1.1 	A bill for an act
1.2 	relating to state government; modifying provisions relating to human services 
1.3 	continuity of care, aging and disability services, and behavioral health services; 
1.4 	modifying provisions relating to health regulation of certain long-term care facilities 
1.5 	and agencies; modifying provisions relating to Direct Care and Treatment; requiring 
1.6 	reports; establishing working groups; providing for civil penalties; permitting 
1.7 	retrieval fee for records; providing for transfers and cancellation of money; 
1.8 	appropriating money;amending Minnesota Statutes 2024, sections 15.43, 
1.9 	subdivision 3; 62A.135, subdivision 1; 62A.46, subdivision 2; 72A.13, subdivision 
1.10 	1; 144.0724, by adding a subdivision; 144.121, subdivision 9; 144.1503, subdivision 
1.11 	7; 144.292, subdivision 6; 144A.291, subdivision 2; 144A.471, subdivision 8; 
1.12 	144G.09, subdivision 2; 144G.15; 144G.16, by adding a subdivision; 144G.195, 
1.13 	subdivision 1; 144G.31, subdivision 7; 144G.40, by adding a subdivision; 144G.41, 
1.14 	subdivisions 1, 2, by adding a subdivision; 144G.45, subdivision 3; 144G.60, 
1.15 	subdivision 4; 144G.61, subdivision 2; 144G.63, subdivisions 2, 5, by adding a 
1.16 	subdivision; 245A.04, subdivisions 2, 2a; 245A.042, by adding a subdivision; 
1.17 	254A.03, subdivision 2; 254B.17; 256.01, subdivision 21; 256B.04, subdivisions 
1.18 	5, 23, by adding subdivisions; 256B.0625, by adding a subdivision; 256B.064, 
1.19 	subdivisions 1c, 1d, 2; 256B.0659, subdivisions 12, 16, 17, 19; 256B.0761, 
1.20 	subdivision 2; 256B.0911, subdivision 26; 256B.0913, subdivision 4; 256B.092, 
1.21 	subdivision 5; 256B.49, subdivision 11; 256B.85, by adding subdivisions; 297E.02, 
1.22 	subdivision 3; Minnesota Statutes 2025 Supplement, sections 144.0724, subdivision 
1.23 	2; 144.121, subdivision 1a; 144A.474, subdivision 11; 144A.4799, subdivision 1; 
1.24 	144G.19, subdivision 5; 145D.40, by adding a subdivision; 145D.41, subdivisions 
1.25 	1, 2, by adding a subdivision; 254B.02, subdivision 5; 254B.0503, subdivision 1; 
1.26 	254B.0509, subdivision 2; 256.4792, subdivisions 1, 7, by adding a subdivision; 
1.27 	256B.0625, subdivisions 17, 18i; 256B.064, subdivision 1a; 256B.092, subdivision 
1.28 	3b; 256B.49, subdivision 17a; 256B.85, subdivision 7; 256I.04, subdivision 2a; 
1.29 	Laws 2023, chapter 61, article 1, sections 61, subdivision 4, as amended; 67, 
1.30 	subdivision 3, as amended; article 9, section 2, subdivision 5, as amended; Laws 
1.31 	2024, chapter 125, article 1, section 47; article 8, section 2, subdivisions 4, 14, as 
1.32 	amended, 20; Laws 2025, First Special Session chapter 3, article 8, section 43; 
1.33 	article 20, section 19, subdivision 1; article 21, section 3, subdivision 2; Laws 
1.34 	2025, First Special Session chapter 9, article 2, section 58, subdivision 9; article 
1.35 	4, sections 2; 23; 38; 39; 40; 41; 42; 43; 44; 50; proposing coding for new law in 
1.36 	Minnesota Statutes, chapters 62A; 144A; 145D; 256B; repealing Minnesota Statutes 
1.37 	2024, sections 256B.055, subdivision 14; 256B.0921; Minnesota Statutes 2025 
1.38 	Supplement, sections 256B.4907, subdivisions 1, 2, 3, 4, 5, 6; 256S.205, subdivision 
2.1 	7; Laws 2019, First Special Session chapter 9, article 5, section 86, as amended; 
2.2 	Laws 2021, First Special Session chapter 7, article 13, sections 73, as amended; 
2.3 	75, subdivision 1, as amended.
2.4 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.5 	ARTICLE 1
2.6 	CONTINUITY OF CARE

2.7 	Section 1. [256B.045] CONTINUITY OF CARE.
2.8 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
2.9 	the meanings given.
2.10 	(b) "Lead agency" means a county, Tribe, or managed care organization.
2.11 	(c) "Residential services and supports" means any of the following services as defined 
2.12 	in the brain injury, community alternative care, community access for disability inclusion, 
2.13 	developmental disabilities, or elderly waiver plans:
2.14 	(1) 24-hour customized living services;
2.15 	(2) community residential services;
2.16 	(3) customized living services;
2.17 	(4) family residential services; and
2.18 	(5) integrated community supports.
2.19 		Subd. 2.Department of Human Services continuity of care team; establishment. To 
2.20 	ensure the continuity of care of older adults and people with disabilities receiving residential 
2.21 	services and supports following the imposition of a payment withhold under section 
2.22 	256B.064, subdivision 2, the commissioner must establish and maintain a continuity of care 
2.23 	team. The commissioner must ensure the continuity of care team always has sufficient staff 
2.24 	capacity and resources for timely compliance with the requirements of this section.
2.25 		Subd. 3.Department of Human Services continuity of care team; duties. (a) Upon 
2.26 	notice from the commissioner under section 256B.064, subdivision 2, paragraph (i), that 
2.27 	the commissioner intends to impose a payment withhold on a provider of residential services 
2.28 	and supports, the continuity of care team must:
2.29 	(1) identify all the provider's clients whose services might be affected by the payment 
2.30 	withhold the commissioner intends to impose, including but not limited to all clients paying 
2.31 	for services from a source other than medical assistance;
3.1 	(2) for each identified client, identify the lead agency responsible for providing case 
3.2 	management or care coordination to the client;
3.3 	(3) for each identified client, identify the client's case manager or care coordinator; and
3.4 	(4) for each identified client, develop an initial profile of the client containing the team's 
3.5 	expectations regarding the services and supports the client is likely to require if the 
3.6 	commissioner's imposition of a payment withhold upon the provider puts the continuity of 
3.7 	care of the provider's client at risk or poses a risk that the provider's client will need to 
3.8 	transition to a new service provider or setting.
3.9 	(b) After the team has completed the tasks identified in paragraph (a), clauses (1) to (4), 
3.10 	the team must inform the commissioner that the team is prepared to intervene on behalf of 
3.11 	each identified client immediately upon imposition of the payment withhold.
3.12 	(c) Upon imposition of the payment withhold, for each identified client, the continuity 
3.13 	of care team must:
3.14 	(1) inform the Office of the Ombudsman for Long-Term Care, the Office of the 
3.15 	Ombudsman for Mental Health and Developmental Disabilities, the Office of the 
3.16 	Ombudsperson for Public Managed Care Health Care Programs, and the lead agency that 
3.17 	the client's services may be disrupted by actions taken by the commissioner under section 
3.18 	256B.064, subdivision 2, and that the lead agency must comply with the requirements of 
3.19 	subdivision 4;
3.20 	(2) directly inform each identified client's case manager or care coordinator that the 
3.21 	client's services may be disrupted by actions taken by the commissioner under section 
3.22 	256B.064, subdivision 2; that the continuity of care team is prepared to offer assistance to 
3.23 	ensure the client's continuity of care; and that the case manager must comply with the 
3.24 	requirements of subdivision 4; and
3.25 	(3) directly inform each identified client that the client's services may be disrupted by 
3.26 	actions taken by the commissioner under section 256B.064, subdivision 2, and that the lead 
3.27 	agency, the client's case manager, and the continuity of care team are already taking steps 
3.28 	to develop contingency plans in the event the client's services are disrupted.
3.29 		Subd. 4.Continuity of care team and lead agency shared duties. (a) This subdivision 
3.30 	applies to all lead agencies regardless of whether a lead agency provides case management 
3.31 	directly or under contract.
3.32 	(b) The continuity of care team and the lead agency must cooperate and coordinate with 
3.33 	the client's case manager to:
4.1 	(1) closely monitor services delivered to a client of a provider subject to a payment 
4.2 	withhold; and
4.3 	(2) develop a person-centered contingency plan for alternative services or an alternative 
4.4 	service provider or setting in the event a client's services are disrupted.
4.5 	(c) If a lead agency fails to develop or implement a person-centered contingency plan 
4.6 	that ensures timely transition to alternative services or to an alternative service provider or 
4.7 	setting, the continuity of care team must directly intervene and provide case management 
4.8 	directly to the client. The lead agency and the client's case manager must fully cooperate 
4.9 	and assist the continuity of care team in the provision of case management services. The 
4.10 	lead agency is responsible for the state share of case management services provided by the 
4.11 	continuity of care team.
4.12 	(d) If the lead agency or the continuity of care team does not identify alternative services 
4.13 	or an alternative service provider or setting, the continuity of care team must notify the 
4.14 	commissioner and the commissioner of health, if applicable, and recommend:
4.15 	(1) the commissioner of human services either determine there is a good cause under 
4.16 	Code of Federal Regulations, title 42, section 455.23(e) or (f), to not suspend payments 
4.17 	under section 256B.064, subdivision 2, or petition the district court of Ramsey County under 
4.18 	section 245A.13 to be appointed receiver to operate the residential program; or
4.19 	(2) the commissioner of health bring an action under section 144G.20, subdivision 21, 
4.20 	against the provider subject to the withhold for violations of section 144G.52 or 144G.53.
4.21 	(e) If the commissioner does not follow the recommendations of the continuity of care 
4.22 	team identified in paragraph (d), within 30 days of receipt of the recommendations, the 
4.23 	commissioner must notify the chairs and ranking minority members of the legislative 
4.24 	committees with jurisdiction over human services of the commissioner's decision and include 
4.25 	in the notice an explanation of the commissioner's rejection of the recommendations, the 
4.26 	number of clients who will lose services as a result of the commissioner's decision, and the 
4.27 	likely outcomes for the clients who will lose services.
4.28 		Subd. 5.Provider duties. (a) The provider must fully cooperate with the lead agency 
4.29 	and the continuity of care team to effectuate a coordinated transfer or coordinated move for 
4.30 	each client who requires a new provider.
4.31 	(b) Nothing in this section absolves a provider of its obligations under chapters 144G, 
4.32 	245A, and 245D with respect to service suspensions, service terminations, contract 
4.33 	terminations, and coordinated moves. The commissioners of health and human services 
5.1 	may impose any sanctions available under law for violations of a licensing requirement 
5.2 	even if the provider complies with paragraph (a).

5.3 	Sec. 2. Minnesota Statutes 2024, section 256B.064, subdivision 2, is amended to read:
5.4 		Subd. 2.Imposition of monetary recovery and sanctions. (a) The commissioner shall 
5.5 	determine any monetary amounts to be recovered and sanctions to be imposed upon an 
5.6 	individual or entity under this section. Except as provided in paragraphs (b) and (d), neither 
5.7 	a monetary recovery nor a sanction will be imposed by the commissioner without prior 
5.8 	notice and an opportunity for a hearing, according to chapter 14, on the commissioner's 
5.9 	proposed action, provided that the commissioner may suspend or reduce payment to an 
5.10 	individual or entity, except a nursing home or convalescent care facility, after notice and 
5.11 	prior to the hearing if in the commissioner's opinion that action is necessary to protect the 
5.12 	public welfare and the interests of the program.
5.13 	(b) Except when the commissioner finds good cause not to suspend payments under 
5.14 	Code of Federal Regulations, title 42, section 455.23(e) or (f), the commissioner shall 
5.15 	withhold or reduce payments to an individual or entity without providing advance notice 
5.16 	of such withholding or reduction if either of the following occurs:
5.17 	(1) the individual or entity is convicted of a crime involving the conduct described in 
5.18 	subdivision 1a; or
5.19 	(2) the commissioner determines there is a credible allegation of fraud for which an 
5.20 	investigation is pending under the program. Allegations are considered credible when they 
5.21 	have an indicium of reliability and the state agency has reviewed all allegations, facts, and 
5.22 	evidence carefully and acts judiciously on a case-by-case basis. A credible allegation of 
5.23 	fraud is an allegation which has been verified by the state, from any source, including but 
5.24 	not limited to:
5.25 	(i) fraud hotline complaints;
5.26 	(ii) claims data mining; and
5.27 	(iii) patterns identified through provider audits, civil false claims cases, and law 
5.28 	enforcement investigations.
5.29 	(c) The commissioner must send notice of the withholding or reduction of payments 
5.30 	under paragraph (b) within five days of taking such action unless requested in writing by a 
5.31 	law enforcement agency to temporarily withhold the notice. The notice must:
5.32 	(1) state that payments are being withheld according to paragraph (b);
6.1 	(2) set forth the general allegations as to the nature of the withholding action, but need 
6.2 	not disclose any specific information concerning an ongoing investigation;
6.3 	(3) except in the case of a conviction for conduct described in subdivision 1a, state that 
6.4 	the withholding is for a temporary period and cite the circumstances under which withholding 
6.5 	will be terminated;
6.6 	(4) identify the types of claims to which the withholding applies; and
6.7 	(5) inform the individual or entity of the right to submit written evidence for consideration 
6.8 	by the commissioner.
6.9 	(d) The withholding or reduction of payments will not continue after The commissioner 
6.10 	determines must cease the withholding or reduction of payments after determining there is 
6.11 	insufficient evidence of fraud by the individual or entity,; after finding good cause not to 
6.12 	continue withholding or reducing payments under Code of Federal Regulations, title 42, 
6.13 	section 455.23(e) or (f); or after legal proceedings relating to the alleged fraud are completed, 
6.14 	unless the commissioner has sent notice of intention to impose monetary recovery or 
6.15 	sanctions under paragraph (a). Upon conviction for a crime related to the provision, 
6.16 	management, or administration of a health service under medical assistance, a payment held 
6.17 	pursuant to this section by the commissioner or a managed care organization that contracts 
6.18 	with the commissioner under section 256B.035 is forfeited to the commissioner or managed 
6.19 	care organization, regardless of the amount charged in the criminal complaint or the amount 
6.20 	of criminal restitution ordered.
6.21 	(e) The commissioner shall suspend or terminate an individual's or entity's participation 
6.22 	in the program without providing advance notice and an opportunity for a hearing when the 
6.23 	suspension or termination is required because of the individual's or entity's exclusion from 
6.24 	participation in Medicare. Within five days of taking such action, the commissioner must 
6.25 	send notice of the suspension or termination. The notice must:
6.26 	(1) state that suspension or termination is the result of the individual's or entity's exclusion 
6.27 	from Medicare;
6.28 	(2) identify the effective date of the suspension or termination; and
6.29 	(3) inform the individual or entity of the need to be reinstated to Medicare before 
6.30 	reapplying for participation in the program.
6.31 	(f) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is 
6.32 	to be imposed, an individual or entity may request a contested case, as defined in section 
6.33 	14.02, subdivision 3, by filing with the commissioner a written request of appeal. The appeal 
7.1 	request must be received by the commissioner no later than 30 days after the date the 
7.2 	notification of monetary recovery or sanction was mailed to the individual or entity. The 
7.3 	appeal request must specify:
7.4 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
7.5 	involved for each disputed item;
7.6 	(2) the computation that the individual or entity believes is correct;
7.7 	(3) the authority in statute or rule upon which the individual or entity relies for each 
7.8 	disputed item;
7.9 	(4) the name and address of the person or entity with whom contacts may be made 
7.10 	regarding the appeal; and
7.11 	(5) other information required by the commissioner.
7.12 	(g) The commissioner may order an individual or entity to forfeit a fine for failure to 
7.13 	fully document services according to standards in this chapter and Minnesota Rules, chapter 
7.14 	9505. The commissioner may assess fines if specific required components of documentation 
7.15 	are missing. The fine for incomplete documentation shall equal 20 percent of the amount 
7.16 	paid on the claims for reimbursement submitted by the individual or entity, or up to $5,000, 
7.17 	whichever is less. If the commissioner determines that an individual or entity repeatedly 
7.18 	violated this chapter, chapter 254B or 245G, or Minnesota Rules, chapter 9505, related to 
7.19 	the provision of services to program recipients and the submission of claims for payment, 
7.20 	the commissioner may order an individual or entity to forfeit a fine based on the nature, 
7.21 	severity, and chronicity of the violations, in an amount of up to $5,000 or 20 percent of the 
7.22 	value of the claims, whichever is greater.
7.23 	(h) The individual or entity shall pay the fine assessed on or before the payment date 
7.24 	specified. If the individual or entity fails to pay the fine, the commissioner may withhold 
7.25 	or reduce payments and recover the amount of the fine. A timely appeal shall stay payment 
7.26 	of the fine until the commissioner issues a final order.
7.27 	(i) Prior to suspending or withholding payments to an entity providing residential services 
7.28 	and supports to an older adult or person with a disability, or suspending or terminating the 
7.29 	entity's participation in medical assistance, the commissioner must notify the Department 
7.30 	of Human Services continuity of care team established under section 256B.045. The 
7.31 	commissioner must not suspend or withhold payments to an entity providing residential 
7.32 	services and supports to an older adult or person with a disability, or suspend or terminate 
7.33 	the entity's participation in the program, until the continuity of care team notifies the 
8.1 	commissioner that the team is prepared to immediately intervene and comply with its duties 
8.2 	under section 256B.045 upon imposition of the commissioner's sanction. For the purposes 
8.3 	of this paragraph, "residential services and supports" has the meaning given in section 
8.4 	256B.045, subdivision 1.

8.5 	ARTICLE 2
8.6 	AGING AND DISABILITY SERVICES

8.7 	Section 1. Minnesota Statutes 2024, section 62A.135, subdivision 1, is amended to read:
8.8 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
8.9 	meanings given them:
8.10 	(a) (1) "fixed indemnity policy" is a policy form, other than an accidental death and 
8.11 	dismemberment policy, a disability income policy, or a long-term care policy as defined in 
8.12 	section 62A.46, subdivision 2, that pays a predetermined, specified, fixed benefit for services 
8.13 	provided. Fixed indemnity policy includes short-term home health and nursing care insurance 
8.14 	under section 62A.70. Claim costs under these forms are generally not subject to inflation, 
8.15 	although they may be subject to changes in the utilization of health care services. For policy 
8.16 	forms providing both expense-incurred and fixed benefits, the policy form is a fixed 
8.17 	indemnity policy if 50 percent or more of the total claims are for predetermined, specified, 
8.18 	fixed benefits;
8.19 	(b) (2) "guaranteed renewable" means that, during the renewal period (to a specified 
8.20 	age) renewal cannot be declined nor coverage changed by the insurer for any reason other 
8.21 	than nonpayment of premiums, fraud, or misrepresentation, but the insurer can revise rates 
8.22 	on a class basis upon approval by the commissioner;
8.23 	(c) (3) "noncancelable" means that, during the renewal period (to a specified age) renewal 
8.24 	cannot be declined nor coverage changed by the insurer for any reason other than nonpayment 
8.25 	of premiums, fraud, or misrepresentation and that rates cannot be revised by the insurer. 
8.26 	This includes policies that are guaranteed renewable to a specified age, such as 60 or 65, at 
8.27 	guaranteed rates; and
8.28 	(d) (4) "average annualized premium" means the average of the estimated annualized 
8.29 	premium per covered person based on the anticipated distribution of business using all 
8.30 	significant criteria having a price difference, such as age, sex, amount, dependent status, 
8.31 	mode of payment, and rider frequency. For filing of rate revisions, the amount is the 
8.32 	anticipated average assuming the revised rates have fully taken effect.

9.1 	Sec. 2. Minnesota Statutes 2024, section 62A.46, subdivision 2, is amended to read:
9.2 		Subd. 2.Long-term care policy. (a) "Long-term care policy" means an individual or 
9.3 	group policy, certificate, subscriber contract, or other evidence of coverage that provides 
9.4 	benefits for prescribed long-term care, including nursing facility services or home care 
9.5 	services, or both nursing facility services and home care services, pursuant to the 
9.6 	requirements of sections 62A.46 to 62A.56. Long-term care policy does not include 
9.7 	short-term home health and nursing care insurance under section 62A.70.
9.8 	(b) Sections 62A.46, 62A.48, and 62A.52 to 62A.56 do not apply to a long-term care 
9.9 	policy issued to (a) (1) an employer or employers or to the trustee of a fund established by 
9.10 	an employer where only employees or retirees, and dependents of employees or retirees, 
9.11 	are eligible for coverage or (b) (2) to a labor union or similar employee organization. The 
9.12 	associations exempted from the requirements of sections 62A.3099 to 62A.44 under 62A.31, 
9.13 	subdivision 1, clause (c) shall not be subject to the provisions of sections 62A.46 to 62A.56
9.14 	until July 1, 1988.

9.15 	Sec. 3. [62A.70] SHORT-TERM HOME HEALTH AND NURSING CARE 
9.16 	INSURANCE.
9.17 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
9.18 	the meanings given.
9.19 	(b) "Activities of daily living" has the meaning given in section 62S.01, subdivision 2.
9.20 	(c) "Cognitive impairment" has the meaning given in section 62S.01, subdivision 9.
9.21 	(d) "Free-look period" means a period with a duration of at least 30 days, beginning the 
9.22 	date the policy, certificate, contract, or other evidence of coverage is issued and delivered 
9.23 	to the insured, during which an insured may cancel the policy, certificate, contract, or other 
9.24 	evidence of coverage and receive a full refund of all paid insurance premiums.
9.25 	(e) "Home health agency" has the meaning given in section 62A.46, subdivision 10.
9.26 	(f) "Insured" means a person covered under a short-term home health and nursing care 
9.27 	insurance policy.
9.28 	(g) "Nursing facility" has the meaning given in section 62A.46, subdivision 3.
9.29 	(h) "Plan of care" has the meaning given in section 62A.46, subdivision 8.
9.30 	(i) "Qualified insurer" means an entity licensed under chapter 62A or 62C.
10.1 	(j) "Short-term home health and nursing care insurance" means an individual or group 
10.2 	policy, certificate, subscriber contract, or other evidence of coverage that provides benefits 
10.3 	for short-term home health services or short-term nursing care services. Short-term home 
10.4 	health and nursing care insurance does not include:
10.5 	(1) a long-term care policy, as defined in section 62A.46, subdivision 2;
10.6 	(2) long-term care insurance, as defined in section 62S.01, subdivision 18;
10.7 	(3) Medicare supplement policies, as defined in section 62A.3099, subdivision 18; or
10.8 	(4) major medical, disability income, or hospital confinement indemnity policies.
10.9 	(k) "Short-term home health services" means one or more of the following services to 
10.10 	care for and treat an insured that are provided by a home health agency in a noninstitutional 
10.11 	setting pursuant to a written diagnosis or assessment and plan of care:
10.12 	(1) nursing and related personal care services under the direction of a registered nurse, 
10.13 	including the services of a home health aide;
10.14 	(2) physical therapy;
10.15 	(3) speech therapy;
10.16 	(4) respiratory therapy;
10.17 	(5) occupational therapy;
10.18 	(6) nutritional services provided by a licensed dietitian;
10.19 	(7) homemaker services, meal preparation, and similar nonmedical services;
10.20 	(8) medical social services; and
10.21 	(9) other similar medical services and health-related support services.
10.22 	(l) "Short-term nursing care services" means services to care for and treat an insured 
10.23 	that are provided by a nursing facility pursuant to a written diagnosis or assessment and 
10.24 	plan of care.
10.25 	(m) "Waiting period" means a specified time period that an insured must wait before 
10.26 	some or all of the insured's coverage becomes effective.
10.27 		Subd. 2.Short-term home health and nursing care insurance approval. (a) A qualified 
10.28 	insurer may offer, issue, deliver, and renew short-term home health and nursing care 
10.29 	insurance if the insurance meets the requirements of this section.
11.1 	(b) Short-term home health and nursing care insurance may be offered, issued, delivered, 
11.2 	or renewed only by a qualified insurer.
11.3 	(c) Short-term home health and nursing care insurance must not be offered, issued, 
11.4 	delivered, or renewed until the short-term home health and nursing care insurance is approved 
11.5 	by the commissioner as necessary under sections 62A.02 and 62A.135.
11.6 		Subd. 3.Policy requirements. (a) Short-term home health and nursing care insurance 
11.7 	must provide benefits upon the insured's:
11.8 	(1) cognitive impairment; or
11.9 	(2) inability to perform at least two activities of daily living without substantial assistance.
11.10 	(b) Short-term home health and nursing care insurance must not provide coverage for a 
11.11 	period exceeding 360 days.
11.12 	(c) Short-term home health and nursing care insurance must provide a free-look period.
11.13 	(d) Short-term home health and nursing care insurance must not be canceled due to an 
11.14 	insured's deterioration in health status or use of benefits.
11.15 	(e) An insurer may deny the renewal of a policy, certificate, contract, or other evidence 
11.16 	of coverage of short-term home health and nursing care insurance only for:
11.17 	(1) nonpayment of a premium by the insured;
11.18 	(2) fraud or misrepresentation by the insured;
11.19 	(3) termination of the insurer's authority to transact business in the state; or
11.20 	(4) the insured's exhaustion of the maximum benefit period.
11.21 	(f) Upon the conversion or replacement by an insurer of a policy, certificate, contract, 
11.22 	or other evidence of coverage containing a waiting period, the insurer is prohibited from 
11.23 	establishing a waiting period that differs from the original waiting period.
11.24 		Subd. 4.Required disclosures. Short-term home health and nursing care insurance must 
11.25 	not be offered or issued without providing the following written disclosures:
11.26 	(1) a statement, in bold text, that the policy, certificate, contract, or other evidence of 
11.27 	coverage is supplemental health insurance; is not long-term care insurance; and is not a 
11.28 	policy under the Minnesota partnership for long-term care program;
11.29 	(2) a clear and understandable explanation of the free-look period; and
11.30 	(3) a clear and understandable explanation of all renewability and continuity provisions.

12.1 	Sec. 4. Minnesota Statutes 2024, section 72A.13, subdivision 1, is amended to read:
12.2 		Subdivision 1.Penalties. Any company, corporation, association, society, or other 
12.3 	insurer, or any officer or agent thereof, which or who solicits, issues or delivers to any 
12.4 	person in this state any policy in violation of the provisions of sections 60A.06, subdivision 
12.5 	3or,62A.01 to 62A.10, or 62A.70 may be punished by a fine of not more than $200 for 
12.6 	each offense, and the commissioner may revoke the license of any company, corporation, 
12.7 	association, society, or other insurer of another state or country, or of the agent thereof, 
12.8 	which or who willfully violates any provision of sections 60A.06, subdivision 3or,62A.01
12.9 	to 62A.10, or 62A.70.

12.10 	Sec. 5. Minnesota Statutes 2025 Supplement, section 144.0724, subdivision 2, is amended 
12.11 	to read:
12.12 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
12.13 	given.
12.14 	(a) "Assessment reference date" or "ARD" means the specific end point for look-back 
12.15 	periods in the MDS assessment process. This look-back period is also called the observation 
12.16 	or assessment period.
12.17 	(b) "Case mix index" means the weighting factors assigned to the case mix reimbursement 
12.18 	classifications determined by an assessment.
12.19 	(c) "Index maximization" means classifying a resident who could be assigned to more 
12.20 	than one category, to the category with the highest case mix index.
12.21 	(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment, 
12.22 	and functional status elements, that include common definitions and coding categories 
12.23 	specified by the Centers for Medicare and Medicaid Services and designated by the 
12.24 	Department of Health.
12.25 	(e) "Representative" means a person who is the resident's guardian or conservator, the 
12.26 	person authorized to pay the nursing home expenses of the resident, a representative of the 
12.27 	Office of Ombudsman for Long-Term Care whose assistance has been requested, or any 
12.28 	other individual designated by the resident.
12.29 	(f) "Activities of daily living" or "ADL" includes personal hygiene, dressing, bathing, 
12.30 	transferring, bed mobility, locomotion, eating, and toileting.
12.31 	(g) "Nursing facility level of care determination" means the assessment process that 
12.32 	results in a determination of a resident's or prospective resident's need for nursing facility 
13.1 	level of care as established in subdivision 11 for purposes of medical assistance payment 
13.2 	of long-term care services for:
13.3 	(1) nursing facility services under chapter 256R;
13.4 	(2) elderly waiver services under chapter 256S;
13.5 	(3) CADI and BI waiver services under section 256B.49; and
13.6 	(4) state payment of alternative care services under section 256B.0913.
13.7 	This paragraph expires upon the effective date of paragraph (h).
13.8 	(h) Effective January 1, 2027, or upon federal approval, whichever is later, "nursing 
13.9 	facility level of care determination" means the assessment process that results in a 
13.10 	determination of a resident's or prospective resident's need for nursing facility level of care:
13.11 	(1) as established in subdivision 11 for purposes of medical assistance payment of 
13.12 	long-term care services for:
13.13 	(i) nursing facility services under chapter 256R;
13.14 	(ii) elderly waiver services under chapter 256S; and
13.15 	(iii) state payment of alternative care services under section 256B.0913; and
13.16 	(2) as established in subdivision 11a for purposes of medical assistance payment of 
13.17 	long-term care services for brain injury and community access for disability and inclusion 
13.18 	waivers under section 256B.49.
13.19 	(h)(i) "Patient Driven Payment Model" or "PDPM" means the case mix reimbursement 
13.20 	classification system for residents in nursing facilities based on the resident's condition, 
13.21 	diagnosis, and the care the resident received at the time of the MDS assessment with an 
13.22 	ARD on or after October 1, 2025.
13.23 	(i)(j) "Resource utilization group" or "RUG" means the case mix reimbursement 
13.24 	classification system for residents in nursing facilities according to the resident's clinical 
13.25 	and functional status as reflected in data supplied by the facility's MDS with an ARD on or 
13.26 	before September 30, 2025.

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

14.1 	Sec. 6. Minnesota Statutes 2024, section 144.0724, is amended by adding a subdivision 
14.2 	to read:
14.3 		Subd. 11a.Nursing facility level of care; BI and CADI waivers. (a) Effective January 
14.4 	1, 2027, or upon federal approval, whichever is later, a determination of need for nursing 
14.5 	facility level of care for brain injury and community access for disability and inclusion 
14.6 	waivers under section 256B.49 must meet one of the following criteria:
14.7 	(1) the person needs the assistance of another person or constant supervision to begin 
14.8 	and complete at least four of the following activities of living: bathing, bed mobility, dressing, 
14.9 	eating, grooming, toileting, transferring, and walking;
14.10 	(2) the person needs the assistance of another person or constant supervision to begin 
14.11 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled; 
14.12 	or
14.13 	(3) the person has significant difficulty with memory, using information, daily decision 
14.14 	making, or behavioral needs that require intervention.
14.15 	(b) Nursing facility level of care determinations for purposes of initial and ongoing 
14.16 	access to brain injury and community access for disability inclusion waiver programs must 
14.17 	be conducted by a MnCHOICES certified assessor in a manner determined by the 
14.18 	commissioner.

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

14.20 	Sec. 7. Minnesota Statutes 2024, section 144.292, subdivision 6, is amended to read:
14.21 		Subd. 6.Cost. (a) When a patient requests a copy of the patient's record for purposes of 
14.22 	reviewing current medical care, the provider must not charge a fee.
14.23 	(b) When a provider or its representative makes copies of patient records upon a patient's 
14.24 	request under this section, the provider or its representative may charge the patient or the 
14.25 	patient's representative no more than the following amount, unless other law or a rule or 
14.26 	contract provide for a lower maximum charge:
14.27 	(1) for paper copies, $1 per page, plus $10 for time spent retrieving and copying the 
14.28 	records;
14.29 	(2) for x-rays, a total of $30 for retrieving and reproducing x-rays; and
14.30 	(3) for electronic copies, a total of $20 for retrieving the records.
15.1 	(c) For any copies of paper records provided under paragraph (b), clause (1), a provider 
15.2 	or the provider's representative may not charge more than a total of:
15.3 	(1) $10 if there are no records available;
15.4 	(2) $30 for copies of records of up to 25 pages;
15.5 	(3) $50 for copies of records of up to 100 pages;
15.6 	(4) $50, plus an additional 20 cents per page for pages 101 and above; or
15.7 	(5) $500 for any request.
15.8 	(d) A provider or its representative may charge a $10 retrieval fee, but must not charge 
15.9 	a per page fee or x-ray fee to provide copies of records requested by a patient or the patient's 
15.10 	authorized representative if the request for copies of records is for purposes of appealing a 
15.11 	denial of Social Security disability income or Social Security disability benefits under title 
15.12 	II or title XVI of the Social Security Act. Notwithstanding the foregoing, a provider or its 
15.13 	representative must not charge a fee, including a retrieval fee, to provide copies of records 
15.14 	requested by a patient or the patient's authorized representative if the request for copies of 
15.15 	records is for purposes of appealing a denial of Social Security disability income or Social 
15.16 	Security disability benefits under title II or title XVI of the Social Security Act when the 
15.17 	patient is receiving public assistance, represented by an attorney on behalf of a civil legal 
15.18 	services program, or represented by a volunteer attorney program based on indigency. The 
15.19 	patient or the patient's representative must submit one of the following to show that they 
15.20 	are entitled to receive records without charge under this paragraph:
15.21 	(1) a public assistance statement from the county or state administering assistance;
15.22 	(2) a request for records on the letterhead of the civil legal services program or volunteer 
15.23 	attorney program based on indigency; or
15.24 	(3) a benefits statement from the Social Security Administration.
15.25 	For the purpose of further appeals, a patient may receive no more than two medical record 
15.26 	updates without charge, but only for medical record information previously not provided.
15.27 	For purposes of this paragraph, a patient's authorized representative does not include units 
15.28 	of state government engaged in the adjudication of Social Security disability claims.
15.29 	(e) A provider or its representative may charge a $10 retrieval fee, but must not charge 
15.30 	a per page fee or x-ray fee to provide copies of records requested by a patient or the patient's 
15.31 	authorized representative if the request for copies of records is for purposes of a disability 
15.32 	determination by the department's state medical review team. Notwithstanding the foregoing, 
16.1 	a provider or its representative must not charge a fee, including a retrieval fee, to provide 
16.2 	copies of records requested by a patient or the patient's authorized representative if the 
16.3 	request for copies of records is for purposes of a disability determination by the department's 
16.4 	state medical review team when the patient is receiving public assistance. To show that the 
16.5 	patient or the patient's representative is entitled to receive records without charge under this 
16.6 	paragraph, the patient or the patient's representative must submit either the patient's public 
16.7 	assistance statement from the county or state administering assistance or the patient's benefits 
16.8 	statement from the Social Security Administration.

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

16.10 	Sec. 8. Minnesota Statutes 2024, section 245A.04, subdivision 2, is amended to read:
16.11 		Subd. 2.Notification of affected municipality. The commissioner must not issue a 
16.12 	license under this chapter without giving 30 calendar days' written notice to the affected 
16.13 	municipality or other political subdivision unless the program is considered a permitted 
16.14 	single-family residential use under sections 245A.11 and 245A.14. If the program is 
16.15 	considered a permitted single-family residence, the commissioner must give the affected 
16.16 	municipality or other political subdivision written notice of the issuance no later than five 
16.17 	days after issuing the license, excluding weekends and holidays. The written notice must 
16.18 	include the prospective license holder's name and contact information, the license type and 
16.19 	capacity, and the proposed address of the licensed facility or program. The commissioner 
16.20 	may provide notice through electronic communication. The notification must be given 
16.21 	before the first issuance of a license under this chapter and annually after that time if annual 
16.22 	notification is requested in writing by the affected municipality or other political subdivision. 
16.23 	State funds must not be made available to or be spent by an agency or department of state, 
16.24 	county, or municipal government for payment to a residential or nonresidential program 
16.25 	licensed under this chapter until the provisions of this subdivision have been complied with 
16.26 	in full. The provisions of this subdivision shall not apply to programs located in hospitals.

16.27 	EFFECTIVE DATE. This section is effective July 1, 2026, and applies to licenses 
16.28 	issued on or after that date.

16.29 	Sec. 9. Minnesota Statutes 2024, section 245A.04, subdivision 2a, is amended to read:
16.30 		Subd. 2a.Meeting fire and safety codes. (a) An applicant or license holder under 
16.31 	sections 245A.01 to 245A.16 must document compliance with applicable building codes, 
16.32 	fire and safety codes, health rules, and zoning ordinances, or document that an appropriate 
16.33 	waiver has been granted.
17.1 	(b) At the request of a county or local unit of government, the commissioner may delegate 
17.2 	to a county agency or local unit of government the commissioner's or local agency's authority 
17.3 	to inspect an existing residential program serving six or fewer persons for compliance with 
17.4 	zoning ordinances and applicable physical plant licensing requirements. If the commissioner 
17.5 	delegates the commissioner's or local agency's authority to a county agency or local unit of 
17.6 	government under this subdivision, the commissioner must execute a formal delegation of 
17.7 	authority that clearly specifies what authority is being delegated to the county agency or 
17.8 	local unit of government, that the commissioner is responsible for any costs incurred by the 
17.9 	county agency or local unit of government for conducting inspections under delegated 
17.10 	authority, and that the county agency or local unit of government must not assess any 
17.11 	additional fees for conducting an inspection under delegated authority. When conducting 
17.12 	an inspection under delegated authority, the county agency or local unit of government must 
17.13 	provide the subject of the inspection with a copy of the delegation of authority.
17.14 	(c) When a county agency or local unit of government is conducting an inspection under 
17.15 	delegated authority as provided in paragraph (b), the county agency or local unit of 
17.16 	government and the agency responsible for licensing inspections must coordinate inspections 
17.17 	to minimize visits to and disruptions of the residential program. A county agency or local 
17.18 	unit of government conducting an inspection must notify the commissioner of any violations 
17.19 	or concerns within ten days of the inspection, excluding weekends and holidays. A county 
17.20 	agency or local unit of government that conducts inspections under this subdivision must 
17.21 	not inspect a residential program more frequently than annually, except a follow-up inspection 
17.22 	is permitted before the next annual inspection to verify correction of a violation discovered 
17.23 	during the most recent inspection.
17.24 	(d) The commissioner must ensure that laws, rules, and codes are uniformly enforced 
17.25 	throughout the state by reviewing at least every four years each county agency and local 
17.26 	unit of government conducting inspections under this subdivision for compliance with this 
17.27 	subdivision and other applicable laws and rules.

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

17.29 	Sec. 10. Minnesota Statutes 2024, section 245A.042, is amended by adding a subdivision 
17.30 	to read:
17.31 		Subd. 7.Colocation of certain home and community-based residential settings. (a) 
17.32 	Effective July 1, 2026, the commissioner must not authorize services in or issue an initial 
17.33 	license under this chapter or chapter 245D for any of the following residential settings or 
18.1 	programs unless the proposed setting meets the heightened home and community-based 
18.2 	setting standards described in this subdivision:
18.3 	(1) a community residential setting, as defined in section 245D.02, subdivision 4a;
18.4 	(2) an adult foster care home;
18.5 	(3) a setting providing customized living services with a resident capacity of six or fewer;
18.6 	(4) a setting providing 24-hour customized living services with a resident capacity of 
18.7 	six or fewer; and
18.8 	(5) an assisted living facility licensed under chapter 144G with a resident capacity of 
18.9 	six or fewer.
18.10 	(b) Newly licensed settings enumerated in paragraph (a) must not be located on the same 
18.11 	property or on an adjoining property of any existing community residential setting, any 
18.12 	existing adult foster care setting, any existing setting providing family residential services 
18.13 	to an adult, any existing setting providing customized living services with a resident capacity 
18.14 	of six or fewer, any existing setting providing 24-hour customized living services with a 
18.15 	resident capacity of six or fewer, or any existing assisted living facility licensed under 
18.16 	chapter 144G with a resident capacity of six or fewer. The requirements of this paragraph 
18.17 	apply regardless of who owns or controls the existing setting. The commissioner must 
18.18 	comply with section 245A.11, subdivision 4, when authorizing services or issuing an initial 
18.19 	license under this subdivision.
18.20 	(c) For the purposes of this subdivision, "adjoining property" means a property that 
18.21 	shares a common boundary line with another property. Adjoining property also includes 
18.22 	properties that meet at a common corner point. The presence of a right-of-way or public 
18.23 	easement, including but not limited to a bicycle path, alley, or residential street, between 
18.24 	adjoining properties, including between properties that but for the right-of-way or public 
18.25 	easement would share a common corner point, are adjoining properties.

18.26 	Sec. 11. Minnesota Statutes 2024, section 256.01, subdivision 21, is amended to read:
18.27 		Subd. 21.Interagency agreement agreements with Department of Health. (a) The 
18.28 	commissioner of human services shall amend the interagency agreement with the 
18.29 	commissioner of health to certify nursing facilities for participation in the medical assistance 
18.30 	program, to require the commissioner of health, as a condition of the agreement, to comply 
18.31 	beginning July 1, 2005, with action plans included in the annual survey and certification 
18.32 	quality improvement report required under section 144A.10, subdivision 17.
19.1 	(b) The commissioners of health and human services must execute an interagency 
19.2 	agreement to determine on behalf of the commissioner of health whether an assisted living 
19.3 	facility for which either an applicant is seeking a provisional license under chapter 144G 
19.4 	or a licensee is seeking to relocate under section 144G.195 meets the standards described 
19.5 	in section 245A.042, subdivision 7.

19.6 	Sec. 12. Minnesota Statutes 2025 Supplement, section 256.4792, subdivision 1, is amended 
19.7 	to read:
19.8 		Subdivision 1.Long-term services and supports loan program. The commissioner 
19.9 	of human services shall establish a loan program to provide operating loans to eligible 
19.10 	long-term services and supports providers. The commissioner shall initiate the application 
19.11 	process for the loan described in this section on an ongoing basis. The commissioner must 
19.12 	not issue any new loans under this program after June 30, 2026.

19.13 	Sec. 13. Minnesota Statutes 2025 Supplement, section 256.4792, subdivision 7, is amended 
19.14 	to read:
19.15 		Subd. 7.Loan repayment. (a) If a borrower is more than 60 calendar days delinquent 
19.16 	in the timely payment of a contractual payment under this section, the provisions in 
19.17 	paragraphs (b) to (e) apply.
19.18 	(b) The commissioner may withhold some or all of the amount of the delinquent loan 
19.19 	payment, together with any penalties due and owing on those amounts, from any money 
19.20 	the department owes to the borrower. The commissioner may, at the commissioner's 
19.21 	discretion, also withhold future contractual payments from any money the commissioner 
19.22 	owes the provider as those contractual payments become due and owing. The commissioner 
19.23 	may continue this withholding until the commissioner determines there is no longer any 
19.24 	need to do so.
19.25 	(c) The commissioner shall give prior notice of the commissioner's intention to withhold 
19.26 	by mail, facsimile, or email at least ten business days before the date of the first payment 
19.27 	period for which the withholding begins. The notice must be deemed received as of the date 
19.28 	of mailing or receipt of the facsimile or electronic notice. The notice must state:
19.29 	(1) the amount of the delinquent contractual payment;
19.30 	(2) the amount of the withholding per payment period;
19.31 	(3) the date on which the withholding is to begin;
20.1 	(4) whether the commissioner intends to withhold future installments of the provider's 
20.2 	contractual payments; and
20.3 	(5) other contents as the commissioner deems appropriate.
20.4 	(d) The commissioner, or the commissioner's designee, may enter into written settlement 
20.5 	agreements with a provider to resolve disputes and other matters involving unpaid loan 
20.6 	contractual payments or future loan contractual payments.
20.7 	(e) Notwithstanding any law to the contrary, all unpaid loans, plus any accrued penalties, 
20.8 	are overpayments for the purposes of section 256B.0641, subdivision 1. The current long-term 
20.9 	services and supports provider is liable for the overpayment amount owed by a former owner 
20.10 	for any provider sold, transferred, or reorganized.
20.11 	(f) By January 15 each year, the commissioner must provide to the chairs and ranking 
20.12 	minority members of the legislative committees with jurisdiction over nursing facilities a 
20.13 	report of all facilities that are delinquent in their repayments. The reporting required under 
20.14 	this paragraph expires upon notification by the commissioner to the committees that there 
20.15 	are no outstanding balances from loan awards issued under this subdivision.

20.16 	Sec. 14. Minnesota Statutes 2025 Supplement, section 256.4792, is amended by adding 
20.17 	a subdivision to read:
20.18 		Subd. 11.Loan program expiration. This section expires after the commissioner collects 
20.19 	all loan repayments incurred on or before June 30, 2026. The commissioner must notify the 
20.20 	revisor of statutes once all loan repayments under this section are collected.

20.21 	Sec. 15. Minnesota Statutes 2024, section 256B.04, is amended by adding a subdivision 
20.22 	to read:
20.23 		Subd. 28.Interpretive guidelines for disability waiver regulation. (a) The 
20.24 	commissioner must develop and publish interpretive guidelines within 120 calendar days 
20.25 	of the effective date of any statutory changes, waiver plan amendments, state or federal 
20.26 	administrative rulings, or state or federal court decisions that affect policies or reimbursement 
20.27 	for services licensed under chapter 245D, authorized under section 256B.092 or 256B.49, 
20.28 	or reimbursed under section 256B.4914.
20.29 	(b) Interpretive guidelines issued by the commissioner under this subdivision do not 
20.30 	have the force and effect of law and have no precedential effect but may be relied on by 
20.31 	consumers, providers of service, county agencies, the Department of Human Services, and 
20.32 	others concerned until revoked or modified. An interpretive guideline may be expressly 
21.1 	revoked or modified by the commissioner or by the issuance of another interpretive guideline 
21.2 	but may not be revoked or modified retroactively to the detriment of consumers, providers 
21.3 	of service, county agencies, the Department of Human Services, or others concerned. A 
21.4 	change in the law or an interpretation of the law occurring after the interpretive guidelines 
21.5 	are issued, whether in the form of a statute, court decision, administrative ruling, or 
21.6 	subsequent interpretive guideline, results in the revocation or modification of the previously 
21.7 	adopted guidelines to the extent that the change affects the guidelines.

21.8 	EFFECTIVE DATE. This section is effective the day following final enactment and 
21.9 	applies to statutory changes, waiver plan amendments, state or federal administrative rulings, 
21.10 	or state or federal court decisions effective or issued on or after that date.

21.11 	Sec. 16. Minnesota Statutes 2024, section 256B.04, is amended by adding a subdivision 
21.12 	to read:
21.13 		Subd. 29.Certified assessor team. The commissioner must employ certified assessors 
21.14 	within the department to conduct assessments under section 256B.0911 on behalf of lead 
21.15 	agencies under conditions and circumstances determined by the commissioner. Certified 
21.16 	assessors employed by the commissioner may conduct assessments in addition to other 
21.17 	duties as assigned, except the certified assessors employed by the commissioner must not 
21.18 	perform any responsibilities of a lead agency described in section 256B.0911 other than 
21.19 	assessments. Nothing in this subdivision creates an obligation for the commissioner to 
21.20 	provide the department's certified assessors to conduct assessments on behalf of a lead 
21.21 	agency.

21.22 	Sec. 17. Minnesota Statutes 2024, section 256B.0659, subdivision 12, is amended to read:
21.23 		Subd. 12.Documentation of personal care assistance services provided. (a) Personal 
21.24 	care assistance services for a recipient must be documented daily by each personal care 
21.25 	assistant, on a time sheet form approved by the commissioner. All documentation may be 
21.26 	web-based, electronic, or paper documentation. The completed form must be submitted on 
21.27 	a monthly basis to the provider and kept in the recipient's health record.
21.28 	(b) The activity documentation must correspond to the personal care assistance care plan 
21.29 	and be reviewed by the qualified professional.
21.30 	(c) The personal care assistant time sheet must be on a form approved by the 
21.31 	commissioner documenting time the personal care assistant provides services in the home. 
21.32 	The following criteria must be included in the time sheet:
22.1 	(1) full name of personal care assistant and individual provider number;
22.2 	(2) provider name and telephone numbers;
22.3 	(3) full name of recipient and either the recipient's medical assistance identification 
22.4 	number or date of birth;
22.5 	(4) consecutive dates, including month, day, and year, and arrival and departure times 
22.6 	with a.m. or p.m. notations;
22.7 	(5) signatures of recipient or the responsible party;
22.8 	(6) personal signature of the personal care assistant;
22.9 	(7) any shared care services provided, if applicable;
22.10 	(8) a statement that it is a federal crime to provide false information on personal care 
22.11 	service billings for medical assistance payments;
22.12 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration; and
22.13 	(10) any time spent traveling, as described in subdivision 1, paragraph (i), including 
22.14 	start and stop times with a.m. and p.m. designations, the origination site, and the destination 
22.15 	site.

22.16 	Sec. 18. Minnesota Statutes 2024, section 256B.0659, subdivision 16, is amended to read:
22.17 		Subd. 16.Shared services. (a) Medical assistance payments for shared personal care 
22.18 	assistance services that are shared services are limited according to this subdivision.
22.19 	(b) Shared service is For the purposes of this section, "shared services" means the 
22.20 	provision of personal care assistance services by a personal care assistant to two or three 
22.21 	recipients, who are all eligible for medical assistance, and who each voluntarily enter into 
22.22 	an agreement to receive services at the same time and in the same setting.
22.23 	(c) For the purposes of this subdivision, "setting" means:
22.24 	(1) the home residence or family foster care home of one or more of the individual 
22.25 	recipients; or
22.26 	(2) a child care program licensed under chapter 142B or operated by a local school 
22.27 	district or private school.
22.28 	(d) Shared personal care assistance services follow the same criteria for covered services 
22.29 	as subdivision 2.
22.30 	(e) Noncovered shared personal care assistance services include the following:
23.1 	(1) services for more than three recipients by one personal care assistant at one time;
23.2 	(2) staff requirements for child care programs under chapter 245C;
23.3 	(3) caring for multiple recipients in more than one setting;
23.4 	(4) additional units of personal care assistance based on the selection of the option; and
23.5 	(5) use of more than one personal care assistance provider agency for the shared care
23.6 	services.
23.7 	(f) The option of shared personal care assistance services is elected by the recipient or 
23.8 	the responsible party with the assistance of the assessor. The option must be determined 
23.9 	appropriate based on the ages of the recipients, compatibility, and coordination of their 
23.10 	assessed care needs. The recipient or the responsible party, in conjunction with the qualified 
23.11 	professional, shall arrange the setting and grouping of shared services based on the individual 
23.12 	needs and preferences of the recipients. The personal care assistance provider agency shall 
23.13 	offer the recipient or the responsible party the option of shared services or one-on-one 
23.14 	personal care assistance services or a combination of both. The recipient or the responsible 
23.15 	party may withdraw from participating in a shared services arrangement at any time.
23.16 	(g) Authorization for the shared service option must be determined by the commissioner 
23.17 	based on the criteria that the shared service is appropriate to meet all of the recipients' needs 
23.18 	and their the recipients' health and safety is maintained. The authorization of shared services 
23.19 	is part of the overall authorization of personal care assistance services. Nothing in this 
23.20 	subdivision must be construed to reduce the total number of hours authorized for an individual 
23.21 	recipient.
23.22 	(h) A personal care assistant providing shared personal care assistance services must:
23.23 	(1) receive training specific for each recipient served; and
23.24 	(2) follow all required documentation requirements for time and services provided.
23.25 	(i) A qualified professional shall:
23.26 	(1) evaluate the ability of the personal care assistant to provide services for all of to all
23.27 	the recipients in a shared setting;
23.28 	(2) visit the shared setting as shared services are being provided at least once every six 
23.29 	months or whenever needed for response to a recipient's request for increased supervision 
23.30 	of the personal care assistance staff;
23.31 	(3) provide ongoing monitoring and evaluation of the effectiveness and appropriateness 
23.32 	of the shared services;
24.1 	(4) develop a contingency plan with each of the recipients which that accounts for absence 
24.2 	of the recipient in a shared services setting due to illness or other circumstances;
24.3 	(5) obtain permission from each of the recipients who are sharing a personal care assistant 
24.4 	for number of shared hours for services provided inside and outside the home residence; 
24.5 	and
24.6 	(6) document the training completed by the personal care assistants specific to the shared 
24.7 	setting and recipients sharing services.

24.8 	Sec. 19. Minnesota Statutes 2024, section 256B.0659, subdivision 17, is amended to read:
24.9 		Subd. 17.Shared services; rates. (a) For the purposes of this subdivision, "additional 
24.10 	revenue for shared services" means the difference between the rate paid to a personal care 
24.11 	assistance provider agency for serving a single recipient and the sum of the rates paid to a 
24.12 	personal care assistance provider agency for shared services provided to more than one 
24.13 	recipient.
24.14 	(b) For the purposes of this subdivision, "wages and wage-related costs" means increased 
24.15 	wages and any corresponding increase in the employer's share of FICA taxes, Medicare 
24.16 	taxes, state and federal unemployment taxes, workers' compensation premiums, and 
24.17 	contributions to employee retirement accounts if the contribution is a function of wages.
24.18 	(c) The commissioner shall provide a rate system for shared personal care assistance
24.19 	services. For two persons recipients sharing services, the rate paid to a personal care 
24.20 	assistance provider agency for the shared services must not exceed one and one-half times 
24.21 	the rate paid for serving a single individual, and recipient. For three persons recipients
24.22 	sharing services, the rate paid to a personal care assistance provider agency for the shared 
24.23 	services must not exceed twice the rate paid for serving a single individual recipient. These 
24.24 	rates apply only when all of the criteria for the shared care personal care assistance service 
24.25 	have been services are met.
24.26 	(d) Of the additional revenue for shared services provided to two recipients, the personal 
24.27 	care assistance provider agency must use 95 percent for the purposes specified in paragraph 
24.28 	(e). Of the additional revenue for shared services provided to three recipients, the personal 
24.29 	care assistance provider agency must use 95 percent for the purposes specified in paragraph 
24.30 	(e).
24.31 	(e) A personal care assistance provider agency must use the percentages of additional 
24.32 	revenue for shared services specified in paragraph (d) for the wages and wage-related costs 
24.33 	of the personal care assistant providing the shared services. The personal care assistance 
25.1 	provider agency must not use additional revenue for shared services to pay for mileage 
25.2 	reimbursements, uniform allowances, health and dental insurance, life insurance, disability 
25.3 	insurance, long-term care insurance, contributions to employee retirement accounts if the 
25.4 	contribution is not a function of wages, or any other employee benefits.

25.5 	Sec. 20. Minnesota Statutes 2024, section 256B.0659, subdivision 19, is amended to read:
25.6 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) Under 
25.7 	personal care assistance choice, the recipient or responsible party shall:
25.8 	(1) recruit, hire, schedule, and terminate personal care assistants according to the terms 
25.9 	of the written agreement required under subdivision 20, paragraph (a);
25.10 	(2) develop a personal care assistance care plan based on the assessed needs and 
25.11 	addressing the health and safety of the recipient with the assistance of a qualified professional 
25.12 	as needed;
25.13 	(3) orient and train the personal care assistant with assistance as needed from the qualified 
25.14 	professional;
25.15 	(4) supervise and evaluate the personal care assistant with the qualified professional, 
25.16 	who is required to visit the recipient at least every 180 days;
25.17 	(5) monitor and verify in writing and report to the personal care assistance choice agency 
25.18 	the number of hours worked by the personal care assistant and the qualified professional;
25.19 	(6) engage in an annual reassessment as required in subdivision 3a to determine 
25.20 	continuing eligibility and service authorization;
25.21 	(7) use the same personal care assistance choice provider agency if shared personal 
25.22 	assistance care is services are being used; and
25.23 	(8) ensure that a personal care assistant driving the recipient under subdivision 1, 
25.24 	paragraph (i), has a valid driver's license and the vehicle used is registered and insured 
25.25 	according to Minnesota law.
25.26 	(b) The personal care assistance choice provider agency shall:
25.27 	(1) meet all personal care assistance provider agency standards;
25.28 	(2) enter into a written agreement with the recipient, responsible party, and personal 
25.29 	care assistants;
25.30 	(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal 
25.31 	care assistant; and
26.1 	(4) ensure arm's-length transactions without undue influence or coercion with the recipient 
26.2 	and personal care assistant.
26.3 	(c) The duties of the personal care assistance choice provider agency are to:
26.4 	(1) be the employer of the personal care assistant and the qualified professional for 
26.5 	employment law and related regulations including but not limited to purchasing and 
26.6 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
26.7 	and liability insurance, and submit any or all necessary documentation including but not 
26.8 	limited to workers' compensation, unemployment insurance, and labor market data required 
26.9 	under section 256B.4912, subdivision 1a;
26.10 	(2) bill the medical assistance program for personal care assistance services and qualified 
26.11 	professional services;
26.12 	(3) request and complete background studies that comply with the requirements for 
26.13 	personal care assistants and qualified professionals;
26.14 	(4) pay the personal care assistant and qualified professional based on actual hours of 
26.15 	services provided;
26.16 	(5) withhold and pay all applicable federal and state taxes;
26.17 	(6) verify and keep records of hours worked by the personal care assistant and qualified 
26.18 	professional;
26.19 	(7) make the arrangements and pay taxes and other benefits, if any, and comply with 
26.20 	any legal requirements for a Minnesota employer;
26.21 	(8) enroll in the medical assistance program as a personal care assistance choice agency; 
26.22 	and
26.23 	(9) enter into a written agreement as specified in subdivision 20 before services are 
26.24 	provided.

26.25 	Sec. 21. Minnesota Statutes 2024, section 256B.0911, subdivision 26, is amended to read:
26.26 		Subd. 26.Determination of institutional level of care. (a) The determination of need 
26.27 	for hospital and intermediate care facility levels of care must be made according to criteria 
26.28 	developed by the commissioner, and in section 256B.092, using forms developed by the 
26.29 	commissioner.
27.1 	(b) The determination of need for nursing facility level of care must be made based on 
27.2 	criteria in section 144.0724, subdivision 11. This paragraph expires upon the effective date 
27.3 	of paragraph (c).
27.4 	(c) Effective January 1, 2027, or upon federal approval, whichever is later, the 
27.5 	determination of need for nursing facility level of care must be made based on criteria in 
27.6 	section 144.0724, subdivision 11, or for brain injury and community access for disability 
27.7 	inclusion waiver services provided under section 256B.49 based on criteria in section 
27.8 	144.0724, subdivision 11a.

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

27.10 	Sec. 22. Minnesota Statutes 2024, section 256B.0913, subdivision 4, is amended to read:
27.11 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients. (a) 
27.12 	Funding for services under the alternative care program is available to persons who meet 
27.13 	the following criteria:
27.14 	(1) the person is a citizen of the United States or a United States national;
27.15 	(2) the person has been determined by a community assessment under section 256B.0911 
27.16 	to be a person who would require the level of care provided in a nursing facility, as 
27.17 	determined under section 256B.0911, subdivision 26, but for the provision of services under 
27.18 	the alternative care program;
27.19 	(3) the person is age 65 or older;
27.20 	(4) the person would be eligible for medical assistance within 135 days of admission to 
27.21 	a nursing facility;
27.22 	(5) the person is not ineligible for the payment of long-term care services by the medical 
27.23 	assistance program due to an asset transfer penalty under section 256B.0595 or equity 
27.24 	interest in the home exceeding $500,000 as stated in section 256B.056;
27.25 	(6) the person needs long-term care services that are not funded through other state or 
27.26 	federal funding, or other health insurance or other third-party insurance such as long-term 
27.27 	care insurance. For purposes of this clause, short-term home health and nursing care insurance 
27.28 	under section 62A.70 does not constitute health or other third-party insurance;
27.29 	(7) except for individuals described in clause (8), the monthly cost of the alternative 
27.30 	care services funded by the program for this person does not exceed 75 percent of the 
27.31 	monthly limit described under section 256S.18. This monthly limit does not prohibit the 
27.32 	alternative care client from payment for additional services, but in no case may the cost of 
28.1 	additional services purchased under this section exceed the difference between the client's 
28.2 	monthly service limit defined under section 256S.04, and the alternative care program 
28.3 	monthly service limit defined in this paragraph. If care-related supplies and equipment or 
28.4 	environmental modifications and adaptations are or will be purchased for an alternative 
28.5 	care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive 
28.6 	months beginning with the month of purchase. If the monthly cost of a recipient's other 
28.7 	alternative care services exceeds the monthly limit established in this paragraph, the annual 
28.8 	cost of the alternative care services shall be determined. In this event, the annual cost of 
28.9 	alternative care services shall not exceed 12 times the monthly limit described in this 
28.10 	paragraph;
28.11 	(8) for individuals assigned a case mix classification A as described under section 
28.12 	256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies 
28.13 	in bathing, dressing, grooming, walking, and eating when the dependency score in eating 
28.14 	is three or greater as determined by an assessment performed under section 256B.0911, the 
28.15 	monthly cost of alternative care services funded by the program cannot exceed $593 per 
28.16 	month for all new participants enrolled in the program on or after July 1, 2011. This monthly 
28.17 	limit shall be applied to all other participants who meet this criteria at reassessment. This 
28.18 	monthly limit shall be increased annually as described in section 256S.18. This monthly 
28.19 	limit does not prohibit the alternative care client from payment for additional services, but 
28.20 	in no case may the cost of additional services purchased exceed the difference between the 
28.21 	client's monthly service limit defined in this clause and the limit described in clause (7) for 
28.22 	case mix classification A;
28.23 	(9) the person is making timely payments of the assessed monthly fee. A person is 
28.24 	ineligible if payment of the fee is over 60 days past due, unless the person agrees to:
28.25 	(i) the appointment of a representative payee;
28.26 	(ii) automatic payment from a financial account;
28.27 	(iii) the establishment of greater family involvement in the financial management of 
28.28 	payments; or
28.29 	(iv) another method acceptable to the lead agency to ensure prompt fee payments; and
28.30 	(10) for a person participating in consumer-directed community supports, the person's 
28.31 	monthly service limit must be equal to the monthly service limits in clause (7), except that 
28.32 	a person assigned a case mix classification L must receive the monthly service limit for 
28.33 	case mix classification A.
29.1 	(b) The lead agency may extend the client's eligibility as necessary while making 
29.2 	arrangements to facilitate payment of past-due amounts and future premium payments. 
29.3 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
29.4 	reinstated for a period of 30 days.
29.5 	(c) Alternative care funding under this subdivision is not available for a person who is 
29.6 	a medical assistance recipient or who would be eligible for medical assistance without a 
29.7 	spenddown or waiver obligation. A person whose initial application for medical assistance 
29.8 	and the elderly waiver program is being processed may be served under the alternative care 
29.9 	program for a period up to 60 days. If the individual is found to be eligible for medical 
29.10 	assistance, medical assistance must be billed for services payable under the federally 
29.11 	approved elderly waiver plan and delivered from the date the individual was found eligible 
29.12 	for the federally approved elderly waiver plan. Notwithstanding this provision, alternative 
29.13 	care funds may not be used to pay for any service the cost of which: (i) is payable by medical 
29.14 	assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a 
29.15 	medical assistance income spenddown for a person who is eligible to participate in the 
29.16 	federally approved elderly waiver program under the special income standard provision.
29.17 	(d) Alternative care funding is not available for a person who resides in a licensed nursing 
29.18 	home, certified boarding care home, hospital, or intermediate care facility, except for case 
29.19 	management services which are provided in support of the discharge planning process for 
29.20 	a nursing home resident or certified boarding care home resident to assist with a relocation 
29.21 	process to a community-based setting.
29.22 	(e) Alternative care funding is not available for a person whose income is greater than 
29.23 	the maintenance needs allowance under section 256S.05, but equal to or less than 120 percent 
29.24 	of the federal poverty guideline effective July 1 in the fiscal year for which alternative care 
29.25 	eligibility is determined, who would be eligible for the elderly waiver with a waiver 
29.26 	obligation.

29.27 	Sec. 23. Minnesota Statutes 2025 Supplement, section 256B.092, subdivision 3b, is 
29.28 	amended to read:
29.29 		Subd. 3b.Service authorizations and service agreements. (a) Recipients must be 
29.30 	screened and authorized for services according to the federally approved waiver application 
29.31 	and its subsequent amendments.
29.32 	(b) The commissioner must require lead agency supervisors to review and accept all 
29.33 	service agreements entered by lead agency staff into the Medicaid management information 
29.34 	system (MMIS) prior to the commissioner's approval of the service agreement.
30.1 	(c) For a service agreement with a proposed total authorized amount that exceeds the 
30.2 	total authorized amount in the recipient's prior service agreement by more than the value 
30.3 	of legislatively enacted rate increases, the commissioner must manually review and manually 
30.4 	approve the service agreement in the MMIS. For purposes of this paragraph, "prior service 
30.5 	agreement" means the service agreement that was in effect 12 months prior to the start date 
30.6 	of the new proposed service agreement.
30.7 	(d) In a format prescribed by the commissioner, lead agencies must submit the following 
30.8 	information for all service agreements subject to the commissioner's approval in paragraph 
30.9 	(c):
30.10 	(1) changes in the number of units authorized;
30.11 	(2) new services authorized;
30.12 	(3) changes in the values used to calculate service rates under section 256B.4914, except 
30.13 	for automatic adjustments required under section 256B.4914, subdivisions 5 and 5b;
30.14 	(4) changes in the person's level of need that require an increase in the amount of services 
30.15 	authorized;
30.16 	(5) documentation detailing why the previous amount of services is not sufficient to 
30.17 	meet the person's needs; and
30.18 	(6) anticipated impact if the total service amount is not increased to the proposed amount.
30.19 	(e) Except for rate increases required under section 256B.4914, subdivisions 5 and 5b, 
30.20 	and rate changes authorized by the 2025 legislature, the commissioner must not approve 
30.21 	service agreements under paragraph (c) that are not the result of either a documented change 
30.22 	in a person's assessed needs or documented evidence that the previous level of service was 
30.23 	insufficient to meet the person's assessed needs.
30.24 	(f) This subdivision expires upon full implementation of waiver reimagine. The 
30.25 	commissioner must inform the revisor of statutes when waiver reimagine is fully 
30.26 	implemented.

30.27 	Sec. 24. Minnesota Statutes 2024, section 256B.092, subdivision 5, is amended to read:
30.28 		Subd. 5.Federal waivers. (a) The commissioner shall apply for any federal waivers 
30.29 	necessary to secure, to the extent allowed by law, federal financial participation under United 
30.30 	States Code, title 42, sections 1396 et seq., as amended, for the provision of services to 
30.31 	persons who, in the absence of the services, would need the level of care provided in a 
30.32 	regional treatment center or a community intermediate care facility for persons with 
31.1 	developmental disabilities. The commissioner may seek amendments to the waivers or apply 
31.2 	for additional waivers under United States Code, title 42, sections 1396 et seq., as amended, 
31.3 	to contain costs. The commissioner shall ensure that payment for the cost of providing home 
31.4 	and community-based alternative services under the federal waiver plan shall not exceed 
31.5 	the cost of intermediate care services including day training and habilitation services that 
31.6 	would have been provided without the waivered services.
31.7 	The commissioner shall seek an amendment to the 1915(c) home and community-based 
31.8 	waiver to allow properly licensed adult foster care homes to provide residential services to 
31.9 	up to five individuals with developmental disabilities. If the amendment to the waiver is 
31.10 	approved, adult foster care providers that can accommodate five individuals shall increase 
31.11 	their capacity to five beds, provided the providers continue to meet all applicable licensing 
31.12 	requirements.
31.13 	(b) The commissioner, in administering home and community-based waivers for persons 
31.14 	with developmental disabilities, shall ensure that day services for eligible persons are not 
31.15 	provided by the person's residential service provider, unless the person or the person's legal 
31.16 	representative is offered a choice of providers and agrees in writing to provision of day 
31.17 	services by the residential service provider. The support plan for individuals who choose 
31.18 	to have their residential service provider provide their day services must describe how health, 
31.19 	safety, protection, and habilitation needs will be met, including how frequent and regular 
31.20 	contact with persons other than the residential service provider will occur. The support plan 
31.21 	must address the provision of services during the day outside the residence on weekdays.
31.22 	(c) When a lead agency is evaluating denials, reductions, or terminations of home and 
31.23 	community-based services under section 256B.0916 for an individual, the lead agency shall 
31.24 	offer to meet with the individual or the individual's guardian in order to discuss the 
31.25 	prioritization of service needs within the support plan. The reduction in the authorized 
31.26 	services for an individual due to changes in funding for waivered services may not exceed 
31.27 	the amount needed to ensure medically necessary services to meet the individual's health, 
31.28 	safety, and welfare.
31.29 	(d) The commissioner shall seek federal approval to allow for the reconfiguration of the 
31.30 	1915(c) home and community-based waivers in this section, as authorized under section 
31.31 	1915(c) of the federal Social Security Act, to implement a two-waiver program structure.
31.32 	(e) The transition to two disability home and community-based services waiver programs 
31.33 	must align with the independent living first policy under section 256B.4905. Unless 
31.34 	superseded by any other state or federal law, waiver eligibility criteria shall be the same for 
32.1 	each waiver. The waiver program that a person uses shall be determined by the support 
32.2 	planning process and whether the person chooses to live in a provider-controlled setting or 
32.3 	in the person's own home.
32.4 	(f) Prior to July 1, 2024, the commissioner shall seek federal approval for the 1915(c) 
32.5 	home and community-based waivers in this section, as authorized under section 1915(c) of 
32.6 	the federal Social Security Act, to implement an individual resource allocation methodology.

32.7 	Sec. 25. Minnesota Statutes 2024, section 256B.49, subdivision 11, is amended to read:
32.8 		Subd. 11.Authority. (a) The commissioner is authorized to apply for home and 
32.9 	community-based service waivers, as authorized under section 1915(c) of the federal Social 
32.10 	Security Act to serve persons under the age of 65 who are determined to require the level 
32.11 	of care provided in a nursing home and persons who require the level of care provided in a 
32.12 	hospital. The commissioner shall apply for the home and community-based waivers in order 
32.13 	to:
32.14 	(1) promote the support of persons with disabilities in the most integrated settings;
32.15 	(2) expand the availability of services for persons who are eligible for medical assistance;
32.16 	(3) promote cost-effective options to institutional care; and
32.17 	(4) obtain federal financial participation.
32.18 	(b) The provision of waiver services to medical assistance recipients with disabilities 
32.19 	shall comply with the requirements outlined in the federally approved applications for home 
32.20 	and community-based services and subsequent amendments, including provision of services 
32.21 	according to a service plan designed to meet the needs of the individual. For purposes of 
32.22 	this section, the approved home and community-based application is considered the necessary 
32.23 	federal requirement.
32.24 	(c) The commissioner shall provide interested persons serving on agency advisory 
32.25 	committees, task forces, the Centers for Independent Living, and others who request to be 
32.26 	on a list to receive, notice of, and an opportunity to comment on, at least 30 days before 
32.27 	any effective dates, (1) any substantive changes to the state's disability services program 
32.28 	manual, or (2) changes or amendments to the federally approved applications for home and 
32.29 	community-based waivers, prior to their submission to the federal Centers for Medicare 
32.30 	and Medicaid Services.
33.1 	(d) The commissioner shall seek approval, as authorized under section 1915(c) of the 
33.2 	federal Social Security Act, to allow medical assistance eligibility under this section for 
33.3 	children under age 21 without deeming of parental income or assets.
33.4 	(e) The commissioner shall seek approval, as authorized under section 1915(c) of the 
33.5 	Social Act, to allow medical assistance eligibility under this section for individuals under 
33.6 	age 65 without deeming the spouse's income or assets.
33.7 	(f) The commissioner shall comply with the requirements in the federally approved 
33.8 	transition plan for the home and community-based services waivers authorized under this 
33.9 	section.
33.10 	(g) The commissioner shall seek federal approval to allow for the reconfiguration of the 
33.11 	1915(c) home and community-based waivers in this section, as authorized under section 
33.12 	1915(c) of the federal Social Security Act, to implement a two-waiver program structure.
33.13 	(h) The commissioner shall seek federal approval for the 1915(c) home and 
33.14 	community-based waivers in this section, as authorized under section 1915(c) of the federal 
33.15 	Social Security Act, to implement an individual resource allocation methodology.

33.16 	Sec. 26. Minnesota Statutes 2025 Supplement, section 256B.49, subdivision 17a, is 
33.17 	amended to read:
33.18 		Subd. 17a.Service authorizations and service agreements. (a) Recipients must be 
33.19 	screened and authorized for services according to the federally approved waiver application 
33.20 	and its subsequent amendments.
33.21 	(b) The commissioner must require lead agency supervisors to review and accept all 
33.22 	service agreements entered by lead agency staff into the Medicaid management information 
33.23 	system (MMIS) prior to the commissioner's approval of the service agreement.
33.24 	(c) For a service agreement with a proposed total authorized amount that exceeds the 
33.25 	total authorized amount in the recipient's prior service agreement by more than the value 
33.26 	of legislatively enacted rate increases, the commissioner must manually review and manually 
33.27 	approve the service agreement in the MMIS. For purposes of this paragraph, "prior service 
33.28 	agreement" means the service agreement that was in effect 12 months prior to the start date 
33.29 	of the new proposed service agreement.
33.30 	(d) In a format prescribed by the commissioner, lead agencies must submit the following 
33.31 	information for all service agreements subject to the commissioner's approval in paragraph 
33.32 	(c):
34.1 	(1) changes in the number of units authorized;
34.2 	(2) new services authorized;
34.3 	(3) changes in the values used to calculate service rates under section 256B.4914, except 
34.4 	for automatic adjustments required under section 256B.4914, subdivisions 5 and 5b;
34.5 	(4) changes in the person's level of need that require an increase in the amount of services 
34.6 	authorized;
34.7 	(5) documentation detailing why the previous amount of services is not sufficient to 
34.8 	meet the person's needs; and
34.9 	(6) anticipated impact if the total service amount is not increased to the proposed amount.
34.10 	(e) Except for rate increases required under section 256B.4914, subdivisions 5 and 5b, 
34.11 	and rate changes authorized by the 2025 legislature, the commissioner must not approve 
34.12 	service agreements under paragraph (c) that are not the result of either a documented change 
34.13 	in a person's assessed needs or documented evidence that the previous level of service was 
34.14 	insufficient to meet the person's assessed needs.
34.15 	(f) This subdivision expires upon full implementation of waiver reimagine. The 
34.16 	commissioner must inform the revisor of statutes when waiver reimagine is fully 
34.17 	implemented.

34.18 	Sec. 27. Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 7, is amended 
34.19 	to read:
34.20 		Subd. 7.Community first services and supports; covered services.  Services and 
34.21 	supports covered under CFSS include:
34.22 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of 
34.23 	daily living (IADLs), and health-related procedures and tasks through hands-on assistance 
34.24 	to accomplish the task or constant supervision and cueing to accomplish the task;
34.25 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to 
34.26 	accomplish activities of daily living, instrumental activities of daily living, or health-related 
34.27 	tasks;
34.28 	(3) expenditures for items, services, supports, environmental modifications, or goods, 
34.29 	including assistive technology. These expenditures must:
34.30 	(i) relate to a need identified in a participant's CFSS service delivery plan; and
35.1 	(ii) increase independence or substitute for human assistance, to the extent that 
35.2 	expenditures would otherwise be made for human assistance for the participant's assessed 
35.3 	needs;
35.4 	(4) observation and redirection for behavior or symptoms where there is a need for 
35.5 	assistance;
35.6 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices, 
35.7 	to ensure continuity of the participant's services and supports;
35.8 	(6) swimming lessons for a participant younger than 12 years of age whose disability 
35.9 	puts the participant at a higher risk of drowning according to the Centers for Disease Control 
35.10 	Vital Statistics System;
35.11 	(7) services described under subdivision 17 provided by a consultation services provider 
35.12 	meeting the requirements of subdivision 17a;
35.13 	(8) services provided by an FMS provider as defined under subdivision 13a, that is an 
35.14 	enrolled provider with the department;
35.15 	(9) CFSS services provided by a support worker who is a parent, stepparent, or legal 
35.16 	guardian of a participant under age 18, or who is the participant's spouse. Covered services 
35.17 	under this clause are subject to the limitations described in subdivision 7b; and
35.18 	(10) shared services meeting the shared services requirements of this section; and
35.19 	(10)(11) worker training and development services as described in subdivision 18a.

35.20 	Sec. 28. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision 
35.21 	to read:
35.22 		Subd. 7c.Shared services under the agency-provider model. (a) The commissioner 
35.23 	shall authorize shared services arrangements if the commissioner determines that a shared 
35.24 	services arrangement is appropriate to meet all the participants' needs and sufficient to 
35.25 	maintain the participants' health and safety. The commissioner must include a decision 
35.26 	regarding authorization of shared services during the process of authorizing CFSS under 
35.27 	subdivision 8. The commissioner must not reduce the total number of authorized units for 
35.28 	a participant who elects to receive shared services.
35.29 	(b) An agency-provider must offer a participant or the participant's representative the 
35.30 	option of shared services, one-on-one services, or a combination of both shared services 
35.31 	and one-on-one services when shared services are authorized by the commissioner. The 
35.32 	option of shared services may be elected at the sole discretion of either the participant or 
36.1 	the participant's representative. The participant or the participant's representative may 
36.2 	withdraw from participating in a shared services arrangement at any time.

36.3 	Sec. 29. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision 
36.4 	to read:
36.5 		Subd. 7d.Shared services rates under the agency-provider model. The commissioner 
36.6 	shall provide a rate system for shared services. For two participants sharing services, the 
36.7 	rate paid to an agency-provider for the shared services must not exceed one and one-half 
36.8 	times the rate paid for serving a single participant. For three participants sharing services, 
36.9 	the rate paid to an agency-provider for the shared services must not exceed twice the rate 
36.10 	paid for serving a single participant. These rates apply only when all criteria for shared 
36.11 	services are met.

36.12 	Sec. 30. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision 
36.13 	to read:
36.14 		Subd. 7e.Pass-through for shared services under the agency-provider model. (a) 
36.15 	Of the additional revenue for shared services provided to two participants, the 
36.16 	agency-provider must use 95 percent for the purposes specified in paragraph (b). Of the 
36.17 	additional revenue for shared services provided to three participants, the agency-provider 
36.18 	must use 95 percent for the purposes specified in paragraph (b).
36.19 	(b) An agency-provider must use the percentages of additional revenue for shared services 
36.20 	specified in paragraph (a) for the wages and wage-related costs of the support worker 
36.21 	providing the shared services. The agency-provider must not use additional revenue for 
36.22 	shared services to pay for mileage reimbursements, uniform allowances, health and dental 
36.23 	insurance, life insurance, disability insurance, long-term care insurance, contributions to 
36.24 	employee retirement accounts when the contribution is not a function of wages, or any other 
36.25 	employee benefits.

36.26 	Sec. 31. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision 
36.27 	to read:
36.28 		Subd. 7f.Shared services under the budget model. (a) A participant who intends to 
36.29 	elect shared services under the budget model, or the participant's representative, must include 
36.30 	a statement of this intention in the CFSS service delivery plan, must develop a plan for 
36.31 	shared services when developing or amending the CFSS service delivery plan, and must 
36.32 	follow the CFSS process for approval of the plan as required under subdivision 6.
37.1 	(b) The commissioner shall authorize shared services arrangements if the commissioner 
37.2 	determines that a shared services arrangement is appropriate to meet all the participants' 
37.3 	needs and sufficient to maintain the participants' health and safety. The commissioner must 
37.4 	include a decision regarding authorization of shared services during the process of authorizing 
37.5 	CFSS under subdivision 8. The commissioner must not reduce the total authorized dollar 
37.6 	amount available to a participant who elects to receive shared services.
37.7 	(c) The participants, or participants' representatives as needed, who elect to share services 
37.8 	under the budget model must jointly develop a shared services agreement with the support 
37.9 	of the participants' representatives as needed. Any participant or any participant's 
37.10 	representative may at any time withdraw from participating in a shared services agreement.
37.11 	(d) The commissioner must develop and publish recommendations for negotiating wages 
37.12 	for support workers providing shared services under the budget model.

37.13 	Sec. 32. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision 
37.14 	to read:
37.15 		Subd. 7g.Pass-through for shared services under the budget model. For shared 
37.16 	services provided under the budget model, participant employers must pay the individual 
37.17 	provider support worker providing the shared services a percentage of the minimum wage 
37.18 	specified in the agreement negotiated under chapter 179A, as made applicable to individual 
37.19 	providers under section 179A.54, that is in effect at the time the services are provided. The 
37.20 	required percentages are specified in clauses (1) and (2):
37.21 	(1) for shared services provided by an individual provider support worker to two 
37.22 	participant employers, the two participant employers must collectively pay the individual 
37.23 	provider support worker at least 150 percent of the applicable minimum wage; and
37.24 	(2) for shared services provided by an individual provider support worker to three 
37.25 	participant employers, the three participant employers must collectively pay the individual 
37.26 	support worker at least 200 percent of the applicable minimum wage.

37.27 	Sec. 33. [256B.8502] COMMUNITY FIRST SERVICES AND SUPPORTS; 
37.28 	DEFINITIONS.
37.29 		Subdivision 1.Scope. For the purposes of this section and sections 256B.85 and 
37.30 	256B.851, the terms in this section have the meanings given.
37.31 		Subd. 2.Additional revenue for shared services. "Additional revenue for shared 
37.32 	services" means the difference between the rate paid to an agency-provider for serving a 
38.1 	single participant and the sum of the rates paid to an agency-provider for shared services 
38.2 	provided to more than one recipient.
38.3 		Subd. 3.Individual provider support worker. "Individual provider support worker" 
38.4 	means a support worker who is an individual provider as defined in section 256B.0711, 
38.5 	subdivision 1.
38.6 		Subd. 4.Wages and wage-related costs. "Wages and wage-related costs" means 
38.7 	increased wages and any corresponding increase in the employer's or participant employer's 
38.8 	share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' 
38.9 	compensation premiums, and contributions to employee retirement accounts when the 
38.10 	contribution is a function of wages.

38.11 	Sec. 34. Laws 2023, chapter 61, article 1, section 61, subdivision 4, as amended by Laws 
38.12 	2025, First Special Session chapter 9, article 2, section 57, is amended to read:
38.13 		Subd. 4.Evaluation and report. By December 1, 2024, the commissioner must submit 
38.14 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
38.15 	over human services finance and policy an interim report on the impact and outcomes of 
38.16 	the grants, including the number of grants awarded and the organizations receiving the 
38.17 	grants. The interim report must include any available evidence of how grantees were able 
38.18 	to increase utilization of supported decision making and reduce or avoid more restrictive 
38.19 	forms of decision making such as guardianship and conservatorship. By December 1, 2026, 
38.20 	the commissioner must submit to the chairs and ranking minority members of the legislative 
38.21 	committees with jurisdiction over human services finance and policy a final second interim
38.22 	report on the impact and outcomes of the grants, including any updated information from 
38.23 	the interim report and the total number of people served by the grants. The final second 
38.24 	interim report must also detail how the money was used to achieve the requirements in 
38.25 	subdivision 3, paragraph (b). By December 1, 2028, the commissioner must submit to the 
38.26 	chairs and ranking minority members of the legislative committees with jurisdiction over 
38.27 	human services finance and policy a final report on the impact and outcomes of the grants, 
38.28 	including any updated information from the interim reports and the total number of people 
38.29 	served by the grants.

38.30 	Sec. 35. Laws 2025, First Special Session chapter 9, article 2, section 58, subdivision 9, 
38.31 	is amended to read:
38.32 		Subd. 9.Savings determinations. (a) When preparing the forecast for state revenue and 
38.33 	expenditures under Minnesota Statutes, section 16A.103, the commissioner of management 
39.1 	and budget must assume the following reductions of a reduction of $82,246,000 in human 
39.2 	services general fund spending for the biennium beginning July 1, 2027, until the end of 
39.3 	the legislative session that enacts a budget for the commissioner of human services for the 
39.4 	biennium beginning July 1, 2027:
39.5 	(1) if a bond appropriation for the replacement of the Miller Building on the Anoka 
39.6 	Metro Regional Treatment Center Campus is enacted during a 2025 special session, 
39.7 	$177,542,000; or
39.8 	(2) if a bond appropriation for the replacement of the Miller Building on the Anoka 
39.9 	Metro Regional Treatment Center Campus is not enacted during a 2025 special session, 
39.10 	$143,542,000.
39.11 	(b) Upon enactment of a budget for the commissioner of human services for the biennium 
39.12 	beginning July 1, 2027, the legislature must identify enacted provisions that were 
39.13 	recommended by the advisory council under subdivision 7.
39.14 	(c) To the extent the net savings attributable to the provisions identified by the legislature 
39.15 	under paragraph (b) for the biennium beginning July 1, 2027, are less than the assumed 
39.16 	savings in paragraph (a), the commissioner of human services must implement the contingent 
39.17 	spending reductions described in subdivision 10, beginning July 1, 2027, or upon federal 
39.18 	approval, whichever is later.

39.19 	Sec. 36. WAIVER CASE MANAGEMENT QUALITY WORKING GROUP.
 39.20 		Subdivision 1.Establishment. The commissioner of human services must convene a 
39.21 	waiver case management quality working group to develop recommendations related to 
39.22 	county provision of home and community-based waiver case management services without 
39.23 	the use of contractors.
39.24 		Subd. 2.Membership. At a minimum, the working group must include the following 
39.25 	members:
39.26 	(1) two individuals receiving waiver services or family members of or advocates for 
39.27 	individuals receiving waiver services, appointed by the commissioner, in consultation with 
39.28 	organizations representing individuals with lived experience of disability and waiver services;
39.29 	(2) three county representatives, appointed by the Minnesota Association of County 
39.30 	Social Service Administrators;
39.31 	(3) at least three representatives of contracted case management agencies, appointed by 
39.32 	the Minnesota Social Service Association, including:
40.1 	(i) at least one representative of a contracted case management agency located in a 
40.2 	metropolitan county, as defined in Minnesota Statutes, section 473.121, subdivision 4; and
40.3 	(ii) at least two representatives of contracted case management agencies located outside 
40.4 	of a metropolitan county;
40.5 	(4) one staff member from the Minnesota Social Service Association, appointed by the 
40.6 	Minnesota Social Service Association;
40.7 	(5) one member of a Tribal Nation, appointed by the commissioner;
40.8 	(6) two representatives of disability advocacy organizations, appointed by the 
40.9 	commissioner; and
40.10 	(7) additional nonvoting participants as determined by the commissioner, which may 
40.11 	include staff from the Department of Human Services and other interested parties.
40.12 		Subd. 3.Duties. (a) The working group must make recommendations to ensure that 
40.13 	clients are receiving high-quality case management services. The working group must 
40.14 	consider the following proposals:
40.15 	(1) requiring written documentation of visits with clients in order to receive payment;
40.16 	(2) requiring initial and annual case management training conducted by the Department 
40.17 	of Human Services, with input from the counties related to core competencies and the 
40.18 	training curriculum;
40.19 	(3) requiring a county to accept a client transfer and continue services at the level provided 
40.20 	by the previous county without the client reapplying for services;
40.21 	(4) prohibiting a county from arbitrarily reducing the level and type of services a client 
40.22 	receives;
40.23 	(5) requiring case management service providers to submit to a yearly financial audit 
40.24 	and random inspections of files and documentation;
40.25 	(6) requiring counties that contract for case management services to utilize a competitive 
40.26 	process for the procurement of contracted case management services at least once every 
40.27 	three years;
40.28 	(7) requiring case management service providers to implement a grievance process for 
40.29 	clients that must document all complaints and responses to and resolutions of complaints; 
40.30 	and
41.1 	(8) requiring contracted case management service providers to annually report to the 
41.2 	county the provider's case load numbers and staff turnover rate.
41.3 	(b) The working group must make recommendations to transition from a contract-based 
41.4 	case management services system to a system in which counties provide case management 
41.5 	services without contracting for those services. The recommendations must include but are 
41.6 	not limited to:
41.7 	(1) ways to reduce complaints and improve quality of waiver case management services;
41.8 	(2) an evaluation of the impact of current funding levels, administrative structures, and 
41.9 	workforce capacity on case management service delivery;
41.10 	(3) an examination of alternative accountability and oversight models that protect access, 
41.11 	provider flexibility, and case management service quality;
41.12 	(4) creation of a variance process, including county oversight and contractor site visits, 
41.13 	to allow a county to continue to use contracted case management services; and
41.14 	(5) legislative or administrative changes to strengthen the waiver case management 
41.15 	services system.
41.16 		Subd. 4.Compensation; expenses. Members of the working group may receive 
41.17 	compensation and expense reimbursement as provided in Minnesota Statutes, section 15.059, 
41.18 	subdivision 3.
41.19 		Subd. 5.Meetings; administrative support. (a) The first meeting of the working group 
41.20 	must be convened no later than August 1, 2026. The working group must meet at least 
41.21 	monthly. Meetings are subject to Minnesota Statutes, chapter 13D. The working group may 
41.22 	meet by telephone or interactive technology consistent with Minnesota Statutes, section 
41.23 	13D.015.
41.24 	(b) The Department of Human Services shall provide staff and administrative support 
41.25 	to convene the working group, facilitate working group meetings, and prepare the final 
41.26 	report.
41.27 		Subd. 6.Report. By September 1, 2027, the commissioner shall submit a report of the 
41.28 	working group's findings and recommendations, including any legislative language necessary 
41.29 	to implement the recommendations, to the chairs and ranking minority members of the 
41.30 	legislative committees with jurisdiction over human services policy and finance.
41.31 		Subd. 7.Expiration. The working group expires upon submission of the report required 
41.32 	under subdivision 6.

42.1 	Sec. 37. DIRECTION TO COMMISSIONER; CASE MANAGEMENT AND HOME 
42.2 	AND COMMUNITY-BASED SERVICES RATES STUDY.
 42.3 	(a) The commissioner of human services shall analyze the current rate-setting 
42.4 	methodology for all case management and medical assistance home and community-based 
42.5 	services waivers and make recommendations to improve rate-setting methodologies to more 
42.6 	accurately reflect service costs. By January 1, 2027, the commissioner shall issue a request 
42.7 	for proposals to analyze the rate frameworks and current rate-setting practices. The 
42.8 	commissioner must consult with lead agencies and providers across the spectrum of services 
42.9 	and regions of the state and with culturally responsive providers when developing the request 
42.10 	for proposals and for the duration of the contract.
42.11 	(b) By January 15, 2028, the commissioner must submit to the chairs and ranking minority 
42.12 	members of the legislative committees with jurisdiction over human services policy and 
42.13 	finance a report on the initial results of the analysis required under this section. By January 
42.14 	15, 2029, the commissioner must submit to the chairs and ranking minority members of the 
42.15 	legislative committees with jurisdiction over human services policy and finance a final 
42.16 	report that includes legislative language necessary to modify existing or implement new 
42.17 	rate methodologies and a detailed fiscal analysis.

42.18 	Sec. 38. MNCHOICES REDESIGN WORKING GROUP.
 42.19 		Subdivision 1.Establishment. The commissioner of human services shall convene a 
42.20 	MnCHOICES redesign working group to develop recommendations related to state provision 
42.21 	of MnCHOICES assessments under Minnesota Statutes, section 256B.0911, subdivision 
42.22 	14, paragraph (g).
42.23 		Subd. 2.Membership. At a minimum, the working group must include the following  
42.24 	members:
42.25 	(1) two individuals receiving waiver services or the individuals' family members or 
42.26 	advocates, appointed by the commissioner in consultation with organizations representing 
42.27 	individuals with lived experience of disability and waiver services;
42.28 	(2) three county representatives, appointed by the Minnesota Association of County 
42.29 	Social Service Administrators, including:
42.30 	(i) at least one representative of a lead agency located in a metropolitan county, as defined 
42.31 	in Minnesota Statutes, section 473.121, subdivision 4; and
42.32 	(ii) at least two representatives of lead agencies located outside of a metropolitan county, 
42.33 	as defined in Minnesota Statutes, section 473.121, subdivision 4;
43.1 	(3) one staff member from the Minnesota Social Service Association, appointed by the 
43.2 	Minnesota Social Service Association;
43.3 	(4) at least three representatives from Tribal Nations, appointed by the commissioner;
43.4 	(5) two representatives of disability advocacy organizations, appointed by the  
43.5 	commissioner; and
43.6 	(6) additional nonvoting participants as determined by the commissioner, which may 
43.7 	include staff from the Department of Human Services and other interested parties.
43.8 		Subd. 3.Duties. The working group shall make recommendations to shift the 
43.9 	responsibility and administration of conducting MnCHOICES assessments to the state. 
43.10 	Recommendations must include:
43.11 	(1) defined roles and responsibilities between county, Tribal Nation, and state functions;
43.12 	(2) revised payment methodologies and financing of duties;
43.13 	(3) efficient workflows between local and state functions;
43.14 	(4) service continuity for people seeking and receiving long-term services and supports; 
43.15 	and
43.16 	(5) methods for gathering public feedback and providing public awareness.
43.17 		Subd. 4.Terms, compensation, and removal. The terms, compensation, and removal 
43.18 	of the working group members are governed by Minnesota Statutes, section 15.059.
43.19 		Subd. 5.Meetings; administrative support. (a) The first meeting of the working group  
43.20 	must be convened no later than August 1, 2026. The working group must meet at least  
43.21 	monthly. The working group may meet by telephone or interactive technology consistent 
43.22 	with Minnesota Statutes, section 13D.015.
43.23 	(b) The Department of Human Services shall provide staff and administrative support  
43.24 	to convene the working group, facilitate working group meetings, and prepare the final 
43.25 	report.
43.26 		Subd. 6.Report. By September 1, 2027, the commissioner must submit a report of the  
43.27 	working group's findings and recommendations, including but not limited to any legislative 
43.28 	changes necessary to implement the recommendations, to the chairs and ranking minority 
43.29 	members of the  legislative committees with jurisdiction over human services policy and 
43.30 	finance.
44.1 		Subd. 7.Expiration. The working group expires upon submission of the report required  
44.2 	under subdivision 6.

44.3 	Sec. 39. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; 
44.4 	IMPLEMENTATION OF NEW NURSING FACILITY LEVEL OF CARE CRITERIA.
 44.5 	For existing brain injury and community access for disability inclusion waiver 
44.6 	participants, the effective date of the termination of waiver services based on Minnesota 
44.7 	Statutes, section 144.0724, subdivision 11a, must be at least 90 days after the date of the 
44.8 	reassessment that results in a determination that the individual no longer meets the level of 
44.9 	care criteria.

44.10 	Sec. 40. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; INCREASE 
44.11 	TIERED RATES FOR FAMILY RESIDENTIAL AND LIFE SHARING SERVICES.
 44.12 	Effective January 1, 2027, or upon federal approval, whichever is later, the commissioner 
44.13 	of human services must increase payment rates for family residential services previously 
44.14 	established under Minnesota Statutes, section 256B.4914, subdivision 19, and amended 
44.15 	under Laws 2025, First Special Session chapter 9, article 2, section 68, as follows:
44.16 	(1) for tier 3, tier 4, and tier 5, by 20 percent;
44.17 	(2) for tier 6, by 30 percent;
44.18 	(3) for children in tiers 1 to 3, by adding an additional $50 per day; and
44.19 	(4) for children in tiers 4 to 6, by adding an additional $100 per day.
44.20 	Rates for life sharing services must be ten percent higher than the corresponding family 
44.21 	residential services rate established under this section.

44.22 	Sec. 41. DIRECTION TO COMMISSIONER; ENVIRONMENTAL 
44.23 	ACCESSIBILITY ADAPTATIONS FOR HOMES.
 44.24 	By October 1, 2026, the commissioner of human services must submit to the Centers 
44.25 	for Medicare and Medicaid Services waiver plan amendments for the brain injury, community 
44.26 	access for disability inclusion, community alternative care, and developmental disabilities 
44.27 	1915(c) waivers to implement the following reforms to environmental accessibility 
44.28 	adaptations for homes:
44.29 	(1) separate the treatment of home modifications from the treatment of vehicle 
44.30 	modifications;
45.1 	(2) replace the existing $40,000 annual limit for home modifications with a $40,000 
45.2 	three-year limit;
45.3 	(3) replace the existing provisions that permit a two-year limit of $80,000 to be authorized 
45.4 	during a two-year period with provisions permitting a six-year limit of $80,000 to be 
45.5 	authorized in a five-year period;
45.6 	(4) limit permissible authorizations for home modifications to only modifications meeting 
45.7 	an assessed need that cannot be met in a less costly way in the person's current home;
45.8 	(5) limit the number of similar or duplicative home modifications to modifications that 
45.9 	are necessary for the health and safety of the person; and
45.10 	(6) establish caps on the number, size, and cost of common home modifications.

45.11 	Sec. 42. DIRECTION TO COMMISSIONER; ENVIRONMENTAL 
45.12 	ACCESSIBILITY ADAPTATIONS FOR VEHICLES.
 45.13 	(a) By October 1, 2026, the commissioner of human services must submit to the Centers 
45.14 	for Medicare and Medicaid Services waiver plan amendments for the brain injury, community 
45.15 	access for disability inclusion, community alternative care, and developmental disabilities 
45.16 	1915(c) waivers to implement the following reforms to environmental accessibility 
45.17 	adaptations for vehicles:
45.18 	(1) separate the treatment of vehicle modifications from the treatment of home 
45.19 	modifications;
45.20 	(2) replace the existing $40,000 annual limit for vehicle modifications with a $40,000 
45.21 	five-year limit; and
45.22 	(3) permit multiple authorizations for vehicle modifications in a five-year period when 
45.23 	a vehicle is sold, provided that subsequent authorizations are limited to:
45.24 	(i) for a purchased adapted vehicle, the portion of the original purchase cost attributable 
45.25 	to the vehicle modifications minus the book value of the purchase price attributable to the 
45.26 	vehicle modifications; or
45.27 	(ii) for vehicle modifications, the original purchase and installation cost of the 
45.28 	modifications minus the book value of the modifications.
45.29 	(b) For purposes of this section, "book value" means the original cost minus the product 
45.30 	of 20 percent of the original cost multiplied by the number of years during which the adapted 
45.31 	vehicle was used by the person.

46.1 	Sec. 43. REVISOR INSTRUCTION.
 46.2 	(a) The revisor of statutes shall renumber the definitions in Minnesota Statutes, section 
46.3 	256B.85, subdivision 2, and the definitions in Minnesota Statutes, section 256B.851, 
46.4 	subdivision 2, as subdivisions in Minnesota Statutes, section 256B.8502, rearranging the 
46.5 	renumbered and existing definitions in Minnesota Statutes, section 256B.8502, as necessary 
46.6 	to place them in alphabetical order. The revisor of statutes shall revise all statutory 
46.7 	cross-references consistent with this recoding.
46.8 	(b) If a provision of Minnesota Statutes, section 256B.85, subdivision 2, or 256B.851, 
46.9 	subdivision 2, is amended or repealed in the 2026 regular legislative session, the revisor of 
46.10 	statutes shall codify the amendment or repealer in Minnesota Statutes, section 256B.8502, 
46.11 	notwithstanding any other law to the contrary.

46.12 	Sec. 44. REPEALER.
 46.13 	(a) Minnesota Statutes 2024, section 256B.0921, is repealed
46.14 	(b) Minnesota Statutes 2025 Supplement, sections 256B.4907, subdivisions 1, 2, 3, 4, 
46.15 	5, and 6; and 256S.205, subdivision 7, are repealed.
46.16 	(c) Laws 2019, First Special Session chapter 9, article 5, section 86, as amended by 
46.17 	Laws 2020, First Special Session chapter 2, article 3, section 2; and Laws 2021, First Special 
46.18 	Session chapter 7, article 13, sections 73, as amended by Laws 2025, First Special Session 
46.19 	chapter 9, article 2, section 56; and 75, subdivision 1, as amended by Laws 2024, chapter 
46.20 	108, article 1, section 28, are repealed.

46.21 	ARTICLE 3
46.22 	BEHAVIORAL HEALTH

46.23 	Section 1. Minnesota Statutes 2024, section 254A.03, subdivision 2, is amended to read:
46.24 		Subd. 2.American Indian programs. There is hereby created a section of American 
46.25 	Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human 
46.26 	Services, to be headed by a special assistant for American Indian programs on substance 
46.27 	misuse and substance use disorder and two assistants to that position. The section shall be 
46.28 	staffed with all personnel necessary to fully administer programming for substance misuse 
46.29 	and substance use disorder services for American Indians in the state. The special assistant 
46.30 	position shall be filled by a person with considerable practical experience in and 
46.31 	understanding of substance misuse and substance use disorder in the American Indian 
46.32 	community, who shall be responsible to the director of the Alcohol and Drug Abuse Section 
47.1 	created in subdivision 1 and shall be in the unclassified service. The special assistant shall 
47.2 	meet and consult with the American Indian Advisory Council as described in section 
47.3 	254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report 
47.4 	on the status of substance misuse and substance use disorder among American Indians in 
47.5 	the state of Minnesota. The special assistant with the approval of the director shall:
47.6 	(1) administer direct payments using funds appropriated for American Indian groups, 
47.7 	organizations and reservations within the state for American Indian substance misuse and 
47.8 	substance use disorder programs;
47.9 	(2) establish policies and procedures for such American Indian programs with the 
47.10 	assistance of the American Indian Advisory Board; and
47.11 	(3) hire and supervise staff to assist in the administration of the American Indian program 
47.12 	section within the Alcohol and Drug Abuse Section of the Department of Human Services.

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

47.14 	Sec. 2. Minnesota Statutes 2025 Supplement, section 254B.02, subdivision 5, is amended 
47.15 	to read:
47.16 		Subd. 5.Tribal allocation. The commissioner may make direct payments to Tribal 
47.17 	Nation servicing agencies from money allocated under this section to support individuals 
47.18 	with substance use disorders and determine eligibility for behavioral health fund payments. 
47.19 	The payment must not be less than 133 percent of the Tribal Nations payment for the fiscal 
47.20 	year ending June 30, 2009, adjusted in proportion to the statewide change in the appropriation 
47.21 	for this chapter.

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

47.23 	Sec. 3. Minnesota Statutes 2025 Supplement, section 254B.0503, subdivision 1, is amended 
47.24 	to read:
47.25 		Subdivision 1.Eligible vendor requirements. (a) Vendors of room and board are 
47.26 	eligible for behavioral health fund payment if the vendor:
47.27 	(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals 
47.28 	while residing in the facility and provide consequences for infractions of those rules;
47.29 	(2) is determined to meet applicable health and safety requirements;
47.30 	(3) is not a jail or prison;
47.31 	(4) is not concurrently receiving funds under chapter 256I for the recipient;
48.1 	(5) admits individuals who are 18 years of age or older;
48.2 	(6) is registered as a board and lodging or lodging establishment according to section 
48.3 	157.17;
48.4 	(7) has awake staff on site whenever a client is present;
48.5 	(8) has staff who are at least 18 years of age and meet the requirements of section 
48.6 	245G.11, subdivision 1, paragraph (b);
48.7 	(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
48.8 	(10) meets the requirements of section 245G.08, subdivision 5, if administering 
48.9 	medications to clients;
48.10 	(11) meets the abuse prevention requirements of section 245A.65, including a policy on 
48.11 	fraternization and the mandatory reporting requirements of section 626.557;
48.12 	(12) documents coordination with the treatment provider to ensure compliance with 
48.13 	section 254B.03, subdivision 2;
48.14 	(13) protects client funds and ensures freedom from exploitation by meeting the 
48.15 	provisions of section 245A.04, subdivision 13;
48.16 	(14) has a grievance procedure that meets the requirements of section 245G.15, 
48.17 	subdivision 2; and
48.18 	(15) has sleeping and bathroom facilities for men and women separated by a door that 
48.19 	is locked, has an alarm, or is supervised by awake staff.
48.20 	(b) Programs providing children's mental health crisis admissions and stabilization under 
48.21 	section 245.4882, subdivision 6, are eligible vendors of room and board.
48.22 	(c) Programs providing children's residential services under section 245.4882, except 
48.23 	services for individuals who have a placement under chapter 260C or 260D, are eligible 
48.24 	vendors of room and board.
48.25 	(d) A vendor that is not licensed as a residential treatment program must have a policy 
48.26 	to address staffing coverage when a client may unexpectedly need to be present at the room 
48.27 	and board site.
48.28 	(e) No new vendors for room and board services may be approved after June 30, 2025, 
48.29 	to receive payments from the behavioral health fund, under the provisions of section 254B.04, 
48.30 	subdivision 2a. Room and board vendors that were approved and operating prior to July 1, 
48.31 	2025, may continue to receive payments from the behavioral health fund for services provided 
49.1 	until June 30, 2027. Room and board vendors and providing services in accordance with 
49.2 	section 254B.04, subdivision 2a, will no longer be eligible to claim reimbursement for room 
49.3 	and board services provided on or after July January 1, 2027, except as provided under 
49.4 	paragraph (f).
49.5 	(f) Room and board vendors that were approved and operating prior to July 1, 2025, 
49.6 	providing services in accordance with section 254B.04, subdivision 2a, and have submitted 
49.7 	before December 31, 2026, a substantially complete application and any required reports 
49.8 	for either initial licensure as a residential treatment program under chapters 245A and 245G, 
49.9 	or applicable Tribal license, may continue to receive payments from the behavioral health 
49.10 	fund until the license is issued or denied.

49.11 	Sec. 4. Minnesota Statutes 2025 Supplement, section 254B.0509, subdivision 2, is amended 
49.12 	to read:
49.13 		Subd. 2.Annual adjustments. Effective January 1, 2027, and annually thereafter, the 
49.14 	commissioner of human services must adjust the payment rates under subdivision 1 section 
49.15 	254B.0505, subdivision 1, clauses (1) to (9), according to the change from the midpoint of 
49.16 	the previous rate year to the midpoint of the rate year for which the rate is being determined 
49.17 	using the Centers for Medicare and Medicaid Services Medicare Economic Index as 
49.18 	forecasted in the fourth quarter of the calendar year before the rate year. Notwithstanding 
49.19 	this subdivision, rates must not be adjusted lower than those established on January 1, 2026.

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

49.21 	Sec. 5. Minnesota Statutes 2024, section 254B.17, is amended to read:
49.22 	254B.17 WITHDRAWAL MANAGEMENT START-UP AND 
49.23 	CAPACITY-BUILDING GRANTS.
49.24 	The commissioner must establish start-up and capacity-building grants for prospective
49.25 	or, new, or existing substance use disorder treatment or withdrawal management programs 
49.26 	licensed under chapter 245F that will meet ASAM criteria for medically monitored managed
49.27 	or clinically monitored levels of care by integrating withdrawal management services into 
49.28 	outpatient, intensive outpatient, or residential treatment services. Grants must be used to 
49.29 	measurably increase the client capacity or expand available services. Grants must align 
49.30 	services with ASAM criteria. Grants may be used to add medications for opioid use disorder 
49.31 	to services. Grants may be used for capacity-building expenses that are not reimbursable 
49.32 	under Minnesota health care programs, including but not limited to:
50.1 	(1) costs associated with hiring staff or contracting with medical services providers;
50.2 	(2) costs associated with staff retention;
50.3 	(3) the purchase of office equipment and supplies;
50.4 	(4) the purchase of software;
50.5 	(5) costs associated with obtaining applicable and required licenses;
50.6 	(6) business formation costs;
50.7 	(7) costs associated with staff training; and
50.8 	(8) the purchase of medical equipment and supplies necessary to meet health and safety 
50.9 	requirements;
50.10 	(9) costs associated with adding or improving physical space;
50.11 	(10) start-up costs associated with adding a new location; and
50.12 	(11) costs associated with becoming ASAM certified for medically managed levels of 
50.13 	care.

50.14 	Sec. 6. Minnesota Statutes 2024, section 256B.04, subdivision 23, is amended to read:
50.15 		Subd. 23.Medical assistance costs for certain inmates. (a) The commissioner shall 
50.16 	execute an interagency agreement with the commissioner of corrections to recover the state 
50.17 	cost attributable to medical assistance eligibility for inmates of public institutions admitted 
50.18 	to a medical institution on an inpatient basis. The annual amount to be transferred from the 
50.19 	Department of Corrections under the agreement must include all eligible state medical 
50.20 	assistance costs, including administrative costs incurred by the Department of Human 
50.21 	Services, attributable to inmates under state and county jurisdiction admitted to medical 
50.22 	institutions on an inpatient basis that are related to the implementation of section 256B.055, 
50.23 	subdivision 14, paragraph (c). This paragraph expires upon the effective date of paragraph 
50.24 	(b).
50.25 	(b) Effective January 1, 2028, or upon federal approval, whichever is later, the 
50.26 	commissioner shall execute an interagency agreement with the commissioner of corrections 
50.27 	to recover the state cost attributable to medical assistance eligibility for inmates of public 
50.28 	institutions admitted to a medical institution on an inpatient basis. The annual amount to 
50.29 	be transferred from the Department of Corrections under the agreement must include all 
50.30 	eligible state medical assistance costs, including administrative costs incurred by the 
50.31 	Department of Human Services, attributable to inmates under state and county jurisdiction 
51.1 	admitted to medical institutions on an inpatient basis that are related to the implementation 
51.2 	of section 256B.0618, paragraph (b).

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

51.4 	Sec. 7. [256B.0618] COVERAGE FOR DETAINED INDIVIDUALS.
51.5 	(a) An inmate of a correctional facility who is conditionally released under section 
51.6 	241.26, 244.065, or 631.425 is eligible for medical assistance if the individual:
51.7 	(1) does not require the security of a public detention facility and is housed:
51.8 	(i) in a halfway house or community correction center; or
51.9 	(ii) under house arrest and monitored by electronic surveillance in a residence approved 
51.10 	by the commissioner of corrections; and
51.11 	(2) meets all other eligibility requirements of this chapter.
51.12 	(b) An individual, regardless of age, who is considered an inmate of a public institution 
51.13 	as defined in Code of Federal Regulations, title 42, section 435.1010, and who meets the 
51.14 	eligibility requirements in section 256B.056 is not eligible for medical assistance, except 
51.15 	for covered medical assistance services received:
51.16 	(1) while an inpatient in a medical institution as defined in Code of Federal Regulations, 
51.17 	title 42, section 435.1010;
51.18 	(2) by an eligible juvenile in accordance with the Consolidated Appropriations Act, 
51.19 	2023, Public Law 117-328, part 5121; or
51.20 	(3) by an eligible individual under section 256B.0761.
51.21 	(c) Security logistics and costs related to the inpatient treatment of an inmate are the 
51.22 	responsibility of the entity with jurisdiction over the inmate.

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

51.24 	Sec. 8. [256B.0619] CARCERAL TARGETED CASE MANAGEMENT SERVICES.
51.25 		Subdivision 1.Generally. Effective January 1, 2028, or upon federal approval, whichever 
51.26 	is later, medical assistance covers carceral targeted case management services in accordance 
51.27 	with section 256B.0761 and United States Code, title 42, sections 1396a(a)(84); 1396d(a)(32); 
51.28 	1397bb(d); and 1397jj(b)(2) and (7).
51.29 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
51.30 	meanings given.
52.1 	(b) "Comprehensive care plan" means a person-centered plan that includes goals, tasks, 
52.2 	and services identified through screening and assessments and agreed upon by all parties. 
52.3 	Comprehensive care plan includes but is not limited to identifying resources and services 
52.4 	necessary to meet the individual's physical, behavioral health, and health-related social 
52.5 	needs prerelease and postrelease.
52.6 	(c) "Consultation" means communication from a carceral targeted case manager to other 
52.7 	providers working with the same individual to inform, inquire, and instruct regarding the 
52.8 	individual's symptoms, strategies for effective engagement, care and intervention needs, 
52.9 	and treatment expectations across service settings, including but not limited to the education 
52.10 	services, social services, probation, home, primary care, medication prescribers, disabilities 
52.11 	services, and other mental health providers and to direct and coordinate clinical service 
52.12 	components provided to the justice-involved individual.
52.13 	(d) "Targeted case management for justice-involved individuals" means the provision 
52.14 	of both county targeted case management and public or private vendor service coordination 
52.15 	services for the purpose of bridging prerelease and postrelease medical assistance services 
52.16 	to support the physical, behavioral health, and health-related social needs of justice-involved 
52.17 	individuals.
52.18 	(e) "Targeted case management services" means services that assist medical assistance 
52.19 	eligible persons to gain access to needed medical, social, educational, and other services.
52.20 		Subd. 3.Eligibility. The following individuals are eligible for carceral targeted case 
52.21 	management services:
52.22 	(1) individuals eligible for medical assistance who meet all eligibility requirements under 
52.23 	United States Code, title 42, section 1396a(nn);
52.24 	(2) individuals eligible for medical assistance who meet eligibility requirements for the 
52.25 	Children's Health Insurance Program under United States Code, title 42, section 1397jj(b)(7); 
52.26 	or
52.27 	(3) individuals eligible for medical assistance who are currently incarcerated at a section 
52.28 	1115 reentry demonstration pilot facility and meet the participation requirements in section 
52.29 	256B.0761, subdivision 2.
52.30 		Subd. 4.Carceral targeted case management services.  (a) For individuals eligible for 
52.31 	services under subdivision 3, clause (1) or (2), carceral targeted case management care 
52.32 	coordination is available for 30 days before release and up to 180 days postrelease. For 
52.33 	individuals eligible for services under subdivision 3, clause (3), carceral targeted case 
53.1 	management care coordination is available for up to 90 days before release and up to 180 
53.2 	days postrelease.
53.3 	(b) Carceral targeted case management care coordination includes:
53.4 	(1) comprehensive assessment and periodic reassessment addressing physical, behavioral, 
53.5 	and health-related social needs in accordance with section 256B.0761 and United States 
53.6 	Code, title 42, sections 1396a(nn) and 1397jj(b)(7);
53.7 	(2) comprehensive care plans, including but not limited to:
53.8 	(i) the desired goals of the individual;
53.9 	(ii) the individual's preferences for services and supports;
53.10 	(iii) formal and informal services and supports based on areas of assessment, such as 
53.11 	social health, mental health, residence, family, education and vocation, safety, legal, 
53.12 	self-determination, financial, and chemical health; and
53.13 	(iv) housing arrangements postrelease;
53.14 	(3) regular review and revision of the comprehensive care plan with the individual to 
53.15 	ensure needs are adequately met by referrals and supports;
53.16 	(4) coordination of referrals, which must contain more than just a list of resources, to 
53.17 	bridge prerelease to postrelease medical assistance services, including but not limited to 
53.18 	referrals to community-based services identified as a need on the comprehensive care plan;
53.19 	(5) warm handoffs and follow-up post release through direct coordination between 
53.20 	providers, including timely communication, active engagement of the individual when 
53.21 	feasible, and facilitation of continuity of care upon release;
53.22 	(6) monitoring and evaluation of services identified in the comprehensive care plan to 
53.23 	ensure personal outcomes are met and to ensure satisfaction with services and service 
53.24 	delivery;
53.25 	(7) consultation with other professionals, including but not limited to community-based 
53.26 	mental health providers; and
53.27 	(8) completion and maintenance of necessary documentation that supports and verifies 
53.28 	the activities in this section.
53.29 		Subd. 5.Carceral targeted case management provider standards. Providers eligible 
53.30 	to receive medical assistance reimbursement under this section must enroll as a Minnesota 
54.1 	Health Care Programs provider. To qualify as a provider of carceral targeted case 
54.2 	management services, a provider must:
54.3 	(1) have a minimum of a bachelor's degree or a license in a health or human services 
54.4 	field, comparable training and two years of experience in human services, or credentials 
54.5 	from an American Indian Tribe under section 256B.02, subdivision 7;
54.6 	(2) demonstrate the capacity and experience to provide targeted case management 
54.7 	activities for justice-involved individuals as defined in subdivision 2;
54.8 	(3) be able to coordinate and connect community resources needed by the recipient;
54.9 	(4) demonstrate administrative capacity and experience to serve the justice-involved 
54.10 	population for which the provider will provide services and ensure quality of services under 
54.11 	state and federal requirements;
54.12 	(5) have a financial management system that provides accurate documentation of services 
54.13 	and costs under state and federal requirements;
54.14 	(6) demonstrate capacity to document and maintain individual case records under state 
54.15 	and federal requirements;
54.16 	(7) demonstrate the capacity to coordinate with county administrative functions;
54.17 	(8) be able to coordinate with health care providers to ensure access to necessary health 
54.18 	care services;
54.19 	(9) have a procedure that (i) notifies the recipient of any conflict of interest if the targeted 
54.20 	case management service provider also provides the recipient's services and supports, (ii) 
54.21 	provides information on all potential conflicts of interest, (iii) obtains the recipient's informed 
54.22 	consent, and (iv) provides the recipient with alternatives; and
54.23 	(10) demonstrate the capacity to achieve the following performance outcomes: (i) access; 
54.24 	(ii) quality; and (iii) consumer satisfaction.
54.25 		Subd. 6.Medical assistance payment and rate setting. (a) Carceral targeted case 
54.26 	management rates are equal to rates authorized by the commissioner for relocation targeted 
54.27 	case management under section 256B.0621, subdivision 10.
54.28 	(b) The carceral targeted case management rate only includes eligible services delivered 
54.29 	to an eligible recipient by an eligible provider.

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

55.1 	Sec. 9. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision 
55.2 	to read:
55.3 		Subd. 77.Carceral targeted case management. Effective January 1, 2028, or upon 
55.4 	federal approval, whichever is later, medical assistance covers carceral targeted case 
55.5 	management services under section 256B.0619.

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

55.7 	Sec. 10. Minnesota Statutes 2024, section 256B.0761, subdivision 2, is amended to read:
55.8 		Subd. 2.Eligible individuals. (a) Notwithstanding section 256B.055, subdivision 14, 
55.9 	individuals are eligible to receive services under this demonstration if they are eligible under 
55.10 	section 256B.055, subdivision 3a, 6, 7, 7a, 9, 15, 16, or 17, as determined by the 
55.11 	commissioner in collaboration with correctional facilities, local governments, and Tribal 
55.12 	governments. This paragraph expires upon the effective date of paragraph (b).
55.13 	(b) Effective January 1, 2028, or upon federal approval, whichever is later, 
55.14 	notwithstanding section 256B.0618, individuals are eligible to receive services under this 
55.15 	demonstration if they are eligible under section 256B.055, subdivision 3a, 6, 7, 7a, 9, 15, 
55.16 	16, or 17, as determined by the commissioner in collaboration with correctional facilities, 
55.17 	local governments, and Tribal governments.

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

55.19 	Sec. 11. Minnesota Statutes 2025 Supplement, section 256I.04, subdivision 2a, is amended 
55.20 	to read:
55.21 		Subd. 2a.License required; staffing qualifications. (a) Except as provided in paragraph 
55.22 	(b), an agency may not enter into an agreement with an establishment to provide housing 
55.23 	support unless:
55.24 	(1) the establishment is licensed by the Department of Health as a hotel and restaurant; 
55.25 	a board and lodging establishment; a boarding care home before March 1, 1985; or a 
55.26 	supervised living facility, and the service provider for residents of the facility is licensed 
55.27 	under chapter 245A. However, an establishment licensed by the Department of Health to 
55.28 	provide lodging need not also be licensed to provide board if meals are being supplied to 
55.29 	residents under a contract with a food vendor who is licensed by the Department of Health;
55.30 	(2) the residence is: (i) licensed by the commissioner of human services under Minnesota 
55.31 	Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior 
55.32 	to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265; 
56.1 	(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120, 
56.2 	with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02, 
56.3 	subdivision 4a, as a community residential setting by the commissioner of human services;
56.4 	(3) the facility is licensed under chapter 144G and provides three meals a day; or
56.5 	(4) effective January 1, 2027 July 1, 2026, the establishment is licensed by the Department 
56.6 	of Health as a board and lodging establishment and is certified by the commissioner as a 
56.7 	recovery residence in accordance with section 254B.215, subdivision 3, that is subject to 
56.8 	the requirements of section 256I.04, subdivisions 2a to 2f. The Department of Human 
56.9 	Services must serve as the lead agency for agreements entered into under this clause.
56.10 	(b) The requirements under paragraph (a) do not apply to establishments exempt from 
56.11 	state licensure because they are:
56.12 	(1) located on Indian reservations and subject to tribal health and safety requirements; 
56.13 	or
56.14 	(2) supportive housing establishments where an individual has an approved habitability 
56.15 	inspection and an individual lease agreement.
56.16 	(c) Supportive housing establishments that serve individuals who have experienced 
56.17 	long-term homelessness and emergency shelters must participate in the homeless management 
56.18 	information system and a coordinated assessment system as defined by the commissioner.
56.19 	(d) Effective July 1, 2016, an agency shall not have an agreement with a provider of 
56.20 	housing support unless all staff members who have direct contact with recipients:
56.21 	(1) have skills and knowledge acquired through one or more of the following:
56.22 	(i) a course of study in a health- or human services-related field leading to a bachelor 
56.23 	of arts, bachelor of science, or associate's degree;
56.24 	(ii) one year of experience with the target population served;
56.25 	(iii) experience as a mental health certified peer specialist according to section 256B.0615; 
56.26 	or
56.27 	(iv) meeting the requirements for unlicensed personnel under sections 144A.43 to 
56.28 	144A.483;
56.29 	(2) hold a current driver's license appropriate to the vehicle driven if transporting 
56.30 	recipients;
57.1 	(3) complete training on vulnerable adults mandated reporting and child maltreatment 
57.2 	mandated reporting, where applicable; and
57.3 	(4) complete housing support orientation training offered by the commissioner.

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

57.5 	Sec. 12. Minnesota Statutes 2024, section 297E.02, subdivision 3, is amended to read:
57.6 		Subd. 3.Collection; disposition. (a) Taxes imposed by this section are due and payable 
57.7 	to the commissioner when the gambling tax return is required to be filed. Distributors must 
57.8 	file their monthly sales figures with the commissioner on a form prescribed by the 
57.9 	commissioner. Returns covering the taxes imposed under this section must be filed with 
57.10 	the commissioner on or before the 20th day of the month following the close of the previous 
57.11 	calendar month. The commissioner shall prescribe the content, format, and manner of returns 
57.12 	or other documents pursuant to section 270C.30. The proceeds, along with the revenue 
57.13 	received from all license fees and other fees under sections 349.11 to 349.191, 349.211, 
57.14 	and 349.213, must be paid to the commissioner of management and budget for deposit in 
57.15 	the general fund.
57.16 	(b) The sales tax imposed by chapter 297A on the sale of pull-tabs and tipboards by the 
57.17 	distributor is imposed on the retail sales price. The retail sale of pull-tabs or tipboards by 
57.18 	the organization is exempt from taxes imposed by chapter 297A and is exempt from all 
57.19 	local taxes and license fees except a fee authorized under section 349.16, subdivision 8.
57.20 	(c) One-half of one percent of the revenue deposited in the general fund under paragraph 
57.21 	(a), is appropriated to the commissioner of human services for the compulsive gambling 
57.22 	treatment program established under section 245.98. One-half of one percent of the revenue 
57.23 	deposited in the general fund under paragraph (a), is appropriated to the commissioner of 
57.24 	human services for a grant to the state affiliate recognized by the National Council on 
57.25 	Problem Gambling to increase public awareness of problem gambling, education and training 
57.26 	for individuals and organizations providing effective treatment services to problem gamblers 
57.27 	and their families, and research relating to problem gambling. Money appropriated by this 
57.28 	paragraph must supplement and must not replace existing state funding for these programs.
57.29 	The balance of amounts appropriated under this paragraph that are unencumbered and 
57.30 	unspent at the close of a fiscal year are available in the next fiscal year for the same purposes 
57.31 	and shall not cancel to the fund from which appropriated.
57.32 	(d) The commissioner of human services must provide to the state affiliate recognized 
57.33 	by the National Council on Problem Gambling a monthly statement of the amounts deposited 
58.1 	under paragraph (c). Beginning January 1, 2022, the commissioner of human services must 
58.2 	provide to the chairs and ranking minority members of the legislative committees with 
58.3 	jurisdiction over treatment for problem gambling and to the state affiliate recognized by the 
58.4 	National Council on Problem Gambling an annual reconciliation of the amounts deposited 
58.5 	under paragraph (c). The annual reconciliation under this paragraph must include the amount 
58.6 	allocated to the commissioner of human services for the compulsive gambling treatment 
58.7 	program established under section 245.98, and the amount allocated to the state affiliate 
58.8 	recognized by the National Council on Problem Gambling. The annual reconciliation must 
58.9 	also include any rollover amounts from the previous fiscal year and the utilization of those 
58.10 	amounts during the current reporting period.

58.11 	Sec. 13. Laws 2025, First Special Session chapter 9, article 4, section 2, the effective date, 
58.12 	is amended to read:

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

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

58.15 	Sec. 14. Laws 2025, First Special Session chapter 9, article 4, section 23, the effective 
58.16 	date, is amended to read:

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

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

58.19 	Sec. 15. Laws 2025, First Special Session chapter 9, article 4, section 38, the effective 
58.20 	date, is amended to read:

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

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

58.23 	Sec. 16. Laws 2025, First Special Session chapter 9, article 4, section 39, the effective 
58.24 	date, is amended to read:

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

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

58.27 	Sec. 17. Laws 2025, First Special Session chapter 9, article 4, section 40, the effective 
58.28 	date, is amended to read:

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

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

59.2 	Sec. 18. Laws 2025, First Special Session chapter 9, article 4, section 41, the effective 
59.3 	date, is amended to read:

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

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

59.6 	Sec. 19. Laws 2025, First Special Session chapter 9, article 4, section 42, the effective 
59.7 	date, is amended to read:

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

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

59.10 	Sec. 20. Laws 2025, First Special Session chapter 9, article 4, section 43, the effective 
59.11 	date, is amended to read:

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

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

59.14 	Sec. 21. Laws 2025, First Special Session chapter 9, article 4, section 44, the effective 
59.15 	date, is amended to read:

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

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

59.18 	Sec. 22. Laws 2025, First Special Session chapter 9, article 4, section 50, the effective 
59.19 	date, is amended to read:

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

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

59.22 	Sec. 23. DIRECTION TO COMMISSIONER; CARCERAL TARGETED CASE 
59.23 	MANAGEMENT SERVICES BILLING UNITS.
 59.24 	The commissioner of human services must establish a new billing code for carceral 
59.25 	targeted case management services. The commissioner must identify reimbursement rates 
59.26 	for the newly defined codes, as required under Minnesota Statutes, section 256B.0619, 
60.1 	subdivision 6. The new billing codes must correspond to a 15-minute unit. The new billing 
60.2 	codes must be available for 180 days postrelease.

60.3 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
60.4 	whichever is later.

60.5 	Sec. 24. REPEALER.
 60.6 	Minnesota Statutes 2024, section 256B.055, subdivision 14, is repealed.

60.7 	EFFECTIVE DATE. This section is effective January 1, 2028, or upon federal approval, 
60.8 	whichever is later.

60.9 	ARTICLE 4
60.10 	LONG-TERM CARE FACILITY REGULATION

60.11 	Section 1. Minnesota Statutes 2024, section 144.1503, subdivision 7, is amended to read:
60.12 		Subd. 7.Selection process. The commissioner shall determine a maximum award for 
60.13 	grants and loan forgiveness, and shall make selections based on the information provided 
60.14 	in the grant application, including the demonstrated need for an applicant provider to enhance 
60.15 	the education of its workforce, the proposed employee scholarship or loan forgiveness 
60.16 	selection process, the applicant's proposed budget, and other criteria as determined by the 
60.17 	commissioner. Notwithstanding any law or rule to the contrary, amounts appropriated for 
60.18 	purposes of this section do not cancel and are available until expended, except that at the 
60.19 	end of each biennium, any remaining amount that is not committed by contract and not 
60.20 	needed to fulfill existing commitments shall cancel to the general fund.

60.21 	Sec. 2. [144A.082] AUTOMATIC EXTERNAL DEFIBRILLATOR.
60.22 	(a) For purposes of this section, "automatic external defibrillator" has the meaning given 
60.23 	in section 403.51, subdivision 1.
60.24 	(b) A nursing home must:
60.25 	(1) maintain an automatic external defibrillator in each building on the nursing home 
60.26 	campus where residents may be present;
60.27 	(2) ensure each of its automatic external defibrillators is maintained and regularly tested 
60.28 	according to the manufacturer's recommendations; and
60.29 	(3) as part of initial orientation and annually thereafter, ensure all nursing home personnel 
60.30 	receive training in cardiopulmonary resuscitation, the use of automatic external defibrillators, 
61.1 	the nursing home's process for checking a resident's code status before initiating lifesaving 
61.2 	measures, and requesting emergency medical assistance as soon as practicable after an 
61.3 	automatic external defibrillator is used.

61.4 	EFFECTIVE DATE. This section is effective August 1, 2026.

61.5 	Sec. 3. Minnesota Statutes 2024, section 144A.291, subdivision 2, is amended to read:
61.6 		Subd. 2.Amounts. (a) Fees may not exceed the following amounts but may be adjusted 
61.7 	lower by board direction and are for the exclusive use of the board as required to sustain 
61.8 	board operations. The maximum amounts of fees are:
61.9 	(1) application for licensure, $200;
61.10 	(2) for a prospective applicant for a review of education and experience advisory to the 
61.11 	license application, $100, to be applied to the fee for application for licensure if the latter 
61.12 	is submitted within one year of the request for review of education and experience;
61.13 	(3) state examination, $125;
61.14 	(4) initial license, $250 if issued between July 1 and December 31, $100 if issued between 
61.15 	January 1 and June 30;
61.16 	(5) acting permit, $400;
61.17 	(6) renewal license or certificate, $250;
61.18 	(7) duplicate license, permit, or certificate, $50;
61.19 	(8) reinstatement fee, $250;
61.20 	(9) health services executive initial license, $250;
61.21 	(10) health services executive renewal license, $250;
61.22 	(11) (9) reciprocity verification fee, $50;
61.23 	(12) second(10) application for shared assignment certificate, $250;
61.24 	(13) (11) continuing education fees:
61.25 	(i) greater than six hours, $50; and
61.26 	(ii) seven hours or more, $75;
61.27 	(14) (12) education review, $100;
61.28 	(15) (13) fee to a sponsor for review of individual continuing education seminars, 
61.29 	institutes, workshops, or home study courses:
62.1 	(i) for less than seven clock hours, $30; and
62.2 	(ii) for seven or more clock hours, $50;
62.3 	(16) (14) fee to a licensee for review of continuing education seminars, institutes, 
62.4 	workshops, or home study courses not previously approved for a sponsor and submitted 
62.5 	with an application for license renewal:
62.6 	(i) for less than seven clock hours total, $30; and
62.7 	(ii) for seven or more clock hours total, $50;
62.8 	(17) (15) late renewal fee, $75;
62.9 	(18) (16) fee to a licensee for verification of licensure status and examination scores, 
62.10 	$30;
62.11 	(19) (17) registration as a registered continuing education sponsor, $1,000;
62.12 	(20) mail (18) mailing list labels, $75; and
62.13 	(21) (19) annual assisted living program education provider fee, $2,500.
62.14 	(b) The revenue generated from the fees must be deposited in an account in the state 
62.15 	government special revenue fund.

62.16 	Sec. 4. Minnesota Statutes 2024, section 144A.471, subdivision 8, is amended to read:
62.17 		Subd. 8.Exemptions from home care services licensure. (a) Except as otherwise 
62.18 	provided in this chapter, home care services that are provided by the state, counties, or other 
62.19 	units of government must be licensed under this chapter.
62.20 	(b) An exemption under this subdivision does not excuse the exempted individual or 
62.21 	organization from complying with applicable provisions of the home care bill of rights in 
62.22 	section 144A.44. The following individuals or organizations are exempt from the requirement 
62.23 	to obtain a home care provider license:
62.24 	(1) an individual or organization that offers, provides, or arranges for personal care 
62.25 	assistance services under the medical assistance program as authorized under sections 
62.26 	256B.0625, subdivision 19a, and 256B.0659;
62.27 	(2) a provider that is licensed by the commissioner of human services to provide 
62.28 	semi-independent living services for persons with developmental disabilities under section 
62.29 	252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
63.1 	(3) a provider that is licensed by the commissioner of human services to provide home 
63.2 	and community-based services for persons with developmental disabilities under section 
63.3 	256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
63.4 	(4) an individual or organization that provides only home management services, if the 
63.5 	individual or organization is registered under section 144A.482; or
63.6 	(5) an individual who is licensed in this state as a nurse, dietitian, social worker, 
63.7 	occupational therapist, physical therapist, or speech-language pathologist who provides 
63.8 	health care services in the home independently and not through any contractual or 
63.9 	employment relationship with a home care provider or other organization; or
63.10 	(6) a federally qualified health center as defined in section 145.9269, when providing 
63.11 	nursing services described in United States Code, title 42, section 1395x(aa)(1)(C).

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

63.13 	Sec. 5. Minnesota Statutes 2025 Supplement, section 144A.474, subdivision 11, is amended 
63.14 	to read:
63.15 		Subd. 11.Fines. (a) Fines and enforcement actions under this subdivision may be assessed 
63.16 	based on the level and scope of the violations described in paragraph (b) and imposed 
63.17 	immediately with no opportunity to correct the violation first as follows:
63.18 	(1) Level 1, no fines or enforcement;
63.19 	(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement 
63.20 	mechanisms authorized in section 144A.475;
63.21 	(3) Level 3, a fine of $1,000 per incident, in addition to any of the enforcement 
63.22 	mechanisms authorized in section 144A.475;
63.23 	(4) Level 4, a fine of $3,000 per incident, in addition to any of the enforcement 
63.24 	mechanisms authorized in section 144A.475;
63.25 	(5) Level 5, a fine of $5,000 per violation, in addition to any enforcement mechanism 
63.26 	authorized in section 144A.475; and
63.27 	(6) for maltreatment violations for which the licensee was determined to be responsible 
63.28 	for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000. 
63.29 	A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible 
63.30 	for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury.
64.1 	The fines in clauses (1) to (5) are increased and immediate fine imposition is authorized 
64.2 	for both surveys and investigations conducted.
64.3 	When a fine is assessed against a facility for substantiated maltreatment, the commissioner 
64.4 	shall not also impose an immediate fine under this chapter for the same circumstance.
64.5 	(b) Correction orders for violations are categorized by both level and scope and fines 
64.6 	shall be assessed as follows:
64.7 	(1) level of violation:
64.8 	(i) Level 1 is a violation that will cause only minimal impact on the client and does not 
64.9 	affect health or safety;
64.10 	(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential 
64.11 	to have harmed a client's health or safety, but was not likely to cause serious injury, 
64.12 	impairment, or death;
64.13 	(iii) Level 3 is a violation that harmed a client's health or safety, or a violation that had 
64.14 	the potential to cause more than minimal harm to the client;
64.15 	(iv) Level 4 is a violation that harmed a client's health or safety, not including serious 
64.16 	injury or death, or a violation that was likely to lead to serious injury or death; and
64.17 	(v) Level 5 is a violation that results in serious injury or death; and
64.18 	(2) scope of violation:
64.19 	(i) isolated, when one or a limited number of clients are affected or one or a limited 
64.20 	number of staff are involved or the situation has occurred only occasionally;
64.21 	(ii) pattern, when more than a limited number of clients are affected, more than a limited 
64.22 	number of staff are involved, or the situation has occurred repeatedly but is not found to be 
64.23 	pervasive; and
64.24 	(iii) widespread, when problems are pervasive or represent a systemic failure that has 
64.25 	affected or has the potential to affect a large portion or all of the clients.
64.26 	(c) If the commissioner finds that the applicant or a home care provider has not corrected 
64.27 	violations by the date specified in the correction order or conditional license resulting from 
64.28 	a survey or complaint investigation, the commissioner shall provide a notice of 
64.29 	noncompliance with a correction order by email to the applicant's or provider's last known 
64.30 	email address. The noncompliance notice must list the violations not corrected.
65.1 	(d) For every violation identified by the commissioner, the commissioner shall issue an 
65.2 	immediate fine pursuant to paragraph (a). The license holder must still correct the violation 
65.3 	in the time specified. The issuance of an immediate fine can occur in addition to any 
65.4 	enforcement mechanism authorized under section 144A.475. The immediate fine may be 
65.5 	appealed as allowed under this subdivision.
65.6 	(e) The license holder must pay the fines assessed on or before the payment date specified. 
65.7 	If the license holder fails to fully comply with the order, the commissioner may issue a 
65.8 	second fine or suspend the license until the license holder complies by paying the fine. A 
65.9 	timely appeal shall stay payment of the fine until the commissioner issues a final order.
65.10 	(f) A license holder shall promptly notify the commissioner in writing when a violation 
65.11 	specified in the order is corrected. If upon reinspection the commissioner determines that 
65.12 	a violation has not been corrected as indicated by the order, the commissioner may issue a 
65.13 	second fine. The commissioner shall notify the license holder by mail to the last known 
65.14 	address in the licensing record that a second fine has been assessed. The license holder may 
65.15 	appeal the second fine as provided under this subdivision.
65.16 	(g) A home care provider that has been assessed a fine under this subdivision has a right 
65.17 	to a reconsideration or a hearing under this section and chapter 14.
65.18 	(h) When a fine has been assessed, the license holder may not avoid payment by closing, 
65.19 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
65.20 	license holder shall be liable for payment of the fine.
65.21 	(i) In addition to any fine imposed under this section, the commissioner may assess a 
65.22 	penalty amount based on costs related to an investigation that results in a final order assessing 
65.23 	a fine or other enforcement action authorized by this chapter.
65.24 	(j) Fines collected under paragraph (a) shall be deposited in a dedicated special revenue 
65.25 	account. On an annual basis, the balance in the special revenue account shall be appropriated 
65.26 	to the commissioner to implement the recommendations of the advisory council established 
65.27 	in section 144A.4799. Money deposited in the account is appropriated to the commissioner 
65.28 	on an annual basis for a competitive grant program for special projects for improving home 
65.29 	care client quality of care and outcomes in Minnesota, with a specific focus on workforce 
65.30 	and clinical outcomes, including projects consistent with criteria in section 144A.4799, 
65.31 	subdivision 3, paragraph (c). Grants must be distributed to home care providers licensed 
65.32 	under this chapter or organizations with experience in or knowledge of home care operations, 
65.33 	compliance, client needs, or best practices. Each grant must be $1,000 at minimum. A 
65.34 	provider with a temporary license under this chapter is not eligible to apply for a grant. The 
66.1 	commissioner may retain up to ten percent of the amount available to cover costs to 
66.2 	administer the grant under this section. The commissioner must publish on the department's 
66.3 	website an annual report on the fines assessed and collected, and how the appropriated 
66.4 	money was allocated.

66.5 	Sec. 6. Minnesota Statutes 2025 Supplement, section 144A.4799, subdivision 1, is amended 
66.6 	to read:
66.7 		Subdivision 1.Membership. (a) The commissioner of health shall appoint 14 persons 
66.8 	to a home care and assisted living advisory council consisting of the following:
66.9 	(1) four public members as defined in section 214.02, one of whom must be a person 
66.10 	who either is receiving or has received home care services preferably within the five years 
66.11 	prior to initial appointment, one of whom must be a person who has or had a family member 
66.12 	receiving home care services preferably within the five years prior to initial appointment, 
66.13 	one of whom must be a person who either is or has been a resident in an assisted living 
66.14 	facility preferably within the five years prior to initial appointment, and one of whom must 
66.15 	be a person who has or had a family member residing in an assisted living facility preferably 
66.16 	within the five years prior to initial appointment;
66.17 	(2) two Minnesota home care licensees representing basic and comprehensive levels of 
66.18 	licensure who may be a managerial official, an administrator, a supervising registered nurse, 
66.19 	or an unlicensed personnel performing home care tasks;
66.20 	(3) one member representing the Minnesota Board of Nursing;
66.21 	(4) one member representing the Office of Ombudsman for Long-Term Care;
66.22 	(5) one member representing the Office of Ombudsman for Mental Health and 
66.23 	Developmental Disabilities;
66.24 	(6) one member of a county health and human services or county adult protection office;
66.25 	(7) two Minnesota assisted living facility licensees representing assisted living facilities 
66.26 	and assisted living facilities with dementia care levels of licensure who may be the facility's 
66.27 	assisted living director, managerial official, or clinical nurse supervisor;
66.28 	(8) one organization representing long-term care providers, home care providers, and 
66.29 	assisted living providers in Minnesota; and
66.30 	(9) one representative of a consumer advocacy organization representing individuals 
66.31 	receiving long-term care from licensed home care providers or assisted living facilities.
67.1 	(b) When a vacancy occurs for an appointment identified in paragraph (a), the 
67.2 	commissioner must select an applicant for appointment within 81 calendar days of the 
67.3 	position being posted by the secretary of state, if the application of a qualified and, if 
67.4 	applicable, a licensee in good standing applicant is received within 21 days of posting. If 
67.5 	no qualified applications are received within the first 21 days, the commissioner must select 
67.6 	an applicant for appointment within 60 calendar days of receiving the application of a 
67.7 	qualified and, if applicable, a licensee in good standing applicant.

67.8 	Sec. 7. Minnesota Statutes 2024, section 144G.09, subdivision 2, is amended to read:
67.9 		Subd. 2.Regulatory functions. (a) The commissioner shall:
67.10 	(1) license, survey, and monitor without advance notice assisted living facilities in 
67.11 	accordance with this chapter and rules;
67.12 	(2) survey every provisional licensee within one year of the provisional license issuance 
67.13 	date subject to the provisional licensee providing assisted living services to residents;
67.14 	(3) survey assisted living facility licensees at least once every two years;
67.15 	(4) investigate complaints of assisted living facilities;
67.16 	(5) issue correction orders and assess civil penalties under sections 144G.30 and 144G.31;
67.17 	(6) take action as authorized in section 144G.20; and
67.18 	(7) approve or disapprove proposed increases in amounts charged for housing or assisted 
67.19 	living services under sections 144G.19, subdivision 5, and 144G.40, subdivision 4; and
67.20 	(7) (8) take other action reasonably required to accomplish the purposes of this chapter.
67.21 	(b) The commissioner shall review blueprints for all new facility construction and must 
67.22 	approve the plans before construction may be commenced.
67.23 	(c) The commissioner shall provide on-site review of the construction to ensure that all 
67.24 	physical environment standards are met before the facility license is complete.

67.25 	Sec. 8. Minnesota Statutes 2024, section 144G.15, is amended to read:
67.26 	144G.15 CONSIDERATION OF APPLICATIONS.
67.27 		Subdivision 1.Consideration. (a) Before issuing a provisional license or license or 
67.28 	renewing a license, the commissioner shall consider an applicant's compliance history in 
67.29 	providing care in this state or any other state in a facility that provides care to children, the 
67.30 	elderly, ill individuals, or individuals with disabilities.
68.1 	(b) The applicant's compliance history shall include repeat violation, rule violations, and 
68.2 	any license or certification involuntarily suspended or terminated during an enforcement 
68.3 	process.
68.4 	(c) Before issuing a provisional license for an assisted living facility with a licensed 
68.5 	resident capacity of six or fewer, the commissioner shall also consider the population, size, 
68.6 	land use plan, availability of community services, and the number and size of existing 
68.7 	licensed assisted living facilities in the town, municipality, or county in which the applicant 
68.8 	seeks to operate an assisted living facility.
68.9 		Subd. 2.Colocation of certain home and community-based residential settings. The 
68.10 	commissioner must not grant a provisional license for an assisted living facility with a 
68.11 	licensed resident capacity of six or fewer until the commissioner of human services 
68.12 	determines that the proposed location of the assisted living facility meets the standard 
68.13 	described in section 245A.042, subdivision 7. This paragraph applies regardless of the 
68.14 	services to be provided in the proposed assisted living facility and regardless of whether 
68.15 	any residents of the facility will receive publicly funded services.
68.16 		Subd. 3.Grounds for licensing action. (c) The commissioner may deny, revoke, suspend, 
68.17 	restrict, or refuse to renew the license or impose conditions if:
68.18 	(1) the applicant fails to provide complete and accurate information on the application 
68.19 	and the commissioner concludes that the missing or corrected information is needed to 
68.20 	determine if a license shall be granted;
68.21 	(2) the applicant, knowingly or with reason to know, made a false statement of a material 
68.22 	fact in an application for the license or any data attached to the application or in any matter 
68.23 	under investigation by the department;
68.24 	(3) the applicant refused to allow agents of the commissioner to inspect its books, records, 
68.25 	and files related to the license application, or any portion of the premises;
68.26 	(4) the applicant willfully prevented, interfered with, or attempted to impede in any way: 
68.27 	(i) the work of any authorized representative of the commissioner, the ombudsman for 
68.28 	long-term care, or the ombudsman for mental health and developmental disabilities; or (ii) 
68.29 	the duties of the commissioner, local law enforcement, city or county attorneys, adult 
68.30 	protection, county case managers, or other local government personnel;
68.31 	(5) the applicant, owner, controlling individual, managerial official, or assisted living 
68.32 	director for the facility has a history of noncompliance with federal or state regulations that 
68.33 	were detrimental to the health, welfare, or safety of a resident or a client; or
69.1 	(6) the applicant violates any requirement in this chapter.
69.2 	(d) If a license is denied, the applicant has the reconsideration rights available under 
69.3 	section 144G.16, subdivision 4.

69.4 	Sec. 9. Minnesota Statutes 2024, section 144G.16, is amended by adding a subdivision to 
69.5 	read:
69.6 		Subd. 8.Notice to affected municipality. (a) No later than five days, excluding weekends 
69.7 	and holidays, after issuing a provisional license to an assisted living facility with a licensed 
69.8 	resident capacity of six or fewer, the commissioner must provide the following information 
69.9 	about the provisional licensee and the facility to the affected municipality or other political 
69.10 	subdivision:
69.11 	(1) business name of the provisional licensee;
69.12 	(2) street address of the facility;
69.13 	(3) license category;
69.14 	(4) licensed resident capacity; and
69.15 	(5) contact information for an authorized agent of the provisional licensee.
69.16 	(b) The commissioner may provide notice through electronic communication or by 
69.17 	submitting a written document to the official address of the municipality or other political 
69.18 	subdivision.

69.19 	EFFECTIVE DATE. This section is effective July 1, 2026, and applies to provisional 
69.20 	licenses issued on or after that date.

69.21 	Sec. 10. Minnesota Statutes 2025 Supplement, section 144G.19, subdivision 5, is amended 
69.22 	to read:
69.23 		Subd. 5.Change of ownership; existing contracts. (a) Following a change of ownership, 
69.24 	the new licensee must honor the terms of an assisted living contract in effect at the time of 
69.25 	the change of ownership until the end of the contract term. A new licensee that proposes to 
69.26 	increase the amount charged for housing or assisted living services in an assisted living 
69.27 	contract replacing a contract in effect at the time of the change of ownership must provide 
69.28 	the commissioner with justification for and specific documentation supporting the proposed 
69.29 	increase.
69.30 	(b) The commissioner must review the justification and documentation provided under 
69.31 	paragraph (a) and approve or disapprove the proposed increase. The commissioner may 
70.1 	request from the new licensee additional documentation or information the commissioner 
70.2 	deems necessary to conduct the review. An assisted living facility must not implement a 
70.3 	proposed increase described in paragraph (a) unless the commissioner approves the proposed 
70.4 	increase.

70.5 	Sec. 11. Minnesota Statutes 2024, section 144G.195, subdivision 1, is amended to read:
70.6 		Subdivision 1.New license not required. (a) Beginning March 15, 2025, An assisted 
70.7 	living facility with a licensed resident capacity of five residents or fewer may operate under 
70.8 	the licensee's current license if the facility is relocated with the approval of the commissioner 
70.9 	of health during the period the current license is valid.
70.10 	(b) A licensee is not required to apply for a new license solely because the licensee 
70.11 	receives approval to relocate a facility. The licensee's license for the relocated facility 
70.12 	remains valid until the expiration date specified on the existing license. The commissioner 
70.13 	of health must apply the licensing and survey cycle previously established for the facility's 
70.14 	prior location to the facility's new location.
70.15 	(c) A licensee must notify the commissioner of health, on a form developed by the 
70.16 	commissioner, of the licensee's intent to relocate the licensee's facility and submit a 
70.17 	nonrefundable relocation fee of $3,905. The commissioner must deposit all relocation fees 
70.18 	in the state treasury to be credited to the state government special revenue fund.
70.19 	(d) The licensee must obtain plan review approval for the building to which the licensee 
70.20 	intends to relocate the facility and a certificate of occupancy from the commissioner of labor 
70.21 	and industry or the commissioner of labor and industry's delegated authority for the building. 
70.22 	Upon issuance of a certificate of occupancy, the commissioner of health must review and 
70.23 	inspect the building to which the licensee intends to relocate the facility and approve or 
70.24 	deny the license relocation within 30 calendar days and must request from the commissioner 
70.25 	of human services a determination of whether the location to which the licensee intends to 
70.26 	relocate complies with the standards described in section 245A.042, subdivision 7. The 
70.27 	commissioner of health must approve or deny the license relocation within 30 calendar days 
70.28 	after inspecting the building and receiving a determination from the commissioner of human 
70.29 	services.
70.30 	(e) A licensee may only relocate a facility within the geographic boundaries of the 
70.31 	municipality in which the facility is currently located or within the geographic boundaries 
70.32 	of a contiguous municipality located in the seven-county metropolitan area may not relocate 
70.33 	outside of the seven-county metropolitan area. A licensee located outside of the seven-county 
71.1 	metropolitan area may not relocate more than two hours or 120 miles from the licensee's 
71.2 	previous location nor relocate within the seven-county metropolitan area.
71.3 	(f) A licensee may only relocate one time in any three-year period, except that the 
71.4 	commissioner may approve an additional relocation within a three-year period upon a 
71.5 	licensee's demonstration of an extenuating circumstance, including but not limited to the 
71.6 	criteria outlined in section 256B.49, subdivision 28a, paragraph (c).
71.7 	(g) A licensee that receives approval from the commissioner to relocate a facility must 
71.8 	provide each resident with a new assisted living contract and comply with the coordinated 
71.9 	move requirements under section 144G.55.
71.10 	(h) A licensee denied approval by the commissioner of health to relocate a facility may 
71.11 	continue to operate the facility in its current location, follow the requirements in section 
71.12 	144G.57 and close the facility, or notify the commissioner of health of the licensee's intent 
71.13 	to relocate the facility to an alternative new location. If the licensee notifies the commissioner 
71.14 	of the licensee's intent to relocate the facility to an alternative new location, paragraph (c) 
71.15 	applies, including all provisions of this section apply, including paragraph (c) and the 
71.16 	timelines for approving or denying the license relocation for the alternative new location.
71.17 	(g) If the commissioner of health approves a relocation under this subdivision, the 
71.18 	commissioner must comply with the provisions of section 144G.16, subdivision 8.

71.19 	Sec. 12. Minnesota Statutes 2024, section 144G.31, subdivision 7, is amended to read:
71.20 		Subd. 7.Additional penalties. In addition to any fine imposed under this section, the 
71.21 	commissioner may:
71.22 	(1) assess a penalty amount based on costs related to an investigation that results in a 
71.23 	final order assessing a fine or other enforcement action authorized by this chapter.; and
71.24 	(2) increase a fine if the violation results in serious injury or death and the commissioner 
71.25 	determines the licensee's conduct was sufficiently egregious to warrant an increase, 
71.26 	notwithstanding the fine amount provided in subdivision 4, paragraph (a), clause (5).

71.27 	Sec. 13. Minnesota Statutes 2024, section 144G.40, is amended by adding a subdivision 
71.28 	to read:
71.29 		Subd. 4.Increase in amount charged for housing or services. (a) If an assisted living 
71.30 	facility proposes to increase the amount charged for housing or assisted living services by 
71.31 	an amount that exceeds the change in the Consumer Price Index for All Urban Consumers 
71.32 	published by the federal Bureau of Labor Statistics, for the most recent 12-month period 
72.1 	for which data is available, the assisted living facility must provide the commissioner with 
72.2 	justification for and specific documentation supporting the proposed increase.
72.3 	(b) The documentation required under paragraph (a) must include:
72.4 	(1) data on operational costs, including but not limited to the cost of staffing, utilities, 
72.5 	maintenance, and other day-to-day expenses necessary to operate the facility;
72.6 	(2) data on the proposed imposition of any new fees, but is not limited to a raw food 
72.7 	fee, community fee, pharmacy choice or coordination fee, hospice choice or coordination 
72.8 	fee, or activities fee;
72.9 	(3) the facility's balance sheet, including projected revenues and expenses for the next 
72.10 	fiscal year;
72.11 	(4) data on costs related to compliance with new regulatory requirements, including but 
72.12 	not limited to health and safety requirements;
72.13 	(5) data on capital improvements to, upgrades to, or expansion of the facility, including 
72.14 	but not limited to building renovations or new construction;
72.15 	(6) a comparison of the facility's costs and fees and the costs and fees of similar facilities 
72.16 	in the region where the facility is located;
72.17 	(7) data on whether the facility's residents have increased needs or are requesting new 
72.18 	amenities; and
72.19 	(8) the percentage of revenue devoted to administrative costs and the percentage of 
72.20 	revenue devoted to marketing costs.
72.21 	(c) The commissioner must review the justification and documentation provided under 
72.22 	paragraph (a) and approve or disapprove the proposed increase. The commissioner may 
72.23 	request from the facility additional documentation or information the commissioner deems 
72.24 	necessary to conduct the review. An assisted living facility must not implement a proposed 
72.25 	increase described in paragraph (a) unless the commissioner approves the proposed increase.
72.26 	(d) If the commissioner approves the proposed increase, approval must be conditioned 
72.27 	on the facility maintaining or improving the quality of care it provides, including but not 
72.28 	limited to hiring additional staff, improving staff training, updating medical equipment, or 
72.29 	upgrading physical environment elements of the facility.

72.30 	Sec. 14. Minnesota Statutes 2024, section 144G.41, subdivision 1, is amended to read:
72.31 		Subdivision 1.Minimum requirements. All assisted living facilities shall:
73.1 	(1) distribute to residents the assisted living bill of rights;
73.2 	(2) provide services in a manner that complies with the Nurse Practice Act in sections 
73.3 	148.171 to 148.285;
73.4 	(3) utilize a person-centered planning and service delivery process;
73.5 	(4) have and maintain a system for delegation of health care activities to unlicensed 
73.6 	personnel by a registered nurse, including supervision and evaluation of the delegated 
73.7 	activities as required by the Nurse Practice Act in sections 148.171 to 148.285;
73.8 	(5) provide a means for residents to request assistance for health and safety needs 24 
73.9 	hours per day, seven days per week, and maintain a log of resident requests for assistance 
73.10 	and staff responses including, for each request, the time that elapsed between the resident's 
73.11 	communication of the request and the staff response. The facility must retain a log for at 
73.12 	least five years after the most recent request and response in the log;
73.13 	(6) allow residents the ability to furnish and decorate the resident's unit within the terms 
73.14 	of the assisted living contract;
73.15 	(7) permit residents access to food at any time;
73.16 	(8) allow residents to choose the resident's visitors and times of visits;
73.17 	(9) allow the resident the right to choose a roommate if sharing a unit;
73.18 	(10) notify the resident of the resident's right to have and use a lockable door to the 
73.19 	resident's unit. The licensee shall provide the locks on the unit. Only a staff member with 
73.20 	a specific need to enter the unit shall have keys, and advance notice must be given to the 
73.21 	resident before entrance, when possible. An assisted living facility must not lock a resident 
73.22 	in the resident's unit;
73.23 	(11) develop and implement a staffing plan for determining its staffing level that:
73.24 	(i) includes an evaluation, to be conducted at least twice a year, of the appropriateness 
73.25 	of staffing levels in the facility;
73.26 	(ii) ensures sufficient staffing at all times to meet the scheduled and reasonably 
73.27 	foreseeable unscheduled needs of each resident as required by the residents' assessments 
73.28 	and service plans on a 24-hour per day basis; and
73.29 	(iii) ensures that the facility can respond promptly and effectively to individual resident 
73.30 	emergencies and to emergency, life safety, and disaster situations affecting staff or residents 
73.31 	in the facility;
74.1 	(12) ensure that one or more persons who are trained in accordance with section 144G.61, 
74.2 	subdivision 2, are available 24 hours per day, seven days per week, who are responsible for 
74.3 	responding to the requests of residents for assistance with health or safety needs. Such 
74.4 	persons must be:
74.5 	(i) awake;
74.6 	(ii) located in the same building, in an attached building, or on a contiguous campus 
74.7 	with the facility in order to respond within a reasonable amount of time;
74.8 	(iii) capable of communicating with residents;
74.9 	(iv) capable of providing or summoning the appropriate assistance; and
74.10 	(v) capable of following directions; and
74.11 	(13) provide staff access to an on-call registered nurse 24 hours per day, seven days per 
74.12 	week.;
74.13 	(14) ensure a plan for facility staff to immediately attend to resident needs in a medical 
74.14 	emergency, until any emergency personnel arrive, if summoned; and
74.15 	(15) ensure a plan for facility staff to meet the nonemergency medical needs of residents 
74.16 	due to falling, including needs for lift assistance.

74.17 	EFFECTIVE DATE. The amendment to clause (5) is effective August 1, 2026. The 
74.18 	amendment to clause (12) is effective August 1, 2027. Clauses (14) and (15) are effective 
74.19 	August 1, 2027.

74.20 	Sec. 15. Minnesota Statutes 2024, section 144G.41, subdivision 2, is amended to read:
74.21 		Subd. 2.Policies and procedures. (a) Each assisted living facility must have policies 
74.22 	and procedures in place to address the following and keep them current:
74.23 	(1) requirements in section 626.557, reporting of maltreatment of vulnerable adults;
74.24 	(2) conducting and handling background studies on employees;
74.25 	(3) orientation, training, and competency evaluations of staff, and a process for evaluating 
74.26 	staff performance;
74.27 	(4) handling complaints regarding staff or services provided by staff;
74.28 	(5) conducting initial evaluations of residents' needs and the providers' ability to provide 
74.29 	those services;
75.1 	(6) conducting initial and ongoing resident evaluations and assessments of resident 
75.2 	needs, including assessments by a registered nurse or appropriate licensed health professional, 
75.3 	and how changes in a resident's condition are identified, managed, and communicated to 
75.4 	staff and other health care providers as appropriate;
75.5 	(7) orientation to and implementation of the assisted living bill of rights;
75.6 	(8) infection control practices;
75.7 	(9) reminders for medications, treatments, or exercises, if provided;
75.8 	(10) conducting appropriate screenings, or documentation of prior screenings, to show 
75.9 	that staff are free of tuberculosis, consistent with current United States Centers for Disease 
75.10 	Control and Prevention standards;
75.11 	(11) ensuring that nurses and licensed health professionals have current and valid licenses 
75.12 	to practice;
75.13 	(12) medication and treatment management;
75.14 	(13) delegation of tasks by registered nurses or licensed health professionals;
75.15 	(14) supervision of registered nurses and licensed health professionals; and
75.16 	(15) supervision of unlicensed personnel performing delegated tasks.;
75.17 	(16) emergency procedures to be initiated by facility staff when a resident experiences 
75.18 	a medical emergency due to falling, a heart event, difficulty breathing, or choking, and to 
75.19 	be followed until emergency personnel arrive, if summoned; and
75.20 	(17) procedures to be initiated by facility staff after determining that a resident is not 
75.21 	experiencing a medical emergency pursuant to clause (16), to meet the nonemergency 
75.22 	medical needs of residents due to falling, including needs for lift assistance.
75.23 	(b) Each assisted living facility must keep all policies and procedures current and make 
75.24 	them available to a resident or the resident's representative upon request. Policies and 
75.25 	procedures covering medical emergency events under paragraph (a), clause (16), must be 
75.26 	provided to prospective residents, before signing an assisted living contract, for whom a 
75.27 	prospective resident assessment has been performed as described under section 144G.70, 
75.28 	subdivision 2, paragraph (b), and to current residents upon any changes to the policies and 
75.29 	procedures covering medical emergencies under paragraph (a), clause (16).

75.30 	EFFECTIVE DATE. This section is effective August 1, 2027.

76.1 	Sec. 16. Minnesota Statutes 2024, section 144G.41, is amended by adding a subdivision 
76.2 	to read:
76.3 		Subd. 9.Automatic external defibrillator. (a) For purposes of this subdivision, 
76.4 	"automatic external defibrillator" has the meaning given in section 403.51, subdivision 1.
76.5 	(b) A facility must:
76.6 	(1) maintain an automatic external defibrillator in each building on the assisted living 
76.7 	facility campus where residents may be present; and
76.8 	(2) ensure each of its automatic external defibrillators is maintained and regularly tested 
76.9 	according to the manufacturer's recommendations.

76.10 	EFFECTIVE DATE. This section is effective August 1, 2026.

76.11 	Sec. 17. Minnesota Statutes 2024, section 144G.45, subdivision 3, is amended to read:
76.12 		Subd. 3.Local laws apply; delegating inspection authority. (a) Assisted living facilities 
76.13 	shall comply with all applicable state and local governing laws, regulations, standards, 
76.14 	ordinances, and codes for fire safety, building, and zoning requirements, except a facility 
76.15 	with a licensed resident capacity of six or fewer is exempt from rental licensing regulations 
76.16 	imposed by any town, municipality, or county.
76.17 	(b) At the request of a county or local unit of government, the commissioner may delegate 
76.18 	to a county agency or local unit of government the commissioner's authority to inspect an 
76.19 	existing assisted living facility with a licensed resident capacity of six or fewer that is in 
76.20 	the jurisdiction of the county or local unit of government for compliance with applicable 
76.21 	physical plant licensing requirements and zoning ordinances. If the commissioner delegates 
76.22 	the commissioner's authority to a county agency or local unit of government under this 
76.23 	subdivision, the commissioner must execute a formal delegation of authority that clearly 
76.24 	specifies what authority is being delegated to the county agency or local unit of government, 
76.25 	that the commissioner is responsible for any costs incurred by the county agency or local 
76.26 	unit of government for conducting inspections under delegated authority, and that the county 
76.27 	agency or local unit of government must not assess any additional fees for conducting an 
76.28 	inspection under delegated authority. When conducting an inspection under delegated 
76.29 	authority, the county agency or local unit of government must provide the subject of the 
76.30 	inspection with a copy of the delegation of authority.
76.31 	(c) When a county agency or local unit of government is conducting an inspection under 
76.32 	delegated authority as provided in paragraph (b), the county agency or local unit of 
76.33 	government and the commissioner must coordinate their inspections to minimize visits to 
77.1 	and disruptions of the facility. A county agency or local unit of government conducting an 
77.2 	inspection must notify the commissioner of any violations or concerns within ten working 
77.3 	days of the inspection. A county agency or local unit of government that conducts inspections 
77.4 	under this subdivision must not inspect an assisted living facility more frequently than 
77.5 	annually, except a follow-up inspection is permitted before the next annual inspection to 
77.6 	verify correction of a violation discovered during the most recent inspection.
77.7 	(d) The commissioner must ensure that laws, rules, and codes are uniformly enforced 
77.8 	throughout the state by reviewing at least every four years each county agency and local 
77.9 	unit of government conducting inspections under this subdivision for compliance with this 
77.10 	subdivision and other applicable laws and rules. The commissioner must ensure that a county 
77.11 	agency or local unit of government to which the commissioner has delegated the 
77.12 	commissioner's authority under this subdivision has at all times sufficient expertise to 
77.13 	conduct delegated inspections competently, and if the county agency or local unit of 
77.14 	government does not, the commissioner must immediately revoke the delegation of authority.

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

77.16 	Sec. 18. Minnesota Statutes 2024, section 144G.60, subdivision 4, is amended to read:
77.17 		Subd. 4.Unlicensed personnel. (a) Unlicensed personnel providing assisted living 
77.18 	services must have:
77.19 	(1) successfully completed a training and competency evaluation appropriate to the 
77.20 	services provided by the facility and the topics listed in section 144G.61, subdivision 2, 
77.21 	paragraph (a); or
77.22 	(2) demonstrated competency by satisfactorily completing a written or oral test on the 
77.23 	tasks the unlicensed personnel will perform and on the topics listed in section 144G.61, 
77.24 	subdivision 2, paragraph (a); and successfully demonstrated competency on topics in section 
77.25 	144G.61, subdivision 2, paragraph (a), clauses (5), (7), and (8), and (19), by a practical 
77.26 	skills test.
77.27 	Unlicensed personnel who only provide assisted living services listed in section 144G.08, 
77.28 	subdivision 9, clauses (1) to (5), shall not perform delegated nursing or therapy tasks.
77.29 	(b) Unlicensed personnel performing delegated nursing tasks in an assisted living facility 
77.30 	must:
77.31 	(1) have successfully completed training and demonstrated competency by successfully 
77.32 	completing a written or oral test of the topics in section 144G.61, subdivision 2, paragraphs 
77.33 	(a) and (b), and a practical skills test on tasks listed in section 144G.61, subdivision 2, 
78.1 	paragraphs (a), clauses (5) and, (7), and (19), and (b), clauses (3), (5), (6), and (7), and all 
78.2 	the delegated tasks they will perform;
78.3 	(2) satisfy the current requirements of Medicare for training or competency of home 
78.4 	health aides or nursing assistants, as provided by Code of Federal Regulations, title 42, 
78.5 	section 483 or 484.36; or
78.6 	(3) have, before April 19, 1993, completed a training course for nursing assistants that 
78.7 	was approved by the commissioner.
78.8 	(c) Unlicensed personnel performing therapy or treatment tasks delegated or assigned 
78.9 	by a licensed health professional must meet the requirements for delegated tasks in section 
78.10 	144G.62, subdivision 2, paragraph (a), and any other training or competency requirements 
78.11 	within the licensed health professional's scope of practice relating to delegation or assignment 
78.12 	of tasks to unlicensed personnel.

78.13 	EFFECTIVE DATE. This section is effective August 1, 2027.

78.14 	Sec. 19. Minnesota Statutes 2024, section 144G.61, subdivision 2, is amended to read:
78.15 		Subd. 2.Training and evaluation of unlicensed personnel. (a) Training and competency 
78.16 	evaluations for all unlicensed personnel must include the following:
78.17 	(1) documentation requirements for all services provided;
78.18 	(2) reports of changes in the resident's condition to the supervisor designated by the 
78.19 	facility;
78.20 	(3) basic infection control, including blood-borne pathogens;
78.21 	(4) maintenance of a clean and safe environment;
78.22 	(5) appropriate and safe techniques in personal hygiene and grooming, including:
78.23 	(i) hair care and bathing;
78.24 	(ii) care of teeth, gums, and oral prosthetic devices;
78.25 	(iii) care and use of hearing aids; and
78.26 	(iv) dressing and assisting with toileting;
78.27 	(6) training on the prevention of falls;
78.28 	(7) standby assistance techniques and how to perform them;
78.29 	(8) medication, exercise, and treatment reminders;
79.1 	(9) basic nutrition, meal preparation, food safety, and assistance with eating;
79.2 	(10) preparation of modified diets as ordered by a licensed health professional;
79.3 	(11) communication skills that include preserving the dignity of the resident and showing 
79.4 	respect for the resident and the resident's preferences, cultural background, and family;
79.5 	(12) awareness of confidentiality and privacy;
79.6 	(13) understanding appropriate boundaries between staff and residents and the resident's 
79.7 	family;
79.8 	(14) procedures to use in handling various nonmedical and medical emergency situations; 
79.9 	and
79.10 	(15) awareness of commonly used health technology equipment and assistive devices.;
79.11 	(16) recognition of and immediate response to signs and symptoms of airway, breathing, 
79.12 	and circulation concerns;
79.13 	(17) recognition of and immediate response to bleeding, including hemorrhage;
79.14 	(18) safe techniques for emergency movement of residents; and
79.15 	(19) log roll technique and spinal precautions.
79.16 	(b) In addition to paragraph (a), training and competency evaluation for unlicensed 
79.17 	personnel providing assisted living services must include:
79.18 	(1) observing, reporting, and documenting resident status;
79.19 	(2) basic knowledge of body functioning and changes in body functioning, injuries, or 
79.20 	other observed changes that must be reported to appropriate personnel;
79.21 	(3) reading and recording temperature, pulse, and respirations of the resident;
79.22 	(4) recognizing physical, emotional, cognitive, and developmental needs of the resident;
79.23 	(5) safe transfer techniques and ambulation;
79.24 	(6) range of motioning and positioning; and
79.25 	(7) administering medications or treatments as required.

79.26 	EFFECTIVE DATE. This section is effective August 1, 2027.

79.27 	Sec. 20. Minnesota Statutes 2024, section 144G.63, subdivision 2, is amended to read:
79.28 		Subd. 2.Content of required orientation. (a) The orientation must contain the following 
79.29 	topics:
80.1 	(1) an overview of this chapter;
80.2 	(2) an introduction and review of the facility's policies and procedures related to the 
80.3 	provision of assisted living services by the individual staff person;
80.4 	(3) handling of emergencies and use of emergency services;
80.5 	(4) compliance with and reporting of the maltreatment of vulnerable adults under section 
80.6 	626.557 to the Minnesota Adult Abuse Reporting Center (MAARC);
80.7 	(5) the assisted living bill of rights and staff responsibilities related to ensuring the 
80.8 	exercise and protection of those rights;
80.9 	(6) the principles of person-centered planning and service delivery and how they apply 
80.10 	to direct support services provided by the staff person;
80.11 	(7) handling of residents' complaints, reporting of complaints, and where to report 
80.12 	complaints, including information on the Office of Health Facility Complaints;
80.13 	(8) consumer advocacy services of the Office of Ombudsman for Long-Term Care, 
80.14 	Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care 
80.15 	Ombudsman at the Department of Human Services, county-managed care advocates, or 
80.16 	other relevant advocacy services; and
80.17 	(9) a review of the types of assisted living services the staff member will be providing 
80.18 	and the facility's category of licensure.; and
80.19 	(10) cardiopulmonary resuscitation, the use of automatic external defibrillators, the 
80.20 	facility's process for checking a resident's code status before initiating lifesaving measures, 
80.21 	and requesting emergency medical assistance as soon as practicable after an automatic 
80.22 	external defibrillator is used.
80.23 	(b) In addition to the topics in paragraph (a), orientation may also contain training on 
80.24 	providing services to residents with hearing loss. Any training on hearing loss provided 
80.25 	under this subdivision must be high quality and research based, may include online training, 
80.26 	and must include training on one or more of the following topics:
80.27 	(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence, 
80.28 	and the challenges it poses to communication;
80.29 	(2) health impacts related to untreated age-related hearing loss, such as increased 
80.30 	incidence of dementia, falls, hospitalizations, isolation, and depression; or
81.1 	(3) information about strategies and technology that may enhance communication and 
81.2 	involvement, including communication strategies, assistive listening devices, hearing aids, 
81.3 	visual and tactile alerting devices, communication access in real time, and closed captions.

81.4 	EFFECTIVE DATE. This section is effective August 1, 2026.

81.5 	Sec. 21. Minnesota Statutes 2024, section 144G.63, subdivision 5, is amended to read:
81.6 		Subd. 5.Required annual training. (a) All staff that perform direct services must 
81.7 	complete at least eight hours of annual training for each 12 months of employment. The 
81.8 	training may be obtained from the facility or another source and must include topics relevant 
81.9 	to the provision of assisted living services. The annual training must include:
81.10 	(1) training on reporting of maltreatment of vulnerable adults under section 626.557;
81.11 	(2) review of the assisted living bill of rights and staff responsibilities related to ensuring 
81.12 	the exercise and protection of those rights;
81.13 	(3) review of infection control techniques used in the home and implementation of 
81.14 	infection control standards including a review of hand washing techniques; the need for and 
81.15 	use of protective gloves, gowns, and masks; appropriate disposal of contaminated materials 
81.16 	and equipment, such as dressings, needles, syringes, and razor blades; disinfecting reusable 
81.17 	equipment; disinfecting environmental surfaces; and reporting communicable diseases;
81.18 	(4) effective approaches to use to problem solve when working with a resident's 
81.19 	challenging behaviors, and how to communicate with residents who have dementia, 
81.20 	Alzheimer's disease, or related disorders;
81.21 	(5) review of the facility's policies and procedures relating to the provision of assisted 
81.22 	living services and how to implement those policies and procedures; and
81.23 	(6) the principles of person-centered planning and service delivery and how they apply 
81.24 	to direct support services provided by the staff person.; and
81.25 	(7) cardiopulmonary resuscitation, the use of automatic external defibrillators, the 
81.26 	facility's process for checking a resident's code status before initiating lifesaving measures, 
81.27 	and requesting emergency medical assistance as soon as practicable after an automatic 
81.28 	external defibrillator is used.
81.29 	(b) In addition to the topics in paragraph (a), annual training may also contain training 
81.30 	on providing services to residents with hearing loss. Any training on hearing loss provided 
81.31 	under this subdivision must be high quality and research based, may include online training, 
81.32 	and must include training on one or more of the following topics:
82.1 	(1) an explanation of age-related hearing loss and how it manifests itself, its prevalence, 
82.2 	and challenges it poses to communication;
82.3 	(2) the health impacts related to untreated age-related hearing loss, such as increased 
82.4 	incidence of dementia, falls, hospitalizations, isolation, and depression; or
82.5 	(3) information about strategies and technology that may enhance communication and 
82.6 	involvement, including communication strategies, assistive listening devices, hearing aids, 
82.7 	visual and tactile alerting devices, communication access in real time, and closed captions.

82.8 	EFFECTIVE DATE. This section is effective August 1, 2026.

82.9 	Sec. 22. Minnesota Statutes 2024, section 144G.63, is amended by adding a subdivision 
82.10 	to read:
82.11 		Subd. 5a.Orientation and annual training; other staff. (a) All staff who are not subject 
82.12 	to the orientation requirements in subdivisions 1 and 2 must complete an orientation on the 
82.13 	topics specified under paragraph (b) within 160 hours of the employment start date. All 
82.14 	staff who are not subject to the annual training requirements in subdivision 5 must complete 
82.15 	annual training on the topics specified under paragraph (b).
82.16 	(b) The orientation and annual training must include training on cardiopulmonary 
82.17 	resuscitation, the use of automatic external defibrillators, the facility's process for checking 
82.18 	a resident's code status before initiating lifesaving measures, and requesting emergency 
82.19 	medical assistance as soon as practicable after an automatic external defibrillator is used.

82.20 	EFFECTIVE DATE. This section is effective August 1, 2026.

82.21 	Sec. 23. Minnesota Statutes 2025 Supplement, section 145D.40, is amended by adding a 
82.22 	subdivision to read:
82.23 		Subd. 5.Health care professional. "Health care professional" means an individual who 
82.24 	is licensed or registered by the state to provide health care services within the professional's 
82.25 	scope of practice and in accordance with state law.

82.26 	Sec. 24. Minnesota Statutes 2025 Supplement, section 145D.41, subdivision 1, is amended 
82.27 	to read:
82.28 		Subdivision 1.Notice. At least 120 days prior to the transfer of ownership or control of 
82.29 	a nonprofit nursing home or nonprofit assisted living facility to a for-profit entity, the nursing 
82.30 	home or assisted living facility must provide written notice to the attorney general, the 
83.1 	commissioner of health, and the commissioner of human services of its intent to transfer 
83.2 	ownership or control to a for-profit entity.

83.3 	Sec. 25. Minnesota Statutes 2025 Supplement, section 145D.41, subdivision 2, is amended 
83.4 	to read:
83.5 		Subd. 2.Information. Together with the notice, the for-profit entity seeking to acquire 
83.6 	ownership or control of the nonprofit nursing home or nonprofit assisted living facility must 
83.7 	provide to the attorney general, commissioner of health, and commissioner of human services:
83.8 	(1) the names of each individual with an interest in the for-profit entity and the percentage 
83.9 	of interest each individual holds in the for-profit entity;
83.10 	(2) a complete and detailed description of the for-profit entity's corporate structure;
83.11 	(3) the names of each individual holding an interest in, and the percentage of interest 
83.12 	held in, any affiliate, subsidiary, or otherwise related entity that the for-profit entity has a 
83.13 	contract to provide goods or services for the operation or maintenance of the nursing home 
83.14 	or assisted living facility or has a contract for goods and services to be provided to residents, 
83.15 	including any real estate investment trusts if permitted under section 145D.42;
83.16 	(4) for the previous five years, any filings required to be made to any federal or state 
83.17 	agency;
83.18 	(5) the for-profit entity's current balance sheet;
83.19 	(6) all application materials required under section 144A.03 or 144G.12, as applicable;
83.20 	(7) a description of the condition of the buildings the for-profit entity seeks to acquire 
83.21 	or manage, identifying any cooling problems, electric medical devices present, recent exterior 
83.22 	additions and replacements, external building conditions, recent flush toilet breakdowns, 
83.23 	foreclosure status in the previous 12 months, heat risk, heating problems, indoor air quality, 
83.24 	recent interior additions and replacements, and mold, as those terms are defined and described 
83.25 	in Appendix A of the American Housing Survey for the United States: 2023;
83.26 	(8) an affidavit and evidence; and
83.27 	(9) other information required by the attorney general, commissioner of health, and 
83.28 	commissioner of human services.

84.1 	Sec. 26. Minnesota Statutes 2025 Supplement, section 145D.41, is amended by adding a 
84.2 	subdivision to read:
84.3 		Subd. 3.Affidavit and evidence. In addition to the notice required under subdivision 
84.4 	1, a for-profit entity seeking to acquire ownership or control of a nonprofit nursing home 
84.5 	or nonprofit assisted living facility must submit to the attorney general an affidavit and 
84.6 	evidence sufficient to demonstrate that:
84.7 	(1) the for-profit entity has the financial, managerial, and operational ability to operate 
84.8 	or manage the nursing home or assisted living facility consistent with the requirements of: 
84.9 	(i) for a nursing home, sections 144A.01 to 144A.1888, chapter 256R, and Minnesota Rules, 
84.10 	chapter 4658; or (ii) for an assisted living facility, chapter 144G and Minnesota Rules, 
84.11 	chapter 4659;
84.12 	(2) neither the for-profit entity nor any of its owners, managerial officials, or managers 
84.13 	have committed a crime listed in, or been found civilly liable for an offense listed in, section 
84.14 	144A.03, subdivision 1, paragraph (b), clause (13), or 144G.12, subdivision 1, clause (13), 
84.15 	as applicable;
84.16 	(3) in the preceding ten years, there have been no judgments and no filed, pending, or 
84.17 	completed public or private litigations, tax liens, written complaints, administrative actions, 
84.18 	or investigations by a government agency against the for-profit entity or any of its owners, 
84.19 	managerial officials, or managers;
84.20 	(4) in the preceding ten years, the for-profit entity has not defaulted in the payment of 
84.21 	money collected for others and has not discharged debts through bankruptcy proceedings;
84.22 	(5) the for-profit entity will invest sufficient capital in the nursing home or assisted living 
84.23 	facility to maintain or improve the facility's infrastructure and staffing;
84.24 	(6)(i) housing costs or costs for services in a nursing home or assisted living facility in 
84.25 	the United States over which the for-profit entity acquired ownership or control have not 
84.26 	increased by more than the increase in the Consumer Price Index for all urban consumers 
84.27 	published by the federal Bureau of Labor Statistics for the 12 months preceding the month 
84.28 	in which the increase became effective; or (ii) if housing costs or costs for services in the 
84.29 	nursing home or assisted living facility increased by more than the increase in the Consumer 
84.30 	Price Index as described in item (i), the increase was justified;
84.31 	(7) within five years after acquiring ownership or control of any other nursing home or 
84.32 	assisted living facility in the United States, the for-profit entity did not sell or otherwise 
85.1 	transfer ownership or control of the nursing home or assisted living facility to another person; 
85.2 	and
85.3 	(8) after acquiring ownership or control of another nursing home in the United States, 
85.4 	that nursing home, with respect to the Centers for Medicare and Medicaid Services rating 
85.5 	system:
85.6 	(i) maintained or improved the nursing home's rating if upon acquisition of ownership 
85.7 	or control the rating was three or more stars; or
85.8 	(ii) improved the nursing home's rating to at least three stars if upon acquisition of 
85.9 	ownership or control the rating was one or two stars.

85.10 	Sec. 27. [145D.42] PROHIBITED PRACTICES.
85.11 	A for-profit entity that acquires ownership or control of a nonprofit nursing home or 
85.12 	nonprofit assisted living facility is prohibited from:
85.13 	(1) interfering with the professional judgment of a health care professional providing 
85.14 	care in the nursing home or assisted living facility or with a health care professional's 
85.15 	diagnosis or treatment of residents in the nursing home or assisted living facility;
85.16 	(2) providing unequal treatment with regard to charges for housing or services based on 
85.17 	whether the resident pays for housing or services with private funds or through a public 
85.18 	program;
85.19 	(3) engaging in any act, practice, or course of business that would strip an asset from an 
85.20 	acquired nursing home or assisted living facility or that would otherwise undermine the 
85.21 	quality of, safety of, or access to care and services provided by the nursing home or assisted 
85.22 	living facility;
85.23 	(4) engaging in self-dealing;
85.24 	(5) engaging in any acts, practices, or courses of business that result in an adverse impact 
85.25 	on the health, safety, and well-being and quality of care of the residents of the nursing home 
85.26 	or assisted living facility;
85.27 	(6) spending less than 75 percent of the funds received by the nursing home or assisted 
85.28 	living facility from public programs and state appropriations on the direct care of residents;
85.29 	(7) raising resident housing costs beyond the Consumer Price Index for all urban 
85.30 	consumers published by the federal Bureau of Labor Statistics for the 12 months preceding 
85.31 	the month in which the increase became effective unless the for-profit entity can demonstrate 
85.32 	that the increase was justified by legitimate business expenses;
86.1 	(8) allowing a diminution of maintenance or a deterioration in the operations and 
86.2 	infrastructure of the nursing home or assisted living facility that results in unsafe conditions 
86.3 	or violations of building and other relevant codes, diminishes the property value of the 
86.4 	facility, or jeopardizes the health and well-being of the residents; or
86.5 	(9) for a nursing home:
86.6 	(i) failing to improve in the Centers for Medicare and Medicaid Services rating if the 
86.7 	nursing home's current rating is one or two stars; or
86.8 	(ii) allowing a decline in the Centers for Medicare and Medicaid Services rating if the 
86.9 	nursing home's current rating is at least three stars.

86.10 	Sec. 28. [145D.43] ENFORCEMENT AND REMEDIES; NURSING HOMES AND 
86.11 	ASSISTED LIVING FACILITIES.
86.12 		Subdivision 1.Equitable remedies. (a) In addition to other remedies provided by law, 
86.13 	the attorney general may bring an action in district court to enjoin or unwind a transaction 
86.14 	or seek other equitable relief if a nonprofit assisted living facility, nonprofit nursing home, 
86.15 	or for-profit entity violates sections 145D.41 and 145D.42.
86.16 	(b) In seeking injunctive relief under this section, the attorney general is not required to 
86.17 	establish irreparable harm but must instead establish that a violation of sections 145D.41 
86.18 	and 145D.42 occurred.
86.19 		Subd. 2.Failure to provide information. Failure of the entities involved in a transaction 
86.20 	subject to sections 145D.41 and 145D.42 to provide timely information as required by the 
86.21 	attorney general, the commissioner of health, or the commissioner of human services is an 
86.22 	independent and sufficient ground for a court to enjoin or unwind the transaction or provide 
86.23 	other equitable relief, provided the attorney general notifies the entities of the inadequacy 
86.24 	of the information provided and provides the entities with a reasonable opportunity to remedy 
86.25 	the inadequacy.
86.26 		Subd. 3.Enforcement. In addition to the remedies provided under this section or other 
86.27 	law, the attorney general may enforce sections 145D.41 and 145D.42 pursuant to section 
86.28 	8.31.
86.29 		Subd. 4.Civil penalties; attorney fees. (a) An officer, director, or other executive found 
86.30 	to have violated sections 145D.41 and 145D.42 shall be subject to a civil penalty of up to 
86.31 	$50,000 for each violation. A nonprofit assisted living facility, nonprofit nursing home, or 
86.32 	for-profit entity that is a party to or materially participated in a transaction found to have 
86.33 	violated sections 145D.41 and 145D.42 shall be subject to a civil penalty of up to $500,000.
87.1 	(b) A court may also award reasonable attorney fees and costs of investigation and 
87.2 	litigation for an action brought under this section.

87.3 	EFFECTIVE DATE. This section is effective August 1, 2026, and applies to violations 
87.4 	occurring on or after that date.

87.5 	Sec. 29. DIRECTION TO COMMISSIONER OF HEALTH; SMALL ASSISTED 
87.6 	LIVING FACILITY LICENSURE.
 87.7 	(a) The commissioner of health must convene a group of interested parties to examine 
87.8 	the licensing requirements under Minnesota Statutes, chapter 144G, for assisted living 
87.9 	facilities with a licensed resident capacity of five residents or fewer. The group must develop 
87.10 	a new licensing category applicable to such facilities to account for health and safety 
87.11 	requirements and practical realities of operating small assisted living facilities that 
87.12 	predominantly serve individuals receiving customized living services under the federally 
87.13 	approved brain injury, community access for disability inclusion, and elderly waiver plans.
87.14 	(b) The commissioner must develop draft legislative language to establish a new assisted 
87.15 	living license category for facilities with a licensed resident capacity of five residents or 
87.16 	fewer.
87.17 	(c) The commissioner must submit the draft legislation to the chairs and ranking minority 
87.18 	members of the legislative committees with jurisdiction over health and human services 
87.19 	policy and finance by January 1, 2028.

87.20 	Sec. 30. SPECIAL PROJECTS GRANT PROGRAM FOR HOME CARE 
87.21 	PROVIDERS.
 87.22 	By December 31, 2028, the commissioner of health must distribute the balance as of 
87.23 	January 1, 2027, in the special revenue account under Minnesota Statutes, section 144A.474, 
87.24 	subdivision 11, paragraph (j), under a competitive grant program for special projects for 
87.25 	improving home care client quality of care and outcomes in Minnesota, with a specific focus 
87.26 	on workforce and clinical outcomes, including projects consistent with criteria in Minnesota 
87.27 	Statutes, section 144A.4799, subdivision 3, paragraph (c). Grants must be distributed to 
87.28 	home care providers licensed under Minnesota Statutes, chapter 144A, or organizations 
87.29 	with experience in or knowledge of home care operations, compliance, client needs, or best 
87.30 	practices. Each grant must be $1,000 at minimum. A provider with a temporary license 
87.31 	under Minnesota Statutes, chapter 144A, is not eligible to apply for a grant. Any amount 
87.32 	that has not been awarded as a grant by December 31, 2028, must be used for the annual 
88.1 	distributions under Minnesota Statutes, section 144A.474, subdivision 11, paragraph (j), 
88.2 	beginning January 1, 2029.

88.3 	ARTICLE 5
88.4 	DIRECT CARE AND TREATMENT

88.5 	Section 1. Minnesota Statutes 2024, section 15.43, subdivision 3, is amended to read:
88.6 		Subd. 3.Other exemptions. The commissioners commissioner of human services and
88.7 	corrections and Direct Care and Treatment executive board may by rule prescribe procedures 
88.8 	for the acceptance of gifts from any person or organization, provided that such gifts are 
88.9 	accepted by the commissioner or executive board, or a designated representative of the 
88.10 	commissioner or executive board, and that such gifts are used solely for the direct benefit 
88.11 	of patients, clients, or inmates under the jurisdiction of the accepting state officer.

88.12 	Sec. 2. Minnesota Statutes 2025 Supplement, section 144.121, subdivision 1a, is amended 
88.13 	to read:
88.14 		Subd. 1a.Fees for ionizing radiation-producing equipment. (a) A facility with ionizing 
88.15 	radiation-producing equipment and other sources of ionizing radiation must pay an initial 
88.16 	or annual renewal registration fee consisting of a base facility fee of $155 and an additional 
88.17 	fee for each x-ray tube, as follows:

88.18	(1)
	medical or veterinary equipment
	$
	130
		
88.19	(2)
	dental x-ray equipment
	$
	60
		
88.2088.21	(3)
	x-ray equipment not used on 
humans or animals
	$
	130
		
88.2288.23
88.24	(4)
	devices with sources of ionizing 
radiation not used on humans or 
animals
	$
	130
		
88.25	(5)
	security screening system
	$
	160
		
88.2688.27	(6)
	radiation therapy and accelerator 
x-ray equipment
	$
	1,000
		
88.2888.29	(7)
	industrial accelerator x-ray 
equipment
	$
	300
		
88.30 	(b) Electron microscopy equipment is exempt from the registration fee requirements of 
88.31 	this section.
88.32 	(c) For purposes of this section, a security screening system means ionizing 
88.33 	radiation-producing equipment designed and used for security screening of humans who 
88.34 	are in the custody of a correctional or detention facility or who are civilly committed in a 
89.1 	secure treatment facility, and used by the facility to image and identify contraband items 
89.2 	concealed within or on all sides of a human body.
89.3 	(d) For purposes of this section, a correctional or detention facility is a facility licensed 
89.4 	under section 241.021 and operated by a state agency or political subdivision charged with 
89.5 	detection, enforcement, or incarceration in respect to state criminal and traffic laws.
89.6 	(e) For purposes of this section, a secure treatment facility includes the facilities listed 
89.7 	in sections 253B.02, subdivision 18a, and 253D.02, subdivision 13.
89.8 	(f) The commissioner shall adopt rules to establish requirements for the use of security 
89.9 	screening systems. Notwithstanding section 14.125, the authority to adopt these rules does 
89.10 	not expire.

89.11 	Sec. 3. Minnesota Statutes 2024, section 144.121, subdivision 9, is amended to read:
89.12 		Subd. 9.Exemption from examination requirements; operators of security screening 
89.13 	systems. (a) An employee of a correctional or, detention, or secure treatment facility who 
89.14 	operates a security screening system and the facility in which the system is being operated 
89.15 	are exempt from the requirements of subdivisions 5 and 6.
89.16 	(b) An employee of a correctional or detention facility who operates a security screening 
89.17 	system and the facility in which the system is being operated must meet the requirements 
89.18 	of a variance to Minnesota Rules, parts 4732.0305 and 4732.0565, issued under Minnesota 
89.19 	Rules, parts 4717.7000 to 4717.7050. This paragraph expires on December 31 of the year 
89.20 	that the permanent rules adopted by the commissioner governing security screening systems 
89.21 	are published in the State Register.
89.22 	(c) An employee of a secure treatment facility who operates a security screening system 
89.23 	and the facility in which the system is being operated must meet the requirements of a 
89.24 	variance to Minnesota Rules, parts 4732.0305 and 4732.0565, issued under Minnesota 
89.25 	Rules, parts 4717.7000 to 4717.7050.

89.26 	ARTICLE 6
89.27 	MISCELLANEOUS

89.28 	Section 1. Minnesota Statutes 2024, section 256B.04, subdivision 5, is amended to read:
89.29 		Subd. 5.Annual report required. The state agency within 60 days after the close of 
89.30 	each fiscal year, shall prepare and print for the fiscal year a report that includes: a full 
89.31 	account of the operations and expenditure of funds under this chapter,; a full account of the 
89.32 	activities undertaken in accordance with subdivision 10,; adequate and complete statistics 
90.1 	divided by counties about all medical assistance provided in accordance with this chapter,; 
90.2 	a full account of all pre-enrollment, postenrollment, and unannounced site visits to providers 
90.3 	under section 256B.04, subdivision 21; and any other information it may deem advisable.

90.4 	Sec. 2. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 17, is 
90.5 	amended to read:
90.6 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
90.7 	means motor vehicle transportation provided by a public or private person that serves 
90.8 	Minnesota health care program beneficiaries who do not require emergency ambulance 
90.9 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
90.10 	(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
90.11 	a census-tract based classification system under which a geographical area is determined 
90.12 	to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance 
90.13 	fee-for-service and January 1, 2027, for prepaid medical assistance upon implementation 
90.14 	of the administrator under subdivision 18i.
90.15 	(c) Medical assistance covers medical transportation costs incurred solely for obtaining 
90.16 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
90.17 	emergency or nonemergency medical care when paid directly to an ambulance company, 
90.18 	nonemergency medical transportation company, or other recognized providers of 
90.19 	transportation services. Medical transportation must be provided by:
90.20 	(1) nonemergency medical transportation providers who meet the requirements of this 
90.21 	subdivision;
90.22 	(2) ambulances, as defined in section 144E.001, subdivision 2;
90.23 	(3) taxicabs that meet the requirements of this subdivision;
90.24 	(4) public transportation, within the meaning of "public transportation" as defined in 
90.25 	section 174.22, subdivision 7; or
90.26 	(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472, 
90.27 	subdivision 1, paragraph (p).
90.28 	(d) Medical assistance covers nonemergency medical transportation provided by 
90.29 	nonemergency medical transportation providers enrolled in the Minnesota health care 
90.30 	programs. All nonemergency medical transportation providers must comply with the 
90.31 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
90.32 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
91.1 	commissioner and reported on the claim as the individual who provided the service. All 
91.2 	nonemergency medical transportation providers shall bill for nonemergency medical 
91.3 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
91.4 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
91.5 	requirements outlined in this paragraph.
91.6 	(e) An organization may be terminated, denied, or suspended from enrollment if:
91.7 	(1) the provider has not initiated background studies on the individuals specified in 
91.8 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
91.9 	(2) the provider has initiated background studies on the individuals specified in section 
91.10 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
91.11 	(i) the commissioner has sent the provider a notice that the individual has been 
91.12 	disqualified under section 245C.14; and
91.13 	(ii) the individual has not received a disqualification set-aside specific to the special 
91.14 	transportation services provider under sections 245C.22 and 245C.23.
91.15 	(f) The administrative agency of nonemergency medical transportation must:
91.16 	(1) adhere to the policies defined by the commissioner;
91.17 	(2) pay nonemergency medical transportation providers for services provided to 
91.18 	Minnesota health care programs beneficiaries to obtain covered medical services;
91.19 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
91.20 	trips, and number of trips by mode; and
91.21 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
91.22 	administrative structure assessment tool that meets the technical requirements established 
91.23 	by the commissioner, reconciles trip information with claims being submitted by providers, 
91.24 	and ensures prompt payment for nonemergency medical transportation services. This 
91.25 	paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
91.26 	for prepaid medical assistance upon implementation of the administrator under subdivision 
91.27 	18i.
91.28 	(g) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid 
91.29 	medical assistance, upon implementation of the administrator under subdivision 18i, the 
91.30 	administrative agency of nonemergency medical transportation must:
91.31 	(1) adhere to the policies defined by the commissioner;
92.1 	(2) pay nonemergency medical transportation providers for services provided to 
92.2 	Minnesota health care program beneficiaries to obtain covered medical services; and
92.3 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
92.4 	trips, and number of trips by mode.
92.5 	(h) Until the commissioner implements the single administrative structure and delivery 
92.6 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
92.7 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
92.8 	clients using modes of transportation under paragraph (n), clauses (4), (5), (6), and (7). This 
92.9 	paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
92.10 	for prepaid medical assistance upon implementation of the administrator under subdivision 
92.11 	18i.
92.12 	(i) The commissioner may use an order by the recipient's attending physician, advanced 
92.13 	practice registered nurse, physician assistant, or a medical or mental health professional to 
92.14 	certify that the recipient requires nonemergency medical transportation services. 
92.15 	Nonemergency medical transportation providers shall perform driver-assisted services for 
92.16 	eligible individuals, when appropriate. Driver-assisted service includes passenger pickup 
92.17 	at and return to the individual's residence or place of business, assistance with admittance 
92.18 	of the individual to the medical facility, and assistance in passenger securement or in securing 
92.19 	of wheelchairs, child seats, or stretchers in the vehicle.
92.20 	(j) Nonemergency medical transportation providers must take clients to the health care 
92.21 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
92.22 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
92.23 	authorization from the local agency. This paragraph expires July 1, 2026, for medical 
92.24 	assistance fee-for-service and January 1, 2027, for prepaid medical assistance upon 
92.25 	implementation of the administrator under subdivision 18i.
92.26 	(k) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027, 
92.27 	for prepaid medical assistance, upon implementation of the administrator under subdivision 
92.28 	18i, nonemergency medical transportation providers must take clients to the health care 
92.29 	provider using the most direct route and must not exceed 30 miles for a trip to a primary 
92.30 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
92.31 	authorization from the administrator.
92.32 	(l) Nonemergency medical transportation providers may not bill for separate base rates 
92.33 	for the continuation of a trip beyond the original destination. Nonemergency medical 
92.34 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
93.1 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
93.2 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
93.3 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
93.4 	services.
93.5 	(m) The administrative agency shall use the level of service process established by the 
93.6 	commissioner to determine the client's most appropriate mode of transportation. If public 
93.7 	transit or a certified transportation provider is not available to provide the appropriate service 
93.8 	mode for the client, the client may receive a onetime service upgrade.
93.9 	(n) The covered modes of transportation are:
93.10 	(1) client reimbursement, which includes client mileage reimbursement provided to 
93.11 	clients who have their own transportation, or to family or an acquaintance who provides 
93.12 	transportation to the client;
93.13 	(2) volunteer transport, which includes transportation by volunteers using their own 
93.14 	vehicle;
93.15 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
93.16 	or public transit. If a taxicab or public transit is not available, the client can receive 
93.17 	transportation from another nonemergency medical transportation provider;
93.18 	(4) assisted transport, which includes transport provided to clients who require assistance 
93.19 	by a nonemergency medical transportation provider;
93.20 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
93.21 	dependent on a device and requires a nonemergency medical transportation provider with 
93.22 	a vehicle containing a lift or ramp;
93.23 	(6) protected transport, which includes transport provided to a client who has received 
93.24 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
93.25 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
93.26 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
93.27 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
93.28 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
93.29 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
93.30 	a client in a prone or supine position.
93.31 	(o) The local agency shall be the single administrative agency and shall administer and 
93.32 	reimburse for modes defined in paragraph (n) according to paragraphs (r) to (t) when the 
93.33 	commissioner has developed, made available, and funded the web-based single administrative 
94.1 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
94.2 	agency's financial obligation is limited to funds provided by the state or federal government. 
94.3 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
94.4 	2027, for prepaid medical assistance upon implementation of the administrator under 
94.5 	subdivision 18i.
94.6 	(p) The commissioner shall:
94.7 	(1) verify that the mode and use of nonemergency medical transportation is appropriate;
94.8 	(2) verify that the client is going to an approved medical appointment; and
94.9 	(3) investigate all complaints and appeals.
94.10 	(q) The administrative agency shall pay for the services provided in this subdivision and 
94.11 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
94.12 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
94.13 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245. 
94.14 	This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 
94.15 	2027, for prepaid medical assistance upon implementation of the administrator under 
94.16 	subdivision 18i.
94.17 	(r) Payments for nonemergency medical transportation must be paid based on the client's 
94.18 	assessed mode under paragraph (m), not the type of vehicle used to provide the service. The 
94.19 	medical assistance reimbursement rates for nonemergency medical transportation services 
94.20 	that are payable by or on behalf of the commissioner for nonemergency medical 
94.21 	transportation services are:
94.22 	(1) $0.22 per mile for client reimbursement;
94.23 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
94.24 	transport;
94.25 	(3) equivalent to the standard fare for unassisted transport when provided by public 
94.26 	transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency 
94.27 	medical transportation provider;
94.28 	(4) $14.30 for the base rate and $1.43 per mile for assisted transport;
94.29 	(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
94.30 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
94.31 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
94.32 	an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026, 
95.1 	for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance
95.2 	upon implementation of the administrator under subdivision 18i.
95.3 	(s) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
95.4 	upon implementation of the administrator under subdivision 18i, for prepaid medical 
95.5 	assistance, payments for nonemergency medical transportation must be paid based on the 
95.6 	client's assessed mode under paragraph (m), not the type of vehicle used to provide the 
95.7 	service.
95.8 	(t) The base rate for nonemergency medical transportation services in areas defined 
95.9 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
95.10 	paragraph (r), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
95.11 	services in areas defined under RUCA to be rural or super rural areas is:
95.12 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
95.13 	rate in paragraph (r), clauses (1) to (7); and
95.14 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
95.15 	rate in paragraph (r), clauses (1) to (7). This paragraph expires July 1, 2026, for medical 
95.16 	assistance fee-for-service and January 1, 2027, for prepaid medical assistance upon 
95.17 	implementation of the administrator under subdivision 18i.
95.18 	(u) For purposes of reimbursement rates for nonemergency medical transportation 
95.19 	services under paragraphs (r) to (t), the zip code of the recipient's place of residence shall 
95.20 	determine whether the urban, rural, or super rural reimbursement rate applies. This paragraph 
95.21 	expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027, for prepaid 
95.22 	medical assistance upon implementation of the administrator under subdivision 18i.
95.23 	(v) The commissioner, when determining reimbursement rates for nonemergency medical 
95.24 	transportation, shall exempt all modes of transportation listed under paragraph (n) from 
95.25 	Minnesota Rules, part 9505.0445, item R, subitem (2).
95.26 	(w) Effective for the first day of each calendar quarter in which the price of gasoline as 
95.27 	posted publicly by the United States Energy Information Administration exceeds $3.00 per 
95.28 	gallon, the commissioner shall adjust the rate paid per mile in paragraph (r) by one percent 
95.29 	up or down for every increase or decrease of ten cents for the price of gasoline. The increase 
95.30 	or decrease must be calculated using a base gasoline price of $3.00. The percentage increase 
95.31 	or decrease must be calculated using the average of the most recently available price of all 
95.32 	grades of gasoline for Minnesota as posted publicly by the United States Energy Information 
95.33 	Administration. This paragraph expires July 1, 2026, for medical assistance fee-for-service 
96.1 	and January 1, 2027, for prepaid medical assistance upon implementation of the administrator 
96.2 	under subdivision 18i.

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

96.4 	Sec. 3. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 18i, is 
96.5 	amended to read:
96.6 		Subd. 18i.Administration of nonemergency medical transportation. (a) Effective 
96.7 	July 1, 2026, for medical assistance fee-for-service and January 1, 2027, for prepaid medical 
96.8 	assistance, the commissioner must contract either statewide or regionally for the 
96.9 	administration of the nonemergency medical transportation program in compliance with 
96.10 	the provisions of this chapter. The contract must include the administration of the 
96.11 	nonemergency medical transportation benefit for those enrolled in managed care as described 
96.12 	in section 256B.69.
96.13 	(b) The commissioner must provide six months notice to counties, managed care 
96.14 	organizations, and county-based purchasing organizations before implementing the 
96.15 	administrator required under this subdivision.
96.16 	(c) The commissioner must notify the revisor of statutes when the administrator under 
96.17 	this subdivision is implemented.

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

96.19 	Sec. 4. Minnesota Statutes 2025 Supplement, section 256B.064, subdivision 1a, is amended 
96.20 	to read:
96.21 		Subd. 1a.Grounds for sanctions. (a) The commissioner may impose sanctions against 
96.22 	any individual or entity that receives payments from medical assistance or provides goods 
96.23 	or services for which payment is made from medical assistance for any of the following:
96.24 	(1) fraud, theft, or abuse in connection with the provision of goods and services to 
96.25 	recipients of public assistance for which payment is made from medical assistance;
96.26 	(2) a pattern of presentment of false or duplicate claims or claims for services not 
96.27 	medically necessary;
96.28 	(3) a pattern of making false statements of material facts for the purpose of obtaining 
96.29 	greater compensation than that to which the individual or entity is legally entitled;
96.30 	(4) suspension or termination as a Medicare vendor;
97.1 	(5) refusal to grant the state agency access during regular business hours to examine all 
97.2 	records necessary to disclose the extent of services provided to program recipients and 
97.3 	appropriateness of claims for payment;
97.4 	(6) failure to repay an overpayment provided in section 256B.0641 or a fine finally 
97.5 	established under this section;
97.6 	(7) failure to correct errors in the maintenance of health service or financial records for 
97.7 	which a fine was imposed or after issuance of a warning by the commissioner; and
97.8 	(8) any reason for which an individual or entity could be excluded from participation in 
97.9 	the Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
97.10 	(b) For the purposes of this section, goods or services for which payment is made from 
97.11 	medical assistance includes but is not limited to care and services identified in section 
97.12 	256B.0625 or provided pursuant to any federally approved waiver.
97.13 	(c) Regardless of the source of payment or other item of value, the commissioner may 
97.14 	impose sanctions against any individual or entity that solicits, receives, pays, or offers to 
97.15 	pay any illegal remuneration as described in section 142E.51, subdivision 6a, in violation 
97.16 	of section 609.542, subdivision 2, or in violation of United States Code, title 42, section 
97.17 	1320a-7b(b)(1) or (2). No conviction is required before the commissioner can impose 
97.18 	sanctions under this paragraph.
97.19 	(d) The commissioner may impose sanctions against a pharmacy provider for failure to 
97.20 	respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph 
97.21 	(g).
97.22 	(e) The commissioner may impose sanctions against a pharmacy provider for failure to 
97.23 	respond to a Minnesota drug acquisition cost survey under section 256B.0625, subdivision 
97.24 	13e, paragraph (i).
97.25 	(f) For the purposes of this subdivision, "abuse" does not include billing errors that result 
97.26 	in unintended overcharges.

97.27 	Sec. 5. Minnesota Statutes 2024, section 256B.064, subdivision 1c, is amended to read:
97.28 		Subd. 1c.Grounds for and methods of monetary recovery. (a) The commissioner 
97.29 	may obtain monetary recovery from an individual or entity that has been improperly paid 
97.30 	by the department either as a result of conduct described in subdivision 1a or as a result of 
97.31 	an error by the individual or entity submitting the claim or by the department, regardless of 
97.32 	whether the error was intentional. Patterns need not be proven as a precondition to monetary 
98.1 	recovery of erroneous or false claims, duplicate claims, claims for services not medically 
98.2 	necessary, or claims based on false statements for an overpayment as defined in Code of 
98.3 	Federal Regulations, title 42, section 433.304.
98.4 	(b) The commissioner may obtain monetary recovery using methods including but not 
98.5 	limited to the following: assessing and recovering money improperly paid and debiting from 
98.6 	future payments any money improperly paid. The commissioner shall must charge interest 
98.7 	on money to be recovered if the recovery is to be made by installment payments or debits, 
98.8 	except when the monetary recovery is of an overpayment that resulted from a department 
98.9 	error. The interest charged shall must be the rate established by the commissioner of revenue 
98.10 	under section 270C.40.

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

98.12 	Sec. 6. Minnesota Statutes 2024, section 256B.064, subdivision 1d, is amended to read:
98.13 		Subd. 1d.Investigative costs. (a) The commissioner may seek recovery of investigative 
98.14 	costs from any individual or entity that willfully submits a claim for reimbursement for 
98.15 	services that the individual or entity knows, or reasonably should have known, is a false 
98.16 	representation and that results in the payment of public funds for which the individual or 
98.17 	entity is ineligible violates the False Claims Act pursuant to United States Code, title 31, 
98.18 	section 3729-3733 or section 15C.02.
98.19 	(b) Billing errors that result in unintentional overcharges shall are not be grounds for 
98.20 	investigative cost recoupment.

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

98.22 	Sec. 7. Laws 2025, First Special Session chapter 3, article 8, section 43, the effective date, 
98.23 	is amended to read:

98.24 	EFFECTIVE DATE. Paragraph (b) is effective July 1, 2026, for medical assistance 
98.25 	fee-for-service and January 1, 2027, for prepaid medical assistance upon implementation 
98.26 	of the administrator under Minnesota Statutes, section 256B.0625, subdivision 18i. The 
98.27 	commissioner of human services must notify the revisor of statutes when the administrator 
98.28 	under Minnesota Statutes, section 256B.0625, subdivision 18i, is implemented. Paragraph 
98.29 	(c) is effective on the latest of the following: (1) January 1, 2026; (2) federal approval of 
98.30 	the medical assistance program changes in this section; (3) federal approval of the 
98.31 	amendments in this act to Minnesota Statutes, section 256B.76, subdivision 6; (4) federal 
98.32 	approval of the amendments in this act to Minnesota Statutes, section 256B.761; or (5) 
99.1 	federal approval of all necessary federal waivers to implement the managed care organization 
99.2 	assessment in Minnesota Statutes, section 295.525. The commissioner of human services 
99.3 	shall notify the revisor of statutes when federal approval is obtained.

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

99.5 	ARTICLE 7
99.6 	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS

99.7	Section 1. HUMAN SERVICES APPROPRIATIONS.
 	
99.8 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
99.9 	parentheses, are subtracted from the appropriations in Laws 2025, First Special Session 
99.10 	chapter 9, article 12, to the agency and for the purposes specified in this article. The 
99.11 	appropriations are from the general fund or other named fund and are available for the fiscal 
99.12 	years indicated for each purpose. The figures "2026" and "2027" used in this article mean 
99.13 	that the addition to or subtraction from the appropriation listed under them is available for 
99.14 	the fiscal year ending June 30, 2026, or June 30, 2027, respectively. Base adjustments mean 
99.15 	the addition to or subtraction from the base level adjustment set in Laws 2025, First Special 
99.16 	Session chapter 9, article 12. Appropriations and reductions to appropriations for the fiscal 
99.17 	year ending June 30, 2026, are effective the day following final enactment unless a different 
99.18 	effective date is explicit.

99.19				APPROPRIATIONS
	
99.20				Available for the Year
	
99.21				Ending June 30
	
99.22					2026
		2027

99.23	Sec. 2. TOTAL APPROPRIATION
	$
	(822,000)
	$
	17,101,000
	
99.24 	The amounts that may be spent for each 
99.25 	purpose are specified in the following sections 
99.26 	and subdivisions.

99.27	Sec. 3. CENTRAL OFFICE; OPERATIONS
 	$
	-0-
	$
	1,371,000
	
99.28 	Base Level Adjustment. The general fund 
99.29 	base is increased by $262,000 in fiscal year 
99.30 	2028 and increased by $300,000 in fiscal year 
99.31 	2029.

99.32	Sec. 4. CENTRAL OFFICE; HEALTH CARE
 	$
	-0-
	$
	482,000
	
99.33 	Base Level Adjustment. The general fund 
99.34 	base is increased by $953,000 in fiscal year 
100.1 	2028 and increased by $918,000 in fiscal year 
100.2 	2029.

100.3
100.4	Sec. 5. CENTRAL OFFICE; AGING AND 
DISABILITY SERVICES
 	$
	-0-
	$
	12,364,000

100.5
100.6	Subdivision 1.MnCHOICES Redesign Working 
Group
 					
100.7 	$450,000 in fiscal year 2027 is for a contract 
100.8 	related to the MnCHOICES redesign working 
100.9 	group. The base for this appropriation is 
100.10 	$500,000 in fiscal year 2028, $250,000 in 
100.11 	fiscal year 2029, $0 in fiscal year 2030, and 
100.12 	$0 in fiscal year 2031.

100.13
100.14	Subd. 2.Waiver Case Management Quality 
Working Group
 					
100.15 	$350,000 in fiscal year 2027 is for a contract 
100.16 	related to the waiver case management quality 
100.17 	working group. The base for this appropriation 
100.18 	is $150,000 in fiscal year 2028 and $0 in fiscal 
100.19 	year 2029.

100.20
100.21	Subd. 3.Case Management and Home and 
Community-Based Services Rates Study
 					
100.22 	$200,000 in fiscal year 2027 is for a rates 
100.23 	study for case management and home and 
100.24 	community-based services. This is a onetime 
100.25 	appropriation and is available until June 30, 
100.26 	2028. The base for this appropriation is 
100.27 	$400,000 in fiscal year 2028, $200,000 in 
100.28 	fiscal year 2029, $0 in fiscal year 2030, and 
100.29 	$0 in fiscal year 2031.

100.30
100.31	Subd. 4.Supported-Decision-Making Programs 
Administration
 					
100.32 	$30,000 in fiscal year 2027 is for a contract 
100.33 	to administer supported-decision-making 
100.34 	grants under Laws 2023, chapter 61, article 1, 
101.1 	section 61. This is a onetime appropriation 
101.2 	and is available until June 30, 2028.

101.3	Subd. 5.Base Level Adjustment
 					
101.4 	The general fund base is increased by 
101.5 	$22,592,000 in fiscal year 2028 and increased 
101.6 	by $24,619,000 in fiscal year 2029.

101.7
101.8	Sec. 6. CENTRAL OFFICE; BEHAVIORAL 
HEALTH
 	$
	-0-
	$
	150,000

101.9101.10
	Subdivision 1.Access to Services for 
Incarcerated Individuals Evaluation
 					
101.11 	$150,000 in fiscal year 2027 is for community 
101.12 	engagement and evaluation related reentry 
101.13 	services.

101.14	Subd. 2.Base Level Adjustment
 					
101.15 	The general fund base is increased by 
101.16 	$353,000 in fiscal year 2028 and increased by 
101.17 	$336,000 in fiscal year 2029.

101.18
101.19	Sec. 7. CENTRAL OFFICE; OFFICE OF 
INSPECTOR GENERAL
 	$
	-0-
	$
	1,284,000
	
101.20 	Base Level Adjustment. The general fund 
101.21 	base is increased by $1,500,000 in fiscal year 
101.22 	2028 and increased by $1,500,000 in fiscal 
101.23 	year 2029.

101.24
101.25	Sec. 8. FORECASTED PROGRAMS; 
HOUSING SUPPORT
 	$
	-0-
	$
	10,057,000

101.26
101.27	Sec. 9. FORECASTED PROGRAMS; 
MEDICAL ASSISTANCE
 	$
	-0-
	$
	192,000

101.28
101.29	Sec. 10. FORECASTED PROGRAMS; 
BEHAVIORAL HEALTH FUND
 	$
	-0-
	$
	(19,220,000)

101.30
101.31	Sec. 11. GRANT PROGRAMS; REFUGEE 
SERVICE GRANTS
 	$
	-0-
	$
	9,861,000
	
101.32 	Human Services Response Contingency 
101.33 	Account. $9,861,000 in fiscal year 2026 is for 
101.34 	the human services response contingency 
102.1 	account established under Minnesota Statutes, 
102.2 	section 256.044. This is a onetime 
102.3 	appropriation.

102.4
102.5	Sec. 12. GRANT PROGRAMS; OTHER 
LONG-TERM CARE GRANTS
 	$
	(822,000)
	$
	55,000

102.6
102.7	Subdivision 1.Supported-Decision-Making 
Programs
 					
102.8 	$2,000,000 in fiscal year 2027 is for 
102.9 	supported-decision-making grants under Laws 
102.10 	2023, chapter 61, article 1, section 61. This is 
102.11 	a onetime appropriation and is available until 
102.12 	June 30, 2028.

102.13	Subd. 2.Base Level Adjustment
 					
102.14 	The general fund base is decreased by 
102.15 	$1,925,000 in fiscal year 2028 and $1,925,000 
102.16 	in fiscal year 2029.

102.17
102.18	Sec. 13. GRANT PROGRAMS; DISABILITY 
GRANTS
 	$
	-0-
	$
	(145,000)
	
102.19 	Base Level Adjustment. The general fund 
102.20 	base is decreased by $956,000 in fiscal year 
102.21 	2028 and decreased by $956,000 in fiscal year 
102.22 	2029.

102.23
102.24	Sec. 14. GRANT PROGRAMS; SUBSTANCE 
USE DISORDER GRANTS
 	$
	-0-
	$
	650,000

102.25
102.26	Subdivision 1.Todd County; Peer Recovery 
Support
 					
102.27 	$300,000 in fiscal year 2027 is for a grant to 
102.28 	Todd County for a contract with an 
102.29 	organization operating in Todd County to 
102.30 	provide daily peer recovery support services 
102.31 	and special sessions for individuals who are 
102.32 	in substance use recovery, are transitioning 
102.33 	out of incarceration, or have experienced 
102.34 	trauma.

103.1	Subd. 2.Thrive Family Recovery Resources
 					
103.2 	$350,000 in fiscal year 2027 is for a grant to 
103.3 	Thrive Family Recovery Resources for a pilot 
103.4 	program that provides family peer services, 
103.5 	education, resource navigation, and general 
103.6 	support for families impacted by substance 
103.7 	use disorder. By January 20, 2027, the 
103.8 	commissioner must submit a report to the 
103.9 	chairs and ranking minority members of the 
103.10 	legislative committees with jurisdiction over 
103.11 	human services that evaluates the results of 
103.12 	the pilot program and makes recommendations 
103.13 	for developing an ongoing grant program to 
103.14 	provide supportive services and education for 
103.15 	families impacted by substance use disorder. 
103.16 	This is a onetime appropriation.

103.17	Subd. 3.Base Level Adjustment
 					
103.18 	The general fund base is increased by 
103.19 	$300,000 in fiscal year 2028 and $300,000 in 
103.20 	fiscal year 2029.

103.21 	Sec. 15. Laws 2023, chapter 61, article 1, section 67, subdivision 3, as amended by Laws 
103.22 	2024, chapter 125, article 8, section 10, is amended to read:
103.23 		Subd. 3.Evaluation and report. (a) The Metropolitan Center for Independent Living 
103.24 	must contract with a third party to evaluate the pilot project's impact on health care costs, 
103.25 	retention of personal care assistants, and patients' and providers' satisfaction of care. The 
103.26 	evaluation must include the number of participants, the hours of care provided by participants, 
103.27 	and the retention of participants from semester to semester.
103.28 	(b) By January 15, 2026 2028, the Metropolitan Center for Independent Living must 
103.29 	report the findings under paragraph (a) to the chairs and ranking minority members of the 
103.30 	legislative committees with jurisdiction over human services finance and policy.

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

104.1 	Sec. 16. Laws 2023, chapter 61, article 9, section 2, subdivision 5, as amended by Laws 
104.2 	2024, chapter 125, article 8, section 12, is amended to read:

104.3
104.4	Subd. 5.Central Office; Aging and Disability 
Services
 		40,115,000
		11,995,000
	
104.5 	(a) Employment Supports Alignment Study.
104.6 	$50,000 in fiscal year 2024 and $200,000 in 
104.7 	fiscal year 2025 are to conduct an interagency 
104.8 	employment supports alignment study. The 
104.9 	base for this appropriation is $150,000 in fiscal 
104.10 	year 2026 and $100,000 in fiscal year 2027.
104.11 	(b) Case Management Training 
104.12 	Curriculum. $377,000 in fiscal year 2024 and 
104.13 	$377,000 in fiscal year 2025 are to develop 
104.14 	and implement a curriculum and training plan 
104.15 	to ensure all lead agency assessors and case 
104.16 	managers have the knowledge and skills 
104.17 	necessary to fulfill support planning and 
104.18 	coordination responsibilities for individuals 
104.19 	who use home and community-based disability 
104.20 	services and live in own-home settings. This 
104.21 	is a onetime appropriation.
104.22 	(c) Office of Ombudsperson for Long-Term 
104.23 	Care. $875,000 in fiscal year 2024 and 
104.24 	$875,000 in fiscal year 2025 are for additional 
104.25 	staff and associated direct costs in the Office 
104.26 	of Ombudsperson for Long-Term Care.
104.27 	(d) Direct Care Services Corps Pilot Project.
104.28 	$500,000 in fiscal year 2024 is from the 
104.29 	general fund for a grant to the Metropolitan 
104.30 	Center for Independent Living for the direct 
104.31 	care services corps pilot project. Up to $25,000 
104.32 	may be used by the Metropolitan Center for 
104.33 	Independent Living for administrative costs. 
104.34 	This is a onetime appropriation and is 
104.35 	available until June 30, 2026 2027.
105.1 	(e) Research on Access to Long-Term Care 
105.2 	Services and Financing. Any unexpended 
105.3 	amount of the fiscal year 2023 appropriation 
105.4 	referenced in Laws 2021, First Special Session 
105.5 	chapter 7, article 17, section 16, estimated to 
105.6 	be $300,000, is canceled. The amount canceled 
105.7 	is appropriated in fiscal year 2024 for the same 
105.8 	purpose.
105.9 	(f) Native American Elder Coordinator.
105.10 	$441,000 in fiscal year 2024 and $441,000 in 
105.11 	fiscal year 2025 are for the Native American 
105.12 	elder coordinator position under Minnesota 
105.13 	Statutes, section 256.975, subdivision 6.
105.14 	(g) Grant Administration Carryforward.
105.15 	(1) Of this amount, $8,154,000 in fiscal year 
105.16 	2024 is available until June 30, 2027.
105.17 	(2) Of this amount, $1,071,000 in fiscal year 
105.18 	2025 is available until June 30, 2027.
105.19 	(3) Of this amount, $19,000,000 in fiscal year 
105.20 	2024 is available until June 30, 2029.
105.21 	(h) Base Level Adjustment. The general fund 
105.22 	base is increased by $8,189,000 in fiscal year 
105.23 	2026 and increased by $8,093,000 in fiscal 
105.24 	year 2027.

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

105.26 	Sec. 17. Laws 2024, chapter 125, article 1, section 47, is amended to read:
105.27 	Sec. 47. DIRECTION TO COMMISSIONER; PEDIATRIC HOSPITAL-TO-HOME 
105.28 	TRANSITION PILOT PROGRAM.
 105.29 	(a) The commissioner of human services must award a single competitive grant to a 
105.30 	home care nursing provider to develop and implement, in coordination with the commissioner 
105.31 	of health, Fairview Masonic Children's Hospital, Gillette Children's Specialty Healthcare, 
105.32 	and Children's Minnesota of St. Paul and Minneapolis, a pilot program to expedite and 
106.1 	facilitate pediatric hospital-to-home discharges for patients receiving services in this state 
106.2 	under medical assistance, including under the community alternative care waiver, community 
106.3 	access for disability inclusion waiver, and developmental disabilities waiver.
106.4 	(b) Grant money awarded under this section must be used only to support the 
106.5 	administrative, training, and auxiliary services necessary to reduce:
106.6 	(1) delayed discharge days due to unavailability of home care nursing staffing to 
106.7 	accommodate complex pediatric patients;
106.8 	(2) avoidable rehospitalization days for pediatric patients;
106.9 	(3) unnecessary emergency department utilization by pediatric patients following 
106.10 	discharge;
106.11 	(4) long-term nursing needs for pediatric patients; and
106.12 	(5) the number of school days missed by pediatric patients.
106.13 	(c) Grant money must not be used to supplant payment rates for services covered under 
106.14 	Minnesota Statutes, chapter 256B.
106.15 	(d) No later than December 15, 2026 2027, the commissioner must prepare a report 
106.16 	summarizing the impact of the pilot program that includes but is not limited to: (1) the 
106.17 	number of delayed discharge days eliminated; (2) the number of rehospitalization days 
106.18 	eliminated; (3) the number of unnecessary emergency department admissions eliminated; 
106.19 	(4) the number of missed school days eliminated; and (5) an estimate of the return on 
106.20 	investment of the pilot program.
106.21 	(e) The commissioner must submit the report under paragraph (d) to the chairs and 
106.22 	ranking minority members of the legislative committees with jurisdiction over health and 
106.23 	human services finance and policy.

106.24 	Sec. 18. Laws 2024, chapter 125, article 8, section 2, subdivision 4, is amended to read:

106.25
106.26	Subd. 4.Central Office; Aging and Disability 
Services
 		(2,664,000)
		4,164,000
	
106.27 	(a) Tribal Vulnerable Adult and 
106.28 	Developmental Disabilities Targeted Case 
106.29 	Management Medical Assistance Benefit.
106.30 	$200,000 in fiscal year 2025 is for a contract 
106.31 	to develop a Tribal vulnerable adult and 
106.32 	developmental disabilities targeted case 
107.1 	management medical assistance benefit under 
107.2 	Minnesota Statutes, section 256B.0924. This 
107.3 	is a onetime appropriation. Notwithstanding 
107.4 	Minnesota Statutes, section 16A.28, 
107.5 	subdivision 3, this appropriation is available 
107.6 	until June 30, 2027.
107.7 	(b) Disability Services Person-Centered 
107.8 	Engagement and Navigation Study.
107.9 	$600,000 in fiscal year 2025 is for the 
107.10 	disability services person-centered engagement 
107.11 	and navigation study. This is a onetime 
107.12 	appropriation. Notwithstanding Minnesota 
107.13 	Statutes, section 16A.28, subdivision 3, this 
107.14 	appropriation is available until June 30, 2026.
107.15 	(c) Pediatric Hospital-to-Home Transition 
107.16 	Pilot Program Administration. $300,000 in 
107.17 	fiscal year 2025 is for a contract related to the 
107.18 	pediatric hospital-to-home transition pilot 
107.19 	program. This is a onetime appropriation. 
107.20 	Notwithstanding Minnesota Statutes, section 
107.21 	16A.28, subdivision 3, this appropriation is 
107.22 	available until June 30, 2027 2028.
107.23 	(d) Reimbursement for Community-First 
107.24 	Services and Supports Workers Report.
107.25 	$250,000 in fiscal year 2025 is for a contract 
107.26 	related to the reimbursement for 
107.27 	community-first services and supports workers 
107.28 	report. This is a onetime appropriation. 
107.29 	Notwithstanding Minnesota Statutes, section 
107.30 	16A.28, subdivision 3, this appropriation is 
107.31 	available until June 30, 2026.
107.32 	(e) Carryforward Authority.
107.33 	Notwithstanding Minnesota Statutes, section 
107.34 	16A.28, subdivision 3, $758,000 in fiscal year 
107.35 	2025 is available until June 30, 2026, and 
108.1 	$2,687,000 in fiscal year 2025 is available 
108.2 	until June 30, 2027.
108.3 	(f) Base Level Adjustment. The general fund 
108.4 	base is increased by $340,000 in fiscal year 
108.5 	2026 and increased by $340,000 in fiscal year 
108.6 	2027.

108.7 	Sec. 19. Laws 2024, chapter 125, article 8, section 2, subdivision 14, as amended by Laws 
108.8 	2025, First Special Session chapter 9, article 12, section 29, is amended to read:

108.9	Subd. 14.Grant Programs; Disabilities Grants
 		1,650,000
		9,574,000
	
108.10 	(a) Capital Improvement for Accessibility.
108.11 	$400,000 in fiscal year 2025 is for a payment 
108.12 	to Anoka County to make capital 
108.13 	improvements to existing space in the Anoka 
108.14 	County Human Services building in the city 
108.15 	of Blaine, including making bathrooms fully 
108.16 	compliant with the Americans with Disabilities 
108.17 	Act with adult changing tables and ensuring 
108.18 	barrier-free access for the purposes of 
108.19 	improving and expanding the services an 
108.20 	existing building tenant can provide to adults 
108.21 	with developmental disabilities. This is a 
108.22 	onetime appropriation.
108.23 	(b) Dakota County Disability Services 
108.24 	Workforce Shortage Pilot Project. $500,000 
108.25 	in fiscal year 2025 is for a grant to Dakota 
108.26 	County for innovative solutions to the 
108.27 	disability services workforce shortage. Up to 
108.28 	$250,000 of this amount must be used to 
108.29 	develop and test an online application for 
108.30 	matching requests for services from people 
108.31 	with disabilities to available staff, and up to 
108.32 	$250,000 of this amount must be used to 
108.33 	develop a communities-for-all program that 
108.34 	engages businesses, community organizations, 
109.1 	neighbors, and informal support systems to 
109.2 	promote community inclusion of people with 
109.3 	disabilities. By October 1, 2026, the 
109.4 	commissioner shall report the outcomes and 
109.5 	recommendations of these pilot projects to the 
109.6 	chairs and ranking minority members of the 
109.7 	legislative committees with jurisdiction over 
109.8 	human services finance and policy. This is a 
109.9 	onetime appropriation. Notwithstanding 
109.10 	Minnesota Statutes, section 16A.28, 
109.11 	subdivision 3, this appropriation is available 
109.12 	until June 30, 2027.
109.13 	(c) Pediatric Hospital-to-Home Transition 
109.14 	Pilot Program. $1,040,000 in fiscal year 2025 
109.15 	is for the pediatric hospital-to-home pilot 
109.16 	program. This is a onetime appropriation. 
109.17 	Notwithstanding Minnesota Statutes, section 
109.18 	16A.28, subdivision 3, this appropriation is 
109.19 	available until June 30, 2027 2028.
109.20 	(d) Artists With Disabilities Support.
109.21 	$690,000 in fiscal year 2025 is for a payment 
109.22 	to a nonprofit organization licensed under 
109.23 	Minnesota Statutes, chapter 245D, located on 
109.24 	Minnehaha Avenue West in Saint Paul, and 
109.25 	that supports artists with disabilities in creating 
109.26 	visual and performing art that challenges 
109.27 	society's views of persons with disabilities. 
109.28 	This is a onetime appropriation. 
109.29 	Notwithstanding Minnesota Statutes, section 
109.30 	16A.28, subdivision 3, this appropriation is 
109.31 	available until June 30, 2027.
109.32 	(e) Emergency Relief Grants for Rural 
109.33 	EIDBI Providers. $600,000 in fiscal year 
109.34 	2025 is for emergency relief grants for EIDBI 
109.35 	providers. This is a onetime appropriation. 
110.1 	Notwithstanding Minnesota Statutes, section 
110.2 	16A.28, subdivision 3, this appropriation is 
110.3 	available until June 30, 2027.
110.4 	(f) Self-Advocacy Grants for Persons with 
110.5 	Intellectual and Developmental Disabilities.
110.6 	$250,000 in fiscal year 2025 is for 
110.7 	self-advocacy grants under Minnesota Statutes, 
110.8 	section 256.477, subdivision 1, paragraph (a), 
110.9 	clauses (5) to (7), and for administrative costs. 
110.10 	This is a onetime appropriation and is 
110.11 	available until June 30, 2027.
110.12 	(g) Electronic Visit Verification 
110.13 	Implementation Grants. $864,000 in fiscal 
110.14 	year 2025 is for electronic visit verification 
110.15 	implementation grants. This is a onetime 
110.16 	appropriation. Notwithstanding Minnesota 
110.17 	Statutes, section 16A.28, subdivision 3, this 
110.18 	appropriation is available until June 30, 2027.
110.19 	(h) Aging and Disability Services for 
110.20 	Immigrant and Refugee Communities.
110.21 	$250,000 in fiscal year 2025 is for a payment 
110.22 	to SEWA-AIFW to address aging, disability, 
110.23 	and mental health needs for immigrant and 
110.24 	refugee communities. This is a onetime 
110.25 	appropriation and is available until June 30, 
110.26 	2027.
110.27 	(i) License Transition Support for Small 
110.28 	Disability Waiver Providers. $3,150,000 in 
110.29 	fiscal year 2025 is for license transition 
110.30 	payments to small disability waiver providers. 
110.31 	This is a onetime appropriation. 
110.32 	Notwithstanding Minnesota Statutes, section 
110.33 	16A.28, subdivision 3, this appropriation is 
110.34 	available until June 30, 2027.
111.1 	(j) Own home services provider 
111.2 	capacity-building grants. $1,519,000 in fiscal 
111.3 	year 2025 is for the own home services 
111.4 	provider capacity-building grant program. 
111.5 	Notwithstanding Minnesota Statutes, section 
111.6 	16A.28, subdivision 3, this appropriation is 
111.7 	available until June 30, 2027. This is a onetime 
111.8 	appropriation.
111.9 	(k) Continuation of Centers for 
111.10 	Independent Living HCBS Access Grants.
111.11 	$311,000 in fiscal year 2024 is for continued 
111.12 	funding of grants awarded under Laws 2021, 
111.13 	First Special Session chapter 7, article 17, 
111.14 	section 19, as amended by Laws 2022, chapter 
111.15 	98, article 15, section 15. This is a onetime 
111.16 	appropriation and is available until June 30, 
111.17 	2025.
111.18 	(l) Base Level Adjustment. The general fund 
111.19 	base is increased by $811,000 in fiscal year 
111.20 	2026 and increased by $811,000 in fiscal year 
111.21 	2027.

111.22 	Sec. 20. Laws 2025, First Special Session chapter 3, article 20, section 19, subdivision 1, 
111.23 	is amended to read:

111.24
111.25
111.26	Subdivision 1.Intensive Residential Treatment 
Services Community Health Unit; Hennepin 
County
 					
111.27 	$563,000 in fiscal year 2026 is for a grant to 
111.28 	the city of Brooklyn Park as start-up funding 
111.29 	for an intensive residential treatment services 
111.30 	and residential crisis stabilization services 
111.31 	facility for the city of Brooklyn Park's 
111.32 	Community Health Unit, operating out of the 
111.33 	Brooklyn Park Police Department. This is a 
111.34 	onetime appropriation and is available until 
111.35 	June 30, 2027 2028.

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

112.2 	Sec. 21. TRANSFERS AND CANCELLATIONS.
 112.3 		Subdivision 1.MnCHOICES modification grants. The fiscal year 2027 general fund 
112.4 	base appropriation for MnCHOICES modifications first established under Laws 2023, 
112.5 	chapter 61, article 9, section 2, subdivision 16, is reduced from $125,000 to $0. The general 
112.6 	fund base for this purpose is $0 in fiscal year 2028 and $0 in fiscal year 2029.
112.7 		Subd. 2.Day training and habilitation facility grants. The fiscal year 2028 and fiscal 
112.8 	year 2029 general fund base appropriations for grant allocations to counties for day training 
112.9 	and habilitation services for adults with developmental disabilities when provided as a social 
112.10 	service under Minnesota Statutes, sections 252.41 to 252.46, are reduced from $811,000 to 
112.11 	$0. The general fund base for this purpose is $0 in fiscal year 2028 and $0 in fiscal year 
112.12 	2029.
112.13 		Subd. 3.Innovation grants. The fiscal year 2027 general fund base appropriation for 
112.14 	the innovation grants program under Minnesota Statutes, section 256B.0921, is reduced 
112.15 	from $1,925,000 to $0. The general fund base for this purpose is $0 in fiscal year 2028 and 
112.16 	$0 in fiscal year 2029.
112.17 		Subd. 4.Preadmission screening grant program. The fiscal year 2027 general fund 
112.18 	base appropriation for the preadmission screening grant program under Minnesota Statutes, 
112.19 	section 256.975, subdivision 7d, paragraph (b), is reduced from $20,000 to $0. The general 
112.20 	fund base for this purpose is $0 in fiscal year 2028 and $0 in fiscal year 2029.
112.21 		Subd. 5.2023 long-term services and supports loan program. Any unencumbered 
112.22 	and unexpended amount of the long-term services and supports program under Minnesota 
112.23 	Statutes, section 256.4792, subdivision 8a, estimated to be $70,854,000, is transferred from 
112.24 	the special revenue fund to the general fund and is canceled.
112.25 		Subd. 6.2024 long-term services and supports loan program. Any unencumbered 
112.26 	and unexpended amount of the fiscal year 2026 general fund base appropriation for the 
112.27 	long-term services and supports loan program first established under Laws 2024, chapter 
112.28 	125, article 8, section 2, subdivision 12, paragraph (e), estimated to be $822,000, is canceled.
112.29 		Subd. 7.Human services response contingency account transfer. The commissioner 
112.30 	of management and budget must transfer $10,000,000 in fiscal year 2026 from the general 
112.31 	fund to the human services response contingency account established under Minnesota 
112.32 	Statutes, section 256.044. This is a onetime transfer.

113.1 	Sec. 22. APPROPRIATIONS GIVEN EFFECT ONCE.
 113.2 	If an appropriation or transfer in this article is enacted more than once during the 2026 
113.3 	regular session, the appropriation or transfer must be given effect once.

113.4 	Sec. 23. EXPIRATION OF UNCODIFIED LANGUAGE.
 113.5 	All uncodified language contained in this article expires on June 30, 2027, unless a 
113.6 	different expiration date is explicit.

113.7 	ARTICLE 8
113.8 	OTHER AGENCY APPROPRIATIONS

113.9	Section 1. OTHER AGENCY APPROPRIATIONS.
 	
113.10 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
113.11 	parentheses, are subtracted from the appropriations in Laws 2025, First Special Session 
113.12 	chapter 9, article 14, to the agencies and for the purposes specified in this article. The 
113.13 	appropriations are from the general fund or other named fund and are available for the fiscal 
113.14 	years indicated for each purpose. The figures "2026" and "2027" used in this article mean 
113.15 	that the addition or subtraction from the appropriation listed under them is available for the 
113.16 	fiscal year ending June 30, 2026, or June 30, 2027, respectively. Base adjustments mean 
113.17 	the addition to or subtraction from the base level adjustment set in Laws 2025, First Special 
113.18 	Session chapter 9, article 14. Supplemental appropriations and reductions to appropriations 
113.19 	for the fiscal year ending June 30, 2026, are effective the day following final enactment 
113.20 	unless a different effective date is explicit.

113.21				APPROPRIATIONS
	
113.22				Available for the Year
	
113.23				Ending June 30
	
113.24					2026
		2027

113.25
113.26	Sec. 2. COMMISSIONER OF HEALTH; 
TOTAL APPROPRIATION
 	$
	-0-
	$
	3,702,000
	
113.27 	The amounts that may be spent for each 
113.28 	purpose are specified in the following sections.

113.29	Sec. 3. HEALTH PROTECTION
 	$
	-0-
	$
	3,702,000

113.30
113.31	Subdivision 1.Small Assisted Living Facility 
Licensure
 					
113.32 	$150,000 in fiscal year 2027 is appropriated 
113.33 	from the general fund to the commissioner of 
113.34 	health to develop small assisted living facility 
114.1 	licensure draft legislation. This is a onetime 
114.2 	appropriation and is available until June 30, 
114.3 	2028.

114.4	Subd. 2.Base Level Adjustment
 					
114.5 	The general fund base is increased by 
114.6 	$3,442,000 in fiscal year 2028 and increased 
114.7 	by $3,442,000 in fiscal year 2029.

114.8 	Sec. 4. ATTORNEY GENERAL; OVERSIGHT AND ENFORCEMENT OF 
114.9 	MINNESOTA STATUTES, SECTIONS 145D.41 TO 145D.43.
 114.10 	$112,000 in fiscal year 2027 is appropriated from the general fund to the attorney general 
114.11 	for oversight and enforcement of Minnesota Statutes, sections 145D.41 to 145D.43.

114.12 	Sec. 5. Laws 2024, chapter 125, article 8, section 2, subdivision 20, is amended to read:

114.13
114.14	Subd. 20.Direct Care and Treatment - 
Operations
 		-0-
		6,094,000
	
114.15 	(a) Free Communication Services for 
114.16 	Patients and Clients. $1,368,000 in fiscal 
114.17 	year 2025 is for free communication services 
114.18 	under article 6, section 1. This is a onetime 
114.19 	appropriation. Notwithstanding Minnesota 
114.20 	Statutes, section 16A.28, subdivision 3, this 
114.21 	appropriation is available until June 30, 2026.
114.22 	(b) Direct Care and Treatment Capacity; 
114.23 	Miller Building. $1,796,000 in fiscal year 
114.24 	2025 is to design a replacement facility for the 
114.25 	Miller Building on the Anoka Metro Regional 
114.26 	Treatment Center campus. This is a onetime 
114.27 	appropriation. Notwithstanding Minnesota 
114.28 	Statutes, section 16A.28, subdivision 3, this 
114.29 	appropriation is available until June 30, 2027.
114.30 	(c) Direct Care and Treatment County 
114.31 	Correctional Facility Support Pilot 
114.32 	Program. $2,387,000 in fiscal year 2025 is 
114.33 	to establish a two-year county correctional 
115.1 	facility support pilot program. The pilot 
115.2 	program must: (1) provide education and 
115.3 	support to counties and county correctional 
115.4 	facilities on protocols and best practices for 
115.5 	the provision of involuntary medications for 
115.6 	mental health treatment; (2) provide technical 
115.7 	assistance to expand access to injectable 
115.8 	psychotropic medications in county 
115.9 	correctional facilities; and (3) survey county 
115.10 	correctional facilities and their contracted 
115.11 	medical providers on their capacity to provide 
115.12 	injectable psychotropic medications, including 
115.13 	involuntary administration of medications, 
115.14 	and barriers to providing these services. This 
115.15 	is a onetime appropriation. Notwithstanding 
115.16 	Minnesota Statutes, section 16A.28, 
115.17 	subdivision 3, this appropriation is available 
115.18 	until June 30, 2026 2027.
115.19 	(d) Advisory Committee for Direct Care 
115.20 	and Treatment. $482,000 in fiscal year 2025 
115.21 	is for the administration of the advisory 
115.22 	committee for the operation of Direct Care 
115.23 	and Treatment. This is a onetime 
115.24 	appropriation. Notwithstanding Minnesota 
115.25 	Statutes, section 16A.28, subdivision 3, this 
115.26 	appropriation is available until June 30, 2027.
115.27 	(e) Base Level Adjustment. The general fund 
115.28 	base is increased by $31,000 in fiscal year 
115.29 	2026 and increased by $0 in fiscal year 2027.

116.1 	Sec. 6. Laws 2025, First Special Session chapter 3, article 21, section 3, subdivision 2, is 
116.2 	amended to read:

116.3
116.4	Subd. 2.Substance Use Treatment, Recovery, 
and Prevention Grants
 					
116.5 	$3,000,000 in fiscal year 2026 and $3,000,000 
116.6 	in fiscal year 2027 are from the general fund 
116.7 	for substance use treatment, recovery, and 
116.8 	prevention grants under Minnesota Statutes, 
116.9 	section 342.72. The commissioner may use 
116.10 	up to $300,000 of this appropriation for 
116.11 	administration.

116.12 	Sec. 7. APPROPRIATIONS GIVEN EFFECT ONCE.
 116.13 	If an appropriation or transfer in this article is enacted more than once during the 2026 
116.14 	regular session, the appropriation or transfer must be given effect once.

116.15 	Sec. 8. EXPIRATION OF UNCODIFIED LANGUAGE.
 116.16 	All uncodified language contained in this article expires on June 30, 2027, unless a 
116.17 	different expiration date is explicit.

	ARTICLE 1	CONTINUITY OF CARE........	Page.Ln 2.5	
	ARTICLE 2	AGING AND DISABILITY SERVICES........	Page.Ln 8.5	
	ARTICLE 3	BEHAVIORAL HEALTH........	Page.Ln 46.21	
	ARTICLE 4	LONG-TERM CARE FACILITY REGULATION........	Page.Ln 60.9	
	ARTICLE 5	DIRECT CARE AND TREATMENT........	Page.Ln 88.3	
	ARTICLE 6	MISCELLANEOUS........	Page.Ln 89.26	
	ARTICLE 7	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS........	Page.Ln 99.5	
	ARTICLE 8	OTHER AGENCY APPROPRIATIONS........	Page.Ln 113.7	

APPENDIX 

Repealed Minnesota Statutes: S4476-3 

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.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.4907 ADVISORY TASK FORCE ON WAIVER REIMAGINE.Subdivision 1.Membership; co-chairs. 
(a) The Advisory Task Force on Waiver Reimagine consists of the following members: 

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

(2) one member of the house of representatives, appointed by the leader of the house of representatives Democratic-Farmer-Labor caucus; 

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

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

(5) four individuals currently receiving disability waiver services who are under the age of 65, appointed by the governor; 

(6) one county employee who conducts long-term care consultation services assessments for persons under the age of 65, appointed by the Minnesota Association of County Social Services Administrators; 

(7) one representative of the Department of Human Services with knowledge of the requirements for a provider to participate in disability waiver service programs and of the administration of benefits, appointed by the commissioner of human services; 

(8) one employee of the Minnesota Council on Disability, appointed by the Minnesota Council on Disability; 

(9) two representatives of disability advocacy organizations, appointed by the governor; 

(10) two family members of individuals who are receiving disability waiver services, appointed by the governor; 

(11) two providers of disability waiver services for persons who are under the age of 65, appointed by the governor; 

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

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

(14) the assistant commissioner of the Department of Human Services administration that oversees disability services; and 

(15) a member of the Minnesota Disability Law Center, appointed by the executive director of Mid-Minnesota Legal Aid. 

(b) Each appointing authority must make appointments by September 30, 2025. Appointments made by an agency or commissioner may also be made by a designee. 

(c) In making task force appointments, the governor must ensure representation from greater Minnesota. 

(d) The Office of Collaboration and Dispute Resolution must convene the task force. 

(e) The task force members must elect co-chairs from the membership of the task force at the first task force meeting. 

Subd. 2.Meetings; administrative support. 
(a) The first meeting of the task force must be convened no later than November 30, 2025. The task force must meet at least quarterly. Meetings are subject to chapter 13D. The task force may meet by telephone or interactive technology consistent with section 13D.015. 

(b) The Department of Human Services shall provide meeting space and administrative and research support to the task force. 

Subd. 3.Duties. 
(a) The task force must make findings and recommendations related to waiver reimagine in Minnesota, including but not limited to the following: 

(1) consolidation of the existing four disability home and community-based waiver service programs into two waiver programs; 

(2) budgets based on the needs of the individual that are not tied to location of services, including resources beyond those required to meet assessed needs that may be necessary for the individual to live in the least restrictive environment; 

(3) criteria and processes for provider rate exceptions and individualized budget exceptions; 

(4) appropriate assessments, including the MnCHOICES 2.0 assessment tool, in determining service needs and individualized budgets; 

(5) covered services under each disability waiver program, including any proposed adjustments to the menu of services; 

(6) service planning and authorization processes for disability waiver services; 

(7) a plan of support, financial and otherwise, to live in the person's own home and in the most integrated setting as defined under Title 2 of the Americans with Disabilities Act Integration Mandate and in Minnesota's Olmstead Plan; 

(8) intended and unintended outcomes of waiver reimagine; and 

(9) other items related to waiver reimagine as necessary. 

(b) The task force must seek input from the public, counties, persons receiving disability waiver services, families of persons receiving disability waiver services, providers, state agencies, and advocacy groups. 

(c) The task force must hold public meetings to gather information to fulfill the purpose of the task force. The meetings must be accessible by remote participants. 

(d) The Department of Human Services shall provide relevant data and research to the task force to facilitate the task force's work. 

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

Subd. 5.Report. 
(a) The task force shall submit a report to the chairs and ranking minority members of the legislative committees with jurisdiction over disability waiver services no later than January 15, 2027, that describes any concerns or recommendations related to waiver reimagine as identified by the task force. 

(b) The report required under Laws 2021, First Special Session chapter 7, article 13, section 75, subdivision 4, as amended by Laws 2024, chapter 108, article 1, section 28, must be presented to the task force prior to December 15, 2026. 

Subd. 6.Task force does not expire. 
Notwithstanding section 15.059, subdivision 6, the task force under this section does not expire. 

256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE RATE ADJUSTMENTS.Subd. 7.Expiration. 
This section expires May 31, 2028. 

Repealed Minnesota Session Laws: S4476-3 

Laws 2019, First Special Session chapter 9, article 5, section 86, as amended by Laws 2020, First Special Session chapter 2, article 3, section 2
Sec. 2. Laws 2019, First Special Session chapter 9, article 5, section 86, is amended to read:Sec. 86. DISABILITY WAIVER RECONFIGURATION. Subdivision 1.Intent. 
It is the intent of the legislature to reform the medical assistance waiver programs for people with disabilities to simplify administration of the programs. Disability waiver reconfiguration must incentivize inclusive, person-centered, individualized supports and services; enhance each person's self-determination and personal authority over the person's service choice; align benefits across waivers; ensure equity across programs and populations; promote long-term sustainability of waiver services; and maintain service stability and continuity of care while prioritizing, promoting, and creating incentives for independent, integrated, and individualized supports and services chosen by each person through an informed decision-making process and person-centered planning. 

Subd. 2.Report. 
By January 15, 2021, the commissioner of human services shall submit a report to the members of the legislative committees with jurisdiction over human services on any necessary waivers, state plan amendments, requests for new funding or realignment of existing funds, any changes to state statute or rule, and any other federal authority necessary to implement this section. The report must include information about the commissioner's work to collect feedback and input from providers, persons accessing home and community-based services waivers and their families, and client advocacy organizations. 

Subd. 3.Proposal. 
By January 15, 2021, the commissioner shall develop a proposal to reconfigure the medical assistance waivers provided in sections 256B.092 and 256B.49. The proposal shall include all necessary plans for implementing two home and community-based services waiver programs, as authorized under section 1915(c) of the Social Security Act that serve persons who are determined to require the levels of care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care facility for persons with developmental disabilities. The proposal must include in each home and community-based waiver program options to self-direct services. Before submitting the final report to the legislature, the commissioner shall publish a draft report with sufficient time for interested persons to offer additional feedback. 

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

Laws 2021, First Special Session chapter 7, article 13, section 73, as amended by Laws 2025, First Special Session chapter 9, article 2, section 56
Sec. 56. Laws 2021, First Special Session chapter 7, article 13, section 73, is amended to read:Sec. 73. WAIVER REIMAGINE PHASE II. 
(a) Effective January 1, 2027, or upon federal approval, whichever is later, the commissioner of human services must implement a two-home and community-based services waiver program structure, as authorized under section 1915(c) of the federal Social Security Act, that serves persons who are determined by a certified assessor to require the levels of care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care facility for persons with developmental disabilities. 

(b) The commissioner of human services must implement an individualized budget methodology, as authorized under section 1915(c) of the federal Social Security Act, that serves persons who are determined by a certified assessor to require the levels of care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care facility for persons with developmental disabilities. 

(c) The commissioner must develop an individualized budget methodology exception to support access to self-directed home care nursing services. Lead agencies must submit budget exception requests to the commissioner in a manner identified by the commissioner. Eligibility for the budget exception in this paragraph is limited to persons meeting all of the following criteria in the person's most recent assessment: 

(1) the person is assessed to need the level of care delivered in a hospital setting as evidenced by the submission of the Department of Human Services form 7096, primary medical provider's documentation of medical monitoring and treatment needs; 

(2) the person is assessed to receive a support range budget of E or H; and 

(3) the person does not receive community residential services, family residential services, integrated community supports services, or customized living services. 

(d) Home care nursing services funded through the budget exception developed under paragraph (c) must be ordered by a physician, physician assistant, or advanced practice registered nurse. If the participant chooses home care nursing, the home care nursing services must be performed by a registered nurse or licensed practical nurse practicing within the registered nurse's or licensed practical nurse's scope of practice as defined under Minnesota Statutes, sections 148.171 to 148.285. If after a person's annual reassessment under Minnesota Statutes, section 256B.0911, any requirements of this paragraph or paragraph (c) are no longer met, the commissioner must terminate the budget exception.  

(e) The commissioner of human services may seek all federal authority necessary to implement this section. 

(f) The commissioner must ensure that the new waiver service menu and individual budgets allow people to live in their own home, family home, or any home and community-based setting of their choice. The commissioner must ensure, within available resources and subject to state and federal regulations and law, that waiver reimagine does not result in unintended service disruptions. 

(g) No later than July 1, 2026, the commissioner must: 

(1) develop and implement an online support planning and tracking tool to provide information in an accessible format to support informed choice for people using disability waiver services that allows access to the total budget available to a person, the services for which they are eligible, and the services they have chosen and used; 

(2) explore operability options that facilitate real-time tracking of a person's remaining available budget throughout the service year; and 

(3) seek input from people with disabilities about the online support planning and tracking tool prior to the tool's implementation. 

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

Laws 2021, First Special Session chapter 7, article 13, section 75, subdivision 1, as amended by Laws 2024, chapter 108, article 1, section 28; 
Sec. 75. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; WAIVER REIMAGINE AND INFORMED CHOICE STAKEHOLDER CONSULTATION. Subdivision 1.Stakeholder consultation; generally. 
(a) The commissioner of human services must consult with and seek input and assistance from stakeholders concerning potential adjustments to the streamlined service menu from waiver reimagine phase I and to the existing rate exemption criteria and process. 

(b) The commissioner of human services must consult with and, seek input and assistance from, and collaborate with stakeholders concerning the development and implementation of waiver reimagine phase II, including criteria and a process for individualized budget exemptions, and how waiver reimagine phase II can support and expand informed choice and informed decision making, including integrated employment, independent living, and self-direction, consistent with Minnesota Statutes, section 256B.4905.  

(c) The commissioner of human services must consult with, seek input and assistance from, and collaborate with stakeholders concerning the implementation and revisions of the MnCHOICES 2.0 assessment tool.