HF 3379

2nd Unofficial Engrossment - 94th Legislature (2025 - 2026)

Posted on 05/11/2026 11:44 a.m.

A bill for an act
relating to human services; modifying provisions related to health care, the
Department of Human Services Office of Inspector General, human services
background studies, uniform service standards, aging and disability services,
administrative reform, children and families, and grant programs; requiring reports;
appropriating money; amending Minnesota Statutes 2024, sections 16A.103, by
adding a subdivision; 62M.07, subdivision 2; 142B.01, subdivision 8; 142E.16,
by adding a subdivision; 245.095, subdivisions 2, 5, by adding a subdivision;
245.096; 245.735, subdivision 6; 245A.02, subdivisions 5a, 13; 245A.03,
subdivision 7, by adding subdivisions; 245A.042, by adding a subdivision;
245A.043, subdivision 2; 245A.07, subdivision 2a; 245A.10, by adding a
subdivision; 245A.65, subdivision 1a; 245C.03, subdivisions 1, 3a, 9, by adding
subdivisions; 245D.081, subdivision 3; 245D.261, subdivision 3; 245G.03,
subdivision 1; 245I.011, subdivisions 3, 5, by adding a subdivision; 245I.02,
subdivisions 33, 39, by adding subdivisions; 245I.03, subdivision 4, by adding a
subdivision; 245I.06, subdivisions 1, 2; 245I.07; 245I.10, subdivisions 6, 8, by
adding a subdivision; 256.01, by adding a subdivision; 256B.02, by adding a
subdivision; 256B.04, subdivision 10; 256B.05, subdivision 1; 256B.0623,
subdivisions 1, 3, 12; 256B.0624, subdivisions 1, 4, by adding a subdivision;
256B.0625, subdivision 17b, by adding a subdivision; 256B.064, subdivisions 1b,
1c, 1d, 2, 3, 4, 5, by adding subdivisions; 256B.073, subdivisions 1, 2, 3, 5, by
adding subdivisions; 256B.0911, subdivision 32; 256B.0943, subdivision 2;
256B.0949, subdivision 17, by adding a subdivision; 256B.4912, subdivision 12,
by adding a subdivision; 256B.4914, subdivision 6, by adding subdivisions;
256B.492, by adding a subdivision; 256B.69, subdivisions 5a, 37, by adding a
subdivision; 256I.03, subdivision 10a; 256I.04, subdivisions 1, 2f; 256I.05,
subdivision 11; 256S.21, by adding subdivisions; Minnesota Statutes 2025
Supplement, sections 15.013, by adding a subdivision; 245A.03, subdivisions 2,
7a; 245A.04, subdivisions 1, 7; 245A.043, subdivision 2a; 245A.05; 245A.07,
subdivision 3; 245A.10, subdivisions 3, 4; 245C.13, subdivision 2; 245C.16,
subdivision 1; 245I.04, subdivisions 5, 17; 256.01, subdivision 2; 256B.04,
subdivision 21; 256B.051, subdivision 6; 256B.0625, subdivisions 5m, 17;
256B.064, subdivision 1a; 256B.0659, subdivision 21; 256B.0701, subdivision 9;
256B.0759, subdivision 4; 256B.0943, subdivisions 3, 12; 256B.0949, subdivisions
2, 16; 256B.4914, subdivision 5a; 256B.85, subdivisions 12, 17a; 256I.04,
subdivision 2a; 260E.14, subdivision 1; 626.5572, subdivision 13; proposing
coding for new law in Minnesota Statutes, chapters 245A; 245I; 256B; 256I;
repealing Minnesota Statutes 2024, sections 245.735, subdivisions 1a, 2a, 3a, 3b,
3c, 3d, 3e, 3f, 3g, 3h, 4a, 4b, 4c, 4e, 7, 8; 245C.03, subdivision 7; 245I.20,
subdivision 9; 245I.23, subdivision 23; 256B.0623, subdivisions 2, 4, 5, 6, 9;
256B.0624, subdivisions 2, 3, 4a, 5, 6, 6a, 6b, 7, 8, 9, 11; 256B.073, subdivision
4; 256B.0943, subdivisions 4, 5, 5a, 6, 7, 11; 256B.4914, subdivision 6c; Minnesota
Statutes 2025 Supplement, sections 245.735, subdivisions 3, 4d; 245A.042,
subdivision 5; 245A.10, subdivision 3a; 256B.0943, subdivisions 1, 9.

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

ARTICLE 1

HEALTH CARE

Section 1.

Minnesota Statutes 2025 Supplement, section 15.013, is amended by adding a
subdivision to read:

new text begin Subd. 7. new text end

new text begin Exemption. new text end

new text begin Nothing in this section modifies, supersedes, limits, or expands
the authority of the commissioner of human services to impose sanctions under section
256B.064.
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. 2.

Minnesota Statutes 2024, section 62M.07, subdivision 2, is amended to read:

Subd. 2.

Prior authorization of certain services prohibited.

new text begin (a) new text end No utilization review
organization, health plan company, or claims administrator may conduct or require prior
authorization of:

(1) emergency confinement or an emergency service. The enrollee or the enrollee's
authorized representative may be required to notify the health plan company, claims
administrator, or utilization review organization as soon as reasonably possible after the
beginning of the emergency confinement or emergency service;

(2) outpatient mental health treatment or outpatient substance use disorder treatment,
except for treatment which is a medication. Prior authorizations required for medications
used for outpatient mental health treatment or outpatient substance use disorder treatment
must be processed according to section 62M.05, subdivision 3b, for initial determinations,
and according to section 62M.06, subdivision 2, for appeals;

(3) antineoplastic cancer treatment that is consistent with guidelines of the National
Comprehensive Cancer Network, except for treatment which is a medication. Prior
authorizations required for medications used for antineoplastic cancer treatment must be
processed according to section 62M.05, subdivision 3b, for initial determinations, and
according to section 62M.06, subdivision 2, for appeals;

(4) services that currently have a rating of A or B from the United States Preventive
Services Task Force, immunizations recommended by the Advisory Committee on
Immunization Practices of the Centers for Disease Control and Prevention, or preventive
services and screenings provided to women as described in Code of Federal Regulations,
title 45, section 147.130;

(5) pediatric hospice services provided by a hospice provider licensed under sections
144A.75 to 144A.755; and

(6) treatment delivered through a neonatal abstinence program operated by pediatric
pain or palliative care subspecialists.

Clauses (2) to (6) are effective January 1, 2026, and apply to health benefit plans offered,
sold, issued, or renewed on or after that date.

new text begin (b) Nothing in this subdivision prohibits a utilization review organization, health plan
company, or claims administrator from conducting or requiring prior authorization to
authorize services by a provider type designated as high-risk under section 256B.044,
subdivision 1.
new text end

Sec. 3.

Minnesota Statutes 2024, section 142B.01, subdivision 8, is amended to read:

Subd. 8.

Controlling individual.

(a) "Controlling individual" means an owner of a
program or service provider licensed under this chapter and the following individuals, if
applicable:

(1) each officer of the organization, including the chief executive officer and chief
financial officer;

(2) the individual designated as the authorized agent under section 142B.10, subdivision
1, paragraph (b);

(3) the individual designated as the compliance officer under section deleted text begin 256B.04, deleted text begin subdivision
deleted text end 21, paragraph (g) deleted text end new text begin 256B.044, subdivision 7, paragraph (b) new text end ;

(4) each managerial official whose responsibilities include the direction of the
management or policies of a program;

(5) the individual designated as the primary provider of care for a special family child
care program under section 142B.41, subdivision 4, paragraph (d); and

(6) the president and treasurer of the board of directors of a nonprofit corporation.

(b) Controlling individual does not include:

(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;

(2) an individual who is a state or federal official, or state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more programs, unless the individual is also an officer,
owner, or managerial official of the program; receives remuneration from the program; or
owns any of the beneficial interests not excluded in this subdivision;

(3) an individual who owns less than five percent of the outstanding common shares of
a corporation:

(i) whose securities are exempt under section 80A.45, clause (6); or

(ii) whose transactions are exempt under section 80A.46, clause (2);

(4) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the program
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or

(5) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual according to paragraph (a).

(c) For purposes of this subdivision, "managerial official" means an individual who has
the decision-making authority related to the operation of the program, and the responsibility
for the ongoing management of or direction of the policies, services, or employees of the
program. A site director who has no ownership interest in the program is not considered to
be a managerial official for purposes of this definition.

Sec. 4.

Minnesota Statutes 2024, section 245.095, is amended by adding a subdivision to
read:

new text begin Subd. 7. new text end

new text begin Exemption. new text end

new text begin Nothing in this section modifies, supersedes, limits, or expands
the commissioner's authority to impose sanctions under section 256B.064.
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. 5.

Minnesota Statutes 2024, section 245A.02, subdivision 5a, is amended to read:

Subd. 5a.

Controlling individual.

(a) "Controlling individual" means an owner of a
program or service provider licensed under this chapter and the following individuals, if
applicable:

(1) each officer of the organization, including the chief executive officer and chief
financial officer;

(2) the individual designated as the authorized agent under section 245A.04, subdivision
1, paragraph (b);

(3) the individual designated as the compliance officer under section deleted text begin 256B.04, subdivision
21, paragraph (g) deleted text end new text begin 256B.044, subdivision 7, paragraph (b) new text end ;

(4) each managerial official whose responsibilities include the direction of the
management or policies of a program; and

(5) the president and treasurer of the board of directors of a nonprofit corporation.

(b) Controlling individual does not include:

(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;

(2) an individual who is a state or federal official, or state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more programs, unless the individual is also an officer,
owner, or managerial official of the program, receives remuneration from the program, or
owns any of the beneficial interests not excluded in this subdivision;

(3) an individual who owns less than five percent of the outstanding common shares of
a corporation:

(i) whose securities are exempt under section 80A.45, clause (6); or

(ii) whose transactions are exempt under section 80A.46, clause (2);

(4) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the program
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or

(5) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual according to paragraph (a).

(c) For purposes of this subdivision, "managerial official" means an individual who has
the decision-making authority related to the operation of the program, and the responsibility
for the ongoing management of or direction of the policies, services, or employees of the
program. A site director who has no ownership interest in the program is not considered to
be a managerial official for purposes of this definition.

Sec. 6.

Minnesota Statutes 2025 Supplement, section 245A.04, subdivision 1, is amended
to read:

Subdivision 1.

Application for licensure.

(a) An individual, organization, or government
entity that is subject to licensure under section 245A.03 must apply for a license. The
application must be made on the forms and in the manner prescribed by the commissioner.
The commissioner shall provide the applicant with instruction in completing the application
and provide information about the rules and requirements of other state agencies that affect
the applicant. An applicant seeking licensure in Minnesota with headquarters outside of
Minnesota must have a program office located within 30 miles of the Minnesota border.
An applicant who intends to buy or otherwise acquire a program or services licensed under
this chapter that is owned by another license holder must apply for a license under this
chapter and comply with the application procedures in this section and section 245A.043. new text begin
A license issued pursuant to a change of ownership under section 245A.043 is not subject
to any moratorium imposed under section 245A.03, subdivision 7 or 7a, provided the change
of ownership does not result in an increase in licensed capacity or service scope.
new text end

The commissioner shall act on the application within 90 working days after a complete
application and any required reports have been received from other state agencies or
departments, counties, municipalities, or other political subdivisions. The commissioner
shall not consider an application to be complete until the commissioner receives all of the
required information. If the applicant or a controlling individual is the subject of a pending
administrative, civil, or criminal investigation, the application is not complete until the
investigation has closed or the related legal proceedings are complete.

When the commissioner receives an application for initial licensure that is incomplete
because the applicant failed to submit required documents or that is substantially deficient
because the documents submitted do not meet licensing requirements, the commissioner
shall provide the applicant written notice that the application is incomplete or substantially
deficient. In the written notice to the applicant the commissioner shall identify documents
that are missing or deficient and give the applicant 45 days to resubmit a second application
that is substantially complete. An applicant's failure to submit a substantially complete
application after receiving notice from the commissioner is a basis for license denial under
section 245A.043.

(b) An application for licensure must identify all controlling individuals as defined in
section 245A.02, subdivision 5a, and must designate one individual to be the authorized
agent. The application must be signed by the authorized agent and must include the authorized
agent's first, middle, and last name; mailing address; and email address. By submitting an
application for licensure, the authorized agent consents to electronic communication with
the commissioner throughout the application process. The authorized agent must be
authorized to accept service on behalf of all of the controlling individuals. A government
entity that holds multiple licenses under this chapter may designate one authorized agent
for all licenses issued under this chapter or may designate a different authorized agent for
each license. Service on the authorized agent is service on all of the controlling individuals.
It is not a defense to any action arising under this chapter that service was not made on each
controlling individual. The designation of a controlling individual as the authorized agent
under this paragraph does not affect the legal responsibility of any other controlling individual
under this chapter.

(c) An applicant or license holder must have a policy that prohibits license holders,
employees, subcontractors, and volunteers, when directly responsible for persons served
by the program, from abusing prescription medication or being in any manner under the
influence of a chemical that impairs the individual's ability to provide services or care. The
license holder must train employees, subcontractors, and volunteers about the program's
drug and alcohol policy before the employee, subcontractor, or volunteer has direct contact,
as defined in section 245C.02, subdivision 11, with a person served by the program.

(d) An applicant and license holder must have a program grievance procedure that permits
persons served by the program and their authorized representatives to bring a grievance to
the highest level of authority in the program.

(e) The commissioner may limit communication during the application process to the
authorized agent or the controlling individuals identified on the license application and for
whom a background study was initiated under chapter 245C. Upon implementation of the
provider licensing and reporting hub, applicants and license holders must use the hub in the
manner prescribed by the commissioner. The commissioner may require the applicant,
except for child foster care, to demonstrate competence in the applicable licensing
requirements by successfully completing a written examination. The commissioner may
develop a prescribed written examination format.

(f) When an applicant is an individual, the applicant must provide:

(1) the applicant's taxpayer identification numbers including the Social Security number
or Minnesota tax identification number, and federal employer identification number if the
applicant has employees;

(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, if any;

(3) if doing business under a different name, the doing business as (DBA) name, as
registered with the secretary of state;

(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique
Minnesota Provider Identifier (UMPI) number; and

(5) at the request of the commissioner, the notarized signature of the applicant or
authorized agent.

(g) When an applicant is an organization, the applicant must provide:

(1) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;

(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, and if doing business under a different
name, the doing business as (DBA) name, as registered with the secretary of state;

(3) the first, middle, and last name, and address for all individuals who will be controlling
individuals, including all officers, owners, and managerial officials as defined in section
245A.02, subdivision 5a, and the date that the background study was initiated by the applicant
for each controlling individual;

(4) if applicable, the applicant's NPI number and UMPI number;

(5) the documents that created the organization and that determine the organization's
internal governance and the relations among the persons that own the organization, have
an interest in the organization, or are members of the organization, in each case as provided
or authorized by the organization's governing statute, which may include a partnership
agreement, bylaws, articles of organization, organizational chart, and operating agreement,
or comparable documents as provided in the organization's governing statute; and

(6) the notarized signature of the applicant or authorized agent.

(h) When the applicant is a government entity, the applicant must provide:

(1) the name of the government agency, political subdivision, or other unit of government
seeking the license and the name of the program or services that will be licensed;

(2) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;

(3) a letter signed by the manager, administrator, or other executive of the government
entity authorizing the submission of the license application; and

(4) if applicable, the applicant's NPI number and UMPI number.

(i) At the time of application for licensure or renewal of a license under this chapter, the
applicant or license holder must acknowledge on the form provided by the commissioner
if the applicant or license holder elects to receive any public funding reimbursement from
the commissioner for services provided under the license that:

(1) the applicant's or license holder's compliance with the provider enrollment agreement
or registration requirements for receipt of public funding may be monitored by the
commissioner as part of a licensing investigation or licensing inspection; and

(2) noncompliance with the provider enrollment agreement or registration requirements
for receipt of public funding that is identified through a licensing investigation or licensing
inspection, or noncompliance with a licensing requirement that is a basis of enrollment for
reimbursement for a service, may result in:

(i) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;

(ii) nonpayment of claims submitted by the license holder for public program
reimbursement;

(iii) recovery of payments made for the service;

(iv) disenrollment in the public payment program; or

(v) other administrative, civil, or criminal penalties as provided by law.

new text begin (j) An applicant or license holder who acknowledges under paragraph (i) that the applicant
or license holder elects to receive any publicly funded reimbursement from the commissioner
for services provided under the license that are designated by the commissioner as high-risk
under section 256B.044, subdivision 1, must provide an attestation with the notarized
signature of the applicant or authorized agent stating whether the applicant or authorized
agent received from an unaffiliated business or consultant any assistance preparing:
new text end

new text begin (1) the application;
new text end

new text begin (2) the renewal;
new text end

new text begin (3) any documentation or written policies submitted with the application;
new text end

new text begin (4) any documentation or written policies submitted with the renewal; or
new text end

new text begin (5) any documentation or written policies maintained as a requirement of licensure or
enrollment as a medical assistance provider.
new text end

Sec. 7.

Minnesota Statutes 2025 Supplement, section 245A.04, subdivision 7, is amended
to read:

Subd. 7.

Grant of license; license extension.

(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
license consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043. At minimum, the license shall state:

(1) the name of the license holder;

(2) the address of the program;

(3) the effective date and expiration date of the license;

(4) the type of license and the specific service the license holder is licensed to provide;

(5) the maximum number and ages of persons that may receive services from the program;
and

(6) any special conditions of licensure.

(b) The commissioner may issue a license for a period not to exceed two years if:

(1) the commissioner is unable to conduct the observation required by subdivision 4,
paragraph (a), clause (3), because the program is not yet operational;

(2) certain records and documents are not available because persons are not yet receiving
services from the program; and

(3) the applicant complies with applicable laws and rules in all other respects.

(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program.

(d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a
license if the applicant, license holder, or an affiliated controlling individual has:

(1) been disqualified and the disqualification was not set aside and no variance has been
granted;

(2) been denied a license under this chapter or chapter 142B within the past two years;

(3) had a license issued under this chapter or chapter 142B revoked within the past five
years; or

(4) failed to submit the information required of an applicant under subdivision 1,
paragraph (f), (g), deleted text begin or deleted text end (h) new text begin , or (j) new text end , after being requested by the commissioner.

When a license issued under this chapter or chapter 142B is revoked, the license holder
and each affiliated controlling individual with a revoked license may not hold any license
under chapter 245A for five years following the revocation, and other licenses held by the
applicant or license holder or licenses affiliated with each controlling individual shall also
be revoked.

(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license
affiliated with a license holder or controlling individual that had a license revoked within
the past five years if the commissioner determines that (1) the license holder or controlling
individual is operating the program in substantial compliance with applicable laws and rules
and (2) the program's continued operation is in the best interests of the community being
served.

(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response
to an application that is affiliated with an applicant, license holder, or controlling individual
that had an application denied within the past two years or a license revoked within the past
five years if the commissioner determines that (1) the applicant or controlling individual
has operated one or more programs in substantial compliance with applicable laws and rules
and (2) the program's operation would be in the best interests of the community to be served.

(g) In determining whether a program's operation would be in the best interests of the
community to be served, the commissioner shall consider factors such as the number of
persons served, the availability of alternative services available in the surrounding
community, the management structure of the program, whether the program provides
culturally specific services, and other relevant factors.

(h) The commissioner shall not issue or reissue a license under this chapter if an individual
living in the household where the services will be provided as specified under section
245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside
and no variance has been granted.

(i) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued
under this chapter has been suspended or revoked and the suspension or revocation is under
appeal, the program may continue to operate pending a final order from the commissioner.
If the license under suspension or revocation will expire before a final order is issued, a
temporary provisional license may be issued provided any applicable license fee is paid
before the temporary provisional license is issued.

(j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of
a controlling individual or license holder, and the controlling individual or license holder
is ordered under section 245C.17 to be immediately removed from direct contact with
persons receiving services or is ordered to be under continuous, direct supervision when
providing direct contact services, the program may continue to operate only if the program
complies with the order and submits documentation demonstrating compliance with the
order. If the disqualified individual fails to submit a timely request for reconsideration, or
if the disqualification is not set aside and no variance is granted, the order to immediately
remove the individual from direct contact or to be under continuous, direct supervision
remains in effect pending the outcome of a hearing and final order from the commissioner.

(k) Unless otherwise specified by statute, all licenses issued under this chapter expire
at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
comply with the requirements in section 245A.10 and be reissued a new license to operate
the program or the program must not be operated after the expiration date. Adult foster care,
family adult day services, child foster residence setting, and community residential services
license holders must apply for and be granted a new license to operate the program or the
program must not be operated after the expiration date. Upon implementation of the provider
licensing and reporting hub, licenses may be issued each calendar year.

(l) The commissioner shall not issue or reissue a license under this chapter if it has been
determined that a Tribal licensing authority has established jurisdiction to license the program
or service.

(m) The commissioner of human services may coordinate and share data with the
commissioner of children, youth, and families to enforce this section.

(n) For substance use disorder treatment programs, for the purposes of paragraph (a),
clause (5), the maximum number of persons who may receive services from the program
includes persons served at satellite locations.

Sec. 8.

Minnesota Statutes 2025 Supplement, section 245A.05, is amended to read:

245A.05 DENIAL OF APPLICATION.

(a) The commissioner may deny a license if an applicant or controlling individual:

(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;

(2) fails to comply with applicable laws or rules;

(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;

(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;

(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;

(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted;

(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) deleted text begin or deleted text end new text begin , new text end (g) new text begin , or (j) new text end ;

(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;

(9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules, including but not limited to this chapter and chapters 142E and
245C;

(10) is prohibited from holding a license according to section 245.095; or

(11) is the subject of a pending administrative, civil, or criminal investigation.

(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial, which must state the reasons for the denial in plain language. Notice
must be given by certified mail, by personal service, or through the provider licensing and
reporting hub. The notice must state the reasons the application was denied and must inform
the applicant of the right to a contested case hearing under chapter 14 and Minnesota Rules,
parts 1400.8505 to 1400.8612. The applicant may appeal the denial by notifying the
commissioner in writing by certified mail, by personal service, or through the provider
licensing and reporting hub. If mailed, the appeal must be postmarked and sent to the
commissioner within 20 calendar days after the applicant received the notice of denial. If
an appeal request is made by personal service, it must be received by the commissioner
within 20 calendar days after the applicant received the notice of denial. If the order is issued
through the provider hub, the appeal must be received by the commissioner within 20
calendar days from the date the commissioner issued the order through the hub. Section
245A.08 applies to hearings held to appeal the commissioner's denial of an application.

Sec. 9.

Minnesota Statutes 2024, section 245D.081, subdivision 3, is amended to read:

Subd. 3.

Program management and oversight.

(a) The license holder must designate
a managerial staff person or persons to provide program management and oversight of the
services provided by the license holder. The designated manager is responsible for the
following:

(1) maintaining a current understanding of the licensing requirements sufficient to ensure
compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph
(e), and when applicable, as identified in section deleted text begin 256B.04, subdivision 21, paragraph (g) deleted text end new text begin
256B.044, subdivision 7 new text end ;

(2) ensuring the duties of the designated coordinator are fulfilled according to the
requirements in subdivision 2;

(3) ensuring the program implements corrective action identified as necessary by the
program following review of incident and emergency reports according to the requirements
in section 245D.11, subdivision 2, clause (7). An internal review of incident reports of
alleged or suspected maltreatment must be conducted according to the requirements in
section 245A.65, subdivision 1, paragraph (b);

(4) evaluation of satisfaction of persons served by the program, the person's legal
representative, if any, and the case manager, with the service delivery and progress toward
accomplishing outcomes identified in sections 245D.07 and 245D.071, and ensuring and
protecting each person's rights as identified in section 245D.04;

(5) ensuring staff competency requirements are met according to the requirements in
section 245D.09, subdivision 3, and ensuring staff orientation and training is provided
according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;

(6) ensuring corrective action is taken when ordered by the commissioner and that the
terms and conditions of the license and any variances are met; and

(7) evaluating the information identified in clauses (1) to (6) to develop, document, and
implement ongoing program improvements.

(b) The designated manager must be competent to perform the duties as required and
must minimally meet the education and training requirements identified in subdivision 2,
paragraph (b), and have a minimum of three years of supervisory level experience in a
program that provides care or education to vulnerable adults or children.

Sec. 10.

Minnesota Statutes 2025 Supplement, section 256.01, subdivision 2, is amended
to read:

Subd. 2.

Specific powers.

Subject to the provisions of section 241.021, subdivision 2,
the commissioner of human services shall carry out the specific duties in paragraphs (a)
through (z):

(a) Administer and supervise the forms of public assistance provided for by state law
and other welfare activities or services that are vested in the commissioner. Administration
and supervision of human services activities or services includes, but is not limited to,
assuring timely and accurate distribution of benefits, completeness of service, and quality
program management. In addition to administering and supervising human services activities
vested by law in the department, the commissioner shall have the authority to:

(1) require county agency participation in training and technical assistance programs to
promote compliance with statutes, rules, federal laws, regulations, and policies governing
human services;

(2) monitor, on an ongoing basis, the performance of county agencies in the operation
and administration of human services, enforce compliance with statutes, rules, federal laws,
regulations, and policies governing welfare services and promote excellence of administration
and program operation;

(3) develop a quality control program or other monitoring program to review county
performance and accuracy of benefit determinations;

(4) require county agencies to make an adjustment to the public assistance benefits issued
to any individual consistent with federal law and regulation and state law and rule and to
issue or recover benefits as appropriate;

(5) delay or deny payment of all or part of the state and federal share of benefits and
administrative reimbursement according to the procedures set forth in section 256.017;

(6) make contracts with and grants to public and private agencies and organizations,
both profit and nonprofit, and individuals, using appropriated funds; and

(7) enter into contractual agreements with federally recognized Indian Tribes with a
reservation in Minnesota to the extent necessary for the Tribe to operate a federally approved
family assistance program or any other program under the supervision of the commissioner.
The commissioner shall consult with the affected county or counties in the contractual
agreement negotiations, if the county or counties wish to be included, in order to avoid the
duplication of county and Tribal assistance program services. The commissioner may
establish necessary accounts for the purposes of receiving and disbursing funds as necessary
for the operation of the programs.

The commissioner shall work in conjunction with the commissioner of children, youth, and
families to carry out the duties of this paragraph when necessary and feasible.

(b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
regulation, and policy necessary to county agency administration of the programs.

(c) Administer and supervise all noninstitutional service to persons with disabilities,
including persons who have vision impairments, and persons who are deaf, deafblind, and
hard-of-hearing or with other disabilities. The commissioner may provide and contract for
the care and treatment of qualified indigent children in facilities other than those located
and available at state hospitals operated by the executive board when it is not feasible to
provide the service in state hospitals operated by the executive board.

(d) Assist and actively cooperate with other departments, agencies and institutions, local,
state, and federal, by performing services in conformity with the purposes of Laws 1939,
chapter 431.

(e) Act as the agent of and cooperate with the federal government in matters of mutual
concern relative to and in conformity with the provisions of Laws 1939, chapter 431,
including the administration of any federal funds granted to the state to aid in the performance
of any functions of the commissioner as specified in Laws 1939, chapter 431, and including
the promulgation of rules making uniformly available medical care benefits to all recipients
of public assistance, at such times as the federal government increases its participation in
assistance expenditures for medical care to recipients of public assistance, the cost thereof
to be borne in the same proportion as are grants of aid to said recipients.

(f) Establish and maintain any administrative units reasonably necessary for the
performance of administrative functions common to all divisions of the department.

(g) Act as designated guardian of both the estate and the person of all the wards of the
state of Minnesota, whether by operation of law or by an order of court, without any further
act or proceeding whatever, except as to persons committed as developmentally disabled.

(h) Act as coordinating referral and informational center on requests for service for
newly arrived immigrants coming to Minnesota.

(i) The specific enumeration of powers and duties as hereinabove set forth shall in no
way be construed to be a limitation upon the general transfer of powers herein contained.

(j) Establish county, regional, or statewide schedules of maximum fees and charges
which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
nursing home care and medicine and medical supplies under all programs of medical care
provided by the state and for congregate living care under the income maintenance programs.

(k) Have the authority to conduct and administer experimental projects to test methods
and procedures of administering assistance and services to recipients or potential recipients
of public welfare. To carry out such experimental projects, it is further provided that the
commissioner of human services is authorized to waive the enforcement of existing specific
statutory program requirements, rules, and standards in one or more counties. The order
establishing the waiver shall provide alternative methods and procedures of administration,
shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
in no event shall the duration of a project exceed four years. It is further provided that no
order establishing an experimental project as authorized by the provisions of this section
shall become effective until the following conditions have been met:

(1) the United States Secretary of Health and Human Services has agreed, for the same
project, to waive state plan requirements relative to statewide uniformity; and

(2) a comprehensive plan, including estimated project costs, shall be approved by the
Legislative Advisory Commission and filed with the commissioner of administration.

(l) According to federal requirements and in coordination with the commissioner of
children, youth, and families, establish procedures to be followed by local welfare boards
in creating citizen advisory committees, including procedures for selection of committee
members.

(m) Allocate federal fiscal disallowances or sanctions which are based on quality control
error rates for medical assistance in the following manner:

(1) one-half of the total amount of the disallowance shall be borne by the county boards
responsible for administering the programs. Disallowances shall be shared by each county
board in the same proportion as that county's expenditures for the sanctioned program are
to the total of all counties' expenditures for medical assistance. Each county shall pay its
share of the disallowance to the state of Minnesota. When a county fails to pay the amount
due hereunder, the commissioner may deduct the amount from reimbursement otherwise
due the county, or the attorney general, upon the request of the commissioner, may institute
civil action to recover the amount due; and

(2) notwithstanding the provisions of clause (1), if the disallowance results from knowing
noncompliance by one or more counties with a specific program instruction, and that knowing
noncompliance is a matter of official county board record, the commissioner may require
payment or recover from the county or counties, in the manner prescribed in clause (1), an
amount equal to the portion of the total disallowance which resulted from the noncompliance,
and may distribute the balance of the disallowance according to clause (1).

(n) Develop and implement special projects that maximize reimbursements and result
in the recovery of money to the state. For the purpose of recovering state money, the
commissioner may enter into contracts with third parties. Any recoveries that result from
projects or contracts entered into under this paragraph shall be deposited in the state treasury
and credited to a special account until the balance in the account reaches $1,000,000. When
the balance in the account exceeds $1,000,000, the excess shall be transferred and credited
to the general fund. All money in the account is appropriated to the commissioner for the
purposes of this paragraph.

(o) Have the authority to establish and enforce the following county reporting
requirements:

(1) the commissioner shall establish fiscal and statistical reporting requirements necessary
to account for the expenditure of funds allocated to counties for human services programs.
When establishing financial and statistical reporting requirements, the commissioner shall
evaluate all reports, in consultation with the counties, to determine if the reports can be
simplified or the number of reports can be reduced;

(2) the county board shall submit monthly or quarterly reports to the department as
required by the commissioner. Monthly reports are due no later than 15 working days after
the end of the month. Quarterly reports are due no later than 30 calendar days after the end
of the quarter, unless the commissioner determines that the deadline must be shortened to
20 calendar days to avoid jeopardizing compliance with federal deadlines or risking a loss
of federal funding. Only reports that are complete, legible, and in the required format shall
be accepted by the commissioner;

(3) if the required reports are not received by the deadlines established in clause (2), the
commissioner may delay payments and withhold funds from the county board until the next
reporting period. When the report is needed to account for the use of federal funds and the
late report results in a reduction in federal funding, the commissioner shall withhold from
the county boards with late reports an amount equal to the reduction in federal funding until
full federal funding is received;

(4) a county board that submits reports that are late, illegible, incomplete, or not in the
required format for two out of three consecutive reporting periods is considered
noncompliant. When a county board is found to be noncompliant, the commissioner shall
notify the county board of the reason the county board is considered noncompliant and
request that the county board develop a corrective action plan stating how the county board
plans to correct the problem. The corrective action plan must be submitted to the
commissioner within 45 days after the date the county board received notice of
noncompliance;

(5) the final deadline for fiscal reports or amendments to fiscal reports is one year after
the date the report was originally due. If the commissioner does not receive a report by the
final deadline, the county board forfeits the funding associated with the report for that
reporting period and the county board must repay any funds associated with the report
received for that reporting period;

(6) the commissioner may not delay payments, withhold funds, or require repayment
under clause (3) or (5) if the county demonstrates that the commissioner failed to provide
appropriate forms, guidelines, and technical assistance to enable the county to comply with
the requirements. If the county board disagrees with an action taken by the commissioner
under clause (3) or (5), the county board may appeal the action according to sections 14.57
to 14.69; and

(7) counties subject to withholding of funds under clause (3) or forfeiture or repayment
of funds under clause (5) shall not reduce or withhold benefits or services to clients to cover
costs incurred due to actions taken by the commissioner under clause (3) or (5).

(p) Allocate federal fiscal disallowances or sanctions for audit exceptions when federal
fiscal disallowances or sanctions are based on a statewide random sample in direct proportion
to each county's claim for that period.

(q) Be responsible for ensuring the detection, prevention, investigation, and resolution
of fraudulent activities or behavior by applicants, recipients, and other participants in the
human services programs administered by the department new text begin , including but not limited to a
preenrollment risk assessment. A preenrollment risk assessment under this paragraph must
be conducted in accordance with the procedures and criteria established in section 256B.0437 new text end .

(r) Require county agencies to identify overpayments, establish claims, and utilize all
available and cost-beneficial methodologies to collect and recover these overpayments in
the human services programs administered by the department.

(s) Have the authority to administer the federal drug rebate program for drugs purchased
under the medical assistance program as allowed by section 1927 of title XIX of the Social
Security Act and according to the terms and conditions of section 1927. Rebates shall be
collected for all drugs that have been dispensed or administered in an outpatient setting and
that are from manufacturers who have signed a rebate agreement with the United States
Department of Health and Human Services.

(t) Have the authority to administer a supplemental drug rebate program for drugs
purchased under the medical assistance program. The commissioner may enter into
supplemental rebate contracts with pharmaceutical manufacturers and may require prior
authorization for drugs that are from manufacturers that have not signed a supplemental
rebate contract. Prior authorization of drugs shall be subject to the provisions of section
256B.0625, subdivision 13.

(u) Operate the department's communication systems account established in Laws 1993,
First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
communication costs necessary for the operation of the programs the commissioner
supervises. Each account must be used to manage shared communication costs necessary
for the operations of the programs the commissioner supervises. The commissioner may
distribute the costs of operating and maintaining communication systems to participants in
a manner that reflects actual usage. Costs may include acquisition, licensing, insurance,
maintenance, repair, staff time and other costs as determined by the commissioner. Nonprofit
organizations and state, county, and local government agencies involved in the operation
of programs the commissioner supervises may participate in the use of the department's
communications technology and share in the cost of operation. The commissioner may
accept on behalf of the state any gift, bequest, devise or personal property of any kind, or
money tendered to the state for any lawful purpose pertaining to the communication activities
of the department. Any money received for this purpose must be deposited in the department's
communication systems accounts. Money collected by the commissioner for the use of
communication systems must be deposited in the state communication systems account and
is appropriated to the commissioner for purposes of this section.

(v) Receive any federal matching money that is made available through the medical
assistance program for the consumer satisfaction survey. Any federal money received for
the survey is appropriated to the commissioner for this purpose. The commissioner may
expend the federal money received for the consumer satisfaction survey in either year of
the biennium.

(w) Designate community information and referral call centers and incorporate cost
reimbursement claims from the designated community information and referral call centers
into the federal cost reimbursement claiming processes of the department according to
federal law, rule, and regulations. Existing information and referral centers provided by
Greater Twin Cities United Way or existing call centers for which Greater Twin Cities
United Way has legal authority to represent, shall be included in these designations upon
review by the commissioner and assurance that these services are accredited and in
compliance with national standards. Any reimbursement is appropriated to the commissioner
and all designated information and referral centers shall receive payments according to
normal department schedules established by the commissioner upon final approval of
allocation methodologies from the United States Department of Health and Human Services
Division of Cost Allocation or other appropriate authorities.

(x) Develop recommended standards for adult foster care homes that address the
components of specialized therapeutic services to be provided by adult foster care homes
with those services.

(y) Authorize the method of payment to or from the department as part of the human
services programs administered by the department. This authorization includes the receipt
or disbursement of funds held by the department in a fiduciary capacity as part of the human
services programs administered by the department.

(z) Designate the agencies that operate the Senior LinkAge Line under section 256.975,
subdivision 7, and the Disability Hub under subdivision 24 as the state of Minnesota Aging
and Disability Resource Center under United States Code, title 42, section 3001, the Older
Americans Act Amendments of 2006, and incorporate cost reimbursement claims from the
designated centers into the federal cost reimbursement claiming processes of the department
according to federal law, rule, and regulations. Any reimbursement must be appropriated
to the commissioner and treated consistent with section 256.011. All Aging and Disability
Resource Center designated agencies shall receive payments of grant funding that supports
the activity and generates the federal financial participation according to Board on Aging
administrative granting mechanisms.

Sec. 11.

Minnesota Statutes 2024, section 256B.02, is amended by adding a subdivision
to read:

new text begin Subd. 20. new text end

new text begin Fraud. new text end

new text begin "Fraud" means an intentional deception or misrepresentation made by
a person with the knowledge that the deception could result in an unauthorized benefit to
the person or another person. Fraud includes:
new text end

new text begin (1) the following crimes, including attempts or conspiracy to commit the crimes:
new text end

new text begin (i) theft in violation of section 609.52;
new text end

new text begin (ii) perjury in violation of section 609.48;
new text end

new text begin (iii) aggravated forgery and forgery in violation of sections 609.625 and 609.63;
new text end

new text begin (iv) medical assistance fraud in violation of section 609.466;
new text end

new text begin (v) financial transaction card fraud in violation of section 609.821;
new text end

new text begin (vi) wrongfully obtaining assistance in violation of section 256.98;
new text end

new text begin (vii) illegal remunerations in violation of section 609.542; and
new text end

new text begin (viii) a felony listed in United States Code, title 42, section 1320a-7b(b)(1) or (2), subject
to any safe harbors established in Code of Federal Regulations, title 42, part 1001, section
952;
new text end

new text begin (2) any act that constitutes fraud under applicable federal or state law, including but not
limited to knowingly and willfully submitting an application for provider status that is false
or fraudulent in whole or in part; and
new text end

new text begin (3) an intentional submission of a claim for reimbursement under chapter 256B, knowing
or having reason to know the claim is ineligible for reimbursement in whole or in part and
acting with the intent to defraud the payor.
new text end

Sec. 12.

Minnesota Statutes 2025 Supplement, section 256B.04, subdivision 21, is amended
to read:

Subd. 21.

Provider enrollment.

deleted text begin (a) deleted text end The commissioner shall enroll providers and conduct
screening activities as required by new text begin sections 256B.0437 to 256B.0445 and new text end Code of Federal
Regulations, title 42, section 455, subpart E.

deleted text begin A provider must enroll each provider-controlled location where direct services are
provided. The commissioner may deny a provider's incomplete application if a provider
fails to respond to the commissioner's request for additional information within 60 days of
the request. The commissioner must conduct a background study under chapter deleted text end deleted text begin 245C deleted text end deleted text begin ,
including a review of databases in section 245C.08, subdivision 1, paragraph (a), clauses
(1) to (5), for a provider described in this paragraph. The background study requirement
may be satisfied if the commissioner conducted a fingerprint-based background study on
the provider that includes a review of databases in section 245C.08, subdivision 1, paragraph
(a), clauses (1) to (5).
deleted text end

deleted text begin (b) The commissioner shall revalidate:
deleted text end

deleted text begin (1) each provider under this subdivision at least once every five years;
deleted text end

deleted text begin (2) each personal care assistance agency, CFSS provider-agency, and CFSS financial
management services provider under this subdivision at least once every three years;
deleted text end

deleted text begin (3) each EIDBI agency under this subdivision at least once every three years; and
deleted text end

deleted text begin (4) at the commissioner's discretion, any medical-assistance-only provider type the
commissioner deems "high-risk" under this subdivision.
deleted text end

deleted text begin (c) The commissioner shall conduct revalidation as follows:
deleted text end

deleted text begin (1) provide 30-day notice of the revalidation due date including instructions for
revalidation and a list of materials the provider must submit;
deleted text end

deleted text begin (2) if a provider fails to submit all required materials by the due date, notify the provider
of the deficiency within 30 days after the due date and allow the provider an additional 30
days from the notification date to comply; and
deleted text end

deleted text begin (3) if a provider fails to remedy a deficiency within the 30-day time period, give 60-day
notice of termination and immediately suspend the provider's ability to bill. The provider
does not have the right to appeal suspension of ability to bill.
deleted text end

deleted text begin (d) If a provider fails to comply with any individual provider requirement or condition
of participation, the commissioner may suspend the provider's ability to bill until the provider
comes into compliance. The commissioner's decision to suspend the provider is not subject
to an administrative appeal.
deleted text end

deleted text begin (e) Correspondence and notifications, including notifications of termination and other
actions, may be delivered electronically to a provider's MN-ITS mailbox. This paragraph
does not apply to correspondences and notifications related to background studies.
deleted text end

deleted text begin (f) If the commissioner or the Centers for Medicare and Medicaid Services determines
that a provider is designated "high-risk," the commissioner may withhold payment from
providers within that category upon initial enrollment for a 90-day period. The withholding
for each provider must begin on the date of the first submission of a claim.
deleted text end

deleted text begin (g) An enrolled provider that is also licensed by the commissioner under chapter deleted text end deleted text begin 245A deleted text end deleted text begin ,
is licensed as a home care provider by the Department of Health under chapter 144A, or is
licensed as an assisted living facility under chapter deleted text end deleted text begin 144G deleted text end deleted text begin and has a home and
community-based services designation on the home care license under section 144A.484,
must designate an individual as the entity's compliance officer. The compliance officer
must:
deleted text end

deleted text begin (1) develop policies and procedures to assure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;
deleted text end

deleted text begin (2) train the employees of the provider entity, and any agents or subcontractors of the
provider entity including billers, on the policies and procedures under clause (1);
deleted text end

deleted text begin (3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services, and implement action to remediate any resulting problems;
deleted text end

deleted text begin (4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;
deleted text end

deleted text begin (5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and
deleted text end

deleted text begin (6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.
deleted text end

deleted text begin The commissioner may require, as a condition of enrollment in medical assistance, that a
provider within a particular industry sector or category establish a compliance program that
contains the core elements established by the Centers for Medicare and Medicaid Services.
deleted text end

deleted text begin (h) The commissioner may revoke the enrollment of an ordering or rendering provider
for a period of not more than one year, if the provider fails to maintain and, upon request
from the commissioner, provide access to documentation relating to written orders or requests
for payment for durable medical equipment, certifications for home health services, or
referrals for other items or services written or ordered by such provider, when the
commissioner has identified a pattern of a lack of documentation. A pattern means a failure
to maintain documentation or provide access to documentation on more than one occasion.
Nothing in this paragraph limits the authority of the commissioner to sanction a provider
under the provisions of section 256B.064.
deleted text end

deleted text begin (i) The commissioner shall terminate or deny the enrollment of any individual or entity
if the individual or entity has been terminated from participation in Medicare or under the
Medicaid program or Children's Health Insurance Program of any other state. The
commissioner may exempt a rehabilitation agency from termination or denial that would
otherwise be required under this paragraph, if the agency:
deleted text end

deleted text begin (1) is unable to retain Medicare certification and enrollment solely due to a lack of billing
to the Medicare program;
deleted text end

deleted text begin (2) meets all other applicable Medicare certification requirements based on an on-site
review completed by the commissioner of health; and
deleted text end

deleted text begin (3) serves primarily a pediatric population.
deleted text end

deleted text begin (j) As a condition of enrollment in medical assistance, the commissioner shall require
that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
Services, its agents, or its designated contractors and the state agency, its agents, or its
designated contractors to conduct unannounced on-site inspections of any provider location.
The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
and standards used to designate Medicare providers in Code of Federal Regulations, title
42, section 424.518. The list and criteria are not subject to the requirements of chapter deleted text end deleted text begin 14 deleted text end deleted text begin .
The commissioner's designations are not subject to administrative appeal.
deleted text end

deleted text begin (k) As a condition of enrollment in medical assistance, the commissioner shall require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
high-risk for fraud, waste, or abuse.
deleted text end

deleted text begin (l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable
medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
meeting the durable medical equipment provider and supplier definition in clause (3),
operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
annually renewed and designates the Minnesota Department of Human Services as the
obligee, and must be submitted in a form approved by the commissioner. For purposes of
this clause, the following medical suppliers are not required to obtain a surety bond: a
federally qualified health center, a home health agency, the Indian Health Service, a
pharmacy, and a rural health clinic.
deleted text end

deleted text begin (2) At the time of initial enrollment or reenrollment, durable medical equipment providers
and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and
fees in pursuing a claim on the bond. Any action to obtain monetary recovery or sanctions
from a surety bond must occur within six years from the date the debt is affirmed by a final
agency decision. An agency decision is final when the right to appeal the debt has been
exhausted or the time to appeal has expired under section 256B.064.
deleted text end

deleted text begin (3) "Durable medical equipment provider or supplier" means a medical supplier that can
purchase medical equipment or supplies for sale or rental to the general public and is able
to perform or arrange for necessary repairs to and maintenance of equipment offered for
sale or rental.
deleted text end

deleted text begin (m) The Department of Human Services may require a provider to purchase a surety
bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
if: (1) the provider fails to demonstrate financial viability, (2) the department determines
there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
provider or category of providers is designated high-risk pursuant to paragraph (f) and as
per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an
amount of $100,000 or ten percent of the provider's payments from Medicaid during the
immediately preceding 12 months, whichever is greater. The surety bond must name the
Department of Human Services as an obligee and must allow for recovery of costs and fees
in pursuing a claim on the bond. This paragraph does not apply if the provider currently
maintains a surety bond under the requirements in section 256B.051, 256B.0659, 256B.0701,
or 256B.85.
deleted text end

Sec. 13.

new text begin [256B.0437] PREENROLLMENT ASSESSMENT.
new text end

new text begin (a) Before enrolling a provider or agency, the commissioner may complete a
preenrollment risk assessment of the provider or agency seeking to enroll to confirm the
provider or agency's eligibility and the provider or agency's ability to meet the requirements
of this chapter. The commissioner must utilize a risk-score framework as a component of
the assessment that identifies service-specific fraud risk indicators, including but not limited
to organizational readiness, financial stability, compliance history, and addressing service
necessity.
new text end

new text begin (b) Based on the assessment of fraud risk indicators described in paragraph (a), the
commissioner may deem the applicant ineligible and deny or rescind enrollment. The
decision to deny or rescind enrollment must be made in writing and sent using a
signature-verified confirmed delivery method. An applicant may request reconsideration
of the decision regarding the applicant's eligibility in writing within 30 business days after
the date the notice was issued. The commissioner must notify each applicant of the
commissioner's final decision regarding the applicant's eligibility.
new text end

new text begin (c) A provider enrolled before July 1, 2026, that billed for services on or after January
1, 2025, must receive a positive preenrollment risk assessment no later than July 1, 2027,
to remain eligible. A provider or agency enrolled before July 1, 2026, that has not billed
for services on or after January 1, 2025, must receive a positive preenrollment risk assessment
no later than July 1, 2026, to remain eligible. A provider that becomes ineligible under this
paragraph regains eligibility after receiving a positive assessment under this section if the
provider remains otherwise eligible.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 14.

new text begin [256B.044] PROVIDER ENROLLMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Designating categorical risk levels. new text end

new text begin (a) The commissioner must designate
provider types as "limited-risk," "moderate-risk," or "high-risk," based on the criteria and
standards used to designate Medicare providers in Code of Federal Regulations, title 42,
section 424.518. The commissioner must publish a list of provider types and designated
categorical risk levels in the Minnesota Health Care Program Provider Manual.
new text end

new text begin (b) The list and criteria are not subject to the requirements of chapter 14, and section
14.386 does not apply.
new text end

new text begin (c) The commissioner's designations are not subject to administrative appeal.
new text end

new text begin Subd. 2. new text end

new text begin Service location enrollment. new text end

new text begin A provider must enroll each provider-controlled
location where direct services are provided.
new text end

new text begin Subd. 3. new text end

new text begin Incomplete provider enrollment applications. new text end

new text begin The commissioner may deny
a provider's incomplete enrollment application if a provider fails to respond to the
commissioner's request for additional information within 60 days of the request.
new text end

new text begin Subd. 4. new text end

new text begin Required background studies. new text end

new text begin (a) The commissioner must conduct a
background study under chapter 245C, including a review of databases in section 245C.08,
subdivision 1, paragraph (a), clauses (1) to (5), for a provider applying for enrollment under
section 256B.04, subdivision 21. The background study requirement may be satisfied if the
commissioner conducted a fingerprint-based background study on the provider that included
a review of databases in section 245C.08, subdivision 1, paragraph (a), clauses (1) to (5).
new text end

new text begin (b) As a condition of enrollment in medical assistance, the commissioner must require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services (CMS) that a provider is
designated high-risk.
new text end

new text begin Subd. 5. new text end

new text begin Surety bonds. new text end

new text begin (a) The commissioner may require a provider to purchase a
surety bond as a condition of initial enrollment, revalidation, reenrollment, reinstatement,
or continued enrollment if:
new text end

new text begin (1) the provider fails to demonstrate financial viability;
new text end

new text begin (2) the commissioner determines there is significant evidence of or potential for fraud
and abuse by the provider; or
new text end

new text begin (3) the provider or category of providers is designated high-risk pursuant to subdivision
1 and Code of Federal Regulations, title 42, section 455.450.
new text end

new text begin (b) The surety bond must be in an amount of $100,000 or ten percent of the provider's
payments from Medicaid during the immediately preceding 12 months, whichever is greater.
The surety bond must name the Department of Human Services as an obligee, must be
purchased new annually, and must allow for recovery of costs and fees in pursuing a claim
on the bond. Any action to obtain monetary recovery or sanctions from a surety bond must
occur within six years from the date the debt is affirmed by a final agency decision. An
agency decision is final when the right to appeal the debt has been exhausted or the time to
appeal has expired under section 256B.064.
new text end

new text begin (c) This subdivision does not apply if the provider currently maintains a surety bond
under the requirements in section 256B.051, 256B.0659, 256B.0701, or 256B.85.
new text end

new text begin Subd. 6. new text end

new text begin Required on-site inspections. new text end

new text begin (a) As a condition of enrollment in medical
assistance, the commissioner shall require that a provider designated moderate-risk or
high-risk by CMS or the commissioner permit CMS, CMS's agents, or CMS's designated
contractors and the state agency, the state agency's agents, or the state agency's designated
contractors to conduct unannounced on-site inspections of any provider location.
new text end

new text begin (b) Consistent with the commissioner's authority under Code of Federal Regulations,
title 42, section 455.452, prior to enrolling, prior to re-enrolling, and prior to revalidating
a provider designated moderate-risk or high-risk, the commissioner must conduct
unannounced on-site inspections of all provider locations.
new text end

new text begin Subd. 7. new text end

new text begin Compliance programs. new text end

new text begin (a) The commissioner may require, as a condition of
enrollment in medical assistance, that a provider within a particular industry sector or
category establish a compliance program that contains the core elements established by
CMS.
new text end

new text begin (b) If an enrolled provider is required by the commissioner or by law to designate an
individual as the provider's compliance officer, the compliance officer must:
new text end

new text begin (1) develop policies and procedures to ensure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;
new text end

new text begin (2) train the employees of the provider entity and any agents or subcontractors of the
provider entity, including billers, on the policies and procedures under clause (1);
new text end

new text begin (3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services and implement action to remediate any resulting problems;
new text end

new text begin (4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;
new text end

new text begin (5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and
new text end

new text begin (6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.
new text end

new text begin Subd. 8. new text end

new text begin Correspondence and notification. new text end

new text begin The commissioner may deliver
correspondence and notifications, including notifications of termination and other actions,
electronically to a provider's MN-ITS mailbox. This subdivision does not apply to
correspondence and notifications related to background studies.
new text end

Sec. 15.

new text begin [256B.0441] PROVIDER REVALIDATION.
new text end

new text begin Subdivision 1. new text end

new text begin Provider revalidation schedule. new text end

new text begin The commissioner shall revalidate:
new text end

new text begin (1) each provider at least once every five years;
new text end

new text begin (2) each personal care assistance agency, community first services and supports (CFSS)
agency-provider, and CFSS financial management services provider at least once every
three years;
new text end

new text begin (3) each early intensive developmental and behavioral intervention agency at least once
every three years; and
new text end

new text begin (4) at the commissioner's discretion, any medical-assistance-only provider type the
commissioner deems high-risk under section 256B.044, subdivision 1.
new text end

new text begin Subd. 2. new text end

new text begin Revalidation procedures. new text end

new text begin The commissioner shall conduct revalidation as
follows:
new text end

new text begin (1) provide 30 days' notice of the revalidation due date including instructions for
revalidation and a list of materials the provider must submit; and
new text end

new text begin (2) if a provider fails to respond or remedy a deficiency within the 30-day time period,
give 30 days' notice of termination and immediately suspend the provider's ability to bill.
The provider does not have the right to appeal suspension of ability to bill.
new text end

Sec. 16.

new text begin [256B.0442] PROVIDER ENROLLMENT SUSPENSIONS AND
TERMINATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Commissioner's general authority to suspend individual provider's
enrollment. new text end

new text begin (a) If a provider fails to comply with any individual provider requirement or
condition of participation, the commissioner may suspend the provider's ability to bill until
the provider comes into compliance.
new text end

new text begin (b) The commissioner's decision to suspend the provider is not subject to an administrative
appeal.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner's authority to revoke enrollment of certain providers for
lack of documentation. new text end

new text begin (a) The commissioner may revoke the enrollment of an ordering
or rendering provider for a period of not more than one year, if the provider fails to maintain
and, upon request from the commissioner, provide access to documentation relating to
written orders or requests for payment for durable medical equipment, certifications for
home health services, or referrals for other items or services written or ordered by the
provider, when the commissioner has identified a pattern of a lack of documentation. A
pattern means a failure to maintain documentation or provide access to documentation on
more than one occasion.
new text end

new text begin (b) Nothing in this subdivision limits the authority of the commissioner to sanction a
provider under section 256B.064.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner's duty to terminate provider enrollment. new text end

new text begin (a) Except as
provided in paragraph (b), the commissioner must terminate or deny the enrollment of any
individual or entity if the individual or entity has been terminated from participation in
Medicare or under the Medicaid program or Children's Health Insurance Program of any
other state.
new text end

new text begin (b) The commissioner may exempt a rehabilitation agency from termination or denial
that would otherwise be required under paragraph (a), if the agency:
new text end

new text begin (1) is unable to retain Medicare certification and enrollment solely due to a lack of billing
to the Medicare program;
new text end

new text begin (2) meets all other applicable Medicare certification requirements based on an on-site
review completed by the commissioner of health; and
new text end

new text begin (3) serves primarily a pediatric population.
new text end

new text begin Subd. 4. new text end

new text begin Commissioner's authority to terminate provider enrollment for lack of
submitted claims. new text end

new text begin The commissioner may terminate the enrollment of an individual or
entity provider if the individual or entity provider has not submitted any claims in the
previous 12 consecutive calendar months.
new text end

Sec. 17.

new text begin [256B.0443] PROVIDER PAYMENT WITHHOLDS.
new text end

new text begin (a) If the commissioner or the Centers for Medicare and Medicaid Services designates
a provider type as high-risk under section 256B.044, subdivision 1, the commissioner may
withhold payment from providers within that category upon initial enrollment for a 90-day
period.
new text end

new text begin (b) The withholding for each provider must begin on the date of the first submission of
a claim.
new text end

Sec. 18.

new text begin [256B.0444] ADDITIONAL PROVIDER ENROLLMENT REQUIREMENTS
FOR HIGH-RISK PROVIDERS.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin This section applies to any agency that provides a service
designated by the commissioner as high-risk under section 256B.044, subdivision 1. For
purposes of this section, "agency" means the legal entity that is applying to be or is enrolled
with Minnesota health care programs as a medical assistance provider according to Minnesota
Rules, part 9505.0195.
new text end

new text begin Subd. 2. new text end

new text begin Mandatory training compliance. new text end

new text begin (a) Effective January 1, 2027, before applying
for enrollment or reenrollment as a medical assistance provider, an agency applying to
provide services designated by the commissioner as high-risk must require all owners of
the agency who are active in the day-to-day management and operations of the agency and
managerial and supervisory employees to complete compliance training. All individuals
who must complete training under this subdivision must repeat the training prior to
revalidation of the agency as a medical assistance provider.
new text end

new text begin (b) New owners active in day-to-day management and operations of the agency and new
managerial and supervisory employees of the agency must complete compliance training
under this subdivision within 30 calendar days of becoming an owner of or employed by
the agency and prior to conducting any management and operations activities for the agency.
If an individual moves to another agency providing the same service and serves in a similar
ownership or employment capacity, the individual is not required to repeat the training
required under this subdivision. If the individual chooses not to repeat the compliance
training, the individual must provide the agency with documentation proving the individual
completed the compliance training within the provider revalidation schedule for the relevant
provider type as determined by the commissioner under section 256B.0441.
new text end

new text begin (c) The commissioner must determine the format and content of the compliance training.
The training must include the following topics, adapted as necessary for each provider type
subject to the requirements of this subdivision:
new text end

new text begin (1) state and federal program billing, documentation, and service delivery requirements;
new text end

new text begin (2) enrollment requirements;
new text end

new text begin (3) provider program integrity, including fraud prevention, detection, and penalties;
new text end

new text begin (4) fair labor standards;
new text end

new text begin (5) workplace safety requirements; and
new text end

new text begin (6) recent changes in service requirements.
new text end

Sec. 19.

new text begin [256B.0445] ADDITIONAL PROVIDER ENROLLMENT REQUIREMENTS
FOR SPECIFIC PROVIDER TYPES.
new text end

new text begin Subdivision 1. new text end

new text begin Durable medical equipment provider or supplier. new text end

new text begin (a) For purposes of
this subdivision, "durable medical equipment provider or supplier" means a medical supplier
that can purchase medical equipment or supplies for sale or rent to the general public and
is able to perform or arrange for necessary repairs to and maintenance of equipment offered
for sale or rent.
new text end

new text begin (b) Upon initial enrollment, reenrollment, and notification of revalidation, all durable
medical equipment, prosthetics, orthotics, and supplies medical suppliers meeting the durable
medical equipment provider or supplier definition in paragraph (a), operating in Minnesota,
and receiving Medicaid money must purchase a surety bond that is annually renewed,
designates the Department of Human Services as the obligee, and is submitted in a form
approved by the commissioner. For purposes of this paragraph, the following medical
suppliers are not required to obtain a surety bond: a federally qualified health center, a home
health agency, the Indian Health Service, a pharmacy, and a rural health clinic.
new text end

new text begin (c) At the time of initial enrollment or reenrollment, durable medical equipment providers
or suppliers defined in paragraph (a) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond must be purchased new annually and
must allow for recovery of costs and fees in pursuing a claim on the bond. Any action to
obtain monetary recovery or sanctions from a surety bond must occur within six years from
the date the debt is affirmed by a final agency decision. An agency decision is final when
the right to appeal the debt has been exhausted or the time to appeal has expired under
section 256B.064.
new text end

new text begin Subd. 2. new text end

new text begin Providers licensed by the commissioner of human services. new text end

new text begin An enrolled
provider that is also licensed by the commissioner under chapter 245A must designate an
individual as the licensee's compliance officer under section 256B.044, subdivision 7,
paragraph (b).
new text end

new text begin Subd. 3. new text end

new text begin Providers licensed by the commissioner of health. new text end

new text begin An enrolled provider that
is also licensed by the commissioner of health as a home care provider under chapter 144A
with a home and community-based services designation under section 144A.484 on the
home care license, or as an assisted living facility under chapter 144G, must designate an
individual as the licensee's compliance officer under section 256B.044, subdivision 7,
paragraph (b).
new text end

Sec. 20.

new text begin [256B.0447] PREPAYMENT REVIEW.
new text end

new text begin Subdivision 1. new text end

new text begin Prepayment review. new text end

new text begin The commissioner must conduct prepayment review
of all submitted fee-for-service medical assistance claims to ensure compliance with state
and federal law and prevent improper payments before payment.
new text end

new text begin Subd. 2. new text end

new text begin Notice. new text end

new text begin (a) Except as provided in paragraph (b), the commissioner must provide
written notice to a provider placed under prepayment review at least 60 days before the
review is implemented. The notice must include:
new text end

new text begin (1) the basis for the review; and
new text end

new text begin (2) the effective date of the review.
new text end

new text begin (b) The commissioner may delay, limit, or withhold notice to a provider if providing
notice would compromise program integrity, prejudice an audit or investigation, or conflict
with federal law or federal guidance.
new text end

new text begin Subd. 3. new text end

new text begin Continued enrollment of new clients. new text end

new text begin Nothing in this section prohibits an
enrolled provider that is subject to prepayment review from enrolling new clients or
beneficiaries during the period of review unless otherwise prohibited by law or by a separate
action of the commissioner.
new text end

new text begin Subd. 4. new text end

new text begin Timely claims processing. new text end

new text begin The commissioner must conduct prepayment review
in a manner consistent with Code of Federal Regulations, title 42, section 447.45.
new text end

new text begin Subd. 5. new text end

new text begin Relationship to other actions. new text end

new text begin Prepayment review under this section does not
preclude the commissioner from conducting a preliminary investigation, full investigation,
payment suspension, postpayment review, audit, overpayment recovery, sanction, or referral
to law enforcement under this chapter or under applicable federal law.
new text end

new text begin Subd. 6. new text end

new text begin Phase-in. new text end

new text begin The commissioner must develop a process to phase in the prepayment
review process under this section based on provider volume, with high-volume providers
subject to prepayment review first.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 21.

new text begin [256B.0448] POSTPAYMENT REVIEW.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose and authority. new text end

new text begin The commissioner may conduct postpayment
review of claims, encounters, cost reports, rate submissions, and other billings submitted
for payment or reimbursement under this chapter to identify improper payments and recover
payments made in violation of state or federal law or program requirements.
new text end

new text begin Subd. 2. new text end

new text begin Scope of review. new text end

new text begin The commissioner may conduct postpayment review on a
claim-by-claim basis or through other review methods authorized by state or federal law.
new text end

new text begin Subd. 3. new text end

new text begin Provider obligations. new text end

new text begin (a) A provider subject to postpayment review must
maintain documentation necessary to support claims, encounters, cost reports, rate
submissions, other billings submitted for payment or reimbursement under this chapter, and
compliance with program requirements.
new text end

new text begin (b) The commissioner may require a provider to submit records or supporting
documentation relevant to a postpayment review.
new text end

new text begin (c) A provider's failure to provide requested records or supporting documentation to the
commissioner according to the timeline specified by the commissioner may result in recovery
of payments or sanctions under section 256B.064 and other applicable laws.
new text end

new text begin Subd. 4. new text end

new text begin Recovery and sanctions. new text end

new text begin If postpayment review identifies an overpayment or
other noncompliance with medical assistance payment requirements, the commissioner may
recover payments and impose sanctions in accordance with section 256B.064 and other
applicable laws.
new text end

new text begin Subd. 5. new text end

new text begin Relationship to other actions. new text end

new text begin Conducting postpayment review of a provider
under this section does not preclude the commissioner from conducting a preliminary
investigation, full investigation, enhanced prepayment review, payment suspension, audit,
overpayment recovery, sanction, or referral to law enforcement under this chapter or
applicable federal law.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 22.

new text begin [256B.0639] ACCESS TO RECORDS AND SERVICE LOCATIONS.
new text end

new text begin (a) The commissioner may conduct on-site inspections of any and all vendors of medical
care and the vendor's service locations. The vendor must give the commissioner immediate
access without prior notice to the vendor's offices and service locations during regular
business hours. The commissioner may request records and documents during an on-site
inspection or by making a written request to the vendor. The commissioner may use the
records and documents to verify the accuracy of any information submitted by the vendor
to the commissioner, to determine compliance with service delivery and billing requirements,
or to determine compliance with any other applicable laws or rules. Failing to provide the
commissioner with immediate access to records or documents or failing to comply with a
written request for records or documents, is a refusal under section 256B.064, subdivision
1a, paragraph (a), clause (5), and is cause for the vendor's immediate suspension of payment
and termination under section 256B.064.
new text end

new text begin (b) Section 256B.27, subdivisions 4 and 5, apply to actions taken by the commissioner
under this section. Notwithstanding any other law to the contrary, a vendor of medical care
shall not be subject to any civil or criminal liability for providing access to medical records
to the commissioner of human services pursuant to this section.
new text end

Sec. 23.

Minnesota Statutes 2025 Supplement, section 256B.064, subdivision 1a, is
amended to read:

Subd. 1a.

Grounds for sanctions.

(a) The commissioner may impose sanctions against
any individual or entity that receives payments from medical assistance or provides goods
or services for which payment is made from medical assistance for any of the following:

(1) fraud, theft, or abuse in connection with the provision of goods and services to
recipients of public assistance for which payment is made from medical assistance;

(2) a pattern of presentment of false or duplicate claims or claims for services not
medically necessary;

(3) a pattern of making false statements of material facts for the purpose of obtaining
greater compensation than that to which the individual or entity is legally entitled;

(4) suspension or termination as a Medicare vendor;

(5) refusal to grant the state agency access during regular business hours to examine all
records necessary to disclose the extent of services provided to program recipients and
appropriateness of claims for payment;

(6) failure to repay an overpayment new text begin provided in section 256B.0641 new text end or a fine finally
established under this section;

(7) failure to correct errors in the maintenance of health service or financial records for
which a fine was imposed or after issuance of a warning by the commissioner; and

(8) any reason for which an individual or entity could be excluded from participation in
the Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.

(b) For the purposes of this section, goods or services for which payment is made from
medical assistance includes but is not limited to care and services identified in section
256B.0625 or provided pursuant to any federally approved waiver.

(c) Regardless of the source of payment or other item of value, the commissioner may
impose sanctions against any individual or entity that solicits, receives, pays, or offers to
pay any illegal remuneration as described in section 142E.51, subdivision 6a, in violation
of section 609.542, subdivision 2, or in violation of United States Code, title 42, section
1320a-7b(b)(1) or (2). No conviction is required before the commissioner can impose
sanctions under this paragraph.

(d) The commissioner may impose sanctions against a pharmacy provider for failure to
respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph
(g).

(e) The commissioner may impose sanctions against a pharmacy provider for failure to
respond to a Minnesota drug acquisition cost survey under section 256B.0625, subdivision
13e, paragraph (i).

new text begin (f) For purposes of this subdivision, "abuse" does not include billing errors that result
in unintended overcharges.
new text end

Sec. 24.

Minnesota Statutes 2024, section 256B.064, subdivision 1b, is amended to read:

Subd. 1b.

Sanctions available.

new text begin (a) new text end The commissioner may impose the following sanctions
for the conduct described in subdivision 1a: deleted text begin suspension or withholding of payments to an
individual or entity and suspending or terminating participation in the program, or imposition
of a fine under subdivision 2, paragraph (g).
deleted text end

new text begin (1) suspending payments to an individual or entity;
new text end

new text begin (2) temporarily withholding payments to an individual or entity;
new text end

new text begin (3) suspending participation in the program;
new text end

new text begin (4) terminating participation in the program; or
new text end

new text begin (5) imposing a fine under subdivision 2a.
new text end

new text begin (b) new text end When imposing sanctions under this section, the commissioner deleted text begin shall deleted text end new text begin must new text end consider
the nature, chronicity, or severity of the conduct and the effect of the conduct on the health
and safety of persons served by the individual or entity.

new text begin (c) new text end The commissioner deleted text begin shall deleted text end new text begin must new text end suspend an individual's or entity's participation in the
program for a minimum of five years if the individual or entity is convicted of a crime,
received a stay of adjudication, or entered a court-ordered diversion program for an offense
related to a provision of a health service under medical assistance, including a federally
approved waiver, or health care fraud.

new text begin (d) new text end Regardless of imposition of sanctions, the commissioner may make a referral to the
appropriate state licensing board.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2024, section 256B.064, subdivision 1c, is amended to read:

Subd. 1c.

Grounds for and methods of monetary recovery.

(a) The commissioner
may obtain monetary recovery from an individual or entity deleted text begin that has been improperly paid
by the department either as a result of conduct described in subdivision 1a or as a result of
an error by the individual or entity submitting the claim or by the department, regardless of
whether the error was intentional. Patterns need not be proven as a precondition to monetary
recovery of erroneous or false claims, duplicate claims, claims for services not medically
necessary, or claims based on false statements deleted text end new text begin for an overpayment as defined in Code of
Federal Regulations, title 42, section 433.304 new text end .

(b) The commissioner may obtain monetary recovery using methods including but not
limited to the following: assessing and recovering money improperly paid and debiting from
future payments any money improperly paid. The commissioner deleted text begin shall deleted text end new text begin must new text end charge interest
on money to be recovered if the recovery is to be made by installment payments or debits,
except when the monetary recovery is of an overpayment that resulted from a department
error. The interest charged deleted text begin shall deleted text end new text begin must new text end be the rate established by the commissioner of revenue
under section 270C.40.

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2024, section 256B.064, subdivision 1d, is amended to read:

Subd. 1d.

Investigative costs.

new text begin (a) new text end The commissioner may seek recovery of investigative
costs from any individual or entity that deleted text begin willfully submits a claim for reimbursement for
services that the individual or entity knows, or reasonably should have known, is a false
representation and that results in the payment of public funds for which the individual or
entity is ineligible deleted text end new text begin violates the False Claims Act pursuant to United States Code, title 31,
section 3729-3733 or section 15C.02 new text end .

new text begin (b) new text end Billing errors that result in unintentional overcharges deleted text begin shall deleted text end new text begin are new text end not deleted text begin be deleted text end grounds for
investigative cost recoupment.

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2024, section 256B.064, subdivision 2, is amended to read:

Subd. 2.

Imposition of monetary recovery and sanctions new text begin ; generally new text end .

(a) The
commissioner deleted text begin shall deleted text end new text begin must new text end determine any monetary amounts to be recovered and sanctions
to be imposed upon an individual or entity under this section. Except as provided in
deleted text begin paragraphs (b) and (d), neither deleted text end new text begin subdivision 2c, the commissioner must not obtain new text end a monetary
recovery deleted text begin nor deleted text end new text begin or impose new text end a sanction deleted text begin will be imposed by the commissioner deleted text end without prior notice
and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed
action, provided that the commissioner may suspend or reduce payment to an individual or
entity, except a nursing home or convalescent care facility, after notice and prior to the
hearing if in the commissioner's opinion that action is necessary to protect the public welfare
and the interests of the program.

deleted text begin (b) Except when the commissioner finds good cause not to suspend payments under
Code of Federal Regulations, title 42, section 455.23(e) or (f), the commissioner shall
withhold or reduce payments to an individual or entity without providing advance notice
of such withholding or reduction if either of the following occurs:
deleted text end

deleted text begin (1) the individual or entity is convicted of a crime involving the conduct described in
subdivision 1a; or
deleted text end

deleted text begin (2) the commissioner determines there is a credible allegation of fraud for which an
investigation is pending under the program. Allegations are considered credible when they
have an indicium of reliability and the state agency has reviewed all allegations, facts, and
evidence carefully and acts judiciously on a case-by-case basis. A credible allegation of
fraud is an allegation which has been verified by the state, from any source, including but
not limited to:
deleted text end

deleted text begin (i) fraud hotline complaints;
deleted text end

deleted text begin (ii) claims data mining; and
deleted text end

deleted text begin (iii) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations.
deleted text end

deleted text begin (c) The commissioner must send notice of the withholding or reduction of payments
under paragraph (b) within five days of taking such action unless requested in writing by a
law enforcement agency to temporarily withhold the notice. The notice must:
deleted text end

deleted text begin (1) state that payments are being withheld according to paragraph (b);
deleted text end

deleted text begin (2) set forth the general allegations as to the nature of the withholding action, but need
not disclose any specific information concerning an ongoing investigation;
deleted text end

deleted text begin (3) except in the case of a conviction for conduct described in subdivision 1a, state that
the withholding is for a temporary period and cite the circumstances under which withholding
will be terminated;
deleted text end

deleted text begin (4) identify the types of claims to which the withholding applies; and
deleted text end

deleted text begin (5) inform the individual or entity of the right to submit written evidence for consideration
by the commissioner.
deleted text end

deleted text begin (d) The withholding or reduction of payments will not continue after the commissioner
determines there is insufficient evidence of fraud by the individual or entity, or after legal
proceedings relating to the alleged fraud are completed, unless the commissioner has sent
notice of intention to impose monetary recovery or sanctions under paragraph (a). Upon
conviction for a crime related to the provision, management, or administration of a health
service under medical assistance, a payment held pursuant to this section by the commissioner
or a managed care organization that contracts with the commissioner under section 256B.035
is forfeited to the commissioner or managed care organization, regardless of the amount
charged in the criminal complaint or the amount of criminal restitution ordered.
deleted text end

deleted text begin (e) The commissioner shall suspend or terminate an individual's or entity's participation
in the program without providing advance notice and an opportunity for a hearing when the
suspension or termination is required because of the individual's or entity's exclusion from
participation in Medicare. Within five days of taking such action, the commissioner must
send notice of the suspension or termination. The notice must:
deleted text end

deleted text begin (1) state that suspension or termination is the result of the individual's or entity's exclusion
from Medicare;
deleted text end

deleted text begin (2) identify the effective date of the suspension or termination; and
deleted text end

deleted text begin (3) inform the individual or entity of the need to be reinstated to Medicare before
reapplying for participation in the program.
deleted text end

deleted text begin (f) deleted text end new text begin (b) new text end Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction
is to be imposed, an individual or entity may request a contested case, as defined in section
14.02, subdivision 3, by filing with the commissioner a written request of appeal. The appeal
request must be received by the commissioner no later than 30 days after the date the
notification of monetary recovery or sanction was mailed to the individual or entity. The
appeal request must specify:

(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount
involved for each disputed item;

(2) the computation that the individual or entity believes is correct;

(3) the authority in statute or rule upon which the individual or entity relies for each
disputed item;

(4) the name and address of the person or entity with whom contacts may be made
regarding the appeal; and

(5) other information required by the commissioner.

deleted text begin (g) The commissioner may order an individual or entity to forfeit a fine for failure to
fully document services according to standards in this chapter and Minnesota Rules, chapter
deleted text end deleted text begin 9505 deleted text end deleted text begin . The commissioner may assess fines if specific required components of documentation
are missing. The fine for incomplete documentation shall equal 20 percent of the amount
paid on the claims for reimbursement submitted by the individual or entity, or up to $5,000,
whichever is less. If the commissioner determines that an individual or entity repeatedly
violated this chapter, chapter deleted text end deleted text begin 254B deleted text end deleted text begin or deleted text end deleted text begin 245G deleted text end deleted text begin , or Minnesota Rules, chapter deleted text end deleted text begin 9505 deleted text end deleted text begin , related to
the provision of services to program recipients and the submission of claims for payment,
the commissioner may order an individual or entity to forfeit a fine based on the nature,
severity, and chronicity of the violations, in an amount of up to $5,000 or 20 percent of the
value of the claims, whichever is greater.
deleted text end

deleted text begin (h) The individual or entity shall pay the fine assessed on or before the payment date
specified. If the individual or entity fails to pay the fine, the commissioner may withhold
or reduce payments and recover the amount of the fine. A timely appeal shall stay payment
of the fine until the commissioner issues a final order.
deleted 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. 28.

Minnesota Statutes 2024, section 256B.064, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Imposition of fines. new text end

new text begin (a) The commissioner may order an individual or entity
to forfeit a fine for failure to fully document services according to standards in this chapter
and Minnesota Rules, chapter 9505. The commissioner may assess fines if specific required
components of documentation are missing. The fine for incomplete documentation equals
20 percent of the amount paid on the claims for reimbursement submitted by the individual
or entity, or up to $5,000, whichever is less.
new text end

new text begin (b) If the commissioner determines that an individual or entity repeatedly violated this
chapter, chapter 245G or 254B, or Minnesota Rules, chapter 9505, related to the provision
of services to program recipients and the submission of claims for payment, the commissioner
may order an individual or entity to forfeit a fine based on the nature, severity, and chronicity
of the violations, in an amount of up to $5,000 or 20 percent of the value of the claims,
whichever is greater.
new text end

new text begin (c) The individual or entity must pay the fine assessed on or before the payment date
specified by the commissioner. If the individual or entity fails to pay the fine, the
commissioner may withhold or reduce payments and recover the amount of the fine.
new text end

new text begin (d) A timely appeal stays payment of the fine until the commissioner issues a final order.
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. 29.

Minnesota Statutes 2024, section 256B.064, is amended by adding a subdivision
to read:

new text begin Subd. 2b. new text end

new text begin Mandatory suspension or termination after exclusion from participation
in Medicare. new text end

new text begin (a) The commissioner must suspend or terminate an individual's or entity's
participation in the program without providing advance notice and an opportunity for a
hearing when the suspension or termination is required because of the individual's or entity's
exclusion from participation in Medicare.
new text end

new text begin (b) Within five days of taking an action under paragraph (a), the commissioner must
send notice of the suspension or termination. The notice must:
new text end

new text begin (1) state that the suspension or termination is the result of the individual's or entity's
exclusion from Medicare;
new text end

new text begin (2) identify the effective date of the suspension or termination; and
new text end

new text begin (3) inform the individual or entity of the need to be reinstated to Medicare before
reapplying for participation in the program.
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. 30.

Minnesota Statutes 2024, section 256B.064, is amended by adding a subdivision
to read:

new text begin Subd. 2c. new text end

new text begin Imposition of withholding or reduction of payments without prior
notice. new text end

new text begin (a) Except when the commissioner finds good cause not to suspend payments under
Code of Federal Regulations, title 42, section 455.23(e) or (f), the commissioner must
temporarily withhold or reduce payments to an individual or entity without providing advance
notice of the withholding or reduction if either of the following occurs:
new text end

new text begin (1) the individual or entity is convicted of a crime involving the conduct described in
subdivision 1a; or
new text end

new text begin (2) the commissioner determines there is a credible allegation of fraud for which an
investigation is pending under the program. Allegations are considered credible when the
allegations have indicia of reliability and the commissioner has reviewed all allegations,
facts, and evidence carefully and acts judiciously on a case-by-case basis.
new text end

new text begin (b) A credible allegation of fraud is an allegation that has been verified by the state from
any source, including but not limited to:
new text end

new text begin (1) fraud hotline complaints;
new text end

new text begin (2) complaints from service recipients, guardians of service recipients, and case managers
of service recipients;
new text end

new text begin (3) claims data mining;
new text end

new text begin (4) patterns identified through provider audits, civil false claims cases, law enforcement
investigations, and investigations by other state or federal agencies; and
new text end

new text begin (5) court filings or other legal documents.
new text end

new text begin (c) The commissioner must send notice of the withholding or reduction of payments
under paragraph (a) within five days of withholding or reducing payment unless requested
in writing by a law enforcement agency to temporarily withhold the notice. The notice must:
new text end

new text begin (1) state that payments are being withheld or reduced according to paragraph (a);
new text end

new text begin (2) set forth the allegations as to the nature of the withholding or reduction in a manner
reasonably calculated to provide notice, which must include but is not limited to date ranges
of suspected claims, locations of suspected service delivery, general nature of individual or
entity conduct, but need not disclose specific information that the commissioner determines
is likely to jeopardize an ongoing investigation;
new text end

new text begin (3) except in the case of a conviction for conduct described in subdivision 1a, state that
the withholding or reduction is for a temporary period and cite the circumstances under
which withholding will be terminated;
new text end

new text begin (4) identify the types of claims to which the withholding or reduction applies; and
new text end

new text begin (5) inform the individual or entity of the right to submit written evidence for consideration
by the commissioner.
new text end

new text begin (d) The commissioner must immediately cease to withhold or reduce payments under
this subdivision and must release the withheld or reduced payments no later than ten days
following the earlier of (1) the individual or entity posts a surety bond as provided under
subdivision 2e, (2) the commissioner determines there is insufficient evidence of fraud by
the individual or entity, or (3) legal proceedings relating to the alleged fraud are completed,
unless the commissioner has sent notice of intention to impose monetary recovery or
sanctions.
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. 31.

Minnesota Statutes 2024, section 256B.064, is amended by adding a subdivision
to read:

new text begin Subd. 2d. new text end

new text begin Appeal of temporary payment withhold. new text end

new text begin (a) Upon receipt of a notice under
subdivision 2c, paragraph (c), that a payment withhold is imposed, an individual or entity
may request a review under paragraph (c) of this subdivision by filing with the commissioner
a written request of appeal. The appeal request must be received by the commissioner no
later than 30 days after the date the notification of the payment withhold was mailed to the
individual or entity. The appeal request must specify the reason the payment withholding
decision is in error and clearly request a hearing. The commissioner must refer the appeal
request to the Court of Administrative Hearings within ten business days of receiving the
appeal request.
new text end

new text begin (b) The cost of the review under paragraph (c) must be paid by the individual or entity.
new text end

new text begin (c) The burden of proof upon appeal of a temporary withhold is limited to whether the
commissioner can establish there is a credible allegation of fraud as provided in subdivision
2c, paragraph (a), clause (2). The administrative law judge's recommendation to the
commissioner must not make findings on the veracity of the underlying allegations of fraud,
as the underlying investigation remains ongoing and underlying facts may be litigated in
future administrative, civil, or criminal proceedings when a final agency decision is issued.
new text end

new text begin (d) To protect the integrity of the ongoing investigation, the commissioner must submit
evidence to support the action to the administrative law judge under seal. The individual or
entity may submit evidence to the administrative law judge that supports the position of the
individual or entity that the payment withholding decision is in error. The administrative
law judge must review the evidence in camera. The commissioner shall not be subject to
discovery by the individual or entity during the proceedings.
new text end

new text begin (e) The commissioner must provide notice to the individual or entity when the
administrative law judge makes a recommendation. The notice must be sent within ten
business days of the administrative law judge's completed recommendation and must state
that the appeal process under this subdivision is completed.
new text end

new text begin (f) The administrative law judge's findings of facts, conclusions of law, and
recommendation as to whether there is a credible allegation of fraud, may not be used or
considered for any other purpose, including impeachment, in any civil, criminal,
administrative, or contractual proceeding. The administrative law judge's findings of facts,
conclusions of law, and recommendation may not be held conclusive or binding or used as
evidence in any separate or subsequent action in any other forum, be it contractual,
administrative, or judicial, regardless of whether the action involves the same or related
parties or involves the same facts.
new text end

Sec. 32.

Minnesota Statutes 2024, section 256B.064, is amended by adding a subdivision
to read:

new text begin Subd. 2e. new text end

new text begin Release of withheld or reduced payments. new text end

new text begin (a) The commissioner must release
to the individual or entity subject to a withhold or reduction of payments under subdivision
2c the amount of withheld or reduced payments for previously rendered services if the
individual or entity posts a surety bond in an amount equal to the greater of (1) the amount
of the withheld or reduced payments, or (2) the amount of the risk of exposure identified
by the commissioner. A surety bond posted under this subdivision must be in addition to
any other surety bond the individual or entity may have previously purchased as a condition
of enrollment as a medical assistance provider.
new text end

new text begin (b) The commissioner may require an individual or owners or employees of an entity
that posts a surety bond under this subdivision to complete remedial provider compliance
training. The commissioner may require an individual or owners or employees of an entity
that posts a surety bond under this subdivision to engage a third party approved by the
commissioner to temporarily manage or provide technical assistance to the individual or
entity.
new text end

new text begin (c) If the individual or entity elects to post a surety bond under this subdivision, the
commissioner is not prohibited from utilizing prepayment review of submitted claims for
ongoing services rendered by the individual or entity, imposing sanctions on the individual
or entity, seeking recovery for improper payments paid to the individual or entity, or
exercising any other regulatory powers, including enforcement of medical assistance provider
enrollment requirements, licensing standards, or service standards.
new text end

Sec. 33.

Minnesota Statutes 2024, section 256B.064, is amended by adding a subdivision
to read:

new text begin Subd. 2f. new text end

new text begin Forfeiture of withheld payments upon criminal conviction. new text end

new text begin Upon conviction
for a crime related to the provision, management, or administration of a health service under
medical assistance, a payment held pursuant to this section by the commissioner or a managed
care organization that contracts with the commissioner under section 256B.035 is forfeited
to the commissioner or managed care organization, regardless of the amount charged in the
criminal complaint or the amount of criminal restitution ordered.
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. 34.

Minnesota Statutes 2024, section 256B.064, subdivision 3, is amended to read:

Subd. 3.

Mandates on prohibited payments.

(a) The commissioner deleted text begin shall deleted text end new text begin must new text end maintain
and publish a list of each excluded individual and entity that was convicted of a crime related
to the provision, management, or administration of a medical assistance health service, or
suspended or terminated under deleted text begin subdivision 2 deleted text end new text begin this section new text end . Medical assistance payments
cannot be made by an individual or entity for items or services furnished either directly or
indirectly by an excluded individual or entity, or at the direction of excluded individuals or
entities.

(b) The entity must check the exclusion list on a monthly basis and document the date
and time the exclusion list was checked and the name and title of the person who checked
the exclusion list. The entity must immediately terminate payments to an individual or entity
on the exclusion list.

(c) An entity's requirement to check the exclusion list and to terminate payments to
individuals or entities on the exclusion list applies to each individual or entity on the
exclusion list, even if the named individual or entity is not responsible for direct patient
care or direct submission of a claim to medical assistance.

(d) An entity that pays medical assistance program funds to an individual or entity on
the exclusion list must refund any payment related to deleted text begin either deleted text end items deleted text begin or deleted text end new text begin and new text end services rendered
by an individual or entity on the exclusion list from the date the individual or entity is first
paid or the date the individual or entity is placed on the exclusion list, whichever is later,
and an entity may be subject to:

(1) sanctions under deleted text begin subdivision 2 deleted text end new text begin this section new text end ;

(2) a civil monetary penalty of up to $25,000 for each determination by the department
that the vendor employed or contracted with an individual or entity on the exclusion list;
and

(3) other fines or penalties allowed by law.

new text begin EFFECTIVE DATE. new text end

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

Sec. 35.

Minnesota Statutes 2024, section 256B.064, subdivision 4, is amended to read:

Subd. 4.

Notice.

(a) The department deleted text begin shall deleted text end new text begin must new text end serve the notice required under deleted text begin subdivision
2 deleted text end new text begin this section new text end using a signature-verified confirmed delivery method to the address submitted
to the department by the individual or entity. Service is complete upon mailing.

(b) The department deleted text begin shall deleted text end new text begin must new text end give notice in writing to a recipient placed in the Minnesota
restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200.
The department deleted text begin shall deleted text end new text begin must new text end send the notice by first class mail to the recipient's current address
on file with the department. A recipient placed in the Minnesota restricted recipient program
may contest the placement by submitting a written request for a hearing to the department
within 90 days of the notice being mailed.

new text begin EFFECTIVE DATE. new text end

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

Sec. 36.

Minnesota Statutes 2024, section 256B.064, subdivision 5, is amended to read:

Subd. 5.

Immunity; good faith reporters.

(a) A person who makes a good faith report
is immune from any civil or criminal liability that might otherwise arise from reporting or
participating in the investigation. Nothing in this subdivision affects an individual's or
entity's responsibility for an overpayment established under this subdivision.

(b) A person employed by a lead investigative agency who is conducting or supervising
an investigation or enforcing the law according to the applicable law or rule is immune from
any civil or criminal liability that might otherwise arise from the person's actions, if the
person is acting in good faith and exercising due care.

(c) For purposes of this subdivision, "person" includes a natural person or any form of
a business or legal entity.

(d) After an investigation is complete, the reporter's name must be kept confidential.
The subject of the report may compel disclosure of the reporter's name only with the consent
of the reporter or upon a written finding by a district court that the report was false and there
is evidence that the report was made in bad faith. This subdivision does not alter disclosure
responsibilities or obligations under the Rules of Criminal Procedure, except that when the
identity of the reporter is relevant to a criminal prosecution the district court deleted text begin shall deleted text end new text begin must new text end
conduct an in-camera review before determining whether to order disclosure of the reporter's
identity.

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Minnesota Statutes 2024, section 256B.064, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Application. new text end

new text begin This section supersedes any inconsistent or contrary provision of
law.
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. 38.

new text begin [256B.0647] REMITTANCE ADVICE MONETARY RECOVERY.
new text end

new text begin (a) The commissioner may use the remittance advice process under Code of Federal
Regulations, title 45, part 162.1601, as the notice to a vendor or provider when seeking
monetary recovery using a department-administered information technology system for
programmatically processed claims. The remittance advice must be delivered electronically
and constitutes the sole notice to the provider. The commissioner must withhold the payments
at issue when using the remittance advice as the notice.
new text end

new text begin (b) Providers may seek reconsideration of a remittance under this section by mailing a
request to the commissioner. The reconsideration request must be received no later than 30
calendar days from the posting of the remittance advice. A request for reconsideration does
not stay the withholding of payments. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The request for
reconsideration must include:
new text end

new text begin (1) each disputed item, the reason for the dispute, and an estimate of the dollar amount
involved for each disputed item;
new text end

new text begin (2) the calculation that the individual or entity believes is correct;
new text end

new text begin (3) the authority in statute or rule upon which the individual or entity relies for each
disputed item;
new text end

new text begin (4) the name and address of the person or entity with whom contacts may be made
regarding the appeal; and
new text end

new text begin (5) other information required by the commissioner.
new text end

new text begin (c) The commissioner may not use the remittance advice process as notice required
under section 256B.064.
new text end

Sec. 39.

Minnesota Statutes 2025 Supplement, section 256B.0759, subdivision 4, is
amended to read:

Subd. 4.

Provider payment rates.

(a) Payment rates for participating providers must
be increased for services provided to medical assistance enrollees. To receive a rate increase,
participating providers must meet demonstration project requirements and provide evidence
of formal referral arrangements with providers delivering step-up or step-down levels of
care. Providers that have enrolled in the demonstration project but have not met the provider
standards under subdivision 3 as of July 1, 2022, are not eligible for a rate increase under
this subdivision until the date that the provider meets the provider standards in subdivision
3. Services provided from July 1, 2022, to the date that the provider meets the provider
standards under subdivision 3 shall be reimbursed at rates according to section 254B.0505,
subdivision 1. Rate increases paid under this subdivision to a provider for services provided
between July 1, 2021, and July 1, 2022, are not subject to recoupment when the provider
is taking meaningful steps to meet demonstration project requirements that are not otherwise
required by law, and the provider provides documentation to the commissioner, upon request,
of the steps being taken.

(b) The commissioner may temporarily suspend payments to the provider according to
section deleted text begin 256B.04, subdivision 21, paragraph (d) deleted text end new text begin 256B.0442, subdivision 1 new text end , if the provider
does not meet the requirements in paragraph (a). Payments withheld from the provider must
be made once the commissioner determines that the requirements in paragraph (a) are met.

(c) For outpatient individual and group substance use disorder services under section
254B.0505, subdivision 1, clause (1), and adolescent treatment programs that are licensed
as outpatient treatment programs according to sections 245G.01 to 245G.18, provided on
or after January 1, 2021, payment rates must be increased by 20 percent over the rates in
effect on December 31, 2020.

(d) Effective January 1, 2021, and contingent on annual federal approval, managed care
plans and county-based purchasing plans must reimburse providers of the substance use
disorder services meeting the criteria described in paragraph (a) who are employed by or
under contract with the plan an amount that is at least equal to the fee-for-service base rate
payment for the substance use disorder services described in paragraph (c). The commissioner
must monitor the effect of this requirement on the rate of access to substance use disorder
services and residential substance use disorder rates. Capitation rates paid to managed care
organizations and county-based purchasing plans must reflect the impact of this requirement.
This paragraph expires if federal approval is not received at any time as required under this
paragraph.

(e) Effective July 1, 2021, contracts between managed care plans and county-based
purchasing plans and providers to whom paragraph (d) applies must allow recovery of
payments from those providers if, for any contract year, federal approval for the provisions
of paragraph (d) is not received, and capitation rates are adjusted as a result. Payment
recoveries must not exceed the amount equal to any decrease in rates that results from this
provision.

(f) For substance use disorder services with medications for opioid use disorder under
section 254B.0505, subdivision 1, clause (7), provided on or after January 1, 2021, payment
rates must be increased by 20 percent over the rates in effect on December 31, 2020. Upon
implementation of new rates according to section 254B.121, the 20 percent increase will
no longer apply.

Sec. 40.

Minnesota Statutes 2025 Supplement, section 256B.0949, subdivision 16, is
amended to read:

Subd. 16.

Agency duties.

(a) An agency delivering an EIDBI service under this section
must:

(1) enroll as a medical assistance Minnesota health care program provider according to
Minnesota Rules, part 9505.0195, and deleted text begin section 256B.04, subdivision 21 deleted text end new text begin sections 256B.044
to 256B.0445 new text end , and meet all applicable provider standards and requirements;

(2) designate an individual as the agency's compliance officer who must perform the
duties described in section deleted text begin 256B.04, subdivision 21, paragraph (g) deleted text end new text begin 256B.044, subdivision
7, paragraph (b) new text end ;

(3) demonstrate compliance with federal and state laws for the delivery of and billing
for EIDBI service;

(4) verify and maintain records of a service provided to the person or the person's legal
representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;

(5) demonstrate that while enrolled or seeking enrollment as a Minnesota health care
program provider the agency did not have a lead agency contract or provider agreement
discontinued because of a conviction of fraud; or did not have an owner, board member, or
manager fail a state or federal criminal background check or appear on the list of excluded
individuals or entities maintained by the federal Department of Human Services Office of
Inspector General;

(6) have established business practices including written policies and procedures, internal
controls, and a system that demonstrates the organization's ability to deliver quality EIDBI
services, appropriately submit claims, conduct required staff training, document staff
qualifications, document service activities, and document service quality;

(7) have an office located in Minnesota or a border state;

(8) initiate a background study as required under subdivision 16a;

(9) report maltreatment according to section 626.557 and chapter 260E;

(10) comply with any data requests consistent with the Minnesota Government Data
Practices Act, sections 256B.064 and 256B.27;

(11) provide training for all agency staff on the requirements and responsibilities listed
in the Maltreatment of Minors Act, chapter 260E, and the Vulnerable Adult Protection Act,
section 626.557, including mandated and voluntary reporting, nonretaliation, and the agency's
policy for all staff on how to report suspected abuse and neglect;

(12) have a written policy to resolve issues collaboratively with the person and the
person's legal representative when possible. The policy must include a timeline for when
the person and the person's legal representative will be notified about issues that arise in
the provision of services;

(13) provide the person's legal representative with prompt notification if the person is
injured while being served by the agency. An incident report must be completed by the
agency staff member in charge of the person. A copy of all incident and injury reports must
remain on file at the agency for at least five years from the report of the incident;

(14) before starting a service, provide the person or the person's legal representative a
description of the treatment modality that the person shall receive, including the staffing
certification levels and training of the staff who shall provide a treatment;

(15) provide clinical supervision for a minimum of one hour for every 16 hours of direct
treatment per person, unless otherwise authorized in the person's individual treatment plan;
and

(16) provide required EIDBI intervention observation and direction at least once per
month. Notwithstanding subdivision 13, paragraph (l), required EIDBI intervention
observation and direction under this clause may be conducted via telehealth provided that
no more than two consecutive monthly required EIDBI intervention observation and direction
sessions under this clause are conducted via telehealth.

(b) Upon request of the commissioner, an agency delivering services under this section
must:

(1) identify the agency's controlling individuals, as defined under section 245A.02,
subdivision 5a;

(2) provide disclosures of the use of billing agencies and other consultants who do not
provide EIDBI services; and

(3) provide copies of any contracts with consultants or independent contractors who do
not provide EIDBI services, including hours contracted and responsibilities.

(c) When delivering the ITP, and annually thereafter, an agency must provide the person
or the person's legal representative with:

(1) a written copy and a verbal explanation of the person's or person's legal
representative's rights and the agency's responsibilities;

(2) documentation in the person's file the date that the person or the person's legal
representative received a copy and explanation of the person's or person's legal
representative's rights and the agency's responsibilities; and

(3) reasonable accommodations to provide the information in another format or language
as needed to facilitate understanding of the person's or person's legal representative's rights
and the agency's responsibilities.

Sec. 41.

Minnesota Statutes 2024, section 256B.0949, subdivision 17, is amended to read:

Subd. 17.

Provider shortage; authority for exceptions.

(a) In consultation with the
Early Intensive Developmental and Behavioral Intervention Advisory Council and
stakeholders, including agencies, professionals, parents of people with ASD or a related
condition, and advocacy organizations, the commissioner shall determine if a shortage of
EIDBI providers exists. For the purposes of this subdivision, "shortage of EIDBI providers"
means a lack of availability of providers who meet the EIDBI provider qualification
requirements under subdivision 15 that results in the delay of access to timely services under
this section, or that significantly impairs the ability of a provider agency to have sufficient
providers to meet the requirements of this section. The commissioner shall consider
geographic factors when determining the prevalence of a shortage. The commissioner may
determine that a shortage exists only in a specific region of the state, multiple regions of
the state, or statewide. The commissioner shall also consider the availability of various types
of treatment modalities covered under this section.

(b) The commissioner, in consultation with the Early Intensive Developmental and
Behavioral Intervention Advisory Council and stakeholders, must establish processes and
criteria for granting an exception under this paragraph. The commissioner may grant an
exception only if the exception would not compromise a person's safety and not diminish
the effectiveness of the treatment. The commissioner may establish an expiration date for
an exception granted under this paragraph. The commissioner may grant an exception for
the following:

(1) EIDBI provider qualifications under this section;

(2) medical assistance provider enrollment requirements under deleted text begin section 256B.04,
subdivision 21 deleted text end new text begin sections 256B.044 to 256B.0445 new text end ; or

(3) EIDBI provider or agency standards or requirements.

(c) If the commissioner, in consultation with the Early Intensive Developmental and
Behavioral Intervention Advisory Council and stakeholders, determines that a shortage no
longer exists, the commissioner must submit a notice that a shortage no longer exists to the
chairs and ranking minority members of the senate and the house of representatives
committees with jurisdiction over health and human services. The commissioner must post
the notice for public comment for 30 days. The commissioner shall consider public comments
before submitting to the legislature a request to end the shortage declaration. The
commissioner shall not declare the shortage of EIDBI providers ended without direction
from the legislature to declare it ended.

Sec. 42.

Minnesota Statutes 2024, section 256B.69, subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.

(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.

(d) The commissioner shall require that managed care plans:

(1) use the assessment and authorization processes, forms, timelines, standards,
documentation, and data reporting requirements, protocols, billing processes, and policies
consistent with medical assistance fee-for-service or the Department of Human Services
contract requirements for all personal care assistance services under section 256B.0659 and
community first services and supports under section 256B.85;

(2) by January 30 of each year that follows a rate increase for any aspect of services
under section 256B.0659 or 256B.85, inform the commissioner and the chairs and ranking
minority members of the legislative committees with jurisdiction over rates determined
under section 256B.851 of the amount of the rate increase that is paid to each personal care
assistance provider agency with which the plan has a contract; deleted text begin and
deleted text end

(3) use a six-month timely filing standard and provide an exemption to the timely filing
timeliness for the resubmission of claims where there has been a denial, request for more
information, or system issue deleted text begin . deleted text end new text begin ;
new text end

new text begin (4) have in place a prepayment review process for all claims that includes claims edit
processing and policies consistent with the procedures under section 256B.0447; and
new text end

new text begin (5) publish metrics related to program integrity actions and outcomes on a publicly
available website.
new text end

(e) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(f) Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.

(g) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
section that is reasonably expected to be returned.

(h) Contracts between the commissioner and a prepaid health plan are exempt from the
set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
7.

(i) The return of the withhold under paragraphs (e) and (f) is not subject to the
requirements of paragraph (c).

(j) Managed care plans and county-based purchasing plans shall maintain current and
fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.

new text begin (k) The commissioner has the right to recover from a managed care plan the full monetary
amount of any claims identified as improperly paid during audits or investigations by the
commissioner or the commissioner's contractors or the Centers for Medicare and Medicaid
Services.
new text end

Sec. 43.

Minnesota Statutes 2024, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 10a. new text end

new text begin Data sharing for program integrity. new text end

new text begin If the commissioner receives a written
report from a managed care plan that has reason to believe that a provider, vendor, managed
care employee, subcontractor, or enrollee committed fraud under this chapter or chapter
256L, the commissioner must provide summary data, as defined in section 13.02, subdivision
19, from the report to other managed care plans contracted under this section within ten
days of receiving the report. Nothing in this subdivision allows release of information that
is nonpublic data pursuant to section 13.02, subdivision 9.
new text end

Sec. 44.

Minnesota Statutes 2024, section 256B.69, subdivision 37, is amended to read:

Subd. 37.

Networks.

(a) The commissioner shall ensure that a managed care
organization's network providers are enrolled with the commissioner as medical assistance
providers, and that the providers comply with the provider disclosure, screening, and
enrollment requirements in Code of Federal Regulations, part 42, section 455. A provider
that has a network provider contract with the managed care organization is not required to
provide services to a medical assistance or MinnesotaCare recipient who is receiving services
through the fee-for-service system.

(b) A managed care organization may enter into a network provider contract with a
provider that is not a medical assistance provider for a period of up to 120 days pending the
outcome of the medical assistance provider enrollment process. A managed care organization
must terminate the contract upon notification that the provider cannot be enrolled as a
medical assistance provider or upon expiration of the 120-day period if notification has not
been received within that period. The managed care organization must notify each affected
enrollee of the provider contract termination.

(c) For purposes of this subdivision, "network provider" means any provider, group of
providers, entity with a network provider agreement with the managed care organization,
or subcontractor that receives payments from the managed care organization either directly
or indirectly to provide services under a managed care contract between the commissioner
and the managed care organization.

new text begin (d) A managed care organization is not required to include a provider in its network
before approving the provider's credentials in accordance with section 62Q.097.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 45. new text begin MANDATORY COMPLIANCE TRAINING FOR CURRENTLY
ENROLLED HIGH-RISK MEDICAL ASSISTANCE PROVIDERS.
new text end

new text begin The owners and employees of any medical assistance provider agency subject to the
requirements of Minnesota Statutes, section 256B.0444, subdivision 2, and enrolled before
January 1, 2027, must complete initial compliance training by January 1, 2028. Owners and
employees of PCA and CFSS agencies who enrolled before January 1, 2027, and have
previously completed training under Minnesota Statutes, section 256B.0659, subdivision
21, paragraph (c), or 256B.85, subdivision 12, paragraph (c), are not subject to the initial
training requirements of this section but must repeat the compliance training prior to
revalidation as a medical assistance provider.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES OFFICE OF INSPECTOR GENERAL
POLICY

Section 1.

Minnesota Statutes 2024, section 245.095, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For purposes of this section, the following definitions have the
meanings given.

(b) "Associated entity" means a provider or vendor owned or controlled by an excluded
individual.

(c) "Associated individual" means an individual or entity that has a relationship with
the business or its owners or controlling individuals, such that the individual or entity would
have knowledge of the financial practices of the program in question.

new text begin (d) "Convicted" means a judgment of conviction has been entered by a federal, state, or
local court, regardless of whether an appeal from the judgment is pending, and includes a
stay of adjudication, a court-ordered diversion program, or a plea of guilty or nolo contendere.
new text end

new text begin (e) "Credible allegation of fraud" means an allegation that has been verified by the
commissioner from any source, including but not limited to:
new text end

new text begin (1) fraud hotline complaints;
new text end

new text begin (2) claims data mining;
new text end

new text begin (3) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations; and
new text end

new text begin (4) court filings and other legal documents, including but not limited to police reports,
complaints, indictments, informations, affidavits, declarations, and search warrants.
new text end

deleted text begin (d) deleted text end new text begin (f) new text end "Excluded" means removed under other authorities from a program administered
by a Minnesota state or federal agency deleted text begin , including deleted text end new text begin . Excluded includes but is not limited to:
new text end

new text begin (1) new text end a final determination to stop payments deleted text begin . deleted text end new text begin ;
new text end

new text begin (2) a conclusive background study disqualification, except for a disqualification issued
under section 245C.15, subdivision 4c, that has not been set aside or had a variance granted
under section 245C.30; and
new text end

new text begin (3) a final agency decision regarding a denial of a license application.
new text end

new text begin (g) "Fraud" has the meaning given in section 256B.02, subdivision 20.
new text end

deleted text begin (e) deleted text end new text begin (h) new text end "Individual" means a natural person providing products or services as a provider
or vendor.

deleted text begin (f) deleted text end new text begin (i) new text end "Provider" means any entity, individual, owner, controlling individual, license
holder, director, or managerial official of an entity receiving payment from a program
administered by a Minnesota state or federal agency.

Sec. 2.

Minnesota Statutes 2024, section 245.095, subdivision 5, is amended to read:

Subd. 5.

Withholding of payments.

(a) Except as otherwise provided by state or federal
law, the commissioner may withhold payments to a provider, vendor, individual, associated
individual, or associated entity in any program administered by the commissioner if the
commissioner determines new text begin :
new text end

new text begin (1) new text end there is a credible allegation of fraud for which an investigation is pending for a
program administered by a Minnesota state or federal agency deleted text begin . deleted text end new text begin ;
new text end

new text begin (2) the individual, the entity, or an associated individual or entity was convicted of a
crime, in state or federal court, for an offense that involves fraud or theft against a program
administered by the commissioner or another state or federal agency;
new text end

new text begin (3) the provider is operating after a state or federal agency orders the suspension,
revocation, or decertification of the provider's license or certification, or if the provider is
subject to a temporary immediate suspension, regardless of whether the action is under
appeal; or
new text end

new text begin (4) the provider, vendor, individual, associated individual, or associated entity, including
those receiving funds under any contract or registered program, has a background study
disqualification under section 245C.15, subdivisions 1 to 4b, that has not been set aside and
for which no variance has been issued.
new text end

deleted text begin (b) For purposes of this subdivision, "credible allegation of fraud" means an allegation
that has been verified by the commissioner from any source, including but not limited to:
deleted text end

deleted text begin (1) fraud hotline complaints;
deleted text end

deleted text begin (2) claims data mining;
deleted text end

deleted text begin (3) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations; and
deleted text end

deleted text begin (4) court filings and other legal documents, including but not limited to police reports,
complaints, indictments, informations, affidavits, declarations, and search warrants.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end The commissioner must send notice of the withholding of payments within five
days of taking such action. The notice must:

(1) state that payments are being withheld according to this subdivision;

(2) set forth the general allegations related to the withholding action, except the notice
need not disclose specific information concerning an ongoing investigation;

(3) state that the withholding is for a temporary period and cite the circumstances under
which the withholding will be terminated; and

(4) inform the provider, vendor, individual, associated individual, or associated entity
of the right to submit written evidence to contest the withholding action for consideration
by the commissioner.

deleted text begin (d) deleted text end new text begin (c) new text end If the commissioner withholds payments under this subdivision, the provider,
vendor, individual, associated individual, or associated entity has a right to request
administrative reconsideration. A request for administrative reconsideration must be made
in writing, state with specificity the reasons the payment withholding decision is in error,
and include documents to support the request. Within 60 days from receipt of the request,
the commissioner shall judiciously review allegations, facts, evidence available to the
commissioner, and information submitted by the provider, vendor, individual, associated
individual, or associated entity to determine whether the payment withholding should remain
in place.

deleted text begin (e) deleted text end new text begin (d) new text end The commissioner shall stop withholding payments if the commissioner determines
there is insufficient evidence of fraud by the provider, vendor, individual, associated
individual, or associated entity or when legal proceedings relating to the alleged fraud are
completed, unless the commissioner has sent notice under subdivision 3 to the provider,
vendor, individual, associated individual, or associated entity.

deleted text begin (f) deleted text end new text begin (e) new text end The withholding of payments new text begin under this section new text end is a temporary action and is not
subject to appeal under section 256.045 or chapter 14.

new text begin (f) Section 15.013 does not apply to the commissioner taking action under this section.
new text end

Sec. 3.

Minnesota Statutes 2024, section 245A.02, subdivision 13, is amended to read:

Subd. 13.

Individual who is related.

"Individual who is related" means a spouse, a
parent, a birth or adopted child or stepchild, a stepparent, a stepbrother, a stepsister, a niece,
a nephew, an adoptive parent, a grandparent, a sibling, an aunt, an uncle, new text begin a cousin, new text end or a legal
guardian new text begin . Individual who is related includes an individual who has a relationship named in
this subdivision through marriage new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 4.

Minnesota Statutes 2025 Supplement, section 245A.03, subdivision 2, is amended
to read:

Subd. 2.

Exclusion from licensure.

(a) This chapter does not apply to:

(1) residential or nonresidential programs that are provided to a person by an individual
who is related;

(2) nonresidential programs that are provided by an unrelated individual to persons from
a single related family;

(3) residential or nonresidential programs that are provided to adults who do not misuse
substances or have a substance use disorder, a mental illness, a developmental disability, a
functional impairment, or a physical disability;

(4) sheltered workshops or work activity programs that are certified by the commissioner
of employment and economic development;

(5) programs operated by a public school for children 33 months or older;

(6) nonresidential programs primarily for children that provide care or supervision for
periods of less than three hours a day while the child's parent or legal guardian is in the
same building as the nonresidential program or present within another building that is
directly contiguous to the building in which the nonresidential program is located;

(7) nursing homes or hospitals licensed by the commissioner of health except as specified
under section 245A.02;

(8) board and lodge facilities licensed by the commissioner of health that do not provide
children's residential services under Minnesota Rules, chapter 2960, mental health or
substance use disorder treatment;

(9) programs licensed by the commissioner of corrections;

(10) recreation programs for children or adults that are operated or approved by a park
and recreation board whose primary purpose is to provide social and recreational activities;

(11) noncertified boarding care homes unless they provide services for five or more
persons whose primary diagnosis is mental illness or a developmental disability;

(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art
programs, and nonresidential programs for children provided for a cumulative total of less
than 30 days in any 12-month period;

(13) residential programs for persons with mental illness, that are located in hospitals;

(14) camps licensed by the commissioner of health under Minnesota Rules, chapter
4630;

(15) mental health outpatient services for adults with mental illness or children with
mental illness;

(16) residential programs serving school-age children whose sole purpose is cultural or
educational exchange, until the commissioner adopts appropriate rules;

(17) community support services programs as defined in section 245.462, subdivision
6, and family community support services as defined in section 245.4871, subdivision 17;

(18) assisted living facilities licensed by the commissioner of health under chapter 144G;

(19) substance use disorder treatment activities of licensed professionals in private
practice as defined in section 245G.01, subdivision 17;

(20) consumer-directed community support service funded under the Medicaid waiver
for persons with developmental disabilities when the individual who provided the service
is:

(i) the same individual who is the direct payee of these specific waiver funds or paid by
a fiscal agent, fiscal intermediary, or employer of record; and

(ii) not otherwise under the control of a residential or nonresidential program that is
required to be licensed under this chapter when providing the service;

(21) a county that is an eligible vendor under section 254B.0501 to provide care
coordination and comprehensive assessment services;

(22) a recovery community organization that is an eligible vendor under section
254B.0501 to provide peer recovery support services; or

(23) programs licensed by the commissioner of children, youth, and families in chapter
142B.

(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
building in which a nonresidential program is located if it shares a common wall with the
building in which the nonresidential program is located or is attached to that building by
skyway, tunnel, atrium, or common roof.

(c) Except for the home and community-based services identified in section 245D.03,
subdivision 1, nothing in this chapter shall be construed to require licensure for any services
provided and funded according to an approved federal waiver plan where licensure is
specifically identified as not being a condition for the services and funding.

new text begin (d) Notwithstanding section 245A.02, subdivision 13, programs initially licensed prior
to July 1, 2026, may continue to operate under and must comply with the definition of
related individual in Minnesota Statutes 2024, section 245A.02, subdivision 13, until the
service recipient related to the license holder is no longer receiving services licensed under
this chapter.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 5.

Minnesota Statutes 2024, section 245A.043, subdivision 2, is amended to read:

Subd. 2.

Change in ownership.

deleted text begin (a) deleted text end If the commissioner determines that there is a change
in ownership, the commissioner shall require submission of a new license application. This
subdivision does not apply to a licensed program or service located in a home where the
license holder resides. A change in ownership occurs when:

(1) deleted text begin except as provided in paragraph (b), deleted text end the license holder sells or transfers 100 percent
of the property, stock, or assets;

(2) the license holder merges with another organization;

(3) the license holder consolidates with two or more organizations, resulting in the
creation of a new organization;

(4) there is a change to the federal tax identification number associated with the license
holder; or

(5) deleted text begin except as provided in paragraph (b), deleted text end all controlling individuals for the original license
have changed.

deleted text begin (b) For changes under paragraph (a), clause (1) or (5), no change in ownership has
occurred and a new license application is not required if at least one controlling individual
has been affiliated as a controlling individual for the license for at least the previous 12
months immediately preceding the change.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2026.
new text end

Sec. 6.

Minnesota Statutes 2025 Supplement, section 245A.043, subdivision 2a, is amended
to read:

Subd. 2a.

Review of change in ownership.

deleted text begin (a) deleted text end After a change in ownership under
subdivision 2, deleted text begin paragraph (a), deleted text end the commissioner may complete a review for all new license
holders within 12 months after the new license is issued.

deleted text begin (b) For all license holders subject to the exception in subdivision 2, paragraph (b), the
license holder must notify the commissioner of the date of the change in controlling
individuals pursuant to section 245A.04, subdivision 7a, and the commissioner may complete
a review within 12 months following the change.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2026.
new text end

Sec. 7.

Minnesota Statutes 2024, section 245A.07, subdivision 2a, is amended to read:

Subd. 2a.

Immediate suspension expedited hearing.

(a) Within five working days of
receipt of the license holder's timely appeal, the commissioner shall request assignment of
an administrative law judge. The request must include a proposed date, time, and place of
a hearing. A hearing must be conducted by an administrative law judge within 30 calendar
days of the request for assignment, unless an extension is requested by either party and
granted by the administrative law judge for good cause. The commissioner shall issue a
notice of hearing by certified mail or personal service at least ten working days before the
hearing. The scope of the hearing shall be limited solely to the issue of whether the temporary
immediate suspension should remain in effect pending the commissioner's final order under
section 245A.08, regarding a licensing sanction issued under subdivision 3 following the
immediate suspension. For suspensions under subdivision 2, paragraph (a), clause (1), the
burden of proof in expedited hearings under this subdivision deleted text begin shall be limited to deleted text end new text begin is met only
if new text end the deleted text begin commissioner's demonstration deleted text end new text begin commissioner demonstrates new text end that reasonable cause exists
to believe that the license holder's new text begin or controlling individual's new text end actions or failure to comply
with applicable law or rule poses, or the actions of other individuals or conditions in the
program poses an imminent risk of harm to the health, safety, or rights of persons served
by the program. "Reasonable cause" means there exist specific articulable facts or
circumstances which provide the commissioner with a reasonable suspicion that there is an
imminent risk of harm to the health, safety, or rights of persons served by the program.
When the commissioner has determined there is reasonable cause to order the temporary
immediate suspension of a license based on a violation of safe sleep requirements, as defined
in section 245A.1435, the commissioner is not required to demonstrate that an infant died
or was injured as a result of the safe sleep violations. For suspensions under subdivision 2,
paragraph (a), clause (2), the burden of proof in expedited hearings under this subdivision
deleted text begin shall be limited to deleted text end new text begin is met only if new text end the deleted text begin commissioner's demonstration deleted text end new text begin commissioner
demonstrates new text end by a preponderance of the evidence that, since the license was revoked, the
license holder committed additional violations of law or rule which may adversely affect
the health or safety of persons served by the program.

(b) The administrative law judge shall issue findings of fact, conclusions, and a
recommendation within ten working days from the date of hearing. The parties shall have
ten calendar days to submit exceptions to the administrative law judge's report. The record
shall close at the end of the ten-day period for submission of exceptions. The commissioner's
final order shall be issued within ten working days from the close of the record. When an
appeal of a temporary immediate suspension is withdrawn or dismissed, the commissioner
shall issue a final order affirming the temporary immediate suspension within ten calendar
days of the commissioner's receipt of the withdrawal or dismissal. Within 90 calendar days
after an immediate suspension has been issued and the license holder has not submitted a
timely appeal under subdivision 2, paragraph (b), or within 90 calendar days after a final
order affirming an immediate suspension, the commissioner shall determine:

(1) whether a final licensing sanction shall be issued under subdivision 3, paragraph (a),
clauses (1) to deleted text begin (6) deleted text end new text begin (5) new text end . The license holder shall continue to be prohibited from operation of
the program during this 90-day period; or

(2) whether the outcome of related, ongoing investigations or judicial proceedings are
necessary to determine if a final licensing sanction under subdivision 3, paragraph (a),
clauses (1) to deleted text begin (6) deleted text end new text begin (5) new text end , will be issued and whether persons served by the program remain at
an imminent risk of harm during the investigation period or proceedings. If so, the
commissioner shall issue a suspension order under subdivision 3, paragraph (a), clause deleted text begin (7). deleted text end new text begin
(6); or
new text end

new text begin (3) whether the license holder or controlling individual remains the subject of a pending
administrative, civil, or criminal investigation or subject to an administrative or civil action
related to fraud against a program administered by a state or federal agency. If so, the
commissioner shall issue a suspension order under subdivision 3, paragraph (a), clause (6).
new text end

(c) When the final order under paragraph (b) affirms an immediate suspension, or the
license holder does not submit a timely appeal of the immediate suspension, and a final
licensing sanction is issued under subdivision 3 and the license holder appeals that sanction,
the license holder continues to be prohibited from operation of the program pending a final
commissioner's order under section 245A.08, subdivision 5, regarding the final licensing
sanction.

(d) The license holder shall continue to be prohibited from operation of the program
while a suspension order issued under paragraph (b), clause (2) new text begin or (3) new text end , remains in effect.

(e) For suspensions under subdivision 2, paragraph (a), clause (3), the burden of proof
in expedited hearings under this subdivision deleted text begin shall be limited to deleted text end new text begin is met only if new text end the
deleted text begin commissioner's demonstration deleted text end new text begin commissioner demonstrates new text end by a preponderance of the
evidence that a criminal complaint and warrant or summons was issued for the license holder
new text begin or controlling individual new text end that was not dismissed, and that the criminal charge is an offense
that involves fraud or theft against a program administered by the commissioner.

new text begin (f) For suspensions under subdivision 2, paragraph (c), the burden of proof in expedited
hearings under this subdivision is met only if the commissioner demonstrates by a
preponderance of the evidence that the license holder or controlling individual is the subject
of a pending administrative, civil, or criminal investigation or is subject to an administrative
or civil action related to fraud against a program administered by a state or federal agency.
new text end

Sec. 8.

Minnesota Statutes 2025 Supplement, section 245A.07, subdivision 3, is amended
to read:

Subd. 3.

License suspension, revocation, or fine.

(a) The commissioner may suspend
or revoke a license, or impose a fine if:

(1) a license holder fails to comply fully with applicable laws or rules including but not
limited to the requirements of this chapter and chapter 245C;

(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
been disqualified and the disqualification was not set aside and no variance has been granted;

(3) a license holder knowingly withholds relevant information from or gives false or
misleading information to the commissioner in connection with an application for a license,
in connection with the background study status of an individual, during an investigation,
or regarding compliance with applicable laws or rules;

(4) a license holder is excluded from any program administered by the commissioner
under section 245.095;

(5) revocation is required under section 245A.04, subdivision 7, paragraph (d); or

(6) suspension is necessary under subdivision 2a, paragraph (b), clause (2) new text begin or (3) new text end .

A license holder who has had a license issued under this chapter suspended, revoked,
or has been ordered to pay a fine must be given notice of the action by certified mail, by
personal service, or through the provider licensing and reporting hub. If mailed, the notice
must be mailed to the address shown on the application or the last known address of the
license holder. The notice must state in plain language the reasons the license was suspended
or revoked, or a fine was ordered.

(b) If the license was suspended or revoked, the notice must inform the license holder
of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
a license. The appeal of an order suspending or revoking a license must be made in writing
by certified mail, by personal service, or through the provider licensing and reporting hub.
If mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
days after the license holder receives notice that the license has been suspended or revoked.
If a request is made by personal service, it must be received by the commissioner within
ten calendar days after the license holder received the order. If the order is issued through
the provider hub, the appeal must be received by the commissioner within ten calendar days
from the date the commissioner issued the order through the hub. Except as provided in
subdivision 2a, paragraph (c), if a license holder submits a timely appeal of an order
suspending or revoking a license, the license holder may continue to operate the program
as provided in section 245A.04, subdivision 7, paragraphs (i) and (j), until the commissioner
issues a final order on the suspension or revocation.

(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
holder of the responsibility for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
order to pay a fine must be made in writing by certified mail, by personal service, or through
the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent
to the commissioner within ten calendar days after the license holder receives notice that
the fine has been ordered. If a request is made by personal service, it must be received by
the commissioner within ten calendar days after the license holder received the order. If the
order is issued through the provider hub, the appeal must be received by the commissioner
within ten calendar days from the date the commissioner issued the order through the hub.

(2) The license holder shall pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies. If the license holder
receives state funds, the state, county, or municipal agencies or departments responsible for
administering the funds shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.

(3) A license holder shall promptly notify the commissioner of human services, in writing,
when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected as indicated by the order
to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
the license holder by certified mail, by personal service, or through the provider licensing
and reporting hub that a second fine has been assessed. The license holder may appeal the
second fine as provided under this subdivision.

(4) Fines shall be assessed as follows:

(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);

(ii) if the commissioner determines that a determination of maltreatment for which the
license holder is responsible is the result of maltreatment that meets the definition of serious
maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
$5,000;

(iii) the license holder shall forfeit $200 for each occurrence of a violation of law or rule
governing matters of health, safety, or supervision, including but not limited to the provision
of adequate staff-to-child or adult ratios, and failure to comply with background study
requirements under chapter 245C; and

(iv) the license holder shall forfeit $100 for each occurrence of a violation of law or rule
other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iii).

For purposes of this section, "occurrence" means each violation identified in the
commissioner's fine order. Fines assessed against a license holder that holds a license to
provide home and community-based services, as identified in section 245D.03, subdivision
1, and a community residential setting or day services facility license under chapter 245D
where the services are provided, may be assessed against both licenses for the same
occurrence, but the combined amount of the fines shall not exceed the amount specified in
this clause for that occurrence.

(5) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the case of a corporation, each
controlling individual is personally and jointly liable for payment.

(d) Except for background study violations involving the failure to comply with an order
to immediately remove an individual or an order to provide continuous, direct supervision,
the commissioner shall not issue a fine under paragraph (c) relating to a background study
violation to a license holder who self-corrects a background study violation before the
commissioner discovers the violation. A license holder who has previously exercised the
provisions of this paragraph to avoid a fine for a background study violation may not avoid
a fine for a subsequent background study violation unless at least 365 days have passed
since the license holder self-corrected the earlier background study violation.

Sec. 9.

Minnesota Statutes 2024, section 256B.04, subdivision 10, is amended to read:

Subd. 10.

Investigation of certain claims.

new text begin The commissioner must new text end establish by rule
general criteria and procedures for the identification and prompt investigation of suspected
medical assistance fraud, theft, abuse, presentment of false or duplicate claims, presentment
of claims for services not new text begin reasonable or new text end medically necessary, or false statement or
representation of material facts by a vendor of medical care deleted text begin , and for the imposition of
sanctions against a vendor of medical care deleted text end . new text begin The commissioner must utilize both prepayment
and postpayment review systems to review claims submitted by vendors. Payment of claims,
including payments made after a prepayment review, does not prohibit the commissioner
from completing a postpayment claims review and taking additional administrative actions
or monetary recovery against a vendor. new text end If it appears to the state agency that a vendor of
medical care may have acted in a manner warranting civil or criminal proceedings, it shall
so inform the attorney general in writing.

Sec. 10.

Minnesota Statutes 2025 Supplement, section 256B.051, subdivision 6, is amended
to read:

Subd. 6.

Agency qualifications and duties.

An agency is eligible for reimbursement
under this section only if the agency:

(1) is confirmed by the commissioner as an eligible provider after a pre-enrollment risk
assessment under subdivision 6a;

(2) is enrolled as a medical assistance Minnesota health care program provider and meets
all applicable provider standards and requirements;

(3) demonstrates compliance with federal and state laws and policies for housing
stabilization services as determined by the commissioner;

(4) complies with background study requirements under chapter 245C and maintains
documentation of background study requests and results;

(5) provides at the time of enrollment, reenrollment, and revalidation in a format
determined by the commissioner, proof of surety bond coverage for each business location
providing services. Upon new enrollment, or if the provider's medical assistance revenue
in the previous calendar year is $300,000 or less, the provider agency must purchase a surety
bond of $50,000. If the provider's medical assistance revenue in the previous year is over
$300,000, the provider agency must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be deleted text begin renewed deleted text end new text begin purchased new new text end annually,
and must allow for recovery of costs and fees in pursuing a claim on the bond. Any action
to obtain monetary recovery or sanctions from a surety bond must occur within six years
from the date the debt is affirmed by a final agency decision. An agency decision is final
when the right to appeal the debt has been exhausted or the time to appeal has expired under
section 256B.064;

(6) directly provides housing stabilization services using employees of the agency and
not by using a subcontractor or reporting agent;

(7) ensures all controlling individuals and employees of the agency complete annual
vulnerable adult training; and

(8) completes compliance training as required under subdivision 6b.

Sec. 11.

Minnesota Statutes 2025 Supplement, section 256B.0659, subdivision 21, is
amended to read:

Subd. 21.

Requirements for provider enrollment of personal care assistance provider
agencies.

(a) All personal care assistance provider agencies must provide, at the time of
enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
a format determined by the commissioner, information and documentation that includes,
but is not limited to, the following:

(1) the personal care assistance provider agency's current contact information including
address, telephone number, and email address;

(2) proof of surety bond coverage for each business location providing services. Upon
new enrollment, or if the provider's Medicaid revenue in the previous calendar year is up
to and including $300,000, the provider agency must purchase a surety bond of $50,000. If
the Medicaid revenue in the previous year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond must be in a form approved by the
commissioner, must be deleted text begin renewed deleted text end new text begin purchased new new text end annually, and must allow for recovery of
costs and fees in pursuing a claim on the bond. Any action to obtain monetary recovery or
sanctions from a surety bond must occur within six years from the date the debt is affirmed
by a final agency decision. An agency decision is final when the right to appeal the debt
has been exhausted or the time to appeal has expired under section 256B.064;

(3) proof of fidelity bond coverage in the amount of $20,000 for each business location
providing service;

(4) proof of workers' compensation insurance coverage identifying the business location
where personal care assistance services are provided;

(5) proof of liability insurance coverage identifying the business location where personal
care assistance services are provided and naming the department as a certificate holder;

(6) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety including process for notification and resolution of consumer
grievances, identification and prevention of communicable diseases, and employee
misconduct;

(7) copies of all other forms the personal care assistance provider agency uses in the
course of daily business including, but not limited to:

(i) a copy of the personal care assistance provider agency's time sheet if the time sheet
varies from the standard time sheet for personal care assistance services approved by the
commissioner, and a letter requesting approval of the personal care assistance provider
agency's nonstandard time sheet;

(ii) the personal care assistance provider agency's template for the personal care assistance
care plan; and

(iii) the personal care assistance provider agency's template for the written agreement
in subdivision 20 for recipients using the personal care assistance choice option, if applicable;

(8) a list of all training and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;

(9) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this section, including the requirements
under subdivision 11, paragraph (d), if enhanced personal care assistance services are
provided and submitted for an enhanced rate under subdivision 17a;

(10) documentation of the agency's marketing practices;

(11) disclosure of ownership, leasing, or management of all residential properties that
is used or could be used for providing home care services;

(12) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services for
employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
care assistance choice option and 72.5 percent of revenue from other personal care assistance
providers. The revenue generated by the qualified professional and the reasonable costs
associated with the qualified professional shall not be used in making this calculation; and

(13) effective May 15, 2010, documentation that the agency does not burden recipients'
free exercise of their right to choose service providers by requiring personal care assistants
to sign an agreement not to work with any particular personal care assistance recipient or
for another personal care assistance provider agency after leaving the agency and that the
agency is not taking action on any such agreements or requirements regardless of the date
signed.

(b) Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider agency
enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
the information specified in paragraph (a) from all personal care assistance providers
beginning July 1, 2009.

(c) All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before submitting an application for enrollment of the
agency as a provider. All personal care assistance provider agencies shall also require
qualified professionals to complete the training required by subdivision 13 before submitting
an application for enrollment of the agency as a provider. Employees in management and
supervisory positions and owners who are active in the day-to-day operations of an agency
who have completed the required training as an employee with a personal care assistance
provider agency do not need to repeat the required training if they are hired by another
agency, if they have completed the training within the past three years. By September 1,
2010, the required training must be available with meaningful access according to title VI
of the Civil Rights Act and federal regulations adopted under that law or any guidance from
the United States Health and Human Services Department. The required training must be
available online or by electronic remote connection. The required training must provide for
competency testing. Personal care assistance provider agency billing staff shall complete
training about personal care assistance program financial management. This training is
effective July 1, 2009. Any personal care assistance provider agency enrolled before that
date shall, if it has not already, complete the provider training within 18 months of July 1,
2009. Any new owners or employees in management and supervisory positions involved
in the day-to-day operations are required to complete mandatory training as a requisite of
working for the agency. Personal care assistance provider agencies certified for participation
in Medicare as home health agencies are exempt from the training required in this
subdivision. When available, Medicare-certified home health agency owners, supervisors,
or managers must successfully complete the competency test.

(d) All surety bonds, fidelity bonds, workers' compensation insurance, and liability
insurance required by this subdivision must be maintained continuously new text begin and purchased new
annually new text end . After initial enrollment, a provider must submit proof of bonds and required
coverages at any time at the request of the commissioner. Services provided while there are
lapses in coverage are not eligible for payment. Lapses in coverage may result in sanctions,
including termination. The commissioner shall send instructions and a due date to submit
the requested information to the personal care assistance provider agency.

Sec. 12.

Minnesota Statutes 2025 Supplement, section 256B.0701, subdivision 9, is
amended to read:

Subd. 9.

Provider qualifications and duties.

A provider is eligible for reimbursement
under this section only if the provider:

(1) is confirmed by the commissioner as an eligible provider after a pre-enrollment risk
assessment under subdivision 10;

(2) is enrolled as a medical assistance Minnesota health care program provider and meets
all applicable provider standards and requirements;

(3) demonstrates compliance with federal and state laws and policies for housing
stabilization services as determined by the commissioner;

(4) complies with background study requirements under chapter 245C and maintains
documentation of background study requests and results;

(5) provides at the time of enrollment, reenrollment, and revalidation in a format
determined by the commissioner, proof of surety bond coverage for each business location
providing services. Upon new enrollment, or if the provider's medical assistance revenue
in the previous calendar year is $300,000 or less, the provider agency must purchase a surety
bond of $50,000. If the provider's medical assistance revenue in the previous year is over
$300,000, the provider agency must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be deleted text begin renewed deleted text end new text begin purchased new new text end annually,
and must allow for recovery of costs and fees in pursuing a claim on the bond. Any action
to obtain monetary recovery or sanctions from a surety bond must occur within six years
from the date the debt is affirmed by a final agency decision. An agency decision is final
when the right to appeal the debt has been exhausted or the time to appeal has expired under
section 256B.064;

(6) ensures all controlling individuals and employees of the agency complete annual
vulnerable adult training;

(7) completes compliance training as required under subdivision 11; and

(8) complies with the habitability inspection requirements in subdivision 13.

Sec. 13.

Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 12, is amended
to read:

Subd. 12.

Requirements for enrollment of CFSS agency-providers.

(a) All CFSS
agency-providers must provide, at the time of enrollment, reenrollment, and revalidation
as a CFSS agency-provider in a format determined by the commissioner, information and
documentation that includes but is not limited to the following:

(1) the CFSS agency-provider's current contact information including address, telephone
number, and email address;

(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's
Medicaid revenue in the previous calendar year is less than or equal to $300,000, the
agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid
revenue in the previous calendar year is greater than $300,000, the agency-provider must
purchase a surety bond of $100,000. The surety bond must be in a form approved by the
commissioner, must be deleted text begin renewed deleted text end new text begin purchased new new text end annually, and must allow for recovery of
costs and fees in pursuing a claim on the bond. Any action to obtain monetary recovery or
sanctions from a surety bond must occur within six years from the date the debt is affirmed
by a final agency decision. An agency decision is final when the right to appeal the debt
has been exhausted or the time to appeal has expired under section 256B.064;

(3) proof of fidelity bond coverage in the amount of $20,000 per provider location;

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

(6) a copy of the CFSS agency-provider's organizational chart identifying the names
and roles of all owners, managing employees, staff, board of directors, and additional
documentation reporting any affiliations of the directors and owners to other service
providers;

(7) proof that the CFSS agency-provider has written policies and procedures including:
hiring of employees; training requirements; service delivery; and employee and consumer
safety, including the process for notification and resolution of participant grievances, incident
response, identification and prevention of communicable diseases, and employee misconduct;

(8) proof that the CFSS agency-provider has all of the following forms and documents:

(i) a copy of the CFSS agency-provider's time sheet; and

(ii) a copy of the participant's individual CFSS service delivery plan;

(9) a list of all training and classes that the CFSS agency-provider requires of its staff
providing CFSS services;

(10) documentation that the CFSS agency-provider and staff have successfully completed
all the training required by this section;

(11) documentation of the agency-provider's marketing practices;

(12) disclosure of ownership, leasing, or management of all residential properties that
are used or could be used for providing home care services;

(13) documentation that the agency-provider will use at least the following percentages
of revenue generated from the medical assistance rate paid for CFSS services for CFSS
support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except
100 percent of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The revenue generated by the worker training and development services and the
reasonable costs associated with the worker training and development services shall not be
used in making this calculation; and

(14) documentation that the agency-provider does not burden participants' free exercise
of their right to choose service providers by requiring CFSS support workers to sign an
agreement not to work with any particular CFSS participant or for another CFSS
agency-provider after leaving the agency and that the agency is not taking action on any
such agreements or requirements regardless of the date signed.

(b) CFSS agency-providers shall provide to the commissioner the information specified
in paragraph (a).

(c) All CFSS agency-providers shall require all employees in management and
supervisory positions and owners of the agency who are active in the day-to-day management
and operations of the agency to complete mandatory training as determined by the
commissioner. Employees in management and supervisory positions and owners who are
active in the day-to-day operations of an agency who have completed the required training
as an employee with a CFSS agency-provider do not need to repeat the required training if
they are hired by another agency and they have completed the training within the past three
years. CFSS agency-provider billing staff shall complete training about CFSS program
financial management. Any new owners or employees in management and supervisory
positions involved in the day-to-day operations are required to complete mandatory training
as a requisite of working for the agency.

(d) Agency-providers shall submit all required documentation in this section within 30
days of notification from the commissioner. If an agency-provider fails to submit all the
required documentation, the commissioner may take action under subdivision 23a.

Sec. 14.

Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 17a, is
amended to read:

Subd. 17a.

Consultation services provider qualifications and
requirements.

Consultation services providers must meet the following qualifications and
requirements:

(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4)
and (5);

(2) be under contract with the department and enrolled as a Minnesota health care program
provider;

(3) not be the FMS provider, the lead agency, or the CFSS or home and community-based
services waiver vendor or agency-provider to the participant;

(4) meet the service standards as established by the commissioner;

(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation
service provider's Medicaid revenue in the previous calendar year is less than or equal to
$300,000, the consultation service provider must purchase a surety bond of $50,000. If the
agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000,
the consultation service provider must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be deleted text begin renewed deleted text end new text begin purchased new new text end annually,
and must allow for recovery of costs and fees in pursuing a claim on the bond new text begin . Any action
to obtain monetary recovery or sanctions from a surety bond must occur within six years
from the date the debt is affirmed by a final agency decision. An agency decision is final
when the right to appeal the debt has been exhausted or the time to appeal has expired under
section 256B.064 new text end ;

(6) employ lead professional staff with a minimum of two years of experience in
providing services such as support planning, support broker, case management or care
coordination, or consultation services and consumer education to participants using a
self-directed program using FMS under medical assistance;

(7) report maltreatment as required under chapter 260E and section 626.557;

(8) comply with medical assistance provider requirements;

(9) understand the CFSS program and its policies;

(10) be knowledgeable about self-directed principles and the application of the
person-centered planning process;

(11) have general knowledge of the FMS provider duties and the vendor fiscal/employer
agent model, including all applicable federal, state, and local laws and regulations regarding
tax, labor, employment, and liability and workers' compensation coverage for household
workers; and

(12) have all employees, including lead professional staff, staff in management and
supervisory positions, and owners of the agency who are active in the day-to-day management
and operations of the agency, complete training as specified in the contract with the
department.

Sec. 15. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2025 Supplement, sections 245A.042, subdivision 5; and 245A.10,
subdivision 3a, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2026.
new text end

ARTICLE 3

BACKGROUND STUDIES

Section 1.

Minnesota Statutes 2024, section 245C.03, subdivision 3a, is amended to read:

Subd. 3a.

Personal care assistance provider agency; background studies.

Personal
care assistance provider agencies enrolled to provide personal care assistance services under
the medical assistance program must meet the following requirements:

(1) owners who have a five percent interest or more new text begin , board members, new text end and all managing
employees are subject to a background study as provided in this chapter. This requirement
applies to currently enrolled personal care assistance provider agencies and agencies seeking
enrollment as a personal care assistance provider agency. "Managing employee" has the
same meaning as in Code of Federal Regulations, title 42, section 455.101. An organization
is barred from enrollment if:

(i) the organization has not initiated background studies of owners and managing
employees; or

(ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14, and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22; and

(2) a background study must be initiated and completed for all new text begin employee and volunteer
new text end qualified professionals.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 15, 2026.
new text end

Sec. 2.

Minnesota Statutes 2024, section 245C.03, subdivision 9, is amended to read:

Subd. 9.

Community first services and supports and financial management services
organizations.

Individuals affiliated with Community First Services and Supports (CFSS)
agency-providers and Financial Management Services (FMS) providers enrolled to provide
CFSS services under the medical assistance program must meet the following requirements:

(1) owners who have a five percent interest or more new text begin , board members, new text end and all managing
employees are subject to a background study under this chapter. This requirement applies
to currently enrolled providers and agencies seeking enrollment. "Managing employee" has
the meaning given in Code of Federal Regulations, title 42, section 455.101. An organization
is barred from enrollment if:

(i) the organization has not initiated background studies of owners and managing
employees; or

(ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14 and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22;

(2) a background study must be initiated and completed for all deleted text begin staff deleted text end new text begin employees or
volunteers new text end who will have direct contact with the participant to provide worker training and
development; and

(3) a background study must be initiated and completed for all new text begin employee and volunteer
new text end support workers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 15, 2026.
new text end

Sec. 3.

Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision to
read:

new text begin Subd. 17. new text end

new text begin Providers of adult rehabilitative mental health services. new text end

new text begin The commissioner
must conduct background studies on any individual who is an owner with an ownership
stake of at least five percent in an adult rehabilitative mental health services provider, an
operator of an adult rehabilitative mental health services provider, or an employee or
volunteer who has direct contact with people receiving adult rehabilitative mental health
services under section 256B.0623. For purposes of this subdivision, operator includes board
members or other individuals who oversee the billing, management, or policies of the
services provided.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon implementation in NETStudy 2.0,
but no sooner than October 13, 2026.
new text end

Sec. 4.

Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision to
read:

new text begin Subd. 18. new text end

new text begin Providers of peer recovery services. new text end

new text begin The commissioner must conduct
background studies on any individual who is an owner with an ownership stake of at least
five percent in a peer recovery services provider, an operator of a peer recovery services
provider, or an employee or volunteer who has direct contact with people receiving peer
recovery services under section 254B.052. For purposes of this subdivision, "operator"
includes board members or other individuals who oversee the billing, management, or
policies of the services provided.
new text end

Sec. 5.

Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision to
read:

new text begin Subd. 19. new text end

new text begin Providers of adult assertive community treatment services. new text end

new text begin The
commissioner must conduct background studies on any individual who is an owner with
an ownership stake of at least five percent in an adult assertive community treatment services
provider, an operator of an adult assertive community treatment services provider, or an
employee or volunteer who has direct contact with people receiving adult assertive
community treatment services under section 256B.0622. For purposes of this subdivision,
"operator" includes board members or other individuals who oversee the billing, management,
or policies of the services provided.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon implementation in NETStudy 2.0,
but no sooner than February 16, 2027.
new text end

Sec. 6.

Minnesota Statutes 2025 Supplement, section 245C.13, subdivision 2, is amended
to read:

Subd. 2.

Activities pending completion of background study.

The subject of a
background study may not perform any activity requiring a background study under
paragraph (c) until the commissioner has issued one of the notices under paragraph (a).

(a) Notices from the commissioner required prior to activity under paragraph (c) include:

(1) a notice of the study results under section 245C.17 stating that:

(i) the individual is not disqualified; or

(ii) more time is needed to complete the study but the individual is not required to be
removed from direct contact or access to people receiving services prior to completion of
the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
that more time is needed to complete the study must also indicate whether the individual is
required to be under continuous direct supervision prior to completion of the background
study. When more time is necessary to complete a background study of an individual
affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
the individual may not work in the facility or setting regardless of whether or not the
individual is supervised;

(2) a notice that a disqualification has been set aside under section 245C.23; or

(3) a notice that a variance has been granted related to the individual under section
245C.30.

(b) For a background study affiliated with a licensed child care center or certified
license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
must not be issued until the commissioner receives a qualifying result for the individual for
the fingerprint-based national criminal history record check or the fingerprint-based criminal
history information from the Bureau of Criminal Apprehension. The notice must require
the individual to be under continuous direct supervision prior to completion of the remainder
of the background study except as permitted in subdivision 3.

(c) Activities prohibited prior to receipt of notice under paragraph (a) include:

(1) being issued a license;

(2) living in the household where the licensed program will be provided;

(3) providing direct contact services to persons served by a program unless the subject
is under continuous direct supervision;

(4) having access to persons receiving services if the background study was completed
under section 144.057, subdivision 1, or 245C.03 deleted text begin , subdivision 1 deleted text end deleted text begin , paragraph (a), clause (2),
(5), or (6), deleted text end unless the subject is under continuous direct supervision;

(5) for licensed child care centers and certified license-exempt child care centers,
providing direct contact services to persons served by the program;

(6) for children's residential facilities or foster residence settings, working in the facility
or setting; new text begin or
new text end

(7) for background studies affiliated with a personal care provider organization, deleted text begin except
as provided in section 245C.03, subdivision 3b, deleted text end new text begin early intensive developmental and behavioral
intervention provider, housing support or supplementary services provider, special
transportation services provider, or community first services and supports provider new text end before
deleted text begin a personal care assistant deleted text end new text begin an individual new text end provides services, the deleted text begin personal care assistance provider
agency deleted text end new text begin entity new text end must initiate a background study of the deleted text begin personal care assistant deleted text end new text begin individual new text end
under this chapter and the deleted text begin personal care assistance provider agency deleted text end new text begin entity new text end must have received
a notice from the commissioner that the deleted text begin personal care assistant deleted text end new text begin individual new text end is:

(i) not disqualified under section 245C.14; or

(ii) disqualified, but the deleted text begin personal care assistant deleted text end new text begin individual new text end has received a set aside of the
disqualification under section 245C.22 deleted text begin ; or deleted text end new text begin .
new text end

deleted text begin (8) for background studies affiliated with an early intensive developmental and behavioral
intervention provider, before an individual provides services, the early intensive
developmental and behavioral intervention provider must initiate a background study for
the individual under this chapter and the early intensive developmental and behavioral
intervention provider must have received a notice from the commissioner that the individual
is:
deleted text end

deleted text begin (i) not disqualified under section 245C.14; or
deleted text end

deleted text begin (ii) disqualified, but the individual has received a set-aside of the disqualification under
section 245C.22.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 15, 2026.
new text end

Sec. 7.

Minnesota Statutes 2025 Supplement, section 245C.16, subdivision 1, is amended
to read:

Subdivision 1.

Determining immediate risk of harm.

(a) If the commissioner determines
that the individual studied has a disqualifying characteristic, the commissioner shall review
the information immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will have direct
contact with, or access to, people receiving services.

(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:

(1) the recency of the disqualifying characteristic;

(2) the recency of discharge from probation for the crimes;

(3) the number of disqualifying characteristics;

(4) the intrusiveness or violence of the disqualifying characteristic;

(5) the vulnerability of the victim involved in the disqualifying characteristic;

(6) the similarity of the victim to the persons served by the program where the individual
studied will have direct contact;

(7) whether the individual has a disqualification from a previous background study that
has not been set aside;

(8) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 1, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense in
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with, or access to, persons receiving services from
the program and from working in a children's residential facility or foster residence setting;
and

(9) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 2, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense during
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with or access to persons receiving services from
the center and from working in a licensed child care center or certified license-exempt child
care center.

(c) This section does not apply when the subject of a background study is regulated by
a health-related licensing board as defined in chapter 214, and the subject is determined to
be responsible for substantiated maltreatment under section 626.557 or chapter 260E.

(d) This section does not apply to a background study related to an initial application
for a child foster family setting license.

(e) Except for paragraph (f), this section does not apply to a background study that is
also subject to the requirements under section deleted text begin 256B.0659, subdivisions 11 and 13, for a
personal care assistant or a qualified professional as defined in section 256B.0659,
subdivision 1, or to a background study for an individual providing early intensive
developmental and behavioral intervention services under section 256B.0949 deleted text end new text begin 245C.13,
subdivision 2, paragraph (c), clause (7) new text end .

(f) If the commissioner has reason to believe, based on arrest information or an active
maltreatment investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously supervised
or immediately removed pending the conclusion of the maltreatment investigation or criminal
proceedings.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 15, 2026.
new text end

ARTICLE 4

UNIFORM SERVICE STANDARDS

Section 1.

Minnesota Statutes 2024, section 245.735, subdivision 6, is amended to read:

Subd. 6.

Section 223 of the Protecting Access to Medicare Act entities.

deleted text begin (a) The
commissioner must request federal approval to participate in the demonstration program
established by section 223 of the Protecting Access to Medicare Act and, if approved, to
continue to participate in the demonstration program as long as federal funding for the
demonstration program remains available from the United States Department of Health and
Human Services. To the extent practicable, the commissioner shall align the requirements
of the demonstration program with the requirements under this section for CCBHCs receiving
medical assistance reimbursement under the authority of the state's Medicaid state plan. A
CCBHC may not apply to participate as a billing provider in both the CCBHC federal
demonstration and the benefit for CCBHCs under the medical assistance program.
deleted text end

deleted text begin (b) The commissioner must follow federal payment guidance, including payment of the
CCBHC daily bundled rate for services rendered by CCBHCs to individuals who are dually
eligible for Medicare and medical assistance when Medicare is the primary payer for the
service. Services provided by a CCBHC operating under the authority of the state's Medicaid
state plan will not receive the prospective payment system rate for services rendered by
CCBHCs to individuals who are dually eligible for Medicare and medical assistance when
Medicare is the primary payer for the service.
deleted text end

deleted text begin (c) deleted text end Payment for services rendered by CCBHCs to individuals who have commercial
insurance as the primary payer and medical assistance as secondary payer is subject to the
requirements under section 256B.37. Services provided by a CCBHC operating under the
authority of the 223 demonstration or the state's Medicaid state plan will not receive the
prospective payment system rate for services rendered by CCBHCs to individuals who have
commercial insurance as the primary payer and medical assistance as the secondary payer.

Sec. 2.

Minnesota Statutes 2025 Supplement, section 245A.03, subdivision 2, is amended
to read:

Subd. 2.

Exclusion from licensure.

(a) This chapter does not apply to:

(1) residential or nonresidential programs that are provided to a person by an individual
who is related;

(2) nonresidential programs that are provided by an unrelated individual to persons from
a single related family;

(3) residential or nonresidential programs that are provided to adults who do not misuse
substances or have a substance use disorder, a mental illness, a developmental disability, a
functional impairment, or a physical disability;

(4) sheltered workshops or work activity programs that are certified by the commissioner
of employment and economic development;

(5) programs operated by a public school for children 33 months or older;

(6) nonresidential programs primarily for children that provide care or supervision for
periods of less than three hours a day while the child's parent or legal guardian is in the
same building as the nonresidential program or present within another building that is
directly contiguous to the building in which the nonresidential program is located;

(7) nursing homes or hospitals licensed by the commissioner of health except as specified
under section 245A.02;

(8) board and lodge facilities licensed by the commissioner of health that do not provide
children's residential services under Minnesota Rules, chapter 2960, mental health or
substance use disorder treatment;

(9) programs licensed by the commissioner of corrections;

(10) recreation programs for children or adults that are operated or approved by a park
and recreation board whose primary purpose is to provide social and recreational activities;

(11) noncertified boarding care homes unless they provide services for five or more
persons whose primary diagnosis is mental illness or a developmental disability;

(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art
programs, and nonresidential programs for children provided for a cumulative total of less
than 30 days in any 12-month period;

(13) residential programs for persons with mental illness, that are located in hospitals;

(14) camps licensed by the commissioner of health under Minnesota Rules, chapter
4630;

(15) mental health outpatient services for adults with mental illness or children with
mental illness new text begin , except, effective January 1, 2028, for programs licensed under section
245A.044 new text end ;

(16) residential programs serving school-age children whose sole purpose is cultural or
educational exchange, until the commissioner adopts appropriate rules;

(17) community support services programs as defined in section 245.462, subdivision
6, and family community support services as defined in section 245.4871, subdivision 17;

(18) assisted living facilities licensed by the commissioner of health under chapter 144G;

(19) substance use disorder treatment activities of licensed professionals in private
practice as defined in section 245G.01, subdivision 17;

(20) consumer-directed community support service funded under the Medicaid waiver
for persons with developmental disabilities when the individual who provided the service
is:

(i) the same individual who is the direct payee of these specific waiver funds or paid by
a fiscal agent, fiscal intermediary, or employer of record; and

(ii) not otherwise under the control of a residential or nonresidential program that is
required to be licensed under this chapter when providing the service;

(21) a county that is an eligible vendor under section 254B.0501 to provide care
coordination and comprehensive assessment services;

(22) a recovery community organization that is an eligible vendor under section
254B.0501 to provide peer recovery support services; or

(23) programs licensed by the commissioner of children, youth, and families in chapter
142B.

(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
building in which a nonresidential program is located if it shares a common wall with the
building in which the nonresidential program is located or is attached to that building by
skyway, tunnel, atrium, or common roof.

(c) Except for the home and community-based services identified in section 245D.03,
subdivision 1, nothing in this chapter shall be construed to require licensure for any services
provided and funded according to an approved federal waiver plan where licensure is
specifically identified as not being a condition for the services and funding.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 3.

new text begin [245A.044] LICENSED NONRESIDENTIAL BEHAVIORAL HEALTH
SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin License required for certain nonresidential behavioral health
services. new text end

new text begin (a) Beginning January 1, 2028, providers of nonresidential mental health and
substance use disorder services must obtain a license under this chapter to provide:
new text end

new text begin (1) adult rehabilitative mental health services under section 245I.22;
new text end

new text begin (2) children's therapeutic services and supports in the community under section 245I.30
and children's day treatment under section 245I.31;
new text end

new text begin (3) crisis response services under section 245I.24; and
new text end

new text begin (4) certified community behavioral health clinic services under section 245I.17.
new text end

new text begin (b) As a condition of licensure, an applicant or license holder must demonstrate and
maintain verification of compliance with:
new text end

new text begin (1) licensing requirements under this chapter and chapter 245I; and
new text end

new text begin (2) applicable health care program requirements under Minnesota Rules, parts 9505.0170
to 9505.0475 and 9505.2160 to 9505.2245.
new text end

new text begin Subd. 2. new text end

new text begin Implementation. new text end

new text begin (a) Beginning July 1, 2027, the commissioner must begin
issuing licenses to providers listed in subdivision 1. The commissioner must transition
providers certified under section 245I.011 and listed in subdivision 1 into licensure with a
phased-in schedule determined by the commissioner. The commissioner must communicate
the implementation schedule to providers at least three months before the application is
made available.
new text end

new text begin (b) Applicants for licensure must have an approved certification under section 245I.011
at least 90 days before the date of the licensure application.
new text end

new text begin (c) A provider's certification under section 245I.011, subdivision 5, paragraph (a), clauses
(2) to (4), or 6, paragraph (b), expires when the commissioner issues a decision on the
provider's license application.
new text end

new text begin (d) Upon licensure, a license holder must notify clients and staff of policies and
procedures outlined in the application.
new text end

new text begin (e) Notwithstanding paragraphs (a) and (c), subdivision 1, and sections 245I.17, 245I.22,
245I.24, 245I.30, and 245I.31, a provider listed under subdivision 1, paragraph (a), clauses
(1) to (4), and certified under section 245I.011 may continue operating past January 1, 2028,
until the commissioner issues a licensing decision if the provider submitted an application
before January 1, 2028.
new text end

new text begin (f) If a provider fails to submit an application for licensure within the time frame in
paragraph (b), the commissioner must disenroll the provider from reimbursement for the
following services:
new text end

new text begin (1) adult rehabilitative mental health services under section 256B.0623;
new text end

new text begin (2) crisis response services under section 256B.0624;
new text end

new text begin (3) children's therapeutic services and supports under section 256B.0943; and
new text end

new text begin (4) certified community behavioral health clinics under section 256B.0625, subdivision
5m.
new text end

new text begin (g) The commissioner must disenroll a provider listed in paragraph (f) from medical
assistance if:
new text end

new text begin (1) the provider's licensing application has been denied or the license has been suspended
or revoked; and
new text end

new text begin (2) the provider appealed the application denial or the license suspension or revocation,
and the commissioner issued a final order on the appeal affirming the action.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 4.

Minnesota Statutes 2025 Supplement, section 245A.10, subdivision 3, is amended
to read:

Subd. 3.

Application fee for initial license or certification.

(a) Except as provided in
paragraphs (c) deleted text begin and deleted text end new text begin , new text end (d), new text begin and (f), new text end for fees required under subdivision 1, an applicant for an
initial license or certification issued by the commissioner shall submit a $2,100 application
fee with each new application required under this subdivision. The application fee shall not
be prorated, is nonrefundable, and is in lieu of the annual license or certification fee that
expires on December 31. The commissioner shall not process an application until the
application fee is paid.

(b) Except as provided in paragraph (c), an applicant shall apply for a license to provide
services at a specific location.

(c) For a license to provide home and community-based services to persons with
disabilities or age 65 and older under chapter 245D, an applicant shall submit an application
to provide services statewide. For fees required under subdivision 1, an applicant for an
initial license issued by the commissioner to provide home and community-based services
under chapter 245D shall submit a $4,200 application fee with each new application.

(d) For fees required under subdivision 1, an applicant for an initial license or certification
issued by the commissioner for children's residential facility deleted text begin or mental health clinic licensure
or certification deleted text end shall submit a $500 application fee with each new application required under
this subdivision.

new text begin (e) For fees required under subdivision 1, an applicant for an initial mental health clinic
certification issued by the commissioner shall submit a $2,100 application fee with each
new application required under this subdivision.
new text end

new text begin (f) For fees required under subdivision 1, an applicant for an initial license issued by
the commissioner to provide services at a certified community behavioral health clinic under
section 245I.17 shall submit a $4,200 application fee with each new application.
new text end

Sec. 5.

Minnesota Statutes 2025 Supplement, section 245A.10, subdivision 4, is amended
to read:

Subd. 4.

License or certification fee for certain programs.

(a)(1) A program licensed
to provide one or more of the home and community-based services and supports identified
under chapter 245D to persons with disabilities or age 65 and older, shall pay an annual
nonrefundable license fee based on revenues derived from the provision of services that
would require licensure under chapter 245D during the calendar year immediately preceding
the year in which the license fee is paid, according to the following schedule:

License Holder Annual Revenue		License Fee
less than or equal to $10,000		$250
greater than $10,000 but less than or equal to $25,000		$375
greater than $25,000 but less than or equal to $50,000		$500
greater than $50,000 but less than or equal to $100,000		$625
greater than $100,000 but less than or equal to $150,000		$750
greater than $150,000 but less than or equal to $200,000		$1,000
greater than $200,000 but less than or equal to $250,000		$1,250
greater than $250,000 but less than or equal to $300,000		$1,500
greater than $300,000 but less than or equal to $350,000		$1,750
greater than $350,000 but less than or equal to $400,000		$2,000
greater than $400,000 but less than or equal to $450,000		$2,250
greater than $450,000 but less than or equal to $500,000		$2,500
greater than $500,000 but less than or equal to $600,000		$2,850
greater than $600,000 but less than or equal to $700,000		$3,200
greater than $700,000 but less than or equal to $800,000		$3,600
greater than $800,000 but less than or equal to $900,000		$3,900
greater than $900,000 but less than or equal to $1,000,000		$4,250
greater than $1,000,000 but less than or equal to $1,250,000		$4,550
greater than $1,250,000 but less than or equal to $1,500,000		$4,900
greater than $1,500,000 but less than or equal to $1,750,000		$5,200
greater than $1,750,000 but less than or equal to $2,000,000		$5,500
greater than $2,000,000 but less than or equal to $2,500,000		$5,900
greater than $2,500,000 but less than or equal to $3,000,000		$6,200
greater than $3,000,000 but less than or equal to $3,500,000		$6,500
greater than $3,500,000 but less than or equal to $4,000,000		$7,200
greater than $4,000,000 but less than or equal to $4,500,000		$7,800
greater than $4,500,000 but less than or equal to $5,000,000		$9,000
greater than $5,000,000 but less than or equal to $7,500,000		$10,000
greater than $7,500,000 but less than or equal to $10,000,000		$14,000
greater than $10,000,000 but less than or equal to $12,500,000		$18,000
greater than $12,500,000 but less than or equal to $15,000,000		$25,000
greater than $15,000,000 but less than or equal to $17,500,000		$28,000
greater than $17,500,000 but less than $20,000,000		$32,000
greater than $20,000,000 but less than $25,000,000		$36,000
greater than $25,000,000 but less than $30,000,000		$45,000
greater than $30,000,000 but less than $35,000,000		$55,000
greater than $35,000,000		$75,000

(2) If requested, the license holder shall provide the commissioner information to verify
the license holder's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(3) At each annual renewal, a license holder may elect to pay the highest renewal fee,
and not provide annual revenue information to the commissioner.

(4) A license holder that knowingly provides the commissioner incorrect revenue amounts
for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount
of double the fee the provider should have paid.

(b) A substance use disorder treatment program licensed under chapter 245G, to provide
substance use disorder treatment shall pay an annual nonrefundable license fee based on
the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$2,600
	25 to 49 persons	$3,000
	50 to 74 persons	$5,000
	75 to 99 persons	$10,000
	100 to 199 persons	$15,000
	200 or more persons	$20,000

(c) A detoxification program licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, or a withdrawal management program licensed under chapter 245F shall pay
an annual nonrefundable license fee based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$2,600
	25 to 49 persons	$3,000
	50 or more persons	$5,000

A detoxification program that also operates a withdrawal management program at the same
location shall only pay one fee based upon the licensed capacity of the program with the
higher overall capacity.

(d) A children's residential facility licensed under Minnesota Rules, chapter 2960, to
serve children shall pay an annual nonrefundable license fee based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$1,000
	25 to 49 persons	$1,100
	50 to 74 persons	$1,200
	75 to 99 persons	$1,300
	100 or more persons	$1,400

(e) A residential facility licensed under section 245I.23 or Minnesota Rules, parts
9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual
nonrefundable license fee based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$2,600
	25 to 49 persons	$3,000
	50 or more persons	$20,000

(f) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400,
to serve persons with physical disabilities shall pay an annual nonrefundable license fee
based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$450
	25 to 49 persons	$650
	50 to 74 persons	$850
	75 to 99 persons	$1,050
	100 or more persons	$1,250

(g) A program licensed as an adult day care center licensed under Minnesota Rules,
parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$2,600
	25 to 49 persons	$3,000
	50 to 74 persons	$5,000
	75 to 99 persons	$10,000
	100 to 199 persons	$15,000
	200 or more persons	$20,000

(h) A program licensed to provide treatment services to persons with sexual psychopathic
personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to
9515.3110, shall pay an annual nonrefundable license fee of $20,000.

(i) A mental health clinic certified under section 245I.20 shall pay an annual
nonrefundable certification fee of deleted text begin $1,550 deleted text end new text begin $3,000 new text end . If the mental health clinic provides services
at a primary location with satellite facilities, the satellite facilities shall be certified with the
primary location without an additional charge.

deleted text begin (j) If a program subject to annual fees under paragraph (b) provides services at a primary
location with satellite facilities, the satellite facilities must be licensed with the primary
location and must be subject to an additional $500 annual nonrefundable license fee per
satellite facility.
deleted text end

new text begin (j) A program licensed to provide behavioral health treatment services licensed under
section 245I.22, 245I.24, 245I.30, or 245I.31 shall pay an annual nonrefundable license fee
of $3,000 for each license.
new text end

new text begin (k) Certified community behavioral health clinics licensed under section 245I.17 shall
pay an annual nonrefundable license fee of $7,800.
new text end

Sec. 6.

Minnesota Statutes 2024, section 245A.10, is amended by adding a subdivision to
read:

new text begin Subd. 4a. new text end

new text begin Fees for satellite locations. new text end

new text begin (a) If a program subject to annual fees under
subdivision 4, paragraph (b), provides services at a primary location with satellite facilities,
the satellite facilities are licensed with the primary location and are subject to an additional
$500 annual nonrefundable license fee per satellite facility.
new text end

new text begin (b) If a program subject to annual fees under subdivision 4, paragraph (j), provides
services at a primary location with satellite sites or facilities, the satellite locations must be
licensed with the primary location and are subject to an additional annual nonrefundable
fee according to the following schedule:
new text end

new text begin (1) one to five satellite locations: $1,500;
new text end

new text begin (2) six to 19 satellite locations: $3,500; or
new text end

new text begin (3) 20 or more satellite locations: $5,000.
new text end

Sec. 7.

Minnesota Statutes 2024, section 245A.65, subdivision 1a, is amended to read:

Subd. 1a.

Determination of vulnerable adult status.

(a) A license holder that provides
services to adults who are excluded from the definition of vulnerable adult under section
626.5572, subdivision 21, paragraph (a), clause (2), must determine whether the person is
a vulnerable adult under section 626.5572, subdivision 21, paragraph (a), clause (4). This
determination must be made within 24 hours of:

(1) admission to the licensed program; and

(2) any incident that:

(i) was reported under section 626.557; or

(ii) would have been required to be reported under section 626.557, if one or more of
the adults involved in the incident had been vulnerable adults.

(b) Upon determining that a person receiving services is a vulnerable adult under section
626.5572, subdivision 21, paragraph (a), clause (4), all requirements relative to vulnerable
adults under this chapter and section 626.557 must be met by the license holder.

new text begin (c) Notwithstanding paragraph (a), clause (1), a license holder providing mobile crisis
services must make the required determination within 24 hours of first providing crisis
stabilization services to an adult under section 245I.24, subdivision 9.
new text end

Sec. 8.

Minnesota Statutes 2024, section 245C.03, subdivision 1, is amended to read:

Subdivision 1.

Programs licensed by the commissioner.

(a) The commissioner shall
conduct a background study on:

(1) the person or persons applying for a license;

(2) an individual age 13 and over living in the household where the licensed program
will be provided who is not receiving licensed services from the program;

(3) current or prospective employees of the applicant or license holder who will have
direct contact with persons served by the facility, agency, or program;

(4) volunteers or student volunteers who will have direct contact with persons served
by the program to provide program services if the contact is not under the continuous, direct
supervision by an individual listed in clause (1) or (3);

(5) an individual age ten to 12 living in the household where the licensed services will
be provided when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;

(6) an individual who, without providing direct contact services at a licensed program,
may have unsupervised access to children or vulnerable adults receiving services from a
program, when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15; and

(7) all controlling individuals as defined in section 245A.02, subdivision 5a;

(8) notwithstanding clause (3), for children's residential facilities and foster residence
settings, any adult working in the facility, whether or not the individual will have direct
contact with persons served by the facility.

(b) For child foster care when the license holder resides in the home where foster care
services are provided, a short-term substitute caregiver providing direct contact services for
a child for less than 72 hours of continuous care is not required to receive a background
study under this chapter.

(c) This subdivision applies to the following programs that must be licensed under
chapter 245A:

(1) adult foster care;

(2) children's residential facilities;

(3) licensed home and community-based services under chapter 245D;

(4) residential mental health programs for adults;

(5) substance use disorder treatment programs under chapter 245G;

(6) withdrawal management programs under chapter 245F;

(7) adult day care centers;

(8) family adult day services;

(9) detoxification programs;

(10) community residential settings;

(11) intensive residential treatment services and residential crisis stabilization under
chapter 245I; deleted text begin and
deleted text end

(12) treatment programs for persons with sexual psychopathic personality or sexually
dangerous persons, licensed under chapter 245A and according to Minnesota Rules, parts
9515.3000 to 9515.3110 deleted text begin . deleted text end new text begin ;
new text end

new text begin (13) adult rehabilitative mental health services under chapter 245I;
new text end

new text begin (14) certified community behavioral health clinic services under chapter 245I;
new text end

new text begin (15) children's therapeutic services and supports under chapter 245I; and
new text end

new text begin (16) crisis response services under chapter 245I.
new text end

Sec. 9.

Minnesota Statutes 2025 Supplement, section 245C.13, subdivision 2, is amended
to read:

Subd. 2.

Activities pending completion of background study.

The subject of a
background study may not perform any activity requiring a background study under
paragraph (c) until the commissioner has issued one of the notices under paragraph (a).

(a) Notices from the commissioner required prior to activity under paragraph (c) include:

(1) a notice of the study results under section 245C.17 stating that:

(i) the individual is not disqualified; or

(ii) more time is needed to complete the study but the individual is not required to be
removed from direct contact or access to people receiving services prior to completion of
the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
that more time is needed to complete the study must also indicate whether the individual is
required to be under continuous direct supervision prior to completion of the background
study. When more time is necessary to complete a background study of an individual
affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
the individual may not work in the facility or setting regardless of whether or not the
individual is supervised;

(2) a notice that a disqualification has been set aside under section 245C.23; or

(3) a notice that a variance has been granted related to the individual under section
245C.30.

(b) For a background study affiliated with a licensed child care center or certified
license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
must not be issued until the commissioner receives a qualifying result for the individual for
the fingerprint-based national criminal history record check or the fingerprint-based criminal
history information from the Bureau of Criminal Apprehension. The notice must require
the individual to be under continuous direct supervision prior to completion of the remainder
of the background study except as permitted in subdivision 3.

(c) Activities prohibited prior to receipt of notice under paragraph (a) include:

(1) being issued a license;

(2) living in the household where the licensed program will be provided;

(3) providing direct contact services to persons served by a program unless the subject
is under continuous direct supervision;

(4) having access to persons receiving services if the background study was completed
under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2),
(5), or (6), unless the subject is under continuous direct supervision;

(5) for licensed child care centers and certified license-exempt child care centers,
providing direct contact services to persons served by the program;

(6) for children's residential facilities or foster residence settings, working in the facility
or setting;

(7) for background studies affiliated with a personal care provider organization, except
as provided in section 245C.03, subdivision 3b, new text begin or with an early intensive developmental
and behavioral intervention provider or adult rehabilitative mental health services provider,
new text end before deleted text begin a personal care assistant deleted text end new text begin an individual new text end provides services, the deleted text begin personal care assistance
provider agency deleted text end new text begin entity new text end must initiate a background study of the deleted text begin personal care assistant deleted text end new text begin
individual new text end under this chapter and the deleted text begin personal care assistance provider agency deleted text end new text begin entity new text end must
have received a notice from the commissioner that the deleted text begin personal care assistant deleted text end new text begin individual new text end is:

(i) not disqualified under section 245C.14; or

(ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22; or

(8) for background studies affiliated with an early intensive developmental and behavioral
intervention provider, before an individual provides services, the early intensive
developmental and behavioral intervention provider must initiate a background study for
the individual under this chapter and the early intensive developmental and behavioral
intervention provider must have received a notice from the commissioner that the individual
is:

(i) not disqualified under section 245C.14; or

(ii) disqualified, but the individual has received a set-aside of the disqualification under
section 245C.22.

Sec. 10.

Minnesota Statutes 2024, section 245G.03, subdivision 1, is amended to read:

Subdivision 1.

License requirements.

(a) An applicant for a license to provide substance
use disorder treatment must comply with the general requirements in section 626.557;
chapters 245A, 245C, and 260E; and Minnesota Rules, chapter 9544.

(b) The commissioner may grant variances to the requirements in this chapter that do
not affect the client's health or safety if the conditions in section 245A.04, subdivision 9,
are met.

(c) If a program is licensed according to this chapter and is part of a certified community
behavioral health clinic under section deleted text begin 245.735 deleted text end new text begin 245I.17 new text end , the license holder must comply with
the requirements in section deleted text begin 245.735 deleted text end new text begin 245I.17 new text end , subdivisions deleted text begin 4b to 4e deleted text end new text begin 12 and 13 new text end , as part of the
licensing requirements under this chapter.

Sec. 11.

Minnesota Statutes 2024, section 245I.011, subdivision 3, is amended to read:

Subd. 3.

Certification required.

(a) An individual, organization, or government entity
that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause
deleted text begin (12) deleted text end new text begin (15) new text end , and chooses to be identified as a certified mental health clinic must:

(1) be a mental health clinic that is certified under section 245I.20;

(2) comply with all of the responsibilities assigned to a license holder by this chapter
except subdivision 1; and

(3) comply with all of the responsibilities assigned to a certification holder by chapter
245A.

(b) An individual, organization, or government entity described by this subdivision must
obtain a criminal background study for each staff person or volunteer who provides direct
contact services to clients.

deleted text begin (c) If a clinic is certified according to this chapter and is part of a certified community
behavioral health clinic under section 245.735, the license holder must comply with the
requirements in section 245.735, subdivisions 4b to 4e, as part of the licensing requirements
under this chapter.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment, except
the amendment striking paragraph (c) is effective January 1, 2028.
new text end

Sec. 12.

Minnesota Statutes 2024, section 245I.011, subdivision 5, is amended to read:

Subd. 5.

Programs certified under chapter 256B.

(a) An individual, organization, or
government entity certified under the following sections must comply with all of the
responsibilities assigned to a license holder under this chapter except subdivision 1:

(1) an assertive community treatment provider under section 256B.0622, subdivision
3a;

deleted text begin (2) an adult rehabilitative mental health services provider under section 256B.0623;
deleted text end

deleted text begin (3) a mobile crisis team under section 256B.0624;
deleted text end

deleted text begin (4) a children's therapeutic services and supports provider under section 256B.0943;
deleted text end

deleted text begin (5) deleted text end new text begin (2) new text end a children's intensive behavioral health services provider under section 256B.0946;
and

deleted text begin (6) deleted text end new text begin (3) new text end an intensive nonresidential rehabilitative mental health services provider under
section 256B.0947.

(b) An individual, organization, or government entity certified under the sections listed
in paragraph (a) deleted text begin , clauses (1) to (6), deleted text end must obtain a criminal background study for each staff
person and volunteer providing direct contact services to a client.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 13.

Minnesota Statutes 2024, section 245I.011, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin License required for nonresidential programs. new text end

new text begin (a) Beginning January 1,
2028, an individual, organization, or government entity must have a license under this
chapter to provide the following services:
new text end

new text begin (1) adult rehabilitative mental health services, as defined in section 256B.0623;
new text end

new text begin (2) mobile crisis services, as defined in section 256B.0624;
new text end

new text begin (3) children's therapeutic services and supports, as defined in section 256B.0943; or
new text end

new text begin (4) certified community behavioral health clinic services, as defined in sections 245I.17
and 256B.0625, subdivision 5m.
new text end

new text begin (b) An individual, organization, or government entity certified as any of the following
must remain certified according to subdivision 5 until the commissioner issues a license,
the commissioner denies the license application, or the certification expires according to
chapter 245A:
new text end

new text begin (1) an adult rehabilitative mental health services provider under section 256B.0623;
new text end

new text begin (2) a mobile crisis team under section 256B.0624;
new text end

new text begin (3) a children's therapeutic services and supports provider under section 256B.0943; or
new text end

new text begin (4) a certified community behavioral health clinic under section 245.735.
new text end

Sec. 14.

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

new text begin Subd. 1a. new text end

new text begin Alcohol and drug counselor. new text end

new text begin "Alcohol and drug counselor" means an
individual qualified under section 245G.11, subdivision 5.
new text end

Sec. 15.

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

new text begin Subd. 10a. new text end

new text begin Comprehensive evaluation. new text end

new text begin "Comprehensive evaluation" means a
person-centered, family-centered, and trauma-informed evaluation conducted according to
section 245I.17, subdivision 12.
new text end

Sec. 16.

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

new text begin Subd. 18a. new text end

new text begin Initial evaluation. new text end

new text begin "Initial evaluation" means the assessment and preliminary
diagnosis necessary to begin client services, conducted according to section 245I.17.
new text end

Sec. 17.

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

new text begin Subd. 31a. new text end

new text begin Psychotherapy. new text end

new text begin "Psychotherapy" has the meaning given in section 256B.0671,
subdivision 11.
new text end

Sec. 18.

Minnesota Statutes 2024, section 245I.02, subdivision 33, is amended to read:

Subd. 33.

Rehabilitative mental health services.

"Rehabilitative mental health services"
means mental health services provided to deleted text begin an adult deleted text end new text begin a new text end client that enable the client to develop
and achieve psychiatric stability, social competencies, personal and emotional adjustment,
independent living skills, family roles, and community skills when symptoms of mental
illness has impaired any of the client's abilities in these areas. new text begin Rehabilitative mental health
services include interventions that allow a client to self-monitor, compensate for, counteract,
or replace psychosocial skills deficits or maladaptive skills acquired over the course of a
mental illness. For a child client, rehabilitative mental health services include interventions
to restore a child or adolescent to an age-appropriate developmental trajectory that has been
disrupted by a mental illness.
new text end

Sec. 19.

Minnesota Statutes 2024, section 245I.02, subdivision 39, is amended to read:

Subd. 39.

Treatment plan.

"Treatment plan" means services that a license holder
formulates to respond to a client's needs and goals. A treatment plan includes individual
treatment plans under section 245I.10, subdivisions 7 and 8; initial treatment plans under
section 245I.23, subdivision 7; and crisis treatment plans under sections 245I.23, subdivision
8, and 256B.0624, subdivision 11. new text begin For a license holder under section 245I.17, a treatment
plan is the integrated treatment plan developed according to section 245I.17, subdivision
13.
new text end

Sec. 20.

Minnesota Statutes 2024, section 245I.03, subdivision 4, is amended to read:

Subd. 4.

Behavioral emergencies.

(a) A license holder must have procedures that each
staff person follows when responding to a client who exhibits behavior that threatens the
immediate safety of the client or others. A license holder's behavioral emergency procedures
must incorporate person-centered planning and trauma-informed care.

(b) A license holder's behavioral emergency procedures must include:

(1) a plan designed to prevent the client from inflicting self-harm and harming others;

(2) contact information for emergency resources that a staff person must use when the
license holder's behavioral emergency procedures are unsuccessful in controlling a client's
behavior;

(3) the types of behavioral emergency procedures that a staff person may use;

(4) the specific circumstances under which the program may use behavioral emergency
procedures; deleted text begin and
deleted text end

(5) the staff persons whom the license holder authorizes to implement behavioral
emergency procedures deleted text begin . deleted text end new text begin ; and
new text end

new text begin (6) the contact information for the local crisis team.
new text end

(c) The license holder's behavioral emergency procedures must not include secluding
or restraining a client except as allowed under section 245.8261.

(d) Staff persons must not use behavioral emergency procedures to enforce program
rules or for the convenience of staff persons. Behavioral emergency procedures must not
be part of any client's treatment plan. A staff person may not use behavioral emergency
procedures except in response to a client's current behavior that threatens the immediate
safety of the client or others.

Sec. 21.

Minnesota Statutes 2024, section 245I.03, is amended by adding a subdivision
to read:

new text begin Subd. 11. new text end

new text begin Quality assurance and improvement plan. new text end

new text begin (a) At a minimum, a license
holder must develop a written quality assurance and improvement plan that includes plans
for:
new text end

new text begin (1) encouraging ongoing consultation among members of the treatment team;
new text end

new text begin (2) obtaining and evaluating feedback about services from clients, family and other
natural supports, referral sources, and staff persons;
new text end

new text begin (3) measuring and evaluating client outcomes;
new text end

new text begin (4) reviewing client suicide deaths and suicide attempts;
new text end

new text begin (5) examining the quality of clinical service delivery to clients; and
new text end

new text begin (6) self-monitoring of compliance with this chapter.
new text end

new text begin (b) At least annually, a license holder must review, evaluate, and update the quality
assurance and improvement plan. The review must:
new text end

new text begin (1) include documentation of the actions that the certification holder will take as a result
of information obtained from monitoring activities in the plan; and
new text end

new text begin (2) establish goals for improved service delivery to clients for the next year.
new text end

Sec. 22.

Minnesota Statutes 2025 Supplement, section 245I.04, subdivision 5, is amended
to read:

Subd. 5.

Behavioral health practitioner scope of practice.

(a) A behavioral health
practitioner under the treatment supervision of a mental health professional or certified
rehabilitation specialist may provide an adult client with client education, rehabilitative
mental health services, functional assessments, level of care assessments, new text begin crisis planning,
new text end and treatment plans. A behavioral health practitioner under the treatment supervision of a
mental health professional may provide skill-building services deleted text begin to a child client deleted text end new text begin , crisis
planning, new text end and complete treatment plans for a child client.

(b) A behavioral health practitioner must not provide treatment supervision to other staff
persons. A behavioral health practitioner may provide direction to mental health rehabilitation
workers and mental health behavioral aides.

(c) A behavioral health practitioner who provides services to clients according to section
256B.0624 may perform crisis assessments and interventions for a client.

Sec. 23.

Minnesota Statutes 2025 Supplement, section 245I.04, subdivision 17, is amended
to read:

Subd. 17.

Mental health behavioral aide scope of practice.

While under the treatment
supervision of a mental health professional, a mental health behavioral aide may deleted text begin practice
psychosocial skills with deleted text end new text begin provide skill-building services to new text end a child client deleted text begin according to the
child's treatment plan and individual behavior plan that a mental health professional, clinical
trainee, or behavioral health practitioner has previously taught to the child deleted text end .

Sec. 24.

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

Subdivision 1.

Generally.

(a) A license holder must ensure that a mental health
professional or certified rehabilitation specialist provides treatment supervision to each staff
person who provides services to a client and who is not a mental health professional or
certified rehabilitation specialist. When providing treatment supervision, a treatment
supervisor must follow a staff person's written treatment supervision plan.

(b) Treatment supervision must focus on each client's treatment needs and the ability of
the staff person under treatment supervision to provide services to each client, including
the following topics related to the staff person's current caseload:

(1) a review and evaluation of the interventions that the staff person delivers to each
client;

(2) instruction on alternative strategies if a client is not achieving treatment goals;

(3) a review and evaluation of each client's assessments, treatment plans, and progress
notes for accuracy and appropriateness;

(4) instruction on the cultural norms or values of the clients and communities that the
license holder serves and the impact that a client's culture has on providing treatment;

(5) evaluation of and feedback regarding a direct service staff person's areas of
competency; deleted text begin and
deleted text end

(6) coaching, teaching, and practicing skills with a staff person deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) modeling service practices that respect the client, include the client in planning and
implementation of the individual treatment plan, recognize the client's strengths, and
coordinate with other involved parties and providers.
new text end

(c) A treatment supervisor must provide treatment supervision to a staff person using
methods that allow for immediate feedback, including in-person, telephone, and interactive
video supervision.

(d) A treatment supervisor's responsibility for a staff person receiving treatment
supervision is limited to the services provided by the associated license holder. If a staff
person receiving treatment supervision is employed by multiple license holders, each license
holder is responsible for providing treatment supervision related to the treatment of the
license holder's clients.

Sec. 25.

Minnesota Statutes 2024, section 245I.06, subdivision 2, is amended to read:

Subd. 2.

Treatment supervision planning.

(a) A treatment supervisor and the staff
person supervised by the treatment supervisor must develop a written treatment supervision
plan. The license holder must ensure that a new staff person's treatment supervision plan is
completed new text begin , approved by the staff person, new text end and implemented by a treatment supervisor and
the new staff person within 30 days of the new staff person's first day of employment. The
license holder must review and update each staff person's treatment supervision plan annually.

(b) Each staff person's treatment supervision plan must include:

(1) the name and qualifications of the staff person receiving treatment supervision;

(2) the names and licensures of the treatment supervisors who are supervising the staff
person;

(3) how frequently the treatment supervisors must provide treatment supervision to the
staff person; and

(4) the staff person's authorized scope of practice, including a description of the client
deleted text begin population deleted text end new text begin ages new text end that the staff person serves, and a description of the treatment methods and
modalities that the staff person may use to provide services to clients.

Sec. 26.

Minnesota Statutes 2024, section 245I.07, is amended to read:

245I.07 PERSONNEL FILES.

(a) For each staff person, a license holder must maintain a personnel file that includes:

(1) verification of the staff person's qualifications required for the position including
training, education, practicum or internship agreement, licensure, and any other required
qualifications;

(2) documentation related to the staff person's background study;

(3) the hiring date of the staff person;

(4) a description of the staff person's job responsibilities with the license holder;

(5) the date that the staff person's specific duties and responsibilities became effective,
including the date that the staff person began having direct contact with clients;

(6) documentation of the staff person's training as required by section 245I.05, subdivision
2;

(7) a verification copy of license renewals that the staff person completed during the
staff person's employment;

(8) annual job performance evaluations; and

(9) if applicable, the staff person's alleged and substantiated violations of the license
holder's policies under section 245I.03, subdivision 8, clauses (3) to (7), and the license
holder's response.

(b) The license holder must ensure that all personnel files are readily accessible for the
commissioner's review. The license holder is not required to keep personnel files in a single
location.

new text begin (c) For a license holder under section 245I.17, a personnel file for staff who provide
substance use disorder treatment services must include records of training required under
section 245G.13, subdivision 2.
new text end

Sec. 27.

Minnesota Statutes 2024, section 245I.10, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Evaluation, treatment authorization, and planning in a certified community
behavioral health clinic. new text end

new text begin Notwithstanding subdivisions 2 and 7, a license holder under
section 245I.17 must meet the requirements for assessments under section 245I.17,
subdivisions 11 and 12, and for treatment planning under section 245I.17, subdivision 13.
Certified community behavioral health clinic service planning and authorization must comply
with the standards in section 245I.17.
new text end

Sec. 28.

Minnesota Statutes 2024, section 245I.10, subdivision 6, is amended to read:

Subd. 6.

Standard diagnostic assessment; required elements.

(a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context. An alcohol and drug counselor
may gather and document the information in paragraphs (b) and (c) when completing a
comprehensive assessment according to section 245G.05.

(b) When completing a standard diagnostic assessment of a client, the assessor must
gather and document information about the client's current life situation, including the
following information:

(1) the client's age;

(2) the client's current living situation, including the client's housing status and household
members;

(3) the status of the client's basic needs;

(4) the client's education level and employment status;

(5) the client's current medications;

(6) any immediate risks to the client's health and safety, including withdrawal symptoms,
medical conditions, and behavioral and emotional symptoms;

(7) the client's perceptions of the client's condition;

(8) the client's description of the client's symptoms, including the reason for the client's
referral;

(9) the client's history of mental health and substance use disorder treatment;

(10) cultural influences on the client; and

(11) substance use history, if applicable, including:

(i) amounts and types of substances, frequency and duration, route of administration,
periods of abstinence, and circumstances of relapse; and

(ii) the impact to functioning when under the influence of substances, including legal
interventions.

(c) If the assessor cannot obtain the information that this paragraph requires without
retraumatizing the client or harming the client's willingness to engage in treatment, the
assessor must identify which topics will require further assessment during the course of the
client's treatment. The assessor must gather and document information related to the following
topics:

(1) the client's relationship with the client's family and other significant personal
relationships, including the client's evaluation of the quality of each relationship;

(2) the client's strengths and resources, including the extent and quality of the client's
social networks;

(3) important developmental incidents in the client's life;

(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;

(5) the client's history of or exposure to alcohol and drug usage and treatment; and

(6) the client's health history and the client's family health history, including the client's
physical, chemical, and mental health history.

(d) When completing a standard diagnostic assessment of a client, an assessor must use
a recognized diagnostic framework.

(1) When completing a standard diagnostic assessment of a client who is five years of
age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
Classification of Mental Health and Development Disorders of Infancy and Early Childhood
published by Zero to Three.

(2) When completing a standard diagnostic assessment of a client who is six years of
age or older, the assessor must use the current edition of the Diagnostic and Statistical
Manual of Mental Disorders published by the American Psychiatric Association.

new text begin (3) When completing a standard diagnostic assessment of a client who is 12 to 17 years
of age, an assessor must use either the CRAFFT Questionnaire or the criteria in the most
recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by
the American Psychiatric Association to screen and assess the client for a substance use
disorder.
new text end

deleted text begin (3) deleted text end new text begin (4) new text end When completing a standard diagnostic assessment of a client who is 18 years
of age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the
criteria in the most recent edition of the Diagnostic and Statistical Manual of Mental
Disorders published by the American Psychiatric Association to screen and assess the client
for a substance use disorder.

(e) When completing a standard diagnostic assessment of a client, the assessor must
include and document the following components of the assessment:

(1) the client's mental status examination;

(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
vulnerabilities; safety needs, including client information that supports the assessor's findings
after applying a recognized diagnostic framework from paragraph (d); and any differential
diagnosis of the client; and

(3) an explanation of: (i) how the assessor diagnosed the client using the information
from the client's interview, assessment, psychological testing, and collateral information
about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
and (v) the client's responsivity factors.

(f) When completing a standard diagnostic assessment of a client, the assessor must
consult the client and the client's family about which services that the client and the family
prefer to treat the client. deleted text begin The assessor must make referrals for the client as to services required
by law.
deleted text end

(g) Information from other providers and prior assessments may be used to complete
the diagnostic assessment if the source of the information is documented in the diagnostic
assessment.

new text begin (h) If the client screens positive for a need for substance use disorder treatment services,
the assessor must document what actions will be taken to address the client's co-occurring
conditions.
new text end

new text begin (i) The assessor must determine if the client is eligible for targeted case management
services according to section 245.462, subdivision 20, or 245.4871, subdivision 6, and refer
the client to the county or contracted provider as appropriate.
new text end

Sec. 29.

Minnesota Statutes 2024, section 245I.10, subdivision 8, is amended to read:

Subd. 8.

Individual treatment plan; required elements.

(a) After completing a client's
diagnostic assessment or reviewing a client's diagnostic assessment received from a different
provider and before providing services to the client beyond those permitted under subdivision
7, the license holder must complete the client's individual treatment plan. The license holder
must:

(1) base the client's individual treatment plan on the client's diagnostic assessment and
baseline measurements;

(2) for a child client, use a child-centered, family-driven, and culturally appropriate
planning process that allows the child's parents and guardians to observe and participate in
the child's individual and family treatment services, assessments, and treatment planning;

(3) for an adult client, use a person-centered, culturally appropriate planning process
that allows the client's family and other natural supports to observe and participate in the
client's treatment services, assessments, and treatment planning;

(4) identify the client's treatment goals, measureable treatment objectives, a schedule
for accomplishing the client's treatment goals and objectives, a treatment strategy, and the
individuals responsible for providing treatment services and supports to the client. The
license holder must have a treatment strategy to engage the client in treatment if the client:

(i) has a history of not engaging in treatment; and

(ii) is ordered by a court to participate in treatment services or to take neuroleptic
medications;

(5) identify the participants involved in the client's treatment planning. The client must
be a participant in the client's treatment planning. If applicable, the license holder must
document the reasons that the license holder did not involve the client's family new text begin , case manager, new text end
or other natural supports in the client's treatment planning; new text begin and
new text end

deleted text begin (6) review the client's individual treatment plan every 180 days and update the client's
individual treatment plan with the client's treatment progress, new treatment objectives and
goals or, if the client has not made treatment progress, changes in the license holder's
approach to treatment; and
deleted text end

deleted text begin (7) deleted text end new text begin (6) new text end ensure that the client approves of the client's individual treatment plan unless a
court orders the client's treatment plan under chapter 253B.

(b) If the client disagrees with the client's treatment plan, the license holder must
document in the client file the reasons why the client does not agree with the treatment plan.
If the license holder cannot obtain the client's approval of the treatment plan, a mental health
professional must make efforts to obtain approval from a person who is authorized to consent
on the client's behalf within 30 days after the client's previous individual treatment plan
expired. A license holder may not deny a client service during this time period solely because
the license holder could not obtain the client's approval of the client's individual treatment
plan. A license holder may continue to bill for the client's otherwise eligible services when
the client re-engages in services.

new text begin (c) The individual treatment plan must be updated as necessary to reflect the changing
needs of the client. The individual treatment plan must provide assistance with accessing
necessary crisis services when the license holder is aware of the client's need for crisis
services. The license holder must review the client's individual treatment plan every 180
days and update the client's individual treatment plan with the client's treatment progress,
new treatment objectives and goals, or, if the client has not made treatment progress, changes
in the license holder's approach to treatment.
new text end

Sec. 30.

new text begin [245I.17] CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
LICENSURE.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms in this subdivision
have the meanings given.
new text end

new text begin (b) "Care coordination" means the activities required to coordinate care across settings
and providers for an individual served to ensure seamless transitions across the full spectrum
of health services. Care coordination includes:
new text end

new text begin (1) outreach and engagement;
new text end

new text begin (2) documenting a plan of care for medical, behavioral health, and social services and
supports in the integrated treatment plan;
new text end

new text begin (3) assisting with obtaining appointments;
new text end

new text begin (4) confirming appointments are kept;
new text end

new text begin (5) developing a crisis plan;
new text end

new text begin (6) tracking medication; and
new text end

new text begin (7) implementing care coordination agreements with external providers. Care coordination
may include psychiatric consultation with primary care practitioners and with mental health
clinical care practitioners.
new text end

new text begin (c) "Certified community behavioral health clinic" or "CCBHC" means a provider of
integrated behavioral health services that is licensed under this section and compliant with
federal CCBHC requirements.
new text end

new text begin (d) "CCBHC client" means an individual who has participated in a preliminary screening
and risk assessment and who has received at least one of the nine required services from a
CCBHC.
new text end

new text begin (e) "Community needs assessment" means an assessment to identify community needs
and determine the community behavioral health clinic's capacity to address the needs of the
population being served.
new text end

new text begin (f) "Designated collaborating organization" means an entity meeting the requirements
of subdivision 5 that has a formal agreement with a CCBHC to furnish CCBHC services.
new text end

new text begin (g) "Federal CCBHC criteria" means the most recently issued Certified Community
Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental
Health Services Administration.
new text end

new text begin (h) "Needs assessment" means the community needs assessment described in federal
criteria for CCBHC.
new text end

new text begin (i) "Preliminary screening and risk assessment" means a mandatory screening and risk
assessment that is completed at the time of first contact, whether that contact is in person,
by telephone, or using other remote communication.
new text end

new text begin Subd. 2. new text end

new text begin Establishment of licensure. new text end

new text begin (a) The certified community behavioral health
clinic model is an integrated service delivery model that uses evidence-based behavioral
health practices to achieve better outcomes for individuals experiencing behavioral health
concerns while achieving sustainable rates through cost-based reimbursement for providers
and economic efficiencies for payors.
new text end

new text begin (b) Beginning January 1, 2028, a CCBHC must be licensed under this section and chapter
245A.
new text end

new text begin (c) A CCBHC must meet the requirements of this section and federal CCBHC criteria.
The commissioner may require a CCBHC applicant or license holder to submit documentation
of compliance with state licensing requirements and federal CCBHC criteria. When permitted
by the Substance Abuse and Mental Health Services Administration, the commissioner may
select a transition date on which revisions to the federal CCBHC criteria become required
as licensing conditions for CCBHCs.
new text end

new text begin Subd. 3. new text end

new text begin License extension. new text end

new text begin (a) The commissioner must extend a compliant license
holder's license under this section for 36 months.
new text end

new text begin (b) The commissioner must complete a licensing review that includes an on-site inspection
within six months before the expiration of the CCBHC's current license.
new text end

new text begin (c) Within 180 days of license expiration, a CCBHC license holder must submit to the
commissioner all documentation required by the commissioner under subdivision 2,
paragraph (c).
new text end

new text begin Subd. 4. new text end

new text begin Required services and scope of licensure. new text end

new text begin Within a declared service area, the
CCBHC must be able to offer:
new text end

new text begin (1) mobile crisis services, directly or through a designated collaborating organization
under subdivision 4;
new text end

new text begin (2) outpatient mental health and substance use disorder treatment services under
subdivisions 9 and 10;
new text end

new text begin (3) screening, diagnosis, and risk assessment under subdivision 11;
new text end

new text begin (4) person- and family-centered treatment planning;
new text end

new text begin (5) psychiatric rehabilitation services under subdivision 14;
new text end

new text begin (6) community-based mental health care for veterans under subdivision 15;
new text end

new text begin (7) outpatient primary care screening and monitoring under subdivision 16;
new text end

new text begin (8) peer services under subdivision 17; and
new text end

new text begin (9) targeted case management under subdivision 18.
new text end

new text begin Subd. 5. new text end

new text begin Designated collaborating organization. new text end

new text begin (a) If a CCBHC is unable to provide
mobile crisis services, the CCBHC may contract with another entity that is licensed to
provide mobile crisis services under section 245I.24 and that meets the requirements of the
federal CCBHC criteria as a designated collaborating organization.
new text end

new text begin (b) The CCBHC must submit a designated collaborating organization arrangement for
approval to the commissioner as part of the licensing process.
new text end

new text begin Subd. 6. new text end

new text begin Exemptions to host county approval. new text end

new text begin Notwithstanding any other law that
requires a county contract or other form of county approval for a service listed in subdivision
4, a CCBHC that meets the requirements of this section may receive the prospective payment
under section 256B.0625, subdivision 5m, for that service without a county contract or
county approval.
new text end

new text begin Subd. 7. new text end

new text begin Variances. new text end

new text begin When the standards listed in this section or other applicable standards
conflict or address similar issues in duplicative or incompatible ways, the commissioner
may grant variances to state requirements if the variances do not conflict with federal
requirements for services reimbursed under medical assistance. If standards overlap, the
commissioner may substitute all or a part of a licensure or certification that is substantially
the same as another licensure or certification. The commissioner must consult with
stakeholders before granting variances under this provision. For a CCBHC that is licensed
but not approved for prospective payment under section 256B.0625, subdivision 5m, the
commissioner may grant a variance under this paragraph if the variance does not increase
the state share of costs.
new text end

new text begin Subd. 8. new text end

new text begin Evidence-based practices. new text end

new text begin The commissioner must issue a list of required
evidence-based practices to be delivered by CCBHCs and may also provide a list of
recommended evidence-based practices. The commissioner may update the list to reflect
advances in outcomes research and medical services for persons living with mental illnesses
or substance use disorders. When developing the list, the commissioner must consider the
adequacy of evidence to support the efficacy of the practice across cultures and ages, the
workforce available, and the current availability of the practices in the state. At least 30
days before issuing the initial list or issuing any revisions, the commissioner must provide
stakeholders with an opportunity to comment.
new text end

new text begin Subd. 9. new text end

new text begin Outpatient mental health services. new text end

new text begin (a) A license holder must provide outpatient
mental health services that comply with the federal CCBHC criteria and applicable state
standards in this chapter, except as provided in this subdivision.
new text end

new text begin (b) Completion of an initial or comprehensive evaluation fulfills the requirements to
perform a diagnostic assessment in accordance with section 245I.10, subdivisions 2 and 6.
new text end

new text begin (c) An integrated treatment plan under this section fulfills the requirements to conduct
treatment planning in accordance with section 245I.10, subdivisions 7 and 8.
new text end

new text begin (d) A license holder under this section is exempt from certification as a mental health
clinic under section 245I.20.
new text end

new text begin Subd. 10. new text end

new text begin Outpatient substance use disorder treatment. new text end

new text begin (a) When a license holder
provides substance use disorder treatment services to an individual with a substance use
disorder diagnosis, the license holder must comply with the requirements for substance use
disorder treatment services in chapter 245G, except as provided in this subdivision.
new text end

new text begin (b) Completion of a preliminary screening and risk assessment under this section fulfills
the requirements to complete an initial services plan under section 245G.04, subdivision 1.
new text end

new text begin (c) Completion of a comprehensive evaluation under this section fulfills the requirements
to administer a comprehensive assessment under section 245G.05.
new text end

new text begin (d) An integrated treatment plan under this section that contains a six-dimension analysis
of the client's needs according to the third edition of ASAM criteria, as defined in section
254B.01, subdivision 2a, fulfills the requirements to provide an individual treatment plan
under section 245G.06.
new text end

new text begin (e) A license holder under this section fulfills the requirement to document personnel
files under section 245G.13, subdivision 3, by complying with the requirements of this
chapter.
new text end

new text begin (f) A license holder under this section fulfills the requirement to protect client rights
under section 245G.15 by complying with the requirements of section 245I.12.
new text end

new text begin (g) A license holder under this section fulfills the requirements to respond to behavioral
emergencies under section 245G.16 by complying with the requirements of section 245I.03,
subdivision 4.
new text end

new text begin (h) A license holder under this section is exempt from licensure under chapter 245G.
new text end

new text begin Subd. 11. new text end

new text begin Initial triage and risk assessment. new text end

new text begin (a) A license holder must have policies
and procedures on:
new text end

new text begin (1) how staff will implement the requirements of this subdivision;
new text end

new text begin (2) staff positions authorized to complete triage and risk assessments;
new text end

new text begin (3) documenting the results of the risk screenings; and
new text end

new text begin (4) ensuring the client is offered timely services according to the federal CCBHC criteria.
new text end

new text begin (b) A license holder must conduct an initial triage and risk assessment when a new client
requests services or is referred to services. A license holder may conduct an initial triage
and risk assessment in person, by telephone, or through other remote communication. Based
on the acuity of needs as assessed in the initial triage and risk assessment, the client must
be categorized as having emergency, urgent, or routine needs.
new text end

new text begin (c) Based on these categorizations, the license holder must offer services that meet the
relevant timelines under the federal CCBHC criteria.
new text end

new text begin (d) The license holder must provide training that addresses:
new text end

new text begin (1) when a prospective client requires intervention from qualified staff;
new text end

new text begin (2) the use of standardized measures that screen for significant risks;
new text end

new text begin (3) other factors that indicate a client has urgent needs besides the Columbia Suicide
Severity Rating Scale or a self-harm screening; and
new text end

new text begin (4) overdose and substance use disorder risks.
new text end

new text begin Subd. 12. new text end

new text begin Initial and comprehensive evaluation. new text end

new text begin (a) A license holder under this section
must provide initial and comprehensive evaluations according to this section and federal
CCBHC criteria.
new text end

new text begin (b) An initial evaluation is necessary to authorize the provision of all medically necessary
CCBHC services until the completion of a comprehensive evaluation. A comprehensive
evaluation is necessary to authorize the provision of all medically necessary CCBHC services
on an ongoing basis. A license holder must ensure that each client's comprehensive evaluation
reflects the needs and assessments for all services provided.
new text end

new text begin Subd. 13. new text end

new text begin Integrated treatment plan. new text end

new text begin (a) A license holder under this section must
complete an integrated treatment plan for each client following the client's comprehensive
evaluation no later than 60 calendar days after the date of the first request for services.
new text end

new text begin (b) A license holder must document all required services under subdivision 9 within the
integrated treatment plan based on the client's needs.
new text end

new text begin (c) A license holder must review and update a client's integrated treatment plan as
necessary to reflect the changing needs of the client and progress made in treatment. If the
client has not made treatment progress, updates to the treatment plan must indicate changes
in the license holder's approach to treatment to better meet the needs of the client. A license
holder must review and update the integrated treatment plan at least every 180 days or as
clinically indicated.
new text end

new text begin Subd. 14. new text end

new text begin Psychiatric rehabilitation services. new text end

new text begin (a) For children, a license holder under
this section must provide children's therapeutic services and supports according to sections
245I.30 and 245I.31, except that an initial or comprehensive assessment under this section
fulfills the requirement to perform a standard diagnostic assessment.
new text end

new text begin (b) For adults, a license holder under this section must provide adult rehabilitative mental
health services according to section 245I.22, except that:
new text end

new text begin (1) the license holder is exempt from the requirement to perform a level of care
assessment under section 245I.22, subdivision 6, paragraph (b); and
new text end

new text begin (2) an initial or comprehensive assessment under this section fulfills the requirement to
perform a standard diagnostic assessment.
new text end

new text begin Subd. 15. new text end

new text begin Community-based care for veterans. new text end

new text begin (a) The license holder must provide
services according to federal requirements for eligibility and coordination with TRICARE
and the United States Department of Veterans Affairs.
new text end

new text begin (b) The license holder must assign and document a principal behavioral health provider
for every veteran receiving services.
new text end

new text begin Subd. 16. new text end

new text begin Primary care screening and monitoring. new text end

new text begin To fulfill the requirements for
primary care screening, a license holder under this section must have policies and procedures
detailing the screenings to be performed with specific populations at the clinic. The policies
and procedures must be approved by the medical director.
new text end

new text begin Subd. 17. new text end

new text begin Peer services. new text end

new text begin A license holder must be able to provide peer services as
described by federal CCBHC criteria and sections 245G.07, subdivision 2, clause (8),
256B.0615, and 256B.0616.
new text end

new text begin Subd. 18. new text end

new text begin Targeted case management. new text end

new text begin (a) A license holder must provide mental health
targeted case management as described by federal CCBHC criteria and section 256B.0625,
subdivision 20.
new text end

new text begin (b) An initial or comprehensive evaluation under this section fulfills any requirement
to perform a standard diagnostic assessment for targeted case management.
new text end

new text begin Subd. 19. new text end

new text begin Community needs assessment. new text end

new text begin (a) The community needs assessment must
be a collaborative document that reflects the license holder's or applicant's engagement with
current clients, other social and medical services agencies, community groups, underserved
populations, and government agencies. The applicant or license holder must document an
outreach plan within the community needs assessment to demonstrate how stakeholder
feedback was solicited and reflected in the plan.
new text end

new text begin (b) The applicant or license holder must publicly post a draft community needs assessment
on the organization's website for 30 days and submit a summary of public comments and
recommendations from the comment period to the commissioner.
new text end

new text begin (c) In the draft community needs assessment, the applicant or license holder must declare
a planned geographic service delivery area in which the CCBHC will be capable of providing
all nine required services. An applicant must provide an analysis of how CCBHC status
will lead to a significant improvement in the availability and quality of the services. An
existing license holder must include analysis of which needs from prior needs assessments
have been improved by the operation of the CCBHC. A clinic that has not made and
demonstrated substantial progress in addressing the identified needs must specify what
changes will occur to address the lack of progress.
new text end

new text begin (d) The commissioner must provide feedback and technical assistance if the community
needs assessment must be revised.
new text end

new text begin Subd. 20. new text end

new text begin Staffing plan. new text end

new text begin Based on an accepted community needs assessment, the
applicant or license holder must complete a staffing plan. The staffing plan must include
analysis of the extent to which identified staffing levels will be capable of meeting the needs
identified in the community needs assessment.
new text end

new text begin Subd. 21. new text end

new text begin Data and evaluation. new text end

new text begin A provider must submit documentation that establishes
the ability of the clinic to complete the required data collection as a CCBHC, as determined
by the commissioner. For an applicant that is an existing provider, the commissioner must
review and evaluate data submitted related to claims, grants, and other reporting to ensure
the data meets reporting requirements.
new text end

new text begin Subd. 22. new text end

new text begin Cost reporting. new text end

new text begin A provider must submit a cost report on the forms and in the
manner required in section 256B.0625, subdivision 5m.
new text end

Sec. 31.

new text begin [245I.22] ADULT REHABILITATIVE MENTAL HEALTH SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin Beginning January 1, 2028, a provider of adult mental health
rehabilitative services must be licensed under this section and chapter 245A.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms in this subdivision have
the meanings given.
new text end

new text begin (b) "Adult mental health rehabilitative services" or "ARMHS" has the meaning given
in section 245I.02, subdivision 33.
new text end

new text begin (c) "Basic living skills" means rehabilitative interventions that instruct, assist, and support
the client with:
new text end

new text begin (1) interpersonal communication skills;
new text end

new text begin (2) community resource utilization and integration skills;
new text end

new text begin (3) crisis planning;
new text end

new text begin (4) relapse prevention skills;
new text end

new text begin (5) health care directives;
new text end

new text begin (6) budgeting and shopping skills;
new text end

new text begin (7) healthy lifestyle skills and practices;
new text end

new text begin (8) cooking and nutrition skills;
new text end

new text begin (9) transportation skills;
new text end

new text begin (10) mental illness symptom management skills;
new text end

new text begin (11) household management skills;
new text end

new text begin (12) employment-related skills; and
new text end

new text begin (13) parenting skills.
new text end

new text begin (d) "Community intervention" means a client's community assisting in the client's
rehabilitation, including consultation with relatives, guardians, friends, employers, treatment
providers, and other significant individuals. Community intervention is appropriate when
directed exclusively to the treatment of the client.
new text end

new text begin (e) "Medication education services" means services provided individually or in groups
that focus on educating the client about mental illness and symptoms, the role and effects
of medications in treating symptoms of mental illness, and the side effects of medications.
Medication education services must be coordinated with, but must not duplicate, medication
management services. Medication education services must be provided by physicians,
advanced practice registered nurses, pharmacists, physician assistants, or registered nurses.
new text end

new text begin (f) "Transition to community living services" means services that maintain continuity
of contact between the ARMHS provider and the client and facilitate discharge from a
hospital, residential treatment program, board and lodging facility, or nursing home.
Transition to community living services must not be used to provide other areas of adult
rehabilitative mental health services.
new text end

new text begin Subd. 3. new text end

new text begin Service components. new text end

new text begin An ARMHS provider must be capable of providing:
new text end

new text begin (1) basic living skills;
new text end

new text begin (2) medication education services;
new text end

new text begin (3) community intervention; and
new text end

new text begin (4) transition to community living services.
new text end

new text begin Subd. 4. new text end

new text begin Provider requirements. new text end

new text begin An ARMHS license holder must be enrolled with
medical assistance and comply with standards in section 256B.0623.
new text end

new text begin Subd. 5. new text end

new text begin Qualifications. new text end

new text begin ARMHS must be provided by:
new text end

new text begin (1) a mental health professional qualified under section 245I.04, subdivision 2;
new text end

new text begin (2) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8;
new text end

new text begin (3) a clinical trainee qualified under section 245I.04, subdivision 6;
new text end

new text begin (4) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
new text end

new text begin (5) a mental health certified peer specialist qualified under section 245I.04, subdivision
12; or
new text end

new text begin (6) a mental health rehabilitation worker qualified under section 245I.04, subdivision
14.
new text end

new text begin Subd. 6. new text end

new text begin Service planning. new text end

new text begin (a) An ARMHS provider must complete a written functional
assessment according to section 245I.10, subdivision 9, for each client.
new text end

new text begin (b) When an ARMHS provider completes a written functional assessment, the provider
must also complete a level of care assessment, as defined in section 245I.02, subdivision
19, for the client.
new text end

new text begin Subd. 7. new text end

new text begin Group modality. new text end

new text begin ARMHS may be provided in group settings if appropriate
to each participating client's needs and treatment plan. A group is defined as two to ten
clients, at least one of whom is concurrently receiving ARMHS. The service and group
must be specified in the client's individual treatment plan.
new text end

Sec. 32.

new text begin [245I.24] MOBILE CRISIS RESPONSE SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin (a) Mobile crisis response services provide short-term,
face-to-face mental health care in community settings for adults and children experiencing
crisis to help individuals maintain safety and return to a baseline level of functioning.
new text end

new text begin (b) Beginning January 1, 2028, a provider of mobile crisis response services must be
licensed under this section and chapter 245A.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms in this subdivision have
the meanings given.
new text end

new text begin (b) "Crisis assessment" means an immediate face-to-face assessment by a physician, a
mental health professional, or a qualified member of a crisis team, as described in subdivision
5.
new text end

new text begin (c) "Crisis intervention" means face-to-face, short-term intensive mental health services
initiated during a mental health crisis to help an individual cope with immediate stressors,
identify and utilize available resources and strengths, engage in voluntary treatment, and
begin to return to the individual's baseline level of functioning.
new text end

new text begin (d) "Crisis screening" means a screening of a client's potential mental health crisis
situation under subdivision 6.
new text end

new text begin (e) "Crisis stabilization services" means individualized mental health services that are
designed to restore an individual to the individual's baseline level of functioning. Crisis
stabilization services may be provided in the individual's home, the home of a family member
or friend of the individual, another community setting, a short-term supervised licensed
residential program, or an emergency department. Crisis stabilization services include family
psychoeducation.
new text end

new text begin (f) "Crisis team" means the staff of a provider entity who are supervised and prepared
to provide mobile crisis services to a client in a potential mental health crisis situation.
new text end

new text begin (g) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without
the provision of crisis response services, would likely result in significantly reducing the
individual's levels of functioning in primary activities of daily living, the individual needing
emergency services under section 62Q.55, or the individual being placed in a more restrictive
setting, including but not limited to inpatient hospitalization.
new text end

new text begin (h) "Mobile crisis services" means screening, assessment, intervention, and
community-based crisis stabilization services that are provided to an individual client.
Mobile crisis services does not include residential crisis stabilization.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) An individual is eligible for crisis assessment services when the
person has screened positive for a potential mental health crisis during a crisis screening.
new text end

new text begin (b) An individual is eligible for crisis intervention services and crisis stabilization services
when the individual has been assessed during a crisis assessment to be experiencing a mental
health crisis.
new text end

new text begin Subd. 4. new text end

new text begin Policies, procedures, and practices specified. new text end

new text begin (a) In addition to the policies
and procedures required by section 245I.03, the license holder must establish, enforce, and
maintain policies and procedures to:
new text end

new text begin (1) ensure that crisis screenings, crisis assessments, and crisis intervention services are
available 24 hours per day, seven days per week;
new text end

new text begin (2) respond to a call for services in a designated service area or according to a written
agreement with the local mental health authority for an adjacent area;
new text end

new text begin (3) have at least one mental health professional on staff at all times and at least one
additional staff member capable of leading a crisis response in the community; and
new text end

new text begin (4) respond to clients in the community according to the requirements and priorities in
subdivision 6.
new text end

new text begin (b) The license holder must provide the commissioner with information about the number
of requests for service, the number of clients that the provider serves face-to-face, and client
outcomes at least every six months, in a form and manner prescribed by the commissioner.
new text end

new text begin (c) The license holder must:
new text end

new text begin (1) provide support for an individual's family and natural supports by enabling the
individual's family and natural supports to observe and participate in the individual's
treatment, assessments, and planning services;
new text end

new text begin (2) implement culturally specific treatment identified in the crisis treatment plan that is
meaningful and appropriate, as determined by the individual's culture, beliefs, values, and
language;
new text end

new text begin (3) respond to an individual's changing intervention and care needs, as identified by the
individual or a family member; and
new text end

new text begin (4) have the communication tools and procedures to communicate and consult promptly
about crisis assessment and interventions as services are provided.
new text end

new text begin (d) The license holder must coordinate services with:
new text end

new text begin (1) county emergency services under section 245.469, community hospitals, ambulance
services, transportation services, social services, law enforcement, engagement services,
and mental health crisis services through regularly scheduled interagency meetings;
new text end

new text begin (2) other behavioral health service providers, county mental health authorities, or federally
recognized American Indian authorities, and others as necessary, with the consent of the
individual or parent or guardian;
new text end

new text begin (3) detoxification, withdrawal management services, and medical stabilization services
as needed; and
new text end

new text begin (4) the individual's case manager if the individual is receiving case management services.
new text end

new text begin Subd. 5. new text end

new text begin Crisis assessment and intervention staff qualifications. new text end

new text begin (a) Crisis assessment
and intervention services must be provided by:
new text end

new text begin (1) a mental health professional qualified under section 245I.04, subdivision 2;
new text end

new text begin (2) a clinical trainee qualified under section 245I.04, subdivision 6;
new text end

new text begin (3) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
new text end

new text begin (4) a mental health certified family peer specialist qualified under section 245I.04,
subdivision 12; or
new text end

new text begin (5) a mental health certified peer specialist qualified under section 245I.04, subdivision
10.
new text end

new text begin (b) When crisis assessment and intervention services are provided to an individual in
the community, a mental health professional, clinical trainee, or mental health practitioner
must lead the response.
new text end

new text begin (c) For providers under this section, the 30 hours of ongoing training required by section
245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children
and adults and include training about evidence-based practices identified by the commissioner
of health to reduce the individual's risk of suicide and self-injurious behavior.
new text end

new text begin (d) At least six hours of the ongoing training under paragraph (c) must be specific to
working with families and providing crisis stabilization services to children and include the
following topics:
new text end

new text begin (1) developmental tasks of childhood and adolescence;
new text end

new text begin (2) family relationships;
new text end

new text begin (3) child and youth engagement and motivation, including motivational interviewing;
new text end

new text begin (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
queer youth;
new text end

new text begin (5) positive behavior support;
new text end

new text begin (6) crisis intervention for youth with developmental disabilities;
new text end

new text begin (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
new text end

new text begin (8) youth substance use.
new text end

new text begin (e) Individual providers must be experienced in crisis assessment, crisis intervention
techniques, treatment engagement strategies, working with families, and clinical decision
making under emergency conditions and have knowledge of local services and resources.
new text end

new text begin Subd. 6. new text end

new text begin Crisis screening. new text end

new text begin (a) A license holder may use the resources of emergency
services under section 245.469 for crisis screening. The crisis screening must gather
information, determine whether a mental health crisis situation exists, identify parties
involved, and determine an appropriate response.
new text end

new text begin (b) When conducting a crisis screening, a provider must:
new text end

new text begin (1) employ evidence-based practices to reduce the individual's risk of suicide and
self-injurious behavior;
new text end

new text begin (2) work with the individual to establish a plan and time frame for responding to the
individual's mental health crisis, including responding to the individual's immediate need
for support by telephone or text message until the provider can respond to the individual
face-to-face;
new text end

new text begin (3) document significant factors in determining whether the individual is experiencing
a mental health crisis, including prior requests for crisis services, an individual's recent
presentation at an emergency department, known calls to 911 or law enforcement, or
information from third parties with knowledge of an individual's history or current needs;
new text end

new text begin (4) accept calls from interested third parties and consider the additional needs or potential
mental health crises that the third parties may be experiencing;
new text end

new text begin (5) provide psychoeducation, including reducing access to means of suicide, to relevant
third parties including family members or other persons living with the individual; and
new text end

new text begin (6) consider other available services to determine which service intervention would best
address the individual's needs and circumstances.
new text end

new text begin (c) For purposes of this section, the following situations indicate a positive screen for a
potential mental health crisis:
new text end

new text begin (1) the individual presents at an emergency department or urgent care setting and the
health care team at that location requested crisis services; or
new text end

new text begin (2) a peace officer requested crisis services for an individual who is potentially subject
to transportation under section 253B.051.
new text end

new text begin (d) The provider must prioritize providing a face-to-face crisis assessment of the
individual, unless a provider documents specific evidence to show why the face-to-face
assessment was not possible, including insufficient staffing resources, concerns for staff or
individual safety, or other clinical factors.
new text end

new text begin (e) A provider is not required to have direct contact with the individual to determine
that the individual is experiencing a potential mental health crisis. A mobile crisis provider
may gather relevant information about the individual from a third party to establish the
individual's need for services and potential safety factors.
new text end

new text begin Subd. 7. new text end

new text begin Crisis assessment. new text end

new text begin (a) If an individual screens positive for a potential mental
health crisis, a crisis assessment must be completed. A crisis assessment must evaluate any
immediate needs for which services are needed and, as time permits, the individual's:
new text end

new text begin (1) current life situation;
new text end

new text begin (2) health information, including current medications;
new text end

new text begin (3) sources of stress;
new text end

new text begin (4) mental health problems and symptoms;
new text end

new text begin (5) strengths;
new text end

new text begin (6) cultural considerations;
new text end

new text begin (7) support network;
new text end

new text begin (8) vulnerabilities;
new text end

new text begin (9) current functioning; and
new text end

new text begin (10) preferences, as communicated directly by the individual or as communicated in a
health care directive as described in chapters 145C and 253B, the crisis treatment plan
described in subdivision 11, a crisis prevention plan, or a wellness recovery action plan.
new text end

new text begin (b) A provider must conduct a crisis assessment at the individual's location when
appropriate and, when not appropriate, document the reasons.
new text end

new text begin (c) Whenever possible, the assessor must attempt to include input from the individual,
the individual's family, and other natural supports to assess whether a crisis exists.
new text end

new text begin (d) A crisis assessment must include a determination of:
new text end

new text begin (1) whether the individual is willing to voluntarily engage in treatment;
new text end

new text begin (2) whether the individual has an advance directive; and
new text end

new text begin (3) gathering the individual's information and history from involved family or other
natural supports.
new text end

new text begin (e) If a team determines that the individual does not need an acute level of care, the team
must provide services or service coordination if the individual has a co-occurring substance
use disorder and is otherwise eligible for services.
new text end

new text begin (f) If, after completing a crisis assessment, a provider refers the individual to an intensive
setting, including an emergency department, inpatient hospitalization, or residential crisis
stabilization, one of the crisis team members who completed or conferred about the
individual's crisis assessment must immediately contact the referral entity and consult with
the staff responsible for triage or intake at the referral entity. During the consultation, the
crisis team member must convey key findings or concerns that led to the individual's referral.
Following the consultation, the provider must also send written documentation to the referral
entity. The provider must document if the individual or the individual's legal guardian signed
releases for health records or if an exception under section 144.293, subdivision 5, exists.
new text end

new text begin Subd. 8. new text end

new text begin Crisis intervention services. new text end

new text begin (a) If the crisis assessment determines an individual
needs mobile crisis intervention services, the license holder must provide crisis intervention
services promptly. As able during the intervention, at least two members of the mobile crisis
intervention team must confer directly or by telephone about the crisis assessment, crisis
treatment plan, and actions taken and needed. At least one of the team members must be
providing face-to-face crisis intervention services. If providing crisis intervention services,
a clinical trainee or mental health practitioner must seek treatment supervision as required
in subdivision 10.
new text end

new text begin (b) If a provider delivers crisis intervention services while the individual is absent, the
provider must document the reason for delivering services while the individual is absent.
new text end

new text begin (c) The mobile crisis intervention team must develop a crisis treatment plan according
to subdivision 11.
new text end

new text begin (d) The mobile crisis intervention team must document which crisis treatment plan goals
and objectives have been met and when no further crisis intervention services are required.
new text end

new text begin (e) If the individual's mental health crisis is stabilized, but the individual needs a referral
to other services, the team must provide referrals to these services. If the individual is unable
to follow up on the referral, the team must link the individual to the service and follow up
to ensure the individual is receiving the service.
new text end

new text begin Subd. 9. new text end

new text begin Crisis stabilization services. new text end

new text begin (a) Crisis stabilization services must be provided
by qualified staff of a crisis stabilization services provider entity, which must:
new text end

new text begin (1) develop a crisis treatment plan that meets the criteria in subdivision 11;
new text end

new text begin (2) complete a vulnerable adult determination in accordance with section 245A.65,
subdivision 1a;
new text end

new text begin (3) deliver crisis stabilization services according to the crisis treatment plan and include
face-to-face contact with the individual receiving services by qualified staff for further
assessment, help with referrals, updating of the crisis treatment plan, skills training, and
collaboration with other service providers in the community;
new text end

new text begin (4) if the provider delivers crisis stabilization services while the individual is absent,
document the reason for delivering services while the individual is absent; and
new text end

new text begin (5) if the individual's mental health crisis is stabilized and the individual does not have
a health care directive or psychiatric declaration, as defined in chapter 145C or section
253B.03, subdivision 6d, offer to work with the individual to develop a directive or
declaration.
new text end

new text begin (b) A staff member providing crisis stabilization services must be:
new text end

new text begin (1) a mental health professional qualified under section 245I.04, subdivision 2;
new text end

new text begin (2) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8;
new text end

new text begin (3) a clinical trainee qualified under section 245I.04, subdivision 6;
new text end

new text begin (4) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
new text end

new text begin (5) a mental health certified family peer specialist qualified under section 245I.04,
subdivision 12;
new text end

new text begin (6) a mental health certified peer specialist qualified under section 245I.04, subdivision
10; or
new text end

new text begin (7) a mental health rehabilitation worker qualified under section 245I.04, subdivision
14.
new text end

new text begin (c) For providers under this section, the 30 hours of ongoing training required in section
245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children
and adults and include training about evidence-based practices identified by the commissioner
of health to reduce an individual's risk of suicide and self-injurious behavior.
new text end

new text begin (d) For providers who deliver care to children 21 years of age or younger, at least six
hours of the ongoing training under this subdivision must be specific to working with families
and providing crisis stabilization services to children, including the following topics:
new text end

new text begin (1) developmental tasks of childhood and adolescence;
new text end

new text begin (2) family relationships;
new text end

new text begin (3) child and youth engagement and motivation, including motivational interviewing;
new text end

new text begin (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
queer youth;
new text end

new text begin (5) positive behavior support;
new text end

new text begin (6) crisis intervention for youth with developmental disabilities;
new text end

new text begin (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
new text end

new text begin (8) youth substance use.
new text end

new text begin This paragraph does not apply to adult residential crisis stabilization services providers
licensed under section 245I.23 or providing services pursuant to section 256B.0624,
subdivision 7a.
new text end

new text begin Subd. 10. new text end

new text begin Supervision. new text end

new text begin Clinical trainees and mental health practitioners may provide
crisis assessment and crisis intervention services if the following treatment supervision
requirements are met:
new text end

new text begin (1) the license holder must accept full responsibility for the services provided;
new text end

new text begin (2) a mental health professional working for the license holder must be immediately
available by telephone or in person for treatment supervision;
new text end

new text begin (3) a mental health professional must be consulted, in person or by telephone, during
the first three hours when a clinical trainee or mental health practitioner provides crisis
assessment or crisis intervention services; and
new text end

new text begin (4) a mental health professional must:
new text end

new text begin (i) review and approve, as defined in section 245I.02, subdivision 2, the tentative crisis
assessment and crisis treatment plan within 24 hours of first providing services to the
individual, notwithstanding section 245I.08, subdivision 3; and
new text end

new text begin (ii) document the consultation required in clause (3).
new text end

new text begin Subd. 11. new text end

new text begin Crisis treatment plan. new text end

new text begin (a) Within 24 hours of an individual's admission, the
license holder must complete the individual's crisis treatment plan. The license holder must:
new text end

new text begin (1) base the individual's crisis treatment plan on the individual's crisis assessment;
new text end

new text begin (2) consider crisis assistance strategies that have been effective for the individual in the
past;
new text end

new text begin (3) for a child, use a child-centered, family-driven, and culturally appropriate planning
process that allows the child's parents and guardians to observe or participate in the child's
individual and family treatment services, assessment, and treatment planning;
new text end

new text begin (4) for an adult, use a person-centered, culturally appropriate planning process that allows
the individual's family and other natural supports to observe or participate in treatment
services, assessment, and treatment planning;
new text end

new text begin (5) identify the participants involved in the individual's treatment planning. The individual
must be a participant if possible;
new text end

new text begin (6) identify the individual's initial treatment goals, measurable treatment objectives, and
specific interventions that the license holder will use to help the person engage in treatment;
new text end

new text begin (7) include documentation of referral to and scheduling of services, including specific
providers where applicable;
new text end

new text begin (8) ensure that the individual or the individual's legal guardian approves under section
245I.02, subdivision 2, of the individual's crisis treatment plan unless a court orders the
individual's treatment plan under chapter 253B. If the individual or the individual's legal
guardian disagrees with the crisis treatment plan, the license holder must document in the
client file the reasons why the individual disagrees with the crisis treatment plan; and
new text end

new text begin (9) ensure that a treatment supervisor approves, as defined in section 245I.02, subdivision
2, of the individual's treatment plan within 24 hours of the individual's admission if a mental
health practitioner or clinical trainee completes the crisis treatment plan, notwithstanding
section 245I.08, subdivision 3.
new text end

new text begin (b) The provider entity must provide the individual and the individual's legal guardian
with a copy of the crisis treatment plan.
new text end

new text begin Subd. 12. new text end

new text begin Application requirements. new text end

new text begin In a licensing application submitted under this
section and section 245A.04, the applicant must demonstrate that the applicant is:
new text end

new text begin (1) enrolled as a medical assistance provider; and
new text end

new text begin (2) in compliance with the provider type requirements under section 256B.0624,
subdivision 4, as determined by the commissioner.
new text end

Sec. 33.

new text begin [245I.30] CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin (a) "Children's therapeutic services and supports" means a
flexible package of community-based mental health services for children who require varying
therapeutic and rehabilitative levels of intervention to treat a diagnosed mental illness.
Interventions are delivered using various treatment modalities and combinations of services
designed to reach treatment outcomes identified in the individual treatment plan. Children's
therapeutic services and supports include development and rehabilitative services that
support a child's developmental treatment needs.
new text end

new text begin (b) Beginning January 1, 2028, a provider of children's therapeutic services and supports
must be licensed under this section and chapter 245A.
new text end

new text begin Subd. 2. new text end

new text begin Service components. new text end

new text begin (a) A children's therapeutic services and supports license
holder must be capable of providing:
new text end

new text begin (1) individual and family psychotherapy, psychotherapy for crises, and group
psychotherapy;
new text end

new text begin (2) individual, family, or group skills training; and
new text end

new text begin (3) crisis planning.
new text end

new text begin (b) Crisis planning that meets the standards in section 245.4871, subdivision 9a, must
be offered to each client's family.
new text end

new text begin Subd. 3. new text end

new text begin Provider requirements. new text end

new text begin A children's therapeutic services and supports license
holder must be enrolled with medical assistance and comply with the requirements in section
256B.0943.
new text end

new text begin Subd. 4. new text end

new text begin Qualifications of provider staff. new text end

new text begin Children's therapeutic services and supports
must be provided by:
new text end

new text begin (1) a mental health professional qualified under section 245I.04, subdivision 2;
new text end

new text begin (2) a clinical trainee qualified under section 245I.04, subdivision 6;
new text end

new text begin (3) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
new text end

new text begin (4) a mental health certified family peer specialist qualified under section 245I.04,
subdivision 12; or
new text end

new text begin (5) a mental health behavioral aide qualified under section 245I.04, subdivision 16.
new text end

new text begin Subd. 5. new text end

new text begin Group modality. new text end

new text begin Group skills training may be provided to multiple clients
who, because of the nature of the clients' emotional, behavioral, or social dysfunction, can
derive mutual benefit from interaction in a group setting. A group must consist of two to
ten clients, at least one of whom is a client and is concurrently receiving a service under
this section. The service and group must be specified in the client's individual treatment
plan.
new text end

Sec. 34.

new text begin [245I.31] CHILDREN'S DAY TREATMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin (a) For purposes of this section, "children's day treatment
program" means a site-based structured mental health program consisting of psychotherapy
and individual or group skills training provided by a team under the treatment supervision
of a mental health professional.
new text end

new text begin (b) A children's day treatment program must be licensed for a specific location of
operation and must not be part of inpatient or residential treatment services.
new text end

new text begin (c) A children's day treatment program must stabilize a client's mental health status while
developing and improving the client's independent living and socialization skills. The goal
of the day treatment program must be to reduce or relieve the effects of mental illness and
provide training to enable the client to live in the community.
new text end

new text begin (d) Beginning January 1, 2028, a provider of children's day services must be licensed
under this section and chapter 245A.
new text end

new text begin Subd. 2. new text end

new text begin Service components. new text end

new text begin A children's day treatment program must be capable of
providing the services in section 245I.30, subdivision 2.
new text end

new text begin Subd. 3. new text end

new text begin Provider requirements. new text end

new text begin A children's day treatment license holder must:
new text end

new text begin (1) be enrolled as a provider with medical assistance;
new text end

new text begin (2) maintain a policy regarding the use of restrictive procedures and meet the requirements
of section 245.8261;
new text end

new text begin (3) maintain a policy on medications in accordance with section 245I.11, subdivision
6; and
new text end

new text begin (4) meet group modality requirements in section 245I.30, subdivision 5.
new text end

new text begin Subd. 4. new text end

new text begin Qualifications of provider staff. new text end

new text begin Children's day treatment services must be
provided by:
new text end

new text begin (1) a mental health professional qualified under section 245I.04, subdivision 2;
new text end

new text begin (2) a clinical trainee qualified under section 245I.04, subdivision 6; or
new text end

new text begin (3) a behavioral health practitioner qualified under section 245I.04, subdivision 4.
new text end

Sec. 35.

Minnesota Statutes 2024, section 256B.0623, subdivision 1, is amended to read:

Subdivision 1.

Scope.

deleted text begin Subject to federal approval, deleted text end Medical assistance covers medically
necessary adult rehabilitative mental health services when the services are provided by an
entity deleted text begin meeting the standards in this section deleted text end new text begin licensed under section 245I.24 new text end . The provider
entity must make reasonable and good faith efforts to report individual client outcomes to
the commissioner, using instruments and protocols approved by the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 36.

Minnesota Statutes 2024, section 256B.0623, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

An eligible recipient is an individual who:

(1) is age 18 or older;

(2) is diagnosed with a medical condition, such as mental illness or traumatic brain
injury, for which adult rehabilitative mental health services are needed;

(3) has substantial disability and functional impairment in three or more of the areas
listed in section 245I.10, subdivision 9, paragraph (a), clause (4), so that self-sufficiency is
markedly reduced; and

(4) has had a recent standard diagnostic assessment new text begin pursuant to section 245I.10,
subdivision 6, new text end by a qualified professional that documents adult rehabilitative mental health
services are medically necessary to address identified disability and functional impairments
and individual recipient goals.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 37.

Minnesota Statutes 2024, section 256B.0623, subdivision 12, is amended to read:

Subd. 12.

Additional requirements.

deleted text begin (a) Providers of adult rehabilitative mental health
services must comply with the requirements relating to referrals for case management in
section 245.467, subdivision 4.
deleted text end

deleted text begin (b) Adult rehabilitative mental health services are provided for most recipients in the
recipient's home and community. Services may also be provided at the home of a relative
or significant other, job site, psychosocial clubhouse, drop-in center, social setting, classroom,
or other places in the community. deleted text end new text begin (a) new text end Except for "transition to community services," the
place of service does not include a regional treatment center, nursing home, residential
treatment facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36),
or section 245I.23, or an acute care hospital.

deleted text begin (c) Adult rehabilitative mental health services may be provided in group settings if
appropriate to each participating recipient's needs and individual treatment plan. A group
is defined as two to ten clients, at least one of whom is a recipient, who is concurrently
receiving a service which is identified in this section. The service and group must be specified
in the recipient's individual treatment plan. deleted text end new text begin (b) new text end No more than two qualified staff may bill
Medicaid for services provided to the same group of recipients. If two adult rehabilitative
mental health workers bill for recipients in the same group session, they must each bill for
different recipients.

deleted text begin (d) deleted text end new text begin (c) new text end Adult rehabilitative mental health services are appropriate if provided to enable
a recipient to retain stability and functioning, when the recipient is at risk of significant
functional decompensation or requiring more restrictive service settings without these
services.

deleted text begin (e) Adult rehabilitative mental health services instruct, assist, and support the recipient
in areas including: interpersonal communication skills, community resource utilization and
integration skills, crisis planning, relapse prevention skills, health care directives, budgeting
and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills,
transportation skills, medication education and monitoring, mental illness symptom
management skills, household management skills, employment-related skills, parenting
skills, and transition to community living services.
deleted text end

deleted text begin (f) Community intervention, including consultation with relatives, guardians, friends,
employers, treatment providers, and other significant individuals, is appropriate when
directed exclusively to the treatment of the client.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 38.

Minnesota Statutes 2024, section 256B.0624, subdivision 1, is amended to read:

Subdivision 1.

Scope.

(a) deleted text begin Subject to federal approval, deleted text end Medical assistance covers medically
necessary crisis response services when the services are provided according to the standards
in deleted text begin this deleted text end section new text begin 245I.24 new text end .

(b) deleted text begin Subject to federal approval, deleted text end Medical assistance covers medically necessary residential
crisis stabilization for adults when the services are provided by an entity licensed under and
meeting the standards in section 245I.23 or an entity with an adult foster care license meeting
the standards in deleted text begin this section deleted text end new text begin subdivision 7a new text end .

(c) The provider entity must make reasonable and good faith efforts to report individual
client outcomes to the commissioner using instruments and protocols approved by the
commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 39.

Minnesota Statutes 2024, section 256B.0624, subdivision 4, is amended to read:

Subd. 4.

Provider entity standards.

(a) A mobile crisis provider must be:

(1) a county board operated entity;

(2) an Indian health services facility or facility owned and operated by a tribe or Tribal
organization operating under United States Code, title 325, section 450f; or

(3) a provider entity that is under contract with the county board in the county where
the potential crisis or emergency is occurring. To provide services under this section, the
provider entity must directly provide the services; or if services are subcontracted, the
provider entity must maintain responsibility for services and billing.

deleted text begin (b) A mobile crisis provider must meet the following standards:
deleted text end

deleted text begin (1) ensure that crisis screenings, crisis assessments, and crisis intervention services are
available to a recipient 24 hours a day, seven days a week;
deleted text end

deleted text begin (2) be able to respond to a call for services in a designated service area or according to
a written agreement with the local mental health authority for an adjacent area;
deleted text end

deleted text begin (3) have at least one mental health professional on staff at all times and at least one
additional staff member capable of leading a crisis response in the community; and
deleted text end

deleted text begin (4) provide the commissioner with information about the number of requests for service,
the number of people that the provider serves face-to-face, outcomes, and the protocols that
the provider uses when deciding when to respond in the community.
deleted text end

deleted text begin (c) A provider entity that provides crisis stabilization services in a residential setting
under subdivision 7 is not required to meet the requirements of paragraphs (a) and (b), but
must meet all other requirements of this subdivision.
deleted text end

deleted text begin (d) A crisis services provider must have the capacity to meet and carry out the standards
in section 245I.011, subdivision 5, and the following standards:
deleted text end

deleted text begin (1) ensures that staff persons provide support for a recipient's family and natural supports,
by enabling the recipient's family and natural supports to observe and participate in the
recipient's treatment, assessments, and planning services;
deleted text end

deleted text begin (2) has adequate administrative ability to ensure availability of services;
deleted text end

deleted text begin (3) is able to ensure that staff providing these services are skilled in the delivery of
mental health crisis response services to recipients;
deleted text end

deleted text begin (4) is able to ensure that staff are implementing culturally specific treatment identified
in the crisis treatment plan that is meaningful and appropriate as determined by the recipient's
culture, beliefs, values, and language;
deleted text end

deleted text begin (5) is able to ensure enough flexibility to respond to the changing intervention and care
needs of a recipient as identified by the recipient or family member during the service
partnership between the recipient and providers;
deleted text end

deleted text begin (6) is able to ensure that staff have the communication tools and procedures to
communicate and consult promptly about crisis assessment and interventions as services
occur;
deleted text end

deleted text begin (7) is able to coordinate these services with county emergency services, community
hospitals, ambulance, transportation services, social services, law enforcement, engagement
services, and mental health crisis services through regularly scheduled interagency meetings;
deleted text end

deleted text begin (8) is able to ensure that services are coordinated with other behavioral health service
providers, county mental health authorities, or federally recognized American Indian
authorities and others as necessary, with the consent of the recipient or parent or guardian.
Services must also be coordinated with the recipient's case manager if the recipient is
receiving case management services;
deleted text end

deleted text begin (9) is able to ensure that crisis intervention services are provided in a manner consistent
with sections 245.461 to 245.486 and 245.487 to 245.4879;
deleted text end

deleted text begin (10) is able to coordinate detoxification services for the recipient according to Minnesota
Rules, parts 9530.6605 to 9530.6655, or withdrawal management according to chapter 245F;
deleted text end

deleted text begin (11) is able to establish and maintain a quality assurance and evaluation plan to evaluate
the outcomes of services and recipient satisfaction; and
deleted text end

deleted text begin (12) is an enrolled medical assistance provider.
deleted text end

new text begin (b) A mobile crisis provider must ensure services are provided consistent with section
245.469, subdivisions 1 and 2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 40.

Minnesota Statutes 2024, section 256B.0624, is amended by adding a subdivision
to read:

new text begin Subd. 7a. new text end

new text begin Residential crisis stabilization services in adult foster care settings. new text end

new text begin (a) If
crisis stabilization services are provided in a supervised, licensed residential setting that
serves no more than four adult residents, and one or more individuals are present at the
setting to receive residential crisis stabilization, the residential setting staff must include,
for at least eight hours per day, at least one mental health professional, clinical trainee,
certified rehabilitation specialist, or mental health practitioner.
new text end

new text begin (b) The commissioner must establish a statewide per diem rate for crisis stabilization
services provided under this paragraph to medical assistance enrollees. The rate for a provider
must not exceed the rate charged by that provider for the same service to other payers.
Payment must not be made to more than one entity for each individual for services provided
under this paragraph on a given day. The commissioner must set rates prospectively for the
annual rate period. The commissioner must require providers to submit annual cost reports
on a uniform cost reporting form and use submitted cost reports to inform the rate-setting
process. The commissioner must recalculate the statewide per diem every year.
new text end

new text begin (c) A provider under this subdivision must follow the requirements under section 245I.24,
subdivisions 4, paragraphs (c) and (d), and 9.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 41.

Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 5m, is
amended to read:

Subd. 5m.

Certified community behavioral health clinic services.

(a) Medical
assistance covers services provided by a not-for-profit certified community behavioral health
clinic (CCBHC) that meets the requirements of section deleted text begin 245.735, subdivision 3 deleted text end new text begin 245I.17 new text end .

(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an
eligible service is delivered using the CCBHC daily bundled rate system for medical
assistance payments as described in paragraph (c). The commissioner shall include a quality
incentive payment in the CCBHC daily bundled rate system as described in paragraph (e).
There is no county share for medical assistance services when reimbursed through the
CCBHC daily bundled rate system.

(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC
payments under medical assistance meets the following requirements:

(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each
CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable
CCBHC costs divided by the total annual number of CCBHC visits. For calculating the
payment rate, total annual visits include visits covered by medical assistance and visits not
covered by medical assistance. Allowable costs include but are not limited to the salaries
and benefits of medical assistance providers; the cost of CCBHC services provided under
section deleted text begin 245.735, subdivision 3, paragraph (a), clauses (6) and (7) deleted text end new text begin 245I.17, subdivision 4 new text end ;
and other costs such as insurance or supplies needed to provide CCBHC services;

(2) payment shall be limited to one payment per day per medical assistance enrollee
when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement
if at least one of the CCBHC services listed under section deleted text begin 245.735, subdivision 3, paragraph
(a), clause (6) deleted text end new text begin 245I.17, subdivision 4 new text end , is furnished to a medical assistance enrollee by a
health care practitioner or licensed agency employed by or under contract with a CCBHC;

(3) initial CCBHC daily bundled rates for newly deleted text begin certified deleted text end new text begin licensed new text end CCBHCs under
section deleted text begin 245.735, subdivision 3 deleted text end new text begin 245I.17 new text end , shall be established by the commissioner using a
provider-specific rate based on the newly deleted text begin certified deleted text end new text begin licensed new text end CCBHC's audited historical
cost report data adjusted for the expected cost of delivering CCBHC services. Estimates
are subject to review by the commissioner and must include the expected cost of providing
the full scope of CCBHC services and the expected number of visits for the rate period;

(4) the commissioner shall rebase CCBHC rates once every two years following the last
rebasing and no less than 12 months following an initial rate or a rate change due to a change
in the scope of services. For CCBHCs certified after September 30, 2020, and before January
1, 2021, the commissioner shall rebase rates according to this clause for services provided
on or after January 1, 2024;

(5) the commissioner shall provide for a 60-day appeals process after notice of the results
of the rebasing;

(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal
Medicaid rate is not eligible for the CCBHC rate methodology;

(7) payments for CCBHC services to individuals enrolled in managed care shall be
coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
complete the phase-out of CCBHC wrap payments within 60 days of the implementation
of the CCBHC daily bundled rate system in the Medicaid Management Information System
(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments
due made payable to CCBHCs no later than 18 months thereafter;

(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each
provider-specific rate by the Medicare Economic Index for primary care services. This
update shall occur each year in between rebasing periods determined by the commissioner
in accordance with clause (4). CCBHCs must provide data on costs and visits to the state
annually using the CCBHC cost report established by the commissioner; and

(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
services when such changes are expected to result in an adjustment to the CCBHC payment
rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
regarding the changes in the scope of services, including the estimated cost of providing
the new or modified services and any projected increase or decrease in the number of visits
resulting from the change. Estimated costs are subject to review by the commissioner. Rate
adjustments for changes in scope shall occur no more than once per year in between rebasing
periods per CCBHC and are effective on the date of the annual CCBHC rate update.

(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of
this requirement on the rate of access to the services delivered by CCBHC providers. 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 provision. This paragraph expires if federal
approval is not received for this paragraph at any time.

(e) The commissioner shall implement a quality incentive payment program for CCBHCs
that meets the following requirements:

(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
thresholds for performance metrics established by the commissioner, in addition to payments
for which the CCBHC is eligible under the CCBHC daily bundled rate system described in
paragraph (c);

(2) a CCBHC must be deleted text begin certified deleted text end new text begin licensed new text end and enrolled as a CCBHC for the entire
measurement year to be eligible for incentive payments;

(3) each CCBHC shall receive written notice of the criteria that must be met in order to
receive quality incentive payments at least 90 days prior to the measurement year; and

(4) a CCBHC must provide the commissioner with data needed to determine incentive
payment eligibility within six months following the measurement year. The commissioner
shall notify CCBHC providers of their performance on the required measures and the
incentive payment amount within 12 months following the measurement year.

(f) All claims to managed care plans for CCBHC services as provided under this section
shall be submitted directly to, and paid by, the commissioner on the dates specified no later
than January 1 of the following calendar year, if:

(1) one or more managed care plans does not comply with the federal requirement for
payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
section 447.45(b), and the managed care plan does not resolve the payment issue within 30
days of noncompliance; and

(2) the total amount of clean claims not paid in accordance with federal requirements
by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
eligible for payment by managed care plans.

If the conditions in this paragraph are met between January 1 and June 30 of a calendar
year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
the following year. If the conditions in this paragraph are met between July 1 and December
31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
on July 1 of the following year.

(g) Peer services provided by a CCBHC deleted text begin certified deleted text end new text begin licensed new text end under section deleted text begin 245.735 deleted text end new text begin 245I.17 new text end
are a covered service under medical assistance when a licensed mental health professional
or alcohol and drug counselor determines that peer services are medically necessary.
Eligibility under this subdivision for peer services provided by a CCBHC supersede eligibility
standards under sections 256B.0615, 256B.0616, and 245G.07, subdivision 2a, paragraph
(b), clause (2).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 42.

Minnesota Statutes 2024, section 256B.0943, subdivision 2, is amended to read:

Subd. 2.

Covered service components of children's therapeutic services and
supports.

(a) Subject to federal approval, medical assistance covers medically necessary
children's therapeutic services and supports when the services are provided by an eligible
provider entity deleted text begin certified under and meeting the standards in this section deleted text end new text begin licensed under
section 245I.30 or children's day treatment services licensed under section 245I.31 new text end . The
provider entity must make reasonable and good faith efforts to report individual client
outcomes to the commissioner, using instruments and protocols approved by the
commissioner.

(b) The new text begin covered new text end service components of children's therapeutic services and supports are:

deleted text begin (1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis,
and group psychotherapy;
deleted text end

deleted text begin (2) individual, family, or group skills training provided by a mental health professional,
clinical trainee, or mental health practitioner;
deleted text end

deleted text begin (3) crisis planning;
deleted text end

deleted text begin (4) mental health behavioral aide services;
deleted text end

new text begin (1) the services described in section 245I.30, subdivision 2, provided by providers
licensed under section 245I.30 or 245I.31;
new text end

new text begin (2) administration of standardized measures;
new text end

deleted text begin (5) deleted text end new text begin (3) new text end direction of a mental health behavioral aide; new text begin and
new text end

deleted text begin (6) deleted text end new text begin (4) new text end mental health service plan development deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (7) children's day treatment.
deleted text end

new text begin (c) In delivering services under this section, a licensed provider entity must ensure that
psychotherapy to address a child's underlying mental health disorder is documented as part
of the child's ongoing treatment. A provider must deliver or arrange for medically necessary
psychotherapy unless the child's parent or caregiver chooses not to receive the psychotherapy
or the provider determines that psychotherapy is no longer medically necessary. When a
provider determines that psychotherapy is no longer medically necessary, the provider must
update required documentation, including but not limited to the individual treatment plan,
the child's medical record, or other authorizations, to include the determination. When a
provider determines that a child needs psychotherapy but psychotherapy cannot be delivered
due to a shortage of licensed mental health professionals in the child's community, the
provider must document the lack of access in the child's medical record.
new text end

new text begin (d) Medical assistance covers service plan development before completion of a child's
individual treatment plan. Service plan development consists of development, review, and
revision of the individual treatment plan by face-to-face or electronic communication,
including time spent gathering client history from other key figures or providers. The provider
must document events, including the time spent with the family and other key participants
in the child's life to approve the individual treatment plan. Service plan development is
covered only if a treatment plan is completed or for work already completed at the time the
client voluntarily chooses to disengage with services for the child. If it is determined upon
review that a treatment plan was not completed for the child, the commissioner shall recover
the payment for the service plan development.
new text end

new text begin (e) Medical assistance covers time spent administering and reporting standardized
measures approved by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 43.

Minnesota Statutes 2025 Supplement, section 256B.0943, subdivision 3, is
amended to read:

Subd. 3.

Determination of client eligibility.

(a) A client's eligibility to receive children's
therapeutic services and supports under this section shall be determined based on a standard
diagnostic assessment by a mental health professional or a clinical trainee that is performed
within one year before the initial start of service and updated as required under section
245I.10, subdivision 2. The standard diagnostic assessment must:

(1) determine whether deleted text begin a child under age 18 has a diagnosis of mental illness or, if the
person is between the ages of 18 and 21, whether deleted text end the person has a mental illness; new text begin and
new text end

(2) document children's therapeutic services and supports as medically necessary to
address an identified disability, functional impairment, and the individual client's needs and
goals deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (3) be used in the development of the individual treatment plan.
deleted text end

(b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to
five days of day treatment under this section based on a hospital's medical history and
presentation examination of the client.

deleted text begin (c) Children's therapeutic services and supports include development and rehabilitative
services that support a child's developmental treatment needs.
deleted text end

Sec. 44.

Minnesota Statutes 2025 Supplement, section 256B.0943, subdivision 12, is
amended to read:

Subd. 12.

Excluded services.

new text begin (a) new text end The following services are not eligible for medical
assistance payment as children's therapeutic services and supports:

(1) service components of children's therapeutic services and supports simultaneously
provided by more than one provider entity unless prior authorization is obtained;

(2) treatment by multiple providers within the same agency at the same clock time,
unless one service is delivered to the child and the other service is delivered to the child's
family or treatment team without the child present;

(3) children's therapeutic services and supports provided in violation of medical assistance
policy in Minnesota Rules, part 9505.0220;

(4) mental health behavioral aide services provided by a personal care assistant who is
not qualified as a mental health behavioral aide and employed by a certified children's
therapeutic services and supports provider entity;

(5) service components of CTSS that are the responsibility of a residential or program
license holder, including foster care providers under the terms of a service agreement or
administrative rules governing licensure; and

(6) adjunctive activities that may be offered by a provider entity but are not otherwise
covered by medical assistance, including:

(i) a service that is primarily recreation oriented or that is provided in a setting that is
not medically supervised. This includes sports activities, exercise groups, activities such as
craft hours, leisure time, social hours, meal or snack time, trips to community activities,
and tours;

(ii) a social or educational service that does not have or cannot reasonably be expected
to have a therapeutic outcome related to the client's mental illness;

(iii) prevention or education programs provided to the community; and

(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.

new text begin (b) Time spent on administrative tasks before and after providing direct services, including
scheduling or maintaining clinical records, is included in CTSS payments and may not be
separately billed as additional clock hours of service.
new text end

Sec. 45.

Minnesota Statutes 2025 Supplement, section 260E.14, subdivision 1, is amended
to read:

Subdivision 1.

Facilities and schools.

(a) The local welfare agency is the agency
responsible for investigating allegations of maltreatment in child foster care, family child
care, legally nonlicensed child care, and reports involving children served by an unlicensed
personal care provider organization under section 256B.0659. Copies of findings related to
personal care provider organizations under section 256B.0659 must be forwarded to the
Department of Human Services provider enrollment.

(b) The Department of Human Services is the agency responsible for screening and
investigating allegations of maltreatment in juvenile correctional facilities listed under
section 241.021 located in the local welfare agency's county and in facilities licensed or
certified under chapters 245A and 245D.

(c) The Department of Health is the agency responsible for screening and investigating
allegations of maltreatment in facilities licensed under sections 144.50 to 144.58 and 144A.43
to 144A.482 or chapter 144H.

(d) The Department of Education is the agency responsible for screening and investigating
allegations of maltreatment in a school as defined in section 120A.05, subdivisions 9, 11,
and 13, and chapter 124E. The Department of Education's responsibility to screen and
investigate includes allegations of maltreatment involving students 18 through 21 years of
age, including students receiving special education services, up to and including graduation
and the issuance of a secondary or high school diploma.

(e) The Department of Human Services is the agency responsible for screening and
investigating allegations of maltreatment of minors in an EIDBI agency operating under
sections 245A.142 and 256B.0949.

(f) A health or corrections agency receiving a report may request the local welfare agency
to provide assistance pursuant to this section and sections 260E.20 and 260E.22.

(g) The Department of Children, Youth, and Families is the agency responsible for
screening and investigating allegations of maltreatment in facilities or programs not listed
in paragraph (a) that are licensed or certified under chapters 142B and 142C.

new text begin (h) The Department of Human Services is the agency responsible for screening and
investigating allegations of maltreatment of minors for mobile crisis response services and
children's therapeutic services and supports programs licensed under chapter 245I.
new text end

Sec. 46.

Minnesota Statutes 2025 Supplement, section 626.5572, subdivision 13, is amended
to read:

Subd. 13.

Lead investigative agency.

"Lead investigative agency" is the primary
administrative agency responsible for investigating reports made under section 626.557.

(a) The Department of Health is the lead investigative agency for facilities or services
licensed or required to be licensed as hospitals, home care providers, nursing homes, boarding
care homes, hospice providers, residential facilities that are also federally certified as
intermediate care facilities that serve people with developmental disabilities, or any other
facility or service not listed in this subdivision that is licensed or required to be licensed by
the Department of Health for the care of vulnerable adults. "Home care provider" has the
meaning provided in section 144A.43, subdivision 4, and applies when care or services are
delivered in the vulnerable adult's home.

(b) The Department of Human Services is the lead investigative agency for facilities or
services licensed or required to be licensed as adult day care, adult foster care, community
residential settings, programs for people with disabilities, EIDBI agencies, family adult day
services, mental health programs new text begin licensed under chapter 245I new text end , mental health clinics, substance
use disorder programs, the Minnesota Sex Offender Program, or any other facility or service
not listed in this subdivision that is licensed or required to be licensed by the Department
of Human Services. The Department of Human Services is also the lead investigative agency
for unlicensed EIDBI agencies under section 256B.0949. new text begin The Department of Human Services
is the lead investigative agency for adult rehabilitative mental health services under section
245I.22, mobile crisis response services under section 245I.24, and certified community
behavioral health clinics under section 245I.17.
new text end

(c) The county social service agency or its designee is the lead investigative agency for
all other reports, including but not limited to reports involving vulnerable adults receiving
services from a personal care provider organization under section 256B.0659.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

Sec. 47. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 245.735, subdivisions
5 and 6, as Minnesota Statutes, section 245I.17, subdivisions 23 and 24.
new text end

Sec. 48. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2024, sections 245.735, subdivisions 1a, 2a, 3a, 3b, 3c, 3d, 3e,
3f, 3g, 3h, 4a, 4b, 4c, 4e, 7, and 8; 245C.03, subdivision 7; 245I.20, subdivision 9; 245I.23,
subdivision 23; 256B.0623, subdivisions 2, 4, 5, 6, and 9; 256B.0624, subdivisions 2, 3,
4a, 5, 6, 6a, 6b, 7, 8, 9, and 11; and 256B.0943, subdivisions 4, 5, 5a, 6, 7, and 11, new text end new text begin are
repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2025 Supplement, sections 245.735, subdivisions 3 and 4d; and
256B.0943, subdivisions 1 and 9, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2028.
new text end

ARTICLE 5

AGING AND DISABILITY SERVICES

Section 1.

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
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, which
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), or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
9555.6265, under this chapter for a physical location that will not be the primary residence
of the license holder for the entire period of licensure. If a 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,
or 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, 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;

(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;
or

(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.

(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 according to section 256B.49, subdivision 15,
paragraph (f), or the 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.

new text begin (k) Except as permitted in this paragraph, the commissioner must not issue an initial
license under chapter 245D authorizing integrated community supports under section
245D.03, subdivision 1, paragraph (c), clause (8), and must not approve a license change
adding integrated community supports to an existing license under chapter 245D. The
commissioner may approve an exception to the moratorium only when the applicant or
licensee meets all requirements under section 245D.12, the request is not superseded by
temporary moratoriums under section 245A.03, subdivision 7a, and the applicant submits
documentation demonstrating compliance with:
new text end

new text begin (1) federal and state home and community-based services requirements for
provider-controlled settings;
new text end

new text begin (2) the prohibition on the use of Medicaid money for room and board under section
256B.4912, subdivision 17, including the requirement that the provider not pay, subsidize,
offset, or otherwise financially contribute to rent, utilities, or other housing costs; and
new text end

new text begin (3) all licensing requirements applicable to integrated community supports under chapter
245D.
new text end

new text begin In determining whether to approve an exception, the commissioner must consider statewide
and regional capacity for integrated community supports based on needs-determination
processes under paragraph (e). Nothing in this paragraph authorizes the commissioner to
deny a change of ownership license, a temporary change of ownership license, or a temporary
transitional license that is otherwise permissible under section 245A.043. A determination
under this paragraph is final and not subject to appeal.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 2.

Minnesota Statutes 2025 Supplement, section 245A.03, subdivision 7a, is amended
to read:

Subd. 7a.

Discretionary temporary licensing moratorium.

(a) The commissioner must
not accept an application from or issue an initial license for an individual, organization, or
government entity seeking licensure under this chapter and must not add a new service to
an existing license when the commissioner determines that exceptional growth in applications
for licensure or requests to add new services exceeds the determined need for service
capacity. The determined need for service capacity may be limited to a specific region,
service focus, or other factors as determined by the commissioner. A temporary licensing
moratorium issued under this subdivision is effective for a period of up to 24 months from
the date the commissioner issues the moratorium.

(b) Any applicant that will not receive a license due to a temporary licensing moratorium
issued under paragraph (a) may apply for a refund of licensing application fees for up to
one year from the date the commissioner issues the moratorium.

(c) The commissioner must notify the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services at least 30 days
prior to issuing a temporary moratorium under this subdivision and publish notice of the
moratorium on the department's website. The notice must include:

(1) a list of all license types to which the moratorium will apply;

(2) the proposed start date of the moratorium; and

(3) the anticipated duration of the moratorium.

(d) The commissioner must establish and make publicly available the processes and
criteria the commissioner will use to grant exceptions to a temporary moratorium issued
under this subdivision.

new text begin (e) Nothing in this subdivision authorizes the commissioner to deny a change of
ownership license, a temporary change of ownership license, or a temporary transitional
license that is otherwise permissible under section 245A.043.
new text end

Sec. 3.

Minnesota Statutes 2025 Supplement, section 245A.03, subdivision 7a, is amended
to read:

Subd. 7a.

Discretionary temporary licensing moratorium.

(a) The commissioner must
not accept an application from or issue an initial license for an individual, organization, or
government entity seeking licensure under this chapter and must not add a new service to
an existing license when the commissioner determines new text begin based on documented and publicly
available data new text end that exceptional growth in applications for licensure or requests to add new
services new text begin materially new text end exceeds the determined need for service capacity. The determined need
for service capacity may be limited to a specific region, service focus, or other factors as
determined by the commissioner. A temporary licensing moratorium issued under this
subdivision is effective for a period of up to 24 months from the date the commissioner
issues the moratorium.

deleted text begin (b) Any applicant that will not receive a license due to a temporary licensing moratorium
issued under paragraph (a) may apply for a refund of licensing application fees for up to
one year from the date the commissioner issues the moratorium.
deleted text end

deleted text begin (c) The commissioner must notify the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services at least 30 days
prior to issuing a temporary moratorium under this subdivision and publish notice of the
moratorium on the department's website. The notice must include:
deleted text end

deleted text begin (1) a list of all license types to which the moratorium will apply;
deleted text end

deleted text begin (2) the proposed start date of the moratorium; and
deleted text end

deleted text begin (3) the anticipated duration of the moratorium.
deleted text end

deleted text begin (d) The commissioner must establish and make publicly available the processes and
criteria the commissioner will use to grant exceptions to a temporary moratorium issued
under this subdivision.
deleted text end

new text begin (b) For purposes of this subdivision, a determination of exceptional growth in applications
for licensure or requests to add new services must be supported by:
new text end

new text begin (1) a comparative analysis of application growth over at least the prior three fiscal years;
new text end

new text begin (2) current service utilization and waiver enrollment data;
new text end

new text begin (3) projected enrollment trends; and
new text end

new text begin (4) a regional service capacity analysis.
new text end

new text begin (c) When determining the need for service capacity under this subdivision, the
commissioner must document consideration of:
new text end

new text begin (1) geographic distribution of providers;
new text end

new text begin (2) accessibility for individuals with disabilities;
new text end

new text begin (3) language access and culturally specific service availability;
new text end

new text begin (4) rural and Tribal community access; and
new text end

new text begin (5) the capacity of providers to serve high-acuity or specialized populations.
new text end

new text begin (d) The determined need for service capacity must be limited to a specific region, service
focus, or other factors as determined by the commissioner. The commissioner's determination
that the statewide service capacity exceeds the statewide need is insufficient to support
issuance of a moratorium under this subdivision.
new text end

new text begin (e) Prior to implementing a moratorium under this subdivision, the commissioner must:
new text end

new text begin (1) prepare written findings explaining the data and methodology used to determine
excess capacity;
new text end

new text begin (2) document the access considerations required under this subdivision; and
new text end

new text begin (3) provide the written findings to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services at least 45 days
prior to implementing the moratorium and publish notice on the department's website and
in the State Register. The notice must include:
new text end

new text begin (i) a list of all license types to which the moratorium will apply;
new text end

new text begin (ii) the proposed start date;
new text end

new text begin (iii) the anticipated duration;
new text end

new text begin (iv) a summary of the data supporting the determination; and
new text end

new text begin (v) a description of the publicly available exception process under subdivision 7c.
new text end

new text begin (f) A temporary licensing moratorium issued under this subdivision is effective for a
period of up to 24 months from the date the commissioner issues the moratorium.
new text end

new text begin (g) Notwithstanding paragraph (a), the commissioner may issue or modify a temporary
licensing moratorium under this subdivision when required by a written directive, corrective
action plan, waiver condition, or enforcement action issued by the Centers for Medicare
and Medicaid Services (CMS). Prior to issuing a moratorium under this paragraph, the
commissioner must:
new text end

new text begin (1) publish the CMS directive or correspondence necessitating the action;
new text end

new text begin (2) certify that the moratorium is narrowly tailored to address only the federally identified
issue; and
new text end

new text begin (3) limit the duration to the minimum period necessary to achieve federal compliance.
new text end

new text begin A moratorium issued under this paragraph remains subject to the reporting requirements
under subdivision 7c.
new text end

new text begin (h) Nothing in this subdivision authorizes the commissioner to deny a change of
ownership license, a temporary change of ownership license, or a temporary transitional
license that is otherwise permissible under section 245A.043.
new text end

Sec. 4.

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

new text begin Subd. 7b. new text end

new text begin Refunds following implementation of a moratorium. new text end

new text begin Any applicant that
will not receive a license due to a temporary licensing moratorium issued under subdivision
7a may apply for a refund of licensing application fees for up to one year from the date the
commissioner issues the moratorium.
new text end

Sec. 5.

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

new text begin Subd. 7c. new text end

new text begin Publicly available exception process and ongoing reporting. new text end

new text begin (a) The
commissioner must establish and make publicly available an explanation of the processes
and criteria the commissioner will use to grant exceptions to a temporary moratorium issued
under subdivision 7a. The publicly available explanation must include:
new text end

new text begin (1) standardized submission requirements to which lead agencies must comply;
new text end

new text begin (2) objective exception evaluation criteria; and
new text end

new text begin (3) defined timelines for decision-making.
new text end

new text begin (b) During any period in which a moratorium under subdivision 7a is in effect, the
commissioner must submit a report every 12 months to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services. The report
must include:
new text end

new text begin (1) the number of applications received for a license subject to the moratorium;
new text end

new text begin (2) the number of applications rejected due to the moratorium;
new text end

new text begin (3) the number of exception requests received, approved, and denied;
new text end

new text begin (4) the geographic distribution of exception requests; and
new text end

new text begin (5) an updated analysis of service capacity and utilization.
new text end

Sec. 6.

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

new text begin Subd. 7. new text end

new text begin Department of Human Services home and community-based services early
and often licensor and compliance team. new text end

new text begin (a) The commissioner must establish and maintain
a home and community-based services early and often licensor and compliance team to
deliver proactive and coordinated support to applicants through the application process and
to license holders during the first year of operation of the licensed home and
community-based program. The commissioner must ensure that the home and
community-based services early and often licensor and compliance team has sufficient staff
and resources to perform the functions required under this subdivision. The commissioner
must ensure that the licensor and compliance team has members with expertise in licensing
requirements and members with expertise in medical assistance enrollment requirements,
medical assistance service delivery requirements, and medical assistance billing requirements.
new text end

new text begin (b) The home and community-based services early and often licensor and compliance
team must provide technical assistance to applicants regarding completing and submitting
license applications under this chapter and chapter 256D and medical assistance provider
enrollment applications under section 256B.04, subdivision 21.
new text end

new text begin (c) The home and community-based services early and often licensor and compliance
team must conduct an initial scheduled technical assistance visit three months after the
effective date of an initial license for the purpose of providing technical assistance to the
license holder. The team must provide technical assistance related to achieving and
maintaining compliance with the applicable laws, rules, and regulations governing the
provision of and reimbursement for home and community-based services under this chapter
and chapters 245D, 256B, and 256S and waiver plans.
new text end

new text begin (d) The home and community-based services early and often licensor and compliance
team must conduct three unscheduled visits after the beginning of the sixth calendar month
following the effective date of an initial license and before the end of the eighteenth month
following the effective date of an initial license.
new text end

new text begin (e) If during the technical assistance visit or during the following three unannounced
visits, the team finds that the license holder has failed to achieve compliance with an
applicable law, rule, or regulation, and the failure does not imminently endanger the health,
safety, or rights of persons served by the program, the team may issue a licensing and
compliance review report with recommendations for achieving and maintaining compliance.
new text end

new text begin (f) Nothing in this subdivision shall be construed to limit the commissioner's authority
to:
new text end

new text begin (1) suspend or revoke a license or issue a fine at any time under section 245A.07 or issue
correction orders and make a license conditional for failure to comply with applicable laws,
rules, or regulations under section 245A.06 based on the nature, chronicity, or severity of
the violation of a law, rule, or regulation and the effect of the violation on the health, safety,
or rights of persons served by the program; or
new text end

new text begin (2) impose a sanction under section 256B.064 based on the nature, chronicity, or severity
of the violation of law, rule, or regulation.
new text end

Sec. 7.

Minnesota Statutes 2024, section 245D.261, subdivision 3, is amended to read:

Subd. 3.

Provider requirements for remote overnight supervision; commissioner
notification.

(a) A license holder providing remote overnight supervision in a community
residential setting must:

(1) use technology;

(2) notify the commissioner of the community residential setting's intent to use technology
in lieu of on-site staff. The notification must:

(i) indicate a start date for the use of technology; and

(ii) attest that all requirements under this section are met and policies required under
subdivision 4 are available upon request;

(3) clearly state in each person's support plan addendum that the community residential
setting is a program without the in-person presence of overnight direct support;

(4) include with each person's support plan addendum the license holder's protocols for
responding to situations that present a serious risk to the health, safety, or rights of residents
served by the program; deleted text begin and
deleted text end

(5) include in each person's support plan addendum the person's maximum permissible
response time as determined by the person's support team new text begin ; and
new text end

new text begin (6) ensure that any third-party monitoring company the license holder contracts with to
provide overnight supervision maintains an appropriate staff ratio to ensure that the maximum
permissible response time specified in clause (5) is met new text end .

(b) Upon being notified via technology that an incident has occurred that jeopardizes
the health, safety, or rights of a resident, the license holder must document an evaluation
of the need for the physical presence of a staff member and determine whether a physical
presence is needed in a time that is less than the maximum permissible response time under
paragraph (a), clause (5). If it is determined that a physical presence is needed that requires
a response time less than the maximum response time under paragraph (a), clause (5), the
plan under subdivision 4, paragraph (a), clause (6), must be deployed.

(c) A license holder must notify the commissioner if remote overnight supervision
technology will no longer be used by the license holder.

(d) Upon receipt of notification of use of remote overnight supervision or discontinuation
of use of remote overnight supervision by a license holder, the commissioner shall notify
the county licensing agency and update the license.

Sec. 8.

Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to
read:

new text begin Subd. 45. new text end

new text begin Department of Human Services home and community-based services
provider support and technical assistance team. new text end

new text begin The commissioner must establish and
maintain a home and community-based services provider support and technical assistance
team to deliver proactive and coordinated support to home and community-based services
providers. The commissioner must ensure that the home and community-based services
provider support and technical assistance team has sufficient staff and resources to perform
the functions required under this subdivision. The home and community-based services
provider support and technical assistance team must:
new text end

new text begin (1) serve as a provider liaison and help desk for providers' technical, regulatory, and
operational questions;
new text end

new text begin (2) develop training and onboarding materials for home and community-based services
providers;
new text end

new text begin (3) collect data on home and community-based provider challenges;
new text end

new text begin (4) coordinate the functions of the department, including information technology,
licensing, provider enrollment, service delivery oversight, and program integrity oversight
to clarify program requirements, provider requirements, and service requirements and to
support providers with compliance and prevention of fraud; and
new text end

new text begin (5) make recommendations to the commissioner regarding changes to the operations of
the department or to the design and implementation of home and community-based services
that would improve the delivery of services and improve program integrity.
new text end

Sec. 9.

Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 17, is
amended to read:

Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.

(c) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transportation, within the meaning of "public transportation" as defined in
section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (p).

(d) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph. new text begin This paragraph expires upon the effective date of
paragraph (e).
new text end

new text begin (e) Effective January 1, 2027, or upon federal approval, whichever is later, medical
assistance covers nonemergency medical transportation provided by nonemergency medical
transportation providers enrolled in the Minnesota health care programs. All nonemergency
medical transportation providers must comply with the operating standards for special
transportation service as defined in sections 174.29 to 174.30 and Minnesota Rules, chapter
8840, and all drivers must be individually enrolled with the commissioner and reported on
the claim as the individual who provided the service. All nonemergency medical
transportation providers must bill for nonemergency medical transportation services in
accordance with Minnesota health care programs criteria and comply with the requirements
of section 256B.073. Publicly operated transit systems, volunteers, and not-for-hire vehicles
are exempt from the requirements outlined in this paragraph.
new text end

deleted text begin (e) deleted text end new text begin (f) new text end An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

deleted text begin (f) deleted text end new text begin (g) new text end The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services. This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.

deleted text begin (g) deleted text end new text begin (h) new text end Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
medical assistance, the administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care program beneficiaries to obtain covered medical services; and

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode.

deleted text begin (h) deleted text end new text begin (i) new text end Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph deleted text begin (n) deleted text end new text begin (o) new text end , clauses (4), (5), (6), and (7).
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.

deleted text begin (i) deleted text end new text begin (j) new text end The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.

deleted text begin (j) deleted text end new text begin (k) new text end Nonemergency medical transportation providers must take clients to the health
care provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency. This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.

deleted text begin (k) deleted text end new text begin (l) new text end Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, nonemergency medical transportation providers must take
clients to the health care provider using the most direct route and must not exceed 30 miles
for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
the client receives authorization from the administrator.

deleted text begin (l) deleted text end new text begin (m) new text end Nonemergency medical transportation providers may not bill for separate base
rates for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

deleted text begin (m) deleted text end new text begin (n) new text end The administrative agency shall use the level of service process established by
the commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.

deleted text begin (n) deleted text end new text begin (o) new text end The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

deleted text begin (o) deleted text end new text begin (p) new text end The local agency shall be the single administrative agency and shall administer
and reimburse for modes defined in paragraph deleted text begin (n) deleted text end new text begin (o) new text end according to paragraphs deleted text begin (r) deleted text end new text begin (s) new text end to deleted text begin (t) deleted text end
new text begin (u) new text end when the commissioner has developed, made available, and funded the web-based single
administrative structure, assessment tool, and level of need assessment under subdivision
18e. The local agency's financial obligation is limited to funds provided by the state or
federal government. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.

deleted text begin (p) deleted text end new text begin (q) new text end The commissioner shall:

(1) verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

deleted text begin (q) deleted text end new text begin (r) new text end The administrative agency shall pay for the services provided in this subdivision
and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
2027, for prepaid medical assistance.

deleted text begin (r) deleted text end new text begin (s) new text end Payments for nonemergency medical transportation must be paid based on the
client's assessed mode under paragraph deleted text begin (m) deleted text end new text begin (n) new text end , not the type of vehicle used to provide the
service. The medical assistance reimbursement rates for nonemergency medical transportation
services that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
medical transportation provider;

(4) $14.30 for the base rate and $1.43 per mile for assisted transport;

(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026,
for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.

deleted text begin (s) deleted text end new text begin (t) new text end Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance, payments for nonemergency medical transportation must
be paid based on the client's assessed mode under paragraph deleted text begin (m) deleted text end new text begin (n) new text end , not the type of vehicle
used to provide the service.

deleted text begin (t) deleted text end new text begin (u) new text end The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph deleted text begin (r) deleted text end new text begin (s) new text end , clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph deleted text begin (r) deleted text end new text begin (s) new text end , clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph deleted text begin (r) deleted text end new text begin (s) new text end , clauses (1) to (7). This paragraph expires July 1, 2026, for medical
assistance fee-for-service and January 1, 2027, for prepaid medical assistance.

deleted text begin (u) deleted text end new text begin (v) new text end For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs deleted text begin (r) deleted text end new text begin (s) new text end to deleted text begin (t) deleted text end new text begin (u) new text end , the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies. This
paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
for prepaid medical assistance.

deleted text begin (v) deleted text end new text begin (w) new text end The commissioner, when determining reimbursement rates for nonemergency
medical transportation, shall exempt all modes of transportation listed under paragraph deleted text begin (n) deleted text end
new text begin (o) new text end from Minnesota Rules, part 9505.0445, item R, subitem (2).

deleted text begin (w) deleted text end new text begin (x) new text end Effective for the first day of each calendar quarter in which the price of gasoline
as posted publicly by the United States Energy Information Administration exceeds $3.00
per gallon, the commissioner shall adjust the rate paid per mile in paragraph deleted text begin (r) deleted text end new text begin (s) new text end by one
percent up or down for every increase or decrease of ten cents for the price of gasoline. The
increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
increase or decrease must be calculated using the average of the most recently available
price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
Information Administration. This paragraph expires July 1, 2026, for medical assistance
fee-for-service and January 1, 2027, for prepaid medical assistance.

Sec. 10.

Minnesota Statutes 2024, section 256B.0625, subdivision 17b, is amended to
read:

Subd. 17b.

Documentation required.

(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain records sufficient to
distinguish individual trips with specific vehicles and drivers. The documentation may be
collected and maintained using electronic systems or software or in paper form but must be
made available and produced upon request. Program funds paid for transportation that is
not documented according to this subdivision may be subject to recovery by the commissioner
pursuant to section 256B.064.

(b) A nonemergency medical transportation provider must compile transportation trip
records that are written in English and legible according to the standard of a reasonable
person and that include each of the following elements:

(1) the recipient's name;

(2) the date or dates the service is provided, if different than the date the entry was made;

(3) either the printed name of the driver sufficient to distinguish the driver of service or
the driver's provider number;

(4) the date and the signature of the driver attesting that the record accurately represents
the services provided and the actual miles driven, and acknowledging that misreporting
information that results in ineligible or excessive payments may result in civil or criminal
action;

(5) the date and the signature of the recipient or authorized party attesting that
transportation services were provided as indicated on the transportation trip record, or the
signature of the medical services provider certifying that the recipient was transported to
the medical services provider destination. In the event that both the medical services provider
and the recipient or authorized party refuse or are unable to provide signatures, the driver
must document on the transportation trip record that signatures were requested and not
provided;

(6) the address, or the description if the address is not available, of both the origin and
destination, and the mileage for the most direct route from the origin to the destination;

(7) the name or number of the mode of transportation in which the service is provided;

(8) the license plate number of the vehicle used to transport the recipient;

(9) the time of the recipient pickup;

(10) the time of the recipient drop-off;

(11) the odometer reading of the vehicle used to transport the recipient taken at the time
of pickup;

(12) the odometer reading of the vehicle used to transport the recipient taken at the time
of drop-off;

(13) the name of the extra attendant when an extra attendant is used to provide special
transportation service; and

(14) the documentation indicating the method that was used to determine the most direct
route.

(c) In determining whether the commissioner will seek recovery, the documentation
requirements in this section apply retroactively to audit findings beginning January 1, 2020,
and to all audit findings thereafter.

new text begin (d) Effective January 1, 2027, or upon federal approval, whichever is later, records that
comply with section 256B.073 may be used to meet the requirements of this subdivision if
all required elements are included in the record.
new text end

Sec. 11.

Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 77. new text end

new text begin Early intensive developmental and behavioral intervention benefit. new text end

new text begin Medical
assistance covers early intensive developmental and behavioral intervention services
according to section 256B.0949.
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. 12.

Minnesota Statutes 2024, section 256B.073, subdivision 1, is amended to read:

Subdivision 1.

Documentation; establishment new text begin and operation new text end .

The commissioner of
human services shall establish deleted text begin implementation requirements and standards for deleted text end new text begin and maintain
the requirements and standards for the ongoing operation of new text end electronic visit verification to
comply with the 21st Century Cures Act, Public Law 114-255. Within available
appropriations, the commissioner shall take steps to comply with the electronic visit
verification requirements in the 21st Century Cures Act, Public Law 114-255.

Sec. 13.

Minnesota Statutes 2024, section 256B.073, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For purposes of this section, the terms in this subdivision have
the meanings given deleted text begin them deleted text end .

new text begin (b) "Data aggregator" means the entity designated by the commissioner to collect, store,
and transmit electronic visit verification data from providers and third-party systems to the
commissioner in accordance with the standards and requirements established under this
section.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end "Electronic visit verification" new text begin or "EVV" new text end means the deleted text begin electronic documentation of
the deleted text end new text begin process required under United States Code, title 42, section 1396b(l), and this section
used to electronically verify the new text end :

(1) type of service performed;

(2) individual receiving the service;

(3) date of the service;

(4) location of the service delivery;

(5) individual providing the service; deleted text begin and
deleted text end

(6) time the service begins and ends new text begin ; and
new text end

new text begin (7) method by which the service recipient, the service recipient's legal guardian or
conservator, or the service recipient's parent, if the service recipient is a minor, attests to
the accuracy of the information contained on the electronic visit verification new text end .

new text begin (d) "Electronic visit verification data" means information collected through an electronic
visit verification system, including data elements required under United States Code, title
42, section 1396b(l), and any additional data elements specified by the commissioner under
this section.
new text end

deleted text begin (c) deleted text end new text begin (e) new text end "Electronic visit verification system" means a system deleted text begin that provides electronic
verification of services deleted text end new text begin used to collect, verify, and transmit electronic visit verification data
to the commissioner or the commissioner's designated data aggregator new text end that complies with
the 21st Century Cures Act, Public Law 114-255, and the requirements of subdivision 3.

new text begin (f) "Electronic visit verification vendor" means any entity that develops, provides, or
supports an electronic visit verification system, including the state-provided vendor and
any third-party vendor.
new text end

new text begin (g) "Financial management services provider" means an entity enrolled with the
commissioner to provide financial management services under section 256B.85 or other
applicable law and responsible for fiscal, payroll, and reporting functions on behalf of
participant employers.
new text end

new text begin (h) "Home health agency" means a home care provider agency that is Medicare certified
under Code of Federal Regulations, title 42, part 484, and licensed as a home care provider
under chapter 144A.
new text end

new text begin (i) "Individual" means a person who receives services subject to electronic visit
verification under the medical assistance program.
new text end

new text begin (j) "Managed care organization" means a public or private organization that contracts
with the commissioner under section 256B.69 or other applicable law to deliver health care
services to individuals eligible for medical assistance or MinnesotaCare.
new text end

new text begin (k) "Manual visit" means a visit:
new text end

new text begin (1) entered administratively and not by the caregiver at the time of service delivery; or
new text end

new text begin (2) where data elements are edited after the time of service delivery.
new text end

new text begin (l) "Provider" means an individual or organization that meets one or more of the following
conditions:
new text end

new text begin (1) is enrolled as a Minnesota health care programs provider;
new text end

new text begin (2) provides services through a managed care organization under contract with the
commissioner under section 256B.69;
new text end

new text begin (3) is a financial management services provider; or
new text end

new text begin (4) is a participant employer under section 256B.85, subdivision 7, or an employer of
record directing services under section 256B.49, subdivision 16.
new text end

deleted text begin (d) deleted text end new text begin (m) new text end "Service" means one of the following:

(1) personal care assistance services as defined in section 256B.0625, subdivision 19a,
and provided according to section 256B.0659;

(2) community first services and supports under section 256B.85;

(3) home health services under section 256B.0625, subdivision 6a; deleted text begin or
deleted text end

(4) new text begin adult companion services;
new text end

new text begin (5) adult day services;
new text end

new text begin (6) adult rehabilitative mental health services;
new text end

new text begin (7) assertive community treatment;
new text end

new text begin (8) early intensive developmental and behavioral intervention;
new text end

new text begin (9) integrated community supports;
new text end

new text begin (10) nonemergency medical transportation services;
new text end

new text begin (11) recovery peer support;
new text end

new text begin (12) recuperative care;
new text end

new text begin (13) home and community-based services reimbursed at an hourly or specified
minute-based rate and provided according to a federally approved waiver plan as authorized
under chapter 256S or section 256B.0913, 256B.092, or 256B.49; or
new text end

new text begin (14) new text end other medical supplies and equipment or home and community-based services that
are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255.

new text begin (n) "State-provided electronic visit verification system" means the electronic visit
verification system made available by the commissioner to providers at no cost for services
subject to federal electronic visit verification requirements.
new text end

new text begin (o) "Third-party electronic visit verification system" means an electronic visit verification
system purchased or operated by a provider or vendor other than the state-provided system
designated by the commissioner.
new text end

new text begin (p) "Verification method" means the electronic process used to capture and verify visit
information, including telephone, fixed visit verification devices, or mobile applications,
as approved by the commissioner.
new text end

new text begin (q) "Visit" means a single occurrence of service delivery subject to electronic visit
verification.
new text end

new text begin (r) "Worker" means an individual who provides personal care assistance services,
community first services and supports, home health services, consumer-directed community
supports, or other services identified by the commissioner as subject to electronic visit.
new text end

Sec. 14.

Minnesota Statutes 2024, section 256B.073, subdivision 3, is amended to read:

Subd. 3.

Requirements.

(a) In deleted text begin developing implementation requirements for deleted text end new text begin administering
new text end electronic visit verification, the commissioner deleted text begin shall deleted text end new text begin must new text end ensure that the new text begin system and related
new text end requirements:

(1) are minimally administratively and financially deleted text begin burdensome to a provider deleted text end new text begin reasonable
for providers of services new text end ;

(2) deleted text begin are minimally burdensome deleted text end new text begin support continued access new text end to deleted text begin the deleted text end new text begin services and are designed
to avoid disruption to new text end service deleted text begin recipient and the least disruptive to the service recipient in
receiving and maintaining allowed services deleted text end new text begin delivery or receipt new text end ;

(3) consider existing best practices and use of electronic visit verification;

(4) are conducted according to all state and federal laws;

(5) are effective methods for preventing fraud when balanced against the requirements
of clauses (1) and (2); and

(6) are consistent with the Department of Human Services' policies related to covered
services, flexibility of service use, and quality assurance.

(b) The commissioner deleted text begin shall deleted text end new text begin must new text end make training new text begin and guidance new text end available to providers new text begin of
services new text end on the electronic visit verification deleted text begin system deleted text end requirements new text begin and system use new text end .

(c) The commissioner deleted text begin shall deleted text end new text begin must new text end establish baseline measurements related to preventing
fraud and establish measures to determine the effect of electronic visit verification
requirements on program integrity.

(d) The commissioner deleted text begin shall deleted text end new text begin must new text end make a deleted text begin state-selected deleted text end new text begin state-provided new text end electronic visit
verification system available to providers of services.

(e) The commissioner deleted text begin shall deleted text end new text begin must new text end make available and publish on the agency website the
name and contact information for the vendor of the deleted text begin state-selected deleted text end new text begin state-provided new text end electronic
visit verification system and the other vendors that offer alternative electronic visit
verification systems. The information provided must state that the deleted text begin state-selected deleted text end new text begin
state-provided new text end electronic visit verification system is offered at no cost to the provider of
services and that the provider new text begin of services new text end may choose an alternative system that may be at
a cost to the provider.

new text begin (f) The commissioner may establish implementation dates and implementation schedules
for system functions subject to electronic visit verification under this section, including but
not limited to verification methods or technical requirements.
new text end

new text begin (g) The commissioner may waive the requirements of this section for any service
component or setting when the application of electronic visit verification is contrary to
paragraph (a).
new text end

Sec. 15.

Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Electronic visit verification system options. new text end

new text begin (a) A provider of services must
use an electronic visit verification system that complies with the requirements established
by the commissioner. A provider of services may use either the state-provided system or a
third-party system. All systems used for compliance must provide data to the commissioner
in the format and frequency required by the commissioner.
new text end

new text begin (b) The commissioner must make a state-provided electronic visit verification system
available at no cost to providers of services. The commissioner must provide training on
the system to all providers of services.
new text end

new text begin (c) The commissioner must allow providers of services to utilize a third-party electronic
visit verification system that the commissioner determines meets the requirements of this
section.
new text end

new text begin (d) A provider of services using a third-party electronic visit verification system that
meets all technical specifications and federal and state laws must:
new text end

new text begin (1) collect and submit all data for each visit to the commissioner, including but not
limited to manual entries;
new text end

new text begin (2) maintain compliance identified by the commissioner, including but not limited to
incorporating into the system any changes in data requirements that must be transmitted to
the commissioner; and
new text end

new text begin (3) integrate the system with the data aggregator to accurately send data.
new text end

new text begin (e) The data aggregator must be available at no cost to a provider of services for purposes
of transmitting electronic visit verification data from approved third-party systems to the
commissioner. Any costs associated with the development and use of a third-party system
are the responsibility of the provider.
new text end

new text begin (f) If a provider is unable to integrate a third-party system with the data aggregator, the
provider of services must use the state-provided electronic visit verification system.
new text end

new text begin (g) The commissioner must provide training on reviewing and correcting imported data
in the data aggregator to providers of services.
new text end

Sec. 16.

Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:

new text begin Subd. 4b. new text end

new text begin Provider responsibilities. new text end

new text begin A provider of services must:
new text end

new text begin (1) use an electronic visit verification system that meets all technical and data submission
requirements established by the commissioner;
new text end

new text begin (2) enroll with the state-provided electronic visit verification system or the data
aggregator, as applicable;
new text end

new text begin (3) provide all information requested by the commissioner for enrollment, access, and
data submission and ensure that such information remains accurate and up to date;
new text end

new text begin (4) maintain records for each individual receiving services subject to electronic visit
verification, including but not limited to all required data elements;
new text end

new text begin (5) maintain a current list of workers providing services subject to electronic visit
verification to individuals receiving services under medical assistance;
new text end

new text begin (6) provide the commissioner and any managed care organization with immediate, direct,
and on-site or remote access to the electronic visit verification system;
new text end

new text begin (7) at the request of the commissioner or a managed care organization, allow review or
copying of electronic visit verification documentation at no cost;
new text end

new text begin (8) ensure that electronic visit verification systems and related processes meet accessibility
and confidentiality requirements under state and federal law;
new text end

new text begin (9) comply with all policies, procedures, and technical specifications issued by the
commissioner under this section; and
new text end

new text begin (10) ensure that workers, participants, and other individuals using electronic visit
verification are trained and comply with all documentation and data entry requirements
established by the commissioner.
new text end

Sec. 17.

Minnesota Statutes 2024, section 256B.073, subdivision 5, is amended to read:

Subd. 5.

Vendor requirements.

(a) The vendor of the electronic visit verification system
deleted text begin selected deleted text end new text begin provided new text end by the commissioner and the vendor's affiliate must comply with the
requirements of this subdivision.

(b) The vendor of the deleted text begin state-selected deleted text end new text begin state-provided new text end electronic visit verification system
and the vendor's affiliate must:

(1) notify the provider of services that the provider may choose the deleted text begin state-selected deleted text end
new text begin state-provided new text end electronic visit verification system at no cost to the provider;

(2) offer the deleted text begin state-selected deleted text end new text begin state-provided new text end electronic visit verification system to the
provider of services prior to offering any fee-based electronic visit verification system;

(3) notify the provider of services that the provider may choose any fee-based electronic
visit verification system prior to offering the vendor's or its affiliate's fee-based electronic
visit verification system; and

(4) when offering the deleted text begin state-selected deleted text end new text begin state-provided new text end electronic visit verification system,
clearly differentiate between the deleted text begin state-selected deleted text end new text begin state-provided new text end electronic visit verification
system and the vendor's or its affiliate's alternative fee-based system.

(c) The vendor of the deleted text begin state-selected deleted text end new text begin state-provided new text end electronic visit verification system
and the vendor's affiliate must not use state data that are not available to other vendors of
electronic visit verification systems to promote or sell the vendor's or its affiliate's alternative
electronic visit verification system.

(d) Upon request from the provider, the vendor of the deleted text begin state-selected deleted text end new text begin state-provided
new text end electronic visit verification system must provide proof of compliance with the requirements
of paragraph (b).

(e) An agreement between the vendor of the deleted text begin state-selected deleted text end new text begin state-provided new text end electronic visit
verification system or its affiliate and a provider of services for an electronic visit verification
system that is not the deleted text begin state-selected deleted text end new text begin state-provided new text end system entered into on or after July 1,
2023, is subject to immediate termination by the provider if the vendor violates any of the
requirements of paragraph (b).

Sec. 18.

Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Data and documentation. new text end

new text begin (a) A provider of services must submit electronic
visit verification data to the commissioner or the data aggregator in accordance with the
technical standards, format, and frequency established under this section. The commissioner
may use integrated electronic visit verification data for oversight, quality assurance, and
program integrity purposes consistent with state and federal law.
new text end

new text begin (b) The commissioner and managed care organizations must use electronic visit
verification data to validate claims for payment under medical assistance. Claims that cannot
be validated in accordance with electronic visit verification requirements may be subject
to actions by the commissioner as authorized under state and federal law, including actions
related to payment, program integrity, or provider compliance.
new text end

new text begin (c) A provider of services must record all required electronic visit verification data at
the time of service delivery using an approved verification method. To be compliant with
electronic visit verification requirements, a provider of services must document a visit with
all required data elements recorded at the time of service delivery.
new text end

new text begin (d) A manual visit does not comply with electronic visit verification requirements. A
manual visit must be confirmed and verified according to processes established by the
commissioner before being used to validate or support a claim for payment.
new text end

new text begin (e) A worker providing services subject to electronic visit verification must record the
start and end times of each visit at the time the service is delivered using an approved
verification method. A worker must complete and verify all time documentation, including
but not limited to verification of service type, date, and duration, on the date the service
occurs and be consistent with documentation requirements of the service being provided.
A provider of services must maintain documentation demonstrating compliance with this
subdivision and make the documentation available to the commissioner or a managed care
organization upon request.
new text end

Sec. 19.

Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Third-party system responsibilities. new text end

new text begin (a) This subdivision is effective for Early
Intensive Developmental and Behavioral Intervention services beginning July 1, 2027, or
upon federal approval, whichever is later. This subdivision is effective for all other services
subject to this subdivision beginning January 1, 2027, or upon federal approval, whichever
is later.
new text end

new text begin (b) A provider of services using a third-party electronic visit verification system must
ensure that the system meets all technical, functional, and data-exchange requirements
established by the commissioner and transmits data to the commissioner or the data
aggregator in the format and frequency required by the commissioner.
new text end

new text begin (c) A third-party electronic visit verification vendor must:
new text end

new text begin (1) comply with all technical, contractual, privacy, and security standards established
by the commissioner;
new text end

new text begin (2) not use or disclose state data for any purpose other than fulfilling the requirements
of this section or federal law;
new text end

new text begin (3) provide the commissioner access to system documentation, data mapping, and audit
records upon request; and
new text end

new text begin (4) immediately report to the commissioner any data transmission failure, breach, or
interruption affecting the commissioner's ability to receive required electronic visit
verification data.
new text end

new text begin (d) A provider of services remains responsible for ensuring compliance with this section
even when using a third-party electronic visit verification system.
new text end

new text begin (e) The third-party vendor must ensure training on the system is available to providers
of services.
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. 20.

Minnesota Statutes 2024, section 256B.0911, subdivision 32, is amended to read:

Subd. 32.

Administrative activity.

(a) The commissioner shall:

(1) streamline the processes, including timelines for when assessments need to be
completed;

(2) provide the services in this section; deleted text begin and
deleted text end

(3) implement integrated solutions to automate the business processes to the extent
necessary for support plan approval, reimbursement, program planning, evaluation, and
policy development deleted text begin . deleted text end new text begin ; and
new text end

new text begin (4) grant limited role-based access to a person's support plan in the MnCHOICES system
to home and community-based service providers who have been designated as a provider
for that person by a lead agency for the purpose of signing the person's support plan
electronically and demonstrating that the provider has reviewed, understood, and agrees to
deliver services as outlined in the plan.
new text end

(b) The commissioner shall work with lead agencies responsible for conducting long-term
care consultation services to:

(1) modify the MnCHOICES application and assessment policies to create efficiencies
while ensuring federal compliance with medical assistance and long-term services and
supports eligibility criteria; and

(2) develop a set of measurable benchmarks sufficient to demonstrate quarterly
improvement in the average time per assessment and other mutually agreed upon measures
of increasing efficiency.

(c) The commissioner shall collect data on the benchmarks developed under paragraph
(b) and provide to the lead agencies an annual trend analysis of the data in order to
demonstrate the commissioner's compliance with the requirements of this subdivision.

Sec. 21.

Minnesota Statutes 2025 Supplement, section 256B.0949, subdivision 2, is
amended to read:

Subd. 2.

Definitions.

(a) The terms used in this section have the meanings given in this
subdivision.

(b) "Advanced certification" means a person who has completed advanced certification
in an approved modality under subdivision 13, paragraph (b).

(c) "Agency" means the legal entity that is enrolled with Minnesota health care programs
as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide
EIDBI services and that has the legal responsibility to ensure that its employees carry out
the responsibilities defined in this section. Agency includes a licensed individual professional
who practices independently and acts as an agency.

(d) "Autism spectrum disorder or a related condition" or "ASD or a related condition"
means either autism spectrum disorder (ASD) as defined in the current version of the
Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found
to be closely related to ASD, as identified under the current version of the DSM, and meets
all of the following criteria:

(1) is severe and chronic;

(2) results in impairment of adaptive behavior and function similar to that of a person
with ASD;

(3) requires treatment or services similar to those required for a person with ASD; and

(4) results in substantial functional limitations in three core developmental deficits of
ASD: social or interpersonal interaction; functional communication, including nonverbal
or social communication; and restrictive or repetitive behaviors or hyperreactivity or
hyporeactivity to sensory input; and may include deficits or a high level of support in one
or more of the following domains:

(i) behavioral challenges and self-regulation;

(ii) cognition;

(iii) learning and play;

(iv) self-care; or

(v) safety.

(e) "Behavior analyst" means an individual licensed under sections 148.9981 to 148.9995
as a behavior analyst.

(f) "Clinical supervision" means the overall responsibility for the control and direction
of EIDBI service delivery, including deleted text begin individual treatment planning, deleted text end staff supervision, new text begin
including observation and direction; new text end individual treatment plan new text begin development and new text end progress
monitoring deleted text begin , deleted text end new text begin ; family training and counseling; new text end and deleted text begin treatment review deleted text end new text begin coordinated care
conference coordination new text end for each person. Clinical supervision is provided by a qualified
supervising professional (QSP) who takes full professional responsibility for the service
provided by each supervisee and the clinical effectiveness of all interventions.

(g) "Commissioner" means the commissioner of human services, unless otherwise
specified.

(h) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive
evaluation of a person to determine medical necessity for EIDBI services based on the
requirements in subdivision 5.

(i) "Department" means the Department of Human Services, unless otherwise specified.

(j) "Early intensive developmental and behavioral intervention benefit" or "EIDBI
benefit" means a variety of individualized, intensive treatment modalities approved and
published by the commissioner that are based in behavioral and developmental science
consistent with best practices on effectiveness.

(k) "Employee of an agency" or "employee" means any individual who is employed
temporarily, part time, or full time by the agency that is submitting claims or billing for the
work, services, supervision, or treatment performed by the individual. Employee does not
include an independent contractor, billing agency, or consultant who is not providing EIDBI
services. Employee does not include an individual who performs work, provides services,
supervises, or provides treatment for less than 80 hours in a 12-month period.

(l) "Generalizable goals" means results or gains that are observed during a variety of
activities over time with different people, such as providers, family members, other adults,
and people, and in different environments including, but not limited to, clinics, homes,
schools, and the community.

(m) "Incident" means when any of the following occur:

(1) an illness, accident, or injury that requires first aid treatment;

(2) a bump or blow to the head; or

(3) an unusual or unexpected event that jeopardizes the safety of a person or staff,
including a person leaving the agency unattended.

(n) "Individual treatment plan" or "ITP" means the person-centered, individualized
written plan of care that integrates and coordinates person and family information from the
CMDE for a person who meets medical necessity for the EIDBI benefit. An individual
treatment plan must meet the standards in subdivision 6.

(o) "Legal representative" means the parent of a child who is under 18 years of age, a
court-appointed guardian, or other representative with legal authority to make decisions
about service for a person. For the purpose of this subdivision, "other representative with
legal authority to make decisions" includes a health care agent or an attorney-in-fact
authorized through a health care directive or power of attorney.

(p) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

(q) "Person" means an individual under 21 years of age.

(r) "Person-centered" means a service that both responds to the identified needs, interests,
values, preferences, and desired outcomes of the person or the person's legal representative
and respects the person's history, dignity, and cultural background and allows inclusion and
participation in the person's community.

(s) "Qualified EIDBI provider" means an individual who is a QSP or a level I, level II,
or level III treatment provider.

Sec. 22.

Minnesota Statutes 2025 Supplement, section 256B.0949, subdivision 16, is
amended to read:

Subd. 16.

Agency duties.

(a) An agency delivering an EIDBI service under this section
must:

(1) enroll as a medical assistance Minnesota health care program provider according to
Minnesota Rules, part 9505.0195, and section 256B.04, subdivision 21, and meet all
applicable provider standards and requirements;

(2) designate an individual as the agency's compliance officer who must perform the
duties described in section 256B.04, subdivision 21, paragraph (g);

(3) demonstrate compliance with federal and state laws for the delivery of and billing
for EIDBI service;

(4) verify and maintain records of a service provided to the person or the person's legal
representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;

(5) demonstrate that while enrolled or seeking enrollment as a Minnesota health care
program provider the agency did not have a lead agency contract or provider agreement
discontinued because of a conviction of fraud; or did not have an owner, board member, or
manager fail a state or federal criminal background check or appear on the list of excluded
individuals or entities maintained by the federal Department of Human Services Office of
Inspector General;

(6) have established business practices including written policies and procedures, internal
controls, and a system that demonstrates the organization's ability to deliver quality EIDBI
services, appropriately submit claims, conduct required staff training, document staff
qualifications, document service activities, and document service quality;

(7) have an office located in Minnesota or a border state;

(8) initiate a background study as required under subdivision 16a;

(9) report maltreatment according to section 626.557 and chapter 260E;

(10) comply with any data requests consistent with the Minnesota Government Data
Practices Act, sections 256B.064 and 256B.27;

(11) provide training for all agency staff on the requirements and responsibilities listed
in the Maltreatment of Minors Act, chapter 260E, and the Vulnerable Adult Protection Act,
section 626.557, including mandated and voluntary reporting, nonretaliation, and the agency's
policy for all staff on how to report suspected abuse and neglect;

(12) have a written policy to resolve issues collaboratively with the person and the
person's legal representative when possible. The policy must include a timeline for when
the person and the person's legal representative will be notified about issues that arise in
the provision of services;

(13) provide the person's legal representative with prompt notification if the person is
injured while being served by the agency. An incident report must be completed by the
agency staff member in charge of the person. A copy of all incident and injury reports must
remain on file at the agency for at least five years from the report of the incident;

(14) before starting a service, provide the person or the person's legal representative a
description of the treatment modality that the person shall receive, including the staffing
certification levels and training of the staff who shall provide a treatment;

(15) provide clinical supervision for a minimum of one hour for every 16 hours of direct
treatment per person, unless otherwise authorized in the person's individual treatment plan;
and

(16) provide new text begin the new text end required EIDBI intervention observation and direction new text begin by a QSP or
Level I provider new text end at least once per month. Notwithstanding subdivision 13, paragraph (l),
required EIDBI intervention observation and direction under this clause may be conducted
via telehealth provided that no more than two consecutive monthly required EIDBI
intervention observation and direction sessions under this clause are conducted via telehealth.

(b) Upon request of the commissioner, an agency delivering services under this section
must:

(1) identify the agency's controlling individuals, as defined under section 245A.02,
subdivision 5a;

(2) provide disclosures of the use of billing agencies and other consultants who do not
provide EIDBI services; and

(3) provide copies of any contracts with consultants or independent contractors who do
not provide EIDBI services, including hours contracted and responsibilities.

(c) When delivering the ITP, and annually thereafter, an agency must provide the person
or the person's legal representative with:

(1) a written copy and a verbal explanation of the person's or person's legal
representative's rights and the agency's responsibilities;

(2) documentation in the person's file the date that the person or the person's legal
representative received a copy and explanation of the person's or person's legal
representative's rights and the agency's responsibilities; and

(3) reasonable accommodations to provide the information in another format or language
as needed to facilitate understanding of the person's or person's legal representative's rights
and the agency's responsibilities.

Sec. 23.

Minnesota Statutes 2024, section 256B.0949, is amended by adding a subdivision
to read:

new text begin Subd. 19. new text end

new text begin Documentation requirements. new text end

new text begin (a) CMDE and EIDBI providers must ensure
that all documentation, including but not limited to health service records and personnel
files, complies with this subdivision, subdivision 16, and Minnesota Rules, parts 9505.2175
and 9505.2197. Documentation must be complete, legible, accurate, and readily accessible.
new text end

new text begin (b) All documentation must:
new text end

new text begin (1) be legible and understandable to individuals outside service delivery;
new text end

new text begin (2) include the participant's name on each health record page and the provider's name
on each personnel file page;
new text end

new text begin (3) be signed and dated by the provider completing the documentation, with the provider's
full name, title, and credentials;
new text end

new text begin (4) be entered within 72 hours of service, and contain a record and explanation of any
delays in entry;
new text end

new text begin (5) clearly reflect clinical decision-making and support medical necessity;
new text end

new text begin (6) be securely stored in accordance with the Health Insurance Portability and
Accountability Act (HIPAA), Public Law 104-191;
new text end

new text begin (7) be stored in accordance with state and federal document retention laws;
new text end

new text begin (8) be available for review or audit;
new text end

new text begin (9) include a record of caregiver involvement where applicable; and
new text end

new text begin (10) include a record of supervision and oversight for staff providing services requiring
supervision under EIDBI policy.
new text end

new text begin (c) Each EIDBI service occurrence must be documented in a progress note in a manner
and with the information determined by the commissioner.
new text end

new text begin (d) All providers must maintain current personnel records for each employee in a manner
determined by the commissioner that include:
new text end

new text begin (1) the employee's name, contact information, and hire date;
new text end

new text begin (2) the employee's completed employment application and acknowledgment of duties;
new text end

new text begin (3) the job description for the employee's job with the effective date;
new text end

new text begin (4) verification of the employee's qualifications, including but not limited to education,
licenses, certifications, enrollment attestation, degrees, transcripts, and experience;
new text end

new text begin (5) a background check pursuant to chapter 245C;
new text end

new text begin (6) orientation and required training the employee attended, including but not limited
to training on mandated reporting, cultural responsiveness, and EIDBI competencies;
new text end

new text begin (7) the dates of the employee's first supervised and unsupervised client contact following
employment;
new text end

new text begin (8) documentation of supervision received by the employee, including but not limited
to the supervisor's name and credentials, dates of supervision, and supervision content;
new text end

new text begin (9) the employee's CPR and emergency response training, if required; and
new text end

new text begin (10) the employee's annual performance evaluations.
new text end

Sec. 24.

Minnesota Statutes 2024, section 256B.4912, subdivision 12, is amended to read:

Subd. 12.

Home and community-based service documentation requirements.

(a)
new text begin Unless the provider is required to use an electronic visit verification system authorized
under section 256B.073, the provider must collect and maintain new text end documentation deleted text begin may be
collected and maintained deleted text end electronically or in paper form deleted text begin by providers and must be produced deleted text end new text begin .
The provider must produce all documentation new text end upon request by the commissioner.

(b) Documentation of a delivered service must be in English and must be legible according
to the standard of a reasonable person.

(c) If the service is reimbursed at an hourly or specified minute-based rate, each
documentation of the provision of a service, unless otherwise specified, must include:

(1) the date the documentation occurred;

(2) the day, month, and year when the service was provided;

(3) the start and stop times with a.m. and p.m. designations, except for case management
services as defined under chapter 256S and sections 256B.0913, subdivision 7; 256B.092,
subdivision 1a; and 256B.49, subdivision 13;

(4) the service name or description of the service provided; and

(5) the name, signature, and title, if any, of the provider of service. If the service is
provided by multiple staff members, the provider may designate a staff member responsible
for verifying services and completing the documentation required by this paragraph.

(d) If the service is reimbursed at a daily rate or does not meet the requirements in
paragraph (c), each documentation of the provision of a service, unless otherwise specified,
must include:

(1) the date the documentation occurred;

(2) the day, month, and year when the service was provided;

(3) the service name or description of the service provided; and

(4) the name, signature, and title, if any, of the person providing the service. If the service
is provided by multiple staff, the provider may designate a staff member responsible for
verifying services and completing the documentation required by this paragraph. new text begin The
designated staff member verifying the services must include in the documentation of the
provision of a service the names of all staff who provided the service.
new text end

Sec. 25.

Minnesota Statutes 2024, section 256B.4912, is amended by adding a subdivision
to read:

new text begin Subd. 17. new text end

new text begin Prohibition on room and board payments. new text end

new text begin (a) The provider must not use
medical assistance money to pay for room and board, including but not limited to rent,
mortgage payments, utilities, property taxes, homeowners association fees, or any other
housing-related cost, in accordance with federal home and community-based services waiver
requirements under United States Code, title 42, section 1396n(c), and Code of Federal
Regulations, title 42, section 441.310.
new text end

new text begin (b) A provider of home and community-based services, including but not limited to
integrated community supports under section 245D.03, subdivision 1, paragraph (c), clause
(8), must not:
new text end

new text begin (1) use, allocate, or apply any payment for home and community-based services to cover,
subsidize, discount, or otherwise contribute to any room and board expenses for a person
receiving services;
new text end

new text begin (2) apply agency operating margins, reserves, or profits derived from home and
community-based services to pay for rent or pay other housing costs for persons receiving
services; or
new text end

new text begin (3) enter into any financial arrangement, discount, concession, or reimbursement structure
that has the effect of using medical assistance service revenue to offset the housing costs
of a person receiving services.
new text end

new text begin (c) Nothing in this subdivision prohibits a provider from charging a person for room
and board in accordance with chapter 504B or applicable housing support laws, provided
the charge is independent of medical assistance payments and complies with all federal
home and community-based services setting requirements, including but not limited to
tenancy protections under Code of Federal Regulations, title 42, section 441.301(c)(4)(vi)(A).
new text end

new text begin (d) The commissioner may pursue corrective action, payment recovery, sanctions under
section 256B.064, and licensing action under chapter 245A or 245D for a violation of this
subdivision.
new text end

new text begin (e) Notwithstanding paragraphs (a) and (b), payment for room and board is permitted
when explicitly included as part of a service authorized in a federally approved home and
community-based services waiver under United States Code, title 42, section 1396n(c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 26.

Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 5a, is
amended to read:

Subd. 5a.

Base wage index; calculations.

The base wage index must be calculated as
follows:

(1) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of positive
supports professional, positive supports analyst, and positive supports specialist, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
code 29-1141);

(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
nurses (SOC code 29-2061);

(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employers;

(5) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
(SOC code 31-1131); and 20 percent of the median wage for social and human services
aide (SOC code 21-1093); and

(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093);

(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
code 31-1131); and 30 percent of the median wage for home health and personal care aide
(SOC code 31-1120);

(7) for day support services staff and prevocational services staff, 20 percent of the
median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
and human services aide (SOC code 21-1093);

(8) for positive supports analyst staff, 100 percent of the median wage for substance
abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);

(9) for positive supports professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(11) for individualized home supports with family training staff, 20 percent of the median
wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

(12) for individualized home supports with training services staff, 40 percent of the
median wage for community social service specialist (SOC code 21-1099); 50 percent of
the median wage for social and human services aide (SOC code 21-1093); and ten percent
of the median wage for psychiatric technician (SOC code 29-2053);

(13) for employment support services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(14) for employment exploration services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselor (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);

(15) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);

(16) for individualized home support without training staff, 50 percent of the median
wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
median wage for nursing assistant (SOC code 31-1131);

(17) effective until the effective date of clauses (18) and (19), for night supervision staff,
40 percent of the median wage for home health and personal care aide (SOC code 31-1120);
20 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent of the
median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median
wage for social and human services aide (SOC code 21-1093);

(18) effective January 1, 2026, or upon federal approval, whichever is later, for awake
night supervision staff, 40 percent of the median wage for home health and personal care
aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code
31-1131); 20 of percent the median wage for psychiatric technician (SOC code 29-2053);
and 20 percent of the median wage for social and human services aid (SOC code 21-1093);
deleted text begin and
deleted text end

(19) effective January 1, 2026, or upon federal approval, whichever is later, for asleep
night supervision staff, the minimum wage in Minnesota for large employers deleted text begin . deleted text end new text begin ; and
new text end

new text begin (20) for integrated community support staff, 40 percent of the median wage for
community and social services specialist (SOC code 21-1099); 50 percent of the median
wage for social and human services aide (SOC code 21-1093); and ten percent of the median
wage for psychiatric technician (SOC code 29-2053).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 27.

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, new text begin and new text end customized living services deleted text begin , and integrated community supports deleted text end .

(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, 2027.
new text end

Sec. 28.

Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
to read:

new text begin Subd. 8a. new text end

new text begin Integrated community supports unit-based services with programming;
component values and calculation of payment rates. new text end

new text begin (a) Component values for integrated
community supports unit-based services with programming are:
new text end

new text begin (1) competitive workforce factor: 6.7 percent;
new text end

new text begin (2) supervisory span of control ratio: 11 percent;
new text end

new text begin (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
new text end

new text begin (4) employee-related cost ratio: 23.6 percent;
new text end

new text begin (5) program plan support ratio: 27 percent;
new text end

new text begin (6) client programming and support ratio: 9.2 percent;
new text end

new text begin (7) general administrative support ratio: 13.25 percent;
new text end

new text begin (8) program-related expense ratio: 6.1 percent; and
new text end

new text begin (9) absence and utilization factor ratio: 9.4 percent.
new text end

new text begin (b) A unit of integrated community supports unit-based services with programming is
15 minutes.
new text end

new text begin (c) Payments for integrated community supports must be calculated as follows:
new text end

new text begin (1) determine the number of units of service to meet a recipient's needs;
new text end

new text begin (2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
new text end

new text begin (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
new text end

new text begin (4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
new text end

new text begin (5) multiply the number of direct staffing hours by the appropriate staff wage;
new text end

new text begin (6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
new text end

new text begin (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;
new text end

new text begin (8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio divided by the approved capacity for the integrated community supports
setting;
new text end

new text begin (9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;
new text end

new text begin (10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;
new text end

new text begin (11) this is the subtotal rate;
new text end

new text begin (12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio; and
new text end

new text begin (13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount.
new text end

new text begin (d) The commissioner must establish maximum allowable in-person and remote service
hours used in the rate methodology for integrated community supports based on the recipient's
case-mix classification. The total number of service hours entered into the rate framework
must not exceed the following limits:
new text end

new text begin (1) for case mix classifications A, C, and L, a maximum of two hours per day;
new text end

new text begin (2) for case mix classifications B, D, and F, a maximum of four hours per day;
new text end

new text begin (3) for case mix classifications E, G, I, J, and K, a maximum of six hours per day; and
new text end

new text begin (4) for case mix classification H, a maximum of eight hours per day.
new text end

new text begin (e) The daily limit in paragraph (d) does not limit a person's use of other disability waiver
services, which may be provided on the same day by the same provider providing integrated
community supports. Nothing in paragraph (d) prohibits approval of a rate exception for
individuals with exceptional or complex needs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 29.

Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
to read:

new text begin Subd. 10e. new text end

new text begin Documentation of staffing; auditing and rate review. new text end

new text begin (a) Effective for
services provided on or after January 1, 2029, a provider enrolled to provide residential
services under subdivision 6 must maintain documentation of direct staffing hours provided
to each person receiving services, including but not limited to documentation identifying:
new text end

new text begin (1) the name, role, and unique identifier for each staff person who provided services to
match records to payroll, time and attendance systems, and any other source documentation;
new text end

new text begin (2) the date services were provided;
new text end

new text begin (3) the total number of hours of direct support provided;
new text end

new text begin (4) awake overnight staffing hours provided, if applicable;
new text end

new text begin (5) asleep overnight staffing hours provided, if applicable; and
new text end

new text begin (6) any other staffing information required by the commissioner.
new text end

new text begin (b) A provider must maintain documentation in a manner and format determined by the
commissioner for at least six years. If a provider changes payroll vendors, merges operations,
or changes staffing identifiers, the provider must maintain a documented link between prior
and current staffing identifiers sufficient to allow tracking of hours worked, turnover, and
role classification for each staff person.
new text end

new text begin (c) A provider must submit the documentation required under paragraph (a) to the
commissioner annually, in a manner and format determined by the commissioner. The
commissioner must establish multiple submission windows throughout the calendar year
and may assign providers to a submission window for administrative efficiency and system
capacity. Documentation must reflect staffing provided during the prior calendar year and
must be submitted no later than the final business day of the provider's assigned submission
window. The commissioner may conduct random or targeted validations and audits of
submitted data and may require supplemental documentation as necessary to verify accuracy
and compliance.
new text end

new text begin (d) The commissioner must conduct periodic analysis of documentation submitted under
this subdivision and may validate staffing data through random audits or other verification
methods.
new text end

new text begin (e) Based on the analysis under paragraph (d), the commissioner may provide
recommendations to lead agencies regarding modifications to the rate of a person receiving
services, including increases or decreases necessary to align the rate with staffing provided
to the person as demonstrated by the submitted historical staffing documentation.
Recommendations must be based on the requirements of this section and applicable federal
and state requirements governing rate setting.
new text end

new text begin (f) If a provider fails to submit documentation requested within the submission window
in paragraph (c), the commissioner must issue a written notice of noncompliance. If
documentation is not received within 60 days following the notice of noncompliance, the
commissioner may temporarily suspend payments to the provider until the required
documentation is submitted. The commissioner must make withheld payments to the provider
once the required documentation is received. If such noncompliance persists, the
commissioner may adjust future rate payments, require the provider to submit a corrective
action plan, or pursue other enforcement actions as authorized by law.
new text end

new text begin (g) The commissioner must publish annual aggregate reports summarizing audit findings
and trends related to staffing provided under this section.
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. 30.

Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
to read:

new text begin Subd. 21. new text end

new text begin Administrative fees charged by providers and vendors. new text end

new text begin Effective July 1,
2027, or upon federal approval, whichever is later, the commissioner must limit
administrative fees charged by enrolled providers and vendors approved by lead agencies
to no more than six percent of the total cost of the service or purchased goods. This limit
applies to the following services and other new market rate services as determined by the
commissioner:
new text end

new text begin (1) chore services billed daily;
new text end

new text begin (2) transitional services; and
new text end

new text begin (3) transportation.
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. 31.

Minnesota Statutes 2024, section 256B.492, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Integrated community supports setting approval moratorium and
exception. new text end

new text begin (a) The commissioner must not approve a new integrated community supports
setting or approve an expansion of an existing integrated community supports setting except
as provided in this subdivision.
new text end

new text begin (b) The commissioner may approve an exception to the moratorium only when the
applicant demonstrates indirect control of the setting and compliance with:
new text end

new text begin (1) the federal home and community-based services requirements under Code of Federal
Regulations, title 42, section 441.301(c);
new text end

new text begin (2) the prohibition on the use of medical assistance money for room and board under
section 256B.4912, subdivision 17;
new text end

new text begin (3) independent lease requirements consistent with chapter 504B; and
new text end

new text begin (4) all documentation requirements under section 245D.12.
new text end

new text begin (c) To approve an exception, the commissioner must determine that the lead agency has
requested the additional capacity to meet the specific disability-related needs of the person.
Priority must be given to geographic regions with insufficient integrated community supports
capacity based on statewide or regional needs determination processes.
new text end

new text begin (d) For purposes of this subdivision, "integrated community supports setting" means a
multifamily housing building where a provider delivers integrated community supports
under section 245D.03, subdivision 1, paragraph (c), clause (8), and for which a provider
has a provider-controlled or provider-associated financial interest as defined under section
245A.02, subdivision 10b.
new text end

new text begin (e) Nothing in this subdivision authorizes the commissioner to revoke approval of a
previously approved setting following a change of ownership permissible under section
245A.043.
new text end

new text begin (f) A determination under this subdivision is final and not subject to appeal.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 32.

Minnesota Statutes 2024, section 256I.03, subdivision 10a, is amended to read:

Subd. 10a.

Housing support.

"Housing support" means assistance that provides at a
minimum room and board to persons who meet the eligibility requirements of section
256I.04. To receive payment for housing support, the residence must meet the requirements
under new text begin :
new text end

new text begin (1) new text end section 256I.04, deleted text begin subdivisions deleted text end new text begin subdivision new text end 2a new text begin , or 256I.041; and
new text end

new text begin (2) section 256I.04, subdivisions 2b new text end to 2f.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 33.

Minnesota Statutes 2024, section 256I.04, subdivision 1, is amended to read:

Subdivision 1.

Individual eligibility requirements.

An individual is eligible for and
entitled to a housing support payment to be made on the individual's behalf if deleted text begin the deleted text end new text begin an new text end agency
deleted text begin has approved the setting deleted text end new text begin or the commissioner has a housing support agreement with the
establishment new text end where the individual will receive housing support and the individual meets
the requirements in paragraph (a), (b), (c), or (d).

(a) The individual is aged, blind, or is over 18 years of age with a disability as determined
under the criteria used by the title II program of the Social Security Act, and meets the
resource restrictions and standards of section 256P.02, and the individual's countable income
after deducting the (1) exclusions and disregards of the SSI program, (2) the medical
assistance personal needs allowance under section 256B.35, and (3) an amount equal to the
income actually made available to a community spouse by an elderly waiver participant
under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058,
subdivision 2, is less than the monthly rate specified in the agency's agreement with the
provider of housing support in which the individual resides.

(b) The individual meets a category of eligibility under section 256D.05, subdivision 1,
paragraph (a), clauses (1), (3), (4) to (8), and (13), and paragraph (b), if applicable, and the
individual's resources are less than the standards specified by section 256P.02, and the
individual's countable income as determined under section 256P.06, less the medical
assistance personal needs allowance under section 256B.35 is less than the monthly rate
specified in the agency's agreement with the provider of housing support in which the
individual resides.

(c) The individual lacks a fixed, adequate, nighttime residence upon discharge from a
residential behavioral health treatment program, as determined by treatment staff from the
residential behavioral health treatment program. An individual is eligible under this paragraph
for up to three months, including a full or partial month from the individual's move-in date
at a setting approved for housing support following discharge from treatment, plus two full
months.

(d) The individual meets the criteria related to establishing a certified disability or
disabling condition in paragraph (a) or (b) and lacks a fixed, adequate, nighttime residence
upon discharge from a correctional facility, as determined by an authorized representative
from a Minnesota-based correctional facility. An individual is eligible under this paragraph
for up to three months, including a full or partial month from the individual's move-in date
at a setting approved for housing support following release, plus two full months. Any
income received by people who meet the disabling condition criteria established in paragraph
(a) or (b) is not countable for the duration of eligibility under this paragraph.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 34.

Minnesota Statutes 2025 Supplement, section 256I.04, subdivision 2a, is amended
to read:

Subd. 2a.

License required; staffing qualifications.

(a) Except as provided in paragraph
(b), an agency may not enter into an agreement with an establishment to provide housing
support unless:

(1) the establishment is licensed by the Department of Health as a hotel and restaurant;
a board and lodging establishment; a boarding care home before March 1, 1985; or a
supervised living facility, and the service provider for residents of the facility is licensed
under chapter 245A. However, an establishment licensed by the Department of Health to
provide lodging need not also be licensed to provide board if meals are being supplied to
residents under a contract with a food vendor who is licensed by the Department of Health; new text begin
or
new text end

(2) the residence is: (i) licensed by the commissioner of human services under Minnesota
Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior
to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265;
(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120,
with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02,
subdivision 4a, as a community residential setting by the commissioner of human services; new text begin
or
new text end

(3) the facility is licensed under chapter 144G and provides three meals a day deleted text begin ; or deleted text end new text begin .
new text end

deleted text begin (4) effective January 1, 2027, the establishment is licensed by the Department of Health
as a board and lodging establishment and is certified by the commissioner as a recovery
residence in accordance with section 254B.215, subdivision 3, that is subject to the
requirements of section 256I.04, subdivisions 2a to 2f. The Department of Human Services
must serve as the lead agency for agreements entered into under this clause.
deleted text end

(b) deleted text begin The requirements under paragraph (a) do not apply to establishments deleted text end new text begin An agency
may enter into an agreement to provide housing support with an establishment new text end exempt from
state licensure because deleted text begin they are deleted text end new text begin it is new text end :

(1) located on new text begin an new text end Indian deleted text begin reservations deleted text end new text begin reservation new text end and subject to tribal health and safety
requirements; or

(2) new text begin a new text end supportive housing deleted text begin establishments deleted text end new text begin establishment new text end where an individual has an
approved habitability inspection and an individual lease agreement.

(c) Supportive housing establishments that serve individuals who have experienced
long-term homelessness and emergency shelters must participate in the homeless management
information system and a coordinated assessment system as defined by the commissioner.

(d) deleted text begin Effective July 1, 2016, deleted text end An agency shall not have an agreement with a provider of
housing support unless all staff members who have direct contact with recipients:

(1) have skills and knowledge acquired through one or more of the following:

(i) a course of study in a health- or human services-related field leading to a bachelor
of arts, bachelor of science, or associate's degree;

(ii) one year of experience with the target population served;

(iii) experience as a mental health certified peer specialist according to section 256B.0615;
or

(iv) meeting the requirements for unlicensed personnel under sections 144A.43 to
144A.483;

(2) hold a current driver's license appropriate to the vehicle driven if transporting
recipients;

(3) complete training on vulnerable adults mandated reporting and child maltreatment
mandated reporting, where applicable; and

(4) complete housing support orientation training offered by the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 35.

Minnesota Statutes 2024, section 256I.04, subdivision 2f, is amended to read:

Subd. 2f.

Required services.

(a) In deleted text begin authorized deleted text end settings new text begin authorized new text end under subdivision 2a new text begin
or under section 256I.041 new text end , providers deleted text begin shall deleted text end new text begin must new text end ensure that participants have at a minimum:

(1) food preparation and service for three nutritional meals a day on site;

(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;

(3) housekeeping, including cleaning and lavatory supplies or service; and

(4) maintenance and operation of the building and grounds, including heat, water, garbage
removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair
and maintain equipment and facilities.

(b) In addition, when providers serve participants described in subdivision 1, paragraph
(c), the providers are required to assist the participants in applying for continuing housing
support payments before the end of the eligibility period.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 36.

new text begin [256I.041] STATE-EXECUTED HOUSING SUPPORT AGREEMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin State-executed housing support agreements. new text end

new text begin At the request of the
establishment, the commissioner may enter into a housing support agreement with the
following types of establishments:
new text end

new text begin (1) a residence with an approved integrated community supports setting capacity report
submitted under section 245D.12; and
new text end

new text begin (2) an establishment licensed by the commissioner of health as a board and lodging
establishment and designated by the commissioner of human services as a level-two certified
recovery residence under section 254B.215, subdivision 3.
new text end

new text begin Subd. 2. new text end

new text begin Requirements of state-executed housing support agreements. new text end

new text begin All housing
support agreements into which the commissioner enters under this section are subject to the
same requirements and limitations as housing support agreements entered into by other
agencies, including the requirements of section 256I.04, subdivisions 2a to 2f.
new text end

new text begin Subd. 3. new text end

new text begin Prohibited agreements. new text end

new text begin The commissioner must not enter into housing support
agreements with any establishment not described in subdivision 1.
new text end

new text begin Subd. 4. new text end

new text begin Administration of state-executed housing support agreements. new text end

new text begin For each
state-executed housing support agreement, the commissioner must designate an agency that
must administer the agreement, including determining eligibility for housing support and
making payments in accordance with the terms of the agreement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 37.

Minnesota Statutes 2024, section 256I.05, subdivision 11, is amended to read:

Subd. 11.

Cost-neutral transfers from the housing support fund.

(a) The commissioner
is authorized to make cost-neutral transfers from the housing support fund for beds under
this section to other funding programs administered by the department after consultation
with the agency in which the affected beds are located.

(b) The commissioner may also make cost-neutral transfers from the housing support
fund to agencies for beds removed from the housing support census under a plan submitted
by the agency and approved by the commissioner.

(c) The commissioner shall make a cost-neutral transfer of funding from the housing
support fund to the agency for emergency shelter beds removed from the housing support
census under a plan submitted by the agency and approved by the commissioner. Plans
submitted under this paragraph must include anticipated and actual outcomes for persons
experiencing homelessness in emergency shelters.

(d) Plans submitted under paragraph (b) or (c) must describe: (1) improved efficiencies
in administration; (2) requirements for individual eligibility; and (3) plans for quality
assurance monitoring and quality assurance outcomes. The commissioner shall review
agency plans to monitor implementation and outcomes at least biennially, and more
frequently if the commissioner deems necessary.

(e) Funding under paragraph (b), (c), or (d) may be used for the provision of room and
board or supplemental services according to section 256I.03, subdivisions 14a and 14b.
Providers must meet the requirements of new text begin both (1) either section 256I.04, subdivision 2a, or
section 256I.041, and (2) new text end section 256I.04, subdivisions deleted text begin 2a deleted text end new text begin 2b new text end to 2f. Funding must be allocated
annually, and the room and board portion of the allocation shall be adjusted according to
the percentage change in the housing support room and board rate. The commissioner or
agency may return beds to the housing support fund with 180 days' notice, including financial
reconciliation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2026.
new text end

Sec. 38.

Minnesota Statutes 2024, section 256S.21, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Documentation of staffing; auditing and rate review for residential support
services. new text end

new text begin (a) For purposes of this subdivision, residential support services include 24-hour
customized living services, customized living services, family adult foster care, and corporate
adult foster care.
new text end

new text begin (b) Effective January 1, 2029, a provider enrolled to provide residential support services
under this subdivision must maintain documentation of direct staffing hours provided to
each person receiving services, including but not limited to documentation identifying:
new text end

new text begin (1) the name, role, and unique identifier for each staff person who provided services to
match records to payroll, time and attendance systems, and any other source documentation;
new text end

new text begin (2) the date services were provided;
new text end

new text begin (3) the total number of hours of direct support provided;
new text end

new text begin (4) awake overnight staffing hours provided, if applicable;
new text end

new text begin (5) asleep overnight staffing hours provided, if applicable; and
new text end

new text begin (6) any other staffing information required by the commissioner.
new text end

new text begin (c) A provider must maintain documentation in a manner and format determined by the
commissioner for at least six years. If a provider changes payroll vendors, merges operations,
or changes staffing identifiers, the provider must maintain a documented link between prior
and current staffing identifiers sufficient to allow tracking of hours worked, turnover, and
role classification for each staff person.
new text end

new text begin (d) A provider must submit the documentation required under paragraph (b) to the
commissioner annually, in a manner and format determined by the commissioner. The
commissioner must establish multiple submission windows throughout the calendar year
and may assign providers to a submission window for administrative efficiency and system
capacity. Documentation must reflect staffing provided during the prior calendar year and
must be submitted no later than the final business day of the provider's assigned submission
window. The commissioner may conduct random or targeted validations and audits of
submitted data and may require supplemental documentation as necessary to verify accuracy
and compliance.
new text end

new text begin (e) The commissioner must conduct periodic analysis of documentation submitted under
this subdivision and may validate staffing data through random audits or other verification
methods.
new text end

new text begin (f) Based on the analysis under paragraph (e), the commissioner may provide
recommendations to lead agencies regarding modifications to the rate of the person receiving
services, including increases or decreases necessary to align the rate with staffing provided
to the person as demonstrated by the submitted historical staffing documentation.
Recommendations must be based on the requirements of this section and applicable federal
and state requirements governing rate setting.
new text end

new text begin (g) If a provider fails to submit documentation requested within the submission window
under paragraph (d), the commissioner must issue a written notice of noncompliance. If
documentation is not received within 60 days following the notice of noncompliance, the
commissioner may temporarily suspend payments to the provider until the required
documentation is submitted. The commissioner must make withheld payments to the provider
once the required documentation is received. If such noncompliance persists, the
commissioner may adjust future rate payments, require the provider to submit a corrective
action plan, or pursue other enforcement actions as authorized by law.
new text end

new text begin (h) The commissioner must publish annual aggregate reports summarizing audit findings
and trends related to staffing provided under this section.
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. 39.

Minnesota Statutes 2024, section 256S.21, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Administrative fees charged by providers or vendors. new text end

new text begin The commissioner
must limit administrative fees charged by enrolled providers or vendors approved by lead
agencies to no more than six percent of the total cost of the service or purchased goods.
This limit applies to the following services but allows for the addition of other services
determined by the commissioner:
new text end

new text begin (1) chore services billed daily;
new text end

new text begin (2) transitional services; and
new text end

new text begin (3) transportation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end

Sec. 40. new text begin MARKET RATE STUDY FOR HOME AND COMMUNITY-BASED
SERVICES.
new text end

new text begin (a) The commissioner of human services must conduct a market rate study to evaluate
the adequacy, sustainability, and equity of payment rates for specific home and
community-based services under the home and community-based services waivers authorized
under Minnesota Statutes, sections 256B.092 and 256B.49.
new text end

new text begin (b) The study must include, at minimum, an analysis of the following services:
new text end

new text begin (1) employment support services delivered in remote or virtual settings;
new text end

new text begin (2) 24-hour emergency assistance;
new text end

new text begin (3) assistive technology;
new text end

new text begin (4) environmental accessibility adaptations;
new text end

new text begin (5) chore services;
new text end

new text begin (6) transitional services;
new text end

new text begin (7) independent living skills training; and
new text end

new text begin (8) specialist services, including positive support services and orientation and mobility
services.
new text end

new text begin (c) In planning and conducting the market rate study, the commissioner must consult
with interested parties, including but not limited to service providers, people with disabilities,
lead agencies, Tribal Nations, culturally specific and community-based providers, and
disability advocacy organizations. The consultation process must be designed to ensure
meaningful participation from providers in greater Minnesota and from providers serving
communities of color and Tribal Nations.
new text end

new text begin (d) In conducting the study, the commissioner must analyze provider costs, workforce
availability, wage competitiveness, regional market conditions, inflationary impacts, and
access issues. The commissioner must also evaluate whether current reimbursement
methodologies reflect actual costs of providing services and support long-term access to
qualified providers.
new text end

new text begin (e) By February 15, 2027, the commissioner must submit a report with findings and
recommendations, including but not limited to any proposed statutory changes, to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
and human services policy and finance.
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. 41. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
METHOD OF VISIT VERIFICATION.
new text end

new text begin The commissioner must develop methods for collecting signatures required under
Minnesota Statutes, section 256B.073, subdivision 2, paragraph (c), clause (7), of the service
recipient, the service recipient's legal guardian or conservator, or the service recipient's
parent, if the service recipient is a minor, on a statement acknowledging that providing false
information on an electronic visit verification is a federal crime and attesting to the accuracy
of the information contained on an electronic visit verification. The methods may differ to
meet the needs of the service recipient, the service recipient's legal guardian or conservator,
or the service recipient's parent, if the service recipient is a minor.
new text end

Sec. 42. new text begin ELECTRONIC VISIT VERIFICATION AND MEDICAL ASSISTANCE
CLAIMS VALIDATION.
new text end

new text begin (a) The commissioner of human services must develop, test, and implement systems
changes necessary to integrate data collected through electronic visit verification systems,
as described under Minnesota Statutes, section 256B.073, with Minnesota's Medicaid
Management Information System (MMIS). Data collected through electronic visit verification
systems must be used as part of the commissioner's processes for validating claims for
services subject to electronic visit verification.
new text end

new text begin (b) The commissioner of human services must require that managed care plans and
county-based purchasing plans ensure electronic visit verification and claims system
interoperability by January 1, 2027.
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. 43. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2024, section 256B.073, subdivision 4, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2024, section 256B.4914, subdivision 6c, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective July 1, 2026. Paragraph (b) is effective
January 1, 2027, or upon federal approval, whichever is later.
new text end

ARTICLE 6

HUMAN SERVICES ADMINISTRATIVE REFORM

Section 1.

Minnesota Statutes 2024, section 16A.103, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Medical assistance; detailed costs. new text end

new text begin (a) In the forecast of state revenues and
expenditures under subdivision 1, the commissioner must include forecasted costs of each
covered service provided under medical assistance.
new text end

new text begin (b) At the time of delivering the forecast of state revenues and expenditures under
subdivision 1, the commissioner, in consultation with the commissioner of human services,
must submit a report to the chairs and ranking minority members of the legislative committees
with jurisdiction over medical assistance that includes the information required under
paragraph (a) and identifies the covered services that are mandatory benefits under federal
law and regulations.
new text end

Sec. 2.

Minnesota Statutes 2024, section 256B.05, subdivision 1, is amended to read:

Subdivision 1.

Administration of medical assistance.

new text begin (a) new text end The county agencies shall
administer medical assistance in their respective counties under the supervision of the state
agency and the commissioner of human services as specified in section 256.01, and shall
make such reports, prepare such statistics, and keep such records and accounts in relation
to medical assistance as the state agency may require under section 256.01, subdivision 2,
paragraph (o).

new text begin (b) The commissioner may administer specific duties related to determining medical
assistance eligibility on behalf of county agency administrations to ensure compliance with
federal and state requirements for the medical assistance program. If the commissioner
elects to assume specific duties under this paragraph, the commissioner must undertake the
assumed duties on a statewide and uniform administrative and operational basis.
new text end

Sec. 3. new text begin DIRECTION TO COMMISSIONER; TRANSFER ASSESSMENT.
new text end

new text begin (a) The commissioner of human services must procure a contract with a vendor to assess
the current status of administration of medical assistance and plan for a transfer of
administration of medical assistance to the commissioner by January 1, 2033. The
commissioner must submit the assessment and plan to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services and health
care policy and finance by October 1, 2028.
new text end

new text begin (b) The assessment and plan must include:
new text end

new text begin (1) a comprehensive assessment of medical assistance eligibility functions performed
by counties and Tribal governments, including identification of handoffs between county
and Tribal eligibility workers and state eligibility workers, and a catalog of eligibility
functions performed by state eligibility workers;
new text end

new text begin (2) examination of current expenditures, administrative budgets, and federal financial
participation in county and Tribal administrative work related to medical assistance eligibility
activities;
new text end

new text begin (3) eligibility system review, mapping, and recommended updates; and
new text end

new text begin (4) recommendations for a successful transition of centralized eligibility functions based
on consultation with stakeholders, review of information provided by county and Tribal
governments, review of other states' best practices for maximizing federal dollars, a feasible
timeline of activities, and required legislative changes and actions.
new text end

new text begin (c) The commissioner must consult with Minnesota's Tribal Nations, the Association of
Minnesota Counties, and the Minnesota Association of County Social Service Administrators
on the final deliverables included in the assessment.
new text end

Sec. 4. new text begin DIRECTION TO COMMISSIONER; ASSESSMENT OF ADMINISTRATIVE
ROLES.
new text end

new text begin (a) The commissioners of human services and children, youth, and families, in
consultation with Minnesota's Tribal Nations and counties, must conduct a study to assess
and recommend improvements to the roles and responsibilities of the Departments of Human
Services and Children, Youth, and Families, the counties, and Minnesota's Tribal Nations
in administering human services programs.
new text end

new text begin (b) The study must include a comprehensive review of programs administered by the
departments, including but not limited to medical assistance, MinnesotaCare, behavioral
health services, long-term services and supports, housing and homelessness programs,
Minnesota supplemental aid, general assistance, economic assistance, child support, child
care and early learning, and licensing and oversight functions.
new text end

new text begin (c) The study must evaluate the:
new text end

new text begin (1) current roles and responsibilities held by the departments, the counties, and
Minnesota's Tribal Nations in administering human services programs, including but not
limited to the challenges and benefits of the current delegation of roles and responsibilities;
new text end

new text begin (2) lived experience of people accessing human services programs related to the
delegation of administrative duties;
new text end

new text begin (3) financing of human services program administration across the departments, the
counties, and Minnesota's Tribal Nations; and
new text end

new text begin (4) administration of human services programs in other states, focusing on the roles and
responsibilities of the local governments versus the state Medicaid or human services agency,
and identifying the benefits, challenges, and financing of the delegation of duties.
new text end

new text begin (d) The study must focus on the goals of transforming the human services system to
ensure a transparent, accessible, accountable, equitable, and effective human services system.
new text end

new text begin (e) The study must provide recommendations for the optimal delegation of duties between
the departments, the counties, and Minnesota's Tribal Nations in the delivery of human
services. Recommendations must include:
new text end

new text begin (1) how the delegation of duties will improve the experience of people accessing human
services;
new text end

new text begin (2) implementation and timing considerations to ensure continuity of services;
new text end

new text begin (3) systems technology adaptations required;
new text end

new text begin (4) workforce considerations; and
new text end

new text begin (5) financing strategies and the estimated fiscal impact to the state budget.
new text end

new text begin (f) Notwithstanding Minnesota Statutes, chapter 13, or other statutes or rules to the
contrary, counties must provide financial, human resources, and other information necessary
to complete the study in the form and manner and on the timeline requested by the
commissioners.
new text end

new text begin (g) By October 1, 2028, the commissioners must submit a report on the study and
recommendations to the chairs and ranking minority members of the legislative committees
with jurisdiction over health; human services; and children, youth, and families policy and
finance.
new text end

Sec. 5. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
EVALUATION OF DHS STRUCTURE AND PROCESSES.
new text end

new text begin (a) The commissioner of human services must contract with an external consultant to
continue and complete the project initiated under Executive Order 25-10, section 1, paragraph
(g), to make recommendations to improve the Department of Human Services' performance
as the state's Medicaid agency. The external consultant must evaluate the department's
structure and processes and assess the adequacy of the department's current policies,
procedures, systems, organizational structure, staffing levels, and funding to effectively
increase program integrity, minimize fraud, and more effectively serve as the state's Medicaid
agency.
new text end

new text begin (b) By October 1, 2026, the commissioner must submit a report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance. The report must include information on the recommendations
of the external contractor made through September 30, 2026, and any actions the
commissioner has taken in response to the external contractor's recommendations or other
actions taken by the commissioner pursuant to Executive Order 25-10, section 1, paragraph
(g), through September 30, 2026.
new text end

new text begin (c) By October 1, 2027, the commissioner must submit a summary of the
recommendations of the external contractor with whom the commissioner contracted under
Executive Order 25-10, section 1, paragraph (g), and any actions the commissioner has
taken in response to either the external contractor's recommendations or other actions taken
by the commissioner pursuant to Executive Order 25-10, section 1, paragraph (g). The
summary must be submitted to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services policy and finance.
new text end

new text begin (d) By October 1, 2028, the commissioner must submit the external consultant's report
summarizing the evaluation and recommendations to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance. The commissioner must also submit draft legislative language to
implement the recommendations of the external consultant's recommendations.
new text end

ARTICLE 7

CHILDREN, YOUTH, AND FAMILIES

Section 1.

Minnesota Statutes 2024, section 142E.16, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Training required for payments. new text end

new text begin (a) As a condition of payment and prior to
authorization, all providers receiving child care assistance payments must complete
compliance training developed by the commissioner that addresses program integrity
requirements including but not limited to record keeping and billing requirements. The
commissioner shall develop criteria, reporting requirements, and standards for when providers
need to renew training after their initial registration.
new text end

new text begin (b) Providers that do not have an active registration to receive child care assistance on
or before April 12, 2027, must complete the training under this subdivision prior to
authorization. Providers with an active registration on or before April 12, 2027, must
complete the training under this subdivision before the provider's first renewal after April
12, 2027, or April 10, 2028, whichever is later.
new text end

ARTICLE 8

MISCELLANEOUS

Section 1.

Minnesota Statutes 2024, section 245.096, is amended to read:

245.096 CHANGES TO GRANT PROGRAMS.

Prior to implementing any deleted text begin substantial deleted text end changes to a grant funding formula disbursed
through allocations administered by the commissioner, the commissioner must provide a
report on the nature of the changes, the effect the changes will have, whether any funding
will change, and other relevant information, to the chairs and ranking minority members of
the legislative committees with jurisdiction over human services. The report must be provided
prior to the start of a regular session, and the proposed changes cannot be implemented until
after the adjournment of that regular session.

Sec. 2. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
CODIFYING THE OFFICE OF INSPECTOR GENERAL.
new text end

new text begin (a) By December 1, 2026, the commissioner of human services must provide statutory
language that codifies the Department of Human Services Office of Inspector General to
the chairs and ranking minority members of the legislative committees with jurisdiction
over human services and the nonpartisan staff from House Research Department and Senate
Counsel, Research, and Fiscal Analysis whose drafting areas include human services. The
statutory language must only contain:
new text end

new text begin (1) existing legal authority identified by the office that the office relies upon to carry
out its duties; and
new text end

new text begin (2) policies and procedures necessary for the office to carry out its existing duties.
new text end

new text begin (b) The commissioner must not include desired policy changes to the office, its structure,
or its duties within the codification language required under paragraph (a).
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

ARTICLE 9

DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS

Section 1. new text begin HUMAN SERVICES APPROPRIATIONS. new text end

new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown in
parentheses, are subtracted from the appropriations in Laws 2025, First Special Session
chapter 3, article 20, and Laws 2025, First Special Session chapter 9, article 12, to the agency
and for purposes specified in this article. The appropriations are from the general fund or
other named fund and are available for the fiscal years indicated for each purpose. The
figures "2026" and "2027" used in this article mean that the addition to or subtraction from
the appropriation listed under them is available for the fiscal year ending June 30, 2026, or
June 30, 2027, respectively. Base adjustments mean the addition to or subtraction from the
base level adjustment set in Laws 2025, First Special Session chapter 3, article 20, and Laws
2025, First Special Session chapter 9, article 12. Appropriations and reductions to
appropriations for the fiscal year ending June 30, 2026, are effective the day following final
enactment unless a different effective date is explicit.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2026 new text end		new text begin 2027 new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin (95,072,000) new text end

new text begin Appropriations by Fund new text end
	new text begin 2026 new text end	new text begin 2027 new text end
new text begin General new text end	new text begin -0- new text end	new text begin (97,085,000) new text end
new text begin Special Government Revenue Fund new text end	new text begin -0- new text end	new text begin 2,013,000 new text end

new text begin The amounts that may be spent for each
purpose are specified in the following sections
and subdivisions.
new text end

Sec. 3. new text begin CENTRAL OFFICE; OPERATIONS new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 30,611,000 new text end

new text begin Subdivision 1. new text end new text begin Assessment of Roles in Administering Human Services Programs new text end

new text begin $3,000,000 in fiscal year 2027 is for an
assessment of the administrative roles and
responsibilities of the state agency, counties,
and Tribal Nations administering human
services programs. This is a onetime
appropriation and is available until June 30,
2029.
new text end

new text begin Subd. 2. new text end new text begin Prepayment Review Vendor Contract new text end

new text begin $2,500,000 in fiscal year 2027 is for a
competitively awarded contract to establish
ongoing prepayment claims analysis
technology for services provided under
medical assistance. This is a onetime
appropriation.
new text end

new text begin Subd. 3. new text end new text begin Prepayment Review Technology Contract new text end

new text begin $3,750,000 in fiscal year 2027 is for a
competitively awarded vendor contract to
support prepayment review technology to
build on and reference existing claims edits
infrastructure, prior authorization criteria, and
continuous refining of the prepayment review
analytic module to automate fraud detection
and payment integrity based on findings over
time.
new text end

new text begin Subd. 4. new text end new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$22,087,000 in fiscal year 2028 and increased
by $20,406,000 in fiscal year 2029.
new text end

Sec. 4. new text begin CENTRAL OFFICE; HEALTH CARE new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 10,411,000 new text end

new text begin Subdivision 1. new text end new text begin Medical Assistance Eligibility Study new text end

new text begin $2,000,000 in fiscal year 2027 is for a study
on the transfer of eligibility functions of the
medical assistance program performed by
county and Tribal governments to the
Department of Human Services. This is a
onetime appropriation and is available until
June 30, 2029.
new text end

new text begin Subd. 2. new text end new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$26,755,000 in fiscal year 2028 and increased
by $26,767,000 in fiscal year 2029.
new text end

Sec. 5. new text begin CENTRAL OFFICE; AGING AND DISABILITY SERVICES new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 9,101,000 new text end

new text begin Subdivision 1. new text end new text begin Market Rate and Homemaking Services Rate Study new text end

new text begin $500,000 in fiscal year 2027 is for a study on
rate setting methodologies for services
currently offered under market rate
methodologies and homemaking services. This
is onetime appropriation and is available until
June 30, 2028.
new text end

new text begin Subd. 2. new text end new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$10,096,000 in fiscal year 2028 and increased
by $10,154,000 in fiscal year 2029.
new text end

Sec. 6. new text begin CENTRAL OFFICE; BEHAVIORAL HEALTH new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 1,558,000 new text end

new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$1,827,000 in fiscal year 2028 and increased
by $1,827,000 in fiscal year 2029.
new text end

Sec. 7. new text begin CENTRAL OFFICE; OFFICE OF INSPECTOR GENERAL new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 41,436,000 new text end

new text begin Subdivision 1. new text end new text begin Appropriations by Fund new text end

new text begin Appropriations by Fund new text end
	new text begin 2026 new text end	new text begin 2027 new text end
new text begin General Fund new text end	new text begin -0- new text end	new text begin 39,423,000 new text end
new text begin Special Government Revenue Fund new text end	new text begin -0- new text end	new text begin 2,013,000 new text end

new text begin Subd. 2. new text end new text begin Post-Payment Review of Managed Care Organization Billing new text end

new text begin $30,000,000 in fiscal year 2027 is for a
competitively awarded vendor contract to
support post-payment review of managed care
organization billing.
new text end

new text begin Subd. 3. new text end new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$41,112,000 in fiscal year 2028 and increased
by $40,963,000 in fiscal year 2029. The
special revenue government fund base is
increased by $2,352,000 in fiscal year 2028
and increased by $2,352,000 in fiscal year
2029.
new text end

Sec. 8. new text begin FORECASTED PROGRAMS; HOUSING SUPPORT new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 2,467,000 new text end

Sec. 9. new text begin FORECASTED PROGRAMS; MEDICAL ASSISTANCE new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin (190,624,000) new text end

Sec. 10. new text begin FORECASTED PROGRAMS; ALTERNATIVE CARE new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin (21,000) new text end

Sec. 11. new text begin FORECASTED PROGRAMS; BEHAVIORAL HEALTH FUND new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin (11,000) new text end

Sec. 12. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit or an appropriation is made available beyond June 30,
2027.
new text end

Sec. 13. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end

new text begin If an appropriation, transfer, or cancellation in this article is enacted more than once
during the 2026 legislative session, the appropriation, transfer, or cancellation must be given
effect once.
new text end

ARTICLE 10

DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS

Section 1. new text begin CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS. new text end

new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown in
parentheses, are subtracted from the appropriations in Laws 2025, First Special Session
chapter 3, article 22, to the agency and for purposes specified in this article. The
appropriations are from the general fund or other named fund and are available for the fiscal
years indicated for each purpose. The figures "2026" and "2027" used in this article mean
that the addition to or subtraction from the appropriation listed under them is available for
the fiscal year ending June 30, 2026, or June 30, 2027, respectively. Base adjustments mean
the addition to or subtraction from the base level adjustment set in Laws 2025, First Special
Session chapter 3, article 22. Appropriations and reductions to appropriations for the fiscal
year ending June 30, 2026, are effective the day following final enactment unless a different
effective date is explicit.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2026 new text end		new text begin 2027 new text end

Sec. 2. new text begin COMMISSIONER OF CHILDREN, YOUTH, AND FAMILIES new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 7,208,000 new text end

Sec. 3. new text begin OPERATIONS AND ADMINISTRATION; AGENCY-WIDE SUPPORTS new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 5,777,000 new text end

new text begin Subdivision 1. new text end new text begin Analysis of Governance Roles for DCYF Programs new text end

new text begin $2,500,000 in fiscal year 2027 is for a study
to analyze the governance roles for DCYF
programs. This is a onetime appropriation.
new text end

new text begin Subd. 2. new text end new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$3,012,000 in fiscal year 2028 and $3,013,000
in fiscal year 2029.
new text end

Sec. 4. new text begin OPERATIONS AND ADMINISTRATION; EARLY CHILDHOOD new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 612,000 new text end

new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$526,000 in fiscal year 2028 and $687,000 in
fiscal year 2029.
new text end

Sec. 5. new text begin GRANT PROGRAMS; SUPPORT SERVICES GRANTS new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 819,000 new text end

new text begin Subdivision 1. new text end new text begin Fraud Prevention Investigation Grants new text end

new text begin $819,000 in fiscal year 2027 is for additional
fraud prevention investigation grants under
Minnesota Statutes, section 256.983.
Notwithstanding Minnesota Statutes, section
16B.98, subdivision 14, the amount for
administrative costs under this section is $0.
new text end

new text begin Subd. 2. new text end new text begin Base Level Adjustment new text end

new text begin The general fund base is increased by
$803,000 in fiscal year 2028 and increased by
$803,000 in fiscal year 2029.
new text end

Sec. 6. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit or an appropriation is made available beyond June 30,
2027.
new text end

Sec. 7. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end

new text begin If an appropriation, transfer, or cancellation in this article is enacted more than once
during the 2026 legislative session, the appropriation, transfer, or cancellation must be given
effect once.
new text end

APPENDIX

Repealed Minnesota Statutes: ueh3379-2

245.735 CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC SERVICES.

Subd. 1a.

Definitions.

(a) For the purposes of this section, the terms in this subdivision have the meanings given.

(b) "Alcohol and drug counselor" has the meaning given in section 245G.11, subdivision 5.

(c) "Care coordination" means the activities required to coordinate care across settings and providers for a person served to ensure seamless transitions across the full spectrum of health services. Care coordination includes outreach and engagement; documenting a plan of care for medical, behavioral health, and social services and supports in the integrated treatment plan; assisting with obtaining appointments; confirming appointments are kept; developing a crisis plan; tracking medication; and implementing care coordination agreements with external providers. Care coordination may include psychiatric consultation with primary care practitioners and with mental health clinical care practitioners.

(d) "Community needs assessment" means an assessment to identify community needs and determine the community behavioral health clinic's capacity to address the needs of the population being served.

(e) "Comprehensive evaluation" means a person-centered, family-centered, and trauma-informed evaluation meeting the requirements of subdivision 4b completed for the purposes of diagnosis and treatment planning.

(f) "Designated collaborating organization" means an entity meeting the requirements of subdivision 3a with a formal agreement with a CCBHC to furnish CCBHC services.

(g) "Functional assessment" means an assessment of a client's current level of functioning relative to functioning that is appropriate for someone the client's age and that meets the requirements of subdivision 4a.

(h) "Initial evaluation" means an evaluation completed by a mental health professional that gathers and documents information necessary to formulate a preliminary diagnosis and begin client services.

(i) "Integrated treatment plan" means a documented plan of care that is person- and family-centered and formulated to respond to a client's needs and goals.

(j) "Mental health professional" has the meaning given in section 245I.04, subdivision 2.

(k) "Mobile crisis services" has the meaning given in section 256B.0624, subdivision 2.

(l) "Preliminary screening and risk assessment" means a mandatory screening and risk assessment that is completed at the first contact with the prospective CCBHC service recipient and determines the acuity of client need.

Subd. 2a.

Establishment.

The certified community behavioral health clinic model is an integrated payment and service delivery model that uses evidence-based behavioral health practices to achieve better outcomes for individuals experiencing behavioral health concerns while achieving sustainable rates for providers and economic efficiencies for payors.

Subd. 3.

Certified community behavioral health clinics.

(a) The commissioner shall establish state certification and recertification processes for certified community behavioral health clinics (CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified under this section to be eligible for reimbursement under medical assistance, without service area limits based on geographic area or region. The commissioner shall consult with CCBHC stakeholders before establishing and implementing changes in the certification or recertification process and requirements. Any changes to the certification or recertification process or requirements must be consistent with the most recently issued Certified Community Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental Health Services Administration. The commissioner must allow a transition period for CCBHCs to meet the revised criteria on or before January 1, 2025. The commissioner is authorized to amend the state's Medicaid state plan or the terms of the demonstration to comply with federal requirements.

(b) As part of the state CCBHC certification and recertification processes, the commissioner shall provide to entities applying for certification or requesting recertification the standard requirements of the community needs assessment and the staffing plan that are consistent with the most recently issued Certified Community Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental Health Services Administration.

(c) The commissioner shall schedule a certification review that includes a site visit within 90 calendar days of receipt of an application for certification or recertification.

(d) Entities that choose to be CCBHCs must:

(1) complete a community needs assessment and complete a staffing plan that is responsive to the needs identified in the community needs assessment and update both the community needs assessment and the staffing plan no less frequently than every 36 months;

(2) comply with state licensing requirements and other requirements issued by the commissioner;

(3) employ or contract with a medical director. A medical director must be a physician licensed under chapter 147 and either certified by the American Board of Psychiatry and Neurology, certified by the American Osteopathic Board of Neurology and Psychiatry, or eligible for board certification in psychiatry. A registered nurse who is licensed under sections 148.171 to 148.285 and is certified as a nurse practitioner in adult or family psychiatric and mental health nursing by a national nurse certification organization may serve as the medical director when a CCBHC is unable to employ or contract a qualified physician;

(4) employ or contract for clinic staff who have backgrounds in diverse disciplines, including licensed mental health professionals and licensed alcohol and drug counselors, and staff who are culturally and linguistically trained to meet the needs of the population the clinic serves;

(5) ensure that clinic services are available and accessible to individuals and families of all ages and genders with access on evenings and weekends and that crisis management services are available 24 hours per day;

(6) establish fees for clinic services for individuals who are not enrolled in medical assistance using a sliding fee scale that ensures that services to patients are not denied or limited due to an individual's inability to pay for services;

(7) comply with quality assurance reporting requirements and other reporting requirements included in the most recently issued Certified Community Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental Health Services Administration;

(8) provide crisis mental health and substance use services, withdrawal management services, emergency crisis intervention services, and stabilization services through existing mobile crisis services; screening, assessment, and diagnosis services, including risk assessments and level of care determinations; person- and family-centered treatment planning; outpatient mental health and substance use services; targeted case management; psychiatric rehabilitation services; peer support and counselor services and family support services; and intensive community-based mental health services, including mental health services for members of the armed forces and veterans. CCBHCs must directly provide the majority of these services to enrollees, but may coordinate some services with another entity through a collaboration or agreement, pursuant to subdivision 3a;

(9) provide coordination of care across settings and providers to ensure seamless transitions for individuals being served across the full spectrum of health services, including acute, chronic, and behavioral needs;

(10) be certified as a mental health clinic under section 245I.20;

(11) comply with standards established by the commissioner relating to CCBHC screenings, assessments, and evaluations that are consistent with this section;

(12) be licensed to provide substance use disorder treatment under chapter 245G;

(13) be certified to provide children's therapeutic services and supports under section 256B.0943;

(14) be certified to provide adult rehabilitative mental health services under section 256B.0623;

(15) be enrolled to provide mental health crisis response services under section 256B.0624;

(16) be enrolled to provide mental health targeted case management under section 256B.0625, subdivision 20;

(17) provide services that comply with the evidence-based practices described in subdivision 3d;

(18) provide peer services as defined in sections 256B.0615, 256B.0616, and 245G.07, subdivision 2a, paragraph (b), clause (2), as applicable when peer services are provided; and

(19) inform all clients upon initiation of care of the full array of services available under the CCBHC model.

Subd. 3a.

Designated collaborating organizations.

If a certified CCBHC is unable to provide one or more of the services listed in subdivision 3, paragraph (d), clauses (8) to (19), the CCBHC may contract with another entity that has the required authority to provide that service and that meets the requirements of the most recently issued Certified Community Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental Health Services Administration.

Subd. 3b.

Exemptions to host county approval.

Notwithstanding any other law that requires a county contract or other form of county approval for a service listed in subdivision 3, paragraph (d), clause (8), a CCBHC that meets the requirements of this section may receive the prospective payment under section 256B.0625, subdivision 5m, for that service without a county contract or county approval.

Subd. 3c.

Variances.

When the standards listed in this section or other applicable standards conflict or address similar issues in duplicative or incompatible ways, the commissioner may grant variances to state requirements if the variances do not conflict with federal requirements for services reimbursed under medical assistance. If standards overlap, the commissioner may substitute all or a part of a licensure or certification that is substantially the same as another licensure or certification. The commissioner shall consult with stakeholders before granting variances under this provision. For a CCBHC that is certified but not approved for prospective payment under section 256B.0625, subdivision 5m, the commissioner may grant a variance under this paragraph if the variance does not increase the state share of costs.

Subd. 3d.

Evidence-based practices.

The commissioner shall issue a list of required evidence-based practices to be delivered by CCBHCs and may also provide a list of recommended evidence-based practices. The commissioner may update the list to reflect advances in outcomes research and medical services for persons living with mental illnesses or substance use disorders. The commissioner shall take into consideration the adequacy of evidence to support the efficacy of the practice across cultures and ages, the workforce available, and the current availability of the practice in the state. At least 30 days before issuing the initial list or issuing any revisions, the commissioner shall provide stakeholders with an opportunity to comment.

Subd. 3e.

Recertification.

A CCBHC must apply for recertification every 36 months.

Subd. 3f.

Notice and opportunity for correction.

(a) The commissioner shall provide a formal written notice to an applicant for CCBHC certification outlining the determination of the application and process for applicable and necessary corrective action required of the applicant signed by the commissioner or appropriate division director to applicant entities within 45 calendar days of the site visit.

(b) The commissioner may reject an application if the applicant entity does not take all corrective actions specified in the notice and notify the commissioner that the applicant entity has done so within 60 calendar days.

(c) The commissioner must send the applicant entity a final decision on the corrected application within 45 calendar days of the applicant entity's notice to the commissioner that the applicant has taken the required corrective actions.

Subd. 3g.

Decertification process.

The commissioner must establish a process for decertification. The commissioner must require corrective action, medical assistance repayment, or decertification of a CCBHC that no longer meets the requirements in this section or that fails to meet the standards provided by the commissioner in the application, certification, or recertification process.

Subd. 3h.

Minimum staffing standards.

A CCBHC must meet minimum staffing requirements required by the most recently issued Certified Community Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental Health Services Administration.

Subd. 4a.

Functional assessment requirements.

(a) For adults, a functional assessment may be completed using a Daily Living Activities-20 tool.

(b) Notwithstanding any law to the contrary, a functional assessment performed by a CCBHC that meets the requirements of this subdivision satisfies the requirements in:

(1) section 256B.0623, subdivision 9;

(2) section 245.4711, subdivision 3; and

(3) Minnesota Rules, part 9520.0914, subpart 2.

Subd. 4b.

Requirements for comprehensive evaluations.

(a) A comprehensive evaluation must be completed for all new clients within 60 calendar days following the preliminary screening and risk assessment.

(b) Only a mental health professional may complete a comprehensive evaluation. The mental health professional must consult with an alcohol and drug counselor when substance use disorder services are deemed clinically appropriate.

(c) The comprehensive evaluation must consist of the synthesis of existing information including but not limited to an external diagnostic assessment, crisis assessment, preliminary screening and risk assessment, initial evaluation, and primary care screenings.

(d) A comprehensive evaluation must be completed in the cultural context of the client and updated to reflect changes in the client's conditions and at the client's request or when the client's condition no longer meets the existing diagnosis.

(e) The psychiatric evaluation and management service fulfills requirements for the comprehensive evaluation when a client of a CCBHC is receiving exclusively psychiatric evaluation and management services. The CCBHC shall complete the comprehensive evaluation within 60 calendar days of a client's referral for additional CCBHC services.

(f) For clients engaging exclusively in substance use disorder services at the CCBHC, a substance use disorder comprehensive assessment as defined in section 245G.05, subdivision 2, that is completed within 60 calendar days of service initiation shall fulfill requirements of the comprehensive evaluation.

(g) Notwithstanding any law to the contrary, a comprehensive evaluation performed by a CCBHC that meets the requirements of this subdivision satisfies the requirements in:

(1) section 245.462, subdivision 20, paragraph (c);

(2) section 245.4711, subdivision 2, paragraph (b);

(3) section 245.4871, subdivision 6;

(4) section 245.4881, subdivision 2, paragraph (c);

(5) section 245G.04, subdivision 1;

(6) section 245G.05, subdivision 1;

(7) section 245I.10, subdivisions 4 to 6;

(8) section 256B.0623, subdivisions 3, clause (4), 8, and 10;

(9) section 256B.0943, subdivisions 3 and 6, paragraph (b), clause (1);

(10) Minnesota Rules, part 9520.0909, subpart 1;

(11) Minnesota Rules, part 9520.0910, subparts 1 and 2; and

(12) Minnesota Rules, part 9520.0914, subpart 2.

Subd. 4c.

Requirements for initial evaluations.

(a) A CCBHC must complete either an initial evaluation or a comprehensive evaluation as required by the most recently issued Certified Community Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental Health Services Administration.

(b) Notwithstanding any law to the contrary, an initial evaluation performed by a CCBHC that meets the requirements of this subdivision satisfies the requirements in:

(1) section 245.4711, subdivision 4;

(2) section 245.4881, subdivisions 3 and 4;

(3) section 245I.10, subdivision 5;

(4) section 256B.0623, subdivisions 3, clause (4), 8, and 10;

(5) section 256B.0943, subdivisions 3 and 6, paragraph (b), clauses (1) and (2);

(6) Minnesota Rules, part 9520.0909, subpart 1;

(7) Minnesota Rules, part 9520.0910, subpart 1;

(8) Minnesota Rules, part 9520.0914, subpart 2;

(9) Minnesota Rules, part 9520.0918, subparts 1 and 2; and

(10) Minnesota Rules, part 9520.0919, subpart 2.

Subd. 4d.

Requirements for integrated treatment plans.

(a) An integrated treatment plan must be completed within 60 calendar days following the preliminary screening and risk assessment and updated no less frequently than every six months or when the client's circumstances change.

(b) Only a mental health professional may complete an integrated treatment plan. The mental health professional must consult with an alcohol and drug counselor when substance use disorder services are deemed clinically appropriate. An alcohol and drug counselor may approve the integrated treatment plan. The integrated treatment plan must be developed through a shared decision-making process with the client, the client's support system if the client chooses, or, for children, with the family or caregivers.

(c) The integrated treatment plan must:

(1) use the ASAM 6 dimensional framework; and

(2) incorporate prevention, medical and behavioral health needs, and service delivery.

(d) The psychiatric evaluation and management service fulfills requirements for the integrated treatment plan when a client of a CCBHC is receiving exclusively psychiatric evaluation and management services. The CCBHC must complete an integrated treatment plan within 60 calendar days of a client's referral for additional CCBHC services.

(e) Notwithstanding any law to the contrary, an integrated treatment plan developed by a CCBHC that meets the requirements of this subdivision satisfies the requirements in:

(1) section 245G.06, subdivision 1;

(2) section 245G.09, subdivision 3, paragraph (a), clause (6);

(3) section 245I.10, subdivisions 7 and 8; and

(4) section 256B.0943, subdivision 6, paragraph (b), clause (2).

Subd. 4e.

Additional licensing and certification requirements.

(a) This subdivision applies to programs and clinics that are a part of a CCBHC.

(b) The requirements for initial evaluations under subdivision 4c, comprehensive evaluations under subdivision 4b, and integrated treatment plans under subdivision 4d are incorporated into the licensing requirements for substance use disorder treatment programs under chapter 245G.

(c) The requirements for initial evaluations under subdivision 4c, comprehensive evaluations under subdivision 4b, and integrated treatment plans under subdivision 4d are incorporated into the certification requirements for mental health clinics under section 245I.20.

(d) The Department of Human Services licensing division will review, inspect, and investigate for compliance with the requirements in subdivisions 4b to 4d for programs or clinics subject to this subdivision.

Subd. 7.

Addition of CCBHCs to section 223 state demonstration programs.

(a) If the commissioner's request under subdivision 6 to reenter the demonstration program established by section 223 of the Protecting Access to Medicare Act is approved, upon reentry the commissioner must follow all federal guidance on the addition of CCBHCs to section 223 state demonstration programs.

(b) Prior to participating in the demonstration, a CCBHC must meet the demonstration certification criteria and prospective payment system guidance in effect at that time and be certified as a CCBHC by the state. The Substance Abuse and Mental Health Services Administration attestation process for CCBHC expansion grants is not sufficient to constitute state certification. CCBHCs newly added to the demonstration must participate in all aspects of the state demonstration program, including but not limited to quality measurement and reporting, evaluation activities, and state CCBHC demonstration program requirements, such as use of state-specified evidence-based practices. A newly added CCBHC must report on quality measures before its first full demonstration year if it joined the demonstration program in calendar year 2023 out of alignment with the state's demonstration year cycle. A CCBHC may provide services in multiple locations and in community-based settings subject to federal rules of the 223 demonstration authority or Medicaid state plan authority.

(c) If a CCBHC meets the definition of a satellite facility, as defined by the Substance Abuse and Mental Health Services Administration, and was established after April 1, 2014, the CCBHC cannot receive payment as a part of the demonstration program.

Subd. 8.

Grievance procedures required.

CCBHCs and designated collaborating organizations must allow all service recipients access to grievance procedures, which must satisfy the minimum requirements of medical assistance and other grievance requirements such as those that may be mandated by relevant accrediting entities.

245A.042 HOME AND COMMUNITY-BASED SERVICES; ADDITIONAL STANDARDS AND PROCEDURES.

Subd. 5.

Compliance education required.

The commissioner must make licensing compliance education available to all license holders operating programs licensed under both this chapter and chapter 245D. The licensing compliance education must include clear and accessible explanations of achieving and maintaining compliance with the relevant licensing requirements under this chapter and chapter 245D.

245A.10 FEES.

Subd. 3a.

Fee for change of ownership exception.

(a) A license holder must submit a fee of $2,100 for each license subject to the change in ownership exception under section 245A.043, subdivision 2, paragraph (b).

(b) License holders under chapter 245D must submit a fee of $4,200 for each license subject to the change in ownership exception under section 245A.043, subdivision 2, paragraph (b).

(c) A license holder for a children's residential facility must submit a fee of $500 for each license subject to the change in ownership exception under section 245A.043, subdivision 2, paragraph (b).

245C.03 BACKGROUND STUDY; INDIVIDUALS TO BE STUDIED.

Subd. 7.

Children's therapeutic services and supports providers.

The commissioner shall conduct background studies of all direct service providers and volunteers for children's therapeutic services and supports providers under section 256B.0943.

245I.20 MENTAL HEALTH CLINIC.

Subd. 9.

Quality assurance and improvement plan.

(a) At a minimum, a certification holder must develop a written quality assurance and improvement plan that includes a plan for:

(1) encouraging ongoing consultation among members of the treatment team;

(2) obtaining and evaluating feedback about services from clients, family and other natural supports, referral sources, and staff persons;

(3) measuring and evaluating client outcomes;

(4) reviewing client suicide deaths and suicide attempts;

(5) examining the quality of clinical service delivery to clients; and

(6) self-monitoring of compliance with this chapter.

(b) At least annually, the certification holder must review, evaluate, and update the quality assurance and improvement plan. The review must: (1) include documentation of the actions that the certification holder will take as a result of information obtained from monitoring activities in the plan; and (2) establish goals for improved service delivery to clients for the next year.

245I.23 INTENSIVE RESIDENTIAL TREATMENT SERVICES AND RESIDENTIAL CRISIS STABILIZATION.

Subd. 23.

Quality assurance and improvement plan.

(a) A license holder must develop a written quality assurance and improvement plan that includes a plan to:

(1) encourage ongoing consultation between members of the treatment team;

(2) obtain and evaluate feedback about services from clients, family and other natural supports, referral sources, and staff persons;

(3) measure and evaluate client outcomes in the program;

(4) review critical incidents in the program;

(5) examine the quality of clinical services in the program; and

(6) self-monitor the license holder's compliance with this chapter.

(b) At least annually, the license holder must review, evaluate, and update the license holder's quality assurance and improvement plan. The license holder's review must:

(1) document the actions that the license holder will take in response to the information that the license holder obtains from the monitoring activities in the plan; and

(2) establish goals for improving the license holder's services to clients during the next year.

256B.0623 ADULT REHABILITATIVE MENTAL HEALTH SERVICES COVERED.

Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings given them.

(a) "Adult rehabilitative mental health services" means the services described in section 245I.02, subdivision 33.

(b) "Medication education services" means services provided individually or in groups which focus on educating the recipient about mental illness and symptoms; the role and effects of medications in treating symptoms of mental illness; and the side effects of medications. Medication education is coordinated with medication management services and does not duplicate it. Medication education services are provided by physicians, advanced practice registered nurses, pharmacists, physician assistants, or registered nurses.

(c) "Transition to community living services" means services which maintain continuity of contact between the rehabilitation services provider and the recipient and which facilitate discharge from a hospital, residential treatment program, board and lodging facility, or nursing home. Transition to community living services are not intended to provide other areas of adult rehabilitative mental health services.

Subd. 4.

Provider entity standards.

(a) The provider entity must be certified by the state following the certification process and procedures developed by the commissioner.

(b) The certification process is a determination as to whether the entity meets the standards in this section and chapter 245I, as required in section 245I.011, subdivision 5. The certification must specify which adult rehabilitative mental health services the entity is qualified to provide.

(c) State-level recertification must occur at least every three years.

(d) The commissioner may intervene at any time and decertify providers with cause. The decertification is subject to appeal to the state. A county board may recommend that the state decertify a provider for cause.

(e) The adult rehabilitative mental health services provider entity must meet the following standards:

(1) have capacity to recruit, hire, manage, and train qualified staff;

(2) have adequate administrative ability to ensure availability of services;

(3) ensure that staff are skilled in the delivery of the specific adult rehabilitative mental health services provided to the individual eligible recipient;

(4) ensure enough flexibility in service delivery to respond to the changing and intermittent care needs of a recipient as identified by the recipient and the individual treatment plan;

(5) assist the recipient in arranging needed crisis assessment, intervention, and stabilization services;

(6) ensure that services are coordinated with other recipient mental health services providers and the county mental health authority and the federally recognized American Indian authority and necessary others after obtaining the consent of the recipient. Services must also be coordinated with the recipient's case manager or care coordinator if the recipient is receiving case management or care coordination services;

(7) keep all necessary records required by law;

(8) deliver services as required by section 245.461;

(9) be an enrolled Medicaid provider; and

(10) maintain a quality assurance plan to determine specific service outcomes and the recipient's satisfaction with services.

Subd. 5.

Qualifications of provider staff.

Adult rehabilitative mental health services must be provided by qualified individual provider staff of a certified provider entity. Individual provider staff must be qualified as:

(1) a mental health professional who is qualified according to section 245I.04, subdivision 2;

(2) a certified rehabilitation specialist who is qualified according to section 245I.04, subdivision 8;

(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;

(4) a mental health practitioner qualified according to section 245I.04, subdivision 4;

(5) a mental health certified peer specialist who is qualified according to section 245I.04, subdivision 10;

(6) a mental health rehabilitation worker who is qualified according to section 245I.04, subdivision 14; or

(7) a licensed occupational therapist, as defined in section 148.6402, subdivision 14.

Subd. 6.

Required supervision.

(a) A treatment supervisor providing treatment supervision required by section 245I.06 must:

(1) meet with staff receiving treatment supervision at least monthly to discuss treatment topics of interest and treatment plans of recipients; and

(2) meet at least monthly with the directing clinical trainee or mental health practitioner, if there is one, to review needs of the adult rehabilitative mental health services program, review staff on-site observations and evaluate mental health rehabilitation workers, plan staff training, review program evaluation and development, and consult with the directing clinical trainee or mental health practitioner.

(b) An adult rehabilitative mental health services provider entity must have a treatment director who is a mental health professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner. The treatment director must:

(1) ensure the direct observation of mental health rehabilitation workers required by section 245I.06, subdivision 3, is provided;

(2) ensure immediate availability by phone or in person for consultation by a mental health professional, certified rehabilitation specialist, clinical trainee, or a mental health practitioner to the mental health rehabilitation worker during service provision;

(3) model service practices which: respect the recipient, include the recipient in planning and implementation of the individual treatment plan, recognize the recipient's strengths, collaborate and coordinate with other involved parties and providers;

(4) ensure that clinical trainees, mental health practitioners, and mental health rehabilitation workers are able to effectively communicate with the recipients, significant others, and providers; and

(5) oversee the record of the results of direct observation, progress note evaluation, and corrective actions taken to modify the work of the clinical trainees, mental health practitioners, and mental health rehabilitation workers.

(c) A clinical trainee or mental health practitioner who is providing treatment direction for a provider entity must receive treatment supervision at least monthly to:

(1) identify and plan for general needs of the recipient population served;

(2) identify and plan to address provider entity program needs and effectiveness;

(3) identify and plan provider entity staff training and personnel needs and issues; and

(4) plan, implement, and evaluate provider entity quality improvement programs.

Subd. 9.

Functional assessment.

(a) Providers of adult rehabilitative mental health services must complete a written functional assessment according to section 245I.10, subdivision 9, for each recipient.

(b) When a provider of adult rehabilitative mental health services completes a written functional assessment, the provider must also complete a level of care assessment as defined in section 245I.02, subdivision 19, for the recipient.

256B.0624 CRISIS RESPONSE SERVICES COVERED.

Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings given them.

(a) "Certified rehabilitation specialist" means a staff person who is qualified under section 245I.04, subdivision 8.

(b) "Clinical trainee" means a staff person who is qualified under section 245I.04, subdivision 6.

(c) "Crisis assessment" means an immediate face-to-face assessment by a physician, a mental health professional, or a qualified member of a crisis team, as described in subdivision 6a.

(d) "Crisis intervention" means face-to-face, short-term intensive mental health services initiated during a mental health crisis to help the recipient cope with immediate stressors, identify and utilize available resources and strengths, engage in voluntary treatment, and begin to return to the recipient's baseline level of functioning.

(e) "Crisis screening" means a screening of a client's potential mental health crisis situation under subdivision 6.

(f) "Crisis stabilization" means individualized mental health services provided to a recipient that are designed to restore the recipient to the recipient's prior functional level. Crisis stabilization services may be provided in the recipient's home, the home of a family member or friend of the recipient, another community setting, a short-term supervised, licensed residential program, or an emergency department. Crisis stabilization services includes family psychoeducation.

(g) "Crisis team" means the staff of a provider entity who are supervised and prepared to provide mobile crisis services to a client in a potential mental health crisis situation.

(h) "Mental health certified family peer specialist" means a staff person who is qualified under section 245I.04, subdivision 12.

(i) "Mental health certified peer specialist" means a staff person who is qualified under section 245I.04, subdivision 10.

(j) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without the provision of crisis response services, would likely result in significantly reducing the recipient's levels of functioning in primary activities of daily living, in an emergency situation under section 62Q.55, or in the placement of the recipient in a more restrictive setting, including but not limited to inpatient hospitalization.

(k) "Mental health practitioner" means a staff person who is qualified under section 245I.04, subdivision 4.

(l) "Mental health professional" means a staff person who is qualified under section 245I.04, subdivision 2.

(m) "Mental health rehabilitation worker" means a staff person who is qualified under section 245I.04, subdivision 14.

(n) "Mobile crisis services" means screening, assessment, intervention, and community-based stabilization, excluding residential crisis stabilization, that is provided to a recipient.

Subd. 3.

Eligibility.

(a) A recipient is eligible for crisis assessment services when the recipient has screened positive for a potential mental health crisis during a crisis screening.

(b) A recipient is eligible for crisis intervention services and crisis stabilization services when the recipient has been assessed during a crisis assessment to be experiencing a mental health crisis.

Subd. 4a.

Alternative provider standards.

If a county or Tribe demonstrates that, due to geographic or other barriers, it is not feasible to provide mobile crisis intervention services according to the standards in subdivision 4, paragraph (b), the commissioner may approve an alternative plan proposed by a county or Tribe. The alternative plan must:

(1) result in increased access and a reduction in disparities in the availability of mobile crisis services;

(2) provide mobile crisis services outside of the usual nine-to-five office hours and on weekends and holidays; and

(3) comply with standards for emergency mental health services in section 245.469.

Subd. 5.

Crisis assessment and intervention staff qualifications.

(a) Qualified individual staff of a qualified provider entity must provide crisis assessment and intervention services to a recipient. A staff member providing crisis assessment and intervention services to a recipient must be qualified as a:

(1) mental health professional;

(2) clinical trainee;

(3) mental health practitioner;

(4) mental health certified family peer specialist; or

(5) mental health certified peer specialist.

(b) When crisis assessment and intervention services are provided to a recipient in the community, a mental health professional, clinical trainee, or mental health practitioner must lead the response.

(c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children and adults and include training about evidence-based practices identified by the commissioner of health to reduce the recipient's risk of suicide and self-injurious behavior.

(d) At least six hours of the ongoing training under paragraph (c) must be specific to working with families and providing crisis stabilization services to children and include the following topics:

(1) developmental tasks of childhood and adolescence;

(2) family relationships;

(3) child and youth engagement and motivation, including motivational interviewing;

(4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and queer youth;

(5) positive behavior support;

(6) crisis intervention for youth with developmental disabilities;

(7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral therapy; and

(8) youth substance use.

(e) Team members must be experienced in crisis assessment, crisis intervention techniques, treatment engagement strategies, working with families, and clinical decision-making under emergency conditions and have knowledge of local services and resources.

Subd. 6.

Crisis screening.

(a) The crisis screening may use the resources of emergency services as defined in section 245.469, subdivisions 1 and 2. The crisis screening must gather information, determine whether a mental health crisis situation exists, identify parties involved, and determine an appropriate response.

(b) When conducting the crisis screening of a recipient, a provider must:

(1) employ evidence-based practices to reduce the recipient's risk of suicide and self-injurious behavior;

(2) work with the recipient to establish a plan and time frame for responding to the recipient's mental health crisis, including responding to the recipient's immediate need for support by telephone or text message until the provider can respond to the recipient face-to-face;

(3) document significant factors in determining whether the recipient is experiencing a mental health crisis, including prior requests for crisis services, a recipient's recent presentation at an emergency department, known calls to 911 or law enforcement, or information from third parties with knowledge of a recipient's history or current needs;

(4) accept calls from interested third parties and consider the additional needs or potential mental health crises that the third parties may be experiencing;

(5) provide psychoeducation, including means reduction, to relevant third parties including family members or other persons living with the recipient; and

(6) consider other available services to determine which service intervention would best address the recipient's needs and circumstances.

(c) For the purposes of this section, the following situations indicate a positive screen for a potential mental health crisis and the provider must prioritize providing a face-to-face crisis assessment of the recipient, unless a provider documents specific evidence to show why this was not possible, including insufficient staffing resources, concerns for staff or recipient safety, or other clinical factors:

(1) the recipient presents at an emergency department or urgent care setting and the health care team at that location requested crisis services; or

(2) a peace officer requested crisis services for a recipient who is potentially subject to transportation under section 253B.051.

(d) A provider is not required to have direct contact with the recipient to determine that the recipient is experiencing a potential mental health crisis. A mobile crisis provider may gather relevant information about the recipient from a third party to establish the recipient's need for services and potential safety factors.

Subd. 6a.

Crisis assessment.

(a) If a recipient screens positive for a potential mental health crisis, a crisis assessment must be completed. A crisis assessment evaluates any immediate needs for which services are needed and, as time permits, the recipient's current life situation, health information, including current medications, sources of stress, mental health problems and symptoms, strengths, cultural considerations, support network, vulnerabilities, current functioning, and the recipient's preferences as communicated directly by the recipient, or as communicated in a health care directive as described in chapters 145C and 253B, the crisis treatment plan described under subdivision 11, a crisis prevention plan, or a wellness recovery action plan.

(b) A provider must conduct a crisis assessment at the recipient's location whenever possible.

(c) Whenever possible, the assessor must attempt to include input from the recipient and the recipient's family and other natural supports to assess whether a crisis exists.

(d) A crisis assessment includes: (1) determining (i) whether the recipient is willing to voluntarily engage in treatment, or (ii) whether the recipient has an advance directive, and (2) gathering the recipient's information and history from involved family or other natural supports.

(e) A crisis assessment must include coordinated response with other health care providers if the assessment indicates that a recipient needs detoxification, withdrawal management, or medical stabilization in addition to crisis response services. If the recipient does not need an acute level of care, a team must serve an otherwise eligible recipient who has a co-occurring substance use disorder.

(f) If, after completing a crisis assessment of a recipient, a provider refers a recipient to an intensive setting, including an emergency department, inpatient hospitalization, or residential crisis stabilization, one of the crisis team members who completed or conferred about the recipient's crisis assessment must immediately contact the referral entity and consult with the triage nurse or other staff responsible for intake at the referral entity. During the consultation, the crisis team member must convey key findings or concerns that led to the recipient's referral. Following the immediate consultation, the provider must also send written documentation upon completion. The provider must document if these releases occurred with authorization by the recipient, the recipient's legal guardian, or as allowed by section 144.293, subdivision 5.

Subd. 6b.

Crisis intervention services.

(a) If the crisis assessment determines mobile crisis intervention services are needed, the crisis intervention services must be provided promptly. As opportunity presents during the intervention, at least two members of the mobile crisis intervention team must confer directly or by telephone about the crisis assessment, crisis treatment plan, and actions taken and needed. At least one of the team members must be providing face-to-face crisis intervention services. If providing crisis intervention services, a clinical trainee or mental health practitioner must seek treatment supervision as required in subdivision 9.

(b) If a provider delivers crisis intervention services while the recipient is absent, the provider must document the reason for delivering services while the recipient is absent.

(c) The mobile crisis intervention team must develop a crisis treatment plan according to subdivision 11.

(d) The mobile crisis intervention team must document which crisis treatment plan goals and objectives have been met and when no further crisis intervention services are required.

(e) If the recipient's mental health crisis is stabilized, but the recipient needs a referral to other services, the team must provide referrals to these services. If the recipient has a case manager, planning for other services must be coordinated with the case manager. If the recipient is unable to follow up on the referral, the team must link the recipient to the service and follow up to ensure the recipient is receiving the service.

(f) If the recipient's mental health crisis is stabilized and the recipient does not have an advance directive, the case manager or crisis team shall offer to work with the recipient to develop one.

Subd. 7.

Crisis stabilization services.

(a) Crisis stabilization services must be provided by qualified staff of a crisis stabilization services provider entity and must meet the following standards:

(1) a crisis treatment plan must be developed that meets the criteria in subdivision 11;

(2) staff must be qualified as defined in subdivision 8;

(3) crisis stabilization services must be delivered according to the crisis treatment plan and include face-to-face contact with the recipient by qualified staff for further assessment, help with referrals, updating of the crisis treatment plan, skills training, and collaboration with other service providers in the community; and

(4) if a provider delivers crisis stabilization services while the recipient is absent, the provider must document the reason for delivering services while the recipient is absent.

(b) If crisis stabilization services are provided in a supervised, licensed residential setting that serves no more than four adult residents, and one or more individuals are present at the setting to receive residential crisis stabilization, the residential staff must include, for at least eight hours per day, at least one mental health professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner. The commissioner shall establish a statewide per diem rate for crisis stabilization services provided under this paragraph to medical assistance enrollees. The rate for a provider shall not exceed the rate charged by that provider for the same service to other payers. Payment shall not be made to more than one entity for each individual for services provided under this paragraph on a given day. The commissioner shall set rates prospectively for the annual rate period. The commissioner shall require providers to submit annual cost reports on a uniform cost reporting form and shall use submitted cost reports to inform the rate-setting process. The commissioner shall recalculate the statewide per diem every year.

Subd. 8.

Crisis stabilization staff qualifications.

(a) Mental health crisis stabilization services must be provided by qualified individual staff of a qualified provider entity. A staff member providing crisis stabilization services to a recipient must be qualified as a:

(1) mental health professional;

(2) certified rehabilitation specialist;

(3) clinical trainee;

(4) mental health practitioner;

(5) mental health certified family peer specialist;

(6) mental health certified peer specialist; or

(7) mental health rehabilitation worker.

(b) The 30 hours of ongoing training required in section 245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children and adults and include training about evidence-based practices identified by the commissioner of health to reduce a recipient's risk of suicide and self-injurious behavior.

(c) For providers who deliver care to children 21 years of age and younger, at least six hours of the ongoing training under this subdivision must be specific to working with families and providing crisis stabilization services to children and include the following topics:

(1) developmental tasks of childhood and adolescence;

(2) family relationships;

(3) child and youth engagement and motivation, including motivational interviewing;

(4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and queer youth;

(5) positive behavior support;

(6) crisis intervention for youth with developmental disabilities;

(7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral therapy; and

(8) youth substance use.

This paragraph does not apply to adult residential crisis stabilization service providers licensed according to section 245I.23.

Subd. 9.

Supervision.

Clinical trainees and mental health practitioners may provide crisis assessment and crisis intervention services if the following treatment supervision requirements are met:

(1) the mental health provider entity must accept full responsibility for the services provided;

(2) the mental health professional of the provider entity must be immediately available by phone or in person for treatment supervision;

(3) the mental health professional is consulted, in person or by phone, during the first three hours when a clinical trainee or mental health practitioner provides crisis assessment or crisis intervention services; and

(4) the mental health professional must:

(i) review and approve, as defined in section 245I.02, subdivision 2, of the tentative crisis assessment and crisis treatment plan within 24 hours of first providing services to the recipient, notwithstanding section 245I.08, subdivision 3; and

(ii) document the consultation required in clause (3).

Subd. 11.

Crisis treatment plan.

(a) Within 24 hours of the recipient's admission, the provider entity must complete the recipient's crisis treatment plan. The provider entity must:

(1) base the recipient's crisis treatment plan on the recipient's crisis assessment;

(2) consider crisis assistance strategies that have been effective for the recipient in the past;

(3) for a child recipient, use a child-centered, family-driven, and culturally appropriate planning process that allows the recipient's parents and guardians to observe or participate in the recipient's individual and family treatment services, assessment, and treatment planning;

(4) for an adult recipient, use a person-centered, culturally appropriate planning process that allows the recipient's family and other natural supports to observe or participate in treatment services, assessment, and treatment planning;

(5) identify the participants involved in the recipient's treatment planning. The recipient, if possible, must be a participant;

(6) identify the recipient's initial treatment goals, measurable treatment objectives, and specific interventions that the license holder will use to help the recipient engage in treatment;

(7) include documentation of referral to and scheduling of services, including specific providers where applicable;

(8) ensure that the recipient or the recipient's legal guardian approves under section 245I.02, subdivision 2, of the recipient's crisis treatment plan unless a court orders the recipient's treatment plan under chapter 253B. If the recipient or the recipient's legal guardian disagrees with the crisis treatment plan, the license holder must document in the client file the reasons why the recipient disagrees with the crisis treatment plan; and

(9) ensure that a treatment supervisor approves under section 245I.02, subdivision 2, of the recipient's treatment plan within 24 hours of the recipient's admission if a mental health practitioner or clinical trainee completes the crisis treatment plan, notwithstanding section 245I.08, subdivision 3.

(b) The provider entity must provide the recipient and the recipient's legal guardian with a copy of the recipient's crisis treatment plan.

256B.073 ELECTRONIC VISIT VERIFICATION.

Subd. 4.

Provider requirements.

(a) A provider of services may select any electronic visit verification system that meets the requirements established by the commissioner.

(b) All electronic visit verification systems used by providers to comply with the requirements established by the commissioner must provide data to the commissioner in a format and at a frequency to be established by the commissioner.

(c) Providers must implement the electronic visit verification systems required under this section by a date established by the commissioner to be set after the state-selected electronic visit verification systems for personal care services and home health services are in production. For purposes of this paragraph, "personal care services" and "home health services" have the meanings given in United States Code, title 42, section 1396b(l)(5). Reimbursement rates for providers must not be reduced as a result of federal action to reduce the federal medical assistance percentage under the 21st Century Cures Act, Public Law 114-255.

256B.0943 CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.

Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have the meanings given them.

(b) "Children's therapeutic services and supports" means the flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention to treat a diagnosed mental illness, as defined in section 245.462, subdivision 20, or 245.4871, subdivision 15. The services are time-limited interventions that are delivered using various treatment modalities and combinations of services designed to reach treatment outcomes identified in the individual treatment plan.

(c) "Clinical trainee" means a staff person who is qualified according to section 245I.04, subdivision 6.

(d) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.

(e) "Culturally competent provider" means a provider who understands and can utilize to a client's benefit the client's culture when providing services to the client. A provider may be culturally competent because the provider is of the same cultural or ethnic group as the client or the provider has developed the knowledge and skills through training and experience to provide services to culturally diverse clients.

(f) "Day treatment program" for children means a site-based structured mental health program consisting of psychotherapy for three or more individuals and individual or group skills training provided by a team, under the treatment supervision of a mental health professional.

(g) "Direct service time" means the time that a mental health professional, clinical trainee, mental health practitioner, or mental health behavioral aide spends face-to-face with a client and the client's family or providing covered services through telehealth as defined under section 256B.0625, subdivision 3b. Direct service time includes time in which the provider obtains a client's history, develops a client's treatment plan, records individual treatment outcomes, or provides service components of children's therapeutic services and supports. Direct service time does not include time doing work before and after providing direct services, including scheduling or maintaining clinical records.

(h) "Direction of mental health behavioral aide" means the activities of a mental health professional, clinical trainee, or mental health practitioner in guiding the mental health behavioral aide in providing services to a client. The direction of a mental health behavioral aide must be based on the client's individual treatment plan and meet the requirements in subdivision 6, paragraph (b), clause (7).

(i) "Individual treatment plan" means the plan described in section 245I.10, subdivisions 7 and 8.

(j) "Mental health behavioral aide services" means medically necessary one-on-one activities performed by a mental health behavioral aide qualified according to section 245I.04, subdivision 16, to assist a child retain or generalize psychosocial skills as previously trained by a mental health professional, clinical trainee, or mental health practitioner and as described in the child's individual treatment plan and individual behavior plan. Activities involve working directly with the child or child's family as provided in subdivision 9, paragraph (b), clause (4).

(k) "Mental health certified family peer specialist" means a staff person who is qualified according to section 245I.04, subdivision 12.

(l) "Mental health practitioner" means a staff person who is qualified according to section 245I.04, subdivision 4.

(m) "Mental health professional" means a staff person who is qualified according to section 245I.04, subdivision 2.

(n) "Mental health service plan development" includes:

(1) development and revision of a child's individual treatment plan; and

(2) administering and reporting standardized outcome measurements approved by the commissioner, as periodically needed to evaluate the effectiveness of treatment.

(o) "Mental illness" has the meaning given in section 245.462, subdivision 20, paragraph (a), for persons at least 18 years of age but under 21 years of age, and has the meaning given in section 245.4871, subdivision 15, for children under 18 years of age.

(p) "Psychotherapy" means the treatment described in section 256B.0671, subdivision 11.

(q) "Rehabilitative services" or "psychiatric rehabilitation services" means interventions to: (1) restore a child or adolescent to an age-appropriate developmental trajectory that had been disrupted by a psychiatric illness; or (2) enable the child to self-monitor, compensate for, cope with, counteract, or replace psychosocial skills deficits or maladaptive skills acquired over the course of a psychiatric illness. Psychiatric rehabilitation services for children combine coordinated psychotherapy to address internal psychological, emotional, and intellectual processing deficits, and skills training to restore personal and social functioning. Psychiatric rehabilitation services establish a progressive series of goals with each achievement building upon a prior achievement.

(r) "Skills training" means individual, family, or group training, delivered by or under the supervision of a mental health professional, designed to facilitate the acquisition of psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child to self-monitor, compensate for, cope with, counteract, or replace skills deficits or maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject to the service delivery requirements under subdivision 9, paragraph (b), clause (2).

(s) "Standard diagnostic assessment" means the assessment described in section 245I.10, subdivision 6.

(t) "Treatment supervision" means the supervision described in section 245I.06.

Subd. 4.

Provider entity certification.

(a) The commissioner shall establish an initial provider entity application and certification process and recertification process to determine whether a provider entity has an administrative and clinical infrastructure that meets the requirements in subdivisions 5 and 6. A provider entity must be certified for the three core rehabilitation services of psychotherapy, skills training, and crisis planning. The commissioner shall recertify a provider entity every three years using the individual provider's certification anniversary or the calendar year end, whichever is later. The commissioner may approve a recertification extension, in the interest of sustaining services, when a certain date for recertification is identified. The commissioner shall establish a process for decertification of a provider entity and shall require corrective action, medical assistance repayment, or decertification of a provider entity that no longer meets the requirements in this section or that fails to meet the clinical quality standards or administrative standards provided by the commissioner in the application and certification process.

(b) The commissioner must provide the following to providers for the certification, recertification, and decertification processes:

(1) a structured listing of required provider certification criteria;

(2) a formal written letter with a determination of certification, recertification, or decertification, signed by the commissioner or the appropriate division director; and

(3) a formal written communication outlining the process for necessary corrective action and follow-up by the commissioner, if applicable.

(c) For purposes of this section, a provider entity must meet the standards in this section and chapter 245I, as required under section 245I.011, subdivision 5, and be:

(1) an Indian health services facility or a facility owned and operated by a tribe or tribal organization operating as a 638 facility under Public Law 93-638 certified by the state;

(2) a county-operated entity certified by the state; or

(3) a noncounty entity certified by the state.

Subd. 5.

Provider entity administrative infrastructure requirements.

(a) An eligible provider entity shall demonstrate the availability, by means of employment or contract, of at least one backup mental health professional in the event of the primary mental health professional's absence.

(b) In addition to the policies and procedures required under section 245I.03, the policies and procedures must include:

(1) fiscal procedures, including internal fiscal control practices and a process for collecting revenue that is compliant with federal and state laws; and

(2) a client-specific treatment outcomes measurement system, including baseline measures, to measure a client's progress toward achieving mental health rehabilitation goals.

(c) A provider entity that uses a restrictive procedure with a client must meet the requirements of section 245.8261.

Subd. 5a.

Background studies.

The requirements for background studies under section 245I.011, subdivision 5, paragraph (b), may be met by a children's therapeutic services and supports services agency through the commissioner's NETStudy system as provided under sections 245C.03, subdivision 7, and 245C.10, subdivision 8.

Subd. 6.

Provider entity clinical infrastructure requirements.

(a) To be an eligible provider entity under this section, a provider entity must have a clinical infrastructure that utilizes diagnostic assessment, individual treatment plans, service delivery, and individual treatment plan review that are culturally competent, child-centered, and family-driven to achieve maximum benefit for the client. The provider entity must review, and update as necessary, the clinical policies and procedures every three years, must distribute the policies and procedures to staff initially and upon each subsequent update, and must train staff accordingly.

(b) The clinical infrastructure written policies and procedures must include policies and procedures for meeting the requirements in this subdivision:

(1) providing or obtaining a client's standard diagnostic assessment, including a standard diagnostic assessment. When required components of the standard diagnostic assessment are not provided in an outside or independent assessment or cannot be attained immediately, the provider entity must determine the missing information within 30 days and amend the child's standard diagnostic assessment or incorporate the information into the child's individual treatment plan;

(2) developing an individual treatment plan;

(3) providing treatment supervision plans for staff according to section 245I.06. Treatment supervision does not include the authority to make or terminate court-ordered placements of the child. A treatment supervisor must be available for urgent consultation as required by the individual client's needs or the situation;

(4) requiring a mental health professional to determine the level of supervision for a behavioral health aide and to document and sign the supervision determination in the behavioral health aide's supervision plan;

(5) ensuring the immediate accessibility of a mental health professional, clinical trainee, or mental health practitioner to the behavioral aide during service delivery;

(6) providing service delivery that implements the individual treatment plan and meets the requirements under subdivision 9; and

(7) individual treatment plan review. The review must determine the extent to which the services have met each of the goals and objectives in the treatment plan. The review must assess the client's progress and ensure that services and treatment goals continue to be necessary and appropriate to the client and the client's family or foster family.

Subd. 7.

Qualifications of individual and team providers.

(a) An individual or team provider working within the scope of the provider's practice or qualifications may provide service components of children's therapeutic services and supports that are identified as medically necessary in a client's individual treatment plan.

(b) An individual provider must be qualified as a:

(1) mental health professional;

(2) clinical trainee;

(3) mental health practitioner;

(4) mental health certified family peer specialist; or

(5) mental health behavioral aide.

(c) A day treatment team must include one mental health professional or clinical trainee.

Subd. 9.

Service delivery criteria.

(a) In delivering services under this section, a certified provider entity must ensure that:

(1) the provider's caseload size should reasonably enable the provider to play an active role in service planning, monitoring, and delivering services to meet the client's and client's family's needs, as specified in each client's individual treatment plan;

(2) site-based programs, including day treatment programs, provide staffing and facilities to ensure the client's health, safety, and protection of rights, and that the programs are able to implement each client's individual treatment plan; and

(3) a day treatment program is provided to a group of clients by a team under the treatment supervision of a mental health professional. The day treatment program must be provided in and by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation of Health Organizations and licensed under sections 144.50 to 144.55; (ii) a community mental health center under section 245.62; or (iii) an entity that is certified under subdivision 4 to operate a program that meets the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must stabilize the client's mental health status while developing and improving the client's independent living and socialization skills. The goal of the day treatment program must be to reduce or relieve the effects of mental illness and provide training to enable the client to live in the community. The remainder of the structured treatment program may include patient and/or family or group psychotherapy, and individual or group skills training, if included in the client's individual treatment plan. Day treatment programs are not part of inpatient or residential treatment services. When a day treatment group that meets the minimum group size requirement temporarily falls below the minimum group size because of a member's temporary absence, medical assistance covers a group session conducted for the group members in attendance. A day treatment program may provide fewer than the minimally required hours for a particular child during a billing period in which the child is transitioning into, or out of, the program.

(b) To be eligible for medical assistance payment, a provider entity must deliver the service components of children's therapeutic services and supports in compliance with the following requirements:

(1) psychotherapy to address the child's underlying mental health disorder must be documented as part of the child's ongoing treatment. A provider must deliver or arrange for medically necessary psychotherapy unless the child's parent or caregiver chooses not to receive it or the provider determines that psychotherapy is no longer medically necessary. When a provider determines that psychotherapy is no longer medically necessary, the provider must update required documentation, including but not limited to the individual treatment plan, the child's medical record, or other authorizations, to include the determination. When a provider determines that a child needs psychotherapy but psychotherapy cannot be delivered due to a shortage of licensed mental health professionals in the child's community, the provider must document the lack of access in the child's medical record;

(2) individual, family, or group skills training is subject to the following requirements:

(i) a mental health professional, clinical trainee, or mental health practitioner shall provide skills training;

(ii) skills training delivered to a child or the child's family must be targeted to the specific deficits or maladaptations of the child's mental health disorder and must be prescribed in the child's individual treatment plan;

(iii) group skills training may be provided to multiple recipients who, because of the nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from interaction in a group setting, which must be staffed as follows:

(A) one mental health professional, clinical trainee, or mental health practitioner must work with a group of three to eight clients; or

(B) any combination of two mental health professionals, clinical trainees, or mental health practitioners must work with a group of nine to 12 clients;

(iv) a mental health professional, clinical trainee, or mental health practitioner must have taught the psychosocial skill before a mental health behavioral aide may practice that skill with the client; and

(v) for group skills training, when a skills group that meets the minimum group size requirement temporarily falls below the minimum group size because of a group member's temporary absence, the provider may conduct the session for the group members in attendance;

(3) crisis planning to a child and family must include development of a written plan that anticipates the particular factors specific to the child that may precipitate a psychiatric crisis for the child in the near future. The written plan must document actions that the family should be prepared to take to resolve or stabilize a crisis, such as advance arrangements for direct intervention and support services to the child and the child's family. Crisis planning must include preparing resources designed to address abrupt or substantial changes in the functioning of the child or the child's family when sudden change in behavior or a loss of usual coping mechanisms is observed, or the child begins to present a danger to self or others;

(4) mental health behavioral aide services must be medically necessary treatment services, identified in the child's individual treatment plan.

To be eligible for medical assistance payment, mental health behavioral aide services must be delivered to a child who has been diagnosed with a mental illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must document the delivery of services in written progress notes. Progress notes must reflect implementation of the treatment strategies, as performed by the mental health behavioral aide and the child's responses to the treatment strategies; and

(5) mental health service plan development must be performed in consultation with the child's family and, when appropriate, with other key participants in the child's life by the child's treating mental health professional or clinical trainee or by a mental health practitioner and approved by the treating mental health professional. Treatment plan drafting consists of development, review, and revision by face-to-face or electronic communication. The provider must document events, including the time spent with the family and other key participants in the child's life to approve the individual treatment plan. Medical assistance covers service plan development before completion of the child's individual treatment plan. Service plan development is covered only if a treatment plan is completed for the child. If upon review it is determined that a treatment plan was not completed for the child, the commissioner shall recover the payment for the service plan development.

Subd. 11.

Documentation and billing.

(a) A provider entity must document the services it provides under this section. The provider entity must ensure that documentation complies with Minnesota Rules, parts 9505.2175 and 9505.2197. Services billed under this section that are not documented according to this subdivision shall be subject to monetary recovery by the commissioner. Billing for covered service components under subdivision 2, paragraph (b), must not include anything other than direct service time.

(b) Required documentation must be completed for each individual provider and service modality for each day a child receives a service under subdivision 2, paragraph (b).

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.

Subd. 6c.

Integrated community supports; component values and calculation of payment rates.

(a) Component values for integrated community supports are:

(1) competitive workforce factor: 6.7 percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence and utilization factor ratio: 3.9 percent.

(b) Payments for integrated community supports must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours to meet a recipient's needs. The base shared direct staffing hours must be eight hours divided by the number of people receiving support in the integrated community support setting, and the individual direct staffing hours must be the average number of direct support hours provided directly to the service recipient;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);

(5) multiply the number of shared direct staffing and individual direct staffing hours in clause (1) by the appropriate staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours in clause (1) by the product of the supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6) and multiply the result by one plus the employee vacation, sick, and training allowance ratio. This is defined as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost by one plus the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) add the results of clauses (8) and (9);

(11) add the standard general administrative support ratio, the program-related expense ratio, and the absence and utilization factor ratio;

(12) divide the result of clause (10) by one minus the result of clause (11). This is the total payment amount; and

(13) adjust the result of clause (12) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services.