1.1 	A bill for an act
1.2 	relating to state government; modifying provisions relating to health finance and 
1.3 	policy, certain health licensing boards, pharmacy benefits, health care finance, the 
1.4 	Office of Emergency Medical Services, opioids, mental health warning labels, 
1.5 	economic assistance, child protection and welfare, early care and learning, and 
1.6 	licensing and certification; establishing licensure for certified midwives; requiring 
1.7 	reports; providing for civil and criminal penalties; appropriating money;amending 
1.8 	Minnesota Statutes 2024, sections 62A.673, subdivision 2; 62J.51, subdivision 
1.9 	19a; 62J.581; 142A.03, subdivision 2, by adding a subdivision; 142A.42; 142B.01, 
1.10 	subdivision 15, by adding a subdivision; 142B.05, subdivision 3; 142B.10, 
1.11 	subdivisions 14, 16; 142B.16, subdivisions 2, 5; 142B.171, subdivision 2; 142B.18, 
1.12 	subdivisions 4, 6; 142B.30, subdivision 1; 142B.41, by adding a subdivision; 
1.13 	142B.47; 142B.51, subdivision 2; 142B.65, subdivisions 8, 9; 142B.66, subdivision 
1.14 	3; 142B.70, subdivisions 7, 8; 142B.77; 142B.80; 142C.06, by adding a subdivision; 
1.15 	142C.11, subdivision 8; 142C.12, subdivisions 1, 6; 142D.21, subdivisions 6, 10, 
1.16 	by adding a subdivision; 142D.23, subdivision 3; 142D.31, subdivision 2; 142E.03, 
1.17 	subdivision 3; 142E.11, subdivisions 1, 2; 142E.13, subdivision 2; 142E.15, 
1.18 	subdivision 1; 142E.16, subdivisions 3, 7; 142E.17, subdivision 9; 142F.14; 
1.19 	144.0758, subdivision 3; 144.1222, subdivision 2d; 144.125, subdivisions 1, 2; 
1.20 	144.50, by adding a subdivision; 144.555, subdivisions 1a, 1b; 144.562, 
1.21 	subdivisions 2, 3; 144.563; 144.608, subdivision 2; 144.966, subdivision 2; 144.99, 
1.22 	subdivision 1; 145.8811; 145C.01, by adding subdivisions; 145C.17; 147.01, 
1.23 	subdivision 7; 147.037, by adding a subdivision; 147D.03, subdivision 1; 148.241; 
1.24 	151.01, subdivision 23; 151.37, subdivision 12; 151.555, subdivisions 6, 10; 152.12, 
1.25 	subdivision 1; 174.30, subdivision 3; 245.0962, subdivision 1; 245A.18, subdivision 
1.26 	1; 245C.02, by adding a subdivision; 256.9657, subdivision 2, by adding a 
1.27 	subdivision; 256.969, subdivision 2f; 256B.0371, subdivision 3; 256B.04, 
1.28 	subdivisions 12, 14; 256B.0625, subdivisions 2, 3b, 13c, 13e, 17, 17a, 30, by 
1.29 	adding subdivisions; 256B.064, subdivision 1a; 256B.1973, subdivision 5, by 
1.30 	adding a subdivision; 256B.69, subdivisions 3a, 6d; 256R.01, by adding a 
1.31 	subdivision; 260.65; 260.66, subdivision 1; 260.691, subdivision 1; 260.692; 
1.32 	260.810, subdivisions 1, 2; 260.821, subdivision 2; 260C.001, subdivision 2; 
1.33 	260C.007, subdivision 19; 260C.141, subdivision 1; 260C.150, subdivision 3; 
1.34 	260C.178, subdivisions 1, 7; 260C.201, subdivisions 1, 2; 260C.202, subdivision 
1.35 	2, by adding subdivisions; 260C.204; 260C.212, subdivisions 1, 1a; 260C.221, 
1.36 	subdivision 2; 260C.223, subdivisions 1, 2; 260C.329, subdivisions 3, 8; 260C.451, 
1.37 	subdivision 9; 260C.452, subdivision 4; 260E.03, subdivision 15; 260E.09; 
1.38 	260E.20, subdivisions 1, 3; 260E.24, subdivisions 1, 2; 325M.34; 518.68, 
2.1 	subdivision 2; 518A.34; 518A.46, subdivision 7; 518A.75, subdivision 1; Laws 
2.2 	2023, chapter 70, article 20, section 8; Laws 2024, chapter 127, article 67, section 
2.3 	4; proposing coding for new law in Minnesota Statutes, chapters 135A; 142B; 
2.4 	144; 144E; 145C; 256B; 260E; 325M; proposing coding for new law as Minnesota 
2.5 	Statutes, chapter 148G; repealing Minnesota Statutes 2024, sections 145.361; 
2.6 	256B.0625, subdivisions 18b, 18e, 18h; Laws 2023, chapter 70, article 16, section 
2.7 	22; Minnesota Rules, part 9503.0030, subpart 1, item B.
2.8 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.9 	ARTICLE 1
2.10 	DEPARTMENT OF HEALTH FINANCE

2.11 	Section 1. [144.063] DEMENTIA SERVICES PROGRAM ESTABLISHED.
2.12 	The commissioner of health shall establish the dementia services program to:
2.13 	(1) facilitate the coordination and support of:
2.14 	(i) state-funded policies and programs that relate to Alzheimer's disease or related forms 
2.15 	of dementia;
2.16 	(ii) outreach programs and services between state agencies, local public health 
2.17 	departments, Tribal Nations, educational institutions, and community groups for the purpose 
2.18 	of fostering public awareness and education regarding Alzheimer's disease and related forms 
2.19 	of dementia; and
2.20 	(iii) services and activities between groups that are interested in dementia research, 
2.21 	programs, and services, including area agencies on aging, service providers, advocacy 
2.22 	groups, legal services, emergency personnel, law enforcement, local public health 
2.23 	departments, Tribal Nations, and state colleges and universities;
2.24 	(2) facilitate the coordination, review, publication, and implementation of and updates 
2.25 	to the Alzheimer's Disease State Plan;
2.26 	(3) collect and analyze data related to the impact of Alzheimer's disease in Minnesota; 
2.27 	and
2.28 	(4) incorporate early detection and risk reduction strategies into existing department-led 
2.29 	public health programs.

2.30 	Sec. 2. Minnesota Statutes 2024, section 144.0758, subdivision 3, is amended to read:
2.31 		Subd. 3.Eligible grantees. (a) Organizations eligible to receive grant funding under 
2.32 	this section are Minnesota's Tribal Nations in accordance with paragraph (b) and urban 
2.33 	American Indian community-based organizations in accordance with paragraph (c).
3.1 	(b) Minnesota's Tribal Nations may choose to receive funding under this section according 
3.2 	to a noncompetitive funding formula specified by the commissioner.
3.3 	(c) Urban American Indian community-based organizations are eligible to apply for 
3.4 	funding under this section by submitting a proposal for consideration by the commissioner.

3.5 	Sec. 3. Minnesota Statutes 2024, section 144.1222, subdivision 2d, is amended to read:
3.6 		Subd. 2d.Hot tubs Spa pools on rental houseboats property. (a) For purposes of this 
3.7 	subdivision, "spa pool" has the meaning given in Minnesota Rules, part 4717.0250, subpart 
3.8 	9.
3.9 	(b) Except as provided in paragraph (c), a hot water spa pool intended for seated 
3.10 	recreational use, including a hot tub or whirlpool, that is located on a houseboat that is rented 
3.11 	to the public the property of a stand-alone, single-unit rental property, offered for rent by 
3.12 	the property owner or through a resort, and that is only intended to be used by the occupants 
3.13 	of the rental property:
3.14 	(1) is not a public pool and;
3.15 	(2) is exempt from the requirements for public pools under subdivisions 1 to 2c, 4, and 
3.16 	5 and Minnesota Rules, chapter 4717, except as otherwise provided in this paragraph; and
3.17 	(3) may be used by renters so long as:
3.18 	(i) the water temperature in the spa pool does not exceed 106 degrees Fahrenheit;
3.19 	(ii) prior to check-in by each new rental party, the resort or property owner tests the 
3.20 	water in the spa pool for the concentration of chlorine or bromine, pH, and alkalinity and 
3.21 	the water in the spa pool meets the requirements for disinfection residual, pH, and alkalinity 
3.22 	in Minnesota Rules, part 4717.1750, subparts 4 to 6; and
3.23 	(iii) at check-in, the resort or property owner provides each rental party with a notice 
3.24 	that there is a spa pool on the property and that the spa pool is not subject to all of the 
3.25 	requirements in state law and rules for public pools.
3.26 	(b) (c) A spa pool intended for seated recreational use, including a hot tub or whirlpool, 
3.27 	that is located on a houseboat that is rented to the public:
3.28 	(1) is not a public pool;
3.29 	(2) is exempt from the requirements for public pools under subdivisions 1 to 2c, 4, and 
3.30 	5 and Minnesota Rules, chapter 4717; and
3.31 	(3) is exempt from the requirements under paragraph (b), clause (3).
4.1 	(d) A political subdivision must not adopt a local law, rule, or ordinance that prohibits 
4.2 	the operation of, or establishes additional requirements for, a spa pool that meets the criteria 
4.3 	in paragraph (b) or (c).
4.4 	(e) A hot water spa pool under this subdivision must be conspicuously posted with the 
4.5 	following notice to renters:
4.6 	"NOTICE
4.7 	This spa is exempt from certain state and local sanitary requirements that prevent disease 
4.8 	transmission.
4.9 	USE AT YOUR OWN RISK
4.10 	This notice is required under Minnesota Statutes, section 144.1222, subdivision 2d."

4.11 	Sec. 4. [144.124] EDUCATION ON RECOGNIZING SIGNS OF PHYSICAL ABUSE 
4.12 	IN INFANTS.
4.13 		Subdivision 1.Education by health care providers. Family practice physicians, 
4.14 	pediatricians, and other pediatric primary care providers must provide parents and primary 
4.15 	caregivers of infants up to six months of age with materials on how to recognize the signs 
4.16 	of physical abuse in infants and how to report suspected physical abuse of infants. These 
4.17 	materials must be identified and approved by the commissioner of health according to 
4.18 	subdivision 2 and must be provided to an infant's parents or primary caregivers at the infant's 
4.19 	first well-baby visit after birth.
4.20 		Subd. 2.Materials. The commissioner of health, in consultation with the commissioner 
4.21 	of children, youth, and families, must identify, approve, and make available to pediatric 
4.22 	primary care providers materials for pediatric primary care providers to use at well-baby 
4.23 	visits to educate parents and primary caregivers of infants up to six months of age on 
4.24 	recognizing the signs of physical abuse in infants and how to report suspected physical 
4.25 	abuse of infants. The commissioner must make these materials available on the Department 
4.26 	of Health website.

4.27 	Sec. 5. Minnesota Statutes 2024, section 144.125, subdivision 1, is amended to read:
4.28 		Subdivision 1.Duty to perform testing. (a) It is the duty of (1) the administrative officer 
4.29 	or other person in charge of each institution caring for infants 28 days or less of age, (2) the 
4.30 	person required in pursuance of the provisions of section 144.215, to register the birth of a 
4.31 	child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have 
5.1 	administered to every infant or child in its care tests for heritable and congenital disorders 
5.2 	according to subdivision 2 and rules prescribed by the state commissioner of health.
5.3 	(b) Testing, recording of test results, reporting of test results, and follow-up of infants 
5.4 	with heritable congenital disorders, including hearing loss detected through the early hearing 
5.5 	detection and intervention program in section 144.966, shall be performed at the times and 
5.6 	in the manner prescribed by the commissioner of health.
5.7 	(c) The fee to support the newborn screening program, including tests administered 
5.8 	under this section and section 144.966, shall be $177 $184 per specimen. This fee amount 
5.9 	shall be deposited in the state treasury and credited to the state government special revenue 
5.10 	fund.
5.11 	(d) The fee to offset the cost of the support services provided under section 144.966, 
5.12 	subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury 
5.13 	and credited to the general fund.

5.14 	Sec. 6. Minnesota Statutes 2024, section 144.125, subdivision 2, is amended to read:
5.15 		Subd. 2.Determination of tests to be administered. (a) The commissioner shall 
5.16 	periodically revise the list of tests to be administered for determining the presence of a 
5.17 	heritable or congenital disorder. Revisions to the list shall reflect advances in medical 
5.18 	science, new and improved testing methods, or other factors that will improve the public 
5.19 	health. In determining whether a test must be administered, the commissioner shall take 
5.20 	into consideration the adequacy of analytical methods to detect the heritable or congenital 
5.21 	disorder, the ability to treat or prevent medical conditions caused by the heritable or 
5.22 	congenital disorder, and the severity of the medical conditions caused by the heritable or 
5.23 	congenital disorder. The list of tests to be performed may be revised if the changes are 
5.24 	recommended by the advisory committee established under section 144.1255, approved by 
5.25 	the commissioner, and published in the State Register. The revision is exempt from the 
5.26 	rulemaking requirements in chapter 14, and sections 14.385 and 14.386 do not apply.
5.27 	(b) The commissioner shall revise the list of tests to be administered for determining 
5.28 	the presence of a heritable or congenital disorder to include metachromatic leukodystrophy 
5.29 	(MLD).

5.30 	Sec. 7. Minnesota Statutes 2024, section 144.562, subdivision 2, is amended to read:
5.31 		Subd. 2.Eligibility for license condition. (a) A hospital is not eligible to receive a 
5.32 	license condition for swing beds unless (1) it either has a licensed bed capacity of less than 
6.1 	50 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42, 
6.2 	section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that 
6.3 	were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed 
6.4 	capacity of less than 65 beds and the available nursing homes within 50 miles have had, in 
6.5 	the aggregate, an average occupancy rate of 96 percent or higher in the most recent two 
6.6 	years as documented on the statistical reports to the Department of Health; and (2) it is 
6.7 	located in a rural area as defined in the federal Medicare regulations, Code of Federal 
6.8 	Regulations, title 42, section 482.66.
6.9 	(b) Except for those critical access hospitals established under section 144.1483, clause 
6.10 	(9), and section 1820 of the federal Social Security Act, United States Code, title 42, section 
6.11 	1395i-4, that have an attached nursing home or that owned a nursing home located in the 
6.12 	same municipality as of May 1, 2005, eligible hospitals are allowed a total number of days 
6.13 	of swing bed use per year as provided in paragraph (c). Critical access hospitals that have 
6.14 	an attached nursing home or that owned a nursing home located in the same municipality 
6.15 	as of May 1, 2005, are allowed swing bed use as provided in federal law. A critical access 
6.16 	hospital described in section 144.5621 is allowed an unlimited number of days of swing 
6.17 	bed use per year.
6.18 	(c) An eligible hospital is allowed a total of 3,000 days of swing bed use in calendar 
6.19 	year 2020. Beginning in calendar year 2021, and for each subsequent calendar year until 
6.20 	calendar year 2027, the total number of days of swing bed use per year is increased by 200 
6.21 	swing bed use days. Beginning in calendar year 2028, an eligible hospital is allowed a total 
6.22 	of 4,500 days of swing bed use per year.
6.23 	(d) Days of swing bed use for medical care that an eligible hospital has determined are 
6.24 	charity care shall not count toward the applicable limit in paragraph (b) or (c). For purposes 
6.25 	of this paragraph, "charity care" means care that an eligible hospital provided for free or at 
6.26 	a discount to persons who cannot afford to pay and for which the eligible hospital did not 
6.27 	expect payment.
6.28 	(e) Days of swing bed use for care of a person who has been denied admission to every 
6.29 	Medicare-certified skilled nursing facility within 25 miles of the eligible hospital shall not 
6.30 	count toward the applicable limit in paragraphs (b) and (c). Eligible hospitals must maintain 
6.31 	documentation that they have contacted each skilled nursing facility within 25 miles to 
6.32 	determine if any skilled nursing facility beds are available and if the skilled nursing facilities 
6.33 	are willing to admit the patient. Skilled nursing facilities that are contacted must admit the 
6.34 	patient or deny admission within 24 hours of being contacted by the eligible hospital. Failure 
6.35 	to respond within 24 hours is deemed a denial of admission.
7.1 	(f) Except for critical access hospitals that have an attached nursing home or that owned 
7.2 	a nursing home located in the same municipality as of May 1, 2005, the commissioner of 
7.3 	health may approve swing bed use beyond 2,000 days as long as there are no Medicare 
7.4 	certified skilled nursing facility beds available within 25 miles of that hospital that are 
7.5 	willing to admit the patient and the patient agrees to the referral being sent to the skilled 
7.6 	nursing facility. Critical access hospitals exceeding 2,000 swing bed days must maintain 
7.7 	documentation that they have contacted skilled nursing facilities within 25 miles to determine 
7.8 	if any skilled nursing facility beds are available that are willing to admit the patient and the 
7.9 	patient agrees to the referral being sent to the skilled nursing facility. This paragraph expires 
7.10 	January 1, 2020.
7.11 	(g) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which 
7.12 	this limit applies may admit six additional patients to swing beds each year without seeking 
7.13 	approval from the commissioner or being in violation of this subdivision. These six swing 
7.14 	bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals 
7.15 	subject to this limit. This paragraph expires January 1, 2020.
7.16 	(h) A health care system that is in full compliance with this subdivision may allocate its 
7.17 	total limit of swing bed days among the hospitals within the system, provided that no hospital 
7.18 	in the system without an attached nursing home may exceed 2,000 swing bed days per year. 
7.19 	This paragraph expires January 1, 2020.

7.20 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
7.21 	whichever is later. The commissioners of health and human services shall inform the revisor 
7.22 	of statutes when federal approval is obtained.

7.23 	Sec. 8. Minnesota Statutes 2024, section 144.562, subdivision 3, is amended to read:
7.24 		Subd. 3.Approval of license condition. (a) The commissioner of health shall approve 
7.25 	a license condition for swing beds if the hospital meets all of the criteria of this subdivision.
7.26 	(b) The hospital must meet the eligibility criteria in subdivision 2.
7.27 	(c) The hospital must be in compliance with the Medicare conditions of participation 
7.28 	for swing beds under Code of Federal Regulations, title 42, section 482.66.
7.29 	(d) Except as provided in section 144.5621, the hospital must agree, in writing, to limit 
7.30 	the length of stay of a patient receiving services in a swing bed to not more than 40 days, 
7.31 	or the duration of Medicare eligibility, unless the commissioner of health approves a greater 
7.32 	length of stay in an emergency situation. To determine whether an emergency situation 
7.33 	exists, the commissioner shall require the hospital to provide documentation that continued 
8.1 	services in the swing bed are required by the patient; that no skilled nursing facility beds 
8.2 	are available within 25 miles from the patient's home, or in some more remote facility of 
8.3 	the resident's choice, that can provide the appropriate level of services required by the 
8.4 	patient; and that other alternative services are not available to meet the needs of the patient. 
8.5 	If the commissioner approves a greater length of stay, the hospital shall develop a plan 
8.6 	providing for the discharge of the patient upon the availability of a nursing home bed or 
8.7 	other services that meet the needs of the patient. Permission to extend a patient's length of 
8.8 	stay must be requested by the hospital at least ten days prior to the end of the maximum 
8.9 	length of stay.
8.10 	(e) Except as provided in section 144.5621, the hospital must agree, in writing, to limit 
8.11 	admission to a swing bed only to (1) patients who have been hospitalized and not yet 
8.12 	discharged from the facility, or (2) patients who are transferred directly from an acute care 
8.13 	hospital.
8.14 	(f) The hospital must agree, in writing, to report to the commissioner of health by 
8.15 	December 1, 1985, and annually thereafter, in a manner required by the commissioner (1) 
8.16 	the number of patients readmitted to a swing bed within 60 days of a patient's discharge 
8.17 	from the facility, (2) the hospital's charges for care in a swing bed during the reporting 
8.18 	period with a description of the care provided for the rate charged, and (3) the number of 
8.19 	beds used by the hospital for transitional care and similar subacute inpatient care.
8.20 	(g) The hospital must agree, in writing, to report statistical data on the utilization of the 
8.21 	swing beds on forms supplied by the commissioner. The data must include the number of 
8.22 	swing beds, the number of admissions to and discharges from swing beds, Medicare 
8.23 	reimbursed patient days, total patient days, and other information required by the 
8.24 	commissioner to assess the utilization of swing beds.

8.25 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
8.26 	whichever is later. The commissioners of health and human services shall inform the revisor 
8.27 	of statutes when federal approval is obtained.

8.28 	Sec. 9. [144.5621] SWING BED APPROVAL; EXCEPTIONS.
8.29 		Subdivision 1.Swing bed exemption. (a) The conditions and limitations in section 
8.30 	144.562, paragraphs (d) and (e), do not apply to any hospital located in Cook County that:
8.31 	(1) is designated as a critical access hospital under section 144.1483, clause (9), and 
8.32 	United States Code, title 42, section 1395i-4; and
8.33 	(2) has an attached nursing home.
9.1 	(b) Any swing bed located in a hospital described in this section may be used to provide 
9.2 	nursing care without requiring a prior hospital stay.
9.3 	(c) The nursing care provided to a patient in a swing bed is a covered medical assistance 
9.4 	service under section 256B.0625, subdivision 2b.
9.5 		Subd. 2.Application of the health care bill of rights. A patient in a swing bed located 
9.6 	in a hospital described in this section is a resident of a nursing home for the purposes of 
9.7 	section 144.651.
9.8 		Subd. 3.Comprehensive resident assessment. A patient in a swing bed located in a 
9.9 	hospital described in this section is a resident of a nursing home for the purposes of Minnesota 
9.10 	Rules, part 4658.0400.

9.11 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
9.12 	whichever is later. The commissioners of health and human services shall inform the revisor 
9.13 	of statutes when federal approval is obtained.

9.14 	Sec. 10. Minnesota Statutes 2024, section 144.563, is amended to read:
9.15 	144.563 NURSING SERVICES PROVIDED IN A HOSPITAL; PROHIBITED 
9.16 	PRACTICES.
9.17 	A hospital that has been granted a license condition under section 144.562or 144.5621 
9.18 	must not provide to patients not reimbursed by Medicare or medical assistance the types of 
9.19 	services that would be usually and customarily provided and reimbursed under medical 
9.20 	assistance or Medicare as services of a skilled nursing facility or intermediate care facility 
9.21 	for more than 42 days and only for patients who have been hospitalized and no longer require 
9.22 	an acute level of care. Permission to extend a patient's length of stay may be granted by the 
9.23 	commissioner if requested by the physician at least ten days prior to the end of the maximum 
9.24 	length of stay.

9.25 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
9.26 	whichever is later. The commissioners of health and human services shall inform the revisor 
9.27 	of statutes when federal approval is obtained.

9.28 	Sec. 11. Minnesota Statutes 2024, section 144.608, subdivision 2, is amended to read:
9.29 		Subd. 2.Council administration. (a) The council must meet at least twice a year but 
9.30 	may meet more frequently at the call of the chair, a majority of the council members, or the 
9.31 	commissioner.
10.1 	(b) The terms, compensation, and removal of members of the council are governed by 
10.2 	section 15.059. The council expires June 30, 2025 2035.
10.3 	(c) The council may appoint subcommittees and work groups. Subcommittees shall 
10.4 	consist of council members. Work groups may include noncouncil members. Noncouncil 
10.5 	members shall be compensated for work group activities under section 15.059, subdivision 
10.6 	3, but shall receive expenses only.

10.7 	Sec. 12. Minnesota Statutes 2024, section 144.966, subdivision 2, is amended to read:
10.8 		Subd. 2.Newborn Hearing Screening Advisory Committee. (a) The commissioner 
10.9 	of health shall establish a Newborn Hearing Screening Advisory Committee to advise and 
10.10 	assist the Department of Health; Department of Children, Youth, and Families; and the 
10.11 	Department of Education in:
10.12 	(1) developing protocols and timelines for screening, rescreening, and diagnostic 
10.13 	audiological assessment and early medical, audiological, and educational intervention 
10.14 	services for children who are deaf or hard-of-hearing;
10.15 	(2) designing protocols for tracking children from birth through age three that may have 
10.16 	passed newborn screening but are at risk for delayed or late onset of permanent hearing 
10.17 	loss;
10.18 	(3) designing a technical assistance program to support facilities implementing the 
10.19 	screening program and facilities conducting rescreening and diagnostic audiological 
10.20 	assessment;
10.21 	(4) designing implementation and evaluation of a system of follow-up and tracking; and
10.22 	(5) evaluating program outcomes to increase effectiveness and efficiency and ensure 
10.23 	culturally appropriate services for children with a confirmed hearing loss and their families.
10.24 	(b) The commissioner of health shall appoint at least one member from each of the 
10.25 	following groups with no less than two of the members being deaf or hard-of-hearing:
10.26 	(1) a representative from a consumer organization representing culturally deaf persons;
10.27 	(2) a parent with a child with hearing loss representing a parent organization;
10.28 	(3) a consumer from an organization representing oral communication options;
10.29 	(4) a consumer from an organization representing cued speech communication options;
10.30 	(5) an audiologist who has experience in evaluation and intervention of infants and 
10.31 	young children;
11.1 	(6) a speech-language pathologist who has experience in evaluation and intervention of 
11.2 	infants and young children;
11.3 	(7) two primary care providers who have experience in the care of infants and young 
11.4 	children, one of which shall be a pediatrician;
11.5 	(8) a representative from the early hearing detection intervention teams;
11.6 	(9) a representative from the Department of Education resource center for the deaf and 
11.7 	hard-of-hearing or the representative's designee;
11.8 	(10) a representative of the Commission of the Deaf, DeafBlind and Hard of Hearing;
11.9 	(11) a representative from the Department of Human Services Deaf and Hard-of-Hearing 
11.10 	Services Division;
11.11 	(12) one or more of the Part C coordinators from the Department of Education; the 
11.12 	Department of Health; the Department of Children, Youth, and Families; or the Department 
11.13 	of Human Services or the department's designees;
11.14 	(13) the Department of Health early hearing detection and intervention coordinators;
11.15 	(14) two birth hospital representatives from one rural and one urban hospital;
11.16 	(15) a pediatric geneticist;
11.17 	(16) an otolaryngologist;
11.18 	(17) a representative from the Newborn Screening Advisory Committee under this 
11.19 	subdivision;
11.20 	(18) a representative of the Department of Education regional low-incidence facilitators;
11.21 	(19) a representative from the deaf mentor program; and
11.22 	(20) a representative of the Minnesota State Academy for the Deaf from the Minnesota 
11.23 	State Academies staff.
11.24 	The commissioner must complete the initial appointments required under this subdivision 
11.25 	by September 1, 2007, and the initial appointments under clauses (19) and (20) by September 
11.26 	1, 2019.
11.27 	(c) The Department of Health member shall chair the first meeting of the committee. At 
11.28 	the first meeting, the committee shall elect a chair from its membership. The committee 
11.29 	shall meet at the call of the chair, at least four times a year. The committee shall adopt 
11.30 	written bylaws to govern its activities. The Department of Health shall provide technical 
11.31 	and administrative support services as required by the committee. These services shall 
12.1 	include technical support from individuals qualified to administer infant hearing screening, 
12.2 	rescreening, and diagnostic audiological assessments.
12.3 	Members of the committee shall receive no compensation for their service, but shall be 
12.4 	reimbursed as provided in section 15.059 for expenses incurred as a result of their duties 
12.5 	as members of the committee.
12.6 	(d) By February 15, 2015, and by February 15 of the odd-numbered years after that date, 
12.7 	the commissioner shall report to the chairs and ranking minority members of the legislative 
12.8 	committees with jurisdiction over health and data privacy on the activities of the committee 
12.9 	that have occurred during the past two years.
12.10 	(e) This subdivision expires June 30, 2025.

12.11 	EFFECTIVE DATE. This section is effective the day following final enactment or 
12.12 	June 30, 2025, whichever is earlier.

12.13 	Sec. 13. Minnesota Statutes 2024, section 145.8811, is amended to read:
12.14 	145.8811 MATERNAL AND CHILD HEALTH ADVISORY TASK FORCE
12.15 	COMMITTEE.
12.16 		Subdivision 1.Composition of task force committee. The commissioner shall establish 
12.17 	and appoint a Maternal and Child Health Advisory Task Force Committee consisting of 15 
12.18 	members who will provide equal representation from:
12.19 	(1) professionals with expertise in maternal and child health services;
12.20 	(2) representatives of community health boards as defined in section 145A.02, subdivision 
12.21 	5; and
12.22 	(3) consumer representatives interested in the health of mothers and children.
12.23 	No members shall be employees of the Minnesota Department of Health. Section 15.059
12.24 	governs the Maternal and Child Health Advisory Task Force Committee. Notwithstanding 
12.25 	section 15.059, the Maternal and Child Health Advisory Task Force Committee does not 
12.26 	expire.
12.27 		Subd. 2.Duties. The advisory task force committee shall meet on a regular basis to 
12.28 	perform the following duties:
12.29 	(1) review and report on the health care needs of mothers and children throughout the 
12.30 	state of Minnesota;
13.1 	(2) review and report on the type, frequency, and impact of maternal and child health 
13.2 	care services provided to mothers and children under existing maternal and child health 
13.3 	care programs, including programs administered by the commissioner of health;
13.4 	(3) establish, review, and report to the commissioner a list of program guidelines and 
13.5 	criteria which the advisory task force committee considers essential to providing an effective 
13.6 	maternal and child health care program to low-income populations and high-risk persons 
13.7 	and fulfilling the purposes defined in section 145.88;
13.8 	(4) make recommendations to the commissioner for the use of other federal and state 
13.9 	funds available to meet maternal and child health needs;
13.10 	(5) make recommendations to the commissioner of health on priorities for funding the 
13.11 	following maternal and child health services:
13.12 	(i) prenatal, delivery, and postpartum care;
13.13 	(ii) comprehensive health care for children, especially from birth through five years of 
13.14 	age;
13.15 	(iii) adolescent health services;
13.16 	(iv) family planning services;
13.17 	(v) preventive dental care;
13.18 	(vi) special services for chronically ill and disabled children; and
13.19 	(vii) any other services that promote the health of mothers and children; and
13.20 	(6) establish in consultation with the commissioner statewide outcomes that will improve 
13.21 	the health status of mothers and children.

13.22 	Sec. 14. Minnesota Statutes 2024, section 256B.0625, subdivision 2, is amended to read:
13.23 		Subd. 2.Skilled and intermediate nursing care. (a) Medical assistance covers skilled 
13.24 	nursing home services and services of intermediate care facilities, including training and 
13.25 	habilitation services, as defined in section 252.41, subdivision 3, for persons with 
13.26 	developmental disabilities who are residing in intermediate care facilities for persons with 
13.27 	developmental disabilities. Medical assistance must not be used to pay the costs of nursing 
13.28 	care provided to a patient in a swing bed as defined in section 144.562, unless (1) the facility 
13.29 	in which the swing bed is located is eligible as a sole community provider, as defined in 
13.30 	Code of Federal Regulations, title 42, section 412.92, or the facility is a public hospital 
13.31 	owned by a governmental entity with 15 or fewer licensed acute care beds; (2) the Centers 
14.1 	for Medicare and Medicaid Services approves the necessary state plan amendments; (3) the 
14.2 	patient was screened as provided by law; (4) the patient no longer requires acute care 
14.3 	services; and (5) no nursing home beds are available within 25 miles of the facility. The 
14.4 	commissioner shall exempt a facility from compliance with the sole community provider 
14.5 	requirement in clause (1) if, as of January 1, 2004, the facility had an agreement with the 
14.6 	commissioner to provide medical assistance swing bed services.
14.7 	(b) Medical assistance also covers up to ten days of nursing care provided to a patient 
14.8 	in a swing bed if: (1) the patient's physician, advanced practice registered nurse, or physician 
14.9 	assistant certifies that the patient has a terminal illness or condition that is likely to result 
14.10 	in death within 30 days and that moving the patient would not be in the best interests of the 
14.11 	patient and patient's family; (2) no open nursing home beds are available within 25 miles 
14.12 	of the facility; and (3) no open beds are available in any Medicare hospice program within 
14.13 	50 miles of the facility. The daily medical assistance payment for nursing care for the patient 
14.14 	in the swing bed is the statewide average medical assistance skilled nursing care per diem 
14.15 	as computed annually by the commissioner on July 1 of each year.

14.16 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
14.17 	whichever is later. The commissioners of health and human services shall inform the revisor 
14.18 	of statutes when federal approval is obtained.

14.19 	Sec. 15. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision 
14.20 	to read:
14.21 		Subd. 2b.Nursing care provided to a patient in a swing bed. (a) Medical assistance 
14.22 	must not be used to pay the costs of nursing care provided to a patient in a swing bed as 
14.23 	defined in section 144.562, unless:
14.24 	(1) the facility in which the swing bed is located is eligible as a sole community provider, 
14.25 	as defined in Code of Federal Regulations, title 42, section 412.92, or the facility is a public 
14.26 	hospital owned by a governmental entity with 25 or fewer licensed acute care beds;
14.27 	(2) the Centers for Medicare and Medicaid Services approves the necessary state plan 
14.28 	amendments;
14.29 	(3) the patient was screened as provided by law;
14.30 	(4) the patient no longer requires acute care services; and
14.31 	(5) no nursing home beds are available within 25 miles of the facility.
15.1 	(b) The commissioner shall exempt a facility from compliance with the sole community 
15.2 	provider requirement in paragraph (a), clause (1), if, as of January 1, 2004, the facility had 
15.3 	an agreement with the commissioner to provide medical assistance swing bed services.
15.4 	(c) Medical assistance also covers up to ten days of nursing care provided to a patient 
15.5 	in a swing bed if:
15.6 	(1) the patient's physician, advanced practice registered nurse, or physician assistant 
15.7 	certifies that the patient has a terminal illness or condition that is likely to result in death 
15.8 	within 30 days and that moving the patient would not be in the best interests of the patient 
15.9 	and patient's family;
15.10 	(2) no open nursing home beds are available within 25 miles of the facility; and
15.11 	(3) no open beds are available in any Medicare hospice program within 50 miles of the 
15.12 	facility.
15.13 	(d) The commissioner shall exempt any facility described under section 144.5621 from 
15.14 	compliance with the requirements of paragraph (a), clauses (3) and (5), and paragraph (c), 
15.15 	and medical assistance covers an unlimited number of days of nursing care provided to a 
15.16 	patient in a swing bed at a facility described under section 144.5621.
15.17 	(e) The daily medical assistance payment for nursing care for the patient in the swing 
15.18 	bed is the statewide average medical assistance skilled nursing care per diem as computed 
15.19 	annually by the commissioner on July 1 of each year.

15.20 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
15.21 	whichever is later. The commissioners of health and human services shall inform the revisor 
15.22 	of statutes when federal approval is obtained.

15.23 	Sec. 16. Minnesota Statutes 2024, section 256R.01, is amended by adding a subdivision 
15.24 	to read:
15.25 		Subd. 1a.Payment rates for nursing care provided to a patient in a swing 
15.26 	bed. Payment rates paid to any hospital for nursing care provided to a patient in a swing 
15.27 	bed must be those rates established pursuant section 256B.0625, subdivision 2b.

15.28 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
15.29 	whichever is later. The commissioners of health and human services shall inform the revisor 
15.30 	of statutes when federal approval is obtained.

16.1 	Sec. 17. SPOKEN LANGUAGE HEALTH CARE INTERPRETER WORK GROUP.
16.2 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
16.3 	the meanings given.
16.4 	(b) "Commissioner" means the commissioner of health.
16.5 	(c) "Common languages" means the 15 most common languages without regard to dialect 
16.6 	in Minnesota.
16.7 	(d) "Registered interpreter" means a spoken language interpreter who is listed on the 
16.8 	Department of Health's spoken language health care interpreter roster.
16.9 	(e) "Work group" means the spoken language health care interpreter work group 
16.10 	established in this section.
16.11 		Subd. 2.Composition. The commissioner, after receiving work group candidate 
16.12 	applications, must appoint 15 members to the work group consisting of the following 
16.13 	members:
16.14 	(1) three members who are interpreters listed on the Department of Health's spoken 
16.15 	language health care interpreter roster and who are Minnesota residents. Of these members:
16.16 	(i) each must be an interpreter for a different language;
16.17 	(ii) at least one must have a national certification credential; and
16.18 	(iii) at least one must have been listed on the roster as an interpreter in a language other 
16.19 	than the common languages and must have completed a nationally recognized training 
16.20 	program for health care interpreters that is, at a minimum, 40 hours in length;
16.21 	(2) three members representing limited English proficiency (LEP) individuals. Of these 
16.22 	members, two must represent LEP individuals who are proficient in a common language 
16.23 	other than English and one must represent LEP individuals who are proficient in a language 
16.24 	that is not one of the common languages;
16.25 	(3) one member representing a health plan company;
16.26 	(4) one member who is not an interpreter and who is representing a Minnesota health 
16.27 	system;
16.28 	(5) two members representing interpreter agencies, including one member representing 
16.29 	agencies whose main office is located outside the seven-county metropolitan area and one 
16.30 	member representing agencies whose main office is located within the seven-county 
16.31 	metropolitan area;
17.1 	(6) one member representing the Department of Health;
17.2 	(7) one member representing the Department of Human Services;
17.3 	(8) one member representing an interpreter training program or postsecondary educational 
17.4 	institution program providing interpreter courses or skills assessment;
17.5 	(9) one member who is affiliated with a Minnesota-based or Minnesota chapter of a 
17.6 	national or international organization representing interpreters; and
17.7 	(10) one member who is a licensed health care provider.
17.8 		Subd. 3.Duties. The work group must compile a list of recommendations to support 
17.9 	and improve access to the critical health care interpreting services provided across the state, 
17.10 	including but not limited to:
17.11 	(1) changing requirements for registered and certified interpreters to reflect changing 
17.12 	needs of the Minnesota health care community and emerging national standards of training, 
17.13 	competency, and testing;
17.14 	(2) addressing barriers for interpreters to gain access to the roster, including barriers for 
17.15 	interpreters of languages other than common languages and interpreters in rural areas;
17.16 	(3) reimbursing spoken language health care interpreting;
17.17 	(4) identifying gaps in interpreter services in rural areas and recommending ways to 
17.18 	address interpreter training and funding needs;
17.19 	(5) training, certification, and continuing education programs;
17.20 	(6) convening a meeting of public and private sector representatives of the spoken 
17.21 	language health care interpreter community to identify ongoing sources of financial assistance 
17.22 	to aid individual interpreters in meeting interpreter training and testing requirements;
17.23 	(7) conducting surveys of people receiving and providing interpreter services to 
17.24 	understand changing needs and consumer quality of care; and
17.25 	(8) suggesting changes in requirements and qualifications on telehealth or remote 
17.26 	interpreting.
17.27 		Subd. 4.Compensation; expense reimbursement. Compensation shall be offered to 
17.28 	work group members not being compensated for their participation in work group activities 
17.29 	as part of their existing job duties. Work group members shall be compensated and 
17.30 	reimbursed for expenses for work group activities under Minnesota Statutes, section 15.059, 
17.31 	subdivision 3.
18.1 		Subd. 5.Administrative support; meeting space, meeting facilitation. The 
18.2 	commissioner must provide meeting space and administrative support for the work group. 
18.3 	The commissioner may contract with a neutral independent consultant to provide this 
18.4 	administrative support and to facilitate and lead the meetings of the work group.
18.5 		Subd. 6.Deadline for appointments. The commissioner must appoint members to the 
18.6 	work group by August 15, 2025.
18.7 		Subd. 7.Expiration. The work group and this section expire on November 2, 2026, or 
18.8 	upon submission of the report required under subdivision 9, whichever is earlier.
18.9 		Subd. 8.Initial work group meetings. The commissioner must convene the first meeting 
18.10 	of the work group by October 1, 2025. Prior to the first meeting, work group members must 
18.11 	receive survey results and evidence-based research on interpreter services in Minnesota. 
18.12 	During the first meetings, work group members must receive survey results and consult 
18.13 	with subject matter experts, including but not limited to signed language interpreting experts, 
18.14 	academic experts with knowledge of interpreting research, and academic health experts to 
18.15 	address specific gaps in spoken language health care interpreting. The work group must 
18.16 	provide a minimum of two opportunities for public comment. These opportunities shall be 
18.17 	announced with at least four weeks' notice, with publicity in the five most common languages 
18.18 	in Minnesota. Interpreters for those same languages shall be provided during the public 
18.19 	comment opportunities.
18.20 		Subd. 9.Report. By November 1, 2026, the commissioner must provide the chairs and 
18.21 	ranking minority members of the legislative committees with jurisdiction over health care 
18.22 	interpreter services with recommendations, including draft legislation and any statutory 
18.23 	changes needed to implement the recommendations, to improve and support access to health 
18.24 	care interpreting services statewide.

18.25 	Sec. 18. TITLE.
 18.26 	The amendments to Minnesota Statutes, section 144.1222, subdivision 2d, in this act 
18.27 	may be cited as the "Free the Hot Tub Act."

18.28 	Sec. 19. REPEALER.
 18.29 	Minnesota Statutes 2024, section 145.361, is repealed.

19.1 	ARTICLE 2
19.2 	DEPARTMENT OF HEALTH POLICY

19.3 	Section 1. Minnesota Statutes 2024, section 62J.51, subdivision 19a, is amended to read:
19.4 		Subd. 19a.Uniform explanation of benefits document. "Uniform explanation of 
19.5 	benefits document" means either the document associated with and explaining the details 
19.6 	of a group purchaser's claim adjudication for services rendered or its electronic equivalent 
19.7 	under section 62J.581, which is sent to a patient.

19.8 	Sec. 2. Minnesota Statutes 2024, section 62J.581, is amended to read:
19.9 	62J.581 STANDARDS FOR MINNESOTA UNIFORM HEALTH CARE 
19.10 	REIMBURSEMENT DOCUMENTS.
19.11 		Subdivision 1.Minnesota uniform remittance advice.  All group purchasers shall 
19.12 	provide a uniform claim payment/advice transaction to health care providers when a claim 
19.13 	is adjudicated. The uniform claim payment/advice transaction shall comply with section 
19.14 	62J.536, subdivision 1, paragraph (b), and rules adopted under section 62J.536, subdivision 
19.15 	2.
19.16 		Subd. 2.Minnesota uniform explanation of benefits document. (a) All group 
19.17 	purchasers shall provide a uniform explanation of benefits document to health care patients 
19.18 	when an explanation of benefits document is provided as otherwise required or permitted 
19.19 	by law. The uniform explanation of benefits document shall comply with the standards 
19.20 	prescribed in this section.
19.21 	(b) Notwithstanding paragraph (a), this section does not apply to group purchasers not 
19.22 	included as covered entities under United States Code, title 42, sections 1320d to 1320d-8, 
19.23 	as amended from time to time, and the regulations promulgated under those sections.
19.24 		Subd. 3.Scope. For purposes of sections 62J.50 to 62J.61, the uniform claim 
19.25 	payment/advice transaction and uniform explanation of benefits document format specified 
19.26 	in subdivision 4 shall apply to all health care services delivered by a health care provider 
19.27 	or health care provider organization in Minnesota, regardless of the location of the payer. 
19.28 	Health care services not paid on an individual claims basis, such as capitated payments, are 
19.29 	not included in this section. A health plan company is excluded from the requirements in 
19.30 	subdivisions 1 and subdivision 2 if they comply with section 62A.01, subdivisions 2 and 
19.31 	3.
20.1 		Subd. 4.Specifications. (a) The uniform explanation of benefits document shall be 
20.2 	provided by use of a paper document conforming to the specifications in this section or its 
20.3 	electronic equivalent under paragraph (b).
20.4 	(b) Group purchasers may make the uniform explanation of benefits available in a version 
20.5 	that can be accessed by health care patients electronically if:
20.6 	(1) the group purchaser making the uniform explanation of benefits available 
20.7 	electronically provides health care patients the ability to choose whether to receive paper, 
20.8 	electronic, or both paper and electronic versions of their uniform explanation of benefits;
20.9 	(2) the group purchaser provides clear, readily accessible information and instructions 
20.10 	for the patient to communicate their choice; and
20.11 	(3) health care patients not responding to the opportunity to make a choice will receive 
20.12 	at a minimum a paper uniform explanation of benefits.
20.13 	(c) The commissioner, after consulting with the Administrative Uniformity Committee, 
20.14 	shall specify the data elements and definitions for the paper uniform explanation of benefits 
20.15 	document. The commissioner and the Administrative Uniformity Committee must consult 
20.16 	with the Minnesota Dental Association and Delta Dental Plan of Minnesota before requiring 
20.17 	under this section the use of a paper document for the uniform explanation of benefits 
20.18 	document or the uniform claim payment/advice transaction for dental care services. Any 
20.19 	electronic version of the uniform explanation of benefits must use the same data elements 
20.20 	and definitions as the paper uniform explanation of benefits.
20.21 		Subd. 5.Effective date. The requirements in subdivisions 1 and 2 are effective June 30, 
20.22 	2007. The requirements in subdivisions 1 and 2 apply regardless of when the health care 
20.23 	service was provided to the patient.

20.24 	Sec. 3. Minnesota Statutes 2024, section 144.50, is amended by adding a subdivision to 
20.25 	read:
20.26 		Subd. 8.Controlling person. (a) For hospitals licensed under sections 144.50 to 144.56, 
20.27 	"controlling person" means an owner and the following individuals and entities, if applicable:
20.28 	(1) each officer of the organization, including the chief executive officer and the chief 
20.29 	financial officer;
20.30 	(2) the hospital administrator;
20.31 	(3) any managerial official; and
20.32 	(4) any individual or entity who has a direct or indirect ownership interest in:
21.1 	(i) any corporation, partnership, or other business association which is a controlling 
21.2 	person;
21.3 	(ii) the land on which a hospital is located;
21.4 	(iii) the structure in which a hospital is located;
21.5 	(iv) any entity with at least a five percent mortgage, contract for deed, deed of trust, or 
21.6 	other security interest in the land or structure comprising a hospital; or
21.7 	(v) any lease or sublease of the land, structure, or facilities comprising a hospital.
21.8 	(b) "Controlling person" does not include:
21.9 	(1) a bank, savings bank, trust company, savings association, credit union, industrial 
21.10 	loan and thrift company, investment banking firm, or insurance company unless the entity 
21.11 	directly or through a subsidiary operates a hospital;
21.12 	(2) government and government-sponsored entities such as the United States Department 
21.13 	of Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the 
21.14 	Minnesota Housing Finance Agency which provide loans, financing, and insurance products 
21.15 	for housing sites;
21.16 	(3) an individual who is a state or federal official, a state or federal employee, or a 
21.17 	member or employee of the governing body of a political subdivision of the state or federal 
21.18 	government that operates one or more hospitals, unless the individual is also an officer, 
21.19 	owner, or managerial official of the hospital, receives any remuneration from the hospital, 
21.20 	or is a controlling person not otherwise excluded in this subdivision;
21.21 	(4) an individual who is a member of a tax-exempt organization under section 290.05, 
21.22 	subdivision 2, unless the individual is also a controlling person not otherwise excluded in 
21.23 	this subdivision; or
21.24 	(5) an individual who owns less than five percent of the outstanding common shares of 
21.25 	a corporation:
21.26 	(i) whose securities are exempt by virtue of section 80A.45, clause (6); or
21.27 	(ii) whose transactions are exempt by virtue of section 80A.46, clause (7).

21.28 	Sec. 4. Minnesota Statutes 2024, section 144.555, subdivision 1a, is amended to read:
21.29 		Subd. 1a.Notice of closing, curtailing operations, relocating services, or ceasing to 
21.30 	offer certain services; hospitals. (a) The controlling persons of a hospital licensed under 
21.31 	sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health, the 
22.1 	public, and others at least 182 days before the hospital or hospital campus voluntarily plans 
22.2 	to implement one of the scheduled actions listed in paragraph (b), unless the controlling 
22.3 	persons can demonstrate to the commissioner that meeting the advanced notice requirement 
22.4 	is not feasible and the commissioner approves a shorter advanced notice.
22.5 	(b) The following scheduled actions require advanced notice under paragraph (a):
22.6 	(1) ceasing operations;
22.7 	(2) curtailing operations to the extent that patients receiving inpatient health services or 
22.8 	emergency department services must be relocated;
22.9 	(3) relocating the provision of inpatient health services or emergency department services 
22.10 	to another hospital or another hospital campus; or
22.11 	(4) ceasing to offer inpatient maternity care and inpatient newborn care services, inpatient 
22.12 	intensive care unit services, inpatient mental health services, or inpatient substance use 
22.13 	disorder treatment services.
22.14 	(c) A notice required under this subdivision must comply with the requirements in 
22.15 	subdivision 1d.
22.16 	(d) The commissioner shall cooperate with the controlling persons and advise them 
22.17 	about relocating the patients.
22.18 	(e) For purposes of this subdivision, "inpatient" means services provided to an individual 
22.19 	admitted to a hospital for bed occupancy.

22.20 	Sec. 5. Minnesota Statutes 2024, section 144.555, subdivision 1b, is amended to read:
22.21 		Subd. 1b.Public hearing. Within 30 days after receiving notice under subdivision 1a, 
22.22 	the commissioner shall conduct a public hearing on the scheduled cessation of operations, 
22.23 	curtailment of operations, relocation of health services, or cessation in offering health 
22.24 	services. The commissioner must provide adequate public notice of the hearing in a time 
22.25 	and manner determined by the commissioner. The commissioner must ensure that video 
22.26 	conferencing technology is used at the public hearing to allow members of the public to 
22.27 	view and participate in the hearing. The controlling persons of the hospital or hospital 
22.28 	campus must participate in the public hearing. The public hearing must be held at a location 
22.29 	that is within ten miles of the hospital or hospital campus or with the commissioner's approval 
22.30 	as close as is practicable, that can accommodate the hearing's anticipated public attendance, 
22.31 	and that is provided or arranged by the hospital or hospital campus. Video conferencing 
23.1 	technology must be used to allow members of the public to view and participate in the 
23.2 	hearing. The public hearing must include:
23.3 	(1) an explanation by the controlling persons of the reasons for ceasing or curtailing 
23.4 	operations, relocating health services, or ceasing to offer any of the listed health services;
23.5 	(2) a description of the actions that controlling persons will take to ensure that residents 
23.6 	in the hospital's or campus's service area have continued access to the health services being 
23.7 	eliminated, curtailed, or relocated;
23.8 	(3) an opportunity for at least one hour of public testimony on the scheduled cessation 
23.9 	or curtailment of operations, relocation of health services, or cessation in offering any of 
23.10 	the listed health services, and on the hospital's or campus's plan to ensure continued access 
23.11 	to those health services being eliminated, curtailed, or relocated; and
23.12 	(4) an opportunity for the controlling persons to respond to questions from interested 
23.13 	persons.

23.14 	ARTICLE 3
23.15 	HEALTH LICENSING BOARDS

23.16 	Section 1. Minnesota Statutes 2024, section 144.99, subdivision 1, is amended to read:
23.17 		Subdivision 1.Remedies available. The provisions of chapters 103I and 157 and sections 
23.18 	115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), 
23.19 	and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385; 
23.20 	144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98; 
23.21 	144.992;147.037, subdivision 1b, paragraph (d); 326.70 to 326.785; 327.10 to 327.131; 
23.22 	and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance 
23.23 	agreements, licenses, registrations, certificates, and permits adopted or issued by the 
23.24 	department or under any other law now in force or later enacted for the preservation of 
23.25 	public health may, in addition to provisions in other statutes, be enforced under this section.

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

23.27 	Sec. 2. Minnesota Statutes 2024, section 147.01, subdivision 7, is amended to read:
23.28 		Subd. 7.Physician application and license fees. (a) The board may charge the following 
23.29 	nonrefundable application and license fees processed pursuant to sections 147.02, 147.03, 
23.30 	147.037, 147.0375, and 147.38:
23.31 	(1) physician application fee, $200;
24.1 	(2) physician annual registration renewal fee, $192;
24.2 	(3) physician endorsement to other states, $40;
24.3 	(4) physician emeritus license, $50;
24.4 	(5) physician late fee, $60;
24.5 	(6) nonrenewable 24-month limited license, $392;
24.6 	(7) initial physician license for limited license holder, $192;
24.7 	(6) (8) duplicate license fee, $20;
24.8 	(7) (9) certification letter fee, $25;
24.9 	(8) (10) education or training program approval fee, $100;
24.10 	(9) (11) report creation and generation fee, $60 per hour;
24.11 	(10) (12) examination administration fee (half day), $50;
24.12 	(11) (13) examination administration fee (full day), $80;
24.13 	(12) (14) fees developed by the Interstate Commission for determining physician 
24.14 	qualification to register and participate in the interstate medical licensure compact, as 
24.15 	established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and
24.16 	(13) (15) verification fee, $25.
24.17 	(b) The board may prorate the initial annual license fee. All licensees are required to 
24.18 	pay the full fee upon license renewal. The revenue generated from the fee must be deposited 
24.19 	in an account in the state government special revenue fund.

24.20 	Sec. 3. Minnesota Statutes 2024, section 147.037, is amended by adding a subdivision to 
24.21 	read:
24.22 		Subd. 1b.Limited license. (a) A limited license under this subdivision is valid for one 
24.23 	24-month period and is not renewable or eligible for reapplication. The board may issue a 
24.24 	limited license, valid for 24 months, to any person who satisfies the requirements of 
24.25 	subdivision 1, paragraphs (a) to (c) and (e) to (g), and who:
24.26 	(1) pursuant to a license or other authorization to practice, has practiced medicine, as 
24.27 	defined in section 147.081, subdivision 3, clauses (2) to (4), for at least 60 months in the 
24.28 	previous 12 years outside of the United States;
25.1 	(2) submits sufficient evidence of an offer to practice within the context of a collaborative 
25.2 	agreement within a hospital or clinical setting where the limited license holder and physicians 
25.3 	work together to provide patient care;
25.4 	(3) provides services in a designated rural area or underserved urban community as 
25.5 	defined in section 144.1501; and
25.6 	(4) submits two letters of recommendation in support of a limited license, which must 
25.7 	include one letter from a physician with whom the applicant previously worked and one 
25.8 	letter from an administrator of the hospital or clinical setting in which the applicant previously 
25.9 	worked. The letters of recommendation must attest to the applicant's good medical standing. 
25.10 	The board may accept alternative forms of proof that demonstrate good medical standing 
25.11 	where there are extenuating circumstances that prevent an applicant from providing letters.
25.12 	(b) For purposes of this subdivision, a person has satisfied the requirements of subdivision 
25.13 	1, paragraph (e), if the person has passed steps or levels one and two of the USMLE or the 
25.14 	COMLEX-USA with passing scores as recommended by the USMLE program or National 
25.15 	Board of Osteopathic Medical Examiners within three attempts.
25.16 	(c) A person issued a limited license under this subdivision must not be required to 
25.17 	present evidence satisfactory to the board of the completion of one year of graduate clinical 
25.18 	medical training in a program accredited by a national accrediting organization approved 
25.19 	by the board.
25.20 	(d) An employer of a limited license holder must pay the limited license holder at least 
25.21 	an amount equivalent to a medical resident in a comparable field. The employer must carry 
25.22 	medical malpractice insurance covering a limited license holder for the duration of the 
25.23 	employment. The commissioner of health may issue a correction order under section 144.99, 
25.24 	subdivision 3, requiring an employer to comply with this paragraph. An employer must not 
25.25 	retaliate against or discipline an employee for raising a complaint or pursuing enforcement 
25.26 	relating to this paragraph.
25.27 	(e) The board may issue a full and unrestricted license to practice medicine to a person 
25.28 	who holds a limited license issued pursuant to paragraph (a) and who has:
25.29 	(1) held the limited license for two years and is in good standing to practice medicine 
25.30 	in this state;
25.31 	(2) practiced for a minimum of 1,692 hours per year for each of the previous two years;
26.1 	(3) submitted a letter of recommendation in support of a full and unrestricted license 
26.2 	containing all attestations required under paragraph (i) from any physician who participated 
26.3 	in the collaborative agreement;
26.4 	(4) passed steps or levels one, two, and three of the USMLE or COMLEX-USA with 
26.5 	passing scores as recommended by the USMLE program or National Board of Osteopathic 
26.6 	Medical Examiners within three attempts; and
26.7 	(5) completed 20 hours of continuing medical education.
26.8 	(f) A limited license holder must submit to the board, every six months or upon request, 
26.9 	a statement certifying whether the person is still employed as a physician in this state and 
26.10 	whether the person has been subjected to professional discipline as a result of the person's 
26.11 	practice. The board may suspend or revoke a limited license if a majority of the board 
26.12 	determines that the limited license holder is no longer employed as a physician in this state 
26.13 	by an employer. The limited license holder must be granted an opportunity to be heard prior 
26.14 	to the board's determination. Upon request by the limited license holder, the limited license 
26.15 	holder may have 90 days to regain employment. A limited license holder may change 
26.16 	employers during the duration of the limited license if the limited license holder has another 
26.17 	offer of employment. In the event that a change of employment occurs, the limited license 
26.18 	holder must still work the number of hours required under paragraph (e), clause (2), to be 
26.19 	eligible for a full and unrestricted license to practice medicine.
26.20 	(g) In addition to any other remedy provided by law, the board may, without a hearing, 
26.21 	temporarily suspend the license of a limited license holder if the board finds that the limited 
26.22 	license holder has violated a statute or rule that the board is empowered to enforce and 
26.23 	continued practice by the limited license holder would create a serious risk of harm to the 
26.24 	public. The suspension takes effect upon written notice to the limited license holder, 
26.25 	specifying the statute or rule violated. The suspension remains in effect until the board 
26.26 	issues a final order in the matter after a hearing. At the time it issues the suspension notice, 
26.27 	the board shall schedule a disciplinary hearing to be held pursuant to the Administrative 
26.28 	Procedure Act. The limited license holder shall be provided with at least 20 days' notice of 
26.29 	any hearing held pursuant to this subdivision. The hearing shall be scheduled to begin no 
26.30 	later than 30 days after the issuance of the suspension order.
26.31 	(h) For purposes of this subdivision, "collaborative agreement" means a mutually agreed 
26.32 	upon plan for the overall working relationship and collaborative arrangement between a 
26.33 	holder of a limited license and one or more physicians licensed under this chapter that 
26.34 	designates the scope of services that can be provided to manage the care of patients. The 
27.1 	limited license holder and one of the collaborating physicians must have experience in 
27.2 	providing care to patients with the same or similar medical conditions. Under the 
27.3 	collaborative agreement, the limited license holder must shadow the collaborating physician 
27.4 	for four weeks, after which time the limited license holder must staff all patient encounters 
27.5 	with the collaborating physician for an additional four weeks. After eight weeks, the 
27.6 	collaborating physician has discretion to allow the limited license holder to see patients 
27.7 	independently and may, at the discretion of the collaborating physician, require the limited 
27.8 	license holder to present patients. However, the limited license holder must be supervised 
27.9 	by the collaborating physician for a minimum of two hours per week. A limited license 
27.10 	holder may practice medicine without a collaborating physician physically present, but the 
27.11 	limited license holder and collaborating physicians must be able to easily contact each other 
27.12 	by radio, telephone, or other telecommunication device while the limited license holder 
27.13 	practices medicine. The limited license holder must have one-on-one practice reviews with 
27.14 	each collaborating physician, provided in person or through eye-to-eye electronic media 
27.15 	while maintaining visual contact, for at least two hours per week.
27.16 	(i) At least one collaborating physician must submit a letter to the board, after the limited 
27.17 	license holder has practiced under the license for 12 months, attesting to the following:
27.18 	(1) the limited license holder has a basic understanding of federal and state laws regarding 
27.19 	the provision of health care, including but not limited to:
27.20 	(i) medical licensing obligations and standards; and
27.21 	(ii) the Health Insurance Portability and Accountability Act, Public Law 104-191;
27.22 	(2) the limited license holder has a basic understanding of documentation standards;
27.23 	(3) the limited license holder has a thorough understanding of which medications are 
27.24 	available and unavailable in the United States;
27.25 	(4) the limited license holder has a thorough understanding of American medical standards 
27.26 	of care;
27.27 	(5) the limited license holder has demonstrated mastery of each of the following:
27.28 	(i) gathering a history and performing a physical exam;
27.29 	(ii) developing and prioritizing a differential diagnosis following a clinical encounter 
27.30 	and selecting a working diagnosis;
27.31 	(iii) recommending and interpreting common diagnostic and screening tests;
27.32 	(iv) entering and discussing orders and prescriptions;
28.1 	(v) providing an oral presentation of a clinical encounter;
28.2 	(vi) giving a patient handover to transition care responsibly;
28.3 	(vii) recognizing a patient requiring urgent care and initiating an evaluation; and
28.4 	(viii) obtaining informed consent for tests, procedures, and treatments; and
28.5 	(6) the limited license holder is providing appropriate medical care.
28.6 	(j) The board must not grant a license under this section unless the applicant possesses 
28.7 	federal immigration status that allows the applicant to practice as a physician in the United 
28.8 	States.

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

28.10 	Sec. 4. Minnesota Statutes 2024, section 147D.03, subdivision 1, is amended to read:
28.11 		Subdivision 1.General. Within the meaning of sections 147D.01 to 147D.27, a person 
28.12 	who shall publicly profess to be a traditional midwife and who, for a fee, shall assist or 
28.13 	attend to a woman in pregnancy, childbirth outside a hospital, and postpartum, shall be 
28.14 	regarded as practicing traditional midwifery. Effective July 1, 2026, a certified midwife 
28.15 	licensed by the Board of Nursing under chapter 148G is not subject to the provisions of this 
28.16 	chapter.

28.17 	Sec. 5. Minnesota Statutes 2024, section 148.241, is amended to read:
28.18 	148.241 EXPENSES.
28.19 		Subdivision 1.Appropriation. The expenses of administering sections 148.171 to 
28.20 	148.285and chapter 148G shall be paid from the appropriation made to the Minnesota 
28.21 	Board of Nursing.
28.22 		Subd. 2.Expenditure. All amounts appropriated to the board shall be held subject to 
28.23 	the order of the board to be used only for the purpose of meeting necessary expenses incurred 
28.24 	in the performance of the purposes of sections 148.171 to 148.285 and chapter 148G, and 
28.25 	the duties imposed thereby as well as the promotion of nursing or certified midwifery 
28.26 	education and standards of nursing or certified midwifery care in this state.

28.27 	Sec. 6. [148G.01] TITLE.
28.28 	This chapter shall be referred to as the "Minnesota Certified Midwife Practice Act."

29.1 	Sec. 7. [148G.02] SCOPE; EFFECTIVE DATE.
29.2 	This chapter is effective July 1, 2026, and applies to all applicants and licensees, all 
29.3 	persons who use the title certified midwife, and all persons in or out of this state who provide 
29.4 	certified midwifery services to patients who reside in this state, unless there are specific 
29.5 	applicable exemptions provided by law.

29.6 	Sec. 8. [148G.03] DEFINITIONS.
29.7 		Subdivision 1.Scope. For purposes of this chapter, the definitions in this section have 
29.8 	the meanings given.
29.9 		Subd. 2.Board. "Board" means the Minnesota Board of Nursing.
29.10 		Subd. 3.Certification. "Certification" means the formal recognition by the American 
29.11 	Midwifery Certification Board of the knowledge, skills, and experience demonstrated by 
29.12 	the achievement of standards identified by the American College of Nurse Midwives or any 
29.13 	successor organization.
29.14 		Subd. 4.Certified midwife. "Certified midwife" means an individual who holds a current 
29.15 	and valid national certification as a certified midwife from the American Midwifery 
29.16 	Certification Board or any successor organization, and who is licensed by the board under 
29.17 	this chapter.
29.18 		Subd. 5.Certified midwifery practice. "Certified midwifery practice" means:
29.19 	(1) managing, diagnosing, and treating women's primary health care beginning in 
29.20 	adolescence, including pregnancy, childbirth, postpartum period, care of the newborn, family 
29.21 	planning, partner care management relating to sexual health, and gynecological care of 
29.22 	women;
29.23 	(2) ordering, performing, supervising, and interpreting diagnostic studies within the 
29.24 	scope of certified midwifery practice, excluding:
29.25 	(i) interpreting and performing specialized ultrasound examinations; and
29.26 	(ii) interpreting computed tomography scans, magnetic resonance imaging scans, positron 
29.27 	emission tomography scans, nuclear scans, and mammography;
29.28 	(3) prescribing pharmacologic and nonpharmacologic therapies appropriate to midwifery 
29.29 	practice;
29.30 	(4) consulting with, collaborating with, or referring to other health care providers as 
29.31 	warranted by the needs of the patient; and
30.1 	(5) performing the role of educator in the theory and practice of midwifery.
30.2 		Subd. 6.Collaborating. "Collaborating" means the process in which two or more health 
30.3 	care professionals work together to meet the health care needs of a patient, as warranted by 
30.4 	the needs of the patient.
30.5 		Subd. 7.Consulting. "Consulting" means the process in which a certified midwife who 
30.6 	maintains primary management responsibility for a patient's care seeks advice or opinion 
30.7 	of a physician, an advanced practice registered nurse, or another member of the health care 
30.8 	team.
30.9 		Subd. 8.Encumbered. "Encumbered" means:
30.10 	(1) a license or other credential that is revoked, is suspended, or contains limitations on 
30.11 	the full and unrestricted practice of certified midwifery when the revocation, suspension, 
30.12 	or limitation is imposed by a state licensing board or other state regulatory entity; or
30.13 	(2) a license or other credential that is voluntarily surrendered.
30.14 		Subd. 9.Licensure period. "Licensure period" means the interval of time during which 
30.15 	the certified midwife is authorized to engage in certified midwifery. The initial licensure 
30.16 	period is from six to 29 full calendar months starting on the day of licensure and ending on 
30.17 	the last day of the certified midwife's month of birth in an even-numbered year if the year 
30.18 	of birth is an even-numbered year, or in an odd-numbered year if the year of birth is in an 
30.19 	odd-numbered year. Subsequent licensure renewal periods are 24 months. For licensure 
30.20 	renewal, the period starts on the first day of the month following expiration of the previous 
30.21 	licensure period. The period ends the last day of the certified midwife's month of birth in 
30.22 	an even- or odd-numbered year according to the certified midwife's year of birth.
30.23 		Subd. 10.Licensed practitioner. "Licensed practitioner" means a physician licensed 
30.24 	under chapter 147, an advanced practice registered nurse licensed under sections 148.171 
30.25 	to 148.235, or a certified midwife licensed under this chapter.
30.26 		Subd. 11.Midwifery education program. "Midwifery education program" means a 
30.27 	program of theory and practice, offered by a university or college, that leads to the preparation 
30.28 	and eligibility for certification in midwifery and is accredited by the Accreditation 
30.29 	Commission for Midwifery Education or any successor organization recognized by the 
30.30 	United States Department of Education or the Council for Higher Education Accreditation.
30.31 		Subd. 12.Patient. "Patient" means a recipient of care provided by a certified midwife 
30.32 	within the scope of certified midwifery practice, including an individual, family, group, or 
30.33 	community.
31.1 		Subd. 13.Prescribing. "Prescribing" means the act of generating a prescription for the 
31.2 	preparation of, use of, or manner of using a drug or therapeutic device under section 148G.09. 
31.3 	Prescribing does not include recommending the use of a drug or therapeutic device that is 
31.4 	not required by the federal Food and Drug Administration to meet the labeling requirements 
31.5 	for prescription drugs and devices.
31.6 		Subd. 14.Prescription. "Prescription" means a written direction or an oral direction 
31.7 	reduced to writing provided to or for a patient for the preparation or use of a drug or 
31.8 	therapeutic device. The requirements of section 151.01, subdivisions 16, 16a, and 16b, apply 
31.9 	to prescriptions for drugs.
31.10 		Subd. 15.Referral. "Referral" means the process in which a certified midwife directs 
31.11 	a patient to a physician or another health care professional for management of a particular 
31.12 	problem or aspect of the patient's care.
31.13 		Subd. 16.Supervision. "Supervision" means monitoring and establishing the initial 
31.14 	direction of, setting expectations for, directing activities in, evaluating, and changing a 
31.15 	course of action in certified midwifery care.

31.16 	Sec. 9. [148G.04] CERTIFIED MIDWIFE LICENSING.
31.17 		Subdivision 1.Licensure. (a) No person shall practice as a certified midwife or serve 
31.18 	as the faculty of record for clinical instruction in a midwifery distance learning program 
31.19 	unless the person is licensed by the board under this chapter.
31.20 	(b) An applicant for a license to practice as a certified midwife must apply to the board 
31.21 	in a format prescribed by the board and pay a fee in an amount determined under section 
31.22 	148G.11.
31.23 	(c) To be eligible for licensure, an applicant must:
31.24 	(1) not hold an encumbered license or other credential as a certified midwife or equivalent 
31.25 	professional designation in any state or territory;
31.26 	(2) hold a current and valid certification as a certified midwife from the American 
31.27 	Midwifery Certification Board or any successor organization acceptable to the board and 
31.28 	provide primary source verification of certification to the board in a format prescribed by 
31.29 	the board;
31.30 	(3) have completed a graduate level midwifery education program that includes clinical 
31.31 	experience, is accredited by the Accreditation Commission for Midwifery Education or any 
31.32 	successor organization recognized by the United States Department of Education or the 
32.1 	Council for Higher Education Accreditation, and leads to a graduate degree. The applicant 
32.2 	must submit primary source verification of program completion to the board in a format 
32.3 	prescribed by the board. The primary source verification must verify the applicant completed 
32.4 	three separate graduate-level courses in physiology and pathophysiology; advanced health 
32.5 	assessment; and advanced pharmacology, including pharmacodynamics, pharmacokinetics, 
32.6 	and pharmacotherapeutics of all broad categories of agents;
32.7 	(4) report any criminal conviction, nolo contendere plea, Alford plea, or other plea 
32.8 	arrangement in lieu of conviction; and
32.9 	(5) not have committed any acts or omissions that are grounds for disciplinary action in 
32.10 	another jurisdiction or, if these acts were committed and would be grounds for disciplinary 
32.11 	action as set forth in section 148G.13, the board has found after an investigation that sufficient 
32.12 	remediation was made.
32.13 		Subd. 2.Clinical practice component. If more than five years have elapsed since the 
32.14 	applicant has practiced in the certified midwife role, the applicant must complete a 
32.15 	reorientation plan as a certified midwife. The plan must include supervision during the 
32.16 	clinical component by a licensed practitioner with experience in providing care to patients 
32.17 	with the same or similar health care needs. The applicant must submit the plan and the name 
32.18 	of the practitioner to the board. The plan must include a minimum of 500 hours of supervised 
32.19 	certified midwifery practice. The certified midwife must submit verification of completion 
32.20 	of the clinical reorientation to the board when the reorientation is complete.

32.21 	Sec. 10. [148G.05] LICENSURE RENEWAL; RELICENSURE.
32.22 		Subdivision 1.Renewal; current applicants. (a) A certified midwife must apply for 
32.23 	renewal of the certified midwife's license before the certified midwife's licensure period 
32.24 	ends. To be considered timely, the board must receive the certified midwife's application 
32.25 	on or before the last day of the certified midwife's licensure period. A certified midwife's 
32.26 	license lapses if the certified midwife's application is untimely.
32.27 	(b) An applicant for license renewal must provide the board evidence of current 
32.28 	certification or recertification as a certified midwife by the American Midwifery Certification 
32.29 	Board or any successor organization.
32.30 	(c) An applicant for license renewal must submit to the board the fee under section 
32.31 	148G.11, subdivision 2.
32.32 		Subd. 2.Clinical practice component. If more than five years have elapsed since the 
32.33 	applicant has practiced as a certified midwife, the applicant must complete a reorientation 
33.1 	plan as a certified midwife. The plan must include supervision during the clinical component 
33.2 	by a licensed practitioner with experience in providing care to patients with the same or 
33.3 	similar health care needs. The licensee must submit the plan and the name of the practitioner 
33.4 	to the board. The plan must include a minimum of 500 hours of supervised certified 
33.5 	midwifery practice. The certified midwife must submit verification of completion of the 
33.6 	clinical reorientation to the board when the reorientation is complete.
33.7 		Subd. 3.Relicensure; lapsed applicants. A person whose license has lapsed and who 
33.8 	desires to resume practice as a certified midwife must apply for relicensure, submit to the 
33.9 	board satisfactory evidence of compliance with the procedures and requirements established 
33.10 	by the board, and pay the board the relicensure fee under section 148G.11, subdivision 4, 
33.11 	for the current licensure period. A penalty fee under section 148G.11, subdivision 4, is 
33.12 	required from a person who practiced certified midwifery without current licensure. The 
33.13 	board must relicense a person who meets the requirements of this subdivision.

33.14 	Sec. 11. [148G.06] FAILURE OR REFUSAL TO PROVIDE INFORMATION.
33.15 		Subdivision 1.Notification requirement. An individual licensed as a certified midwife 
33.16 	must notify the board when the individual renews their certification. If a licensee fails to 
33.17 	provide notification, the licensee is prohibited from practicing as a certified midwife.
33.18 		Subd. 2.Denial of license. Refusal of an applicant to supply information necessary to 
33.19 	determine the applicant's qualifications, failure to demonstrate qualifications, or failure to 
33.20 	satisfy the requirements for a license contained in this chapter or rules of the board may 
33.21 	result in denial of a license. The burden of proof is upon the applicant to demonstrate the 
33.22 	qualifications and satisfaction of the requirements.

33.23 	Sec. 12. [148G.07] NAME CHANGE AND CHANGE OF ADDRESS.
33.24 	A certified midwife must maintain a current name and address with the board and must 
33.25 	notify the board in writing within 30 days of any change in name or address. All notices or 
33.26 	other correspondence mailed to or served upon a certified midwife by the board at the 
33.27 	licensee's address on file with the board are considered received by the licensee.

33.28 	Sec. 13. [148G.08] IDENTIFICATION OF CERTIFIED MIDWIVES.
33.29 	Only those persons who hold a current license to practice certified midwifery in this 
33.30 	state may use the title of certified midwife. A certified midwife licensed by the board must 
33.31 	use the designation of "CM" for professional identification and in documentation of services 
33.32 	provided.

34.1 	Sec. 14. [148G.09] PRESCRIBING DRUGS AND THERAPEUTIC DEVICES.
34.2 		Subdivision 1.Diagnosing, prescribing, and ordering. Certified midwives, within the 
34.3 	scope of certified midwifery practice, are authorized to:
34.4 	(1) diagnose, prescribe, and institute therapy or referrals of patients to health care agencies 
34.5 	and providers;
34.6 	(2) prescribe, procure, sign for, record, administer, and dispense over-the-counter, legend, 
34.7 	and controlled substances, including sample drugs; and
34.8 	(3) plan and initiate a therapeutic regimen that includes ordering and prescribing durable 
34.9 	medical devices and equipment, nutrition, diagnostic services, and supportive services, 
34.10 	including but not limited to home health care, physical therapy, and occupational therapy.
34.11 		Subd. 2.Drug Enforcement Administration requirements. (a) Certified midwives 
34.12 	must:
34.13 	(1) comply with federal Drug Enforcement Administration (DEA) requirements related 
34.14 	to controlled substances; and
34.15 	(2) file the certified midwife's DEA registrations and numbers, if any, with the board.
34.16 	(b) The board must maintain current records of all certified midwives with a DEA 
34.17 	registration and number.

34.18 	Sec. 15. [148G.10] FEES.
34.19 	The fees specified in section 148G.11 are nonrefundable and must be deposited in the 
34.20 	state government special revenue fund.

34.21 	Sec. 16. [148G.11] FEE AMOUNTS.
34.22 		Subdivision 1.Licensure. The fee for licensure is $105.
34.23 		Subd. 2.Renewal. The fee for licensure renewal is $85.
34.24 		Subd. 3.Practicing without current certification. The penalty fee for a person who 
34.25 	practices certified midwifery without a current certification or recertification, or who practices 
34.26 	certified midwifery without current certification or recertification on file with the board, is 
34.27 	$200 for the first month or part of a month and an additional $100 for each subsequent 
34.28 	month or parts of months of practice. The penalty fee must be calculated from the first day 
34.29 	the certified midwife practiced without a current certification to the last day of practice 
34.30 	without a current certification, or from the first day the certified midwife practiced without 
35.1 	a current certification or recertification on file with the board until the day the current 
35.2 	certification or recertification is filed with the board.
35.3 		Subd. 4.Relicensure. The fee for relicensure is $105. The fee for practicing without 
35.4 	current licensure is two times the amount of the current renewal fee for any part of the first 
35.5 	calendar month, plus the current renewal fee for any part of each subsequent month up to 
35.6 	24 months.
35.7 		Subd. 5.Dishonored check fee. The service fee for a dishonored check is as provided 
35.8 	in section 604.113.

35.9 	Sec. 17. [148G.12] APPROVED MIDWIFERY EDUCATION PROGRAM.
35.10 		Subdivision 1.Initial approval. A university or college desiring to conduct a certified 
35.11 	midwifery education program must submit evidence to the board that the university or 
35.12 	college is prepared to:
35.13 	(1) provide a program of theory and practice in certified midwifery leading to eligibility 
35.14 	for certification in midwifery;
35.15 	(2) achieve preaccreditation and eventual full accreditation by the American Commission 
35.16 	for Midwifery Education or any successor organization recognized by the United States 
35.17 	Department of Education or the Council for Higher Education Accreditation. Instruction 
35.18 	and required experience may be obtained in one or more institutions or agencies outside 
35.19 	the applying university or college if the program retains accountability for all clinical and 
35.20 	nonclinical teaching; and
35.21 	(3) meet other standards established by law and by the board.
35.22 		Subd. 2.Continuing approval. The board must, through the board's representative, 
35.23 	annually survey all midwifery education programs in the state for current accreditation 
35.24 	status by the American Commission for Midwifery Education or any successor organization 
35.25 	recognized by the United States Department of Education or the Council for Higher Education 
35.26 	Accreditation. If the results of the survey show that a certified midwifery education program 
35.27 	meets all standards for continuing accreditation, the board must continue approval of the 
35.28 	certified midwifery education program.
35.29 		Subd. 3.Loss of approval. If the board determines that an accredited certified midwifery 
35.30 	education program is not maintaining the standards required by the American Commission 
35.31 	on Midwifery Education or any successor organization, the board must obtain the defect in 
35.32 	writing from the accrediting body. If a program fails to correct the defect to the satisfaction 
35.33 	of the accrediting body and the accrediting body revokes the program's accreditation, the 
36.1 	board must remove the program from the list of approved certified midwifery education 
36.2 	programs.
36.3 		Subd. 4.Reinstatement of approval. The board must reinstate approval of a certified 
36.4 	midwifery education program upon submission of satisfactory evidence that the certified 
36.5 	midwifery education program of theory and practice meets the standards required by the 
36.6 	accrediting body.

36.7 	Sec. 18. [148G.13] GROUNDS FOR DISCIPLINARY ACTION.
36.8 		Subdivision 1.Grounds listed. The board may deny, revoke, suspend, limit, or condition 
36.9 	the license of any person to practice certified midwifery under this chapter or otherwise 
36.10 	discipline a licensee or applicant as described in section 148G.14. The following are grounds 
36.11 	for disciplinary action:
36.12 	(1) failure to demonstrate the qualifications or satisfy the requirements for a license 
36.13 	contained in this chapter or rules of the board. In the case of an applicant for licensure, the 
36.14 	burden of proof is upon the applicant to demonstrate the qualifications or satisfaction of the 
36.15 	requirements;
36.16 	(2) employing fraud or deceit in procuring or attempting to procure a license to practice 
36.17 	certified midwifery;
36.18 	(3) conviction of a felony or gross misdemeanor reasonably related to the practice of 
36.19 	certified midwifery. Conviction, as used in this subdivision, includes a conviction of an 
36.20 	offense that if committed in this state would be considered a felony or gross misdemeanor 
36.21 	without regard to its designation elsewhere, or a criminal proceeding where a finding or 
36.22 	verdict of guilt is made or returned, but the adjudication of guilt is either withheld or not 
36.23 	entered;
36.24 	(4) revocation, suspension, limitation, conditioning, or other disciplinary action against 
36.25 	the person's certified midwife credential in another state, territory, or country; failure to 
36.26 	report to the board that charges regarding the person's certified midwifery license, 
36.27 	certification, or other credential are pending in another state, territory, or country; or failure 
36.28 	to report to the board having been refused a license or other credential by another state, 
36.29 	territory, or country;
36.30 	(5) failure or inability to practice as a certified midwife with reasonable skill and safety, 
36.31 	or departure from or failure to conform to standards of acceptable and prevailing certified 
36.32 	midwifery, including failure of a certified midwife to adequately supervise or monitor the 
36.33 	performance of acts by any person working at the certified midwife's direction;
37.1 	(6) engaging in unprofessional conduct, including but not limited to a departure from 
37.2 	or failure to conform to statutes relating to certified midwifery practice or to the minimal 
37.3 	standards of acceptable and prevailing certified midwifery practice, or engaging in any 
37.4 	certified midwifery practice that may create unnecessary danger to a patient's life, health, 
37.5 	or safety. Actual injury to a patient need not be established under this clause;
37.6 	(7) supervision or accepting the supervision of a midwifery function or a prescribed 
37.7 	health care function when the acceptance could reasonably be expected to result in unsafe 
37.8 	or ineffective patient care;
37.9 	(8) actual or potential inability to practice certified midwifery with reasonable skill and 
37.10 	safety to patients by reason of illness; by reason of the use of alcohol, drugs, chemicals, or 
37.11 	any other material; or as a result of any mental or physical condition;
37.12 	(9) adjudication as mentally incompetent, mentally ill, a chemically dependent person, 
37.13 	or a person dangerous to the public by a court of competent jurisdiction, within or outside 
37.14 	of this state;
37.15 	(10) engaging in any unethical conduct, including but not limited to conduct likely to 
37.16 	deceive, defraud, or harm the public, or demonstrating a willful or careless disregard for 
37.17 	the health, welfare, or safety of a patient. Actual injury need not be established under this 
37.18 	clause;
37.19 	(11) engaging in conduct with a patient that is sexual or may reasonably be interpreted 
37.20 	by the patient as sexual, in any verbal behavior that is seductive or sexually demeaning to 
37.21 	a patient, or in sexual exploitation of a patient or former patient;
37.22 	(12) obtaining money, property, or services from a patient, other than reasonable fees 
37.23 	for services provided to the patient, through the use of undue influence, harassment, duress, 
37.24 	deception, or fraud;
37.25 	(13) revealing a privileged communication from or relating to a patient except when 
37.26 	otherwise required or permitted by law;
37.27 	(14) engaging in abusive or fraudulent billing practices, including violations of federal 
37.28 	Medicare and Medicaid laws or state medical assistance laws;
37.29 	(15) improper management of patient records, including failure to maintain adequate 
37.30 	patient records, to comply with a patient's request made pursuant to sections 144.291 to 
37.31 	144.298, or to furnish a patient record or report required by law;
37.32 	(16) knowingly aiding, assisting, advising, or allowing an unlicensed person to engage 
37.33 	in the unlawful practice of certified midwifery;
38.1 	(17) violating a rule adopted by the board, an order of the board, a state or federal law 
38.2 	relating to the practice of certified midwifery, or a state or federal narcotics or controlled 
38.3 	substance law;
38.4 	(18) knowingly providing false or misleading information to a patient that is directly 
38.5 	related to the care of that patient unless done for an accepted therapeutic purpose such as 
38.6 	the administration of a placebo;
38.7 	(19) aiding suicide or aiding attempted suicide in violation of section 609.215 as 
38.8 	established by any of the following:
38.9 	(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation 
38.10 	of section 609.215, subdivision 1 or 2;
38.11 	(ii) a copy of the record of a judgment of contempt of court for violating an injunction 
38.12 	issued under section 609.215, subdivision 4;
38.13 	(iii) a copy of the record of a judgment assessing damages under section 609.215, 
38.14 	subdivision 5; or
38.15 	(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2. 
38.16 	The board must investigate any complaint of a violation of section 609.215, subdivision 1 
38.17 	or 2;
38.18 	(20) practicing outside the scope of certified midwifery practice as defined under section 
38.19 	148G.03, subdivision 5;
38.20 	(21) making a false statement or knowingly providing false information to the board, 
38.21 	failing to make reports as required by section 148G.15, or failing to cooperate with an 
38.22 	investigation of the board as required by section 148G.17;
38.23 	(22) engaging in false, fraudulent, deceptive, or misleading advertising;
38.24 	(23) failure to inform the board of the person's certification or recertification status as 
38.25 	a certified midwife;
38.26 	(24) engaging in certified midwifery practice without a license and current certification 
38.27 	or recertification by the American Midwifery Certification Board or any successor 
38.28 	organization; or
38.29 	(25) failure to maintain appropriate professional boundaries with a patient. A certified 
38.30 	midwife must not engage in practices that create an unacceptable risk of patient harm or of 
38.31 	the impairment of a certified midwife's objectivity or professional judgment. A certified 
38.32 	midwife must not act or fail to act in a way that, as judged by a reasonable and prudent 
39.1 	certified midwife, inappropriately encourages the patient to relate to the certified midwife 
39.2 	outside of the boundaries of the professional relationship, or in a way that interferes with 
39.3 	the patient's ability to benefit from certified midwife services. A certified midwife must not 
39.4 	use the professional relationship with a patient, student, supervisee, or intern to further the 
39.5 	certified midwife's personal, emotional, financial, sexual, religious, political, or business 
39.6 	benefit or interests.
39.7 		Subd. 2.Conviction of a felony-level criminal sexual offense. (a) Except as provided 
39.8 	in paragraph (e), the board must not grant or renew a license to practice certified midwifery 
39.9 	to any person who has been convicted on or after August 1, 2014, of any of the provisions 
39.10 	of section 609.342, subdivision 1 or 1a; 609.343, subdivision 1 or 1a; 609.344, subdivision 
39.11 	1 or 1a, paragraphs (c) to (g); or 609.345, subdivision 1 or 1a, paragraphs (c) to (g); or a 
39.12 	similar statute in another jurisdiction.
39.13 	(b) A license to practice certified midwifery is automatically revoked if the licensee is 
39.14 	convicted of an offense listed in paragraph (a).
39.15 	(c) A license to practice certified midwifery that has been denied or revoked under this 
39.16 	subdivision is not subject to chapter 364.
39.17 	(d) For purposes of this subdivision, "conviction" means a plea of guilty, a verdict of 
39.18 	guilty by a jury, or a finding of guilty by the court, unless the court stays imposition or 
39.19 	execution of the sentence and final disposition of the case is accomplished at a nonfelony 
39.20 	level.
39.21 	(e) The board may establish criteria whereby an individual convicted of an offense listed 
39.22 	in paragraph (a) may become licensed if the criteria:
39.23 	(1) utilize a rebuttable presumption that the applicant is not suitable for licensing;
39.24 	(2) provide a standard for overcoming the presumption; and
39.25 	(3) require that a minimum of ten years has elapsed since the applicant's sentence was 
39.26 	discharged.
39.27 	(f) The board must not consider an application under paragraph (e) if the board determines 
39.28 	that the victim involved in the offense was a patient or a client of the applicant at the time 
39.29 	of the offense.
39.30 		Subd. 3.Evidence. In disciplinary actions alleging a violation of subdivision 1, clause 
39.31 	(3) or (4), or 2, a copy of the judgment or proceeding under the seal of the court administrator 
39.32 	or of the administrative agency that entered the same is admissible into evidence without 
39.33 	further authentication and constitutes prima facie evidence of the violation concerned.
40.1 		Subd. 4.Examination; access to medical data. (a) If the board has probable cause to 
40.2 	believe that grounds for disciplinary action exist under subdivision 1, clause (8) or (9), it 
40.3 	may direct the applicant or certified midwife to submit to a mental or physical examination 
40.4 	or chemical dependency evaluation. For the purpose of this subdivision, when a certified 
40.5 	midwife licensed under this chapter is directed in writing by the board to submit to a mental 
40.6 	or physical examination or chemical dependency evaluation, that person is considered to 
40.7 	have consented and to have waived all objections to admissibility on the grounds of privilege. 
40.8 	Failure of the applicant or certified midwife to submit to an examination when directed 
40.9 	constitutes an admission of the allegations against the applicant or certified midwife, unless 
40.10 	the failure was due to circumstances beyond the person's control, and the board may enter 
40.11 	a default and final order without taking testimony or allowing evidence to be presented. A 
40.12 	certified midwife affected under this paragraph must, at reasonable intervals, be given an 
40.13 	opportunity to demonstrate that the competent practice of certified midwifery can be resumed 
40.14 	with reasonable skill and safety to patients. Neither the record of proceedings nor the orders 
40.15 	entered by the board in a proceeding under this paragraph may be used against a certified 
40.16 	midwife in any other proceeding.
40.17 	(b) Notwithstanding sections 13.384, 144.651, and 595.02, or any other law limiting 
40.18 	access to medical or other health data, the board may obtain medical data and health records 
40.19 	relating to a certified midwife or applicant for a license without that person's consent if the 
40.20 	board has probable cause to believe that grounds for disciplinary action exist under 
40.21 	subdivision 1, clause (8) or (9). The medical data may be requested from a provider, as 
40.22 	defined in section 144.291, subdivision 2; an insurance company; or a government agency, 
40.23 	including the Department of Human Services or Direct Care and Treatment. A provider, 
40.24 	insurance company, or government agency must comply with any written request of the 
40.25 	board under this subdivision and is not liable in any action for damages for releasing the 
40.26 	data requested by the board if the data are released pursuant to a written request under this 
40.27 	subdivision, unless the information is false and the provider giving the information knew 
40.28 	or had reason to believe the information was false. Information obtained under this 
40.29 	subdivision is classified as private data on individuals as defined in section 13.02.

40.30 	Sec. 19. [148G.14] FORMS OF DISCIPLINARY ACTION; AUTOMATIC 
40.31 	SUSPENSION; TEMPORARY SUSPENSION; REISSUANCE.
40.32 		Subdivision 1.Forms of disciplinary action. If the board finds that grounds for 
40.33 	disciplinary action exist under section 148G.13, it may take one or more of the following 
40.34 	actions:
41.1 	(1) deny the license application or application for license renewal;
41.2 	(2) revoke the license;
41.3 	(3) suspend the license;
41.4 	(4) impose limitations on the certified midwife's practice of certified midwifery, including 
41.5 	but not limited to limitation of scope of practice or the requirement of practice under 
41.6 	supervision;
41.7 	(5) impose conditions on the retention of the license, including but not limited to the 
41.8 	imposition of retraining or rehabilitation requirements or the conditioning of continued 
41.9 	practice on demonstration of knowledge or skills by appropriate examination, monitoring, 
41.10 	or other review;
41.11 	(6) impose a civil penalty not exceeding $10,000 for each separate violation. The amount 
41.12 	of the civil penalty must be fixed so as to deprive the certified midwife of any economic 
41.13 	advantage gained by reason of the violation charged; to reimburse the board for the cost of 
41.14 	counsel, investigation, and proceeding; and to discourage repeated violations;
41.15 	(7) order the certified midwife to provide unremunerated service;
41.16 	(8) censure or reprimand the certified midwife; or
41.17 	(9) any other action justified by the facts in the case.
41.18 		Subd. 2.Automatic suspension of license. (a) Unless the board orders otherwise, a 
41.19 	license to practice certified midwifery is automatically suspended if:
41.20 	(1) a guardian of a certified midwife is appointed by order of a court under sections 
41.21 	524.5-101 to 524.5-502;
41.22 	(2) the certified midwife is committed by order of a court under chapter 253B; or
41.23 	(3) the certified midwife is determined to be mentally incompetent, mentally ill, 
41.24 	chemically dependent, or a person dangerous to the public by a court of competent 
41.25 	jurisdiction within or outside of this state.
41.26 	(b) The license remains suspended until the certified midwife is restored to capacity by 
41.27 	a court and, upon petition by the certified midwife, the suspension is terminated by the 
41.28 	board after a hearing or upon agreement between the board and the certified midwife.
41.29 		Subd. 3.Temporary suspension of license. In addition to any other remedy provided 
41.30 	by law, the board may, through its designated board member under section 214.10, 
41.31 	subdivision 2, temporarily suspend the license of a certified midwife without a hearing if 
42.1 	the board finds that there is probable cause to believe the certified midwife has violated a 
42.2 	statute or rule the board is empowered to enforce and continued practice by the certified 
42.3 	midwife would create a serious risk of harm to others. The suspension takes effect upon 
42.4 	written notice to the certified midwife, served by first-class mail, specifying the statute or 
42.5 	rule violated. The suspension must remain in effect until the board issues a temporary stay 
42.6 	of suspension or a final order in the matter after a hearing or upon agreement between the 
42.7 	board and the certified midwife. At the time it issues the suspension notice, the board must 
42.8 	schedule a disciplinary hearing to be held under the Administrative Procedure Act. The 
42.9 	board must provide the certified midwife at least 20 days' notice of any hearing held under 
42.10 	this subdivision. The board must schedule the hearing to begin no later than 30 days after 
42.11 	the issuance of the suspension order.
42.12 		Subd. 4.Reissuance. The board may reinstate and reissue a license to practice certified 
42.13 	midwifery, but as a condition may impose any disciplinary or corrective measure that it 
42.14 	might originally have imposed. Any person whose license has been revoked, suspended, or 
42.15 	limited may have the license reinstated and a new license issued when, at the discretion of 
42.16 	the board, the action is warranted, provided that the board must require the person to pay 
42.17 	the costs of the proceedings resulting in the revocation, suspension, or limitation of the 
42.18 	license; the relicensure fee; and the fee for the current licensure period. The cost of 
42.19 	proceedings includes but is not limited to the cost paid by the board to the Office of 
42.20 	Administrative Hearings and the Office of the Attorney General for legal and investigative 
42.21 	services; the costs of a court reporter and witnesses, reproduction of records, board staff 
42.22 	time, travel, and expenses; and the costs of board members' per diem reimbursements, travel 
42.23 	costs, and expenses.

42.24 	Sec. 20. [148G.15] REPORTING OBLIGATIONS.
42.25 		Subdivision 1.Permission to report. A person who has knowledge of any conduct 
42.26 	constituting grounds for discipline under section 148G.13 may report the alleged violation 
42.27 	to the board.
42.28 		Subd. 2.Institutions. The chief nursing executive or chief administrative officer of any 
42.29 	hospital, clinic, prepaid medical plan, or other health care institution or organization located 
42.30 	in this state must report to the board any action taken by the institution or organization or 
42.31 	any of its administrators or committees to revoke, suspend, limit, or condition a certified 
42.32 	midwife's privilege to practice in the institution, or as part of the organization, any denial 
42.33 	of privileges, any dismissal from employment, or any other disciplinary action. The institution 
42.34 	or organization must also report the resignation of any certified midwife before the conclusion 
43.1 	of any disciplinary proceeding, or before commencement of formal charges, but after the 
43.2 	certified midwife had knowledge that formal charges were contemplated or in preparation. 
43.3 	The reporting described by this subdivision is required only if the action pertains to grounds 
43.4 	for disciplinary action under section 148G.13.
43.5 		Subd. 3.Licensed professionals. A person licensed by a health-related licensing board 
43.6 	as defined in section 214.01, subdivision 2, must report to the board personal knowledge 
43.7 	of any conduct the person reasonably believes constitutes grounds for disciplinary action 
43.8 	under section 148G.13 by any certified midwife, including conduct indicating that the 
43.9 	certified midwife may be incompetent, may have engaged in unprofessional or unethical 
43.10 	conduct, or may be mentally or physically unable to engage safely in the practice of certified 
43.11 	midwifery.
43.12 		Subd. 4.Insurers. (a) By the first day of February, May, August, and November, each 
43.13 	insurer authorized to sell insurance described in section 60A.06, subdivision 1, clause (13), 
43.14 	and providing professional liability insurance to certified midwives must submit to the board 
43.15 	a report concerning any certified midwife against whom a malpractice award has been made 
43.16 	or who has been a party to a settlement. The report must contain at least the following 
43.17 	information:
43.18 	(1) the total number of settlements or awards;
43.19 	(2) the date a settlement or award was made;
43.20 	(3) the allegations contained in the claim or complaint leading to the settlement or award;
43.21 	(4) the dollar amount of each malpractice settlement or award and whether that amount 
43.22 	was paid as a result of a settlement or of an award; and
43.23 	(5) the name and address of the practice of the certified midwife against whom an award 
43.24 	was made or with whom a settlement was made.
43.25 	(b) An insurer must also report to the board any information it possesses that tends to 
43.26 	substantiate a charge that a certified midwife may have engaged in conduct in violation of 
43.27 	this chapter.
43.28 		Subd. 5.Courts. The court administrator of district court or another court of competent 
43.29 	jurisdiction must report to the board any judgment or other determination of the court that 
43.30 	adjudges or includes a finding that a certified midwife is a person who is mentally ill, 
43.31 	mentally incompetent, chemically dependent, dangerous to the public, guilty of a felony or 
43.32 	gross misdemeanor, guilty of a violation of federal or state narcotics laws or controlled 
43.33 	substances act, guilty of operating a motor vehicle while under the influence of alcohol or 
44.1 	a controlled substance, or guilty of an abuse or fraud under Medicare or Medicaid; or if the 
44.2 	court appoints a guardian of the certified midwife under sections 524.5-101 to 524.5-502 
44.3 	or commits a certified midwife under chapter 253B.
44.4 		Subd. 6.Deadlines; forms. Reports required by subdivisions 2, 3, and 5 must be 
44.5 	submitted no later than 30 days after the occurrence of the reportable event or transaction. 
44.6 	The board may provide forms for the submission of reports required by this section, may 
44.7 	require that the reports be submitted on the forms provided, and may adopt rules necessary 
44.8 	to ensure prompt and accurate reporting. The board must review all reports, including those 
44.9 	submitted after the deadline.
44.10 		Subd. 7.Failure to report. Any person, institution, insurer, or organization that fails to 
44.11 	report as required under subdivisions 2 to 6 is subject to civil penalties for failing to report 
44.12 	as required by law.

44.13 	Sec. 21. [148G.16] IMMUNITY.
44.14 		Subdivision 1.Reporting. Any person, health care facility, business, or organization is 
44.15 	immune from civil liability and criminal prosecution for submitting in good faith a report 
44.16 	to the board under section 148G.15 or for otherwise reporting in good faith to the board 
44.17 	violations or alleged violations of this chapter. All such reports are investigative data as 
44.18 	defined in chapter 13.
44.19 		Subd. 2.Investigation. (a) Members of the board and persons employed by the board 
44.20 	or engaged in the investigation of violations and in the preparation and management of 
44.21 	charges of violations of this chapter on behalf of the board, or persons participating in the 
44.22 	investigation or testifying regarding charges of violations, are immune from civil liability 
44.23 	and criminal prosecution for any actions, transactions, or publications in the execution of, 
44.24 	or relating to, their duties under this chapter.
44.25 	(b) Members of the board and persons employed by the board or engaged in maintaining 
44.26 	records and making reports regarding adverse health care events are immune from civil 
44.27 	liability and criminal prosecution for any actions, transactions, or publications in the 
44.28 	execution of, or relating to, their duties under this chapter.

44.29 	Sec. 22. [148G.17] CERTIFIED MIDWIFE COOPERATION.
44.30 	A certified midwife who is the subject of an investigation by or on behalf of the board 
44.31 	must cooperate fully with the investigation. Cooperation includes responding fully and 
44.32 	promptly to any question raised by or on behalf of the board relating to the subject of the 
45.1 	investigation and providing copies of patient or other records in the certified midwife's 
45.2 	possession, as reasonably requested by the board, to assist the board in its investigation and 
45.3 	to appear at conferences and hearings scheduled by the board. The board must pay for copies 
45.4 	requested. If the board does not have written consent from a patient permitting access to 
45.5 	the patient's records, the certified midwife must delete any data in the record that identify 
45.6 	the patient before providing it to the board. The board must maintain any records obtained 
45.7 	pursuant to this section as investigative data under chapter 13. The certified midwife must 
45.8 	not be excused from giving testimony or producing any documents, books, records, or 
45.9 	correspondence on the grounds of self-incrimination, but the testimony or evidence must 
45.10 	not be used against the certified midwife in any criminal case.

45.11 	Sec. 23. [148G.18] DISCIPLINARY RECORD ON JUDICIAL REVIEW.
45.12 	Upon judicial review of any board disciplinary action taken under this chapter, the 
45.13 	reviewing court must seal the administrative record, except for the board's final decision, 
45.14 	and must not make the administrative record available to the public.

45.15 	Sec. 24. [148G.19] EXEMPTIONS.
45.16 	The provisions of this chapter do not prohibit:
45.17 	(1) the furnishing of certified midwifery assistance in an emergency;
45.18 	(2) the practice of certified midwifery by any legally qualified certified midwife of 
45.19 	another state who is employed by the United States government or any bureau, division, or 
45.20 	agency thereof while in the discharge of official duties;
45.21 	(3) the practice of any profession or occupation licensed by the state, other than certified 
45.22 	midwifery, by any person licensed to practice the profession or occupation, or the 
45.23 	performance by a person of any acts properly coming within the scope of the profession, 
45.24 	occupation, or license;
45.25 	(4) the practice of traditional midwifery as specified under section 147D.03;
45.26 	(5) certified midwifery practice by a student practicing under the supervision of an 
45.27 	instructor while the student is enrolled in an approved certified midwifery education program; 
45.28 	or
45.29 	(6) certified midwifery practice by a certified midwife licensed in another state, territory, 
45.30 	or jurisdiction who is in Minnesota temporarily:
45.31 	(i) providing continuing or in-service education;
46.1 	(ii) serving as a guest lecturer;
46.2 	(iii) presenting at a conference; or
46.3 	(iv) teaching didactic content via distance education to a student located in Minnesota 
46.4 	who is enrolled in a formal, structured course of study, such as a course leading to a higher 
46.5 	degree in midwifery.

46.6 	Sec. 25. [148G.20] VIOLATIONS; PENALTY.
46.7 		Subdivision 1.Violations described. It is unlawful for any person, corporation, firm, 
46.8 	or association to:
46.9 	(1) sell or fraudulently obtain or furnish any certified midwifery diploma, license, or 
46.10 	record, or aid or abet therein;
46.11 	(2) practice certified midwifery under cover of any diploma, permit, license, certified 
46.12 	midwife credential, or record illegally or fraudulently obtained or signed or issued unlawfully 
46.13 	or under fraudulent representation;
46.14 	(3) practice certified midwifery unless the person is licensed to do so under this chapter;
46.15 	(4) use the professional title certified midwife or licensed certified midwife unless 
46.16 	licensed to practice certified midwifery under this chapter;
46.17 	(5) use any abbreviation or other designation tending to imply licensure as a certified 
46.18 	midwife unless licensed to practice certified midwifery under this chapter;
46.19 	(6) practice certified midwifery in a manner prohibited by the board in any limitation 
46.20 	of a license issued under this chapter;
46.21 	(7) practice certified midwifery during the time a license issued under this chapter is 
46.22 	suspended or revoked;
46.23 	(8) knowingly employ persons in the practice of certified midwifery who have not been 
46.24 	issued a current license to practice as a certified midwife in this state; or
46.25 	(9) conduct a certified midwifery program for the education of persons to become certified 
46.26 	midwives unless the program has been approved by the board.
46.27 		Subd. 2.Penalty. Any person, corporation, or association violating any provision of 
46.28 	subdivision 1 is guilty of a gross misdemeanor and must be punished according to law.
46.29 		Subd. 3.Penalty; certified midwives. In addition to subdivision 2, a person who practices 
46.30 	certified midwifery without a current license and certification or recertification, or without 
47.1 	current certification or recertification on file with the board, is subject to the applicable 
47.2 	penalties in section 148G.11.

47.3 	Sec. 26. [148G.21] UNAUTHORIZED PRACTICE OF MIDWIFERY.
47.4 	The practice of certified midwifery by any person who is not licensed to practice certified 
47.5 	midwifery under this chapter, whose license has been suspended or revoked, or whose 
47.6 	national certification credential has expired, is inimical to the public health and welfare and 
47.7 	constitutes a public nuisance. Upon a complaint being made by the board or any prosecuting 
47.8 	officer, and upon a proper showing of the facts, the district court of the county where such 
47.9 	practice occurred may enjoin such acts and practice. The injunction proceeding is in addition 
47.10 	to, and not in lieu of, all other penalties and remedies provided by law.

47.11 	Sec. 27. Minnesota Statutes 2024, section 151.01, subdivision 23, is amended to read:
47.12 		Subd. 23.Practitioner. "Practitioner" means a licensed doctor of medicine, licensed 
47.13 	doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of 
47.14 	dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed 
47.15 	advanced practice registered nurse, licensed certified midwife effective July 1, 2026, or 
47.16 	licensed physician assistant. For purposes of sections 151.15, subdivision 4; 151.211, 
47.17 	subdivision 3; 151.252, subdivision 3; 151.37, subdivision 2, paragraph (b); and 151.461, 
47.18 	"practitioner" also means a dental therapist authorized to dispense and administer under 
47.19 	chapter 150A. For purposes of sections 151.252, subdivision 3, and 151.461, "practitioner" 
47.20 	also means a pharmacist authorized to prescribe self-administered hormonal contraceptives, 
47.21 	nicotine replacement medications, or opiate antagonists under section 151.37, subdivision 
47.22 	14, 15, or 16, or authorized to prescribe drugs to prevent the acquisition of human 
47.23 	immunodeficiency virus (HIV) under section 151.37, subdivision 17.

47.24 	Sec. 28. Minnesota Statutes 2024, section 151.555, subdivision 6, is amended to read:
47.25 		Subd. 6.Standards and procedures for accepting donations of drugs and supplies
47.26 	and purchasing drugs from licensed wholesalers. (a) Notwithstanding any other law or 
47.27 	rule, a donor may donate drugs or medical supplies to the central repository or a local 
47.28 	repository if the drug or supply meets the requirements of this section as determined by a 
47.29 	pharmacist or practitioner who is employed by or under contract with the central repository 
47.30 	or a local repository.
47.31 	(b) A drug is eligible for donation under the medication repository program if the 
47.32 	following requirements are met:
48.1 	(1) the drug's expiration date is at least six months after the date the drug was donated. 
48.2 	If a donated drug bears an expiration date that is less than six months from the donation 
48.3 	date, the drug may be accepted and distributed if the drug is in high demand and can be 
48.4 	dispensed for use by a patient before the drug's expiration date;
48.5 	(2) the drug is in its original, sealed, unopened, tamper-evident packaging that includes 
48.6 	the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging 
48.7 	is unopened;
48.8 	(3) the drug or the packaging does not have any physical signs of tampering, misbranding, 
48.9 	deterioration, compromised integrity, or adulteration;
48.10 	(4) the drug does not require storage temperatures other than normal room temperature 
48.11 	as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being 
48.12 	donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located 
48.13 	in Minnesota; and
48.14 	(5) the drug is not a controlled substance.
48.15 	(c) A medical supply is eligible for donation under the medication repository program 
48.16 	if the following requirements are met:
48.17 	(1) the supply has no physical signs of tampering, misbranding, or alteration and there 
48.18 	is no reason to believe it has been adulterated, tampered with, or misbranded;
48.19 	(2) the supply is in its original, unopened, sealed packaging; and
48.20 	(3) if the supply bears an expiration date, the date is at least six months later than the 
48.21 	date the supply was donated. If the donated supply bears an expiration date that is less than 
48.22 	six months from the date the supply was donated, the supply may be accepted and distributed 
48.23 	if the supply is in high demand and can be dispensed for use by a patient before the supply's 
48.24 	expiration date.
48.25 	(d) The board shall develop the medication repository donor form and make it available 
48.26 	on the board's website. Prior to the first donation from a new donor, a central repository or 
48.27 	local repository shall verify and record the following information on the donor form:
48.28 	(1) the donor's name, address, phone number, and license number, if applicable;
48.29 	(2) that the donor will only make donations in accordance with the program;
48.30 	(3) to the best of the donor's knowledge, only drugs or supplies that have been properly 
48.31 	stored under appropriate temperature and humidity conditions will be donated; and
49.1 	(4) to the best of the donor's knowledge, only drugs or supplies that have never been 
49.2 	opened, used, tampered with, adulterated, or misbranded will be donated.
49.3 	(e) Notwithstanding any other law or rule, a central repository or a local repository may 
49.4 	receive donated drugs from donors. Donated drugs and supplies may be shipped or delivered 
49.5 	to the premises of the central repository or a local repository, and shall be inspected by a 
49.6 	pharmacist or an authorized practitioner who is employed by or under contract with the 
49.7 	repository and who has been designated by the repository prior to dispensing. A drop box 
49.8 	must not be used to deliver or accept donations.
49.9 	(f) The central repository and local repository shall maintain a written or electronic 
49.10 	inventory of all drugs and supplies donated to the repository upon acceptance of each drug 
49.11 	or supply. For each drug, the inventory must include the drug's name, strength, quantity, 
49.12 	manufacturer, expiration date, and the date the drug was donated. For each medical supply, 
49.13 	the inventory must include a description of the supply, its manufacturer, the date the supply 
49.14 	was donated, and, if applicable, the supply's brand name and expiration date. The board 
49.15 	may waive the requirement under this paragraph if an entity is under common ownership 
49.16 	or control with a central repository or local repository and either the entity or the repository 
49.17 	maintains an inventory containing all the information required under this paragraph.
49.18 	(g) The central repository may purchase a drug from a wholesaler licensed by the board 
49.19 	to fill prescriptions for eligible patients when the repository does not have a sufficient supply 
49.20 	of donated drugs to fill the prescription. The central repository may use any purchased drugs 
49.21 	remaining after filling the prescriptions for which the drugs were initially purchased to fill 
49.22 	other prescriptions. Whenever possible, the repository must use donated drugs to fill 
49.23 	prescriptions.

49.24 	Sec. 29. Minnesota Statutes 2024, section 151.555, subdivision 10, is amended to read:
49.25 		Subd. 10.Distribution of donated drugs and supplies. (a) The central repository and 
49.26 	local repositories may distribute drugs and supplies donated under the medication repository 
49.27 	program to other participating repositories for use pursuant to this program.
49.28 	(b) A local repository that elects not to dispense donated drugs or supplies that are 
49.29 	suitable for donation and dispensing must transfer all those donated drugs and supplies to 
49.30 	the central repository. A copy of the donor form that was completed by the original donor 
49.31 	under subdivision 6 must be provided to the central repository at the time of transfer. A 
49.32 	local repository must dispose of drugs and supplies in its possession that are not suitable 
49.33 	for donation or dispensing pursuant to subdivision 7.

50.1 	Sec. 30. Minnesota Statutes 2024, section 152.12, subdivision 1, is amended to read:
50.2 		Subdivision 1.Prescribing, dispensing, administering controlled substances in 
50.3 	Schedules II through V. A licensed doctor of medicine, a doctor of osteopathic medicine, 
50.4 	duly licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine, 
50.5 	a licensed doctor of podiatry, a licensed advanced practice registered nurse, a licensed 
50.6 	certified midwife effective July 1, 2026, a licensed physician assistant, or a licensed doctor 
50.7 	of optometry limited to Schedules IV and V, and in the course of professional practice only, 
50.8 	may prescribe, administer, and dispense a controlled substance included in Schedules II 
50.9 	through V of section 152.02, may cause the same to be administered by a nurse, an intern 
50.10 	or an assistant under the direction and supervision of the doctor, and may cause a person 
50.11 	who is an appropriately certified and licensed health care professional to prescribe and 
50.12 	administer the same within the expressed legal scope of the person's practice as defined in 
50.13 	Minnesota Statutes.

50.14 	Sec. 31. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision 
50.15 	to read:
50.16 		Subd. 28c.Certified midwifery practice services. Effective January 1, 2026, or upon 
50.17 	federal approval, whichever is later, medical assistance covers services performed by a 
50.18 	licensed certified midwife if:
50.19 	(1) the service provided on an inpatient basis is not included as part of the cost for 
50.20 	inpatient services included in the facility payment;
50.21 	(2) the service is otherwise covered under this chapter as a physician service; and
50.22 	(3) the service is within the scope of practice of the certified midwife's license as defined 
50.23 	under chapter 148G.

50.24 	ARTICLE 4
50.25 	PHARMACY BENEFITS

50.26 	Section 1. Minnesota Statutes 2024, section 256B.0625, subdivision 13c, is amended to 
50.27 	read:
50.28 		Subd. 13c.Formulary Committee. The commissioner, after receiving recommendations 
50.29 	from professional medical associations and professional pharmacy associations, and consumer 
50.30 	groups shall designate a Formulary Committee to carry out duties as described in subdivisions 
50.31 	13 to 13g. The Formulary Committee shall be comprised of at least five licensed physicians 
50.32 	actively engaged in the practice of medicine in Minnesota, one of whom is an actively 
51.1 	practicing psychiatrist, one of whom specializes in the diagnosis and treatment of rare 
51.2 	diseases, one of whom specializes in pediatrics, and one of whom actively treats persons 
51.3 	with disabilities; at least three licensed pharmacists actively engaged in the practice of 
51.4 	pharmacy in Minnesota, one of whom practices outside the metropolitan counties listed in 
51.5 	section 473.121, subdivision 4, one of whom practices in the metropolitan counties listed 
51.6 	in section 473.121, subdivision 4, and one of whom is a practicing hospital pharmacist; at 
51.7 	least two consumer representatives, all of whom must have a personal or professional 
51.8 	connection to medical assistance; and one representative designated by the Minnesota Rare 
51.9 	Disease Advisory Council established under section 256.4835; the remainder to be made 
51.10 	up of health care professionals who are licensed in their field and have recognized knowledge 
51.11 	in the clinically appropriate prescribing, dispensing, and monitoring of covered outpatient 
51.12 	drugs. Members of the Formulary Committee shall not be employed by the Department of 
51.13 	Human Services or have a personal interest in a pharmaceutical company, pharmacy benefits 
51.14 	manager, health plan company, or their affiliate organizations, but the committee shall be 
51.15 	staffed by an employee of the department who shall serve as an ex officio, nonvoting member 
51.16 	of the committee. For the purposes of this subdivision, "personal interest" means that a 
51.17 	person owns at least five percent of the voting interest or equity interest in the entity, the 
51.18 	equity interest owned by a person represents at least five percent of that person's net worth, 
51.19 	or more than five percent of a person's gross income for the preceding year was derived 
51.20 	from the entity. A committee member must notify the committee of any potential conflict 
51.21 	of interest and recuse themselves from any communications, discussion, or vote on any 
51.22 	matter where a conflict of interest exists. A conflict of interest alone, without a personal 
51.23 	interest, does not preclude an applicant from serving as a member of the Formulary 
51.24 	Committee. Members may be removed from the committee for cause after a recommendation 
51.25 	for removal by a majority of the committee membership. For the purposes of this subdivision, 
51.26 	"cause" does not include offering a differing or dissenting clinical opinion on a drug or drug 
51.27 	class. The department's medical director shall also serve as an ex officio, nonvoting member 
51.28 	for the committee. Committee members shall serve three-year terms and may be reappointed 
51.29 	twice by the commissioner. The committee members shall vote on a chair and vice chair 
51.30 	from among their membership. The chair shall preside over all committee meetings, and 
51.31 	the vice chair shall preside over the meetings if the chair is not present. The Formulary 
51.32 	Committee shall meet at least three times per year. The commissioner may require more 
51.33 	frequent Formulary Committee meetings as needed. An honorarium of $100 per meeting 
51.34 	and reimbursement for mileage shall be paid to each committee member in attendance. The 
51.35 	Formulary Committee expires June 30, 2027 2029. The Formulary Committee is subject to 
51.36 	the Open Meeting Law under chapter 13D. For purposes of establishing a quorum to transact 
52.1 	business, vacant committee member positions do not count in the calculation as long as at 
52.2 	least 60 percent of the committee member positions are filled.

52.3 	Sec. 2. Minnesota Statutes 2024, section 256B.0625, subdivision 13e, is amended to read:
52.4 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment shall 
52.5 	be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the 
52.6 	usual and customary price charged to the public. The usual and customary price means the 
52.7 	lowest price charged by the provider to a patient who pays for the prescription by cash, 
52.8 	check, or charge account and includes prices the pharmacy charges to a patient enrolled in 
52.9 	a prescription savings club or prescription discount club administered by the pharmacy or 
52.10 	pharmacy chain, unless the prescription savings club or prescription discount club is one 
52.11 	in which an individual pays a recurring monthly access fee for unlimited access to a defined 
52.12 	list of drugs for which the pharmacy does not bill the member or a payer on a 
52.13 	per-standard-transaction basis. The amount of payment basis must be reduced to reflect all 
52.14 	discount amounts applied to the charge by any third-party provider/insurer agreement or 
52.15 	contract for submitted charges to medical assistance programs. The net submitted charge 
52.16 	may not be greater than the patient liability for the service. The professional dispensing fee 
52.17 	shall be $11.55 for prescriptions filled with legend drugs meeting the definition of "covered 
52.18 	outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The 
52.19 	dispensing fee for intravenous solutions that must be compounded by the pharmacist shall 
52.20 	be $11.55 per claim. The professional dispensing fee for prescriptions filled with 
52.21 	over-the-counter drugs meeting the definition of covered outpatient drugs shall be $11.55 
52.22 	for dispensed quantities equal to or greater than the number of units contained in the 
52.23 	manufacturer's original package. The professional dispensing fee shall be prorated based 
52.24 	on the percentage of the package dispensed when the pharmacy dispenses a quantity less 
52.25 	than the number of units contained in the manufacturer's original package. The pharmacy 
52.26 	dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered 
52.27 	outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units 
52.28 	contained in the manufacturer's original package and shall be prorated based on the 
52.29 	percentage of the package dispensed when the pharmacy dispenses a quantity less than the 
52.30 	number of units contained in the manufacturer's original package. The ingredient cost for 
52.31 	a drug is the lowest of the National Average Drug Acquisition Cost (NADAC) shall be used 
52.32 	to determine the ingredient cost of a drug; the Minnesota actual acquisition cost (MNAAC), 
52.33 	as defined in paragraph (i); or the maximum allowable cost. For drugs for which a NADAC, 
52.34 	MNAAC, or maximum allowable cost is not reported, the commissioner shall estimate the 
52.35 	ingredient cost at the wholesale acquisition cost minus two percent. The ingredient cost of 
53.1 	a drug for a provider participating in the federal 340B Drug Pricing Program shall be either
53.2 	the 340B Drug Pricing Program ceiling price established by the Health Resources and 
53.3 	Services Administration or, the NADAC, the MNAAC, or the maximum allowable cost,
53.4 	whichever is lower lowest. Wholesale acquisition cost is defined as the manufacturer's list 
53.5 	price for a drug or biological to wholesalers or direct purchasers in the United States, not 
53.6 	including prompt pay or other discounts, rebates, or reductions in price, for the most recent 
53.7 	month for which information is available, as reported in wholesale price guides or other 
53.8 	publications of drug or biological pricing data. The maximum allowable cost of a multisource
53.9 	drug may be set by the commissioner and it shall be comparable to the actual acquisition 
53.10 	cost of the drug product and no higher than the NADAC of the generic product. Establishment 
53.11 	of the amount of payment for drugs shall not be subject to the requirements of the 
53.12 	Administrative Procedure Act.
53.13 	(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using 
53.14 	an automated drug distribution system meeting the requirements of section 151.58, or a 
53.15 	packaging system meeting the packaging standards set forth in Minnesota Rules, part 
53.16 	6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ 
53.17 	retrospective billing for prescription drugs dispensed to long-term care facility residents. A 
53.18 	retrospectively billing pharmacy must submit a claim only for the quantity of medication 
53.19 	used by the enrolled recipient during the defined billing period. A retrospectively billing 
53.20 	pharmacy must use a billing period not less than one calendar month or 30 days.
53.21 	(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota 
53.22 	Rules, part 6800.2700, is required to credit the department for the actual acquisition cost 
53.23 	of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective 
53.24 	billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that 
53.25 	is less than a 30-day supply.
53.26 	(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the lesser 
53.27 	of the NADAC of the generic product, the MNAAC of the generic product, or the maximum 
53.28 	allowable cost of the generic product established by the commissioner unless prior 
53.29 	authorization for the brand name product has been granted according to the criteria 
53.30 	established by the Drug Formulary Committee as required by subdivision 13f, paragraph 
53.31 	(a), and the prescriber has indicated "dispense as written" on the prescription in a manner 
53.32 	consistent with section 151.21, subdivision 2. If prior authorization is granted, the ingredient 
53.33 	cost shall be the lesser of the NADAC of the brand name product, the MNAAC of the brand 
53.34 	name product, or the maximum allowable cost of the brand name product. A generic product 
53.35 	includes a generic drug, an authorized generic drug, and a biosimilar biological product as 
54.1 	defined in Code of Federal Regulations, title 42, section 423.4. A brand name product 
54.2 	includes a brand name drug, a brand name biological product, and an unbranded biological 
54.3 	product as defined in Code of Federal Regulations, title 42, section 423.4.
54.4 	(e) The basis for determining the amount of payment for drugs administered in an 
54.5 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
54.6 	provider, 106 percent of the average sales price as determined by the United States 
54.7 	Department of Health and Human Services pursuant to title XVIII, section 1847a of the 
54.8 	federal Social Security Act, the specialty pharmacy rate MNAAC, or the maximum allowable 
54.9 	cost set by the commissioner. If average sales price is, MNAAC, and the maximum allowable 
54.10 	cost are unavailable, the amount of payment must be lower of the usual and customary cost 
54.11 	submitted by the provider, or the wholesale acquisition cost, the specialty pharmacy rate, 
54.12 	or the maximum allowable cost set by the commissioner. The commissioner shall discount 
54.13 	the payment rate for drugs obtained through the federal 340B Drug Pricing Program by 
54.14 	28.6 percent. The payment for drugs administered in an outpatient setting shall be made to 
54.15 	the administering facility or practitioner. A retail or specialty pharmacy dispensing a drug 
54.16 	for administration in an outpatient setting is not eligible for direct reimbursement.
54.17 	(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy 
54.18 	products that are lower than the ingredient cost formulas specified in paragraph (a). The 
54.19 	commissioner may require individuals enrolled in the health care programs administered 
54.20 	by the department to obtain specialty pharmacy products from providers with whom the 
54.21 	commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are 
54.22 	defined as those used by a small number of recipients or recipients with complex and chronic 
54.23 	diseases that require expensive and challenging drug regimens. Examples of these conditions 
54.24 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, 
54.25 	growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of 
54.26 	cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
54.27 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that 
54.28 	require complex care. The commissioner shall consult with the Formulary Committee to 
54.29 	develop a list of specialty pharmacy products subject to maximum allowable cost 
54.30 	reimbursement. In consulting with the Formulary Committee in developing this list, the 
54.31 	commissioner shall take into consideration the population served by specialty pharmacy 
54.32 	products, the current delivery system and standard of care in the state, and access to care 
54.33 	issues. The commissioner shall have the discretion to adjust the maximum allowable cost 
54.34 	to prevent access to care issues.
55.1 	(g) (f) Home infusion therapy services provided by home infusion therapy pharmacies 
55.2 	must be paid at rates according to subdivision 8d.
55.3 	(h) (g) The commissioner shall contract with a vendor to conduct a cost of dispensing 
55.4 	survey for all pharmacies that are physically located in the state of Minnesota that dispense 
55.5 	outpatient drugs under medical assistance. The commissioner shall ensure that the vendor 
55.6 	has prior experience in conducting cost of dispensing surveys. Each pharmacy enrolled with 
55.7 	the department to dispense outpatient prescription drugs to fee-for-service members must 
55.8 	respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under 
55.9 	section 256B.064 for failure to respond. The commissioner shall require the vendor to 
55.10 	measure a single statewide cost of dispensing for specialty prescription drugs and a single 
55.11 	statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies 
55.12 	to measure the mean, mean weighted by total prescription volume, mean weighted by 
55.13 	medical assistance prescription volume, median, median weighted by total prescription 
55.14 	volume, and median weighted by total medical assistance prescription volume. The 
55.15 	commissioner shall post a copy of the final cost of dispensing survey report on the 
55.16 	department's website. The initial survey must be completed no later than January 1, 2021, 
55.17 	and repeated every three years. The commissioner shall provide a summary of the results 
55.18 	of each cost of dispensing survey and provide recommendations for any changes to the 
55.19 	dispensing fee to the chairs and ranking minority members of the legislative committees 
55.20 	with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section 
55.21 	256.01, subdivision 42, this paragraph does not expire.
55.22 	(i) (h) The commissioner shall increase the ingredient cost reimbursement calculated in 
55.23 	paragraphs (a) and (f) (e) by 1.8 percent the amount of the wholesale drug distributor tax
55.24 	for prescription and nonprescription drugs subject to the wholesale drug distributor tax 
55.25 	under section 295.52.
55.26 	(i) The commissioner shall contract with a vendor to create the MNAAC through a 
55.27 	periodic survey of enrolled pharmacy providers. Each pharmacy enrolled with the department 
55.28 	to dispense outpatient prescription drugs must respond to the periodic surveys. The 
55.29 	commissioner may sanction a pharmacy under section 256B.064 for failure to respond. The 
55.30 	current MNAAC rates must be publicly available on the department's or vendor's website. 
55.31 	The commissioner must require that the MNAAC is measured and calculated at least 
55.32 	quarterly, but the MNAAC can be measured and calculated more frequently. The 
55.33 	commissioner must ensure that the vendor has an appeal process available to providers for 
55.34 	the time between the measurement and calculation of the periodically updated MNAAC 
55.35 	rates if price fluctuations result in a MNAAC that is lower than what enrolled providers can 
56.1 	purchase a drug for. Establishment of the MNAAC and survey reporting requirements are 
56.2 	not subject to the requirements of the Administrative Procedure Act. Data provided by 
56.3 	pharmacies for the measurement and calculation of the MNAAC is nonpublic data as defined 
56.4 	under section 13.02, subdivision 9.

56.5 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
56.6 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
56.7 	when federal approval is obtained.

56.8 	Sec. 3. Minnesota Statutes 2024, section 256B.064, subdivision 1a, is amended to read:
56.9 		Subd. 1a.Grounds for sanctions. (a) The commissioner may impose sanctions against 
56.10 	any individual or entity that receives payments from medical assistance or provides goods 
56.11 	or services for which payment is made from medical assistance for any of the following: 
56.12 	(1) fraud, theft, or abuse in connection with the provision of goods and services to recipients 
56.13 	of public assistance for which payment is made from medical assistance; (2) a pattern of 
56.14 	presentment of false or duplicate claims or claims for services not medically necessary; (3) 
56.15 	a pattern of making false statements of material facts for the purpose of obtaining greater 
56.16 	compensation than that to which the individual or entity is legally entitled; (4) suspension 
56.17 	or termination as a Medicare vendor; (5) refusal to grant the state agency access during 
56.18 	regular business hours to examine all records necessary to disclose the extent of services 
56.19 	provided to program recipients and appropriateness of claims for payment; (6) failure to 
56.20 	repay an overpayment or a fine finally established under this section; (7) failure to correct 
56.21 	errors in the maintenance of health service or financial records for which a fine was imposed 
56.22 	or after issuance of a warning by the commissioner; and (8) any reason for which an 
56.23 	individual or entity could be excluded from participation in the Medicare program under 
56.24 	section 1128, 1128A, or 1866(b)(2) of the Social Security Act. For the purposes of this 
56.25 	section, goods or services for which payment is made from medical assistance includes but 
56.26 	is not limited to care and services identified in section 256B.0625 or provided pursuant to 
56.27 	any federally approved waiver.
56.28 	(b) The commissioner may impose sanctions against a pharmacy provider for failure to 
56.29 	respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph 
56.30 	(h).
56.31 	(c) The commissioner may impose sanctions against a pharmacy provider for failure to 
56.32 	respond to a Minnesota drug acquisition cost survey under section 256B.0625, subdivision 
56.33 	13e, paragraph (i).

57.1 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
57.2 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
57.3 	when federal approval is obtained.

57.4 	Sec. 4. Minnesota Statutes 2024, section 256B.69, subdivision 6d, is amended to read:
57.5 		Subd. 6d.Prescription drugs. (a) The commissioner may exclude or modify coverage 
57.6 	for prescription drugs from the prepaid managed care contracts entered into under this 
57.7 	section in order to increase savings to the state by collecting additional prescription drug 
57.8 	rebates.
57.9 	(b) The contracts must maintain incentives for the managed care plan to manage drug 
57.10 	costs and utilization and may require that the managed care plans maintain an open drug 
57.11 	formulary. In order to manage drug costs and utilization, the contracts may authorize the 
57.12 	managed care plans to use preferred drug lists and prior authorization. The contracts must 
57.13 	require that the managed care plans enter into contracts with the state pharmacy benefit 
57.14 	manager under section 256B.696 to administer the pharmacy benefit.
57.15 	(c) This subdivision is contingent on federal approval of the managed care contract 
57.16 	changes and the collection of additional prescription drug rebates.

57.17 	Sec. 5. [256B.696] PRESCRIPTION DRUGS; STATE PHARMACY BENEFIT 
57.18 	MANAGER.
57.19 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
57.20 	the meanings given.
57.21 	(b) "Managed care enrollees" means medical assistance and MinnesotaCare enrollees 
57.22 	receiving coverage from managed care plans.
57.23 	(c) "Managed care plans" means health plans and county-based purchasing organizations 
57.24 	providing coverage to medical assistance and MinnesotaCare enrollees under the managed 
57.25 	care delivery system.
57.26 	(d) "State pharmacy benefit manager" means the pharmacy benefit manager that is a 
57.27 	prepaid ambulatory plan as defined in Code of Federal Regulations, title 42, section 438.2, 
57.28 	selected pursuant to the procurement process in subdivision 2.
57.29 		Subd. 2.Procurement process. (a) The commissioner must, through a competitive 
57.30 	procurement process in compliance with paragraph (b), select a single pharmacy benefit 
57.31 	manager to comply with the requirements set forth in subdivision 3.
58.1 	(b) The commissioner must, when selecting the single pharmacy benefit manager, do 
58.2 	the following:
58.3 	(1) accept applications for entities seeking to become the single pharmacy benefit 
58.4 	manager;
58.5 	(2) establish eligibility criteria an entity must meet in order to become the single pharmacy 
58.6 	benefit manager; and
58.7 	(3) enter into a master contract with a single pharmacy benefit manager.
58.8 	(c) The contract required under paragraph (b), clause (3), must include a prohibition on:
58.9 	(1) the single pharmacy benefit manager requiring an enrollee to obtain a drug from a 
58.10 	pharmacy owned or otherwise affiliated with the single pharmacy benefit manager; and
58.11 	(2) paying or reimbursing a pharmacy or pharmacist for the ingredient drug product 
58.12 	component of pharmacist services, including a prescription drug, less than the lesser of the 
58.13 	national average drug acquisition cost; the Minnesota actual acquisition cost (MNAAC) as 
58.14 	defined in section 256B.0625, subdivision 13e, paragraph (j); or the maximum allowable 
58.15 	cost as defined in section 62W.08, of that pharmacy service or prescription drug, or, if the 
58.16 	national average drug acquisition cost is unavailable, the wholesale acquisition cost minus 
58.17 	two percent at the time the drug is administered or dispensed, plus a professional dispensing 
58.18 	fee equal to the amount of the dispensing fee if it were determined pursuant to section 
58.19 	256B.0625, subdivision 13e.
58.20 	(d) Applicants for the single pharmacy benefit manager must disclose to the commissioner 
58.21 	the following during the procurement process:
58.22 	(1) any activity, policy, practice, contract, or arrangement of the single pharmacy benefit 
58.23 	manager that may directly or indirectly present any conflict of interest with the pharmacy 
58.24 	benefit manager's relationship with or obligation to the Department of Human Services, a 
58.25 	health plan company, or county-based purchasing organization;
58.26 	(2) all common ownership, members of a board of directors, managers, or other control 
58.27 	of the pharmacy benefit manager or any of the pharmacy benefit manager's affiliated 
58.28 	companies with:
58.29 	(i) a health plan company administering the medical assistance or MinnesotaCare benefits 
58.30 	or an affiliate of the health plan company;
58.31 	(ii) a county-based purchasing organization;
59.1 	(iii) an entity that contracts on behalf of a pharmacy or any pharmacy services 
59.2 	administration organization and its affiliates;
59.3 	(iv) a drug wholesaler or distributor and its affiliates;
59.4 	(v) a third-party payer and its affiliates; or
59.5 	(vi) a pharmacy and its affiliates that are enrolled to provide medical assistance or 
59.6 	MinnesotaCare;
59.7 	(3) any direct or indirect fees, charges, or any kind of assessments imposed by the 
59.8 	pharmacy benefit manager on pharmacies licensed in this state with which the pharmacy 
59.9 	benefit manager shares common ownership, management, or control, or that are owned, 
59.10 	managed, or controlled by any of the pharmacy benefit manager's affiliated companies;
59.11 	(4) any direct or indirect fees, charges, or any kind of assessments imposed by the 
59.12 	pharmacy benefit manager on pharmacies licensed in this state; and
59.13 	(5) any financial terms and arrangements between the pharmacy benefit manager and a 
59.14 	prescription drug manufacturer or labeler, including formulary management, drug substitution 
59.15 	programs, educational support claims processing, or data sales fees.
59.16 		Subd. 3.Drug coverage. (a) The commissioner may require the pharmacy benefit 
59.17 	manager to modify utilization review limitations, requirements, and strategies imposed by 
59.18 	managed care plans on prescription drug coverage.
59.19 	(b) The state pharmacy benefit manager is responsible for processing all point of sale 
59.20 	outpatient pharmacy claims under the managed care delivery system. Managed care plans 
59.21 	must use the state pharmacy benefit manager pursuant to the terms of the master contract 
59.22 	required under subdivision 2, paragraph (b), clause (3). The pharmacy benefit manager 
59.23 	selected is the exclusive pharmacy benefit manager used by health plan companies and 
59.24 	county-based purchasing organizations when providing coverage to enrollees. The 
59.25 	commissioner may require the managed care plans and pharmacy benefit manager to directly 
59.26 	exchange data and files for members enrolled with managed care plans.
59.27 	(c) All payment arrangements between the Department of Human Services, managed 
59.28 	care plans, and the state pharmacy benefit manager must comply with state and federal 
59.29 	statutes, regulations adopted by the Centers for Medicare and Medicaid Services, and any 
59.30 	other agreement between the department and the Centers for Medicare and Medicaid Services. 
59.31 	The commissioner may change a payment arrangement to comply with this paragraph.
59.32 	(d) The commissioner must administer and oversee this section to:
60.1 	(1) ensure proper administration of prescription drug benefits for managed care enrollees; 
60.2 	and
60.3 	(2) increase the transparency of prescription drug prices and other information for the 
60.4 	benefit of pharmacies.
60.5 		Subd. 4.Prescription drug disclosures. (a) The state pharmacy benefit manager must, 
60.6 	on request from the commissioner, disclose to the commissioner all sources of payment the 
60.7 	state pharmacy benefit manager receives for prescribed drugs, including any financial 
60.8 	benefits, drug rebates, discounts, credits, clawbacks, fees, grants, chargebacks, 
60.9 	reimbursements, or other payments related to services provided for a managed care plan.
60.10 	(b) Each managed care plan must disclose to the commissioner, in the format specified 
60.11 	by the commissioner, the entity's administrative costs associated with providing pharmacy 
60.12 	services under the managed care delivery system.
60.13 	(c) The state pharmacy benefit manager must provide a written quarterly report to the 
60.14 	commissioner containing the following information from the immediately preceding quarter:
60.15 	(1) the prices the state pharmacy benefit manager negotiated for prescribed drugs under 
60.16 	the managed care delivery system. The price must include any rebates the state pharmacy 
60.17 	benefit manager received from the drug manufacturer;
60.18 	(2) any rebate amounts the state pharmacy benefit manager passed on to individual 
60.19 	pharmacies;
60.20 	(3) any changes to the information previously disclosed under subdivision 2, paragraph 
60.21 	(d); and
60.22 	(4) any other information required by the commissioner, including unredacted copies 
60.23 	of contracts between the pharmacy benefit manager and enrolled pharmacies.
60.24 	(d) The commissioner may request and collect additional information and clinical data 
60.25 	from the state pharmacy benefit manager.
60.26 	(e) At the time of contract execution, renewal, or modification, the commissioner must 
60.27 	modify the reporting requirements under its managed care contracts as necessary to meet 
60.28 	the requirements of this subdivision.
60.29 		Subd. 5.Program authority. (a) To accomplish the requirements of subdivision 3, the 
60.30 	commissioner, in consultation with the Formulary Committee established under section 
60.31 	256B.0625, subdivision 13c, has the authority to:
60.32 	(1) adopt or develop a preferred drug list for managed care plans;
61.1 	(2) at the commissioner's discretion, engage in price negotiations with prescription drug 
61.2 	manufacturers, wholesalers, or group purchasing organizations in place of the state pharmacy 
61.3 	benefit manager to obtain price discounts and rebates for prescription drugs for managed 
61.4 	care enrollees; and
61.5 	(3) develop and manage a drug formulary for managed care plans.
61.6 	(b) The commissioner may contract with one or more entities to perform any of the 
61.7 	functions described in paragraph (a).
61.8 		Subd. 6.Pharmacies. The commissioner may review contracts between the state 
61.9 	pharmacy benefit manager and pharmacies for compliance with this section and the master 
61.10 	contract required under subdivision 2, paragraph (b), clause (3). The commissioner may 
61.11 	amend any term or condition of a contract that does not comply with this section or the 
61.12 	master contract.
61.13 		Subd. 7.Federal approval. The commissioner must seek any necessary federal approvals 
61.14 	to implement this section.

61.15 	EFFECTIVE DATE. Subdivisions 1 to 6 are effective January 1, 2027, or upon federal 
61.16 	approval, whichever is later. The commissioner of human services shall notify the revisor 
61.17 	of statutes when federal approval is obtained. Subdivision 7 is effective the day following 
61.18 	final enactment.

61.19 	Sec. 6. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
61.20 	DIRECTED PHARMACY DISPENSING PAYMENTS.
 61.21 	(a) For plan year 2026, the commissioner shall provide a directed pharmacy dispensing 
61.22 	payment of $1.84 per filled prescription under the medical assistance program to eligible 
61.23 	outpatient retail pharmacies in Minnesota to improve and maintain access to pharmaceutical 
61.24 	services in rural and underserved areas of the state. Managed care and county-based 
61.25 	purchasing plans delivering services under Minnesota Statutes, section 256B.69 or 256B.692, 
61.26 	and any pharmacy benefit managers under contract with these entities, must pay the directed 
61.27 	pharmacy dispensing payment to eligible outpatient retail pharmacies for drugs dispensed 
61.28 	to medical assistance enrollees. The directed pharmacy dispensing payment is in addition 
61.29 	to, and must not supplant or reduce, any other dispensing fee paid by these entities to the 
61.30 	pharmacy. Entities paying the directed pharmacy dispensing payment must not reduce other 
61.31 	payments to the pharmacy as a result of payment of the directed pharmacy dispensing 
61.32 	payment.
62.1 	(b) For purposes of this section, "eligible outpatient retail pharmacy" means an outpatient 
62.2 	retail pharmacy licensed under chapter 151 that is not owned, either directly or indirectly 
62.3 	or through an affiliate or subsidiary, by a pharmacy benefit manager licensed under chapter 
62.4 	62W or a health carrier, as defined in Minnesota Statutes, section 62A.011, subdivision 2, 
62.5 	and that:
62.6 	(1) is located in a medically underserved area or primarily serves a medically underserved 
62.7 	population, as defined by the United States Department of Health and Human Services 
62.8 	Health Resources and Services Administration under United States Code, title 42, section 
62.9 	254; or
62.10 	(2) shares common ownership with 13 or fewer Minnesota pharmacies.
62.11 	(c) In order to receive the directed pharmacy dispensing payment, a pharmacy must 
62.12 	submit to the commissioner a form, developed by the commissioner, attesting that the 
62.13 	pharmacy meets the requirements of paragraph (b).
62.14 	(d) The commissioner shall set and adjust the amount of the directed pharmacy dispensing 
62.15 	payment to reflect the available state and federal funding.
62.16 	(e) Managed care and county-based purchasing plans, and any pharmacy benefit managers 
62.17 	under contract with these entities, shall pay the directed pharmacy dispensing payment to 
62.18 	eligible outpatient retail pharmacies. The commissioner shall monitor the effect of this 
62.19 	requirement on access to pharmaceutical services in rural and underserved areas of the state. 
62.20 	If, for any contract year, federal approval is not received for this section, the commissioner 
62.21 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
62.22 	plans for that contract year to reflect removal of this section. Contracts between managed 
62.23 	care plans and county-based purchasing plans, and any pharmacy benefit managers under 
62.24 	contract with these entities, and providers to whom this section applies, must allow recovery 
62.25 	of payments from those providers if capitation rates are adjusted in accordance with this 
62.26 	paragraph. Payment recoveries must not exceed the amount equal to any increase in rates 
62.27 	that results from this section. This section expires if federal approval is not received for this 
62.28 	section at any time.

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

63.1 	ARTICLE 5
63.2 	HEALTH CARE FINANCE

63.3 	Section 1. Minnesota Statutes 2024, section 62A.673, subdivision 2, is amended to read:
63.4 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
63.5 	have the meanings given.
63.6 	(b) "Distant site" means a site at which a health care provider is located while providing 
63.7 	health care services or consultations by means of telehealth.
63.8 	(c) "Health care provider" means a health care professional who is licensed or registered 
63.9 	by the state to perform health care services within the provider's scope of practice and in 
63.10 	accordance with state law. A health care provider includes a mental health professional 
63.11 	under section 245I.04, subdivision 2; a mental health practitioner under section 245I.04, 
63.12 	subdivision 4; a clinical trainee under section 245I.04, subdivision 6; a treatment coordinator 
63.13 	under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11, 
63.14 	subdivision 5; and a recovery peer under section 245G.11, subdivision 8.
63.15 	(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
63.16 	(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan 
63.17 	includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental 
63.18 	plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed 
63.19 	to pay benefits directly to the policy holder.
63.20 	(f) "Originating site" means a site at which a patient is located at the time health care 
63.21 	services are provided to the patient by means of telehealth. For purposes of store-and-forward 
63.22 	technology, the originating site also means the location at which a health care provider 
63.23 	transfers or transmits information to the distant site.
63.24 	(g) "Store-and-forward technology" means the asynchronous electronic transfer or 
63.25 	transmission of a patient's medical information or data from an originating site to a distant 
63.26 	site for the purposes of diagnostic and therapeutic assistance in the care of a patient.
63.27 	(h) "Telehealth" means the delivery of health care services or consultations through the 
63.28 	use of real time two-way interactive audio and visual communications to provide or support 
63.29 	health care delivery and facilitate the assessment, diagnosis, consultation, treatment, 
63.30 	education, and care management of a patient's health care. Telehealth includes the application 
63.31 	of secure video conferencing, store-and-forward technology, and synchronous interactions 
63.32 	between a patient located at an originating site and a health care provider located at a distant 
63.33 	site. Until July 1, 2025 2028, telehealth also includes audio-only communication between 
64.1 	a health care provider and a patient in accordance with subdivision 6, paragraph (b) if the 
64.2 	communication is a scheduled appointment and the standard of care for that particular 
64.3 	service can be met through the use of audio-only communication or if, for substance use 
64.4 	disorder treatment services and mental health care services delivered through telehealth by 
64.5 	means of audio-only communication, the communication was initiated by the enrollee while 
64.6 	in an emergency or crisis situation and a scheduled appointment was not possible due to 
64.7 	the need of an immediate response. Telehealth does not include communication between 
64.8 	health care providers that consists solely of a telephone conversation, email, or facsimile 
64.9 	transmission. Telehealth does not include communication between a health care provider 
64.10 	and a patient that consists solely of an email or facsimile transmission. Telehealth does not 
64.11 	include telemonitoring services as defined in paragraph (i).
64.12 	(i) "Telemonitoring services" means the remote monitoring of clinical data related to 
64.13 	the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits 
64.14 	the data electronically to a health care provider for analysis. Telemonitoring is intended to 
64.15 	collect an enrollee's health-related data for the purpose of assisting a health care provider 
64.16 	in assessing and monitoring the enrollee's medical condition or status.

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

64.18 	Sec. 2. Minnesota Statutes 2024, section 174.30, subdivision 3, is amended to read:
64.19 		Subd. 3.Other standards; wheelchair securement; protected transport. (a) A special 
64.20 	transportation service that transports individuals occupying wheelchairs is subject to the 
64.21 	provisions of sections 299A.11 to 299A.17 concerning wheelchair securement devices. The 
64.22 	commissioners of transportation and public safety shall cooperate in the enforcement of 
64.23 	this section and sections 299A.11 to 299A.17 so that a single inspection is sufficient to 
64.24 	ascertain compliance with sections 299A.11 to 299A.17 and with the standards adopted 
64.25 	under this section. Representatives of the Department of Transportation may inspect 
64.26 	wheelchair securement devices in vehicles operated by special transportation service 
64.27 	providers to determine compliance with sections 299A.11 to 299A.17 and to issue certificates 
64.28 	under section 299A.14, subdivision 4.
64.29 	(b) In place of a certificate issued under section 299A.14, the commissioner may issue 
64.30 	a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if 
64.31 	the device complies with sections 299A.11 to 299A.17 and the decal displays the information 
64.32 	in section 299A.14, subdivision 4.
64.33 	(c) For vehicles designated as protected transport under section 256B.0625, subdivision 
64.34 	17, paragraph (l) (n), the commissioner of transportation, during the commissioner's 
65.1 	inspection, shall check to ensure the safety provisions contained in that paragraph are in 
65.2 	working order.

65.3 	Sec. 3. Minnesota Statutes 2024, section 256.9657, subdivision 2, is amended to read:
65.4 		Subd. 2.Hospital surcharge. (a) Effective October 1, 1992, each Minnesota hospital 
65.5 	except facilities of the federal Indian Health Service and regional treatment centers shall 
65.6 	pay to the medical assistance account health care access fund a surcharge equal to 1.4 percent 
65.7 	of net patient revenues excluding net Medicare revenues reported by that provider to the 
65.8 	health care cost information system according to the schedule in subdivision 4.
65.9 	(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56 percent.
65.10 	(c) Notwithstanding the Medicare cost finding and allowable cost principles, the hospital 
65.11 	surcharge is not an allowable cost for purposes of rate setting under sections 256.9685 to 
65.12 	256.9695.

65.13 	Sec. 4. Minnesota Statutes 2024, section 256.9657, is amended by adding a subdivision 
65.14 	to read:
65.15 		Subd. 2b.Hospital assessment. (a) For purposes of this subdivision, the following terms 
65.16 	have the meanings given:
65.17 	(1) "eligible hospital" means a hospital:
65.18 	(i) licensed under section 144.50;
65.19 	(ii) located in Minnesota; and
65.20 	(iii) with a Medicare cost report filed and showing in the Healthcare Cost Report 
65.21 	Information System (HCRIS);
65.22 	(2) "net outpatient revenue" means the value to reflect total outpatient revenue less 
65.23 	Medicare revenue as calculated from Worksheet G of the hospital's Medicare cost report; 
65.24 	and
65.25 	(3) "total patient days" means the value to reflect total hospital inpatient days as reported 
65.26 	on Worksheet S-3 of the hospital's Medicare cost report.
65.27 	(b) Subject to paragraphs (k) to (n), each eligible hospital must pay assessments to the 
65.28 	hospital directed payment program account, with an aggregate annual assessment amount 
65.29 	equal to the sum of the following:
65.30 	(1) $120.22 multiplied by total patient days; and
66.1 	(2) 5.96 percent of the hospital's net outpatient revenue.
66.2 	(c) The assessment amount for calendar years 2026 and 2027 must be based on the total 
66.3 	patient days and net outpatient revenue reflected on an eligible hospital's Medicare cost 
66.4 	report as follows:
66.5 	(1) an eligible hospital with a fiscal year ending on March 31 or June 30 must use data 
66.6 	from a cost report from hospital fiscal year 2022; and
66.7 	(2) an eligible hospital with a fiscal year ending on September 30 or December 31 must 
66.8 	use data from a cost report from hospital fiscal year 2021.
66.9 	The annual assessment amount for calendar years after 2027 must be set for a two-year 
66.10 	period and must be based on the total patient days and net outpatient revenue reflected on 
66.11 	an eligible hospital's most recent Medicare cost report filed and showing in HCRIS as of 
66.12 	August 1 of the year prior to the subsequent two-year period.
66.13 	(d) The commissioner may, after consultation with the Minnesota Hospital Association, 
66.14 	modify the rates of assessment in paragraph (b) as necessary to comply with federal law, 
66.15 	obtain or maintain a waiver under Code of Federal Regulations, title 42, section 433.72, or 
66.16 	otherwise maximize under this section federal financial participation for medical assistance.
66.17 	(e) Eligible hospitals must pay the annual assessment amount under paragraph (b) to the 
66.18 	commissioner by paying four equal, quarterly assessments. Eligible hospitals must pay the 
66.19 	quarterly assessments by January 1, April 1, July 1, and October 1 each year. Assessments 
66.20 	must be paid in the form and manner specified by the commissioner. An eligible hospital 
66.21 	is prohibited from paying a quarterly assessment until the eligible hospital has received the 
66.22 	applicable invoice under paragraph (f).
66.23 	(f) The commissioner must provide eligible hospitals with an invoice by December 1 
66.24 	for the assessment due January 1, March 1 for the assessment due April 1, June 1 for the 
66.25 	assessment due July 1, and September 1 for the assessment due October 1 each year.
66.26 	(g) The commissioner must notify each eligible hospital of its estimated annual assessment 
66.27 	amount for the subsequent calendar year by October 15 each year.
66.28 	(h) If any of the dates for assessments or invoices in paragraphs (d) to (f) fall on a holiday, 
66.29 	the applicable date is the next business day.
66.30 	(i) A hospital that has merged with another hospital must have the hospital's assessment 
66.31 	revised at the start of the first full fiscal year after the merger is complete. A closed hospital 
66.32 	is retroactively responsible for assessments owed for services provided through the final 
66.33 	date of operations.
67.1 	(j) If the commissioner determines that a hospital has underpaid or overpaid an 
67.2 	assessment, the commissioner must notify the hospital of the unpaid assessment or of any 
67.3 	refund due.
67.4 	(k) Revenue from an assessment under this subdivision must only be used by the 
67.5 	commissioner to pay the nonfederal share of the directed payment program under section 
67.6 	256B.1974.
67.7 	(l) The commissioner is prohibited from collecting any assessment under this subdivision 
67.8 	during any period of time when:
67.9 	(1) federal financial participation is unavailable or disallowed, or if the approved federal 
67.10 	financial participation for the directed payment under section 256B.1974 is less than 51 
67.11 	percent; or
67.12 	(2) a directed payment under section 256B.1974 is not approved by the Centers for 
67.13 	Medicare and Medicaid Services.
67.14 	(m) The commissioner must make the following discounts from the inpatient portion of 
67.15 	the assessment under paragraph (b), clause (1), in the stated amount or as necessary to 
67.16 	achieve federal approval of the assessment in this section:
67.17 	(1) Hennepin Healthcare, with a discount of 25 percent off the inpatient portion of the 
67.18 	assessment rate;
67.19 	(2) Mayo Rochester, with a discount of ten percent off the inpatient portion of the 
67.20 	assessment rate;
67.21 	(3) Gillette Children's Hospital, with a discount of 90 percent off the inpatient portion 
67.22 	of the assessment rate;
67.23 	(4) each hospital not included in another discount category, and with greater than 
67.24 	$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service 
67.25 	and managed care, as reported in the state fiscal year 2022 Medicare cost report, with a 
67.26 	discount of five percent off the inpatient portion of the assessment rate; and
67.27 	(5) a discount off the inpatient portion of the assessment rate, as is necessary, in order 
67.28 	to ensure that no single hospital is responsible for greater than 12 percent of the total 
67.29 	assessment annually collected statewide.
67.30 	(n) The commissioner must make the following discounts from the outpatient portion 
67.31 	of the assessment under paragraph (b), clause (2), in the stated amount or as necessary to 
67.32 	achieve federal approval of the assessment in this section:
68.1 	(1) each critical access hospital or independent hospital located outside a city of the first 
68.2 	class and paid under the Medicare prospective payment system, with a discount of 40 percent 
68.3 	off the outpatient portion of the assessment rate;
68.4 	(2) Gillette Children's Hospital, with a discount of 90 percent off the outpatient portion 
68.5 	of the assessment rate;
68.6 	(3) Hennepin Healthcare, with a discount of 60 percent off the outpatient portion of the 
68.7 	assessment rate;
68.8 	(4) Mayo Rochester, with a discount of 20 percent off the outpatient portion of the 
68.9 	assessment rate; and
68.10 	(5) each hospital not included in another discount category, and with greater than 
68.11 	$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service 
68.12 	and managed care, as reported in the state fiscal year 2022 Medicare cost report, with a 
68.13 	discount of ten percent off the outpatient portion of the assessment rate.
68.14 	(o) The commissioner must fully exempt the following from the assessment in this 
68.15 	section:
68.16 	(1) federal Indian Health Service facilities;
68.17 	(2) state-owned or state-operated regional treatment centers and all state-operated services;
68.18 	(3) federal Veterans Administration Medical Centers; and
68.19 	(4) long-term acute care hospitals.
68.20 	(p) If the federal share of the hospital directed payment program under section 256B.1974 
68.21 	is increased as the result of an increase to the federal medical assistance percentage, the 
68.22 	commissioner must reduce the assessment on a uniform percentage basis across eligible 
68.23 	hospitals on which the assessment is imposed, such that the aggregate amount collected 
68.24 	from hospitals under this subdivision does not exceed the total amount needed to maintain 
68.25 	the same aggregate state and federal funding level for the directed payments authorized by 
68.26 	section 256B.1974.
68.27 	(q) Hospitals subject to the assessment under this subdivision must submit to the 
68.28 	commissioner on an annual basis, in the form and manner specified by the commissioner 
68.29 	in consultation with the Minnesota Hospital Association, all documentation necessary to 
68.30 	determine the assessment amounts under this subdivision.

68.31 	EFFECTIVE DATE. (a) This section is effective the later of January 1, 2026, or federal 
68.32 	approval of all of the following:
69.1 	(1) the waiver for the assessment required under this section; and
69.2 	(2) the amendments in this act to Minnesota Statutes, sections 256B.1973 and 256B.1974.
69.3 	(b) The commissioner of human services shall notify the revisor of statutes when federal 
69.4 	approval for all amendments set forth in paragraph (a) is obtained.

69.5 	Sec. 5. Minnesota Statutes 2024, section 256.969, subdivision 2f, is amended to read:
69.6 		Subd. 2f.Alternate inpatient payment rate. (a) Effective January 1, 2022, for a hospital 
69.7 	eligible to receive disproportionate share hospital payments under subdivision 9, paragraph 
69.8 	(d), clause (6), the commissioner shall reduce the amount calculated under subdivision 9, 
69.9 	paragraph (d), clause (6), by 99 percent and compute an alternate inpatient payment rate. 
69.10 	The alternate payment rate shall be structured to target a total aggregate reimbursement 
69.11 	amount equal to what the hospital would have received for providing fee-for-service inpatient 
69.12 	services under this section to patients enrolled in medical assistance had the hospital received 
69.13 	the entire amount calculated under subdivision 9, paragraph (d), clause (6). This paragraph 
69.14 	expires when paragraph (b) becomes effective.
69.15 	(b) For hospitals eligible to receive payment under section 256B.1973 or 256B.1974 
69.16 	and meeting the criteria in subdivision 9, paragraph (d), the commissioner shall reduce the 
69.17 	amount calculated under subdivision 9, paragraph (d), by one percent and compute an 
69.18 	alternate inpatient payment rate. The alternate payment rate shall be structured to target a 
69.19 	total aggregate reimbursement amount equal to what the hospital would have received for 
69.20 	providing fee-for-service inpatient services under this section to patients enrolled in medical 
69.21 	assistance had the hospital received 99 percent of the entire amount calculated under 
69.22 	subdivision 9, paragraph (d). Hospitals that do not meet federal requirements for Medicaid 
69.23 	disproportionate share hospitals are not eligible for this alternate payment.

69.24 	EFFECTIVE DATE. (a) Paragraph (b) of this section is effective the later of January 
69.25 	1, 2026, or federal approval of all of the following:
69.26 	(1) this section; and
69.27 	(2) the amendments in this act to Minnesota Statutes, sections 256B.1973 and 256B.1974.
69.28 	(b) The commissioner of human services shall notify the revisor of statutes when federal 
69.29 	approval for all amendments set forth in paragraph (a) is obtained.

70.1 	Sec. 6. Minnesota Statutes 2024, section 256B.0371, subdivision 3, is amended to read:
70.2 		Subd. 3.Contingent contract with dental administrator. (a) The commissioner shall 
70.3 	determine the extent to which managed care and county-based purchasing plans in the 
70.4 	aggregate meet the performance benchmark specified in subdivision 1 for coverage year 
70.5 	2024. If managed care and county-based purchasing plans in the aggregate fail to meet the 
70.6 	performance benchmark, the commissioner, after issuing a request for information followed 
70.7 	by a request for proposals, shall contract with a dental administrator to administer dental 
70.8 	services beginning January 1, 2026 2028, for all recipients of medical assistance and 
70.9 	MinnesotaCare, including persons who are served under fee-for-service and persons receiving 
70.10 	services through managed care and county-based purchasing plans.
70.11 	(b) The dental administrator must provide administrative services, including but not 
70.12 	limited to:
70.13 	(1) provider recruitment, contracting, and assistance;
70.14 	(2) recipient outreach and assistance;
70.15 	(3) utilization management and reviews of medical necessity for dental services;
70.16 	(4) dental claims processing;
70.17 	(5) coordination of dental care with other services;
70.18 	(6) management of fraud and abuse;
70.19 	(7) monitoring access to dental services statewide;
70.20 	(8) performance measurement;
70.21 	(9) quality improvement and evaluation; and
70.22 	(10) management of third-party liability requirements.; and
70.23 	(11) establishment of grievance and appeals processes for providers and enrollees that 
70.24 	the commissioner can monitor.
70.25 	(c) Dental administrator payments to contracted dental providers must be at the based 
70.26 	on rates established under sections 256B.76 and 256L.11 recommended by the dental access 
70.27 	working group. If the recommended rates are not established in law prior to July 1, 2027, 
70.28 	then dental administrator payments to contracted dental providers must be at the rates 
70.29 	established under sections 256B.76 and 256L.11.
70.30 	(d) Recipients must be given a choice of dental provider, including any provider who 
70.31 	agrees to provider participation requirements and payment rates established by the 
71.1 	commissioner and dental administrator. The dental administrator must comply with the 
71.2 	network adequacy and geographic access requirements that apply to managed care and 
71.3 	county-based purchasing plans for dental services under section 62K.14.
71.4 	(e) The contract with the dental administrator must include a provision that states that 
71.5 	if the dental administrator fails to meet, by calendar year 2029, a performance benchmark 
71.6 	under which at least 55 percent of children and adults who were continuously enrolled for 
71.7 	at least 11 months in either medical assistance or MinnesotaCare received at least one dental 
71.8 	visit during the calendar year, the contract must be terminated and the commissioner must 
71.9 	enter into a contract with a new dental administrator as soon as practicable performance 
71.10 	benchmarks, accountability measures, and progress rewards based on the recommendations 
71.11 	from the dental access working group.
71.12 	(f) The commissioner shall implement this subdivision in consultation with representatives 
71.13 	of providers who provide dental services to patients enrolled in medical assistance or 
71.14 	MinnesotaCare, including but not limited to providers serving primarily low-income and 
71.15 	socioeconomically complex populations, and with representatives of managed care plans 
71.16 	and county-based purchasing plans.

71.17 	Sec. 7. Minnesota Statutes 2024, section 256B.04, subdivision 12, is amended to read:
71.18 		Subd. 12.Limitation on services. (a) The commissioner shall place limits on the types 
71.19 	of services covered by medical assistance, the frequency with which the same or similar 
71.20 	services may be covered by medical assistance for an individual recipient, and the amount 
71.21 	paid for each covered service. The state agency shall promulgate rules establishing maximum 
71.22 	reimbursement rates for emergency and nonemergency transportation.
71.23 	The rules shall provide:
71.24 	(1) an opportunity for all recognized transportation providers to be reimbursed for 
71.25 	nonemergency transportation consistent with the maximum rates established by the agency; 
71.26 	and
71.27 	(2) reimbursement of public and private nonprofit providers serving the population with 
71.28 	a disability generally at reasonable maximum rates that reflect the cost of providing the 
71.29 	service regardless of the fare that might be charged by the provider for similar services to 
71.30 	individuals other than those receiving medical assistance or medical care under this chapter.
71.31 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
71.32 	2027, for prepaid medical assistance.
72.1 	(b) The commissioner shall encourage providers reimbursed under this chapter to 
72.2 	coordinate their operation with similar services that are operating in the same community. 
72.3 	To the extent practicable, the commissioner shall encourage eligible individuals to utilize 
72.4 	less expensive providers capable of serving their needs. This paragraph expires July 1, 2026, 
72.5 	for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
72.6 	(c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective 
72.7 	on January 1, 1981, "recognized provider of transportation services" means an operator of 
72.8 	special transportation service as defined in section 174.29 that has been issued a current 
72.9 	certificate of compliance with operating standards of the commissioner of transportation 
72.10 	or, if those standards do not apply to the operator, that the agency finds is able to provide 
72.11 	the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized 
72.12 	transportation provider" includes an operator of special transportation service that the agency 
72.13 	finds is able to provide the required transportation in a safe and reliable manner. This 
72.14 	paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
72.15 	for prepaid medical assistance.
72.16 	(d) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
72.17 	for prepaid medical assistance, the commissioner shall place limits on the types of services 
72.18 	covered by medical assistance, the frequency with which the same or similar services may 
72.19 	be covered by medical assistance for an individual recipient, and the amount paid for each 
72.20 	covered service.

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

72.22 	Sec. 8. Minnesota Statutes 2024, section 256B.04, subdivision 14, is amended to read:
72.23 		Subd. 14.Competitive bidding. (a) When determined to be effective, economical, and 
72.24 	feasible, the commissioner may utilize volume purchase through competitive bidding and 
72.25 	negotiation under the provisions of chapter 16C, to provide items under the medical assistance 
72.26 	program including but not limited to the following:
72.27 	(1) eyeglasses;
72.28 	(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation 
72.29 	on a short-term basis, until the vendor can obtain the necessary supply from the contract 
72.30 	dealer;
72.31 	(3) hearing aids and supplies;
72.32 	(4) durable medical equipment, including but not limited to:
73.1 	(i) hospital beds;
73.2 	(ii) commodes;
73.3 	(iii) glide-about chairs;
73.4 	(iv) patient lift apparatus;
73.5 	(v) wheelchairs and accessories;
73.6 	(vi) oxygen administration equipment;
73.7 	(vii) respiratory therapy equipment;
73.8 	(viii) electronic diagnostic, therapeutic and life-support systems; and
73.9 	(ix) allergen-reducing products as described in section 256B.0625, subdivision 67, 
73.10 	paragraph (c) or (d);
73.11 	(5) nonemergency medical transportation level of need determinations, disbursement of 
73.12 	public transportation passes and tokens, and volunteer and recipient mileage and parking 
73.13 	reimbursements;
73.14 	(6) drugs; and
73.15 	(7) quitline services as described in section 256B.0625, subdivision 68, paragraph (c).
73.16 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
73.17 	2027, for prepaid medical assistance.
73.18 	(b) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
73.19 	for prepaid medical assistance, when determined to be effective, economical, and feasible, 
73.20 	the commissioner may utilize volume purchase through competitive bidding and negotiation 
73.21 	under the provisions of chapter 16C to provide items under the medical assistance program, 
73.22 	including but not limited to the following:
73.23 	(1) eyeglasses;
73.24 	(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation 
73.25 	on a short-term basis, until the vendor can obtain the necessary supply from the contract 
73.26 	dealer;
73.27 	(3) hearing aids and supplies;
73.28 	(4) durable medical equipment, including but not limited to:
73.29 	(i) hospital beds;
73.30 	(ii) commodes;
74.1 	(iii) glide-about chairs;
74.2 	(iv) patient lift apparatus;
74.3 	(v) wheelchairs and accessories;
74.4 	(vi) oxygen administration equipment;
74.5 	(vii) respiratory therapy equipment; and
74.6 	(viii) electronic diagnostic, therapeutic, and life-support systems;
74.7 	(5) nonemergency medical transportation; and
74.8 	(6) drugs.
74.9 	(b) (c) Rate changes and recipient cost-sharing under this chapter and chapter 256L do 
74.10 	not affect contract payments under this subdivision unless specifically identified.
74.11 	(c) (d) The commissioner may not utilize volume purchase through competitive bidding 
74.12 	and negotiation under the provisions of chapter 16C for special transportation services or 
74.13 	incontinence products and related supplies. This paragraph expires July 1, 2026, for medical 
74.14 	assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
74.15 	(e) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
74.16 	for prepaid medical assistance, the commissioner must not utilize volume purchase through 
74.17 	competitive bidding and negotiation under the provisions of chapter 16C for incontinence 
74.18 	products and related supplies.

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

74.20 	Sec. 9. Minnesota Statutes 2024, section 256B.0625, subdivision 3b, is amended to read:
74.21 		Subd. 3b.Telehealth services. (a) Medical assistance covers medically necessary services 
74.22 	and consultations delivered by a health care provider through telehealth in the same manner 
74.23 	as if the service or consultation was delivered through in-person contact. Services or 
74.24 	consultations delivered through telehealth shall be paid at the full allowable rate.
74.25 	(b) The commissioner may establish criteria that a health care provider must attest to in 
74.26 	order to demonstrate the safety or efficacy of delivering a particular service through 
74.27 	telehealth. The attestation may include that the health care provider:
74.28 	(1) has identified the categories or types of services the health care provider will provide 
74.29 	through telehealth;
75.1 	(2) has written policies and procedures specific to services delivered through telehealth 
75.2 	that are regularly reviewed and updated;
75.3 	(3) has policies and procedures that adequately address patient safety before, during, 
75.4 	and after the service is delivered through telehealth;
75.5 	(4) has established protocols addressing how and when to discontinue telehealth services; 
75.6 	and
75.7 	(5) has an established quality assurance process related to delivering services through 
75.8 	telehealth.
75.9 	(c) As a condition of payment, a licensed health care provider must document each 
75.10 	occurrence of a health service delivered through telehealth to a medical assistance enrollee. 
75.11 	Health care service records for services delivered through telehealth must meet the 
75.12 	requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must 
75.13 	document:
75.14 	(1) the type of service delivered through telehealth;
75.15 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
75.16 	designation;
75.17 	(3) the health care provider's basis for determining that telehealth is an appropriate and 
75.18 	effective means for delivering the service to the enrollee;
75.19 	(4) the mode of transmission used to deliver the service through telehealth and records 
75.20 	evidencing that a particular mode of transmission was utilized;
75.21 	(5) the location of the originating site and the distant site;
75.22 	(6) if the claim for payment is based on a physician's consultation with another physician 
75.23 	through telehealth, the written opinion from the consulting physician providing the telehealth 
75.24 	consultation; and
75.25 	(7) compliance with the criteria attested to by the health care provider in accordance 
75.26 	with paragraph (b).
75.27 	(d) Telehealth visits provided through audio and visual communication or accessible 
75.28 	video-based platforms may be used to satisfy the face-to-face requirement for reimbursement 
75.29 	under the payment methods that apply to a federally qualified health center, rural health 
75.30 	clinic, Indian health service, 638 tribal clinic, and certified community behavioral health 
75.31 	clinic, if the service would have otherwise qualified for payment if performed in person.
75.32 	(e) For purposes of this subdivision, unless otherwise covered under this chapter:
76.1 	(1) "telehealth" means the delivery of health care services or consultations using real-time 
76.2 	two-way interactive audio and visual communication or accessible telehealth video-based 
76.3 	platforms to provide or support health care delivery and facilitate the assessment, diagnosis, 
76.4 	consultation, treatment, education, and care management of a patient's health care. Telehealth 
76.5 	includes: the application of secure video conferencing consisting of a real-time, full-motion 
76.6 	synchronized video; store-and-forward technology; and synchronous interactions, between 
76.7 	a patient located at an originating site and a health care provider located at a distant site. 
76.8 	Telehealth does not include communication between health care providers, or between a 
76.9 	health care provider and a patient that consists solely of an audio-only communication, 
76.10 	email, or facsimile transmission or as specified by law, except that between July 1, 2025, 
76.11 	and July 1, 2028, telehealth includes communication between a health care provider and a 
76.12 	patient that solely consists of audio-only communication;
76.13 	(2) "health care provider" means a health care provider as defined under section 62A.673; 
76.14 	a community paramedic as defined under section 144E.001, subdivision 5f; a community 
76.15 	health worker who meets the criteria under subdivision 49, paragraph (a); a mental health 
76.16 	certified peer specialist under section 245I.04, subdivision 10; a mental health certified 
76.17 	family peer specialist under section 245I.04, subdivision 12; a mental health rehabilitation 
76.18 	worker under section 245I.04, subdivision 14; a mental health behavioral aide under section 
76.19 	245I.04, subdivision 16; a treatment coordinator under section 245G.11, subdivision 7; an 
76.20 	alcohol and drug counselor under section 245G.11, subdivision 5; or a recovery peer under 
76.21 	section 245G.11, subdivision 8; and
76.22 	(3) "originating site," "distant site," and "store-and-forward technology" have the 
76.23 	meanings given in section 62A.673, subdivision 2.

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

76.25 	Sec. 10. Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:
76.26 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
76.27 	means motor vehicle transportation provided by a public or private person that serves 
76.28 	Minnesota health care program beneficiaries who do not require emergency ambulance 
76.29 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
76.30 	(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
76.31 	a census-tract based classification system under which a geographical area is determined 
76.32 	to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance 
76.33 	fee-for-service and January 1, 2027, for prepaid medical assistance.
77.1 	(c) Medical assistance covers medical transportation costs incurred solely for obtaining 
77.2 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
77.3 	emergency or nonemergency medical care when paid directly to an ambulance company, 
77.4 	nonemergency medical transportation company, or other recognized providers of 
77.5 	transportation services. Medical transportation must be provided by:
77.6 	(1) nonemergency medical transportation providers who meet the requirements of this 
77.7 	subdivision;
77.8 	(2) ambulances, as defined in section 144E.001, subdivision 2;
77.9 	(3) taxicabs that meet the requirements of this subdivision;
77.10 	(4) public transportation, within the meaning of "public transportation" as defined in 
77.11 	section 174.22, subdivision 7; or
77.12 	(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472, 
77.13 	subdivision 1, paragraph (p).
77.14 	(d) Medical assistance covers nonemergency medical transportation provided by 
77.15 	nonemergency medical transportation providers enrolled in the Minnesota health care 
77.16 	programs. All nonemergency medical transportation providers must comply with the 
77.17 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
77.18 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
77.19 	commissioner and reported on the claim as the individual who provided the service. All 
77.20 	nonemergency medical transportation providers shall bill for nonemergency medical 
77.21 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
77.22 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
77.23 	requirements outlined in this paragraph.
77.24 	(e) An organization may be terminated, denied, or suspended from enrollment if:
77.25 	(1) the provider has not initiated background studies on the individuals specified in 
77.26 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
77.27 	(2) the provider has initiated background studies on the individuals specified in section 
77.28 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
77.29 	(i) the commissioner has sent the provider a notice that the individual has been 
77.30 	disqualified under section 245C.14; and
77.31 	(ii) the individual has not received a disqualification set-aside specific to the special 
77.32 	transportation services provider under sections 245C.22 and 245C.23.
78.1 	(f) The administrative agency of nonemergency medical transportation must:
78.2 	(1) adhere to the policies defined by the commissioner;
78.3 	(2) pay nonemergency medical transportation providers for services provided to 
78.4 	Minnesota health care programs beneficiaries to obtain covered medical services;
78.5 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
78.6 	trips, and number of trips by mode; and
78.7 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
78.8 	administrative structure assessment tool that meets the technical requirements established 
78.9 	by the commissioner, reconciles trip information with claims being submitted by providers, 
78.10 	and ensures prompt payment for nonemergency medical transportation services. This 
78.11 	paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
78.12 	for prepaid medical assistance.
78.13 	(g) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid 
78.14 	medical assistance, the administrative agency of nonemergency medical transportation must:
78.15 	(1) adhere to the policies defined by the commissioner;
78.16 	(2) pay nonemergency medical transportation providers for services provided to 
78.17 	Minnesota health care program beneficiaries to obtain covered medical services; and
78.18 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
78.19 	trips, and number of trips by mode.
78.20 	(g) (h) Until the commissioner implements the single administrative structure and delivery 
78.21 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
78.22 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
78.23 	clients using modes of transportation under paragraph (l) (n), clauses (4), (5), (6), and (7).
78.24 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
78.25 	2027, for prepaid medical assistance.
78.26 	(h) (i) The commissioner may use an order by the recipient's attending physician, 
78.27 	advanced practice registered nurse, physician assistant, or a medical or mental health 
78.28 	professional to certify that the recipient requires nonemergency medical transportation 
78.29 	services. Nonemergency medical transportation providers shall perform driver-assisted 
78.30 	services for eligible individuals, when appropriate. Driver-assisted service includes passenger 
78.31 	pickup at and return to the individual's residence or place of business, assistance with 
78.32 	admittance of the individual to the medical facility, and assistance in passenger securement 
78.33 	or in securing of wheelchairs, child seats, or stretchers in the vehicle.
79.1 	(i) (j) Nonemergency medical transportation providers must take clients to the health 
79.2 	care provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
79.3 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
79.4 	authorization from the local agency. This paragraph expires July 1, 2026, for medical 
79.5 	assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
79.6 	(k) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
79.7 	for prepaid medical assistance, nonemergency medical transportation providers must take 
79.8 	clients to the health care provider using the most direct route and must not exceed 30 miles 
79.9 	for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless 
79.10 	the client receives authorization from the administrator.
79.11 	(j) (l) Nonemergency medical transportation providers may not bill for separate base 
79.12 	rates for the continuation of a trip beyond the original destination. Nonemergency medical 
79.13 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
79.14 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
79.15 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
79.16 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
79.17 	services.
79.18 	(k) (m) The administrative agency shall use the level of service process established by 
79.19 	the commissioner to determine the client's most appropriate mode of transportation. If public 
79.20 	transit or a certified transportation provider is not available to provide the appropriate service 
79.21 	mode for the client, the client may receive a onetime service upgrade.
79.22 	(l) (n) The covered modes of transportation are:
79.23 	(1) client reimbursement, which includes client mileage reimbursement provided to 
79.24 	clients who have their own transportation, or to family or an acquaintance who provides 
79.25 	transportation to the client;
79.26 	(2) volunteer transport, which includes transportation by volunteers using their own 
79.27 	vehicle;
79.28 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
79.29 	or public transit. If a taxicab or public transit is not available, the client can receive 
79.30 	transportation from another nonemergency medical transportation provider;
79.31 	(4) assisted transport, which includes transport provided to clients who require assistance 
79.32 	by a nonemergency medical transportation provider;
80.1 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
80.2 	dependent on a device and requires a nonemergency medical transportation provider with 
80.3 	a vehicle containing a lift or ramp;
80.4 	(6) protected transport, which includes transport provided to a client who has received 
80.5 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
80.6 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
80.7 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
80.8 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
80.9 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
80.10 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
80.11 	a client in a prone or supine position.
80.12 	(m) (o) The local agency shall be the single administrative agency and shall administer 
80.13 	and reimburse for modes defined in paragraph (l) (n) according to paragraphs (p) and (q)
80.14 	(r) to (t) when the commissioner has developed, made available, and funded the web-based 
80.15 	single administrative structure, assessment tool, and level of need assessment under 
80.16 	subdivision 18e. The local agency's financial obligation is limited to funds provided by the 
80.17 	state or federal government. This paragraph expires July 1, 2026, for medical assistance 
80.18 	fee-for-service and January 1, 2027, for prepaid medical assistance.
80.19 	(n) (p) The commissioner shall:
80.20 	(1) verify that the mode and use of nonemergency medical transportation is appropriate;
80.21 	(2) verify that the client is going to an approved medical appointment; and
80.22 	(3) investigate all complaints and appeals.
80.23 	(o) (q) The administrative agency shall pay for the services provided in this subdivision 
80.24 	and seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
80.25 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
80.26 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
80.27 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
80.28 	2027, for prepaid medical assistance.
80.29 	(p) (r) Payments for nonemergency medical transportation must be paid based on the 
80.30 	client's assessed mode under paragraph (k) (m), not the type of vehicle used to provide the 
80.31 	service. The medical assistance reimbursement rates for nonemergency medical transportation 
80.32 	services that are payable by or on behalf of the commissioner for nonemergency medical 
80.33 	transportation services are:
81.1 	(1) $0.22 per mile for client reimbursement;
81.2 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
81.3 	transport;
81.4 	(3) equivalent to the standard fare for unassisted transport when provided by public 
81.5 	transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency 
81.6 	medical transportation provider;
81.7 	(4) $14.30 for the base rate and $1.43 per mile for assisted transport;
81.8 	(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
81.9 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
81.10 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
81.11 	an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026, 
81.12 	for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
81.13 	(s) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
81.14 	for prepaid medical assistance, payments for nonemergency medical transportation must 
81.15 	be paid based on the client's assessed mode under paragraph (m), not the type of vehicle 
81.16 	used to provide the service.
81.17 	(q) (t) The base rate for nonemergency medical transportation services in areas defined 
81.18 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
81.19 	paragraph (p) (r), clauses (1) to (7). The mileage rate for nonemergency medical 
81.20 	transportation services in areas defined under RUCA to be rural or super rural areas is:
81.21 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
81.22 	rate in paragraph (p) (r), clauses (1) to (7); and
81.23 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
81.24 	rate in paragraph (p) (r), clauses (1) to (7). This paragraph expires July 1, 2026, for medical 
81.25 	assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
81.26 	(r) (u) For purposes of reimbursement rates for nonemergency medical transportation 
81.27 	services under paragraphs (p) and (q) (r) to (t), the zip code of the recipient's place of 
81.28 	residence shall determine whether the urban, rural, or super rural reimbursement rate applies.
81.29 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
81.30 	2027, for prepaid medical assistance.
82.1 	(s) (v) The commissioner, when determining reimbursement rates for nonemergency 
82.2 	medical transportation under paragraphs (p) and (q), shall exempt all modes of transportation 
82.3 	listed under paragraph (l) (n) from Minnesota Rules, part 9505.0445, item R, subitem (2).
82.4 	(t) (w) Effective for the first day of each calendar quarter in which the price of gasoline 
82.5 	as posted publicly by the United States Energy Information Administration exceeds $3.00 
82.6 	per gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) (r) by one 
82.7 	percent up or down for every increase or decrease of ten cents for the price of gasoline. The 
82.8 	increase or decrease must be calculated using a base gasoline price of $3.00. The percentage 
82.9 	increase or decrease must be calculated using the average of the most recently available 
82.10 	price of all grades of gasoline for Minnesota as posted publicly by the United States Energy 
82.11 	Information Administration. This paragraph expires July 1, 2026, for medical assistance 
82.12 	fee-for-service and January 1, 2027, for prepaid medical assistance.

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

82.14 	Sec. 11. Minnesota Statutes 2024, section 256B.0625, subdivision 17a, is amended to 
82.15 	read:
82.16 		Subd. 17a.Payment for ambulance services. (a) Medical assistance covers ambulance 
82.17 	services. Providers shall bill ambulance services according to Medicare criteria. 
82.18 	Nonemergency ambulance services shall not be paid as emergencies. Effective for services 
82.19 	rendered on or after July 1, 2001, medical assistance payments for ambulance services shall 
82.20 	be paid at the Medicare reimbursement rate or at the medical assistance payment rate in 
82.21 	effect on July 1, 2000, whichever is greater.
82.22 	(b) Effective for services provided on or after July 1, 2016, medical assistance payment 
82.23 	rates for ambulance services identified in this paragraph are increased by five percent. 
82.24 	Capitation payments made to managed care plans and county-based purchasing plans for 
82.25 	ambulance services provided on or after January 1, 2017, shall be increased to reflect this 
82.26 	rate increase. The increased rate described in this paragraph applies to ambulance service 
82.27 	providers whose base of operations as defined in section 144E.10 is located:
82.28 	(1) outside the metropolitan counties listed in section 473.121, subdivision 4, and outside 
82.29 	the cities of Duluth, Mankato, Moorhead, St. Cloud, and Rochester; or
82.30 	(2) within a municipality with a population of less than 1,000.
82.31 	(c) Effective for services provided statewide on or after January 1, 2026, medical 
82.32 	assistance payment rates for ambulance services are increased by 13.68 percent. Capitation 
83.1 	payments made to managed care plans and county-based purchasing plans for ambulance 
83.2 	services provided on or after January 1, 2026, must be increased to reflect this rate increase.
83.3 	(c) (d) Effective for the first day of each calendar quarter in which the price of gasoline 
83.4 	as posted publicly by the United States Energy Information Administration exceeds $3.00 
83.5 	per gallon, the commissioner shall adjust the rate paid per mile in paragraph (a) by one 
83.6 	percent up or down for every increase or decrease of ten cents for the price of gasoline. The 
83.7 	increase or decrease must be calculated using a base gasoline price of $3.00. The percentage 
83.8 	increase or decrease must be calculated using the average of the most recently available 
83.9 	price of all grades of gasoline for Minnesota as posted publicly by the United States Energy 
83.10 	Information Administration.
83.11 	(d) (e) Managed care plans and county-based purchasing plans must provide a fuel 
83.12 	adjustment for ambulance services rates when fuel exceeds $3 per gallon. If, for any contract 
83.13 	year, federal approval is not received for this paragraph, the commissioner must adjust the 
83.14 	capitation rates paid to managed care plans and county-based purchasing plans for that 
83.15 	contract year to reflect the removal of this provision. Contracts between managed care plans 
83.16 	and county-based purchasing plans and providers to whom this paragraph applies must 
83.17 	allow recovery of payments from those providers if capitation rates are adjusted in accordance 
83.18 	with this paragraph. Payment recoveries must not exceed the amount equal to any increase 
83.19 	in rates that results from this paragraph. This paragraph expires if federal approval is not 
83.20 	received for this paragraph at any time.

83.21 	Sec. 12. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision 
83.22 	to read:
83.23 		Subd. 18i.Administration of nonemergency medical transportation. Effective July 
83.24 	1, 2026, for medical assistance fee-for-service and January 1, 2027, for prepaid medical 
83.25 	assistance, the commissioner must contract either statewide or regionally for the 
83.26 	administration of the nonemergency medical transportation program in compliance with 
83.27 	the provisions of this chapter. The contract must include the administration of the 
83.28 	nonemergency medical transportation benefit for those enrolled in managed care as described 
83.29 	in section 256B.69.

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

83.31 	Sec. 13. Minnesota Statutes 2024, section 256B.0625, subdivision 30, is amended to read:
83.32 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic services, 
83.33 	federally qualified health center services, nonprofit community health clinic services, and 
84.1 	public health clinic services. Rural health clinic services and federally qualified health center 
84.2 	services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and 
84.3 	(C). Payment for rural health clinic and federally qualified health center services shall be 
84.4 	made according to applicable federal law and regulation.
84.5 	(b) A federally qualified health center (FQHC) that is beginning initial operation shall 
84.6 	submit an estimate of budgeted costs and visits for the initial reporting period in the form 
84.7 	and detail required by the commissioner. An FQHC that is already in operation shall submit 
84.8 	an initial report using actual costs and visits for the initial reporting period. Within 90 days 
84.9 	of the end of its reporting period, an FQHC shall submit, in the form and detail required by 
84.10 	the commissioner, a report of its operations, including allowable costs actually incurred for 
84.11 	the period and the actual number of visits for services furnished during the period, and other 
84.12 	information required by the commissioner. FQHCs that file Medicare cost reports shall 
84.13 	provide the commissioner with a copy of the most recent Medicare cost report filed with 
84.14 	the Medicare program intermediary for the reporting year which support the costs claimed 
84.15 	on their cost report to the state.
84.16 	(c) In order to continue cost-based payment under the medical assistance program 
84.17 	according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation 
84.18 	as an essential community provider within six months of final adoption of rules by the 
84.19 	Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and 
84.20 	rural health clinics that have applied for essential community provider status within the 
84.21 	six-month time prescribed, medical assistance payments will continue to be made according 
84.22 	to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural 
84.23 	health clinics that either do not apply within the time specified above or who have had 
84.24 	essential community provider status for three years, medical assistance payments for health 
84.25 	services provided by these entities shall be according to the same rates and conditions 
84.26 	applicable to the same service provided by health care providers that are not FQHCs or rural 
84.27 	health clinics.
84.28 	(d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural 
84.29 	health clinic to make application for an essential community provider designation in order 
84.30 	to have cost-based payments made according to paragraphs (a) and (b) no longer apply.
84.31 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall 
84.32 	be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
84.33 	(f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health 
84.34 	clinic may elect to be paid either under the prospective payment system established in United 
85.1 	States Code, title 42, section 1396a(aa), or under an alternative payment methodology 
85.2 	consistent with the requirements of United States Code, title 42, section 1396a(aa), and 
85.3 	approved by the Centers for Medicare and Medicaid Services. The alternative payment 
85.4 	methodology shall be 100 percent of cost as determined according to Medicare cost 
85.5 	principles.
85.6 	(g) Effective for services provided on or after January 1, 2021, all claims for payment 
85.7 	of clinic services provided by FQHCs and rural health clinics shall be paid by the 
85.8 	commissioner, according to an annual election by the FQHC or rural health clinic, under 
85.9 	the current prospective payment system described in paragraph (f) or the alternative payment 
85.10 	methodology described in paragraph (l), or, upon federal approval, for FQHCs that are also 
85.11 	urban Indian organizations under Title V of the federal Indian Health Improvement Act, as 
85.12 	provided under paragraph (k).
85.13 	(h) For purposes of this section, "nonprofit community clinic" is a clinic that:
85.14 	(1) has nonprofit status as specified in chapter 317A;
85.15 	(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
85.16 	(3) is established to provide health services to low-income population groups, uninsured, 
85.17 	high-risk and special needs populations, underserved and other special needs populations;
85.18 	(4) employs professional staff at least one-half of which are familiar with the cultural 
85.19 	background of their clients;
85.20 	(5) charges for services on a sliding fee scale designed to provide assistance to 
85.21 	low-income clients based on current poverty income guidelines and family size; and
85.22 	(6) does not restrict access or services because of a client's financial limitations or public 
85.23 	assistance status and provides no-cost care as needed.
85.24 	(i) Effective for services provided on or after January 1, 2015, all claims for payment 
85.25 	of clinic services provided by FQHCs and rural health clinics shall be paid by the 
85.26 	commissioner. the commissioner shall determine the most feasible method for paying claims 
85.27 	from the following options:
85.28 	(1) FQHCs and rural health clinics submit claims directly to the commissioner for 
85.29 	payment, and the commissioner provides claims information for recipients enrolled in a 
85.30 	managed care or county-based purchasing plan to the plan, on a regular basis; or
86.1 	(2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed 
86.2 	care or county-based purchasing plan to the plan, and those claims are submitted by the 
86.3 	plan to the commissioner for payment to the clinic.
86.4 	(j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate 
86.5 	and pay monthly the proposed managed care supplemental payments to clinics, and clinics 
86.6 	shall conduct a timely review of the payment calculation data in order to finalize all 
86.7 	supplemental payments in accordance with federal law. Any issues arising from a clinic's 
86.8 	review must be reported to the commissioner by January 1, 2017. Upon final agreement 
86.9 	between the commissioner and a clinic on issues identified under this subdivision, and in 
86.10 	accordance with United States Code, title 42, section 1396a(bb), no supplemental payments 
86.11 	for managed care plan or county-based purchasing plan claims for services provided prior 
86.12 	to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are 
86.13 	unable to resolve issues under this subdivision, the parties shall submit the dispute to the 
86.14 	arbitration process under section 14.57.
86.15 	(k) The commissioner shall establish an encounter payment rate that is equivalent to the 
86.16 	all inclusive rate (AIR) payment established by the Indian Health Service and published in 
86.17 	the Federal Register. The encounter rate must be updated annually and must reflect the 
86.18 	changes in the AIR established by the Indian Health Service each calendar year. FQHCs 
86.19 	that are also urban Indian organizations under Title V of the federal Indian Health 
86.20 	Improvement Act may elect to be paid: (1) at the encounter rate established under this 
86.21 	paragraph; (2) under the alternative payment methodology described in paragraph (l); or 
86.22 	(3) under the federally required prospective payment system described in paragraph (f). 
86.23 	FQHCs that elect to be paid at the encounter rate established under this paragraph must 
86.24 	continue to meet all state and federal requirements related to FQHCs and urban Indian 
86.25 	organizations, and must maintain their statuses as FQHCs and urban Indian organizations.
86.26 	(l) All claims for payment of clinic services provided by FQHCs and rural health clinics, 
86.27 	that have elected to be paid under this paragraph, shall be paid by the commissioner according 
86.28 	to the following requirements:
86.29 	(1) the commissioner shall establish a single medical and single dental organization 
86.30 	encounter rate for each FQHC and rural health clinic when applicable;
86.31 	(2) each FQHC and rural health clinic is eligible for same day reimbursement of one 
86.32 	medical and one dental organization encounter rate if eligible medical and dental visits are 
86.33 	provided on the same day;
87.1 	(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance 
87.2 	with current applicable Medicare cost principles, their allowable costs, including direct 
87.3 	patient care costs and patient-related support services. Nonallowable costs include, but are 
87.4 	not limited to:
87.5 	(i) general social services and administrative costs;
87.6 	(ii) retail pharmacy;
87.7 	(iii) patient incentives, food, housing assistance, and utility assistance;
87.8 	(iv) external lab and x-ray;
87.9 	(v) navigation services;
87.10 	(vi) health care taxes;
87.11 	(vii) advertising, public relations, and marketing;
87.12 	(viii) office entertainment costs, food, alcohol, and gifts;
87.13 	(ix) contributions and donations;
87.14 	(x) bad debts or losses on awards or contracts;
87.15 	(xi) fines, penalties, damages, or other settlements;
87.16 	(xii) fundraising, investment management, and associated administrative costs;
87.17 	(xiii) research and associated administrative costs;
87.18 	(xiv) nonpaid workers;
87.19 	(xv) lobbying;
87.20 	(xvi) scholarships and student aid; and
87.21 	(xvii) nonmedical assistance covered services;
87.22 	(4) the commissioner shall review the list of nonallowable costs in the years between 
87.23 	the rebasing process established in clause (5), in consultation with the Minnesota Association 
87.24 	of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall 
87.25 	publish the list and any updates in the Minnesota health care programs provider manual;
87.26 	(5) the initial applicable base year organization encounter rates for FQHCs and rural 
87.27 	health clinics shall be computed for services delivered on or after January 1, 2021, and:
87.28 	(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports 
87.29 	from 2017 and 2018;
88.1 	(ii) must be according to current applicable Medicare cost principles as applicable to 
88.2 	FQHCs and rural health clinics without the application of productivity screens and upper 
88.3 	payment limits or the Medicare prospective payment system FQHC aggregate mean upper 
88.4 	payment limit;
88.5 	(iii) must be subsequently rebased every two years thereafter using the Medicare cost 
88.6 	reports that are three and four years prior to the rebasing year. Years in which organizational 
88.7 	cost or claims volume is reduced or altered due to a pandemic, disease, or other public health 
88.8 	emergency shall not be used as part of a base year when the base year includes more than 
88.9 	one year. The commissioner may use the Medicare cost reports of a year unaffected by a 
88.10 	pandemic, disease, or other public health emergency, or previous two consecutive years, 
88.11 	inflated to the base year as established under item (iv);
88.12 	(iv) must be inflated to the base year using the inflation factor described in clause (6); 
88.13 	and
88.14 	(v) the commissioner must provide for a 60-day appeals process under section 14.57;
88.15 	(6) the commissioner shall annually inflate the applicable organization encounter rates 
88.16 	for FQHCs and rural health clinics from the base year payment rate to the effective date by 
88.17 	using the CMS FQHC Market Basket inflator established under United States Code, title 
88.18 	42, section 1395m(o), less productivity;
88.19 	(7) FQHCs and rural health clinics that have elected the alternative payment methodology 
88.20 	under this paragraph shall submit all necessary documentation required by the commissioner 
88.21 	to compute the rebased organization encounter rates no later than six months following the 
88.22 	date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid 
88.23 	Services;
88.24 	(8) the commissioner shall reimburse FQHCs and rural health clinics an additional 
88.25 	amount relative to their medical and dental organization encounter rates that is attributable 
88.26 	to the tax required to be paid according to section 295.52, if applicable;
88.27 	(9) FQHCs and rural health clinics may submit change of scope requests to the 
88.28 	commissioner if the change of scope would result in an increase or decrease of 2.5 percent 
88.29 	or higher in the medical or dental organization encounter rate currently received by the 
88.30 	FQHC or rural health clinic;
88.31 	(10) for FQHCs and rural health clinics seeking a change in scope with the commissioner 
88.32 	under clause (9) that requires the approval of the scope change by the federal Health 
88.33 	Resources Services Administration:
89.1 	(i) FQHCs and rural health clinics shall submit the change of scope request, including 
89.2 	the start date of services, to the commissioner within seven business days of submission of 
89.3 	the scope change to the federal Health Resources Services Administration;
89.4 	(ii) the commissioner shall establish the effective date of the payment change as the 
89.5 	federal Health Resources Services Administration date of approval of the FQHC's or rural 
89.6 	health clinic's scope change request, or the effective start date of services, whichever is 
89.7 	later; and
89.8 	(iii) within 45 days of one year after the effective date established in item (ii), the 
89.9 	commissioner shall conduct a retroactive review to determine if the actual costs established 
89.10 	under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in 
89.11 	the medical or dental organization encounter rate, and if this is the case, the commissioner 
89.12 	shall revise the rate accordingly and shall adjust payments retrospectively to the effective 
89.13 	date established in item (ii);
89.14 	(11) for change of scope requests that do not require federal Health Resources Services 
89.15 	Administration approval, the FQHC and rural health clinic shall submit the request to the 
89.16 	commissioner before implementing the change, and the effective date of the change is the 
89.17 	date the commissioner received the FQHC's or rural health clinic's request, or the effective 
89.18 	start date of the service, whichever is later. The commissioner shall provide a response to 
89.19 	the FQHC's or rural health clinic's request within 45 days of submission and provide a final 
89.20 	approval within 120 days of submission. This timeline may be waived at the mutual 
89.21 	agreement of the commissioner and the FQHC or rural health clinic if more information is 
89.22 	needed to evaluate the request;
89.23 	(12) the commissioner, when establishing organization encounter rates for new FQHCs 
89.24 	and rural health clinics, shall consider the patient caseload of existing FQHCs and rural 
89.25 	health clinics in a 60-mile radius for organizations established outside of the seven-county 
89.26 	metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan 
89.27 	area. If this information is not available, the commissioner may use Medicare cost reports 
89.28 	or audited financial statements to establish base rates;
89.29 	(13) the commissioner, when establishing organization encounter rates under this section 
89.30 	for FQHCs and rural health clinics resulting from a merger of existing clinics or the 
89.31 	acquisition of an existing clinic by another existing clinic, must use the combined costs and 
89.32 	caseloads from the clinics participating in the merger or acquisition to set the encounter rate 
89.33 	for the new clinic organization resulting from the merger or acquisition. The scope of services 
90.1 	for the newly formed clinic must be inclusive of the scope of services of the clinics 
90.2 	participating in the merger or acquisition;
90.3 	(13) (14) the commissioner shall establish a quality measures workgroup that includes 
90.4 	representatives from the Minnesota Association of Community Health Centers, FQHCs, 
90.5 	and rural health clinics, to evaluate clinical and nonclinical measures; and
90.6 	(14) (15) the commissioner shall not disallow or reduce costs that are related to an 
90.7 	FQHC's or rural health clinic's participation in health care educational programs to the extent 
90.8 	that the costs are not accounted for in the alternative payment methodology encounter rate 
90.9 	established in this paragraph.
90.10 	(m) Effective July 1, 2023, an enrolled Indian health service facility or a Tribal health 
90.11 	center operating under a 638 contract or compact may elect to also enroll as a Tribal FQHC. 
90.12 	Requirements that otherwise apply to an FQHC covered in this subdivision do not apply to 
90.13 	a Tribal FQHC enrolled under this paragraph, except that any requirements necessary to 
90.14 	comply with federal regulations do apply to a Tribal FQHC. The commissioner shall establish 
90.15 	an alternative payment method for a Tribal FQHC enrolled under this paragraph that uses 
90.16 	the same method and rates applicable to a Tribal facility or health center that does not enroll 
90.17 	as a Tribal FQHC.
90.18 	(n) FQHC reimbursement for mental health targeted case management services is limited 
90.19 	to:
90.20 	(1) only those services described under subdivision 20 and provided in accordance with 
90.21 	contracts executed with counties authorized to subcontract for mental health targeted case 
90.22 	management services; and
90.23 	(2) an FQHC's actual incurred costs as separately reported on the cost report submitted 
90.24 	to the Centers for Medicare and Medicaid Services and further identified in reports submitted 
90.25 	to the commissioner.
90.26 	(o) Counties contracting with FQHCs for mental health targeted case management remain 
90.27 	responsible for the nonfederal share of the cost of the provided mental health targeted case 
90.28 	management services. The commissioner must bill each county for the nonfederal share of 
90.29 	the mental health targeted case management costs as reported by the FQHC.

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

91.1 	Sec. 14. Minnesota Statutes 2024, section 256B.1973, subdivision 5, is amended to read:
91.2 		Subd. 5.Commissioner's duties; state-directed fee schedule requirement. (a) For 
91.3 	each federally approved directed payment arrangement that is a state-directed fee schedule 
91.4 	requirement, the commissioner shall determine a uniform adjustment factor to be applied 
91.5 	to each claim submitted by an eligible provider to a health plan. The uniform adjustment 
91.6 	factor shall be determined using the average commercial payer rate or using another method 
91.7 	acceptable to the Centers for Medicare and Medicaid Services if the average commercial 
91.8 	payer rate is not approved, minus the amount necessary for the plan to satisfy tax liabilities 
91.9 	under sections 256.9657 and 297I.05 attributable to the directed payment arrangement. The 
91.10 	commissioner shall ensure that the application of the uniform adjustment factor maximizes 
91.11 	the allowable directed payments and does not result in payments exceeding federal limits, 
91.12 	and may use an annual settle-up process. The directed payment shall may be specific to 
91.13 	each health plan and prospectively incorporated into capitation payments for that plan.
91.14 	(b) For each federally approved directed payment arrangement that is a state-directed 
91.15 	fee schedule requirement, the commissioner shall develop a plan for the initial 
91.16 	implementation of the state-directed fee schedule requirement to ensure that the eligible 
91.17 	provider receives the entire permissible value of the federally approved directed payment 
91.18 	arrangement. If federal approval of a directed payment arrangement under this subdivision 
91.19 	is retroactive, the commissioner shall make a onetime pro rata increase to the uniform 
91.20 	adjustment factor and the initial payments in order to include claims submitted between the 
91.21 	retroactive federal approval date and the period captured by the initial payments.

91.22 	Sec. 15. Minnesota Statutes 2024, section 256B.1973, is amended by adding a subdivision 
91.23 	to read:
91.24 		Subd. 9.Interaction with other directed payments. An eligible provider under 
91.25 	subdivision 3 may participate in the hospital directed payment program under section 
91.26 	256B.1974 for inpatient hospital services, outpatient hospital services, or both. A provider 
91.27 	participating in the hospital directed payment program must not receive a directed payment 
91.28 	under this section for any provider classes paid via the hospital directed payment program. 
91.29 	A hospital subject to this section must notify the commissioner in writing no later than 30 
91.30 	days after enactment of this subdivision of its intention to participate in the hospital directed 
91.31 	payment program under section 256B.1974 for inpatient hospital services, outpatient hospital 
91.32 	services, or both. The election under this subdivision is a onetime election, except that if 
91.33 	an eligible provider elects to participate in the hospital directed payment program, and the 
92.1 	hospital directed payment program expires, then the eligible provider may thereafter elect 
92.2 	to participate in the directed payment under this section.

92.3 	EFFECTIVE DATE. (a) This section is effective on the later of January 1, 2026, or 
92.4 	federal approval of all of the following:
92.5 	(1) the waiver for the assessment required under Minnesota Statutes, section 256.9657, 
92.6 	subdivision 2b; and
92.7 	(2) the amendments in this act to Minnesota Statutes, section 256B.1974.
92.8 	(b) The commissioner of human services shall notify the revisor of statutes when federal 
92.9 	approval for all amendments set forth in paragraph (a) is obtained.

92.10 	Sec. 16. [256B.1974] HOSPITAL DIRECTED PAYMENT PROGRAM.
92.11 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
92.12 	the meanings given.
92.13 	(b) "Health plan" means a managed care plan or county-based purchasing plan that is 
92.14 	under contract with the commissioner to deliver services to medical assistance enrollees 
92.15 	under section 256B.69.
92.16 	(c) "Eligible hospital" has the meaning given in section 256.9657, subdivision 2b, 
92.17 	paragraph (a), clause (1).
92.18 		Subd. 2.Required conditions for program. The hospital directed payment program is 
92.19 	contingent on the satisfaction of all requirements necessary for the collection of an assessment 
92.20 	under section 256.9657, and must conform with the requirements for permissible directed 
92.21 	managed care organization expenditures under section 256B.6928, subdivision 5.
92.22 		Subd. 3.Commissioner's duties; state-directed fee schedule requirement. (a) For 
92.23 	each federally approved directed payment program that is a state-directed fee schedule 
92.24 	requirement that includes a quarterly payment amount to be submitted by each health plan 
92.25 	to each eligible hospital, the commissioner must determine the quarterly payment amount 
92.26 	using the statewide average commercial payer rate, or using another method acceptable to 
92.27 	the Centers for Medicare and Medicaid Services if the statewide average commercial payer 
92.28 	rate is not approved. The commissioner must ensure that the application of the quarterly 
92.29 	payment amounts maximizes the amount generated by the hospital assessment in section 
92.30 	256.9657, subdivision 2b, for allowable directed payments and does not result in payments 
92.31 	exceeding federal limits.
93.1 	(b) The commissioner must use an annual settle-up process that occurs within the time 
93.2 	period allowed for medical assistance managed care claims adjustments.
93.3 	(c) On and after January 1, 2028, if the federal regulations set forth in Code of Federal 
93.4 	Regulations, title 42, parts 430, 438, and 457, remain effective, the hospital directed payment 
93.5 	program may be specific to each health plan and prospectively incorporated into capitation 
93.6 	payments for that plan.
93.7 	(d) For each federally approved directed payment program that is a state-directed fee 
93.8 	schedule requirement, the commissioner must develop a plan for the initial implementation 
93.9 	of the state-directed fee schedule requirement to ensure that eligible hospitals receive the 
93.10 	entire permissible value of the federally approved directed payment.
93.11 	(e) Directed payments under this section must only be used to supplement, and not 
93.12 	supplant, medical assistance reimbursement to eligible hospitals. The directed payment 
93.13 	program must not modify, reduce, or offset the medical assistance payment rates determined 
93.14 	for each eligible hospital as required by section 256.969.
93.15 	(f) The commissioner must require health plans to make quarterly directed payments 
93.16 	according to this section.
93.17 	(g) Health plans must make quarterly directed payments using electronic funds transfers, 
93.18 	if the eligible hospital provides the information necessary to process such transfers, and in 
93.19 	accordance with directions provided by the commissioner. Health plans must make quarterly 
93.20 	directed payments:
93.21 	(1) for the first two quarters for which such payments are due, within 30 calendar days 
93.22 	of the date the commissioner issued sufficient payments to the health plan to make the 
93.23 	directed payments according to this section; and
93.24 	(2) for all subsequent quarters, within ten calendar days of the date the commissioner 
93.25 	issued sufficient payments to the health plan to make the directed payments according to 
93.26 	this section.
93.27 	(h) The commissioner of human services must publish on the Department of Human 
93.28 	Services website, on a quarterly basis, the dates that the health plans completed their required 
93.29 	quarterly payments under this section.
93.30 	(i) Payments to health plans that would be paid consistent with actuarial certification 
93.31 	and enrollment in the absence of the increased capitation payments under this section must 
93.32 	not be reduced as a result of this section.
94.1 	(j) The commissioner must publish all directed payments resulting from this section 
94.2 	owed to each eligible hospital from each health plan on the Department of Human Services 
94.3 	website for at least two years. All calculations and reports must be posted no later than the 
94.4 	first day of the quarter for which the payments are to be issued.
94.5 	(k) By December 1 each year, the commissioner must notify each eligible hospital of 
94.6 	any changes to the payment methodologies in this section, including but not limited to 
94.7 	changes in the directed payment rates, the aggregate directed payment amount for all eligible 
94.8 	hospitals, and the eligible hospital's directed payment amount for the upcoming calendar 
94.9 	year.
94.10 	(l) The commissioner must distribute payments required under this section for each 
94.11 	eligible hospital within 30 days of a quarterly assessment under section 256.9657, subdivision 
94.12 	2b, being received. The commissioner must pay the directed payments to health plans under 
94.13 	contract no later than January 1, April 1, July 1, and October 1 each year.
94.14 	(m) A hospital is not entitled to payments under this section until it is an eligible hospital. 
94.15 	An eligible hospital that has merged with another hospital must have its payments under 
94.16 	this section revised at the start of the first full fiscal year after the merger is complete. A 
94.17 	closed eligible hospital is entitled to the payments under this section for services provided 
94.18 	through the final date of operations.
94.19 		Subd. 4.Health plan duties; submission of claims. Each health plan must submit to 
94.20 	the commissioner, in accordance with its contract with the commissioner to serve as a 
94.21 	managed care organization in medical assistance, payment information for each claim paid 
94.22 	to an eligible hospital for services provided to a medical assistance enrollee. Health plans 
94.23 	must allow each eligible hospital to review the health plan's own paid claims detail to enable 
94.24 	proper validation that the medical assistance managed care claims volume and content is 
94.25 	consistent with the eligible hospital's internal records. To support the validation process for 
94.26 	the directed payment program, health plans must permit the commissioner to share inpatient 
94.27 	and outpatient claims-level details with eligible hospitals identifying only those claims 
94.28 	where the prepaid medical assistance program under section 256B.69 is the payer source. 
94.29 	Eligible hospitals must provide notice of discrepancies in claims paid to the commissioner 
94.30 	in a form determined by the commissioner. The commissioner is authorized to determine 
94.31 	the final disposition of the validation process for disputed claims.
94.32 		Subd. 5.Health plan duties; directed payment add-on. (a) Each health plan must 
94.33 	make, in accordance with its contract with the commissioner to serve as a managed care 
94.34 	organization in medical assistance, a directed payment to each eligible hospital. The amount 
95.1 	of the directed payment to the eligible hospital must be equal to the payment amounts the 
95.2 	plan received from the commissioner for the hospital.
95.3 	(b) Health plans are prohibited from:
95.4 	(1) setting, establishing, or negotiating reimbursement rates with an eligible hospital in 
95.5 	a manner that directly or indirectly takes into account a directed payment that a hospital 
95.6 	receives under this section;
95.7 	(2) unnecessarily delaying a directed payment to an eligible hospital; or
95.8 	(3) recouping or offsetting a directed payment for any reason, except as expressly 
95.9 	authorized by the commissioner.
95.10 		Subd. 6.Hospital duties; quarterly supplemental directed payment add-on. (a) An 
95.11 	eligible hospital receiving a directed payment under this section is prohibited from:
95.12 	(1) setting, establishing, or negotiating reimbursement rates with a managed care 
95.13 	organization in a manner that directly or indirectly takes into account a directed payment 
95.14 	that an eligible hospital receives under this section; or
95.15 	(2) directly passing on the cost of an assessment to patients or nonmedical assistance 
95.16 	payers, including as a fee or rate increase.
95.17 	(b) An eligible hospital that violates this subdivision is prohibited from receiving a 
95.18 	directed payment under this section for the remainder of the calendar year. This subdivision 
95.19 	does not prohibit an eligible hospital from negotiating with a payer for a rate increase.
95.20 	(c) Any eligible hospital receiving a directed payment under this section must meet the 
95.21 	commissioner's standards for directed payments as described in subdivision 7.
95.22 		Subd. 7.State minimum policy goals established. (a) The effect of the directed 
95.23 	payments under this section must align with the state's policy goals for medical assistance 
95.24 	enrollees. The directed payments must be used to maintain quality and access to a full range 
95.25 	of health care delivery mechanisms for medical assistance enrollees, and specifically provide 
95.26 	improvement for one of the following quality measures:
95.27 	(1) overall well child visit rates;
95.28 	(2) maternal depression screening rates; or
95.29 	(3) colon cancer screening rates.
95.30 	(b) The commissioner, in consultation with the Minnesota Hospital Association, must 
95.31 	submit to the Centers for Medicare and Medicaid Services a quality measures performance 
96.1 	evaluation criteria and methodology to regularly measure access to care and the achievement 
96.2 	of state policy goals described in this subdivision.
96.3 	(c) The quality measures evaluation data, as determined by paragraph (b), must be 
96.4 	reported to the Centers for Medicare and Medicaid Services after at least 12 months of 
96.5 	directed payments to hospitals.
96.6 		Subd. 8.Administrative review. Before making the payments required under this 
96.7 	section, and on at least an annual basis, the commissioner must consult with and provide 
96.8 	for review of the payment amounts by a permanent select committee established by the 
96.9 	Minnesota Hospital Association. Any data or information reviewed by members of the 
96.10 	committee are data not on individuals, as defined in section 13.02. The committee's members 
96.11 	may not include any current employee or paid consultant of any hospital.

96.12 	EFFECTIVE DATE. (a) This section is effective the later of January 1, 2026, or federal 
96.13 	approval of all of the following:
96.14 	(1) the amendments in this act adding Minnesota Statutes, section 256.9657, subdivision 
96.15 	2b; and
96.16 	(2) the amendments in this act to this section.
96.17 	(b) The commissioner of human services shall notify the revisor of statutes when federal 
96.18 	approval for all amendments set forth in paragraph (a) is obtained.

96.19 	Sec. 17. [256B.1975] HOSPITAL DIRECTED PAYMENT PROGRAM ACCOUNT.
96.20 		Subdivision 1.Account established; appropriation. (a) The hospital directed payment 
96.21 	program account is created in the special revenue fund in the state treasury.
96.22 	(b) Money in the account, including interest earned, is annually appropriated to the 
96.23 	commissioner for the purposes specified in section 256B.1974.
96.24 	(c) Transfers from this account to another fund are prohibited, except as necessary to 
96.25 	make the payments required under section 256B.1974.
96.26 		Subd. 2.Reports to the legislature. By January 15, 2027, and each January 15 thereafter, 
96.27 	the commissioner must submit a report to the chairs and ranking minority members of the 
96.28 	legislative committees with jurisdiction over health and human services policy and finance 
96.29 	that details the activities and uses of money in the hospital directed payment program 
96.30 	account, including the metrics and outcomes of the policy goals established by section 
96.31 	256B.1974, subdivision 7.

97.1 	EFFECTIVE DATE. This section is effective on the later of January 1, 2026, or federal 
97.2 	approval of the amendments in this act adding Minnesota Statutes, section 256.9657, 
97.3 	subdivision 2b. The commissioner of human services shall notify the revisor of statutes 
97.4 	when federal approval is obtained.

97.5 	Sec. 18. Minnesota Statutes 2024, section 256B.69, subdivision 3a, is amended to read:
97.6 		Subd. 3a.County authority. (a) The commissioner, when implementing the medical 
97.7 	assistance prepayment program within a county, must include the county board in the process 
97.8 	of development, approval, and issuance of the request for proposals to provide services to 
97.9 	eligible individuals within the proposed county. County boards must be given reasonable 
97.10 	opportunity to make recommendations regarding the development, issuance, review of 
97.11 	responses, and changes needed in the request for proposals. The commissioner must provide 
97.12 	county boards the opportunity to review each proposal based on the identification of 
97.13 	community needs under chapters 142F and 145A and county advocacy activities. If a county 
97.14 	board finds that a proposal does not address certain community needs, the county board and 
97.15 	commissioner shall continue efforts for improving the proposal and network prior to the 
97.16 	approval of the contract. The county board shall make recommendations regarding the 
97.17 	approval of local networks and their operations to ensure adequate availability and access 
97.18 	to covered services. The provider or health plan must respond directly to county advocates 
97.19 	and the state prepaid medical assistance ombudsperson regarding service delivery and must 
97.20 	be accountable to the state regarding contracts with medical assistance funds. The county 
97.21 	board may recommend a maximum number of participating health plans after considering 
97.22 	the size of the enrolling population; ensuring adequate access and capacity; considering the 
97.23 	client and county administrative complexity; and considering the need to promote the 
97.24 	viability of locally developed health plans. The county board or a single entity representing 
97.25 	a group of county boards and the commissioner shall mutually select health plans for 
97.26 	participation at the time of initial implementation of the prepaid medical assistance program 
97.27 	in that county or group of counties and at the time of contract renewal. The commissioner 
97.28 	shall also seek input for contract requirements from the county or single entity representing 
97.29 	a group of county boards at each contract renewal and incorporate those recommendations 
97.30 	into the contract negotiation process.
97.31 	(b) At the option of the county board, the board may develop contract requirements 
97.32 	related to the achievement of local public health goals to meet the health needs of medical 
97.33 	assistance enrollees. These requirements must be reasonably related to the performance of 
97.34 	health plan functions and within the scope of the medical assistance benefit set. If the county 
97.35 	board and the commissioner mutually agree to such requirements, the department shall 
98.1 	include such requirements in all health plan contracts governing the prepaid medical 
98.2 	assistance program in that county at initial implementation of the program in that county 
98.3 	and at the time of contract renewal. The county board may participate in the enforcement 
98.4 	of the contract provisions related to local public health goals.
98.5 	(c) For counties in which a prepaid medical assistance program has not been established, 
98.6 	the commissioner shall not implement that program if a county board submits an acceptable 
98.7 	and timely preliminary and final proposal under section 256B.692, until county-based 
98.8 	purchasing is no longer operational in that county. For counties in which a prepaid medical 
98.9 	assistance program is in existence on or after September 1, 1997, the commissioner must 
98.10 	terminate contracts with health plans according to section 256B.692, subdivision 5, if the 
98.11 	county board submits and the commissioner accepts a preliminary and final proposal 
98.12 	according to that subdivision. The commissioner is not required to terminate contracts that 
98.13 	begin on or after September 1, 1997, according to section 256B.692 until two years have 
98.14 	elapsed from the date of initial enrollment. This paragraph expires upon the effective date 
98.15 	of paragraph (d).
98.16 	(d) For counties in which a prepaid medical assistance program is in existence on or 
98.17 	after September 1, 1997, the commissioner must terminate contracts with health plans 
98.18 	according to section 256B.692, subdivision 5, if the county board submits and the 
98.19 	commissioner accepts a preliminary and final proposal according to that subdivision. This 
98.20 	paragraph is effective January 1, 2027, or upon federal approval, whichever is later. The 
98.21 	commissioner of human services shall notify the revisor of statutes when federal approval 
98.22 	is obtained.
98.23 	(d) (e) In the event that a county board or a single entity representing a group of county 
98.24 	boards and the commissioner cannot reach agreement regarding: (i) the selection of 
98.25 	participating health plans in that county; (ii) contract requirements; or (iii) implementation 
98.26 	and enforcement of county requirements including provisions regarding local public health 
98.27 	goals, the commissioner shall resolve all disputes after taking into account the 
98.28 	recommendations of a three-person mediation panel. The panel shall be composed of one 
98.29 	designee of the president of the association of Minnesota counties, one designee of the 
98.30 	commissioner of human services, and one person selected jointly by the designee of the 
98.31 	commissioner of human services and the designee of the Association of Minnesota Counties. 
98.32 	Within a reasonable period of time before the hearing, the panelists must be provided all 
98.33 	documents and information relevant to the mediation. The parties to the mediation must be 
98.34 	given 30 days' notice of a hearing before the mediation panel.
99.1 	(e) (f) If a county which elects to implement county-based purchasing ceases to implement 
99.2 	county-based purchasing, it is prohibited from assuming the responsibility of county-based 
99.3 	purchasing for a period of five years from the date it discontinues purchasing.
99.4 	(f) (g) The commissioner shall not require that contractual disputes between county-based 
99.5 	purchasing entities and the commissioner be mediated by a panel that includes a 
99.6 	representative of the Minnesota Council of Health Plans.
99.7 	(g) (h) At the request of a county-purchasing entity, the commissioner shall adopt a 
99.8 	contract reprocurement or renewal schedule under which all counties included in the entity's 
99.9 	service area are reprocured or renewed at the same time.
99.10 	(h) (i) The commissioner shall provide a written report under section 3.195 to the chairs 
99.11 	of the legislative committees having jurisdiction over human services in the senate and the 
99.12 	house of representatives describing in detail the activities undertaken by the commissioner 
99.13 	to ensure full compliance with this section. The report must also provide an explanation for 
99.14 	any decisions of the commissioner not to accept the recommendations of a county or group 
99.15 	of counties required to be consulted under this section. The report must be provided at least 
99.16 	30 days prior to the effective date of a new or renewed prepaid or managed care contract 
99.17 	in a county.

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

99.19 	Sec. 19. [256B.695] COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE 
99.20 	PROGRAM.
99.21 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
99.22 	the meanings given.
99.23 	(b) "CARMA" means the county-administered rural medical assistance program 
99.24 	established under this section.
99.25 	(c) "Commissioner" means the commissioner of human services.
99.26 	(d) "Eligible individual" means an individual who is:
99.27 	(1) residing in a county administering CARMA; and
99.28 	(2) eligible for medical assistance, MinnesotaCare, Minnesota Senior Health Options 
99.29 	(MSHO), Minnesota Senior Care Plus (MSC+), or Special Needs Basic Care (SNBC).
99.30 	(e) "Enrollee" means an individual enrolled in CARMA.
99.31 	(f) "PMAP" means the prepaid medical assistance program under section 256B.69.
100.1 	(g) "Rural county" has the meaning given to "rural area" in Code of Federal Regulations, 
100.2 	title 42, section 438.52.
100.3 		Subd. 2.Program established. CARMA is established to:
100.4 	(1) provide a county-owned and county-administered alternative to PMAP;
100.5 	(2) facilitate integration of health care, public health, and social services to address 
100.6 	health-related social needs in rural communities;
100.7 	(3) account for the fewer enrollees and local providers of health care and community 
100.8 	services in rural communities; and
100.9 	(4) promote accountability for health outcomes, health equity, customer service, 
100.10 	community outreach, and cost of care.
100.11 		Subd. 3.County participation. Each county or group of counties authorized under 
100.12 	section 256B.692 may administer CARMA for any or all eligible individuals as an alternative 
100.13 	to PMAP, MinnesotaCare, MSHO, MSC+, or SNBC programs. Counties choosing and 
100.14 	authorized to administer CARMA are exempt from the procurement process as required 
100.15 	under section 256B.69.
100.16 		Subd. 4.Oversight and regulation. CARMA is governed by sections 256B.69 and 
100.17 	256B.692, unless otherwise provided for under this section. The commissioner must develop 
100.18 	and implement a procurement process requiring applications from county-based purchasing 
100.19 	plans interested in offering CARMA. The procurement process must require county-based 
100.20 	purchasing plans to demonstrate compliance with federal and state regulatory requirements 
100.21 	and the ability to meet the goals of the program set forth in subdivision 2. The commissioner 
100.22 	must review and approve or disapprove applications.
100.23 		Subd. 5.CARMA enrollment. (a) Subject to paragraphs (d) and (e), eligible individuals 
100.24 	must be automatically enrolled in CARMA, but may decline enrollment. Eligible individuals 
100.25 	may enroll in fee-for-service medical assistance. Eligible individuals may change their 
100.26 	CARMA elections on an annual basis.
100.27 	(b) Eligible individuals must be able to enroll in CARMA through the selection process 
100.28 	in accordance with the election period established in section 256B.69, subdivision 4, 
100.29 	paragraph (e).
100.30 	(c) Enrollees who were not previously enrolled in the medical assistance program or 
100.31 	MinnesotaCare can change their selection once within the first year after enrollment in 
100.32 	CARMA. Enrollees who were not previously enrolled in CARMA have 90 days to make a 
100.33 	change and changes are allowed for additional special circumstances.
101.1 	(d) The commissioner may offer a second health plan other than, and in addition to, 
101.2 	CARMA to eligible individuals when another health plan is required by federal law or rule. 
101.3 	The commissioner may offer a replacement plan to eligible individuals, as determined by 
101.4 	the commissioner, when counties administering CARMA have their contract terminated 
101.5 	for cause.
101.6 	(e) The commissioner may, on a county-by-county basis, offer a health plan other than, 
101.7 	and in addition to, CARMA to individuals who are eligible for both Medicare and medical 
101.8 	assistance due to age or disability if the commissioner deems it necessary for enrollees to 
101.9 	have another choice of health plan. Factors the commissioner must consider when 
101.10 	determining if the other health plan is necessary include the number of available Medicare 
101.11 	Advantage Plan options that are not special needs plans in the county, the size of the enrolling 
101.12 	population, the additional administrative burden placed on providers and counties by multiple 
101.13 	health plan options in a county, the need to ensure the viability and success of the CARMA 
101.14 	program, and the impact to the medical assistance program.
101.15 	(f) In counties where the commissioner is required by federal law or elects to offer a 
101.16 	second health plan other than CARMA pursuant to paragraphs (d) and (e), eligible enrollees 
101.17 	who do not select a health plan at the time of enrollment must automatically be enrolled in 
101.18 	CARMA.
101.19 	(g) This subdivision supersedes section 256B.694.
101.20 		Subd. 6.Benefits and services. (a) Counties or groups of counties administering CARMA 
101.21 	must cover all benefits and services required to be covered by medical assistance under 
101.22 	section 256B.0625.
101.23 	(b) Counties or groups of counties administering CARMA may include health-related 
101.24 	social needs (HRSN) benefits as covered services under medical assistance as of January 
101.25 	1, 2030. Coverage for HRSN must be based on the assessed needs of housing, food, 
101.26 	transportation, utilities, and interpersonal safety.
101.27 	(c) Counties or groups of counties administering CARMA may reimburse enrollees 
101.28 	directly for out-of-pocket costs incurred obtaining assessed HRSN services provided by 
101.29 	nontraditional providers who are unable to accept payment via traditional health insurance 
101.30 	methods. Enrollees must not be reimbursed for out-of-pocket costs paid to providers eligible 
101.31 	to enroll.
101.32 		Subd. 7.Payment. (a) The commissioner, in consultation with counties and groups of 
101.33 	counties administering CARMA, must develop a mechanism for making payments to 
101.34 	counties and groups of counties that administer CARMA. The payment mechanism must:
102.1 	(1) be governed by contracts with terms, including but not limited to payment rates, 
102.2 	amended on an as-needed basis;
102.3 	(2) pay a full-risk monthly capitation payment for services included in CARMA, including 
102.4 	the cost for administering CARMA benefits and services;
102.5 	(3) include risk corridors based on minimum loss ratio, total cost of care, or other metrics;
102.6 	(4) include a settle-up process tied to the risk corridor arrangement allowing a county 
102.7 	or group of counties administering CARMA to retain savings for reinvestment in health 
102.8 	care activities and operations to protect against significant losses that a county or group of 
102.9 	counties administering CARMA or the state might realize, beginning no sooner than after 
102.10 	a county's or group of counties' third year of CARMA operations;
102.11 	(5) include a collaborative rate-setting process accounting for CARMA experience, 
102.12 	regional experience, and the Department of Human Services fee-for-service experience; 
102.13 	and
102.14 	(6) be exempt from section 256B.69, subdivisions 5a, paragraphs (c) and (f), and 5d, 
102.15 	and payment for Medicaid services provided under section 256B.69, subdivision 28, 
102.16 	paragraph (b), no sooner than three years after CARMA implementation.
102.17 	(b) Payments for benefits and services under subdivision 6, paragraph (a), must not 
102.18 	exceed payments that otherwise would have been paid to health plans under medical 
102.19 	assistance for that county or region. Payments for HRSN benefits under subdivision 6, 
102.20 	paragraph (b), must be in addition to payments for benefits and services under subdivision 
102.21 	6, paragraph (a).
102.22 		Subd. 8.Quality measures. (a) The commissioner and counties and groups of counties 
102.23 	administering CARMA must collaborate to establish quality measures for CARMA not to 
102.24 	exceed the extent of quality measures required under sections 256B.69 and 256B.692. The 
102.25 	measures must include:
102.26 	(1) enrollee experience and outcomes;
102.27 	(2) population health;
102.28 	(3) health equity; and
102.29 	(4) the value of health care spending.
102.30 	(b) The commissioner and counties and groups of counties administering CARMA must 
102.31 	collaborate to define a quality improvement model for CARMA. The model must include 
102.32 	a focus on locally specified measures based on counties' unique needs. The locally specified 
103.1 	measures for the county or group of counties administering CARMA must be determined 
103.2 	before the commissioner enters into any contract with a county or group of counties.
103.3 		Subd. 9.Data and systems integration. The commissioner and counties and groups of 
103.4 	counties administering CARMA must collaborate to:
103.5 	(1) identify and address barriers that prevent counties and groups of counties 
103.6 	administering CARMA from reviewing individual enrollee eligibility information to identify 
103.7 	eligibility and to help enrollees apply for other appropriate programs and resources;
103.8 	(2) identify and address barriers preventing counties and groups of counties administering 
103.9 	CARMA from more readily communicating with and educating potential and current 
103.10 	enrollees regarding other program opportunities, including helping enrollees apply for those 
103.11 	programs and navigate transitions between programs;
103.12 	(3) develop and test, in counties participating in CARMA, a universal public assistance 
103.13 	application form to reduce the administrative barriers associated with applying for and 
103.14 	participating in various public programs;
103.15 	(4) identify and address regulatory and system barriers that may prohibit counties and 
103.16 	groups of counties administering CARMA, agencies, and other partners from working 
103.17 	together to identify and address an individual's needs;
103.18 	(5) facilitate greater interoperability between counties and groups of counties 
103.19 	administering CARMA, agencies, and other partners to send and receive the data necessary 
103.20 	to support CARMA, counties, and local health system efforts to improve the health and 
103.21 	welfare of prospective and enrolled populations;
103.22 	(6) support efforts of counties and groups of counties administering CARMA to 
103.23 	incorporate the necessary automation and interoperability to eliminate manual processes 
103.24 	when related to the data exchanged; and
103.25 	(7) support the creation and maintenance by counties and groups of counties administering 
103.26 	CARMA of an updated electronic inventory of community resources available to assist the 
103.27 	enrollee in the enrollee's HRSN, including an electronic closed-loop referral system.

103.28 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
103.29 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
103.30 	when federal approval is obtained.

104.1 	Sec. 20. IMPLEMENTATION OF HOSPITAL ASSESSMENT AND DIRECTED 
104.2 	PAYMENT PROGRAM.
 104.3 	(a) The commissioner of human services must immediately begin all necessary claims 
104.4 	analysis to calculate the assessment and payments required under Minnesota Statutes, section 
104.5 	256.9657, subdivision 2b, and the hospital directed payment program described in Minnesota 
104.6 	Statutes, section 256B.1974.
104.7 	(b) The commissioner of human services, in consultation with the Minnesota Hospital 
104.8 	Association, must submit to the Centers for Medicare and Medicaid Services a request for 
104.9 	federal approval to implement the hospital assessment described in Minnesota Statutes, 
104.10 	section 256.9657, subdivision 2b, and the hospital directed payment program under 
104.11 	Minnesota Statutes, section 256B.1974. At least 15 days before submitting the request for 
104.12 	approval, the commissioner must make available to the public the draft assessment 
104.13 	requirements, the draft directed payment details, and an estimate of each assessment amount 
104.14 	for each eligible hospital without an exemption from the assessment pursuant to Minnesota 
104.15 	Statutes, section 256.9657, subdivision 2b, paragraph (k).
104.16 	(c) During the design and prior to submission of the request for approval under paragraph 
104.17 	(b), the commissioner of human services must consult with the Minnesota Hospital 
104.18 	Association and any eligible hospitals without an exemption from the assessment pursuant 
104.19 	to Minnesota Statutes, section 256.9657, subdivision 2b, paragraph (k), and that are not 
104.20 	members of the Minnesota Hospital Association.
104.21 	(d) If federal approval is received for the request under paragraph (b), the commissioner 
104.22 	of human services must provide at least 15 days of public posting and review of the federally 
104.23 	approved terms and conditions for the assessment and the directed payment program prior 
104.24 	to any assessment under Minnesota Statutes, section 256.9657, subdivision 2b, becoming 
104.25 	due from an eligible hospital.

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

104.27 	Sec. 21. REQUEST FOR FEDERAL WAIVER.
 104.28 	The commissioner of human services must seek all federal waivers and authority 
104.29 	necessary to implement the county-assisted rural medical assistance (CARMA) program 
104.30 	under Minnesota Statutes, section 256B.695. Any part of the CARMA program that does 
104.31 	not require federal approval shall have an effective date as specified in state law. The 
104.32 	commissioner of human services shall notify the revisor of statutes when federal approval 
104.33 	is obtained.

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

105.2 	Sec. 22. COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE PROGRAM 
105.3 	IMPLEMENTATION COSTS.
 105.4 	Up to $500,000 of the nonfederal share of the costs to the Department of Human Services 
105.5 	for implementation of the requirements under the county-assisted rural medical assistance 
105.6 	(CARMA) program under Minnesota Statutes, section 256B.695, must be paid via an 
105.7 	intergovernmental funds transfer to the commissioner of human services by each county or 
105.8 	group of counties authorized under Minnesota Statutes, section 256B.692, seeking to 
105.9 	administer a CARMA program. The costs must be paid in a manner that is in compliance 
105.10 	with the requirements of Code of Federal Regulations, title 42, section 433.51. Within one 
105.11 	year of receiving payment under this section, the commissioner must provide a settle-up 
105.12 	process for any county or group of counties authorized under Minnesota Statutes, section 
105.13 	256B.692, administering a CARMA program and making payment under this section to 
105.14 	document and adjust payments owed to account for the commissioner's actual implementation 
105.15 	costs for Minnesota Statutes, section 256B.695.

105.16 	Sec. 23. MEDICAL ASSISTANCE COVERAGE OF TRADITIONAL HEALTH 
105.17 	CARE PRACTICES.
 105.18 		Subdivision 1.Waiver request. By October 1, 2025, the commissioner of human services, 
105.19 	in consultation with Tribes, Tribal organizations, and urban Indian organizations, shall apply 
105.20 	to the Centers for Medicare and Medicaid Services for a waiver to allow the state's medical 
105.21 	assistance program to provide coverage for traditional health care practices received through 
105.22 	Indian health service facilities, facilities operated by Tribes or Tribal organizations under 
105.23 	the Indian Self-Determination and Education Assistance Act, or facilities operated by urban 
105.24 	Indian organizations under Title V of the Indian Health Care Improvement Act.
105.25 		Subd. 2.Requirements. (a) A qualified provider must determine whether a medical 
105.26 	assistance enrollee is eligible to receive traditional health care practices under this section.
105.27 	(b) Traditional health care practices are covered under this section if they are received 
105.28 	from a qualified provider.
105.29 	(c) For purposes of this section, "qualified provider" means a practitioner or provider 
105.30 	who is employed by or under contract with the Indian Health Service, a 638 Tribal clinic, 
105.31 	or a Title V urban Indian organization. Each facility is responsible for ensuring that a 
105.32 	qualified provider has the necessary experience and appropriate training to provide traditional 
105.33 	health care practices.
106.1 		Subd. 3.Payments for traditional health care practices. Reimbursement for traditional 
106.2 	health care practices under this section is set at the outpatient, per-visit rate established by 
106.3 	the Indian Health Service under sections 321(a) and 322(b) of the Public Health Service 
106.4 	Act. Reimbursement is limited to one payment per day, per medical assistance enrollee 
106.5 	receiving traditional health care practices.

106.6 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
106.7 	whichever is later, except that subdivision 1 is effective the day following final enactment. 
106.8 	The commissioner of human services must notify the revisor of statutes when federal 
106.9 	approval is obtained.

106.10 	Sec. 24. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; ENHANCED 
106.11 	FEDERAL REIMBURSEMENT FOR FAMILY PLANNING SERVICES IN 
106.12 	MEDICAL ASSISTANCE.
 106.13 	The commissioner of human services must make the systems modification necessary to 
106.14 	claim enhanced federal reimbursement for all family planning services under the medical 
106.15 	assistance program.

106.16 	Sec. 25. DENTAL ACCESS WORKING GROUP.
 106.17 		Subdivision 1.Establishment. (a) The commissioner of human services must establish 
106.18 	a working group as part of the Dental Services Advisory Committee to identify and make 
106.19 	recommendations on the state's goals, priorities, and processes for contracting with a dental 
106.20 	administrator under Minnesota Statutes, section 256B.0371.
106.21 	(b) The working group must include members of the Dental Services Advisory 
106.22 	Committee, and at least one representative from each of the following:
106.23 	(1) critical access dental providers;
106.24 	(2) dental providers that primarily serve low-income and socioeconomically complex 
106.25 	populations;
106.26 	(3) dental providers that serve private-pay patients as well as medical assistance and 
106.27 	MinnesotaCare enrollees;
106.28 	(4) rural critical access dental providers that do not have clinics in the seven-county 
106.29 	metropolitan area as defined in Minnesota Statutes, section 473.121, subdivision 2; and
106.30 	(5) managed care plans.
107.1 		Subd. 2.Recommendations. (a) The working group must provide recommendations to 
107.2 	the commissioner on:
107.3 	(1) establishing and implementing a dental payment rate structure for medical assistance 
107.4 	and MinnesotaCare that:
107.5 	(i) is based on the most recent cost data available;
107.6 	(ii) promotes accountability while considering geographic differences in access to and 
107.7 	cost of dental services, critical access dental status, patient characteristics, transportation 
107.8 	needs, and medical and dental benefit coordination; and
107.9 	(iii) can be updated regularly;
107.10 	(2) performance benchmarks that focus on improving oral health for medical assistance 
107.11 	and MinnesotaCare enrollees, including consideration of Dental Quality Alliance and Oral 
107.12 	Health Impact Profile measures for broader assessment of a full range of services, and the 
107.13 	feasibility, cost, and value of providing the services;
107.14 	(3) methods for measuring progress toward the performance benchmarks and holding 
107.15 	the dental administrator accountable for progress, including providing rewards for progress;
107.16 	(4) establishing goals and processes to ensure coordination of care among medical 
107.17 	assistance and MinnesotaCare providers, including dental, medical, and other care providers, 
107.18 	particularly for patients with complex cases engaged in active treatment plans at the time 
107.19 	of transition to the dental administrator under Minnesota Statutes, section 256B.0371;
107.20 	(5) developing and implementing an infrastructure and workforce development strategy 
107.21 	that invests in the medical assistance and MinnesotaCare dental system through grants and 
107.22 	loans at a level that enables continued development of dental capacity commensurate with 
107.23 	that obtained through the managed care delivery system and from philanthropic sources; 
107.24 	and
107.25 	(6) developing and implementing a workforce development strategy to support the 
107.26 	pipeline of dental providers and oral health practitioners at all levels.
107.27 	(b) The working group must provide the recommendations required under this subdivision 
107.28 	to the commissioner by ........
107.29 		Subd. 3.Reporting requirements. (a) By ......., the commissioner, in consultation with 
107.30 	its contracted dental administrator, must develop an implementation plan and timeline to 
107.31 	effectuate the recommendations from the working group under this section.
108.1 	(b) By ......., the commissioner must submit a report with the working group 
108.2 	recommendations, implementation plan, timeline, and any draft legislation required to 
108.3 	implement the implementation plan to the chairs and ranking minority members of the 
108.4 	legislative committees with jurisdiction over health and human services policy and finance.

108.5 	Sec. 26. REPEALER.
 108.6 	(a) Laws 2023, chapter 70, article 16, section 22, is repealed.
108.7 	(b) Minnesota Statutes 2024, section 256B.0625, subdivisions 18b, 18e, and 18h, are 
108.8 	repealed.

108.9 	EFFECTIVE DATE. Paragraph (b) is effective July 1, 2026, for medical assistance 
108.10 	fee-for-service and January 1, 2027, for prepaid medical assistance.

108.11 	ARTICLE 6
108.12 	OFFICE OF EMERGENCY MEDICAL SERVICES

108.13 	Section 1. [144E.54] AMBULANCE OPERATING DEFICIT GRANT PROGRAM.
108.14 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
108.15 	subdivision have the meanings given.
108.16 	(b) "Capital expenses" means expenses incurred by a licensee for the purchase, 
108.17 	improvement, or maintenance of assets with an expected useful life of greater than five 
108.18 	years that improve the efficiency of provided ambulance services or the capabilities of the 
108.19 	licensee.
108.20 	(c) "Eligible applicant" or "eligible licensee" means any licensee who possessed a license 
108.21 	not excluded under subdivision 4 or 5 in the last completed state fiscal year for which data 
108.22 	was provided to the director, as provided in section 62J.49; who continues to operate that 
108.23 	same nonexcluded license at the time of application; and who provides verifiable evidence 
108.24 	of an operating deficit in the state fiscal year prior to submitting an application.
108.25 	(d) "Government licensee" means any government entity, as defined in section 118A.01, 
108.26 	subdivision 2, including a Tribe, that is a licensee.
108.27 	(e) "Insurance revenue" means revenue from Medicare, medical assistance, private health 
108.28 	insurance, third-party liability insurance, and payments from individuals.
108.29 	(f) "Operating deficit" means the sum of insurance revenue and other revenue is less 
108.30 	than the sum of operational expenses and capital expenses.
109.1 	(g) "Operational expenses" means costs related to the day-to-day operations of an 
109.2 	ambulance service, including but not limited to costs related to personnel, supplies and 
109.3 	equipment, fuel, vehicle maintenance, travel, education, and fundraising.
109.4 	(h) "Other revenue" means revenue from any revenue that is not insurance revenue, 
109.5 	including but not limited to grants, tax revenue, donations, fundraisers, or standby fees.
109.6 		Subd. 2.Program establishment. An ambulance operating deficit grant program is 
109.7 	established to award grants to applicants to address revenue shortfalls creating operating 
109.8 	deficits among eligible applicants.
109.9 		Subd. 3.Licensee providing specialized life support services excluded. Licensees 
109.10 	providing specialized life support services as described in section 144E.101, subdivision 9, 
109.11 	are not eligible for grants under this section.
109.12 		Subd. 4.Other licensees excluded. Licensees whose individual primary service areas 
109.13 	are located mostly within a metropolitan county listed in section 473.121, subdivision 4, or 
109.14 	within the cities of Duluth, Mankato, St. Cloud, or Rochester are not eligible for grants 
109.15 	under this section.
109.16 		Subd. 5.Application process. (a) An eligible licensee may apply to the director, in the 
109.17 	form and manner determined by the director, for a grant under this section.
109.18 	(b) A grant application made by a government licensee must be accompanied by a 
109.19 	resolution of support from the governing body.
109.20 		Subd. 6.Director calculations. The director shall award grants only to applicants who 
109.21 	provide verifiable evidence of an operating deficit in the last completed state fiscal year for 
109.22 	which data were provided to the director. The director may audit the financial data provided 
109.23 	to the director by applicants, as provided in section 62J.49. A grant awarded must not be 
109.24 	more than five percent more than any previous grant without special permission from the 
109.25 	director.
109.26 		Subd. 7.Grant awards; limitations. (a) Grants awarded under this section to eligible 
109.27 	applicants may be proportionally distributed based on money available. Total amounts 
109.28 	awarded must not exceed the amount in the ambulance operating deficit account.
109.29 	(b) The director shall award grants annually.
109.30 	(c) The director must not award individual grants that exceed the amount of the grantee's 
109.31 	most recent verified operating deficit as reported to the director.
110.1 		Subd. 8.Eligible expenditures. A grantee must spend grant money received under this 
110.2 	section on operational expenses and capital expenses incurred to provide ambulance services.
110.3 		Subd. 9.Report. By February 15, 2026, and annually thereafter, the director must submit 
110.4 	a report to the chairs and ranking minority members of the legislative committees with 
110.5 	jurisdiction over health finance and policy. The report must describe the number and amount 
110.6 	of grants awarded under this section and the uses made of grant money by grantees.

110.7 	Sec. 2. [144E.55] RURAL EMS UNCOMPENSATED CARE POOL PAYMENT 
110.8 	PROGRAM.
110.9 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
110.10 	the meanings given.
110.11 	(b) "Eligible licensee" means a licensee that primarily provides ambulance services 
110.12 	outside the metropolitan counties listed in section 473.121, subdivision 4.
110.13 	(c) "Public safety answering point" has the meaning given in section 403.02, subdivision 
110.14 	19.
110.15 		Subd. 2.Payment program established. The director must establish and administer a 
110.16 	rural EMS uncompensated care pool payment program. Under the program, the director 
110.17 	must make payments to eligible licensees according to this section.
110.18 		Subd. 3.Excluded responses. The director must exclude EMS responses by specialized 
110.19 	life support, as described in section 144E.101, subdivision 9, in calculating payments under 
110.20 	this section.
110.21 		Subd. 4.Application process. (a) An eligible licensee seeking a payment under this 
110.22 	section must apply to the director each year by March 31, in the form and manner determined 
110.23 	by the director. In the application, the eligible licensee must specify the number of the 
110.24 	eligible licensee's EMS responses that meet the criteria in subdivision 5.
110.25 	(b) When an eligible licensee, an eligible licensee's parent company, a subsidiary of an 
110.26 	eligible licensee, or a subsidiary of an eligible licensee's parent company collectively hold 
110.27 	multiple licenses, the director must treat all such related licensees as a single eligible licensee.
110.28 		Subd. 5.Eligible EMS responses. In order for an EMS response to be an eligible EMS 
110.29 	response for purposes of subdivision 6, the EMS response must meet the following criteria:
110.30 	(1) the EMS response was initiated by a request for emergency medical services initially 
110.31 	received by a public safety answering point;
110.32 	(2) an ambulance responded to the scene;
111.1 	(3) the ambulance was not canceled while en route to the scene;
111.2 	(4) the ambulance did not transport a person from the scene to a hospital emergency 
111.3 	department;
111.4 	(5) the eligible licensee did not receive any payment for the EMS response from any 
111.5 	source; and
111.6 	(6) the EMS response was initiated between January 1 and December 31 of the year 
111.7 	prior to the year the application is submitted.
111.8 		Subd. 6.Calculations. (a) The director must calculate payments as provided in paragraphs 
111.9 	(b) and (c) for an eligible licensee that completes an application under subdivision 4.
111.10 	(b) The director must award points for eligible EMS responses as follows:
111.11 	(1) for eligible EMS responses one to 25, an eligible licensee is awarded ten points per 
111.12 	response;
111.13 	(2) for eligible EMS responses 26 to 50, an eligible licensee is awarded five points per 
111.14 	response;
111.15 	(3) for eligible EMS responses 51 to 100, an eligible licensee is awarded three points 
111.16 	per response;
111.17 	(4) for eligible EMS responses 101 to 200, an eligible licensee is awarded one point per 
111.18 	response; and
111.19 	(5) for eligible EMS responses exceeding 200, an eligible licensee is awarded zero points.
111.20 	(c) The director must total the number of all points awarded to all applying eligible 
111.21 	licensees under paragraph (b). The director must divide the amount appropriated for purposes 
111.22 	of this section by the total number of points awarded to determine a per-point amount. The 
111.23 	payment for each eligible licensee shall be calculated by multiplying the eligible licensee's 
111.24 	number of awarded points by the established per-point amount.
111.25 		Subd. 7.Payment. The director must certify the payment amount for each eligible 
111.26 	licensee and must make the full payment to each eligible licensee by May 30 each year.

112.1 	ARTICLE 7
112.2 	ECONOMIC ASSISTANCE

112.3 	Section 1. Minnesota Statutes 2024, section 142A.03, is amended by adding a subdivision 
112.4 	to read:
112.5 		Subd. 35.Electronic benefits transfer; contracting and procurement. Notwithstanding 
112.6 	chapter 16C, the commissioner is exempt from the contract term limits for the issuance of 
112.7 	public benefits through an electronic benefit transfer system and related services. These 
112.8 	contracts may have up to an initial five-year term, with extensions not to exceed a ten-year 
112.9 	total contract duration.

112.10 	Sec. 2. Minnesota Statutes 2024, section 142F.14, is amended to read:
112.11 	142F.14  FOOD SHELF.
112.12 		Subdivision 1.Distribution of appropriation. The commissioner must distribute funds 
112.13 	appropriated to the commissioner by law for that purpose for purposes of this section to 
112.14 	Hunger Solutions The Food Group, a statewide association of food shelves organized as a 
112.15 	nonprofit corporation as defined under section 501(c)(3) of the Internal Revenue Code of 
112.16 	1986, to distribute to qualifying food shelves. A food shelf qualifies under this section if:
112.17 	(1) it is a nonprofit corporation, or is affiliated with a nonprofit corporation, as defined 
112.18 	in section 501(c)(3) of the Internal Revenue Code of 1986 or a federally recognized Tribal 
112.19 	nation;
112.20 	(2) it distributes standard food orders without charge to needy individuals. The standard 
112.21 	food order must consist of at least a two-day supply or six pounds per person of nutritionally 
112.22 	balanced food items;
112.23 	(3) it does not limit food distributions to individuals of a particular religious affiliation, 
112.24 	race, or other criteria unrelated to need or to requirements necessary to administration of a 
112.25 	fair and orderly distribution system;
112.26 	(4) it does not use the money received or the food distribution program to foster or 
112.27 	advance religious or political views; and
112.28 	(5) it has a stable address and directly serves individuals.
112.29 		Subd. 2.Application. In order to receive money appropriated under this section, Hunger 
112.30 	Solutions The Food Group must apply to the commissioner. The application must be in a 
112.31 	form prescribed by the commissioner and must indicate the proportion of money each 
113.1 	qualifying food shelf shall receive. Applications must be filed at the times and for the periods 
113.2 	determined by the commissioner.
113.3 		Subd. 3.Distribution formula. Hunger Solutions The Food Group must distribute 
113.4 	money distributed to it by the department to food shelf programs in proportion to the number 
113.5 	of individuals served by each food shelf program. The commissioner must gather data from 
113.6 	Hunger Solutions The Food Group or other appropriate sources to determine the proportionate 
113.7 	amount each qualifying food shelf program is entitled to receive. The commissioner may 
113.8 	increase or decrease the qualifying food shelf program's proportionate amount if the 
113.9 	commissioner determines the increase or decrease is necessary or appropriate to meet 
113.10 	changing needs or demands.
113.11 		Subd. 4.Use of money. At least 96 percent of the money distributed to Hunger Solutions
113.12 	The Food Group under this section must be distributed to food shelf programs to purchase, 
113.13 	transport, and coordinate the distribution of nutritious food to needy individuals and families. 
113.14 	The money distributed to food shelf programs may also be used to purchase personal hygiene 
113.15 	products, including but not limited to diapers and toilet paper. No more than four percent 
113.16 	of the money may be expended for other expenses, such as rent, salaries, and other 
113.17 	administrative expenses of Hunger Solutions The Food Group.
113.18 		Subd. 5.Enforcement. Hunger Solutions The Food Group must retain records 
113.19 	documenting expenditure of the money and comply with any additional requirements 
113.20 	imposed by the commissioner. The commissioner may require Hunger Solutions The Food 
113.21 	Group to report on its use of the funds. The commissioner may require that the report contain 
113.22 	an independent audit. If ineligible expenditures are made by Hunger Solutions The Food 
113.23 	Group, the ineligible amount must be repaid to the commissioner and deposited in the 
113.24 	general fund.
113.25 		Subd. 6.Administrative expenses. All funds appropriated under this section must be 
113.26 	distributed to Hunger Solutions The Food Group as provided under this section with 
113.27 	deduction by the commissioner for administrative expenses limited to 1.8 percent.
113.28 		Subd. 7.Data classification. Data collected on individuals from which the identity of 
113.29 	any individual receiving services may be determined are private data on individuals as 
113.30 	defined in section 13.02.

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

114.1 	ARTICLE 8
114.2 	CHILD PROTECTION AND WELFARE POLICY

114.3 	Section 1. Minnesota Statutes 2024, section 142B.01, subdivision 15, is amended to read:
114.4 		Subd. 15.Individual who is related. "Individual who is related" means a spouse, a 
114.5 	parent, a birth or adopted child or stepchild, a stepparent, a stepbrother, a stepsister, a niece, 
114.6 	a nephew, an adoptive parent, a grandparent, a sibling, an aunt, an uncle, or a legal guardian.
114.7 	For purposes of family child foster care, individual who is related also includes an individual 
114.8 	who, prior to the child's placement in the individual's home for foster care or adoption, was 
114.9 	an important friend of the child or of the child's parent or custodian, including an individual 
114.10 	with whom the child has resided or had significant contact or who has a significant 
114.11 	relationship to the child or the child's parent or custodian.

114.12 	Sec. 2. Minnesota Statutes 2024, section 142B.05, subdivision 3, is amended to read:
114.13 		Subd. 3.Foster care by an individual who is related to a child; license required. (a) 
114.14 	Notwithstanding subdivision 2, paragraph (a), clause (1), in order to provide foster care for 
114.15 	a child, an individual who is related to the child, other than a parent, or legal guardian, must 
114.16 	be licensed by the commissioner except as provided by section 142B.06.
114.17 	(b) An individual who is related to the child may seek foster care licensure through the 
114.18 	county agency or a private agency in the community licensed and authorized by the 
114.19 	commissioner. The placing agency must provide information to all potential relative foster 
114.20 	care providers about this choice. Counties are not obligated to pay costs for services provided 
114.21 	by private agencies.
114.22 	(c) If an individual who is related to a child is seeking licensure to provide foster care 
114.23 	for the child and the individual has a domestic partner but is not married to the domestic 
114.24 	partner, only the individual related to the child must be licensed to provide foster care. The 
114.25 	commissioner must conduct background studies on household members according to section 
114.26 	245C.03, subdivision 1.

114.27 	Sec. 3. Minnesota Statutes 2024, section 142B.47, is amended to read:
114.28 	142B.47 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT DEATH 
114.29 	AND ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE PROVIDERS.
114.30 	(a) Licensed child foster care providers, except individuals related to the child, that care 
114.31 	for infants or children through five years of age must document that before caregivers assist 
114.32 	in the care of infants or children through five years of age, they the caregivers are instructed 
115.1 	on the standards in section 142B.46 and receive training on reducing the risk of sudden 
115.2 	unexpected infant death and abusive head trauma from shaking infants and young children.
115.3 	Licensed child foster care providers who are related to the child and who only serve a relative 
115.4 	child must document completion of the training required under this section within 30 days 
115.5 	after licensure. This section does not apply to emergency relative placement under section 
115.6 	142B.06. The training on reducing the risk of sudden unexpected infant death and abusive 
115.7 	head trauma may be provided as:
115.8 	(1) orientation training to child foster care providers who care for infants or children 
115.9 	through five years of age under Minnesota Rules, part 2960.3070, subpart 1; or
115.10 	(2) in-service training to child foster care providers who care for infants or children 
115.11 	through five years of age under Minnesota Rules, part 2960.3070, subpart 2.
115.12 	(b) Training required under this section must be at least one hour in length and must be 
115.13 	completed at least once every five years. At a minimum, the training must address the risk 
115.14 	factors related to sudden unexpected infant death and abusive head trauma, means of reducing 
115.15 	the risk of sudden unexpected infant death and abusive head trauma, and license holder 
115.16 	communication with parents regarding reducing the risk of sudden unexpected infant death 
115.17 	and abusive head trauma.
115.18 	(c) Training for child foster care providers must be approved by the county or private 
115.19 	licensing agency that is responsible for monitoring the child foster care provider under 
115.20 	section 142B.30. The approved training fulfills, in part, training required under Minnesota 
115.21 	Rules, part 2960.3070.

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

115.23 	Sec. 4. Minnesota Statutes 2024, section 142B.51, subdivision 2, is amended to read:
115.24 		Subd. 2.Child passenger restraint systems; training requirement. (a) Programs 
115.25 	licensed by the Department of Human Services under chapter 245A or the Department of 
115.26 	Children, Youth, and Families under this chapter and Minnesota Rules, chapter 2960, that 
115.27 	serve a child or children under eight years of age must document training that fulfills the 
115.28 	requirements in this subdivision.
115.29 	(b) Before a license holder, staff person, or caregiver transports a child or children under 
115.30 	age eight in a motor vehicle, the person transporting the child must satisfactorily complete 
115.31 	training on the proper use and installation of child restraint systems in motor vehicles. 
115.32 	Training completed under this section may be used to meet initial or ongoing training under 
115.33 	Minnesota Rules, part 2960.3070, subparts 1 and 2.
116.1 	(c) Training required under this section must be completed at orientation or initial training 
116.2 	and repeated at least once every five years. At a minimum, the training must address the 
116.3 	proper use of child restraint systems based on the child's size, weight, and age, and the 
116.4 	proper installation of a car seat or booster seat in the motor vehicle used by the license 
116.5 	holder to transport the child or children.
116.6 	(d) Training under paragraph (c) must be provided by individuals who are certified and 
116.7 	approved by the Office of Traffic Safety within the Department of Public Safety. License 
116.8 	holders may obtain a list of certified and approved trainers through the Department of Public 
116.9 	Safety website or by contacting the agency.
116.10 	(e) Notwithstanding paragraph (a), for an emergency relative placement under section 
116.11 	142B.06, the commissioner may grant a variance to the training required by this subdivision 
116.12 	for a relative who completes a child seat safety check up. The child seat safety check up 
116.13 	trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and 
116.14 	must provide one-on-one instruction on placing a child of a specific age in the exact child 
116.15 	passenger restraint in the motor vehicle in which the child will be transported. Once granted 
116.16 	a variance, and if all other licensing requirements are met, the relative applicant may receive 
116.17 	a license and may transport a relative foster child younger than eight years of age. A child 
116.18 	seat safety check up must be completed each time a child requires a different size car seat 
116.19 	according to car seat and vehicle manufacturer guidelines. A relative license holder must 
116.20 	complete training that meets the other requirements of this subdivision prior to placement 
116.21 	of another foster child younger than eight years of age in the home or prior to the renewal 
116.22 	of the child foster care license.
116.23 	(f) Notwithstanding paragraph (b), a child foster care license holder who is an individual 
116.24 	related to the child and who only serves a relative child must document completion of the 
116.25 	training required under this section within 30 days after licensure.

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

116.27 	Sec. 5. Minnesota Statutes 2024, section 142B.80, is amended to read:
116.28 	142B.80 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL 
116.29 	HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
116.30 	Prior to a nonemergency placement of a child in a foster care home, the child foster care 
116.31 	license holder and caregivers in foster family and treatment foster care settings must complete 
116.32 	two hours of training that addresses the causes, symptoms, and key warning signs of mental 
116.33 	health disorders; cultural considerations; and effective approaches for dealing with a child's 
117.1 	behaviors. At least one hour of the annual training requirement for the foster family license 
117.2 	holder and caregivers must be on children's mental health issues and treatment. Except for 
117.3 	providers and services under chapter 245D and child foster care license holders who are 
117.4 	individuals related to the child and who only serve a relative child who does not have fetal 
117.5 	alcohol spectrum disorder, the annual training must also include at least one hour of training 
117.6 	on fetal alcohol spectrum disorders, which must be counted toward the 12 hours of required 
117.7 	in-service training per year. Short-term substitute caregivers are exempt from these 
117.8 	requirements. Training curriculum shall be approved by the commissioner of children, 
117.9 	youth, and families.

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

117.11 	Sec. 6. [142B.81] CHILD FOSTER CARE TRAINING; RELATIVE CAREGIVERS.
117.12 	Notwithstanding the required hours under Minnesota Rules, part 2960.3070, subpart 2, 
117.13 	a child foster care license holder who is an individual related to the child must complete a 
117.14 	minimum of six hours of in-service training per year in one or more of the areas in Minnesota 
117.15 	Rules, part 2960.3070, subpart 2, or in other areas as agreed upon by the licensing agency 
117.16 	and the foster parent. The relative child foster care license holder must consult with the 
117.17 	licensing agency and complete training in areas that are most applicable to caring for the 
117.18 	relative children in foster care in the home. This section does not apply to a child foster care 
117.19 	license holder who is licensed to care for both a relative child and a nonrelative child.

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

117.21 	Sec. 7. Minnesota Statutes 2024, section 245C.02, is amended by adding a subdivision to 
117.22 	read:
117.23 		Subd. 16b.Relative. "Relative" has the meaning given in section 260C.007, subdivision 
117.24 	27. For purposes of background studies affiliated with child foster care licensure, a person 
117.25 	is a relative if the person was known to the child or the child's parent before the child is 
117.26 	placed in foster care.

117.27 	Sec. 8. Minnesota Statutes 2024, section 260.65, is amended to read:
117.28 	260.65 NONCUSTODIAL PARENTS; RELATIVE PLACEMENT.
117.29 	(a) Prior to the removal of an African American or a disproportionately represented child 
117.30 	from the child's home, the responsible social services agency must make active efforts to 
117.31 	identify and locate the child's noncustodial or nonadjudicated parent and the child's relatives 
117.32 	to notify the child's parent and relatives that the child is or will be placed in foster care, and 
118.1 	provide the child's parent and relatives with a list of legal resources. The notice to the child's 
118.2 	noncustodial or nonadjudicated parent and relatives must also include the information 
118.3 	required under section 260C.221, subdivision 2, paragraph (b). The responsible social 
118.4 	services agency must maintain detailed records of the agency's efforts to notify parents and 
118.5 	relatives under this section.
118.6 	(b) Notwithstanding the provisions of section 260C.219, the responsible social services 
118.7 	agency must assess an African American or a disproportionately represented child's 
118.8 	noncustodial or nonadjudicated parent's ability to care for the child before placing the child 
118.9 	in foster care. If a child's noncustodial or nonadjudicated parent is willing and able to provide 
118.10 	daily care for the African American or disproportionately represented child temporarily or 
118.11 	permanently, the court shall order that the child be placed in into the home of the noncustodial 
118.12 	or nonadjudicated parent pursuant to section 260C.178 or 260C.201, subdivision 1. The 
118.13 	responsible social services agency must make active efforts to assist a noncustodial or 
118.14 	nonadjudicated parent with remedying any issues that may prevent the child from being 
118.15 	placed with the ordered into the home of a noncustodial or nonadjudicated parent.
118.16 	(c) The relative search, notice, engagement, and placement consideration requirements 
118.17 	under section 260C.221 apply under this act.

118.18 	Sec. 9. Minnesota Statutes 2024, section 260.66, subdivision 1, is amended to read:
118.19 		Subdivision 1.Emergency removal or placement permitted. Nothing in this section 
118.20 	shall be construed to prevent the emergency removal of an African American or a 
118.21 	disproportionately represented child's parent or custodian child or the emergency placement 
118.22 	of the child in a foster setting in order to prevent imminent physical damage or harm to the 
118.23 	child.

118.24 	Sec. 10. Minnesota Statutes 2024, section 260.691, subdivision 1, is amended to read:
118.25 		Subdivision 1.Establishment and duties. (a) The African American Child and Family 
118.26 	Well-Being Advisory Council is established for the Department of Children, Youth, and 
118.27 	Families.
118.28 	(b) The council shall consist of 31 members appointed by the commissioner and must 
118.29 	include representatives with lived personal or professional experience within African 
118.30 	American communities. Members may include but are not limited to youth who have exited 
118.31 	the child welfare system; parents; legal custodians; relative and kinship caregivers or foster 
118.32 	care providers; community service providers, advocates, and members; county and private 
118.33 	social services agency case managers; representatives from faith-based institutions; academic 
119.1 	professionals; a representative from the Council for Minnesotans of African Heritage; the 
119.2 	Ombudsperson for African American Families; and other individuals with experience and 
119.3 	knowledge of African American communities. Council members must be selected through 
119.4 	an open appointments process under section 15.0597. The terms, compensation, and removal 
119.5 	of council members are governed by section 15.059.
119.6 	(c) The African American Child Well-Being Advisory council must:
119.7 	(1) review annual reports related to African American children involved in the child 
119.8 	welfare system. These reports may include but are not limited to the maltreatment, 
119.9 	out-of-home placement, and permanency of African American children;
119.10 	(2) assist with and make recommendations to the commissioner for developing strategies 
119.11 	to reduce maltreatment determinations, prevent unnecessary out-of-home placement, promote 
119.12 	culturally appropriate foster care and shelter or facility placement decisions and settings for 
119.13 	African American children in need of out-of-home placement, ensure timely achievement 
119.14 	of permanency, and improve child welfare outcomes for African American children and 
119.15 	their families;
119.16 	(3) review summary reports on targeted case reviews prepared by the commissioner to 
119.17 	ensure that responsible social services agencies meet the needs of African American children 
119.18 	and their families. Based on data collected from those reviews, the council shall assist the 
119.19 	commissioner with developing strategies needed to improve any identified child welfare 
119.20 	outcomes, including but not limited to maltreatment, out-of-home placement, and permanency 
119.21 	for African American children;
119.22 	(4) assist the Cultural and Ethnic Communities Leadership Council with making make
119.23 	recommendations to the commissioner and the legislature for public policy and statutory 
119.24 	changes that specifically consider the needs of African American children and their families 
119.25 	involved in the child welfare system;
119.26 	(5) advise the commissioner on stakeholder engagement strategies and actions that the 
119.27 	commissioner and responsible social services agencies may take to improve child welfare 
119.28 	outcomes for African American children and their families;
119.29 	(6) assist the commissioner with developing strategies for public messaging and 
119.30 	communication related to racial disproportionality and disparities in child welfare outcomes 
119.31 	for African American children and their families;
119.32 	(7) assist the commissioner with identifying and developing internal and external 
119.33 	partnerships to support adequate access to services and resources for African American 
120.1 	children and their families, including but not limited to housing assistance, employment 
120.2 	assistance, food and nutrition support, health care, child care assistance, and educational 
120.3 	support and training; and
120.4 	(8) assist the commissioner with developing strategies to promote the development of 
120.5 	a culturally diverse and representative child welfare workforce in Minnesota that includes 
120.6 	professionals who are reflective of the community served and who have been directly 
120.7 	impacted by lived experiences within the child welfare system. The council must also assist 
120.8 	the commissioner with exploring strategies and partnerships to address education and training 
120.9 	needs, hiring, recruitment, retention, and professional advancement practices.

120.10 	Sec. 11. Minnesota Statutes 2024, section 260.692, is amended to read:
120.11 	260.692 AFRICAN AMERICAN CHILD AND FAMILY WELL-BEING UNIT.
120.12 		Subdivision 1.Duties. The African American Child and Family Well-Being Unit, 
120.13 	currently established by the commissioner, must:
120.14 	(1) assist with the development of African American cultural competency training and 
120.15 	review child welfare curriculum in the Minnesota Child Welfare Training Academy to 
120.16 	ensure that responsible social services agency staff and other child welfare professionals 
120.17 	are appropriately prepared to engage with African American children and their families and 
120.18 	to support family preservation and reunification;
120.19 	(2) provide technical assistance, including on-site technical assistance, and case 
120.20 	consultation to responsible social services agencies to assist agencies with implementing 
120.21 	and complying with the Minnesota African American Family Preservation and Child Welfare 
120.22 	Disproportionality Act;
120.23 	(3) monitor individual county and statewide disaggregated and nondisaggregated data 
120.24 	to identify trends and patterns in child welfare outcomes, including but not limited to 
120.25 	reporting, maltreatment, out-of-home placement, and permanency of African American 
120.26 	children and develop strategies to address disproportionality and disparities in the child 
120.27 	welfare system;
120.28 	(4) develop and implement a system for conducting case reviews when the commissioner 
120.29 	receives reports of noncompliance with the Minnesota African American Family Preservation 
120.30 	and Child Welfare Disproportionality Act or when requested by the parent or custodian of 
120.31 	an African American child. Case reviews may include but are not limited to a review of 
120.32 	placement prevention efforts, safety planning, case planning and service provision by the 
121.1 	responsible social services agency, relative placement consideration, and permanency 
121.2 	planning;
121.3 	(5) establish and administer a request for proposals process for African American and 
121.4 	disproportionately represented family preservation grants under section 260.693, monitor 
121.5 	grant activities, and provide technical assistance to grantees;
121.6 	(6) in coordination with the African American Child and Family Well-Being Advisory 
121.7 	Council, coordinate services and create internal and external partnerships to support adequate 
121.8 	access to services and resources for African American children and their families, including 
121.9 	but not limited to housing assistance, employment assistance, food and nutrition support, 
121.10 	health care, child care assistance, and educational support and training; and
121.11 	(7) develop public messaging and communication to inform the public about racial 
121.12 	disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities, 
121.13 	and resources available to African American children and their families involved in the 
121.14 	child welfare system.
121.15 		Subd. 2.Case reviews. (a) The African American Child and Family Well-Being Unit 
121.16 	must conduct systemic case reviews to monitor targeted child welfare outcomes, including 
121.17 	but not limited to maltreatment, out-of-home placement, and permanency of African 
121.18 	American children.
121.19 	(b) The reviews under this subdivision must be conducted using a random sampling of 
121.20 	representative child welfare cases stratified for certain case related factors, including but 
121.21 	not limited to case type, maltreatment type, if the case involves out-of-home placement, 
121.22 	and other demographic variables. In conducting the reviews, unit staff may use court records 
121.23 	and documents, information from the social services information system, and other available 
121.24 	case file information to complete the case reviews.
121.25 	(c) The frequency of the reviews and the number of cases, child welfare outcomes, and 
121.26 	selected counties reviewed shall be determined by the unit in consultation with the African 
121.27 	American Child and Family Well-Being Advisory Council, with consideration given to the 
121.28 	availability of unit resources needed to conduct the reviews.
121.29 	(d) The unit must monitor all case reviews and use the collective case review information 
121.30 	and data to generate summary case review reports, ensure compliance with the Minnesota 
121.31 	African American Family Preservation and Child Welfare Disproportionality Act, and 
121.32 	identify trends or patterns in child welfare outcomes for African American children.
122.1 	(e) The unit must review information from members of the public received through the 
122.2 	compliance and feedback portal, including policy and practice concerns related to individual 
122.3 	child welfare cases. After assessing a case concern, the unit may determine if further 
122.4 	necessary action should be taken, which may include coordinating case remediation with 
122.5 	other relevant child welfare agencies in accordance with data privacy laws, including the 
122.6 	African American Child and Family Well-Being Advisory Council, and offering case 
122.7 	consultation and technical assistance to the responsible local social services agency as 
122.8 	needed or requested by the agency.
122.9 		Subd. 3.Reports. (a) The African American Child and Family Well-Being Unit must 
122.10 	provide regular updates on unit activities, including summary reports of case reviews, to 
122.11 	the African American Child and Family Well-Being Advisory Council, and must publish 
122.12 	an annual census of African American children in out-of-home placements statewide. The 
122.13 	annual census must include data on the types of placements, age and sex of the children, 
122.14 	how long the children have been in out-of-home placements, and other relevant demographic 
122.15 	information.
122.16 	(b) The African American Child and Family Well-Being Unit shall gather summary data 
122.17 	about the practice and policy inquiries and individual case concerns received through the 
122.18 	compliance and feedback portal under subdivision 2, paragraph (e). The unit shall provide 
122.19 	regular reports of the nonidentifying compliance and feedback portal summary data to the 
122.20 	African American Child and Family Well-Being Advisory Council to identify child welfare 
122.21 	trends and patterns to assist with developing policy and practice recommendations to support 
122.22 	eliminating disparity and disproportionality for African American children.

122.23 	Sec. 12. Minnesota Statutes 2024, section 260C.001, subdivision 2, is amended to read:
122.24 		Subd. 2.Juvenile protection proceedings. (a) The paramount consideration in all 
122.25 	juvenile protection proceedings is the health, safety, and best interests of the child. In 
122.26 	proceedings involving an American Indian child, as defined in section 260.755, subdivision 
122.27 	8, the best interests of the child must be determined consistent with sections 260.751 to 
122.28 	260.835 and the Indian Child Welfare Act, United States Code, title 25, sections 1901 to 
122.29 	1923.
122.30 	(b) The purpose of the laws relating to juvenile protection proceedings is:
122.31 	(1) to secure for each child under the jurisdiction of the court, the care and guidance, 
122.32 	preferably in the child's own home, as will best serve the spiritual, emotional, mental, and 
122.33 	physical welfare of the child;
123.1 	(2) to provide judicial procedures that protect the welfare of the child;
123.2 	(3) to preserve and strengthen the child's family ties whenever possible and in the child's 
123.3 	best interests, removing the child from the custody of parents only when the child's welfare 
123.4 	or safety cannot be adequately safeguarded without removal;
123.5 	(4) to ensure that when removal from the child's own family is necessary and in the 
123.6 	child's best interests, the responsible social services agency has legal responsibility for the 
123.7 	child removal either:
123.8 	(i) pursuant to a voluntary placement agreement between the child's parent or guardian 
123.9 	or the child, when the child is over age 18, and the responsible social services agency; or
123.10 	(ii) by court order pursuant to section 260C.151, subdivision 6; 260C.178; 260C.201; 
123.11 	260C.325; or 260C.515;
123.12 	(5) to ensure that, when placement is pursuant to court order, the court order removing 
123.13 	the child or continuing the child in foster care contains an individualized determination that 
123.14 	placement is in the best interests of the child that coincides with the actual removal of the 
123.15 	child;
123.16 	(6) to ensure that when the child is removed, the child's care and discipline is, as nearly 
123.17 	as possible, equivalent to that which should have been given by the parents and is either in:
123.18 	(i) the home of a noncustodial parent pursuant to section 260C.178 or 260C.201, 
123.19 	subdivision 1, paragraph (a), clause (1);
123.20 	(ii) the home of a relative pursuant to emergency placement by the responsible social 
123.21 	services agency under chapter 245A; or
123.22 	(iii) foster care licensed under chapter 245A; and
123.23 	(7) to ensure appropriate permanency planning for children in foster care including:
123.24 	(i) unless reunification is not required under section 260.012, developing a permanency 
123.25 	plan for the child that includes a primary plan for reunification with the child's parent or 
123.26 	guardian and a secondary plan for an alternative, legally permanent home for the child in 
123.27 	the event reunification cannot be achieved in a timely manner;
123.28 	(ii) identifying, locating, and assessing both parents of the child as soon as possible and 
123.29 	offering reunification services to both parents of the child as required under sections 260.012
123.30 	and 260C.219;
124.1 	(iii) inquiring about the child's heritage, including the child's Tribal lineage pursuant to 
124.2 	section 260.761, and their race, culture, and ethnicity pursuant to section 260.63, subdivision 
124.3 	10;
124.4 	(iii) (iv) identifying, locating, and notifying relatives of both parents of the child according 
124.5 	to section 260C.221;
124.6 	(iv) (v) making a placement with a family that will commit to being the legally permanent 
124.7 	home for the child in the event reunification cannot occur at the earliest possible time while 
124.8 	at the same time actively supporting the reunification plan; and
124.9 	(v) (vi) returning the child home with supports and services, as soon as return is safe for 
124.10 	the child, or when safe return cannot be timely achieved, moving to finalize another legally 
124.11 	permanent home for the child.

124.12 	Sec. 13. Minnesota Statutes 2024, section 260C.007, subdivision 19, is amended to read:
124.13 		Subd. 19.Habitual truant. "Habitual truant" means a child under the age of 17 who is 
124.14 	at least 12 years old and less than 18 years old who is absent from attendance at school 
124.15 	without lawful excuse for seven school days per school year if the child is in elementary 
124.16 	school or for one or more class periods on seven school days per school year if the child is 
124.17 	in middle school, junior high school, or high school or a child who is 17 years of age who 
124.18 	is absent from attendance at school without lawful excuse for one or more class periods on 
124.19 	seven school days per school year and who has not lawfully withdrawn from school under 
124.20 	section 120A.22, subdivision 8. Pursuant to section 260C.163, subdivision 11, habitual 
124.21 	truant also means a child under age 12 who has been absent from school for seven school 
124.22 	days without lawful excuse, based on a showing by clear and convincing evidence that the 
124.23 	child's absence is not due to the failure of the child's parent, guardian, or custodian to comply 
124.24 	with compulsory instruction laws.

124.25 	Sec. 14. Minnesota Statutes 2024, section 260C.141, subdivision 1, is amended to read:
124.26 		Subdivision 1.Who may file; required form. (a) Any reputable person, including but 
124.27 	not limited to any agent of the commissioner of children, youth, and families, having 
124.28 	knowledge of a child in this state or of a child who is a resident of this state, who appears 
124.29 	to be in need of protection or services or neglected and in foster care, may petition the 
124.30 	juvenile court in the manner provided in this section.
124.31 	(b) A petition for a child in need of protection filed by an individual who is not a county 
124.32 	attorney or an agent of the commissioner of children, youth, and families shall be filed on 
125.1 	a form developed by the state court administrator and provided to court administrators. 
125.2 	Copies of the form may be obtained from the court administrator in each county. The court 
125.3 	administrator shall review the petition before it is filed to determine that it is completed. 
125.4 	The court administrator may reject the petition if it does not indicate that the petitioner has 
125.5 	contacted the responsible social services agency.
125.6 	An individual may file a petition under this subdivision without seeking internal review 
125.7 	of the responsible social services agency's decision. The court shall determine whether there 
125.8 	is probable cause to believe that a need for protection or services exists before the matter 
125.9 	is set for hearing. If the matter is set for hearing, the court administrator shall notify the 
125.10 	responsible social services agency by sending notice to the county attorney.
125.11 	The petition must contain:
125.12 	(1) a statement of facts that would establish, if proven, that there is a need for protection 
125.13 	or services for the child named in the petition;
125.14 	(2) a statement that petitioner has reported the circumstances underlying the petition to 
125.15 	the responsible social services agency, and protection or services were not provided to the 
125.16 	child;
125.17 	(3) a statement whether there are existing juvenile or family court custody orders or 
125.18 	pending proceedings in juvenile or family court concerning the child; and
125.19 	(4) a statement of the relationship of the petitioner to the child and any other parties.; 
125.20 	and
125.21 	(5) a statement whether the petitioner has inquired of the parent or parents of the child, 
125.22 	the child, and relatives about the child's heritage, including the child's Tribal lineage pursuant 
125.23 	to section 260.761 and their race, culture, and ethnicity pursuant to section 260.63, 
125.24 	subdivision 10.
125.25 	The court may not allow a petition to proceed under this paragraph if it appears that the 
125.26 	sole purpose of the petition is to modify custody between the parents.

125.27 	Sec. 15. Minnesota Statutes 2024, section 260C.150, subdivision 3, is amended to read:
125.28 		Subd. 3.Identifying parents of child; diligent efforts; data. (a) The responsible social 
125.29 	services agency shall make diligent efforts to inquire about the child's heritage, including 
125.30 	the child's Tribal lineage pursuant to section 260.761 and their race, culture, and ethnicity 
125.31 	pursuant to section 260.63, subdivision 10, and to identify and locate both parents of any 
125.32 	child who is the subject of proceedings under this chapter. Diligent efforts include:
126.1 	(1) asking the custodial or known parent to identify any nonresident parent of the child 
126.2 	and provide information that can be used to verify the nonresident parent's identity including 
126.3 	the dates and locations of marriages and divorces; dates and locations of any legal 
126.4 	proceedings regarding paternity; date and place of the child's birth; nonresident parent's full 
126.5 	legal name; nonresident parent's date of birth, or if the nonresident parent's date of birth is 
126.6 	unknown, an approximate age; the nonresident parent's Social Security number; the 
126.7 	nonresident parent's whereabouts including last known whereabouts; and the whereabouts 
126.8 	of relatives of the nonresident parent. For purposes of this subdivision, "nonresident parent" 
126.9 	means a parent who does not reside in the same household as the child or did not reside in 
126.10 	the same household as the child at the time the child was removed when the child is in foster 
126.11 	care;
126.12 	(2) obtaining information that will identify and locate the nonresident parent from the 
126.13 	county and state of Minnesota child support enforcement information system;
126.14 	(3) requesting a search of the Minnesota Fathers' Adoption Registry 30 days after the 
126.15 	child's birth; and
126.16 	(4) using any other reasonable means to identify and locate the nonresident parent.
126.17 	(b) The agency may disclose data which is otherwise private under section 13.46 or 
126.18 	chapter 260E in order to carry out its duties under this subdivision.
126.19 	(c) Upon the filing of a petition alleging the child to be in need of protection or services, 
126.20 	the responsible social services agency may contact a putative father who registered with 
126.21 	the Minnesota Fathers' Adoption Registry more than 30 days after the child's birth. The 
126.22 	social service agency may consider a putative father for the day-to-day care of the child 
126.23 	under section 260C.219 if the putative father cooperates with genetic testing and there is a 
126.24 	positive test result under section 257.62, subdivision 5. Nothing in this paragraph:
126.25 	(1) relieves a putative father who registered with the Minnesota Fathers' Adoption 
126.26 	Registry more than 30 days after the child's birth of the duty to cooperate with paternity 
126.27 	establishment proceedings under section 260C.219;
126.28 	(2) gives a putative father who registered with the Minnesota Fathers' Adoption Registry 
126.29 	more than 30 days after the child's birth the right to notice under section 260C.151 unless 
126.30 	the putative father is entitled to notice under sections 259.24 and 259.49, subdivision 1, 
126.31 	paragraph (a) or (b), clauses (1) to (7); or
126.32 	(3) establishes a right to assert an interest in the child in a termination of parental rights 
126.33 	proceeding contrary to section 259.52, subdivision 6, unless the putative father is entitled 
127.1 	to notice under sections 259.24 and 259.49, subdivision 1, paragraph (a) or (b), clauses (1) 
127.2 	to (7).

127.3 	Sec. 16. Minnesota Statutes 2024, section 260C.178, subdivision 1, is amended to read:
127.4 		Subdivision 1.Hearing and release requirements. (a) If a child was taken into custody 
127.5 	under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a 
127.6 	hearing within 72 hours of the time that the child was taken into custody, excluding 
127.7 	Saturdays, Sundays, and holidays, to determine whether the child should continue to be in 
127.8 	custody.
127.9 	(b) Unless there is reason to believe that the child would endanger self or others or not 
127.10 	return for a court hearing, or that the child's health or welfare would be immediately 
127.11 	endangered, the child shall be released to the custody of a parent, guardian, custodian, or 
127.12 	other suitable person, subject to reasonable conditions of release including, but not limited 
127.13 	to, a requirement that the child undergo a chemical use assessment as provided in section 
127.14 	260C.157, subdivision 1.
127.15 	(c) If the court determines that there is reason to believe that the child would endanger 
127.16 	self or others or not return for a court hearing, or that the child's health or welfare would be 
127.17 	immediately endangered if returned to the care of the parent or guardian who has custody 
127.18 	and from whom the child was removed, the court shall order the child:
127.19 	(1) into the care of the child's noncustodial parent and order the noncustodial parent to 
127.20 	comply with any conditions that the court determines appropriate to ensure the safety and 
127.21 	care of the child, including requiring the noncustodial parent to cooperate with paternity 
127.22 	establishment proceedings if the noncustodial parent has not been adjudicated the child's 
127.23 	father; or
127.24 	(2) into foster care as defined in section 260C.007, subdivision 18, under the legal 
127.25 	responsibility of the responsible social services agency or responsible probation or corrections 
127.26 	agency for the purposes of protective care as that term is used in the juvenile court rules. 
127.27 	The court shall not give the responsible social services legal custody and order a trial home 
127.28 	visit at any time prior to adjudication and disposition under section 260C.201, subdivision 
127.29 	1, paragraph (a), clause (3), but may order the child returned to the care of the parent or 
127.30 	guardian who has custody and from whom the child was removed and order the parent or 
127.31 	guardian to comply with any conditions the court determines to be appropriate to meet the 
127.32 	safety, health, and welfare of the child.
128.1 	(d) In determining whether the child's health or welfare would be immediately 
128.2 	endangered, the court shall consider whether the child would reside with a perpetrator of 
128.3 	domestic child abuse.
128.4 	(e) The court, before determining whether a child should be placed in or continue in 
128.5 	foster care under the protective care of the responsible agency, shall also make a 
128.6 	determination, consistent with section 260.012 as to whether reasonable efforts were made 
128.7 	to prevent placement or whether reasonable efforts to prevent placement are not required. 
128.8 	In the case of an Indian child, the court shall determine whether active efforts, according 
128.9 	to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25, 
128.10 	section 1912(d), were made to prevent placement. The court shall enter a finding that the 
128.11 	responsible social services agency has made reasonable efforts to prevent placement when 
128.12 	the agency establishes either:
128.13 	(1) that the agency has actually provided services or made efforts in an attempt to prevent 
128.14 	the child's removal but that such services or efforts have not proven sufficient to permit the 
128.15 	child to safely remain in the home; or
128.16 	(2) that there are no services or other efforts that could be made at the time of the hearing 
128.17 	that could safely permit the child to remain home or to return home. The court shall not 
128.18 	make a reasonable efforts determination under this clause unless the court is satisfied that 
128.19 	the agency has sufficiently demonstrated to the court that there were no services or other 
128.20 	efforts that the agency was able to provide at the time of the hearing enabling the child to 
128.21 	safely remain home or to safely return home. When reasonable efforts to prevent placement 
128.22 	are required and there are services or other efforts that could be ordered that would permit 
128.23 	the child to safely return home, the court shall order the child returned to the care of the 
128.24 	parent or guardian and the services or efforts put in place to ensure the child's safety. When 
128.25 	the court makes a prima facie determination that one of the circumstances under paragraph 
128.26 	(g) exists, the court shall determine that reasonable efforts to prevent placement and to 
128.27 	return the child to the care of the parent or guardian are not required.
128.28 	(f) If the court finds the social services agency's preventive or reunification efforts have 
128.29 	not been reasonable but further preventive or reunification efforts could not permit the child 
128.30 	to safely remain at home, the court may nevertheless authorize or continue the removal of 
128.31 	the child.
128.32 	(g) The court may not order or continue the foster care placement of the child unless the 
128.33 	court makes explicit, individualized findings that continued custody of the child by the 
129.1 	parent or guardian would be contrary to the welfare of the child and that placement is in the 
129.2 	best interest of the child.
129.3 	(h) At the emergency removal hearing, or at any time during the course of the proceeding, 
129.4 	and upon notice and request of the county attorney, the court shall determine whether a 
129.5 	petition has been filed stating a prima facie case that:
129.6 	(1) the parent has subjected a child to egregious harm as defined in section 260C.007, 
129.7 	subdivision 14;
129.8 	(2) the parental rights of the parent to another child have been involuntarily terminated;
129.9 	(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph 
129.10 	(a), clause (2);
129.11 	(4) the parents' custodial rights to another child have been involuntarily transferred to a 
129.12 	relative under a juvenile protection proceeding or a similar process of another jurisdiction;
129.13 	(5) the parent has committed sexual abuse as defined in section 260E.03, against the 
129.14 	child or another child of the parent;
129.15 	(6) the parent has committed an offense that requires registration as a predatory offender 
129.16 	under section 243.166, subdivision 1b, paragraph (a) or (b); or
129.17 	(7) the provision of services or further services for the purpose of reunification is futile 
129.18 	and therefore unreasonable.
129.19 	(i) When a petition to terminate parental rights is required under section 260C.301, 
129.20 	subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to 
129.21 	proceed with a termination of parental rights petition, and has instead filed a petition to 
129.22 	transfer permanent legal and physical custody to a relative under section 260C.507, the 
129.23 	court shall schedule a permanency hearing within 30 days of the filing of the petition.
129.24 	(j) If the county attorney has filed a petition under section 260C.307, the court shall 
129.25 	schedule a trial under section 260C.163 within 90 days of the filing of the petition except 
129.26 	when the county attorney determines that the criminal case shall proceed to trial first under 
129.27 	section 260C.503, subdivision 2, paragraph (c).
129.28 	(k) If the court determines the child should be ordered into foster care and, the court 
129.29 	shall inquire about the child's heritage, including the child's Tribal lineage pursuant to section 
129.30 	260.761; their race, culture, and ethnicity pursuant to section 260.63, subdivision 10; and 
129.31 	the responsible social services agency's initial relative search efforts. If the child's parent 
129.32 	refuses to give information to the responsible social services agency regarding the child's 
130.1 	father or relatives of the child, the court may order the parent to disclose the names, addresses, 
130.2 	telephone numbers, and other identifying information to the responsible social services 
130.3 	agency for the purpose of complying with sections 260C.150, 260C.151, 260C.212, 
130.4 	260C.215, 260C.219, and 260C.221.
130.5 	(l) If a child ordered into foster care has siblings, whether full, half, or step, who are 
130.6 	also ordered into foster care, the court shall inquire of the responsible social services agency 
130.7 	of the efforts to place the children together as required by section 260C.212, subdivision 2, 
130.8 	paragraph (d), if placement together is in each child's best interests, unless a child is in 
130.9 	placement for treatment or a child is placed with a previously noncustodial parent who is 
130.10 	not a parent to all siblings. If the children are not placed together at the time of the hearing, 
130.11 	the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place 
130.12 	the siblings together, as required under section 260.012. If any sibling is not placed with 
130.13 	another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing 
130.14 	contact among the siblings as required under section 260C.212, subdivision 1, unless it is 
130.15 	contrary to the safety or well-being of any of the siblings to do so.
130.16 	(m) When the court has ordered the child into the care of a noncustodial parent or in 
130.17 	foster care, the court may order a chemical dependency evaluation, mental health evaluation, 
130.18 	medical examination, and parenting assessment for the parent as necessary to support the 
130.19 	development of a plan for reunification required under subdivision 7 and section 260C.212, 
130.20 	subdivision 1, or the child protective services plan under section 260E.26, and Minnesota 
130.21 	Rules, part 9560.0228.
130.22 	(n) When the court has ordered an Indian child into an emergency child placement, the 
130.23 	Indian child shall be placed according to the placement preferences in the Minnesota Indian 
130.24 	Family Preservation Act, section 260.773.

130.25 	Sec. 17. Minnesota Statutes 2024, section 260C.178, subdivision 7, is amended to read:
130.26 		Subd. 7.Case plan. (a) When the court has ordered the child into the care of a parent 
130.27 	under subdivision 1, paragraph (c), clause (1), the child protective services plan under section 
130.28 	260E.26 must be filed within 30 days of the filing of the juvenile protection petition under 
130.29 	section 260C.141, subdivision 1.
130.30 	(b) When the court orders the child into foster care under subdivision 1, paragraph (c), 
130.31 	clause (2), and not into the care of a parent, an out-of-home placement plan summary required 
130.32 	under section 260C.212, subdivision 1, must be filed with the court within 30 days of the 
130.33 	filing of a juvenile protection petition under section 260C.141, subdivision 1, when the 
130.34 	court orders emergency removal of the child under this section, or filed with the petition if 
131.1 	the petition is a review of a voluntary placement under section 260C.141, subdivision 2.
131.2 	An out-of-home placement plan shall be prepared and filed with the court within 60 days 
131.3 	after any child is placed in foster care under section 260C.212, subdivision 1.
131.4 	(c) Upon the filing of the child protective services plan under section 260E.26 or 
131.5 	out-of-home placement plan that has been developed jointly with the parent and in 
131.6 	consultation with others as required under section 260C.212, subdivision 1, the court may 
131.7 	approve implementation of the plan by the responsible social services agency based on the 
131.8 	allegations contained in the petition and any evaluations, examinations, or assessments 
131.9 	conducted under subdivision 1, paragraph (m). The court shall send written notice of the 
131.10 	approval of the child protective services plan or out-of-home placement plan to all parties 
131.11 	and the county attorney or may state such approval on the record at a hearing. A parent may 
131.12 	agree to comply with the terms of the plan filed with the court.
131.13 	(d) The responsible social services agency shall make reasonable efforts to engage both 
131.14 	parents of the child in case planning. The responsible social services agency shall report 
131.15 	the results of its efforts to engage the child's parents in the child protective services plan or 
131.16 	out-of-home placement plan filed with the court. The agency shall notify the court of the 
131.17 	services it will provide or efforts it will attempt under the plan notwithstanding the parent's 
131.18 	refusal to cooperate or disagreement with the services. The parent may ask the court to 
131.19 	modify the plan to require different or additional services requested by the parent, but which 
131.20 	the agency refused to provide. The court may approve the plan as presented by the agency 
131.21 	or may modify the plan to require services requested by the parent. The court's approval 
131.22 	must be based on the content of the petition.
131.23 	(e) Unless the parent agrees to comply with the terms of the child protective services 
131.24 	plan or out-of-home placement plan, the court may not order a parent to comply with the 
131.25 	provisions of the plan until the court finds the child is in need of protection or services and 
131.26 	orders disposition under section 260C.201, subdivision 1. However, the court may find that 
131.27 	the responsible social services agency has made reasonable efforts for reunification if the 
131.28 	agency makes efforts to implement the terms of the child protective services plan or 
131.29 	out-of-home placement plan approved under this section.

131.30 	Sec. 18. Minnesota Statutes 2024, section 260C.201, subdivision 1, is amended to read:
131.31 		Subdivision 1.Dispositions. (a) If the court finds that the child is in need of protection 
131.32 	or services or neglected and in foster care, the court shall enter an order making any of the 
131.33 	following dispositions of the case:
132.1 	(1) place the child under the protective supervision of the responsible social services 
132.2 	agency or child-placing agency in the home of a parent of the child under conditions 
132.3 	prescribed by the court directed to the correction of the child's need for protection or services:
132.4 	(i) the court may order the child into the home of a parent who does not otherwise have 
132.5 	legal custody of the child, however, an order under this section does not confer legal custody 
132.6 	on that parent;
132.7 	(ii) if the court orders the child into the home of a father who is not adjudicated, the 
132.8 	father must cooperate with paternity establishment proceedings regarding the child in the 
132.9 	appropriate jurisdiction as one of the conditions prescribed by the court for the child to 
132.10 	continue in the father's home; and
132.11 	(iii) the court may order the child into the home of a noncustodial parent with conditions 
132.12 	and may also order both the noncustodial and the custodial parent to comply with the 
132.13 	requirements of a case plan under subdivision 2; or
132.14 	(2) transfer legal custody to one of the following:
132.15 	(i) a child-placing agency; or
132.16 	(ii) the responsible social services agency. In making a foster care placement of a child 
132.17 	whose custody has been transferred under this subdivision, the court shall inquire about the 
132.18 	child's heritage, including the child's Tribal lineage pursuant to section 260.761 and their 
132.19 	race, culture, and ethnicity pursuant to section 260.63, subdivision 10, and the agency shall 
132.20 	make an individualized determination of how the placement is in the child's best interests 
132.21 	using the placement consideration order for relatives and the best interest factors in section 
132.22 	260C.212, subdivision 2, and may include a child colocated with a parent in a licensed 
132.23 	residential family-based substance use disorder treatment program under section 260C.190; 
132.24 	or
132.25 	(3) order a trial home visit without modifying the transfer of legal custody to the 
132.26 	responsible social services agency under clause (2). Trial home visit means the child is 
132.27 	returned to the care of the parent or guardian from whom the child was removed for a period 
132.28 	not to exceed six months. During the period of the trial home visit, the responsible social 
132.29 	services agency:
132.30 	(i) shall continue to have legal custody of the child, which means that the agency may 
132.31 	see the child in the parent's home, at school, in a child care facility, or other setting as the 
132.32 	agency deems necessary and appropriate;
132.33 	(ii) shall continue to have the ability to access information under section 260C.208;
133.1 	(iii) shall continue to provide appropriate services to both the parent and the child during 
133.2 	the period of the trial home visit;
133.3 	(iv) without previous court order or authorization, may terminate the trial home visit in 
133.4 	order to protect the child's health, safety, or welfare and may remove the child to foster care;
133.5 	(v) shall advise the court and parties within three days of the termination of the trial 
133.6 	home visit when a visit is terminated by the responsible social services agency without a 
133.7 	court order; and
133.8 	(vi) shall prepare a report for the court when the trial home visit is terminated whether 
133.9 	by the agency or court order that describes the child's circumstances during the trial home 
133.10 	visit and recommends appropriate orders, if any, for the court to enter to provide for the 
133.11 	child's safety and stability. In the event a trial home visit is terminated by the agency by 
133.12 	removing the child to foster care without prior court order or authorization, the court shall 
133.13 	conduct a hearing within ten days of receiving notice of the termination of the trial home 
133.14 	visit by the agency and shall order disposition under this subdivision or commence 
133.15 	permanency proceedings under sections 260C.503 to 260C.515. The time period for the 
133.16 	hearing may be extended by the court for good cause shown and if it is in the best interests 
133.17 	of the child as long as the total time the child spends in foster care without a permanency 
133.18 	hearing does not exceed 12 months;
133.19 	(4) if the child has been adjudicated as a child in need of protection or services because 
133.20 	the child is in need of special services or care to treat or ameliorate a physical or mental 
133.21 	disability or emotional disturbance as defined in section 245.4871, subdivision 15, the court 
133.22 	may order the child's parent, guardian, or custodian to provide it. The court may order the 
133.23 	child's health plan company to provide mental health services to the child. Section 62Q.535 
133.24 	applies to an order for mental health services directed to the child's health plan company. 
133.25 	If the health plan, parent, guardian, or custodian fails or is unable to provide this treatment 
133.26 	or care, the court may order it provided. Absent specific written findings by the court that 
133.27 	the child's disability is the result of abuse or neglect by the child's parent or guardian, the 
133.28 	court shall not transfer legal custody of the child for the purpose of obtaining special 
133.29 	treatment or care solely because the parent is unable to provide the treatment or care. If the 
133.30 	court's order for mental health treatment is based on a diagnosis made by a treatment 
133.31 	professional, the court may order that the diagnosing professional not provide the treatment 
133.32 	to the child if it finds that such an order is in the child's best interests; or
133.33 	(5) if the court believes that the child has sufficient maturity and judgment and that it is 
133.34 	in the best interests of the child, the court may order a child 16 years old or older to be 
134.1 	allowed to live independently, either alone or with others as approved by the court under 
134.2 	supervision the court considers appropriate, if the county board, after consultation with the 
134.3 	court, has specifically authorized this dispositional alternative for a child.
134.4 	(b) If the child was adjudicated in need of protection or services because the child is a 
134.5 	runaway or habitual truant, the court may order any of the following dispositions in addition 
134.6 	to or as alternatives to the dispositions authorized under paragraph (a):
134.7 	(1) counsel the child or the child's parents, guardian, or custodian;
134.8 	(2) place the child under the supervision of a probation officer or other suitable person 
134.9 	in the child's own home under conditions prescribed by the court, including reasonable rules 
134.10 	for the child's conduct and the conduct of the parents, guardian, or custodian, designed for 
134.11 	the physical, mental, and moral well-being and behavior of the child;
134.12 	(3) subject to the court's supervision, transfer legal custody of the child to one of the 
134.13 	following:
134.14 	(i) a reputable person of good moral character. No person may receive custody of two 
134.15 	or more unrelated children unless licensed to operate a residential program under sections 
134.16 	245A.01 to 245A.16; or
134.17 	(ii) a county probation officer for placement in a group foster home established under 
134.18 	the direction of the juvenile court and licensed pursuant to section 241.021;
134.19 	(4) require the child to pay a fine of up to $100. The court shall order payment of the 
134.20 	fine in a manner that will not impose undue financial hardship upon the child;
134.21 	(5) require the child to participate in a community service project;
134.22 	(6) order the child to undergo a chemical dependency evaluation and, if warranted by 
134.23 	the evaluation, order participation by the child in a drug awareness program or an inpatient 
134.24 	or outpatient chemical dependency treatment program;
134.25 	(7) if the court believes that it is in the best interests of the child or of public safety that 
134.26 	the child's driver's license or instruction permit be canceled, the court may order the 
134.27 	commissioner of public safety to cancel the child's license or permit for any period up to 
134.28 	the child's 18th birthday. If the child does not have a driver's license or permit, the court 
134.29 	may order a denial of driving privileges for any period up to the child's 18th birthday. The 
134.30 	court shall forward an order issued under this clause to the commissioner, who shall cancel 
134.31 	the license or permit or deny driving privileges without a hearing for the period specified 
134.32 	by the court. At any time before the expiration of the period of cancellation or denial, the 
135.1 	court may, for good cause, order the commissioner of public safety to allow the child to 
135.2 	apply for a license or permit, and the commissioner shall so authorize;
135.3 	(8) order that the child's parent or legal guardian deliver the child to school at the 
135.4 	beginning of each school day for a period of time specified by the court; or
135.5 	(9) require the child to perform any other activities or participate in any other treatment 
135.6 	programs deemed appropriate by the court.
135.7 	To the extent practicable, the court shall enter a disposition order the same day it makes 
135.8 	a finding that a child is in need of protection or services or neglected and in foster care, but 
135.9 	in no event more than 15 days after the finding unless the court finds that the best interests 
135.10 	of the child will be served by granting a delay. If the child was under eight years of age at 
135.11 	the time the petition was filed, the disposition order must be entered within ten days of the 
135.12 	finding and the court may not grant a delay unless good cause is shown and the court finds 
135.13 	the best interests of the child will be served by the delay.
135.14 	(c) If a child who is 14 years of age or older is adjudicated in need of protection or 
135.15 	services because the child is a habitual truant and truancy procedures involving the child 
135.16 	were previously dealt with by a school attendance review board or county attorney mediation 
135.17 	program under section 260A.06 or 260A.07, the court shall order a cancellation or denial 
135.18 	of driving privileges under paragraph (b), clause (7), for any period up to the child's 18th 
135.19 	birthday.
135.20 	(d) In the case of a child adjudicated in need of protection or services because the child 
135.21 	has committed domestic abuse and been ordered excluded from the child's parent's home, 
135.22 	the court shall dismiss jurisdiction if the court, at any time, finds the parent is able or willing 
135.23 	to provide an alternative safe living arrangement for the child as defined in paragraph (f).
135.24 	(e) When a parent has complied with a case plan ordered under subdivision 6 and the 
135.25 	child is in the care of the parent, the court may order the responsible social services agency 
135.26 	to monitor the parent's continued ability to maintain the child safely in the home under such 
135.27 	terms and conditions as the court determines appropriate under the circumstances.
135.28 	(f) For the purposes of this subdivision, "alternative safe living arrangement" means a 
135.29 	living arrangement for a child proposed by a petitioning parent or guardian if a court excludes 
135.30 	the minor from the parent's or guardian's home that is separate from the victim of domestic 
135.31 	abuse and safe for the child respondent. A living arrangement proposed by a petitioning 
135.32 	parent or guardian is presumed to be an alternative safe living arrangement absent information 
135.33 	to the contrary presented to the court. In evaluating any proposed living arrangement, the 
135.34 	court shall consider whether the arrangement provides the child with necessary food, clothing, 
136.1 	shelter, and education in a safe environment. Any proposed living arrangement that would 
136.2 	place the child in the care of an adult who has been physically or sexually violent is presumed 
136.3 	unsafe.

136.4 	Sec. 19. Minnesota Statutes 2024, section 260C.201, subdivision 2, is amended to read:
136.5 		Subd. 2.Written findings. (a) Any order for a disposition authorized under this section 
136.6 	shall contain written findings of fact to support the disposition and case plan ordered and 
136.7 	shall also set forth in writing the following information:
136.8 	(1) why the best interests and safety of the child are served by the disposition and case 
136.9 	plan ordered;
136.10 	(2) what alternative dispositions or services under the case plan were considered by the 
136.11 	court and why such dispositions or services were not appropriate in the instant case;
136.12 	(3) when legal custody of the child is transferred, the appropriateness of the particular 
136.13 	placement made or to be made by the placing agency using the relative and sibling placement 
136.14 	considerations and best interest factors in section 260C.212, subdivision 2, or the 
136.15 	appropriateness of a child colocated with a parent in a licensed residential family-based 
136.16 	substance use disorder treatment program under section 260C.190;
136.17 	(4) whether reasonable efforts to finalize the permanent plan for the child consistent 
136.18 	with section 260.012 were made including reasonable efforts:
136.19 	(i) to prevent the child's placement and to reunify the child with the parent or guardian 
136.20 	from whom the child was removed at the earliest time consistent with the child's safety. 
136.21 	The court's findings must include a brief description of what preventive and reunification 
136.22 	efforts were made and why further efforts could not have prevented or eliminated the 
136.23 	necessity of removal or that reasonable efforts were not required under section 260.012 or 
136.24 	260C.178, subdivision 1;
136.25 	(ii) to identify and locate any noncustodial or nonresident parent of the child and to 
136.26 	assess such parent's ability to provide day-to-day care of the child, and, where appropriate, 
136.27 	provide services necessary to enable the noncustodial or nonresident parent to safely provide 
136.28 	day-to-day care of the child as required under section 260C.219, unless such services are 
136.29 	not required under section 260.012 or 260C.178, subdivision 1. The court's findings must 
136.30 	include a description of the agency's efforts to:
136.31 	(A) identify and locate the child's noncustodial or nonresident parent;
137.1 	(B) assess the noncustodial or nonresident parent's ability to provide day-to-day care of 
137.2 	the child; and
137.3 	(C) if appropriate, provide services necessary to enable the noncustodial or nonresident 
137.4 	parent to safely provide the child's day-to-day care, including efforts to engage the 
137.5 	noncustodial or nonresident parent in assuming care and responsibility of the child;
137.6 	(iii) to inquire about the child's heritage, including the child's Tribal lineage pursuant to 
137.7 	section 260.761 and their race, culture, and ethnicity pursuant to section 260.63, subdivision 
137.8 	10, and make the diligent search for relatives and provide the notices required under section 
137.9 	260C.221; a finding made pursuant to a hearing under section 260C.202 that the agency 
137.10 	has made diligent efforts to conduct a relative search and has appropriately engaged relatives 
137.11 	who responded to the notice under section 260C.221 and other relatives, who came to the 
137.12 	attention of the agency after notice under section 260C.221 was sent, in placement and case 
137.13 	planning decisions fulfills the requirement of this item;
137.14 	(iv) to identify and make a foster care placement of the child, considering the order in 
137.15 	section 260C.212, subdivision 2, paragraph (a), in the home of an unlicensed relative, 
137.16 	according to the requirements of section 142B.06, a licensed relative, or other licensed foster 
137.17 	care provider, who will commit to being the permanent legal parent or custodian for the 
137.18 	child in the event reunification cannot occur, but who will actively support the reunification 
137.19 	plan for the child. If the court finds that the agency has not appropriately considered relatives 
137.20 	for placement of the child, the court shall order the agency to comply with section 260C.212, 
137.21 	subdivision 2, paragraph (a). The court may order the agency to continue considering 
137.22 	relatives for placement of the child regardless of the child's current placement setting; and
137.23 	(v) to place siblings together in the same home or to ensure visitation is occurring when 
137.24 	siblings are separated in foster care placement and visitation is in the siblings' best interests 
137.25 	under section 260C.212, subdivision 2, paragraph (d); and
137.26 	(5) if the child has been adjudicated as a child in need of protection or services because 
137.27 	the child is in need of special services or care to treat or ameliorate a mental disability or 
137.28 	emotional disturbance as defined in section 245.4871, subdivision 15, the written findings 
137.29 	shall also set forth:
137.30 	(i) whether the child has mental health needs that must be addressed by the case plan;
137.31 	(ii) what consideration was given to the diagnostic and functional assessments performed 
137.32 	by the child's mental health professional and to health and mental health care professionals' 
137.33 	treatment recommendations;
138.1 	(iii) what consideration was given to the requests or preferences of the child's parent or 
138.2 	guardian with regard to the child's interventions, services, or treatment; and
138.3 	(iv) what consideration was given to the cultural appropriateness of the child's treatment 
138.4 	or services.
138.5 	(b) If the court finds that the social services agency's preventive or reunification efforts 
138.6 	have not been reasonable but that further preventive or reunification efforts could not permit 
138.7 	the child to safely remain at home, the court may nevertheless authorize or continue the 
138.8 	removal of the child.
138.9 	(c) If the child has been identified by the responsible social services agency as the subject 
138.10 	of concurrent permanency planning, the court shall review the reasonable efforts of the 
138.11 	agency to develop a permanency plan for the child that includes a primary plan that is for 
138.12 	reunification with the child's parent or guardian and a secondary plan that is for an alternative, 
138.13 	legally permanent home for the child in the event reunification cannot be achieved in a 
138.14 	timely manner.

138.15 	Sec. 20. Minnesota Statutes 2024, section 260C.202, subdivision 2, is amended to read:
138.16 		Subd. 2.Court review for a child placed in foster care. (a) If the court orders a child 
138.17 	placed in foster care, the court shall review the out-of-home placement plan and the child's 
138.18 	placement at least every 90 days as required in juvenile court rules to determine whether 
138.19 	continued out-of-home placement is necessary and appropriate or whether the child should 
138.20 	be returned home.
138.21 	(b) This review is not required if the court has returned the child home, ordered the child 
138.22 	permanently placed away from the parent under sections 260C.503 to 260C.521, or 
138.23 	terminated rights under section 260C.301. Court review for a child permanently placed 
138.24 	away from a parent, including where the child is under guardianship of the commissioner, 
138.25 	is governed by section 260C.607.
138.26 	(c) When a child is placed in a qualified residential treatment program setting as defined 
138.27 	in section 260C.007, subdivision 26d, the responsible social services agency must submit 
138.28 	evidence to the court as specified in section 260C.712.
138.29 	(d) No later than three months after the child's placement in foster care, the court shall 
138.30 	review agency efforts to search for and notify relatives pursuant to section 260C.221, and 
138.31 	order that the agency's efforts begin immediately, or continue, if the agency has failed to 
138.32 	perform, or has not adequately performed, the duties under that section. The court must 
138.33 	order the agency to continue to appropriately engage relatives who responded to the notice 
139.1 	under section 260C.221 in placement and case planning decisions and to consider relatives 
139.2 	for foster care placement consistent with section 260C.221. Notwithstanding a court's finding 
139.3 	that the agency has made reasonable efforts to search for and notify relatives under section 
139.4 	260C.221, the court may order the agency to continue making reasonable efforts to search 
139.5 	for, notify, engage, and consider relatives who came to the agency's attention after sending 
139.6 	the initial notice under section 260C.221.
139.7 	(e) The court shall review the out-of-home placement plan and may modify the plan as 
139.8 	provided under section 260C.201, subdivisions 6 and 7.
139.9 	(f) When the court transfers the custody of a child to a responsible social services agency 
139.10 	resulting in foster care or protective supervision with a noncustodial parent under subdivision 
139.11 	1, the court shall notify the parents of the provisions of sections 260C.204 and 260C.503 
139.12 	to 260C.521, as required under juvenile court rules.
139.13 	(g) When a child remains in or returns to foster care pursuant to section 260C.451 and 
139.14 	the court has jurisdiction pursuant to section 260C.193, subdivision 6, paragraph (c), the 
139.15 	court shall at least annually conduct the review required under section 260C.203.

139.16 	Sec. 21. Minnesota Statutes 2024, section 260C.202, is amended by adding a subdivision 
139.17 	to read:
139.18 		Subd. 3.Court review prior to the 18th birthday of a child in foster care. (a) The 
139.19 	court must conduct a review during the 90-day period prior to the 18th birthday of a child 
139.20 	in foster care.
139.21 	(b) The responsible social services agency must file a written report with the court 
139.22 	containing or attaching the following:
139.23 	(1) the child's name, date of birth, race, gender, and current address;
139.24 	(2) whether the child is eligible for extended foster care and if not, the reason or reasons 
139.25 	why the child is not eligible;
139.26 	(3) a written summary describing how the child was involved in creating the child's plan 
139.27 	for after their 18th birthday;
139.28 	(4) the date the required extended foster care eligibility notice in section 260C.451, 
139.29 	subdivision 1, was provided and the child's plan after the child's 18th birthday;
139.30 	(5) the child's most recent independent living plan required under section 260C.212, 
139.31 	subdivision 1;
140.1 	(6) if the agency's recommendation is to extend jurisdiction up to age 19 under section 
140.2 	260C.193, why the extended jurisdiction is in the child's best interest;
140.3 	(7) if the agency's recommendation is to reunify the child with their parent or legal 
140.4 	guardian, why reunification is in the child's best interest;
140.5 	(8) if the agency plans to transition the child into adult services on or after the child's 
140.6 	18th birthday, a summary of the transition plan as required in section 260C.452 and how 
140.7 	this plan is in the child's best interest; and
140.8 	(9) if the child's plan is to leave foster care at age 18 and not continue in extended foster 
140.9 	care, a copy of their 180-day transition plan required in section 260C.452 and the reasons 
140.10 	the child is not continuing in extended foster care.
140.11 	(c) The agency must inform the child and parties to the proceeding of the reporting and 
140.12 	court review requirements of this subdivision and their right to request a hearing. The child 
140.13 	or a party to the proceeding may request a hearing if they believe the agency did not make 
140.14 	reasonable efforts under this subdivision.
140.15 	(d) Upon receiving the report, the court must hold a hearing when a party to the 
140.16 	proceeding or the child requests a hearing. In all other circumstances, the court has the 
140.17 	discretion to hold a hearing or issue an order without a hearing.
140.18 	(e) The court must issue an order with findings including but not limited to the following:
140.19 	(1) whether the responsible social services agency provided the notice to the child about 
140.20 	extended foster care as required in section 260C.451;
140.21 	(2) whether the responsible social services agency engaged with the child and 
140.22 	appropriately planned with the child to transition to adulthood; and
140.23 	(3) if the child has decided to not continue in the extended foster care program at age 
140.24 	18, whether the responsible social services agency informed the child that they can reenter 
140.25 	extended foster care up to age 21 or that the child is not eligible to reenter and why.

140.26 	Sec. 22. Minnesota Statutes 2024, section 260C.202, is amended by adding a subdivision 
140.27 	to read:
140.28 		Subd. 4.Court reviews for a child over age 18 in foster care. When a child remains 
140.29 	in or returns to foster care pursuant to section 260C.451 and the court has jurisdiction 
140.30 	pursuant to section 260C.193, subdivision 6, paragraph (c), the court must at least annually 
140.31 	conduct the review required under section 260C.203.

141.1 	Sec. 23. Minnesota Statutes 2024, section 260C.204, is amended to read:
141.2 	260C.204 PERMANENCY PROGRESS REVIEW FOR CHILDREN IN FOSTER 
141.3 	CARE FOR SIX MONTHS.
141.4 	(a) When a child continues in placement out of the home of the parent or guardian from 
141.5 	whom the child was removed, no later than six months after the child's placement the court 
141.6 	shall conduct a permanency progress hearing to review:
141.7 	(1) the progress of the case, the parent's progress on the case plan or out-of-home 
141.8 	placement plan, whichever is applicable;
141.9 	(2) the agency's reasonable, or in the case of an Indian child, active efforts for 
141.10 	reunification and its provision of services;
141.11 	(3) the agency's reasonable efforts to finalize the permanent plan for the child under 
141.12 	section 260.012, paragraph (e), and to make a placement as required under section 260C.212, 
141.13 	subdivision 2, in a home that will commit to being the legally permanent family for the 
141.14 	child in the event the child cannot return home according to the timelines in this section; 
141.15 	and
141.16 	(4) in the case of an Indian child, active efforts to prevent the breakup of the Indian 
141.17 	family and to make a placement according to the placement preferences under United States 
141.18 	Code, title 25, chapter 21, section 1915.
141.19 	(b) When a child is placed in a qualified residential treatment program setting as defined 
141.20 	in section 260C.007, subdivision 26d, the responsible social services agency must submit 
141.21 	evidence to the court as specified in section 260C.712.
141.22 	(c) The court shall ensure that notice of the hearing is sent to any relative who:
141.23 	(1) responded to the agency's notice provided under section 260C.221, indicating an 
141.24 	interest in participating in planning for the child or being a permanency resource for the 
141.25 	child and who has kept the court apprised of the relative's address; or
141.26 	(2) asked to be notified of court proceedings regarding the child as is permitted in section 
141.27 	260C.152, subdivision 5.
141.28 	(d)(1) If the parent or guardian has maintained contact with the child and is complying 
141.29 	with the court-ordered out-of-home placement plan, and if the child would benefit from 
141.30 	reunification with the parent, the court may either:
141.31 	(i) return the child home, if the conditions that led to the out-of-home placement have 
141.32 	been sufficiently mitigated that it is safe and in the child's best interests to return home; or
142.1 	(ii) continue the matter up to a total of six additional months. If the child has not returned 
142.2 	home by the end of the additional six months, the court must conduct a hearing according 
142.3 	to sections 260C.503 to 260C.521.
142.4 	(2) If the court determines that the parent or guardian is not complying, is not making 
142.5 	progress with or engaging with services in the out-of-home placement plan, or is not 
142.6 	maintaining regular contact with the child as outlined in the visitation plan required as part 
142.7 	of the out-of-home placement plan under section 260C.212, the court may order the 
142.8 	responsible social services agency:
142.9 	(i) to develop a plan for legally permanent placement of the child away from the parent;
142.10 	(ii) to consider, identify, recruit, and support one or more permanency resources from 
142.11 	the child's relatives and foster parent, consistent with clause (3) and section 260C.212, 
142.12 	subdivision 2, paragraph (a), to be the legally permanent home in the event the child cannot 
142.13 	be returned to the parent. Any relative or the child's foster parent may ask the court to order 
142.14 	the agency to consider them for permanent placement of the child in the event the child 
142.15 	cannot be returned to the parent. A relative or foster parent who wants to be considered 
142.16 	under this item shall cooperate with the background study required under section 245C.08, 
142.17 	if the individual has not already done so, and with the home study process required under 
142.18 	chapter 142B for providing child foster care and for adoption under section 259.41. The 
142.19 	home study referred to in this item shall be a single-home study in the form required by the 
142.20 	commissioner of children, youth, and families or similar study required by the individual's 
142.21 	state of residence when the subject of the study is not a resident of Minnesota. The court 
142.22 	may order the responsible social services agency to make a referral under the Interstate 
142.23 	Compact on the Placement of Children when necessary to obtain a home study for an 
142.24 	individual who wants to be considered for transfer of permanent legal and physical custody 
142.25 	or adoption of the child; and
142.26 	(iii) to file a petition to support an order for the legally permanent placement plan.
142.27 	(3) Consistent with section 260C.223, subdivision 2, paragraph (b), the responsible social 
142.28 	services agency must not define a foster family as the permanent home for a child until:
142.29 	(i) inquiry and Tribal notice requirements under section 260.761, subdivisions 1 and 2, 
142.30 	are satisfied;
142.31 	(ii) inquiry about the child's heritage, including their race, culture, and ethnicity pursuant 
142.32 	to section 260.63, subdivision 10, has been completed; and
143.1 	(iii) the court has determined that reasonable or active efforts toward completing the 
143.2 	relative search requirements in section 260C.221 have been made.
143.3 	(e) Following the review under this section:
143.4 	(1) if the court has either returned the child home or continued the matter up to a total 
143.5 	of six additional months, the agency shall continue to provide services to support the child's 
143.6 	return home or to make reasonable efforts to achieve reunification of the child and the parent 
143.7 	as ordered by the court under an approved case plan;
143.8 	(2) if the court orders the agency to develop a plan for the transfer of permanent legal 
143.9 	and physical custody of the child to a relative, a petition supporting the plan shall be filed 
143.10 	in juvenile court within 30 days of the hearing required under this section and a trial on the 
143.11 	petition held within 60 days of the filing of the pleadings; or
143.12 	(3) if the court orders the agency to file a termination of parental rights, unless the county 
143.13 	attorney can show cause why a termination of parental rights petition should not be filed, 
143.14 	a petition for termination of parental rights shall be filed in juvenile court within 30 days 
143.15 	of the hearing required under this section and a trial on the petition held within 60 days of 
143.16 	the filing of the petition.

143.17 	Sec. 24. Minnesota Statutes 2024, section 260C.212, subdivision 1, is amended to read:
143.18 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan shall 
143.19 	be prepared within 30 days after any child is placed in foster care by court order or a 
143.20 	voluntary placement agreement between the responsible social services agency and the 
143.21 	child's parent pursuant to section 260C.227 or chapter 260D.
143.22 	(b) (a) An out-of-home placement plan means a written document individualized to the 
143.23 	needs of the child and the child's parents or guardians that is prepared by the responsible 
143.24 	social services agency using a form developed by the commissioner. The plan must be 
143.25 	completed jointly with the child's parents or guardians and in consultation with the child's 
143.26 	guardian ad litem; the child's tribe, if the child is an Indian child; the child's foster parent 
143.27 	or representative of the foster care facility; and, when appropriate, the child. When a child 
143.28 	is age 14 or older, the child may include two other individuals on the team preparing the 
143.29 	child's out-of-home placement plan. The child may select one member of the case planning 
143.30 	team to be designated as the child's advisor and to advocate with respect to the application 
143.31 	of the reasonable and prudent parenting standards. The responsible social services agency 
143.32 	may reject an individual selected by the child if the agency has good cause to believe that 
143.33 	the individual would not act in the best interest of the child. For a child in voluntary foster 
144.1 	care for treatment under chapter 260D, preparation of the out-of-home placement plan shall 
144.2 	additionally include the child's mental health treatment provider. For a child 18 years of 
144.3 	age or older, the responsible social services agency shall involve the child and the child's 
144.4 	parents as appropriate. As appropriate, the plan shall be:
144.5 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
144.6 	(2) ordered by the court, either as presented or modified after hearing, under section 
144.7 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
144.8 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem, 
144.9 	a representative of the child's tribe, the responsible social services agency, and, if possible, 
144.10 	the child.
144.11 	(b) Before an out-of-home placement plan is signed by the parent or parents or guardian 
144.12 	of the child, the responsible social services agency must provide the parent or parents or 
144.13 	guardian with a one- to two-page summary of the plan using a form developed by the 
144.14 	commissioner. The out-of-home placement plan summary must clearly summarize the plan's 
144.15 	contents under paragraph (d) and list the requirements and responsibilities for the parent or 
144.16 	parents or guardian using plain language. The summary must be updated and provided to 
144.17 	the parent or parents or guardian when the out-of-home placement plan is updated under 
144.18 	subdivision 1a.
144.19 	(c) An out-of-home placement plan summary shall be prepared within 30 days after any 
144.20 	child is placed in foster care by court order or voluntary placement agreement between the 
144.21 	responsible social services agency and the child's parent pursuant to section 260C.227 or 
144.22 	chapter 260D. An out-of-home placement plan shall be prepared within 60 days after any 
144.23 	child is placed in foster care by court order or a voluntary placement agreement between 
144.24 	the responsible social services agency and the child's parent pursuant to section 260C.227 
144.25 	or chapter 260D.
144.26 	(c) (d) The out-of-home placement plan shall be explained by the responsible social 
144.27 	services agency to all persons involved in the plan's implementation, including the child 
144.28 	who has signed the plan, and shall set forth:
144.29 	(1) a description of the foster care home or facility selected, including how the 
144.30 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
144.31 	least restrictive, most family-like setting available that is in close proximity to the home of 
144.32 	the child's parents or guardians when the case plan goal is reunification; and how the 
144.33 	placement is consistent with the best interests and special needs of the child according to 
144.34 	the factors under subdivision 2, paragraph (b);
145.1 	(2) a description of the services offered and provided to prevent removal of the child 
145.2 	from the home;
145.3 	(2) (3) the specific reasons for the placement of the child in foster care, and when 
145.4 	reunification is the plan, a description of the problems or conditions in the home of the 
145.5 	parent or parents that necessitated removal of the child from home and the services offered 
145.6 	and provided to support the changes the parent or parents must make for the child to safely 
145.7 	return home;
145.8 	(3) a description of the services offered and provided to prevent removal of the child 
145.9 	from the home and to reunify the family including:
145.10 	(i) the specific actions to be taken by the parent or parents of the child to eliminate or 
145.11 	correct the problems or conditions identified in clause (2), and the time period during which 
145.12 	the actions are to be taken; and
145.13 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to 
145.14 	achieve a safe and stable home for the child including social and other supportive services 
145.15 	to be provided or offered to the parent or parents or guardian of the child, the child, and the 
145.16 	residential facility during the period the child is in the residential facility;
145.17 	(4) a description of any services or resources that were requested by the child or the 
145.18 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
145.19 	in the residential facility, and whether those services or resources were provided and if not, 
145.20 	the basis for the denial of the services or resources;
145.21 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined in 
145.22 	section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not 
145.23 	placed together in foster care, and whether visitation is consistent with the best interest of 
145.24 	the child, during the period the child is in foster care;
145.25 	(6) when a child cannot return to or be in the care of either parent, documentation of 
145.26 	steps to finalize permanency through either:
145.27 	(i) adoption as the permanency plan for the child through reasonable efforts to place the 
145.28 	child for adoption pursuant to section 260C.605. At a minimum, the documentation must 
145.29 	include consideration of whether adoption is in the best interests of the child and 
145.30 	child-specific recruitment efforts such as a relative search, consideration of relatives for 
145.31 	adoptive placement, and the use of state, regional, and national adoption exchanges to 
145.32 	facilitate orderly and timely placements in and outside of the state. A copy of this 
146.1 	documentation shall be provided to the court in the review required under section 260C.317, 
146.2 	subdivision 3, paragraph (b); or
146.3 	(7) when a child cannot return to or be in the care of either parent, documentation of 
146.4 	steps to finalize (ii) the transfer of permanent legal and physical custody to a relative as the 
146.5 	permanency plan for the child. This documentation must support the requirements of the 
146.6 	kinship placement agreement under section 142A.605 and must include the reasonable 
146.7 	efforts used to determine that it is not appropriate for the child to return home or be adopted, 
146.8 	and reasons why permanent placement with a relative through a Northstar kinship assistance 
146.9 	arrangement is in the child's best interest; how the child meets the eligibility requirements 
146.10 	for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's 
146.11 	relative foster parent and reasons why the relative foster parent chose not to pursue adoption, 
146.12 	if applicable; and agency efforts to discuss with the child's parent or parents the permanent 
146.13 	transfer of permanent legal and physical custody or the reasons why these efforts were not 
146.14 	made;
146.15 	(8) (7) efforts to ensure the child's educational stability while in foster care for a child 
146.16 	who attained the minimum age for compulsory school attendance under state law and is 
146.17 	enrolled full time in elementary or secondary school, or instructed in elementary or secondary 
146.18 	education at home, or instructed in an independent study elementary or secondary program, 
146.19 	or incapable of attending school on a full-time basis due to a medical condition that is 
146.20 	documented and supported by regularly updated information in the child's case plan. 
146.21 	Educational stability efforts include:
146.22 	(i) efforts to ensure that the child remains in the same school in which the child was 
146.23 	enrolled prior to placement or upon the child's move from one placement to another, including 
146.24 	efforts to work with the local education authorities to ensure the child's educational stability 
146.25 	and attendance; or
146.26 	(ii) if it is not in the child's best interest to remain in the same school that the child was 
146.27 	enrolled in prior to placement or move from one placement to another, efforts to ensure 
146.28 	immediate and appropriate enrollment for the child in a new school;
146.29 	(9) (8) the educational records of the child including the most recent information available 
146.30 	regarding:
146.31 	(i) the names and addresses of the child's educational providers;
146.32 	(ii) the child's grade level performance;
146.33 	(iii) the child's school record;
147.1 	(iv) a statement about how the child's placement in foster care takes into account 
147.2 	proximity to the school in which the child is enrolled at the time of placement; and
147.3 	(v) any other relevant educational information;
147.4 	(10) (9) the efforts by the responsible social services agency to ensure support the child's 
147.5 	well-being by ensuring the oversight and continuity of health care services for the foster 
147.6 	child and documenting their health record, including:
147.7 	(i) the plan to schedule the child's initial health screens;
147.8 	(ii) how the child's known medical problems and identified needs from the screens, 
147.9 	including any known communicable diseases, as defined in section 144.4172, subdivision 
147.10 	2, shall be monitored and treated while the child is in foster care;
147.11 	(iii) how the child's medical information shall be updated and shared, including the 
147.12 	child's immunizations;
147.13 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
147.14 	including the role of the parent, the agency, and the foster parent;
147.15 	(v) who is responsible for oversight of the child's prescription medications;
147.16 	(vi) how physicians or other appropriate medical and nonmedical professionals shall be 
147.17 	consulted and involved in assessing the health and well-being of the child and determine 
147.18 	the appropriate medical treatment for the child; and
147.19 	(vii) the responsibility to ensure that the child has access to medical care through either 
147.20 	medical insurance or medical assistance; and
147.21 	(11) the health records of the child including (viii) information available regarding:
147.22 	(i) (A) the names and addresses of the child's health care and dental care providers;
147.23 	(ii) (B) a record of the child's immunizations;
147.24 	(iii) (C) the child's known medical problems, including any known communicable 
147.25 	diseases as defined in section 144.4172, subdivision 2;
147.26 	(iv) (D) the child's medications; and
147.27 	(v) (E) any other relevant health care information such as the child's eligibility for medical 
147.28 	insurance or medical assistance;
147.29 	(12) (10) an independent living plan for a child 14 years of age or older, developed in 
147.30 	consultation with the child. The child may select one member of the case planning team to 
147.31 	be designated as the child's advisor and to advocate with respect to the application of the 
148.1 	reasonable and prudent parenting standards in subdivision 14. The plan should include, but 
148.2 	not be limited to, the following objectives:
148.3 	(i) educational, vocational, or employment planning;
148.4 	(ii) health care planning and medical coverage;
148.5 	(iii) transportation including, where appropriate, assisting the child in obtaining a driver's 
148.6 	license;
148.7 	(iv) money management, including the responsibility of the responsible social services 
148.8 	agency to ensure that the child annually receives, at no cost to the child, a consumer report 
148.9 	as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies 
148.10 	in the report;
148.11 	(v) planning for housing;
148.12 	(vi) social and recreational skills;
148.13 	(vii) establishing and maintaining connections with the child's family and community; 
148.14 	and
148.15 	(viii) regular opportunities to engage in age-appropriate or developmentally appropriate 
148.16 	activities typical for the child's age group, taking into consideration the capacities of the 
148.17 	individual child;
148.18 	(13) (11) for a child in voluntary foster care for treatment under chapter 260D, diagnostic 
148.19 	and assessment information, specific services relating to meeting the mental health care 
148.20 	needs of the child, and treatment outcomes;
148.21 	(14) (12) for a child 14 years of age or older, a signed acknowledgment that describes 
148.22 	the child's rights regarding education, health care, visitation, safety and protection from 
148.23 	exploitation, and court participation; receipt of the documents identified in section 260C.452; 
148.24 	and receipt of an annual credit report. The acknowledgment shall state that the rights were 
148.25 	explained in an age-appropriate manner to the child; and
148.26 	(15) (13) for a child placed in a qualified residential treatment program, the plan must 
148.27 	include the requirements in section 260C.708.
148.28 	(d) (e) The parent or parents or guardian and the child each shall have the right to legal 
148.29 	counsel in the preparation of the case plan and shall be informed of the right at the time of 
148.30 	placement of the child. The child shall also have the right to a guardian ad litem. If unable 
148.31 	to employ counsel from their own resources, the court shall appoint counsel upon the request 
148.32 	of the parent or parents or the child or the child's legal guardian. The parent or parents may 
149.1 	also receive assistance from any person or social services agency in preparation of the case 
149.2 	plan.
149.3 	(e) Before an out-of-home placement plan is signed by the parent or parents or guardian 
149.4 	of the child, the responsible social services agency must provide the parent or parents or 
149.5 	guardian with a one- to two-page summary of the plan using a form developed by the 
149.6 	commissioner. The out-of-home placement plan summary must clearly summarize the plan's 
149.7 	contents under paragraph (c) and list the requirements and responsibilities for the parent or 
149.8 	parents or guardian using plain language. The summary must be updated and provided to 
149.9 	the parent or parents or guardian when the out-of-home placement plan is updated under 
149.10 	subdivision 1a.
149.11 	(f) After the plan has been agreed upon by the parties involved or approved or ordered 
149.12 	by the court, the foster parents shall be fully informed of the provisions of the case plan and 
149.13 	shall be provided a copy of the plan.
149.14 	(g) Upon the child's discharge from foster care, the responsible social services agency 
149.15 	must provide the child's parent, adoptive parent, or permanent legal and physical custodian, 
149.16 	and the child, if the child is 14 years of age or older, with a current copy of the child's health 
149.17 	and education record. If a child meets the conditions in subdivision 15, paragraph (b), the 
149.18 	agency must also provide the child with the child's social and medical history. The responsible 
149.19 	social services agency may give a copy of the child's health and education record and social 
149.20 	and medical history to a child who is younger than 14 years of age, if it is appropriate and 
149.21 	if subdivision 15, paragraph (b), applies.

149.22 	Sec. 25. Minnesota Statutes 2024, section 260C.212, subdivision 1a, is amended to read:
149.23 		Subd. 1a.Out-of-home placement plan update. (a) Within 30 days of placing the child 
149.24 	in foster care, the agency must complete the child's out-of-home placement plan summary 
149.25 	and file it with the court. Within 60 days of placing the child in foster care, the agency must
149.26 	file the child's initial out-of-home placement plan with the court. After filing the child's 
149.27 	initial out-of-home placement plan, the agency shall update and file the child's out-of-home 
149.28 	placement plan with the court as follows:
149.29 	(1) when the agency moves a child to a different foster care setting, the agency shall 
149.30 	inform the court within 30 days of the child's placement change or court-ordered trial home 
149.31 	visit. The agency must file the child's updated out-of-home placement plan summary and
149.32 	out-of-home placement plan with the court at the next required review hearing;
150.1 	(2) when the agency places a child in a qualified residential treatment program as defined 
150.2 	in section 260C.007, subdivision 26d, or moves a child from one qualified residential 
150.3 	treatment program to a different qualified residential treatment program, the agency must 
150.4 	update the child's out-of-home placement plan within 60 days. To meet the requirements 
150.5 	of section 260C.708, the agency must file the child's out-of-home placement plan along 
150.6 	with the agency's report seeking the court's approval of the child's placement at a qualified 
150.7 	residential treatment program under section 260C.71. After the court issues an order, the 
150.8 	agency must update the child's out-of-home placement plan to document the court's approval 
150.9 	or disapproval of the child's placement in a qualified residential treatment program;
150.10 	(3) when the agency places a child with the child's parent in a licensed residential 
150.11 	family-based substance use disorder treatment program under section 260C.190, the agency 
150.12 	must identify the treatment program where the child will be placed in the child's out-of-home 
150.13 	placement plan prior to the child's placement. The agency must file the child's out-of-home 
150.14 	placement plan summary and out-of-home placement plan with the court at the next required 
150.15 	review hearing; and
150.16 	(4) under sections 260C.227 and 260C.521, the agency must update the child's
150.17 	out-of-home placement plan summary and out-of-home placement plan and file the child's 
150.18 	out-of-home placement plan with the court.
150.19 	(b) When none of the items in paragraph (a) apply, the agency must update the child's
150.20 	out-of-home placement plan summary and out-of-home placement plan no later than 180 
150.21 	days after the child's initial placement and every six months thereafter, consistent with 
150.22 	section 260C.203, paragraph (a).

150.23 	Sec. 26. Minnesota Statutes 2024, section 260C.221, subdivision 2, is amended to read:
150.24 		Subd. 2.Relative notice requirements. (a) The agency may provide oral or written 
150.25 	notice to a child's relatives. In the child's case record, the agency must document providing 
150.26 	the required notice to each of the child's relatives. The responsible social services agency 
150.27 	must notify relatives:
150.28 	(1) of the need for a foster home for the child, the option to become a placement resource 
150.29 	for the child, the order of placement that the agency will consider under section 260C.212, 
150.30 	subdivision 2, paragraph (a), and the possibility of the need for a permanent placement for 
150.31 	the child;
150.32 	(2) of their responsibility to keep the responsible social services agency and the court 
150.33 	informed of their current address in order to receive notice in the event that a permanent 
151.1 	placement is sought for the child and to receive notice of the permanency progress review 
151.2 	hearing under section 260C.204. A relative who fails to provide a current address to the 
151.3 	responsible social services agency and the court forfeits the right to receive notice of the 
151.4 	possibility of permanent placement and of the permanency progress review hearing under 
151.5 	section 260C.204, until the relative provides a current address to the responsible social 
151.6 	services agency and the court. A decision by a relative not to be identified as a potential 
151.7 	permanent placement resource or participate in planning for the child shall not affect whether 
151.8 	the relative is considered for placement of, or as a permanency resource for, the child with 
151.9 	that relative at any time in the case, and shall not be the sole basis for the court to rule out 
151.10 	the relative as the child's placement or permanency resource;
151.11 	(3) that the relative may participate in the care and planning for the child, as specified 
151.12 	in subdivision 3, including that the opportunity for such participation may be lost by failing 
151.13 	to respond to the notice sent under this subdivision;
151.14 	(4) of the family foster care licensing and adoption home study requirements and supports, 
151.15 	including how to complete an application and how to request a variance from licensing 
151.16 	standards that do not present a safety or health risk to the child in the home under section 
151.17 	142B.10 and supports that are available for relatives and children who reside in a family 
151.18 	foster home;:
151.19 	(i) the choice between county or private agency licensing and services under section 
151.20 	142B.05, subdivision 3;
151.21 	(ii) how to complete an application;
151.22 	(iii) how to request a variance from licensing standards that do not present a safety or 
151.23 	health risk to the child in the home under section 142B.10; and
151.24 	(iv) supports that are available for relatives and children who reside in a family foster 
151.25 	home, including but not limited to ways to include resource or substitute caregivers in the 
151.26 	child's case plan, strategies for leveraging the child and family's natural supports, and how 
151.27 	to access legal services and support and respite care;
151.28 	(5) of the relatives' right to ask to be notified of any court proceedings regarding the 
151.29 	child, to attend the hearings, and of a relative's right to be heard by the court as required 
151.30 	under section 260C.152, subdivision 5;
151.31 	(6) that regardless of the relative's response to the notice sent under this subdivision, the 
151.32 	agency is required to establish permanency for a child, including planning for alternative 
151.33 	permanency options if the agency's reunification efforts fail or are not required; and
152.1 	(7) that by responding to the notice, a relative may receive information about participating 
152.2 	in a child's family and permanency team if the child is placed in a qualified residential 
152.3 	treatment program as defined in section 260C.007, subdivision 26d.
152.4 	(b) The responsible social services agency shall send the notice required under paragraph 
152.5 	(a) to relatives who become known to the responsible social services agency, except for 
152.6 	relatives that the agency does not contact due to safety reasons under subdivision 5, paragraph 
152.7 	(b). The responsible social services agency shall continue to send notice to relatives 
152.8 	notwithstanding a court's finding that the agency has made reasonable efforts to conduct a 
152.9 	relative search.
152.10 	(c) The responsible social services agency is not required to send the notice under 
152.11 	paragraph (a) to a relative who becomes known to the agency after an adoption placement 
152.12 	agreement has been fully executed under section 260C.613, subdivision 1. If the relative 
152.13 	wishes to be considered for adoptive placement of the child, the agency shall inform the 
152.14 	relative of the relative's ability to file a motion for an order for adoptive placement under 
152.15 	section 260C.607, subdivision 6.

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

152.17 	Sec. 27. Minnesota Statutes 2024, section 260C.223, subdivision 1, is amended to read:
152.18 		Subdivision 1.Program; goals. (a) The commissioner of children, youth, and families 
152.19 	shall establish a program for concurrent permanency planning for child protection services.
152.20 	(b) Concurrent permanency planning involves a planning process for children who are 
152.21 	placed out of the home of their parents pursuant to a court order, or who have been voluntarily 
152.22 	placed out of the home by the parents for 60 days or more and who are not developmentally 
152.23 	disabled or emotionally disabled under section 260C.212, subdivision 9. The responsible 
152.24 	social services agency shall develop an alternative permanency plan while making reasonable 
152.25 	efforts for reunification of the child with the family, if required by section 260.012. The 
152.26 	goals of concurrent permanency planning are to:
152.27 	(1) achieve early permanency for children;
152.28 	(2) decrease children's length of stay in foster care and reduce the number of moves 
152.29 	children experience in foster care; and
152.30 	(3) develop a group of families establish a foster parent for a child who will work towards
152.31 	toward reunification and also serve as a permanent families family for children.

153.1 	Sec. 28. Minnesota Statutes 2024, section 260C.223, subdivision 2, is amended to read:
153.2 		Subd. 2.Development of guidelines and protocols. (a) The commissioner shall establish 
153.3 	guidelines and protocols for social services agencies involved in concurrent permanency 
153.4 	planning, including criteria for conducting concurrent permanency planning based on relevant 
153.5 	factors such as:
153.6 	(1) age of the child and duration of out-of-home placement;
153.7 	(2) prognosis for successful reunification with parents;
153.8 	(3) availability of relatives and other concerned individuals to provide support or a 
153.9 	permanent placement for the child; and
153.10 	(4) special needs of the child and other factors affecting the child's best interests.
153.11 	(b) In developing the guidelines and protocols, the commissioner shall consult with 
153.12 	interest groups within the child protection system, including child protection workers, child 
153.13 	protection advocates, county attorneys, law enforcement, community service organizations, 
153.14 	the councils of color, and the ombudsperson for families.
153.15 	(c) The responsible social services agency must not make a foster family the permanent 
153.16 	home for a child until:
153.17 	(1) inquiry and Tribal notice requirements under section 260.761, subdivisions 1 and 2, 
153.18 	are satisfied;
153.19 	(2) inquiry about the child's heritage, including their race, culture, and ethnicity pursuant 
153.20 	to section 260.63, subdivision 10, has been completed; and
153.21 	(3) the court has determined that reasonable or active efforts toward completing the 
153.22 	relative search requirements in section 260C.221 have been made.

153.23 	Sec. 29. Minnesota Statutes 2024, section 260C.329, subdivision 3, is amended to read:
153.24 		Subd. 3.Petition. (a) The following individuals may file a petition for the reestablishment 
153.25 	of the legal parent and child relationship:
153.26 	(1) county attorney,;
153.27 	(2) a parent whose parental rights were terminated under a previous order of the court,;
153.28 	(3) a parent whose voluntary consent to adoption was accepted by the court and:
153.29 	(i) the identified prospective adoptive parent did not finalize the adoption; or
154.1 	(ii) the adoption finalized but subsequently dissolved and the child returned to foster 
154.2 	care and guardianship of the commissioner;
154.3 	(4) a child who is ten years of age or older,;
154.4 	(5) the responsible social services agency,; or
154.5 	(6) a guardian ad litem may file a petition for the reestablishment of the legal parent and 
154.6 	child relationship.
154.7 	(b) A parent filing a petition under this section shall pay a filing fee in the amount 
154.8 	required under section 357.021, subdivision 2, clause (1). The filing fee may be waived 
154.9 	pursuant to chapter 563. A petition for the reestablishment of the legal parent and child 
154.10 	relationship may be filed when:
154.11 	(1) the parent has corrected the conditions that led to an order terminating parental rights;
154.12 	(2) the parent is willing and has the capability to provide day-to-day care and maintain 
154.13 	the health, safety, and welfare of the child;
154.14 	(3) the child has been in foster care for at least 24 months after the court issued the order 
154.15 	terminating parental rights;
154.16 	(4) the child has is not been currently adopted; and
154.17 	(5) the child is not the subject of a written adoption placement agreement between the 
154.18 	responsible social services agency and the prospective adoptive parent, as required under 
154.19 	Minnesota Rules, part 9560.0060, subpart 2.

154.20 	Sec. 30. Minnesota Statutes 2024, section 260C.329, subdivision 8, is amended to read:
154.21 		Subd. 8.Hearing. The court may grant the petition ordering the reestablishment of the 
154.22 	legal parent and child relationship only if it finds by clear and convincing evidence that:
154.23 	(1) reestablishment of the legal parent and child relationship is in the child's best interests;
154.24 	(2) the child has is not been currently adopted;
154.25 	(3) the child is not the subject of a written adoption placement agreement between the 
154.26 	responsible social services agency and the prospective adoptive parent, as required under 
154.27 	Minnesota Rules, part 9560.0060, subpart 2;
154.28 	(4) at least 24 months have elapsed following a final order terminating parental rights 
154.29 	and the child remains in foster care;
154.30 	(5) the child desires to reside with the parent;
155.1 	(6) the parent has corrected the conditions that led to an order terminating parental rights; 
155.2 	and
155.3 	(7) the parent is willing and has the capability to provide day-to-day care and maintain 
155.4 	the health, safety, and welfare of the child.

155.5 	Sec. 31. Minnesota Statutes 2024, section 260C.451, subdivision 9, is amended to read:
155.6 		Subd. 9.Administrative or court review of placements. (a) The court shall must
155.7 	conduct reviews at least annually to ensure the responsible social services agency is making 
155.8 	reasonable efforts to finalize the permanency plan for the child.
155.9 	(b) The responsible social services agency must file a written report with the court 
155.10 	containing or attaching the following:
155.11 	(1) the child's name, date of birth, race, gender, and current address;
155.12 	(2) a written summary describing planning with the child, including supports and services 
155.13 	to ensure the child's safety, housing stability, well-being needs, and independent living 
155.14 	skills;
155.15 	(3) the child's most recent out-of-home placement plan and independent living plan 
155.16 	required under section 260C.212, subdivision 1;
155.17 	(4) if the child's plan is to not continue in extended foster care or if the child will reach 
155.18 	age 21 before the next review, a copy of their 180-day transition plan as required in section 
155.19 	260C.452, subdivision 4; and
155.20 	(5) if the agency plans to transition the child into adult services, a summary of the 
155.21 	transition plan as required in section 260C.452, subdivision 4, and how this plan is in the 
155.22 	child's best interest.
155.23 	(b) (c) The court shall must find that the responsible social services agency is making 
155.24 	reasonable efforts to finalize the permanency plan for the child when the responsible social 
155.25 	services agency:
155.26 	(1) provides appropriate support to the child and caregiver or foster care provider parent
155.27 	to ensure continuing stability and success in placement;
155.28 	(2) works with the child to plan for transition to adulthood and assists the child in 
155.29 	demonstrating progress in achieving related goals;
155.30 	(3) works with the child to plan for independent living skills and assists the child in 
155.31 	demonstrating progress in achieving independent living goals; and
156.1 	(4) prepares the child for independence according to sections 260C.203, paragraph (d), 
156.2 	and 260C.452, subdivision 4.
156.3 	(c) (d) The responsible social services agency must ensure that an administrative review 
156.4 	that meets the requirements of this section and section 260C.203 is completed at least six 
156.5 	months after each of the court's annual reviews.

156.6 	Sec. 32. Minnesota Statutes 2024, section 260C.452, subdivision 4, is amended to read:
156.7 		Subd. 4.Administrative or court review of placements. (a) When the youth is 14 years 
156.8 	of age or older, the court, in consultation with the youth, shall review the youth's independent 
156.9 	living plan according to section 260C.203, paragraph (d).
156.10 	(b) The responsible social services agency shall file a copy of the notification of foster 
156.11 	care benefits for a youth who is 18 years of age or older according to section 260C.451, 
156.12 	subdivision 1, with the court. If the responsible social services agency does not file the 
156.13 	notice by the time the youth is 17-1/2 years of age, the court shall require the responsible 
156.14 	social services agency to file the notice.
156.15 	(c) When a youth is 18 years of age or older, the court shall ensure that the responsible 
156.16 	social services agency assists the youth in obtaining the following documents before the 
156.17 	youth leaves foster care: a Social Security card; an official or certified copy of the youth's 
156.18 	birth certificate; a state identification card or driver's license, Tribal enrollment identification 
156.19 	card, green permanent resident card, or school visa; health insurance information; the youth's 
156.20 	school, medical, and dental records; a contact list of the youth's medical, dental, and mental 
156.21 	health providers; and contact information for the youth's siblings, if the siblings are in foster 
156.22 	care.
156.23 	(d) For a youth who will be discharged from foster care at 18 years of age or older 
156.24 	because the youth is not eligible for extended foster care benefits or chooses to leave foster 
156.25 	care, the responsible social services agency must develop a personalized transition plan as 
156.26 	directed by the youth during the 180-day period immediately prior to the expected date of 
156.27 	discharge. The transition plan must be as detailed as the youth elects and include specific 
156.28 	options, including but not limited to:
156.29 	(1) affordable housing with necessary supports that does not include a homeless shelter;
156.30 	(2) health insurance, including eligibility for medical assistance as defined in section 
156.31 	256B.055, subdivision 17;
156.32 	(3) education, including application to the Education and Training Voucher Program;
157.1 	(4) local opportunities for mentors and continuing support services;
157.2 	(5) workforce supports and employment services;
157.3 	(6) a copy of the youth's consumer credit report as defined in section 13C.001 and 
157.4 	assistance in interpreting and resolving any inaccuracies in the report, at no cost to the youth;
157.5 	(7) information on executing a health care directive under chapter 145C and on the 
157.6 	importance of designating another individual to make health care decisions on behalf of the 
157.7 	youth if the youth becomes unable to participate in decisions;
157.8 	(8) appropriate contact information through 21 years of age if the youth needs information 
157.9 	or help dealing with a crisis situation; and
157.10 	(9) official documentation that the youth was previously in foster care.

157.11 	Sec. 33. Minnesota Statutes 2024, section 260E.03, subdivision 15, is amended to read:
157.12 		Subd. 15.Neglect. (a) "Neglect" means the commission or omission of any of the acts 
157.13 	specified under clauses (1) to (8), other than by accidental means:
157.14 	(1) failure by a person responsible for a child's care to supply a child with necessary 
157.15 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
157.16 	mental health when reasonably able to do so;
157.17 	(2) failure to protect a child from conditions or actions that seriously endanger the child's 
157.18 	physical or mental health when reasonably able to do so, including a growth delay, which 
157.19 	may be referred to as a failure to thrive, that has been diagnosed by a physician and is due 
157.20 	to parental neglect;
157.21 	(3) failure to provide for necessary supervision or child care arrangements appropriate 
157.22 	for a child after considering factors as the child's age, mental ability, physical condition, 
157.23 	length of absence, or environment, when the child is unable to care for the child's own basic 
157.24 	needs or safety, or the basic needs or safety of another child in their care;
157.25 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
157.26 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
157.27 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 
157.28 	5;
157.29 	(5) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 
157.30 	2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in 
157.31 	the child at birth, results of a toxicology test performed on the mother at delivery or the 
157.32 	child at birth, medical effects or developmental delays during the child's first year of life 
158.1 	that medically indicate prenatal exposure to a controlled substance, or the presence of a 
158.2 	fetal alcohol spectrum disorder;
158.3 	(6) medical neglect, as defined in section 260C.007, subdivision 6, clause (5);
158.4 	(7) chronic and severe use of alcohol or a controlled substance by a person responsible 
158.5 	for the child's care that adversely affects the child's basic needs and safety; or
158.6 	(8) emotional harm from a pattern of behavior that contributes to impaired emotional 
158.7 	functioning of the child which may be demonstrated by a substantial and observable effect 
158.8 	in the child's behavior, emotional response, or cognition that is not within the normal range 
158.9 	for the child's age and stage of development, with due regard to the child's culture.
158.10 	(b) Nothing in this chapter shall be construed to mean that a child is neglected solely 
158.11 	because the child's parent, guardian, or other person responsible for the child's care in good 
158.12 	faith selects and depends upon spiritual means or prayer for treatment or care of disease or 
158.13 	remedial care of the child in lieu of medical care.
158.14 	(c) This chapter does not impose upon persons not otherwise legally responsible for 
158.15 	providing a child with necessary food, clothing, shelter, education, or medical care a duty 
158.16 	to provide that care.
158.17 	(d) Nothing in this chapter shall be construed to mean that a child who has a mental, 
158.18 	physical, or emotional condition is neglected solely because the child remains in an 
158.19 	emergency department or hospital setting because services, including residential treatment, 
158.20 	that are deemed necessary by the child's medical or mental health care professional or county 
158.21 	case manager are not available to the child's parent, guardian, or other person responsible 
158.22 	for the child's care, and the child cannot be safely discharged to the child's family.

158.23 	Sec. 34. Minnesota Statutes 2024, section 260E.09, is amended to read:
158.24 	260E.09 REPORTING REQUIREMENTS.
158.25 	(a) An oral report shall be made immediately by telephone or otherwise. An oral report 
158.26 	made by a person required under section 260E.06, subdivision 1, to report shall be followed 
158.27 	within 72 hours, exclusive of weekends and holidays, by a report in writing to the appropriate 
158.28 	police department, the county sheriff, the agency responsible for assessing or investigating 
158.29 	the report, or the local welfare agency.
158.30 	(b) Any report shall be of sufficient content to identify the child, any person believed 
158.31 	to be responsible for the maltreatment of the child if the person is known, the nature and 
158.32 	extent of the maltreatment, and the name and address of the reporter. The local welfare 
159.1 	agency or agency responsible for assessing or investigating the report shall accept a report 
159.2 	made under section 260E.06 notwithstanding refusal by a reporter to provide the reporter's 
159.3 	name or address as long as the report is otherwise sufficient under this paragraph. The local 
159.4 	welfare agency or agency responsible for assessing or investigating the report shall ask the 
159.5 	reporter if the reporter is aware of the child or family heritage, including the child's Tribal 
159.6 	lineage pursuant to section 260.761 and their race, culture, and ethnicity pursuant to section 
159.7 	260.63, subdivision 10.
159.8 	(c) Notwithstanding paragraph (a), upon implementation of the provider licensing and 
159.9 	reporting hub, an individual who has an account with the provider licensing and reporting 
159.10 	hub and is required to report suspected maltreatment at a licensed program under section 
159.11 	260E.06, subdivision 1, may submit a written report in the hub in a manner prescribed by 
159.12 	the commissioner and is not required to make an oral report. A report submitted through 
159.13 	the provider licensing and reporting hub must be made immediately.

159.14 	Sec. 35. Minnesota Statutes 2024, section 260E.20, subdivision 1, is amended to read:
159.15 		Subdivision 1.General duties. (a) The local welfare agency shall offer services to 
159.16 	prevent future maltreatment, safeguarding and enhancing the welfare of the maltreated child, 
159.17 	and supporting and preserving family life whenever possible.
159.18 	(b) If the report alleges a violation of a criminal statute involving maltreatment or child 
159.19 	endangerment under section 609.378, the local law enforcement agency and local welfare 
159.20 	agency shall coordinate the planning and execution of their respective investigation and 
159.21 	assessment efforts to avoid a duplication of fact-finding efforts and multiple interviews. 
159.22 	Each agency shall prepare a separate report of the results of the agency's investigation or 
159.23 	assessment.
159.24 	(c) In cases of alleged child maltreatment resulting in death, the local agency may rely 
159.25 	on the fact-finding efforts of a law enforcement investigation to make a determination of 
159.26 	whether or not maltreatment occurred.
159.27 	(d) When necessary, the local welfare agency shall seek authority to remove the child 
159.28 	from the custody of a parent, guardian, or adult with whom the child is living.
159.29 	(e) In performing any of these duties, the local welfare agency shall maintain an 
159.30 	appropriate record.
159.31 	(f) In conducting a family assessment, noncaregiver human trafficking assessment, or 
159.32 	investigation, the local welfare agency shall gather information on the existence of substance 
159.33 	abuse and domestic violence.
160.1 	(g) If the family assessment, noncaregiver human trafficking assessment, or investigation 
160.2 	indicates there is a potential for abuse of alcohol or other drugs by the parent, guardian, or 
160.3 	person responsible for the child's care, the local welfare agency must coordinate a 
160.4 	comprehensive assessment pursuant to section 245G.05.
160.5 	(h) The agency may use either a family assessment or investigation to determine whether 
160.6 	the child is safe when responding to a report resulting from birth match data under section 
160.7 	260E.03, subdivision 23, paragraph (c). If the child subject of birth match data is determined 
160.8 	to be safe, the agency shall consult with the county attorney to determine the appropriateness 
160.9 	of filing a petition alleging the child is in need of protection or services under section 
160.10 	260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is 
160.11 	determined not to be safe, the agency and the county attorney shall take appropriate action 
160.12 	as required under section 260C.503, subdivision 2.
160.13 	(i) When conducting any assessment or investigation, the agency shall ask the child, if 
160.14 	age appropriate; parents; extended family; and reporter about the child's family heritage, 
160.15 	including the child's Tribal lineage pursuant to section 260.761 and the child's race, culture, 
160.16 	and ethnicity pursuant to section 260.63, subdivision 10.

160.17 	Sec. 36. Minnesota Statutes 2024, section 260E.20, subdivision 3, is amended to read:
160.18 		Subd. 3.Collection of information. (a) The local welfare agency responsible for 
160.19 	conducting a family assessment, noncaregiver human trafficking assessment, or investigation 
160.20 	shall collect available and relevant information to determine child safety, risk of subsequent 
160.21 	maltreatment, and family strengths and needs and share not public information with an 
160.22 	Indian's Tribal social services agency without violating any law of the state that may 
160.23 	otherwise impose a duty of confidentiality on the local welfare agency in order to implement 
160.24 	the Tribal state agreement.
160.25 	(b) The local welfare agency or the agency responsible for investigating the report shall 
160.26 	collect available and relevant information to ascertain whether maltreatment occurred and 
160.27 	whether protective services are needed.
160.28 	(c) Information collected includes, when relevant, information regarding the person 
160.29 	reporting the alleged maltreatment, including the nature of the reporter's relationship to the 
160.30 	child and to the alleged offender, and the basis of the reporter's knowledge for the report; 
160.31 	the child allegedly being maltreated; the alleged offender; the child's caretaker; and other 
160.32 	collateral sources having relevant information related to the alleged maltreatment.
161.1 	(d) Information relevant to the assessment or investigation must be requested, and may 
161.2 	include:
161.3 	(1) the child's sex and age; prior reports of maltreatment, including any maltreatment 
161.4 	reports that were screened out and not accepted for assessment or investigation; information 
161.5 	relating to developmental functioning; credibility of the child's statement; and whether the 
161.6 	information provided under this clause is consistent with other information collected during 
161.7 	the course of the assessment or investigation;
161.8 	(2) except in a noncaregiver human trafficking assessment, the alleged offender's age, 
161.9 	a record check for prior reports of maltreatment, and criminal charges and convictions;
161.10 	(3) collateral source information regarding the alleged maltreatment and care of the 
161.11 	child. Collateral information includes, when relevant: (i) a medical examination of the child; 
161.12 	(ii) prior medical records relating to the alleged maltreatment or the care of the child 
161.13 	maintained by any facility, clinic, or health care professional and an interview with the 
161.14 	treating professionals; and (iii) interviews with the child's caretakers, including the child's 
161.15 	parent, guardian, foster parent, child care provider, teachers, counselors, family members, 
161.16 	relatives, and other persons who may have knowledge regarding the alleged maltreatment 
161.17 	and the care of the child; and
161.18 	(4) information on the existence of domestic abuse and violence in the home of the child, 
161.19 	and substance abuse.
161.20 	(e) Nothing in this subdivision precludes the local welfare agency, the local law 
161.21 	enforcement agency, or the agency responsible for assessing or investigating the report from 
161.22 	collecting other relevant information necessary to conduct the assessment or investigation.
161.23 	(f) Notwithstanding section 13.384 or 144.291 to 144.298, the local welfare agency has 
161.24 	access to medical data and records for purposes of paragraph (d), clause (3).

161.25 	Sec. 37. [260E.215] REPORTING OF SCHOOL ATTENDANCE CONCERNS.
161.26 		Subdivision 1.Reports required. (a) A person mandated to report under this chapter 
161.27 	must immediately report to the local welfare agency or designated partner if the person 
161.28 	knows or has reason to believe that a child required to be enrolled in school under section 
161.29 	120A.22 has at least seven unexcused absences in the current school year and is at risk of 
161.30 	educational neglect or truancy under section 260C.163, subdivision 11.
161.31 	(b) Any person may make a voluntary report if the person knows or has reason to believe 
161.32 	that a child required to be enrolled in school under section 120A.22 has at least seven 
162.1 	unexcused absences in the current school year and is at risk of educational neglect or truancy 
162.2 	under section 260C.163, subdivision 11.
162.3 	(c) An oral report must be made immediately. An oral report made by a person required 
162.4 	to report under paragraph (a) must be followed within 72 hours, exclusive of weekends and 
162.5 	holidays, by a report in writing to the local welfare agency. A report must sufficiently 
162.6 	identify the child and the child's parent or guardian, the actual or estimated number of the 
162.7 	child's unexcused absences in the current school year, the efforts made by school officials 
162.8 	to resolve attendance concerns with the family, and the name and address of the reporter. 
162.9 	A voluntary reporter under paragraph (b) may refuse to provide their name or address if the 
162.10 	report is otherwise sufficient, and the local welfare agency must accept such a report.
162.11 		Subd. 2.Local welfare agency. (a) The local welfare agency or partner designated to 
162.12 	provide child welfare services must provide a child welfare response for a report that alleges 
162.13 	a child enrolled in school has seven or more unexcused absences. When providing a child 
162.14 	welfare response under this paragraph, the local welfare agency or designated partner must 
162.15 	offer services to the child and the child's family to address school attendance concerns or 
162.16 	may partner with a county attorney's office, a community-based organization, or other 
162.17 	community partner to provide the services. The services must be culturally and linguistically 
162.18 	appropriate and tailored to the needs of the child and the child's family. This section is 
162.19 	subject to the requirements of the Minnesota Indian Family Preservation Act under sections 
162.20 	260.751 to 260.835 and the Minnesota African American Family Preservation and Child 
162.21 	Welfare Disproportionality Act under sections 260.61 to 260.693.
162.22 	(b) If the unexcused absences continue and the family has not engaged with services 
162.23 	under paragraph (a) after the local welfare agency or partner designated to provide child 
162.24 	welfare services has made multiple varied attempts to engage the child's family, a report of 
162.25 	educational neglect must be made regardless of the number of unexcused absences the child 
162.26 	has accrued. The local welfare agency must determine the response path assignment pursuant 
162.27 	to section 260E.17 and may proceed with the process outlined in section 260C.141.

162.28 	Sec. 38. Minnesota Statutes 2024, section 260E.24, subdivision 1, is amended to read:
162.29 		Subdivision 1.Timing. The local welfare agency shall conclude the family assessment, 
162.30 	the noncaregiver human trafficking assessment, or the investigation within 45 days of the 
162.31 	receipt of a report. The conclusion of the assessment or investigation may be extended to 
162.32 	permit the completion of a criminal investigation or the receipt of expert information 
162.33 	requested within 45 days of the receipt of the report.

163.1 	Sec. 39. Minnesota Statutes 2024, section 260E.24, subdivision 2, is amended to read:
163.2 		Subd. 2.Determination after family assessment or a noncaregiver human trafficking 
163.3 	assessment. After conducting a family assessment or a noncaregiver human trafficking 
163.4 	assessment, the local welfare agency shall determine whether child protective services are 
163.5 	needed to address the safety of the child and other family members and the risk of subsequent 
163.6 	maltreatment. The local welfare agency must document the information collected under 
163.7 	section 260E.20, subdivision 3, related to the completed family assessment or noncaregiver 
163.8 	human trafficking assessment in the child's or family's case notes.

163.9 	Sec. 40. REVISOR INSTRUCTION.
 163.10 	The revisor of statutes shall change paragraphs to subdivisions, clauses to paragraphs, 
163.11 	and items to clauses in Minnesota Statutes, sections 260C.203 and 260C.204. The revisor 
163.12 	shall make any necessary grammatical changes or changes to sentence structure necessary 
163.13 	to preserve the meaning of the text as a result of the changes. The revisor of statutes must 
163.14 	correct any statutory cross-references consistent with the changes in this section.

163.15 	ARTICLE 9
163.16 	CHILD PROTECTION AND WELFARE FINANCE

163.17 	Section 1. Minnesota Statutes 2024, section 142A.03, subdivision 2, is amended to read:
163.18 		Subd. 2.Duties of the commissioner. (a) The commissioner may apply for and accept 
163.19 	on behalf of the state any grants, bequests, gifts, or contributions for the purpose of carrying 
163.20 	out the duties and responsibilities of the commissioner. Any money received under this 
163.21 	paragraph is appropriated and dedicated for the purpose for which the money is granted. 
163.22 	The commissioner must biennially report to the chairs and ranking minority members of 
163.23 	relevant legislative committees and divisions by January 15 of each even-numbered year a 
163.24 	list of all grants and gifts received under this subdivision.
163.25 	(b) Pursuant to law, the commissioner may apply for and receive money made available 
163.26 	from federal sources for the purpose of carrying out the duties and responsibilities of the 
163.27 	commissioner.
163.28 	(c) The commissioner may make contracts with and grants to Tribal Nations, public and 
163.29 	private agencies, for-profit and nonprofit organizations, and individuals using appropriated 
163.30 	money.
163.31 	(d) The commissioner must develop program objectives and performance measures for 
163.32 	evaluating progress toward achieving the objectives. The commissioner must identify the 
164.1 	objectives, performance measures, and current status of achieving the measures in a biennial 
164.2 	report to the chairs and ranking minority members of relevant legislative committees and 
164.3 	divisions. The report is due no later than January 15 each even-numbered year. The report 
164.4 	must include, when possible, the following objectives:
164.5 	(1) centering and including the lived experiences of children and youth, including those 
164.6 	with disabilities and mental illness and their families, in all aspects of the department's work;
164.7 	(2) increasing the effectiveness of the department's programs in addressing the needs of 
164.8 	children and youth facing racial, economic, or geographic inequities;
164.9 	(3) increasing coordination and reducing inefficiencies among the department's programs 
164.10 	and the funding sources that support the programs;
164.11 	(4) increasing the alignment and coordination of family access to child care and early 
164.12 	learning programs and improving systems of support for early childhood and learning 
164.13 	providers and services;
164.14 	(5) improving the connection between the department's programs and the kindergarten 
164.15 	through grade 12 and higher education systems; and
164.16 	(6) minimizing and streamlining the effort required of youth and families to receive 
164.17 	services to which the youth and families are entitled.
164.18 	(e) The commissioner shall administer and supervise the forms of public assistance and 
164.19 	other activities or services that are vested in the commissioner. Administration and 
164.20 	supervision of activities or services includes but is not limited to assuring timely and accurate 
164.21 	distribution of benefits, completeness of service, and quality program management. In 
164.22 	addition to administering and supervising activities vested by law in the department, the 
164.23 	commissioner has the authority to:
164.24 	(1) require county agency participation in training and technical assistance programs to 
164.25 	promote compliance with statutes, rules, federal laws, regulations, and policies governing 
164.26 	the programs and activities administered by the commissioner;
164.27 	(2) monitor, on an ongoing basis, the performance of county agencies in the operation 
164.28 	and administration of activities and programs; enforce compliance with statutes, rules, 
164.29 	federal laws, regulations, and policies governing welfare services; and promote excellence 
164.30 	of administration and program operation;
164.31 	(3) develop a quality control program or other monitoring program to review county 
164.32 	performance and accuracy of benefit determinations;
165.1 	(4) require county agencies to make an adjustment to the public assistance benefits issued 
165.2 	to any individual consistent with federal law and regulation and state law and rule and to 
165.3 	issue or recover benefits as appropriate;
165.4 	(5) delay or deny payment of all or part of the state and federal share of benefits and 
165.5 	administrative reimbursement according to the procedures set forth in section 142A.10;
165.6 	(6) make contracts with and grants to public and private agencies and organizations, 
165.7 	both for-profit and nonprofit, and individuals, using appropriated funds; and
165.8 	(7) enter into contractual agreements with federally recognized Indian Tribes with a 
165.9 	reservation in Minnesota to the extent necessary for the Tribe to operate a federally approved 
165.10 	family assistance program or any other program under the supervision of the commissioner. 
165.11 	The commissioner shall consult with the affected county or counties in the contractual 
165.12 	agreement negotiations, if the county or counties wish to be included, in order to avoid the 
165.13 	duplication of county and Tribal assistance program services. The commissioner may 
165.14 	establish necessary accounts for the purposes of receiving and disbursing funds as necessary 
165.15 	for the operation of the programs.
165.16 	The commissioner shall work in conjunction with the commissioner of human services to 
165.17 	carry out the duties of this paragraph when necessary and feasible.
165.18 	(f) The commissioner shall inform county agencies, on a timely basis, of changes in 
165.19 	statute, rule, federal law, regulation, and policy necessary to county agency administration 
165.20 	of the programs and activities administered by the commissioner.
165.21 	(g) The commissioner shall administer and supervise child welfare activities, including 
165.22 	promoting the enforcement of laws preventing child maltreatment and protecting children 
165.23 	with a disability and children who are in need of protection or services, licensing and 
165.24 	supervising child care and child-placing agencies, and supervising the care of children in 
165.25 	foster care. The commissioner shall coordinate with the commissioner of human services 
165.26 	on activities impacting children overseen by the Department of Human Services, such as 
165.27 	disability services, behavioral health, and substance use disorder treatment.
165.28 	(h) The commissioner shall assist and cooperate with local, state, and federal departments, 
165.29 	agencies, and institutions.
165.30 	(i) The commissioner shall establish and maintain any administrative units reasonably 
165.31 	necessary for the performance of administrative functions common to all divisions of the 
165.32 	department.
166.1 	(j) The commissioner shall act as designated guardian of children pursuant to chapter 
166.2 	260C. For children under the guardianship of the commissioner or a Tribe in Minnesota 
166.3 	recognized by the Secretary of the Interior whose interests would be best served by adoptive 
166.4 	placement, the commissioner may contract with a licensed child-placing agency or a 
166.5 	Minnesota Tribal social services agency to provide adoption services. For children in 
166.6 	out-of-home care whose interests would be best served by a transfer of permanent legal and 
166.7 	physical custody to a relative under section 260C.515, subdivision 4, or equivalent in Tribal 
166.8 	code, the commissioner may contract with a licensed child-placing agency or a Minnesota 
166.9 	Tribal social services agency to provide permanency services. A contract with a licensed 
166.10 	child-placing agency must be designed to supplement existing county efforts and may not 
166.11 	replace existing county programs or Tribal social services, unless the replacement is agreed 
166.12 	to by the county board and the appropriate exclusive bargaining representative, Tribal 
166.13 	governing body, or the commissioner has evidence that child placements of the county 
166.14 	continue to be substantially below that of other counties. Funds encumbered and obligated 
166.15 	under an agreement for a specific child shall remain available until the terms of the agreement 
166.16 	are fulfilled or the agreement is terminated.
166.17 	(k) The commissioner has the authority to conduct and administer experimental projects 
166.18 	to test methods and procedures of administering assistance and services to recipients or 
166.19 	potential recipients of public benefits. To carry out the experimental projects, the 
166.20 	commissioner may waive the enforcement of existing specific statutory program 
166.21 	requirements, rules, and standards in one or more counties. The order establishing the waiver 
166.22 	must provide alternative methods and procedures of administration and must not conflict 
166.23 	with the basic purposes, coverage, or benefits provided by law. No project under this 
166.24 	paragraph shall exceed four years. No order establishing an experimental project as authorized 
166.25 	by this paragraph is effective until the following conditions have been met:
166.26 	(1) the United States Secretary of Health and Human Services has agreed, for the same 
166.27 	project, to waive state plan requirements relative to statewide uniformity; and
166.28 	(2) a comprehensive plan, including estimated project costs, has been approved by the 
166.29 	Legislative Advisory Commission and filed with the commissioner of administration.
166.30 	(l) The commissioner shall, according to federal requirements and in coordination with 
166.31 	the commissioner of human services, establish procedures to be followed by local welfare 
166.32 	boards in creating citizen advisory committees, including procedures for selection of 
166.33 	committee members.
167.1 	(m) The commissioner shall allocate federal fiscal disallowances or sanctions that are 
167.2 	based on quality control error rates for the aid to families with dependent children (AFDC) 
167.3 	program formerly codified in sections 256.72 to 256.87 or the Supplemental Nutrition 
167.4 	Assistance Program (SNAP) in the following manner:
167.5 	(1) one-half of the total amount of the disallowance shall be borne by the county boards 
167.6 	responsible for administering the programs. For AFDC, disallowances shall be shared by 
167.7 	each county board in the same proportion as that county's expenditures to the total of all 
167.8 	counties' expenditures for AFDC. For SNAP, sanctions shall be shared by each county 
167.9 	board, with 50 percent of the sanction being distributed to each county in the same proportion 
167.10 	as that county's administrative costs for SNAP benefits are to the total of all SNAP 
167.11 	administrative costs for all counties, and 50 percent of the sanctions being distributed to 
167.12 	each county in the same proportion as that county's value of SNAP benefits issued are to 
167.13 	the total of all benefits issued for all counties. Each county shall pay its share of the 
167.14 	disallowance to the state of Minnesota. When a county fails to pay the amount due under 
167.15 	this paragraph, the commissioner may deduct the amount from reimbursement otherwise 
167.16 	due the county, or the attorney general, upon the request of the commissioner, may institute 
167.17 	civil action to recover the amount due; and
167.18 	(2) notwithstanding the provisions of clause (1), if the disallowance results from knowing 
167.19 	noncompliance by one or more counties with a specific program instruction, and that knowing 
167.20 	noncompliance is a matter of official county board record, the commissioner may require 
167.21 	payment or recover from the county or counties, in the manner prescribed in clause (1), an 
167.22 	amount equal to the portion of the total disallowance that resulted from the noncompliance 
167.23 	and may distribute the balance of the disallowance according to clause (1).
167.24 	(n) The commissioner shall develop and implement special projects that maximize 
167.25 	reimbursements and result in the recovery of money to the state. For the purpose of recovering 
167.26 	state money, the commissioner may enter into contracts with third parties. Any recoveries 
167.27 	that result from projects or contracts entered into under this paragraph shall be deposited 
167.28 	in the state treasury and credited to a special account until the balance in the account reaches 
167.29 	$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be 
167.30 	transferred and credited to the general fund. All money in the account is appropriated to the 
167.31 	commissioner for the purposes of this paragraph.
167.32 	(o) The commissioner has the authority to establish and enforce the following county 
167.33 	reporting requirements:
168.1 	(1) the commissioner shall establish fiscal and statistical reporting requirements necessary 
168.2 	to account for the expenditure of funds allocated to counties for programs administered by 
168.3 	the commissioner. When establishing financial and statistical reporting requirements, the 
168.4 	commissioner shall evaluate all reports, in consultation with the counties, to determine if 
168.5 	the reports can be simplified or the number of reports can be reduced;
168.6 	(2) the county board shall submit monthly or quarterly reports to the department as 
168.7 	required by the commissioner. Monthly reports are due no later than 15 working days after 
168.8 	the end of the month. Quarterly reports are due no later than 30 calendar days after the end 
168.9 	of the quarter, unless the commissioner determines that the deadline must be shortened to 
168.10 	20 calendar days to avoid jeopardizing compliance with federal deadlines or risking a loss 
168.11 	of federal funding. Only reports that are complete, legible, and in the required format shall 
168.12 	be accepted by the commissioner;
168.13 	(3) if the required reports are not received by the deadlines established in clause (2), the 
168.14 	commissioner may delay payments and withhold funds from the county board until the next 
168.15 	reporting period. When the report is needed to account for the use of federal funds and the 
168.16 	late report results in a reduction in federal funding, the commissioner shall withhold from 
168.17 	the county boards with late reports an amount equal to the reduction in federal funding until 
168.18 	full federal funding is received;
168.19 	(4) a county board that submits reports that are late, illegible, incomplete, or not in the 
168.20 	required format for two out of three consecutive reporting periods is considered 
168.21 	noncompliant. When a county board is found to be noncompliant, the commissioner shall 
168.22 	notify the county board of the reason the county board is considered noncompliant and 
168.23 	request that the county board develop a corrective action plan stating how the county board 
168.24 	plans to correct the problem. The corrective action plan must be submitted to the 
168.25 	commissioner within 45 days after the date the county board received notice of 
168.26 	noncompliance;
168.27 	(5) the final deadline for fiscal reports or amendments to fiscal reports is one year after 
168.28 	the date the report was originally due. If the commissioner does not receive a report by the 
168.29 	final deadline, the county board forfeits the funding associated with the report for that 
168.30 	reporting period and the county board must repay any funds associated with the report 
168.31 	received for that reporting period;
168.32 	(6) the commissioner may not delay payments, withhold funds, or require repayment 
168.33 	under clause (3) or (5) if the county demonstrates that the commissioner failed to provide 
168.34 	appropriate forms, guidelines, and technical assistance to enable the county to comply with 
169.1 	the requirements. If the county board disagrees with an action taken by the commissioner 
169.2 	under clause (3) or (5), the county board may appeal the action according to sections 14.57 
169.3 	to 14.69; and
169.4 	(7) counties subject to withholding of funds under clause (3) or forfeiture or repayment 
169.5 	of funds under clause (5) shall not reduce or withhold benefits or services to clients to cover 
169.6 	costs incurred due to actions taken by the commissioner under clause (3) or (5).
169.7 	(p) The commissioner shall allocate federal fiscal disallowances or sanctions for audit 
169.8 	exceptions when federal fiscal disallowances or sanctions are based on a statewide random 
169.9 	sample in direct proportion to each county's claim for that period.
169.10 	(q) The commissioner is responsible for ensuring the detection, prevention, investigation, 
169.11 	and resolution of fraudulent activities or behavior by applicants, recipients, and other 
169.12 	participants in the programs administered by the department. The commissioner shall 
169.13 	cooperate with the commissioner of education to enforce the requirements for program 
169.14 	integrity and fraud prevention for investigation for child care assistance under chapter 142E.
169.15 	(r) The commissioner shall require county agencies to identify overpayments, establish 
169.16 	claims, and utilize all available and cost-beneficial methodologies to collect and recover 
169.17 	these overpayments in the programs administered by the department.
169.18 	(s) The commissioner shall develop recommended standards for child foster care homes 
169.19 	that address the components of specialized therapeutic services to be provided by child 
169.20 	foster care homes with those services.
169.21 	(t) The commissioner shall authorize the method of payment to or from the department 
169.22 	as part of the programs administered by the department. This authorization includes the 
169.23 	receipt or disbursement of funds held by the department in a fiduciary capacity as part of 
169.24 	the programs administered by the department.
169.25 	(u) In coordination with the commissioner of human services, the commissioner shall 
169.26 	create and provide county and Tribal agencies with blank applications, affidavits, and other 
169.27 	forms as necessary for public assistance programs.
169.28 	(v) The commissioner shall cooperate with the federal government and its public welfare 
169.29 	agencies in any reasonable manner as may be necessary to qualify for federal aid for 
169.30 	temporary assistance for needy families and in conformity with Title I of Public Law 104-193, 
169.31 	the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and successor 
169.32 	amendments, including making reports that contain information required by the federal 
170.1 	Social Security Advisory Board and complying with any provisions the board may find 
170.2 	necessary to assure the correctness and verification of the reports.
170.3 	(w) On or before January 15 in each even-numbered year, the commissioner shall make 
170.4 	a biennial report to the governor concerning the activities of the agency.
170.5 	(x) The commissioner shall enter into agreements with other departments of the state as 
170.6 	necessary to meet all requirements of the federal government.
170.7 	(y) The commissioner may cooperate with other state agencies in establishing reciprocal 
170.8 	agreements in instances where a child receiving Minnesota family investment program 
170.9 	(MFIP) assistance or its out-of-state equivalent moves or contemplates moving into or out 
170.10 	of the state, in order that the child may continue to receive MFIP or equivalent aid from the 
170.11 	state moved from until the child has resided for one year in the state moved to.
170.12 	(z) The commissioner shall provide appropriate technical assistance to county agencies 
170.13 	to develop methods to have county financial workers remind and encourage recipients of 
170.14 	aid to families with dependent children, the Minnesota family investment program, the 
170.15 	Minnesota family investment plan, family general assistance, or SNAP benefits whose 
170.16 	assistance unit includes at least one child under the age of five to have each young child 
170.17 	immunized against childhood diseases. The commissioner must examine the feasibility of 
170.18 	utilizing the capacity of a statewide computer system to assist county agency financial 
170.19 	workers in performing this function at appropriate intervals.
170.20 	(aa) The commissioner shall have the power and authority to accept on behalf of the 
170.21 	state contributions and gifts for the use and benefit of children under the guardianship or 
170.22 	custody of the commissioner. The commissioner may also receive and accept on behalf of 
170.23 	such children money due and payable to them as old age and survivors insurance benefits, 
170.24 	veterans benefits, pensions, or other such monetary benefits. Gifts, contributions, pensions, 
170.25 	and benefits under this paragraph must be deposited in and disbursed from the social welfare 
170.26 	fund provided for in sections 256.88 to 256.92.
170.27 	(bb) The specific enumeration of powers and duties in this section must not be construed 
170.28 	to be a limitation upon the general powers granted to the commissioner.

170.29 	Sec. 2. Minnesota Statutes 2024, section 260.810, subdivision 1, is amended to read:
170.30 		Subdivision 1.Payments. The commissioner shall make grant payments to each approved 
170.31 	program in four quarterly installments a year. The commissioner may certify an advance 
170.32 	payment for the first quarter of the state fiscal year. Later payments must be made upon 
170.33 	receipt by the state of a quarterly report on finances and program activities quarterly.

171.1 	Sec. 3. Minnesota Statutes 2024, section 260.810, subdivision 2, is amended to read:
171.2 		Subd. 2.Quarterly report Reporting. The commissioner shall specify engage Tribal 
171.3 	and urban Indian organizations to establish requirements for reports and reporting timelines, 
171.4 	including quarterly fiscal reports submitted to the commissioner at least annually, according 
171.5 	to section 142A.03, subdivision 2, paragraph (o). Each quarter reporting period as agreed 
171.6 	upon by the commissioner and grantee, an approved program receiving an Indian child 
171.7 	welfare grant shall submit a report to the commissioner that includes:
171.8 	(1) a detailed accounting of grant money expended during the preceding quarter reporting 
171.9 	period, specifying expenditures by line item and year to date; and
171.10 	(2) a description of Indian child welfare activities conducted during the preceding quarter
171.11 	reporting period, including the number of clients served and the type of services provided.
171.12 	The quarterly Reports must be submitted no later than 30 days after the end of each 
171.13 	quarter agreed upon reporting timelines of the state fiscal year.

171.14 	Sec. 4. Minnesota Statutes 2024, section 260.821, subdivision 2, is amended to read:
171.15 		Subd. 2.Special focus grants. The amount available for grants established under section 
171.16 	260.785, subdivision 2, for child-placing agencies, Tribes, Indian organizations, and other 
171.17 	social services organizations is one-fifth of the total annual appropriation for Indian child 
171.18 	welfare grants. The maximum award under this subdivision is $100,000 a year for programs 
171.19 	approved by the commissioner.

171.20 	Sec. 5. Minnesota Statutes 2024, section 518.68, subdivision 2, is amended to read:
171.21 		Subd. 2.Contents. (a) This subdivision expires January 1, 2027. For orders issued prior 
171.22 	to January 1, 2027, the required notices must be substantially as follows:
171.23 	IMPORTANT NOTICE
171.24 	1. PAYMENTS TO PUBLIC AGENCY
171.25 	According to Minnesota Statutes, section 518A.50, payments ordered for maintenance 
171.26 	and support must be paid to the public agency responsible for child support enforcement 
171.27 	as long as the person entitled to receive the payments is receiving or has applied for 
171.28 	public assistance or has applied for support and maintenance collection services. MAIL 
171.29 	PAYMENTS TO:
171.30 	2. DEPRIVING ANOTHER OF CUSTODIAL OR PARENTAL RIGHTS -- A FELONY
172.1 	A person may be charged with a felony who conceals a minor child or takes, obtains, 
172.2 	retains, or fails to return a minor child from or to the child's parent (or person with 
172.3 	custodial or visitation rights), according to Minnesota Statutes, section 609.26. A copy 
172.4 	of that section is available from any district court clerk.
172.5 	3. NONSUPPORT OF A SPOUSE OR CHILD -- CRIMINAL PENALTIES
172.6 	A person who fails to pay court-ordered child support or maintenance may be charged 
172.7 	with a crime, which may include misdemeanor, gross misdemeanor, or felony charges, 
172.8 	according to Minnesota Statutes, section 609.375. A copy of that section is available 
172.9 	from any district court clerk.
172.10 	4. RULES OF SUPPORT, MAINTENANCE, PARENTING TIME
172.11 	(a) Payment of support or spousal maintenance is to be as ordered, and the giving of 
172.12 	gifts or making purchases of food, clothing, and the like will not fulfill the obligation.
172.13 	(b) Payment of support must be made as it becomes due, and failure to secure or denial 
172.14 	of parenting time is NOT an excuse for nonpayment, but the aggrieved party must seek 
172.15 	relief through a proper motion filed with the court.
172.16 	(c) Nonpayment of support is not grounds to deny parenting time. The party entitled to 
172.17 	receive support may apply for support and collection services, file a contempt motion, 
172.18 	or obtain a judgment as provided in Minnesota Statutes, section 548.091.
172.19 	(d) The payment of support or spousal maintenance takes priority over payment of debts 
172.20 	and other obligations.
172.21 	(e) A party who accepts additional obligations of support does so with the full knowledge 
172.22 	of the party's prior obligation under this proceeding.
172.23 	(f) Child support or maintenance is based on annual income, and it is the responsibility 
172.24 	of a person with seasonal employment to budget income so that payments are made 
172.25 	throughout the year as ordered.
172.26 	(g) Reasonable parenting time guidelines are contained in Appendix B, which is available 
172.27 	from the court administrator.
172.28 	(h) The nonpayment of support may be enforced through the denial of student grants; 
172.29 	interception of state and federal tax refunds; suspension of driver's, recreational, and 
172.30 	occupational licenses; referral to the department of revenue or private collection agencies; 
172.31 	seizure of assets, including bank accounts and other assets held by financial institutions; 
173.1 	reporting to credit bureaus; income withholding and contempt proceedings; and other 
173.2 	enforcement methods allowed by law.
173.3 	(i) The public authority may suspend or resume collection of the amount allocated for 
173.4 	child care expenses if the conditions of Minnesota Statutes, section 518A.40, subdivision 
173.5 	4, are met.
173.6 	(j) The public authority may remove or resume a medical support offset if the conditions 
173.7 	of Minnesota Statutes, section 518A.41, subdivision 16, are met.
173.8 	5. MODIFYING CHILD SUPPORT
173.9 	If either the obligor or obligee is laid off from employment or receives a pay reduction, 
173.10 	child support may be modified, increased, or decreased. Any modification will only take 
173.11 	effect when it is ordered by the court, and will only relate back to the time that a motion 
173.12 	is filed. Either the obligor or obligee may file a motion to modify child support, and may 
173.13 	request the public agency for help. UNTIL A MOTION IS FILED, THE CHILD 
173.14 	SUPPORT OBLIGATION WILL CONTINUE AT THE CURRENT LEVEL. THE 
173.15 	COURT IS NOT PERMITTED TO REDUCE SUPPORT RETROACTIVELY.
173.16 	6. PARENTAL RIGHTS FROM MINNESOTA STATUTES, SECTION 518.17, 
173.17 	SUBDIVISION 3
173.18 	Unless otherwise provided by the Court:
173.19 	(a) Each party has the right of access to, and to receive copies of, school, medical, dental, 
173.20 	religious training, and other important records and information about the minor children. 
173.21 	Each party has the right of access to information regarding health or dental insurance 
173.22 	available to the minor children. Presentation of a copy of this order to the custodian of 
173.23 	a record or other information about the minor children constitutes sufficient authorization 
173.24 	for the release of the record or information to the requesting party.
173.25 	(b) Each party shall keep the other informed as to the name and address of the school 
173.26 	of attendance of the minor children. Each party has the right to be informed by school 
173.27 	officials about the children's welfare, educational progress and status, and to attend 
173.28 	school and parent teacher conferences. The school is not required to hold a separate 
173.29 	conference for each party.
173.30 	(c) In case of an accident or serious illness of a minor child, each party shall notify the 
173.31 	other party of the accident or illness, and the name of the health care provider and the 
173.32 	place of treatment.
174.1 	(d) Each party has the right of reasonable access and telephone contact with the minor 
174.2 	children.
174.3 	7. WAGE AND INCOME DEDUCTION OF SUPPORT AND MAINTENANCE
174.4 	Child support and/or spousal maintenance may be withheld from income, with or without 
174.5 	notice to the person obligated to pay, when the conditions of Minnesota Statutes, section 
174.6 	518A.53 have been met. A copy of those sections is available from any district court 
174.7 	clerk.
174.8 	8. CHANGE OF ADDRESS OR RESIDENCE
174.9 	Unless otherwise ordered, each party shall notify the other party, the court, and the public 
174.10 	authority responsible for collection, if applicable, of the following information within 
174.11 	ten days of any change: the residential and mailing address, telephone number, driver's 
174.12 	license number, Social Security number, and name, address, and telephone number of 
174.13 	the employer.
174.14 	9. COST OF LIVING INCREASE OF SUPPORT AND MAINTENANCE
174.15 	Prior to January 1, 2027, basic support and/or spousal maintenance may be adjusted 
174.16 	every two years based upon a change in the cost of living (using Department of Labor 
174.17 	Consumer Price Index .........., unless otherwise specified in this order) when the 
174.18 	conditions of Minnesota Statutes, section 518A.75, are met. Cost of living increases are 
174.19 	compounded. A copy of Minnesota Statutes, section 518A.75, and forms necessary to 
174.20 	request or contest a cost of living increase are available from any district court clerk.
174.21 	10. JUDGMENTS FOR UNPAID SUPPORT
174.22 	If a person fails to make a child support payment, the payment owed becomes a judgment 
174.23 	against the person responsible to make the payment by operation of law on or after the 
174.24 	date the payment is due, and the person entitled to receive the payment or the public 
174.25 	agency may obtain entry and docketing of the judgment WITHOUT NOTICE to the 
174.26 	person responsible to make the payment under Minnesota Statutes, section 548.091.
174.27 	11. JUDGMENTS FOR UNPAID MAINTENANCE
174.28 	(a) A judgment for unpaid spousal maintenance may be entered when the conditions of 
174.29 	Minnesota Statutes, section 548.091, are met. A copy of that section is available from 
174.30 	any district court clerk.
174.31 	(b) The public authority is not responsible for calculating interest on any judgment for 
174.32 	unpaid spousal maintenance. When providing services in IV-D cases, as defined in 
175.1 	Minnesota Statutes, section 518A.26, subdivision 10, the public authority will only 
175.2 	collect interest on spousal maintenance if spousal maintenance is reduced to a sum 
175.3 	certain judgment.
175.4 	12. ATTORNEY FEES AND COLLECTION COSTS FOR ENFORCEMENT OF CHILD 
175.5 	SUPPORT
175.6 	A judgment for attorney fees and other collection costs incurred in enforcing a child 
175.7 	support order will be entered against the person responsible to pay support when the 
175.8 	conditions of Minnesota Statutes, section 518A.735, are met. A copy of Minnesota 
175.9 	Statutes, sections 518.14 and 518A.735 and forms necessary to request or contest these 
175.10 	attorney fees and collection costs are available from any district court clerk.
175.11 	13. PARENTING TIME EXPEDITOR PROCESS
175.12 	On request of either party or on its own motion, the court may appoint a parenting time 
175.13 	expeditor to resolve parenting time disputes under Minnesota Statutes, section 518.1751. 
175.14 	A copy of that section and a description of the expeditor process is available from any 
175.15 	district court clerk.
175.16 	14. PARENTING TIME REMEDIES AND PENALTIES
175.17 	Remedies and penalties for the wrongful denial of parenting time are available under 
175.18 	Minnesota Statutes, section 518.175, subdivision 6. These include compensatory parenting 
175.19 	time; civil penalties; bond requirements; contempt; and reversal of custody. A copy of 
175.20 	that subdivision and forms for requesting relief are available from any district court 
175.21 	clerk.
175.22 	(b) For orders issued on or after January 1, 2027, the required notices must be 
175.23 	substantially as follows:
175.24 	IMPORTANT NOTICE
175.25 	1. PAYMENTS TO PUBLIC AGENCY
175.26 	According to Minnesota Statutes, section 518A.50, payments ordered for maintenance 
175.27 	and support must be paid to the public agency responsible for child support enforcement 
175.28 	as long as the person entitled to receive the payments is receiving or has applied for 
175.29 	public assistance or has applied for support and maintenance collection services. MAIL 
175.30 	PAYMENTS TO:
175.31 	2. DEPRIVING ANOTHER OF CUSTODIAL OR PARENTAL RIGHTS -- A FELONY
176.1 	A person may be charged with a felony who conceals a minor child or takes, obtains, 
176.2 	retains, or fails to return a minor child from or to the child's parent (or person with 
176.3 	custodial or visitation rights), according to Minnesota Statutes, section 609.26. A copy 
176.4 	of that section is available from any district court clerk.
176.5 	3. NONSUPPORT OF A SPOUSE OR CHILD -- CRIMINAL PENALTIES
176.6 	A person who fails to pay court-ordered child support or maintenance may be charged 
176.7 	with a crime, which may include misdemeanor, gross misdemeanor, or felony charges, 
176.8 	according to Minnesota Statutes, section 609.375. A copy of that section is available 
176.9 	from any district court clerk.
176.10 	4. RULES OF SUPPORT, MAINTENANCE, PARENTING TIME
176.11 	(a) Payment of support or spousal maintenance is to be as ordered, and the giving of 
176.12 	gifts or making purchases of food, clothing, and the like will not fulfill the obligation.
176.13 	(b) Payment of support must be made as it becomes due, and failure to secure or denial 
176.14 	of parenting time is NOT an excuse for nonpayment, but the aggrieved party must seek 
176.15 	relief through a proper motion filed with the court.
176.16 	(c) Nonpayment of support is not grounds to deny parenting time. The party entitled to 
176.17 	receive support may apply for support and collection services, file a contempt motion, 
176.18 	or obtain a judgment as provided in Minnesota Statutes, section 548.091.
176.19 	(d) The payment of support or spousal maintenance takes priority over payment of debts 
176.20 	and other obligations.
176.21 	(e) A party who accepts additional obligations of support does so with the full knowledge 
176.22 	of the party's prior obligation under this proceeding.
176.23 	(f) Child support or maintenance is based on annual income, and it is the responsibility 
176.24 	of a person with seasonal employment to budget income so that payments are made 
176.25 	throughout the year as ordered.
176.26 	(g) Reasonable parenting time guidelines are contained in Appendix B, which is available 
176.27 	from the court administrator.
176.28 	(h) The nonpayment of support may be enforced through the denial of student grants; 
176.29 	interception of state and federal tax refunds; suspension of driver's, recreational, and 
176.30 	occupational licenses; referral to the Department of Revenue or private collection 
176.31 	agencies; seizure of assets, including bank accounts and other assets held by financial 
177.1 	institutions; reporting to credit bureaus; income withholding and contempt proceedings; 
177.2 	and other enforcement methods allowed by law.
177.3 	(i) The public authority may suspend or resume collection of the amount allocated for 
177.4 	child care expenses if the conditions of Minnesota Statutes, section 518A.40, subdivision 
177.5 	4, are met.
177.6 	(j) The public authority may remove or resume a medical support offset if the conditions 
177.7 	of Minnesota Statutes, section 518A.41, subdivision 16, are met.
177.8 	5. MODIFYING CHILD SUPPORT
177.9 	If either the obligor or obligee is laid off from employment or receives a pay reduction, 
177.10 	child support may be modified, increased, or decreased. Any modification will only take 
177.11 	effect when it is ordered by the court, and will only relate back to the time that a motion 
177.12 	is filed. Either the obligor or obligee may file a motion to modify child support, and may 
177.13 	request the public agency for help. UNTIL A MOTION IS FILED, THE CHILD 
177.14 	SUPPORT OBLIGATION WILL CONTINUE AT THE CURRENT LEVEL. THE 
177.15 	COURT IS NOT PERMITTED TO REDUCE SUPPORT RETROACTIVELY.
177.16 	6. PARENTAL RIGHTS FROM MINNESOTA STATUTES, SECTION 518.17, 
177.17 	SUBDIVISION 3
177.18 	Unless otherwise provided by the court:
177.19 	(a) Each party has the right of access to, and to receive copies of, school, medical, dental, 
177.20 	religious training, and other important records and information about the minor children. 
177.21 	Each party has the right of access to information regarding health or dental insurance 
177.22 	available to the minor children. Presentation of a copy of this order to the custodian of 
177.23 	a record or other information about the minor children constitutes sufficient authorization 
177.24 	for the release of the record or information to the requesting party.
177.25 	(b) Each party shall keep the other informed as to the name and address of the school 
177.26 	of attendance of the minor children. Each party has the right to be informed by school 
177.27 	officials about the children's welfare, educational progress, and status, and to attend 
177.28 	school and parent-teacher conferences. The school is not required to hold a separate 
177.29 	conference for each party.
177.30 	(c) In case of an accident or serious illness of a minor child, each party shall notify the 
177.31 	other party of the accident or illness, and the name of the health care provider and the 
177.32 	place of treatment.
178.1 	(d) Each party has the right of reasonable access and telephone contact with the minor 
178.2 	children.
178.3 	7. WAGE AND INCOME DEDUCTION OF SUPPORT AND MAINTENANCE
178.4 	Child support and/or spousal maintenance may be withheld from income, with or without 
178.5 	notice to the person obligated to pay, when the conditions of Minnesota Statutes, section 
178.6 	518A.53, have been met. A copy of those sections is available from any district court 
178.7 	clerk.
178.8 	8. CHANGE OF ADDRESS OR RESIDENCE
178.9 	Unless otherwise ordered, each party shall notify the other party, the court, and the public 
178.10 	authority responsible for collection, if applicable, of the following information within 
178.11 	ten days of any change: the residential and mailing address, telephone number, driver's 
178.12 	license number, Social Security number, and name, address, and telephone number of 
178.13 	the employer.
178.14 	9. JUDGMENTS FOR UNPAID SUPPORT
178.15 	If a person fails to make a child support payment, the payment owed becomes a judgment 
178.16 	against the person responsible to make the payment by operation of law on or after the 
178.17 	date the payment is due, and the person entitled to receive the payment or the public 
178.18 	agency may obtain entry and docketing of the judgment WITHOUT NOTICE to the 
178.19 	person responsible to make the payment under Minnesota Statutes, section 548.091.
178.20 	10. JUDGMENTS FOR UNPAID MAINTENANCE
178.21 	(a) A judgment for unpaid spousal maintenance may be entered when the conditions of 
178.22 	Minnesota Statutes, section 548.091, are met. A copy of that section is available from 
178.23 	any district court clerk.
178.24 	(b) The public authority is not responsible for calculating interest on any judgment for 
178.25 	unpaid spousal maintenance. When providing services in IV-D cases, as defined in 
178.26 	Minnesota Statutes, section 518A.26, subdivision 10, the public authority will only 
178.27 	collect interest on spousal maintenance if spousal maintenance is reduced to a sum 
178.28 	certain judgment.
178.29 	11. ATTORNEY FEES AND COLLECTION COSTS FOR ENFORCEMENT OF CHILD 
178.30 	SUPPORT
178.31 	A judgment for attorney fees and other collection costs incurred in enforcing a child 
178.32 	support order will be entered against the person responsible to pay support when the 
179.1 	conditions of Minnesota Statutes, section 518A.735, are met. A copy of Minnesota 
179.2 	Statutes, sections 518.14 and 518A.735, and forms necessary to request or contest these 
179.3 	attorney fees and collection costs are available from any district court clerk.
179.4 	12. PARENTING TIME EXPEDITOR PROCESS
179.5 	On request of either party or on its own motion, the court may appoint a parenting time 
179.6 	expeditor to resolve parenting time disputes under Minnesota Statutes, section 518.1751. 
179.7 	A copy of that section and a description of the expeditor process is available from any 
179.8 	district court clerk.
179.9 	13. PARENTING TIME REMEDIES AND PENALTIES
179.10 	Remedies and penalties for the wrongful denial of parenting time are available under 
179.11 	Minnesota Statutes, section 518.175, subdivision 6. These include compensatory parenting 
179.12 	time, civil penalties, bond requirements, contempt, and reversal of custody. A copy of 
179.13 	that subdivision and forms for requesting relief are available from any district court 
179.14 	clerk.

179.15 	Sec. 6. Minnesota Statutes 2024, section 518A.34, is amended to read:
179.16 	518A.34 COMPUTATION OF CHILD SUPPORT OBLIGATIONS.
179.17 	(a) To determine the presumptive child support obligation of a parent, the court shall 
179.18 	follow the procedure set forth in this section.
179.19 	(b) To determine the obligor's basic support obligation, the court shall:
179.20 	(1) determine the gross income of each parent under section 518A.29;
179.21 	(2) calculate the parental income for determining child support (PICS) of each parent, 
179.22 	by subtracting from the gross income the credit, if any, for each parent's nonjoint children 
179.23 	under section 518A.33;
179.24 	(3) determine the percentage contribution of each parent to the combined PICS by 
179.25 	dividing the combined PICS into each parent's PICS;
179.26 	(4) determine the combined basic support obligation by application of the guidelines in 
179.27 	section 518A.35;
179.28 	(5) determine each parent's share of the combined basic support obligation by multiplying 
179.29 	the percentage figure from clause (3) by the combined basic support obligation in clause 
179.30 	(4); and
180.1 	(6) apply the parenting expense adjustment formula provided in section 518A.36 to 
180.2 	determine the obligor's basic support obligation.
180.3 	(c) If the parents have split custody of joint children, child support must be calculated 
180.4 	for each joint child as follows:
180.5 	(1) the court shall determine each parent's basic support obligation under paragraph (b) 
180.6 	and include the amount of each parent's obligation in the court order. If the basic support 
180.7 	calculation results in each parent owing support to the other, the court shall offset the higher 
180.8 	basic support obligation with the lower basic support obligation to determine the amount 
180.9 	to be paid by the parent with the higher obligation to the parent with the lower obligation. 
180.10 	For the purpose of the cost-of-living adjustment required under section 518A.75, the 
180.11 	adjustment a future modification, the application of section 518A.39 must be based on each 
180.12 	parent's basic support obligation prior to offset. For the purposes of this paragraph, "split 
180.13 	custody" means that there are two or more joint children and each parent has at least one 
180.14 	joint child more than 50 percent of the time;
180.15 	(2) if each parent pays all child care expenses for at least one joint child, the court shall 
180.16 	calculate child care support for each joint child as provided in section 518A.40. The court 
180.17 	shall determine each parent's child care support obligation and include the amount of each 
180.18 	parent's obligation in the court order. If the child care support calculation results in each 
180.19 	parent owing support to the other, the court shall offset the higher child care support 
180.20 	obligation with the lower child care support obligation to determine the amount to be paid 
180.21 	by the parent with the higher obligation to the parent with the lower obligation; and
180.22 	(3) if each parent pays all medical or dental insurance expenses for at least one joint 
180.23 	child, medical support shall be calculated for each joint child as provided in section 518A.41. 
180.24 	The court shall determine each parent's medical support obligation and include the amount 
180.25 	of each parent's obligation in the court order. If the medical support calculation results in 
180.26 	each parent owing support to the other, the court shall offset the higher medical support 
180.27 	obligation with the lower medical support obligation to determine the amount to be paid by 
180.28 	the parent with the higher obligation to the parent with the lower obligation. Unreimbursed 
180.29 	and uninsured medical expenses are not included in the presumptive amount of support 
180.30 	owed by a parent and are calculated and collected as provided in section 518A.41.
180.31 	(d) The court shall determine the child care support obligation for the obligor as provided 
180.32 	in section 518A.40.
180.33 	(e) The court shall determine the medical support obligation for each parent as provided 
180.34 	in section 518A.41. Unreimbursed and uninsured medical expenses are not included in the 
181.1 	presumptive amount of support owed by a parent and are calculated and collected as described 
181.2 	in section 518A.41.
181.3 	(f) The court shall determine each parent's total child support obligation by adding 
181.4 	together each parent's basic support, child care support, and health care coverage obligations 
181.5 	as provided in this section.
181.6 	(g) If Social Security benefits or veterans' benefits are received by one parent as a 
181.7 	representative payee for a joint child based on the other parent's eligibility, the court shall 
181.8 	subtract the amount of benefits from the other parent's net child support obligation, if any. 
181.9 	Any benefit received by the obligee for the benefit of the joint child based upon the obligor's 
181.10 	disability or past earnings in any given month in excess of the child support obligation must 
181.11 	not be treated as an arrearage payment or a future payment.
181.12 	(h) The final child support order shall separately designate the amount owed for basic 
181.13 	support, child care support, and medical support. If applicable, the court shall use the 
181.14 	self-support adjustment and minimum support adjustment under section 518A.42 to determine 
181.15 	the obligor's child support obligation.

181.16 	EFFECTIVE DATE. This section is effective January 1, 2027.

181.17 	Sec. 7. Minnesota Statutes 2024, section 518A.46, subdivision 7, is amended to read:
181.18 		Subd. 7.Administrative redirection of support. (a) The public authority must provide 
181.19 	written notice of redirection to the obligee, the obligor, and the caregiver. The notice must 
181.20 	be mailed to the obligor, obligee, and caregiver at the obligee's, the obligor's, and the 
181.21 	caregiver's respective last known address. The notice must state the name of the child or 
181.22 	children for whom support will be redirected, to whom the support will be redirected, the 
181.23 	date the support will be redirected, and the amount of the support that will be redirected. 
181.24 	The notice must also inform the parties of the right to contest the redirection of support 
181.25 	according to paragraph (c).
181.26 	(b) If fewer than all of the children for whom the support is ordered reside with the 
181.27 	caregiver, the public authority must redirect the proportional share of the support for the 
181.28 	number of children residing with the caregiver.
181.29 	(c) The obligee or obligor may contest the redirection of support on the limited grounds 
181.30 	that:
181.31 	(1) the child or children do not reside or no longer reside with the caregiver;
182.1 	(2) under an out-of-home placement plan under section 260C.212, subdivision 1, that 
182.2 	includes a plan for reunification, all or part of the support is needed to maintain the obligee's 
182.3 	home; or
182.4 	(3) the redirection of support is not in the best interests of the child.
182.5 	(d) To contest the redirection, the obligee or obligor must make a written request for a 
182.6 	hearing to the public authority within 30 calendar days of the date of the written notice of 
182.7 	redirection. The hearing must be held at the earliest practicable time, but no later than 30 
182.8 	calendar days from the date the public authority receives the written request for a hearing. 
182.9 	If the public authority receives a timely written request for a hearing, the public authority 
182.10 	must schedule a hearing and serve the obligee and the obligor with a notice of hearing at 
182.11 	least 14 days before the date of the hearing. The notice must be served personally or by 
182.12 	mail at the obligee's and the obligor's respective last known address. The public authority 
182.13 	must file with the court the notice of hearing along with the notice of redirection at least 
182.14 	five days before the scheduled hearing. The court administrator must schedule these hearings 
182.15 	to be heard in the expedited process before a child support magistrate, but may schedule 
182.16 	these hearings in district court if the availability of a child support magistrate does not permit 
182.17 	a hearing to occur within the time frames of this subdivision.
182.18 	(e) If neither the obligee nor the obligor contests the redirection of support under this 
182.19 	subdivision, support must be redirected to the caregiver effective the first day of the month 
182.20 	following the expiration of the time period to contest under paragraph (d). If the obligee or 
182.21 	the obligor contests the redirection of support under paragraph (d), the public authority must 
182.22 	not redirect support to the caregiver pending the outcome of the hearing.
182.23 	(f) The redirection of the basic support, medical support, and child care support terminates 
182.24 	and the public authority must direct support to the obligee if the public authority determines 
182.25 	that:
182.26 	(1) the caregiver for the child no longer receives public assistance for the child;
182.27 	(2) the voluntary placement agreement expires; or
182.28 	(3) the court order placing the child is no longer in effect.; or
182.29 	(4) the redirection of support is not in the best interests of the child as determined under 
182.30 	section 260B.331, subdivision 1, or 260C.331, subdivision 1.
182.31 	(g) The public authority must notify the obligee, obligor, and caregiver of a termination 
182.32 	of the redirection of support by mailing a written notice to each of them at their last known 
183.1 	address. The termination is effective the first day of the month that occurs at least 14 calendar 
183.2 	days after the date the notice is mailed.

183.3 	EFFECTIVE DATE. This section is effective September 1, 2025.

183.4 	Sec. 8. Minnesota Statutes 2024, section 518A.75, subdivision 1, is amended to read:
183.5 		Subdivision 1.Requirement. (a) An order establishing, modifying, or enforcing 
183.6 	maintenance or child support shall provide for a biennial adjustment in the amount to be 
183.7 	paid based on a change in the cost of living. An order that provides for a cost-of-living 
183.8 	adjustment shall specify the cost-of-living index to be applied and the date on which the 
183.9 	cost-of-living adjustment shall become effective. The court may use the Consumer Price 
183.10 	Index for all urban consumers, Minneapolis-St. Paul (CPI-U), the Consumer Price Index 
183.11 	for wage earners and clerical, Minneapolis-St. Paul (CPI-W), or another cost-of-living index 
183.12 	published by the Department of Labor which it specifically finds is more appropriate. 
183.13 	Cost-of-living increases under this section shall be compounded. The court may also increase 
183.14 	the amount by more than the cost-of-living adjustment by agreement of the parties or by 
183.15 	making further findings.
183.16 	(b) The adjustment becomes effective on the first of May of the year in which it is made, 
183.17 	for cases in which payment is made to the public authority. For cases in which payment is 
183.18 	not made to the public authority, application for an adjustment may be made in any month 
183.19 	but no application for an adjustment may be made sooner than two years after the date of 
183.20 	the dissolution decree. A court may waive the requirement of the cost-of-living clause if it 
183.21 	expressly finds that the obligor's occupation or income, or both, does not provide for 
183.22 	cost-of-living adjustment or that the order for maintenance or child support has a provision 
183.23 	such as a step increase that has the effect of a cost-of-living clause. The court may waive a 
183.24 	cost-of-living adjustment in a maintenance order if the parties so agree in writing. The 
183.25 	commissioner of children, youth, and families may promulgate rules for child support 
183.26 	adjustments under this section in accordance with the rulemaking provisions of chapter 14. 
183.27 	Notice of this statute must comply with section 518.68, subdivision 2.
183.28 	(c) No adjustment under this section shall be made after January 1, 2027, for any 
183.29 	maintenance or child support order established before, on, or after January 1, 2027.

183.30 	Sec. 9. SOCIAL SERVICES INFORMATION SYSTEM MODERNIZATION.
 183.31 	(a) The commissioner of children, youth, and families must improve and modernize the 
183.32 	child welfare social services information system. Elements the commissioner must address 
183.33 	as part of the system modernization include but are not limited to:
184.1 	(1) capabilities that support case intake, screening, assessments, and investigations;
184.2 	(2) the capacity for local social services agencies to track various financial information, 
184.3 	including benefits received by counties on behalf of children in the child welfare system, 
184.4 	and fees received by counties from parents with children in out-of-home placements;
184.5 	(3) access for the ombudspersons for families, the ombudsperson for American Indian 
184.6 	families, and the foster youth ombudsperson, on a case-by-case basis, to nonprivileged 
184.7 	information necessary for the discharge of the ombudsperson's duties, including specific 
184.8 	child protection case information, while protecting Tribal data sovereignty;
184.9 	(4) comprehensive statewide data reports, including data on law enforcement involvement 
184.10 	in the child protection system;
184.11 	(5) demographic information about children in the child welfare system, including race, 
184.12 	cultural and ethnic identity, disability status, and economic status;
184.13 	(6) bidirectional data exchanges, as required by federal Comprehensive Child Welfare 
184.14 	Information System regulations; and
184.15 	(7) data quality measures, as required by federal Comprehensive Child Welfare 
184.16 	Information System regulations.
184.17 	(b) By March 15, 2026, the commissioner of children, youth, and families must provide 
184.18 	the chairs and ranking minority members of the legislative committees with jurisdiction 
184.19 	over child welfare and state and local government with a plan and estimated timeline for 
184.20 	modernization of the social services information system in compliance with state law and 
184.21 	federal Comprehensive Child Welfare Information System requirements.
184.22 	(c) By August 15, 2026, and by each January 15 and July 15 thereafter, the commissioner 
184.23 	must provide an update on the social services information system modernization efforts and 
184.24 	progress toward federal compliance required under this section to the chairs and ranking 
184.25 	minority members of the legislative committees with jurisdiction over child welfare and 
184.26 	state and local government. This paragraph expires upon the commissioner's report to the 
184.27 	chairs and ranking minority members of the legislative committees with jurisdiction over 
184.28 	child welfare and state and local government that the modernization required under this 
184.29 	section has been substantially completed.

185.1 	ARTICLE 10
185.2 	EARLY CARE AND LEARNING POLICY

185.3 	Section 1. Minnesota Statutes 2024, section 142A.42, is amended to read:
185.4 	142A.42 DIAPER DISTRIBUTION GRANT PROGRAM.
185.5 		Subdivision 1.Establishment; purpose. The commissioner of children, youth, and 
185.6 	families shall establish a diaper distribution program to award competitive grants to eligible 
185.7 	applicants a sole-source grant to the Diaper Bank of Minnesota to provide diapers to 
185.8 	underresourced families statewide.
185.9 		Subd. 2.Eligibility. To be eligible for a grant under this section, an applicant the Diaper 
185.10 	Bank of Minnesota must demonstrate its capacity to distribute diapers statewide by having:
185.11 	(1) a network of well-established partners for diaper distribution;
185.12 	(2) the infrastructure needed to efficiently manage diaper procurement and distribution 
185.13 	statewide;
185.14 	(3) relationships with national organizations that support and enhance the work of 
185.15 	addressing diaper need;
185.16 	(4) the ability to engage in building community awareness of diaper need and advocate 
185.17 	for diaper need at local, state, and federal levels;
185.18 	(5) a commitment to and demonstration of working with organizations across ideological 
185.19 	and political spectrums;
185.20 	(6) the ability to address diaper need for children from birth through early childhood; 
185.21 	and
185.22 	(7) a commitment to working within an equity framework by ensuring access to 
185.23 	organizations that provide culturally specific services or are located in communities with 
185.24 	high concentrations of poverty.
185.25 		Subd. 3.Application. Applicants The Diaper Bank of Minnesota must apply to the 
185.26 	commissioner in a form and manner prescribed by the commissioner. Applications must be 
185.27 	filed at the times and for the periods determined by the commissioner.
185.28 		Subd. 4.Eligible uses of grant money. An eligible applicant that receives grant money 
185.29 	under this section shall The Diaper Bank of Minnesota must use the money awarded under 
185.30 	this section to purchase diapers and wipes and may use up to ten percent of the money for 
185.31 	administrative costs.
186.1 		Subd. 5.Enforcement. (a) An eligible applicant that receives grant money under this 
186.2 	section The Diaper Bank of Minnesota must:
186.3 	(1) retain records documenting expenditure of the grant money;
186.4 	(2) report to the commissioner on the use of the grant money; and
186.5 	(3) comply with any additional requirements imposed by the commissioner.
186.6 	(b) The commissioner may require that a report submitted under this subdivision include 
186.7 	an independent audit.

186.8 	Sec. 2. Minnesota Statutes 2024, section 142D.21, subdivision 6, is amended to read:
186.9 		Subd. 6.Payments. (a) The commissioner shall provide payments under this section to 
186.10 	all eligible programs on a noncompetitive basis. The payment amounts shall be based on 
186.11 	the number of full-time equivalent staff who regularly care for children in the program, 
186.12 	including any employees, sole proprietors, or independent contractors.
186.13 	(b) For purposes of this section, "one full-time equivalent" is defined as an individual 
186.14 	caring for children 32 hours per week. An individual can count as more or less than one 
186.15 	full-time equivalent staff, but as no more than two full-time equivalent staff.
186.16 	(c) The commissioner must establish an amount to award per full-time equivalent 
186.17 	individual who regularly cares for children in the program.
186.18 	(d) Payments must be increased by ten percent for programs receiving child care 
186.19 	assistance payments under section 142E.08 or 142E.17 or early learning scholarships under 
186.20 	section 142D.25, or for programs located in a child care access equity area. The commissioner 
186.21 	must develop a method for establishing child care access equity areas. For purposes of this 
186.22 	section, "child care access equity area" means an area with low access to child care, high 
186.23 	poverty rates, high unemployment rates, low homeownership rates, and low median 
186.24 	household incomes.
186.25 	(e) (d) The commissioner shall establish the form, frequency, and manner for making 
186.26 	payments under this section.

186.27 	Sec. 3. Minnesota Statutes 2024, section 142D.21, is amended by adding a subdivision to 
186.28 	read:
186.29 		Subd. 11.Data. (a) For the purposes of this subdivision, the following terms have the 
186.30 	meanings given in this paragraph.
187.1 	(1) "Great start compensation program support payment data" means data for a specified 
187.2 	time period showing that a great start compensation payment under this section was made 
187.3 	and the amount of great start compensation payments made to a child care and early learning 
187.4 	program.
187.5 	(2) "Data on children and families" means data about the enrollment and attendance as 
187.6 	described in subdivision 3, paragraph (a), clause (2).
187.7 	(b) Great start compensation program support payment data are public except that:
187.8 	(1) any data on children and families collected by the great start compensation support 
187.9 	payment program that may identify a specific family or child or, as determined by the 
187.10 	commissioner, are private data on individuals as defined in section 13.02, subdivision 12;
187.11 	(2) great start compensation payment data about operating expenses and personnel 
187.12 	expenses are private or nonpublic data; and
187.13 	(3) great start compensation payment data about legal nonlicensed child care providers 
187.14 	as described in subdivision 8 are private or nonpublic data.

187.15 	ARTICLE 11
187.16 	EARLY CARE AND LEARNING FINANCE

187.17 	Section 1. Minnesota Statutes 2024, section 142B.18, subdivision 4, is amended to read:
187.18 		Subd. 4.License suspension, revocation, or fine. (a) The commissioner may suspend 
187.19 	or revoke a license, or impose a fine if:
187.20 	(1) a license holder fails to comply fully with applicable laws or rules including but not 
187.21 	limited to the requirements of this chapter and chapter 245C;
187.22 	(2) a license holder, a controlling individual, or an individual living in the household 
187.23 	where the licensed services are provided or is otherwise subject to a background study has 
187.24 	been disqualified and the disqualification was not set aside and no variance has been granted;
187.25 	(3) a license holder knowingly withholds relevant information from or gives false or 
187.26 	misleading information to the commissioner in connection with an application for a license, 
187.27 	in connection with the background study status of an individual, during an investigation, 
187.28 	or regarding compliance with applicable laws or rules;
187.29 	(4) a license holder is excluded from any program administered by the commissioner 
187.30 	under section 142A.12;
187.31 	(5) revocation is required under section 142B.10, subdivision 14, paragraph (d);
188.1 	(6) for a family foster setting, a license holder, or an individual living in the household 
188.2 	where the licensed services are provided or who is otherwise subject to a background study, 
188.3 	has nondisqualifying background study information, as described in section 245C.05, 
188.4 	subdivision 4, that reflects on the license holder's ability to safely provide care to foster 
188.5 	children; or
188.6 	(7) suspension is necessary under subdivision 3, paragraph (b), clause (2).
188.7 	A license holder who has had a license issued under this chapter suspended, revoked, or 
188.8 	has been ordered to pay a fine must be given notice of the action by certified mail, by 
188.9 	personal service, or through the provider licensing and reporting hub. If mailed, the notice 
188.10 	must be mailed to the address shown on the application or the last known address of the 
188.11 	license holder. The notice must state in plain language the reasons the license was suspended 
188.12 	or revoked, or a fine was ordered.
188.13 	(b) If the license was suspended or revoked, the notice must inform the license holder 
188.14 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
188.15 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
188.16 	a license. The appeal of an order suspending or revoking a license must be made in writing 
188.17 	by certified mail, by personal service, or through the provider licensing and reporting hub. 
188.18 	If mailed, the appeal must be postmarked and sent to the commissioner within ten calendar 
188.19 	days after the license holder receives notice that the license has been suspended or revoked. 
188.20 	If a request is made by personal service, it must be received by the commissioner within 
188.21 	ten calendar days after the license holder received the order. If the order is issued through 
188.22 	the provider hub, the appeal must be received by the commissioner within ten calendar days 
188.23 	from the date the commissioner issued the order through the hub. Except as provided in 
188.24 	subdivision 3, paragraph (c), if a license holder submits a timely appeal of an order 
188.25 	suspending or revoking a license, the license holder may continue to operate the program 
188.26 	as provided under section 142B.10, subdivision 14, paragraphs (i) and (j), until the 
188.27 	commissioner issues a final order on the suspension or revocation.
188.28 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
188.29 	holder of the responsibility for payment of fines and the right to a contested case hearing 
188.30 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
188.31 	order to pay a fine must be made in writing by certified mail, by personal service, or through 
188.32 	the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent 
188.33 	to the commissioner within ten calendar days after the license holder receives notice that 
188.34 	the fine has been ordered. If a request is made by personal service, it must be received by 
188.35 	the commissioner within ten calendar days after the license holder received the order. If the 
189.1 	order is issued through the provider hub, the appeal must be received by the commissioner 
189.2 	within ten calendar days from the date the commissioner issued the order through the hub.
189.3 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
189.4 	If the license holder fails to fully comply with the order, the commissioner may issue a 
189.5 	second fine or suspend the license until the license holder complies. If the license holder 
189.6 	receives state funds, the state, county, or municipal agencies or departments responsible for 
189.7 	administering the funds shall withhold payments and recover any payments made while the 
189.8 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
189.9 	until the commissioner issues a final order.
189.10 	(3) A license holder shall promptly notify the commissioner of children, youth, and 
189.11 	families, in writing, when a violation specified in the order to forfeit a fine is corrected. If 
189.12 	upon reinspection the commissioner determines that a violation has not been corrected as 
189.13 	indicated by the order to forfeit a fine, the commissioner may issue a second fine. The 
189.14 	commissioner shall notify the license holder by certified mail, by personal service, or through 
189.15 	the provider licensing and reporting hub that a second fine has been assessed. The license 
189.16 	holder may appeal the second fine as provided under this subdivision.
189.17 	(4) Fines shall be assessed as follows:
189.18 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
189.19 	child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557 
189.20 	for which the license holder is determined responsible for the maltreatment under section 
189.21 	260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);
189.22 	(ii) if the commissioner determines that a determination of maltreatment for which the 
189.23 	license holder is responsible is the result of maltreatment that meets the definition of serious 
189.24 	maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit 
189.25 	$5,000;
189.26 	(iii) for a program that operates out of the license holder's home and a program licensed 
189.27 	under Minnesota Rules, parts 9502.0300 to 9502.0445, the fine assessed against the license 
189.28 	holder shall not exceed $1,000 for each determination of maltreatment;
189.29 	(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule 
189.30 	governing matters of health, safety, or supervision, including but not limited to the provision 
189.31 	of adequate staff-to-child or adult ratios, and failure to comply with background study 
189.32 	requirements under chapter 245C; and
190.1 	(v) the license holder shall forfeit $500 for each occurrence of failure to comply with 
190.2 	background study requirements under chapter 245C; and
190.3 	(v) (vi) the license holder shall forfeit $100 for each occurrence of a violation of law or 
190.4 	rule other than those subject to a $5,000, $1,000, or $200, or $500 fine in items (i) to (iv)
190.5 	(v).
190.6 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
190.7 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
190.8 	license holder will be personally liable for payment. In the case of a corporation, each 
190.9 	controlling individual is personally and jointly liable for payment.
190.10 	(d) Except for background study violations involving the failure to comply with an order 
190.11 	to immediately remove an individual or an order to provide continuous, direct supervision, 
190.12 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
190.13 	violation to a license holder who self-corrects a background study violation before the 
190.14 	commissioner discovers the violation. A license holder who has previously exercised the 
190.15 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
190.16 	a fine for a subsequent background study violation unless at least 365 days have passed 
190.17 	since the license holder self-corrected the earlier background study violation.

190.18 	Sec. 2. [142B.68] VIDEO SECURITY CAMERAS IN CHILD CARE CENTERS.
190.19 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
190.20 	subdivision have the meanings given.
190.21 	(b) "Facility" means the indoor and outdoor space in which child care is provided that 
190.22 	is owned, leased, or operated by a licensed child care center and does not include any outdoor 
190.23 	space that is not located on the same property as the licensed child care center.
190.24 	(c) "Video security camera" means a closed circuit video camera or other closed circuit 
190.25 	device that captures or records video.
190.26 		Subd. 2.Requirements for video security cameras. (a) Beginning July 1, 2026, a 
190.27 	licensed child care center must have video security cameras in public and shared areas of 
190.28 	its facility as provided under this subdivision and comply with the requirements of this 
190.29 	section if the center is required to post a maltreatment investigation memorandum under 
190.30 	section 142B.16, subdivision 5, or 142B.18, subdivision 6. A center must comply with the 
190.31 	requirements under this section within six months of when the maltreatment investigation 
190.32 	memorandum is posted and must maintain compliance for the length of time the 
190.33 	memorandum is required to be posted.
191.1 	(b) A licensed child care center must have at least one video security camera in each 
191.2 	room designated for infants or toddlers. The camera must be positioned to provide maximum 
191.3 	visibility of the room. If one camera is not sufficient to view at least 80 percent of the square 
191.4 	footage of the room, the center must place an additional camera or cameras in the room to 
191.5 	achieve maximum visibility of the room.
191.6 	(c) A licensed child care center must have a sufficient number of video security cameras 
191.7 	to provide visibility of all the facility's outdoor recreational equipment used by infants or 
191.8 	toddlers and at least 80 percent of the square footage of the facility's fenced-in outdoor space 
191.9 	used by infants or toddlers.
191.10 	(d) The video security cameras must:
191.11 	(1) be turned on and recording at all times the licensed child care center is in operation;
191.12 	(2) record and display the accurate date and time;
191.13 	(3) have a display resolution of 720p or higher; and
191.14 	(4) have a frames per second rate of 15 or higher.
191.15 	(e) A licensed child care center is exempt from having cameras that meet the requirements 
191.16 	under paragraph (d), clauses (2), (3), and (4), if the center has cameras as required in 
191.17 	paragraphs (b) and (c) prior to July 1, 2025.
191.18 		Subd. 3.Retention and disposal of recordings; access to recordings. (a) A licensed 
191.19 	child care center must retain video security camera recordings for 60 calendar days after 
191.20 	the date of the recording. Except as provided under paragraphs (b), (c), and (d), a licensed 
191.21 	child care center must dispose of video security camera recordings after 60 calendar days.
191.22 	(b) A licensed child care center that receives notice from a law enforcement official of 
191.23 	a suspected crime committed against a child at the center may not dispose of any video 
191.24 	security camera recordings until the law enforcement investigation of the suspected crime 
191.25 	is complete.
191.26 	(c) A licensed child care center must retain video security camera recordings related to 
191.27 	an incident that the center must report to the commissioner under Minnesota Rules, part 
191.28 	9503.0130, for six months from the date of the incident.
191.29 	(d) A licensed child care center may retain video security camera recordings to use for 
191.30 	training center employees. Any recordings used for training purposes must redact, as defined 
191.31 	under section 13.825, subdivision 1, identifying information on children shown or heard in 
192.1 	the recording, unless a parent or legal guardian has provided written consent providing that 
192.2 	the center may use unredacted recordings of the parent's or guardian's child.
192.3 	(e) A licensed child care center must adhere to additional requirements issued by the 
192.4 	commissioner regarding retention and disposal of video security camera recordings.
192.5 	(f) A licensed child care center must establish appropriate security safeguards for video 
192.6 	security camera recordings, including procedures for ensuring that the recordings are only 
192.7 	accessible to persons whose work assignment reasonably requires access to the recordings, 
192.8 	and are only accessed by those persons for purposes described in the procedure. All queries 
192.9 	and responses, and all actions in which the recordings are accessed, shared, or disseminated, 
192.10 	must be recorded, including the day and time of the action and who was involved in the 
192.11 	action. The data created pursuant to this paragraph are subject to the same requirements as 
192.12 	the underlying recording under this section.
192.13 		Subd. 4.Dissemination of recordings. (a) A licensed child care center may not sell, 
192.14 	share, transmit, or disseminate a video security camera recording to any person except as 
192.15 	authorized by this subdivision.
192.16 	(b) A child care center must disseminate a video security camera recording pursuant to 
192.17 	a valid court order, search warrant, or subpoena in a civil, criminal, or administrative 
192.18 	proceeding, including an investigation by the commissioner.
192.19 	(c) A licensed child care center must establish a process by which a parent or legal 
192.20 	guardian may review, but not obtain a copy of, a video security camera recording if the 
192.21 	parent or guardian provides documentation from a physician of a child's physical injury.
192.22 	(d) An employee of a licensed child care center who is the subject of proposed disciplinary 
192.23 	action by the center based upon evidence obtained by a video security camera must be given 
192.24 	access to that evidence for purposes of defending against the proposed action. An employee 
192.25 	who obtains a recording or a copy of the recording must treat the recording or copy 
192.26 	confidentially and must not further disseminate it to any other person except as required 
192.27 	under law. The employee must not keep the recording or copy or a portion of the recording 
192.28 	or copy after it is no longer needed for purposes of defending against a proposed action.
192.29 		Subd. 5.Exception. Notwithstanding the requirement to have closed circuit video security 
192.30 	cameras under this section and subdivision 4, paragraph (a), a licensed child care center 
192.31 	that, as of July 1, 2025, provided remote viewing of video footage for parents and legal 
192.32 	guardians may continue to do so in the same manner.
193.1 		Subd. 6.Hold harmless. (a) The commissioner may not issue a fix-it ticket, correction 
193.2 	order, or order of conditional license against a child care center license holder for a licensing 
193.3 	violation that does not imminently endanger the health or safety of the children served by 
193.4 	the center, if the only source of evidence for the violation is video security camera recordings 
193.5 	reviewed as part of an investigation under subdivision 4, paragraph (b). This paragraph 
193.6 	expires upon implementation of the child care weighted risk system under section 142B.171. 
193.7 	The commissioner shall notify the revisor of statutes when the system has been implemented.
193.8 	(b) Upon implementation of the child care weighted risk system under section 142B.171, 
193.9 	the commissioner may not take a licensing action against a child care center license holder 
193.10 	for a violation that counts as 6.5 or below for a child care center in the weighted risk system, 
193.11 	if the only source of evidence for the violation is video security camera recordings reviewed 
193.12 	as part of an investigation under subdivision 4, paragraph (b).
193.13 		Subd. 7.Written policy required. A licensed child care center must have a written 
193.14 	policy on the center's use of video security cameras that includes the following:
193.15 	(1) the days and times the video security cameras in the facility are in use;
193.16 	(2) the locations of all areas monitored by video security cameras in the facility;
193.17 	(3) the center's retention and disposal policies and procedures for the video security 
193.18 	camera recordings;
193.19 	(4) the center's policies governing access to the video security camera recordings; and
193.20 	(5) the center's security safeguards and procedures regarding employee access to the 
193.21 	recordings.
193.22 		Subd. 8.Notices. (a) A licensed child care center must notify all parents and legal 
193.23 	guardians who apply to enroll or enroll a child in the center about the use of video security 
193.24 	cameras in the facility. At the time of a child's enrollment, the center must provide parents 
193.25 	and legal guardians with the video security camera policy required under subdivision 7.
193.26 	(b) A licensed child care center must post a sign at each facility entrance accessible to 
193.27 	visitors that states: "Video security cameras are present to record persons and activities."
193.28 		Subd. 9.Data practices. Video footage collected or maintained by the commissioner 
193.29 	under this section is classified as welfare data under section 13.46.

194.1 	Sec. 3. Minnesota Statutes 2024, section 142D.21, subdivision 10, is amended to read:
194.2 		Subd. 10.Account; carryforward authority. Money appropriated under this section 
194.3 	is available until expended. (a) An account is established in the special revenue fund known 
194.4 	as the great start compensation support payment program account.
194.5 	(b) Money appropriated under this section must be transferred to the great start 
194.6 	compensation support payment program account in the special revenue fund.
194.7 	(c) Money in the account is annually appropriated to the commissioner for the purposes 
194.8 	of this section. Any returned funds are available to be regranted.

194.9 	Sec. 4. Minnesota Statutes 2024, section 142D.23, subdivision 3, is amended to read:
194.10 		Subd. 3.Eligible uses of money. Grantees must use money received under this section, 
194.11 	either directly or through grants to eligible child care providers, for one or more of the 
194.12 	following purposes:
194.13 	(1) the purchase of computers or mobile devices for use in business management;
194.14 	(2) access to the Internet through the provision of necessary hardware such as routers 
194.15 	or modems or by covering the costs of monthly fees for Internet access;
194.16 	(3) covering the costs of subscription to child care management software;
194.17 	(4) covering the costs of training in the use of technology for business management 
194.18 	purposes; or
194.19 	(5) providing grants for up to $4,000 to licensed child care centers to help cover the 
194.20 	costs of video security cameras and related training; or
194.21 	(5) (6) other services as determined by the commissioner.

194.22 	Sec. 5. Minnesota Statutes 2024, section 142D.31, subdivision 2, is amended to read:
194.23 		Subd. 2.Program components. (a) The nonprofit organization must use the grant for:
194.24 	(1) tuition scholarships up to $10,000 per year in amounts per year consistent with the 
194.25 	national TEACH early childhood program requirements for courses leading to the nationally 
194.26 	recognized child development associate credential or college-level courses leading to an 
194.27 	associate's degree or bachelor's degree in early childhood development and school-age care; 
194.28 	and
194.29 	(2) education incentives of a minimum of $250 to participants in the tuition scholarship 
194.30 	program if they complete a year of working in the early care and education field.
195.1 	(b) Applicants for the scholarship must be employed by a licensed or certified early 
195.2 	childhood or child care program and working directly with children, a licensed family child 
195.3 	care provider, employed by a public prekindergarten program, employed by a Head Start 
195.4 	program, or an employee in a school-age program exempt from licensing under section 
195.5 	142B.05, subdivision 2, paragraph (a), clause (8). Lower wage earners must be given priority 
195.6 	in awarding the tuition scholarships. Scholarship recipients must contribute at least ten 
195.7 	percent of the total scholarship and must be sponsored by their employers, who must also 
195.8 	contribute at least five percent of the total scholarship. Scholarship recipients who are 
195.9 	self-employed work in licensed family child care under Minnesota Rules, chapter 9502,
195.10 	must contribute 20 at least ten percent of the total scholarship and are not required to receive 
195.11 	employer sponsorship or employer match.

195.12 	Sec. 6. Minnesota Statutes 2024, section 142E.03, subdivision 3, is amended to read:
195.13 		Subd. 3.Redeterminations. (a) Notwithstanding Minnesota Rules, part 3400.0180, item 
195.14 	A, the county shall conduct a redetermination according to paragraphs (b) and (c).
195.15 	(b) The county shall use the redetermination form developed by the commissioner. The 
195.16 	county must verify the factors listed in subdivision 1, paragraph (a), as part of the 
195.17 	redetermination.
195.18 	(c) An applicant's eligibility must be redetermined no more frequently than every 12 
195.19 	months. The following criteria apply:
195.20 	(1) a family meets the eligibility redetermination requirements if a complete 
195.21 	redetermination form and all required verifications are received within 30 days after the 
195.22 	date the form was due;
195.23 	(2) if the 30th day after the date the form was due falls on a Saturday, Sunday, or holiday, 
195.24 	the 30-day time period is extended to include the next day that is not a Saturday, Sunday, 
195.25 	or holiday. Assistance shall be payable retroactively from the redetermination due date;
195.26 	(3) for a family where at least one parent is younger than 21 years of age, does not have 
195.27 	a high school degree or commissioner of education-selected high school equivalency 
195.28 	certification, and is a student in a school district or another similar program that provides 
195.29 	or arranges for child care, parenting, social services, career and employment supports, and 
195.30 	academic support to achieve high school graduation, the redetermination of eligibility may 
195.31 	be deferred beyond 12 months, to the end of the student's school year; and
196.1 	(4) starting May 25, 2026, if a new eligible child is added to the family and has care 
196.2 	authorized, the redetermination of eligibility must be extended 12 months from the eligible 
196.3 	child's arrival date; and
196.4 	(4) (5) a family and the family's providers must be notified that the family's 
196.5 	redetermination is due at least 45 days before the end of the family's 12-month eligibility 
196.6 	period.

196.7 	Sec. 7. Minnesota Statutes 2024, section 142E.11, subdivision 1, is amended to read:
196.8 		Subdivision 1.General authorization requirements. (a) When authorizing the amount 
196.9 	of child care, the county agency must consider the amount of time the parent reports on the 
196.10 	application or redetermination form that the child attends preschool, a Head Start program, 
196.11 	or school while the parent is participating in an authorized activity.
196.12 	(b) Care must be authorized and scheduled with a provider based on the applicant's or 
196.13 	participant's verified activity schedule when:
196.14 	(1) the family requests care from more than one provider per child;
196.15 	(2) the family requests care from a legal nonlicensed provider; or
196.16 	(3) an applicant or participant is employed by any child care center that is licensed by 
196.17 	the Department of Children, Youth, and Families or has been identified as a high-risk 
196.18 	Medicaid-enrolled provider.
196.19 	This paragraph expires March 2, 2026.
196.20 	(c) If the family remains eligible at redetermination, a new authorization with fewer 
196.21 	hours, the same hours, or increased hours may be determined.

196.22 	Sec. 8. Minnesota Statutes 2024, section 142E.11, subdivision 2, is amended to read:
196.23 		Subd. 2.Maintain steady child care authorizations. (a) Notwithstanding Minnesota 
196.24 	Rules, chapter 3400, the amount of child care authorized under section 142E.12 for 
196.25 	employment, education, or an MFIP employment plan shall continue at the same number 
196.26 	of hours or more hours until redetermination, including:
196.27 	(1) when the other parent moves in and is employed or has an education plan under 
196.28 	section 142E.12, subdivision 3, or has an MFIP employment plan; or
196.29 	(2) when the participant's work hours are reduced or a participant temporarily stops 
196.30 	working or attending an approved education program. Temporary changes include, but are 
197.1 	not limited to, a medical leave, seasonal employment fluctuations, or a school break between 
197.2 	semesters.
197.3 	(b) The county may increase the amount of child care authorized at any time if the 
197.4 	participant verifies the need for increased hours for authorized activities.
197.5 	(c) The county may reduce the amount of child care authorized if a parent requests a 
197.6 	reduction or because of a change in:
197.7 	(1) the child's school schedule;
197.8 	(2) the custody schedule; or
197.9 	(3) the provider's availability.
197.10 	(d) The amount of child care authorized for a family subject to subdivision 1, paragraph 
197.11 	(b), must change when the participant's activity schedule changes. Paragraph (a) does not 
197.12 	apply to a family subject to subdivision 1, paragraph (b). This paragraph expires March 2, 
197.13 	2026.
197.14 	(e) When a child reaches 13 years of age or a child with a disability reaches 15 years of 
197.15 	age, the amount of child care authorized shall continue at the same number of hours or more 
197.16 	hours until redetermination.

197.17 	Sec. 9. Minnesota Statutes 2024, section 142E.13, subdivision 2, is amended to read:
197.18 		Subd. 2.Extended eligibility and redetermination. (a) If the family received three 
197.19 	months of extended eligibility and redetermination is not due, to continue receiving child 
197.20 	care assistance the participant must be employed or have an education plan that meets the 
197.21 	requirements of section 142E.12, subdivision 3, or have an MFIP employment plan. 
197.22 	Notwithstanding Minnesota Rules, part 3400.0110, if child care assistance continues, the 
197.23 	amount of child care authorized shall continue at the same number or more hours until 
197.24 	redetermination, unless a condition in section 142E.11, subdivision 2, paragraph (c), applies. 
197.25 	A family subject to section 142E.11, subdivision 1, paragraph (b), shall have child care 
197.26 	authorized based on a verified activity schedule.
197.27 	(b) If the family's redetermination occurs before the end of the three-month extended 
197.28 	eligibility period to continue receiving child care assistance, the participant must verify that 
197.29 	the participant meets eligibility and activity requirements for child care assistance under 
197.30 	this chapter. IfNotwithstanding Minnesota Rules, part 3400.0110, if child care assistance 
197.31 	continues, the amount of child care authorized is based on section 142E.12. A family subject 
198.1 	to section 142E.11, subdivision 1, paragraph (b), shall have child care authorized based on 
198.2 	a verified activity schedule.

198.3 	EFFECTIVE DATE. This section is effective May 25, 2026.

198.4 	Sec. 10. Minnesota Statutes 2024, section 142E.15, subdivision 1, is amended to read:
198.5 		Subdivision 1.Fee schedule. All changes to parent fees must be implemented on the 
198.6 	first Monday of the service period following the effective date of the change.
198.7 	PARENT FEE SCHEDULE. The parent fee schedule is as follows, except as noted in 
198.8 	subdivision 2:

198.9198.10
198.11
	Income Range (as a percent of the state 
median income, except at the start of the first 
tier)
	Co-payment (as a percentage of adjusted 
gross income)
	
198.12
198.13	0-74.99% 0-99.99% of federal poverty 
guidelines
	$0/biweekly
	
198.14	75.00-99.99% of federal poverty guidelines
	$2/biweekly
	
198.15
198.16	100.00% of federal poverty 
guidelines-27.72% 27.99%
	2.61% 2.6%
	
198.17	27.73-29.04%
	2.61%
	
198.18	29.05-30.36%
	2.61%
	
198.19	30.37-31.68%
	2.61%
	
198.20	31.69-33.00%
	2.91%
	
198.21	33.01-34.32%
	2.91%
	
198.22	34.33-35.65%
	2.91%
	
198.23	35.66-36.96%
	2.91%
	
198.24	36.97-38.29%
	3.21%
	
198.25	38.30-39.61%
	3.21%
	
198.26	39.62-40.93%
	3.21%
	
198.27	40.94-42.25%
	3.84%
	
198.28	42.26-43.57%
	3.84%
	
198.29	43.58-44.89%
	4.46%
	
198.30	44.90-46.21%
	4.76%
	
198.31	46.22-47.53%
	5.05%
	
198.32	47.54-48.85%
	5.65%
	
198.33	48.86-50.17%
	5.95%
	
198.34	50.18-51.49%
	6.24%
	
198.35	51.50-52.81%
	6.84%
	
198.36	52.82-54.13%
	7.58%
	
198.37	54.14-55.45%
	8.33%
	
199.1	55.46-56.77%
	9.20%
	
199.2	56.78-58.09%
	10.07%
	
199.3	58.10-59.41%
	10.94%
	
199.4	59.42-60.73%
	11.55%
	
199.5	60.74-62.06%
	12.16%
	
199.6	62.07-63.38%
	12.77%
	
199.7	63.39-64.70%
	13.38%
	
199.8	64.71-67.00%
	14.00%
	
199.9	28.00-30.99%
	2.6%
	
199.10	31.00-33.99%
	2.6%
	
199.11	34.00-36.99%
	2.9%
	
199.12	37.00-39.99%
	3.2%
	
199.13	40.00-42.99%
	3.8%
	
199.14	43.00-45.99%
	4.4%
	
199.15	46.00-48.99%
	5.0%
	
199.16	49.00-51.99%
	5.6%
	
199.17	52.00-54.99%
	6.2%
	
199.18	55.00-57.99%
	6.8%
	
199.19	58.00-60.99%
	6.9%
	
199.20	61.00-63.99%
	6.9%
	
199.21	64.00-67.00%
	6.9%
	
199.22	Greater than 67.00%
	ineligible
	
199.23 	A family's biweekly co-payment fee is the fixed percentage established for the income 
199.24 	range multiplied by the highest lowest possible income within that income range.

199.25 	EFFECTIVE DATE. This section is effective October 13, 2025.

199.26 	Sec. 11. Minnesota Statutes 2024, section 142E.16, subdivision 3, is amended to read:
199.27 		Subd. 3.Training required. (a) Prior to initial authorization as required in subdivision 
199.28 	1, a legal nonlicensed family child care provider must complete first aid and CPR training 
199.29 	and provide the verification of first aid and CPR training to the commissioner. The training 
199.30 	documentation must have valid effective dates as of the date the registration request is 
199.31 	submitted to the commissioner. The training must have been provided by an individual 
199.32 	approved to provide first aid and CPR instruction and have included CPR techniques for 
199.33 	infants and children.
199.34 	(b) Upon each reauthorization after the authorization period when the initial first aid 
199.35 	and CPR training requirements are met, a legal nonlicensed family child care provider must 
200.1 	provide verification of at least eight hours of additional training listed in the Minnesota 
200.2 	Center for Professional Development Registry.
200.3 	(c) Every 12 months, a legal nonlicensed family child care provider who is unrelated to 
200.4 	the child they care for must complete two hours of training in caring for children approved 
200.5 	by the commissioner.
200.6 	(c) (d) This subdivision only applies to legal nonlicensed family child care providers.

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

200.8 	Sec. 12. Minnesota Statutes 2024, section 142E.16, subdivision 7, is amended to read:
200.9 		Subd. 7.Record-keeping requirement. (a) As a condition of payment, all providers 
200.10 	receiving child care assistance payments must:
200.11 	(1) keep accurate and legible daily attendance records at the site where services are 
200.12 	delivered for children receiving child care assistance; and
200.13 	(2) make those records available immediately to the county or the commissioner upon 
200.14 	request. Any records not provided to a county or the commissioner at the date and time of 
200.15 	the request are deemed inadmissible if offered as evidence by the provider in any proceeding 
200.16 	to contest an overpayment or disqualification of the provider.; and
200.17 	(3) submit data on child enrollment and attendance in the form and manner specified by 
200.18 	the commissioner.
200.19 	(b) As a condition of payment, attendance records must be completed daily and include 
200.20 	the date, the first and last name of each child in attendance, and the times when each child 
200.21 	is dropped off and picked up. To the extent possible, the times that the child was dropped 
200.22 	off to and picked up from the child care provider must be entered by the person dropping 
200.23 	off or picking up the child. The daily attendance records must be retained at the site where 
200.24 	services are delivered for six years after the date of service.
200.25 	(c) When the county or the commissioner knows or has reason to believe that a current 
200.26 	or former provider has not complied with the record-keeping requirement in this subdivision:
200.27 	(1) the commissioner may:
200.28 	(i) deny or revoke a provider's authorization to receive child care assistance payments 
200.29 	under section 142E.17, subdivision 9, paragraph (d);
200.30 	(ii) pursue an administrative disqualification under sections 142E.51, subdivision 5, and 
200.31 	256.98; or
201.1 	(iii) take an action against the provider under sections 142E.50 to 142E.58 section 
201.2 	142E.51; or
201.3 	(2) a county or the commissioner may establish an attendance record overpayment under 
201.4 	paragraph (d).
201.5 	(d) To calculate an attendance record overpayment under this subdivision, the 
201.6 	commissioner or county agency shall subtract the maximum daily rate from the total amount 
201.7 	paid to a provider for each day that a child's attendance record is missing, unavailable, 
201.8 	incomplete, inaccurate, or otherwise inadequate.
201.9 	(e) The commissioner shall develop criteria for a county to determine an attendance 
201.10 	record overpayment under this subdivision.

201.11 	EFFECTIVE DATE. This section is effective June 22, 2026.

201.12 	Sec. 13. Minnesota Statutes 2024, section 142E.17, subdivision 9, is amended to read:
201.13 		Subd. 9.Provider payments. (a) A provider shall bill only for services documented 
201.14 	according to section 142E.16, subdivision 7. The provider shall bill for services provided 
201.15 	within ten days of the end of the service period. A provider must sign each bill and declare, 
201.16 	under penalty of perjury as provided in section 609.48, that the information in the bill is 
201.17 	true and correct. Payments under the child care fund shall be made within 21 days of 
201.18 	receiving a complete bill from the provider. Counties or the state may establish policies that 
201.19 	make payments on a more frequent basis.
201.20 	(b) If a provider has received an authorization of care and been issued a billing form for 
201.21 	an eligible family, the bill must be submitted within 60 days of the last date of service on 
201.22 	the bill. A bill submitted more than 60 days after the last date of service must be paid if the 
201.23 	county determines that the provider has shown good cause why the bill was not submitted 
201.24 	within 60 days. Good cause must be defined in the county's child care fund plan under 
201.25 	section 142E.09, subdivision 3, and the definition of good cause must include county error. 
201.26 	Any bill submitted more than a year after the last date of service on the bill must not be 
201.27 	paid.
201.28 	(c) If a provider provided care for a time period without receiving an authorization of 
201.29 	care and a billing form for an eligible family, payment of child care assistance may only be 
201.30 	made retroactively for a maximum of three months from the date the provider is issued an 
201.31 	authorization of care and a billing form. For a family at application, if a provider provided 
201.32 	child care during a time period without receiving an authorization of care and a billing form, 
201.33 	a county may only make child care assistance payments to the provider retroactively from 
202.1 	the date that child care began, or from the date that the family's eligibility began under 
202.2 	section 142E.10, subdivision 7, or from the date that the family meets authorization 
202.3 	requirements, not to exceed six months from the date that the provider is issued an 
202.4 	authorization of care and a billing form, whichever is later.
202.5 	(d) The commissioner may refuse to issue a child care authorization to a certified, 
202.6 	licensed, or legal nonlicensed provider; revoke an existing child care authorization to a 
202.7 	certified, licensed, or legal nonlicensed provider; stop payment issued to a certified, licensed, 
202.8 	or legal nonlicensed provider; or refuse to pay a bill submitted by a certified, licensed, or 
202.9 	legal nonlicensed provider if:
202.10 	(1) the provider admits to intentionally giving the county materially false information 
202.11 	on the provider's billing forms;
202.12 	(2) the commissioner finds by a preponderance of the evidence that the provider 
202.13 	intentionally gave the county materially false information on the provider's billing forms, 
202.14 	or provided false attendance records to a county or the commissioner;
202.15 	(3) the provider is in violation of child care assistance program rules, until the agency 
202.16 	determines those violations have been corrected;
202.17 	(4) the provider is operating after:
202.18 	(i) an order of suspension of the provider's license issued by the commissioner;
202.19 	(ii) an order of revocation of the provider's license issued by the commissioner; or
202.20 	(iii) an order of decertification issued to the provider;
202.21 	(5) the provider submits false attendance reports or refuses to provide documentation 
202.22 	of the child's attendance upon request;
202.23 	(6) the provider gives false child care price information; or
202.24 	(7) the provider fails to report decreases in a child's attendance as required under section 
202.25 	142E.16, subdivision 9.
202.26 	(e) For purposes of paragraph (d), clauses (3), (5), (6), and (7), the commissioner may 
202.27 	withhold the provider's authorization or payment for a period of time not to exceed three 
202.28 	months beyond the time the condition has been corrected.
202.29 	(f) A county's payment policies must be included in the county's child care plan under 
202.30 	section 142E.09, subdivision 3. If payments are made by the state, in addition to being in 
202.31 	compliance with this subdivision, the payments must be made in compliance with section 
202.32 	16A.124.
203.1 	(g) If the commissioner suspends or refuses payment to a provider under paragraph (d), 
203.2 	clause (1) or (2), or sections 142E.50 to 142E.58 and the provider has:
203.3 	(1) a disqualification for wrongfully obtaining assistance under section 256.98, 
203.4 	subdivision 8, paragraph (c);
203.5 	(2) an administrative disqualification under section 142E.51, subdivision 5; or
203.6 	(3) a termination under section 142E.51, subdivision 4, paragraph (c), clause (4), or 
203.7 	142E.55;
203.8 	then the provider forfeits the payment to the commissioner or the responsible county agency, 
203.9 	regardless of the amount assessed in an overpayment, charged in a criminal complaint, or 
203.10 	ordered as criminal restitution.

203.11 	EFFECTIVE DATE. This section is effective September 15, 2025.

203.12 	Sec. 14. Minnesota Statutes 2024, section 245.0962, subdivision 1, is amended to read:
203.13 		Subdivision 1.Establishment. The commissioner of human services children, youth, 
203.14 	and families must establish a quality parenting initiative grant program to implement quality 
203.15 	parenting initiative principles and practices to support children and families experiencing 
203.16 	foster care placements.

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

203.18 	Sec. 15. ELIMINATING SCHEDULE REPORTER DESIGNATION.
 203.19 	Notwithstanding Minnesota Statutes, section 142E.04, subdivisions 6, 7, and 8, the 
203.20 	commissioner of children, youth, and families must allocate additional basic sliding fee 
203.21 	child care money for calendar years 2026 and 2027 to counties and Tribes to account for 
203.22 	eliminating the schedule reporter designation in the child care assistance program. In 
203.23 	allocating the additional money, the commissioner shall consider:
203.24 	(1) the number of children who are in schedule reporter families; and
203.25 	(2) the average basic sliding fee cost of care in the county or Tribe.

203.26 	Sec. 16. CHILDREN AND FAMILIES INFORMATION TECHNOLOGY SYSTEMS 
203.27 	MODERNIZATION.
 203.28 		Subdivision 1.Direction to commissioner. To the extent there is funding available for 
203.29 	these purposes in the state systems account established under Minnesota Statutes, section 
204.1 	142A.04, subdivision 2, the commissioner of children, youth, and families must establish 
204.2 	and implement the information technology systems described under this section.
204.3 		Subd. 2.Family common application tool. (a) The commissioner must establish and 
204.4 	implement an application tool that allows families to apply for available early care and 
204.5 	education support programs. The application tool must:
204.6 	(1) provide integrated support in multiple languages, including real-time translation 
204.7 	capabilities;
204.8 	(2) include an eligibility screener;
204.9 	(3) include capability for automatic pre-population of known family information and 
204.10 	use open authorization to validate identity;
204.11 	(4) enable application completion and submission across multiple programs and services;
204.12 	(5) integrate selection tool for early care and education programs;
204.13 	(6) reach families through various ways, including employers, employee organizations, 
204.14 	and medical assistance managed care organizations; and
204.15 	(7) operate using the software as a service model that ensures frequent maintenance and 
204.16 	user experience updates.
204.17 	(b) Funding under this section for the application tool may only be used for early care 
204.18 	and education support programs.
204.19 		Subd. 3.Payments system. The commissioner must establish and implement a 
204.20 	centralized, integrated payment system for early care and education funding streams that:
204.21 	(1) integrates seamlessly with the existing provider licensing and reporting hub;
204.22 	(2) implements real-time payment processing and cash management capabilities, including 
204.23 	instant fund transfers and automated reconciliation;
204.24 	(3) incorporates robust security measures, including fraud detection and prevention;
204.25 	(4) enables automated compliance with state and federal reporting requirements;
204.26 	(5) provides a user-friendly interface with mobile accessibility for child care providers 
204.27 	to manage invoices and payments;
204.28 	(6) ensures interoperability with other relevant state systems and databases; and
204.29 	(7) implements data quality monitoring and reporting tools to support decision making.
205.1 		Subd. 4.Reporting requirements. The commissioner must provide quarterly 
205.2 	implementation updates to the chairs and minority leads of the committees with jurisdiction 
205.3 	over programs for children and families. The quarterly updates must describe the department's 
205.4 	progress toward establishing and implementing the information technology systems under 
205.5 	this section. The quarterly updates must continue until either the systems are fully 
205.6 	implemented or the department no longer has sufficient funding for the purposes identified 
205.7 	in this section.

205.8 	Sec. 17. REVISOR INSTRUCTION.
 205.9 	The revisor of statutes shall renumber Minnesota Statutes, section 245.0962, as Minnesota 
205.10 	Statutes, section 142A.47. The revisor shall also make necessary cross-reference changes 
205.11 	consistent with the renumbering.

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

205.13 	Sec. 18. REVISOR INSTRUCTION.
 205.14 	The revisor of statutes shall renumber Minnesota Statutes, section 142D.12, subdivision 
205.15 	3, as Minnesota Statutes, section 120B.121. The revisor shall also make necessary 
205.16 	cross-reference changes consistent with the renumbering.

205.17 	ARTICLE 12
205.18 	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES
205.19 	LICENSING AND CERTIFICATION POLICY

205.20 	Section 1. Minnesota Statutes 2024, section 142B.01, is amended by adding a subdivision 
205.21 	to read:
205.22 		Subd. 12a.Education. For purposes of child care centers, "education" means accredited 
205.23 	coursework in behavior guidance, child abuse and neglect prevention, child development, 
205.24 	child health and safety, child health and wellness, child nutrition, child psychology, child 
205.25 	study techniques, children with special needs, communication studies, computer science, 
205.26 	coordination of community and school activities, cultural studies, curriculum planning, 
205.27 	early childhood education, early childhood special education, elementary education, 
205.28 	elementary special education, English language arts, ethics, family studies, history, 
205.29 	mathematics, music, parent involvement, psychology, recreational sports, arts and crafts 
205.30 	methods or theory, science, social studies, sociology, or other coursework approved by the 
205.31 	commissioner.

205.32 	EFFECTIVE DATE. This section is effective August 1, 2025.

206.1 	Sec. 2. Minnesota Statutes 2024, section 142B.10, subdivision 14, is amended to read:
206.2 		Subd. 14.Grant of license; license extension. (a) If the commissioner determines that 
206.3 	the program complies with all applicable rules and laws, the commissioner shall issue a 
206.4 	license consistent with this section or, if applicable, a temporary change of ownership license 
206.5 	under section 142B.11. At minimum, the license shall state:
206.6 	(1) the name of the license holder;
206.7 	(2) the address of the program;
206.8 	(3) the effective date and expiration date of the license;
206.9 	(4) the type of license;
206.10 	(5) the maximum number and ages of persons that may receive services from the program; 
206.11 	and
206.12 	(6) any special conditions of licensure.
206.13 	(b) The commissioner may issue a license for a period not to exceed two years if:
206.14 	(1) the commissioner is unable to conduct the observation required by subdivision 11, 
206.15 	paragraph (a), clause (3), because the program is not yet operational;
206.16 	(2) certain records and documents are not available because persons are not yet receiving 
206.17 	services from the program; and
206.18 	(3) the applicant complies with applicable laws and rules in all other respects.
206.19 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
206.20 	or persons will be placed or cared for in the licensed program.
206.21 	(d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a 
206.22 	license if the applicant, license holder, or an affiliated controlling individual has:
206.23 	(1) been disqualified and the disqualification was not set aside and no variance has been 
206.24 	granted;
206.25 	(2) been denied a license under this chapter or chapter 245A within the past two years;
206.26 	(3) had a license issued under this chapter or chapter 245A revoked within the past five 
206.27 	years; or
206.28 	(4) failed to submit the information required of an applicant under subdivision 1, 
206.29 	paragraph (f), (g), or (h), after being requested by the commissioner.
207.1 	When a license issued under this chapter or chapter 245A is revoked, the license holder 
207.2 	and each affiliated controlling individual with a revoked license may not hold any license 
207.3 	under chapter 142B for five years following the revocation, and other licenses held by the 
207.4 	applicant or license holder or licenses affiliated with each controlling individual shall also 
207.5 	be revoked.
207.6 	(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license 
207.7 	affiliated with a license holder or controlling individual that had a license revoked within 
207.8 	the past five years if the commissioner determines that (1) the license holder or controlling 
207.9 	individual is operating the program in substantial compliance with applicable laws and rules 
207.10 	and (2) the program's continued operation is in the best interests of the community being 
207.11 	served.
207.12 	(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response 
207.13 	to an application that is affiliated with an applicant, license holder, or controlling individual 
207.14 	that had an application denied within the past two years or a license revoked within the past 
207.15 	five years if the commissioner determines that (1) the applicant or controlling individual 
207.16 	has operated one or more programs in substantial compliance with applicable laws and rules 
207.17 	and (2) the program's operation would be in the best interests of the community to be served.
207.18 	(g) In determining whether a program's operation would be in the best interests of the 
207.19 	community to be served, the commissioner shall consider factors such as the number of 
207.20 	persons served, the availability of alternative services available in the surrounding 
207.21 	community, the management structure of the program, whether the program provides 
207.22 	culturally specific services, and other relevant factors.
207.23 	(h) The commissioner shall not issue or reissue a license under this chapter if an individual 
207.24 	living in the household where the services will be provided as specified under section 
207.25 	245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside 
207.26 	and no variance has been granted.
207.27 	(i) Pursuant to section 142B.18, subdivision 1, paragraph (b), when a license issued 
207.28 	under this chapter has been suspended or revoked and the suspension or revocation is under 
207.29 	appeal, the program may continue to operate pending a final order from the commissioner. 
207.30 	If the license under suspension or revocation will expire before a final order is issued, a 
207.31 	temporary provisional license may be issued provided any applicable license fee is paid 
207.32 	before the temporary provisional license is issued.
207.33 	(j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of 
207.34 	a controlling individual or license holder, and the controlling individual or license holder 
208.1 	is ordered under section 245C.17 to be immediately removed from direct contact with 
208.2 	persons receiving services or is ordered to be under continuous, direct supervision when 
208.3 	providing direct contact services, the program may continue to operate only if the program 
208.4 	complies with the order and submits documentation demonstrating compliance with the 
208.5 	order. If the disqualified individual fails to submit a timely request for reconsideration, or 
208.6 	if the disqualification is not set aside and no variance is granted, the order to immediately 
208.7 	remove the individual from direct contact or to be under continuous, direct supervision 
208.8 	remains in effect pending the outcome of a hearing and final order from the commissioner.
208.9 	(k) For purposes of reimbursement for meals only, under the Child and Adult Care Food 
208.10 	Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, part 226, 
208.11 	relocation within the same county by a licensed family day care provider, shall be considered 
208.12 	an extension of the license for a period of no more than 30 calendar days or until the new 
208.13 	license is issued, whichever occurs first, provided the county agency has determined the 
208.14 	family day care provider meets licensure requirements at the new location.
208.15 	(l) Unless otherwise specified by statute, all licenses issued under this chapter expire at 
208.16 	12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
208.17 	apply for and be granted comply with the requirements in section 142B.12 and be reissued
208.18 	a new license to operate the program or the program must not be operated after the expiration 
208.19 	date. Child foster care license holders must apply for and be granted a new license to operate 
208.20 	the program or the program must not be operated after the expiration date. Upon 
208.21 	implementation of the provider licensing and reporting hub, licenses may be issued each 
208.22 	calendar year.
208.23 	(m) The commissioner shall not issue or reissue a license under this chapter if it has 
208.24 	been determined that a tribal licensing authority has established jurisdiction to license the 
208.25 	program or service.
208.26 	(n) The commissioner of children, youth, and families shall coordinate and share data 
208.27 	with the commissioner of human services to enforce this section.

208.28 	Sec. 3. Minnesota Statutes 2024, section 142B.10, subdivision 16, is amended to read:
208.29 		Subd. 16.Variances. (a) The commissioner may grant variances to rules that do not 
208.30 	affect the health or safety of persons in a licensed program if the following conditions are 
208.31 	met:
208.32 	(1) the variance must be requested by an applicant or license holder on a form and in a 
208.33 	manner prescribed by the commissioner;
209.1 	(2) the request for a variance must include the reasons that the applicant or license holder 
209.2 	cannot comply with a requirement as stated in the rule and the alternative equivalent measures 
209.3 	that the applicant or license holder will follow to comply with the intent of the rule; and
209.4 	(3) the request must state the period of time for which the variance is requested.
209.5 	The commissioner may grant a permanent variance when conditions under which the variance 
209.6 	is requested do not affect the health or safety of persons being served by the licensed program, 
209.7 	nor compromise the qualifications of staff to provide services. The permanent variance shall 
209.8 	expire as soon as the conditions that warranted the variance are modified in any way. Any 
209.9 	applicant or license holder must inform the commissioner of any changes or modifications 
209.10 	that have occurred in the conditions that warranted the permanent variance. Failure to advise 
209.11 	the commissioner shall result in revocation of the permanent variance and may be cause for 
209.12 	other sanctions under sections 142B.17 and 142B.18.
209.13 	The commissioner's decision to grant or deny a variance request is final and not subject to 
209.14 	appeal under the provisions of chapter 14.
209.15 	(b) The commissioner shall consider variances for child care center staff qualification 
209.16 	requirements under Minnesota Rules, parts 9503.0032 and 9503.0033, that do not affect 
209.17 	the health and safety of children served by the center. A variance request must be submitted 
209.18 	to the commissioner in accordance with paragraph (a) and must include a plan for the staff 
209.19 	person to gain additional experience, education, or training, as requested by the commissioner. 
209.20 	When reviewing a variance request under this section, the commissioner shall consider the 
209.21 	staff person's level of professional development, including but not limited to steps completed 
209.22 	on the Minnesota career lattice.
209.23 	(c) The commissioner must grant a variance for a child care program's licensed capacity 
209.24 	limit if:
209.25 	(1) the program's indoor space is within 100 square feet of what would be required for 
209.26 	maximum capacity in the program based on the program's number and qualifications of 
209.27 	staff;
209.28 	(2) the state fire marshal approves the variance; and
209.29 	(3) the applicant or license holder submits the variance request to the commissioner in 
209.30 	accordance with paragraph (a).
209.31 	A child care program's licensed capacity must not increase by more than two children under 
209.32 	this paragraph. For purposes of this paragraph, a "child care program" means a child care 
210.1 	center or family or group family child care provider licensed under this chapter and Minnesota 
210.2 	Rules, chapter 9502 or 9503.
210.3 	(c) (d) Counties shall use a uniform application form developed by the commissioner 
210.4 	for variance requests by family child care license holders.

210.5 	Sec. 4. Minnesota Statutes 2024, section 142B.16, subdivision 2, is amended to read:
210.6 		Subd. 2.Reconsideration of correction orders. (a) If the applicant or license holder 
210.7 	believes that the contents of the commissioner's correction order are in error, the applicant 
210.8 	or license holder may ask the Department of Children, Youth, and Families to reconsider 
210.9 	the parts of the correction order that are alleged to be in error. The request for reconsideration 
210.10 	must be made in writing and must be postmarked and sent to the commissioner within 20 
210.11 	calendar days after receipt of the correction order under this paragraph, or receipt of the 
210.12 	interpretive guidance under paragraph (d), by the applicant or license holder or submitted 
210.13 	in the provider licensing and reporting hub within 20 calendar days from the date the 
210.14 	commissioner issued the order under this paragraph, or provided the interpretive guidance 
210.15 	under paragraph (d), through the hub, and:
210.16 	(1) specify the parts of the correction order that are alleged to be in error;
210.17 	(2) explain why they are in error; and
210.18 	(3) include documentation to support the allegation of error.
210.19 	(b) Upon implementation of the provider licensing and reporting hub, the provider must 
210.20 	use the hub to request reconsideration under this paragraph, or to request interpretive guidance 
210.21 	under paragraph (d). A request for reconsideration does not stay any provisions or 
210.22 	requirements of the correction order. The commissioner's disposition of a request for 
210.23 	reconsideration is final and not subject to appeal under chapter 14.
210.24 	(b) (c) This paragraph applies only to licensed family child care providers. A licensed 
210.25 	family child care provider who requests reconsideration of a correction order under paragraph 
210.26 	(a) may also request, on a form and in the manner prescribed by the commissioner, that the 
210.27 	commissioner expedite the review if:
210.28 	(1) the provider is challenging a violation and provides a description of how complying 
210.29 	with the corrective action for that violation would require the substantial expenditure of 
210.30 	funds or a significant change to their program; and
211.1 	(2) describes what actions the provider will take in lieu of the corrective action ordered 
211.2 	to ensure the health and safety of children in care pending the commissioner's review of the 
211.3 	correction order.
211.4 	(d) Prior to a request for reconsideration under paragraph (a), if the applicant or license 
211.5 	holder believes that the applicable rule or statute is ambiguous or the commissioner's 
211.6 	interpretation of the applicable rule or statute is in error, the applicant or license holder may 
211.7 	ask the Department of Children, Youth, and Families to provide interpretive guidance on 
211.8 	the applicable rule or statute underlying the correction order.
211.9 	(e) The commissioner must not publicly post the correction order for licensed child care 
211.10 	centers or licensed family child care providers on the department's website until:
211.11 	(1) after the 20-calendar-day period for requesting reconsideration; or
211.12 	(2) if the applicant or license holder requested reconsideration, after the commissioner's 
211.13 	disposition of a request for reconsideration is provided to the applicant or license holder.

211.14 	EFFECTIVE DATE. This section is effective July 1, 2025, except that paragraph (e) 
211.15 	is effective January 1, 2026, or upon federal approval, whichever is later. The commissioner 
211.16 	of children, youth, and families must notify the revisor of statutes when federal approval is 
211.17 	obtained.

211.18 	Sec. 5. Minnesota Statutes 2024, section 142B.16, subdivision 5, is amended to read:
211.19 		Subd. 5.Requirement to post conditional license. For licensed family child care 
211.20 	providers and child care centers, upon receipt of any order of conditional license issued by 
211.21 	the commissioner under this section, and notwithstanding a pending request for 
211.22 	reconsideration of the order of conditional license by the license holder, the license holder 
211.23 	shall post the order of conditional license in a place that is conspicuous to the people receiving 
211.24 	services and all visitors to the facility for two years. When the order of conditional license 
211.25 	is accompanied by a maltreatment investigation memorandum prepared under section 
211.26 	626.557 or chapter 260E, the investigation memoranda must be posted with the order of 
211.27 	conditional license, and the license holder must post both in a place that is conspicuous to 
211.28 	the people receiving services and all visitors to the facility for ten years.

211.29 	Sec. 6. Minnesota Statutes 2024, section 142B.171, subdivision 2, is amended to read:
211.30 		Subd. 2.Documented technical assistance.  (a) In lieu of a correction order under section 
211.31 	142B.16, the commissioner shall provide documented technical assistance to a family child 
211.32 	care or child care center license holder if the commissioner finds that:
212.1 	(1) the license holder has failed to comply with a requirement in this chapter or Minnesota 
212.2 	Rules, chapter 9502 or 9503, that the commissioner determines to be low risk as determined 
212.3 	by the child care weighted risk system;
212.4 	(2) the noncompliance does not imminently endanger the health, safety, or rights of the 
212.5 	persons served by the program; and
212.6 	(3) the license holder did not receive documented technical assistance or a correction 
212.7 	order for the same violation at the license holder's most recent annual licensing inspection.
212.8 	(b) Documented technical assistance must include communication from the commissioner 
212.9 	to the license holder that:
212.10 	(1) states the conditions that constitute a violation of a law or rule;
212.11 	(2) references the specific law or rule violated; and
212.12 	(3) explains remedies for correcting the violation.
212.13 	(c) The commissioner shall not publicly publish documented technical assistance on the 
212.14 	department's website.

212.15 	Sec. 7. Minnesota Statutes 2024, section 142B.18, subdivision 6, is amended to read:
212.16 		Subd. 6.Requirement to post licensing order or fine. For licensed family child care 
212.17 	providers and child care centers, upon receipt of any order of license suspension, temporary 
212.18 	immediate suspension, fine, or revocation issued by the commissioner under this section, 
212.19 	and notwithstanding a pending appeal of the order of license suspension, temporary 
212.20 	immediate suspension, fine, or revocation by the license holder, the license holder shall 
212.21 	post the order of license suspension, temporary immediate suspension, fine, or revocation 
212.22 	in a place that is conspicuous to the people receiving services and all visitors to the facility 
212.23 	for two years. When the order of license suspension, temporary immediate suspension, fine, 
212.24 	or revocation is accompanied by a maltreatment investigation memorandum prepared under 
212.25 	section 626.557 or chapter 260E, the investigation memoranda must be posted with the 
212.26 	order of license suspension, temporary immediate suspension, fine, or revocation, and the 
212.27 	license holder must post both in a place that is conspicuous to the people receiving services 
212.28 	and all visitors to the facility for ten years.

213.1 	Sec. 8. [142B.181] POSTING LICENSING ACTIONS ON DEPARTMENT 
213.2 	WEBSITE.
213.3 	(a) The commissioner must post a summary document for each licensing action, except 
213.4 	correction orders under section 142B.16, issued to a licensed child care center and family 
213.5 	child care provider on the Licensing Information Lookup public website maintained by the 
213.6 	Department of Children, Youth, and Families. The commissioner must not post any 
213.7 	communication, including letters, from the commissioner to the center or provider.
213.8 	(b) The commissioner must remove a summary document from the Licensing Information 
213.9 	Lookup public website within ten days of the length of time that the document is required 
213.10 	to be posted under Code of Federal Regulations, title 45, section 98.33.
213.11 	(c) The requirement to post summary documents under this section only applies to 
213.12 	licensing actions issued to licensed child care centers and family child care providers after 
213.13 	the effective date of this section.

213.14 	EFFECTIVE DATE. This section is effective January 1, 2026, or upon federal approval, 
213.15 	whichever is later. The commissioner of children, youth, and families must notify the revisor 
213.16 	of statutes when federal approval is obtained.

213.17 	Sec. 9. Minnesota Statutes 2024, section 142B.30, subdivision 1, is amended to read:
213.18 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and private 
213.19 	agencies that have been designated or licensed by the commissioner to perform licensing 
213.20 	functions and activities under section 142B.10; to recommend denial of applicants under 
213.21 	section 142B.15; to issue correction orders, to issue variances, and to recommend a 
213.22 	conditional license under section 142B.16; or to recommend suspending or revoking a 
213.23 	license or issuing a fine under section 142B.18, shall comply with rules and directives of 
213.24 	the commissioner governing those functions and with this section. The following variances 
213.25 	are excluded from the delegation of variance authority and may be issued only by the 
213.26 	commissioner:
213.27 	(1) dual licensure of family child care and family child foster care;
213.28 	(2) child foster care maximum age requirement;
213.29 	(3) variances regarding disqualified individuals;
213.30 	(4) variances to requirements relating to chemical use problems of a license holder or a 
213.31 	household member of a license holder; and
214.1 	(5) variances to section 142B.74 for a time-limited period. If the commissioner grants 
214.2 	a variance under this clause, the license holder must provide notice of the variance to all 
214.3 	parents and guardians of the children in care.
214.4 	(b) The commissioners of human services and children, youth, and families must both 
214.5 	approve a variance for dual licensure of family child foster care and family adult foster care 
214.6 	or family adult foster care and family child care. Variances under this paragraph are excluded 
214.7 	from the delegation of variance authority and may be issued only by both commissioners.
214.8 	(c) Except as provided in section 142B.41, subdivision 4, paragraph (e), a county agency 
214.9 	must not grant a license holder a variance to exceed the maximum allowable family child 
214.10 	care license capacity of 14 children.
214.11 	(d) A county agency that has been designated by the commissioner to issue family child 
214.12 	care variances must:
214.13 	(1) publish the county agency's policies and criteria for issuing variances on the county's 
214.14 	public website and update the policies as necessary; and
214.15 	(2) annually distribute the county agency's policies and criteria for issuing variances to 
214.16 	all family child care license holders in the county.
214.17 	(e) Before the implementation of NETStudy 2.0, county agencies must report information 
214.18 	about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision 
214.19 	2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the 
214.20 	commissioner at least monthly in a format prescribed by the commissioner.
214.21 	(f) For family child care programs, the commissioner shall require a county agency to 
214.22 	conduct one unannounced licensing review at least annually.
214.23 	(g) A child foster care license issued under this section may be issued for up to two years
214.24 	until implementation of the provider licensing and reporting hub. Upon implementation of 
214.25 	the provider licensing and reporting hub, licenses may be issued each calendar year.
214.26 	(h) A county agency shall report to the commissioner, in a manner prescribed by the 
214.27 	commissioner, the following information for a licensed family child care program:
214.28 	(1) the results of each licensing review completed, including the date of the review, and 
214.29 	any licensing correction order issued;
214.30 	(2) any death, serious injury, or determination of substantiated maltreatment; and
215.1 	(3) any fires that require the service of a fire department within 48 hours of the fire. The 
215.2 	information under this clause must also be reported to the state fire marshal within two 
215.3 	business days of receiving notice from a licensed family child care provider.

215.4 	Sec. 10. Minnesota Statutes 2024, section 142B.41, is amended by adding a subdivision 
215.5 	to read:
215.6 		Subd. 7a.Staff distribution. Notwithstanding Minnesota Rules, part 9503.0040, subpart 
215.7 	2, item B, an aide may substitute for a teacher during morning arrival and afternoon departure 
215.8 	times in a licensed child care center if the total arrival and departure time does not exceed 
215.9 	25 percent of the center's daily hours of operation. In order for an aide to be used in this 
215.10 	capacity, an aide must:
215.11 	(1) be at least 18 years of age;
215.12 	(2) have worked in the licensed child care center for a minimum of 30 days; and
215.13 	(3) have completed all preservice and first-90-days training required for licensing.

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

215.15 	Sec. 11. Minnesota Statutes 2024, section 142B.51, subdivision 2, is amended to read:
215.16 		Subd. 2.Child passenger restraint systems; training requirement. (a) Programs 
215.17 	licensed by the Department of Human Services under chapter 245A or the Department of 
215.18 	Children, Youth, and Families under this chapter and Minnesota Rules, chapter 2960, that 
215.19 	serve a child or children under eight nine years of age must document training that fulfills 
215.20 	the requirements in this subdivision.
215.21 	(b) Before a license holder, staff person, or caregiver transports a child or children under 
215.22 	age eight nine in a motor vehicle, the person transporting the child must satisfactorily 
215.23 	complete training on the proper use and installation of child restraint systems in motor 
215.24 	vehicles. Training completed under this section may be used to meet initial or ongoing 
215.25 	training under Minnesota Rules, part 2960.3070, subparts 1 and 2.
215.26 	(c) Training required under this section must be completed at orientation or initial training 
215.27 	and repeated at least once every five years. At a minimum, the training must address the 
215.28 	proper use of child restraint systems based on the child's size, weight, and age, and the 
215.29 	proper installation of a car seat or booster seat in the motor vehicle used by the license 
215.30 	holder to transport the child or children.
216.1 	(d) Training under paragraph (c) must be provided by individuals who are certified and 
216.2 	approved by the Office of Traffic Safety within the Department of Public Safety. License 
216.3 	holders may obtain a list of certified and approved trainers through the Department of Public 
216.4 	Safety website or by contacting the agency.
216.5 	(e) Notwithstanding paragraph (a), for an emergency relative placement under section 
216.6 	142B.06, the commissioner may grant a variance to the training required by this subdivision 
216.7 	for a relative who completes a child seat safety check up. The child seat safety check up 
216.8 	trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and 
216.9 	must provide one-on-one instruction on placing a child of a specific age in the exact child 
216.10 	passenger restraint in the motor vehicle in which the child will be transported. Once granted 
216.11 	a variance, and if all other licensing requirements are met, the relative applicant may receive 
216.12 	a license and may transport a relative foster child younger than eight years of age. A child 
216.13 	seat safety check up must be completed each time a child requires a different size car seat 
216.14 	according to car seat and vehicle manufacturer guidelines. A relative license holder must 
216.15 	complete training that meets the other requirements of this subdivision prior to placement 
216.16 	of another foster child younger than eight years of age in the home or prior to the renewal 
216.17 	of the child foster care license.

216.18 	EFFECTIVE DATE. This section is effective January 1, 2026, except paragraph (e), 
216.19 	which is effective July 1, 2026.

216.20 	Sec. 12. Minnesota Statutes 2024, section 142B.65, subdivision 8, is amended to read:
216.21 		Subd. 8.Child passenger restraint systems; training requirement.  (a) Before a license 
216.22 	holder transports a child or children under age eight nine in a motor vehicle, the person 
216.23 	placing the child or children in a passenger restraint must satisfactorily complete training 
216.24 	on the proper use and installation of child restraint systems in motor vehicles.
216.25 	(b) Training required under this subdivision must be repeated at least once every five 
216.26 	years. At a minimum, the training must address the proper use of child restraint systems 
216.27 	based on the child's size, weight, and age, and the proper installation of a car seat or booster 
216.28 	seat in the motor vehicle used by the license holder to transport the child or children.
216.29 	(c) Training required under this subdivision must be provided by individuals who are 
216.30 	certified and approved by the Department of Public Safety, Office of Traffic Safety. License 
216.31 	holders may obtain a list of certified and approved trainers through the Department of Public 
216.32 	Safety website or by contacting the agency.
217.1 	(d) Child care providers that only transport school-age children as defined in section 
217.2 	142B.01, subdivision 25, in child care buses as defined in section 169.448, subdivision 1, 
217.3 	paragraph (e), are exempt from this subdivision.
217.4 	(e) Training completed under this subdivision may be used to meet in-service training 
217.5 	requirements under subdivision 9. Training completed within the previous five years is 
217.6 	transferable upon a staff person's change in employment to another child care center.

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

217.8 	Sec. 13. Minnesota Statutes 2024, section 142B.65, subdivision 9, is amended to read:
217.9 		Subd. 9.In-service training. (a) A license holder must ensure that the center director, 
217.10 	staff persons, substitutes, and unsupervised volunteers complete in-service training each 
217.11 	calendar year.
217.12 	(b) The center director and staff persons who work more than 20 hours per week must 
217.13 	complete 24 hours of in-service training each calendar year. Staff persons who work 20 
217.14 	hours or less per week must complete 12 hours of in-service training each calendar year. 
217.15 	Substitutes and unsupervised volunteers must complete at least two hours of training each 
217.16 	year, and the training must include the requirements of paragraphs (d) to (g) and do not 
217.17 	otherwise have a minimum number of hours of training to complete.
217.18 	(c) The number of in-service training hours may be prorated for individuals center 
217.19 	directors and staff persons not employed for an entire year.
217.20 	(d) Each year, in-service training must include:
217.21 	(1) the center's procedures for maintaining health and safety according to section 142B.66 
217.22 	and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according 
217.23 	to Minnesota Rules, part 9503.0110;
217.24 	(2) the reporting responsibilities under chapter 260E and Minnesota Rules, part 
217.25 	9503.0130;
217.26 	(3) at least one-half hour of training on the standards under section 142B.46 and on 
217.27 	reducing the risk of sudden unexpected infant death as required under subdivision 6, if 
217.28 	applicable; and
217.29 	(4) at least one-half hour of training on the risk of abusive head trauma from shaking 
217.30 	infants and young children as required under subdivision 7, if applicable.
217.31 	(e) Each year, or when a change is made, whichever is more frequent, in-service training 
217.32 	must be provided on: (1) the center's risk reduction plan under section 142B.54, subdivision 
218.1 	2; and (2) a child's individual child care program plan as required under Minnesota Rules, 
218.2 	part 9503.0065, subpart 3.
218.3 	(f) At least once every two calendar years, the in-service training must include:
218.4 	(1) child development and learning training under subdivision 3;
218.5 	(2) pediatric first aid that meets the requirements of subdivision 4;
218.6 	(3) pediatric cardiopulmonary resuscitation training that meets the requirements of 
218.7 	subdivision 5;
218.8 	(4) cultural dynamics training to increase awareness of cultural differences; and
218.9 	(5) disabilities training to increase awareness of differing abilities of children.
218.10 	(g) At least once every five years, in-service training must include child passenger 
218.11 	restraint training that meets the requirements of subdivision 8, if applicable.
218.12 	(h) The remaining hours of the in-service training requirement must be met by completing 
218.13 	training in the following content areas of the Minnesota Knowledge and Competency 
218.14 	Framework:
218.15 	(1) Content area I: child development and learning;
218.16 	(2) Content area II: developmentally appropriate learning experiences;
218.17 	(3) Content area III: relationships with families;
218.18 	(4) Content area IV: assessment, evaluation, and individualization;
218.19 	(5) Content area V: historical and contemporary development of early childhood 
218.20 	education;
218.21 	(6) Content area VI: professionalism;
218.22 	(7) Content area VII: health, safety, and nutrition; and
218.23 	(8) Content area VIII: application through clinical experiences.
218.24 	(i) For purposes of this subdivision, the following terms have the meanings given them.
218.25 	(1) "Child development and learning training" means training in understanding how 
218.26 	children develop physically, cognitively, emotionally, and socially and learn as part of the 
218.27 	children's family, culture, and community.
218.28 	(2) "Developmentally appropriate learning experiences" means creating positive learning 
218.29 	experiences, promoting cognitive development, promoting social and emotional development, 
218.30 	promoting physical development, and promoting creative development.
219.1 	(3) "Relationships with families" means training on building a positive, respectful 
219.2 	relationship with the child's family.
219.3 	(4) "Assessment, evaluation, and individualization" means training in observing, 
219.4 	recording, and assessing development; assessing and using information to plan; and assessing 
219.5 	and using information to enhance and maintain program quality.
219.6 	(5) "Historical and contemporary development of early childhood education" means 
219.7 	training in past and current practices in early childhood education and how current events 
219.8 	and issues affect children, families, and programs.
219.9 	(6) "Professionalism" means training in knowledge, skills, and abilities that promote 
219.10 	ongoing professional development.
219.11 	(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring 
219.12 	safety, and providing healthy nutrition.
219.13 	(8) "Application through clinical experiences" means clinical experiences in which a 
219.14 	person applies effective teaching practices using a range of educational programming models.
219.15 	(j) The license holder must ensure that documentation, as required in subdivision 10, 
219.16 	includes the number of total training hours required to be completed, name of the training, 
219.17 	the Minnesota Knowledge and Competency Framework content area, number of hours 
219.18 	completed, and the director's approval of the training.
219.19 	(k) In-service training completed by a staff person that is not specific to that child care 
219.20 	center is transferable upon a staff person's change in employment to another child care 
219.21 	program.

219.22 	Sec. 14. Minnesota Statutes 2024, section 142B.66, subdivision 3, is amended to read:
219.23 		Subd. 3.Emergency preparedness. (a) A licensed child care center must have a written 
219.24 	emergency plan for emergencies that require evacuation, sheltering, or other protection of 
219.25 	a child, such as fire, natural disaster, intruder, or other threatening situation that may pose 
219.26 	a health or safety hazard to a child. The plan must be written on a form developed by the 
219.27 	commissioner and must include:
219.28 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
219.29 	(2) a designated relocation site and evacuation route;
219.30 	(3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation, 
219.31 	shelter-in-place, or lockdown, including procedures for reunification with families;
220.1 	(4) accommodations for a child with a disability or a chronic medical condition;
220.2 	(5) procedures for storing a child's medically necessary medicine that facilitates easy 
220.3 	removal during an evacuation or relocation;
220.4 	(6) procedures for continuing operations in the period during and after a crisis;
220.5 	(7) procedures for communicating with local emergency management officials, law 
220.6 	enforcement officials, or other appropriate state or local authorities; and
220.7 	(8) accommodations for infants and toddlers.
220.8 	(b) The license holder must train staff persons on the emergency plan at orientation, 
220.9 	when changes are made to the plan, and at least once each calendar year. Training must be 
220.10 	documented in each staff person's personnel file.
220.11 	(c) The license holder must conduct drills according to the requirements in Minnesota 
220.12 	Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented.
220.13 	(d) The license holder must review and update the emergency plan annually each calendar 
220.14 	year. Documentation of the annual yearly emergency plan review shall be maintained in 
220.15 	the program's administrative records.
220.16 	(e) The license holder must include the emergency plan in the program's policies and 
220.17 	procedures as specified under section 142B.10, subdivision 21. The license holder must 
220.18 	provide a physical or electronic copy of the emergency plan to the child's parent or legal 
220.19 	guardian upon enrollment.
220.20 	(f) The relocation site and evacuation route must be posted in a visible place as part of 
220.21 	the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140, 
220.22 	subpart 21.

220.23 	Sec. 15. Minnesota Statutes 2024, section 142B.70, subdivision 7, is amended to read:
220.24 		Subd. 7.Child passenger restraint systems; training requirement. (a) A license 
220.25 	holder must comply with all seat belt and child passenger restraint system requirements 
220.26 	under section 169.685.
220.27 	(b) Family and group family child care programs licensed by the Department of Children, 
220.28 	Youth, and Families that serve a child or children under eight nine years of age must 
220.29 	document training that fulfills the requirements in this subdivision.
220.30 	(1) Before a license holder, second adult caregiver, substitute, or helper transports a 
220.31 	child or children under age eight nine in a motor vehicle, the person placing the child or 
221.1 	children in a passenger restraint must satisfactorily complete training on the proper use and 
221.2 	installation of child restraint systems in motor vehicles. Training completed under this 
221.3 	subdivision may be used to meet initial training under subdivision 1 or ongoing training 
221.4 	under subdivision 8.
221.5 	(2) Training required under this subdivision must be at least one hour in length, completed 
221.6 	at initial training, and repeated at least once every five years. At a minimum, the training 
221.7 	must address the proper use of child restraint systems based on the child's size, weight, and 
221.8 	age, and the proper installation of a car seat or booster seat in the motor vehicle used by the 
221.9 	license holder to transport the child or children.
221.10 	(3) Training under this subdivision must be provided by individuals who are certified 
221.11 	and approved by the Department of Public Safety, Office of Traffic Safety. License holders 
221.12 	may obtain a list of certified and approved trainers through the Department of Public Safety 
221.13 	website or by contacting the agency.
221.14 	(c) Child care providers that only transport school-age children as defined in section 
221.15 	142B.01, subdivision 13, paragraph (f), in child care buses as defined in section 169.448, 
221.16 	subdivision 1, paragraph (e), are exempt from this subdivision.

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

221.18 	Sec. 16. Minnesota Statutes 2024, section 142B.70, subdivision 8, is amended to read:
221.19 		Subd. 8.Training requirements for family and group family child care. (a) For 
221.20 	purposes of family and group family child care, the license holder and each second adult 
221.21 	caregiver must complete 16 hours of ongoing training each year. Repeat of topical training 
221.22 	requirements in subdivisions 3 to 9 shall count toward the annual 16-hour training 
221.23 	requirement. Additional ongoing training subjects to meet the annual 16-hour training 
221.24 	requirement must be selected from the following areas:
221.25 	(1) child development and learning training in understanding how a child develops 
221.26 	physically, cognitively, emotionally, and socially, and how a child learns as part of the 
221.27 	child's family, culture, and community;
221.28 	(2) developmentally appropriate learning experiences, including training in creating 
221.29 	positive learning experiences, promoting cognitive development, promoting social and 
221.30 	emotional development, promoting physical development, promoting creative development; 
221.31 	and behavior guidance;
221.32 	(3) relationships with families, including training in building a positive, respectful 
221.33 	relationship with the child's family;
222.1 	(4) assessment, evaluation, and individualization, including training in observing, 
222.2 	recording, and assessing development; assessing and using information to plan; and assessing 
222.3 	and using information to enhance and maintain program quality;
222.4 	(5) historical and contemporary development of early childhood education, including 
222.5 	training in past and current practices in early childhood education and how current events 
222.6 	and issues affect children, families, and programs;
222.7 	(6) professionalism, including training in knowledge, skills, and abilities that promote 
222.8 	ongoing professional development; and
222.9 	(7) health, safety, and nutrition, including training in establishing healthy practices; 
222.10 	ensuring safety; and providing healthy nutrition.
222.11 	(b) A provider who is approved as a trainer through the Develop data system may count 
222.12 	up to two hours of training instruction toward the annual 16-hour training requirement in 
222.13 	paragraph (a). The provider may only count training instruction hours for the first instance 
222.14 	in which they deliver a particular content-specific training during each licensing year. Hours 
222.15 	counted as training instruction must be approved through the Develop data system with 
222.16 	attendance verified on the trainer's individual learning record and must be in Knowledge 
222.17 	and Competency Framework content area VII A (Establishing Healthy Practices) or B 
222.18 	(Ensuring Safety).
222.19 	(c) Substitutes and adult caregivers who provide care for 500 or fewer hours per year 
222.20 	must complete a minimum of one hour of training each calendar year, and the training must 
222.21 	include the requirements in subdivisions 3, 4, 5, 6, and 9.

222.22 	Sec. 17. Minnesota Statutes 2024, section 142B.77, is amended to read:
222.23 	142B.77 SUPERVISION OF REQUIREMENTS FOR FAMILY CHILD CARE 
222.24 	LICENSE HOLDER'S OWN CHILD.
222.25 		Subdivision 1.Supervision of license holder's own child. (a) Notwithstanding Minnesota 
222.26 	Rules, part 9502.0365, subpart 5, and with the license holder's consent, an individual may 
222.27 	be present in the licensed space, may supervise the family child care license holder's own 
222.28 	child both inside and outside of the licensed space, and is exempt from the training and 
222.29 	supervision requirements of this chapter and Minnesota Rules, chapter 9502, if the individual:
222.30 	(1) is related to the license holder or to the license holder's child, as defined in section 
222.31 	142B.01, subdivision 15, or is a household member who the license holder has reported to 
222.32 	the county agency;
223.1 	(2) is not a designated caregiver, helper, or substitute for the licensed program;
223.2 	(3) is involved only in the care of the license holder's own child; and
223.3 	(4) does not have direct, unsupervised contact with any nonrelative children receiving 
223.4 	services.
223.5 	(b) If the individual in paragraph (a) is not a household member, the individual is also 
223.6 	exempt from background study requirements under chapter 245C.
223.7 		Subd. 2.Exclusion from licensed capacity. For the purposes of licensed capacity 
223.8 	requirements under Minnesota Rules, part 9502.0367, one of a license holder's own children 
223.9 	is excluded from licensed capacity, provided the excluded child is at least eight years old 
223.10 	and the license holder has never been determined to have maltreated a child or vulnerable 
223.11 	adult under section 626.557 or chapter 260E.

223.12 	Sec. 18. Minnesota Statutes 2024, section 142C.06, is amended by adding a subdivision 
223.13 	to read:
223.14 		Subd. 4.Requirement to post conditional certification. Upon receipt of any order of 
223.15 	conditional certification issued by the commissioner under this section, and notwithstanding 
223.16 	a pending request for reconsideration of the order of conditional certification by the 
223.17 	certification holder, the certification holder shall post the order of conditional certification 
223.18 	in a place that is conspicuous to the people receiving services and all visitors to the facility 
223.19 	for the duration of the conditional certification. When the order of conditional certification 
223.20 	is accompanied by a maltreatment investigation memorandum prepared under chapter 260E, 
223.21 	the investigation memoranda must be posted with the order of conditional certification.

223.22 	Sec. 19. Minnesota Statutes 2024, section 142C.11, subdivision 8, is amended to read:
223.23 		Subd. 8.Required policies. A certified center must have written policies for health and 
223.24 	safety items in subdivisions 1 to 6, 9, and 10.

223.25 	Sec. 20. Minnesota Statutes 2024, section 142C.12, subdivision 1, is amended to read:
223.26 		Subdivision 1.First aid and cardiopulmonary resuscitation. (a) Before having 
223.27 	unsupervised direct contact with a child, but within 90 days after the first date of direct 
223.28 	contact with a child, the director, all staff persons, substitutes, and unsupervised volunteers 
223.29 	must successfully complete pediatric first aid and pediatric cardiopulmonary resuscitation 
223.30 	(CPR) training, unless the training has been completed within the previous two calendar 
223.31 	years. Staff must complete the pediatric first aid and pediatric CPR training at least every 
224.1 	other calendar year and the center must document the training in the staff person's personnel 
224.2 	record.
224.3 	(b) Training completed under this subdivision may be used to meet the in-service training 
224.4 	requirements under subdivision 6.
224.5 	(c) Training must include CPR and techniques for providing immediate care to people 
224.6 	experiencing life-threatening cardiac emergencies, choking, bleeding, fractures and sprains, 
224.7 	head injuries, poisoning, and burns. Training developed by the American Heart Association, 
224.8 	the American Red Cross, or another organization that uses nationally recognized, 
224.9 	evidence-based guidelines meets these requirements.

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

224.11 	Sec. 21. Minnesota Statutes 2024, section 142C.12, subdivision 6, is amended to read:
224.12 		Subd. 6.In-service training. (a) The certified center must ensure that the director and 
224.13 	all staff persons, including substitutes and unsupervised volunteers, are trained at least once 
224.14 	each calendar year on health and safety requirements in this section and sections 142C.10, 
224.15 	142C.11, and 142C.13.
224.16 	(b) The director and each staff person, not including substitutes, must complete at least 
224.17 	six hours of training each calendar year. Substitutes must complete at least two hours of 
224.18 	training each calendar year. Training required under paragraph (a) may be used toward the 
224.19 	hourly training requirements of this subdivision.

224.20 	Sec. 22. Minnesota Statutes 2024, section 245A.18, subdivision 1, is amended to read:
224.21 		Subdivision 1.Seat belt and child passenger restraint system use. All license holders 
224.22 	that transport children must comply with the requirements of section 142B.51, subdivision 
224.23 	1, and license holders that transport a child or children under eight nine years of age must 
224.24 	document training that fulfills the requirements in section 142B.51, subdivision 2.

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

224.26 	Sec. 23. DIRECTION TO COMMISSIONER OF CHILDREN, YOUTH, AND 
224.27 	FAMILIES; STANDARDIZED LICENSING VISIT TIMELINE AND 
224.28 	REQUIREMENTS.
 224.29 	(a) The commissioner of children, youth, and families must, in consultation with 
224.30 	stakeholders, develop and implement a standardized timeline and standards for the conduct 
225.1 	of licensors when conducting inspections of licensed child care centers. The timeline and 
225.2 	standards developed by the commissioner must clearly identify:
225.3 	(1) the steps of a licensing visit;
225.4 	(2) the expectations for licensors and license holders before, during, and after the licensing 
225.5 	visit;
225.6 	(3) the standards of conduct that licensors must follow during a visit;
225.7 	(4) the rights of license holders;
225.8 	(5) when and how license holders can request technical assistance; and
225.9 	(6) a process for license holders to request additional review of an issue related to the 
225.10 	licensing visit from someone other than the assigned licensor.
225.11 	(b) The timeline and standards must be implemented by January 1, 2026.

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

225.13 	Sec. 24. DIRECTION TO COMMISSIONER OF CHILDREN, YOUTH, AND 
225.14 	FAMILIES; STANDARDIZED COUNTY-DELEGATED LICENSING.
 225.15 	By January 1, 2026, the commissioner of children, youth, and families must:
225.16 	(1) establish time frames for county licensors to respond to time-sensitive or urgent 
225.17 	requests and implement a system to track response times to the requests; and
225.18 	(2) require county licensors to use the electronic licensing inspection tool during an 
225.19 	inspection of a family child care provider and to complete the inspection report on site with 
225.20 	the license holder, including direct communication related to any correction orders issued.

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

225.22 	Sec. 25. REPEALER.
 225.23 	Minnesota Rules, part 9503.0030, subpart 1, item B, is repealed.

225.24 	EFFECTIVE DATE. This section is effective August 1, 2025.

226.1 	ARTICLE 13
226.2 	MISCELLANEOUS

226.3 	Section 1. [135A.1367] OPIATE ANTAGONIST.
226.4 		Subdivision 1.Definition. For purposes of this section, "opiate antagonist" has the 
226.5 	meaning given in section 604A.04, subdivision 1.
226.6 		Subd. 2.Minnesota State Colleges and Universities; University of Minnesota. (a) 
226.7 	The Board of Trustees of the Minnesota State Colleges and Universities shall, and the Board 
226.8 	of Regents of the University of Minnesota is requested to:
226.9 	(1) maintain a supply of opiate antagonists at each campus site to be administered in 
226.10 	compliance with section 151.37, subdivision 12; and
226.11 	(2) have at least two doses of a nasal opiate antagonist available on site at each campus 
226.12 	residential building.
226.13 	(b) The commissioner of health shall identify resources, including at least one training 
226.14 	video, to help postsecondary institutions implement an opiate antagonist emergency response 
226.15 	and make the resources available for institutions.
226.16 	(c) The Board of Trustees and the Board of Regents may adopt a model plan for use, 
226.17 	storage, and administration of opiate antagonists on system campuses.
226.18 		Subd. 3.Tribal colleges. (a) The commissioner of health shall distribute money to Leech 
226.19 	Lake Tribal College, White Earth Tribal College, and Red Lake Nation Tribal College to 
226.20 	make opiate antagonists available according to paragraph (b). The commissioner may 
226.21 	determine an appropriate method to equitably allocate the amounts appropriated among the 
226.22 	colleges.
226.23 	(b) A Tribal college receiving money under this section must:
226.24 	(1) maintain a supply of opiate antagonists at each campus site to be administered in 
226.25 	compliance with section 151.37, subdivision 12; and
226.26 	(2) have at least two doses of a nasal opiate antagonist available on site at each campus 
226.27 	residential building.

226.28 	EFFECTIVE DATE. This section is effective beginning in the 2025-2026 academic 
226.29 	year.

227.1 	Sec. 2. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to 
227.2 	read:
227.3 		Subd. 1c.Emergency medical services provider. "Emergency medical services provider" 
227.4 	means:
227.5 	(1) an ambulance service licensed under chapter 144E;
227.6 	(2) a medical response unit as defined in section 144E.275, subdivision 1;
227.7 	(3) an emergency medical responder as defined in section 144E.001, subdivision 6; or
227.8 	(4) ambulance service personnel as defined in section 144E.001, subdivision 3a.

227.9 	Sec. 3. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to 
227.10 	read:
227.11 		Subd. 7b.Nonopioid directive. "Nonopioid directive" means a written instrument that 
227.12 	includes one or more instructions that a patient must not be administered an opioid by a 
227.13 	health professional or be offered a prescription for an opioid by a prescriber.

227.14 	Sec. 4. Minnesota Statutes 2024, section 145C.01, is amended by adding a subdivision to 
227.15 	read:
227.16 		Subd. 7c.Prescriber. "Prescriber" means an individual who is authorized by section 
227.17 	148.235; 151.01, subdivision 23; or 151.37 to prescribe prescription drugs.

227.18 	Sec. 5. Minnesota Statutes 2024, section 145C.17, is amended to read:
227.19 	145C.17 OPIOID INSTRUCTIONS ENTERED INTO HEALTH RECORD.
227.20 	At the request of the patient or health care agent, a health care provider shall enter into 
227.21 	the patient's health care record any instructions relating to administering, dispensing, or 
227.22 	prescribing an opioid. A health care provider presented with a nonopioid directive executed 
227.23 	by or on behalf of a patient must include the nonopioid directive in the patient's health care 
227.24 	record. A health care provider receiving notice of revocation of a patient's nonopioid directive 
227.25 	must note the revocation in the patient's health care record.

227.26 	Sec. 6. [145C.18] NONOPIOID DIRECTIVE.
227.27 		Subdivision 1.Execution. A patient with the capacity to do so may execute a nonopioid 
227.28 	directive on the patient's own behalf. A patient's health care agent may execute a nonopioid 
227.29 	directive on behalf of the patient. A nonopioid directive must include one or more instructions 
228.1 	that the patient must not be administered an opioid by a health professional or be offered a 
228.2 	prescription for an opioid by a prescriber.
228.3 		Subd. 2.Revocation. A patient who executed a nonopioid directive on the patient's own 
228.4 	behalf may revoke the nonopioid directive at any time and in any manner in which the 
228.5 	patient is able to communicate an intent to revoke the nonopioid directive. A patient's health 
228.6 	care agent may revoke the nonopioid directive executed on behalf of a patient by executing 
228.7 	a written, dated statement of revocation and by providing notice of the revocation to the 
228.8 	patient's health care provider.
228.9 		Subd. 3.Compliance with nonopioid directive; exception. (a) Except as specified in 
228.10 	paragraph (b), prescribers and health professionals must comply with a nonopioid directive 
228.11 	executed under this section.
228.12 	(b) A prescriber or a health professional acting on the order of a prescriber may administer 
228.13 	an opioid to a patient with a nonopioid directive if:
228.14 	(1) the patient is being treated, in emergency circumstances, in a hospital setting or in 
228.15 	a setting outside a hospital;
228.16 	(2) in the prescriber's professional opinion, it is medically necessary to administer an 
228.17 	opioid to the patient in order to treat the patient, including but not limited to during a surgical 
228.18 	procedure when one or more complications arise; and
228.19 	(3) it is not practical or feasible for the prescriber or health professional to access the 
228.20 	patient's health care record.
228.21 	If an opioid is administered according to this paragraph to a patient with a nonopioid 
228.22 	directive, the prescriber must ensure that the patient is provided with information on substance 
228.23 	use disorder services.
228.24 		Subd. 4.Immunities. Except as otherwise provided by law, the following persons or 
228.25 	entities are not subject to criminal prosecution, civil liability, or professional disciplinary 
228.26 	action for failing to prescribe, administer, or dispense an opioid to a patient with a nonopioid 
228.27 	directive; for the administration of an opioid in the circumstances in subdivision 3, paragraph 
228.28 	(b), to a patient with a nonopioid directive; or for the inadvertent administration of an opioid 
228.29 	to a patient with a nonopioid directive, if the act or failure to act was performed in good 
228.30 	faith and in accordance with the applicable standard of care:
228.31 	(1) a health professional whose scope of practice includes prescribing, administering, 
228.32 	or dispensing a controlled substance;
228.33 	(2) an employee of a health professional described in clause (1);
229.1 	(3) a health care facility or an employee of a health care facility; or
229.2 	(4) an emergency medical services provider.
229.3 		Subd. 5.Nonopioid directive form. The commissioner of health must develop a 
229.4 	nonopioid directive form for use by patients and health care agents to communicate to health 
229.5 	professionals and prescribers that a patient with a nonopioid directive must not be 
229.6 	administered an opioid or offered a prescription for an opioid. The commissioner must 
229.7 	include on the nonopioid directive form instructions for how to revoke a nonopioid directive 
229.8 	and other information the commissioner deems relevant. The commissioner must post the 
229.9 	form on the Department of Health website.

229.10 	Sec. 7. Minnesota Statutes 2024, section 151.37, subdivision 12, is amended to read:
229.11 		Subd. 12.Administration of opiate antagonists for drug overdose. (a) A licensed 
229.12 	physician, a licensed advanced practice registered nurse authorized to prescribe drugs 
229.13 	pursuant to section 148.235, or a licensed physician assistant may authorize the following 
229.14 	individuals to administer opiate antagonists, as defined in section 604A.04, subdivision 1:
229.15 	(1) an emergency medical responder registered pursuant to section 144E.27;
229.16 	(2) a peace officer as defined in section 626.84, subdivision 1, paragraphs (c) and (d);
229.17 	(3) correctional employees of a state or local political subdivision;
229.18 	(4) staff of community-based health disease prevention or social service programs;
229.19 	(5) a volunteer firefighter;
229.20 	(6) a nurse or any other personnel employed by, or under contract with, a postsecondary 
229.21 	institution or a charter, public, or private school; and
229.22 	(7) transit rider investment program personnel authorized under section 473.4075.
229.23 	(b) For the purposes of this subdivision, opiate antagonists may be administered by one 
229.24 	of these individuals only if:
229.25 	(1) the licensed physician, licensed physician assistant, or licensed advanced practice 
229.26 	registered nurse has issued a standing order to, or entered into a protocol with, the individual; 
229.27 	and
229.28 	(2) the individual has training in the recognition of signs of opiate overdose and the use 
229.29 	of opiate antagonists as part of the emergency response to opiate overdose.
229.30 	(c) Nothing in this section prohibits the possession and administration of naloxone 
229.31 	pursuant to section 604A.04.
230.1 	(d) Notwithstanding section 148.235, subdivisions 8 and 9, a licensed practical nurse is 
230.2 	authorized to possess and administer according to this subdivision an opiate antagonist in 
230.3 	a school setting.

230.4 	Sec. 8. [325M.335] MENTAL HEALTH WARNING LABEL.
230.5 		Subdivision 1.Warning label required. (a) A social media platform must ensure that 
230.6 	a conspicuous mental health warning label that complies with the requirements under this 
230.7 	section:
230.8 	(1) appears each time a user accesses the social media platform; and
230.9 	(2) only disappears when the user: (i) exits the social media platform; or (ii) acknowledges 
230.10 	the potential for harm and chooses to proceed to the social media platform despite the risk.
230.11 	(b) A mental health warning label under this section must:
230.12 	(1) in a manner that conforms with the guidelines established under subdivision 2, warn 
230.13 	the user of potential negative mental health impacts of accessing the social media platform; 
230.14 	and
230.15 	(2) provide the user access to resources to address the potential negative mental health 
230.16 	impacts described in clause (1) and include the website and telephone number of a national 
230.17 	suicide prevention and mental health crisis hotline system, including but not limited to the 
230.18 	988 Suicide and Crisis Lifeline.
230.19 	(c) A social media platform is prohibited from:
230.20 	(1) providing the warning label exclusively in the social media platform's terms and 
230.21 	conditions;
230.22 	(2) including extraneous information in the warning label that obscures the visibility or 
230.23 	prominence of the warning label; or
230.24 	(3) allowing a user to disable a warning label, except as provided under paragraph (a).
230.25 		Subd. 2.Content of label. (a) The commissioner of health, in consultation with the 
230.26 	commissioner of commerce, must develop guidelines for social media platforms that contain 
230.27 	appropriate requirements for the warning labels required under this section. The guidelines 
230.28 	must be based on current evidence regarding the negative mental health impacts of social 
230.29 	media platforms. The commissioners must review and revise the guidelines as appropriate.
230.30 	(b) The commissioner of health is exempt from chapter 14, including section 14.386, 
230.31 	when implementing this subdivision.

231.1 	Sec. 9. Minnesota Statutes 2024, section 325M.34, is amended to read:
231.2 	325M.34 ENFORCEMENT AUTHORITY.
231.3 	(a) The attorney general may investigate and bring an action against a social media 
231.4 	platform for an alleged violation of section 325M.33 or 325M.335.
231.5 	(b) Nothing in sections 325M.30 to 325M.34 creates a private cause of action in favor 
231.6 	of a person injured by a violation of section 325M.33.

231.7 	ARTICLE 14
231.8 	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS

231.9	Section 1. HUMAN SERVICES APPROPRIATIONS.
 	
231.10 	The sums shown in the columns marked "Appropriations" are appropriated to the 
231.11 	commissioner of human services for the purposes specified in this article. The appropriations 
231.12 	are from the general fund, or another named fund, and are available for the fiscal years 
231.13 	indicated for each purpose. The figures "2026" and "2027" used in this article mean that 
231.14 	the appropriations listed under them are available for the fiscal year ending June 30, 2026, 
231.15 	or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The second year" is 
231.16 	fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.

231.17				APPROPRIATIONS
	
231.18				Available for the Year
	
231.19				Ending June 30
	
231.20					2026
		2027

231.21
231.22	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES
 	$
	2,865,274,000
	$
	2,954,109,000

231.23	Subdivision 1.Total Appropriation

231.24	Appropriations by Fund
	
231.25		2026
	2027
	
231.26	General
	1,583,167,000
	1,795,471,000
	
231.27	Health Care Access
	1,282,107,000
	1,158,634,000
	
231.28 	The amounts that may be spent for each 
231.29 	purpose are specified in this article.

231.30	Subd. 2.Information Technology Appropriations
 					
231.31 	(a) IT appropriations generally. This 
231.32 	appropriation includes money for information 
231.33 	technology projects, services, and support. 
231.34 	Funding for information technology project 
232.1 	costs must be incorporated into the 
232.2 	service-level agreement and paid to Minnesota 
232.3 	IT Services by the Department of Human 
232.4 	Services under the rates and mechanism 
232.5 	specified in that agreement.
232.6 	(b) Receipts for systems project.
232.7 	Appropriations and federal receipts for 
232.8 	information technology systems projects for 
232.9 	MMIS and METS must be deposited in the 
232.10 	state systems account authorized in Minnesota 
232.11 	Statutes, section 256.014. Money appropriated 
232.12 	for information technology projects approved 
232.13 	by the commissioner of Minnesota IT 
232.14 	Services, funded by the legislature, and 
232.15 	approved by the commissioner of management 
232.16 	and budget may be transferred from one 
232.17 	project to another and from development to 
232.18 	operations as the commissioner of human 
232.19 	services deems necessary. Any unexpended 
232.20 	balance in the appropriation for these projects 
232.21 	does not cancel and is available for ongoing 
232.22 	development and operations.

232.23	Sec. 3. CENTRAL OFFICE; OPERATIONS

232.24	Subdivision 1.Total Appropriation
 	$
	232,000
	$
	232,000

232.25	Subd. 2.Base Level Adjustment
 					
232.26 	The base for this section is $75,000 in fiscal 
232.27 	year 2028 and $75,000 in fiscal year 2029.

232.28	Sec. 4. CENTRAL OFFICE; HEALTH CARE

232.29	Subdivision 1.Total Appropriation
 	$
	3,964,000
	$
	24,131,000

232.30	Subd. 2.Base Level Adjustment
 					
232.31 	The base for this section is $44,158,000 in 
232.32 	fiscal year 2028 and $44,158,000 in fiscal year 
232.33 	2029.

233.1
233.2	Sec. 5. CENTRAL OFFICE; BEHAVIORAL 
HEALTH

233.3	Subdivision 1.Total Appropriation
 	$
	-0-
	$
	741,000

233.4	Subd. 2.Base Level Adjustment
 					
233.5 	The base for this section is $768,000 in fiscal 
233.6 	year 2028 and $768,000 in fiscal year 2029.

233.7
233.8	Sec. 6. FORECASTED PROGRAMS; 
MEDICAL ASSISTANCE

233.9	Subdivision 1.Total Appropriation
 	$
	2,852,802,000
	$
	2,920,843,000

233.10	Appropriations by Fund
	
233.11	General
	1,574,160,000
	1,765,674,000
	
233.12	Health Care Access
	1,278,642,000
	1,155,169,000

233.13	Subd. 2.Base Level Adjustment
 					
233.14 	The health care access fund base for this 
233.15 	section is $1,157,833,000 in fiscal year 2028 
233.16 	and $1,176,922,000 in fiscal year 2029.

233.17
233.18	Sec. 7. FORECASTED PROGRAMS; 
BEHAVIORAL HEALTH FUND
 	$
	-0-
	$
	39,000

233.19
233.20	Sec. 8. GRANT PROGRAMS; HEALTH CARE 
GRANTS
 	$
	8,276,000
	$
	8,276,000

233.21	Appropriations by Fund
	
233.22	General
	4,811,000
	4,811,000
	
233.23	Health Care Access
	3,465,000
	3,465,000

233.24 	Sec. 9. TRANSFERS.
 233.25 		Subdivision 1.Grants. The commissioner of human services, with the advance approval 
233.26 	of the commissioner of management and budget, may transfer unencumbered appropriation 
233.27 	balances for the biennium ending June 30, 2027, within fiscal years among general assistance, 
233.28 	medical assistance, MinnesotaCare, the Minnesota supplemental aid program, the housing 
233.29 	support program, and the entitlement portion of the behavioral health fund between fiscal 
233.30 	years of the biennium. The commissioner shall report to the chairs and ranking minority 
233.31 	members of the legislative committees with jurisdiction over health and human services 
233.32 	quarterly about transfers made under this subdivision.
234.1 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
234.2 	may be transferred within the Department of Human Services as the commissioner deems 
234.3 	necessary, with the advance approval of the commissioner of management and budget. The 
234.4 	commissioner shall report to the chairs and ranking minority members of the legislative 
234.5 	committees with jurisdiction over health and human services finance quarterly about transfers 
234.6 	made under this section.

234.7 	Sec. 10. GRANT ADMINISTRATION COSTS.
 234.8 	The administrative costs retention requirement under Minnesota Statutes, section 16B.98, 
234.9 	subdivision 14, is inapplicable to any appropriation in this article for a grant.

234.10 	Sec. 11. APPROPRIATIONS GIVEN EFFECT ONCE.
 234.11 	If an appropriation, cancellation, or transfer in this article is enacted more than once 
234.12 	during the 2025 regular session, the appropriation, cancellation, or transfer must be given 
234.13 	effect once.

234.14 	Sec. 12. EXPIRATION OF UNCODIFIED LANGUAGE.
 234.15 	All uncodified language contained in this article expires June 30, 2027, unless a different 
234.16 	expiration date is explicit or an appropriation is made available beyond June 30, 2027.

234.17 	ARTICLE 15
234.18 	DEPARTMENT OF HEALTH APPROPRIATIONS

234.19	Section 1. HEALTH APPROPRIATIONS.
 	
234.20 	The sums shown in the columns marked "Appropriations" are appropriated to the 
234.21 	commissioner of health for the purposes specified in this article. The appropriations are 
234.22 	from the general fund, or another named fund, and are available for the fiscal years indicated 
234.23 	for each purpose. The figures "2026" and "2027" used in this article mean that the 
234.24 	appropriations listed under them are available for the fiscal year ending June 30, 2026, or 
234.25 	June 30, 2027, respectively. "The first year" is fiscal year 2026. "The second year" is fiscal 
234.26 	year 2027. "The biennium" is fiscal years 2026 and 2027.

234.27				APPROPRIATIONS
	
234.28				Available for the Year
	
234.29				Ending June 30
	
234.30					2026
		2027

234.31	Sec. 2. COMMISSIONER OF HEALTH
 	$
	413,039,000
	$
	410,410,000

235.1	Appropriations by Fund
	
235.2		2026
	2027
	
235.3	General
	265,883,000
	264,366,000
	
235.4
235.5	State Government 
Special Revenue
	80,678,000
	80,512,000
	
235.6	Health Care Access
	54,765,000
	53,819,000
	
235.7	Federal TANF
	11,713,000
	11,713,000
	
235.8 	The amounts that may be spent for each 
235.9 	purpose are specified in this article.

235.10	Sec. 3. HEALTH IMPROVEMENT

235.11	Subdivision 1.Total Appropriation
 	$
	285,240,000
	$
	280,679,000

235.12	Appropriations by Fund
	
235.13	General
	210,915,000
	208,746,000
	
235.14
235.15	State Government 
Special Revenue
	9,258,000
	9,258,000
	
235.16	Health Care Access
	53,354,000
	50,962,000
	
235.17	Federal TANF
	11,713,000
	11,713,000

235.18
235.19	Subd. 2.Local and Tribal Public Health 
Cannabis and Substance Misuse Grant Program
 					
235.20 	$6,256,000 in fiscal year 2026 and $6,256,000 
235.21 	in fiscal year 2027 are from the general fund 
235.22 	for the local and Tribal public health cannabis 
235.23 	and substance misuse grant program under 
235.24 	Minnesota Statutes, section 144.197, 
235.25 	subdivision 4.

235.26
235.27
235.28	Subd. 3.Cannabis and Substance Misuse 
Prevention and Education Programs; Youth 
Prevention and Education Program
 					
235.29 	$4,876,000 in fiscal year 2026 and $4,890,000 
235.30 	in fiscal year 2027 are from the general fund 
235.31 	for the cannabis and substance misuse youth 
235.32 	prevention and education program under 
235.33 	Minnesota Statutes, section 144.197, 
235.34 	subdivision 1.

236.1	Subd. 4.Public Health Infrastructure Funds
 					
236.2 	$4,000,000 in fiscal year 2026 and $4,000,000 
236.3 	in fiscal year 2027 are from the general fund 
236.4 	to distribute to community health boards and 
236.5 	Tribal governments to support their ability to 
236.6 	meet national public health standards.

236.7
236.8	Subd. 5.Sexual and Reproductive Health 
Services Grant Program
 					
236.9 	$11,483,000 in fiscal year 2026 and 
236.10 	$11,483,000 in fiscal year 2027 are from the 
236.11 	general fund for the sexual and reproductive 
236.12 	health services grant program under Minnesota 
236.13 	Statutes, section 145.925.

236.14
236.15	Subd. 6.Internal Policy to Promote Diversity, 
Equity, and Inclusion
 					
236.16 	The general fund appropriations in this section 
236.17 	include reductions of $337,000 in fiscal year 
236.18 	2026 and $337,000 in fiscal year 2027 for an 
236.19 	internal Department of Health policy to 
236.20 	promote diversity, equity, and inclusion 
236.21 	funded under Laws 2023, chapter 70.

236.22	Subd. 7.Partner Engagement and Staffing
 					
236.23 	The general fund appropriations in this section 
236.24 	include reductions of $110,000 in fiscal year 
236.25 	2026 and $110,000 in fiscal year 2027 for 
236.26 	partner engagement and staffing activities 
236.27 	funded under Laws 2023, chapter 70, and 
236.28 	Laws 2021, First Special Session chapter 7.

236.29
236.30	Subd. 8.Development of Nonopioid Directive 
Form
 					
236.31 	$10,000 in fiscal year 2026 is from the general 
236.32 	fund for the development of a nonopioid 
236.33 	directive form under Minnesota Statutes, 
236.34 	section 145C.18, subdivision 5.

237.1
237.2	Subd. 9.Spoken Language Health Care 
Interpreter Work Group
 					
237.3 	$150,000 in fiscal year 2026 is from the 
237.4 	general fund for the spoken language health 
237.5 	care interpreter work group. This appropriation 
237.6 	is available until June 30, 2027.

237.7	Subd. 10.Dementia Services Program
 					
237.8 	$500,000 in fiscal year 2026 and $500,000 in 
237.9 	fiscal year 2027 are from the general fund for 
237.10 	the dementia services program under 
237.11 	Minnesota Statutes, section 144.063.

237.12	Subd. 11.Opiate Antagonists at Tribal Colleges
 					
237.13 	$75,000 in fiscal year 2026 and $75,000 in 
237.14 	fiscal year 2027 are from the general fund to 
237.15 	make opiate antagonists available at Tribal 
237.16 	colleges under Minnesota Statutes, section 
237.17 	135A.1367, subdivision 3.

237.18
237.19	Subd. 12.Materials on Recognizing Signs of 
Physical Abuse in Infants
 					
237.20 	$55,000 in fiscal year 2026 is from the general 
237.21 	fund for the development of materials on 
237.22 	recognizing the signs of physical abuse in 
237.23 	infants under Minnesota Statutes, section 
237.24 	144.124, subdivision 2.

237.25	Subd. 13.Opioid Use Prevention and Education
 					
237.26 	$500,000 in fiscal year 2026 and $500,000 in 
237.27 	fiscal year 2027 are from the general fund for 
237.28 	a grant to Change the Outcome to provide:
237.29 	(1) data-centered learning opportunities on the 
237.30 	dangers of opioid use in middle and high 
237.31 	schools and communities in Minnesota;
238.1 	(2) instruction on prevention strategies, 
238.2 	assessing personal risk, and how to recognize 
238.3 	an overdose;
238.4 	(3) information on emerging drug trends 
238.5 	including but not limited to fentanyl, xylazine, 
238.6 	and pressed pills; and
238.7 	(4) access to resources, including support for 
238.8 	those struggling with substance use disorders.

238.9238.10
	Subd. 14.Guidelines for Social Media Mental 
Health Warning Labels
 					
238.11 	$45,000 in fiscal year 2026 is from the general 
238.12 	fund to develop and review guidelines for 
238.13 	social media mental health warning labels 
238.14 	under Minnesota Statutes, section 325M.335, 
238.15 	subdivision 2.

238.16	Subd. 15.TANF Appropriations
 					
238.17 	TANF funds must be used as follows:
238.18 	(1) $3,579,000 in fiscal year 2026 and 
238.19 	$3,579,000 in fiscal year 2027 are from the 
238.20 	TANF fund for home visiting and nutritional 
238.21 	services listed under Minnesota Statutes, 
238.22 	section 145.882, subdivision 7, clauses (6) and 
238.23 	(7). Funds must be distributed to community 
238.24 	health boards according to Minnesota Statutes, 
238.25 	section 145A.131, subdivision 1;
238.26 	(2) $2,000,000 in fiscal year 2026 and 
238.27 	$2,000,000 in fiscal year 2027 are from the 
238.28 	TANF fund for decreasing racial and ethnic 
238.29 	disparities in infant mortality rates under 
238.30 	Minnesota Statutes, section 145.928, 
238.31 	subdivision 7;
238.32 	(3) $4,978,000 in fiscal year 2026 and 
238.33 	$4,978,000 in fiscal year 2027 are from the 
238.34 	TANF fund for the family home visiting grant 
239.1 	program under Minnesota Statutes, section 
239.2 	145A.17. Of these amounts, $4,000,000 in 
239.3 	fiscal year 2026 and $4,000,000 in fiscal year 
239.4 	2027 must be distributed to community health 
239.5 	boards under Minnesota Statutes, section 
239.6 	145A.131, subdivision 1; and $978,000 in 
239.7 	fiscal year 2026 and $978,000 in fiscal year 
239.8 	2027 must be distributed to Tribal 
239.9 	governments under Minnesota Statutes, section 
239.10 	145A.14, subdivision 2a;
239.11 	(4) $1,156,000 in fiscal year 2026 and 
239.12 	$1,156,000 in fiscal year 2027 are from the 
239.13 	TANF fund for sexual and reproductive health 
239.14 	services grants under Minnesota Statutes, 
239.15 	section 145.925; and
239.16 	(5) the commissioner may use up to 6.23 
239.17 	percent of the funds appropriated from the 
239.18 	TANF fund each fiscal year to conduct the 
239.19 	ongoing evaluations required under Minnesota 
239.20 	Statutes, section 145A.17, subdivision 7, and 
239.21 	training and technical assistance required 
239.22 	under Minnesota Statutes, section 145A.17, 
239.23 	subdivisions 4 and 5.

239.24	Subd. 16.TANF Carryforward
 					
239.25 	Any unexpended balance of the TANF 
239.26 	appropriation in the first year does not cancel 
239.27 	but is available in the second year.

239.28	Subd. 17.Base Level Adjustment
 					
239.29 	The general fund base for this section is 
239.30 	$207,520,000 in fiscal year 2028 and 
239.31 	$207,520,000 in fiscal year 2029.

239.32	Sec. 4. HEALTH PROTECTION

239.33	Subdivision 1.Total Appropriation
 	$
	105,523,000
	$
	104,982,000

240.1	Appropriations by Fund
	
240.2	General
	34,103,000
	33,728,000
	
240.3
240.4	State Government 
Special Revenue
	71,420,000
	71,254,000

240.5
240.6	Subd. 2.Infectious Disease Prevention, Early 
Detection, and Outbreak Response
 					
240.7 	$1,300,000 in fiscal year 2026 and $1,300,000 
240.8 	in fiscal year 2027 are from the general fund 
240.9 	for infectious disease prevention, early 
240.10 	detection, and outbreak response activities 
240.11 	under Minnesota Statutes, section 144.05, 
240.12 	subdivision 1.

240.13
240.14	Subd. 3.Collaborative Funding for State and 
Outside Partners
 					
240.15 	The general fund appropriations in this section 
240.16 	include reductions of $30,000 in fiscal year 
240.17 	2026 and $30,000 in fiscal year 2027 for 
240.18 	collaborative funding for state and outside 
240.19 	partners funded under Laws 2023, chapter 70.

240.20	Subd. 4.Base Level Adjustments
 					
240.21 	The general fund base for this section is 
240.22 	$33,683,000 in fiscal year 2028 and 
240.23 	$33,683,000 in fiscal year 2029. The state 
240.24 	government special revenue fund base for this 
240.25 	section is $71,265,000 in fiscal year 2028 and 
240.26 	$71,277,000 in fiscal year 2029.

240.27	Sec. 5. HEALTH OPERATIONS
 	$
	22,276,000
	$
	24,749,000

240.28	Appropriations by Fund
	
240.29	General
	20,865,000
	21,892,000
	
240.30	Health Care Access
	1,411,000
	2,857,000

240.31 	Sec. 6. TRANSFERS.
 240.32 	Positions, salary money, and nonsalary administrative money may be transferred within 
240.33 	the Department of Health as the commissioner deems necessary with the advance approval 
240.34 	of the commissioner of management and budget. The commissioner shall report to the chairs 
241.1 	and ranking minority members of the legislative committees with jurisdiction over health 
241.2 	finance quarterly about transfers made under this section.

241.3 	Sec. 7. INDIRECT COSTS NOT TO FUND PROGRAMS.
 241.4 	The commissioner of health shall not use indirect cost allocations to pay for the 
241.5 	operational costs of any program for which the commissioner is responsible.

241.6 	Sec. 8. GRANT ADMINISTRATION COSTS.
 241.7 	The administrative costs retention requirement under Minnesota Statutes, section 16B.98, 
241.8 	subdivision 14, is inapplicable to any appropriation in this article for a grant.

241.9 	Sec. 9. APPROPRIATIONS GIVEN EFFECT ONCE.
 241.10 	If an appropriation, cancellation, or transfer in this article is enacted more than once 
241.11 	during the 2025 regular session, the appropriation, cancellation, or transfer must be given 
241.12 	effect once.

241.13 	Sec. 10. EXPIRATION OF UNCODIFIED LANGUAGE.
 241.14 	All uncodified language contained in this article expires on June 30, 2027, unless a 
241.15 	different expiration date is explicit or an appropriation is made available after June 30, 2027.

241.16 	ARTICLE 16
241.17 	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES
241.18 	APPROPRIATIONS

241.19	Section 1. CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS.
 	
241.20 	The sums shown in the columns marked "Appropriations" are appropriated to the 
241.21 	commissioner of children, youth, and families for the purposes specified in this article. The 
241.22 	appropriations are from the general fund, or another named fund, and are available for the 
241.23 	fiscal years indicated for each purpose. The figures "2026" and "2027" used in this article 
241.24 	mean that the appropriations listed under them are available for the fiscal year ending June 
241.25 	30, 2026, or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The second 
241.26 	year" is fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.

241.27				APPROPRIATIONS
	
241.28				Available for the Year
	
241.29				Ending June 30
	
241.30					2026
		2027

241.31	Sec. 2. TOTAL APPROPRIATION
 	$
	1,312,922,000
	$
	1,341,755,000

242.1	Appropriations by Fund
	
242.2		2026
	2027
	
242.3	General
	1,084,762,000
	1,093,133,000
	
242.4
242.5	State Government 
Special Revenue
	732,000
	732,000
	
242.6	Federal TANF
	227,428,000
	247,890,000
	
242.7 	The amounts that may be spent for each 
242.8 	purpose are specified in the following sections.

242.9	Sec. 3. TANF MAINTENANCE OF EFFORT

242.10	Subdivision 1.Nonfederal Expenditures
 					
242.11 	The commissioner shall ensure that sufficient 
242.12 	qualified nonfederal expenditures are made 
242.13 	each year to meet the state's maintenance of 
242.14 	effort requirements of the TANF block grant 
242.15 	specified under Code of Federal Regulations, 
242.16 	title 45, section 263.1. In order to meet these 
242.17 	basic TANF maintenance of effort 
242.18 	requirements, the commissioner may report 
242.19 	as TANF maintenance of effort expenditures 
242.20 	only nonfederal money expended for allowable 
242.21 	activities listed in the following clauses:
242.22 	(1) MFIP cash, diversionary work program, 
242.23 	and food assistance benefits under Minnesota 
242.24 	Statutes, chapter 142G;
242.25 	(2) the child care assistance programs under 
242.26 	Minnesota Statutes, sections 142E.04 and 
242.27 	142E.08, and county child care administrative 
242.28 	costs under Minnesota Statutes, section 
242.29 	142E.02, subdivision 9;
242.30 	(3) state and county MFIP administrative costs 
242.31 	under Minnesota Statutes, chapters 142G and 
242.32 	256K;
243.1 	(4) state, county, and Tribal MFIP 
243.2 	employment services under Minnesota 
243.3 	Statutes, chapters 142G and 256K;
243.4 	(5) expenditures made on behalf of legal 
243.5 	noncitizen MFIP recipients who qualify for 
243.6 	the MinnesotaCare program under Minnesota 
243.7 	Statutes, chapter 256L;
243.8 	(6) qualifying working family credit 
243.9 	expenditures under Minnesota Statutes, section 
243.10 	290.0671, and child tax credit expenditures 
243.11 	under Minnesota Statutes, section 290.0661;
243.12 	(7) qualifying Minnesota education credit 
243.13 	expenditures under Minnesota Statutes, section 
243.14 	290.0674; and
243.15 	(8) qualifying Head Start expenditures under 
243.16 	Minnesota Statutes, section 142D.12.

243.17	Subd. 2.Nonfederal Expenditures; Reporting
 					
243.18 	For the activities listed in subdivision 1, 
243.19 	clauses (2) to (8), the commissioner may 
243.20 	report only expenditures that are excluded 
243.21 	from the definition of assistance under Code 
243.22 	of Federal Regulations, title 45, section 
243.23 	260.31.

243.24	Subd. 3.Supplemental Expenditures
 					
243.25 	For the purposes of this section, the 
243.26 	commissioner may supplement the 
243.27 	maintenance of effort claim with working 
243.28 	family credit expenditures or other qualified 
243.29 	expenditures to the extent such expenditures 
243.30 	are otherwise available after considering the 
243.31 	expenditures allowed in this section.

244.1	Subd. 4.Reduction of Appropriations; Exception
 					
244.2 	The requirement in Minnesota Statutes, section 
244.3 	142A.06, subdivision 3, that federal grants or 
244.4 	aids secured or obtained under that subdivision 
244.5 	be used to reduce any direct appropriations 
244.6 	provided by law does not apply if the grants 
244.7 	or aids are federal TANF funds.

244.8	Subd. 5.IT Appropriations Generally
 					
244.9 	This appropriation includes funds for 
244.10 	information technology projects, services, and 
244.11 	support. Funding for information technology 
244.12 	project costs must be incorporated into the 
244.13 	service level agreement and paid to Minnesota 
244.14 	IT Services by the Department of Children, 
244.15 	Youth, and Families under the rates and 
244.16 	mechanism specified in that agreement.

244.17	Subd. 6.Receipts for Systems Project
 					
244.18 	Appropriations and federal receipts for 
244.19 	information technology systems projects for 
244.20 	MAXIS, PRISM, MMIS, ISDS, METS, and 
244.21 	SSIS must be deposited in the state systems 
244.22 	account authorized in Minnesota Statutes, 
244.23 	section 142A.04. Money appropriated for 
244.24 	information technology projects approved by 
244.25 	the commissioner of Minnesota IT Services 
244.26 	funded by the legislature, and approved by the 
244.27 	commissioner of management and budget may 
244.28 	be transferred from one project to another and 
244.29 	from development to operations as the 
244.30 	commissioner of children, youth, and families 
244.31 	considers necessary. Any unexpended balance 
244.32 	in the appropriation for these projects does not 
244.33 	cancel and is available for ongoing 
244.34 	development and operations.

245.1
245.2	Subd. 7.Federal SNAP Education and Training 
Grants
 					
245.3 	Federal funds available during fiscal years 
245.4 	2026 and 2027 for Supplemental Nutrition 
245.5 	Assistance Program Education and Training 
245.6 	and SNAP Quality Control Performance 
245.7 	Bonus grants are appropriated to the 
245.8 	commissioner of human services for the 
245.9 	purposes allowable under the terms of the 
245.10 	federal award. This subdivision is effective 
245.11 	the day following final enactment.

245.12
245.13	Sec. 4. CENTRAL OFFICE; AGENCY 
SUPPORTS

245.14	Subdivision 1.Total Appropriation
 	$
	138,708,000
	$
	102,070,000

245.15	Appropriations by Fund
	
245.16		2026
	2027
	
245.17	General
	137,876,000
	101,238,000
	
245.18
245.19	State Government 
Special Revenue
	732,000
	732,000
	
245.20	Federal TANF
	100,000
	100,000

245.21	Subd. 2.Information Technology
 					
245.22 	$40,000,000 in fiscal year 2026 is for 
245.23 	information technology improvements to 
245.24 	SSIS. The appropriation must be used to 
245.25 	develop and implement a modernization plan 
245.26 	for SSIS that addresses priorities established 
245.27 	through collaborative planning with counties 
245.28 	and Tribal Nations that use SSIS. Priorities 
245.29 	must take into consideration available funding 
245.30 	and have a direct impact on child welfare 
245.31 	casework. The appropriation must not be used 
245.32 	for changes to SSIS that are not part of the 
245.33 	child welfare modernization plan. This is a 
245.34 	onetime appropriation.

246.1	Subd. 3.Base Level Adjustment
 					
246.2 	The general fund base is $95,066,000 in fiscal 
246.3 	year 2028 and $95,066,000 in fiscal year 2029.

246.4
246.5	Sec. 5. CENTRAL OFFICE; CHILD SAFETY 
AND PERMANENCY
 	$
	17,232,000
	$
	16,945,000

246.6
246.7	Sec. 6. CENTRAL OFFICE; EARLY 
CHILDHOOD
 	$
	17,212,000
	$
	13,337,000

246.8
246.9	Subdivision 1.Child Care Attendance and 
Record-Keeping System
 					
246.10 	$5,555,000 in fiscal year 2026 and $1,639,000 
246.11 	in fiscal year 2027 are to develop a statewide 
246.12 	electronic attendance and record-keeping 
246.13 	system for the child care assistance program. 
246.14 	The system must provide the commissioner, 
246.15 	county agencies, and Tribal Nations that 
246.16 	administer the program with real-time access 
246.17 	to electronic attendance records to verify 
246.18 	children's enrollment in the program. This is 
246.19 	a onetime appropriation.

246.20	Subd. 2.Base Level Adjustment
 					
246.21 	The general fund base is $11,698,000 in fiscal 
246.22 	year 2028 and $11,698,000 in fiscal year 2029.

246.23
246.24	Sec. 7. CENTRAL OFFICE; ECONOMIC 
OPPORTUNITIES AND YOUTH SERVICES
 	$
	3,852,000
	$
	3,562,000

246.25
246.26	Sec. 8. CENTRAL OFFICE; FAMILY 
WELL-BEING
 	$
	14,147,000
	$
	14,147,000

246.27	Appropriations by Fund
	
246.28		2026
	2027
	
246.29	General
	10,471,000
	10,471,000
	
246.30	Federal TANF
	3,676,000
	3,676,000

246.31
246.32	Sec. 9. FORECASTED PROGRAMS; 
MFIP/DWP
 	$
	230,473,000
	$
	268,167,000

246.33	Appropriations by Fund
	
246.34		2026
	2027
	
247.1	General
	103,272,000
	120,504,000
	
247.2	Federal TANF
	127,201,000
	147,663,000

247.3
247.4	Sec. 10. FORECASTED PROGRAMS; MFIP 
CHILD CARE ASSISTANCE
 	$
	100,244,000
	$
	137,333,000

247.5
247.6	Sec. 11. FORECASTED PROGRAMS; 
NORTHSTAR CARE FOR CHILDREN
 	$
	110,214,000
	$
	116,160,000

247.7
247.8	Sec. 12. GRANT PROGRAMS; SUPPORT 
SERVICES GRANTS
 	$
	111,359,000
	$
	111,359,000

247.9	Appropriations by Fund
	
247.10		2026
	2027
	
247.11	General
	14,908,000
	14,908,000
	
247.12	Federal TANF
	96,451,000
	96,451,000

247.13
247.14
247.15	Sec. 13. GRANT PROGRAMS; BASIC 
SLIDING FEE CHILD ASSISTANCE CARE 
GRANTS
 	$
	137,768,000
	$
	135,212,000

247.16
247.17	Sec. 14. GRANT PROGRAMS; CHILD CARE 
DEVELOPMENT GRANTS
 	$
	139,319,000
	$
	138,819,000
	
247.18 	$500,000 in fiscal year 2026 is from the 
247.19 	general fund for child care provider access to 
247.20 	technology grants under Minnesota Statutes, 
247.21 	section 142D.23, subdivision 3, clause (5). 
247.22 	This appropriation is available until fiscal year 
247.23 	2029.

247.24
247.25	Sec. 15. GRANT PROGRAMS; CHILD 
SUPPORT ENFORCEMENT GRANTS
 	$
	50,000
	$
	50,000

247.26
247.27	Sec. 16. GRANT PROGRAMS; CHILDREN'S 
SERVICES GRANTS
 	$
	43,204,000
	$
	43,205,000
	
247.28 	The commissioner shall allocate funds from 
247.29 	the state's savings from the Fostering 
247.30 	Connections to Success and Increasing 
247.31 	Adoptions Act's expanded eligibility for Title 
247.32 	IV-E adoption assistance as required in 
247.33 	Minnesota Statutes, section 142A.61, and as 
247.34 	allowable under federal law. Additional 
247.35 	savings to the state as a result of the Fostering 
247.36 	Connections to Success and Increasing 
248.1 	Adoptions Act's expanded eligibility for Title 
248.2 	IV-E adoption assistance is for postadoption, 
248.3 	foster care, adoption, and kinship services, 
248.4 	including a parent-to-parent support network 
248.5 	and as allowable under federal law.

248.6
248.7	Sec. 17. GRANT PROGRAMS; CHILDREN 
AND COMMUNITY SERVICE GRANTS
 	$
	87,984,000
	$
	87,984,000

248.8
248.9	Sec. 18. GRANT PROGRAMS; CHILDREN 
AND ECONOMIC SUPPORT GRANTS
 	$
	14,327,000
	$
	12,426,000

248.10	Subdivision 1.FAIM
 					
248.11 	$209,000 in fiscal year 2026 and $210,000 in 
248.12 	fiscal year 2027 are from the general fund for 
248.13 	the family assets for independence program. 
248.14 	This is a onetime appropriation and is 
248.15 	available until fiscal year 2029.

248.16
248.17	Subd. 2.American Indian Food Sovereignty 
Funding Program
 					
248.18 	$500,000 in fiscal year 2026 is for the 
248.19 	American Indian food sovereignty funding 
248.20 	program under Minnesota Statutes, section 
248.21 	142F.15. This is a onetime appropriation and 
248.22 	is available until June 30, 2027.

248.23	Subd. 3.Minnesota Food Shelf Program
 					
248.24 	$451,000 in fiscal year 2026 is for the 
248.25 	Minnesota food shelf program under 
248.26 	Minnesota Statutes, section 142F.14. This is 
248.27 	a onetime appropriation.

248.28	Subd. 4.Prepared Meals Food Relief
 					
248.29 	$451,000 in fiscal year 2026 is for prepared 
248.30 	meals food relief grants under Laws 2023, 
248.31 	chapter 70, article 12, section 33. This is a 
248.32 	onetime appropriation.

249.1	Subd. 5.Minnesota Food Bank Program
 					
249.2 	$500,000 in fiscal year 2026 is for Minnesota's 
249.3 	regional food banks with an annual operating 
249.4 	budget of less than $100,000,000 that the 
249.5 	commissioner contracts with for the purposes 
249.6 	of the emergency food assistance program 
249.7 	(TEFAP). The commissioner shall distribute 
249.8 	funding under this paragraph in accordance 
249.9 	with the federal TEFAP formula and 
249.10 	guidelines of the United States Department of 
249.11 	Agriculture. Funding must be used to purchase 
249.12 	food that will be distributed free of charge to 
249.13 	TEFAP partner agencies. Funding must also 
249.14 	cover the handling and delivery fees typically 
249.15 	paid by food shelves to food banks to ensure 
249.16 	that costs associated with funding under this 
249.17 	paragraph are not incurred at the local level. 
249.18 	This is a onetime appropriation.

249.19	Subd. 6.Base Level Adjustment
 					
249.20 	The general fund base is $12,216,000 in fiscal 
249.21 	year 2028 and $12,216,000 in fiscal year 2029.

249.22
249.23	Sec. 19. GRANT PROGRAMS; EARLY 
LEARNING GRANTS
 	$
	138,688,000
	$
	132,838,000

249.24
249.25	Sec. 20. GRANT PROGRAMS; YOUTH 
SERVICES GRANTS
 	$
	8,141,000
	$
	8,141,000

249.26
249.27	Subdivision 1.Restorative Practices Initiative 
Grant
 					
249.28 	$1,750,000 in fiscal year 2026 and $1,750,000 
249.29 	in fiscal year 2027 are from the general fund 
249.30 	for restorative practices initiative grants. The 
249.31 	general fund base for this appropriation is 
249.32 	$2,500,000 in fiscal year 2028 and $2,500,000 
249.33 	in fiscal year 2029.

250.1	Subd. 2.Base Level Adjustment
 					
250.2 	The general fund base is $8,891,000 in fiscal 
250.3 	year 2028 and $8,891,000 in fiscal year 2029.

250.4	Sec. 21. TECHNICAL ACTIVITIES
 	$
	74,493,000
	$
	74,493,000
	
250.5 	This appropriation is from the federal TANF 
250.6 	fund.

250.7 	Sec. 22. APPROPRIATIONS; FOOD ASSISTANCE.
 250.8 	(a) $2,500,000 in fiscal year 2025 is appropriated from the general fund to the 
250.9 	commissioner of children, youth, and families for food shelf programs under Minnesota 
250.10 	Statutes, section 142F.14. This is a onetime emergency appropriation with the intent to 
250.11 	distribute as quickly as possible and is available until June 30, 2026.
250.12 	(b) $500,000 in fiscal year 2025 is appropriated from the general fund to the commissioner 
250.13 	of children, youth, and families for the American Indian food sovereignty funding program 
250.14 	under Minnesota Statutes, section 142F.15. This is a onetime appropriation. Notwithstanding 
250.15 	Minnesota Statutes, section 16A.28, subdivision 3, this appropriation is available until June 
250.16 	30, 2026.
250.17 	(c) $1,000,000 in fiscal year 2025 is appropriated from the general fund to the 
250.18 	commissioner of children, youth, and families for contracts with Minnesota's regional food 
250.19 	banks with an annual operating budget of less than $100,000,000 for the purposes of The 
250.20 	Emergency Food Assistance Program (TEFAP). The commissioner shall distribute the food 
250.21 	bank funding under this paragraph in accordance with the federal TEFAP formula and 
250.22 	guidelines of the United States Department of Agriculture. Funding must be used by all 
250.23 	regional food banks to purchase food that will be distributed free of charge to TEFAP partner 
250.24 	agencies. Funding must also cover the handling and delivery fees typically paid by food 
250.25 	shelves to food banks to ensure that costs associated with funding under this paragraph are 
250.26 	not incurred at the local level. Funding distributed under this paragraph must not be used 
250.27 	for food bank administrative costs. This is a onetime appropriation. Notwithstanding 
250.28 	Minnesota Statutes, section 16A.28, subdivision 3, this appropriation is available until June 
250.29 	30, 2026.

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

251.1 	Sec. 23. Laws 2023, chapter 70, article 20, section 8, is amended to read:

251.2
251.3	Sec. 8. OFFICE OF THE FOSTER YOUTH 
OMBUDSPERSON
 	$
	842,000
	$
	759,000
	
251.4 	This appropriation is available until June 30, 
251.5 	2027.

251.6 	Sec. 24. CANCELLATIONS.
 251.7 		Subdivision 1.Child welfare initiative grants. $5,294,000 of the fiscal year 2025 
251.8 	general fund appropriation in Laws 2023, chapter 70, article 20, section 2, subdivision 22, 
251.9 	paragraph (b), is canceled to the general fund.
251.10 		Subd. 2.Establishing the Department of Children, Youth, and Families. $8,500,000 
251.11 	of the fiscal year 2024 general fund appropriation in Laws 2023, chapter 70, article 20, 
251.12 	section 12, paragraph (b), is canceled to the general fund.
251.13 		Subd. 3.Social service information system technology improvements. $5,059,000 
251.14 	of the fiscal year 2024 general fund appropriation in Laws 2023, chapter 70, article 20, 
251.15 	section 2, subdivision 4, paragraph (g), is canceled to the general fund.

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

251.18 	Sec. 25. TRANSFERS.
 251.19 		Subdivision 1.Programs and grants. The commissioner of children, youth, and families, 
251.20 	with the approval of the commissioner of management and budget, may transfer 
251.21 	unencumbered appropriation balances for the biennium ending June 30, 2027, within fiscal 
251.22 	years among MFIP; MFIP child care assistance under Minnesota Statutes, section 142E.08; 
251.23 	the entitlement portion of Northstar Care for Children under Minnesota Statutes, sections 
251.24 	142A.60 to 142A.612; and early childhood family education under Minnesota Statutes, 
251.25 	section 142D.11, between fiscal years of the biennium. The commissioner shall inform the 
251.26 	chairs and ranking minority members of the legislative committees with jurisdiction over 
251.27 	children and families finance and policy quarterly about transfers made under this 
251.28 	subdivision.
251.29 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
251.30 	may be transferred within the Department of Children, Youth, and Families as the 
251.31 	commissioners deem necessary, with the advance approval of the commissioner of 
251.32 	management and budget. The commissioners shall report to the chairs and ranking minority 
252.1 	members of the legislative committees with jurisdiction over children and families finance 
252.2 	quarterly about transfers made under this subdivision.
252.3 		Subd. 3.Interdepartmental transfers. Administrative money may be transferred 
252.4 	between the Department of Children, Youth, and Families and Department of Human 
252.5 	Services or the Department of Education as the commissioners deem necessary, with the 
252.6 	advance approval of the commissioner of management and budget. The commissioners 
252.7 	shall report to the chairs and ranking minority members of the legislative committees with 
252.8 	jurisdiction over children and families finance and policy quarterly about transfers made 
252.9 	under this subdivision.

252.10 	Sec. 26. EXPIRATION OF UNCODIFIED LANGUAGE.
 252.11 	All uncodified language contained in this article expires on June 30, 2027, unless a 
252.12 	different expiration date is explicit or an appropriation is made available beyond June 30, 
252.13 	2027.

252.14 	Sec. 27. APPROPRIATIONS GIVEN EFFECT ONCE.
 252.15 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
252.16 	during the 2025 regular session, the appropriation, transfer, or cancellation must be given 
252.17 	effect once.

252.18 	ARTICLE 17
252.19 	OTHER AGENCY HEALTH APPROPRIATIONS

252.20	Section 1. OTHER AGENCY APPROPRIATIONS.
 	
252.21 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
252.22 	and for the purposes specified in this article. The appropriations are from the general fund, 
252.23 	or another named fund, and are available for the fiscal years indicated for each purpose. 
252.24 	The figures "2026" and "2027" used in this article mean that the appropriations listed under 
252.25 	them are available for the fiscal year ending June 30, 2026, or June 30, 2027, respectively. 
252.26 	"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" 
252.27 	is fiscal years 2026 and 2027.

252.28				APPROPRIATIONS
	
252.29				Available for the Year
	
252.30				Ending June 30
	
252.31					2026
		2027

252.32	Sec. 2. HEALTH-RELATED BOARDS

252.33	Subdivision 1.Total Appropriation
 	$
	35,241,000
	$
	35,127,000

253.1	Appropriations by Fund
	
253.2		2026
	2027
	
253.3	General
	643,000
	643,000
	
253.4
253.5	State Government 
Special Revenue
	34,598,000
	34,484,000
	
253.6 	These amounts are appropriated from the state 
253.7 	government special revenue fund, unless 
253.8 	specified otherwise, for the purposes specified 
253.9 	in the following subdivisions.

253.10
253.11	Subd. 2.Board of Behavioral Health and 
Therapy
 		1,309,000
		1,309,000

253.12	Subd. 3.Board of Chiropractic Examiners
 		1,114,000
		1,114,000

253.13	Subd. 4.Board of Dentistry
 		4,308,000
		4,310,000
	
253.14 	(a) Administrative services unit; operating 
253.15 	costs. Of this appropriation, $1,936,000 in 
253.16 	fiscal year 2026 and $1,936,000 in fiscal year 
253.17 	2027 are for operating costs of the 
253.18 	administrative services unit. The 
253.19 	administrative services unit may receive and 
253.20 	expend reimbursements for services it 
253.21 	performs for other agencies.
253.22 	(b) Administrative services unit; volunteer 
253.23 	health care provider program. Of this 
253.24 	appropriation, $150,000 in fiscal year 2026 
253.25 	and $150,000 in fiscal year 2027 are to pay 
253.26 	for medical professional liability coverage 
253.27 	required under Minnesota Statutes, section 
253.28 	214.40.
253.29 	(c) Administrative services unit; retirement 
253.30 	costs. Of this appropriation, $237,000 in fiscal 
253.31 	year 2026 and $237,000 in fiscal year 2027 
253.32 	are for the administrative services unit to pay 
253.33 	for the retirement costs of health-related board 
253.34 	employees. This funding may be transferred 
253.35 	to the health board incurring retirement costs. 
254.1 	Any board that has an unexpended balance for 
254.2 	an amount transferred under this paragraph 
254.3 	shall transfer the unexpended amount to the 
254.4 	administrative services unit. If the amount 
254.5 	appropriated in the first year of the biennium 
254.6 	is not sufficient, the amount from the second 
254.7 	year of the biennium is available.
254.8 	(d) Administrative services unit; contested 
254.9 	cases and other legal proceedings. Of this 
254.10 	appropriation, $200,000 in fiscal year 2026 
254.11 	and $200,000 in fiscal year 2027 are for costs 
254.12 	of contested case hearings and other 
254.13 	unanticipated costs of legal proceedings 
254.14 	involving health-related boards under this 
254.15 	section. Upon certification by a health-related 
254.16 	board to the administrative services unit that 
254.17 	unanticipated costs for legal proceedings will 
254.18 	be incurred and that available appropriations 
254.19 	are insufficient to pay for the unanticipated 
254.20 	costs for that board, the administrative services 
254.21 	unit is authorized to transfer money from this 
254.22 	appropriation to the board for payment of costs 
254.23 	for contested case hearings and other 
254.24 	unanticipated costs of legal proceedings with 
254.25 	the approval of the commissioner of 
254.26 	management and budget. The commissioner 
254.27 	of management and budget must require any 
254.28 	board that has an unexpended balance or an 
254.29 	amount transferred under this paragraph to 
254.30 	transfer the unexpended amount to the 
254.31 	administrative services unit to be deposited in 
254.32 	the state government special revenue fund.

254.33
254.34	Subd. 5.Board of Dietetics and Nutrition 
Practice
 		277,000
		277,000

254.35
254.36	Subd. 6.Board of Executives for Long-term 
Services and Supports
 		835,000
		835,000

255.1	Subd. 7.Board of Marriage and Family Therapy
 		457,000
		457,000

255.2	Subd. 8.Board of Medical Practice
 		6,196,000
		6,141,000
	
255.3 	Base Level Adjustment. The state 
255.4 	government special revenue fund base for this 
255.5 	subdivision is $6,132,000 in fiscal year 2028 
255.6 	and $6,132,000 in fiscal year 2029.

255.7	Subd. 9.Board of Nursing
 		6,275,000
		6,275,000

255.8
255.9	Subd. 10.Board of Occupational Therapy 
Practice
 		560,000
		560,000

255.10	Subd. 11.Board of Optometry
 		280,000
		280,000

255.11	Subd. 12.Board of Pharmacy

255.12	Appropriations by Fund
	
255.13	General
	643,000
	643,000
	
255.14
255.15	State Government 
Special Revenue
	6,280,000
	6,280,000
	
255.16 	(a) Medication Repository Program.
255.17 	$175,000 in fiscal year 2026 and $175,000 in 
255.18 	fiscal year 2027 are from the general fund for 
255.19 	the medication repository program under 
255.20 	Minnesota Statutes, section 151.555. The 
255.21 	general fund base for this appropriation is 
255.22 	$450,000 in fiscal year 2028 and $450,000 in 
255.23 	fiscal year 2029.
255.24 	(b) Base Level Adjustments. The general 
255.25 	fund base for this subdivision is $918,000 in 
255.26 	fiscal year 2028 and $918,000 in fiscal year 
255.27 	2029.

255.28	Subd. 13.Board of Physical Therapy
 		789,000
		789,000

255.29	Subd. 14.Board of Podiatric Medicine
 		301,000
		301,000

255.30	Subd. 15.Board of Psychology
 		2,781,000
		2,781,000
	
255.31 	Health Professionals Services Program.
255.32 	$1,324,000 in fiscal year 2026 and $1,324,000 
256.1 	in fiscal year 2027 are for the health 
256.2 	professionals services program.

256.3	Subd. 16.Board of Social Work
 		2,073,000
		2,012,000
	
256.4 	Base Level Adjustments. The state 
256.5 	government special revenue fund base for this 
256.6 	subdivision is $2,022,000 in fiscal year 2028 
256.7 	and $2,022,000 in fiscal year 2029.

256.8	Subd. 17.Board of Veterinary Medicine
 		763,000
		763,000

256.9256.10
	Sec. 3. OFFICE OF EMERGENCY MEDICAL 
SERVICES
 	$
	22,168,000
	$
	20,631,000

256.11
256.12	Subdivision 1.Ambulance Operating Deficit 
Grant Program
 					
256.13 	$9,916,000 in fiscal year 2026 and $9,916,000 
256.14 	in fiscal year 2027 are for the ambulance 
256.15 	operating deficit grant program under 
256.16 	Minnesota Statutes, section 144E.54. The base 
256.17 	for this appropriation is $9,516,000 in fiscal 
256.18 	year 2028 and $9,516,000 in fiscal year 2029.

256.19
256.20	Subd. 2.Rural EMS Uncompensated Care Pool 
Payment Program
 					
256.21 	$5,239,000 in fiscal year 2026 and $5,267,000 
256.22 	in fiscal year 2027 are for the rural EMS 
256.23 	uncompensated care pool payment program 
256.24 	under Minnesota Statutes, section 144E.55. 
256.25 	The base for this appropriation is $4,978,000 
256.26 	in fiscal year 2028 and $4,978,000 in fiscal 
256.27 	year 2029.

256.28	Subd. 3.Base Level Adjustments
 					
256.29 	The base for this section is $19,942,000 in 
256.30 	fiscal year 2028 and $19,942,000 in fiscal year 
256.31 	2029.

256.32
256.33	Sec. 4. RARE DISEASE ADVISORY 
COUNCIL
 	$
	674,000
	$
	679,000

256.34	Sec. 5. BOARD OF DIRECTORS OF MNSURE
 	$
	70,000
	$
	70,000

257.1 	Sec. 6. Laws 2024, chapter 127, article 67, section 4, is amended to read:

257.2	Sec. 4. BOARD OF PHARMACY

257.3	Appropriations by Fund
	
257.4	General
	1,500,000
	-0-
	
257.5
257.6	State Government 
Special Revenue
	-0-
	27,000
	
257.7 	(a) Legal Costs. $1,500,000 in fiscal year 
257.8 	2024 is from the general fund for legal costs. 
257.9 	This is a onetime appropriation and is 
257.10 	available until June 30, 2027.
257.11 	(b) Base Level Adjustment. The state 
257.12 	government special revenue fund base is 
257.13 	increased by $27,000 in fiscal year 2026 and 
257.14 	increased by $27,000 in fiscal year 2027.

257.15 	EFFECTIVE DATE. This section is effective June 30, 2025.

257.16 	Sec. 7. GRANT ADMINISTRATION COSTS.
 257.17 	The administrative costs retention requirement under Minnesota Statutes, section 16B.98, 
257.18 	subdivision 14, is inapplicable to any appropriation in this article for a grant.

257.19 	Sec. 8. APPROPRIATIONS GIVEN EFFECT ONCE.
 257.20 	If an appropriation, cancellation, or transfer in this article is enacted more than once 
257.21 	during the 2025 regular session, the appropriation, cancellation, or transfer must be given 
257.22 	effect once.

257.23 	Sec. 9. EXPIRATION OF UNCODIFIED LANGUAGE.
 257.24 	All uncodified language contained in this article expires June 30, 2027, unless a different 
257.25 	expiration date is explicit or an appropriation is made available after June 30, 2027.

257.26 	ARTICLE 18
257.27 	OTHER AGENCY CHILDREN APPROPRIATIONS

257.28	Section 1. OTHER AGENCY APPROPRIATIONS.
 	
257.29 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
257.30 	and for the purposes specified in this article. The appropriations are from the general fund, 
258.1 	or another named fund, and are available for the fiscal years indicated for each purpose. 
258.2 	The figures "2026" and "2027" used in this article mean that the appropriations listed under 
258.3 	them are available for the fiscal year ending June 30, 2026, or June 30, 2027, respectively. 
258.4 	"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" 
258.5 	is fiscal years 2026 and 2027.

258.6				APPROPRIATIONS
	
258.7				Available for the Year
	
258.8				Ending June 30
	
258.9					2026
		2027

258.10	Sec. 2. OMBUDSPERSON FOR FAMILIES
 	$
	792,000
	$
	808,000

258.11
258.12	Sec. 3. OMBUDSPERSON FOR AMERICAN 
INDIAN FAMILIES
 	$
	344,000
	$
	347,000

258.13
258.14	Sec. 4. OFFICE OF THE FOSTER YOUTH 
OMBUDSPERSON
 	$
	772,000
	$
	785,000

258.15	Sec. 5. DEPARTMENT OF EDUCATION
 	$
	7,950,000
	$
	7,950,000

258.16 	Sec. 6. EXPIRATION OF UNCODIFIED LANGUAGE.
 258.17 	All uncodified language contained in this article expires on June 30, 2027, unless a 
258.18 	different expiration date is explicit or an appropriation is made available beyond June 30, 
258.19 	2027.

258.20 	Sec. 7. APPROPRIATIONS GIVEN EFFECT ONCE.
 258.21 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
258.22 	during the 2025 regular session, the appropriation, transfer, or cancellation must be given 
258.23 	effect once.

	ARTICLE 1	DEPARTMENT OF HEALTH FINANCE........	Page.Ln 2.9	
	ARTICLE 2	DEPARTMENT OF HEALTH POLICY........	Page.Ln 19.1	
	ARTICLE 3	HEALTH LICENSING BOARDS........	Page.Ln 23.14	
	ARTICLE 4	PHARMACY BENEFITS........	Page.Ln 50.24	
	ARTICLE 5	HEALTH CARE FINANCE........	Page.Ln 63.1	
	ARTICLE 6	OFFICE OF EMERGENCY MEDICAL SERVICES........	Page.Ln 108.11	
	ARTICLE 7	ECONOMIC ASSISTANCE........	Page.Ln 112.1	
	ARTICLE 8	CHILD PROTECTION AND WELFARE POLICY........	Page.Ln 114.1	
	ARTICLE 9	CHILD PROTECTION AND WELFARE FINANCE........	Page.Ln 163.15	
	ARTICLE 10	EARLY CARE AND LEARNING POLICY........	Page.Ln 185.1	
	ARTICLE 11	EARLY CARE AND LEARNING FINANCE........	Page.Ln 187.15	
	ARTICLE 12	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIESLICENSING AND CERTIFICATION POLICY........	Page.Ln 205.17	
	ARTICLE 13	MISCELLANEOUS........	Page.Ln 226.1	
	ARTICLE 14	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS........	Page.Ln 231.7	
	ARTICLE 15	DEPARTMENT OF HEALTH APPROPRIATIONS........	Page.Ln 234.17	
	ARTICLE 16	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS........	Page.Ln 241.16	
	ARTICLE 17	OTHER AGENCY HEALTH APPROPRIATIONS........	Page.Ln 252.18	
	ARTICLE 18	OTHER AGENCY CHILDREN APPROPRIATIONS........	Page.Ln 257.26	

APPENDIX 

Repealed Minnesota Statutes: H2435-2 

145.361 LONG COVID AND RELATED CONDITIONS; ASSESSMENT AND MONITORING.Subdivision 1.Definitions. 
(a) For the purposes of this section, the following terms have the meanings given. 

(b) "Long COVID" means health problems that people experience four or more weeks after being infected with SARS-CoV-2, the virus that causes COVID-19. Long COVID is also called post-COVID conditions, long-haul COVID, chronic COVID, post-acute COVID, or post-acute sequelae of COVID-19 (PASC). 

(c) "Related conditions" means conditions associated with or sequelae of long COVID, including but not limited to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and dysautonomia, and postural orthostatic tachycardia syndrome (POTS). 

Subd. 2.Establishment. 
The commissioner of health shall establish a program to conduct community assessments and epidemiologic investigations to monitor and address impacts of long COVID and related conditions. The purposes of these activities are to: 

(1) monitor trends in: incidence, prevalence, mortality, and health outcomes; changes in disability status, employment, and quality of life; and service needs of individuals with long COVID or related conditions and to detect potential public health problems, predict risks, and assist in investigating long COVID and related conditions health inequities; 

(2) more accurately target information and resources for communities and patients and their families; 

(3) inform health professionals and citizens about risks and early detection; 

(4) promote evidence-based practices around long COVID and related conditions prevention and management and to address public concerns and questions about long COVID and related conditions; and 

(5) research and track related conditions. 

Subd. 3.Partnerships. 
The commissioner of health shall, in consultation with health care professionals, the commissioner of human services, local public health entities, health insurers, employers, schools, survivors of long COVID or related conditions, and community organizations serving people at high risk of long COVID or related conditions, identify priority actions and activities to address the needs for communication, services, resources, tools, strategies, and policies to support survivors of long COVID or related conditions and their families. 

Subd. 4.Grants and contracts. 
The commissioner of health shall coordinate and collaborate with community and organizational partners to implement evidence-informed priority actions through community-based grants and contracts. The commissioner of health shall award grants and enter into contracts to organizations that serve communities disproportionately impacted by COVID-19, long COVID, or related conditions, including but not limited to rural and low-income areas, Black and African Americans, African immigrants, American Indians, Asian American-Pacific Islanders, Latino(a) communities, LGBTQ+ communities, and persons with living disabilities. Organizations may also address intersectionality within the groups. The commissioner shall award grants and award contracts to eligible organizations to plan, construct, and disseminate resources and information to support survivors of long COVID or related conditions, including caregivers, health care providers, ancillary health care workers, workplaces, schools, communities, and local and Tribal public health. 

256B.0625 COVERED SERVICES.Subd. 18b.Broker dispatching prohibition. 
Except for establishing level of service process, the commissioner shall not use a broker or coordinator for any purpose related to nonemergency medical transportation services under subdivision 18. 

Subd. 18e.Single administrative structure and delivery system. 
 The commissioner, in coordination with the commissioner of transportation, shall implement a single administrative structure and delivery system for nonemergency medical transportation, beginning the latter of the date the single administrative assessment tool required in this subdivision is available for use, as determined by the commissioner or by July 1, 2016. 

In coordination with the Department of Transportation, the commissioner shall develop and authorize a web-based single administrative structure and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee assessment process for nonemergency medical transportation services. The web-based tool shall facilitate the transportation eligibility determination process initiated by clients and client advocates; shall include an accessible automated intake and assessment process and real-time identification of level of service eligibility; and shall authorize an appropriate and auditable mode of transportation authorization. The tool shall provide a single framework for reconciling trip information with claiming and collecting complaints regarding inappropriate level of need determinations, inappropriate transportation modes utilized, and interference with accessing nonemergency medical transportation. The web-based single administrative structure shall operate on a trial basis for one year from implementation and, if approved by the commissioner, shall be permanent thereafter. 

Subd. 18h.Nonemergency medical transportation provisions related to managed care. 
(a) The following nonemergency medical transportation (NEMT) subdivisions apply to managed care plans and county-based purchasing plans: 

(1) subdivision 17, paragraphs (a), (b), (i), and (n); 

(2) subdivision 18; and 

(3) subdivision 18a. 

(b) A nonemergency medical transportation provider must comply with the operating standards for special transportation service specified in sections 174.29 to 174.30 and Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirements in this paragraph. 

(c) Managed care plans and county-based purchasing plans must provide a fuel adjustment for NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval is not received for this paragraph, the commissioner must adjust the capitation rates paid to managed care plans and county-based purchasing plans for that contract year to reflect the removal of this provision. Contracts between managed care plans and county-based purchasing plans and providers to whom this paragraph applies must allow recovery of payments from those providers if capitation rates are adjusted in accordance with this paragraph. Payment recoveries must not exceed the amount equal to any increase in rates that results from this paragraph. This paragraph expires if federal approval is not received for this paragraph at any time. 

Repealed Minnesota Session Laws: H2435-2 

Laws 2023, chapter 70, article 16, section 22
Sec. 22. WAIVER SUBMITTAL. 
(a) The commissioner of commerce is authorized to perform the steps necessary to submit a 1332 waiver application, including but not limited to submitting the waiver application and all other steps necessary to complete the waiver application process, based on the final recommendation of the commissioner of commerce under section 21 if the legislature does not enact a law by June 1, 2024, modifying the:  

(1) recommendation under section 21; or  

(2) commissioner of commerce's authority under this section.  

(b) Upon receipt of a federal waiver and the enactment of any necessary legislation, the commissioner of commerce shall implement a public option to be made available to consumers beginning January 1, 2027. 

(c) In implementing this section, the commissioner of commerce shall consult with the commissioners of human services and health and the Board of Directors of MNsure. 

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

9503.0030QUALIFICATIONS OF APPLICANT AND STAFF. Subpart 1.Definitions.  B.
 "Education" means accredited course work from an accredited postsecondary institution in child development; children with special needs; early childhood education methods or theory; curriculum planning; child study techniques; family studies; child psychology; parent involvement; behavior guidance; child nutrition; child health and safety; early childhood special education methods or theory; child abuse and neglect prevention; recreational sports, arts, and crafts methods or theory; or coordination of community and school activities. "Education," as specified on the charts in parts 9503.0032 and 9503.0033, is in addition to the credential specified in column A unless the course work has been completed as part of the credential.