteria and limitations. (a) A county board may choose to 
56.3 	participate in the consumer support grant program. If a county has not chosen to participate 
56.4 	by July 1, 2002, the commissioner shall contract with another county or other entity to 
56.5 	provide access to residents of the nonparticipating county who choose the consumer support 
56.6 	grant option. The commissioner shall notify the county board in a county that has declined 
56.7 	to participate of the commissioner's intent to enter into a contract with another county or 
56.8 	other entity at least 30 days in advance of entering into the contract. The local agency shall 
56.9 	establish written procedures and criteria to determine the amount and use of support grants. 
56.10 	These procedures must include, at least, the availability of respite care, assistance with daily 
56.11 	living, and adaptive aids. The local agency may establish monthly or annual maximum 
56.12 	amounts for grants and procedures where exceptional resources may be required to meet 
56.13 	the health and safety needs of the person on a time-limited basis, however, the total amount 
56.14 	awarded to each individual may not exceed the limits established in subdivision 11.
56.15 	(b) Support grants to a person, a person's legal representative, or other authorized 
56.16 	representative will be provided through a monthly subsidy payment and be in the form of 
56.17 	cash, voucher, or direct county payment to vendor. Support grant amounts must be determined 
56.18 	by the local agency. Each service and item purchased with a support grant must meet all of 
56.19 	the following criteria:
56.20 	(1) it must be over and above the normal cost of caring for the person if the person did 
56.21 	not have functional limitations, including adaptive or one-on-one swimming lessons for 
56.22 	drowning prevention for a person younger than 12 years of age whose disability puts the 
56.23 	person at a higher risk of drowning according to the Centers for Disease Control Vital 
56.24 	Statistics System;
56.25 	(2) it must be directly attributable to the person's functional limitations;
56.26 	(3) it must enable the person, a person's legal representative, or other authorized 
56.27 	representative to delay or prevent out-of-home placement of the person; and
56.28 	(4) it must be consistent with the needs identified in the service agreement, when 
56.29 	applicable.
56.30 	(c) Items and services purchased with support grants must be those for which there are 
56.31 	no other public or private funds available to the person, a person's legal representative, or 
56.32 	other authorized representative. Fees assessed to the person or the person's family for health 
56.33 	and human services are not reimbursable through the grant.
57.1 	(d) In approving or denying applications, the local agency shall consider the following 
57.2 	factors:
57.3 	(1) the extent and areas of the person's functional limitations;
57.4 	(2) the degree of need in the home environment for additional support; and
57.5 	(3) the potential effectiveness of the grant to maintain and support the person in the 
57.6 	family environment or the person's own home.
57.7 	(e) At the time of application to the program or screening for other services, the person, 
57.8 	a person's legal representative, or other authorized representative shall be provided sufficient 
57.9 	information to ensure an informed choice of alternatives by the person, the person's legal 
57.10 	representative, or other authorized representative, if any. The application shall be made to 
57.11 	the local agency and shall specify the needs of the person or the person's legal representative 
57.12 	or other authorized representative, the form and amount of grant requested, the items and 
57.13 	services to be reimbursed, and evidence of eligibility for medical assistance.
57.14 	(f) Upon approval of an application by the local agency and agreement on a support plan 
57.15 	for the person or the person's legal representative or other authorized representative, the 
57.16 	local agency shall make grants to the person or the person's legal representative or other 
57.17 	authorized representative. The grant shall be in an amount for the direct costs of the services 
57.18 	or supports outlined in the service agreement.
57.19 	(g) Reimbursable costs shall not include costs for resources already available, such as 
57.20 	special education classes, day training and habilitation, case management, other services to 
57.21 	which the person is entitled, medical costs covered by insurance or other health programs, 
57.22 	or other resources usually available at no cost to the person or the person's legal representative 
57.23 	or other authorized representative.
57.24 	(h) The state of Minnesota, the county boards participating in the consumer support 
57.25 	grant program, or the agencies acting on behalf of the county boards in the implementation 
57.26 	and administration of the consumer support grant program shall not be liable for damages, 
57.27 	injuries, or liabilities sustained through the purchase of support by the individual, the 
57.28 	individual's family, or the authorized representative under this section with funds received 
57.29 	through the consumer support grant program. Liabilities include but are not limited to: 
57.30 	workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the 
57.31 	Federal Unemployment Tax Act (FUTA). For purposes of this section, participating county 
57.32 	boards and agencies acting on behalf of county boards are exempt from the provisions of 
57.33 	section 268.035.

58.1 	Sec. 18. Minnesota Statutes 2024, section 256B.04, subdivision 21, is amended to read:
58.2 		Subd. 21.Provider enrollment. (a) The commissioner shall enroll providers and conduct 
58.3 	screening activities as required by Code of Federal Regulations, title 42, section 455, subpart 
58.4 	E. A provider must enroll each provider-controlled location where direct services are 
58.5 	provided. The commissioner may deny a provider's incomplete application if a provider 
58.6 	fails to respond to the commissioner's request for additional information within 60 days of 
58.7 	the request. The commissioner must conduct a background study under chapter 245C, 
58.8 	including a review of databases in section 245C.08, subdivision 1, paragraph (a), clauses 
58.9 	(1) to (5), for a provider described in this paragraph. The background study requirement 
58.10 	may be satisfied if the commissioner conducted a fingerprint-based background study on 
58.11 	the provider that includes a review of databases in section 245C.08, subdivision 1, paragraph 
58.12 	(a), clauses (1) to (5).
58.13 	(b) The commissioner shall revalidate each:
58.14 	(1) each provider under this subdivision at least once every five years; and
58.15 	(2) each personal care assistance agency, CFSS provider-agency, and CFSS financial 
58.16 	management services provider under this subdivision at least once every three years.;
58.17 	(3) each EIDBI agency under this subdivision at least once every three years; and
58.18 	(4) at the commissioner's discretion, any medical-assistance-only provider type the 
58.19 	commissioner deems "high risk" under this subdivision.
58.20 	(c) The commissioner shall conduct revalidation as follows:
58.21 	(1) provide 30-day notice of the revalidation due date including instructions for 
58.22 	revalidation and a list of materials the provider must submit;
58.23 	(2) if a provider fails to submit all required materials by the due date, notify the provider 
58.24 	of the deficiency within 30 days after the due date and allow the provider an additional 30 
58.25 	days from the notification date to comply; and
58.26 	(3) if a provider fails to remedy a deficiency within the 30-day time period, give 60-day 
58.27 	notice of termination and immediately suspend the provider's ability to bill. The provider 
58.28 	does not have the right to appeal suspension of ability to bill.
58.29 	(d) If a provider fails to comply with any individual provider requirement or condition 
58.30 	of participation, the commissioner may suspend the provider's ability to bill until the provider 
58.31 	comes into compliance. The commissioner's decision to suspend the provider is not subject 
58.32 	to an administrative appeal.
59.1 	(e) Correspondence and notifications, including notifications of termination and other 
59.2 	actions, may be delivered electronically to a provider's MN-ITS mailbox. This paragraph 
59.3 	does not apply to correspondences and notifications related to background studies.
59.4 	(f) If the commissioner or the Centers for Medicare and Medicaid Services determines 
59.5 	that a provider is designated "high-risk," the commissioner may withhold payment from 
59.6 	providers within that category upon initial enrollment for a 90-day period. The withholding 
59.7 	for each provider must begin on the date of the first submission of a claim.
59.8 	(g) An enrolled provider that is also licensed by the commissioner under chapter 245A, 
59.9 	is licensed as a home care provider by the Department of Health under chapter 144A, or is 
59.10 	licensed as an assisted living facility under chapter 144G and has a home and 
59.11 	community-based services designation on the home care license under section 144A.484, 
59.12 	must designate an individual as the entity's compliance officer. The compliance officer 
59.13 	must:
59.14 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
59.15 	regulations and to prevent inappropriate claims submissions;
59.16 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
59.17 	provider entity including billers, on the policies and procedures under clause (1);
59.18 	(3) respond to allegations of improper conduct related to the provision or billing of 
59.19 	medical assistance services, and implement action to remediate any resulting problems;
59.20 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
59.21 	regulations;
59.22 	(5) promptly report to the commissioner any identified violations of medical assistance 
59.23 	laws or regulations; and
59.24 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
59.25 	overpayment, report the overpayment to the commissioner and make arrangements with 
59.26 	the commissioner for the commissioner's recovery of the overpayment.
59.27 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
59.28 	provider within a particular industry sector or category establish a compliance program that 
59.29 	contains the core elements established by the Centers for Medicare and Medicaid Services.
59.30 	(h) The commissioner may revoke the enrollment of an ordering or rendering provider 
59.31 	for a period of not more than one year, if the provider fails to maintain and, upon request 
59.32 	from the commissioner, provide access to documentation relating to written orders or requests 
59.33 	for payment for durable medical equipment, certifications for home health services, or 
60.1 	referrals for other items or services written or ordered by such provider, when the 
60.2 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
60.3 	to maintain documentation or provide access to documentation on more than one occasion. 
60.4 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
60.5 	under the provisions of section 256B.064.
60.6 	(i) The commissioner shall terminate or deny the enrollment of any individual or entity 
60.7 	if the individual or entity has been terminated from participation in Medicare or under the 
60.8 	Medicaid program or Children's Health Insurance Program of any other state. The 
60.9 	commissioner may exempt a rehabilitation agency from termination or denial that would 
60.10 	otherwise be required under this paragraph, if the agency:
60.11 	(1) is unable to retain Medicare certification and enrollment solely due to a lack of billing 
60.12 	to the Medicare program;
60.13 	(2) meets all other applicable Medicare certification requirements based on an on-site 
60.14 	review completed by the commissioner of health; and
60.15 	(3) serves primarily a pediatric population.
60.16 	(j) As a condition of enrollment in medical assistance, the commissioner shall require 
60.17 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
60.18 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
60.19 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
60.20 	designated contractors to conduct unannounced on-site inspections of any provider location. 
60.21 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
60.22 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
60.23 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
60.24 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
60.25 	The commissioner's designations are not subject to administrative appeal.
60.26 	(k) As a condition of enrollment in medical assistance, the commissioner shall require 
60.27 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
60.28 	provider of five percent or higher, consent to criminal background checks, including 
60.29 	fingerprinting, when required to do so under state law or by a determination by the 
60.30 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
60.31 	high-risk for fraud, waste, or abuse.
60.32 	(l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable 
60.33 	medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
60.34 	meeting the durable medical equipment provider and supplier definition in clause (3), 
61.1 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
61.2 	annually renewed and designates the Minnesota Department of Human Services as the 
61.3 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
61.4 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
61.5 	federally qualified health center, a home health agency, the Indian Health Service, a 
61.6 	pharmacy, and a rural health clinic.
61.7 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
61.8 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
61.9 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
61.10 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
61.11 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
61.12 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
61.13 	fees in pursuing a claim on the bond.
61.14 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
61.15 	purchase medical equipment or supplies for sale or rental to the general public and is able 
61.16 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
61.17 	sale or rental.
61.18 	(m) The Department of Human Services may require a provider to purchase a surety 
61.19 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
61.20 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
61.21 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
61.22 	provider or category of providers is designated high-risk pursuant to paragraph (f) and as 
61.23 	per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an 
61.24 	amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
61.25 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
61.26 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
61.27 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
61.28 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

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

61.30 	Sec. 19. Minnesota Statutes 2024, section 256B.0659, subdivision 17a, is amended to 
61.31 	read:
61.32 		Subd. 17a.Enhanced rate. (a) An enhanced rate of 107.5 percent of the rate paid for 
61.33 	personal care assistance services shall be paid for services provided to persons who qualify 
61.34 	for ten or more hours of personal care assistance services per day when provided by a 
62.1 	personal care assistant who meets the requirements of subdivision 11, paragraph (d). This 
62.2 	paragraph expires upon the effective date of paragraph (b).
62.3 	(b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced 
62.4 	rate of 112.5 percent of the rate paid for personal care assistance services shall be paid for 
62.5 	services provided to persons who qualify for ten or more hours of personal care assistance 
62.6 	services per day when provided by a personal care assistant who meets the requirements of 
62.7 	subdivision 11, paragraph (d).
62.8 	(b) (c) A personal care assistance provider must use all additional revenue attributable 
62.9 	to the rate enhancements under this subdivision for the wages and wage-related costs of the 
62.10 	personal care assistants, including any corresponding increase in the employer's share of 
62.11 	FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 
62.12 	compensation premiums. The agency must not use the additional revenue attributable to 
62.13 	any enhanced rate under this subdivision to pay for mileage reimbursement, health and 
62.14 	dental insurance, life insurance, disability insurance, long-term care insurance, uniform 
62.15 	allowance, contributions to employee retirement accounts, or any other employee benefits.
62.16 	(c) (d) Any change in the eligibility criteria for the enhanced rate for personal care 
62.17 	assistance services as described in this subdivision and referenced in subdivision 11, 
62.18 	paragraph (d), does not constitute a change in a term or condition for individual providers 
62.19 	as defined in section 256B.0711, and is not subject to the state's obligation to meet and 
62.20 	negotiate under chapter 179A.

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

62.22 	Sec. 20. Minnesota Statutes 2024, section 256B.0911, subdivision 1, is amended to read:
62.23 		Subdivision 1.Purpose and goal. (a) The purpose of long-term care consultation services 
62.24 	is to assist persons with long-term or chronic care needs in making care decisions and 
62.25 	selecting support and service options that meet their needs and reflect their preferences. 
62.26 	The availability of, and access to, information and other types of assistance, including 
62.27 	long-term care consultation assessment and support planning, is also intended to prevent 
62.28 	or delay institutional placements and to provide access to transition assistance after 
62.29 	placement. Further, the goal of long-term care consultation services is to contain costs 
62.30 	associated with unnecessary institutional admissions. Long-term care consultation services 
62.31 	must be available to any person regardless of public program eligibility.
62.32 	(b) The commissioner of human services shall seek to maximize use of available federal 
62.33 	and state funds and establish the broadest program possible within the funding available.
63.1 	(c) Long-term care consultation services must be coordinated with long-term care options 
63.2 	counseling, long-term care options counseling for assisted living at critical care transitions, 
63.3 	the Disability Hub, and preadmission screening.
63.4 	(d) A lead agency providing long-term care consultation services shall encourage the 
63.5 	use of volunteers from families, religious organizations, social clubs, and similar civic and 
63.6 	service organizations to provide community-based services.

63.7 	Sec. 21. Minnesota Statutes 2024, section 256B.0911, subdivision 10, is amended to read:
63.8 		Subd. 10.Definitions. (a) For purposes of this section, the following definitions apply.
63.9 	(b) "Available service and setting options" or "available options," with respect to the 
63.10 	home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49, 
63.11 	means all services and settings defined under the waiver plan for which a waiver applicant 
63.12 	or waiver participant is eligible.
63.13 	(c) "Competitive employment" means work in the competitive labor market that is 
63.14 	performed on a full-time or part-time basis in an integrated setting, and for which an 
63.15 	individual is compensated at or above the minimum wage, but not less than the customary 
63.16 	wage and level of benefits paid by the employer for the same or similar work performed by 
63.17 	individuals without disabilities.
63.18 	(d) "Cost-effective" means community services and living arrangements that cost the 
63.19 	same as or less than institutional care. For an individual found to meet eligibility criteria 
63.20 	for home and community-based service programs under chapter 256S or section 256B.49, 
63.21 	"cost-effectiveness" has the meaning found in the federally approved waiver plan for each 
63.22 	program.
63.23 	(e) "Independent living" means living in a setting that is not controlled by a provider.
63.24 	(f) "Informed choice" has the meaning given in section 256B.4905, subdivision 1a.
63.25 	(g) "Lead agency" means a county administering or a Tribe or health plan under contract 
63.26 	with the commissioner to administer long-term care consultation services.
63.27 	(h) "Long-term care consultation services" means the activities described in subdivision 
63.28 	11.
63.29 	(i) "Long-term care options counseling" means the services provided by sections 256.01, 
63.30 	subdivision 24, and 256.975, subdivision 7, and also includes telephone assistance and 
63.31 	follow-up after a long-term care consultation assessment has been completed.
64.1 	(j) "Long-term care options counseling for assisted living at critical care transitions" 
64.2 	means the services provided under section 256.975, subdivisions subdivision 7eto 7g.
64.3 	(k) "Minnesota health care programs" means the medical assistance program under this 
64.4 	chapter and the alternative care program under section 256B.0913.
64.5 	(l) "Person-centered planning" is a process that includes the active participation of a 
64.6 	person in the planning of the person's services, including in making meaningful and informed 
64.7 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
64.8 	and informed choices about the services the person receives, the settings in which the person 
64.9 	receives the services, and the setting in which the person lives.
64.10 	(m) "Preadmission screening" means the services provided under section 256.975, 
64.11 	subdivisions 7a to 7c.

64.12 	Sec. 22. Minnesota Statutes 2024, section 256B.0911, subdivision 13, is amended to read:
64.13 		Subd. 13.MnCHOICES assessor qualifications, training, and certification. (a) The 
64.14 	commissioner shall develop and implement a curriculum and an assessor certification 
64.15 	process.
64.16 	(b) MnCHOICES certified assessors must have received training and certification specific 
64.17 	to assessment and consultation for long-term care services in the state and either:
64.18 	(1) either have a bachelor's at least an associate's degree in social work, human services, 
64.19 	or other closely related field;
64.20 	(2) have at least an associate's degree in nursing with a public health nursing certificate, 
64.21 	or other closely related field; or
64.22 	(3) be a registered nurse; and.
64.23 	(2) have received training and certification specific to assessment and consultation for 
64.24 	long-term care services in the state.
64.25 	(c) Certified assessors shall demonstrate best practices in assessment and support 
64.26 	planning, including person-centered planning principles, and have a common set of skills 
64.27 	that ensures consistency and equitable access to services statewide.
64.28 	(d) Certified assessors must be recertified every three years.

65.1 	Sec. 23. Minnesota Statutes 2024, section 256B.0911, subdivision 14, is amended to read:
65.2 		Subd. 14.Use of MnCHOICES certified assessors required. (a) Each lead agency 
65.3 	shall use MnCHOICES certified assessors who have completed MnCHOICES training and 
65.4 	the certification process determined by the commissioner in subdivision 13.
65.5 	(b) Each lead agency must ensure that the lead agency has sufficient numbers of certified 
65.6 	assessors to provide long-term consultation assessment and support planning within the 
65.7 	timelines and parameters of the service.
65.8 	(c) A lead agency may choose, according to departmental policies, to contract with a 
65.9 	qualified, certified assessor to conduct assessments and reassessments on behalf of the lead 
65.10 	agency.
65.11 	(d) Tribes and health plans under contract with the commissioner must provide long-term 
65.12 	care consultation services as specified in the contract.
65.13 	(e) A lead agency must provide the commissioner with an administrative contact for 
65.14 	communication purposes.
65.15 	(f) A lead agency may contract under this subdivision with any hospital licensed under 
65.16 	sections 144.50 to 144.56 to conduct assessments of patients in the hospital on behalf of 
65.17 	the lead agency when the lead agency has failed to meet its obligations under subdivision 
65.18 	17. The contracted assessment must be conducted by a hospital employee who is a qualified, 
65.19 	certified assessor. The hospital employees who perform assessments under the contract 
65.20 	between the hospital and the lead agency may perform assessments in addition to other 
65.21 	duties assigned to the employee by the hospital, except the hospital employees who perform 
65.22 	the assessments under contract with the lead agency must not perform any waiver-related 
65.23 	tasks other than assessments. Hospitals are not eligible for reimbursement under subdivision 
65.24 	33. The lead agency that enters into a contract with a hospital under this paragraph is 
65.25 	responsible for oversight, compliance, and quality assurance for all assessments performed 
65.26 	under the contract.

65.27 	Sec. 24. Minnesota Statutes 2024, section 256B.0911, subdivision 24, is amended to read:
65.28 		Subd. 24.Remote reassessments. (a) Assessments performed according to subdivisions 
65.29 	17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the 
65.30 	requirements of this subdivision. Remote reassessments conducted by interactive video or 
65.31 	telephone may substitute for in-person reassessments.
65.32 	(b) For services provided by the developmental disabilities waiver under section 
65.33 	256B.092, and the community access for disability inclusion, community alternative care, 
66.1 	and brain injury waiver programs under section 256B.49, remote reassessments may be 
66.2 	substituted for two four consecutive reassessments if followed by an in-person reassessment.
66.3 	(c) For services provided by alternative care under section 256B.0913, essential 
66.4 	community supports under section 256B.0922, and the elderly waiver under chapter 256S, 
66.5 	remote reassessments may be substituted for one reassessment if followed by an in-person 
66.6 	reassessment.
66.7 	(d) For personal care assistance provided under section 256B.0659 and community first 
66.8 	services and supports provided under section 256B.85, remote reassessments may be 
66.9 	substituted for two consecutive reassessments if followed by an in-person reassessment.
66.10 	(e) A remote reassessment is permitted only if the lead agency provides informed choice 
66.11 	and the person being reassessed or the person's legal representative provides informed 
66.12 	consent for a remote assessment. Lead agencies must document that informed choice was 
66.13 	offered.
66.14 	(f) The person being reassessed, or the person's legal representative, may refuse a remote 
66.15 	reassessment at any time.
66.16 	(g) During a remote reassessment, if the certified assessor determines an in-person 
66.17 	reassessment is necessary in order to complete the assessment, the lead agency shall schedule 
66.18 	an in-person reassessment.
66.19 	(h) All other requirements of an in-person reassessment apply to a remote reassessment, 
66.20 	including updates to a person's support plan.

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

66.24 	Sec. 25. Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision 
66.25 	to read:
66.26 		Subd. 24a.Verbal attestation to replace required reassessment signatures. Effective 
66.27 	January 1, 2026, or upon federal approval, whichever is later, the commissioner shall allow 
66.28 	for verbal attestation to replace required reassessment signatures.

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

67.1 	Sec. 26. Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision 
67.2 	to read:
67.3 		Subd. 25a.Attesting to no changes in needs or services. (a) A person who is older 
67.4 	than 21 years of age, under 65 years of age, and receiving home and community-based 
67.5 	waiver services under the developmental disabilities waiver program under section 256B.092; 
67.6 	community access for disability inclusion, community alternative care, and brain injury 
67.7 	waiver programs under section 256B.49; or community first services and supports under 
67.8 	section 256B.85 may attest that the person has unchanged needs from the most recent prior 
67.9 	assessment or reassessment for up to two consecutive reassessments if the lead agency 
67.10 	provides informed choice and the person being reassessed or the person's legal representative 
67.11 	provides informed consent. Lead agencies must document that informed choice was offered.
67.12 	(b) The person or person's legal representative must attest, verbally or through alternative 
67.13 	communications, that the information provided in the previous assessment or reassessment 
67.14 	is still accurate and applicable and that no changes in the person's circumstances have 
67.15 	occurred that would require changes from the most recent prior assessment or reassessment. 
67.16 	The person or the person's legal representative may request a full reassessment at any time.
67.17 	(c) The assessor must review the most recent prior assessment or reassessment as required 
67.18 	in subdivision 22, paragraphs (a) and (b), clause (1), before conducting the interview. The 
67.19 	certified assessor must confirm that the information from the previous assessment or 
67.20 	reassessment is current.
67.21 	(d) The assessment conducted under this section must:
67.22 	(1) verify current assessed support needs;
67.23 	(2) confirm continued need for the currently assessed level of care;
67.24 	(3) inform the person of alternative long-term services and supports available;
67.25 	(4) provide informed choice of institutional or home and community-based services; 
67.26 	and
67.27 	(5) identify changes in need that may require a full reassessment.
67.28 	(e) The assessor must ensure that any new assessment items or requirements mandated 
67.29 	by federal or state authority are addressed and the person must provide required information.

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

68.1 	Sec. 27. Minnesota Statutes 2024, section 256B.0911, subdivision 26, is amended to read:
68.2 		Subd. 26.Determination of institutional level of care. (a) The determination of need 
68.3 	for hospital and intermediate care facility levels of care must be made according to criteria 
68.4 	developed by the commissioner, and in section 256B.092, using forms developed by the 
68.5 	commissioner.
68.6 	(b) The determination of need for nursing facility level of care must be made based on 
68.7 	criteria in section 144.0724, subdivision 11. This paragraph expires upon the effective date 
68.8 	of paragraph (c).
68.9 	(c) Effective January 1, 2026, or upon federal approval, whichever is later, the 
68.10 	determination of need for nursing facility level of care must be made based on criteria in 
68.11 	section 144.0724, subdivision 11, except for determinations of need for purposes of the 
68.12 	brain injury and community access for disability inclusion waivers under section 256B.49.
68.13 	(d) Determinations of need for the purposes of the brain injury and community access 
68.14 	for disability inclusion waivers must be made based on criteria in section 144.0724, 
68.15 	subdivision 11a. If a person is found ineligible for waiver services under this paragraph 
68.16 	because of a determination that the person does not meet the criteria in section 144.0724, 
68.17 	subdivision 11a, the lead agency must review the person's latest assessment under section 
68.18 	256B.0911 to determine if the person meets any of the nursing facility level of care criteria 
68.19 	under section 144.0724, subdivision 11. If the lead agency determines after the review that 
68.20 	the person does meet a nursing facility level of care criteria under section 144.0724, 
68.21 	subdivision 11, the lead agency must provide a notice of action to the person informing the 
68.22 	person specifically that the person's waiver services are being terminated because the person 
68.23 	meets only a nursing facility level of care of under section 144.0724, subdivision 11, that 
68.24 	is no longer a basis for waiver eligibility. The lead agency must also inform the person of 
68.25 	other benefits options for which the person may be eligible. For existing waiver participants, 
68.26 	the effective date of the termination of waiver services based on this paragraph must be no 
68.27 	sooner than 90 days after the date of the assessment under section 256B.0911.

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

68.29 	Sec. 28. Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision 
68.30 	to read:
68.31 		Subd. 35.Dashboard on assessment completions. (a) The commissioner shall maintain 
68.32 	a dashboard on the department's public website containing summary data on the completion 
69.1 	of assessments under this section. The commissioner must update the dashboard at least 
69.2 	twice per year.
69.3 	(b) The dashboard must include:
69.4 	(1) the total number of assessments performed since the previous reporting period, by 
69.5 	lead agency;
69.6 	(2) the total number of initial assessments performed since the previous reporting period, 
69.7 	by lead agency;
69.8 	(3) the total number of reassessments performed since the previous reporting period, by 
69.9 	lead agency;
69.10 	(4) the number and percentage of assessments completed within the required timeline, 
69.11 	by a lead agency;
69.12 	(5) the average length of time to complete an assessment, by a lead agency;
69.13 	(6) summary data of the location in which the assessments were performed, by lead 
69.14 	agency; and
69.15 	(7) other information the commissioner determines is valuable to assess the capacity of 
69.16 	lead agencies to complete assessments within the timelines prescribed by law.

69.17 	Sec. 29. Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision 
69.18 	to read:
69.19 		Subd. 36.Cooperation with state certified MnCHOICES assessor teams. (a) In the 
69.20 	event that the commissioner deploys state certified assessors under section 256.01, 
69.21 	subdivision 30a, to temporarily supplement the capacity of the lead agency to perform 
69.22 	long-term care consultation assessments and to meet its obligations under this section, the 
69.23 	lead agency must cooperate with the commissioner and the state assessor team to implement 
69.24 	a work plan to reduce the backlog and improve both training of lead agency staff and 
69.25 	processes to minimize future backlogs.
69.26 	(b) In the event that the commissioner deploys state certified assessors under section 
69.27 	256.01, subdivision 30a, to perform an expedited long-term care consultation assessment 
69.28 	under section 256.01, subdivision 30a, at the request of the state assessor, the lead agency 
69.29 	must ensure that the person is visited by lead agency staff within five days of the visit by 
69.30 	the state assessor to begin the process of determining financial eligibility for medical 
69.31 	assistance.

70.1 	Sec. 30. Minnesota Statutes 2024, section 256B.0924, subdivision 6, is amended to read:
70.2 		Subd. 6.Payment for targeted case management. (a) Medical assistance and 
70.3 	MinnesotaCare payment for targeted case management shall be made on a monthly basis. 
70.4 	In order to receive payment for an eligible adult, the provider must document at least one 
70.5 	contact per month and not more than two consecutive months without a face-to-face contact 
70.6 	either in person or by interactive video that meets the requirements in section 256B.0625, 
70.7 	subdivision 20b, with the adult or the adult's legal representative, family, primary caregiver, 
70.8 	or other relevant persons identified as necessary to the development or implementation of 
70.9 	the goals of the personal service plan.
70.10 	(b) Except as provided under paragraph (m), payment for targeted case management 
70.11 	provided by county staff under this subdivision shall be based on the monthly rate 
70.12 	methodology under section 256B.094, subdivision 6, paragraph (b), calculated as one 
70.13 	combined average rate together with adult mental health case management under section 
70.14 	256B.0625, subdivision 20, except for calendar year 2002. In calendar year 2002, the rate 
70.15 	for case management under this section shall be the same as the rate for adult mental health 
70.16 	case management in effect as of December 31, 2001. Billing and payment must identify the 
70.17 	recipient's primary population group to allow tracking of revenues.
70.18 	(c) Payment for targeted case management provided by county-contracted vendors shall 
70.19 	be based on a monthly rate calculated in accordance with section 256B.076, subdivision 2. 
70.20 	The rate must not exceed the rate charged by the vendor for the same service to other payers. 
70.21 	If the service is provided by a team of contracted vendors, the team shall determine how to 
70.22 	distribute the rate among its members. No reimbursement received by contracted vendors 
70.23 	shall be returned to the county, except to reimburse the county for advance funding provided 
70.24 	by the county to the vendor.
70.25 	(d) If the service is provided by a team that includes contracted vendors and county staff, 
70.26 	the costs for county staff participation on the team shall be included in the rate for 
70.27 	county-provided services. In this case, the contracted vendor and the county may each 
70.28 	receive separate payment for services provided by each entity in the same month. In order 
70.29 	to prevent duplication of services, the county must document, in the recipient's file, the need 
70.30 	for team targeted case management and a description of the different roles of the team 
70.31 	members.
70.32 	(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
70.33 	targeted case management shall be provided by the recipient's county of responsibility, as 
71.1 	defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
71.2 	used to match other federal funds.
71.3 	(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider 
71.4 	that does not meet the reporting or other requirements of this section. The county of 
71.5 	responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal 
71.6 	disallowances. The county may share this responsibility with its contracted vendors.
71.7 	(g) The commissioner shall set aside five percent of the federal funds received under 
71.8 	this section for use in reimbursing the state for costs of developing and implementing this 
71.9 	section.
71.10 	(h) Payments to counties for targeted case management expenditures under this section 
71.11 	shall only be made from federal earnings from services provided under this section. Payments 
71.12 	to contracted vendors shall include both the federal earnings and the county share.
71.13 	(i) Notwithstanding section 256B.041, county payments for the cost of case management 
71.14 	services provided by county staff shall not be made to the commissioner of management 
71.15 	and budget. For the purposes of targeted case management services provided by county 
71.16 	staff under this section, the centralized disbursement of payments to counties under section 
71.17 	256B.041 consists only of federal earnings from services provided under this section.
71.18 	(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
71.19 	and the recipient's institutional care is paid by medical assistance, payment for targeted case 
71.20 	management services under this subdivision is limited to the lesser of:
71.21 	(1) the last 180 days of the recipient's residency in that facility; or
71.22 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
71.23 	(k) Payment for targeted case management services under this subdivision shall not 
71.24 	duplicate payments made under other program authorities for the same purpose.
71.25 	(l) Any growth in targeted case management services and cost increases under this 
71.26 	section shall be the responsibility of the counties.
71.27 	(m) The commissioner may make payments for Tribes according to section 256B.0625, 
71.28 	subdivision 34, or other relevant federally approved rate setting methodologies for vulnerable 
71.29 	adult and developmental disability targeted case management provided by Indian health 
71.30 	services and facilities operated by a Tribe or Tribal organization.

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

72.1 	Sec. 31. Minnesota Statutes 2024, section 256B.0949, subdivision 2, is amended to read:
72.2 		Subd. 2.Definitions. (a) The terms used in this section have the meanings given in this 
72.3 	subdivision.
72.4 	(b) "Advanced certification" means a person who has completed advanced certification 
72.5 	in an approved modality under subdivision 13, paragraph (b).
72.6 	(c) "Agency" means the legal entity that is enrolled with Minnesota health care programs 
72.7 	as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide 
72.8 	EIDBI services and that has the legal responsibility to ensure that its employees or contractors
72.9 	carry out the responsibilities defined in this section. Agency includes a licensed individual 
72.10 	professional who practices independently and acts as an agency.
72.11 	(d) "Autism spectrum disorder or a related condition" or "ASD or a related condition" 
72.12 	means either autism spectrum disorder (ASD) as defined in the current version of the 
72.13 	Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found 
72.14 	to be closely related to ASD, as identified under the current version of the DSM, and meets 
72.15 	all of the following criteria:
72.16 	(1) is severe and chronic;
72.17 	(2) results in impairment of adaptive behavior and function similar to that of a person 
72.18 	with ASD;
72.19 	(3) requires treatment or services similar to those required for a person with ASD; and
72.20 	(4) results in substantial functional limitations in three core developmental deficits of 
72.21 	ASD: social or interpersonal interaction; functional communication, including nonverbal 
72.22 	or social communication; and restrictive or repetitive behaviors or hyperreactivity or 
72.23 	hyporeactivity to sensory input; and may include deficits or a high level of support in one 
72.24 	or more of the following domains:
72.25 	(i) behavioral challenges and self-regulation;
72.26 	(ii) cognition;
72.27 	(iii) learning and play;
72.28 	(iv) self-care; or
72.29 	(v) safety.
72.30 	(e) "Person" means a person under 21 years of age.
73.1 	(f) "Clinical supervision" means the overall responsibility for the control and direction 
73.2 	of EIDBI service delivery, including individual treatment planning, staff supervision, 
73.3 	individual treatment plan progress monitoring, and treatment review for each person. Clinical 
73.4 	supervision is provided by a qualified supervising professional (QSP) who takes full 
73.5 	professional responsibility for the service provided by each supervisee and the clinical 
73.6 	effectiveness of all interventions.
73.7 	(g) "Commissioner" means the commissioner of human services, unless otherwise 
73.8 	specified.
73.9 	(h) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive 
73.10 	evaluation of a person to determine medical necessity for EIDBI services based on the 
73.11 	requirements in subdivision 5.
73.12 	(i) "Department" means the Department of Human Services, unless otherwise specified.
73.13 	(j) "Early intensive developmental and behavioral intervention benefit" or "EIDBI 
73.14 	benefit" means a variety of individualized, intensive treatment modalities approved and 
73.15 	published by the commissioner that are based in behavioral and developmental science 
73.16 	consistent with best practices on effectiveness.
73.17 	(k) "Employee" means any person who is employed by an agency, including temporary 
73.18 	and part-time employees, and who performs work for at least 80 hours in a year for that 
73.19 	agency in Minnesota. Employee does not include an independent contractor.
73.20 	(k) (l) "Generalizable goals" means results or gains that are observed during a variety 
73.21 	of activities over time with different people, such as providers, family members, other adults, 
73.22 	and people, and in different environments including, but not limited to, clinics, homes, 
73.23 	schools, and the community.
73.24 	(l) (m) "Incident" means when any of the following occur:
73.25 	(1) an illness, accident, or injury that requires first aid treatment;
73.26 	(2) a bump or blow to the head; or
73.27 	(3) an unusual or unexpected event that jeopardizes the safety of a person or staff, 
73.28 	including a person leaving the agency unattended.
73.29 	(m) (n) "Individual treatment plan" or "ITP" means the person-centered, individualized 
73.30 	written plan of care that integrates and coordinates person and family information from the 
73.31 	CMDE for a person who meets medical necessity for the EIDBI benefit. An individual 
73.32 	treatment plan must meet the standards in subdivision 6.
74.1 	(n) (o) "Legal representative" means the parent of a child who is under 18 years of age, 
74.2 	a court-appointed guardian, or other representative with legal authority to make decisions 
74.3 	about service for a person. For the purpose of this subdivision, "other representative with 
74.4 	legal authority to make decisions" includes a health care agent or an attorney-in-fact 
74.5 	authorized through a health care directive or power of attorney.
74.6 	(o) (p) "Mental health professional" means a staff person who is qualified according to 
74.7 	section 245I.04, subdivision 2.
74.8 	(p) (q) "Person-centered" means a service that both responds to the identified needs, 
74.9 	interests, values, preferences, and desired outcomes of the person or the person's legal 
74.10 	representative and respects the person's history, dignity, and cultural background and allows 
74.11 	inclusion and participation in the person's community.
74.12 	(q) (r) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II, 
74.13 	or level III treatment provider.

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

74.15 	Sec. 32. Minnesota Statutes 2024, section 256B.0949, subdivision 13, is amended to read:
74.16 		Subd. 13.Covered services. (a) The services described in paragraphs (b) to (l) are 
74.17 	eligible for reimbursement by medical assistance under this section. Services must be 
74.18 	provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must 
74.19 	address the person's medically necessary treatment goals and must be targeted to develop, 
74.20 	enhance, or maintain the individual developmental skills of a person with ASD or a related 
74.21 	condition to improve functional communication, including nonverbal or social 
74.22 	communication, social or interpersonal interaction, restrictive or repetitive behaviors, 
74.23 	hyperreactivity or hyporeactivity to sensory input, behavioral challenges and self-regulation, 
74.24 	cognition, learning and play, self-care, and safety.
74.25 	(b) EIDBI treatment must be delivered consistent with the standards of an approved 
74.26 	modality, as published by the commissioner. EIDBI modalities include:
74.27 	(1) applied behavior analysis (ABA);
74.28 	(2) developmental individual-difference relationship-based model (DIR/Floortime);
74.29 	(3) early start Denver model (ESDM); or
74.30 	(4) PLAY project;
74.31 	(5) (4) relationship development intervention (RDI); or.
75.1 	(6) additional modalities not listed in clauses (1) to (5) upon approval by the 
75.2 	commissioner.
75.3 	(c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b), 
75.4 	clauses (1) to (5) (4), as the primary modality for treatment as a covered service, or several 
75.5 	EIDBI modalities in combination as the primary modality of treatment, as approved by the 
75.6 	commissioner. An EIDBI provider that identifies and provides assurance of qualifications 
75.7 	for a single specific treatment modality, including an EIDBI provider with advanced 
75.8 	certification overseeing implementation, must document the required qualifications to meet 
75.9 	fidelity to the specific model in a manner determined by the commissioner.
75.10 	(d) Each qualified EIDBI provider must identify and provide assurance of qualifications 
75.11 	for professional licensure certification, or training in evidence-based treatment methods, 
75.12 	and must document the required qualifications outlined in subdivision 15 in a manner 
75.13 	determined by the commissioner.
75.14 	(e) CMDE is a comprehensive evaluation of the person's developmental status to 
75.15 	determine medical necessity for EIDBI services and meets the requirements of subdivision 
75.16 	5. The services must be provided by a qualified CMDE provider.
75.17 	(f) EIDBI intervention observation and direction is the clinical direction and oversight 
75.18 	of EIDBI services by the QSP, level I treatment provider, or level II treatment provider, 
75.19 	including developmental and behavioral techniques, progress measurement, data collection, 
75.20 	function of behaviors, and generalization of acquired skills for the direct benefit of a person. 
75.21 	EIDBI intervention observation and direction informs any modification of the current 
75.22 	treatment protocol to support the outcomes outlined in the ITP.
75.23 	(g) Intervention is medically necessary direct treatment provided to a person with ASD 
75.24 	or a related condition as outlined in their ITP. All intervention services must be provided 
75.25 	under the direction of a QSP. Intervention may take place across multiple settings. The 
75.26 	frequency and intensity of intervention services are provided based on the number of 
75.27 	treatment goals, person and family or caregiver preferences, and other factors. Intervention 
75.28 	services may be provided individually or in a group. Intervention with a higher provider 
75.29 	ratio may occur when deemed medically necessary through the person's ITP.
75.30 	(1) Individual intervention is treatment by protocol administered by a single qualified 
75.31 	EIDBI provider delivered to one person.
75.32 	(2) Group intervention is treatment by protocol provided by one or more qualified EIDBI 
75.33 	providers, delivered to at least two people who receive EIDBI services.
76.1 	(3) Higher provider ratio intervention is treatment with protocol modification provided 
76.2 	by two or more qualified EIDBI providers delivered to one person in an environment that 
76.3 	meets the person's needs and under the direction of the QSP or level I provider.
76.4 	(h) ITP development and ITP progress monitoring is development of the initial, annual, 
76.5 	and progress monitoring of an ITP. ITP development and ITP progress monitoring documents 
76.6 	provide oversight and ongoing evaluation of a person's treatment and progress on targeted 
76.7 	goals and objectives and integrate and coordinate the person's and the person's legal 
76.8 	representative's information from the CMDE and ITP progress monitoring. This service 
76.9 	must be reviewed and completed by the QSP, and may include input from a level I provider 
76.10 	or a level II provider.
76.11 	(i) Family caregiver training and counseling is specialized training and education for a 
76.12 	family or primary caregiver to understand the person's developmental status and help with 
76.13 	the person's needs and development. This service must be provided by the QSP, level I 
76.14 	provider, or level II provider.
76.15 	(j) A coordinated care conference is a voluntary meeting with the person and the person's 
76.16 	family to review the CMDE or ITP progress monitoring and to integrate and coordinate 
76.17 	services across providers and service-delivery systems to develop the ITP. This service may 
76.18 	include the CMDE provider, QSP, a level I provider, or a level II provider.
76.19 	(k) Travel time is allowable billing for traveling to and from the person's home, school, 
76.20 	a community setting, or place of service outside of an EIDBI center, clinic, or office from 
76.21 	a specified location to provide in-person EIDBI intervention, observation and direction, or 
76.22 	family caregiver training and counseling. The person's ITP must specify the reasons the 
76.23 	provider must travel to the person.
76.24 	(l) Medical assistance covers medically necessary EIDBI services and consultations 
76.25 	delivered via telehealth, as defined under section 256B.0625, subdivision 3b, in the same 
76.26 	manner as if the service or consultation was delivered in person.

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

76.28 	Sec. 33. Minnesota Statutes 2024, section 256B.0949, subdivision 15, is amended to read:
76.29 		Subd. 15.EIDBI provider qualifications. (a) A QSP must be employed by an employee 
76.30 	of an agency and be:
76.31 	(1) a licensed mental health professional who has at least 2,000 hours of supervised 
76.32 	clinical experience or training in examining or treating people with ASD or a related condition 
76.33 	or equivalent documented coursework at the graduate level by an accredited university in 
77.1 	ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child 
77.2 	development; or
77.3 	(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised 
77.4 	clinical experience or training in examining or treating people with ASD or a related condition 
77.5 	or equivalent documented coursework at the graduate level by an accredited university in 
77.6 	the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and 
77.7 	typical child development.
77.8 	(b) A level I treatment provider must be employed by an employee of an agency and:
77.9 	(1) have at least 2,000 hours of supervised clinical experience or training in examining 
77.10 	or treating people with ASD or a related condition or equivalent documented coursework 
77.11 	at the graduate level by an accredited university in ASD diagnostics, ASD developmental 
77.12 	and behavioral treatment strategies, and typical child development or an equivalent 
77.13 	combination of documented coursework or hours of experience; and
77.14 	(2) have or be at least one of the following:
77.15 	(i) a master's degree in behavioral health or child development or related fields including, 
77.16 	but not limited to, mental health, special education, social work, psychology, speech 
77.17 	pathology, or occupational therapy from an accredited college or university;
77.18 	(ii) a bachelor's degree in a behavioral health, child development, or related field 
77.19 	including, but not limited to, mental health, special education, social work, psychology, 
77.20 	speech pathology, or occupational therapy, from an accredited college or university, and 
77.21 	advanced certification in a treatment modality recognized by the department;
77.22 	(iii) a board-certified behavior analyst as defined by the Behavior Analyst Certification 
77.23 	Board or a qualified behavior analyst as defined by the Qualified Applied Behavior Analysis 
77.24 	Credentialing Board; or
77.25 	(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical 
77.26 	experience that meets all registration, supervision, and continuing education requirements 
77.27 	of the certification.
77.28 	(c) A level II treatment provider must be employed by an employee of an agency and 
77.29 	must be:
77.30 	(1) a person who has a bachelor's degree from an accredited college or university in a 
77.31 	behavioral or child development science or related field including, but not limited to, mental 
77.32 	health, special education, social work, psychology, speech pathology, or occupational 
77.33 	therapy; and meets at least one of the following:
78.1 	(i) has at least 1,000 hours of supervised clinical experience or training in examining or 
78.2 	treating people with ASD or a related condition or equivalent documented coursework at 
78.3 	the graduate level by an accredited university in ASD diagnostics, ASD developmental and 
78.4 	behavioral treatment strategies, and typical child development or a combination of 
78.5 	coursework or hours of experience;
78.6 	(ii) has certification as a board-certified assistant behavior analyst from the Behavior 
78.7 	Analyst Certification Board or a qualified autism service practitioner from the Qualified 
78.8 	Applied Behavior Analysis Credentialing Board;
78.9 	(iii) is a registered behavior technician as defined by the Behavior Analyst Certification 
78.10 	Board or an applied behavior analysis technician as defined by the Qualified Applied 
78.11 	Behavior Analysis Credentialing Board; or
78.12 	(iv) is certified in one of the other treatment modalities recognized by the department; 
78.13 	or
78.14 	(2) a person who has:
78.15 	(i) an associate's degree in a behavioral or child development science or related field 
78.16 	including, but not limited to, mental health, special education, social work, psychology, 
78.17 	speech pathology, or occupational therapy from an accredited college or university; and
78.18 	(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people 
78.19 	with ASD or a related condition. Hours worked as a mental health behavioral aide or level 
78.20 	III treatment provider may be included in the required hours of experience; or
78.21 	(3) a person who has at least 4,000 hours of supervised clinical experience in delivering 
78.22 	treatment to people with ASD or a related condition. Hours worked as a mental health 
78.23 	behavioral aide or level III treatment provider may be included in the required hours of 
78.24 	experience; or
78.25 	(4) a person who is a graduate student in a behavioral science, child development science, 
78.26 	or related field and is receiving clinical supervision by a QSP affiliated with an agency to 
78.27 	meet the clinical training requirements for experience and training with people with ASD 
78.28 	or a related condition; or
78.29 	(5) a person who is at least 18 years of age and who:
78.30 	(i) is fluent in a non-English language or is an individual certified by a Tribal Nation;
78.31 	(ii) completed the level III EIDBI training requirements; and
79.1 	(iii) receives observation and direction from a QSP or level I treatment provider at least 
79.2 	once a week until the person meets 1,000 hours of supervised clinical experience.
79.3 	(d) A level III treatment provider must be employed by an employee of an agency, have 
79.4 	completed the level III training requirement, be at least 18 years of age, and have at least 
79.5 	one of the following:
79.6 	(1) a high school diploma or commissioner of education-selected high school equivalency 
79.7 	certification;
79.8 	(2) fluency in a non-English language or Tribal Nation certification;
79.9 	(3) one year of experience as a primary personal care assistant, community health worker, 
79.10 	waiver service provider, or special education assistant to a person with ASD or a related 
79.11 	condition within the previous five years; or
79.12 	(4) completion of all required EIDBI training within six months of employment.

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

79.14 	Sec. 34. Minnesota Statutes 2024, section 256B.0949, subdivision 16, is amended to read:
79.15 		Subd. 16.Agency duties. (a) An agency delivering an EIDBI service under this section 
79.16 	must:
79.17 	(1) enroll as a medical assistance Minnesota health care program provider according to 
79.18 	Minnesota Rules, part 9505.0195, and section 256B.04, subdivision 21, and meet all 
79.19 	applicable provider standards and requirements;
79.20 	(2) designate an individual as the agency's compliance officer who must perform the 
79.21 	duties described in section 256B.04, subdivision 21, paragraph (g);
79.22 	(3) demonstrate compliance with federal and state laws for the delivery of and billing 
79.23 	for EIDBI service;
79.24 	(3) (4) verify and maintain records of a service provided to the person or the person's 
79.25 	legal representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;
79.26 	(4) (5) demonstrate that while enrolled or seeking enrollment as a Minnesota health care 
79.27 	program provider the agency did not have a lead agency contract or provider agreement 
79.28 	discontinued because of a conviction of fraud; or did not have an owner, board member, or 
79.29 	manager fail a state or federal criminal background check or appear on the list of excluded 
79.30 	individuals or entities maintained by the federal Department of Human Services Office of 
79.31 	Inspector General;
80.1 	(5) (6) have established business practices including written policies and procedures, 
80.2 	internal controls, and a system that demonstrates the organization's ability to deliver quality 
80.3 	EIDBI services, appropriately submit claims, conduct required staff training, document staff 
80.4 	qualifications, document service activities, and document service quality;
80.5 	(6) (7) have an office located in Minnesota or a border state;
80.6 	(7) conduct a criminal background check on an individual who has direct contact with 
80.7 	the person or the person's legal representative (8) initiate a background study as required 
80.8 	under subdivision 16a;
80.9 	(8) (9) report maltreatment according to section 626.557 and chapter 260E;
80.10 	(9) (10) comply with any data requests consistent with the Minnesota Government Data 
80.11 	Practices Act, sections 256B.064 and 256B.27;
80.12 	(10) (11) provide training for all agency staff on the requirements and responsibilities 
80.13 	listed in the Maltreatment of Minors Act, chapter 260E, and the Vulnerable Adult Protection 
80.14 	Act, section 626.557, including mandated and voluntary reporting, nonretaliation, and the 
80.15 	agency's policy for all staff on how to report suspected abuse and neglect;
80.16 	(11) (12) have a written policy to resolve issues collaboratively with the person and the 
80.17 	person's legal representative when possible. The policy must include a timeline for when 
80.18 	the person and the person's legal representative will be notified about issues that arise in 
80.19 	the provision of services;
80.20 	(12) (13) provide the person's legal representative with prompt notification if the person 
80.21 	is injured while being served by the agency. An incident report must be completed by the 
80.22 	agency staff member in charge of the person. A copy of all incident and injury reports must 
80.23 	remain on file at the agency for at least five years from the report of the incident; and
80.24 	(13) (14) before starting a service, provide the person or the person's legal representative 
80.25 	a description of the treatment modality that the person shall receive, including the staffing 
80.26 	certification levels and training of the staff who shall provide a treatment.;
80.27 	(15) provide clinical supervision for a minimum of one hour for every 20 hours of direct 
80.28 	treatment per person; and
80.29 	(16) provide clinical supervision sessions at least once per month for EIDBI intervention 
80.30 	observation and direction. Notwithstanding subdivision 13, paragraph (l), clinical supervision 
80.31 	sessions under this clause may be conducted via telehealth provided:
81.1 	(i) the telehealth clinical supervision session is conducted in tandem with a level I or 
81.2 	level II provider who is in person and not billing for any EIDBI services; and
81.3 	(ii) no more than two consecutive monthly clinical supervision sessions under this clause 
81.4 	are conducted via telehealth.
81.5 	(b) Upon request of the commissioner, an agency delivering services under this section 
81.6 	must:
81.7 	(1) identify the agency's controlling individuals, as defined under section 245A.02, 
81.8 	subdivision 5a;
81.9 	(2) provide disclosures of the use of billing agencies and other consultants; and
81.10 	(3) provide copies of any contracts with independent contractors for qualified supervising 
81.11 	professionals, including hours contracted and responsibilities.
81.12 	(b) (c) When delivering the ITP, and annually thereafter, an agency must provide the 
81.13 	person or the person's legal representative with:
81.14 	(1) a written copy and a verbal explanation of the person's or person's legal 
81.15 	representative's rights and the agency's responsibilities;
81.16 	(2) documentation in the person's file the date that the person or the person's legal 
81.17 	representative received a copy and explanation of the person's or person's legal 
81.18 	representative's rights and the agency's responsibilities; and
81.19 	(3) reasonable accommodations to provide the information in another format or language 
81.20 	as needed to facilitate understanding of the person's or person's legal representative's rights 
81.21 	and the agency's responsibilities.

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

81.23 	Sec. 35. Minnesota Statutes 2024, section 256B.0949, subdivision 16a, is amended to 
81.24 	read:
81.25 		Subd. 16a.Background studies. An early intensive developmental and behavioral 
81.26 	intervention services agency must fulfill any background studies requirements under this 
81.27 	section by initiating a background study through the commissioner's NETStudy 2.0 system 
81.28 	as provided under sections 245C.03, subdivision 15, and 245C.10, subdivision 17. Before 
81.29 	an individual subject to the background study requirements under this subdivision has direct 
81.30 	contact with the person, the agency must have received a notice from the commissioner that 
81.31 	the subject of the background study is:
82.1 	(1) not disqualified under section 245C.14; or
82.2 	(2) disqualified but the subject of the study has received a set-aside of the disqualification 
82.3 	under section 245C.22.

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

82.5 	Sec. 36. Minnesota Statutes 2024, section 256B.0949, is amended by adding a subdivision 
82.6 	to read:
82.7 		Subd. 18.Site visits and sanctions. (a) The commissioner may conduct unannounced 
82.8 	on-site inspections of any and all EIDBI agencies  and service locations to verify that 
82.9 	information submitted to the commissioner is accurate, determine compliance with all 
82.10 	enrollment requirements, investigate reports of maltreatment, determine compliance with 
82.11 	service delivery and billing requirements, and determine compliance with any other applicable 
82.12 	laws or rules.
82.13 	(b) The commissioner may withhold payment from an agency or suspend or terminate 
82.14 	the agency's enrollment number if the agency fails to provide access to the agency's service 
82.15 	locations or records or the commissioner determines the agency has failed to comply fully 
82.16 	with applicable laws or rules. The provider has the right to appeal the decision of the 
82.17 	commissioner under section 256B.064.

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

82.19 	Sec. 37. Minnesota Statutes 2024, section 256B.49, subdivision 12, is amended to read:
82.20 		Subd. 12.Informed choice. Persons who are determined likely to require the level of 
82.21 	care provided in a nursing facility as determined under section 256B.0911, subdivision 26, 
82.22 	or a hospital shall be informed of the home and community-based support alternatives to 
82.23 	the provision of inpatient hospital services or nursing facility services. Each person must 
82.24 	be given the choice of either institutional or home and community-based services using the 
82.25 	provisions described in section 256B.77, subdivision 2, paragraph (p).

82.26 	Sec. 38. Minnesota Statutes 2024, section 256B.49, subdivision 13, is amended to read:
82.27 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
82.28 	shall be provided case management services by qualified vendors as described in the federally 
82.29 	approved waiver application. The case management service activities provided must include:
82.30 	(1) finalizing the person-centered written support plan within the timelines established 
82.31 	by the commissioner and section 256B.0911, subdivision 29;
83.1 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
83.2 	options, including all service options available under the waiver plans;
83.3 	(3) assisting the recipient in the identification of potential service providers of chosen 
83.4 	services, including:
83.5 	(i) available options for case management service and providers;
83.6 	(ii) providers of services provided in a non-disability-specific setting;
83.7 	(iii) employment service providers;
83.8 	(iv) providers of services provided in settings that are not community residential settings; 
83.9 	and
83.10 	(v) providers of financial management services;
83.11 	(4) assisting the recipient to access services and assisting with appeals under section 
83.12 	256.045; and
83.13 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
83.14 	plan.
83.15 	(b) The case manager may delegate certain aspects of the case management service 
83.16 	activities to another individual provided there is oversight by the case manager. The case 
83.17 	manager may not delegate those aspects which require professional judgment including:
83.18 	(1) finalizing the person-centered support plan;
83.19 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
83.20 	approved person-centered support plan; and
83.21 	(3) adjustments to the person-centered support plan.
83.22 	(c) Case management services must be provided by a public or private agency that is 
83.23 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
83.24 	the requirements in the approved federal waiver plans. If a county agency provides case 
83.25 	management under contracts with other individuals or agencies and the county agency 
83.26 	utilizes a competitive proposal process for the procurement of contracted case management 
83.27 	services, the competitive proposal process must include evaluation criteria to ensure that 
83.28 	the county maintains a culturally responsive program for case management services adequate 
83.29 	to meet the needs of the population of the county. For the purposes of this section, "culturally 
83.30 	responsive program" means a case management services program that: (1) ensures effective, 
83.31 	equitable, comprehensive, and respectful quality care services that are responsive to 
83.32 	individuals within a specific population's values, beliefs, practices, health literacy, preferred 
84.1 	language, and other communication needs; and (2) is designed to address the unique needs 
84.2 	of individuals who share a common language or racial, ethnic, or social background.
84.3 	(d) Case management services must not be provided to a recipient by a private agency 
84.4 	that has any financial interest in the provision of any other services included in the recipient's 
84.5 	support plan. For purposes of this section, "private agency" means any agency that is not 
84.6 	identified as a lead agency under section 256B.0911, subdivision 10.
84.7 	(e) For persons who need a positive support transition plan as required in chapter 245D, 
84.8 	the case manager shall participate in the development and ongoing evaluation of the plan 
84.9 	with the expanded support team. At least quarterly, the case manager, in consultation with 
84.10 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
84.11 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
84.12 	identify whether the plan has been developed and implemented in a manner to achieve the 
84.13 	following within the required timelines:
84.14 	(1) phasing out the use of prohibited procedures;
84.15 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
84.16 	timeline; and
84.17 	(3) accomplishment of identified outcomes.
84.18 	If adequate progress is not being made, the case manager shall consult with the person's 
84.19 	expanded support team to identify needed modifications and whether additional professional 
84.20 	support is required to provide consultation.
84.21 	(f) The Department of Human Services shall offer ongoing education in case management 
84.22 	to case managers. Case managers shall receive no less than 20 hours of case management 
84.23 	education and disability-related training each year. The education and training must include 
84.24 	appropriate service authorization under the community access for disability inclusion waiver, 
84.25 	person-centered planning, informed choice, cultural competency, employment planning, 
84.26 	community living planning, self-direction options, and use of technology supports. By 
84.27 	August 1, 2024, all case managers must complete an employment support training course 
84.28 	identified by the commissioner of human services. For case managers hired after August 
84.29 	1, 2024, this training must be completed within the first six months of providing case 
84.30 	management services. For the purposes of this section, "person-centered planning" or 
84.31 	"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case 
84.32 	managers shall document completion of training in a system identified by the commissioner.

85.1 	Sec. 39. Minnesota Statutes 2024, section 256B.4914, subdivision 3, is amended to read:
85.2 		Subd. 3.Applicable services. (a) Applicable services are those authorized under the 
85.3 	state's home and community-based services waivers under sections 256B.092 and 256B.49, 
85.4 	including the following, as defined in the federally approved home and community-based 
85.5 	services plan:
85.6 	(1) 24-hour customized living;
85.7 	(2) adult day services;
85.8 	(3) adult day services bath;
85.9 	(4) community residential services;
85.10 	(5) customized living;
85.11 	(6) day support services;
85.12 	(7) employment development services;
85.13 	(8) employment exploration services;
85.14 	(9) employment support services;
85.15 	(10) family residential services;
85.16 	(11) individualized home supports;
85.17 	(12) individualized home supports with family training;
85.18 	(13) individualized home supports with training;
85.19 	(14) integrated community supports;
85.20 	(15) life sharing;
85.21 	(16) effective until the effective date of clauses (17) and (18), night supervision;
85.22 	(17) effective January 1, 2026, or upon federal approval, whichever is later, awake night 
85.23 	supervision;
85.24 	(18) effective January 1, 2026, or upon federal approval, whichever is later, asleep night 
85.25 	supervision;
85.26 	(17) (19) positive support services;
85.27 	(18) (20) prevocational services;
85.28 	(19) (21) residential support services;
86.1 	(20) respite services;
86.2 	(21) (22) transportation services; and
86.3 	(22) (23) other services as approved by the federal government in the state home and 
86.4 	community-based services waiver plan.
86.5 	(b) Effective January 1, 2024, or upon federal approval, whichever is later, respite 
86.6 	services under paragraph (a), clause (20), are not an applicable service under this section.

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

86.8 	Sec. 40. Minnesota Statutes 2024, section 256B.4914, subdivision 5, is amended to read:
86.9 		Subd. 5.Base wage index; establishment and updates. (a) The base wage index is 
86.10 	established to determine staffing costs associated with providing services to individuals 
86.11 	receiving home and community-based services. For purposes of calculating the base wage, 
86.12 	Minnesota-specific wages taken from job descriptions and standard occupational 
86.13 	classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational 
86.14 	Handbook must be used.
86.15 	(b) The commissioner shall update the base wage index in subdivision 5a, publish these 
86.16 	updated values, and load them into the rate management system as follows: on January 1, 
86.17 	2030, and every two years thereafter, based on wage data by SOC from the Bureau of Labor 
86.18 	Statistics published in the spring approximately 21 months prior to the scheduled update.
86.19 	(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics 
86.20 	available as of December 31, 2019;
86.21 	(2) on January 1, 2024, based on wage data by SOC from the Bureau of Labor Statistics 
86.22 	published in March 2022; and
86.23 	(3) on January 1, 2026, and every two years thereafter, based on wage data by SOC from 
86.24 	the Bureau of Labor Statistics published in the spring approximately 21 months prior to the 
86.25 	scheduled update.

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

86.29 	Sec. 41. Minnesota Statutes 2024, section 256B.4914, subdivision 5a, is amended to read:
86.30 		Subd. 5a.Base wage index; calculations. The base wage index must be calculated as 
86.31 	follows:
87.1 	(1) for supervisory staff, 100 percent of the median wage for community and social 
87.2 	services specialist (SOC code 21-1099), with the exception of the supervisor of positive 
87.3 	supports professional, positive supports analyst, and positive supports specialist, which is 
87.4 	100 percent of the median wage for clinical counseling and school psychologist (SOC code 
87.5 	19-3031);
87.6 	(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC 
87.7 	code 29-1141);
87.8 	(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical 
87.9 	nurses (SOC code 29-2061);
87.10 	(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large 
87.11 	employers;
87.12 	(5) for residential direct care staff, the sum of:
87.13 	(i) 15 percent of the subtotal of 50 percent of the median wage for home health and 
87.14 	personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant 
87.15 	(SOC code 31-1131); and 20 percent of the median wage for social and human services 
87.16 	aide (SOC code 21-1093); and
87.17 	(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and 
87.18 	personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant 
87.19 	(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code 
87.20 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
87.21 	21-1093);
87.22 	(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC 
87.23 	code 31-1131); and 30 percent of the median wage for home health and personal care aide 
87.24 	(SOC code 31-1120);
87.25 	(7) for day support services staff and prevocational services staff, 20 percent of the 
87.26 	median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for 
87.27 	psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social 
87.28 	and human services aide (SOC code 21-1093);
87.29 	(8) for positive supports analyst staff, 100 percent of the median wage for substance 
87.30 	abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);
87.31 	(9) for positive supports professional staff, 100 percent of the median wage for clinical 
87.32 	counseling and school psychologist (SOC code 19-3031);
88.1 	(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric 
88.2 	technicians (SOC code 29-2053);
88.3 	(11) for individualized home supports with family training staff, 20 percent of the median 
88.4 	wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community 
88.5 	social service specialist (SOC code 21-1099); 40 percent of the median wage for social and 
88.6 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
88.7 	technician (SOC code 29-2053);
88.8 	(12) for individualized home supports with training services staff, 40 percent of the 
88.9 	median wage for community social service specialist (SOC code 21-1099); 50 percent of 
88.10 	the median wage for social and human services aide (SOC code 21-1093); and ten percent 
88.11 	of the median wage for psychiatric technician (SOC code 29-2053);
88.12 	(13) for employment support services staff, 50 percent of the median wage for 
88.13 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
88.14 	community and social services specialist (SOC code 21-1099);
88.15 	(14) for employment exploration services staff, 50 percent of the median wage for 
88.16 	education, guidance, school, and vocational counselor (SOC code 21-1012); and 50 percent 
88.17 	of the median wage for community and social services specialist (SOC code 21-1099);
88.18 	(15) for employment development services staff, 50 percent of the median wage for 
88.19 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
88.20 	of the median wage for community and social services specialist (SOC code 21-1099);
88.21 	(16) for individualized home support without training staff, 50 percent of the median 
88.22 	wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the 
88.23 	median wage for nursing assistant (SOC code 31-1131); and
88.24 	(17) effective until the effective date of clauses (18) and (19), for night supervision staff, 
88.25 	40 percent of the median wage for home health and personal care aide (SOC code 31-1120); 
88.26 	20 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent of the 
88.27 	median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median 
88.28 	wage for social and human services aide (SOC code 21-1093).;
88.29 	(18) effective January 1, 2026, or upon federal approval, whichever is later, for awake 
88.30 	night supervision staff, 40 percent of the median wage for home health and personal care 
88.31 	aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code 
88.32 	31-1131); 20 percent the median wage for psychiatric technician (SOC code 29-2053); and 
88.33 	20 percent of the median wage for social and human services aid (SOC code 21-1093); and
89.1 	(19) effective January 1, 2026, or upon federal approval, whichever is later, for asleep 
89.2 	night supervision staff, the minimum wage in Minnesota for large employers.

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

89.4 	Sec. 42. Minnesota Statutes 2024, section 256B.4914, subdivision 5b, is amended to read:
89.5 		Subd. 5b.Standard component value adjustments. (a) The commissioner shall update 
89.6 	the client and programming support, transportation, and program facility cost component 
89.7 	values as required in subdivisions 6 to 9 and the rates identified in subdivision 19 for changes 
89.8 	in the Consumer Price Index. The commissioner shall adjust these values higher or lower, 
89.9 	publish these updated values, and load them into the rate management system as follows:
89.10 	(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the 
89.11 	previous update to the data available on December 31, 2019;
89.12 	(2) on January 1, 2024, by the percentage change in the CPI-U from the date of the 
89.13 	previous update to the data available as of December 31, 2022; and
89.14 	(3) on January 1, 2026, and every two years thereafter, by the percentage change in the 
89.15 	CPI-U from the date of the previous update to the data available 24 months and one day 
89.16 	prior to the scheduled update.
89.17 	(b) The commissioner shall update the base wage index under subdivision 5a for changes 
89.18 	in the Consumer Price Index. The commissioner shall adjust these values higher or lower, 
89.19 	publish these updated values, and load them into the rate management system on January 
89.20 	1, 2026, and January 1, 2028, by the percentage change in the CPI-U from the date of the 
89.21 	previous update to the data available 24 months and one day prior to the scheduled update. 
89.22 	This paragraph expires December 31, 2029.

89.23 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
89.24 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
89.25 	approval is obtained.

89.26 	Sec. 43. Minnesota Statutes 2024, section 256B.4914, subdivision 6a, is amended to read:
89.27 		Subd. 6a.Community residential services; component values and calculation of 
89.28 	payment rates. (a) Component values for community residential services are:
89.29 	(1) competitive workforce factor: 6.7 percent;
89.30 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
90.1 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
90.2 	This item expires upon the effective date of item (iii);
90.3 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
90.4 	This item expires upon the effective date of item (iv); and
90.5 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
90.6 	(2) supervisory span of control ratio: 11 percent;
90.7 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
90.8 	(4) employee-related cost ratio: 23.6 percent;
90.9 	(5) general administrative support ratio: 13.25 percent;
90.10 	(6) program-related expense ratio: 1.3 percent; and
90.11 	(7) absence and utilization factor ratio: 3.9 percent.
90.12 	(b) Payments for community residential services must be calculated as follows:
90.13 	(1) determine the number of shared direct staffing and individual direct staffing hours 
90.14 	to meet a recipient's needs provided on site or through monitoring technology;
90.15 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
90.16 	provided in subdivisions 5 and 5a;
90.17 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
90.18 	product of one plus the competitive workforce factor;
90.19 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
90.20 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
90.21 	to the result of clause (3);
90.22 	(5) multiply the number of shared direct staffing and individual direct staffing hours 
90.23 	provided on site or through monitoring technology and nursing hours by the appropriate 
90.24 	staff wages;
90.25 	(6) multiply the number of shared direct staffing and individual direct staffing hours 
90.26 	provided on site or through monitoring technology and nursing hours by the product of the 
90.27 	supervision span of control ratio and the appropriate supervisory staff wage in subdivision 
90.28 	5a, clause (1);
90.29 	(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and 
90.30 	individual direct staffing hours provided through monitoring technology, and multiply the 
91.1 	result by one plus the employee vacation, sick, and training allowance ratio. This is defined 
91.2 	as the direct staffing cost;
91.3 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
91.4 	direct staffing and individual hours provided through monitoring technology, by one plus 
91.5 	the employee-related cost ratio;
91.6 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
91.7 	commissioner shall update the amount in this clause as specified in subdivision 5b;
91.8 	(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided 
91.9 	by 365 if customized for adapted transport, based on the resident with the highest assessed 
91.10 	need. The commissioner shall update the amounts in this clause as specified in subdivision 
91.11 	5b;
91.12 	(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing 
91.13 	and individual direct staffing hours provided through monitoring technology that was 
91.14 	excluded in clause (8);
91.15 	(12) sum the standard general administrative support ratio, the program-related expense 
91.16 	ratio, and the absence and utilization factor ratio;
91.17 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
91.18 	total payment amount; and
91.19 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
91.20 	to adjust for regional differences in the cost of providing services.

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

91.22 	Sec. 44. Minnesota Statutes 2024, section 256B.4914, subdivision 6b, is amended to read:
91.23 		Subd. 6b.Family residential services; component values and calculation of payment 
91.24 	rates. (a) Component values for family residential services are:
91.25 	(1) competitive workforce factor: 6.7 percent;
91.26 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
91.27 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
91.28 	This item expires upon the effective date of item (iii);
91.29 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
91.30 	This item expires upon the effective date of item (iv); and
91.31 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
92.1 	(2) supervisory span of control ratio: 11 percent;
92.2 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
92.3 	(4) employee-related cost ratio: 23.6 percent;
92.4 	(5) general administrative support ratio: 3.3 percent;
92.5 	(6) program-related expense ratio: 1.3 percent; and
92.6 	(7) absence factor: 1.7 percent.
92.7 	(b) Payments for family residential services must be calculated as follows:
92.8 	(1) determine the number of shared direct staffing and individual direct staffing hours 
92.9 	to meet a recipient's needs provided on site or through monitoring technology;
92.10 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
92.11 	provided in subdivisions 5 and 5a;
92.12 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
92.13 	product of one plus the competitive workforce factor;
92.14 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
92.15 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
92.16 	to the result of clause (3);
92.17 	(5) multiply the number of shared direct staffing and individual direct staffing hours 
92.18 	provided on site or through monitoring technology and nursing hours by the appropriate 
92.19 	staff wages;
92.20 	(6) multiply the number of shared direct staffing and individual direct staffing hours 
92.21 	provided on site or through monitoring technology and nursing hours by the product of the 
92.22 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
92.23 	5a, clause (1);
92.24 	(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and 
92.25 	individual direct staffing hours provided through monitoring technology, and multiply the 
92.26 	result by one plus the employee vacation, sick, and training allowance ratio. This is defined 
92.27 	as the direct staffing cost;
92.28 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
92.29 	and individual direct staffing hours provided through monitoring technology, by one plus 
92.30 	the employee-related cost ratio;
93.1 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
93.2 	commissioner shall update the amount in this clause as specified in subdivision 5b;
93.3 	(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided 
93.4 	by 365 if customized for adapted transport, based on the resident with the highest assessed 
93.5 	need. The commissioner shall update the amounts in this clause as specified in subdivision 
93.6 	5b;
93.7 	(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing 
93.8 	and individual direct staffing hours provided through monitoring technology that was 
93.9 	excluded in clause (8);
93.10 	(12) sum the standard general administrative support ratio, the program-related expense 
93.11 	ratio, and the absence and utilization factor ratio;
93.12 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
93.13 	total payment rate; and
93.14 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
93.15 	to adjust for regional differences in the cost of providing services.

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

93.17 	Sec. 45. Minnesota Statutes 2024, section 256B.4914, subdivision 6c, is amended to read:
93.18 		Subd. 6c.Integrated community supports; component values and calculation of 
93.19 	payment rates.  (a) Component values for integrated community supports are:
93.20 	(1) competitive workforce factor: 6.7 percent;
93.21 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
93.22 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
93.23 	This item expires upon the effective date of item (iii);
93.24 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
93.25 	This item expires upon the effective date of item (iv); and
93.26 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
93.27 	(2) supervisory span of control ratio: 11 percent;
93.28 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
93.29 	(4) employee-related cost ratio: 23.6 percent;
93.30 	(5) general administrative support ratio: 13.25 percent;
94.1 	(6) program-related expense ratio: 1.3 percent; and
94.2 	(7) absence and utilization factor ratio: 3.9 percent.
94.3 	(b) Payments for integrated community supports must be calculated as follows:
94.4 	(1) determine the number of shared direct staffing and individual direct staffing hours 
94.5 	to meet a recipient's needs. The base shared direct staffing hours must be eight hours divided 
94.6 	by the number of people receiving support in the integrated community support setting, and 
94.7 	the individual direct staffing hours must be the average number of direct support hours 
94.8 	provided directly to the service recipient;
94.9 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
94.10 	provided in subdivisions 5 and 5a;
94.11 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
94.12 	product of one plus the competitive workforce factor;
94.13 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
94.14 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
94.15 	to the result of clause (3);
94.16 	(5) multiply the number of shared direct staffing and individual direct staffing hours in 
94.17 	clause (1) by the appropriate staff wages;
94.18 	(6) multiply the number of shared direct staffing and individual direct staffing hours in 
94.19 	clause (1) by the product of the supervisory span of control ratio and the appropriate 
94.20 	supervisory staff wage in subdivision 5a, clause (1);
94.21 	(7) combine the results of clauses (5) and (6) and multiply the result by one plus the 
94.22 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
94.23 	cost;
94.24 	(8) for employee-related expenses, multiply the direct staffing cost by one plus the 
94.25 	employee-related cost ratio;
94.26 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
94.27 	commissioner shall update the amount in this clause as specified in subdivision 5b;
94.28 	(10) add the results of clauses (8) and (9);
94.29 	(11) add the standard general administrative support ratio, the program-related expense 
94.30 	ratio, and the absence and utilization factor ratio;
95.1 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
95.2 	total payment amount; and
95.3 	(13) adjust the result of clause (12) by a factor to be determined by the commissioner 
95.4 	to adjust for regional differences in the cost of providing services.

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

95.6 	Sec. 46. Minnesota Statutes 2024, section 256B.4914, subdivision 7a, is amended to read:
95.7 		Subd. 7a.Adult day services; component values and calculation of payment rates. (a) 
95.8 	Component values for adult day services are:
95.9 	(1) competitive workforce factor: 6.7 percent;
95.10 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
95.11 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
95.12 	This item expires upon the effective date of item (iii);
95.13 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
95.14 	This item expires upon the effective date of item (iv); and
95.15 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
95.16 	(2) supervisory span of control ratio: 11 percent;
95.17 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
95.18 	(4) employee-related cost ratio: 23.6 percent;
95.19 	(5) program plan support ratio: 5.6 percent;
95.20 	(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision 
95.21 	5b;
95.22 	(7) general administrative support ratio: 13.25 percent;
95.23 	(8) program-related expense ratio: 1.8 percent; and
95.24 	(9) absence and utilization factor ratio: 9.4 percent.
95.25 	(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of 
95.26 	service is six or more hours of time spent providing direct service.
95.27 	(c) Payments for adult day services must be calculated as follows:
95.28 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
95.29 	needs;
96.1 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
96.2 	provided in subdivisions 5 and 5a;
96.3 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
96.4 	product of one plus the competitive workforce factor;
96.5 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
96.6 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
96.7 	to the result of clause (3);
96.8 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
96.9 	appropriate staff wage;
96.10 	(6) multiply the number of day program direct staffing hours by the product of the 
96.11 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
96.12 	5a, clause (1);
96.13 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
96.14 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
96.15 	rate;
96.16 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
96.17 	plan support ratio;
96.18 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
96.19 	employee-related cost ratio;
96.20 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
96.21 	the client programming and support ratio;
96.22 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
96.23 	to meet individual needs, updated as specified in subdivision 5b;
96.24 	(12) for adult day bath services, add $7.01 per 15 minute unit;
96.25 	(13) this is the subtotal rate;
96.26 	(14) sum the standard general administrative rate support ratio, the program-related 
96.27 	expense ratio, and the absence and utilization factor ratio;
96.28 	(15) divide the result of clause (13) by one minus the result of clause (14). This is the 
96.29 	total payment amount; and
96.30 	(16) adjust the result of clause (15) by a factor to be determined by the commissioner 
96.31 	to adjust for regional differences in the cost of providing services.

97.1 	EFFECTIVE DATE. The amendments to paragraph (a), clause (1), are effective the 
97.2 	day following final enactment.

97.3 	Sec. 47. Minnesota Statutes 2024, section 256B.4914, subdivision 7b, is amended to read:
97.4 		Subd. 7b.Day support services; component values and calculation of payment 
97.5 	rates. (a) Component values for day support services are:
97.6 	(1) competitive workforce factor: 6.7 percent;
97.7 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
97.8 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
97.9 	This item expires upon the effective date of item (iii);
97.10 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
97.11 	This item expires upon the effective date of item (iv); and
97.12 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
97.13 	(2) supervisory span of control ratio: 11 percent;
97.14 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
97.15 	(4) employee-related cost ratio: 23.6 percent;
97.16 	(5) program plan support ratio: 5.6 percent;
97.17 	(6) client programming and support ratio: 10.37 percent, updated as specified in 
97.18 	subdivision 5b;
97.19 	(7) general administrative support ratio: 13.25 percent;
97.20 	(8) program-related expense ratio: 1.8 percent; and
97.21 	(9) absence and utilization factor ratio: 9.4 percent.
97.22 	(b) A unit of service for day support services is 15 minutes.
97.23 	(c) Payments for day support services must be calculated as follows:
97.24 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
97.25 	needs;
97.26 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
97.27 	provided in subdivisions 5 and 5a;
97.28 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
97.29 	product of one plus the competitive workforce factor;
98.1 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
98.2 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
98.3 	to the result of clause (3);
98.4 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
98.5 	appropriate staff wage;
98.6 	(6) multiply the number of day program direct staffing hours by the product of the 
98.7 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
98.8 	5a, clause (1);
98.9 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
98.10 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
98.11 	rate;
98.12 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
98.13 	plan support ratio;
98.14 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
98.15 	employee-related cost ratio;
98.16 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
98.17 	the client programming and support ratio;
98.18 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
98.19 	to meet individual needs, updated as specified in subdivision 5b;
98.20 	(12) this is the subtotal rate;
98.21 	(13) sum the standard general administrative rate support ratio, the program-related 
98.22 	expense ratio, and the absence and utilization factor ratio;
98.23 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
98.24 	total payment amount; and
98.25 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
98.26 	to adjust for regional differences in the cost of providing services.

98.27 	EFFECTIVE DATE. The amendments to paragraph (a), clause (1), are effective the 
98.28 	day following final enactment.

98.29 	Sec. 48. Minnesota Statutes 2024, section 256B.4914, subdivision 7c, is amended to read:
98.30 		Subd. 7c.Prevocational services; component values and calculation of payment 
98.31 	rates. (a) Component values for prevocational services are:
99.1 	(1) competitive workforce factor: 6.7 percent;
99.2 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
99.3 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
99.4 	This item expires upon the effective date of item (iii);
99.5 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
99.6 	This item expires upon the effective date of item (iv); and
99.7 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
99.8 	(2) supervisory span of control ratio: 11 percent;
99.9 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
99.10 	(4) employee-related cost ratio: 23.6 percent;
99.11 	(5) program plan support ratio: 5.6 percent;
99.12 	(6) client programming and support ratio: 10.37 percent, updated as specified in 
99.13 	subdivision 5b;
99.14 	(7) general administrative support ratio: 13.25 percent;
99.15 	(8) program-related expense ratio: 1.8 percent; and
99.16 	(9) absence and utilization factor ratio: 9.4 percent.
99.17 	(b) A unit of service for prevocational services is either a day or 15 minutes. A day unit 
99.18 	of service is six or more hours of time spent providing direct service.
99.19 	(c) Payments for prevocational services must be calculated as follows:
99.20 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
99.21 	needs;
99.22 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
99.23 	provided in subdivisions 5 and 5a;
99.24 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
99.25 	product of one plus the competitive workforce factor;
99.26 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
99.27 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
99.28 	to the result of clause (3);
99.29 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
99.30 	appropriate staff wage;
100.1 	(6) multiply the number of day program direct staffing hours by the product of the 
100.2 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
100.3 	5a, clause (1);
100.4 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
100.5 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
100.6 	rate;
100.7 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
100.8 	plan support ratio;
100.9 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
100.10 	employee-related cost ratio;
100.11 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
100.12 	the client programming and support ratio;
100.13 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
100.14 	to meet individual needs, updated as specified in subdivision 5b;
100.15 	(12) this is the subtotal rate;
100.16 	(13) sum the standard general administrative rate support ratio, the program-related 
100.17 	expense ratio, and the absence and utilization factor ratio;
100.18 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
100.19 	total payment amount; and
100.20 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
100.21 	to adjust for regional differences in the cost of providing services.

100.22 	EFFECTIVE DATE. The amendments to paragraph (a), clause (1), are effective the 
100.23 	day following final enactment.

100.24 	Sec. 49. Minnesota Statutes 2024, section 256B.4914, subdivision 8, is amended to read:
100.25 		Subd. 8. Unit-based services with programming; component values and calculation 
100.26 	of payment rates. (a) For the purpose of this section, unit-based services with programming 
100.27 	include employment exploration services, employment development services, employment 
100.28 	support services, individualized home supports with family training, individualized home 
100.29 	supports with training, and positive support services provided to an individual outside of 
100.30 	any service plan for a day program or residential support service.
100.31 	(b) Component values for unit-based services with programming are:
101.1 	(1) competitive workforce factor: 6.7 percent;
101.2 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
101.3 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
101.4 	This item expires upon the effective date of item (iii);
101.5 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
101.6 	This item expires upon the effective date of item (iv); and
101.7 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
101.8 	(2) supervisory span of control ratio: 11 percent;
101.9 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
101.10 	(4) employee-related cost ratio: 23.6 percent;
101.11 	(5) program plan support ratio: 15.5 percent;
101.12 	(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision 
101.13 	5b;
101.14 	(7) general administrative support ratio: 13.25 percent;
101.15 	(8) program-related expense ratio: 6.1 percent; and
101.16 	(9) absence and utilization factor ratio: 3.9 percent.
101.17 	(c) A unit of service for unit-based services with programming is 15 minutes.
101.18 	(d) Payments for unit-based services with programming must be calculated as follows, 
101.19 	unless the services are reimbursed separately as part of a residential support services or day 
101.20 	program payment rate:
101.21 	(1) determine the number of units of service to meet a recipient's needs;
101.22 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
101.23 	provided in subdivisions 5 and 5a;
101.24 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
101.25 	product of one plus the competitive workforce factor;
101.26 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
101.27 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
101.28 	to the result of clause (3);
101.29 	(5) multiply the number of direct staffing hours by the appropriate staff wage;
102.1 	(6) multiply the number of direct staffing hours by the product of the supervisory span 
102.2 	of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
102.3 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
102.4 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
102.5 	rate;
102.6 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
102.7 	plan support ratio;
102.8 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
102.9 	employee-related cost ratio;
102.10 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
102.11 	the client programming and support ratio;
102.12 	(11) this is the subtotal rate;
102.13 	(12) sum the standard general administrative support ratio, the program-related expense 
102.14 	ratio, and the absence and utilization factor ratio;
102.15 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
102.16 	total payment amount;
102.17 	(14) for services provided in a shared manner, divide the total payment in clause (13) 
102.18 	as follows:
102.19 	(i) for employment exploration services, divide by the number of service recipients, not 
102.20 	to exceed five;
102.21 	(ii) for employment support services, divide by the number of service recipients, not to 
102.22 	exceed six;
102.23 	(iii) for individualized home supports with training and individualized home supports 
102.24 	with family training, divide by the number of service recipients, not to exceed three; and
102.25 	(iv) for night supervision, divide by the number of service recipients, not to exceed two; 
102.26 	and
102.27 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
102.28 	to adjust for regional differences in the cost of providing services.
102.29 	(e) Effective January 1, 2026, or upon federal approval, whichever is later, providers 
102.30 	must not bill more than nine hours per day for individualized home supports with training 
103.1 	and individualized home supports with family training. This maximum does not limit a 
103.2 	person's use of other disability waiver services.

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

103.4 	Sec. 50. Minnesota Statutes 2024, section 256B.4914, subdivision 9, is amended to read:
103.5 		Subd. 9. Unit-based services without programming; component values and 
103.6 	calculation of payment rates. (a) For the purposes of this section, unit-based services 
103.7 	without programming include individualized home supports without training and night 
103.8 	supervision provided to an individual outside of any service plan for a day program or 
103.9 	residential support service. Unit-based services without programming do not include respite.
103.10 	This paragraph expires upon the effective date of paragraph (b).
103.11 	(b) Effective January 1, 2026, or upon federal approval, whichever is later, for the 
103.12 	purposes of this section, unit-based services without programming include individualized 
103.13 	home supports without training, awake night supervision, and asleep night supervision 
103.14 	provided to an individual outside of any service plan for a day program or residential support 
103.15 	service.
103.16 	(b) (c) Component values for unit-based services without programming are:
103.17 	(1) competitive workforce factor: 6.7 percent;
103.18 	(i) 6.7 percent. This item expires upon the effective date of item (ii);
103.19 	(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent. 
103.20 	This item expires upon the effective date of item (iii);
103.21 	(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent. 
103.22 	This item expires upon the effective date of item (iv); and
103.23 	(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
103.24 	(2) supervisory span of control ratio: 11 percent;
103.25 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
103.26 	(4) employee-related cost ratio: 23.6 percent;
103.27 	(5) program plan support ratio: 7.0 percent;
103.28 	(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision 
103.29 	5b;
103.30 	(7) general administrative support ratio: 13.25 percent;
104.1 	(8) program-related expense ratio: 2.9 percent; and
104.2 	(9) absence and utilization factor ratio: 3.9 percent.
104.3 	(c) (d) A unit of service for unit-based services without programming is 15 minutes.
104.4 	(d) (e) Payments for unit-based services without programming must be calculated as 
104.5 	follows unless the services are reimbursed separately as part of a residential support services 
104.6 	or day program payment rate:
104.7 	(1) determine the number of units of service to meet a recipient's needs;
104.8 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
104.9 	provided in subdivisions 5 to 5a;
104.10 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
104.11 	product of one plus the competitive workforce factor;
104.12 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
104.13 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
104.14 	to the result of clause (3);
104.15 	(5) multiply the number of direct staffing hours by the appropriate staff wage;
104.16 	(6) multiply the number of direct staffing hours by the product of the supervisory span 
104.17 	of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
104.18 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
104.19 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
104.20 	rate;
104.21 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
104.22 	plan support ratio;
104.23 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
104.24 	employee-related cost ratio;
104.25 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
104.26 	the client programming and support ratio;
104.27 	(11) this is the subtotal rate;
104.28 	(12) sum the standard general administrative support ratio, the program-related expense 
104.29 	ratio, and the absence and utilization factor ratio;
104.30 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
104.31 	total payment amount;
105.1 	(14) for individualized home supports without training provided in a shared manner, 
105.2 	divide the total payment amount in clause (13) by the number of service recipients, not to 
105.3 	exceed three; and
105.4 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
105.5 	to adjust for regional differences in the cost of providing services.

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

105.7 	Sec. 51. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision 
105.8 	to read:
105.9 		Subd. 14a.Limitations on rate exceptions for residential services. (a) Effective July 
105.10 	1, 2026, the commissioner must implement limitations on the size and number of rate 
105.11 	exceptions for community residential services, customized living services, family residential 
105.12 	services, and integrated community supports.
105.13 	(b) The commissioner must restrict rate exceptions to the absence and utilization factor 
105.14 	ratio to people temporarily receiving hospital or crisis respite services.
105.15 	(c) For rate exceptions related to behavioral needs, the commissioner must include:
105.16 	(1) a documented behavioral diagnosis; or
105.17 	(2) determined assessed needs for behavioral supports as identified in the person's most 
105.18 	recent assessment.
105.19 	(d) Community residential services rate exceptions must not include positive supports 
105.20 	costs.
105.21 	(e) The commissioner must not approve rate exception requests related to increased 
105.22 	community time or transportation.
105.23 	(f) For the commissioner to approve a rate exception annual renewal, the person's most 
105.24 	recent assessment must indicate continued extraordinary needs in the areas cited in the 
105.25 	exception request. If a person's assessment continues to identify these extraordinary needs, 
105.26 	lead agencies requesting an annual renewal of rate exceptions must submit provider-created 
105.27 	documentation supporting the continuation of the exception, including but not limited to:
105.28 	(1) payroll records for direct care wages cited in the request;
105.29 	(2) payment records or receipts for other costs cited in the request; and
105.30 	(3) documentation of expenses paid that were identified as necessary for the initial rate 
105.31 	exception.
106.1 	(g) The commissioner must not increase rate exception annual renewals that request an 
106.2 	exception to direct care or supervision wages more than the most recently implemented 
106.3 	base wage index determined under subdivision 5.
106.4 	(h) The commissioner must publish online an annual report detailing the impact of the 
106.5 	limitations under this subdivision on home and community-based services spending, including 
106.6 	but not limited to:
106.7 	(1) the number and percentage of rate exceptions granted and denied;
106.8 	(2) total spending on community residential setting services and rate exceptions;
106.9 	(3) trends in the percentage of spending attributable to rate exceptions; and
106.10 	(4) an evaluation of the effectiveness of the limitations in controlling spending growth.

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

106.14 	Sec. 52. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision 
106.15 	to read:
106.16 		Subd. 20.Sanctions and monetary recovery. Payments under this section are subject 
106.17 	to the sanctions and monetary recovery requirements under section 256B.064.

106.18 	Sec. 53. Minnesota Statutes 2024, section 256B.85, subdivision 2, is amended to read:
106.19 		Subd. 2.Definitions. (a) For the purposes of this section and section 256B.851, the terms 
106.20 	defined in this subdivision have the meanings given.
106.21 	(b) "Activities of daily living" or "ADLs" means:
106.22 	(1) dressing, including assistance with choosing, applying, and changing clothing and 
106.23 	applying special appliances, wraps, or clothing;
106.24 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
106.25 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail 
106.26 	care, except for recipients who are diabetic or have poor circulation;
106.27 	(3) bathing, including assistance with basic personal hygiene and skin care;
106.28 	(4) eating, including assistance with hand washing and applying orthotics required for 
106.29 	eating or feeding;
107.1 	(5) transfers, including assistance with transferring the participant from one seating or 
107.2 	reclining area to another;
107.3 	(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility 
107.4 	does not include providing transportation for a participant;
107.5 	(7) positioning, including assistance with positioning or turning a participant for necessary 
107.6 	care and comfort; and
107.7 	(8) toileting, including assistance with bowel or bladder elimination and care, transfers, 
107.8 	mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing 
107.9 	the perineal area, inspection of the skin, and adjusting clothing.
107.10 	(c) "Agency-provider model" means a method of CFSS under which a qualified agency 
107.11 	provides services and supports through the agency's own employees and policies. The agency 
107.12 	must allow the participant to have a significant role in the selection and dismissal of support 
107.13 	workers of their choice for the delivery of their specific services and supports.
107.14 	(d) "Behavior" means a description of a need for services and supports used to determine 
107.15 	the home care rating and additional service units. The presence of Level I behavior is used 
107.16 	to determine the home care rating.
107.17 	(e) "Budget model" means a service delivery method of CFSS that allows the use of a 
107.18 	service budget and assistance from a financial management services (FMS) provider for a 
107.19 	participant to directly employ support workers and purchase supports and goods.
107.20 	(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that 
107.21 	has been ordered by a physician, advanced practice registered nurse, or physician's assistant 
107.22 	and is specified in an assessment summary, including:
107.23 	(1) tube feedings requiring:
107.24 	(i) a gastrojejunostomy tube; or
107.25 	(ii) continuous tube feeding lasting longer than 12 hours per day;
107.26 	(2) wounds described as:
107.27 	(i) stage III or stage IV;
107.28 	(ii) multiple wounds;
107.29 	(iii) requiring sterile or clean dressing changes or a wound vac; or
107.30 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
107.31 	care;
108.1 	(3) parenteral therapy described as:
108.2 	(i) IV therapy more than two times per week lasting longer than four hours for each 
108.3 	treatment; or
108.4 	(ii) total parenteral nutrition (TPN) daily;
108.5 	(4) respiratory interventions, including:
108.6 	(i) oxygen required more than eight hours per day;
108.7 	(ii) respiratory vest more than one time per day;
108.8 	(iii) bronchial drainage treatments more than two times per day;
108.9 	(iv) sterile or clean suctioning more than six times per day;
108.10 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
108.11 	as BiPAP and CPAP; and
108.12 	(vi) ventilator dependence under section 256B.0651;
108.13 	(5) insertion and maintenance of catheter, including:
108.14 	(i) sterile catheter changes more than one time per month;
108.15 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
108.16 	times per day; or
108.17 	(iii) bladder irrigations;
108.18 	(6) bowel program more than two times per week requiring more than 30 minutes to 
108.19 	perform each time;
108.20 	(7) neurological intervention, including:
108.21 	(i) seizures more than two times per week and requiring significant physical assistance 
108.22 	to maintain safety; or
108.23 	(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse, 
108.24 	or physician's assistant and requiring specialized assistance from another on a daily basis; 
108.25 	and
108.26 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
108.27 	hands-on assistance and interventions in six to eight activities of daily living.
108.28 	(g) "Community first services and supports" or "CFSS" means the assistance and supports 
108.29 	program under this section needed for accomplishing activities of daily living, instrumental 
108.30 	activities of daily living, and health-related tasks through hands-on assistance to accomplish 
109.1 	the task or constant supervision and cueing to accomplish the task, or the purchase of goods 
109.2 	as defined in subdivision 7, clause (3), that replace the need for human assistance.
109.3 	(h) "Community first services and supports service delivery plan" or "CFSS service 
109.4 	delivery plan" means a written document detailing the services and supports chosen by the 
109.5 	participant to meet assessed needs that are within the approved CFSS service authorization, 
109.6 	as determined in subdivision 8. Services and supports are based on the support plan identified 
109.7 	in sections 256B.092, subdivision 1b, and 256S.10.
109.8 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
109.9 	organization that provides assistance to the assisting a participant in making informed 
109.10 	choices about CFSS services in general and self-directed tasks in particular, and in developing 
109.11 	a person-centered CFSS service delivery plan to achieve quality service outcomes.
109.12 	(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
109.13 	(k) "Dependency" in activities of daily living means a person requires hands-on assistance 
109.14 	or constant supervision and cueing to accomplish one or more of the activities of daily living 
109.15 	every day or on the days during the week that the activity is performed; however, a child 
109.16 	must not be found to be dependent in an activity of daily living if, because of the child's 
109.17 	age, an adult would either perform the activity for the child or assist the child with the 
109.18 	activity and the assistance needed is the assistance appropriate for a typical child of the 
109.19 	same age.
109.20 	(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are 
109.21 	included in the CFSS service delivery plan through one of the home and community-based 
109.22 	services waivers and as approved and authorized under chapter 256S and sections 256B.092, 
109.23 	subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state 
109.24 	plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
109.25 	(m) "Financial management services provider" or "FMS provider" means a qualified 
109.26 	organization required for participants using the budget model under subdivision 13 that is 
109.27 	an enrolled provider with the department to provide vendor fiscal/employer agent financial 
109.28 	management services (FMS).
109.29 	(n) "Health-related procedures and tasks" means procedures and tasks related to the 
109.30 	specific assessed health needs of a participant that can be taught or assigned by a 
109.31 	state-licensed health care or mental health professional and performed by a support worker.
109.32 	(o) "Instrumental activities of daily living" means activities related to living independently 
109.33 	in the community, including but not limited to: meal planning, preparation, and cooking; 
110.1 	shopping for food, clothing, or other essential items; laundry; housecleaning; assistance 
110.2 	with medications; managing finances; communicating needs and preferences during activities; 
110.3 	arranging supports; and assistance with traveling around and participating in the community, 
110.4 	including traveling to medical appointments. For purposes of this paragraph, traveling 
110.5 	includes driving and accompanying the recipient in the recipient's chosen mode of 
110.6 	transportation and according to the individual CFSS service delivery plan.
110.7 	(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 10.
110.8 	(q) "Legal representative" means parent of a minor, a court-appointed guardian, or 
110.9 	another representative with legal authority to make decisions about services and supports 
110.10 	for the participant. Other representatives with legal authority to make decisions include but 
110.11 	are not limited to a health care agent or an attorney-in-fact authorized through a health care 
110.12 	directive or power of attorney.
110.13 	(r) "Level I behavior" means physical aggression toward self or others or destruction of 
110.14 	property that requires the immediate response of another person.
110.15 	(s) "Medication assistance" means providing verbal or visual reminders to take regularly 
110.16 	scheduled medication, and includes any of the following supports listed in clauses (1) to 
110.17 	(3) and other types of assistance, except that a support worker must not determine medication 
110.18 	dose or time for medication or inject medications into veins, muscles, or skin:
110.19 	(1) under the direction of the participant or the participant's representative, bringing 
110.20 	medications to the participant including medications given through a nebulizer, opening a 
110.21 	container of previously set-up medications, emptying the container into the participant's 
110.22 	hand, opening and giving the medication in the original container to the participant, or 
110.23 	bringing to the participant liquids or food to accompany the medication;
110.24 	(2) organizing medications as directed by the participant or the participant's representative; 
110.25 	and
110.26 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
110.27 	(t) "Participant" means a person who is eligible for CFSS.
110.28 	(u) "Participant's representative" means a parent, family member, advocate, or other 
110.29 	adult authorized by the participant or participant's legal representative, if any, to serve as a 
110.30 	representative in connection with the provision of CFSS. If the participant is unable to assist 
110.31 	in the selection of a participant's representative, the legal representative shall appoint one.
110.32 	(v) "Person-centered planning process" means a process that is directed by the participant 
110.33 	to plan for CFSS services and supports.
111.1 	(w) "Service budget" means the authorized dollar amount used for the budget model or 
111.2 	for the purchase of goods.
111.3 	(x) "Shared services" means the provision of CFSS services by the same CFSS support 
111.4 	worker to two or three participants who voluntarily enter into a written agreement to receive 
111.5 	services at the same time, in the same setting, and through the same agency-provider or 
111.6 	FMS provider.
111.7 	(y) "Support worker" means a qualified and trained employee of the agency-provider 
111.8 	as required by subdivision 11b or of the participant employer under the budget model as 
111.9 	required by subdivision 14 who has direct contact with the participant and provides services 
111.10 	as specified within the participant's CFSS service delivery plan.
111.11 	(z) "Unit" means the increment of service based on hours or minutes identified in the 
111.12 	service agreement.
111.13 	(aa) "Vendor fiscal employer agent" means an agency that provides financial management 
111.14 	services.
111.15 	(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share 
111.16 	of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
111.17 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
111.18 	long-term care insurance, uniform allowance, contributions to employee retirement accounts, 
111.19 	or other forms of employee compensation and benefits.
111.20 	(cc) "Worker training and development" means services provided according to subdivision 
111.21 	18a for developing workers' skills as required by the participant's individual CFSS service 
111.22 	delivery plan that are arranged for or provided by the agency-provider or purchased by the 
111.23 	participant employer. These services include training, education, direct observation and 
111.24 	supervision, and evaluation and coaching of job skills and tasks, including supervision of 
111.25 	health-related tasks or behavioral supports.

111.26 	Sec. 54. Minnesota Statutes 2024, section 256B.85, subdivision 5, is amended to read:
111.27 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
111.28 	(1) be conducted by a certified assessor according to the criteria established in section 
111.29 	256B.0911, subdivisions 17 to 21, 23, 24, and 29 to 31;
111.30 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there is 
111.31 	a significant change in the participant's condition or a change in the need for services and 
112.1 	supports, or at the request of the participant when the participant experiences a change in 
112.2 	condition or needs a change in the services or supports; and
112.3 	(3) be completed using the format established by the commissioner.
112.4 	(b) The results of the assessment and any recommendations and authorizations for CFSS 
112.5 	must be determined and communicated in writing by the lead agency's assessor as defined 
112.6 	in section 256B.0911 to the participant or the participant's representative and chosen CFSS 
112.7 	providers within ten business days and must include the participant's right to appeal the 
112.8 	assessment under section 256.045, subdivision 3.
112.9 	(c) The lead agency assessor may authorize a temporary authorization for CFSS services 
112.10 	to be provided under the agency-provider model. The lead agency assessor may authorize 
112.11 	a temporary authorization for CFSS services to be provided under the agency-provider 
112.12 	model without using the assessment process described in this subdivision. Authorization 
112.13 	for a temporary level of CFSS services under the agency-provider model is limited to the 
112.14 	time specified by the commissioner, but shall not exceed 45 days. The level of services 
112.15 	authorized under this paragraph shall have no bearing on a future authorization. For CFSS 
112.16 	services needed beyond the 45-day temporary authorization, the lead agency must conduct 
112.17 	an assessment as described in this subdivision and participants must use consultation services 
112.18 	to complete their orientation and selection of a service model.

112.19 	Sec. 55. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision 
112.20 	to read:
112.21 		Subd. 5a.Temporary authorization without assessment. The lead agency assessor 
112.22 	may authorize a temporary authorization for CFSS services to be provided under the 
112.23 	agency-provider model. The lead agency assessor may authorize a temporary authorization 
112.24 	for CFSS services to be provided under the agency-provider model without using the 
112.25 	assessment process described in subdivision 5. Authorization for a temporary level of CFSS 
112.26 	services under the agency-provider model is limited to the time specified by the 
112.27 	commissioner, but shall not exceed 45 days. The level of services authorized under this 
112.28 	subdivision shall have no bearing on a future authorization. For CFSS services needed 
112.29 	beyond the 45-day temporary authorization, the lead agency must conduct an assessment 
112.30 	as described in subdivision 5 and participants must use consultation services to complete 
112.31 	their orientation and selection of a service model.

113.1 	Sec. 56. Minnesota Statutes 2024, section 256B.85, subdivision 7, is amended to read:
113.2 		Subd. 7.Community first services and supports; covered services.  Services and 
113.3 	supports covered under CFSS include:
113.4 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of 
113.5 	daily living (IADLs), and health-related procedures and tasks through hands-on assistance 
113.6 	to accomplish the task or constant supervision and cueing to accomplish the task;
113.7 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to 
113.8 	accomplish activities of daily living, instrumental activities of daily living, or health-related 
113.9 	tasks;
113.10 	(3) expenditures for items, services, supports, environmental modifications, or goods, 
113.11 	including assistive technology. These expenditures must:
113.12 	(i) relate to a need identified in a participant's CFSS service delivery plan; and
113.13 	(ii) increase independence or substitute for human assistance, to the extent that 
113.14 	expenditures would otherwise be made for human assistance for the participant's assessed 
113.15 	needs;
113.16 	(4) observation and redirection for behavior or symptoms where there is a need for 
113.17 	assistance;
113.18 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices, 
113.19 	to ensure continuity of the participant's services and supports;
113.20 	(6) swimming lessons for a participant younger than 12 years of age whose disability 
113.21 	puts the participant at a higher risk of drowning according to the Centers for Disease Control 
113.22 	Vital Statistics System;
113.23 	(6) (7) services described under subdivision 17 provided by a consultation services 
113.24 	provider as defined under subdivision 17, that is under contract with the department and 
113.25 	enrolled as a Minnesota health care program provider meeting the requirements of subdivision 
113.26 	17a;
113.27 	(7) (8) services provided by an FMS provider as defined under subdivision 13a, that is 
113.28 	an enrolled provider with the department;
113.29 	(8) (9) CFSS services provided by a support worker who is a parent, stepparent, or legal 
113.30 	guardian of a participant under age 18, or who is the participant's spouse. Covered services 
113.31 	under this clause are subject to the limitations described in subdivision 7b; and
113.32 	(9) (10) worker training and development services as described in subdivision 18a.

114.1 	EFFECTIVE DATE. This section is effective July 1, 2025, or upon federal approval, 
114.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
114.3 	when federal approval is obtained.

114.4 	Sec. 57. Minnesota Statutes 2024, section 256B.85, subdivision 7a, is amended to read:
114.5 		Subd. 7a.Enhanced rate. (a) An enhanced rate of 107.5 percent of the rate paid for 
114.6 	CFSS must be paid for services provided to persons who qualify for ten or more hours of 
114.7 	CFSS per day when provided by a support worker who meets the requirements of subdivision 
114.8 	16, paragraph (e). This paragraph expires upon the effective date of paragraph (b).
114.9 	(b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced 
114.10 	rate of 112.5 percent of the rate paid for CFSS must be paid for services provided to persons 
114.11 	who qualify for ten or more hours of CFSS per day when provided by a support worker 
114.12 	who meets the requirements of subdivision 16, paragraph (e). This paragraph expires upon 
114.13 	the effective date of paragraph (c).
114.14 	(c) Effective January 1, 2027, or upon federal approval, whichever is later, an enhanced 
114.15 	rate of 112.5 percent of the rate paid for CFSS must be paid for services provided to persons 
114.16 	who qualify for ten or more hours of CFSS per day.
114.17 	(b) (d) An agency provider must use all additional revenue attributable to the rate 
114.18 	enhancements under this subdivision for the wages and wage-related costs of the support 
114.19 	workers, including any corresponding increase in the employer's share of FICA taxes, 
114.20 	Medicare taxes, state and federal unemployment taxes, and workers' compensation premiums. 
114.21 	The agency provider must not use the additional revenue attributable to any enhanced rate 
114.22 	under this subdivision to pay for mileage reimbursement, health and dental insurance, life 
114.23 	insurance, disability insurance, long-term care insurance, uniform allowance, contributions 
114.24 	to employee retirement accounts, or any other employee benefits.
114.25 	(c) (e) Any change in the eligibility criteria for the enhanced rate for CFSS as described 
114.26 	in this subdivision and referenced in subdivision 16, paragraph (e), does not constitute a 
114.27 	change in a term or condition for individual providers as defined in section 256B.0711, and 
114.28 	is not subject to the state's obligation to meet and negotiate under chapter 179A.

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

114.30 	Sec. 58. Minnesota Statutes 2024, section 256B.85, subdivision 8, is amended to read:
114.31 		Subd. 8.Determination of CFSS service authorization amount. (a) All community 
114.32 	first services and supports must be authorized by the commissioner or the commissioner's 
115.1 	designee before services begin. The authorization for CFSS must be completed as soon as 
115.2 	possible following an assessment but no later than 40 calendar days from the date of the 
115.3 	assessment.
115.4 	(b) The amount of CFSS authorized must be based on the participant's home care rating 
115.5 	described in paragraphs (d) and (e) and any additional service units for which the participant 
115.6 	qualifies as described in paragraph (f).
115.7 	(c) The home care rating shall be determined by the commissioner or the commissioner's 
115.8 	designee based on information submitted to the commissioner identifying the following for 
115.9 	a participant:
115.10 	(1) the total number of dependencies of activities of daily living;
115.11 	(2) the presence of complex health-related needs; and
115.12 	(3) the presence of Level I behavior.
115.13 	(d) The methodology to determine the total service units for CFSS for each home care 
115.14 	rating is based on the median paid units per day for each home care rating from fiscal year 
115.15 	2007 data for the PCA program.
115.16 	(e) Each home care rating is designated by the letters P through Z and EN and has the 
115.17 	following base number of service units assigned:
115.18 	(1) P home care rating requires Level I behavior or one to three dependencies in ADLs 
115.19 	and qualifies the person for five service units;
115.20 	(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs 
115.21 	and qualifies the person for six service units;
115.22 	(3) R home care rating requires a complex health-related need and one to three 
115.23 	dependencies in ADLs and qualifies the person for seven service units;
115.24 	(4) S home care rating requires four to six dependencies in ADLs and qualifies the person 
115.25 	for ten service units;
115.26 	(5) T home care rating requires four to six dependencies in ADLs and Level I behavior 
115.27 	and qualifies the person for 11 service units;
115.28 	(6) U home care rating requires four to six dependencies in ADLs and a complex 
115.29 	health-related need and qualifies the person for 14 service units;
115.30 	(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the 
115.31 	person for 17 service units;
116.1 	(8) W home care rating requires seven to eight dependencies in ADLs and Level I 
116.2 	behavior and qualifies the person for 20 service units;
116.3 	(9) Z home care rating requires seven to eight dependencies in ADLs and a complex 
116.4 	health-related need and qualifies the person for 30 service units; and
116.5 	(10) EN home care rating includes ventilator dependency as defined in section 256B.0651, 
116.6 	subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent 
116.7 	and the EN home care rating and utilize a combination of CFSS and home care nursing 
116.8 	services is limited to a total of 96 service units per day for those services in combination. 
116.9 	Additional units may be authorized when a person's assessment indicates a need for two 
116.10 	staff to perform activities. Additional time is limited to 16 service units per day.
116.11 	(f) Additional service units are provided through the assessment and identification of 
116.12 	the following:
116.13 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
116.14 	living;
116.15 	(2) 30 additional minutes per day for each complex health-related need; and
116.16 	(3) 30 additional minutes per day for each behavior under this clause that requires 
116.17 	assistance at least four times per week:
116.18 	(i) level I behavior that requires the immediate response of another person;
116.19 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior; 
116.20 	or
116.21 	(iii) increased need for assistance for participants who are verbally aggressive or resistive 
116.22 	to care so that the time needed to perform activities of daily living is increased.
116.23 	(g) The service budget for budget model participants shall be based on:
116.24 	(1) assessed units as determined by the home care rating; and
116.25 	(2) an adjustment needed for administrative expenses. This paragraph expires upon the 
116.26 	effective date of paragraph (h).
116.27 	(h) Effective January 1, 2026, or upon federal approval, whichever is later, the service 
116.28 	budget for budget model participants shall be based on:
116.29 	(1) assessed units as determined by the home care rating and the payment methodologies 
116.30 	under section 256B.851; and
116.31 	(2) an adjustment needed for administrative expenses.

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

117.2 	Sec. 59. Minnesota Statutes 2024, section 256B.85, subdivision 8a, is amended to read:
117.3 		Subd. 8a.Authorization; exceptions. All CFSS services must be authorized by the 
117.4 	commissioner or the commissioner's designee as described in subdivision 8 except when:
117.5 	(1) the lead agency temporarily authorizes services in the agency-provider model as 
117.6 	described in subdivision 5, paragraph (c) 5a;
117.7 	(2) CFSS services in the agency-provider model were required to treat an emergency 
117.8 	medical condition that if not immediately treated could cause a participant serious physical 
117.9 	or mental disability, continuation of severe pain, or death. The CFSS agency provider must 
117.10 	request retroactive authorization from the lead agency no later than five working days after 
117.11 	providing the initial emergency service. The CFSS agency provider must be able to 
117.12 	substantiate the emergency through documentation such as reports, notes, and admission 
117.13 	or discharge histories. A lead agency must follow the authorization process in subdivision 
117.14 	5 after the lead agency receives the request for authorization from the agency provider;
117.15 	(3) the lead agency authorizes a temporary increase to the amount of services authorized 
117.16 	in the agency or budget model to accommodate the participant's temporary higher need for 
117.17 	services. Authorization for a temporary level of CFSS services is limited to the time specified 
117.18 	by the commissioner, but shall not exceed 45 days. The level of services authorized under 
117.19 	this clause shall have no bearing on a future authorization;
117.20 	(4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated, 
117.21 	and an authorization for CFSS services is completed based on the date of a current 
117.22 	assessment, eligibility, and request for authorization;
117.23 	(5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization 
117.24 	requests must be submitted by the provider within 20 working days of the notice of denial 
117.25 	or adjustment. A copy of the notice must be included with the request;
117.26 	(6) the commissioner has determined that a lead agency or state human services agency 
117.27 	has made an error; or
117.28 	(7) a participant enrolled in managed care experiences a temporary disenrollment from 
117.29 	a health plan, in which case the commissioner shall accept the current health plan 
117.30 	authorization for CFSS services for up to 60 days. The request must be received within the 
117.31 	first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after 
117.32 	the 60 days and before 90 days, the provider shall request an additional 30-day extension 
118.1 	of the current health plan authorization, for a total limit of 90 days from the time of 
118.2 	disenrollment.

118.3 	Sec. 60. Minnesota Statutes 2024, section 256B.85, subdivision 11, is amended to read:
118.4 		Subd. 11.Agency-provider model. (a) The agency-provider model includes services 
118.5 	provided by support workers and staff providing worker training and development services 
118.6 	who are employed by an agency-provider that meets the criteria established by the 
118.7 	commissioner, including required training.
118.8 	(b) The agency-provider shall allow the participant to have a significant role in the 
118.9 	selection and dismissal of the support workers for the delivery of the services and supports 
118.10 	specified in the participant's CFSS service delivery plan. The agency must make a reasonable 
118.11 	effort to fulfill the participant's request for the participant's preferred support worker.
118.12 	(c) A participant may use authorized units of CFSS services as needed within a service 
118.13 	agreement that is not greater than 12 months. Using authorized units in a flexible manner 
118.14 	in either the agency-provider model or the budget model does not increase the total amount 
118.15 	of services and supports authorized for a participant or included in the participant's CFSS 
118.16 	service delivery plan.
118.17 	(d) A participant may share CFSS services. Two or three CFSS participants may share 
118.18 	services at the same time provided by the same support worker.
118.19 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated 
118.20 	by the medical assistance payment for CFSS for support worker wages and benefits, except 
118.21 	all of the revenue generated by a medical assistance rate increase due to a collective 
118.22 	bargaining agreement under section 179A.54 must be used for support worker wages and 
118.23 	benefits. The agency-provider must document how this requirement is being met. The 
118.24 	revenue generated by the worker training and development services and the reasonable costs 
118.25 	associated with the worker training and development services must not be used in making 
118.26 	this calculation.
118.27 	(f) The agency-provider model must be used by participants who are restricted by the 
118.28 	Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 
118.29 	9505.2245.
118.30 	(g) Participants purchasing goods under this the agency-provider model, along with 
118.31 	support worker services, must:
119.1 	(1) specify the goods in the CFSS service delivery plan and detailed budget for 
119.2 	expenditures that must be approved by the lead agency, case manager, or care coordinator; 
119.3 	and
119.4 	(2) use the FMS provider for the billing and payment of such goods.
119.5 	(h) The agency provider is responsible for ensuring that any worker driving a participant 
119.6 	under subdivision 2, paragraph (o), has a valid driver's license and the vehicle used is 
119.7 	registered and insured according to Minnesota law.

119.8 	Sec. 61. Minnesota Statutes 2024, section 256B.85, subdivision 13, is amended to read:
119.9 		Subd. 13.Budget model. (a) Under the budget model participants exercise responsibility 
119.10 	and control over the services and supports described and budgeted within the CFSS service 
119.11 	delivery plan. Participants must use consultation services specified in subdivision 17 and 
119.12 	services specified in subdivision 13a provided by an FMS provider. Under this model, 
119.13 	participants may use their approved service budget allocation to:
119.14 	(1) directly employ support workers, and pay wages, federal and state payroll taxes, and 
119.15 	premiums for workers' compensation, liability, family and medical benefit insurance, and 
119.16 	health insurance coverage; and
119.17 	(2) obtain supports and goods as defined in subdivision 7.
119.18 	(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may 
119.19 	authorize a legal representative or participant's representative to do so on their behalf.
119.20 	(c) If two or more participants using the budget model live in the same household and 
119.21 	have the same support worker, the participants must use the same FMS provider.
119.22 	(d) If the FMS provider advises that there is a joint employer in the budget model, all 
119.23 	participants associated with that joint employer must use the same FMS provider.
119.24 	(e) The commissioner shall disenroll or exclude participants from the budget model and 
119.25 	transfer them to the agency-provider model under, but not limited to, the following 
119.26 	circumstances:
119.27 	(1) when a participant has been restricted by the Minnesota restricted recipient program, 
119.28 	in which case the participant may be excluded for a specified time period under Minnesota 
119.29 	Rules, parts 9505.2160 to 9505.2245;
119.30 	(2) when a participant exits the budget model during the participant's service plan year. 
119.31 	Upon transfer, the participant shall not access the budget model for the remainder of that 
119.32 	service plan year; or
120.1 	(3) when the department determines that the participant or participant's representative 
120.2 	or legal representative is unable to fulfill the responsibilities under the budget model, as 
120.3 	specified in subdivision 14.
120.4 	(f) A participant may appeal in writing to the department under section 256.045, 
120.5 	subdivision 3, to contest the department's decision under paragraph (e), clause (3), to disenroll 
120.6 	or exclude the participant from the budget model.

120.7 	Sec. 62. Minnesota Statutes 2024, section 256B.85, subdivision 16, is amended to read:
120.8 		Subd. 16.Support workers requirements. (a) Support workers shall:
120.9 	(1) enroll with the department as a support worker after a background study under chapter 
120.10 	245C has been completed and the support worker has received a notice from the 
120.11 	commissioner that the support worker:
120.12 	(i) is not disqualified under section 245C.14; or
120.13 	(ii) is disqualified, but has received a set-aside of the disqualification under section 
120.14 	245C.22;
120.15 	(2) have the ability to effectively communicate with the participant or the participant's 
120.16 	representative;
120.17 	(3) have the skills and ability to provide the services and supports according to the 
120.18 	participant's CFSS service delivery plan and respond appropriately to the participant's needs;
120.19 	(4) complete the basic standardized CFSS training as determined by the commissioner 
120.20 	before completing enrollment. The training must be available in languages other than English 
120.21 	and to those who need accommodations due to disabilities. CFSS support worker training 
120.22 	must include successful completion of the following training components: basic first aid, 
120.23 	vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and 
120.24 	responsibilities of support workers including information about basic body mechanics, 
120.25 	emergency preparedness, orientation to positive behavioral practices, orientation to 
120.26 	responding to a mental health crisis, fraud issues, time cards and documentation, and an 
120.27 	overview of person-centered planning and self-direction. Upon completion of the training 
120.28 	components, the support worker must pass the certification test to provide assistance to 
120.29 	participants;
120.30 	(5) complete employer-directed training and orientation on the participant's individual 
120.31 	needs;
120.32 	(6) maintain the privacy and confidentiality of the participant; and
121.1 	(7) not independently determine the medication dose or time for medications for the 
121.2 	participant.
121.3 	(b) The commissioner may deny or terminate a support worker's provider enrollment 
121.4 	and provider number if the support worker:
121.5 	(1) does not meet the requirements in paragraph (a);
121.6 	(2) fails to provide the authorized services required by the employer;
121.7 	(3) has been intoxicated by alcohol or drugs while providing authorized services to the 
121.8 	participant or while in the participant's home;
121.9 	(4) has manufactured or distributed drugs while providing authorized services to the 
121.10 	participant or while in the participant's home; or
121.11 	(5) has been excluded as a provider by the commissioner of human services, or by the 
121.12 	United States Department of Health and Human Services, Office of Inspector General, from 
121.13 	participation in Medicaid, Medicare, or any other federal health care program.
121.14 	(c) A support worker may appeal in writing to the commissioner to contest the decision 
121.15 	to terminate the support worker's provider enrollment and provider number.
121.16 	(d) A support worker must not provide or be paid for more than 310 hours of CFSS per 
121.17 	month, regardless of the number of participants the support worker serves or the number 
121.18 	of agency-providers or participant employers by which the support worker is employed. 
121.19 	The department shall not disallow the number of hours per day a support worker works 
121.20 	unless it violates other law.
121.21 	(e) CFSS qualify for an enhanced rate or budget if the support worker providing the 
121.22 	services:
121.23 	(1) provides services, within the scope of CFSS described in subdivision 7, to a participant 
121.24 	who qualifies for ten or more hours per day of CFSS; and
121.25 	(2) satisfies the current requirements of Medicare for training and competency or 
121.26 	competency evaluation of home health aides or nursing assistants, as provided in the Code 
121.27 	of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved 
121.28 	training or competency requirements. This paragraph expires December 31, 2026.

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

122.1 	Sec. 63. Minnesota Statutes 2024, section 256B.85, subdivision 17a, is amended to read:
122.2 		Subd. 17a.Consultation services provider qualifications and 
122.3 	requirements. Consultation services providers must meet the following qualifications and 
122.4 	requirements:
122.5 	(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4) 
122.6 	and (5);
122.7 	(2) are be under contract with the department and enrolled as a Minnesota health care 
122.8 	program provider;
122.9 	(3) are not not be the FMS provider, the lead agency, or the CFSS or home and 
122.10 	community-based services waiver vendor or agency-provider to the participant;
122.11 	(4) meet the service standards as established by the commissioner;
122.12 	(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation 
122.13 	service provider's Medicaid revenue in the previous calendar year is less than or equal to 
122.14 	$300,000, the consultation service provider must purchase a surety bond of $50,000. If the 
122.15 	agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000, 
122.16 	the consultation service provider must purchase a surety bond of $100,000. The surety bond 
122.17 	must be in a form approved by the commissioner, must be renewed annually, and must 
122.18 	allow for recovery of costs and fees in pursuing a claim on the bond;
122.19 	(6) employ lead professional staff with a minimum of two years of experience in 
122.20 	providing services such as support planning, support broker, case management or care 
122.21 	coordination, or consultation services and consumer education to participants using a 
122.22 	self-directed program using FMS under medical assistance;
122.23 	(7) report maltreatment as required under chapter 260E and section 626.557;
122.24 	(8) comply with medical assistance provider requirements;
122.25 	(9) understand the CFSS program and its policies;
122.26 	(10) are be knowledgeable about self-directed principles and the application of the 
122.27 	person-centered planning process;
122.28 	(11) have general knowledge of the FMS provider duties and the vendor fiscal/employer 
122.29 	agent model, including all applicable federal, state, and local laws and regulations regarding 
122.30 	tax, labor, employment, and liability and workers' compensation coverage for household 
122.31 	workers; and
123.1 	(12) have all employees, including lead professional staff, staff in management and 
123.2 	supervisory positions, and owners of the agency who are active in the day-to-day management 
123.3 	and operations of the agency, complete training as specified in the contract with the 
123.4 	department.

123.5 	Sec. 64. Minnesota Statutes 2024, section 256B.851, subdivision 5, is amended to read:
123.6 		Subd. 5.Payment rates; component values. (a) The commissioner must use the 
123.7 	following component values:
123.8 	(1) employee vacation, sick, and training factor, 8.71 percent;
123.9 	(2) employer taxes and workers' compensation factor, 11.56 percent;
123.10 	(3) employee benefits factor, 12.04 percent;
123.11 	(4) client programming and supports factor, 2.30 percent;
123.12 	(5) program plan support factor, 7.00 percent;
123.13 	(6) general business and administrative expenses factor, 13.25 percent;
123.14 	(7) program administration expenses factor, 2.90 percent; and
123.15 	(8) absence and utilization factor, 3.90 percent.
123.16 	(b) For purposes of implementation, the commissioner shall use the following 
123.17 	implementation components:
123.18 	(1) personal care assistance services and CFSS: 88.19 percent;
123.19 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 88.19 
123.20 	percent; and
123.21 	(3) qualified professional services and CFSS worker training and development: 88.19 
123.22 	percent.
123.23 	(c) (b) Effective January 1, 2025, for purposes of implementation, the commissioner 
123.24 	shall use the following implementation components:
123.25 	(1) personal care assistance services and CFSS: 92.08 percent;
123.26 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08 
123.27 	percent; and
123.28 	(3) qualified professional services and CFSS worker training and development: 92.08 
123.29 	percent. This paragraph expires upon the effective date of subdivision 5a.
124.1 	(d) (c) The commissioner shall use the following worker retention components:
124.2 	(1) for workers who have provided fewer than 1,001 cumulative hours in personal care 
124.3 	assistance services or CFSS, the worker retention component is zero percent;
124.4 	(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal 
124.5 	care assistance services or CFSS, the worker retention component is 2.17 percent;
124.6 	(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal 
124.7 	care assistance services or CFSS, the worker retention component is 4.36 percent;
124.8 	(4) for workers who have provided between 6,001 and 10,000 cumulative hours in 
124.9 	personal care assistance services or CFSS, the worker retention component is 7.35 percent; 
124.10 	and
124.11 	(5) for workers who have provided more than 10,000 cumulative hours in personal care 
124.12 	assistance services or CFSS, the worker retention component is 10.81 percent. This paragraph 
124.13 	expires upon the effective date of subdivision 5b.
124.14 	(e) (d) The commissioner shall define the appropriate worker retention component under 
124.15 	subdivision 5b or 5c based on the total number of units billed for services rendered by the 
124.16 	individual provider since July 1, 2017. The worker retention component must be determined 
124.17 	by the commissioner for each individual provider and is not subject to appeal.

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

124.19 	Sec. 65. Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision 
124.20 	to read:
124.21 		Subd. 5a.Payment rates; implementation factor. Effective January 1, 2026, or upon 
124.22 	federal approval, whichever is later, for purposes of implementation, the commissioner shall 
124.23 	use the following implementation components:
124.24 	(1) personal care assistance services and CFSS: 92.20 percent;
124.25 	(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.20 
124.26 	percent; and
124.27 	(3) qualified professional services and CFSS worker training and development: 92.20 
124.28 	percent.

125.1 	Sec. 66. Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision 
125.2 	to read:
125.3 		Subd. 5b.Payment rates; worker retention component. Effective January 1, 2026, 
125.4 	or upon federal approval, whichever is later, the commissioner shall use the following 
125.5 	worker retention components:
125.6 	(1) for workers who have provided fewer than 1,001 cumulative hours in personal care 
125.7 	assistance services or CFSS, the worker retention component is zero percent;
125.8 	(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal 
125.9 	care assistance services or CFSS, the worker retention component is 4.05 percent;
125.10 	(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal 
125.11 	care assistance services or CFSS, the worker retention component is 6.24 percent;
125.12 	(4) for workers who have provided between 6,001 and 10,000 cumulative hours in 
125.13 	personal care assistance services or CFSS, the worker retention component is 9.23 percent; 
125.14 	and
125.15 	(5) for workers who have provided more than 10,000 cumulative hours in personal care 
125.16 	assistance services or CFSS, the worker retention component is 12.69 percent.

125.17 	Sec. 67. Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision 
125.18 	to read:
125.19 		Subd. 5c.Payment rates; enhanced worker retention component. Effective January 
125.20 	1, 2027, or upon federal approval, whichever is later, the commissioner shall use the 
125.21 	following worker retention components if a worker has completed either the orientation for 
125.22 	individual providers offered through the Home Care Orientation Trust or an orientation 
125.23 	defined and offered by the commissioner:
125.24 	(1) for workers who have provided fewer than 1,001 cumulative hours in personal care 
125.25 	assistance services or CFSS, the worker retention component is 1.88 percent;
125.26 	(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal 
125.27 	care assistance services or CFSS, the worker retention component is 5.92 percent;
125.28 	(3) for workers who have provided between 2,001, and 6,000 cumulative hours in personal 
125.29 	care assistance services or CFSS, the worker retention component is 8.11 percent;
125.30 	(4) for workers who have provided between 6,001 and 10,000 cumulative hours in 
125.31 	personal care assistance services or CFSS, the worker retention component is 11.10 percent; 
125.32 	and
126.1 	(5) for workers who have provided more than 10,000 cumulative hours in personal care 
126.2 	assistance services or CFSS, the worker retention component is 14.56 percent.

126.3 	Sec. 68. Minnesota Statutes 2024, section 256B.851, subdivision 6, is amended to read:
126.4 		Subd. 6.Payment rates; rate determination. (a) The commissioner must determine 
126.5 	the rate for personal care assistance services, CFSS, extended personal care assistance 
126.6 	services, extended CFSS, enhanced rate personal care assistance services, enhanced rate 
126.7 	CFSS, qualified professional services, and CFSS worker training and development as 
126.8 	follows:
126.9 	(1) multiply the appropriate total wage component value calculated in subdivision 4 by 
126.10 	one plus the employee vacation, sick, and training factor in subdivision 5;
126.11 	(2) for program plan support, multiply the result of clause (1) by one plus the program 
126.12 	plan support factor in subdivision 5;
126.13 	(3) for employee-related expenses, add the employer taxes and workers' compensation 
126.14 	factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is 
126.15 	employee-related expenses. Multiply the product of clause (2) by one plus the value for 
126.16 	employee-related expenses;
126.17 	(4) for client programming and supports, multiply the product of clause (3) by one plus 
126.18 	the client programming and supports factor in subdivision 5;
126.19 	(5) for administrative expenses, add the general business and administrative expenses 
126.20 	factor in subdivision 5, the program administration expenses factor in subdivision 5, and 
126.21 	the absence and utilization factor in subdivision 5;
126.22 	(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is 
126.23 	the hourly rate;
126.24 	(7) multiply the hourly rate by the appropriate implementation component under 
126.25 	subdivision 5 or 5a. This is the adjusted hourly rate; and
126.26 	(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment 
126.27 	rate.
126.28 	(b) In processing personal care assistance provider agency and CFSS provider agency 
126.29 	claims, the commissioner shall incorporate the applicable worker retention component
126.30 	components specified in subdivision 5, 5b, or 5c, by multiplying one plus the total adjusted 
126.31 	payment rate by the appropriate worker retention component under subdivision 5, paragraph 
126.32 	(d) 5b, or 5c.
127.1 	(c) The commissioner must publish the total final payment rates.

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

127.5 	Sec. 69. Minnesota Statutes 2024, section 256B.851, subdivision 7, is amended to read:
127.6 		Subd. 7.Treatment of rate adjustments provided outside of cost components. Any 
127.7 	rate adjustments applied to the service rates calculated under this section outside of the cost 
127.8 	components and rate methodology specified in this section, including but not limited to 
127.9 	those implemented to enable participant-employers and provider agencies to meet the terms 
127.10 	and conditions of any collective bargaining agreement negotiated under chapter 179A, shall 
127.11 	be applied as changes to the value of component values or, implementation components, 
127.12 	or worker retention components in subdivision subdivisions 5 to 5c.

127.13 	Sec. 70. Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision 
127.14 	to read:
127.15 		Subd. 7a.Budget determinations. The commissioner shall increase the authorized 
127.16 	amount for the CFSS budget model of those CFSS participant-employers employing 
127.17 	individual providers who have provided more than 1,000 hours of services and individual 
127.18 	providers who have completed the orientation offered by the Home Care Orientation Trust 
127.19 	or an orientation defined and offered by the commissioner. The commissioner shall determine 
127.20 	the amount and method of the authorized amount increase.

127.21 	Sec. 71. Minnesota Statutes 2024, section 260E.14, subdivision 1, is amended to read:
127.22 		Subdivision 1.Facilities and schools. (a) The local welfare agency is the agency 
127.23 	responsible for investigating allegations of maltreatment in child foster care, family child 
127.24 	care, legally nonlicensed child care, and reports involving children served by an unlicensed 
127.25 	personal care provider organization under section 256B.0659. Copies of findings related to 
127.26 	personal care provider organizations under section 256B.0659 must be forwarded to the 
127.27 	Department of Human Services provider enrollment.
127.28 	(b) The Department of Children, Youth, and Families is the agency responsible for 
127.29 	screening and investigating allegations of maltreatment in juvenile correctional facilities 
127.30 	listed under section 241.021 located in the local welfare agency's county and in facilities 
127.31 	licensed or certified under chapters 245A and 245D.
128.1 	(c) The Department of Health is the agency responsible for screening and investigating 
128.2 	allegations of maltreatment in facilities licensed under sections 144.50 to 144.58 and 144A.43 
128.3 	to 144A.482 or chapter 144H.
128.4 	(d) The Department of Education is the agency responsible for screening and investigating 
128.5 	allegations of maltreatment in a school as defined in section 120A.05, subdivisions 9, 11, 
128.6 	and 13, and chapter 124E. The Department of Education's responsibility to screen and 
128.7 	investigate includes allegations of maltreatment involving students 18 through 21 years of 
128.8 	age, including students receiving special education services, up to and including graduation 
128.9 	and the issuance of a secondary or high school diploma.
128.10 	(e) The Department of Human Services is the agency responsible for screening and 
128.11 	investigating allegations of maltreatment of minors in an EIDBI agency operating under 
128.12 	sections 245A.142 and 256B.0949.
128.13 	(e) (f) A health or corrections agency receiving a report may request the local welfare 
128.14 	agency to provide assistance pursuant to this section and sections 260E.20 and 260E.22.
128.15 	(f) (g) The Department of Children, Youth, and Families is the agency responsible for 
128.16 	screening and investigating allegations of maltreatment in facilities or programs not listed 
128.17 	in paragraph (a) that are licensed or certified under chapters 142B and 142C.

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

128.19 	Sec. 72. Minnesota Statutes 2024, section 626.5572, subdivision 13, is amended to read:
128.20 		Subd. 13.Lead investigative agency. "Lead investigative agency" is the primary 
128.21 	administrative agency responsible for investigating reports made under section 626.557.
128.22 	(a) The Department of Health is the lead investigative agency for facilities or services 
128.23 	licensed or required to be licensed as hospitals, home care providers, nursing homes, boarding 
128.24 	care homes, hospice providers, residential facilities that are also federally certified as 
128.25 	intermediate care facilities that serve people with developmental disabilities, or any other 
128.26 	facility or service not listed in this subdivision that is licensed or required to be licensed by 
128.27 	the Department of Health for the care of vulnerable adults. "Home care provider" has the 
128.28 	meaning provided in section 144A.43, subdivision 4, and applies when care or services are 
128.29 	delivered in the vulnerable adult's home.
128.30 	(b) The Department of Human Services is the lead investigative agency for facilities or 
128.31 	services licensed or required to be licensed as adult day care, adult foster care, community 
128.32 	residential settings, programs for people with disabilities, EIDBI agencies, family adult day 
128.33 	services, mental health programs, mental health clinics, substance use disorder programs, 
129.1 	the Minnesota Sex Offender Program, or any other facility or service not listed in this 
129.2 	subdivision that is licensed or required to be licensed by the Department of Human Services.
129.3 	The Department of Human Services is also the lead investigative agency for unlicensed 
129.4 	EIDBI agencies under section 256B.0949.
129.5 	(c) The county social service agency or its designee is the lead investigative agency for 
129.6 	all other reports, including, but not limited to, reports involving vulnerable adults receiving 
129.7 	services from a personal care provider organization under section 256B.0659.

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

129.9 	Sec. 73. Laws 2021, First Special Session chapter 7, article 13, section 73, is amended to 
129.10 	read:
129.11 	Sec. 73. WAIVER REIMAGINE PHASE II.
 129.12 	(a) Effective January 1, 2027, or upon federal approval, whichever is later, the 
129.13 	commissioner of human services must implement a two-home and community-based services 
129.14 	waiver program structure, as authorized under section 1915(c) of the federal Social Security 
129.15 	Act, that serves persons who are determined by a certified assessor to require the levels of 
129.16 	care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate 
129.17 	care facility for persons with developmental disabilities.
129.18 	(b) The commissioner of human services must implement an individualized budget 
129.19 	methodology, as authorized under section 1915(c) of the federal Social Security Act, that 
129.20 	serves persons who are determined by a certified assessor to require the levels of care 
129.21 	provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care 
129.22 	facility for persons with developmental disabilities.
129.23 	(c) The commissioner must develop an individualized budget methodology exception 
129.24 	to support access to self-directed home care nursing services. Lead agencies must submit 
129.25 	budget exception requests to the commissioner in a manner identified by the commissioner. 
129.26 	Eligibility for the budget exception in this paragraph is limited to persons meeting all of the 
129.27 	following criteria in the person's most recent assessment:
129.28 	(1) the person is assessed to need the level of care delivered in a hospital setting as 
129.29 	evidenced by the submission of the Department of Human Services form 7096, primary 
129.30 	medical provider's documentation of medical monitoring and treatment needs;
129.31 	(2) the person is assessed to receive a support range budget of E or H; and
130.1 	(3) the person does not receive community residential services, family residential services, 
130.2 	integrated community supports services, or customized living services.
130.3 	(d) Home care nursing services funded through the budget exception developed under 
130.4 	paragraph (c) must be ordered by a physician, physician assistant, or advanced practice 
130.5 	registered nurse. If the participant chooses home care nursing, the home care nursing services 
130.6 	must be performed by a registered nurse or licensed practical nurse practicing within the 
130.7 	registered nurse's or licensed practical nurse's scope of practice as defined under Minnesota 
130.8 	Statutes, sections 148.171 to 148.285. If after a person's annual reassessment under Minnesota 
130.9 	Statutes, section 256B.0911, any requirements of this paragraph or paragraph (c) are no 
130.10 	longer met, the commissioner must terminate the budget exception.
130.11 	(c) (e) The commissioner of human services may seek all federal authority necessary to 
130.12 	implement this section.
130.13 	(d) (f) The commissioner must ensure that the new waiver service menu and individual 
130.14 	budgets allow people to live in their own home, family home, or any home and 
130.15 	community-based setting of their choice. The commissioner must ensure, within available 
130.16 	resources and subject to state and federal regulations and law, that waiver reimagine does 
130.17 	not result in unintended service disruptions.

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

130.19 	Sec. 74. Laws 2021, First Special Session chapter 7, article 13, section 75, subdivision 6, 
130.20 	as amended by Laws 2024, chapter 108, article 1, section 28, is amended to read:
130.21 		Subd. 6.Online support planning tool. The commissioner must develop an online 
130.22 	support planning and tracking tool for people using disability waiver services that allows 
130.23 	access to the total budget available to the person, the services for which they are eligible, 
130.24 	and the services they have chosen and used. The commissioner must explore operability 
130.25 	options that would facilitate real-time tracking of a person's remaining available budget 
130.26 	throughout the service year. The online support planning tool must provide information in 
130.27 	an accessible format to support the person's informed choice. The commissioner must seek 
130.28 	input from people with disabilities about the online support planning tool prior to its 
130.29 	implementation. The commissioner must implement the online support planning and tracking 
130.30 	tool no later than January 1, 2027.

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

131.1 	Sec. 75. DISABILITY SERVICES TECHNOLOGY AND ADVOCACY EXPANSION 
131.2 	GRANT.
131.3 		Subdivision 1.Establishment. (a) A disability services technology and advocacy 
131.4 	expansion grant is established to:
131.5 	(1) support the expansion of assistive technology and remote support services for people 
131.6 	with disabilities; and
131.7 	(2) strengthen advocacy efforts for individuals with disabilities and the providers who 
131.8 	serve individuals with disabilities.
131.9 	(b) The commissioner of human services must award the grant to an eligible grantee. In 
131.10 	awarding the grant, the commissioner must consult with the commissioner of administration's 
131.11 	System of Technology to Achieve Results (STAR) Program under Minnesota Statutes, 
131.12 	section 16B.055.
131.13 		Subd. 2.Eligible grantee. An eligible grantee must:
131.14 	(1) be a nonprofit organization with a statewide reach;
131.15 	(2) have demonstrated knowledge of various forms of assistive technology and remote 
131.16 	support for people with disabilities; and
131.17 	(3) have proven capacity to provide education and training to multiple constituencies.
131.18 		Subd. 3.Allowable uses of grant money. Grant money must be used to:
131.19 	(1) develop and deliver comprehensive training programs for lead agencies, disability 
131.20 	service providers, schools, employment support agencies, and individuals with disabilities 
131.21 	and their families to ensure effective use of assistive technology and remote support tools. 
131.22 	Training programs must be developed in consultation with the STAR Program to ensure 
131.23 	alignment with national assistive technology standards and best practices. Training must 
131.24 	address specific challenges faced by individuals with disabilities, such as accessibility, 
131.25 	independence, and health monitoring;
131.26 	(2) provide resources and support to advocacy organizations that work with individuals 
131.27 	with disabilities and service providers. Resources and support must be used to promote the 
131.28 	use of assistive technology to increase self-determination and community participation;
131.29 	(3) maintain, distribute, and create accessible resources related to assistive technology 
131.30 	and remote support. Resources must be developed in collaboration with the STAR Program 
131.31 	to reflect current assistive technology tools and guidance that are tailored to Minnesota's 
132.1 	disability community. Materials must be tailored to address the unique needs of individuals 
132.2 	with disabilities and the people and organizations who support individuals with disabilities;
132.3 	(4) conduct research to explore new and emerging assistive technology solutions that 
132.4 	address the evolving needs of individuals with disabilities. The research must emphasize 
132.5 	the role of technology in promoting independence, improving quality of life, and ensuring 
132.6 	safety; and
132.7 	(5) conduct outreach initiatives to engage disability communities, service providers, and 
132.8 	advocacy groups across Minnesota to promote awareness of assistive technology and remote 
132.9 	support services. Outreach initiatives must focus on reaching underserved and rural 
132.10 	populations.
132.11 		Subd. 4.Evaluation and reporting requirements. (a) The grant recipient must submit 
132.12 	an annual report by June 30 each year to the chairs and ranking minority members of the 
132.13 	legislative committees with jurisdiction over disability services. The annual report must 
132.14 	include:
132.15 	(1) the number of individuals with disabilities and service providers who received training 
132.16 	during the reporting year;
132.17 	(2) data on the impact of assistive technology and remote support in improving quality 
132.18 	of life, safety, and independence for individuals with disabilities; and
132.19 	(3) recommendations for further advancing technology-driven disability advocacy efforts 
132.20 	based on feedback and research findings.
132.21 	(b) No later than three months after the grant period has ended, a final evaluation must 
132.22 	be submitted to the chairs and ranking minority members of the legislative committees with 
132.23 	jurisdiction over disability services to assess the overall impact on expanding access to 
132.24 	assistive technology and remote support, with a focus on lessons learned and future 
132.25 	opportunities for Minnesota's disability communities and service providers.
132.26 		Subd. 5.Grant period. The grant period under this section is from July 1, 2025, to June 
132.27 	30, 2030.

132.28 	Sec. 76. BUDGET INCREASE FOR CONSUMER-DIRECTED COMMUNITY 
132.29 	SUPPORTS.
 132.30 	Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner 
132.31 	of human services must increase the consumer-directed community support budgets identified 
132.32 	in the waiver plans under Minnesota Statutes, sections 256B.092 and 256B.49, and chapter 
133.1 	256S; and the alternative care program under Minnesota Statutes, section 256B.0913, by 
133.2 	0.13 percent.

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

133.4 	Sec. 77. ENHANCED BUDGET INCREASE FOR CONSUMER-DIRECTED 
133.5 	COMMUNITY SUPPORTS.
 133.6 	Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner 
133.7 	of human services must increase the consumer-directed community supports budget exception 
133.8 	percentage identified in the waiver plans under Minnesota Statutes, sections 256B.092 and 
133.9 	256B.49, and chapter 256S; and the alternative care program under Minnesota Statutes, 
133.10 	section 256B.0913, from 7.5 to 12.5.

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

133.12 	Sec. 78. STIPEND PAYMENTS TO SEIU HEALTHCARE MINNESOTA & IOWA 
133.13 	BARGAINING UNIT MEMBERS.
 133.14 	(a) The commissioner of human services shall issue stipend payments to collective 
133.15 	bargaining unit members as required by the labor agreement between the state of Minnesota 
133.16 	and the Service Employees International Union (SEIU) Healthcare Minnesota & Iowa.
133.17 	(b) The definitions in Minnesota Statutes, section 290.01, apply to this section.
133.18 	(c) For the purposes of this section, "subtraction" has the meaning given in Minnesota 
133.19 	Statutes, section 290.0132, subdivision 1, and the rules in that subdivision apply to this 
133.20 	section.
133.21 	(d) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa 
133.22 	collective bargaining unit members under this section is a subtraction.
133.23 	(e) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa 
133.24 	collective bargaining unit members under this section is excluded from income as defined 
133.25 	in Minnesota Statutes, sections 290.0693, subdivision 1, paragraph (i), and 290A.03, 
133.26 	subdivision 3.
133.27 	(f) Notwithstanding any law to the contrary, stipend payments under this section must 
133.28 	not be considered income, assets, or personal property for purposes of determining or 
133.29 	recertifying eligibility for:
133.30 	(1) child care assistance programs under Minnesota Statutes, chapter 142E;
134.1 	(2) general assistance, Minnesota supplemental aid, and food support under Minnesota 
134.2 	Statutes, chapter 256D;
134.3 	(3) housing support under Minnesota Statutes, chapter 256I;
134.4 	(4) the Minnesota family investment program under Minnesota Statutes, chapter 142G; 
134.5 	and
134.6 	(5) economic assistance programs under Minnesota Statutes, chapter 256P.
134.7 	(g) The commissioner of human services must not consider stipend payments under this 
134.8 	section as income or assets under Minnesota Statutes, section 256B.056, subdivision 1a, 
134.9 	paragraph (a); 3; or 3c, or for persons with eligibility determined under Minnesota Statutes, 
134.10 	section 256B.057, subdivision 3, 3a, or 3b.

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

134.12 	Sec. 79. DIRECTION TO COMMISSIONER; COST REPORTING IMPROVEMENT 
134.13 	AND DIRECT CARE STAFF REVIEW.
 134.14 	(a) The commissioner of human services must consult with interested parties and make 
134.15 	recommendations to the legislature to clarify provider cost reporting obligations to promote 
134.16 	more uniform and meaningful data collection under Minnesota Statutes, section 256B.4914. 
134.17 	By February 15, 2026, the commissioner must submit to the chairs and ranking minority 
134.18 	members of the legislative committees with jurisdiction over health and human services 
134.19 	policy and finance draft legislation required to implement the commissioner's 
134.20 	recommendations.
134.21 	(b) The commissioner of human services must consult with interested parties and, based 
134.22 	on the results of the cost reporting completed for calendar year 2026, recommend what, if 
134.23 	any, encumbrance of medical assistance reimbursement is appropriate to support direct care 
134.24 	staff retention and the provision of quality services under Minnesota Statutes, section 
134.25 	256B.4914. By January 15, 2028, the commissioner must submit to the chairs and ranking 
134.26 	minority members of the legislative committees with jurisdiction over health and human 
134.27 	services policy and finance draft legislation required to implement the commissioner's 
134.28 	recommendations.

134.29 	Sec. 80. COMMUNITY FIRST SERVICES AND SUPPORTS REIMBURSEMENT 
134.30 	DURING ACUTE CARE HOSPITAL STAYS.
 134.31 	(a) The commissioner of human services must seek to amend Minnesota's federally 
134.32 	approved community first services and supports program, authorized under United States 
135.1 	Code, title 42, sections 1915(i) and 1915(k), to reimburse for delivery of community first 
135.2 	services and supports under Minnesota Statutes, sections 256B.85 and 256B.851, during 
135.3 	an acute care stay in an acute care hospital setting that does not have the effect of isolating 
135.4 	individuals receiving community first services and supports from the broader community 
135.5 	of individuals not receiving community first services and supports, as permitted under Code 
135.6 	of Federal Regulations, title 42, section 441.530.
135.7 	(b) Reimbursed services must:
135.8 	(1) be identified in an individual's person-centered support plan as required under 
135.9 	Minnesota Statutes, section 256B.0911;
135.10 	(2) be provided to meet the needs of the person that are not met through the provision 
135.11 	of hospital services;
135.12 	(3) not substitute services that the hospital is obligated to provide as required under state 
135.13 	and federal law; and
135.14 	(4) be designed to preserve the person's functional abilities during a hospital stay for 
135.15 	acute care and to ensure smooth transitions between acute care settings and home and 
135.16 	community-based settings.

135.17 	EFFECTIVE DATE. Paragraph (a) is effective the day following final enactment. 
135.18 	Paragraph (b) is effective January 1, 2026, or upon federal approval, whichever is later. The 
135.19 	commissioner of human services shall notify the revisor of statutes when federal approval 
135.20 	is obtained.

135.21 	Sec. 81. POSITIVE SUPPORTS COMPETENCY PROGRAM.
 135.22 	(a) The commissioner shall establish a positive supports competency program with the 
135.23 	money appropriated for this purpose.
135.24 	(b) When establishing the positive supports competency program, the commissioner 
135.25 	must use a community-partner-driven process to:
135.26 	(1) define the core activities associated with effective intervention services at the levels 
135.27 	of positive support specialist, positive support analyst, and positive support professional;
135.28 	(2) create tools providers may use to track whether their positive supports specialists, 
135.29 	positive support analysts, and positive support professionals are competently performing 
135.30 	the core activities associated with effective intervention services;
135.31 	(3) align existing training systems funded through the Department of Human Services 
135.32 	and develop free online modules for competency-based training to prepare positive support 
136.1 	specialists, positive support analysts, and positive support professionals to provide effective 
136.2 	intervention services;
136.3 	(4) assist providers interested in utilizing a competency-based training model to create 
136.4 	a career pathway for the positive support analysts and positive support specialists within 
136.5 	their organizations by using experienced professionals;
136.6 	(5) create written guidelines, stories, and examples for providers that will be placed on 
136.7 	Department of Human Services websites promoting capacity building; and
136.8 	(6) disseminate resources and guidance to providers interested in meeting 
136.9 	competency-based qualifications for positive supports through existing regional networks 
136.10 	of experts, including communities of practice, and develop new avenues for disseminating 
136.11 	these resources and guidance, including through implementation of ECHO models.

136.12 	Sec. 82. DIRECTION TO COMMISSIONER; INTEGRATED COMMUNITY 
136.13 	SUPPORTS CODIFICATION.
 136.14 	(a) The commissioner of human services must develop draft language to codify in 
136.15 	Minnesota Statutes the standards and requirements for integrated community supports as 
136.16 	specified in the federally approved brain injury, community access for disability inclusion, 
136.17 	community alternative care, and developmental disabilities waiver plans.
136.18 	(b) When developing and drafting the proposed legislative language, the commissioner 
136.19 	must consult with interested parties, including the Association of Residential Resources in 
136.20 	Minnesota, the Residential Providers Association of Minnesota, the Minnesota Association 
136.21 	of County Social Service Administrators, and people with disabilities currently or potentially 
136.22 	receiving integrated community supports. The commissioner must ensure that the interested 
136.23 	parties with whom the commissioner consults represent a broad spectrum of active and 
136.24 	potential providers and service recipients. The commissioner's consultation with interested 
136.25 	parties must be transparent and provide the opportunity for meaningful input from active 
136.26 	and potential providers and service recipients.
136.27 	(c) The commissioner must submit the draft legislation to the chairs and ranking minority 
136.28 	members of the legislative committees with jurisdiction over health and human services 
136.29 	policy and finance by January 1, 2026.

137.1 	Sec. 83. DIRECTION TO COMMISSIONER; PROVISIONAL OR TRANSITIONAL 
137.2 	APPROVAL OF INTEGRATED COMMUNITY SERVICES SETTINGS.
 137.3 	(a) The commissioner of human services must develop draft language to improve the 
137.4 	process for approving integrated community supports settings, including a process for issuing 
137.5 	provisional or transitional licenses to allow applicants to obtain an initial approval to operate 
137.6 	prior to securing control of the approved setting. This process must also allow applicants 
137.7 	to change the approved setting during the application review period when needed to ensure 
137.8 	an available setting.
137.9 	(b) The commissioner must submit the draft legislation to the chairs and ranking minority 
137.10 	members of the legislative committees with jurisdiction over health and human services 
137.11 	policy and finance by January 1, 2026.

137.12 	Sec. 84. DIRECTION TO COMMISSIONER; GUIDANCE TO COUNTIES.
 137.13 	Upon receipt of approval from the Centers for Medicare and Medicaid Services, the 
137.14 	commissioner of human services shall provide guidance to counties on the administration 
137.15 	of the family support program under Minnesota Statutes, section 252.32; the consumer 
137.16 	support program under Minnesota Statutes, section 256.476; disability waivers under 
137.17 	Minnesota Statutes, sections 256B.092 and 256B.49; and the community first services and 
137.18 	supports program under Minnesota Statutes, section 256B.85, to clarify that the cost of 
137.19 	adaptive or one-on-one swimming lessons provided to a person younger than 12 years of 
137.20 	age whose disability puts the person at a higher risk of drowning according to the Centers 
137.21 	for Disease Control Vital Statistics System is an allowable use of money.

137.22 	Sec. 85. DIRECTION TO COMMISSIONER; SWIMMING LESSONS COVERED 
137.23 	UNDER DISABILITY WAIVERS.
 137.24 	The commissioner of human services shall include swimming lessons for a participant 
137.25 	younger than 12 years of age whose disability puts the participant at a higher risk of drowning 
137.26 	as a covered service under the disability waivers, including the consumer-directed community 
137.27 	supports option, under Minnesota Statutes, sections 256B.092 and 256B.49.

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

138.1 	Sec. 86. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
138.2 	DEVELOPMENT OF COMPREHENSIVE EIDBI LICENSE.
 138.3 	(a) By October 1, 2025, the commissioner of human services must convene a working 
138.4 	group consisting of staff from the Department of Human Services with policy and clinical 
138.5 	expertise related to EIDBI services, and with expertise in licensing standards for other 
138.6 	licensed programs and settings, particularly other programs serving children; staff from the 
138.7 	Department of Children, Youth, and Families  with expertise in the licensing standards for 
138.8 	home child care and child care centers; the Early Intensive Developmental and Behavioral 
138.9 	Advisory Council; families of individuals receiving EIDBI services; advocates for individuals 
138.10 	receiving EIDBI services; and other community partners and interested parties.
138.11 	(b) The working group must advise the commissioner as the commissioner develops 
138.12 	comprehensive EIDBI licensing standards and a plan to transition EIDBI agencies from the 
138.13 	provisional license established under Minnesota Statutes, section 245A.142, to a newly 
138.14 	established comprehensive EIDBI license. The working group must provide the commissioner 
138.15 	with advice on at least the following topics:
138.16 	(1) basic health and safety standards;
138.17 	(2) basic physical plant standards;
138.18 	(3) medication management and other ancillary services that might be provided by EIDBI 
138.19 	providers;
138.20 	(4) privacy and the use of cameras in settings where EIDBI services are being provided;
138.21 	(5) third-party billing procedures and requirements;
138.22 	(6) billing standards and policies regarding duplicative, simultaneous, and mid-point 
138.23 	billing practices;
138.24 	(7) measures of clinical effectiveness; and
138.25 	(8) appropriate restrictions on the commissioner's authority under Minnesota Statutes, 
138.26 	section 256B.0949, subdivision 17, to issue exceptions to EIDBI provider qualifications, 
138.27 	medical assistance provider enrollment requirements, and EIDBI provider or agency standards 
138.28 	or requirements.
138.29 	(c) By January 1, 2027, the commissioner must propose standards for a nonprovisional, 
138.30 	comprehensive EIDBI license or licenses, and submit proposed draft legislation to the chairs 
138.31 	and ranking minority members of the legislative committees with jurisdiction over EIDBI 
138.32 	services.

139.1 	Sec. 87. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
139.2 	TEMPORARY MORATORIUM ON ENROLLMENT OF NEW EIDBI PROVIDERS.
 139.3 	Upon federal approval and subject to continued federal approval, beginning July 1, 2025, 
139.4 	the commissioner must not enroll new EIDBI agencies to provide EIDBI services under 
139.5 	Minnesota Statutes, chapter 256B, unless the agency is licensed as an EIDBI agency under 
139.6 	Minnesota Statutes, chapter 245A, but may enroll new locations where EIDBI services are 
139.7 	provided by an agency that was enrolled prior to July 1, 2025.

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

139.9 	Sec. 88. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
139.10 	INCREASE TO PAYMENTS FOR FAMILY RESIDENTIAL AND LIFE SHARING 
139.11 	SERVICES.
 139.12 	Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner 
139.13 	of human services must increase by 51.69 percent payment rates previously established 
139.14 	under Minnesota Statutes, section 256B.4914, subdivision 19, for family residential services. 
139.15 	Rates for life sharing services must be ten percent higher than the corresponding family 
139.16 	residential services rate established under this section.

139.17 	Sec. 89. COMMISSIONER OF HUMAN SERVICES; WAIVER CASE 
139.18 	MANAGEMENT EVALUATION AND RATE STUDY.
 139.19 		Subdivision 1.Reimbursement rate study. The commissioner of human services must 
139.20 	issue a request for proposals to develop and model a proposed reimbursement rate 
139.21 	methodology for waiver case management services under Minnesota Statutes, sections 
139.22 	256B.0913, 256B.092, 256B.0922, and 256B.49, and Minnesota Statutes, chapter 256S. 
139.23 	The proposed methodology for waiver case management reimbursement rates must be 
139.24 	predicated on a methodology that is transparent, culturally responsive, and supportive of 
139.25 	lead agency staffing needed to provide high-quality, person-centered, and culturally 
139.26 	responsive case management services. The development of the rate methodology must 
139.27 	consider costs and workforce pressures that impact the delivery of case management services; 
139.28 	costs to provide culturally responsive case management services as described in Minnesota 
139.29 	Statutes, section 256B.076, subdivision 3; and compensation required to attract and retain 
139.30 	qualified case managers.
139.31 		Subd. 2.Evaluation of case management service delivery. The commissioner must 
139.32 	conduct an evaluation of lead agency duties associated with waiver case management; 
139.33 	current caseloads; best practices related to caseloads and case mix; required professional 
140.1 	qualifications, experience, and training of case management professionals; and quality 
140.2 	assurance measures, and make recommendations to improve the quality, consistency, and 
140.3 	timeliness of the provision of waiver case management services.
140.4 		Subd. 3.Community engagement. (a) The commissioner must consult with interested 
140.5 	parties from across each region of the state including, but not limited to, lead agencies, 
140.6 	contracted waiver case management service providers, culturally responsive providers, 
140.7 	individuals receiving services and their families, advocacy organizations, and relevant 
140.8 	experts in the development of the request for proposals under subdivision 1.
140.9 	(b) The commissioner must collaborate with interested parties from across each region 
140.10 	of the state including, but not limited to, lead agencies, contracted waiver case management 
140.11 	service providers, culturally responsive providers, individuals receiving services and their 
140.12 	families, advocacy organizations, and relevant experts in the evaluation of the delivery of 
140.13 	waiver case management services.
140.14 		Subd. 4.Recommendations and reports. By December 15, 2025, the commissioner 
140.15 	of human services must submit a preliminary report to the chairs and ranking minority 
140.16 	members of the legislative committees with jurisdiction over human services policy and 
140.17 	finance on the initial results of the rate study and service delivery evaluation. By December 
140.18 	15, 2026, the commissioner of human services must submit to the chairs and ranking minority 
140.19 	members of committees with jurisdiction over health and human services a report detailing 
140.20 	(1) the waiver rate methodology, including all rate components, and modeled rates; and (2) 
140.21 	findings and recommendations of the evaluation of case management service delivery. The 
140.22 	report must include (1) legislative language necessary to modify existing or implement new 
140.23 	rate methodologies and a detailed fiscal analysis of the proposed rate methodology; and (2) 
140.24 	legislative language necessary to implement recommendations to improve wavier case 
140.25 	management service delivery.

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

140.27 	Sec. 90. CHAPTER 245D PROVIDER LICENSING TIMELINESS IMPROVEMENT 
140.28 	INITIATIVE.
 140.29 	(a) The commissioner of human services must conduct a comprehensive business process 
140.30 	analysis and redesign of the provider licensing system with a particular focus on Minnesota 
140.31 	Statutes, chapter 245D, licensing activities.
140.32 	(b) The commissioner's business process analysis must include at least the following 
140.33 	elements:
141.1 	(1) a full mapping of the current provider licensing process, including provider inquiry, 
141.2 	application intake, documentation requirements, inspections, background checks, approval 
141.3 	or denial, and renewal processes;
141.4 	(2) identification of all bottlenecks, backlogs, batches, redundancies, and inefficiencies;
141.5 	(3) engagement with providers, people receiving services, lead agencies, and advocates 
141.6 	and other stakeholders to gather feedback on process challenges and recommendations for 
141.7 	improvement; and
141.8 	(4) analysis of opportunities to incorporate digital and tech solutions or workflow 
141.9 	automation.
141.10 	(c) When developing a proposal to redesign Minnesota Statutes, chapter 245D, licensing 
141.11 	processes to better service individuals and providers, the commissioner must work directly 
141.12 	with licensing staff, managers, and leadership and develop revised performance metrics and 
141.13 	timelines, including a target average time frame for initial license decisions and renewals 
141.14 	with the creation of a dashboard assuring transparency and ongoing accountability.
141.15 	(d) By January 1, 2026, the commissioner must submit to the chairs and ranking minority 
141.16 	members of the legislative committees with jurisdiction over human services licensing and 
141.17 	over long-term services and supports a report that includes:
141.18 	(1) the findings of the analysis of current Minnesota Statutes, chapter 245D, provider 
141.19 	licensing processes;
141.20 	(2) the proposed redesign of Minnesota Statutes, chapter 245D, provider licensing 
141.21 	processes;
141.22 	(3) an implementation plan of agreed upon improvements with timelines and required 
141.23 	resources; and
141.24 	(4) recommended statutory or regulatory changes, if any, necessary to support 
141.25 	implementation.

141.26 	Sec. 91. REPEALER.
 141.27 		Subdivision 1.Obsolete home and community-based services licensing 
141.28 	provisions. Minnesota Statutes 2024, section 245A.042, subdivisions 2, 3, and 4, are 
141.29 	repealed.
141.30 		Subd. 2.Direct care provider premiums. Laws 2023, chapter 59, article 3, section 11, 
141.31 	is repealed.
142.1 		Subd. 3.Legislative Task Force on Guardianship. Laws 2024, chapter 127, article 
142.2 	46, section 39, is repealed.
142.3 		Subd. 4.Revision of treatment modalities. Minnesota Statutes 2024, section 256B.0949, 
142.4 	subdivision 9, is repealed.

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

142.6 	ARTICLE 3
142.7 	LONG-TERM SERVICES AND SUPPORTS REFORM

142.8 	Section 1. Minnesota Statutes 2024, section 256B.49, is amended by adding a subdivision 
142.9 	to read:
142.10 		Subd. 17a.Service authorizations and service agreements; generally. Recipients 
142.11 	must be screened and authorized for services according to the federally approved waiver 
142.12 	application and its subsequent amendments.

142.13 	Sec. 2. Minnesota Statutes 2024, section 256B.49, is amended by adding a subdivision to 
142.14 	read:
142.15 		Subd. 17b.Service authorizations and service agreements; community access for 
142.16 	disability inclusion waiver services. (a) For service agreements under the community 
142.17 	access for disability inclusion waiver program only, the commissioner must require lead 
142.18 	agency supervisors to review and accept all service agreements entered by lead agency staff 
142.19 	into the Medicaid management information system (MMIS) prior to the commissioner's 
142.20 	approval of the service agreement.
142.21 	(b) For a service agreement under the community access for disability inclusion waiver 
142.22 	with a proposed total authorized amount that exceeds the total authorized amount in the 
142.23 	recipient's prior service agreement by more than the value of legislatively enacted rate 
142.24 	increases, the commissioner must manually review and manually approve the service 
142.25 	agreement in the MMIS. For purposes of this paragraph, "prior service agreement" means 
142.26 	the service agreement that was in effect 12 months prior to the start date of the new proposed 
142.27 	service agreement.
142.28 	(c) In a format prescribed by the commissioner, lead agencies must submit the following 
142.29 	information for all service agreements subject to the commissioner's approval in paragraph 
142.30 	(b):
142.31 	(1) changes in the number of units authorized;
143.1 	(2) new services authorized;
143.2 	(3) changes in the values used to calculate service rates under section 256B.4914, except 
143.3 	for automatic adjustments required under section 256B.4914, subdivisions 5 and 5b;
143.4 	(4) changes in the person's level of need requiring an increase in the amount of services 
143.5 	authorized;
143.6 	(5) documentation detailing why the previous amount of services is not sufficient to 
143.7 	meet the person's needs; and
143.8 	(6) anticipated impact if the total service amount is not increased to the proposed amount.
143.9 	(d) Except for rate increases required under section 256B.4914, subdivisions 5 and 5b, 
143.10 	and rate changes authorized by the 2025 legislature, the commissioner must not approve 
143.11 	service agreements under paragraph (b) that are not the result of either a documented change 
143.12 	in a person's assessed needs or documented evidence that the previous level of service was 
143.13 	insufficient to meet the person's assessed needs.
143.14 	(e) This subdivision expires upon full implementation of waiver reimagine. The 
143.15 	commissioner must inform the revisor of statutes when waiver reimagine is fully 
143.16 	implemented.

143.17 	Sec. 3. Minnesota Statutes 2024, section 256B.49, subdivision 18, is amended to read:
143.18 		Subd. 18.Payments. The commissioner shall reimburse approved vendors from the 
143.19 	medical assistance account for the costs of providing home and community-based services 
143.20 	to eligible recipients using the invoice processing procedures of the Medicaid management 
143.21 	information system (MMIS). Recipients will be screened and authorized for services 
143.22 	according to the federally approved waiver application and its subsequent amendments.

143.23 	Sec. 4. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
143.24 	LONG-TERM SERVICES AND SUPPORTS REFORM WORK GROUP.
 143.25 		Subdivision 1.Development of alternative service models for long-term services 
143.26 	and supports. (a) By October 1, 2025, the commissioner of human services must convene 
143.27 	a group of department staff and community partners to assist the commissioner in developing 
143.28 	alternative service models to provide long-term services and supports to people with limited 
143.29 	dependencies, low-acuity assessed needs, or natural supports. The commissioner is 
143.30 	encouraged to consider increasing available service models; tailoring available services to 
143.31 	meet the needs of the target population; supplementing or subsidizing family caregivers, 
143.32 	religious organizations, social clubs, and similar civic and service organizations; exercising 
144.1 	the commissioner's authority under Minnesota Statutes, section 256B.092, subdivision 4a; 
144.2 	reexamining the provision of services under Minnesota Statutes, section 245A.03, subdivision 
144.3 	9; reexamining the viability of a demonstration project similar for the target population to 
144.4 	the projects authorized under Minnesota Statutes, sections 256B.69, subdivision 23, and 
144.5 	256B.77; modifying licensing and regulator requirements to permit family or other natural 
144.6 	supports to live with a person with a disability, behavioral health needs, or an older adult 
144.7 	in licensed settings, such as an assisted living facility or senior living setting; and tax credits 
144.8 	or other tax incentives to encourage intergenerational living arrangements, accessory dwelling 
144.9 	units, or other residential arrangements that permit easier access to natural supports.
144.10 	(b) By October 1, 2026, the commissioner must submit to the chairs and ranking minority 
144.11 	members of the legislative committees with jurisdiction over medical assistance long-term 
144.12 	services and supports a set of proposals that if enacted is estimated to reduce expected 
144.13 	general fund expenditures relative to the February 2025 forecast during the biennium 
144.14 	beginning July 1, 2027, by at least the amount assumed in subdivision 3, paragraph (a). An 
144.15 	estimate of the estimated savings as well as a summary of the expected impact on people 
144.16 	served must accompany each proposal.
144.17 		Subd. 2.Administration. (a) The commissioner of human services must provide meeting 
144.18 	space and general administrative support to the workgroup.
144.19 	(b) The commissioner of human services must contract with a third party to provide 
144.20 	facilitation services for the workgroup. Use of a third party for this purpose is exempt from 
144.21 	state procurement process requirements under Minnesota Statutes, chapter 16C.
144.22 	(c) The commissioner of human services may contract with a third party or parties to 
144.23 	provide policy research and analysis, data analysis, and administrative support related to 
144.24 	drafting the action plan and supporting materials. Use of a third party for these purposes is 
144.25 	exempt from state procurement process requirements under Minnesota Statutes, chapter 
144.26 	16C.
144.27 		Subd. 3.Savings determination. (a) When preparing the forecast for state revenues and 
144.28 	expenditures under Minnesota Statutes, section 16A.103, the commissioner of management 
144.29 	and budget must assume a reduction of human services spending of $135,000,000 relative 
144.30 	to the February 2025 forecast for the biennium beginning July 1, 2027, until the end of the 
144.31 	legislative session that enacts a budget for the Department of Human Services for the 
144.32 	biennium beginning July 1, 2027.
144.33 	(b) Upon enactment of a budget for the Department of Human Services for the biennium 
144.34 	beginning July 1, 2027, the legislature must identify enacted provisions that were 
145.1 	recommended by or based on the action plan submitted by the commissioner of human 
145.2 	services under subdivision 1.
145.3 	(c) To the extent the net savings attributable to the provisions identified by the legislature 
145.4 	under paragraph (b) for the biennium beginning July 1, 2027, are less than the assumed 
145.5 	savings in paragraph (a), the commissioner of human services must implement the contingent 
145.6 	rate reductions described in subdivision 4.
145.7 		Subd. 4.Contingent rate reductions. If upon enactment of a budget for the Department 
145.8 	of Human Services for the biennium beginning July 1, 2027, the net savings for the biennium 
145.9 	beginning July 1, 2027, attributable to the provisions identified by the legislature under 
145.10 	subdivision 3, paragraph (b), are less than the assumed savings in subdivision 3, paragraph 
145.11 	(a), notwithstanding Minnesota Statutes, section 256B.4914, the commissioner of human 
145.12 	services must adjust the competitive workforce factors under Minnesota Statutes, section 
145.13 	256B.4914, subdivisions 6 to 9, to a value that will produce by June 30, 2029, a net reduction 
145.14 	in expected general fund expenditures relative to the February 2025 forecast equal to the 
145.15 	difference between the savings attributable to the provisions identified in subdivision 3, 
145.16 	paragraph (b), and the assumed savings in subdivision 3, paragraph (a).

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

145.18 	Sec. 5. DIRECTION TO THE COMMISSIONERS OF HUMAN SERVICES AND 
145.19 	MANAGEMENT AND BUDGET; COST SAVING REFORMS WORKING GROUP.
 145.20 		Subdivision 1.Identifying cost saving reforms. (a) By October 1, 2025, the 
145.21 	commissioner of human services must convene a group of department staff and community 
145.22 	partners to assist the commissioner in identifying cost saving reforms to licensing 
145.23 	requirements, service standards, provider qualifications, provider duties and responsibilities, 
145.24 	lead agency duties and responsibilities, eligibility, covered services, service authorizations, 
145.25 	service limits, service rate calculations, rate enhancements and add-ons, rate exceptions, 
145.26 	rate limits, budget limits, or any other cost saving reforms to medical assistance long-term 
145.27 	services and supports and other programs serving people with disabilities, people with 
145.28 	behavioral health needs, or older adults.
145.29 	(b) By October 1, 2026, the commissioner must submit to the chairs and ranking minority 
145.30 	members of the legislative committees with jurisdiction over medical assistance long-term 
145.31 	services and supports an action plan that if enacted is estimated to reduce expected general 
145.32 	fund expenditures relative to the February 2025 forecast during the biennium beginning 
145.33 	July 1, 2027, by at least the amount assumed in subdivision 3, paragraph (a). Each strategy 
146.1 	included in the action plan must include an estimate of the estimated savings as well as a 
146.2 	summary of the expected impact on people served.
146.3 		Subd. 2.Administration. (a) The commissioner of human services must provide meeting 
146.4 	space and general administrative support to the workgroup.
146.5 	(b) The commissioner of human services must contract with a third party to provide 
146.6 	facilitation services for the workgroup. Use of a third party for this purpose is exempt from 
146.7 	state procurement process requirements under Minnesota Statutes, chapter 16C.
146.8 	(c) The commissioner of human services may contract with a third party or parties to 
146.9 	provide policy research and analysis, data analysis, and administrative support related to 
146.10 	drafting the action plan and supporting materials. Use of a third party for these purposes is 
146.11 	exempt from state procurement process requirements under Minnesota Statutes, chapter 
146.12 	16C.
146.13 		Subd. 3.Savings determination. (a) When preparing the forecast for state revenues and 
146.14 	expenditures under Minnesota Statutes, section 16A.103, the commissioner of management 
146.15 	and budget must assume a reduction of human services spending of $150,000,000 relative 
146.16 	to the February 2025 forecast for the biennium beginning July 1, 2027, until the end of the 
146.17 	legislative session that enacts a budget for the Department of Human Services for the 
146.18 	biennium beginning July 1, 2027.
146.19 	(b) Upon enactment of a budget for the Department of Human Services for the biennium 
146.20 	beginning July 1, 2027, the legislature must identify enacted provisions that were 
146.21 	recommended by or based on the action plan submitted by the commissioner of human 
146.22 	services under subdivision 1.
146.23 	(c) To the extent the net savings attributable to the provisions identified by the legislature 
146.24 	under paragraph (b) for the biennium beginning July 1, 2027, are less than the assumed 
146.25 	savings in paragraph (a), the commissioner of human services must implement the contingent 
146.26 	rate reductions described in subdivision 4.
146.27 		Subd. 4.Contingent rate reductions. If upon enactment of a budget for the Department 
146.28 	of Human Services for the biennium beginning July 1, 2027, the net savings for the biennium 
146.29 	beginning July 1, 2027, attributable to the provisions identified by the legislature under 
146.30 	subdivision 3, paragraph (b), are less than the assumed savings in subdivision 3, paragraph 
146.31 	(a), notwithstanding Minnesota Statutes, section 256B.4914, the commissioner of human 
146.32 	services must adjust the competitive workforce factors under Minnesota Statutes, section 
146.33 	256B.4914, subdivisions 6 to 9, to a value that will produce by June 30, 2029, a net reduction 
146.34 	in expected general fund expenditures relative to the February 2025 forecast equal to the 
147.1 	difference between the savings attributable to the provisions identified in subdivision 3, 
147.2 	paragraph (b), and the assumed savings in subdivision 3, paragraph (a).

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

147.4 	Sec. 6. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; OPTIONAL 
147.5 	CONSULTATION SERVICES.
 147.6 	The commissioner of human services must consider submitting a medical assistance 
147.7 	state plan amendment to permit consultation services that are currently required under the 
147.8 	community first services and supports program to be an optional service for individuals 
147.9 	receiving waiver case management services under Minnesota Statutes, sections 256B.0913, 
147.10 	256B.092, 256B.0922, and 256B.49, or Minnesota Statutes, chapter 256S.

147.11 	Sec. 7. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
147.12 	LONG-TERM CARE CONSULTATION SERVICES PAYMENT REFORM.
 147.13 		Subdivision 1.Development of alternative payment methodology for long-term care 
147.14 	consultation services. (a) The commissioner of human services must develop a proposal 
147.15 	for a long-term care consultation services payment methodology that does not rely on a 
147.16 	time study to determine reimbursement to the counties for providing long-term care 
147.17 	consultation services under Minnesota Statutes, section 256B.0911. The new reimbursement 
147.18 	methodology must be a methodology that:
147.19 	(1) results in a flat reimbursement amount per long-term care consultation assessment 
147.20 	under Minnesota Statutes, section 256B.0911;
147.21 	(2) reduces expected general fund expenditures relative to the February 2025 forecast 
147.22 	during the biennium beginning July 1, 2027, by at least the amount assumed in subdivision 
147.23 	2, paragraph (a);
147.24 	(3) preserves the commissioner's ability to allocate to medical assistance costs incurred 
147.25 	by counties for providing long-term care consultation services; and
147.26 	(4) does not jeopardize the commissioner's ability to allocate other local administrative 
147.27 	costs to medical assistance or other federal programs.
147.28 	(b) By October 1, 2026, the commissioner must submit to the chairs and ranking minority 
147.29 	members of the legislative committees with jurisdiction over medical assistance long-term 
147.30 	services and supports the proposal developed under paragraph (a) and any draft legislation 
147.31 	required to implement the proposal.
148.1 		Subd. 2.Savings determination. (a) When preparing the forecast for state revenues and 
148.2 	expenditures under Minnesota Statutes, section 16A.103, the commissioner of management 
148.3 	and budget must assume a reduction of human services spending of $18,000,000 relative 
148.4 	to the February 2025 forecast for the biennium beginning July 1, 2027, until the end of the 
148.5 	legislative session that enacts a budget for the Department of Human Services for the 
148.6 	biennium beginning July 1, 2027.
148.7 	(b) Upon enactment of a budget for the Department of Human Services for the biennium 
148.8 	beginning July 1, 2027, the legislature must identify enacted provisions that were 
148.9 	recommended by or based on the proposal submitted by the commissioner of human services 
148.10 	under subdivision 1.
148.11 	(c) To the extent the net savings attributable to the provisions identified by the legislature 
148.12 	under paragraph (b) for the biennium beginning July 1, 2027, are less than the assumed 
148.13 	savings in paragraph (a), the commissioner of human services shall implement the contingent 
148.14 	reductions in reimbursement to counties described in subdivision 4.
148.15 		Subd. 3.Contingent reimbursement reductions. If upon enactment of a budget for 
148.16 	the Department of Human Services for the biennium beginning July 1, 2027, the net savings 
148.17 	for the biennium beginning July 1, 2027, attributable to the provisions identified by the 
148.18 	legislature under subdivision 2, paragraph (b), are less than the assumed savings in 
148.19 	subdivision 2, paragraph (a), notwithstanding Minnesota Statutes, section 256B.0911, 
148.20 	subdivision 33, the commissioner of human services must reduce the percentage of the 
148.21 	nonfederal share for the provision of long-term care consultation services the state pays to 
148.22 	the counties as reimbursement to a value that will produce by June 30, 2029, a net reduction 
148.23 	in expected general fund expenditures relative to the February 2025 forecast equal to the 
148.24 	difference between the savings attributable to the provisions identified in subdivision 2, 
148.25 	paragraph (b), and the assumed savings in subdivision 2, paragraph (a).

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

148.27 	Sec. 8. DIRECTIONS TO THE COMMISSIONERS OF HUMAN SERVICES AND 
148.28 	MANAGEMENT AND BUDGET; ADDITIONAL OFFSETS TO CONTINGENT 
148.29 	REIMBURSEMENT REDUCTIONS.
 148.30 	(a) When preparing the forecast for state revenues and expenditures under Minnesota 
148.31 	Statutes, section 16A.103, the commissioner of management and budget, in consultation 
148.32 	with the commissioner of human services, must estimate the net reduction in estimated 
148.33 	spending for the biennium beginning July 1, 2027, attributable to the amendments in sections 
149.1 	1 to 3 and 6 of this article that exceed the general fund reductions included in this act for 
149.2 	these sections of this article.
149.3 	(b) The commissioner of management and budget must reduce the assumed reductions 
149.4 	in human services spending required under section 7, subdivision 2, paragraph (a), of this 
149.5 	article by the amount identified in paragraph (a).
149.6 	(c) If the amount identified in paragraph (a) exceeds the assumed reductions required 
149.7 	under section 7, subdivision 2, paragraph (a), of this article, notwithstanding Minnesota 
149.8 	Statutes, section 256B.0911, subdivision 33, the commissioner of human services must 
149.9 	increase the percentage of the nonfederal share for the provision of long-term care 
149.10 	consultation services the state pays to the counties as reimbursement to a value that will 
149.11 	produce, by June 30, 2029, a net zero change in expected general fund expenditures relative 
149.12 	to the February 2025 forecast for these services.

149.13 	ARTICLE 4
149.14 	SUBSTANCE USE DISORDER TREATMENT

149.15 	Section 1. Minnesota Statutes 2024, section 245G.01, subdivision 13b, is amended to 
149.16 	read:
149.17 		Subd. 13b.Guest speaker. (a) "Guest speaker" means an individual who is not an alcohol 
149.18 	and drug counselor qualified according to section 245G.11, subdivision 5; is not qualified 
149.19 	according to the commissioner's list of professionals under section 245G.07, subdivision 
149.20 	3; and who works under the direct observation of an alcohol and drug counselor to present 
149.21 	to clients on topics in which the guest speaker has expertise and that the license holder has 
149.22 	determined to be beneficial to a client's recovery.
149.23 	(b) Tribally licensed programs have autonomy to identify the qualifications of their guest 
149.24 	speakers.

149.25 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
149.26 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
149.27 	when federal approval is obtained.

149.28 	Sec. 2. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to 
149.29 	read:
149.30 		Subd. 13d.Individual counseling. "Individual counseling" means professionally led 
149.31 	psychotherapeutic treatment for substance use disorders that is delivered in a one-to-one 
149.32 	setting or in a setting with the client and the client's family and other natural supports.

150.1 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
150.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
150.3 	when federal approval is obtained.

150.4 	Sec. 3. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to 
150.5 	read:
150.6 		Subd. 20f.Psychoeducation. "Psychoeducation" means the services described in section 
150.7 	245G.07, subdivision 1a, clause (2).

150.8 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
150.9 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
150.10 	when federal approval is obtained.

150.11 	Sec. 4. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to 
150.12 	read:
150.13 		Subd. 20g.Psychosocial treatment services. "Psychosocial treatment services" means 
150.14 	the services described in section 245G.07, subdivision 1a.

150.15 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
150.16 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
150.17 	when federal approval is obtained.

150.18 	Sec. 5. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to 
150.19 	read:
150.20 		Subd. 20h.Recovery support services. "Recovery support services" means the services 
150.21 	described in section 245G.07, subdivision 2a, paragraph (b), clause (1).

150.22 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
150.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
150.24 	when federal approval is obtained.

150.25 	Sec. 6. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to 
150.26 	read:
150.27 		Subd. 26a.Treatment coordination. "Treatment coordination" means the services 
150.28 	described in section 245G.07, subdivision 1b.

151.1 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
151.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
151.3 	when federal approval is obtained.

151.4 	Sec. 7. Minnesota Statutes 2024, section 245G.02, subdivision 2, is amended to read:
151.5 		Subd. 2.Exemption from license requirement. This chapter does not apply to a county 
151.6 	or recovery community organization that is providing a service for which the county or 
151.7 	recovery community organization is an eligible vendor under section 254B.05. This chapter 
151.8 	does not apply to an organization whose primary functions are information, referral, 
151.9 	diagnosis, case management, and assessment for the purposes of client placement, education, 
151.10 	support group services, or self-help programs. This chapter does not apply to the activities 
151.11 	of a licensed professional in private practice. A license holder providing the initial set of 
151.12 	substance use disorder services allowable under section 254A.03, subdivision 3, paragraph 
151.13 	(c), to an individual referred to a licensed nonresidential substance use disorder treatment 
151.14 	program after a positive screen for alcohol or substance misuse is exempt from sections 
151.15 	245G.05; 245G.06, subdivisions 1, 1a, and 4; 245G.07, subdivisions 1, paragraph (a), clauses 
151.16 	(2) to (4), and 2, clauses (1) to (7) subdivision 1a, clause (2); and 245G.17.

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

151.18 	Sec. 8. Minnesota Statutes 2024, section 245G.05, subdivision 1, is amended to read:
151.19 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
151.20 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
151.21 	counselor within five calendar days from the day of service initiation for a residential 
151.22 	program or by the end of the fifth day on which a treatment service is provided in a 
151.23 	nonresidential program. The number of days to complete the comprehensive assessment 
151.24 	excludes the day of service initiation.
151.25 	(b) A comprehensive assessment must be administered by:
151.26 	(1) an alcohol and drug counselor;
151.27 	(2) a mental health professional who meets the qualifications under section 245I.04, 
151.28 	subdivision 2, practices within the scope of their professional licensure, and has training in 
151.29 	addiction, co-occurring disorders, and substance use disorder diagnosis and treatment 
151.30 	according to the requirements in section 245G.13, subdivision 2, paragraph (f);
152.1 	(3) a clinical trainee who meets the qualifications under section 245I.04, subdivision 6, 
152.2 	practicing under the supervision of a mental health professional who meets the requirements 
152.3 	of clause (2); or
152.4 	(4) an advanced practice registered nurse as defined in section 148.171, subdivision 3, 
152.5 	who practices within the scope of their professional licensure and has training in addiction, 
152.6 	co-occurring disorders, and substance use disorder diagnosis and treatment according to 
152.7 	the requirements in section 245G.13, subdivision 2, paragraph (f).
152.8 	(c) If the comprehensive assessment is not completed within the required time frame, 
152.9 	the person-centered reason for the delay and the planned completion date must be documented 
152.10 	in the client's file. The comprehensive assessment is complete upon a qualified staff member's 
152.11 	dated signature. If the client received a comprehensive assessment that authorized the 
152.12 	treatment service, an alcohol and drug counselor a staff member qualified under paragraph 
152.13 	(b) may use the comprehensive assessment for requirements of this subdivision but must 
152.14 	document a review of the comprehensive assessment and update the comprehensive 
152.15 	assessment as clinically necessary to ensure compliance with this subdivision within 
152.16 	applicable timelines. An alcohol and drug counselor A staff member qualified under 
152.17 	paragraph (b) must sign and date the comprehensive assessment review and update.

152.18 	Sec. 9. Minnesota Statutes 2024, section 245G.07, subdivision 1, is amended to read:
152.19 		Subdivision 1.Treatment service. (a) A licensed residential treatment program must 
152.20 	offer the treatment services in clauses (1) to (5) subdivisions 1a and 1b and may offer the 
152.21 	treatment services in subdivision 2 to each client, unless clinically inappropriate and the 
152.22 	justifying clinical rationale is documented. A nonresidential The treatment program must 
152.23 	offer all treatment services in clauses (1) to (5) and document in the individual treatment 
152.24 	plan the specific services for which a client has an assessed need and the plan to provide 
152.25 	the services:.
152.26 	(1) individual and group counseling to help the client identify and address needs related 
152.27 	to substance use and develop strategies to avoid harmful substance use after discharge and 
152.28 	to help the client obtain the services necessary to establish a lifestyle free of the harmful 
152.29 	effects of substance use disorder;
152.30 	(2) client education strategies to avoid inappropriate substance use and health problems 
152.31 	related to substance use and the necessary lifestyle changes to regain and maintain health. 
152.32 	Client education must include information on tuberculosis education on a form approved 
152.33 	by the commissioner, the human immunodeficiency virus according to section 245A.19, 
152.34 	other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis;
153.1 	(3) a service to help the client integrate gains made during treatment into daily living 
153.2 	and to reduce the client's reliance on a staff member for support;
153.3 	(4) a service to address issues related to co-occurring disorders, including client education 
153.4 	on symptoms of mental illness, the possibility of comorbidity, and the need for continued 
153.5 	medication compliance while recovering from substance use disorder. A group must address 
153.6 	co-occurring disorders, as needed. When treatment for mental health problems is indicated, 
153.7 	the treatment must be integrated into the client's individual treatment plan; and
153.8 	(5) treatment coordination provided one-to-one by an individual who meets the staff 
153.9 	qualifications in section 245G.11, subdivision 7. Treatment coordination services include:
153.10 	(i) assistance in coordination with significant others to help in the treatment planning 
153.11 	process whenever possible;
153.12 	(ii) assistance in coordination with and follow up for medical services as identified in 
153.13 	the treatment plan;
153.14 	(iii) facilitation of referrals to substance use disorder services as indicated by a client's 
153.15 	medical provider, comprehensive assessment, or treatment plan;
153.16 	(iv) facilitation of referrals to mental health services as identified by a client's 
153.17 	comprehensive assessment or treatment plan;
153.18 	(v) assistance with referrals to economic assistance, social services, housing resources, 
153.19 	and prenatal care according to the client's needs;
153.20 	(vi) life skills advocacy and support accessing treatment follow-up, disease management, 
153.21 	and education services, including referral and linkages to long-term services and supports 
153.22 	as needed; and
153.23 	(vii) documentation of the provision of treatment coordination services in the client's 
153.24 	file.
153.25 	(b) A treatment service provided to a client must be provided according to the individual 
153.26 	treatment plan and must consider cultural differences and special needs of a client.
153.27 	(c) A supportive service alone does not constitute a treatment service. Supportive services 
153.28 	include:
153.29 	(1) milieu management or supervising or monitoring clients without also providing a 
153.30 	treatment service identified in subdivision 1a, 1b, or 2a;
153.31 	(2) transporting clients;
154.1 	(3) waiting with clients for appointments at social service agencies, court hearings, and 
154.2 	similar activities; and
154.3 	(4) collecting urinalysis samples.
154.4 	(d) A treatment service provided in a group setting must be provided in a cohesive 
154.5 	manner and setting that allows every client receiving the service to interact and receive the 
154.6 	same service at the same time.

154.7 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
154.8 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
154.9 	when federal approval is obtained.

154.10 	Sec. 10. Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision 
154.11 	to read:
154.12 		Subd. 1a.Psychosocial treatment service. Psychosocial treatment services must be 
154.13 	provided according to the hours identified in section 254B.19 for the ASAM level of care 
154.14 	provided to the client. A license holder must provide the following psychosocial treatment 
154.15 	services as a part of the client's individual treatment:
154.16 	(1) counseling services that provide a client with professional assistance in managing 
154.17 	substance use disorder and co-occurring conditions, either individually or in a group setting. 
154.18 	Counseling must:
154.19 	(i) use evidence-based techniques to help a client modify behavior, overcome obstacles, 
154.20 	and achieve and sustain recovery through techniques such as active listening, guidance, 
154.21 	discussion, feedback, and clarification;
154.22 	(ii) help the client to identify and address needs related to substance use, develop 
154.23 	strategies to avoid harmful substance use, and establish a lifestyle free of the harmful effects 
154.24 	of substance use disorder; and
154.25 	(iii) work to improve well-being and mental health, resolve or mitigate symptomatic 
154.26 	behaviors, beliefs, compulsions, thoughts, and emotions, and enhance relationships and 
154.27 	social skills, while addressing client-centered psychological and emotional needs; and
154.28 	(2) psychoeducation services to provide a client with information about substance use 
154.29 	and co-occurring conditions, either individually or in a group setting. Psychoeducation 
154.30 	includes structured presentations, interactive discussions, and practical exercises to help 
154.31 	clients understand and manage their conditions effectively. Topics include but are not limited 
154.32 	to:
155.1 	(i) the causes of substance use disorder and co-occurring disorders;
155.2 	(ii) behavioral techniques that help a client change behaviors, thoughts, and feelings;
155.3 	(iii) the importance of maintaining mental health, including understanding symptoms 
155.4 	of mental illness;
155.5 	(iv) medications for addiction and psychiatric disorders and the importance of medication 
155.6 	adherence;
155.7 	(v) the importance of maintaining physical health, health-related risk factors associated 
155.8 	with substance use disorder, and specific health education on tuberculosis, HIV, other 
155.9 	sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis; and
155.10 	(vi) harm-reduction strategies.

155.11 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
155.12 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
155.13 	when federal approval is obtained.

155.14 	Sec. 11. Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision 
155.15 	to read:
155.16 		Subd. 1b.Treatment coordination. (a) Treatment coordination must be provided to a 
155.17 	single client by an individual who meets the staff qualifications in section 245G.11, 
155.18 	subdivision 7. Treatment coordination services include:
155.19 	(1) coordinating directly with others involved in the client's treatment and recovery, 
155.20 	including the referral source, family or natural supports, social services agencies, and external 
155.21 	care providers;
155.22 	(2) providing clients with training and facilitating connections to community resources 
155.23 	that support recovery;
155.24 	(3) assisting clients in obtaining necessary resources and services such as financial 
155.25 	assistance, housing, food, clothing, medical care, education, harm reduction services, 
155.26 	vocational support, and recreational services that promote recovery;
155.27 	(4) helping clients connect and engage with self-help support groups and expand social 
155.28 	support networks with family, friends, and organizations; and
155.29 	(5) assisting clients in transitioning between levels of care, including providing direct 
155.30 	connections to ensure continuity of care.
156.1 	(b) Treatment coordination does not include coordinating services or communicating 
156.2 	with staff members within the licensed program.
156.3 	(c) Treatment coordination may be provided in a setting with the individual client and 
156.4 	others involved in the client's treatment and recovery.

156.5 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
156.6 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
156.7 	when federal approval is obtained.

156.8 	Sec. 12. Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision 
156.9 	to read:
156.10 		Subd. 2a.Ancillary treatment service. (a) A license holder may provide ancillary 
156.11 	services in addition to the hours of psychosocial treatment services identified in section 
156.12 	254B.19 for the ASAM level of care provided to the client.
156.13 	(b) A license holder may provide the following ancillary treatment services as a part of 
156.14 	the client's individual treatment:
156.15 	(1) recovery support services provided individually or in a group setting, that include:
156.16 	(i) supporting clients in restoring daily living skills, such as health and health care 
156.17 	navigation and self-care to enhance personal well-being;
156.18 	(ii) providing resources and assistance to help clients restore life skills, including effective 
156.19 	parenting, financial management, pro-social behavior, education, employment, and nutrition;
156.20 	(iii) assisting clients in restoring daily functioning and routines affected by substance 
156.21 	use and supporting them in developing skills for successful community integration; and
156.22 	(iv) helping clients respond to or avoid triggers that threaten their community stability, 
156.23 	assisting the client in identifying potential crises and developing a plan to address them, 
156.24 	and providing support to restore the client's stability and functioning; and
156.25 	(2) peer recovery support services provided according to sections 254B.05, subdivision 
156.26 	5, and 254B.052.

156.27 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
156.28 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
156.29 	when federal approval is obtained.

157.1 	Sec. 13. Minnesota Statutes 2024, section 245G.07, subdivision 3, is amended to read:
157.2 		Subd. 3.Counselors Treatment service providers. (a) All treatment services, except 
157.3 	peer recovery support services and treatment coordination, must be provided by an alcohol 
157.4 	and drug counselor qualified according to section 245G.11, subdivision 5, unless the
157.5 	individual providing the service is specifically qualified according to the accepted credential 
157.6 	required to provide the service. The commissioner shall maintain a current list of 
157.7 	professionals qualified to provide treatment services.
157.8 	(b) Psychosocial treatment services must be provided by an alcohol and drug counselor 
157.9 	qualified according to section 245G.11, subdivision 5, unless the individual providing the 
157.10 	service is specifically qualified according to the accepted credential required to provide the 
157.11 	service. The commissioner shall maintain a current list of professionals qualified to provide 
157.12 	psychosocial treatment services.
157.13 	(c) Treatment coordination must be provided by a treatment coordinator qualified 
157.14 	according to section 245G.11, subdivision 7.
157.15 	(d) Recovery support services must be provided by a behavioral health practitioner 
157.16 	qualified according to section 245G.11, subdivision 12.
157.17 	(e) Peer recovery support services must be provided by a recovery peer qualified 
157.18 	according to section 245I.04, subdivision 18.

157.19 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
157.20 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
157.21 	when federal approval is obtained.

157.22 	Sec. 14. Minnesota Statutes 2024, section 245G.07, subdivision 4, is amended to read:
157.23 		Subd. 4.Location of service provision. (a) The license holder must provide all treatment 
157.24 	services a client receives at one of the license holder's substance use disorder treatment 
157.25 	licensed locations or at a location allowed under paragraphs (b) to (f). If the services are 
157.26 	provided at the locations in paragraphs (b) to (d), the license holder must document in the 
157.27 	client record the location services were provided.
157.28 	(b) The license holder may provide nonresidential individual treatment services at a 
157.29 	client's home or place of residence.
157.30 	(c) If the license holder provides treatment services by telehealth, the services must be 
157.31 	provided according to this paragraph:
158.1 	(1) the license holder must maintain a licensed physical location in Minnesota where 
158.2 	the license holder must offer all treatment services in subdivision 1, paragraph (a), clauses 
158.3 	(1) to (4), 1a physically in-person to each client;
158.4 	(2) the license holder must meet all requirements for the provision of telehealth in sections 
158.5 	254B.05, subdivision 5, paragraph (f), and 256B.0625, subdivision 3b. The license holder 
158.6 	must document all items in section 256B.0625, subdivision 3b, paragraph (c), for each client 
158.7 	receiving services by telehealth, regardless of payment type or whether the client is a medical 
158.8 	assistance enrollee;
158.9 	(3) the license holder may provide treatment services by telehealth to clients individually;
158.10 	(4) the license holder may provide treatment services by telehealth to a group of clients 
158.11 	that are each in a separate physical location;
158.12 	(5) the license holder must not provide treatment services remotely by telehealth to a 
158.13 	group of clients meeting together in person, unless permitted under clause (7);
158.14 	(6) clients and staff may join an in-person group by telehealth if a staff member qualified 
158.15 	to provide the treatment service is physically present with the group of clients meeting 
158.16 	together in person; and
158.17 	(7) the qualified professional providing a residential group treatment service by telehealth 
158.18 	must be physically present on-site at the licensed residential location while the service is 
158.19 	being provided. If weather conditions or short-term illness prohibit a qualified professional 
158.20 	from traveling to the residential program and another qualified professional is not available 
158.21 	to provide the service, a qualified professional may provide a residential group treatment 
158.22 	service by telehealth from a location away from the licensed residential location. In such 
158.23 	circumstances, the license holder must ensure that a qualified professional does not provide 
158.24 	a residential group treatment service by telehealth from a location away from the licensed 
158.25 	residential location for more than one day at a time, must ensure that a staff person who 
158.26 	qualifies as a paraprofessional is physically present with the group of clients, and must 
158.27 	document the reason for providing the remote telehealth service in the records of clients 
158.28 	receiving the service. The license holder must document the dates that residential group 
158.29 	treatment services were provided by telehealth from a location away from the licensed 
158.30 	residential location in a central log and must provide the log to the commissioner upon 
158.31 	request.
158.32 	(d) The license holder may provide the additional ancillary treatment services under 
158.33 	subdivision 2, clauses (2) to (6) and (8), 2a away from the licensed location at a suitable 
158.34 	location appropriate to the treatment service.
159.1 	(e) Upon written approval from the commissioner for each satellite location, the license 
159.2 	holder may provide nonresidential treatment services at satellite locations that are in a 
159.3 	school, jail, or nursing home. A satellite location may only provide services to students of 
159.4 	the school, inmates of the jail, or residents of the nursing home. Schools, jails, and nursing 
159.5 	homes are exempt from the licensing requirements in section 245A.04, subdivision 2a, to 
159.6 	document compliance with building codes, fire and safety codes, health rules, and zoning 
159.7 	ordinances.
159.8 	(f) The commissioner may approve other suitable locations as satellite locations for 
159.9 	nonresidential treatment services. The commissioner may require satellite locations under 
159.10 	this paragraph to meet all applicable licensing requirements. The license holder may not 
159.11 	have more than two satellite locations per license under this paragraph.
159.12 	(g) The license holder must provide the commissioner access to all files, documentation, 
159.13 	staff persons, and any other information the commissioner requires at the main licensed 
159.14 	location for all clients served at any location under paragraphs (b) to (f).
159.15 	(h) Notwithstanding sections 245A.65, subdivision 2, and 626.557, subdivision 14, a 
159.16 	program abuse prevention plan is not required for satellite or other locations under paragraphs 
159.17 	(b) to (e). An individual abuse prevention plan is still required for any client that is a 
159.18 	vulnerable adult as defined in section 626.5572, subdivision 21.

159.19 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
159.20 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
159.21 	when federal approval is obtained.

159.22 	Sec. 15. Minnesota Statutes 2024, section 245G.11, subdivision 6, is amended to read:
159.23 		Subd. 6.Paraprofessionals. A paraprofessional must have knowledge of client rights, 
159.24 	according to section 148F.165, and staff member responsibilities. A paraprofessional may 
159.25 	not make decisions to admit, transfer, or discharge a client but may perform tasks related 
159.26 	to intake and orientation. A paraprofessional may be the responsible for the delivery of 
159.27 	treatment service staff member according to section 245G.10, subdivision 3. A 
159.28 	paraprofessional must not provide a treatment service unless qualified to do so according 
159.29 	to section 245G.07, subdivision 3.

160.1 	Sec. 16. Minnesota Statutes 2024, section 245G.11, is amended by adding a subdivision 
160.2 	to read:
160.3 		Subd. 12.Behavioral health practitioners. (a) A behavioral health practitioner must 
160.4 	meet the mental health practitioner qualifications in section 245I.04, subdivision 4.
160.5 	(b) A behavioral health practitioner working within a substance use disorder treatment 
160.6 	program licensed under this chapter has the following scope of practice:
160.7 	(1) a behavioral health practitioner may provide clients with recovery support services, 
160.8 	as defined in section 245G.07, subdivision 2a, paragraph (b), clause (1); and
160.9 	(2) a behavioral health practitioner must not provide treatment supervision to other staff 
160.10 	persons.
160.11 	(c) A behavioral health practitioner working within a substance use disorder treatment 
160.12 	program licensed under this chapter must receive at least one hour of supervision per month 
160.13 	on individual service delivery from an alcohol and drug counselor or a mental health 
160.14 	professional who has substance use treatment and assessments within the scope of their 
160.15 	practice.

160.16 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
160.17 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
160.18 	when federal approval is obtained.

160.19 	Sec. 17. Minnesota Statutes 2024, section 245G.22, subdivision 11, is amended to read:
160.20 		Subd. 11.Waiting list. An opioid treatment program must have a waiting list system. 
160.21 	If the person seeking admission cannot be admitted within 14 days of the date of application, 
160.22 	each person seeking admission must be placed on the waiting list, unless the person seeking 
160.23 	admission is assessed by the program and found ineligible for admission according to this 
160.24 	chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12 (e), 
160.25 	and title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each 
160.26 	person seeking treatment while awaiting admission. A person seeking admission on a waiting 
160.27 	list who receives no services under section 245G.07, subdivision 1 1a or 1b, must not be 
160.28 	considered a client as defined in section 245G.01, subdivision 9.

160.29 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
160.30 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
160.31 	when federal approval is obtained.

161.1 	Sec. 18. Minnesota Statutes 2024, section 245G.22, subdivision 15, is amended to read:
161.2 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
161.3 	offer at least 50 consecutive minutesfour units of individual or group therapy treatment 
161.4 	services as defined in section 245G.07, subdivision 1, paragraph (a) 1a, clause (1), per week, 
161.5 	for the first ten weeks following the day of service initiation, and at least 50 consecutive 
161.6 	minutesone unit per month thereafter. As clinically appropriate, the program may offer 
161.7 	these services cumulatively and not consecutively in increments of no less than 15 minutes 
161.8 	over the required time period, and for a total of 60 minutes of treatment services over the 
161.9 	time period, and must document the reason for providing services cumulatively in the client's 
161.10 	record. The program may offer additional levels of service when deemed clinically necessary.
161.11 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
161.12 	the assessment must be completed within 21 days from the day of service initiation.

161.13 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
161.14 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
161.15 	when federal approval is obtained.

161.16 	Sec. 19. Minnesota Statutes 2024, section 254B.01, subdivision 10, is amended to read:
161.17 		Subd. 10.Skilled Psychosocial treatment services. "Skilled Psychosocial treatment 
161.18 	services" includes the treatment services described in section 245G.07, subdivisions 1, 
161.19 	paragraph (a), clauses (1) to (4), and 2, clauses (1) to (6). Skilled subdivision 1a. Psychosocial
161.20 	treatment services must be provided by qualified professionals as identified in section 
161.21 	245G.07, subdivision 3, paragraph (b).

161.22 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
161.23 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
161.24 	when federal approval is obtained.

161.25 	Sec. 20. Minnesota Statutes 2024, section 254B.04, subdivision 1a, is amended to read:
161.26 		Subd. 1a.Client eligibility. (a) Persons eligible for benefits under Code of Federal 
161.27 	Regulations, title 25, part 20, who meet the income standards of section 256B.056, 
161.28 	subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health 
161.29 	fund services. State money appropriated for this paragraph must be placed in a separate 
161.30 	account established for this purpose.
161.31 	(b) Persons with dependent children who are determined to be in need of substance use 
161.32 	disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in 
162.1 	need of chemical dependency treatment pursuant to a case plan under section 260C.201, 
162.2 	subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment 
162.3 	services. Treatment services must be appropriate for the individual or family, which may 
162.4 	include long-term care treatment or treatment in a facility that allows the dependent children 
162.5 	to stay in the treatment facility. The county shall pay for out-of-home placement costs, if 
162.6 	applicable.
162.7 	(c) Notwithstanding paragraph (a), any person enrolled in medical assistance or 
162.8 	MinnesotaCare is eligible for room and board services under section 254B.05, subdivision 
162.9 	5, paragraph (b), clause (9).
162.10 	(d) A client is eligible to have substance use disorder treatment paid for with funds from 
162.11 	the behavioral health fund when the client:
162.12 	(1) is eligible for MFIP as determined under chapter 142G;
162.13 	(2) is eligible for medical assistance as determined under Minnesota Rules, parts 
162.14 	9505.0010 to 9505.0150 9505.140;
162.15 	(3) is eligible for general assistance, general assistance medical care, or work readiness 
162.16 	as determined under Minnesota Rules, parts 9500.1200 to 9500.1318 9500.1272; or
162.17 	(4) has income that is within current household size and income guidelines for entitled 
162.18 	persons, as defined in this subdivision and subdivision 7.
162.19 	(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have 
162.20 	a third-party payment source are eligible for the behavioral health fund if the third-party 
162.21 	payment source pays less than 100 percent of the cost of treatment services for eligible 
162.22 	clients.
162.23 	(f) A client is ineligible to have substance use disorder treatment services paid for with 
162.24 	behavioral health fund money if the client:
162.25 	(1) has an income that exceeds current household size and income guidelines for entitled 
162.26 	persons as defined in this subdivision and subdivision 7; or
162.27 	(2) has an available third-party payment source that will pay the total cost of the client's 
162.28 	treatment.
162.29 	(g) A client who is disenrolled from a state prepaid health plan during a treatment episode 
162.30 	is eligible for continued treatment service that is paid for by the behavioral health fund until 
162.31 	the treatment episode is completed or the client is re-enrolled in a state prepaid health plan 
162.32 	if the client:
163.1 	(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance 
163.2 	medical care; or
163.3 	(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local 
163.4 	agency under section 254B.04.
163.5 	(h) When a county commits a client under chapter 253B to a regional treatment center 
163.6 	for substance use disorder services and the client is ineligible for the behavioral health fund, 
163.7 	the county is responsible for the payment to the regional treatment center according to 
163.8 	section 254B.05, subdivision 4.
163.9 	(i) Persons enrolled in MinnesotaCare are eligible for room and board services when 
163.10 	provided through intensive residential treatment services and residential crisis services under 
163.11 	section 256B.0622.
163.12 	(j) A person is eligible for one 60-consecutive-calendar-day period per year. A person 
163.13 	may submit a request for additional eligibility to the commissioner. A person denied 
163.14 	additional eligibility under this paragraph may request a state agency hearing under section 
163.15 	256.045.

163.16 	EFFECTIVE DATE.  This section is effective July 1, 2026, except the amendments to 
163.17 	paragraph (d) are effective July 1, 2025.

163.18 	Sec. 21. Minnesota Statutes 2024, section 254B.05, subdivision 1, is amended to read:
163.19 		Subdivision 1.Licensure or certification required. (a) Programs licensed by the 
163.20 	commissioner are eligible vendors. Hospitals may apply for and receive licenses to be 
163.21 	eligible vendors, notwithstanding the provisions of section 245A.03. American Indian 
163.22 	programs that provide substance use disorder treatment, extended care, transitional residence, 
163.23 	or outpatient treatment services, and are licensed by tribal government are eligible vendors.
163.24 	(b) A licensed professional in private practice as defined in section 245G.01, subdivision 
163.25 	17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible 
163.26 	vendor of a comprehensive assessment provided according to section 254A.19, subdivision 
163.27 	3, and treatment services provided according to sections 245G.06 and 245G.07, subdivision 
163.28 	1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses (1) to (6). subdivisions 
163.29 	1, 1a, and 1b.
163.30 	(c) A county is an eligible vendor for a comprehensive assessment when provided by 
163.31 	an individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 5, 
163.32 	and completed according to the requirements of section 254A.19, subdivision 3. A county 
163.33 	is an eligible vendor of care treatment coordination services when provided by an individual 
164.1 	who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and provided 
164.2 	according to the requirements of section 245G.07, subdivision 1, paragraph (a), clause (5)
164.3 	1b. A county is an eligible vendor of peer recovery services when the services are provided 
164.4 	by an individual who meets the requirements of section 245G.11, subdivision 8, and 
164.5 	according to section 254B.052.
164.6 	(d) A recovery community organization that meets the requirements of clauses (1) to 
164.7 	(14) and meets certification or accreditation requirements of the Alliance for Recovery 
164.8 	Centered Organizations, the Council on Accreditation of Peer Recovery Support Services, 
164.9 	or a Minnesota statewide recovery organization identified by the commissioner is an eligible 
164.10 	vendor of peer recovery support services. A Minnesota statewide recovery organization 
164.11 	identified by the commissioner must update recovery community organization applicants 
164.12 	for certification or accreditation on the status of the application within 45 days of receipt. 
164.13 	If the approved statewide recovery organization denies an application, it must provide a 
164.14 	written explanation for the denial to the recovery community organization. Eligible vendors 
164.15 	under this paragraph must:
164.16 	(1) be nonprofit organizations under section 501(c)(3) of the Internal Revenue Code, be 
164.17 	free from conflicting self-interests, and be autonomous in decision-making, program 
164.18 	development, peer recovery support services provided, and advocacy efforts for the purpose 
164.19 	of supporting the recovery community organization's mission;
164.20 	(2) be led and governed by individuals in the recovery community, with more than 50 
164.21 	percent of the board of directors or advisory board members self-identifying as people in 
164.22 	personal recovery from substance use disorders;
164.23 	(3) have a mission statement and conduct corresponding activities indicating that the 
164.24 	organization's primary purpose is to support recovery from substance use disorder;
164.25 	(4) demonstrate ongoing community engagement with the identified primary region and 
164.26 	population served by the organization, including individuals in recovery and their families, 
164.27 	friends, and recovery allies;
164.28 	(5) be accountable to the recovery community through documented priority-setting and 
164.29 	participatory decision-making processes that promote the engagement of, and consultation 
164.30 	with, people in recovery and their families, friends, and recovery allies;
164.31 	(6) provide nonclinical peer recovery support services, including but not limited to 
164.32 	recovery support groups, recovery coaching, telephone recovery support, skill-building, 
164.33 	and harm-reduction activities, and provide recovery public education and advocacy;
165.1 	(7) have written policies that allow for and support opportunities for all paths toward 
165.2 	recovery and refrain from excluding anyone based on their chosen recovery path, which 
165.3 	may include but is not limited to harm reduction paths, faith-based paths, and nonfaith-based 
165.4 	paths;
165.5 	(8) maintain organizational practices to meet the needs of Black, Indigenous, and people 
165.6 	of color communities, LGBTQ+ communities, and other underrepresented or marginalized 
165.7 	communities. Organizational practices may include board and staff training, service offerings, 
165.8 	advocacy efforts, and culturally informed outreach and services;
165.9 	(9) use recovery-friendly language in all media and written materials that is supportive 
165.10 	of and promotes recovery across diverse geographical and cultural contexts and reduces 
165.11 	stigma;
165.12 	(10) establish and maintain a publicly available recovery community organization code 
165.13 	of ethics and grievance policy and procedures;
165.14 	(11) not classify or treat any recovery peer hired on or after July 1, 2024, as an 
165.15 	independent contractor;
165.16 	(12) not classify or treat any recovery peer as an independent contractor on or after 
165.17 	January 1, 2025;
165.18 	(13) provide an orientation for recovery peers that includes an overview of the consumer 
165.19 	advocacy services provided by the Ombudsman for Mental Health and Developmental 
165.20 	Disabilities and other relevant advocacy services; and
165.21 	(14) provide notice to peer recovery support services participants that includes the 
165.22 	following statement: "If you have a complaint about the provider or the person providing 
165.23 	your peer recovery support services, you may contact the Minnesota Alliance of Recovery 
165.24 	Community Organizations. You may also contact the Office of Ombudsman for Mental 
165.25 	Health and Developmental Disabilities." The statement must also include:
165.26 	(i) the telephone number, website address, email address, and mailing address of the 
165.27 	Minnesota Alliance of Recovery Community Organizations and the Office of Ombudsman 
165.28 	for Mental Health and Developmental Disabilities;
165.29 	(ii) the recovery community organization's name, address, email, telephone number, and 
165.30 	name or title of the person at the recovery community organization to whom problems or 
165.31 	complaints may be directed; and
165.32 	(iii) a statement that the recovery community organization will not retaliate against a 
165.33 	peer recovery support services participant because of a complaint.
166.1 	(e) A recovery community organization approved by the commissioner before June 30, 
166.2 	2023, must have begun the application process as required by an approved certifying or 
166.3 	accrediting entity and have begun the process to meet the requirements under paragraph (d) 
166.4 	by September 1, 2024, in order to be considered as an eligible vendor of peer recovery 
166.5 	support services.
166.6 	(f) A recovery community organization that is aggrieved by an accreditation, certification, 
166.7 	or membership determination and believes it meets the requirements under paragraph (d) 
166.8 	may appeal the determination under section 256.045, subdivision 3, paragraph (a), clause 
166.9 	(14), for reconsideration as an eligible vendor. If the human services judge determines that 
166.10 	the recovery community organization meets the requirements under paragraph (d), the 
166.11 	recovery community organization is an eligible vendor of peer recovery support services.
166.12 	(g) All recovery community organizations must be certified or accredited by an entity 
166.13 	listed in paragraph (d) by June 30, 2025.
166.14 	(h) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
166.15 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
166.16 	nonresidential substance use disorder treatment or withdrawal management program by the 
166.17 	commissioner or by tribal government or do not meet the requirements of subdivisions 1a 
166.18 	and 1b are not eligible vendors.
166.19 	(i) Hospitals, federally qualified health centers, and rural health clinics are eligible 
166.20 	vendors of a comprehensive assessment when the comprehensive assessment is completed 
166.21 	according to section 254A.19, subdivision 3, and by an individual who meets the criteria 
166.22 	of an alcohol and drug counselor according to section 245G.11, subdivision 5. The alcohol 
166.23 	and drug counselor must be individually enrolled with the commissioner and reported on 
166.24 	the claim as the individual who provided the service.
166.25 	(j) Any complaints about a recovery community organization or peer recovery support 
166.26 	services may be made to and reviewed or investigated by the ombudsperson for behavioral 
166.27 	health and developmental disabilities under sections 245.91 and 245.94.

166.28 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
166.29 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
166.30 	when federal approval is obtained.

167.1 	Sec. 22. Minnesota Statutes 2024, section 254B.05, subdivision 5, is amended to read:
167.2 		Subd. 5.Rate requirements. (a) Subject to the requirements of subdivision 6, the 
167.3 	commissioner shall establish rates for the following substance use disorder treatment services 
167.4 	and service enhancements funded under this chapter.:
167.5 	(b) Eligible substance use disorder treatment services include:
167.6 	(1) those licensed, as applicable, according to chapter 245G or applicable Tribal license 
167.7 	and provided according to the following ASAM levels of care:
167.8 	(i) ASAM level 0.5 early intervention services provided according to section 254B.19, 
167.9 	subdivision 1, clause (1);
167.10 	(ii) ASAM level 1.0 outpatient services provided according to section 254B.19, 
167.11 	subdivision 1, clause (2);
167.12 	(iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19, 
167.13 	subdivision 1, clause (3);
167.14 	(iv) ASAM level 2.5 partial hospitalization services provided according to section 
167.15 	254B.19, subdivision 1, clause (4);
167.16 	(v) ASAM level 3.1 clinically managed low-intensity residential services provided 
167.17 	according to section 254B.19, subdivision 1, clause (5). The commissioner shall use the 
167.18 	base payment rate of $79.84 per day for services provided under this item;
167.19 	(vi) ASAM level 3.1 clinically managed low-intensity residential services provided 
167.20 	according to section 254B.19, subdivision 1, clause (5), at 15 or more hours of skilled 
167.21 	treatment services each week. The commissioner shall use the base payment rate of $166.13 
167.22 	per day for services provided under this item;
167.23 	(vii) ASAM level 3.3 clinically managed population-specific high-intensity residential 
167.24 	services provided according to section 254B.19, subdivision 1, clause (6). The commissioner 
167.25 	shall use the specified base payment rate of $224.06 per day for services provided under 
167.26 	this item; and
167.27 	(viii) ASAM level 3.5 clinically managed high-intensity residential services provided 
167.28 	according to section 254B.19, subdivision 1, clause (7). The commissioner shall use the 
167.29 	specified base payment rate of $224.06 per day for services provided under this item;
167.30 	(2) comprehensive assessments provided according to section 254A.19, subdivision 3;
167.31 	(3) treatment coordination services provided according to section 245G.07, subdivision 
167.32 	1, paragraph (a), clause (5);
168.1 	(4) peer recovery support services provided according to section 245G.07, subdivision 
168.2 	2, clause (8);
168.3 	(5) withdrawal management services provided according to chapter 245F;
168.4 	(6) hospital-based treatment services that are licensed according to sections 245G.01 to 
168.5 	245G.17 or applicable Tribal license and licensed as a hospital under sections 144.50 to 
168.6 	144.56;
168.7 	(7) substance use disorder treatment services with medications for opioid use disorder 
168.8 	provided in an opioid treatment program licensed according to sections 245G.01 to 245G.17 
168.9 	and 245G.22, or under an applicable Tribal license;
168.10 	(8) medium-intensity residential treatment services that provide 15 hours of skilled 
168.11 	treatment services each week and are licensed according to sections 245G.01 to 245G.17 
168.12 	and 245G.21 or applicable Tribal license;
168.13 	(9) adolescent treatment programs that are licensed as outpatient treatment programs 
168.14 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
168.15 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
168.16 	applicable Tribal license;
168.17 	(10) ASAM 3.5 clinically managed high-intensity residential services that are licensed 
168.18 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable Tribal license, which 
168.19 	provide ASAM level of care 3.5 according to section 254B.19, subdivision 1, clause (7), 
168.20 	and are provided by a state-operated vendor or to clients who have been civilly committed 
168.21 	to the commissioner, present the most complex and difficult care needs, and are a potential 
168.22 	threat to the community; and
168.23 	(11) room and board facilities that meet the requirements of subdivision 1a.
168.24 	(c) (b) The commissioner shall establish higher rates for programs that meet the 
168.25 	requirements of paragraph (b) (a) and one of the following additional requirements: the 
168.26 	requirements of one clause in this paragraph.
168.27 	(1) Programs that serve parents with their children are eligible for an enhanced payment 
168.28 	rate if the program:
168.29 	(i) provides on-site child care during the hours of treatment activity that:
168.30 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
168.31 	9503; or
168.32 	(B) is licensed under chapter 245A and sections 245G.01 to 245G.19; or
169.1 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
169.2 	licensed under chapter 245A as:
169.3 	(A) a child care center under Minnesota Rules, chapter 9503; or
169.4 	(B) a family child care home under Minnesota Rules, chapter 9502;.
169.5 	In order to be eligible for a higher rate under this clause, a program that provides 
169.6 	arrangements for off-site child care must maintain current documentation at the substance 
169.7 	use disorder facility of the child care provider's current licensure to provide child care 
169.8 	services.
169.9 	(2) Culturally specific or culturally responsive programs as defined in section 254B.01, 
169.10 	subdivision 4a; are eligible for an enhanced payment rate.
169.11 	(3) Disability responsive programs as defined in section 254B.01, subdivision 4b; are 
169.12 	eligible for an enhanced payment rate.
169.13 	(4) Programs that offer medical services delivered by appropriately credentialed health 
169.14 	care staff in an amount equal to one hour per client per week are eligible for an enhanced 
169.15 	payment rate if the medical needs of the client and the nature and provision of any medical 
169.16 	services provided are documented in the client file; or.
169.17 	(5) Programs that offer services to individuals with co-occurring mental health and 
169.18 	substance use disorder problems are eligible for an enhanced payment rate if:
169.19 	(i) the program meets the co-occurring requirements in section 245G.20;
169.20 	(ii) the program employs a mental health professional as defined in section 245I.04, 
169.21 	subdivision 2;
169.22 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
169.23 	health diagnostic assessment within ten days of admission;
169.24 	(iv) the program has standards for multidisciplinary case review that include a monthly 
169.25 	review for each client that, at a minimum, includes a licensed mental health professional 
169.26 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
169.27 	(v) family education is offered that addresses mental health and substance use disorder 
169.28 	and the interaction between the two; and
169.29 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
169.30 	training annually.
170.1 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
170.2 	that provides arrangements for off-site child care must maintain current documentation at 
170.3 	the substance use disorder facility of the child care provider's current licensure to provide 
170.4 	child care services.
170.5 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, parts 
170.6 	2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
170.7 	in paragraph (c), clause (5), items (i) to (iv).
170.8 	(f) (c) Substance use disorder services that are otherwise covered as direct face-to-face 
170.9 	services may be provided via telehealth as defined in section 256B.0625, subdivision 3b. 
170.10 	The use of telehealth to deliver services must be medically appropriate to the condition and 
170.11 	needs of the person being served. Reimbursement shall be at the same rates and under the 
170.12 	same conditions that would otherwise apply to direct face-to-face services.
170.13 	(g) (d) For the purpose of reimbursement under this section, substance use disorder 
170.14 	treatment services provided in a group setting without a group participant maximum or 
170.15 	maximum client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 
170.16 	48 to one. At least one of the attending staff must meet the qualifications as established 
170.17 	under this chapter for the type of treatment service provided. A recovery peer may not be 
170.18 	included as part of the staff ratio.
170.19 	(h) (e) Payment for outpatient substance use disorder services that are licensed according 
170.20 	to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless 
170.21 	prior authorization of a greater number of hours is obtained from the commissioner.
170.22 	(i) (f) Payment for substance use disorder services under this section must start from the 
170.23 	day of service initiation, when the comprehensive assessment is completed within the 
170.24 	required timelines.
170.25 	(j) (g) A license holder that is unable to provide all residential treatment services because 
170.26 	a client missed services remains eligible to bill for the client's intensity level of services 
170.27 	under this paragraph if the license holder can document the reason the client missed services 
170.28 	and the interventions done to address the client's absence.
170.29 	(k) (h) Hours in a treatment week may be reduced in observance of federally recognized 
170.30 	holidays.
170.31 	(l) (i) Eligible vendors of peer recovery support services must:
170.32 	(1) submit to a review by the commissioner of up to ten percent of all medical assistance 
170.33 	and behavioral health fund claims to determine the medical necessity of peer recovery 
171.1 	support services for entities billing for peer recovery support services individually and not 
171.2 	receiving a daily rate; and
171.3 	(2) limit an individual client to 14 hours per week for peer recovery support services 
171.4 	from an individual provider of peer recovery support services.
171.5 	(m) (j) Peer recovery support services not provided in accordance with section 254B.052 
171.6 	are subject to monetary recovery under section 256B.064 as money improperly paid.

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

171.8 	Sec. 23. Minnesota Statutes 2024, section 254B.05, is amended by adding a subdivision 
171.9 	to read:
171.10 		Subd. 6.Rate adjustments. (a) Effective for services rendered on or after January 1, 
171.11 	2026, the commissioner must implement the following base payment rates for substance 
171.12 	use disorder treatment services under subdivision 5, paragraph (a):
171.13 	(1) for low-intensity residential, 100 percent of the modeled rate included in the final 
171.14 	report required by Laws 2021, First Special Session chapter 7, article 17, section 18;
171.15 	(2) for high-intensity residential services, the rates in effect on December 31, 2025; and
171.16 	(3) for all other services not included in clause (1) or (2), 55 percent of the modeled rate 
171.17 	included in the final report required by Laws 2021, First Special Session chapter 7, article 
171.18 	17, section 18.
171.19 	(b) Effective January 1, 2028, and annually thereafter, the commissioner of human 
171.20 	services must adjust the payment rates under paragraph (a) according to the change from 
171.21 	the midpoint of the previous rate year to the midpoint of the rate year for which the rate is 
171.22 	being determined using the Centers for Medicare and Medicaid Services Medicare Economic 
171.23 	Index as forecasted in the fourth quarter of the calendar year before the rate year.

171.24 	Sec. 24. Minnesota Statutes 2024, section 254B.06, is amended by adding a subdivision 
171.25 	to read:
171.26 		Subd. 5.Prohibition of duplicative claim submission. (a) For time-based claims, 
171.27 	submissions must follow the guidelines in the Centers for Medicare and Medicaid Services' 
171.28 	Healthcare Common Procedure Coding System and the American Medical Association's 
171.29 	Current Procedural Terminology to determine the appropriate units of time to report.
171.30 	(b) More than half the duration of a time-based code must be spent performing the service 
171.31 	to be eligible under this section. Any provision of service during the remaining balance of 
172.1 	the unit of time is not eligible for any other claims submission and would be considered a 
172.2 	duplicative claim submission.
172.3 	(c) A provider may only round up to the next whole number of service units on a 
172.4 	submitted claim when more than one and one-half times the defined value of the code has 
172.5 	occurred and no additional time increment code exists.

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

172.7 	Sec. 25. Minnesota Statutes 2024, section 254B.09, subdivision 2, is amended to read:
172.8 		Subd. 2.American Indian agreements. The commissioner may enter into agreements 
172.9 	with federally recognized Tribal units to pay for substance use disorder treatment services 
172.10 	provided under Laws 1986, chapter 394, sections 8 to 20. The agreements must clarify how 
172.11 	the governing body of the Tribal unit fulfills local agency the Tribal unit's responsibilities 
172.12 	regarding the form and manner of invoicing.

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

172.14 	Sec. 26. Minnesota Statutes 2024, section 254B.19, subdivision 1, is amended to read:
172.15 		Subdivision 1.Level of care requirements. (a) For each client assigned an ASAM level 
172.16 	of care, eligible vendors must implement the standards set by the ASAM for the respective 
172.17 	level of care. Additionally, vendors must meet the following requirements:
172.18 	(1) For ASAM level 0.5 early intervention targeting individuals who are at risk of 
172.19 	developing a substance-related problem but may not have a diagnosed substance use disorder, 
172.20 	early intervention services may include individual or group counseling, treatment 
172.21 	coordination, peer recovery support, screening brief intervention, and referral to treatment 
172.22 	provided according to section 254A.03, subdivision 3, paragraph (c).
172.23 	(2) For ASAM level 1.0 outpatient clients, adults must receive up to eight hours per 
172.24 	week of skilled psychosocial treatment services and adolescents must receive up to five 
172.25 	hours per week. Services must be licensed according to section 245G.20 and meet 
172.26 	requirements under section 256B.0759. Peer recovery Ancillary services and treatment 
172.27 	coordination may be provided beyond the hourly skilled psychosocial treatment service 
172.28 	hours allowable per week.
172.29 	(3) For ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours 
172.30 	per week of skilled psychosocial treatment services and adolescents must receive six or 
172.31 	more hours per week. Vendors must be licensed according to section 245G.20 and must 
172.32 	meet requirements under section 256B.0759. Peer recovery Ancillary services and treatment 
173.1 	coordination may be provided beyond the hourly skilled psychosocial treatment service 
173.2 	hours allowable per week. If clinically indicated on the client's treatment plan, this service 
173.3 	may be provided in conjunction with room and board according to section 254B.05, 
173.4 	subdivision 1a.
173.5 	(4) For ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or 
173.6 	more of skilled psychosocial treatment services. Services must be licensed according to 
173.7 	section 245G.20 and must meet requirements under section 256B.0759. Level 2.5 is for 
173.8 	clients who need daily monitoring in a structured setting, as directed by the individual 
173.9 	treatment plan and in accordance with the limitations in section 254B.05, subdivision 5, 
173.10 	paragraph (h). If clinically indicated on the client's treatment plan, this service may be 
173.11 	provided in conjunction with room and board according to section 254B.05, subdivision 
173.12 	1a.
173.13 	(5) For ASAM level 3.1 clinically managed low-intensity residential clients, programs 
173.14 	must provide at least 5 hours of skilled psychosocial treatment services per week according 
173.15 	to each client's specific treatment schedule, as directed by the individual treatment plan. 
173.16 	Programs must be licensed according to section 245G.20 and must meet requirements under 
173.17 	section 256B.0759.
173.18 	(6) For ASAM level 3.3 clinically managed population-specific high-intensity residential 
173.19 	clients, programs must be licensed according to section 245G.20 and must meet requirements 
173.20 	under section 256B.0759. Programs must have 24-hour staffing coverage. Programs must 
173.21 	be enrolled as a disability responsive program as described in section 254B.01, subdivision 
173.22 	4b, and must specialize in serving persons with a traumatic brain injury or a cognitive 
173.23 	impairment so significant, and the resulting level of impairment so great, that outpatient or 
173.24 	other levels of residential care would not be feasible or effective. Programs must provide, 
173.25 	at a minimum, daily skilled psychosocial treatment services seven days a week according 
173.26 	to each client's specific treatment schedule, as directed by the individual treatment plan.
173.27 	(7) For ASAM level 3.5 clinically managed high-intensity residential clients, services 
173.28 	must be licensed according to section 245G.20 and must meet requirements under section 
173.29 	256B.0759. Programs must have 24-hour staffing coverage and provide, at a minimum, 
173.30 	daily skilled psychosocial treatment services seven days a week according to each client's 
173.31 	specific treatment schedule, as directed by the individual treatment plan.
173.32 	(8) For ASAM level withdrawal management 3.2 clinically managed clients, withdrawal 
173.33 	management must be provided according to chapter 245F.
174.1 	(9) For ASAM level withdrawal management 3.7 medically monitored clients, withdrawal 
174.2 	management must be provided according to chapter 245F.
174.3 	(b) Notwithstanding the minimum daily skilled psychosocial treatment service 
174.4 	requirements under paragraph (a), clauses (6) and (7), ASAM level 3.3 and 3.5 vendors 
174.5 	must provide each client at least 30 hours of treatment services per week for the period 
174.6 	between January 1, 2024, through June 30, 2024.

174.7 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
174.8 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
174.9 	when federal approval is obtained.

174.10 	Sec. 27. Minnesota Statutes 2024, section 256.042, subdivision 4, is amended to read:
174.11 		Subd. 4.Grants. (a) The commissioner of human services shall submit a report of the 
174.12 	grants proposed by the advisory council to be awarded for the upcoming calendar year to 
174.13 	the chairs and ranking minority members of the legislative committees with jurisdiction 
174.14 	over health and human services policy and finance, by December 1 of each year, beginning 
174.15 	December 1, 2022. This paragraph expires upon the expiration of the advisory council.
174.16 	(b) The grants shall be awarded to proposals selected by the advisory council that address 
174.17 	the priorities in subdivision 1, paragraph (a), clauses (1) to (4), unless otherwise appropriated 
174.18 	by the legislature. The advisory council shall determine grant awards and funding amounts 
174.19 	based on the funds appropriated to the commissioner under section 256.043, subdivision 3, 
174.20 	paragraph (n) (m), and subdivision 3a, paragraph (d). The commissioner shall award the 
174.21 	grants from the opiate epidemic response fund and administer the grants in compliance with 
174.22 	section 16B.97. No more than ten percent of the grant amount may be used by a grantee for 
174.23 	administration.

174.24 	EFFECTIVE DATE. This section is effective the day following final enactment or 
174.25 	retroactively from June 30, 2025, whichever is earlier.

174.26 	Sec. 28. Minnesota Statutes 2024, section 256.043, subdivision 3, is amended to read:
174.27 		Subd. 3.Appropriations from registration and license fee account. (a) The 
174.28 	appropriations in paragraphs (b) to (n) (m) shall be made from the registration and license 
174.29 	fee account on a fiscal year basis in the order specified.
174.30 	(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs 
174.31 	(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be 
174.32 	made accordingly.
175.1 	(c) $100,000 is appropriated to the commissioner of human services for grants for opiate 
175.2 	antagonist distribution. Grantees may utilize funds for opioid overdose prevention, 
175.3 	community asset mapping, education, and opiate antagonist distribution.
175.4 	(d) $2,000,000 is appropriated to the commissioner of human services for grants to Tribal 
175.5 	nations and five urban Indian communities for traditional healing practices for American 
175.6 	Indians and to increase the capacity of culturally specific providers in the behavioral health 
175.7 	workforce.
175.8 	(e) $400,000 is appropriated to the commissioner of human services for competitive 
175.9 	grants for opioid-focused Project ECHO programs.
175.10 	(f) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to the 
175.11 	commissioner of human services to administer the funding distribution and reporting 
175.12 	requirements in paragraph (o) (n).
175.13 	(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated 
175.14 	to the commissioner of human services for safe recovery sites start-up and capacity building 
175.15 	grants under section 254B.18.
175.16 	(h) (g) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated 
175.17 	to the commissioner of human services for the opioid overdose surge alert system under 
175.18 	section 245.891.
175.19 	(i) (h) $300,000 is appropriated to the commissioner of management and budget for 
175.20 	evaluation activities under section 256.042, subdivision 1, paragraph (c).
175.21 	(j) (i) $261,000 is appropriated to the commissioner of human services for the provision 
175.22 	of administrative services to the Opiate Epidemic Response Advisory Council and for the 
175.23 	administration of the grants awarded under paragraph (n) (m).
175.24 	(k) (j) $126,000 is appropriated to the Board of Pharmacy for the collection of the 
175.25 	registration fees under section 151.066.
175.26 	(l) (k) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
175.27 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
175.28 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
175.29 	(m) (l) After the appropriations in paragraphs (b) to (l) (k) are made, 50 percent of the 
175.30 	remaining amount is appropriated to the commissioner of children, youth, and families for 
175.31 	distribution to county social service agencies and Tribal social service agency initiative 
175.32 	projects authorized under section 256.01, subdivision 14b, to provide prevention and child 
175.33 	protection services to children and families who are affected by addiction. The commissioner 
176.1 	shall distribute this money proportionally to county social service agencies and Tribal social 
176.2 	service agency initiative projects through a formula based on intake data from the previous 
176.3 	three calendar years related to substance use and out-of-home placement episodes where 
176.4 	parental drug abuse is a reason for the out-of-home placement. County social service agencies 
176.5 	and Tribal social service agency initiative projects receiving funds from the opiate epidemic 
176.6 	response fund must annually report to the commissioner on how the funds were used to 
176.7 	provide prevention and child protection services, including measurable outcomes, as 
176.8 	determined by the commissioner. County social service agencies and Tribal social service 
176.9 	agency initiative projects must not use funds received under this paragraph to supplant 
176.10 	current state or local funding received for child protection services for children and families 
176.11 	who are affected by addiction.
176.12 	(n) (m) After the appropriations in paragraphs (b) to (m) (l) are made, the remaining 
176.13 	amount in the account is appropriated to the commissioner of human services to award 
176.14 	grants as specified by the Opiate Epidemic Response Advisory Council in accordance with 
176.15 	section 256.042, unless otherwise appropriated by the legislature.
176.16 	(o) (n) Beginning in fiscal year 2022 and each year thereafter, funds for county social 
176.17 	service agencies and Tribal social service agency initiative projects under paragraph (m)
176.18 	(l) and grant funds specified by the Opiate Epidemic Response Advisory Council under 
176.19 	paragraph (n) (m) may be distributed on a calendar year basis.
176.20 	(p) (o) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
176.21 	(c), (d), (e), (g) (h), (m) (l), and (n) (m) are available for three years after the funds are 
176.22 	appropriated.

176.23 	EFFECTIVE DATE. This section is effective the day following final enactment or 
176.24 	retroactively from June 30, 2025, whichever is earlier.

176.25 	Sec. 29. Minnesota Statutes 2024, section 256.043, subdivision 3a, is amended to read:
176.26 		Subd. 3a.Appropriations from settlement account. (a) The appropriations in paragraphs 
176.27 	(b) to (e) shall be made from the settlement account on a fiscal year basis in the order 
176.28 	specified.
176.29 	(b) If the balance in the registration and license fee account is not sufficient to fully fund 
176.30 	the appropriations specified in subdivision 3, paragraphs (b) to (l) (k), an amount necessary 
176.31 	to meet any insufficiency shall be transferred from the settlement account to the registration 
176.32 	and license fee account to fully fund the required appropriations.
177.1 	(c) $209,000 in fiscal year 2023 and $239,000 in fiscal year 2024 and subsequent fiscal 
177.2 	years are appropriated to the commissioner of human services for the administration of 
177.3 	grants awarded under paragraph (e). $276,000 in fiscal year 2023 and $151,000 in fiscal 
177.4 	year 2024 and subsequent fiscal years are appropriated to the commissioner of human 
177.5 	services to collect, collate, and report data submitted and to monitor compliance with 
177.6 	reporting and settlement expenditure requirements by grantees awarded grants under this 
177.7 	section and municipalities receiving direct payments from a statewide opioid settlement 
177.8 	agreement as defined in section 256.042, subdivision 6.
177.9 	(d) After any appropriations necessary under paragraphs (b) and (c) are made, an amount 
177.10 	equal to the calendar year allocation to Tribal social service agency initiative projects under 
177.11 	subdivision 3, paragraph (m) (l), is appropriated from the settlement account to the 
177.12 	commissioner of children, youth, and families for distribution to Tribal social service agency 
177.13 	initiative projects to provide child protection services to children and families who are 
177.14 	affected by addiction. The requirements related to proportional distribution, annual reporting, 
177.15 	and maintenance of effort specified in subdivision 3, paragraph (m) (l), also apply to the 
177.16 	appropriations made under this paragraph.
177.17 	(e) After making the appropriations in paragraphs (b), (c), and (d), the remaining amount 
177.18 	in the account is appropriated to the commissioner of human services to award grants as 
177.19 	specified by the Opiate Epidemic Response Advisory Council in accordance with section 
177.20 	256.042.
177.21 	(f) Funds for Tribal social service agency initiative projects under paragraph (d) and 
177.22 	grant funds specified by the Opiate Epidemic Response Advisory Council under paragraph 
177.23 	(e) may be distributed on a calendar year basis.
177.24 	(g) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
177.25 	(d) and (e) are available for three years after the funds are appropriated.

177.26 	EFFECTIVE DATE. This section is effective the day following final enactment or 
177.27 	retroactively from June 30, 2025, whichever is earlier.

177.28 	Sec. 30. Minnesota Statutes 2024, section 256B.0625, subdivision 5m, is amended to read:
177.29 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
177.30 	assistance covers services provided by a not-for-profit certified community behavioral health 
177.31 	clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.
177.32 	(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an 
177.33 	eligible service is delivered using the CCBHC daily bundled rate system for medical 
178.1 	assistance payments as described in paragraph (c). The commissioner shall include a quality 
178.2 	incentive payment in the CCBHC daily bundled rate system as described in paragraph (e). 
178.3 	There is no county share for medical assistance services when reimbursed through the 
178.4 	CCBHC daily bundled rate system.
178.5 	(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC 
178.6 	payments under medical assistance meets the following requirements:
178.7 	(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each 
178.8 	CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable 
178.9 	CCBHC costs divided by the total annual number of CCBHC visits. For calculating the 
178.10 	payment rate, total annual visits include visits covered by medical assistance and visits not 
178.11 	covered by medical assistance. Allowable costs include but are not limited to the salaries 
178.12 	and benefits of medical assistance providers; the cost of CCBHC services provided under 
178.13 	section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as 
178.14 	insurance or supplies needed to provide CCBHC services;
178.15 	(2) payment shall be limited to one payment per day per medical assistance enrollee 
178.16 	when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement 
178.17 	if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph 
178.18 	(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or 
178.19 	licensed agency employed by or under contract with a CCBHC;
178.20 	(3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735, 
178.21 	subdivision 3, shall be established by the commissioner using a provider-specific rate based 
178.22 	on the newly certified CCBHC's audited historical cost report data adjusted for the expected 
178.23 	cost of delivering CCBHC services. Estimates are subject to review by the commissioner 
178.24 	and must include the expected cost of providing the full scope of CCBHC services and the 
178.25 	expected number of visits for the rate period;
178.26 	(4) the commissioner shall rebase CCBHC rates once every two years following the last 
178.27 	rebasing and no less than 12 months following an initial rate or a rate change due to a change 
178.28 	in the scope of services. For CCBHCs certified after September 31, 2020, and before January 
178.29 	1, 2021, the commissioner shall rebase rates according to this clause for services provided 
178.30 	on or after January 1, 2024;
178.31 	(5) the commissioner shall provide for a 60-day appeals process after notice of the results 
178.32 	of the rebasing;
178.33 	(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal 
178.34 	Medicaid rate is not eligible for the CCBHC rate methodology;
179.1 	(7) payments for CCBHC services to individuals enrolled in managed care shall be 
179.2 	coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall 
179.3 	complete the phase-out of CCBHC wrap payments within 60 days of the implementation 
179.4 	of the CCBHC daily bundled rate system in the Medicaid Management Information System 
179.5 	(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments 
179.6 	due made payable to CCBHCs no later than 18 months thereafter;
179.7 	(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each 
179.8 	provider-specific rate by the Medicare Economic Index for primary care services. This 
179.9 	update shall occur each year in between rebasing periods determined by the commissioner 
179.10 	in accordance with clause (4). CCBHCs must provide data on costs and visits to the state 
179.11 	annually using the CCBHC cost report established by the commissioner; and
179.12 	(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of 
179.13 	services when such changes are expected to result in an adjustment to the CCBHC payment 
179.14 	rate by 2.5 percent or more. The CCBHC must provide the commissioner with information 
179.15 	regarding the changes in the scope of services, including the estimated cost of providing 
179.16 	the new or modified services and any projected increase or decrease in the number of visits 
179.17 	resulting from the change. Estimated costs are subject to review by the commissioner. Rate 
179.18 	adjustments for changes in scope shall occur no more than once per year in between rebasing 
179.19 	periods per CCBHC and are effective on the date of the annual CCBHC rate update.
179.20 	(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC 
179.21 	providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of 
179.22 	this requirement on the rate of access to the services delivered by CCBHC providers. If, for 
179.23 	any contract year, federal approval is not received for this paragraph, the commissioner 
179.24 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
179.25 	plans for that contract year to reflect the removal of this provision. Contracts between 
179.26 	managed care plans and county-based purchasing plans and providers to whom this paragraph 
179.27 	applies must allow recovery of payments from those providers if capitation rates are adjusted 
179.28 	in accordance with this paragraph. Payment recoveries must not exceed the amount equal 
179.29 	to any increase in rates that results from this provision. This paragraph expires if federal 
179.30 	approval is not received for this paragraph at any time.
179.31 	(e) The commissioner shall implement a quality incentive payment program for CCBHCs 
179.32 	that meets the following requirements:
179.33 	(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric 
179.34 	thresholds for performance metrics established by the commissioner, in addition to payments 
180.1 	for which the CCBHC is eligible under the CCBHC daily bundled rate system described in 
180.2 	paragraph (c);
180.3 	(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement 
180.4 	year to be eligible for incentive payments;
180.5 	(3) each CCBHC shall receive written notice of the criteria that must be met in order to 
180.6 	receive quality incentive payments at least 90 days prior to the measurement year; and
180.7 	(4) a CCBHC must provide the commissioner with data needed to determine incentive 
180.8 	payment eligibility within six months following the measurement year. The commissioner 
180.9 	shall notify CCBHC providers of their performance on the required measures and the 
180.10 	incentive payment amount within 12 months following the measurement year.
180.11 	(f) All claims to managed care plans for CCBHC services as provided under this section 
180.12 	shall be submitted directly to, and paid by, the commissioner on the dates specified no later 
180.13 	than January 1 of the following calendar year, if:
180.14 	(1) one or more managed care plans does not comply with the federal requirement for 
180.15 	payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42, 
180.16 	section 447.45(b), and the managed care plan does not resolve the payment issue within 30 
180.17 	days of noncompliance; and
180.18 	(2) the total amount of clean claims not paid in accordance with federal requirements 
180.19 	by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims 
180.20 	eligible for payment by managed care plans.
180.21 	If the conditions in this paragraph are met between January 1 and June 30 of a calendar 
180.22 	year, claims shall be submitted to and paid by the commissioner beginning on January 1 of 
180.23 	the following year. If the conditions in this paragraph are met between July 1 and December 
180.24 	31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning 
180.25 	on July 1 of the following year.
180.26 	(g) Peer services provided by a CCBHC certified under section 245.735 are a covered 
180.27 	service under medical assistance when a licensed mental health professional or alcohol and 
180.28 	drug counselor determines that peer services are medically necessary. Eligibility under this 
180.29 	subdivision for peer services provided by a CCBHC supersede eligibility standards under 
180.30 	sections 256B.0615, 256B.0616, and 245G.07, subdivision 2 2a, paragraph (b), clause (8)
180.31 	(2).

181.1 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
181.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
181.3 	when federal approval is obtained.

181.4 	Sec. 31. Minnesota Statutes 2024, section 256B.0757, subdivision 4c, is amended to read:
181.5 		Subd. 4c.Behavioral health home services staff qualifications. (a) A behavioral health 
181.6 	home services provider must maintain staff with required professional qualifications 
181.7 	appropriate to the setting.
181.8 	(b) If behavioral health home services are offered in a mental health setting, the 
181.9 	integration specialist must be a licensed nurse, as defined in section 148.171, subdivision 
181.10 	9.
181.11 	(c) If behavioral health home services are offered in a primary care setting, the integration 
181.12 	specialist must be a mental health professional who is qualified according to section 245I.04, 
181.13 	subdivision 2.
181.14 	(d) If behavioral health home services are offered in either a primary care setting or 
181.15 	mental health setting, the systems navigator must be a mental health practitioner who is 
181.16 	qualified according to section 245I.04, subdivision 4, or a community health worker as 
181.17 	defined in section 256B.0625, subdivision 49.
181.18 	(e) If behavioral health home services are offered in either a primary care setting or 
181.19 	mental health setting, the qualified health home specialist must be one of the following:
181.20 	(1) a mental health certified peer specialist who is qualified according to section 245I.04, 
181.21 	subdivision 10;
181.22 	(2) a mental health certified family peer specialist who is qualified according to section 
181.23 	245I.04, subdivision 12;
181.24 	(3) a case management associate as defined in section 245.462, subdivision 4, paragraph 
181.25 	(g), or 245.4871, subdivision 4, paragraph (j);
181.26 	(4) a mental health rehabilitation worker who is qualified according to section 245I.04, 
181.27 	subdivision 14;
181.28 	(5) a community paramedic as defined in section 144E.28, subdivision 9;
181.29 	(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5)
181.30 	245G.11, subdivision 8; or
181.31 	(7) a community health worker as defined in section 256B.0625, subdivision 49.

182.1 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
182.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
182.3 	when federal approval is obtained.

182.4 	Sec. 32. Minnesota Statutes 2024, section 256B.0761, subdivision 4, is amended to read:
182.5 		Subd. 4.Services and duration. (a) Services must be provided 90 days prior to an 
182.6 	individual's release date or, if an individual's confinement is less than 90 days, during the 
182.7 	time period between a medical assistance eligibility determination and the release to the 
182.8 	community.
182.9 	(b) Facilities must offer the following services using either community-based or 
182.10 	corrections-based providers:
182.11 	(1) case management activities to address physical and behavioral health needs, including 
182.12 	a comprehensive assessment of individual needs, development of a person-centered care 
182.13 	plan, referrals and other activities to address assessed needs, and monitoring and follow-up 
182.14 	activities;
182.15 	(2) drug coverage in accordance with section 256B.0625, subdivision 13, including up 
182.16 	to a 30-day supply of drugs upon release;
182.17 	(3) substance use disorder comprehensive assessments according to section 254B.05, 
182.18 	subdivision 5, paragraph (b), clause (2);
182.19 	(4) treatment coordination services according to section 254B.05, subdivision 5, paragraph 
182.20 	(b), clause (3);
182.21 	(5) peer recovery support services according to sections 245I.04, subdivisions 18 and 
182.22 	19, and 254B.05, subdivision 5, paragraph (b), clause (4);
182.23 	(6) substance use disorder individual and group counseling provided according to sections 
182.24 	245G.07, subdivision 1, paragraph (a), clause (1), and 254B.05;
182.25 	(7) mental health diagnostic assessments as required under section 245I.10;
182.26 	(8) group and individual psychotherapy as required under section 256B.0671;
182.27 	(9) peer specialist services as required under sections 245I.04 and 256B.0615;
182.28 	(10) family planning and obstetrics and gynecology services; and
182.29 	(11) physical health well-being and screenings and care for adults and youth; and
182.30 	(12) medications and nonmedication treatment services for opioid use disorder under 
182.31 	section 245G.22.
183.1 	(c) Services outlined in this subdivision must only be authorized when an individual 
183.2 	demonstrates medical necessity or other eligibility as required under this chapter or applicable 
183.3 	state and federal laws.

183.4 	Sec. 33. Minnesota Statutes 2024, section 256B.761, is amended to read:
183.5 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
183.6 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
183.7 	management provided to psychiatric patients, outpatient mental health services, day treatment 
183.8 	services, home-based mental health services, and family community support services shall 
183.9 	be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 
183.10 	1999 charges.
183.11 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
183.12 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
183.13 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, 
183.14 	with at least 33 percent of the clients receiving rehabilitation services in the most recent 
183.15 	calendar year who are medical assistance recipients, will be increased by 38 percent, when 
183.16 	those services are provided within the comprehensive outpatient rehabilitation facility and 
183.17 	provided to residents of nursing facilities owned by the entity.
183.18 	(c) In addition to rate increases otherwise provided, the commissioner may restructure 
183.19 	coverage policy and rates to improve access to adult rehabilitative mental health services 
183.20 	under section 256B.0623 and related mental health support services under section 256B.021, 
183.21 	subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected 
183.22 	state share of increased costs due to this paragraph is transferred from adult mental health 
183.23 	grants under sections 245.4661 and 256K.10. The transfer for fiscal year 2016 is a permanent 
183.24 	base adjustment for subsequent fiscal years. Payments made to managed care plans and 
183.25 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
183.26 	the rate changes described in this paragraph.
183.27 	(d) Any ratables effective before July 1, 2015, do not apply to early intensive 
183.28 	developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.
183.29 	(e) Effective for services rendered on or after January 1, 2024, payment rates for 
183.30 	behavioral health services included in the rate analysis required by Laws 2021, First Special 
183.31 	Session chapter 7, article 17, section 18, except for adult day treatment services under section 
183.32 	256B.0671, subdivision 3; early intensive developmental and behavioral intervention services 
183.33 	under section 256B.0949; and substance use disorder services under chapter 254B, must be 
184.1 	increased by three percent from the rates in effect on December 31, 2023. Effective for 
184.2 	services rendered on or after January 1, 2025, payment rates for behavioral health services 
184.3 	included in the rate analysis required by Laws 2021, First Special Session chapter 7, article 
184.4 	17, section 18;, and early intensive developmental behavioral intervention services under 
184.5 	section 256B.0949; and substance use disorder services under chapter 254B, must be annually 
184.6 	adjusted according to the change from the midpoint of the previous rate year to the midpoint 
184.7 	of the rate year for which the rate is being determined using the Centers for Medicare and 
184.8 	Medicaid Services Medicare Economic Index as forecasted in the fourth quarter of the 
184.9 	calendar year before the rate year. For payments made in accordance with this paragraph, 
184.10 	if and to the extent that the commissioner identifies that the state has received federal 
184.11 	financial participation for behavioral health services in excess of the amount allowed under 
184.12 	United States Code, title 42, section 447.321, the state shall repay the excess amount to the 
184.13 	Centers for Medicare and Medicaid Services with state money and maintain the full payment 
184.14 	rate under this paragraph. This paragraph does not apply to federally qualified health centers, 
184.15 	rural health centers, Indian health services, certified community behavioral health clinics, 
184.16 	cost-based rates, and rates that are negotiated with the county. This paragraph expires upon 
184.17 	legislative implementation of the new rate methodology resulting from the rate analysis 
184.18 	required by Laws 2021, First Special Session chapter 7, article 17, section 18.
184.19 	(f) Effective January 1, 2024, the commissioner shall increase capitation payments made 
184.20 	to managed care plans and county-based purchasing plans to reflect the behavioral health 
184.21 	service rate increase provided in paragraph (e). Managed care and county-based purchasing 
184.22 	plans must use the capitation rate increase provided under this paragraph to increase payment 
184.23 	rates to behavioral health services providers. The commissioner must monitor the effect of 
184.24 	this rate increase on enrollee access to behavioral health services. If for any contract year 
184.25 	federal approval is not received for this paragraph, the commissioner must adjust the 
184.26 	capitation rates paid to managed care plans and county-based purchasing plans for that 
184.27 	contract year to reflect the removal of this provision. Contracts between managed care plans 
184.28 	and county-based purchasing plans and providers to whom this paragraph applies must 
184.29 	allow recovery of payments from those providers if capitation rates are adjusted in accordance 
184.30 	with this paragraph. Payment recoveries must not exceed the amount equal to any increase 
184.31 	in rates that results from this provision.

184.32 	Sec. 34. DIRECTION TO COMMISSIONER; SUBSTANCE USE DISORDER 
184.33 	TREATMENT STAFF REPORT AND RECOMMENDATIONS.
 184.34 	The commissioner of human services must, in consultation with the Board of Nursing, 
184.35 	Board of Behavioral Health and Therapy, and Board of Medical Practice, conduct a study 
185.1 	and develop recommendations to the legislature for amendments to Minnesota Statutes, 
185.2 	chapter 245G, that would eliminate any limitations on licensed health professionals' ability 
185.3 	to provide substance use disorder treatment services while practicing within their licensed 
185.4 	or statutory scopes of practice. The commissioner must submit a report on the study and 
185.5 	recommendations to the chairs and ranking minority members of the legislative committees 
185.6 	with jurisdiction over human services finance and policy by January 15, 2027.

185.7 	Sec. 35. DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER 
185.8 	TREATMENT BILLING UNITS.
 185.9 	The commissioner of human services must establish six new billing codes for 
185.10 	nonresidential substance use disorder individual and group counseling, individual and group 
185.11 	psychoeducation, and individual and group recovery support services. The commissioner 
185.12 	must identify reimbursement rates for the newly defined codes and update the substance 
185.13 	use disorder fee schedule. The new billing codes must correspond to a 15-minute unit and 
185.14 	become effective for services provided on or after July 1, 2026, or upon federal approval, 
185.15 	whichever is later.

185.16 	EFFECTIVE DATE. This section is effective July 1, 2026, or upon federal approval, 
185.17 	whichever is later. The commissioner of human services must inform the revisor of statutes 
185.18 	when federal approval is obtained.

185.19 	Sec. 36. REVISOR INSTRUCTION.
 185.20 	The revisor of statutes, in consultation with the House Research Department; the Office 
185.21 	of Senate Counsel, Research and Fiscal Analysis; and the Department of Human Services 
185.22 	shall make necessary cross-reference changes and remove statutory cross-references in 
185.23 	Minnesota Statutes to conform with the renumbering in this act. The revisor may make 
185.24 	technical and other necessary changes to sentence structure to preserve the meaning of the 
185.25 	text. The revisor may alter the coding in this act to incorporate statutory changes made by 
185.26 	other law in the 2025 regular legislative session or a special session. If a provision stricken 
185.27 	in this act is also amended in the 2025 regular legislative session or a special session by 
185.28 	other law, the revisor shall merge the amendment into the numbering, notwithstanding 
185.29 	Minnesota Statutes, section 645.30.

186.1 	Sec. 37. REVISOR INSTRUCTION.
 186.2 	The revisor of statutes shall renumber each provision of Minnesota Statutes listed in 
186.3 	column A as amended in this act to the number listed in column B. The revisor shall also 
186.4 	make necessary cross-reference changes consistent with the renumbering.

186.5	Column A
	Column B
	
186.6	254B.05, subdivision 1, paragraph (a)
	254B.0501, subdivision 1
	
186.7	254B.05, subdivision 1, paragraph (i)
	254B.0501, subdivision 2
	
186.8	254B.05, subdivision 4
	254B.0501, subdivision 3
	
186.9	254B.05, subdivision 1, paragraph (b)
	254B.0501, subdivision 4
	
186.10	254B.05, subdivision 1, paragraph (c)
	254B.0501, subdivision 5
	
186.11	254B.05, subdivision 1, paragraph (d)
	254B.0501, subdivision 6, paragraph (a)
	
186.12	254B.05, subdivision 1, paragraph (e)
	254B.0501, subdivision 6, paragraph (b)
	
186.13	254B.05, subdivision 1, paragraph (f)
	254B.0501, subdivision 6, paragraph (c)
	
186.14	254B.05, subdivision 1, paragraph (g)
	254B.0501, subdivision 6, paragraph (d)
	
186.15	254B.05, subdivision 1, paragraph (h)
	254B.0501, subdivision 7
	
186.16	254B.05, subdivision 1b
	254B.0501, subdivision 8
	
186.17	254B.05, subdivision 2
	254B.0501, subdivision 9
	
186.18	254B.05, subdivision 3
	254B.0501, subdivision 10
	
186.19	254B.05, subdivision 1a, paragraph (a)
	254B.0503, subdivision 1, paragraph (a)
	
186.20	254B.05, subdivision 1a, paragraph (c)
	254B.0503, subdivision 1, paragraph (b)
	
186.21	254B.05, subdivision 1a, paragraph (d)
	254B.0503, subdivision 1, paragraph (c)
	
186.22	254B.05, subdivision 1a, paragraph (e)
	254B.0503, subdivision 1, paragraph (d)
	
186.23	254B.05, subdivision1a, paragraph (b)
	254B.0503, subdivision 2, paragraph (a)
	
186.24	254B.05, subdivision 1a, paragraph (e)
	254B.0503, subdivision 2, paragraph (b)
	
186.25	254B.05, subdivision 5, paragraph (a)
	254B.0505, subdivision 1
	
186.26	254B.05, subdivision 5, paragraph (c)
	254B.0505, subdivision 2
	
186.27	254B.05, subdivision 5, paragraph (d)
	254B.0505, subdivision 3
	
186.28	254B.05, subdivision 5, paragraph (e)
	254B.0505, subdivision 4
	
186.29	254B.05, subdivision 5, paragraph (f)
	254B.0505, subdivision 5
	
186.30	254B.05, subdivision 5, paragraph (g)
	254B.0505, subdivision 6
	
186.31	254B.05, subdivision 5, paragraph (h)
	254B.0505, subdivision 7
	
186.32	254B.05, subdivision 5, paragraph (i)
	254B.0505, subdivision 8
	
186.33
186.34	254B.05, subdivision 5, paragraph (b), first 
sentence
	254B.0507, subdivision 1
	
186.35
186.36	254B.05, subdivision 5, paragraph (b), clause 
(1), items (i) and (ii)
	254B.0507, subdivision 2, paragraph (a)
	
186.37
186.38	254B.05, subdivision 5, paragraph (b), block 
left paragraph
	254B.0507, subdivision 2, paragraph (b)
	
187.1
187.2	254B.05, subdivision 5, paragraph (b), clause 
(2)
	254B.0507, subdivision 3
	
187.3
187.4	254B.05, subdivision 5, paragraph (b), clause 
(3)
	254B.0507, subdivision 4
	
187.5
187.6	254B.05, subdivision 5, paragraph (b), clause 
(4)
	254B.0507, subdivision 5
	
187.7
187.8	254B.05, subdivision 5, paragraph (b), clause 
(5)
	254B.0507, subdivision 6, paragraph (a)
	
187.9187.10
	254B.05, subdivision 5, paragraph (b), clause 
(5), block left paragraph
	254B.0507, subdivision 6, paragraph (b)
	
187.11	254B.05, subdivision 6, paragraph (a)
	254B.0509, subdivision 1
	
187.12	254B.05, subdivision 6, paragraph (b)
	254B.0509, subdivision 2
	
187.13	254B.05, subdivision 1, paragraph (j)
	254B.052, subdivision 4
	
187.14	254B.05, subdivision 5, paragraph (j)
	254B.052, subdivision 5

187.15 	Sec. 38. REVISOR INSTRUCTION.
 187.16 	The revisor of statutes shall change the terms "mental health practitioner" and "mental 
187.17 	health practitioners" to "behavioral health practitioner" or "behavioral health practitioners" 
187.18 	wherever they appear in Minnesota Statutes, chapter 245I.

187.19 	Sec. 39. REPEALER.
 187.20 	Minnesota Statutes 2024, sections 245G.01, subdivision 20d; 245G.07, subdivision 2; 
187.21 	254B.01, subdivision 5; and 254B.18, are repealed.

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

187.23 	ARTICLE 5
187.24 	HOUSING SUPPORTS

187.25 	Section 1. Minnesota Statutes 2024, section 256I.05, is amended by adding a subdivision 
187.26 	to read:
187.27 		Subd. 1v.Supplemental rate; Blue Earth County. Notwithstanding the provisions of 
187.28 	subdivisions 1a and 1c, beginning July 1, 2025, a county agency shall negotiate a 
187.29 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per 
187.30 	month, including any legislatively authorized inflationary adjustments, for a housing support 
187.31 	provider located in Blue Earth County that operates a long-term residential facility that 
187.32 	opened in 2007 in Garden City with a total of 20 beds that serves chemically dependent 
187.33 	women and provides 24-hour-a-day supervision and other support services.

188.1 	Sec. 2. Minnesota Statutes 2024, section 256I.05, is amended by adding a subdivision to 
188.2 	read:
188.3 		Subd. 1w.Supplemental rate; Otter Tail County. Notwithstanding the provisions in 
188.4 	this section, beginning July 1, 2025, a county agency shall negotiate a supplemental rate 
188.5 	for up to 24 beds in addition to the rate specified in subdivision 1, not to exceed the maximum 
188.6 	rate allowed under subdivision 1a, including any legislatively authorized inflationary 
188.7 	adjustments, for housing support providers located in Otter Tail County that operate facilities 
188.8 	and provide room and board and supplementary services to adults recovering from substance 
188.9 	use disorder, mental illness, or housing instability.

188.10 	ARTICLE 6
188.11 	HEALTH CARE

188.12 	Section 1. Minnesota Statutes 2024, section 256.01, subdivision 29, is amended to read:
188.13 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
188.14 	determinations of disability by the commissioner's state medical review team under sections 
188.15 	256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the 
188.16 	commissioner shall review all medical evidence and seek information from providers, 
188.17 	applicants, and enrollees to support the determination of disability where necessary. Disability 
188.18 	shall be determined according to the rules of title XVI and title XIX of the Social Security 
188.19 	Act and pertinent rules and policies of the Social Security Administration.
188.20 	(b) Medical assistance providers must grant the state medical review team access to 
188.21 	electronic health records held by the medical assistance providers, when available, to support 
188.22 	efficient and accurate disability determinations.
188.23 	(c) Medicaid providers shall accept electronically signed authorizations to release medical 
188.24 	records provided by the state medical review team.
188.25 	(b) (d) Prior to a denial or withdrawal of a requested determination of disability due to 
188.26 	insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary 
188.27 	and appropriate to a determination of disability, and (2) assist applicants and enrollees to 
188.28 	obtain the evidence, including, but not limited to, medical examinations and electronic 
188.29 	medical records.
188.30 	(c) (e) Any appeal made under section 256.045, subdivision 3, of a disability 
188.31 	determination made by the state medical review team must be decided according to the 
188.32 	timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is not 
189.1 	issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal 
189.2 	must be immediately reviewed by the chief human services judge.

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

189.4 	Sec. 2. Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to 
189.5 	read:
189.6 		Subd. 29a.State medical review team; expedited disability determinations. (a) The 
189.7 	commissioner must establish an expedited disability determination process within the state 
189.8 	medical review team for applicants in the following high-risk categories:
189.9 	(1) individuals in a facility who cannot be discharged without home- and 
189.10 	community-based services or long-term care supports in place;
189.11 	(2) individuals experiencing life-threatening medical conditions requiring urgent access 
189.12 	to treatment or prescription medication;
189.13 	(3) individuals diagnosed with a condition listed on the Social Security Administration's 
189.14 	Compassionate Allowance List; and
189.15 	(4) children under the age of two who have screened positive for a rare disease recognized 
189.16 	by national medical registries or evidence-based standards.
189.17 	(b) Hospitals submitting requests under paragraph (a) must complete an application for 
189.18 	medical assistance prior to an expedited request and assist patients with returning required 
189.19 	documentation necessary to determine disability.
189.20 	(c) The commissioner must designate staff within the state medical review team to 
189.21 	coordinate expedited requests, communicate with county and tribal agencies, and ensure 
189.22 	timely electronic transmission of required documentation, including the use of electronic 
189.23 	signature platforms.

189.24 	Sec. 3. Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:
189.25 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
189.26 	means motor vehicle transportation provided by a public or private person that serves 
189.27 	Minnesota health care program beneficiaries who do not require emergency ambulance 
189.28 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
189.29 	(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
189.30 	a census-tract based classification system under which a geographical area is determined 
189.31 	to be urban, rural, or super rural.
190.1 	(c) Medical assistance covers medical transportation costs incurred solely for obtaining 
190.2 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
190.3 	emergency or nonemergency medical care when paid directly to an ambulance company, 
190.4 	nonemergency medical transportation company, or other recognized providers of 
190.5 	transportation services. Medical transportation must be provided by:
190.6 	(1) nonemergency medical transportation providers who meet the requirements of this 
190.7 	subdivision;
190.8 	(2) ambulances, as defined in section 144E.001, subdivision 2;
190.9 	(3) taxicabs that meet the requirements of this subdivision;
190.10 	(4) public transportation, within the meaning of "public transportation" as defined in 
190.11 	section 174.22, subdivision 7; or
190.12 	(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472, 
190.13 	subdivision 1, paragraph (p).
190.14 	(d) Medical assistance covers nonemergency medical transportation provided by 
190.15 	nonemergency medical transportation providers enrolled in the Minnesota health care 
190.16 	programs. All nonemergency medical transportation providers must comply with the 
190.17 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
190.18 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
190.19 	commissioner and reported on the claim as the individual who provided the service. All 
190.20 	nonemergency medical transportation providers shall bill for nonemergency medical 
190.21 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
190.22 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
190.23 	requirements outlined in this paragraph.
190.24 	(e) An organization may be terminated, denied, or suspended from enrollment if:
190.25 	(1) the provider has not initiated background studies on the individuals specified in 
190.26 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
190.27 	(2) the provider has initiated background studies on the individuals specified in section 
190.28 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
190.29 	(i) the commissioner has sent the provider a notice that the individual has been 
190.30 	disqualified under section 245C.14; and
190.31 	(ii) the individual has not received a disqualification set-aside specific to the special 
190.32 	transportation services provider under sections 245C.22 and 245C.23.
191.1 	(f) The administrative agency of nonemergency medical transportation must:
191.2 	(1) adhere to the policies defined by the commissioner;
191.3 	(2) pay nonemergency medical transportation providers for services provided to 
191.4 	Minnesota health care programs beneficiaries to obtain covered medical services;
191.5 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
191.6 	trips, and number of trips by mode; and
191.7 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
191.8 	administrative structure assessment tool that meets the technical requirements established 
191.9 	by the commissioner, reconciles trip information with claims being submitted by providers, 
191.10 	and ensures prompt payment for nonemergency medical transportation services.
191.11 	(g) Until the commissioner implements the single administrative structure and delivery 
191.12 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
191.13 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
191.14 	clients using modes of transportation under paragraph (l), clauses (4), (5), (6), and (7).
191.15 	(h) The commissioner may use an order by the recipient's attending physician, advanced 
191.16 	practice registered nurse, physician assistant, or a medical or mental health professional to 
191.17 	certify that the recipient requires nonemergency medical transportation services. 
191.18 	Nonemergency medical transportation providers shall perform driver-assisted services for 
191.19 	eligible individuals, when appropriate. Driver-assisted service includes passenger pickup 
191.20 	at and return to the individual's residence or place of business, assistance with admittance 
191.21 	of the individual to the medical facility, and assistance in passenger securement or in securing 
191.22 	of wheelchairs, child seats, or stretchers in the vehicle.
191.23 	(i) Nonemergency medical transportation providers must take clients to the health care 
191.24 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
191.25 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
191.26 	authorization from the local agency.
191.27 	(j) Nonemergency medical transportation providers may not bill for separate base rates 
191.28 	for the continuation of a trip beyond the original destination. Nonemergency medical 
191.29 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
191.30 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
191.31 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
191.32 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
191.33 	services.
192.1 	(k) The administrative agency shall use the level of service process established by the 
192.2 	commissioner to determine the client's most appropriate mode of transportation. If public 
192.3 	transit or a certified transportation provider is not available to provide the appropriate service 
192.4 	mode for the client, the client may receive a onetime service upgrade.
192.5 	(l) The covered modes of transportation are:
192.6 	(1) client reimbursement, which includes client mileage reimbursement provided to 
192.7 	clients who have their own transportation, or to family or an acquaintance who provides 
192.8 	transportation to the client;
192.9 	(2) volunteer transport, which includes transportation by volunteers using their own 
192.10 	vehicle;
192.11 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
192.12 	or public transit. If a taxicab or public transit is not available, the client can receive 
192.13 	transportation from another nonemergency medical transportation provider;
192.14 	(4) assisted transport, which includes transport provided to clients who require assistance 
192.15 	by a nonemergency medical transportation provider;
192.16 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
192.17 	dependent on a device and requires a nonemergency medical transportation provider with 
192.18 	a vehicle containing a lift or ramp;
192.19 	(6) protected transport, which includes transport provided to a client who has received 
192.20 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
192.21 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
192.22 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
192.23 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
192.24 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
192.25 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
192.26 	a client in a prone or supine position.
192.27 	(m) The local agency shall be the single administrative agency and shall administer and 
192.28 	reimburse for modes defined in paragraph (l) according to paragraphs (p) and (q) when the 
192.29 	commissioner has developed, made available, and funded the web-based single administrative 
192.30 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
192.31 	agency's financial obligation is limited to funds provided by the state or federal government.
192.32 	(n) The commissioner shall:
193.1 	(1) verify that the mode and use of nonemergency medical transportation is appropriate;
193.2 	(2) verify that the client is going to an approved medical appointment; and
193.3 	(3) investigate all complaints and appeals.
193.4 	(o) The administrative agency shall pay for the services provided in this subdivision and 
193.5 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
193.6 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
193.7 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
193.8 	(p) Payments for nonemergency medical transportation must be paid based on the client's 
193.9 	assessed mode under paragraph (k), not the type of vehicle used to provide the service. The 
193.10 	medical assistance reimbursement rates for nonemergency medical transportation services 
193.11 	that are payable by or on behalf of the commissioner for nonemergency medical 
193.12 	transportation services are:
193.13 	(1) $0.22 per mile for client reimbursement;
193.14 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
193.15 	transport;
193.16 	(3) equivalent to the standard fare for unassisted transport when provided by public 
193.17 	transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency 
193.18 	medical transportation provider;
193.19 	(4) $14.30 for the base rate and $1.43 per mile for assisted transport;
193.20 	(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
193.21 	(6) $75 for the base rate for the first 100 miles and an additional $75 for trips over 100 
193.22 	miles and $2.40 per mile for protected transport; and
193.23 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
193.24 	an additional attendant if deemed medically necessary.
193.25 	(q) The base rate for nonemergency medical transportation services in areas defined 
193.26 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
193.27 	paragraph (p), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
193.28 	services in areas defined under RUCA to be rural or super rural areas is:
193.29 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
193.30 	rate in paragraph (p), clauses (1) to (7); and
194.1 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
194.2 	rate in paragraph (p), clauses (1) to (7).
194.3 	(r) For purposes of reimbursement rates for nonemergency medical transportation services 
194.4 	under paragraphs (p) and (q), the zip code of the recipient's place of residence shall determine 
194.5 	whether the urban, rural, or super rural reimbursement rate applies.
194.6 	(s) The commissioner, when determining reimbursement rates for nonemergency medical 
194.7 	transportation under paragraphs (p) and (q), shall exempt all modes of transportation listed 
194.8 	under paragraph (l) from Minnesota Rules, part 9505.0445, item R, subitem (2).
194.9 	(t) Effective for the first day of each calendar quarter in which the price of gasoline as 
194.10 	posted publicly by the United States Energy Information Administration exceeds $3.00 per 
194.11 	gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) by one percent 
194.12 	up or down for every increase or decrease of ten cents for the price of gasoline. The increase 
194.13 	or decrease must be calculated using a base gasoline price of $3.00. The percentage increase 
194.14 	or decrease must be calculated using the average of the most recently available price of all 
194.15 	grades of gasoline for Minnesota as posted publicly by the United States Energy Information 
194.16 	Administration.

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

194.18 	Sec. 4. Minnesota Statutes 2024, section 256B.766, is amended to read:
194.19 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
194.20 		Subdivision 1.Payment reductions for base care services effective July 1, 2009. (a)
194.21 	Effective for services provided on or after July 1, 2009, total payments for basic care services, 
194.22 	shall be reduced by three percent, except that for the period July 1, 2009, through June 30, 
194.23 	2011, total payments shall be reduced by 4.5 percent for the medical assistance and general 
194.24 	assistance medical care programs, prior to third-party liability and spenddown calculation.
194.25 		Subd. 2.Classification of therapies as basic care services. Effective July 1, 2010, The 
194.26 	commissioner shall classify physical therapy services, occupational therapy services, and 
194.27 	speech-language pathology and related services as basic care services. The reduction in this 
194.28 	paragraph subdivision 1 shall apply to physical therapy services, occupational therapy 
194.29 	services, and speech-language pathology and related services provided on or after July 1, 
194.30 	2010.
194.31 		Subd. 3.Payment reductions to managed care plans effective October 1, 2009. (b)
194.32 	Payments made to managed care plans and county-based purchasing plans shall be reduced 
194.33 	for services provided on or after October 1, 2009, to reflect the reduction in subdivision 1 
195.1 	effective July 1, 2009, and payments made to the plans shall be reduced effective October 
195.2 	1, 2010, to reflect the reduction in subdivision 1 effective July 1, 2010.
195.3 		Subd. 4.Temporary payment reductions effective September 1, 2011. (c) (a) Effective 
195.4 	for services provided on or after September 1, 2011, through June 30, 2013, total payments 
195.5 	for outpatient hospital facility fees shall be reduced by five percent from the rates in effect 
195.6 	on August 31, 2011.
195.7 	(d) (b) Effective for services provided on or after September 1, 2011, through June 30, 
195.8 	2013, total payments for ambulatory surgery centers facility fees, medical supplies and 
195.9 	durable medical equipment not subject to a volume purchase contract, prosthetics and 
195.10 	orthotics, renal dialysis services, laboratory services, public health nursing services, physical 
195.11 	therapy services, occupational therapy services, speech therapy services, eyeglasses not 
195.12 	subject to a volume purchase contract, hearing aids not subject to a volume purchase contract, 
195.13 	and anesthesia services shall be reduced by three percent from the rates in effect on August 
195.14 	31, 2011.
195.15 		Subd. 5.Payment increases effective September 1, 2014. (e) (a) Effective for services 
195.16 	provided on or after September 1, 2014, payments for ambulatory surgery centers facility 
195.17 	fees, hospice services, renal dialysis services, laboratory services, public health nursing 
195.18 	services, eyeglasses not subject to a volume purchase contract, and hearing aids not subject 
195.19 	to a volume purchase contract shall be increased by three percent and payments for outpatient 
195.20 	hospital facility fees shall be increased by three percent.
195.21 	(b) Payments made to managed care plans and county-based purchasing plans shall not 
195.22 	be adjusted to reflect payments under this paragraph subdivision.
195.23 		Subd. 6.Temporary payment reductions effective July 1, 2014. (f) Payments for 
195.24 	medical supplies and durable medical equipment not subject to a volume purchase contract, 
195.25 	and prosthetics and orthotics, provided on or after July 1, 2014, through June 30, 2015, shall 
195.26 	be decreased by .33 percent.
195.27 		Subd. 7.Payment increases effective July 1, 2015. (a) Payments for medical supplies 
195.28 	and durable medical equipment not subject to a volume purchase contract, and prosthetics 
195.29 	and orthotics, provided on or after July 1, 2015, shall be increased by three percent from 
195.30 	the rates as determined under paragraphs (i) and (j) subdivisions 9 and 10.
195.31 	(g) (b) Effective for services provided on or after July 1, 2015, payments for outpatient 
195.32 	hospital facility fees, medical supplies and durable medical equipment not subject to a 
195.33 	volume purchase contract, prosthetics, and orthotics to a hospital meeting the criteria specified 
196.1 	in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent 
196.2 	from the rates in effect on June 30, 2015.
196.3 	(c) Payments made to managed care plans and county-based purchasing plans shall not 
196.4 	be adjusted to reflect payments under this paragraph (b).
196.5 		Subd. 8.Exempt services. (h) This section does not apply to physician and professional 
196.6 	services, inpatient hospital services, family planning services, mental health services, dental 
196.7 	services, prescription drugs, medical transportation, federally qualified health centers, rural 
196.8 	health centers, Indian health services, and Medicare cost-sharing.
196.9 		Subd. 9.Individually priced items. (i) (a) Effective for services provided on or after 
196.10 	July 1, 2015, the following categories of medical supplies and durable medical equipment 
196.11 	shall be individually priced items: customized and other specialized tracheostomy tubes 
196.12 	and supplies, electric patient lifts, and durable medical equipment repair and service.
196.13 	(b) This paragraph subdivision does not apply to medical supplies and durable medical 
196.14 	equipment subject to a volume purchase contract, products subject to the preferred diabetic 
196.15 	testing supply program, and items provided to dually eligible recipients when Medicare is 
196.16 	the primary payer for the item.
196.17 	(c) The commissioner shall not apply any medical assistance rate reductions to durable 
196.18 	medical equipment as a result of Medicare competitive bidding.
196.19 		Subd. 10.Rate increases effective July 1, 2015. (j) (a) Effective for services provided 
196.20 	on or after July 1, 2015, medical assistance payment rates for durable medical equipment, 
196.21 	prosthetics, orthotics, or supplies shall be increased as follows:
196.22 	(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that 
196.23 	were subject to the Medicare competitive bid that took effect in January of 2009 shall be 
196.24 	increased by 9.5 percent; and
196.25 	(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on 
196.26 	the medical assistance fee schedule, whether or not subject to the Medicare competitive bid 
196.27 	that took effect in January of 2009, shall be increased by 2.94 percent, with this increase 
196.28 	being applied after calculation of any increased payment rate under clause (1).
196.29 	This (b) Paragraph (a) does not apply to medical supplies and durable medical equipment 
196.30 	subject to a volume purchase contract, products subject to the preferred diabetic testing 
196.31 	supply program, items provided to dually eligible recipients when Medicare is the primary 
196.32 	payer for the item, and individually priced items identified in paragraph (i) subdivision 9.
197.1 	(c) Payments made to managed care plans and county-based purchasing plans shall not 
197.2 	be adjusted to reflect the rate increases in this paragraph subdivision.
197.3 		Subd. 11.Rates for ventilators. (k) (a) Effective for nonpressure support ventilators 
197.4 	provided on or after January 1, 2016, the rate shall be the lower of the submitted charge or 
197.5 	the Medicare fee schedule rate.
197.6 	(b) Effective for pressure support ventilators provided on or after January 1, 2016, the 
197.7 	rate shall be the lower of the submitted charge or 47 percent above the Medicare fee schedule 
197.8 	rate.
197.9 	(c) For payments made in accordance with this paragraph subdivision, if, and to the 
197.10 	extent that, the commissioner identifies that the state has received federal financial 
197.11 	participation for ventilators in excess of the amount allowed effective January 1, 2018, 
197.12 	under United States Code, title 42, section 1396b(i)(27), the state shall repay the excess 
197.13 	amount to the Centers for Medicare and Medicaid Services with state funds and maintain 
197.14 	the full payment rate under this paragraph subdivision.
197.15 		Subd. 12.Rates subject to the upper payment limit. (l) Payment rates for durable 
197.16 	medical equipment, prosthetics, orthotics or supplies, that are subject to the upper payment 
197.17 	limit in accordance with section 1903(i)(27) of the Social Security Act, shall be paid the 
197.18 	Medicare rate. Rate increases provided in this chapter shall not be applied to the items listed 
197.19 	in this paragraph subdivision.
197.20 		Subd. 13.Temporary rates for enteral nutrition and supplies. (m) (a) For dates of 
197.21 	service on or after July 1, 2023, through June 30, 2025 2027, enteral nutrition and supplies 
197.22 	must be paid according to this paragraph subdivision. If sufficient data exists for a product 
197.23 	or supply, payment must be based upon the 50th percentile of the usual and customary 
197.24 	charges per product code submitted to the commissioner, using only charges submitted per 
197.25 	unit. Increases in rates resulting from the 50th percentile payment method must not exceed 
197.26 	150 percent of the previous fiscal year's rate per code and product combination. Data are 
197.27 	sufficient if: (1) the commissioner has at least 100 paid claim lines by at least ten different 
197.28 	providers for a given product or supply; or (2) in the absence of the data in clause (1), the 
197.29 	commissioner has at least 20 claim lines by at least five different providers for a product or 
197.30 	supply that does not meet the requirements of clause (1). If sufficient data are not available 
197.31 	to calculate the 50th percentile for enteral products or supplies, the payment rate must be 
197.32 	the payment rate in effect on June 30, 2023.
197.33 	(b) This subdivision expires June 30, 2027.
198.1 		Subd. 14.Rates for enteral nutrition and supplies. (n) For dates of service on or after 
198.2 	July 1, 2025 2027, enteral nutrition and supplies must be paid according to this paragraph
198.3 	subdivision and updated annually each January 1. If sufficient data exists for a product or 
198.4 	supply, payment must be based upon the 50th percentile of the usual and customary charges 
198.5 	per product code submitted to the commissioner for the previous calendar year, using only 
198.6 	charges submitted per unit. Increases in rates resulting from the 50th percentile payment 
198.7 	method must not exceed 150 percent of the previous year's rate per code and product 
198.8 	combination. Data are sufficient if: (1) the commissioner has at least 100 paid claim lines 
198.9 	by at least ten different providers for a given product or supply; or (2) in the absence of the 
198.10 	data in clause (1), the commissioner has at least 20 claim lines by at least five different 
198.11 	providers for a product or supply that does not meet the requirements of clause (1). If 
198.12 	sufficient data are not available to calculate the 50th percentile for enteral products or 
198.13 	supplies, the payment must be the manufacturer's suggested retail price of that product or 
198.14 	supply minus 20 percent. If the manufacturer's suggested retail price is not available, payment 
198.15 	must be the actual acquisition cost of that product or supply plus 20 percent.

198.16 	Sec. 5. SINGLE ADMINISTRATIVE STRUCTURE AND DELIVERY SYSTEM 
198.17 	PILOT PROGRAM.
 198.18 	(a) By January 1, 2026, the commissioner of human services, in coordination with the 
198.19 	commissioner of transportation, must implement one or two pilot programs for a web-based 
198.20 	single administrative structure and delivery system for nonemergency medical transportation 
198.21 	under medical assistance and MinnesotaCare. The administrative structure and delivery 
198.22 	system must meet the requirements in paragraph (b). Each pilot program must include at 
198.23 	least two counties. Metropolitan counties, as defined in Minnesota Statutes, section 473.121, 
198.24 	subdivision 4, are not eligible to participate. Each pilot program shall operate for three years 
198.25 	from the date of implementation.
198.26 	(b) The web-based single administrative structure and delivery system must provide for 
198.27 	the following:
198.28 	(1) bidirectional communication between payers and transportation providers;
198.29 	(2) client and client advocate access to ride scheduling and real-time trip monitoring;
198.30 	(3) real-time eligibility and level of service determination;
198.31 	(4) on-demand reporting;
198.32 	(5) expedited payments for transportation providers; and
199.1 	(6) the ability to collect feedback, including but not limited to complaints regarding 
199.2 	inappropriate level of needs determinations, utilization of inappropriate transportation modes, 
199.3 	and interference with accessing nonemergency medical transportation.
199.4 	(c) By February 1, 2027, and each year thereafter that a pilot program is in effect, the 
199.5 	commissioner must submit a report on the pilot programs to the chairs and ranking minority 
199.6 	members of the legislative committees with jurisdiction over nonemergency medical 
199.7 	transportation under medical assistance and MinnesotaCare.

199.8 	ARTICLE 7
199.9 	DIRECT CARE AND TREATMENT

199.10 	Section 1. [246.0142] FREE COMMUNICATION SERVICES FOR PATIENTS AND 
199.11 	CLIENTS.
199.12 		Subdivision 1.Free communication services. The commissioner of human services 
199.13 	and the Direct Care and Treatment executive board and all facilities, settings, and programs 
199.14 	owned, operated, or under the programmatic or fiscal control of the commissioner of human 
199.15 	services or the Direct Care and Treatment executive board are subject to section 241.252. 
199.16 	The commissioner and executive board must not include the cost of voice or other 
199.17 	communication services in the cost of care as defined under section 246.50 or 246B.01.
199.18 		Subd. 2.Communication service restrictions. Notwithstanding section 241.252, 
199.19 	subdivisions 2 and 4, nothing in this section entitles a civilly committed person to 
199.20 	communication services restricted or limited under section 253B.03, subdivision 3, or 
199.21 	253D.19.

199.22 	Sec. 2. Minnesota Statutes 2024, section 611.43, is amended by adding a subdivision to 
199.23 	read:
199.24 		Subd. 5.Costs related to confined treatment. (a) When a defendant is ordered to 
199.25 	participate in an examination in a treatment facility, a locked treatment facility, or a 
199.26 	state-operated treatment facility under subdivision 1, paragraph (b), the facility shall bill 
199.27 	the responsible health plan.
199.28 	(b) The Direct Care and Treatment executive board shall determine the cost of 
199.29 	confinement in a state-operated treatment facility based on the executive board's 
199.30 	determination of cost of care pursuant to section 246.50, subdivision 5.

200.1 	Sec. 3. Minnesota Statutes 2024, section 611.46, subdivision 1, is amended to read:
200.2 		Subdivision 1.Order to competency attainment program. (a) If the court finds the 
200.3 	defendant incompetent and the charges have not been dismissed, the court shall order the 
200.4 	defendant to participate in a program to assist the defendant in attaining competency. The 
200.5 	court may order participation in a competency attainment program provided outside of a 
200.6 	jail, a jail-based competency attainment program, or an alternative program. The court must 
200.7 	determine the least-restrictive program appropriate to meet the defendant's needs and public 
200.8 	safety. In making this determination, the court must consult with the forensic navigator and 
200.9 	consider any recommendations of the court examiner. The court shall not order a defendant 
200.10 	to participate in a jail-based program or a state-operated treatment program if the highest 
200.11 	criminal charge is a targeted misdemeanor.
200.12 	(b) If the court orders the defendant to a locked treatment facility or jail-based program, 
200.13 	the court must calculate the defendant's custody credit and cannot order the defendant to a 
200.14 	locked treatment facility or jail-based program for a period that would cause the defendant's 
200.15 	custody credit to exceed the maximum sentence for the underlying charge.
200.16 	(c) The court may only order the defendant to participate in competency attainment at 
200.17 	an inpatient or residential treatment program under this section if the head of the treatment 
200.18 	program determines that admission to the program is clinically appropriate and consents to 
200.19 	the defendant's admission. The court may only order the defendant to participate in 
200.20 	competency attainment at a state-operated treatment facility under this section if the Direct 
200.21 	Care and Treatment executive board or a designee determines that admission of the defendant 
200.22 	is clinically appropriate and consents to the defendant's admission. The court may require 
200.23 	a competency program that qualifies as a locked facility or a state-operated treatment program 
200.24 	to notify the court in writing of the basis for refusing consent for admission of the defendant 
200.25 	in order to ensure transparency and maintain an accurate record. The court may not require 
200.26 	personal appearance of any representative of a competency program. The court shall send 
200.27 	a written request for notification to the locked facility or state-operated treatment program 
200.28 	and the locked facility or state-operated treatment program shall provide a written response 
200.29 	to the court within ten days of receipt of the court's request.
200.30 	(d) If the defendant is confined in jail and has not received competency attainment 
200.31 	services within 30 days of the finding of incompetency, the court shall review the case with 
200.32 	input from the prosecutor and defense counsel and may:
200.33 	(1) order the defendant to participate in an appropriate competency attainment program 
200.34 	that takes place outside of a jail;
201.1 	(2) order a conditional release of the defendant with conditions that include but are not 
201.2 	limited to a requirement that the defendant participate in a competency attainment program 
201.3 	when one becomes available and accessible;
201.4 	(3) make a determination as to whether the defendant is likely to attain competency in 
201.5 	the reasonably foreseeable future and proceed under section 611.49; or
201.6 	(4) upon a motion, dismiss the charges in the interest of justice.
201.7 	(e) The court may order any hospital, treatment facility, or correctional facility that has 
201.8 	provided care or supervision to a defendant in the previous two years to provide copies of 
201.9 	the defendant's medical records to the competency attainment program or alternative program 
201.10 	in which the defendant was ordered to participate. This information shall be provided in a 
201.11 	consistent and timely manner and pursuant to all applicable laws.
201.12 	(f) If at any time the defendant refuses to participate in a competency attainment program 
201.13 	or an alternative program, the head of the program shall notify the court and any entity 
201.14 	responsible for supervision of the defendant.
201.15 	(g) At any time, the head of the program may discharge the defendant from the program 
201.16 	or facility. The head of the program must notify the court, prosecutor, defense counsel, and 
201.17 	any entity responsible for the supervision of the defendant prior to any planned discharge. 
201.18 	Absent emergency circumstances, this notification shall be made five days prior to the 
201.19 	discharge if the defendant is not being discharged to jail or a correctional facility. Upon the 
201.20 	receipt of notification of discharge or upon the request of either party in response to 
201.21 	notification of discharge, the court may order that a defendant who is subject to bail or 
201.22 	unmet conditions of release be returned to jail upon being discharged from the program or 
201.23 	facility. If the court orders a defendant returned to jail, the court shall notify the parties and 
201.24 	head of the program at least one day before the defendant's planned discharge, except in 
201.25 	the event of an emergency discharge where one day notice is not possible. The court must 
201.26 	hold a review hearing within seven days of the defendant's return to jail. The forensic 
201.27 	navigator must be given notice of the hearing and be allowed to participate.
201.28 	(h) If the defendant is discharged from the program or facility under emergency 
201.29 	circumstances, notification of emergency discharge shall include a description of the 
201.30 	emergency circumstances and may include a request for emergency transportation. The 
201.31 	court shall make a determination on a request for emergency transportation within 24 hours. 
201.32 	Nothing in this section prohibits a law enforcement agency from transporting a defendant 
201.33 	pursuant to any other authority.
202.1 	(i) If the defendant is ordered to participate in an inpatient or residential competency 
202.2 	attainment or alternative program, the program or facility must notify the court, prosecutor, 
202.3 	defense counsel, forensic navigator, and any entity responsible for the supervision of the 
202.4 	defendant if the defendant is placed on a leave or elopement status from the program and 
202.5 	if the defendant returns to the program from a leave or elopement status.
202.6 	(j) Defense counsel, prosecutors, and forensic navigators must have access to information 
202.7 	relevant to a defendant's participation and treatment in a competency attainment program 
202.8 	or alternative program, including but not limited to discharge planning.

202.9 	Sec. 4. Minnesota Statutes 2024, section 611.55, is amended by adding a subdivision to 
202.10 	read:
202.11 		Subd. 5.Data access. Forensic navigators must have access to all data collected, created, 
202.12 	or maintained by a competency attainment program or an alternative program regarding a 
202.13 	defendant in order for navigators to carry out their duties under this section. A competency 
202.14 	attainment program or alternative program may request a copy of the court order appointing 
202.15 	the forensic navigator before disclosing any private information about a defendant.

202.16 	ARTICLE 8
202.17 	DEPARTMENT OF DIRECT CARE AND TREATMENT ESTABLISHMENT

202.18 	Section 1. Minnesota Statutes 2024, section 10.65, subdivision 2, is amended to read:
202.19 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
202.20 	given:
202.21 	(1) "agency" means the Department of Administration; Department of Agriculture; 
202.22 	Department of Children, Youth, and Families; Department of Commerce; Department of 
202.23 	Corrections; Department of Direct Care and Treatment; Department of Education; Department 
202.24 	of Employment and Economic Development; Department of Health; Office of Higher 
202.25 	Education; Housing Finance Agency; Department of Human Rights; Department of Human 
202.26 	Services; Department of Information Technology Services; Department of Iron Range 
202.27 	Resources and Rehabilitation; Department of Labor and Industry; Minnesota Management 
202.28 	and Budget; Bureau of Mediation Services; Department of Military Affairs; Metropolitan 
202.29 	Council; Department of Natural Resources; Pollution Control Agency; Department of Public 
202.30 	Safety; Department of Revenue; Department of Transportation; Department of Veterans 
202.31 	Affairs; Direct Care and Treatment; Gambling Control Board; Racing Commission; the 
202.32 	Minnesota Lottery; the Animal Health Board; the Public Utilities Commission; and the 
202.33 	Board of Water and Soil Resources;
203.1 	(2) "consultation" means the direct and interactive involvement of the Minnesota Tribal 
203.2 	governments in the development of policy on matters that have Tribal implications. 
203.3 	Consultation is the proactive, affirmative process of identifying and seeking input from 
203.4 	appropriate Tribal governments and considering their interest as a necessary and integral 
203.5 	part of the decision-making process. This definition adds to statutorily mandated notification 
203.6 	procedures. During a consultation, the burden is on the agency to show that it has made a 
203.7 	good faith effort to elicit feedback. Consultation is a formal engagement between agency 
203.8 	officials and the governing body or bodies of an individual Minnesota Tribal government 
203.9 	that the agency or an individual Tribal government may initiate. Formal meetings or 
203.10 	communication between top agency officials and the governing body of a Minnesota Tribal 
203.11 	government is a necessary element of consultation;
203.12 	(3) "matters that have Tribal implications" means rules, legislative proposals, policy 
203.13 	statements, or other actions that have substantial direct effects on one or more Minnesota 
203.14 	Tribal governments, or on the distribution of power and responsibilities between the state 
203.15 	and Minnesota Tribal governments;
203.16 	(4) "Minnesota Tribal governments" means the federally recognized Indian Tribes located 
203.17 	in Minnesota including: Bois Forte Band; Fond Du Lac Band; Grand Portage Band; Leech 
203.18 	Lake Band; Mille Lacs Band; White Earth Band; Red Lake Nation; Lower Sioux Indian 
203.19 	Community; Prairie Island Indian Community; Shakopee Mdewakanton Sioux Community; 
203.20 	and Upper Sioux Community; and
203.21 	(5) "timely and meaningful" means done or occurring at a favorable or useful time that 
203.22 	allows the result of consultation to be included in the agency's decision-making process for 
203.23 	a matter that has Tribal implications.

203.24 	Sec. 2. Minnesota Statutes 2024, section 15.01, is amended to read:
203.25 	15.01 DEPARTMENTS OF THE STATE.
203.26 	The following agencies are designated as the departments of the state government: the 
203.27 	Department of Administration; the Department of Agriculture; the Department of Children, 
203.28 	Youth, and Families; the Department of Commerce; the Department of Corrections; the 
203.29 	Department of Direct Care and Treatment; the Department of Education; the Department 
203.30 	of Employment and Economic Development; the Department of Health; the Department of 
203.31 	Human Rights; the Department of Human Services; the Department of Information 
203.32 	Technology Services; the Department of Iron Range Resources and Rehabilitation; the 
203.33 	Department of Labor and Industry; the Department of Management and Budget; the 
203.34 	Department of Military Affairs; the Department of Natural Resources; the Department of 
204.1 	Public Safety; the Department of Revenue; the Department of Transportation; the Department 
204.2 	of Veterans Affairs; and their successor departments.

204.3 	Sec. 3. Minnesota Statutes 2024, section 15.06, subdivision 1, is amended to read:
204.4 		Subdivision 1.Applicability. This section applies to the following departments or 
204.5 	agencies: the Departments of Administration; Agriculture; Children, Youth, and Families; 
204.6 	Commerce; Corrections; Direct Care and Treatment; Education; Employment and Economic 
204.7 	Development; Health; Human Rights; Human Services; Iron Range Resources and 
204.8 	Rehabilitation; Labor and Industry; Management and Budget; Natural Resources; Public 
204.9 	Safety; Revenue; Transportation; and Veterans Affairs; the Housing Finance and Pollution 
204.10 	Control Agencies; the Department of Information Technology Services; the Bureau of 
204.11 	Mediation Services; and their successor departments and agencies. The heads of the foregoing 
204.12 	departments or agencies are "commissioners."

204.13 	Sec. 4. Minnesota Statutes 2024, section 43A.241, is amended to read:
204.14 	43A.241 INSURANCE CONTRIBUTIONS; FORMER EMPLOYEES.
204.15 	(a) This section applies to a person who:
204.16 	(1) was employed by the commissioner of corrections, the commissioner of human 
204.17 	services, or the commissioner of direct care and treatment executive board;
204.18 	(2) was covered by the correctional employee retirement plan under section 352.91 or 
204.19 	the general state employees retirement plan of the Minnesota State Retirement System as 
204.20 	defined in section 352.021;
204.21 	(3) while employed under clause (1), was assaulted by:
204.22 	(i) a person under correctional supervision for a criminal offense; or
204.23 	(ii) a client or patient at the Minnesota Sex Offender Program, or at a state-operated 
204.24 	forensic services program as defined in section 352.91, subdivision 3j; and
204.25 	(4) as a direct result of the assault under clause (3), was determined to be totally and 
204.26 	permanently physically disabled under laws governing the Minnesota State Retirement 
204.27 	System.
204.28 	(b) For a person to whom this section applies, the commissioner of corrections, the 
204.29 	commissioner of human services, or the commissioner of direct care and treatment executive 
204.30 	board, using existing budget resources, must continue to make the employer contribution 
204.31 	for medical and dental benefits under the State Employee Group Insurance Program after 
205.1 	the person terminates state service. If the person had dependent coverage at the time of 
205.2 	terminating state service, employer contributions for dependent coverage also must continue 
205.3 	under this section. The employer contributions must be in the amount of the employer 
205.4 	contribution for active state employees at the time each payment is made. The employer 
205.5 	contributions must continue until the person reaches age 65, provided the person makes the 
205.6 	required employee contributions, in the amount required of an active state employee, at the 
205.7 	time and in the manner specified by the commissioner or executive board.

205.8 	Sec. 5. Minnesota Statutes 2024, section 246C.01, is amended to read:
205.9 	246C.01 TITLE.
205.10 	This chapter may be cited as the "Department of Direct Care and Treatment Act."

205.11 	Sec. 6. Minnesota Statutes 2024, section 246C.015, subdivision 3, is amended to read:
205.12 		Subd. 3.Commissioner. "Commissioner" means the commissioner of human services
205.13 	direct care and treatment.

205.14 	Sec. 7. Minnesota Statutes 2024, section 246C.015, is amended by adding a subdivision 
205.15 	to read:
205.16 		Subd. 5b.Department. "Department" means the Department of Direct Care and 
205.17 	Treatment.

205.18 	Sec. 8. Minnesota Statutes 2024, section 246C.02, subdivision 1, is amended to read:
205.19 		Subdivision 1.Establishment. The Department of Direct Care and Treatment is created 
205.20 	as an agency headed by an executive board established.

205.21 	Sec. 9. Minnesota Statutes 2024, section 246C.04, subdivision 2, is amended to read:
205.22 		Subd. 2.Transfer of custody of civilly committed persons. The commissioner of 
205.23 	human services shall continue to exercise all authority and responsibility for and retain 
205.24 	custody of persons subject to civil commitment under chapter 253B or 253D until July 1, 
205.25 	2025. Effective July 1, 2025, custody of persons subject to civil commitment under chapter 
205.26 	253B or 253D and in the custody of the commissioner of human services as of that date is 
205.27 	hereby transferred to the executive board commissioner without any further act or proceeding. 
205.28 	Authority and responsibility for the commitment of such persons is transferred to the 
205.29 	executive board commissioner July 1, 2025.

206.1 	Sec. 10. Minnesota Statutes 2024, section 246C.04, subdivision 3, is amended to read:
206.2 		Subd. 3.Control of direct care and treatment. The commissioner of human services 
206.3 	shall continue to exercise all authorities and responsibilities under this chapter and chapters 
206.4 	13, 245, 246, 246B, 252, 253, 253B, 253C, 253D, 254A, 254B, and 256, with reference to 
206.5 	any state-operated service, program, or facility subject to transfer under Laws 2024, chapter 
206.6 	79; Laws 2024, chapter 125, article 5; and Laws 2024, chapter 127, article 50, until July 1, 
206.7 	2025. Effective July 1, 2025, the powers and duties vested in or imposed upon the 
206.8 	commissioner of human services with reference to any state-operated service, program, or 
206.9 	facility are hereby transferred to, vested in, and imposed upon the executive board
206.10 	commissioner according to this chapter and applicable state law. Effective July 1, 2025, the 
206.11 	executive board commissioner has the exclusive power of administration and management 
206.12 	of all state hospitals for persons with a developmental disability, mental illness, or substance 
206.13 	use disorder. Effective July 1, 2025, the executive board commissioner has the power and 
206.14 	authority to determine all matters relating to the development of all of the foregoing 
206.15 	institutions and of such other institutions vested in the executive board commissioner. 
206.16 	Effective July 1, 2025, the powers, functions, and authority vested in the commissioner of 
206.17 	human services relative to such state institutions are transferred to the executive board
206.18 	commissioner according to this chapter and applicable state law.

206.19 	Sec. 11. Minnesota Statutes 2024, section 246C.07, subdivision 1, is amended to read:
206.20 		Subdivision 1.Generally. (a) The executive board commissioner must operate the 
206.21 	agency department according to this chapter and applicable state and federal law. The overall 
206.22 	management and control of the agency department is vested in the executive board
206.23 	commissioner in accordance with this chapter.
206.24 	(b) The executive board commissioner must appoint a chief executive officer according 
206.25 	to section 246C.08. The chief executive officer is responsible for the administrative and 
206.26 	operational duties of the Department of Direct Care and Treatment in accordance with this 
206.27 	chapter and serves as the deputy commissioner for the purposes of section 15.06 and as 
206.28 	deputy agency head for the purposes of section 43A.08.
206.29 	(c) The executive board commissioner may delegate duties imposed by this chapter and 
206.30 	under applicable state and federal law as deemed appropriate by the board commissioner
206.31 	and in accordance with this chapter. Any delegation of a specified statutory duty or power 
206.32 	to an employee of the Department of Direct Care and Treatment other than the chief executive 
206.33 	officer must be made by written order and filed with the secretary of state. Only the chief 
207.1 	executive officer shall have the powers and duties of the executive board commissioner as 
207.2 	specified in section 246C.08.

207.3 	Sec. 12. Minnesota Statutes 2024, section 246C.07, subdivision 2, is amended to read:
207.4 		Subd. 2.Principles. The executive board commissioner, in undertaking its the 
207.5 	commissioner's duties and responsibilities and within the Department of Direct Care and 
207.6 	Treatment resources, shall act according to the following principles:
207.7 	(1) prevent the waste or unnecessary spending of public money;
207.8 	(2) use innovative fiscal and human resource practices to manage the state's resources 
207.9 	and operate the agency department as efficiently as possible;
207.10 	(3) coordinate Department of Direct Care and Treatment activities wherever appropriate 
207.11 	with the activities of other governmental agencies;
207.12 	(4) use technology where appropriate to increase agency department productivity, improve 
207.13 	customer service, increase public access to information about government, and increase 
207.14 	public participation in the business of government; and
207.15 	(5) utilize constructive and cooperative labor management practices to the extent 
207.16 	otherwise required by chapter 43A or 179A.

207.17 	Sec. 13. Minnesota Statutes 2024, section 246C.07, subdivision 8, is amended to read:
207.18 		Subd. 8.Biennial estimates; suggestions for legislation. The executive board
207.19 	commissioner shall prepare, for the use of the legislature, biennial estimates of appropriations 
207.20 	necessary or expedient to be made for the support of the institutions and for extraordinary 
207.21 	and special expenditures for buildings and other improvements. The executive board
207.22 	commissioner shall make suggestions relative to legislation for the benefit of the institutions. 
207.23 	The executive board commissioner shall report the estimates and suggestions to the legislature 
207.24 	on or before November 15 in each even-numbered year. A designee of the executive board
207.25 	The commissioner on request shall appear before any legislative committee and furnish any 
207.26 	required information in regard to the condition of any such institution.

207.27 	Sec. 14. [246C.075] ADVISORY COUNCIL ON DIRECT CARE AND TREATMENT.
207.28 		Subdivision 1.Establishment. An Advisory Council on Direct Care and Treatment is 
207.29 	established.
208.1 		Subd. 2.Membership. (a) The Advisory Council on Direct Care and Treatment must 
208.2 	consist of no more than 15 members appointed as provided in section 15.0597. The advisory 
208.3 	council must include:
208.4 	(1) one member who is a licensed physician with experience serving behavioral health 
208.5 	patients or a licensed psychiatrist, appointed by the commissioner;
208.6 	(2) two members with executive management experience at a hospital or health care 
208.7 	system, or experience serving on the board of a hospital or health care system, appointed 
208.8 	by the commissioner;
208.9 	(3) three members, each appointed by the commissioner, who have experience working:
208.10 	(i) in the delivery of behavioral health services;
208.11 	(ii) in care coordination;
208.12 	(iii) in traditional healing practices;
208.13 	(iv) as a licensed health care professional;
208.14 	(v) within health care administration; or
208.15 	(vi) with residential services;
208.16 	(4) one member appointed by the Association of Counties;
208.17 	(5) one member who has an active role as a union representative representing staff at 
208.18 	the Department of Direct Care and Treatment appointed by joint representatives of the 
208.19 	following unions: American Federation of State, County, and Municipal Employees 
208.20 	(AFSCME); Minnesota Association of Professional Employees (MAPE); Minnesota Nurses 
208.21 	Association (MNA); Middle Management Association (MMA); and State Residential 
208.22 	Schools Education Association (SRSEA);
208.23 	(6) one member appointed by the National Alliance on Mental Illness Minnesota;
208.24 	(7) two members representing people with lived experience being served by state-operated 
208.25 	treatment programs or their families, appointed by the commissioner;
208.26 	(8) one member appointed by the Minnesota Disability Law Center; and
208.27 	(9) up to three additional members appointed by the commissioner reflecting community 
208.28 	interests or perspectives the commissioner deems valuable.
208.29 	(b) Membership on the advisory council must include representation from outside the 
208.30 	seven-county metropolitan area, as defined in section 473.121, subdivision 2.
209.1 	(c) Appointing authorities under paragraph (a) must make initial appointments by 
209.2 	September 1, 2025.
209.3 		Subd. 3.Terms; compensation; removal; vacancies; expiration. (a) The membership 
209.4 	terms, compensation, removal of members, and filling of vacancies of members are as 
209.5 	provided in section 15.059, except that council members shall not receive a per diem.
209.6 	(b) The advisory council does not expire.
209.7 		Subd. 4.Meetings. (a) The members of the advisory council shall elect a chair from 
209.8 	among their membership at the first meeting and annually thereafter or upon a vacancy in 
209.9 	the chair. The advisory council shall meet at the call of the commissioner, the call of the 
209.10 	chair, or upon the call of a majority of members.
209.11 	(b) The first meeting of the advisory council must be held no later than September 15, 
209.12 	2025.
209.13 		Subd. 5.Duties. The advisory council shall advise the commissioner regarding the 
209.14 	operations of the Department of Direct Care and Treatment, the clinical standards of care 
209.15 	for patients and clients of state-operated programs, and provide recommendations to the 
209.16 	commissioner for improving the department's role in the state's mental health care system.

209.17 	Sec. 15. Minnesota Statutes 2024, section 246C.08, is amended to read:
209.18 	246C.08 CHIEF EXECUTIVE OFFICER; SERVICE; DUTIES.
209.19 		Subdivision 1.Service. (a) The direct care and treatment chief executive officer is 
209.20 	appointed by the executive board, in consultation with the governor, and serves at the 
209.21 	pleasure of the executive board, with the advice and consent of the senate commissioner, 
209.22 	and is the deputy commissioner for the purposes of section 15.06.
209.23 	(b) The chief executive officer shall serve in the unclassified service in accordance with 
209.24 	section 43A.08. The Compensation Council under section 15A.082 shall establish the salary 
209.25 	of the chief executive officer.
209.26 		Subd. 2.Powers and duties. (a) The chief executive officer's primary duty is to assist 
209.27 	the executive board commissioner. The chief executive officer is responsible for the 
209.28 	administrative and operational management of the agency.
209.29 	(b) The chief executive officer shall have all the powers of the executive board unless 
209.30 	the executive board directs otherwise. The chief executive officer shall have the authority 
209.31 	to speak for the executive board and Direct Care and Treatment within and outside the 
209.32 	agency.
210.1 	(c) (b) In the event that a vacancy occurs for any reason within the chief executive officer 
210.2 	position, the executive medical director appointed under section 246C.09 shall immediately 
210.3 	become the temporary chief executive officer until the executive board commissioner
210.4 	appoints a new chief executive officer. During this period, the executive medical director 
210.5 	shall have all the powers and authority delegated to the chief executive officer by the board
210.6 	commissioner and specified in this chapter.
210.7 		Subd. 3.Minimum qualifications. The chief executive officer must be selected by the 
210.8 	commissioner without regard to political affiliation and must have wide and successful 
210.9 	administrative experience in and understanding of health care, preferably behavioral health 
210.10 	care, including clinical and operational needs of a large health care service and delivery 
210.11 	organization.

210.12 	EFFECTIVE DATE. This section is effective July 1, 2025, except the amendment to 
210.13 	subdivision 1, paragraph (b), is effective retroactively from July 1, 2024.

210.14 	Sec. 16. Minnesota Statutes 2024, section 246C.09, subdivision 3, is amended to read:
210.15 		Subd. 3.Duties. The executive medical director shall:
210.16 	(1) oversee the clinical provision of inpatient mental health services provided in the 
210.17 	state's regional treatment centers;
210.18 	(2) recruit and retain psychiatrists to serve on the Direct Care and Treatment department
210.19 	medical staff established in subdivision 4;
210.20 	(3) consult with the executive board, the chief executive officer, commissioner, the chief 
210.21 	executive officer, and community mental health center directors to develop standards for 
210.22 	treatment and care of patients in state-operated service programs;
210.23 	(4) develop and oversee a continuing education program for members of the medical 
210.24 	staff; and
210.25 	(5) participate and cooperate in the development and maintenance of a quality assurance 
210.26 	program for state-operated services that assures that residents receive continuous quality 
210.27 	inpatient, outpatient, and postdischarge care.

210.28 	Sec. 17. Minnesota Statutes 2024, section 246C.091, subdivision 2, is amended to read:
210.29 		Subd. 2.Facilities management account. A facilities management account is created 
210.30 	in the special revenue fund of the state treasury. Beginning July 1, 2025, money in the 
210.31 	account is appropriated to the commissioner of direct care and treatment executive board
211.1 	and may be used to maintain buildings, acquire facilities, renovate existing buildings, or 
211.2 	acquire land for the design and construction of buildings for Direct Care and Treatment
211.3 	department use. Money received for maintaining state property under control of the executive 
211.4 	board commissioner may be deposited into this account.

211.5 	Sec. 18. Minnesota Statutes 2024, section 246C.091, subdivision 3, is amended to read:
211.6 		Subd. 3.Direct care and treatment systems account. (a) The direct care and treatment 
211.7 	systems account is created in the special revenue fund of the state treasury. Beginning July 
211.8 	1, 2025, money in the account is appropriated to the commissioner of direct care and 
211.9 	treatment executive board and may be used for security systems and information technology 
211.10 	projects, services, and support under the control of the executive board commissioner.
211.11 	(b) The commissioner of human services shall transfer all money allocated to the direct 
211.12 	care and treatment systems projects under section 256.014 to the direct care and treatment 
211.13 	systems account under this section by June 30, 2026.

211.14 	Sec. 19. Minnesota Statutes 2024, section 246C.091, subdivision 4, is amended to read:
211.15 		Subd. 4.Cemetery maintenance account. The cemetery maintenance account is created 
211.16 	in the special revenue fund of the state treasury. Money in the account is appropriated to 
211.17 	the executive board commissioner of direct care and treatment for the maintenance of 
211.18 	cemeteries under control of the executive board commissioner. Money allocated to Direct 
211.19 	Care and Treatment department cemeteries may be transferred to this account.

211.20 	Sec. 20. Laws 2024, chapter 127, article 50, section 41, subdivision 2, is amended to read:
211.21 		Subd. 2.Chief executive officer. (a) The commissioner of direct care and treatment 
211.22 	executive board must appoint as the initial chief executive officer for direct care and treatment 
211.23 	under Minnesota Statutes, section 246C.07 246C.08, the chief executive officer of the direct 
211.24 	care and treatment division of the Department of Human Services holding that position at 
211.25 	the time the initial appointment is made by the board commissioner. The initial appointment 
211.26 	of the chief executive officer must be made by the executive board commissioner by July 
211.27 	1, 2025. The initial appointment of the chief executive officer is subject to confirmation by 
211.28 	the senate.
211.29 	(b) In its report issued April 1, 2025, the Compensation Council under Minnesota Statutes, 
211.30 	section 15A.082, must establish the salary of the chief executive officer at an amount equal 
211.31 	to or greater than the amount paid to the chief executive officer of the direct care and 
211.32 	treatment division of the Department of Human Services as of the date of initial appointment. 
212.1 	The salary of the chief executive officer shall become effective July 1, 2025, pursuant to 
212.2 	Minnesota Statutes, section 15A.082, subdivision 3. Notwithstanding Minnesota Statutes, 
212.3 	sections 15A.082 and 246C.08, subdivision 1, if the initial appointment of the chief executive 
212.4 	officer occurs prior to the effective date of the salary specified by the Compensation Council 
212.5 	in its April 1, 2025, report, theThe initial salary of the chief executive officer must equal 
212.6 	the amount paid to the chief executive officer of the direct care and treatment division of 
212.7 	the Department of Human Services as of the date of initial appointment.

212.8 	EFFECTIVE DATE. This section is effective July 1, 2025, except the amendment to 
212.9 	paragraph (b) is effective retroactively from July 1, 2024.

212.10 	Sec. 21. INITIAL APPOINTMENT OF COMMISSIONER OF DIRECT CARE 
212.11 	AND TREATMENT.
 212.12 	The initial appointment of a commissioner of direct care and treatment or initial 
212.13 	designation of a temporary commissioner of direct care and treatment by the governor under 
212.14 	Minnesota Statutes, section 15.06, must be made by July 1, 2025. Notwithstanding Minnesota 
212.15 	Statutes, section 15.066, subdivision 2, clause (4), the initial appointment of a commissioner 
212.16 	of direct care and treatment or initial designation of a temporary commissioner of direct 
212.17 	care and treatment is effective no earlier than July 1, 2025.

212.18 	Sec. 22. SALARY FOR THE COMMISSIONER OF THE DEPARTMENT OF 
212.19 	DIRECT CARE AND TREATMENT.
 212.20 	If the initial appointment of the commissioner of the Department of Direct Care and 
212.21 	Treatment occurs prior to the commissioner's salary being determined by the Compensation 
212.22 	Council under Minnesota Statutes, section 15A.082, the commissioner's salary must equal 
212.23 	the salary of the commissioner of human services, as determined under Minnesota Statutes, 
212.24 	section 15A.0815, subdivision 2.

212.25 	EFFECTIVE DATE. This section is effective the day following final enactment and 
212.26 	expires upon adoption by the Compensation Council of a salary for the position of 
212.27 	commissioner of the Department of Direct Care and Treatment.

212.28 	Sec. 23. DISSOLUTION OF THE DIRECT CARE AND TREATMENT EXECUTIVE 
212.29 	BOARD.
 212.30 		Subdivision 1.Dissolution of executive board. Upon the effective date of this section, 
212.31 	the direct care and treatment executive board under Minnesota Statutes, section 246C.06, 
212.32 	is dissolved.
213.1 		Subd. 2.Transfer of duties. (a) Any authorities and responsibilities that were vested 
213.2 	in the executive board prior to July 1, 2025, are transferred to the commissioner of human 
213.3 	services. Minnesota Statutes, section 15.039, applies to the transfer of responsibilities from 
213.4 	the direct care and treatment executive board to the commissioner of human services between 
213.5 	the effective date of this section and July 1, 2025.
213.6 	(b) Minnesota Statutes, section 246C.04, governs the transfer of authority and 
213.7 	responsibility on July 1, 2025, from the commissioner of human services to the commissioner 
213.8 	of direct care and treatment.

213.9 	Sec. 24. REVISOR INSTRUCTION.
 213.10 	(a) The revisor of statutes shall change the term "Direct Care and Treatment" to "the 
213.11 	Department of Direct Care and Treatment" and "agency" to "department" wherever the 
213.12 	terms appear in respect to the governmental entity with programmatic direction and fiscal 
213.13 	control over state-operated services, programs, or facilities under Minnesota Statutes, chapter 
213.14 	246C. The revisor may make technical and other necessary changes to sentence structure 
213.15 	to preserve the meaning of the text.
213.16 	(b) The revisor of statutes shall change the term "executive board" to "commissioner" 
213.17 	and "Direct Care and Treatment executive board" to "commissioner of direct care and 
213.18 	treatment" wherever the terms appear in respect to the head of the governmental entity with 
213.19 	programmatic direction and fiscal control over state-operated services, programs, or facilities 
213.20 	under Minnesota Statutes, chapter 246C. The revisor may make technical and other necessary 
213.21 	changes to sentence structure to preserve the meaning of the text.

213.22 	Sec. 25. REVISOR INSTRUCTION.
 213.23 	The revisor of statutes, in consultation with the House Research Department; the Office 
213.24 	of Senate Counsel, Research and Fiscal Analysis; the Department of Human Services; and 
213.25 	the Department of Direct Care and Treatment, shall make necessary cross-reference changes 
213.26 	to conform with this act. The revisor may make technical and other necessary changes to 
213.27 	sentence structure to preserve the meaning of the text. The revisor may alter the coding in 
213.28 	this act to incorporate statutory changes made by other law in the 2025 regular legislative 
213.29 	session.

213.30 	Sec. 26. REVISOR INSTRUCTION.
 213.31 	The revisor of statutes shall renumber Minnesota Statutes, section 246C.06, subdivision 
213.32 	11, as Minnesota Statutes, section 246C.07, subdivision 4a, and correct all cross-references.

214.1 	Sec. 27. REPEALER.
 214.2 	(a) Minnesota Statutes 2024, sections 246C.015, subdivisions 5a and 6; 246C.06, 
214.3 	subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10; and 246C.07, subdivisions 4 and 5, are repealed.
214.4 	(b) Laws 2024, chapter 79, article 1, section 20, is repealed.
214.5 	(c) Laws 2024, chapter 125, article 5, sections 40; and 41; and Laws 2024, chapter 127, 
214.6 	article 50, sections 40; and 41, subdivisions 1, and 3, are repealed retroactive to July 1, 
214.7 	2024.

214.8 	Sec. 28. EFFECTIVE DATE.
 214.9 	This article is effective the day following final enactment.

214.10 	ARTICLE 9
214.11 	DEPARTMENT OF DIRECT CARE AND TREATMENT CONFORMING CHANGES

214.12 	Section 1. Minnesota Statutes 2024, section 15A.0815, subdivision 2, is amended to read:
214.13 		Subd. 2.Agency head salaries. The salary for a position listed in this subdivision shall 
214.14 	be determined by the Compensation Council under section 15A.082. The commissioner of 
214.15 	management and budget must publish the salaries on the department's website. This 
214.16 	subdivision applies to the following positions:
214.17 	Commissioner of administration;
214.18 	Commissioner of agriculture;
214.19 	Commissioner of education;
214.20 	Commissioner of children, youth, and families;
214.21 	Commissioner of commerce;
214.22 	Commissioner of corrections;
214.23 	Commissioner of health;
214.24 	Commissioner, Minnesota Office of Higher Education;
214.25 	Commissioner, Minnesota IT Services;
214.26 	Commissioner, Housing Finance Agency;
214.27 	Commissioner of human rights;
214.28 	Commissioner of human services;
215.1 	Commissioner of labor and industry;
215.2 	Commissioner of management and budget;
215.3 	Commissioner of natural resources;
215.4 	Commissioner, Pollution Control Agency;
215.5 	Commissioner of public safety;
215.6 	Commissioner of revenue;
215.7 	Commissioner of employment and economic development;
215.8 	Commissioner of transportation;
215.9 	Commissioner of veterans affairs;
215.10 	Commissioner of direct care and treatment;
215.11 	Executive director of the Gambling Control Board;
215.12 	Executive director of the Minnesota State Lottery;
215.13 	Executive director of the Office of Cannabis Management;
215.14 	Commissioner of Iron Range resources and rehabilitation;
215.15 	Commissioner, Bureau of Mediation Services;
215.16 	Ombudsman for mental health and developmental disabilities;
215.17 	Ombudsperson for corrections;
215.18 	Chair, Metropolitan Council;
215.19 	Chair, Metropolitan Airports Commission;
215.20 	School trust lands director;
215.21 	Executive director of pari-mutuel racing;
215.22 	Commissioner, Public Utilities Commission;
215.23 	Chief Executive Officer, Direct Care and Treatment; and
215.24 	Director of the Office of Emergency Medical Services.

215.25 	EFFECTIVE DATE. This section is effective July 1, 2025, except the amendment 
215.26 	striking "Chief Executive Officer, Direct Care and Treatment;" is effective retroactively 
215.27 	from July 1, 2024.

216.1 	Sec. 2. Minnesota Statutes 2024, section 15A.082, subdivision 1, is amended to read:
216.2 		Subdivision 1.Creation. A Compensation Council is created each odd-numbered year 
216.3 	to establish the compensation of constitutional officers and the heads of state and metropolitan 
216.4 	agencies identified in section 15A.0815, and to assist the legislature in establishing the 
216.5 	compensation of justices of the supreme court and judges of the court of appeals and district 
216.6 	court, and to determine the daily compensation for voting members of the Direct Care and 
216.7 	Treatment executive board.

216.8 	Sec. 3. Minnesota Statutes 2024, section 15A.082, subdivision 3, is amended to read:
216.9 		Subd. 3.Submission of recommendations and determination. (a) By April 1 in each 
216.10 	odd-numbered year, the Compensation Council shall submit to the speaker of the house and 
216.11 	the president of the senate salary recommendations for justices of the supreme court, and 
216.12 	judges of the court of appeals and district court. The recommended salaries take effect on 
216.13 	July 1 of that year and July 1 of the subsequent even-numbered year and at whatever interval 
216.14 	the council recommends thereafter, unless the legislature by law provides otherwise. The 
216.15 	salary recommendations take effect if an appropriation of money to pay the recommended 
216.16 	salaries is enacted after the recommendations are submitted and before their effective date. 
216.17 	Recommendations may be expressly modified or rejected.
216.18 	(b) By April 1 in each odd-numbered year, the Compensation Council must prescribe 
216.19 	salaries for constitutional officers, and for the agency and metropolitan agency heads 
216.20 	identified in section 15A.0815. The prescribed salary for each office must take effect July 
216.21 	1 of that year and July 1 of the subsequent even-numbered year and at whatever interval 
216.22 	the council determines thereafter, unless the legislature by law provides otherwise. An 
216.23 	appropriation by the legislature to fund the relevant office, branch, or agency of an amount 
216.24 	sufficient to pay the salaries prescribed by the council constitutes a prescription by law as 
216.25 	provided in the Minnesota Constitution, article V, sections 4 and 5.
216.26 	(c) By April 1 in each odd-numbered year, the Compensation Council must prescribe 
216.27 	daily compensation for voting members of the Direct Care and Treatment executive board. 
216.28 	The recommended daily compensation takes effect on July 1 of that year and July 1 of the 
216.29 	subsequent even-numbered year and at whatever interval the council recommends thereafter, 
216.30 	unless the legislature by law provides otherwise.

216.31 	Sec. 4. Minnesota Statutes 2024, section 15A.082, subdivision 7, is amended to read:
216.32 		Subd. 7.No ex parte communications. Members may not have any communication 
216.33 	with a constitutional officer, a head of a state agency, or a member of the judiciary, or a 
217.1 	member of the Direct Care and Treatment executive board during the period after the first 
217.2 	meeting is convened under this section and the date the prescribed and recommended salaries 
217.3 	and daily compensation are submitted under subdivision 3.

217.4 	Sec. 5. Minnesota Statutes 2024, section 43A.08, subdivision 1, is amended to read:
217.5 		Subdivision 1.Unclassified positions.  Unclassified positions are held by employees 
217.6 	who are:
217.7 	(1) chosen by election or appointed to fill an elective office;
217.8 	(2) heads of agencies required by law to be appointed by the governor or other elective 
217.9 	officers, and the executive or administrative heads of departments, bureaus, divisions, and 
217.10 	institutions specifically established by law in the unclassified service;
217.11 	(3) deputy and assistant agency heads and one confidential secretary in the agencies 
217.12 	listed in subdivision 1a;
217.13 	(4) the confidential secretary to each of the elective officers of this state and, for the 
217.14 	secretary of state and state auditor, an additional deputy, clerk, or employee;
217.15 	(5) intermittent help employed by the commissioner of public safety to assist in the 
217.16 	issuance of vehicle licenses;
217.17 	(6) employees in the offices of the governor and of the lieutenant governor and one 
217.18 	confidential employee for the governor in the Office of the Adjutant General;
217.19 	(7) employees of the Washington, D.C., office of the state of Minnesota;
217.20 	(8) employees of the legislature and of legislative committees or commissions; provided 
217.21 	that employees of the Legislative Audit Commission, except for the legislative auditor, the 
217.22 	deputy legislative auditors, and their confidential secretaries, shall be employees in the 
217.23 	classified service;
217.24 	(9) presidents, vice-presidents, deans, other managers and professionals in academic 
217.25 	and academic support programs, administrative or service faculty, teachers, research 
217.26 	assistants, and student employees eligible under terms of the federal Economic Opportunity 
217.27 	Act work study program in the Perpich Center for Arts Education and the Minnesota State 
217.28 	Colleges and Universities, but not the custodial, clerical, or maintenance employees, or any 
217.29 	professional or managerial employee performing duties in connection with the business 
217.30 	administration of these institutions;
217.31 	(10) officers and enlisted persons in the National Guard;
218.1 	(11) attorneys, legal assistants, and three confidential employees appointed by the attorney 
218.2 	general or employed with the attorney general's authorization;
218.3 	(12) judges and all employees of the judicial branch, referees, receivers, jurors, and 
218.4 	notaries public, except referees and adjusters employed by the Department of Labor and 
218.5 	Industry;
218.6 	(13) members of the State Patrol; provided that selection and appointment of State Patrol 
218.7 	troopers must be made in accordance with applicable laws governing the classified service;
218.8 	(14) examination monitors and intermittent training instructors employed by the 
218.9 	Departments of Management and Budget and Commerce and by professional examining 
218.10 	boards and intermittent staff employed by the technical colleges for the administration of 
218.11 	practical skills tests and for the staging of instructional demonstrations;
218.12 	(15) student workers;
218.13 	(16) executive directors or executive secretaries appointed by and reporting to any 
218.14 	policy-making board or commission established by statute;
218.15 	(17) employees unclassified pursuant to other statutory authority;
218.16 	(18) intermittent help employed by the commissioner of agriculture to perform duties 
218.17 	relating to pesticides, fertilizer, and seed regulation;
218.18 	(19) the administrators and the deputy administrators at the State Academies for the 
218.19 	Deaf and the Blind; and
218.20 	(20) the chief executive officer of Direct Care and Treatment who serves as the deputy 
218.21 	agency head.

218.22 	Sec. 6. Minnesota Statutes 2024, section 43A.08, subdivision 1a, is amended to read:
218.23 		Subd. 1a.Additional unclassified positions. Appointing authorities for the following 
218.24 	agencies may designate additional unclassified positions according to this subdivision: the 
218.25 	Departments of Administration; Agriculture; Children, Youth, and Families; Commerce; 
218.26 	Corrections; Direct Care and Treatment; Education; Employment and Economic 
218.27 	Development; Explore Minnesota Tourism; Management and Budget; Health; Human 
218.28 	Rights; Human Services; Labor and Industry; Natural Resources; Public Safety; Revenue; 
218.29 	Transportation; and Veterans Affairs; the Housing Finance and Pollution Control Agencies; 
218.30 	the State Lottery; the State Board of Investment; the Office of Administrative Hearings; the 
218.31 	Department of Information Technology Services; the Offices of the Attorney General, 
218.32 	Secretary of State, and State Auditor; the Minnesota State Colleges and Universities; the 
219.1 	Minnesota Office of Higher Education; the Perpich Center for Arts Education; Direct Care 
219.2 	and Treatment; the Minnesota Zoological Board; and the Office of Emergency Medical 
219.3 	Services.
219.4 	A position designated by an appointing authority according to this subdivision must 
219.5 	meet the following standards and criteria:
219.6 	(1) the designation of the position would not be contrary to other law relating specifically 
219.7 	to that agency;
219.8 	(2) the person occupying the position would report directly to the agency head or deputy 
219.9 	agency head and would be designated as part of the agency head's management team;
219.10 	(3) the duties of the position would involve significant discretion and substantial 
219.11 	involvement in the development, interpretation, and implementation of agency policy;
219.12 	(4) the duties of the position would not require primarily personnel, accounting, or other 
219.13 	technical expertise where continuity in the position would be important;
219.14 	(5) there would be a need for the person occupying the position to be accountable to, 
219.15 	loyal to, and compatible with, the governor and the agency head, the employing statutory 
219.16 	board or commission, or the employing constitutional officer;
219.17 	(6) the position would be at the level of division or bureau director or assistant to the 
219.18 	agency head; and
219.19 	(7) the commissioner has approved the designation as being consistent with the standards 
219.20 	and criteria in this subdivision.

219.21 	Sec. 7. Minnesota Statutes 2024, section 245.021, is amended to read:
219.22 	245.021 DEFINITIONS DEFINITION.
219.23 	(a) For the purposes of this chapter, the definitions definition in this section have has
219.24 	the meanings meaning given them.
219.25 	(b) "Commissioner" means the commissioner of human services.
219.26 	(c) "Executive board" has the meaning given in section 246C.015.

219.27 	Sec. 8. Minnesota Statutes 2024, section 245.073, is amended to read:
219.28 	245.073 TECHNICAL TRAINING; COMMUNITY-BASED PROGRAMS.
219.29 	(a) In conjunction with the discharge of persons from regional treatment centers and 
219.30 	their admission to state-operated and privately operated community-based programs, the 
220.1 	commissioner may provide technical training assistance to the community-based programs. 
220.2 	The commissioner may apply for and accept money from any source including reimbursement 
220.3 	charges from the community-based programs for reasonable costs of training. Money 
220.4 	received must be deposited in the general fund and is appropriated annually to the 
220.5 	commissioner of human services for training under this section.
220.6 	(b) The commissioner must coordinate with the executive board commissioner of direct 
220.7 	care and treatment or the commissioner's designee to provide technical training assistance 
220.8 	to community-based programs under this section and section 246C.11, subdivision 5.

220.9 	Sec. 9. Minnesota Statutes 2024, section 246.13, subdivision 1, is amended to read:
220.10 		Subdivision 1.Executive board Record responsibilities. (a) The chief executive officer 
220.11 	or a designee shall have, accessible only by consent of the executive board commissioner
220.12 	or on the order of a judge or court of record, a record showing:
220.13 	(1) the residence, sex, age, nativity, occupation, civil condition, and date of entrance or 
220.14 	commitment of every person, in the state-operated services facilities as defined under section 
220.15 	246C.02 under exclusive control of the executive board commissioner;
220.16 	(2) the date of discharge of any such person and whether such discharge was final;
220.17 	(3) the condition of the person when the person left the state-operated services facility;
220.18 	(4) the vulnerable adult abuse prevention associated with the person; and
220.19 	(5) the date and cause of any death of such person.
220.20 	(b) The record in paragraph (a) must state every transfer of a person from one 
220.21 	state-operated services facility to another, naming each state-operated services facility. The 
220.22 	head of each facility or a designee must provide this transfer information to the executive 
220.23 	board commissioner, along with other obtainable facts as the executive board commissioner
220.24 	requests.
220.25 	(c) The head of the state-operated services facility or designee shall inform the executive 
220.26 	board commissioner of any discharge, transfer, or death of a person in that facility within 
220.27 	ten days of the date of discharge, transfer, or death in a manner determined by the executive 
220.28 	board commissioner.
220.29 	(d) The executive board commissioner shall maintain an adequate system of records and 
220.30 	statistics for all basic record forms, including patient personal records and medical record 
220.31 	forms. The use and maintenance of such records must be consistent throughout all 
220.32 	state-operated services facilities.

221.1 	Sec. 10. Minnesota Statutes 2024, section 246B.01, is amended by adding a subdivision 
221.2 	to read:
221.3 		Subd. 2e.Commissioner. "Commissioner" means the commissioner of direct care and 
221.4 	treatment.

221.5 	Sec. 11. Minnesota Statutes 2024, section 252.021, is amended by adding a subdivision 
221.6 	to read:
221.7 		Subd. 4.Commissioner. "Commissioner" means the commissioner of human services.

221.8 	Sec. 12. Minnesota Statutes 2024, section 252.50, subdivision 5, is amended to read:
221.9 		Subd. 5.Location of programs. (a) In determining the location of state-operated, 
221.10 	community-based programs, the needs of the individual client shall be paramount. The 
221.11 	executive board commissioner of direct care and treatment shall also take into account:
221.12 	(1) prioritization of beds in state-operated, community-based programs for individuals 
221.13 	with complex behavioral needs that cannot be met by private community-based providers;
221.14 	(2) choices made by individuals who chose to move to a more integrated setting, and 
221.15 	shall coordinate with the lead agency to ensure that appropriate person-centered transition 
221.16 	plans are created;
221.17 	(3) the personal preferences of the persons being served and their families as determined 
221.18 	by Minnesota Rules, parts 9525.0004 to 9525.0036;
221.19 	(4) the location of the support services established by the individual service plans of the 
221.20 	persons being served;
221.21 	(5) the appropriate grouping of the persons served;
221.22 	(6) the availability of qualified staff;
221.23 	(7) the need for state-operated, community-based programs in the geographical region 
221.24 	of the state; and
221.25 	(8) a reasonable commuting distance from a regional treatment center or the residences 
221.26 	of the program staff.
221.27 	(b) The executive boardcommissioner of direct care and treatment must locate 
221.28 	state-operated, community-based programs in coordination with the commissioner of human 
221.29 	services according to section 252.28.

222.1 	Sec. 13. Minnesota Statutes 2024, section 253.195, is amended by adding a subdivision 
222.2 	to read:
222.3 		Subd. 2a.Commissioner. "Commissioner" means the commissioner of direct care and 
222.4 	treatment.

222.5 	Sec. 14. Minnesota Statutes 2024, section 253B.02, is amended by adding a subdivision 
222.6 	to read:
222.7 		Subd. 2a.Commissioner. "Commissioner" means the commissioner of direct care and 
222.8 	treatment.

222.9 	Sec. 15. Minnesota Statutes 2024, section 253B.02, subdivision 3, is amended to read:
222.10 		Subd. 3.Commissioner of human services. "Commissioner of human services" means 
222.11 	the commissioner of human services or the commissioner's designee.

222.12 	Sec. 16. Minnesota Statutes 2024, section 253B.02, subdivision 4c, is amended to read:
222.13 		Subd. 4c.County of financial responsibility. (a) "County of financial responsibility" 
222.14 	has the meaning specified in chapter 256G. This definition does not require that the person 
222.15 	qualifies for or receives any other form of financial, medical, or social service assistance 
222.16 	in addition to the services under this chapter. Disputes about the county of financial 
222.17 	responsibility shall be submitted for determination to the executive board commissioner
222.18 	through the commissioner of human services in the manner prescribed in section 256G.09.
222.19 	(b) For purposes of proper venue for filing a petition pursuant to section 253B.064, 
222.20 	subdivision 1, paragraph (a); 253B.07, subdivision 1, paragraph (a); or 253D.07, where the 
222.21 	designated agency of a county has determined that it is the county of financial responsibility, 
222.22 	then that county is the county of financial responsibility until a different determination is 
222.23 	made by the appropriate county agencies or the commissioner of human services pursuant 
222.24 	to chapter 256G.

222.25 	Sec. 17. Minnesota Statutes 2024, section 253B.03, subdivision 7, is amended to read:
222.26 		Subd. 7.Treatment plan. A patient receiving services under this chapter has the right 
222.27 	to receive proper care and treatment, best adapted, according to contemporary professional 
222.28 	standards, to rendering further supervision unnecessary. The treatment facility, state-operated 
222.29 	treatment program, or community-based treatment program shall devise a written treatment 
222.30 	plan for each patient which describes in behavioral terms the case problems, the precise 
222.31 	goals, including the expected period of time for treatment, and the specific measures to be 
223.1 	employed. The development and review of treatment plans must be conducted as required 
223.2 	under the license or certification of the treatment facility, state-operated treatment program, 
223.3 	or community-based treatment program. If there are no review requirements under the 
223.4 	license or certification, the treatment plan must be reviewed quarterly. The treatment plan 
223.5 	shall be devised and reviewed with the designated agency and with the patient. The clinical 
223.6 	record shall reflect the treatment plan review. If the designated agency or the patient does 
223.7 	not participate in the planning and review, the clinical record shall include reasons for 
223.8 	nonparticipation and the plans for future involvement. The commissioner of human services
223.9 	shall monitor the treatment plan and review process for state-operated treatment programs 
223.10 	to ensure compliance with the provisions of this subdivision.

223.11 	Sec. 18. Minnesota Statutes 2024, section 253B.041, subdivision 4, is amended to read:
223.12 		Subd. 4.Evaluation. Counties may, but are not required to, provide engagement services. 
223.13 	The commissioner of human services may conduct a pilot project evaluating the impact of 
223.14 	engagement services in decreasing commitments, increasing engagement in treatment, and 
223.15 	other measures.

223.16 	Sec. 19. Minnesota Statutes 2024, section 253B.09, subdivision 3a, is amended to read:
223.17 		Subd. 3a.Reporting judicial commitments; private treatment program or 
223.18 	facility. Notwithstanding section 253B.23, subdivision 9, when a court commits a patient 
223.19 	to a non-state-operated treatment facility or program, the court shall report the commitment 
223.20 	to the commissioner through the supreme court information system for purposes of providing 
223.21 	commitment information for firearm background checks under section 246C.15. If the 
223.22 	patient is committed to a state-operated treatment program, the court shall send a copy of 
223.23 	the commitment order to the commissioner and the executive board.

223.24 	Sec. 20. Minnesota Statutes 2024, section 253B.18, subdivision 6, is amended to read:
223.25 		Subd. 6.Transfer. (a) A patient who is a person who has a mental illness and is 
223.26 	dangerous to the public shall not be transferred out of a secure treatment facility unless it 
223.27 	appears to the satisfaction of the executive board commissioner, after a hearing and favorable 
223.28 	recommendation by a majority of the special review board, that the transfer is appropriate. 
223.29 	Transfer may be to another state-operated treatment program. In those instances where a 
223.30 	commitment also exists to the Department of Corrections, transfer may be to a facility 
223.31 	designated by the commissioner of corrections.
224.1 	(b) The following factors must be considered in determining whether a transfer is 
224.2 	appropriate:
224.3 	(1) the person's clinical progress and present treatment needs;
224.4 	(2) the need for security to accomplish continuing treatment;
224.5 	(3) the need for continued institutionalization;
224.6 	(4) which facility can best meet the person's needs; and
224.7 	(5) whether transfer can be accomplished with a reasonable degree of safety for the 
224.8 	public.
224.9 	(c) If a committed person has been transferred out of a secure treatment facility pursuant 
224.10 	to this subdivision, that committed person may voluntarily return to a secure treatment 
224.11 	facility for a period of up to 60 days with the consent of the head of the treatment facility.
224.12 	(d) If the committed person is not returned to the original, nonsecure transfer facility 
224.13 	within 60 days of being readmitted to a secure treatment facility, the transfer is revoked and 
224.14 	the committed person must remain in a secure treatment facility. The committed person 
224.15 	must immediately be notified in writing of the revocation.
224.16 	(e) Within 15 days of receiving notice of the revocation, the committed person may 
224.17 	petition the special review board for a review of the revocation. The special review board 
224.18 	shall review the circumstances of the revocation and shall recommend to the commissioner 
224.19 	whether or not the revocation should be upheld. The special review board may also 
224.20 	recommend a new transfer at the time of the revocation hearing.
224.21 	(f) No action by the special review board is required if the transfer has not been revoked 
224.22 	and the committed person is returned to the original, nonsecure transfer facility with no 
224.23 	substantive change to the conditions of the transfer ordered under this subdivision.
224.24 	(g) The head of the treatment facility may revoke a transfer made under this subdivision 
224.25 	and require a committed person to return to a secure treatment facility if:
224.26 	(1) remaining in a nonsecure setting does not provide a reasonable degree of safety to 
224.27 	the committed person or others; or
224.28 	(2) the committed person has regressed clinically and the facility to which the committed 
224.29 	person was transferred does not meet the committed person's needs.
224.30 	(h) Upon the revocation of the transfer, the committed person must be immediately 
224.31 	returned to a secure treatment facility. A report documenting the reasons for revocation 
224.32 	must be issued by the head of the treatment facility within seven days after the committed 
225.1 	person is returned to the secure treatment facility. Advance notice to the committed person 
225.2 	of the revocation is not required.
225.3 	(i) The committed person must be provided a copy of the revocation report and informed, 
225.4 	orally and in writing, of the rights of a committed person under this section. The revocation 
225.5 	report must be served upon the committed person, the committed person's counsel, and the 
225.6 	designated agency. The report must outline the specific reasons for the revocation, including 
225.7 	but not limited to the specific facts upon which the revocation is based.
225.8 	(j) If a committed person's transfer is revoked, the committed person may re-petition for 
225.9 	transfer according to subdivision 5.
225.10 	(k) A committed person aggrieved by a transfer revocation decision may petition the 
225.11 	special review board within seven business days after receipt of the revocation report for a 
225.12 	review of the revocation. The matter must be scheduled within 30 days. The special review 
225.13 	board shall review the circumstances leading to the revocation and, after considering the 
225.14 	factors in paragraph (b), shall recommend to the commissioner whether or not the revocation 
225.15 	shall be upheld. The special review board may also recommend a new transfer out of a 
225.16 	secure treatment facility at the time of the revocation hearing.

225.17 	Sec. 21. Minnesota Statutes 2024, section 253B.19, subdivision 2, is amended to read:
225.18 		Subd. 2.Petition; hearing. (a) A patient committed as a person who has a mental illness 
225.19 	and is dangerous to the public under section 253B.18, or the county attorney of the county 
225.20 	from which the patient was committed or the county of financial responsibility, may petition 
225.21 	the judicial appeal panel for a rehearing and reconsideration of a decision by the 
225.22 	commissioner under section 253B.18, subdivision 5. The judicial appeal panel must not 
225.23 	consider petitions for relief other than those considered by the executive board commissioner
225.24 	from which the appeal is taken. The petition must be filed with the supreme court within 
225.25 	30 days after the decision of the executive board commissioner is signed. The hearing must 
225.26 	be held within 45 days of the filing of the petition unless an extension is granted for good 
225.27 	cause.
225.28 	(b) For an appeal under paragraph (a), the supreme court shall refer the petition to the 
225.29 	chief judge of the judicial appeal panel. The chief judge shall notify the patient, the county 
225.30 	attorney of the county of commitment, the designated agency, the executive board
225.31 	commissioner, the head of the facility or program to which the patient was committed, any 
225.32 	interested person, and other persons the chief judge designates, of the time and place of the 
225.33 	hearing on the petition. The notice shall be given at least 14 days prior to the date of the 
225.34 	hearing.
226.1 	(c) Any person may oppose the petition. The patient, the patient's counsel, the county 
226.2 	attorney of the committing county or the county of financial responsibility, and the executive 
226.3 	board commissioner shall participate as parties to the proceeding pending before the judicial 
226.4 	appeal panel and shall, except when the patient is committed solely as a person who has a 
226.5 	mental illness and is dangerous to the public, no later than 20 days before the hearing on 
226.6 	the petition, inform the judicial appeal panel and the opposing party in writing whether they 
226.7 	support or oppose the petition and provide a summary of facts in support of their position. 
226.8 	The judicial appeal panel may appoint court examiners and may adjourn the hearing from 
226.9 	time to time. It shall hear and receive all relevant testimony and evidence and make a record 
226.10 	of all proceedings. The patient, the patient's counsel, and the county attorney of the 
226.11 	committing county or the county of financial responsibility have the right to be present and 
226.12 	may present and cross-examine all witnesses and offer a factual and legal basis in support 
226.13 	of their positions. The petitioning party seeking discharge or provisional discharge bears 
226.14 	the burden of going forward with the evidence, which means presenting a prima facie case 
226.15 	with competent evidence to show that the person is entitled to the requested relief. If the 
226.16 	petitioning party has met this burden, the party opposing discharge or provisional discharge 
226.17 	bears the burden of proof by clear and convincing evidence that the discharge or provisional 
226.18 	discharge should be denied. A party seeking transfer under section 253B.18, subdivision 6, 
226.19 	must establish by a preponderance of the evidence that the transfer is appropriate.

226.20 	Sec. 22. Minnesota Statutes 2024, section 253B.20, subdivision 2, is amended to read:
226.21 		Subd. 2.Necessities. (a) The state-operated treatment program shall make necessary 
226.22 	arrangements at the expense of the state to insure that no patient is discharged or provisionally 
226.23 	discharged without suitable clothing. The head of the state-operated treatment program 
226.24 	shall, if necessary, provide the patient with a sufficient sum of money to secure transportation 
226.25 	home, or to another destination of the patient's choice, if the destination is located within a 
226.26 	reasonable distance of the state-operated treatment program.
226.27 	(b) The commissioner of human services shall establish procedures by rule to help the 
226.28 	patient receive all public assistance benefits provided by state or federal law to which the 
226.29 	patient is entitled by residence and circumstances. The rule shall be uniformly applied in 
226.30 	all counties. All counties shall provide temporary relief whenever necessary to meet the 
226.31 	intent of this subdivision.
226.32 	(c) The commissioner of human services and the executive board commissioner may 
226.33 	adopt joint rules necessary to accomplish the requirements under paragraph (b).

227.1 	Sec. 23. Minnesota Statutes 2024, section 253D.02, is amended by adding a subdivision 
227.2 	to read:
227.3 		Subd. 2a.Commissioner. "Commissioner" means the commissioner of direct care and 
227.4 	treatment.

227.5 	Sec. 24. Minnesota Statutes 2024, section 253D.02, subdivision 3, is amended to read:
227.6 		Subd. 3.Commissioner of corrections. "Commissioner of corrections" means the 
227.7 	commissioner of corrections or the commissioner's designee.

227.8 	Sec. 25. Minnesota Statutes 2024, section 254B.05, subdivision 4, is amended to read:
227.9 		Subd. 4.Regional treatment centers. Regional treatment center substance use disorder 
227.10 	treatment units are eligible vendors. The executive board commissioner of direct care and 
227.11 	treatment may expand the capacity of substance use disorder treatment units beyond the 
227.12 	capacity funded by direct legislative appropriation to serve individuals who are referred for 
227.13 	treatment by counties and whose treatment will be paid for by funding under this chapter 
227.14 	or other funding sources. Notwithstanding the provisions of sections 254B.03 to 254B.04, 
227.15 	payment for any person committed at county request to a regional treatment center under 
227.16 	chapter 253B for chemical dependency treatment and determined to be ineligible under the 
227.17 	behavioral health fund, shall become the responsibility of the county.

227.18 	Sec. 26. Minnesota Statutes 2024, section 256.045, is amended by adding a subdivision 
227.19 	to read:
227.20 		Subd. 1b.Commissioner. For purposes of this section, "commissioner" means the 
227.21 	commissioner of human services.

227.22 	Sec. 27. Minnesota Statutes 2024, section 256.045, subdivision 6, is amended to read:
227.23 		Subd. 6.Additional powers of commissioner; subpoenas. (a) The commissioner of 
227.24 	human services, the commissioner of health for matters within the commissioner's jurisdiction 
227.25 	under subdivision 3b, or the Direct Care and Treatment executive board commissioner of 
227.26 	direct care and treatment for matters within the commissioner's jurisdiction of the executive 
227.27 	board under subdivision 5a, may initiate a review of any action or decision of a county 
227.28 	agency and direct that the matter be presented to a state human services judge for a hearing 
227.29 	held under subdivision 3, 3a, 3b, or 4a. In all matters dealing with human services committed 
227.30 	by law to the discretion of the county agency, the judgment of the applicable commissioner 
228.1 	or executive board may be substituted for that of the county agency. The applicable 
228.2 	commissioner or executive board may order an independent examination when appropriate.
228.3 	(b) Any party to a hearing held pursuant to subdivision 3, 3a, 3b, or 4a may request that 
228.4 	the applicable commissioner or executive board issue a subpoena to compel the attendance 
228.5 	of witnesses and the production of records at the hearing. A local agency may request that 
228.6 	the applicable commissioner or executive board issue a subpoena to compel the release of 
228.7 	information from third parties prior to a request for a hearing under section 256.046 upon 
228.8 	a showing of relevance to such a proceeding. The issuance, service, and enforcement of 
228.9 	subpoenas under this subdivision is governed by section 357.22 and the Minnesota Rules 
228.10 	of Civil Procedure.
228.11 	(c) The commissioner of human services may issue a temporary order staying a proposed 
228.12 	demission by a residential facility licensed under chapter 245A:
228.13 	(1) while an appeal by a recipient under subdivision 3 is pending;
228.14 	(2) for the period of time necessary for the case management provider to implement the 
228.15 	commissioner's order; or
228.16 	(3) for appeals under subdivision 3, paragraph (a), clause (11), when the individual is 
228.17 	seeking a temporary stay of demission on the basis that the county has not yet finalized an 
228.18 	alternative arrangement for a residential facility, a program, or services that will meet the 
228.19 	assessed needs of the individual by the effective date of the service termination, a temporary 
228.20 	stay of demission may be issued for no more than 30 calendar days to allow for such 
228.21 	arrangements to be finalized.

228.22 	Sec. 28. Minnesota Statutes 2024, section 256.045, subdivision 7, is amended to read:
228.23 		Subd. 7.Judicial review. Except for a prepaid health plan, any party who is aggrieved 
228.24 	by an order of the commissioner of human services; the commissioner of health; or the 
228.25 	commissioner of children, youth, and families in appeals within the commissioner's 
228.26 	jurisdiction under subdivision 3b; or the Direct Care and Treatment executive board
228.27 	commissioner of direct care and treatment in appeals within the commissioner's jurisdiction 
228.28 	of the executive board under subdivision 5a may appeal the order to the district court of the 
228.29 	county responsible for furnishing assistance, or, in appeals under subdivision 3b, the county 
228.30 	where the maltreatment occurred, by serving a written copy of a notice of appeal upon the 
228.31 	applicable commissioner or executive board and any adverse party of record within 30 days 
228.32 	after the date the commissioner or executive board issued the order, the amended order, or 
228.33 	order affirming the original order, and by filing the original notice and proof of service with 
229.1 	the court administrator of the district court. Service may be made personally or by mail; 
229.2 	service by mail is complete upon mailing; no filing fee shall be required by the court 
229.3 	administrator in appeals taken pursuant to this subdivision, with the exception of appeals 
229.4 	taken under subdivision 3b. The applicable commissioner or executive board may elect to 
229.5 	become a party to the proceedings in the district court. Except for appeals under subdivision 
229.6 	3b, any party may demand that the applicable commissioner or executive board furnish all 
229.7 	parties to the proceedings with a copy of the decision, and a transcript of any testimony, 
229.8 	evidence, or other supporting papers from the hearing held before the human services judge, 
229.9 	by serving a written demand upon the applicable commissioner or executive board within 
229.10 	30 days after service of the notice of appeal. Any party aggrieved by the failure of an adverse 
229.11 	party to obey an order issued by the applicable commissioner or executive board under 
229.12 	subdivision 5 or 5a may compel performance according to the order in the manner prescribed 
229.13 	in sections 586.01 to 586.12.

229.14 	Sec. 29. Minnesota Statutes 2024, section 256G.09, subdivision 3, is amended to read:
229.15 		Subd. 3.Commissioner obligations. (a) Except as provided in paragraph (b) for matters 
229.16 	under the jurisdiction of the Direct Care and Treatment executive board commissioner of 
229.17 	direct care and treatment, the commissioner shall then promptly decide any question of 
229.18 	financial responsibility as outlined in this chapter and make an order referring the application 
229.19 	to the local agency of the proper county for further action. Further action may include 
229.20 	reimbursement by that county of assistance that another county has provided to the applicant 
229.21 	under this subdivision. The commissioner shall decide disputes within 60 days of the last 
229.22 	county evidentiary submission and shall issue an immediate opinion.
229.23 	(b) For disputes regarding financial responsibility relating to matters under the jurisdiction 
229.24 	of the direct care and treatment executive board commissioner of direct care and treatment, 
229.25 	the commissioner shall promptly issue an advisory opinion on any question of financial 
229.26 	responsibility as outlined in this chapter and recommend to the executive board commissioner 
229.27 	of direct care and treatment an order referring the application to the local agency of the 
229.28 	proper county for further action. Further action may include reimbursement by that county 
229.29 	of assistance that another county has provided to the applicant under this subdivision. The 
229.30 	commissioner shall provide an advisory opinion and recommended order to the executive 
229.31 	board commissioner of direct care and treatment within 30 days of the last county evidentiary 
229.32 	submission. The executive board commissioner of direct care and treatment shall decide to 
229.33 	accept or reject the commissioner's advisory opinion and recommended order within 60 
229.34 	days of the last county evidentiary submission and shall issue an immediate opinion stating 
229.35 	the reasons for accepting or rejecting the commissioner's recommendation.
230.1 	(c) The commissioner may make any investigation it the commissioner considers proper 
230.2 	before making a decision or a recommendation to the executive board commissioner of 
230.3 	direct care and treatment. The commissioner may prescribe rules it the commissioner
230.4 	considers necessary to carry out this subdivision except that the commissioner must not 
230.5 	create rules purporting to bind the executive board's decision of the commissioner of direct 
230.6 	care and treatment on any advisory opinion or recommended order under paragraph (b).
230.7 	(d) Except as provided in paragraph (e) for matters under the jurisdiction of the executive 
230.8 	board commissioner of direct care and treatment, the order of the commissioner binds the 
230.9 	local agency involved and the applicant or recipient. That agency shall comply with the 
230.10 	order unless reversed on appeal as provided in section 256.045, subdivision 7. The agency 
230.11 	shall comply with the order pending the appeal.
230.12 	(e) For disputes regarding financial responsibility relating to matters under the jurisdiction 
230.13 	of the Direct Care and Treatment executive board commissioner of direct care and treatment, 
230.14 	the order of the executive board commissioner of direct care and treatment binds the local 
230.15 	agency involved and the applicant or recipient. That agency shall comply with the order of 
230.16 	the executive board commissioner of direct care and treatment unless the order is reversed 
230.17 	on appeal as provided in section 256.045, subdivision 7. The agency shall comply with the 
230.18 	order of the executive board commissioner of direct care and treatment pending the appeal.

230.19 	Sec. 30. Minnesota Statutes 2024, section 352.91, subdivision 2a, is amended to read:
230.20 		Subd. 2a.Special teachers. "Covered correctional service" also means service rendered 
230.21 	by a state employee as a special teacher employed by the Department of Corrections or by 
230.22 	the Department of Direct Care and Treatment at a security unit, provided that at least 75 
230.23 	percent of the employee's working time is spent in direct contact with inmates or patients 
230.24 	and the fact of this direct contact is certified to the executive director by the appropriate 
230.25 	commissioner or executive board, unless the person elects to retain the current retirement 
230.26 	coverage under Laws 1996, chapter 408, article 8, section 21.

230.27 	Sec. 31. Minnesota Statutes 2024, section 352.91, subdivision 3c, is amended to read:
230.28 		Subd. 3c.Nursing personnel. (a) "Covered correctional service" means service by a 
230.29 	state employee in one of the employment positions at a correctional facility, in the 
230.30 	state-operated forensic services program, or in the Minnesota Sex Offender Program that 
230.31 	are specified in paragraph (b) if at least 75 percent of the employee's working time is spent 
230.32 	in direct contact with inmates or patients and the fact of this direct contact is certified to the 
230.33 	executive director by the appropriate commissioner or executive board.
231.1 	(b) The employment positions are as follows:
231.2 	(1) registered nurse - senior;
231.3 	(2) registered nurse;
231.4 	(3) registered nurse - principal;
231.5 	(4) licensed practical nurse;
231.6 	(5) registered nurse advance practice; and
231.7 	(6) psychiatric advance practice registered nurse.

231.8 	Sec. 32. Minnesota Statutes 2024, section 352.91, subdivision 3d, is amended to read:
231.9 		Subd. 3d.Other correctional personnel. (a) "Covered correctional service" means 
231.10 	service by a state employee in one of the employment positions at a correctional facility or 
231.11 	in the state-operated forensic services program specified in paragraph (b) if at least 75 
231.12 	percent of the employee's working time is spent in direct contact with inmates or patients 
231.13 	and the fact of this direct contact is certified to the executive director by the appropriate 
231.14 	commissioner or executive board.
231.15 	(b) The employment positions are:
231.16 	(1) automotive mechanic;
231.17 	(2) baker;
231.18 	(3) central services administrative specialist, intermediate;
231.19 	(4) central services administrative specialist, principal;
231.20 	(5) chaplain;
231.21 	(6) chief cook;
231.22 	(7) clinical program therapist 1;
231.23 	(8) clinical program therapist 2;
231.24 	(9) clinical program therapist 3;
231.25 	(10) clinical program therapist 4;
231.26 	(11) cook;
231.27 	(12) cook coordinator;
231.28 	(13) corrections inmate program coordinator;
232.1 	(14) corrections transitions program coordinator;
232.2 	(15) corrections security caseworker;
232.3 	(16) corrections security caseworker career;
232.4 	(17) corrections teaching assistant;
232.5 	(18) delivery van driver;
232.6 	(19) dentist;
232.7 	(20) electrician supervisor;
232.8 	(21) general maintenance worker lead;
232.9 	(22) general repair worker;
232.10 	(23) library/information research services specialist;
232.11 	(24) library/information research services specialist senior;
232.12 	(25) library technician;
232.13 	(26) painter lead;
232.14 	(27) plant maintenance engineer lead;
232.15 	(28) plumber supervisor;
232.16 	(29) psychologist 1;
232.17 	(30) psychologist 3;
232.18 	(31) recreation therapist;
232.19 	(32) recreation therapist coordinator;
232.20 	(33) recreation program assistant;
232.21 	(34) recreation therapist senior;
232.22 	(35) sports medicine specialist;
232.23 	(36) work therapy assistant;
232.24 	(37) work therapy program coordinator; and
232.25 	(38) work therapy technician.

233.1 	Sec. 33. Minnesota Statutes 2024, section 352.91, subdivision 4a, is amended to read:
233.2 		Subd. 4a.Process for evaluating and recommending potential employment positions 
233.3 	for membership inclusion. (a) The Department of Corrections and the Department of 
233.4 	Direct Care and Treatment must establish a procedure for evaluating periodic requests by 
233.5 	department and agency employees for qualification for recommendation by the applicable 
233.6 	commissioner or executive board for inclusion of the employment position in the correctional 
233.7 	facility or direct care and treatment facility in the correctional retirement plan and for 
233.8 	periodically determining employment positions that no longer qualify for continued 
233.9 	correctional retirement plan coverage.
233.10 	(b) The procedure must provide for an evaluation of the extent of the employee's working 
233.11 	time spent in direct contact with patients or inmates, the extent of the physical hazard that 
233.12 	the employee is routinely subjected to in the course of employment, and the extent of 
233.13 	intervention routinely expected of the employee in the event of a facility incident. The 
233.14 	percentage of routine direct contact with inmates or patients may not be less than 75 percent.
233.15 	(c) The applicable commissioner or executive board shall notify the employee of the 
233.16 	determination of the appropriateness of recommending the employment position for inclusion 
233.17 	in the correctional retirement plan, if the evaluation procedure results in a finding that the 
233.18 	employee:
233.19 	(1) routinely spends 75 percent of the employee's time in direct contact with inmates or 
233.20 	patients; and
233.21 	(2) is regularly engaged in the rehabilitation, treatment, custody, or supervision of inmates 
233.22 	or patients.
233.23 	(d) After providing the affected employee an opportunity to dispute or clarify any 
233.24 	evaluation determinations, if the applicable commissioner or executive board determines 
233.25 	that the employment position is appropriate for inclusion in the correctional retirement plan, 
233.26 	the commissioner or executive board shall forward that recommendation and supporting 
233.27 	documentation to the chair of the Legislative Commission on Pensions and Retirement, the 
233.28 	chair of the State and Local Governmental Operations Committee of the senate, the chair 
233.29 	of the Governmental Operations and Veterans Affairs Policy Committee of the house of 
233.30 	representatives, and the executive director of the Legislative Commission on Pensions and 
233.31 	Retirement in the form of the appropriate proposed legislation. The recommendation must 
233.32 	be forwarded to the legislature before January 15 for the recommendation to be considered 
233.33 	in that year's legislative session.

234.1 	Sec. 34. Minnesota Statutes 2024, section 524.3-801, is amended to read:
234.2 	524.3-801 NOTICE TO CREDITORS.
234.3 	(a) Unless notice has already been given under this section, upon appointment of a 
234.4 	general personal representative in informal proceedings or upon the filing of a petition for 
234.5 	formal appointment of a general personal representative, notice thereof, in the form prescribed 
234.6 	by court rule, shall be given under the direction of the court administrator by publication 
234.7 	once a week for two successive weeks in a legal newspaper in the county wherein the 
234.8 	proceedings are pending giving the name and address of the general personal representative 
234.9 	and notifying creditors of the estate to present their claims within four months after the date 
234.10 	of the court administrator's notice which is subsequently published or be forever barred, 
234.11 	unless they are entitled to further service of notice under paragraph (b) or (c).
234.12 	(b) The personal representative shall, within three months after the date of the first 
234.13 	publication of the notice, serve a copy of the notice upon each then known and identified 
234.14 	creditor in the manner provided in paragraph (c). If the decedent or a predeceased spouse 
234.15 	of the decedent received assistance for which a claim could be filed under section 246.53, 
234.16 	256B.15, 256D.16, or 261.04, notice to the commissioner of human services or Direct Care 
234.17 	and Treatment executive board the commissioner of direct care and treatment, as applicable, 
234.18 	must be given under paragraph (d) instead of under this paragraph or paragraph (c). A 
234.19 	creditor is "known" if: (i) the personal representative knows that the creditor has asserted 
234.20 	a claim that arose during the decedent's life against either the decedent or the decedent's 
234.21 	estate; (ii) the creditor has asserted a claim that arose during the decedent's life and the fact 
234.22 	is clearly disclosed in accessible financial records known and available to the personal 
234.23 	representative; or (iii) the claim of the creditor would be revealed by a reasonably diligent 
234.24 	search for creditors of the decedent in accessible financial records known and available to 
234.25 	the personal representative. Under this section, a creditor is "identified" if the personal 
234.26 	representative's knowledge of the name and address of the creditor will permit service of 
234.27 	notice to be made under paragraph (c).
234.28 	(c) Unless the claim has already been presented to the personal representative or paid, 
234.29 	the personal representative shall serve a copy of the notice required by paragraph (b) upon 
234.30 	each creditor of the decedent who is then known to the personal representative and identified 
234.31 	either by delivery of a copy of the required notice to the creditor, or by mailing a copy of 
234.32 	the notice to the creditor by certified, registered, or ordinary first class mail addressed to 
234.33 	the creditor at the creditor's office or place of residence.
235.1 	(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a 
235.2 	predeceased spouse of the decedent received assistance for which a claim could be filed 
235.3 	under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the 
235.4 	attorney for the personal representative shall serve the commissioner of human services or 
235.5 	executive board the commissioner of direct care and treatment, as applicable, with notice 
235.6 	in the manner prescribed in paragraph (c), or electronically in a manner prescribed by the 
235.7 	applicable commissioner or executive board, as soon as practicable after the appointment 
235.8 	of the personal representative. The notice must state the decedent's full name, date of birth, 
235.9 	and Social Security number and, to the extent then known after making a reasonably diligent 
235.10 	inquiry, the full name, date of birth, and Social Security number for each of the decedent's 
235.11 	predeceased spouses. The notice may also contain a statement that, after making a reasonably 
235.12 	diligent inquiry, the personal representative has determined that the decedent did not have 
235.13 	any predeceased spouses or that the personal representative has been unable to determine 
235.14 	one or more of the previous items of information for a predeceased spouse of the decedent. 
235.15 	A copy of the notice to creditors must be attached to and be a part of the notice to the 
235.16 	applicable commissioner or executive board.
235.17 	(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed 
235.18 	in this paragraph, no property subject to administration by the estate may be distributed by 
235.19 	the estate or the personal representative until 70 days after the date the notice is served on 
235.20 	the commissioner of human services or executive board commissioner of direct care and 
235.21 	treatment as provided in paragraph (c), unless the local agency consents as provided for in 
235.22 	clause (6). This restriction on distribution does not apply to the personal representative's 
235.23 	sale of real or personal property, but does apply to the net proceeds the estate receives from 
235.24 	these sales. The personal representative, or any person with personal knowledge of the facts, 
235.25 	may provide an affidavit containing the description of any real or personal property affected 
235.26 	by this paragraph and stating facts showing compliance with this paragraph. If the affidavit 
235.27 	describes real property, it may be filed or recorded in the office of the county recorder or 
235.28 	registrar of titles for the county where the real property is located. This paragraph does not 
235.29 	apply to proceedings under sections 524.3-1203 and 525.31, or when a duly authorized 
235.30 	agent of a county is acting as the personal representative of the estate.
235.31 	(3) At any time before an order or decree is entered under section 524.3-1001 or 
235.32 	524.3-1002, or a closing statement is filed under section 524.3-1003, the personal 
235.33 	representative or the attorney for the personal representative may serve an amended notice 
235.34 	on the commissioner of human services or executive board commissioner of direct care and 
235.35 	treatment to add variations or other names of the decedent or a predeceased spouse named 
236.1 	in the notice, the name of a predeceased spouse omitted from the notice, to add or correct 
236.2 	the date of birth or Social Security number of a decedent or predeceased spouse named in 
236.3 	the notice, or to correct any other deficiency in a prior notice. The amended notice must 
236.4 	state the decedent's name, date of birth, and Social Security number, the case name, case 
236.5 	number, and district court in which the estate is pending, and the date the notice being 
236.6 	amended was served on the applicable commissioner or executive board. If the amendment 
236.7 	adds the name of a predeceased spouse omitted from the notice, it must also state that 
236.8 	spouse's full name, date of birth, and Social Security number. The amended notice must be 
236.9 	served on the applicable commissioner or executive board in the same manner as the original 
236.10 	notice. Upon service, the amended notice relates back to and is effective from the date the 
236.11 	notice it amends was served, and the time for filing claims arising under section 246.53, 
236.12 	256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended 
236.13 	notice. Claims filed during the 60-day period are undischarged and unbarred claims, may 
236.14 	be prosecuted by the entities entitled to file those claims in accordance with section 
236.15 	524.3-1004, and the limitations in section 524.3-1006 do not apply. The personal 
236.16 	representative or any person with personal knowledge of the facts may provide and file or 
236.17 	record an affidavit in the same manner as provided for in clause (1).
236.18 	(4) Within one year after the date an order or decree is entered under section 524.3-1001 
236.19 	or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has 
236.20 	an interest in property that was subject to administration by the estate may serve an amended 
236.21 	notice on the commissioner of human services or executive board commissioner of direct 
236.22 	care and treatment to add variations or other names of the decedent or a predeceased spouse 
236.23 	named in the notice, the name of a predeceased spouse omitted from the notice, to add or 
236.24 	correct the date of birth or Social Security number of a decedent or predeceased spouse 
236.25 	named in the notice, or to correct any other deficiency in a prior notice. The amended notice 
236.26 	must be served on the applicable commissioner or executive board in the same manner as 
236.27 	the original notice and must contain the information required for amendments under clause 
236.28 	(3). If the amendment adds the name of a predeceased spouse omitted from the notice, it 
236.29 	must also state that spouse's full name, date of birth, and Social Security number. Upon 
236.30 	service, the amended notice relates back to and is effective from the date the notice it amends 
236.31 	was served. If the amended notice adds the name of an omitted predeceased spouse or adds 
236.32 	or corrects the Social Security number or date of birth of the decedent or a predeceased 
236.33 	spouse already named in the notice, then, notwithstanding any other laws to the contrary, 
236.34 	claims against the decedent's estate on account of those persons resulting from the amendment 
236.35 	and arising under section 246.53, 256B.15, 256D.16, or 261.04 are undischarged and 
236.36 	unbarred claims, may be prosecuted by the entities entitled to file those claims in accordance 
237.1 	with section 524.3-1004, and the limitations in section 524.3-1006 do not apply. The person 
237.2 	filing the amendment or any other person with personal knowledge of the facts may provide 
237.3 	and file or record an affidavit describing affected real or personal property in the same 
237.4 	manner as clause (1).
237.5 	(5) After one year from the date an order or decree is entered under section 524.3-1001 
237.6 	or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission, 
237.7 	or defect of any kind in the notice to the commissioner of human services or executive board
237.8 	commissioner of direct care and treatment required under this paragraph or in the process 
237.9 	of service of the notice on the applicable commissioner or executive board, or the failure 
237.10 	to serve the applicable commissioner or executive board with notice as required by this 
237.11 	paragraph, makes any distribution of property by a personal representative void or voidable. 
237.12 	The distributee's title to the distributed property shall be free of any claims based upon a 
237.13 	failure to comply with this paragraph.
237.14 	(6) The local agency may consent to a personal representative's request to distribute 
237.15 	property subject to administration by the estate to distributees during the 70-day period after 
237.16 	service of notice on the applicable commissioner or executive board. The local agency may 
237.17 	grant or deny the request in whole or in part and may attach conditions to its consent as it 
237.18 	deems appropriate. When the local agency consents to a distribution, it shall give the estate 
237.19 	a written certificate evidencing its consent to the early distribution of assets at no cost. The 
237.20 	certificate must include the name, case number, and district court in which the estate is 
237.21 	pending, the name of the local agency, describe the specific real or personal property to 
237.22 	which the consent applies, state that the local agency consents to the distribution of the 
237.23 	specific property described in the consent during the 70-day period following service of the 
237.24 	notice on the applicable commissioner or executive board, state that the consent is 
237.25 	unconditional or list all of the terms and conditions of the consent, be dated, and may include 
237.26 	other contents as may be appropriate. The certificate must be signed by the director of the 
237.27 	local agency or the director's designees and is effective as of the date it is dated unless it 
237.28 	provides otherwise. The signature of the director or the director's designee does not require 
237.29 	any acknowledgment. The certificate shall be prima facie evidence of the facts it states, 
237.30 	may be attached to or combined with a deed or any other instrument of conveyance and, 
237.31 	when so attached or combined, shall constitute a single instrument. If the certificate describes 
237.32 	real property, it shall be accepted for recording or filing by the county recorder or registrar 
237.33 	of titles in the county in which the property is located. If the certificate describes real property 
237.34 	and is not attached to or combined with a deed or other instrument of conveyance, it shall 
237.35 	be accepted for recording or filing by the county recorder or registrar of titles in the county 
238.1 	in which the property is located. The certificate constitutes a waiver of the 70-day period 
238.2 	provided for in clause (2) with respect to the property it describes and is prima facie evidence 
238.3 	of service of notice on the applicable commissioner or executive board. The certificate is 
238.4 	not a waiver or relinquishment of any claims arising under section 246.53, 256B.15, 256D.16, 
238.5 	or 261.04, and does not otherwise constitute a waiver of any of the personal representative's 
238.6 	duties under this paragraph. Distributees who receive property pursuant to a consent to an 
238.7 	early distribution shall remain liable to creditors of the estate as provided for by law.
238.8 	(7) All affidavits provided for under this paragraph:
238.9 	(i) shall be provided by persons who have personal knowledge of the facts stated in the 
238.10 	affidavit;
238.11 	(ii) may be filed or recorded in the office of the county recorder or registrar of titles in 
238.12 	the county in which the real property they describe is located for the purpose of establishing 
238.13 	compliance with the requirements of this paragraph; and
238.14 	(iii) are prima facie evidence of the facts stated in the affidavit.
238.15 	(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997. 
238.16 	Clause (5) also applies with respect to all notices served on the commissioner of human 
238.17 	services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55. All notices 
238.18 	served on the commissioner of human services before July 1, 1997, pursuant to Laws 1996, 
238.19 	chapter 451, article 2, section 55, shall be deemed to be legally sufficient for the purposes 
238.20 	for which they were intended, notwithstanding any errors, omissions or other defects.

238.21 	Sec. 35. Minnesota Statutes 2024, section 611.57, subdivision 2, is amended to read:
238.22 		Subd. 2.Membership. (a) The Certification Advisory Committee consists of the 
238.23 	following members:
238.24 	(1) a mental health professional, as defined in section 245I.02, subdivision 27, with 
238.25 	community behavioral health experience, appointed by the governor;
238.26 	(2) a board-certified forensic psychiatrist with experience in competency evaluations, 
238.27 	providing competency attainment services, or both, appointed by the governor;
238.28 	(3) a board-certified forensic psychologist with experience in competency evaluations, 
238.29 	providing competency attainment services, or both, appointed by the governor;
238.30 	(4) the president of the Minnesota Corrections Association or a designee;
238.31 	(5) the direct care and treatment deputy commissionerchief executive officer of direct 
238.32 	care and treatment or a designee;
239.1 	(6) the president of the Minnesota Association of County Social Service Administrators 
239.2 	or a designee;
239.3 	(7) the president of the Minnesota Association of Community Mental Health Providers 
239.4 	or a designee;
239.5 	(8) the president of the Minnesota Sheriffs' Association or a designee; and
239.6 	(9) the executive director of the National Alliance on Mental Illness Minnesota or a 
239.7 	designee.
239.8 	(b) Members of the advisory committee serve without compensation and at the pleasure 
239.9 	of the appointing authority. Vacancies shall be filled by the appointing authority consistent 
239.10 	with the qualifications of the vacating member required by this subdivision.

239.11 	Sec. 36. REVISOR INSTRUCTION.
 239.12 	The revisor of statutes shall renumber each provision of Minnesota Statutes listed in 
239.13 	column A to the number listed in column B.

239.14		Column A
	Column B
	
239.15		246B.01, subdivision 2b
	246B.01, subdivision 2f
	
239.16		246B.01, subdivision 2c
	246B.01, subdivision 2g
	
239.17		246B.01, subdivision 2d
	246B.01, subdivision 2h

239.18 	Sec. 37. REPEALER.
 239.19 	Minnesota Statutes 2024, sections 246B.01, subdivision 2; 252.021, subdivision 2; 
239.20 	253.195, subdivision 2; 253B.02, subdivision 7b; 253D.02, subdivision 7a; 254B.01, 
239.21 	subdivision 15; 256.045, subdivision 1a; and 256G.02, subdivision 5a, are repealed.

239.22 	Sec. 38. EFFECTIVE DATE.
 239.23 	This article is effective the day following final enactment.

239.24 	ARTICLE 10
239.25 	DEPARTMENT OF HEALTH

239.26 	Section 1. Minnesota Statutes 2024, section 144A.01, subdivision 4, is amended to read:
239.27 		Subd. 4.Controlling person. (a) "Controlling person" means an owner and the following 
239.28 	individuals and entities, if applicable:
240.1 	(1) each officer of the organization, including the chief executive officer and the chief 
240.2 	financial officer;
240.3 	(2) the nursing home administrator; and
240.4 	(3) any managerial official.; and
240.5 	(4) if no individual has at least a five percent ownership interest, every individual with 
240.6 	an ownership interest in a privately held corporation, limited liability company, or other 
240.7 	business entity, including a business entity that is publicly traded or nonpublicly traded, 
240.8 	that collects capital investments from individuals or entities.
240.9 	(b) "Controlling person" also means any entity or natural person who has any direct or 
240.10 	indirect ownership interest in:
240.11 	(1) any corporation, partnership or other business association which is a controlling 
240.12 	person;
240.13 	(2) the land on which a nursing home is located;
240.14 	(3) the structure in which a nursing home is located;
240.15 	(4) any entity with at least a five percent mortgage, contract for deed, deed of trust, or 
240.16 	other security interest in the land or structure comprising a nursing home; or
240.17 	(5) any lease or sublease of the land, structure, or facilities comprising a nursing home.
240.18 	(c) "Controlling person" does not include:
240.19 	(1) a bank, savings bank, trust company, savings association, credit union, industrial 
240.20 	loan and thrift company, investment banking firm, or insurance company unless the entity 
240.21 	directly or through a subsidiary operates a nursing home;
240.22 	(2) government and government-sponsored entities such as the United States Department 
240.23 	of Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the 
240.24 	Minnesota Housing Finance Agency which provide loans, financing, and insurance products 
240.25 	for housing sites;
240.26 	(3) an individual who is a state or federal official, a state or federal employee, or a 
240.27 	member or employee of the governing body of a political subdivision of the state or federal 
240.28 	government that operates one or more nursing homes, unless the individual is also an officer, 
240.29 	owner, or managerial official of the nursing home, receives any remuneration from a nursing 
240.30 	home, or who is a controlling person not otherwise excluded in this subdivision;
241.1 	(4) a natural person who is a member of a tax-exempt organization under section 290.05, 
241.2 	subdivision 2, unless the individual is also a controlling person not otherwise excluded in 
241.3 	this subdivision; and
241.4 	(5) a natural person who owns less than five percent of the outstanding common shares 
241.5 	of a corporation:
241.6 	(i) whose securities are exempt by virtue of section 80A.45, clause (6); or
241.7 	(ii) whose transactions are exempt by virtue of section 80A.46, clause (7).

241.8 	Sec. 2. Minnesota Statutes 2024, section 144A.474, subdivision 11, is amended to read:
241.9 		Subd. 11.Fines. (a) Fines and enforcement actions under this subdivision may be assessed 
241.10 	based on the level and scope of the violations described in paragraph (b) and imposed 
241.11 	immediately with no opportunity to correct the violation first as follows:
241.12 	(1) Level 1, no fines or enforcement;
241.13 	(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement 
241.14 	mechanisms authorized in section 144A.475 for widespread violations;
241.15 	(3) Level 3, a fine of $3,000 per incident, in addition to any of the enforcement 
241.16 	mechanisms authorized in section 144A.475;
241.17 	(4) Level 4, a fine of $5,000 per incident, in addition to any of the enforcement 
241.18 	mechanisms authorized in section 144A.475;
241.19 	(5) for maltreatment violations for which the licensee was determined to be responsible 
241.20 	for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000. 
241.21 	A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible 
241.22 	for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury; 
241.23 	and
241.24 	(6) the fines in clauses (1) to (4) are increased and immediate fine imposition is authorized 
241.25 	for both surveys and investigations conducted.
241.26 	When a fine is assessed against a facility for substantiated maltreatment, the commissioner 
241.27 	shall not also impose an immediate fine under this chapter for the same circumstance.
241.28 	(b) Correction orders for violations are categorized by both level and scope and fines 
241.29 	shall be assessed as follows:
241.30 	(1) level of violation:
242.1 	(i) Level 1 is a violation that has no potential to cause more than a minimal impact on 
242.2 	the client and does not affect health or safety;
242.3 	(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential 
242.4 	to have harmed a client's health or safety, but was not likely to cause serious injury, 
242.5 	impairment, or death;
242.6 	(iii) Level 3 is a violation that harmed a client's health or safety, not including serious 
242.7 	injury, impairment, or death, or a violation that has the potential to lead to serious injury, 
242.8 	impairment, or death; and
242.9 	(iv) Level 4 is a violation that results in serious injury, impairment, or death;
242.10 	(2) scope of violation:
242.11 	(i) isolated, when one or a limited number of clients are affected or one or a limited 
242.12 	number of staff are involved or the situation has occurred only occasionally;
242.13 	(ii) pattern, when more than a limited number of clients are affected, more than a limited 
242.14 	number of staff are involved, or the situation has occurred repeatedly but is not found to be 
242.15 	pervasive; and
242.16 	(iii) widespread, when problems are pervasive or represent a systemic failure that has 
242.17 	affected or has the potential to affect a large portion or all of the clients.
242.18 	(c) If the commissioner finds that the applicant or a home care provider has not corrected 
242.19 	violations by the date specified in the correction order or conditional license resulting from 
242.20 	a survey or complaint investigation, the commissioner shall provide a notice of 
242.21 	noncompliance with a correction order by email to the applicant's or provider's last known 
242.22 	email address. The noncompliance notice must list the violations not corrected.
242.23 	(d) For every violation identified by the commissioner, the commissioner shall issue an 
242.24 	immediate fine pursuant to paragraph (a), clause (6). The license holder must still correct 
242.25 	the violation in the time specified. The issuance of an immediate fine can occur in addition 
242.26 	to any enforcement mechanism authorized under section 144A.475. The immediate fine 
242.27 	may be appealed as allowed under this subdivision.
242.28 	(e) The license holder must pay the fines assessed on or before the payment date specified. 
242.29 	If the license holder fails to fully comply with the order, the commissioner may issue a 
242.30 	second fine or suspend the license until the license holder complies by paying the fine. A 
242.31 	timely appeal shall stay payment of the fine until the commissioner issues a final order.
243.1 	(f) A license holder shall promptly notify the commissioner in writing when a violation 
243.2 	specified in the order is corrected. If upon reinspection the commissioner determines that 
243.3 	a violation has not been corrected as indicated by the order, the commissioner may issue a 
243.4 	second fine. The commissioner shall notify the license holder by mail to the last known 
243.5 	address in the licensing record that a second fine has been assessed. The license holder may 
243.6 	appeal the second fine as provided under this subdivision.
243.7 	(g) A home care provider that has been assessed a fine under this subdivision has a right 
243.8 	to a reconsideration or a hearing under this section and chapter 14.
243.9 	(h) When a fine has been assessed, the license holder may not avoid payment by closing, 
243.10 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
243.11 	license holder shall be liable for payment of the fine.
243.12 	(i) In addition to any fine imposed under this section, the commissioner may assess a 
243.13 	penalty amount based on costs related to an investigation that results in a final order assessing 
243.14 	a fine or other enforcement action authorized by this chapter.
243.15 	(j) Fines collected under paragraph (a), clauses (1) to (4), shall be deposited in a dedicated 
243.16 	special revenue account. On an annual basis, the balance in the special revenue account 
243.17 	shall be appropriated to the commissioner to implement the recommendations of the advisory 
243.18 	council established in section 144A.4799. The commissioner must publish on the department's 
243.19 	website an annual report on the fines assessed and collected, and how the appropriated 
243.20 	money was allocated.
243.21 	(k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated 
243.22 	special revenue account and appropriated to the commissioner to provide compensation 
243.23 	according to subdivision 14 to clients subject to maltreatment. A client may choose to receive 
243.24 	compensation from this fund, not to exceed $5,000 for each substantiated finding of 
243.25 	maltreatment, or take civil action. This paragraph expires July 31, 2021.

243.26 	Sec. 3. Minnesota Statutes 2024, section 144A.4799, is amended to read:
243.27 	144A.4799 DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER
243.28 	AND ASSISTED LIVING ADVISORY COUNCIL.
243.29 		Subdivision 1.Membership. The commissioner of health shall appoint 13 14 persons 
243.30 	to a home care and assisted living program advisory council consisting of the following:
243.31 	(1) two four public members as defined in section 214.02who shall be persons who are 
243.32 	currently receiving home care services, persons who have received home care services 
243.33 	within five years of the application date, persons who have family members receiving home 
244.1 	care services, or persons who have family members who have received home care services 
244.2 	within five years of the application date, one of whom must be a person who either is 
244.3 	receiving or has received home care services preferably within the five years prior to initial 
244.4 	appointment, one of whom must be a person who has or had a family member receiving 
244.5 	home care services preferably within the five years prior to initial appointment, one of whom 
244.6 	must be a person who either is or has been a resident in an assisted living facility preferably 
244.7 	within the five years prior to initial appointment, and one of whom must be a person who 
244.8 	has or had a family member residing in an assisted living facility preferably within the five 
244.9 	years prior to initial appointment;
244.10 	(2) two Minnesota home care licensees representing basic and comprehensive levels of 
244.11 	licensure who may be a managerial official, an administrator, a supervising registered nurse, 
244.12 	or an unlicensed personnel performing home care tasks;
244.13 	(3) one member representing the Minnesota Board of Nursing;
244.14 	(4) one member representing the Office of Ombudsman for Long-Term Care;
244.15 	(5) one member representing the Office of Ombudsman for Mental Health and 
244.16 	Developmental Disabilities;
244.17 	(6) beginning July 1, 2021, one member of a county health and human services or county 
244.18 	adult protection office;
244.19 	(7) two Minnesota assisted living facility licensees representing assisted living facilities 
244.20 	and assisted living facilities with dementia care levels of licensure who may be the facility's 
244.21 	assisted living director, managerial official, or clinical nurse supervisor;
244.22 	(8) one organization representing long-term care providers, home care providers, and 
244.23 	assisted living providers in Minnesota; and
244.24 	(9) two public members as defined in section 214.02. One public member shall be a 
244.25 	person who either is or has been a resident in an assisted living facility and one public 
244.26 	member shall be a person who has or had a family member living in an assisted living 
244.27 	facility setting one representative of a consumer advocacy organization representing 
244.28 	individuals receiving long-term care from licensed home care or assisted living providers.
244.29 		Subd. 2.Organizations and meetings. The advisory council shall be organized and 
244.30 	administered under section 15.059 with per diems and costs paid within the limits of available 
244.31 	appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees 
244.32 	may be developed as necessary by the commissioner. Advisory council meetings are subject 
244.33 	to the Open Meeting Law under chapter 13D.
245.1 		Subd. 3.Duties. (a) At the commissioner's request, the advisory council shall provide 
245.2 	advice regarding regulations of Department of Health licensed assisted living and home 
245.3 	care providers in this chapter and chapter 144G, including advice on the following:
245.4 	(1) community standards for home care practices;
245.5 	(2) enforcement of licensing standards and whether certain disciplinary actions are 
245.6 	appropriate;
245.7 	(3) ways of distributing information to licensees and consumers of .home care and 
245.8 	assisted living services defined under chapter 144G;
245.9 	(4) training standards;
245.10 	(5) identifying emerging issues and opportunities in home care and assisted living services 
245.11 	defined under chapter 144G;
245.12 	(6) identifying the use of technology in home and telehealth capabilities;
245.13 	(7) allowable home care licensing modifications and exemptions, including a method 
245.14 	for an integrated license with an existing license for rural licensed nursing homes to provide 
245.15 	limited home care services in an adjacent independent living apartment building owned by 
245.16 	the licensed nursing home; and
245.17 	(8) recommendations for studies using the data in section 62U.04, subdivision 4, including 
245.18 	but not limited to studies concerning costs related to dementia and chronic disease among 
245.19 	an elderly population over 60 and additional long-term care costs, as described in section 
245.20 	62U.10, subdivision 6.
245.21 	(b) The advisory council shall perform other duties as directed by the commissioner.
245.22 	(c) The advisory council shall annually make recommendations annually to the 
245.23 	commissioner for the purposes of allocating the appropriation in section sections144A.474, 
245.24 	subdivision 11, paragraph (i) (j), and 144G.31, subdivision 8. The commissioner shall act 
245.25 	upon the recommendations of the advisory council within one year of the advisory council 
245.26 	submitting its recommendations to the commissioner. The recommendations shall address 
245.27 	ways the commissioner may improve protection of the public under existing statutes and 
245.28 	laws and improve quality of care. The council's recommendations may include but are not 
245.29 	limited to special projects or initiatives that:
245.30 	(1) create and administer training of licensees and ongoing training for their employees 
245.31 	to improve clients' and residents' lives, supporting ways that support licensees,can improve 
246.1 	and enhance quality care, and ways to provide technical assistance to licensees to improve 
246.2 	compliance;
246.3 	(2) develop and implement information technology and data projects that analyze and 
246.4 	communicate information about trends of in violations or lead to ways of improving resident 
246.5 	and client care;
246.6 	(3) improve communications strategies to licensees and the public;
246.7 	(4) recruit and retain direct care staff;
246.8 	(5) recommend education related to the care of vulnerable adults in professional nursing 
246.9 	programs, nurse aide programs, and home health aide programs; and
246.10 	(6)other projects or pilots that benefit residents, clients, families, and the public in other 
246.11 	ways.

246.12 	EFFECTIVE DATE. This section is effective July 1, 2025, and the amendments to 
246.13 	subdivision 1, clause (1), apply to members whose initial appointment occurs on or after 
246.14 	that date.

246.15 	Sec. 4. Minnesota Statutes 2024, section 144G.08, subdivision 15, is amended to read:
246.16 		Subd. 15.Controlling individual. (a) "Controlling individual" means an owner and the 
246.17 	following individuals and entities, if applicable:
246.18 	(1) each officer of the organization, including the chief executive officer and chief 
246.19 	financial officer;
246.20 	(2) each managerial official; and
246.21 	(3) any entity with at least a five percent mortgage, deed of trust, or other security interest 
246.22 	in the facility.; and
246.23 	(4) if no individual has at least a five percent ownership interest, every individual with 
246.24 	an ownership interest in a privately held corporation, limited liability company, or other 
246.25 	business entity, including a business entity that is publicly traded or nonpublicly traded, 
246.26 	that collects capital investments from individuals or entities.
246.27 	(b) Controlling individual also means any entity or natural person who has any direct 
246.28 	or indirect ownership interest in:
246.29 	(1) any corporation, partnership, or other business association such as a limited liability 
246.30 	company that is a controlling individual;
246.31 	(2) the land on which an assisted living facility is located; or
247.1 	(3) the structure in which an assisted living facility is located.
247.2 	(b) (c) Controlling individual does not include:
247.3 	(1) a bank, savings bank, trust company, savings association, credit union, industrial 
247.4 	loan and thrift company, investment banking firm, or insurance company unless the entity 
247.5 	operates a program directly or through a subsidiary;
247.6 	(2) government and government-sponsored entities such as the U.S. Department of 
247.7 	Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the Minnesota 
247.8 	Housing Finance Agency which provide loans, financing, and insurance products for housing 
247.9 	sites;
247.10 	(3) an individual who is a state or federal official, a state or federal employee, or a 
247.11 	member or employee of the governing body of a political subdivision of the state or federal 
247.12 	government that operates one or more facilities, unless the individual is also an officer, 
247.13 	owner, or managerial official of the facility, receives remuneration from the facility, or 
247.14 	owns any of the beneficial interests not excluded in this subdivision;
247.15 	(4) an individual who owns less than five percent of the outstanding common shares of 
247.16 	a corporation:
247.17 	(i) whose securities are exempt under section 80A.45, clause (6); or
247.18 	(ii) whose transactions are exempt under section 80A.46, clause (2);
247.19 	(5) an individual who is a member of an organization exempt from taxation under section 
247.20 	290.05, unless the individual is also an officer, owner, or managerial official of the license 
247.21 	or owns any of the beneficial interests not excluded in this subdivision. This clause does 
247.22 	not exclude from the definition of controlling individual an organization that is exempt from 
247.23 	taxation; or
247.24 	(6) an employee stock ownership plan trust, or a participant or board member of an 
247.25 	employee stock ownership plan, unless the participant or board member is a controlling 
247.26 	individual.

247.27 	Sec. 5. Minnesota Statutes 2024, section 144G.31, subdivision 8, is amended to read:
247.28 		Subd. 8.Deposit of fines. (a) Fines collected under this section shall be deposited in a 
247.29 	dedicated special revenue account. On an annual basis, the balance in the special revenue 
247.30 	account shall be appropriated to a competitive grant program for assisted living providers 
247.31 	licensed under chapter 144G or other organizations with experience in assisted living 
247.32 	operations, compliance, and best practices for the purpose of the commissioner for special 
248.1 	projects to improve resident quality of care and outcomes in assisted living facilities licensed 
248.2 	under this chapter in Minnesota. A provider with a provisional license under chapter 144G 
248.3 	is not eligible to apply. The balance in the special revenue account as of January 1, 2026, 
248.4 	must be appropriated for grants within two years, provided there are enough grant requests 
248.5 	totaling the sum in the account. Thereafter, money in the special revenue account must be 
248.6 	appropriated annually as recommended by the advisory council established in section 
248.7 	144A.4799, or as recommended by the commissioner after the advisory council's review 
248.8 	and approval. The minimum amount of a grant award is $10,000. The commissioner may 
248.9 	retain up to ten percent of the amount available to cover costs to administer the grants under 
248.10 	this section.
248.11 	(b) The commissioner must publish on the department's website an annual report on the 
248.12 	fines assessed and collected, and how the appropriated money was allocated.

248.13 	Sec. 6. Minnesota Statutes 2024, section 144G.52, subdivision 1, is amended to read:
248.14 		Subdivision 1.Definition. For purposes of sections 144G.52 to 144G.55, "termination" 
248.15 	means:
248.16 	(1) a facility-initiated termination of housing provided to the resident under the contract
248.17 	an assisted living contract; or
248.18 	(2) a facility-initiated termination or nonrenewal of all assisted living services the resident 
248.19 	receives from the facility under the assisted living contract.

248.20 	Sec. 7. Minnesota Statutes 2024, section 144G.52, subdivision 2, is amended to read:
248.21 		Subd. 2.Prerequisite to termination of a contract. (a) Before issuing a notice of 
248.22 	termination of an assisted living contract, a facility must schedule and participate in a meeting 
248.23 	with the resident and the resident's legal representative and designated representative. The 
248.24 	purposes of the meeting are to:
248.25 	(1) explain in detail the reasons for the proposed termination; and
248.26 	(2) identify and offer reasonable accommodations or modifications, interventions, or 
248.27 	alternatives to avoid the termination or enable the resident to remain in the facility, including 
248.28 	but not limited to securing services from another provider of the resident's choosing that 
248.29 	may allow the resident to avoid the termination. A facility is not required to offer 
248.30 	accommodations, modifications, interventions, or alternatives that fundamentally alter the 
248.31 	nature of the operation of the facility.
249.1 	(b) For a termination pursuant to subdivision 3 or 4, the meeting must be scheduled to 
249.2 	take place at least seven days before a notice of termination is issued. The facility must 
249.3 	make reasonable efforts to ensure that the resident, legal representative, and designated 
249.4 	representative are able to attend the meeting.
249.5 	(c) For a termination pursuant to subdivision 5, the meeting must be scheduled to take 
249.6 	place at least five days before a notice of termination is issued. The facility must make 
249.7 	reasonable efforts to ensure that the resident, legal representative, and designated 
249.8 	representative are able to attend the meeting.
249.9 	(d) The facility must notify the resident that the resident may invite family members, 
249.10 	relevant health professionals, a representative of the Office of Ombudsman for Long-Term 
249.11 	Care, a representative of the Office of Ombudsman for Mental Health and Developmental 
249.12 	Disabilities, or other persons of the resident's choosing to participate in the meeting. For 
249.13 	residents who receive home and community-based waiver services under chapter 256S and 
249.14 	section 256B.49, the facility must notify the resident's case manager of the meeting.
249.15 	(d) (e) In the event of an emergency relocation under subdivision 9, where the facility 
249.16 	intends to issue a notice of termination and an in-person meeting is impractical or impossible, 
249.17 	the facility must use telephone, video, or other electronic means to conduct and participate 
249.18 	in the meeting required under this subdivision and rules within Minnesota Rules, chapter 
249.19 	4659.

249.20 	Sec. 8. Minnesota Statutes 2024, section 144G.52, subdivision 3, is amended to read:
249.21 		Subd. 3.Termination for nonpayment. (a) A facility may initiate a termination of 
249.22 	housing because of nonpayment of rent or a termination of services because of nonpayment 
249.23 	for services. Upon issuance of a notice of termination for nonpayment, the facility must 
249.24 	inform the resident that public benefits may be available and must provide contact 
249.25 	information for the Senior LinkAge Line under section 256.975, subdivision 7, or the 
249.26 	Disability Hub under section 256.01, subdivision 24.
249.27 	(b) An interruption to a resident's public benefits that lasts for no more than 60 days 
249.28 	does not constitute nonpayment.

249.29 	Sec. 9. Minnesota Statutes 2024, section 144G.52, subdivision 8, is amended to read:
249.30 		Subd. 8.Content of notice of termination. The notice required under subdivision 7 
249.31 	must contain, at a minimum:
249.32 	(1) the effective date of the termination of the assisted living contract;
250.1 	(2) a detailed explanation of the basis for the termination, including the clinical or other 
250.2 	supporting rationale;
250.3 	(3) a detailed explanation of the conditions under which a new or amended contract may 
250.4 	be executed;
250.5 	(4) a statement that the resident has the right to appeal the termination by requesting a 
250.6 	hearing, and information concerning the time frame within which the request must be 
250.7 	submitted and the contact information for the agency to which the request must be submitted;
250.8 	(5) a statement that the facility must participate in a coordinated move to another provider 
250.9 	or caregiver, as required under section 144G.55;
250.10 	(6) the name and contact information of the person employed by the facility with whom 
250.11 	the resident may discuss the notice of termination;
250.12 	(7) information on how to contact the Office of Ombudsman for Long-Term Care and 
250.13 	the Office of Ombudsman for Mental Health and Developmental Disabilities to request an 
250.14 	advocate to assist regarding the termination;
250.15 	(8) information on how to contact the Senior LinkAge Line under section 256.975, 
250.16 	subdivision 7, or the Disability Hub under section 256.01, subdivision 24, and an explanation 
250.17 	that the Senior LinkAge Line and the Disability Hub may provide information about other 
250.18 	available housing or service options; and
250.19 	(9) if the termination is only for services, a statement that the resident may remain in 
250.20 	the facility and may secure any necessary services from another provider of the resident's 
250.21 	choosing.

250.22 	Sec. 10. Minnesota Statutes 2024, section 144G.54, subdivision 3, is amended to read:
250.23 		Subd. 3.Appeals process. (a) The Office of Administrative Hearings must conduct an 
250.24 	expedited hearing as soon as practicable under this section, but in no event later than 14 
250.25 	calendar days after the office receives the request, unless the parties agree otherwise or the 
250.26 	chief administrative law judge deems the timing to be unreasonable, given the complexity 
250.27 	of the issues presented. For terminations initiated pursuant to section 144G.52, subdivision 
250.28 	5, the Office of Administrative Hearings must conduct an expedited hearing as soon as 
250.29 	practicable but in no event later than ten calendar days after the office receives the request, 
250.30 	unless the parties agree otherwise. The Office of Administrative Hearings has discretion to 
250.31 	order a continuance.
251.1 	(b) The hearing must be held at the facility where the resident lives, unless holding the 
251.2 	hearing at that location is impractical, the parties agree to hold the hearing at a different 
251.3 	location, or the chief administrative law judge grants a party's request to appear at another 
251.4 	location or by telephone or interactive video.
251.5 	(c) The hearing is not a formal contested case proceeding, except when determined 
251.6 	necessary by the chief administrative law judge.
251.7 	(d) Parties may but are not required to be represented by counsel. The appearance of a 
251.8 	party without counsel does not constitute the unauthorized practice of law.
251.9 	(e) The hearing shall be limited to the amount of time necessary for the participants to 
251.10 	expeditiously present the facts about the proposed termination. The administrative law judge 
251.11 	shall issue a recommendation to the commissioner as soon as practicable, but in no event 
251.12 	later than ten business days after the hearing related to a termination issued under section 
251.13 	144G.52, subdivision 3 or 4, or five business days for a hearing related to a termination 
251.14 	issued under section 144G.52, subdivision 5.

251.15 	Sec. 11. Minnesota Statutes 2024, section 144G.54, subdivision 7, is amended to read:
251.16 		Subd. 7.Application of chapter 504B to appeals of terminations. A resident may not 
251.17 	bring an action under chapter 504B to challenge a termination that has occurred and been 
251.18 	upheld under this section. A facility is entitled to a writ of recovery of premises and order 
251.19 	to vacate pursuant to section 504B.361 when a termination has been upheld under this 
251.20 	section and the facility has met its obligation under section 144G.55.

251.21 	Sec. 12. Minnesota Statutes 2024, section 144G.55, subdivision 1, is amended to read:
251.22 		Subdivision 1.Duties of facility. (a) If a facility terminates an assisted living contract, 
251.23 	reduces services to the extent that a resident needs to move or obtain a new service provider 
251.24 	or the facility has its license restricted under section 144G.20, or the facility conducts a 
251.25 	planned closure under section 144G.57, the facility:
251.26 	(1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is 
251.27 	appropriate for the resident and that is identified by the facility prior to any hearing under 
251.28 	section 144G.54 and document the same;
251.29 	(2) must ensure a coordinated move of the resident to an appropriate service provider 
251.30 	identified by the facility prior to any hearing under section 144G.54, provided services are 
251.31 	still needed and desired by the resident; and
252.1 	(3) must consult and cooperate with the resident, legal representative, designated 
252.2 	representative, case manager for a resident who receives home and community-based waiver 
252.3 	services under chapter 256S and section 256B.49, relevant health professionals, and any 
252.4 	other persons of the resident's choosing to make arrangements to move the resident, including 
252.5 	consideration of the resident's goals and document the same.
252.6 	(b) A facility may satisfy the requirements of paragraph (a), clauses (1) and (2), by 
252.7 	moving the resident to a different location within the same facility, if appropriate for the 
252.8 	resident.
252.9 	(c) A resident may decline to move to the location the facility identifies or to accept 
252.10 	services from a service provider the facility identifies, and may choose instead to move to 
252.11 	a location of the resident's choosing or receive services from a service provider of the 
252.12 	resident's choosing within the timeline prescribed in the termination notice.
252.13 	(d) A facility has met its obligations under this section, following a termination completed 
252.14 	in accordance with section 144G.52 if:
252.15 	(1) for residents of facilities in the seven-county metropolitan area, the facility identifies 
252.16 	at least three other facilities willing and able to meet the individual's service needs, one of 
252.17 	which is within the seven-county metropolitan area;
252.18 	(2) for residents of facilities outside of the seven-county metropolitan area, the facility 
252.19 	identifies at least two other facilities willing and able to meet the individual's service needs, 
252.20 	and to the extent such facilities exist, one must be within two hours or 120 miles from the 
252.21 	resident's current location; and
252.22 	(3) the facility documents, in writing, the resident or the resident's designated 
252.23 	representative has:
252.24 	(i) consented to move; or
252.25 	(ii) expressly refused to relocate to any of the facilities identified in accordance with 
252.26 	this subdivision.
252.27 	(e) Sixty days before the facility plans to reduce or eliminate one or more services for 
252.28 	a particular resident, the facility must provide written notice of the reduction that includes:
252.29 	(1) a detailed explanation of the reasons for the reduction and the date of the reduction;
252.30 	(2) the contact information for the Office of Ombudsman for Long-Term Care, the Office 
252.31 	of Ombudsman for Mental Health and Developmental Disabilities, and the name and contact 
253.1 	information of the person employed by the facility with whom the resident may discuss the 
253.2 	reduction of services;
253.3 	(3) a statement that if the services being reduced are still needed by the resident, the 
253.4 	resident may remain in the facility and seek services from another provider; and
253.5 	(4) a statement that if the reduction makes the resident need to move, the facility must 
253.6 	participate in a coordinated move of the resident to another provider or caregiver, as required 
253.7 	under this section.
253.8 	(e) (f) In the event of an unanticipated reduction in services caused by extraordinary 
253.9 	circumstances, the facility must provide the notice required under paragraph (d) (e) as soon 
253.10 	as possible.
253.11 	(f) (g) If the facility, a resident, a legal representative, or a designated representative 
253.12 	determines that a reduction in services will make a resident need to move to a new location, 
253.13 	the facility must ensure a coordinated move in accordance with this section, and must provide 
253.14 	notice to the Office of Ombudsman for Long-Term Care.
253.15 	(g) (h) Nothing in this section affects a resident's right to remain in the facility and seek 
253.16 	services from another provider.

253.17 	Sec. 13. [145D.40] DEFINITIONS.
253.18 		Subdivision 1.Application. For purposes of sections 145D.40 to 145D.41, the following 
253.19 	terms have the meanings given.
253.20 		Subd. 2.Assisted living facility. "Assisted living facility" has the meaning given in 
253.21 	section 144G.08, subdivision 7. Assisted living facility includes an assisted living facility 
253.22 	with dementia care as defined in section 144G.08, subdivision 8.
253.23 		Subd. 3.Health care professional. "Health care professional" means an individual who 
253.24 	is licensed or registered by the state to provide health care services within the professional's 
253.25 	scope of practice and in accordance with state law.
253.26 		Subd. 4.Nursing home. "Nursing home" means a facility licensed as a nursing home 
253.27 	under chapter 144A.
253.28 		Subd. 5.Ownership or control. "Ownership or control" means the assumption of 
253.29 	governance or the acquisition of an ownership interest or direct or indirect control by a 
253.30 	for-profit entity over the operations of a nonprofit nursing home or a nonprofit assisted 
253.31 	living facility through any means, including but not limited to a purchase, lease, transfer, 
253.32 	exchange, option, conveyance, creation of a joint venture, or other manner of acquisition 
254.1 	of assets, governance, an ownership interest, or direct or indirect control of a nonprofit 
254.2 	nursing home or a nonprofit assisted living facility.

254.3 	Sec. 14. [145D.41] NOTICE, INFORMATION, AND AFFIDAVIT REQUIRED.
254.4 		Subdivision 1.Notice and information. (a) At least 120 days prior to the transfer of 
254.5 	ownership or control of a nonprofit nursing home or nonprofit assisted living facility to a 
254.6 	for-profit entity, the nursing home or assisted living facility must provide written notice to 
254.7 	the attorney general, the commissioner of health, and the commissioner of human services 
254.8 	of its intent to transfer ownership or control to a for-profit entity.
254.9 	(b) Together with the notice, the for-profit entity seeking to acquire ownership or control 
254.10 	of the nonprofit nursing home or nonprofit assisted living facility must provide the following 
254.11 	information to the attorney general, commissioner of health, and commissioner of human 
254.12 	services:
254.13 	(1) the names of each individual with an interest in the for-profit entity and the percentage 
254.14 	of interest each individual holds in the for-profit entity;
254.15 	(2) a complete and detailed description of the for-profit entity's corporate structure;
254.16 	(3) the names of each individual holding an interest in, and the percentage of interest 
254.17 	held in, any affiliate, subsidiary, or otherwise related entity that the for-profit entity has a 
254.18 	contract to provide goods or services for the operation or maintenance of the nursing home 
254.19 	or assisted living facility or has a contract for goods and services to be provided to residents, 
254.20 	including any real estate investment trusts;
254.21 	(4) for the previous five years, any filings required to be made to any federal or state 
254.22 	agency;
254.23 	(5) the for-profit entity's current balance sheet;
254.24 	(6) all application materials required under section 144A.03 or 144G.12, as applicable;
254.25 	(7) a description of the condition of the buildings the for-profit entity seeks to acquire 
254.26 	or manage, identifying any cooling problems, electric medical devices present, recent exterior 
254.27 	additions and replacements, external building conditions, recent flush toilet breakdowns, 
254.28 	foreclosure status in the last 12 months, heat risk, heating problems, indoor air quality, 
254.29 	recent interior additions and replacements, and mold, as those terms are defined and described 
254.30 	in Appendix A of the American Housing Survey for the United States: 2023;
254.31 	(8) an affidavit and evidence as required under subdivision 2; and
255.1 	(9) other information required by the attorney general, commissioner of health, and 
255.2 	commissioner of human services.
255.3 		Subd. 2.Affidavit and evidence. In addition to the notice required under subdivision 
255.4 	1, a for-profit entity seeking to acquire ownership or control of a nonprofit nursing home 
255.5 	or nonprofit assisted living facility must submit to the attorney general an affidavit and 
255.6 	evidence sufficient to demonstrate that:
255.7 	(1) the for-profit entity has the financial, managerial, and operational ability to operate 
255.8 	or manage the nursing home or assisted living facility consistent with the requirements of 
255.9 	(i) for a nursing home, sections 144A.01 to 144A.1888, chapter 256R, and Minnesota Rules, 
255.10 	chapter 4658; or (ii) for an assisted living facility, chapter 144G and Minnesota Rules, 
255.11 	chapter 4659;
255.12 	(2) neither the for-profit entity nor any of its owners, managerial officials, or managers 
255.13 	have committed a crime listed in, or been found civilly liable for an offense listed in section 
255.14 	144A.03, subdivision 1, clause (13), or 144G.12, subdivision 1, clause (13), as applicable;
255.15 	(3) in the preceding ten years, there have been no judgments and no filed, pending, or 
255.16 	completed public or private litigations, tax liens, written complaints, administrative actions, 
255.17 	or investigations by a government agency against the for-profit entity or any of its owners, 
255.18 	managerial officials, or managers;
255.19 	(4) in the preceding ten years, the for-profit entity has not defaulted in the payment of 
255.20 	money collected for others and has not discharged debts through bankruptcy proceedings;
255.21 	(5) the for-profit entity will invest sufficient capital in the nursing home or assisted living 
255.22 	facility to maintain or improve the facility's infrastructure and staffing;
255.23 	(6)(i) housing costs or costs for services in a nursing home or assisted living facility in 
255.24 	the United States over which the for-profit entity acquired ownership or control have not 
255.25 	increased by more than the increase in the Consumer Price Index for all urban consumers 
255.26 	published by the federal Bureau of Labor Statistics for the 12 months preceding the month 
255.27 	in which the increase became effective; or (ii) if housing costs or costs for services in the 
255.28 	nursing home or assisted living facility increased by more than the increase in the Consumer 
255.29 	Price Index as described in item (i), the increase was justified;
255.30 	(7) within five years after acquiring ownership or control of any other nursing home or 
255.31 	assisted living facility in the United States, the for-profit entity did not sell or otherwise 
255.32 	transfer ownership or control of the nursing home or assisted living facility to another person; 
255.33 	and
256.1 	(8) after acquiring ownership or control of another nursing home in the United States, 
256.2 	that nursing home, with respect to the Centers for Medicare and Medicaid Services rating 
256.3 	system:
256.4 	(i) maintained or improved the nursing home's rating if upon acquisition of ownership 
256.5 	or control the rating was three or more stars; or
256.6 	(ii) improved the nursing home's rating to at least three stars if upon acquisition of 
256.7 	ownership or control the rating was one or two stars.

256.8 	Sec. 15. [256.4751] MINNESOTA HOMELESS STUDY GRANTS.
256.9 		Subdivision 1.Minnesota homeless study grant program established. The 
256.10 	commissioner shall establish a grant program for activities directly related to a triennial 
256.11 	Minnesota homeless study.
256.12 		Subd. 2.Eligibility. Minnesota-based nonprofits with experience conducting point-in-time 
256.13 	studies of prevalence of homelessness in Minnesota are eligible for grants under this section.
256.14 		Subd. 3.Study administration and reporting. Beginning in fiscal year 2027, the grantee 
256.15 	must conduct a triennial point-in-time study that includes face-to-face interviews with people 
256.16 	experiencing homelessness. The grantee must submit a copy of the Minnesota homeless 
256.17 	study and a report that summarizes the findings of the study to the chairs and ranking 
256.18 	minority members of the legislative committees with jurisdiction over human services and 
256.19 	housing and homelessness by March 1 of the year that is approximately 18 months after the 
256.20 	date of the point-in-time study.
256.21 		Subd. 4.Minnesota homeless study account created. A Minnesota homeless study 
256.22 	account is created in the special revenue fund in the state treasury. Appropriations made 
256.23 	for the Minnesota homeless study administered under this section must be transferred to 
256.24 	this account. Money in the Minnesota homeless study account is appropriated to the 
256.25 	commissioner of human services for purposes of this section. Notwithstanding section 
256.26 	16B.98, subdivision 14, for each fiscal year in which a grant is awarded under this section, 
256.27 	the commissioner may use an amount not to exceed one percent of the money awarded.
256.28 		Subd. 5.Carryforward. Notwithstanding section 16A.28, subdivision 3, money in the 
256.29 	Minnesota homeless study account does not cancel.

257.1 	Sec. 16. Minnesota Statutes 2024, section 256B.092, subdivision 1a, is amended to read:
257.2 		Subd. 1a.Case management services. (a) Each recipient of a home and community-based 
257.3 	waiver shall be provided case management services by qualified vendors as described in 
257.4 	the federally approved waiver application.
257.5 	(b) Case management service activities provided to or arranged for a person include:
257.6 	(1) development of the person-centered support plan under subdivision 1b;
257.7 	(2) informing the individual or the individual's legal guardian or conservator, or parent 
257.8 	if the person is a minor, of service options, including all service options available under the 
257.9 	waiver plan;
257.10 	(3) consulting with relevant medical experts or service providers;
257.11 	(4) assisting the person in the identification of potential providers of chosen services, 
257.12 	including:
257.13 	(i) providers of services provided in a non-disability-specific setting;
257.14 	(ii) employment service providers;
257.15 	(iii) providers of services provided in settings that are not controlled by a provider; and
257.16 	(iv) providers of financial management services;
257.17 	(5) assisting the person to access services and assisting in appeals under section 256.045;
257.18 	(6) coordination of services, if coordination is not provided by another service provider;
257.19 	(7) evaluation and monitoring of the services identified in the support plan, which must 
257.20 	incorporate at least one annual face-to-face visit by the case manager with each person; and
257.21 	(8) reviewing support plans and providing the lead agency with recommendations for 
257.22 	service authorization based upon the individual's needs identified in the support plan; and
257.23 	(9) assisting and cooperating with providers licensed under chapter 144G with the 
257.24 	licensee's obligations under section 144G.55.
257.25 	(c) Case management service activities that are provided to the person with a 
257.26 	developmental disability shall be provided directly by county agencies or under contract. 
257.27 	If a county agency contracts for case management services, the county agency must provide 
257.28 	each recipient of home and community-based services who is receiving contracted case 
257.29 	management services with the contact information the recipient may use to file a grievance 
257.30 	with the county agency about the quality of the contracted services the recipient is receiving 
257.31 	from a county-contracted case manager. If a county agency provides case management 
258.1 	under contracts with other individuals or agencies and the county agency utilizes a 
258.2 	competitive proposal process for the procurement of contracted case management services, 
258.3 	the competitive proposal process must include evaluation criteria to ensure that the county 
258.4 	maintains a culturally responsive program for case management services adequate to meet 
258.5 	the needs of the population of the county. For the purposes of this section, "culturally 
258.6 	responsive program" means a case management services program that: (1) ensures effective, 
258.7 	equitable, comprehensive, and respectful quality care services that are responsive to 
258.8 	individuals within a specific population's values, beliefs, practices, health literacy, preferred 
258.9 	language, and other communication needs; and (2) is designed to address the unique needs 
258.10 	of individuals who share a common language or racial, ethnic, or social background.
258.11 	(d) Case management services must be provided by a public or private agency that is 
258.12 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
258.13 	the requirements in the approved federal waiver plans. Case management services must not 
258.14 	be provided to a recipient by a private agency that has a financial interest in the provision 
258.15 	of any other services included in the recipient's support plan. For purposes of this section, 
258.16 	"private agency" means any agency that is not identified as a lead agency under section 
258.17 	256B.0911, subdivision 10.
258.18 	(e) Case managers are responsible for service provisions listed in paragraphs (a) and 
258.19 	(b). Case managers shall collaborate with consumers, families, legal representatives, and 
258.20 	relevant medical experts and service providers in the development and annual review of the 
258.21 	person-centered support plan and habilitation plan.
258.22 	(f) For persons who need a positive support transition plan as required in chapter 245D, 
258.23 	the case manager shall participate in the development and ongoing evaluation of the plan 
258.24 	with the expanded support team. At least quarterly, the case manager, in consultation with 
258.25 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
258.26 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
258.27 	identify whether the plan has been developed and implemented in a manner to achieve the 
258.28 	following within the required timelines:
258.29 	(1) phasing out the use of prohibited procedures;
258.30 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
258.31 	timeline; and
258.32 	(3) accomplishment of identified outcomes.
259.1 	If adequate progress is not being made, the case manager shall consult with the person's 
259.2 	expanded support team to identify needed modifications and whether additional professional 
259.3 	support is required to provide consultation.
259.4 	(g) The Department of Human Services shall offer ongoing education in case management 
259.5 	to case managers. Case managers shall receive no less than 20 hours of case management 
259.6 	education and disability-related training each year. The education and training must include 
259.7 	person-centered planning, informed choice, cultural competency, employment planning, 
259.8 	community living planning, self-direction options, and use of technology supports. By 
259.9 	August 1, 2024, all case managers must complete an employment support training course 
259.10 	identified by the commissioner of human services. For case managers hired after August 
259.11 	1, 2024, this training must be completed within the first six months of providing case 
259.12 	management services. For the purposes of this section, "person-centered planning" or 
259.13 	"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case 
259.14 	managers must document completion of training in a system identified by the commissioner.

259.15 	Sec. 17. Minnesota Statutes 2024, section 256B.49, subdivision 13, is amended to read:
259.16 		Subd. 13.Case management. (a) Each recipient of a home and community-based waiver 
259.17 	shall be provided case management services by qualified vendors as described in the federally 
259.18 	approved waiver application. The case management service activities provided must include:
259.19 	(1) finalizing the person-centered written support plan within the timelines established 
259.20 	by the commissioner and section 256B.0911, subdivision 29;
259.21 	(2) informing the recipient or the recipient's legal guardian or conservator of service 
259.22 	options, including all service options available under the waiver plans;
259.23 	(3) assisting the recipient in the identification of potential service providers of chosen 
259.24 	services, including:
259.25 	(i) available options for case management service and providers;
259.26 	(ii) providers of services provided in a non-disability-specific setting;
259.27 	(iii) employment service providers;
259.28 	(iv) providers of services provided in settings that are not community residential settings; 
259.29 	and
259.30 	(v) providers of financial management services;
259.31 	(4) assisting the recipient to access services and assisting with appeals under section 
259.32 	256.045; and
260.1 	(5) coordinating, evaluating, and monitoring of the services identified in the service 
260.2 	plan; and
260.3 	(6) assisting and cooperating with providers licensed under chapter 144G with the 
260.4 	licensee's obligations under section 144G.55.
260.5 	(b) The case manager may delegate certain aspects of the case management service 
260.6 	activities to another individual provided there is oversight by the case manager. The case 
260.7 	manager may not delegate those aspects which require professional judgment including:
260.8 	(1) finalizing the person-centered support plan;
260.9 	(2) ongoing assessment and monitoring of the person's needs and adequacy of the 
260.10 	approved person-centered support plan; and
260.11 	(3) adjustments to the person-centered support plan.
260.12 	(c) Case management services must be provided by a public or private agency that is 
260.13 	enrolled as a medical assistance provider determined by the commissioner to meet all of 
260.14 	the requirements in the approved federal waiver plans. If a county agency provides case 
260.15 	management under contracts with other individuals or agencies and the county agency 
260.16 	utilizes a competitive proposal process for the procurement of contracted case management 
260.17 	services, the competitive proposal process must include evaluation criteria to ensure that 
260.18 	the county maintains a culturally responsive program for case management services adequate 
260.19 	to meet the needs of the population of the county. For the purposes of this section, "culturally 
260.20 	responsive program" means a case management services program that: (1) ensures effective, 
260.21 	equitable, comprehensive, and respectful quality care services that are responsive to 
260.22 	individuals within a specific population's values, beliefs, practices, health literacy, preferred 
260.23 	language, and other communication needs; and (2) is designed to address the unique needs 
260.24 	of individuals who share a common language or racial, ethnic, or social background.
260.25 	(d) Case management services must not be provided to a recipient by a private agency 
260.26 	that has any financial interest in the provision of any other services included in the recipient's 
260.27 	support plan. For purposes of this section, "private agency" means any agency that is not 
260.28 	identified as a lead agency under section 256B.0911, subdivision 10.
260.29 	(e) For persons who need a positive support transition plan as required in chapter 245D, 
260.30 	the case manager shall participate in the development and ongoing evaluation of the plan 
260.31 	with the expanded support team. At least quarterly, the case manager, in consultation with 
260.32 	the expanded support team, shall evaluate the effectiveness of the plan based on progress 
260.33 	evaluation data submitted by the licensed provider to the case manager. The evaluation must 
261.1 	identify whether the plan has been developed and implemented in a manner to achieve the 
261.2 	following within the required timelines:
261.3 	(1) phasing out the use of prohibited procedures;
261.4 	(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's 
261.5 	timeline; and
261.6 	(3) accomplishment of identified outcomes.
261.7 	If adequate progress is not being made, the case manager shall consult with the person's 
261.8 	expanded support team to identify needed modifications and whether additional professional 
261.9 	support is required to provide consultation.
261.10 	(f) The Department of Human Services shall offer ongoing education in case management 
261.11 	to case managers. Case managers shall receive no less than 20 hours of case management 
261.12 	education and disability-related training each year. The education and training must include 
261.13 	person-centered planning, informed choice, cultural competency, employment planning, 
261.14 	community living planning, self-direction options, and use of technology supports. By 
261.15 	August 1, 2024, all case managers must complete an employment support training course 
261.16 	identified by the commissioner of human services. For case managers hired after August 
261.17 	1, 2024, this training must be completed within the first six months of providing case 
261.18 	management services. For the purposes of this section, "person-centered planning" or 
261.19 	"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case 
261.20 	managers shall document completion of training in a system identified by the commissioner.

261.21 	Sec. 18. DIRECTION TO COMMISSIONER; COMPLIANCE COSTS AND 
261.22 	REIMBURSEMENT RATES.
 261.23 	(a) The commissioner of human services and the commissioner of health must convene 
261.24 	a group of interested parties to examine the relationship between the costs incurred to comply 
261.25 	with the licensing requirements under Minnesota Statutes, chapter 144G, and reimbursement 
261.26 	rates for providing customized living services under Minnesota Statutes, chapter 256S, and 
261.27 	section 256B.4914, subdivision 6d. The commissioners must include among the interested 
261.28 	parties the Long-Term Care Imperative, the Residential Providers Association of Minnesota, 
261.29 	the Minnesota Association of County Social Service Administrators, and people with 
261.30 	disabilities currently receiving customized living services under the federally approved 
261.31 	brain injury, community access for disability inclusion, and elderly waiver plans.
261.32 	(b) The commissioners of human services and health must develop draft legislative 
261.33 	language to better align the licensing requirements and reimbursement framework so that 
262.1 	the costs incurred to comply with licensing requirements and fees are adequately reimbursed 
262.2 	through the rates paid for providing customized living services.
262.3 	(c) The commissioners must submit the draft legislation to the chairs and ranking minority 
262.4 	members of the legislative committees with jurisdiction over health and human services 
262.5 	policy and finance by January 1, 2027.

262.6 	Sec. 19. DIRECTION TO THE COMMISSIONER OF HEALTH; COMMUNITY 
262.7 	CARE HUB GRANT.
 262.8 		Subdivision 1.Establishment. The commissioner of health shall establish a single grant 
262.9 	to expand and strengthen the community care hub model in Minnesota by organizing and 
262.10 	supporting a network of health and social care service providers to address health-related 
262.11 	social needs.
262.12 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
262.13 	meanings given.
262.14 	(b) "Community-based organization" means a public or private nonprofit organization 
262.15 	of demonstrated effectiveness that is representative of a community or significant segments 
262.16 	of a community and provides services that address the social drivers of health, education, 
262.17 	or related services to individuals in the community.
262.18 	(c) "Community care hub" means a nonprofit organization that provides a centralized 
262.19 	administrative and operational interface between health care institutions and a network of 
262.20 	community-based organizations that provide health promotion and social care services.
262.21 	(d) "Health-related social needs" means the individual-level, adverse social conditions 
262.22 	that can negatively impact a person's health or health care, such as poor health literacy, food 
262.23 	insecurity, housing instability, and lack of access to transportation.
262.24 	(e) "Social care services" means culturally informed services to address health-related 
262.25 	social needs and community-informed health promotion programs.
262.26 		Subd. 3.Eligible applicants. To be eligible for the single grant available under this 
262.27 	section, a grant applicant must:
262.28 	(1) be recognized as a selected community care hub by the federal Administration for 
262.29 	Community Living and the Centers for Disease Control and Prevention;
262.30 	(2) be the recipient of the community care hub planning grant under Laws 2024, chapter 
262.31 	127, article 53, section 3, subdivision 2, paragraph (a);
263.1 	(3) hold contracts with health plans within Minnesota that allow the applicant to provide 
263.2 	social care services to a plan's covered member population; and
263.3 	(4) demonstrate active engagement in providing, coordinating, and aiding health care 
263.4 	and social care services at the community level.
263.5 		Subd. 4.Eligible uses. The grantee must use awarded money to:
263.6 	(1) engage and organize community-based organizations to deliver social care services;
263.7 	(2) expand the reach and scope of social care services;
263.8 	(3) centralize administrative functions and operational infrastructure of community care 
263.9 	hubs related to:
263.10 	(i) contracting with health care organizations;
263.11 	(ii) payment operations;
263.12 	(iii) management of referrals, including reporting on the outcome of the services and 
263.13 	the specific help provided;
263.14 	(iv) service delivery fidelity and compliance;
263.15 	(v) quality improvement;
263.16 	(vi) technology;
263.17 	(vii) information security; and
263.18 	(viii) data collection, data analysis, and reporting;
263.19 	(4) create sustainable financial pathways for services that address health-related social 
263.20 	needs throughout the state of Minnesota; and
263.21 	(5) support tracking of the financial pathways and the services provided.
263.22 		Subd. 5.Grantee report. The grantee must report community care hub initiative 
263.23 	outcomes as determined by the commissioner of health to the commissioner on the forms 
263.24 	and according to the timelines established by the commissioner.
263.25 		Subd. 6.Evaluation. The commissioner of health shall design, conduct, and evaluate 
263.26 	the community care hub initiative implemented by the grantee using measures to assess 
263.27 	cost savings, impact, and health impact outcomes.

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

264.1 	Sec. 20. RESIDENTIAL HOSPICE; IVY HOUSE.
 264.2 	(a) Southern Minnesota Crisis Nursery, DBA Ivy House, may apply under Minnesota 
264.3 	Statutes, sections 144A.75 to 144A.756, to be a licensed residential hospice facility as 
264.4 	defined in Minnesota Statutes, section 144A.75, subdivision 13, paragraph (a). Nothing in 
264.5 	this section shall be construed to require the commissioner of health to issue a license to an 
264.6 	applicant that does not meet the licensing requirements under Minnesota Statutes, sections 
264.7 	144A.75 to 144A.756.
264.8 	(b) If Southern Minnesota Crisis Nursery, DBA Ivy House, is issued a residential hospice 
264.9 	facility license under Minnesota Statutes, sections 144A.75 to 144A.756, and meets all 
264.10 	applicable enrollment criteria under Minnesota Statutes, chapter 256B, it may seek 
264.11 	reimbursement for the provision of hospice respite and end-of-life care for children under 
264.12 	Minnesota Statutes, section 256B.0625, subdivision 22a. Nothing in this section shall be 
264.13 	construed to require the commissioner of human services to make payments to any provider 
264.14 	of hospice respite or end-of-life care for children that the provider is not otherwise lawfully 
264.15 	eligible to receive under Minnesota Statutes, chapter 256B.

264.16 	ARTICLE 11
264.17 	MISCELLANEOUS

264.18 	Section 1. Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision 
264.19 	to read:
264.20 		Subd. 44.Implementation of audit recommendations. No later than February 1 each 
264.21 	year following a year in which the Department of Human Services was subject to an audit 
264.22 	under section 3.971, the commissioner must submit to the chairs and ranking minority 
264.23 	members of the legislative committees with fiscal jurisdiction over the Department of Human 
264.24 	Services a report detailing whether the department has implemented any recommendations 
264.25 	identified during the prior five years by the legislative auditor in a financial audit, program 
264.26 	evaluation, or special review. The report must include a specific itemization of 
264.27 	recommendations that have not been implemented during that period, along with the basis 
264.28 	for that decision.

264.29 	Sec. 2. Laws 2023, chapter 61, article 1, section 61, subdivision 4, is amended to read:
264.30 		Subd. 4.Evaluation and report. By December 1, 2024, the commissioner must submit 
264.31 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
264.32 	over human services finance and policy an interim report on the impact and outcomes of 
264.33 	the grants, including the number of grants awarded and the organizations receiving the 
265.1 	grants. The interim report must include any available evidence of how grantees were able 
265.2 	to increase utilization of supported decision making and reduce or avoid more restrictive 
265.3 	forms of decision making such as guardianship and conservatorship. By December 1, 2025
265.4 	2026, the commissioner must submit to the chairs and ranking minority members of the 
265.5 	legislative committees with jurisdiction over human services finance and policy a final 
265.6 	report on the impact and outcomes of the grants, including any updated information from 
265.7 	the interim report and the total number of people served by the grants. The final report must 
265.8 	also detail how the money was used to achieve the requirements in subdivision 3, paragraph 
265.9 	(b).

265.10 	Sec. 3. Laws 2024, chapter 127, article 49, section 9, subdivision 1, is amended to read:
265.11 		Subdivision 1.Establishment; purpose. The Mentally Ill and Dangerous Civil 
265.12 	Commitment Reform Task Force is established to:
265.13 	(1) evaluate current statutes related to mentally ill and dangerous civil commitments 
265.14 	and;
265.15 	(2) evaluate current statutes related to the process by which a former patient may seek 
265.16 	an order to expunge or vacate a prior commitment as mentally ill and dangerous; and
265.17 	(3) develop recommendations to optimize the use of state-operated mental health 
265.18 	resources and increase equitable access and outcomes for patients.

265.19 	Sec. 4. Laws 2024, chapter 127, article 49, section 9, is amended by adding a subdivision 
265.20 	to read:
265.21 		Subd. 7a.Duties; expungements and vacaturs. The task force must:
265.22 	(1) analyze current trends in civil commitments as mentally ill and dangerous, 
265.23 	expungements, and vacaturs, including but not limited to the frequency of expungements 
265.24 	and vacaturs in Minnesota as compared to other jurisdictions;
265.25 	(2) review national practices and criteria for expunging and vacating civil commitments 
265.26 	as mentally ill and dangerous;
265.27 	(3) develop recommended statutory changes necessary to provide clear direction to 
265.28 	former patients who are seeking to file a motion to expunge or vacate a civil commitment 
265.29 	as mentally ill and dangerous;
266.1 	(4) develop recommended statutory changes necessary to provide clear direction, criteria 
266.2 	to apply, and evidentiary standards to the courts when considering a motion from a former 
266.3 	patient to expunge or vacate a civil commitment as mentally ill and dangerous; and
266.4 	(5) develop recommended statutory changes to provide clear direction to former patients 
266.5 	and the courts to address situations in which an individual is civilly committed as mentally 
266.6 	ill and dangerous and is later determined to not have an organic disorder of the brain or a 
266.7 	substantial psychiatric disorder of thought, mood, perception, orientation, or memory.

266.8 	Sec. 5. Laws 2024, chapter 127, article 49, section 9, subdivision 8, is amended to read:
266.9 		Subd. 8.Report required. (a) By August 1, 2025, the task force shall submit to the 
266.10 	chairs and ranking minority members of the legislative committees with jurisdiction over 
266.11 	mentally ill and dangerous civil commitments a written report that includes the outcome of 
266.12 	the duties in subdivision 7, including but not limited to recommended statutory changes.
266.13 	(b) By August 1, 2026, the task force shall submit to the chairs and ranking minority 
266.14 	members of the legislative committees with jurisdiction over civil commitments a written 
266.15 	report that includes the outcome of the duties in subdivision 7a, including but not limited 
266.16 	to recommended statutory changes.

266.17 	Sec. 6. Laws 2024, chapter 127, article 49, section 9, subdivision 9, is amended to read:
266.18 		Subd. 9.Expiration. The task force expires January 1, 2026 2027.

266.19 	ARTICLE 12
266.20 	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS

266.21	Section 1. HUMAN SERVICES APPROPRIATIONS.
 	
266.22 	The sums shown in the columns marked "Appropriations" are appropriated to the 
266.23 	commissioner of human services and for the purposes specified in this article. The 
266.24 	appropriations are from the general fund, or another named fund, and are available for the 
266.25 	fiscal years indicated for each purpose. The figures "2026" and "2027" used in this article 
266.26 	mean that the appropriations listed under them are available for the fiscal year ending June 
266.27 	30, 2026, or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The second 
266.28 	year" is fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.

266.29				APPROPRIATIONS
	
266.30				Available for the Year
	
266.31				Ending June 30
	
266.32					2026
		2027

266.33	Sec. 2. TOTAL APPROPRIATION
	$
	7,779,124,000
	$
	7,976,910,000

267.1	Subdivision 1.Appropriations by Fund

267.2	Appropriations by Fund
	
267.3		2026
	2027
	
267.4	General
	7,777,163,000
	7,974,721,000
	
267.5	Lottery Prize
	1,733,000
	1,733,000
	
267.6
267.7
267.8	State Government 
Special Revenue 
Fund
	228,000
	456,000
	
267.9 	The amounts that may be spent for each 
267.10 	purpose are specified in the following sections 
267.11 	and subdivisions.

267.12	Subd. 2.Information Technology Appropriations
 					
267.13 	(a) IT Appropriations Generally
267.14 	This appropriation includes money for 
267.15 	information technology projects, services, and 
267.16 	support. Funding for information technology 
267.17 	project costs must be incorporated into the 
267.18 	service-level agreement and paid to Minnesota 
267.19 	IT Services by the Department of Human 
267.20 	Services under the rates and mechanism 
267.21 	specified in that agreement.
267.22 	(b) Receipts for Systems Project
267.23 	Appropriations and federal receipts for 
267.24 	information technology systems projects for 
267.25 	MMIS and METS must be deposited in the 
267.26 	state systems account authorized in Minnesota 
267.27 	Statutes, section 256.014. Money appropriated 
267.28 	for information technology projects approved 
267.29 	by the commissioner of Minnesota IT 
267.30 	Services, funded by the legislature, and 
267.31 	approved by the commissioner of management 
267.32 	and budget may be transferred from one 
267.33 	project to another and from development to 
267.34 	operations as the commissioner of human 
267.35 	services deems necessary. Any unexpended 
268.1 	balance in the appropriation for these projects 
268.2 	does not cancel and is available for ongoing 
268.3 	development and operations.

268.4	Sec. 3. CENTRAL OFFICE; OPERATIONS
 	$
	4,309,000
	$
	5,032,000

268.5	Subdivision 1.Budget and Legislative Staff
 					
268.6 	$805,000 in fiscal year 2026 and $955,000 in 
268.7 	fiscal year 2027 are for five additional 
268.8 	full-time budget and legislative staff. The 
268.9 	commissioner must not supplant existing 
268.10 	spending on staff performing budget and 
268.11 	legislative functions and must not supplement 
268.12 	compensation of existing staff performing 
268.13 	budget and legislative functions, but must use 
268.14 	the money appropriated under this subdivision 
268.15 	only to hire additional staff. This subdivision 
268.16 	does not expire.

268.17	Subd. 2.Base Level Adjustment
 					
268.18 	The general fund base for this section is 
268.19 	$3,385,000 in fiscal year 2028 and $3,201,000 
268.20 	in fiscal year 2029.

268.21	Sec. 4. CENTRAL OFFICE; HEALTH CARE
 	$
	1,066,000
	$
	1,349,000
	
268.22 	Single Administrative Structure and 
268.23 	Delivery System Pilot Program
268.24 	$150,000 in fiscal year 2026 and $300,000 in 
268.25 	fiscal year 2027 are for a contract to 
268.26 	implement a web-based single administrative 
268.27 	structure and delivery system for the delivery 
268.28 	of nonemergency medical transportation. The 
268.29 	base for this appropriation is $300,000 in fiscal 
268.30 	year 2028, $300,000 in fiscal year 2029, and 
268.31 	$0 in fiscal year 2030.

268.32
268.33	Sec. 5. CENTRAL OFFICE; AGING AND 
DISABILITY SERVICES
 	$
	13,707,000
	$
	9,216,000

269.1
269.2
269.3	Subdivision 1.Provisional or Transitional 
Approval of Integrated Community Services 
Settings
 					
269.4 	$150,000 in fiscal year 2026 is to develop 
269.5 	draft legislative language to improve the 
269.6 	process for approving integrated community 
269.7 	support settings. This is a onetime 
269.8 	appropriation.

269.9	Subd. 2.Positive Supports Competency Program
 					
269.10 	$1,000,000 in fiscal year 2026 is for the 
269.11 	positive supports competency program. This 
269.12 	is a onetime appropriation and is available 
269.13 	until June 30, 2029.

269.14
269.15	Subd. 3.Cost Reporting Improvement and Direct 
Care Staff Review
 					
269.16 	$150,000 in fiscal year 2026 is to complete a 
269.17 	cost reporting improvement study and direct 
269.18 	care staffing review. This is a onetime 
269.19 	appropriation.

269.20
269.21	Subd. 4.Assisted Living Licensure and Disability 
Waiver Rate Study And Draft Legislation
 					
269.22 	$100,000 in fiscal year 2026 is to complete a 
269.23 	study on assisted living licensure and disability 
269.24 	waiver reimbursement rates and to draft 
269.25 	proposed legislation. This is a onetime 
269.26 	appropriation.

269.27	Subd. 5.Budget and Legislative Analysis
 					
269.28 	$458,000 in fiscal year 2026 and $540,000 in 
269.29 	fiscal year 2027 are for three additional 
269.30 	full-time budget and legislative analysis staff. 
269.31 	The commissioner must not supplant existing 
269.32 	spending on staff performing budget and 
269.33 	legislative analysis functions and must not 
269.34 	supplement compensation of existing staff 
269.35 	performing budget and legislative analysis 
270.1 	functions, but must use the money 
270.2 	appropriated under this subdivision only to 
270.3 	hire additional staff. This subdivision does not 
270.4 	expire.

270.5	Subd. 6.Base Level Adjustment
 					
270.6 	The general fund base for this section is 
270.7 	$7,201,000 in fiscal year 2028 and $5,755,000 
270.8 	in fiscal year 2029.

270.9270.10
	Sec. 6. CENTRAL OFFICE; BEHAVIORAL 
HEALTH
 	$
	(39,000)
	$
	12,000

270.11	Subdivision 1.Fiscal Year 2026 Reduction
 					
270.12 	The reduction in the fiscal year 2026 
270.13 	appropriation in this section is subtracted from 
270.14 	appropriations to the Department of Human 
270.15 	Services for behavioral health administration 
270.16 	made in any other law enacted by the 
270.17 	ninety-fourth legislature during the 2025 
270.18 	legislative session.

270.19
270.20	Subd. 2.Substance Use Disorder Treatment Staff 
Report and Recommendations
 					
270.21 	$100,000 in fiscal year 2026 and $50,000 in 
270.22 	fiscal year 2027 are for a substance use 
270.23 	disorder treatment staff report and 
270.24 	recommendations. This is a onetime 
270.25 	appropriation.

270.26	Subd. 3.Base Level Adjustment
 					
270.27 	The general fund base for this section is 
270.28 	reduced by $38,000 in fiscal year 2028 and 
270.29 	$38,000 in fiscal year 2029.

270.30
270.31	Sec. 7. CENTRAL OFFICE; OFFICE OF 
INSPECTOR GENERAL
 	$
	4,257,000
	$
	5,105,000

270.32	Subdivision 1.Appropriations by Fund

270.33	Appropriations by Fund
	
270.34		2026
	2027
	
271.1	General
	4,029,000
	4,649,000
	
271.2
271.3	State Government 
Special Revenue
	228,000
	456,000

271.4	Subd. 2.Base Level Adjustment
 					
271.5 	The general fund base for this section is 
271.6 	$4,648,000 in fiscal year 2028 and $4,648,000 
271.7 	in fiscal year 2029.

271.8
271.9	Sec. 8. FORECASTED PROGRAMS; 
HOUSING SUPPORT
 	$
	323,000
	$
	323,000

271.10
271.11	Sec. 9. FORECASTED PROGRAMS; 
MEDICAL ASSISTANCE
 	$
	7,445,352,000
	$
	7,703,200,000
	
271.12 	Additional Critical Access Nursing Facility 
271.13 	Funding
271.14 	Up to $5,000,000 in fiscal year 2026 and up 
271.15 	to $10,000,000 in fiscal year 2027 are for 
271.16 	supplemental payments under Minnesota 
271.17 	Statutes, section 256R.47, to designated 
271.18 	critical access nursing facilities. The base for 
271.19 	this appropriation is $17,500,000 in fiscal year 
271.20 	2028, $17,500,000 in fiscal year 2029, and $0 
271.21 	each year thereafter.

271.22
271.23	Sec. 10. FORECASTED PROGRAMS; 
ALTERNATIVE CARE
 	$
	55,694,000
	$
	56,382,000
	
271.24 	Any money allocated to the alternative care 
271.25 	program that is not spent for the purposes 
271.26 	indicated does not cancel but must be 
271.27 	transferred to the medical assistance account.

271.28
271.29	Sec. 11. FORECASTED PROGRAMS; 
BEHAVIORAL HEALTH FUND
 	$
	138,575,000
	$
	122,512,000

271.30
271.31	Sec. 12. GRANT PROGRAMS; CHILD AND 
COMMUNITY SERVICE GRANTS
 	$
	(5,655,000)
	$
	(5,655,000)
	
271.32 	Fiscal Year 2026 and 2027 Reductions
271.33 	The reductions in the fiscal year 2026 and 
271.34 	fiscal year 2027 appropriations in this section 
271.35 	are subtracted from appropriations to the 
272.1 	Department of Human Services for child and 
272.2 	community service grants made in any other 
272.3 	law enacted by the ninety-fourth legislature 
272.4 	during the 2025 legislative session.

272.5
272.6	Sec. 13. GRANT PROGRAMS; OTHER 
LONG-TERM CARE GRANTS
 	$
	2,747,000
	$
	1,925,000
	
272.7 	Home and Community-Based Services 
272.8 	Incentive Pool
272.9 	$2,747,000 in fiscal year 2026 and $1,925,000 
272.10 	in fiscal year 2027 are for the home and 
272.11 	community-based services incentive pool 
272.12 	under Minnesota Statutes, section 256B.0921.

272.13
272.14	Sec. 14. GRANT PROGRAMS; AGING AND 
ADULT SERVICES GRANTS
 	$
	40,804,000
	$
	40,805,000

272.15	Subdivision 1.Age-Friendly Community Grants
 					
272.16 	The base for this appropriation for age-friendly 
272.17 	community grants under Minnesota Statutes, 
272.18 	section 256.9747, subdivision 1, is $882,000 
272.19 	in fiscal year 2028 and $882,000 in fiscal year 
272.20 	2029.

272.21
272.22	Subd. 2.Age-Friendly Technical Assistance 
Grants
 					
272.23 	The base for this appropriation for age-friendly 
272.24 	technical assistance grants under Minnesota 
272.25 	Statutes, section 256.9747, subdivision 2, is 
272.26 	$507,000 in fiscal year 2028 and $507,000 in 
272.27 	fiscal year 2029.

272.28	Subd. 3.Minnesota Board on Aging
 					
272.29 	$788,000 in fiscal year 2026 and $788,000 in 
272.30 	fiscal year 2027 are for the Minnesota Board 
272.31 	on Aging under Minnesota Statutes, section 
272.32 	256.975, to add additional staff positions for 
272.33 	the area agencies on aging contact centers to 
272.34 	support senior LinkAge Line operations.

273.1	Subd. 4.Senior Dining Programs
 					
273.2 	$250,000 in fiscal year 2026 and $250,000 in 
273.3 	fiscal year 2027 are for a competitive grant or 
273.4 	grants to address the unique nutritional needs 
273.5 	of older adults or to operate senior dining 
273.6 	programs. The base for this appropriation is 
273.7 	$400,000 in fiscal year 2028 and $400,000 in 
273.8 	fiscal year 2029.

273.9273.10
	Subd. 5.Long-Term Care Consultation Services 
Grants
 					
273.11 	$1,739,000 in fiscal year 2026 and $1,739,000 
273.12 	in fiscal year 2027 are for grants for long-term 
273.13 	care consultation services under Minnesota 
273.14 	Statutes, section 256B.0911, and long-term 
273.15 	care options counseling under Minnesota 
273.16 	Statutes, section 256.975, subdivision 7.

273.17	Subd. 6.Prescription Drug Assistance Program
 					
273.18 	$1,191,000 in fiscal year 2026 and $1,191,000 
273.19 	in fiscal year 2027 are for a grant to the Board 
273.20 	on Aging for the prescription drug assistance 
273.21 	program under Minnesota Statutes, section 
273.22 	256.975, subdivision 9.

273.23
273.24	Subd. 7.Core Home and Community-Based 
Service Projects
 					
273.25 	$1,585,000 in fiscal year 2026 and $1,585,000 
273.26 	in fiscal year 2027 are for core home and 
273.27 	community-based service projects under 
273.28 	Minnesota Statutes, section 256.9754, 
273.29 	subdivision 3d.

273.30
273.31	Subd. 8.Caregiver Support and Respite Care 
Projects
 					
273.32 	$479,000 in fiscal year 2026 and $479,000 in 
273.33 	fiscal year 2027 are for caregiver support and 
274.1 	respite care projects under Minnesota Statutes, 
274.2 	section 256.9754, subdivision 3c.

274.3
274.4	Subd. 9.Community Services Development 
Grants
 					
274.5 	$2,980,000 in fiscal year 2026 and $2,980,000 
274.6 	in fiscal year 2027 are for community services 
274.7 	development grants under Minnesota Statutes, 
274.8 	section 256.9754, subdivision 3.

274.9	Subd. 10.Community Service Grants
 					
274.10 	$3,128,000 in fiscal year 2026 and $3,128,000 
274.11 	in fiscal year 2027 are for community service 
274.12 	grants under Minnesota Statutes, section 
274.13 	256.9754, subdivision 3e.

274.14
274.15	Subd. 11.Customized Living Quality 
Improvement Grants
 					
274.16 	$1,000,000 in fiscal year 2026 and $1,000,000 
274.17 	in fiscal year 2027 are for customized living 
274.18 	quality improvement grants under Minnesota 
274.19 	Statutes, section 256.479.

274.20	Subd. 12.Regional and Local Dementia Grants
 					
274.21 	$1,000,000 in fiscal year 2026 and $1,000,000 
274.22 	in fiscal year 2027 are for regional and local 
274.23 	dementia grants under Minnesota Statutes, 
274.24 	section 256.975, subdivision 11. The base for 
274.25 	this appropriation is $1,500,000 in fiscal year 
274.26 	2028 and $1,500,000 in fiscal year 2029.

274.27	Subd. 13.Eldercare Development Partnerships
 					
274.28 	$1,758,000 in fiscal year 2026 and $1,758,000 
274.29 	in fiscal year 2027 are for eldercare 
274.30 	development partnerships under Minnesota 
274.31 	Statutes, section 256B.0917, subdivision 1c.

275.1	Subd. 14.Gaps Analysis
 					
275.2 	$218,000 in fiscal year 2026 and $218,000 in 
275.3 	fiscal year 2027 are for analysis of gaps in 
275.4 	long-term care services under Minnesota 
275.5 	Statutes, section 144A.351.

275.6	Subd. 15.Consumer Information and Assistance
 					
275.7 	$3,449,000 in fiscal year 2026 and $3,449,000 
275.8 	in fiscal year 2027 are for a grant to the Board 
275.9 	on Aging to provide information and 
275.10 	assistance services under Minnesota Statutes, 
275.11 	section 256.975, subdivision 7.

275.12	Subd. 16.Minnesota Adult Abuse Reporting
 					
275.13 	$1,819,000 in fiscal year 2026 and $1,819,000 
275.14 	in fiscal year 2027 are for a grant to the 
275.15 	Minnesota Board on Aging to handle all 
275.16 	reports of adult abuse for older adults and 
275.17 	people with disabilities in various care 
275.18 	settings.

275.19	Subd. 17.Return to Community Services
 					
275.20 	$9,341,000 in fiscal year 2026 and $9,341,000 
275.21 	in fiscal year 2027 are for a grant to the Board 
275.22 	on Aging for return to community services 
275.23 	under Minnesota Statutes, section 256.975, 
275.24 	subdivision 7.

275.25	Subd. 18.Preadmission Screening
 					
275.26 	$817,000 in fiscal year 2026 and $817,000 in 
275.27 	fiscal year 2027 are for a grant to the Board 
275.28 	on Aging for preadmission screening under 
275.29 	Minnesota Statutes, section 256.975, 
275.30 	subdivisions 7a to 7d.

275.31	Subd. 19.Direct Support Connect
 					
275.32 	$236,000 in fiscal year 2026 and $236,000 in 
275.33 	fiscal year 2027 are for a grant to the Board 
276.1 	on Aging for activities supporting Direct 
276.2 	Support Connect.

276.3	Subd. 20.Self-Directed Caregiver Grants
 					
276.4 	$477,000 in fiscal year 2026 and $477,000 in 
276.5 	fiscal year 2027 are for self-directed caregiver 
276.6 	grants under Minnesota Statutes, section 
276.7 	256.975, subdivision 12.

276.8	Subd. 21.Senior Nutrition Program
 					
276.9 	$2,695,000 in fiscal year 2026 and $2,695,000 
276.10 	in fiscal year 2027 are for the senior nutrition 
276.11 	program under Minnesota Statutes, section 
276.12 	256.9752. The base for senior nutrition 
276.13 	programs under Minnesota Statutes, section 
276.14 	256.9752, is $2,820,000 in fiscal year 2028 
276.15 	and $2,820,000 in fiscal year 2029.

276.16	Subd. 22.Senior Volunteer Programs
 					
276.17 	$1,988,000 in fiscal year 2026 and $1,988,000 
276.18 	in fiscal year 2027 are for volunteer programs 
276.19 	for retired senior citizens under Minnesota 
276.20 	Statutes, section 256.9753; the foster 
276.21 	grandparents program under Minnesota 
276.22 	Statutes, section 256.976; and the senior 
276.23 	companion program under Minnesota Statutes, 
276.24 	section 256.977.

276.25	Subd. 23.Adult Protection Grants
 					
276.26 	$866,000 in fiscal year 2026 and $867,000 in 
276.27 	fiscal year 2027 are for adult protection grants 
276.28 	to counties and Tribes under Minnesota 
276.29 	Statutes, section 256M.42.

276.30	Subd. 24.Base Level Adjustment
 					
276.31 	The general fund base for this section is 
276.32 	$42,969,000 in fiscal year 2028 and 
276.33 	$42,969,000 in fiscal year 2029.

277.1
277.2	Sec. 15. DEAF, DEAFBLIND, AND HARD OF 
HEARING GRANTS
 	$
	2,886,000
	$
	2,886,000

277.3
277.4	Sec. 16. GRANT PROGRAMS; DISABILITY 
GRANTS
 	$
	67,522,000
	$
	28,293,000

277.5
277.6	Subdivision 1.Self-Directed Bargaining 
Agreement; Orientation Start-Up Funds
 					
277.7 	$3,000,000 in fiscal year 2026 is for 
277.8 	orientation program start-up costs as defined 
277.9 	by the SEIU collective bargaining agreement. 
277.10 	This is a onetime appropriation.

277.11
277.12	Subd. 2.Self-Directed Bargaining Agreement; 
Orientation Ongoing Funds
 					
277.13 	$2,000,000 in fiscal year 2026 and $500,000 
277.14 	in fiscal year 2027 are for ongoing costs 
277.15 	related to the orientation program as defined 
277.16 	by the SEIU collective bargaining agreement.

277.17
277.18	Subd. 3.Self-Directed Bargaining Agreement; 
Training Stipends
 					
277.19 	$2,250,000 in fiscal year 2026 is for onetime 
277.20 	stipends of $750 for collective bargaining unit 
277.21 	members for training. This is a onetime 
277.22 	appropriation.

277.23
277.24	Subd. 4.Self-Directed Bargaining Agreement; 
Retirement Trust Funds
 					
277.25 	$350,000 in fiscal year 2026 is for a vendor 
277.26 	to create a retirement trust, as defined by the 
277.27 	SEIU collective bargaining agreement. This 
277.28 	is a onetime appropriation.

277.29
277.30	Subd. 5.Self-Directed Bargaining Agreement; 
Health Care Stipends
 					
277.31 	$30,750,000 in fiscal year 2026 is for stipends 
277.32 	of $1,200 for each collective bargaining unit 
277.33 	member for retention and defraying any health 
277.34 	insurance costs the member may incur. 
277.35 	Stipends are available once per fiscal year per 
278.1 	member for fiscal year 2026 and fiscal year 
278.2 	2027. Of this amount, $30,000,000 in fiscal 
278.3 	year 2026 is for stipends and $750,000 in 
278.4 	fiscal year 2026 is for administration. This is 
278.5 	a onetime appropriation and is available until 
278.6 	June 30, 2027.

278.7
278.8	Subd. 6.Disability Services Technology And 
Advocacy Expansion Grant
 					
278.9 	(a) $226,000 in fiscal year 2026 and $220,000 
278.10 	in fiscal year 2027 are for the disability 
278.11 	services technology and advocacy expansion 
278.12 	grant under Minnesota Statutes, section 
278.13 	256.4768. The general fund base for this 
278.14 	purpose is $220,000 in fiscal year 2028, 
278.15 	$220,000 in fiscal year 2029, $220,000 in 
278.16 	fiscal year 2030, and $0 in fiscal year 2031.
278.17 	(b) This subdivision expires June 30, 2030.

278.18	Subd. 7.Disability Inclusion Pilot Project
 					
278.19 	(a) $816,000 in fiscal year 2026 is for a 
278.20 	competitive grant for a statewide disability 
278.21 	inclusion pilot project. This is a onetime 
278.22 	appropriation.
278.23 	(b) The pilot project must:
278.24 	(1) persuade employers to diversify their 
278.25 	workforces by hiring people with disabilities;
278.26 	(2) educate businesses on the economic 
278.27 	benefits of inclusive employment and provide 
278.28 	coaching on affordable accommodations;
278.29 	(3) educate Minnesotans with disabilities and 
278.30 	their families on navigating services and 
278.31 	achieving inclusion in both work and 
278.32 	community settings;
279.1 	(4) build capacity and support for culturally 
279.2 	specific services by rural, Black, Indigenous, 
279.3 	or People of Color entrepreneurs;
279.4 	(5) pilot community-requested support 
279.5 	services;
279.6 	(6) invest in safe community-focused spaces 
279.7 	to host trainings and requested support 
279.8 	services; and
279.9 	(7) launch a statewide disability inclusion 
279.10 	assessment for businesses and community 
279.11 	spaces to improve accessibility and inclusion.
279.12 	(c) The pilot project must reach all six 
279.13 	Minnesota planning areas to ensure equal 
279.14 	access to the pilot project activities in rural 
279.15 	and Tribal regions.

279.16
279.17	Subd. 8. Direct Support Professional 
Development
 					
279.18 	(a) $230,000 in fiscal year 2026 is for a 
279.19 	competitive grant to:
279.20 	(1) develop curriculum for a pretraining 
279.21 	program tailored to the educational needs of 
279.22 	potential direct support professionals;
279.23 	(2) provide workforce readiness training for 
279.24 	individuals entering the field of direct care 
279.25 	and support services;
279.26 	(3) expand recruitment efforts to increase 
279.27 	direct support professional workforce capacity, 
279.28 	particularly among diverse and 
279.29 	underrepresented communities; and
279.30 	(4) collaborate with community-based 
279.31 	organizations, educational institutions, and 
279.32 	providers to support the long-term 
280.1 	development of the direct support 
280.2 	professionals workforce.
280.3 	(b) This is a onetime appropriation.

280.4	Subd. 9.Technology for Home Grants
 					
280.5 	$922,000 in fiscal year 2026 and $922,000 in 
280.6 	fiscal year 2027 are for technology for home 
280.7 	grants under Minnesota Statutes, section 
280.8 	256.4773.

280.9280.10
	Subd. 10.Self-Advocacy Grants for Persons with 
Intellectual and Developmental Disabilities
 					
280.11 	$248,000 in fiscal year 2026 and $248,000 in 
280.12 	fiscal year 2027 are for self-advocacy grants 
280.13 	under Minnesota Statutes, section 256.477. 
280.14 	Of these amounts:
280.15 	(1) $143,000 in fiscal year 2026 and $143,000 
280.16 	in fiscal year 2027 are for the activities under 
280.17 	Minnesota Statutes, section 256.477, 
280.18 	subdivision 1, paragraph (a), and for 
280.19 	administrative costs associated with those 
280.20 	activities incurred by the grantee; and
280.21 	(2) $105,000 in fiscal year 2026 and $105,000 
280.22 	in fiscal year 2027 are for the activities under 
280.23 	Minnesota Statutes, section 256.477, 
280.24 	subdivision 2.

280.25	Subd. 11.Case Management Training Grants
 					
280.26 	$45,000 in fiscal year 2026 and $45,000 in 
280.27 	fiscal year 2027 are for grants to provide case 
280.28 	management training to organizations and 
280.29 	employers to support the state's disability 
280.30 	employment supports system.

281.1	Subd. 12.Family Support Program
 					
281.2 	$9,423,000 in fiscal year 2026 and $9,096,000 
281.3 	in fiscal year 2027 are for support grants under 
281.4 	Minnesota Statutes, section 252.32.

281.5	Subd. 13.Disability Hub for Families Grants
 					
281.6 	$200,000 in fiscal year 2026 and $200,000 in 
281.7 	fiscal year 2027 are for grants under Laws 
281.8 	2019, First Special Session chapter 9, article 
281.9 	14, section 2, subdivision 29, paragraph (e), 
281.10 	to connect families through innovation grants, 
281.11 	life planning tools, and website information 
281.12 	as they support a child or family member with 
281.13 	disabilities.

281.14	Subd. 14.Disability Hub
 					
281.15 	$1,716,000 in fiscal year 2026 and $2,041,000 
281.16 	in fiscal year 2027 are for the Disability Hub 
281.17 	under Minnesota Statutes, section 256.01, 
281.18 	subdivision 24.

281.19
281.20	Subd. 15.Minnesota Aging and Disability 
Resource Center
 					
281.21 	$900,000 in fiscal year 2026 and $900,000 in 
281.22 	fiscal year 2027 are for grants under 
281.23 	Minnesota Statutes, section 256.01, 
281.24 	subdivision 2, paragraph (z), to support the 
281.25 	Minnesota Aging and Disability Resource 
281.26 	Center.

281.27
281.28	Subd. 16.Day Training and Habilitation Facility 
Grants
 					
281.29 	$811,000 in fiscal year 2026 and $811,000 in 
281.30 	fiscal year 2027 are for grant allocations to 
281.31 	counties for day training and habilitation 
281.32 	services for adults with developmental 
281.33 	disabilities when provided as a social service 
282.1 	under Minnesota Statutes, sections 252.41 to 
282.2 	252.46.

282.3
282.4	Subd. 17.Employment and Technical Assistance 
Center Grants
 					
282.5 	$450,000 in fiscal year 2026 and $1,800,000 
282.6 	in fiscal year 2027 are for employment and 
282.7 	technical assistance grants to assist 
282.8 	organizations and employers in promoting a 
282.9 	more inclusive workplace for people with 
282.10 	disabilities.

282.11	Subd. 18.Grant to Family Voices in Minnesota
 					
282.12 	$75,000 in fiscal year 2026 and $75,000 in 
282.13 	fiscal year 2027 are for a grant to Family 
282.14 	Voices in Minnesota under Minnesota 
282.15 	Statutes, section 256.4776.

282.16
282.17	Subd. 19.Intractable Epilepsy Demonstration 
Project
 					
282.18 	$344,000 in fiscal year 2026 and $344,000 in 
282.19 	fiscal year 2027 are for the demonstration 
282.20 	project established under Laws 1988, chapter 
282.21 	689, article 2, section 251, and a grant to a 
282.22 	nonresidential program that provides medical 
282.23 	monitoring and living skills training programs 
282.24 	for persons with intractable epilepsy who need 
282.25 	assistance in the transition to independent 
282.26 	living. The grant awarded under this section 
282.27 	must be used for salaries, administration, 
282.28 	transportation, and other program costs.

282.29
282.30	Subd. 20.Lead Agency Capacity-Building 
Grants
 					
282.31 	$2,413,000 in fiscal year 2026 and $2,411,000 
282.32 	in fiscal year 2027 are for grants to assist 
282.33 	organizations, counties, and Tribes to build 
282.34 	capacity for employment opportunities for 
282.35 	people with disabilities.

283.1	Subd. 21.Minnesota Inclusion Initiative Grants
 					
283.2 	$150,000 in fiscal year 2026 and $150,000 in 
283.3 	fiscal year 2027 are from the general fund for 
283.4 	grants under Minnesota Statutes, section 
283.5 	256.4772.

283.6	Subd. 22.MnCHOICES Modifications
 					
283.7 	$450,000 in fiscal year 2026 and $125,000 in 
283.8 	fiscal year 2027 are for enhancements to the 
283.9 	MnCHOICES assessment tool to provide 
283.10 	real-time employment information, 
283.11 	communication, and resources, supporting 
283.12 	individuals and professionals in improving 
283.13 	education, engagement, and access to 
283.14 	employment opportunities.

283.15	Subd. 23.Parent-to-Parent USA Peer Support
 					
283.16 	$125,000 in fiscal year 2026 and $125,000 in 
283.17 	fiscal year 2027 are for a grant to an alliance 
283.18 	member of Parent-to-Parent USA under 
283.19 	Minnesota Statutes, section 256.4776.

283.20
283.21
283.22	Subd. 24.Preadmission Screening and Resident 
Reviews for Persons with Mental Illness or 
Developmental Disabilities
 					
283.23 	$20,000 in fiscal year 2026 and $20,000 in 
283.24 	fiscal year 2027 are for reimbursement to 
283.25 	counties for costs associated with completing 
283.26 	federally required preadmission screening and 
283.27 	resident reviews of nursing home applicants 
283.28 	or residents with a probable mental illness or 
283.29 	a developmental disability.

283.30
283.31	Subd. 25.Regional Support for Person-Centered 
Practices Grants
 					
283.32 	$710,000 in fiscal year 2026 and $710,000 in 
283.33 	fiscal year 2027 are for grants to regional 
283.34 	cohorts to extend and expand regional capacity 
284.1 	for person-centered planning through training, 
284.2 	coaching, and mentoring for person-centered 
284.3 	and collaborative safety practices benefiting 
284.4 	people with disabilities and employees, 
284.5 	organizations, and communities serving people 
284.6 	with disabilities.

284.7	Subd. 26.Region 10 Grants
 					
284.8 	$100,000 in fiscal year 2026 and $100,000 in 
284.9 	fiscal year 2027 are for a grant provided under 
284.10 	Minnesota Statutes, section 256B.097.

284.11
284.12	Subd. 27.Semi-Independent Living Services 
Grants
 					
284.13 	$7,229,000 in fiscal year 2026 and $7,229,000 
284.14 	in fiscal year 2027 are for semi-independent 
284.15 	living services grants under Minnesota 
284.16 	Statutes, section 252.275.

284.17
284.18	Subd. 28.Case Management Supportive Services 
for People Living with HIV/AIDS
 					
284.19 	$1,156,000 in fiscal year 2026 and $1,156,000 
284.20 	in fiscal year 2027 are for grants to 
284.21 	community-based HIV/AIDS supportive 
284.22 	services providers as defined in Minnesota 
284.23 	Statutes, section 256.01, subdivision 19.

284.24
284.25	Subd. 29.Health Care Coverage for People 
Living with HIV/AIDS
 					
284.26 	$1,064,000 in fiscal year 2026 and $1,064,000 
284.27 	in fiscal year 2027 are for payment of allowed 
284.28 	health care costs under Minnesota Statutes, 
284.29 	section 256.9365.

284.30	Subd. 30.State Quality Council
 					
284.31 	$600,000 in fiscal year 2026 and $600,000 in 
284.32 	fiscal year 2027 are for the State Quality 
284.33 	Council under Minnesota Statutes, section 
284.34 	256B.097, to provide technical assistance and 
285.1 	monitoring of person-centered outcomes 
285.2 	related to inclusive community living and 
285.3 	employment. The funding must be used by the 
285.4 	State Quality Council to execute a statewide 
285.5 	plan for a systems change in person-centered 
285.6 	planning that will achieve desired outcomes, 
285.7 	including increased integrated employment 
285.8 	and community living.

285.9	Subd. 31.Transition to Community Initiative
 					
285.10 	$1,811,000 in fiscal year 2026 and $1,811,000 
285.11 	in fiscal year 2027 are for the transition to 
285.12 	community initiative under Minnesota 
285.13 	Statutes, section 256.478.

285.14
285.15	Subd. 32.Self-Directed Bargaining Agreement; 
Training Stipends; Allocation Correction
 					
285.16 	$87,000 in fiscal year 2026 and $87,000 in 
285.17 	fiscal year 2027 are to correct a funding 
285.18 	allocation mistake for stipends for collective 
285.19 	bargaining unit members initially appropriated 
285.20 	under Laws 2017, First Special Session 
285.21 	chapter 6, article 18, section 2, subdivision 15, 
285.22 	paragraph (b), clause (2).

285.23	Subd. 33.Base Level Adjustments
 					
285.24 	The general fund base for this section is 
285.25 	$28,293,000 in fiscal year 2028 and 
285.26 	$28,293,000 in fiscal year 2029.

285.27
285.28	Sec. 17. GRANT PROGRAMS; HOUSING 
SUPPORT GRANTS
 	$
	450,000
	$
	450,000
	
285.29 	Minnesota Homeless Study
285.30 	$450,000 in fiscal year 2026 and $450,000 in 
285.31 	fiscal year 2027 are for the Minnesota 
285.32 	homeless study under Minnesota Statutes, 
285.33 	section 256.4751.

286.1
286.2	Sec. 18. GRANT PROGRAMS; ADULT 
MENTAL HEALTH GRANTS
 	$
	1,300,000
	$
	250,000

286.3
286.4	Subdivision 1.Health Services and Support 
Grants
 					
286.5 	$1,300,000 in fiscal year 2026 and $250,000 
286.6 	in fiscal year 2027 are for competitive grants 
286.7 	to provide health services and supports to 
286.8 	communities that are underserved due to 
286.9 	language or demographic barriers. The 
286.10 	amounts appropriated in fiscal years 2026 and 
286.11 	2027 are available until June 30, 2029. The 
286.12 	base for this appropriation is $500,000 in fiscal 
286.13 	year 2028 and $500,000 in fiscal year 2029.

286.14	Subd. 2.Base Level Adjustments
 					
286.15 	The general fund base for this section is 
286.16 	$500,000 in fiscal year 2028 and $500,000 in 
286.17 	fiscal year 2029.

286.18
286.19
286.20	Sec. 19. GRANT PROGRAMS; CHEMICAL 
DEPENDENCY TREATMENT SUPPORT 
GRANTS
 	$
	5,826,000
	$
	4,825,000

286.21	Subdivision 1.Appropriations by Fund

286.22	Appropriations by Fund
	
286.23		2026
	2027
	
286.24	General
	4,093,000
	3,092,000
	
286.25	Lottery Prize
	1,733,000
	1,733,000

286.26	Subd. 2.Problem Gambling
 					
286.27 	$225,000 in fiscal year 2026 and $225,000 in 
286.28 	fiscal year 2027 are from the lottery prize fund 
286.29 	for a grant to a state affiliate recognized by 
286.30 	the National Council on Problem Gambling. 
286.31 	The affiliate must provide services to increase 
286.32 	public awareness of problem gambling, 
286.33 	education, training for individuals and 
286.34 	organizations that provide effective treatment 
286.35 	services to problem gamblers and their 
287.1 	families, and research related to problem 
287.2 	gambling.

287.3	Subd. 3. Recovery Community Grants
 					
287.4 	$1,475,000 in fiscal year 2026 and $775,000 
287.5 	in fiscal year 2027 are from the general fund 
287.6 	for competitive grants to recovery community 
287.7 	organizations serving underserved 
287.8 	communities or geographic locations.

287.9	Subd. 4. Suicide Prevention Grants
 					
287.10 	$435,000 in fiscal year 2026 and $434,000 in 
287.11 	fiscal year 2027 are from the general fund for 
287.12 	a competitive grant for activities designed to 
287.13 	enhance culturally relevant services and 
287.14 	resources for Minnesota's African immigrant 
287.15 	refugee community related to mental health, 
287.16 	substance use disorder, and suicide prevention. 
287.17 	Grant money may also be used to address the 
287.18 	physical and mental wellness needs of the 
287.19 	elderly and mental health support and suicide 
287.20 	prevention for underrepresented students in 
287.21 	higher education. This is a onetime 
287.22 	appropriation and is available until June 30, 
287.23 	2027.

287.24	Subd. 5.Peer Specialists
 					
287.25 	$300,000 in fiscal year 2026 is for peer 
287.26 	specialists grants first established under Laws 
287.27 	2016, chapter 189, article 23, section 2, 
287.28 	subdivision 4, paragraph (f). This is a onetime 
287.29 	appropriation.

287.30	Subd. 6.American Indian Programs
 					
287.31 	$1,397,000 in fiscal year 2026 and $1,397,000 
287.32 	in fiscal year 2027 are from the general fund 
287.33 	for the American Indian programs under 
288.1 	Minnesota Statutes, section 254A.03, 
288.2 	subdivision 2.

288.3	Subd. 7.Methamphetamine Treatment Grant
 					
288.4 	$125,000 in fiscal year 2026 and $125,000 in 
288.5 	fiscal year 2027 are from the general fund for 
288.6 	a grant to a nonprofit organization to treat 
288.7 	methamphetamine abuse and the abuse of 
288.8 	other substances. The focus audience is 
288.9 	women with dependent children identified as 
288.10 	substance abusers, especially those whose 
288.11 	most-used controlled substance is 
288.12 	methamphetamine.

288.13	Subd. 8.Base Level Adjustment
 					
288.14 	The general fund base for this section is 
288.15 	$2,658,000 in fiscal year 2028 and $2,658,000 
288.16 	in fiscal year 2029.

288.17 	Sec. 20. Laws 2023, chapter 61, article 9, section 2, subdivision 13, is amended to read:

288.18
288.19	Subd. 13.Grant Programs; Other Long-Term 
Care Grants
 		152,387,000
		1,925,000
	
288.20 	(a) Provider Capacity Grant for Rural and 
288.21 	Underserved Communities. $17,148,000 in 
288.22 	fiscal year 2024 is for provider capacity grants 
288.23 	for rural and underserved communities. 
288.24 	Notwithstanding Minnesota Statutes, section 
288.25 	16A.28, this appropriation is available until 
288.26 	June 30, 2027. This is a onetime appropriation.
288.27 	(b) New American Legal, Social Services, 
288.28 	and Long-Term Care Grant Program.
288.29 	$28,316,000 in fiscal year 2024 is for 
288.30 	long-term care workforce grants for new 
288.31 	Americans. Notwithstanding Minnesota 
288.32 	Statutes, section 16A.28, this appropriation is 
289.1 	available until June 30, 2027. This is a onetime 
289.2 	appropriation.
289.3 	(c) Supported Decision Making Programs.
289.4 	$4,000,000 in fiscal year 2024 is for supported 
289.5 	decision making grants. This is a onetime 
289.6 	appropriation and is available until June 30, 
289.7 	2025 2026.
289.8 	(d) Direct Support Professionals 
289.9 	Employee-Owned Cooperative Program.
289.10 	$350,000 in fiscal year 2024 is for a grant to 
289.11 	the Metropolitan Consortium of Community 
289.12 	Developers for the Direct Support 
289.13 	Professionals Employee-Owned Cooperative 
289.14 	program. The grantee must use the grant 
289.15 	amount for outreach and engagement, 
289.16 	managing a screening and selection process, 
289.17 	providing one-on-one technical assistance, 
289.18 	developing and providing training curricula 
289.19 	related to cooperative development and home 
289.20 	and community-based waiver services, 
289.21 	administration, reporting, and program 
289.22 	evaluation. This is a onetime appropriation 
289.23 	and is available until June 30, 2025.
289.24 	(e) Long-Term Services and Supports 
289.25 	Workforce Incentive Grants. $83,560,000 
289.26 	in fiscal year 2024 is for long-term services 
289.27 	and supports workforce incentive grants 
289.28 	administered according to Minnesota Statutes, 
289.29 	section 256.4764. Notwithstanding Minnesota 
289.30 	Statutes, section 16A.28, this appropriation is 
289.31 	available until June 30, 2029. This is a onetime 
289.32 	appropriation.
289.33 	(f) Base Level Adjustment. The general fund 
289.34 	base is $3,949,000 in fiscal year 2026 and 
289.35 	$3,949,000 in fiscal year 2027. Of these 
290.1 	amounts, $2,024,000 in fiscal year 2026 and 
290.2 	$2,024,000 in fiscal year 2027 are for PCA 
290.3 	background study grants.

290.4 	Sec. 21. Laws 2023, chapter 61, article 9, section 2, subdivision 16, as amended by Laws 
290.5 	2023, chapter 70, article 15, section 8, and Laws 2024, chapter 125, article 8, section 14, is 
290.6 	amended to read:

290.7	Subd. 16.Grant Programs; Disabilities Grants
 		113,684,000
		30,377,000
	
290.8 	(a) Temporary Grants for Small 
290.9 	Customized Living Providers. $5,450,000 
290.10 	in fiscal year 2024 is for grants to assist small 
290.11 	customized living providers to transition to 
290.12 	community residential services licensure or 
290.13 	integrated community supports licensure. 
290.14 	Notwithstanding Minnesota Statutes, section 
290.15 	16A.28, this appropriation is available until 
290.16 	June 30, 2027. This is a onetime appropriation.
290.17 	(b) Lead Agency Capacity Building Grants.
290.18 	$444,000 in fiscal year 2024 and $2,396,000 
290.19 	in fiscal year 2025 are for grants to assist 
290.20 	organizations, counties, and Tribes to build 
290.21 	capacity for employment opportunities for 
290.22 	people with disabilities. The base for this 
290.23 	appropriation is $2,413,000 in fiscal year 2026 
290.24 	and $2,411,000 in fiscal year 2027.
290.25 	(c) Employment and Technical Assistance 
290.26 	Center Grants. $450,000 in fiscal year 2024 
290.27 	and $1,800,000 in fiscal year 2025 are for 
290.28 	employment and technical assistance grants 
290.29 	to assist organizations and employers in 
290.30 	promoting a more inclusive workplace for 
290.31 	people with disabilities.
290.32 	(d) Case Management Training Grants.
290.33 	$37,000 in fiscal year 2024 and $123,000 in 
290.34 	fiscal year 2025 are for grants to provide case 
291.1 	management training to organizations and 
291.2 	employers to support the state's disability 
291.3 	employment supports system. The base for 
291.4 	this appropriation is $45,000 in fiscal year 
291.5 	2026 and $45,000 in fiscal year 2027.
291.6 	(e) Self-Directed Bargaining Agreement; 
291.7 	Electronic Visit Verification Stipends.
291.8 	$6,095,000 in fiscal year 2024 is for onetime 
291.9 	stipends of $200 to bargaining members to 
291.10 	offset the potential costs related to people 
291.11 	using individual devices to access the 
291.12 	electronic visit verification system. Of this 
291.13 	amount, $5,600,000 is for stipends and 
291.14 	$495,000 is for administration. This is a 
291.15 	onetime appropriation and is available until 
291.16 	June 30, 2025.
291.17 	(f) Self-Directed Collective Bargaining 
291.18 	Agreement; Temporary Rate Increase 
291.19 	Memorandum of Understanding. $1,600,000 
291.20 	in fiscal year 2024 is for onetime stipends for 
291.21 	individual providers covered by the SEIU 
291.22 	collective bargaining agreement based on the 
291.23 	memorandum of understanding related to the 
291.24 	temporary rate increase in effect between 
291.25 	December 1, 2020, and February 7, 2021. Of 
291.26 	this amount, $1,400,000 of the appropriation 
291.27 	is for stipends and $200,000 is for 
291.28 	administration. This is a onetime 
291.29 	appropriation.
291.30 	(g) Self-Directed Collective Bargaining 
291.31 	Agreement; Retention Bonuses. $50,750,000 
291.32 	in fiscal year 2024 is for onetime retention 
291.33 	bonuses covered by the SEIU collective 
291.34 	bargaining agreement. Of this amount, 
291.35 	$50,000,000 is for retention bonuses and 
292.1 	$750,000 is for administration of the bonuses. 
292.2 	This is a onetime appropriation and is 
292.3 	available until June 30, 2025.
292.4 	(h) Self-Directed Bargaining Agreement; 
292.5 	Training Stipends. $2,100,000 in fiscal year 
292.6 	2024 and $100,000 in fiscal year 2025 are for 
292.7 	onetime stipends of $500 for collective 
292.8 	bargaining unit members who complete 
292.9 	designated, voluntary trainings made available 
292.10 	through or recommended by the State Provider 
292.11 	Cooperation Committee. Of this amount, 
292.12 	$2,000,000 in fiscal year 2024 is for stipends, 
292.13 	and $100,000 in fiscal year 2024 and $100,000 
292.14 	in fiscal year 2025 are for administration. This 
292.15 	is a onetime appropriation.
292.16 	(i) Self-Directed Bargaining Agreement; 
292.17 	Orientation Program. $2,000,000 in fiscal 
292.18 	year 2024 and $2,000,000 in fiscal year 2025 
292.19 	are for onetime $100 payments to collective 
292.20 	bargaining unit members who complete 
292.21 	voluntary orientation requirements. Of this 
292.22 	amount, $1,500,000 in fiscal year 2024 and 
292.23 	$1,500,000 in fiscal year 2025 are for the 
292.24 	onetime $100 payments, and $500,000 in 
292.25 	fiscal year 2024 and $500,000 in fiscal year 
292.26 	2025 are for orientation-related costs. This is 
292.27 	a onetime appropriation.
292.28 	(j) Self-Directed Bargaining Agreement; 
292.29 	Home Care Orientation Trust. $1,000,000 
292.30 	in fiscal year 2024 is for the Home Care 
292.31 	Orientation Trust under Minnesota Statutes, 
292.32 	section 179A.54, subdivision 11. The 
292.33 	commissioner shall disburse the appropriation 
292.34 	to the board of trustees of the Home Care 
292.35 	Orientation Trust for deposit into an account 
293.1 	designated by the board of trustees outside the 
293.2 	state treasury and state's accounting system. 
293.3 	This is a onetime appropriation and is 
293.4 	available until June 30, 2025.
293.5 	(k) HIV/AIDS Supportive Services.
293.6 	$12,100,000 in fiscal year 2024 is for grants 
293.7 	to community-based HIV/AIDS supportive 
293.8 	services providers as defined in Minnesota 
293.9 	Statutes, section 256.01, subdivision 19, and 
293.10 	for payment of allowed health care costs as 
293.11 	defined in Minnesota Statutes, section 
293.12 	256.9365. This is a onetime appropriation and 
293.13 	is available until June 30, 2025.
293.14 	(l) Motion Analysis Advancements Clinical 
293.15 	Study and Patient Care. $400,000 is in fiscal 
293.16 	year 2024 is for a grant to the Mayo Clinic 
293.17 	Motion Analysis Laboratory and Limb Lab 
293.18 	for continued research in motion analysis 
293.19 	advancements and patient care. This is a 
293.20 	onetime appropriation and is available through 
293.21 	June 30, 2025 2027.
293.22 	(m) Grant to Family Voices in Minnesota.
293.23 	$75,000 in fiscal year 2024 and $75,000 in 
293.24 	fiscal year 2025 are for a grant to Family 
293.25 	Voices in Minnesota under Minnesota 
293.26 	Statutes, section 256.4776.
293.27 	(n) Parent-to-Parent Programs.
293.28 	(1) $550,000 in fiscal year 2024 and $550,000 
293.29 	in fiscal year 2025 are for grants to 
293.30 	organizations that provide services to 
293.31 	underserved communities with a high 
293.32 	prevalence of autism spectrum disorder. This 
293.33 	is a onetime appropriation and is available 
293.34 	until June 30, 2025.
294.1 	(2) The commissioner shall give priority to 
294.2 	organizations that provide culturally specific 
294.3 	and culturally responsive services.
294.4 	(3) Eligible organizations must:
294.5 	(i) conduct outreach and provide support to 
294.6 	newly identified parents or guardians of a child 
294.7 	with special health care needs;
294.8 	(ii) provide training to educate parents and 
294.9 	guardians in ways to support their child and 
294.10 	navigate the health, education, and human 
294.11 	services systems;
294.12 	(iii) facilitate ongoing peer support for parents 
294.13 	and guardians from trained volunteer support 
294.14 	parents; and
294.15 	(iv) communicate regularly with other 
294.16 	parent-to-parent programs and national 
294.17 	organizations to ensure that best practices are 
294.18 	implemented.
294.19 	(4) Grant recipients must use grant money for 
294.20 	the activities identified in clause (3).
294.21 	(5) For purposes of this paragraph, "special 
294.22 	health care needs" means disabilities, chronic 
294.23 	illnesses or conditions, health-related 
294.24 	educational or behavioral problems, or the risk 
294.25 	of developing disabilities, illnesses, conditions, 
294.26 	or problems.
294.27 	(6) Each grant recipient must report to the 
294.28 	commissioner of human services annually by 
294.29 	January 15 with measurable outcomes from 
294.30 	programs and services funded by this 
294.31 	appropriation the previous year including the 
294.32 	number of families served and the number of 
295.1 	volunteer support parents trained by the 
295.2 	organization's parent-to-parent program.
295.3 	(o) Self-Advocacy Grants for Persons with 
295.4 	Intellectual and Developmental Disabilities.
295.5 	$323,000 in fiscal year 2024 and $323,000 in 
295.6 	fiscal year 2025 are for self-advocacy grants 
295.7 	under Minnesota Statutes, section 256.477. 
295.8 	This is a onetime appropriation. Of these 
295.9 	amounts, $218,000 in fiscal year 2024 and 
295.10 	$218,000 in fiscal year 2025 are for the 
295.11 	activities under Minnesota Statutes, section 
295.12 	256.477, subdivision 1, paragraph (a), clauses 
295.13 	(5) to (7), and for administrative costs, and 
295.14 	$105,000 in fiscal year 2024 and $105,000 in 
295.15 	fiscal year 2025 are for the activities under 
295.16 	Minnesota Statutes, section 256.477, 
295.17 	subdivision 2.
295.18 	(p) Technology for Home Grants. $300,000 
295.19 	in fiscal year 2024 and $300,000 in fiscal year 
295.20 	2025 are for technology for home grants under 
295.21 	Minnesota Statutes, section 256.4773.
295.22 	(q) Community Residential Setting 
295.23 	Transition. $500,000 in fiscal year 2024 is 
295.24 	for a grant to Hennepin County to expedite 
295.25 	approval of community residential setting 
295.26 	licenses subject to the corporate foster care 
295.27 	moratorium exception under Minnesota 
295.28 	Statutes, section 245A.03, subdivision 7, 
295.29 	paragraph (a), clause (5).
295.30 	(r) Base Level Adjustment. The general fund 
295.31 	base is $27,343,000 in fiscal year 2026 and 
295.32 	$27,016,000 in fiscal year 2027.

296.1 	Sec. 22. Laws 2024, chapter 127, article 53, section 2, subdivision 13, is amended to read:

296.2
296.3	Subd. 13.Grant Programs; Aging and Adult 
Services Grants
 		-0-
		4,500,000
	
296.4 	(a) Caregiver Respite Services Grants.
296.5 	$2,000,000 in fiscal year 2025 is for caregiver 
296.6 	respite services grants under Minnesota 
296.7 	Statutes, section 256.9756. This is a onetime 
296.8 	appropriation. Notwithstanding Minnesota 
296.9 	Statutes, section 16A.28, subdivision 3, this 
296.10 	appropriation is available until June 30, 2027.
296.11 	(b) Caregiver Support Programs.
296.12 	$2,500,000 in fiscal year 2025 is for the 
296.13 	Minnesota Board on Aging for the purposes 
296.14 	of the caregiver support programs under 
296.15 	Minnesota Statutes, section 256.9755. 
296.16 	Programs receiving funding under this 
296.17 	paragraph must include an ALS-specific 
296.18 	respite service in their caregiver support 
296.19 	program. This is a onetime appropriation. 
296.20 	Notwithstanding Minnesota Statutes, section 
296.21 	16A.28, subdivision 3, this appropriation is 
296.22 	available until June 30, 2027 2028.

296.23 	Sec. 23. Laws 2024, chapter 127, article 53, section 2, subdivision 15, is amended to read:

296.24
296.25	Subd. 15.Grant Programs; Adult Mental Health 
Grants
 		(8,900,000)
		2,364,000
	
296.26 	(a) Locked Intensive Residential Treatment 
296.27 	Services. $1,000,000 in fiscal year 2025 is for 
296.28 	start-up funds to intensive residential treatment 
296.29 	services providers to provide treatment in 
296.30 	locked facilities for patients meeting medical 
296.31 	necessity criteria and who may also be referred 
296.32 	for competency attainment or a competency 
296.33 	examination under Minnesota Statutes, 
296.34 	sections 611.40 to 611.59. This is a onetime 
297.1 	appropriation. Notwithstanding Minnesota 
297.2 	Statutes, section 16A.28, subdivision 3, this 
297.3 	appropriation is available until June 30, 2027.
297.4 	(b) Engagement Services Pilot Grants.
297.5 	$1,500,000 in fiscal year 2025 is for 
297.6 	engagement services pilot grants. Of this 
297.7 	amount, $250,000 in fiscal year 2025 is for an 
297.8 	engagement services pilot grant to Otter Tail 
297.9 	County. This is a onetime appropriation. 
297.10 	Notwithstanding Minnesota Statutes, section 
297.11 	16A.28, subdivision 3, this appropriation is 
297.12 	available until June 30, 2026 2028.
297.13 	(c) Mental Health Innovation Grant 
297.14 	Program. $1,321,000 in fiscal year 2025 is 
297.15 	for the mental health innovation grant program 
297.16 	under Minnesota Statutes, section 245.4662. 
297.17 	This is a onetime appropriation. 
297.18 	Notwithstanding Minnesota Statutes, section 
297.19 	16A.28, subdivision 3, this appropriation is 
297.20 	available until June 30, 2026.
297.21 	(d) Behavioral Health Services For 
297.22 	Immigrant And Refugee Communities.
297.23 	$354,000 in fiscal year 2025 is for a payment 
297.24 	to African Immigrant Community Services to 
297.25 	provide culturally and linguistically 
297.26 	appropriate services to new Americans with 
297.27 	disabilities, mental health needs, and substance 
297.28 	use disorders and to connect such individuals 
297.29 	with appropriate alternative service providers 
297.30 	to ensure continuity of care. This is a onetime 
297.31 	appropriation. Notwithstanding Minnesota 
297.32 	Statutes, section 16A.28, subdivision 3, this 
297.33 	appropriation is available until June 30, 2027.
297.34 	(e) Base Level Adjustment. The general fund 
297.35 	base is decreased by $1,811,000 in fiscal year 
298.1 	2026 and decreased by $1,811,000 in fiscal 
298.2 	year 2027.

298.3 	Sec. 24. TRANSFERS AND GRANT CANCELLATIONS AND ELIMINATIONS.
 298.4 		Subdivision 1.Local planning grant elimination. The fiscal year 2026 and fiscal year 
298.5 	2027 general fund base appropriations for local planning grants for creating alternatives to 
298.6 	congregate living for individuals with lower needs first established under Laws 2011, First 
298.7 	Special Session chapter 9, article 10, section 3, subdivision 4, paragraph (k), are reduced 
298.8 	from $254,000 to $0.
298.9 		Subd. 2.Chemical dependency peer specialists grant elimination. The fiscal year 
298.10 	2027 general fund base appropriation for grants for peer specialists first established under 
298.11 	Laws 2016, chapter 189, article 23, section 2, subdivision 4, paragraph (f), is reduced from 
298.12 	$725,000 to $0.
298.13 		Subd. 3.Community residential setting transitional grant cancellation. Any 
298.14 	unencumbered and unexpended amount of the fiscal year 2024 appropriation in Laws 2023, 
298.15 	chapter 61, article 9, section 2, subdivision 16, paragraph (a), for grants to assist small 
298.16 	customized living providers to transition to community residential services licensure or 
298.17 	integrated community supports licensure, estimated to be $5,450,000, is canceled.
298.18 		Subd. 4.Retention bonus cancellation. Any unencumbered and unexpended amount 
298.19 	of the fiscal year 2024 appropriation in Laws 2023, chapter 61, article 9, section 2, 
298.20 	subdivision 16, paragraph (g), for retention bonuses, estimated to be $27,000,000, is canceled.
298.21 		Subd. 5.Orientation payments cancellation. Any unencumbered and unexpended 
298.22 	amount of the fiscal year 2024 appropriation referenced in Laws 2023, chapter 61, article 
298.23 	9, section 2, subdivision 16, paragraph (i), for orientation payments, estimated to be 
298.24 	$1,830,000, is canceled.
298.25 		Subd. 6.Safe recovery site grant cancellation. Any unencumbered and unexpended 
298.26 	amount of the fiscal year 2024 appropriation in Laws 2023, chapter 61, article 9, section 2, 
298.27 	subdivision 18, paragraph (b), for grants to establish safe recovery sites, estimated to be 
298.28 	$13,528,000, is canceled.
298.29 		Subd. 7.Harm reduction grant cancellation. Any unencumbered and unexpended 
298.30 	amount of the fiscal year 2024 appropriation in Laws 2023, chapter 61, article 9, section 2, 
298.31 	subdivision 18, paragraph (e), for grants to purchase syringes, testing supplies, and opiate 
298.32 	antagonists, estimated to be $7,597,000, is canceled.
299.1 		Subd. 8.Nursing facility payment program cancellation. Any unencumbered and 
299.2 	unexpended amount of the fiscal year 2024 appropriation in Laws 2023, chapter 74, article 
299.3 	1, section 6, subdivision 2, for payments to nursing facilities, estimated to be $1,416,000, 
299.4 	is canceled.
299.5 		Subd. 9.Advisory committee for Direct Care and Treatment funding 
299.6 	cancellation. Any unencumbered and unexpended amount of the fiscal year 2025 
299.7 	appropriation in Laws 2024, chapter 127, article 53, section 2, subdivision 20, paragraph 
299.8 	(d),  for the Direct Care and Treatment advisory committee, estimated to be $482,000, is 
299.9 	canceled.
299.10 		Subd. 10.Cancellation and transfer of the human services response contingency 
299.11 	account balance. (a) $813,000 of the remaining unencumbered balance in the human 
299.12 	services response contingency account established under Minnesota Statutes, section 256.044, 
299.13 	is canceled to the special revenue fund.
299.14 	(b) An amount equal to the amount canceled under paragraph (a) is transferred from the 
299.15 	special revenue fund to the general fund.
299.16 		Subd. 11.Cancellation and transfer of family and medical benefit funding. (a) 
299.17 	$20,000,000 in fiscal year 2026 is canceled from the family and medical benefit account to 
299.18 	the family and medical benefit insurance fund.
299.19 	(b) An amount equal to the amount canceled under paragraph (a) is transferred from the 
299.20 	family and medical benefit insurance fund to the general fund.
299.21 		Subd. 12.Transfer from the opiate epidemic response fund to the general fund. The 
299.22 	commissioner of management and budget must transfer $1,000,000 in fiscal year 2026 and 
299.23 	$1,000,000 in fiscal year 2027 from the registration and license fee account in the opiate 
299.24 	epidemic response fund under Minnesota Statutes, section 256.043, subdivision 3, to the 
299.25 	general fund. For fiscal years 2028 to 2031, the commissioner of management and budget 
299.26 	must include a transfer of $1,000,000 each year from the registration and license fee account 
299.27 	in the opiate epidemic response fund to the general fund when preparing each forecast under 
299.28 	Minnesota Statutes, section 16A.103, from the effective date of this subdivision through 
299.29 	the February 2027 forecast.
299.30 		Subd. 13.Transfers to and from the workforce incentive grant account. (a) By July 
299.31 	30, 2025, the commissioner must transfer $70,805,000 from the workforce incentive grant 
299.32 	account in the special revenue fund, under Minnesota Statutes, section 256.4764, subdivision 
299.33 	9, to the general fund. This is a onetime transfer.
300.1 	(b) In fiscal year 2028, the commissioner must transfer $70,805,000 from the general 
300.2 	fund to the workforce incentive grant account in the special revenue fund under Minnesota 
300.3 	Statutes, section 256.4764, subdivision 9. This is a onetime transfer and is available for the 
300.4 	purposes of the account until June 30, 2029. Any remaining balance cancels to the general 
300.5 	fund.
300.6 		Subd. 14.Transfer from the long-term services and supports loan account to the 
300.7 	general fund. The commissioner of management and budget must transfer unencumbered 
300.8 	money from the long-term services and supports loan account under Minnesota Statutes, 
300.9 	section 256.4792, subdivision 8a, in the special revenue fund, to the general fund. The 
300.10 	amounts transferred must not exceed $5,000,000 in fiscal year 2026 and $10,000,000 in 
300.11 	fiscal year 2027. For fiscal years 2028 through 2031, the commissioner of management and 
300.12 	budget must include an assumption that a transfer of $17,500,000 in fiscal year 2028, 
300.13 	$17,500,000 in fiscal year 2029, and $0 each year thereafter of unencumbered money in 
300.14 	the long-term services and supports loan account from the special revenue fund to the general 
300.15 	fund, when preparing each forecast from the effective date of this section through the 
300.16 	February 2027 forecast, under Minnesota Statutes, section 16A.103.

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

300.18 	Sec. 25. TRANSFERS.
 300.19 		Subdivision 1.Grants. The commissioner of human services, with the advance approval 
300.20 	of the commissioner of management and budget, may transfer unencumbered appropriation 
300.21 	balances for the biennium ending June 30, 2027, within fiscal years among general assistance, 
300.22 	medical assistance, MinnesotaCare, the Minnesota supplemental aid program, the housing 
300.23 	support program, and the entitlement portion of the behavioral health fund between fiscal 
300.24 	years of the biennium. The commissioner must submit to the chairs and ranking minority 
300.25 	members of the legislative committees with jurisdiction over health and human services a 
300.26 	quarterly grants transfer report. The report must include the amounts transferred and the 
300.27 	purpose of each transfer.
300.28 		Subd. 2.Administration; intra-agency transfers. Positions, salary money, and nonsalary 
300.29 	administrative money may be transferred within the Department of Human Services as the 
300.30 	commissioner deems necessary, with the advance approval of the commissioner of 
300.31 	management and budget. The commissioner must submit to the chairs and ranking minority 
300.32 	members of the legislative committees with jurisdiction over health and human services 
300.33 	finance a quarterly intra-agency transfer report. The report must include the amounts 
300.34 	transferred and the purpose of each transfer.
301.1 		Subd. 3.Administration; interagency transfers. During fiscal year 2026, with advance 
301.2 	approval of the commissioner of management and budget, administrative money may be 
301.3 	transferred between the Department of Human Services and Direct Care and Treatment as 
301.4 	the commissioner and executive board deem necessary. The commissioner and executive 
301.5 	board must submit to the chairs and ranking minority members of the legislative committees 
301.6 	with jurisdiction over human services and direct care and treatment an interagency transfers 
301.7 	report. The report must include the amounts transferred and the purpose of each transfer.

301.8 	Sec. 26. GRANT ADMINISTRATION.
 301.9 	Notwithstanding Minnesota Statutes, section 16B.98, subdivision 14, the commissioner 
301.10 	of human services must not use any of the grant amounts appropriated under this article for 
301.11 	administrative costs.

301.12 	Sec. 27. APPROPRIATIONS GIVEN EFFECT ONCE.
 301.13 	If an appropriation or transfer in this article is enacted more than once during the 2025 
301.14 	regular session, the appropriation or transfer must be given effect once.

301.15 	Sec. 28. EXPIRATION OF UNCODIFIED LANGUAGE.
 301.16 	All uncodified language contained in this article expires on June 30, 2027, unless a 
301.17 	different expiration date is explicit.

301.18 	Sec. 29. EFFECTIVE DATE.
 301.19 	This article is effective July 1, 2025, unless a different effective date is specified.

301.20 	ARTICLE 13
301.21 	DIRECT CARE AND TREATMENT APPROPRIATIONS

301.22	Section 1. DIRECT CARE AND TREATMENT APPROPRIATIONS.
 	
301.23 	The sums shown in the columns marked "Appropriations" are appropriated to the 
301.24 	executive board of direct care and treatment and for the purposes specified in this article. 
301.25 	The appropriations are from the general fund, or another named fund, and are available for 
301.26 	the fiscal years indicated for each purpose. The figures "2026" and "2027" used in this 
301.27 	article mean that the appropriations listed under them are available for the fiscal year ending 
301.28 	June 30, 2026, or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The 
301.29 	second year" is fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.

301.30				APPROPRIATIONS
	
301.31				Available for the Year
	
302.1				Ending June 30
	
302.2					2026
		2027

302.3
302.4
302.5	Sec. 2. EXECUTIVE BOARD OF DIRECT 
CARE AND TREATMENT; TOTAL 
APPROPRIATION
 	$
	577,915,000
	$
	603,261,000
	
302.6 	The amounts that may be spent for each 
302.7 	purpose are specified in the following sections.

302.8
302.9	Sec. 3. MENTAL HEALTH AND SUBSTANCE 
ABUSE
 	$
	189,761,000
	$
	194,840,000

302.10	Sec. 4. COMMUNITY-BASED SERVICES
 	$
	13,927,000
	$
	14,170,000

302.11	Sec. 5. FORENSIC SERVICES
 	$
	160,239,000
	$
	164,094,000

302.12	Sec. 6. SEX OFFENDER PROGRAM
 	$
	128,050,000
	$
	131,351,000

302.13	Sec. 7. ADMINISTRATION
 	$
	85,938,000
	$
	98,806,000

302.14
302.15	Subdivision 1.Locked Psychiatric Residential 
Treatment Facility Planning
 					
302.16 	(a) $100,000 in fiscal year 2026 is for planning 
302.17 	a build out of a locked psychiatric residential 
302.18 	treatment facility operated by Direct Care and 
302.19 	Treatment. This is a onetime appropriation 
302.20 	and is available until June 30, 2027.
302.21 	(b) By March 1, 2026, the executive board 
302.22 	must report to the chairs and ranking minority 
302.23 	members of the legislative committees with 
302.24 	jurisdiction over human services finance and 
302.25 	policy on the plan developed using the 
302.26 	appropriation in this section to build out a 
302.27 	locked psychiatric residential treatment facility 
302.28 	(PRTF) operated by Direct Care and 
302.29 	Treatment.
302.30 	(c) The report must include but is not limited 
302.31 	to the following information:
302.32 	(1) the risks and benefits of locating the locked 
302.33 	PRTF in a metropolitan or rural location;
303.1 	(2) the estimated cost for the build out of the 
303.2 	locked PRTF;
303.3 	(3) the estimated ongoing cost of maintaining 
303.4 	the locked PRTF; and
303.5 	(4) the estimated amount of costs that can be 
303.6 	recouped from medical assistance, 
303.7 	MinnesotaCare, and private insurance 
303.8 	payments.

303.9303.10
303.11
	Subd. 2.Mentally Ill and Dangerous 
Commitment Reform Task Force Extension, 
Report, and Recommendations
 					
303.12 	$31,000 in fiscal year 2026 and $31,000 in 
303.13 	fiscal year 2027 are for the administrative 
303.14 	costs associated with the extension of the 
303.15 	Mentally Ill and Dangerous Commitment 
303.16 	Reform Task Force and preparing the 
303.17 	recommendations and report of the task force. 
303.18 	This is a onetime appropriation.

303.19	Subd. 3.Base Level Adjustment
 					
303.20 	The general fund base for this section is 
303.21 	$173,775,000 in fiscal year 2028 and 
303.22 	$98,775,000 in fiscal year 2029. The base for 
303.23 	fiscal year 2028 includes $75,000,000 for the 
303.24 	renovation of the Anoka Regional Treatment 
303.25 	Center Miller Building.

303.26 	Sec. 8. TRANSFER AUTHORITY.
 303.27 		Subdivision 1.Interprogrammatic transfers. Money appropriated for budget programs 
303.28 	in this article may be transferred between budget programs and between years of the biennium 
303.29 	with the approval of the commissioner of management and budget.
303.30 		Subd. 2.Security systems and information technology transfer. The Direct Care and 
303.31 	Treatment executive board, with the advance approval of the commissioner of management 
303.32 	and budget, may transfer money appropriated for Direct Care and Treatment into the special 
303.33 	revenue account for security systems and information technology projects, services, and 
304.1 	support. The executive board must submit to the chairs and ranking minority members of 
304.2 	the legislative committees with jurisdiction over Direct Care and Treatment a quarterly 
304.3 	security systems and information technology transfer report. The report must include the 
304.4 	amounts transferred in that period and the purpose of each transfer.
304.5 		Subd. 3.Facilities management transfer. The Direct Care and Treatment executive 
304.6 	board, with the advance approval of the commissioner of management and budget, may 
304.7 	transfer money appropriated for Direct Care and Treatment into the special revenue account 
304.8 	for facilities management. The executive board must submit to the chairs and ranking 
304.9 	minority members of the legislative committees with jurisdiction over Direct Care and 
304.10 	Treatment a quarterly facilities management transfer report. The report must include the 
304.11 	amounts transferred in that period and the purpose of each transfer.
304.12 		Subd. 4.Administration. Positions, salary money, and nonsalary administrative money 
304.13 	may be transferred within Direct Care and Treatment as the executive board considers 
304.14 	necessary, with the advance approval of the commissioner of management and budget. The 
304.15 	executive board must submit to the chairs and ranking minority members of the legislative 
304.16 	committees with jurisdiction over Direct Care and Treatment a quarterly intra-agency transfer 
304.17 	report. The report must include the amounts transferred in that period and the purpose of 
304.18 	each transfer.
304.19 		Subd. 5.Administration; interagency transfers. During fiscal year 2026, administrative 
304.20 	money may be transferred between the Department of Human Services and Direct Care and 
304.21 	Treatment as the commissioner and executive board deem necessary, with advance approval 
304.22 	of the commissioner of management and budget. The commissioner and executive board 
304.23 	shall submit to the chairs and ranking minority members of the legislative committees with 
304.24 	jurisdiction over human services and direct care and treatment an interagency transfers 
304.25 	report. The report must include the amounts transferred and the purpose of each transfer.

304.26 	Sec. 9. APPROPRIATIONS GIVEN EFFECT ONCE.
 304.27 	If an appropriation or transfer in this article is enacted more than once during the 2025 
304.28 	regular session, the appropriation or transfer must be given effect once.

304.29 	Sec. 10. EXPIRATION OF UNCODIFIED LANGUAGE.
 304.30 	All uncodified language contained in this article expires on June 30, 2027, unless a 
304.31 	different expiration date is explicit.

305.1 	Sec. 11. EFFECTIVE DATE.
 305.2 	This article is effective July 1, 2025, unless a different effective date is specified.

305.3 	ARTICLE 14
305.4 	HEALTH APPROPRIATIONS

305.5	Section 1. HEALTH APPROPRIATIONS.
 	
305.6 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
305.7 	and for the purposes specified in this article. The appropriations are from the general fund, 
305.8 	or another named fund, and are available for the fiscal years indicated for each purpose. 
305.9 	The figures "2026" and "2027" used in this article mean that the appropriations listed under 
305.10 	them are available for the fiscal year ending June 30, 2026, or June 30, 2027, respectively. 
305.11 	"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" 
305.12 	is fiscal years 2026 and 2027.

305.13				APPROPRIATIONS
	
305.14				Available for the Year
	
305.15				Ending June 30
	
305.16					2026
		2027

305.17
305.18	Sec. 2. COMMISSIONER OF HEALTH; 
TOTAL APPROPRIATION
 	$
	3,092,000
	$
	2,996,000
	
305.19 	The amounts that may be spent for each 
305.20 	purpose are specified in the following sections.

305.21	Sec. 3. HEALTH IMPROVEMENT
 	$
	2,836,000
	$
	2,836,000

305.22	Subdivision 1.Community Care Hub Grant
 					
305.23 	$2,240,000 in fiscal year 2026 and $2,240,000 
305.24 	in fiscal year 2027 are for the community care 
305.25 	hub grant.

305.26
305.27	Subd. 2.Spinal Cord and Traumatic Brain 
Injury Research
 					
305.28 	$500,000 in fiscal year 2026 and $500,000 in 
305.29 	fiscal year 2027 are for a transfer to the spinal 
305.30 	cord and traumatic brain injury grant account 
305.31 	in the special revenue fund under Minnesota 
305.32 	Statutes, section 136A.901, subdivision 1. The 
305.33 	commissioner of management and budget must 
305.34 	include a transfer of $500,000 each year from 
306.1 	the general fund to the spinal cord and 
306.2 	traumatic brain injury grant account in each 
306.3 	forecast prepared under Minnesota Statutes, 
306.4 	section 16A.103.

306.5	Sec. 4. HEALTH PROTECTION
 	$
	256,000
	$
	160,000

306.6
306.7	Subdivision 1.Skin-Lightening Product 
Awareness
 					
306.8 	$100,000 in fiscal year 2026 and $100,000 in 
306.9 	fiscal year 2027 are for a competitive grant 
306.10 	for public awareness and education activities 
306.11 	to address issues of colorism, skin-lightening 
306.12 	products, and chemical exposures from 
306.13 	skin-lightening products. This is a onetime 
306.14 	appropriation and is available until June 30, 
306.15 	2027.

306.16	Subd. 2.Base Level Adjustment
 					
306.17 	The general fund base for this section is 
306.18 	$60,000 in fiscal year 2028 and $60,000 in 
306.19 	fiscal year 2029.

306.20 	Sec. 5. GRANT ADMINISTRATION.
 306.21 	Notwithstanding Minnesota Statutes, section 16B.98, subdivision 14, the commissioner 
306.22 	of health must not use any of the grant amounts appropriated under this article for 
306.23 	administrative costs.

306.24 	Sec. 6. APPROPRIATIONS GIVEN EFFECT ONCE.
 306.25 	If an appropriation or transfer in this article is enacted more than once during the 2025 
306.26 	regular session, the appropriation or transfer must be given effect once.

306.27 	Sec. 7. EXPIRATION OF UNCODIFIED LANGUAGE.
 306.28 	All uncodified language contained in this article expires on June 30, 2027, unless a 
306.29 	different expiration date is explicit.

307.1 	Sec. 8. EFFECTIVE DATE.
 307.2 	This article is effective July 1, 2025, unless a different effective date is specified.

307.3 	ARTICLE 15
307.4 	OTHER AGENCY APPROPRIATIONS

307.5	Section 1. OTHER AGENCY APPROPRIATIONS.
 	
307.6 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
307.7 	and for the purposes specified in this article. The appropriations are from the general fund, 
307.8 	or another named fund, and are available for the fiscal years indicated for each purpose. 
307.9 	The figures "2026" and "2027" used in this article mean that the appropriations listed under 
307.10 	them are available for the fiscal year ending June 30, 2026, or June 30, 2027, respectively. 
307.11 	"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" 
307.12 	is fiscal years 2026 and 2027.

307.13				APPROPRIATIONS
	
307.14				Available for the Year
	
307.15				Ending June 30
	
307.16					2026
		2027

307.17	Sec. 2. COUNCIL ON DISABILITY
 	$
	2,432,000
	$
	2,457,000
	
307.18 	Legislative Task Force On Guardianship 
307.19 	Funding Cancellation
307.20 	Any unencumbered and unexpended amount 
307.21 	of the fiscal year 2025 appropriation 
307.22 	referenced in Laws 2024, chapter 127, article 
307.23 	53, section 4, for the Legislative Task Force 
307.24 	on Guardianship, estimated to be $400,000, 
307.25 	is canceled.

307.26
307.27
307.28	Sec. 3. OFFICE OF THE OMBUDSMAN FOR 
MENTAL HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	3,706,000
	$
	3,765,000

307.29
307.30	Sec. 4. OFFICE OF ADMINISTRATIVE 
HEARINGS
 	$
	272,000
	$
	262,000

307.31	Sec. 5. MINNESOTA HUMANITIES CENTER
 	$
	68,000
	$
	-0-
	
307.32 	YouLead2025
307.33 	$68,000 in fiscal year 2026 is for a competitive 
307.34 	grant for a youth development and youth 
308.1 	leadership program focused on inspiring youth 
308.2 	to be intercultural ambassadors for positive 
308.3 	change in their respective countries. This is a 
308.4 	onetime appropriation. Notwithstanding 
308.5 	Minnesota Statutes, section 16B.98, 
308.6 	subdivision 14, the Board of Directors of the 
308.7 	Minnesota Humanities Center must not use 
308.8 	any of the grant amounts for administrative 
308.9 	costs.

308.10
308.11	Sec. 6. BOARD OF BEHAVIORAL HEALTH 
AND THERAPY
 	$
	2,000
	$
	1,000
	
308.12 	The general fund base for this section is $0 in 
308.13 	fiscal year 2028 and $0 in fiscal year 2029.

308.14	Sec. 7. BOARD OF MEDICAL PRACTICE
 	$
	3,000
	$
	1,000
	
308.15 	The general fund base for this section is $0 in 
308.16 	fiscal year 2028 and $0 in fiscal year 2029.

308.17	Sec. 8. BOARD OF NURSING
 	$
	4,000
	$
	2,000
	
308.18 	The general fund base for this section is $0 in 
308.19 	fiscal year 2028 and $0 in fiscal year 2029.

308.20
308.21	Sec. 9. COMMISSIONER OF CHILDREN, 
YOUTH, AND FAMILIES
 	$
	100,000
	$
	100,000

308.22
308.23	Subdivision 1.Families and Children Opiate 
Epidemic Grant to Beltrami County
 					
308.24 	$100,000 in fiscal year 2026 and $100,000 in 
308.25 	fiscal year 2027 are for a grant to Beltrami 
308.26 	County to support families and children 
308.27 	affected by the opiate epidemic who are in the 
308.28 	child welfare system or at risk of entering the 
308.29 	child welfare system. This is a onetime 
308.30 	appropriation.

308.31	Subd. 2.General Fund Base
 					
308.32 	The general fund base for this section is $0 in 
308.33 	fiscal year 2028 and $0 in fiscal year 2029.

309.1 	Sec. 10. APPROPRIATIONS GIVEN EFFECT ONCE.
 309.2 	If an appropriation or transfer in this article is enacted more than once during the 2025 
309.3 	regular session, the appropriation or transfer must be given effect once.

309.4 	Sec. 11. EXPIRATION OF UNCODIFIED LANGUAGE.
 309.5 	All uncodified language contained in this article expires on June 30, 2027, unless a 
309.6 	different expiration date is explicit.

309.7 	Sec. 12. EFFECTIVE DATE.
 309.8 	This article is effective July 1, 2025, unless a different effective date is specified.

	ARTICLE 1	AGING AND OLDER ADULT SERVICES........	Page.Ln 2.29	
	ARTICLE 2	DISABILITY SERVICES........	Page.Ln 37.21	
	ARTICLE 3	LONG-TERM SERVICES AND SUPPORTS REFORM........	Page.Ln 142.6	
	ARTICLE 4	SUBSTANCE USE DISORDER TREATMENT........	Page.Ln 149.13	
	ARTICLE 5	HOUSING SUPPORTS........	Page.Ln 187.23	
	ARTICLE 6	HEALTH CARE........	Page.Ln 188.10	
	ARTICLE 7	DIRECT CARE AND TREATMENT........	Page.Ln 199.8	
	ARTICLE 8	DEPARTMENT OF DIRECT CARE AND TREATMENT ESTABLISHMENT........	Page.Ln 202.16	
	ARTICLE 9	DEPARTMENT OF DIRECT CARE AND TREATMENT CONFORMING CHANGES........	Page.Ln 214.10	
	ARTICLE 10	DEPARTMENT OF HEALTH........	Page.Ln 239.24	
	ARTICLE 11	MISCELLANEOUS........	Page.Ln 264.16	
	ARTICLE 12	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS........	Page.Ln 266.19	
	ARTICLE 13	DIRECT CARE AND TREATMENT APPROPRIATIONS........	Page.Ln 301.20	
	ARTICLE 14	HEALTH APPROPRIATIONS........	Page.Ln 305.3	
	ARTICLE 15	OTHER AGENCY APPROPRIATIONS........	Page.Ln 307.3	

APPENDIX 

Repealed Minnesota Statutes: ueh2434-1 

144A.071 MORATORIUM ON CERTIFICATION OF NURSING HOME BEDS.Subd. 4c.Exceptions for replacement beds after June 30, 2003. 
(a) The commissioner of health, in coordination with the commissioner of human services, may approve the renovation, replacement, upgrading, or relocation of a nursing home or boarding care home, under the following conditions: 

(1) to license and certify an 80-bed city-owned facility in Nicollet County to be constructed on the site of a new city-owned hospital to replace an existing 85-bed facility attached to a hospital that is also being replaced. The threshold allowed for this project under section 144A.073 shall be the maximum amount available to pay the additional medical assistance costs of the new facility; 

(2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis County, provided that the 29 beds must be transferred from active or layaway status at an existing facility in St. Louis County that had 235 beds on April 1, 2003. 

The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment rate at that facility shall not be adjusted as a result of this transfer. The operating payment rate of the facility adding beds after completion of this project shall be the same as it was on the day prior to the day the beds are licensed and certified. This project shall not proceed unless it is approved and financed under the provisions of section 144A.073; 

(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new beds are transferred from a 45-bed facility in Austin under common ownership that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common ownership; (ii) the commissioner of human services is authorized by the 2004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) money is available from planned closures of facilities under common ownership to make implementation of this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's disease or related dementias; 

(4) to license and certify up to 80 beds transferred from an existing state-owned nursing facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be determined based on the interim and settle-up payment provisions of section 256R.27 and the reimbursement provisions of chapter 256R. The property payment rate for the first three years of operation shall be $35 per day. For subsequent years, the property payment rate of $35 per day shall be adjusted for inflation as provided in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract under section 256B.434; 

(5) to initiate a pilot program to license and certify up to 80 beds transferred from an existing county-owned nursing facility in Steele County relocated to the site of a new acute care facility as part of the county's Communities for a Lifetime comprehensive plan to create innovative responses to the aging of its population. Upon relocation to the new site, the nursing facility shall delicense 28 beds. The payment rate for external fixed costs for the new facility shall be increased by an amount as calculated according to items (i) to (v): 

(i) compute the estimated decrease in medical assistance residents served by the nursing facility by multiplying the decrease in licensed beds by the historical percentage of medical assistance resident days; 

(ii) compute the annual savings to the medical assistance program from the delicensure of 28 beds by multiplying the anticipated decrease in medical assistance residents, determined in item (i), by the existing facility's weighted average payment rate multiplied by 365; 

(iii) compute the anticipated annual costs for community-based services by multiplying the anticipated decrease in medical assistance residents served by the nursing facility, determined in item (i), by the average monthly elderly waiver service costs for individuals in Steele County multiplied by 12; 

(iv) subtract the amount in item (iii) from the amount in item (ii); 

(v) divide the amount in item (iv) by an amount equal to the relocated nursing facility's occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance resident days; and 

(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County and to integrate these services with other community-based programs and services under a communities for a lifetime pilot program and comprehensive plan to create innovative responses to the aging of its population. Two nursing facilities, one for 84 beds and one for 65 beds, in the city of Red Wing licensed on July 1, 2015, shall be consolidated into a newly renovated 64-bed nursing facility resulting in the delicensure of 85 beds. Notwithstanding the carryforward of the approval authority in section 144A.073, subdivision 11, the funding approved in April 2009 by the commissioner of health for a project in Goodhue County shall not carry forward. The closure of the 85 beds shall not be eligible for a planned closure rate adjustment under section 256R.40. The construction project permitted in this clause shall not be eligible for a threshold project rate adjustment under section 256B.434, subdivision 4f. The payment rate for external fixed costs for the new facility shall be increased by an amount as calculated according to items (i) to (vi): 

(i) compute the estimated decrease in medical assistance residents served by both nursing facilities by multiplying the difference between the occupied beds of the two nursing facilities for the reporting year ending September 30, 2009, and the projected occupancy of the facility at 95 percent occupancy by the historical percentage of medical assistance resident days; 

(ii) compute the annual savings to the medical assistance program from the delicensure by multiplying the anticipated decrease in the medical assistance residents, determined in item (i), by the hospital-owned nursing facility weighted average payment rate multiplied by 365; 

(iii) compute the anticipated annual costs for community-based services by multiplying the anticipated decrease in medical assistance residents served by the facilities, determined in item (i), by the average monthly elderly waiver service costs for individuals in Goodhue County multiplied by 12; 

(iv) subtract the amount in item (iii) from the amount in item (ii); 

(v) multiply the amount in item (iv) by 57.2 percent; and 

(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an amount equal to the relocated nursing facility's occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance resident days. 

(b) Projects approved under this subdivision shall be treated in a manner equivalent to projects approved under subdivision 4a. 

245A.042 HOME AND COMMUNITY-BASED SERVICES; ADDITIONAL STANDARDS AND PROCEDURES.Subd. 2.Modified application procedures. 
(a) Applicants seeking chapter 245D licensure who meet the following criteria are subject to modified application procedures: 

(1) the applicant holds a chapter 245B license issued on or before December 31, 2012, at the time of application; 

(2) the applicant's chapter 245B license or licenses are in substantial compliance according to the licensing standards in this chapter and chapter 245B; and 

(3) the commissioner has conducted at least one on-site inspection of the chapter 245B license or licenses within the two-year period before submitting the chapter 245D license application. 

For purposes of this subdivision, "substantial compliance" means the commissioner has not issued a sanction according to section 245A.07 against any chapter 245B license held by the applicant or made the chapter 245B license or licenses conditional according to section 245A.06 within the 12-month period before submitting the application for chapter 245D licensure. 

(b) The modified application procedures mean the commissioner must accept the applicant's attestation of compliance with certain requirements in lieu of providing information to the commissioner for evaluation that is otherwise required when seeking chapter 245D licensure. 

Subd. 3.Implementation. 
(a) The commissioner shall implement the responsibilities of this chapter according to the timelines in paragraphs (b) and (c) only within the limits of available appropriations or other administrative cost recovery methodology. 

(b) The licensure of home and community-based services according to this section shall be implemented January 1, 2014. License applications shall be received and processed on a phased-in schedule as determined by the commissioner beginning July 1, 2013. Licenses will be issued thereafter upon the commissioner's determination that the application is complete according to section 245A.04. 

(c) Within the limits of available appropriations or other administrative cost recovery methodology, implementation of compliance monitoring must be phased in after January 1, 2014. 

(1) Applicants who do not currently hold a license issued under chapter 245B must receive an initial compliance monitoring visit after 12 months of the effective date of the initial license for the purpose of providing technical assistance on how to achieve and maintain compliance with the applicable law or rules governing the provision of home and community-based services under chapter 245D. If during the review the commissioner finds that the license holder has failed to achieve compliance with an applicable law or rule and this failure does not imminently endanger the health, safety, or rights of the persons served by the program, the commissioner may issue a licensing review report with recommendations for achieving and maintaining compliance. 

(2) Applicants who do currently hold a license issued under this chapter must receive a compliance monitoring visit after 24 months of the effective date of the initial license. 

(d) Nothing in this subdivision shall be construed to limit the commissioner's authority to suspend or revoke a license or issue a fine at any time under section 245A.07, or issue correction orders and make a license conditional for failure to comply with applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity of the violation of law or rule and the effect of the violation on the health, safety, or rights of persons served by the program. 

(e) License holders governed under chapter 245D must ensure compliance with the following requirements within the stated timelines: 

(1) service initiation and service planning requirements must be met at the next annual meeting of the person's support team or by January 1, 2015, whichever is later, for the following: 

(i) provision of a written notice that identifies the service recipient rights and an explanation of those rights as required under section 245D.04, subdivision 1; 

(ii) service planning for basic support services as required under section 245D.07, subdivision 2; and 

(iii) service planning for intensive support services under section 245D.071, subdivisions 3 and 4; 

(2) staff orientation to program requirements as required under section 245D.09, subdivision 4, for staff hired before January 1, 2014, must be met by January 1, 2015. The license holder may otherwise provide documentation verifying these requirements were met before January 1, 2014; 

(3) development of policy and procedures as required under section 245D.11, must be completed no later than August 31, 2014; 

(4) written or electronic notice and copies of policies and procedures must be provided to all persons or their legal representatives and case managers as required under section 245D.10, subdivision 4, paragraphs (b) and (c), by September 15, 2014, or within 30 days of development of the required policies and procedures, whichever is earlier; and 

(5) all employees must be informed of the revisions and training must be provided on implementation of the revised policies and procedures as required under section 245D.10, subdivision 4, paragraph (d), by September 15, 2014, or within 30 days of development of the required policies and procedures, whichever is earlier. 

Subd. 4.Stakeholder consultation. 
The commissioner shall consult with the existing stakeholder group established as part of the provider standards process to gather input related to the development of an administrative cost recovery methodology to implement the provisions in chapter 245D. 

245G.01 DEFINITIONS.Subd. 20d.Skilled treatment services. 
"Skilled treatment services" has the meaning provided in section 254B.01, subdivision 10. 

245G.07 TREATMENT SERVICE.Subd. 2.Additional treatment service. 
A license holder may provide or arrange the following additional treatment service as a part of the client's individual treatment plan: 

(1) relationship counseling provided by a qualified professional to help the client identify the impact of the client's substance use disorder on others and to help the client and persons in the client's support structure identify and change behaviors that contribute to the client's substance use disorder; 

(2) therapeutic recreation to allow the client to participate in recreational activities without the use of mood-altering chemicals and to plan and select leisure activities that do not involve the inappropriate use of chemicals; 

(3) stress management and physical well-being to help the client reach and maintain an appropriate level of health, physical fitness, and well-being; 

(4) living skills development to help the client learn basic skills necessary for independent living; 

(5) employment or educational services to help the client become financially independent; 

(6) socialization skills development to help the client live and interact with others in a positive and productive manner; 

(7) room, board, and supervision at the treatment site to provide the client with a safe and appropriate environment to gain and practice new skills; and 

(8) peer recovery support services must be provided by a recovery peer qualified according to section 245I.04, subdivision 18. Peer recovery support services must be provided according to sections 254B.05, subdivision 5, and 254B.052. 

246B.01 MINNESOTA SEX OFFENDER PROGRAM; DEFINITIONS.Subd. 2.Executive board. 
"Executive board" has the meaning given in section 246C.015. 

246C.015 DEFINITIONS.Subd. 5a.Direct Care and Treatment. 
"Direct Care and Treatment" means the agency of Direct Care and Treatment established under this chapter. 

Subd. 6.Executive board. 
"Executive board" means the Direct Care and Treatment executive board established under section 246C.06. 

246C.06 EXECUTIVE BOARD; MEMBERSHIP; GOVERNANCE.Subdivision 1.Establishment. 
The Direct Care and Treatment executive board is established. 

Subd. 2.Membership. 
(a) The Direct Care and Treatment executive board consists of nine members with seven voting members and two nonvoting members. The seven voting members must include six members appointed by the governor with the advice and consent of the senate in accordance with paragraph (b) and the commissioner of human services or a designee. The two nonvoting members must be appointed in accordance with paragraph (c). Section 15.0597 applies to all executive board appointments except for the commissioner of human services. 

(b) The executive board voting members appointed by the governor must meet the following qualifications: 

(1) one member must be a licensed physician who is a psychiatrist or has experience in serving behavioral health patients; 

(2) two members must have experience serving on a hospital or nonprofit board; and 

(3) three members must have experience working: (i) in the delivery of behavioral health services or care coordination or in traditional healing practices; (ii) as a licensed health care professional; (iii) within health care administration; or (iv) with residential services. 

(c) The executive board nonvoting members must be appointed as follows: 

(1) one member appointed by the Association of Counties; and 

(2) one member who has an active role as a union representative representing staff at Direct Care and Treatment appointed by joint representatives of the following unions: American Federation of State, County and Municipal Employees (AFSCME); Minnesota Association of Professional Employees (MAPE); Minnesota Nurses Association (MNA); Middle Management Association (MMA); and State Residential Schools Education Association (SRSEA). 

(d) Membership on the board must include representation from outside the seven-county metropolitan area, as defined in section 473.121, subdivision 2. 

(e) A voting member of the executive board must not be or must not have been within one year prior to appointment: (1) an employee of Direct Care and Treatment; (2) an employee of a county, including a county commissioner; (3) an active employee or representative of a labor union that represents employees of Direct Care and Treatment; or (4) a member of the state legislature. This paragraph does not apply to the nonvoting members or the commissioner of human services or designee. 

Subd. 3.Procedures. 
Except as otherwise provided in this section, the membership terms and removal and filling of vacancies for the executive board are governed by section 15.0575. 

Subd. 4.Compensation. 
(a) Notwithstanding section 15.0575, subdivision 3, paragraph (a), the nonvoting members of the executive board must not receive daily compensation for executive board activities. Nonvoting members of the executive board may receive expenses in the same manner and amount as authorized by the commissioner's plan adopted under section 43A.18, subdivision 2. Nonvoting members who, as a result of time spent attending board meetings, incur child care expenses that would not otherwise have been incurred may be reimbursed for those expenses upon board authorization. 

(b) Notwithstanding section 15.0575, subdivision 3, paragraph (a), the Compensation Council under section 15A.082 must determine the compensation for voting members of the executive board per day spent on executive board activities authorized by the executive board. Voting members of the executive board may also receive the expenses in the same manner and amount as authorized by the commissioner's plan adopted under section 43A.18, subdivision 2. Voting members who, as a result of time spent attending board meetings, incur child care expenses that would not otherwise have been incurred may be reimbursed for those expenses upon board authorization. 

(c) The commissioner of management and budget must publish the daily compensation rate for voting members of the executive board determined under paragraph (b) on the Department of Management and Budget's website. 

(d) Voting members of the executive board must adopt internal standards prescribing what constitutes a day spent on board activities for the purposes of making payments authorized under paragraph (b). 

(e) All other requirements under section 15.0575, subdivision 3, apply to the compensation of executive board members. 

Subd. 5.Acting chair; officers. 
(a) The governor shall designate one member from the voting membership appointed by the governor as acting chair of the executive board. 

(b) At the first meeting of the executive board, the executive board must elect a chair from among the voting membership appointed by the governor. 

(c) The executive board must annually elect a chair from among the voting membership appointed by the governor. 

(d) The executive board must elect officers from among the voting membership appointed by the governor. The elected officers shall serve for one year. 

Subd. 6.Terms. 
(a) Except for the commissioner of human services, executive board members must not serve more than two consecutive terms unless service beyond two consecutive terms is approved by the majority of voting members. The commissioner of human services or a designee shall serve until replaced by the governor. 

(b) An executive board member may resign at any time by giving written notice to the executive board. 

(c) The initial term of the member appointed under subdivision 2, paragraph (b), clause (1), is two years. The initial term of the members appointed under subdivision 2, paragraph (b), clause (2), is three years. The initial term of the members appointed under subdivision 2, paragraph (b), clause (3), and the members appointed under subdivision 2, paragraph (c), is four years. 

(d) After the initial term, the term length of all appointed executive board members is four years. 

Subd. 7.Conflicts of interest. 
Executive board members must recuse themselves from discussion of and voting on an official matter if the executive board member has a conflict of interest. A conflict of interest means an association, including a financial or personal association, that has the potential to bias or have the appearance of biasing an executive board member's decision in matters related to Direct Care and Treatment or the conduct of activities under this chapter. 

Subd. 8.Meetings. 
The executive board must meet at least four times per fiscal year at a place and time determined by the executive board. 

Subd. 9.Quorum. 
A majority of the voting members of the executive board constitutes a quorum. The affirmative vote of a majority of the voting members of the executive board is necessary and sufficient for action taken by the executive board. 

Subd. 10.Immunity; indemnification. 
(a) Members of the executive board are immune from civil liability for any act or omission occurring within the scope of the performance of their duties under this chapter. 

(b) When performing executive board duties or actions, members of the executive board are employees of the state for purposes of indemnification under section 3.736, subdivision 9. 

246C.07 POWERS AND DUTIES OF EXECUTIVE BOARD.Subd. 4.Creation of bylaws. 
The board may establish bylaws governing its operations and the operations of Direct Care and Treatment in accordance with this chapter. 

Subd. 5.Performance of chief executive officer. 
The governor may request that the executive board review the performance of the chief executive officer at any time. Within 14 days of receipt of the request, the board must meet and conduct a performance review as specifically requested by the governor. During the performance review, a representative of the governor must be included as a voting member of the board for the purpose of the board's discussions and decisions regarding the governor's request. The board must establish a performance improvement plan as necessary or take disciplinary or other corrective action, including dismissal. The executive board must report to the governor on action taken by the board, including an explanation if no action is deemed necessary. 

252.021 DEFINITION.Subd. 2.Executive board. 
"Executive board" has the meaning given in section 246C.015. 

253.195 DEFINITIONS.Subd. 2.Executive board. 
"Executive board" has the meaning given in section 246C.015. 

253B.02 DEFINITIONS.Subd. 7b.Executive board. 
"Executive board" has the meaning given in section 246C.015. 

253D.02 DEFINITIONS.Subd. 7a.Executive board. 
"Executive board" has the meaning given under section 246C.015. 

254B.01 DEFINITIONS.Subd. 5.Local agency. 
"Local agency" means the agency designated by a board of county commissioners, a local social services agency, or a human services board authorized under section 254B.03, subdivision 1, to determine financial eligibility for the behavioral health fund. 

Subd. 15.Executive board. 
"Executive board" has the meaning given in section 246C.015. 

254B.18 SAFE RECOVERY SITES START-UP AND CAPACITY-BUILDING GRANTS.
(a) The commissioner of human services must establish start-up and capacity-building grants for current or prospective harm reduction organizations to promote health, wellness, safety, and recovery to people who are in active stages of substance use disorder. Grants must be used to establish safe recovery sites that offer harm reduction services and supplies, including but not limited to: 

(1) safe injection spaces; 

(2) sterile needle exchange; 

(3) opiate antagonist rescue kits; 

(4) fentanyl and other drug testing; 

(5) street outreach; 

(6) educational and referral services; 

(7) health, safety, and wellness services; and 

(8) access to hygiene and sanitation. 

(b) The commissioner must conduct local community outreach and engagement in collaboration with newly established safe recovery sites. The commissioner must evaluate the efficacy of safe recovery sites and collect data to measure health-related and public safety outcomes. 

(c) The commissioner must prioritize grant applications for organizations that are culturally specific or culturally responsive and that commit to serving individuals from communities that are disproportionately impacted by the opioid epidemic, including: 

(1) Native American, American Indian, and Indigenous communities; and 

(2) Black, African American, and African-born communities. 

(d) For purposes of this section, a "culturally specific" or "culturally responsive" organization is an organization that is designed to address the unique needs of individuals who share a common language, racial, ethnic, or social background, and is governed with significant input from individuals of that specific background. 

256.045 ADMINISTRATIVE AND JUDICIAL REVIEW OF HUMAN SERVICES MATTERS.Subd. 1a.Direct Care and Treatment executive board or executive board. 
For purposes of this section, "Direct Care and Treatment executive board" or "executive board" means the Direct Care and Treatment executive board established under section 246C.06. 

256B.0949 EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL INTERVENTION BENEFIT.Subd. 9.Revision of treatment modalities. 
(a) The commissioner may revise covered treatment modalities as needed based on outcome data and other evidence. EIDBI treatment modalities approved by the department must: 

(1) cause no harm to the person or the person's family; 

(2) be individualized and person-centered; 

(3) be developmentally appropriate and highly structured, with well-defined goals and objectives that provide a strategic direction for treatment; 

(4) be based in recognized principles of developmental and behavioral science; 

(5) utilize sound practices that are replicable across providers and maintain the fidelity of the specific modality; 

(6) demonstrate an evidentiary basis; 

(7) have goals and objectives that are measurable, achievable, and regularly evaluated and adjusted to ensure that adequate progress is being made; 

(8) be provided intensively with a high staff-to-person ratio; and 

(9) include participation by the person and the person's legal representative in decision making, knowledge building and capacity building, and developing and implementing the person's ITP. 

(b) Before revisions in department recognized treatment modalities become effective, the commissioner must provide public notice of the changes, the reasons for the change, and a 30-day public comment period to those who request notice through an electronic list accessible to the public on the department's website. 

256G.02 DEFINITIONS.Subd. 5a.Direct Care and Treatment executive board or executive board. 
"Direct Care and Treatment executive board" or "executive board" means the Direct Care and Treatment executive board established under section 246C.06. 

256R.02 DEFINITIONS.Subd. 38.Prior system operating cost payment rate. 
"Prior system operating cost payment rate" means the operating cost payment rate in effect on December 31, 2015, under Minnesota Rules and Minnesota Statutes, inclusive of health insurance, plus property insurance costs from external fixed costs, minus any rate increases allowed under Minnesota Statutes 2015 Supplement, section 256B.441, subdivision 55a. 

256R.12 COST ALLOCATION.Subd. 10.Allocation of self-insurance costs. 
For the rate year beginning on July 1, 1998, a group of nursing facilities related by common ownership that self-insures group health, dental, or life insurance may allocate its directly identified costs of self-insuring its Minnesota nursing facility workers among those nursing facilities in the group that are reimbursed under this chapter. The method of cost allocation shall be based on the ratio of each nursing facility's total allowable salaries and wages to that of the nursing facility group's total allowable salaries and wages, then similarly allocated within each nursing facility's operating cost categories. The costs associated with the administration of the group's self-insurance plan must remain classified in the nursing facility's administrative cost category. A written request of the nursing facility group's election to use this alternate method of allocation of self-insurance costs must be received by the commissioner no later than May 1, 1998, to take effect July 1, 1998, or those self-insurance costs shall continue to be allocated under the existing cost allocation methods. Once a nursing facility group elects this method of cost allocation for its group health, dental, or life insurance self-insurance costs, it shall remain in effect until such time as the group no longer self-insures these costs. 

256R.23 TOTAL CARE-RELATED PAYMENT RATES.Subd. 6.Payment rate limit reduction. 
No facility shall be subject in any rate year to a care-related payment rate limit reduction greater than five percent of the median determined in subdivision 4. 

256R.36 HOLD HARMLESS.
No nursing facility's operating payment rate, plus its employer health insurance costs portion of the external fixed costs payment rate, will be less than its prior system operating cost payment rate. 

256R.40 NURSING FACILITY VOLUNTARY CLOSURE; ALTERNATIVES.Subdivision 1.Definitions. 
(a) The definitions in this subdivision apply to this section. 

(b) "Closure" means the cessation of operations of a nursing facility and delicensure and decertification of all beds within the facility. 

(c) "Closure plan" means a plan to close a nursing facility and reallocate a portion of the resulting savings to provide planned closure rate adjustments at other facilities. 

(d) "Commencement of closure" means the date on which residents and designated representatives are notified of a planned closure as provided in section 144A.161, subdivision 5a, as part of an approved closure plan. 

(e) "Completion of closure" means the date on which the final resident of the nursing facility designated for closure in an approved closure plan is discharged from the facility or the date that beds from a partial closure are delicensed and decertified. 

(f) "Partial closure" means the delicensure and decertification of a portion of the beds within the facility. 

(g) "Planned closure rate adjustment" means an increase in a nursing facility's operating rates resulting from a planned closure or a planned partial closure of another facility. 

Subd. 2.Applications for planned closure rate. 
(a) To be considered for approval of a planned closure, an application must include: 

(1) a description of the proposed closure plan, which must include identification of the facility or facilities to receive a planned closure rate adjustment; 

(2) the proposed timetable for any proposed closure, including the proposed dates for announcement to residents, commencement of closure, and completion of closure; 

(3) if available, the proposed relocation plan for current residents of any facility designated for closure. If a relocation plan is not available, the application must include a statement agreeing to develop a relocation plan designed to comply with section 144A.161; 

(4) a description of the relationship between the nursing facility that is proposed for closure and the nursing facility or facilities proposed to receive the planned closure rate adjustment. If these facilities are not under common ownership, copies of any contracts, purchase agreements, or other documents establishing a relationship or proposed relationship must be provided; and 

(5) documentation, in a format approved by the commissioner, that all the nursing facilities receiving a planned closure rate adjustment under the plan have accepted joint and several liability for recovery of overpayments under section 256B.0641, subdivision 2, for the facilities designated for closure under the plan. 

(b) The application must also address the criteria listed in subdivision 3. 

Subd. 3.Criteria for review of application. 
In reviewing and approving closure proposals, the commissioner shall consider, but not be limited to, the following criteria: 

(1) improved quality of care and quality of life for consumers; 

(2) closure of a nursing facility that has a poor physical plant; 

(3) the existence of excess nursing facility beds, measured in terms of beds per thousand persons aged 85 or older. The excess must be measured in reference to: 

(i) the county in which the facility is located. A facility in a county that is in the lowest quartile of counties with reference to beds per thousand persons aged 85 or older is not in an area of excess capacity; 

(ii) the county and all contiguous counties; 

(iii) the region in which the facility is located; or 

(iv) the facility's service area. The facility shall indicate in its application the service area it believes is appropriate for this measurement; 

(4) low-occupancy rates, provided that the unoccupied beds are not the result of a personnel shortage. In analyzing occupancy rates, the commissioner shall examine waiting lists in the applicant facility and at facilities in the surrounding area, as determined under clause (3); 

(5) evidence of coordination between the community planning process and the facility application. If the planning group does not support a level of nursing facility closures that the commissioner considers to be reasonable, the commissioner may approve a planned closure proposal without its support; 

(6) proposed usage of funds available from a planned closure rate adjustment for care-related purposes; 

(7) innovative use planned for the closed facility's physical plant; 

(8) evidence that the proposal serves the interests of the state; and 

(9) evidence of other factors that affect the viability of the facility, including excessive nursing pool costs. 

Subd. 4.Review and approval of applications. 
(a) The commissioner, in consultation with the commissioner of health, shall approve or deny an application within 30 days after receiving it. The commissioner may appoint an advisory review panel composed of representatives of counties, consumers, and providers to review proposals and provide comments and recommendations to the committee. The commissioners of human services and health shall provide staff and technical assistance to the committee for the review and analysis of proposals. 

(b) Approval of a planned closure expires 18 months after approval by the commissioner unless commencement of closure has begun. 

(c) The commissioner may change any provision of the application to which the applicant, the regional planning group, and the commissioner agree. 

Subd. 5.Planned closure rate adjustment. 
(a) The commissioner shall calculate the amount of the planned closure rate adjustment available under subdivision 6 according to clauses (1) to (4): 

(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080; 

(2) the total number of beds in the nursing facility or facilities receiving the planned closure rate adjustment must be identified; 

(3) capacity days are determined by multiplying the number determined under clause (2) by 365; and 

(4) the planned closure rate adjustment is the amount available in clause (1), divided by capacity days determined under clause (3). 

(b) A planned closure rate adjustment under this section is effective on the first day of the month of January or July, whichever occurs immediately following completion of closure of the facility designated for closure in the application and becomes part of the nursing facility's external fixed payment rate. 

(c) Upon the request of a closing facility, the commissioner must allow the facility a closure rate adjustment as provided under section 144A.161, subdivision 10. 

(d) A facility that has received a planned closure rate adjustment may reassign it to another facility that is under the same ownership at any time within three years of its effective date. The amount of the adjustment is computed according to paragraph (a). 

(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the commissioner shall recalculate planned closure rate adjustments for facilities that delicense beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar amount. The recalculated planned closure rate adjustment is effective from the date the per bed dollar amount is increased. 

Subd. 6.Assignment of closure rate to another facility. 
A facility or facilities reimbursed under this chapter with a closure plan approved by the commissioner under subdivision 4 may assign a planned closure rate adjustment to another facility or facilities that are not closing or in the case of a partial closure, to the facility undertaking the partial closure. A facility may also elect to have a planned closure rate adjustment shared equally by the five nursing facilities with the lowest total operating payment rates in the state development region designated under section 462.385, in which the facility that is closing is located. The planned closure rate adjustment must be calculated under subdivision 5. Facilities that delicense beds without a closure plan, or whose closure plan is not approved by the commissioner, are not eligible to assign a planned closure rate adjustment under subdivision 5, unless they: (1) are delicensing five or fewer beds, or less than six percent of their total licensed bed capacity, whichever is greater; (2) are located in a county in the top three quartiles of beds per 1,000 persons aged 65 or older; and (3) have not delicensed beds in the prior three months. Facilities meeting these criteria are eligible to assign the amount calculated under subdivision 5 to themselves. If a facility is delicensing the greater of six or more beds, or six percent or more of its total licensed bed capacity, and does not have an approved closure plan or is not eligible for the adjustment under subdivision 5, the commissioner shall calculate the amount the facility would have been eligible to assign under subdivision 5, and shall use this amount to provide equal rate adjustments to the five nursing facilities with the lowest total operating payment rates in the state development region designated under section 462.385, in which the facility that delicensed beds is located. 

Subd. 7.Other rate adjustments. 
Facilities receiving planned closure rate adjustments remain eligible for any applicable rate adjustments provided under this chapter. 

256R.41 SINGLE-BED ROOM INCENTIVE.
(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed under this chapter shall be increased by 20 percent multiplied by the ratio of the number of new single-bed rooms created divided by the number of active beds on July 1, 2005, for each bed closure that results in the creation of a single-bed room after July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each year. For eligible bed closures for which the commissioner receives a notice from a facility that a bed has been delicensed and a new single-bed room has been established, the rate adjustment in this paragraph shall be effective on either the first day of the month of January or July, whichever occurs first following the date of the bed delicensure. 

(b) A nursing facility is prohibited from discharging residents for purposes of establishing single-bed rooms. A nursing facility must submit documentation to the commissioner in a form prescribed by the commissioner, certifying the occupancy status of beds closed to create single-bed rooms. In the event that the commissioner determines that a facility has discharged a resident for purposes of establishing a single-bed room, the commissioner shall not provide a rate adjustment under paragraph (a). 

256R.481 RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
(a) The commissioner shall allow each nonprofit nursing facility located within the boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once annually for a rate add-on to the facility's external fixed costs payment rate. 

(b) A facility seeking an add-on to its external fixed costs payment rate under this section must apply annually to the commissioner to receive the add-on. A facility must submit the application within 60 calendar days of the effective date of any add-on under this section. The commissioner may waive the deadlines required by this paragraph under extraordinary circumstances. 

(c) The commissioner shall provide the add-on to each eligible facility that applies by the application deadline. 

(d) The add-on to the external fixed costs payment rate is the difference on January 1 of the median total payment rate for case mix classification PA1 of the nonprofit facilities located in an adjacent city in another state and in cities contiguous to the adjacent city minus the eligible nursing facility's total payment rate for case mix classification PA1 as determined under section 256R.22, subdivision 4. 

256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE RATE ADJUSTMENTS.Subd. 7.Expiration. 
This section expires January 1, 2026. 

Repealed Minnesota Session Laws: ueh2434-1 

Laws 2023, chapter 59, article 3, section 11
Sec. 11. DIRECT CARE PROVIDER PREMIUMS THROUGH HCBS WORKFORCE INCENTIVE FUND. 
(a) $20,000,000 in fiscal year 2026 is added to the base appropriation from the family and medical benefit account to the commissioner of human services to provide reimbursement for premiums incurred for the paid family and medical leave program under this chapter. Funds shall be administered through the home and community-based workforce incentive fund under Minnesota Statutes, section 256.4764.  

(b) The commissioner of employment and economic development shall share premium payment data collected under this chapter to assist the commissioner of human services in the verification process of premiums paid under this section. 

(c) This amount is for the purposes of Minnesota Statutes, section 256.4764. This is a one-time appropriation and is available until June 30, 2027.   

Laws 2024, chapter 125, article 5, section 40
Sec. 40. DIRECT CARE AND TREATMENT ADVISORY COMMITTEE. 
(a) The Direct Care and Treatment executive board under Minnesota Statutes, section 246C.07, shall establish an advisory committee to provide state legislators, counties, union representatives, the National Alliance on Mental Illness Minnesota, people being served by direct care and treatment programs, and other stakeholders the opportunity to advise the executive board regarding the operation of Direct Care and Treatment. 

(b) The members of the advisory committee must be appointed as follows: 

(1) one member appointed by the speaker of the house; 

(2) one member appointed by the minority leader of the house of representatives; 

(3) two members appointed by the senate Committee on Committees, one member representing the majority caucus and one member representing the minority caucus; 

(4) one member appointed by the Association of Minnesota Counties; 

(5) one member appointed by joint representatives of the American Federation of State and Municipal Employees, the Minnesota Association of Professional Employees, the Minnesota Nurses Association, the Middle Management Association, and the State Residential Schools Education Association; 

(6) one member appointed by the National Alliance on Mental Illness Minnesota; and 

(7) two members representing people with lived experience being served by state-operated treatment programs or their families, appointed by the governor. 

(c) Appointing authorities under paragraph (b) shall make appointments by January 1, 2026. 

(d) The first meeting of the advisory committee must be held no later than January 15, 2026. The members of the advisory committee shall elect a chair from among their membership at the first meeting. The advisory committee shall meet as frequently as it determines necessary. 

(e) The executive board shall regularly consult with the advisory committee. 

(f) The advisory committee under this section expires December 31, 2027. 

Laws 2024, chapter 125, article 5, section 41
Sec. 41. INITIAL APPOINTMENTS AND COMPENSATION OF THE DIRECT CARE AND TREATMENT EXECUTIVE BOARD AND CHIEF EXECUTIVE OFFICER. Subdivision 1.Executive board. 
(a) The initial appointments of the members of the Direct Care and Treatment executive board under Minnesota Statutes, section 246C.06, must be made by January 1, 2025. 

(b) Prior to the first Compensation Council determination of the daily compensation rate for voting members of the executive board under Minnesota Statutes, section 246C.06, subdivision 4, paragraph (b), voting members of the executive board must be paid the per diem rate provided for in Minnesota Statutes, section 15.0575, subdivision 3, paragraph (a). 

(c) The executive board is exempt from Minnesota Statutes, section 13D.01, until the authority and responsibilities for Direct Care and Treatment are transferred to the executive board in accordance with Minnesota Statutes, section 246C.04. 

Subd. 2.Chief executive officer. 
(a) The Direct Care and Treatment executive board must appoint as the initial chief executive officer for Direct Care and Treatment under Minnesota Statutes, section 246C.07, the chief executive officer of the direct care and treatment division of the Department of Human Services holding that position at the time the initial appointment is made by the board. The initial appointment of the chief executive officer must be made by the executive board by July 1, 2025. The initial appointment of the chief executive officer is subject to confirmation by the senate. 

(b) In its report issued April 1, 2025, the Compensation Council under Minnesota Statutes, section 15A.082, must establish the salary of the chief executive officer at an amount equal to or greater than the amount paid to the chief executive officer of the direct care and treatment division of the Department of Human Services as of the date of initial appointment. The salary of the chief executive officer shall become effective July 1, 2025, pursuant to Minnesota Statutes, section 15A.082, subdivision 3. Notwithstanding Minnesota Statutes, sections 15A.082 and 246C.08, subdivision 1, if the initial appointment of the chief executive officer occurs prior to the effective date of the salary specified by the Compensation Council in its April 1, 2025, report, the salary of the chief executive officer must equal the amount paid to the chief executive officer of the direct care and treatment division of the Department of Human Services as of the date of initial appointment. 

Subd. 3.Commissioner of human services to consult. 
In preparing the budget estimates required under Minnesota Statutes, section 16A.10, for the direct care and treatment division for the 2026-2027 biennial budget and any legislative proposals for the 2025 legislative session that involve direct care and treatment operations, the commissioner of human services must consult with the Direct Care and Treatment executive board before submitting the budget estimates or legislative proposals. If the executive board is not appointed by the date the budget estimates must be submitted to the commissioner of management and budget, the commissioner of human services must provide the executive board with a summary of the budget estimates that were submitted. 

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

Laws 2024, chapter 127, article 46, section 39
Sec. 39. LEGISLATIVE TASK FORCE ON GUARDIANSHIP. Subdivision 1.Membership. 
(a) The Legislative Task Force on Guardianship consists of the following members: 

(1) one member of the house of representatives, appointed by the speaker of the house of representatives; 

(2) one member of the house of representatives, appointed by the minority leader of the house of representatives; 

(3) one member of the senate, appointed by the senate majority leader; 

(4) one member of the senate, appointed by the senate minority leader; 

(5) one judge who has experience working on guardianship cases, appointed by the chief justice of the supreme court; 

(6) two individuals presently or formerly under guardianship or emergency guardianship, appointed by the Minnesota Council on Disability; 

(7) one private, professional guardian, appointed by the Minnesota Council on Disability; 

(8) one private, nonprofessional guardian, appointed by the Minnesota Council on Disability; 

(9) one representative of the Department of Human Services with knowledge of public guardianship issues, appointed by the commissioner of human services; 

(10) one member appointed by the Minnesota Council on Disability; 

(11) two members of two different disability advocacy organizations, appointed by the Minnesota Council on Disability; 

(12) one member of a professional or advocacy group representing the interests of the guardian who has experience working in the judicial system on guardianship cases, appointed by the Minnesota Council on Disability; 

(13) one member of a professional or advocacy group representing the interests of persons subject to guardianship who has experience working in the judicial system on guardianship cases, appointed by the Minnesota Council on Disability; 

(14) two members of two different advocacy groups representing the interests of older Minnesotans who are or may find themselves subject to guardianship, appointed by the Minnesota Council on Disability; 

(15) one employee acting as the Disability Systems Planner in the Center for Health Equity at the Minnesota Department of Health, appointed by the commissioner of health; 

(16) one member appointed by the Minnesota Indian Affairs Council; 

(17) one member from the Commission of the Deaf, Deafblind, and Hard-of-Hearing, appointed by the executive director of the commission; 

(18) one member of the Council on Developmental Disabilities, appointed by the executive director of the council; 

(19) one employee from the Office of Ombudsman for Mental Health and Developmental Disabilities, appointed by the ombudsman; 

(20) one employee from the Office of Ombudsman for Long Term Care, appointed by the ombudsman;  

(21) one member appointed by the Minnesota Association of County Social Services Administrators (MACSSA);  

(22) one employee from the Olmstead Implementation Office, appointed by the director of the office; and  

(23) one member representing an organization dedicated to supported decision-making alternatives to guardianship, appointed by the Minnesota Council on Disability.  

(b) Appointees to the task force must be named by each appointing authority by June 30, 2025. Appointments made by an agency or commissioner may also be made by a designee. 

(c) The member from the Minnesota Council on Disability serves as chair of the task force. The chair must designate a member to serve as secretary. 

Subd. 2.Meetings; administrative support. 
The first meeting of the task force must be convened by the chair no later than September 1, 2025, if an appropriation is made by that date for the task force. The task force must meet at least quarterly. Meetings are subject to Minnesota Statutes, chapter 13D. The task force may meet by telephone or interactive technology consistent with Minnesota Statutes, section 13D.015. The Minnesota Council on Disability shall provide meeting space and administrative and research support to the task force. 

Subd. 3.Duties. 
(a) The task force must make recommendations to address concerns and gaps related to guardianships and less restrictive alternatives to guardianships in Minnesota, including but not limited to: 

(1) developing efforts to sustain and increase the number of qualified guardians;  

(2) increasing compensation for in forma pauperis (IFP) guardians by studying current funding streams to develop approaches to ensure that the funding streams are consistent across the state and sufficient to serve the needs of persons subject to guardianship; 

(3) securing ongoing funding for guardianships and less restrictive alternatives; 

(4) establishing guardian certification or licensure; 

(5) identifying standards of practice for guardians and options for providing education to guardians on standards and less restrictive alternatives; 

(6) securing ongoing funding for the guardian and conservator administrative complaint process; 

(7) identifying and understanding alternatives to guardianship whenever possible to meet the needs of patients and the challenges of providers in the delivery of health care, behavioral health care, and residential and home-based care services; 

(8) expanding supported decision-making alternatives to guardianships and conservatorships; 

(9) reducing the removal of civil rights when appointing a guardian, including by ensuring guardianship is only used as a last resort; and 

(10) identifying ways to preserve and to maximize the civil rights of the person, including due process considerations. 

(b) The task force must seek input from the public, the judiciary, people subject to guardianship, guardians, advocacy groups, and attorneys. The task force must hold hearings to gather information to fulfill the purpose of the task force. 

Subd. 4.Compensation; expenses. 
Members of the task force may receive compensation and expense reimbursement as provided in Minnesota Statutes, section 15.059, subdivision 3. 

Subd. 5.Report; expiration. 
The task force shall submit a report to the chairs and ranking minority members of the legislative committees with jurisdiction over guardianship issues no later than January 15, 2027. The report must describe any concerns about the current guardianship system identified by the task force and recommend policy options to address those concerns and to promote less restrictive alternatives to guardianship. The report must include draft legislation to implement recommended policy. 

Subd. 6.Expiration. 
The task force expires upon submission of its report, or January 16, 2027, whichever is earlier.  

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

Laws 2024, chapter 127, article 50, section 40
Sec. 40. DIRECT CARE AND TREATMENT ADVISORY COMMITTEE. 
(a) The Direct Care and Treatment executive board under Minnesota Statutes, section 246C.07, shall establish an advisory committee to provide state legislators, counties, union representatives, the National Alliance on Mental Illness Minnesota, people being served by direct care and treatment programs, and other stakeholders the opportunity to advise the executive board regarding the operation of Direct Care and Treatment. 

(b) The members of the advisory committee must be appointed as follows: 

(1) one member appointed by the speaker of the house; 

(2) one member appointed by the minority leader of the house of representatives; 

(3) two members appointed by the senate Committee on Committees, one member representing the majority caucus and one member representing the minority caucus; 

(4) one member appointed by the Association of Minnesota Counties; 

(5) one member appointed by joint representatives of the American Federation of State and Municipal Employees, the Minnesota Association of Professional Employees, the Minnesota Nurses Association, the Middle Management Association, and the State Residential Schools Education Association; 

(6) one member appointed by the National Alliance on Mental Illness Minnesota; and 

(7) two members representing people with lived experience being served by state-operated treatment programs or their families, appointed by the governor. 

(c) Appointing authorities under paragraph (b) shall make appointments by January 1, 2026. 

(d) The first meeting of the advisory committee must be held no later than January 15, 2026. The members of the advisory committee shall elect a chair from among their membership at the first meeting. The advisory committee shall meet as frequently as it determines necessary. 

(e) The executive board shall regularly consult with the advisory committee. 

(f) The advisory committee under this section expires December 31, 2027. 

Laws 2024, chapter 127, article 50, section 41 Subdivisions 1, 3, 
Sec. 41. INITIAL APPOINTMENTS AND COMPENSATION OF THE DIRECT CARE AND TREATMENT EXECUTIVE BOARD AND CHIEF EXECUTIVE OFFICER. Subdivision 1.Executive board. 
(a) The initial appointments of the members of the Direct Care and Treatment executive board under Minnesota Statutes, section 246C.06, must be made by January 1, 2025. 

(b) Prior to the first Compensation Council determination of the daily compensation rate for voting members of the executive board under Minnesota Statutes, section 246C.06, subdivision 4, paragraph (b), voting members of the executive board must be paid the per diem rate provided for in Minnesota Statutes, section 15.0575, subdivision 3, paragraph (a). 

(c) The executive board is exempt from Minnesota Statutes, section 13D.01, until the authority and responsibilities for Direct Care and Treatment are transferred to the executive board in accordance with Minnesota Statutes, section 246C.04. 

Subd. 3.Commissioner of human services to consult. 
In preparing the budget estimates required under Minnesota Statutes, section 16A.10, for the direct care and treatment division for the 2026-2027 biennial budget and any legislative proposals for the 2025 legislative session that involve direct care and treatment operations, the commissioner of human services must consult with the Direct Care and Treatment executive board before submitting the budget estimates or legislative proposals. If the executive board is not appointed by the date the budget estimates must be submitted to the commissioner of management and budget, the commissioner of human services must provide the executive board with a summary of the budget estimates that were submitted. 

Laws 2024, chapter 79, article 1, section 20
Sec. 20. Minnesota Statutes 2023 Supplement, section 246C.03, subdivision 2, is amended to read:Subd. 2.Development of Department of Direct Care and Treatment Board. 
(a) The commissioner of human services shall prepare legislation for introduction during the 2024 legislative session, with input from stakeholders the commissioner deems necessary, proposing legislation for the creation and implementation of the Direct Care and Treatment executive board and defining the responsibilities, powers, and function of the Department of Direct Care and Treatment executive board. 

(b) The Department of Direct Care and Treatment executive board shall consist of no more than five members, all appointed by the governor. 

(c) An executive board member's qualifications must be appropriate for overseeing a complex behavioral health system, such as experience serving on a hospital or non-profit board, serving as a public sector labor union representative, experience in delivery of behavioral health services or care coordination, or working as a licensed health care provider, in an allied health profession, or in health care administration.