SF 3027

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/28/2025 09:47 a.m.

A bill for an act
relating to human services; modifying licensing requirements for family adult
foster care homes; amending Minnesota Statutes 2024, sections 245A.02, by adding
subdivisions; 245A.03, subdivisions 6a, 7; 245A.042, by adding a subdivision;
245A.06, subdivision 1a; 256B.4914, subdivisions 6, 19; Laws 2023, chapter 61,
article 1, sections 47, subdivision 19; 85; repealing Laws 2023, chapter 61, article
1, section 32.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 245A.02, is amended by adding a subdivision
to read:

new text begin Subd. 11a. new text end

new text begin Primary residence. new text end

new text begin (a) "Primary residence" means the location where the
license holder lives and usually sleeps and from which the license holder has no present
intention of moving without also intending to transfer the license.
new text end

new text begin (b) A license holder's primary residence does not change if the license holder leaves
home to live temporarily at another residence without the intention of making the other
location the license holder's permanent home.
new text end

new text begin (c) Without other supporting evidence that the license holder has moved, the
commissioner must not determine that a license holder has a different primary residence
than the one listed on the license if the license holder:
new text end

new text begin (1) owns, acquires, or leases another residence;
new text end

new text begin (2) uses a different location for the license holder's address on a driver's license,
homestead declaration, tax form, or other official document, unless the address reflects a
change made after the license holder obtained the license under this section; or
new text end

new text begin (3) lives separately from a spouse or children.
new text end

Sec. 2.

Minnesota Statutes 2024, section 245A.02, is amended by adding a subdivision to
read:

new text begin Subd. 11b. new text end

new text begin Primary caregiver. new text end

new text begin (a) "Primary caregiver" means the person primarily
responsible for the supervision, oversight, and coordination of care for persons receiving
services in an adult foster care home licensed under this chapter or chapter 245D.
new text end

new text begin (b) A license holder for an adult foster care home licensed under chapter 245A who is
assisted without limitation by unpaid family members who also reside in the home or who
visit the home as unpaid family members is still the primary caregiver if the assistance is
under the direction and control of the license holder.
new text end

new text begin (c) A license holder for an adult foster care home licensed under chapter 245A who is
assisted by paid staff or by unpaid volunteers not residing in the home is still the primary
caregiver if the staff or volunteers provide no more than a total of 40 work hours of services
per week and the assistance is under the direction and control of the license holder.
new text end

new text begin (d) A license holder for a family adult foster care home that also provides services
licensed under chapter 245D who is assisted by paid staff or by unpaid volunteers not
residing in the home is still the primary caregiver if the staff or volunteers provide no more
than the total hourly amount of chapter 245D services called for in the service plans of the
service recipients in the home, plus 40 work hours per week, and the assistance is under the
direction and control of the license holder.
new text end

Sec. 3.

Minnesota Statutes 2024, section 245A.03, subdivision 6a, is amended to read:

Subd. 6a.

Adult foster care homes or community residential settings serving people
with mental illness; certification.

(a) The commissioner of human services shall issue a
mental health certification for adult foster care deleted text begin homes licensed under this chapter and
Minnesota Rules, parts 9555.5105 to 9555.6265, or community residential settings licensed
under chapter 245D, deleted text end new text begin settings new text end that serve people with a primary diagnosis of mental illness
deleted text begin where the home is not the primary residence of the license holder deleted text end when a provider is
determined to have met the requirements under paragraph (b) deleted text begin . deleted text end new text begin , if the setting is either:
new text end

new text begin (1) an adult foster care home licensed under this chapter and Minnesota Rules, parts
9555.5105 to 9555.6265; or
new text end

new text begin (2) a community residential setting licensed under chapter 245D.
new text end

This certification is voluntary for license holders. The certification shall be printed on the
license, and identified on the commissioner's public website.

(b) The requirements for certification are:

(1) all staff working in the adult foster care home or community residential setting have
received at least seven hours of annual training under paragraph (c) covering all of the
following topics:

(i) mental health diagnoses;

(ii) mental health crisis response and de-escalation techniques;

(iii) recovery from mental illness;

(iv) treatment options including evidence-based practices;

(v) medications and their side effects;

(vi) suicide intervention, identifying suicide warning signs, and appropriate responses;

(vii) co-occurring substance abuse and health conditions; and

(viii) community resources;

(2) a mental health professional, as defined in section 245.462, subdivision 18, or a
mental health practitioner as defined in section 245.462, subdivision 17, are available for
consultation and assistance;

(3) there is a protocol in place to address a mental health crisis; and

(4) there is a crisis plan for each individual that identifies who is providing clinical
services and their contact information, and includes an individual crisis prevention and
management plan developed with the individual.

(c) The training curriculum must be approved by the commissioner of human services
and must include a testing component after training is completed. Training must be provided
by a mental health professional or a mental health practitioner. Training may also be provided
by an individual living with a mental illness or a family member of such an individual, who
is from a nonprofit organization with a history of providing educational classes on mental
illnesses approved by the Department of Human Services to deliver mental health training.
Staff must receive three hours of training in the areas specified in paragraph (b), clause (1),
items (i) and (ii), prior to working alone with residents. The remaining hours of mandatory
training, including a review of the information in paragraph (b), clause (1), item (ii), must
be completed within six months of the hire date. For programs licensed under chapter 245D,
training under this section may be incorporated into the 30 hours of staff orientation required
under section 245D.09, subdivision 4.

(d) License holders seeking certification under this subdivision must request this
certification on forms provided by the commissioner and must submit the request to the
county licensing agency in which the home or community residential setting is located. The
county licensing agency must forward the request to the commissioner with a county
recommendation regarding whether the commissioner should issue the certification.

(e) Ongoing compliance with the certification requirements under paragraph (b) shall
be reviewed by the county licensing agency at each licensing review. When a county licensing
agency determines that the requirements of paragraph (b) are not met, the county shall
inform the commissioner, and the commissioner will remove the certification.

(f) A denial of the certification or the removal of the certification based on a determination
that the requirements under paragraph (b) have not been met by the adult foster care or
community residential setting license holder are not subject to appeal. A license holder that
has been denied a certification or that has had a certification removed may again request
certification when the license holder is in compliance with the requirements of paragraph
(b).

Sec. 4.

Minnesota Statutes 2024, section 245A.03, subdivision 7, is amended to read:

Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
new text begin under this chapter new text end for child foster care licensed under Minnesota Rules, parts 2960.3000 to
2960.3340, deleted text begin which deleted text end new text begin that new text end does not include child foster residence settings with residential
program certifications for compliance with the Family First Prevention Services Act under
section 245A.25, subdivision 1, paragraph (a), deleted text begin or deleted text end new text begin for a physical location that will not be the
primary residence of the license holder for the entire period of licensure. The commissioner
shall not issue an initial license under this chapter for new text end adult foster care licensed under
Minnesota Rules, parts 9555.5105 to 9555.6265, deleted text begin under this chapter deleted text end for a physical location
that will not be the primary residence of the license holder for the entire period of licensure.
If a child foster residence setting that was previously exempt from the licensing moratorium
under this paragraph has its Family First Prevention Services Act certification rescinded
under section 245A.25, subdivision 9, deleted text begin or deleted text end new text begin the commissioner shall revoke the license according
to section 245A.07. new text end If a family adult foster care home license is issued during this
moratorium, and the license holder changes the license holder's primary residence away
from the physical location of the foster care license new text begin without first obtaining permission from
the commissioner to also relocate the family adult foster care home to the license holder's
new primary residence new text end , the commissioner shall revoke the license according to section
245A.07. The commissioner shall not issue an initial license for a community residential
setting licensed under chapter 245D. When approving an exception under this paragraph,
the commissioner shall consider the resource need determination process in paragraph (h),
the availability of foster care licensed beds in the geographic area in which the licensee
seeks to operate, the results of a person's choices during their annual assessment and service
plan review, and the recommendation of the local county board. The determination by the
commissioner is final and not subject to appeal. Exceptions to the moratorium include:

(1) a license for a person in a foster care setting that is not the primary residence of the
license holder and where at least 80 percent of the residents are 55 years of age or older;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24; new text begin or
new text end

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital-level care deleted text begin ;
or deleted text end new text begin .
new text end

deleted text begin (5) new community residential setting licenses determined necessary by the commissioner
for people affected by the closure of homes with a capacity of five or six beds currently
licensed as supervised living facilities licensed under Minnesota Rules, chapter 4665, but
not designated as intermediate care facilities. This exception is available until June 30, 2025.
deleted text end

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder deleted text begin according to section 256B.49, subdivision 15,
paragraph (f), or the deleted text end new text begin or an new text end adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) must be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
data required by section 144A.351, and other data and information must be used to determine
where the reduced capacity determined under section 256B.493 will be implemented. The
commissioner shall consult with the stakeholders described in section 144A.351, and employ
a variety of methods to improve the state's capacity to meet the informed decisions of those
people who want to move out of corporate foster care or community residential settings,
long-term service needs within budgetary limits, including seeking proposals from service
providers or lead agencies to change service type, capacity, or location to improve services,
increase the independence of residents, and better meet needs identified by the long-term
services and supports reports and statewide data and information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493.

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

Sec. 5.

Minnesota Statutes 2024, section 245A.042, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Fair notice of investigative criteria; adult foster care. new text end

new text begin The commissioner
must provide specific written notice to all adult foster care license holders of all criteria the
commissioner intends to use while enforcing the requirements of this chapter and chapter
245D. The commissioner's written notice must include any interpretive guidance or other
source of information, including government documents or other official records the
commissioner or the commissioner's licensing investigators rely upon while investigating
and making determinations regarding compliance with this chapter and chapter 245D. The
commissioner must provide the specific written notice to all adult foster care license holders
concurrent with the issuance of an initial adult foster care license under this chapter or
chapter 245D at least 90 calendar days prior to the renewal of an adult foster care license
under this chapter or chapter 245D and at least 90 calendar days prior to any enforcement
action under this chapter.
new text end

Sec. 6.

Minnesota Statutes 2024, section 245A.06, subdivision 1a, is amended to read:

Subd. 1a.

Correction orders and conditional licenses for programs licensed as home
and community-based services.

(a) For programs licensed under both this chapter and
chapter 245D, if the license holder operates more than one service site under a single license
governed by chapter 245D, the order issued under this section shall be specific to the service
site or sites at which the violations of applicable law or rules occurred. The order shall not
apply to other service sites governed by chapter 245D and operated by the same license
holder unless the commissioner has included in the order the articulable basis for applying
the order to another service site.

(b) If the commissioner has issued more than one license to the license holder under this
chapter, the conditions imposed under this section shall be specific to the license for the
program at which the violations of applicable law or rules occurred and shall not apply to
other licenses held by the same license holder if those programs are being operated in
substantial compliance with applicable law and rules.

new text begin (c) For license holders suspected of violating the requirement that family adult foster
care be provided in the license holder's primary residence or that the license holder be the
primary caregiver, before issuing a correction order, issuing an order of conditional license,
or imposing any licensing sanctions under section 245A.07, the commissioner must:
new text end

new text begin (1) review all guidance for determining a family adult foster care license holder's primary
residence or status as the primary caregiver;
new text end

new text begin (2) conduct audio-recorded interviews of all persons with likely personal knowledge of
the license holder's primary residence or status as primary caregiver, including residents of
the family adult foster care home, the license holder, the license holder's coresiding family
members, and the family members, appointed guardians, and social workers of residents of
the family adult foster care home;
new text end

new text begin (3) ensure that commissioner's investigators have performed a complete and thorough
investigation of the suspected violation, including investigation of all criteria identified by
the commissioner pursuant to section 245A.042, subdivision 5, and all considerations set
forth in section 245A.04, subdivision 6.
new text end

Sec. 7.

Minnesota Statutes 2024, section 256B.4914, subdivision 6, is amended to read:

Subd. 6.

Residential support services; generally.

(a) For purposes of this section,
residential support services includes 24-hour customized living services, community
residential services, customized living services, new text begin family residential services, new text end and integrated
community supports.

(b) A unit of service for residential support services is a day. Any portion of any calendar
day, within allowable Medicaid rules, where an individual spends time in a residential setting
is billable as a day. The number of days authorized for all individuals enrolling in residential
support services must include every day that services start and end.

(c) When the available shared staffing hours in a residential setting are insufficient to
meet the needs of an individual who enrolled in residential support services after January
1, 2014, then individual staffing hours shall be used.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from May 25, 2023.
new text end

Sec. 8.

Minnesota Statutes 2024, section 256B.4914, subdivision 19, is amended to read:

Subd. 19.

Payments for family residential and life sharing services.

The commissioner
shall establish rates for deleted text begin family residential services and deleted text end life sharing services based on a
person's assessed need, as described in the federally-approved waiver plans. deleted text begin Rates for life
sharing services must be ten percent higher than the corresponding family residential services
rate.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from May 25, 2023.
new text end

Sec. 9.

Laws 2023, chapter 61, article 1, section 47, subdivision 19, is amended to read:

Subd. 19.

Payments for deleted text begin family residential and deleted text end life sharing services.

The commissioner
shall establish rates for deleted text begin family residential services and deleted text end life sharing services based on a
person's assessed need, as described in the federally-approved waiver plans. deleted text begin Rates for life
sharing services must be ten percent higher than the corresponding family residential services
rate.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from May 25, 2023.
new text end

Sec. 10.

Laws 2023, chapter 61, article 1, section 85, is amended to read:

Sec. 85. REPEALER.

deleted text begin (a) deleted text end Minnesota Statutes 2022, section 256B.4914, subdivision 9a, is repealed.

deleted text begin (b) deleted text end deleted text begin Minnesota Statutes 2022, section 256B.4914, subdivision 6b, deleted text end deleted text begin is repealed.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from May 25, 2023.
new text end

Sec. 11.

Laws 2023, chapter 61, article 1, section 85, the effective date, is amended to
read:

EFFECTIVE DATE.

deleted text begin Paragraph (a) deleted text end new text begin This section new text end is effective January 1, 2024, or upon
federal approval, whichever is later deleted text begin , and paragraph (b) is effective January 1, 2026, or upon
federal approval, whichever is later deleted text end . The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from May 25, 2023.
new text end

Sec. 12. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
REMEDIAL LICENSING OF FAMILY ADULT FOSTER CARE.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, sections 245A.03, subdivision 7, and 245A.04,
subdivision 7, the commissioner shall accept applications for licensure under Minnesota
Statutes, chapters 245A and 245D, from former adult foster care license holders whose
license to provide family adult foster care was revoked after January 1, 2022, and before
July 1, 2025, on the basis of suspicion of providing services in a home that was not the
license holder's primary residence or that the license holder was not the primary caregiver.
The commissioner shall review, evaluate, and act on the applications as required under
Minnesota Statutes, section 245A.04, except that the commissioner must not consider any
prior correction orders, orders of conditional license, or sanction under Minnesota Statutes,
section 245A.07, that were based on the applicant's provision of family adult foster care in
a home that was not the license holder's primary residence or that the license holder was
not the primary caregiver. If the commissioner determines that the applicant and the
applicant's program complies with all applicable rules and laws, the commissioner shall
issue a license.
new text end

new text begin (b) The deadline for submitting an application under this section is five years after the
prior revocation became final.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 13. new text begin REPEALER.
new text end

new text begin Laws 2023, chapter 61, article 1, section 32, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from May 25, 2023.
new text end

APPENDIX

Repealed Minnesota Session Laws: 25-04835

Laws 2023, chapter 61, article 1, section 32

Sec. 32.

Minnesota Statutes 2022, section 256B.4914, subdivision 6, is amended to read:

Subd. 6.

Residential support services; generally.

(a) For purposes of this section, residential support services includes 24-hour customized living services, community residential services, customized living services, deleted text begin family residential services, deleted text end and integrated community supports.

(b) A unit of service for residential support services is a day. Any portion of any calendar day, within allowable Medicaid rules, where an individual spends time in a residential setting is billable as a day. The number of days authorized for all individuals enrolling in residential support services must include every day that services start and end.

(c) When the available shared staffing hours in a residential setting are insufficient to meet the needs of an individual who enrolled in residential support services after January 1, 2014, then individual staffing hours shall be used.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end