1.1 	A bill for an act
1.2 	relating to human services; modifying human services provisions on aging and 
1.3 	disability services, behavioral health, licensing and program integrity, mental 
1.4 	health licensing, background studies, and forecasted program appropriations 
1.5 	adjustments; requiring reports; appropriating money;amending Minnesota Statutes 
1.6 	2024, sections 62D.04, subdivision 5; 142B.15; 142B.79; 144.057, subdivision 1; 
1.7 	144.0724, by adding a subdivision; 245.4661, subdivision 10, by adding 
1.8 	subdivisions; 245.735, subdivision 6; 245A.03, subdivision 7; 245A.10, by adding 
1.9 	a subdivision; 245A.65, subdivision 1a; 245C.03, subdivisions 1, 2, 3, 4, 5a, 5b, 
1.10 	7, 9, 10, 12, by adding subdivisions; 245C.04, subdivisions 1, 4a; 245C.10, 
1.11 	subdivisions 4, 5, 8, 17; 245C.14, subdivisions 1, 2; 245C.24, subdivision 2; 
1.12 	245D.09, subdivisions 6, 7; 245G.03, subdivision 1; 245I.011, subdivisions 3, 5, 
1.13 	by adding a subdivision; 245I.02, subdivisions 33, 39, by adding subdivisions; 
1.14 	245I.03, subdivision 4, by adding a subdivision; 245I.06, subdivisions 1, 2; 245I.07; 
1.15 	245I.10, subdivisions 6, 8, by adding a subdivision; 254A.03, subdivision 2; 
1.16 	254B.06, subdivision 2; 256.975, subdivision 7b; 256B.04, by adding a subdivision; 
1.17 	256B.05, subdivision 1; 256B.0623, subdivisions 1, 3, 12, by adding a subdivision; 
1.18 	256B.0624, subdivisions 1, 4, by adding a subdivision; 256B.0625, subdivisions 
1.19 	3c, 3d, 17b, by adding subdivisions; 256B.073, subdivisions 1, 2, 3, 5, by adding 
1.20 	subdivisions; 256B.0761, subdivision 2; 256B.0911, subdivisions 26, 32; 
1.21 	256B.0943, subdivisions 2, 5a; 256B.4905, subdivisions 11, 12; 256B.4912, by 
1.22 	adding subdivisions; 256B.4914, subdivisions 6, 6a, 6b, 6d, 7a, 7b, 7c, by adding 
1.23 	subdivisions; 256B.492, by adding a subdivision; 256B.69, subdivision 1; 256R.10, 
1.24 	subdivision 8; 256R.23, subdivision 5; 256S.21, by adding subdivisions; 297E.02, 
1.25 	subdivision 3; Minnesota Statutes 2025 Supplement, sections 142A.09, subdivision 
1.26 	1; 142B.05, subdivision 3; 142B.10, subdivision 14; 144.0724, subdivisions 2, 11; 
1.27 	245.4661, subdivision 9; 245A.03, subdivision 2; 245A.04, subdivision 7; 245A.05; 
1.28 	245A.07, subdivision 3; 245A.10, subdivisions 3, 4; 245C.02, subdivision 15a; 
1.29 	245C.05, subdivisions 5, 5a; 245C.08, subdivision 1; 245C.10, subdivisions 9, 22; 
1.30 	245C.13, subdivision 2; 245C.16, subdivision 1; 245C.22, subdivision 5; 245I.04, 
1.31 	subdivisions 5, 17; 254B.02, subdivision 5; 254B.03, subdivision 4; 254B.0503, 
1.32 	subdivision 1; 254B.0509, subdivision 2; 256.01, subdivision 2; 256.4792, 
1.33 	subdivisions 1, 7, by adding a subdivision; 256B.04, subdivision 21; 256B.0625, 
1.34 	subdivisions 5m, 17; 256B.0632, by adding a subdivision; 256B.0911, subdivision 
1.35 	14; 256B.0943, subdivisions 3, 12; 256B.4914, subdivisions 3, 5a, 5b; 256I.04, 
1.36 	subdivision 2c; 256R.23, subdivisions 7, 8; 256R.24, subdivision 3; 256R.38; 
1.37 	256S.205, subdivisions 2, 3, 5, 7; 260E.14, subdivision 1; 626.5572, subdivision 
1.38 	13; Laws 2024, chapter 125, article 8, section 2, subdivisions 4, 14, as amended; 
2.1 	Laws 2025, First Special Session chapter 9, article 4, sections 2; 23; 38; 39; 40; 
2.2 	41; 42; 43; 44; 50; 51; proposing coding for new law in Minnesota Statutes, chapters 
2.3 	245A; 245I; 256B; repealing Minnesota Statutes 2024, sections 245.735, 
2.4 	subdivisions 1a, 2a, 3a, 3b, 3c, 3d, 3e, 3f, 3g, 3h, 4a, 4b, 4c, 4e, 7, 8; 245A.70; 
2.5 	245A.71; 245A.72; 245A.73; 245A.74; 245A.75; 245C.03, subdivisions 3a, 3b, 
2.6 	5, 6a, 7, 9a; 245C.04, subdivisions 2, 3, 4, 5, 7, 8, 9, 10, 11; 245D.261; 245I.20, 
2.7 	subdivision 9; 245I.23, subdivision 23; 256.975, subdivision 7d; 256B.0371, 
2.8 	subdivisions 1, 2, 4; 256B.055, subdivision 14; 256B.0623, subdivisions 2, 4, 5, 
2.9 	6, 9; 256B.0624, subdivisions 2, 3, 4a, 5, 6, 6a, 6b, 7, 8, 9, 11; 256B.073, 
2.10 	subdivision 4; 256B.0911, subdivision 21; 256B.0921; 256B.0943, subdivisions 
2.11 	4, 5, 5a, 6, 7, 11; 256B.4914, subdivision 6c; 256R.40, subdivisions 1, 2, 3, 4, 6, 
2.12 	7; 256R.42; 256S.205, subdivision 4; Minnesota Statutes 2025 Supplement, sections 
2.13 	245.735, subdivisions 3, 4d; 245C.04, subdivisions 6, 12, 13; 256B.0371, 
2.14 	subdivision 3; 256B.0943, subdivisions 1, 9; 256B.695; 256B.696; 256R.25, 
2.15 	subdivision 6; 256R.40, subdivision 5; Laws 2025, First Special Session chapter 
2.16 	9, article 2, section 68.
2.17 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.18 	ARTICLE 1
2.19 	AGING AND DISABILITY SERVICES

2.20 	Section 1. Minnesota Statutes 2025 Supplement, section 144.0724, subdivision 2, is 
2.21 	amended to read:
2.22 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
2.23 	given.
2.24 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
2.25 	periods in the MDS assessment process. This look-back period is also called the observation 
2.26 	or assessment period.
2.27 	(b) "Case mix index" means the weighting factors assigned to the case mix reimbursement 
2.28 	classifications determined by an assessment.
2.29 	(c) "Index maximization" means classifying a resident who could be assigned to more 
2.30 	than one category, to the category with the highest case mix index.
2.31 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
2.32 	and functional status elements, that include common definitions and coding categories 
2.33 	specified by the Centers for Medicare and Medicaid Services and designated by the 
2.34 	Department of Health.
2.35 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
2.36 	person authorized to pay the nursing home expenses of the resident, a representative of the 
2.37 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
2.38 	other individual designated by the resident.
3.1 	(f) "Activities of daily living" or "ADL" includes personal hygiene, dressing, bathing, 
3.2 	transferring, bed mobility, locomotion, eating, and toileting.
3.3 	(g) "Nursing facility level of care determination" means the assessment process that 
3.4 	results in a determination of a resident's or prospective resident's need for nursing facility 
3.5 	level of care as established in subdivision 11 for purposes of medical assistance payment 
3.6 	of long-term care services for:
3.7 	(1) nursing facility services under chapter 256R;
3.8 	(2) elderly waiver services under chapter 256S;
3.9 	(3) CADI and BI waiver services under section 256B.49; and
3.10 	(4) state payment of alternative care services under section 256B.0913.
3.11 	This paragraph expires upon the effective date of paragraph (h).
3.12 	(h) Effective January 1, 2027, or upon federal approval, whichever is later, "nursing 
3.13 	facility level of care determination" means the assessment process that results in a 
3.14 	determination of a resident's or prospective resident's need for nursing facility level of care:
3.15 	(1) as established in subdivision 11 for purposes of medical assistance payment of 
3.16 	long-term care services for:
3.17 	(i) nursing facility services under chapter 256R;
3.18 	(ii) elderly waiver services under chapter 256S; and
3.19 	(iii) state payment of alternative care services under section 256B.0913; and
3.20 	(2) as established in subdivision 11a for purposes of medical assistance payment of 
3.21 	long-term care services for brain injury and community access for disability and inclusion 
3.22 	waivers under section 256B.49.
3.23 	(h)(i) "Patient Driven Payment Model" or "PDPM" means the case mix reimbursement 
3.24 	classification system for residents in nursing facilities based on the resident's condition, 
3.25 	diagnosis, and the care the resident received at the time of the MDS assessment with an 
3.26 	ARD on or after October 1, 2025.
3.27 	(i)(j) "Resource utilization group" or "RUG" means the case mix reimbursement 
3.28 	classification system for residents in nursing facilities according to the resident's clinical 
3.29 	and functional status as reflected in data supplied by the facility's MDS with an ARD on or 
3.30 	before September 30, 2025.

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

4.1 	Sec. 2. Minnesota Statutes 2025 Supplement, section 144.0724, subdivision 11, is amended 
4.2 	to read:
4.3 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance payment 
4.4 	of long-term care services, a recipient must be determined, using assessments defined in 
4.5 	subdivision 4, to meet one of the following nursing facility level of care criteria:
4.6 	(1) the person requires formal clinical monitoring at least once per day;
4.7 	(2) the person needs the assistance of another person or constant supervision to begin 
4.8 	and complete at least four of the following activities of living: bathing, bed mobility, dressing, 
4.9 	eating, grooming, toileting, transferring, and walking;
4.10 	(3) the person needs the assistance of another person or constant supervision to begin 
4.11 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
4.12 	(4) the person has significant difficulty with memory, using information, daily decision 
4.13 	making, or behavioral needs that require intervention;
4.14 	(5) the person has had a qualifying nursing facility stay of at least 90 days;
4.15 	(6) the person meets the nursing facility level of care criteria determined 90 days after 
4.16 	admission or on the first quarterly assessment after admission, whichever is later; or
4.17 	(7) the person is determined to be at risk for nursing facility admission or readmission 
4.18 	through a face-to-face long-term care consultation assessment as specified in section 
4.19 	256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, Tribe, or managed care 
4.20 	organization under contract with the Department of Human Services. The person is 
4.21 	considered at risk under this clause if the person currently lives alone or will live alone or 
4.22 	be homeless without the person's current housing and also meets one of the following criteria:
4.23 	(i) the person has experienced a fall resulting in a fracture;
4.24 	(ii) the person has been determined to be at risk of maltreatment or neglect, including 
4.25 	self-neglect; or
4.26 	(iii) the person has a sensory impairment that substantially impacts functional ability 
4.27 	and maintenance of a community residence.
4.28 	(b) The assessment used to establish medical assistance payment for nursing facility 
4.29 	services must be the most recent assessment performed under subdivision 4, paragraph (b), 
4.30 	that occurred no more than 90 calendar days before the effective date of medical assistance 
4.31 	eligibility for payment of long-term care services. In no case shall medical assistance payment 
5.1 	for long-term care services occur prior to the date of the determination of nursing facility 
5.2 	level of care.
5.3 	(c) The assessment used to establish medical assistance payment for long-term care 
5.4 	services provided under chapter 256S and section 256B.49 and alternative care payment 
5.5 	for services provided under section 256B.0913 must be the most recent face-to-face 
5.6 	assessment performed under section 256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, 
5.7 	that occurred no more than one calendar year before the effective date of medical assistance 
5.8 	eligibility for payment of long-term care services.

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

5.10 	Sec. 3. Minnesota Statutes 2024, section 144.0724, is amended by adding a subdivision 
5.11 	to read:
5.12 		Subd. 11a.Nursing facility level of care; BI and CADI waivers. (a) Effective January 
5.13 	1, 2027, or upon federal approval, whichever is later, a determination of need for nursing 
5.14 	facility level of care for brain injury and community access for disability and inclusion 
5.15 	waivers under section 256B.49 must meet one of the following criteria:
5.16 	(1) the person needs the assistance of another person or constant supervision to begin 
5.17 	and complete at least four of the following activities of living: bathing, bed mobility, dressing, 
5.18 	eating, grooming, toileting, transferring, and walking;
5.19 	(2) the person needs the assistance of another person or constant supervision to begin 
5.20 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled; 
5.21 	or
5.22 	(3) the person has significant difficulty with memory, using information, daily decision 
5.23 	making, or behavioral needs that require intervention.
5.24 	(b) Nursing facility level of care determinations for purposes of initial and ongoing 
5.25 	access to brain injury and community access for disability inclusion waiver programs must 
5.26 	be conducted by a MnCHOICES certified assessor in a manner determined by the 
5.27 	commissioner.

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

5.29 	Sec. 4. Minnesota Statutes 2024, section 245A.03, subdivision 7, is amended to read:
5.30 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
5.31 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, which 
6.1 	does not include child foster residence settings with residential program certifications for 
6.2 	compliance with the Family First Prevention Services Act under section 245A.25, subdivision 
6.3 	1, paragraph (a), or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
6.4 	9555.6265, under this chapter for a physical location that will not be the primary residence 
6.5 	of the license holder for the entire period of licensure. If a child foster residence setting that 
6.6 	was previously exempt from the licensing moratorium under this paragraph has its Family 
6.7 	First Prevention Services Act certification rescinded under section 245A.25, subdivision 9, 
6.8 	or if a family adult foster care home license is issued during this moratorium, and the license 
6.9 	holder changes the license holder's primary residence away from the physical location of 
6.10 	the foster care license, the commissioner shall revoke the license according to section 
6.11 	245A.07. The commissioner shall not issue an initial license for a community residential 
6.12 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
6.13 	the commissioner shall consider the resource need determination process in paragraph (h), 
6.14 	the availability of foster care licensed beds in the geographic area in which the licensee 
6.15 	seeks to operate, the results of a person's choices during their annual assessment and service 
6.16 	plan review, and the recommendation of the local county board. The determination by the 
6.17 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
6.18 	(1) a license for a person in a foster care setting that is not the primary residence of the 
6.19 	license holder and where at least 80 percent of the residents are 55 years of age or older;
6.20 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
6.21 	community residential setting licenses replacing adult foster care licenses in existence on 
6.22 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
6.23 	(b);
6.24 	(3) new foster care licenses or community residential setting licenses determined to be 
6.25 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
6.26 	or regional treatment center; restructuring of state-operated services that limits the capacity 
6.27 	of state-operated facilities; or allowing movement to the community for people who no 
6.28 	longer require the level of care provided in state-operated facilities as provided under section 
6.29 	256B.092, subdivision 13, or 256B.49, subdivision 24;
6.30 	(4) new foster care licenses or community residential setting licenses determined to be 
6.31 	needed by the commissioner under paragraph (b) for persons requiring hospital-level care; 
6.32 	or
6.33 	(5) new community residential setting licenses determined necessary by the commissioner 
6.34 	for people affected by the closure of homes with a capacity of five or six beds currently 
7.1 	licensed as supervised living facilities licensed under Minnesota Rules, chapter 4665, but 
7.2 	not designated as intermediate care facilities. This exception is available until June 30, 2025.
7.3 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
7.4 	community residential settings as defined under this subdivision. As part of the determination, 
7.5 	the commissioner shall consider the availability of foster care capacity in the area in which 
7.6 	the licensee seeks to operate, and the recommendation of the local county board. The 
7.7 	determination by the commissioner must be final. A determination of need is not required 
7.8 	for a change in ownership at the same address.
7.9 	(c) When an adult resident served by the program moves out of a foster home that is not 
7.10 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
7.11 	paragraph (f), or the adult community residential setting, the county shall immediately 
7.12 	inform the Department of Human Services Licensing Division. The department may decrease 
7.13 	the statewide licensed capacity for adult foster care settings.
7.14 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
7.15 	established in paragraph (c) must be exempt if the license holder's beds are occupied by 
7.16 	residents whose primary diagnosis is mental illness and the license holder is certified under 
7.17 	the requirements in subdivision 6a or section 245D.33.
7.18 	(e) A resource need determination process, managed at the state level, using the available 
7.19 	data required by section 144A.351, and other data and information must be used to determine 
7.20 	where the reduced capacity determined under section 256B.493 will be implemented. The 
7.21 	commissioner shall consult with the stakeholders described in section 144A.351, and employ 
7.22 	a variety of methods to improve the state's capacity to meet the informed decisions of those 
7.23 	people who want to move out of corporate foster care or community residential settings, 
7.24 	long-term service needs within budgetary limits, including seeking proposals from service 
7.25 	providers or lead agencies to change service type, capacity, or location to improve services, 
7.26 	increase the independence of residents, and better meet needs identified by the long-term 
7.27 	services and supports reports and statewide data and information.
7.28 	(f) At the time of application and reapplication for licensure, the applicant and the license 
7.29 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
7.30 	required to inform the commissioner whether the physical location where the foster care 
7.31 	will be provided is or will be the primary residence of the license holder for the entire period 
7.32 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
7.33 	or license holder must notify the commissioner immediately. The commissioner shall print 
8.1 	on the foster care license certificate whether or not the physical location is the primary 
8.2 	residence of the license holder.
8.3 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
8.4 	primary residence of the license holder and that also provide services in the foster care home 
8.5 	that are covered by a federally approved home and community-based services waiver, as 
8.6 	authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human 
8.7 	services licensing division that the license holder provides or intends to provide these 
8.8 	waiver-funded services.
8.9 	(h) The commissioner may adjust capacity to address needs identified in section 
8.10 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
8.11 	delicense existing settings. Delicensing of settings will be accomplished through a process 
8.12 	identified in section 256B.493.
8.13 	(i) The commissioner must notify a license holder when its corporate foster care or 
8.14 	community residential setting licensed beds are reduced under this section. The notice of 
8.15 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
8.16 	mail or personal service. The notice must state why the licensed beds are reduced and must 
8.17 	inform the license holder of its right to request reconsideration by the commissioner. The 
8.18 	license holder's request for reconsideration must be in writing. If mailed, the request for 
8.19 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
8.20 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
8.21 	reconsideration is made by personal service, it must be received by the commissioner within 
8.22 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
8.23 	(j) The commissioner shall not issue an initial license for children's residential treatment 
8.24 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
8.25 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
8.26 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
8.27 	moratorium described in this paragraph. The commissioner has the authority to manage 
8.28 	existing statewide capacity for children's residential treatment services subject to the 
8.29 	moratorium under this paragraph and may issue an initial license for such facilities if the 
8.30 	initial license would not increase the statewide capacity for children's residential treatment 
8.31 	services subject to the moratorium under this paragraph.
8.32 	(k) Except as permitted in this paragraph, the commissioner must not issue an initial 
8.33 	license under chapter 245D authorizing integrated community supports under section 
8.34 	245D.03, subdivision 1, paragraph (c), clause (8), and must not approve a license change 
9.1 	adding integrated community supports to an existing license under chapter 245D. The 
9.2 	commissioner may approve an exception to the moratorium only when the applicant or 
9.3 	licensee meets all requirements under section 245D.12, the request is not superseded by 
9.4 	temporary moratoriums under section 245A.03, subdivision 7a, and the applicant submits 
9.5 	documentation demonstrating compliance with:
9.6 	(1) federal and state home and community-based services requirements for 
9.7 	provider-controlled settings;
9.8 	(2) the prohibition on the use of Medicaid money for room and board under section 
9.9 	256B.4912, subdivision 17, including the requirement that the provider not pay, subsidize, 
9.10 	offset, or otherwise financially contribute to rent, utilities, or other housing costs; and
9.11 	(3) all licensing requirements applicable to integrated community supports under chapter 
9.12 	245D. In determining whether to approve an exception, the commissioner must consider 
9.13 	statewide and regional capacity for integrated community supports based on 
9.14 	needs-determination processes under paragraph (e). A determination under this paragraph 
9.15 	is final and not subject to appeal.

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

9.17 	Sec. 5. Minnesota Statutes 2025 Supplement, section 256.4792, subdivision 1, is amended 
9.18 	to read:
9.19 		Subdivision 1.Long-term services and supports loan program. The commissioner 
9.20 	of human services shall establish a loan program to provide operating loans to eligible 
9.21 	long-term services and supports providers. The commissioner shall initiate the application 
9.22 	process for the loan described in this section on an ongoing basis. The commissioner must 
9.23 	not issue any new loans under this program after July 1, 2026.

9.24 	Sec. 6. Minnesota Statutes 2025 Supplement, section 256.4792, subdivision 7, is amended 
9.25 	to read:
9.26 		Subd. 7.Loan repayment. (a) If a borrower is more than 60 calendar days delinquent 
9.27 	in the timely payment of a contractual payment under this section, the provisions in 
9.28 	paragraphs (b) to (e) apply.
9.29 	(b) The commissioner may withhold some or all of the amount of the delinquent loan 
9.30 	payment, together with any penalties due and owing on those amounts, from any money 
9.31 	the department owes to the borrower. The commissioner may, at the commissioner's 
9.32 	discretion, also withhold future contractual payments from any money the commissioner 
10.1 	owes the provider as those contractual payments become due and owing. The commissioner 
10.2 	may continue this withholding until the commissioner determines there is no longer any 
10.3 	need to do so.
10.4 	(c) The commissioner shall give prior notice of the commissioner's intention to withhold 
10.5 	by mail, facsimile, or email at least ten business days before the date of the first payment 
10.6 	period for which the withholding begins. The notice must be deemed received as of the date 
10.7 	of mailing or receipt of the facsimile or electronic notice. The notice must state:
10.8 	(1) the amount of the delinquent contractual payment;
10.9 	(2) the amount of the withholding per payment period;
10.10 	(3) the date on which the withholding is to begin;
10.11 	(4) whether the commissioner intends to withhold future installments of the provider's 
10.12 	contractual payments; and
10.13 	(5) other contents as the commissioner deems appropriate.
10.14 	(d) The commissioner, or the commissioner's designee, may enter into written settlement 
10.15 	agreements with a provider to resolve disputes and other matters involving unpaid loan 
10.16 	contractual payments or future loan contractual payments.
10.17 	(e) Notwithstanding any law to the contrary, all unpaid loans, plus any accrued penalties, 
10.18 	are overpayments for the purposes of section 256B.0641, subdivision 1. The current long-term 
10.19 	services and supports provider is liable for the overpayment amount owed by a former owner 
10.20 	for any provider sold, transferred, or reorganized.
10.21 	(f) By January 15 each year, the commissioner must provide a report to the chairs and 
10.22 	ranking minority members of the legislative committees with jurisdiction over nursing 
10.23 	facilities of all facilities that are delinquent in their repayments. The reporting required 
10.24 	under this paragraph expires upon notification by the commissioner to the committees that 
10.25 	there are no outstanding balances from loan awards issued under this subdivision.

10.26 	Sec. 7. Minnesota Statutes 2025 Supplement, section 256.4792, is amended by adding a 
10.27 	subdivision to read:
10.28 		Subd. 11.Loan program expiration. After the commissioner collects all loan repayments 
10.29 	incurred on or before July 1, 2026, this section expires. The commissioner must notify the 
10.30 	revisor of statutes once all loan repayments under this section are collected.

11.1 	Sec. 8. Minnesota Statutes 2024, section 256.975, subdivision 7b, is amended to read:
11.2 		Subd. 7b.Exemptions and emergency admissions. (a) Exemptions from the federal 
11.3 	screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
11.4 	(1) a person who, having entered an acute care facility from a certified nursing facility, 
11.5 	is returning to a certified nursing facility; or
11.6 	(2) a person transferring from one certified nursing facility in Minnesota to another 
11.7 	certified nursing facility in Minnesota.
11.8 	(b) Persons who are exempt from preadmission screening for purposes of level of care 
11.9 	determination include:
11.10 	(1) persons described in paragraph (a);
11.11 	(2) an individual who has a contractual right to have nursing facility care paid for 
11.12 	indefinitely by the Veterans Administration; and
11.13 	(3) an individual enrolled in a demonstration project under section 256B.69, subdivision 
11.14 	8, at the time of application to a nursing facility; and.
11.15 	(4) an individual currently being served under the alternative care program or under a 
11.16 	home and community-based services waiver authorized under section 1915(c) of the federal 
11.17 	Social Security Act.
11.18 	(c) Persons admitted to a Medicaid-certified nursing facility from the community on an 
11.19 	emergency basis as described in paragraph (d) or from an acute care facility on a nonworking 
11.20 	day must be screened the first working day after admission.
11.21 	(d) Emergency admission to a nursing facility prior to screening is permitted when all 
11.22 	of the following conditions are met:
11.23 	(1) a person is admitted from the community to a certified nursing or certified boarding 
11.24 	care facility during Senior LinkAge Line nonworking hours;
11.25 	(2) a physician, advanced practice registered nurse, or physician assistant has determined 
11.26 	that delaying admission until preadmission screening is completed would adversely affect 
11.27 	the person's health and safety;
11.28 	(3) there is a recent precipitating event that precludes the client from living safely in the 
11.29 	community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's 
11.30 	inability to continue to provide care;
12.1 	(4) the attending physician, advanced practice registered nurse, or physician assistant 
12.2 	has authorized the emergency placement and has documented the reason that the emergency 
12.3 	placement is recommended; and
12.4 	(5) the Senior LinkAge Line is contacted on the first working day following the 
12.5 	emergency admission.
12.6 	(e) Transfer of a patient from an acute care hospital to a nursing facility is not considered 
12.7 	an emergency except for a person who has received hospital services in the following 
12.8 	situations: hospital admission for observation, care in an emergency room without hospital 
12.9 	admission, or following hospital 24-hour bed care and from whom admission is being sought 
12.10 	on a nonworking day.
12.11 	(f) A nursing facility must provide written information to all persons admitted regarding 
12.12 	the person's right to request and receive long-term care consultation services as defined in 
12.13 	section 256B.0911, subdivision 11. The information must be provided prior to the person's 
12.14 	discharge from the facility and in a format specified by the commissioner.

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

12.16 	Sec. 9. Minnesota Statutes 2024, section 256B.0623, is amended by adding a subdivision 
12.17 	to read:
12.18 		Subd. 15.Billing limits. The maximum billable units for adult rehabilitation mental 
12.19 	health services under this section without authorization from the commissioner are:
12.20 	(1) four hours per week per recipient combined total of H2017, H2017 HM, and H2017 
12.21 	HQ;
12.22 	(2) 18 hours per month per recipient combined total of H2017, H2017 HM, and H2017 
12.23 	HQ; or
12.24 	(3) 200 hours per year per recipient combined total of H2017, H2017 HM, and H2017 
12.25 	HQ.

12.26 	Sec. 10. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 17, is 
12.27 	amended to read:
12.28 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
12.29 	means motor vehicle transportation provided by a public or private person that serves 
12.30 	Minnesota health care program beneficiaries who do not require emergency ambulance 
12.31 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
13.1 	(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
13.2 	a census-tract based classification system under which a geographical area is determined 
13.3 	to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance 
13.4 	fee-for-service and January 1, 2027, for prepaid medical assistance.
13.5 	(c) Medical assistance covers medical transportation costs incurred solely for obtaining 
13.6 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
13.7 	emergency or nonemergency medical care when paid directly to an ambulance company, 
13.8 	nonemergency medical transportation company, or other recognized providers of 
13.9 	transportation services. Medical transportation must be provided by:
13.10 	(1) nonemergency medical transportation providers who meet the requirements of this 
13.11 	subdivision;
13.12 	(2) ambulances, as defined in section 144E.001, subdivision 2;
13.13 	(3) taxicabs that meet the requirements of this subdivision;
13.14 	(4) public transportation, within the meaning of "public transportation" as defined in 
13.15 	section 174.22, subdivision 7; or
13.16 	(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472, 
13.17 	subdivision 1, paragraph (p).
13.18 	(d) Medical assistance covers nonemergency medical transportation provided by 
13.19 	nonemergency medical transportation providers enrolled in the Minnesota health care 
13.20 	programs. All nonemergency medical transportation providers must comply with the 
13.21 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
13.22 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
13.23 	commissioner and reported on the claim as the individual who provided the service. All 
13.24 	nonemergency medical transportation providers shall bill for nonemergency medical 
13.25 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
13.26 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
13.27 	requirements outlined in this paragraph. This paragraph expires upon the effective date of 
13.28 	paragraph (e).
13.29 	(e) Effective January 1, 2027, or upon federal approval, whichever is later, medical 
13.30 	assistance covers nonemergency medical transportation provided by nonemergency medical 
13.31 	transportation providers enrolled in the Minnesota health care programs. All nonemergency 
13.32 	medical transportation providers must comply with the operating standards for special 
13.33 	transportation service as defined in sections 174.29 to 174.30 and Minnesota Rules, chapter 
14.1 	8840, and all drivers must be individually enrolled with the commissioner and reported on 
14.2 	the claim as the individual who provided the service. All nonemergency medical 
14.3 	transportation providers shall bill for nonemergency medical transportation services in 
14.4 	accordance with Minnesota health care programs criteria and comply with the requirements 
14.5 	of section 256B.073. Publicly operated transit systems, volunteers, and not-for-hire vehicles 
14.6 	are exempt from the requirements outlined in this paragraph.
14.7 	(e)(f) An organization may be terminated, denied, or suspended from enrollment if:
14.8 	(1) the provider has not initiated background studies on the individuals specified in 
14.9 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
14.10 	(2) the provider has initiated background studies on the individuals specified in section 
14.11 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
14.12 	(i) the commissioner has sent the provider a notice that the individual has been 
14.13 	disqualified under section 245C.14; and
14.14 	(ii) the individual has not received a disqualification set-aside specific to the special 
14.15 	transportation services provider under sections 245C.22 and 245C.23.
14.16 	(f)(g) The administrative agency of nonemergency medical transportation must:
14.17 	(1) adhere to the policies defined by the commissioner;
14.18 	(2) pay nonemergency medical transportation providers for services provided to 
14.19 	Minnesota health care programs beneficiaries to obtain covered medical services;
14.20 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
14.21 	trips, and number of trips by mode; and
14.22 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
14.23 	administrative structure assessment tool that meets the technical requirements established 
14.24 	by the commissioner, reconciles trip information with claims being submitted by providers, 
14.25 	and ensures prompt payment for nonemergency medical transportation services. This 
14.26 	paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
14.27 	for prepaid medical assistance.
14.28 	(g)(h) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid 
14.29 	medical assistance, the administrative agency of nonemergency medical transportation must:
14.30 	(1) adhere to the policies defined by the commissioner;
14.31 	(2) pay nonemergency medical transportation providers for services provided to 
14.32 	Minnesota health care program beneficiaries to obtain covered medical services; and
15.1 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
15.2 	trips, and number of trips by mode.
15.3 	(h)(i) Until the commissioner implements the single administrative structure and delivery 
15.4 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
15.5 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
15.6 	clients using modes of transportation under paragraph (n) (o), clauses (4), (5), (6), and (7). 
15.7 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
15.8 	2027, for prepaid medical assistance.
15.9 	(i)(j) The commissioner may use an order by the recipient's attending physician, advanced 
15.10 	practice registered nurse, physician assistant, or a medical or mental health professional to 
15.11 	certify that the recipient requires nonemergency medical transportation services. 
15.12 	Nonemergency medical transportation providers shall perform driver-assisted services for 
15.13 	eligible individuals, when appropriate. Driver-assisted service includes passenger pickup 
15.14 	at and return to the individual's residence or place of business, assistance with admittance 
15.15 	of the individual to the medical facility, and assistance in passenger securement or in securing 
15.16 	of wheelchairs, child seats, or stretchers in the vehicle.
15.17 	(j)(k) Nonemergency medical transportation providers must take clients to the health 
15.18 	care provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
15.19 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
15.20 	authorization from the local agency. This paragraph expires July 1, 2026, for medical 
15.21 	assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
15.22 	(k)(l) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
15.23 	for prepaid medical assistance, nonemergency medical transportation providers must take 
15.24 	clients to the health care provider using the most direct route and must not exceed 30 miles 
15.25 	for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless 
15.26 	the client receives authorization from the administrator.
15.27 	(l)(m) Nonemergency medical transportation providers may not bill for separate base 
15.28 	rates for the continuation of a trip beyond the original destination. Nonemergency medical 
15.29 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
15.30 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
15.31 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
15.32 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
15.33 	services.
16.1 	(m)(n) The administrative agency shall use the level of service process established by 
16.2 	the commissioner to determine the client's most appropriate mode of transportation. If public 
16.3 	transit or a certified transportation provider is not available to provide the appropriate service 
16.4 	mode for the client, the client may receive a onetime service upgrade.
16.5 	(n)(o) The covered modes of transportation are:
16.6 	(1) client reimbursement, which includes client mileage reimbursement provided to 
16.7 	clients who have their own transportation, or to family or an acquaintance who provides 
16.8 	transportation to the client;
16.9 	(2) volunteer transport, which includes transportation by volunteers using their own 
16.10 	vehicle;
16.11 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
16.12 	or public transit. If a taxicab or public transit is not available, the client can receive 
16.13 	transportation from another nonemergency medical transportation provider;
16.14 	(4) assisted transport, which includes transport provided to clients who require assistance 
16.15 	by a nonemergency medical transportation provider;
16.16 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
16.17 	dependent on a device and requires a nonemergency medical transportation provider with 
16.18 	a vehicle containing a lift or ramp;
16.19 	(6) protected transport, which includes transport provided to a client who has received 
16.20 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
16.21 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
16.22 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
16.23 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
16.24 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
16.25 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
16.26 	a client in a prone or supine position.
16.27 	(o)(p) The local agency shall be the single administrative agency and shall administer 
16.28 	and reimburse for modes defined in paragraph (n)(o) according to paragraphs (r)(s) to (t)
16.29 	(u) when the commissioner has developed, made available, and funded the web-based single 
16.30 	administrative structure, assessment tool, and level of need assessment under subdivision 
16.31 	18e. The local agency's financial obligation is limited to funds provided by the state or 
16.32 	federal government. This paragraph expires July 1, 2026, for medical assistance 
16.33 	fee-for-service and January 1, 2027, for prepaid medical assistance.
17.1 	(p)(q) The commissioner shall:
17.2 	(1) verify that the mode and use of nonemergency medical transportation is appropriate;
17.3 	(2) verify that the client is going to an approved medical appointment; and
17.4 	(3) investigate all complaints and appeals.
17.5 	(q)(r) The administrative agency shall pay for the services provided in this subdivision 
17.6 	and seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
17.7 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
17.8 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245. 
17.9 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
17.10 	2027, for prepaid medical assistance.
17.11 	(r)(s) Payments for nonemergency medical transportation must be paid based on the 
17.12 	client's assessed mode under paragraph (m) (n), not the type of vehicle used to provide the 
17.13 	service. The medical assistance reimbursement rates for nonemergency medical transportation 
17.14 	services that are payable by or on behalf of the commissioner for nonemergency medical 
17.15 	transportation services are:
17.16 	(1) $0.22 per mile for client reimbursement;
17.17 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
17.18 	transport;
17.19 	(3) equivalent to the standard fare for unassisted transport when provided by public 
17.20 	transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency 
17.21 	medical transportation provider;
17.22 	(4) $14.30 for the base rate and $1.43 per mile for assisted transport;
17.23 	(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
17.24 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
17.25 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
17.26 	an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026, 
17.27 	for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
17.28 	(s)(t) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
17.29 	for prepaid medical assistance, payments for nonemergency medical transportation must 
17.30 	be paid based on the client's assessed mode under paragraph (m) (n), not the type of vehicle 
17.31 	used to provide the service.
18.1 	(t)(u) The base rate for nonemergency medical transportation services in areas defined 
18.2 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
18.3 	paragraph (r) (s), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
18.4 	services in areas defined under RUCA to be rural or super rural areas is:
18.5 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
18.6 	rate in paragraph (r) (s), clauses (1) to (7); and
18.7 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
18.8 	rate in paragraph (r) (s), clauses (1) to (7). This paragraph expires July 1, 2026, for medical 
18.9 	assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
18.10 	(u)(v) For purposes of reimbursement rates for nonemergency medical transportation 
18.11 	services under paragraphs (r)(s) to (t) (u), the zip code of the recipient's place of residence 
18.12 	shall determine whether the urban, rural, or super rural reimbursement rate applies. This 
18.13 	paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
18.14 	for prepaid medical assistance.
18.15 	(v)(w) The commissioner, when determining reimbursement rates for nonemergency 
18.16 	medical transportation, shall exempt all modes of transportation listed under paragraph (n)
18.17 	(o) from Minnesota Rules, part 9505.0445, item R, subitem (2).
18.18 	(w)(x) Effective for the first day of each calendar quarter in which the price of gasoline 
18.19 	as posted publicly by the United States Energy Information Administration exceeds $3.00 
18.20 	per gallon, the commissioner shall adjust the rate paid per mile in paragraph (r)(s) by one 
18.21 	percent up or down for every increase or decrease of ten cents for the price of gasoline. The 
18.22 	increase or decrease must be calculated using a base gasoline price of $3.00. The percentage 
18.23 	increase or decrease must be calculated using the average of the most recently available 
18.24 	price of all grades of gasoline for Minnesota as posted publicly by the United States Energy 
18.25 	Information Administration. This paragraph expires July 1, 2026, for medical assistance 
18.26 	fee-for-service and January 1, 2027, for prepaid medical assistance.

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

18.28 	Sec. 11. Minnesota Statutes 2024, section 256B.0625, subdivision 17b, is amended to 
18.29 	read:
18.30 		Subd. 17b.Documentation required. (a) As a condition for payment, nonemergency 
18.31 	medical transportation providers must document each occurrence of a service provided to 
18.32 	a recipient according to this subdivision. Providers must maintain records sufficient to 
18.33 	distinguish individual trips with specific vehicles and drivers. The documentation may be 
19.1 	collected and maintained using electronic systems or software or in paper form but must be 
19.2 	made available and produced upon request. Program funds paid for transportation that is 
19.3 	not documented according to this subdivision may be subject to recovery by the commissioner 
19.4 	pursuant to section 256B.064.
19.5 	(b) A nonemergency medical transportation provider must compile transportation trip 
19.6 	records that are written in English and legible according to the standard of a reasonable 
19.7 	person and that include each of the following elements:
19.8 	(1) the recipient's name;
19.9 	(2) the date or dates the service is provided, if different than the date the entry was made;
19.10 	(3) either the printed name of the driver sufficient to distinguish the driver of service or 
19.11 	the driver's provider number;
19.12 	(4) the date and the signature of the driver attesting that the record accurately represents 
19.13 	the services provided and the actual miles driven, and acknowledging that misreporting 
19.14 	information that results in ineligible or excessive payments may result in civil or criminal 
19.15 	action;
19.16 	(5) the date and the signature of the recipient or authorized party attesting that 
19.17 	transportation services were provided as indicated on the transportation trip record, or the 
19.18 	signature of the medical services provider certifying that the recipient was transported to 
19.19 	the medical services provider destination. In the event that both the medical services provider 
19.20 	and the recipient or authorized party refuse or are unable to provide signatures, the driver 
19.21 	must document on the transportation trip record that signatures were requested and not 
19.22 	provided;
19.23 	(6) the address, or the description if the address is not available, of both the origin and 
19.24 	destination, and the mileage for the most direct route from the origin to the destination;
19.25 	(7) the name or number of the mode of transportation in which the service is provided;
19.26 	(8) the license plate number of the vehicle used to transport the recipient;
19.27 	(9) the time of the recipient pickup;
19.28 	(10) the time of the recipient drop-off;
19.29 	(11) the odometer reading of the vehicle used to transport the recipient taken at the time 
19.30 	of pickup;
19.31 	(12) the odometer reading of the vehicle used to transport the recipient taken at the time 
19.32 	of drop-off;
20.1 	(13) the name of the extra attendant when an extra attendant is used to provide special 
20.2 	transportation service; and
20.3 	(14) the documentation indicating the method that was used to determine the most direct 
20.4 	route.
20.5 	(c) In determining whether the commissioner will seek recovery, the documentation 
20.6 	requirements in this section apply retroactively to audit findings beginning January 1, 2020, 
20.7 	and to all audit findings thereafter.
20.8 	(d) Effective January 1, 2027, or upon federal approval, whichever is later, records that 
20.9 	comply with section 256B.073 may be used to meet the requirements of this subdivision if 
20.10 	all required elements are included in the record.

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

20.12 	Sec. 12. Minnesota Statutes 2025 Supplement, section 256B.0632, is amended by adding 
20.13 	a subdivision to read:
20.14 		Subd. 3a.Billing limits. An individual client must not receive more than 30 days of 
20.15 	services under this section without prior authorization from the commissioner.

20.16 	Sec. 13. Minnesota Statutes 2024, section 256B.073, subdivision 1, is amended to read:
20.17 		Subdivision 1.Documentation; establishment and operation. The commissioner of 
20.18 	human services shall establish implementation requirements and standards for and maintain 
20.19 	the requirements and standards for the ongoing operation of electronic visit verification to 
20.20 	comply with the 21st Century Cures Act, Public Law 114-255. Within available 
20.21 	appropriations, the commissioner shall take steps to comply with the electronic visit 
20.22 	verification requirements in the 21st Century Cures Act, Public Law 114-255.

20.23 	Sec. 14. Minnesota Statutes 2024, section 256B.073, subdivision 2, is amended to read:
20.24 		Subd. 2.Definitions. (a) For purposes of this section, the terms in this subdivision have 
20.25 	the meanings given them.
20.26 	(b) "Electronic visit verification" or "EVV" means the electronic documentation of the
20.27 	process required under United States Code, title 42, section 1396b(l), and this section used 
20.28 	to electronically verify:
20.29 	(1) type of service performed;
20.30 	(2) individual receiving the service;
21.1 	(3) date of the service;
21.2 	(4) location of the service delivery;
21.3 	(5) individual providing the service; and
21.4 	(6) time the service begins and ends.
21.5 	(c) "Electronic visit verification system" means a system that provides electronic 
21.6 	verification of servicesused to collect, verify, and transmit EVV data to the commissioner 
21.7 	or the commissioner's designated data aggregator that complies with the 21st Century Cures 
21.8 	Act, Public Law 114-255, and the requirements of subdivision 3.
21.9 	(d) "Managed care organization" means a public or private organization that contracts 
21.10 	with the commissioner under section 256B.69 or other applicable law to deliver health care 
21.11 	services to individuals eligible for medical assistance or MinnesotaCare.
21.12 	(e) "Provider" means an individual or organization that meets one or more of the following 
21.13 	conditions:
21.14 	(1) is enrolled as a Minnesota health care programs provider;
21.15 	(2) provides services through a managed care organization under contract with the 
21.16 	commissioner under section 256B.69;
21.17 	(3) is a financial management services provider; or
21.18 	(4) is a participant employer under section 256B.85, subdivision 7, or an employer of 
21.19 	record directing services under section 256B.49, subdivision 16.
21.20 	(d)(f) "Service" means one of the following:
21.21 	(1) personal care assistance services as defined in section 256B.0625, subdivision 19a, 
21.22 	and provided according to section 256B.0659;
21.23 	(2) community first services and supports under section 256B.85;
21.24 	(3) home health services under section 256B.0625, subdivision 6a; or
21.25 	(4) other medical supplies and equipment or home and community-based services that 
21.26 	are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255.; 
21.27 	or
21.28 	(5) other services determined by the commissioner.
21.29 	(g) "Financial management services provider" means an entity enrolled with the 
21.30 	commissioner to provide financial management services under section 256B.85 or other 
22.1 	applicable law and responsible for fiscal, payroll, and reporting functions on behalf of 
22.2 	participant employers.
22.3 	(h) "Home health agency" means a home care provider agency that is Medicare certified 
22.4 	under Code of Federal Regulations, title 42, part 484, and licensed as a home care provider 
22.5 	under chapter 144A.
22.6 	(i) "Worker" means an individual who provides personal care assistance services, 
22.7 	community first services and supports, home health services, consumer-directed community 
22.8 	supports, or other services identified by the commissioner as subject to electronic visit 
22.9 	verification.
22.10 	(j) "Individual" means a person who receives services subject to electronic visit 
22.11 	verification under the medical assistance program.
22.12 	(k) "Electronic visit verification data" means information collected through an electronic 
22.13 	visit verification system, including data elements required under United States Code, title 
22.14 	42, section 1396b(l), and any additional data elements specified by the commissioner under 
22.15 	this section.
22.16 	(l) "Visit" means a single occurrence of service delivery subject to electronic visit 
22.17 	verification.
22.18 	(m) "Verification method" means the electronic process used to capture and verify visit 
22.19 	information, including telephone, fixed visit verification devices, or mobile applications, 
22.20 	as approved by the commissioner.
22.21 	(n) "Data aggregator" means the entity designated by the commissioner to collect, store, 
22.22 	and transmit electronic visit verification data from providers and third-party systems to the 
22.23 	commissioner in accordance with the standards and requirements established under this 
22.24 	section.
22.25 	(o) "Third-party electronic visit verification system" means an electronic visit verification 
22.26 	system purchased or operated by a provider or vendor other than the state-provided system 
22.27 	designated by the commissioner.
22.28 	(p) "State-provided electronic visit verification system" means the electronic visit 
22.29 	verification system made available by the commissioner to providers at no cost for services 
22.30 	subject to federal electronic visit verification requirements.
22.31 	(q) "Electronic visit verification vendor" means any entity that develops, provides, or 
22.32 	supports an electronic visit verification system, including the state-provided vendor and 
22.33 	any third-party vendor.

23.1 	Sec. 15. Minnesota Statutes 2024, section 256B.073, subdivision 3, is amended to read:
23.2 		Subd. 3.Requirements. (a) In developing implementation requirements foradministering 
23.3 	electronic visit verification, the commissioner shallmust ensure that the system and related 
23.4 	requirements:
23.5 	(1) are minimally administratively and financially burdensome to a provider reasonable 
23.6 	for providers;
23.7 	(2) are minimally burdensomesupport continued access to theservices and are designed 
23.8 	to avoid disruption to service recipient and the least disruptive to the service recipient in 
23.9 	receiving and maintaining allowed services delivery or receipt;
23.10 	(3) consider existing best practices and use of electronic visit verification;
23.11 	(4) are conducted according to all state and federal laws;
23.12 	(5) are effective methods for preventing fraud when balanced against the requirements 
23.13 	of clauses (1) and (2); and
23.14 	(6) are consistent with the Department of Human Services' policies related to covered 
23.15 	services, flexibility of service use, and quality assurance.
23.16 	(b) The commissioner shallmust make training and guidance available to providers on 
23.17 	the electronic visit verification system requirements and system use.
23.18 	(c) The commissioner shallmust establish baseline measurements related to preventing 
23.19 	fraud and establish measures to determine the effect of electronic visit verification 
23.20 	requirements on program integrity.
23.21 	(d) The commissioner shallmust make a state-selected electronic visit verification system 
23.22 	available to providers of services.
23.23 	(e) The commissioner shallmust make available and publish on the agency website the 
23.24 	name and contact information for the vendor of the state-selected electronic visit verification 
23.25 	system and the other vendors that offer alternative electronic visit verification systems. The 
23.26 	information provided must state that the state-selected electronic visit verification system 
23.27 	is offered at no cost to the provider of services and that the provider may choose an alternative 
23.28 	system that may be at a cost to the provider.
23.29 	(f) The commissioner may establish implementation dates and implementation schedules 
23.30 	for services or system functions subject to electronic visit verification under this section, 
23.31 	including but not limited to the phased addition of new services, verification methods, or 
23.32 	technical requirements.
24.1 	(g) The commissioner may waive the requirements of this section for any service 
24.2 	component or setting when the application of electronic visit verification is contrary to 
24.3 	paragraph (a).

24.4 	Sec. 16. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision 
24.5 	to read:
24.6 		Subd. 4a.Electronic visit verification system options. (a) A provider must use an 
24.7 	electronic visit verification system that complies with the requirements established by the 
24.8 	commissioner. A provider may use either the state-provided system or a third-party system. 
24.9 	All systems used for compliance must provide data to the commissioner in the format and 
24.10 	frequency required by the commissioner.
24.11 	(b) The commissioner must make a state-provided electronic visit verification system 
24.12 	available at no cost to providers of services. The commissioner must provide training on 
24.13 	the system to all providers.
24.14 	(c) The commissioner must allow providers of services to utilize a third-party electronic 
24.15 	visit verification system that the commissioner determines meets the requirements of this 
24.16 	section.
24.17 	(d) A provider using a third-party electronic visit verification system that meets all 
24.18 	technical specifications and federal and state laws must:
24.19 	(1) collect and submit all data for each visit to the commissioner, including but not 
24.20 	limited to manual entries;
24.21 	(2) maintain compliance identified by the commissioner, including but not limited to 
24.22 	incorporating into the system any changes in data requirements that must be transmitted to 
24.23 	the state EVV system; and
24.24 	(3) integrate the system with the state's designated data aggregator to accurately send 
24.25 	data.
24.26 	(e) The state-designated data aggregator must be available at no cost to a provider for 
24.27 	purposes of transmitting electronic visit verification data from approved third-party systems 
24.28 	to the commissioner. Any costs associated with the development and use of a third-party 
24.29 	system are the responsibility of the provider.
24.30 	(f) If a provider is unable to integrate a third-party system with the designated state 
24.31 	aggregator, the provider must use the state EVV system.
25.1 	(g) The commissioner must provide training on reviewing and correcting imported data 
25.2 	in the state's designated data aggregator to providers.

25.3 	Sec. 17. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision 
25.4 	to read:
25.5 		Subd. 4b.Provider responsibilities. A provider must:
25.6 	(1) use an electronic visit verification system that meets all technical and data submission 
25.7 	requirements established by the commissioner;
25.8 	(2) enroll with the state-provided electronic visit verification system or the commissioner's 
25.9 	designated data aggregator, as applicable;
25.10 	(3) provide all information requested by the commissioner for enrollment, access, and 
25.11 	data submission and ensure that such information remains accurate and up to date;
25.12 	(4) maintain records for each individual receiving services subject to electronic visit 
25.13 	verification, including but not limited to all required data elements;
25.14 	(5) maintain a current list of workers providing services subject to electronic visit 
25.15 	verification to individuals receiving services under medical assistance;
25.16 	(6) provide the commissioner and any managed care organization under contract with 
25.17 	the commissioner under section 256B.69 with immediate, direct, and on-site or remote 
25.18 	access to the electronic visit verification system;
25.19 	(7) at the request of the commissioner or a managed care organization, allow review or 
25.20 	copying of electronic visit verification documentation at no cost;
25.21 	(8) ensure that electronic visit verification systems and related processes meet accessibility 
25.22 	and confidentiality requirements under state and federal law;
25.23 	(9) comply with all policies, procedures, and technical specifications issued by the 
25.24 	commissioner under this section; and
25.25 	(10) ensure that workers, participants, and other individuals using electronic visit 
25.26 	verification are trained and comply with all documentation and data entry requirements 
25.27 	established by the commissioner.

26.1 	Sec. 18. Minnesota Statutes 2024, section 256B.073, subdivision 5, is amended to read:
26.2 		Subd. 5.Vendor requirements. (a) The vendor of the electronic visit verification system 
26.3 	selected by the commissioner and the vendor's affiliate must comply with the requirements 
26.4 	of this subdivision.
26.5 	(b) The vendor of the state-selectedstate-provided electronic visit verification system 
26.6 	and the vendor's affiliate must:
26.7 	(1) notify the provider of services that the provider may choose the state-selected
26.8 	state-provided electronic visit verification system at no cost to the provider;
26.9 	(2) offer the state-selectedstate-provided electronic visit verification system to the 
26.10 	provider of services prior to offering any fee-based electronic visit verification system;
26.11 	(3) notify the provider of services that the provider may choose any fee-based electronic 
26.12 	visit verification system prior to offering the vendor's or its affiliate's fee-based electronic 
26.13 	visit verification system; and
26.14 	(4) when offering the state-selectedstate-provided electronic visit verification system, 
26.15 	clearly differentiate between the state-selectedstate-provided electronic visit verification 
26.16 	system and the vendor's or its affiliate's alternative fee-based system.
26.17 	(c) The vendor of the state-selectedstate-provided electronic visit verification system 
26.18 	and the vendor's affiliate must not use state data that are not available to other vendors of 
26.19 	electronic visit verification systems to promote or sell the vendor's or its affiliate's alternative 
26.20 	electronic visit verification system.
26.21 	(d) Upon request from the provider, the vendor of the state-selectedstate-provided 
26.22 	electronic visit verification system must provide proof of compliance with the requirements 
26.23 	of paragraph (b).
26.24 	(e) An agreement between the vendor of the state-selectedstate-provided electronic visit 
26.25 	verification system or its affiliate and a provider of services for an electronic visit verification 
26.26 	system that is not the state-selectedstate-provided system entered into on or after July 1, 
26.27 	2023, is subject to immediate termination by the provider if the vendor violates any of the 
26.28 	requirements of paragraph (b).

26.29 	Sec. 19. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision 
26.30 	to read:
26.31 		Subd. 6.Data and documentation. (a) A provider must submit electronic visit 
26.32 	verification data to the commissioner or the commissioner's designated data aggregator in 
27.1 	accordance with the technical standards, format, and frequency established under this section. 
27.2 	The commissioner may use integrated electronic visit verification data for oversight, quality 
27.3 	assurance, and program integrity purposes consistent with state and federal law.
27.4 	(b) The commissioner and managed care organizations must use electronic visit 
27.5 	verification data to validate claims for payment under medical assistance. Claims that cannot 
27.6 	be validated in accordance with electronic visit verification requirements may be subject 
27.7 	to actions by the commissioner as authorized under state and federal law, including actions 
27.8 	related to payment, program integrity, or provider compliance.
27.9 	(c) A provider must record all required electronic visit verification data at the time of 
27.10 	service delivery using an approved verification method. To be compliant with electronic 
27.11 	visit verification requirements, a provider must document a visit with all required data 
27.12 	elements recorded at the time of service delivery.
27.13 	(d) A manual visit is a visit:
27.14 	(1) entered administratively and not by the caregiver at the time of service delivery; or
27.15 	(2) where data elements are edited after the time of service delivery.
27.16 	(e) A manual visit does not comply with electronic visit verification requirements. A 
27.17 	manual visit must be confirmed and verified according to processes established by the 
27.18 	commissioner before being used to validate or support a claim for payment.
27.19 	(f) A worker providing services subject to electronic visit verification must record the 
27.20 	start and end times of each visit at the time the service is delivered using an approved 
27.21 	verification method. A worker must complete and verify all time documentation, including 
27.22 	but not limited to verification of service type, date, and duration, on the date the service 
27.23 	occurs and be consistent with documentation requirements under sections 256B.0659, 
27.24 	subdivision 12; 256B.85, subdivision 15; 256B.49, subdivision 16; and 256B.0625, 
27.25 	subdivision 6a. A provider of services must maintain documentation demonstrating 
27.26 	compliance with this subdivision and make the documentation available to the commissioner 
27.27 	or a managed care organization under contract with the commissioner under section 256B.69 
27.28 	upon request.

27.29 	Sec. 20. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision 
27.30 	to read:
27.31 		Subd. 7.Third-party system responsibilities. (a) This section is effective for Early 
27.32 	Intensive Developmental and Behavioral Intervention services beginning July 1, 2027, or 
27.33 	upon federal approval, whichever is later. This section is effective for all other services 
28.1 	subject to this subdivision beginning January 1, 2027, or upon federal approval, whichever 
28.2 	is later.
28.3 	(b) A provider that uses a third-party electronic visit verification system must ensure 
28.4 	that the system meets all technical, functional, and data-exchange requirements established 
28.5 	by the commissioner and transmits data to the commissioner or the commissioner's designated 
28.6 	data aggregator in the format and frequency required by the commissioner.
28.7 	(c) A third-party electronic visit verification vendor must:
28.8 	(1) comply with all technical, contractual, privacy, and security standards established 
28.9 	by the commissioner;
28.10 	(2) not use or disclose state data for any purpose other than fulfilling the requirements 
28.11 	of this section or federal law;
28.12 	(3) provide the commissioner access to system documentation, data mapping, and audit 
28.13 	records upon request; and
28.14 	(4) immediately report to the commissioner any data transmission failure, breach, or 
28.15 	interruption affecting the state's ability to receive required electronic visit verification data.
28.16 	(d) A provider remains responsible for ensuring compliance with this section even when 
28.17 	using a third-party electronic visit verification system.
28.18 	(e) The third-party vendor must ensure training on the system is available to providers.

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

28.20 	Sec. 21. Minnesota Statutes 2024, section 256B.0911, subdivision 26, is amended to read:
28.21 		Subd. 26.Determination of institutional level of care. (a) The determination of need 
28.22 	for hospital and intermediate care facility levels of care must be made according to criteria 
28.23 	developed by the commissioner, and in section 256B.092, using forms developed by the 
28.24 	commissioner.
28.25 	(b) The determination of need for nursing facility level of care must be made based on 
28.26 	criteria in section 144.0724, subdivision 11. This paragraph expires upon the effective date 
28.27 	of paragraph (c).
28.28 	(c) Effective January 1, 2027, or upon federal approval, whichever is later, the 
28.29 	determination of need for nursing facility level of care must be made based on criteria in 
28.30 	section 144.0724, subdivision 11, or criteria in section 144.0724, subdivision 11a, for brain 
29.1 	injury and community access for disability inclusion waiver services provided under section 
29.2 	256B.49.

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

29.4 	Sec. 22. Minnesota Statutes 2024, section 256B.0911, subdivision 32, is amended to read:
29.5 		Subd. 32.Administrative activity. (a) The commissioner shall:
29.6 	(1) streamline the processes, including timelines for when assessments need to be 
29.7 	completed;
29.8 	(2) provide the services in this section; and
29.9 	(3) implement integrated solutions to automate the business processes to the extent 
29.10 	necessary for support plan approval, reimbursement, program planning, evaluation, and 
29.11 	policy development.; and
29.12 	(4) grant limited role-based access to a person's support plan in the MnCHOICES system 
29.13 	to home and community-based service providers who have been designated as a provider 
29.14 	for that person by a lead agency for the purpose of signing the person's support plan 
29.15 	electronically and demonstrating that the provider has reviewed, understood, and agrees to 
29.16 	deliver services as outlined in the plan.
29.17 	(b) The commissioner shall work with lead agencies responsible for conducting long-term 
29.18 	care consultation services to:
29.19 	(1) modify the MnCHOICES application and assessment policies to create efficiencies 
29.20 	while ensuring federal compliance with medical assistance and long-term services and 
29.21 	supports eligibility criteria; and
29.22 	(2) develop a set of measurable benchmarks sufficient to demonstrate quarterly 
29.23 	improvement in the average time per assessment and other mutually agreed upon measures 
29.24 	of increasing efficiency.
29.25 	(c) The commissioner shall collect data on the benchmarks developed under paragraph 
29.26 	(b) and provide to the lead agencies an annual trend analysis of the data in order to 
29.27 	demonstrate the commissioner's compliance with the requirements of this subdivision.

29.28 	Sec. 23. Minnesota Statutes 2024, section 256B.4905, subdivision 11, is amended to read:
29.29 		Subd. 11.Informed choice in technology policy. It is the policy of this state that all 
29.30 	adults who have disabilities and children who have disabilities:
30.1 	(1) can use assistive technology, remote supports, or a combination of both to enhance 
30.2 	the adult's or child's independence and quality of life; and
30.3 	(2) have the right, at least annually, to make an informed choice about the adult's or 
30.4 	child's use of assistive technology and remote supports when permitted under the individual's 
30.5 	federally approved waiver plan, service authorization, and applicable service standards.

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

30.7 	Sec. 24. Minnesota Statutes 2024, section 256B.4905, subdivision 12, is amended to read:
30.8 		Subd. 12.Informed choice and technology prioritization in implementation for 
30.9 	disability waiver services. (a) The commissioner of human services shall ensure that:
30.10 	(1) disability waivers under sections 256B.092 and 256B.49 support the presumption 
30.11 	that all adults who have disabilities and children who have disabilities may use assistive 
30.12 	technology, remote supports, or both to enhance the adult's or child's independence and 
30.13 	quality of life; and
30.14 	(2) each individual accessing waiver services is offered, after an informed 
30.15 	decision-making process and during a person-centered planning process, the opportunity 
30.16 	to choose assistive technology, remote support, or both prior to the commissioner offering 
30.17 	or reauthorizing services that utilize direct support staff to ensure equitable access.; and
30.18 	(3) policies and procedures related to the use of technology, including but not limited 
30.19 	to remote support, promote informed choice and protect the health and safety of individuals 
30.20 	receiving services consistent with federal law and the terms of approved waiver plans.
30.21 	(b) Nothing in this subdivision authorizes the use of remote support as a method of 
30.22 	service delivery unless expressly permitted under the applicable service definition, waiver 
30.23 	plan, and service standards approved by the Centers for Medicare and Medicaid Services.

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

30.25 	Sec. 25. Minnesota Statutes 2024, section 256B.4912, is amended by adding a subdivision 
30.26 	to read:
30.27 		Subd. 17.Prohibition on room and board payments. (a) The provider must not use 
30.28 	medical assistance money to pay for room and board, including but not limited to rent, 
30.29 	mortgage payments, utilities, property taxes, homeowners association fees, or any other 
30.30 	housing-related cost, in accordance with federal home and community-based services waiver 
31.1 	requirements under United States Code, title 42, section 1396n(c), and Code of Federal 
31.2 	Regulations, title 42, section 441.310.
31.3 	(b) A provider of home and community-based services, including but not limited to 
31.4 	integrated community supports under section 245D.03, subdivision 1, paragraph (c), clause 
31.5 	(8), must not:
31.6 	(1) use, allocate, or apply any payment for home and community-based services to cover, 
31.7 	subsidize, discount, or otherwise contribute to any room and board expenses for a person 
31.8 	receiving services;
31.9 	(2) apply agency operating margins, reserves, or profits derived from home and 
31.10 	community-based services to pay for rent or pay other housing costs for persons receiving 
31.11 	services; or
31.12 	(3) enter into any financial arrangement, discount, concession, or reimbursement structure 
31.13 	that has the effect of using medical assistance service revenue to offset the housing costs 
31.14 	of a person receiving services.
31.15 	(c) Nothing in this subdivision prohibits a provider from charging a person for room 
31.16 	and board in accordance with chapter 504B or applicable housing support laws, provided 
31.17 	the charge is independent of medical assistance payments and complies with all federal 
31.18 	home and community-based services setting requirements, including but not limited to 
31.19 	tenancy protections under Code of Federal Regulations, title 42, section 441.301(c)(4)(vi)(A).
31.20 	(d) The commissioner may pursue corrective action, payment recovery, sanctions under 
31.21 	section 256B.064, and licensing action under chapter 245A or 245D for a violation of this 
31.22 	subdivision.

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

31.24 	Sec. 26. Minnesota Statutes 2024, section 256B.4912, is amended by adding a subdivision 
31.25 	to read:
31.26 		Subd. 19.Billing limits. (a) The limits in this subdivision establish the maximum amounts 
31.27 	of authorized units for each service within a service day, week, or month.
31.28 	(b) Effective January 1, 2027, or upon federal approval, whichever is later, to ensure 
31.29 	fiscal accountability and consistency across home and community-based services authorized 
31.30 	under sections 256B.092, 256B.49, 256B.0913, 256B.0922, and 256B.0949 and chapter 
31.31 	256S, the following billing limits apply:
32.1 	(1) adult companion services: up to six hours per day per recipient with a maximum of 
32.2 	963 hours annually;
32.3 	(2) chore services: up to six hours per week per recipient for 15-minute units;
32.4 	(3) homemaking services, cleaning: up to 16 hours per week per recipient;
32.5 	(4) homemaking services, home management: up to 16 hours per week per recipient;
32.6 	(5) day support services: up to eight hours per day per recipient;
32.7 	(6) family training and counseling under a disability waiver: up to two hours per week 
32.8 	per recipient or family unit;
32.9 	(7) community residential services one-to-one staffing: the maximum daily hours 
32.10 	permitted under the applicable service tier under section 256B.4914, as published by the 
32.11 	commissioner;
32.12 	(8) independent living skills: up to six hours per day per recipient;
32.13 	(9) individualized home supports with training and individualized home supports with 
32.14 	family training: three consecutive hours in a day or six total hours per day;
32.15 	(10) home-delivered meals: up to two meals per day per recipient;
32.16 	(11) individualized home supports: up to 16 hours per day per recipient, inclusive of all 
32.17 	staffing ratios;
32.18 	(12) personal emergency response system: one unit per month per recipient, inclusive 
32.19 	of installation, monitoring, and maintenance;
32.20 	(13) respite services provided in the recipient's home: 30 consecutive days per occurrence;
32.21 	(14) overnight supervision services: ten hours per day per recipient, with no more than 
32.22 	eight hours asleep; and
32.23 	(15) transportation services: 28 one-way trips per week per participant.
32.24 	(c) Effective July 1, 2027, or upon federal approval, whichever is later, to ensure fiscal 
32.25 	accountability and consistency across home and community-based services authorized under 
32.26 	sections 256B.092, 256B.49, 256B.0913, 256B.0922, and 256B.0949 and chapter 256S, 
32.27 	the following billing limits apply to early intensive development and behavioral intervention 
32.28 	services:
32.29 	(1) intensive services: 40 hours per week per recipient;
32.30 	(2) travel: two hours per day per recipient;
33.1 	(3) observation and direction: 20 hours per week per recipient; and
33.2 	(4) individual treatment and planning: 300 units per year per recipient.
33.3 	(d) For personal emergency response system billing units under paragraph (b), clause 
33.4 	(12), lead agency staff must end service lines for any inactive providers to prevent duplicate 
33.5 	billing.
33.6 	(e) The limits in this subdivision do not limit a person's use of other waiver services. 
33.7 	Billing limits under this subdivision apply only to the individual service listed and do not 
33.8 	prohibit the recipient from accessing other services for which they are eligible on the same 
33.9 	day, week, or month, subject to other applicable requirements.

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

33.11 	Sec. 27. Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 3, is 
33.12 	amended to read:
33.13 		Subd. 3.Applicable services. (a) Applicable services are those authorized under the 
33.14 	state's home and community-based services waivers under sections 256B.092 and 256B.49, 
33.15 	including the following, as defined in the federally approved home and community-based 
33.16 	services plan:
33.17 	(1) 24-hour customized living;
33.18 	(2) adult day services;
33.19 	(3) adult day services bath;
33.20 	(4) community residential services;
33.21 	(5) customized living;
33.22 	(6) day support services;
33.23 	(7) employment development services;
33.24 	(8) employment exploration services;
33.25 	(9) employment support services;
33.26 	(10) family residential services;
33.27 	(11) individualized home supports;
33.28 	(12) individualized home supports with family training;
33.29 	(13) individualized home supports with training;
34.1 	(14) integrated community supports;
34.2 	(15) life sharing;
34.3 	(16) effective until the effective date of clauses (17) and (18) (19), night supervision;
34.4 	(17) effective January 1, 2026, or upon federal approval, whichever is later, awake night 
34.5 	supervision;
34.6 	(18) effective January 1, 2027, or upon federal approval, whichever is later, awake night 
34.7 	supervision only if documentation for an exception is provided and approved by the 
34.8 	commissioner;
34.9 	(18)(19) effective January 1, 2026, or upon federal approval, whichever is later, asleep 
34.10 	night supervision;
34.11 	(19)(20) positive support services;
34.12 	(20)(21) prevocational services;
34.13 	(21)(22) residential support services;
34.14 	(22)(23) transportation services; and
34.15 	(23)(24) other services as approved by the federal government in the state home and 
34.16 	community-based services waiver plan.
34.17 	(b) Paragraph (a), clause (17), expires upon the effective date of paragraph (a), clause 
34.18 	(18).

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

34.20 	Sec. 28. Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 5a, is 
34.21 	amended to read:
34.22 		Subd. 5a.Base wage index; calculations. The base wage index must be calculated as 
34.23 	follows:
34.24 	(1) for supervisory staff, 100 percent of the median wage for community and social 
34.25 	services specialist (SOC code 21-1099), with the exception of the supervisor of positive 
34.26 	supports professional, positive supports analyst, and positive supports specialist, which is 
34.27 	100 percent of the median wage for clinical counseling and school psychologist (SOC code 
34.28 	19-3031);
34.29 	(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC 
34.30 	code 29-1141);
35.1 	(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical 
35.2 	nurses (SOC code 29-2061);
35.3 	(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large 
35.4 	employers;
35.5 	(5) for residential direct care staff, the sum of:
35.6 	(i) 15 percent of the subtotal of 50 percent of the median wage for home health and 
35.7 	personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant 
35.8 	(SOC code 31-1131); and 20 percent of the median wage for social and human services 
35.9 	aide (SOC code 21-1093); and
35.10 	(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and 
35.11 	personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant 
35.12 	(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code 
35.13 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
35.14 	21-1093);
35.15 	(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC 
35.16 	code 31-1131); and 30 percent of the median wage for home health and personal care aide 
35.17 	(SOC code 31-1120);
35.18 	(7) for day support services staff and prevocational services staff, 20 percent of the 
35.19 	median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for 
35.20 	psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social 
35.21 	and human services aide (SOC code 21-1093);
35.22 	(8) for positive supports analyst staff, 100 percent of the median wage for substance 
35.23 	abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);
35.24 	(9) for positive supports professional staff, 100 percent of the median wage for clinical 
35.25 	counseling and school psychologist (SOC code 19-3031);
35.26 	(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric 
35.27 	technicians (SOC code 29-2053);
35.28 	(11) for individualized home supports with family training staff, 20 percent of the median 
35.29 	wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community 
35.30 	social service specialist (SOC code 21-1099); 40 percent of the median wage for social and 
35.31 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
35.32 	technician (SOC code 29-2053);
36.1 	(12) for individualized home supports with training services staff, 40 percent of the 
36.2 	median wage for community social service specialist (SOC code 21-1099); 50 percent of 
36.3 	the median wage for social and human services aide (SOC code 21-1093); and ten percent 
36.4 	of the median wage for psychiatric technician (SOC code 29-2053);
36.5 	(13) for employment support services staff, 50 percent of the median wage for 
36.6 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
36.7 	community and social services specialist (SOC code 21-1099);
36.8 	(14) for employment exploration services staff, 50 percent of the median wage for 
36.9 	education, guidance, school, and vocational counselor (SOC code 21-1012); and 50 percent 
36.10 	of the median wage for community and social services specialist (SOC code 21-1099);
36.11 	(15) for employment development services staff, 50 percent of the median wage for 
36.12 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
36.13 	of the median wage for community and social services specialist (SOC code 21-1099);
36.14 	(16) for individualized home support without training staff, 50 percent of the median 
36.15 	wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the 
36.16 	median wage for nursing assistant (SOC code 31-1131);
36.17 	(17) effective until the effective date of clauses (18) and (19), for night supervision staff, 
36.18 	40 percent of the median wage for home health and personal care aide (SOC code 31-1120); 
36.19 	20 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent of the 
36.20 	median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median 
36.21 	wage for social and human services aide (SOC code 21-1093);
36.22 	(18) effective January 1, 2026, or upon federal approval, whichever is later, for awake 
36.23 	night supervision staff, 40 percent of the median wage for home health and personal care 
36.24 	aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code 
36.25 	31-1131); 20 of percent the median wage for psychiatric technician (SOC code 29-2053); 
36.26 	and 20 percent of the median wage for social and human services aid (SOC code 21-1093); 
36.27 	and
36.28 	(19) effective January 1, 2026, or upon federal approval, whichever is later, for asleep 
36.29 	night supervision staff, the minimum wage in Minnesota for large employers.; and
36.30 	(20) for integrated community support staff, 40 percent of the median wage for 
36.31 	community social service specialist (SOC code 21-1099); 50 percent of the median wage 
36.32 	for social and human services aide (SOC code 21-1093); and ten percent of the median 
36.33 	wage for psychiatric technician (SOC code 29-2053).

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

37.2 	Sec. 29. Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 5b, is 
37.3 	amended to read:
37.4 		Subd. 5b.Standard component value adjustments. (a) The commissioner shall update 
37.5 	the base wage index under subdivision 5a; client and programming support, transportation, 
37.6 	and program facility cost component values as required in subdivisions 6 to 9; and the rates 
37.7 	identified in subdivision 19 for changes in the Consumer Price Index. If the result of this 
37.8 	update exceeds eight percent, the commissioner shall implement a change to the base wage 
37.9 	index, component values, and rates under subdivision 19 of eight percent. If the result of 
37.10 	this update is less than eight percent, the commissioner shall implement the full value of 
37.11 	the change. The commissioner shall adjust these values higher or lower, publish these 
37.12 	updated values, and load them into the rate management system on January 1, 2026, and 
37.13 	every two years thereafter, by the percentage change in the CPI-U from the date of the 
37.14 	previous update to the data available 24 months and one day prior to the scheduled update.
37.15 	This paragraph expires upon the effective date of paragraph (b).
37.16 	(b) Effective January 1, 2028, or upon federal approval, whichever is later, the 
37.17 	commissioner shall update the base wage index under subdivision 5a; client and programming 
37.18 	support, transportation, and program facility cost component values as required in 
37.19 	subdivisions 6 to 9; and the rates identified in subdivision 19 for changes in the Consumer 
37.20 	Price Index. If the result of this update exceeds four percent, the commissioner shall 
37.21 	implement a change to the base wage index, component values, and rates under subdivision 
37.22 	19 of four percent. If the result of this update is less than four percent, the commissioner 
37.23 	shall implement the full value of the change. The commissioner shall adjust these values 
37.24 	higher or lower, publish these updated values, and load them into the rate management 
37.25 	system on January 1, 2028, and every two years thereafter, by the percentage change in the 
37.26 	CPI-U from the date of the previous update to the data available 24 months and one day 
37.27 	prior to the scheduled update.

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

37.29 	Sec. 30. Minnesota Statutes 2024, section 256B.4914, subdivision 6, is amended to read:
37.30 		Subd. 6.Residential support services; generally. (a) For purposes of this section, 
37.31 	residential support services includes 24-hour customized living services, community 
37.32 	residential services, and customized living services, and integrated community supports.
38.1 	(b) A unit of service for residential support services is a day. Any portion of any calendar 
38.2 	day, within allowable Medicaid rules, where an individual spends time in a residential setting 
38.3 	is billable as a day. The number of days authorized for all individuals enrolling in residential 
38.4 	support services must include every day that services start and end.
38.5 	(c) When the available shared staffing hours in a residential setting are insufficient to 
38.6 	meet the needs of an individual who enrolled in residential support services after January 
38.7 	1, 2014, then individual staffing hours shall be used.

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

38.9 	Sec. 31. Minnesota Statutes 2024, section 256B.4914, subdivision 6a, is amended to read:
38.10 		Subd. 6a.Community residential services; component values and calculation of 
38.11 	payment rates. (a) Component values for community residential services are:
38.12 	(1) competitive workforce factor: 6.7 percent;
38.13 	(2) supervisory span of control ratio: 11 percent;
38.14 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.15 	(4) employee-related cost ratio: 23.6 percent;
38.16 	(5) general administrative support ratio: 13.25 percent;
38.17 	(6) program-related expense ratio: 1.3 percent; and
38.18 	(7) absence and utilization factor ratio: 3.9 percent.
38.19 	(b) Payments for community residential services must be calculated as follows:
38.20 	(1) determine the number of shared direct staffing and individual direct staffing hours 
38.21 	to meet a recipient's needs provided on site or through monitoring technology;
38.22 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
38.23 	provided in subdivisions 5 and 5a;
38.24 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
38.25 	product of one plus the competitive workforce factor;
38.26 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
38.27 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
38.28 	to the result of clause (3);
39.1 	(5) multiply the number of shared direct staffing and individual direct staffing hours 
39.2 	provided on site or through monitoring technology and nursing hours by the appropriate 
39.3 	staff wages;
39.4 	(6) multiply the number of shared direct staffing and individual direct staffing hours 
39.5 	provided on site or through monitoring technology and nursing hours by the product of the 
39.6 	supervision span of control ratio and the appropriate supervisory staff wage in subdivision 
39.7 	5a, clause (1);
39.8 	(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and 
39.9 	individual direct staffing hours provided through monitoring technology, and multiply the 
39.10 	result by one plus the employee vacation, sick, and training allowance ratio. This is defined 
39.11 	as the direct staffing cost;
39.12 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
39.13 	direct staffing and individual hours provided through monitoring technology, by one plus 
39.14 	the employee-related cost ratio;
39.15 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
39.16 	commissioner shall update the amount in this clause as specified in subdivision 5b;
39.17 	(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided 
39.18 	by 365 if customized for adapted transport, based on the resident with the highest assessed 
39.19 	need. The commissioner shall update the amounts in this clause as specified in subdivision 
39.20 	5b;
39.21 	(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing 
39.22 	and individual direct staffing hours provided through monitoring technology that was 
39.23 	excluded in clause (8);
39.24 	(12) sum the standard general administrative support ratio, the program-related expense 
39.25 	ratio, and the absence and utilization factor ratio;
39.26 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
39.27 	total payment amount; and
39.28 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
39.29 	to adjust for regional differences in the cost of providing services.
39.30 	(c) Effective January 1, 2026, or upon federal approval, whichever is later, community 
39.31 	residential services under this section must be billed at a maximum of 351 days per year.

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

40.1 	Sec. 32. Minnesota Statutes 2024, section 256B.4914, subdivision 6a, is amended to read:
40.2 		Subd. 6a.Community residential services; component values and calculation of 
40.3 	payment rates. (a) Component values for community residential services are:
40.4 	(1) competitive workforce factor: 6.7 percent;
40.5 	(2) supervisory span of control ratio: 11 percent;
40.6 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
40.7 	(4) employee-related cost ratio: 23.6 percent;
40.8 	(5) general administrative support ratio: 13.25 percent;
40.9 	(6) program-related expense ratio: 1.3 percent; and
40.10 	(7) absence and utilization factor ratio: 3.9 percent.
40.11 	(b) Payments for community residential services must be calculated as follows:
40.12 	(1) determine the number of shared direct staffing and individual direct staffing hours 
40.13 	to meet a recipient's needs provided on site or through monitoring technology;
40.14 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
40.15 	provided in subdivisions 5 and 5a;
40.16 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
40.17 	product of one plus the competitive workforce factor;
40.18 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
40.19 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
40.20 	to the result of clause (3);
40.21 	(5) multiply the number of shared direct staffing and individual direct staffing hours 
40.22 	provided on site or through monitoring technology and nursing hours by the appropriate 
40.23 	staff wages;
40.24 	(6) multiply the number of shared direct staffing and individual direct staffing hours 
40.25 	provided on site or through monitoring technology and nursing hours by the product of the 
40.26 	supervision span of control ratio and the appropriate supervisory staff wage in subdivision 
40.27 	5a, clause (1);
40.28 	(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and 
40.29 	individual direct staffing hours provided through monitoring technology, and multiply the 
40.30 	result by one plus the employee vacation, sick, and training allowance ratio. This is defined 
40.31 	as the direct staffing cost;
41.1 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
41.2 	direct staffing and individual hours provided through monitoring technology, by one plus 
41.3 	the employee-related cost ratio;
41.4 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
41.5 	commissioner shall update the amount in this clause as specified in subdivision 5b;
41.6 	(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided 
41.7 	by 365 if customized for adapted transport, based on the resident with the highest assessed 
41.8 	need. The commissioner shall update the amounts in this clause as specified in subdivision 
41.9 	5b;
41.10 	(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing 
41.11 	and individual direct staffing hours provided through monitoring technology that was 
41.12 	excluded in clause (8);
41.13 	(12) sum the standard general administrative support ratio, the program-related expense 
41.14 	ratio, and the absence and utilization factor ratio;
41.15 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
41.16 	total payment amount; and
41.17 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
41.18 	to adjust for regional differences in the cost of providing services.

41.19 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
41.20 	whichever is later.

41.21 	Sec. 33. Minnesota Statutes 2024, section 256B.4914, subdivision 6b, is amended to read:
41.22 		Subd. 6b.Family residential services; component values and calculation of payment 
41.23 	rates. (a) Component values for family residential services are:
41.24 	(1) competitive workforce factor: 6.7 percent;
41.25 	(2) supervisory span of control ratio: 11 percent;
41.26 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
41.27 	(4) employee-related cost ratio: 23.6 percent;
41.28 	(5) general administrative support ratio: 3.3 percent;
41.29 	(6) program-related expense ratio: 1.3 percent; and
41.30 	(7) absence factor: 1.7 percent.
42.1 	(b) Payments for family residential services must be calculated as follows:
42.2 	(1) determine the number of shared direct staffing and individual direct staffing hours 
42.3 	to meet a recipient's needs provided on site or through monitoring technology;
42.4 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
42.5 	provided in subdivisions 5 and 5a;
42.6 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
42.7 	product of one plus the competitive workforce factor;
42.8 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
42.9 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
42.10 	to the result of clause (3);
42.11 	(5) multiply the number of shared direct staffing and individual direct staffing hours 
42.12 	provided on site or through monitoring technology and nursing hours by the appropriate 
42.13 	staff wages;
42.14 	(6) multiply the number of shared direct staffing and individual direct staffing hours 
42.15 	provided on site or through monitoring technology and nursing hours by the product of the 
42.16 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
42.17 	5a, clause (1);
42.18 	(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and 
42.19 	individual direct staffing hours provided through monitoring technology, and multiply the 
42.20 	result by one plus the employee vacation, sick, and training allowance ratio. This is defined 
42.21 	as the direct staffing cost;
42.22 	(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
42.23 	and individual direct staffing hours provided through monitoring technology, by one plus 
42.24 	the employee-related cost ratio;
42.25 	(9) for client programming and supports, add $2,260.21 divided by 365. The 
42.26 	commissioner shall update the amount in this clause as specified in subdivision 5b;
42.27 	(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided 
42.28 	by 365 if customized for adapted transport, based on the resident with the highest assessed 
42.29 	need. The commissioner shall update the amounts in this clause as specified in subdivision 
42.30 	5b;
43.1 	(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing 
43.2 	and individual direct staffing hours provided through monitoring technology that was 
43.3 	excluded in clause (8);
43.4 	(12) sum the standard general administrative support ratio, the program-related expense 
43.5 	ratio, and the absence and utilization factor ratio;
43.6 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
43.7 	total payment rate; and
43.8 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
43.9 	to adjust for regional differences in the cost of providing services.

43.10 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
43.11 	whichever is later.

43.12 	Sec. 34. Minnesota Statutes 2024, section 256B.4914, subdivision 6d, is amended to read:
43.13 		Subd. 6d.Payment for customized living. (a) The payment methodology for customized 
43.14 	living and 24-hour customized living must be the customized living tool. The commissioner 
43.15 	shall revise the customized living tool to reflect the services and activities unique to 
43.16 	disability-related recipient needs and adjust for regional differences in the cost of providing 
43.17 	services.
43.18 	(b) The rate adjustments described in section 256S.205 do not apply to rates paid under 
43.19 	this section.
43.20 	(c) Customized living and 24-hour customized living rates determined under this section 
43.21 	shall not include more than 24 hours of support in a daily unit.
43.22 	(d) The commissioner shall establish the following acuity-based customized living tool 
43.23 	input limits, based on case mix, for customized living and 24-hour customized living rates 
43.24 	determined under this section:
43.25 	(1) no more than two hours of mental health management per day for people assessed 
43.26 	for case mixes A, D, and G;
43.27 	(2) no more than four hours of activities of daily living assistance per day for people 
43.28 	assessed for case mix B; and
43.29 	(3) no more than six hours of activities of daily living assistance per day for people 
43.30 	assessed for case mix D.
44.1 	(e) Customized living monthly service rate limits must align with monthly service rate 
44.2 	limits determined under section 256S.202, subdivisions 1 and 2.

44.3 	Sec. 35. Minnesota Statutes 2024, section 256B.4914, subdivision 7a, is amended to read:
44.4 		Subd. 7a.Adult day services; component values and calculation of payment rates. (a) 
44.5 	Component values for adult day services are:
44.6 	(1) competitive workforce factor: 6.7 percent;
44.7 	(2) supervisory span of control ratio: 11 percent;
44.8 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
44.9 	(4) employee-related cost ratio: 23.6 percent;
44.10 	(5) program plan support ratio: 5.6 percent;
44.11 	(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision 
44.12 	5b;
44.13 	(7) general administrative support ratio: 13.25 percent;
44.14 	(8) program-related expense ratio: 1.8 percent; and
44.15 	(9) absence and utilization factor ratio: 9.43.9 percent.
44.16 	(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of 
44.17 	service is six or more hours of time spent providing direct service.
44.18 	(c) Payments for adult day services must be calculated as follows:
44.19 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
44.20 	needs;
44.21 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
44.22 	provided in subdivisions 5 and 5a;
44.23 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
44.24 	product of one plus the competitive workforce factor;
44.25 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
44.26 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
44.27 	to the result of clause (3);
44.28 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
44.29 	appropriate staff wage;
45.1 	(6) multiply the number of day program direct staffing hours by the product of the 
45.2 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
45.3 	5a, clause (1);
45.4 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
45.5 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
45.6 	rate;
45.7 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
45.8 	plan support ratio;
45.9 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
45.10 	employee-related cost ratio;
45.11 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
45.12 	the client programming and support ratio;
45.13 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
45.14 	to meet individual needs, updated as specified in subdivision 5b;
45.15 	(12) for adult day bath services, add $7.01 per 15 minute unit;
45.16 	(13) this is the subtotal rate;
45.17 	(14) sum the standard general administrative rate support ratio, the program-related 
45.18 	expense ratio, and the absence and utilization factor ratio;
45.19 	(15) divide the result of clause (13) by one minus the result of clause (14). This is the 
45.20 	total payment amount; and
45.21 	(16) adjust the result of clause (15) by a factor to be determined by the commissioner 
45.22 	to adjust for regional differences in the cost of providing services.

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

45.24 	Sec. 36. Minnesota Statutes 2024, section 256B.4914, subdivision 7b, is amended to read:
45.25 		Subd. 7b.Day support services; component values and calculation of payment 
45.26 	rates. (a) Component values for day support services are:
45.27 	(1) competitive workforce factor: 6.7 percent;
45.28 	(2) supervisory span of control ratio: 11 percent;
45.29 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
45.30 	(4) employee-related cost ratio: 23.6 percent;
46.1 	(5) program plan support ratio: 5.6 percent;
46.2 	(6) client programming and support ratio: 10.37 percent, updated as specified in 
46.3 	subdivision 5b;
46.4 	(7) general administrative support ratio: 13.25 percent;
46.5 	(8) program-related expense ratio: 1.8 percent; and
46.6 	(9) absence and utilization factor ratio: 9.43.9 percent.
46.7 	(b) A unit of service for day support services is 15 minutes.
46.8 	(c) Payments for day support services must be calculated as follows:
46.9 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
46.10 	needs;
46.11 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
46.12 	provided in subdivisions 5 and 5a;
46.13 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
46.14 	product of one plus the competitive workforce factor;
46.15 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
46.16 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
46.17 	to the result of clause (3);
46.18 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
46.19 	appropriate staff wage;
46.20 	(6) multiply the number of day program direct staffing hours by the product of the 
46.21 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
46.22 	5a, clause (1);
46.23 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
46.24 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
46.25 	rate;
46.26 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
46.27 	plan support ratio;
46.28 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
46.29 	employee-related cost ratio;
46.30 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
46.31 	the client programming and support ratio;
47.1 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
47.2 	to meet individual needs, updated as specified in subdivision 5b;
47.3 	(12) this is the subtotal rate;
47.4 	(13) sum the standard general administrative rate support ratio, the program-related 
47.5 	expense ratio, and the absence and utilization factor ratio;
47.6 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
47.7 	total payment amount; and
47.8 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
47.9 	to adjust for regional differences in the cost of providing services.

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

47.11 	Sec. 37. Minnesota Statutes 2024, section 256B.4914, subdivision 7c, is amended to read:
47.12 		Subd. 7c.Prevocational services; component values and calculation of payment 
47.13 	rates. (a) Component values for prevocational services are:
47.14 	(1) competitive workforce factor: 6.7 percent;
47.15 	(2) supervisory span of control ratio: 11 percent;
47.16 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
47.17 	(4) employee-related cost ratio: 23.6 percent;
47.18 	(5) program plan support ratio: 5.6 percent;
47.19 	(6) client programming and support ratio: 10.37 percent, updated as specified in 
47.20 	subdivision 5b;
47.21 	(7) general administrative support ratio: 13.25 percent;
47.22 	(8) program-related expense ratio: 1.8 percent; and
47.23 	(9) absence and utilization factor ratio: 9.43.9 percent.
47.24 	(b) A unit of service for prevocational services is either a day or 15 minutes. A day unit 
47.25 	of service is six or more hours of time spent providing direct service.
47.26 	(c) Payments for prevocational services must be calculated as follows:
47.27 	(1) determine the number of units of service and the staffing ratio to meet a recipient's 
47.28 	needs;
48.1 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
48.2 	provided in subdivisions 5 and 5a;
48.3 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
48.4 	product of one plus the competitive workforce factor;
48.5 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
48.6 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
48.7 	to the result of clause (3);
48.8 	(5) multiply the number of day program direct staffing hours and nursing hours by the 
48.9 	appropriate staff wage;
48.10 	(6) multiply the number of day program direct staffing hours by the product of the 
48.11 	supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 
48.12 	5a, clause (1);
48.13 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
48.14 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
48.15 	rate;
48.16 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
48.17 	plan support ratio;
48.18 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
48.19 	employee-related cost ratio;
48.20 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
48.21 	the client programming and support ratio;
48.22 	(11) for program facility costs, add $19.30 per week with consideration of staffing ratios 
48.23 	to meet individual needs, updated as specified in subdivision 5b;
48.24 	(12) this is the subtotal rate;
48.25 	(13) sum the standard general administrative rate support ratio, the program-related 
48.26 	expense ratio, and the absence and utilization factor ratio;
48.27 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
48.28 	total payment amount; and
48.29 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
48.30 	to adjust for regional differences in the cost of providing services.

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

49.1 	Sec. 38. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision 
49.2 	to read:
49.3 		Subd. 8a.Integrated community supports unit-based services with programming; 
49.4 	component values and calculation of payment rates. (a) Component values for integrated 
49.5 	community supports unit-based services with programming are:
49.6 	(1) competitive workforce factor: 6.7 percent;
49.7 	(2) supervisory span of control ratio: 11 percent;
49.8 	(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
49.9 	(4) employee-related cost ratio: 23.6 percent;
49.10 	(5) program plan support ratio: 27 percent;
49.11 	(6) client programming and support ratio: 9.2 percent;
49.12 	(7) general administrative support ratio: 13.25 percent;
49.13 	(8) program-related expense ratio: 6.1 percent; and
49.14 	(9) absence and utilization factor ratio: 3.9 percent.
49.15 	(b) A unit of integrated community supports unit-based services with programming is 
49.16 	15 minutes.
49.17 	(c) Payments for integrated community supports must be calculated as follows:
49.18 	(1) determine the number of units of service to meet a recipient's needs;
49.19 	(2) determine the appropriate hourly staff wage rates derived by the commissioner as 
49.20 	provided in subdivisions 5 and 5a;
49.21 	(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the 
49.22 	product of one plus the competitive workforce factor;
49.23 	(4) for a recipient requiring customization for deaf and hard-of-hearing language 
49.24 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
49.25 	to the result of clause (3);
49.26 	(5) multiply the number of direct staffing hours by the appropriate staff wage;
49.27 	(6) multiply the number of direct staffing hours by the product of the supervisory span 
49.28 	of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
50.1 	(7) combine the results of clauses (5) and (6), and multiply the result by one plus the 
50.2 	employee vacation, sick, and training allowance ratio. This is defined as the direct staffing 
50.3 	rate;
50.4 	(8) for program plan support, multiply the result of clause (7) by one plus the program 
50.5 	plan support ratio divided by the approved capacity for the integrated community supports 
50.6 	setting;
50.7 	(9) for employee-related expenses, multiply the result of clause (8) by one plus the 
50.8 	employee-related cost ratio;
50.9 	(10) for client programming and supports, multiply the result of clause (9) by one plus 
50.10 	the client programming and support ratio;
50.11 	(11) this is the subtotal rate;
50.12 	(12) sum the standard general administrative support ratio, the program-related expense 
50.13 	ratio, and the absence and utilization factor ratio; and
50.14 	(13) divide the result of clause (11) by one minus the result of clause (12). This is the 
50.15 	total payment amount.
50.16 	(d) The commissioner must establish maximum allowable in-person and remote service 
50.17 	hours used in the rate methodology for integrated community supports based on the recipient's 
50.18 	case-mix classification. The total number of service hours entered into the rate framework 
50.19 	must not exceed the following limits:
50.20 	(1) for case mix classifications A, C, and L, a maximum of two hours per day;
50.21 	(2) for case mix classifications B, D, and F, a maximum of four hours per day;
50.22 	(3) for case mix classifications E, G, I, J, and K, a maximum of six hours per day; and
50.23 	(4) for case mix classification H, a maximum of eight hours per day.
50.24 	(e) The daily limit in paragraph (d) does not limit a person's use of other disability waiver 
50.25 	services, which may be provided on the same day by the same provider providing integrated 
50.26 	community supports. Nothing in paragraph (d) prohibits approval of a rate exception for 
50.27 	individuals with exceptional or complex needs.

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

51.1 	Sec. 39. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision 
51.2 	to read:
51.3 		Subd. 10e.Documentation of staffing; auditing and rate review. (a) Effective for 
51.4 	services provided on or after January 1, 2029, a provider enrolled to provide residential 
51.5 	services under subdivision 6 must maintain documentation of direct staffing hours provided 
51.6 	to each person receiving services, including but not limited to documentation identifying:
51.7 	(1) the name, role, and unique identifier for each staff person who provided services to 
51.8 	match records to payroll, time and attendance systems, and any other source documentation;
51.9 	(2) the date services were provided;
51.10 	(3) the total number of hours of direct support provided;
51.11 	(4) awake overnight staffing hours provided, if applicable;
51.12 	(5) asleep overnight staffing hours provided, if applicable; and
51.13 	(6) any other staffing information required by the commissioner.
51.14 	(b) A provider must maintain documentation in a manner and format determined by the 
51.15 	commissioner for at least six years. If a provider changes payroll vendors, merges operations, 
51.16 	or changes staffing identifiers, the provider must maintain a documented link between prior 
51.17 	and current staffing identifiers sufficient to allow tracking of hours worked, turnover, and 
51.18 	role classification for each staff person.
51.19 	(c) A provider must submit the documentation required under paragraph (a) to the 
51.20 	commissioner annually, in a manner and format determined by the commissioner. The 
51.21 	commissioner must establish multiple submission windows throughout the calendar year 
51.22 	and may assign providers to a submission window for administrative efficiency and system 
51.23 	capacity. Documentation must reflect staffing provided during the prior calendar year and 
51.24 	must be submitted no later than the final business day of the provider's assigned submission 
51.25 	window. The commissioner may conduct random or targeted validations and audits of 
51.26 	submitted data and may require supplemental documentation as necessary to verify accuracy 
51.27 	and compliance.
51.28 	(d) The commissioner must conduct periodic analysis of documentation submitted under 
51.29 	this subdivision and may validate staffing data through random audits or other verification 
51.30 	methods.
51.31 	(e) Based on the analysis under paragraph (d), the commissioner may provide 
51.32 	recommendations to lead agencies regarding modifications to the rate of a person receiving 
52.1 	services, including increases or decreases necessary to align the rate with staffing provided 
52.2 	to the person as demonstrated by the submitted historical staffing documentation. 
52.3 	Recommendations must be based on the requirements of this section and applicable federal 
52.4 	and state requirements governing rate setting.
52.5 	(f) If a provider fails to submit documentation requested within the submission window 
52.6 	in paragraph (c), the commissioner must issue a written notice of noncompliance. If 
52.7 	documentation is not received within 60 days following the notice of noncompliance, the 
52.8 	commissioner may temporarily suspend payments to the provider until the required 
52.9 	documentation is submitted. The commissioner must make withheld payments to the provider 
52.10 	once the required documentation is received. If such noncompliance persists, the 
52.11 	commissioner may adjust future rate payments, require the provider to submit a corrective 
52.12 	action plan, or pursue other enforcement actions as authorized by law.
52.13 	(g) The commissioner must publish annual aggregate reports summarizing audit findings 
52.14 	and trends related to staffing provided under this section.

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

52.16 	Sec. 40. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision 
52.17 	to read:
52.18 		Subd. 21.Administrative fees charged by providers and vendors. Effective July 1, 
52.19 	2027, or upon federal approval, whichever is later, the commissioner must limit 
52.20 	administrative fees charged by enrolled providers and vendors approved by lead agencies 
52.21 	to no more than six percent of the total cost of the service or purchased goods. This limit 
52.22 	applies to the following services and other new market rate services as determined by the 
52.23 	commissioner:
52.24 	(1) 24-hour emergency assistance;
52.25 	(2) assistive technology;
52.26 	(3) caregiver living expenses;
52.27 	(4) chore services;
52.28 	(5) crisis respite;
52.29 	(6) environmental accessibility adaptations;
52.30 	(7) family training and counseling;
52.31 	(8) respite, billed daily or in 15-minute units;
53.1 	(9) specialist services;
53.2 	(10) transitional services; and
53.3 	(11) transportation.

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

53.5 	Sec. 41. Minnesota Statutes 2024, section 256B.492, is amended by adding a subdivision 
53.6 	to read:
53.7 		Subd. 4.Integrated community supports setting approval moratorium and 
53.8 	exception. (a) The commissioner must not approve a new integrated community supports 
53.9 	setting or approve an expansion of an existing integrated community supports setting except 
53.10 	as provided in this subdivision.
53.11 	(b) The commissioner may approve an exception to the moratorium only when the 
53.12 	applicant demonstrates indirect control of the setting and compliance with:
53.13 	(1) the federal home and community-based services requirements under Code of Federal 
53.14 	Regulations, title 42, section 441.301(c);
53.15 	(2) the prohibition on the use of medical assistance money for room and board under 
53.16 	section 256B.4912, subdivision 17;
53.17 	(3) independent lease requirements consistent with chapter 504B; and
53.18 	(4) all documentation requirements under section 245D.12.
53.19 	(c) To approve an exception, the commissioner must determine that the lead agency has 
53.20 	requested the additional capacity to meet the specific disability-related needs of the person. 
53.21 	Priority must be given to geographic regions with insufficient integrated community supports 
53.22 	capacity based on statewide or regional needs determination processes.
53.23 	(d) For purposes of this subdivision, "integrated community supports setting" means a 
53.24 	multifamily housing building where a provider delivers integrated community supports 
53.25 	under section 245D.03, subdivision 1, paragraph (c), clause (8), and for which a provider 
53.26 	has a provider-controlled or provider-associated financial interest as defined under section 
53.27 	245A.02, subdivision 10b.
53.28 	(e) A determination under this subdivision is final and not subject to appeal.

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

54.1 	Sec. 42. Minnesota Statutes 2024, section 256R.10, subdivision 8, is amended to read:
54.2 		Subd. 8.Employer health insurance costs. (a) Employer health insurance costs are 
54.3 	allowable for (1) all nursing facility employees and (2) the spouse and dependents of those 
54.4 	nursing facility employees who are employed on average at least 30 hours per week.
54.5 	(b) The commissioner must not treat employer contributions to employer-sponsored 
54.6 	individual coverage health reimbursement arrangements as allowable costs if the facility 
54.7 	does not provide the commissioner copies of the employer-sponsored individual coverage 
54.8 	health reimbursement arrangement plan documents and documentation of any health 
54.9 	insurance premiums and associated co-payments reimbursed under the arrangement. 
54.10 	Documentation of reimbursements must denote any reimbursements for health insurance 
54.11 	premiums or associated co-payments incurred by the spouses or dependents of nursing 
54.12 	facility employees who work on average less than 30 hours per week.
54.13 	(c) Effective for the rate year beginning January 1, 2027, the annual reimbursement cap 
54.14 	for health insurance costs is $15,000 as adjusted according to paragraph (d). The allowable 
54.15 	costs for health insurance must not exceed the reimbursement cap multiplied by the annual 
54.16 	average month-end number of allowed enrolled nursing facility employees from the 
54.17 	applicable cost report period. For shared employees, the allowable number of enrolled 
54.18 	employees includes only the nursing facility percentage of any shared allowed enrolled 
54.19 	employees. The allowable number of enrolled employees must not include nonnursing 
54.20 	facility employees or individuals who elect COBRA continuation coverage.
54.21 	(d) Effective for rate years beginning on or after January 1, 2028, the commissioner 
54.22 	shall adjust the annual reimbursement cap for employer health insurance costs by the previous 
54.23 	year's cap plus an adjustment for CPI-U inflation as defined in section 256R.02, subdivision 
54.24 	14a.

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

54.26 	Sec. 43. Minnesota Statutes 2024, section 256R.23, subdivision 5, is amended to read:
54.27 		Subd. 5.Determination of total care-related payment rate limits. (a) Effective until 
54.28 	December 31, 2027, the commissioner must determine each facility's total care-related 
54.29 	payment rate limit by:
54.30 	(1) multiplying the facility's quality score, as determined under section 256R.16, 
54.31 	subdivision 1, by 0.5625;
54.32 	(2) adding 89.375 to the amount determined in clause (1), and dividing the total by 100; 
54.33 	and
55.1 	(3) multiplying the amount determined in clause (2) by the median total care-related 
55.2 	cost per day.
55.3 	(b) Effective January 1, 2028, the commissioner must determine each facility's total 
55.4 	care-related payment rate limit by:
55.5 	(1) multiplying the facility's quality score, as determined under section 256R.16, 
55.6 	subdivision 1, by two;
55.7 	(2) subtracting 40 from the amount determined in clause (1), and dividing the total by 
55.8 	100; and
55.9 	(3) multiplying the amount determined in clause (2) by the median total care-related 
55.10 	cost per day.

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

55.12 	Sec. 44. Minnesota Statutes 2025 Supplement, section 256R.23, subdivision 7, is amended 
55.13 	to read:
55.14 		Subd. 7.Determination of direct care payment rates. (a) A facility's direct care 
55.15 	payment rate equals the lesser of (1) the facility's direct care costs per standardized day, (2) 
55.16 	the facility's direct care costs per standardized day divided by its cost to limit ratio, (3) the 
55.17 	previous year's direct care payment rate times one plus CPI-U inflation, or (4) 104 percent 
55.18 	of the previous year's direct care payment rate. This paragraph expires upon the effective 
55.19 	date of paragraph (b).
55.20 	(b) Effective January 1, 2027, or upon federal approval, whichever is later, a facility's 
55.21 	direct care payment rate equals the lesser of (1) the facility's direct care costs per standardized 
55.22 	day, (2) the facility's direct care costs per standardized day divided by its cost to limit ratio, 
55.23 	(3) the previous year's direct care payment rate times one plus CPI-U inflation, or (4) 102 
55.24 	percent of the previous year's direct care payment rate.

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

55.26 	Sec. 45. Minnesota Statutes 2025 Supplement, section 256R.23, subdivision 8, is amended 
55.27 	to read:
55.28 		Subd. 8.Determination of other care-related payment rates. (a) A facility's other 
55.29 	care-related payment rate equals the lesser of (1) the facility's other care-related cost per 
55.30 	resident day, (2) the facility's other care-related cost per resident day divided by its cost to 
55.31 	limit ratio, (3) the previous year's other care-related rate times one plus CPI-U inflation, or 
56.1 	(4) 104 percent of the previous year's other care-related payment rate. This paragraph expires 
56.2 	upon the effective date of paragraph (b).
56.3 	(b) Effective January 1, 2027, or upon federal approval, whichever is later, a facility's 
56.4 	other care-related payment rate equals the lesser of (1) the facility's other care-related cost 
56.5 	per resident day, (2) the facility's other care-related cost per resident day divided by its cost 
56.6 	to limit ratio, (3) the previous year's other care-related rate times one plus CPI-U inflation, 
56.7 	or (4) 102 percent of the previous year's other care-related payment rate.

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

56.9 	Sec. 46. Minnesota Statutes 2025 Supplement, section 256R.24, subdivision 3, is amended 
56.10 	to read:
56.11 		Subd. 3.Determination of the other operating payment rate. (a) Effective until 
56.12 	December 31, 2027, a facility's other operating payment rate equals the lesser of (1) 105 
56.13 	percent of the median other operating cost per day, (2) the previous year's other operating 
56.14 	payment rate times one plus CPI-U inflation, or (3) 104 percent of the previous year's other 
56.15 	operating payment rate.
56.16 	(b) Effective January 1, 2028, a facility's other operating payment rate equals the lesser 
56.17 	of (1) 100 percent of the median other operating cost per day, (2) the previous year's other 
56.18 	operating payment rate times one plus CPI-U inflation, or (3) 104 percent of the previous 
56.19 	year's other operating payment rate.

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

56.21 	Sec. 47. Minnesota Statutes 2025 Supplement, section 256R.24, subdivision 3, is amended 
56.22 	to read:
56.23 		Subd. 3.Determination of the other operating payment rate. (a) A facility's other 
56.24 	operating payment rate equals the lesser of (1) 105 percent of the median other operating 
56.25 	cost per day, (2) the previous year's other operating payment rate times one plus CPI-U 
56.26 	inflation, or (3) 104 percent of the previous year's other operating payment rate. This 
56.27 	paragraph expires upon the effective date of paragraph (b).
56.28 	(b) Effective January 1, 2027, or upon federal approval, whichever is later, a facility's 
56.29 	other operating payment rate equals the lesser of (1) 105 percent of the median other 
56.30 	operating cost per day, (2) the previous year's other operating payment rate times one plus 
56.31 	CPI-U inflation, or (3) 102 percent of the previous year's other operating payment rate.

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

57.1 	Sec. 48. Minnesota Statutes 2025 Supplement, section 256R.38, is amended to read:
57.2 	256R.38 PERFORMANCE-BASED INCENTIVE PAYMENTS.
57.3 	The commissioner shall develop additional incentive-based payments of up to five 
57.4 	percent above a facility's operating payment rate for achieving outcomes specified in a 
57.5 	contract. The commissioner may solicit proposals and select those which, on a competitive 
57.6 	basis, best meet the state's policy objectives. The commissioner shall limit the amount of 
57.7 	any incentive payment and the number of contract amendments under this section to operate 
57.8 	the incentive payments within funds appropriated for this purpose. The commissioner shall 
57.9 	approve proposals through a memorandum of understanding which shall specify various 
57.10 	levels of payment for various levels of performance. Incentive payments to facilities under 
57.11 	this section shall be in the form ofare time-limited rate adjustments which shall be included 
57.12 	in the external fixed costs payment rate under section 256R.25.In establishing the specified 
57.13 	outcomes and related criteria, the commissioner shall consider the following state policy 
57.14 	objectives: that must only be paid if approved by the commissioner before the effective date 
57.15 	of this section. This section expires January 1, 2028.
57.16 	(1) successful diversion or discharge of residents to the residents' prior home or other 
57.17 	community-based alternatives;
57.18 	(2) adoption of new technology to improve quality or efficiency;
57.19 	(3) improved quality as measured in the Minnesota Nursing Home Report Card;
57.20 	(4) reduced acute care costs; and
57.21 	(5) any additional outcomes proposed by a nursing facility that the commissioner finds 
57.22 	desirable.

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

57.24 	Sec. 49. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 2, is amended 
57.25 	to read:
57.26 		Subd. 2.Rate adjustment application. (a) Effective through September 30, 2023, a 
57.27 	facility may apply to the commissioner for an initial designation as a disproportionate share 
57.28 	facility. Applications must be submitted annually between September 1 and September 30. 
57.29 	The applying facility must apply in a manner determined by the commissioner. The applying 
57.30 	facility must document each of the following on the application:
57.31 	(1) the number of customized living residents in the facility on September 1 of the 
57.32 	application year, broken out by specific waiver program; and
58.1 	(2) the total number of people residing in the facility on September 1 of the application 
58.2 	year.
58.3 	(b) Effective October 1, 2023, the commissioner must not process any new initial 
58.4 	applications for disproportionate share facilities.
58.5 	(c) A facility that received rate floor payments in rate year 2024 may submit an annual 
58.6 	application under this subdivision to maintain its designation as a disproportionate share 
58.7 	facility.
58.8 	(d) The commissioner must not process applications for disproportionate share facilities 
58.9 	after the September 1 through September 30, 2025, application period.

58.10 	Sec. 50. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 3, is amended 
58.11 	to read:
58.12 		Subd. 3.Rate adjustment eligibility criteria. (a) Only facilities satisfying all of the 
58.13 	following conditions on September 1 of the application year are eligible for designation as 
58.14 	a disproportionate share facility:
58.15 	(1) at least 83.5 percent of the residents of the facility are customized living residents; 
58.16 	and
58.17 	(2) at least 70 percent of the customized living residents are elderly waiver participants.
58.18 	(b) A facility determined eligible for the disproportionate share rate adjustment in 
58.19 	application year 2023 and receiving payments in rate year 2024 is eligible to receive payments 
58.20 	in rate years beginning on or after January 1, 2025, only if the commissioner determines 
58.21 	that the facility continues to meet the eligibility requirements under this subdivision as 
58.22 	determined by the application process under subdivision 2, paragraph (c).
58.23 	A facility is eligible to apply for the program in calendar year 2025 to receive payments 
58.24 	in 2026 if the facility was determined eligible for the disproportionate share rate adjustment 
58.25 	in 2023 and received payments in calendar year 2024.

58.26 	Sec. 51. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 5, is amended 
58.27 	to read:
58.28 		Subd. 5.Rate adjustment; rate floor. (a) Notwithstanding the 24-hour customized 
58.29 	living monthly service rate limits under section 256S.202, subdivision 2, and the component 
58.30 	service rates established under section 256S.201, subdivision 4, the commissioner must 
58.31 	establish a rate floor equal to $141 per resident per day for 24-hour customized living 
59.1 	services provided to an elderly waiver participant in a designated disproportionate share 
59.2 	facility.
59.3 	(b) The commissioner must apply the rate floor to the services described in paragraph 
59.4 	(a) provided during the rate year.
59.5 	The commissioner must not implement any adjustments to the disproportionate share 
59.6 	rate floor amount after January 1, 2027.

59.7 	Sec. 52. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 7, is amended 
59.8 	to read:
59.9 		Subd. 7.Expiration. This section expires May 31, 2028 January 1, 2027.

59.10 	Sec. 53. Minnesota Statutes 2024, section 256S.21, is amended by adding a subdivision 
59.11 	to read:
59.12 		Subd. 4.Documentation of staffing; auditing and rate review for residential support 
59.13 	services. (a) For purposes of this subdivision, residential support services include 24-hour 
59.14 	customized living services, customized living services, family adult foster care, and corporate 
59.15 	adult foster care.
59.16 	(b) Effective January 1, 2029, a provider enrolled to provide residential services under 
59.17 	this subdivision must maintain documentation of direct staffing hours provided to each 
59.18 	person receiving services, including but not limited to documentation identifying:
59.19 	(1) the name, role, and unique identifier for each staff person who provided services to 
59.20 	match records to payroll, time and attendance systems, and any other source documentation;
59.21 	(2) the date services were provided;
59.22 	(3) the total number of hours of direct support provided;
59.23 	(4) awake overnight staffing hours provided, if applicable;
59.24 	(5) asleep overnight staffing hours provided, if applicable; and
59.25 	(6) any other staffing information required by the commissioner.
59.26 	(c) A provider must maintain documentation in a manner and format determined by the 
59.27 	commissioner for at least six years. If a provider changes payroll vendors, merges operations, 
59.28 	or changes staffing identifiers, the provider must maintain a documented link between prior 
59.29 	and current staffing identifiers sufficient to allow tracking of hours worked, turnover, and 
59.30 	role classification for each staff person.
60.1 	(d) A provider must submit the documentation required under paragraph (b) to the 
60.2 	commissioner annually, in a manner and format determined by the commissioner. The 
60.3 	commissioner must establish multiple submission windows throughout the calendar year 
60.4 	and may assign providers to a submission window for administrative efficiency and system 
60.5 	capacity. Documentation must reflect staffing provided during the prior calendar year and 
60.6 	must be submitted no later than the final business day of the provider's assigned submission 
60.7 	window. The commissioner may conduct random or targeted validations and audits of 
60.8 	submitted data and may require supplemental documentation as necessary to verify accuracy 
60.9 	and compliance.
60.10 	(e) The commissioner must conduct periodic analysis of documentation submitted under 
60.11 	this subdivision and may validate staffing data through random audits or other verification 
60.12 	methods.
60.13 	(f) Based on the analysis under paragraph (e), the commissioner may provide 
60.14 	recommendations to lead agencies regarding modifications to the rate of the person receiving 
60.15 	services, including increases or decreases necessary to align the rate with staffing provided 
60.16 	to the person as demonstrated by the submitted historical staffing documentation. 
60.17 	Recommendations must be based on the requirements of this section and applicable federal 
60.18 	and state requirements governing rate setting.
60.19 	(g) If a provider fails to submit documentation requested within the submission window 
60.20 	under paragraph (c), the commissioner must issue a written notice of noncompliance. If 
60.21 	documentation is not received within 60 days following the notice of noncompliance, the 
60.22 	commissioner may temporarily suspend payments to the provider until the required 
60.23 	documentation is submitted. The commissioner must make withheld payments to the provider 
60.24 	once the required documentation is received. If such noncompliance persists, the 
60.25 	commissioner may adjust future rate payments, require the provider to submit a corrective 
60.26 	action plan, or pursue other enforcement actions as authorized by law.
60.27 	(h) The commissioner must publish annual aggregate reports summarizing audit findings 
60.28 	and trends related to staffing provided under this section.

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

60.30 	Sec. 54. Minnesota Statutes 2024, section 256S.21, is amended by adding a subdivision 
60.31 	to read:
60.32 		Subd. 5.Administrative fees charged by providers or vendors. The commissioner 
60.33 	must limit administrative fees charged by enrolled providers or vendors approved by lead 
61.1 	agencies to no more than six percent of the total cost of the service or purchased goods. 
61.2 	This limit applies to the following services but allows for the addition of other services 
61.3 	determined by the commissioner:
61.4 	(1) chore services;
61.5 	(2) environmental accessibility adaptations;
61.6 	(3) transitional services;
61.7 	(4) transportation; and
61.8 	(5) specialized equipment and supplies.

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

61.10 	Sec. 55. MARKET RATE STUDY FOR HOME AND COMMUNITY-BASED 
61.11 	SERVICES.
 61.12 	(a) The commissioner of human services must conduct a market rate study to evaluate 
61.13 	the adequacy, sustainability, and equity of payment rates for specific home and 
61.14 	community-based services under the home and community-based services waivers authorized 
61.15 	under Minnesota Statutes, sections 256B.092 and 256B.49.
61.16 	(b) The study must include, at minimum, an analysis of the following services:
61.17 	(1) employment support services delivered in remote or virtual settings;
61.18 	(2) 24-hour emergency assistance;
61.19 	(3) assistive technology;
61.20 	(4) environmental accessibility adaptations;
61.21 	(5) chore services;
61.22 	(6) transitional services;
61.23 	(7) independent living skills training; and
61.24 	(8) specialist services, including positive support services and orientation and mobility 
61.25 	services.
61.26 	(c) In planning and conducting the market rate study, the commissioner must consult 
61.27 	with interested parties, including but not limited to service providers, people with disabilities, 
61.28 	lead agencies, Tribal Nations, culturally specific and community-based providers, and 
61.29 	disability advocacy organizations. The consultation process must be designed to ensure 
62.1 	meaningful participation from providers in greater Minnesota and from providers serving 
62.2 	communities of color and Tribal Nations.
62.3 	(d) In conducting the study, the commissioner must analyze provider costs, workforce 
62.4 	availability, wage competitiveness, regional market conditions, inflationary impacts, and 
62.5 	access issues. The commissioner must also evaluate whether current reimbursement 
62.6 	methodologies reflect actual costs of providing services and support long-term access to 
62.7 	qualified providers.
62.8 	(e) By February 15, 2027, the commissioner must submit a report with findings and 
62.9 	recommendations, including but not limited to any proposed statutory changes, to the chairs 
62.10 	and ranking minority members of the legislative committees with jurisdiction over health 
62.11 	and human services policy and finance.

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

62.13 	Sec. 56. WAIVER AMENDMENTS; REMOTE SUPPORTS.
 62.14 	(a) The commissioner of human services must seek federal approval from the Centers 
62.15 	for Medicare and Medicaid Services to amend the state's home and community-based 
62.16 	services waiver plans under United States Code, title 42, section 1396n(c), to remove 
62.17 	authorization for the use of remote supports as a method of service delivery or supervision 
62.18 	for the following services:
62.19 	(1) adult day services;
62.20 	(2) community residential services;
62.21 	(3) day support services;
62.22 	(4) family residential services; and
62.23 	(5) integrated community supports.
62.24 	(b) Until federal approval is obtained, the commissioner must continue to allow the use 
62.25 	of remote support only to the extent permitted under the terms of the state's federally 
62.26 	approved waiver plans in effect on the effective date of this section.

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

62.28 	Sec. 57. REPEALER.
 62.29 		Subdivision 1.Repealer. Minnesota Statutes 2024, section 256S.205, subdivision 4, is 
62.30 	repealed.
63.1 		Subd. 2.Repealer. (a) Minnesota Statutes 2024, sections 256.975, subdivision 7d; 
63.2 	256B.073, subdivision 4; 256B.0921; and 256R.40, subdivisions 1, 2, 3, 4, 6, and 7, are 
63.3 	repealed.
63.4 	(b) Minnesota Statutes 2025 Supplement, sections 256R.25, subdivision 6; and 256R.40, 
63.5 	subdivision 5, are repealed.
63.6 	(c) Laws 2025, First Special Session chapter 9, article 2, section 68, is repealed.
63.7 		Subd. 3.Repealer.  Minnesota Statutes 2024, sections 256B.0911, subdivision 21; and 
63.8 	256B.4914, subdivision 6c, are repealed.
63.9 		Subd. 4.Repealer. Minnesota Statutes 2024, sections 245A.70; 245A.71; 245A.72; 
63.10 	245A.73; 245A.74; 245A.75; and 245D.261, are repealed.
63.11 		Subd. 5.Repealer. Minnesota Statutes 2024, section 256R.42, is repealed.

63.12 	EFFECTIVE DATE. Subdivision 1 is effective the day following final enactment. 
63.13 	Subdivision 2 is effective July 1, 2026. Subdivision 3 is effective January 1, 2027. 
63.14 	Subdivision 4 is effective January 1, 2027, or upon federal approval, whichever is later. 
63.15 	Subdivision 5 is effective July 1, 2028.

63.16 	ARTICLE 2
63.17 	BEHAVIORAL HEALTH

63.18 	Section 1. Minnesota Statutes 2024, section 245.4661, is amended by adding a subdivision 
63.19 	to read:
63.20 		Subd. 1a.Direct payment. For purposes of this section, "direct payment" means a 
63.21 	funding mechanism used by the commissioner to distribute state appropriations to a county, 
63.22 	Tribe, or other eligible governmental entity for the purpose of carrying out duties, services, 
63.23 	or activities authorized under this section. A direct payment is not a grant under section 
63.24 	16B.97 and is not subject to statewide grant-making policies and laws, including but not 
63.25 	limited to sections 16A.15 and 16C.05, except as specifically required by the commissioner. 
63.26 	A direct payment must be used for the purposes and allowable activities established by the 
63.27 	commissioner and is subject to financial oversight, reporting, and monitoring requirements 
63.28 	under subdivision 11.

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

64.1 	Sec. 2. Minnesota Statutes 2024, section 245.4661, is amended by adding a subdivision 
64.2 	to read:
64.3 		Subd. 3a.Authority and rulemaking. The commissioner may distribute money under 
64.4 	this section through direct payments when the commissioner determines that a direct payment 
64.5 	is the most effective and efficient method to support the delivery of adult mental health 
64.6 	services, Tribal government activities, or county responsibilities under this section. The 
64.7 	commissioner shall establish eligibility criteria, allowable uses, documentation standards, 
64.8 	and reporting requirements for recipients of direct payments. The commissioner is authorized 
64.9 	to engage in rulemaking to fulfill the requirements of this subdivision.

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

64.11 	Sec. 3. Minnesota Statutes 2025 Supplement, section 245.4661, subdivision 9, is amended 
64.12 	to read:
64.13 		Subd. 9.Programs and eligible services and programs. (a) The following three distinct 
64.14 	grant programs are funded may receive direct payments under this section:
64.15 	(1) mental health crisis services;
64.16 	(2) housing with supports for adults with serious mental illness; and
64.17 	(3) projects for assistance in transitioning from homelessness (PATH program).
64.18 	(b) In addition, The following services are eligible for grant funds funding as direct 
64.19 	payments under this section as the payor of last resort:
64.20 	(1) community education and prevention;
64.21 	(2) client outreach;
64.22 	(3) early identification and intervention;
64.23 	(4) adult outpatient diagnostic assessment and psychological testing;
64.24 	(5) peer support services;
64.25 	(6) community support program services (CSP);
64.26 	(7) adult residential crisis stabilization;
64.27 	(8) supported employment;
64.28 	(9) assertive community treatment (ACT);
64.29 	(10) housing subsidies;
65.1 	(11) basic living, social skills, and community intervention;
65.2 	(12) emergency response services;
65.3 	(13) adult outpatient psychotherapy;
65.4 	(14) adult outpatient medication management;
65.5 	(15) adult mobile crisis services, including the purchase and renovation of vehicles by 
65.6 	mobile crisis teams in order to provide protected transport under section 256B.0625, 
65.7 	subdivision 17, paragraph (l), clause (6);
65.8 	(16) adult day treatment;
65.9 	(17) partial hospitalization;
65.10 	(18) adult residential treatment;
65.11 	(19) adult mental health targeted case management; and
65.12 	(20) transportation.

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

65.14 	Sec. 4. Minnesota Statutes 2024, section 245.4661, subdivision 10, is amended to read:
65.15 		Subd. 10.Commissioner duty to report on use of grant funds biennially. (a) By 
65.16 	November 1, 2016, and biennially thereafter, the commissioner of human services shall 
65.17 	provide sufficient information to the members of the legislative committees having 
65.18 	jurisdiction over mental health funding and policy issues to evaluate the use of funds 
65.19 	appropriated under this section. The commissioner shall provide, at a minimum, the following 
65.20 	information:
65.21 	(1) the amount of funding to adult mental health initiatives, what programs and services 
65.22 	were funded in the previous two years, gaps in services that each initiative brought to the 
65.23 	attention of the commissioner, and outcome data for the programs and services that were 
65.24 	funded; and
65.25 	(2) the amount of funding for other targeted services and the location of services.
65.26 	(b) This subdivision expires January 1, 2032.

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

66.1 	Sec. 5. Minnesota Statutes 2024, section 245.4661, is amended by adding a subdivision 
66.2 	to read:
66.3 		Subd. 12.Oversight of direct payments.  (a) The commissioner shall develop and 
66.4 	maintain monitoring, financial review, and accountability procedures for all direct payments 
66.5 	issued under this section.
66.6 	(b) Recipients of direct payments must comply with all documentation, reporting, and 
66.7 	expenditure requirements established by the commissioner.
66.8 	(c) The commissioner may require corrective action, suspend payments, or recover funds 
66.9 	if a recipient fails to comply with requirements established under this subdivision.
66.10 	(d) The commissioner shall develop a direct payment acknowledgment process to ensure 
66.11 	that recipients understand the terms, conditions, and oversight requirements associated with 
66.12 	direct payments.
66.13 	(e) The commissioner is authorized to engage in rulemaking to fulfill the requirements 
66.14 	of this subdivision.

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

66.16 	Sec. 6. Minnesota Statutes 2024, section 245I.011, subdivision 5, is amended to read:
66.17 		Subd. 5.Programs certified under chapter 256B. (a) An individual, organization, or 
66.18 	government entity certified under the following sections must comply with all of the 
66.19 	responsibilities assigned to a license holder under this chapter except subdivision 1:
66.20 	(1) an assertive community treatment provider under section 256B.0622, subdivision 
66.21 	3a;
66.22 	(2) an adult rehabilitative mental health services provider under section 256B.0623;
66.23 	(3) a mobile crisis team under section 256B.0624;
66.24 	(4) a children's therapeutic services and supports provider under section 256B.0943;
66.25 	(5) a children's intensive behavioral health services provider under section 256B.0946; 
66.26 	and
66.27 	(6) an intensive nonresidential rehabilitative mental health services provider under section 
66.28 	256B.0947.; and
66.29 	(7) effective July 1, 2027, or upon federal approval, whichever is later, a coordinated 
66.30 	specialty care team under section 256B.0672.
67.1 	(b) An individual, organization, or government entity certified under the sections listed 
67.2 	in paragraph (a), clauses (1) to (6) (7), must obtain a criminal background study for each 
67.3 	staff person and volunteer providing direct contact services to a client.

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

67.5 	Sec. 7. Minnesota Statutes 2024, section 254A.03, subdivision 2, is amended to read:
67.6 		Subd. 2.American Indian programs. There is hereby created a section of American 
67.7 	Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human 
67.8 	Services, to be headed by a special assistant for American Indian programs on substance 
67.9 	misuse and substance use disorder and two assistants to that position. The section shall be 
67.10 	staffed with all personnel necessary to fully administer programming for substance misuse 
67.11 	and substance use disorder services for American Indians in the state. The special assistant 
67.12 	position shall be filled by a person with considerable practical experience in and 
67.13 	understanding of substance misuse and substance use disorder in the American Indian 
67.14 	community, who shall be responsible to the director of the Alcohol and Drug Abuse Section 
67.15 	created in subdivision 1 and shall be in the unclassified service. The special assistant shall 
67.16 	meet and consult with the American Indian Advisory Council as described in section 
67.17 	254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report 
67.18 	on the status of substance misuse and substance use disorder among American Indians in 
67.19 	the state of Minnesota. The special assistant with the approval of the director shall:
67.20 	(1) administer direct payments using funds appropriated for American Indian groups, 
67.21 	organizations and reservations within the state for American Indian substance misuse and 
67.22 	substance use disorder programs;
67.23 	(2) establish policies and procedures for such American Indian programs with the 
67.24 	assistance of the American Indian Advisory Board; and
67.25 	(3) hire and supervise staff to assist in the administration of the American Indian program 
67.26 	section within the Alcohol and Drug Abuse Section of the Department of Human Services.

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

67.28 	Sec. 8. Minnesota Statutes 2025 Supplement, section 254B.02, subdivision 5, is amended 
67.29 	to read:
67.30 		Subd. 5.Tribal allocation. The commissioner may make direct payments to Tribal 
67.31 	Nation servicing agencies from money allocated under this section to support individuals 
67.32 	with substance use disorders and determine eligibility for behavioral health fund payments. 
68.1 	The payment must not be less than 133 percent of the Tribal Nations payment for the fiscal 
68.2 	year ending June 30, 2009, adjusted in proportion to the statewide change in the appropriation 
68.3 	for this chapter.

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

68.5 	Sec. 9. Minnesota Statutes 2025 Supplement, section 254B.03, subdivision 4, is amended 
68.6 	to read:
68.7 		Subd. 4.Division of costs. (a) Except for services provided by a county under section 
68.8 	254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out 
68.9 	of local money, pay the state for 22.95 50 percent of the cost of substance use disorder 
68.10 	services, except for those services provided to persons enrolled in medical assistance under 
68.11 	chapter 256B and room and board services under section 254B.0505, subdivision 1. Counties 
68.12 	may use the indigent hospitalization levy for treatment and hospital payments made under 
68.13 	this section.
68.14 	(b) 22.95 50 percent of any state collections from private or third-party pay, less 15 
68.15 	percent for the cost of payment and collections, must be distributed to the county that paid 
68.16 	for a portion of the treatment under this section.

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

68.18 	Sec. 10. Minnesota Statutes 2025 Supplement, section 254B.0503, subdivision 1, is 
68.19 	amended to read:
68.20 		Subdivision 1.Eligible vendor requirements. (a) Vendors of room and board are 
68.21 	eligible for behavioral health fund payment if the vendor:
68.22 	(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals 
68.23 	while residing in the facility and provide consequences for infractions of those rules;
68.24 	(2) is determined to meet applicable health and safety requirements;
68.25 	(3) is not a jail or prison;
68.26 	(4) is not concurrently receiving funds under chapter 256I for the recipient;
68.27 	(5) admits individuals who are 18 years of age or older;
68.28 	(6) is registered as a board and lodging or lodging establishment according to section 
68.29 	157.17;
68.30 	(7) has awake staff on site whenever a client is present;
69.1 	(8) has staff who are at least 18 years of age and meet the requirements of section 
69.2 	245G.11, subdivision 1, paragraph (b);
69.3 	(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
69.4 	(10) meets the requirements of section 245G.08, subdivision 5, if administering 
69.5 	medications to clients;
69.6 	(11) meets the abuse prevention requirements of section 245A.65, including a policy on 
69.7 	fraternization and the mandatory reporting requirements of section 626.557;
69.8 	(12) documents coordination with the treatment provider to ensure compliance with 
69.9 	section 254B.03, subdivision 2;
69.10 	(13) protects client funds and ensures freedom from exploitation by meeting the 
69.11 	provisions of section 245A.04, subdivision 13;
69.12 	(14) has a grievance procedure that meets the requirements of section 245G.15, 
69.13 	subdivision 2; and
69.14 	(15) has sleeping and bathroom facilities for men and women separated by a door that 
69.15 	is locked, has an alarm, or is supervised by awake staff.
69.16 	(b) Programs providing children's mental health crisis admissions and stabilization under 
69.17 	section 245.4882, subdivision 6, are eligible vendors of room and board.
69.18 	(c) Programs providing children's residential services under section 245.4882, except 
69.19 	services for individuals who have a placement under chapter 260C or 260D, are eligible 
69.20 	vendors of room and board.
69.21 	(d) A vendor that is not licensed as a residential treatment program must have a policy 
69.22 	to address staffing coverage when a client may unexpectedly need to be present at the room 
69.23 	and board site.
69.24 	(e) No new vendors for room and board services may be approved after June 30, 2025, 
69.25 	to receive payments from the behavioral health fund, under the provisions of section 254B.04, 
69.26 	subdivision 2a. Room and board vendors that were approved and operating prior to July 1, 
69.27 	2025, may continue to receive payments from the behavioral health fund for services provided 
69.28 	until June 30, 2027 December 31, 2026. Room and board vendors providing services in 
69.29 	accordance with section 254B.04, subdivision 2a, will no longer be eligible to claim 
69.30 	reimbursement for room and board services provided on or after July January 1, 2027.

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

70.1 	Sec. 11. Minnesota Statutes 2025 Supplement, section 254B.0509, subdivision 2, is 
70.2 	amended to read:
70.3 		Subd. 2.Annual adjustments. Effective January 1, 2027, and annually thereafter, the 
70.4 	commissioner of human services must adjust the payment rates under subdivision 1 according 
70.5 	to the change from the midpoint of the previous rate year to the midpoint of the rate year 
70.6 	for which the rate is being determined using the Centers for Medicare and Medicaid Services 
70.7 	Medicare Economic Index as forecasted in the fourth quarter of the calendar year before 
70.8 	the rate year. Notwithstanding this subdivision, rates must not be adjusted lower than those 
70.9 	established on January 1, 2026.

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

70.11 	Sec. 12. Minnesota Statutes 2024, section 254B.06, subdivision 2, is amended to read:
70.12 		Subd. 2.Allocation of collections.  The commissioner shall allocate 77.05 50 percent 
70.13 	of patient payments and third-party payments to the special revenue account and 22.95 50
70.14 	percent to the county financially responsible for the patient.

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

70.16 	Sec. 13. [256B.0618] COVERAGE FOR DETAINED INDIVIDUALS.
70.17 	(a) An inmate of a correctional facility who is conditionally released under section 
70.18 	241.26, 244.065, or 631.425 is eligible for medical assistance if the individual:
70.19 	(1) does not require the security of a public detention facility and is housed:
70.20 	(i) in a halfway house or community correction center; or
70.21 	(ii) under house arrest and monitored by electronic surveillance in a residence approved 
70.22 	by the commissioner of corrections; and
70.23 	(2) meets all other eligibility requirements of this chapter.
70.24 	(b) An individual, regardless of age, who is considered an inmate of a public institution 
70.25 	as defined in Code of Federal Regulations, title 42, section 435.1010, and who meets the 
70.26 	eligibility requirements in section 256B.056 is not eligible for medical assistance, except 
70.27 	for covered medical assistance services received:
70.28 	(1) while an inpatient in a medical institution as defined in Code of Federal Regulations, 
70.29 	title 42, section 435.1010;
71.1 	(2) by an eligible juvenile in accordance with the Consolidated Appropriations Act, 
71.2 	2023, Public Law 117-328, part 5121; and
71.3 	(3) by an eligible individual under with section 256B.0761.
71.4 	(c) Security logistics and costs related to the inpatient treatment of an inmate are the 
71.5 	responsibility of the entity with jurisdiction over the inmate.

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

71.7 	Sec. 14. [256B.0619] CARCERAL TARGETED CASE MANAGEMENT SERVICES.
71.8 		Subdivision 1.Generally. Effective January 1, 2027, or upon federal approval, whichever 
71.9 	is later, medical assistance covers carceral targeted case management services in accordance 
71.10 	with section 256B.0761 and United States Code, title 42, sections 1396a(a)(84); 1396d(a)(32); 
71.11 	1397bb(d); and 1397jj(b)(2) and (7).
71.12 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
71.13 	meanings given.
71.14 	(b) "Comprehensive care plan" means a person-centered plan that includes goals, tasks, 
71.15 	and services identified through screening and assessments and agreed upon by all parties. 
71.16 	This includes but is not limited to identifying resources and services necessary to meet the 
71.17 	individual's physical, behavioral health, and health-related social needs prerelease and 
71.18 	postrelease.
71.19 	(c) "Consultation" means communication from a carceral targeted case manager to other 
71.20 	providers working with the same individual to inform, inquire, and instruct regarding the 
71.21 	individual's symptoms, strategies for effective engagement, care and intervention needs, 
71.22 	and treatment expectations across service settings, including but not limited to the education 
71.23 	services, social services, probation, home, primary care, medication prescribers, disabilities 
71.24 	services, and other mental health providers and to direct and coordinate clinical service 
71.25 	components provided to the justice-involved individual.
71.26 	(d) "Targeted case management for justice-involved individuals" means the provision 
71.27 	of both county targeted case management and public or private vendor service coordination 
71.28 	services for the purpose of bridging prerelease and postrelease medical assistance services 
71.29 	to support the physical, behavioral health, and health-related social needs of justice-involved 
71.30 	individuals.
71.31 	(e) "Targeted case management services" means services that assist medical assistance 
71.32 	eligible persons to gain access to needed medical, social, educational, and other services.
72.1 		Subd. 3.Eligibility. The following individuals are eligible for carceral targeted case 
72.2 	management services:
72.3 	(1) individuals eligible for medical assistance who meet all eligibility requirements under 
72.4 	United States Code, title 42, section 1396a(nn);
72.5 	(2) individuals eligible for medical assistance who meet eligibility requirements for the 
72.6 	Children's Health Insurance Program under United States Code, title 42, section 1397jj(b)(7); 
72.7 	or
72.8 	(3) individuals eligible for medical assistance who are currently incarcerated at a section 
72.9 	1115 reentry demonstration pilot facility and meet the participation requirements in section 
72.10 	256B.0761, subdivision 2.
72.11 		Subd. 4.Carceral targeted case management services.  (a) For individuals eligible for 
72.12 	services under subdivision 3, clause (1) or (2), carceral targeted case management care 
72.13 	coordination is available for 30 days before release and up to 180 days postrelease. For 
72.14 	individuals eligible for services under subdivision 3, clause (3), carceral targeted case 
72.15 	management care coordination is available for up to 90 days before release and up to 180 
72.16 	days postrelease.
72.17 	(b) Carceral targeted case management care coordination includes:
72.18 	(1) comprehensive assessment and periodic reassessment addressing physical, behavioral, 
72.19 	and health-related social needs in accordance with section 256B.0761 and United States 
72.20 	Code, title 42, sections 1396a(nn) and 1397jj(b)(7).
72.21 	(2) comprehensive care plans including but not limited to;
72.22 	(i) the desired goals of the individual;
72.23 	(ii) the individual's preferences for services and supports;
72.24 	(iii) formal and informal services and supports based on areas of assessment, such as 
72.25 	social health, mental health, residence, family, education and vocation, safety, legal, 
72.26 	self-determination, financial, and chemical health; and
72.27 	(iv) housing arrangements postrelease.
72.28 	(3) regular review and revision of the comprehensive care plan with the individual to 
72.29 	ensure needs are adequately met by referrals and supports;
72.30 	(4) coordination of referrals, which must contain more than just a list of resources, to 
72.31 	bridge prerelease to postrelease medical assistance services, including but not limited to 
72.32 	referrals to community-based services identified as a need on the comprehensive care plan;
73.1 	(5) warm handoffs and follow-up post release;
73.2 	(6) monitoring and evaluation of services identified in the comprehensive care plan to 
73.3 	ensure personal outcomes are met and to ensure satisfaction with services and service 
73.4 	delivery;
73.5 	(7) consultation with other professionals, including but not limited to community-based 
73.6 	mental health providers; and
73.7 	(8) completion and maintenance of necessary documentation that supports and verifies 
73.8 	the activities in this section.
73.9 		Subd. 5.Carceral targeted case management provider standards. Providers eligible 
73.10 	to receive medical assistance reimbursement under this section must enroll as a Minnesota 
73.11 	Health Care Programs provider. To qualify as a provider of carceral targeted case 
73.12 	management services, a provider must:
73.13 	(1) have a minimum of a bachelor's degree or a license in a health or human services 
73.14 	field, comparable training and two years of experience in human services, or credentials 
73.15 	from an American Indian Tribe under section 256B.02, subdivision 7;
73.16 	(2) demonstrate the capacity and experience to provide targeted case management 
73.17 	activities for justice-involved individuals as defined in subdivision 2;
73.18 	(3) be able to coordinate and connect community resources needed by the recipient;
73.19 	(4) demonstrate administrative capacity and experience to serve the justice-involved 
73.20 	population for which the provider will provide services and ensure quality of services under 
73.21 	state and federal requirements;
73.22 	(5) have a financial management system that provides accurate documentation of services 
73.23 	and costs under state and federal requirements;
73.24 	(6) demonstrate capacity to document and maintain individual case records under state 
73.25 	and federal requirements;
73.26 	(7) demonstrate the capacity to coordinate with county administrative functions;
73.27 	(8) be able to coordinate with health care providers to ensure access to necessary health 
73.28 	care services;
73.29 	(9) have a procedure that (i) notifies the recipient of any conflict of interest if the targeted 
73.30 	case management service provider also provides the recipient's services and supports, (ii) 
73.31 	provides information on all potential conflicts of interest, (iii) obtains the recipient's informed 
73.32 	consent, and (iv) provides the recipient with alternatives; and
74.1 	(10) demonstrate the capacity to achieve the following performance outcomes: (i) access; 
74.2 	(ii) quality; and (iii) consumer satisfaction.
74.3 		Subd. 6.Medical assistance payment and rate setting. (a) Carceral targeted case 
74.4 	management rates are equal to rates authorized by the commissioner for relocation targeted 
74.5 	case management under section 256B.0621, subdivision 10.
74.6 	(b) The carceral targeted case management rate only includes eligible services delivered 
74.7 	to an eligible recipient by an eligible provider.

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

74.9 	Sec. 15. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision 
74.10 	to read:
74.11 		Subd. 77.Carceral targeted case management. Effective January 1, 2027, or upon 
74.12 	federal approval, whichever is later, medical assistance covers carceral targeted case 
74.13 	management services under 256B.0619.

74.14 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
74.15 	whichever is later.

74.16 	Sec. 16. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision 
74.17 	to read:
74.18 		Subd. 78.Coordinated specialty care services. Effective July 1, 2027, or upon federal 
74.19 	approval, whichever is later, medical assistance covers coordinated specialty care services 
74.20 	according to section 256B.0672.

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

74.22 	Sec. 17. [256B.0672] COORDINATED SPECIALTY CARE FOR THE TREATMENT 
74.23 	OF EARLY EPISODE PSYCHOSIS.
74.24 		Subdivision 1.Coverage. (a) Effective July 1, 2027, or upon federal approval, whichever 
74.25 	is later, medical assistance covers medically necessary coordinated specialty care services 
74.26 	when the services are provided by an entity certified under and meeting the standards in 
74.27 	this section.
74.28 	(b) The provider entity must report individual client outcomes to the commissioner using 
74.29 	instruments and protocols approved by the commissioner.
75.1 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
75.2 	meanings given.
75.3 	(b) "Coordinated specialty care services" means rehabilitative services that include six 
75.4 	core activities: (1) cognitive or behavioral psychotherapy; (2) medication management; (3) 
75.5 	family education and support; (4) service coordination; (5) case management; and (6) 
75.6 	supported employment and education.
75.7 	(c) "Coordinated specialty care team" means a group of interdisciplinary mental health 
75.8 	staff who work as a team to provide coordinated specialty care.
75.9 	(d) "Early psychosis" means clinical high-risk stage or early-stage psychotic symptoms 
75.10 	or psychotic episodes present in Attenuated Psychosis Syndrome and first-episode psychosis. 
75.11 	Psychotic symptoms may include but are not limited to combinations of confused thinking, 
75.12 	delusions, hallucinations, changed feelings, and changed behavior.
75.13 	(e) "Mental health professional" means a staff person who is qualified according to 
75.14 	section 245I.04, subdivision 2.
75.15 		Subd. 3.Eligibility. An individual who is experiencing early psychosis with a duration 
75.16 	of onset of less than two years and has been on antipsychotic medications for less than a 
75.17 	total of 12 months is eligible for coordinated specialty care services.
75.18 		Subd. 4.Eligibility exclusion. An individual is not eligible for coordinated specialty 
75.19 	care services under this section if it is determined that the individual's psychotic symptoms 
75.20 	are attributable primarily to a:
75.21 	(1) substance-induced psychotic disorder;
75.22 	(2) major medical condition;
75.23 	(3) neurocognitive disorder; or
75.24 	(4) developmental disorder.
75.25 		Subd. 5.Provider certification requirements. (a) The commissioner must establish a 
75.26 	process for the certification of coordinated specialty care teams. The certification process 
75.27 	must determine if a team meets the standards for coordinated specialty care services under 
75.28 	this section and the standards in section 245I.011, subdivision 5. The provider certification 
75.29 	process must include ongoing review of required program fidelity standards under subdivision 
75.30 	13. Recertification may occur at any time and must occur at least every three years.
75.31 	(b) The coordinated specialty care services provider must have at least one team. Each 
75.32 	team must be certified.
76.1 	(c) To be certified under this section, a coordinated specialty care team must:
76.2 	(1) demonstrate capacity to recruit, hire, manage, and train required team members;
76.3 	(2) demonstrate adequate administrative ability to ensure availability of services;
76.4 	(3) demonstrate flexibility in service delivery to respond to the changing and intermittent 
76.5 	care needs of a client as identified by the client and the individual treatment plan as defined 
76.6 	in section 245I.10, subdivisions 7 and 8;
76.7 	(4) keep all necessary records required by law;
76.8 	(5) be an enrolled medical assistance provider; and
76.9 	(6) meet all treatment team staff requirements outlined in subdivision 7.
76.10 	(d) The commissioner must establish a process for decertification of a coordinated 
76.11 	specialty care team and must require corrective action, medical assistance repayment, or 
76.12 	decertification of a coordinated specialty care team that no longer meets the requirements 
76.13 	in this section or that fails to meet the clinical quality standards or administrative standards 
76.14 	provided by the commissioner in the application and certification process. The commissioner 
76.15 	may decertify a coordinated specialty care team with cause at any time. The decertification 
76.16 	is subject to appeal to the state.
76.17 		Subd. 6.Covered coordinated specialty care services. Coordinated specialty care 
76.18 	teams must offer and have the capacity to directly provide:
76.19 	(1) assertive outreach and engagement strategies to encourage involvement in services;
76.20 	(2) assessment for underlying and contributing factors to eligibility;
76.21 	(3) person-centered care, delivered in a home and community, extending beyond typical 
76.22 	hours of operation, including evenings and weekends;
76.23 	(4) crisis assessment, planning, and mobile crisis response services under section 
76.24 	256B.0624;
76.25 	(5) team leadership from a mental health professional who provides ongoing consultation 
76.26 	to the team members, coordinates admission screening, and leads the weekly team meetings 
76.27 	to facilitate case review and entry to the program;
76.28 	(6) employment and education services designed to enable individuals to retain or 
76.29 	rehabilitate function in workplace and educational settings consistent with individual 
76.30 	preferences;
77.1 	(7) family psychoeducation and support provided to the client's family and other natural 
77.2 	supports to restore and strengthen the client's unique social and family relationships;
77.3 	(8) individual and group psychotherapy, including but not limited to cognitive behavioral 
77.4 	therapies;
77.5 	(9) care coordination services in clinic, community, and home settings;
77.6 	(10) pharmacotherapy;
77.7 	(11) medication management; and
77.8 	(12) primary care coordination provided by a mental health professional authorized to 
77.9 	prescribe psychiatric medications.
77.10 		Subd. 7.Team members. (a) Each coordinated specialty care team must have a program 
77.11 	director, psychiatric care provider, supported employment and education specialist, and 
77.12 	case manager.
77.13 	(b) Coordinated specialty care teams may have a certified peer specialist, a certified peer 
77.14 	recovery specialist, and a certified family peer specialist.
77.15 		Subd. 8.Program director. The program director must be a mental health professional 
77.16 	or a clinical trainee qualified according to section 245I.04, subdivision 6, and a single 
77.17 	full-time staff member. The program director must be dedicated to the coordinated specialty 
77.18 	care team, responsible for overseeing the administrative operations of the team, and 
77.19 	responsible for supervising team members to ensure delivery of best and ethical practices. 
77.20 	The program director is responsible for:
77.21 	(1) serving as the primary liaison for referrals to the program;
77.22 	(2) performing assessment and intake interviews for potential coordinated specialty care 
77.23 	services clients;
77.24 	(3) ensuring medical necessity has been established to support all services delivered;
77.25 	(4) engaging clients and family members in treatment and during treatment;
77.26 	(5) actively participating in the coordinated specialty care team and providing direct 
77.27 	services to clients; and
77.28 	(6) ensuring that overall treatment supervision for the coordinated specialty care team 
77.29 	is available after regular business hours and on weekends and holidays and that services 
77.30 	are provided by a qualified member of the team.
77.31 		Subd. 9.Psychiatric care provider. (a) The psychiatric care provider must:
78.1 	(1) be a mental health professional qualified according to section 245I.04, subdivision 
78.2 	2, clause (1) or (4), who is authorized to prescribe psychiatric medications as part of the 
78.3 	mental health professional's scope of practice. The psychiatric care provider must have 
78.4 	demonstrated clinical experience working with individuals and families, including but not 
78.5 	limited to the population served and specifically persons experiencing psychosis.
78.6 	(2) fulfill the following functions for coordinated specialty care clients:
78.7 	(i) provide assessment and treatment of clients' symptoms and response to medications, 
78.8 	including but not limited to side effects;
78.9 	(ii) provide brief therapy to clients;
78.10 	(iii) provide diagnostic and medication education to clients, with medication decisions 
78.11 	based on shared decision making;
78.12 	(iv) monitor clients' nonpsychiatric medical conditions and nonpsychiatric medications; 
78.13 	and
78.14 	(v) conduct home and community visits;
78.15 	(3) be employed at no less than 0.20 full-time equivalent and comply with the staffing 
78.16 	requirements in paragraph (b); and
78.17 	(4) provide psychiatric backup to the program after regular business hours and on 
78.18 	weekends and holidays. The psychiatric care provider may delegate this duty to another 
78.19 	qualified psychiatric provider.
78.20 	(b) Psychiatric care providers must have designated hours to work on the coordinated 
78.21 	specialty care team with sufficient blocks of time on consistent days to carry out the provider's 
78.22 	clinical, supervisory, and administrative responsibilities. No more than two psychiatric care 
78.23 	providers may share the psychiatric care provider role on any one team. Backup coverage 
78.24 	must be arranged when the psychiatric care provider is on vacation or is unavailable for any 
78.25 	reason. If an individual is receiving care from a medication prescriber who is an ad hoc 
78.26 	member of the team or a primary care provider, the psychiatric care provider is responsible 
78.27 	for providing continuity of care with other medical providers, including but not limited to 
78.28 	the ad hoc psychiatrist, primary care provider, or advanced practice registered nurse, in the 
78.29 	team meetings and treatment planning.
78.30 		Subd. 10.Individual and group psychotherapy provider. An individual or group 
78.31 	psychotherapy provider must:
79.1 	(1) be a mental health professional qualified under section 245I.04, subdivision 2; a 
79.2 	clinical trainee qualified under section 245I.04, subdivision 6; or a mental health practitioner 
79.3 	qualified under section 245I.04, subdivision 4, who has prior experience with providing 
79.4 	mental health services to individuals and families, particularly persons experiencing 
79.5 	psychosis; and
79.6 	(2) be responsible for:
79.7 	(i) providing individual and group therapy or skills training; and
79.8 	(ii) working with clients to identify goals, learn about symptoms and symptom 
79.9 	management through social and coping skills training, receive psychoeducation, learn 
79.10 	relaxation techniques, and engage in behavioral activation and other therapeutic techniques 
79.11 	in both an individual and group setting.
79.12 		Subd. 11.Case manager. A case manager must be a case management service provider 
79.13 	as defined in section 245.462, subdivision 4, or 245.4871, subdivision 4, and be responsible 
79.14 	for providing case management and family community support services as established in 
79.15 	section 245.4711 or 245.4881.
79.16 		Subd. 12.Mental health certified peer specialist and certified family peer 
79.17 	specialist. (a) A coordinated specialty care team may have:
79.18 	(1) a mental health certified peer specialist qualified under section 245I.04, subdivision 
79.19 	10;
79.20 	(2) a mental health certified family peer specialist qualified under section 245I.04, 
79.21 	subdivision 12; or
79.22 	(3) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8.
79.23 		Subd. 13.Compliance with evidence-based practice and data reporting. (a) A 
79.24 	coordinated specialty care team must remain in compliance with fidelity standards as 
79.25 	measured by a fidelity tool for the treatment of early episode psychosis approved by the 
79.26 	commissioner. A team must submit data necessary to ensure fidelity with evidence-based 
79.27 	practice models in a form and manner prescribed by the commissioner.
79.28 	(b) A team must submit quality and outcomes data, including but not limited to client 
79.29 	satisfaction data, to the commissioner on a timeline and in a form and manner prescribed 
79.30 	by the commissioner.
79.31 		Subd. 14.Coordinated specialty care team variances. The commissioner may grant 
79.32 	a variance to specific requirements under this section for a coordinated specialty care team 
80.1 	when the coordinated specialty care team demonstrates an inability to meet the specific 
80.2 	requirement and how the team will ensure that the variance does not negatively impact 
80.3 	outcomes for clients. The commissioner may require a plan of action for the coordinated 
80.4 	specialty care team to come into compliance with the specific variance requirement and 
80.5 	establish specific time limits for the variance. A decision to grant or deny a variance request 
80.6 	is final and not subject to appeal.
80.7 		Subd. 15.Concurrent services. (a) The rate for coordinated specialty care services does 
80.8 	not include medical assistance payment for the following services:
80.9 	(1) inpatient psychiatric hospital treatment;
80.10 	(2) partial hospitalization;
80.11 	(3) child or adult mental health day treatment services;
80.12 	(4) physician services outside of care provided by a psychiatrist serving as a member of 
80.13 	the treatment team;
80.14 	(5) medical assistance room and board rate as defined in section 256B.056, subdivision 
80.15 	5d;
80.16 	(6) home and community-based waiver services;
80.17 	(7) mental health services identified in a child's individualized education program;
80.18 	(8) child and family psychoeducation services as defined in section 256B.0671, 
80.19 	subdivision 5;
80.20 	(9) dialectical behavior therapy as defined in section 256B.0671, subdivision 6;
80.21 	(10) neuropsychological assessments as defined in section 256B.0671, subdivision 8;
80.22 	(11) neuropsychological testing as defined in section 256B.0671, subdivision 9; and
80.23 	(12) psychological testing as defined in section 256B.0671, subdivision 10.
80.24 	(b) The services in paragraph (a) may be billed separately.
80.25 		Subd. 16.Excluded services. The following services are not covered under this section 
80.26 	and are not eligible for medical assistance payment while an individual is receiving 
80.27 	coordinated specialty care services:
80.28 	(1) mental health residential treatment, except during the last 30 days of residential 
80.29 	treatment to support discharge planning;
81.1 	(2) children's therapeutic services and supports as defined in section 256B.0943, except 
81.2 	for children's day treatment;
81.3 	(3) intensive rehabilitative mental health services as defined in section 256B.0947;
81.4 	(4) assertive community treatment services as defined in section 256B.0622;
81.5 	(5) mental health targeted case management under section 245.4881; and
81.6 	(6) mental health clinical care consultation as defined in section 256B.0671, subdivision 
81.7 	7.
81.8 		Subd. 17.Payments. The commissioner must make payments to each designated provider 
81.9 	for the provision of coordinated specialty care services under subdivision 6 to each eligible 
81.10 	individual under subdivision 3.

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

81.12 	Sec. 18. Minnesota Statutes 2024, section 256B.0761, subdivision 2, is amended to read:
81.13 		Subd. 2.Eligible individuals. Notwithstanding section 256B.055, subdivision 14,
81.14 	Individuals are eligible to receive services under this demonstration if they are eligible under 
81.15 	section 256B.055, subdivision 3a, 6, 7, 7a, 9, 15, 16, or 17, as determined by the 
81.16 	commissioner in collaboration with correctional facilities, local governments, and Tribal 
81.17 	governments.

81.18 	Sec. 19. Minnesota Statutes 2024, section 297E.02, subdivision 3, is amended to read:
81.19 		Subd. 3.Collection; disposition. (a) Taxes imposed by this section are due and payable 
81.20 	to the commissioner when the gambling tax return is required to be filed. Distributors must 
81.21 	file their monthly sales figures with the commissioner on a form prescribed by the 
81.22 	commissioner. Returns covering the taxes imposed under this section must be filed with 
81.23 	the commissioner on or before the 20th day of the month following the close of the previous 
81.24 	calendar month. The commissioner shall prescribe the content, format, and manner of returns 
81.25 	or other documents pursuant to section 270C.30. The proceeds, along with the revenue 
81.26 	received from all license fees and other fees under sections 349.11 to 349.191, 349.211, 
81.27 	and 349.213, must be paid to the commissioner of management and budget for deposit in 
81.28 	the general fund.
81.29 	(b) The sales tax imposed by chapter 297A on the sale of pull-tabs and tipboards by the 
81.30 	distributor is imposed on the retail sales price. The retail sale of pull-tabs or tipboards by 
82.1 	the organization is exempt from taxes imposed by chapter 297A and is exempt from all 
82.2 	local taxes and license fees except a fee authorized under section 349.16, subdivision 8.
82.3 	(c) One-half of one percent of the revenue deposited in the general fund under paragraph 
82.4 	(a), is appropriated to the commissioner of human services for the compulsive gambling 
82.5 	treatment program established under section 245.98. One-half of one percent of the revenue 
82.6 	deposited in the general fund under paragraph (a), is appropriated to the commissioner of 
82.7 	human services for a grant to the state affiliate recognized by the National Council on 
82.8 	Problem Gambling to increase public awareness of problem gambling, education and training 
82.9 	for individuals and organizations providing effective treatment services to problem gamblers 
82.10 	and their families, and research relating to problem gambling. Money appropriated by this 
82.11 	paragraph must supplement and must not replace existing state funding for these programs.
82.12 	(d) The commissioner of human services must provide to the state affiliate recognized 
82.13 	by the National Council on Problem Gambling a monthly statement of the amounts deposited 
82.14 	under paragraph (c). Beginning January 1, 2022, the commissioner of human services must 
82.15 	provide to the chairs and ranking minority members of the legislative committees with 
82.16 	jurisdiction over treatment for problem gambling and to the state affiliate recognized by the 
82.17 	National Council on Problem Gambling an annual reconciliation of the amounts deposited 
82.18 	under paragraph (c). The annual reconciliation under this paragraph must include the amount 
82.19 	allocated to the commissioner of human services for the compulsive gambling treatment 
82.20 	program established under section 245.98, and the amount allocated to the state affiliate 
82.21 	recognized by the National Council on Problem Gambling. The annual reconciliation must 
82.22 	also include any rollover amounts from the previous fiscal year and the utilization of those 
82.23 	amounts during the current reporting period.

82.24 	Sec. 20. Laws 2025, First Special Session chapter 9, article 4, section 2, the effective date, 
82.25 	is amended to read:

82.26 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

82.28 	Sec. 21. Laws 2025, First Special Session chapter 9, article 4, section 23, the effective 
82.29 	date, is amended to read:

82.30 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

83.1 	Sec. 22. Laws 2025, First Special Session chapter 9, article 4, section 38, the effective 
83.2 	date, is amended to read:

83.3 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

83.5 	Sec. 23. Laws 2025, First Special Session chapter 9, article 4, section 39, the effective 
83.6 	date, is amended to read:

83.7 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

83.9 	Sec. 24. Laws 2025, First Special Session chapter 9, article 4, section 40, the effective 
83.10 	date, is amended to read:

83.11 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

83.13 	Sec. 25. Laws 2025, First Special Session chapter 9, article 4, section 41, the effective 
83.14 	date, is amended to read:

83.15 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

83.17 	Sec. 26. Laws 2025, First Special Session chapter 9, article 4, section 42, the effective 
83.18 	date, is amended to read:

83.19 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

83.21 	Sec. 27. Laws 2025, First Special Session chapter 9, article 4, section 43, the effective 
83.22 	date, is amended to read:

83.23 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

83.25 	Sec. 28. Laws 2025, First Special Session chapter 9, article 4, section 44, the effective 
83.26 	date, is amended to read:

83.27 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

84.2 	Sec. 29. Laws 2025, First Special Session chapter 9, article 4, section 50, the effective 
84.3 	date, is amended to read:

84.4 	EFFECTIVE DATE. This section is effective January July 1, 2027 2026.

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

84.6 	Sec. 30. Laws 2025, First Special Session chapter 9, article 4, section 51, is amended to 
84.7 	read:
84.8 	Sec. 51. RECOVERY RESIDENCE WORK GROUP.
 84.9 	(a) The commissioner of human services must convene a work group to develop 
84.10 	recommendations specific to recovery residences. The work group must:
84.11 	(1) produce a report that examines how other states fund recovery residences, identifying 
84.12 	best practices and models that could be applicable to Minnesota;
84.13 	(2) engage with stakeholders to ensure meaningful collaboration with key external 
84.14 	stakeholders on the ideas being developed that will inform the final plan and 
84.15 	recommendations; and
84.16 	(3) create an implementable plan addressing housing needs for individuals in outpatient 
84.17 	substance use disorder treatment that includes:
84.18 	(i) clear strategies for aligning housing models with individual treatment needs;
84.19 	(ii) an assessment of funding streams, including potential federal funding sources;
84.20 	(iii) a timeline for implementation with key milestones and action steps;
84.21 	(iv) recommendations for future resource allocation to ensure long-term housing stability 
84.22 	for individuals in recovery;
84.23 	(v) specific recommendations for policy or legislative changes that may be required to 
84.24 	support sustainable recovery housing solutions, including challenges faced by recovery 
84.25 	residences resulting from state and local housing regulations and ordinances; and
84.26 	(vi) recommendations for potentially delegating the commissioner's recovery residence 
84.27 	certification duties under Minnesota Statutes, sections 254B.21 to 254B.216 to a third-party 
84.28 	organization.
84.29 	(b) The work group must include but is not limited to:
85.1 	(1) at least two designees from the Department of Human Services representing: (i) 
85.2 	behavioral health; and (ii) homelessness and housing and support services;
85.3 	(2) the commissioner of health or a designee;
85.4 	(3) two people who have experience living in a recovery residence;
85.5 	(4) representatives from at least three substance use disorder lodging facilities currently 
85.6 	operating in Minnesota;
85.7 	(5) three representatives from county social services agencies, at least one from inside 
85.8 	the seven-county metropolitan area and one from outside the seven-county metropolitan 
85.9 	area;
85.10 	(6) a representative from a Tribal social services agency;
85.11 	(7) representatives from the state affiliate of the National Alliance for Recovery 
85.12 	Residences; and
85.13 	(8) representatives from state mental health advocacy and adult mental health provider 
85.14 	organizations.
85.15 	(c) The work group must meet at least monthly and as necessary to fulfill its 
85.16 	responsibilities. The commissioner of human services must provide administrative support 
85.17 	and meeting space for the work group. The work group may conduct meetings remotely.
85.18 	(d) The commissioner of human services must make appointments to the work group 
85.19 	by October 1, 2025, and convene the first meeting of the work group by January 15, 2026.
85.20 	(e) The work group must submit a final report with recommendations to the chairs and 
85.21 	ranking minority members of the legislative committees with jurisdiction over health and 
85.22 	human services policy and finance on or before January July 1, 2027 2026.

85.23 	Sec. 31. DIRECTION TO COMMISSIONER; CARCERAL TARGETED CASE 
85.24 	MANAGEMENT SERVICES BILLING UNITS.
 85.25 	The commissioner of human services must establish a new billing code for carceral 
85.26 	targeted case management services. The commissioner must identify reimbursement rates 
85.27 	for the newly defined codes, as required under Minnesota Statutes, section 256B.0619, 
85.28 	subdivision 6. The new billing codes must correspond to a 15-minute unit. The new billing 
85.29 	codes must be available for 180 days postrelease.

85.30 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
85.31 	whichever is later.

86.1 	Sec. 32. REPEALER.
 86.2 	Minnesota Statutes 2024, section 256B.055, subdivision 14, is repealed.

86.3 	EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval, 
86.4 	whichever is later.

86.5 	ARTICLE 3
86.6 	DEPARTMENT OF HUMAN SERVICES OFFICE OF INSPECTOR GENERAL

86.7 	Section 1. [245A.034] LICENSEE CONDUCT TOWARD PUBLIC OFFICIALS.
86.8 	(a) Applicants, license holders, certification holders, and controlling individuals must 
86.9 	refrain from engaging in conduct that threatens the safety or well-being of Department of 
86.10 	Human Services staff, county employees, or other individuals acting under the authority of 
86.11 	the commissioner for duties authorized under this chapter, chapter 260E, and section 626.557. 
86.12 	Prohibited conduct includes but is not limited to:
86.13 	(1) assault, including attempts, under sections 609.221, 609.222, 609.223, 609.2231, 
86.14 	and 609.224, regardless of whether there is a criminal proceeding or conviction;
86.15 	(2) threats of violence under section 609.713, regardless of whether there is a criminal 
86.16 	proceeding or conviction;
86.17 	(3) harassment or stalking under section 609.749, regardless of whether there is a criminal 
86.18 	proceeding or conviction;
86.19 	(4) damage to property under section 609.595, regardless of whether there is a criminal 
86.20 	proceeding or conviction; or
86.21 	(5) any other act with the intent to cause harm to personal safety.
86.22 	(b) If the commissioner determines that conduct prohibited by paragraph (a) occurred 
86.23 	to an individual engaged in licensing, certification, investigation, or compliance activities, 
86.24 	the commissioner may take action under sections 245A.05, 245A.06, or 245A.07.

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

86.26 	Sec. 2. Minnesota Statutes 2025 Supplement, section 245A.07, subdivision 3, is amended 
86.27 	to read:
86.28 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may suspend 
86.29 	or revoke a license, or impose a fine if:
87.1 	(1) a license holder fails to comply fully with applicable laws or rules including but not 
87.2 	limited to the requirements of this chapter and chapter 245C;
87.3 	(2) a license holder, a controlling individual, or an individual living in the household 
87.4 	where the licensed services are provided or is otherwise subject to a background study has 
87.5 	been disqualified and the disqualification was not set aside and no variance has been granted;
87.6 	(3) a license holder knowingly withholds relevant information from or gives false or 
87.7 	misleading information to the commissioner in connection with an application for a license, 
87.8 	in connection with the background study status of an individual, during an investigation, 
87.9 	or regarding compliance with applicable laws or rules;
87.10 	(4) a license holder is excluded from any program administered by the commissioner 
87.11 	under section 245.095;
87.12 	(5) revocation is required under section 245A.04, subdivision 7, paragraph (d); or
87.13 	(6) suspension is necessary under subdivision 2a, paragraph (b), clause (2).
87.14 	A license holder who has had a license issued under this chapter suspended, revoked, 
87.15 	or has been ordered to pay a fine must be given notice of the action by certified mail, by 
87.16 	personal service, or through the provider licensing and reporting hub. If mailed, the notice 
87.17 	must be mailed to the address shown on the application or the last known address of the 
87.18 	license holder. The notice must state in plain language the reasons the license was suspended 
87.19 	or revoked, or a fine was ordered.
87.20 	(b) If the license was suspended or revoked, the notice must inform the license holder 
87.21 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
87.22 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
87.23 	a license. The appeal of an order suspending or revoking a license must be made in writing 
87.24 	by certified mail, by personal service, or through the provider licensing and reporting hub. 
87.25 	If mailed, the appeal must be postmarked and sent to the commissioner within ten calendar 
87.26 	days after the license holder receives notice that the license has been suspended or revoked. 
87.27 	If a request is made by personal service, it must be received by the commissioner within 
87.28 	ten calendar days after the license holder received the order. If the order is issued through 
87.29 	the provider hub, the appeal must be received by the commissioner within ten calendar days 
87.30 	from the date the commissioner issued the order through the hub. Except as provided in 
87.31 	subdivision 2a, paragraph (c), if a license holder submits a timely appeal of an order 
87.32 	suspending or revoking a license, the license holder may continue to operate the program 
87.33 	as provided in section 245A.04, subdivision 7, paragraphs (i) and (j), until the commissioner 
87.34 	issues a final order on the suspension or revocation.
88.1 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
88.2 	holder of the responsibility for payment of fines and the right to a contested case hearing 
88.3 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
88.4 	order to pay a fine must be made in writing by certified mail, by personal service, or through 
88.5 	the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent 
88.6 	to the commissioner within ten calendar days after the license holder receives notice that 
88.7 	the fine has been ordered. If a request is made by personal service, it must be received by 
88.8 	the commissioner within ten calendar days after the license holder received the order. If the 
88.9 	order is issued through the provider hub, the appeal must be received by the commissioner 
88.10 	within ten calendar days from the date the commissioner issued the order through the hub.
88.11 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
88.12 	If the license holder fails to fully comply with the order, the commissioner may issue a 
88.13 	second fine or suspend the license until the license holder complies. If the license holder 
88.14 	receives state funds, the state, county, or municipal agencies or departments responsible for 
88.15 	administering the funds shall withhold payments and recover any payments made while the 
88.16 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
88.17 	until the commissioner issues a final order.
88.18 	(3) A license holder shall promptly notify the commissioner of human services, in writing, 
88.19 	when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the 
88.20 	commissioner determines that a violation has not been corrected as indicated by the order 
88.21 	to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify 
88.22 	the license holder by certified mail, by personal service, or through the provider licensing 
88.23 	and reporting hub that a second fine has been assessed. The license holder may appeal the 
88.24 	second fine as provided under this subdivision.
88.25 	(4) Fines shall be assessed as follows:
88.26 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
88.27 	child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557 
88.28 	for which the license holder is determined responsible for the maltreatment under section 
88.29 	260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);
88.30 	(ii) if the commissioner determines that a determination of maltreatment for which the 
88.31 	license holder is responsible is the result of maltreatment that meets the definition of serious 
88.32 	maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit 
88.33 	$5,000;
89.1 	(iii) the license holder shall forfeit $200 $500 for each occurrence of a violation of law 
89.2 	or rule governing matters of health, safety, or supervision, including but not limited to the 
89.3 	provision of adequate staff-to-child or adult ratios, and failure to comply with background 
89.4 	study requirements under chapter 245C; and
89.5 	(iv) the license holder shall forfeit $100 $300 for each occurrence of a violation of law 
89.6 	or rule other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iii).
89.7 	For purposes of this section, "occurrence" means each violation identified in the 
89.8 	commissioner's fine order. Fines assessed against a license holder that holds a license to 
89.9 	provide home and community-based services, as identified in section 245D.03, subdivision 
89.10 	1, and a community residential setting or day services facility license under chapter 245D 
89.11 	where the services are provided, may be assessed against both licenses for the same 
89.12 	occurrence, but the combined amount of the fines shall not exceed the amount specified in 
89.13 	this clause for that occurrence.
89.14 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
89.15 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
89.16 	license holder will be personally liable for payment. In the case of a corporation, each 
89.17 	controlling individual is personally and jointly liable for payment.
89.18 	(d) Except for background study violations involving the failure to comply with an order 
89.19 	to immediately remove an individual or an order to provide continuous, direct supervision, 
89.20 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
89.21 	violation to a license holder who self-corrects a background study violation before the 
89.22 	commissioner discovers the violation. A license holder who has previously exercised the 
89.23 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
89.24 	a fine for a subsequent background study violation unless at least 365 days have passed 
89.25 	since the license holder self-corrected the earlier background study violation.

89.26 	Sec. 3. Minnesota Statutes 2025 Supplement, section 256.01, subdivision 2, is amended 
89.27 	to read:
89.28 		Subd. 2.Specific powers. Subject to the provisions of section 241.021, subdivision 2, 
89.29 	the commissioner of human services shall carry out the specific duties in paragraphs (a) 
89.30 	through (z):
89.31 	(a) Administer and supervise the forms of public assistance provided for by state law 
89.32 	and other welfare activities or services that are vested in the commissioner. Administration 
89.33 	and supervision of human services activities or services includes, but is not limited to, 
90.1 	assuring timely and accurate distribution of benefits, completeness of service, and quality 
90.2 	program management. In addition to administering and supervising human services activities 
90.3 	vested by law in the department, the commissioner shall have the authority to:
90.4 	(1) require county agency participation in training and technical assistance programs to 
90.5 	promote compliance with statutes, rules, federal laws, regulations, and policies governing 
90.6 	human services;
90.7 	(2) monitor, on an ongoing basis, the performance of county agencies in the operation 
90.8 	and administration of human services, enforce compliance with statutes, rules, federal laws, 
90.9 	regulations, and policies governing welfare services and promote excellence of administration 
90.10 	and program operation;
90.11 	(3) develop a quality control program or other monitoring program to review county 
90.12 	performance and accuracy of benefit determinations;
90.13 	(4) require county agencies to make an adjustment to the public assistance benefits issued 
90.14 	to any individual consistent with federal law and regulation and state law and rule and to 
90.15 	issue or recover benefits as appropriate;
90.16 	(5) delay or deny payment of all or part of the state and federal share of benefits and 
90.17 	administrative reimbursement according to the procedures set forth in section 256.017;
90.18 	(6) make contracts with and grants to public and private agencies and organizations, 
90.19 	both profit and nonprofit, and individuals, using appropriated funds; and
90.20 	(7) enter into contractual agreements with federally recognized Indian Tribes with a 
90.21 	reservation in Minnesota to the extent necessary for the Tribe to operate a federally approved 
90.22 	family assistance program or any other program under the supervision of the commissioner. 
90.23 	The commissioner shall consult with the affected county or counties in the contractual 
90.24 	agreement negotiations, if the county or counties wish to be included, in order to avoid the 
90.25 	duplication of county and Tribal assistance program services. The commissioner may 
90.26 	establish necessary accounts for the purposes of receiving and disbursing funds as necessary 
90.27 	for the operation of the programs.
90.28 	The commissioner shall work in conjunction with the commissioner of children, youth, and 
90.29 	families to carry out the duties of this paragraph when necessary and feasible.
90.30 	(b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law, 
90.31 	regulation, and policy necessary to county agency administration of the programs.
90.32 	(c) Administer and supervise all noninstitutional service to persons with disabilities, 
90.33 	including persons who have vision impairments, and persons who are deaf, deafblind, and 
91.1 	hard-of-hearing or with other disabilities. The commissioner may provide and contract for 
91.2 	the care and treatment of qualified indigent children in facilities other than those located 
91.3 	and available at state hospitals operated by the executive board when it is not feasible to 
91.4 	provide the service in state hospitals operated by the executive board.
91.5 	(d) Assist and actively cooperate with other departments, agencies and institutions, local, 
91.6 	state, and federal, by performing services in conformity with the purposes of Laws 1939, 
91.7 	chapter 431.
91.8 	(e) Act as the agent of and cooperate with the federal government in matters of mutual 
91.9 	concern relative to and in conformity with the provisions of Laws 1939, chapter 431, 
91.10 	including the administration of any federal funds granted to the state to aid in the performance 
91.11 	of any functions of the commissioner as specified in Laws 1939, chapter 431, and including 
91.12 	the promulgation of rules making uniformly available medical care benefits to all recipients 
91.13 	of public assistance, at such times as the federal government increases its participation in 
91.14 	assistance expenditures for medical care to recipients of public assistance, the cost thereof 
91.15 	to be borne in the same proportion as are grants of aid to said recipients.
91.16 	(f) Establish and maintain any administrative units reasonably necessary for the 
91.17 	performance of administrative functions common to all divisions of the department.
91.18 	(g) Act as designated guardian of both the estate and the person of all the wards of the 
91.19 	state of Minnesota, whether by operation of law or by an order of court, without any further 
91.20 	act or proceeding whatever, except as to persons committed as developmentally disabled.
91.21 	(h) Act as coordinating referral and informational center on requests for service for 
91.22 	newly arrived immigrants coming to Minnesota.
91.23 	(i) The specific enumeration of powers and duties as hereinabove set forth shall in no 
91.24 	way be construed to be a limitation upon the general transfer of powers herein contained.
91.25 	(j) Establish county, regional, or statewide schedules of maximum fees and charges 
91.26 	which may be paid by county agencies for medical, dental, surgical, hospital, nursing and 
91.27 	nursing home care and medicine and medical supplies under all programs of medical care 
91.28 	provided by the state and for congregate living care under the income maintenance programs.
91.29 	(k) Have the authority to conduct and administer experimental projects to test methods 
91.30 	and procedures of administering assistance and services to recipients or potential recipients 
91.31 	of public welfare. To carry out such experimental projects, it is further provided that the 
91.32 	commissioner of human services is authorized to waive the enforcement of existing specific 
91.33 	statutory program requirements, rules, and standards in one or more counties. The order 
92.1 	establishing the waiver shall provide alternative methods and procedures of administration, 
92.2 	shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and 
92.3 	in no event shall the duration of a project exceed four years. It is further provided that no 
92.4 	order establishing an experimental project as authorized by the provisions of this section 
92.5 	shall become effective until the following conditions have been met:
92.6 	(1) the United States Secretary of Health and Human Services has agreed, for the same 
92.7 	project, to waive state plan requirements relative to statewide uniformity; and
92.8 	(2) a comprehensive plan, including estimated project costs, shall be approved by the 
92.9 	Legislative Advisory Commission and filed with the commissioner of administration.
92.10 	(l) According to federal requirements and in coordination with the commissioner of 
92.11 	children, youth, and families, establish procedures to be followed by local welfare boards 
92.12 	in creating citizen advisory committees, including procedures for selection of committee 
92.13 	members.
92.14 	(m) Allocate federal fiscal disallowances or sanctions which are based on quality control 
92.15 	error rates for medical assistance in the following manner:
92.16 	(1) one-half of the total amount of the disallowance shall be borne by the county boards 
92.17 	responsible for administering the programs. Disallowances shall be shared by each county 
92.18 	board in the same proportion as that county's expenditures for the sanctioned program are 
92.19 	to the total of all counties' expenditures for medical assistance. Each county shall pay its 
92.20 	share of the disallowance to the state of Minnesota. When a county fails to pay the amount 
92.21 	due hereunder, the commissioner may deduct the amount from reimbursement otherwise 
92.22 	due the county, or the attorney general, upon the request of the commissioner, may institute 
92.23 	civil action to recover the amount due; and
92.24 	(2) notwithstanding the provisions of clause (1), if the disallowance results from knowing 
92.25 	noncompliance by one or more counties with a specific program instruction, and that knowing 
92.26 	noncompliance is a matter of official county board record, the commissioner may require 
92.27 	payment or recover from the county or counties, in the manner prescribed in clause (1), an 
92.28 	amount equal to the portion of the total disallowance which resulted from the noncompliance, 
92.29 	and may distribute the balance of the disallowance according to clause (1).
92.30 	(n) Develop and implement special projects that maximize reimbursements and result 
92.31 	in the recovery of money to the state. For the purpose of recovering state money, the 
92.32 	commissioner may enter into contracts with third parties. Any recoveries that result from 
92.33 	projects or contracts entered into under this paragraph shall be deposited in the state treasury 
92.34 	and credited to a special account until the balance in the account reaches $1,000,000. When 
93.1 	the balance in the account exceeds $1,000,000, the excess shall be transferred and credited 
93.2 	to the general fund. All money in the account is appropriated to the commissioner for the 
93.3 	purposes of this paragraph.
93.4 	(o) Have the authority to establish and enforce the following county reporting 
93.5 	requirements:
93.6 	(1) the commissioner shall establish fiscal and statistical reporting requirements necessary 
93.7 	to account for the expenditure of funds allocated to counties for human services programs. 
93.8 	When establishing financial and statistical reporting requirements, the commissioner shall 
93.9 	evaluate all reports, in consultation with the counties, to determine if the reports can be 
93.10 	simplified or the number of reports can be reduced;
93.11 	(2) the county board shall submit monthly or quarterly reports to the department as 
93.12 	required by the commissioner. Monthly reports are due no later than 15 working days after 
93.13 	the end of the month. Quarterly reports are due no later than 30 calendar days after the end 
93.14 	of the quarter, unless the commissioner determines that the deadline must be shortened to 
93.15 	20 calendar days to avoid jeopardizing compliance with federal deadlines or risking a loss 
93.16 	of federal funding. Only reports that are complete, legible, and in the required format shall 
93.17 	be accepted by the commissioner;
93.18 	(3) if the required reports are not received by the deadlines established in clause (2), the 
93.19 	commissioner may delay payments and withhold funds from the county board until the next 
93.20 	reporting period. When the report is needed to account for the use of federal funds and the 
93.21 	late report results in a reduction in federal funding, the commissioner shall withhold from 
93.22 	the county boards with late reports an amount equal to the reduction in federal funding until 
93.23 	full federal funding is received;
93.24 	(4) a county board that submits reports that are late, illegible, incomplete, or not in the 
93.25 	required format for two out of three consecutive reporting periods is considered 
93.26 	noncompliant. When a county board is found to be noncompliant, the commissioner shall 
93.27 	notify the county board of the reason the county board is considered noncompliant and 
93.28 	request that the county board develop a corrective action plan stating how the county board 
93.29 	plans to correct the problem. The corrective action plan must be submitted to the 
93.30 	commissioner within 45 days after the date the county board received notice of 
93.31 	noncompliance;
93.32 	(5) the final deadline for fiscal reports or amendments to fiscal reports is one year after 
93.33 	the date the report was originally due. If the commissioner does not receive a report by the 
93.34 	final deadline, the county board forfeits the funding associated with the report for that 
94.1 	reporting period and the county board must repay any funds associated with the report 
94.2 	received for that reporting period;
94.3 	(6) the commissioner may not delay payments, withhold funds, or require repayment 
94.4 	under clause (3) or (5) if the county demonstrates that the commissioner failed to provide 
94.5 	appropriate forms, guidelines, and technical assistance to enable the county to comply with 
94.6 	the requirements. If the county board disagrees with an action taken by the commissioner 
94.7 	under clause (3) or (5), the county board may appeal the action according to sections 14.57 
94.8 	to 14.69; and
94.9 	(7) counties subject to withholding of funds under clause (3) or forfeiture or repayment 
94.10 	of funds under clause (5) shall not reduce or withhold benefits or services to clients to cover 
94.11 	costs incurred due to actions taken by the commissioner under clause (3) or (5).
94.12 	(p) Allocate federal fiscal disallowances or sanctions for audit exceptions when federal 
94.13 	fiscal disallowances or sanctions are based on a statewide random sample in direct proportion 
94.14 	to each county's claim for that period.
94.15 	(q) Be responsible for ensuring the detection, prevention, investigation, and resolution 
94.16 	of fraudulent activities or behavior by applicants, recipients, and other participants in the 
94.17 	human services programs administered by the department, including but not limited to a 
94.18 	preenrollment risk assessment. A preenrollment risk assessment under this paragraph must 
94.19 	be conducted in accordance with the procedures and criteria established in section 256B.04, 
94.20 	subdivision 21a.
94.21 	(r) Require county agencies to identify overpayments, establish claims, and utilize all 
94.22 	available and cost-beneficial methodologies to collect and recover these overpayments in 
94.23 	the human services programs administered by the department.
94.24 	(s) Have the authority to administer the federal drug rebate program for drugs purchased 
94.25 	under the medical assistance program as allowed by section 1927 of title XIX of the Social 
94.26 	Security Act and according to the terms and conditions of section 1927. Rebates shall be 
94.27 	collected for all drugs that have been dispensed or administered in an outpatient setting and 
94.28 	that are from manufacturers who have signed a rebate agreement with the United States 
94.29 	Department of Health and Human Services.
94.30 	(t) Have the authority to administer a supplemental drug rebate program for drugs 
94.31 	purchased under the medical assistance program. The commissioner may enter into 
94.32 	supplemental rebate contracts with pharmaceutical manufacturers and may require prior 
94.33 	authorization for drugs that are from manufacturers that have not signed a supplemental 
95.1 	rebate contract. Prior authorization of drugs shall be subject to the provisions of section 
95.2 	256B.0625, subdivision 13.
95.3 	(u) Operate the department's communication systems account established in Laws 1993, 
95.4 	First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared 
95.5 	communication costs necessary for the operation of the programs the commissioner 
95.6 	supervises. Each account must be used to manage shared communication costs necessary 
95.7 	for the operations of the programs the commissioner supervises. The commissioner may 
95.8 	distribute the costs of operating and maintaining communication systems to participants in 
95.9 	a manner that reflects actual usage. Costs may include acquisition, licensing, insurance, 
95.10 	maintenance, repair, staff time and other costs as determined by the commissioner. Nonprofit 
95.11 	organizations and state, county, and local government agencies involved in the operation 
95.12 	of programs the commissioner supervises may participate in the use of the department's 
95.13 	communications technology and share in the cost of operation. The commissioner may 
95.14 	accept on behalf of the state any gift, bequest, devise or personal property of any kind, or 
95.15 	money tendered to the state for any lawful purpose pertaining to the communication activities 
95.16 	of the department. Any money received for this purpose must be deposited in the department's 
95.17 	communication systems accounts. Money collected by the commissioner for the use of 
95.18 	communication systems must be deposited in the state communication systems account and 
95.19 	is appropriated to the commissioner for purposes of this section.
95.20 	(v) Receive any federal matching money that is made available through the medical 
95.21 	assistance program for the consumer satisfaction survey. Any federal money received for 
95.22 	the survey is appropriated to the commissioner for this purpose. The commissioner may 
95.23 	expend the federal money received for the consumer satisfaction survey in either year of 
95.24 	the biennium.
95.25 	(w) Designate community information and referral call centers and incorporate cost 
95.26 	reimbursement claims from the designated community information and referral call centers 
95.27 	into the federal cost reimbursement claiming processes of the department according to 
95.28 	federal law, rule, and regulations. Existing information and referral centers provided by 
95.29 	Greater Twin Cities United Way or existing call centers for which Greater Twin Cities 
95.30 	United Way has legal authority to represent, shall be included in these designations upon 
95.31 	review by the commissioner and assurance that these services are accredited and in 
95.32 	compliance with national standards. Any reimbursement is appropriated to the commissioner 
95.33 	and all designated information and referral centers shall receive payments according to 
95.34 	normal department schedules established by the commissioner upon final approval of 
96.1 	allocation methodologies from the United States Department of Health and Human Services 
96.2 	Division of Cost Allocation or other appropriate authorities.
96.3 	(x) Develop recommended standards for adult foster care homes that address the 
96.4 	components of specialized therapeutic services to be provided by adult foster care homes 
96.5 	with those services.
96.6 	(y) Authorize the method of payment to or from the department as part of the human 
96.7 	services programs administered by the department. This authorization includes the receipt 
96.8 	or disbursement of funds held by the department in a fiduciary capacity as part of the human 
96.9 	services programs administered by the department.
96.10 	(z) Designate the agencies that operate the Senior LinkAge Line under section 256.975, 
96.11 	subdivision 7, and the Disability Hub under subdivision 24 as the state of Minnesota Aging 
96.12 	and Disability Resource Center under United States Code, title 42, section 3001, the Older 
96.13 	Americans Act Amendments of 2006, and incorporate cost reimbursement claims from the 
96.14 	designated centers into the federal cost reimbursement claiming processes of the department 
96.15 	according to federal law, rule, and regulations. Any reimbursement must be appropriated 
96.16 	to the commissioner and treated consistent with section 256.011. All Aging and Disability 
96.17 	Resource Center designated agencies shall receive payments of grant funding that supports 
96.18 	the activity and generates the federal financial participation according to Board on Aging 
96.19 	administrative granting mechanisms.

96.20 	Sec. 4. Minnesota Statutes 2025 Supplement, section 256B.04, subdivision 21, is amended 
96.21 	to read:
96.22 		Subd. 21.Provider enrollment. (a) The commissioner shall enroll providers and conduct 
96.23 	screening activities as required by Code of Federal Regulations, title 42, section 455, subpart 
96.24 	E. A provider must enroll each provider-controlled location where direct services are 
96.25 	provided. The commissioner may deny a provider's incomplete application if a provider 
96.26 	fails to respond to the commissioner's request for additional information within 60 days of 
96.27 	the request. The commissioner must conduct a background study under chapter 245C, 
96.28 	including a review of databases in section 245C.08, subdivision 1, paragraph (a), clauses 
96.29 	(1) to (5), for a provider described in this paragraph. The background study requirement 
96.30 	may be satisfied if the commissioner conducted a fingerprint-based background study on 
96.31 	the provider that includes a review of databases in section 245C.08, subdivision 1, paragraph 
96.32 	(a), clauses (1) to (5).
96.33 	(b) The commissioner shall revalidate:
97.1 	(1) each provider under this subdivision at least once every five years;
97.2 	(2) each personal care assistance agency, CFSS provider-agency, and CFSS financial 
97.3 	management services provider under this subdivision at least once every three years;
97.4 	(3) each EIDBI agency under this subdivision at least once every three years; and
97.5 	(4) at the commissioner's discretion, any medical-assistance-only provider type the 
97.6 	commissioner deems "high-risk" under this subdivision.
97.7 	(c) The commissioner shall conduct revalidation as follows:
97.8 	(1) provide 30-day notice of the revalidation due date including instructions for 
97.9 	revalidation and a list of materials the provider must submit; and
97.10 	(2) if a provider fails to submit all required materials by the due date, notify the provider 
97.11 	of the deficiency within 30 days after the due date and allow the provider an additional 30 
97.12 	days from the notification date to comply; and
97.13 	(3) (2) if a provider fails to respond or remedy a deficiency within the 30-day time period, 
97.14 	give 60-day notice of termination and immediately suspend the provider's ability to bill. 
97.15 	The provider does not have the right to appeal suspension of ability to bill.
97.16 	(d) If a provider fails to comply with any individual provider requirement or condition 
97.17 	of participation, the commissioner may suspend the provider's ability to bill until the provider 
97.18 	comes into compliance. The commissioner's decision to suspend the provider is not subject 
97.19 	to an administrative appeal.
97.20 	(e) Correspondence and notifications, including notifications of termination and other 
97.21 	actions, may be delivered electronically to a provider's MN-ITS mailbox. This paragraph 
97.22 	does not apply to correspondences and notifications related to background studies.
97.23 	(f) If the commissioner or the Centers for Medicare and Medicaid Services determines 
97.24 	that a provider is designated "high-risk," the commissioner may withhold payment from 
97.25 	providers within that category upon initial enrollment for a 90-day period. The withholding 
97.26 	for each provider must begin on the date of the first submission of a claim.
97.27 	(g) An enrolled provider that is also licensed by the commissioner under chapter 245A, 
97.28 	is licensed as a home care provider by the Department of Health under chapter 144A, or is 
97.29 	licensed as an assisted living facility under chapter 144G and has a home and 
97.30 	community-based services designation on the home care license under section 144A.484, 
97.31 	must designate an individual as the entity's compliance officer. The compliance officer 
97.32 	must:
98.1 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
98.2 	regulations and to prevent inappropriate claims submissions;
98.3 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
98.4 	provider entity including billers, on the policies and procedures under clause (1);
98.5 	(3) respond to allegations of improper conduct related to the provision or billing of 
98.6 	medical assistance services, and implement action to remediate any resulting problems;
98.7 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
98.8 	regulations;
98.9 	(5) promptly report to the commissioner any identified violations of medical assistance 
98.10 	laws or regulations; and
98.11 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
98.12 	overpayment, report the overpayment to the commissioner and make arrangements with 
98.13 	the commissioner for the commissioner's recovery of the overpayment.
98.14 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
98.15 	provider within a particular industry sector or category establish a compliance program that 
98.16 	contains the core elements established by the Centers for Medicare and Medicaid Services.
98.17 	(h) The commissioner may revoke the enrollment of an ordering or rendering provider 
98.18 	for a period of not more than one year, if the provider fails to maintain and, upon request 
98.19 	from the commissioner, provide access to documentation relating to written orders or requests 
98.20 	for payment for durable medical equipment, certifications for home health services, or 
98.21 	referrals for other items or services written or ordered by such provider, when the 
98.22 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
98.23 	to maintain documentation or provide access to documentation on more than one occasion. 
98.24 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
98.25 	under the provisions of section 256B.064.
98.26 	(i) The commissioner shall terminate or deny the enrollment of any individual or entity 
98.27 	if the individual or entity has been terminated from participation in Medicare or under the 
98.28 	Medicaid program or Children's Health Insurance Program of any other state. The 
98.29 	commissioner may exempt a rehabilitation agency from termination or denial that would 
98.30 	otherwise be required under this paragraph, if the agency:
98.31 	(1) is unable to retain Medicare certification and enrollment solely due to a lack of billing 
98.32 	to the Medicare program;
99.1 	(2) meets all other applicable Medicare certification requirements based on an on-site 
99.2 	review completed by the commissioner of health; and
99.3 	(3) serves primarily a pediatric population.
99.4 	(j) As a condition of enrollment in medical assistance, the commissioner shall require 
99.5 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
99.6 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
99.7 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
99.8 	designated contractors to conduct unannounced on-site inspections of any provider location. 
99.9 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
99.10 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
99.11 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
99.12 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
99.13 	The commissioner's designations are not subject to administrative appeal.
99.14 	(k) As a condition of enrollment in medical assistance, the commissioner shall require 
99.15 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
99.16 	provider of five percent or higher, consent to criminal background checks, including 
99.17 	fingerprinting, when required to do so under state law or by a determination by the 
99.18 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
99.19 	high-risk for fraud, waste, or abuse.
99.20 	(l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable 
99.21 	medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
99.22 	meeting the durable medical equipment provider and supplier definition in clause (3), 
99.23 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
99.24 	annually renewed and designates the Minnesota Department of Human Services as the 
99.25 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
99.26 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
99.27 	federally qualified health center, a home health agency, the Indian Health Service, a 
99.28 	pharmacy, and a rural health clinic.
99.29 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
99.30 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
99.31 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
99.32 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
99.33 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
99.34 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
100.1 	fees in pursuing a claim on the bond. Any action to obtain monetary recovery or sanctions 
100.2 	from a surety bond must occur within six years from the date the debt is affirmed by a final 
100.3 	agency decision. An agency decision is final when the right to appeal the debt has been 
100.4 	exhausted or the time to appeal has expired under section 256B.064.
100.5 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
100.6 	purchase medical equipment or supplies for sale or rental to the general public and is able 
100.7 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
100.8 	sale or rental.
100.9 	(m) The Department of Human Services may require a provider to purchase a surety 
100.10 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
100.11 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
100.12 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
100.13 	provider or category of providers is designated high-risk pursuant to paragraph (f) and as 
100.14 	per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an 
100.15 	amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
100.16 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
100.17 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
100.18 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
100.19 	maintains a surety bond under the requirements in section 256B.051, 256B.0659, 256B.0701, 
100.20 	or 256B.85.

100.21 	Sec. 5. Minnesota Statutes 2024, section 256B.04, is amended by adding a subdivision to 
100.22 	read:
100.23 		Subd. 21a.Preenrollment assessment. (a) Before enrolling a provider or agency, the 
100.24 	commissioner may complete a preenrollment risk assessment of the provider or agency 
100.25 	seeking to enroll to confirm the provider or agency's eligibility and the provider or agency's 
100.26 	ability to meet the requirements of this chapter.  The commissioner must utilize a risk-score 
100.27 	framework as a component of the assessment that identifies service-specific fraud risk 
100.28 	indicators, including but not limited to organizational readiness, financial stability, 
100.29 	compliance history, and addressing service necessity.
100.30 	(b) Based on the assessment of fraud risk indicators described in paragraph (a), the 
100.31 	commissioner may deem the applicant ineligible and deny or rescind enrollment. The 
100.32 	decision to deny or rescind enrollment must be made in writing and sent using a 
100.33 	signature-verified confirmed delivery method. An applicant may request reconsideration 
100.34 	of the decision regarding the applicant's eligibility in writing within 30 business days after 
101.1 	the date the notice was issued. The commissioner must notify each applicant of the 
101.2 	commissioner's final decision regarding the applicant's eligibility.
101.3 	(c) This subdivision is effective July 1, 2026. A provider enrolled before July 1, 2026, 
101.4 	that billed for services on or after January 1, 2025, must receive a positive preenrollment 
101.5 	risk assessment no later than July 1, 2027, to remain eligible. A provider or agency enrolled 
101.6 	before July 1, 2026, that has not billed for services on or after January 1, 2025, must receive 
101.7 	a positive preenrollment risk assessment no later than July 1, 2026, to remain eligible. A 
101.8 	provider that becomes ineligible under this paragraph regains eligibility after receiving a 
101.9 	positive assessment under this subdivision if the provider remains otherwise eligible.

101.10 	Sec. 6. [256B.0647] REMITTANCE ADVICE MONETARY RECOVERY.
101.11 	(a) The commissioner may use the remittance advice process under Code of Federal 
101.12 	Regulations, title 45, part 162.1601, as the notice to a vendor or provider when seeking 
101.13 	monetary recovery using a department-administered information technology system for 
101.14 	programmatically processed claims. The remittance advice must be delivered electronically 
101.15 	and constitutes the sole notice to the provider. The commissioner must withhold the payments 
101.16 	at issue when using the remittance advice as the notice.
101.17 	(b) Providers may seek reconsideration of a remittance under this section by mailing a 
101.18 	request to the commissioner.  The reconsideration request must be received no later than 30 
101.19 	calendar days from the posting of the remittance advice. A request for reconsideration does 
101.20 	not stay the withholding of payments.  The commissioner's disposition of a request for 
101.21 	reconsideration is final and not subject to appeal under chapter 14. The request for 
101.22 	reconsideration must include:
101.23 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
101.24 	involved for each disputed item;
101.25 	(2) the calculation that the individual or entity believes is correct;
101.26 	(3) the authority in statute or rule upon which the individual or entity relies for each 
101.27 	disputed item;
101.28 	(4) the name and address of the person or entity with whom contacts may be made 
101.29 	regarding the appeal; and
101.30 	(5) other information required by the commissioner.

102.1 	ARTICLE 4
102.2 	UNIFORM SERVICE STANDARDS

102.3 	Section 1. Minnesota Statutes 2024, section 245.735, subdivision 6, is amended to read:
102.4 		Subd. 6.Section 223 of the Protecting Access to Medicare Act entities. (a) The 
102.5 	commissioner must request federal approval to participate in the demonstration program 
102.6 	established by section 223 of the Protecting Access to Medicare Act and, if approved, to 
102.7 	continue to participate in the demonstration program as long as federal funding for the 
102.8 	demonstration program remains available from the United States Department of Health and 
102.9 	Human Services. To the extent practicable, the commissioner shall align the requirements 
102.10 	of the demonstration program with the requirements under this section for CCBHCs receiving 
102.11 	medical assistance reimbursement under the authority of the state's Medicaid state plan. A 
102.12 	CCBHC may not apply to participate as a billing provider in both the CCBHC federal 
102.13 	demonstration and the benefit for CCBHCs under the medical assistance program.
102.14 	(b) The commissioner must follow federal payment guidance, including payment of the 
102.15 	CCBHC daily bundled rate for services rendered by CCBHCs to individuals who are dually 
102.16 	eligible for Medicare and medical assistance when Medicare is the primary payer for the 
102.17 	service. Services provided by a CCBHC operating under the authority of the state's Medicaid 
102.18 	state plan will not receive the prospective payment system rate for services rendered by 
102.19 	CCBHCs to individuals who are dually eligible for Medicare and medical assistance when 
102.20 	Medicare is the primary payer for the service.
102.21 	(c) Payment for services rendered by CCBHCs to individuals who have commercial 
102.22 	insurance as the primary payer and medical assistance as secondary payer is subject to the 
102.23 	requirements under section 256B.37. Services provided by a CCBHC operating under the 
102.24 	authority of the 223 demonstration or the state's Medicaid state plan will not receive the 
102.25 	prospective payment system rate for services rendered by CCBHCs to individuals who have 
102.26 	commercial insurance as the primary payer and medical assistance as the secondary payer.

102.27 	Sec. 2. Minnesota Statutes 2025 Supplement, section 245A.03, subdivision 2, is amended 
102.28 	to read:
102.29 		Subd. 2.Exclusion from licensure. (a) This chapter does not apply to:
102.30 	(1) residential or nonresidential programs that are provided to a person by an individual 
102.31 	who is related;
102.32 	(2) nonresidential programs that are provided by an unrelated individual to persons from 
102.33 	a single related family;
103.1 	(3) residential or nonresidential programs that are provided to adults who do not misuse 
103.2 	substances or have a substance use disorder, a mental illness, a developmental disability, a 
103.3 	functional impairment, or a physical disability;
103.4 	(4) sheltered workshops or work activity programs that are certified by the commissioner 
103.5 	of employment and economic development;
103.6 	(5) programs operated by a public school for children 33 months or older;
103.7 	(6) nonresidential programs primarily for children that provide care or supervision for 
103.8 	periods of less than three hours a day while the child's parent or legal guardian is in the 
103.9 	same building as the nonresidential program or present within another building that is 
103.10 	directly contiguous to the building in which the nonresidential program is located;
103.11 	(7) nursing homes or hospitals licensed by the commissioner of health except as specified 
103.12 	under section 245A.02;
103.13 	(8) board and lodge facilities licensed by the commissioner of health that do not provide 
103.14 	children's residential services under Minnesota Rules, chapter 2960, mental health or 
103.15 	substance use disorder treatment;
103.16 	(9) programs licensed by the commissioner of corrections;
103.17 	(10) recreation programs for children or adults that are operated or approved by a park 
103.18 	and recreation board whose primary purpose is to provide social and recreational activities;
103.19 	(11) noncertified boarding care homes unless they provide services for five or more 
103.20 	persons whose primary diagnosis is mental illness or a developmental disability;
103.21 	(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art 
103.22 	programs, and nonresidential programs for children provided for a cumulative total of less 
103.23 	than 30 days in any 12-month period;
103.24 	(13) residential programs for persons with mental illness, that are located in hospitals;
103.25 	(14) camps licensed by the commissioner of health under Minnesota Rules, chapter 
103.26 	4630;
103.27 	(15) mental health outpatient services for adults with mental illness or children with 
103.28 	mental illness, except for programs under section 245A.044;
103.29 	(16) residential programs serving school-age children whose sole purpose is cultural or 
103.30 	educational exchange, until the commissioner adopts appropriate rules;
104.1 	(17) community support services programs as defined in section 245.462, subdivision 
104.2 	6, and family community support services as defined in section 245.4871, subdivision 17;
104.3 	(18) assisted living facilities licensed by the commissioner of health under chapter 144G;
104.4 	(19) substance use disorder treatment activities of licensed professionals in private 
104.5 	practice as defined in section 245G.01, subdivision 17;
104.6 	(20) consumer-directed community support service funded under the Medicaid waiver 
104.7 	for persons with developmental disabilities when the individual who provided the service 
104.8 	is:
104.9 	(i) the same individual who is the direct payee of these specific waiver funds or paid by 
104.10 	a fiscal agent, fiscal intermediary, or employer of record; and
104.11 	(ii) not otherwise under the control of a residential or nonresidential program that is 
104.12 	required to be licensed under this chapter when providing the service;
104.13 	(21) a county that is an eligible vendor under section 254B.0501 to provide care 
104.14 	coordination and comprehensive assessment services;
104.15 	(22) a recovery community organization that is an eligible vendor under section 
104.16 	254B.0501 to provide peer recovery support services; or
104.17 	(23) programs licensed by the commissioner of children, youth, and families in chapter 
104.18 	142B.
104.19 	(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a 
104.20 	building in which a nonresidential program is located if it shares a common wall with the 
104.21 	building in which the nonresidential program is located or is attached to that building by 
104.22 	skyway, tunnel, atrium, or common roof.
104.23 	(c) Except for the home and community-based services identified in section 245D.03, 
104.24 	subdivision 1, nothing in this chapter shall be construed to require licensure for any services 
104.25 	provided and funded according to an approved federal waiver plan where licensure is 
104.26 	specifically identified as not being a condition for the services and funding.

104.27 	EFFECTIVE DATE. This section is effective January 1, 2028.

104.28 	Sec. 3. [245A.044] LICENSED NONRESIDENTIAL BEHAVIORAL HEALTH 
104.29 	SERVICES.
104.30 		Subdivision 1.License required for certain nonresidential behavioral health 
104.31 	services.  (a) Beginning January 1, 2028, behavioral health service providers providing 
105.1 	mental health and substance use disorder services must obtain a license under this chapter 
105.2 	to provide:
105.3 	(1) adult rehabilitative mental health services under section 245I.22;
105.4 	(2) children's therapeutic services and supports in the community under section 245I.30 
105.5 	and children's day treatment under section 245I.31;
105.6 	(3) crisis response services under section 245I.24; and
105.7 	(4) certified community behavioral health clinic services under section 245I.17.
105.8 	(b) As a condition of licensure, an applicant or license holder must demonstrate and 
105.9 	maintain verification of compliance with:
105.10 	(1) licensing requirements under this chapter and chapter 245I; and
105.11 	(2) applicable health care program requirements under Minnesota Rules, parts 9505.0170 
105.12 	to 9505.0475 and 9505.2160 to 9505.2245.
105.13 		Subd. 2.Implementation. (a) Beginning July 1, 2027, the commissioner shall begin 
105.14 	issuing licenses to behavioral health service providers listed in subdivision 1. The 
105.15 	commissioner shall transition certified providers listed in subdivision 1 into licensure with 
105.16 	a phased-in schedule determined by the commissioner. The commissioner shall communicate 
105.17 	the schedule of implementation to providers certified under section 245I.011 at least three 
105.18 	months before the application is made available.
105.19 	(b) Applicants for licensure must have an approved certification under section 245I.011 
105.20 	at least 90 days before the date of application.
105.21 	(c) A provider's certification under section 245I.011, subdivision 5, paragraph (a), clauses 
105.22 	(2) to (4), or 6, paragraph (b), expires when the commissioner issues a decision on the 
105.23 	provider's license application.
105.24 	(d) Upon licensure, a license holder must notify clients and staff of policies and 
105.25 	procedures outlined in the application.
105.26 	(e) Notwithstanding paragraphs (a) and (c), subdivision 1, and sections 245I.17, 245I.22, 
105.27 	245I.24, 245I.30, and 245I.31, a provider listed under subdivision 1, paragraph (a), clauses 
105.28 	(1) to (4), and certified under section 245I.011 may continue operating past January 1, 2028, 
105.29 	until the commissioner issues a licensing decision if the provider submitted an application 
105.30 	before January 1, 2028.
106.1 	(f) The commissioner must disenroll a provider from reimbursement for nonresidential 
106.2 	behavioral health services under the following sections if the provider fails to submit an 
106.3 	application for licensure within the time frame in paragraph (b):
106.4 	(1) adult rehabilitative mental health services under section 256B.0623;
106.5 	(2) crisis response services under section 256B.0624;
106.6 	(3) children's therapeutic services and supports under section 256B.0943; and
106.7 	(4) certified community behavioral health clinics under section 256B.0625, subdivision 
106.8 	5m.
106.9 	(g) The commissioner must disenroll a provider listed in paragraph (f) from medical 
106.10 	assistance if:
106.11 	(1) the application has been denied or the license has been suspended or revoked; and
106.12 	(2) the provider appealed the application denial or the license suspension or revocation, 
106.13 	and the commissioner issued a final order on the appeal affirming the action.

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

106.15 	Sec. 4. Minnesota Statutes 2025 Supplement, section 245A.10, subdivision 3, is amended 
106.16 	to read:
106.17 		Subd. 3.Application fee for initial license or certification. (a) Except as provided in 
106.18 	paragraphs (c) and, (d), and (f), for fees required under subdivision 1, an applicant for an 
106.19 	initial license or certification issued by the commissioner shall submit a $2,100 application 
106.20 	fee with each new application required under this subdivision. The application fee shall not 
106.21 	be prorated, is nonrefundable, and is in lieu of the annual license or certification fee that 
106.22 	expires on December 31. The commissioner shall not process an application until the 
106.23 	application fee is paid.
106.24 	(b) Except as provided in paragraph (c), an applicant shall apply for a license to provide 
106.25 	services at a specific location.
106.26 	(c) For a license to provide home and community-based services to persons with 
106.27 	disabilities or age 65 and older under chapter 245D, an applicant shall submit an application 
106.28 	to provide services statewide. For fees required under subdivision 1, an applicant for an 
106.29 	initial license issued by the commissioner to provide home and community-based services 
106.30 	under chapter 245D shall submit a $4,200 application fee with each new application.
107.1 	(d) For fees required under subdivision 1, an applicant for an initial license or certification 
107.2 	issued by the commissioner for children's residential facility or mental health clinic licensure 
107.3 	or certification shall submit a $500 application fee with each new application required under 
107.4 	this subdivision.
107.5 	(e) For fees required under subdivision 1, an applicant for an initial certification issued 
107.6 	by the commissioner for mental health clinic certification shall submit a $2,100 application 
107.7 	fee with each new application required under this subdivision.
107.8 	(f) For fees required under subdivision 1, an applicant for an initial license issued by 
107.9 	the commissioner to provide services at a certified community behavioral health clinic under 
107.10 	section 245I.17 shall submit a $4,200 application fee with each new application.

107.11 	Sec. 5. Minnesota Statutes 2025 Supplement, section 245A.10, subdivision 4, is amended 
107.12 	to read:
107.13 		Subd. 4.License or certification fee for certain programs. (a)(1) A program licensed 
107.14 	to provide one or more of the home and community-based services and supports identified 
107.15 	under chapter 245D to persons with disabilities or age 65 and older, shall pay an annual 
107.16 	nonrefundable license fee based on revenues derived from the provision of services that 
107.17 	would require licensure under chapter 245D during the calendar year immediately preceding 
107.18 	the year in which the license fee is paid, according to the following schedule:

107.19	License Holder Annual Revenue
		License Fee
	
107.20	less than or equal to $10,000
		$250
	
107.21
107.22	greater than $10,000 but less than or 
equal to $25,000
		$375
	
107.23
107.24	greater than $25,000 but less than or 
equal to $50,000
		$500
	
107.25
107.26	greater than $50,000 but less than or 
equal to $100,000
		$625
	
107.27
107.28	greater than $100,000 but less than or 
equal to $150,000
		$750
	
107.29
107.30	greater than $150,000 but less than or 
equal to $200,000
		$1,000
	
107.31
107.32	greater than $200,000 but less than or 
equal to $250,000
		$1,250
	
107.33
107.34	greater than $250,000 but less than or 
equal to $300,000
		$1,500
	
107.35
107.36	greater than $300,000 but less than or 
equal to $350,000
		$1,750
	
107.37
107.38	greater than $350,000 but less than or 
equal to $400,000
		$2,000
	
108.1
108.2	greater than $400,000 but less than or 
equal to $450,000
		$2,250
	
108.3
108.4	greater than $450,000 but less than or 
equal to $500,000
		$2,500
	
108.5
108.6	greater than $500,000 but less than or 
equal to $600,000
		$2,850
	
108.7
108.8	greater than $600,000 but less than or 
equal to $700,000
		$3,200
	
108.9108.10
	greater than $700,000 but less than or 
equal to $800,000
		$3,600
	
108.11
108.12	greater than $800,000 but less than or 
equal to $900,000
		$3,900
	
108.13
108.14	greater than $900,000 but less than or 
equal to $1,000,000
		$4,250
	
108.15
108.16	greater than $1,000,000 but less than or 
equal to $1,250,000
		$4,550
	
108.17
108.18	greater than $1,250,000 but less than or 
equal to $1,500,000
		$4,900
	
108.19
108.20	greater than $1,500,000 but less than or 
equal to $1,750,000
		$5,200
	
108.21
108.22	greater than $1,750,000 but less than or 
equal to $2,000,000
		$5,500
	
108.23
108.24	greater than $2,000,000 but less than or 
equal to $2,500,000
		$5,900
	
108.25
108.26	greater than $2,500,000 but less than or 
equal to $3,000,000
		$6,200
	
108.27
108.28	greater than $3,000,000 but less than or 
equal to $3,500,000
		$6,500
	
108.29
108.30	greater than $3,500,000 but less than or 
equal to $4,000,000
		$7,200
	
108.31
108.32	greater than $4,000,000 but less than or 
equal to $4,500,000
		$7,800
	
108.33
108.34	greater than $4,500,000 but less than or 
equal to $5,000,000
		$9,000
	
108.35
108.36	greater than $5,000,000 but less than or 
equal to $7,500,000
		$10,000
	
108.37
108.38	greater than $7,500,000 but less than or 
equal to $10,000,000
		$14,000
	
108.39
108.40	greater than $10,000,000 but less than or 
equal to $12,500,000
		$18,000
	
108.41
108.42	greater than $12,500,000 but less than or 
equal to $15,000,000
		$25,000
	
108.43
108.44	greater than $15,000,000 but less than or 
equal to $17,500,000
		$28,000
	
108.45
108.46	greater than $17,500,000 but less than 
$20,000,000
		$32,000
	
109.1
109.2	greater than $20,000,000 but less than 
$25,000,000
		$36,000
	
109.3
109.4	greater than $25,000,000 but less than 
$30,000,000
		$45,000
	
109.5
109.6	greater than $30,000,000 but less than 
$35,000,000
		$55,000
	
109.7	greater than $35,000,000
		$75,000
	
109.8 	(2) If requested, the license holder shall provide the commissioner information to verify 
109.9 	the license holder's annual revenues or other information as needed, including copies of 
109.10 	documents submitted to the Department of Revenue.
109.11 	(3) At each annual renewal, a license holder may elect to pay the highest renewal fee, 
109.12 	and not provide annual revenue information to the commissioner.
109.13 	(4) A license holder that knowingly provides the commissioner incorrect revenue amounts 
109.14 	for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount 
109.15 	of double the fee the provider should have paid.
109.16 	(b) A substance use disorder treatment program licensed under chapter 245G, to provide 
109.17 	substance use disorder treatment shall pay an annual nonrefundable license fee based on 
109.18 	the following schedule:

109.19		Licensed Capacity
	License Fee
	
109.20		1 to 24 persons
	$2,600
	
109.21		25 to 49 persons
	$3,000
	
109.22		50 to 74 persons
	$5,000
	
109.23		75 to 99 persons
	$10,000
	
109.24		100  to 199 persons
	$15,000
	
109.25		200 or more persons
	$20,000
	
109.26 	(c) A detoxification program licensed under Minnesota Rules, parts 9530.6510 to 
109.27 	9530.6590, or a withdrawal management program licensed under chapter 245F shall pay 
109.28 	an annual nonrefundable license fee based on the following schedule:

109.29		Licensed Capacity
	License Fee
	
109.30		1 to 24 persons
	$2,600
	
109.31		25 to 49 persons
	$3,000
	
109.32		50 or more persons
	$5,000
	
109.33 	A detoxification program that also operates a withdrawal management program at the same 
109.34 	location shall only pay one fee based upon the licensed capacity of the program with the 
109.35 	higher overall capacity.
110.1 	(d) A children's residential facility licensed under Minnesota Rules, chapter 2960, to 
110.2 	serve children shall pay an annual nonrefundable license fee based on the following schedule:

110.3		Licensed Capacity
	License Fee
	
110.4		1 to 24 persons
	$1,000
	
110.5		25 to 49 persons
	$1,100
	
110.6		50 to 74 persons
	$1,200
	
110.7		75 to 99 persons
	$1,300
	
110.8		100 or more persons
	$1,400
	
110.9 	(e) A residential facility licensed under section 245I.23 or Minnesota Rules, parts 
110.10 	9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual 
110.11 	nonrefundable license fee based on the following schedule:

110.12		Licensed Capacity
	License Fee
	
110.13		1 to 24 persons
	$2,600
	
110.14		25  to 49 persons
	$3,000
	
110.15		50 or more persons
	$20,000
	
110.16 	(f) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400, 
110.17 	to serve persons with physical disabilities shall pay an annual nonrefundable license fee 
110.18 	based on the following schedule:

110.19		Licensed Capacity
	License Fee
	
110.20		1 to 24 persons
	$450
	
110.21		25 to 49 persons
	$650
	
110.22		50 to 74 persons
	$850
	
110.23		75 to 99 persons
	$1,050
	
110.24		100 or more persons
	$1,250
	
110.25 	(g) A program licensed as an adult day care center licensed under Minnesota Rules, 
110.26 	parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the 
110.27 	following schedule:

110.28		Licensed Capacity
	License Fee
	
110.29		1 to 24 persons
	$2,600
	
110.30		25 to 49 persons
	$3,000
	
110.31		50 to 74 persons
	$5,000
	
110.32		75 to 99 persons
	$10,000
	
110.33		100  to 199 persons
	$15,000
	
110.34		200 or more persons
	$20,000
	
111.1 	(h) A program licensed to provide treatment services to persons with sexual psychopathic 
111.2 	personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to 
111.3 	9515.3110, shall pay an annual nonrefundable license fee of $20,000.
111.4 	(i) A mental health clinic certified under section 245I.20 shall pay an annual 
111.5 	nonrefundable certification fee of $1,550 $3,000. If the mental health clinic provides services 
111.6 	at a primary location with satellite facilities, the satellite facilities shall be certified with the 
111.7 	primary location without an additional charge.
111.8 	(j) If a program subject to annual fees under paragraph (b) provides services at a primary 
111.9 	location with satellite facilities, the satellite facilities must be licensed with the primary 
111.10 	location and must be subject to an additional $500 annual nonrefundable license fee per 
111.11 	satellite facility.
111.12 	(j) A program licensed to provide behavioral health treatment services licensed under 
111.13 	section 245I.22, 245I.24, 245I.30, or 245I.31 shall pay an annual nonrefundable license fee 
111.14 	of $3,000 for each license.
111.15 	(k) Certified community behavioral health clinics licensed under section 245I.17 shall 
111.16 	pay an annual nonrefundable license fee of $7,800.

111.17 	Sec. 6. Minnesota Statutes 2024, section 245A.10, is amended by adding a subdivision to 
111.18 	read:
111.19 		Subd. 4a.Fees for satellite locations. (a) If a program subject to annual fees under 
111.20 	subdivision 4, paragraph (b), provides services at a primary location with satellite facilities, 
111.21 	the satellite facilities are licensed with the primary location and are subject to an additional 
111.22 	$500 annual nonrefundable license fee per satellite facility.
111.23 	(b) If a program subject to annual fees under subdivision 4, paragraph (j), provides 
111.24 	services at a primary location with satellite sites or facilities, the satellite locations must be 
111.25 	licensed with the primary location and shall pay an additional annual nonrefundable fee 
111.26 	according to the following schedule:
111.27 	(1) one to five satellite locations: $1,500;
111.28 	(2) six to 19 satellite locations: $3,500; or
111.29 	(3) 20 or more satellite locations: $5,000.

112.1 	Sec. 7. Minnesota Statutes 2024, section 245A.65, subdivision 1a, is amended to read:
112.2 		Subd. 1a.Determination of vulnerable adult status. (a) A license holder that provides 
112.3 	services to adults who are excluded from the definition of vulnerable adult under section 
112.4 	626.5572, subdivision 21, paragraph (a), clause (2), must determine whether the person is 
112.5 	a vulnerable adult under section 626.5572, subdivision 21, paragraph (a), clause (4). This 
112.6 	determination must be made within 24 hours of:
112.7 	(1) admission to the licensed program; and
112.8 	(2) any incident that:
112.9 	(i) was reported under section 626.557; or
112.10 	(ii) would have been required to be reported under section 626.557, if one or more of 
112.11 	the adults involved in the incident had been vulnerable adults.
112.12 	(b) Upon determining that a person receiving services is a vulnerable adult under section 
112.13 	626.5572, subdivision 21, paragraph (a), clause (4), all requirements relative to vulnerable 
112.14 	adults under this chapter and section 626.557 must be met by the license holder.
112.15 	(c) Notwithstanding paragraph (a), clause (1), a license holder providing mobile crisis 
112.16 	services must make a determination within 24 hours of first receiving crisis stabilization 
112.17 	services under section 245I.24, subdivision 9.

112.18 	Sec. 8. Minnesota Statutes 2024, section 245C.03, subdivision 1, is amended to read:
112.19 		Subdivision 1. Programs licensed by the commissioner. (a) The commissioner shall 
112.20 	conduct a background study on:
112.21 	(1) the person or persons applying for a license;
112.22 	(2) an individual age 13 and over living in the household where the licensed program 
112.23 	will be provided who is not receiving licensed services from the program;
112.24 	(3) current or prospective employees of the applicant or license holder who will have 
112.25 	direct contact with persons served by the facility, agency, or program;
112.26 	(4) volunteers or student volunteers who will have direct contact with persons served 
112.27 	by the program to provide program services if the contact is not under the continuous, direct 
112.28 	supervision by an individual listed in clause (1) or (3);
112.29 	(5) an individual age ten to 12 living in the household where the licensed services will 
112.30 	be provided when the commissioner has reasonable cause as defined in section 245C.02, 
112.31 	subdivision 15;
113.1 	(6) an individual who, without providing direct contact services at a licensed program, 
113.2 	may have unsupervised access to children or vulnerable adults receiving services from a 
113.3 	program, when the commissioner has reasonable cause as defined in section 245C.02, 
113.4 	subdivision 15; and
113.5 	(7) all controlling individuals as defined in section 245A.02, subdivision 5a;
113.6 	(8) notwithstanding clause (3), for children's residential facilities and foster residence 
113.7 	settings, any adult working in the facility, whether or not the individual will have direct 
113.8 	contact with persons served by the facility.
113.9 	(b) For child foster care when the license holder resides in the home where foster care 
113.10 	services are provided, a short-term substitute caregiver providing direct contact services for 
113.11 	a child for less than 72 hours of continuous care is not required to receive a background 
113.12 	study under this chapter.
113.13 	(c) This subdivision applies to the following programs that must be licensed under 
113.14 	chapter 245A:
113.15 	(1) adult foster care;
113.16 	(2) children's residential facilities;
113.17 	(3) licensed home and community-based services under chapter 245D;
113.18 	(4) residential mental health programs for adults;
113.19 	(5) substance use disorder treatment programs under chapter 245G;
113.20 	(6) withdrawal management programs under chapter 245F;
113.21 	(7) adult day care centers;
113.22 	(8) family adult day services;
113.23 	(9) detoxification programs;
113.24 	(10) community residential settings;
113.25 	(11) intensive residential treatment services and residential crisis stabilization under 
113.26 	chapter 245I; and
113.27 	(12) treatment programs for persons with sexual psychopathic personality or sexually 
113.28 	dangerous persons, licensed under chapter 245A and according to Minnesota Rules, parts 
113.29 	9515.3000 to 9515.3110.;
113.30 	(13) adult rehabilitative mental health services under chapter 245I;
114.1 	(14) certified community behavioral health clinic services under chapter 245I;
114.2 	(15) children's therapeutic services and supports under chapter 245I; and
114.3 	(16) crisis response services under chapter 245I.

114.4 	Sec. 9. Minnesota Statutes 2025 Supplement, section 245C.13, subdivision 2, is amended 
114.5 	to read:
114.6 		Subd. 2.Activities pending completion of background study. The subject of a 
114.7 	background study may not perform any activity requiring a background study under 
114.8 	paragraph (c) until the commissioner has issued one of the notices under paragraph (a).
114.9 	(a) Notices from the commissioner required prior to activity under paragraph (c) include:
114.10 	(1) a notice of the study results under section 245C.17 stating that:
114.11 	(i) the individual is not disqualified; or
114.12 	(ii) more time is needed to complete the study but the individual is not required to be 
114.13 	removed from direct contact or access to people receiving services prior to completion of 
114.14 	the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice 
114.15 	that more time is needed to complete the study must also indicate whether the individual is 
114.16 	required to be under continuous direct supervision prior to completion of the background 
114.17 	study. When more time is necessary to complete a background study of an individual 
114.18 	affiliated with a Title IV-E eligible children's residential facility or foster residence setting, 
114.19 	the individual may not work in the facility or setting regardless of whether or not the 
114.20 	individual is supervised;
114.21 	(2) a notice that a disqualification has been set aside under section 245C.23; or
114.22 	(3) a notice that a variance has been granted related to the individual under section 
114.23 	245C.30.
114.24 	(b) For a background study affiliated with a licensed child care center or certified 
114.25 	license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii), 
114.26 	must not be issued until the commissioner receives a qualifying result for the individual for 
114.27 	the fingerprint-based national criminal history record check or the fingerprint-based criminal 
114.28 	history information from the Bureau of Criminal Apprehension. The notice must require 
114.29 	the individual to be under continuous direct supervision prior to completion of the remainder 
114.30 	of the background study except as permitted in subdivision 3.
114.31 	(c) Activities prohibited prior to receipt of notice under paragraph (a) include:
115.1 	(1) being issued a license;
115.2 	(2) living in the household where the licensed program will be provided;
115.3 	(3) providing direct contact services to persons served by a program unless the subject 
115.4 	is under continuous direct supervision;
115.5 	(4) having access to persons receiving services if the background study was completed 
115.6 	under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2), 
115.7 	(5), or (6), unless the subject is under continuous direct supervision;
115.8 	(5) for licensed child care centers and certified license-exempt child care centers, 
115.9 	providing direct contact services to persons served by the program;
115.10 	(6) for children's residential facilities or foster residence settings, working in the facility 
115.11 	or setting;
115.12 	(7) for background studies affiliated with a personal care provider organization, except 
115.13 	as provided in section 245C.03, subdivision 3b, early intensive developmental and behavioral 
115.14 	intervention provider, or adult rehabilitative mental health services provider, before a 
115.15 	personal care assistant an individual provides services, the personal care assistance provider 
115.16 	agency entity must initiate a background study of the personal care assistant individual
115.17 	under this chapter and the personal care assistance provider agency entity must have received 
115.18 	a notice from the commissioner that the personal care assistant individual is:
115.19 	(i) not disqualified under section 245C.14; or
115.20 	(ii) disqualified, but the personal care assistant has received a set aside of the 
115.21 	disqualification under section 245C.22; or
115.22 	(8) for background studies affiliated with an early intensive developmental and behavioral 
115.23 	intervention provider, before an individual provides services, the early intensive 
115.24 	developmental and behavioral intervention provider must initiate a background study for 
115.25 	the individual under this chapter and the early intensive developmental and behavioral 
115.26 	intervention provider must have received a notice from the commissioner that the individual 
115.27 	is:
115.28 	(i) not disqualified under section 245C.14; or
115.29 	(ii) disqualified, but the individual has received a set-aside of the disqualification under 
115.30 	section 245C.22.

116.1 	Sec. 10. Minnesota Statutes 2025 Supplement, section 245C.16, subdivision 1, is amended 
116.2 	to read:
116.3 		Subdivision 1.Determining immediate risk of harm. (a) If the commissioner determines 
116.4 	that the individual studied has a disqualifying characteristic, the commissioner shall review 
116.5 	the information immediately available and make a determination as to the subject's immediate 
116.6 	risk of harm to persons served by the program where the individual studied will have direct 
116.7 	contact with, or access to, people receiving services.
116.8 	(b) The commissioner shall consider all relevant information available, including the 
116.9 	following factors in determining the immediate risk of harm:
116.10 	(1) the recency of the disqualifying characteristic;
116.11 	(2) the recency of discharge from probation for the crimes;
116.12 	(3) the number of disqualifying characteristics;
116.13 	(4) the intrusiveness or violence of the disqualifying characteristic;
116.14 	(5) the vulnerability of the victim involved in the disqualifying characteristic;
116.15 	(6) the similarity of the victim to the persons served by the program where the individual 
116.16 	studied will have direct contact;
116.17 	(7) whether the individual has a disqualification from a previous background study that 
116.18 	has not been set aside;
116.19 	(8) if the individual has a disqualification which may not be set aside because it is a 
116.20 	permanent bar under section 245C.24, subdivision 1, or the individual is a child care 
116.21 	background study subject who has a felony-level conviction for a drug-related offense in 
116.22 	the last five years, the commissioner may order the immediate removal of the individual 
116.23 	from any position allowing direct contact with, or access to, persons receiving services from 
116.24 	the program and from working in a children's residential facility or foster residence setting; 
116.25 	and
116.26 	(9) if the individual has a disqualification which may not be set aside because it is a 
116.27 	permanent bar under section 245C.24, subdivision 2, or the individual is a child care 
116.28 	background study subject who has a felony-level conviction for a drug-related offense during 
116.29 	the last five years, the commissioner may order the immediate removal of the individual 
116.30 	from any position allowing direct contact with or access to persons receiving services from 
116.31 	the center and from working in a licensed child care center or certified license-exempt child 
116.32 	care center.
117.1 	(c) This section does not apply when the subject of a background study is regulated by 
117.2 	a health-related licensing board as defined in chapter 214, and the subject is determined to 
117.3 	be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
117.4 	(d) This section does not apply to a background study related to an initial application 
117.5 	for a child foster family setting license.
117.6 	(e) Except for paragraph (f), this section does not apply to a background study that is 
117.7 	also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a 
117.8 	personal care assistant or a qualified professional as defined in section 256B.0659, 
117.9 	subdivision 1, or to a background study for an individual providing early intensive 
117.10 	developmental and behavioral intervention services under section 256B.0949 245C.13, 
117.11 	subdivision 2, paragraph (c), clause (7).
117.12 	(f) If the commissioner has reason to believe, based on arrest information or an active 
117.13 	maltreatment investigation, that an individual poses an imminent risk of harm to persons 
117.14 	receiving services, the commissioner may order that the person be continuously supervised 
117.15 	or immediately removed pending the conclusion of the maltreatment investigation or criminal 
117.16 	proceedings.

117.17 	Sec. 11. Minnesota Statutes 2024, section 245G.03, subdivision 1, is amended to read:
117.18 		Subdivision 1.License requirements. (a) An applicant for a license to provide substance 
117.19 	use disorder treatment must comply with the general requirements in section 626.557; 
117.20 	chapters 245A, 245C, and 260E; and Minnesota Rules, chapter 9544.
117.21 	(b) The commissioner may grant variances to the requirements in this chapter that do 
117.22 	not affect the client's health or safety if the conditions in section 245A.04, subdivision 9, 
117.23 	are met.
117.24 	(c) If a program is licensed according to this chapter and is part of a certified community 
117.25 	behavioral health clinic under section 245.735 245I.17, the license holder must comply with 
117.26 	the requirements in section 245.735 245I.17, subdivisions 4b to 4e 12 and 13, as part of the 
117.27 	licensing requirements under this chapter.

117.28 	Sec. 12. Minnesota Statutes 2024, section 245I.011, subdivision 3, is amended to read:
117.29 		Subd. 3.Certification required. (a) An individual, organization, or government entity 
117.30 	that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause 
117.31 	(12) (15), and chooses to be identified as a certified mental health clinic must:
117.32 	(1) be a mental health clinic that is certified under section 245I.20;
118.1 	(2) comply with all of the responsibilities assigned to a license holder by this chapter 
118.2 	except subdivision 1; and
118.3 	(3) comply with all of the responsibilities assigned to a certification holder by chapter 
118.4 	245A.
118.5 	(b) An individual, organization, or government entity described by this subdivision must 
118.6 	obtain a criminal background study for each staff person or volunteer who provides direct 
118.7 	contact services to clients.
118.8 	(c) If a clinic is certified according to this chapter and is part of a certified community 
118.9 	behavioral health clinic under section 245.735, the license holder must comply with the 
118.10 	requirements in section 245.735, subdivisions 4b to 4e, as part of the licensing requirements 
118.11 	under this chapter.

118.12 	EFFECTIVE DATE. This section is effective the day following final enactment, except 
118.13 	the amendment striking paragraph (c) is effective January 1, 2028.

118.14 	Sec. 13. Minnesota Statutes 2024, section 245I.011, subdivision 5, is amended to read:
118.15 		Subd. 5.Programs certified under chapter 256B. (a) An individual, organization, or 
118.16 	government entity certified under the following sections must comply with all of the 
118.17 	responsibilities assigned to a license holder under this chapter except subdivision 1:
118.18 	(1) an assertive community treatment provider under section 256B.0622, subdivision 
118.19 	3a;
118.20 	(2) an adult rehabilitative mental health services provider under section 256B.0623;
118.21 	(3) a mobile crisis team under section 256B.0624;
118.22 	(4) a children's therapeutic services and supports provider under section 256B.0943;
118.23 	(5) (2) a children's intensive behavioral health services provider under section 256B.0946; 
118.24 	and
118.25 	(6) (3) an intensive nonresidential rehabilitative mental health services provider under 
118.26 	section 256B.0947.
118.27 	(b) An individual, organization, or government entity certified under the sections listed 
118.28 	in paragraph (a), clauses (1) to (6), must obtain a criminal background study for each staff 
118.29 	person and volunteer providing direct contact services to a client.

118.30 	EFFECTIVE DATE. This section is effective January 1, 2028.

119.1 	Sec. 14. Minnesota Statutes 2024, section 245I.011, is amended by adding a subdivision 
119.2 	to read:
119.3 		Subd. 6.License required for nonresidential programs. (a) Beginning January 1, 
119.4 	2028, an individual, organization, or government entity must have a license under this 
119.5 	chapter to provide the following services:
119.6 	(1) adult rehabilitative mental health services, as defined in section 256B.0623;
119.7 	(2) mobile crisis services, as defined in section 256B.0624;
119.8 	(3) children's therapeutic services and supports, as defined in section 256B.0943; or
119.9 	(4) certified community behavioral health clinic services, as defined in sections 245I.17 
119.10 	and 256B.0625, subdivision 5m.
119.11 	(b) An individual, organization, or government entity certified as any of the following 
119.12 	programs shall remain certified according to subdivision 5 until the commissioner issues a 
119.13 	license, the commissioner denies the license application, or the certification expires according 
119.14 	to chapter 245A:
119.15 	(1) an adult rehabilitative mental health services provider under section 256B.0623;
119.16 	(2) a mobile crisis team under section 256B.0624;
119.17 	(3) a children's therapeutic services and supports provider under section 256B.0943; or
119.18 	(4) a certified community behavioral health clinic under section 245.735.

119.19 	Sec. 15. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision 
119.20 	to read:
119.21 		Subd. 1a.Alcohol and drug counselor "Alcohol and drug counselor" means an individual 
119.22 	qualified under section 245G.11, subdivision 5.

119.23 	Sec. 16. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision 
119.24 	to read:
119.25 		Subd. 10a.Comprehensive evaluation. "Comprehensive evaluation" means a 
119.26 	person-centered, family-centered, and trauma-informed evaluation conducted according to 
119.27 	section 245I.17, subdivision 12.

120.1 	Sec. 17. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision 
120.2 	to read:
120.3 		Subd. 18a.Initial evaluation. "Initial evaluation" means the assessment and preliminary 
120.4 	diagnosis necessary to begin client services and conducted according to section 245I.17.

120.5 	Sec. 18. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision 
120.6 	to read:
120.7 		Subd. 31a.Psychotherapy. "Psychotherapy" has the meaning given in section 256B.0671, 
120.8 	subdivision 11.

120.9 	Sec. 19. Minnesota Statutes 2024, section 245I.02, subdivision 33, is amended to read:
120.10 		Subd. 33.Rehabilitative mental health services. "Rehabilitative mental health services" 
120.11 	means mental health services provided to an adult a client that enable the client to develop 
120.12 	and achieve psychiatric stability, social competencies, personal and emotional adjustment, 
120.13 	independent living skills, family roles, and community skills when symptoms of mental 
120.14 	illness has impaired any of the client's abilities in these areas. Rehabilitation mental health 
120.15 	services include interventions that allow a client to self-monitor, compensate for, counteract, 
120.16 	or replace psychosocial skills deficits or maladaptive skills acquired over the course of a 
120.17 	mental illness. For a child client, rehabilitation includes intervention to restore a child or 
120.18 	adolescent to an age-appropriate developmental trajectory that had been disrupted by a 
120.19 	mental illness.

120.20 	Sec. 20. Minnesota Statutes 2024, section 245I.02, subdivision 39, is amended to read:
120.21 		Subd. 39.Treatment plan. "Treatment plan" means services that a license holder 
120.22 	formulates to respond to a client's needs and goals. A treatment plan includes individual 
120.23 	treatment plans under section 245I.10, subdivisions 7 and 8; initial treatment plans under 
120.24 	section 245I.23, subdivision 7; and crisis treatment plans under sections 245I.23, subdivision 
120.25 	8, and 256B.0624, subdivision 11. For a license holder under section 245I.17, treatment 
120.26 	plan refers to the integrated treatment plan developed according to section 245I.17, 
120.27 	subdivision 13.

120.28 	Sec. 21. Minnesota Statutes 2024, section 245I.03, subdivision 4, is amended to read:
120.29 		Subd. 4.Behavioral emergencies. (a) A license holder must have procedures that each 
120.30 	staff person follows when responding to a client who exhibits behavior that threatens the 
121.1 	immediate safety of the client or others. A license holder's behavioral emergency procedures 
121.2 	must incorporate person-centered planning and trauma-informed care.
121.3 	(b) A license holder's behavioral emergency procedures must include:
121.4 	(1) a plan designed to prevent the client from inflicting self-harm and harming others;
121.5 	(2) contact information for emergency resources that a staff person must use when the 
121.6 	license holder's behavioral emergency procedures are unsuccessful in controlling a client's 
121.7 	behavior;
121.8 	(3) the types of behavioral emergency procedures that a staff person may use;
121.9 	(4) the specific circumstances under which the program may use behavioral emergency 
121.10 	procedures; and
121.11 	(5) the staff persons whom the license holder authorizes to implement behavioral 
121.12 	emergency procedures.; and
121.13 	(6) the contact information for the local crisis team.
121.14 	(c) The license holder's behavioral emergency procedures must not include secluding 
121.15 	or restraining a client except as allowed under section 245.8261.
121.16 	(d) Staff persons must not use behavioral emergency procedures to enforce program 
121.17 	rules or for the convenience of staff persons. Behavioral emergency procedures must not 
121.18 	be part of any client's treatment plan. A staff person may not use behavioral emergency 
121.19 	procedures except in response to a client's current behavior that threatens the immediate 
121.20 	safety of the client or others.

121.21 	Sec. 22. Minnesota Statutes 2024, section 245I.03, is amended by adding a subdivision 
121.22 	to read:
121.23 		Subd. 11.Quality assurance and improvement plan. (a) At a minimum, a license 
121.24 	holder must develop a written quality assurance and improvement plan that includes plans 
121.25 	for:
121.26 	(1) encouraging ongoing consultation among members of the treatment team;
121.27 	(2) obtaining and evaluating feedback about services from clients, family and other 
121.28 	natural supports, referral sources, and staff persons;
121.29 	(3) measuring and evaluating client outcomes;
121.30 	(4) reviewing client suicide deaths and suicide attempts;
122.1 	(5) examining the quality of clinical service delivery to clients; and
122.2 	(6) self-monitoring of compliance with this chapter.
122.3 	(b) At least annually, a license holder must review, evaluate, and update the quality 
122.4 	assurance and improvement plan. The review must:
122.5 	(1) include documentation of the actions that the certification holder will take as a result 
122.6 	of information obtained from monitoring activities in the plan; and
122.7 	(2) establish goals for improved service delivery to clients for the next year.

122.8 	Sec. 23. Minnesota Statutes 2025 Supplement, section 245I.04, subdivision 5, is amended 
122.9 	to read:
122.10 		Subd. 5.Behavioral health practitioner scope of practice. (a) A behavioral health 
122.11 	practitioner under the treatment supervision of a mental health professional or certified 
122.12 	rehabilitation specialist may provide an adult client with client education, rehabilitative 
122.13 	mental health services, functional assessments, level of care assessments, crisis planning, 
122.14 	and treatment plans. A behavioral health practitioner under the treatment supervision of a 
122.15 	mental health professional may provide skill-building services to a child client, crisis 
122.16 	planning, and complete treatment plans for a child client.
122.17 	(b) A behavioral health practitioner must not provide treatment supervision to other staff 
122.18 	persons. A behavioral health practitioner may provide direction to mental health rehabilitation 
122.19 	workers and mental health behavioral aides.
122.20 	(c) A behavioral health practitioner who provides services to clients according to section 
122.21 	256B.0624 may perform crisis assessments and interventions for a client.

122.22 	Sec. 24. Minnesota Statutes 2025 Supplement, section 245I.04, subdivision 17, is amended 
122.23 	to read:
122.24 		Subd. 17.Mental health behavioral aide scope of practice. While under the treatment 
122.25 	supervision of a mental health professional, a mental health behavioral aide may practice 
122.26 	psychosocial skills with provide skill-building services to a child client according to the 
122.27 	child's treatment plan and individual behavior plan that a mental health professional, clinical 
122.28 	trainee, or behavioral health practitioner has previously taught to the child.

122.29 	Sec. 25. Minnesota Statutes 2024, section 245I.06, subdivision 1, is amended to read:
122.30 		Subdivision 1.Generally. (a) A license holder must ensure that a mental health 
122.31 	professional or certified rehabilitation specialist provides treatment supervision to each staff 
123.1 	person who provides services to a client and who is not a mental health professional or 
123.2 	certified rehabilitation specialist. When providing treatment supervision, a treatment 
123.3 	supervisor must follow a staff person's written treatment supervision plan.
123.4 	(b) Treatment supervision must focus on each client's treatment needs and the ability of 
123.5 	the staff person under treatment supervision to provide services to each client, including 
123.6 	the following topics related to the staff person's current caseload:
123.7 	(1) a review and evaluation of the interventions that the staff person delivers to each 
123.8 	client;
123.9 	(2) instruction on alternative strategies if a client is not achieving treatment goals;
123.10 	(3) a review and evaluation of each client's assessments, treatment plans, and progress 
123.11 	notes for accuracy and appropriateness;
123.12 	(4) instruction on the cultural norms or values of the clients and communities that the 
123.13 	license holder serves and the impact that a client's culture has on providing treatment;
123.14 	(5) evaluation of and feedback regarding a direct service staff person's areas of 
123.15 	competency; and
123.16 	(6) coaching, teaching, and practicing skills with a staff person.; and
123.17 	(7) modeling service practices that respect the recipient, include the recipient in planning 
123.18 	and implementation of the individual treatment plan, recognize the recipient's strengths, 
123.19 	and coordinate with other involved parties and providers.
123.20 	(c) A treatment supervisor must provide treatment supervision to a staff person using 
123.21 	methods that allow for immediate feedback, including in-person, telephone, and interactive 
123.22 	video supervision.
123.23 	(d) A treatment supervisor's responsibility for a staff person receiving treatment 
123.24 	supervision is limited to the services provided by the associated license holder. If a staff 
123.25 	person receiving treatment supervision is employed by multiple license holders, each license 
123.26 	holder is responsible for providing treatment supervision related to the treatment of the 
123.27 	license holder's clients.

123.28 	Sec. 26. Minnesota Statutes 2024, section 245I.06, subdivision 2, is amended to read:
123.29 		Subd. 2.Treatment supervision planning. (a) A treatment supervisor and the staff 
123.30 	person supervised by the treatment supervisor must develop a written treatment supervision 
123.31 	plan. The license holder must ensure that a new staff person's treatment supervision plan is 
123.32 	completed, approved by the staff person, and implemented by a treatment supervisor and 
124.1 	the new staff person within 30 days of the new staff person's first day of employment. The 
124.2 	license holder must review and update each staff person's treatment supervision plan annually.
124.3 	(b) Each staff person's treatment supervision plan must include:
124.4 	(1) the name and qualifications of the staff person receiving treatment supervision;
124.5 	(2) the names and licensures of the treatment supervisors who are supervising the staff 
124.6 	person;
124.7 	(3) how frequently the treatment supervisors must provide treatment supervision to the 
124.8 	staff person; and
124.9 	(4) the staff person's authorized scope of practice, including a description of the client 
124.10 	population ages that the staff person serves, and a description of the treatment methods and 
124.11 	modalities that the staff person may use to provide services to clients.

124.12 	Sec. 27. Minnesota Statutes 2024, section 245I.07, is amended to read:
124.13 	245I.07 PERSONNEL FILES.
124.14 	(a) For each staff person, a license holder must maintain a personnel file that includes:
124.15 	(1) verification of the staff person's qualifications required for the position including 
124.16 	training, education, practicum or internship agreement, licensure, and any other required 
124.17 	qualifications;
124.18 	(2) documentation related to the staff person's background study;
124.19 	(3) the hiring date of the staff person;
124.20 	(4) a description of the staff person's job responsibilities with the license holder;
124.21 	(5) the date that the staff person's specific duties and responsibilities became effective, 
124.22 	including the date that the staff person began having direct contact with clients;
124.23 	(6) documentation of the staff person's training as required by section 245I.05, subdivision 
124.24 	2;
124.25 	(7) a verification copy of license renewals that the staff person completed during the 
124.26 	staff person's employment;
124.27 	(8) annual job performance evaluations; and
124.28 	(9) if applicable, the staff person's alleged and substantiated violations of the license 
124.29 	holder's policies under section 245I.03, subdivision 8, clauses (3) to (7), and the license 
124.30 	holder's response.
125.1 	(b) The license holder must ensure that all personnel files are readily accessible for the 
125.2 	commissioner's review. The license holder is not required to keep personnel files in a single 
125.3 	location.
125.4 	(c) For a license holder under section 245I.17, a personnel file for staff who provide 
125.5 	substance use disorder treatment services must include records of training required under 
125.6 	section 245G.13, subdivision 2.

125.7 	Sec. 28. Minnesota Statutes 2024, section 245I.10, is amended by adding a subdivision 
125.8 	to read:
125.9 		Subd. 2a.Evaluation, treatment authorization, and planning in a certified community 
125.10 	behavioral health clinic. Notwithstanding subdivisions 2 and 7, a license holder under 
125.11 	section 245I.17 must meet the requirements of section 245I.17, subdivisions 11 and 12, for 
125.12 	assessments and section 245I.17, subdivision 13, for treatment planning. Service planning 
125.13 	and authorization for services delivered by a certified community behavioral health clinic 
125.14 	must be done pursuant to the standards in section 245I.17.

125.15 	Sec. 29. Minnesota Statutes 2024, section 245I.10, subdivision 6, is amended to read:
125.16 		Subd. 6.Standard diagnostic assessment; required elements. (a) Only a mental health 
125.17 	professional or a clinical trainee may complete a standard diagnostic assessment of a client. 
125.18 	A standard diagnostic assessment of a client must include a face-to-face interview with a 
125.19 	client and a written evaluation of the client. The assessor must complete a client's standard 
125.20 	diagnostic assessment within the client's cultural context. An alcohol and drug counselor 
125.21 	may gather and document the information in paragraphs (b) and (c) when completing a 
125.22 	comprehensive assessment according to section 245G.05.
125.23 	(b) When completing a standard diagnostic assessment of a client, the assessor must 
125.24 	gather and document information about the client's current life situation, including the 
125.25 	following information:
125.26 	(1) the client's age;
125.27 	(2) the client's current living situation, including the client's housing status and household 
125.28 	members;
125.29 	(3) the status of the client's basic needs;
125.30 	(4) the client's education level and employment status;
125.31 	(5) the client's current medications;
126.1 	(6) any immediate risks to the client's health and safety, including withdrawal symptoms, 
126.2 	medical conditions, and behavioral and emotional symptoms;
126.3 	(7) the client's perceptions of the client's condition;
126.4 	(8) the client's description of the client's symptoms, including the reason for the client's 
126.5 	referral;
126.6 	(9) the client's history of mental health and substance use disorder treatment;
126.7 	(10) cultural influences on the client; and
126.8 	(11) substance use history, if applicable, including:
126.9 	(i) amounts and types of substances, frequency and duration, route of administration, 
126.10 	periods of abstinence, and circumstances of relapse; and
126.11 	(ii) the impact to functioning when under the influence of substances, including legal 
126.12 	interventions.
126.13 	(c) If the assessor cannot obtain the information that this paragraph requires without 
126.14 	retraumatizing the client or harming the client's willingness to engage in treatment, the 
126.15 	assessor must identify which topics will require further assessment during the course of the 
126.16 	client's treatment. The assessor must gather and document information related to the following 
126.17 	topics:
126.18 	(1) the client's relationship with the client's family and other significant personal 
126.19 	relationships, including the client's evaluation of the quality of each relationship;
126.20 	(2) the client's strengths and resources, including the extent and quality of the client's 
126.21 	social networks;
126.22 	(3) important developmental incidents in the client's life;
126.23 	(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
126.24 	(5) the client's history of or exposure to alcohol and drug usage and treatment; and
126.25 	(6) the client's health history and the client's family health history, including the client's 
126.26 	physical, chemical, and mental health history.
126.27 	(d) When completing a standard diagnostic assessment of a client, an assessor must use 
126.28 	a recognized diagnostic framework.
126.29 	(1) When completing a standard diagnostic assessment of a client who is five years of 
126.30 	age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic 
127.1 	Classification of Mental Health and Development Disorders of Infancy and Early Childhood 
127.2 	published by Zero to Three.
127.3 	(2) When completing a standard diagnostic assessment of a client who is six years of 
127.4 	age or older, the assessor must use the current edition of the Diagnostic and Statistical 
127.5 	Manual of Mental Disorders published by the American Psychiatric Association.
127.6 	(3) When completing a standard diagnostic assessment of a client who is 12 to 17 years 
127.7 	of age, an assessor must use either the CRAFFT Questionnaire or the criteria in the most 
127.8 	recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by 
127.9 	the American Psychiatric Association to screen and assess the client for a substance use 
127.10 	disorder.
127.11 	(3) (4) When completing a standard diagnostic assessment of a client who is 18 years 
127.12 	of age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the 
127.13 	criteria in the most recent edition of the Diagnostic and Statistical Manual of Mental 
127.14 	Disorders published by the American Psychiatric Association to screen and assess the client 
127.15 	for a substance use disorder.
127.16 	(e) When completing a standard diagnostic assessment of a client, the assessor must 
127.17 	include and document the following components of the assessment:
127.18 	(1) the client's mental status examination;
127.19 	(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources; 
127.20 	vulnerabilities; safety needs, including client information that supports the assessor's findings 
127.21 	after applying a recognized diagnostic framework from paragraph (d); and any differential 
127.22 	diagnosis of the client; and
127.23 	(3) an explanation of: (i) how the assessor diagnosed the client using the information 
127.24 	from the client's interview, assessment, psychological testing, and collateral information 
127.25 	about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths; 
127.26 	and (v) the client's responsivity factors.
127.27 	(f) When completing a standard diagnostic assessment of a client, the assessor must 
127.28 	consult the client and the client's family about which services that the client and the family 
127.29 	prefer to treat the client. The assessor must make referrals for the client as to services required 
127.30 	by law.
127.31 	(g) Information from other providers and prior assessments may be used to complete 
127.32 	the diagnostic assessment if the source of the information is documented in the diagnostic 
127.33 	assessment.
128.1 	(h) If the client screens positive for a need for substance use disorder services, the assessor 
128.2 	must document what actions will be taken to address the client's co-occurring conditions.
128.3 	(i) The assessor must determine if the client is eligible for targeted case management 
128.4 	services according to section 245.462, subdivision 20, or 245.4871, subdivision 6, and refer 
128.5 	the client to the county or contracted provider as appropriate.

128.6 	Sec. 30. Minnesota Statutes 2024, section 245I.10, subdivision 8, is amended to read:
128.7 		Subd. 8.Individual treatment plan; required elements. (a) After completing a client's 
128.8 	diagnostic assessment or reviewing a client's diagnostic assessment received from a different 
128.9 	provider and before providing services to the client beyond those permitted under subdivision 
128.10 	7, the license holder must complete the client's individual treatment plan. The license holder 
128.11 	must:
128.12 	(1) base the client's individual treatment plan on the client's diagnostic assessment and 
128.13 	baseline measurements;
128.14 	(2) for a child client, use a child-centered, family-driven, and culturally appropriate 
128.15 	planning process that allows the child's parents and guardians to observe and participate in 
128.16 	the child's individual and family treatment services, assessments, and treatment planning;
128.17 	(3) for an adult client, use a person-centered, culturally appropriate planning process 
128.18 	that allows the client's family and other natural supports to observe and participate in the 
128.19 	client's treatment services, assessments, and treatment planning;
128.20 	(4) identify the client's treatment goals, measureable treatment objectives, a schedule 
128.21 	for accomplishing the client's treatment goals and objectives, a treatment strategy, and the 
128.22 	individuals responsible for providing treatment services and supports to the client. The 
128.23 	license holder must have a treatment strategy to engage the client in treatment if the client:
128.24 	(i) has a history of not engaging in treatment; and
128.25 	(ii) is ordered by a court to participate in treatment services or to take neuroleptic 
128.26 	medications;
128.27 	(5) identify the participants involved in the client's treatment planning. The client must 
128.28 	be a participant in the client's treatment planning. If applicable, the license holder must 
128.29 	document the reasons that the license holder did not involve the client's family, case manager,
128.30 	or other natural supports in the client's treatment planning; and
128.31 	(6) review the client's individual treatment plan every 180 days and update the client's 
128.32 	individual treatment plan with the client's treatment progress, new treatment objectives and 
129.1 	goals or, if the client has not made treatment progress, changes in the license holder's 
129.2 	approach to treatment; and
129.3 	(7) (6) ensure that the client approves of the client's individual treatment plan unless a 
129.4 	court orders the client's treatment plan under chapter 253B.
129.5 	(b) If the client disagrees with the client's treatment plan, the license holder must 
129.6 	document in the client file the reasons why the client does not agree with the treatment plan. 
129.7 	If the license holder cannot obtain the client's approval of the treatment plan, a mental health 
129.8 	professional must make efforts to obtain approval from a person who is authorized to consent 
129.9 	on the client's behalf within 30 days after the client's previous individual treatment plan 
129.10 	expired. A license holder may not deny a client service during this time period solely because 
129.11 	the license holder could not obtain the client's approval of the client's individual treatment 
129.12 	plan. A license holder may continue to bill for the client's otherwise eligible services when 
129.13 	the client re-engages in services.
129.14 	(c) The individual treatment plan must be updated as necessary to reflect the changing 
129.15 	needs of the client, including offering assistance in accessing necessary crisis services when 
129.16 	the license holder is aware of client need for the services. The license holder must review 
129.17 	the client's individual treatment plan every 180 days and update the client's individual 
129.18 	treatment plan with the client's treatment progress, new treatment objectives and goals, or, 
129.19 	if the client has not made treatment progress, changes in the license holder's approach to 
129.20 	treatment.

129.21 	Sec. 31. [245I.17] CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
129.22 	LICENSURE.
129.23 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms in this 
129.24 	subdivision have the meanings given.
129.25 	(b) "Care coordination" means the activities required to coordinate care across settings 
129.26 	and providers for an individual served to ensure seamless transitions across the full spectrum 
129.27 	of health services. Care coordination includes outreach and engagement; documenting a 
129.28 	plan of care for medical, behavioral health, and social services and supports in the integrated 
129.29 	treatment plan; assisting with obtaining appointments; confirming appointments are kept; 
129.30 	developing a crisis plan; tracking medication; and implementing care coordination agreements 
129.31 	with external providers. Care coordination may include psychiatric consultation with primary 
129.32 	care practitioners and with mental health clinical care practitioners.
130.1 	(c) "CCBHC client" means an individual who has participated in a preliminary screening 
130.2 	and risk assessment and who has received at least one of the nine required services from a 
130.3 	CCBHC.
130.4 	(d) "Certified community behavioral health clinic" or "CCBHC" means a provider of 
130.5 	integrated behavioral health services that is licensed under this section and compliant with 
130.6 	federal CCBHC requirements.
130.7 	(e) "Community needs assessment" means an assessment to identify community needs 
130.8 	and determine the community behavioral health clinic's capacity to address the needs of the 
130.9 	population being served.
130.10 	(f) "Designated collaborating organization" means an entity meeting the requirements 
130.11 	of subdivision 5 with a formal agreement with a CCBHC to furnish CCBHC services.
130.12 	(g) "Federal CCBHC criteria" means the most recently issued Certified Community 
130.13 	Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental 
130.14 	Health Services Administration.
130.15 	(h) "Needs assessment" means the community needs assessment described in federal 
130.16 	criteria for CCBHC.
130.17 	(i) "Preliminary screening and risk assessment" means a mandatory screening and risk 
130.18 	assessment that is completed at the time of first contact, whether that contact is in person, 
130.19 	by telephone, or using other remote communication.
130.20 		Subd. 2.Establishment of licensure. (a) The certified community behavioral health 
130.21 	clinic model is an integrated service delivery model that uses evidence-based behavioral 
130.22 	health practices to achieve better outcomes for individuals experiencing behavioral health 
130.23 	concerns while achieving sustainable rates through cost-based reimbursement for providers 
130.24 	and economic efficiencies for payors.
130.25 	(b) Beginning January 1, 2028, a CCBHC must be licensed under this section and chapter 
130.26 	245A.
130.27 	(c) A CCBHC must meet the requirements of this section and the federal CCBHC criteria. 
130.28 	The commissioner may require a CCBHC applicant or license holder to submit documentation 
130.29 	of compliance with state licensing requirements and federal CCBHC criteria. When permitted 
130.30 	by the Substance Abuse and Mental Health Services Administration, the commissioner may 
130.31 	select a transition date on which revisions to the federal CCBHC criteria become required 
130.32 	as licensing conditions for CCBHCs.
131.1 		Subd. 3.License extension. (a) The commissioner shall extend a compliant license 
131.2 	holder's license under this section for 36 months.
131.3 	(b) The commissioner must complete a licensing review that includes an on-site inspection 
131.4 	within six months before the expiration of the CCBHC's current license.
131.5 	(c) Within 180 days of license expiration, a CCBHC license holder must submit to the 
131.6 	commissioner all documentation required by the commissioner under subdivision 2, 
131.7 	paragraph (b).
131.8 		Subd. 4.Required services and scope of licensure. Within a declared service area, the 
131.9 	CCBHC must be able to offer:
131.10 	(1) mobile crisis services, directly or through a designated collaborating organization 
131.11 	under subdivision 4;
131.12 	(2) outpatient mental health and substance use disorder services under subdivisions 9 
131.13 	and 10;
131.14 	(3) screening, diagnosis, and risk assessment under subdivision 11;
131.15 	(4) person- and family-centered treatment planning;
131.16 	(5) psychiatric rehabilitation services under subdivision 14;
131.17 	(6) community-based mental health care for veterans under subdivision 15;
131.18 	(7) outpatient primary care screening and monitoring under subdivision 16;
131.19 	(8) peer services under subdivision 17; and
131.20 	(9) targeted case management under subdivision 18.
131.21 		Subd. 5.Designated collaborating organization. (a) If a CCBHC is unable to provide 
131.22 	mobile crisis services, the CCBHC may contract with another entity that is licensed to 
131.23 	provide mobile crisis services under section 245I.24 and that meets the requirements of the 
131.24 	federal CCBHC criteria.
131.25 	(b) The CCBHC must submit a designated collaborating organization arrangement for 
131.26 	approval to the commissioner as part of the licensing process.
131.27 		Subd. 6.Exemptions to host county approval. Notwithstanding any other law that 
131.28 	requires a county contract or other form of county approval for a service listed in subdivision 
131.29 	4, a CCBHC that meets the requirements of this section may receive the prospective payment 
131.30 	under section 256B.0625, subdivision 5m, for that service without a county contract or 
131.31 	county approval.
132.1 		Subd. 7.Variances. When the standards listed in this section or other applicable standards 
132.2 	conflict or address similar issues in duplicative or incompatible ways, the commissioner 
132.3 	may grant variances to state requirements if the variances do not conflict with federal 
132.4 	requirements for services reimbursed under medical assistance. If standards overlap, the 
132.5 	commissioner may substitute all or a part of a licensure or certification that is substantially 
132.6 	the same as another licensure or certification. The commissioner shall consult with 
132.7 	stakeholders before granting variances under this provision. For a CCBHC that is licensed 
132.8 	but not approved for prospective payment under section 256B.0625, subdivision 5m, the 
132.9 	commissioner may grant a variance under this paragraph if the variance does not increase 
132.10 	the state share of costs.
132.11 		Subd. 8.Evidence-based practices. The commissioner shall issue a list of required 
132.12 	evidence-based practices to be delivered by CCBHCs and may also provide a list of 
132.13 	recommended evidence-based practices. The commissioner may update the list to reflect 
132.14 	advances in outcomes research and medical services for persons living with mental illnesses 
132.15 	or substance use disorders. The commissioner shall take into consideration the adequacy 
132.16 	of evidence to support the efficacy of the practice across cultures and ages, the workforce 
132.17 	available, and the current availability of the practice in the state. At least 30 days before 
132.18 	issuing the initial list or issuing any revisions, the commissioner shall provide stakeholders 
132.19 	with an opportunity to comment.
132.20 		Subd. 9.Outpatient mental health services. (a) A license holder must provide outpatient 
132.21 	mental health services that comply with the federal CCBHC criteria and applicable state 
132.22 	standards in this chapter, except as provided in this subdivision.
132.23 	(b) An initial or comprehensive evaluation fulfills the requirements to perform a 
132.24 	diagnostic assessment in accordance with section 245I.10, subdivisions 2 and 6.
132.25 	(c) An integrated treatment plan under this section fulfills the requirements to perform 
132.26 	treatment planning in accordance with section 245I.10, subdivisions 7 and 8.
132.27 	(d) A license holder under this section is exempt from certification as a mental health 
132.28 	clinic under section 245I.20.
132.29 		Subd. 10.Outpatient substance use disorder care. (a) When a license holder provides 
132.30 	substance use disorder treatment services to an individual with a substance use disorder 
132.31 	diagnosis, the license holder must comply with the requirements for substance use disorder 
132.32 	services in chapter 245G, except as provided in this subdivision.
132.33 	(b) A preliminary screening and risk assessment under this section fulfills the 
132.34 	requirements to perform an initial services plan under section 245G.04, subdivision 1.
133.1 	(c) A comprehensive evaluation under this section fulfills the requirements to perform 
133.2 	a comprehensive assessment under section 245G.05.
133.3 	(d) An integrated treatment plan under this section and containing a six-dimension 
133.4 	analysis of the client's needs according to the third edition of ASAM criteria, as defined in 
133.5 	section 254B.01, subdivision 2a, fulfills the requirements to provide an individual treatment 
133.6 	plan under section 245G.06.
133.7 	(e) A license holder under this section fulfills the requirement to document personnel 
133.8 	files under section 245G.13, subdivision 3, by complying with the requirements of this 
133.9 	chapter.
133.10 	(f) A license holder under this section fulfills the requirement to protect client rights 
133.11 	under section 245G.15 by complying with the requirements of section 245I.12.
133.12 	(g) A license holder under this section fulfills the requirements to respond to behavioral 
133.13 	emergencies under section 245G.16 by complying with the requirements of section 245I.03, 
133.14 	subdivision 4.
133.15 	(h) A license holder under this section is exempt from licensure under chapter 245G.
133.16 		Subd. 11.Initial triage and risk assessment. (a) A license holder must have policies 
133.17 	and procedures on:
133.18 	(1) how staff will implement the requirements of this subdivision;
133.19 	(2) staff positions authorized to complete triage and risk assessments;
133.20 	(3) documenting the results of the risk screenings; and
133.21 	(4) ensuring the client is offered timely services according to the federal CCBHC criteria.
133.22 	(b) A license holder must conduct an initial triage and risk assessment when a new client 
133.23 	requests services or is referred to services. A license holder may conduct an initial triage 
133.24 	and risk assessment in person, by telephone, or other remote communication. Based on the 
133.25 	acuity of needs as assessed in the initial triage and risk assessment, the client must be 
133.26 	categorized as having emergency, urgent, or routine needs.
133.27 	(c) Based on these categorizations, the license holder must offer services that meet the 
133.28 	relevant timelines under the federal CCBHC criteria.
133.29 	(d) The license holder must provide training that addresses:
133.30 	(1) when a prospective client requires intervention from qualified staff;
133.31 	(2) use of standardized measures that screen for significant risks;
134.1 	(3) other factors that indicate a client has urgent needs besides the Columbia Suicide 
134.2 	Severity Rating Scale or a self-harm screening; and
134.3 	(4) overdose and substance use disorder risks.
134.4 		Subd. 12.Initial and comprehensive evaluation. (a) A license holder under this section 
134.5 	must provide initial and comprehensive evaluations according to this section and federal 
134.6 	CCBHC criteria.
134.7 	(b) An initial evaluation is necessary to authorize the provision of all medically necessary 
134.8 	CCBHC services until the completion of a comprehensive evaluation. A comprehensive 
134.9 	evaluation is necessary to authorize the provision of all medically necessary CCBHC services 
134.10 	on an ongoing basis. A license holder must ensure that each client's comprehensive evaluation 
134.11 	reflects the needs and assessments for all services provided.
134.12 		Subd. 13.Integrated treatment plan. (a) A license holder under this section must 
134.13 	complete an integrated treatment plan for each client following the comprehensive evaluation 
134.14 	and no later than 60 calendar days after the date of the first request for services.
134.15 	(b) A license holder must reflect all required services under subdivision 9 within the 
134.16 	integrated treatment plan according to the client's needs.
134.17 	(c) A license hold must review and update a client's treatment plan as necessary to reflect 
134.18 	the changing needs of the client and progress made in treatment. If the client has not made 
134.19 	treatment progress, the revision of the treatment plan must indicate changes in the license 
134.20 	holder's approach to treatment to better meet the needs of the client. A license holder must 
134.21 	review and update the treatment plan at least every 180 days or as clinically indicated.
134.22 		Subd. 14.Psychiatric rehabilitation services. (a) For children, a license holder under 
134.23 	this section must provide children's therapeutic services and supports according to sections 
134.24 	245I.30 and 245I.31, except that an initial or comprehensive assessment under this section 
134.25 	fulfills the requirement to perform a standard diagnostic assessment.
134.26 	(b) For adults, a license holder under this section must provide adult rehabilitative mental 
134.27 	health services according to section 245I.22, except that:
134.28 	(1) the license holder is exempt from the requirement to perform a level of care 
134.29 	assessment under section 245I.22, subdivision 6, paragraph (b); and
134.30 	(2) an initial or comprehensive assessment under this section fulfills the requirement to 
134.31 	perform a standard diagnostic assessment.
135.1 		Subd. 15.Community-based care for veterans. (a) The license holder must provide 
135.2 	services according to federal requirements for eligibility and coordination with TRICARE 
135.3 	and the United States Department of Veterans Affairs.
135.4 	(b) The license holder must assign and document a principal behavioral health provider 
135.5 	for every veteran receiving services.
135.6 		Subd. 16.Primary care screening and monitoring. To fulfill the requirements for 
135.7 	primary care screening, a license holder under this section must have policies and procedures 
135.8 	detailing the screenings to be performed with specific populations at the clinic. The policies 
135.9 	and procedures must be approved by the medical director.
135.10 		Subd. 17.Peer services. A license holder must be able to provide peer services as 
135.11 	described by federal CCBHC criteria and sections 245G.07, subdivision 2, clause (8), 
135.12 	256B.0615, and 256B.0616.
135.13 		Subd. 18.Targeted case management. (a) A license holder must provide mental health 
135.14 	targeted case management as described by federal CCBHC criteria and section 256B.0625, 
135.15 	subdivision 20.
135.16 	(b) An initial or comprehensive evaluation under this section fulfills any requirement 
135.17 	to perform a standard diagnostic assessment.
135.18 		Subd. 19.Community needs assessment. (a) The community needs assessment must 
135.19 	be a collaborative document that reflects the engagement of the applicant or license holder 
135.20 	with current clients, other social and medical services agencies, community groups, 
135.21 	underserved populations, and government agencies. An applicant or license holder must 
135.22 	document an outreach plan within the community needs assessment to demonstrate how 
135.23 	stakeholder feedback was solicited and reflected in the plan.
135.24 	(b) The applicant or license holder must publicly post a draft community needs assessment 
135.25 	on the organization's website for 30 days and submit a summary of public comments and 
135.26 	recommendations from the comment period to the commissioner.
135.27 	(c) In the draft community needs assessment, the applicant or license holder must declare 
135.28 	a planned geographic service delivery area in which the CCBHC will be capable of providing 
135.29 	all nine required services. An applicant must show an analysis of how CCBHC status will 
135.30 	make a significant improvement in the availability and quality of the services. An existing 
135.31 	license holder must include analysis of which needs from prior needs assessments have 
135.32 	been improved by the operation of the CCBHC. A clinic that has not made and demonstrated 
136.1 	substantial progress in addressing the identified needs must specify what changes will occur 
136.2 	to address the lack of progress.
136.3 	(d) The commissioner must provide feedback and technical assistance if the needs 
136.4 	assessment must be revised.
136.5 		Subd. 20.Staffing plan. (a) Based on an accepted community needs assessment, the 
136.6 	applicant or license holder must complete a staffing plan. The staffing plan must include 
136.7 	analysis of the extent to which identified staffing levels will be capable of meeting the needs 
136.8 	identified in the community needs assessment.
136.9 	(b) The commissioner must provide feedback and technical assistance if the needs 
136.10 	assessment must be revised.
136.11 		Subd. 21.Data and evaluation. A provider must submit documentation that establishes 
136.12 	the ability of the clinic to complete the required data collection as a CCBHC, as determined 
136.13 	by the commissioner. For an applicant that is an existing provider, the commissioner must 
136.14 	review and evaluate data submitted related to claims, grants, and other reporting to ensure 
136.15 	the data meets reporting requirements.
136.16 		Subd. 22.Cost reporting. A provider must submit a cost report on the forms and in the 
136.17 	manner required in section 256B.0625, subdivision 5m.

136.18 	Sec. 32. [245I.22] ADULT REHABILITATIVE MENTAL HEALTH SERVICES.
136.19 		Subdivision 1.Generally. Beginning January 1, 2028, a provider of adult mental health 
136.20 	rehabilitative services must be licensed under this section and chapter 245A.
136.21 		Subd. 2.Definitions. (a) For the purposes of this section, the terms in this subdivision 
136.22 	have the meanings given.
136.23 	(b) "Adult mental health rehabilitative services" or "ARMHS" has the meaning given 
136.24 	in section 245I.02, subdivision 33.
136.25 	(c) "Basic living skills" means rehabilitative interventions that instruct, assist, and support 
136.26 	the client in areas, including interpersonal communication skills, community resource 
136.27 	utilization and integration skills, crisis planning, relapse prevention skills, health care 
136.28 	directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking and 
136.29 	nutrition skills, transportation skills, mental illness symptom management skills, household 
136.30 	management skills, employment-related skills, and parenting skills.
136.31 	(d) "Community intervention" means a client's community assisting in the client's 
136.32 	rehabilitation and includes consultation with relatives, guardians, friends, employers, 
137.1 	treatment providers, and other significant individuals. Community intervention is appropriate 
137.2 	when directed exclusively to the treatment of the client.
137.3 	(e) "Medication education services" means services provided individually or in groups 
137.4 	that focus on educating the client about mental illness and symptoms, the role and effects 
137.5 	of medications in treating symptoms of mental illness, and the side effects of medications. 
137.6 	Medication education must be coordinated with medication management services and not 
137.7 	duplicate it. Medication education services must be provided by physicians, advanced 
137.8 	practice registered nurses, pharmacists, physician assistants, or registered nurses.
137.9 	(f) "Transition to community living" means services that maintain continuity of contact 
137.10 	between the rehabilitation services provider and the client and facilitate discharge from a 
137.11 	hospital, residential treatment program, board and lodging facility, or nursing home. 
137.12 	Transition to community living services must not be used to provide other areas of adult 
137.13 	rehabilitative mental health services.
137.14 		Subd. 3.Service components. An ARMHS provider must be capable of providing:
137.15 	(1) basic living skills;
137.16 	(2) medication education;
137.17 	(3) community intervention; and
137.18 	(4) transition to community living.
137.19 		Subd. 4.Provider requirements. An ARMHS license holder must be enrolled with 
137.20 	medical assistance and comply with standards in section 256B.0623.
137.21 		Subd. 5.Qualifications. ARMHS must be provided by:
137.22 	(1) a mental health professional qualified under section 245I.04, subdivision 2;
137.23 	(2) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8;
137.24 	(3) a clinical trainee qualified under section 245I.04, subdivision 6;
137.25 	(4) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
137.26 	(5) a mental health certified peer specialist qualified under section 245I.04, subdivision 
137.27 	12; or
137.28 	(6) a mental health rehabilitation worker qualified under section 245I.04, subdivision 
137.29 	14.
137.30 		Subd. 6.Service planning. (a) A provider of ARMHS must complete a written functional 
137.31 	assessment according to section 245I.10, subdivision 9, for each client.
138.1 	(b) When a provider of ARMHS completes a written functional assessment, the provider 
138.2 	must also complete a level of care assessment, as defined in section 245I.02, subdivision 
138.3 	19, for the client.
138.4 		Subd. 7.Group modality. ARMHS may be provided in group settings if appropriate 
138.5 	to each participating client's needs and treatment plan. A group is defined as two to ten 
138.6 	clients, at least one of whom is concurrently receiving ARMHS. The service and group 
138.7 	must be specified in the client's individual treatment plan.

138.8 	Sec. 33. [245I.24] MOBILE CRISIS RESPONSE SERVICES.
138.9 		Subdivision 1.Generally. (a) Mobile crisis response services provide short-term, 
138.10 	face-to-face mental health care for adults and children experiencing crisis in community 
138.11 	settings to help the individual maintain safety and return to a baseline level of functioning.
138.12 	(b) Beginning January 1, 2028, a provider of mobile crisis response services must be 
138.13 	licensed under this section and chapter 245A.
138.14 		Subd. 2.Definitions.  (a) For the purposes of this section, the terms in this subdivision 
138.15 	have the meanings given.
138.16 	(b) "Crisis assessment" means an immediate face-to-face assessment by a physician, a 
138.17 	mental health professional, or a qualified member of a crisis team, as described in subdivision 
138.18 	5.
138.19 	(c) "Crisis intervention" means face-to-face, short-term intensive mental health services 
138.20 	initiated during a mental health crisis to help the individual cope with immediate stressors, 
138.21 	identify and utilize available resources and strengths, engage in voluntary treatment, and 
138.22 	begin to return to the individual's baseline level of functioning.
138.23 	(d) "Crisis screening" means a screening of a client's potential mental health crisis 
138.24 	situation under subdivision 6.
138.25 	(e) "Crisis stabilization" means individualized mental health services provided to an 
138.26 	individual that are designed to restore the individual to the individual's baseline level of 
138.27 	functioning. Crisis stabilization services may be provided in the individual's home, the home 
138.28 	of a family member or friend of the individual, another community setting, a short-term 
138.29 	supervised licensed residential program, or an emergency department. Crisis stabilization 
138.30 	services include family psychoeducation.
138.31 	(f) "Crisis team" means the staff of a provider entity who are supervised and prepared 
138.32 	to provide mobile crisis services to a client in a potential mental health crisis situation.
139.1 	(g) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without 
139.2 	the provision of crisis response services, would likely result in significantly reducing the 
139.3 	individual's levels of functioning in primary activities of daily living, the individual needing 
139.4 	emergency services under section 62Q.55, or the individual being placed in a more restrictive 
139.5 	setting, including but not limited to inpatient hospitalization.
139.6 	(h) "Mobile crisis services" means screening, assessment, intervention, and 
139.7 	community-based stabilization that is provided to an individual client. Mobile crisis services 
139.8 	does not include residential crisis stabilization.
139.9 		Subd. 3.Eligibility. (a) An individual is eligible for crisis assessment services when the 
139.10 	person has screened positive for a potential mental health crisis during a crisis screening.
139.11 	(b) An individual is eligible for crisis intervention services and crisis stabilization services 
139.12 	when the individual has been assessed during a crisis assessment to be experiencing a mental 
139.13 	health crisis.
139.14 		Subd. 4.Policies, procedures, and practices specified. (a) In addition to the policies 
139.15 	and procedures required by section 245I.03, the license holder must establish, enforce, and 
139.16 	maintain policies and procedures to:
139.17 	(1) ensure that crisis screenings, assessments, and intervention services are available 24 
139.18 	hours per day, seven days per week;
139.19 	(2) respond to a call for services in a designated service area or according to a written 
139.20 	agreement with the local mental health authority for an adjacent area;
139.21 	(3) have at least one mental health professional on staff at all times and at least one 
139.22 	additional staff member capable of leading a crisis response in the community; and
139.23 	(4) respond to clients in the community according to the requirements and priorities in 
139.24 	subdivision 6.
139.25 	(b) The license holder must provide the commissioner with information about the number 
139.26 	of requests for service, the number of clients that the provider serves face-to-face, and client 
139.27 	outcomes a minimum of every six months.
139.28 	(c) The license holder must:
139.29 	(1) provide support for an individual's family and natural supports by enabling the 
139.30 	individual's family and natural supports to observe and participate in the individual's 
139.31 	treatment, assessments, and planning services;
140.1 	(2) implement culturally specific treatment identified in the crisis treatment plan that is 
140.2 	meaningful and appropriate as determined by the individual's culture, beliefs, values, and 
140.3 	language;
140.4 	(3) respond to the changing intervention and care needs of an individual as identified 
140.5 	by the individual or a family member; and
140.6 	(4) have the communication tools and procedures to communicate and consult promptly 
140.7 	about crisis assessment and interventions as services occur.
140.8 	(d) The license holder must coordinate services with:
140.9 	(1) county emergency services under section 245.469, community hospitals, ambulance, 
140.10 	transportation services, social services, law enforcement, engagement services, and mental 
140.11 	health crisis services through regularly scheduled interagency meetings;
140.12 	(2) other behavioral health service providers, county mental health authorities, or federally 
140.13 	recognized American Indian authorities and others as necessary, with the consent of the 
140.14 	individual or parent or guardian;
140.15 	(3) detoxification, withdrawal management services, and medical stabilization services 
140.16 	as required by clients; and
140.17 	(4) the individual's case manager if the individual is receiving case management services.
140.18 		Subd. 5.Crisis assessment and intervention staff qualifications. (a) Crisis assessment 
140.19 	and intervention services must be provided by:
140.20 	(1) a mental health professional qualified under section 245I.04, subdivision 2;
140.21 	(2) a clinical trainee qualified under section 245I.04, subdivision 6;
140.22 	(3) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
140.23 	(4) a mental health certified family peer specialist qualified under section 245I.04, 
140.24 	subdivision 12; or
140.25 	(5) a mental health certified peer specialist qualified under section 245I.04, subdivision 
140.26 	10.
140.27 	(b) When crisis assessment and intervention services are provided to an individual in 
140.28 	the community, a mental health professional, clinical trainee, or mental health practitioner 
140.29 	must lead the response.
140.30 	(c) For providers under this section, the 30 hours of ongoing training required by section 
140.31 	245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children 
141.1 	and adults and include training about evidence-based practices identified by the commissioner 
141.2 	of health to reduce the individual's risk of suicide and self-injurious behavior.
141.3 	(d) At least six hours of the ongoing training under paragraph (c) must be specific to 
141.4 	working with families and providing crisis stabilization services to children and include the 
141.5 	following topics:
141.6 	(1) developmental tasks of childhood and adolescence;
141.7 	(2) family relationships;
141.8 	(3) child and youth engagement and motivation, including motivational interviewing;
141.9 	(4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and 
141.10 	queer youth;
141.11 	(5) positive behavior support;
141.12 	(6) crisis intervention for youth with developmental disabilities;
141.13 	(7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral 
141.14 	therapy; and
141.15 	(8) youth substance use.
141.16 	(e) Individual providers must be experienced in crisis assessment, crisis intervention 
141.17 	techniques, treatment engagement strategies, working with families, and clinical decision 
141.18 	making under emergency conditions and have knowledge of local services and resources.
141.19 		Subd. 6.Crisis screening.  (a) A license holder may use the resources of emergency 
141.20 	services under section 245.469 for crisis screening. The crisis screening must gather 
141.21 	information, determine whether a mental health crisis situation exists, identify parties 
141.22 	involved, and determine an appropriate response.
141.23 	(b) When conducting a crisis screening, a provider must:
141.24 	(1) employ evidence-based practices to reduce the individual's risk of suicide and 
141.25 	self-injurious behavior;
141.26 	(2) work with the individual to establish a plan and time frame for responding to the 
141.27 	individual's mental health crisis, including responding to the individual's immediate need 
141.28 	for support by telephone or text message until the provider can respond to the individual 
141.29 	face-to-face;
141.30 	(3) document significant factors in determining whether the individual is experiencing 
141.31 	a mental health crisis, including prior requests for crisis services, an individual's recent 
142.1 	presentation at an emergency department, known calls to 911 or law enforcement, or 
142.2 	information from third parties with knowledge of an individual's history or current needs;
142.3 	(4) accept calls from interested third parties and consider the additional needs or potential 
142.4 	mental health crises that the third parties may be experiencing;
142.5 	(5) provide psychoeducation, including means reduction, to relevant third parties 
142.6 	including family members or other persons living with the individual; and
142.7 	(6) consider other available services to determine which service intervention would best 
142.8 	address the individual's needs and circumstances.
142.9 	(c) For the purposes of this section, the following situations indicate a positive screen 
142.10 	for a potential mental health crisis and the provider must prioritize providing a face-to-face 
142.11 	crisis assessment of the individual, unless a provider documents specific evidence to show 
142.12 	why the face-to-face assessment was not possible, including insufficient staffing resources, 
142.13 	concerns for staff or individual safety, or other clinical factors:
142.14 	(1) the individual presents at an emergency department or urgent care setting and the 
142.15 	health care team at that location requested crisis services; or
142.16 	(2) a peace officer requested crisis services for an individual who is potentially subject 
142.17 	to transportation under section 253B.051.
142.18 	(d) A provider is not required to have direct contact with the individual to determine 
142.19 	that the individual is experiencing a potential mental health crisis. A mobile crisis provider 
142.20 	may gather relevant information about the individual from a third party to establish the 
142.21 	individual's need for services and potential safety factors.
142.22 		Subd. 7.Crisis assessment.  (a) If an individual screens positive for a potential mental 
142.23 	health crisis, a crisis assessment must be completed. A crisis assessment must evaluate any 
142.24 	immediate needs for which services are needed and, as time permits, the individual's:
142.25 	(1) current life situation;
142.26 	(2) health information, including current medications;
142.27 	(3) sources of stress;
142.28 	(4) mental health problems and symptoms;
142.29 	(5) strengths;
142.30 	(6) cultural considerations;
142.31 	(7) support network;
143.1 	(8) vulnerabilities;
143.2 	(9) current functioning; and
143.3 	(10) preferences as communicated directly by the individual or as communicated in a 
143.4 	health care directive as described in chapters 145C and 253B, the crisis treatment plan 
143.5 	described in subdivision 11, a crisis prevention plan, or a wellness recovery action plan.
143.6 	(b) A provider must conduct a crisis assessment at the individual's location when 
143.7 	appropriate and, when not appropriate, document the reasons.
143.8 	(c) Whenever possible, the assessor must attempt to include input from the individual 
143.9 	and the individual's family and other natural supports to assess whether a crisis exists.
143.10 	(d) A crisis assessment includes determining whether the individual is willing to 
143.11 	voluntarily engage in treatment, whether the individual has an advance directive, and 
143.12 	gathering the individual's information and history from involved family or other natural 
143.13 	supports.
143.14 	(e) If the individual does not need an acute level of care, a team must serve an otherwise 
143.15 	eligible individual who has a co-occurring substance use disorder.
143.16 	(f) If after completing a crisis assessment of an individual, a provider refers the individual 
143.17 	to an intensive setting, including an emergency department, inpatient hospitalization, or 
143.18 	residential crisis stabilization, one of the crisis team members who completed or conferred 
143.19 	about the individual's crisis assessment must immediately contact the referral entity and 
143.20 	consult with the triage nurse or other staff responsible for intake at the referral entity. During 
143.21 	the consultation, the crisis team member must convey key findings or concerns that led to 
143.22 	the individual's referral. Following the consultation, the provider must also send written 
143.23 	documentation to the referral entity upon completion. The provider must document if the 
143.24 	individual or the individual's legal guardian signed releases for health records or if an 
143.25 	exception under section 144.293, subdivision 5, exists.
143.26 		Subd. 8.Crisis intervention services.  (a) If the crisis assessment determines an individual 
143.27 	needs mobile crisis intervention services, the license holder must provide crisis intervention 
143.28 	services promptly. As opportunity presents during the intervention, at least two members 
143.29 	of the mobile crisis intervention team must confer directly or by telephone about the crisis 
143.30 	assessment, crisis treatment plan, and actions taken and needed. At least one of the team 
143.31 	members must be providing face-to-face crisis intervention services. If providing crisis 
143.32 	intervention services, a clinical trainee or mental health practitioner must seek treatment 
143.33 	supervision as required in subdivision 10.
144.1 	(b) If a provider delivers crisis intervention services while the individual is absent, the 
144.2 	provider must document the reason for delivering services while the individual is absent.
144.3 	(c) The mobile crisis intervention team must develop a crisis treatment plan according 
144.4 	to subdivision 11.
144.5 	(d) The mobile crisis intervention team must document which crisis treatment plan goals 
144.6 	and objectives have been met and when no further crisis intervention services are required.
144.7 	(e) If the individual's mental health crisis is stabilized, but the individual needs a referral 
144.8 	to other services, the team must provide referrals to these services. If the individual is unable 
144.9 	to follow up on the referral, the team must link the individual to the service and follow up 
144.10 	to ensure the individual is receiving the service.
144.11 		Subd. 9.Crisis stabilization services. (a) Crisis stabilization services must be provided 
144.12 	by qualified staff of a crisis stabilization services provider entity which must:
144.13 	(1) develop a crisis treatment plan that meets the criteria in subdivision 11;
144.14 	(2) complete a vulnerable adult determination in accordance with section 245A.65, 
144.15 	subdivision 1a;
144.16 	(3) deliver crisis stabilization services according to the crisis treatment plan and include 
144.17 	face-to-face contact with the individual receiving services by qualified staff for further 
144.18 	assessment, help with referrals, updating of the crisis treatment plan, skills training, and 
144.19 	collaboration with other service providers in the community;
144.20 	(4) if the provider delivers crisis stabilization services while the individual is absent, 
144.21 	document the reason for delivering services while the individual is absent; and
144.22 	(5) if the individual's mental health crisis is stabilized and the individual does not have 
144.23 	a health care directive or psychiatric declaration, as defined in chapter 145C or section 
144.24 	253B.03, subdivision 6d, offer to work with the individual to develop a directive or 
144.25 	declaration.
144.26 	(b) A staff member providing crisis stabilization services must be:
144.27 	(1) a mental health professional qualified under section 245I.04, subdivision 2;
144.28 	(2) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8;
144.29 	(3) a clinical trainee qualified under section 245I.04, subdivision 6;
144.30 	(4) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
145.1 	(5) a mental health certified family peer specialist qualified under section 245I.04, 
145.2 	subdivision 12;
145.3 	(6) a mental health certified peer specialist qualified under section 245I.04, subdivision 
145.4 	10; or
145.5 	(7) a mental health rehabilitation worker qualified under section 245I.04, subdivision 
145.6 	14.
145.7 	(c) For providers under this section, the 30 hours of ongoing training required in section 
145.8 	245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children 
145.9 	and adults and include training about evidence-based practices identified by the commissioner 
145.10 	of health to reduce an individual's risk of suicide and self-injurious behavior.
145.11 	(d) For providers who deliver care to children 21 years of age or younger, at least six 
145.12 	hours of the ongoing training under this subdivision must be specific to working with families 
145.13 	and providing crisis stabilization services to children, including the following topics:
145.14 	(1) developmental tasks of childhood and adolescence;
145.15 	(2) family relationships;
145.16 	(3) child and youth engagement and motivation, including motivational interviewing;
145.17 	(4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and 
145.18 	queer youth;
145.19 	(5) positive behavior support;
145.20 	(6) crisis intervention for youth with developmental disabilities;
145.21 	(7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral 
145.22 	therapy; and
145.23 	(8) youth substance use.
145.24 	This paragraph does not apply to adult residential crisis stabilization services providers 
145.25 	licensed under section 245I.23 or providing services pursuant to section 256B.0624, 
145.26 	subdivision 7a.
145.27 		Subd. 10.Supervision. Clinical trainees and mental health practitioners may provide 
145.28 	crisis assessment and crisis intervention services if the following treatment supervision 
145.29 	requirements are met:
145.30 	(1) the license holder must accept full responsibility for the services provided;
146.1 	(2) a mental health professional working for the license holder must be immediately 
146.2 	available by telephone or in person for treatment supervision;
146.3 	(3) a mental health professional must be consulted, in person or by telephone, during 
146.4 	the first three hours when a clinical trainee or mental health practitioner provides crisis 
146.5 	assessment or crisis intervention services; and
146.6 	(4) a mental health professional must:
146.7 	(i) review and approve, as defined in section 245I.02, subdivision 2, the tentative crisis 
146.8 	assessment and crisis treatment plan within 24 hours of first providing services to the 
146.9 	individual, notwithstanding section 245I.08, subdivision 3; and
146.10 	(ii) document the consultation required in clause (3).
146.11 		Subd. 11.Crisis treatment plan.  (a) Within 24 hours of an individual's admission, the 
146.12 	license holder must complete the individual's crisis treatment plan. The license holder must:
146.13 	(1) base the individual's crisis treatment plan on the individual's crisis assessment;
146.14 	(2) consider crisis assistance strategies that have been effective for the individual in the 
146.15 	past;
146.16 	(3) for a child, use a child-centered, family-driven, and culturally appropriate planning 
146.17 	process that allows the child's parents and guardians to observe or participate in the child's 
146.18 	individual and family treatment services, assessment, and treatment planning;
146.19 	(4) for an adult, use a person-centered, culturally appropriate planning process that allows 
146.20 	the individual's family and other natural supports to observe or participate in treatment 
146.21 	services, assessment, and treatment planning;
146.22 	(5) identify the participants involved in the individual's treatment planning. The individual 
146.23 	must be a participant if possible;
146.24 	(6) identify the individual's initial treatment goals, measurable treatment objectives, and 
146.25 	specific interventions that the license holder will use to help the person engage in treatment;
146.26 	(7) include documentation of referral to and scheduling of services, including specific 
146.27 	providers where applicable;
146.28 	(8) ensure that the individual or the individual's legal guardian approves under section 
146.29 	245I.02, subdivision 2, of the individual's crisis treatment plan unless a court orders the 
146.30 	individual's treatment plan under chapter 253B. If the individual or the individual's legal 
146.31 	guardian disagrees with the crisis treatment plan, the license holder must document in the 
146.32 	client file the reasons why the individual disagrees with the crisis treatment plan; and
147.1 	(9) ensure that a treatment supervisor approves, as defined in section 245I.02, subdivision 
147.2 	2, of the individual's treatment plan within 24 hours of the individual's admission if a mental 
147.3 	health practitioner or clinical trainee completes the crisis treatment plan, notwithstanding 
147.4 	section 245I.08, subdivision 3.
147.5 	(b) The provider entity must provide the individual and the individual's legal guardian 
147.6 	with a copy of the crisis treatment plan.
147.7 		Subd. 12.Application requirements. In an application made under this section and 
147.8 	section 245A.04, the applicant must demonstrate that the applicant is:
147.9 	(1) enrolled as a medical assistance provider; and
147.10 	(2) in compliance with the provider type requirements under section 256B.0624, 
147.11 	subdivision 4, as determined by the commissioner.

147.12 	Sec. 34. [245I.30] CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS IN 
147.13 	THE COMMUNITY.
147.14 		Subdivision 1.Generally. (a) "Children's therapeutic services and supports" means the 
147.15 	flexible package of mental health services for children who require varying therapeutic and 
147.16 	rehabilitative levels of intervention to treat a diagnosed mental illness. The services are 
147.17 	interventions that are delivered using various treatment modalities and combinations of 
147.18 	services designed to reach treatment outcomes identified in the individual treatment plan. 
147.19 	Children's therapeutic services and supports include development and rehabilitative services 
147.20 	that support a child's developmental treatment needs.
147.21 	(b) Beginning January 1, 2028, a provider of children's therapeutic services and supports 
147.22 	in the community must be licensed under this section and chapter 245A.
147.23 		Subd. 2.Service components. (a) A children's therapeutic services and supports license 
147.24 	holder must be capable of providing:
147.25 	(1) individual and family psychotherapy, psychotherapy for crises, and group 
147.26 	psychotherapy;
147.27 	(2) individual, family, or group skills training; and
147.28 	(3) crisis planning.
147.29 	(b) Crisis planning that meets the standards in section 245.4871, subdivision 9a, must 
147.30 	be offered to each client's family.
148.1 		Subd. 3.Provider requirements. A children's therapeutic services and supports license 
148.2 	holder must be enrolled with medical assistance and comply with the requirements in section 
148.3 	256B.0943.
148.4 		Subd. 4.Qualifications of provider staff. Children's therapeutic services and supports 
148.5 	must be provided by:
148.6 	(1) a mental health professional qualified under section 245I.04, subdivision 2;
148.7 	(2) a clinical trainee qualified under section 245I.04, subdivision 6;
148.8 	(3) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
148.9 	(4) a mental health certified family peer specialist qualified under section 245I.04, 
148.10 	subdivision 12; or
148.11 	(5) a mental health behavioral aide qualified under section 245I.04, subdivision 16.
148.12 		Subd. 5.Group modality. Group skills training may be provided to multiple clients 
148.13 	who, because of the nature of the clients' emotional, behavioral, or social dysfunction, can 
148.14 	derive mutual benefit from interaction in a group setting. A group is defined as two to ten 
148.15 	clients, at least one of whom is a client and is concurrently receiving a service under this 
148.16 	section. The service and group must be specified in the client's individual treatment plan.

148.17 	Sec. 35. [245I.31] CHILDREN'S DAY TREATMENT.
148.18 		Subdivision 1.Generally. (a) For the purposes of this section, "children's day treatment 
148.19 	program" means a site-based structured mental health program consisting of psychotherapy 
148.20 	and individual or group skills training provided by a team under the treatment supervision 
148.21 	of a mental health professional.
148.22 	(b) Children's day treatment programs are licensed for a specific location of operation 
148.23 	and are not part of inpatient or residential treatment services.
148.24 	(c) A children's day treatment program must stabilize a client's mental health status while 
148.25 	developing and improving the client's independent living and socialization skills. The goal 
148.26 	of the day treatment program must be to reduce or relieve the effects of mental illness and 
148.27 	provide training to enable the client to live in the community.
148.28 	(d) Beginning January 1, 2028, a provider of children's day services must be licensed 
148.29 	under this section and chapter 245A.
148.30 		Subd. 2.Service components. A children's day treatment program must be capable of 
148.31 	providing the services in section 245I.30, subdivision 2.
149.1 		Subd. 3.Provider requirements. A children's day treatment license holder must:
149.2 	(1) be enrolled as a provider with medical assistance;
149.3 	(2) maintain a policy regarding the use of restrictive procedures and meet the requirements 
149.4 	of section 245.8261;
149.5 	(3) maintain a policy on medications in accordance with section 245I.11, subdivision 
149.6 	6; and
149.7 	(4) meet group modality requirements in section 245I.30, subdivision 5.
149.8 		Subd. 4.Qualifications of provider staff. Children's day treatment services must be 
149.9 	provided by:
149.10 	(1) a mental health professional qualified under section 245I.04, subdivision 2;
149.11 	(2) a clinical trainee qualified under section 245I.04, subdivision 6; or
149.12 	(3) a behavioral health practitioner qualified under section 245I.04, subdivision 4.

149.13 	Sec. 36. Minnesota Statutes 2024, section 256B.0623, subdivision 1, is amended to read:
149.14 		Subdivision 1.Scope. Subject to federal approval, Medical assistance covers medically 
149.15 	necessary adult rehabilitative mental health services when the services are provided by an 
149.16 	entity meeting the standards in this section licensed under section 245I.24. The provider 
149.17 	entity must make reasonable and good faith efforts to report individual client outcomes to 
149.18 	the commissioner, using instruments and protocols approved by the commissioner.

149.19 	EFFECTIVE DATE. This section is effective January 1, 2028.

149.20 	Sec. 37. Minnesota Statutes 2024, section 256B.0623, subdivision 3, is amended to read:
149.21 		Subd. 3.Eligibility. An eligible recipient is an individual who:
149.22 	(1) is age 18 or older;
149.23 	(2) is diagnosed with a medical condition, such as mental illness or traumatic brain 
149.24 	injury, for which adult rehabilitative mental health services are needed;
149.25 	(3) has substantial disability and functional impairment in three or more of the areas 
149.26 	listed in section 245I.10, subdivision 9, paragraph (a), clause (4), so that self-sufficiency is 
149.27 	markedly reduced; and
149.28 	(4) has had a recent standard diagnostic assessment pursuant to section 245I.10, 
149.29 	subdivision 6, by a qualified professional that documents adult rehabilitative mental health 
150.1 	services are medically necessary to address identified disability and functional impairments 
150.2 	and individual recipient goals.

150.3 	EFFECTIVE DATE. This section is effective January 1, 2028.

150.4 	Sec. 38. Minnesota Statutes 2024, section 256B.0623, subdivision 12, is amended to read:
150.5 		Subd. 12.Additional requirements. (a) Providers of adult rehabilitative mental health 
150.6 	services must comply with the requirements relating to referrals for case management in 
150.7 	section 245.467, subdivision 4.
150.8 	(b) Adult rehabilitative mental health services are provided for most recipients in the 
150.9 	recipient's home and community. Services may also be provided at the home of a relative 
150.10 	or significant other, job site, psychosocial clubhouse, drop-in center, social setting, classroom, 
150.11 	or other places in the community. (a) Except for "transition to community services," the 
150.12 	place of service does not include a regional treatment center, nursing home, residential 
150.13 	treatment facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 
150.14 	or section 245I.23, or an acute care hospital.
150.15 	(c) Adult rehabilitative mental health services may be provided in group settings if 
150.16 	appropriate to each participating recipient's needs and individual treatment plan. A group 
150.17 	is defined as two to ten clients, at least one of whom is a recipient, who is concurrently 
150.18 	receiving a service which is identified in this section. The service and group must be specified 
150.19 	in the recipient's individual treatment plan. (b) No more than two qualified staff may bill 
150.20 	Medicaid for services provided to the same group of recipients. If two adult rehabilitative 
150.21 	mental health workers bill for recipients in the same group session, they must each bill for 
150.22 	different recipients.
150.23 	(d) (c) Adult rehabilitative mental health services are appropriate if provided to enable 
150.24 	a recipient to retain stability and functioning, when the recipient is at risk of significant 
150.25 	functional decompensation or requiring more restrictive service settings without these 
150.26 	services.
150.27 	(e) Adult rehabilitative mental health services instruct, assist, and support the recipient 
150.28 	in areas including: interpersonal communication skills, community resource utilization and 
150.29 	integration skills, crisis planning, relapse prevention skills, health care directives, budgeting 
150.30 	and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills, 
150.31 	transportation skills, medication education and monitoring, mental illness symptom 
150.32 	management skills, household management skills, employment-related skills, parenting 
150.33 	skills, and transition to community living services.
151.1 	(f) Community intervention, including consultation with relatives, guardians, friends, 
151.2 	employers, treatment providers, and other significant individuals, is appropriate when 
151.3 	directed exclusively to the treatment of the client.

151.4 	EFFECTIVE DATE. This section is effective January 1, 2028.

151.5 	Sec. 39. Minnesota Statutes 2024, section 256B.0624, subdivision 1, is amended to read:
151.6 		Subdivision 1.Scope. (a) Subject to federal approval, Medical assistance covers medically 
151.7 	necessary crisis response services when the services are provided according to the standards 
151.8 	in this section 245I.24.
151.9 	(b) Subject to federal approval, Medical assistance covers medically necessary residential 
151.10 	crisis stabilization for adults when the services are provided by an entity licensed under and 
151.11 	meeting the standards in section 245I.23 or an entity with an adult foster care license meeting 
151.12 	the standards in this section subdivision 7a.
151.13 	(c) The provider entity must make reasonable and good faith efforts to report individual 
151.14 	client outcomes to the commissioner using instruments and protocols approved by the 
151.15 	commissioner.

151.16 	EFFECTIVE DATE. This section is effective January 1, 2028.

151.17 	Sec. 40. Minnesota Statutes 2024, section 256B.0624, subdivision 4, is amended to read:
151.18 		Subd. 4.Provider entity standards. (a) A mobile crisis provider must be:
151.19 	(1) a county board operated entity;
151.20 	(2) an Indian health services facility or facility owned and operated by a tribe or Tribal 
151.21 	organization operating under United States Code, title 325, section 450f; or
151.22 	(3) a provider entity that is under contract with the county board in the county where 
151.23 	the potential crisis or emergency is occurring. To provide services under this section, the 
151.24 	provider entity must directly provide the services; or if services are subcontracted, the 
151.25 	provider entity must maintain responsibility for services and billing.
151.26 	(b) A mobile crisis provider must meet the following standards:
151.27 	(1) ensure that crisis screenings, crisis assessments, and crisis intervention services are 
151.28 	available to a recipient 24 hours a day, seven days a week;
151.29 	(2) be able to respond to a call for services in a designated service area or according to 
151.30 	a written agreement with the local mental health authority for an adjacent area;
152.1 	(3) have at least one mental health professional on staff at all times and at least one 
152.2 	additional staff member capable of leading a crisis response in the community; and
152.3 	(4) provide the commissioner with information about the number of requests for service, 
152.4 	the number of people that the provider serves face-to-face, outcomes, and the protocols that 
152.5 	the provider uses when deciding when to respond in the community.
152.6 	(c) A provider entity that provides crisis stabilization services in a residential setting 
152.7 	under subdivision 7 is not required to meet the requirements of paragraphs (a) and (b), but 
152.8 	must meet all other requirements of this subdivision.
152.9 	(d) A crisis services provider must have the capacity to meet and carry out the standards 
152.10 	in section 245I.011, subdivision 5, and the following standards:
152.11 	(1) ensures that staff persons provide support for a recipient's family and natural supports, 
152.12 	by enabling the recipient's family and natural supports to observe and participate in the 
152.13 	recipient's treatment, assessments, and planning services;
152.14 	(2) has adequate administrative ability to ensure availability of services;
152.15 	(3) is able to ensure that staff providing these services are skilled in the delivery of 
152.16 	mental health crisis response services to recipients;
152.17 	(4) is able to ensure that staff are implementing culturally specific treatment identified 
152.18 	in the crisis treatment plan that is meaningful and appropriate as determined by the recipient's 
152.19 	culture, beliefs, values, and language;
152.20 	(5) is able to ensure enough flexibility to respond to the changing intervention and care 
152.21 	needs of a recipient as identified by the recipient or family member during the service 
152.22 	partnership between the recipient and providers;
152.23 	(6) is able to ensure that staff have the communication tools and procedures to 
152.24 	communicate and consult promptly about crisis assessment and interventions as services 
152.25 	occur;
152.26 	(7) is able to coordinate these services with county emergency services, community 
152.27 	hospitals, ambulance, transportation services, social services, law enforcement, engagement 
152.28 	services, and mental health crisis services through regularly scheduled interagency meetings;
152.29 	(8) is able to ensure that services are coordinated with other behavioral health service 
152.30 	providers, county mental health authorities, or federally recognized American Indian 
152.31 	authorities and others as necessary, with the consent of the recipient or parent or guardian. 
153.1 	Services must also be coordinated with the recipient's case manager if the recipient is 
153.2 	receiving case management services;
153.3 	(9) is able to ensure that crisis intervention services are provided in a manner consistent 
153.4 	with sections 245.461 to 245.486 and 245.487 to 245.4879;
153.5 	(10) is able to coordinate detoxification services for the recipient according to Minnesota 
153.6 	Rules, parts 9530.6605 to 9530.6655, or withdrawal management according to chapter 245F;
153.7 	(11) is able to establish and maintain a quality assurance and evaluation plan to evaluate 
153.8 	the outcomes of services and recipient satisfaction; and
153.9 	(12) is an enrolled medical assistance provider.
153.10 	(b) A mobile crisis provider must ensure services are provided consistent with section 
153.11 	245.469, subdivisions 1 and 2.

153.12 	EFFECTIVE DATE. This section is effective January 1, 2028.

153.13 	Sec. 41. Minnesota Statutes 2024, section 256B.0624, is amended by adding a subdivision 
153.14 	to read:
153.15 		Subd. 7a.Residential crisis stabilization services in adult foster care settings. (a) If 
153.16 	crisis stabilization services are provided in a supervised, licensed residential setting that 
153.17 	serves no more than four adult residents and one or more individuals are present at the 
153.18 	setting to receive residential crisis stabilization, the residential staff must include, for at 
153.19 	least eight hours per day, at least one mental health professional, clinical trainee, certified 
153.20 	rehabilitation specialist, or mental health practitioner. The commissioner must establish a 
153.21 	statewide per diem rate for crisis stabilization services provided under this paragraph to 
153.22 	medical assistance enrollees. The rate for a provider must not exceed the rate charged by 
153.23 	that provider for the same service to other payers. Payment must not be made to more than 
153.24 	one entity for each individual for services provided under this paragraph on a given day. 
153.25 	The commissioner must set rates prospectively for the annual rate period. The commissioner 
153.26 	must require providers to submit annual cost reports on a uniform cost reporting form and 
153.27 	use submitted cost reports to inform the rate-setting process. The commissioner must 
153.28 	recalculate the statewide per diem every year.
153.29 	(b) A provider under this subdivision must follow the requirements under section 245I.24, 
153.30 	subdivisions 4, paragraphs (c) and (d), and 9.

153.31 	EFFECTIVE DATE. This section is effective January 1, 2028.

154.1 	Sec. 42. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 5m, is 
154.2 	amended to read:
154.3 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
154.4 	assistance covers services provided by a not-for-profit certified community behavioral health 
154.5 	clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3 245I.17.
154.6 	(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an 
154.7 	eligible service is delivered using the CCBHC daily bundled rate system for medical 
154.8 	assistance payments as described in paragraph (c). The commissioner shall include a quality 
154.9 	incentive payment in the CCBHC daily bundled rate system as described in paragraph (e). 
154.10 	There is no county share for medical assistance services when reimbursed through the 
154.11 	CCBHC daily bundled rate system.
154.12 	(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC 
154.13 	payments under medical assistance meets the following requirements:
154.14 	(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each 
154.15 	CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable 
154.16 	CCBHC costs divided by the total annual number of CCBHC visits. For calculating the 
154.17 	payment rate, total annual visits include visits covered by medical assistance and visits not 
154.18 	covered by medical assistance. Allowable costs include but are not limited to the salaries 
154.19 	and benefits of medical assistance providers; the cost of CCBHC services provided under 
154.20 	section 245.735, subdivision 3, paragraph (a), clauses (6) and (7) 245I.17, subdivision 4; 
154.21 	and other costs such as insurance or supplies needed to provide CCBHC services;
154.22 	(2) payment shall be limited to one payment per day per medical assistance enrollee 
154.23 	when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement 
154.24 	if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph 
154.25 	(a), clause (6) 245I.17, subdivision 4, is furnished to a medical assistance enrollee by a 
154.26 	health care practitioner or licensed agency employed by or under contract with a CCBHC;
154.27 	(3) initial CCBHC daily bundled rates for newly certified licensed CCBHCs under 
154.28 	section 245.735, subdivision 3 245I.17, shall be established by the commissioner using a 
154.29 	provider-specific rate based on the newly certified licensed CCBHC's audited historical 
154.30 	cost report data adjusted for the expected cost of delivering CCBHC services. Estimates 
154.31 	are subject to review by the commissioner and must include the expected cost of providing 
154.32 	the full scope of CCBHC services and the expected number of visits for the rate period;
154.33 	(4) the commissioner shall rebase CCBHC rates once every two years following the last 
154.34 	rebasing and no less than 12 months following an initial rate or a rate change due to a change 
155.1 	in the scope of services. For CCBHCs certified after September 30, 2020, and before January 
155.2 	1, 2021, the commissioner shall rebase rates according to this clause for services provided 
155.3 	on or after January 1, 2024;
155.4 	(5) the commissioner shall provide for a 60-day appeals process after notice of the results 
155.5 	of the rebasing;
155.6 	(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal 
155.7 	Medicaid rate is not eligible for the CCBHC rate methodology;
155.8 	(7) payments for CCBHC services to individuals enrolled in managed care shall be 
155.9 	coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall 
155.10 	complete the phase-out of CCBHC wrap payments within 60 days of the implementation 
155.11 	of the CCBHC daily bundled rate system in the Medicaid Management Information System 
155.12 	(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments 
155.13 	due made payable to CCBHCs no later than 18 months thereafter;
155.14 	(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each 
155.15 	provider-specific rate by the Medicare Economic Index for primary care services. This 
155.16 	update shall occur each year in between rebasing periods determined by the commissioner 
155.17 	in accordance with clause (4). CCBHCs must provide data on costs and visits to the state 
155.18 	annually using the CCBHC cost report established by the commissioner; and
155.19 	(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of 
155.20 	services when such changes are expected to result in an adjustment to the CCBHC payment 
155.21 	rate by 2.5 percent or more. The CCBHC must provide the commissioner with information 
155.22 	regarding the changes in the scope of services, including the estimated cost of providing 
155.23 	the new or modified services and any projected increase or decrease in the number of visits 
155.24 	resulting from the change. Estimated costs are subject to review by the commissioner. Rate 
155.25 	adjustments for changes in scope shall occur no more than once per year in between rebasing 
155.26 	periods per CCBHC and are effective on the date of the annual CCBHC rate update.
155.27 	(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC 
155.28 	providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of 
155.29 	this requirement on the rate of access to the services delivered by CCBHC providers. If, for 
155.30 	any contract year, federal approval is not received for this paragraph, the commissioner 
155.31 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
155.32 	plans for that contract year to reflect the removal of this provision. Contracts between 
155.33 	managed care plans and county-based purchasing plans and providers to whom this paragraph 
155.34 	applies must allow recovery of payments from those providers if capitation rates are adjusted 
156.1 	in accordance with this paragraph. Payment recoveries must not exceed the amount equal 
156.2 	to any increase in rates that results from this provision. This paragraph expires if federal 
156.3 	approval is not received for this paragraph at any time.
156.4 	(e) The commissioner shall implement a quality incentive payment program for CCBHCs 
156.5 	that meets the following requirements:
156.6 	(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric 
156.7 	thresholds for performance metrics established by the commissioner, in addition to payments 
156.8 	for which the CCBHC is eligible under the CCBHC daily bundled rate system described in 
156.9 	paragraph (c);
156.10 	(2) a CCBHC must be certified licensed and enrolled as a CCBHC for the entire 
156.11 	measurement year to be eligible for incentive payments;
156.12 	(3) each CCBHC shall receive written notice of the criteria that must be met in order to 
156.13 	receive quality incentive payments at least 90 days prior to the measurement year; and
156.14 	(4) a CCBHC must provide the commissioner with data needed to determine incentive 
156.15 	payment eligibility within six months following the measurement year. The commissioner 
156.16 	shall notify CCBHC providers of their performance on the required measures and the 
156.17 	incentive payment amount within 12 months following the measurement year.
156.18 	(f) All claims to managed care plans for CCBHC services as provided under this section 
156.19 	shall be submitted directly to, and paid by, the commissioner on the dates specified no later 
156.20 	than January 1 of the following calendar year, if:
156.21 	(1) one or more managed care plans does not comply with the federal requirement for 
156.22 	payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42, 
156.23 	section 447.45(b), and the managed care plan does not resolve the payment issue within 30 
156.24 	days of noncompliance; and
156.25 	(2) the total amount of clean claims not paid in accordance with federal requirements 
156.26 	by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims 
156.27 	eligible for payment by managed care plans.
156.28 	If the conditions in this paragraph are met between January 1 and June 30 of a calendar 
156.29 	year, claims shall be submitted to and paid by the commissioner beginning on January 1 of 
156.30 	the following year. If the conditions in this paragraph are met between July 1 and December 
156.31 	31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning 
156.32 	on July 1 of the following year.
157.1 	(g) Peer services provided by a CCBHC certified licensed under section 245.735 245I.17
157.2 	are a covered service under medical assistance when a licensed mental health professional 
157.3 	or alcohol and drug counselor determines that peer services are medically necessary. 
157.4 	Eligibility under this subdivision for peer services provided by a CCBHC supersede eligibility 
157.5 	standards under sections 256B.0615, 256B.0616, and 245G.07, subdivision 2a, paragraph 
157.6 	(b), clause (2).

157.7 	EFFECTIVE DATE. This section is effective January 1, 2028.

157.8 	Sec. 43. Minnesota Statutes 2024, section 256B.0943, subdivision 2, is amended to read:
157.9 		Subd. 2.Covered service components of children's therapeutic services and 
157.10 	supports. (a) Subject to federal approval, medical assistance covers medically necessary 
157.11 	children's therapeutic services and supports when the services are provided by an eligible 
157.12 	provider entity certified under and meeting the standards in this section licensed under 
157.13 	section 245I.30 or children's day treatment services licensed under section 245I.31. The 
157.14 	provider entity must make reasonable and good faith efforts to report individual client 
157.15 	outcomes to the commissioner, using instruments and protocols approved by the 
157.16 	commissioner.
157.17 	(b) The covered service components of children's therapeutic services and supports are:
157.18 	(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis, 
157.19 	and group psychotherapy;
157.20 	(2) individual, family, or group skills training provided by a mental health professional, 
157.21 	clinical trainee, or mental health practitioner;
157.22 	(3) crisis planning;
157.23 	(4) mental health behavioral aide services;
157.24 	(1) the services described in section 245I.30, subdivision 2, by providers licensed under 
157.25 	section 245I.30 or 245I.31;
157.26 	(2) administration of standardized measures;
157.27 	(5) (3) direction of a mental health behavioral aide; and
157.28 	(6) (4) mental health service plan development; and.
157.29 	(7) children's day treatment.
157.30 	(c) In delivering services under this section, a licensed provider entity must ensure that 
157.31 	psychotherapy to address a child's underlying mental health disorder is documented as part 
158.1 	of the child's ongoing treatment. A provider must deliver or arrange for medically necessary 
158.2 	psychotherapy unless the child's parent or caregiver chooses not to receive the psychotherapy 
158.3 	or the provider determines that psychotherapy is no longer medically necessary. When a 
158.4 	provider determines that psychotherapy is no longer medically necessary, the provider must 
158.5 	update required documentation, including but not limited to the individual treatment plan, 
158.6 	the child's medical record, or other authorizations, to include the determination. When a 
158.7 	provider determines that a child needs psychotherapy but psychotherapy cannot be delivered 
158.8 	due to a shortage of licensed mental health professionals in the child's community, the 
158.9 	provider must document the lack of access in the child's medical record.
158.10 	(d) Medical assistance covers service plan development before completion of a child's 
158.11 	individual treatment plan. Service plan development consists of development, review, and 
158.12 	revision of the individual treatment plan by face-to-face or electronic communication, 
158.13 	including time spent gathering client history from other key figures or providers. The provider 
158.14 	must document events, including the time spent with the family and other key participants 
158.15 	in the child's life to approve the individual treatment plan. Service plan development is 
158.16 	covered only if a treatment plan is completed or for work already completed at the time the 
158.17 	client voluntarily chooses to disengage with services for the child. If it is determined upon 
158.18 	review that a treatment plan was not completed for the child, the commissioner shall recover 
158.19 	the payment for the service plan development.
158.20 	(e) Medical assistance covers time spent administering and reporting standardized 
158.21 	measures approved by the commissioner.

158.22 	EFFECTIVE DATE. This section is effective January 1, 2028.

158.23 	Sec. 44. Minnesota Statutes 2025 Supplement, section 256B.0943, subdivision 3, is 
158.24 	amended to read:
158.25 		Subd. 3.Determination of client eligibility. (a) A client's eligibility to receive children's 
158.26 	therapeutic services and supports under this section shall be determined based on a standard 
158.27 	diagnostic assessment by a mental health professional or a clinical trainee that is performed 
158.28 	within one year before the initial start of service and updated as required under section 
158.29 	245I.10, subdivision 2. The standard diagnostic assessment must:
158.30 	(1) determine whether a child under age 18 has a diagnosis of mental illness or, if the 
158.31 	person is between the ages of 18 and 21, whether the person has a mental illness; and
159.1 	(2) document children's therapeutic services and supports as medically necessary to 
159.2 	address an identified disability, functional impairment, and the individual client's needs and 
159.3 	goals; and.
159.4 	(3) be used in the development of the individual treatment plan.
159.5 	(b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to 
159.6 	five days of day treatment under this section based on a hospital's medical history and 
159.7 	presentation examination of the client.
159.8 	(c) Children's therapeutic services and supports include development and rehabilitative 
159.9 	services that support a child's developmental treatment needs.

159.10 	Sec. 45. Minnesota Statutes 2025 Supplement, section 256B.0943, subdivision 12, is 
159.11 	amended to read:
159.12 		Subd. 12.Excluded services. (a) The following services are not eligible for medical 
159.13 	assistance payment as children's therapeutic services and supports:
159.14 	(1) service components of children's therapeutic services and supports simultaneously 
159.15 	provided by more than one provider entity unless prior authorization is obtained;
159.16 	(2) treatment by multiple providers within the same agency at the same clock time, 
159.17 	unless one service is delivered to the child and the other service is delivered to the child's 
159.18 	family or treatment team without the child present;
159.19 	(3) children's therapeutic services and supports provided in violation of medical assistance 
159.20 	policy in Minnesota Rules, part 9505.0220;
159.21 	(4) mental health behavioral aide services provided by a personal care assistant who is 
159.22 	not qualified as a mental health behavioral aide and employed by a certified children's 
159.23 	therapeutic services and supports provider entity;
159.24 	(5) service components of CTSS that are the responsibility of a residential or program 
159.25 	license holder, including foster care providers under the terms of a service agreement or 
159.26 	administrative rules governing licensure; and
159.27 	(6) adjunctive activities that may be offered by a provider entity but are not otherwise 
159.28 	covered by medical assistance, including:
159.29 	(i) a service that is primarily recreation oriented or that is provided in a setting that is 
159.30 	not medically supervised. This includes sports activities, exercise groups, activities such as 
159.31 	craft hours, leisure time, social hours, meal or snack time, trips to community activities, 
159.32 	and tours;
160.1 	(ii) a social or educational service that does not have or cannot reasonably be expected 
160.2 	to have a therapeutic outcome related to the client's mental illness;
160.3 	(iii) prevention or education programs provided to the community; and
160.4 	(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.
160.5 	(b) Time spent doing work before and after providing direct services, including scheduling 
160.6 	or maintaining clinical records, is included in CTSS payments and may not be separately 
160.7 	billed as additional clock hours of service.

160.8 	Sec. 46. Minnesota Statutes 2025 Supplement, section 260E.14, subdivision 1, is amended 
160.9 	to read:
160.10 		Subdivision 1.Facilities and schools. (a) The local welfare agency is the agency 
160.11 	responsible for investigating allegations of maltreatment in child foster care, family child 
160.12 	care, legally nonlicensed child care, and reports involving children served by an unlicensed 
160.13 	personal care provider organization under section 256B.0659. Copies of findings related to 
160.14 	personal care provider organizations under section 256B.0659 must be forwarded to the 
160.15 	Department of Human Services provider enrollment.
160.16 	(b) The Department of Human Services is the agency responsible for screening and 
160.17 	investigating allegations of maltreatment in juvenile correctional facilities listed under 
160.18 	section 241.021 located in the local welfare agency's county and in facilities licensed or 
160.19 	certified under chapters 245A and 245D.
160.20 	(c) The Department of Health is the agency responsible for screening and investigating 
160.21 	allegations of maltreatment in facilities licensed under sections 144.50 to 144.58 and 144A.43 
160.22 	to 144A.482 or chapter 144H.
160.23 	(d) The Department of Education is the agency responsible for screening and investigating 
160.24 	allegations of maltreatment in a school as defined in section 120A.05, subdivisions 9, 11, 
160.25 	and 13, and chapter 124E. The Department of Education's responsibility to screen and 
160.26 	investigate includes allegations of maltreatment involving students 18 through 21 years of 
160.27 	age, including students receiving special education services, up to and including graduation 
160.28 	and the issuance of a secondary or high school diploma.
160.29 	(e) The Department of Human Services is the agency responsible for screening and 
160.30 	investigating allegations of maltreatment of minors in an EIDBI agency operating under 
160.31 	sections 245A.142 and 256B.0949.
161.1 	(f) A health or corrections agency receiving a report may request the local welfare agency 
161.2 	to provide assistance pursuant to this section and sections 260E.20 and 260E.22.
161.3 	(g) The Department of Children, Youth, and Families is the agency responsible for 
161.4 	screening and investigating allegations of maltreatment in facilities or programs not listed 
161.5 	in paragraph (a) that are licensed or certified under chapters 142B and 142C.
161.6 	(h) The Department of Human Services is the agency responsible for screening and 
161.7 	investigating allegations of maltreatment of minors for mobile crisis response services and 
161.8 	children's therapeutic services and supports programs licensed under chapter 245I.

161.9 	Sec. 47. Minnesota Statutes 2025 Supplement, section 626.5572, subdivision 13, is amended 
161.10 	to read:
161.11 		Subd. 13.Lead investigative agency. "Lead investigative agency" is the primary 
161.12 	administrative agency responsible for investigating reports made under section 626.557.
161.13 	(a) The Department of Health is the lead investigative agency for facilities or services 
161.14 	licensed or required to be licensed as hospitals, home care providers, nursing homes, boarding 
161.15 	care homes, hospice providers, residential facilities that are also federally certified as 
161.16 	intermediate care facilities that serve people with developmental disabilities, or any other 
161.17 	facility or service not listed in this subdivision that is licensed or required to be licensed by 
161.18 	the Department of Health for the care of vulnerable adults. "Home care provider" has the 
161.19 	meaning provided in section 144A.43, subdivision 4, and applies when care or services are 
161.20 	delivered in the vulnerable adult's home.
161.21 	(b) The Department of Human Services is the lead investigative agency for facilities or 
161.22 	services licensed or required to be licensed as adult day care, adult foster care, community 
161.23 	residential settings, programs for people with disabilities, EIDBI agencies, family adult day 
161.24 	services, mental health programs licensed under chapter 245I, mental health clinics, substance 
161.25 	use disorder programs, the Minnesota Sex Offender Program, or any other facility or service 
161.26 	not listed in this subdivision that is licensed or required to be licensed by the Department 
161.27 	of Human Services. The Department of Human Services is also the lead investigative agency 
161.28 	for unlicensed EIDBI agencies under section 256B.0949. The Department of Human Services 
161.29 	is the lead investigative agency for adult rehabilitative mental health services under section 
161.30 	245I.22, mobile crisis response services under section 245I.24, and certified community 
161.31 	behavioral health clinics under section 245I.17.
162.1 	(c) The county social service agency or its designee is the lead investigative agency for 
162.2 	all other reports, including but not limited to reports involving vulnerable adults receiving 
162.3 	services from a personal care provider organization under section 256B.0659.

162.4 	EFFECTIVE DATE. This section is effective January 1, 2028.

162.5 	Sec. 48. REVISOR INSTRUCTION.
 162.6 	The revisor of statutes shall renumber Minnesota Statutes, section 245.735, subdivisions 
162.7 	5 and 6, as Minnesota Statutes, section 245I.17, subdivisions 23 and 24.

162.8 	Sec. 49. REPEALER.
 162.9 	(a) Minnesota Statutes 2024, sections 245.735, subdivisions 1a, 2a, 3a, 3b, 3c, 3d, 3e, 
162.10 	3f, 3g, 3h, 4a, 4b, 4c, 4e, 7, and 8; 245C.03, subdivision 7; 245I.20, subdivision 9; 245I.23, 
162.11 	subdivision 23; 256B.0623, subdivisions 2, 4, 5, 6, and 9; 256B.0624, subdivisions 2, 3, 
162.12 	4a, 5, 6, 6a, 6b, 7, 8, 9, and 11; and 256B.0943, subdivisions 4, 5, 5a, 6, 7, and 11, are 
162.13 	repealed.
162.14 	(b) Minnesota Statutes 2025 Supplement, sections 245.735, subdivisions 3 and 4d; and 
162.15 	256B.0943, subdivisions 1 and 9, are repealed.

162.16 	EFFECTIVE DATE. This section is effective January 1, 2028.

162.17 	ARTICLE 5
162.18 	BACKGROUND STUDIES

162.19 	Section 1. Minnesota Statutes 2025 Supplement, section 142A.09, subdivision 1, is 
162.20 	amended to read:
162.21 		Subdivision 1.Background studies required. The commissioner of human services 
162.22 	shall conduct background studies of individuals specified in section 245C.03, subdivision 
162.23 	5c, affiliated with:
162.24 	(1) a facility or program licensed or seeking a license under chapter 142B;
162.25 	(2) a license-exempt child care center certified under chapter 142C; or
162.26 	(3) a legal nonlicensed child care provider authorized under chapter 142E.

163.1 	Sec. 2. Minnesota Statutes 2025 Supplement, section 142B.05, subdivision 3, is amended 
163.2 	to read:
163.3 		Subd. 3.Foster care by an individual who is related to a child; license required. (a) 
163.4 	Notwithstanding subdivision 2, paragraph (a), clause (1), in order to provide foster care for 
163.5 	a child, an individual who is related to the child, other than a parent, or legal guardian, must 
163.6 	be licensed by the commissioner except as provided by section 142B.06.
163.7 	(b) If an individual who is related to a child is seeking licensure to provide foster care 
163.8 	for the child and the individual has a domestic partner but is not married to the domestic 
163.9 	partner, only the individual related to the child must be licensed to provide foster care. The 
163.10 	commissioner must conduct background studies on household members according to section 
163.11 	245C.03, subdivision 1.

163.12 	Sec. 3. Minnesota Statutes 2025 Supplement, section 142B.10, subdivision 14, is amended 
163.13 	to read:
163.14 		Subd. 14.Grant of license; license extension. (a) If the commissioner determines that 
163.15 	the program complies with all applicable rules and laws, the commissioner shall issue a 
163.16 	license consistent with this section or, if applicable, a temporary change of ownership license 
163.17 	under section 142B.11. At minimum, the license shall state:
163.18 	(1) the name of the license holder;
163.19 	(2) the address of the program;
163.20 	(3) the effective date and expiration date of the license;
163.21 	(4) the type of license;
163.22 	(5) the maximum number and ages of persons that may receive services from the program; 
163.23 	and
163.24 	(6) any special conditions of licensure.
163.25 	(b) The commissioner may issue a license for a period not to exceed two years if:
163.26 	(1) the commissioner is unable to conduct the observation required by subdivision 11, 
163.27 	paragraph (a), clause (3), because the program is not yet operational;
163.28 	(2) certain records and documents are not available because persons are not yet receiving 
163.29 	services from the program; and
163.30 	(3) the applicant complies with applicable laws and rules in all other respects.
164.1 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
164.2 	or persons will be placed or cared for in the licensed program.
164.3 	(d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a 
164.4 	license if the applicant, license holder, or an affiliated controlling individual has:
164.5 	(1) been disqualified and the disqualification was not set aside and no variance has been 
164.6 	granted;
164.7 	(2) been denied a license under this chapter or chapter 245A within the past two years;
164.8 	(3) had a license issued under this chapter or chapter 245A revoked within the past five 
164.9 	years; or
164.10 	(4) failed to submit the information required of an applicant under subdivision 1, 
164.11 	paragraph (f), (g), or (h), after being requested by the commissioner.
164.12 	When a license issued under this chapter or chapter 245A is revoked, the license holder 
164.13 	and each affiliated controlling individual with a revoked license may not hold any license 
164.14 	under chapter 142B for five years following the revocation, and other licenses held by the 
164.15 	applicant or license holder or licenses affiliated with each controlling individual shall also 
164.16 	be revoked.
164.17 	(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license 
164.18 	affiliated with a license holder or controlling individual that had a license revoked within 
164.19 	the past five years if the commissioner determines that (1) the license holder or controlling 
164.20 	individual is operating the program in substantial compliance with applicable laws and rules 
164.21 	and (2) the program's continued operation is in the best interests of the community being 
164.22 	served.
164.23 	(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response 
164.24 	to an application that is affiliated with an applicant, license holder, or controlling individual 
164.25 	that had an application denied within the past two years or a license revoked within the past 
164.26 	five years if the commissioner determines that (1) the applicant or controlling individual 
164.27 	has operated one or more programs in substantial compliance with applicable laws and rules 
164.28 	and (2) the program's operation would be in the best interests of the community to be served.
164.29 	(g) In determining whether a program's operation would be in the best interests of the 
164.30 	community to be served, the commissioner shall consider factors such as the number of 
164.31 	persons served, the availability of alternative services available in the surrounding 
164.32 	community, the management structure of the program, whether the program provides 
164.33 	culturally specific services, and other relevant factors.
165.1 	(h) The commissioner shall not issue or reissue a license under this chapter if an individual 
165.2 	living in the household where the services will be provided as specified under section 
165.3 	245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside 
165.4 	and no variance has been granted.
165.5 	(i) Pursuant to section 142B.18, subdivision 1, paragraph (b), when a license issued 
165.6 	under this chapter has been suspended or revoked and the suspension or revocation is under 
165.7 	appeal, the program may continue to operate pending a final order from the commissioner. 
165.8 	If the license under suspension or revocation will expire before a final order is issued, a 
165.9 	temporary provisional license may be issued provided any applicable license fee is paid 
165.10 	before the temporary provisional license is issued.
165.11 	(j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of 
165.12 	a controlling individual or license holder, and the controlling individual or license holder 
165.13 	is ordered under section 245C.17 to be immediately removed from direct contact with 
165.14 	persons receiving services or is ordered to be under continuous, direct supervision when 
165.15 	providing direct contact services, the program may continue to operate only if the program 
165.16 	complies with the order and submits documentation demonstrating compliance with the 
165.17 	order. If the disqualified individual fails to submit a timely request for reconsideration, or 
165.18 	if the disqualification is not set aside and no variance is granted, the order to immediately 
165.19 	remove the individual from direct contact or to be under continuous, direct supervision 
165.20 	remains in effect pending the outcome of a hearing and final order from the commissioner.
165.21 	(k) For purposes of reimbursement for meals only, under the Child and Adult Care Food 
165.22 	Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, part 226, 
165.23 	relocation within the same county by a licensed family day care provider, shall be considered 
165.24 	an extension of the license for a period of no more than 30 calendar days or until the new 
165.25 	license is issued, whichever occurs first, provided the county agency has determined the 
165.26 	family day care provider meets licensure requirements at the new location.
165.27 	(l) Unless otherwise specified by statute, all licenses issued under this chapter expire at 
165.28 	12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
165.29 	comply with the requirements in section 142B.12 and be reissued a new license to operate 
165.30 	the program or the program must not be operated after the expiration date. Child foster care 
165.31 	license holders must apply for and be granted a new license to operate the program or the 
165.32 	program must not be operated after the expiration date. Upon implementation of the provider 
165.33 	licensing and reporting hub, licenses may be issued each calendar year.
166.1 	(m) The commissioner shall not issue or reissue a license under this chapter if it has 
166.2 	been determined that a tribal licensing authority has established jurisdiction to license the 
166.3 	program or service.
166.4 	(n) The commissioner of children, youth, and families shall coordinate and share data 
166.5 	with the commissioner of human services to enforce this section.

166.6 	Sec. 4. Minnesota Statutes 2024, section 142B.15, is amended to read:
166.7 	142B.15 DENIAL OF APPLICATION.
166.8 	(a) The commissioner may deny a license if an applicant or controlling individual:
166.9 	(1) fails to submit a substantially complete application after receiving notice from the 
166.10 	commissioner under section 142B.10, subdivision 1;
166.11 	(2) fails to comply with applicable laws or rules;
166.12 	(3) knowingly withholds relevant information from or gives false or misleading 
166.13 	information to the commissioner in connection with an application for a license or during 
166.14 	an investigation;
166.15 	(4) has a disqualification that has not been set aside under section 245C.22 and no 
166.16 	variance has been granted;
166.17 	(5) has an individual living in the household who received a background study under 
166.18 	section 245C.03, subdivision 1, paragraph (a), clause (2),and who has a disqualification 
166.19 	that has not been set aside under section 245C.22, and no variance has been granted;
166.20 	(6) is associated with an individual who received a background study under section 
166.21 	245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to 
166.22 	children or vulnerable adults, and who has a disqualification that has not been set aside 
166.23 	under section 245C.22, and no variance has been granted;
166.24 	(7) fails to comply with section 142B.10, subdivision 1, paragraph (f) or (g);
166.25 	(8) fails to demonstrate competent knowledge as required by section 142B.10, subdivision 
166.26 	13;
166.27 	(9) has a history of noncompliance as a license holder or controlling individual with 
166.28 	applicable laws or rules, including but not limited to this chapter and chapters 142E, 245A, 
166.29 	and 245C;
166.30 	(10) is prohibited from holding a license according to section 142A.12 or 245.095; or
167.1 	(11) for a family foster setting, has or has an individual who is living in the household 
167.2 	where the licensed services are provided or is otherwise subject to a background study who 
167.3 	has nondisqualifying background study information, as described in section 245C.05, 
167.4 	subdivision 4, that reflects on the applicant's ability to safely provide care to foster children.
167.5 	(b) An applicant whose application has been denied by the commissioner must be given 
167.6 	notice of the denial, which must state the reasons for the denial in plain language. Notice 
167.7 	must be given by certified mail, by personal service, or through the provider licensing and 
167.8 	reporting hub. The notice must state the reasons the application was denied and must inform 
167.9 	the applicant of the right to a contested case hearing under chapter 14 and Minnesota Rules, 
167.10 	parts 1400.8505 to 1400.8612. The applicant may appeal the denial by notifying the 
167.11 	commissioner in writing by certified mail, by personal service, or through the provider 
167.12 	licensing and reporting hub. If mailed, the appeal must be postmarked and sent to the 
167.13 	commissioner within 20 calendar days after the applicant received the notice of denial. If 
167.14 	an appeal request is made by personal service, it must be received by the commissioner 
167.15 	within 20 calendar days after the applicant received the notice of denial. If the order is issued 
167.16 	through the provider hub, the appeal must be received by the commissioner within 20 
167.17 	calendar days from the date the commissioner issued the order through the hub. Section 
167.18 	142B.20 applies to hearings held to appeal the commissioner's denial of an application.

167.19 	Sec. 5. Minnesota Statutes 2024, section 142B.79, is amended to read:
167.20 	142B.79 CONTRACTORS SERVING MULTIPLE FAMILY CHILD CARE 
167.21 	LICENSE HOLDERS.
167.22 	Contractors who serve multiple family child care license holders may request that the 
167.23 	county agency maintain a record of:
167.24 	(1) the contractor's background study results as required in section 245C.04, subdivision 
167.25 	8, to verify that the contractor does not have a disqualification or a disqualification that has 
167.26 	not been set aside, and is eligible to provide direct contact services in a licensed program; 
167.27 	and
167.28 	(2) the contractor's compliance with training requirements.

167.29 	Sec. 6. Minnesota Statutes 2024, section 144.057, subdivision 1, is amended to read:
167.30 		Subdivision 1.Background studies required. (a) Except as specified in paragraph (b), 
167.31 	the commissioner of health shall contract with the commissioner of human services to 
167.32 	conduct background studies of:
168.1 	(1) individuals providing services that have direct contact, as defined under section 
168.2 	245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes, 
168.3 	outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and 
168.4 	home care agencies licensed under chapter 144A; assisted living facilities and assisted living 
168.5 	facilities with dementia care licensed under chapter 144G; and board and lodging 
168.6 	establishments that are registered to provide supportive or health supervision services under 
168.7 	section 157.17;
168.8 	(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact 
168.9 	services in a nursing home or a home care agency licensed under chapter 144A; an assisted 
168.10 	living facility or assisted living facility with dementia care licensed under chapter 144G; 
168.11 	or a boarding care home licensed under sections 144.50 to 144.58. If the individual under 
168.12 	study resides outside Minnesota, the study must include a check for substantiated findings 
168.13 	of maltreatment of adults and children in the individual's state of residence when the 
168.14 	information is made available by that state, and must include a check of the National Crime 
168.15 	Information Center database;
168.16 	(3) all other employees in assisted living facilities or assisted living facilities with 
168.17 	dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A, 
168.18 	and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of 
168.19 	an individual in this section shall disqualify the individual from positions allowing direct 
168.20 	contact or access to patients or residents receiving services. "Access" means physical access 
168.21 	to a client or the client's personal property without continuous, direct supervision as defined 
168.22 	in section 245C.02, subdivision 8, when the employee's employment responsibilities do not 
168.23 	include providing direct contact services;
168.24 	(4) individuals employed by a supplemental nursing services agency, as defined under 
168.25 	section 144A.70, who are providing services in health care facilities;
168.26 	(5) controlling persons of a supplemental nursing services agency, as defined under 
168.27 	section 144A.70; and
168.28 	(6) license applicants, owners, managerial officials, and controlling individuals who are 
168.29 	required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a 
168.30 	background study under chapter 245C, regardless of the licensure status of the license 
168.31 	applicant, owner, managerial official, or controlling individual.
168.32 	(b) The commissioner of human services shall not conduct a background study on any 
168.33 	individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license 
168.34 	issued by a health-related licensing board as defined in section 214.01, subdivision 2, and 
169.1 	has completed the criminal background check as required in section 214.075. An entity that 
169.2 	is affiliated with individuals who meet the requirements of this paragraph must separate 
169.3 	those individuals from the entity's roster for NETStudy 2.0.
169.4 	(c) If a facility or program is licensed by the Department of Human Services and subject 
169.5 	to the background study provisions of chapter 245C and is also licensed by the Department 
169.6 	of Health, the Department of Human Services is solely responsible for the background 
169.7 	studies of individuals in the jointly licensed programs.

169.8 	Sec. 7. Minnesota Statutes 2025 Supplement, section 245A.04, subdivision 7, is amended 
169.9 	to read:
169.10 		Subd. 7.Grant of license; license extension. (a) If the commissioner determines that 
169.11 	the program complies with all applicable rules and laws, the commissioner shall issue a 
169.12 	license consistent with this section or, if applicable, a temporary change of ownership license 
169.13 	under section 245A.043. At minimum, the license shall state:
169.14 	(1) the name of the license holder;
169.15 	(2) the address of the program;
169.16 	(3) the effective date and expiration date of the license;
169.17 	(4) the type of license and the specific service the license holder is licensed to provide;
169.18 	(5) the maximum number and ages of persons that may receive services from the program; 
169.19 	and
169.20 	(6) any special conditions of licensure.
169.21 	(b) The commissioner may issue a license for a period not to exceed two years if:
169.22 	(1) the commissioner is unable to conduct the observation required by subdivision 4, 
169.23 	paragraph (a), clause (3), because the program is not yet operational;
169.24 	(2) certain records and documents are not available because persons are not yet receiving 
169.25 	services from the program; and
169.26 	(3) the applicant complies with applicable laws and rules in all other respects.
169.27 	(c) A decision by the commissioner to issue a license does not guarantee that any person 
169.28 	or persons will be placed or cared for in the licensed program.
169.29 	(d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a 
169.30 	license if the applicant, license holder, or an affiliated controlling individual has:
170.1 	(1) been disqualified and the disqualification was not set aside and no variance has been 
170.2 	granted;
170.3 	(2) been denied a license under this chapter or chapter 142B within the past two years;
170.4 	(3) had a license issued under this chapter or chapter 142B revoked within the past five 
170.5 	years; or
170.6 	(4) failed to submit the information required of an applicant under subdivision 1, 
170.7 	paragraph (f), (g), or (h), after being requested by the commissioner.
170.8 	When a license issued under this chapter or chapter 142B is revoked, the license holder 
170.9 	and each affiliated controlling individual with a revoked license may not hold any license 
170.10 	under chapter 245A for five years following the revocation, and other licenses held by the 
170.11 	applicant or license holder or licenses affiliated with each controlling individual shall also 
170.12 	be revoked.
170.13 	(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license 
170.14 	affiliated with a license holder or controlling individual that had a license revoked within 
170.15 	the past five years if the commissioner determines that (1) the license holder or controlling 
170.16 	individual is operating the program in substantial compliance with applicable laws and rules 
170.17 	and (2) the program's continued operation is in the best interests of the community being 
170.18 	served.
170.19 	(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response 
170.20 	to an application that is affiliated with an applicant, license holder, or controlling individual 
170.21 	that had an application denied within the past two years or a license revoked within the past 
170.22 	five years if the commissioner determines that (1) the applicant or controlling individual 
170.23 	has operated one or more programs in substantial compliance with applicable laws and rules 
170.24 	and (2) the program's operation would be in the best interests of the community to be served.
170.25 	(g) In determining whether a program's operation would be in the best interests of the 
170.26 	community to be served, the commissioner shall consider factors such as the number of 
170.27 	persons served, the availability of alternative services available in the surrounding 
170.28 	community, the management structure of the program, whether the program provides 
170.29 	culturally specific services, and other relevant factors.
170.30 	(h) The commissioner shall not issue or reissue a license under this chapter if an individual 
170.31 	living in the household where the services will be provided as specified under section 
170.32 	245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside 
170.33 	and no variance has been granted.
171.1 	(i) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued 
171.2 	under this chapter has been suspended or revoked and the suspension or revocation is under 
171.3 	appeal, the program may continue to operate pending a final order from the commissioner. 
171.4 	If the license under suspension or revocation will expire before a final order is issued, a 
171.5 	temporary provisional license may be issued provided any applicable license fee is paid 
171.6 	before the temporary provisional license is issued.
171.7 	(j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of 
171.8 	a controlling individual or license holder, and the controlling individual or license holder 
171.9 	is ordered under section 245C.17 to be immediately removed from direct contact with 
171.10 	persons receiving services or is ordered to be under continuous, direct supervision when 
171.11 	providing direct contact services, the program may continue to operate only if the program 
171.12 	complies with the order and submits documentation demonstrating compliance with the 
171.13 	order. If the disqualified individual fails to submit a timely request for reconsideration, or 
171.14 	if the disqualification is not set aside and no variance is granted, the order to immediately 
171.15 	remove the individual from direct contact or to be under continuous, direct supervision 
171.16 	remains in effect pending the outcome of a hearing and final order from the commissioner.
171.17 	(k) Unless otherwise specified by statute, all licenses issued under this chapter expire 
171.18 	at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must 
171.19 	comply with the requirements in section 245A.10 and be reissued a new license to operate 
171.20 	the program or the program must not be operated after the expiration date. Adult foster care, 
171.21 	family adult day services, child foster residence setting, and community residential services 
171.22 	license holders must apply for and be granted a new license to operate the program or the 
171.23 	program must not be operated after the expiration date. Upon implementation of the provider 
171.24 	licensing and reporting hub, licenses may be issued each calendar year.
171.25 	(l) The commissioner shall not issue or reissue a license under this chapter if it has been 
171.26 	determined that a Tribal licensing authority has established jurisdiction to license the program 
171.27 	or service.
171.28 	(m) The commissioner of human services may coordinate and share data with the 
171.29 	commissioner of children, youth, and families to enforce this section.
171.30 	(n) For substance use disorder treatment programs, for the purposes of paragraph (a), 
171.31 	clause (5), the maximum number of persons who may receive services from the program 
171.32 	includes persons served at satellite locations.

172.1 	Sec. 8. Minnesota Statutes 2025 Supplement, section 245A.05, is amended to read:
172.2 	245A.05 DENIAL OF APPLICATION.
172.3 	(a) The commissioner may deny a license if an applicant or controlling individual:
172.4 	(1) fails to submit a substantially complete application after receiving notice from the 
172.5 	commissioner under section 245A.04, subdivision 1;
172.6 	(2) fails to comply with applicable laws or rules;
172.7 	(3) knowingly withholds relevant information from or gives false or misleading 
172.8 	information to the commissioner in connection with an application for a license or during 
172.9 	an investigation;
172.10 	(4) has a disqualification that has not been set aside under section 245C.22 and no 
172.11 	variance has been granted;
172.12 	(5) has an individual living in the household who received a background study under 
172.13 	section 245C.03, subdivision 1, paragraph (a), clause (2),and who has a disqualification 
172.14 	that has not been set aside under section 245C.22, and no variance has been granted;
172.15 	(6) is associated with an individual who received a background study under section 
172.16 	245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to 
172.17 	children or vulnerable adults, and who has a disqualification that has not been set aside 
172.18 	under section 245C.22, and no variance has been granted;
172.19 	(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);
172.20 	(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision 
172.21 	6;
172.22 	(9) has a history of noncompliance as a license holder or controlling individual with 
172.23 	applicable laws or rules, including but not limited to this chapter and chapters 142E and 
172.24 	245C;
172.25 	(10) is prohibited from holding a license according to section 245.095; or
172.26 	(11) is the subject of a pending administrative, civil, or criminal investigation.
172.27 	(b) An applicant whose application has been denied by the commissioner must be given 
172.28 	notice of the denial, which must state the reasons for the denial in plain language. Notice 
172.29 	must be given by certified mail, by personal service, or through the provider licensing and 
172.30 	reporting hub. The notice must state the reasons the application was denied and must inform 
172.31 	the applicant of the right to a contested case hearing under chapter 14 and Minnesota Rules, 
173.1 	parts 1400.8505 to 1400.8612. The applicant may appeal the denial by notifying the 
173.2 	commissioner in writing by certified mail, by personal service, or through the provider 
173.3 	licensing and reporting hub. If mailed, the appeal must be postmarked and sent to the 
173.4 	commissioner within 20 calendar days after the applicant received the notice of denial. If 
173.5 	an appeal request is made by personal service, it must be received by the commissioner 
173.6 	within 20 calendar days after the applicant received the notice of denial. If the order is issued 
173.7 	through the provider hub, the appeal must be received by the commissioner within 20 
173.8 	calendar days from the date the commissioner issued the order through the hub. Section 
173.9 	245A.08 applies to hearings held to appeal the commissioner's denial of an application.

173.10 	Sec. 9. Minnesota Statutes 2025 Supplement, section 245C.02, subdivision 15a, is amended 
173.11 	to read:
173.12 		Subd. 15a.Reasonable cause to require a national criminal history record check. (a) 
173.13 	"Reasonable cause to require a national criminal history record check" means information 
173.14 	or circumstances exist that provide the commissioner with articulable suspicion that further 
173.15 	pertinent information may exist concerning a background study subject that merits conducting 
173.16 	a national criminal history record check on that subject. The commissioner has reasonable 
173.17 	cause to require a national criminal history record check when:
173.18 	(1) information from the Bureau of Criminal Apprehension indicates that the subject is 
173.19 	a multistate offender;
173.20 	(2) information from the Bureau of Criminal Apprehension indicates that multistate 
173.21 	offender status is undetermined;
173.22 	(3) the commissioner has received a report from the subject or a third party indicating 
173.23 	that the subject has a criminal history in a jurisdiction other than Minnesota; or
173.24 	(4) information from the Bureau of Criminal Apprehension for a state-based name and 
173.25 	date of birth background study in which the subject is a minor that indicates that the subject 
173.26 	has a criminal history.
173.27 	(b) In addition to the circumstances described in paragraph (a), the commissioner has 
173.28 	reasonable cause to require a national criminal history record check if the subject is not 
173.29 	currently residing in Minnesota or resided in a jurisdiction other than Minnesota during the 
173.30 	previous five years.
173.31 	(c) Reasonable cause to require a national criminal history check does not apply to family 
173.32 	child foster care or, adoption, adult day services, or adult foster care studies.

173.33 	EFFECTIVE DATE. This section is effective January 25, 2028.

174.1 	Sec. 10. Minnesota Statutes 2024, section 245C.03, subdivision 1, is amended to read:
174.2 		Subdivision 1. Programs licensed by the commissioner. (a) The commissioner shall 
174.3 	conduct a background study when initiated on the following individuals affiliated with 
174.4 	programs licensed by the commissioner:
174.5 	(1) the person or persons applying for a license;
174.6 	(2) an individual age 13 and over living in the household where the licensed program 
174.7 	will be provided who is not receiving licensed services from the program;
174.8 	(3) current or prospective employees of the applicant or license holder who will have 
174.9 	direct contact with persons served by the facility, agency, or program;
174.10 	(4) volunteers or student volunteers who will have direct contact with persons served 
174.11 	by the program to provide program services if the contact is not under the continuous, direct 
174.12 	supervision by an individual listed in clause (1) or (3);
174.13 	(5) an individual age ten to 12 living in the household where the licensed services will 
174.14 	be provided when the commissioner has reasonable cause as defined in section 245C.02, 
174.15 	subdivision 15;
174.16 	(6) an individual who, without providing direct contact services at a licensed program, 
174.17 	may have unsupervised access to children or vulnerable adults receiving services from a 
174.18 	program, when the commissioner has reasonable cause as defined in section 245C.02, 
174.19 	subdivision 15; and
174.20 	(7) all controlling individuals as defined in section 245A.02, subdivision 5a;
174.21 	(8) notwithstanding clause (3), for children's residential facilities and foster residence 
174.22 	settings, any adult working in the facility, whether or not the individual will have direct 
174.23 	contact with persons served by the facility.
174.24 	(b) For child foster care when the license holder resides in the home where foster care 
174.25 	services are provided, a short-term substitute caregiver providing direct contact services for 
174.26 	a child for less than 72 hours of continuous care is not required to receive a background 
174.27 	study under this chapter.
174.28 	(c) This subdivision applies to the following programs that must be licensed under 
174.29 	chapter 245A:
174.30 	(1) adult foster care;
174.31 	(2) children's residential facilities;
175.1 	(3) licensed home and community-based services under chapter 245D;
175.2 	(4) residential mental health programs for adults;
175.3 	(5) substance use disorder treatment programs under chapter 245G;
175.4 	(6) withdrawal management programs under chapter 245F;
175.5 	(7) adult day care centers;
175.6 	(8) family adult day services;
175.7 	(9) detoxification programs;
175.8 	(10) community residential settings;
175.9 	(11) intensive residential treatment services and residential crisis stabilization under 
175.10 	chapter 245I; and
175.11 	(12) treatment programs for persons with sexual psychopathic personality or sexually 
175.12 	dangerous persons, licensed under chapter 245A and according to Minnesota Rules, parts 
175.13 	9515.3000 to 9515.3110.

175.14 	Sec. 11. Minnesota Statutes 2024, section 245C.03, subdivision 2, is amended to read:
175.15 		Subd. 2.Personal care provider organizations. The commissioner shall conduct 
175.16 	background studies on any individual required under sections 256B.0651 to 256B.0654 and 
175.17 	256B.0659 to have a background study completed under this chapter with at least a five 
175.18 	percent ownership stake in, an operator of, or an employee or volunteer who provides direct 
175.19 	contact services for a personal care provider organization under section 256B.0659. For the 
175.20 	purposes of this subdivision, operator includes board members or other individuals who 
175.21 	oversee the billing, management, or policies of the services provided.

175.22 	Sec. 12. Minnesota Statutes 2024, section 245C.03, subdivision 3, is amended to read:
175.23 		Subd. 3.Supplemental nursing services agencies. The commissioner shall conduct all
175.24 	background studies required under this chapter and initiated by on any individual who is 
175.25 	an owner with at least a five percent ownership stake in, an operator of, or an employee or 
175.26 	volunteer who provides direct contact services for a supplemental nursing services agencies 
175.27 	registered agency under section 144A.71, subdivision 1. For the purposes of this subdivision, 
175.28 	operator includes board members or other individuals who oversee the billing, management, 
175.29 	or policies of the services provided.

176.1 	Sec. 13. Minnesota Statutes 2024, section 245C.03, subdivision 4, is amended to read:
176.2 		Subd. 4.Personnel pool agencies; temporary personnel agencies; educational 
176.3 	programs; professional services agencies. (a) The commissioner also may shall conduct 
176.4 	studies on individuals specified in subdivision 1, paragraph (a), clauses (3) and (4), employees 
176.5 	or volunteers seeking to provide direct contact services for programs licensed by the 
176.6 	commissioner of human services or health when the studies are initiated by:
176.7 	(1) personnel pool agencies;
176.8 	(2) temporary personnel agencies;
176.9 	(3) educational programs that train individuals by providing direct contact services in 
176.10 	licensed programs; and
176.11 	(4) professional services agencies that are not licensed and that work with licensed 
176.12 	programs to provide direct contact services or individuals who provide direct contact services.
176.13 	(b) Personnel pool agencies, temporary personnel agencies, and professional services 
176.14 	agencies must employ the individuals providing direct care services for children, people 
176.15 	with disabilities, or the elderly. Individuals must be affiliated in NETStudy 2.0 and subject 
176.16 	to oversight by the entity, which includes but is not limited to continuous, direct supervision 
176.17 	by the entity and being subject to immediate removal from providing direct care services 
176.18 	when required.

176.19 	Sec. 14. Minnesota Statutes 2024, section 245C.03, subdivision 5a, is amended to read:
176.20 		Subd. 5a.Facilities Programs serving children or adults licensed or regulated by 
176.21 	the Department of Health. (a) Except as specified in paragraph (b), the commissioner shall 
176.22 	conduct background studies under this chapter of:
176.23 	(1) individuals providing services who have direct contact, as defined under section 
176.24 	245C.02, subdivision 11, with patients and residents in any individual with at least a five 
176.25 	percent ownership stake in, an operator of, or an employee or volunteer who provides direct 
176.26 	contact services for hospitals, boarding care homes, outpatient surgical centers licensed 
176.27 	under sections 144.50 to 144.58; nursing homes and home care agencies licensed under 
176.28 	chapter 144A; assisted living facilities and assisted living facilities with dementia care 
176.29 	licensed under chapter 144G; and board and lodging establishments that are registered to 
176.30 	provide supportive or health supervision services under section 157.17;
176.31 	(2) individuals specified in subdivision 2 who provide direct contact services in a any 
176.32 	individual with at least a five percent ownership stake in, an operator of, or an employee or 
177.1 	volunteer who provides direct contact services for nursing home or a home care agency 
177.2 	licensed under chapter 144A; an assisted living facility or assisted living facility with 
177.3 	dementia care licensed under chapter 144G; or a boarding care home licensed under sections 
177.4 	144.50 to 144.58. If the individual undergoing a study resides outside of Minnesota, the 
177.5 	study must include a check for substantiated findings of maltreatment of adults and children 
177.6 	in the individual's state of residence when the state makes the information available; and
177.7 	(3) all other employees in any individual with at least a five percent ownership stake in, 
177.8 	an operator of, or an employee or volunteer who provides direct contact services for assisted 
177.9 	living facilities or assisted living facilities with dementia care licensed under chapter 144G, 
177.10 	nursing homes licensed under chapter 144A, and boarding care homes licensed under sections 
177.11 	144.50 to 144.58. A disqualification of an individual in this section shall disqualify the 
177.12 	individual from positions allowing direct contact with or access to patients or residents 
177.13 	receiving services. "Access" means physical access to a client or the client's personal property 
177.14 	without continuous, direct supervision as defined in section 245C.02, subdivision 8, when 
177.15 	the employee's employment responsibilities do not include providing direct contact services;
177.16 	(4) individuals employed by a supplemental nursing services agency, as defined under 
177.17 	section 144A.70, who are providing services in health care facilities;
177.18 	(5) controlling persons of a supplemental nursing services agency, as defined by section 
177.19 	144A.70; and
177.20 	(6) license applicants, owners, managerial officials, and controlling individuals who are 
177.21 	required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a 
177.22 	background study under this chapter, regardless of the licensure status of the license applicant, 
177.23 	owner, managerial official, or controlling individual.
177.24 	(b) An entity shall not initiate a background study on any individual identified in 
177.25 	paragraph (a), clauses (1) to (5) (3), if the individual has a valid license issued by a 
177.26 	health-related licensing board as defined in section 214.01, subdivision 2, and has completed 
177.27 	the criminal background check as required in section 214.075. An entity that is affiliated 
177.28 	with individuals who meet the requirements of this paragraph must separate those individuals 
177.29 	from the entity's roster for NETStudy 2.0. The Department of Human Services is not liable 
177.30 	for conducting background studies that have been submitted or not removed from the roster 
177.31 	in violation of this provision.
177.32 	(c) If a facility or program is licensed by the Department of Human Services and the 
177.33 	Department of Health and is subject to the background study provisions of this chapter, the 
178.1 	Department of Human Services is solely responsible for the background studies of individuals 
178.2 	in the jointly licensed program.
178.3 	(d) The commissioner of health shall review and make decisions regarding reconsideration 
178.4 	requests, including whether to grant variances, according to the procedures and criteria in 
178.5 	this chapter. The commissioner of health shall inform the requesting individual and the 
178.6 	Department of Human Services of the commissioner of health's decision regarding the 
178.7 	reconsideration. The commissioner of health's decision to grant or deny a reconsideration 
178.8 	of a disqualification is a final administrative agency action.

178.9 	Sec. 15. Minnesota Statutes 2024, section 245C.03, subdivision 5b, is amended to read:
178.10 		Subd. 5b.Facilities serving children or youth licensed by the Department of 
178.11 	Corrections. (a) The commissioner shall conduct background studies of individuals any 
178.12 	individual with at least a five percent ownership stake in, an operator of, or an employee
178.13 	working in secure and nonsecure children's residential facilities, juvenile detention facilities, 
178.14 	and foster residence settings, whether or not the individual will have direct contact, as 
178.15 	defined under section 245C.02, subdivision 11, with persons served in the facilities or 
178.16 	settings.
178.17 	(b) A clerk or administrator of any court, the Bureau of Criminal Apprehension, a 
178.18 	prosecuting attorney, a county sheriff, or a chief of a local police department shall assist in 
178.19 	conducting background studies by providing the commissioner of human services or the 
178.20 	commissioner's representative all criminal conviction data available from local and state 
178.21 	criminal history record repositories related to applicants, operators, all persons living in a 
178.22 	household, and all staff of any facility subject to background studies under this subdivision.
178.23 	(c) (b) For the purpose of this subdivision, the term "secure and nonsecure residential 
178.24 	facility and detention facility" includes programs licensed or certified under section 241.021, 
178.25 	subdivision 2.
178.26 	(d) If an individual is disqualified, the Department of Human Services shall notify the 
178.27 	disqualified individual and the facility in which the disqualified individual provides services 
178.28 	of the disqualification and shall inform the disqualified individual of the right to request a 
178.29 	reconsideration of the disqualification by submitting the request to the Department of 
178.30 	Corrections.
178.31 	(e) The commissioner of corrections shall review and make decisions regarding 
178.32 	reconsideration requests, including whether to grant variances, according to the procedures 
178.33 	and criteria in this chapter. The commissioner of corrections shall inform the requesting 
179.1 	individual and the Department of Human Services of the commissioner of corrections' 
179.2 	decision regarding the reconsideration. The commissioner of corrections' decision to grant 
179.3 	or deny a reconsideration of a disqualification is the final administrative agency action.

179.4 	Sec. 16. Minnesota Statutes 2024, section 245C.03, subdivision 7, is amended to read:
179.5 		Subd. 7.Children's therapeutic services and supports providers. The commissioner 
179.6 	shall conduct background studies of all direct service providers and volunteers any individual 
179.7 	with at least a five percent ownership stake in, an operator of, or an employee or volunteer
179.8 	for children's therapeutic services and supports providers under section 256B.0943.

179.9 	Sec. 17. Minnesota Statutes 2024, section 245C.03, subdivision 9, is amended to read:
179.10 		Subd. 9.Community first services and supports and financial management services 
179.11 	organizations. Individuals affiliated with Community First Services and Supports (CFSS) 
179.12 	agency-providers and Financial Management Services (FMS) providers enrolled to provide 
179.13 	CFSS services under the medical assistance program must meet the following requirements:
179.14 	(1) owners who have a five percent interest or more and all managing employees are 
179.15 	subject to a background study under this chapter. This requirement applies to currently 
179.16 	enrolled providers and agencies seeking enrollment. "Managing employee" has the meaning 
179.17 	given in Code of Federal Regulations, title 42, section 455.101. An organization is barred 
179.18 	from enrollment if:
179.19 	(i) the organization has not initiated background studies of owners and managing 
179.20 	employees; or
179.21 	(ii) the organization has initiated background studies of owners and managing employees 
179.22 	and the commissioner has sent the organization a notice that an owner or managing employee 
179.23 	of the organization has been disqualified under section 245C.14 and the owner or managing 
179.24 	employee has not received a set aside of the disqualification under section 245C.22;
179.25 	(2) a background study must be initiated and completed for all staff who will have direct 
179.26 	contact with the participant to provide worker training and development; and
179.27 	(3) a background study must be initiated and completed for all support workers.
179.28 	The commissioner shall conduct background studies of any individual with at least a 
179.29 	five percent ownership stake in, an operator of, or an employee or volunteer for Community 
179.30 	First Services and Supports (CFSS) agency-providers and Financial Management Services 
179.31 	providers enrolled to provide CFSS services under section 256B.85. For the purposes of 
180.1 	this subdivision, operator includes board members or other individuals who oversee the 
180.2 	billing, management, or policies of the services provided.

180.3 	Sec. 18. Minnesota Statutes 2024, section 245C.03, subdivision 10, is amended to read:
180.4 		Subd. 10.Providers of housing support or supplementary services. (a) The 
180.5 	commissioner shall conduct background studies of the following individuals who provide 
180.6 	services under section 256I.04:
180.7 	(1) controlling individuals as defined in section 245A.02;
180.8 	(2) managerial officials as defined in section 245A.02; and
180.9 	(3) all employees and volunteers of the establishment who have direct contact with 
180.10 	recipients or who have unsupervised access to recipients, recipients' personal property, or 
180.11 	recipients' private data.
180.12 	(b) The provider of housing support must comply with all requirements for entities 
180.13 	initiating background studies under this chapter.
180.14 	(c) A provider of housing support must demonstrate that all individuals who are required 
180.15 	to have a background study according to paragraph (a) have a notice stating that:
180.16 	(1) the individual is not disqualified under section 245C.14; or
180.17 	(2) the individual is disqualified and the individual has been issued a set aside of the 
180.18 	disqualification for the setting under section 245C.22.

180.19 	Sec. 19. Minnesota Statutes 2024, section 245C.03, subdivision 12, is amended to read:
180.20 		Subd. 12.Providers of special transportation service. (a) The commissioner shall 
180.21 	conduct background studies of the following individuals who provide special transportation 
180.22 	services under section 174.30:
180.23 	(1) each person with a direct or indirect ownership interest of five percent or higher in 
180.24 	a transportation service provider;
180.25 	(2) each controlling individual as defined under section 245A.02;
180.26 	(3) a managerial official as defined in section 245A.02;
180.27 	(4) each driver employed by the transportation service provider;
180.28 	(5) each individual employed by the transportation service provider to assist a passenger 
180.29 	during transport; and
181.1 	(6) each employee of the transportation service agency who provides administrative 
181.2 	support, including an employee who:
181.3 	(i) may have face-to-face contact with or access to passengers, passengers' personal 
181.4 	property, or passengers' private data;
181.5 	(ii) performs any scheduling or dispatching tasks; or
181.6 	(iii) performs any billing activities.
181.7 	(b) When a local or contracted agency is authorizing a ride under section 256B.0625, 
181.8 	subdivision 17, by a volunteer driver, and the agency authorizing the ride has a reason to 
181.9 	believe that the volunteer driver has a history that would disqualify the volunteer driver or 
181.10 	that may pose a risk to the health or safety of passengers, the agency may initiate a 
181.11 	background study that shall be completed according to this chapter using the commissioner 
181.12 	of human services' online NETStudy system, or by contacting the Department of Human 
181.13 	Services background study division for assistance. The agency that initiates the background 
181.14 	study under this paragraph shall be responsible for providing the volunteer driver with the 
181.15 	privacy notice required by section 245C.05, subdivision 2c, and with the payment for the 
181.16 	background study required by section 245C.10 before the background study is completed.

181.17 	Sec. 20. Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision 
181.18 	to read:
181.19 		Subd. 17.Providers of adult rehabilitative mental health services. The commissioner 
181.20 	shall conduct background studies on any individual with an ownership stake of at least five 
181.21 	percent in an adult rehabilitative mental health services provider, an operator of an adult 
181.22 	rehabilitative mental health services provider, or an employee or volunteer who has direct 
181.23 	contact with people receiving adult rehabilitative mental health services under section 
181.24 	256B.0623.

181.25 	Sec. 21. Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision 
181.26 	to read:
181.27 		Subd. 18.Providers of peer recovery services. The commissioner shall conduct 
181.28 	background studies on any individual with an ownership stake of at least five percent in a 
181.29 	peer recovery services provider, an operator of a peer recovery service provider, or an 
181.30 	employee or volunteer who has direct contact with people receiving peer recovery services 
181.31 	under section 254B.052.

182.1 	Sec. 22. Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision 
182.2 	to read:
182.3 		Subd. 19.Providers of adult assertive community treatment services. The 
182.4 	commissioner shall conduct background studies on any individual with an ownership stake 
182.5 	of at least five percent in an adult assertive community treatment services provider, an 
182.6 	operator of an adult assertive community treatment services provider, or an employee or 
182.7 	volunteer who has direct contact with people receiving adult assertive community treatment 
182.8 	services under section 256B.0622.

182.9 	Sec. 23. Minnesota Statutes 2024, section 245C.04, subdivision 1, is amended to read:
182.10 		Subdivision 1.Licensed programs; other child care programs When studies are 
182.11 	initiated. (a) The commissioner shall conduct a background study of an individual required 
182.12 	to be studied For all studies required under section 245C.03, subdivision 1, the entity shall 
182.13 	initiate the study using the electronic system known as NETStudy 2.0 at least upon 
182.14 	application for initial license for all license types or enrollment and before owning, operating, 
182.15 	or providing direct contact services.
182.16 	(b) The commissioner shall conduct a background study of an individual required to be 
182.17 	studied under section 245C.03, subdivision 1, including a child care background study 
182.18 	subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed 
182.19 	child care center, certified license-exempt child care center, or legal nonlicensed child care 
182.20 	provider, on a schedule determined by the commissioner. Except as provided in section 
182.21 	245C.05, subdivision 5a, a child care background study must include submission of 
182.22 	fingerprints for a national criminal history record check and a review of the information 
182.23 	under section 245C.08. A background study for a child care program must be repeated 
182.24 	within five years from the most recent study conducted under this paragraph.
182.25 	(c) At reauthorization or when a new background study is needed under section 142E.16, 
182.26 	subdivision 2, for a legal nonlicensed child care provider authorized under chapter 142E:
182.27 	(1) for a background study affiliated with a legal nonlicensed child care provider, the 
182.28 	individual shall provide information required under section 245C.05, subdivision 1, 
182.29 	paragraphs (a), (b), and (d), to the commissioner and be fingerprinted and photographed 
182.30 	under section 245C.05, subdivision 5; and
182.31 	(2) the commissioner shall verify the information received under clause (1) and submit 
182.32 	the request in NETStudy 2.0 to complete the background study.
182.33 	(d) At reapplication for a family child care license:
183.1 	(1) for a background study affiliated with a licensed family child care center, the 
183.2 	individual shall provide information required under section 245C.05, subdivision 1, 
183.3 	paragraphs (a), (b), and (d), to the county agency, and be fingerprinted and photographed 
183.4 	under section 245C.05, subdivision 5;
183.5 	(2) the county agency shall verify the information received under clause (1) and forward 
183.6 	the information to the commissioner and submit the request in NETStudy 2.0 to complete 
183.7 	the background study; and
183.8 	(3) the background study conducted by the commissioner under this paragraph must 
183.9 	include a review of the information required under section 245C.08.
183.10 	(e) The commissioner is not required to conduct a study of an individual at the time of 
183.11 	reapplication for a license if the individual's background study was completed by the 
183.12 	commissioner of human services and the following conditions are met:
183.13 	(1) a study of the individual was conducted either at the time of initial licensure or when 
183.14 	the individual became affiliated with the license holder;
183.15 	(2) the individual has been continuously affiliated with the license holder since the last 
183.16 	study was conducted; and
183.17 	(3) the last study of the individual was conducted on or after October 1, 1995.
183.18 	(f) The commissioner of human services shall conduct a background study of an 
183.19 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), 
183.20 	who is newly affiliated with a child foster family setting license holder:
183.21 	(1) the county or private agency shall collect and forward to the commissioner the 
183.22 	information required under section 245C.05, subdivisions 1 and 5, when the child foster 
183.23 	family setting applicant or license holder resides in the home where child foster care services 
183.24 	are provided; and
183.25 	(2) the background study conducted by the commissioner of human services under this 
183.26 	paragraph must include a review of the information required under section 245C.08, 
183.27 	subdivisions 1, 3, and 4.
183.28 	(g) The commissioner shall conduct a background study of an individual specified under 
183.29 	section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated 
183.30 	with an adult foster care or family adult day services and with a family child care license 
183.31 	holder or a legal nonlicensed child care provider authorized under chapter 142E and:
184.1 	(1) except as provided in section 245C.05, subdivision 5a, the county shall collect and 
184.2 	forward to the commissioner the information required under section 245C.05, subdivision 
184.3 	1, paragraphs (a) and (b), and subdivision 5, paragraph (b), for background studies conducted 
184.4 	by the commissioner for all family adult day services, for adult foster care when the adult 
184.5 	foster care license holder resides in the adult foster care residence, and for family child care 
184.6 	and legal nonlicensed child care authorized under chapter 142E;
184.7 	(2) the license holder shall collect and forward to the commissioner the information 
184.8 	required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs 
184.9 	(a) and (b), for background studies conducted by the commissioner for adult foster care 
184.10 	when the license holder does not reside in the adult foster care residence; and
184.11 	(3) the background study conducted by the commissioner under this paragraph must 
184.12 	include a review of the information required under section 245C.08, subdivision 1, paragraph 
184.13 	(a), and subdivisions 3 and 4.
184.14 	(h) Applicants for licensure, license holders, and other entities as provided in this chapter 
184.15 	must submit completed background study requests to the commissioner using the electronic 
184.16 	system known as NETStudy before individuals specified in section 245C.03, subdivision 
184.17 	1, begin positions allowing direct contact in any licensed program.
184.18 	(i) For an individual who is not on the entity's active roster, the entity must initiate a 
184.19 	new background study through NETStudy when:
184.20 	(1) an individual returns to a position requiring a background study following an absence 
184.21 	of 120 or more consecutive days; or
184.22 	(2) a program that discontinued providing licensed direct contact services for 120 or 
184.23 	more consecutive days begins to provide direct contact licensed services again.
184.24 	The license holder shall maintain a copy of the notification provided to the commissioner 
184.25 	under this paragraph in the program's files. If the individual's disqualification was previously 
184.26 	set aside for the license holder's program and the new background study results in no new 
184.27 	information that indicates the individual may pose a risk of harm to persons receiving 
184.28 	services from the license holder, the previous set-aside shall remain in effect.
184.29 	(j) For purposes of this section, a physician licensed under chapter 147, advanced practice 
184.30 	registered nurse licensed under chapter 148, or physician assistant licensed under chapter 
184.31 	147A is considered to be continuously affiliated upon the license holder's receipt from the 
184.32 	commissioner of health or human services of the physician's, advanced practice registered 
184.33 	nurse's, or physician assistant's background study results.
185.1 	(k) For purposes of family child care, a substitute caregiver must receive repeat 
185.2 	background studies at the time of each license renewal.
185.3 	(l) A repeat background study at the time of license renewal is not required if the family 
185.4 	child care substitute caregiver's background study was completed by the commissioner on 
185.5 	or after October 1, 2017, and the substitute caregiver is on the license holder's active roster 
185.6 	in NETStudy 2.0.
185.7 	(m) Before and after school programs authorized under chapter 142E, are exempt from 
185.8 	the background study requirements under section 123B.03, for an employee for whom a 
185.9 	background study under this chapter has been completed.

185.10 	Sec. 24. Minnesota Statutes 2024, section 245C.04, subdivision 4a, is amended to read:
185.11 		Subd. 4a.Agency background studies; electronic criminal case information updates; 
185.12 	rosters; and criteria for eliminating repeat background studies. (a) The commissioner 
185.13 	shall develop and implement an electronic process as a part of NETStudy 2.0 for the regular 
185.14 	transfer of new criminal case information that is added to the Minnesota court information 
185.15 	system. The commissioner's system must include for review only information that relates 
185.16 	to individuals who are on the master roster. Entities initiating studies under section 245C.03 
185.17 	are exempt from any requirement to initiate repeat studies as long as the individual remains 
185.18 	continually affiliated with the roster; the individual has a final determination of eligibility, 
185.19 	a set aside, or a variance granted; and the individual's legal name does not change.
185.20 	(b) The commissioner shall develop and implement an online system as a part of 
185.21 	NETStudy 2.0 for agencies that initiate background studies under this chapter to access and 
185.22 	maintain records of background studies initiated by that agency. The system must show all 
185.23 	active background study subjects affiliated with that agency and the status of each individual's 
185.24 	background study. Each agency that initiates background studies must use this system to 
185.25 	notify the commissioner of discontinued affiliation for purposes of the processes required 
185.26 	under paragraph (a). Notwithstanding paragraph (a), every individual continuously affiliated 
185.27 	with a child care provider must have a new background study initiated every five years.
185.28 	(c) After an entity initiating a background study has paid the applicable fee for the study 
185.29 	and has provided the individual with the privacy notice required under section 245C.05, 
185.30 	subdivision 2c, NETStudy 2.0 shall immediately inform the entity whether the individual 
185.31 	requires a background study or whether the individual is immediately eligible to provide 
185.32 	services based on a previous background study. If the individual is immediately eligible, 
185.33 	the entity initiating the background study shall be able to view the information previously 
185.34 	supplied by the individual who is the subject of a background study as required under section 
186.1 	245C.05, subdivision 1, including the individual's photograph taken at the time the 
186.2 	individual's fingerprints were recorded. The commissioner shall not provide any entity 
186.3 	initiating a subsequent background study with information regarding the other entities that 
186.4 	initiated background studies on the subject.
186.5 	(d) Verification that an individual is eligible to provide services based on a previous 
186.6 	background study is dependent on the individual voluntarily providing the individual's 
186.7 	Social Security number to the commissioner at the time each background study is initiated. 
186.8 	When an individual does not provide the individual's Social Security number for the 
186.9 	background study, that study is not transferable and a repeat background study on that 
186.10 	individual is required if the individual seeks a position requiring a background study under 
186.11 	this chapter with another entity.

186.12 	Sec. 25. Minnesota Statutes 2025 Supplement, section 245C.05, subdivision 5, is amended 
186.13 	to read:
186.14 		Subd. 5.Fingerprints and photograph. (a) Notwithstanding paragraph (c), for 
186.15 	background studies conducted by the commissioner for current or prospective child foster 
186.16 	or adoptive parents, and for any adult working in a children's residential facility, the subject 
186.17 	of the background study shall provide the commissioner with a set of classifiable fingerprints 
186.18 	obtained from an authorized agency for a national criminal history record check.
186.19 	(b) Notwithstanding paragraph (c), for background studies conducted by the commissioner 
186.20 	for Head Start programs, the subject of the background study shall provide the commissioner 
186.21 	with a set of classifiable fingerprints obtained from an authorized agency for a national 
186.22 	criminal history record check.
186.23 	(c) For background studies initiated on or after the implementation of NETStudy 2.0, 
186.24 	except as provided under subdivision 5a, every subject of a background study must provide 
186.25 	the commissioner with a set of the background study subject's classifiable fingerprints and 
186.26 	photograph. The photograph and fingerprints must be recorded at the same time by the 
186.27 	authorized fingerprint collection vendor or vendors and sent to the commissioner through 
186.28 	the commissioner's secure data system described in section 245C.32, subdivision 1a, 
186.29 	paragraph (b).
186.30 	(d) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal 
186.31 	Apprehension and, when specifically required by law, submitted to the Federal Bureau of 
186.32 	Investigation for a national criminal history record check.
187.1 	(e) The fingerprints must not be retained by the Department of Public Safety, Bureau 
187.2 	of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will 
187.3 	not retain background study subjects' fingerprints.
187.4 	(f) The authorized fingerprint collection vendor or vendors shall, for purposes of verifying 
187.5 	the identity of the background study subject, be able to view the identifying information 
187.6 	entered into NETStudy 2.0 by the entity that initiated the background study, but shall not 
187.7 	retain the subject's fingerprints, photograph, or information from NETStudy 2.0. The 
187.8 	authorized fingerprint collection vendor or vendors shall retain no more than the name and 
187.9 	date and time the subject's fingerprints were recorded and sent, only as necessary for auditing 
187.10 	and billing activities.
187.11 	(g) For any background study conducted under this chapter, except for family child 
187.12 	foster care or, adoption, adult day services, or adult foster care studies, the subject shall 
187.13 	provide the commissioner with a set of classifiable fingerprints when the commissioner has 
187.14 	reasonable cause to require a national criminal history record check as defined in section 
187.15 	245C.02, subdivision 15a.

187.16 	EFFECTIVE DATE. This section is effective January 25, 2028.

187.17 	Sec. 26. Minnesota Statutes 2025 Supplement, section 245C.05, subdivision 5a, is amended 
187.18 	to read:
187.19 		Subd. 5a.Background study requirements for minors. (a) A background study 
187.20 	completed under this chapter on a subject who is required to be studied under section 
187.21 	245C.03, subdivision 1, and is 17 years of age or younger shall be completed by the 
187.22 	commissioner for:
187.23 	(1) a legal nonlicensed child care provider authorized under chapter 142E;
187.24 	(2) a licensed family child care program; or
187.25 	(3) a licensed foster care home.
187.26 	(b) The subject shall submit to the commissioner only the information under subdivision 
187.27 	1, paragraph (a).
187.28 	(c) For child care studies, a subject who is 17 years of age or younger is required to 
187.29 	submit fingerprints and a photograph, and the commissioner shall conduct a national criminal 
187.30 	history record check, if:
187.31 	(1) the commissioner has reasonable cause to require a national criminal history record 
187.32 	check defined in section 245C.02, subdivision 15a; or
188.1 	(2) under paragraph (a), clauses (1) and (2), the subject is employed by the provider or 
188.2 	supervises children served by the program.
188.3 	(d) For child care studies, a subject who is 17 years of age or younger is required to 
188.4 	submit non-fingerprint-based data according to section 245C.08, subdivision 1, paragraph 
188.5 	(a), clause (6), item (iii), and the commissioner shall conduct the check if:
188.6 	(1) the commissioner has reasonable cause to require a national criminal history record 
188.7 	check defined in section 245C.02, subdivision 15a; or
188.8 	(2) the subject is employed by the provider or supervises children served by the program 
188.9 	under paragraph (a), clauses (1) and (2).

188.10 	Sec. 27. Minnesota Statutes 2025 Supplement, section 245C.08, subdivision 1, is amended 
188.11 	to read:
188.12 		Subdivision 1.Background studies conducted by Department of Human Services. (a) 
188.13 	For a background study conducted by the Department of Human Services, the commissioner 
188.14 	shall review:
188.15 	(1) information related to names of substantiated perpetrators of maltreatment of 
188.16 	vulnerable adults that has been received by the commissioner as required under section 
188.17 	626.557, subdivision 9c, paragraph (j);
188.18 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
188.19 	programs, and from findings of maltreatment of minors as indicated through the social 
188.20 	service information system;
188.21 	(3) information from juvenile courts as required for studies under this chapter when 
188.22 	there is reasonable cause;
188.23 	(4) information from the Bureau of Criminal Apprehension, including information 
188.24 	regarding a background study subject's registration in Minnesota as a predatory offender 
188.25 	under section 243.166;
188.26 	(5) except as provided in clause (6), information received as a result of submission of 
188.27 	fingerprints for a national criminal history record check, as defined in section 245C.02, 
188.28 	subdivision 13c, when the commissioner has reasonable cause for a national criminal history 
188.29 	record check as defined under section 245C.02, subdivision 15a, or as required under section 
188.30 	144.057, subdivision 1, clause (2);
188.31 	(6) for a background study related to a child foster family setting application for licensure, 
188.32 	foster residence settings, children's residential facilities, a transfer of permanent legal and 
189.1 	physical custody of a child under sections 260C.503 to 260C.515, or adoptions, and for a 
189.2 	background study required for family child care, certified license-exempt child care, child 
189.3 	care centers, and legal nonlicensed child care authorized under chapter 142E, the 
189.4 	commissioner shall also review:
189.5 	(i) information from the child abuse and neglect registry for any state in which the 
189.6 	background study subject has resided for the past five years;
189.7 	(ii) information received from a national criminal history record check, if authorized for 
189.8 	the study; and
189.9 	(iii) when the background study subject is 18 years of age or older or a minor under 
189.10 	section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified 
189.11 	license-exempt child care, licensed child care centers, and legal nonlicensed child care 
189.12 	authorized under chapter 142E, information obtained using non-fingerprint-based data 
189.13 	including information from the criminal and sex offender registries for any state in which 
189.14 	the background study subject resided for the past five years and information from the national 
189.15 	crime information database and the national sex offender registry;
189.16 	(7) for a background study required for family child care, certified license-exempt child 
189.17 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
189.18 	chapter 142E, the background study shall also include, to the extent practicable, a name and 
189.19 	date-of-birth search of the National Sex Offender Public website; and
189.20 	(8) for a background study required for treatment programs for sexual psychopathic 
189.21 	personalities or sexually dangerous persons, the background study shall only include a 
189.22 	review of the information required under paragraph (a), clauses (1) to (4).
189.23 	(b) Except as otherwise provided in this paragraph, notwithstanding expungement by a 
189.24 	court, the commissioner may consider information obtained under paragraph (a), clauses 
189.25 	(3) and (4), unless:
189.26 	(1) the commissioner received notice of the petition for expungement and the court order 
189.27 	for expungement is directed specifically to the commissioner; or
189.28 	(2) the commissioner received notice of the expungement order issued pursuant to section 
189.29 	609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically 
189.30 	to the commissioner.
189.31 	The commissioner may not consider information obtained under paragraph (a), clauses (3) 
189.32 	and (4), or from any other source that identifies a violation of chapter 152 without 
189.33 	determining if the offense involved the possession of marijuana or tetrahydrocannabinol 
190.1 	and, if so, whether the person received a grant of expungement or order of expungement, 
190.2 	or the person was resentenced to a lesser offense. If the person received a grant of 
190.3 	expungement or order of expungement, the commissioner may not consider information 
190.4 	related to that violation but may consider any other relevant information arising out of the 
190.5 	same incident.
190.6 	(c) The commissioner shall also review criminal case information received according 
190.7 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
190.8 	to individuals who have already been studied under this chapter and who remain affiliated 
190.9 	with the agency that initiated the background study.
190.10 	(d) When the commissioner has reasonable cause to believe that the identity of a 
190.11 	background study subject is uncertain, the commissioner may require the subject to provide 
190.12 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
190.13 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
190.14 	shall not be saved by the commissioner after they have been used to verify the identity of 
190.15 	the background study subject against the particular criminal record in question.
190.16 	(e) The commissioner may inform the entity that initiated a background study under 
190.17 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

190.18 	Sec. 28. Minnesota Statutes 2024, section 245C.10, subdivision 4, is amended to read:
190.19 		Subd. 4.Temporary personnel agencies, personnel pool agencies, educational 
190.20 	programs, and professional services agencies. The commissioner shall recover the cost 
190.21 	of the background studies initiated by temporary personnel agencies, personnel pool agencies, 
190.22 	educational programs, and professional services agencies that initiate background studies 
190.23 	under section 245C.03, subdivision 4, through a fee of no more than $44 per study charged 
190.24 	to the agency. The fees collected under this subdivision are appropriated to the commissioner 
190.25 	for the purpose of conducting background studies.

190.26 	Sec. 29. Minnesota Statutes 2024, section 245C.10, subdivision 5, is amended to read:
190.27 		Subd. 5.Adult foster care and family adult day services. The commissioner shall 
190.28 	recover the cost of background studies required under section 245C.03, subdivision 1, for 
190.29 	the purposes of adult foster care and family adult day services licensing, through a fee of 
190.30 	no more than $44 per study charged to the license holder. The fees collected under this 
190.31 	subdivision are appropriated to the commissioner for the purpose of conducting background 
190.32 	studies.

191.1 	Sec. 30. Minnesota Statutes 2024, section 245C.10, subdivision 8, is amended to read:
191.2 		Subd. 8.Children's therapeutic services and supports providers. The commissioner 
191.3 	shall recover the cost of background studies required under section 245C.03, subdivision 
191.4 	7, for the purposes of children's therapeutic services and supports under section 256B.0943, 
191.5 	through a fee of no more than $44 per study charged to the license holder. The fees collected 
191.6 	under this subdivision are appropriated to the commissioner for the purpose of conducting 
191.7 	background studies.

191.8 	Sec. 31. Minnesota Statutes 2025 Supplement, section 245C.10, subdivision 9, is amended 
191.9 	to read:
191.10 		Subd. 9.Human services licensed programs. The commissioner shall recover the cost 
191.11 	of background studies required under section 245C.03, subdivision 1, for all programs that 
191.12 	are licensed by the commissioner through a fee of no more than $44 per study charged to 
191.13 	the license holder. The fees collected under this subdivision are appropriated to the 
191.14 	commissioner for the purpose of conducting background studies.

191.15 	Sec. 32. Minnesota Statutes 2024, section 245C.10, subdivision 17, is amended to read:
191.16 		Subd. 17.Early intensive developmental and behavioral intervention providers. The 
191.17 	commissioner shall recover the cost of background studies required under section 245C.03, 
191.18 	subdivision 15, for the purposes of early intensive developmental and behavioral intervention 
191.19 	under section 256B.0949, through a fee of no more than $44 per study charged to the enrolled 
191.20 	agency. The fees collected under this subdivision are appropriated to the commissioner for 
191.21 	the purpose of conducting background studies.

191.22 	Sec. 33. Minnesota Statutes 2025 Supplement, section 245C.10, subdivision 22, is amended 
191.23 	to read:
191.24 		Subd. 22.Recuperative care providers. The commissioner shall recover the cost of 
191.25 	background studies required under section 245C.03, subdivision 16, for recuperative care 
191.26 	under section 256B.0701, through a fee of no more than $44 per study charged to the enrolled 
191.27 	provider. The fees collected under this subdivision are appropriated to the commissioner 
191.28 	for the purpose of conducting background studies.

192.1 	Sec. 34. Minnesota Statutes 2025 Supplement, section 245C.13, subdivision 2, is amended 
192.2 	to read:
192.3 		Subd. 2.Activities pending completion of background study. The subject of a 
192.4 	background study may not perform any activity requiring a background study under 
192.5 	paragraph (c) until the commissioner has issued one of the notices under paragraph (a).
192.6 	(a) Notices from the commissioner required prior to activity under paragraph (c) include:
192.7 	(1) a notice of the study results under section 245C.17 stating that:
192.8 	(i) the individual is not disqualified; or
192.9 	(ii) more time is needed to complete the study but the individual is not required to be 
192.10 	removed from direct contact or access to people receiving services prior to completion of 
192.11 	the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice 
192.12 	that more time is needed to complete the study must also indicate whether the individual is 
192.13 	required to be under continuous direct supervision prior to completion of the background 
192.14 	study. When more time is necessary to complete a background study of an individual 
192.15 	affiliated with a Title IV-E eligible children's residential facility or foster residence setting, 
192.16 	the individual may not work in the facility or setting regardless of whether or not the 
192.17 	individual is supervised;
192.18 	(2) a notice that a disqualification has been set aside under section 245C.23; or
192.19 	(3) a notice that a variance has been granted related to the individual under section 
192.20 	245C.30.
192.21 	(b) For a background study affiliated with a licensed child care center or certified 
192.22 	license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii), 
192.23 	must not be issued until the commissioner receives a qualifying result for the individual for 
192.24 	the fingerprint-based national criminal history record check or the fingerprint-based criminal 
192.25 	history information from the Bureau of Criminal Apprehension. The notice must require 
192.26 	the individual to be under continuous direct supervision prior to completion of the remainder 
192.27 	of the background study except as permitted in subdivision 3.
192.28 	(c) Activities prohibited prior to receipt of notice under paragraph (a) include:
192.29 	(1) being issued a license;
192.30 	(2) living in the household where the licensed program will be provided;
192.31 	(3) providing direct contact services to persons served by a program unless the subject 
192.32 	is under continuous direct supervision;
193.1 	(4) having access to persons receiving services if the background study was completed 
193.2 	under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2), 
193.3 	(5), or (6), unless the subject is under continuous direct supervision;
193.4 	(5) for licensed child care centers and certified license-exempt child care centers, 
193.5 	providing direct contact services to persons served by the program;
193.6 	(6) for children's residential facilities or foster residence settings, working in the facility 
193.7 	or setting; or
193.8 	(7) for background studies affiliated with a personal care provider organization, except 
193.9 	as provided in section 245C.03, subdivision 3b, early intensive developmental and behavioral 
193.10 	intervention provider, housing support or supplementary services provider, special 
193.11 	transportation services provider, or community first services and supports provider before 
193.12 	a personal care assistant an individual provides services, the personal care assistance provider 
193.13 	agency entity must initiate a background study of the personal care assistant individual
193.14 	under this chapter and the personal care assistance provider agency entity must have received 
193.15 	a notice from the commissioner that the personal care assistant individual is:
193.16 	(i) not disqualified under section 245C.14; or
193.17 	(ii) disqualified, but the personal care assistant individual has received a set aside of the 
193.18 	disqualification under section 245C.22; or.
193.19 	(8) for background studies affiliated with an early intensive developmental and behavioral 
193.20 	intervention provider, before an individual provides services, the early intensive 
193.21 	developmental and behavioral intervention provider must initiate a background study for 
193.22 	the individual under this chapter and the early intensive developmental and behavioral 
193.23 	intervention provider must have received a notice from the commissioner that the individual 
193.24 	is:
193.25 	(i) not disqualified under section 245C.14; or
193.26 	(ii) disqualified, but the individual has received a set-aside of the disqualification under 
193.27 	section 245C.22.

193.28 	Sec. 35. Minnesota Statutes 2024, section 245C.14, subdivision 1, is amended to read:
193.29 		Subdivision 1.Disqualification from direct contact. (a) The commissioner shall 
193.30 	disqualify an individual who is the subject of a background study from any position allowing 
193.31 	direct contact with persons receiving services from the license holder or entity identified in 
194.1 	section 245C.03, upon receipt of information showing, or when a background study 
194.2 	completed under this chapter shows any of the following:
194.3 	(1) a conviction of, admission to, or Alford plea to one or more crimes listed in section 
194.4 	245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor, 
194.5 	or misdemeanor level crime;
194.6 	(2) a preponderance of the evidence indicates the individual has committed an act or 
194.7 	acts that meet the definition of any of the crimes listed in section 245C.15, regardless of 
194.8 	whether the preponderance of the evidence is for a felony, gross misdemeanor, or 
194.9 	misdemeanor level crime;
194.10 	(3) an investigation results in an administrative determination listed under section 
194.11 	245C.15, subdivision 4, paragraph (b); or
194.12 	(4) the individual's parental rights have been terminated under section 260C.301, 
194.13 	subdivision 1, paragraph (b), or section 260C.301, subdivision 3.
194.14 	(b) No individual who is disqualified following a background study under section 
194.15 	245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with 
194.16 	persons served by a program or entity identified in section 245C.03, unless the commissioner 
194.17 	has provided written notice under section 245C.17 stating that:
194.18 	(1) the individual may remain in direct contact during the period in which the individual 
194.19 	may request reconsideration as provided in section 245C.21, subdivision 2;
194.20 	(2) the commissioner has set aside the individual's disqualification for that program or 
194.21 	entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or
194.22 	(3) the license holder has been granted a variance for the disqualified individual under 
194.23 	section 245C.30.
194.24 	(c) Notwithstanding paragraph (a), for the purposes of a background study affiliated 
194.25 	with a licensed family foster setting, the commissioner shall disqualify an individual who 
194.26 	is the subject of a background study from any position allowing direct contact with persons 
194.27 	receiving services from the license holder or entity identified in section 245C.03, upon 
194.28 	receipt of information showing or when a background study completed under this chapter 
194.29 	shows reason for disqualification under section 245C.15, subdivision 4a.

194.30 	Sec. 36. Minnesota Statutes 2024, section 245C.14, subdivision 2, is amended to read:
194.31 		Subd. 2.Disqualification from access. (a) If an individual who is studied under section 
194.32 	245C.03, subdivision 1, paragraph (a), clauses (2), (5), and (6), is disqualified from direct 
195.1 	contact under subdivision 1, the commissioner shall also disqualify the individual from 
195.2 	access to a person receiving services from the license holder.
195.3 	(b) No individual who is disqualified following a background study under section 
195.4 	245C.03, subdivision 1, paragraph (a), clauses (2), (5), and (6), or as provided elsewhere 
195.5 	in statute who is disqualified as a result of this section, may be allowed access to persons 
195.6 	served by the program unless the commissioner has provided written notice under section 
195.7 	245C.17 stating that:
195.8 	(1) the individual may remain in direct contact during the period in which the individual 
195.9 	may request reconsideration as provided in section 245C.21, subdivision 2;
195.10 	(2) the commissioner has set aside the individual's disqualification for that licensed 
195.11 	program or entity identified in section 245C.03 as provided in section 245C.22, subdivision 
195.12 	4; or
195.13 	(3) the license holder has been granted a variance for the disqualified individual under 
195.14 	section 245C.30.

195.15 	Sec. 37. Minnesota Statutes 2025 Supplement, section 245C.16, subdivision 1, is amended 
195.16 	to read:
195.17 		Subdivision 1.Determining immediate risk of harm. (a) If the commissioner determines 
195.18 	that the individual studied has a disqualifying characteristic, the commissioner shall review 
195.19 	the information immediately available and make a determination as to the subject's immediate 
195.20 	risk of harm to persons served by the program where the individual studied will have direct 
195.21 	contact with, or access to, people receiving services.
195.22 	(b) The commissioner shall consider all relevant information available, including the 
195.23 	following factors in determining the immediate risk of harm:
195.24 	(1) the recency of the disqualifying characteristic;
195.25 	(2) the recency of discharge from probation for the crimes;
195.26 	(3) the number of disqualifying characteristics;
195.27 	(4) the intrusiveness or violence of the disqualifying characteristic;
195.28 	(5) the vulnerability of the victim involved in the disqualifying characteristic;
195.29 	(6) the similarity of the victim to the persons served by the program where the individual 
195.30 	studied will have direct contact;
196.1 	(7) whether the individual has a disqualification from a previous background study that 
196.2 	has not been set aside;
196.3 	(8) if the individual has a disqualification which may not be set aside because it is a 
196.4 	permanent bar under section 245C.24, subdivision 1, or the individual is a child care 
196.5 	background study subject who has a felony-level conviction for a drug-related offense in 
196.6 	the last five years, the commissioner may order the immediate removal of the individual 
196.7 	from any position allowing direct contact with, or access to, persons receiving services from 
196.8 	the program and from working in a children's residential facility or foster residence setting; 
196.9 	and
196.10 	(9) if the individual has a disqualification which may not be set aside because it is a 
196.11 	permanent bar under section 245C.24, subdivision 2, or the individual is a child care 
196.12 	background study subject who has a felony-level conviction for a drug-related offense during 
196.13 	the last five years, the commissioner may order the immediate removal of the individual 
196.14 	from any position allowing direct contact with or access to persons receiving services from 
196.15 	the center and from working in a licensed child care center or certified license-exempt child 
196.16 	care center.
196.17 	(c) This section does not apply when the subject of a background study is regulated by 
196.18 	a health-related licensing board as defined in chapter 214, and the subject is determined to 
196.19 	be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
196.20 	(d) This section does not apply to a background study related to an initial application 
196.21 	for a child foster family setting license.
196.22 	(e) Except for paragraph (f), this section does not apply to a background study that is 
196.23 	also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a 
196.24 	personal care assistant or a qualified professional as defined in section 256B.0659, 
196.25 	subdivision 1, or to a background study for an individual providing early intensive 
196.26 	developmental and behavioral intervention services under section 256B.0949 245C.13, 
196.27 	subdivision 2, paragraph (c), clause (7).
196.28 	(f) If the commissioner has reason to believe, based on arrest information or an active 
196.29 	maltreatment investigation, that an individual poses an imminent risk of harm to persons 
196.30 	receiving services, the commissioner may order that the person be continuously supervised 
196.31 	or immediately removed pending the conclusion of the maltreatment investigation or criminal 
196.32 	proceedings.

197.1 	Sec. 38. Minnesota Statutes 2025 Supplement, section 245C.22, subdivision 5, is amended 
197.2 	to read:
197.3 		Subd. 5.Scope of set-aside. (a) If the commissioner sets aside a disqualification under 
197.4 	this section, the disqualified individual remains disqualified, but may hold a license and 
197.5 	have direct contact with or access to persons receiving services. Except as provided in 
197.6 	paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the 
197.7 	licensed program, applicant, or agency specified in the set aside notice under section 245C.23. 
197.8 	For personal care provider organizations, financial management services organizations, 
197.9 	community first services and supports organizations, unlicensed home and community-based 
197.10 	organizations, and consumer-directed community supports organizations, the commissioner's 
197.11 	set-aside may further be limited to a specific individual who is receiving services. For new 
197.12 	background studies required under section 245C.04, subdivision 1, paragraph (h), if an 
197.13 	individual's disqualification was previously set aside for the license holder's program and 
197.14 	the new background study results in no new information that indicates the individual may 
197.15 	pose a risk of harm to persons receiving services from the license holder, the previous 
197.16 	set-aside shall remain in effect.
197.17 	(b) If the commissioner has previously set aside an individual's disqualification for one 
197.18 	or more programs or agencies, and the individual is the subject of a subsequent background 
197.19 	study for a different program or agency, the commissioner shall determine whether the 
197.20 	disqualification is set aside for the program or agency that initiated the subsequent 
197.21 	background study. A notice of a set-aside under paragraph (c) shall be issued within 15 
197.22 	working days if all of the following criteria are met:
197.23 	(1) the subsequent background study was initiated in connection with a program licensed 
197.24 	or regulated under the same provisions of law and rule for at least one program for which 
197.25 	the individual's disqualification was previously set aside by the commissioner;
197.26 	(2) the individual is not disqualified for an offense specified in section 245C.15, 
197.27 	subdivision 1 or 2;
197.28 	(3) the commissioner has received no new information to indicate that the individual 
197.29 	may pose a risk of harm to any person served by the program; and
197.30 	(4) the previous set-aside was not limited to a specific person receiving services.
197.31 	(c) Notwithstanding paragraph (b), clause (2), for an individual who is employed in the 
197.32 	substance use disorder field, if the commissioner has previously set aside an individual's 
197.33 	disqualification for one or more programs or agencies in the substance use disorder treatment 
197.34 	field, and the individual is the subject of a subsequent background study for a different 
198.1 	program or agency in the substance use disorder treatment field, the commissioner shall set 
198.2 	aside the disqualification for the program or agency in the substance use disorder treatment 
198.3 	field that initiated the subsequent background study when the criteria under paragraph (b), 
198.4 	clauses (1), (3), and (4), are met and the individual is not disqualified for an offense specified 
198.5 	in section 245C.15, subdivision 1. A notice of a set-aside under paragraph (d) shall be issued 
198.6 	within 15 working days.
198.7 	(d) When a disqualification is set aside under paragraph (b), the notice of background 
198.8 	study results issued under section 245C.17, in addition to the requirements under section 
198.9 	245C.17, shall state that the disqualification is set aside for the program or agency that 
198.10 	initiated the subsequent background study. The notice must inform the individual that the 
198.11 	individual may request reconsideration of the disqualification under section 245C.21 on the 
198.12 	basis that the information used to disqualify the individual is incorrect.

198.13 	Sec. 39. Minnesota Statutes 2024, section 245C.24, subdivision 2, is amended to read:
198.14 		Subd. 2.Permanent bar to set aside a disqualification. (a) Except as provided in 
198.15 	paragraphs (b) to (g), the commissioner may not set aside the disqualification of any 
198.16 	individual disqualified pursuant to this chapter, regardless of how much time has passed, 
198.17 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
198.18 	1.
198.19 	(b) For an individual in the substance use disorder or corrections field who was 
198.20 	disqualified for a crime or conduct listed under section 245C.15, subdivision 1, and whose 
198.21 	disqualification was set aside prior to July 1, 2005, the commissioner must consider granting 
198.22 	a variance pursuant to section 245C.30 for the license holder for a program dealing primarily 
198.23 	with adults. A request for reconsideration evaluated under this paragraph must include a 
198.24 	letter of recommendation from the license holder that was subject to the prior set-aside 
198.25 	decision addressing the individual's quality of care to children or vulnerable adults and the 
198.26 	circumstances of the individual's departure from that service.
198.27 	(c) If an individual who requires a background study for nonemergency medical 
198.28 	transportation services under section 245C.03, subdivision 12, was disqualified for a crime 
198.29 	or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have 
198.30 	passed since the discharge of the sentence imposed, the commissioner may consider granting 
198.31 	a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this 
198.32 	paragraph must include a letter of recommendation from the employer. This paragraph does 
198.33 	not apply to a person disqualified based on a violation of sections 243.166; 609.185 to 
199.1 	609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3, 
199.2 	clause (1); 617.246; or 617.247.
199.3 	(d) When a licensed foster care provider adopts an individual who had received foster 
199.4 	care services from the provider for over six months, and the adopted individual is required 
199.5 	to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause 
199.6 	(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30 
199.7 	to permit the adopted individual with a permanent disqualification to remain affiliated with 
199.8 	the license holder under the conditions of the variance when the variance is recommended 
199.9 	by the county of responsibility for each of the remaining individuals in placement in the 
199.10 	home and the licensing agency for the home.
199.11 	(e) For an individual 18 years of age or older affiliated with a licensed family foster 
199.12 	setting, the commissioner must not set aside or grant a variance for the disqualification of 
199.13 	any individual disqualified pursuant to this chapter, regardless of how much time has passed, 
199.14 	if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 
199.15 	4a, paragraphs (a) and (b).
199.16 	(f) In connection with a family foster setting license, the commissioner may grant a 
199.17 	variance to the disqualification for an individual who is under 18 years of age at the time 
199.18 	the background study is submitted.
199.19 	(g) In connection with foster residence settings and children's residential facilities, the 
199.20 	commissioner must not set aside or grant a variance for the disqualification of any individual 
199.21 	disqualified pursuant to this chapter, regardless of how much time has passed, if the individual 
199.22 	was disqualified for a crime or conduct listed in section 245C.15, subdivision 4a, paragraph 
199.23 	(a) or (b).

199.24 	Sec. 40. Minnesota Statutes 2024, section 245D.09, subdivision 6, is amended to read:
199.25 		Subd. 6.Subcontractors and temporary staff. If the license holder uses a subcontractor 
199.26 	or temporary staff to perform services licensed under this chapter on the license holder's 
199.27 	behalf, the license holder must ensure that the subcontractor or temporary staff meets and 
199.28 	maintains compliance with all requirements under this chapter that apply to the services to 
199.29 	be provided, including training, orientation, and supervision necessary to fulfill their 
199.30 	responsibilities. The license holder must ensure that a background study has been completed 
199.31 	according to the requirements in sections 245C.03, subdivision 1, and 245C.04. 
199.32 	Subcontractors and temporary staff hired by the license holder must meet the Minnesota 
199.33 	licensing requirements applicable to the disciplines in which they are providing services. 
200.1 	The license holder must maintain documentation that the applicable requirements have been 
200.2 	met.

200.3 	Sec. 41. Minnesota Statutes 2024, section 245D.09, subdivision 7, is amended to read:
200.4 		Subd. 7.Volunteers. The license holder must ensure that volunteers who provide direct 
200.5 	support services to persons served by the program receive the training, orientation, and 
200.6 	supervision necessary to fulfill their responsibilities. The license holder must ensure that a 
200.7 	background study has been completed according to the requirements in sections 245C.03, 
200.8 	subdivision 1, and 245C.04. The license holder must maintain documentation that the 
200.9 	applicable requirements have been met.

200.10 	Sec. 42. Minnesota Statutes 2024, section 256B.0943, subdivision 5a, is amended to read:
200.11 		Subd. 5a.Background studies. The requirements for background studies under section 
200.12 	245I.011, subdivision 5, paragraph (b), may be met by a children's therapeutic services and 
200.13 	supports services agency through the commissioner's NETStudy system as provided under 
200.14 	sections 245C.03, subdivision 7, and 245C.10, subdivision 8.

200.15 	Sec. 43. Minnesota Statutes 2025 Supplement, section 256I.04, subdivision 2c, is amended 
200.16 	to read:
200.17 		Subd. 2c.Background study requirements. (a) A provider of housing support must 
200.18 	initiate background studies in accordance with section 245C.03, subdivision 10.
200.19 	(b) A provider initiating a background study pursuant to chapter 245C is not required 
200.20 	to initiate a background study in accordance with sections 299C.66 to 299C.71 or chapter 
200.21 	364.

200.22 	Sec. 44. REPEALER.
 200.23 	(a) Minnesota Statutes 2024, sections 245C.03, subdivisions 3a, 3b, 5, 6a, and 9a; and 
200.24 	245C.04, subdivisions 2, 3, 4, 5, 7, 8, 9, 10, and 11, are repealed.
200.25 	(b) Minnesota Statutes 2025 Supplement, section 245C.04, subdivisions 6, 12, and 13,
200.26 	are repealed.

201.1 	ARTICLE 6
201.2 	MISCELLANEOUS

201.3 	Section 1. Minnesota Statutes 2024, section 62D.04, subdivision 5, is amended to read:
201.4 		Subd. 5.Participation; government programs. (a) Health maintenance organizations 
201.5 	that are a nonprofit corporation organized under chapter 317A or a local governmental unit 
201.6 	shall, as a condition of receiving and retaining a certificate of authority, participate in the 
201.7 	medical assistance and MinnesotaCare programs. A health maintenance organization 
201.8 	governed by this subdivision is required to submit proposals in good faith that meet the 
201.9 	requirements of the request for proposal provided that the requirements can be reasonably 
201.10 	met by a health maintenance organization to serve individuals eligible for the above programs 
201.11 	in a geographic region of the state if, at the time of publication of a request for proposal, 
201.12 	the percentage of recipients in the public programs in the region who are enrolled in the 
201.13 	health maintenance organization is less than the health maintenance organization's percentage 
201.14 	of the total number of individuals enrolled in health maintenance organizations in the same 
201.15 	region. Geographic regions shall be defined by the commissioner of human services in the 
201.16 	request for proposals. This paragraph expires upon the effective date of paragraph (b).
201.17 	(b) Effective January 1, 2029, or upon the date the administrative service organization 
201.18 	begins administering medical assistance under section 256B.697, whichever is later, a health 
201.19 	maintenance organization that is a nonprofit corporation organized under chapter 317A or 
201.20 	a local governmental unit shall, as a condition of receiving and retaining a certificate of 
201.21 	authority, participate in the integrated medical assistance and MinnesotaCare programs. A 
201.22 	health maintenance organization governed by this subdivision is required to submit proposals 
201.23 	in good faith that meet the requirements of the request for proposal provided that the 
201.24 	requirements can be reasonably met by a health maintenance organization. A health 
201.25 	maintenance organization must serve individuals eligible for the integrated medical assistance 
201.26 	and MinnesotaCare programs in a geographic region of the state if, at the time of publication 
201.27 	of a request for proposal, the percentage of recipients in the public programs in the region 
201.28 	who are enrolled in the health maintenance organization is less than the health maintenance 
201.29 	organization's percentage of the total number of individuals enrolled in health maintenance 
201.30 	organizations in the same region. The commissioner of human services must define 
201.31 	geographic regions in the request for proposals.
201.32 	(c) The commissioner of human services must notify the revisor of statutes when the 
201.33 	administrative service organization begins administering medical assistance.

202.1 	Sec. 2. Minnesota Statutes 2024, section 256B.05, subdivision 1, is amended to read:
202.2 		Subdivision 1.Administration of medical assistance. (a) The county agencies shall 
202.3 	administer medical assistance in their respective counties under the supervision of the state 
202.4 	agency and the commissioner of human services as specified in section 256.01, and shall 
202.5 	make such reports, prepare such statistics, and keep such records and accounts in relation 
202.6 	to medical assistance as the state agency may require under section 256.01, subdivision 2, 
202.7 	paragraph (o).
202.8 	(b) The commissioner must administer specific duties related to determining medical 
202.9 	assistance eligibility on behalf of a county agency administration to ensure compliance with 
202.10 	federal and state requirements for the medical assistance program. The commissioner must 
202.11 	undertake the specific duties on a statewide and uniform administrative and operational 
202.12 	basis.

202.13 	Sec. 3. Minnesota Statutes 2024, section 256B.0625, subdivision 3c, is amended to read:
202.14 		Subd. 3c.Health Services Advisory Council. (a) The commissioner, after receiving 
202.15 	recommendations from professional physician associations, professional associations 
202.16 	representing licensed nonphysician health care professionals, and consumer groups, shall 
202.17 	establish a 14-member Health Services Advisory Council, which consists of 13 voting 
202.18 	members and one nonvoting member. The Health Services Advisory Council shall advise 
202.19 	the commissioner regarding (1) health services pertaining to the administration of health 
202.20 	care benefits covered under Minnesota health care programs (MHCP); and (2) evidence-based 
202.21 	decision-making and health care benefit and coverage policies for MHCP. The Health 
202.22 	Services Advisory Council shall consider available evidence regarding quality, safety, and 
202.23 	cost-effectiveness when advising the commissioner. The Health Services Advisory Council 
202.24 	shall meet at least quarterly. The Health Services Advisory Council shall annually select a 
202.25 	chair from among its members who shall work directly with the commissioner's medical 
202.26 	director to establish the agenda for each meeting. The Health Services Advisory Council 
202.27 	may recommend criteria for verifying centers of excellence for specific aspects of medical 
202.28 	care where a specific set of combined services, a volume of patients necessary to maintain 
202.29 	a high level of competency, or a specific level of technical capacity is associated with 
202.30 	improved health outcomes.
202.31 	(b) The commissioner shall establish a dental subcouncil to operate under the Health 
202.32 	Services Advisory Council. The dental subcouncil consists of general dentists, dental 
202.33 	specialists, safety net providers, dental hygienists, health plan company entities under 
202.34 	contract to serve MHCP and county and public health representatives, health researchers, 
203.1 	consumers, and a designee of the commissioner of health. The dental subcouncil shall advise 
203.2 	the commissioner regarding:
203.3 	(1) the critical access dental program under section 256B.76, subdivision 4, including 
203.4 	but not limited to criteria for designating and terminating critical access dental providers;
203.5 	(2) any changes to the critical access dental provider program necessary to comply with 
203.6 	program expenditure limits;
203.7 	(3) dental coverage policy based on evidence, quality, continuity of care, and best 
203.8 	practices;
203.9 	(4) the development of dental delivery models; and
203.10 	(5) dental services to be added or eliminated from subdivision 9.
203.11 	(c) The Health Services Advisory Council may monitor and track the practice patterns 
203.12 	of health care providers who serve MHCP recipients under fee-for-service, managed care, 
203.13 	and county-based purchasing. The monitoring and tracking shall focus on services or 
203.14 	specialties for which there is a high variation in utilization or quality across providers, or 
203.15 	which are associated with high medical costs. The commissioner, based upon the findings 
203.16 	of the Health Services Advisory Council, may notify providers whose practice patterns 
203.17 	indicate below average quality or higher than average utilization or costs. Managed care 
203.18 	and county-based purchasing plans Entities contracted to administer MHCP programs shall 
203.19 	provide the commissioner with utilization and cost data necessary to implement this 
203.20 	paragraph, and the commissioner shall make these data available to the Health Services 
203.21 	Advisory Council.

203.22 	Sec. 4. Minnesota Statutes 2024, section 256B.0625, subdivision 3d, is amended to read:
203.23 		Subd. 3d.Health Services Advisory Council members. (a) The Health Services 
203.24 	Advisory Council consists of:
203.25 	(1) six voting members who are licensed physicians actively engaged in the practice of 
203.26 	medicine in Minnesota, three of whom must represent health plans entities currently under 
203.27 	contract to serve MHCP recipients, including but not limited to integrated health partnerships, 
203.28 	health plans, and county-based purchasing plans;
203.29 	(2) two voting members who are licensed physician specialists actively practicing their 
203.30 	specialty in Minnesota and providing care to MHCP recipients;
204.1 	(3) two voting members who are nonphysician health care professionals licensed or 
204.2 	registered in their profession and actively engaged in their practice of their profession in 
204.3 	Minnesota and providing care to MHCP recipients;
204.4 	(4) one voting member who is a health care or mental health professional licensed or 
204.5 	registered in the member's profession, actively engaged in the practice of the member's 
204.6 	profession in Minnesota, and actively engaged in the treatment of persons with mental 
204.7 	illness, and providing care to MHCP recipients;
204.8 	(5) two consumers who are enrolled in MHCP programs directly or are caregivers for 
204.9 	MHCP recipients who shall serve as voting members; and
204.10 	(6) the commissioner's medical director who shall serve as a nonvoting member.
204.11 	(b) Members of the Health Services Advisory Council shall not be employed by the state 
204.12 	of Minnesota, except for the medical director. A quorum shall comprise a simple majority 
204.13 	of the voting members. Vacant seats shall not count toward a quorum.

204.14 	Sec. 5. Minnesota Statutes 2025 Supplement, section 256B.0911, subdivision 14, is 
204.15 	amended to read:
204.16 		Subd. 14.Use of MnCHOICES certified assessors required. (a) Each lead agency 
204.17 	shall use MnCHOICES certified assessors who have completed MnCHOICES training and 
204.18 	the certification process determined by the commissioner in subdivision 13.
204.19 	(b) Each lead agency must ensure that the lead agency has sufficient numbers of certified 
204.20 	assessors to provide long-term consultation assessment and support planning within the 
204.21 	timelines and parameters of the service.
204.22 	(c) A lead agency may choose, according to departmental policies, to contract with a 
204.23 	qualified, certified assessor to conduct assessments and reassessments on behalf of the lead 
204.24 	agency.
204.25 	(d) Tribes and health plans under contract with the commissioner must provide long-term 
204.26 	care consultation services as specified in the contract.
204.27 	(e) A lead agency must provide the commissioner with an administrative contact for 
204.28 	communication purposes.
204.29 	(f) A lead agency may contract under this subdivision with any hospital licensed under 
204.30 	sections 144.50 to 144.56 to conduct assessments of patients in the hospital on behalf of 
204.31 	the lead agency when the lead agency has failed to meet its obligations under subdivision 
204.32 	17. The contracted assessment must be conducted by a hospital employee who is a qualified, 
205.1 	certified assessor. The hospital employees who perform assessments under the contract 
205.2 	between the hospital and the lead agency may perform assessments in addition to other 
205.3 	duties assigned to the employee by the hospital, except the hospital employees who perform 
205.4 	the assessments under contract with the lead agency must not perform any waiver-related 
205.5 	tasks other than assessments. Hospitals are not eligible for reimbursement under subdivision 
205.6 	33. The lead agency that enters into a contract with a hospital under this paragraph is 
205.7 	responsible for oversight, compliance, and quality assurance for all assessments performed 
205.8 	under the contract.
205.9 	(g) The commissioner must employ certified assessors within the department to conduct 
205.10 	assessments on behalf of lead agencies under conditions and circumstances determined by 
205.11 	the commissioner. Certified assessors employed by the department may conduct assessments 
205.12 	in addition to other duties as assigned, except the certified assessors employed by the 
205.13 	department must not perform any responsibilities of a lead agency described in this section 
205.14 	other than assessments. Nothing in this paragraph creates an obligation for the department 
205.15 	to provide the department's certified assessors to conduct assessments on behalf of a lead 
205.16 	agency.

205.17 	Sec. 6. Minnesota Statutes 2024, section 256B.69, subdivision 1, is amended to read:
205.18 		Subdivision 1.Purpose. (a) The commissioner of human services shall establish a 
205.19 	medical assistance demonstration project to determine whether prepayment combined with 
205.20 	better management of health care services is an effective mechanism to ensure that all 
205.21 	eligible individuals receive necessary health care in a coordinated fashion while containing 
205.22 	costs. For the purposes of this project, waiver of certain statutory provisions is necessary 
205.23 	in accordance with this section.
205.24 	(b) Effective January 1, 2029, or upon the date the administrative service organization 
205.25 	begins administering medical assistance under section 256B.697, whichever is later, this 
205.26 	section applies only to medical assistance members enrolled in integrated Medicare products 
205.27 	for individuals with disabilities and seniors and MinnesotaCare. The commissioner of human 
205.28 	services must notify the revisor of statutes when the administrative service organization 
205.29 	begins administering medical assistance.

205.30 	Sec. 7. [256B.697] MEDICAL ASSISTANCE ADMINISTRATIVE SERVICE 
205.31 	ORGANIZATION.
205.32 	(a) Effective January 1, 2029, the commissioner must contract with an administrative 
205.33 	service organization to administer the medical assistance program on a statewide basis. The 
206.1 	administrator is responsible for the administration of all populations within medical assistance 
206.2 	except individuals enrolled in integrated Medicare products, including but not limited to 
206.3 	Minnesota Senior Health Options and Special Needs BasicCare.
206.4 	(b) Services performed by the administrator may include but are not limited to:
206.5 	(1) claims processing for all covered services;
206.6 	(2) coordination of care for members;
206.7 	(3) program integrity initiatives;
206.8 	(4) management of third-party liability requirements;
206.9 	(5) development, execution, and maintenance of a claims processing system compliant 
206.10 	with all applicable state and federal laws and regulations;
206.11 	(6) assistance and outreach to recipients to manage and access needed care;
206.12 	(7) assistance and outreach to enrolled providers;
206.13 	(8) utilization management and medical necessity review of services; and
206.14 	(9) quality improvement and program evaluation initiatives.
206.15 	(c) Rates paid to providers under this section must be the same rates paid to providers 
206.16 	under this chapter and chapter 256.
206.17 	(d) The administrator may, with the approval of the commissioner, elect to subcontract 
206.18 	with other entities to assist in the delivery and administration of services.
206.19 	(e) The commissioner may elect to contract separately from the administrative services 
206.20 	organization for care coordination if the commissioner determines additional support is 
206.21 	needed for members to access medically necessary care.

206.22 	Sec. 8. DIRECTION TO COMMISSIONER; ADMINISTRATIVE SERVICE 
206.23 	ORGANIZATION TRANSFER ASSESSMENT.
 206.24 	(a) The commissioner of human services must procure a contract with a vendor to assess 
206.25 	the current status and plan for the transfer of administration of medical assistance to the 
206.26 	commissioner's administrative service organization under Minnesota Statutes, section 
206.27 	256B.697, by January 1, 2033. The commissioner must submit the assessment to the chairs 
206.28 	and ranking minority members of the legislative committees with jurisdiction over human 
206.29 	services and health care policy and finance by October 1, 2028.
206.30 	(b) The assessment must include:
207.1 	(1) a comprehensive assessment of medical assistance eligibility functions performed 
207.2 	by counties and Tribal governments, including identification of handoffs between county 
207.3 	and Tribal eligibility workers and state eligibility workers, and a catalog of eligibility 
207.4 	functions performed by state eligibility workers;
207.5 	(2) examination of current expenditures, administrative budgets, and federal financial 
207.6 	participation in county and Tribal administrative work related to medical assistance eligibility 
207.7 	activities;
207.8 	(3) eligibility system review, mapping, and recommended updates; and
207.9 	(4) recommendations for a successful transition of centralized eligibility functions based 
207.10 	on consultation with stakeholders, review of information provided by county and Tribal 
207.11 	governments, review of other states' best practices for maximizing federal dollars, a feasible 
207.12 	timeline of activities, and required legislative changes and actions.
207.13 	(c) The commissioner must consult with the Tribal Nations, the Association of Minnesota 
207.14 	Counties, and the Minnesota Association of County Social Service Administrators on the 
207.15 	final deliverables included in the assessment.

207.16 	Sec. 9. MNCHOICES REDESIGN WORKING GROUP.
 207.17 		Subdivision 1.Establishment. The commissioner of human services shall convene a 
207.18 	MnCHOICES Redesign Working Group to develop recommendations related to state 
207.19 	provision of MnCHOICES assessments under Minnesota Statutes, section 256B.0911, 
207.20 	subdivision 14, paragraph (g).
207.21 		Subd. 2.Membership. At a minimum, the working group must include the following  
207.22 	members:
207.23 	(1) two individuals receiving waiver services or the individuals' family members or 
207.24 	advocates, appointed by the commissioner in consultation with organizations representing 
207.25 	individuals with lived experience of disability and waiver services;
207.26 	(2) three county representatives, appointed by the Minnesota Association of County 
207.27 	Social Service Administrators, including;
207.28 	(i) at least one representative of a lead agency located in a metropolitan county, as defined 
207.29 	in Minnesota Statutes, section 473.121, subdivision 4; and
207.30 	(ii) at least two representatives of lead agencies located outside of a metropolitan county, 
207.31 	as defined in Minnesota Statutes, section 473.121, subdivision 4;
208.1 	(3) one staff member from the Minnesota Social Service Association, appointed by the 
208.2 	Minnesota Social Service Association;
208.3 	(4) at least three representatives from Tribal Nations, appointed by the commissioner;
208.4 	(5) two representatives of disability advocacy organizations, appointed by the  
208.5 	commissioner; and
208.6 	(6) additional nonvoting participants as determined by the commissioner, which may 
208.7 	include staff from the Department of Human Services and other interested parties.
208.8 		Subd. 3.Duties. The working group shall make recommendations to shift the 
208.9 	responsibility and administration of conducting MnCHOICES assessments to the state. 
208.10 	Recommendations must include:
208.11 	(1) defined roles and responsibilities between county, Tribal Nation, and state functions;
208.12 	(2) revised payment methodologies and financing of duties;
208.13 	(3) efficient workflows between local and state functions;
208.14 	(4) service continuity for people seeking and receiving long-term services and supports; 
208.15 	and
208.16 	(5) methods for gathering public feedback and providing public awareness.
208.17 		Subd. 4.Terms, compensation, and removal. The terms, compensation, and removal 
208.18 	of the working group members are governed by Minnesota Statutes, section 15.059, 
208.19 	subdivision 3.
208.20 		Subd. 5.Meetings; administrative support. (a) The first meeting of the working group  
208.21 	must be convened no later than August 1, 2026. The working group must meet at least  
208.22 	monthly. The working group may meet by telephone or interactive technology consistent 
208.23 	with Minnesota Statutes, section 13D.015.
208.24 	(b) The Department of Human Services shall provide staff and administrative support  
208.25 	to convene the working group, facilitate working group meetings, and prepare the final 
208.26 	report.
208.27 		Subd. 6.Report. By September 1, 2027, the commissioner must submit a report of the  
208.28 	working group's findings and recommendations, including but not limited to any legislative 
208.29 	changes necessary to implement the recommendations, to the chairs and ranking minority 
208.30 	members of the  legislative committees with jurisdiction over human services policy and 
208.31 	finance.
209.1 		Subd. 7.Expiration. The working group expires upon submission of the report required  
209.2 	under subdivision 6.

209.3 	Sec. 10. DIRECTION TO COMMISSIONER; WAIVER CASE MANAGEMENT 
209.4 	REQUIREMENTS AND COSTS STUDY.
 209.5 	(a) The commissioner of human services must analyze and provide recommendations 
209.6 	on waiver case management services. The commissioner must develop a request for proposals 
209.7 	for a contract with a third party to conduct a study. The study and recommendations must 
209.8 	include:
209.9 	(1) definition of roles and responsibilities for waiver case management services, including 
209.10 	but not limited to oversight functions and requirements of waiver case management services;
209.11 	(2) an assessment of providing waiver case management in acute care settings to ensure 
209.12 	continuity of care; and
209.13 	(3) an update to the rate methodology to ensure payments reflect the costs of providing 
209.14 	waiver case management services.
209.15 	(b) The commissioner must consult with lead agencies, providers across the spectrum 
209.16 	of services and regions of the state, and culturally responsive providers in the development 
209.17 	of the request for proposals for the study and for the duration of the contract.
209.18 	(c) By June 30, 2027, the commissioner must submit a final report to the chairs and 
209.19 	ranking minority members of the legislative committees with jurisdiction over human 
209.20 	services policy and finance that includes the results of the analysis and the recommendations 
209.21 	required under this section.

209.22 	Sec. 11. DIRECTION TO COMMISSIONER; ASSESSMENT OF 
209.23 	ADMINISTRATION ROLES.
 209.24 	(a) The commissioner of human services, in consultation with Tribal Nations and counties, 
209.25 	must conduct a study to assess and recommend improvements to the roles and responsibilities 
209.26 	of the state agency, counties, and Tribal Nations in administering human services programs.
209.27 	(b) The study must include a comprehensive review of programs administered by the 
209.28 	department, including but not limited to medical assistance, MinnesotaCare, behavioral 
209.29 	health services, long-term services and supports, housing and homelessness programs, 
209.30 	Minnesota supplemental aid, general assistance, and licensing and oversight functions.
209.31 	(c) The study must evaluate the:
210.1 	(1) current roles and responsibilities held by the state agency, counties, and Tribal Nations 
210.2 	in administering human services programs, including but not limited to the challenges and 
210.3 	benefits of the current delegation of roles and responsibilities;
210.4 	(2) lived experience of people accessing human services programs related to the 
210.5 	delegation of administrative duties;
210.6 	(3) financing of human services program administration across the state agency, counties, 
210.7 	and Tribal Nations; and
210.8 	(4) administration of human services programs in other states, focusing on the roles and 
210.9 	responsibilities of the local governments versus the state Medicaid or human services agency, 
210.10 	and identifying the benefits, challenges, and financing of the delegation of duties.
210.11 	(d) The study must focus on the goals of transforming the human services system to 
210.12 	ensure a transparent, accessible, accountable, equitable, and effective human services system.
210.13 	(e) The study must provide recommendations for the optimal delegation of duties between 
210.14 	the state agency, counties, and Tribal Nations in the delivery of human services. 
210.15 	Recommendations must include:
210.16 	(1) how the delegation of duties will improve the experience of people accessing human 
210.17 	services;
210.18 	(2) implementation and timing considerations to ensure continuity of services;
210.19 	(3) systems technology adaptations required;
210.20 	(4) workforce considerations; and
210.21 	(5) financing strategies and the estimated fiscal impact to the state budget.
210.22 	(f) By October 1, 2028, the commissioner must submit a report on the study and 
210.23 	recommendations to the chairs and ranking minority members of the legislative committees 
210.24 	with jurisdiction over health and human services policy and finance.

210.25 	Sec. 12. REPEALER.
 210.26 	(a) Minnesota Statutes 2024, section 256B.0371, subdivisions 1, 2, and 4, are repealed.
210.27 	(b) Minnesota Statutes 2025 Supplement, sections 256B.0371, subdivision 3; and 
210.28 	256B.696, are repealed.
210.29 	(c) Minnesota Statutes 2025 Supplement, section 256B.695, is repealed.

211.1 	EFFECTIVE DATE. Paragraphs (a) and (b) are effective the day following final 
211.2 	enactment. Paragraph (c) is effective January 1, 2029, or upon the date the administrative 
211.3 	service organization begins administering medical assistance under Minnesota Statutes, 
211.4 	section 256B.697, whichever is later. The commissioner of human services must notify the 
211.5 	revisor of statutes when the administrative service organization begins administering medical 
211.6 	assistance.

211.7 	ARTICLE 7
211.8 	HUMAN SERVICES FORECAST ADJUSTMENTS

211.9	Section 1. HUMAN SERVICES FORECAST ADJUSTMENTS.
 	
211.10 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
211.11 	parentheses, subtracted from the appropriations in Laws 2025, First Special Session chapter 
211.12 	3, article 20, and Laws 2025, First Special Session chapter 9, article 12, to the commissioner 
211.13 	of human services from the general fund or other named fund for the purposes specified in 
211.14 	section 2 and are available for the fiscal years indicated for each purpose. The figures "2026" 
211.15 	and "2027" used in this article mean that the addition to or subtraction from the appropriation 
211.16 	listed under them is available for the fiscal year ending June 30, 2026, or June 30, 2027, 
211.17 	respectively.

211.18				APPROPRIATIONS
	
211.19				Available for the Year
	
211.20				Ending June 30
	
211.21					2026
		2027

211.22
211.23	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES.

211.24	Subdivision 1.Total Appropriation
 	$
	739,634,000
	$
	775,035,000

211.25	Appropriations by Fund
	
211.26	General Fund
	652,953,000
	615,407,000
	
211.27
211.28	Health Care Access 
Fund
	86,681,000
	159,628,000

211.29	Subd. 2.Forecasted Programs

211.30	(a) General Assistance
		7,909,000
		9,653,000

211.31	(b) Minnesota Supplemental Aid
		2,976,000
		3,233,000

211.32	(c) Housing Support
		29,593,000
		44,727,000

211.33	(d) MinnesotaCare
		86,681,000
		159,628,000
	
212.1 	These appropriations are from the health care 
212.2 	access fund.

212.3	(e) Medical Assistance
		589,777,000
		525,140,000

212.4	(f) Behavioral Health Fund
		22,698,000
		32,654,000

212.5 	Sec. 3. EFFECTIVE DATE.
 212.6 	This article is effective the day following final enactment.

212.7 	ARTICLE 8
212.8 	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS

212.9	Section 1. HUMAN SERVICES APPROPRIATIONS.
 	
212.10 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
212.11 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
212.12 	Session chapter 9, article 12, from the general fund or any fund named for the purposes 
212.13 	specified in this article, to be available for the fiscal year indicated for each purpose. The 
212.14 	figures "2026" and "2027" used in this article mean that the appropriations listed under them 
212.15 	are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The 
212.16 	first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is 
212.17 	fiscal years 2026 and 2027.

212.18				APPROPRIATIONS
	
212.19				Available for the Year
	
212.20				Ending June 30
	
212.21					2026
		2027

212.22	Sec. 2. TOTAL APPROPRIATION
	$
	(822,000)
	$
	(145,196,000)

212.23	Appropriations by Fund
	
212.24		2026
	2027
	
212.25	General
	(822,000)
	(147,209,000)
	
212.26
212.27	Special Government 
Revenue Fund
	-0-
	2,013,000

212.28	Sec. 3. CENTRAL OFFICE; OPERATIONS
 	$
	-0-
	$
	30,851,000

212.29
212.30	Subdivision 1.Evaluation of DHS Structure and 
Processes
 					
212.31 	$500,000 in fiscal year 2027 is for a 
212.32 	comprehensive evaluation of the Department 
212.33 	of Human Service's structure and processes. 
213.1 	This is a onetime appropriation and is 
213.2 	available until June 30, 2028.

213.3	Subd. 2.Base Level Adjustment
 					
213.4 	The general fund base is increased by 
213.5 	$21,665,000 in fiscal year 2028 and increased 
213.6 	by $19,895,000 in fiscal year 2029.

213.7	Sec. 4. CENTRAL OFFICE; HEALTH CARE
 	$
	-0-
	$
	34,186,000

213.8
213.9	Subdivision 1.Medical Assistance Eligibility 
Study
 					
213.10 	$2,000,000 in fiscal year 2027 is for a study 
213.11 	on the transfer of eligibility functions of the 
213.12 	medical assistance program performed by 
213.13 	county and Tribal governments to the 
213.14 	Department of Human Services. This is a 
213.15 	onetime appropriation and is available until 
213.16 	June 30, 2029.

213.17	Subd. 2.Base Level Adjustment
 					
213.18 	The general fund base is increased by 
213.19 	$70,976,000 in fiscal year 2028 and increased 
213.20 	by $86,272,000 in fiscal year 2029.

213.21
213.22	Sec. 5. CENTRAL OFFICE; AGING AND 
DISABILITY SERVICES
 	$
	-0-
	$
	7,589,000

213.23
213.24	Subdivision 1.Market Rate and Homemaking 
Services Rate Study
 					
213.25 	$500,000 in fiscal year 2027 is for a study on 
213.26 	rate setting methodologies for services 
213.27 	currently offered under market rate 
213.28 	methodologies and homemaking services. This 
213.29 	is onetime appropriation and is available until 
213.30 	June 30, 2028.

213.31	Subd. 2.Waiver Case Management Study
 					
213.32 	$300,000 in fiscal year 2027 is for a study on 
213.33 	waiver case management services. This is a 
214.1 	onetime appropriation and is available until 
214.2 	June 30, 2028.

214.3	Subd. 3.Base Level Adjustment
 					
214.4 	The general fund base is increased by 
214.5 	$15,839,000 in fiscal year 2028 and increased 
214.6 	by $17,129,000 in fiscal year 2029.

214.7
214.8	Sec. 6. CENTRAL OFFICE; BEHAVIORAL 
HEALTH
 	$
	-0-
	$
	568,000

214.9214.10
	Subdivision 1.Coordinated Specialty Care 
Evaluation
 					
214.11 	$250,000 in fiscal year 2027 is for evaluation, 
214.12 	provider training, capacity building, and 
214.13 	outcome reporting related to the 
214.14 	implementation of coordinated specialty care. 
214.15 	The base for this appropriation is $250,000 in 
214.16 	fiscal year 2028 and $150,000 in fiscal year 
214.17 	2029.

214.18
214.19	Subd. 2.Access to Services for Incarcerated 
Individuals Evaluation
 					
214.20 	$150,000 in fiscal year 2027 is for community 
214.21 	engagement and evaluation related reentry 
214.22 	services.

214.23	Subd. 3.Base Level Adjustment
 					
214.24 	The general fund base is increased by 
214.25 	$993,000 in fiscal year 2028 and increased by 
214.26 	$858,000 in fiscal year 2029.

214.27
214.28	Sec. 7. CENTRAL OFFICE; OFFICE OF 
INSPECTOR GENERAL
 	$
	-0-
	$
	37,841,000

214.29	Subdivision 1.Appropriations by Fund

214.30	Appropriations by Fund
	
214.31		2026
	2027
	
214.32	General Fund
	-0-
	35,828,000
	
214.33
214.34	Special Government 
Revenue Fund
	-0-
	2,013,000

215.1	Subd. 2.Base Level Adjustment
 					
215.2 	The general fund base is increased by 
215.3 	$36,259,000 in fiscal year 2028 and increased 
215.4 	by $36,259,000 in fiscal year 2029. The 
215.5 	special revenue government fund base is 
215.6 	increased by $2,352,000 in fiscal year 2028 
215.7 	and increased by $2,352,000 in fiscal year 
215.8 	2029.

215.9215.10
	Sec. 8. FORECASTED PROGRAMS; 
HOUSING SUPPORT
 	$
	-0-
	$
	12,524,000

215.11
215.12	Sec. 9. FORECASTED PROGRAMS; 
MEDICAL ASSISTANCE
 	$
	-0-
	$
	(250,391,000)
	
215.13 	Base Level Adjustment. The general fund 
215.14 	base for this section is increased by 
215.15 	$8,883,000 in fiscal year 2029 for increases 
215.16 	in Medical Assistance payment rates for the 
215.17 	implementation of the Administrative Service 
215.18 	Organization model.

215.19
215.20	Sec. 10. FORECASTED PROGRAMS; 
ALTERNATIVE CARE
 	$
	-0-
	$
	(160,000)

215.21
215.22	Sec. 11. FORECASTED PROGRAMS; 
BEHAVIORAL HEALTH FUND
 	$
	-0-
	$
	(26,259,000)

215.23	Sec. 12. REFUGEE SERVICE GRANTS
 	$
	-0-
	$
	10,000,000
	
215.24 	This is a onetime appropriation.

215.25	Sec. 13. HOUSING SUPPORT GRANTS
 	$
	-0-
	$
	1,442,000

215.26
215.27	Subdivision 1.Housing Support Agreements 
Grants
 					
215.28 	$1,250,000 in fiscal year 2027 is for grants to 
215.29 	utilize a collaborative model whereby a 
215.30 	housing support provider operating under 
215.31 	section 256I.04 connects eligible individuals 
215.32 	receiving integrated community supports with 
215.33 	housing support assistance. This is a onetime 
215.34 	appropriation and is available until June 30, 
215.35 	2028.

216.1	Subd. 2.Base Level Adjustment
 					
216.2 	The general fund base is increased by 
216.3 	$192,000 in fiscal year 2028 and increased by 
216.4 	$192,000 in fiscal year 2029.

216.5
216.6	Sec. 14. GRANT PROGRAMS; ADULT 
MENTAL HEALTH GRANTS
 	$
	-0-
	$
	(1,317,000)

216.7
216.8	Sec. 15. GRANT PROGRAMS; CHILDREN'S 
MENTAL HEALTH GRANTS
 	$
	-0-
	$
	361,000

216.9216.10
216.11
	Sec. 16. GRANT PROGRAMS; CHEMICAL 
DEPENDENCY TREATMENT SUPPORT 
GRANTS
 	$
	-0-
	$
	(361,000)

216.12 	Sec. 17. Laws 2024, chapter 125, article 8, section 2, subdivision 4, is amended to read:

216.13
216.14	Subd. 4.Central Office; Aging and Disability 
Services
 		(2,664,000)
		4,164,000
	
216.15 	(a) Tribal Vulnerable Adult and 
216.16 	Developmental Disabilities Targeted Case 
216.17 	Management Medical Assistance Benefit.
216.18 	$200,000 in fiscal year 2025 is for a contract 
216.19 	to develop a Tribal vulnerable adult and 
216.20 	developmental disabilities targeted case 
216.21 	management medical assistance benefit under 
216.22 	Minnesota Statutes, section 256B.0924. This 
216.23 	is a onetime appropriation. Notwithstanding 
216.24 	Minnesota Statutes, section 16A.28, 
216.25 	subdivision 3, this appropriation is available 
216.26 	until June 30, 2027.
216.27 	(b) Disability Services Person-Centered 
216.28 	Engagement and Navigation Study.
216.29 	$600,000 in fiscal year 2025 is for the 
216.30 	disability services person-centered engagement 
216.31 	and navigation study. This is a onetime 
216.32 	appropriation. Notwithstanding Minnesota 
216.33 	Statutes, section 16A.28, subdivision 3, this 
216.34 	appropriation is available until June 30, 2026.
217.1 	(c) Pediatric Hospital-to-Home Transition 
217.2 	Pilot Program Administration. $300,000 in 
217.3 	fiscal year 2025 is for a contract related to the 
217.4 	pediatric hospital-to-home transition pilot 
217.5 	program. This is a onetime appropriation. 
217.6 	Notwithstanding Minnesota Statutes, section 
217.7 	16A.28, subdivision 3, this appropriation is 
217.8 	available until June 30, 2027 2028.
217.9 	(d) Reimbursement for Community-First 
217.10 	Services and Supports Workers Report.
217.11 	$250,000 in fiscal year 2025 is for a contract 
217.12 	related to the reimbursement for 
217.13 	community-first services and supports workers 
217.14 	report. This is a onetime appropriation. 
217.15 	Notwithstanding Minnesota Statutes, section 
217.16 	16A.28, subdivision 3, this appropriation is 
217.17 	available until June 30, 2026.
217.18 	(e) Carryforward Authority.
217.19 	Notwithstanding Minnesota Statutes, section 
217.20 	16A.28, subdivision 3, $758,000 in fiscal year 
217.21 	2025 is available until June 30, 2026, and 
217.22 	$2,687,000 in fiscal year 2025 is available 
217.23 	until June 30, 2027.
217.24 	(f) Base Level Adjustment. The general fund 
217.25 	base is increased by $340,000 in fiscal year 
217.26 	2026 and increased by $340,000 in fiscal year 
217.27 	2027.

217.28 	Sec. 18. Laws 2024, chapter 125, article 8, section 2, subdivision 14, as amended by Laws 
217.29 	2025, First Special Session chapter 9, article 12, section 29, is amended to read:

217.30	Subd. 14.Grant Programs; Disabilities Grants
 		1,650,000
		9,574,000
	
217.31 	(a) Capital Improvement for Accessibility.
217.32 	$400,000 in fiscal year 2025 is for a payment 
217.33 	to Anoka County to make capital 
217.34 	improvements to existing space in the Anoka 
218.1 	County Human Services building in the city 
218.2 	of Blaine, including making bathrooms fully 
218.3 	compliant with the Americans with Disabilities 
218.4 	Act with adult changing tables and ensuring 
218.5 	barrier-free access for the purposes of 
218.6 	improving and expanding the services an 
218.7 	existing building tenant can provide to adults 
218.8 	with developmental disabilities. This is a 
218.9 	onetime appropriation.
218.10 	(b) Dakota County Disability Services 
218.11 	Workforce Shortage Pilot Project. $500,000 
218.12 	in fiscal year 2025 is for a grant to Dakota 
218.13 	County for innovative solutions to the 
218.14 	disability services workforce shortage. Up to 
218.15 	$250,000 of this amount must be used to 
218.16 	develop and test an online application for 
218.17 	matching requests for services from people 
218.18 	with disabilities to available staff, and up to 
218.19 	$250,000 of this amount must be used to 
218.20 	develop a communities-for-all program that 
218.21 	engages businesses, community organizations, 
218.22 	neighbors, and informal support systems to 
218.23 	promote community inclusion of people with 
218.24 	disabilities. By October 1, 2026, the 
218.25 	commissioner shall report the outcomes and 
218.26 	recommendations of these pilot projects to the 
218.27 	chairs and ranking minority members of the 
218.28 	legislative committees with jurisdiction over 
218.29 	human services finance and policy. This is a 
218.30 	onetime appropriation. Notwithstanding 
218.31 	Minnesota Statutes, section 16A.28, 
218.32 	subdivision 3, this appropriation is available 
218.33 	until June 30, 2027.
218.34 	(c) Pediatric Hospital-to-Home Transition 
218.35 	Pilot Program. $1,040,000 in fiscal year 2025 
219.1 	is for the pediatric hospital-to-home pilot 
219.2 	program. This is a onetime appropriation. 
219.3 	Notwithstanding Minnesota Statutes, section 
219.4 	16A.28, subdivision 3, this appropriation is 
219.5 	available until June 30, 2027 2028.
219.6 	(d) Artists With Disabilities Support.
219.7 	$690,000 in fiscal year 2025 is for a payment 
219.8 	to a nonprofit organization licensed under 
219.9 	Minnesota Statutes, chapter 245D, located on 
219.10 	Minnehaha Avenue West in Saint Paul, and 
219.11 	that supports artists with disabilities in creating 
219.12 	visual and performing art that challenges 
219.13 	society's views of persons with disabilities. 
219.14 	This is a onetime appropriation. 
219.15 	Notwithstanding Minnesota Statutes, section 
219.16 	16A.28, subdivision 3, this appropriation is 
219.17 	available until June 30, 2027.
219.18 	(e) Emergency Relief Grants for Rural 
219.19 	EIDBI Providers. $600,000 in fiscal year 
219.20 	2025 is for emergency relief grants for EIDBI 
219.21 	providers. This is a onetime appropriation. 
219.22 	Notwithstanding Minnesota Statutes, section 
219.23 	16A.28, subdivision 3, this appropriation is 
219.24 	available until June 30, 2027.
219.25 	(f) Self-Advocacy Grants for Persons with 
219.26 	Intellectual and Developmental Disabilities.
219.27 	$250,000 in fiscal year 2025 is for 
219.28 	self-advocacy grants under Minnesota Statutes, 
219.29 	section 256.477, subdivision 1, paragraph (a), 
219.30 	clauses (5) to (7), and for administrative costs. 
219.31 	This is a onetime appropriation and is 
219.32 	available until June 30, 2027.
219.33 	(g) Electronic Visit Verification 
219.34 	Implementation Grants. $864,000 in fiscal 
219.35 	year 2025 is for electronic visit verification 
220.1 	implementation grants. This is a onetime 
220.2 	appropriation. Notwithstanding Minnesota 
220.3 	Statutes, section 16A.28, subdivision 3, this 
220.4 	appropriation is available until June 30, 2027.
220.5 	(h) Aging and Disability Services for 
220.6 	Immigrant and Refugee Communities.
220.7 	$250,000 in fiscal year 2025 is for a payment 
220.8 	to SEWA-AIFW to address aging, disability, 
220.9 	and mental health needs for immigrant and 
220.10 	refugee communities. This is a onetime 
220.11 	appropriation and is available until June 30, 
220.12 	2027.
220.13 	(i) License Transition Support for Small 
220.14 	Disability Waiver Providers. $3,150,000 in 
220.15 	fiscal year 2025 is for license transition 
220.16 	payments to small disability waiver providers. 
220.17 	This is a onetime appropriation. 
220.18 	Notwithstanding Minnesota Statutes, section 
220.19 	16A.28, subdivision 3, this appropriation is 
220.20 	available until June 30, 2027.
220.21 	(j) Own home services provider 
220.22 	capacity-building grants. $1,519,000 in fiscal 
220.23 	year 2025 is for the own home services 
220.24 	provider capacity-building grant program. 
220.25 	Notwithstanding Minnesota Statutes, section 
220.26 	16A.28, subdivision 3, this appropriation is 
220.27 	available until June 30, 2027. This is a onetime 
220.28 	appropriation.
220.29 	(k) Continuation of Centers for 
220.30 	Independent Living HCBS Access Grants.
220.31 	$311,000 in fiscal year 2024 is for continued 
220.32 	funding of grants awarded under Laws 2021, 
220.33 	First Special Session chapter 7, article 17, 
220.34 	section 19, as amended by Laws 2022, chapter 
220.35 	98, article 15, section 15. This is a onetime 
221.1 	appropriation and is available until June 30, 
221.2 	2025.
221.3 	(l) Base Level Adjustment. The general fund 
221.4 	base is increased by $811,000 in fiscal year 
221.5 	2026 and increased by $811,000 in fiscal year 
221.6 	2027.

221.7 	Sec. 19. TRANSFERS AND CANCELLATIONS.
 221.8 		Subdivision 1.MnCHOICES modification grants. The fiscal year 2027 general fund 
221.9 	base appropriation for MnCHOICES modifications is reduced from $125,000 to $0 first 
221.10 	established under Laws 2023, chapter 61, article 9, section 2, subdivision 16. The general 
221.11 	fund base for this purpose is $0 in fiscal year 2028 and $0 in fiscal year 2029.
221.12 		Subd. 2.Day training and habilitation facility grants. The fiscal year 2028 and fiscal 
221.13 	year 2029 general fund base appropriations for grant allocations to counties for day training 
221.14 	and habilitation services for adults with developmental disabilities when provided as a social 
221.15 	service under Minnesota Statutes, sections 252.41 to 252.46, are reduced from $811,000 to 
221.16 	$0. The general fund base for this purpose is also reduced to $0.
221.17 		Subd. 3.Innovation grants. The fiscal year 2027 general fund base appropriations for 
221.18 	the innovation grants program under Minnesota Statutes, section 256B.0921, are reduced 
221.19 	from $1,925,000 to $0. The general fund base for this purpose is also reduced to $0.
221.20 		Subd. 4.Preadmission screening grant program. The fiscal year 2027 general fund 
221.21 	base appropriation for the preadmission screening grant program under Minnesota Statutes, 
221.22 	section 256.975, subdivision 7d, paragraph (b), is reduced from $20,000 to $0. The general 
221.23 	fund base for this purpose is also reduced to $0.
221.24 		Subd. 5.2023 long-term services and supports loan program. Any unencumbered 
221.25 	and unexpended amount of the long-term services and supports program under Minnesota 
221.26 	Statutes, section 256.4792, subdivision 8a, estimated to be $70,854,000, is transferred from 
221.27 	the special revenue fund to the general fund and is canceled.
221.28 		Subd. 6.2024 long-term services and supports loan program. The fiscal year 2026 
221.29 	general fund base appropriations for the long-term services and supports loan program first 
221.30 	established under Laws 2024, chapter 125, article 8, section 1, subdivision 12, paragraph 
221.31 	(e), are reduced from $822,000 to $0.

222.1 	ARTICLE 9
222.2 	OTHER AGENCY APPROPRIATIONS

222.3	Section 1. OTHER AGENCY APPROPRIATIONS.
 	
222.4 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
222.5 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
222.6 	Session chapter 9, article 14, from the general fund or any fund named for the purposes 
222.7 	specified in this article, to be available for the fiscal year indicated for each purpose. The 
222.8 	figures "2026" and "2027" used in this article mean that the appropriations listed under them 
222.9 	are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The 
222.10 	first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is 
222.11 	fiscal years 2026 and 2027.

222.12				APPROPRIATIONS
	
222.13				Available for the Year
	
222.14				Ending June 30
	
222.15					2026
		2027

222.16
222.17	Sec. 2. COMMISSIONER OF HEALTH; 
TOTAL APPROPRIATION
 	$
	-0-
	$
	1,125,000
	
222.18 	The amounts that may be spent for each 
222.19 	purpose are specified in the following sections.

222.20	Sec. 3. HEALTH IMPROVEMENT
 	$
	-0-
	$
	1,125,000

222.21 	Sec. 4. DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES 
222.22 	APPROPRIATION; LOCAL ADMINISTRATION ASSESSMENT.
 222.23 	$2,500,000 in fiscal year 2027 is appropriated from the general fund to the commissioner 
222.24 	of children, youth, and families for an assessment of state, county, and Tribal Nation roles 
222.25 	in administering human services programs. This is a onetime appropriation and is available 
222.26 	until June 30, 2029.

	ARTICLE 1	AGING AND DISABILITY SERVICES........	Page.Ln 2.18	
	ARTICLE 2	BEHAVIORAL HEALTH........	Page.Ln 63.16	
	ARTICLE 3	DEPARTMENT OF HUMAN SERVICES OFFICE OF INSPECTOR GENERAL........	Page.Ln 86.5	
	ARTICLE 4	UNIFORM SERVICE STANDARDS........	Page.Ln 102.1	
	ARTICLE 5	BACKGROUND STUDIES........	Page.Ln 162.17	
	ARTICLE 6	MISCELLANEOUS........	Page.Ln 201.1	
	ARTICLE 7	HUMAN SERVICES FORECAST ADJUSTMENTS........	Page.Ln 211.7	
	ARTICLE 8	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS........	Page.Ln 212.7	
	ARTICLE 9	OTHER AGENCY APPROPRIATIONS........	Page.Ln 222.1	

APPENDIX 

Repealed Minnesota Statutes: 26-08138 

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.70 REMOTE ADULT DAY SERVICES.
(a) For the purposes of sections 245A.70 to 245A.75, the following terms have the meanings given. 

(b) "Adult day care" and "adult day services" have the meanings given in section 245A.02, subdivision 2a. 

(c) "Remote adult day services" means an individualized and coordinated set of services provided via live two-way communication by an adult day care or adult day services center. 

(d) "Live two-way communication" means real-time audio or audio and video transmission of information between a participant and an actively involved staff member. 

245A.71 APPLICABILITY AND SCOPE.Subdivision 1.Licensing requirements. 
Adult day care centers or adult day services centers that provide remote adult day services must be licensed under this chapter and comply with the requirements set forth in this section. 

Subd. 2.Standards for licensure. 
License holders seeking to provide remote adult day services must submit a request in the manner prescribed by the commissioner. Remote adult day services must not be delivered until approved by the commissioner. The designation to provide remote services is voluntary for license holders. Upon approval, the designation of approval for remote adult day services must be printed on the center's license and identified on the commissioner's public website. 

Subd. 3.Federal requirements. 
Adult day care centers or adult day services centers that provide remote adult day services to participants receiving alternative care under section 256B.0913, essential community supports under section 256B.0922, or home and community-based services waivers under chapter 256S or section 256B.092 or 256B.49 must comply with federally approved waiver plans. 

Subd. 4.Service limitations. 
Remote adult day services must be provided during the days and hours of in-person services specified on the license of the adult day care center or adult day services center. 

245A.72 RECORD REQUIREMENTS.
Adult day care centers and adult day services centers providing remote adult day services must comply with participant record requirements set forth in Minnesota Rules, part 9555.9660. The center must document how remote services will help a participant reach the short- and long-term objectives in the participant's plan of care. 

245A.73 REMOTE ADULT DAY SERVICES STAFF.Subdivision 1.Staff ratios. 
(a) A staff person who provides remote adult day services without two-way interactive video must only provide services to one participant at a time. 

(b) A staff person who provides remote adult day services through two-way interactive video must not provide services to more than eight participants at one time. 

Subd. 2.Staff training. 
A center licensed under section 245A.71 must document training provided to each staff person regarding the provision of remote services in the staff person's record. The training must be provided prior to a staff person delivering remote adult day services without supervision. The training must include: 

(1) how to use the equipment, technology, and devices required to provide remote adult day services via live two-way communication; 

(2) orientation and training on each participant's plan of care as directly related to remote adult day services; and 

(3) direct observation by a manager or supervisor of the staff person while providing supervised remote service delivery sufficient to assess staff competency. 

245A.74 INDIVIDUAL SERVICE PLANNING.Subdivision 1.Eligibility. 
(a) A person must be eligible for and receiving in-person adult day services to receive remote adult day services from the same provider. The same provider must deliver both in-person adult day services and remote adult day services to a participant. 

(b) The license holder must update the participant's plan of care according to Minnesota Rules, part 9555.9700. 

(c) For a participant who chooses to receive remote adult day services, the license holder must document in the participant's plan of care the participant's proposed schedule and frequency for receiving both in-person and remote services. The license holder must also document in the participant's plan of care that remote services: 

(1) are chosen as a service delivery method by the participant or the participant's legal representative; 

(2) will meet the participant's assessed needs; 

(3) are provided within the scope of adult day services; and 

(4) will help the participant achieve identified short- and long-term objectives specific to the provision of remote adult day services. 

Subd. 2.Participant daily service limitations. 
In a 24-hour period, a participant may receive: 

(1) a combination of in-person adult day services and remote adult day services on the same day but not at the same time; 

(2) a combination of in-person and remote adult day services that does not exceed 12 hours in total; and 

(3) up to six hours of remote adult day services. 

Subd. 3.Minimum in-person requirement. 
A participant who receives remote services must receive services in-person as assigned in the participant's plan of care at least quarterly. 

245A.75 SERVICE AND PROGRAM REQUIREMENTS.
Remote adult day services must be in the scope of adult day services provided in Minnesota Rules, part 9555.9710, subparts 3 to 7. 

245C.03 BACKGROUND STUDY; INDIVIDUALS TO BE STUDIED.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 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 qualified professionals. 

Subd. 3b.Exception to personal care assistant; requirements. 
The personal care assistant for a recipient may be allowed to enroll with a different personal care assistance provider agency upon initiation of a new background study according to this chapter if: 

(1) the commissioner determines that a change in enrollment or affiliation of the personal care assistant is needed in order to ensure continuity of services and protect the health and safety of the recipient; 

(2) the chosen agency has been continuously enrolled as a personal care assistance provider agency for at least two years; 

(3) the recipient chooses to transfer to the personal care assistance provider agency; 

(4) the personal care assistant has been continuously enrolled with the former personal care assistance provider agency since the last background study was completed; and 

(5) the personal care assistant continues to meet requirements of section 256B.0659, subdivision 11, notwithstanding paragraph (a), clause (3). 

Subd. 5.Other state agencies. 
The commissioner shall conduct background studies on applicants and license holders under the jurisdiction of other state agencies who are required in other statutory sections to initiate background studies under this chapter, including the applicant's or license holder's employees and volunteers when required under other statutory sections. 

Subd. 6a.Legal nonlicensed and certified child care programs. 
The commissioner shall conduct background studies for each child care background study subject as defined in section 245C.02, subdivision 6a, as required by sections 142C.09 and 142E.16. 

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. 

Subd. 9a.Exception to support worker requirements for continuity of services. 
The support worker for a participant may enroll with a different Community First Services and Supports (CFSS) agency-provider or Financial Management Services (FMS) provider upon initiation, rather than completion, of a new background study according to this chapter if: 

(1) the commissioner determines that the support worker's change in enrollment or affiliation is necessary to ensure continuity of services and to protect the health and safety of the participant; 

(2) the chosen agency-provider or FMS provider has been continuously enrolled as a CFSS agency-provider or FMS provider for at least two years or since the inception of the CFSS program, whichever is shorter; 

(3) the participant served by the support worker chooses to transfer to the CFSS agency-provider or the FMS provider to which the support worker is transferring; 

(4) the support worker has been continuously enrolled with the former CFSS agency-provider or FMS provider since the support worker's last background study was completed; and 

(5) the support worker continues to meet the requirements of section 256B.85, subdivision 16, notwithstanding paragraph (a), clause (1). 

245C.04 WHEN BACKGROUND STUDY MUST OCCUR.Subd. 2.Other state agencies. 
Applicants and license holders under the jurisdiction of other state agencies who are required in other statutory sections to initiate background studies under this chapter must submit completed background study forms to the commissioner before the background study subject begins in a position allowing direct contact in the licensed program or, where applicable, prior to being employed. 

Subd. 3.Personal care provider organizations. 
(a) The commissioner shall conduct a background study of an individual required to be studied under section 245C.03, subdivision 2, at least upon application for initial enrollment under sections 256B.0651 to 256B.0654 and 256B.0659. 

(b) Organizations required to initiate background studies under sections 256B.0651 to 256B.0654 and 256B.0659 for individuals described in section 245C.03, subdivision 2, must submit a completed background study request to the commissioner using the electronic system known as NETStudy before those individuals begin a position allowing direct contact with persons served by the organization. 

(c) Organizations required to initiate background studies under sections 256B.0651 to 256B.0654 and 256B.0659 for individuals described in section 245C.03, subdivision 2, must initiate a new background study through NETStudy when an individual returns to a position requiring a background study following an absence of 120 or more consecutive days. 

Subd. 4.Supplemental nursing services agencies. 
(a) The commissioner shall conduct a background study of an individual required to be studied under section 245C.03, subdivision 3, at least upon application for registration under section 144A.71, subdivision 1. 

(b) Each supplemental nursing services agency must initiate background studies using the electronic system known as NETStudy before an individual begins a position allowing direct contact with persons served by the agency and annually thereafter. 

(c) A supplemental nursing services agency that initiates background studies through NETStudy 2.0 is exempt from the requirement to initiate annual background studies under paragraph (b) for individuals who are on the agency's active roster. 

Subd. 5.Personnel agencies; educational programs; professional services agencies. 
(a) Agencies, programs, and individuals who initiate background studies under section 245C.03, subdivision 4, must initiate the studies annually using the electronic system known as NETStudy. 

(b) Agencies, programs, and individuals who initiate background studies through NETStudy 2.0 are exempt from the requirement to initiate annual background studies under paragraph (a) for individuals who are on the agency's or program's active roster. 

Subd. 6.Unlicensed home and community-based waiver providers of service to seniors and individuals with disabilities and providers of housing stabilization services. 
(a) Providers required to initiate background studies under section 245C.03, subdivision 6, must initiate a study using the electronic system known as NETStudy 2.0 before the individual begins in a position allowing direct contact with persons served by the provider. New providers must initiate a study under this subdivision before initial enrollment if the provider has not already initiated background studies as part of the service licensure requirements. 

(b) Except as provided in paragraph (c), the providers must initiate a background study annually of an individual required to be studied under section 245C.03, subdivision 6. 

(c) After an initial background study under this subdivision is initiated on an individual by a provider of both services licensed by the commissioner and the unlicensed services under this subdivision, a repeat annual background study is not required if: 

(1) the provider maintains compliance with the requirements of section 245C.07, paragraph (a), regarding one individual with one address and telephone number as the person to receive sensitive background study information for the multiple programs that depend on the same background study, and that the individual who is designated to receive the sensitive background information is capable of determining, upon the request of the commissioner, whether a background study subject is providing direct contact services in one or more of the provider's programs or services and, if so, at which location or locations; and 

(2) the individual who is the subject of the background study provides direct contact services under the provider's licensed program for at least 40 hours per year so the individual will be recognized by a probation officer or corrections agent to prompt a report to the commissioner regarding criminal convictions as required under section 245C.05, subdivision 7. 

Subd. 7.New study required with legal name change. 
(a) For a background study completed on an individual required to be studied under section 245C.03, the license holder or other entity that initiated the background study must initiate a new background study using the electronic system known as NETStudy when an individual who is affiliated with the license holder or other entity undergoes a legal name change. 

(b) For background studies subject to a fee paid through the NETStudy system, the entity that initiated the study may initiate a new study under paragraph (a) or notify the commissioner of the name change through a notice to the commissioner. 

Subd. 8.Current or prospective contractors serving multiple family child care license holders. 
(a) Before the implementation of NETStudy 2.0, current or prospective contractors who are required to have a background study under section 245C.03, subdivision 1, who provide services for multiple family child care license holders in a single county, and will have direct contact with children served in the family child care setting are required to have only one background study which is transferable to all family child care programs in that county if: 

(1) the county agency maintains a record of the contractor's background study results which verify the contractor is approved to have direct contact with children receiving services; 

(2) the license holder contacts the county agency and obtains notice that the current or prospective contractor is in compliance with background study requirements and approved to have direct contact; and 

(3) the contractor's background study is repeated every two years. 

(b) For a family child care license holder operating under NETStudy 2.0, the license holder's active roster shall be the system used to document when a background study subject is affiliated with the license holder. 

Subd. 9.Community first services and supports organizations. 
(a) The commissioner shall conduct a background study of an individual required to be studied under section 245C.03, subdivision 9, at least upon application for initial enrollment under section 256B.85. 

(b) Before an individual described in section 245C.03, subdivision 9, begins a position allowing direct contact with a person served by an organization required to initiate a background study under section 256B.85, the organization must receive a notice from the commissioner that the support worker is: 

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

(2) disqualified, but the individual has received a set-aside of the disqualification under section 245C.22. 

Subd. 10.Child protection workers or social services staff having responsibility for child protective duties. 
The commissioner shall conduct background studies of employees of county social services and local welfare agencies having responsibility for child protection duties when the background study is initiated according to section 260E.36, subdivision 3. 

Subd. 11.Children's residential facilities and foster residence settings. 
Applicants and license holders for children's residential facilities and foster residence settings must submit a background study request to the commissioner using the electronic system known as NETStudy 2.0: 

(1) before the commissioner issues a license to an applicant; 

(2) before an individual age 13 or older, who is not currently receiving services from the licensed facility or setting, may live in the licensed program or setting; 

(3) before a volunteer has unsupervised direct contact with persons that the program serves; 

(4) before an individual becomes a controlling individual as defined in section 245A.02, subdivision 5a; 

(5) before an adult, regardless of whether or not the individual will have direct contact with persons served by the facility, begins working in the facility or setting; 

(6) when directed to by the commissioner for an individual who resides in the household as described in section 245C.03, subdivision 1, paragraph (a), clause (5); and 

(7) when directed to by the commissioner for an individual who may have unsupervised access to children or vulnerable adults as described in section 245C.03, subdivision 1, paragraph (a), clause (6). 

Subd. 12.Early intensive developmental and behavioral intervention providers. 
Providers required to initiate background studies under section 245C.03, subdivision 15, must initiate a study using the electronic system known as NETStudy 2.0 before the individual begins in a position allowing direct contact with persons served by the provider or before the individual becomes an operator or acquires five percent or more ownership. 

Subd. 13.Recuperative care providers. 
Providers required to initiate background studies under section 245C.03, subdivision 16, must initiate a study using the electronic system known as NETStudy 2.0 before the individual begins in a position allowing direct contact with persons served by the provider, before the individual becomes an operator of the provider, or before the individual acquires an ownership interest of at least five percent in the provider. 

245D.261 COMMUNITY RESIDENTIAL SETTINGS; REMOTE OVERNIGHT SUPERVISION.Subdivision 1.Definitions. 
(a) For purposes of this section, the following terms have the meanings given, unless otherwise specified. 

(b) "Resident" means an adult residing in a community residential setting. 

(c) "Technology" means: 

(1) enabling technology, which is a device capable of live two-way communication or engagement between a resident and direct support staff at a remote location; or 

(2) monitoring technology, which is the use of equipment to oversee, monitor, and supervise an individual who receives medical assistance waiver or alternative care services under section 256B.0913, 256B.092, or 256B.49 or chapter 256S. 

Subd. 2.Documentation of permissible remote overnight supervision. 
A license holder providing remote overnight supervision in a community residential setting in lieu of on-site direct support staff must comply with the requirements of this chapter, including the requirement under section 245D.02, subdivision 33b, paragraph (a), clause (3), that the absence of direct support staff from the community residential setting while services are being delivered must be documented in the resident's support plan or support plan addendum. 

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; and 

(5) include in each person's support plan addendum the person's maximum permissible response time as determined by the person's support team. 

(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. 

Subd. 4.Required policies and procedures for remote overnight supervision. 
(a) A license holder providing remote overnight supervision must have policies and procedures that: 

(1) protect the residents' health, safety, and rights; 

(2) explain the discharge process if a person served by the program requires in-person supervision or other services that cannot be provided by the license holder due to the limited hours that direct support staff are on site, including information explaining that if a resident provides informed consent to the use of monitoring technology but later revokes their consent, the resident may be subject to a service termination in accordance with section 245D.10, subdivision 3a; 

(3) ensure that services may not be terminated for any person or resident currently served by the program and receiving in-person services solely because the person declines to provide informed consent to the initial change to the use of monitoring technology as required under subdivision 5; 

(4) explain the backup system for technology in times of electrical outages or other equipment malfunctions; 

(5) explain how the license holder trains the direct support staff on the use of the technology; and 

(6) establish a plan for dispatching emergency response personnel to the site in the event of an identified emergency. 

(b) Nothing in this section requires the license holder to develop or maintain separate or duplicative policies, procedures, documentation, consent forms, or individual plans that may be required for other licensing standards if the requirements of this section are incorporated into those documents. 

(c) When no physical presence response is completed for a three-month period, the license holder must conduct a physical presence response drill. The effectiveness of the response protocol must be reviewed and documented. 

Subd. 5.Consent to use of monitoring technology. 
If a license holder uses monitoring technology in a community residential setting, the license holder must obtain a signed informed consent form from each resident served by the program or the resident's legal representative documenting the resident's or legal representative's agreement to use of the specific monitoring technology used in the setting. The informed consent form documenting this agreement must also explain: 

(1) how the license holder uses monitoring technology to provide remote supervision; 

(2) the risks and benefits of using monitoring technology; 

(3) how the license holder protects each resident's privacy while monitoring technology is being used in the setting; and 

(4) how the license holder protects each resident's privacy when the monitoring technology system electronically records personally identifying data. 

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. 

256.975 MINNESOTA BOARD ON AGING.Subd. 7d.Payment for preadmission screening. 
(a) The Department of Human Services shall provide funding for preadmission screening to the Minnesota Board on Aging to cover screener salaries and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota Board on Aging shall: 

(1) employ, or contract with other agencies to employ, within the limits of available funding, sufficient personnel to provide preadmission screening and level of care determination services; and 

(2) seek to maximize federal funding for the service as provided under section 256.01, subdivision 2, paragraph (aa). 

(b) The Department of Human Services shall provide funding for preadmission screening follow-up to the Disability Hub for the under-60 population to cover options counseling salaries and expenses to provide the services described in subdivisions 7a to 7c. The Disability Hub shall: 

(1) employ, or contract with other agencies to employ, within the limits of available funding, sufficient personnel to provide preadmission screening follow-up services; and 

(2) seek to maximize federal funding for the service as provided under section 256.01, subdivision 2, paragraph (aa). 

256B.0371 PERFORMANCE BENCHMARKS FOR DENTAL ACCESS; CONTINGENT DENTAL ADMINISTRATOR.Subdivision 1.Benchmark for dental access. 
For coverage years 2022 to 2024, the commissioner shall establish a performance benchmark under which at least 55 percent of children and adults who were continuously enrolled for at least 11 months in either medical assistance or MinnesotaCare through a managed care or county-based purchasing plan received at least one dental visit during the coverage year. 

Subd. 2.Corrective action plan. 
For coverage years 2022 to 2024, if a managed care or county-based purchasing plan under contract with the commissioner to provide dental services under this chapter or chapter 256L has a rate of dental utilization that is ten percent or more below the performance benchmark specified in subdivision 1, the commissioner shall require the managed care or county-based purchasing plan to submit a corrective action plan to the commissioner describing how the entity intends to increase dental utilization to meet the performance benchmark. The managed care or county-based purchasing plan must: 

(1) provide a written corrective action plan to the commissioner for approval; 

(2) implement the plan; and 

(3) provide the commissioner with documentation of each corrective action taken. 

Subd. 3.Contingent contract with dental administrator. 
(a) The commissioner shall determine the extent to which managed care and county-based purchasing plans in the aggregate meet the performance benchmark specified in subdivision 1 for coverage year 2024. If managed care and county-based purchasing plans in the aggregate fail to meet the performance benchmark, the commissioner, after issuing a request for information followed by a request for proposals, shall contract with a dental administrator to administer dental services beginning January 1, 2028, for recipients of medical assistance and MinnesotaCare who are served under fee-for-service and persons receiving services through managed care plans. 

(b) The dental administrator must provide administrative services, including but not limited to: 

(1) provider recruitment, contracting, and assistance; 

(2) recipient outreach and assistance; 

(3) utilization management and reviews of medical necessity for dental services; 

(4) dental claims processing; 

(5) coordination of dental care with other services; 

(6) management of fraud and abuse; 

(7) monitoring access to dental services statewide; 

(8) performance measurement; 

(9) quality improvement and evaluation; 

(10) management of third-party liability requirements; and 

(11) establishment of grievance and appeals processes for providers and enrollees that the commissioner can monitor. 

(c) Dental administrator payments to contracted dental providers must be based on rates recommended by the dental access working group. If the recommended rates are not established in law prior to July 1, 2027, dental administrator payments to contracted dental providers must be at the rates established under sections 256B.76 and 256L.11. 

(d) Recipients must be given a choice of dental provider, including any provider who agrees to provider participation requirements and payment rates established by the commissioner and dental administrator. The dental administrator must comply with the network adequacy and geographic access requirements that apply to managed care plans for dental services under section 62K.14. 

(e) The contract with the dental administrator must include performance benchmarks, accountability measures, and progress rewards based on the recommendations from the dental access working group. 

(f) Notwithstanding the contract term limits under section 16C.06, subdivision 3b, the commissioner may extend the implementation contract for the single dental administrator under paragraph (a) up to three years from the date of execution and may contract with the same contractor as the single dental administrator for up to five years, beginning in 2028. 

Subd. 4.Dental utilization report. 
(a) The commissioner shall submit an annual report beginning March 15, 2022, and ending March 15, 2026, to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance that includes the percentage for adults and children one through 20 years of age for the most recent complete calendar year receiving at least one dental visit for both fee-for-service and the prepaid medical assistance program. The report must include: 

(1) statewide utilization for both fee-for-service and for the prepaid medical assistance program; 

(2) utilization by county; 

(3) utilization by children receiving dental services through fee-for-service and through a managed care plan or county-based purchasing plan; and 

(4) utilization by adults receiving dental services through fee-for-service and through a managed care plan or county-based purchasing plan. 

(b) The report must also include a description of any corrective action plans required to be submitted under subdivision 2. 

(c) The initial report due on March 15, 2022, must include the utilization metrics described in paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020. 

(d) In the annual report due on March 15, 2023, and in each report due thereafter, the commissioner shall include the following: 

(1) the number of dentists enrolled with the commissioner as a medical assistance dental provider and the congressional district or districts in which the dentist provides services; 

(2) the number of enrolled dentists who provided fee-for-service dental services to medical assistance or MinnesotaCare patients within the previous calendar year in the following increments: one to nine patients, ten to 100 patients, and over 100 patients; 

(3) the number of enrolled dentists who provided dental services to medical assistance or MinnesotaCare patients through a managed care plan or county-based purchasing plan within the previous calendar year in the following increments: one to nine patients, ten to 100 patients, and over 100 patients; and 

(4) the number of dentists who provided dental services to a new patient who was enrolled in medical assistance or MinnesotaCare within the previous calendar year. 

(e) The report due on March 15, 2023, must include the metrics described in paragraph (d) for each of the following years: 2017, 2018, 2019, 2020, and 2021. 

256B.055 ELIGIBILITY CATEGORIES.Subd. 14.Persons detained by law. 
(a) Medical assistance may be paid for an inmate of a correctional facility who is conditionally released as authorized under section 241.26, 244.065, or 631.425, if the individual does not require the security of a public detention facility and is housed in a halfway house or community correction center, or under house arrest and monitored by electronic surveillance in a residence approved by the commissioner of corrections, and if the individual meets the other eligibility requirements of this chapter. 

(b) An individual who is enrolled in medical assistance, and who is charged with a crime and incarcerated for less than 12 months shall be suspended from eligibility at the time of incarceration until the individual is released. Upon release, medical assistance eligibility is reinstated without reapplication using a reinstatement process and form, if the individual is otherwise eligible. 

(c) An individual, regardless of age, who is considered an inmate of a public institution as defined in Code of Federal Regulations, title 42, section 435.1010, and who meets the eligibility requirements in section 256B.056, is not eligible for medical assistance, except for covered services received while an inpatient in a medical institution as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues, including costs, related to the inpatient treatment of an inmate are the responsibility of the entity with jurisdiction over the inmate. 

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.0911 LONG-TERM CARE CONSULTATION SERVICES.Subd. 21.MnCHOICES assessments; exceptions following institutional stay. 
(a) A person receiving home and community-based waiver services under section 256B.0913, 256B.092, or 256B.49 or chapter 256S may return to a community with home and community-based waiver services under the same waiver without being assessed or reassessed under this section if the person temporarily entered one of the following for 121 or fewer days: 

(1) a hospital; 

(2) an institution of mental disease; 

(3) a nursing facility; 

(4) an intensive residential treatment services program; 

(5) a transitional care unit; or 

(6) an inpatient substance use disorder treatment setting. 

(b) Nothing in paragraph (a) changes annual long-term care consultation reassessment requirements, payment for institutional or treatment services, medical assistance financial eligibility, or any other law. 

256B.0921 HOME AND COMMUNITY-BASED SERVICES INNOVATION POOL.
The commissioner of human services shall develop an initiative to provide incentives for innovation in: (1) achieving integrated competitive employment; (2) achieving integrated competitive employment for youth under age 25 upon their graduation from school; (3) living in the most integrated setting; and (4) other outcomes determined by the commissioner. The commissioner shall seek requests for proposals and shall contract with one or more entities to provide incentive payments for meeting identified outcomes. 

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. 

256B.695 COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE PROGRAM.Subdivision 1.Definitions. 
(a) For the purposes of this section, the following terms have the meanings given. 

(b) "CARMA" means the county-administered rural medical assistance program established under this section. 

(c) "Commissioner" means the commissioner of human services. 

(d) "Eligible individual" means an individual who is: 

(1) residing in a county administering CARMA; and 

(2) eligible for medical assistance, MinnesotaCare, Minnesota Senior Health Options (MSHO), Minnesota Senior Care Plus (MSC+), or Special Needs Basic Care (SNBC). 

(e) "Enrollee" means an individual enrolled in CARMA. 

(f) "PMAP" means the prepaid medical assistance program under section 256B.69. 

(g) "Rural county" has the meaning given to "rural area" in Code of Federal Regulations, title 42, section 438.52. 

Subd. 2.Program established. 
CARMA is established to: 

(1) provide a county-owned and county-administered alternative to PMAP; 

(2) facilitate integration of health care, public health, and social services to address health-related social needs in rural communities; 

(3) account for the fewer enrollees and local providers of health care and community services in rural communities; and 

(4) promote accountability for health outcomes, health equity, customer service, community outreach, and cost of care. 

Subd. 3.County participation. 
Each county or group of counties authorized under section 256B.692 may administer CARMA for any or all eligible individuals as an alternative to PMAP, MinnesotaCare, MSHO, MSC+, or SNBC programs. Counties choosing and authorized to administer CARMA are exempt from the procurement process as required under section 256B.69. 

Subd. 4.Oversight and regulation. 
CARMA is governed by sections 256B.69 and 256B.692, unless otherwise provided for under this section. The commissioner must develop and implement a procurement process requiring applications from county-based purchasing plans interested in offering CARMA. The procurement process must require county-based purchasing plans to demonstrate compliance with federal and state regulatory requirements and the ability to meet the goals of the program set forth in subdivision 2. The commissioner must review and approve or disapprove applications. 

Subd. 5.CARMA enrollment. 
(a) Subject to paragraphs (d) and (e), eligible individuals must be automatically enrolled in CARMA, but may decline enrollment. Eligible individuals may enroll in fee-for-service medical assistance. Eligible individuals may change their CARMA elections on an annual basis. 

(b) Eligible individuals must be able to enroll in CARMA through the selection process in accordance with the election period established in section 256B.69, subdivision 4, paragraph (e). 

(c) Enrollees who were not previously enrolled in the medical assistance program or MinnesotaCare can change their selection once within the first year after enrollment in CARMA. Enrollees who were not previously enrolled in CARMA have 90 days to make a change and changes are allowed for additional special circumstances. 

(d) The commissioner may offer a second health plan other than, and in addition to, CARMA to eligible individuals when another health plan is required by federal law or rule. The commissioner may offer a replacement plan to eligible individuals, as determined by the commissioner, when counties administering CARMA have their contract terminated for cause. 

(e) The commissioner may, on a county-by-county basis, offer a health plan other than, and in addition to, CARMA to individuals who are eligible for both Medicare and medical assistance due to age or disability if the commissioner deems it necessary for enrollees to have another choice of health plan. Factors the commissioner must consider when determining if the other health plan is necessary include the number of available Medicare Advantage Plan options that are not special needs plans in the county, the size of the enrolling population, the additional administrative burden placed on providers and counties by multiple health plan options in a county, the need to ensure the viability and success of the CARMA program, and the impact to the medical assistance program. 

(f) In counties where the commissioner is required by federal law or elects to offer a second health plan other than CARMA pursuant to paragraphs (d) and (e), eligible enrollees who do not select a health plan at the time of enrollment must automatically be enrolled in CARMA. 

(g) This subdivision supersedes section 256B.694. 

Subd. 6.Benefits and services. 
(a) Counties or groups of counties administering CARMA must cover all benefits and services required to be covered by medical assistance under section 256B.0625. 

(b) Counties or groups of counties administering CARMA may reimburse enrollees directly for out-of-pocket costs incurred obtaining assessed HRSN services provided by nontraditional providers who are unable to accept payment via traditional health insurance methods. Enrollees must not be reimbursed for out-of-pocket costs paid to providers eligible to enroll. 

Subd. 7.Payment. 
(a) The commissioner, in consultation with counties and groups of counties administering CARMA, must develop a mechanism for making payments to counties and groups of counties that administer CARMA. The payment mechanism must: 

(1) be governed by contracts with terms, including but not limited to payment rates, amended on an as-needed basis; 

(2) pay a full-risk monthly capitation payment for services included in CARMA, including the cost for administering CARMA benefits and services; 

(3) include risk corridors based on minimum loss ratio, total cost of care, or other metrics; 

(4) include a settle-up process tied to the risk corridor arrangement allowing a county or group of counties administering CARMA to retain savings for reinvestment in health care activities and operations to protect against significant losses that a county or group of counties administering CARMA or the state might realize, beginning no sooner than after a county's or group of counties' third year of CARMA operations; 

(5) include a collaborative rate-setting process accounting for CARMA experience, regional experience, and the Department of Human Services fee-for-service experience; and 

(6) be exempt from section 256B.69, subdivisions 5a, paragraphs (c) and (f), and 5d, and payment for Medicaid services provided under section 256B.69, subdivision 28, paragraph (b), no sooner than three years after CARMA implementation. 

(b) Payments for benefits and services under subdivision 6, paragraph (a), must not exceed payments that otherwise would have been paid to health plans under medical assistance for that county or region. 

Subd. 8.Quality measures. 
(a) The commissioner and counties and groups of counties administering CARMA must collaborate to establish quality measures for CARMA not to exceed the extent of quality measures required under sections 256B.69 and 256B.692. The measures must include: 

(1) enrollee experience and outcomes; 

(2) population health; 

(3) health equity; and 

(4) the value of health care spending. 

(b) The commissioner and counties and groups of counties administering CARMA must collaborate to define a quality improvement model for CARMA. The model must include a focus on locally specified measures based on counties' unique needs. The locally specified measures for the county or group of counties administering CARMA must be determined before the commissioner enters into any contract with a county or group of counties. 

Subd. 9.Data and systems integration. 
The commissioner and counties and groups of counties administering CARMA must collaborate to: 

(1) identify and address barriers that prevent counties and groups of counties administering CARMA from reviewing individual enrollee eligibility information to identify eligibility and to help enrollees apply for other appropriate programs and resources; 

(2) identify and address barriers preventing counties and groups of counties administering CARMA from more readily communicating with and educating potential and current enrollees regarding other program opportunities, including helping enrollees apply for those programs and navigate transitions between programs; 

(3) develop and test, in counties participating in CARMA, a universal public assistance application form to reduce the administrative barriers associated with applying for and participating in various public programs; 

(4) identify and address regulatory and system barriers that may prohibit counties and groups of counties administering CARMA, agencies, and other partners from working together to identify and address an individual's needs; 

(5) facilitate greater interoperability between counties and groups of counties administering CARMA, agencies, and other partners to send and receive the data necessary to support CARMA, counties, and local health system efforts to improve the health and welfare of prospective and enrolled populations; 

(6) support efforts of counties and groups of counties administering CARMA to incorporate the necessary automation and interoperability to eliminate manual processes when related to the data exchanged; and 

(7) support the creation and maintenance by counties and groups of counties administering CARMA of an updated electronic inventory of community resources available to assist the enrollee in the enrollee's HRSN, including an electronic closed-loop referral system. 

256B.696 PRESCRIPTION DRUGS; STATE PHARMACY BENEFIT MANAGER.Subdivision 1.Definitions. 
(a) For purposes of this section, the following terms have the meanings given. 

(b) "Managed care enrollees" means medical assistance and MinnesotaCare enrollees receiving coverage from managed care plans. 

(c) "Managed care organizations" means health plan companies and county-based purchasing organizations providing coverage to medical assistance and MinnesotaCare enrollees under the managed care delivery system. 

(d) "State pharmacy benefit manager" means the pharmacy benefit manager selected pursuant to the procurement process in subdivision 2. 

Subd. 2.Procurement process. 
(a) The commissioner must, through a competitive procurement process in compliance with paragraph (b), select a state pharmacy benefit manager to comply with the requirements set forth in subdivision 3. The state pharmacy benefit manager selected under this subdivision must be a prepaid ambulatory health plan, as defined in Code of Federal Regulations, title 42, section 438.2. 

(b) When selecting the state pharmacy benefit manager, the commissioner must: 

(1) accept applications for entities seeking to become the state pharmacy benefit manager; 

(2) establish eligibility criteria an entity must meet in order to become the state pharmacy benefit manager; and 

(3) enter into a master contract with a single pharmacy benefit manager. 

(c) Applicants for the state pharmacy benefit manager must disclose to the commissioner the following during the procurement process: 

(1) any activity, policy, practice, contract, or arrangement of the pharmacy benefit manager that may directly or indirectly present any conflict of interest with the pharmacy benefit manager's relationship with or obligation to the Department of Human Services or a managed care organization; 

(2) all common ownership, members of a board of directors, managers, or other control of the pharmacy benefit manager or any of the pharmacy benefit manager's affiliated companies with: 

(i) a managed care organization administering medical assistance or MinnesotaCare benefits in Minnesota or an affiliate of the managed care organization; 

(ii) an entity that contracts on behalf of a pharmacy or any pharmacy services administration organization and its affiliates; 

(iii) a drug wholesaler or distributor and its affiliates; 

(iv) a third-party payer and its affiliates; or 

(v) a pharmacy and its affiliates; 

(3) any direct or indirect fees, charges, or any kind of assessments imposed by the pharmacy benefit manager on pharmacies licensed in the state with which the pharmacy benefit manager shares common ownership, management, or control, or that are owned, managed, or controlled by any of the pharmacy benefit manager's affiliated companies; 

(4) any direct or indirect fees, charges, or any kind of assessments imposed by the pharmacy benefit manager on pharmacies licensed in the state; and 

(5) any financial terms and arrangements between the pharmacy benefit manager and a prescription drug manufacturer or labeler, including formulary management, drug substitution programs, educational support claims processing, or data sales fees. 

Subd. 3.Contract requirements. 
The master contract required under subdivision 2, paragraph (b), clause (3), must include provisions that prohibit the state pharmacy benefit manager from: 

(1) requiring, enticing, or coercing an enrollee to obtain pharmacy services, including a prescription drug, from a pharmacy owned or otherwise affiliated with the state pharmacy benefit manager; 

(2) communicating to an enrollee, in any manner, that the enrollee is required to obtain pharmacy services or have a prescription dispensed at, or pharmacy services provided by, a particular pharmacy owned or affiliated with the state pharmacy benefit manager if there are other nonaffiliated pharmacies that have the ability to dispense the medication or provide the services and are also in network; 

(3) requiring an enrollee to obtain pharmacy services, including a prescription drug, exclusively through a mail order pharmacy; 

(4) directly or indirectly retroactively denying or reducing a claim or aggregate of claims for pharmacy services, including prescription drugs, after adjudication of the claim or aggregation of claims; and 

(5) paying a rate for pharmacy services, including the prescription drug, that is less than the sum of the following: 

(i) the amount of the professional dispensing fee if it were determined pursuant to section 256B.0625, subdivision 13e; and 

(ii) either: 

(A) the lower of the national average drug acquisition cost or the Minnesota actual acquisition cost under section 256B.0625, subdivision 13e, paragraph (i); 

(B) the maximum allowable cost, as described in section 62W.08, if the national average drug acquisition cost and the Minnesota actual acquisition cost are unreported; or 

(C) the wholesale acquisition cost minus two percent at the time the drug is administered or dispensed if the costs of subitems (A) and (B) are unreported or unavailable. 

Subd. 4.Prescription drug coverage requirements. 
(a) The state pharmacy benefit manager is responsible for processing all point of sale outpatient pharmacy claims under the managed care delivery system. Managed care and county-based purchasing plans must use the state pharmacy benefit manager pursuant to the terms of the master contract required under subdivision 2, paragraph (b), clause (3). The state pharmacy benefit manager selected is the exclusive pharmacy benefit manager used by managed care and county-based purchasing plans when providing coverage to enrollees. The commissioner may require the managed care and county-based purchasing plans and state pharmacy benefit manager to directly exchange data and files for members enrolled with the plans. 

(b) The commissioner may require the state pharmacy benefit manager to modify utilization review limitations, requirements, and strategies imposed on prescription drug coverage. 

(c) All payment arrangements between the Department of Human Services, managed care plans, county-based purchasing plans, and the state pharmacy benefit manager must comply with state and federal statutes, regulations adopted by the Centers for Medicare and Medicaid Services, and any other agreement between the department and the Centers for Medicare and Medicaid Services. The commissioner may change a payment arrangement to comply with this paragraph. 

(d) The commissioner must administer and oversee this section to: 

(1) ensure proper administration of prescription drug benefits for managed care enrollees; and 

(2) increase the transparency of prescription drug prices and other information for the benefit of pharmacies. 

Subd. 5.Reporting requirements. 
(a) The state pharmacy benefit manager must, on request from the commissioner, disclose to the commissioner all sources of payment the state pharmacy benefit manager receives for prescribed drugs, including drug rebates, discounts, credits, clawbacks, fees, grants, chargebacks, reimbursements, or other financial benefits or payments related to services provided for a managed care or county-based purchasing plan. 

(b) Each managed care and county-based purchasing plan must disclose to the commissioner, in the format specified by the commissioner, the entity's administrative costs associated with providing pharmacy services under the managed care delivery system. 

(c) The state pharmacy benefit manager must provide a written quarterly report to the commissioner containing the following information from the immediately preceding quarter: 

(1) the prices the state pharmacy benefit manager negotiated for prescribed drugs under the managed care delivery system. The prices must include any rebates the state pharmacy benefit manager received from drug manufacturers; 

(2) unredacted copies of contracts between the state pharmacy benefit manager and enrolled pharmacies; 

(3) any rebate amounts the state pharmacy benefit manager passed on to individual pharmacies; 

(4) any changes to the information previously disclosed in accordance with subdivision 2, paragraph (c); and 

(5) any other information required by the commissioner. 

(d) Data submitted pursuant to paragraph (c), clause (3), are nonpublic data, as defined in section 13.02, subdivision 9. 

(e) The commissioner may request and collect additional information and clinical data from the state pharmacy benefit manager. 

(f) At the time of contract execution, renewal, or modification, the commissioner must modify the reporting requirements under its managed care contracts as necessary to meet the requirements of this subdivision. 

Subd. 6.Commissioner's program authority. 
(a) To accomplish the requirements of subdivision 4, paragraph (d), the commissioner, in consultation with the Formulary Committee established under section 256B.0625, subdivision 13c, has the authority to: 

(1) adopt or develop a preferred drug list for managed care plans; 

(2) at the commissioner's discretion, engage in price negotiations with prescription drug manufacturers, wholesalers, or group purchasing organizations in place of the state pharmacy benefit manager to obtain price discounts and rebates for prescription drugs for managed care enrollees; and 

(3) develop and manage a drug formulary for managed care and county-based purchasing plans. 

(b) The commissioner may contract with one or more entities to perform any of the functions described in paragraph (a). 

Subd. 7.Contracts with pharmacies. 
(a) The commissioner may review contracts between the state pharmacy benefit manager and pharmacies for compliance with this section and the master contract required under subdivision 2, paragraph (b), clause (3). The commissioner may amend any term or condition of a contract that does not comply with this section or the master contract. 

(b) A master contract and a contract between a state pharmacy benefit manager and a pharmacy are nonpublic data, as defined in section 13.02, subdivision 9. 

Subd. 8.Federal approval. 
(a) The commissioner must seek any necessary federal approval to implement this section. 

(b) The commissioner shall monitor the effect of state directed payments under this section on access to pharmaceutical services in rural and underserved areas of Minnesota. If, for any contract year, federal approval is not received for a state directed payment under this section, the commissioner must adjust payments made to the managed care entity for that contract year to reflect removal of the payment. Contracts between the state pharmacy benefit manager and providers to whom this section applies must allow recovery of payments from those providers if rates are adjusted in accordance with this paragraph. Payment recoveries must not exceed the amount equal to any increase in rates that results from state directed payments under this section. This paragraph expires if federal approval is not received for state directed payments under this section at any time. 

256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.Subd. 6.Planned closures. 
 The portion related to planned closure rate adjustments is as determined under section 256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(ii) the county and all contiguous counties; 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

256R.42 RATE ADJUSTMENT FOR THE FIRST 30 DAYS.
(a) During the first 30 calendar days after admission, the total payment rate for a case mix classification must be increased by 20 percent. Beginning with the 31st calendar day after admission, the total payment rate is the rate otherwise determined under this chapter. 

(b) The enhanced rates under this section shall not be allowed if a resident has resided during the previous 30 calendar days in: 

(1) the same nursing facility; 

(2) a nursing facility owned or operated by a related party; or 

(3) a nursing facility or part of a facility that closed or was in the process of closing. 

256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE RATE ADJUSTMENTS.Subd. 4.Designation as a disproportionate share facility. 
(a) By October 15 of each application year, the commissioner must designate as a disproportionate share facility a facility that complies with the application requirements of subdivision 2 and meets the eligibility criteria of subdivision 3. 

(b) An annual designation is effective for one rate year. 

Repealed Minnesota Session Laws: 26-08138 

Laws 2025, First Special Session chapter 9, article 2, section 68
Sec. 68. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; INCREASE TO PAYMENTS FOR FAMILY RESIDENTIAL AND LIFE SHARING SERVICES. 
Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner of human services must increase by 25.84 percent payment rates previously established under Minnesota Statutes, section 256B.4914, subdivision 19, for family residential services. Rates for life sharing services must be ten percent higher than the corresponding family residential services rate established under this section.